The Banana Suit

I know, I know... I missed writing a blog last week. I should have never spoiled you the week before last with such a terrific blog. I got your hopes up last week and you woke up Monday morning disappointed. I'm sorry. But as you were too busy being disappointed, I was busy studying my butt off for Mini II on the Heme, Lymphatic, & Musculoskeletal Systems. It was 101 questions long with an allotted test time of 2 hours and 11 minutes. And believe me, every second was precious during that test. I don't know how some people do it, but I'm one that always takes up the entire amount of time to take a test. During Mini II, someone got up and turned in their test with 56 minutes remaining. I couldn't have even read the entire test in that amount of time, let alone have time to think about each question sensibly and pick the correct answer. Crazy.

It was interesting celebrating Halloween in Dominica this year....or should I put it, not celebrating Halloween in Dominica. The majority of people just pretended like it was any old random day, but every once in a while you would see someone dressed up. As you can probably guess, Halloween was just another Thursday night studying for me. I don't know if I have said this on my blog before, but "classroom studying" is, how should I put this, a strict activity. When you study in the classroom, you have to be quiet. And I mean really quiet! We are all here studying to become doctors, each with a ton of pressure and stress on us, so the last thing we want is people distracting others while they are trying to study. Occasionally a cell phone does go off or someone doesn't realize that their headphones aren't properly connected to their computer so we can hear them listening to the "Barbie Girl" song (mildly embarrassing for that person), but really, the only way you are supposed to communicate with one another within a classroom outside of lecture hours is by whispering. As you can imagine, Halloween was no exception and everyone in the classroom was being respectfully quiet. I can't remember what I was doing (I mean, I'm fairly certain I was studying), but what I do remember was faintly hearing... a song. And not just any song...I'm pretty sure it was Michael Jackson's "Thriller". It was! So I turned around....and what did I find??? Someone dressed in a banana suit, walking from one end of the classroom to the other, dancing, while holding a cell phone playing "Thriller". They didn't say a single word. Actually, nobody said anything. The banana just exited the classroom through a door on the opposite side and they were gone. Never to be seen again. At this point, everyone just kind of looked at each other with the look of "what did we just see". And then...the classroom erupted with laughter. I don't know who it was or why they did what they did, but the person in the banana suit provided me, and I'm fairly certain I can speak for others, a small relief of stress that was much needed. I'll never forget that.

A new block started on Wednesday: Cardiovascular & Respiratory. It's supposed to be a doozey. I hope that I'll have the time to keep you guys updated.

And I think it's mandatory that I leave you with this:

http://www.youtube.com/watch?v=ZEHsIcsjtdI

RCSA Clinic

Today I participated in a clinic just outside of Portsmouth and as part of an assignment I had to write a reflection on my experience. Instead of just rewriting everything in the form of a blog, I'll just share with you what I wrote about for my assignment:

"On Sunday, October 27^th, 2013, I participated in the RCSA Health Clinic that was held in Toucari, Dominica. I, along with approximately thirty other schoolmates, left early in the morning to set up for our clinic outside of St. John and St. Lewis Church. The clinic featured stations for HPI, blood pressure, blood glucose, height and weight, vision, as well as a station for heart and lung examination. After setting up, the entire group of Ross students attended mass with the local congregation. Afterwards, about 75 patrons of the church attended the clinic.

            Since this was the second community clinic that I have done during my time here at Ross, I came into this clinic with some preconceived ideas about how it was going to go. But much to my surprise, most of those assumptions were wrong. The first clinic that I attended at Ross was located in Dublanc, which featured a much larger population than Toucari. During the Dublanc clinic, I worked at the HPI station and remember being busy the entire three hours that the clinic was open. It didn’t provide me the opportunity to get to really talk to people and listen to their health concerns, but instead forced me to move quickly through the HPI and shuffle the patients along to the next station. I suppose this was due to the sheer amount of people waiting in the line for the clinic. On the other hand, the Toucari clinic was a much more relaxed atmosphere and I think it was mainly because there were less people waiting in line for our service. But less people wasn’t necessarily a bad thing; in fact, it gave me more of a chance to talk to each individual patient and elicit their concerns. For the Toucari clinic, I worked at the blood pressure station. Blood pressure is not something that I am completely 100% confident in doing, so that’s why I signed up to work at that station. As everyone always says, “practice makes perfect”, and practice is exactly what I needed.

            Besides practicing my skills of actually taking blood pressure, talking to patients and discussing their health lifestyles was a successful component of the clinic for me as well. I tried to ask the typical questions you normally do before taking blood pressure and it was interesting to me that I always received similar answers. For example: when I would ask, “Do you have a history of high blood pressure?”, most people would respond by saying something like, “Just barely” or “It’s just a little high”. As you probably already know, the majority of local people here in Dominica do have high blood pressure, which is a result of many factors including their diet, exercise habits, and culture. With that being the case, I was able to do a lot of counseling. I was able to tell many of my patients about what the blood pressure measurement actually means and how everyone has the tools to control it, mainly through diet and exercise. It’s one thing to measure a blood pressure and report a number, but it’s a totally different experience if you can analyze that number and give advice to others on how that number can change. I guess that was the biggest difference between the two clinics that I have participated in thus far. The first was more about completing the task and moving people along, whereas the second clinic centered around the idea of helping people change their lifestyle. The Toucari clinic was one of the first times in Dominica where I have felt more like a teacher than a student. And that was a good feeling.

            Overall, I think the clinic was very successful. It’s just astonishing to me to hear from local individuals that our student-driven health clinics are sometimes the only medical attention they receive all year. I find that a sad thing to hear. However, in their eyes, our student health clinics do mean the world to them and can influence their lives. One aspect of the RCSA health clinics that I find absolutely empowering is the fact that we attend mass with the local congregation. It’s one thing to put on a free health clinic for random people, but it’s a totally different experience when you worship, sing, laugh, and pray with those individuals. I think that aspect of the RCSA health clinic makes it all the more special. One thing that I won’t be able to forget about this community clinic experience was when the congregation made us Ross students stand and they began to sing to us. They sang a song that said, “We love you and we mean it from the bottom of our hearts.” I don’t think I’ve ever been more humbled in my life."

Until next week.

Soggy Shoes

As most of you faithful readers already know, there was no blog last week. Last Sunday, I was finishing up my studying on Block 1 material in preparation for Mini I, which took place last Monday. It's always a little difficult to write a blog the night before a big test, so unfortunately writing this blog takes a back seat to studying...I hope you can forgive me. With that being said, the test went well and the results showed off all the hard work that I put into it. Mini I was 157 questions long with an allotted testing time of 3 hours and 21 minutes. That doesn't seem too horrible, except for the fact that I had to take the test with soaking wet shoes.

So before every Mini, each student gets an email from the Testing Center saying when the test is, which students take the test where, and the breakdown of the number of questions per subject. This time, students with the last names A-L were assigned to take Mini I in the Annex. That's me. Now, I'm not sure if I've mentioned the Annex before, but it is the only classroom that is not on the main Ross campus. The Annex is about a block away; so to get there, you have to walk.

Long story short, as I was putting my backpack and other belongings into my locker (on the main campus) before the test, it began to downpour. So I quickly grabbed my two pencils & ID, along with my umbrella, and began the treacherous walk to the Annex. And to describe things even more precisely, when it downpours in Dominica, it never rains straight down. It rains sideways. So as you're walking down the street shielding yourself from the rain, you look more like a Spartan soldier going to war than a medical student going to take a Mini. And of course, an umbrella only covers so much of my body, so naturally my feet got soaked. Next, as you probably guessed, I was faced with a dilemma. To take the test with my wet shoes on OR take my shoes off? In other words, make myself comfortable with dry feet and risk my feet smelling awful when I take my shoes off OR just suck it up and wear the wet shoes? I ended up just wearing the shoes. One thing is for sure, once a Mini begins, you sort of forget about everything else around you...yes, even the fact that you are wearing wet shoes. And, as it turned out, wet shoes might even be my good luck charm. I might even try it for the next Mini!

The following day, Tuesday, marked the beginning of Block 2 - the Heme & Lymph & Musculoskeletal System module. It seems pretty crazy, but we are almost at the halfway point of 3rd Semester. Time sure does fly!

http://www.youtube.com/watch?v=Bm5HKlQ6nGM

Trying To Beat The Heat

Thus far, 3rd Semester has been pretty cool in terms of weather. Of course, it's usually somewhere in the 90's, but it hasn't been as humid compared to the last two semesters. As long as you can walk in the shade and stay inside the classrooms for the greater part of your day, the heat won't really affect you. Like I've said before, my apartment does have air-conditioning, but, proudly, I haven't even turned it on for the entire time that I have been on the island...for multiple reasons: (1) I barely spend any time in my room unless it's to sleep (2) it's kind of expensive and (3) I only have wooden planks and screens on my windows (I don't have actual glass), so I don't feel much like air-conditioning the outside world. But, for the most part, the fan gets the job done...until it doesn't. And when I say it doesn't...I mean my fan broke...again. It's always a nice surprise when you come home from a long day of studying only to find a palpable warmth in your room that, without a fan, you can't get rid of. I don't know what it is, either the poor quality of fans that they sell down here or some sort of corrosion to the electrical wire caused by the nearby saltwater, but nonetheless, it's an inconvenience. Luckily, I have nice enough friends to borrow me an extra fan until I have time to go to a store to buy another one.

The only other time that I really get overwhelmed by the heat is when we have to dress up for school activities, which is pretty much every Monday and Thursday this semester. This past Monday I had to dress up because I had my first community clinic! Three other classmates and I were assigned to make a visit to St. Joseph's Health Center in a town called St. Joseph's (Duh!!!) about 40 mins from Portsmouth. So basically, we showed up at 7:45 AM at our meeting spot, school officials ushered us into our respective transports, and some random Dominican driver drove us to our destination. When we got to the health center, we were greeted by the friendly nurse who gave is a tour of the facilities and a brief history of the area. Now, when I say "health center"...it's nothing like what we have back in the US. Not in the least bit. It's more like an entrance room (about 20 feet X 10 feet), one office room (about the same size), and one hospital room with two beds. That's it. The nurse told us that it was actually the largest "health center" on the West side of Dominica (not including the hospitals in Portsmouth or Roseau). Regardless of its size, it was functional and clearly sufficient to get the job done. At that time, us students were divided and assigned our own patients to interview. Yada yada yada. After our interviews, we then met with the local medical doctor at St. Joseph's and reviewed each of our cases. It was a really cool experience working with the local MD and seeing her own viewpoints and assessments of the patients that we saw. She also critiqued our interviewing techniques and gave us a lot of helpful advice, so all in all it was a worthwhile experience. After debriefing, we drove back to Portsmouth and went on with our day. Over the course of this semester I will do two community clinics. One down...one to go.

Third semesters now have one week left before our first test, Mini I. So I'm sure it will be a long week of studying and making sure that all of the information that we have learned thus far is cemented into our brains. We will just have to wait and see.

Anyway, that's it for me. I'm glad the Big Bang Theory is back on TV! (Sorry, I didn't mean to rhyme)(Ok maybe I did). Have a good week!

http://www.youtube.com/watch?v=lhTSfOZUNLo

Bugs & Drugs

If you needed a recap of the entire week that us Third Semesters have just gone through, you can read it in the title. That's really it. Like I have said before, Third & Fourth Semester are all about describing the processes in the body and our ways to adapt when things go wrong. And apparently, as we found out this week, those adaptive processes are initiated by a lot of viruses and bacteria (that we pretty much need to know everything about...size, shape, color, favorite foods, hobbies....ok maybe not all of that). But it is a lot of detail and takes a tremendous amount of memorization and time. On top of all of that, we had a huge list of drugs dropped into our lap this week all dealing with the autonomic nervous system. And since that pretty much involves the entire body, you can imagine how many effects and sides effects those drugs have with their administration. Ok, it's not all that bad! Even though it is a lot of work, it is still very interesting and I am just shocked every single day at how much I am learning.

Besides the schoolwork, nothing too much has changed. The basketball season started on Friday and team "Hoops! I Did It Again"  and I won our first game in our 3rd season together. It was a great game for us (not so much for the other team), but just the beginning to our quest to win that ever elusive championship. 

Subway is still Subway. 

I tried spinach and eggplant pizza the other day. I know a few of you reading this are probably shocked, since I would never have done that in a million years in the US because (1) I'm not that adventurous, (2) they probably don't have it in the US, and (3) US pizza restaurants never run out of EVERYTHING ELSE! All in all, it wasn't too bad. I might even have it again.

Tomorrow is my first community clinic where I will go with a small group of classmates to interview a few patients and maybe watch some procedures at a nearby health facility. It is Ross' way to get us, not only involved with actual patients, but working alongside actual MD's in a real health clinic. It should be really exciting!

Hasta luego

http://www.youtube.com/watch?v=Wo4GJ6YdDeY

Food Fight

Living in Dominica, for the lack of better words, has become a little repetitive. Whether I know what is going to happen the following day or not, I can most likely assume that it will include waking up, eating, going to class for four hours, eating, studying till dinner, eating, studying, working out, going home, and finally sleep. There isn't too much variation to that schedule. The only things that do change are the lectures that I attend, the material that I study, and the food that I eat. I know that I've said that I eat Subway for dinner every night, but lately, especially during the beginning of this semester, I've really tried to branch out. It's a little sad, but most people here can't wait to go eat because that means they get to take a break from studying.

Recently, a new/old restaurant opened up in the Picard area. I say new/old because it was an old restaurant called Tomatoes that has changed locations and opened up for this semester in a brand new building. It's actually quite impressive and comparable to something that you might see in the US. I've eaten there twice in the last two weeks and it's been really good food (mushroom & swiss burger; chicken caesar salad). I have also went to a restaurant called Pelligrinos a few times this semester and once again have nothing but good things to say about it. I guess that sometimes it's just nicer to have a real meal instead of plain old Subway.

However, it's not always bad to have Subway in your back pocket for a quick meal. They've really outdone themselves this semester with updating their merchandise. I'm not sure what Subway typically keeps in stock in the US these days, but down here they just upgraded their cookies; they now have "Raspberry Cheesecake" cookies! I never thought that anybody would ever need anything better than a good old fashion chocolate chip cookie. Oh well, surprisingly a lot of people get them.

Besides the new variation of foods and restaurants that I've tried this semester, everything else is same old same old. I feel like I'm becoming a creature of habit.

http://www.youtube.com/watch?v=0C3zgYW_FAM

M2S1, But Still Making Rookie Mistakes

I may be in the first semester (S1) of my second year of medical school (M2), but every once in a while I still make mistakes like I've never spent a day on this island. Whether it's walking all the way to the grocery store (that closes at 5 PM on Sunday) at 5:15 PM or leaving a box of frosted flakes semi-open, only to find it infested with ants when you return home, the island has the uncanny ability to make even the simplest things...difficult.

The other night, I finished studying early and went home. Perfect. Nothing better than getting more than six and half hours of sleep. But sometimes you're just too darn excited to sleep...at least this was my case. I was woken up by my phone ringing at 7:55 AM. It wasn't my alarm. It was one of my friends calling me to remind me that class started in 5 mins. Great! Just the way I wanted to start the morning after a refreshing night of sleep, by being behind a whole lecture and having to rush. It looks like I was too excited to sleep that I forgot to set my alarm. Stupid. So, instead I took my time to get ready and made it in time for my 9 o'clock class. Luckily, at Ross we have something called Mediasite where we can re-watch all of the lectures any time we want (each lecture is video recorded). I know this doesn't sound like a big deal, but if you know me at all...that stuff just doesn't typically happen. Im usually on top of things.

This week was filled with "firsts". Not only did I oversleep for the first time (which is strange since it seems that I'm always sleep-deprived), but another odd thing happened to me for the first time as well. I was taking a shower and washing my hair the other day. All of the sudden, a big black thing dropped onto the floor of the shower. I saw it out of the corner of my eye and sort of thought that it came out of my hair. But that's strange. My hair is blonde and I would have definitely noticed a big hunk of dark something in my hair. I got closer to look at it when it suddenly moved! It was a baby gecko in my shower! That's never happened before. And so the moral of the story is that I had a baby gecko running rampant around my room for two days until I finally caught it and set it free outside on my porch. Elusive little fellas!

It should be a short upcoming week with no classes on Monday (only a session on learning how to do a General Survey and a second session where I will do a Patient Interview) as well as classes Tuesday-Thursday. No classes Friday! Woohoo! Have a good week!

http://www.youtube.com/watch?v=SHhrZgojY1Q

Semester Tres

First and foremost, I'd like to welcome all of you back to my blog . As you probably could tell, the end of last semester was very hectic and stressful. After our Mini III, we had our CCSB final exam and then about a week later...our Semester 3 Final. But all of that, thankfully, is behind me and I am looking forward to Semester 3.

However, before I can talk about Semester 3, I get to talk about the two weeks that preceded the beginning of the new semester. Those two weeks consisted of flying back home (with a few bumps along the way), spending a few days helping my parents move to a new home, traveling to the Bahamas for a short period, and then spending the rest of break at home before flying back to Dominica. Flying back and forth from the US to Dominica is always an experience and every time that I have done it, it's been different. The first time flying to Dominica, I had to spend the night in San Juan. Then on the way back, I had to spend the night in Barbados. Flying home for this break, once again, I ran into problems. Typically when you book and pay for a direct flight, you get a direct flight (Dominica to San Juan). But if you book your flight with the notoriously bad Liat Airlines, they sometimes make unscheduled stops in Antigua. After landing in Antigua, our connecting flight from Antigua to San Juan was delayed making the next flight impossible to make. In other words, I had to purchase a new ticket from San Juan to Orlando and I wasn't reimbursed for anything. So mad.

Anyway, after finally making it home (a little later than I had expected), it was so nice just to lay in my own bed in an air-conditioned room. The things I realized on break that I missed the most about the US in comparison to living in Dominica are the following: home-cooked meals, air-conditioning, actual toilet paper (instead of this papier-mâché junk they give us down here), TV, driving, paved sidewalks/roads (I am not joking), and not eating Subway for every meal. Oh...and most importantly...my parents!

Well, the first few days being home were spent helping my parents move into a beautiful new home and move out of their old apartment. Since the last few weeks of Semester 2 were so hectic, I didn't really get much of a chance to workout as much as I had wanted to, but throughout those first few days of break that were spent moving...made up for the time I missed.

After being home for a while, I took a short hiatus down in the Bahamas to an island called Abaco. As you could imagine, the weather was beautiful, especially compared to what we have here in Dominica. For the most part, it was clear blue skies and over 90 degrees every day. Perfect for beach weather.
The pictures below show the playground that I had access to during my four day trip. Swimming, snorkeling, paddle-boarding, you name it.

During my time in Abaco, I tried my best to eat as much fresh seafood that I could get my hands on; lobster, grouper, mussels, clams, shrimp...oh and I guess I also had a 14 oz. steak at one point. Delicious. 

But after a much too short trip, it was back to Orlando for the rest of break. This time a little more restful and relaxing. I'm not sure if this was because there was less to do...or I got lazy. Probably a combination of both.

So for me, semester break flew by...much shorter than the break after first semester. And now I'm back "on island" after a long travel day (due to the same shenanigans that Liat Airlines always pulls). But I made it back with my luggage and I'm very motivated to start Semester 3 strong. 

Now, Semester 3 differs somewhat from the previous two semesters. At this point we have been through the entire human body in situations that we consider "normal". However, the next two semesters will be spent going over the exact same systems of the body, but focusing on situations that are "not normal". Semesters 3 and 4 are more clinically based. So, our first day is tomorrow. Fundamentals block. And...my blog is back. 

http://www.youtube.com/watch?v=pAgnJDJN4VA

Pathetic Blog

I know...I know...I missed last week and I'm about to pull off another weekend of not writing anything. I hope you can understand.

This week's schedule:
Monday - Micro Anatomy Practical & Gross Anatomy Practical
Tuesday - Mini III Reproductive & Integument Systems
Wednesday - Clinical Competencies & Skills Block Exam

That's a mouthful. As you can tell, I've been busy and about to get busier. In a way, you're lucky that I'm not writing a well thought out blog because if I did, it would mainly consist of me telling you how much I have been studying, which is no fun. Anyway, pray for me and enjoy your week.

http://www.youtube.com/watch?v=Z0GFRcFm-aY

Last Stretch

Finally, we are in the last stretch as Second Semesters. We survived (well, maybe not all of us...at least most of us...ok, most importantly I survived) what was supposedly the most difficult test that us medical students will take at Ross. After we took the Renal & Digestive System exam (Mini II) on Tuesday afternoon, we were so graciously given the night off from studying, only to have to start the last block the very next day. But taking the rest of that day and night off was just what my mind needed. I was so sick and tired of taking tests and studying that I decided to what? Partake in trivia night at DeChamps! That night I was able to enjoy a few refreshing beverages and hang out with friends for a little while, but had to quickly get back in the swing of things the next day for the start of the Reproductive & Integument module.

That's right. You heard me. We get to spend 2 and a 1/2 weeks studying one of the most uncomfortable topics concerning the human body. Splendid. But if there is one thing that I have learned so far...med school is not med school until you see your first mangled penis. Yea, I just said that too. You know that feeling when you see someone else hurt a part of their body, for example they break an arm, and then your own arm starts to hurt? Yep, I have been having that feeling a lot lately.

I guess I would be lying if I didn't say that I have been counting down the days until I go back to Florida. We are less than a month away from finishing Second Semester with only Mini III, a Micro Anatomy exam, a Gross Anatomy exam, a CCSB exam, and our Semester II Final standing in our way. Oh gosh, just writing that made me realize how much there is left! That equates to a lot of hours studying.

This upcoming week starts off quickly with lab tomorrow ("Male & Female External Genitalia"), 2 sessions of SGL, a Beginner's Suture Lab (put on by Surgery Club), and the usual...lectures everyday. It should provide for an eventful week. Anyway, that's all I have for today...

http://www.youtube.com/watch?v=fC_q9KPczAg

Another Big Test

Once again, a big test is upon us (I know, I say that every time). Mini II is on Tuesday (117 questions over the span of 2 hours and 30 mins). Heck, I've watched movies longer than that...it should be no problem. Anyway, it will test us on our knowledge of both the Digestive and Renal Systems. 

Despite the upcoming test, this week has been pretty uneventful. Oh, I guess we got a day off on Tuesday as Tropical Storm Chantal moved past us. Let me say this...it couldn't have been over-hyped any more. A little rain and some mild wind. That's all. But it was still able to manage to cause problems to Ross' communication systems and faculty email, which might not seem like a big deal, but it correlates to a lot of miscommunication between everyone on the island. However, most of those problems have been resolved and now we have carried on with our regular schedules.

Sorry to keep it short, but I gotta get back to studying. 

Can anyone guess the male actor in the following music video?

http://www.youtube.com/watch?v=xqmFxgEGKH0

Disaster Averted...For Now

I'm not sure if everyone is familiar with the theory of "Basic Needs", but it states that there are three main things that every person must have in order to survive. Food. Shelter. Clothing. That's it. And throughout the last two weeks, I thought I was going to lose out on one of them. Shelter? No. There haven't been any hurricanes down here yet, so thus far I still have my shelter. Clothing? Once again, no. I have plenty of clothing and multiple options for laundromats to keep my clothing clean, so that's not it. What does that leave us? Food. As most of you probably know, I am an avid fan of the Subway on campus. It's just a little taste of home and for the price, it's a pretty filling meal. I typically eat dinner there 6 out of 7 nights of the week. But over the last couple of weeks, I started to notice a trend. First it was the chocolate milk. They had it one night and the next night it was gone. Then went the chocolate chip cookies. Ooooh boy, you don't want to mess with my chocolate chip cookie cravings. When those began to disappear, I started to get a little peeved. So peeved, in fact, that I began to use the word peeved. Then it was tomatoes...followed by green peppers. You see where this is going. Then last Thursday, when I went to Subway for dinner, they were out of cookies, chocolate milk, bread, tomatoes, green peppers, yes I said bread, and the toaster for pizzas was broken. At that moment, I told myself that I had had enough and I walked out. A trusty establishment whose sole purpose is to serve delicious and nutritious subs to people couldn't even throw together a decent meal. Sad day.

So, I told myself that I would not go back there for a while. I couldn't face the disappointment of walking in there to find half the ingredients available to make a sandwich and still get charged full price. But then my prayers were answered! For some reason I was walking by the other day, probably because I was having Subway withdrawals, and I saw the cookie container stocked full of double chocolate, oatmeal raisin, macadamia nut, and chocolate chip cookies. Jackpot! All the ingredients to make every sub on the menu were available and I was back in business. So it was a quick scare...and that's all. Apparently, sometimes the shipment of supplies from the US can be a tad late, but it will eventually get there. And when it does, what a glorious day that is! Subway...eat fresh!

UPDATE: As I sit here writing this blog, a friend sends me a picture of the path of Tropical Storm Chantal, which appears to be heading straight towards Dominica. Now my Theory of Basic Needs seems very appropriate. Hopefully, it will provide some blog material this next week. And rain. We are in desperate need for rain (THIS COULDN'T BE ANY MORE SARCASTIC).

Big week coming up. Three and a half days of classes and one lab with a long weekend ahead of me, which will be spent studying for Mini II on the following Monday. Thanks for reading.

http://www.youtube.com/watch?v=QLHso6hLHFA

The Swirling Vortex

Sometimes you have things to say...and then sometimes you don't. This is the latter. This past week has been absolutely tortuous with all of the lecture "crap" that Ross has thrown at us (pun intended...we are studying the digestive tract). But in all seriousness, it has been really fast-paced and difficult material in addition to all of the outside-of-lecture activities that we have had to participate in.

One thing that has become really apparent to me over the past week is how mature all of us students, myself included, have become. What I am about to say is probably not at all what you think I am about to say. And let me preface this by saying that this might get awkward. Typically, the digestive system is something that most people like to keep private. It is usually a very uncomfortable topic for people to talk about. Heck, it took me the longest time to even surrender to the idea that girls poop! You know what convinced me on the topic? The informative novel entitled, "Everybody Poops". A great read and available in every Barnes & Noble kid's section. But here in medical school...anything goes. Studying both what goes in and comes out of the digestive system is equally important, and can actually reveal so much about a patient's symptoms/condition. One of the best diagnostic tools that we learned about this week that ANYBODY can use is something called The Bristol Stool Scale. Yep, you guessed it. It's a classification system for poop. And you may never admit it to anyone else, but we all "look", so you might as well rate it. Here's the scale. Enjoy!!!!

http://en.wikipedia.org/wiki/Bristol_stool_scale

Haha! Funny thing is...anyone that actually looks at it...will probably use it. But this is exactly what I'm talking about when it comes to maturity. If you were to show the Bristol Stool Scale in any undergraduate classroom in America, you would hear nothing but laughter, horrific screams, and yes...maybe even some poop jokes. But here at med school...surprisingly, we all look at it like something that will be useful in our later medical practice...and I hope that's something you can appreciate about doctors. When they say that doctors have pretty much seen everything...I can believe it. I've seen more naked "whatevers" and bloody "thingamabobs" in the last six months than you can possibly imagine. But it's all in the pursuit of learning and knowledge. So I guess my message is just that each and everyone of our states of health is very personal and sometimes embarrassing. But that's why you should choose a doctor that makes you feel comfortable (because they have already become sensitized to pretty much everything) and is worthy of your trust. Sometimes it is those really embarrassing or socially awkward symptoms (example:. Chronic Type 7 on the Bristol Stool Scale...you see what I did there...now you have to look at the scale) that could quite possibly save a person's life...so tell your doctors everything. Don't leave things out! They (and hopefully soon to be ME) are only there to help you. Happy early 4th of July everyone!

http://www.youtube.com/watch?v=zUtnwcv-quE

Working For The Weekend

I'm back and after a long...long week, I know I've got things to share, so sit down, buckle up, and enjoy the ride! We have now finished our First Block of Semester 2. Of course, we had to go through a Gross Anatomy Practical (last Monday) and our first Mini (last Wednesday) to get to this point, but here we are just chugging along. And if you're wondering, my bladder did not explode during the Mini. But, after a 3 hr and 41 min test, let's just say there was a line outside the bathroom. Typically, I drink about 20 ounces of water right when I wake up every morning, but on test day, I just can't do it. Too bad I had to learn from experience to figure that one out.

Well, enough about my bodily functions. After our two big tests, we started Block 2 on Thursday, Gastrointestinal/Renal Systems. From what I hear, this block should be pretty difficult. But we only had two days of lectures (that means less material than normal to go over on the weekend), so that provided a relaxing weekend. Hey, we ARE in medical school, but we need a break every once in a while! Originally I had planned to go on a hike with some friends. ROSS has a club called "The Excursion Club" that organizes and goes on adventures every weekend, so I had signed up for "The Seven Waterfalls" hike. Apparently, it is a pretty difficult hike that includes climbing over rocks and boulders, ascending/descending a mountain, crossing a few rivers, and yep...you guessed it, seeing seven waterfalls. You're so smart! It sounded like a lot of fun...but it didn't happen. The weather in Dominica during this time of year is very unpredictable. It will be clear blue skies out and then in an instant it will be pouring rain. Because of the heavy rains, the rivers up in the mountains become very dangerous and the mountain becomes difficult to climb. About midweek, I got an email saying that the excursion had been called off. Sadly, two locals died earlier this past week up in the mountains because they were swept away by a river. So yea...we decided not to go. Yes, it would be really cool to see some of the natural side of this island (instead of the inside of a classroom) at some point, but it wasn't worth risking my life. I'll just have to go next time when the conditions are better. So what was a disappointing cancelled-hike-day turned into a beautiful beach day! Not a bad tradeoff. Here are a few pictures I've taken lately:

Could you spot the crab in the first picture? Or the pelican in the last? The one great thing about living in Portsmouth is...you can never mess up a sunset picture. Well, that's pretty much all I got for you, since the beginning of the week was mostly spent studying for tests. This next week is a full slate of lectures and one lab, Supracolic Viscera. Should be fun.

P.S. Shout out to my Godson Charlie for learning how to crawl and stand during the last few weeks, while also enjoying his first time swinging and swimming! Way to go!

http://www.youtube.com/watch?v=9n5G0qFBsHM

The Big Week

Happy Father's Day!!! Too bad I'm not back in Florida "letting" my Dad beat me in golf today, but instead I've been stuck in a classroom studying all day long. No joke. All day. Regardless, I hope it was a good one. It's going to be a long week. For starters, Gross Anatomy Practical tomorrow on everything in the Head & Neck. And then the big kahuna...Mini 1 on Wednesday covering the first six weeks of classes: Neuro & Endocrine. 176 questions. 3 hours and 41 mins. Good luck bladder.

http://www.youtube.com/watch?v=ec0XKhAHR5I

Only In Dominica...

Well, it's been a long week, but I made it through. The Standard Patient session went great and it was a terrific experience working with a real-life patient (even if they were acting!). But they were really awesome and if you didn't previously know that they were faking their symptoms and injuries, you honestly would have no clue. As for me, I got so wrapped up into treating the SP session as if it was a real patient interview and physical examination (which we were supposed to do) that I totally forgot that the patient was just "portraying" certain symptoms.

Besides the SP session, last week was the same old stuff. We now have 5 weeks of lecture and lab material on our plates, and we still have one last week of lecture material on top of that until our first Mini in a week and a half. Hoofta! That's going to be a really long test, especially since it will cover approximately half of 2nd semester.

This upcoming week, like I already said, will be a full slate of lectures, a Simulation activity, and a hands-on Thyroid Palpitation lab. It should be fun.

So this past week has also brought up a couple of things that I feel like only happen in Dominica...and they both deal with dogs. (1) It must be that time of year when the stray dogs down here get a little frisky...and let me tell you, it can spoil your lunch. And (2) well...this little gem:

If you're wondering what the heck that is...that would be a dog carrying an iguana. Never seen that before! It was actually pretty funny. I was outside practicing taking someone's blood pressure when I overheard a few screams and some laughter, and all of the sudden...a dog turns the corner carrying this humongous iguana in its mouth! You might not be able to tell from the picture, but that iguana is longer than the dog. Crazy! Anyway...only in Dominica...

I know this song doesn't have the right reptile in it, but I can't think of any better song that goes with this post. Sorry for the sort of freaky video...enjoy!

http://www.youtube.com/watch?v=JmcA9LIIXWw

Time Keeps Flying By

Well, I hate to say it, but the last four weeks have flown by and its already June. With that being said, last Friday was the end of our Neuro block and tomorrow we start the Endocrine system. But there's never just an easy transition from one topic to the other. Of course, we had to have some sort of test that caused each and every one of us a lot of stress and angst, which came in the form of a Neuro Practical that we took on Friday. A measly 50 questions about anything and everything about the brain/spinal cord...and trust me, that's quite a lot of material. But I do have to admit that taking the Neuro Practical is a lot more interactive and fun than taking a regular written test; the Neuro Practical consists of 25 questions relating to stained brain/spinal cord samples and another 25 questions pertaining to wet brain/spinal cord specimens. It's only 16% of our final grade so...no pressure or anything.

Besides the Neuro Practical, we also had our first SGL (small group learning) session of the semester. As you know, this usually consists of a group (around 7-8 students) that gets together with a facilitator and discusses specific clinical cases that are relevant to our lecture material. But once again, things are different this time around in Second semester. Instead of clinical cases like last semester, we are reviewing scientific research papers and basically dissecting every tiny aspect about them (if you just fell asleep just thinking about that...try having to actually read one of them). Brutal is the only word to describe it.

Although the workload was pretty heavy this past week, the weekend did provide some opportunities to take our minds off studying...especially since the weather cleared up a little (but it still seems to rain at the most inopportune times...you'll soon find out why). So we were able to kick off the start of the intramural basketball season with our first game on Friday. We normally play two 20 minute halves...and with 3 minutes left to play in Friday's game (you probably guessed it), it started to rain. What that means is that we had to reschedule the entire game for a later date and start back at 0-0 (even though we were winning). Aaaarrrrgggghhh!!! I don't get it either. Oh well, as long its a chance to get outside and enjoy the fresh air, I'm happy. We then had a second game on Saturday, which was successfully completed and won.

One thing that I have learned being at Ross so far is that when it seems like things couldn't get any busier...they can. And this next week will a prime example of that. Besides lectures, I'll have lab, SGL, and a Standardized Patient (SP) session. The Standardized Patient program is a unique program that Ross provides to its students at a much earlier stage in our medical education in comparison to most US medical schools. It gives students an opportunity to interact with patients and gain vital experience taking medical histories/physical examinations with actual people (trained spouses of current students that display a certain range of symptoms and illnesses). It should look something like this...and yet...absolutely nothing like this:

https://www.youtube.com/watch?v=wLRlbsBJhio

Since I have not yet actually had my first SP session, I can't really tell you much more about it besides the fact that we have to take the history of present illness, past medical history, social history, family history, complete a general examination, physical examination, take the height, weight, pulse, blood pressure, visual acuity/eye exam, neurological examination, reflexes...amongst a few other things. No big deal...you get 45 minutes (plenty of time!). We shall see how it goes and hopefully I'll be able to share a few things about it next time (not too much though...remember that thing called doctor-patient confidentiality). Talk to you next week.

https://www.youtube.com/watch?v=MH6TJU0qWoY

Rain Rain Rain

Well it's that time of the week again and it's raining...like it has been for the past three days. No joke...it's been pouring for a long time. Long enough to prevent the kick-off to our intramural basketball season and keep us indoors studying all weekend long. This past week did bring a lot of new and exciting things, so if this post seems a little all over the place, forgive me. Our lectures throughout the week mainly covered the optical and acoustic systems, so once again we got to learn all about my favorite topic...the eyes.

On Friday, we had another hands-on lab, but this time it was for learning about the eye reflexes. We learned how to check if all of the external muscles of the eye were intact (by doing the follow-the-finger test...it's a lot more complicated than that), testing peripheral vision, looking for strabismus, nystagmus, pupillary light reflex (constriction and dilation), Argyll Robertson's pupil, Marcus Gunn pupil, and finally...we tested visual acuity. If you don't know what any of those are and would like to know, I'm sure Wikipedia and/or Youtube give great explanations...but for those of you that don't, I'll save you the boredom. One interesting thing that I was never aware of is that when you are a doctor, before measuring a patient's visual acuity, the proper thing to do is to make sure that they are comfortable with reading letters. I guess it's something that I always take for granted since I can read, but many people can't read. In those cases, different visual acuity charts exist that replace the letters with shapes or a single letter that faces different directions, ultimately allowing the doctor to get a more accurate result. Just because someone can't read, it doesn't mean that they can't see.

Another interesting thing that I learned this week (amongst hundreds of other things) was about the development of speech and language. So each one of us has an area in the brain called Broca's area, which is located in the inferior frontal gyrus of each cerebral hemisphere. This area is responsible for speech production. What I found so interesting was that this area of the brain matures around the ages 7-10. Prior to the age of 7-10, most of us learned how to speak a native language, whether it was English, Spanish, Chinese, whatever. Broca's area is where the knowledge and ability to speak that native language is stored. Now, every language that you learned after the maturation of Broca's area (after 7-10 years of age), they are stored in an area surrounding it. So, for example, in class we were presented with a case where a gentleman had a stroke in Broca's area. When he recovered, he no longer had the ability to speak his native language, but he could speak German...a language that he learned in his adult life. The funny thing about this is, if there is anything funny about it, was that none of his family members could speak German, so they had to hire a translator in order to understand what he was saying. Wow, the brain can do some complex, yet amazing things!

Before I call it a night, I just want to leave you guys with a video (not my typical music video), but one that has been floating around on the internet for the past week. If you have not seen it already, I hope that you enjoy it and that it provides a little perspective in your life. We have so much to be thankful for...so make sure you let those around you know. Grab a Kleenex.

http://www.youtube.com/watch?v=9NjKgV65fpo

The Doctor Reflex

Hi everyone! I am happy to say that right now I am enjoying the third day of a four-day weekend (we don't get to celebrate American holidays, but we do get to celebrate Dominican ones like the one on this upcoming Monday). So with a little extra time on my hands, I've been able to master all of the material that we have covered thus far this semester (it's not that impressive because it's only been two weeks) and be able to reflect on this past week's events and share them with you.

Besides the typical schedule of lectures and excessive studying, the last few days did present two unique experiences that I would like to write about: anatomy lab and reflex lab. I guess I'll start with gross anatomy lab. Since we just began a new semester, all of our class was reassigned to new lab groups, so it's always an interesting experience working with new faces and meeting people that you have never talked to before. Not to be cheesy, but's it's good practice for when we will finally become doctors where we will be encountering new patients on a daily basis. With that said, last Tuesday was my first lab session and the dissection was The Orbit. Now, I'm not sure if I have ever shared this before, but one of the specialties that I do have a strong interest in is ophthalmology. I'm not ready to rule everything else out at this point (I'm sure a stronger inclination towards a specialty will be made during Rotations), but it is an area that I have previous work experience in and enjoyed thoroughly. So to do a dissection concerning the eye is like a dream come true. And let me tell you...it did not disappoint! It was honestly one of the best hands-on experiences I have ever had! If you can imagine what the cadavers look like (with the top of the skull and brains removed) with only an empty fossa where the brains used to rest. And what lies beneath the forebrain? The eyeballs...and oh yeah, a little layer of bone called the anterior cranial fossa. So using all of the experience I gained working as truck driver/electrical apprentice/gopher-that-does-everything-anybody-tells-him-to-do, I had to use a chisel and hammer to remove the bones that comprise the roof of the orbit. I've never felt more accomplished in my life. To remove the shards of bone and dissect through layers of fat to reveal the multiple nerves and musculature that function to move the eyeball...was awesome. On top of that, I got to use a saw (yea, like an actual hand-saw) on the other eye socket and remove the bone (basically what was left of the forehead) directly above the eye, so that we could investigate the musculature below the eyeball. Overall, it was a really cool lab, which was made even more exciting by my actual genuine interest in the topic. 

On the last day of the week, Thursday, I also had a reflex lab. Now, I have been to the doctor plenty of times and have had my reflexes tested (I am sure you have too) and really didn't think much of it. But eliciting reflexes from a patient is not that easy, especially if you've never practiced it before. So we had our first lab where we learned to test the reflexes of the biceps brachii (biceps), brachioradialis (forearm), patellar ligament (quadriceps), achilles (calves), and a few other things that would sound like gibberish if I wrote them. It was basically a chance for us to learn the proper techniques for eliciting these handful of reflexes on one another (for example, if you are a guy, don't stand directly in front of a patient when eliciting a patellar tendon reflex...if you do, you might want to wear a cup!) and gaining the confidence so that we will be able to do them while under the pressure of an examination. And I guess if you have Podophobia...it was a chance for you to get over that (if you don't know what that means...look it up). These types of labs are always helpful, not only because it forms the foundation for the things that we will be doing routinely later in our career, but it takes us out of the classroom and reminds us why we are here becoming doctors. 

Anyway, those were a few of the interesting things that happened over the course of the past week. I'm looking forward to intramural basketball starting next weekend and the chance to take our minds off school for a little bit...even if it is only one hour every weekend. Alright, well that's it...

Oh and here is the weekly song...it's kind of my thing now.

http://www.youtube.com/watch?v=3_I8RCUpe-c

Dominica Diet

First off, Happy Mother's Day to all the mothers out there that are reading my blog and specifically to MY mother. I love you and I wish I could have been in the US to celebrate this day. But as fate would have it, I am here in Dominica.

Let's just say the first week of this semester went a lot faster than that of last semester. My high hopes that we would start things off slow...were completely, yet not surprisingly, shattered. We are back in the full swing of things almost like we didn't even have a break. But I will admit that the material that we covered this week has been really fascinating...the central nervous system (brain and spinal cord). It's not every day that in the middle of a lecture that a teacher pulls out a cadaver brain with the spinal cord still attached (really cool!!!). It also feels quite satisfying to know all of the nerve pathways for touch, vibration, pressure, pain, and temperature for the entire body and how those connect to the brain. This first week of the Neurovascular block has also seemed a lot more relevant/applicable and clinical in comparison to previous material, which makes learning a lot more engaging. For example, one thing we learned about this week was a reflex called the Babinski Sign or Extensor Plantar Response. This is tested by taking a blunt object and pressing it firmly against the heel of an individual's foot, and then tracing the object to the balls of the feet. Now, in individuals above the age of 2 with no neurovascular damage, the typical response would be to curl your toes or plantarflex. However, in infants ( up to 12-18 months), their nerves aren't completely developed yet, so this response does not happen. Instead, they will spread and extend their toes (dorsiflex). This was one of the first things that I have learned here that I could directly apply to my life (I had my sister try it on my 8 month-old nephew and it really worked) and it provides assurance that what they are teaching us here is really true and not a bunch of malarkey. Yea, I used the word malarkey. This is what I was trying to explain in a video:

http://www.youtube.com/watch?v=oI_ONptx2Ns

In addition to the academic side of life, over the past week I've made a more conscientious effort to eat more. If you are a regular on this blog, you would know that I typically eat cereal in the morning, grab a meal at the Shacks for lunch, and have dinner at Subway. So...apparently if you follow that regimen and maintain a pretty active lifestyle over the course of 4 months, you are bound to lose weight. Fifteen pounds to be exact. In order to try and prevent the loss of any more weight, I now eat a banana around 10 o'clock between lectures (they are really good here and only $.50 EC) and a Snickers candy bar in the afternoon. Mmmmm delicious and it reminds me of home. We'll see how it works out for me...I don't want to look like the skeletons we study in anatomy lab...that would be bad. 

Have a great week everyone...until next time. 

http://www.youtube.com/watch?v=StDahGh8emA

Two Week Hiatus

Well folks, it's been approximately two weeks...two restful weeks might I add, since you last heard from me. If you are a regular follower of this blog, the last time I wrote I probably left you in a little bit of suspense. We did have our end of Semester 1 Final, which was very difficult (166 questions in about 3 and 1/2 hours). That's a long time to take a test...especially if you have to pee right from the start. But I'm here writing, so I obviously got through it and did well enough to pass onto the next semester.

After the final (and I think I can speak for most people), I absolutely checked out. It was relax mode (beach, gym, celebration) and getting ready for a well-deserved break from school (and yes, the island). I took a treacherous taxi ride from Portsmouth to the airport two days later and flew to Barbados in the evening amidst a torrential downpour. I was extremely lucky because  I was on one of the last flights to leave Dominica for the following two days due to weather. On the day that I flew out of Dominica, a group of students waited over 14 hours for their plane to arrive and take them home (I would have gone crazy in that tiny airport). By the way, the airport is about the size of one departing gate at an American airport. Once I got to Barbados, I hailed a cab and went to my hotel, Silver Point. I grabbed a late bite to eat, spent the night, and got in a cab at 5:30 in the morning in order to make my next flight. After making a stop in Miami, I took a short 45 minute flight to Orlando....and I was finally home.

Now, I'm not sure at how well I describe the amount of stress and pressure us Ross students are under all the time, but, regardless, it felt amazing for those factors to be nonexistent over break. No schedules, no reading, no tests. Nothing. If you ask anybody now about how their break was, it usually goes something like this, "It was toooo short and I just pretty much relaxed the whole time." And, honestly, that response pretty much sums up my break as well. Golf, Charley's steakhouse, NBA playoffs, home cooked meals, chocolate chip cookies, Ross friends, Argo, relatives, sleeping-in, gym, Pain and Gain, etc. That's it in a nutshell.

http://www.youtube.com/watch?v=jKMK3XGO27k

I flew back to Dominica on May 2nd via San Juan. Sidenote: I was very impressed with JetBlue; they had delicious snacks and free in-flight television. I got back to my room at Portsmouth Beach Hotel very late, so I only had time to unpack, which was a sweaty process (I will explain). Unfortunately, sometime during my break my fan decided to stop working....that was a nice welcome back. As Kramer would say...

http://www.youtube.com/watch?v=zY9eN-1rR0o

But a quick fix (and more importantly $97 EC later), I have a brand new fan keeping me cool. The last three days of being on the island were a lot less stressful than when I first came to the island four months ago. This time around, I have spent tons of time at the beach, gym, restaurants (AND NOT SUBWAY YET!!! Im holding out until tomorrow), and less time freaking out about the upcoming semester. I feel a lot more prepared for this semester, not only because I have all the material things that need here (since I brought more stuff back to Dominica with me that I forgot the first time), but also with my mindset. I am already among the 71% of students from my class to advance to the 2nd semester, which is an accomplishment in itself. But also, I will be able to learn from my mistakes that I made last semester as well as improve on the things that I did well. Tomorrow is my second first day. Block 5: Nervous System/Psychiatrics and Endocrine System. I'm pumped...are you?

http://www.youtube.com/watch?v=uIPS4LyveJs

Shortest Blog Ever

Semester 1 Final tomorrow. Enough said. 

I Guess I'll Settle For Soy Milk

Hoofta, if you are coming to my blog today and expecting to find a lengthy summary of everything that has been going over the last week, I regret to inform that that is not what you are going to find. My fellow Semester 1 classmates and I had four days of lecture this past week and we had our last day of classes for the semester on Thursday! Woohoo! Unfortunately, that means a bunch of tests are right around the corner. I have basically sat in a classroom since Thursday afternoon studying and preparing for the upcoming week:

Monday: Mini III
Tuesday: Behavioral Practical
Wednesday: Histology Practical & Gross Anatomy Practical

And just for good measure, we have our Cumulative Exam on the following Monday, so there will be no celebration after these first set of tests. It will be right back to the books!

I'm not sure if this is a good sign or not, but I ran out of milk today that I normally have with my cereal in the morning. So this afternoon, I went to the grocery store and they were out of regular milk, so I had to settle for soy milk. I have never had soy milk. Nothing like trying something new on the day of the biggest test of your life (by the way, in medical school the next test is always the biggest/most important test of your life).

Keep me in your thoughts during this treacherous week!

Another One Bites the Dust

Happy Easter everyone back home!!!

Well, we are getting down to the nitty-gritty down here in Dominica with one more full week of classes left before our last Mini exam followed by our comprehensive final. That translates into a lot less fun and a lot more studying. Unfortunately due to the recently heavy workload, not much has happened over the last week that I deem blog-worthy. When I'm not sleeping....I'm studying....and when I'm not studying...I'm eating. Vicious cycle. Besides getting every single one of my Final Four picks wrong for the Men's NCAA Basketball Tournament, I am trucking along with high spirits and motivation to finish this semester strong. I hope there's more to talk about next time.

http://www.youtube.com/watch?v=rY0WxgSXdEE

Med School Has Ruined TV And Movies For Me

Week 11 of medical school was a busy one...the material that we covered wasn't that difficult, but the additional extracurricular activities that I participated in made it far more tortuous than it needed to be. On Monday night, we had our last game of the intramural basketball season in which team "Hoops!...I Did It Again" came out victorious. It was a much needed confidence booster (since the two previous games resulted in last-second losses) for going into the first round of playoffs, which took place on Friday. Once again, we won and now await our opponents that we will play on Monday. Who knew medical school intramural basketball would be so competitive? Not me, that's for sure.

On Tuesday, I had a blood pressure lab where I was officially taught how to take a patient's blood pressure using my stethoscope and, my favorite instrument, the sphygmomanometer (BP meter). It's a fun word. It's the little things in medical school that keep you going. After becoming an expert in taking blood pressure, the following day I had my second simulation. This time, however, it wasn't as action packed. We used a modified version of SimMan (this time with no legs) to listen to heart sounds. It's scary how real these dummies look; during respiration, his chest went up and down; you could see his jugular veins pulsating; and you could palpate his apical pulse. Each of the students in my group all used a stethoscope that functioned to project whatever sound that was being heard through the facilitators stethoscope (so we could all hear the exact same thing as the facilitator). That's some pretty cool technology if you ask me. Anyway, we learned how to palpate all four regions of the heart valves (aortic, pulmonary, tricuspid, and mitral) along with listening for S1-S4 heart sounds, as well as diastolic/systolic murmurs. A bunch of gibberish...I know, but it's what actually occurs at pretty much every doctor's appointment that you go to. Important stuff.

The very next day, Thursday, I had lab where we dissected the internal heart. Now, if you have never held a human heart in your hands, it's quite a spectacular feeling. After learning every minor detail about the development of the structure and vasculature of the heart, it is a nice reward to be able to actually hold the real thing and appreciate all of its components. Admittedly, my favorite part was rinsing all of the dried-clotted blood out of the four chambers of the heart. It sort of spoils your appetite though...

So here I am at the end of the weekend (filled with studying the cardiovascular system), feeling pretty good about myself and my understanding of the material. But before I go, I wanted to enlighten you with some interesting information that I learned over this last week. On Friday, during our pharmacology lecture, we learned about a drug commonly used to treat heart failure called Digitalis. Now, Digitalis is a positive inotropic drug that increases the contractility of the heart during periods of unstable heart failure; however, if given to someone in toxic doses that is not experiencing heart failure, it will induce cardiac arrhythmia and eventually put the person into cardiac arrest. If you have ever seen the movie Casino Royale, they depict James Bond being (and accurately, I might add) poisoned with Digitalis and going into cardiac arrest. Here's the scene:

http://www.youtube.com/watch?v=_yNntwSjOwo

Unfortunately, the accuracy stops with his heart beat. Fun fact: you can't restart a person's heart using a defibrillator after they have flatlined. A person's heart has its own electrical conducting cells that maintain the heart beat; external electrical impulse can only regulate the speed at which the heart beats...not create the heart beat itself...that's impossible. Defibrillators are used to reset the heart rate when a person is having irregular heart rhythms (ex. atrial/ventricular fibrillation). So yes, in all of the medical shows, movies, and even James Bond flicks, the patient would not be brought back to life using a defibrillator (they would use CPR!!!). Sorry if I ruined all those nail-biting moments where you aren't sure if the person is going to live or not because they flatlined! Just trying to spread the wealth of knowledge here. Moral of the story: always know the person making your Grey Goose Martini...shaken, not stirred...

Happy March Madness everyone!

I Thought I Was The Medical Student, Not The Patient

First and foremost, Happy St. Patrick’s Day to everyone at home! I hope everyone is having a jolly time and wearing green (because if I were there and you weren’t wearing green, I would certainly pinch you). Here, on the other hand, St. Patrick’s Day does not exist.

Another week. Another Mini grade returned and once again I have not had to pack my bags yet to come home. Phew! You breathe a sigh of relief every time you get one of those scores back and realize that the hard work is really paying off.

Honestly, not much has gone on this week. Fun fact: today marks the first day that it has rained since last Friday. Ten whole days. That doesn’t sound too long for those of you in the U.S., but for here…it’s really unheard of. I usually carry an umbrella in my backpack at all times. (You’re thinking to yourselves, don’t people usually talk about the weather when they really have nothing much to say…yep, yes they do). Today also begins my one-month countdown till I return back to Florida (and if you have read some of my previous posts, Florida IS IN the United States). I am ecstatic about going home, seeing my parents, not having to study, and of course indulging in some gourmet home-cooked meals (always followed by a few chocolate chip cookies, of course).

So in my previous post I told you that this Block was all about the Cardiovascular and Respiratory System. Thus far, we have only had lectures concerning the Cardiovascular System and I actually find the information quite amazing. First off, it’s some of the most practical information we have learned so far, since cardiovascular disease is one of the leading causes of death throughout the entire world. Besides its clinical significance, its’ also one of the first things that we can see, hear, and feel, unlike all of the microscopic stuff that we have learned so far.  Plus there are so many disorders, diseases, syndromes (whatever descriptive word you want to use) that involve the thoracic cavity, that most of us students can relate to either personally, through a friend, or a family member. This week of lectures has made me, someone who has never broken a major bone or had surgery of any type, realize that I have had some strange illnesses. For example, pleuritis. I mean, who the heck gets pleuritis!?! Benjamin Franklin, that’s who. He actually died from pleuritis. It looks like I’m in good company.  I had pleuritis during my senior year in high school during basketball season. After about five minutes into practice or games, I would experience a sharp pain in my back whenever I took a deep breath. At the time, I only knew that pleuritis was caused by a viral infection of the lung. But now I know that the inflammation of my lung, caused my visceral pleura to rub against my parietal pleura (which is highly sensitive to touch, pain and temperature) causing the stabbing pain in my back. Yea, that’s more than you ever wanted to know about pleuritis. Nonetheless, it is cool to learn about something you were inflicted with in the past and know the pathology behind its symptoms/effects. The other odd infection that we learned about this week was Herpes Zoster aka Shingles. And once again, I had shingles during my sophomore year in college and had splotches of red blisters on the left side of my forehead. Knowing what I know now, it makes sense that the shingles only stayed in that quadrant of my face because shingles can only infect a single dermatome (mine was the upper left quadrant of my forehead). Wow, I feel like a doctor already…or does that make me the patient?

Anyway, now that I’m done nerding-it-up and boring you to death, I’ll leave you with this picture. Have a great week everyone!

Remnants of an old distillery on campus

Shhhhh....It's A Secret Beach

Phew! I once again survived another Mini! Although it seemed a little harder than the first two (probably because most of the material covered on it was no longer review), I felt like I did pretty well and should find out my exact result later on this week. With the anticipation of my potential grade looming over my head (when you study so hard for something, you are kind of anxious to find out how you did), I had all of Friday (after the Mini of course), Saturday, and Sunday to participate in all types of shenanigans that were unrelated to school. This weekend was the first time us First Semesters really had a break from school to just relax, celebrate, and not feel guilty that we weren't studying.

Most of my time off, as you can probably guess, was spent at the beach. Now, during the days of our previous two Minis, it had rained and been cloudy. But this weekend, it was clear blue skies! You know what the means...sky's out, thighs out! That's what us really pale-skinned fellas like to call tanning and spending time in the sun. And we couldn't have had better weather for it.

Waves crashing against the retaining wall just outside of my room.
The soothing sounds put me out like a baby every night. 

So with a little extra time on my hands this weekend, I wanted to enhance the beach experience by doing something a little different. I wanted to explore a place that I had been hearing about called Secret Beach. From what I had heard, before I actually went there, was that Secret Beach was this small beach/bay that could only be reached by water transportation. People told me that it was just a beautiful, serene place to go when you have nothing else to do that gives you an idea of the true natural beauty of Dominica. So that's what I did. 

To get there, a friend and I rented a two-person kayak from the local water-sports man that rents equipment to students and other tourists. He urged us to leave all of our valuable items with him for safe-keeping just in case we happened to tip over the kayak or something crazy like that. So we did, minus a bag with my wallet, water-proof camera, a couple of waters, sunscreen, and the sunglasses that each of us were wearing. After convincing the rental guy that we had indeed kayaked before and that we were good enough swimmers not to need life-jackets, we set off on our journey to Secret Beach. This was the first time that I had seen the Portsmouth/Picard area from several hundred yards out from the shore and, honestly, the scenery was breathtaking. The mountains, the green forests, the crystal clear water, and the boats anchored in the harbor...astonishing.

To get to Secret Beach, you basically need to head south a little less than a mile from where I live, but, once again, you can't get there any other way than by water. When you're on an adventure like this, it always makes working-out a lot easier...paddling about a mile through wavy water is actually pretty tough, especially when the Caribbean sun is baking down on you. Despite the physical exertion it took just to get there, the anticipation of seeing this "secret" beach was pretty motivating and the sight of it was very rewarding.

I don't remember exactly where it's from, but I feel like I have seen this arch in a movie before.

The Secret Beach Resort is located to the left of this picture just on top of the cliff. 

Most people think that the reason Secret Beach is called "secret" is because of the means of travel that you need to take to get there. I agree, but I also think that it's called "secret" for an additional reason. A reason that neither my friend nor I were not told about...and that reason would be how the heck you are supposed to land a kayak on this beach with 5 foot waves thrashing you about every which way (the pictures above do not do those waves justice!). Long story short...we flipped. A huge wave turned our kayak sideways and both of us had to bail as our kayak flipped over, along with all of our belongings and paddles. After initially making sure both of us weren't hurt, we had to gather up all of our stuff that was diffused throughout the water and finally set foot on Secret Beach. Mission accomplished. A little unorthodox on the landing, but it got us there. It only took about twenty minutes before both of us finally realized that we were each wearing sunglasses when we flipped. Oops...I guess they are buried treasure now! Before we left the beach, I thought to myself, "If it was that difficult riding the waves into shore, how the heck were we supposed to get out of there?" It wasn't pretty, but I am writing this blog, so it is safe to say that we survived.

Tomorrow marks the first day of Block 3 (Circulation and Respiration) of my first semester. Man, the days are going by quickly and before I know it, I'll be back in the U.S. on break.

I hope everyone back in Minnesota is enjoying the snow! It doesn't snow here...obviously. Until next week.

Hoops!...We Did It Again

It's been quite a while since I have updated you about intramural basketball, so I thought I would do so tonight. Overall we are 6-1 and after losing our first game (obviously it takes at least one game to get used to the Dominican outdoor basketball conditions), team "Hoops!...We Did It Again" has been undefeated. Now, if you didn't understand the reference I just made with our team name...well that most likely means you are old. I don't know why we came up with this name or why we agreed to naming ourselves after a Britney Spears pop song...but we did. Maybe because it was the only thing we could fit the word "hoops" into, I'm not sure. Please don't judge. If you are reading this and are totally lost...I'll try to help you out. Here is a link to what I am talking about:

http://www.youtube.com/watch?v=CduA0TULnow

Here is what our jerseys look like. Again, don't judge...we are bored med students with nothing else to amuse us.

Our team actually draws quite the following, so we ordered t-shirts for all of our fans with the same front, numbers on the back, and the words "Sixth Man" written over the number. You have to give thanks to where it is do...and honestly, I don't know how much fun intramural basketball would be if people didn't come to watch. Now, you're probably wondering why my nickname on the back of my jersey is "The Spaniard." Well, if you didn't know, I was actually born in Madrid, Spain. That's the connection. Besides that, I love the movie Gladiator and could picture myself asking the crowd, after I rattle off a few baskets in a row, the following question:

http://www.youtube.com/watch?v=3sndSXsLSD0

Once again, you would either have to watch the full clip or have seen the movie to completely understand that reference. But once again, I am glad that I am able to play basketball down here. It brings back a lot of memories from when I played in college...like how it's nice not to have to practice anymore or run suicides. Those days are over.

It is a big week for my fellow first semesters and I; Mini II is on Friday and then we get the whole weekend off!!!! That never happens. Seriously...it never happens. But it is going to happen and I am going to enjoy every minute of it. However, until then I will be studying my butt off all the way to the exam. Godspeed.

I Haven't Watched TV In Over A Month

Well I ought to preface this post by saying...yes, I am alive (clearly). I'm sure some of you were worried I got bitten by a killer centipede (they actually have those here) or something to that effect, but I am actually alive and doing quite well. I'm sorry I let down my avid readers last Sunday, but sometimes my responsibilities as a medical student take precedence over writing this blog. As I have said before, my plan is to write a new excerpt every Sunday night, but if you wake up on Monday morning (bright and early) just to read my blog and it isn't there, just know it's probably because I was really busy.

Since the last time I wrote on here, I took Mini I Part II, a Gross Anatomy Practical, and a Histology Practical...and passed all of them with flying colors. After spending the afternoon at the beach on the day of our Mini and celebrating a little that night, it was back to lectures the very next day. From then till now, we have had a week and a half of lectures/labs/small group learning...nothing out of the ordinary.

This picture is not of me. It's a random picture from
the SimMan3G manufacturer. We aren't allowed to
take pictures in Simulation, so this is the best I could do.

One aspect of school that was new since the last time I posted and probably one of my favorite activities that I have participated in since I came to Ross was Simulation. So, Simulation is probably exactly what you picture it to be. At Ross, we have a building that is set up like a hospital...with individual rooms for patients. You enter the a patient's room and the patient is laying on the table. Once we are given a background update on the patient's status, the fun begins. Now, the unique thing about Simulation is that we don't use real patients. Instead, we use Harvey (SimMan3G). Harvey is a computerized, human-like, human-sized doll that can pretty much do everything an actual human patient can do; he can talk, cry, scream, bleed, vomit, urinate, defecate...you name it, he can do it. He can dilate his eyes, you can take his blood pressure (in multiple places), you can give him medicine/injections, you can give him CPR, you can administer shocks to him through a defibrillator, and, of course, he can die.

I took a lot away from my first Simulation experience. Unfortunately (and I am extremely excited to use this for the very first time), I can't tell you what happened during Simulation because of Doctor-Patient confidentiality!!! But I think you can assume what happened. Do you think my first Simulation experience was about a patient with the flu? Or do you think it was some medical emergency that required immediate intervention because it was a life or death situation? Come on people, I hope you're picking up on these not-so-subtle hints. Anyway, I felt like this first Simulation concentrated more on the range of emotions and ethical issues associated with being a physician rather than our bleak medical knowledge thus far.

Besides Simulation, there isn't too much to report from Dominica. I know it's random, but I do want to share a conversation I had with a Ross Dominican maintenance man the other day; this conversation is both funny and sad, and I hope it demonstrates the importance of being aware of the world beyond where we live.

Him: Are you a new first semester student? (Picture him being very hard to understand because he is from Dominica)
Me: Yea, I am.
Him: Oh, how are you liking Dominica so far?
Me: I like it. The weather isn't too much different from where I came from, so I am used to the heat.
Him: Where did you come here from?
Me: Florida.
Him: How close is that to the United States?
Me: Hmm, well Florida actually is in the United States.
Him: Yea, but how close is that?
Me: Well, Florida is one of the states that makes up the United States. So when you are in Florida, you are in the United States.
Him: Oh, how long does it take to get there?
Me: To Florida? Or to the United States?
Him: No, from Florida to the United States?
Me: Hmm, not long because when you are in Florida, you are actually in the United States.
Him: Can you drive there?
Me: From Florida to the United States?
Him: Yea.
Me: Yea. It takes three hours by car. Sorry, but I got to run.

I've never been more convinced that I didn't know my US geography than at that moment. His circular line of questioning and obvious lack of geographical knowledge beyond Dominica almost had me believe that I was wrong. So strange.

In three days, it will mark two months that I have been in Dominica. While I'm in lecture or studying, time passes so slowly, but when I actually reflect on how long I have been here...time is absolutely flying. I try my best to remind myself of where I am, in Dominica for medical school, everyday...man it would be tough going to med school in a state like Iowa or Nebraska (so boring!). Anyway, these thoughts sort of made me think of some wise words that a great philosopher once said:

http://www.youtube.com/watch?v=91lJhEzMaH4


Have a great week everyone!