Nov 12, 2006 19:41
Terrible. Awful. Scum-of-the-earth type. Just crummy.
Why you may ask? You might remember me as a good, cheerful, happy
person who occasionally tells jokes that are actually funny and is
fully awake for an entire day at a time. But your memory serves you
wrong!
I am bad, as I have been ...gently... reminded by several of you,
because I have been silent. I left you all in suspense weeks ago--in
fact what feels like YEARS, or at least months, ago--back at the end
of "Block 2" anatomy with the internal organs and what not. In the 6
or 7 week interim that I fell off the earth and lost my email voice
(thus becoming bad), I've finished anatomy and resurfaced for air and
occasional sleep, and this last weekend, guilt-free recreation! So
the e-mails begin again and hopefully won't cease when I get stressed
out this time. (Part of the problem is finding the time and energy to
brain dump all this poorly constructed prose, and Fridays after
preceptorship were definitely NOT it. I'll figure it out, though)
So let's rewind back to my naive, innocent 5th week of school and then
fast forward through what's happened since then. (I'm SO glad that
all of the "anatomy" parts of this are quickly becoming distant
memory. Yeay for being done with anatomy.)
After we took our block 2 exam covering the internal organs and
genito-urinary organs. Yet again, I got an "Honors" (read "A") grade
on the test. It was DEFINITELY harder than the other exam, though!
It set my boots shaking. In fact, I considered writing an email the
Monday after the exam but I was so worried I wouldn't have an Honors
to report that I didn't. *Sheepish look*. We them moved on to 'Block
3,' which covered the legs and feet. This was a very hard block for
my lab mates and me. As I might have said before, our cadaver was
pretty chubby, so there was a lot of fat cleaning to do. And I had no
idea how many structures are in the back of the knee (the "popliteal
fossa") that are totally obscured by chubby tissue. To complicate
matters, our cadaver was poorly preserved (he didn't have good
circulation, it sounds like), so the feet were mummified and we could
only dissect a 2"x3" patch on the bottom of one foot. Nonetheless, my
lab mate Angela perservered in her foot dissection and did a beautiful
job, earning our table an extra 1% extra credit on our exams! (On
which I also got an "Honors", but it was not as high a grade as I
would have expected. Again, I felt sheeping reporting anything less
than 98% to y'all. Something about high expectations.) The leg was a
lot like the arm, and therefore not all that interesting to me.. In
fact, I pretty much despised working on the leg--it was very messy,
very frustrating, and not as rewarding as, say, looking at the inside
of the kidney or carefully dissecting out all of the vasa rectae
(read: very small blood vessels feeing the intestine. It was like
slicing apart saran wrap covering easily-breakable pieces of pencil
lead Just imagine it was very wet, fatty saran wrap and it smelled
unpleasant).
But oh, the last three weeks of anatomy were SOO cool!
SOOOOoOoOO cool! Omg. It was awesome.
The last three weeks were spent dissecting the neck, face, and
head/cranial cavity (we didn't get to dissect the brain, much to my
dismay). I'll spare y'all the details, because even I didn't have the
stomach for it and I've had weeks of in-person desensitization.
Needless to say, I loved it. I loved it enough to almost convince
myself I could enjoy life as an otolaryngologist or some other kind of
head/ears/nose/throat doctor. In part, I loved it because there was
little fat, and no unexpected "hey this cadaver shouldn't have fat
there" fat. Mostly, I loved it because everything was beautiful and
delicate and hard to dissect out. In the last block, I took a lot of
pride in, and spent hours, dissecting out the facial nerve, the eye
socket, my beautiful tensor veli palatini, the pterygopalatine
ganglion (which is buried in bone, I might add. I was delicately
chiselling away using the smallest probes and scissors I could find
for hourS after lab was over, it paid off--the professor said it's the
prettiest pterygopalatine ganglion she's seen in over 20 years of
teaching anatomy. I nearly glowed myself to death). I think I
enjoyed this dissection because you HAD to work hard on it, and there
was a lot of skill involved, not just fat-shucking. In other words,
Melissa hates mindless work and enjoys being challenged--big surprise.
There are few moments in anatomy as cool as removing the brain,
finding the inner ear bones with your hammer and chisel, or tracing a
nerve from its cranial outlet to its targets. (Don't worry, there
were plenty of gross moments to keep me in line and appropriately
grossed out.)
That being said, the 4th anatomy exam has a reputation for being, far
and away, the hardest. There is quite a bit of information covered on
the written exam, and the practical exam because it covers some 500+
structures and the space that you're looking at is so small. Example:
which do you think is easier to identify, a thigh muscles or a
ganglion the size of a head of a pin? So I stressed out, went
underground, lost sleep, lost sanity, and otherwise freaked out about
this exam. And thus I studied really hard--in fact, I studied really
hard from day 1 of this block. And what was my pay off? a 100% on
the hardest practical of the year! And 2% extra credit for superb
dissection! OH YEAH. That's how we rock it, Melissa style. Talk
about an ego booster.
A sad note from this block, however. My lab mate Lauren decided to
take a leave of absence. As the only woman in our class with an
infant, she was having a lot of trouble attending school, taking care
of a frequently sick little boy (who had just started daycare, aka
germcare), and commuting from Sherwood when her husband worked full
time. She left about 3 days into the first week of the head/neck
dissection, and we all really missed her when we had those "ooh/ahh"
moments that anatomy students are prone to have between the
"eww/gross!" moments. She'll start over next year, and I guess have
three built-in mentors and textbook suppliers, but it was sad to see
her go. Yet another reminder that medical school is difficult to
manage, and that I should be grateful that I am able to, and at a time
in my life when it's easy... well.. easier.
So that speeds us up to last Monday. See, I can be concise-ish.
Really. Ok, from now on. Honest.
So after anatomy, we started "Cell Structure and Function." Imagine
rolling histology, cell biology, molecular biology, biochemistry,
genetics (mmm, genetics), and a bit of physiology all together into
ONE course. That's what I'm taking now. The ranks of 2nd/3rd/4th
year students were divided about CSF as to whether it was harder or
easier than gross anatomy. Some people said that gross anatomy was
the hardest course they'd ever taken and CSF was a cakewalk in
comparison (conceptual, non-memorization learners). Others, well
most, said that CSF is a major gear-shift and very difficult after
gross anatomy (probably the rest of us, half memorization, half
conceptual) and grades drop. Mom, relax. Take a deep breath, it's
O.K. So far, it's cake-walk. We've talked about organelles... and
let me tell you how THANKFUL I was to have a lecture on organelles.
After the bulk memorization and redundancy of anatomy, organelles were
a breath of fresh air. They felt like what "biology" feels like, like
I was back on my game and taking classes like I used to in college.
Not that I ever took any cell biology classes, mind you--I always
thought that if it wasn't genetic, or living human, it was boring.
But it /feels/ like biology. It feels good. Anyway, we've also
talked about collagen and hematopoeisis (making blood cells etc) and
leukocytes, and spent 2 hours a day looking at said cells under the
microscope. I think I've been so joyous at staring down an un-smelly
microscope that I've tricked myself into believing that CSF is a
cake-walk. I assume it will become progressively more difficult over
the coming weeks, however. At least I know that I can manage, grace
under fire, if without e-mail correspondence, and do just fine in
class.
I have another test this Wednesday, in my PCM course. PCM has been
moving steadily along week by week, covering topics from domestic
abuse to stress management to heart/lung exam to
head/eyes/ears/nose/throat
(HEENT) exam. Our test on Wednesday is 1/2 written (2 hours) and 1/2
GOSCE (2 hours). A GOSCE is a group clinical skills test. We are
organized into groups of four to five students and cycled through 6(ish)
stations where we do mock patient interaction. So we'll be given a card
"prompt" that has a patient situation on it like, "Mr. Jones is here for
a recheck after an acute myocardial infarction 3 months ago. The doctor
wants you to give him a complete heart exam and take his recent history
before he sees the patient." (although usually with more detail.) One
randomly assigned student has to act out the appointment in 7 minutes
while his/her groupmates and a grader stand by, asking all the
appropriate questions and demonstrating the physical exam skills we've
learned this far and explaining their importance so the grader knows we
understand what we're doing. Our saving grace is that our groupmates
can huddle with us for 3 minutes BEFORE the mock exam so make sure we
know what we're doing, and then there's a 1 minute huddle afterward to
cover anything missed, and we can get points back for anything we
mention during that time period. So if I do a heart exam and forget to
say, listen to the heart, my group mate can point it out later and we
still earn credit for that part of the exam. And Thankee Lord, for the
*G*OSCE. If I were solo (in an OSCE) I would be shaking in my boots and
terrified now. Fortunately, my group is pretty darn competent and we've
been practicing all weekend and this evening and we've got pretty much
everything down. Still, a test is a test and a test is stressful :)
I recall writing in one of my email missives that I thought PCM was
pretty lame, in so many words. In a way, it still kind of is--there's
a lot of "wishy washy" information that is awfully long and hard to
absorb after you've been sitting in lecture or lab for four hours
already. I've actually come to really appreciate class. I'm very glad
that we at OHSU are starting to learn these kinds of skills in our
first year instead of having to play catch up during our 3rd year when
clinical rotations start. Not only are we covering exams, we're also
learning some important patient interaction skills, like how to work
with difficult patients (read: psychological problems, non-compliant,
hostile, etc), and how to deal with awkward situations like domestic
abuse or substance abuse. During a mock domestic abuse interview with
another student the other day, the awkwardness was palpable--just in
PRETEND patient interaction. How do I phrase this? Am I crossing the
line? Am I offending the patient? Should I push this topic? All of
these questions whirl through our minds and most of us have never
brought this up with a patient before. I'm glad we're practicing on
each other and in groups. However, this brings me to my lasting
complaint about PCM. It's supposed to be a great learning experience
with practicing these skills--but my PCM small group hasn't been
practicing! Our small group leaders chat our sessions away (one more
than the other) and we end up hearing E.R. stories instead of learning
how to look in each other's ears. With the test drawing closer, more
of us have become vocal about our frustration and asked our leaders if
we could practice instead of talk, and still we wasted time on
tangential topics, so we're all pretty peeved right now. *grumble*
Finally, a quick note about my preceptorship. It still rocks! The
doctor I work for is awesome (he is rising in my esteem to a near Dr
W-ness) and does go out of his way when he can to teach me clinical
skills. By listening to what my friends have described of their
experiences, I am definitely ahead of the curve in terms of hands-on
interaction with patients and a nice, understanding, somewhat hip and
very funny preceptor. It's family practice, so I haven't scrubbed in
on a surgery like some of my friends, but it's still pretty cool.
I've seen a few biopsies, a circumcision, and done a lot of exams.
Even though I'm only in for 1/2 day once a week, I've seen a few
patients 2 or 3 times, and it's really nice to see faces I recognize
(even if that means they're back in the doctor's office because of
presumed health problems). It reminds me of the satisfaction I got at
my old job from seeing people frequently and making relationships with
them. It's reinforcing in my mind that primary care is a definite,
likely avenue for my future practice and I feel very comfortable with
that. I just don't think I could go into a profession, and be HAPPY,
not knowing "well what happened to Mrs. Jones" or seeing people
regularly. A lot of my peers don't understand that, because some of
them believe in the glory of medicine, or "just want to cut" and
participate in acute interventions, whereas I'm happy to watch people
grow and help them do so over a long period of time. Still... there's
that fascination with the head/neck anatomy to consider now... gasp!
Melissa? A specialist? nooooo...
What of life outside school, you ask? Is there a thing such as this?
There is, in fact. I make sure to take time off every weekend and
relax, read a book if I have one (which I currently don't--any
suggestions?), go out and play with friends. I'm trying to organize a
little "wine/food/catch up/movie" night with some friends every month
so that we don't lose touch--it's easy to not see people for months at
a time and not realize it. My big bro & his wife gave me a movie gift
certificate card for my bday so I've seen some pretty funny movies
lately, too :) Yeay entertainment!Somehow, all the little things I do
to keep busy on the weekend don't seem to add up to all that much when
you lay it out on paper, but it sure seems busy. I could use a night
off. What am I forgetting?
Oh yes, my life-consuming passion. I'm still dancing every week, my
beloved West Coast Swing can't die in my heart. I may even be
improving. I'm plotting an excursion early next year to a dance
convention in california, one of the biggest of the year I understand,
and hopefully that will come to fruition. I vowed to restart Lindy
Hop now that I've proven to myself that I can dance AND get Honors in
school, so I even went out and did Lindy last week. It was SO much
fun--and such... ridiculously... good exercise. My relationship with
Lindy Hop is "one month on, two months off" (much like my e-mails?) so I
guess I'm starting an "on month" until I get tired of it again. THAT's
where all my non-school time goes...
I'm still dating J, and my beloved boyfriend can't die in my heart,
either. He tolerates the whole "no, I can't see you, I'm studying all
weekend" thing before tests (read: every other weekend) pretty well.
He's very supportive, and helps me as I need it--either to motivate
myself to study or to remind me to relax as I need it. I'm glad I
have him as another pillar of support. My family's been great too--my
mom calls me every couple days to make sure I'm healthy, alive, and
keeping up; Barb actually made me Halloween cookies to give me sugar
to study for a test, and they were GREAT! I had to fight my roommates
for them, but fortunately there were enough to go around. My friends
send me little e-mails to check in (or scold me when I don't check in,
*cough* Don and Carole), and that reminds me that they care and
reminds me that even med students need to be social ;) My point is
that I'm really lucky to have people who take care of me and keep me
going. It's a lot easier to tackle a hard test when you know there
are people around to catch you if you fall.
Well, hopefully this is enough of an update, if vague and short and
relatively un-funny (as usual, I'm sure), to keep the e-mail wolves at
bay. I promise I've reformed and hope to continue sending out
updates, if shorter, about how I'm doing at school. The bottom line
is: really well. But it IS hard and requires a lot of studying at
times. I definitely don't have the time or the money (stupid loans)
to do all the things I used to enjoy, or want to, even though I'm in
class now for half the time that I was at work last year.
Hugs to all, I miss you.
Melissa
email,
school