Sort-of-finish-line with Gossip Gubernaculum

Yes, it's been so long since I've written on this blog that it's Christmas time! Such a jolly time. Christmas music, sweaters and socks are the quintessence of this time of the year. But I must reflect back now, to the tough times - the times through finals, pre-final studying/cramming/recalling and failing at these mentioned activities.

Post-midterms was definitely better in terms of coping with stress, catching up with classes and trying to stay sane with 8 hours (or more) of studying a day. In fact, I didn't feel horrible deep down when I took a day off during the week to watch a movie with friends or cook a proper dinner for myself and my roommate.

In terms of material - it wasn't really a smooth ride. Especially Biochemistry. We learned at least one cycle and it's clinical relatives every lecture. Biochemistry lectures per week were about 8 week while Histology only had 3. Anatomy kept it's pace at 7-8 lectures per week though. Catching up with the material wasn't too bad but the concepts and material became harder to retain and required more integration. This is what I learned to do post-midterms - integration. As you might expect, the study of medicine builds upon itself. But it only does if you build it in your brain. To quote one of my friends, "connect and recall" is what we need to constantly do as students. As simple as that sounds, it's not. You see something and you build it to your previous knowledge. Not so easy if "previous knowledge" is still something you're trying to master.

Efficiency - how has this improved? I knew what type of studying works for me and what doesn't. For the most part at least. I started making concept charts for Biochemistry pathways and memorized the hell out of Histology. Anatomy - spent a lot more time with lecture notes and atlas. And my finals grades improved, which suggests that these new, efficient study methods helped me. But there is always room for improvement.

So this term, we also has an exam called OSPE (Objective Structured Practical Exam). This exam consisted of all the clinical correlates mentioned in our classes and had stations for physical examination. This exam accounted for an insignificant portion of our practical exam in 4th term. But I worried about it and studied for it. We were told multiple times to not pay too much attention to it by our review session instructors and other upper term students. And it was true. One exam that actually followed the rumors and advice. It was easier than expected and the physical exam questions were simple enough. However, I found myself extremely nervous during the test. It was the first time we were being tested in a examination setting as "doctors". We had to wear professional clothing with our white coats with fake patients. Greeting the patient, performing the correct technique for liver percussion or testing the sternocleidomastoid, and saying thank you at the end of it seemed dreadful. Why was I being tested for this already!? I haven't learned everything yet! How do I evaluate myself if I'm right!? There's no process of elimination to figure it out....all of these thoughts raced through my mind before, during and after the test. And I'm afraid to say, these thoughts are just the beginning of it all....
I'm excited nonetheless for such challenges and the complexity it adds to my life.

A special note to my roomie: This is the first time I've had to share a room (besides family). Thanks for amazing late night talks about our lives, things we've learned in class, lesbians, weddings, siblings, philosophy, news, marriage...(I think that covers a lot of topics already lol). Thanks for starting Gossip Gubernaculum with me! Thank you for waking me up every morning with your alarm...and having a good laugh about it....everyday lol. A huge thanks for laughing about the million problems in our room. And to all of our cooking experiments and meals together I can never forget - thanks for enriching my circumvallate papillae. You're a great person and I value our friendship very much. Thanks to everything. It has been a wonderful experience starting medical school with you =)

Shoutouts to family, friends and an awesome bf back home for keeping me sane! Thanks for bearing with my long periods of not-speaking to them because of studying =)

At this point, I think it's safe to say that we have reached our sort-of-finish-line in medical school - end of Term 1! Here's to a great rest of winter break and a strong start to Term 2 filled with Neuroscience, Genetics, Immunology, Physiology, Parasitology and round 2 of Bioethics! Will keep you guys posted on what's up during winter break.

బట్టర్ స్కాట్చ్ 

81 milligrams of Aspirin

It's 4:27am and I should be sleeping. I could finish reviewing my notes on Nitrogen Metabolism. But I'm gonna write here instead. I've isolated Ligamentum Flavum for too long. It's been normal for me to up at this time either studying or feeling anxious about tomorrow's study session. I've been studying for about two and half months. Sadly, I still haven't figured out how to be efficient with time or my study session. Maybe I am sometimes but I don't know when/what that is. And yes, getting a lot of work done is considered productive but our daily intake of information is so large, it's hard to tell. It's like swimming in the ocean here. Sometimes you're swimming so hard for a good 5 minutes and you realize, you haven't moved that far. I mean, look at the ocean. It's astounding.

Speaking of shooting stars, I've seen at least 30 shooting stars so far. I ran out wishes to wish for. And after the 18th one or so, I just enjoy that jolt of excitement in my heart when I see one. Some of them are very distinct and stay in the sky for a good 3 seconds. They're truly gorgeous. I wish I could catch one and sit on and be wished on.

So classes. Yes, I've been attending classes since midterms. In fact, I haven't missed any yet. But it still feels like we took our midterms last week. In Biochemistry, we recently learned what happens when people ingest 81mg of Aspirin (among a million other compounds, enzymes, cofactors and all). I mention this specific detail for a reason. It's one of the details I've always wondered about. 81milligrams. Or any amount of milligrams of a drug. How do doctors know what specific dose to give to a patient? Well, I learned how 81mg of Aspirin works in our body to the cellular and enzymatic level. It's considered a low dose. And it made realize how important every detail in my notes will help me be a better physician later on. At the end of the day, you can only depend on your knowledge to make sound decisions; for now, I'm happy that learning about the lengthy eicosanoid pathway will help me prescribe an NSAID to a patient.

I have to put down my thoughts about SGU in general. I've been treated really well around here. The professors have always been encouraging to us as a class and during office hours. One of our Anatomy professors told us a story about a student from years ago who attended SGU - Bob. He apparently studied intensely during his Basic Sciences classes without taking a breaks. Ever. And he was able to get through medical school with a good GPA and was able to land a residency somewhere in California. But sometime during his residency, he shot himself because of all the stress in his life. Yes, this isn't an encouraging story at all. But our professor told me this story in person and he mentioned it to the entire class. And his point was to relax at least once a week. I'm starting to realize how much more stressed I was pre-midterms. Yes, we did have one extra class - Bioethics, but relaxation never crossed my mind and I was continuously under stress and being stressed was the normal state of my mind. After midterms has been much better in terms of the way I relax and noticing when I should stop studying.

So the biggest lesson I've learned so far in medical school is to realize my weaknesses and improve on them. Everyone has strengths but mastery of material and understanding requires careful introspection. And that minute detail you know you'll forget, remember it and come back to it again. And again. And again. Until you remember it so much, you can teach it to someone else.

RandomSome of my friends and I have been feeling this peculiar thought everytime we try to remember the date. We still think it's August or closer to September. Time somehow froze in our mind. I guess that means we're living every moment right? I have no idea. But I've certainly enjoyed the random study sessions at Subway, dancing the night away 5 hours after our midterms, concocting food out of random ingredients, having an elaborate discussion about the innervation of the forearm on a walk, that 10 second glimpse of the ocean as I slowly descend the steps to cadaver lab, climbing up the huge hill that has become a "good exercise" for the day, and best of all, late night talks on the dock.

Time for some sleep...keep smiling =) Make it meaningful.

Taylor

I've been wanting to write a blog post but got caught up with all the fun after midterms around here. Our school really cares about us and realizes that we need to relax after a marathon week of midterms. And by marathon, I mean a marathon. We had 3 midterms - Monday, Wednesday and Friday. We studied at all times of the day...and night. I would review by myself, with a group of friends, with my roommate, and in my sleep. It's like my brain was programmed to process and connect dots at all times. This is how a computer must feel.

But I'm glad that's over. At least for the moment. I feel somewhat successful getting through the first set of midterms of medical school. By the end of the week, my brain felt overloaded...it was a rather strange feeling. I felt nothing. And all I craved for was a good meal at the end of it all.

Now, I'm trying to get back into a routine. Or rather figuring out what a routine would consist of.

I realized that I don't go to the dock as much. The purpose of going to the dock was to relax, relieve my stress and just take in all that the ocean has to offer. I guess with midterms and post-midterms relaxation right in my room, I haven't needed it much. It's become more of a social spot to go to with a bunch of friends at the end of a fun night.

Speaking of nights, at the end of each night after studying at Taylor Hall, I spend the 30-50 or so steps walking slow, yet steady, enjoying the sight of the sky. I've always appreciated the existence of stars and the moon. Here in Grenada, they're much clearer. But I usually start noticing everything I've studied that night. Tonight, I could see the epidermal ridges interacting with the dermis. I could point to you, every layer of the epidermis and dermis in that white ghostly figure. And when I look down, I see dense connective tissue lining the curb of the street. Call it sad, pathetic, mentally disturbed...I call it the evolution of a medical student's mind. Every person has a lens through which they see the world. Even though I love this new lens I'm creating in medical school, I want to be able to see the world through all of it's colors. I wonder what others see when they look up during a busy day to notice the sky and it's vastness.

I have much to write about....but I will keep you guys hanging for now. 

Unified ocean

Picture yourself standing on cliff of an island. Imagine a storm pouring down on the ocean. Now picture yourself being in it and watching the rain pour down on the ocean and creating that blurry haze from seeing that island in the distance but at the same time, feeling completely connected with the ocean in the pouring rain. I was there. I closed my eyes, to make sure it was all real. And it was. After that I jumped into the warm, Caribbean ocean water. The ocean instantly embraced me with all of its glory. What am I compared to it's majestic strength? Just another one of those humans who can be swallowed and washed away....
Usually, I'd want to take as many pictures as I could. But in that moment, it was too powerful and overpowering to witness nature's beauty. There is no way a picture or any number of pictures could have captured the wondrous sensation.

It was definitely a good break from 4 weeks of studying non-stop (almost). I feel more alive. I also cooked some food that can last for the next two days.

And as for what's going on education-wise around here, we just took our first quiz in medical school. It was called the Unified Assessment Quiz, about 5% of our grade (in each class) and it's purpose is to make sure we are keeping up with the material and making sure we're studying the right way to perform well on tests. There were 25 questions for each subject - Anatomy, Biochemistry & Histology and we had an hour and 45 minutes to complete it. It's amazing how much everyone has studied for a 5% quiz. Some people said it was like studying for a final...this, I agree with. I was up till 4:30am this Saturday trying to understand every detail of Biochemistry. Oh yea, and I have been studying every day since the first day of classes. After the quiz, I felt like I should have studied more. I guess we'll never be well-prepared. But studying definitely helped me answer questions and put down correct answer choices, so I have to give it some credit. Understanding and memorization are key to scoring some easy points. In reality, the true test of our knowledge will be our patients. Hopefully when we encounter patients with Sickle Cell Anemia, we remember that there is a point mutation in their genetic code or realize that we need to do a spinal tap in between L4 and L5 to test their cerebrospinal fluid.

To quote my Anatomy professor, all of us feel as though we graduated from medical school. But as the evening approaches, I feel the need to get back to my routine. I value my free time like a delicious piece of Dove milk chocolate (with raspberry filling), and I realize the importance of keeping up with the material. I have a small aspiration though...someday, somehow, I want to be "ahead" of the material.

In our last Bioethics Small Group Discussion (this class will be ending next week...and yes, that means a final exam on Monday), there was a peculiar phrase that the facilitator mentioned that caught my attention immediately. Our topics of discussion included Physician Assisted Suicide and Climate Change and it's effects on health. As we neared the end of a case, the facilitator said, sometimes physicians make decisions for "The Greater Good". I can't imagine making a decision for the "The Greater Good". Isn't that what Batman or Spiderman would do? How does patient-assessment, ordering CAT scans/MRIs or even writing a prescription help the greater good. What is the greater good when it comes to a patient or a family? It is specific to certain medical cases, yes, but it's amazing how much power is being invested in us, future physicians.

My poetic skills came out tonight and I shall share some of my less-than-average creativity with you guys. I didn't know what to title it so I'm calling it:

The Greater Good

a drop of rain descends
stretches and relaxes
and meets my epidermis

part of it squeezes through
and the rest bounces,
surrenders to gravity
and oscillates with
the gentle wave

Sayonara until next time.

Flexor Digitorum Profundus

Hello humans. This is going to be a blog about my experiences in medical school! That's right, I'm a first year medical school. I'm going to St. George's University in Grenada, which is known as the Isle of Spice in the Caribbean. Yes that's correct, it is gorgeous down here. Everywhere you look, it's beautiful. It's helping me tremendously to cope with the stress of being a medical student.

In my opinion, having this blog is one of my greatest privileges. Publishing a post seems worth it. Everything I've read, learned about and looked forward to, has come true. So did the common burdens/extra efforts of being a medical student - eternal studying/learning, adjusting to the least amount of sleep needed to get up tomorrow, always being on time and professional, and a million other things they've been teaching us since the first day. Thankfully, I enjoy all of it. And right now I love reading about ligamentum flavum in my spine and flexor digitorum profundus that's helping me type this.

I'll dedicate a part of this post to describe my typical day. From 1-5pm from Mon-Fri, we have lectures. Four days of the week (our schedule keeps changing every week), we have labs/small group discussions from 10am-12pm. One of the 4 days, we have anatomy lab from 7:45am - 12pm. As for how much material we cover - a week's worth of undergraduate course material is covered in one day. This semester, we're taking Human Gross & Developmental Anatomy, Medical Biochemistry, Histology & Cell Biology and Bioethics.

What do I do the other hours of the day? After lectures, we usually study at a great study space called Taylor Hall or the study rooms in my dorm. I try to move around and study in different places. And during our well-deserved breaks, we usually go to this dock right behind my dorm that overlooks the ocean and if it's at night, we enjoy watching the stars. If you're lucky, you can see some shooting stars. I've seen 5 since I've been here. I also like to cook food as a study break/survival mechanism. But, most of the time is dedicated to studying. Anatomy, Histology and Biochemistry demand a lot of memorization and understanding of the material, and that's basically what takes up my time on a typical week day. I also attend some review sessions held up upperclassmen and go to open wet lab hours to learn the structures on cadavers.

In our Bioethics class, however, I think a lot about the topics we cover in class. One topic really struck me during the last lecture. We learned that morbidity rate is highly correlated to poverty. It's implying that money governs the type of health care a human can receive from physicians (and how much money a person has depends on various factors). A bit irrational? To me, it is. People who cannot afford health care are also the people who tend to develop disorders due to malnutrition, poor living conditions, etc. But a lot of advanced medicine is derived from trying to cure disorders humans have previously had or witnessed. Physicians and researchers don't try to find cures to diseases that don't exist. Take the military for example, physicians learned a lot of the anatomy and how a human body can really be injured through battlefield injuries. But patients who come to the hospital everyday with interesting (?) illnesses are the ones who cannot access proper health care - a lot can be learned from them as well. Somehow, all of this leads to my thoughtful conclusion - people developing disorders/diseases with less access to health care are helping future generations by educating physicians about medical illnesses and regulations of the human body. In my head, I think I just went around in a circle. Moreover, I neglected numerous factors in this analysis...but I think it's a good start to thinking about issues of health care and access to health care in the US and in the world. Bioethics definitely stimulated a nerve-firing thought during my third week of medical school.

Coming back to my current life, I sometimes stop during my long hours of study and be amazed at how much my brain can process all of this information. I might have forgotten most of it. But as I read and learn, I understand. I'm proud to be part of this school and I enjoy my study breaks to look at some breathtaking sights on this rather small campus. After the White Coat Ceremony and a full blast with lectures, labs and discussions, it's starting to sink in that I'm a medical student, a future physician. One last thing before I leave, I want to mention that physicians play a huge rule in the society (yeah, you probably expected this statement from a medical student). They're known as the cure-alls, the smart people, the authority, professionals, the "higher" and magicians who take the pain away. But I don't agree with this idea. I'd like to think of myself as just another human trying to figure out a problem...and it just happens to be about the human body. As a future physician, I hope I'm not considered God, but rather a modulator of this society....like a paintbrush or another color of paint to make this artwork of life look a bit more beautiful, lively and profundus.

Back to the hussle....