Lynsey, MS 2

dopplegangers

2007-03-16T21:05:00.000-07:00

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'

2007-02-28T22:01:00.000-08:00

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

2007-02-28T19:53:00.000-08:00

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

2007-02-10T13:59:00.000-08:00

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

2006-12-14T18:36:00.000-08:00

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!

2006-12-14T00:33:00.000-08:00

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

2006-12-06T15:12:00.000-08:00

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

2006-12-06T00:43:00.000-08:00

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

2006-11-13T22:58:00.000-08:00

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

2006-08-09T21:47:00.000-07:00

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. :)

Get me to the church on time

2006-06-04T10:44:00.000-07:00

Okay, so even though I read wedding guest horror stories at Pearls before Swine and other places, I know most of my anxiety over "guests bringing guests" was just due to traditional bridal angst.

Mainly, if someone comes who wasn't on the initial guest, it's out of my control... bring a bride, things that rank under the category of "out of my control" are scary. But I guess it's good I accept that some things will always be out of my control (particularly when it comes to the wedding) now, versus the day of the event.

Besides, my friend Diehl has come up with an even more insidious "punishment" for uninvited guests: he's offered to bring a golden apple marked "for the fairest" and throw it into the crowd if there's any sign of guest-related unrest. That sure to be more destructive than flame throwers. ;-)

Fresh meat...

2006-05-31T11:45:00.000-07:00

The new first years are crawling around campus right now. It's so cute to see the all fresh-faced and eager... before med school starts, that is. ;-)

Some of my friends are tutoring the newbies, so I went into their rooms to check out the fresh meat... everyone's just so determined and unbroken!!!! I can kind of see why the class ahead of us hasn't always been too nice to us (as evidenced by the scary t-shirt they made for us :( )...all that first year idealism is kind of repulsive! ;-)

One solution to the uninvited guests problem

2006-05-23T21:13:00.000-07:00

Hmm, I dunno why I didn't think of this sooner...

Well, my ushers have been sending mass emails to one another with instructions on how to make homemade flame throwers. I have thus-far discouraged this (well, mostly), because it takes 20 minutes for me to get in and out of my dress, and stop drop and roll just ain't gonna cut it with such highly flammable attire (not to mention the hair spray!). However, maybe I should reconsider this and field promote the ushers to "bouncers."

That's why I love my UTMB friends (who are ushering), they're so loyal and such great pyromaniacs. :)

I should have read Miss Manners sooner...

2006-05-22T21:05:00.000-07:00

Ah, Miss Manners, has she ever steered me wrong? :-)

I suppose I feel fortunate that few people have "invited themselves" to our wedding, (and that the location isn't so easy for wedding crashers to "happen" upon), still, I get the feeling I should have memorized (and posted on bill boards!) the phrase "I'm sorry, we're having a small ceremony with family and a few old friends" sooner - it might make one of the irksome aspects of being a bride (dealing with other people's expectations of your wedding) a little easier to handle.

Or I could just blame Frank. :-) First, the parents of a friend of his called his mom and expressed their excitement about our wedding. From then on, I got the distinct message that they'd invited themselves, and so I just sighed and sent them an invitation (I figured I've met them twice, and they are nice people, afterall).

But then I get their rsvp: "Mr. and Mrs. ____, PLUS S_____." Who is S_____? Her name certainly was not conveyed to me before I addressed the invitation, and after practically being raised by a community of etiquette book-toting antique dealers I knew that you ALWAYS specifically address wedding invitations to the individuals you expect to attend.

Additionally, Frank related to me another "innocuous" story: his friend, "L," casually mentioned how her mom would like to attend, and, she supposed that she could just take her mom instead of her boyfriend if we didn't have room. This struck me as odd, considering that Frank only gave me *her* name, and there was no "and guest" on any invitations that went out. Ah!!! Univited guests strike again!!

Besides the space (the reception only holds about 100 people, unless we forced everyone to *stand* for 4 hours), and the money (the reception is usually the biggest bill for weddings), what *really* irks is that these "guests" just sort of invited themselves, or others, without asking. The first two, more practical, aspects could be ignored (when another acquintance of Frank's asked us *personally*, I was more than happy to make room for him and his wife), but the emotional aspect is harder to ignore. It brings up guilt - like somehow I was supposed to know that weddings are "traditionally" open to *everyone* and thus I'm not supposed to care about a few extra guests.

I don't hold it personally against these people, because I know it's all innocuous and everything will work out in the end, but I don't like feeling as if I must uphold other people's ideals/ prejudices/ fears/ expectations at my own wedding.

Mr. and Mrs. Alcoholic Knife-happy Agoraphobics

2006-05-15T21:08:00.000-07:00

According to a number my "kind" friends, evidently the gift registry that Frank and I set up makes us look like all we want to do is drink, sharpen knives, and make our bed.

I swear I can't win... first I get slack for a honeymoon registry, and then, because we have few wine glass sets (besides the plastic stuff that came from a favorite sandwich shop in Austin), sheets (I swear Frank has got some garfield sheets from 1989 lying around somewhere), and cooking utensils (because I have the same flatware that I got from a garage sale before I left for college), we get teased for the proportion of our registry that seems to represent those 3 things.

Registries are just supposed to suggest what the bride and groom might be lacking in their future home - it's a statement that says "no guest has to bring a gift, but if they really want to, here is what the couple might like." It is supposed to be more for the guests that the couple, so I am at a loss as to how Frank and I could have crossed so many etiquette rules about it. Ah well.

Besides, if anything, people should be more worried if we *hadn't* registered for so many glasses, sheets, and knives... it would mean we'd already amassed enough of those items to cause mischief. :)

Fair Praise

2006-04-26T19:55:00.000-07:00

I feel pretty good right now. I've got a neuro test looming in 2 days, which ordinarily would scare me into a neurotic, babbling idiot (yes, moreso than now), but I had some good news today.

This morning we had our problem based learning facilitator evaluations, which in my group meant we go through the excrutiating process of meeting at our faculty member's office and "self-evaluating" our performance in the small groups. It's actually not too customary to self-evaluate, but my facilitator is a psychiatrist and mind games are her specialty (okay, it's reall not that bad ;-) ).

The last time we did evaluations in this class I got averages on most of the criteria. The one "exceptional" score was because I confessed that I'd controlled my impulse to strangle the ADHD guy in my group who is constantly figeting and annoying everyone - my facilitator laughed and so I got an exceptional rating for having "good impulse control" ;-) ).

This time, however, she said that I'd markedly improved in my knowledge acquisition (which could be seen in my higher quiz grades and such), but the best part was when she talked about how she felt my greatest strengths were that I am very sincere and I have a good "attitude." My facilitator said I could always improve my skills, but what she really respected about me what my *attitude*. She went on to say that I had a great attitude about learning and participating in general.

Honestly, that's gotta be one of the best praises I've ever received, and I felt on cloud nine for the rest of the day. My facilitator told me that my attitude will take me far, because in the real world "attitude counts for everything." Since I really respect my facilitator (she can come across in lecture as a little caustic, but she really cares about her students - and she brought food for us everyday!!!), that was totally the coolest thing she could tell me.

Of course, she did say "You don't have the best skills, but skills can be learned." Hehe, I guess that means I'm not the smartest, but oh well... :)

So, I'm happy... either she's a good enough psychiatrist to know just what each student wants to hear (many do want to hear they're the smartest), or else I can be very proud of myself. :) Wikipedia:Sincere

A theory as to why we don't study bipolar...

2006-04-18T19:48:00.000-07:00

A classmate and I were discussing how interesting it is that we don't have a formal lecture on "bipolar disorder" in our neurosceince and human behavior class (neuro+psych), particularly considering the apparent incidence of mania in med students (oh, it's so true!).

He pointed out that it would be a waste of time, since the lecturer would just hold up a mirror facing the class for 45 minutes, while someone in the front row wrote down notes furiously and someone else asked repeatedly for clarification.

Yeah, we've got a week and a half left of our first year of med school - and my pbl facilitator assures me that spending all weekend cleaning and building shelving before my osce (observed skills & clinical exam) is not in fact mania... it's a "defense mechanism" for not wanting to study... supression/ repression/ denial, or all of the above. ;-)

Regardless, my osce was pretty painful... if I had to write some bad poetry about it, "osce" would rhythm with "tragedy" somehow (I said it was bad poetry). I didn't forget anything (that I can remember), but I took too long with my history-taking and thus did not finish the physical exam in under an hour. Talking with other people who either had the same "patient," or saw that the room I was in always had the last student coming out, I figured out that I wasn't the only one who had to deal with the excrutiatingly slow patient. It's frustrating, but so far I have not received the "you've failed your osce" email, so at least it looks like I'm done with this class for good. Yeah! :)

A lesson in medicine

2006-03-27T13:07:00.000-08:00

During my "preceptorships" (follow around an MD for an afternoon), my family medicine mentor taught me the value of knowing the difference between a "WAG" and a "SWAG". Now, what are WAGs and SWAGs you say? A WAG is a "Wild Ass Guess" and a SWAG is a "'Scientific' Wild Ass Guess."

Guess how many of those I used on today's Neuro midterm? *sigh*

Aww, fairwell to my old stomping grounds :(

2006-03-21T18:55:00.000-08:00

Alumni to bid farewell
to HISD’s Rogers Elementary

March 21, 2006—Alumni of HISD’s Will Rogers Elementary School are invited for fellowship and a chance to bid “farewell” to the campus during a special reunion Saturday, March 25. The school, which is located on the grounds of the old HISD administration building, will close at the end of this school year because the property has been sold.
The party will take place from 11 a.m. to 3 p.m. on the grounds of Rogers Elementary School, 3101 Weslayan. Children’s entertainment, food and refreshments will be provided.
Rogers Elementary School, along with the former HISD complex at 3830 Richmond Avenue, will be razed later this year to make room for a new residential and retail space maintained by Trammel Crow real estate company.
Opened in 1950, Rogers Elementary School has for years been recognized for its outstanding academic performance. It is one of the first campuses in the Houston Independent School District to offer an extended-day magnet program.
Noted Rogers alumni include Texas State Representative Harold V. Dutton, Jr., Cleveland Browns football player Warrick Holdman, actor Salim Grant, and Houston Chronicle columnist Shannon Buggs.

Who reads this stuff??

2006-03-21T18:45:00.000-08:00

You know an essay grading system has got to be crazy when a classmate of yours gets an A- grade for a paper in which his opening sentence was roughly "I hate this course, it's keeping me from studying for my real class."

Yes, once again begging the question as to why we are required to write personal, subjective essays for a *clinical skills* course, when they just get graded on a bell curve (ie, only 15% of the class can get an "honors" on the essay, and on down) and returned to us *3 months* after we submit them. ;-P

Spirituality, in vitro fertilization, natural family planning, oh my!

2006-03-19T12:40:00.000-08:00

In the past week I have gone to three different talks on in vitro fertilization (for a school organization), spirituality in medicine (required for my practice of medicine class), and “intro to natural family planning” (I’m getting married in a Catholic church, so you put two and two together on that one ;-) ). These talks, oddly enough, overlapped remarkably well.

Much to my chagrin, I was less than impressed with the spirituality in medicine lecture series. I agree with the spirit of this discourse, that patients come to physicians with myriad personal, spiritual, and religious beliefs, and by respecting those we will likely improve communication and even their health outcomes. Indeed, there is too much convincing evidence (though, understandably most are correlations) of a mind-body-health connection that I think it would be reckless for a doctor to ignore his or her patient’s self-efficacy as a valid part of healing.

However, I think turning the spirituality in medicine talk into a rather didactic lecture with lists of correlations was not the way to go (ie, saying that “religious people live an average of 7 years more that non-religious people”…well, come to think of it, left-handers live an average of 7 years less than right-handers, that doesn’t mean I should change which hand I write with – although it would be nice not to smear my lettering for once). Normally, I am all for “show me the evidence,” but I think the speakers would have been more compelling had they included more personal stories/ parables, and left some of the lists of correlations at home.

Surprisingly, I came away from the “Natural Family Planning” class with a little more understanding about the people who would choose that method. Admittedly, I was prepared for thinly-veiled propaganda aimed at getting married couples to “go forth and multiply,” (which, admittedly, we got… some of those pamphlets were very annoying and incendiary), but I was impressed that the couple teaching the class stuck most with the personal reasons for why they chose NFP over other forms of “birth control” (or “conception regulation” as they called it).

By sticking with their personal stories (the couple said that tracking the woman’s temperature and charting it daily helps their communication), I could respect that, for some people, NFP is a valid and healthy means of “hedging their bets.” I even thought that physicians should at least be aware of this option for women who might be too sensitive to estrogen and cannot afford or don’t want hormonal/ surgical birth control. That is sort of why I wished the spirituality in medicine class had included more personal stories, because you don’t always have to cite “research” to get people to understand something.

Now, granted, Frank still had to remove the pen from my hands when I was about to inconspicuously cross out all the lies in the pamphlets that were passed out to us (for the most part the NFP couple told the truth… they just kept the lies in the pamphlets ;-)).

I absolutely could not hold my tongue when the couple tried to say that hormonal birth control (pill, patch, ring, etc) was abortifacient… I HATE that people lie and try to say that birth control kills a life – being a health peer advisor in college, I ran into this rumor a LOT and it always irritates me. But fortunately, the couple was actually very responsive when I corrected them that there used to be a rumor of “break through ovulation,” when the pill was first tested, because women were not using it correctly (ie, not taking it at the same time every day, etc). However, when BC methods became available that lowered human input (and thus, human error), like once a week patches and once a month rings, BC efficacy goes up to nearly predicted levels, thus largely discounting the unproven "break-through ovulation" theory (because, if there was really such a thing as "break through ovulation," then wouldn't the practical effectiveness of hormonal contraception be the same no matter *what* method a woman used?). Birth control works by stopping ovulation and impeding sperm, NOT by aborting fetuses, and I wish people would stop misrepresenting that for their own gains.

Since the couple was so welcoming of information about hormonal birth control, I decided not to point out to them that, statistically speaking, a woman is more likely to have a “spontaneous abortion” (yeah, this is bad wording, but it's meant to show the fallacy of using emotionally manipulative language) on a non-hormonally regulated cycle (ie, NFP), than she would with hormonal birth control. But I do find it ironic (and yes, in this case I mean “irony”) when some uninformed person tries to say that a fertilized egg could be “aborted” by a birth control pill, when the majority of fertilized eggs are washed out of the uterus without implantation in any normal fertile woman.

The couple was right when they said that “fertility is fragile,” although I doubt they meant it in terms of the fact that, even if both the make and female are completely healthy, their fertilized egg has only a 25% (optimistically) chance of implanting, developing, and being born. THAT is what irks me about people trying to scare the public by saying birth control kills, because (taking a kind of sick look at it all), a woman NOT on birth control is more likely to "kill" a zygote than a woman on birth control. I would DEFINITELY never use that argument to say everyone should be on birth control (because it would also be a misrepresentation to influence personal decisions), but I think people should stop spreading lies to scare individuals about hormonal (and other forms) of contraception. Seriously, it is not fair or moral to tell a woman that her choices could end a life - child birth and contraception are already emotional and personal aspects of life that don't need unnecessary pain added to them.

Out of curiosity, I did a pubmed search on NFP – I went back nearly 10 years and could not find a good longitudinal study or review article on its efficacy, although I found a number of surveys that have couples self-reporting better communication when both take an active role with it, and a number of cross-sectional studies that suggested many people do not follow it soundly (ie, one study reported 1/3 of surveyed NFP couples had unplanned pregnancies, another study said it was hard to follow couples longitudinally because the majority of NFP practitioners discontinued it prematurely). With these data in mind, I don’t think NFP teachers should misrepresent its practical effectiveness (our teachers said it’s 99% effective, but didn’t quote a peer-reviewed source). I agree that it’s theoretically effective, but like any method, it is still influenced by human error.

Anyways, so the in vitro fertilization talk was by far the least incendiary and annoying. The chief of the in vitro clinic at UTMB gave a power point presentation about how IVT works, how it’s even more effective than natural conception (IVT is 50% effective, while natural conception is 25%), and the benefits and drawbacks. Then she spoke personally about how rewarding it is to help couples achieve their dreams of having children. I thought she did a great job of balancing science with personal stories. ;-)

In all, I have more respect for speakers who use appropriate methods to discuss their topics. There is enough scientific evidence on in vitro fertilization that it was appropriate for the chief of the IVT program to be a little didactic, but I liked how she added a personal touch at the end. I don't really think the natural family planning teachers were completely balanced and unbiased, but they were fairly convincing when they stuck to discussing how NFP improves their own communication. And ultimately, the spirituality in medicine people need to learn that "correlation does not equal causation!" :)

some citings from pub med:
1/3 NFP users experiences unexpected pregnancy, cross-sectional.

difficulty getting people to stay on the program

Another biological arms race

2006-03-14T16:39:00.000-08:00

http://www.nytimes.com/2006/03/14/health/14preg.html?pagewanted=1&ei=5094&en=7cd88834c78b9cba&hp&ex=1142398800&partner=homepage

The NYT has a cool article about the envolution of pregnancy... how, even though an individual inherits (usually) 2 copies of a single gene, the function of those genes could depend on whether he or she inherited a copy from their mother or father. It's a fairly neat, thought-provoking article.

Oh, and Happy Pi Day! (3.14) ;-)

Conflict of Interest

2006-03-08T13:31:00.000-08:00

I am somewhat ambivalent about the new problem based learning (PBL) format of "pitting students against one another." In past classes, our small groups were encouraged to bring our reference books to class and work together to solve problems. This would sometimes lead to 10-15 page cases per session, a length I do not miss, but I did feel like I was more of a group member at that time. This time around, while we sometimes have only 1 page per day, we are separated into 2 groups and must compete to see who can answer the most questions correctly on quizzes (called "RAT" test... that makes us feel good ;-) ).

For instance, today I arrive in PBL, and one of my friends declared "you can't sit there, you're not in our group!" I know she was joking, and I was halfway joking when I expressed to our facilitator (who is also a course director, so of course I wasn't trying to influence curriculum policy or anything... ;-) ) that this new format was in conflict with our commitment to work together with other medical professionals. She just laughed (I'm pretty certain at me ;-) ), and told me to just take it as a game and don't worry too much... the other facilitator suggested I no longer be friends with the girl. ;-)

So yes, we do seem to have shorter cases (which I like), but our groups don't seem to be as "close" (which I miss) in this course. Still, it's only been a week and a half, so we're all trying to give it time.

For the time being, I will focus my ire on more important things... like the *other* course facilitator, who made an angry threat this morning that he would lock the doors at 8am from now on so that no one comes in late anymore. At lunch today my classmates and I were discussing t-shirt ideas from this announcement, perhaps one that says "Module 1: Gross Anatomy, Module 2: MCT, Module 3: Pathobio, Module 4: Neuro, Module 5: lock picking . You just know this is going to backfire with students banging on the doors @ 8:02am and really disturbing class, when before a few stragglers would barely raise an eyebrow (it's not like someone doesn't already feel bad for being late!).

Of course, I might be feeling a little sensitive because I was that 8:02 straggler this morning - but I had a perfectly legitimate excuse - my stupid, cheap underwear drawer wouldn't open this morning!!! I spent 10 minutes yanking on that thing before finally almost pulling it out on top of me! :( That's what I get for living in a frat with "built-in" furniture! ;-P

Do as we say, not as we assign...

2006-02-27T18:47:00.000-08:00

A little part of me is both crying and laughing right now. This morning we got an introduction to our new "neuroscience and human behavior" class that featured the class directors encouraging us to "get more sleep." Then we checked the syllabus: we're supposed to read 25 chapters this week by Friday's lectures. It would seem that, if the directors truly were concerned about our sleeping patterns, they might consider cutting the reading assignments down *just a smidge*!

...guess I don't get that "week off from studying" after last weeks finals afterall.

New bridal tradition: flame throwers for the ushers!

2006-02-18T10:59:00.000-08:00

http://www.goingbridal.com/etc/wedding_crap.shtml

Check out the modernized bridal check list... my ushers particularly like the idea of wedding flamethrowers... I like the idea of being adopted (j/k). ;-)

Oh, and Frank and I got our "compatibility" test results back... evidently we did very well (for whatever that's worth on a bubble in the blank "test"). Today Frank and I were discussing combining cell phone plans (aww, our first step as a family... setting up a "family" phone plan) and he grumbled about signing a two year contract for our service. I tried to point out that someone who is getting married in 4 months shouldn't be afraid of a little cell phone commitment, but evidently the "irony" was lost on him... ah well. ;-)

Okay, back to studying parasites.

BrideAudit™