ndab Ah Yes, Medical School: March 2005

Wednesday, March 30, 2005

PBL: A Primer for the Novice

This week marks the last week of official classroom-related problem-based learning (PBL) I will ever have to do in my entire life.

Excuse me for a moment while I shed a tear of joy and re-read the previous sentence to myself 100 times.

OK, I'm back. Having been through almost two full years of weekly PBL sessions, I think I've learned a lot about how these things work, what constitutes good behavior, and, more frequently, what constitutes bad behavior. So as a public service to all, and to continue my ever-alarming rate of procrastination on the impending set of finals, I have created an important list of Do's and Dont's to help future medical students contribute to the enriching learning experience that is PBL...by which I mean to teach them not be such annoying assholes all the time (a losing battle, I know, but a noble one):

DO: volunteer at least once to be the scribe (aka the schmuck who has to keep track of all the stupid things people say and write them down on the white board). Volunteer?!? Have I been kidnapped and replaced by…well…any sane person in his class?!? But seriously, this can actually be fun - when that moron in your class says something stupid, you can just give him/her a look and/or totally ignore the idea. This also means shooting down stupid learning issue ideas, and having the chance to write so illegibly that people just give up and you can draw whatever you want on the board for your own amusement (as an example of what I have used the scribe board for, you can view my rendition of the human body that kept me from getting skipped past second grade here). And there's no better way to guarantee not falling asleep in a classroom with eight other people than being forced to stand up for the entire time (feel free to ask my roommate how falling asleep in a small classroom of eight people turns out).

DO NOT: volunteer other people to be the scribe on multiple occasions. What kind of schmuck does something like this? The kind that goes to medical school, apparently. I'm dying here.

DO: make a contribution or hypothesis when you have something intelligent to say, which, given the material they give you, can only happen a maximum of three times per session. There is so much to these cases that is either obvious or completely unintelligible at the onset; given this, there are really only a few things that any of us can comment on given our level of knowledge. However, you may be shocked (shocked!) to learn that this is not quite as common-sense as you'd think, which leads naturally to…

DO NOT: feel the need to say something every five minutes. This could include drawing on your time as an experienced EMT (asshole) or that one time you had a cold (moron). This also goes for showboating about how rich you are. If we’re on a case at all dealing with muscles and you start off a sentence with “I feel like I can sympathize with these patients because this one time I was hanging out in this country club with Arnold Schwarzenegger and Maria Shriver…”, just end it. You know who you are. Maybe Daddy can buy you first class tickets to Vail, or even an Oompa Loopma, but he sure as hell can't buy you half a brain.

DO: pay attention to the name of the patient if you want to look smart. Huh? Well if your medical school is as academically questionable as mine, you may find that hidden in the name of the patient’s initials or actual name is the clue to figuring out the disease at hand. I wish I was joking, but we had an entire block of this crap not too long ago. So if Herman I. Venereal or Drinky McAlcoholic presents to you in the form of a PBL case, save your group the suspense and make the diagnosis on Part I. And yes, people like me trained under this method of education will be diagnosing and operating on you in the near future.

DO NOT: intentionally give other people more work to do. This has actually happened to me on multiple occasions. Everyone gets their learning issue (an assigned topic to be researched and presented to the group in the concluding session for a given case) at the end of the first session, and someone thinks of something else they want to be looked up. The topic mildly, vaguely, BARELY relates to my topic. And some prick decides it’s ok to say something like “well, it is very similar to what you are doing, so would you mind adding an additional learning issue and look up that stuff as well?” The hopeful eyes of an entire group, doctor included, turn in your direction, leaving you with either the option of sucking it up and taking the assignment or “not being a team player.” Maybe this is why I was never good at sports.

(Quick aside: Issues of being a team player notwithstanding, I was probably never really good at sports because, despite my six-foot height, I am afflicted with a serious case of Jew. Thus, I peaked athletically at age 10, batting 1.000 in a Jewish baseball league against Orthodox Jewish kids half my height. Paul Young Sports Camp Hall of Fame sucka!!!)

DO: pay attention when you are copy-and-pasting learning issues. While there is no reason to re-write whatever AccessMedicine has already condensed to perfection, don’t be that moron in your group who is copy-and-pasting from different sources with glee, only to not notice that everything is in different fonts. That’s just blatant and poor form. And if there’s one thing I won’t stand for, it is poor form when cutting corners.

DO NOT: be an ethnically or racially insensitive asshole. OK, so it turns out that Ashkenazi Jews are predisposed to any number of horrifically terrible genetic diseases. But if you feel the need to stare at me, or my equally pasty brethren, every time Tay-Sachs or Crohn’s Disease is brought up in PBL, I’m going to do what any self-respecting Jew would do and…call my lawyer. Asshole. This same logic applies to diseases that other racial or ethnic groups are predisposed to. Hey, moron, no need to stare at the African-American girl in our group for two hours when we’re talking about sickle cell disease. I’m pretty sure she knows she’s black.

(And just in case any nice Jewish girls are reading this, I am disease free! And tall. And at least marginally good looking, depending on who you ask.)

Well, I hope this has been useful – I know there’s more where this came from, I’m just too tired to think of it at the moment. Now, having procrastinated for a solid 30 minutes writing this instead of studying for finals, I guess it’s time to get back to work.

Tuesday, March 29, 2005

The Art of Skipping a Grade

By popular demand (OK fine, I'm just bored) related to PBL: A Primer for the Novice, the above artistic sketch is my modern depiction of the struggle of man in this heartless and cruel society. Or, it is what I drew upon entering second grade that convinced educators I was not psychologically mature enough to skip a grade, despite my astronomically dorkified test scores (thank you to the kind folks at Temple Emanuel Community Day School for making that possible). To the dismay of the aforementioned educators, I have yet to reach the maturity of the average third grader, thus making their attempts to keep my social progress to that of my peers null and void. Why no body? Why couldn't I just go for the classic stick figure? The mind of a genius needs no justification. Which is another way of saying I am a complete and utter jackass.

You may be surprised to learn that my knowledge of human anatomy has not increased significantly despite the fine and 75% scandal-free anatomy education I received last year. And just in case you are worried, I have no desire to become a surgeon.

Wednesday, March 23, 2005

Rags To Riches

We are currently approaching the last round of didactic finals classes, and with this comes the last Doctoring II class. What is Doctoring II? This is an opportunity to explore the psychosocial aspects of medicine in the context of a supporting and nurturing environment, where students can practice their clinical skills with standardized patients. Which means it's basically a massive bore-a-thon. Naturally, I figured our last session together would be equally as boring, if not slightly reduced in time.

But, as is becoming more and more rare in my life, God chose to smile upon my existence and spice up what is otherwise a painful and Jewish-girl-free life. How, you ask? Let me explain.

We arrived at Doctoring at about 1:30PM and quickly rushed through the required curriculum stuff, which dealt with asthma (I think - honestly, I have no clue because I was daydreaming about doing all that cool shit in the Matrix movies like flying around and stopping bullets. Yes, I am that big a dork), in about an hour or so. The doctoring doctor leader people then tell us they want to take us out for a late lunch to celebrate all that we have achieved throughout the course of this year (nothing). Fine.

We get up and pack our stuff, when one of the doctors says a peculiar thing:

"OK so get your things, the limo is waiting outside."

Excuse me? Did she just say limo?

Yes, in what will likely seem as the epitome of excess, our doctoring people got us a full-on decked out limo to take us out lunch/linner/dunch. We all pile into the limo, bust out the champagne and glasses, and drink the commute away.

The next shocker (no, no, not THAT kind) comes when we arrive at our swanky restaurant. While I was not entirely familiar with this place, I could have sworn it sounded really familar. What my roommate would later tell me (he's very in the know, which is another way of saying he has style and class and I...well I have a vast array of flip flops and t-shirts that say stupid things like "Prose Before Hos"), and what I was about to find out, was "Are you kidding?!? That is like one of the most trendy and expensive places to eat!". We are all seated at this restaurant overlooking the ocean, and I crack open the menu. I struggle between a few cheaper options before hearing the other people in my group go all out with expensive food, so I settle on the $35 salmon dish. I should add that it tasted damn good.

To top the eating experience off, one of my classmates looked at me and said, "Eli, you know I never noticed this before, but you have really pretty blue eyes." Aww shucks. Seriously, can this possibly get any better?

Yes it can. It was a delightful meal full of witty banter and overpriced food, but a spontaneous limo adventure to a fancy and trendy restaurant on its own does not make for rags to riches...it is missing the random celebrity sighting. Fear not, however, because as our meal was concluding, I was prompted to look over my shoulder at the table behind me. Who should be sitting there but none other than Pamela Anderson, her male companion, her two children, and her two massive (MASSIVE!) breasts.

I'm in heaven.

Tuesday, March 15, 2005

So You Want To Be A Pathologist

As our non-clinical curriculum winds down, many in our class have begun seriously considering what kind of doctor they want to be. For example, today there was a lunch time talk I attended that was geared towards enlightening us about the surgical speciality. Now, if you know me at all and know my chances of ever going into surgery, this proves two things: One, I will listen to absolutely anything if I have the chance to whore myself for free food; and two, when it comes down to it, I might as well keep an open mind about the specialties until I experience them more next year and have a better sense of what I am (or am not) getting myself into.

This is all well and good, but just after this momentary lapse of judgement where I reconsidered surgery, I entered a pathology lab that was run by varios pathology residents, who intended to teach us about some basic heart pathology with all sorts of gross cut out hearts. Hmm...pathology. To be honest, unlike just about every specialty I can think of, it occurred to me that I had never really considered that specialty at all. After all, the pay is decent and the lifestyle is more than reasonable (since you're often dealing with things that are already dead, there really isn't any concept of "emergency" or "stat!" in pathology). However, after enduring this lab session, I am convinced that I do not fit in with the social or psychological profile necessary to become a pathologist. What do I mean? Well let me list for you some of the character traits I've observed that appear to be requirements for the pathology specialty, and maybe you can see where I'm going with this (and maybe, just maybe, I've helped bring out the little pathologist in you):

1. Expulsions: No, I don't mean getting kicked out of school. Nor am I referring to peeing, deuce dropping, or any variation of the two. I am talking about the stuff that comes out of your mouth when you talk. Now we all spit accidentally here and there, and some more than others. Hell, I admit to having fired out a few (un)intentional spit balls now and then. But it appears that if you wish to become a pathologist, you must be able and willing to spit copious amounts of fluid out of your mouth with every word uttered. Like a machine gunner, you must mow down your students, drench them in a salty mess of loogey. How do I know this? After finishing the talk at one pathologist's station today, I literally had wet spots all over my face, my left arm, and I could notice a few water spots on my shirt. And this was after continuously moving my stool farther and farther away from the spit source. It's just awful.

2. Personal Hygiene: Do you like not taking showers? Do you like wearing clothes that expose your special areas? Well then maybe pathology is for you. I bring this trait up because of what was left down on one hapless pathologist today. Namely, his pants. Yes, as he hunched over his tray of hearts with his disheveled face fixated on the pathology items, his butt crack was so visible to passers by that the laughter was booming across the entire room. I almost felt sorry for the guy. Almost. We all have moments of butt-crackage (especially the ladies, with those lovely tight-fitting clothes), but I cannot believe it was possible that this young man did not feel an especially strong breeze blowing past his overexposed crack, leaving his actual conscious desire to expose his asscrack as the only remaining reason for why it was so out there in the first place. Seriously, what the hell is wrong with these people?

3. Place of Birth: You must not, I repeat, NOT, have been born in the United States if you want to become a successful pathologist in the United States (not that there's anything wrong with that - hell, given the current status of the American political climate, you might consider yourself lucky to be from somewhere else). How do I know this? Just about every one of the residents has some obscure foreign accent. No, no, not the sophisticated British accent or the temptuous French accent, we're talking incomprehensible Chinese, painfully boring and nails-on-chalkboard sounding [insert obscure Eastern European former Soviet-bloc nation]-ese, or straight up Pers-aaaaan "ehhhhhh". While this makes for an excruciatingly difficult-to-follow listening experience, it does provide moments of purely original unintentional lost in translation comedy. For example, Persian Pathologist #1 was discussing restrictive heart disease and the fibrotic hearts, which led to this gem of a statement:

"Now, ehhh, this specimeeeen here is ehhh like ehhh dried semen."

Excuse me? Yes, this actually happened. It was only a moment later when I realized he was trying to say "cement". This observation had me wondering, where do all the American-born pathologists go? I have no idea, but I am comforted with the thought that my equally neurotic Chinese/Soviet-bloc/Persian medical student counterpart is writing up something nasty about American pathololgists with horrific accents as I write this...and good for him! (OK, her.)

4. People: As in, do you like being around them? Pathology is one of the very few specialities, if not the only speciality, that has absolutely, positively ZERO patient contact (you gotta figure that even the radiologist talks to one now and then, right?). Beyond that, everything they deal with, whether it is a stained slide or a fixed organ, is absolutely, positively, 100% Grade A dead. If you like the prospect of never having the stuff you deal with talk back to you, then pathology may be for you. If this prospective specialty actually turns you on, perhaps you should seek some counseling. However, if you are also a Jewish female, I can play dead.

5. Style of Speech: Do you know how to carry on a conversation? Are you familiar with normal social cues regarding speech pauses? If so, then pathology is definitely not for you! No seriously, it's like someone took all those kids who went to speech class in elementary school, trained them in the wonders of pathology, and set them loose on unsuspecting medical students. We're talking everything from "So...umm...[this goes on for about 45 seconds of pure and unadulterated silence]...you have this lesion over here" to "HeythisistheischemiasectionI'mreallyexcitedtobeteaching youthisSothefirstthingis-woahwhatwasthatnoise? It'slikeI'mhearingthevoicesinmyheadorsomething I'mreallygladyouallheardthisotherwiseIdon'tknowwhatI'd-" (to fully appreciate the latter example, which is an almost verbatim transcription of what one resident actually said today, read it again except this time go 20 times faster than you normally would. OK then read it 100 times faster than that. OK then just imagine it being faster, and that pretty much mimics what the speed of this one guy's speech).

Anyways, this is just the beginning, based on one 2-hour pathology lab I had this afternoon, and I am sure I am leaving out many other traits that might help you decide if pathology is for you. Me, though, I'm going to have to find something else. Why, you ask? Well, as shocking as it may sound, I actually like people. Well, some people. So I will continue to search for the speciality that is right for me, and I wish you future pathologists all the best. And maybe hope that the future will bring you some better fitting pants.

Saturday, March 12, 2005

A (New) New Low

While in the process of wetting my pants after having seen the Star Wars: Revenge of the Sith trailor premeire at the end of The OC last Thursday, it occurred to me that I am quite possibly the biggest nerd of all time. While changing my pants, I looked down and noticed the gift two of my closest friends got for my birthday: the DVD collection of the first three Harry Potter movies, which I greatly appreciated especially in light of the news of the newest book that was coming out (and frankly, it says enough about me that my close friends would even think to get this in the first place). When you add in all the academics, med school, etc., it makes for quite a resume of dorkitude.

Anyways, while looking over this utterly riveting lecture on community acquired pneumonia, I decided to procrastinate and came across this website that promised to tell me the answer to the question I have long struggled with: What OC character am I? Without further ado, I give you the results:

You scored as Seth. You are amiable and insecure and are too willing to sacrifice yourself to make friends. Pursue your interests more to gain mastery over them and confidence in life. The more progress you make, the more your weaknesses and insecurities will fade.



























Now, you may be thinking, "Wow he most closely matched with Seth? What a fucking loser." And you'd be right, but not for the right reason. A closer look at the results indicate that, of the top 5 people I matched with, four were women (two of whom are incredibly stupid, catty, and bitchy) and Seth...well, he's the biggest pussy of them all.

So it's official. I have now reached a new low. Back to the studying...