Back in the Saddle Again

It’s been a while. The week of Feb 21st to the 25th was finals. I was nonstop studying. I had Biochemistry on Monday, Psych and Clinical on Tuesday, Physiology on Wednesday, and Anatomy and Histology on Friday. It was a rough week. The worst of the exams were Friday’s. I walked out of the exams genuinely concerned that I might have failed the courses. Unfortunately, since there were written portions to the exams, they would take a few days to grade. Then, to cap off an already long day Friday, we had our memorial ceremony for the cadavers following the exam. We had to work an additional hour after finishing the exam. Part of the wrap-up process was a literal “wrap-up” of the cadavers. We had to package the bodies for return shipment into body bags. We left the brains out because we will use them this (3rd) quarter. We finally finished and were ale to leave. You wouldn’t believe the uses we found for duct tape!

The week after finals was spring break. We had planned a trip to Legoland and Disneyland. I had 2 days for work around the house and then we left on Wednesday. I got a lot done. We got our spring/summer garden planted, car maintenance, landscaping maintenance, cleaning, etc. Oddly enough, I actually enjoyed doing those chores. Anything but studying! Wednesday rolled around, and still I had no word on my results. I had all of my grades except for the two that I was most concerned about. I checked our online reporting system about ½ hour before we left. Anatomy had a line displaying for the grades, but it was not populated yet. But Histology was there. Something is wrong when you walk out of an exam thinking you might have failed, and you end up with an A in the class. I checked back with Anatomy. Still there was nothing. I kept refreshing the screen. After about 5 minutes, there it was. My B. After all of that worrying, I got an A and a B. It just reinforces my feeling that I am the worst assessor of my own performance on an exam.

The trip was fun. We invited my in-laws to go with us. Legoland was better that I expected it to be. The kids really enjoyed it. There were lots of rids and activities geared for their ages. Disneyland was fun, too. But the crowds were larger and there was more walking. By Saturday night, we were all ready to go home. But that meant that I had to drive all night to get there. We pulled in at 3:00 AZ time. Sunday was restful.

Monday was back to school. My courses do not appear to be too difficult except for Neuroscience. I am taking Physiology, Immunology, OMM, Psychiatry, Clinical Medicine, and a couple of general medical lectures. I have spent about 3 hours per night on just Neuroscience. More than all of my other classes combined. I hope it pays off. We have our first exam on Friday.

The blog hiatus was unfortunately necessary due to a lack of time. As it is, I have much to do tonight before bed, so it’s off to the brain vasculature…

Endure to the End

Have you ever had one of those times where you feel like you are at mile 25 of a marathon and just realized that the last mile is up a 10% incline? That’s about how I feel. Today was the last day of class for the second quarter of school. One more to go and I will be done with my first year. However, next week is my finals week.

I already had finals for my OMM class last week. It was a two-parter (written and practical). I did alright. I scored slightly above average, but not what I had hoped for. However, there is some controversy. The final lecture given was poorly done. Worse than the delivery, was the handout. Our exams are primarily taken from our lecture handouts. When they printed them (from the PowerPoint slides) they did a “background print” which reversed the text coloring. In other words, all of the text was white (on a light gray background). None of the notes were legible. We asked the professor about the notes and he indicated that we would receive new notes from the department secretary.

Exam day rolls around and we had not received any notes, so we concluded that that lecture would not be tested on the written notes. Wrong. 10% of the questions were from those notes. In discussing the exam with other students, it turns out that the secretary did print new legible notes and put them in the OMM lab. However, she did not tell the class that they were available or where they were. There were about 5 students that happened upon the notes and got copies. They did not let the other students know about the notes either. The really sad part is that one of the recipients is our class liaison and should have emailed the class to let us know about the notes.

Well, the secretary thinks that the exam is OK since a few of the students found the notes. Of course, that doesn’t sit well with the other 150 students that did not. A few (5) have formed a formal appeals committee (med school beurocracy) to appeal those questions. Who knows what will happen.

This coming week I have 5 final exams. Friday is my last one. Fittingly, it is Anatomy. I have enjoyed the course, but it has been a challenge. Following the exam, we are having a memorial to pay respect to the donors. Then we package the bodies for return to the donor program. We have had to keep ALL parts removed in a large plastic bin under our tables. The donor company verifies that all parts are accounted for thanks to the UCLA scandal.

I have a TON of studying to do over the next week for my exams. I hope things go well. I am in a good place with regards to my grades. I’ve done well enough this quarter so that I only need about a 30% on my exams to pass, but of course I want to do as well as I can.

Wish me luck (or skill, whichever works)!

The Court Jester

So, I have decided that I hate lawyers. I’ll admit it, I’m a rabid anti-lawite. Now before any pro lawyer type goes ballistic and sues me, let me say that my sister is a lawyer. Also, may I submit a recent experience for your consideration (lawyer talk for Here’s a little story).

I got drug (as a witness) into a lawsuit filed by a former coworker (from 5 years ago). He supposed that I had some incriminating information about my former employer (which I did not). His lawyers really wanted to depose me, so I was extended an invitation (a.k.a. subpoena) to meet with them as well as the defense counsel. In order to confirm my address for the subpoena, someone concocted an elaborate scheme to trick me into thinking that I was giving my address to a potential client. When I tried to call the individual back based on the phone number on my caller ID, I was connected to this former coworkers’ cell phone. Hmmm, already fishy.

I was eventually deposed and videotaped. I had hoped that that was all. But no, I then got subpoenaed by both sides to testify at trial. A couple of days before the trial, I called to confirm the time to be there and they told me that it had been continued until a later date. Apparently they had no intention of letting me know that. Nice communication!

A few months later I get another 2 subpoenas, one from each side. I called the prosecution to try to find out when I will be testifying. As it turns out, THEY DON’T WANT ME! But the defense still did. That’s irony. The people that took the time to hunt me down decide that they would rather not have my information but their opponents would. It took 4 phone calls to the defense to find out when I would be testifying. It was finally set. Wouldn’t you know it, right in the middle of Finals at school! Of course, my schedule and convenience don’t really matter when there’s cash on the line. I had to get special permission to miss my final anatomy lab (we are required to be at all sessions). I was to be at trial at 1:30 PM on Tuesday.

Then on Monday at 3:30, I got a call from the defense. They now needed me there at 9:30 in the morning. They were anticipating finishing early and didn’t want to have to wait until the afternoon for my testimony. Great, now I have to quickly rearrange my morning to accommodate them. Plus, my wife and I were planning on attending a temple session since the trial was about 5 miles from the temple. That was not going to happen now, too.

So, I get up and drive the 1 hour 30 minutes in rush hour to the courthouse. I was prompt at 9:30. Wouldn’t you know it… I waited until 12:00 before ANYONE gave me an update on when I would testify. “After the lunch break at 1:15 sharp”, they told me. So I went to lunch, fairly put out. I got back at 1:10 and waited around until 1:35 to testify. I was asked a total of 12 questions (including my name and occupation) that lasted 7 minutes!!! The answers that I gave were confirmation of facts they already knew. Then they dismissed me.

I understand that I am not paying their bills, but come on. A little common courtesy would do wonders for their already less-than-pristine image. If this whole experience never happens again, it’ll still be too soon!

Double Your Pleasure Double Your Fun

Sorry about the duplicate posts that were there. I email in my posts and there was a delay sending or receiving them. I sent one off and it never arrived, so I resent it. I even sent a test email, but nothing. So I manually posted it. Then a few days later, bada boom bada bing, duplicate posts. I think that they are all cleaned up now.

Please forgive me.

Return of the Prodigal Son

When I was getting ready to start school, I didn’t realize the extent of the sacrifices I’d be called upon to make. Before school began, we gave up our…gulp...Costco membership. It was hard to do, but we figured that we could go with someone else if we needed to get something. Well, six months later, I returned to Costco, this time, under the wing (membership card) of my father. Costco had a massage table that I wanted to get to do OMM (osteopathic manipulative medicine) on. One of the differences between an MD and a DO is that a DO is trained to correct skeletal and muscular dysfunctions in order to return the body to its natural state. Structure and function are so closely related, it only makes sense that if your framework is dysfunctional, other things must compensate or suffer along with it. We don’t only treat the spine (common misconception equating us with Chiropractors). We deal with all musculoskeletal issues. If you ask me, it is just another tool that I have to help improve the quality of peoples’ lives.

Anyways, I went to Costco to buy my table. This is it here. When I got it home, my kids were begging me to open it and give them a “massage”. They see me working on my wife and her family and now want their turn. It has been a couple of days and I still have not been able to give them their “massage”. They are funny. They are so supportive and excited for me. Emma (my 5 year old daughter), now says that she wants to be a doctor. It is hard for me to be away as much as I am. Even if I am home, I’m studying and not playing. There will be successive days in which I do not see them because I leave before they are up and get home after they are in bed. One day, Emma asked me if, “I was coming home today?” It just about broke my heart. That was in the midst of my crazy exam week a while back. Luckily, I was going to be home earlier that night. In fact, it was the morning of my Anatomy exam and I came home about 2:30 that afternoon. I played with the kids all that day and we even went out to dinner that night. I think I read Harry Potter to them for about an hour. It was a nice afternoon. I don’t get too many of those these days. Even though I am very driven and passionate about what I am doing, I am more passionate about my family. It is a difficult balance, but I try hard to make it work. I am sure that my grades suffer a little, but in the end what is really more important? They are sacrificing so much for me; it is only fair that I can sacrifice a little for them, too.

I had a splitting headache

Today may have been the goriest day yet in Anatomy lab. Yesterday (my preceptor day) the lab group studied the pharynx and throat structures. As you can imagine, those are difficult to see (from the outside). In order to make them visible, they bisected (cut) the posterior (rear) muscles of the neck and lifted the head forward off of the spine (the anterior muscles were still attached). Basically imagine looking down with your chin on your chest, and your head popping off and continuing to roll forward until your eyes and nose were flat on your chest. But that sure opened up the area.

Well, I went to lab today and my tablemates reviewed the structures identified yesterday. Not too bad. Then we got going on today’s dissection. We were studying the nasal cavity and related structures (sinuses, etc.). Of course, you can’t see all the way up and back through the nostril so obviously you have to split the head into the right and left halves. I mean, what else could you do? And just who do you think the hacksaw (yes, hacksaw) was handed to? Yours truly. Not that I really minded though. Sparing you the grossest details, suffice it to say that it sounds just like you’d expect it to.

After I got the head split, we commenced to clean out the nasal septum and some extraneous structures. My group and I spent a long time cleaning and were very meticulous. We exposed all of the nerves and arteries and stuff that we needed to see when a professor came up to look at our work. His eyes got big he smiled. He said that, "he’d never seen that successfully dissected out intact before." He was talking about a tiny nervous ball (ganglion, cool word huh) hanging from a delicate nerve. He called the other professors over to show them. We tried to look nonchalant about it, but we were really beaming inside. Then he got on the microphone and told the entire lab to come over to our table and see our dissection. We took grief after class for that, but I think that my classmates were genuinely impressed. As much as I enjoy anatomy lab (and I seem to be quite good at the dissections), I do hope that I am able to get into surgery.

I also got my scores for the last exam of the horrible last week. I got another "B". I apparently took the 6 B’s talk a little too seriously. I feel OK about it though since my score was the average grade. I seem to be scoring within 1-2 % above or below average in all of my classes. In undergrad I would have been disappointed, but this is a little different. It makes me optimistic for graduating and passing all of my boards, but I hope it is enough to get into a good residency.

Amanda Hugnkiss

My terribly difficult Anatomy exam that I took last Thursday was just that. Terrible! Or at least that’s what I expected as I walked out of the test. We got our scores back today. When scores are delivered, they put them into our mailboxes at school. It was like an Alaskan river during salmon spawning in the mailroom. There must have been 50 people in my class in there. The smell of apprehension was thick. I could actually hear pulses as I walked into the room. Apparently, everyone else felt as I did about our prospective scores of such a difficult exam. As I worked my way to my box, I passed many telling countenances, some smiling, some not. As I sidled up to my mailbox, I could see it inside, all pink and ominous (our anatomy practicals are done on pink answer sheets). For the moment, it was just me and that mailbox. I could feel my palms sweating; my heart racing. “Whoa there big fella”, I said. There’s still another exam to make up the points. As I reached down for my key, I had an uneasy feeling, like waiting for the warden to throw the switch. I slowly slid the key in, turned, and opened the door. Had it come to this? Was I really afraid of a pink paper? And as I felt my last ounce of courage begin to flee, I saw it; a “B”.

What happened next cannot be explained. I grabbed the guy next to me (good thing it was a guy and a straight one at that) and hugged him. He simply smiled and said, “Good news?” I closed my box and began to leave the room, a smiling salmon with my pink “B”.

Apparently size does matter

Ok, I guess that this entry should be rated PG-13. In Physiology, we have been studying cardiac function and along with it, vasculature. It is very interesting and if I were truly psychotic, I might consider cardiology. In the course of our studies, we discussed edema and its vascular causes. As it turns out, there are island populations in the Pacific that are prone to a certain parasitic infestation. One of the results of this infestation is elephantitis. The oddity in the story is that the elephantitis is typically limited to the legs or more commonly…the scrotum. There are even recorded cases of the scrotal weight exceeding 175 lbs! This particular parasite is easily eradicated with antibiotics, but the indigenous hosts refuse treatment. It is a sign of virility and masculinity. So there you have it, size does matter. In case you think that I’m making this up… Again, PG-13. Picture.

To my throngs of faithful readers (You know who you are.. all three of you!), here are the answers to your questions.

My related preceptor is Dr. Adam Nally D.O. (Terry’s first cousin). My tests are timed. For example, a typical Anatomy/Histology test runs as follows:

6:30 am Anatomy Practical (Identify and Name indicated structures on cadavers). We have one minute per station and usually have 35-45 stations. Spelling counts!

7:30 am Histology Practical (Identify and Name microscopic specimens shown via PowerPoint). Again, one minute per slide with a total of 35-45 slides. Spelling still counts!

8:30 am Written Examinations. We have 120 minutes total to take both a 45-50 question Anatomy exam and a 45-50 question Histology exam.

All done before lectures start at 11:00.

My summer volunteer program will probably cost somewhere in the neighborhood of $1,400. I am still collecting information about locations and dates. Of course, costs are related to where you go, but Mexico/South America tend to be pretty reasonable. All funds that I am able to solicit from companies or individuals are tax-deductible for them.

I guess that I did not mention it before, but I am not at an allopathic Medical School (MD). I am at an Osteopathic Medical School. My school's Website. When I graduate I will be a DO (Doctor of Osteopathy) not an MD. Same credentials, same training, same practicing privileges, just a different philosophy concerning the body’s innate healing ability. But that’s a topic for another day.

With tests like these, who needs class?

So, I went to two out of six hours of classes today. And I only went to them because it was mandatory. This seems to be the status quo this week for me and most of the other students. I spent the majority of the day in the library. There is SO much material to learn for Thursday. The material in and of itself is not that difficult, but the pace kills you. The volume is tremendous. Oh well, the quarter is almost over.

I got my Biochemistry exam back from yesterday. I scored just a bit below the class average. I did about as well as I thought though. It did drop me from an A in the class to a B, but it is a high B. I will try to pull it to an A with the final. No pressure or anything;-).

We requested our third quarter electives this week. I requested a medical Spanish class and a community service class. The community service class is two Saturdays of performing sports physicals at a local high school for student athletes. It is rumored to be a great experience. The electives are on a first come first serve basis, so I hope that I get into the classes. They did not tell us when we will get our schedules, but I hope that it’s fairly soon. I hate waiting!

Levator labii superioris alaeque nasi

That’s a little muscle that runs from the side of your nose (near the top) to the corners of your mouth. It assists in smiling. No, really, that’s its name. That’s the kind of stuff that I’m studying right now. In Anatomy we are continuing our study of the head and neck. I have an Anatomy exam on Thursday, then Physiology on Monday, then…no more until finals. Incidentally, my first written final is on Valentine’s Day. I only have two finals that week, but I have five the following week. Then I have a week off. It’ll be nice to have some time off.

This morning was the Biochemistry exam that I was studying for this weekend. I don’t like having so many exams this close together. There isn’t enough time to prepare for them. I am not sure how I did. I felt comfortable with most of the material on the exam. However, there are always some things that I can narrow down to a couple of answers and then make an educated guess. Hopefully I did well enough. This is the second of three exams that we have in that class. It is also weighted the least of the three. I did very well on the first exam. I got a 95%. The class average was 84%, so I was elated. That also means that I do not have to do as well on subsequent exams to still get a respectable grade. We’ll just have to wait and see what happens with this one.

Do you see what I see?

Today in Anatomy we exposed and studied the eye and surrounding structures (nerves, arteries/veins, muscles, etc). It was pretty cool. In order to get to the eye though, we approached from behind and above the orbit (since the top of the skull and the brain have been removed). We had to use chisels and mallets to remove the bone behind the eye. This was really neat for me since I have interests in orthopedic surgery (the carpenters of the surgical world). I was surprised to see how much fat is deposited surrounding the eyeball filling the orbital space. A girl in my dissection group joked that, “Great! I’m even fat behind my eyes!”

As for our dissection groups, at the beginning of the year there were 6 of us in my group. Each assigned pair (three pair per table) rotates out of lab once a week so that there are never more that four students at a dissection table. My day to rotate out is Monday. My partner and I are in the lab on Tuesday and Thursday. Monday afternoons that I am not in the lab I do my clinical preceptorship (every other week anyways). Well, two people that began in my group have left school. One was my assigned partner and the other was Kim’s (the joking girl from above). That means that on Thursdays it is just Kim and me at our table. I kind of enjoy it since we each can work on a side and are not bumping into each other. I guess that I am selfish, but I like not having to share my dissection time.

Tomorrow night my wife and I have a date planned. We haven’t had a real date since our anniversary at the beginning of January. The kids are off to PaPa and LaLa’s house to spend the night, so we don’t have to rush home. I am REALLY looking forward to it! We don’t know what we’re doing, but something along the lines of dinner and a movie is probably not far from the plan. Then Saturday will be another long study day at the library. I would much rather be studying at home, but I am too easily distractible. I can always find things to do besides study, like clean bathrooms, change the oil, type a blog…… ;-)

Como se dice volunteer?

I went to the initial meeting of a new organization at school yesterday. It is the service portion of the surgery club (of which I am already a member). It is call the “Unite for Sight” club and is a local chapter of a national group. Their focus is on providing eye related services (exams, glasses, cataract treatment, etc) to underserved populations. That’s not really my thing (I mean eye stuff, not helping underserved populations), but in the meeting they discussed something pretty cool. There are short-term summer international internships available for interested students. These students go to a needy area and provide services. It gives a great opportunity to provide service, have a cool international experience, and possibly work on a language. I am thinking about looking into a 2-3 week program in Mexico. The main obstacle is funding the trip. However, many students solicit sponsorship from professional organizations and practitioners. If I decide to go on one of these excursions, I will need to do that.

For anyone reading this that may not know, I am a Mormon. As such, I had a chance to serve as a missionary for two years. I was called to serve in Tokyo Japan and was there from 1993 to 1995. As a result of that assignment, I was required to learn Japanese. Growing up, I always had a fascination with Japan and the language. When I submitted my paperwork for missionary consideration, I indicated that I had minor Japanese language training (I’d had a few private lessons from a Japanese friend’s dad). At that time, I did NOT want to go to a Spanish speaking mission. Well, I was called to Japan and I loved it! Don’t get me wrong though, I loved Japan and would not trade the experiences that I had there for anything, but living in Arizona, sometimes I wish that I had learned Spanish. It’d be more useful to me now. I did take Spanish in high school and still remember quite a bit of it. I also have an elective available this next quarter at school that I think I will fill with a Spanish class. Maybe if I do that, and I go on a summer Internship, I will be able to speak well enough to consider Spanish an asset.

Tendremos que esperar y ver!

Heads up

So today was kind of cool. In the anatomy lab we studied the brain and cranium. The brain is actually larger that I expected, but I’m not sure why I thought that it’d be smaller. It’s the first time I’ve ever held a human brain. It is truly amazing how everything in the body is controlled by a 5 lb mass of tubes. Anyways, it was made even more interesting because my cadaver had a brain tumor. He was a smoker and had both lung and brain cancer as a result. When we were dissecting the lungs last quarter, he had a bunch of tumors and adhesions there, too. It is hard for me to understand how anyone (especially in healthcare) can smoke. But even at school, I see a few people lighting up. There were also some school photographers in the lab to take pictures for advertising brochures. The anatomy professor is VERY mindful of showing respect in the lab, so she will preview all of the photos taken to ensure that none of the cadavers are shown, only students. If anyone ever doubted the respect and gratitude shown to those who allow us to learn from them, they should meet her. She speaks of the lab as sacred and comes down HARD if anyone is ever disrespectful.

Well, I’m off to study. Tonight it’s Biochemistry and Anatomy. Fun, fun, fun!

I hate it when that happens!

You’d think that I’d be a better judge of examination performance than I am, considering I’ve taken a few in my days. But, I am not. Take Christmas for example. We had a major Anatomy and Histology exam the day before Christmas break. I studied until I was cross-eyed and still felt shaky about the material. Friday came and I took my exams (All 4 hours of them). I left feeling like my head had been run up and down a cheese grater. Then it was off to break. About Wednesday (Christmas Eve Day) I went to view my grades online and lo and behold…Solid A’s.

Back to today. I was up at 4:00 this morning to review for the exam. I knew the material forwards and backwards. Took the exam, reviewed my answers, and walked out confident. I felt like there were 1 or 2 that I may have missed, but all in all I felt great. Historically, if I felt great about an exam, I misinterpreted something. I went online to get my grades this afternoon and wouldn’t you know it…B. Granted, it is a good B, but not what I was expecting. I hate it when that happens.

What can I do but get ready for the next one coming Monday?

One weekend every other week we go to a Physician Preceptor. My day is Monday so I went today. Interestingly, my preceptor is my wife’s cousin. We do it in order to get clinical experience before beginning rotations our 3^rd and 4^th years. Ideally, we are supposed to be honing our History and Physical skills. I lucked out. His office is 15 minutes from my house. Some students have to drive an hour or so each way. It’s kind of a catch 22. Our clinical skills are weak so we go to preceptors. However, because our clinical skills are weak, we don’t do much. Therefore our clinical skills stay weak. It gets a bit frustrating, but honestly, how much can we really do yet? Then again, most of his patients are “patient education” cases where he is interpreting test results, diabetes consultations, and the like. Aside from taking vitals, there’s not a ton for me to do. I just hang around, somewhat voyeuristically. Still, it’s nice to interact with patients. After all, that’s why I am going into medicine.

Another fun weekend

I have never had to study so much in my life. I can’t remember ever studying in high school or much in undergrad for that matter. I always did my homework, but maybe that took 3 or 4 hours per week (on a busy week). Last week was midterms. We had Anatomy on Tuesday, Clinical Medicine on Thursday, and Human Behavior (Psychiatry) on Friday. The only salvation that I had was that last Monday was a holiday (MLK day) so in honor of Dr. King, I spent all day in the library. Actually, it was nice to have a day without any new material. So last weekend, I got to spend all day Saturday and all day Monday in the library studying.

Fast forward to this weekend.

I spent all day today in the library studying for my Physiology exam on this coming Monday. (Do you sense a theme?) They close at 10:00 on Saturdays and they kicked me out. Typically, I spend about 40 hours per week at school in lectures and another 30 outside of school studying. It is tough to get it all in since I do not study on Sundays. That is my only day to devote to worship and family. Sometimes, I feel like that is the only thing that gets me through. However, in order to do that, I generally get up at 4:00 am on Monday mornings to review material before our 8:00 exams. Some weeks though, they are mean and schedule exams to begin at 6:30. On those days, I usually get up about 2:30 or so. Who would ever have thought that I could get up that early?

I am usually studying late into the nights as well. I am in my books until 11:30 or so each night (except for an attempted weekly date night). Then it is off to school at 7:25. Sleep is totally over-rated. However to be honest, I do catch a few naps during lectures. Thankfully, all of the professors distribute lecture notes for us so we only have to take minimal personal notes. Exams typically come from the notes and assigned readings.

Well, since I am home, I think that I will go relax for a bit before bed so until next time…….

Welcome

I have never been good at journaling, but I seem to like computers. So...what the heck. I'll give this a shot.

Seeing as how I am in the middle of a fairly major time in my life and quite busy, I guess that I will try to share it with friends and family at once. As for any future patients reading this, don’t worry, contrary to what may be contained on this site, I graduated at the top of my class and never had any trouble in school!

For the rest of you, I guess that this is a little window into my world of medical school. Hopefully, it won’t turn anyone reading it off of going to medical school, but instead give them confidence that if this loser can do it, anyone can.