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