Friday, August 3, 2007

How to spend a day preparing for rotations

Alternate title #1: Doing everything you won't have time for later
Alternate title #2: What to do on your day off from your McJob
Alternate title #3: What I did TODAY
  1. Read up on the subject, i.e 250 Biggest Mistakes 3rd Year Medical Students Make
  2. Then don't read up on the subject, as in, read whatever cool non-medical book you've been putting off.
  3. Laze it up for as long as possible. Guitar Hero helps.
  4. Work out. You need to build up that physical stamina you lost in exchange for mental stamina with boards. Plus none of your professional clothes fit anymore, fatty fatty two by four.
  5. Get totally settled into your place. Getting the stuff out of the box isn't enough, you also need to put it somewhere.
  6. Make your bed a comfy piece of heaven, so, like, replace those flat grody pillow you've had for 10 years.
  7. Stock up on food at the Safeway or other bulk foods store. As long as its not Walmart. Fascist.
  8. Call friends and family, or at least Google chat.
  9. Work out all the drama. Whatever the problem, stop putting it off and fix it now or you never will. Shit, that reminds me, I need to call a dentist, and get new insurance, and overhaul my car, and...gah!
  10. Enjoy the feel of the the summer breeze on your face. Soon you'll be stuck inside most of the time and 2 days later its winter.

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Thursday, August 2, 2007

Blog Rounds 1: Learning to Drool on Command

Glad to see there are still people reading this blog. We all had to take a little break after boards and to finish the end of our second year. Much, much more on that from my POV still to come, stay tuned for a month or two and you'll get the good stuff.

So I read a lot of other blogs, probably way too many. The good ones often leave me thinking about far more than I end up writing in comments, but us three Type B girls often get into good conversations about why these posts appeal to/disgust/inspire/amuse us. I've decided to do some posting on here about why it is that certain posts hit a nerve, and call these posts "Blog Rounds."

I caught this post tonight. It's over on a not uber-popular (read: Michelle Au..yeah you know who I'm talking about) but BEAUTIFULLY written blog, Nobody wears a white coat anymore... The writer is a resident at a hospital in Indiana (my home state!). She is amazingly clear and insightful about what is happening around her, I highly recommend it.

She was writing the other day about a patient of hers that she had just diagnosed with amyloidosis, and despite everyone saying what a "nice" woman this was, the unfairness that she will most likely die soon of this horrible disease.

Here's the excerpt that moved me the most out of all this, bold and italics added for emphasis:

"A has systemic AL-type amyloidosis. It's a horrible disease in which a particular line of cells in the bone marrow is overproduced, yielding an excess of a particular protein, which then simply silts out into the spaces between cells. The only good thing about this disease is that when you stain amyloid with Congo Red and light it up with a polarized microscope, it glows a bright shade of green and looks very pretty. The prognosis is poor, the progression is relentless, and most people who have it die within the year."

The post is much deeper and longer than this. But I think I've just figured out what it is that hit me so hard about it. We're taught in the first two years of med school how to make quick associations that lead us to develop differentials. Any med student entering their third year in the States will quickly, in true Pavlovian nature, shout out "Apple green with Congo Red stain!" if you so much as mutter the phrase amyloidosis anywhere near them. (Go ahead, try it sometime, I dare you. Even if they don't shout it, I can guarantee you that a picture somewhat like the one posted here popped into their minds.)

What is difficult for so many of us to deal with during these first two years, though, is that these aren't just diseases we're dealing with, they're PEOPLE with diseases. These people have lives. They have families. They have hopes and dreams. We came into med school saying that we were here to help PEOPLE, not learn how to knee-jerk diagnose a disease. But that knee-jerk association is necessary to even begin to be able to help them.

Somewhere between the beginning of med school and now, we've, I've, forgotten at times that the people are what matter. It isn't that I think they don't matter, but it's hard to not get caught up in the tornado of memorizing facts and spitting them back out that med school can be.

I'm glad to see it put into perspective that sometime down the line, a few years from the constant onslaught of Scantron tests and lab practicals, this information still came back to her in residency. But it was somehow separate and a tangent to what actually mattered, the patient.

Med Q from the McJob

Is there such a thing as ketchup bottle squirter's thumb?

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Wednesday, August 1, 2007

LOLcat of Death

NEJM -- A Day in the Life of Oscar the Cat
Since he was adopted by staff members as a kitten, Oscar the Cat has had an uncanny ability to predict when residents are about to die. Thus far, he has presided over the deaths of more than 25 residents on the third floor of Steere House Nursing and Rehabilitation Center in Providence, Rhode Island. His mere presence at the bedside is viewed by physicians and nursing home staff as an almost absolute indicator of impending death, allowing staff members to adequately notify families. Oscar has also provided companionship to those who would otherwise have died alone. For his work, he is highly regarded by the physicians and staff at Steere House and by the families of the residents whom he serves.

And Michelle's fave

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