Saturday, December 29, 2012

Memory Problems

I'm a big fan of the educated guess.  In lots of practice questions, I often have no choice but to try and make one.  But sometimes having just enough information to reason through an answer (but not enough information to actually know the answer), can hurt you more than help you in trying to answer a question.

For example, I had a question about a kid who is brought to the ER because he fainted for no reason; he also had a history of hearing problems, and had a family history of sudden cardiac death.  "Ok, brain," I thought to myself.  "This sounds vaguely familiar as that prolonged QT syndrome, right?"  "Right," my brain answered genially because we often agree on things like that. 

But the question was actually asking what to treat him with - propranolol (a beta blocker), verapamil (a calcium-channel blocker), quinidine (errrr, ummm...), ethosuximide (anti-seizure maybe?), or phenobarbital (definitely anti-seizure).

So I immediately crossed off the alleged anti-seizure meds, and then I was left with the cardiac ones.  I knew propranolol (and verapamil?) lower blood pressure, and the only thing I could remember about quinidine is that it had sooomething somewhere to do with the QT interval.  Since the prolonged QT syndrome has nothing to do with your blood pressure, I went with my gut and picked quinidine.

. . . . Nope.

Turns out quinidine proloooooongs the QT interval, so it is most certainly contraindicated in a patient with an already-prolonged QT interval.  I was right that it had something to do with the QT interval!  Huzzah!  I do know something!  Happy face!  But that led me to the very wrong answer (quite possibly the wrongiest answer of all of them - but at least I didn't think he was having a seizure, right?)  Sad face?  Happy and sad face? 

(For the record, the answer was propranolol, and the syndrome is called Jervell-Lange-Nielson syndrome, duh.  I'll definitely remember that for next time...)

Saturday, December 22, 2012

The Most Useful Things I Learned in the Peds ER

1. How to (usually) successfully look in a child's ears

2. What a wheeze sounds like

3. Where the apple juice and graham crackers are kept

Wednesday, December 12, 2012

Monday, December 10, 2012


I was in the medical ICU for my elective, and I really learned a lot there.  One neat fact I learned was a scientifically-sound, sure-fire way to tell someone's prognosis...

cartoon bronch
We had a patient who was showing symptoms of a very, very rare lung disease.  The prognosis for this disease is actually much better than any of the other diseases in the differential, meaning we were all hoping this rare disease was what the patient had not only so we could say we've seen it, but because the alternatives if it's NOT what he had were really not so great for the patient.

While the pulmonary fellow was convinced this rare disease was what the patient had, the attending did not really agree.  He gave two reasons for his reservations: one, what we saw in the bronchoscope was not actually suggestive of this rare disease, and two, the patient was a nice guy.


nice guys finish last
The attending called this "the nice guy prognosis," meaning that the nicer you are, the worse your prognosis is.  He said this with complete seriousness and confidence, as if he had just told us that beta-blockers lowered blood pressure or smoking can make asthma worse.

Sooo, lesson learned.  I'm going to start being meaner.  For my health.

Monday, December 3, 2012

Just Skim It

When I studied for a semester in Spain during undergrad, I took a class on Don Quixote.  The professor "understood" how hard it was for us non-native speakers to read it, so she tried to "make it easier" by telling us which were the important chapters and which chapters we could just skim.

Now, I don't know how many of you have attempted to read any book in a foreign language, much less Don Quixote in it's original Spanish.  It's pretty much exactly like reading Shakespeare... but not in English.  Now, I can't skim Shakespeare and still have a clue what's going on, and I also can't skim even young adult books in Spanish and have a clue what's going on.  I pretty much have to pore over every word to have even a faint idea about what's happening.  So I certainly couldn't just skim 50-100 pages of olde Spanish a night and be able to talk about it intelligently in class the next day. 

This relates to med school, I promise.  Stick with me...

me, reading
I'm working on a research paper that involves reading a billion other papers (more or less) on a rare disease and pulling out specific quotes from those papers.  My boss told me to just skim the papers for the quotes we need.  But since I don't know much about this disease, I feel like I need to read the papers in their entirety so I can actually understand what's going on.  Which is making it go much slower than it probably should. 

In the Don Quixote class, I survived by (DON'T TELL ANYONE EVER) occasionally reading the non-important chapters in English (or much much worse, I even read the spark notes for some chapters --- don't look at me, I'm so ashamed).  I'm still working on a solution for making the research paper go faster, but for now all I'm doing is hoping that the more papers I read, the more I'll understand about the disease, and the faster it will go.

Monday, November 26, 2012

Halfway Point

 As you may have guessed from the title of this post, Thanksgiving break marked the halfway point of third year.  Check to surgery, neurology/psychiatry, ob/gyn, and elective #1.  Still to come: elective #2, pediatrics, family medicine, and internal medicine.  I can't pretend that I'm not extremely happy to have (what I think are) the hardest rotations behind me.  If I've survived so far, I feel pretty confident that I'm going to make it through this year in one piece with my sanity and empathy mostly intact.

Tuesday, November 20, 2012


We may not get sick days, and we may not get Columbus day, but we get A WHOLE WEEK OFF FOR THANKSGIVING!  I didn't even get that in college!

Here is how I am spending it:

That's right.  As a big, useless pile of jelly.  Doing nothing.  Relaxing.  Sleeping.

(Also getting all my yearly doctors' appointments done, running all the errands I've been putting off for ages, seeing my out of town friends who are back home for the week, celebrating a birthday or two, maybe finally cleaning my apartment floors.  But mooostly as a big, useless pile of jelly doing nothing.)

Happy Turkey Day everyone!  Have a happy, healthy holiday! 

I'm sorry, I can't help myself, here's a fun holiday timeline:
  • 1863: Abe Lincoln makes Thanksgiving a national holiday to be celebrated on the last Thursday of November to help unify the country (this is wiiiidely believed to be the primary event leading to the end of the Civil War).
  • 1939: FDR changes it to the second-to-last Thursday to lengthen the Christmas shopping season to help spur the economy.  People flip out, and only half the country listens.  And then there's Texas, who celebrated on the second-to-last AND the last Thursday, because YOLO, right?
  • 1942: Congress passes a law (well, in 1941, but it took effect in '42) officially making Thanksgiving the fourth Thursday of November, which is sometimes the last and sometimes the second-to-last Thursday.  This law is also remembered fondly as the last time Congress was ever able to broker a compromise.

Monday, November 12, 2012

The Best Way to Study

I wrote a post wayyyyy back when I was a wee bitty first year about the best way to study (or at least the best weather to study in), and what I came up with is that there is no best way to study.  BUT for those of you out there who look to this blog for study advice (if there is anyone who does this, I imagine you must be quite disillusioned by this point), RELAX - based on years of research and much trial and error, I have finally figured out the best way to study.

First I'll give you a hint about ways that are NOT efficient.  The best way to learn new info is not reading it in a textbook, it's not hearing it in a lecture, it's not copying it over and over a million times in pretty-colored pens, and it's not even seeing it on a patient and then reading about it later in a textbook (sorry, Student Affairs).

The absolute best way to learn new information in medical school is to be scared and/or humiliated into learning it.

"But how do I go about being scared into information?" you ask.  "Do I have my roommate jump out at me and scream 'boo!' while I'm reading, as if I have the hiccups?"  No.  That is stupid.

Here is a handy step by step guide to being scared into learning:

1. Don't know the information to start off with.
2. Get asked simple question by attending while in patient's room ("What are the plantar flexors of the ankle?").
3. Have your mind go completely blank and say, "Umm" stupidly a few times.
4. Get prodded by the attending ("Ok, just give me one of them").
5. Make sure mind remains completely blank.  Forget all muscles of the entire body.  Turn your face red, say, "Umm" again to make it look like you are thinking about muscles (but we all know you're really only thinking about how stupid you feel or just repeating 'think think think think' to yourself).
6. Begin humiliation ("You don't know a siiiiingle plantar flexor?  You did take anatomy didn't you?"  Cue everyone else in the room such as residents, patient, patient's family, and researchers getting extreeeemely awkward and avoiding eye contact with you at all costs).
7.  Be told the answer exasperatedly ("You really don't know? ((sigh)) It's the gastrocnemius, soleus, and tibialis posterior.")
8. For the rest of the day, wish that you are dead and feel woefully inadequate no matter how much else you may know.
10. Be asked the next day jokingly by the attending what the plantar flexors are, have a brief panic attack, but then rattle them off like it's nothing.  Boo-yah.

And that, my friends, is the best way to learn information in medical school.

Monday, November 5, 2012

Live-Blogging Sandy (More or Less True)

Friday (pre-Sandy, Day -3)
Mom: You should really go and buy water and flashlights and fill your car with gas.
Me: Stop being a crazy person.

Saturday (Day -2)
Around Noon
Should I be nervous?  No, it will be a dud.  But what if it's not?  It probably will be.  Maybe I'll fill up my gas tank and stock up at Target just in case.  I'm probably being crazy.  I'm not gonna go.  I have a lot of studying to do anyway.

1:00 pm
Maybe I'm just being prepared.  Is my mom making me crazy?  Or am I stupid if I don't go?  Maybe I'm being stupid.  I'll go just in case.  I'll still have the whole afternoon to study when I get back.

Fiiiiiine, I'll get off the couch and go.

Target = SO CROWDED.  At least if I'm being crazy, I have a lot of company.  And I can do practice questions on my phone while I wait in this check-out line for half an hour.

So many interesting things happening on Twitter!

Sooo I guess I should start studying?

Sunday (Day -1)
I am really craving peanut butter and salami right now.  Think it's appropriate to delve into my hurricane non-perishable stash yet?

Official Email: School and clinical activities are hereby canceled for Monday and Tuesday.

Immediately After That
Facebook timeline explosion of everyone in the world starting to drink and writing about their drinking and hurricane parties.  My thoughts: Thank goodness I have two extra days to study for my OSCE on Wednesday and shelf on Friday.

Monday (Day 0)
Early Morning
Well this doesn't look like hurricane weather.  Canned chili for breakfast?

Slightly Later But Still Early Morning
I don't wannnnnna study.

Later Morning
I'm going to eat some crackers and peanut butter, and then I am DEFINITELY getting through all of the OB chapters in Blueprints today.

I am definitely going to get through half of the OB chapters in Blueprints today.  Also, it's starting to get mildly windy.  This could be exciting.

Later Afternoon
This is feeling more like a hurricane.  Keeping everything at 100% charged at all times.  Also keeping our blinds closed because it feels like our windows are going to explode at any second.  Feeling pretty good that I got through two of the twelve OB chapters in Blueprints.

Early Evening
Seriously, what do we do if our windows explode?  Let's move the TV into the hallway that doesn't have windows.

Later Evening
Let's watch TV.  We can move the TV back just for a half hour, right?

5 Seconds After Moving TV Back
Power out.  Dammit.

10 Seconds Later
Let's walk down the bajillion flights of stairs in our building to see what the damage is like downstairs.

20 Minutes Later
Shoot, we have to walk back up?

20 Minutes Later
We are definitely going to go through our water supply faster than expected if we keep making that trip.

1 Minute Later
You can't flush the toilet without electricity????

2 Minutes Later
Let's have a glass of vodka, eat all our melting ice cream, and go to sleep.

Tuesday (Post-Sandy, Day 1)
Still no power.  I guess I should study while it's light out.

Friend: Don't study, come play with me!
Me: I can't, test tomorrow, ahhh!
Email: Class canceled until next Monday, November 5.
Me: Ok let's play, I'll meet you downstairs in a second.

20 Minutes Later
Ok, I made it down all the stairs.  Let's play.

5 Hours Later
Catch phrase + wine + Jesus and yahrtzeit candles = great night.

Wednesday (Day 2)
Still no power.  I reallllllly would like to flush my toilet.  And maybe shower.  And have some coffee.  I should go downstairs and see if people are talking in the lobby about when the power will be back.

20 Minutes later
In the lobby, no one knows anything.  Obviously.  Charge my cell phone in my car for a few minutes, and decide to walk back upstairs.

20 Minutes Later
Back upstairs.  Still can't flush (obviously).  Decision officially made to make the trek to my parents' house.

Thursday (Day 3)
Wake up on the living room couch.  Apparently my parents are the only ones in the tristate area with power so there are about 85 people staying in the house, and I am second to last on the waiting list for a bed (I did beat out my brother) - fiiiine Grandma, I guess you can be greedy and take my bedroom if you want.

Learning mah-jong, getting all my meals cooked, kinda-sorta-maybe studying.  Life is ok.

Later Afternoon
Email: Power back on in my apartment!  But being home is sort of fun, I can wait until tomorrow to head back to Jersey City.

Friday (Day 4)
AHHHHH.  Need. Alone. Time. Now.

Early Afternoon
Good-bye family and houseguests, back to Jersey City I go.

A Few Minutes Later
Holy crap, the lines for gas are so crazy-long.  Good thing I filled up my tank over the weekend.

Getting Close to the Holland Tunnel
Uh oh, here is where I turn to get onto my street and it's all blocked off.

5 Minutes Later
Feel like I'm really learning a lot about Jersey City geography.

Back in my apartment; boy it feels good to take the elevator.

Sunday (Day 6)
Email (and I'm pretttttty sure this is a direct quote): We have absolutely no idea when your make-up OSCE or shelf will be, so continue to study indefinitely, but have fun starting a new rotation on Monday and make sure you keep up with both OB/GYN studying and your new rotation.  Also the exams will probably be on Christmas or Thanksgiving night or New Years' Eve, but we won't tell you until two days before.

Monday (Day 7, Also Known as Right Now)
Scared about starting my new rotation.  I still have a mostly-full gas tank.  Seriously considering going into the gas-price-gouging business and leaving medical school behind.  Still waiting for news on the OSCE and shelf.

Wednesday, October 31, 2012


Happy Halloween!  Here's me this past weekend as a witch doctor (easiest, most comfortable costume everrrrr).  Scrubs are clean, I promise.

Friday, October 26, 2012

How Do You Feel Today?

Do you remember this?  I definitely had a magnetic one of these in middle school that I hung on my bedroom door (with fun-tak obviously - my door was, unfortunately, not magnetic) so that I could warn my family ahead of time if their preteen daughter was feeling disgusted or exhausted or angry before they decided to knock on my door (or to not knock on my door).

Now, every single day my feeling is "awkward" - and that's not even an option on the magnetic feeling board!  I have realized that being a med student means always always feeling uncomfortable and out of place:

Awkwardly waiting outside of OR doors wondering if now is the right time to introduce yourself to the attending or the patient (note: no matter what time it is, it's definitely the wrong time).

Awkwardly running behind residents as they try and lose you (note: that is potentially only in my head that they are trying to lose me, but seriously why do they walk so fast and not ever tell you where they're going?!) - or, when a resident gets up and walks out of the room without saying a word to you, awkwardly wondering if you should follow or not (note: whichever you chose was the wrong decision).

med student?
Awkwardly walking in white pockets so full of crap that you look like a waddling penguin everywhere you go. 

Awkwardly asking patients for their permission to ask a question/wake them up/do any portion of the physical exam (even more awkward, getting turned down - "but wait, I actually really do need to know if you've pooped yet today... pretty please, I can't go back to my resident with no answer").

Or, silently and awkwardly standing behind the attending and resident and PA and nurse as they ask the patient questions and do the physical exam.

Awkwardly living life outside of the hospital and realizing you have nothing to talk about except for all the gross things you do/see in the hospital, or to complain about feeling awkward all the time.

....What else you got?

Wednesday, October 24, 2012

Only in Medicine

would someone say, "Oh right, you guys only work 12 hour shifts here" dripping with condescension (I almost typed condensation there, but that would be a whole different story).

Friday, October 19, 2012

Commercial Break

I interrupt my naming-origin obsession with a not-so-brief public service grammatical announcement.  Fear not, this is no treatise on your vs. you're or its vs. it's or there vs. their vs. they're.  If you don't already know when and when not to use an apostrophe, then get out of here.  Seriously.  I can't help you, you're (you are) too far gone.

This is about my true passion in life, the oxford comma (what? medicine? who's that?).  No, seriously.  There are very few things in life that I am willing to physically fight for.  The first is getting eight hours of sleep, and the second is the oxford comma.  There are many reasons for and against using it (which I've recently read on Wikipedia - check them out here if you care), but to me the only one that matters is that it removes ambiguity (ok, as Wikipedia points out, it's also possible to create ambiguity with the oxford comma, but it seems like way more often, it removes ambiguity).  In this case, I think a picture is worth 1,000 words:


End of discussion.

On another grammatical note, I feel pretty strongly about putting two spaces after each sentence.  I've recently learned that this is wrong (see this article: Space Invaders), and it comes from when we used to use typewriters and all of the letters took up the same exact amount of space, and it was harder to see where a sentence ended.  But now that that's not a problem anymore (unless there's someone out there typing in Courier, God help us all), it's outdated and silly (suppooooosedly).  But here's the thing, I STILL thing it makes a paragraph easier to read and more aesthetically pleasing.

More importantly, THIS IS THE WAY I'VE ALWAYS DONE IT.  In medicine, that is the absolutely wrong reason to do something, and you should question anyone who does something for that reason.  But with grammar, no one's health, and very little money, is at stake (seriously, no one is charging extra for more spaces, unless maybe you're sending a telegram, in which case, please rejoin us in the 21st century before we resume this conversation).

But for realsies, this is how I've alllllways done it, so it hassssss to be right.

the only difference is I'm a rebel WITH a cause. grammar.
For the record, I break grammatical rules ALL. THE. TIME.  (For examples, please see previous sentence where I typed in all caps and put a period between each word, or the previous three paragraphs which I spent talking about how I put two spaces after a sentence even though I know in my heart of hearts that it's wrong.)

But whatevah, whatevah, I do what I want.  No Slate article (aka THE MAN) is gonna hold me down.

Saturday, October 13, 2012

Adventures in Nomenclature, Ob/Gyn Edition

The Apgar score.  Assessing babies.  You all have it memorized, right?  0-2 points each for newborn's color, heart rate, reflexes, tone, and respiration?  Yeah?  Ok good.

Virginia Apgar

Let me tell you how awesome (the naming of) this test is.  First of all it is named for arguably one of the coolest women ever, Virginia Apgar (more about her later).  But on top of that, the test is ALSO an acronym!  Appearance, Pulse, Grimace, Activity, Respiration.  Come on, that is cool.  It's like she was boooorn to invent this test.  So even though you all know I hate eponyms (except that now that there's a whole movement to get rid of them, I suppose I'm starting to become a little nostalgic), this one is pretty bad-ass as far as eponyms go.

tee hee, she has an upside-down baby
 So let me tell you all the things I like about Virginia.  First of all, born and raised in NJ (whatup).  Second of all, she trained under Allen Whipple (this means nothing, but I have another post about him - #makingconnections).  Third of all, she was the first woman to become a full professor at Columbia University College of Physicians and Surgeons.  Fourth of all, she basically made anesthesiology into a respectable field.  Fifth of all, she developed the Apgar score and pretty much invented the field of perinatology.  Sixth of all, she was a total public health advocate (a March of Dimes director and a huge promoter of the rubella vaccination and Rh testing for mothers).  Seventh of all, her glasses!!  Eighth of all, she supposedly said (although I'm having some trouble finding a legitimate source for this and I really need to start studying) that, "women are liberated from the time they leave the womb."  Duh now, but not so duh back then.

but seriously, you know you made it when you're on a stamp

non-MLA, non-peer-reviewed sources: National Library of Medicine, PBS They Made America

Saturday, October 6, 2012

The Real Baby

As much as I still love being in the OR (seriously, there is nothing more awesome in the world than watching someone cut a belly, cut through some more tissue (uch, please don't ask me to name all the layers because I can't), and suddenly there's a (very large) gush of disgusting fluid and then THEY PULL A BABY OUT OF YOU), I realize these surgery-esque rotations make me revert to an infant whenever I'm not in the hospital.  [note to self, that sentence was wayyyyyy too long for anyone to follow]

I blame it on the hours that just mess up my internal clock so badly that I never know when I'm supposed to be awake or asleep or eating breakfast or dinner or studying or what.  But whatever it is, I can only fake being awake and adult and not-grumpy for so many hours.  As soon as I get home and the scrubs come off, my id immediately takes over:

The only things I truly care about once I'm home are sleeping, eating, and pooping.  Sometimes I cry for no reason at all.  I'm mean to my mom no matter how nice she's being to me ("what are you having for dinner tonight?" "WHY WOULD YOU EVEN ASK ME THAT STUPID QUESTION?").  I don't talk to anyone, I don't call my friends back (babies can't use phones!), I can't pay attention to a TV show for more than 5 minutes, I take everything personally, and I expect everyone to cater to my every need (most don't, except for the good people at

"Hi, I'm student-doctor Elena. Is it ok if I watch that baby come out of your vagina later?"

The good news is that I'm done with night float (where your hours are 7pm to 7am), and no other rotation from now on has any full overnight calls!!  Soooo... yay!

Sunday, September 23, 2012


tomorrow.  my uterus is all a-flutter.  so many teeny tiny fingers and teeny tiny toes!!!

everyone knows the it's the stork who reallllly delivers babies

just kidding - as doctors, we get to help the babies hatch

Anne Geddes, making babies even cuter (and creepier) since 1956.

Friday, September 21, 2012

Adventures in Nomenclature: Jersey Finger

When first reading about the Jersey Finger in the surgery review book (I know, I'm still stuck on surgery, but the disorders just have some great names), I thought maybe it was an injury that had to do with the middle finger, and that it was named after the beautiful state of New Jersey due to Jerseyans' (Jersey-ites?) propensity for cursing people on the roads.

Turns out that's false.  It's called the Jersey Finger because it's the injury that occurs when someone playing football (or I guess any sport?) gets their finger caught on another player's jersey as that player is running away, thus causing injury to the flexor digitorum profundus tendon and keeping the finger in forced extension.  Less fun, and also less relevant to me.

photo credit
But come on, if this happened to the middle finger, wouldn't you think it would be a cursing reference?  

Also, I'm bad at computers (espeeeeeecially for someone who calls herself a blogger) and I have no idea how to flip that image so it's not upside down.  Help?

Wednesday, September 19, 2012


And the award for the most alliterative symptom goes to . . . [drum roll please] . . .

. . .
. . .
. . .

Scintillating Scotoma!

The runner-up prize goes to Horton's Histamine Headaches (whether or not it's the same Horton from Horton Hears a Who is still up for debate).

Monday, September 17, 2012


I kind of really like neurology, like, a lot (which makes me even sadder that two of the four weeks of the rotation were stuck on neurosurgery).  This may require some exploring...

Thursday, September 13, 2012

Not For Me

Now that I am officially done with surgery, I think I can safely say that it is not for me.  I like clinic wayyyy too much (surgeons are supposed to hate clinic with a vengeance), and I also really love writing notes (cue everyone ahead of me in the medical world rolling their eyes and thinking: oh just you wait, honey).

Don't get me wrong - being in the OR is really really awesome, and the idea of being able to go inside someone and just fixing them with your bare (but scrubbed and gloved) hands is so freaking cool (and I totally get the whole God complex thing - you are fixing someone WITH YOUR HANDS).

But once I got past the wow factor of seeing someone's insides manipulated, I've realized that my favorite part of surgery is actually seeing the patient each day after the operation on morning rounds and seeing what progress they've made.

I like hearing their stories; reading their charts; asking them about their ability to poop, pass gas, and ambulate ("have you passed any gas from below?" "you mean farted?"); meeting their family when they come to visit.

I've noticed that it's the lowest-level residents who spend the most time on the floors with the patients, and the least amount of time in the OR, and as you get more senior, you get to spend more and more time operating.  This makes sense, as the final goal of a surgical residency is, of course, to be doing surgeries (duh).  But I think I like what the lower residents do better!

Plus, I'm already bored of some surgeries.  After I saw like, two thyroidectomies, I was totally over them and chose not to scrub into any because I felt like I had already been-there-done-that.  But the same surgeon does at least a few of them every single day.  You probably lose some of the wow factor after your 50 billionth thyroidectomy.

Plus plus, writing long, detailed notes is like writing a story!  You get all this mumbo jumbo of information (uch, patients as historians are the worsttttt, amiright?), and you get to organize that info in such a way so that it is coherent and will make logical sense to anyone else who reads it.  Challenge accepted!  And rounding is just telling that story, hearing other people's stories, and coming up with the next chapter (sort of?).  I think I could handle the whole rounding-until-noon thing if I get me some comfier walking shoes.

Plus plus plus, the hourssssssss.

Soooo... internal medicine? yesnomaybe?

Monday, September 10, 2012

Quotes From the OR

Scrub Nurse: Put a towel down on the floor, don't make a mess in my OR!

Surgeon: But if we don't make a mess, how will anyone know we did anything?

Thursday, September 6, 2012

All in a Row

Today's post is just an observation.  On many rotations (and so far it seems like neurosurgery especially since we're (understandably) not trusted to do a whole lot on our own), the med students are like little ducklings that follow our mother duck (the resident) around blindly.

(for clarification)
I have this vision that one day the resident is going to just stop short, and each of us is going to just just bump into the person in front of us, one after another.  This hasn't happened ....yet.  But one morning this week on the way to the cafeteria after rounds, one of the residents walked past the entrance to go to the bathroom and everyone did continue to follow until we realized where he was going.  Oops.

Friday, August 31, 2012

Quotes From a Neurosurgery Resident

"You [medical students] are going to get yelled at a lot, but it's only because you're incompetent; try not to take it personally."

Sunday, August 26, 2012

It's Not Exactly Rocket Science

Not to be a cranky-pants or anything, but wahhhhh.  Tomorrow I start neurosurgery.

For our psych/neuro rotation we have four weeks of psychiatry (two rotations of two weeks each) and four weeks of neurology (same deal).  So, like everything else in third year med school, you ranked which sites you wanted, and you were assigned via lottery.  I ranked neurosurgery last last last (other options included stroke, general neurology, and pediatric neurology).  Eight weeks of waking up between 3:30 and 4 was more than enough for me - plus I'm pretty positive that neurosurgery is not what I want to do in life (seven years of residency? no thank you).

I'm tryinggggggg to look on the bright side (although anyone who's talked to me all weekend knows I've been pretty unsuccessful at that).  Neurosurgery is going to be cool, right??  I'll get to see inside the brain!  How many people get to say they've done that?  And the residents and attendings I'll work with I'm sure will be incredibly smart and accomplished people, and hopefully I can learn a lot from them.  Also, it's only two weeks long, and unlike the actual surgery rotation, I won't have any overnight or weekend call.  AND labor day falls in the middle, so I get next Monday off. :)

But who knows?  Maybe I'll fall in love with neurosurgery, decide I'm willing to give up every other aspect of my life to pursue it, and then I could be like this guy...

Friday, August 24, 2012

Not What I Expected

When I found out I would be rotating at Greystone Park Psychiatric Hospital for two weeks during the psychiatry rotation (no, for the ob/gyn rotation! ha. ha. pity laugh?), I was very excited.  This was going to be a REAL psychiatry experience.  I've seen pictures of the old buildings, and I couldn't wait to be walking through them, imagining myself as a close personal friend to Dorothea Dix in the late 19th century (I'm very normal, I know).  I had this romantic vision of the historic hospital - even my dad told me stories about how HIS dad would drive him through the grounds as a kid late at night to try and spook him.

not the modern building, just a modern pic of the old one
So imagine my disappointment when I found out that a new modern (and totally boring) building replaced the old decrepit buildings in 2008.  Obviously much better for the patients and the staff, and it really is a beautiful facility.  But it looks nothing like the horror movie-style psychiatric hospital, and there's no history, and I haven't felt the presence of Dorothea Dix's ghost a single time so far!  While I understand this is a very selfish way to feel, it's not that I would wish the hospital to still be housed in dilapidated buildings, it's more that I wish I did my rotations four years ago so that I could see what the old romantic buildings were like.

A few of the old buildings are still standing, and they are gorgeous.  They are covered in ivy, and the windows are all boarded up, just as a historic haunted psychiatric hospital should be.  But there are lots of no trespassing signs around, and I tend to be a rule follower unfortunately, so I'll probably never get to see them up close.

The fate of the remaining standing buildings still seems to be unknown, but I'm hoping they don't get knocked down, but instead can be restored and one day re-opened in some capacity (something educational? a museum? a haunted house?).

view of the grounds in 1899

inside a ward, also 1899

 Disappointment number two came when I found out I would get to watch a court proceeding involving a patient.  There's a courtroom IN the hospital!  Court cases tend to involve renewing involuntary commitment status, and I was expecting something along the lines of the courtroom scenes in Harry Potter, where the poor patient sits in the center of a room, and there are lots of scary judges and doctors sitting high above, waiting to condemning them.  Turns out it's nothing like that at all (obviously), and it's really just a conference room with a judge.  What a let down!!

this is not what the court room looked like

(I really had a wonderful experience at Greystone, and I imagine that if I had had a psych rotation in the "romantic" 1950's or earlier, I probably would have walked away completely scarred for life.  I just like feeling like I'm part of history, and sometimes my imagination over-exaggerates.  In NO way do I wish psychiatry was anything like how it used to be - although, it turns out that Greystone was built according to the Kirkbride plan which was actually supposed to be a more humane and compassionate way to treat mentally ill patients, ruined of course by overcrowding.)

Check out more old-school pictures of Greystone here: 1899 photo album
For more modern (and colored) pictures, as well as info about other Kirkbride buildings: Kirkbride Buildings, Greystone
And lastly, for more info on the history of Greystone: Preserve Greystone

Thursday, August 16, 2012

You Know What's Unfair?

The fact that getting anxious about being anxious makes anxiety worse.

Monday, August 13, 2012

Adventures in Nomenclature: Gamekeeper's Thumb

Does anyone else love things that are named after totally antiquated concepts?  When I first read about gamekeeper's thumb in the orthopedics chapter of the Kaplan surgery review book, I felt like I had to really do a bit of research to fully understand the name.

The injury is a tear to a ligament in the thumb (the UCL), and occurs via hyperabduction of the thumb.  Forget the movements of the thumb?  Me too; below is a handy study guide.

hyperabduction. ouch.
So how does a thumb get hyperabducted?  Well, it can happen acutely by falling on an already-outstretched thumb, or apparently in skiing if you fall and your thumb gets stuck in one of the loops of your ski pole (in fact, the injury is also known as skier's thumb).  It also could happen chronically, as with gamekeepers who would kill small animals by breaking their necks with their thumb and forefinger.  And I'm not sure why they got shafted in the naming department, but apparently this was also a common injury among Scottish fowl hunters because they would carry their game home in a bag that they attached to their thumb and threw over their shoulder.

Cumbria. Fun!
Naaaturally, I was curious about gamekeepers, because, um, what the heck is a gamekeeper?  They are usually employed by landowners to prevent poaching and to take care of/maintain the game (not "the game" - oh sorry, you all just lost - but the game as in deer, fish, fowl, etc.).  Turns out there are still 5,000 employed in the UK, and you can even specialize!  Lowlands, uplands, river keepers... the opportunities are truly endless.

If you or someone you know is looking for a career change, you can get a diploma in gamekeeping from the Northern School of Game and Wildlife in Cumbria, England.

gamekeepers gaming

Wednesday, August 8, 2012

Well That Made My Day

I'm in the elevator in my building after getting home from the hospital today and I'm wearing my white coat, and my next-door neighbor gets in the elevator with her two year old (one? three? somewhere in that range) son.  He's very shy so he doesn't speak the whole ride up, but as we get off the elevator on our floor he calls out, "Bye, doctor!!" before running embarrassedly to his own door.  :)

I didn't have the heart to correct him into saying student-doctor.  He hasn't yet learned what the short white coat means.

Sunday, August 5, 2012

Modern Day Fairy Tale

Once upon a time (this Friday night), I was out in the city with some friends (actually enjoying a weekend? add it to the list of what I love about psychiatry), and a young gentleman struck up a conversation with me at the bar.  Normally this type of conversation goes something along the lines of:

"What do you do in the city?"

"I actually live in Jersey - I go to med school in Newark."

"Jersey? Ew."

"I know, right? The worst."

And then we both chuckle and carry on with the conversation like two normal people.  On this occasion though, the gentleman in question had no interest in even continuing a conversation with someone from Jersey (understandable, though - I've heard Jersey-ness can rub off on people who stand too close for too long).  As soon as I mentioned NJ, he - I KID YOU NOT - started slowly backing away from me.

a video of the incident in question

"Jersey?  I don't know how I feel about that."  Takes two tiny steps backwards.

"Haha, I don't know I feel about it either," I self-deprecatingly replied.  He takes another few tiny steps backwards, his smile starting to waver.

"No, seriously," he said seriously.  And after just a few more steps backwards (still facing me of course - everyone knows it's dangerous to turn your back on either the ocean or someone from NJ), he had reached the corner of the bar, and he was able to safely turn away and immediately start a conversation with his friends on the other side without so much as a fake excuse to even pretend to end the conversation.

And we all lived happily ever after.

Monday, July 30, 2012

Surgery with Friends

*All names in this story have been changed, I do not in fact know anyone with the name of Joe Shmoe.

So especially towards the end of the rotation, myself and the other med students on my team sometimes opted to scrub in on the shorter rather than the longer cases when there was a choice (thyroidectomy? sign me up!) - not because we were slackers (ok, a little because we were slackers), but because we were starting to get stressed about our surgery shelf exam and wanted that extra time to be in the library studying.

literally could be anyone
But on the last day of our rotation, I decided to scrub into the more complicated GI case knowing it was maybe the last chance I would get to watch a surgery (ever???).  The case ended up being even more complicated than expected, so the attending surgeon wanted another attending with him rather than only the resident (and me, but med students don't count in the being helpful department during surgery).  So who walks into the OR but one of my parents' closest friends, and someone I've known literally since I was born. 

He obviously did not notice me, as he was there to help with the case, and went immediately to the open body in front of him.  Plus I'm in a gown, face mask, and shower cap - no one exactly looks like themselves in the OR.

it was him the whole time!
I was so excited to see him - I wasn't expecting to be in on any cases with him since he usually doesn't operate at the hospital where my rotation was.  But how to let him know it was me since he clearly didn't see me?  Talk about inner turmoil!!  I wasn't going to interrupt the two surgeons discussing the case to be like "Hi, Joe, it's me, Elena!" but at the same time, I couldn't stand there silent for the whole hours-long surgery and at the end rip off my mask and shower cap and say, "Ha-ha, I've been here the whole time!"

So they're operating away, and I'm retracting away, and the chief resident is standing to the side looking sullen because his surgery was stolen, and every time there was a silence I opened my mouth to announce myself, but then chickened out and didn't say anything.  Was it silent because they were concentrating, and if I spoke the patient would die, or was it actually a good time to interject?  I started and stopped myself at least a good five times.  The more time that went by, the more awkward I felt, because the longer it went on, the weirder it was for me to not say anything.

The biggest problem, besides timing, was how to phrase the sentence.  Everyone in the room obviously called him Dr. Shmoe, but I have never once in my life called him anything but Joe.  So would it be weirder to call him Joe and have everyone in the room be like uh, who does this med student think she is?  Or weirder to be overly formal?  I KNOW, serious problems right?

Finally both the attending surgeons stepped back as a third surgeon went in to do her thing (there were some non-GI components to the surgery, so another specialist was there to deal with those).  So finally I had my opportunity, and I said, "Hi Joe, I didn't want to interrupt before but it's Elena."  And then I could finally stop feeling awkward, and the inside of my head could stop exploding, and the rest of the surgery was great.  The best part was that the first thing he said to me was, "How's your car doing?"  because not that I think my chief resident would ever think I lied about that, but it's always good to have proof that I didn't.

some of the things I got to see

The real best part was getting to see him operate.  Surgery continues to awe and amaze me, and it was very cool to see someone I know from such a different, non-surgical setting to actually perform surgery.  And the case lent itself to good teaching - he was able to point out a lot of structures to me which I hadn't really gotten a good look at in any other surgeries I had seen.  Even after he left the room, the other GI surgeon continued to teach much more than he had at the beginning.  It also ended up just being a really interesting case, and even though it lasted 5+ hours, I'm glad I got to watch it.  A really awesome last day of surgery.

Monday, July 23, 2012


At the end of each rotation, the chief resident gives us a number grade and also makes a few short comments about us.  We then get to go over what's said about us with the clerkship director.  One of my comments was that I present information concisely, and am able to get important patient information across efficiently.  As part of our evaluation, we also had to hand in two patient write-ups to the clerkship director, who said my HPI was "concise and well-written."

When I was going over my evaluation with the clerkship director, I actually LOLed (that's right, I laughed out loud) and told him I've never ever in my life been called concise.  Verbose, repetitive, "uses too much flowery language," loquacious, circumlocutory, magniloquent, uses too many details, annoyingly repetitive, tells really long stories, seriously repetitive, "please just get to the damn point" those are phrases I'm used to hearing about myself.  Concise is a new one.  Maybe I'm maturing?

Confession.  To my knowledge, no one has ever actually called me circumlocutory.  Or magniloquent for that matter.  But I prefer those to "annoyingly talkative."  But seriously, try having a conversation with me after a couple beers and tell me I'm not loquacious. 

Saturday, July 21, 2012

One Down

I made it alive through my first clerkship!  Sometimes I find it hard to put my feelings into words (hah, yeah right), so I'd rather let Destiny's Child express my feelings for me - they just get me, you know?  And nothing says "I'm a survivor" like Beyonce crawling sexily on the beach.

Side note - prepare yourself, gird your loins, whatever you have to do, for the next couple weeks when I'll finally (maybe?) be finishing and posting all the half-written posts I have from throughout the surgery rotation.

Under side note - gird your loins comes from the ancient Meryl Streep tradition, where men would have to gather up all the extra material on their long Prada robes and tie it out of the way so that they could ride horses into battle without the robes getting in the way.

Tuesday, July 17, 2012

Sucks for Them?

This morning, I walked to my car (for which I pay a hefty sum to park in a garage next to my apartment building), and was a little annoyed when I got there to see shattered glass by the driver's side door, because, well, that's annoying.  Obviously, at 4:30 in the morning (and pre-coffee, I usually drink it on the way to the hospital), I was not on my A game, and it took me a second to realize that the reason there was shattered glass on the floor was because I had no driver's seat window anymore... because it was all on the floor and on the driver's seat in millions of teeny tiny little pieces.

think of all the sea glass this could make!
Why would anyone target my car, on the third floor, full of dents from some unhappy run-ins with garbage dumpsters, scratches from getting keyed in St. Louis (apparently I have an enemy somewhere out there), and two screws sticking up from the trunk where the spoiler used to be (don't even ask)?  Well, I did have a package in my backseat - it's been sitting there for about four weeks now, and it's a bra I ordered from Nordstrom, but I've just been too lazy to bring it upstairs.  The garage owners said two other cars were also broken into last night, and the guy (or girl, I'm not sexist here) clearly knew what he was doing because he avoided all the cameras.  He probably thought my package was something like a laptop or iPad I had ordered.

So my first thought (after my initial crying session obviously, because I'm a mature adult) was:

sucks for them, they thought they were gonna find a sweet laptop, but all they found was a measly bra (which they left for me, thanks).  But then I remembered that it still definitely sucks more for me.

Also my car is chock-full of empty coffee cups and granola bars - I can't believe the thieves didn't want any of those!!

Friday, July 6, 2012

So Sleepy

I love love love surgery but I hate hate hate the hours.  Advice?

Seriously, when have I ever not had time to update the blog?  Never is the answer.  Now I barely have the energy to shower and eat before I crawl into bed at the end of the day.  But it's all so coooooooool.  I want to cut things open and sew them back up all the time!  But also kind of maybe I want something that resembles a life?

Wednesday, June 6, 2012

Surgery Begins

I started on trauma surgery with four other medical students, and one of us is on call each night - I got lucky enough to get picked the first night.  Which means that two days into third year I have already had a 30 hour day.  And so I bid you goodnight.

Sunday, June 3, 2012


...was awesome.  Apparently I'm really bad at writing blog posts while on break though.  I've been asked lots of times how I find time to keep up with the blog throughout school, but I'm really much better about it the busier I am - hmmm, a form of procrastination perhaps?

For my ten days off after Step 1, I rented a car and drove up a good chunk of the California coast.  It was so so beautiful, and I got really lucky with the weather which always makes everything better.  I was nervous because my driving and directional skills are slightly sub-par, and I was also spending four days completely on my own (I visited friends on either end in LA and San Fran, and spent the middle days alone).  But it was great, and I loved it, and I loved relaxing after Step 1!  Not studying is so fun!!  Who knew?

Highway 1.  I must have pulled over every 3 minutes to take pics.

I actually went hiking!  This was in Pfieffer Big Sur State Park

Proof.  I hiked.  I'm super athletic.
I stayed in Monterey, but went to Carmel for the beach and candy store

Golden Gate Bridge at sunset.  75th birthday!

I start my surgery rotation tomorrow, and I am pretttttty nervous.  I don't thiiiink that I am interested in surgery, but I am obviously keeping an open mind, and we shall see what happens!  Hopefully as third year continues, I'll still find time to keep everyone updated.

In the meantime, all med school and pre-med readers should like The New Physician on facebook ( - it's AMSA's magazine and in my own humble opinion, it is awesome (full disclosure, I'm on the Editorial Advisory Board - but still, it's awesome).  The page is a little empty right now, but updates will be coming!

Wednesday, May 16, 2012

What Will You Do With That Freedom?

Today it ends.  Step 1 may have taken my life (for the past 6-ish weeks) but it will never take my FREEDOM.  Alba gu brath!! (Pretty sure that translates to "I'm getting a 280 on Step 1!" - jokes, I'll totes be happy with a 270)

I've never actually seen Braveheart, don't tell anyone.  Things end well for William Wallace, though, right? Right?!

Tuesday, May 15, 2012

Pump Up Mix

The test is officially one day away (tomorrow - the test is tomorrow).  As a special treat, I would like to share with you the music I listen to when studying gets me down and I just need something to pump me up.  Most of the songs are old, because it's only fun if you know all the words.  Judge away (and judge you will because my taste in music is so odd), but there's no way you can listen to any of these songs and not belt them out at the top of your lungs.

After listening to any of these songs, I am always re-ready to take on the world.  Although sometimes I get carried away and will listen to an entire Broadway show before I'm truly ready to study again.  And sometimes it makes me sad, because it reminds me that I will probably, PROBABLY, never be a Broadway star, and I think that's a fact that I just need to learn to accept.

And so in no particular order, I present to you my pump-up mix:

Hairspray: Good Morning Baltimore, You Can't Stop the Beat, Without Love
Wicked: The Wizard and I, Defying Gravity
Sean Paul: Fire Burning
Eminem: Lose Yourself
Lady Gaga: The Edge of Glory
Guster: Come Downstairs and Say Hello
LMFAO: Party Rock Anthem
Kid Cudi: Up Up and Away
Bruce Springsteen: Born to Run
Mamma Mia: SOS, Thank You For the Music, Take a Chance on Me, Honey Honey
Rent: Out Tonight, La Vie Boheme, Take Me or Leave Me, Today 4 U
Billy Joel: I Go To Extremes
Annie Lennox: Walking on Broken Glass
DJ Sammy: Heaven
Elton John: Crocodile Rock
Goo Goo Dolls: January Friend
Green Day: J.A.R.
Led Zeppelin: Misty Mountain Hop, The Ocean
Mariah Carey: Hero
Queen: Bohemian Rhapsody, Don't Stop Me Now
Sum 41: Fat Lip
Bonnie Taylor: Holding Out For a Hero (the Footloose version is also acceptable "yeah!")
Tom Petty: Don't Do Me Like That, Surrender
White Snake: Here Go I Again on my Own
Whitney Houston: Greatest Love of All, It's Not Right But It's Ok

Saturday, May 12, 2012

My Weirdest Study Habit

This post is for anyone who is still under the impression that I am a normal human being (spoiler alert: I'm really weird).

Naturally the more I study, the more questions I've been getting right in UWorld.  However, I still get very excited with every question I get right, especially if it's particularly hard, or I got a similar question wrong earlier and *GASP* I actually learned the concept!  And because I study by myself, I have no one to share that excitement with, so I totally high five the air.  And not just one semi-fist pump type high five, but a whole rally of high fives as if there were a receiving line of people in front of me just waiting to share my excitement by accepting my high fives.

For illustration purposes, I've included Liz Lemon, but imagine the high fives more at face level, and going from left to right (you know, to make sure I don't miss any of the people who are lined up in front of me waiting for my high fives, as imaginary people are wont to do).

It's the little things in life.  And correct questions cannot go uncelebrated.