Globally

I consider myself very accepting of behaviors cultivated by other people. I don't like preaching to people about what they should be doing, health wise. It's hard for me to walk over to a person, especially a friend whom you respect, and tell them: "Hey! You need to watch what you eat. You can't just keep eating frozen dinners…" or "Listen. I don't think it's safe to smoke as often as you do."

The first topic, diet and weight, is especially touchy. Either you're eating too much or you're not eating enough. A lot of my female friends seem to have actual eating problems, but how do you tell someone to stop worrying about how much they weigh? If I remember psychology correctly, anorexia, full-on, actual anorexia, is a devilish, tricky thing to treat. Perhaps equally uncomfortable is telling someone they should be more selective with what they choose to cram into their mouths. Fat isn't necessarily bad. I don't subscribe to the notion that the less fat you have, the better. But I do think if you're going to eat a ton of food, it might as well have "good" fats in it. That's why you shouldn't eat frozen dinners. The amount of saturated fat in prepared foods is horrendous. And saturated fat is bad for you.

The second topic, however, is interesting. I still don't fully understand why people smoke cigarettes. I've probably had about ten to twenty cigarettes in my entire life and I don't think they have ever done anything for me. I know they're bad for me, every student in the United States probably knows that they're bad for the human body. But in medical school, you get even more details about the absolutely horrible things cigarettes can do to your entire body. 

So why do people smoke? It will kill you. But it's a pleasure not reserved for just a few. Almost anyone can afford to smoke enough to kill themselves. It may be one of the world's greatest equalizers. Which should be depressing, alarming, and troublesome from a global health standpoint… The World Health Organization has some data points of the most common causes of death in both the Developing and Developed worlds. Diseases springing from polluted water? Developing world. Diseases spewing from eating too much? Developed world. Diseases arising from cigarette smoking? The entire planet. 

Fun stuff, global health. Does it help remind us that we are all very much the same when we realize that a sizable amount of deaths result from a vice? 

And as a physician, how much vice can you allow before your professional duties outweigh interpersonal courtesies? 

Expectations

I did not want to have ADD. On a personal level, my peers joked about the “stereotypically” ADHD-afflicted individual—or smuggled Adderall into parties. On a social level, the overall astronomic increase in diagnosing individuals with mental problems made me distrust the industry (pharmaceutical companies) and its purveyors (psychiatrists).

I expected the psychiatrist to be annoying and pushy, like most guidance counselors, who are surprisingly great at not listening. But the faux leather couch I was instructed to sit on in his office was the softest thing I had ever sat on and shortly I no longer felt that seeing a psychiatrist was a negative reflection on whom I was as a person.

I expected all psychiatrists to have calming voices that lull you into accepting their verdict, whether it is correct or not. Any physician can point to my blood work and conclude without error that I am 100% diabetic. How do you point to someone’s anything and say they are 100% clinically depressed or manic-depressive? I assumed my psychiatrist would ask me a couple of questions, diagnose me with whatever condition I came in to question, give me a prescription, and send me away.

Instead, my psychiatrist invited discussions, participation, about a number of things. I felt I had a chance to convey my skepticism, which he listened to before changing the way I looked at the diagnosing of mental illness in the US.

In a way, my expectations were superseded. I had feared the worst. I expected no one would listen to me. It was odd, but reassuring, to have a physician make note of my fears and aspirations before sending me away. Yes, psychiatrists should be forced to interact more closely with a patient’s psyche, but why not all physicians? Diabetes is still terrifying—should that blame then fall on endocrinologists?

Temporal Orientation x 3

A funny thing has been happening all year long. I may have already mentioned it, but it bears repeating again: I have no idea what time it is.

I mean, okay, it's past midnight and it's now Tuesday February 21st; the only reason I know this is because my laptop has this exciting information ready for me at the upper right corner of its screen. But if you had asked me early monday morning what today's date was, I probably would have had to check something--a phone, my laptop. Something electronic because my mind can't remember things.

Time has never passed this quickly for me.

It's kind of terrifying. But scientifically it makes sense. It's been researched and it's been concluded that the more repetitive our lifestyles, the faster the illusion of time flies past us. If, everyday, you wake up to go to lecture for four hours, then spend the afternoon and night studying, your life will fly by because your mind has already built up immunity against the excitement that is studying all day for medical school. This is why older people generally feel like time is passing them more quickly than when they were younger.

So time flies. And it's deeply upsetting me. Last week was Valentine's Day. I often say that Valentine's Day is my favorite holiday. Of course, Christmas can put up a strong offense. But Christmas is sometimes really bad. Winter holidays can be dangerous with the amount of time you have to spend around the fam. Valentine's Day, however, will always be more or less the same. You're either in a relationship, or you're not. I don't understand why people go out of their way to hate it so much. It's predictably going to  be a day that encourages parties to be thrown on the weekends surrounding it.

But Valentine's Day came at me so quick that I didn't have time to make cute and funny cards. I've also missed two of my best friends' birthdays. I have a hard time remembering what month I'm in. I'm always finding myself disoriented whenever someone tells me a date for an important event that I know I will forget.

Guilting Eyes

Anatomy practical is coming up. Since I failed the first one, I kind of need to do well on this one. B is a must. So I went into the lab today. It was a scheduled event, so it's not like I put too much effort into it. But as soon as I started reviewing with a group of my peers and an instructor, I realized how many details of anatomy I had let my group completely gloss over during our dissections. Panic has now descended.

I am not too worried about the abdomen, because everything is more or less straightforward. Hey! That vessel going to the spleen? It's either the splenic artery or the splenic vein. 50% chance of getting that right! Yay! The neck is another story. And I do not know how fond of studying it I will be since I made a horrible discovery today.

Our body, Debbie, is absolutely wonderful. Which is why I am so ashamed we have done such a "just okay" job with her. One of the nice things about Debbie, however, is that her eyes are completely shut.

The first cadaver I was at today--as the instructor pulled the two halves of his head every which way to look at his neck and then his oral cavity--seemed to enjoy giving me the eye. That's right. I could see its eyes. It was absolutely horrifying. I tried to look away, but how do you look away from something looking at you? Especially when it's so human?

But he wasn't even the worst one. There was another cadaver who had a really interesting amber eye color. I wanted to look more at it, but when I realized that I was essentially gazing into this person's last unadulterated possession, I kind of lost it.

I feel a lot of guilt in anatomy lab. If I do poorly, I'm not only letting myself down, I'm essentially telling the recently deceased that I don't really care about them at all. They are clearly still human. We've removed a lot of fat and skin and muscle. We've carelessly, idiotically removed many a vessel and nerve. Yesterday we removed their legs! But they are still clearly human. And as such, I should probably feel more than just helplessness every time I walk into lab. Anatomy is by far my hardest class. But not simply because it's difficult material for me to process. It is difficult because I consciously recognize its import. Technically, Biochemistry is my hardest class, if we look only at my exam averages. But anatomy makes me feel horrible in a way I can't just argue away with simple logic. Anatomy appeals to my darkest human emotions: the image of myself, a body--one among many--laying in the various deconstructed poses of post-mortem torture is much more excruciating than knowing that I may never memorize the complete citric acid cycle*.

So I've thrown myself into studying for this lab practical. I will report on how I did the morning after Valentine's Day. That's right, we have a lab practical on Valentine's Day. Because I guess the guy who organizes exam dates figured it wasn't enough for us to just be stressed out medical students. He also wanted to make sure we wouldn't be able to enjoy the holiday. Try eating a copious amount of chocolates, or ice cream, or smelling roses, when you're bathed in the clinging stench of formaldehyde.

*Fun fact: I have memorized the citric acid cycle. It is interesting.  One of those last two sentences is a lie. Apologies.

Today in Anatomy...

We removed our cadaver's leg. It was pretty gruesome. Possibly more gruesome than sawing her skull in half with a hand saw. Life is sometimes weird like that. The weirdest things will gross you out. Like, the third week in anatomy lab, we were covered in flesh and embalming fluid--formaldehyde. One of my lab partners burped and I yelled "Ew, gross," because I find burping in someone else's face distasteful. In reflection, that was probably one of the "cleaner" things I did that day.

Other than that, I now love anatomy. I do not know if that is because I am doing poorly in it and need to straighten out my act to pass the course, or if because we are finally covering the abdomen, and all your organs and mesentery form the most intricate, beautiful patterns I have ever seen. I spent a good hour losing myself gently separating connective tissue from the small intestine and associated organs. It was mesmerizing. It seemed like everything was an artery, a vein, or a nerve, forming crazy plexi and complex associations.

Much more interesting than your limbs. I swear, your forearm has seventeen muscles in it, and I think the majority of them are useless. Another point, you can survive without an arm. Hell, you can survive sans-limbs. It's not fun, but you can live. You can't live without your liver. Or your heart. But your life would also suck without your kidneys, pancreas, spleen, or your intestines.

Yes. I am really excited that we are finally learning something important in anatomy.

Sadly, my podiatry student lab partner does not feel the same way. If he's not working on the legs, he gets a tad restless. Restless leg syndrome, I'd call it.

Was that a good pun? I'll keep working on them. I don't think I can be a good doctor if I'm not good at puns.

Clinical Anatomy

We have a medical doctorate holder teaching our Clinical Anatomy course! This is very exciting. But also terrifying, because his notes aren't like any of the other instructor's. Regardless, this is looking to be my favorite section, and I'm not sure if it's because of our professor's quality as an instructor, or because organs are inherently much more fascinating than all seventeen of the muscles in your forearm.

Regardless, perhaps the most adorable and terrifying thing our lecturer has said thus far was this:

"The pancreas, with a head, body, and tail, is like a little animal."

In reflection, I realize that that doesn't sound very funny, or cute, or scary. But keep in mind this was told to me at around 8:30 in the morning. Everything is funnier, cuter, and much scarier at this time. I also have a lot of trust issues with my own pancreas, especially after it gave me diabetes.

Also, since my parents met while operating on a pancreatic cancer, I've always been a little worried that I might get pancreatic cancer myself. Though that may have a lot to do with my irrational superstitions.

No matter. Thinking that my pancreas is a cognitive individual is incredibly frightening.

And ridiculously funny.