goodbye Neuro, hello life!

It has been a while since i have written, mostly because Neurology is over and i have been enjoying my life :) It was a brutal class and I am very glad to have passed and be done with it. sadly, the amount of hours i spent studying does not correlate well with the grade i will get in the class, but thats med school for ya. I have accepted that some things [like the million neuronal pathways that are all different and control every slight movement we make or feeling we have] are just beyond the scope of my memory. lets hope that i will learn them well enough to pass my first of many medical licensing board exams which is next year.

i have been out doing the things i love most. i have been out by the pool, hiking, playing tennis, camping with my classmates, and celebrating much much more. alcohol consumption has gone up exponentially since neuro finished, never to a huge excess though :) i have been able to see friends more often and have started buying the necessary clothes and equipment i will need for my trip to Africa this summer. Dont let me foul you, we still have school though. Right now we are in Behavioral Science [Psych] because the amount of class hours are greatly decreased. We also just finished ECM [essentials of clinical medicine]...the class where we see the actors and play dress up with our white coats and do history and physicals on them.

aside from all the goofing off, ending neuro has brought me more time to do more extracurricular activities. i have volunteered in the Montclair clinic again and worked in a club called PCHAT [Pomona Community Health Action Team]. PCAHT holds clinics every month in various locations throughout Pomona, usually in elementary schools. They are advertised and open to the public. Run by students and supervised by physicians through Western, PCHAT provides basic health screening for those that do not have access otherwise. I had an amazing experience when i volunteered last week. I worked in a team with two other colleagues and first we had an 8 year old patient that had a possible urinary tract infection. She was a sweet girl and I enjoyed interacting with her. We then had a 50something year old man which was pretty much was the most educational case I have seen yet.
So Mr. X [as i will refer to him] came in with his wife for what he says was just to get a routine checkup. He admitted to not being seen by a doctor in several years. Sitting down and getting a history, we discovered the real reason for his visit. He was having numbness in his feet and hands which was progressively getting worse. Mr X was not a obese man but he did admit to drug use in the past and was not an ideally healthy patient. HIs wife told us that he was pretty scared about coming. After doing a thorough history and neurological physical exam, we found everything to be pretty normal [so not a neuro problem] but he did answer a few questions that led us to believe he had diabetes. Questions we have been taught to ask like 'are you always really thirst, do you get up to urinate in the night multiple times, etc were all answered with a yes. Basically, this was the most classical and cliche presentation of diabetes that anyone could have thrown at us. So, we checked his blood sugar and sure enough, it was 460 and 470ish on re-check. Without any help from an attending, my colleagues and i diagnosed a man who walked in with a simple request for a 'routine check.' WIth the knowledge of what questions to ask and what physical exam aspects we should do, we truly were being doctors :) Granted, it was bittersweet because we were happy over a not so happy matter [diabetes is never a happy matter] but still, i was very very excited about what we had just done.
When we were done working up Mr. X I got to present this case to the attending and all of us were pretty damn excited that we did so well. Presenting is always fun because that is pretty much what i will be doing for the rest of my life. I have started to become familiar with the medical jargon and abbreviations and its really starting to click. I can rattle of "Mr. X, a 52 year old Male, presents to the clinic today for a routine visit. Upon questioning, it was reveled that he has had peripheral neuropathy symptoms in his upper and lower extremities for close to one year in duration. [then i would go on about the onset, location, duration, characteristics, aggravating factors, alleviating factors, if it radiates, the timing, severity and associated symtpomts..blah blah blah....yeah...its a mouthful]


After pretending to be a doctor for a night, I looked back at my two patients that were pretty much extremes. The young girl and the old man. For now, I will say I enjoyed working with the young girl more. Actually, having had a couple pediatric experiences...i think it could be something i enjoy and i am looking into the field more. stay tuned....

one thing i know i wont be doing is psych [and of course surgery...i will NEVER do surgery]. We just had a patient encounter [ya know, the actors] in psych. It was creepy. I had to deal with a 54 year old man who had bipolar disorder who repeatedly went out of his way to make me feel uncomfortable. not...so....fun.

well, im down with this computer for now and am going to pretend to study for a bit...we have our one and only test in Psych next week and then musculoskeletal begins. For now, im going to look forward to tomorrow, we are playing a pick up volleyball game. life is good :) 46 more days until summer!

another weekend in the library

Medical school: "... it will give you lemons and then squeeze them in your eye. As you try to figure out how to stop the burning school will kick you in the shin and then make you feel retarded since you should have seen that coming. Depending on how much you bitch they may or may not put salt in your eye too " -melissa

neuro is ALMOST over....

"Today, during our 9 straight hour lecture-a-thon, I think I saw more material than I saw in entire COURSES in college....."
-EH speaking about our long day of clinical neuropathology lectures

on a word document from one of my neuro professors

"the auditory system includes collateral projections to the reticular formation to increase arousal, attention, and awareness (startle reflex)- who doesn't hate the alarm clock"
-Dr. B

spring break over....

"I arise in the morning torn between a desire to improve the world and a desire to enjoy the world. This makes it hard to plan the day." -EB White

A Professor's funnies

Neuro Lecture Quotes so far:

"What is the human brain designed for? do you think it is sitting in this lecture and learning about neuroscience? not likely...there is no reproductive advantage to sitting in this classroom. you could be doing something else that would produce much more offspring right now"

On brain capability/limitations:
"You reached this point in your life by showing you are capable of doing a lot of academic problem solving, we dont know wether you can do real world problem solving, but many of you did well on whatever test you needed to take to get here...or at least reasonably well. Now there are lots of people who didnt do well on these tests...and those are going to be your patients."

"Hello Neuro, Good-bye Life" -LB

Wellll, I had saw my first patient Monday but it feels like it was so long ago because of everything that has happened since! Tuesday we had our Blood and Lymphatics Final and then Tuesday afternoon we had OMM. Wednesday we started Neuro, ahhhhhhhhhhhhhh. It is the hardest block we have our first year and it is gonna SUCK.

Back to Monday, I shadowed a 2nd year and saw 2 patients. One was a 24 year old female with a sore throat and another was an 18 year old Male who needed a physical exam to be able to play varsity tennis in his high school. In both cases, the 2nd year and I talked to the patient and got a good history and did the appropriate physical exam components to each. Then we went back and spoke with the resident about what we thought we should do, and then he came back to the exam room with us. It was a great experience and it made it even better knowing the resident was very approachable and easy to joke around with. We stayed from 5 to 9pm and then I went straight to a group study session to review all the things i had studied for the next day's exam. It was great/stressful. Great because I felt like a DOCTOR! Stressful because it made me realize how much i need to know and how much responsibility i am going to have in the near future on my 3rd and 4th year rotations. I laughed every now and again to myself because i couldn't help thinking 'what the hell am i doing here, they are really letting me do this? i feel like im still a child, how am i supposed to treat people when i feel like a kid?!' When i voiced this to the 2nd year i was following she laughed back and let me know not to worry, she still feels like that all the time.' I guess i will act like i am playing dress up :)

well we have an OMM exam this Monday so we will be practicing a ton for that as well as balancing neurology studying. Two more full weeks of school and 2 more exams before break...almost there. Oh and i almost forgot, the best part (*cough*sarcasm*cough*) is that we are back in the anatomy lab on our own time to do required anatomy learning of the brain. Remember all those cadavers we stared at all last semester? well, now we get to stare at their brains for a while. just we i thought it couldnt get any worse, i get to add formaldehyde back into my life. but hey, they are going to let me be a doctor so i will just keep playing along until one day i actually feel component enough to be one!