Still not really sinking in

Pharm exam tomorrow. That's my last exam of basic sciences.

Then I go home to the USA, study for the biggest exam ever dreamed up in the nightmares of mankind, and then, go to Brooklyn to be a 'real' med student, in that I get to touch patients... like litigious US patients. Grenadian patients have been oddly unconcerned with the whole thing, and at most, seem amused by us. "Sure, go ahead, crowd of 8 frightened inexperienced students. Auscultate my scrotum even though you really obviously don't know what you're doing, and since there's a loop of bowel IN my scrotum, it's probably going to be uncomfortable. Not like I'm doing anything else."

But I digress...

Last exam of basic sciences. Then US. No more Grenada. No more Bananas. No more Grand Anse. No more "Hey beautiful!! Wanna take a ride?" No more sunset point. No more Carib. No more wandering onto campus and knowing half the people around with the view of the sea on both sides. No more "Hello Dear!!" from Mrs. Patel. No more gut-crushing guilt by cheating on Mrs. Patel by buying Indian food from the couple across the bus stop from her because they have meat dishes. No more any of that.

It's very very odd. People's reactions are weird. I keep getting congratulated for stuff... on 'getting out', on 'making it through', on 'going home', on getting Brooklyn. On taking the second to last exam, on finishing pathophys... and I keep feeling like "any second now, this is going to sink in".

But it isn't. I sold my crock pot and my blender. I can't go to Angel Falls right now because they can get me TO Venezuela, but not back, and while what I've seen of the country, I love, spending Christmas there instead of with my family isn't on my to-do list, so I'm slating it for next year (fingers crossed, no embargo!).

So I take the exam tomorrow, and then I have a week to pack everything up, take down the sheets and aluminum foil protecting my room from any form of UV radiation, and hang at the beach, and say goodbye, as about half the people I know leave the island forever, and I have to leave the other half behind. But then I go to New Bern, which is beautiful, and I get to see my family, and winter, and all that. No more administration for a while.

I get moments where the excitement starts to seep through. I went to the point with Lori yesterday because we were both procrastinating, and we were talking about places we were going to go in Brooklyn, and there was this rising excited fluttering. I started talking to her about google-earthing New Bern, and how the apartment is across from a bed and breakfast and down the street from a lobster deli, and you can see the river from the window, and it's in walking distance to the beautiful old city center, and I was talking faster and got excited again.

And then we lay on our backs at the point as the sun set and the stars came out (I know it's cheesy, but it's awesome in real life) and just chatted, and the occasional sailboat shadow would pass by. She and I talked about getting all our diving in after exams, the champagne sendoff Sej arranged and how excited we are about all of it, and I felt a fluttering of excitement about that too, of doing those things, not of leaving it.

Thus the utter ambivalence I've been facing this term, which has extended to almost every area (such as liking pathophys, hating how it's run, though to their credit after the whole showdown thing, everything improved dramatically, and hating pharm but liking how it's run), so arrrggghhhh.

Oh, speaking of pathophys. I was unable to work up a suitable amount of stress for the final exam, largely because this term and this week, I'm continuing the senioritis trend to an extreme, but while I can't comment on the fairness of the dermatology section since I did virtually *nothing* to prepare for it, including reading the lecture notes, it was actually a pretty fair exam.

More to the point, it went with a more "first order/second order question" approach. While I'm not saying 5th-10th order questions are unfair, and that'll certainly be the board questions, thinking through those sorts of questions also tend to break my brain pathways and leave me so exhausted for the remainder that I can't do much, which usually spells bad news for whatever exam is second.

Now granted, I've been using the spare brain cells allowed by the last exam to then subsequently kill them with television and facebook, but at least now I have no excuse for my utter ignorance of pharm.

So somewhere around a week and change before I'm gone...

Scary exciting...

Second to last exam of basic sciences tomorrow, namely pathophysiology exam.

Considering three days ago, I was three weeks behind, I'm feeling pretty decent right now sans dermatology, which I'm hoping to cram into the morning hour.

Still an odd surreality where I really don't feel like I'm leaving yet. Don't even really feel like I've got a massive final exam tomorrow, more like "Hmm, another day, another scantron."

Contrast that to what'll happen to me Wednesday night, as I realize that pharm is going to club me like a baby seal.

Tons of people going for exams tomorrow, so good luck to all of you and I wish you well.

Nighty night!

The Germans really DO have a name for everything

Witzelsucht: excessive and inappropriate facetiousness.

In other news, I'm not obnoxious; I just have a brain tumor.

Things I should have known two weeks ago...

Hmm, Dr. Endocrine-lecturer is really nice.

I don't learn pathophys by osmosis, as much as I want to.

I don't learn pharmacology by any means necessary, as much as I've stopped caring.

Anesthesia is now running neck and neck with oncology in "I would rather take a shotgun blast full of rock salt to the face every morning than do". Anesthesia drugs suck, pulmonary physiology sucks, and lungs are only fun when they're breaking, which tends to not be the goal of an anesthesiologist.

There's enough of medicine that's actually interesting and varied and all that I'm not not so much trying to pick an eventual direction as I'm trying to eliminate those that would drive me to heavier drinking if I actually stumbled into them as career choices.

I should have invented a dying fiance who was taking care of my emotionally fragile war scarred twin boys and their adopted labrador puppy in Green Park if I wanted to score Brooklyn hospital. I'm guessing they're going to send me to the corner of John Deere and Crystal Meth for failing to jump back to California, which is where my currently missing driver's license shows my residency.

Speaking of that driver's license, if anyone somewhere between Dublin, Berlin, Prague, Budapest, Vienna, Venice, Bologna, Verona, Cinque Terre, Zurich, Bern, Engleberg, Dijon, Paris, Brussels, Amsterdam, Rotterdam, Orleans, Calais, Dover, Canterbury, or London happens to spot a California driver's license with a clueless looking blonde chick on it, please pop it to Grenada. Sigh.

Oh wait...

Renal lectures are up on Sonic. I'd say that makes all right in the world, but I've just discovered that I need to know 8 billion anti-cancer drugs. I've got the brilliant idea of combining them into one giant super drug, call it Cancer-Ex, and go home. The pill will be a little large but you can dissolve it into pink beer.

Good start

As I've posted before, there's been some major uproar regarding the current 5/6 term stuff, and I think for good reason. I'm still in favor of instituting the old grading scale and to open up more lines of communication, BUT...

Notes for GI, which starts on Monday, were already in the lecture hall, facilitating pre-study for the industrious folks, and ensuring even the lazy people (like me) that they will be able to follow along in lecture.

Either the physio people had another place to go or they were on an off week because we got booked use of the path lab today versus the last session where we didn't have a room and got booted back to the lecture hall. While I complained about the path lab in fourth term because the A/C was not keeping up with how incredibly loud and overcrowded it was, it seems to work decently for its purposes, plus nothing makes you appreciate the path lab more than trying to conduct a discussion group by yelling down a row in Bell Hall before having to go in front of a lecture theater with a microphone to present to 150 of your classmates on 10 minutes notice. Stage fright much? So I think this format works much better. I was actually able to interact with my group and the projection of the cases on the screen means everyone can see them and contribute equally.

I don't know about the "think on your own first" format to BSFCR, but the fact that they've changed it and are now posting the enabling objectives the Monday before is a big plus and a strong indication that someone's listening. I also like the one case per set of questions format to having the exact same case with two groups presenting 8 different things, which gets repetitive without being helpful and takes forever. Much appreciated.

The list of "question types" at the end of BSFCR session. YES. That is the sort of thing we need.

The agreement to post the BSFCR cases on Angel. THANK YOU.

The addition of the points to both pathophys and BSFCR grades. This was definitely necessary and I really believe we need a consistent standard for the future, but leaving the average at 64 really would have been unacceptable.

There is an open forum to discuss the problems of this term with the department heads on Monday. That is a HUGE step forward. I don't know what will come of the discussion, but the willingness for this meeting to happen is definitely encouraging. Thank you to the SGA for meeting to convey the students' expressed desire for an open forum and thank you to the heads and deans for agreeing to meet.

The GI objectives, which were posted early, had a change that was posted on Angel, and the announcement was made along with an apology for the inconvenience. While this doesn't seem like a big deal, for me, it really is. Part of what has really gotten on my wick previously is a feeling that any inconvenience, even minor, that the students suffered was somehow our faults, and informing us of it was a favor. A "sorry guys" goes a long way, at least for me.

Though this has absolutely nothing to do with the pathophys or BSFCR classes, my freaking sixth term loan check arrived on schedule. Trumpets and fanfare, people!

---------

This doesn't mean all is sunshine and rainbows, of course. And I know there's going to be obnoxious problems that persist right until the end, because there's been things about every term that I think could have really been changed to the benefit of the students, but I felt this one needed special address, and it seems like the problem is being taken seriously. So long as students are able to have a voice if the going gets tough enough, I'm willing to take difficulties (though will certainly whine about it) if there's an effort to fix gross malfunctions in the system. It's only when I felt that the departments were completely unaccountable for any action with no capacity for a change to occur in our better that I honestly had started to regret coming and not pursuing a different route to doctorhood, and while that sounds extreme, that's honestly how I was starting to feel.

Let's hope this is a new beginning for all of us.

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!

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.

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.

Incompetence

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.

Sincerely,

An *Extremely* Frustrated Student

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...

Eating too much; studying too little

Argh, getting into the swing of the new term is a difficult task, and progressively getting more difficult by my steadfast refusal to catch up.

Instead, I'm finding myself lamenting over all the stuff I need to do before I leave the island for good... oh, not study stuff, I've been doing that for a year and a half... no, stuff like "see the monkeys", "go to Carriacou", "Do six dives", and that sort of thing. I'm also realizing how much I like my colleagues, and how I'd much rather do stuff like eat dinner with them and hang out, or go to parties, or swim at the beach, rather than doing that whole studying thing, which can wait, and then it can wait until tomorrow, and then it can wait until after Obama's speech.

It doesn't help that I have absolutely no idea how to study for pathophysiology because I'm not sure what the exact goal is other than "Remember everything from the last two years, because it's all testable". And I'm still recovering from an awesome summer, so that leaves me lazy and worried about my sloth. Also worried about not being able to spot memorize thirty drugs at a time.

So today, after a LONNNNNG pathophys session, I headed to the new Italian place to sample that stuff with a friend... then to Rituals to try some of their cake and check out the ambiance and realize that they turn it into a wine and cheese bar every night at 6. I'm sure THAT won't have a deleterious effect on my study habits. Then, a necessary shopping trip. Then, catch up with a girl I haven't seen in months, hang at her place for dinner, eating a homecooked meal (not my cooking of course, but I did provide the salad dressing) and watching Animal Planet...

All of which is awesome. So awesome, in fact, that I lament having to leave that early, not do the 90s Party, which I'd love to do, and instead sulkily attempt to glean something from my pathophys lectures so that I can do the quiz this weekend. The horror.

Now my only feat is to determine whether my complete sloth is limited only to me, or if I can be reassured by similar echoings from my classmates.

BBQ

Mmm... free food. Thanks Grace! And thanks incredibly nice little red Lance Aux Epines bus driver. That guy takes you where you need to be, announces where you are, and will stop someplace and wait for people to assemble, so I got to go to the nice BBQ.

Uhhh, what to say. Tomorrow marks the day that I need to try to figure out what on earth is going on with pharmacology. I was ensured a class full of pointless memorization of drugs with hideous names, their conditions, and their side effects, in other words, a flashcard class, and instead I'm getting a horrible array of graphs and math and all manner of mean nasty stuff, and my numbers-poor brain is addled.

And the instructor didn't help by saying "if you don't understand pharmacokinetics, you are not going to get over a C in this class" or something to that effect, and guess what? Ah well.

In other news, pathophys, the class proper, has a delightfully eccentric professor doing infection studies, so it's not proving too difficult since the way he says it sets it well in my brain. We did have our first "other class" that is the bastard child of pathophys and it was a combination of being really frightening, in that it requires us to remember everything we knew in the past 1.5 years, while being a complete waste of time in being exquisitely badly organized, a fact even the tutors and instructors were aware of. Also, not a good idea to set a mandatory session that involves EVERYONE in the class getting together in the same space at the same time that involves discussion, particularly when those groups are supposed to sit in rows, necessitating yelling to the other end of the row to be heard. Can you say chaos, boys and girls?

It's also not wildly nice since there's about 350 people, give or take a few, in there, and a member of each group has to present the questions and be drilled, while standing at a podium, in front of said individuals. Since public speaking is listed as one of the top fears, I believe above spiders and death, this seems unkind to put people on the spot.

But we shall see. In the meantime, the main class that's going to eat my attention is pharm. In other news, once again, it's bedtime, or now that I'm trying to be diurnal, 2 hours past. On the plus side, I've been able to sleep despite doing it largely on my couch without linens, the latter of which were destroyed when I had a minor apartment flood and were mildewed beyond repair. So now, my linens consist of my couch cushions and my novelty Pirates of the Caribbean Jack Sparrow blanket (don't judge me). And I'm STILL able to sleep! Progress!