Jul 22, 2013

Clerkship

I hate my life.

But first, let's focus on the positives:
  • During my last entry, I had decided (although not revealed) that I was going to push my step one test date back 10 days to June 11th. Good news, I passed. 
  • I am now almost entirely moved into my downtown apartment. My room is still full of random stuff and I still don't have a well stocked fridge, but I know the area pretty well now and every weekend I go to the beach (within walking distance) with my friends. 
Okay, now on to clerkships.

I started with Surgery. At Lutheran. Widely rumored to be the toughest place to do a surgery rotation. Results are in: I hate it even though I love how much I'm learning and how much I'm doing everyday. In the last two-and-a-half weeks I have cried six times, every single time because of surgery. I am a mess. And I finally know exactly why so I'll tell you:

Being a third year medical student on rotations is like being a middle child: no one likes you and no one pays attention to you so you might as well die. 

If we were to compare the classical hierarchy of teaching hospitals to a nuclear American family circa 1950, the Attendings would be your parents, your older sibling is the residents, medical students are the middle child, and depending on group dynamics, the role of younger sibling is played by either medical students who are great at sucking up and being professional or interns. 

Attendings are the people you want to be like. They are your role models. Sometimes you hate them, but most of the time you love/respect them. They may make you upset because they yell at you and occasionally call you dumb, but eventually you realize they are right about almost everything. 

Residents are your older sibling. But there are a lot of different ways older siblings can act:
-We're in this together: Life is hard. But with any luck, your older sibling likes you and wants you to succeed. This sibling gets extra points if they know how to succeed. Residents can be good role models, just like attendings, but they can also be terrible influences. And as a young med student, you can't really know what's right or what's wrong yet. So you just pray these people are good influences.
-Too cool for you: Okay, you can't really blame someone for this, and to be honest, medical students are dorks. So...
-Constantly antagonistic: For some unknown reason, most likely being they are still bitter about that you took attention away from them (i.e., your birth), they hate you. They would never say that. But if they can, they will make you look bad. For fun. Because, to sum it all up, the world is cruel and if seeing someone else suffers helps you get through your shift, then someone's going to suffer. 

Essentially, residents will determine how you feel about yourself day after day. Your parents may be important to you, but sometimes, they just don't understand. If a resident physician tells you that you did something well, then you feel pretty cool and competent. Otherwise you're just a useless person who know one pays any attention to.

Finally, there are the suck-up med students, the little sibling who really just makes you feel worthless. Everyone is so much nicer to them for reasons you cannot completely elucidate. They are even nice to you--but only some times. At other times they are totally working the angle so they get more assignments. Everyone wants to be around them... nobody wants to be around you. 

Anyway, I'll probably post up something less... emotional, more analytical later. But right now, an hour past my bedtime, I'm genuinely shocked that I haven't quit yet. 

More good news I guess.

May 28, 2013

Thalassic

Thalassic is defined as "of or relating to the sea." Thalassemias are hematological conditions in which you don't produce adequate amounts of certain proteins that compose your hemoglobin (the stuff that carries oxygen around on your RBCs).

The name for this condition comes from the prevalence of this condition around the Mediterranean Sea, essentially: you live around a sea and your blood is messed up. However, another translation of Thalassemia would be something like.... "Blood full of the sea" or "Sea Blood" which sounds to me like the exact opposite of Land Lubber. I love it.

Unfortunately, there is a wide spectrum of how severe a thalassemia can be: from clinically silent to death in utero


13 days, 23 hours

I pushed back my test 10 days. I wasn't hitting what I wanted to get on my practice exams, and it didn't seem realistic that I'd get to that target in five days, no matter how much I studied. Also, I've probably spent over $1000 on books and reviews for this exam and all the courses it supposedly covers. I'd like to at least skim all the materials I have.

Oddly, my stress headache has returned. Which is impairing my ability to study. You can't overdose on Ibuprofen right? Damn it. I should know this.

HOLY .... ! IT'S ACTUALLY A TUESDAY! This update on my progressive is appropriately timed, then. And I'm taking the exam on a Tuesday. That bodes well, doesn't it? 


May 25, 2013

6 days, 20 hours

Continuing on with how poorly my body handles stress:

I've developed BPPV (benign paroxysmal positional vertigo) and the skin on my outer ear (my auricle) is peeling off and scabbing over and it is thoroughly gross.

I was going to claim that I have trichotillomania (compulsive pulling of hair) or dermatillomania (compulsive picking at skin), but apparently these are serious conditions. And even though I can't sit still and not pull my hair or pick scabs while I study, I feel absolutely fine when I get up to do something else (that's a lie. I never feel fine anymore).

Regardless, my exam is in 6 days and 20 hours. I have a box of Pop-Tarts, a box of Teddy Grahams, Hansen's natural cane soda, Fruity pebbles, and a box of Quaker Chewy bars. I also have about 65 more hours of lectures to watch. So.......

May 21, 2013

Rifampin blocks RNA Polymerase.

Okay, so I think I was being a tad melodramatic. True, this level of stress and constant cramming is incredibly dangerous to my health: I have lesions on the mucous membrane of my mouth, I bruise much more readily than ever before, I see so few people that I talk to myself and drag my teddy bear everywhere I go for companionship.
So I lied to myself. I'm going to pass step 1. Now I'm just studying. Not for a good score. Not to pass. But simply to learn. And it is fun. I'll tell you why:
There are fundamental concepts I just don't understand--never understood them--but now I have a chance to solidify the simplest things, and hopefully memorizing from this point will get easier as I develop a stronger framework.
I should have anticipated this earlier--I barely passed all my classes last year. UWorld tells me my worst subject is Physiology. Uh... what?That's not good! Physio is pretty much everything in medicine without a proper name (because pathology is actually everything in medicine, but it's just so obnoxious with all of it's diseases named after now dead jerks). So now I'm just focusing on physiology for a few more days than I originally planned. And I feel like that'll be alright.
Honestly, I just want to sound like I know what I'm taking about--even if it's just vaguely--when I step into surgery July 1st.
Speaking of....!!! I finally know the difference between prothrombim time, partial prothrombin time, and bleeding time! It was so simple I don't understand how biochemistry AND pathology overexplained it to a point where it didn't make sense. But it's probably also my fault, considering I thought plasma cells were platelets until recently. I AM DUMB.
For know...