Spice Island Queen's 2010 Blog Recap

So here is my blog 2010 year in review (The rules: take the first sentence or line from the initial post of each month). 

What do Minnie Mouse, Santa, Michael Jackson, the Rockettes, Cinderella's carrriage and the nativity scene all have in common? So, third term in a nutshell: Mental Illness - one case The Power of Placebo I just checked my school email and this is the opening line: "There are wild rumors circulating about the water shortage, most of which are very far from the truth." Classic Rock knocked on my door, "come outside and bring your camera." Just a minute to rant.... Each set of pictures describes one pathology (See link to Path Pictionary V). Summer Break- Day 2, I'm here with a new West Coast address. I love the sound of the rain on our tin roof in my new off campus apartment. This sounds crazy even to write but if all goes well I will be celebrating being done with my boards in just six months from today! So one of the things that sucks is not so nice about being in medical school far far away is missing occasions and celebrations. So the week before last I told you all about how much I adored biochem, not! Today marked the last official day of Basic Sciences.

May 2011 bring you much peace and joy. And have a safe and festive New Year's Eve, cheers!


Day Zero (aka home sweet home)

I made it! Yesterday I said goodbye to Grenada and now I'm back in the good old USA with my husband in our cozy apartment and I couldn't be happier. The tree is up (he surprised me) and lit, we plan to decorate it tonight. The weather is a 60 degrees and I'm thinking of flannel sheets and sweaters. I guess after living on a tropical island for two years this is good intro to mild California winters. The Colorado blood in me not so secretly wishes for snow at Christmas but I'll settle for being with the ones I love.

Time to unpack and contemplate studying. I have a brand new 2010 First Aid and RR Biochem not to mention some lovely new pens. I can walk to Starbucks and I get to have good wine and dinner with the love of my life tonight. Life is good. I need to reflect on the past year of medical school but for now I'm just going to enjoy being home. Happy Holidays!


Grenada Goodbyes with 2 Days To Go...

I  thought this post would be easier to write. I'm done. No more medical school in Grenada. In just two days I fly home. Basic Sciences are over and this chapter of my life is closed. It seems both triumphantly amazing and like a big let down simultaneously. 

Since Thursday there have been parties and more parties, several trips to the beach, a drive around the island and sailing trip to another island. I'm not bolting from Grenada but rather making the rounds and saying my goodbyes.

It wouldn't be a pictorial countdown without a picture or more, so... 
The Shadowfax catamaron sail boat that took us around Grenda and to Hog Island. My third time going, love it!

 Christmas spirit in Grenada. Did I mention I heart X-mas lights?

Belmont Estate and Chocolate Factory. Beautiful plantation and they do a nice lunch if you find yourself on the North side of island. If in doubt, go! (Its worth the trip.)


This time tomorrow...

...I will be finishing my final exam of basic sciences. Two years of medical school will be over and I'll just 6 days away from leaving Grenada.

I'm trying to decide what this means for my blog, it will be hard to write Notes from Spice Island when I'm not ON Spice Island but I'll figure something out.

In the meantime I've got some pharm studying to do. And a few more raggae bus decals and pictures to share.... enjoy! (Next time I blog I will be a MS3. Crazy, huh?)

Also seen around town: Log In, Swagger, Bawl & Beg, Street of Heart, Just Amazing, Playboyz, Royalty, Endz Out, The Baddest King, Overcommer and Street Smart.


9 ladies dancing (and I'm dancing too, in celebration of single digits!)

Woo hoo, just 9 days to go. Oh Grenada, I will miss you at some point, in the maybe not so distant future but right now I am ready to go home! Pathophys final is tomorrow (well today) and then pharm on Thurs. The end is near.... So to celebrate and because I love Christmas and dancing so much, here is a hodge podge of of things for your viewing pleasure.

First up a video of an orchestrated dancing mob. Because it is fun. I think I need to find more of these (after exams) but today the credit goes to Everythinghealth.

From the neighborhood, I know it is not the best but I was just so excited that my neighbors had Christmas lights that I had to post this.

And finally, the 12 Days of Christmas lyrics and fun to get you into the Christmas spirit. I know it is bit pre-mature but its my blog and I'll post if I want to!


A Mocha kind of day...

So with only 11 days left on the island I am feeling a bit nostalgic. I spent the majority of my day studying at Mocha Jumby. It was my primary place of study 1st term and while I've been spending much less time here this term it still holds a special place in my heart. They seem to remodel every term but the coffee and food has been consistent and while I have to admit I'm looking forward to Starbucks and discovering new coffee houses for Step 1 studying I will miss this place too.

So to Mocha Jumby and the girls I met here first term I raise my coffee cup!

And some pics of Mocha today, because this is my pictorial countdown after all.


only a dozen to go...

Today marked the last official day of Basic Sciences. Two years of medical school is over (or will be as soon as exams are written next week.) Everyone was a little sad as small group came to a close today. I grabbed all my first year group members from Anatomy lab and we took a picture because it seemed fitting... oh how time flies. Anatomy lab and first term seem both forever distant and remarkably recent.

It is strange to reflect back over the past two years, upon how much we have learned and upon what is next. Third year and clinical rotations means we will all be scattered among many different hospitals and states and save the exams and after exam partying I likely won't see many of my classmates until graduation. I am not sad that basic sciences is over. My love of sitting in a classroom and doing small group busy work is not exactly why I came to medical school. But I WILL miss all my amazing friends and future colleagues (tear.)

Well enough of this reflecting... I'll be stateside in just 12 days and it can't get here soon enough. Now it is time to study my weekend away, for the last time ever in Grenada!

And b/c I heart Dr. Dasso- here is random question he put up during the pre-exam pharm quiz yesterday. Enjoy!


enough fingers and toes

Okay so there are now less than 20 days until I leave Grenada. I told you I was bad at keeping track... I started with good intentions but then somewhere between day 30 and now I got busy and lost motivation to take a picture and figure out a Grenada memory each day.

But never fear, I'm back and here is a quick recap. I have been trying to stay motivated to study... it has been a loosing battle. However, I've shipped a large portion of my stuff, donated and sold everything I don't plan on taking home. We took the NBME today and tomorrow starts the final week of classes. Yep just one more week of class, and two exams to go. That is all that stands between me and home for the holidays. I literally cannot wait! 

Some pics to make up for lost time...
Christmas comes to Grenada early (this was the week before Thanksgiving at the campus bank.) Also  Christmas carols are now regularly played on the busses. Raggae Christmas of course, gotta love it!

Cheers and sunset from my old balcony with a good friend. I love good friends and Stag and random inspirations to watch the sunset...  I will miss this!

Yep, you read that right- "Don't Hate, Appreciate" on the same van that has a Baby on Board decal along with the Playboy bunny. Gotta love Grenada! And I've been looking and a few other noticed Reggae bus decals to add to the list including: "Street Smart", "Overcommer" and "Not Lucky but Blessed."  See Grenadians are thankful, as am I. And to celebrate American Thanksgiving I made pumpkin cheesecake. Yum!

And now a picture of my Chrismtas lights because I love all things Christmas (almost as much as my husband.) Who I will see in less wake-ups then my fingers and toes. How very exciting!
Happy Holidays!


first signs (leaving 29 days of island pre-Christmas to go)

Christmas is coming~

On my way to the grocery store, walking through the mall... what did I see?
but a wreath and some hollly and a Chrismtas Tree!

On the speakers overhead, carols filled the air-
Old Saint Nick is watching, so you'd better beware!

Here in Grenada, Thanksgiving has past,
so we are allowed to have our pre-Christmas!


hay is for horses and 30 days left

So I took the weekend off. Well not exactly off off, but off from blogging. We had a lovely 8 hour exam yesterday testing everything taught in the past 2 years.  While the stuff like path and pharm are pretty recent and therefore memorable, subjects such as neuro and anatomy are less so. Good times.

Anyhow, the weather yesterday was nice, it was actually cool, it almost felt like fall. And I saw horses on the way to the exam. I don't think I've seen horses in Grenada before... I've seen goats, cows, stray dogs, lizards, coakroaches, crabs, but no horses. Until yesterday. I'm not sure why it made me so happy but the horses coupled with the weather made me feel like I was somewhere else... not a tropical island.

As for things I'm thankful for and/or will miss upon leaving:

Flip flops-I have 10 pair here which I admit, is kind of ridiculous but I do love my shoes.  And since there is rarely a reason to wear anything else it is footwear of choice on all days.

Random facts learned in lecture- Did you know that cabbage can cause goiter? I mean, you would have to eat a lot of it over an extended period of time, but still... I thought that was a cool factoid. I wonder if other people get excited learning about such random things.


Only 33 days remain to spend time with my amazing friends

"Lots of people want to ride with you in the limo, but what you want is someone who will take the bus with you when the limo breaks down." - Oprah Winfrey

Classic Rock is the kind of friend that will ride the bus with me. Just last week she missed Unity Ball (aka our med school prom) to do biochem with me. For 13 hours. The day after exams ended. Yep. Talk about a good friend...

This is her in Carriacou (another place I will miss) at Bogles Roundhouses where we were staying for a Hash earlier in the term...  (If you ever go to Carriacou I recommend eating or staying at Bogles. Roxanne is a great cook and the cottages are nice too.)

I am so glad that we are almost to third year, and finally being in the hospitals will be great, but I will miss my friends and classmates from Grenada. We are all going our separate ways... so this is my continued reflection on friends I will miss when MS II is over.


my kayak mornings, only 34 left (sigh)

On of my favorite ways to start the day is with an early morning kayak. Lucky for me, Miss P was also in the mood and so we went for a kayak followed by breakfast at the University Club. By 9:30am I'd gotten my exercise in, breakfast, some sunshine and water time. I WILL miss these mornings once I'm stateside.

Are you sick of the water shots yet? Too bad, I'm not...


Stag opportunities last for only 35 more days...

So, the official beer of Grenada is Carib, but I've never really enjoyed it. There is another option however and that is Stag. I will miss my Stag. Perfect with pizza at Prickly Bay or after a powder puff football game. My drink of choice post exams and for all around good times. Cheers!

Confessions of a Med Student Part III

This is part three of the series Confessions. Reflections on my medical school infancy and childhood can be found here: Part I and here: Part II.
Part III. The Third Term Breakdown.

One class. 5 subjects. 6 credits. 6 weeks.

aka. Psychiatry + Biostatistics + Epidemiology + Health care policy + Law and Medicine + Bioethics cont. = Behavioral Science and Medicine.

Maybe because I was a psych major in college, or maybe because I tend to like the non-science part of medicine- recall first term, my favorite class was the one most students couldn't stand (bioethics)- but for whatever reason I really liked third term. Because it was so many different subjects you couldn't really get bored or bogged down with any one thing. Perhaps I'd seen 80% of the material at some point in my prior education. I wonder if that is how the undergrad biochem majors felt during first term. Or how the students with master's degrees in neuroscience felt during 2nd term. In any case, I enjoyed what was for me by far, the easiest of terms. And I got to enjoy the island a bit too. I went sailing. I fully lived my weekends. I had friends over. I went out.  I baked. And I planned and anticipated fourth term.

Fourth term is known to be the hardest of all terms at SGU. You hear rumors. Like- the average of the 2nd exam is a failing grade, 1/4 of the class above you had to decel and 100 students are retaking the class. It is hyped up to be the big bad fourth term, the mountain you must scale and the raison de etre of medical school, it is pathology. All of pathology.  Taught in 4.5 months alongside microbiology and clinical skills because just one class at a time would be humane. Be scared. Be very scared. Or so the rumors go... (you'll have to wait for Part IV to find out my take.)

So in summary: third term is created to torture you before fourth term starts. Since four and half months away from home is not long enough third term ensures that you will be on the rock for a full six months and I think this is why it gets a bad rap. That and people have to do math. And read. Or so my theory goes. As for me, third term was finally a step in the right direction and a great start to what is the 2nd year of medical school.

Stay tuned for fourth term. What doesn't kill you makes you stronger. Or something like that.


36 sunsets to go...

The sunset over the Caribbean Sea is enough to give me pause, every time.

I'm so happy when I'm actually in the right place to enjoy it for a moment and reflect on the two years that were medical school in Grenada. I am getting excited about almost being an MS III and being done with the classroom, more or less... I mean I know there will still be lectures but not every day and not for hours and hours at a time. I just wish the next month would hurry up already. But while I'm here I'll try to enjoy the 36 sunsets I have left.


my Caribbean Sea doesn't expire for 37 more days

In a sort of random chain of events I found myself at La Source this afternoon with my sister-in-law. And yes I will miss the beautiful, warm turquoise waters just minutes from my apartment and the off chance that I can end up at one of Grenada's top resorts for the afternoon in lieu of pharm and pathophys.

I was too busy enjoying the pool to take a picture, but this is from another beach on the North side of the island taken last term on a day not so unlike today...
... and yes I am aware that I go to medical school in paradise.


Brothers & Sisters - watching with 38 days to go

So, I have to back up for today's memory. During first term I met a classmate and we were instant friends. Every Sunday night I would go to her place off campus and I would enjoy off campus living, complete with oven to bake in and TV to watch. We would normally have dinner (something baked), do some anatomy questions and then watch a mutual favorite TV show- Brothers and Sisters. And so it was, our first term tradition. 

But she is Canadian and was worried that an SGU education may leave her stranded in the USA so when she got accepted to a US medical school she decided to attend. And although she didn't come back to SGU we've kept in touch.  Every Sunday night that we are both in school (provided one of us doesn't have an exam the next day) we Skype and I watch Brothers and Sisters with her, virtually. It is one of my favorite med school rituals. And just another example of a friend made, gratis SGU. And the best part is I don't have to leave the friendship in Grenada. So today is reflecting on things that Grenada has given me instead of things I'll miss. But I will miss the school kids in their uniforms.

I know these picture are not the best but if you look carefully you can make out two boys in the first one, the older brother leading the way. The sisters had matching school uniforms and backpacks. Both were taken on the way to the Hospital last week. I love Grenada kids in their matching uniforms. And Brothers & Sisters always make me smile. And now it is almost time to tune in for my show....


the days dwindle: reflecting on friends far (day 40) and near (day 39)...

Un-inspired is hopefully over.

T-40: More good mail, this time in the form of a lovely pink box with yummy fall treats (think snickerdoodle cookies and home-made maple pecan granola.) Thank you dear K! The PERFECT thing to open after a week of difficult exams.

T-39: Happy feet, because your feet are happy if you are! 
And my feet are very happy here because I have such an amazing friend...


41 more days of random

i won't miss it all, but i will miss a few things.... like the random animals around campus and the island. you never know when you'll run into a goat or bull for that matter. and well it wouldn't be a day without seeing a gecko.

case and point....


hoping uninspired doesn't last (42 more days)

it is the middle of exam week and studying pharm tends to kill my soul. i forgot wasn't inspired to take a picture today (so here is one from my stockpile.) the view is one of my favorites from campus. i use to walk this way every day and take it all in on on my way to class. living off campus this term i have a different view, but sometimes i miss this one...


43 days left to hang my laundry

Today is laundry day and here in the Caribbean we dry our laundry on clotheslines.  I am not sure if I will miss it, to be honest I like my towels fluffy but hanging clothes out to dry is kind of fun. I'm not green enough nor do I have space to do this at home so it is another thing that happens only here....

And because I'm studying today and just had to create a MCQ for clinical skills I'll leave you with this.

A 48 year old woman presents to your office with goiter. Upon palpation the gland feels nodular and there is no tenderness. No bruits are heard upon auscultation. Patient denies any previous illness such as an upper respiratory tract infection but does have a history of rheumatoid arthritis for which she takes NSAIDs. Lab tests reveal decreased TSH levels and increased T3 and T4 levels. Antibody tests come back positive. Nucleotide scanning reveals decreased uptake. What is your patient at an increased risk of developing?

  1. Plummer’s Disease
  2. Hoarse voice and dysphagia
  3. Non-Hodgkin’s Lymphoma
  4. Hypothyroidism secondary to treatment
  5. Toxic Adenoma


44 more days to bake (with ample room)

If you've read more than a post of mine you'll know that I love to bake. And what does a baker love? Counterspace.  And now that I live off campus I have an abundance...

I think it just might be one of those things I will miss. My counter space at home is not so plentiful.

Confessions of a Med Student- Part II

So the week before last I told you all about how much I adored biochem, not! But I survived it and so it was on to term 2.

This week I'll reflect on the term that was 2nd. (Genetics, Parasitology, Physiology, Neurology, CPM)

It started off with Genetics and Parasitology and truth be told these were well taught and interesting. Each one was only one or two hours of lecture a day, worth two credits each and only two weeks long.  It was compact, doable and a great way to start the term. Good times.

Side Note- I got a toaster oven. Now you might be wondering how this fits into term 2. But it made all the difference for me. I love to bake and having only a stove in my on campus apartment wore on me during first term (not that I would have had time to make anything but the option would have been nice.) Anyhow I made it my goal to get a toaster oven 2nd term and I think that it was one of the things that kept me sane. That and the hammock that I ordered for my balcony. Some people need to run, I need to bake. I like making something from raw ingredients and I love to give away my baked goods, which I did a lot of during the term. Now back to the classroom aspect....

The true fun began when we started Neurology and Physiology. We also had Community and Preventative Medicine to balance things out. In full disclosure, I am interested in Neuro and have past experience in the area so I expected to enjoy the class and was a bit disappointed. The team taught approach made Neuro seem like 5 different classes: there was neuroanatomy and then neurotransmitters and then the neuro clinical exam. And each subject was taught by a different prof which would have been fine except it was as if they never talked to one another. Each lecturer didn't seem to know what we had already learned so I found it frustrating and a bit disorganized. On the upside small groups were fairly useful, we worked through cases and identified structures on plastic brain models. And they did attempt to bring it all together at the end with comprehensive cases but by that point it was too late to be making integrations.

Physiology on the other hand was under the auspice of Dr. Holroyd who I would easily nominate at Professor of the Year. Entertaining in the way that only someone from Australia can be and well presented material, it was almost fun to go to class. Our 10 minute breaks would be filled with Dr. Holroyd's music and as he turned up the volume he would add the visualizer via the projector for full effect. You felt like you were at a rock concert instead of in medical school. But it wasn't easy. I had to work very hard in both neuro (anatomy again, ugh) and physio. Some of my classmates would talk about how physio was all just common sense, I never felt that way, but it was important to the basics of medicine and I felt like we were given a solid background. I frequently look back at my physio notes, they are golden.

So to sum up term 2: Much better than first term. Got a toaster oven.  Classes really depended upon the lecturer of the day. Dr. Holroyd was/is amazing.

So all in all it was an interesting yet difficult term.

Next time I'll tell you all about on one of my favorites, term 3!


hashing through 45 more days

Exam week starts tomorrow so I didn't leave the apt today. I did study in my cat ears for awhile but only my roommates got to see my headband costume. Oh well.

I will miss the chance to go on a Grenada Hash once I'm stateside. I mean there is always hiking but it is not quite the same.....

Happy Halloween!

Pics take at the La Phare Blue Halloween Hash last year, good times were had.


T-46= the calm before the storm?

Tropical Storm Tomas has now been upgraded to a Cat 1 Hurricane. It doesn't look like Grenada is in its direct path so while that is good news I still worry that tropical storm conditions may mean loss of electricity so I'm enjoying my a/c and lights for now and keeping my fingers crossed. There is an ill defined wind not blowing from any certain direction and rain off and on... I've never really lived in hurricane territory before, it is a strange feeling, this eerie calm... 

This is the latest email from the school:  

All students, faculty and staff are advised to remain at home/in shelter until the warning is lifted.

Picture above- our water supply, as they turned our water off last night. We are currently using water from our holding tank but this is our supply of "fresh water" until this is over.


"No Comment" (47 days to go)

I was taught that if you didn't have anything nice to say.... So I should just say "No comment" and leave it at that... I should, but I won't because:

As Tropical Storm Tomas approaches the island and we get ready to turn off our water for the night I am ready to go home. As in California, near my husband and away from here home. (Please Tropical Storm Tomas, find another island to bother, I'm begging you! Or better yet just play in the water and take a detour south, you don't need to bother with land, the water is better, I promise. You can come another time, but this weekend I would really like to study with a/c and lights. I hope you don't mind but you are not welcome here.)

If only I had a picture of "No Comment"... I don't but I do have this one, taken on the drive to the Hospital today as I reflected upon all of the named Raggae buses. (Think mini vans with loud music and interesting window decals.) This is actually a tour van but you get the idea.  And there is a King Elvis Raggae bus as well, although I didn't get a picture. Sorry!

Others I saw today....
Mr. Faithful
DJ Thunderz
A New Beginning
Flavours after Flavours
No weapon form against me shall prosper
No Comment (my favorite!)


a clean desk and good mail- days 49/48

Okay, I told you I didn't keep track. After I posted last night (or rather early this morning) I realized that I only had 48 days left. So this post is for days 49 and 48.

Things that I love about Grenada continued...

A desk that is (mostly clean), no clutter, no extra stuff, just what I need to study. As I was pondering why this never seems to happen at home it dawned on me that I've had to share a desk with Dr. Boyfriend (and although I love him dearly, tidy is not exactly a good description of his work space). But it isn't all his fault either, there is the issue of mail. We get so much of it, it always accumulates and some of it you don't want to throw out but you don't have the time to put it all away each day either so it piles up and takes over the desk.... but here in Grenada I don't seem to have that problem. The only mail I ever get is much desired. Artwork from my nieces and fun cards from family and friends. No bills, no junk mail, just love in the form of stamped paper in my mailbox.

This is the latest piece of mail, a post card from a dear friend traveling in Japan. (Snow monkey and baby, SO cute... at least I think so.) I am proudly displaying it on my desk!

Back to studying. I love this part of the term when classes are over but exams are still a few days out and you can study and organize and do lots of practice questions. And if that makes me a med school dork, so be it.


a pictorial countdown of sorts- 50 days left

Okay, so in an effort to blog more, remember all the things I appreciate about Grenada and make sure I am appropriately reflecting during my final weeks of my final term here I've decided to blog a picture a day. Today is day 1, or rather day 50 as that is how many days I have left in Grenada.

Now, I really wasn't keeping track per se, but everyone else is and I'm hardly immune. Plus I think it is only natural after two years on this island to start thinking of home and thus how many more days until then. And I think any 2nd year medical student at any school is sick of lectures and ready for clinicals come this point. But whatever, I'm doing a countdown. I'm not sure why I am trying to justify it. Here goes day 50, just 49 to go....
 The view from my balcony.... enough said.


Grand Rounds-Volume 7 No.5: Lessons Learned

Welcome to this Edition of Grand Rounds. I'm honored to be hosting for my first time. The topic is education and lessons learned. I hope you enjoy!

The classroom (aka- how a medical student spends her days..) 
Clinical Skills & Patient Communication

To start us off let’s talk about the physical exam. Is it dying? The Stanford 25 is here to say no, or at least attempt its revival. Check out this post discussing the use of simulation technology in medicine. And browse the blog sidebar for 25 physical exam skills every doctor should know.

In contrast Fizzy gives us a humorous reflection of medical students learning heart murmurs on her blog, A Cartoon Guide to Becoming a Doctor. Do you know the 6 grades of heart murmurs?

Don't forget your communication skills! Dr. Val of Better Health shares her experience as a patient and reminds healthcare staff to Please Hold the Snark.

And finally a medical sign that won't be found in the textbooks. Dr. Happy of The Happy Hospitalist presents "Texting in the ER Sign" as a good prognostic indicator for the clinical findings of status asthmaticus.

Review for Step 1: Anatomy, Neurology and Nutrition

For a fresh look at some anatomical illustrastions from Edo Period Japan we have a blog by medical student Kambiz.

The Tangled Neuron bring us The Trouble with Expectations and a reminder to take health headlines (particularly Alzheimer’s research headlines) with a grain of salt.

In case you have ever wondered what exactly is in those prenatal vitamins The Examining Room of Dr. Charles is here to break it down for you.

Pondering life over lunch break...
Miles in My Shoes offers a "Karate Kid Lesson" for  medical students like me.  And if you are done with your training maybe you'll find the reflection apropos as well. In either case, it is worth checking out.

On to Hospital Rotations (aka what kind of doctor should one become?)

Internal Medicine

Dr. Manning of ACP Hospitalist brings us a lesson learned in her touching post, One is Enough. Her synopsis: “A physician trying to make it to a colleague's educational seminar learns a life lesson about what's truly important when she misses it.”


Beth of Life. Not Terribly Ordinary. chronicles her arrival as a new attending in The Ride.

And from the unique viewpoint of the medical photographer come this post: Two Kids in Hospital from The Sterile Eye.

ER & Radiology

The Colorado Health Insurance Insider gives us an example of The Wisdom of Evidence Based Medicine with this post about reducing the number of CTs given to children with head injuries.

Primary Care & Geriatrics

The Doctors' Rheum posts a love letter to her friends in primary care thanking them for their incredibly difficult job.

Nurse Resnick of Health AGEnda writes about the need for Increasing Gerontology Education for Nurses.

I think it is time for a coffee break. Go grap yourself a cup, drink in those antioxidants and while you do, read this post about blueberries and coffee gratis The Cockroachcatcher.

So, are you ready to go run a marathon? No!?!  (Me neither...) but Traci did and tells us all about it in her blog with the post Just DID it!

Dr. Pullen.com updates us on the progress made in Preventing teen traffic deaths.

Next up, you can read about how "researchers learn a lesson in unintended consequences when they try to influence medical decision-making through policy changes" here courtesy of ACP Internist.

And on to life lessons taught and those that teach us. A touching tribute by Insure Blog, In Memorium- Bye Papa.

And now for a few things 
NOT learned in medical school

Academicobgyn writes an informative series of two posts regarding the insurance appeals process- Part 1: How it all works and Part 2: Winning your appeals. This is worth the read if you or your doctor are trying to get an insurance appeal granted or if you are a medical resident and are looking for a moonlighting opportunity.

Healthbusinessblog brings us a look at mini-meds (low coverage insurance plans) and how they can be useful in some patient populations.

And the learning is never done. In finale we have...
Lessons not yet learned

How To Cope With Pain shares Guess What? There's STILL a Lack of Knowledge about Pain Treatment.

I thank you for stopping by. And I'd like to give a big thank you to Dr. Nick Genes of blogborygmi and Dr. Val Jones of Better Health for letting me host.

Don't forget to check out Grand Round next week with a special election themed edition, Dr. Wes is hosting. Enjoy your Tuesday!


Grand Rounds Call for Submissions- Lessons Learned

I am honored and excited to host my first Ground Rounds here next week!

The topic is education/ learning but this is broad. I welcome stories from your medical training and other lessons learned along the way. What are you still learning? If you are a patient or educator what do doctors/doctors in training still need to learn? Poems and comics are welcome as well. I look forward to reading your submissions.

Include your post, url link to your blog entry, blog name and a sentence or two about who you are and where you fit into the health care system. If this is your first time submitting to Grand Rounds you can follow this link for further instructions and writing guidelines.

Submit entries to spiceislandqueen@gmail.com by Sunday October 24th at 6pm EST.

"Learning is not attained by chance, it must be sought for with ardor and attended to with diligence." -Abigail Adams


Confessions of a Med Student- Part I

I always meant to write a little summary/reflection for each term but never got around to it. This is my stab at it before I leave Grenada. I will try to write about a term a week over the next month.

Term 1 Rehash
(Biochemistry, Anatomy & Embryology, Histology, Bioethics)  

Okay, I'll admit it. I hated biochemistry- yep, hate! I know that is awfully strong but it is true. I was scared I was going to fail. I didn't enjoy the class. The department obviously was having some type of family feud and despite going to special group review sessions given by upper termers I just didn't feel like I got it. Theoretically I was interested in the material, but when it came down to it, I really had a hard time counting ATP and remembering enzyme names. Biochem haunts me to this day which is too bad since Pharmacology is like applied biochem. The upside is I understand the importance of pharm in my clinical years so I'm tolerating it. Biochem is #1 on my list to focus on for USMLE Step 1 starting now,  but I feel like I retained nothing...  so of course I'm not happy about having to study it. Again.

I didn't like anatomy either... I know, I know, what kind of a medical student am I? (Now you are probably waiting for my future confessions that I don't like patients or blood makes me faint...) I wanted to like anatomy. I tried. But it was so much to memorize and no matter how much I studied, I would always feel like I knew nothing when I stepped into the wet lab. The smell didn't bother me, and I liked the idea of finding vessels and nerves and muscles. But who knew that bones had so many parts? Not I.  During the term, I felt rushed and unsure of everything.  Every week I dreaded anatomy small group. I was scared to be asked a question I couldn't answer. I tried to prepare and study but there just wasn't enough time. I remember being tired and stung out on caffeine. The physician tutors would inevitably ask us something we didn't know and I'd always feel bad, like it it was my fault I hadn't read and memorized that exact page of Gray's. Maybe it was all part of the process, you have to be humbled and you have to realize that medicine is so much larger and more complex than you will ever master, but still you have to try. (I would love to go back to anatomy now, just for a week or two, into the wet lab and see if having the foundation makes it more palatable. I'm guessing it would. (I could probably arrange this if I was super motivated but honestly I didn't like it enough the first time around and I have NO plans to go into surgery so I'll stick to Netters and BRS Anatomy for the Boards.)

Histology was tolerable. I enjoyed it more than biochem or anatomy, although I didn't feel like I had the time to truly master it... It was like everything else, a bit overwhelming in depth but necessary foundation.

Bioethics on the other hand was my favorite class of the term, of course it was only worth a minor 3 credits and only lasted half of the term, but I actually enjoyed it (although I was definitely in the minority). I found it interesting and manageable, unlike the rest of the term. Or course the realization of this during Term 1 also made me question exactly what I was doing in medical school... I just hoped and trusted it was going to get better.... and kept going.

Medical school was/is hard. During first year I truly doubted myself for the first time (maybe ever). I wondered if I was smart enough. I was lonely, I missed my husband. I didn't feel academically satisfied no matter how hard or much I studied. However, now that I'm approaching the end of my 2nd year I can appreciate that it wasn't so much WHAT I learned during first term but that I learned HOW to learn and HOW to study. But at the time, it was painful and not my favorite part of medical school. So there you have it. (And it did get better. So if you are an MS 1 and reading this, hang in there. You can do it!)

Stay tuned for Part II (and Term II).


"The Best Place on Earth" (A Camp for Teens with Multiple Sclerosis)

In the middle of Rhode Island is a place where teenagers who have MS (Multiple Sclerosis) gather for 5 days each summer. They travel from all over the US, Canada and even sometimes farther to greet old friends and make new ones. Some of them have just been diagnosed and do not know anyone with MS, let alone a fellow teenager. In five days they go from being strangers to being family. At MS camp not having MS is belonging to the minority.

In some ways it is normal summer camp, the teens kayak, do a ropes course and tell stories while roasting marshmallows around a campfire but in other ways it is so much more. The teens are able to talk about dating with MS, when to disclose their illness to friends, how to manage meds away from home, etc. They watch each other do medication injections and swap stories of diagnosis, spinal taps, countless MRIs and commiserate on how much they hate taking steroids for relapses. They talk about hospitalizations and how they were diagnosed, everyone compares symptoms and they soon realize that someone else truly gets what they are going through. MS is a greater bond than anything else. The pretty cheerleader from Colorado jokes with the awkward guy who bowls and loves to fish from Florida. Together they help another camper with his dinner tray, as MS has left him spastic with a noticeable tremor. Over dinner they look like normal teenagers, texting jokes to the far end of the table and trading SillyBanz (TM) bracelets.

Camp inspires me.  For five days I belong to a community with these teens.  Many of them have dealt with more medicine than adults two and three times their age. As a group these teenagers have a maturity that comes with having to shoulder a chronic illness. Before medical school when I shadowed MS clinic I would see these teens in the context of their neuro exams and symptoms. I was privileged to be able to look at MRIs and be present as they were given the diagnosis. I was there with some during neurocognitive testing and I got to know each better during the three hour test battery but only at camp did I have the opportunity to really spend time talking to these amazing teens about their lives.

Camp is transforming. A previous patient is now appreciated for his acting skills and silly jokes along with his fear of another relapse and the belief that maybe if he just forgets he has MS, it will go away. David doesn't skip his meds because the shot is all that horrible but more because by taking it, he reminds himself of his vulnerability and like all teenagers he thinks nothing will ever happen to him, except that it already did... (But he is still persevering, so this life lessons has been learned.  Camp ends and David resumes his DMTs with the encouragement of the other campers. Camp success story #223.) Alisha plays soccer and tells the other campers of having to learn how to walk again and how horrible it was to miss her own HS graduation because she was in the hospital with a relapse. But then she talks about how she got a phone call from another camper and how much that cheered her, she reminds the campers that they need to keep in touch throughout the year, how sometimes that text, Facebook message or phone call can mean the world.

I have been honored to attend and inspired by MS Camp for the past five years. This summer I will be in my third year of medical school and busy with clinical rotations so unless I can arrange to have camp week off I won't make it. But 40+ campers will and once again they will find themselves in the middle of their MS Family in the Best Place on Earth.

In case you need more inspiration. See the video below. It is a little dated, as it was filmed during my first ever camp five years ago, but I think these teens tell it better than I can.

Update. Recent Facebook activity.

Alisha to David- "Camp 2011 :)"
David to Alisha- "I can't wait, best place on earth!"
13 Likes. 2 Comments.
Link to old photo album titled- Camp is Love.

***Names, details, identifying data changed, etc. Video filmed and posted to You Tube with permission.


Calling All Student Bloggers (And non-students too!)

Announcing Grand Rounds, Blog Carnival here on October 26th! I am excited and honored to be hosting my first ever Grand Rounds.

Since I'm a medical student and spend my days in lecture and learning about how vast the knowledge of medicine really is I thought education would be an appropriate topic. And I think that one of things that attracted me to medicine in the first place was the never ending opportunities for lifelong learning.

I just read a great article in the New York Times about the Physical Exam. If you are a medical student and have never submitted to Grand Rounds in the past I suggest you do so now. What do you think about the physical exam? Do you feel like SGU or your school prepares us to be well rounded physicians? I want to know!

And if you are not a student but a practicing physician, educator or patient I want to hear your stories too. What have you learned? What are you still learning?

Be creative! Comics, poems and other art forms are welcome too. I'd like to either organize the entries by Subject/System (Biochem, Anatomy, Cardio, Path, etc) or via Physical Exam (head to toe) so if you have a funny anatomy lab story or a teachable moment to share, now is the time!

Send entries to spiceislandqueen@gmail.com

Deadine is October 24th, 6pm EST.

Happy writing!


I Hear Not

"Sometimes it feels as if [I'm] literally in the back seat of the car, auditing a fascinating conversation but unable to distinguish — over the noise of the traffic, the defogger, the wipers and R.E.M. on the radio — exactly what’s being said."

These are not my words, but they describe very well how I feel so much of the time.... I am aware of the general content of what people are saying but the exact words are up to my imagination and skills I've refined over the years. Cars are actually the worst spot and having a real conversation in one, forget it. Windy areas outside are a close second, and noisy dark places, well I may as well go sit by myself in the corner because I'm not going to hear what you say. If I can see you, I do okay because I'm sure I lip read to some extent. 

What exactly do I not hear? Try 20% of everyday spoken language in an ideal (quiet, no background noise) setting. Of course I can lip read and 20% of words does not equal 20% of content. Sure if you randomly walk up to me and without me seeing your face say a word I only have an 80% of getting it correct.  However, people don't talk in words, they communicate in sentences with body language and intonation so I end up getting by. And for those non-ideal times, I have hearing aids. I was only officially diagnosed and fitted with hearing aids shortly before medical school started. And I hate wearing my hearing aids (if you couldn't tell) but they do help in some situations and since I don't want to be the incompetent medical student I wear them in those situations. 

It has only been a little of 2 years since the audiologist looked at me and asked "can you hear me?" as she raised her voice and sat down in front of me with my audiogram. I wasn't prepared for the label, for being told I had severe bilateral sensorineural high frequency hearing loss and that I needed to consult an ENT (in case it was progressive or part of some other pathology- its not.) I wasn't prepared to have someone tell me that I needed hearing aids. Of course now, with perspective it is not so bad but thinking back to that visit, I walked in hearing and walked out with a label. I wasn't emotionally prepared and nobody was with me. I remember calling my husband, he was at work so I left him a voice mail and then I just sat in my car and cried,  I mean I "knew" I had high frequency trouble hearing because I didn't hear sounds like a tea kettle whistling or a pager peeping but I didn't think those high frequencies were actually involved with my day to day hearing of conversation, etc.  

I'm still adjusting and I'm becoming more comfortable disclosing my hearing loss to my friends and classmates.  I told every one of my 12 path group members and my CPD group of 5 at the start of last term and it made it easier for me to compensate or ask for someone to repeat something. The more people I tell the more comfortable I become with putting my hearing aids on in public or changing a battery when I need to, etc. During first term I completely protected who saw them, when I wore them and I've come to realize that it is just easier if I disclose. It is part of who I am at this point (I have no idea when my hearing stared to fade but my theory is the massive number of antibiotics I took during my childhood when I would get strep throat after strep throat. Beware of those aminoglycosides!) 

So that explains why when you call my name walking around campus I walk right on by. I didn't see you, and while a normal person would hear you calling, I don't and so I keep right on walking. Also don't whisper to me in class, there is a 99% chance I won't hear what you are saying (hearing aids or not.) Sorry! 

My latest audio report.

*Quote from David's Lipsky's totally unrelated book on David Wallace Foster, "ALTHOUGH OF COURSE YOU END UP BECOMING YOURSELF"


Pumpkin Inspired

So one of the things that sucks is not so nice about being in medical school far far away is missing occasions and celebrations. And I am not normally one for self-pity but I've been a little homesick this week. My cousin is getting married this weekend and most of my extended family is going to be there. My mom is one of 11 so between all of her siblings and their children that means a lot of family. And it is in Colorado so not only am I missing a beautiful wedding, I'm missing a fall wedding. I love fall and it pains me to be stuck in sunny hot summer weather for the foreseeable future... no fall for me.

But to lift my depression I have pumpkin! A friend was stateside earlier this week and she was amazing enough to find and bring back a Pumpkin Brulee scented candle for me, so at least my room smells like fall! Also I bought fresh pumpkin at the grocery store which inspired me to bake a simple and healthy pumpkin bread. (To turn the muffins into a sweet afternoon treat I added a not so healthy glaze and cranberries.)

 Pumpkin Bread/ Muffins with Cream cheese glaze and cranberries

For the Bread/Muffins you will need:

2 cups whole wheat flour
1 cup white flour
1/2 cup honey
1/2 cup light brown sugar
1 t. baking powder
1 t. baking soda
1/2 t. sea salt
2 t. cinnamon
1 t. nutmeg
3/4 cup applesauce
4 eggs
1/2 cup butter, melted

Mix dry ingredients.  In separate bowl mix wet ingredients and the sugar. Combine and stir well.  Pour into a buttered/floured pans.  Bake for 45-55 minutes at 350 degrees, or until a toothpick inserted in the middle of the loaf comes out clean. (For muffins bake 25 minutes at 400 degrees.)

Makes 2 small loaves or 1 medium loaf and 6 muffins or 24 muffins.

For the cream cheese glaze
Blend together
8 oz. of cream cheese
1/2 cup powdered sugar
1/2 t vanilla
1/4 cup milk

Garnish with cranberries, enjoy!

Recipe adapted from several others including these-


Perd mon temps

Today was my fifth clinical/ hospital rotation visit and today my group went to the neighborhood of Perdmontemps. In case you don't speak French, Perdmontemps means "I'm wasting my time." I have to say, it is one of the more unique town names I've come across. I only wish the translation didn't have any literal truth to it for anyone involved today.

It was a good 35 minute drive up and down and around the island to St. David's Parish. I had been prepped by my roommate and other classmates but still, first impressions were not much. We pulled up to an unassuming cement building just off the road with a sign that said Perdmontemps Health Clinic. As we entered there were at least 30 patients crammed into a small waiting room. There was small window and door on one side of the waiting room (the pharmacy) and on the other side a small divider was set up, behind it a nurse took vitals and triaged the patients. There was a make shift lab area and two examining rooms. Two other assistants helped organize the patients and there was one doctor. This was at 8:35am in the morning. When I later asked our patient if it was always this busy she said yes. She told me that she had arrived extra early this morning, much before 8am so that she could be patient #1 (and as a reward for coming early she got to see 5 medical students and hang out at the clinic for several hours instead of just a few minutes, lucky her!)

We were escorted into one of the examining rooms where our preceptor and physician, Dr. Drum came in to greet us. He gave us a brief run down on how public health care in Grenada worked and how patients were seen in their neighborhood clinics on a set day, once a week. Medical care is free but patients pay a nominal fee for prescriptions. Each neighborhood has its own clinic and the doctors rotate through different clinics much like traveling circuit pastors use to do in rural areas of the US.  He then brought us a patient, instructed her to let us ask whatever we needed to ask and left us to do our interview and exam....

And so we did. Now our patient was diabetic and hypertensive and she took medications for both. But she explained that usually when she came to the clinic (she said she came every three months for check ups) her visit was only a few minutes long, and since she was coming so early this morning she didn't take her meds or eat breakfast beforehand. Dr. Drum came back to check in on the group once but he was so busy seeing other patients that it really was just 5 medical students and our patient for over an hour. As the time passed on she started complaining of being hungry and wanting to leave and I began to wonder exactly why she should continue to let her blood sugar fall at our learning expense. (Of course, me who ALWAYS has a snack in my bag of some kind, had only water today.... And no one in my group had anything either. Our white coats are not yet the hold all bags and walking storage units that they will soon become.) Finally we were finished and our patient was threatening to walk out so I went in search of Dr. Drum on behalf of her blood sugar. Dr. Drum came back. I presented the patient. (He critqued me and I didn't fell all warm and fuzzy, but he ended up giving my 5/5 for presentation skills so I guess I did okay.) We presented our clinical findings. He made us demonstate our technique and any pathology had to be examined and appreciated by all five of us. This was not a waste of my time, but I felt complicit in a relationship that I am not sure the patient wanted to be a part of, she was clearly ready to go at this point but Dr. Drum felt that he still had teaching to do. When we finally finished and she bolted from the room we had been there for over 90 minutes.

We (as 5 students) had seen one patient. There was a waiting room full of patients to be seen and we still had plenty of time left before the bus would be back to pick us up. A group member asked Dr. Drum if we might be able to see another patient and he replied that we should have taken more time with our given patient. (Now I think that 90 minutes is more time then we will ever get in the US healthcare system and more time than we needed. We could have subjected her an entire complete physical, instead of a focused, but to what end? She didn't even want to be examined by us. And she certainly didn't want to sit around and be reexamined again and again. I didn't ask if this wasn't a "Perdmontemps" for the patient, but I wanted to.)

I am grateful for the opportunity to see medicine at  a community level in Grenada. I am thankful to Dr. Drum for allowing medical students to come to the clinic and see patients with him. He also comes to SGU and is a preceptor in our clinical skills course so I know that he cares about students and is a physician educator. But I also feel more than just a little bad "using" patients to learn when I don't think they they really benefit from the encounter. Maybe this is something that I will have to accept and come to terms with. But as of now I am still wrestling with how to be a medical student that has something to give. I don't want to simply take.... I know that more often than not what I will have to offer is time, a listening ear... and hopefully I can be a good conversationalist for whatever time we have together.... the patient has so much to teach me. I only hope I can give something in return.


Half a Dozen Moons

This sounds crazy even to write but if all goes well I will be celebrating being done with my boards in just six months from today! Dr. Boyfriend has a conference in San Francisco and Napa is maybe my favorite place on earth so we decided that I'd write my Step 1 and then join him in paradise for a post-exam Valentine's and two year anniversary of sorts.  It means that I will only have one week off between finishing 5th term and starting to study, but I think that is okay.... The promise of good wine will keep my super motivated. That and dinner reservations at French Laundry.

For some reason this term is not flying by at usual Grenada speed but maybe it is just because it is my last and so everything just feels bitter sweet. I have been osculating between sick of the island, ready to go home and thankful for this opportunity, mindful of my good friends here and not sure if I want this year to be over.

Even so, 5th term is okay... at this point in my education 80% of what we cover is review so that feels nice but the objectives that say know (aka remember) everything since day one of medical school are kind of anxiety producing. I for sure do NOT remember all that anatomy. Histology was a distant blur and Biochem, what's that? So basically it is the term to review (restudy) all that has past you by. On the bright side, at least pathology and physiology for the most part are forthright in my brain and I actually feel like SGU did a good job with preparing us to pass our boards. I'm happy with my education. I mean maybe I should wait until after I get my Step 1 score back but so far everything seems to be coming together. Except maybe the 900+ drugs I am suppose to know for pharm. I study and study and study and they just don't seem to stick. Class IB anti-arrhythmics versus the types of diuretics you can use to treat heart failure vs keeping the macrolides straight from the aminoglycosides is perhaps the answer to why I've had so many migraines this term. (But at least I can tell you the MOA of my triptan of choice and the top prophylaxis for migraines, right?)

Oh well. 6 months. That seems scary, exciting, stress-inducing, light at the end of the tunnel soon! 


Feeling Fine with New Shoes and Wine

Fifth term is picking up the pace and life is in full swing. I've been busy, but I love it.... here are a few highlights.

Tuesday: I made from scratch, pumpkin soup and cornbread with my neighbor. We then had family dinner with the roommates.  And of course I did the pre-requisite class, small groups, study time, etc.

Wednesday: I managed to buy a new pair of shoes and a cute top to wear to the Hospital.  This was in between studying all morning, reviewing 90 questions from Exam Masters and 4 hours of class. I also went for a sunset walk and swim. Not too shabby of a day....

Today: My hospital group was assigned a local GP to follow and I examined a 7 year old, interviewed a young man for his annual work physical and saw textbook anemia in a women with Hb of 5 (don't ask me how she was even walking around). I ran home to change at lunch and on my way stopped to visit my local wine store. I chatted up the owners and staff while picking out 2 bottles of wine for the weekend. I then sprinted to class for 4 hours, followed by powder puff football practice, woo hoo! I think I can manage 3 good hours of study time before I call this day done.

Tomorrow: I have the morning free to study and then my first (mini) test of 5th term. Depending how that goes I'll open the wine or hit the books again. The weekend is almost here and I cannot wait to study without distractions (yes I know I am a med school dork, but I'm okay with that because I have new shoes!)


Reflections on a Sunday in 5th Term: Hot & Humid but with a View

I love the sound of the rain on our tin roof in my new off campus apartment. I hate the humidity and bugs that come with the rain. On the upside, living off campus means a wonderful balcony overlooking Lanse Aux Epines and the marina and it is breathtaking, worth the bugs and humidity for sure. (And my room has a/c, I just feel like a hermit always running into my room to escape the heat.)

I'm here in my (cross my fingers, nose to the books) last term and week 3 is about to start. I think I've grown complacent, I still enjoy the island but the goats wandering into the middle of road and the chance to swim in the amazing Caribbean Sea whenever I want have somehow lost their luster.

Fifth term is.... well, busy.... lots of exams, small groups, plus hospital rotations and class 3 or 4 or 5 hours a day. I might have time if I stopped going to class like more than half of my colleagues but I don't really enjoy sonicing and I figure it can't hurt (well as long as I put in the study time despite the time suck) so that is about all I have to say about 5th term. I started my clinical rotations in Peds and I loved it! Physical exam and reflexes on a 3 day old, what's not to love?!?

Here is hoping for inspiration to blog more often and that fifth term flies by so I can go study and take my boards and start 3rd year already. Senior-island-itis... who me????
Happy Sunday!

P.S. I found a new favorite med blog and my title is a clue, any guesses?


A Boston Love Letter (aka- 4th Term Antidote)

So if you know me then you know that I love, love, LOVE Boston. As Dr. Boyfriend points out it was my first real city to fall in love with so it has a special place in my heart. (And bonus we met and fell in love there too.) Anyhow, I spent the weekend in the Boston area and got to relive all my favorite Boston memories with a good friend from undergrad. Drive down Charles River.... check. Blueberry Ale from Boston Beerworks.... check. Red Sox game at Fenway.... check. Hands down the best frozen yogurt anywhere (and I would know, I've looked- no one else makes carrot cake blended fro yo) from Angora Cafe..... CHECK! Rewatching "Good Will Hunting" after a local grown veggie meal and nice bottle of wine with good friends..... Priceless. (Thank you K and R!) It was a wonderful, nostalgic, blissful weekend.

And as if it can't get any better it was sandwiched between camp which deserved its own post and my family coming to California to visit. So in short, life it good.

I have not studied half as much as I had planned to but I still have 2+ weeks until I go back to the rock and there is something to be said for downtime and enjoying life outside of medical school. I'll be back to the grind soon enough so I'm really not beating myself up about not doing First Aid Questions every day as I had planned.

So here is to summer, great friends, a loving family, Boston memories and new beginnings in California. I am truly blessed. Life is good.


Sunny California

Summer Break- Day 2. I'm here with a new West Coast address. Fourth term ended without much fanfare. Five weeks to unpack our apartment, explore a new city, see my family, go to camp, and enjoy not studying (well, maybe in moderation.) Then I'm back to Grenada for a final term. With time I'm sure I'll have something to say about Term 4 but right now I'm just enjoying my new city. It's summer break, woo hoo!


Oh and another thing...

As if Forensics wasn't bad enough, it also includes physics (my all time least favorite subject, ever).

This is one of our Pathology Objectives: Describe how changing the Delta V (change in rate of momentum) can improve transportation safety.

Really! I'm not making this up. Most of what we learn in medical school is medicine, or at least closely related. And while I don't minimize the importance of safety I think this one is better left to the transportation and vehicle engineers. It is not like I'm going to be a human bumper for my patients. Though I suppose if one was fainting onto the tile floor I could use this law of physics to soften his fall, or something.... (sigh.)

On a semi-related note, this is pretty cool and since bike helmets prevent brain injury I'm safely back to the subject of neurology which I am quite happy to talk about and study.

I need this term to be over, I think I'm getting grumpy....


The Anatomy of Tears

I cried today.... it was part sadness: I miss my husband, this term has been long and I am ready to go home. He graduates from residency tomorrow and I won't be there to share it with him. His Birthday is this this week but I'll be here, studying for my path final. Sometime things don't work out like you want. And I know that I'll be home soon but right now it just doesn't seem soon enough.... and so I cried.

It was part anger: we finished pathology with forensics and there is something despairing in how humans treat one another. The last two days have included lectures on child abuse, rape, homicide and suicide, all complete with pictures so I started to doubt the humanity left on this earth. ( I expected forensics to be fun, like solving cases on "CSI", but the problem is they are all true cases and pictures of real people.... It was the opposite of fun. It was emotionally draining and terrible and I have ruled out Medical Examiner, Forensic Pathologist and possibly ER based upon how I've felt these past two days.) 

I tried to turn my day around, I ran out of class and came home for lunch but found myself looking at pictures of the oil spill, haunting, sad, heart-breaking pictures. The highlight of my day was an actual mid day conversation with Dr. Boyfriend and skype let us both be on video for the first time in forever, so that was nice. But then I had to go to lab and hear more about terrible, horrible things that humans do to one another. I tried to redeem my day again and went for a swim at with a plan to watch the sunset, but locals kept bothering me, peddling their necklaces, mangoes and company. I escaped to IGA and stocked up on a few things for the final two weeks I'm here.... But when I got home the new iphone Facetime video flashed across my computer and the music and the orchestration was just too much, so I cried. Tears of sadness and disappointment in mankind. 

I know that I will see things and do things that will make me feel this way again. Medicine does not always provide a happy ending and that is a reality I have chosen by coming to medical school and embarking on the life a physician. I just hope that the sun comes out and the encouraging days outnumber the heart-breaking ones. And when they don't or when I need to, I'll cry....


I feel like burnt toast, oh and Path Pictionary VI

Okay, so this Path Pictionary has taken away my desire to post anything of substance. I guess I'm just tired. Term 4 is not so bad.... I mean I like Path, it is interesting, yada yada but I'm tired and want to go home.... every day has become a chore to get through. I feel like all I do is sleep, study and drag myself to class, lab, etc.  I miss being a real person....

But soon, so soon, I'll be back in the US with my husband learning a new city and having a nice summer break before coming back her just one more time. Crazy how fast time has gone by, sometimes it seems like just yesterday that I was packing and planning to move to Grenada.

Now if only these last two and half weeks can go as quickly as the past year and half has..... But I digress, I'm done whining (for now).

For your Pathology fix I present the last installment of Path Pictionary: Brain and Bone

A. Diagnose by weather or fruit.
Patient complaint:
MRI shows:

 MRI shows:

B. Sticks and stones....



Path Pictionary V

Each set of pictures describes one pathology. The subject is endocrine. 


B. Hard as   or  hard.

Think Nuclei!