ndab Ah Yes, Medical School: November 2004

Monday, November 22, 2004

In The Spirit of Free Speech

(Note: Names have been changed to protect...well...me)

After parking myself on the couch for the weekend, chips, salsa, and the tv remote in hand (once again inspiring confidence in the future generation of doctors for you outsiders I’m sure), I received a particular bizarre email from an anonymous classmate. It was written by someone who listed his/her name as “I don’t like Rachel” and the email address was dntlkrachel@yahoo.com.

Strange, I thought. Using my exemplary deductive skills that will no doubt translate into me becoming an incredible doctor, I figured that this must have something to do with the mysterious summertime disappearance of the head of the student affairs office, who’s name is also Rachel (how’s that for putting two and two together? Eh? Eh?). Many rumors floated around about her sudden disappearance, ranging from “some administrative bureaucratic bullshit that the higher-ups had to enforce” to “I heard she sold crack to little boys and girls”, but for the last few months the school administration has been silent on this issue. As a result of frustration over this silence and a need to fight the injustices of this world, some students, who likely had delightful encounters with this lady, started an email petition and tried to set up a meeting with the dean of the medical school to demand answers, action, and her immediate return.

However, it appears as if these students have acted too fast. They must have assumed that everyone liked the head, but apparently they were mistaken. Below is the email the mysterious dntlkecharlotte sent out to all four classes:

I think it is important that if you go to the SAO [Student Affairs Office], you emphasize that you only represent those students who have signed your petition. I, for one, do NOT like Rachel, and I know that there are other students, who, like me, feel that the SAO is running smoother and is a more welcoming place without her there. In almost every interaction I ever had with her I felt that she was rude and unfriendly, and I feel that she does not do a good job of making us feel welcome in the SAO. I understand that she was overworked and always too busy - but that was never an excuse to be rude to students. For fear of angering those of you who do like her, we can't as easily march in to the Dean’s office to express our applause for what has happened - and so I only ask that you emphasize that you do NOT represent the entire student body when you speak with the Dean. Thank you.

Which followed later in the day with:

Thank you to the students who have written me to tell me their appreciation for my email.

As one student mentioned, "I have had very similar experiences in my interactions with Rachel, although given the woman's grip on the SAO, I haven't felt safe vocalizing my opinion."

If you agree with this student, please write me back to let me know. If there are enough of us that we wouldn't eventually be risking our own necks to make a public statement, perhaps we can draft a letter of our own opposing Rachel's reinstatement. I give my word to keep your identity completely confidential unless we all agree to draft a letter together.

To everyone else, I apologize for the intrusive emails - I will not send any more.
Thank you.

Wow. Besides once again demonstrating how fucked up medical students are, it is evident that I am obviously not the only person who has a lot of time on his hands. I’d like to ignore the fact that this person chose to remain anonymous (thus losing a lot of credibility – ok if you’re going to call someone out in front of everyone it seems reasonable that you shouldn’t hide behind anonymity) for now and instead consider how this new form of email social action can be used to address other problems with medical school (at least in my experiences so far). So without further ado, I give you the great anonymous email activists of the future, appearing in an inbox near you (and before you call me a hypocrite for hiding behind my own veil of anonymity, I'd just like to point out that this is meant for entertainment/my own cathartic purposes, and if I ever felt a need to make someone look bad in front of 4 years worth of medical students, the administrative staff, and the deans, I promise I will put my name at the end of the email):


Dear Complete Waste Of Space,

I like it that you don’t interrupt lecture and disrupt class too much. In fact, I don’t even know your real name. But when you do talk, it is like taking the noise from nails on chalkboard, multiplying that by a billion, and then adding the vocals from Lindsay Lohan’s song (without the accompanying slutty images). Why, you ask? Well, you have a way of making all of us medical students look bad when you talk. For example, a while ago a doctor came in to announce small group pairings, but she was not aware that the groups she was reading were incorrectly organized. However, rather than just quietly laugh at her and the uncomfortable confusion she was creating, you had the gall to raise your hand and ask “Umm. Are you sure you aren’t supposed to be teaching the first years or something?” Now this lady had obviously made a mistake, but she did not get this far in life by being a complete idiot, which is what it would take to not know which year of medical school you’d be teaching for the next two weeks given the amount of scheduling preparation that goes into this sort of stuff. So don't call her out as a total idiot in front of everyone. From now on, could you please do us all a favor and never talk ever again? Thanks a bunch.

P.S. Don’t think I forgot about you, Frenchie – yea, you are involved in this email too. Just because a guy gets up and lectures to us about a French disease and mentions that he is French, that doesn’t give you the right to raise your hand and start talking in French to the guy while the whole class sits there and listens to you show off. I hope a plague of French bread filled with anthrax rains down upon you for eternity. Not that I’m bitter or anything, but honestly who does that?


This is for you people that can’t control your hands in class. You know who you are. For the sake of humanity, STOP PICKING AT YOUR FEET AND FLICKING YOUR DRIED UP FOOT JUICE ON US. I swear if you keep doing this I’m going to collect these specks and make you eat them, vomit them up, and eat them again.


Dear classes of 2005, 2006, 2007, and 2008,

I’ve been sitting on my hands about this for a while now, but things have seriously gotten out of hand. A doc told us once that we were entitled to nothing, which may not be true. But what is true is that we aren’t babies who need to have everything handed to us on a silver platter. You all keep complaining about the most ridiculous things – “We should have every lecture powerpoint given to us a week in advance!”, “We insist that the administration clearly tell us how letters of distinction are awarded so we know who’s ass to kiss!”, “We refuse, REFUSE, to accept any mistake in an optional self-assessment!”. Seriously guys, this is getting out of hand. Any day now I’m expecting the “We demand our own personal helper midgets to carry our books and provide the occasional massage and/or sexual favor!” If you keep complaining about the stupid shit, they won’t bother to listen to you when something really bad happens. Like, say, oh I don’t know…an entire block run by people who are completely inept at organizing or presenting material? So from now on, please follow this simple rule:

1. Shut the fuck up
2. Calmly suggest your ideas to the student representatives so they can a) do their job and b) more calmly present the actual good ideas to the people in charge, which is how it’s supposed to work in the first place. See, it’s just that simple.


Hey you, Mr. Block Chair. Ya, I’m talking to you. You seem to have a problem with a lot of us coming a few minutes late to class sometimes or leaving early if the lecture is painfully boring. Look, it’s hard to get 150 people to show up at the same place and the same time for anything, much less a painful lecture about perirectal bleeding or the miracles of biostatistics. We’re busy and lazy students, and the shit you keep dishing out is so boring I keep having to restrain from taking my pen and shoving it through my eye, pulling it back out, and shoving it up my neighbor’s ass just to stay awake. But if that was just the problem, then I would have been complaining since the start of medschool. No, this is much worse. See, you just had too get all snotty with us, didn’t you? Remember that [cue British accent] “Never in my years at Oxford, Yale, or San Francisco have I ever seen such behavior in students!” line? Well I do. And if you know what’s good for you, you better just shut the fuck up from now on. We saved your asses in World War II, so stop biting my ass every time I’m a little too hung-over to get to class right on time or if I have to leave an atrocious lecture before I kill myself.


Dear Mr. You Don’t Belong Here,

We’ve all been together for more than a year now. 150 people coming to lecture, sitting for two hours, and getting up to leave. As is the case in any lecture-based class that lasts more than two weeks, seating arrangements have been extensively established. The cool kids sit over here. The question-askers sit over there. The sleepers sit in the back. And, as has been a tradition since about week 3 of medical school, the talkers, joke-makers, and hybrid talker-sleepers sit in the upper left corner. This is how our class seating plan has evolved, and everyone has been living in harmony for a long time. However, a few weeks ago, for some inexplicable reason, you took your old, attentive, engaged with lecture Mormon ass and transported it alarmingly close to the upper left corner. Since that time, you have shushed us, whistled at us, and came very close to uttering whatever weak curse word you people are allowed to say on many occasions. Just what exactly were you expecting? It has been firmly established that the hours of 10-12AM are the social hours for the upper left corner. I just wanted to write and say that no one here likes you. We all want you to leave and go back to where you came from. No, not the center of class. We mean 1975, when none of us were around and you could whistle and shush all you want.

Saturday, November 20, 2004


So it seems I was trying a little too hard in my previous post, and I got a lot of "I don't get it", "This is really boring" or "Are you retarded?" responses.

Based on this feedback, I promise that from now on I will stick to the bread and butter of my medical school experiences, which basically amounts to me making a fool out of myself, sticking my finger up other peoples asses, and/or being felt up by B-list middle aged old female celebrities. No more ridiculously bizarre political commentary, I swear.

But since I have nothing exciting to bitch about now, I'll just bring out a classic from when I was actually funny. Well not really all that funny, but I just don't really know how to end this apology without rambling on end (and yes I realize that is what I'm doing right now). Enjoy.

Tuesday, November 16, 2004

Feeling Blue

Now that the elections have (finally) passed, there appears to be a rise in stress and anxiety for many people, especially for us blue-staters, over what the next four years will bring. Such stressors may inadvertently lead to a rise in heart attacks throughout our nation. Given this information, I felt it was my duty as a writer of useless medical stories filled with questionable medical expertise to provide a public service and explain to you, the lay people, the pathophysiology behind what may end up happening to you in a few weeks (as well as provide me with the opportunity to see how far I can stretch a metaphor/allusion). Why in a few weeks, you ask? Well, just consider the heart attack you will have when you learn that we are invading El Salvador because the images of starving children Suzanne Summers keeps showing us on TV are deemed indecent by the religious right.

An acute heart attack, or myocardial infarction (MI) for those of you who want to sound smart to your friends, often occurs when a sudden and catastrophic blockage of cardiac arteries by things called thrombi (a collection of platelets, fat particles, and bits of that quarterpounder with cheese you had for lunch at McDonalds yesterday) leads to a cutting off of blood supply to parts of the heart. This can sometimes occur a result of sudden changes in blood pressure seen in stress. Imagine two big branches off a main cardiac artery, once the towering source of pride shared by an entire community of heart cells, being suddenly bombarded with two huge thrombi that cause a complete blockage. These two arteries then can quickly and catastrophically collapse, suddenly blocking off all the blood supply to part of the heart that these arteries served. The heart cells that depend on these arteries will soon go through a process called necrosis (for you porn freaks, it is from the same root as necrophilia), which is a fancy way of saying they are as done as Roe v. Wade once a couple of current supreme court justices kick the bucket.

From here, things start getting really bad. The part of the heart that is not getting blood will stop working, and this will have dramatic consequences for the rest of the body. Since the heart stops pumping blood as well as it used to as a result of faulty heart cells, the whole cardiovascular system gets backed up because the blood that was supposed to be pumped to the body is now just sitting there (and if you think cardiology could essentially be done by a plumber, you are correct). The first areas to notice this ironically enough represent other targets that are commonly targeted by the thrombi and are consistently under threat of a thrombotic “attack” (if you will): the two lobes of the lung. Due to a long process of evolution (or say about 6,000 years ago if you are currently a high school student in Alabama), the heart and lungs have been directly connected by arteries and veins to ensure efficient oxygen exchange for use by the rest of the body. The two lung lobes are especially interesting to consider, because upon dissection they tend to have a bluish tinge and have almost a coastal shape to them (excuse me while I stretch this metaphor a little too far).

So lets recap what is going on so far: the heart goes kaput, blood is getting backed up, oxygen is not getting to the blood like it is supposed to because the lungs are failing and being filled with fluid, and the brain is getting a little woozy because it isn’t getting any oxygen.

However, we are forgetting one important player in this game of love (and by love, I mean massive heart attack). Yes, the kidneys. That bastion of piss-producing, nutrient-saving fresh tissue is, just like the rest of the body, currently suffering from reduced blood flow as a result of the MI. However, the kidney has a peculiar response to what is occurring. Rather than recognize that the heart and lungs, whose main purposes are, interestingly enough, to obtain and distribute ("subsidize" comes to mind) the necessary blood and oxygen the rest of the body needs, are in trouble and need some help, the kidneys are a bit selfish. Very small and specific parts of the kidneys begin sending out this compound called renin, which, after a process of conversion to various other compounds, acts to maintain normal blood flow to the kidneys and constrict blood flow to other places.

You may be thinking to yourself, “wow, that’s a bit strange”. (Alternatively, you could be thinking to yourself, “why am I still reading this?”, in which case I suggest you consider whether I am trying to make a bigger point and failing miserably at it. And if you are thinking, “Beer goes in here” and pointing to your mouth, please apply to medical school now. We'd love to have you.)

After all, it’s not like the kidneys were directly hurt by the heart attack. The heart was. The kidneys also aren’t the organs most immediately threatened with future attacks. The lungs are. You could argue that the kidneys are just completely misinformed about what is going on in the rest of the body, as if a small part of the kidneys is responsible for sending out misinformation in the form of renin to the rest of the body in order to manipulate blood flow for its own greed and power. That the sea of red blood, which is too ignorant to do anything other than follow the orders of the compounds that control it, is simply blinded by the sheer horror of the situation. Or perhaps the kidneys think they know what is best for the rest of the body, as if they were moralizing the parts of the body that work to provide them with what they need in the first place.

While you chew on that, let’s return to what is now happening in the rest of the body. When we last left our clogged up plumbing system, the blood had backed up into the lungs, causing excess fluid to spread into the lungs and some shortness of breath. What is next up in the backward blood flow bonanza? The liver! Yes, that lifesaver for college binge drinkers worldwide is now overflowing with deoxygenated (blue) blood, incapacitating it and leading to fluids spilling into the area around the gut ("ascites" for you medically curious folk). It doesn’t take a degree in rocket science to know that this is probably not a good thing. While I’m at it, it also doesn’t take a degree in rocket science to know that, unfortunately, Jesus probably does not have a subscription to Science, Nature, or The New England Journal of Medicine, so he is probably not going to be very helpful in making policy decisions about little things like global warming or stem cells. But I digress.

Returning to the action, the kidneys have not stopped their actions. They are pretty stubborn when it comes to getting their blood, and this is just compounding the blood flow problem for every other organ. If you really think about it (or have way too much time on your hands), you could argue that the kidneys, which come in identically shaped pairs in most people, are concerned that somehow their inability to get their normal blood supply could result in something like the lungs getting too close together so that their surfaces kiss (hows THAT for a stretch to try to make a point?). Could something as inane, primitive-minded, and unimportant (considering there is some serious heart attack and organ failure going on here) be the primary driving force for the kidneys selfish actions? Please don’t answer that question.

Well, as you can imagine, this just keeps on getting worse and worse. Even the kidneys, who thought they were helping the entire body by maintaining their own blood supply, begin to fail. Pretty soon, the heart will stop pumping. The lungs will stop expanding and shrinking. The kidneys will stop filtering and being ignorant. And, most importantly, the brain will no longer be able to think…

You can imagine what comes next.

While many friends of mine described the voting results of November 2, 2004 as emblematic of a huge brain fart on the part of millions of people, a more thoughtful friend of mine said that it is as if our country, clutching at its heart and soul, just suffered a massive heart attack last week, and that we will all be gasping for air for the foreseeable future.

Is there a doctor in the house?

Please note: All medical information presented in this post is factual. Or as factual as you might expect from some putz medical student who doesn’t pay attention to lecture half the time. As far as the other stuff goes, well, rather than accept the company line (whether that is Fox News, moveon.org, Jesus, or whatever), do your own reading and research and draw your own conclusions. I would suggest 1984, by George Orwell, as a good place to start.