ndab Ah Yes, Medical School: June 2005

Thursday, June 30, 2005

Well Played

Last summer I had the opportunity to not only deliver a baby (incredible experience), but also perform an episiotomy. For the non-medical folk out there, an episiotomy is when the doctor makes a straight cut extending out from the woman's vagina in order to provide further space for the baby's head to emerge out of the vaginal canal, and to avoid uncontrolled tearing of the vaginal and perineal wall (which can lead to excessive scarring, disfigurement, and potentially infection). In other words, I done cut da pussy.

Anyways, I also had the chance to suture up the incision I had made. Rather than go into further details of this experience (which, again, was incredible - but this website is more mockery than medicine), I have provided it for you as backstory leading up to the following conversation I had with a couple of friends during lunch today, right before I was to enter a suturing workshop:

Friend 1: ...so ya the suturing thing was tough at first, but it was really interesting.
Me: You know, I did sew up a woman's vagina once.
Friend 2: While most guys try to enter the vagina, you spend your time sewing it shut. Nice job.
Me (humiliated that I set myself up for something like that): Story of my life.

Just thought I'd share. Something more involved in the next few days.

Monday, June 27, 2005

Oh, The Places You'll Go

After spending two years in the same place, for the same amount of time, with the same amount of people, in the same place (did I mention we were stuck in the same place?), I began to notice that something interesting developed in our lecture room. What was once a sickening collection of rundown seats and broken desks became…a sickening collection of rundown students and broken dreams. Coinciding with the twenty minutes I just spent futzing with Photoshop, it also became a fascinating lesson in geography. Much like in real life, your location determined who you were, who you spent time with, and whom you talked shit about behind their backs. In order to chart this territory for my own personal memory, and to give you an idea of the rough terrain associated with a typical medical school lecture hall, I have provided the map with an appropriate key. Explore. Discover. Apply to a different professional school. But, most importantly…actually, maybe you should consider business school. I hear they have nice mixers.

The Map of D.O.O.M. (Dungeon Of Oratory Medicine)

1: Entry/Exit door – symbolic of the wretched decay of the building that houses the lecture hall, this door came with a built in creak that can be heard up until at least twenty minutes have passed in the first lecture, as people file in late or check out (very) early. Also, this door can be so difficult to push open, people unfamiliar with this terrain often fall into the trap of thinking that location 2, and not this location, is the actual door. Extreme unintentional comedy ensues.
2: Lecture storage closet – created to store the vast array of tools and supplies necessary to maintain a room with…umm…a bunch of chairs, this door also serves as a place for people to enter when desiring to make out with that special someone during class, and/or when desiring to make a complete and utter ass out of oneself (see extreme unintentional comedy).
3: Computer Zone - Do you like to click incessantly on your computer, furiously transcribing every single word that comes out of the lecturers mouth and thoroughly annoying the crap out of everyone in the entire class? Do you not mind that lecturers publicly ridicule you for trying to write down every word of what they say, as even they recognize that half of what they are saying isn’t of the slightest bit of importance? If you answered yes to either one of these questions, then you belong here.
4: Computer Zone, Stinky Province - If you answered “yes” to both questions from location 3, and you also enjoy spending time in lecture eating the slimy, smelly crap you call a lunch but everyone else thinks is more vomit-inducing than Tom and Katie, then you belong here. And congrats, your new name is Mrs. Stinky.
5: Welcome to Little Utah, home of aging Mormons who like to berate and shush at anyone and anything that makes a peep of noise during lecture. You’d think the satisfaction of knowing that the rest of us are going to be spending eternity burning in hell would be enough, but you’d be wrong.
6: The Jew Crew – this region consists of four Jews, three Indians, and the feistiest African-American girl you’ll ever meet (I love you, Trish). This is also the famed location of a six-foot-tall, dark-haired, blue-eyed, dashing young Jewish medical student who bears a faint resemblance to Matthew Perry and who is not only single, but also is me.
7: Slackers Heaven - completely devoid of gunners (people who try so damn hard it pisses everyone off). Well, there is one nose-picking gunner who has infiltrated this section, but that’s another story. On any given day you’re likely to find an all-star lineup of people who can sleep through just about anything. Somebody give these guys a medal already.
8: Coolest Kids In School - where the coolest kids in class sit, where the best impromptu verbal smack-downs originate from, and where the best cat-calls can be heard from when any hot first year comes in to make an announcement. It therefore goes without saying that Whitey need not apply.
9: The Cursed Seat of Mr. Stinky. After his daily jog to class, Mr. Stinky, utterly drenched in sweat and dripping his salty bodily juices all over the seat cushion and desk, sits down here to enjoy lecture and make everyone around him uncomfortable and queasy. Not all is lost, however, because by observing the color change of his shirt (dark to light) as a result of the gallons of sweat evaporating into the musty lecture hall air, one can infer how much longer lecture will be going on. It just occurred to me that I have been breathing this air for two years. I think I’m going to be sick. Anyways, for a guy so devoted to his faith, you’d think he would remember the part that equated cleanliness with godliness. I guess he’s too busy trying to find that part banning gay marriage.
10: Authentic Trail of Sweat - This is the trail of sweat that Mr. Stinky leaves behind each and every day on his way to and from his seat (see location 9). The beads of sweat gracing the floor are actually visible on warm days. Now that’s a trail of tears! Zing! Is this thing on?
11: The Enchanted Forest – Named in honor of the female often found in this spot who received this name after the discovery that, at the age of 23 and currently studying medicine, she has not yet had a gynecologic exam and does not know what a speculum is. In other words, there are unconfirmed (pending a poor soul getting really really drunk) reports of undocumented species, exotic foliage, and even belligerent leprechauns roaming around in that forest. If you answer “yes” to any of the following questions, then perhaps you belong here, too. Do you ever find yourself raising your hand in class wanting to say something funny, only to find that no one else thinks what you are saying is even remotely funny? Do you ever find yourself raising your hand in class out of sheer indignation over something you found to be sexist, even when no one else in a ridiculously PC class read even a glimpse of sexism into the statement, thereby making a fool of yourself? Do you like sending dumb emails to the class list? Do you think people are following you? Does your name rhyme with “farta”? Welcome to your seat.
12: Seat reserved for boy geniuses. Whatever you do, don’t shop for clothes online during lecture when sitting behind this guy. Trust me.
13: Medical School Frat – where fart jokes, excessive wise-ass-ness, and blatant attempts to call attention to yourself pretending to fall asleep in the middle of lecture to show everyone that you are cool reside. Unless you are actually asleep, in which case, well played.
14: The Noah’s Bagels Crew – there is a saying that the only thing you can count on is death and taxes. I’d like to propose a third thing: Five minutes into lecture, I guarantee you that the door will open and the same three people will enter the lecture hall, noisily bumping there ways into the seats their devoted friend reserved from them while carrying massive bags from Noah’s Bagels. They will all proceed to eat bagel after bagel after bagel, fumbling while trying to spread their cream cheese and take notes at the same time. Apparently they didn’t get the memo that if you’re going to do that every day, you damn well better get enough for everyone. Assholes.
15: The Dreaded Front Row – don’t even think about taking a seat away from someone who has been sitting there for more than a year. These people are as protective of their seats as they are of whatever shred of dignity they have left. However, there are a couple of brave souls who have the balls to sit here and either fall asleep or blatantly open up the sports section of the newspaper one foot away from the lecturer. To that, I say well played. Weeeeeeell played.
16: Trusty and pointless table placed conveniently in front of the projector screen – where people put their audio recorders to tape lectures. The only thing worse than living through 97% of the lectures I heard over the course of two years of medical school is listening to them again. Which is apparently what a select few people do – listen to lectures over and over and over again. Maybe they have this crazy master plan to listen to two years worth of lectures straight while watching The Wizard of Oz, baked out of their minds and hoping to find the meaning of life. Maybe not. Either way, they’re assholes.
17: The Black Hole Vortex of Doom – also known as the location where Question Girl can be found most of the time. In this vortex, all concept of space, time, logic, intelligence, respect for time constraints on lecturers, ability to think more than one step ahead, and sheer decency are lost, ferociously devoured by the evil and disfigured creature that rules over this cruel dominion. Her two year reign of terror is over, but I still cannot understand how one person can ignore the pleas of just about every single person in our class and ask so many off-topic, disruptive, and irritating questions without any violent repercussions. There are rumors that those who plunge through this vortex are instantly crushed by a gravitational anomaly, but I’m pretty it’s just her ass.
18: Mature Interest Group – requirements for entry into this section include having a spouse and/or children, an interest in constant intellectual discourse on complex metaphysical topics, a taste for fine wine, and a general haughty nature. Other qualifications include being named Brandon (sorry Bizzle, it had to be done). If your name is Stacey, then you should be sitting in section 6, so please find your way there ASAP.
19: Oh the humanity! Shield your eyes from the horrors that sit in these seats. Unless you find yourself attracted to women who sound like Betty Boop but look more like Betty’s deformed aunt, Mertyl, or to pretentious East Coast men with curiously large and attractive breasts. In which case, approach with caution.
20: Anonymous Asian Female Section – do you ever feel like you blend into a crowd? That you’ve spent two years with the same group of people, but they either don’t know your name or consistently use the name of the person sitting next to you when addressing you? Then you and your Hello Kitty notepad belong here. The interesting thing is that I have spoken to two different people in two different medical school classes in different parts of the country, and they have independently described the exact same phenomenon. I smell a PhD thesis.
21: My artistic rendition of the hideous medical-related artwork plastered to the wall. Seriously, there are enough actual things about medicine that make me want to throw up, so these artistic depictions are really unnecessary. Furthermore, staring at said artwork for more than one year has still left me absolutely clueless as to what is actually being depicted, further bolstering my self esteem. Attempts to remove these works and put up a poster of Lindsay Lohan would be greatly appreciated.
22: Block Chairs Only – if you’re sitting here, that means you’ve truly made it as an academician, doctor, and medical scholar. You have masterfully choreographed a stunning array of stimulating and insightful lectures geared towards educating and enlightening medical students and giving them enou - hey…where are you going? Class isn’t ov - hey!
23: Track Marks – created over time by lecturers as they propel themselves out of the lecture hall with speeds not seen since the time I tried (but failed) to run away from the Creature of the Enchanted Forest at a medical school party last year. They are usually futile in their attempts to escape the hordes of medical students who flock to them at the end of class, and said lecturers must then field generally pointless questions for the next 30 to 45 minutes. I’d suggest getting better shoes or making clearer lectures to remedy this situation, but realistically that would not change anything because these freak medical students are more ferocious than those tigers on the Discovery channel when it comes to shit like this.
24: Lecturer’s podium and microphone equipment station – ever wonder where they came up with that noise for when the teacher talks in Peanuts? The magic happened here first. It’s amazing what happens when you combine the monotonous ramblings of an introverted pathology professor with publicly-funded audio-visual equipment that dates back to the discovery of cheese.
25: Exit, stage left – the mysterious abyss that block chairs run through when they just don’t want to be here anymore (see location 22). Surely, they are just so horrified by the classroom torture that they have spawned that they can no longer sit through it for another second. Well, that, or maybe Winona got caught stealing stuff again (obscure inside joke alert).

I hope you enjoyed the grand tour. For those of you interested in or about to begin your medical school career, I encourage you to stake out your spot in this vast landscape. However, if after reading enough of this you still want to go to medical school, might I also suggest some medication? Just a thought.

Friday, June 24, 2005

Tales From The Crypt VI: Yes, This Actually Happened*

In my final installment of TFTC before clinical rotations begin (crap crap crap crap), I would like to revisit a special time in my former life as a lecture-going medical student: the time I literally almost died trying to contain my laughter.

Sometime during the end of the first year of medical school, first year lecture halls are commonly filled with admitted students who want to revisit the school and get another glimpse at what they might be getting themselves into. It makes sense, after all – their first visit to the school was for their interview, which was likely very stressful and barred them from really getting a true feel for the school. One such individual, a petite Asian female, arrived uneventfully for one of our lectures at around this time, perhaps hoping to get a better sense of the freakshow that is my class.

She sat down somewhere in the middle of the lecture hall and probably would have gone unnoticed by me and the other six people who were awake in class. However, if that were the case, you would probably be pretty pissed off that I just took two minutes of your life away reading a totally pointless story.

Instead, she had the good wisdom to realize that, unlike the rest of us, she was not yet accountable for anything that the lecturer was talking about, and that maybe there were better ways to spend her last days of freedom before she started medical school (but I guess no one really knows what they have until it’s taken from them, so she was probably thinking “Wow this stuff is so interesting and exciting, I can’t wait!!!”…ah, to be young and naïve again...but I digress). Anyways, she gets up in the middle of the lecture to leave. Hey, looks like they finally accepted someone so smart she knows when to peace out of lecture!

Well, not so fast.

Our lecture hall is unique in that the entry/exit doors are in the front of the hall, so if you plan on coming in late or leaving early, you have to walk in or out in front of everyone (lecturer and block chairs, with their judging eyes, included). It is also unique in that this door is not only very difficult to push open, it also blends in very nicely with the wall. Our lecture hall is even more unique in that there is a door right next to the exit door that a) unlike the entry/exit door, actually looks like a door, and b) is very easy to open.

Revisiting our plucky young future medical student leaving class in front of everyone, she quickly approaches the exit door so as to not disturb the lecturer. Unfamiliar with the stiff nature of said door, she pushes rather hard (but apparently not hard enough) before determining that what she was pushing at was, in fact, not a door, glowing "Exit" signs be damned. Looking to her right, she notices the other door, opens it easily, walks into the darkness on the other side, and closes the door behind her. There is only one slight problem:

She just walked into a closet.

However, she didn’t just walk into a closet in front of 150 people, students and doctors alike, who would mark her for permanent humiliation should she ever cross their paths again for the rest of her career.

She stayed in the closet for the rest of class.

At first there were a few giggles from the people who noticed. Then word spread, and the laughter got a bit louder. And then, louder still. Whether out of sheer terror, embarrassment, or a complete lack of common sense, she remained in that supply closet for what must have felt like an eternity.

This raised an interesting question. What does one do in this situation? Laugh? Cry? Lau-ry? (Get it? Laugh and Cry, combined? Seriously could I be anymore brilliant?) Do you get up from your seat and open the door and show her the way out? Do you get up from your seat and walk into the closet with her? There is no protocol for something like this, because this kind of stuff is only supposed to happen on TV or in the movies. As for me, like I mentioned in the beginning, I had an urge to laugh larger than any in my entire life…but I held it in. Perhaps out of sympathy, perhaps out of respect, I kept it in as much as possible. Why? It is hard to explain the unspeakable bond that we share, but let me just say that after referring to myself as my sister’s “sister” (contrary to popular belief, I am actually a man) once in front of an entire camp filled with over 100 of my 8-year-old peers, and again as a 10-year-old on her Bat-Mitzvah tape (thus saving this moment of embarrassment for an eternity), I can only say that I’ve been there myself, and it just wouldn’t be right. As for her, I think someone eventually got her out of there, but I did not see her once in the past year so I think she decided to go somewhere else for medical school. Shocking, I know.

*I may have made reference to this story in past posts, but I felt like it was so good it was worth some elaboration. Apologies to any of you who feel cheated by a repeat story, but seriously, if you feel cheated, then you probably have bigger problems anyways.

Friday, June 17, 2005

Hmm...That Was Awkward

I'm not sure what it is about the white coat, but whenever I put it on and go to my preceptor (a doctor who lets first and second year medical students practice their skills), it somehow brings out the innermost thoughts, emotions, fears, and desires in the patients I see, who are suddenly willing to share all of these personal aspects of their lives with me, a complete stranger (amazingly attractive, yes, but still a complete stranger). If I were slightly less tired and massively more mature, I would probably wax philosophical on this topic and delve into the special nature of the white coat and how this is an incredible aspect of the profession I will one day, in theory, be entering. Instead, I'd like to take a detour and demonstrate that because of (or in spite of) this phenomenon of openness when a white coat is present, the white coat also brings out some of the most awkward conversations I have ever experienced. Case in point, my final preceptor visit this morning (what, you thought I was on vacation?). I was called in to see a LOL in NAD (little old lady in no apparent distress - see, I'm learning things...or at least remembering what I read in The House of God), who told the nurse she'd be willing to talk to a student. What follows is the beginning of my visit, as close to verbatim as I can remember:

Me: Hi Ms. ___, thank you for taking the time to speak with me.
LOL: Oh no problem...
Me: O.K., so how ar-
LOL: Actually I don't normally bother with students, but there was a special reason I wanted to talk to you.
Me: Uhh...OK...
LOL: Ya, so I'm getting on in years and I guess I don't have much time left.
Me: [About to launch into a "You're doing great!" pep talk]
LOL: But anyways, I donated my body to your anatomy department and I wanted to meet one of you medical students while I was still alive.
Me: [mouth gaping]
LOL: Ya, I wanted to meet one of you while I was still alive and before you all cut me open and poked at my body when I'm a corpse. [Points to her noticeably frail and wrinkled body] My husband signed up for it too. So remember there was a nice old lady once before you all cut me up.

I mean seriously, what the hell am I supposed to say to that?

On an awkward scale of 1-10, with 1 being the least awkward (a typical blind date) and 10 being the most awkward (a blind date with me), I'd have to put this at least at a 6 or 7, if only because it was almost necessary to spend the entire first year of medical school forgetting that cadavers were once human beings, much less human beings that talked and that I'd ever meet, in order to do what we had to do to them. Basically, as she said this, I had images of my cadaver opening his eyes and trying to have a conversation about politics while my scalpal was slicing open his left testicle. I realize this sounds really awful, but I guess this is something you can only understand after spending a year cutting open a cadaver.

Since I am no expert at these things anyways, perhaps you'd like to fill in what you would have said in response to the LOL if you were me, and make a note of this in the comments section.

Monday, June 13, 2005

USMLE Step 1: The Tale of the Tape

Rather than go on and on (and on - lets face it, I have a wee bit of a whining problem) about how miserable I've been the last six weeks, I thought I'd just show you a collection of numbers and facts that I have not embellished at all (no seriously, I'm not joking) and let you come to your own conclusions:

Number of days spent studying: 46
Approximate number of hours per day: 9
Approximate percentage of those hours staring at the amazingly hot women that freqent the Starbucks I studied at: 23%
Percentage of time they stared back: 0.7%
Percentage of time the homeless regulars would stare at me: 3%
Weeks I pushed my test back out of a sheer and utter fear of not knowing anything: 1
Times I said "Kill me now" to myself or someone I know: 322
Times I sung the phrase "Kill me now" to myself, to the tune of some atrocious 80s song (the name of which escapes me at the moment - it has this whiny voice singing "Hooooooold me now..."): 52
Days spent studying at Starbucks: 34
Days I got so confused and tired after studying at Starbucks for so long that I had trouble finding my way home: 3
Times I overheard someone at Starbucks pointing at me, laughing, and saying something about "...that medical student is here all the time..." to her friends: 1
Days spent at Starbucks with my "Medicine" sweatshirt on: 27
Days I hoped some hot undergrad female would notice me with my medical school paraphenalia and hit on me: 27
Days that actually happened: 0
Times I read First Aid for the USMLE Step 1, cover to cover: 3
Times I read BRS Pathology, cover to cover: 2
Total number of medical books I made reference to during the course of my studying: 22
Total number of bags under my eyes by test day: 4
Total number of practice questions completed and reviewed: 3,865
Overall percent correct on Kaplan Qbank (out of 2,115 questions): 69% (which actually isn't that bad)
Times I thought to myself, "well at least something in my life is revolving around the number '69' ": 2
Practice questions that began with something like "21 year old sexually active female, who has had multiple partners over the past six months, presents with...": ~50
Times I caught myself "daydreaming" about these fictional sexually active females: 3
Times I felt ashamed of myself for these daydreams: 2
Leaks in my apartment building that required someone to punch a 2-foot-wide hole in the ceiling of my bedroom: 2
Days there was a gaping hole in the ceiling of my bedroom: 5
Days I had to sleep on the floor in the den because of a carpet dryer blowing 24/7 in my bedroom: 2
Dreams I had about kidnapping my manager's tiny dog and torturing it until she got my ceiling patched up: 1
Dreams/Nightmares I had about various aspects of medicine and this exam: 5
Dreams I had about Natalie Portman: 46 (no day would be complete otherwise)
Number of minutes I left my apartment over the final five days preceeding the exam: 75
Total hours of this exam: 8 (including one hour of break)
Blocks in this exam: 7 (one hour each)
Questions per block: 50
Times the worker at Prometric (the company that coordinates the computerized exam) said "Looking at you makes me sad"to me on my test day: 1
Times I read an article in MensHealth.com about the “squeeze technique” and premature ejaculation (umm…just out of curiosity) in the months prior to this exam: 1
Questions I had on my exam (each exam is a randomly generated series of questions out of a pool of thousands, such that each person takes a different test) that made a specific reference to the "squeeze technique" and premature ejaculation: 1

I can honestly say that I have never even come close to working this hard over this long a period in my entire life. The odd thing is that the nature of this test is such that I have no idea if all that worked paid off. Still, it's pretty impressive if you ask me. But I guess you didn't. Anyways, that's not all. Through the course of studying, I came across some pretty random pieces of information that I thought I'd record here so you could impress your friends at the next cocktail party:

  • The nerve responsible for all of the sensation in the anal, penile, and vaginal region (the pudendal nerve) runs through something conveniently called Alcock's canal.
  • Excessive glue sniffing can lead to a potentially fatal non-gap metabolic acidosis.
  • A direct quote from my BRS Pathology textbook: "The degree of mental retardation appears to increase with the number of additional X chromosomes."
  • The origin of the phrase "going cold turkey" originated from experiences people had after sudden withdrawal from opiods (i.e. morphine), which lead to a massive case of the goosebumps that some observer thought resembled a cold turkey. Needless to say, the observer that came up with this probably got the shit kicked out of him by the people craving the drugs, likely leading to the origin of the phrase "let's kick the shit out of that guy".
  • Fornication = good. Formication (the feeling of bugs crawling over your body while in alcohol or cocaine withdrawal) = bad.
  • Telephone scatologia = making telephone calls to unsuspecting women and engaging them in conversations of a sexual nature.
  • Frotteurism = rubbing the penis against a clothed woman who is nonconsenting and not aware.
  • The rooting reflex is a reflex of newborns such that when you brush against a baby's cheek, he or she should turn to the stimulus in a "nipple seeking" fashion. Apparently this goes away in one year, but somehow I feel like a lot of guys (and some ladies) never got that memo.

So there you have it. With the conclusion of this exam came the conclusion of my life as a lecture-going student. Beginning in about two weeks, I will be on the wards, being a fake doctor 24/7 and actually being partially responsible for real patients. Excited? Yep. Scared shitless? Absolutely. Looking forward to a multitude of experiences to laugh about, mock, and record in the pages of this blog? As if there was any doubt.

Friday, June 10, 2005

It's Kinda Like That

Have you ever had to go to the bathroom so bad that it hurt? That you could feel the urge building up within you, but you had to hold it? That you could sense the firm wads of poo desperately trying to push their way out of you, only to be held back by your struggling sphincter? That you would give anything just to find a bathroom and let it all out? And when you do eventually go and get up to flush, you notice that there are a lot of colors, smells, and consistencies that probably shouldn't be there (and maybe a little corn)? Except you don't care because it just feels so good to be out of your system?

Finishing USMLE Step 1...it's kinda like that.

(Note: A more complete review of my Step 1 experience will be coming shortly)