ndab Ah Yes, Medical School: April 2005

Thursday, April 28, 2005

Tales From The Crypt II: Bat Out of Hell

First year anatomy was many things. Painful. Long. Filled with a stench worse than death. Riddled with awkwardness, difficulty, and confusion. Did I mention the thing about the smell? But anatomy lab was never complete without the helpful guidance of our instructors, who consistently went the extra mile to make us realize how little we actually knew. Granted, most of them were nice about it, but it still didn't help with the self-esteem (seriously folks, years-worth of psychoses are being poured into this website). However, right about when our school was uncovering a massive body-snatching and body-selling scandal that would serve as an international embarassment, they decided that the anatomy department needed an image change.

To help with that change, they hired a new instructor to teach us for the second half of the year and to reshape the attitude of the department. Whom did the administrators choose? A gangly-looking young white guy with brown hair down to his hips, a slightly pudgy white face and a slightly protruding abdomen. He quickly became known for walking around campus in tight rocker pants (often laden with dragon-shaped images down the legs) and old 70's shirts he possibly stole from the homeless guys that hang around the school. Sound familiar? In a word, he was...no, he is...Meat Loaf*. To this day I have no idea what his real name is - I just started calling him Meat Loaf and it stuck.

Meat Loaf quickly engrained himself into the medical student community by shamelessly hitting on every single female medical student that graced the anatomy lab, and also by telling us stories about his stripper girlfriends. No joke. However, this alone would not have made him stand out in the crowd of awkward anatomy instructors. One day we learned that this Meatloaf, unlike the actual rocker with whom he bears such a striking resemblence, would do anything for love...AND that.

What's that? Let me explain.

One day in lab I was following my usual routine of pretending like I was doing something while waiting to snag one of the good anatomy instructors to our table so he/she could tell us what we needed to know. I had my scalpel in hand, poking around at stuff, just killing time and making jokes with my lab partners (as an aside, our lab group was so cool that other people started bailing on their more hardcore groups, riddled with future surgeons/gunners, to join our table, otherwise known as Future Family Medicine Doctors of America). This when on for a little while, until I got an urgent tap on the shoulder from one of my friends.

"Holy shit, turn around!"

I turned around and focused on one of the tables behind me, only to find Meat Loaf, scalpel in hand and firmly positioned on one side of that table, slowly raising his left leg up onto the table, over the cadaver's two legs, and then thrusting his entire body literally on top of the naked female cadaver, which I should add by this point was completely cut open, intestines, stomach, liver, lungs, and heart all out there in a pile of organs for everyone to see.

Yes, ladies and gentlemen, Meat Loaf had officially mounted a cadaver.

Somewhere in God's list of rules, perhaps nestled between "Do not kill" and "If other options exist, do not choose the urinal next to a currently occupied urinal", there has to be something that says "Under no circumstances do you ever, EVER, get on top of a dead body in any way that even faintly resembles a sexual act."

By this point, the entire room, 40 medical students plus 5 instructors, had all stopped what we were doing and were staring in sheer horror. Every mouth was gaped wide open. What the hell was this guy doing? Did he not get the memo that the last thing our school needed was another scandal involving cadavers, only this time instead of stealing parts of their bodies, it'd be about stealing their post-mortem virginity? To make things worse, he actually made a few thrusting movements, further positioning himself on top of her.

It turns out that he was actually just trying to make a learning point about something on the other side of the cadaver, but instead of doing what any normal person would do and walk around the table, he decided to lunge himself over it. The moral of this story? Don't do that.


*If you would like to learn more about the real Meat Loaf, I highly recommend the VH1 film about his life, with Meat Loaf brilliantly portrayed by the guy that played the retarded brother from There's Something About Mary.

Tuesday, April 26, 2005

Tales From the Crypt (And By Crypt I Mean Medical School)

In order to maintain some sense of sanity in the midst of hardcore USMLE studying, I thought it'd be nice to take a break every now and then to write down some of the classic stories from my first two years that, for whatever reason, did not yet make it onto this blog - not because they weren't quality material (and, lets face it, if they actually were quality it might preclude them from being here in the first place), but more likely because I was probably too lazy to get around to writing them up in the first place. I will be writing these true stories (vignettes, for your USMLEers) for your enjoyment and, more importantly, for my own personal records, because for every new disease I memorize a part of my memory and soul disappears. So without further ado, I give you the first tale:


In January of our second year, we were taught the basics of the female gential exam, the "pelvic", with the expectation that we would perform said exam on models who get handsomely paid for each poke. To my absolute amazement, nothing funny happened while I was doing my pelvic. Not one damn thing. And I was even assigned to the group with the now 19-year-old in our class who, until he says otherwise, hasn't even made it past the hand holding stages (I kid because I care, David). Truly shocking.

However, if there's one thing I learned in medical school (and as I start reviewing for the boards, I haven't learned much else), it's that when there's even the slightest bit of opportunity for awkwardness, embarrassment, or humiliation, someone among the freakshows in my class will step up and seize the opportunity to do something outrageously terrible, even if it's not quite when I'd normally expect it.

Fast forward to the next day, and I'm looking at gir...err...people watc...umm...studying at the Starbucks near school (as an aside, and to satisfy my required "I'm lonely and available" message for each blog: if you are an nice Jewish female and you see someone passed out at one of the tables who faintly resembles a miserable but dashingly attractive medical student with brown hair, blue eyes, and a First Aid for the USMLE Step 1 book under his drooling mouth, please wake him up. And give him your number). It's getting late and darker outside when one of my classmates strolls in. He was decked out in his white coat, so I knew he had just come from his pelvic exam - we were required to dress professionally to remind these women that yes, we were fake doctors. While I don't want to give out his name, I will mention that he is endearingly referred in my circle of friends as the FCMA - former coolest man alive. Why? Well, I'll let you use your imagination for now and maybe I'll write up another blurb about the origins of that name later.

The FCMA approaches me as he pimp-walks (not sure how else to describe it) his way through the Starbucks crowd, a smile beaming across his face.

FCMA: "Hey dawg...how's it going?"
Me: "Good man, how about you?"
FCMA: "Great. I just came back from my pelvic exam. Awwwww maaaaaan!"
Me: "Ha! Was she cute?" (As if that matters. It's a freaking pelvic exam, not a hot second date. Although, as was so gracefully pointed out in my surprise birthday party evite a while back, it's about as close to a second date as I've gotten with anyone.)
FCMA: "No man..."
Me: "Ah wel-"
FCMA: "...but she was tight."
Me (incredulously): "What do you mean?"
FCMA: "Here man, let me show you. Stick out your finger."

I think for a moment, then stick my right pointer finger out. He opens up one of his large hands and wraps it fully around my finger. Then he starts squeezing. And squeezing. And squeezing, to the point where I was losing feeling in my finger.

FCMA: "Tight."

The moral of this story? Christ, I don't have the slightest fucking clue, I mean I can't even look at my pointer finger anymore without thinking of how the FCMA violated it. But if there's enough interest in "Medical School. It's tight." t-shirts (you can express your interest and make fun of me at the same time by posting a comment), maybe I'll try to whip something up for all my adoring fans.

Saturday, April 23, 2005

The Future of Medicine

Before you think this is going to be some self-rightous piece about health care policy or the Medicare crisis, take a moment to consider that most of what I write here involves some combination of me telling stories about sticking my finger up other peoples asses and embarrassing myself as much as possible. Instead, this is going to be about what is in store for me in the future during my third year of medical school. After two years of developing my sitting-uncomfortably-in-lecture skills, I will soon transition to the world of, dare I say it, real hospitals. With real patients. Shocking. (For those of you who don't know, the third year of medical school consists of rotations through many of the more common fields like surgery, pediatrics, and internal medicine, with the intent of introducing the medical student to the different options that he or she has to choose from for a career while being taught by experts and elder statesmen/women in the respective fields. In other words, it's a chance to be screamed at, humiliated, and have any ounce of self-respect squeezed out of the withering teat that is your soul by actual doctors for an entire year.)

Needless to say, I'm really excited. All sarcasm aside (for once), I am actually (kind of) excited. For one thing, I won't have to be around the stunning array of freakshows that is my class and instructors because I will see, at most, one other student with me on rotations at the many different hopsitals at which I will be making a fool of myself. This means goodbye to visa, frenchie, question girl, waste of space, FCMA, Mr. and Mrs. Stinky, the tool, anonymous Asian female, and all the other colorful characters. Also, this means I might actually spend my time actually doing something and maybe, just maybe, even learning medicine, which may come as a shock to those of you who were under the perception that I've been in medical school for the last two years or so. Lastly, upon receiving my rotations schedule this week, I am excited about how the year will play out. Why, you ask? This might be a little complicated to explain, so I thought I'd create a little key (legend? Is that the right word? I mean like the thing on those maps that help label different parts - Christ, one week of boards studying and I've already lost the part of my brain that stored 2nd grade) that can be applied to the rotations, and I'll let you, the reader, figure out why the schedule is so appealing to me.


Rotation Key:

Fucked - If a rotation received this label, this means it will involve a maximum amount of being screamed at and a minimum amount of sleep. While the potential for unintentional comedy will be through the roof (just imagine the laughs when, after going on no sleep for two days, I fall asleep face first into someone's opened up abdomen - hah! OK maybe not so funny.), the potential for actually being responsible for seriously hurting or killing somebody directly as a result of my own incompetence will also be at a maximum. If I'm on a rotation with this label, there is a 75% chance you will find me on the floor of a hosptial somewhere, curled up in the fetal position, crying for mommy. And not just because I do that every Thursday anyways.

Focused - If a rotation received this label, this means I might actually be considering this specialty for the future. This leads to a few consequences:
  • I have to do everything possible to cover up my gross incompetence.
  • Since it is something I am seriuosly considering, it must inherently mean that there is at least some acceptable level of sleep involved.
  • I find the field at least marginally interesting, which will make the time go by faster.
  • Seriously, I have to do everything possible to cover up my gross incompetence.
Given this, a rotation with this label probably implies that while I won't be on the verge of dying from sleep deprivation, I will still have to be busting my ass. But who knows, maybe I'll actually enjoy what I'm doing?

Ah, Fuck It - If a rotation received this label, this means that a) I could care less about it because I have no intentions of ever going into this field (part of me wants to make a note of this so, when I do choose one of these fields next year, I can have a good laugh at my own expense) and b) they are very chill rotations, literally having the potential for check in at 8am, check out at 11am work days - this means that while on one of these rotations, I will have ample time to go to a baseball game at night (hell, maybe even a day game) or romance a lovely Jewish lady (for a few of you special readers, I would like to point out that I made it through two, yes TWO, posts without making any reference to either my depressing lonliness and/or any available Jewish women near me). In other words, if I'm one of these rotations, life is good. Or as good as it can be for a third year medical student.


Rotation Schedule:

1. Surgery - 12 weeks, July-September - Fucked.
2. Ob/Gyn - 6 weeks - October-November - Fucked.
3. Pediatrics - 6 weeks - November-December - Focused.
4. Inpatient Internal Medicine - 8 weeks - January-March - Focused.
5. Ambulatory Internal Medicine - 4 weeks - March - Focused/Ah Fuck It.
6. Family Medicine - 4 weeks - April-May - Ah Fuck It.
7. Psychiatry - 5 weeks - May-June - Ah Fuck It. Times a million.
8. Neurology - 3 weeks - June-July - Ah Fuck It.


In other words, maybe next year is the year I invest in season tickets.

Saturday, April 16, 2005

Faking It

Medical school is many things. It can be humbling, which I am appreciating more and more as I try to cram the most obscure details about the most obscure diseases in my head for the USMLE board exam. It can be frustrating, which I am still appreciating as the wise curriculum folks are taking attendance for the current set of lectures and am being treated like I am twelve years old. It can be downright moronic, as evidenced by the simulator session we had to do this week that involved four clueless medical students being in charge of medical management for an acutely ill robot (RIP, Mr. Robot man).

But sometimes, medical school can transcend these pretty simple traits and become something so wholly unbelieveable, so amazingly ridiculous, that it reminds me why I am so privileged to be experiencing this torture in the first place. How, you ask? Let me explain.

As part of our two week integrated block, we were required to complete a practice OSCE exam (I have no idea what this stands for - Openly Stupid Clinical Exam? Only Schmucks Choose Eel? Odd Sluts Choke Ears? No clue.), which involves the medical student, three standardized patients (i.e. a random sampling of the wasteland of failed actors), and a camera recording our every moves. Yes, we had to "see" three different "patients", take focused histories of their "presenting situations", perform necessary physical exams, and attempt a diagnosis and/or formulate a plan for their "problems." All the while, we are being videotaped faking sympathy to patients who are faking illness, and trying our best not to fuck up all the physical exam skills we don't really know how to do in the first place. Needless to say, this has potential for disaster.

Interestingly, my initial run-through of this test did not yield anything too ridiculous to report. OK well nothing too bad. On two of the three patients I struggled mightly to get the leg rest thing to open up from under the patient's bed (one was completely stuck but the faint remnants of my manhood forced me to struggle with it for a minute before giving up, and the other gave so easily I pulled the entire leg rest off the bed before I could stop anything, which led to large clanging noises and laughter from the supposedly gravely ill actress - nice job staying in character, lady). I'm pretty sure I gave one patient the stunningly intelligent feedback of "cool beans" after learning she had no other complaints. I'm also sure that while taking a sexual history of one patient, I responded to his "oooh well it's been a while - too long!" with a "ya man I hear ya, me too." And I know I didn't know what I was doing for a lot of the physical exam stuff, but I figured I had gotten pretty good at faking that I knew what I was doing and just going through the motions, so no worries. But nothing completely and utterly horrible. Or so I thought.

Today we received the videotape of our OSCE, to be reviewed over the weekend and talked about in a session next week, as well as a feedback form from the actors themselves. Like I said, I wasn't really expecting much in the way of anything in the feedback. I quickly scanned the numerical data to make sure I wasn't completely incompetent. Check (surprised? Not as much as I was!). But then I noticed something...Yes, something in this report caught my eye. It seemed like one of the actresses, who I vaguely recalled as being the young but not especially attractive woman with "chest pain" (the same woman who had a good laugh at my attempts to provide her with some leg comfort), actually wrote something in my comments section. What follows is, verbatim, her critique of my skills:

"I felt awkward when the student was listening to my lungs on my chest; each time I took a breath he rolled his eyes as he closed them and tentaively did the physical exam."

Excuse me?

Did she just write something about breathing and rolling eyes back? Was she implying that, with her chest exposed (bra on), I was becoming aroused while I poked my stethescope all over said chest - the rolling of the eyes a sign of something more? That I was having all sorts of kinky and dirty thoughts? That I was preparing to show her my 'O' face? That all I wanted to do was thrust myself ontop of her and do the Shasty McNasty (bringing back a classic!), videotapes be damned?

As pointed out by an astutely observant friend of mine, she might as well have just written "As he did the physical exam, I couldn't help but wonder whether his massive boner would bar him from getting close enough to take my blood pressure, and whether he would have to leave the room partway through the interview after having some sort of 'accident' involving his pants and his dirty imagination."

The irony behind it all was that I was actually trying to do my "I'm intensely focused on the task at hand and I am 110% committed to hearing every ounce of noise that emanated from her lungs with the hope of making the appropriate medical diagnosis" face. As it turns out, this face is the same as my "Ms. Portman is waiting for me, naked save for some body parts covered in whipped cream" face. Needless to say, this is probably something I need to fix. The lesson behind all this? When you're faking it, be sure you know what it is you are faking.

Friday, April 08, 2005

Lost In Translation

I'm sitting here on a Friday afternoon, still recovering from a hangover courtesy of the last lecture-based final I will ever take in my lifetime and the copious amounts of drinking that ensued (which apparently took a greater toll on me than I had expected). Perhaps the headache, with the pain in my left ear due to an infection making a nice contribution to my overall malaise (excuse me while I note a new record for SAT words in a single post - two!), has sucked all the creativity I have to write another entry into this fantastic journey of fun called medical school. Or perhaps I'm really tired and lazy. Or perhaps a few so-called friends of mine made a posting on the medical school fantasy baseball league that I am in (my team name = The Hebrew Nationals - it works on so many levels) completely and uterly mocking me and this collection of neurotic Jewish whining known as Ah Yes, Medical School and I've lost all will to live.

Any way you slice it, I just am too tired to come up with anything. But fear not, because while I was studying (and by studying I mean a continous cycle of reading a sentence from the notes, refreshing espn.com, checking the lineup on HBO, and seeing if there was anyone online to talk to), I managed to make a small collection of some of the ridiculous, retarded, and/or raunchy things people have said over the last block, and I am sharing the best of them with you:

“Interestingly, it’s good to be a woman. I don’t know why.” - Lecturer, regarding lung transplants. Duh.

"Before you stick it in, have a plan to take it out." - Lecturer, regarding ventilators.

“What do you mean by this?” – Classmate, in response to a slide that listed an obviously incomprehensible treatment option for kidney stones, “Dietary protein restriction”.

“[Quick hand raise] Question! [pause]. Umm…I have a question, but I don’t even know what to ask.” Same classmate as the previous quote, during a lecture on acute acid-base management.

“[Quick hand raise] Question! [pause]. Umm…I have a question, but I don’t even know what to ask.” Again, same classmate as before, next day, EKG lab.

“First thing you do is go bedside and tap this guy.” – Lecturer, obviously talking about pleural effusions and the lung.

“When are you going to tap that?” – Same lecturer.
“When there’s an infection?” – Different classmate, who is drawing upon her experiences as a prostitute in Thailand.
“No.” – Lecturer.

“Only tap it when it’s wet.” – Same lecturer. Peace!