I have attempted to look over one lecture in the past two hours. I have yet to complete it....I just CANT physically learn anything right now. It already feels like summer, how am i supposed to be in school mode. WIth two more weeks left of my first year, I feel like my brain is jam packed with information yet I am supposed to cram in everything about the musculoskeletal system, like its no big deal or something. Where is this new information going to fit? I'll tell you where...in the spaces where Anatomy and Microbiology used to be...cause I sure as hell dont remember all that from months ago. HAHA. it occurs to me as i write this that I realistically remember 25% of what I learned this year [and that is being generous]. How am i supposed to take a Board exam at the end of NEXT YEAR after learning a whole other year of information? these people are nutso if they think i will remember all this stuff. 2 more weeks...just 2 more weeks! then i can pretend for 8 weeks that I live a normal life :)
I recently learned that my school has the shortest summer of ANY medical school in the country. my luck is exquisite
Last week I volunteered at the Montclair clinic again. It was pretty fun. Luck would have it that I examined the same patient I saw the last time I volunteered. This is pretty impossible as the clinic is open 3 days a week and there are a LOT of volunteers. That, and we randomly get assigned cases. Obviously, someone special was watching over me and decided I needed to learn some more about diabetic medications because the patient came in complaining about the drugs we had switched her too. It was a pretty obvious case and family practice may have lost a point in my book after this uneventful patient.
My next patient was a 80 something year old Philippino man who came in with a chief complaint of general fatigue and also to double check his blood pressure [I'll call him Mr. Grandpa]. Mr.Grandpa was pretty sweet as we chatted for a while and then after 10 minutes of learning about his family's health but not his, i realized i had to take control of the situation and ask about his symptoms. After we got that out of the way [he was much more interested in learning about me then telling me his problems] he asked what school I went to. I told him I was a first year medical student and my answer gave him a pretty puzzled look on his face. 'How old are you? You cant be more than 19' Mr. Grandpa said, I laughed and told him I was 24. of course his next question was if i was married and when i said no he said 'you should start working on that, dont want to get too old.' [Like I havent heard THAT before from a grandparent....] I told him i was in no rush to END my life and he smiled back [i dont think he understood my joke...but really, i wasnt joking]. While we spoke he kept staring at my ID badge so after a while I asked him what he was so curious about. He said he was trying to learn my name and see where my last name is from. I told him i was Polish [blah blah...all the usual 'Mom is from here, Dad is from here..stuff] and he still kept staring at it. So i took it off and gave it to him. Ss he grasped it he said, 'Ok, lets see if this picture does you justice. Does it? [looks at the ID card then back at me, shakes his head...] No..No it doesnt.' Im not sure if he meant it as an insult or a complement but either way, I was entertained.
I presented his case to the resident working that night and after he examined the patient, we all walked to the front desk to schedule his follow up. Mr. Grandpa made his appointment and then asked if he could schedule to see me again. ME, HE WANTED TO RESCHEDULE TO SEE ME!!! I had to apologize and tell him I was just a volunteer and that there was no way I could be here the next time he was to come. I explained that our schedules were already set for the next couple months. He was pretty disappointed and mentioned that every time he went to our clinic he saw a different doctor and that it was hard to build a relationship with a doctor this way. This small comment made me surprisingly sad as there are a LOT of uninsured [or underinsured] patients who must feel the same way. On the flip side, it made me confident knowing he thought I was competent enough to see him again [even though I was a 24 year old single woman..haha]. Either way, family practice gained a point on my list because I believe the aspect of continuity of care is something I want to uphold in my future as a physician. So, as of now peds and family practice are starting to lead the pack. BUT, dont be fooled, it is still a large and jumbled together pack. Of course, there is still the common understanding that surgery is not even IN the pack...its laying in a ditch somewhere crying about how all the gunners are fighting over it while.
have i mentioned that i will NEVER BE A SURGEON
ok, now that i have successfully wasted half an hour, I am going back to the embryology of muscle and skeletal development in the fetus. It would have been a lot easier if we just started as mini human beings and grew exactly like that instead of all the development that has to take place. Just so you know what the hell i am talking about, google 'mesodermal development' and then click images. YEAH, IT KINDA BLOWS.
14 days until summer!!!
Tuesday, June 1, 2010
Sunday, May 23, 2010
Psychology Quotable Quotes again from Melissa
"Of course you could encourage some of these mal-adaptive behaviors in your patients, it might bring more people into your office." Martin on how behavior relates to illness.
"Are we living in a good environment in Pomona? You'd be crazy to get on your bike and ride to school here." Martin on the concept of wellness.
“guns…children find one and shoot someone with it.”-Martin
"… the president of the US should have a degree in anthro..I’m going to wait a long time for that for sure."-Martin
“instead of taking a hike up mt. baldy…WHY DID YOU COME HERE?"-Martin
"The status quo is not being maintained in our country…because some…groups..are reproducing more than others…"-Martin
"Adulters-do they have an illness? Well, maybe the church would say they did like 500 years ago…but I don’t think the church has much room to talk nowadays.” -Martin...oh snap!
“native hawaiians didn’t grow up eating things like spam.” -Martin
“my mom..can’t drink. She’s the cheapest date you’ve ever seen.” -KJ
“tell your pts to put their car keys and their cell phone in their pocket, cause they’re not going to remember where they put them….so I’ve heard…”-KJ, on the effects of marijuana
“let’s make pot legal, make $100 from it and give the $ to public schools…..THIS guy (points to picture of snoop) would be in favor of it…fo shizzle..”-KJ
"You shouldn't give this drug to truck drivers, school kids, and tight rope walkers." -KJ on SSRIs and the side effect of sedation.
These people will have their nose turned up like this ::points face toward ceiling:: - Heh on Manic Episodes.
"When I press the lever, I feel good" - KJ describing an experiment in which a rat stimulates its pleasure centers with electrodes... he is pretending to be the rat...
"My mom had an alcohol problem. But alcohol isn't my kind of thing, I like amphetamines" KJ on substance abuse
"What is so wrong with a baby breastfeeding the mother?" - Martin
"Maybe if you get the patient a new wife... they won't drink..." -Ask on alcoholism as a primary vs secondary process.
"Don't tell my wife, that's my mistress.." -Heh
"These people do not like buffets, they like to go to Black Angus." -Heh on Social Phobia and Social Anxiety Disorder
"If you are ill and you are treating sick patients, that is not cool." - Heh
Ershad: "Do you have any advice for us on how to study for Dr. Martin?"
Heh: ::looks at test, begins shaking head back and forth:: "No, its 15 questions, just do your best."
"Perhaps you should all go into farming, fishing, or forestry if you are prone to depression." Heh on the occurrence of depression amongst health care providers.
"If you try you die..." -Heh on suicide complete rate for MDs
"You might start to think this resembles you, your boyfriend, your parents, etc. Don’t take this to heart." Singer-Chang on studying psych and how students think they have every disorder studied.
“Becoming a high-functioning neurotic person is the most that we can hope for” - Singer-Chang
“they died…unfortunate for them, good for the rest of us cause now we know not to take those things together.”-KJ, on mixing certain drugs with grapefruit juice.
“my dad..oh I shouldn’t say this…nah, he’ll probably never watch this! My dad is probably dysthymic…he can find the cloud in any silver lining.”-KJ
“when I found out that brain cells could regenerate…I celebrated. All those nights in college of doing things…involving funnels and water pipes….”-KJ
“looking at this list..I dunno about you, but my risk of suicide just jumped up.”-KJ, in regards to the dietary restrictions of MAO inhibitors.
“I won’t bore you with the story…oh wait, I already did. Sorry.”-KJ
"Marty... he's out there somewhere probably growing [marijuana] legally and making more money than all of us" - Norcos referring to a classmate of his who was expelled his 4th year of medical school for substance abuse.
“pts with dementia have a hard time tying their shoes, putting their belt on, or putting their pants on. How do you treat this?..... Buy them stretch pants” - Heh on apraxia associated with dementia.
"Take the example of the lady who went into Target and began stabbing people. Is that woman bad? Is this really the product of a neuron in the thalamus that is having a bad day or firing too much?" -Martin on the concept of behavior as a scientific process or illness.
"We have to be concerned about fitness. Is med school conducive to reproduction? Not so much." -Martin
"Since Jerry Springer started our cultures perception of shame has changed." - Martin on emotion.
"In your 20’s alcohol is an aphrodisiac. But in your later years…he wrong head is flushing. Viagra doesn’t work if you drink too much."-Norcross
"Are we living in a good environment in Pomona? You'd be crazy to get on your bike and ride to school here." Martin on the concept of wellness.
“guns…children find one and shoot someone with it.”-Martin
"… the president of the US should have a degree in anthro..I’m going to wait a long time for that for sure."-Martin
“instead of taking a hike up mt. baldy…WHY DID YOU COME HERE?"-Martin
"The status quo is not being maintained in our country…because some…groups..are reproducing more than others…"-Martin
"Adulters-do they have an illness? Well, maybe the church would say they did like 500 years ago…but I don’t think the church has much room to talk nowadays.” -Martin...oh snap!
“native hawaiians didn’t grow up eating things like spam.” -Martin
“my mom..can’t drink. She’s the cheapest date you’ve ever seen.” -KJ
“tell your pts to put their car keys and their cell phone in their pocket, cause they’re not going to remember where they put them….so I’ve heard…”-KJ, on the effects of marijuana
“let’s make pot legal, make $100 from it and give the $ to public schools…..THIS guy (points to picture of snoop) would be in favor of it…fo shizzle..”-KJ
"You shouldn't give this drug to truck drivers, school kids, and tight rope walkers." -KJ on SSRIs and the side effect of sedation.
These people will have their nose turned up like this ::points face toward ceiling:: - Heh on Manic Episodes.
"When I press the lever, I feel good" - KJ describing an experiment in which a rat stimulates its pleasure centers with electrodes... he is pretending to be the rat...
"My mom had an alcohol problem. But alcohol isn't my kind of thing, I like amphetamines" KJ on substance abuse
"What is so wrong with a baby breastfeeding the mother?" - Martin
"Maybe if you get the patient a new wife... they won't drink..." -Ask on alcoholism as a primary vs secondary process.
"Don't tell my wife, that's my mistress.." -Heh
"These people do not like buffets, they like to go to Black Angus." -Heh on Social Phobia and Social Anxiety Disorder
"If you are ill and you are treating sick patients, that is not cool." - Heh
Ershad: "Do you have any advice for us on how to study for Dr. Martin?"
Heh: ::looks at test, begins shaking head back and forth:: "No, its 15 questions, just do your best."
"Perhaps you should all go into farming, fishing, or forestry if you are prone to depression." Heh on the occurrence of depression amongst health care providers.
"If you try you die..." -Heh on suicide complete rate for MDs
"You might start to think this resembles you, your boyfriend, your parents, etc. Don’t take this to heart." Singer-Chang on studying psych and how students think they have every disorder studied.
“Becoming a high-functioning neurotic person is the most that we can hope for” - Singer-Chang
“they died…unfortunate for them, good for the rest of us cause now we know not to take those things together.”-KJ, on mixing certain drugs with grapefruit juice.
“my dad..oh I shouldn’t say this…nah, he’ll probably never watch this! My dad is probably dysthymic…he can find the cloud in any silver lining.”-KJ
“when I found out that brain cells could regenerate…I celebrated. All those nights in college of doing things…involving funnels and water pipes….”-KJ
“looking at this list..I dunno about you, but my risk of suicide just jumped up.”-KJ, in regards to the dietary restrictions of MAO inhibitors.
“I won’t bore you with the story…oh wait, I already did. Sorry.”-KJ
"Marty... he's out there somewhere probably growing [marijuana] legally and making more money than all of us" - Norcos referring to a classmate of his who was expelled his 4th year of medical school for substance abuse.
“pts with dementia have a hard time tying their shoes, putting their belt on, or putting their pants on. How do you treat this?..... Buy them stretch pants” - Heh on apraxia associated with dementia.
"Take the example of the lady who went into Target and began stabbing people. Is that woman bad? Is this really the product of a neuron in the thalamus that is having a bad day or firing too much?" -Martin on the concept of behavior as a scientific process or illness.
"We have to be concerned about fitness. Is med school conducive to reproduction? Not so much." -Martin
"Since Jerry Springer started our cultures perception of shame has changed." - Martin on emotion.
"In your 20’s alcohol is an aphrodisiac. But in your later years…he wrong head is flushing. Viagra doesn’t work if you drink too much."-Norcross
Neuroanatomy Quotes- 2010 Edition
Melissa made sure to keep track of all thee quotable quotes of neuro:
"I like to think of tear fluid as eye saliva" Dr. Bales
"This should all be coming back to you from gross... there should be a big sucking sound in this room as all the knowledge floods back into your brain." Dr. Bales on the ciliary ganglia
"You just can't move one eye out at a time. We're not chameleons, maybe it would be cool if we were, but were not." Dr. Bales on horizontal gaze.
"There is one thing that is almost impossible to get, and if your patient got it, they are probably dead." Dr. Bales on combined cranial nerve lesions.
"I always thought it was cheating to use the bar, you should just use your macula" Dr. Bales on tightropists walking the niagra gorge carrying poles to aid their balance.
Bales "What do you call it, The business in the....::gestures with hands::"
Student: "A mullet?"
Bales: "yeah, a mullet."
"If your motor thalamus is not properly inhibited, it's bad news." Dr. Bales
"Let's say that there are two college roomates, and they share a shower, well there may be fecal material in the shower..." Dr. Saviola on how tape worms can be transmitted from person to person.
"cannibalism is probably never a good idea" - Dr. Saviola
"So, what do you need to know? Well, all of them"-Al Tikriti
The cerebrum might say [to the cerebellum], "Mini brain, you complete me." -Bales (in his notes)
"Now this..is the speech banana."-Martin, on the sound level vs. frequency chart
“some excuse for women, they can kick their spouse at night. Like my wife…she always wake me up at night.”-Dr.Wong, on Restless Leg Syndrome
“the brain is sensitive to being injured… it doesn’t like it very much” Dr. Pummerantz on Bacterial Meningitis and its symptoms.
“Getting old is a good excuse for a lot of things, but not for Parkinson’s” Dr. Qazi on Parkinson's disease occuring more frequently in the middle aged individuals (less than 1% in age 65+)
"I’ve never really asked a patient what makes them develop the urge to utter an obscenity, but I think it is an urge that a lot of adults have too." Dr Qazi on Tourette’s Disorder.
“most of you have heard of this ::giggle::..get high and euphoric by sniffing cocaine and smoking it.”-Dr. Wong
“Did I mess this up…oh..well, let me go onto the next slide.”-Bales
"The Auricle is cartilage that is covered in skin, this is the part that flaps in the wind for some people" Dr. Felton on the External Ear
“eh, I think it’s true, but you can look it up. Swimmers ear, like for people in georgia, may be why people speak funny in that area." -Dr. Felton
"If some one is sweaty and has an itch in their ear, and they try and itch it with a paper clip…or an ice axe..”-Felton
“they didn’t actually take a person and slice their head open like that. It’s just a picture.”-Dr. Felton, referring to a cartoon drawing of the ear
“this is a hoaky picture, I hate this picture. At least they made it look pink.” -Felton, referring to an electron microscope picture.
“I wanted to show a picture of an eardrum with a Q-tip going through it. But I figured that you knew not to do that anyway, so I didn’t show it.” -Dr. Felton
Necrotizing external otitis (malignant external otitis): “you can tell they’re severe b/c they contain the words “necrotizing” and “malignant.” You NEVER want to hear those words.”-Felton
Aspergillus niger: “that’s the one when you pull an orange from behind the milk in the fridge, it’s been there for a few months…it’s all black or something…” -Felton
"I'm going to go a few minutes over and finish this up so you won't be in here til lunch time. You can then go and practice your movement disorders again." Dr. May in referrence to the DO 2013 class filming a dance bit before his lecture for the class video.
"I had a second year student come up to me and tell me, 'Oh Dr. Martin, I remember what you told us about the pinna'... and I thought to myself well that's good, at least you remember something." Dr. Martin on the function of the pinna
"One student looked into the ear of a child and found a cockroach, and that was unpleasant for the student *chuckles to self*" Dr. Martin on the things one can find in peoples ears.
"Those whacky early zoologists considered gill stuctures as visceral, so we are stuck with the term
“visceral” attached to striated muscles [a concept which makes my head hurt]" Dr. Bales on the difference between SVE of the head and GSE, in his lecture document.
"Massive excitation of the cerebellum makes you wonder why it doesn't just dance right out of your head." Dr. Bales on the circuitry of the cerebellum.
"Some part of your consciousness will put this image together, hopefully it is focused on me right now" Dr. Bales on your brain assimilating the parts of the visual field into a coherent image.
"Most of [the visual cortex] we don't know what it does yet. If I could tell you what it was doing I would have a bigger office with at least one window." Dr. Bales
“..this is done by the superior colliculus, which I already told you that I know nothing about…”-Dr. Bales
“Alpha, beta, gamma delta..uhh…::pauses:: all these Greek syllables…”-Dr. Wong
"When I was pregnant and got a cold sore on my lip...." Followed by an awkward pause as Saviola just realizes she told the entire class that she has Herpes! (TORCH & HSV-1 lecture)
"it is no accident that these two systems are related anatomically and functionally at the
cellular level (but that is a different lecture, in a different course, in a different discipline)" Dr. Bales on the vestibular and auditory system.
"the “rocks in your head” include otolith and statolith" Bales
"The CNS can suppress back ground irrelevant noise, like some people are doing with my lecture right now." Bales
"scientific summary --> there's a whole lot a connectin' goin' on" Bales
"When a train is here, you want to be able to see the engine number so you can report the engineer for not stopping when you are on the tracks" Bales
"Geometry is a requirement to be here [as a student], but it is not a requirement to lecture." Bales on an addition error he made during lecture.
"The olfactory system is relatively less important in primates, a shark will smell you before you smell the shark" Bales
"You walk out of a crowded bar into the daylight... or have you not had that opportunity yet?" Martin on the bleaching of the cones in the retina during phototopic vision.
"I don't know what konio means, perhaps one of you will tell me in a moment when you look it up on google..." Martin
"almost everyone smells with their nose" Martin on olfactory sense.
"How do you tell if there is a Herpes infection in the cornea? Well the answer is you go to the eye clinic." Tiwari
"The book is rambling, incoherent, and doesn't make a lot of sense, this could be due to the authors or the fact that the subject matter is just rambling, incoherent, and doesn't make sense." Bales on the Thalamus
"Think of the pulvinar as the butt of the 'thalamoose' and it is mooning the corpus quadrigemina" Bales
"Things that fluctuate during sleep... including penile erection, perhaps I should point out that this does not occur in females...." Martin
"If you lesion a rat and put it in a cage, it may be like 'hey what's happenin dude?' It gets even wierder, the rat may try to hump the snake..." Bales on lesions of the amygdala.
"So you get dressed, you put on one sleeve of your sweater and you are done." Bales on hemineglect.
“so when you see a big sign that says, DO NOT URINATE HERE…you don’t” -Bales
"continual inclusion of new structures to the expanding “system” are making it less meaningful
or useful (limbic lobe --> Papes circuit --> lymbic system --> extended limbic system -->
superginormous limbic system --> whole brain)" Bales on the limbic system.
"rats prefer electrical stimulation of the septal nuclei to food and water... stimulation and lesion studies in animals and some lesions in humans have implicated the septal region in sexuality and orgasm (hypersexuality); no wonder the rats prefer stimulaton to food and water !" Bales
"Amygdala, a complex nuclei with a fantastical number of connections... all of which you will need to know for the exam..." Bales (we all pray that he was actually being sarcastic on purpose)
"Layer 2 is the most boring layer, there is not much going on there..." Bales on layers of the cortex.
"This is a photo of Keith Richards, a long time heroin user (photo of him slumped over and passed out) it looks like he is having a good time." Wong on the effects of heroin.
"The reticular formation is very involved in maintaining consciousness, and arousal. It allows you to pay attention…if , indeed, you are”-Bales
"If you decorticate a cat with it’s feet on a sling, you can get it to walk still. The motor pattern in the brainstem is still there. uh, sorry if this offends anyone..but it has been done before…”-Bales
. “Ondine’s curse. That’s not a good thing to have.” -Bales (talking about a lesion that makes you stop breathing if you sleep.
“do you want to urinate now? In the middle of lecuture, while walking to the back? Well, maybe you could just do it in your seat...of course if you have had too much to drink”-Martin (on micturition reflex)
“people are ashamed to pee their pants”-Martin
“..this figure is taken from google again>snickers<..”-Wong
"You can ask your patient, 'Do you have problems with deglutition?' and your patient will ask you 'What the hell is that?' " Martin on swallowing reflex
"If you don't treat viral conjunctivitis it will probably go away in 7 days, if you do treat it... it will go away in about a week." Mintz
"Hopefully you can do some studying of this on your own... or maybe some research." Martin on the physiology of the autonomic sexual response and orgasm.
"Think about those cranial nerves.. you know those heads in a jar, like on futurama? There is no reason that shouldn't be..." - Bertetta on Cause of Death
"What would you predict the symptoms of thalamic lesion would be? Flip a coin or throw some darts at a dart board." Bales on thalamic lesions, and their many uncorrelatable effects
There is no such thing as brain transplants, only body transplants - Dr. Miulli, Neurosurgeon
"You will notice that I said Guillain-Barre' two times... and I didn't say the others two times." - Dr. Berman on his lectures and how to study for his Qs.
"What does the PC section have to say about this? We shouldn't ask the apple section. What's wrong you guys aren't answering? " Miulli
Student with apple "they got a virus..."
Miulli on how much of the brain has blood supply
"Brendon is going to come down here in a couple of minutes and give you a super secret password to win you $500 or something." Miulli on the lunch lecture he is giving and the intro for it.
"A few reasons not to do a rectal exam; patient does not have an anus (congenital colostomy), or the doctor has no fingers." Dr. Berman
"I'm being videotaped??? ::turns off microphone and walks out of camera range, proceeds to give answers to test:: "Well now those were the answers to the test." Miulli on the attendance to his lectures after the lunch break. -these were not actual answers to the test
"When you go into the room the pt is not going to say... I am a 45 yo right handed male with a 3 week history of back pain. It gets worse when I do the valsalvo maneuver..." Dr. Miulli on taking a thorough history.
"We are going to kill everyone in the next three slides..." Dr. Miulli on the NASCIS study I and II
"This is medicine at its best" Miulli on a massive academic spinal cord injury drug trial study where they 'forgot to use placebo'.
"Well this isn't on the test anyway so who cares..." Miulli on the difference between an epidural and subdural hematoma.
"Here is a tumor that I have made in photoshop..." Roscoe on neural pathology
"We do the same thing, freeze the tissue and put it on the shabu shabu slicer..." Roscoe on how they analyze surgical pathology specimens.
"Remember the brachial plexus? I don't.. remember that horrible thing that looks like a freeway accident... I always have to talk to students about it and pretend I know what I am talking about." - Roscoe
"We want to cut the brain open to see the germinal matrix ::cues animation of chainsaw being used to section a brain::" -Roscoe
"This is a photo of the infection occuring ::cue video of cute kittehs::" Atkinson on toxoplasmosis as a torch pathogen.
"Hopefully you don't have to remember the broadman areas... oh you do... sorry about that." Roscoe
"Use the objective when you start studying for my portion of the test at 4am the day of the test." Atkinson
"In Florida you eat the baracuda if you... want to be in a movie like Jackass or something." Atkinson on Red tide and other forms of toxin peripheral neuropathy.
"This is a horrible list... when I had to study for the neurology boards we had to memorize the inborn errors in metabolism. We had all these mnemonics, and a chart to understand the mnemonics... as soon as the test is over... you will forget them all." Roscoe
"BTW when you take your boards, and you open the letter and you pass, you realize that unless you let your driver's license lapse, you will never have to take another test again in your life, you will do a football touchdown dance ::proceeds to demonstrate::" Roscoe
"The teddy bear is the uncus, you can push on it and it is easy to push on it. But if I am the person pushing on it, and there are five of you pushing back against me there is a lot of resistance.... Now I know that is the lamest example you have ever heard...." Roscoe on uncal herniation
"Now I don't remember if theses are greek or roman columns, so we will just say their are greek or roman columns..." Roscoe on some insane way to remember that CN3 innervates levator palpebrae superioris.
"Its okay to say bruise on a medical record, but if you say contusion it sounds cooler..." Roscoe
"The teddy bear example was the worst example, well this is the second. Pretend you are ice skating on bear feet. You hit a patch that is kinda rough, you aren't moving very fast, but it still kinda hurts your feet... the brain is the same way." Roscoe on Contracoup contusion.
“I should take some of these out…I’m repeating the same things here..”-Parsa, on the repetitive slides
“the time is up, and..I’m over it…see you tomorrrow morning.” -Parsa at the end of lecture
“stage 4 is when people have diuresis, have their, um, ….episodes.”-Marti
"I like to think of tear fluid as eye saliva" Dr. Bales
"This should all be coming back to you from gross... there should be a big sucking sound in this room as all the knowledge floods back into your brain." Dr. Bales on the ciliary ganglia
"You just can't move one eye out at a time. We're not chameleons, maybe it would be cool if we were, but were not." Dr. Bales on horizontal gaze.
"There is one thing that is almost impossible to get, and if your patient got it, they are probably dead." Dr. Bales on combined cranial nerve lesions.
"I always thought it was cheating to use the bar, you should just use your macula" Dr. Bales on tightropists walking the niagra gorge carrying poles to aid their balance.
Bales "What do you call it, The business in the....::gestures with hands::"
Student: "A mullet?"
Bales: "yeah, a mullet."
"If your motor thalamus is not properly inhibited, it's bad news." Dr. Bales
"Let's say that there are two college roomates, and they share a shower, well there may be fecal material in the shower..." Dr. Saviola on how tape worms can be transmitted from person to person.
"cannibalism is probably never a good idea" - Dr. Saviola
"So, what do you need to know? Well, all of them"-Al Tikriti
The cerebrum might say [to the cerebellum], "Mini brain, you complete me." -Bales (in his notes)
"Now this..is the speech banana."-Martin, on the sound level vs. frequency chart
“some excuse for women, they can kick their spouse at night. Like my wife…she always wake me up at night.”-Dr.Wong, on Restless Leg Syndrome
“the brain is sensitive to being injured… it doesn’t like it very much” Dr. Pummerantz on Bacterial Meningitis and its symptoms.
“Getting old is a good excuse for a lot of things, but not for Parkinson’s” Dr. Qazi on Parkinson's disease occuring more frequently in the middle aged individuals (less than 1% in age 65+)
"I’ve never really asked a patient what makes them develop the urge to utter an obscenity, but I think it is an urge that a lot of adults have too." Dr Qazi on Tourette’s Disorder.
“most of you have heard of this ::giggle::..get high and euphoric by sniffing cocaine and smoking it.”-Dr. Wong
“Did I mess this up…oh..well, let me go onto the next slide.”-Bales
"The Auricle is cartilage that is covered in skin, this is the part that flaps in the wind for some people" Dr. Felton on the External Ear
“eh, I think it’s true, but you can look it up. Swimmers ear, like for people in georgia, may be why people speak funny in that area." -Dr. Felton
"If some one is sweaty and has an itch in their ear, and they try and itch it with a paper clip…or an ice axe..”-Felton
“they didn’t actually take a person and slice their head open like that. It’s just a picture.”-Dr. Felton, referring to a cartoon drawing of the ear
“this is a hoaky picture, I hate this picture. At least they made it look pink.” -Felton, referring to an electron microscope picture.
“I wanted to show a picture of an eardrum with a Q-tip going through it. But I figured that you knew not to do that anyway, so I didn’t show it.” -Dr. Felton
Necrotizing external otitis (malignant external otitis): “you can tell they’re severe b/c they contain the words “necrotizing” and “malignant.” You NEVER want to hear those words.”-Felton
Aspergillus niger: “that’s the one when you pull an orange from behind the milk in the fridge, it’s been there for a few months…it’s all black or something…” -Felton
"I'm going to go a few minutes over and finish this up so you won't be in here til lunch time. You can then go and practice your movement disorders again." Dr. May in referrence to the DO 2013 class filming a dance bit before his lecture for the class video.
"I had a second year student come up to me and tell me, 'Oh Dr. Martin, I remember what you told us about the pinna'... and I thought to myself well that's good, at least you remember something." Dr. Martin on the function of the pinna
"One student looked into the ear of a child and found a cockroach, and that was unpleasant for the student *chuckles to self*" Dr. Martin on the things one can find in peoples ears.
"Those whacky early zoologists considered gill stuctures as visceral, so we are stuck with the term
“visceral” attached to striated muscles [a concept which makes my head hurt]" Dr. Bales on the difference between SVE of the head and GSE, in his lecture document.
"Massive excitation of the cerebellum makes you wonder why it doesn't just dance right out of your head." Dr. Bales on the circuitry of the cerebellum.
"Some part of your consciousness will put this image together, hopefully it is focused on me right now" Dr. Bales on your brain assimilating the parts of the visual field into a coherent image.
"Most of [the visual cortex] we don't know what it does yet. If I could tell you what it was doing I would have a bigger office with at least one window." Dr. Bales
“..this is done by the superior colliculus, which I already told you that I know nothing about…”-Dr. Bales
“Alpha, beta, gamma delta..uhh…::pauses:: all these Greek syllables…”-Dr. Wong
"When I was pregnant and got a cold sore on my lip...." Followed by an awkward pause as Saviola just realizes she told the entire class that she has Herpes! (TORCH & HSV-1 lecture)
"it is no accident that these two systems are related anatomically and functionally at the
cellular level (but that is a different lecture, in a different course, in a different discipline)" Dr. Bales on the vestibular and auditory system.
"the “rocks in your head” include otolith and statolith" Bales
"The CNS can suppress back ground irrelevant noise, like some people are doing with my lecture right now." Bales
"scientific summary --> there's a whole lot a connectin' goin' on" Bales
"When a train is here, you want to be able to see the engine number so you can report the engineer for not stopping when you are on the tracks" Bales
"Geometry is a requirement to be here [as a student], but it is not a requirement to lecture." Bales on an addition error he made during lecture.
"The olfactory system is relatively less important in primates, a shark will smell you before you smell the shark" Bales
"You walk out of a crowded bar into the daylight... or have you not had that opportunity yet?" Martin on the bleaching of the cones in the retina during phototopic vision.
"I don't know what konio means, perhaps one of you will tell me in a moment when you look it up on google..." Martin
"almost everyone smells with their nose" Martin on olfactory sense.
"How do you tell if there is a Herpes infection in the cornea? Well the answer is you go to the eye clinic." Tiwari
"The book is rambling, incoherent, and doesn't make a lot of sense, this could be due to the authors or the fact that the subject matter is just rambling, incoherent, and doesn't make sense." Bales on the Thalamus
"Think of the pulvinar as the butt of the 'thalamoose' and it is mooning the corpus quadrigemina" Bales
"Things that fluctuate during sleep... including penile erection, perhaps I should point out that this does not occur in females...." Martin
"If you lesion a rat and put it in a cage, it may be like 'hey what's happenin dude?' It gets even wierder, the rat may try to hump the snake..." Bales on lesions of the amygdala.
"So you get dressed, you put on one sleeve of your sweater and you are done." Bales on hemineglect.
“so when you see a big sign that says, DO NOT URINATE HERE…you don’t” -Bales
"continual inclusion of new structures to the expanding “system” are making it less meaningful
or useful (limbic lobe --> Papes circuit --> lymbic system --> extended limbic system -->
superginormous limbic system --> whole brain)" Bales on the limbic system.
"rats prefer electrical stimulation of the septal nuclei to food and water... stimulation and lesion studies in animals and some lesions in humans have implicated the septal region in sexuality and orgasm (hypersexuality); no wonder the rats prefer stimulaton to food and water !" Bales
"Amygdala, a complex nuclei with a fantastical number of connections... all of which you will need to know for the exam..." Bales (we all pray that he was actually being sarcastic on purpose)
"Layer 2 is the most boring layer, there is not much going on there..." Bales on layers of the cortex.
"This is a photo of Keith Richards, a long time heroin user (photo of him slumped over and passed out) it looks like he is having a good time." Wong on the effects of heroin.
"The reticular formation is very involved in maintaining consciousness, and arousal. It allows you to pay attention…if , indeed, you are”-Bales
"If you decorticate a cat with it’s feet on a sling, you can get it to walk still. The motor pattern in the brainstem is still there. uh, sorry if this offends anyone..but it has been done before…”-Bales
. “Ondine’s curse. That’s not a good thing to have.” -Bales (talking about a lesion that makes you stop breathing if you sleep.
“do you want to urinate now? In the middle of lecuture, while walking to the back? Well, maybe you could just do it in your seat...of course if you have had too much to drink”-Martin (on micturition reflex)
“people are ashamed to pee their pants”-Martin
“..this figure is taken from google again>snickers<..”-Wong
"You can ask your patient, 'Do you have problems with deglutition?' and your patient will ask you 'What the hell is that?' " Martin on swallowing reflex
"If you don't treat viral conjunctivitis it will probably go away in 7 days, if you do treat it... it will go away in about a week." Mintz
"Hopefully you can do some studying of this on your own... or maybe some research." Martin on the physiology of the autonomic sexual response and orgasm.
"Think about those cranial nerves.. you know those heads in a jar, like on futurama? There is no reason that shouldn't be..." - Bertetta on Cause of Death
"What would you predict the symptoms of thalamic lesion would be? Flip a coin or throw some darts at a dart board." Bales on thalamic lesions, and their many uncorrelatable effects
There is no such thing as brain transplants, only body transplants - Dr. Miulli, Neurosurgeon
"You will notice that I said Guillain-Barre' two times... and I didn't say the others two times." - Dr. Berman on his lectures and how to study for his Qs.
"What does the PC section have to say about this? We shouldn't ask the apple section. What's wrong you guys aren't answering? " Miulli
Student with apple "they got a virus..."
Miulli on how much of the brain has blood supply
"Brendon is going to come down here in a couple of minutes and give you a super secret password to win you $500 or something." Miulli on the lunch lecture he is giving and the intro for it.
"A few reasons not to do a rectal exam; patient does not have an anus (congenital colostomy), or the doctor has no fingers." Dr. Berman
"I'm being videotaped??? ::turns off microphone and walks out of camera range, proceeds to give answers to test:: "Well now those were the answers to the test." Miulli on the attendance to his lectures after the lunch break. -these were not actual answers to the test
"When you go into the room the pt is not going to say... I am a 45 yo right handed male with a 3 week history of back pain. It gets worse when I do the valsalvo maneuver..." Dr. Miulli on taking a thorough history.
"We are going to kill everyone in the next three slides..." Dr. Miulli on the NASCIS study I and II
"This is medicine at its best" Miulli on a massive academic spinal cord injury drug trial study where they 'forgot to use placebo'.
"Well this isn't on the test anyway so who cares..." Miulli on the difference between an epidural and subdural hematoma.
"Here is a tumor that I have made in photoshop..." Roscoe on neural pathology
"We do the same thing, freeze the tissue and put it on the shabu shabu slicer..." Roscoe on how they analyze surgical pathology specimens.
"Remember the brachial plexus? I don't.. remember that horrible thing that looks like a freeway accident... I always have to talk to students about it and pretend I know what I am talking about." - Roscoe
"We want to cut the brain open to see the germinal matrix ::cues animation of chainsaw being used to section a brain::" -Roscoe
"This is a photo of the infection occuring ::cue video of cute kittehs::" Atkinson on toxoplasmosis as a torch pathogen.
"Hopefully you don't have to remember the broadman areas... oh you do... sorry about that." Roscoe
"Use the objective when you start studying for my portion of the test at 4am the day of the test." Atkinson
"In Florida you eat the baracuda if you... want to be in a movie like Jackass or something." Atkinson on Red tide and other forms of toxin peripheral neuropathy.
"This is a horrible list... when I had to study for the neurology boards we had to memorize the inborn errors in metabolism. We had all these mnemonics, and a chart to understand the mnemonics... as soon as the test is over... you will forget them all." Roscoe
"BTW when you take your boards, and you open the letter and you pass, you realize that unless you let your driver's license lapse, you will never have to take another test again in your life, you will do a football touchdown dance ::proceeds to demonstrate::" Roscoe
"The teddy bear is the uncus, you can push on it and it is easy to push on it. But if I am the person pushing on it, and there are five of you pushing back against me there is a lot of resistance.... Now I know that is the lamest example you have ever heard...." Roscoe on uncal herniation
"Now I don't remember if theses are greek or roman columns, so we will just say their are greek or roman columns..." Roscoe on some insane way to remember that CN3 innervates levator palpebrae superioris.
"Its okay to say bruise on a medical record, but if you say contusion it sounds cooler..." Roscoe
"The teddy bear example was the worst example, well this is the second. Pretend you are ice skating on bear feet. You hit a patch that is kinda rough, you aren't moving very fast, but it still kinda hurts your feet... the brain is the same way." Roscoe on Contracoup contusion.
“I should take some of these out…I’m repeating the same things here..”-Parsa, on the repetitive slides
“the time is up, and..I’m over it…see you tomorrrow morning.” -Parsa at the end of lecture
“stage 4 is when people have diuresis, have their, um, ….episodes.”-Marti
Psych done tomorrow, 1 more system to go before summer!
[learning about substance abuse in psych]
it is clear we can substitute 'school' or 'studying' in for 'alcohol' or 'drinking' in diagnostic questions for alcoholism. A clear pattern of brain/studying abuse can be seen
Is School a problem in your life? Do you feel the need to cut down on studying? Do you get annoyed when people critize how much you study? Do you ever feel guilty about school? Do you need a little review in the morning to get your academic day going? Study Alone? Do you have a compulsion to study? Do you keep studying despite consequences to your happiness?
it is clear we can substitute 'school' or 'studying' in for 'alcohol' or 'drinking' in diagnostic questions for alcoholism. A clear pattern of brain/studying abuse can be seen
Is School a problem in your life? Do you feel the need to cut down on studying? Do you get annoyed when people critize how much you study? Do you ever feel guilty about school? Do you need a little review in the morning to get your academic day going? Study Alone? Do you have a compulsion to study? Do you keep studying despite consequences to your happiness?
Monday, May 17, 2010
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!
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!
Saturday, May 1, 2010
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
Wednesday, April 28, 2010
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
-EH speaking about our long day of clinical neuropathology lectures
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