Big Bad MS3

I haven't forgotten to post; I've just been really busy & temporarily distracted.

Promise to update more fully.... sometime. Now that I'm spending 10-11 hours daily in pediatrics, it's hard to remember to do things that don't involve hospitals & clinics -- like preparing for lunch, making sure I have clean(-ish) clothes, remembering to refill prescriptions, etc. Don't worry, I'm still comfortably afloat, just rather disorganized.

It's probably lucky that my cat doesn't depend on me for survival right now.... Although I'm sure he'd never allow me to forget him.

More soon -- if I remember...

Springing

I've decided that if I wear colors that are bright enough, I can force spring to get here faster. I'm not saying it's thanks to me -- but it's been a good bit warmer the past few days...

Wissahickon Park time!! (This pic is from last November, when it was still warm enough to play outside -- but only just.)

Unfortunately, much of my spring is going to be occupied with studying -- which is really a shame. (Countdown to Step 1: 54 days. ACK! Panic attack!) Maybe I can find a nice outdoor study site... I need to find a good place to study, anyhow - like a public library, maybe. Somewhere quiet but not absolutely silent, with plenty of natural light, climate controlled, without things that look fun enough to distract me. Starbucks works pretty well, but I really don't think I want to go there every day, for the whole day, for 6 straight weeks.

In the last unit of second-year: Hematology & Oncology (i.e., blood & cancer). We're a week in, and I actually haven't fallen too far behind yet! I have, however, been abnormally fatigued the past couple days... Can't quite figure out why.

Today I have my end-of-second-year OSCE. (Objective/Subjective Clinical Exam? I'm not sure on that.) It's basically a history & physical -- or, rather, several of them. They then grade us on how well we did. We have one near the end of every year, and they progressively get more difficult. This is actually rather anxiety-provoking, because there are a LOT of physical maneuvers and a LOT of ways you can do them wrong, and there are a LOT of questions you need to ask (and a LOT you don't need to ask!), and there's only 20 minutes to do it all!

Now I've gotten myself worked up. Need to use the next 45 minutes to calm down. Then my OSCE from 4:00-7:00 (worst timing ever!), then homeward bound for studying... I'm kidding - I'm going to eat, watch TV, & go to bed!!

Songs, Hospitals, and Intestines

I bid neurology and osteoporosis adieu, and prepare myself to be buried in GI. Yes - it really is as disgusting as it sounds. We spent all morning -- four straight hours -- in lectures about diarrhea. Really makes it difficult to choose something for lunch.

Last week was pretty crazy simply because of the final exam on Friday. Didn't get a whole lot of sleep throughout the entire week. I passed, with a narrow margin of error. Luckily, due to what was described as an "error in statistics" and a "bimodal peak" formation (translation: half the class failed), I gained a good 4%!

Studying for the USMLE Step 1 is well underway... Not well underway exactly, but it is in progress. I ordered Doctors In Training -- a program that helps you review all the material from the past two years. They email me fifteen questions on Mondays and Thursdays... But since I didn't sign up until last week, they sent me all of January's questions at one time. And with the craziness last week, I didn't actually do many questions.... Suffice it to say, I'm a little behind. Like, 150 questions behind. But it's hard to balance along with regular class work.

Why would they save hematology & oncology until the end of the year? March may be a bit rough for me...

Bought a guitar on Monday. It's decently good quality, especially for the price! I can already feel calluses forming on the fingertips of my left hand... which is good, because I'll be able to practice a lot better if it doesn't hurt! I think Kitty's a bit jealous of the attention it's getting.

I think guitar is one of those things that I've thought about (or even attempted) doing before, but I never got very far because I was fairly sure it was too difficult for me. Kind of like graduate school. It seemed like such a difficult task, and I either didn't know how or didn't put forth the effort to find the resources to help me. Lack of motivation? Excessive self-doubt? I'm not too sure what it was, but I figure there's no time like the present to overcome it.

Besides, I need an intermittent distraction from mucosal membranes, serous antibodies, and bacterial exotoxins -- something that has NOTHING to do with medicine.

Speaking of - the Transplantations (our school's a capella group) is performing at a concert on the 26th to benefit CHOP (Children's Hospital of Philadelphia). A capella groups from Philadelphia med schools get together for it every year -- U Penn, PCOM, Drexel... I'm thrilled, because I have a solo in the song "Rabies" about being bitten by a fuzzy little friend, and Alisha will be rapping -- it'll be a blast! As long as my throat doesn't close up when I get nervous... I seem to have a slight bit of performance anxiety...

This week has been rather busy, mostly due to Doctoring events. Monday I had an OSCE (basically, a history and physical on a standardized patient), and today I had the follow-up OSCE -- both in preparation for my end-of-year OSCE. (Everyone gets points deducted for something - doing a maneuver incorrectly, not determining the full history of illness, etc., so I don't exacly expect to be perfect. I just expect to pass. And if today's was any indication, I should be okay.) Tomorrow afternoon will be spent in the pediatric hospital, again practicing H&P skills. Last hospital session of the year!! And Friday... Friday will be intense.

For possibly the first time in my life, I'm in a lottery. Your number determines your priority, and the entire afternoon Friday will be devoted to setting up the order of our rotations throughout our third year. I've been having trouble nailing down my preferences... I could see myself ending up in Peds, OB, Psych, or Family Med, and I have to do one of them first. (They typically recommend not doing your area of interest first - since your skills won't be as well-established and you need the doctors' recommendations for residency - nor doing it last - since you'll have already determined your fourth-year schedule by then, and if you end up hating your area of interest you'll be in a jam.) The second semester, I want to do: Internal Med, Surgery, and Neuro -- in that order. I doubt I'll have an interest in Neuro (plus, I think I'll be doing research for my elective... blech). I don't really know yet whether I'll like Med or Surgery, so I want to have them early in case I do!

Being undecided makes all this so much harder . . . . Plus some rotations are at different campuses -- in Reading, Upland, Lehigh Valley, even as far as Pittsburgh! I definitely want to have a rotation at Geisinger, since it's a more rural environment, but moving to another town for 6 weeks seems like such a hassle!!

Sometimes, I feel as though I have to make a conscious effort to keep my head from exploding. I promise I'll try to delay it as long as possible.

From Here to Insanity

Apologies for the infrequent updates... Although once per month really isn't bad for me.

Been back at school for a week. It honestly feels like it could be a month-- except that I haven't had an exam yet. Got sick -- again -- upon returning to Philadelphia. Decided I must be allergic to returning to school. Should carry an epi pen after all major vacations. At least this round wasn't stomach flu, but it was still pretty debilitating for a few days...

And so, I once again start the block a few days behind. *sigh* I'm almost caught up, though - after spending several hours at Starbucks this weekend. (I think the baristas are starting to get annoyed with me; maybe I don't spend enough money to earn the right to stay there so long?)

Topic of the month: neuro. So far, we haven't gotten past psychopathology. I was once told that this time of year is the most depressing: the holidays are over, people have to get back to the daily grind, and yet there's still so much cold and snow lying ahead... Really bad timing for psych. The psychiatrist who organizes most of the lectures is determined that we grasp the mechanics and magnitude of mental illness. We watched a mandatory documentary -- "The Bridge" -- that covered the stories of people who had jumped from the Golden Gate Bridge. (I know, Mom; you must be cringing. Like in 5th grade when we had a unit on Anne Frank.) It was intense and, at points, rather hard to watch. (Apparently, that bridge is the #1 spot in America where people go to commit suicide. I suppose the railing on the Empire State Building is too high.) Directly after this movie, I was forced to participate in an exercise in which I had to tell an unsuspecting patient that she had less than a year to live. Even knowing it's a fictitious simulation just for the sake of the learning experience, telling a mother that she has aggressive, incurable brain cancer is not an easy thing to do.

That day . . . That day was rough.

The good news is that I already know several of the drugs either from personal experience or from working at the group home. Unfortunately, I'm pretty sure they name these drugs by pulling out a handful of Scrabble tiles and slamming them down on a table. Now if I can only remember how they work on a molecular level...

This week holds: much more neuro, an afternoon in the hospital, and a four-hour instructive session on how to perform a reproductive exam. It's going to be another interesting one...

Girl in the Bubble

It's been a rather rough week...

At least Thanksgiving was fabulous! (And delicious!) It seems I'm never sure whether or not it's worth it to go all the way back to Indiana for a short period of time, but I always end up glad I did. Even the drive wasn't that bad - aside from holiday traffic on the turnpike holding me up an extra hour. I hate that that highway is the only convenient way to get across the state. And it's even more irritating that it's a toll road, so I'm paying to wait in a long line of cars with no feasible alternate route.

By the way, it turns out that a larger carrier does not make Kitty feel any better about car trips.

Anyhow, a short six hours after returning to my apartment, I woke up in the wee morning hours with a alimentary canal-cleansing stomach flu. Still don't know how and where I got it. Most of Monday was spent in and out of sleep. Tuesday was the same, but without the purging. I would have recovered nicely, but for the migraine that set in Tuesday night and carried well into Wednesday, keeping me from sleeping. It was a pretty awful night. It took me awhile to realize that my neighbor's TV wasn't actually getting louder; it was just gradually causing me more pain. Thursday I finally went to class, but still felt pretty nauseous and gross. I just today got to the point where I'm almost actually eating normally....

Like I said -- rough week. Every time we start a new segment, I tell myself that I'm going to hit the ground running and stay on top of all the material. I never do. But at least this time I have a good reason.

Registered for the USMLE Step 1. (Can you believe it -- I've been at it this long and this is only step one?) Mark your calendars for May 4th, people! And don't expect me at any event between now and then, because -- if all goes according to plan -- I will be deep within my study cave.

Alisha & I plastic-insulated our windows this week... which is good, because they're pretty drafty. (Still a little. Need caulk.) It's really rather fun, like living in a bubble of saran wrap. Kitty's not a fan, though... Hope he doesn't find he can destroy it with his claws; there's a finite number of times I'm willing to re-insulate a window...

Post-Pulmonary

Good news - I have passed cardiac and pulmonary pathology.Went a little crazy with the final - apologies to Mom for not talking to her all week. I wish the weekend were longer... Had some intensive retail therapy with Alisha yesterday -- plus a nature walk in Wissahickon Park. Aaaand I have new sweaters for the season!

Not happy that winter's coming up... The idea of several layers of clothes, ice on my windshield, and sunset at 4:00 just doesn't excite me. And, of course, I'll have to deal with three months of it . . .

Not sure yet if I'll be home for Thanksgiving... Thinking I will -- but I'm not sure what to do about the cat. I'd rather fly than drive, but I'm not sure if it'd be worse to leave him alone for four days or to put him through a plane ride... Well, I still have a couple weeks to figure it out.

Next block is renal/endocrine. I like that there's less physics involved. Plus, these were the systems I did especially well in last year, so that bodes well... Need to get working on Step 1 preparation soon... The exam isn't until May, but it's going to require months and months of studying..... Maybe if I ignore it it'll go away. :)

Physics: My Old Nemesis...

Almost as evil as stairs.

Survived Microbiology. On to Pathophysiology. First stop: the heart. Not that cardiology doesn't interest me, but it just involves so much physics!! Pressure, flow, cross-sectional area... It's too much for a Monday morning. I was SO not ready to come back to class today... I somehow lost ten minutes this morning -- or maybe I just thought I got up earlier than I actually did.

Ugly story regarding those tests last week....

Good news first: I definitely passed the final. No grade yet on the shelf exam. My physical conditions again had horrible timing... The night before the final, I somehow exacerbated the chronic cramp in my left shoulder, and it became an unbearable spasm radiating up into my neck. Didn't sleep at all that night (this is becoming a horrible pattern for Wednesday nights), was glad that I didn't wake up Alisha with my pained yelps. (It was pretty ugly at some points.) When she woke up & found me, she convinced me to go to the ER before the exam. We'd been told before that if we just said we were med students, they'd practically fall over themselves to help us. As it turned out, I had to be a bit pushy -- which I hate, especially since the nurse seemed to think I was quite an annoyance -- in order to even get out of there in time for the exam. The only thing that got me through the exam is acetaminophen with codeine, leftover from a tooth infection. (Amazing that it didn't put me to sleep!) Once the test was over, I filled the prescription for a muscle relaxant - the one thing I got out of the ER visit - and SLEPT like the dead!! Didn't even manage to study for the next exam. Woke up early the next day, and found my pain to be incredibly tolerable -- SUCH relief to have an almost-normal range of motion again!

Still have pain in my back, it's just slightly worse than it normally is. Will see my doctor about it this week, whenever I manage to find the time. And it turns out I'm allergic to the muscle relaxant they prescribed me. That would figure.

The weekend: I decided I deserved some relaxation, so I went to redeem this voucher I'd bought for month-long access to "spa services." Arrived at the place to find that it was pretty much just a tanning salon with a few extra "spa" machines... Not. Pleased. Felt that walking out would be too rude, and since I'd already paid for it I got a "facial" (misted in the face), a steaming, and a spray tan. Was so upset that I'd spent $50 on orange skin (that stinks, and will probably give me adenocarcinoma in 20 years) that I wrote an email expressing my dissatisfaction. A refund would make this better, but I'm not expecting it.

Need to get with it again! It's going to be a full sort of week...