Fun medical fact of the day: Hemochromatosis, the increased deposition of iron in the body, can cause levels of iron high enough to set off airport metal detectors. I bet those people have fun explaining to the TSA worker that they're not terrorists.

I've been on Christmas break for 4 days now. Thank goodness. Although, will the pathetic amount of studying I did for the last two weeks of school, this might as well be my third week of break. I finally bit the bullet and went to a coffee shop to study, knowing that bribing myself with hot chocolate would be the only way I could force myself to study for the boards.

Speaking of the Test That Shall Not Be Named, I am officially signed up to be tortured on June 13, 2011.

And it's only costing me my first born child. There's something inherently wrong with having to pay hundreds of dollars to take a 9 hour test. Not to mention, a week later I'll have to do it all over again when I take the MD boards.

If I don't pass these stupid tests, I'm quitting med school and joining the circus. Our school has an 80 something pass rate for the boards, so logic states that I'll pass, but that doesn't stop me from having the increasing certainty that I know absolutely nothing about medicine. Or that I'll forget everything I did know when I start the test.

I'm sitting in this coffee shop, trying to remember all this stuff I once knew about liver pathology, but I can't concentrate because these two guys next to me have never heard of volume control. They are in dentistry school and they're complaining about school and professors and patients and they're talking like dentistry is the most important profession on earth. Maybe the fact that any talk of teeth and dentists make me want to cry and then go floss is coloring my feelings, but I kind of want to punch these guys because teeth are not life and death like they make them out to be. Medicine is life and death, and if you can't use your inside voice, my future patient might die because I won't have learned that scorpion bites can cause acute pancreatitis.

The longer I listen to these guys, the more I'm starting to get the sinking feeling that my friends and I sound just like them, although I can be fairly certain that we're not nearly as arrogant as these two. I'm pretty sure dentistry is not God's gift to mankind (not that I'm saying medicine is). But we sit around and complain about how hard med school is, how much busy work we have to do, how many hoops we're being made to jump through. We talk about our futures with such certainty, like we have any idea what real medicine is like. We bitch about studying for the boards, like I'm doing in this post.

I don't think we take enough time to sit back and realize how lucky we are to be here, to be doing what we've worked years to do. We have the chance to join a profession that makes a difference, a profession that is respected. We've made it to a place where thousands of people never do. Last year 42,742 people applied to medical school. Only 18,665 matriculated. I forget how lucky I am amidst the tests and late night study sessions and crazy Deans and drama.

I need to remind myself more often that all of this will be worth it on the other side. Maybe that will get me to stop complaining so much... but then again probably not. Whining is, after all, the official sport of medical school, and if I stopped whining, then there would probably be more drinking. And I don't really want liver flap, because that's not so attractive.

Happy Holidays!

Reality

When I tell people that I'm moving to New Jersey next year, everybody brings up the cast of Jersey Shore. I have less than no interest in meeting these people with their weird tans (maybe they all have hemochromatosis) and an unhealthy obsession with doing laundry. Maybe I should start a prophylactic course of Doxycycline and Ceftriaxone just in case I ever run into these people. I bet you could catch an STD just by breathing near them.

It got me thinking about reality television and how there's a show for every lifestyle known to man. Even Sarah Palin gets one to "promote the wonders of outdoor Alaska" (read: make the dumbest bid for the Presidency ever. If our next President is a reality star, I'm moving to Europe. Hello, socialized medicine. Oh, wait...)

So how come there's not a reality show about medical school?

The camera following the Mad Medical Student (MMS) around would slowly zoom in on MMS sitting on her couch, wearing sweatpants, surrounded by a moat of pathology notes, muttering to herself about the most common types of appendiceal tumors (Carcinoid, btw). And you wait for something to happen. You go get a snack. When you get back, she's still there. Still studying.

Then the camera falls to the ground and the scene is all sideways, the screen cracked. What just happened, you wonder? Maybe the cameraman was attacked by zombies? Oh wait, he just fell asleep from the sheer mind-numbing boringness and dropped the camera.

All reality shows run on a steady diet of drama, and medical school has its fair share. For instance, they'd film the MMS as she exits her test and begins to compare answers with her fellow inmates classmates. The audience will watch, breathless with anticipation over who will win the argument about the answer to question 10. Does the MMS triumph over her adversary? Find out after the commercial break.

Sadly, no. The adversary's right, as always, dammit. She threatens to kick him in the shins just to make herself feel better for not remembering that it's antifreeze, not methanol, that will cause the kidneys to crystallize when consumed.

And then there'll be a nice montage of MMS studying and mainlining caffeine and checking her email for the 576th time that day.

When Friday rolls around, the audience will sit up a little straighter in their chairs. If there's ever a time for something TV worthy to happen, it would be on Friday night, right? Ooh, look, MMS is wearing real jeans, not sweatpants! She's getting into her car; she must be going out....

To Walmart. You'll watch her stand in the butter aisle for 10 minutes agonizing over the 17 different kinds of I Can't Believe It's Not Butter. She's crippled by the choices, because she just took a test that morning and can no longer make decisions. You'll accompany her home, where she'll spend the rest of the night cleaning a weeks worth of dishes out of the sink and doing a month's worth of laundry.

That sounds fascinating, doesn't it. I'm going to call it Why Am I Paying $200,000 To Be Tortured: My "Life" As A Medical Student. Maybe TLC will air it right before I Didn't Know I Was Pregnant.

T-23 Hours

T-31 hours

Thank goodness finals week is almost done.

Every test I've taken in the last 2 weeks has been about diarrhea. I am not a 12 year old boy, therefore, I do not find this amusing.

And the Winner Is...

New Jersey!

I got my first choice. I think my blood pressure probably increased 20 points today. It was really stressful. Here's pretty much how it went:
9 am: The match closed. I checked my confirmation email for the 15th time to make sure I put in the right spots. Then I attempted to pay attention to a lecture on endocarditis.
10-12: I sat in OTM for two hours and checked my phone when the professors weren't looking. My partner and I contemplated the likelihood of getting murdered if we prank called people in the class pretending to be the person who tells you that you didn't match.
12: The administration ran the match results. Then they told everyone that they'd be making the calls around 12:15.
12:15-1 pm: Stared at my phone and willed it not to ring. Also I took a depression test the mental health department was offering. No depression, but I scored really high on the Generalized Anxiety Disorder section. The score sheet told me I needed to be evaluated by a professional. So I worried about that for a while, then I stared at my phone for a while.
1-2: Made up answers on a quiz and stared at my phone again.
2-4: Watched people get the phone calls telling them they went unmatched. There were 20 people that didn't get a spot! Had a minor heart attack over that fact and then checked my phone again. Still no calls.
4:30 Realized that I hadn't gotten a call, which meant that I'd gotten a top 3 spot. Then started watching my computer screen for the placement email, which would be out by 5.
5: Still no email.
5:30: Still no email. But I think I pressed refresh about 500 times in the last 30 minutes. Gave up and went to get something to eat.
5:45: Got the email while I was waiting for my food. New Jersey!

Whew. Now that I'm done stressing about where I'm going to be living next year, I can start stressing about finding an apartment without actually having time to visit.

So I'm moving to New Jersey, which I know practically nothing about, except there are gardens and a show called Jersey Shore that I've never seen. But maybe I'll get to treat one of the cast members for an STD when I'm on an Infectious Disease rotation. The hospital that will be training me has one of the largest infectious disease departments in the country, which guarantees that I'll get an opportunity to see some weird stuff. Plus, they have an ID fellowship, so I can start kissing up now.

Time to study, not that I can actually concentration, but I have a test "Girl Parts" as my professor calls them on Friday and I know nothing other than some random facts about placenta.

Placenta Lisa

Here's what my Pathology Notes have to say about Placenta:

1. Leonardo da Vinci made a detailed drawing of the placenta, but for some reason this picture didn't catch on as well as the Mona Lisa or The Last Supper (Go figure).

2. Top Five Reasons to Bury Your Placenta-
          1. So dogs won't eat it and make the mother sick
          2. So dogs won't eat it and make the child a criminal
          3. So the mother won't get pregnant right away
          4. So the mother will get pregnant right away
          5. So it won't end up near a body of water, otherwise the kid might drown.

3. Placenta is Latin for "flat cake." (Great, yet another food medicine is ruined for me. Not that I know what flat cake is.)

4. There are references for articles in some Mommy magazine about eating your placenta and all sorts of recipes for placenta pizza.

After that there's some actual medicine, but that part is boring.

Hope you didn't just eat.

A Match Made In Heaven...

Or possibly hell.

Medical school works like this: the first two years you sit in a classroom and cram every piece of medical knowledge you'll never possibly remember into your brain and pray it sticks. Then you take the Test-that-must-not-be-named and pray you pass. And then you stick around town for two more years and hang out in different parts of the hospital and learn the actual medicine from real doctors who ask you random questions about biochemistry and then point and laugh when you can't remember all the steps of the Krebs cycle. And then you pray they give you a diploma and you get to pretend to be a real doctor.

This isn't quite how it works at my school because the town where my school is located is so small it doesn't even have a Target. However, it does somehow manage to have about 200 hundred churches. And a man in a motorized wheelchair that drives down the middle of the street clutching his beer in one hand and a cigarette in the other. And a movie theater that only takes cash. And about 15 thousand blinking stop lights. It's too small to be a country, but too big to be an insane asylum. That's my favorite Civil War quote (yes, I have a favorite Civil War quote, I am such a nerd). Some congressman said that about South Carolina when it seceded from the Union and it totally applies to this town. This place kind of reminds me of Stars Hollow from Gilmore Girls, except there's more rednecks and less Kirk, which makes it infinitely less charming.

Anyway, because my town is small, the hospital is small, and cannot support 300+ medical students at a time. So hospitals all over the country have agreements with our school to take us for the last two years and teach us some medicine.

Thank goodness, because I will do just about anything to get out of this place. Suffice it to say that getting out of here means not having to deal with surprise dress codes, and not having to see the majority of the people in my class every day, and not having to stop at 15 stop lights in the mile from my house to the school.
Man, I just read that over again, and I sound like Scrooge and the Grinch all rolled into one, but I think that's mostly because I left school last night at 1 am and returned at 6 am this morning, which means that I never actually saw the sun yesterday. And then I checked my inbox to find an email from the Dean that encouraged me to enjoy the nice day outside and to remember it when I'm stuck in the hospital on night call and will never see the sun again. Way to rub salt in my wounds.

Somehow this post started out about the match and mutated into 10 Things I Hate About You, not unlike cancer cells. This post is metastasizing.

The Match is officially on Monday. I get to pick 6 places that I'm interested in them and I rank them 1 to 6 (imagine that). We can write a letter to our number one choice telling them how awesome we are and how much they should want to choose us. The medical term for this is Kissing Ass. The hospitals have the ability to choose up to half of their spots before the match based on these letters. If you're chosen based on your letter, you're taken out of the match. The match is then calculated by some fancy computer program that randomly assigns everybody else to the highest rankings it can.

I think the hospitals have already made their choices based on the letters, which means that I could already be placed and I don't even know. The suspense is killing me. I think this process is giving me even more gray hair than medical school in general is doing.

Here's the kicker of all this. I'm either going to get my first choice or I'm going to go unmatched. Which would be very very bad. Because then the only options would be Arizona (where I will melt like the Wicked Witch of the West) or a little town in the boot-heel of Missouri that is rumored to still have white-only restaurants. I cannot spend the next two years in a town that is responsible for Missouri beings a Slave State (Jeeze, another Civil War reference. Sorry, I need to put my major to use somehow). I need a Target. Or at the very least a speed limit above 30 mph.

Suffice it to say that this process cannot end soon enough and I really need to get my first choice. The odds are fairly good that I'll get it, but I've learned that there are no guarantees in medicine education. At least at this school. And there's no crying in baseball, but there is crying in medical school. Especially if I'm unmatched.

At least I'll know by Tuesday, whatever happens. I promise to tell you where I'm going. If I'm still alive on Tuesday.

I forgot to mention the craziest part about all of this! After the match, there's a trading season where students can switch spots with someone. And people will pay to get the spot the want. Like $7,000 kind of paying. If I didn't get my top spot and someone wanted my spot, I would totally switch for that kind of money. I could use all that extra cash to pay for the Tests-that-must-not-be-named because they are expensive. I am paying good money to be tortured. Lovely.

You know, the "Mad" in Diary of a Mad Med Student originally meant angry, but I'm pretty sure it's more of the Alice in Wonderland's Mad Hatter version of the word now.

You know you're in med school when...

You can study a pictorial guide to STDs and eat dinner at the same time.
And not even feel queasy.

Wherein I ramble because I'm tired

This is what I had for dinner tonight. I didn't realize until I put all the food on the plate, but everything is orange. I'm pretty sure the only thing I learned in nutrition was that a monochrome diet is not well-balanced. What's that saying? Do as your med student says, not as she does.

In other news, I am apparently no longer allowed to sleep. I've had have some sort of insomnia for the last two weeks, which is perfect timing considering all the tests. I don't even try to go to sleep until about 1 am because otherwise it's just like torturing myself, lying there pleading with my brain to TURN OFF. Three nights ago, I decided at about midnight that I'd rearrange the furniture, make it more Zen or something. Two nights ago, I watched about 4 episodes of Glee. I figured maybe the cast of Glee could lull me into sleep with their rendition of Don't Stop Believin', but no such luck.

Last night, I was getting desperate, so after about 30 minutes of tossing and turning I got out the big guns.

I figured maybe I could read some of it and maybe bore myself into sleep. After all, I did pay $100 for this sucker; in addition to teaching me something about medicine it better double as a sleep aid. 

 There's 2754 pages in Harrison's, so there should be something soporific enough, right? Beetle vesication apparently wasn't boring enough. Maybe I should have tried the section on African Sleeping Sickness.

Tonight I'm going to have to break out my Robbins. Maybe reading about the histologic appearance of squamous cell carcinoma will put me to sleep. If it does, Pathology will be my new best friend. And if it doesn't, well, then maybe all that reading will help me do better on the test...that is, if I don't fall asleep on the scantron.

Sugar

In all the studying I did today, here's the only useful piece of information I learned:

Estimated amount of glucose used by an adult human brain each day, expressed in M&Ms: 250

Harpers Index

I wonder if those the regular or pretzel kind...

What I Do Instead of Study

Accessorize the skulls.

I wish my cranium had hinges on it like this guy's so I could cram some more stuff in my brain.

What do AIDS and med school have in common?

It sounds like the start of a bad joke. Unfortunately, it's not a joke; it's just bad. Or pathetic. I can't decide.

Here's what my notes say about AIDS dementia:

Cognitive Impairment: memory loss, difficulty reading, inability to concentrate, increased difficulty in performing common and then complex tasks.

Behavioral and mood impairments: apathy, lack of initiative that can progress to a near-vegetative state, agitation and mild mania.

I have textbook AIDS dementia minus the actual part about having the HIV. Maybe I have med dementia. This must explain why I have to ban myself from Walmart on test days otherwise I'll stand in the shampoo aisle for 20 minutes because I can't make a decision. Oh, and why I have no idea what month it is. And why sometimes I stop at green lights. And why I can't remember the name of the organism that causes Cutaneous Myiasis.

Dear Moron,

To the people of the town in which I'm being held hostage by my medical education:

Were you too busy making meth to learn how to read? Is that why you've never read the Missouri Driver's manual?

Or have the rules of the road different here than in civilization.

Perhaps it's just that in this God-forsaken, redneck hell-hole, your kindergarten teachers forgot to teach you about waiting your damn turn!

Is that why you refuse to obey the law and actually stop your car at a four-way stop. How hard it must be on you to wait the four extra seconds it would take for you to stop and let the person with the right of way go first.

No, wait! Let me guess. You're Sandra Bullock and this is some low-budget version of the movie Speed. If you press on your break your car is going to explode, right? That must be the reason why I get cut off at least once a day by some moron that hasn't figured out that blinking red lights = stop. They are not saying "Please run me! And crash into the law abiding citizen next to you."

And what's even better, when I honk at you because you're breaking the law and getting your piece of junk dangerously close to one year old Conrad, you get all pissy, LIKE IT'S MY FAULT.

Whew, rant over. I think this blog has just become a place to store my whining. Either that, or my life just sucks right now. Or both.

I realize this sounds dumb, but I've been in more near-accidents in a one mile radius in this teeny, tiny town than I have been ever anyplace else. How many more days until I get to leave this place? If I end up here for third and fourth years, I'm quitting med school. It's not like they even have a Target here to make up for all the morons.

This is just another of a million incentives to pass my classes so I am not stuck here for another year. Please, fancy hospitals in far away states, don't make me stay in this town-sized insane asylum. I'll do all your scut work for free, and I'll even pay you for it.

P.S. Boards studying starts today... Goodbye, life.

Tales from the Homefront

This just in: my dishwasher actually works. I haven't used it since the day I moved in and water came gushing out the bottom and all over the floor. I've been hand-washing my dishes all year and using the dishwasher as a giant drying rack. I decided that because today is the first day of a new quarter (and, therefore, a self-imposed no-study day) that I'd try it again (pathetic, I know). A year later. And it totally works. It's like magic....

Or it could just be that the last time I used it, I may have put in dish soap instead of dishwasher detergent.
Just think, I could be your doctor someday!

As a bonus, the thing washes my dishes to the back beat from We Will Rock You by Queen.

Germaphobic Tooth Fairy

I've been an official second year medical student since last Thursday at 11:00 am.
The other day, somebody said that if they had to repeat the first year over again, they'd quit med school. I have to say, I totally agree. It was torture the first time around. I'd rather spend the rest of my life working at the DMV than repeat the first year.

I'm currently enjoying my last vacation that is completely devoid of studying. From here on out, my vacations will consist of board preparation in the form of relearning everything I've managed to forget in the last year. Yay. I've bought a board prep book, of whose cover I haven't even bothered to crack. My current board study plan is this: When I'm studying for about the effects of saw palmetto on Benign Prostatic Hypertrophy and I think, "Hmm, I used to know in what section of the prostate BPH is most commonly found," I stop and look it up right then, instead of doing what I would normally do, which would be to promise myself that I'll remember to look it up 9 months from now when I'm really studying for the boards. We'll see how well this actually works out.

In other news, I'm currently playing single mother to the four kids of a fellow medical student while he and his wife are on vacation.
I'm learning such things as:

1. The Fives should come once a day, unless its test day. I do not like waking up in the fives every day. It makes the day really, really long.

2. The person who invented the child lock on the car windows is a genius and I love him.

3. I now respect my mother on a whole new level. Especially after having to repeat everything I say approximately 5 times before anything gets done. I actually said, "Did you hear me? I'm not just speaking for my health." Oy.

4. Did you know that you can deep fry tater tots?! They're already awesome little bullets of cholesterol that go straight to my coronary arteries, but you can drop them in a vat of hot oil and make them that much better! Where have deep fried tater tots been all my life? Granted, I did not actually feed the children this because I don't want to give them heart attacks and their mother is trusting me to at least feed them a carrot or two while she's gone, but I seriously considered making some for myself after they went to bed. Alas, I was too tired from all that 5 am-ness that is going around this house and fell asleep.

5. I'm an awesome tooth fairy. The youngest's tooth fell out at lunch yesterday, and I didn't even throw up. I hate teeth. I don't want to see them wiggle, much less fall out of your head. Granted, I never even touched the tooth. I made her put it in a strainer to wash it off, and then transferred it to a plastic baggie.

6. In the event that I fail out of med school, I'm going to get a job as a stay at home mom. Although I have this sneaking suspicion that in real life, it might be harder than becoming a doctor.


Currently Reading: Stiff: The Curious Lives of Human Cadavers
The book is supposed to be about all the different ways society has used cadavers throughout history, from anatomy labs to proving the Crucifixion of Jesus. I think what I've really learned is that there are some really loony people out there that should probably not be allowed to run scientific studies. Or let out in public. What made these people think that it was a good use of time and money to take cheek swabs from people and test to see if the cells can still feel their owner's emotions from 50 yards away?

Growing Pains

Here's the thing I hate about having to be an adult: learning how to handle conflict. I feel like that's been the theme of my life in the last year. Back in the day (or two years ago) when I was only a semi-adult, I liked to pretend that my problems didn't exist and I would just let everything go.

But now that I'm old, I think I'm no longer allowed to do that. Speaking of being old, I was babysitting my four favorite kids last weekend and one of them asked me how old I was. It took me a while to remember. Am I 24 or have I already turned 25 and just can't remember. So after much deliberation I told her that I was 24. And she says "How come you don't know how old you are?" Well, I hate to break it to you kid, but after 21, there's not a whole lot to look forward to. Well, discounting the fact that at 25 I can finally rent a car without the extra premiums. Woohoo. But I love that in little kids minds there is a huge difference between being 5 and 5 1/2.

Anyway, now that I'm practically a senior citizen, it's officially time to put on my big girl pants and learn to stand up for myself. Which I hate doing because I want to live in La-la-Land where the fairies take care of all my problems and I never have to be confrontational about anything and there are puppies and kitties romping around on grassy knolls and garden gnomes give me lollipops. La-la-Land sounds an awful lot like an acid trip (not that I would know what that's like).

I'm in medical school, which is awash with Type A personalities that operate on the theory that in any human-to-human interaction if you haven't steamrolled the other person, you should get your money back. Now I do attend a school that likes to be known for its lack of cutthroat competitiveness and where everyone wants to hug and be friends and share notes and study strategies. All the warm fuzzies are well and good, but we're in medical school and there are still a good number of people that are out for blood. They just have to pretend they're not.

So what happened? We have this bi-monthly torture session called Pathology lab where you're supposed to diagnose fake patients using your considerable knowledge of pathology (meaning we scan the pages of the Robbins book until we find the picture she used in the case and write down the disease, all the while pretending we know exactly what we're doing). One person has to type up all our answers. I volunteered to type because then I don't have to stay after for the review session. I've typed before several times without issue. Except this time, there's this kid who must be angling to be God because he's sure he's omnipotent and therefore feels entitled to run the show (I'm not bitter or anything).  I can tell he's upset that he doesn't get to type and be all in charge, so he spends the next two hours correcting my every move, which is ANNOYING. He especially likes to correct my spelling while the professor is in the room and she's talking and I'm trying to frantically write down everything she says so we all get a good grade. That is the least appropriate time to be correcting my spelling.

I finally get frustrated with him and make that known and he backs off a little. And he "apologizes" at the end of the lab, which wasn't really an apology but more of a "I'm sorry if I kept telling you what to do, I just wanted to get everything right." Which in medical student speak is: "I'd like to take this opportunity in front of everyone to make it known that I'm so much smarter than you and your pathetic because you can't spell atelectasis off the top of your head."

No big deal. He's a controlling know-it-all, I already knew that. But then I find out that he's going around complaining about me! Now I'm mad. What do I do? Do I send him an email or talk to him and call him out on being an ass? Because I'm over not standing up for myself. But where do you draw the line? Where does not being a doormat end and being a pain in the ass begin? Am I making a big deal out of nothing and should just let it go? Or is it a big deal because I think it's a big deal? Ahh, the joys of growing up. Maybe I should go visit the Magic 8 Ball in the library and ask it what to do.

Okay, I think I'm officially done whining. And anyone reading this is probably muttering about crazy medical students and their inane problems. Just writing about this has been so cathartic that I am no longer mad, and I don't feel the need to go yell at this guy resolve this dispute in a mature fashion. This was like a virtual therapy session, only cheaper. The power of the internet.

Plus I think postal service in this town has decided to stop delivering mail to me. They keep dropping off mail addressed to people who no longer live here and I dutifully put it back in the mail slot with a note. After about the tenth time with the same person's mail, I might have gotten a little bit shirty with my note, and I haven't had any mail since. How do I figure out if I'm just not getting any mail or if I've been blacklisted by the postal service short of sending myself a letter, which is pathetic?

Update: My books finally came in the mail! There's no conspiracy, just the possibility that the post office employs sloths to sort the mail.

I Object!

Today we started our jurisprudence class. Jurisprudence being basically a fancy word for "Let's teach the doctors how not to get sued." We received such helpful advise as "Patients don't sue the nice doctors, so smile when you inform a patient that you have to perform second surgery  because you were an idiot and left a surgical sponge in their belly. And if you're really good they'll be so grateful that you're not even charging them for it."

I don't think I've ever been more sure that medical school is the right place for me. No offense to my law schooled friends, but I don't think I've ever been more bored in class. Granted, they probably learn about the cool parts of law; we learned the difference between the plaintive and the defendant. Seriously? Anyone who's ever watched Judge Judy knows about that.

Also, I thought medical words had a lot of hard-to-remember Latin terms, but compared to some of the terms this guy was throwing around, medicalese is a breeze (heh, I rhymed). This law stuff, however, is basically indecipherable. And all these phrases sound faintly dirty. Don't believe me? Try saying Ad Testificandum out loud.

The only thing that kept me from poking my brainstem out with a pencil was that the professor does magic tricks. It's like attending the Criss Angel School of Law. Well, that and the fact that he tells you what all the test questions will be during the lecture.

It's all in your head

There's this generalization in medicine that says when you're in medical school, you think you have every disease you learn about, and when you're finally a doctor, you think nothing can touch you. Basically when you're in med school, you're a hypochondriac, and when you're a doctor, you're invincible.

Let me be the first to tell you that the first part is totally true. Granted, I've been the first category going on 24 years now and I'm ready to move into the super hero, nothing-can-touch-me phase. Although, I have a sneaking suspicion that I'm going to be a permanent resident of the Hypochondriacs Anonymous group.

And it's true, what they say. In school, we spend an eternity learning about all the symptoms of these horrible, fatal diseases, that you can't help wondering if that muscle cramp in your calf is the first sign of Muscular Dystrophy. During a lecture last week on throat cancer, there was so much psychosomatic coughing going on that it sounded like we all had emphysema.

I have a Neurology test tomorrow and it covers all manner of neurologic diseases like Parkinson's and Huntington's and Lou Gherig's disease. The really bad stuff, full of weird muscle twitches and hemiballismus, and numbness, and tingling, and no cures.

Do you think it's a coincidence that I've just started having bilateral distal leg numbness and some occasional hand tremors? Or how about the fact that I'm having a harder time clicking on the stupid trackpad on my laptop? Obviously that means I'm having some distal upper limb weakness! I must have early onset Parkinson's, right? Oh no! I'm obviously wasting my last few healthy years slaving away in med school. I should be sitting on a beach someplace drinking pina coladas.

Nevermind the fact that my legs are numb because I've been sitting in the same chair for the past 8 hours, and my hands are shaking because I drank my first soda in two weeks and my nervous system is in shock from all the caffeine, and I think the trackpad must have some dirt underneath it or something, because it really has gotten harder to click and the sound it makes is no longer loud, but dull and sad.

Earlier this year, I managed to convince myself that I had a brain tumor. This was totally a second year's fault, though, because she made the mistake of telling me that because my migraines are always in my left temple area that I might want to worry about the possibility of brain tumors. She obviously didn't realize that she was telling this to the person who likes worrying so much that it's the only exercise she gets (I'm convinced that anxiety burns calories and I read somewhere once that people who fidget burn an extra 350 calories a day. When I'm anxious I can't make my leg stop bouncing up and down. I'm sure the USDA totally counts that as exercise, right?).

It's going to be just my luck, too. After convincing myself that every little ache or pain is evidence of a tumor or infection, I'm going to end up playing The Boy Who Cried Wolf with myself when the one symptom I finally choose to ignore is actually a problem.

I guess this is the price I pay to learn about all these things. I'll just have to hold out until I graduate, then I'll never be sick again! (eye roll)

God complex here I come!

Speaking of crazy neurological disorders, check out this YouTube video. The human brain can do some really messed up stuff. Just don't be afraid to get a flu shot.

Currently Reading: Mind Hunter: Inside The FBI's Elite Crime Unit Because I need to worry about serial killers like I need a hole in my head.

You know you're in med school when... (round two)

You start contemplating the viability of mainlining caffeine through an IV.

Which is unfortunate seeing as I gave up drinking caffeine this summer.

Granted my version of "no caffeine" is kind of like the kind of vegetarianism where people only refrain from eating anything with a cute face. I've given up daily soda drinking because the amount required to keep me functioning was getting slightly ridiculous. Now I just drink it when I feel like if I don't have a soda in my hands right this very instant I'm going to have a meltdown. And since I stopped drinking so much caffeine, one soda makes me feel like I've just downed a bottle of caffeine pills, which, I would imagine, is not dissimilar to having a caffeine drip.

What I Know:

Or should I say, what I'm supposed to know.

This is all the material that I covered in my first year of medical school...

This is how much I think I've retained:

I lived to tell the tale. Barely.

I'm just not dwelling on the fact that I have another quarter in August before I'm legitimately a second year.

But until then this is where I'll be:

I wish.

Almost there

I have 16 hours 30 minutes and 07 seconds and one microbiology test until I am done with third quarter!

That is if I can make it to 10 am tomorrow without my head exploding.

Summer here I come!

Anything but this

One of our favorite pastimes around these parts (besides whining; we're really talented at that) is talking about quitting medical school and doing something else, anything else has to be better than this. We play the "I'd rather" game a lot too. "I'd rather have my eyeballs poked out than sit through another physiology workshop." But mostly we just talk about all those things we could be doing right now, if we weren't here.

While I don't think any of us are actually serious about that, it's nice to at least pretend that it would possible. Sometimes daydreaming about being anywhere but here is the only thing that gets me through another day.

Don't get me wrong, I love med school, and I'm very glad I'm here, but let's just state a fact: med school can make you feel like your brain is leaking out your ears and you're about one multiple choice test away from riding the crazy train to the nearest asylum.

So in honor of medical school, here's a list what I rather be doing right now instead of cramming for a test on the neural control of vomiting (seriously):

1. Vomit.

2. Join the circus- a friend of mine here has a brother who actually did join the circus for a couple months. We were all really jealous.

3. Sit on my couch until my butt fuses to the cushion.

4. Be a voice in an animated movie.

5. Make up names for fingernail polish.

6. Have my fingernails pulled out with a pair of pliers.

7. Drink. A doctor I used to work with assured me that med school would drive me to start drinking. I told him that he was crazy. This is me publicly admitting that Dan was right and I was wrong.

8. Sit in the DMV all day. I'd rather hang out with the cranky DMV employees than hang out with my neurology textbook.

9. Go back to undergrad. Sad, I know. But when I think about how hard I thought those classes were and how much I had to study then, it seems like a cake walk compared to this. Sometimes I go sit at the university library across town just to pretend that I'm back in college and I've never heard of this pit of hell called med school.

10. Any thing that lets me sleep a normal amount on a regular basis. If I get more than 6 hours of sleep, I wake up with a migraine.

11. Anything that doesn't cause so much stress that I can't eat without feeling nauseous and can't get my left eye to stop twitching.

12. Anything but this.

But in all reality, if I quit med school for any of those things, I'd probably start missing school in a week. Especially if I was missing my fingernails.

You know you're in med school when...

You find yourself standing in the crowd at a Flogging Molly concert and you can't pay attention to the music because you're too busy wondering if the Irish have a higher incidence of liver disease due to the amount of alcohol they drink or if, as a society, their genes have adapted.

Med School Lesson # 1

It's hard to drive in high heels.

I can press the brake just fine, but the gas pedal is going to be the end of me! After several seconds of wondering why I'm not going anywhere and cursing Toyota for making a defective gas pedal, I remember that it's just easier if I take off the high heel and drive barefoot (which is possibly illegal, don't turn me over to the cops).

What does this have to do with medical school?

Nothing really, except let's just take a moment to marvel over the fact that I actually wear high heels now. My mom is reading this and having heart palpitations over that last sentence because I do not dress up. Ever.

I think I aged my mother 10 years when we had to buy a suit for my med school interviews, because I hate shopping in general, and I'd rather drink battery acid than shop for suits. My mother is a saint for not murdering me and stashing my body in a changing room. So the fact that I voluntarily wear high heels when I "see patients" (which, by the way, are people that get paid to pretend to have something wrong with them; like Kramer did once on Seinfeld) is nothing short of a miracle.

A year ago I was wearing Old Navy flip flops with my work clothes and buying my work pants a size too big so they resembled pajama pants instead of actual slacks (slacks makes me sound like I'm 80. My grandma wears slacks and she was born in 1920.). Now I put on heels and dress pants that actually fit. Well, only on days when I have to actually dress up. You couldn't pay me money to wear dress pants if I didn't have to. I might have "grown up" but I'm not insane.

Someplace in my med school damaged brain, wearing heels equates with being a grown up.

But now I'm in medical school, and I'm pretending to be a real adult that knows something about medicine, so when I have to wear professional dress to see patients, I wear heels. And that makes me feel old (and about four hundred feet tall, but I'm getting used to that). I feel like I'm playing dress up because when did I get this old? I'm pretty sure I'm still 18 and skipping Classical Mythology because it was after lunch and who went to class right after lunch anyway?

Medical school is the weirdest combination of real life and high school (which is another post for another time) and half the time I don't feel old enough to be here, and HOLY CRAP, I'm learning how to save lives and I'm not old enough to have that type of responsibility. The reality of this blows my mind sometimes because most of the time I feel like I'm still in college. I go to class (and I skip class), and I study, and I turn in homework, and I take tests (and I sleep with my notes under my pillow the night before the test because osmosis totally works).

I have to remind myself that, unlike college, if I don't learn this information, my grade won't be the only thing that suffers. If I don't learn this stuff, my future patients will suffer. Which brings me right back to, "Who let me into medical school; I am not mature enough for this?"

I guess the only cure for this is the ole' fake-it-until-you-make-it. Pretend to know what you're doing until you actually do. So I'll keep wearing high heels and pretending to be grown-up. Well, that and saying a prayer of thanks that in medicine you don't make a decision unsupervised until you've been a doctor for almost a decade.

So It Begins

At my medical school, we use a teaching tool called the Human Patient Simulator or HPS. Basically its a mannequin that lays on a gurney, hooked up to a bunch of machines, in a pretend ER room. Apparently they are a big selling point for prospective students. We'll be practicing medicine on these dummies so we don't have to subject real human beings to our complete lack of doctoring skills. Poor mannequins.

These HPS dummies are incredibly high tech. You can take their pulse, stick a tube down their throats, give them drugs and watch their vitals react. Pretty cool. During orientation, the second year students tell us that we will have our first HPS lab towards the end of orientation week. Sounds easy enough. Then they tell us that this first lab is commonly called the "Shock and Awe" lab. Um... I think I signed up for medical school, not the military. That sounds bad. Apparently people have been reduced to tears during this exercise.
Welcome to medical school.

The day of lab arrives and I'm not too nervous. Yet, anyway. I figure that if the professors in charge of this circus actually expect up to know what we're doing then they wouldn't have done this 72 hours into our first year.

My little group gathers outside the ER room with a resident. We read over the patient’s history. 25 year old female. Presents to ER with severe shortness of breath and a blue tint to her skin. History of asthma. Used her prescribed inhaler. No change. Simple enough.

So we troop into the room, wearing our white coats that are so new you can still see the crease marks from where they've been folded in their plastic wrapping. We're all fiddling with our new stethoscopes, trying to surreptitiously figure out which way they go into our ears. It seems like it should be obvious, but its not. One of the docs turns mine the right direction for me. Maybe our first class should teach us how to use all the gadgets that come with our intended profession.

Three or four doctors line the perimeter of the room. One shuts the door and stands in front of it. Maybe he thinks we’ll try to escape otherwise. In the middle of the room is our mannequin, Jane Doe. Apparently Ms. Doe likes to cross dress in her free time because "she” is wearing some awesome acid wash 80's man pants, men's tennis shoes that look like they lost a fight with a lawnmower, and a t-shirt that’s three sizes too big. The least they could have done was stick a wig on her.

We all gather around her, not sure of what we're supposed to be doing or even if we're supposed to start pretending to know what we're doing. They're not big on directions here apparently. This must be part of the "shock and awe." I hope they took bets on who cries first. I’m praying the didn’t decide that it’s me.

"So what do you do first?" one of the doctors asks, like we are complete idiots. So we all mumble something unintelligible to our patient. I sincerely hope that everyone else is having problems with the fact that we're talking to a mannequin.

"Is she contagious or something?" the scary doctor asks. "Move closer. She's probably scared. You're her doctors now, you're supposed to comfort her."

We all dutifully shuffle toward her. And then immediately shove our hands in our pockets and glance uncertainly at each other, willing someone else to do somethings. One of the doctors finally takes pity on us and tells us to check her vitals. We're all abuzz now that we have some direction. Vitals! We can do this. It doesn't take a genius to count how many times she breaths in a minute. So I do. 30 bpm. A couple people work on the blood pressure, somebody gets a pulse.

Look at us! We totally know what we're doing.

Or not. "You should be telling your patient what you're doing every step of the way," a doctor admonishes. Oops. "You should also be asking her how she's doing."

We all hesitate for a second. I'm sure we're all thinking the same thing. She's a mannequin for crying out loud, she can’t talk! Someone steps up to the plate and asks her how she’s feeling.

And then... she speaks. Well hot damn, the mannequin just talked. The 28 year old cross dressing mannequin spoke in the voice of a 60 year old woman with a 2 pack a day smoking habit. And she can throw her voice because its not coming from the dummy, its coming from the ceiling. A speaker in the ceiling to be specific. In all the tours we'd had during the interview process, not once did anyone mention that the dummy speaks, or rather, that they had someone in the weird Star Trek command center next door speaking for it. Or maybe they did, and I missed it because I was too busy staring at the awful fashion choices.

Well we were all over that, like, well, like med students on As. All of us, with our varying degrees of Type A personality disorder, not wanting to be the least of the bunch, were asking questions left and right. We're asking about her asthma and her allergies and what she ate for lunch and the name of her childhood pet.

The professors have to keep reminding us to touch her, to let our patient know that we are here for her and that we care about how she's feeling. So there I am, standing by a cross dressing mannequin, patting her weird plastic hand over and over thinking that this might just be the weirdest thing I have ever done. Thinking that I have a good imagination but even I can't suspend my disbelief long enough to truly pretend that I care about this fake patient whose vitals are being controlled by the Wizard of Oz behind the curtain in the Star Trek command center.

And then it hits me. I am in medical school. It hadn't really sunk in until that moment. Even though I'd had my white coat ceremony and I'd sat through a couple of biochemistry lectures and I'd been to see the cadaver I'd be working on in the coming months, it hadn't truly felt like medical school. It felt a lot like college: same material, different hairstyle. Until I was standing there holding the plastic hand of my asthmatic dummy. This was it, the thing I've wanted to do since I was three and obsessed with my fisher price doctor's kit and the endless supply of surgical booties my dad would bring home.

My very first lesson on how to be a doctor didn't involve some inane biochemistry equation or even a good look at Oscar, my anatomy cadaver, but a mannequin in 80s clothes. My first lesson on how to be a doctor was possibly the single most important thing I will learn in the next four years: Empathy. On the importance of extending empathy to my patient. To every patient regardless of how hard it might be to do so. Even if "she" is just a machine covered in skin-toned plastic and dressed like an 80s nightmare, my patient deserves my compassion, my understanding, and my best. And if I can comfort a plastic dummy, then surely I can do the same for my human patients.

My patient needs my empathy, deserves it even. And I can't think of a better first lesson.

Welcome to medical school.