Okay, so I’m sitting here about to go to sleep when I get this urge to go check out Twitter.com. So its not a short visit. I already have an account there from way back when I was trying to stay updated on something. Anyhow, I decide to set it up so I can use it with my iPhone (yeah, got one 2 weeks ago).

Well now it works with my phone. So I can text a message and it shows up as an update right here on JeffreyMD.com. So next week as I walk into exams, I’ll twitter a little message like “We who are about to die, salute you” or something like that and it will show up on the right sidebar. Ms. Gross, if you’re reading this, you can be happy I did not forget all of my dates and quotes .

Oh, and it shows up on my facebook status too.

We’ll see if I keep this thing goin or not.

But, what I am saying is that this was a big waste of 20 minutes! I should be sleeping now so that I can wake up early and hit the books before I have to drive home (1.25 hours). As usual, the Friday before exams have no scheduled classes. I’m in a wedding this weekend, so I have to pick up my tuxedo.

Busy weekend.

As you can tell by my writing I’m a bit scatter-brained at the moment… Either that or my brain is not functioning properly because I need sleep!

The patient shook his doctor’s hand in gratitude and said, “Since we are the best of friends, I would not want to insult you by offering payment. But I would like for you to know that I had mentioned you in my will.”

“That is very kind of you,” said the doctor emotionally, and then added, “Can I see that prescription I just gave you? I’d like to make a little change…”

Well I finally reached my 101st post. Unfortunately I can’t celebrate. It’s been really busy lately. I know my monthly post rate has plummeted recently. Hopefully that has an inverse relationship with my exam scores?

Anyways, this is the last week of lectures. I can’t believe the year is almost over. That’s right, it’s the last week of lectures for the first year! So right now I should be studying. The next two and a half weeks will be exams. Some quarter finals and a couple in-house cumulative finals and a few standardized exams. We are required to score in at least the 7th percentile in the standardized exams. And last year, for Physiology, that meant a score of approximately 60%.

Wish me luck. Or pray for me. Whichever you believe in. I’ve included a copy of my exam schedule below for any curious onlookers. (A few blocks are highlighted to indicate a recent change in schedule).

Last week, I attended a Memorial Service at my school. The service was held for all those who had donated their bodies for use in the anatomy labs. There were three schools in attendance (Schools of Medicine, Dentistry, and Allied Health).

A couple of musical numbers were performed by students and a handful of students volunteered to speak and express their appreciation. At the end of the ceremony I looked around and saw some wet eyes. It made me realize that donating one’s body is a sacrifice for the loved ones as well. These friends and relatives never got to bury a coffin. And they won’t. In a few weeks we will have our Gross Anatomy final exams and the school will proceed to cremate the bodies.

I’ve heard that some medical schools have ended anatomy dissections. If I remember correctly, UCSF School of Medicine no longer has students dissect in Anatomy lab. They have models that the students can come and look at.

Personally, I have long thought models are the way to go. I think a whole lot of Anatomy lab is wasted trying to pick away fat and and fascia. But once you get through all the fat and fascia, there are benefits to actually finding the Vagus nerve coursing through the thorax, or the recurrent laryngeal nerve coming through the tracheoesophageal groove. It’s not something easily forgotten after dissecting to find those structures.

So to those who have donated your bodies for science, to those who believed in education enough to sign over yourself, to the families who have waited over a year before getting closure in the form of ashes: Thank You.

I’ve been hearing a lot about these quick-stop clinics staffed by nurse practitioners. I hear about them in the news or read about them online. They seem to be on the east coast or midwest. Or maybe I’m just not paying any attention to them here locally.

As someone going into a medical career, this is somewhat discouraging. I don’t see how a family physician can compete against an NP based solely on costs. It seems like the scope of nursing just keeps getting expanded more and more. I’m sure the nurses are elated about this. And their paychecks continue to rise as they get more specialized.

I don’t think we need to go back to the days were the doctors were kings of their wards and nurses stood whenever one came in the room. But I do think that scope of practice of nurses and doctors cannot overlap too much. Because let’s face it, the nurses will always be able to offer their services at lower costs. And, more often than not, they (nurses) have less debt coming out of school.

Amy from RNCentral.com sent me this post titled 20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare. It’s a good read discussing the pros and cons of Wal-Mart entering the health service industry by opening up clinics at their stores.

I know it has been a while since I last wrote. Been a bit busy lately. And in my moments of downtime I’ve found myself doing a different type of writing. I’ve been writing some fiction. Mostly because it’s a bit therapeutic. Anyhow, back to Medical School related matters.

On Friday we had two guest lecturers for our two-hour session of a class called Understanding Your Patient. During the first hour, a professor spoke about understanding cultural differences among our patients. He primarily focused on the latino culture because there is a huge hispanic population in the local area. One thing he mentioned is that in general, the hispanic population would put up very little resistance when talking to a physician. But that does not give any indication that they agree with what you are saying to them.

And that is a very important thing. In this class we have discussed the idea of getting a patient to cooperate and accept the treatment plan. And this applies to everyone, not just the latino community. In order to have the best results, doctors must team up with the patient for a common goal. The idea of white-coat-wearing-doctor dishing out his wisdom on health and a patient obediently following instructions is outdated and just doesn’t work.

During the second hour he gave the time to a local Mexican woman who talked to us about various herbal and traditional remedies the Mexican people use. She told us that many times they turn to those first, because going to see a doctor is just too expensive. She also brought samples of the things she talked about.

I learned that they use a camomile and spearmint tea for a of different things. She shared remedies for many common ailments. There is one treatment, for headaches, that I plan to try. It involves soaking a pinto bean in rubbing alcohol. In the event a headache, the bean is placed on the temples. Supposedly this relieves the pain. I’m quite interested in trying it out. Cause every once in a while, when I don’t drink enough water, I get some pretty annoying headaches.

Anyways, I hope to be able to post with a little more frequency this month.

P.S.
Remember the disclaimer. I’m not offering medical advice on this site. So try that pinto bean thing at your own discretion.

It’s getting busy now. It must seem like I say that a lot on my posts. At least I feel like I write that a lot. But its once again the week before exams. The lecture schedule is tapering off. We have only 3 lectures on Thursday (as opposed to the normal 4) and then no lectures at all on Friday.

I’ve been posting less in the past 2 months. It was an attempt to cut out some distractions. Although I do enjoy writing here and it can be, at times, quite therapeutic. But as it goes, school comes first. After all, I would have nothing to blog about if I don’t pass the year. And JeffreyMD.com would no longer make any sense. Cause I’m not planning to move to Maryland anytime soon.

Even now, I should be studying. I’m sitting here writing this post in the library. But I saw something in here that looked out of place. It looked so out of place that I actually found an excuse to walk by the aisle a second time to get another look.

I saw someone sleeping in the library! No, this was not the normal exhausted looking medical student. This was an older woman. And she wasn’t sitting at a desk either. She was sitting in a chair placed in the middle of an aisle of books. She took up the whole aisle. You couldn’t get by her.

I suppose one might think she was a student. But something tells me otherwise. She didn’t look that clean. Behind her chair there was what looked like a small piece of luggage. In front of her was some push cart filled with her things. I couldn’t get a good look at what exactly was in there. It just struck me as an odd sight to see.

I don’t want to assume she is homeless. But I’m afraid I’ve already done so. That may be a by-product of living within 20 minutes of downtown Los Angeles where I have often seen homeless people going around with a suitcase. Regardless, she does not look like a student. And, technically, I don’t believe non-students are supposed to be in the campus library.

I attend a university whose motto is “to continue the healing and teaching ministry of Jesus Christ — to make man whole.” Is her presence in the library a lapse in our security? Or are they intentionally allowing her to escape the nasty heat outside and sit a while in the cool of the library’s basement where she is no bother to anyone. She really isn’t in the way, even if you can’t get at the books she is sleeping in front of. She’s in a part of the library that hardly has any traffic anyways.

I wonder if I, hoping to one day become a good, Christian, physician should have gone up to talk to her. From the little experience I have had in life, I know that every one has a story to tell. Maybe she would have been grateful for it. But maybe she would’ve been annoyed at being woken up. I know I don’t like that.

Well, as the title implies, this was just a random post. I really don’t have anything to write about except that which I already have. It’s possible I’m just avoiding my physiology notes right now…

So with that, it’s off Physio-Land to study the hormonal miracle of life!

Well it looks like the Democratic nomination just keeps getting more complicated by the minute. Last night Clinton pulled off some victories in Texas, Rhode Island, and Ohio. A while back (in a post titled Hillary Healthcare 2.0)I wrote about the healthcare plan proposed by Hillary. My intention was to highlight the plan so that others who are interested in medicine might get a clearer picture of this. I had hoped to do a comparison of all the major candidates.

Well it looks like some other people have done the work for me. I found this site: Health08.org. It had all the candidates and what the proposed (as far as healthcare is concerned). Now, they only list McCain, Clinton, and Obama since they are the only ones left in the race. So just keep in mind that the site changes as the political landscape does. So if you’re reading this 10 years from now, they probably won’t have anything left.

Hope it helps for everyone getting ready for the November elections.

Everyone loves February. It’s the cute little month with only 28 days (most of the time). And it also has that special holiday, Valentine’s Day. But someone also referred to it as Singles Awareness Day. So I guess there’s a mixed audience when it comes to that day.

This month I also had a couple of hours of lectures covering topics like sexual relationships with patients, dating, marriage, and adultery. Those are the ones I can think of right now but I don’t think I’m missing any February-related topics.

The class where we learned about sexual relationships — I think the lecture was titled “Sexual Boundaries” — was called Understanding Your Patient. The course director is a practicing psychiatrist. I’ll sheepishly admit that I would probably have a hard time explaining what that class is all about. At least not very succinctly. Listing some of the other topics discussed in that class might help paint the picture, though. We’ve talked about how to partner with our patients with a goal of better healthcare (as opposed to giving orders). We’ve discussed breaking bad news to patients. We’ve talked about aging and the difficulties associated with it. We’ve also talked about child abuse, red flags that we might encounter, and the responsibility to report our suspicions to the appropriate higher-ups.

We spent two whole hours talking about sexual boundaries. The take home message for those two hours? Don’t have sex with your patients.

We heard about doctors having their license taken away for getting involved with their patients. We learned that psychiatrists, because of the intimate nature of their work, can never get involved with their patients. A surgeon, who after operating on a patient, may be able to date the patient as long as number of years has passed. I guess the point was that “they” don’t want a physician to abuse his or her “power differential.”

A few days later, in a religion class called “Wholeness for Physicians,” we were talking about adultery. The instructor, who is a practicing psychologist, warned us that it is very easy for physicians to go down this path. Doctors at work, he told us, are constantly being attended to by the nurses. There is a very friendly relationship there (hopefully). And when the doctor goes home, he or she hears, “Honey, I’m tired. Watch the kids.”

Eventually the doctor begins to compare the spouse with the attractive young nurse. It can be a recipe for disaster. I think I understand the dynamics now.

So that was my experience during the month of love. That was the extent of my foray into anything close to relationship or romance — I listened to lectures about it.

Last year CNN ran an article written by Emily Breidbart, then a second year medical student. It’s an interesting read. At times I do feel that it is a struggle to protect my own idealism. But maybe she is doing a better job than I. Because I’ll admit, at times I find myself downright cynical — even comically cynical. But that’s another story. Anyways, in her article, Emily writes about how her curriculum, at times, seems to revolve around preventing lawsuits than the patient’s health.

Fortunately, this hasn’t been the case for me at my school during my first year. I think there has been the occasional mention of the litigious nature of the profession. And I think we (as students) have all heard plenty of stories about it. So it isn’t like we are ignoring malpractice. I’d say that they, and by they I mean the professors who teach us, choose to focus on the patient.

Who knows? Maybe one day Loma Linda’s curriculum will have to change. Maybe someday they will have to place the fear of litigation into the heart of every incoming first year. I hope not, though. Because a society in which doctors are afraid to treat patients is a society in trouble.

Oh, and check out Emily’s article “Med student struggles to preserve her idealism” over at CNN.com.