An ‘A’ I didn’t earn

I don’t really like the way I feel right now. Before taking my exams, I’d heard that the class historically does poorly on these tests and this makes the cut-off for an A much lower. Knowing this, I decided not to push myself and to be comfortable with a lesser score. I got exactly what I asked for: two As just above the new cut-offs.

 

I’m not proud of what I’ve done and don’t feel much for celebrating. Worse, I think I saw this coming.

When they start us out in medicine, there’s a quote that gets thrown around to make each of us a little less nervous about our grades and a little more smug about getting by. Vitum Medicinus drew my attention to it once again:

Q: What do you call someone who graduated at the bottom of their med school class?
A: Doctor.

It’s funny, and it’s not.

Imagine a guy…

Beginning in Pathology, you begin to learn about some horrible diseases. You don’t know that they’re horrible, not really, since you haven’t seen someone with them. And medical terminology being what it is, there are some pretty nasty things hiding behind relatively innocuous words. E.g.

In Duchene Muscular Dystrophy, a child is born that will die around the ages of 18-24. Symptoms don’t appear until around the age of 3 when the kid is walking. The parents will tell the doctor that their son is walking around on his tip toes, his calves are enormous, and that he seems unstable. Whenever he falls over, he has a very strange way of getting back up (Gower’s maneuver). Eventually, this child will lose the ability to walk and the disease takes over his hips, shoulders, and spine leading to scoliosis.

Now all of that is pretty straight-forward-horrible. But then they throw in this gem: Contractures develop. Two words to describe a focal muscle tightening that will twist someone’s son into a shape that noone can unstretch. Contractures.

Out of a book and onto the roof

I spent two hours on the roof today in the sun, watching planes land and take off from the runway.

I have a lot that I have to do. I have an exam coming on Monday that’s a behemoth, I haven’t gone over Immunology or Rheumatology, Endocrinology or Neurology. That’s over half the material. I have all day tomorrow, but I’m not going to be productive. I just don’t care to be, and I’m not worried about doing poorly. I’m inappropriately convinced that I’ll be fine. I even expect to get an A.

I don’t know what’s going on with me. The material is fascinating and, once this test is over, I plan on taking notes on all of it just so I have it for some later date. It’s not the work that I’m rebelling against; it’s the stress. I refuse to be stressed by these tests. I refuse to push myself. I haven’t done this before, and it feels good to experiment.

SVD Frustration

I’m so fucking frustrated right now.

At SGU, after any exam, the scantrons are collected and those students wishing to may leave. Students may choose to remain to be passed the answer key. They then have a half hour to look over their own answers. This system is so important to me as a student because it:

1) allows me to catch things I’ve missed that may be important

2) catch mis-keyed items

3) write challenges to questions that are poorly worded or have more than one correct answer.

All of this is important when you consider that everyone (profs included) make mistakes and that many of our professors are foreign-born, so the use of English sometimes does not sync correctly.

Why you would screw up a system that works is beyond me.

Deadwood

A week ago, I had a dream that I lost both of my arms in a car accident. Stoic that I am, I decided that it didn’t make sense to cry over things that I couldn’t fix and decided to learn to live without half of my limbs. It was hard, but I had a singular goal that kept me focused on the positive and off the negative: to become capable again.

Later in the dream, I learn about the new work that’s being done with bionic arms. I call up the group that is pioneering this work and am able to convince them to take my case. “I was going to be a surgeon!” I plead. After months of work with this group, they present me with my new limbs. As they attach them, I’m trembling. I feel scared of them even though this is what I want more than anything else in life.

Grand Rounds 2.52

Grand Rounds is up at Tundra Medicine. Go read the week’s best writing from students, nurses, doctors, etc.

Drunk Driving

 

I do not care much for scare tactics. It is a right of passage in high school that a local police officer comes before the entire student body to give a lecture on the dangers of drunk driving. I remember hearing about it beforehand that this guy used scare tactics and would show us a bunch of car crashes that claimed the lives of teens ‘just like you’. Most of my friends thought, “Cool! I like car wrecks. Let’s see who totaled his car the worst.” Slide after slide of cars bent around trees, charred from fires and road scenes cleared of everything except a little blood on the asphalt clicked by. We would snicker to each other, “Wow, that guy must have been going fast.” Sure, we were being callous on purpose, but the consequences just couldn’t register anyway. Then he brought out the beer goggles.These were thick plastic lenses that horribly distorted your vision. He lectured us about the level of alcohol in your system after a single beer, and how you were drunk after just two. Don’t believe me? I’ll show you what it’s like for someone your age after two beers He asked someone to come onto the stage to wear the goggles, and he would let us all laugh at our friend’s inability to walk against his best efforts to just ‘maintain’. That’s when the officer would yell sternly, “That’s what it’s like when you’re drunk! Not funny, is it!” What a bag of mixed messages.

Six months

Six months. In six months I will have taken the USMLE step 1. I will go home, pack my bags, and get on a plane. In six months I will be in Southeast Asia.

I will swim with fluorescent algae. I will push my arms through the water and watch as their outline of my arm glows green/blue and then fades. I will get out of the water and watch the drops fall clear and splash brightly against the sand. It will be like cold, liquid fire.

Vietnam, Laos, Thailand, Cambodia. Two months between the USMLE and Clinicals in New York. My backpack, my roommate, and the $4000 I didn’t spend on a Kaplan course.

Southeast Asia. Six months.

Can’t wait.

Psych 0-5

Another psychiatry experience today. This man hallucinates fisherman turning into giant frogs. He describes smells coming to attack him. He was jealous of his brother’s success so set fire to his mother’s house. He tells us all of this while smiling. He says that his sister, who died years ago from GI cancer, visits him in recurring dreams. She keeps trying to have sex with him, he says. He’s missing a leg. Really ‘missing’ it, as in, can’t remember where it went. His file says that after setting fire to his mother’s house, he attacked his guards in prison and they shot him in the knee. No heroic measures were taken to save the limb.

All of that sounds interesting except I can’t focus on any of it. There’s a patient in the courtyard outside the window whose been playing the guitar for the last two hours. He’s a very good player and singer. I wish I were outside and far away from this guy’s problems.

I told my roommates today that I was very close to ruling out psych altogether. They all laughed at that: “Like you could ever be a psychiatrist.” I’m not offended by this at all because it’s just so completely true.

SHOUT*!

My landlady just popped and brought the baby over. While my roommates are cooing over how cute he is, I ask if I can hold him. Want to know a cool trick about babies?

If you let a healthy baby’s head drop suddenly, it’s arms will reflexively extend and grasp. I think this is a defense against falling from the mother’s arms. Instead, I like to use it in the following context where “*” means dropping the baby’s head.

“Now waiiiit a minute. You know you make me want to SHOUT*! Come on now, SHOUT*! Come on now, SHOUT*! Come on now, SHOUT*!”

By the way, this never gets old.

Greetings from St. Vincent.