Officially in da clinic, say whaaat!

Well..... after a long couple of months studying for finals and the dreaded USMLE Step 1, I'm back!!!! I'm alive!!!! I survived! Hopefully I am still saying that in nine days when I get my score. 

Today was my first day on rotations! 

Yesterday morning, I had the thought of "Wow, starting tomorrow, the next (at least) five years of your life are totally going to be dedicated to the hospital and real patients. No more sleeping in until noon. No more eating 80 times a day, whenever you want to. No more fake notes with fake responsibility. $hit is getting REAL!!!!"

In an attempt to avoid this last realization (which in reality I am extremely excited about, even though slightly terrified), I went on a massive cleaning binge - polished all of my jewelry, rearranged every dresser drawer, reorganized all of my pathology notes in preparation for tutoring, which won't even start until September. 

Today, I woke up bright and early. Packed my lunch. Walked to the hospital. Forgot my caffeine. 

Got pimped. Got the pimp question right! 

Got two keys to I don't know what. Got lost. Got found. Got caffeine. 

My first rotation is Psychiatry and I am on inpatient pediatric psychiatry for 4 weeks, with half a day at the local VA. It was an extremely eye-opening and incredible experience, which included: 

3 hours of lecture, which included completing a mental status exam on a Robin Williams clip

6 hours trying to interpret what my non-English speaking resident was saying to me

8 minutes for lunch
 
30 minutes trying to make a phone call on a hospital phone to an outside location

15 minutes looking up drugs that I have never heard of, such as Geodon, only to find out that I actually have heard of them, I just need to learn 3-4 Brand names for every drug I ever learned. No big deal. Geodon sounds exactly like ziprasidone, right?

40 minutes being an accidental gunner and staying longer than I had to 




At the end of the day, I came home feeling super excited, despite not having a clue about how to use the computer systems, phones, keys, doors, bathrooms (for real, I can't figure out how to work the door handles), ID swipes and dosage book. 

My fellow med student roomie summed it up perfectly: 

It is exhausting to feel stupid all day. 

The Dreaded Double Negative... English Rant

Did you ever have that one professor, one boss, one family member who just made everything more difficult? The one that could never be straightforward? The one that made you internally cringe every time his mouth opened because you feared what awkwardness would come out of it?

If you are picturing someone right now, well, that stinks for you! I have never known anyone like this (Please note my sarcasm...). 

I am studying for my clinical course... just diligently reading away at my notes... being bombarded by facts and dosages and numerical cut-offs and EKG algorithms... when I come across this sentence:

EKG at rest without angina present not uncommonly is normal.

While this makes complete sense to me, and I truly do understand the choice of words, I just want to throw it out there that double negatives, more often than not, are ridiculous.

Now, in this case, to take the double negative out and say that "EKG at rest without angina present commonly is normal" would be incorrect, therefore requiring the double negative. And this is just too bad, because that sentence stinks.

Thus, my entire studying game has been thrown off and I cannot get off my English language soapbox. Therefore, I will share with you two of my biggest pet peeves:

- Formal writing with CONTRACTIONS!!!! Just the other day, I read a statement written by a candidate running for an office at my medical school. Is it terrible that I saw the contractions, immediately stopped reading, and voted for the other person?

- SUBJECT/VERB AGREEMENT. Having grown up in the "North," I developed a whole new love and appreciation for my 4th grade English teacher and good ole' subject/verb agreement when I moved to the "South" to teach high school and on the very first day of class, the PRINCIPAL got on the loudspeaker and said phrases such as, "We was" and "They was".... NO, WE WAS NOT! THEY WAS NOT! 

If you, dear Reader, commonly do these things.... the English language would grant you great Karma if you stopped your crimes and became an English Language Law Abiding Citizen. (And all the Type A Weirdos -- me-- would be forever thankful!).

What do nerves sound like!?

In pediatrics, you get asked lots of questions, which have a wide range of correct answers, from the very basic to the very complicated. 

For example: what does a heart sound like? 

There are many answers for this, depending on your familiarity with the heart and it's many variations/murmus/etc.... boom boom..... lub dub...... lub click dub.... lub whooosh dub.... etc. etc. The list goes on.

What do lungs sound like?

A healthy lung really just sounds like breathing, amplified through the stethoscope. Unhealthy lungs may have rattles.... crackless... wheezes... etc. etc. The list goes on.

What do intestines sound like?

We've all heard this one... the low rumble... sometimes embarrassing high pitch squeal your tummy makes when you are starving...

What do nerves sound like?

This is a tricky one. What does a nerve sound like? Nerves? Do they make sounds?

YES, THEY DO! 

I will tell you what nerves sound like, as I discovered this a few days ago. 

The sound of nerves... is also the sound of terror... of awkwardness... of the unknown.

The sound of nerves...

...is the sound of an uncontrollably rattling speculum as you grab it for the first time and slowly advance towards your standardized patient in an attempt to give your first female pelvic exam. 

Upon speculum removal...  and successful examination:

37 minutes to go...

I know, I know... I have not blogged in SO LONG! But, the boards prep has commenced and M2 year is keeping me very busy... Really, I have no excuse. 

So, what is the delightful reason I have decided to blog right now?


 


I give my first penis and rectal exam in 38 minutes and I am terrified. You needed to know.



37 minutes... 



...

...

The 2am Debate (Med Student Style)

Every Friday, when we actually get the chance to go out and party, my friends and I like to wrap the evening up by grabbing some of our favorite eats. While sitting there one evening... around 2:30 am... I glanced up at the wall and saw this:

 "OMG! Look at that angry ovary!"

 

Seriously though, there is a fallopian tube... and follicles of different sizes/stages... and fimbriae (the teeth on the picture)....

http://embryology.med.unsw.edu.au/Medicine/images/week1.jpg

http://php.med.unsw.edu.au/embryology/images/4/4e/Week1_summary.jpg

http://www.scielo.cl/fbpe/img/rca/v18n2/img31.gif

HSIL looks at the wall for a moment... cocks her head... deep in thought... and responds with:

I think it is an angry bronchiole.

http://www.yale.edu/imaging/anatomy/bronchioles/graphics/bronchiole_diagram.gif

http://img.tfd.com/dorland/thumbs/bronchiole_terminal.jpg

http://cal.vet.upenn.edu/projects/histo/lab12respiratory/respimages/s70_bronchiole10x.jpg

Note: there is another area of the wall that has the same angry image branching off of another one, validating the bronchiole comparison.

And thus began the debate:

Is this an angry ovary? Or an angry bronchiole? 

And if it is neither,  

since only we would look at it and compare it to female reproductive organs and the respiratory tract, 

 then what is it!??!?!?!

What is this creature? Monster? Body part? And why is it on the wall of our favorite restaurant!?!??!

Some of My Fave Nerd Gifts!!!

 It's a tradition in my family to open presents super early (3am). This started when I was a wee girl, and is one of my favorite memories. I would wake up bubbling with anticipation, sneak downstairs just to make sure Santa had made it, then go crashing back upstairs screaming "IT'S CHRISTMAS, IT'S CHRISTMAS!!!" and basically dive bomb my parents' bed to make sure they received the message loud and clear. That first view of Santa's magic is one of my favorite mental images... I peak around the corner of our winding steps... the sounds of Elvis crooning out a Christmas classic in the air... the entire downstairs dimly lit by our four Christmas trees... a silvery glitter trail of Santa dust moving from the chimney to the overstuffed stockings to the cookies and milk to the Family tree... evidence that Santa had been all through the house and quiet as a mouse. Isn't Christmas just magical?

This year was slightly different, thanks to -- you guessed it -- MED SCHOOL! Med school turns my sleep schedule all inside-out. I wake up at 10-11am, and don't go to bed until 4-5am..... 6am during finals. Much to my parents' dismay, it took quite awhile for me to adjust to real life once break started, and Christmas Eve was no exception. At 4am Christmas morning, I finally got tired and tried to sneak upstairs to bed. My sneaking skills have gotten progressively worse over the years, and I woke my Dad up. He suggested we start opening presents! So, without ever going to bed, I got to go straight from Christmas Eve into Christmas Day, which was pretty awesome, and in line with our tradition of opening presents in the early morning hours. Here's where it gets nerdy. My family knows me so well. If you are ever looking for gifts to give your favorite nerd, chances are high that one of these will be greatly appreciated.

Last year, I got these:

This year, I got this:

I am REALLY HOPING this is a trend (get it, nerds.... trends!!?!?!?) and I will be receiving a periodic table gift every year (hint hint.... no pressure, fam).

I also got these:

Anyone in med school knows that the Pilot G2s or Sharpie Pens are the way to go, especially for color-coding nuts like myself. Also, camo band-aids!?!? SCORE! You never know when you might cut yourself and not want anyone to see it... And, because I always forget to charge my phone.... a powermat!

Next, I opened up the coolest gift ever... the DAMMIT DOLL!!!!!!!!! And.... in CAMO!!!!!! What better way is there to work out my boards rage than to whack things with this!!?!??!?! Trust me, I've been practicing.

I also bought myself a Christmas present..... upgrading from the iPad 1 to the iPad 4 (w/retina display). WOWZER! It took a lot of convincing for me to drop that pretty penny when I already had an iPad, but it was totally worth it. I'm now doing all of med school electronically, and the iPad 4 is capable of things I didn't even know existed. Straight up BALLER! My only sadness is that Apple doesn't make a hot pink or purple Smart Cover. What up with that!?

Lookin' flyyyy!

And next... this is a gift my Mom got from my Dad. It's called a Power Pod 360 Jr. None of us had ever heard of it before, but Dad found it in the electronics section, and the salesman convinced him to get it. Dad described it like this:

"You plug your iPod into it, and then stick this end to something. Whatever you stick it to will amplify the sound, basically making any object a speaker."

Mom's reaction was an ohhh-cool-i-kinda-get-it-not-really face.

The abbreviated version of my reaction was something like this:

"OH MY GOD!!!! THAT IS SO COOL! Basically, because the particles in a solid are much closer together and compact, the sound is able to travel faster and with more power through a solid than in the air... as the particles bump into each other and pass on the energy (demonstrating with my hands), LET'S TRY IT ON EVERYTHING!!!!!!!"

Needless to say, I ended up with a Power Pod 360 Jr, because my parents were so taken aback by my enthusiasm that they decided I deserved it. 

DEAR NERDS: INVEST IN ONE OF THESE NOW AND YOU WILL NEVER REGRET IT. 

Lamp shades? 

Car? 

Table?

 Floor? 

Glass? 

Book? 

YES, they are all awesome speakers. 

 Coolest. Thing. Ever. 

Check it out, here!!!!

And lastly, but certainly not least, I got a new Disney Traditions collectible! Isn't Minnie an adorable doctor!?

"To Your Health"

She fits right in with my Dr. Mickey, 

"The Doctor Is In"

Needless to say, I had a wonderful Christmas. I hope you all did, as well!!!! 

Here is another really cool site for Nerd Gifts.

The Wine Goes In, and the Nerd Comes Out

While cleaning my room -- today's main form of productination (productive procrastination... critical skill to develop in med school) -- I came across the Wine 101 Notes I took in August. My fellow med ladies and I decided to treat ourselves to a wine tasting seminar before school started.

The paper has a few "Basic Wine Questions" to consider when picking out a wine, and outlines how to use each of your senses, in order to have the full wine experience. It was an awesome class that we found on Living Social, so that made it all the better, as we could actually afford to go -- courtesy of the Monopoly Money the government throws at us (Monopoly Money: money that we never see... money that just magically appears in our bank accounts... thousands of dollars at a time... every time we pass 'Go' ... aka every time a new semester begins... we have tons of it, but it will inevitably get us in trouble because we will have to pay it back 3-fold someday... instead of actually buying Boardwalk -- like all our friends think we will do -- we will be in stuck in monetary jail... with no free pass... the good thing is, we really don't have a lot of time to spend all of it anyway... the bad thing is, we have no other income so it all gets spent eventually). 

The lady leading the wine course encourages everybody to take notes. And, being the diligent students that we are, we did not let her down.


Asian --> turns red --> Histamine reaction

Sight: Look at three factors: appearance, color (Cloudy = bacteria!!!) and body (weight).

Dry wine = no CHO

Tannins (in skin of grapes) decrease bitterness with cheese. Skin = vitamins.

Four enemies of wine:
1. Air - ferment
2. Light - volatile
3. Heat
4. Corks - oxidation (it's actually better to have screw-on caps!)

Smell: Stir --> oxidize --> ester --> aromatic      
(My personal favorite. The only thing that would have made this better was if I would have actually drawn the structures... and believe me... they were dancing around in my head.)

Oak barrel --> heat + CO2 + EtOH

Basically, we somehow managed to turn our entire wine tasting seminar into an Organic Chemistry review session.  

Below is one of my fave wine labels, Educated Guess! See? We aren't the only ones who turn wine into OChem! At least these people profit!!! Salute!

One of my fave wine labels!!! Educated Guess! See? We aren't the only ones who turn wine into OChem! At least these people profit!!!