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!

I'll Take A Tattoo And A Haircut

Woohoo! I'm on day three of a four day weekend, plus its Carnivale down hear in the islands! Party! Sounds too good to be true, doesn't it?....and that's because it is. Looming in the near future are three big exams for us First Semesters; this upcoming Tuesday we have a histology practical and an anatomy practical followed by Mini I Part II the very next day. So as tempting as a four day weekend sounds in the Caribbean, this one couldn't be more of a buzzkill. But despite these upcoming events, I do have some exciting news.

I got my first......haircut. Sorry to disappoint, but to get your first haircut down here is kind of a big deal. They don't really have hair salons or barbers. Nope, there are no Supercuts, Great Clips, Master Cuts, Fantastic Sams, what have you...they don't exist down here. Instead, there are individuals that cut hair, amongst other things. They don't need to get a license from a cosmetology school or anything; all they need is a reputation. And I had heard from a few other guys that Benji's was the place to go for a good haircut. So that's where I went. I walked all the way to Benji's in the sweltering heat only to find out that he was out to lunch and nobody knew when he would be back. Okay, now what? Well, I had heard from a few other people about this place near a restaurant named Tulips. So I went there and found myself staring at some painted words on the outside of an apartment that read, "Chen's Tattoos and Haircuts." Hmmm, maybe I could let my hair grow out a little bit. It crossed my mind, but my heart was set on getting a haircut. So I opened the front screen door and stepped into....a living room? Yep, I walked into a living room that was connected to a kitchen where, lo and behold, was Chen and his wife eating lunch watching Chinese soap operas streaming on their computer. After (I'm assuming his name was Chen; I guess I never really even asked) Chen reassured me that this was indeed a place that I could get a haircut, he directed me toward a swivel chair in the living room that was next to a table that had a mirror resting against the wall on it. Even though their apartment was absolutely stifling because they didn't have any air conditioning, Chen insisted that I put on the impenetrable-yet-I-always-get-hair-in-my-shirt-anyway smock, which made me sweat even more. Then he began to cut. He used one razor to shave the sides of my head and to fade the length all the way to the top. But in order to get that perfect blend from the one inch long hair on top to the short sides, he swung the razor through the air, just barely grazing the tips of my hair. If I would have leaned to the side that he was blending by just a quarter of an inch, I would have been rewarded with a bald spot. And then to trim up the neckline and sideburns, he used a straight edge razor (I'm not used to that back in the good ole US of A). After all was said and done, it didn't look too shabby, and now I'm feeling fresh and clean. Plus it was only $15 EC (~$6 US). Meanwhile, his wife was still eating in the kitchen watching her husband cut my hair (awkward). 

Well, that's all I really have for you today, since most of my time in the recent past has been spent studying, but I hope it was entertaining nonetheless. 

P.S. Pictures of my new tattoo are pending. Stay tuned.