Mexico Medical Student |

I am alone; Claudia left this morning back the states for her final weeks of pregnancy. It’s for the best of course, but I can’t help feeling it still sux. Even though I don’t always (usually) have time to go places as often as she would like and usually wind up just being homebodies, even though I am holed up in my study almost 80% of the time I’m at home, it’s still comforting to know someone is there, even if you don’t get to talk that much. I’m just not the person that sees a situation like this and thinks, “Party at my house!”  Although it’s not a bad idea… heh.

So, to pass the time all day while she traveled/got settled (because I couldn’t really concentrate for study purposes otherwise), I did the following:

• Watched History of Violence (pretty good), Flightplan (almost as bad as Contact–I am never watching a Jodie Foster movie again), and about 4 episodes of Grey’s Anatomy.
• Played more Splinter Cell (Pandora Tomorrow, not started Chaos Theory yet) on Xbox
• Organized Ziploc bags (click “More” below before you think I’m OCD :P)

As you can see, there was absolutely no academic anything in the above. I feel good, because a day like today (save my wife leaving for 2 months) is exactly what I was aiming to have, at least part of the time, when I had my “vacation” a couple of weeks back. I feel like I’ve spent some decent decompress time, and I’m ready to move on, at least for now.

Oh, and just for the record: Ellen Pompeo (Meredith on Grey’s Anatomy) needs a serious intervention for her anorexia. When a disposable surgical cap looks like some kind of clown prop it’s so big on you (I don’t want to think about the rest of her wraith-like body) it’s time to check yourself in. When Lara Flynn Boyle calls you because she wants to know your “secret,” that’s another clue. I’m just sayin’…

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OK, so the final is behind me, and my path is cleared of the insanity. The exam was 80% giveaway easy, 5% questions that actually made you think in a real way, and 10% questions that were impossibly ambiguous or written so badly you had to wonder what the hell was being asked. I mean a baboon with a set of sentence fragments in a magnetic poetry kit could have constructed some of those questions. To be fair, MANY of our tests are like that, but it’s way too long a post do describe the pathetic reasons why. Now before you wonder where that other 5% went, it refers to the questions that were almost certainly dead wrong. MAOIs as a first line treatment for acute panic disorder? Give me a break. It’s either choose that (as part of “all of the above”) or deal with two right answers (SSRIs and benzodiazepenes)–either way, it’s wrong wrong wrong.

Anyway, enough bitching and on to funny stuff. While reviewing the other day, I came across this in a Kaplan review book regarding defense mechanisms:

Intellectualization: affect is stripped away and replaced by an excessive use of intellectual processes. The intellectual process is academically, but not humanly, relevant.
Example: A boy who is about to ask a girl on a date for the first time talks with this friend about the importance of mating rituals for the long-term survival of the species and the mechanisms by which societies arrange for these rituals.

That’s funny (in a pathetic kind of way), but what would be even better is if the guy had told the girl while actually on the date the above as a justification for “mating” — that’s good reading! I’m sure that isn’t just intellectualization anymore.

My final little ditty on the subject comes once again from the not-worth-the-paper-it’s-printed-on BRS, which I am very happy to say I got used. Like many used books that I didn’t choose at a bookstore and bought sight-unseen it was so cheap, it’s highlighted and annotated to all hell, but for the class and the price it was fine. I also get entertainment value from some of the margin comments and “reduxes” that the previous owner made and wonder why on earth she (her name/address is on the front cover, which is silly for a review book used for a few weeks, but I digress) felt compelled to summarize yet again in even more succinct terms what was already pretty condensed.

For example, regarding anxiety and phobias, one needs to make the distinction between true and appropriate fear as a result of true danger, present or impending, and irrational fear caused by oneself. The student wrote the following in the margin–why, I have no idea:

Fear is the tiger; anxiety is being in the jungle

And speaking of tigers, when Tony the Tiger on the box of Frosted Flakes tells you there is a chip in the back of your neck implanted by the NSA and that you have to dig it out with a spork before the black helicopters come and take you away for more testing, that, boys and girls, is schizophrenia.

I’ve said many times how disappointed I am in this class. I know it’s not a huge part of the USMLE, but it’s important in everyday life and patient care dealing with patients and their families. The course is held hostage by a “Gestalt psychotherapist” (masters level) who is nearly incomprehensible and is obviously more concerned with the more useless parts of psychology (from a medical POV) such as learning/behavior theories, psychological testing/batteries, etc. That’s of course when we aren’t watching movies like “28 Days” with Sandra Bullock to learn, say about alcoholism. Speaking of alcoholism, there is ONE (1) question on our final about it, out of I think 60 or 70. You know, because alcoholism is a minor disease and isn’t presented frequently in clinical settings, unlike other critical factors with higher medical importance, like psychological testing and DSM IV axes, which together represent 10x more questions.

So I escape the insanity of her slides and try to make sense of that which I know is missing, get some perspective (while still dancing like a monkey trying to do well on my final), and I come across this in the Board Review Series in Behavioral Science, 2nd ed pp142-144 (1994) in the chapter on relating to minorities and families (emphases below appear as printed):

• As a group, Hispanic Americans place great value on the nuclear family and on large families.
• Mexican Americans are called Chicanos, especially in the Southwest where most live
• Mexican Americans often seek health care from folk healers known as curanderos. Treatment by curanderos includes magic, herbal medicines, or specific changes in diet.
• “Hot” and “cold” influences are believed to result in illness (eg. rheumatic fever is a hot illness)

What the f*ck is this crap? We’re talking about Mexican Americans here, not indigenous immigrants from the mountains of Mexico. Curanderos are, of course, a part of Mexican and Mexican American culture, but it is beyond irresponsible to say most seek medical help from curanderos to receive herbs and spiritual healing. Since Latinos make the largest minority in the US and Mexican Americans make up the largest % among them by far, that would make curanderos easily searchable with large ads in any urban yellow pages if this were remotely true. As for being called Chicanos, if anyone called anybody that were I grew up, you got labeled some Che-loving radical AT BEST and got your ass kicked at worst. That is a highly specific California/Southwest US term and is nearly synonymous with political activism, not ethnic identity. “Texicans” are not politicallty active in the same way as those wingnut Californians; we just want to be left alone to chillax. (chill + relax) Oh, and I love how the BRS just sort of slides in “where most live,” like we have some kind of beaner tropism (”Here is just the right minerals in the soil and warmth from the sun to allow optimal Chicano growth”) Ok, so I’m being hypersensitive now, but it’s the whole class, subject, everything.
I know the BRS has to focus on basics often without a context, but I really, really expected more (or just omit if there’s nothing intelligent to say) from a medical school study guide in the 90s.

Just to spread the love, here are other quotes, written verbatim from the same pages [with my comments]:

• Among black Americans, the condition of the blood is considered important. “High blood” is thought to be caused by rich foods, and “low blood” is thought to result in sumptoms such as tiredness. [as such, this explains why we give blacks "blood tests:" to placate their superstitious nonsense thinking that high or low blood levels of substances have anything to do with disease]
• In some groups of black Americans, hexes and voodoo imposed by the anger of a friend or relative are believed to cause illness. [as can be seen in any inner city where street gangs kill chickens and sacrifice goats to increase their street cred]
• Americans of Jewish descent are more likely than other groups to report their medical problems and visit physicians for help. [Yes folks, it's the stereotypical whiny Jew that the BRS is warning you about before you have to deal with them in the hospital. This was the ONLY Jewish mention, so this their one-sentence "redux" ]

It looks like as a whole, the entire subject is screwed when you can’t even get mainstream medical publications on this to be free of tripe. It’s good that I really don’t care much anymore. I mean, this week I have probably studied maybe 8 hours total, and it hasn’t been good studying. Last night, I was dividing my time between BS and Splinter Cell, and today, well, I’m writing this post, aren’t I? Until I review in a year or so for Step 1, this is the end of my BS experience. Thank God.

The new vaginal ring contraceptive, NuvaRing, has found a strong advertising presence here in Mexico as well. I found a brochure on a table in the doctors center where Claudia’s OB is located. It was a polished, well-made pamphlet designed to sucker inform prospective patients about this contraceptive.

Then I saw the back with this URL, which I link here so you know I’m not kidding: http://www.tuvagina.com.mx/. Just in case someone can’t read between the lines, tu in Spanish is “you” or “your” (informal, familiar form). The link will redirect you to entremujeres.com.mx (”among/between women”), and the ad will be ‘anillo vaginal’ which takes you to another site, unavezalmes.com.mx (”una vez al mes” = “once a month”)

Now I’m a guy, so the elevated testosterone in my bloodstream may prevent my brain from comprehending these estrogen-dependent things, but I have a feeling that the idea of promoting that site in English with the commensurate URL wouldn’t even get past the conference table in a marketing firm’s brainstorm room, much less printed on who-knows-how-many million little pamphlets to be distributed everywhere. But that’s just me…I don’t ever recall seeing a yourpenis.com URL associated in any way shape or form with the overabundance of erectile dysfunction drugs (thank GOD).

Just to test my useless theory, http://www.yourvagina.com/ resolves, but it’s “in repair” and owned by a web hosting company, indicating a probable squatted domain or the like. Either way, it’s unlikely you’ll see that link resolve anytime soon to anything resembling NuvaRing….perhaps other things which involve lots of pop-up windows and “over 18″ disclaimers, but I wouldn’t know anything about that.

Well, update from me, FINALLY. A lot has happened, and not a lot has happened. I have been trying to maximize my time with Claudia, since she’s traveling back to the states this weekend to stay for good until baby is born. She has insurance and all that back home (I wish I did), so while the primary reason is family support on both sides, not having not to pay out of pocket due to no insurance here is not an insignificant reason, especially since a C-section is very much a probability. Compared to the US, however, a C-section delivery here is dirt cheap, starting around $2500 all expenses paid, and they are oldskool here about keeping you as an inpatient until you are absolutely ready to go. The hospital where Claud would have it where her OB works out of is a bit more, but it’s *posh*.

Anyway, didn’t mean to type all that, but it’s getting to the point where I’m alienating my readers–the precious few I appreciate so much–with the lack of posts, so it’s either stream-of-consciousness or nothing right now.

Regarding our recent vacation, let me catch you up. In the middle of the previous posts about photos and heat in Texas, Claudia was having to close on a house that belonged to her late sister (she’s the executor of the estate) and that process consumed almost the entirety of our vacation since there was already queued up problems before we arrived. She’s 8 months pregnant, so it’s not like I can sit home with a clear conscience and say, “Not my problem,” as much as I’d love to. Oh yeah, and my scatterbrained aunt was the realtor, so the family mix continued. I won’t get into details, but our stay was not as fun and relaxing as it should have been. When I left here, I was totally cursing out random people — I needed a vacation in a bad way. I felt I needed to go back to the US and recharge my batteries, but life made sure I left the charger here.

Regarding going back to school, I really, really tried to have a good attitude about it in spite of the shortchanged vacation. I actually enjoyed resuming classes once I was there…for about a couple of hours or so. Then the time wastage resumed, going to classes that just read PowerPoint slides to you, etc. I have my Behavioral Sciences final on Friday, and if it is possible to have a negative interest/motivational level, that’s what I have. I don’t feel that way about every class, but in general, I’m back to a study slump. It seems every time I have an extended break from studying, the inertia that needs to be overcome to build momentum again seems to increase.

Speaking of bodies at rest and all that, I am going to be posting a flurry of entries in the next 24-36 hours (”Sure Rico, you say that all the time…” I hear already) from half-written drafts and others that were just waiting on a picture edit. Just thought I’d mention in case you find this post buried under more than 4 others having just checked within a day or so. I hope you, dear reader, are well.

I am awake w/o sleep hours before we’re supposed to drive back with only two days rest until classes resume. Of course, I’m not going to get two days rest, because there is the requisite time to unpack, get resettled, tend to lapsed tasks, and of course, make a decent grocery run since we intentionally left the fridge/freezer bare by using up all perishables. I’m not sleeping not because I’m anxious or whatever (which I usually am, just as a matter of course) but because my GI system is giving me so much cramping, pressure, and bloating. I’ve taken enough simethicone to flatten a keg of cheap beer but it seems to have had minimal effect on me.

Anyway, I hope to be back online Saturday evening. See y’all then.
-e

UPDATE: Sun, 23 Apr:

Ok, back in GDL now as of last night, but man am I tired. I need to sleep more today in prep for classes resuming tomorrow. Until I finish up my post drafts, my advice is this: don’t ever travel across the country (much less in a different country) with a cat. That is all for now.

It is so hot here. My skin feels like it’s boiling off. Braising is perhaps a better cooking term, since it’s 80%+ humidity outside, so I get to oven roast in my own juices. It doesn’t help that I’m dealing with a stomach bug right now–how ironic is THAT? I came from Mexico to Texas, remember? So it’s oh-so-pleasant dealing with the infernal temperatures outside. They said we’d get a reprive tomorrow of a few degrees.

And nothing is more small-talk useless than the ubiquitous, “It’s a hot one today, eh?” every place you go. Such depth. I can’t blame them — their brains are scramble-fried about as much as mine. I’ll post more about other stuff that’s happened, but before I do, I had to share at least this.

Here is a little infographic courtesy of the Weather Channel, annotated by yours truly to make the data more clear:

Keep cool!

I’m going to be a daddy! Our little girl will be introduced to the world in about 5 weeks. I always knew I’d post about it since it would be nearly impossible not to include here such a huge change in my life, but for several reasons, I just didn’t get around to it until now. I am becoming a little more forthcoming with personal details since I know I identify with other bloggers, anonymous or not, who share the details of their lives in a way that makes readers feel they are a part of their world. My world is about to be shaken substantially.

One reason I waited was because we lost our first baby last year in the first trimester before med school began. It was what’s called simply a “spontaneous abortion,” but such sterile clinical labels and explanations regarding statistics re:viability don’t help when it happens to you. I wanted to make sure this one “stuck” first and foremost. After it was pretty clear she wasn’t going anywhere, I was waiting for a good picture. She is her mother’s daughter (*ducking for dear life*) lollying about, kicking, rolling, etc. when she wanted to, but she never wanted to pose for good pictures or be “on” when the doctor/sonographer was taking notice. As such, it was always, “Well, next time we’ll get a good shot and I’ll post it.” Now at 35 weeks, she’s sitting up breech and facing backwards. She apparently likes the view of the posterior uterine wall for whatever reason. Maybe she put up some decorations there or that’s where the TV reception is best.

After 2.5 years of marriage, 9 months of medical school, who knows how many years and credit hours of undergraduate and graduate education, I can say wholeheartedly that I am woefully underqualified to being a parent. I think we all are with our first. I know I’ll be a good dad, but you always want “more time,” waiting for the perfect moment when all the finances are set, the house is bought, etc. That doesn’t even happen in the movies anymore, much less real life. True life for me, right or wrong, has been doing it the hard way against more odds than needed to be there, perhaps stubbornly, perhaps through bad luck, but getting the job done regardless.

Except this isn’t a “job,” or a goal–this is another life, my life, about to come into this world, helpless and full of unlimited possibilities. I’m scared, excited, proud, and a whole host of emotions all at the same time. I totally believe in sympathy pregnancy symptoms, since I’ve experienced weight gain, moodiness, odd cravings, unexplained pains, and every minor symptomatic oddity (save, perhaps, breast tenderness) in far greater frequency than when before Claudia was pregnant.

Medical Madhouse Madman (Doctor) had “Future Intern;” thankfully, she won’t be in my daughter’s graduating class, since I’m sure Doctor’s daughter already has the lock on valedictorian. I am wondering if I’m going to have “Future Biochemist” or “Future Concert Pianist,” or any number of roads I left behind in my not-so-distant past. Right now, “Future Daddy’s Girl” sounds pretty good to me.

Just to let y’all know that I have enough photos uploaded to re-share with everyone. The “Photos” link at the top is now enabled, but you can just go here, too.

The URL might change (I can’t get the Gallery software to behave to change paths/domains w/o breaking links), but I’d update the links on the page(s) anyway. Benzo.org was and is the original name of the site, so if you see that in the title bar, it’s still me.

Enjoy!

I just re-read my last post saying “See y’all on Monday/Tuesday.” It’s Friday night (technically now Saturday) and I’m BARELY getting to posting. Vacations are extremes for me: they are either too laden with “to-dos” and “gotta-see-everythings” that I don’t actually relax, or I relax, as in staring at the wall for hours on end, just reveling in doing nothing. I’m so weird that I can have the dubious distinction of being able to claim both phenomena in the same vacation. Seriously, I think I lost an entire day around Wednesday or so just putt-putting around my parents’ house, confining myself to the upstairs where I (we) fashion almost a studio apartment, complete w/microwave and dorm fridge for cold drinks. I brought my Franken-TiVo (thrice upgraded Series 1 unit from 2000 with more after-market hardware than original) and am loading it up with programming (thanks to parental units’ subscribing to every cable premium/movie channel) to have goodies to watch when I go back to Mexico.

But back to life in general, parents are well, family is well. Claudia’s been consumed with closing the sale of her late sister’s house (as executor, she’s responsible for executing those who disagree with her) which is being managed badly by my realtor aunt, so it’s rock/hard place all the time between yelling at my aunt for lacking such obvious managerial skills vs. not impeding a sale that all want to happen. This means that we haven’t really done much together now that I don’t have school, which is a shame. Hopefully things will calm down this weekend until the trip back.

There is quite a few more things to say, but I’m going to say them in separate posts because they deserve their own space to ferment grow. To all my readers (notice, I used the plural form), I apologize if I haven’t commented on your blogs or stopped in lately. You see, I am rather retarded without my trusty newsreader, NetNewsWire. I have tried FeedBurner and RSSOwl on the PC (my laptop (tablet) that travel with) to substitute when I’m away, but it just doesn’t cut it. If any of you have any good suggestions or wouldn’t mind sharing your thoughts on what works for you regarding RSS/ATOM readers for Windows, I’d shore ‘preciate it. *tips hat*

On to the other posts, now that you know I’m alive!