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Consider the Cow

October 2, 2009 by 2 Comments

Pastor Nick, a friend of mine, tweeted this:

Anyone else realize that they need to “chew the cud” when it comes to meditating on Scripture? (link)

cowAs I read that tweet I had a mental image of a cow chewing. And chewing. And chewing. All to properly digest its food.

It reminded me of something that King Solomon is credited with saying, “Go to the ant… Consider her ways and be wise” (Proverbs 6:6, NKJV).

I tweeted back that Nick should write a blog entry titled “Consider The Cow,” but as soon as I sent that I wanted to use it. Because while Nick tweeted about needing to “chew the cud” in the context of meditating on scripture, I think it is also the very thing we need to do as medical students.

With the sheer amounts of information thrown at us it is very easy to try and speed through the various reading assignments. But when trying to memorize, repetition is the key. Slowing down and taking time is paramount (although one cannot be too slow). Without doing so, the material is quickly forgotten — or at least the details eventually slip away.

And as they say, the devil is in the details. It will be the little things that trip us up on an exam. When considering a clinical case, one little detail can mean the difference between a diagnosis of schizophrenia and schizophreniform disorder.

So go to the cow. Consider her ways, and be wise! Take time to process the material and linger a few moments longer on the little details that help to differentiate (and here I am writing this for me more than anyone else).

Now if the details are that important, if they can lead to making man whole — or at least helping them get better — then would that mean that God is in the details?

I suppose that would be a topic best left to the philosophy and theology bloggers…

Me? I’ll just put up my brand new cow poster. And every time I see it I will remember to slow down and properly digest my “food.”

Filed Under: Medical School, My Life Tagged With: , ,
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Studying Pharm — A Look At My Notes

September 24, 2009 by 18 Comments

“They” say that one way to aid memorization is to use drawings and diagrams (the crazier and more vivid, the better) because the brain more easily remembers spacial relationships that just straight lists. So as I have started this second year of medical school I am studying in a totally different way than I have in the past and using a lot of drawing/diagrams and writing out of my own notes.

Here is what my Pharmacology notes look like. It is the drug list for the autonomic drugs I need to know.

Sorry for the blurry video. I didn’t realize the video was out of focus until after I was done. The Flip Ultra doesn’t do very well this close to an object.

Hopefully I will be able to continue doing this throughout the year. I think it will really help me with the memorizing. If I can push through every day and avoid getting too far behind, I think the chances look good.

Again, sorry for the vid being blurry. If I do this again I’ll film from farther away or use my other camcorder.

Filed Under: Medical School, My Life Tagged With: , , ,
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MSNBC.com: Facebook misconduct: Med students cross line

September 22, 2009 by 8 Comments

Article: MSNBC.com: Facebook misconduct: Med students cross line

Sometime last year there was an article about students posting inappropriate things on Facebook and having to deal with administrative consequences from their school or lose out on a job because some potential employer decided to check up on the job candidates online.

Well in this latest story, medical students across the country are getting reamed for being inappropriate on Facebook. What kinds of things? Offenses included “posting unprofessional content online, including photos of drug paraphernalia and violations of patient privacy.” Even posting YouTube videos of practical jokes with a cadaver.

While I agree that medical students should conduct themselves appropriately with the dignity expected of someone in the profession and that some of the offenses should never have taken place (like being disrespectful with a cadaver or violating patient privacy), I will point to one section of the article:

Medical students are no different from other young adults, said Anastasia Goodstein, a San Francisco-based marketing expert who tracks youth trends on her Ypulse Web site. The generation that first embraced social networking still considers Facebook merely a way to connect with friends.

“Now they’re waking up to the reality of older people and people with authority over them, like deans, seeing their Facebook pages,” Goodstein said.

And I don’t mean to point that part out to make an excuse for the behavior, but just to offer an opinion (that isn’t necessarily mine) from the other side.

However, I do strongly believe that all patient-identifyng information should never be posted online. And that was a line young and old never have a right to cross.

Oh, and one part of the article kind of pointed out something else. One medical student was in trouble for friend-requesting a patient on Facebook. I understand the ethical dilemma. We discussed this in class — that physicians and patients need to keep the relationship professional. But as Facebook has become more and more commonly used as a means to communicate (in addition to staying in touch with friends), I think this is a gray area.

Why can’t doctors add patients as a facebook friend? Is it because the patient will be exposed to the physician’s less guarded, non-professional moment? Or what if the physician had a dedicated professional account? Anyways, not everyone who is a “friend” on Facebook is really a friend (i.e. people who add/approve anyone regardless of whether or not they know them personally).

And now, I must go dig through both this blog’s archive and my twitter account and selectively purge entries…. lol Kidding. Kind of.

Filed Under: Medical School, My Life, News, Opinion Tagged With: , , , ,
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Year 2, Week 2 — I Have My Goal

September 18, 2009 by 7 Comments

I apologize for my completely lazy title. I’m tired. And it fits.

It’s the end of the second week of the sophomore year here at LLU. Some of you who have read my blog in the past might be wondering why I am writing about the beginning of sophomore year. Well because I am in the sophomore class — again. If you’re curious, check out my post titled “Back to Blogging” where I wrote about coming back to LLU after skipping exams and telling my dean I wanted his signature on my withdrawal slip.

It’s definitely strange. There is a sense of deja vu. Maybe it’s more than just a sense. I am hearing the same lectures for a second time. And I hope I can make the most of it.

But it is alienating to come into the lecture hall and see a totally different class. Unfamiliar voices and faces. And everyone there knows that you are a new face that was not part of the class 3 months ago — that you don’t belong.

I suck it up though. Because this is what I have to go through to get to where I want to be. And I’m not saying that my new classmates are unfriendly. They very well might be. And I have met a couple here and there that have been really nice. But I am definitely not the outgoing type. So that doesn’t help.

As I begin the second year for a second time I have to ask, what about me is different? Because if nothing has changed, then the outcome is likely to be the same frustration and anger that I felt before — which is definitely not a good thing. The last time it led to a failed attempt at withdrawing.

Well in short, a lot has changed. I am not the same student. Sure, I still want to goof off and procrastinate. But I have put myself on a schedule to keep myself on task. My break times, study times, meal times, and sleep times are planned out and printed out. I make a more concerted effort to focus and absorb/understand as much as possible from lectures. I cut down my internet/TV time. But the most significant change is probably attitude. I hate studying. I’ve said that before and I will probably be saying it many more times (or write it, for that matter).

But I have decided that I want to be a doctor. Yes, dear reader (intentionally left in the singular), I WANT TO BE A DOCTOR. And this process of spending hours with the books is NOT just a means to an end. Every opportunity to learn in medical school is a chance to shape the kind of doctor I will one day become. I don’t want to be some run-of-the-mill MD that just barely gets through, perfectly able to handle 90% of the problems 90% of the population see a doctor for.

The thing is, this will probably require me to throw my entire being at chasing a class ranking in the top 20% for this sophomore year (I’m not including the freshman year because mine sucked. I passed. But I’m definitely not proud of it.) Not for the sake of bragging rights, competitive residencies, or being “smart,” but because effectively soaking up everything I can in order to be the best doctor I can be will probably put me in that envied company as a serendipitous byproduct.

It’s a high challenge — especially for a life-long procrastinator and self-proclaimed loather-of-studying like me. Because it almost sounds like that percentile is my goal. And shockingly, that is the case. That’s what I am aiming for. In writing. On the Internet. For all (or one) to see.

In the end, should I fail to reach my goal, I hope that it is because I could not pull it off — not because I did not try hard enough or was not disciplined enough. Only time will tell, though.But the bar has been set high because one doesn’t achieve lofty goals without first being willing to set the goal behind daunting obstacles.

Wish me luck 😉

Filed Under: Medical School, My Life Tagged With: , ,
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If I were an actor…

September 18, 2009 by Leave a Comment

Every once in a while I read about how some actor or actress refuses to watch any film that he or she acts in. I used to think that was odd. I mean, why wouldn’t you want to see yourself?

That’s how I felt — at least until I had to watch myself on video. After I saw a standardized patient in an OSCE I had to sit with two other students who had a interviewed two different actresses playing the same role.

The clinical case was simple. A 21 year old Caucasian female who previously suffered from Bronchitis (1.5 weeks ago) has a complaint of vaginal itching. She just completed her course of antibiotics 1 day before coming into the office. Based on that patient ID, and the subsequent history I (and I believe my two colleagues) concluded that this woman had a yeast infection.

That was the easy part. Well, more or less…

The difficult part came after. We sat in a group of three with one of the physicians and watched clips of each other’s interview. We had to comment on what we liked about it and what could be done to improve the interview as a whole.

After this group session we split up and had to watch our own videos in it’s entirety before writing a self-evaluation as well as what we think we could do to get better and what we planned to do in order to actually get better at it.

Well I cringed. I didn’t like watching myself on video. It was awkward. My voice sounded… well it just didn’t sound quite right. I watched myself and thought, “hmmm… I guess I could lose a couple more pounds.” (Is that girly of me to think that? LOL)

At least, however, I did get some positive comments. I’m not horrible at interviewing as long as I don’t go blank midway through. The physician told me I did not look nervous and I actually looked like a doctor in there — or at least on camera.

And the standardized patient wrote the following: “Good job!” and that I made her feel very comfortable during as a patient.

But on the bright side I know I can look a stranger in the eye and with a straight face talk about her vaginal itching, sexual activity, and sexual orientation all while making her feel comfortable.

Filed Under: Medical School, My Life Tagged With: , ,
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Sacrifices

August 14, 2009 by 2 Comments

I recently read a twitter update from a friend of mine. It read:

After tonight, i don’t understand how anyone in their right mind used school as an excuse not to come to Oshkosh.

First of all I should probably explain the tweet. My friend is at Oshkosh for an International Pathfinder Camporee. (My friend is there as one of the staff members.) Pathfinders is sort of like co-ed Boy/Girl Scouts. This year there is a camporee in Wisconsin where clubs from all over the world gather for a few days, sing songs, play games, and learn different things.

As usual there are young people who choose not to go and claim that it is because they don’t want to miss out on school.

But my friend doesn’t understand why someone would use school as an excuse for something that is so much fun.

I would venture to guess that the person willing to use school as an excuse would do so for a couple reasons:

  1. They are lying and school really isn’t the reason. They just figure it sounds like a “good” excuse — that the excuse is a respectable-sounding one.
  2. They are telling the truth because school is important to them.

I would venture to say that medical students, in general, are most likely to be willing to sacrifice fun for school — not necessarily because we like school (although many do thoroughly enjoy school and learning), but because we are pursuing a goal that will only be realized in the long-term.

And so we sacrifice while others around us wonder why we would do such a thing. We sacrifice as a pre-med student trying to push as hard as we can to get into school. We sacrifice as a medical student to get into the best residency we can get into. We sacrifice as a resident to get into the best fellowship we can get into.

It’s just the nature of our “business.” We have to prioritize. We have to pick and choose which of our interests we will indulge in (Yeah, I know I ended that sentence in a preposition. Sorry.). And that is just something many people will never understand.

Filed Under: Medical School, My Life
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Back to Blogging

July 29, 2009 by 11 Comments

After a long hiatus I am finally back to blogging. The last few months have been quite hectic. It’s been full of questions. Those of you who have been following me on twitter know that I have been on a leave of absence since sometime around March.

But before I went on a leave of absence, I had actually planned to withdraw. Here is an excerpt form a post I was working on:

I’ve been thinking about writing this post for a while. Well at least I’ve been thinking about it shortly after I came to my decision.

My decision: withdraw from medical school.

It’s a weird feeling. It’s also a bit scary. But I’ve concluded that medical school and me are not a good fit — at least not right now.

After writing that post I went to see my dean, fully intent on following through with my decision. At that point I had already skipped two midterm exams because of my decision. But an hour after I walked into my dean’s office, I left with a signature for a leave of absence.

He asked me why I wanted to quit.

My answers were simple. I had been struggling to stay focused and concentrate on what I needed to do. At the suggestion of another dean (we’ll call him Dr. A), I went to see someone who could serve as a coach to get me motivated. That was in November. By March he told me that if I couldn’t get myself focused by now it probably would not happen. Furthermore, he mentioned that maybe it just wasn’t a good fit. He also said that others in my position had benefited from withdrawing and then re-applying in a couple years if they still wanted to. If they got in again, they usually never had any issues staying focused.

A few days later, Dr. A said the same thing.

And so, I strolled into the office of Dr. B to ask for his signature for a withdrawal (Dr. A and Dr. B must both sign the slip). And as I wrote above, I walked away an hour later with a leave of absence.

The leave didn’t guarantee anything. Dr. B said that if I wanted to return I’d have to begin my second year over. I’d also have to go before the Academic Review Committee and make a case that I should be allowed to do so.

Well I saw the committee on Monday (2 days ago). A couple hours later Dr. A called me to let me know that they had decided to allow me back.

Looking back, I am glad that Dr. B stopped me from withdrawing. Between getting my leave and asking the committee for another chance I had to do quite a bit of questioning. I had to examine myself and figure out why I had a problem focusing, concentrating, and staying motivated.

It was never an issue of whether or not I wanted to be a doctor. The problem was the training part. I don’t like studying. I don’t like spending hours with textbooks in a cool, windowless library. But it is a necessary step to reach that goal.

I believe I now know what was wrong… More importantly, I am hopeful that I now have the tools to fix it… (I may write about it some other time… but not now…)

And so the countdown begins. I will have to start my second year over again right after Labor Day (September 8, I believe) and join the Class of 2012.

As far as residency goes, a committee member told me that it would be extremely hard (if not impossible) for me to get into certain residencies as I would have to explain all of this. (And I wonder how wise it is for me to detail these things on a public blog like this. After all, it isn’t exactly anonymous — at least not the way I have done it.) I would have have to do very well on Step 1.

As my journey once again continues, I will continue to write about it here (I no longer write for Medscape’s The Differential blog). I’ve taken a strange path — definitely not the typical medical school path. And maybe that will provide for some interesting perspectives. And in the end I hope to achieve what I set out to do when I applied to come here: tacking on that “MD” onto my name.

P.S.
No, I didn’t apply to medical school just to add a couple initials to the back of my name.

Filed Under: Medical School, My Life