The semester from hell is finally over. This semester saw the worst academic performance as a class for everyone to date–nobody I know didn’t do worse overall–as well as the most morale-crushing, asinine bullshit from administration and faculty (from inexcusable neglect to outright hostility). One doesn’t have to think too hard if there was a connection between their poor treatment and our poor performance.
This semester, personally, also saw some of the most incredible changes I have gone through as a person. Not only having to deal with the above (as if it wasn’t enough), as a new father, I had all sorts of adjustments to make: personally, academically, maritally, and just about every other humanly possible way. I look back to last July and see blood, tears of joy and grief, remnants in the sand where past struggles left their mark, and a few incongruous flowers fertilized by the detritus of the time. Almost as if my psyche’s defense mechanism forced itself to detach from the goings on, looking back seems both so intensely personal and yet it’s as though the experiences weren’t quite my own. It’s hard to explain, but I can already feel at least the beginnings of healing. I’ll write more later once I’m further along, away from my Gitmo and can reflect with more depth.
Right now, I’ve switched to organize and pack mode. Claudia is flying in tomorrow night, partly because she wants to go through some more things here at the house, but also, she’d rather not have me drive by myself, even though I’ve done it before. I started to object, but after her being away for 2 weeks and us not having had alone time since–well, since the baby was born–48 hours of just the two of us sounds pretty damn good to me, even if a good chunk is on the road. Grandma will be babysitting, and she’s thrilled at the prospect. I can’t wait to hold my Niblet again, though.
Unless there’s something that is just too juicy to share that can’t wait for me to get settled stateside, I probably won’t be posting/updating much until next week, well after I’ve settled in. A post or two from here notwithstanding, I look forward to posting from the U.S. for the first time since June.
Alone and studying for two exams in less than 4 hours (starting at 7am) is no way to spend one’s birthday. That’s why it was especially nice when I got to spend some study time tonight with a friend who not only provided dinner, but a cupcake, etc. for dessert in lieu of a cake, which for my expanding wasitline was perfect.
Good things can sometimes still be found amidst seemingly desolate circumstances.
Happy Thanksgiving to all! I’m missing my family down here alone, but we have a dinner sponsored by our students’ association, so I’ll be getting a traditional meal tonight at least. I have to wear something “nice,” so nixing my usual repertoire of scrubs, jeans, shorts or sweats means I have to break out the iron and ironing board and sift through my closet for something presentable (and that fits ). At least I’ll have turkey! Yay! And there’s always the Dallas Cowboys game, too–can’t forget that.
For a funny, offbeat Thanksgiving video, go here. Have a great day!
I was gathering all the notes scattered about from our pathology exam yesterday, starting the process to get ready for our partial exam in pharm on Monday (with a comprehensive final three days later–go figure). In doing so, I came across an unintentional joke our visiting professor made while lecturing on the pathology of the male reproductive system.
To set this up for the non-medical readers, a few basic points on anatomy. We have a blood-brain barrier formed by special capillaries that don’t allow any passage to/from the cerebrospinal fluid and brain of anything from/to the circulatory system except those things which normally diffuse across all cell membranes (O2, CO2, alcohol (whee!)) and channels/pores for other ubiquitous nutrients, like glucose, sodium, potassium, etc. It’s slightly more complicated than that, but that’s most of it for sure. A very similar thing exists in the testes, believe it or not, and separates the goings-on in the gonads from the blood circulating around it.
While talking about hematogenous spread of metastases from testicular cancer, there were some special points made regarding this by the professor with respect to the “blood-brain barrier” that exists in the testes. The prof turned beet red and apologized profusely, swearing it was an innocent mistake, not an insult. I laughed out loud, but as I kept looking at most of the class (I sit in the back, like a good slacker), it was clear that not everyone got it, or were too distracted/asleep to care. Sad, because for all the cracks made about men thinking “with their other head,” it was a classic moment.
GR 3:9 is up at Doctor Anonymous. Apparently this round was very selective. I didn’t submit anything, which is probably a good thing given the competition! (pre-rounds interview here)
I’m pretty good about not getting grossed out, but today shows I clearly have a ways to go before I really consider myself jaded. I can view surgery videos all day long, even while eating; the juxtaposition of whatever is on my plate with a close-up of an open chest/belly or a plastic surgeon hunking off chunks of abdominal fat during an abdominoplasty or panniculectomy poses no problem for me.
However, I could not, for the life of me, study pathology at all while eating lunch. Both GI and gyn path were just right out. I had a little leftover pasta from last night and made a good-sized salad to go with, so there was no correlation with the food–it’s just that pictures of ulcerations, nasty polyps, and diverticula on/in the colon was too much. I jumped ahead and was greeted with necrotic vulva, cervical discharge, and God knows what kind of myriad ovarian/uterine malignancies. I’m sorry, there’s a limit, and I just couldn’t do it. Things were easier when it was the heart and lungs. This is a different animal.
I closed the book, put on the Pittsburg/Cleveland game, and finished out my meal in peace.
My wife and daughter left back for the States yesterday, and it’s just kinda hitting me how much I miss them, especially my Niblet. Several times yesterday I caught myself hearing a baby crying from outside the window (Mexican houses are very close together) and I’d reflexively tense up and stop what I was doing, ready to check out the situation. Fortunately, it’s only another two weeks and change before I see her again when I return to Texas for vacation. However, with end-of-semester stuff in between, I’ll be more than busy. It’s still hard, though.
As soon as I knew that her hearing was developing in the 2nd trimester, I began what will certainly be a lifelong process of teaching her about music. On Claudia’s iPod Mini, I put a small playlist of various “soothing” classical music selections. Claudia prefers rock, and sometimes I play jazz, so she got a variety to be sure, but classical music is something special on so many levels–too many for me to wax philosophical about here. One of the pieces I had in the playlist was a famous variation from Sir Edward Elgar’s work, “Enigma Variations,” where each variation on a theme had a mystery surrounding it. Musical historians are still working on that one, but the one I am referring to is entitled “Nimrod” (referring (partially) to the biblical character). This piece is very famous and is used often at funerals and memorials, namely British Remembrance Day (for World War I), where its performance is mandatory.
In spite of its use at such somber and sad events, I always think of her when I hear it. I hadn’t heard it in a few months, but since I’ve become a YouTube slave, uploading and watching videos like mad, I happened to be with her when I was preparing a video of this very work on my computer for upload earlier this week. I sat her on my lap and we watched it, and in spite of the lack of flashy anything on the screen, she actually paid attention! I put my chin on her head, listened, then looked at her angelic face seeing and hearing the music and I started crying–crying because I knew she was about to leave, but mostly because of the beauty and perfection of that moment. She, of course, just looked at me and smacked her hand on my face a few times and wondered why it was wet, oblivious to everything I was feeling.
I look forward to many such times in the future with her (hopefully I can keep my emotions in check before she thinks her daddy is a nutcase), each time being able to share more and more. She turns 6 months tomorrow–half a year that feels so much longer, yet so much like yesterday. I am including the video here (from YouTube) for your viewing and listening pleasure. I hope you enjoy.
From an “Ask the Expert” article in last week’s Medscape (that I’m finally getting to write down before I forget), a reader ponders if they’re really cut out for all of this since the more they learn, the more they seem unable to retain all the facts they previously learned:
My advice is this: First, keep in mind that what you are experiencing is not rare and in no way means that you do not have the ability to be a good doctor, or that you do not have the discipline to continue. Although you feel as though you are having a difficult time remembering facts, keep in mind that you will be exposed to the most important information multiple if not dozens of times. As a pathologist, I am in a field where the depth and breadth of required knowledge can be quite intimidating, but even in our training, this repetition occurs. I guarantee that you will come across and retain what you need. Next, remember that medical school is a finite period of time that serves 2 main purposes: to give you basic information to pass the boards, and to help you choose a specialty. If these things happen, you will have succeeded.
In my own experience, when I felt as if I was losing interest or enthusiasm, I thought back to why I applied to medical school in the first place and why I wanted to be a physician. I reread my medical school application personal statement and talked to family members who had helped foster my career choice. Often, these simple acts put my goals into sharper relief and reminded me of the “big picture.” I also got a boost when I finally chose my specialty. I became reinvested in my remaining rotations, as it seemed that I had more of a focus and direction. Additionally, I was able to tailor my schedule to services that I felt were more applicable, and I found a faculty mentor who gave me advice and served as a sounding board for many of the issues that I have previously discussed.
In the end, don’t lose hope. Remind yourself of why you began the journey. If you haven’t done so yet, narrow down your choice of specialties and optimize your remaining schedule if possible. Faculty mentors can help you with these tasks and provide you with valuable counsel.
Good to remember when at this stage in our learning when we are faced with endless trivia and mindless details as part of the dehumanizing process (literally, in that the facts and data presented in lecture are removed from almost any semblance of the clinical context from which it came) of basic science curriculum in med school (at least for the traditional schools, and our curriculum is still stuck in the 70s, so there ya go…)
“Change of Shift,” the weekly nursing blog carnival, jumps across the pond with this week’s addition at Life in the NHS. Read for some good stories, tea and crumpets style.
Medical School, Personal | enrico | 
November 30, 2006 3:48 pm | 
Comments (4) 
Happy Thanksgiving to all! I’m missing my family down here alone, but we have a dinner sponsored by our students’ association, so I’ll be getting a traditional meal tonight at least. I have to wear something “nice,” so nixing my usual repertoire of scrubs, jeans, shorts or sweats means I have to break out the iron and ironing board and sift through my closet for something presentable (and that fits 
). At least I’ll have turkey! Yay! And there’s always the Dallas Cowboys game, too–can’t forget that. 
(4 out of 5)
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