Top 5 Lessons Learned During My First Semester Of Medical School

I'm not even going to address the fact that I went into hibernation over the last two months with this blog, so don't even ask. I'll just try and write as comprehensibly as possible, since this will no doubt seem like an enormous diarrhea of the keyboard. Here goes...

My second semester of medical school is well under way. I'm officially a full fledged med student (before I was just a pee-on) who knows some of the in's and out's of what I have to do to succeed here. I've realized a few things after completing this past semester that I'd really like to share.

1. I hated anatomy. Now I know I spoke of "Charlie" so reverently and how much I learned from the experience and all but the truth is I found that whole process to be gross and abusive to both the students having to do it and the poor souls that thought they were donating their bodies for the sake of academic achievement. Don't get me wrong, I learned a ton from these bodies but I just don't see the point of slicing into a male scrotum to take a testicle out and dissect it so carefully only to realize you can't see anything because its colorless and your head's spinning because of the noxious fumes from the formaldehyde. This brings me to my next point:

2. Professors love genitals. During undergrad I kind of had the feeling that professors tend to place special emphasis on the reproductive system in biology since it's important to understand to understand evolution and genetic recombination and the like. But in medical school it's like some Freudian parade every time the reproductive system comes up. Our first exposure to medical school was on how to make a baby in embryology when we spent a solid week on how the penis forms versus a vagina and looked at colorful pictures like this one:

And no, that is not a hermaphroditic clown. Frank Netter, the man who drew these fine images for his Atlas of Human Anatomy was also a perv by the way. I've never seen a book place so much emphasis on the taint before. Then in anatomy we were given sex advice on how to fully stimulate those just right areas (you hear that ladies?). I'm sure there's more to come. Get excited.

3. Med school's not so bad. I know I may get rammed for this but I remember this time last year I was writing 30-page lab reports on the particle-in-a-box theory on chromophore electron excitation almost every single week. Now I have one test every few weeks, no homework, and I'm learning things I actually care to know and enjoy the process. Of course I have to know more than I'd ever like to know about the stretch receptors in the right atria which regulate heart rate - but overall it's no big deal. So why is it that we all hear from medical students that the first year is the worst thing ever? It's all because of the people you're asking. Med students. And we all know that...

4. Med students are crazy. No seriously, mental. It goes without saying that you need to have certain special qualities to a. get into medical school and b. become a doctor. A lot of the times medical schools are looking for something fresh and new in their students. I seriously think they're starting to look for things that make people unique that others would consider a mental disability. Med students get a sick pleasure in meeting a sick patient with a super contagious disease and then telling everyone they know that they were probably exposed and could die if not treated. These are the same students who when told a story about death and dying often say "cool." They find words like "radiculopathy" funny.  I find more and more that medical students border sociopathy the more I get to know them. Many can't talk to peers let alone patients. They'll make excellent scholars, but I'm concerned they'll make awful physicians. This leaves the world open to those of us who may be a little less inclined to study and more inclined to socialize, I suppose. So cheers to that!

and finally...

5. By doing what you love, you'll be better off than doing your best in school. I've heard it a thousand times before. It's really easy to get into the notion of going to class, going to the library, eating somewhere in between, then going to sleep and doing it all over again the next day. Part of the reason why I decided to come to this city was to make sure I never had a routine life. I like not realizing what day of the week it is or occasionally forgetting to go to class because I was playing music and lost track of time. This was basically my New Year's resolution - to make sure I do a few things each week that I love to do that has nothing to do with medical school. In the end it makes you a more worldly person and reminds you that there's a world out there that's just wasting away without you exploring it. So first step of my resolution was to finally buy an electric drum kit after selling my last one when I moved away from Gainesville. I've been playing for so long and I don't remember not having something to bang on since I was 13. So that's check one.

The other thing I decided I'd do is to go see more concerts. I already went to a few this semester, and I have another few lined up. I'm even going to see Copeland in their farewell tour with just one ticket for myself. Besides, going to an emo show alone makes it all the more emo. I just need to grow my hair out to cover my left crying eye which burns ever so lightly. Just for kicks here's a picture of me with that exact image in high school.

 There you have it. The top 5 lessons learned during my first semester of medical school. Here's to hoping the list expands as the years go by. I'm paying thousands of dollars a semester for something, right? That's another depressing story.

Short post...

It's warm in the library. This has always made me feel tired more than anything. I just had a big cup of coffee as I got ready for a long night of studying and this warmth still got the best of me. I found myself passed out on my jacket on the desk for I don't know how long. Judging by the drool and the earache from my leaving the earbuds from my iPod in my ear while sleeping I'd say it was a solid 45 minutes. 45 minutes out of my studying and now I'm only starting at 9pm. For some reason studying the different pathways folic acid is involved with just doesn't strike my fancy. These next 2 weeks are finals, so don't expect too much from me. Will update again when the bombs stop dropping from above.

Until then,
Eric

The Bipolarity of Life in Medical School

It's been awhile since I last posted anything and I'm seriously sorry about that! This past month or so has been filled with greatness, randomness, and sadness. I can't even say that I've been all that busy since the month of November during my first year will probably be the least involved month in all of my medical school career. Not to worry though, this is New York City - and there's no such thing as free time here.

Rewinding back some to late October, I finished my first set of medical school midterms. All went fairly well (remember, P = MD where P means "Pass") and since then its been one big celebration for midterms being over. For some reason I've been feeling like I should get some kind of reward from myself for finishing this milestone and so I've pretty much put my classes on hold temporarily and enjoyed the city life and time here with friends. First stop after midterms though - Jacksonville, Florida for the Florida/Georgia football game, the "Worlds Largest Cocktail Party" over Halloween weekend.


This was my first time back to Gainesville and Jacksonville since I left UF - and it was everything I imagined, except with babies running around. It was the first time I realized that I was getting older and maybe I shouldn't be doing the things I did that weekend all that much anymore. Outside of college, drinking too much is called alcoholism. Not doing your work isn't just "procrastination," it's failure. Nonetheless, drinking and procrastinate I did - and it was well worth it. I was Dexter for Halloween - which rocked - took shots with Riley Cooper, had a heart-to-heart with Jonathan Phillips, and had the time of my life with my friends and girlfriend who I hadn't seen in forever. Until next year.

In New York things have been fun as well. Without any exams to worry about in the month of November, I could worry about things that matter most to me - like enjoying my weekends. On one night after the UF/Vandy game I decided to meet up with the rest of the Sinai group at an APAMSA inter-med school mixer at a pretty nice club in NYC. I'm not the clubbing type, but I figured I'd give it a shot. I knew AMSA from undergrad and had assumed "APAMSA" was the version of it once you're already in medical school. Oh was I wrong...

On the way there with my friend we found 4 men in US Navy uniforms that said "USS New York" on the sleeves. This was the ship that was built from the steel found at Ground Zero from the WTC attacks. It had just been dedicated that morning and so they were all out celebrating. I said hi to them and thanked them for doing what they're doing and they asked me what our plans were for the night, since they'd never been to NYC before. I told them I was going to this inter-med school mixer and that they should come along and find themselves a med school girl - a future sugar momma. They agreed and we went inside of the club.

Now, rememeber when I said APAMSA was the "once-in-med-school" AMSA? When I walked into the club I immediately realized what AP stood for:

I realized then that my friend had told me this earlier but I thought they were unsure about it. I had a great time though, since my cousins came along and the sailors were heterosexual, contrary to popular belief.

Then during class one day we had a speaker come in to discuss how to screen for drug abuse in patients while taking a history. The speaker went through each drug one by one and discussed the side effects of each.

Speaker: Marijuana - sleepiness, incessant hunger, feeling less worried about about one's problems, and forgetfulness.

Me: (mumbling) Well that doesn't sound all that bad.

Speaker: Cocaine - Hyperactivity, reduction in hunger, loosening on inhibitions, faster metabolism.

Me: (mumbling) Well that doesn't sound all that bad either...

Speaker: Methamphetamine, or Crystal Meth - Sympathetic nervous response, depression, itchiness, loss of inhibitions, sexual hyperactivity.

Me: (forgetting to mumble and actually quite loud) Sexual hyperactivity!?
-----------


The entire class cracked up, as well as any professors who were there. Now I'm on the list for suspected meth abusers in the class of 2013. Fantastic.


The latest piece of news is of true sadness. Earlier this month we received patients for our projects called "Longitudinal Clinical Experience." The idea behind this is to introduce students to patients who are chronically ill, having ongoing issues that need constant attention. This is supposed to give students an idea of what the patient experience is like, hopefully allowing us to empathize with patients better. We each had an opportunity to choose a specialty of interest from a list, and I chose GI. I was hooked up with a GI doctor who introduced me to a patient who underwent a relatively rare procedure - a small intestine transplant.

The patient was still in recovery from the surgery when we were introduced but was set to be released shortly. This man was a really great guy who was extremely optimistic about life and his main goal in life was to just live normally alongside the rest of his family for the rest of his life. After taking a history of his life and medical past and assessing his plans for the future he assured my partner and I that we'd be over for dinner one day since we would be following him for the next two years and were sure to get close to him.

Just yesterday I received an e-mail from the GI doctor saying that he had contracted H1N1 outside of the hospital shortly after being discharged. He couldn't fight it off due to the surgery, and he passed away only a couple days later.

I can't say I was actively invested in his medical care, but something's very off about how I've been feeling about it. I guess it's just the fact that at one point there was this man who was cracking jokes and perfectly fine upon meeting him and now there just isn't. I had never really known anyone that died so abruptly after being so great. It'll definitely be something I'll always remember.

Now that I've depressed you, I have work to get to. November's almost up, and finals are coming closer and closer. Until next time!

Spreading the Love One Vaccine at a Time

I really can't believe the amount of trust they've instilled in medical students in the United States. A few weeks ago we had a "training" teaching us how to give flu vaccines through the shoulder muscle. New York City law has mandated that all health care workers (including med students) require both the seasonal flu vaccine and the H1N1 vaccine or else we can't work or go to school.

Mount Sinai felt it would be best to use this as a teaching opportunity and have med students administer the vaccines. At the training, we didn't practice on each other or anything of the sort, we actually practiced on oranges. Apparently, the faculty felt that oranges had a similar skin resistance as a human being and therefore would be just as effective in teaching us how to give injections. So here I was, in my shining glory, injecting water into oranges like it was my business and then continuing to put on band-aids where I punctured the orange.

Fast forward to last Thursday, from 4-8pm. I was in the front of the assembly line, meaning I was almost non-stop for at least 3 of the 4 hours giving vaccine after vaccine. My first vaccination was miserable. I was shaking, went way too slow (which makes it hurt more), and was just all over the place. Thankfully the patient didn't ask me if it was my first time, probably since I had the white coat on. Something about that coat makes people think you know what you're doing. Don't ever be fooled, ladies n' gents. Actually, only one person showed any concern at all by saying, "I'm not too worried, you've probably done so many of these!" I continued to say, "yea, don't worry." I didn't think it was lying if I didn't clarify that I've only done a lot of those just that day. I mean she was around my 20th vaccination - that's a lot to me.

I also went on last Saturday to do some vaccines for the health department in a project in Central Harlem. The health department sponsored free vaccinations to anyone in Harlem since it's a vastly underserved community, and preventative medicine (vaccinations) would decrease the economic effect of the mostly uninsured population of Harlem. As much as people want to say its a humanitarian thing, it all comes down to cost reduction. That's a different story though - The people we encountered at the St. Nicholas Houses (left) really caught me off guard. I'd always ask myself, "Why don't these people care about their health care and start to take care of themselves instead of getting so sick that they have to go to the emergency room and waste tax dollars on something that could have been easily prevented?"

I realized after Saturday that these people care just as much as everyone else about their health care. The difference is that I generally trust the doctors I go to and the studies that suggest what treatment I should receive. Throughout the years that these people have been living in Harlem they've seen things that would make them never trust the government or health department ever again. One man told me that he wont do anything for his health that the government mandates because the government is just trying to kill off the poor people in the country as a means to reduce poverty. He actually felt his life was endangered by his own government.

Another training we had we actually did practice on one another. This time it was to practice taking blood samples, known as venipuncture. This is the one that you stick them in the arm after putting a rubber band around their bicep and hope you hit a vein, or else you do it again. I was the first to get stuck by my partner. The needle went in like butter and she actually hit the vein spot on - but as she turned to her left to grab the band aid from the box, she yanked out the needle and any blood that was along with it. My blood spattered all over the table and the floor and my arm became bruised. It looked a lot worse than it actually was though - and I think she felt really bad about it. I laughed - a lot. Here's a picture of the Dexter-esque crime scene.



Then it was my turn. Same thing went on. I hit her vein spot on, took the needle out, put the cotton in the place the needle was, and when I removed the cotton to put the band aid on she kept on bleeding a lot. Seeing the blood come out caused her to turn white as a ghost and I couldn't figure out what I did wrong. Finally a friend came over and said I left the rubber band around the arm which makes it so the blood keeps on coming out. I took of the band and everything was fine. She almost fainted, my blood was all over the table and floor - overall a great experience.


My first anatomy exam is this Friday and is causing me to have this bad taste of vomit constitutively attached to the back of my throat. I've been studying more than I've ever studied for anything before (I know I've been throwing that around a lot, but this time it's true). The supposed toughest part of the body to study is the perineum, or in layman's terms, the taint, gooch or grundle. This is a curious little area of the body that can be seen right here: The Perineum, according to Wikipedia. I can't attach any pictures because honestly I don't know what's offensive or what's not anymore. This has been the topic of my studies for the past few days. The perineum refers to the mysterious area between the anus and the vagina/penis. This is a curious little piece of skin and is often considered prime real estate. The funny thing is, I tried to study this thing and whats behind it over at the NYU undergraduate library and only realized after a solid couple of hours that the people around me were all disgusted with me for staring into this vast wonder world at the level of detail I need to in order to really know the anatomy I need to know for the exam. I finally turned around and saw people staring at me with a face that said, "what is the matter with you?" I went back to the heart and mesenteries shortly after.

Since we're starting learn the intricacies of the all the different systems of the body through anatomy the ominous question of what specialty everyone will be pursuing has become more and more prevalent amongst the first years. I've made my decision. I will be Dr. Mario and I've mapped out the next several years of my life below:

Special thanks to Romit for that one. Have a good one guys. I'll see you after the midterm.

Are you single?

Ahh, Sundays. The only day of the week you wake up knowing you can't drink that night but always regret what you drank the night before. In celebration of finishing my exam the night before a few friends and I headed over to Six Flags Great Adventure in Jersey. In case you're wondering, our decision to go had absolutely no influence by Mr. Six, Six Flags' official mascot who will forever haunt my dreams.

The morning started out pretty standard - took us about an hour to head out of the city because the Lincoln tunnel was closed for an MS charity bike race. The second we got there we started going on coaster after coaster.

There's something about theme parks that always tickle my fancy, for lack of a better term. They make me feel like a kid and let me do stupid things knowing I'll never see any of those people ever again. So what was one of the first things I did? Bought a Scooby Doo cape and wore it the entire day, naturally.

One of the coasters we went on was the world's tallest and fastest roller coaster, Kingda Ka. This thing was ridiculous - accelerate to 128mph in 3 seconds, climb 456 feet up into the air, just to fall back down. As the train pulled up and the person in front of me jumped in, I saw there was an extra seat for a single ride. I quickly turned to the people behind me who happened to be two boys around the age of 13 and asked them, "Are any of you single?" It took me a good 5 seconds after saying that to realize they thought I was coming onto them. Then I continued, "riders? single riders?" and turned around cracking up to myself. Good job by me.

Then when the night fell there were people dressed up to try and scare the guests for Halloween. One event they had was a hypnotist, so we went. I volunteered to be hypnotized, but sadly I was sent back because I couldn't be. I realized that it was stupid of me to even try, since the first step in all of this is to be completely relaxed, completely void of thought. That's always been a problem for me - I obsess and can never completely void myself of any thought. He started by telling us to shut our eyes, forget everything, and pretend we were suspended on a cloud. Then my leg started to shake because it was in a weird position. Then I started to think, if I move my leg then people will know I'm not hypnotized, so I better keep it that way and hope it stops. Then I started to think of the nerve response that would cause my leg to shake so abruptly. Then I remembered that I hadn't eaten in awhile which could be the cause of the shaking then started to wonder what was for dinner. He sent me down back into the audience because he realized I kept laughing.

Overall it was a good day. Now another week of med school started, this week with our dreaded anatomy table conferences starting. During table conferences we are grilled by a professor as a group for about 45 minutes answering questions that are presented to us such as "what exists within the spermatic cord, and what are the layers comprised of which surround its contents?" Since we're graded as a group I feel like its extra important for me to do well, because I don't want to be the person who causes us to fail our table conference. Personally, I wouldn't care all that much if we failed a table conference so long as it wasn't me that made me fail since they're worth so little towards our final grade.

Also, interviews started for the next year's class. This is always funny for me to see from the other perspective of someone who's already in medical school. The few interviewees I spoke to asked me questions like, "what kinds of research opportunities do you partake in?" and "do you find the diversity of the school to be high?" Too many times I want to say to them, "cut the shit, dude." I hope I wasn't like that. I know I was a little tense but come on. Maybe I'm being a little too harsh. My advice for anyone doing an interview here or anywhere else is to just be yourself. If they accept you based on a person you're not, you may be seriously disappointed with your medical school experience since you might find yourself in a situation you don't want to be in. Nobody's been from UF yet though, so I know redemption is still coming.

UF-LSU coming up Saturday. Probably the most important game of the season yet Tebow may or may not play. I don't worry though. Since Tebow is G-d, he can do his playing off the field just as well through Brantley's healthy body. I also already booked my flight and hotel room for Florida/Georgia in Jacksonville over Halloween weekend. Look out now!

Enough procrastination though - back to anatomy. So much for the short posts!

Apples, Alcohol, and Hypoglycemia

The Jewish High Holidays (Rosh Hashanah and Yom Kippur) in New York City are what separates Jews into denominations first, then tax brackets second. First off, there's the price of the ticket to attend services. This goes anywhere from about $200 - $600 for both holidays, depending on the synagogue you wish to join. After this, it's often customary to buy any specific honor, such as being able to hold the Torah or to stand beside the Rabbi as he reads from it or even to just open the door to get to the Torah. No, this isn't done by approaching the Rabbi before the holidays and requesting it, they deal out these honors by holding an auction mid-service at the synagogue. That way everyone hears how much each person donated and who did or didn't donate. In a sense, its a humiliating experience.

So, for Rosh Hashanah I went to Chabad with some friends in the Financial District. Since Chabad can't accommodate the influx of congregants in its building, services were moved to a recently closed Bank of America across the street. Jews...praying...in a bank...holding an auction for religious honors. Definitely the scene of a bad joke.

Shortly after was Yom Kippur. This time I decided to go to services at the chapel at Mount Sinai, expecting there to be other med students there. Instead I found mainly old Jewish men and women hooked up to their IVs and heart monitors praying. This has always really fascinated me. Many of these people wont leave the hospital ever again. This Yom Kippur service may be the last they'll ever have. In their last days though they turn to praying rather than traveling to Fiji or jumping out of a plane.

The most interesting part of the night though was towards the end of the final service, only 10 minutes before we can officially break our fast. The Rabbi was finishing up his prayers then all of a sudden he stopped in the middle of a sentence. Then he continued for a little and stopped again. Nobody seemed to notice it though. Then I start to see his right hand start to shake and then the rest of his body start to shake - then his legs gave out, thankfully onto a chair.

You'd think that since we were in a hospital there would be a bunch of doctors in the service running to the Rabbi's rescue, so nobody did anything drastic as 2 men approached the Rabbi and started talking to him. Someone in the back shouted, "are any of you doctors?!" and they both replied, "no." So this man ran to the emergency room and called for help and within minutes 20 attending physicians, residents, and medical students were in the chapel trying to help the Rabbi out - one of the attendings was a teacher of mine, oddly enough. Turns out he was simply hypoglycemic (low blood sugar) since he hadn't eaten. Like a trooper he took a sip of coke, jumped up, and finished his service, shofar and all.

My birthday also came around and went. I had a great time, no doubt, it's just since it's still early in the year I didn't have a solid group of friends that I'd want to throw a party for. So instead, I had a pregame in my apartment and went out to sing karaoke with a few good friends as well as a good chunk of randoms. After the pregame I realized that what I had at UF is now gone. No more throwing shit around and making a lot of noise while we play rock band while people are trying to talk next to us or getting noise complaints. Actually the last one did happen, thankfully.

The pregame at UF was the most integral part of going out. It ended when the alcohol ended or the bars were close to closing. Here, I'm sad to say, people just don't get down like that. Everyone's super awkward and wishing they were somewhere else but at the same time they think that if they didn't stick around then they'd be doomed to social inadequacy for the rest of their med school careers. So instead you get me - wasted - while most other people are casually sipping their screwdrivers waiting for me to say, OK - lets go.

So we went out and I sang a riveting rendition of "I'll Make Love To You" by Boys II Men, the greatest R&B group of their time. I made a fool of myself, and it showed the following day when people made comments to me like, "It seems like you had a fun night last night!"

Nevertheless, I'm stuck in another week of tests. This time for Molecules and Cells, our Biochemistry course. Today we had a "Small Group Discussion," a clinically relevant example of what we had been learning that we need to prepare for in advance. I also had a quiz today and I have an exam which I plan on taking Saturday night. Sinai does things a little differently. Exams and quizzes are all online. The idea is that we should be able to take our exams on our own schedule rather then the professor's in the comfort of wherever we'd like to take it.

I know most people would think that this is stupid since it would just encourage cheating. Surprisingly I don't think cheating's such an issue since we all realize we've worked so hard to have the opportunity to learn this stuff, so we'd only be cheating ourselves. It really does take only one person to take advantage of this system to make it all come crashing down, since all classes are curved. It's about trusting your peers, something that was never a concept as a premed.

About that quiz today...I failed it miserably. This was the first assessment here that I flat out failed. I came into medical school thinking I wasn't qualified for the school I'm at. Now I know that's the case. I'm studying like crazy and have nothing to show for it. To top it all off, it was in Biochemistry - my undergraduate major! I keep on having to remind myself that I'm here for a reason and that these setbacks happen - and it's important to use them for the better.

That's why I've been stuck in the hospital from 9am - 12am every day for awhile now. Studying. Studying. Studying. I promise to post a little more often. I think it'll be better to do shorter posts more often rather than these long narratives about what I did since the last post. Keep on keeping on.

The Perils of the White Coat and More Timeless Adventures

The white coat - a symbol that has so many connotations based on who you are. To a child, the white coat represents fear. To an adult, the white coat represents help. To an elder, the white coat represents unavoidable death. To me, the white coat represents one thing and one thing only - a chick magnet. Just kidding.

Yesterday we had our White Coat Ceremony. The best description for it was a ceremony which officially graduated us into the medical world as medical students. Basically a chance for parents to come and see what we've been doing so that they know their money wasn't being spent on random trips to Georgia to pick up 40's at 4am like it was in college. The ceremony was the first time we saw or put on our white coats and we also got our stethoscopes (which I most likely wont be using for the next year or two). I felt foolish in the whole getup, like I was wearing a costume or something. "Bend over and say cheese for me!" I thought it, but didn't say it. See, I'm learning something here.


Since then its been a game of shuffling the time of day around to accommodate my vices while still trying to maintain some sort of grip on the stuff I have to learn. Pretty much, the last few days since the ceremony have either been spent studying or sleeping. Eating only happens when there's a book or slideshow in front of me, and sleep hasn't exactly been long enough to have a proper fantasy of me and Megan Fox on the ocean front. Because of all this, friends, family, and yes, even bathroom breaks have had to take a cut. Surgeons have to stand for 6 hours at a time without bathroom breaks, so I guess that means I could do it. I better stock up on some cranberry juice.

I'm starting to see a really clear separation of the gunners and the relaxed kids since we have so many tests and quizzes coming up. I don't really hate people for being gunners. I think the world needs them in order to motivate (or scare) everyone else to be more productive. The one's I do hate are the gunners who fly under the radar. These are the ones who say they're going to go back to the room and take a nap or go out with some friends nobody knows but actually just end up studying alone in their rooms with fears of being found out by all the others. They're the ones who secretly go to office hours for no reason but to ask questions that they already know the answer to just to show the professor his or her face.

Nonetheless, big weekend coming up - Lane Kiffin will be running all the way home wheezing rocky top through his endotracheal tube after the the Gators get a hold of him. Too much?


I picked up a non-medical school book yesterday, then had to immediately put it down. I haven't watched a single second of TV this entire week. I haven't left the 98th-100th Street 2 block radius for 4 days now. My jokes have been limited to "that's what she said" when the professors say something like, "You can't just find a hole in the body and not go inside of it to see what's inside" for the sole sake of lack of inspiration. But the nerdiest statement of the night is: I'm really loving it all. By the way, I found out my cadaver's name. His name was Charles.