"Studying endocrine = alphabet soup....CK14-, lower p27 index , PTH+, Ki-67+, cyclin D1 overexpression in >90%, DNA ploidy, Rb gene loss, HRPT2 gene mutation (hereditary hyperparathyroidism and jaw tumors syndrome)"
-Nolan
The acronyms just keep on coming....I think getting a medical degree is partly based on learning what a bunch of letters mean in the medical context. That way, you have to pay a doctor just to translate each others writing. its actually pretty brilliant!
Tuesday, August 10, 2010
Monday, August 9, 2010
Day One...again
Today was my first day of second year and it was.....uneventful. Unfortunately, school began just like every other day and before I knew it, I was sitting in a histology lecture again trying my hardest to keep my attention span. After 3 hours, we had lunch and got to catch up with each other but after that there was a realistic feeling of work looming. Our first quiz is Wednesday [in 2 days], then another one Friday and our first exam is Monday [one week from today]. We are going to be studying the endocrine system for 3 weeks and every week will be the same... Our school has changed the curriculum and we will be doing a part Problem Based Learning instead of lecture style. Basically, we are given 5 cases with questions and in a group of 10 selected peers we will meet up and come up with a diagnosis and answers to the questions. The quizzes we have are all based on these cases and then after the quiz we get lectured on them. If it sounds confusing its because it IS confusing and its going to take me a good amount of time to 'learn how to learn' best in this style of teaching. For example, this is next weeks schedule
Monday: Exam 1 [from the previous weeks material]
Tuesday: the entire day is blocked off to meet with our group to go over the 5 cases and for self study
Wednesday: 8:30am to 12-Quiz on the cases we covered Tuesday and then 3 hours of lecture on this material
1pm- 5pm-Essentials of Clinical Medicine [this is the class where we learn to deal with patients and see standardized patients [actors] every other week]
Thursday: AM is blocked off again for groups to meet about another 5 cases
1-4pm- Osteopathic Manipulative Medicine
Friday: 8:30am to 12-Quiz on the cases we covered Thursday and then 3 hours of lecture on this material
*note, there are some Medical Ethics classes and other randoms thrown in their as well. Also, this will change with each system but the general set up is the same.
As you can see, things are very different from the usual lecture day. I am not sure how i feel about it yet but im thinking positively and im sure it will be good for me to have my own free study days.
Sooooo, now that Africa and my incredible summer are behind me, im gonna go learn lots of stuff so i can eventually go back and be able to help [and not just look over people's shoulders].
And another thought, today was my last 'first day of school' EVER. Thats because next year [actually in July] I will be spending my first day of third year in a hospital...and then rotating in and out of hospitals. CRAZY to think about
Tuesday, June 22, 2010
ONE down THREE to go
Well, its been a lil over a week since my first year ended and its hard to reflect on what I just accomplished. It's also very hard to grasp that it has been a full year of quite possibly the hardest working year of my life. Having met so many new amazing people, I can't help but love what I am doing even though at times I was very miserable. Most of the time I was having fun, even if most of it was spent in the library. I was still in the library with friends and still had plenty of opportunities to get to know my classmates. Honestly, my classmates are the major contributing factor to my sanity. It actually is hard to relate to friends who aren't in my class because med school has become such a major part of my life....well, it IS my life. But, now I am on summer break and get 8 weeks of guilt free time. Right now I am sitting on my friend's couch in London just having made a great breakfast. I plan on sitting here for a lil while longer and then heading out into the city. Tomorrow is an England World Cup game and I am meeting a friend to watch it, should be a great time in a pub somewhere :) Then Thursday night I leave for MALAWIIIII!!!!!
Of course, I didnt let go of all responsibilities since break has started. Last week before I left for London, I volunteered for the third [or fourth, cant remember] time at the Montclair clinic. I had two patients, a Spanish speaking 45yo Male and a 44yo Female. The man was the first time i encountered a patient who did not understand English at all. I worked my way through it as best as possible. I led him to exam room one and with a smile on my face the entire time (it was the only way i knew to break the tension) I took his blood pressure, pulse, temperature, respiratory rate, height and weight. After doing his vitals, the only thing I could manage to say was 'dalor?' as I pointed to his eye [it looked a lil red and droopy...dalor means pain]. He said no....thats it. After an awkward pause and another smile, I told him [in english which he obviously couldnt understand] that I would be right back. I then got the Clinic Coordinator [our saving grace at the clinic...she helps us with everything] to interpret for me. Through her, we asked him a few questions and it was all I needed because he was just there for a BP check and medication refills for HTN and Diabetes.
After this patient I had a 44 year old lady who could speak English and suddenly I felt 20x more confident in myself. It seemed like a no brainer since i could ask her any question i wanted [retrospectively, having this spanish speaking patient was pretty good for my learning curve]. She was here for HTN medication refills but also because she wanted to switch her anti-depression medication. She was just put on them at her last visit 2 months ago and since then she was having major side affects of 'shaking' and 'trembling.' I asked her a ton of questions about her symptoms and didnt do any physical exam cause I didnt really think it through and didnt think it was needed. I went back to the resident and presented the cause and it became pretty clear that I did not do enough. He asked if I did any physical tests and educated me on why a neuro exam would be very important. So, I went back to the patient and did a full neuro exam to rule out any other causes. I did reflexes, muscle strength testing and sensation testing...all were intact and within normal limits. After going back and giving my pertinent negative findings to the resident, we went to see the patient together and ended up switching her medication.
Retrospectively, I really should have known to do the neuro exam and present this to the resident in the first place. We just learned about this a couple months ago and it should have been in the back of my mind when I was listening to the patient. I felt pretty stupid for having forgotten it. Its hard to see a patient, learn all their symptoms and really critically think while i am in front of them. Its hard enough trying to pretend and look semi-competent while in the exam room... its another to actually BE competent. So, I took this experience as a valuable one and next time, I will slow myself down a bit and not feel bad about thinking things through and making the patient wait while i study their chart and my notes. After all, thats what doctors are supposed to do, right?
On that note, I am also VERY happy I have been volunteering at the clinic because if I am already learning and becoming more comfortable with patients and charting, I wont make these basic mistakes when I start rotations. Then ill just look like a rockstar!
Anyways, it was a very long night at the clinic and we didnt get out until 10:30pm [we start at 5pm.] We had a resident that was pretty slow but he was also valuable as he spent a lot of time teaching us about the patients and also giving us pointers while writing our SOAP notes [the exam documentation complete with Assessment and Plan for treatment]. Sadly, its this kind of stuff that makes me dislike medicine. We spend about 20 minutes with the patients but then at least an hour on their chart. granted, charting will go much quicker and smoother when we are more experienced but for now, everything I am about to write gets scrutinized in my head a couple times before it actually get puts on paper. This is a legal document and I have to make sure everything is complete and accurate. Well... that and the resident and clinic coordinator have to sign off on our charts and i dont want to look/sound like a complete idiot. I havent been doing this for long but I should have some ideas of how to do this, it has been a year after all!
Every shift after our last patient appointment at 7:30pm, we all finish up our patients documentation [SOAP notes] and give them to the resident and then to the clinic coordinator to sign off. It has become a competition each shift to see who can write their chart without getting 'called back' from her to correct something.
I didnt get called back at this shift, she said my charts looked great and were done very well :)
A small triumph but a triumph nonetheless.
be back in a month when i return from Africa, will have lots of medical stuff to write about then!
Sunday, June 13, 2010
Musculoskeletal Quotes
"And on his 2nd birthday you can imagine how happy we all were saying 'Yay! He's up to the 0th percentile!" -Dr. Rega about her son Darwin's inherited shortness
"I hate to break it to you, but fat shows up on x-rays.. can you hide it? No... Can patients hide it with clothes? No... but don't tell your patients that, it might give them a complex" Dr. Fraix on X-ray imaging
"Which finger do you guys think this is? It's the middle finger. It's my way of being politically incorrect to you. Just kidding, it's the ring finger." -Dr. Fraix
"Being a guy he was like 'I'm a guy, its not big deal... it'll go away.." Dr. Fraix describing the typical mentality of 20 something male patients.
"Dude, do you think this is a big deal?" -Dr. Fraix asking a professor about an injury that he was 'being a guy about' and ignored while in med school. Then later describing the wound saying 'Dude, this thing looks angry."
"I just lust after these nuts..all different kinds" -Dr. Redding on nutrition
" 'David... why are you so happy all the time...' Dr. Sugarman said to me... and I said.. well the first reason I won't tell you about... but the second was and attitude of gratitude." - Dr. Redding
"I started going to a doctor on a regular basis, even though I lectured him on being overweight... he was a student here at one point and I was worried about him." Dr. Redding on his longevity.
"I show this, not because it is a chicken wing from Hooters..." Dr. Finley on a picture of knee cartilage destroyed by osteoarthritis.
"They come in and can barely move and say okay Dr. I am ready to get that total joint replacement, and you think they are going to get up from their chair and rise like lazarus...that is not true, their pre-surgical status predicts their post-surgical status" Dr. Finley on joint replacement surgery.
"If you have ever driven over a pothole in the street, then you know what Osteoarthritis is." -Finley
"I had a dream that I was lecturing a group of students, and sure enough, when I woke up, there was an audience in front of me." Dr. Lin
"Do you understand this? No? go read my notes. If you still don't understand it...read them again."-Dr. Lin
"Any thing??? Is everything all right? I know these are very big words..." Dr. Lin's version of asking 'any questions?'
"Achondroplasia.. a failure of endochondral bone growth... this is what you see in the little people in the circus..." - Lin
"Am I talking to fast? No? Good, most orientals talk too fast and talk too soft." -Lin
"Should we begin, so you can go home, and study, and study, and study..." -Lin
"Sometimes you need to take the patients history to diagnose a muscle weakness. If you have a body builder come in and tell you they used to lift 310lbs and they can now only do 295lbs now... you have to trust them, there is no way for you to test their strength." - Lin
"You guys have all seen Barbara Walters on the TV right? She looks a little funny." - Dr. Wong on Botox and its cosmetic applications
"Nice thing is they dont know you so they cant sue you" -Dr Milton on performing muscle biopsies
"I weigh my board exams through guessing" -Dr Milton
"That's the thing, they are boring" -Dr. Milton on muscle biopsies.
"What is the first think you do if a patient comes into your office and then falls down dead on the way out the door? Well my father told me you need to turn the patient around so it looks like they were coming towards you not leaving" Dr. Milton.
Have any of you done a muscle biopsy? Its not so bad, you'd be surprised you can jam this thing into a persons bicep and they don't fight you to much." - Milton
"That works for the classic presentation of the disease, so you have to put a sign on your clinic that says 'only the classic presentation of the disease here please.'" - Milton
"So you are a nytella and you are sitting in a pond, and a moose comes by and munches on you... and your guts spill out into the pond..." -Milton trying to describe active transport???
"Atrophy... gee you know... it loses the mass... there's nothing secret about that" -Parsa
"These are the things were going to get to... you know.. objectives.." - Parsa
"If you are eating chick... kentucky fried chicken... you know the red and the white.." - Parsa
"All of the things I said were important are the things that you need to know for the test..." -Parsa during his most concise and hence enjoyable lecture to date.
"Ejection from a vehicle....thats probably not a good thing" -Doherty during ER lecture
"If you are going to sleep [during this lecture], don't sleep during this part..." - Sherman
"We took it back with us in a skippy peanut butter jar, and luckily customs didn't make us open it..." Faeber on a pathology sample they took home from Haiti.
"Here's Charlie Sheen being examined, not it's not him..." -Faeber on a photo of a patient examination technique.
"Is that me making that noise? It sounds like a river running?" -Faeber on the clicking from everyones lap-top after he told us he was going to go over all the concepts he felt were of importance.
"Lumbar vertebra are more prone to herniation because they are load bearing... for your big fat head." - Fraix
"Because the spinal cord is near and dear to our hearts..." - Fraix
"The reason I like to do EMG is because I get to poke people with needles and shock them... but don't tell people that..." - Fraix
"You are a physician, you need to make sure something else isn't going on... - Fraix about differential diagnoses.
"And thats why i get payed the big bucks...I dont get paid to diagnose Osgood-Shlatter, my grandmother can diagnose that" - Fraix
"I am going to keep repeating these things to you, because when you get on rotations you are going to be tempted to say 'fracture' when you see growth plates. And your attendings will wonder 'what are they teaching you at that school??? Obviously nothing..." - Fraix about growth plates on X rays
"You'll point at it and be like 'thats the problem!' Again, my grandmother could diagnose that" -Fraix on AC injury
"I would get a call on friday asking me to take a patient, so I would bring my junior resident with me who was a linebacker for stanford. I would walk into the hospital with him behind me and say 'what, do you want me to take this patient???" - Dr. Fraix on bullying his way out of getting stuck with a case.
"unfortunately you dont get these arrows in clinic" [on X rays in powerpoint]
"i'll also have patients do heel-toe walking...its not just for drunk driving, its for diagnosing too"
"so the moral of the story is..when you're out doing crack cocaine or whatever dancing all night...take a break!"-Fraix.
"i kinda feel like a talk show host" -Fraix passing the microphone around during large group
"other than guessing, did anybody find anything?" - Fraix
"Ottawa, its not just another place in Canada. Hopefully I didnt offend anyone by saying that.."
- Fraix
"as a medical student you want to put yourself out there because people dont expect much from you" -Fraix
"How many views is better than one view.... 2 or 3" -Fraix on how many xray views to ask for
"You look at your patient and realize 'oh my god he's from the 1950's." -Fraix on a stock photo of a child with DMD.
"XY, you remember it because guys will ask... why do I have to pick up my clothes off the floor, why do I have to get up early..." - Fraix
"Dr. Parsa talked about this 'c'mon guys what do you need to know... its necrotic, it's classic..." - Fraix doing a classic immitation of Parsa
"oh hypothermia, you might think to yourself, we can freeze people and thats a good thing... no it doesn't work out that way..." -Docherty on the effects of hypothermia.
"people will get really specific, 'oh i'm allergic to donuts', well thats okay, b/c we aren't going to feed you right now." -Docherty on taking a hx for a trauma patient.
"These guys are getting up close and personal" - Rao on two rugby guys on top of each other.
"when bones break break its loud...it even echoes off the wall" - Rao
"Must be better than 20/50 with both eyes ::repeats twice:: you know... that would be a good test question..." - Rao on requirements for the sports physical.
"I remember when i was a freshmen medical student and they were calling us doctors...thats pretty funny" -Dr Lee
"Im sitting there looking at the finish line at an old lady that looked like she just came out of a beauty palor with a shirt on that said 'circa 1909' on it as there are young kids laying in the medical tent hooked up to two IVs and im thinking 'whats wrong with this picture?'" -Dr Rice at a San Diego marathon
"This is a steroid induced, genetic freak..." - Rice on body building hypertrophy pic.
"being a freshmen medical student is not a good excuse to abuse yourself" -Rice
"can you imagine the stress of being a chronic sniper???" - Rice
"one monkey is no monkey" -Rice powerpoint
"You can see here ::points with a pencil to ppt on screen::" Steinmen trying to point out radiologic findings without the use of a laser pointer.
"If they got hit by the coca-cola truck & were involved in a lawsuit, then none of them got better..." Steinmen on the surprising finding on a study involving chronic back pain and treatment outcomes.
"I hate to break it to you, but fat shows up on x-rays.. can you hide it? No... Can patients hide it with clothes? No... but don't tell your patients that, it might give them a complex" Dr. Fraix on X-ray imaging
"Which finger do you guys think this is? It's the middle finger. It's my way of being politically incorrect to you. Just kidding, it's the ring finger." -Dr. Fraix
"Being a guy he was like 'I'm a guy, its not big deal... it'll go away.." Dr. Fraix describing the typical mentality of 20 something male patients.
"Dude, do you think this is a big deal?" -Dr. Fraix asking a professor about an injury that he was 'being a guy about' and ignored while in med school. Then later describing the wound saying 'Dude, this thing looks angry."
"I just lust after these nuts..all different kinds" -Dr. Redding on nutrition
" 'David... why are you so happy all the time...' Dr. Sugarman said to me... and I said.. well the first reason I won't tell you about... but the second was and attitude of gratitude." - Dr. Redding
"I started going to a doctor on a regular basis, even though I lectured him on being overweight... he was a student here at one point and I was worried about him." Dr. Redding on his longevity.
"I show this, not because it is a chicken wing from Hooters..." Dr. Finley on a picture of knee cartilage destroyed by osteoarthritis.
"They come in and can barely move and say okay Dr. I am ready to get that total joint replacement, and you think they are going to get up from their chair and rise like lazarus...that is not true, their pre-surgical status predicts their post-surgical status" Dr. Finley on joint replacement surgery.
"If you have ever driven over a pothole in the street, then you know what Osteoarthritis is." -Finley
"I had a dream that I was lecturing a group of students, and sure enough, when I woke up, there was an audience in front of me." Dr. Lin
"Do you understand this? No? go read my notes. If you still don't understand it...read them again."-Dr. Lin
"Any thing??? Is everything all right? I know these are very big words..." Dr. Lin's version of asking 'any questions?'
"Achondroplasia.. a failure of endochondral bone growth... this is what you see in the little people in the circus..." - Lin
"Am I talking to fast? No? Good, most orientals talk too fast and talk too soft." -Lin
"Should we begin, so you can go home, and study, and study, and study..." -Lin
"Sometimes you need to take the patients history to diagnose a muscle weakness. If you have a body builder come in and tell you they used to lift 310lbs and they can now only do 295lbs now... you have to trust them, there is no way for you to test their strength." - Lin
"You guys have all seen Barbara Walters on the TV right? She looks a little funny." - Dr. Wong on Botox and its cosmetic applications
"Nice thing is they dont know you so they cant sue you" -Dr Milton on performing muscle biopsies
"I weigh my board exams through guessing" -Dr Milton
"That's the thing, they are boring" -Dr. Milton on muscle biopsies.
"What is the first think you do if a patient comes into your office and then falls down dead on the way out the door? Well my father told me you need to turn the patient around so it looks like they were coming towards you not leaving" Dr. Milton.
Have any of you done a muscle biopsy? Its not so bad, you'd be surprised you can jam this thing into a persons bicep and they don't fight you to much." - Milton
"That works for the classic presentation of the disease, so you have to put a sign on your clinic that says 'only the classic presentation of the disease here please.'" - Milton
"So you are a nytella and you are sitting in a pond, and a moose comes by and munches on you... and your guts spill out into the pond..." -Milton trying to describe active transport???
"Atrophy... gee you know... it loses the mass... there's nothing secret about that" -Parsa
"These are the things were going to get to... you know.. objectives.." - Parsa
"If you are eating chick... kentucky fried chicken... you know the red and the white.." - Parsa
"All of the things I said were important are the things that you need to know for the test..." -Parsa during his most concise and hence enjoyable lecture to date.
"Ejection from a vehicle....thats probably not a good thing" -Doherty during ER lecture
"If you are going to sleep [during this lecture], don't sleep during this part..." - Sherman
"We took it back with us in a skippy peanut butter jar, and luckily customs didn't make us open it..." Faeber on a pathology sample they took home from Haiti.
"Here's Charlie Sheen being examined, not it's not him..." -Faeber on a photo of a patient examination technique.
"Is that me making that noise? It sounds like a river running?" -Faeber on the clicking from everyones lap-top after he told us he was going to go over all the concepts he felt were of importance.
"Lumbar vertebra are more prone to herniation because they are load bearing... for your big fat head." - Fraix
"Because the spinal cord is near and dear to our hearts..." - Fraix
"The reason I like to do EMG is because I get to poke people with needles and shock them... but don't tell people that..." - Fraix
"You are a physician, you need to make sure something else isn't going on... - Fraix about differential diagnoses.
"And thats why i get payed the big bucks...I dont get paid to diagnose Osgood-Shlatter, my grandmother can diagnose that" - Fraix
"I am going to keep repeating these things to you, because when you get on rotations you are going to be tempted to say 'fracture' when you see growth plates. And your attendings will wonder 'what are they teaching you at that school??? Obviously nothing..." - Fraix about growth plates on X rays
"You'll point at it and be like 'thats the problem!' Again, my grandmother could diagnose that" -Fraix on AC injury
"I would get a call on friday asking me to take a patient, so I would bring my junior resident with me who was a linebacker for stanford. I would walk into the hospital with him behind me and say 'what, do you want me to take this patient???" - Dr. Fraix on bullying his way out of getting stuck with a case.
"unfortunately you dont get these arrows in clinic" [on X rays in powerpoint]
"i'll also have patients do heel-toe walking...its not just for drunk driving, its for diagnosing too"
"so the moral of the story is..when you're out doing crack cocaine or whatever dancing all night...take a break!"-Fraix.
"i kinda feel like a talk show host" -Fraix passing the microphone around during large group
"other than guessing, did anybody find anything?" - Fraix
"Ottawa, its not just another place in Canada. Hopefully I didnt offend anyone by saying that.."
- Fraix
"as a medical student you want to put yourself out there because people dont expect much from you" -Fraix
"How many views is better than one view.... 2 or 3" -Fraix on how many xray views to ask for
"You look at your patient and realize 'oh my god he's from the 1950's." -Fraix on a stock photo of a child with DMD.
"XY, you remember it because guys will ask... why do I have to pick up my clothes off the floor, why do I have to get up early..." - Fraix
"Dr. Parsa talked about this 'c'mon guys what do you need to know... its necrotic, it's classic..." - Fraix doing a classic immitation of Parsa
"oh hypothermia, you might think to yourself, we can freeze people and thats a good thing... no it doesn't work out that way..." -Docherty on the effects of hypothermia.
"people will get really specific, 'oh i'm allergic to donuts', well thats okay, b/c we aren't going to feed you right now." -Docherty on taking a hx for a trauma patient.
"These guys are getting up close and personal" - Rao on two rugby guys on top of each other.
"when bones break break its loud...it even echoes off the wall" - Rao
"Must be better than 20/50 with both eyes ::repeats twice:: you know... that would be a good test question..." - Rao on requirements for the sports physical.
"I remember when i was a freshmen medical student and they were calling us doctors...thats pretty funny" -Dr Lee
"Im sitting there looking at the finish line at an old lady that looked like she just came out of a beauty palor with a shirt on that said 'circa 1909' on it as there are young kids laying in the medical tent hooked up to two IVs and im thinking 'whats wrong with this picture?'" -Dr Rice at a San Diego marathon
"This is a steroid induced, genetic freak..." - Rice on body building hypertrophy pic.
"being a freshmen medical student is not a good excuse to abuse yourself" -Rice
"can you imagine the stress of being a chronic sniper???" - Rice
"one monkey is no monkey" -Rice powerpoint
"You can see here ::points with a pencil to ppt on screen::" Steinmen trying to point out radiologic findings without the use of a laser pointer.
"If they got hit by the coca-cola truck & were involved in a lawsuit, then none of them got better..." Steinmen on the surprising finding on a study involving chronic back pain and treatment outcomes.
Sunday, June 6, 2010
Are we there yet?
Tuesday, June 1, 2010
Procrastination Perfection
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!!!
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!!!
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
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