dopplegangers

Some person with the same name as me has been registering on girly shopping and trashy gossip sites with my email address. Luckily, she just registered on some blog site, so I logged in and wrote her first entry for her: "change your email please." :)

Ugh, we have to wake early up on St. Patrick's day to take some stupid 4 hour practice USMLE tomorrow. My only goal is to not be called into a dean's office and told to postpone my exam). My studies have been "okay" and fairly consistent (and we have 3 months to go), but it never feels like I reach my study goals.

Well, at least my photography goals are being met. ;-) All my digital photography reminded me of how much I enjoyed simple black and white photography back in middle school and high school. I recently joined the photography online community, flick'r, and while looking through other people's work, I got interested in some of the 30 year old + rangefinder cameras. These are the kinds that went to the moon and were top before SLRs showed up in the 70's. I liked their simplicity and the different quality of the images. I don't think they're better or worse than a traditional SLR, although the image quality is similar (without as much selective blur, perhaps), and the rangefinder tends to be smaller and quieter. The shutter and aperture are set in a similar fashion as an SLR, but to focus you look through the lens and line up a yellow "ghost" image on top of the scene. When you only see one image instead of two, you have the correct focus. There's no automatic focusing with this. ;-)

The truly dangerous part is that these cameras are still around and you can find them pretty cheaply on eBay. So, I capitulated and got a Canonet QL17 GIII. I really enjoy it! I shot an experimental roll and was very happy with most of my photos. The textures and sharpness were amazing, particularly in black and white. I took photos of some neighbors, animals, and Galveston homes and I liked the results. Not to mention, the shutter is quiet enough to take to class and sneak candids... not that I would *ever* do that. ;-)

So as for the medicine front, a couple of weeks ago I did my 3rd hospital/ medicine in-patient visit and enjoyed it. It's generally good to be reminded of why we're here every once in a while. ;-) I'm actually enjoying our derm-heme-musculoskeletal class quite a bit. It really reminds us that we have to pick our parents and grandparents well. ;-)

And speaking of medicine, a recent study showed that sleep deprivation impairs moral decision making. http://www.webmd.com/sleep-disorders/news/20070302/sleep-deprivation-blurs-moral-judgment?src=RSS_PUBLIC. Good thing that has no implications for the medical community and their 36-hour work days.

Houstonist 'Photo of the Day'

Yeah, one of my photos won "Photo of the Day" on the Houstonist Flick'r Group. *smile*, it's the little things of life... ;-)

http://www.houstonist.com/archives/2007/02/27/houstonist_flic_202.php

Physician, heal thyself

Today I had my musculoskeletal workshop (basically, reviewing how to do a msculoskeletal exam on a patient). It starts getting pretty depressing when you realize you'd had/ have nearly every single major musculoskeletal/ joint problem on the list, and you're not even a quarter of a centery old yet! knee arthritis?/ Check. Shoulder tendonitis/ rotator cuff problems? Yep. Messed up ankle, back pain (hurt on a toilet seat!!), carpal tunnel syndrome (thanks to crappy pipetter), tennis elbow (from tapping out thousands of cell on a clicker)...

Quite frankly, the only thing that didn't make me wince in recognition was the hip rotation exam... yeah, I'm feeling old. ;-)

Dear med school, high school called... it wants its drama back

There's a joke about Will Rogers that goes... "Will Rogers used to say that he never met a man he didn't like... well, Will Rogers never spent much time around a medical school." While MOST of my classmates are really kind/ awesome people, there are a few that could give Will Rogers pause.

Case in point: this week I got my first ever "Phone call out of the blue from someone telling me he absolutely cannot stand me." Put another feather in my cap. Now, there were a couple of times in the past when I've had a falling out with someone, but typically if it ever got to this level (pseudo-mean email or phone call), it was cuz the person was actually hurt because I hadn't talked to them in a while. In those situations, better communication almost always fixed the problem (and brought us closer).

This call was weird because a) I've never really been close to the individual in question, and, b) evidently this guy has been "holding it in" for a *year and a half*!

It all started in my first med school class, when I had to share a small group with, well, let's call him "Not Funny Guy." That group was generally fun loving and worked hard, and I felt that we all got along reasonable well (considering that we had to work elbow to cadaver-covered-elbow nearly every day). There were, of course, some quirks... namely, Not Funny Guy enjoyed telling loud jokes, insulting his classmates, singing, and banging on the tank (where the "cadaver lives," according to my friend, Lydia ;-) ). A few times I asked NFG to stop beating on the tank, and eventually I told him that some of his jokes were pretty mean and over the top (For instance, he once loudly announced in class that I "made his penis shrink," and proceeded to illustrate this by jumping forward and backwards in front of me and shouting the effects on his madhood. Not only is that fairly inappropriate and rude, but it clearly violates sexual harassment rules. I didn't feel like being the butt of his joke, so I told him to stop).

I eventually learned that he wasn't going to temper his behavior, and took others advice to straight out ignore him; but according to him, the damage had been done. I never had any animosity towards him (until now), but evidently that was not reciprocated. In the interim, Not Funny Guy persisted with insulting jokes, but would add "I'm just kidding... you're too sensitive!" to the end... even though I mostly ignored him. We shared more labs and never had any outright disagreements (that I can recall), and eventually did not see or talk to one another from a number of months.

So now we're back to this week, when NFG called me up after our first tutoring session together, and started with "I just want us to have a professional relationship." He then went on to say that he "gets along with everyone" but me, told me I was too sensitive and could not take a joke, that I made everyone in our first small group "uncomfortable," and that I am "always picking fights with people." While the last accusation wasn't totally off the mark (as my friends have "kindly" pointed out to me ;-) ), his words left me crying and deeply confused/ hurt.

Shortly thereafter, I called up someone I thought was Not Funny Guy's friend (they hung out all last year), to see what was going on with him and why I was the target of his vitriole. The person on the other end of the line told me that she hadn't talked to NFG in months because she was sick of him always picking on people, having tantrums if someone got upset at his bad jokes, and eventualy we both agreed that he was never really that funny/ mature. That completely made me feel better (mostly, I'm still writing him off).

It just amazes me that, amid some really wonderful classmates, this guy gets away with practically *bullying* people and retreats behind the argument that everyone has a problem but him. I know I should not give a second thought to such a person, and I certainly should not let someone tell me he thinks how I made *other* people feel, but I am irritated that this acting out is being perpetuated by a future physician.

A number of people said it's likely displaced anger from something else going on in NFG's life, but I'm just glad I have some very supportive/ mature friends to balance that fruitcake out. ;-P

The arguing, she is afoot

As recently as last week, a resident told me that residencies are very interested in recruiting med school graduates who have been on teams or worked in an organization. The purpose being that medicine is very much a team oriented atmosphere and they would rather not spend the time breaking someone of the habit of thinking there's "an I in team." But sometimes teams go astray too, particularly when the teammates want it done their way and don't want to listen to other people.

Enter: Phi Chi politics. It seems there are people around here who have been used to getting their way for a very long time. That, coupled with a very emotional topic (namely bicycle storage - it gets emotional when you consider the lack of space around here, crime rates in Galveston, and what the caustic sea air does to your bike metal), leads to a lot of tension.

Last week we tried to address this issue, namely because someone was really mad that her bike was stolen from *inside* the house and as a result, *everyone and their mother had to chime in on their feelings on the matter*. Granted, the person who had her bike stolen had a legitimate concern - what can we do to improve security around Phi Chi? But, naturally, that issue was turned around by people who a) don't live at Phi Chi or B) don't own a bike. Soon the issue became "don't store the bikes in the house." As for security, the most vocal people just decided to point fingers and blame others for not closing the doors. Way to be mature.

There became two camps: the one side wanted all of the bikes moved out of the house and those of us who had bikes who felt like we were being unfairly punished and our concerns dismissed. The issue of security was not addressed (beyond people pointing fingers and the upperclassmen saying that it MUST be the first years who are leaving the doors open).

Since this issue was getting so emotional for so many people, it was tabled at our last house meeting. Most of us thought the issue was tabled until a) a solution could be reached (ie, we could have a storage shed with enough space for the bikes AND a lock), b) we could look at it from a fresh POV and not be so emotional over it.

So imagine our surprise on receiving an email earlier this day from the Phi Chi president who said, in essence, that our bikes had to be moved by 6:30pm tonight or they would be thrown into the courtyard. So much for voting. When someone pointed out that the timing was quite bad (most of us have a final tomorrow), the shed option had not materialized (it's full and has no lock), *where was the vote* on the matter (we have bylaws for these things, right??), - those concerns were dismissed as "whining."

And oh yes, what would a discourse be without the old (when I was your age favorite) "When I had a bike, I kept it in my room!" Well, that person moved out to have more room (which I don't have enough of), and I doubt he would have hauled my 80 pound bike up the stairs every day.

I am willing to admit that having bikes in the main house is not aesthetic (but neither is most of Phi Chi - we live here cuz it's cheap and close to campus, not because we think it's pretty). However, when not so simple issues are decided by ONE person who is not directly affected by them, and any discourse on the matter is dismissed as whining, I get very disillussioned with the whole "team spirit" aspect of Phi Chi. If the upperclassmen want to get their way, they need to learn the fine art of negotiating: to be quite cynical, they should have either given us an offer we could not refuse (ie, a secure place for our bikes), or made us think this whole thing was our idea. Instead they really engendered a lot of anger and tension.

No wonder Will Rogers never spent much time around a medical school.

Get your Study On!

This morning I woke up with a stomach ache (probably from the red bull and chocolate mint kisses I've been living off of this week), & my first thought was "Hey, maybe I have appendicitis and I don't have to take the renal final on Friday." Yes, it's troublesome when the thought of a painful and possibly life-threatening disease brings me more hope than taking a renal exam.

Luckily, there's evidence (like this video), that other people are suffering med school psychosis too. :)

MFBP = Mothers for Beer Patrol

Nothing warms the cockles of my sarcastic heart *quite* like seeing a new mother emerge from the maternity ward with a baby, an "It's a girl!" balloon, and a shirt proclaiming her proud membership in the "beer patrol." I'm sure that family will be just fine. ;-)

Speaking of sarcasm, I might have gotten some points docked from my professionalism grade in POM for speaking my mind about a hypothetical patient situation in which a family asks a physician not to tell their father that he's got *terminal cancer*. Sure, given a real situation, I'd be civil to the family and try to ascertain why they feel that their father should not know he only has 3 months left to live. But realistically, I think that's one of the most assinine requests I've ever heard. If a patient doesn't want to know their diagnosis, that's a different story... but I'm not going to hold my tongue among my own peers when the idea of lying to a patient is discussed. Although I guess I could have gone without basically saying I thought the hypothetical family was stupid for making that request, particularly in front of my faculty.

Perhaps it's because I've seen so many terminally ill people (in my family, working at a hospice, etc), so to me that part of one's life is not something you can just force a person to ignore. If someone wants to ignore that they are dying, it's their choice (though, that choice is often harder on everyone else)... but never giving someone that choice is disrespectful (and not realistic). I know there are always exceptions in medicine, but overall that idea makes me uncomfortable.

Renal 911

I'm noticing a change in the seasons. I've started rearranging furniture and building shelving, which means it's almost time for finals again (next week, in fact). Of course, being not the sharpest tack, I decided to do all this home improvement while my back is recovering from last week's "flooded bathroom-induced" re-injury. So, technically speaking, I'm gimped up on heating pads and NSAIDS for... well, with my record, probably the rest of eternity.

I actually don't recall what exactly hurt my back in the first place, but considering I was wincing and twitching during PBL a week before my last final, I highly suspect it had something to do with shelving. Luckily, my PBL facilitator let me lay down on the examination bed in our room (every room comes with one and I finally discovered why!), and my back *slowly* healed over the next few weeks.

But then, disaster struck! It turns out that Phi Chi pipes are older than God. When I came home one day last week, my bathroom was flooded and said pipes had disintegrated. Naturally, the plumbers we called not *only* made fun of Phi Chi (who doesn't like being asked "So you're slumming it by living here until you can make the big bucks, huh?"), but they also left the first day without halting the flow of water out of my pipe. I spent an excrutiating evening carting wet towels to the washing machine and trying to figure out how to stop the leak (first knowledge gleamed from this adventure - duct tape does NOT in fact work on pipes).

I finally did manage to rig up my toilet to no longer fill (for some reason, when the toilet is constantly "running," even though the water is supposedly turned off, the leak stopped). The next day the plumbers sledge-hammered my wall and I got a new toilet... and a sore back from all the wet towels.

So now I'm getting nice and cozy with my heating pad and renal powerpoints...and praying there will be no more excitement in the next 2 weeks.

When the Phi Chi mice start taunting you

There's a mouse in my room, and I fear that it might be craftier than me.

Last week, I put out poison. The box sat for a day until I decided to wedge a piece of cheese into it (hoping that the mouse would eat some poison with its midnight snack).

The next time I saw the box, the mouse had just dragged the cheese out and left it about 6 inches away, as if to say "You call this cheese?!"

I decided to take some advice from one of my neighbors and put out the sticky traps tonight. Lo and behold, within a couple of hours, I found a mouse 1/2 way trapped on one. Unfortunately, when I went to find a dust pan, the mouse somehow managed to pull itself free. And now I have a pissed off mouse with a bald spot running around my abode!

Later I tried to use nature against my new foe: I convinced one of the "house cats" (read: strays that hangs around Phi Chi) to come into my room, thinking it would follow its instincts. I guess feline instincts now involve running away from anything reeking of rodent. First, I tried to get it to smell the trap that "caught" the mouse earlier tonight... it didn't seem interested.

I even resorted to *bribing* the cat with tuna to get it to go near the closet (the last place I saw the mouse). The cat just refused to eat the tuna once it was placed near the closet. Is there some mouse-cat truce (the "Tom and Jerry Accord"??) that I wasn't aware of?

The cat DID manage to get itself stuck on TWO of the sticky traps, tho... even after I picked them up off the floor. The cat got booted after that, but I'm sure it left some fleas (or fungus... thanks pulmonary course for freaking me out about that prospect!) around here.

I'm hoping the cat left enough of its scent that the mouse will be too scared to come back... but I did leave a piece of corned beef and some peanut butter on a couple more traps, just in case.

"That's why you married me!" ;-P

It's no joke that the number one question I've received in that last nearly 2 months has been "So, how's married life?" I can't really even say it's always inspired by a genuine *need* to know exactly how "married life" is... even married people are asking it. Due to my aversion to questions I can't answer easily, I feel almost "pimped" (med school term for getting grilled by the faculty, often in front of patients, to prove they are superior to you) by that question, because there's no simple answer.

For better or worse, most things have stayed the same (we're still in separate cities, we still see each other once a week and talk most nights, I still think he's the most handsome man on earth, it still irritates me when he's right about things, and I STILL have not let Frank live down the fact that he had our Catholic priest read his personal statement "...and then Lynsey *seduced* me with her nerdiness" to a church full of our wedding guests!!).

Besides Frank's embarassing disclosures, the wedding was wonderful. We both had friends and family who braved the rains to join us (both at the church and at the reception at Daily Review Cafe, which was across the city). I love looking at all the photos and seeing so many beaming faces and happy people (guests and me and Frank). Most of the photos are available at http://www.ProctorTamborelloWedding.com, although I will be adding more of the professional photos that my friend, Alex, took... probably when I add the honeymoon photos (and since we won't have the honeymoon until early September, the whole lot will be up in mid to late September).

I have to admit, the photos I love the most are the spontaneous ones - like shots of our proud parents, the picture of me and Frank feeding cake to one another while his little cousin laughs and points as us in the background, pictures of my friends going crazy with the fake rings we left around the restaurant, me hoofing it into the getaway car, or kicking Frank... wait, that last one was an accident... just check his expression in the garter photo ;-). Even though, for the first time in my entire life, *I* wasn't the one taking the embarassing/ candid photos of people (believe me, that was a hard reality for me that day ;-) ), my friends captured so many great memories that I know I'll always laugh and enjoy the photos for years to come. :):)

So, yeah, onto my second year of medical school...it sucks!!! I didn't know how good I had it last year. I finished first year/ neurology on such a high note in terms of grades and enjoyment of material... and then they drop us into the fiery hell known as CVP (cardiovascular pulmonary course)! ;-P

Cardiology itself is fascinating...I LOVED learning all the clinically relevant information, telling people (even if they didn't ask) how good it was for them to start their hypertension meds early in life because they were saving their heart from permanent, chronic damage down the road, spending an entire evening listening to my heart to figure out if that strange sound I heard was a murmur (a LOT of us did this, etc), and I was totally expecting the midterm we took last week to be as clinically oriented as last year's exams (after all, that's what they are supposed to be preparing us for).

So, imagine my surprise when the cardiology exam was *completely* didactic and physiology-based... the closest clinical question we got was on a toxin we had not even studied (and that question was later thrown out). I thought 2nd year was supposed to be more clinically-based to prepare us for our all important board exams next summer?!? As one gal put it after preparing for the test "When will we ever get the chance to tell a patient 'I saved your life because I was able to calculate the Fick Equation!' !??! ;-P

For the rest of the course I'm just going to basically memorize everything I read, not think of any possible patients I might have to treat, and make certain I never have to take this again. When I griped about this course to one of my favorite lecturers (from first year), his response was "Well, what do you expect... it's taught by physiologists!"

The material is interesting, but this class makes me wish I'd gotten an engineering degree in college...maybe that would have helped me.

So, as for the question of how's married life... I can say that the main difference I've noticed so far is that our favorite phrase to one another now seems to be "That's why you married me!"... in a smarmy tone. :)