Tired

Ok, I don't talk to alllll that many people in my med school class on a regular basis, but it seems like with the people I do talk to, we feel pretty similarly (towards med school) a lot of the time.  And I generally try to keep this blog somewhat upbeat, but I feel like I would be doing a disservice if I didn't have at least one post about how sometimes I am so tired and frustrated and just plain exhausted with the pace of school these past few months because I know I'm not the only one who feels this way.

Most of us in med school are pretty good students and pretty dedicated studiers. I don't really know anyone who actually slacks off - if someone is taking a weekend or night off to relax/party/sleep/ski/doanythingbutstudy, you can bet they busted their hump (is that a real saying or did I just make that up?) the week before or the week after to make up for it.  So I know if someone is behind in work it's not because they've been slacking off or not putting in the requisite time.

No one wants to be behind in work - and a lot of us med students are pretty type-A (shocking, I know) and ideally would like to be ahead.  But it's absolutely impossible to get ahead, and sometimes barely feasible just to stay on top of everything.  Constantly feeling like you're playing catch-up is exhausting.  It's also exhausting to finish an exam and then have a podcast and quiz due later that afternoon, or have to get to the hospital two hours after the exam for your preceptorship - there's no down-time or a moment for a mental deep breath. 


Thankfully second year and its constant tests lasts only two more months - and then it's time to study for The Big Test, aka Step 1 of board certification, aka the test that determines the rest of our lives - no big deal.  But at least we can make our own study schedule for that and take breaks when we feel like we need them.

I expected med school to be slightly soul-sucking, but I'm not sure I expected to feel so tired before third year and rotations even begin (and when I never get less than eight hours of sleep a night, ever).

Quotes from a Neurologist

The anti-Whipple.  Sometimes, the professors "get" what it's like to be a med student a little toooo well.


It was just like the Milgram experiments:

During our lecture on how to conduct a neurological exam, an ARS (audience-response system) question read, "What's your favorite cranial nerve?"  This was obviously more of an attendance question than knowledge-testing question, but interestingly enough (although besides the point), the vagus nerve won with a wide margin.  The professor (jokingly?) says, "This was actually a psychological test to see how much stress is created when you ask a group of med students a question with no right answer."  Sigh, he really does know us too well...

Whipple Part II

This post really has nothing to do with either George Hoyt Whipple or Allen Oldfather Whipple, or the disease or procedure that are respectively named after them.  But it's a continuation on the thought that professors don't always remember what it was like to be a student and how quickly (or slowly) we absorb information.





We all have clickers so that the lecture can be interactive (see picture) - the professor can put up a multiple choice question, and we all put in our responses, and then it shows us what percentage of students chose each answer.  It can be used for attendance as well as just a gauge for who knows what (are we high-tech or what?!).




Some lecturers put audience response questions throughout their lecture.  While I certainly have no problem with that, it drives me bonkers when professors actually get upset with us for picking the wrong answer.  "Come on guys, I just went over this 10 minutes ago!"  Sorry that some of us don't automatically recall every detail you tell us after hearing it once - if we did, there would be no need to study, and med school would be a breeze!

Same thing with a case discussion we had the other day on liver diseases.  The four hours of liver lectures had been given the morning before, and that afternoon there had been a mandatory three-hour class for Physician's Core on how to do an abdominal exam.  So, our apologies for not being able to learn everything about the liver in one evening - again, if we could do that, med school would be easy-peasy!


But during the group discussion we had about a fake patient with liver disease, the professor leading the group was so upset when we didn't have all the answers.  "Guys, your test is in a week, you're making me very nervous right now."  A week is a liiiiifetime for studying in med school (especially when we have a test every other week...).  Like I mentioned in Whipple I, most people I know don't get a good grasp on the information until the weekend before the exam.  Cut us some slack, and give us time to study the information before you assume we're never going to learn it!

Whipple Part I

Unlike those lucky people who only need to hear things once to learn them, I need time to digest material before it enters my brain.  In med school, that means listening to a lecture, going home and typing up all my notes I took during the lecture, and then organizing my typed notes into a way that makes sense for me - categorizing, or making charts, or combining info from related lectures, just something that makes the information my own.  That, as you might imagine, takes a fair bit of time.

Because of our schedule, there's not a whole lot of extra time outside of listening to lectures and going to mandatory labs and discussions to study extra.  That's fine, it is what it is - med school's supposed to be busy, right?  But for me that means that I'm not going to have a really good grasp on most of the material until the weekend before the exam when we have full days (or at least half-days) to really study.  And I don't think I'm alone in this.

George Hoyt Whipple is...

But I don't think professors really understand that some of us need actual time to learn the information.  So when we learn about something called Whipple Disease at the beginning of the week, and then later in the week we learn about something called Whipple Procedure, chances are most of us are not going to realize that we just learned about Whipple twice.

...not the same as Allen Oldfather Whipple

During the second lecture, when we learned about the procedure, the professor pointed out that it was actually named for a different Whipple than the disease.  Rather than thinking, "My, what an interesting fact" or "There are two people named Whipple who were good enough doctors to get something named after them?!" all I could think was, "That's cute that he thinks we remember a disease that we learned three whole days ago."







Fun fact: the non-eponymous name for the Whipple procedure is pancreaticoduodenectomy - maybe the only time the eponym is actually easier to remember than the real name?

Bonus Book Review!

As much as I usually would like to hate people who do similar things to what I do but much better and earlier than me, I happen to love Dr. Fizzy McFizz, the anonymous (unless that's her very unfortunate real name...?) blogger from http://doccartoon.blogspot.com/.  Her posts are always so honest and relatable.  AND she also draws cartoons!  What a great way for those who are too lazy/busy to read words to still get in their medical humor for the day!  On her blog, though, you would have to sift through alllll her many posts to be able to find each cartoon.  LUCKILY she recently collected all her cartoons and made them into a book for easy access - and - spoiler alert - it only costs $12.99 on Amazon (although there is one used copy for $999... I would suggest just going for the cheaper new copy).  A perfect gift for your cartoon-loving, humor-appreciating med-student friend, just saying.

Nail-Biting Update #1

You may think I have forgotten about my New Year's resolution to stop biting my nails.  I haven't.  Week 1 I was too embarrassed by how bad a job I was doing, so I decided to give myself a by-week (yeahh, that sort of defeats the purpose, I know - but whatever, I can really only handle so many disgusting pictures that come up when I google my name).


But look, I did it!  I stopped biting my nails and they already grew out perfectly!

....If anyone was fooled by that, well, you have way too much faith in me, and also no sense of how long it takes for nails to grow.  I got gels put on for the wedding this weekend.  So far I haven't ruined any of them, so hopefully my real nails are growing out underneath and when I take the gels off I'll have long, beautiful nails in real life.  The key now is to not bite the cuticles.  I'll keep you updated on my progress.

See Ya Later, Med School

Tomorrow my older brother is getting married!!  I am not doing a single minute of work this weekend.  And I spent all of this past week "getting ahead" aka honing my maid of honor speech.  Good thing we don't have a test next week, because I would not do well on it if we did.  Gotta have soooome priorities.  And gaining a new sister is priority #1 right now.  Yay!

In Stitches

When I was younger, a friend's mom once asked me to recommend some books that my friend might like (since she really hated reading), and I spent hooooouuuuurs looking through my bookshelves - picking the perfect books; ranking them in not one, but two different categories (my favorites and what I thought would be my friend's favorites); and writing up descriptions on little post-it notes that I stuck on the inside cover of each book.  I was so excited to share my favorite books!  However, I'm pretty sure not a single one of those books were ever even opened by my friend, and all my fabulous reviews went to waste.



Recently Dr. Anthony Youn, a plastic surgeon from Michigan, sent me a copy of In Stitches, a memoir about the path that led him to be the doctor he is today.  Consider this my post-it note.  I hope someone takes my recommendations.

the book!

First of all, the book was hilarious.  A fairly quick and easy read, it's full of enough self-deprecation not to hate the author for being so damn good at everything he does.  Being only halfway through my med school career, Dr. Youn got me equal parts terrified and excited for my clinical years and residency application process.  I can only hope to have such a meaningful experience during my rotations that leads me so clearly to a career path like Dr. Youn had.  I had never thought much about the altruistic side of plastic surgery, and this book broke down some of my stereotypes.  However, all the normal stereotypes of med school were still there - the gunners, first day of anatomy lab, the mean horrible interns and attendings who scare the crap out of med students (ok, I haven't experienced that myself yet, but I'm waiting for it), feeling useless, trying to maintain a social life while still doing well...


I had two favorite lines that I liked so much, I wish I could claim I wrote them:

the doctor!

"Second year worse.  Way worse.  I'm ambushed by the sheer volume of information we have to memorize.  At least I know what's on each exam - everything."  [Since I'm going through second year now, I can absolutely vouch for the veracity of and lack of exaggeration in that statement.]

And once he finds out he passes step 1 of the board exam, meaning he can go on to year three, the beginning of the clinical years... "And that concludes medical school, year two.  Now I can play doctor.  For real."  Because isn't that what med school really is - playing doctor until you know enough to really be a doctor?



For med students, I recommend this book so you can see that even seeming geniuses struggle at some point (many points?) during this journey.  It's not just you!  For parents or friends of med students, I recommend this book so you understand what it is that we're going through (not just the crazy workload, but also the mental stress we put on ourselves).  For anyone else, I would recommend this book for a few good laughs and a "thank God I'm not going into medicine" moment.


Find more info, excerpts from the book, other reviews, and how to buy it HERE!

Lasers

There are many ways to measure how cool you are in life (and it's obviously very important to know where you fit in the cool spectrum).  Apparently one way is based on what color laser pointer you have.  Now I would argue that anyone who owns a laser pointer probably isn't very cool to begin with - but what do I know, I'm just a med student.

so old school

I didn't even realize that there was a hierarchy of laser pointers until during an EKG training session, a cardiology attending pointed out to me that green lasers (one of which he just happened to have) were way cooler than the red lasers.  This is apparently because the green ones came out more recently and are more expensive (oh em gee - it's the same reason the iphone 4s is so much cooler than the iphone 4!).  To show how much cooler cardiology is than the other specialties, he asked our small group if we've ever seen anyone with a green laser pointer besides a cardiologist.  Apparently our other professors are all Luddites who insist on using their clearly outdated red laser pointers.

cardiology cool. already outdated.

Soon though, the green laser pointer will also be outdated because now there are PURPLE lasers which became commercially available in 2010.  Right now they are a bit expensive, but I imagine that by the time I'll need one they will be more affordable.  Or, if anyone was looking for a very very early birthday or Hanukkah gift for me, I would accept a purple laser pointer.  Although the one time I taught a lecture as a TA during my undergrad, I was so excited to finally use a laser pointer - but because I was nervous, my hands were shaking slightly uncontrollably, and using the laser pointer made it so obvious that my hands were shaking that I had to stop using it.  SHOW NO FEAR.  So first, confidence.  Then, purple laser pointer.

what all the cool kids are using (and apparently purple lasers are also patriotic)

Requisite Resolutions Post

Last  year I had two New Year's Resolutions: update the blog more regularly, on Tuesdays and Fridays, and start flossing every day.  I managed to keep one of those resolutions - I'll let you figure out which one.  This year I have exactly one resolution.  I need to stop biting my nails.  This doesn't seem like such a hard thing, except that I've spent the last 20 years of my life trying and failing at this.


How can I do this?  I have tried fake nails (turns out those are bite-able, too), the bad-tasting nail polish, wearing a rubber band to snap every time I bite, wearing rings to play with, snacking instead - so far, nothing has worked even slightly long-term.  So.  Here I am.  My second-to-last resort (last resort will be trying hypnotism, or maybe wearing latex gloves 24/7).  I am going cold turkey, and I am going to post a picture of my hands each week so everyone can see my progress.  That might not sound like such a big deal, but anyone who knows me well (and is also observant) knows that I always hide my hands - I keep them behind my back, put them in pockets, make a fist, or hold my hands so that my nails aren't showing.

As a doctor, you can't really hide your hands so much.  I'm going to be shaking hands, taking notes, prodding people, poking people, percussing people, comforting people ... there are plenty of things I'll feel self-conscious about, and wondering if people are judging me based on my nails doesn't need to be one of them.  Plus, the last thing I need is to be putting my fingers in my mouth or picking until I bleed in a hospital setting.  I think I'm supposed to be trying to MINIMIZE infection, not inoculate myself.


So this is it.  Starting two days ago, I am not going to bite or pick at my nails AT ALL, no matter HOW UNEVEN THEY MAY BE (the thought is already giving me anxiety).  When I want to bite them, I'm just not going to.  And as always, I will share too much information with the internet.  And perhaps the shame of my ugly fingers will keep me motivated, yay!


Also, I've decided it's pathetic if I can't.  As far as I know, there is no actual addictive substance in my nails or cuticles.  As a doctor, I am going to be asking people to quit smoking, cut down on drinking, stop eating fast food, start exercising, stop doing drugs like heroin - how can I possibly expect anyone to change their legitimately addictive habits if I can't even stop biting my nails?


Soooo.... Here goes.... My nails.  Day 0.