Med school before the internet?

There's no way! At first, I was jealous of the long-ago docs because they got to become doctors before half the biochem and immuno stuff was discovered, which is so wonderful.

Nothing makes you hate scientific discovery quite like medical school, and nothing is sweeter to the ears than "And A becomes B, but no one is sure of the mechanism". Versus "A becomes B, and thanks to research done two years ago, we now know the seventeen page esoteric, difficult to conceptualize process by which it happens. This WILL be on the test." Damn! Is it wrong to beat someone with their own Nobel Prize?

Which is all the more impetus to get into school as soon as you can... before they discover anything else!

But to continue my first thought, I am no longer envious of the ago-docs because WE HAVE INTERNET. I have come to the realization that it is impossible to pass medical school without the internet, particularly if you're as lazy as I am and have no intention of bussing it down the the library to page through reference books to find something that's confusing you.

Nope, instead, while watching a neuro lecture on Sonic Foundry, in the air conditioned comfort of my apartment, I realized I didn't quite get what the instructor was saying about testing clonus... so it was onto Wikipedia. Hmm.. kind of hard to visualize that test. Oh wait, Wiki has a link to a video SHOWING it being done. Huzzah.

So I suppose I can trade all the obnoxious discoveries (like in immuno, any fragment of anything containing the letter "w", meaning "workshop", meaning "discovered in the last five minutes and will change names by the end of the week) for my sweet sweet internet.

Not quite the "bender"...

Problem being that during first term, you finish midterms and then have a week before Sandblast. In second term, it's the day after your last midterm.

I was planning the sort of self-indulgent bender that killed Hendrix, when I discovered something: Midterms are Tiring.

Friday after the exam? How about some lunch at the mall, a trombone concert outside, home for some vegetation, and then a quiet dinner at the local pasta joint after getting kicked out of Coyaba because they suddenly decided to enforce a dress code (in the Caribbean??) and were going to grant us the distinct honor of sitting off from everyone else in an area that wouldn't get waited on, but we'd get to pay the same price. Er, no. Then? Hang at my apartment with friends.

So Saturday; THAT'S the day everyone parties, right? I can sleep off the no sleep before neuro, wake up at noon and party hard? Except, it's kind of rainy, I WANT to feel like partying but really don't, and my cupboard has been stripped to nothingness by midterms. So I'll just go shopping. But that takes awhile, and then Sandblast is over, and oh, gosh darn I missed it and it was pretty expensive, and there's an after party at Aquarium, but there's parties like that all the time, so no need for this one, so quiet night hanging with Nina and watching Fight Club. Ahhh...

This, at first, made me feel like a loser (the skipping partying; not the hanging with friends), until I realized that nearly all the second termers I ran into were doing the same thing. That week sucked.

So how'd it go? I passed everything. Which means Ishie Happy. It also means Ishie's standards have lowered significantly from "I'm going to try for straight As" to the post midterm/pre grade posted "Gee, I hope I get an 'F' high enough I can bring up during finals".

Neuro... sucked for me, though the test was fair. Was going to pull a deliberate (Ishie, Ishie, you never learn) all nighter to learn everything I could, particularly in neurodevelopment, which I'd been neglecting. Because cramming the entire night before an exam during a week where you've used up all your mental reserves and are living off dry honey nut cheerios because you ran out of everything else is a good idea.

This meant in the exam, I got the distinct pleasure of nearly passing out. Fantastic. Stress + sleeplessness = Health problems. I was sitting there, heard humming, thought "no way", started sweating profusely, and nearly dropped. Asked for a restroom run, which of course is highly moderated (thanks, cheating microbio students that screwed up the privilage of going to the bathroom by yourself, for that, by the way), and they apparently had my number and I put my head down and drank water, which recharged my batteries, so I burned through the rest of the exam.

Someone, fairly close to the exam, said "Don't expect neuro to be any easier than physio", which considering physio was harder than giving birth to an rabid adult Saint Bernard is less than encouraging.

Er... your results may vary, but neuro was easier than physio. It was not easy; don't get me wrong, and was made far more difficult by virtue of it being the last exam. But while the physio exam almost seemed deadset on punishing you for knowing ALMOST enough but not quite enough, the neuro exam seemed to, for the most part, hit on key points that were made. The questions were fairly straightforward with a few curve balls, and many of them answered other questions within the test. Oh, though guys? Venom properties? An aside paragraph in one handout? One question, but c'mon now. Ask me about tetanus. I know about tetanus.

But so my "party weekend" was really more of a "Ahhhh.... I can relax and lounge without feeling GUILTY" weekend. Which I really like. This was punctuated today by diving with Lori. Hooray for diving! I went out on the water for the first time in 6 months and just the sensation of being back in the water was wonderful. No pictures I'm afraid, since I was reorienting and didn't want to mess with my camera.

And tonight? I learned to properly make lentils, which should carve a substantial slice off my food budget.

Caribbean example

When it comes to sound, we have a twofer Caribbean example!

If you recall, for illustrating sensitization of the area around a burn, we have "burning yourself when you light your stove".

Now, we have sound waves traveling through water when you're snorkeling at Grand Anse Beach, hear a high-pitched whine, and want to avoid getting hit by the boat that's inevitably heading towards you, as well as the delay in sound when you're overlooking a valley and a man is cutting down a tree with a cutlass/machete.

All in all, this professor is pretty cool, and is the same one who let a student jab him in the eye to demonstrate corneal reflexes. But will this offer be made again *AFTER* the midterm?

Note to self:

When trying to demonstrate the vestibulo-ocular, and optokinetic reflexes to yourself, do not stand up and spin around really fast in a circle, especially when you're full of tea.

On the plus side, now I *really* can visualize my endolymph sloshing around. Glurgh.

Oh, and I passed immuno, which means if I don't tank the final, I never have to see the alternative pathway of complement again, which fills me with a joy I cannot adequately express.

Two Down!

Today's Final Jeopardy answer is: "The class you've avoided all term to study physio that is about to bite you on the medulla oblongata."

Hmm... What is Neuroscience, Alex? No... really. Because I need to know by Friday.

Verdict on Physio: OMG, I FREAKING PASSED!!!!!!!!! To repeat myself. Hardest. Exam. Ever.

Today was Immunology, a 100 question test consisting of first order questions I probably should have known more of the answers to. As to why I DIDN'T know a lot of them, it's probably because by the time I got to studying the TWELVE interleukins (creatively named "IL-1" and up, that we needed to know, my head was so full of letters and numbers that they all just spilled out into a jumble on my floor and I was too lazy to pick em up.

So Jay showed me a great video that represents not only the kind of logic you need to understand immuno, but represents pretty much what the inside of my head looks like after two midterms.

My brain kind of rebelled last night, and I think it was after I wrote down the following:

"Classical: C4a & C4b; C2a & C2b; C3a & C3b; (C5a & C5b) to C3conv:C2aC4b and C5conv: C2aC4bC3b"
Alternative: C3a & C3b (tickover); Ba&Bb; (C5a & C5b) to C3conv:C3bBb and C5conv:C3bBbC3b"

Yeah. Wrote that down. From memory. On the front of my summary notes. I still have it. And then I looked at it, and told *myself* to go to hell. Because I've seen more coherence on an eye chart. I could make more sense out of the letters on the scantron sheet. So I tried to concentrate after that, and decided to go over the interleukins "quickly" because I knew they were important and would definitely be on the test, and that pack/cram regurg stuff is usually something that works pretty well for me, but I think I overestimated my ability to do it this time around.

I can't really complain (well... that's not true, but you know), but the exam was pretty fair, I think (just know the disproportionate crap for T cell differentiation and interleukin secretion, but though I wasn't good with it, it didn't come as any major surprise that it was there), and you get flat told the sort of thing that's going to be on it. The questions are all first order and don't require much logic, some are the same ones given as samples in either the summary notes, the text, or in lecture, but do require you to separate letters and numbers that don't really mean anything to you, and I'm not that great at it.

But I do actually think I passed, and it didn't give me the brain aneurysm feeling I had after physio, so it's onto neuro!! And then a 48 hour bender!

Ouch.

First exam: Physio.

Having heard this was a notoriously difficult exam, I devoted a pretty disproportionate amount of my study time to this so that I would feel REALLY confident when I took the test, understand the concepts, be able to extrapolate, and all that.

Yeah... that exam was so bloody difficult, it made the MCAT seem like an "Is he that into you?" Teen Beat magazine quizlet. And the weird thing is that except for the like 20 minutes of yesterday I spent reviewing heart sounds and EKGs (you know you're in trouble when calculating the mean electrical axis of the heart is the EASY part of the exam), I have no idea how I could have studied differently or better for it. The seven HOURS of yesterday I spent dedicated to understanding all the relationships didn't seem to help, but it's also not like the quiz was full of minutia. I don't even know how to categorize it. 17th order type questions that required a form of logic I'm not sure I have... can you just let me be a doctor yet? I promise I won't be a heart doctor!

What also didn't help was that the test was exhausting. Halfway into it I wanted to be done, and not like "Gee, I wish I weren't taking a test" kind of done, but a "My brain is overloaded and I'm getting to the point where I don't even CARE what the answers are anymore." For every question, I ended up feeling like I knew about 85% of what the question was talking about, and understood what it was, and what it related to, but when it came to that final "So then, what color are the bus driver's eyes?" endgame, that bridging connection just wasn't there. So I dunno. I would have preferred the Histo approach with "Hmmm... had time to cover that lecture. Know the answers. Hmm... did not even LOOK at that lecture once, thus am completely justified and comfortable with getting every one of those questions wrong... because I didn't earn it."

This one, it was more like going to work for a couple weeks, doing your best, and then they just decide not to give you a paycheck this time around. You earned it, but too bad. Unfortunately, neither medical school, nor likely the USMLEs, let you by on what you EARNED. Instead, it's on what you KNOW. Whether that takes 20 minutes or 20 years.

What's weird is that tests with 150 questions, while grueling, were much less so. Know it or don't. Next question. Not "I know most of this, so let me spend 10 minutes working out three perfectly logical conclusions to this problem, and have all three of them be answer choices." I also kept having those moments Dr. Curry joked about with us last term where you read the question with the answers covered, feel confident in an answer, and then realize that the "right" answer isn't there. Awesome.

And two more exams to go! On the plus side, if I don't fail physio completely (as in the final), I don't have to LOOK at cardiovascular again until the USMLE. Hallelujah.

Ave, Caesar, morituri te salutant

Yes kids, midterms start tomorrow with a walloping bowl of physiology.

For those who aren't in medical school, this short clip is the most realistic depiction I've found to date...

Hi Feds...

So in my review of my neuro stuff, since I realized I was neglecting it to inhale physio (no word yet on immunology; I'm ignoring it in the hopes it will go away), I went over some old cellular neuroscience lecture notes so that now I know how sarin and tabun work (nastily). For the uninitiated or non-CNN watchers, these are nerve gases. For those who need a cheap exam pickup, they irreversibly bind acetylcholinesterase. My, that's a big word, but it's got "ase" in it, which makes it biochem relevant. If you're not being tested on it Friday, don't worry about what that implicates.

In lecture, it was mentioned that these agents cause flaccid paralysis because there's certain channels can only be open for so long before they inactivate, and then no more nerve signals get through, aka death...

Leaving me to wonder that since the neurons initially FIRE, which should produce things like seizures/convulsions, would that lead to those actions prior to the flaccid paralysis? Just trying to see how complete my understanding of this neuromuscular junction stuff is, not because I like to trade in human misery.

Leading to the title of this post, because to solve this mystery, it meant looking up "Sarin" on Wikipedia, which conveniently also provides a section on prolonging the shelf life of the stuff (gee, that's some useful information), leading me further ponder: "How many watch lists can I get myself on by wiki'ing nerve gas?"

Just please don't put me on the no-fly list. I wanna go home for Christmas.

The lunch special

is knowing every detail of this diagram upways, downways, frontways, and sideways.

On the plus side, once I do, with the exception of calculating the mean electrical axis of the heart, I am ONE with the heart, because this diagram pretty much involves nearly everything there is to know about it, with the caveat that you have to be able to conceptually understand every dip and valley.

Yesterday, after missing my immuno lecture because I couldn't get my dumb ass to bed on time, I buckled in with the 6th lecture of gastrointestinal goodness, a dabbling in the retina in neuro, and then decided it would be good for my brain to inhale the first half of our first set of Cardiovascular notes. 52 pages later, it was time for bed. I did break to go for my evening walk, allowing me to discover that two of my previous walking trails are conveniently connected without having to stroll by the house of the evil, untethered dog. I hate this frigging mutt. If you don't look him in the eye and scream "I am your alpha bitch!!! NO NO NO BAD DOG GO HOME!", he runs out and tries to nip you in the ankles, and he is not a small dog... and since I love dogs and miss mine, I prefer to avoid him, because if I pound his rabid teeth out with my water bottle, I know it'll inevitably make me feel bad.

So today? Minus the skipping immuno (I went! I swear!), the plan is to rinse and repeat. Is midterms over yet?

It was a dark and stormy night

And boy howdy, is it freaking ever. I'm no safety nut, and I've got my computer unplugged and on wireless and everything because the thunder was cracking so loudly it was literally shaking the apartment.

Of course, being the person that I am, I can only think it's freaking cool (so long as my power, aka, air conditioning, stays on), but it's coming down like it did during Felix, sans the heavy winds.

First off, let me give a big THANK YOU to Slappy for tracking down this picture, illustrative of what humans would look like if we did the same thing to them as we do to fruit flies:

Gentlemen, BEHOLD:



And when Adult Swim tracks me down to break my thumbs, I will also share in that prize.

Today, prior to the inevitable viewing of House (and thus necessary weekly social interaction, which keeps me sane enough that I don't have to start making up invisible friends), I was again enraptured in front of Sonic Foundry, inhaling three physio lectures and a neuro lecture, with another one planned before bed. So I suppose, while being "productive", I think that means that except for going to my immuno lecture, I watched tv all day. Ah, med school.

Midterms midterms... but we're going to ignore them to talk about House.

House points (not House rules, which should be far more important to my current situation, since I'm required to know them for the neuro midterm):

1. Not a big fan of this episode, much as I love NearDeathExperience!House. He's dying more than Mulder lately.

2. The ending violated cardinal television rule number 1, and I am NOT a fan. I'm becoming a people-doctor so I *don't* have to watch furry little critters die. Don't screw my record.

3. Cuddy's been one of my favorite characters since I started watching the show, but she is now so totally ineffective that it starts to stretch reality even for this show, and oh-my-god can we stop with the stripper clothes? It's beyond even tv-revealing embarrassing and right into trailer park hussy.

4. Seriously? Cameron needs to die. There are crazed gunmen, stalker teenagers, girls plummeting off balconies, and thrillchasers with switchblades running all over this hospital; she works in the ER, and not ONE tragedy can befall her short of falling into a vat of peroxide (Yes, I know it's Jennifer Morrison's natural color, I don't care, and it's giving her this weird twincest vibe with Chase)? I'd say kill Foreman too, but since they already assassinated his character at the end of season 2 (interesting intelligent character replaced with Stabby McPaperStealer), he's already dead. Which means he'll probably be seen in the next Very Special Supernatural Episode of House.

5. I am convinced that there is an unseen, uncredited writer working for the show that goes to this school. Not only do the diagnoses tend to follow what we're studying with an inordinate number of shoutouts to parasitology (the only class any of us seem to remember), BUT there's a hiatus in the show smack dab in the middle of midterms to be resumed the week after? C'mon hidden SGU student. Step up and take credit. And kill Cameron. I know you have the power.

Scientists are evil...

I know; I know, and you thought it was only Duane Gish who thought that...

We have a new neuro professor, who seems really cool and is doing the unenviable task of making developmental neuroanatomy seem interesting the week before midterms.

One of the interesting aspects involves the Drosophila (much-abused species of fruit fly) homeotic genes, similar to our hox genes, with the short version of the story being that by screwing with them, we can make these unsuspecting arthropods grow eyes all over their bodies.

To someone studying this, awesome. To a fruitfly... AHHHHHH!!!! Which was going to be linked to a picture of Carl from Aqua Teen Hunger Force with his body made up of eyes (if you haven't seen it, don't ask), but alas, I couldn't find one.

Fun facts about your gut...

Apparently one of the minor features of the gastrointestinal system is "homestatis".

I wonder if that has anything to do with homeostasis?

Needless to say, the questions on this part of the physio test better damn well match the information presented in the class and not what we're likely *supposed* to know. And I'm not cracking that massive doorstop of a textbook the week before midterms to figure it out, either.

You know you're in the Caribbean when...

Your neuroscience professor uses "You burn yourself while lighting your stove" as the example for increased pain sensitivity following an injury.

You also know you're getting closer to midterms when all your blog posts involve direct correlations to what you're studying.

Now that I've discovered a wireless signal, I can curl up on my SOFA watching Sonic Foundry rather than being tethered by my ethernet cable. Ahhh, bliss. So I'm inhaling neuro lectures like popcorn (mmm, popcorn) while periodically using Wiki to track down structures in the brain I should have learned a month ago. And it's *television* (sort of) so it's having that history channel effect where I'm actually retaining stuff from watching it, rather than reading it, highlighting it, painstakingly writing it in my own words, and then forgetting it five seconds later.

Weird...

In our immunology lecture notes, there's reference to "an alternative hypothesis explaining persistence of memory cells."

Personally, I'm guessing it has something to do with melting clocks.

Thank you, biochem

Never thought I'd say *those* words.

And yes, someone's procrastinating. Lotta blog posts, eh?

Though initially exceptionally disappointed to spend a good part of my summer memorizing the second half of biochem because I'm such a spaz, DAMN, am I glad of it now. I'm also glad for the work I did in histo (with Manlocks' help, of course) because there is some mystifying stuff that is only making sense in light of stuff I learned last term, and I don't mean "general stuff you should have conceptualized last term", I mean "piddling minutia that isn't adequately explained, so thank freaking heavens you actually remember it".

Thus, due in large part to biochemistry's unhealthy obsession with enzymes and the fun little things they do, I'm finding error after error in my gastrointestinal system notes, leading me to wonder if, on the exam, I put what I know to be *right* (and what was taught in biochem and histo) answer, or do I put the answers in the new physio lecture notes? Decisions decisions. And I'm pretty sure Intrinsic Factor isn't an exocrine secretion, but I've been wrong before.

For a little background, in physiology, we finished the cardiovascular lectures (which I thought were really good) and started with a new set of notes, a new lecturer, and a new set of potential midterm questions with GI tract.

So far, I'm not finding gastrointestinal that *hard* per se (cardiovascular was harder because this summer made me good at biochem but did nothing for my fifth grade understanding of physics and the CV system is just one big fluid dynamics nightmare taunting me in the voice of my high school physics teacher), but the lecture quality has dropped off, so I'm having to cross reference stuff that "seems wrong", because turns out, it is. Sigh.

But, turns out, all that biochem that seemed irrelevant actually is really important, and may save my butt, which is more important. It's also the only way I can remotely begin to understand immunology, and the parts I understand best are the ones that have an overlap in biochem or oddly enough, parasitology.

So though I haven't taken any exams and certainly have not been a paradigm of "success" this term, if I have any advice as of late (other than parroting my dad's "don't spin your wheels"), it's that so far the best help I've had in second term is understanding first term. Seems obvious, but there ya go.

Physics is helpful, apparently, but for the cardiovascular lectures, that awesome prof started with "I'm going to assume you all think the heart is something on the front of a valentine and go from there." Thank the gods.