Sep 30, 2008

Geeze where do I begin?

I went from having really nothing to say but "camped at Taylor Hall; made doe-eyes at boyfriend; tried to find source of study for pathophys; periodically mimed the First Aid book eating my head. Highlighted every line of pulmonary physiology in the BRS Physio since it all seemed important. Thought I was doing well at studying pharm but totally wasn't. Watched Red Dwarf. Slept." to having a ton going on where I don't know where to start. As frequently seems to occur.

Midterms! Aiiiiieeeeeeeeeeee.... oh, was that ever an exercise in humility. Weirdly, the exam I had the most problem with at a philosophical level is the one I'm pretty sure I did the best on with all the added hoopla (not that it justifies anything), while I'm thinking I didn't do half as well in Clinical Skills as I thought (damn you, Hashimoto's thyroiditis!), and I have no idea what I got in pharm, but I'm kind of hoping it's in the double digits. Gods.

Taking the pharm exam made me realize two things:
1: I'm VERY bad at drugs. I knew this from biochem when I was going through my flashcards while my dad was visiting, and he was reading me off the answer for the mechanism of neomycin without looking at the card because I'd missed it so many times.
2: When I learn drugs, it's kind of like I have this new deck of playing cards in my head where each suite represents a drug class and I know what order they're in. Taking a pharm exam is kind of like taking that deck of cards and playing 52 card pickup. And I just look at the fluttering mess on the floor and go "Uh oh." So... new study approach for me, I think.

In the wake of midterms, I pretty much spent the rest of Friday in full on bender-mode, starting with George's party, featuring great company, great rum punch, great food, great pinata. Then the Beauty and the Geek party which had some really innovative costumes by my colleagues. Then Banana's, largely to steal Dem's french fries.

Then spent the rest of the weekend recovering from Friday by lounging on various beaches and making a two and a half week overdue trip to Spiceland Mall to buy food, since my on campus studies have caused me to subsist off food from Pearl's, which means I've hit my upper limit for intestinal parasites.

Saturday, La Sagesse was characteristically gorgeous and the weather went from looking like it was going to rain us out to being really nice. We had a wonderful lunch at the restaurant there, went for a long swim, and got eaten by ants on the beach. Oh, though word of advice since this applied to all of us, myself included... don't go out for a long night of drinking and reveling, get four to five hours of sleep and then jump into a cab for a lengthy ride along fast tight curves. Glurgh.

Sunday, initially dive planned, but still recovering, so lounged at Grand Anse. The beach was nice, but apparently the storm that missed us hit it, and the water was kind of eerie. There was a dead eel washed up on the beach which some brave girl, as everyone watched her in awe, picked it up by its rotting dead tail and hauled it over to the garbage can so people wouldn't have to deal with it. REALLY nice of her.

The seascape though, save for a couple flying gernards (woo hoo!) seemed oddly dead. The coral was pretty brown, and then Lori and I swam through a patch where there were bubbles on the surface and we couldn't see anything, but then started feeling itchy and then actively stingy and we were like "okay, time to go", so I have no idea what that was about and it's never happened before. I'm wondering if we swam through the remains of a boat propeller-hit jellyfish. I had some spots when we got out, but quickly faded, and drying off to a diminishing sun made it all worthwhile. As did not having to study.

Last night was Dark Knight night, since Lori and I seem to be the last people on earth who haven't seen it, so we made a night of it with Dave. Awww, RIP Heath Ledger. Much as I love Batman, I've always thought most of its villains weren't half as scary as Batman himself, but that is the kind of Joker that makes you want to sleep with the lights on. Sorry Jack Nicholson; you'll always have the Shining.

In the meantime, the surge of response to the whole pathophys thing has been awesome and you guys are absolutely fantastic!! It looks like we may get some changes too: Our note packet was printed and there for lecture (Yes, I went; stop the presses, though three buses passing me made it a thirty minutes late for first lecture thing), they seem to be shifting the setup of the Friday classes AND have already posted the objectives, they're having a meeting, and stuff's happening. Wahoo!

We just started the hematology unit which so far seems to be recycling path. Hematology is one of the nastiest parts of path due to having to be able to read a CBC in 75 seconds and pull a diagnosis out of it, but so far it's review, which is good, because eventually if I study myeloid derivations enough, it may stick in my head like the frigging female menstrual cycle finally did. You'd think, that being female, it would not take me FIVE SEPARATE medical school classes to learn when the progesterone rises, but I'm slow like that. Some stuff goes in once and stays there until I'm dead and other stuff that other people have gotten a year ago, when they're reviewing it in class, I'm going "dammit. Still don't know it." And I go back to my original source or the internet (Wiggers Diagram, I'm looking in your direction) and I redraw it, and I read all the parts of it out loud, and I see if I can redraw it from memory, and state all the parts, and feel secure, and know it on the exam, and promptly forget it entirely until it comes up again.

To backtrack a bit, I had my anesthesia rotation this morning, which I thought would be really boring (ewww, pulmonary phys), but was really interesting, particularly when first the Bovie died, and then the entire power shut off three times until the OR was running on the backup generator. The doctors were great, let us close in on a hernia operation, and showed us everything. They're also a very calm lot, moving effectively and deliberately, but not panicky as the anesthesia cart is screaming over its sudden power cut, the lights have gone out (hooray for windows), and the patient is open. Noooo problem. Continue putting hernia back in, no reason for alarm, sewn up, with awesome response to being put under.

They let us in pretty close without screwing up the sterile field, and were very willing and ready to answer our questions. So far all the docs have been like that, so I've been impressed, as I've mentioned, with the rotations, and find them to be a really cool experience that's giving us not only a taste of a lot of different areas of medicine, but also of the whole "medical experience in another country". Some stuff is utterly the same, while other stuff is mystifyingly different.

Got home from the selective to wash up since I knew I had a nice dinner after lecture, but found I had no water. I haven't found that this happens to me all that frequently, but when it does, it tends to hit at inconvenient times. Same with internet access. I'll have NO problems with internet access for weeks when I'm screwing around watching youtube videos while trying not to study, but the second I try to download some small group assignment that's due the next day? Total connection meltdown.

In other news, FANTASTIC dinner with Dave tonight where he was, per usual, being a perfect gentleman, and is gradually breaking me into Merlot, which is usually up with Cab on the "List of the only two wines I have trouble choking down", but I've been really enjoying it lately. What can I say; I'm a wino!

Sep 27, 2008

Oh, and while I'm thinking about it...

To the "Geek" at the Beauty and the Geek party last night that had the turning point remote (aka, the evil clicker) in your breast pocket behind all the pens:

Pure. Comic. Gold.

I said what now?

Clarification: Yes, I definitely am not happy with the pathophys department, and think there needs to be actions to change the current course of things, which is pretty much the collective class opinion. Yes, I posted a letter expressing my feelings on the matter because I figured that was the right way to go.

No, I'm not staging any sort of walk-out. Given that I would probably skip a lecture entitled "Ishie, there is a deadly parasite in your drinking water and the only way you'll be able to survive it is...", walking out of a class I rarely attend in the first place seems like it doesn't make much of a statement, nor do I think it would help given the peculiarities of this particular department.

However; I would encourage others of those that also would like a more proactive (and less 'blaming the students for a 64% average, as if that's our fault and the points added back were some sort of favor because the dept's going to cut us some slack just this once') change to respectfully voice their concerns. It's been awesome seeing the responses on SGUPost, and the support we have together in this matter. I don't know if it'll help, but I think it's the best option.

Sep 26, 2008


"Some Drugs Create Awesome Knockers" for the drugs that can cause gynecomastia (think Bob from Fight Club) may be the best mnemonic to ever exist, and that includes all the really dirty ones from anatomy.

In other news, I thought that "qiss and qiq 'til you're siq of sqs" (kiss and kick 'til you're sick of sex) was an incredibly stupid one until I reviewed the intro pharm lectures and discovered that I needed it to keep my head from exploding, and I certainly can't think of a better one in the time allotted.

I think I'm losing it. My head is full of "SAFE Moms Take Really Good Care" and "buy AT 30; CELL at 50" until all the information (which there still isn't enough of) is threatening to fall out.

I've spent the last unfathomable length of time holed up in Taylor Hall studying with my hair progressively messier and my t-shirts progressively dorkier (today's even has a math pun) and despite feeling like I know absolutely nothing about pharmacology, there are times in med school, and this is one of them, where you cram so much for an exam that you feel like if you bump your head against something, there's just going to be a flood of notebook pages coming out of your skull.

But if med school has taught me nothing else (which is possible), it's that there are two types of people:
1: Those that feel intense stress during exams, and in an unconscious attempt to escape- jerk, twitch, and bounce their legs uncontrollably. This is the "flight" response.
2: Those that feel intense stress during exams, and in an unconscious attempt to confront their antagonist (the test), want to jam a pencil into the necks of the people in Group 1. This is the "fight" response.

Sep 25, 2008

We're dead...

dead da dead dead dead

Pharm exam tomorrow and everyone's pretty much expressing the same sentiment: too much material; too little time; nothing is sticking.

Can't say the department is lacking in effort though; but this leading-up week has been so hellish with the pathophys exam that we all find ourselves painfully behind in a difficult and new topic. Oh, and there was that CS exam on Wednesday, which seemed primarily as a distraction from people trying desperately to study for pharm.

So pretty much, I'm living for the weekend. Par-tay.

Sep 19, 2008

Helpful hints for life

If you see a child born with ambiguous genitalia, just tell the parents to give it an androgynous name and don't tell anyone until the karyotype comes back.

I arrived at Taylor Hall this morning at 10:30. I just got home. Break for lunch; "break" for tutorial EKG lecture. Finally understand pulmonary physiology and it only took a year longer than it was supposed to. Brain full of lungs and ovaries. Send help.

Sep 16, 2008

What now?

A bus strike... The fourth termers are in their current exam week and ours are next week, for reference. Hooray for living in walking distance from campus. Sucks to be anybody else.

This warrants a 1980s stereotype slow-clap! Who wants to join me?

More tests

Up and coming.

It's been hard coming up with new stuff to say. My term seems to be in a loose consensus over the problems: pharm's too hard; pathophys is a crapshoot of no-direction, and there hasn't been real elaboration on that, leaving me in a perpetual state of "Hmmm".

This steady state sort of situation, even as the countdown heads towards the first set of exams for us, is creating a sort of passive discontent among myself and my fellows. The advent of cardio in pathophys at first brought a loud angry voice, then one that continued but waning into a grim but more passive acceptance that it's not going to change. When you see your classmates, you go "How's it going?" and they say "Dude, I just can't get a handle on this stuff" or "I'm drowning" or some variety, and you shake your head with a resigned laugh and assert agreement. And repeat. And when other-termers ask how 5th term is, you say "It sucks" and again with the head shake/laugh.

Exams coming up are unpredictable. Part of me is plugging away, camped out in Taylor Hall (which is very nice), but calm about it, used to exam stress by now despite my whole first term meltdown. But another part of me is making my eyes twitch, including making my pupils do this weird contract/dilate thing that I can't explain, so there seems to be some sort of whole sympathetic firing going on even if I'm not feeling it as acutely.

I re-discovered that my apartment is the procrastination central for procrastination studies (if no other kind of studies), so following Dave's example, I've been bussing it to campus, studying until late, bussing back. I think I need to re-incorporate some walks though, since I think my new and complete lack of exercise is getting into my head. And probably my waistline. But it's also cool because I get pretty decent company while having to study away. And good luck to the fourth termers with their exams this week!

So what else besides the usual. Oh, on loan check status, one of them finally arrived (not sure if it's the missing 5th term one or the 6th term one on time), so I've gotten partial access to my funds (thanks dad!) with full access coming on Friday. For reference, I got here August 17th. You guys can do the math.

On a more positive note, since I'm not half as depressed as the above sounds... actually in a decent mood.

Did my ER visit Monday morning, and that was pretty cool, and we saw the quick through patients. Our facilitator today was a no-nonsense doc of the old school variety. No BS. Don't try to run through your clinical skills checklist on a woman who's very obviously in pretty severe pain. Don't try to interview the asthma kid until AFTER he's been on the nebulizer. Now I'll show you the way you're actually supposed to do a bulge test, since you all are touching that woman's knee like it's about to detonate. Come here. As you all are upcoming doctors, I will plead with you now to try to write legibly. Find the fracture on this x-ray. Next patient. That's what we call 'ER Drama' It goes away when their significant other does.

Nice and informative. Nothing really crazy, though I did again demonstrate my ineptitude for doing ear exams, which is second only to my inability to do an eye exam, the latter of which consists of seeing a vaguely vascular-looking pink haze through the opthalmoscope while trying to find the optic disc until the patient's pupil is the size of a pinprick due to having me shine a light in their eye for ten minutes, and then I make a noncommittal affirmative noise that gives the false impression that I know what I'm looking at or have gleaned something meaningful from it. Practice practice. I'm getting better at interpreting what I'm hearing through a stethoscope though.

Well, gotta get up tomorrow and study some more. Night all.

Sep 10, 2008


REALLY getting tired of it.

Dear Pathophysiology department: Either get out your handouts on time, with some structure, and in order, or at the very least, stop sending us threatening course announcements because enough there aren't enough students participating in the latest experimental learning style of the week that our class keeps getting subjected to. If you're wondering why students aren't using it enough, it's probably due to them being very busy attempting to sort out the 2500 cardiovascular slides (think I'm exaggerating?) that you have yet refused to issue in order or prior to the lectures. It seems to many of us fairly hypocritical that we are being chided for failing to meet the expectations of us when you are unwilling or unable to meet your own. Also, please cease telling us not to print handouts from the library if you have no intention of providing them. It wasn't our idea to put white text on dark backgrounds for 2500 slides, so if you want the insanity to stop and the library staff to stop getting angry, you know what to do.

Dear library: Sorry guys.

Dear Pulmonary guy: Thank you for being a good instructor and for sensing our frustration at not having the handouts for your class, and I'll go ahead and apologize for you having to teach through that, particularly with our class's pretty solid irritation at the disorganization this term. I'll extend the apology myself, since if the department treats professors like it treats the students, they're certainly not going to.

Dear other hapless victims who are on the faculty but don't have control over this sort of thing and the persistent scheduling problems that trailed after us from last term: we know it's not your fault, and we feel your pain.

Dear Pharmacology department: your class is hellishly difficult and due to my own biases, I like the subject material way less than I would hypothetically like pathophysiology if it were consistently being taught to us. Despite these prejudices, your department seems well run, organized, relevant, and empathetic. Kudos.

Dear finances: I don't know whose fault it is this time, but I would REALLY like my loan check. Considering I had to apply for it twice (as did over half the people on loans) since the company initially recommended to us for our loans went bankrupt, which cost me another hard credit pull, and considering I had to fax in the paperwork twice despite not being told there was an additional problem with the MPN until the first day of class which nearly cost me the ability to register, I think I've earned it. Some friends of mine, who received their third term loan checks after fourth term started, do appreciate receiving theirs though. Really helped them with the overdue rent.


An *Extremely* Frustrated Student

Sep 4, 2008

A good professor...

Unfortunately, one from a year ago.

Ahhh... pathophys... does anyone have the remotest idea how to study for this class? Alas, I fear not.

The physiology department magnanimously decided to allow some of our old notes to be put back up on Angel so we can make some sense out of what we're doing now, and by "magnanimously", I am not being sarcastic. This also served to remind me that I STILL HAVE MY PHYSIO NOTES, which is absolutely awesome, because with the glaring exception of pulmonary physio, the notes for that class were really good. Hard as hell and full of equations, but well spelled out, particularly the cardio notes, which is the only reason I was able to get through something that physics-ricious the first time.

This whole physio path pathophysio thing is a conundrum for me. You see, I hated physio. Really really really did not like it at all. This was my feeling despite the fact that the class (again, except pulmonary) was well taught, the notes were organized, the labs relevant, and the material extremely important. Just didn't resonate, and it confused me.

Contrast to path. I really like pathology. I really didn't like the way the general philosophy and structure of the class, so I abandoned it (sans labs, which were good), which kept me from chewing off my own face last term.

So now we have pathophys, which is combining being new and completely disorganized without much in the way of clear objectives, with physio, which I never fully "got" and didn't like, but without the instructors that say "I'm going to assume you guys think the heart is something in a valentine and go from there". Because that is still where I like to start out. I still literally have to draw out the heart any time I'm trying to figure something out with it so I can follow the blood flow around like I'm figuring the maze on the side of a Happy Meal box.

BUT, now I have my physio notes, which I had forgotten at some level that I had, and now that I'm going back over the stuff that mystified me in second term due to its math/graph heaviness, *I'm actually understanding it* now that I've gotten older, wiser, and have gotten used to having to teach myself material. And as I'm going through it, I'm remembering just how much I loved Dr. Parry because a lot of her little expressions and analogies are suddenly firing back up in my memory from when I was watching her on Sonic Foundry back in the day (some things never change). And since path wasn't as difficult for me (no math), I'm now able to apply disease pathologies on top of the physio stuff I hadn't fully understood before.

Which I think is the point, though damned if I'm going to know that until after the first exam. Or until after I fail the boards; one or the other. Unfortunately, it's taken a month for me to even be able to sort out where to BEGIN to approach, so I'm hoping it's not past the point of no return. And having pharm (aka micro on crack) is not helping at all, though mnemonics are helping me sort some stuff out.

So how to celebrate this drowning feeling? I'm thinking Saturday hash, I truly am...