(I didn't make this chart myself, but I have no idea who did make it so I can't give proper credit)
Tuesday, December 21, 2010
(I didn't make this chart myself, but I have no idea who did make it so I can't give proper credit)
Friday, December 17, 2010
Dissecting a body is definitely one of the weirdest experiences I’ve ever had, and probably will ever have. First of all, I find it crazy how much every body is the same (except you, reader, you’re special and unique!). Of course we learn about so many birth defects, but what I’m amazed by is how often things go right, considering how complicated everything is inside us. Where things are in the body and where things go and drain and lead to, etc, etc, are so consistent (most of the time). Maybe I’m some naïve first-year student, but I truly am amazed by how good our bodies are at doing what they’re supposed to do. I wonder though if I’ll still feel that same way as I go forward in school and learn about more things that can go wrong.
So my favorite part of dissecting was getting to see and open up the heart and lungs. The lungs were cool because they were surprisingly squishy, and you could also immediately tell the smokers from the non-smokers. The heart was amazing to see because it is such a perfect example of form following function. Getting to open up all the chambers and follow where the blood would run, and seeing the valves – it just all makes such perfect sense, and I like things that make sense.
I also really liked seeing the inside of the kidneys – I don’t know why I liked it so much, but they just looked exactly like the pictures in the book, and they were so much smaller than I was expecting so that I felt like I was holding a mini-version of a kidney, and the first word that came to mind was “cute.” I know, that’s weird. How could a kidney be cute? But I swear it was – the kidneys are seriously adorable. But 180 liters of liquid run through these teeny tiny structures every single day to be filtered – I couldn’t believe it. I still don’t really believe it.
The other thing I really enjoyed about dissecting in general was getting to check out other groups’ bodies. As similar as all bodies are, there are always some surprises. For example, when one group found their heart, there were wires sticking out of it! Robot cadaver? I wish. But it was just a surprise pacemaker. Another group had staples down their rib cage, two groups had cadavers with undescended testicles, one group was missing the gallbladder, and another group had a gallbladder that was enormous! And some of the smaller arteries – uchhh – they are all over the place. Consistent enough to survive I guess, but seeeeeriously, they do not all follow the same path, and that is kind of annoying for those of us who are trying to study for an exam (while we’re on the topic of annoying things about studying for an anatomy exam – why aren’t our bodies completely symmetrical???? That would make my life easier).
The biggest variation between bodies is the size of the muscles and the amount and surprisingly, the color, of fat. Some groups have to spend almost their entire lab time just digging through stuff to get to what we’re actually looking for. One time, one of our professors pointed out an atherosclerotic artery and didn’t even refer to it as an artery, but said “ok, here’s the cheeseburger…” It really made me almost want to start going back to the gym. It also really made me wonder: at what point in a doctor’s career do you start getting cynical?
Tuesday, December 14, 2010
So during one of the first dissections, we were asking one of the professors where a certain structure was. He quickly pointed to what we were looking for and said, "See, there it is! Whomp, there it is, whomp whomp, like the Run-DMC song!" So since everything in our body was so easy to find (and because with every muscle we identified we could say "whomp there it is"),we decided to call our cadaver Run-DMC. But after some careful, peer-reviewed internet research, we discovered it is not Run-DMC but Tag Team who sings that song - oops, now it's public - I have no music knowledge. So, moral of the story, we call our cadaver Tag.
This name also works because half of our Anatomy exams are "practical" - where the professors tag a structure on the cadaver, and you have to identify that structure. Because our cadaver lends itself to clear dissections, he's always one of the bodies chosen to be tagged on the exams.
Friday, December 10, 2010
So we had a little break from dissecting recently, and we're just getting back into it. Anatomy is divided into four units. The first unit included the arms, legs, chest, and back. The second unit, which we just finished about a week ago, was the thoracic cavity - basically the heart, lungs, and ribs. Not surprisingly, it felt like a MUCH more manageable amount of information than the first unit. There was a also a lot less dissecting, because once you take the heart and lungs out, there's not much to do within the body itself. In comparison, during the first unit it felt like every day we were digging around for a new set of muscles.
Now we're in Unit III which is the abdomen. That includes all of the internal organs - the liver, pancreas, gall bladder, stomach, spleen, small intestine, colon, and about a bajillion and a half arteries, give or take a few. Coming up after December break is Unit IV, the head and neck, which we won't actually be dissecting ourselves, but instead looking at prosections, or pre-dissected structures. So, while it's incredibly hard to believe, we're almost done with dissecting already!
I thought I would introduce you to my cadaver first, and through the next couple posts I'll talk about some of my favorite things about dissecting and then some of the more uncomfortable parts - but I promise, nothing too gory! Before I start talking about all of this though, remember that the cadavers were real living people who made the most amazing donation to allow us to learn from them. When I'm tired and start to get lazy during dissections or want to rush through them (this happens during most dissections...), I try to remind myself that to not take full advantage and learn everything I can is selfish and disrespectful. So while sometimes you have to be able to step back from the cadaver as a person to be able to stomach what you're doing (for example, we cover his face with a towel as we dissect), you should constantly remember to treat the cadaver with as much respect as you would a living patient - minus the whole being-able-to-feel-pain thing.
Tuesday, December 7, 2010
Tuesday, November 30, 2010
Let's say I discover a new type of cell in the body that no one has ever seen before. And let's say this cell has a big blue blob in the middle of it - would I name it Elena Cell? Noooo, I would not torture future med students that way (plus, they'd probably spell it Elana Cell on exams, and I would get super annoyed by that for eternity). Instead, I would name it the Big Blue Blobby Cell. That way, when future med students are studying they can be like, "Wait, what's the name of that cell with the big blue blob? Oh yeah, the Big Blue Blobby Cell, how logical!" And maybe no one will remember my name as the famous scientist who discovered it, but at least they won't hate me with the same venomous passion that I have for people like Dr. Albert Adamkiewicz or Dr. Hans Kohn, or really anyone on this list - although, I have to admit that I am ok with there being an element called Einsteinium, he can totally have that one.
I know sometimes it's not the scientists who name things after themselves - it's other annoying people who do it later to honor them - but I still hate Adamkiewicz and his stupid anterior segmental medullary artery.
Tuesday, November 23, 2010
New obsession. If only because of the tag line, "smells like spleen spirit" - not only is it a clever pun, but it's also alliteration! Sigh, it's discoveries like this that make me believe in a higher being.
Just to be clear, anyone who is expecting a present from me anytime soon: assume it will be a plush microbe. Check them out by clicking on the link above or below, and let me know your favorite.
Personally, I find syphillis adorable.
Tuesday, November 16, 2010
It's that lovely time of year right now - that time between taking an exam and actually getting your grade back. There are those I've spoken to that are absolutely positive they completely bombed our first anatomy exam, there are those (whom I haven't actually talked to, but I'm sure they exist somewhere) that are secretly happy about how they felt it went, and then there are those like me who vacillate constantly between best and worst case scenarios depending on the moment (my "worst"-case scenario: law school next year). And then of course there are the smart people who choose not to obsess about the exam after it's too late to do anything about it anyway, and do fun things instead.
Let me explain how anatomy works here, and why this test seemed so particularly difficult to everyone. And then, I promise, I will talk about something other than class for the next few blog posts.
So first off, there are no lectures at all for anatomy or histology (there are a few for embryology). Everything we learn is through TBL, or Team-Based Learning, which is the newest cool thing in medical education. Let's say tomorrow's subject is the upper arm. In our syllabus, there will be a list of pages in our book to read (for example, the chapter on the upper arm), followed by 3-4 pages of questions to answer or structures to identify based on that reading. When we go into class the next day, everyone takes an individual short quiz based on the reading, then we go over alllll the reading questions with our TBL group (a 6-person team assigned at the beginning of the course), and then at the end you take that same quiz again as a group. Finally, you go to the lab and dissect, or look at histology slides. The tests are supposedly based only on questions and structures from the TBLs (also, apparently, on practice questions from specific review books which we should be required to buy if they are needed to adequately prepare for the exam, just saying...)
During all this time, the professors are walking around answering any questions that people may have. The professors really are so helpful and amazing at explaining things ... when you ask them questions. If you go through the TBL and your group knows all the answers (or worse: thinks they know all the answers), then you don't fully utilize the professors. But they tend to give lots of hints to the groups they talk to about what to focus on and what can sort of be ignored for the test, so the groups that don't ask as many questions seem to be at a disadvantage to the groups that are constantly badgering the professors (in my head: professor-hogs). But no matter what, each group talks to different professors and for different amounts of time, so by the time the test comes around, there are lots of different rumors floating around like "I heard this nerve is super important, but don't really bother with the lower leg" or "someone told me that it came straight from the professor that there are only two important arteries we have to know." Everyone ends up knowing, or thinking they know, a different amount of information for the test. Which is frustrating when you actually get to the test and (shocking!) some rumors are true, and some are so very not true.
The reason TBL is big right now is because it's all about active learning vs. lectures, which are passive learning. For a lecture, you as the student don't need to do any preparation, and you can totally sleep or zone out through the whole thing. With TBL, you come into class prepared every day having basically learned the information already, and in class you reinforce that information by going over it with your teammates and getting to actually see the things you read about in the body or on models. In general, I really like TBL. It forces you to stay on top of your stuff, which is important. But I really think we need a fewwwww lectures interspersed throughout (a) to tie some things together so we can see the big picture, which is hard to do when you're answering very specific questions from a text book, (b) to learn how to correctly pronounce things!!!, and (c) so that everyone is getting the same reliable information when it comes to what to focus on for the test. As a friend of mine put it, "I'm so happy to be spending close to $30,000 a year to get the opportunity to teach myself anatomy." Of course that's not really the case, but sometimes it does feel that way.
Tuesday, November 2, 2010
No but seriously, I love anatomy. I finally feel like a real med student. In fact, it is so exactly how I've always imagined it would be that I don't even feel like I'm a med student; I feel like I'm in a movie pretending to be a first year med student taking anatomy.
But, like all things in life (just call me Positive Polly), there is a downside. Jesus. H. Christ. It smells so bad (it = everything). Putting on my scrubs yesterday actually took two tries because the first time I attempted putting the shirt on I almost threw up and couldn't get it over my head. The second time I learned my lesson and held my breath until it was all the way on. What's funny is that in the anatomy lab itself, the smell of formaldehyde doesn't bother me. It's really just the scrubs and lab coats and the lockers we keep them all in. I'm not kidding, you would pass out if you tried locking yourself in one of our lockers - I don't know why you would ever do that though, so it's probably not something you should worry too much about.
One other teensy little downside is the insane amount of work we now have. Luckily, it is all SO INTERESTING. That is not sarcastic. I literally love everything we're learning. Even histology, and that's incredibly boring. I even enjoy having to stay up late to study sometimes. OK fine, that last part is obviously a lie - I still hate staying up late, even for anatomy.
Saturday, October 23, 2010
In Medical Interviewing, we learned how to ... wait for it ... interview a patient and take a history. There are a LOT of questions that you are supposed to ask a new patient (most of which I've never actually been asked at a doctor's appointment; usually you just fill it out on a form, butttt I guess it's sorta important that we at least know how to do it). Some of the topics of questions include taking a history of present illness, past medical history, family history, medications and allergies, current health behavior and risk factors, sexual history, and social history.
So the test. They have fake doctor's offices set up with one of those two-way mirrors and a hidden video camera (it probably wasn't very hidden, I just obviously didn't see it). Inside this fake exam room is an actor who is pretending to be a sick patient. You knock on the door, introduce yourself as a first year medical student, and ask all your questions. Then you ask if they have any questions for you or have anything to add, and then you say that you are going to talk to the attending physician who will be back to see them shortly. You do this three times in three fake rooms to three fake patients. And then they grade you.
You are not supposed to forget any questions. Luckily we were allowed to bring an index card with notes in with us... and guess what, I still forgot to ask a few questions. How? I really don't know, maybe nerves make me forget how to read. But rumor has it that if you have ever spoken to another human being in your life, you will pass. And in fact, I have spoken to many human beings throughout my life! So I'm not too worried. I was also in the first group to go (whatupppp backwards alphabetical order!) so I had the rest of Tuesday and Wednesday off while everyone else was still freaking out.
Level of Scariness: Terrifying. And I'm sort of a people person. Still terrifying.
Thursday, October 21, 2010
So, our MGM (aka biochem and genetics) final was last Friday. As many of you know, that was awesome timing because it allowed me to actually enjoy my birthday this weekend (thanks to those who were part of it!). Throughout the class, we had three non-cumulative tests, and then a cumulative final a mere ONE AND A HALF days after our third test. That sucked. The final was actually a national biochemstry test, scored and curved by a national board (aka our professors were too lazy to write and grade a final exam - I'm joking, they had good reasons, see below).
This national exam is called the "shelf." There is a shelf exam available for each course/topic in medical school, and it is a way of assessing your abilities in a subject in comparison to the rest of the country. This also means that based on how your class does as a whole, you can see how your med school ranks in comparison to others in specific subjects.
Here are my thoughts on taking the shelf exam instead of a final written by our own professors:
Con: The test doesn't necessarily follow what we focused on in class, so it seemed like the test was missing questions on topics we had covered really well, and vice versa - I definitely came across some (many?) questions on things that I am positive I had never seen before, and let me tell you, that is not a fun feeling during a test. But at least it's curved.
Pro: Getting used to these kinds of tests starts preparing us for the USMLE Step 1 which we take at the end of second year and is super important for getting into residencies. The Step 1 is also a national, standardized exam that will not be prepared by my professors.
Level of scariness: Same as any scantron test. Even less scary because we were so tired and burnt out from studying for Wednesday's exam that by Friday we were all just ready to be done.
Tuesday, October 12, 2010
OK fine, I'll just tell you. This year is the 100th anniversary of the FLEXNER REPORT! That was your next guess, right? I know not everyone is quite as interested in science history as I am, so I don't want to bore you too much, but I had to talk about it in at least one blog post. Basically everything we do in medical school, the classes we take, the number of years it takes, the necessary science pre-requisites (I still vomit in my mouth a little every time I think of physics), are all because of this guy Abraham Flexner and the Council on Medical Education in 1910.
There are a million things I could go into right now about how things have changed or stayed the same since Flexner's heyday and what is still relevant. But relax, I know this is already long, so I won't go into all one million of them.
One thing I do want to point out though is what seems to be a growing de-emphasis on science as the end-all be-all, and instead a focus on becoming a socially, economically, and politically-conscious physician. With the rising use of technology (like typing notes on laptops during patient interviews) and the increasing number of patients it seems like doctors, especially primary care doctors, have to take on each day to be cost-effective, the human element of being a physician looks like it is in danger of being lost.
100 years ago, medical education was in dire need of an upheaval, and that need was met with more science. Today we get the science, but the so-called "pre-med syndrome" can get in the way of becoming a compassionate, informed doctor. As Flexner himself believed (I'm not assuming here; I totally know what all his personal thoughts were), continual self-assessment and making appropriate changes based on that assessment are essential. No major upheaval (in med school curricula, anyway) is needed, but I personally am a fan of the small changes many med schools have recently been making in the gradual evolution of the education system. BUT I was a humanities major, and I'm not a fan of biochem, so disclaimer: I'm biased.
still interested? check out this NEJM article on the Flexner report or this NYTimes article on humanities in medicine or this AMA article that actually has specifics on how medical education is evolving.
Thursday, October 7, 2010
When tests are every two weeks, it is always the week before a test, the week of a test, or the first week of a new unit. There is always, always something I could be studying at any given moment of the day. The hardest thing I've found about med school so far is knowing when to stop, and what's important enough to be taking breaks for (#1: writing blog posts, duh).
There are a million and one excuses not to get involved or do things here (most of those reasons are some variation of "I have too much to study"). For me, the first activity to get cut when I have too much work to do is going to the gym. Of course, I also happen to hate going to the gym and things like 'my shoe is untied' or 'it's cloudy out' are usually enough for me to decide to skip it on any given day. On the opposite side of the spectrum, no matter how close it is to the test, I always seem to have time to stalk people on facebook; it's funny how that works...
So, recap. The hardest part of med school = finding the balance between studying and facebook. Wait, no, sorry. I mean finding the balance between studying and living. Because as much as I like to think that it will, life isn't going to stop and wait for me to finish school (but that would be nice, wouldn't it?).
Thursday, September 30, 2010
(sorry if I led you on with the title of the post, and you were expecting an actual answer as to what the ideal studying weather is)
Monday, September 27, 2010
A neutron walks into a bar and asks how much for a beer. The bartender says, "For you? No charge."
Friday, September 24, 2010
A quote from the MGM course director during our lecture on glycogen (please read in a British accent for full effect):
"I always think of the liver as a very altruistic organ. A lot of what it does is for the benefit of other tissues. The muscle is much more self centered."
I give you this quote because it has inspired the creation of my new favorite activity: assigning human emotions and motivations to organs and compounds in the body. It may not be productive, but it sure is a lot of fun. Let me give you some examples:
I like to imagine that when the heart beats, it's actually pounding on your rib cage shouting, "Help, let me out, I'm bleeeeeeeding," or when enzymes break down sugars, I imagine them as ChompChomp from Super Mario64 (and Mario Kart, Rainbow Road) happily saying "om nom nom" as they chow down.
Since we have our next test coming up next week, I will be alone in my room studying for the majority of the weekend (wooo, party time!). For those of you who might be worried that I would get bored, now that you know how I spend my alone time, you don't have to be worried anymore. :)
Wednesday, September 22, 2010
To avoid (a) making my posts so long that no one will read them and (b) running out of posting topics in less than a month, I will talk about each elective separately. Also we've only had one introductory lecture for each of them so far, and they were kind of boring. And by kind of boring, I mean make-you-want-to-bite-your-fake-nails-off-because-you-don't-know-what-else-to-do-with-yourself boring. But only the health care reform and international health are in a lecture format, and each week is a different topic with a different speaker. The emergency medicine elective involves shadowing residents in University Hospital's emergency room for four-hour shifts, and the clinic is... volunteering in the clinic.
I also joined a global health interest group. On Tuesday we had our first session where we talked about the problem of maternal mortality which was, as you would expect, extremely uplifting and fun (that was sarcasm in case it didn't quite come across in type. IMPORTANT NOTE: this blogger does not find any type of mortality either uplifting or fun).
I will leave you hanging for details on the rest of the electives until I get more involved with them and they (hopefully) get more interesting. I am expecting two very special arrivals by next week - so stay tuned for some pictures.
Friday, September 17, 2010
Wednesday, September 15, 2010
UMDNJ stands for the University of Medicine and Dentistry of New Jersey. It is a state-run health-science institution that is an umbrella organization, not a school itself. It is comprised of eight separate schools: three medical schools- New Jersey Medical School (NJMS), Robert Wood Johnson Medical School (RWJ), and the School of Osteopathic Medicine- and five other schools: nursing, dentistry, public health, and biomedical sciences. I go to NJMS, and we are affiliated with University Hospital, located right next door to the school. Most of the schools are at the Newark campus, where I live, but RWJ is in New Brunswick, and the osteopathic school is in Stratford.
Immediately upon beginning orientation, we learned that as students at NJMS, our mortal enemies include the students at RWJ and the dental students. Why, you ask? Because apparently we're better - a second-year told me that, so it must be true. Sounds reasonable, so they are now your enemies too if you have any loyalty to me.
I know what you're thinking: WHEN DOES SHE GET HER CADAVER? I know I know, it's bugging me too. Most (all?) medical schools start with anatomy - first day of class and right away you're cutting; it's as much a rite of passage as getting your white coat. But, since MGM is more similar to a college science course (and way less time intensive than anatomy will be), the reasoning is that it is a better transition course to begin med school. While I totally agree with that, and while I love having lecture only three hours a day instead of like, eight, I can't waitttt to start anatomy, which is our second block and starts in the middle of October. Anatomy is actually paired (tripled?) with embryology and histology, sooo I'm thinking I might be pretty busy once that starts. And at the same time, the Physican's Core class switches from Medical Interviewing to Physical Examination.
Last few boring things, stick with me! I live in the dorm which is also attached to the school and hospital via a skyway (which, I'm not gonna lie, is totally as creepy to walk through as it is to walk outside). The dorm is only five years old, and it's apartment style (with a dishwasher!), so I don't quite feel like I'm reverting back to freshman-year-in-college-Elena. But the lack of grocery stores in safe walking distance does make me rely on the generosity of my mom's cooking and shopping for me more than I would like (although her frozen meals beat what I could make any day). The drive from Newark to my parents' house is shorter than their drive to the train station, and the train to NYC from Newark is a whopping 18 minutes. But most importantly, Don Pepe is like two seconds away - lobster every day, yummm.
I planned on starting this in August, at the beginning of my med school adventure, butttt turns out that I'm lazy (surprise!), so here we are mid-September and most of you know NOTHING ABOUT MY LIFE. The horror! How are you all even getting through each day?? But don't panic, that will soon change.
First I'm going to tell you guys a secret. I don't really want to be a doctor. The last five years of my life have all been a ploy, Joaquin Phoenix style, so that I could get the inside scoop on medical school life and eventually create an investigatory documentary (based of course, on the investigatory blog in front of you). OK fine, I'm kidding; Joaquin Phoenix's rap career was obviously meant in earnest and not as a hoax.
So I figured I'd pretend that med school is something cool that people normally blog about, like going abroad, or... going abroad, or I don't know, traveling abroad, and write about things I see and people I meet. While I'm actually quite close (maybe too close?) to most of my family and friends, med school is still a new adventure for me, and one that most people I know aren't experiencing. I think that qualifies as enough of an excuse to be self-centered and to think that people might be interested in reading the things I have to say. So I hope for your sake and for mine that I have time to do interesting things other than studying! (ok, more for my sake than yours, because you can always stop reading if I get boring.. I however have to actually live it as my life)