Shake Hands

April 18, 2006

I’m a Caribbean medical student. Like most people I tried to get into medicine in the states and was rejected for perfectly good reasons. Chief among them were:

1) immaturity
2) poor scholastic performance in spite of the tools to excel
3) horrible recommendations from teachers aware of points 1 and 2.

Despite those failings, I was done with mediocrity and standing still in life. After graduating I tried to find work in the medical field for a better shot at a second application cycle. The job that I eventually landed was a Patient Care Tech. in a very fancy hospital. The requirements were that you have:

1) GED / High school diploma
2) no drugs in your urine
3) no criminal history
4) no better options

I didn’t even get this job cleanly, but instead with an inside man who knew my family and thought I was a good enough guy. It was one of those great times when someone in the position to help sees a little of himself in you. I was glad for it. I worked that job alongside full-time nursing students, grizzled nurses, and a revolving door of people that weren’t rejected early enough.

My life consisted of 12 to 16 hour shifts at night on a Hem/Onc ward. In case your curious, the nicest hospital floors are usually on top, except in the Onc building, where everyone is trying to work there way from the ICU on floor 9 to terminal Onc on 8 down to the lobby where people are smiling because they get to go home. I spent 13 months there learning to love patients and hate patients and become used to the worst juices of the body. Like most people seeing that world with fresh eyes, I have several anecdotes about life in Term Onc and I’ll write about them in time, whenever I have a slow day in the present. But we’re just getting introduced now.

After 13 months of working the same job on the same schedule with the same part of your brain asleep for all of it, you learn a better answer to any admissions question:

Interviewer: “Why do you want to be a doctor?”
You predictably answer: “I feel like each of us owes something to those most in need. I enjoy helping those that are sick and knowing that I have made a difference in their life.”
Interviewer: “F minus.”

Now let’s see what happens after hospital grizzling…
Interviewer: “Why do you want to be a doctor?”
You answer: “I used to think it was to help people, and that’s part of it, but if that’s all I wanted to do I’d be a nurse or a tech. I’m a smart person and I work well with stress and prefer it, and if I don’t end up in a field where I am being pushed to the point of a panic attack, then I just don’t want to do it. I am not going to end up as a computer being used as a doorstop. I had 13 months of that already and I just about lost my mind. I want to help people, but the best help I can give them is to go get some amazing training, study my ass off, and return a more capable physician. I’m not going to die happy having done anything less than that.”

After it all I was a better applicant with better recommendations but I still didn’t have the grades. Schools like to see trends. Straight Bs with straight As your last term is not a trend; it’s the picture perfect of someone who could have gotten As the whole time but has horrible foresight. Every school was right to pass again. I prepared for that to happen and had a few applications out to Caribbean schools. They all accepted and so I went with the “Harvard of the Caribbean.”

That’ where I am now. I’m a second year student so Anatomy, Biochem, Histo, Embryo, Parasit, Bioethics, Jurisprudence, Immunology, Genetics, and a few others are all behind me. I plan on saying a little here and there about them as I move forward, but trying to tackle all of that right now is a sure-fire way to fail at the rest of life.

So that’s our introduction. Nice to meet you.


retsaf si tebahpla

April 17, 2006

Sherin thinks that I have a gambling problem. It started with the SuperBowl bet of $500 that turned into $1100. Then at the IEA talent show there was a raffle. I bought 200EC in tickets and got 100EC back. Then for Sandblast I gave Sherin another 200EC to buy as many raffle tickets as possible (which involved filling out my name and phone number 200 times, poor girl). I ended up with over 700EC in merchandise and gift certificates. My gambling problem is convincing Sherin that my winnings are not her winnings. My logic is bulletproof: “If I had lost a whole lot of money, would you have shared the loss?” Too bad Sherin is logicproof.

I’ve always wondered why police officers ask people in a sobriety test to say the alphabet, backwards. No one can do it, right? I think the trick is that only a person with impaired judgement would try to pull it off, so even if you go from Z to A flawlessly you’re going to jail. While I never plan on putting myself in that situation, I cannot deny that it is an attractive stupid human trick, which is why I was thrilled when Sherin asked me if I could do it the other day. She had no idea how seriously I was going to take it. She would say “Z”, then I would say “Y” and so on with a reset if either one of us missed our cue. Within two minutes Sherin didn’t want to play anymore as I started screaming, “F comes after L? Come on, you know this!” This is why I can’t play with others. The interesting thing is that you should be able to say the alphabet backwards faster than forwards. It has everything to do with the phonetic groupings. Everyone knows that LMNO rolls off the tongue like “elemeno”. But try this beaut on for size: VUTSRQPONMLKJIHGFEDCBA

AB CD EFG HI JK LMNOP QR ST UV W X Y Z
ZYX W VUTSRQPONMLKJIHGFEDCBA

See what I mean? You really have to slow down at the end if you’re going from A to Z. Don’t worry, when I get home we’ll race each other. If I knew how to record it and attach it to this email, well, you’d be listening to it.

So Sherin’s Mom and sister are in town, which means Sherin finally gets a new computer, which is a miracle considering her history. When she first came to GND she dropped her computer on the floor, cracking the screen. She made the call back home to beg for a new one and somehow “I dropped it and broke” turned into “It doesn’t work right because it has a virus I think.” Her father was nonplussed. A year and a half later and that fixed computer is failing with a 30 minute battery life and a broken touch-pad. So the last computer her father will ever buy her is in her mother’s luggage waiting in New York to board the plane when Sherin puts the laptop on a chair with the mouse inside. The details aren’t important as they implicate me, but suffice it say that Sherin sat on her laptop and cracked the screen. As with most things, I recognized the humor of the situation and started laughing immediately. Sherin had a panic attack thinking about the loss of her Father’s love. It balanced out.

The meeting of the mother and the sister (Tasha) went well enough. Tasha teaches the first grade and has great stories about children being children. My favorite was the book report about “Elaphits Gerald”. Her mother and sister being here is also a great opportunity to whip out my Sherin-impression. Judging by her scowl, I say it’s dead on. But more than anything, the best reason to ever meet the parents is for the treasure trove of “You sound just like your Mom,” “God, you sound just like your Mom!” and my personal favorite, “Whatever you say, Mrs. T.”

Working on being non-confrontational, topher.


Golf is LIfe

April 17, 2006

We’ve just added another course to the pile. Walking into the lab, the professor announced that this was “Clinical skills, Advanced clinical skills.” This was funny only to me. When we broke into groups I introduced my self as “Lastname, Firstname Lastname.” Again, only funny to me.

I am with half of my path group as we learn how to take vital signs, inspect the cervical lymph nodes, etc. I hopped onto a bench and volunteered to be the dummy patient for the instructor. She inspected my scalp (newly shorn), my throat (I shaved off my neck-beard for just this reason) and my mouth. Now it’s the group’s turn to mimic her. With anything like this, there’s about 10 minutes of awkwardness before everyone relaxes and I enjoyed every moment of it.

First, when asked to describe the findings of examination, my friend Peter was very uncomfortable mentioning my Male Pattern Baldness. He was also unsure if my skull was of normal shape and size. The tutor said that it was within normal limits, which is tact-speak for “you’re absolutely right.” A few minutes later, Scott is trying to see the back of my throat and is accusing me of having a tongue that is “too big for my mouth. No one can see past that thing.” When inspecting the ducts underneath my tongue, I am politely asked not to gleek on anyone. I do my best.

Eventually more members of the group volunteer to be patients. We use tongue depressors to move the cheeks and tongue around. Each patient is responsible for holding his/her own depressor so that cross-contamination doesn’t happen. It takes three minutes before Scott and Sam are making-out by proxy.

All in all, fantastic experience and my new favorite class.

I wrote a few days ago that the dodgeball tournament was coming. After some soul-searching, my roommates and I decided not to play. We’re growing up, and that means becoming very boring. Instead, I sat in the library on a Friday night while the entire campus was cheering drunk. In my defense, the time was put to good use. Because SGU is not a wealthy institution and has no history of research, resources are scarce. To get around this, Marios emails a friend of his at Harvard with a list of journal articles that we need. His friend takes a camera into the library and sends us pictures, page by page. I then have to remove the camera glare, rotate the pictures into frame, and remove every thumb with Photoshop before I can send it to our black and white printers. Even in academia, there are hand-me-downs.

So dodgeball didn’t happen, but golf did. The roomates had signed up as a team, and as any team we try to bring the ridiculous with us. If it’s Kelly and Winston wearing togas to announce the beginning of the winter Olympics to our class or dumpster-cardboard Halloween outfits, we try to come up with something. We were too busy this time, but figured the least any of us could do was stop shaving and play with mustaches. Yes, I know exactly how stupid that sounds. The mustache didn’t look that great, so I decided to take it a little further. Into my head.

The golf tournament was a complete success and very profitable. The highlights:

Riding the 7am bus through the hills of GND with people still out from the night before, letting their 80s costumes double as totally normal golf attire. Getting a chip-in-birdie on the first hole from 60 yards out. Hitting a great drive on the 6th only to watch a Grenadian caddy walk into the fairway and pocket the ball. Arriving moments later huffing from a beer-fueled tee box sprint to find that my ball was fine. Finishing 9 holes of “captain’s choice” golf +8. Shaving the rest of your head to look professional for your tutoring session to be told that you have a sunburn-negative and are not fooling anyone.

Addendum:
1) “gleeking” is when you press your tongue in such a way that you shoot jets of saliva from underneath. I have a talent for this, both voluntary and involuntary.
2) “make-out by proxy” Like sharing gum, what was in my mouth is in your mouth. Sam and Scott were inspected with the same tongue depressor.
3) Captain’s Choice golf means four people hit a drive and all take their second shot from the best drive, and the best chip, and so on.


Not a doctor, not by a mile

April 6, 2006

Early this morning, at 1:02am, the time read:

01:02:03 on 04/05/06

Sherin says that this is special because it won’t happen again until 2106. I say it isn’t special because it will happen again at 02:03:04 on 05/06/07, and so on, until 09:10:11 on 12/13/2014 when we run out of conveniently numbered months.

Sherin says that, “No, it only counts if it starts with the number 01.”
To which I retort, “A straight is a straight! It’s the same thing!”
“No, you don’t start counting at 02, you start counting at 01.”
“You can start counting anywhere, so long as it’s a sequence with regular intervals!”
“TOPHER! A number line starts at 01! Not at 02, 01!”
“SHERIN! NUMBER LINES DON”T START ANYWHERE! IT’S INFINITY AND BACK BOTH WAYS!”

Sherin wonders why I have to argue about everything. I argue that I don’t have to argue about everything, proving her point.

So I haven’t written in over a month and with good reason. I’ve been busy. For the first time I feel like a real grad student. Ana, when I see you again, I’m buying us beers and you must join me in a heavy sigh.

Pathology swallowed us hole and I haven’t handled it with any grace. In one week, the Board of the research society held elections, passed off any and all responsibility for training our replacements and the planning of the golf tournament. We must have thought we were saving time. Haste.

What happened, of course, was a President that was all show and no work, an alienated Board, a collapse of communication within the club, a huge drop in club morale, and a pending disaster on the golf course. Waste.

So to correct this we recruited our faculty advisor, Marios, to tear apart and emasculate Napoleon to the point where he can make no decision outside of Board approval. The previous President is now present for any and all meetings to report back to Marios and to keep Napoleon honest. Second, I started talking to the brave students that decided to make the golf tournament work. They were very excited to have made a brochure for golf. It was tri-fold, double-sided, and everything. It talked about how great the tournament was going to be and when it was going to be and a place for you to write your teammates. I found out about this the day they started handing them out so grabbed one. Here’s what it was missing:

Cost
What was included in the cost
Contact information
Registration information
Dates
Transportation

But it was cool-looking. I’ll give them that.

So I wrote them an email detailing what changes had to be made to the brochure before they could distribute it. On second thought, I wondered how the actual tournament planning was going. So I wrote a second, more epic, email that took a player through the day of the tournament, pointing out everything that had to be handled before during and after the tournament for it to work. It was about 1000 words. To be tactful, I signed off:

“I’m sure you guys have thought of most of this already, I just wanted to make sure.”

The guy running the tournament saw me later that night. He was ashen.
“We hadn’t thought of any of that.”
“Well, you realize that all that stuff has to happen, right? The tournament doesn’t just throw itself, right?”
“Now I do.”

All of this is superimposed on Pathology and Microbiology, mind you. Once again, medical school has managed to be more work this term than the last, than the last, than the last. I bet next term is easier.

My Path group is made of 10 other people, all friends, and I hate it. I get three or four pictures of a disease. In the stomach, eyeball, head, leg, etc. I have to go look up that disease, know as much as I can, and then teach it to the rest of the group. I get to do all of this in front of an tutor (MD) who wants nothing more than to remind me that I am not an MD, but an idiot. Whenever I get anything wrong, or omit an important piece of information, the tutor calls me on it, and I promptly embarrass myself by stumbling through nonsense in a squeaky, pleading voice.

WRONG.

I just earned my group a ten minute exposition on the disease. Had I known my material and answered the tutors questions correctly we could move on and finish the 40 slides that are due this week. Instead, we have to come in on our days off. SO the extension of this is:

If a person in my lab doesn’t completely prepare, I don’t learn the disease and have to look it up on my own AND come in on my days off to finish the remaining slides. So naturally, I cringe every time someone is presenting and I can hear a quiver in their voice, because the tutors can hear that quiver and it’s like crack to them. And the entire time the tutor is speaking slowly to us (because we are idiots) I can feel my rage replacing my friendship with this person.

So 1-3pm, every day, is a stressful time in my life.

Luckily, my group has a sense of humor about it. We have two awards. The first is a statue of a woman in the throws of passion riding a crescent moon. The second is a sheet of xmas stickers. Brilliant comment of the day or best performance earns you the statue; and the biggest idiot gets a sticker on their books. I’m happy to report that I have dodged the stickers so far and have taken the trophy home twice.

It’s important that I keep my blood pressure under control, and I do give myself breaks now and again. A few weeks ago the 42nd Airborne division came to GND for disaster preparedness exercises. They were traveling between the islands setting up emergency clinics and treating everyone for free. They were nice enough to accept student volunteers and I jumped at the chance. For the first time, I was on a boat traveling through the Caribbean islands. We got off at Petite Martinique, marched the supplies down the road from the dock to an abandoned building where 200 people sat, blocking every entrance and exit, waiting for us. There were two minutes of confusion before someone started barking orders and everyone else started following. Bless the military for their chain of command.

I ended up in triage, asking little boys and girls why they felt sick. They would look puzzled, stare at their mothers, and then remember that their stomach was hurting them and their eyes were scratchy. No matter how many times I tried to tell the mother’s that it was ok to say “check-up,” they insisted that their children were very sick. We developed a code with the physicians:

“abd pain” means check up
“loss of appetite” means check up
“itchy eyes” means check up

The physicians had their own code:

“Here’s some medicine” means “I bet you have thin blood, here’s some iron.”

Everyone was treated for thin blood. It’s the carpal tunnel of free clinics.

Later I went to the General Practitioner and saw five patients before we had to pack it up and head back to GND. The highlight was an old woman who came in with “a stomach ache.” She had a strong heart murmur, hypertension, swollen legs and abdominal pain. I’m still teaching Neuro and Physio, so I knew this woman’s pathology pretty well and was able to talk to the physician about everything I found during her workup. She listened to all of this but didn’t catch any of it because of all the jargon involved. I became excited that I knew what was going on with this woman and she heard it in my voice. She smiled and asked what we were talking about. The doctor looked at her and said that we had medicine that might make her feel better and we would make sure she saw a heart doctor that week.

I’m not sure how to describe the feeling you get when you’re excited about someone’s congestive heart disease, but I hope no one reading this ever gets to go through it.

Another great distraction was my roommate’s parents coming into town. Sam’s father is a Cardiothoracic surgeon, and every year or so he and his surgeon friends travel to a different vacation spot for a week with their wives. They came to GND and decided to cook for us every other night, entertain us with stories from their careers, and explain to us why surgery was the worst profession to get into and why surgeons hated their jobs. So it’s official: I have yet to discover a single medical discipline where the people practicing it would recommend it before panning it. It’s a bright bright future.

They great thing to come of it was having Sam’s father look over the paper I had written, tear it apart, and make suggestions that helped turn it into the type of paper that could be submitted to a surgical journal. With those changes, I rewrote most of it over a weekend and submitted it with Marios to the Annals of Thoracic Surgery. Fingers crossed, everybody.

Back to school…

So two weeks before the Path exam the usual library bunker shenanigans started, complete with room-squatting and hurt feelings. While I was busy trying to learn the minutia of every disease and the names of every translocated proto-oncogene, the Path department was busy writing a painfully simple exam, with just the type of big-picture concepts and plainly-stated questions that you dream about. I can solve a problem in calculus but I can’t tell you what a number is. They wanted me to define a number. I did not do well.

I stayed to check my grade which was a mistake that cost me a day of studying to self-pity. That left three days till the Microbiology midterm. While Micro is 5 credits (making it of equal weight to Neuro or Physio from last term) it pales against Path’s 13 credits. So we ignore it much like we ignored Embryo in first term. Sure enough, I barely know the material, cram and cram and cram, and leave with an A. So add bacteria and viruses to the list of things that I don’t have to understand at all. They can keep the fetuses company.

So with Micro and Path behind me, I have this weekend to enjoy the dodgeball tournament on Friday and the golf tournament on Sunday. I’ll be wearing a mustache to both.

Cheers, and thanks for waiting. topher.



Welcome to Grenada

April 1, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.

**************

Welcome to Grenada.

First off, you probably do not know how lucky you are. The surprise for each new student is how beautiful Grenada is and how anyone could keep their sanity studying in any other place. What follows is a guide to your classes and a glimpse into what your life is going to be like in Grenada. A small disclaimer: I am a white American male twenty-something who had never left the US before coming to Grenada. It is very possible that certain aspects of Grenadian life specific to women are undereported. I apologize. Now let us get started.

ARRIVING

It is GrenEHda, not GrenAHda. Pronouncing it correctly is a big deal. Grenada was described to me as a third world country before I came and this will not be your experience. Your time on campus will be indistinguishable from any university in the US; your dorm life will be no different than your undergraduate experience. Everyone uses the bus or drives a car. You will have your Subway, your TCBY Treats, movie theaters, malls, grocery stores, hardware stores, school supplies, bars and clubs. You probably will not be able to find the laundry detergent you like or fresh milk, but these are small things. Anyone who says you will be “roughing it” is lying to you.

***That being said, a few people each year have a hard time adjusting. Some have dietary concerns (it is not hard to be a vegetarian; it is hard to be a vegan). Some get very homesick or cannot adjust to Grenada’s culture. The pace here is very slow. ***

The very first mistake people make when traveling to Grenada is NOT taking a layover. Often times the airlines will overbook a connecting flight from Puerto Rico to Grenada and ask that passengers volunteer to take a later flight, often the next day. TAKE IT! You will be put up in a hotel, given miles for a flight in the future, and have a chance to enjoy another island carefree.

Many students have questions about how much their luggage can weigh. American Airlines (in my experience) will tell you to bring no more than two pieces of luggage weighing 50 lbs. each and one carry-on weighing no more than 40 lbs. The problem is that your connecting flight to Grenada may only allow ONE 50 lb. piece of checked luggage and will charge you an arm and a leg to bring the other, or flatly refuse. Call ahead and make absolutely certain with an airline official that your luggage will make it to Grenada, and then get that persons’ phone number.

You will likely spend your first night in Grenada without your entire luggage. This is not a big deal. The airline will give you a number to call and you will have your luggage within a day or two. Try to come to the island early so you can take full advantage of Orientation week. It is nice to have that time for settling in, to speak nothing of all of the trips around the island that are provided.

Grenada’s weather has two settings: downpour and blindingly sunny, so come to the island wearing a rain jacket over a bathing suit. Grenada is likely hotter than you are used to. During those first few days, you will break a sweat from standing, lose weight, and drink water like breathing air. You will see students going to class wearing jeans and long sleeved shirts and wonder what is wrong with them. Just know that your body is getting used to the island; it takes about a month.

WHAT DOES IT LOOK LIKE?

It’s amazing how a few photographs taken by students can add some perspective to the place. Go to Flickr and search for SGU. It says something that the students love the school enough to put all of this together themselves. My favortite albums are shot by Josh and Felix.

PHONE SECTION

No one gets a landline and you should not bring a cordless phone with you. So that means you are buying a cell phone. Since you are now going to travel from the mainland to Grenada and St. Vincent’s (and possibly Prague) you probably want a phone that can work in all areas. For this, you need to buy a Quad-Band GSM phone. There are two main companies that offer GSM service in the USA. AT&T and Cingular are now merged into one company, and the second company is T-Mobile. So here’s what you do:

1) buy a Quad-Band GSM phone from one of these companies
2) make sure that it is a pay-as-you-go phone with a SIM card
3) go to this website and pay for your phone to be unlocked

I’ll explain all of that:

There are four major broadcasting systems used throughout the world. So a Quad-Band phone means that you’ll never have to buy a new phone for travel. The SIM card is a chip that contains your phone number and your contacts. Put another way, it does not matter from what phone you call: if you put your SIM card in any phone the person you are calling will see that it is you. So if you buy a SIM Quad-Band phone at home, you will have a SIM card with your home’s area code. When you come to Grenada, you will buy another SIM card with a Grenadian number. At this point, you can simply switch the SIM cards while you’re one the islands and then switch them back when you return home. Taping them into your passport is a nice way to keep track of them when not in use.

The reason you have to “unlock” your phone is so that your T-Mobile phone (for example) will operate with a Digicel SIM card from Grenada (for example). Pay-as-you-go means that if you want to talk for ten minutes, you buy ten minutes. If you talk over that, the phone simply cuts off (after a warning of course). This means that you cannot possibly suffer overage charges and you don’t get roped into a contract. And why do you have to pay to unlock your phone? Because T-mobile doesn’t want you to buy there phone and then use it with an AT&T SIM card. T-mobile wants your money. Typically, these companies will unlock your phone for free if you’ve owned it for three months, but if you’re reading this now that’s a bit of late notice. So pay to have it unlocked from a separate code vendor and you should be set.

Some students make use of internet phones as well. There are several programs that allow you to make phone calls over the internet for pennies a minute to anywhere in the world. Skype, Netphone, and PCPhone are popular programs and only require a headset with microphone.

MONEY

For the next few years you will be using Eastern Caribbean currency, or ECs. The conversion rate is easy.

$100 = 260 EC. (exact ratio is 1/2.67, but we will keep the math easy and lose the pennies)
100 EC = $40.
Ex.
I have $25 in my pocket. 25 x 2 = 50. 25 x 0.6 = 15. 50 + 15 = 65 EC
A three ring binder is 35 EC. 35 x 4 = 150. 150 / 10 = $15 (binders ARE this expensive)

There are banks on the island and no need to ever use them. You can pull EC from your US account at any ATM on the island with a VISA/MasterCard debit card (sorry American Express and Discover). Some credit card companies charge a higher rate for foreign conversions, so check yours. The ATM charge is $1.50 and the conversion rate is standard. If you have a refund check coming to you, I suggest having the school send it home and having family/friends deposit it. You will need to leave deposit slips back home. Do not forget to leave deposit slips back home. However, if you want to pay for things by check, you will have to open an account with a local bank or have traveler’s checks at the ready.

How much EC will you spend a day?

Depends. EC is pretty, looks like Monopoly money and you will spend it as such. Breakfast of eggs and toast is 7 EC, lunch is around 15 EC, and dinner can be up to 20 EC. That comes to 42 EC/$17 a day, eating out every meal. It sounds expensive but few people can pull off three meals a day. Most have one full meal and fill the rest with coffee and snacks. You will find your own happy middle. Remember that if you cook and buy your own groceries, you will save quite a bit.

If you drink anything other than water, you are in for a shock. Name brands like Coke, Starbucks and Arizona drinks cost three to four times what they do in the states. That being said, some people still manage to spend a great deal of money on water. Bottled water is sold everywhere on the island and is more expensive than beer. Some students buy a bottle every day. Others (and I recommend doing this) buy one bottle and refill it at dinking fountains on campus. All of the water on campus is filtered; this is not the case elsewhere on the island. I for one have had the same bottle for a month now and may have saved as much as one million dollars. Cigarettes are no more expensive than you are used to, but you should quit anyway.

WHAT WILL EACH DAY BE LIKE?

I get up every morning around 7am and check the class schedule. Typically only two courses are taught a day with each getting two hours of lecture time. On some days you will have Anatomy lab that can begin at 8 or 9am and lasts for three hours, or you have Histology lab at 8 or 10am that lasts for two hours. Lectures begin at 1pm each day and last till 5pm. You do not need to bring much to campus. I usually put my laptop, water bottle, two three ring binders and two textbooks into my backpack and grab the bus.

Eating on campus is not hard though students do complain about the selection. At the top of the hill (you will know it well) there are vendors selling fresh fruits and the Patels selling homemade Indian food. Halfway down campus is the Student’s Center which has two restaurants (Glover’s and Pearl’s) along with a convenience store. At the base of campus is the Sugar Shack. You will not go hungry.

Time before and after lecture is often spent in the library. The library has wireless internet and so should your computer (the “Computing at SGU” section of the SGU website does a good job of preparing you). During peak hours it can be difficult to get a strong connection (bringing an Ethernet cable is a bad move, as many of the plugs on campus work sporadically). The wireless network extends throughout campus into the lecture halls (you can follow lectures online or check email during breaks), across to the bus stop and down to the Student Area (where the gym and restaurants are located). Some students are able to get a connection in their rooms as well. If you live off campus in Grand Anse dorms there is a study room with a wireless connection. High-speed internet is available in off-campus apartments through a contract with Cable & Wireless.

SCHOOL CULTURE

During your first two weeks here you have carte blanche to introduce yourself to as many people as you wish. Your class will probably go out each night that first week and I recommend you go each time. The first week does not contain difficult material and you will not have another chance like it. After this grace period the classes pick up a bit, people fall into routines and your opportunities to meet every member of your class will start to drop off.

SGU operates by four-month-long terms. This tricks you into thinking that each term is a year long and that people in second, third and fourth term are somehow separated from you. This is of course nonsense. The uppertermers will have advice for you on every class and most of it should be ignored. Instead, find a good DES tutor, give yourself a few weeks, and then start making judgments on how to handle your course load. Everyone should go to the Department of Educational Services (DES) office and take a look at all of their handouts on studying, test-taking strategies, and review sessions. It is a goldmine of helpful information.

***I am aware of the irony that, as an uppertermer, I am writing this letter of advice.***

ISLAND CULTURE

English is the language spoken in Grenada. In the school guide, they describe it as a “slightly lilting Caribbean accent”. I disagree. Those Grenadians that work with the university, or in another position that requires constant exposure to tourists and students, are easy to understand. Those that have very little exposure to foreigners can be near unintelligible, but once you have an idea for what someone is trying to say, everything seems much clearer. It is not unlike listening to lyrics from a difficult song after you have already read them in the CD jacket.

If you have a healthy sense of humor, the stressful things about Grenada can be hilarious. First off, if you go to a restaurant and read the menu, do not kid yourself and think that what is on the menu is available. The menu is instead a list of things that were once available and may be available in the future. This is due either to a lack of ingredients, the staff is too busy to make your order, or the staff does not care to make your order. So order something else with a smile.

Second, if you order a drink at a US bar and it takes more than a few moments, it is often because the place is very busy and the bar is understaffed. If you order a drink in a Grenadian bar on a dead night when you are the only customer, it will take even longer. This is not because the bartender is trying to piss you off or ruin your whole day as some dramatics will say, it is instead because the island is a slow place and you need to get used to it. That Grenadian bartender could turn to you and ask, “What’s your hurry anyway?” Try to remember that there is no hurry and life will be a lot easier on you.

SPORTS

SGU has a healthy intramural sports program. Basketball and Football (soccer to some) are the major sports (bring cleats and guards, balls are provided). Hockey is also big (played on the basketball courts, sticks and nets provided). Rounding out the selection we have Ultimate Frisbee, Dance Classes, Yoga, and Dodgeball. I have yet to see a single person play tennis (I have not even seen courts) or cricket.

WET AND DRY SEASON

The wet season is very wet and runs from August to December. It can rain for days on end. If you bring an umbrella, make sure it is the type that opens to form a complete sphere around you, because the rain falls sideways. Honestly, go to a camping store and get a waterproof cover for your backpack, a light waterproof jacket and a shamie. You will be the envy of everyone. Another thing to consider is the mosquitoes. The breeding ground for mosquitoes is standing water, and there will be a lot of it. Invest in a mesh tent for your bed and screens for your windows (only applicable if living off campus). Want to know a fun trick? Instead of a mesh net, get a standing oscillating fan. If you go to sleep with it by your head, the mosquitos get sucked into the back of it and murdered. You get to wake up the next morning with a pile of them on the ground. Good times.

There is little rain in the dry season which runs from January till June. It is the best time to be on the island and enjoy everything that it has to offer. Go to the beach, learn to kite surf, bring your surf board, or rent a jet ski. Head to the capital and learn how to haggle in the market. Most of all, remember to get a tan so that people believe you when you say that you go to school on a tropical island.

GENERAL ADVICE

1. If you are buying a computer for school, make sure that it is light, portable and has a long-lasting battery.
2. Do not get a car your first term. You first term will be spent in campus housing and the bus schedule is more than adequate. A car is a luxury.
3. Sometimes the buses can get crowded. I suggest you say goodbye to personal space.
4. About a month into the term, Prof. Goodmurphy of the Anatomy Dept. will give a note-taking lecture that is invaluable and will change the way you and your class study. Do not miss it.
5. I have yet to use a single battery.
6. You can talk to prospective and current SGU students at ValueMD.com. Most posts receive a prompt reply.
7. If you get onto a Reggae bus and want to get out at your stop, tap the metal ceiling.

WHAT TO BRING

***This is not meant to be comprehensive by any means, but instead a few things that really would have helped me. ***

Binders are expensive on the island and worth the space in your luggage to bring a few. Anatomy gives you a binder so you should only need to bring three of your own. Multicolored highlighters are invaluable when reading biochemistry and hard to find on the island. I wish I had brought more. I also wish I had brought dry erase markers. Do not bring floppy disks and blank CDs, hardly anyone uses them. Instead BRING A FLASH DRIVE. Students share all of their files and useful programs with each other via flash drives or iPods. With exception to the iPod Mini and iPod Shuffle, iPods are actually much better than flash drives. They can play music, store 20+ Gigabytes of information in any form, and are far and away worth your investment.
As for your course books, the school supplies you with them the first week you are here. They are stored at the base of campus and are heavy. I would recommend picking them up in an empty piece of wheeled-luggage. Opinion varies in the upper terms as to which textbooks are useful and which never left their shrink wrap. Take advantage of your Footsteps Buddy and try to figure out which books will be most helpful for you. That said, there are some books that most people wish they had. Check the First-termer section.


First term classes

April 1, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.

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Your first term classes:

ANATOMY
You are given a binder that contains, in order, every lecture for the term. This is useful for both following lecture and adding your own notes in the margin. You are given an Anatomy Atlas by Netter that contains oil paintings of every structure in the body with labels. You also receive Essential Clinical Anatomy by Moore which is the closest thing you will have to a text book. How helpful people found these texts is based more on individual learning styles than the actual content of the book. There are two books which nearly everyone found helpful that the campus bookstore does not always carry:

The Color Atlas of Anatomy by Rohen (ISBN# 0683304925)
An invaluable companion to the lab portion of your class, this book contains pictures of perfectly dissected cadavers to help in your ability to identify structures both in lab and on exams. This is best used in conjunction with your Netter Atlas.

Gross Anatomy by Chung (ISBN# 0683307274)
Part of the Board Review Series (BRS) collection, this book covers the material stressed on the USMLE Step 1, offers tables and clinical explanations that can save you hours in the library, and has hundreds of clinical questions that help you to prepare for your exams.

BIOCHEMISTRY
To date, the biochemistry department gives lecture handouts to the class two to three days before each specific lecture. These handouts reflect the stress and focus that each professor will give to the material. To fill in any gaps and round out your understanding, two textbooks are given. Lipincott’s Illustrated Biochemistry is an excellent textbook that closely follows the scope of the class. The other text, Mark’s Basic Medical Biochemistry, aims to tie everything that you will earn into clinical vignettes with patients like Al Martini the alcoholic.
You will kick yourself if you do not also purchase the Biochemistry BRS book (ISBN# 0683304917). It is written by, get this, Dr. Mark’s wife: Dr. Mark. She goes through her husband’s text, pulls the pertinent illustrations, and puts all of the information into a bare-bones linear style that makes learning the material laughably simple. Because of this, you could make the case that you do not need the full Marks text if you are going to buy the BRS book. Once again, the school bookstore does not always carry this title, so I suggest bringing it to the island.

HISTOLOGY
The Histology faculty has the best companion of all of your classes. It is so comprehensive as to be considered its own textbook. You will also have access to a free program called HistoTime. HistoTime consists of short histology lessons followed by hundreds of slides to help you recognize each specific tissue type. This program along with the companion is all that you need to do well in the course and walk away with an understanding of histology. That said, some students found the two textbooks required for the class (Color Atlas of Histology by Gartner and Basic Histology by Junqueira) to be helpful.

EMBRYOLOGY
The embryology course is changing faculty so I cannot guarantee that anything I am about to type is accurate. Embryology operates from a single textbook and a course companion. Some students complain that the course companion is hard to follow and is poorly written. While this is not altogether untrue, it is more accurate to say that Embryology is a difficult course of study in the first place and there are few things that could make it easy to follow and understand. One text that does a fair job of making the course manageable is the Embryology BRS book (ISBN #0683302728). Once again, the school bookstore may not carry this title, and I would suggest bringing it with you to the island.


BSCE 1

April 1, 2006

This test is given a day or two after your last exam of 2nd term. It tests your retention up to that point with questions that are both external to the university (USMLE type) and internal (you’ve probably seen these questions on previous tests). It’s a 200 question brute over 4 hours. Everyone feels like blowing this test off because a) failing it doesn’t stop you from doing anything and b) passing it doesn’t help you do anything.

I disagree. Your score on this exam ranks you against your class. You’ll get a letter in the mail telling you your rank, your Z score, the mean and a breakdown of how you did in every section on external and internal questions. If you’re serious about doing well on the USMLE, I don’t know why you wouldn’t take advantage of this test. Normally you have to pay Kaplan to tell you your weaknesses; the school is offering it for free. The school maintains that your rank is kept in house and does not make it onto your transcript. I haven’t graduated yet so can’t verify this. Students maintain that part of the decision-making when it comes to your hospital placement in 3rd and 4th year has to do with your rank, everything else being equal.

Moral of the story: doing well can’t possibly hurt you, and doing poorly can’t possibly help you. I for one was open to the possibilities, so tried to do my best. The best way you could possibly prepare (for the BSCE or USMLE) is to teach it. If you pulled a B or better in Anatomy, Biochem, Histo or Embryo then tutor the class. It takes two hours out of your week every week and it’s a great review that your classmates aren’t getting. And don’t let fourth term scare you too much: my roommate and I team-taught Physio and Neuro and it was fine. We even had fun doing it.

So good luck and enjoy your summer.


Go to Prague

April 1, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.

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Prague

Go to Prague! As a January student, I went after my first term and knew nothing. Enjoyed the hell out of it. If you start in January and wait till the end of 4th term (2nd year) to go, you’ll be squeezing the dates a little close together. I recommend as a freshman. If you’re an August student, you get one crack at it: after 2nd term. This is probably the perfect time to go.

**The Official Prague Selective website is run by Martin Stransky**

Get your friends together and rent a cheap apartment or stay in a 4-bed hostel suite. You chose your own level of grit. If you’re a vegetarian, eat a face. If you’re a recovering alcoholic, relapse. Prague is beer and meat and beautiful people and you shouldn’t miss any of it.

Smiling beer

Before you head over, go online and buy the DK Publishing Top 10 Eyewitness Guide to Prague. I lived by this book and it did not disappoint. Useful Czech phrases in the back. Also, don’t ever call it “Czechoslovakia.” The Czech Republic and Slovakia are quite separate now.

The set up of your selective is simple: Once a week you meet as a class with Dr. Stransky (the guy throwing this party) above Club N11. Besides being a big deal in Prague, he said one of my favorite things: “In life, it’s good to be best, but it’s better to be first.” He owns the club N11 and will host a part there pretty early into the selective. As I remember, the first day you meet Dr. Stransky, learn about the program and what your rotations are going to be. Wear professional clothes. For guys this means shirt and tie. Do not be the guy with tennis shoes, an untucked shirt and a poorly-knotted tie. Ladies, wear comfortable shoes and a nice dress or skirt. Once you have your assignment, you meet in front of the N11 club with a bunch of other students, and someone working for Dr. Stransky takes your group onto the metro system for your destination. Remember it, because you’ll have to do it yourself every day after. Your destination will change every week, so you’ll repeat this process every Monday morning. Some people start rotations at 8:00am, some at 9:30. Everyone checks out by 5:00.

Each rotation at each hospital is different. For example, my Neuro rotation consisted of locking us in a room and letting a tape play (half the time), talking with Czech medical students so that they could practice their English (1/4th the time) and seeing a bunch of really interesting cases for the rest of it. If you understand 1 and 1/2 syndrome and the workings of nystagmus, you’re golden. My Cardio rotation consisted of puting on a heavy-ass vest and standing in the room while the doctors snaked line up everyone’s femoral artery into the heart. We watched all of it on angiogram. It was great, except for the vest and the revolving door nature of it all. My Orthopedic surgery rotation was my favorite. The doctors and nurses do not care what you do, so long as you don’t hurt anybody. You change into their scrubs and gowns (their locker room) and just pick a surgery. Axilla surgery in room 1, hip replacement in room 2, and so on. I went to see a hip replacement and got blood all over me, which was AWESOME! Loved that rotation. At the end of the week you meet up above N11 with Dr. Stransky, see a patient, and talk about the week. Wash Rinse Repeat.

Neuro Selective SGU

You’re in Europe, the center of it, so you’ll want to travel. I know people that made it out of Prague to go to Germany, Italy, what have you. It’s hard though. You have to be at the hospitals on Monday and Friday. Once you factor in the time of transit to and from another country, you are really cutting things close to say nothing of a slow train or a broken one. To get the credit for the class, you have to have perfect attendance. That said, some of the doctors will sign your sheet for the week regardless of your attendance and I don’t know of anyone that did the selective and didn’t get credit. So who knows. Travel at your own peril I guess.

The weather in Prague swings. Bringing nothing but summer clothes with something nice for the hospital is not going to cut it. Bring a sweater, a jacket, something. Also, it rains in Prague. Don’t be that wet guy without a raincoat.

Speaking of clothing, you should probably buy the greatest pair of shoes on the planet before getting on that plane. Everyone wonders why the people in Europe are so skinny? Not me. They walk everywhere, never stopping, always walking. So if you buy a pair of shoes that pinches your toe or drags on your heal ever so slightly, that’ll be a gapping hole bleeding through your socks by the end of the third day. And since you’re walking everywhere all the time, it will NEVER have a chance to heal. So just avoid that whole mess and buy yourself something nice.

The nightlife is great. Try to avoid the comfort of your two favorite clubs every night and see as much as you can. Joe’s Cafe was a great one, and no trip to Prague can possibly be complete without a few trips to the Duplex. Enjoy the dancers and the air horn.

All in all, I hope you really enjoy Prague. Their subway system is larger than anything I’ve ever seen, and you’ll have a great time getting lost even though their are only three subway lines. Every set of directions you’ll ever give will be in terms of Tesco. It will take you a week to discover Andel. You’ll buy a bottle of water, take one sip and spit it out, and forever after ask for “Voda, neperlive.” (Voh-dah, nay-per-leh-veh) Make sure you’re friends with someone who takes a lot of pictures; you’d be surprised how quickly you forget how great it was.

Hostel

I wrote home when I was there, and I’ve included those posts. If you have any questions, please post them and I’ll add where it’s empty.

In Prague

Prague, Part Dva