5.31.2011

It IS brain surgery

So far I'm s/p day two of week two in my neurosurgery rotation and I have:
performed my first lumbar puncture
observed a craniectomy and tumor resection
watched a patient go into surgery talking and emerge aphasic
witnessed seizures and gotten crash courses in how to read an EEG and prescribe AEDs
assisted in a subdural hematoma resection x 2
seen a stroke patient in his final hours
held hands with patients pre and post-op
seen all varieties of aneurysms: s/p rupture, coil and clip
worked with three amazing residents that take the time to teach
scrubbed for surgery four times
been told I need to read and I should know this or that
been told I am the best medical student in a long time and that I should consider applying to neurosx

It is fascinating, it is exciting. It makes being at the hospital from 5:30am until 6pm or 7pm or 9pm seem like a blink of the eye. Clinical rotations make the first two years worth it. I know that I am only starting my third year and that I don't really know that much, but I know that I like clinic and I like patients and I like talking to their family members. I like being at the hospital. I don't always know what to do but at the same time, I feel like I belong. And so- being an MS III is a good thing. (And now it is time for bed.) I'll have lots more to share once I am done with my rotation (only three more days, -tear-sigh) and have had time to properly reflect...
Stay tuned.

5.16.2011

Lost (and Found?)

Since I'm on the "study hall" portion of my surgery core I have a bit of time to roam the hospital and ponder life. And I am studying. I've read/outlined the first 19 chapters of Lawrence's "Essentials of General Surgery" but it doesn't take an entire day to read three chapters so I have some time.

Last week I went to the ladies room and found a very well-loved lost lion in my stall.

I found him propped up, just like this so I have to think that he fell out of a stroller or was dropped and someone hung him here in hopes he would be reclaimed. I checked the restroom later in the day and he was gone so hopefully his owner was happily reunited.

I don't have any patient stories or amazing tidbits of info to share with you (yet) but I'm one week closer to being on a team, writing notes, rounding on patients and all of that fun stuff. In the meantime I'll leave you with this fun fact: the liver has over 2000 metabolic functions. So love your liver, because it loves you! Oh, and good luck to any and all of those "already brave" lost lions (and other well-loved stuffed animals) out there.

-Kudos if you read a rather amazing blog and get the reference!

5.10.2011

False Start

So,  I have been orientated. I am at my surgical site and new home for the next three months. But due to new SGU guidelines our 12 weeks of surgery now includes protected study time. Which is great, but guess what? I ended up getting my two weeks of study time upfront and my six weeks of general surgery at the very end until the day before exams. Yippee for me! (NOT.)

So no early morning rounding for me or scrubbing in to watch a case, or any of that. Just sitting in the assigned library or conference room from 8am-4pm. Of course I can take breaks and leave for lunch but it kind of feels just like studying for Step 1. Sure I get to walk around the hospital in my short white coat and attend all the resident and academic lectures but I just don't feel like a third year. I know, my time will come. Pretty soon I'll be wishing I was back in the library with the entire day to read (at least this is what I am telling myself.) I have entertained the idea of just walking into a patient's room and assuming her care like I belong there, no one will call if there are extra notes in her chart, right?  Fine, I suppose I will just stick to pre-reading for surgery. It has been a long day. In a quiet/boring kind of way.

Time for Fun Facts:
-A normal healthy person sighs 9-10 x per hour. This protects the lungs from atelectasis. (Patients undergoing and awakening from anasthesia do not sigh or cough and thus this is a possible complication. I'd never thought of sighing as protective, had you?)

-Licorice consumption can lead to renal potassium loss. (Okay, I think I knew this one, but it is still pretty cool, so be careful what you eat!)

There are more, but I don't want to bore you. I am 90 pages in to Lawrence's "Essentials of General Surgery" and I have to say, I wouldn't be if it were not for this protected study time, so yay!?!

13 days until my neurosurgery rotation, at least I have that to look forward to!

5.08.2011

(gulp)

Tomorrow is my first day of third year. I think I am ready but it seems like I can't really be ready because I have no idea what this will be. It feels like the first day of school and the start of first year all over again.

For those of you playing along at home I got my first choice in that I got to stay in California (for now). I was assigned surgery as my first rotation which is 12 weeks long.  And while I am not at a clinical center I am within driving distance of Dr. Boyfriend for weekends, etc. Of course after surgery I will have to most likely move and then move again and again but I don't know what comes next so I really can't worry about it right now. Instead I just have to focus on remembering my anatomy and being the best third year I can be.

The new apartment is set up and unpacked. My fridge and freezer are stocked. I have clean laundry. I guess I'm ready. In the meantime I am enjoying a glass of chilled wine. Cheers to surgery!

4.27.2011

Confessions of a Med Student- Part V

After much delay this is the final Grenada installment of my confessions series. The following post is all about Term 5.  Follow these links for previous terms: 1st2nd3rd4th

The schedule: Pathophys, BSCE (Basic Science Comprehensive Exam Review), Pharm, Clinical Skills, oh and don't forget to self study for Step 1!

Lectures are in the afternoon which I liked much less than morning lectures. Because I went to class most of the time I felt like I never really had a chance to study until after dinner which is a bit late to start (think back to first term, yikes!) and what this meant for me was that I had a lot to cover on the weekends and that I rarely went out during the week. I found that 5th term was just a busy as 4th but that might have only been my class going perception.

Mornings are consumed with small groups and clinical rotations. One day of the week you go to the Hospital for Clinical Skills and mini-rotate through the different wards. In theory you get to see a variety of patients and practices but really the point of this is not to learn about pediatrics vs OB/GYN vs Family Med (that's what 3rd year is for!) but to practice taking histories and doing physical exams. As long as you don't expect that you will be suturing in surgery or actually doing anything of importance this can be a fun morning to hone your skills and meet a variety of Grenadian docs. I enjoyed being about to see the difference between the hospital, private practice and clinics. It was educational on many levels. Grenada does not have the resources of a well developed country and so the type of medicine practiced did not always reflect the US style health-care system but there are fundamental similarities and for the most part the teaching was good and the patients more than willing to assist as themselves.

There is a small group for everything! Pharm, Clinical Skills and Pathophys all include a morning session and depending upon the tutor/Prof/subject they ranged from helpful group learning experiences to a total waste of time. In theory these were great but in reality it was lots of busy work preparing for the sessions and then attending, etc. And because these were in the morning I tended to not get a lot done beforehand or during the lunch break. I think it is because of the schedule that so many students stop going to class. Small groups + mid-day break/lunch + class = day over and no studying accomplished. If I could have stomached sonicing I would have but alas I had to stick out the lecture hall. Hence my lack of life outside of 5th term. But I guess it is medical school after all...

Class in and of itself was okay. The pharm department is well run (I heart Dr. Dasso) and lectures are as exciting as pharm can be I would guess. Basically it was biochem on drugs. I hated biochem and found pharm to be a fair amount of work and a ton to memorize but I somehow survived. Small groups were a bit tedious for my liking but overall I think SGU pharm prepares you well for Step 1.

Pathophys is taught in conjunction with BSCE and is basically a huge review course: Pathophys is a subtle repeat of Path minus the morphology and BSCE is a review of everything else (anat, biochem, histo, physio, etc). I annotated into First Aid and started doing questions in prep for Step 1 as part of the class studying because at this point it all becomes one and the same. Which is not to say that prepping for BSCE or spending Friday afternoons in Taylor are enjoyable but if you use your time wisely the work you put into BSCE can be helpful come Step 1.

I already wrote about Clinical Skills. And actually I thought these small groups were some of the best. Each week a different system is assigned and the tutor takes you through a case and review which as a group you use to review the system and arrive a diagnosis. (Bonus- minimal prep needed besides reading through that section of First Aid and the class notes.)

All in all, 5th term is like your senior year of anything else. It is physically hard to be in Grenada and you just want to go Study for Step 1 and be done with basic sciences already. But the classes are okay and the material matters so you just do it. And then before know now it, you are packing your suitcases and shipping your things home. Grenada is over and two years of your life never felt so difficult, rewarding, simultaneously long and fly-by quick. Then you take a break (optional) and prepare for an exam that will test your past two years and determine your future. So yeah, that is 5th term in a nutshell. I hope this has shed some light on the final term of basic sciences. I do not yet miss lecture, but I do sometimes miss Grenada. Enjoy it while you can.