Wednesday, October 2, 2013


Hello there, and welcome to my blog if you've never checked it out before!  Feel free to look around, and click back through all my old posts to see my full journey from a scared first year to a slightly-less-scared fourth year medical student.  On the off-chance that you don't have hours to waste reading about me (although that just seems impossible), below are links to my favorite posts from each school year so you can get a small sample.

I'm going to be taking a brief hiatus on new posts, so this will have to satisfy for now.  And of course feel free to continue following my updates on twitter (@elenawelt) and continue to check back here for my return!

Where it All Began:
Welcome to My Blog

First Year:
Funkmaster Flex and the Future of Medical Education
Muggle Medicine or Magic?
Studying and My Bed

Second Year:
 Med Student Stereotypes
Jewish Housewives' Disease
Pop Quiz

Third and Fourth Year:
Adventures in Nomenclature: APGAR
The Best Way to Study
What I Learned in the Peds ED
Elena's Parking Space Theorum

Thursday, September 12, 2013


It took me awhile to see it, but I truly love being in University Hospital in Newark.  After spending so much time here over the past four years, I've realized it's started to feel like home.  I only recognize how comfortable I am here when I rotate at other hospitals.  There's a learning curve at every new hospital - the computer system, where everything is, the people.  Sometimes I spend a month at other hospitals and am in awe at how luxurious it feels - you mean you just order a lab and it automatically gets done?  Free lunch every day (ok, that only happened for me once)?  Carpeting in the hallways?  But I've just never been able to feel as comfortable at another hospital as I do at UH, no matter how amazing other hospital experiences have been (and I have had really fantastic experiences all over the place).

It's like vacation.  I love going away and staying in a hotel - who doesn't?  I mean, how great can it get - someone cleans up after you every single day, you could (probably?) drown in the fluffiness of the comforter, breakfast is included and set out for you each morning.  But no matter how luxurious my vacation may feel, I'm always ready to come home at the end.  There's just something so much more comfortable about sleeping in your own bed, perusing your own refrigerator (even if you know it's empty since you haven't gone food shopping), using your own bathroom products.

At UH, I love being able to wave hello to everyone in the hallways because I know the attendings and the security guards and the nurses and the other students.  I like being able to volunteer to run things down to the lab because I actually know where the lab is.  I like knowing that no matter what time of day I'm in the cafeteria, I'll be able to find someone to sit with.

(cheesy, but oh so true)

Maybe I'm just getting nostalgic because I can finally count the months left of medical school on my fingers.  Or maybe it's a little sad that I can describe a hospital as home.  And I know if I spend as much time in another hospital system, I'll get equally attached.  But whether I end up here for residency, or a program close by, or a program far away, I'll always think of University Hospital as my first "home" of my medical career.

Sunday, July 21, 2013

Pearls of Wisdom from the ICU

Doing drugs is bad.  Doing drugs in 90 degree heat is really really bad.

Monday, July 8, 2013


Nurse: Ah, you get to go home soon right?  You look tired.

Me: I literally just got here 10 minutes ago.

but thanks for noticing

Thursday, June 27, 2013

Tuesday, June 25, 2013

Elena's Parking Space Theorum

Back in elementary school I had a teacher who told me not to worry (my pretty little head)* about math but just focus on the things I was naturally good at like reading and writing.  I've always had a bit of a complex about math since then, but LOOK AT ME NOW, I just invented a mathematical theorem:

*note: I added that condescending part myself, but that's definitely what her tone implied.

How much your life stinks on any given day is inversely proportional to how good a parking spot you get at the hospital.

It's true, here are some examples:
  • You get to the hospital at 5am for surgery rotation: parking spot right next to the door.
  • You're on outpatient and you don't have to be there till 8 or (gasp!) 9: forget it, you're parking on Mars... if you're lucky.
  • You're on call on Sunday: park annnnnywhere you like.
  • You take a study/research month, and mosey in around 11 for a quick meeting: don't even bother driving, take the train.
  • You're on night float and get to the hospital at 7pm after everyone's left: park inside the ER for all we care.

So in summary:  Life Happiness = 1/Parking Spot + B 

where B includes other factors such as weather, fun dinner plans, an upcoming exam, world events, etc.

And that, my friends, is Math Made Easy by Elena.

Monday, June 3, 2013

Best Summer Vacation Ever

I took my last exam of third year on Friday, had some amaaaaaazing time off, and then fourth year starts today!  I can't wait to see everyone, and see how they spent their summer vacation - traveling, volunteering, research? 

Lucky for me, I am actually using June as a study month for Step 2 CK.  For those that thought Step 1 was the end of it - well, nope.  It (literally) never ends.  So even though I wan to do really well and will be studying pretty intensely all month, 3 months of medicine were definitely exhausting, and I am pretty happy not to be jumping immediately into another month of intensity on the wards.  That can wait until July. :)

Thursday, May 30, 2013

Quotes from an Internal Medicine Attending

"Everyone sees medicine through the anoscope* of their own specialty."

*[anoscope: it's better than a rectoscope]

Tuesday, May 28, 2013

Breaking Up with a Med Student

When normal people break up, there's a certain amount of time afterwards where you are insufferable because every little thing reminds you of your significant other and you just have to tell everyone about it.  "This song makes me so sad, we used to listen to it all the time" [most popular song on the radio].  "This is that the ice cream place we passed once and almost thought about going into."   "We're right near where his brother used to live!"  Friend's response to all of the above:  "Oh ...sorry?"

And of course long after you stop being annoying, little things still remind you of him, catching you off guard way too long after the breakup than you probably care to admit.  For normal people, the trigger could be a commercial you laughed at together, a friend suggesting a restaurant the two of you always ate at, a politician you made fun of, a dessert you shared - whatever it is, you see the trigger and your heart rate speeds up a tiny bit, or you get sadly nostalgic for a moment, and then you move on.

When two med students date and break up, it's a little bit of a different story.  I was recently reading a Wikipedia article peer-reviewed article about cutaneous conditions, and one of the pictures on the side was of Norwegian scabies (don't look it up, it's gross) and I kid you not, my heart totally skipped a beat.  I'm not sure what it says about me, or him, or the relationship in general, but Norweigan scabies (and Surinam toads - definitely don't look those up either) are always going to be my trigger.  Fortunately these are things that don't ((often)) come up in everyday conversation.

Tuesday, May 14, 2013

Pretty Much the Same Thing

Patient: You bite your nails?
Me: Unfortunately, yeah.  It's my nervous habit.
Patient: Well, we all got our addictions.  You and your nails, me and my heroin.
Doctor: ::shakes head::

Thursday, May 9, 2013

Personal Statement

Writing a personal statement for residency applications is not that fun, even for someone who loves to write as much as I do.  A friend of mine brought up an excellent point about it.  "For the love of God.  I want to be a [insert specialty here].  Why do I need to write an essay about it?  Doesn't my thousands of dollars of tuition loans speak for themselves?"

And seriously.  A one page essay talking about why we want to be a doctor?  We just finished medical school and we're now applying to residency... what else would we want to do?  Who is out there that doesn't believe us?  (And for those smarties out there going into pharmaceuticals or consulting or something, they wouldn't be writing this essay in the first place because they're not applying to residency!)  Am I wrong?

[Note: Residency directors, don't read this post!  But if you already did... I really really really want to be a doctor, pretty please with a cherry on top.]

Sunday, May 5, 2013

Why It's Impossible to Memorize Anything Ever

So I'm studying the skin chapter in Step Up to Medicine, and I get to the disorder called lichen planus.  No big deal, the book tells me just to remember the 4 P's: pruritic, polygonal, purple, flat-topped papules.  I can forgive them for the last one (I can call it papule (comma) flat-topped, like a last name (comma) first name sort of thing). 

But now fast-forward two pages later (aka three facebook breaks and two youtube videos later), and I get to basal cell carcinoma.  OK, no biggy, the book says it's classic appearance can easily be remembered by the 3 P's: pearly, pink, papule.

. . . .

I'm sorry but that is too many P's in too short a time!  How am I supposed to remember which are the 4 P's and which are the 3 P's, and which one goes with which?  Where is the mnemonic for that??

Monday, April 29, 2013

Beer Potomania!

Guyssssss, who's coming to this awesome fun event with me?!??!?

Coming Summer 2013 to an open field outside of a city near you!  With music by all your favorite bands and food trucks from all your favorite restaurants!  Tickets priced only just outside of your comfort zone for how much you want to spend in one weekend!

Just kidding, it's a disease name (drinking all beer and eating no food means lots of free water intake but not enough solutes which causes hyponatremia).  But come on, doesn't it sound like a really fun outdoor beer-tasting festival?  And admit it, doesn't part of you sort of wish it was?

Wednesday, April 24, 2013

Oh you meant SURGERY?

Me: Have you ever had any surgeries?
Patient: Nope.
Me: Have you ever had any eye problems?
Patient: Yeah, I just had cataract surgery last week.

Sunday, April 21, 2013


I was talking with some friends on internal medicine the other day and complaining (naturally, because what other type of conversation is there?) about the traffic that morning, and another friend on surgery was like, "Really? At 5 this morning, 280 was totally clear."  It got me thinking about the pros and cons about the different rotations. 

In terms of call schedule and hours, surgery is obviously the worst (helloooo 5 am).  But you got the best parking spots, it took you half the time to get to the hospital, and you got to wear scrubs every. single. day.  Ob/gyn was the second worst (helloooo night float), but you also got to wear scrubs every day - except for your week of outpatient clinic when your hours were 9-5 but you had to dress professionally.

Now for internal medicine, there are no overnights.  But you are on call every fourth day (weekends included) which more or less means you stay till 8pm and admit all the new patients for the day.  You are expected to dress professionally in the hospital, but on your call days you are allowed to wear scrubs. 

...Is anyone else sensing a pattern here?  Being allowed to wear scrubs is obviously a consolation prize for having a crappy day.  And it's totally effective!  "Sorry you have to be at the hospital for all of the daylight hours, but at least you get to wear pajamas!"  #Winning!

consolation prize
By the end of surgery, I was so excited to put on real clothes again - it was like a full two months of never wearing pants without a drawstring, and that can get depressing.  But now that I have to dress up almost every day, getting to wear scrubs and sneakers makes call days so so much more bearable.

Sunday, April 14, 2013

More Technical Talk

A patient not too much older than me had been having erectile dysfunction, and his testosterone level was in the normal but low range, and he asked the doctor if he should be prescribed some testosterone. 

Doctor: Testosterone doesn't help with your erection but it does with the dirty talk, the dirty thoughts - if you know what I mean.
Patient: You mean sex drive?
Doctor: Sure, yeah, that.

The doctor was also trying to convince him to lose weight (more fat tissue --> more estrogen --> negative feedback on LH/FSH --> less testosterone) and told him if he lost 30 pounds he would become an unstoppable animal, and that girls would start calling him "The Animal."

...Meanwhile, I sat awkwardly in the corner typing the patient's vitals into the EMR.

Friday, March 1, 2013


Holy guacamole, I only have one clerkship left in third year.  Check to surgery, psychiatry, neurology, ob/gyn, pediatrics, and now check to family medicine.  And hellooooo to internal medicine.  Granted, it's the longest of the clerkships, clocking in at a solid 3 months.  But still!  The last one.  And then I'm a fourth year.  Which is basically vacation (I mean.... valuable time to learn all the things I feel like I missed out on the other years and brush up on before residency), and then I'm a doctor.

Tuesday, February 26, 2013

Textbook Classic

Sometimes a patient walks in and is the exact textbook version of whatever their diagnosis is.  In the middle of January, I saw a patient walking out of the clinic wearing a sundress, flip flops, and no jacket (and for those of you who forget I'm from NJ, reminder: I do not live in Florida).  And in my head, I was like, "Wow, crazy person."  But then later the other med student in the office was like, "We had such a stereotypical hyperthyroidism patient today."  And I was like, "I SAW HER!"  (because amongst other things, hyperthyroidism raises your body temp.)

a clear-cut case of hyperthyroidism

But sometimes things are really not so textbook.  For example, to remember who is most at risk for gallstones, everyone thinks of the Four F's: Female, Fat, Forty, and Fertile.  One day in college I get a call that my lanky 20-year old brother was in the emergency room with terrible abdominal pain.  It turned out to be gallstones, and a LOT of them.  My brother is not female, certainly not fat (especially three years ago), not forty, and not fertile (at least not in the estrogen-heavy-between-menarche-and-menopause sense of the word). 

However, he had very recently gotten over a really intense infection and was on like 7 billion different antibiotics (I took some creative liberties there and exaggerated just a touch), and the gallstones were most likely caused by one of those.  Once he stopped taking all the medications, the gallstones disappeared.

wise like Yoda I am

All I'm saying is .... sometimes things happen exactly as you expect them to, and sometimes they don't.  (Yes, I know, I'm very wise.)

Saturday, February 23, 2013

Addendum to Theory of Relativity

Last night (Friday), I went out to dinner with some friends, and one of my friends is on his surgery rotation and was on call Saturday (today).  For those who have not gone through third year of medical school: when you are on call on the weekend, it means you show up in the morning for rounds and stay overnight through rounds the next morning. 

We were debating how much sake we wanted to order and my friend who was on call the next morning said, "I can drink as much as I want, I don't have to be in until SEVEN tomorrow!"  As if that was an awesome time to have to be somewhere on a Saturday morning.

And so I absolutely stand by my post that everything is relative, and seven can be awful or amazing depending on what time you woke up the mornings leading up to it.

....says the girl who wakes up at 8 am on Saturdays to update her blog.

Friday, February 22, 2013

Favorite Body Part

As I'm sure you all assumed, my favorite cells in the body are the juxtaglomerular cells in the kidney!

Why?  Because they are next to the glomerulus, of course!

"But Elena," you say questioningly.  "Who cares?  Why would that make them your favorite?"

Well, let me tell you.  'To juxtapose' (loosely) means "to place side by side" - so then what does juxta-glomerular mean?  It's an adjective meaning next to the glomerulus!  And wait, someone remind me where the juxtaglomerular cells are... THAT'S RIGHT, just next to the glomerulus.  Love it!

[If we wanted to take this one step further (which we do), they should really be called the renin-secreting juxtaglomerular cells - because then I could also remember what they actually do, not just where they are.  But hey, I'll take what I can get.]

Tuesday, February 19, 2013

Theory of Relativity

It's funny how quickly we get used to things.  I was soooo looking forward to this half of the year; after getting to the hospital at 5 for my surgical rotations, I figured 7 would seem like a godsend - I mean, the sun is already up by then!!  And family medicine - working outpatient hours?  Like a normal human being?  Unbelievable.

Well, turns out 7 is still pretty early to be somewhere.  It's not like my alarm goes off at 5:50 and I jump out of bed whistling a merry tune and thinking, "Gee golly am I happy it's not 4 am" - my first thought is usually still just, "Uchhhh." 

I'll be honest, there were some mornings on surgery when I cried actual tears when my alarm went off (not even kidding) - soooo obviously that was much worse, and maybe if there was a day on surgery when the residents were like, "no, please, don't come in until 7 am tomorrow," then 7 would seem AMAZING.  But when they're not right next to each other, 7 is so not amazing.

And I'll admit, my family medicine hours are amazing - the practice doesn't open till 10!  Yet somehow, I am still EXHAUSTED at the end of every day, and more often than not, no studying AND no socializing get done in the evening (oh, I had such high hopes for both during this rotation).  I know, I know, woe is me, I'm tired, wahh.  But I'm tired!  Wahh!

Thursday, February 14, 2013

Naming Origins

The antibiotic vancomycin is named for the person who....

Just kidding.  It's named after no one.  It comes from the word "vanquish."  So naturally, from here on out, I will only be spelling it vanquomycin to be more correct.

It was actually originally called Mississippi Mud because (I kid you not) the preparation was brown and full of impurities.  I guess if I had to choose, I'd rather my antibiotics be named after a word meaning to conquer than after murky river dirt.

But I mean... yumm: Mississippi Mud Cake.

..I'm not lying! Source

Monday, February 11, 2013

Technical Terms

Me: Have you ever had a mammography?
Patient: Which one is that?
Me: It's a breast -
Patient: Oh yeah yeah yeah, the titty press.
Me: Yes, that one.

Wednesday, February 6, 2013


I am sorry, but does Dr. Guido Fanconi need two major (and completely separate and unrelated) diseases named after him?  No, no he does not.  That is greedy.  I don't care if he was a brilliant clinician as well as hospital administrator and discovered like eleven separate syndromes - one eponym should be more than satisfactory.

so smug

And noOooo this post is not out of bitterness because an attending told me to read about Fanconi Anemia and I accidentally read about Fanconi Syndrome, and then knew close to nothing about Fanconi Anemia the next day.

....Ok, so maybe it's a teeny tiny bit out of bitterness.  Geeeeze.  Shut up.

Friday, February 1, 2013

Logic Games

I love logic games as much as the next person.  You know the kinds I'm talking about:  "You're planning a dinner party, and Bob wants to sit next to Mary and Mary can't sit next to anyone over 6 feet tall, and Joe is a gorilla.  So what color shirt is Cassandra wearing?"

That is what it felt like to memorize the catch-up immunization schedule (aka, a 15-month old comes into your office and mom says he hasn't been to a doctor since he was 6 months old - what immunizations are you going to give him today, and when should his next appointment be?).

Well if you are over 6 months old, then you can't get the rotavirus vaccine at all (you snooze, you lose).  But you have to be at least 6 weeks old to start getting any doses of Rota, DTaP, Hib, PCV, IPV, or MCV.  And you have to be at least 1 whole year before getting MMR, varicella, and hep A.  But that's just the first dose!

Let's take Hib (Haemophilus influenza type B) as an example [the vaccine which has, by the way, drastically reduced the number of cases of meningitis, life-threatening epiglottitis (seriously, you don't even see that anymore), septic arthritis, osteomyelitis, and occult bacteremia in kids].  Ok, put your logic cap on, because this is where it gets tricky:

this is my logic cap. find your own.

If Billy received his first dose of Hib at younger than 12 months, then you have to wait at least 4 weeks before giving him the second dose.  If the first dose was received between 12 and 14 months, then you have to wait at least 8 weeks to give the second dose!  But if the first dose was given at older than 15 months, then he doesn't even need a second dose.

But don't worry, you're not even done with Hib yet.  For the third dose, it's similar.  A 4 week waiting period if current age (NOT previous dose) is less than 12 months, an 8 week waiting period if current age is greater than 12 months AND first dose was administered before 12 month and second dose before 15 months.  And again, no third dose needed if second dose was given at older than 15 months.

And lastly, a fourth dose is only needed if all three previous doses were given before the age of 12 months.

That's just one of the vaccines (ok fine you got me, it's definitely one of the more complicated ones - some of them are only two doses with no caveats).  And since we didn't know what aged child we would encounter on the exam, you had to* memorize the catch-up schedule for all possible ages.

I was half-expecting to see the question on the exam to say "So how many kids did Billy ride the school bus with on Wednesday?"

*were supposed to

Wednesday, January 30, 2013

The Two Kinds of Indecision

As you may or may not have noticed, I have not updated in over a month.  We are right in the middle of picking our fourth year schedule, deciding on fourth year electives and away rotations, and registering for Step 2 of the board exams - aka figuring out the rest of our lives.  NBD.

So obviously having so many things to do and keep track of as well as studying for the pediatrics shelf and OSCE this past Friday have turned me into a mess of indecisiveness with the inability to do anything at all.  Which is exactly the opposite of the reaction one should have with such a full to-do list.

...And I'm one of the lucky ones!  I've decided on what I want to do with my life (for now, anyway).  The people who still don't know what specialty they want to go into have it much harder around this time because they have to figure out all this stuff and also decide what they're going to be when they grow up.  We've now rotated through four out of the six main specialties, and I like to group the people who are still undecided into two groups:

Positive Polly (or Positive Pablo, let's not be sexist) and Negative Nancy (...or Negative Norbert).  Positive Polly looooooves every specialty so freaking much and can't posssssibly be expected to make a decision between them.  On the other side, Negative Nancy has not found anything yet that she could actually imagine doing for her whoooole entire life.

So those of you who are undecided, where do you fit in?  Or is there a middle ground somewhere? (Just kidding, there's no gray area - you HAVE TO CHOOSE ONE.)