Television

I'm back!

Let me re-introduce myself. My name is DC Med Student and I am a TV addict.

The smartest decision I ever made was getting rid of my television two years ago. While I was home on vacation, I swear I spent the majority of my time in front of the new 42" plasma television with Direct TV. Who needs to go out into nature when you can sit comfortably on the couch and watch Planet Earth in HD surround sound on the Discovery Channel? And boy do I love it when networks decide to do series marathons! I was able to watch a season of The Biggest Loser, the latest season of Kathy Griffin: My life on the D-List, as well as the latest season of Little People, Big World. I also came close to earning my master's degree in Egyptology from watching the History Channel. And then there were all of the home improvement shows on HGTV. . . (How I wish I had the money to redecorate my apartment.) Oh, but my favorite show. . . Judge Judy! I know, it's sick.

I would have failed out of medical school last year had I had a television with cable. Seriously, I cannot tear myself away from that thing. And now that there are a bunch of shows that highlight obesity, another one of my interests, I know for sure that I would have convinced myself that it was of educational value to watch shows like Big Medicine, Honey We're Killing the Kids, and Plastic Surgery: Before and After.

It is really important to know yourself well before entering medical school. You need to know what works for you and what doesn't. The sooner you can identify your weaknesses, the sooner you can make the necessary changes that will make you stronger, more effective, and, ultimately, more successful.

I'm not going to lie. It's hard. I mean, right now all I'm thinking is, "I can't believe I'm going to miss the season premiere of Flipping Out (on Bravo) today." It's true. This, when I should be preparing for my second year of medical school. I need to buy books; I need to pay rent; I need my loan disbursement money. Thankfully, now that I am back in my DC apartment sans 42" plasma television with Direct TV, it won't take long before I've switched gears and focus again on all things medical school.

Vacation

Tomorrow I head out to the Rocky Mountains for some much needed rest and rehabilitation. I will be there (at a base elevation of approximately 5,400 feet) for three weeks before I return to D.C. to tackle my second year of medical school.

Some planned activities are white-water rafting, hiking (peak elevation approximately 10,200 feet), jogging, and plenty of TV-watching (I have much to catch up on). I will have limited Internet access, so my posting will be less frequent.

The next three weeks will likely be the last three-week vacation that I take for a long time to come. Next summer I will be studying for USMLE Step 1, and the summer after that is only a two-week break. You don't get much time off during medical school. Even on this trip I will likely spend some time reviewing first-year material and previewing second-year material. Nevertheless, when that vacation time rolls around, make the most of it. Do something. Do nothing. Just be sure that you come out feeling refreshed. You deserve it!

Attendance

Some mornings you wake up and just don't want to go to class. Many mornings were like this for me during my first year of medical school. I would have Jill Scott's "Gotta Get Up" playing in my head:

I don't want to go to work today
I'd rather stay home and play video games
I'd rather chill for real / I don't know how you feel
But sometimes I feel like I'm
Workin' for nuthin' / tryin' to get sumthin'
Everywhere I turn there's a bill standing out
Swim the river climb the hill
Complacency you ain't gone get me
no no no no . . .

I want to say that most days I made myself go to lecture, but there were plenty of days when I felt I needed a break from the lecture hall and remained in the quiet comfort of my apartment.

You may ask, "Don't you have to attend every lecture to do well in medical school?" My experience so far tells me, No. In fact, my exam grades improved in some units when I did NOT attend lecture. It all depends on the subject being taught, your learning style, and the teaching style of the professor(s). Besides, you could always watch the recorded video lectures or listen to the recorded audio lectures for the days you missed if the guilt (or, perhaps, fear of missing something important) was really getting to you.

If you are not getting anything from a series of lectures, that time can be better spent on any number of things. My top ten alternatives (in no particular order) are listed below. Please feel free to add your own favorites in the comments.

1. Catching up on sleep
2. Catching up on grooming
3. Catching up on sleep
4. Catching up on laundry
5. Catching up on sleep
6. Catching up on "Grey's Anatomy"
7. Catching up on sleep
8. Catching up on "Ugly Betty"
9. Catching up on sleep
10. Catching up on life outside of medical school

Language

According to U.S. Census Bureau data from 2000, roughly 17% of D.C. residents aged five years and older spoke a language other than English in the home. Of that 17%, nearly 55% spoke Spanish in the home. Nationally, the figures are similar with 18% of people aged five years and older speaking a language other than English in the home. Nearly 60% of those spoke Spanish in the home. Furthermore, a 2003 U.S. Census Bureau report on language use and English-speaking ability showed that nationwide, just over half of those who spoke a language other than English in the home indicated that they spoke English "Very well" (the other categories were "Well," "Not well," or "Not at all").

Being able to speak Spanish will help me during my medical education and career. This I know for sure. I have heard plenty of stories from friends in medical school about the difficulty of working with translators or of being the only person who is able to speak some Spanish and getting "stuck" with all the Spanish-speaking patients.

In addition to the gripes from some of my friends (and the gripes I've read on other medical students' blogs) there have been other moments that have reminded me of the key role I could play in the clinical setting. This past year of medical school, during our course on patient care and the practice of medicine, we discussed the many barriers to health care that immigrants face in Washington such as language, cultural, and economic barriers. The top three languages, after Spanish, that are most sought-after from medical professionals are French, African languages such as Amharic, and Chinese.

I did not always believe that being able to speak Spanish was an asset. In fact, from about age ten to fourteen it made me very self-conscious. During that time I was attending a private school full of rich kids; I wasn't rich. In my mind at the time, rich people didn't speak Spanish; only nannies and house-keepers and gardeners spoke Spanish. I wanted desperately to fit in with my classmates. I was young and foolish and ignorant.

I look forward to the day when I will be part of a Spanish-speaking patient's health care team. To be able to care for them in their native tongue will be a very proud moment for me.

Dear Mom,

Feliz cumpleaños! Today would have been your 55th birthday. Gosh you're getting old! ;)

I know it's been some time now, but I still find myself wanting to call and talk to you about what's going on in my life. I miss the comfort in hearing you say, "Todo va a salir bien." But I've learned that, for the most part, things do turn out okay.

What did you think of the fireworks this year? I know you loved them; you always did. I like to think that now you have the best view of all.

Happy 55th! I miss you. Tu sonrisa vive en mi por siempre.

Independence

The Nation's Capital. Can you think of a better place to celebrate Independence Day?

I will be going to a small get-together late this afternoon, and then I will make my way down to The Mall to enjoy the Capitol Fourth celebration, which is being hosted this year by Tony Danza of "Who's the Boss?" fame. You can't help but feel patriotic when you are surrounded by the Capitol Building, the Washington Monument, the Lincoln Memorial, the Jefferson Memorial, the FDR Memorial, the WWII Veterans Memorial, the Vietnam Veterans Memorial, the Korean War Veterans Memorial, and the White House. Now imagine them at night, all lit up, with one of the best fireworks displays in the nation. The experience can't be beat.

As a reminder of what today's celebrations are all about (because CLEARLY we have forgotten), I have posted below some of the text of the Declaration of Independence that was drafted and signed in Philadelphia in 1776. You can read the full text at The National Archives.

Happy Fourth of July! Be safe.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

Anatomy Lab

I have mixed feelings about anatomy lab. On the one hand, I enjoyed nothing more than learning the anatomy of the body and seeing it on the cadaver, but on the other hand, most dissections were a tedious chore. On yet another hand (work with me people), I struggled, on a spiritual level, with the poor treatment of some of the bodies.

Anatomy came easy to me. I could study figures from Netter's Atlas of Human Anatomy, go into the lab and identify the structures, review by flipping through Moore's Clinically Oriented Anatomy, and calling it a day. I think it has to do with the way my brain is wired. As I mentioned in the "Teaching" post, I am a visual learner. Once I saw a structure and identified the structures around it, it just stuck in my mind. For example, if it was a muscle, I could visualize what it would move and any nerves and blood vessels associated with it. I think it has something to do with the way my brain processes and stores spatial arrangements. For instance, when taking Organic Chemistry in college, determining whether a given stereoisomer was the S or R configuration, was like distinguishing my right shoe from my left.

The only lesson learned from actually dissecting was that the body has a lot of fat and fascia. I feel that many of the hours wasted in lab could have been better used studying physiology and the rest of the lecture material. It is just not possible for everyone to work on the body at the same time. In addition, when the instructor came around to review structures, it was not possible for everyone to see the demonstration. Having said all that, a couple of the dissections (e.g., opening the cranium, opening the thoracic cavity) were exciting and really held my attention. I do not believe that lab is pointless. I simply think that it is most effective with a small group and, unfortunately, my tank had a lot of people.

How does one decide that they are going to participate in a body donation program? At this point in my life, I could not make that choice. I can't even bring myself to become an organ donor, though I like the idea and understand that it could save someone's life or improve their quality of life. I mean, it's not like I'm going to need my organs when I'm dead, right?

The individuals who donate their bodies to medical education trust that their bodies will be used and handled appropriately and treated with respect. I feel that this trust was broken by tanks that allowed their bodies to quickly dry up and that did not wrap and cover their bodies well at the end of their sessions. I heard some people making jokes or inappropriate comments about the bodies. My strong feelings on this issue made it difficult to look at and work on the face. At times I would think, "We should not be doing this." But I can see that these feelings have to do with me and the beliefs that my mother had about the connection between mind, body, and spirit.

To those individuals and families that donated bodies to further my medical education, I say Thank You.

"Question!"

"Shut up!"

Sorry. It's reflexive. Let me try to explain.

Imagine. You are in medical school, which means that you are probably a bit high-strung and anal retentive. You are under intense pressure to learn (i.e., memorize) a million facts about human histology, physiology, embryology, anatomy, etc., every 2-3 weeks. You are presented with this information during 50-minute lectures five times a day, five days a week, for approximately 40 weeks. It's a terribly fast pace so you try to pay attention and jot notes as the professor flips through their 100-slide presentation. If they don't get through the whole presentation, it is up to you to go over it yourself at a later time (yeah, good luck). This is why questions should be asked sparingly and only to clarify key points or discrepancies. Three of my classmates, however, felt compelled to ask at least three asinine questions during each lecture hour.

"Question! You just said that blood enters the right side of the heart, so does that mean that blood enters the right side of the heart?"

"Question! You keep saying 'intracellular' and 'extracellular'. . . does that mean 'inside' and 'outside' the cell?"

"Question! My friend has long legs and a short torso, so does that mean they have Klinefelter syndrome?"

"Question! --"

"SHUT UP!"

Lecutre Hall

The first-year medical lecture hall was a fascinating landscape. This vast expanse consisted of distinct territories and, as occurs throughout the animal kingdom, distinct groups were associated with these territories. The lecture hall was divided into three primary sections: Left, Center, and Right. Each primary section was further subdivided into three secondary sections: Front, Middle, and Rear. Distinct groups established themselves within these territories early in the school year. Those seated in your immediate vicinity were likely to become your closest friends at school.

Movement within your section (e.g., Left Rear) was generally accepted, but heaven forbid you move to another (e.g., Left Rear to Right Middle). I committed this ultimate faux pas one morning when I arrived to lecture thirty minutes late. Not wanting to disturb those seated in the aisle seats of my section, I took a seat in the Center Rear section. "What's wrong?" "Are you lost?" "What happened?" "Did you have a falling out with X?" "Why are you sitting here?" Clearly, I had upset the fragile lecture hall landscape. When break time arrived after an hour of lecture, I quickly made my way to my usual seat.

Through the year, the lecture hall became a second home. It's a place I went not only to listen to lectures, but to eat, sleep, study and socialize. It also provided constant entertainment: people falling down steps, people tripping up steps, dropped laptops, spilled coffee, and -- I kid you not -- George Foreman grilling.

I know for sure that next year will be much of the same, albeit in the noticeably smaller, more intimate setting of the second-year lecture hall.