Wednesday, February 25, 2009

My Car Thinks I'm Evil

So my car thinks I'm kidnapping children. When I throw my bag onto the passenger seat, the 'seat belt' light turns on and the car beeps at me. Now, my bag weighs, what, 25 pounds? 30 if I have some atlases in it. Who does my car think is sitting in that seat? Does it think I'm kidnapping a 2-year old? And if it does, why is it not calling the police? Not only do I have a child in the front seat, but he's also not buckled up. That's a double whammy. My car needs to have a light that means "Dude, put him in the back in a child seat." Or a light for, "Hey, creeper, stop kidnapping children."

I question the benefit of us learning the ins and outs of all the biochemisty we're learning right now. Not the actual biochem, but the techniques used to find all this stuff. Like, mentioning it in passing would be ok, but going through all this chromosome mapping is ridiculous. We can do all sorts of ridiculous things like sequencing stuff now. All that is completely obsolete. It'd be like not using preservatives in our cadavers because "That's how it was originally done."

I want to congratulate whoever came up with the words 'digiti minimi'. I can't say that without laughing.
"Let's call it 'digiti minimi'"
"Are you serious? That doesn't even sound real."
"I know, but can you imagine going to a conference and hearing doctors discussing that?"
"You can't name an anatomical structure based on comedic effect."

Speaking of things that make me laugh, Dr. Lim always talks to our Gross lab before we start each dissection. "Now, when you dissect the upper limb." (giggle) "make sure you use the board to put the limb to the side." (giggling louder) "The lower limbs are detached, so those limbs will have more mobility." (on the ground rolling). I do this every day.

The guy who won the Best Short Film Oscar made me feel good with his acceptance speech. He said he spent 4 years on the 14-minute film. Granted, after our 4 years we won't have a golden statue, but I feel like we'll have a lot more to show for our work.

Sunday, February 22, 2009


I'm going to get serious here and talk about something that we will all deal with a lot in our careers. Most of us have had experiences with death in our lives with loved ones, but now we're moving into a career where it will be a part of our daily lives. Surgery, Emergency, and Oncology will deal with death in very different ways than Family Medicine or Pediatrics, but we will all be touched in one way or another by patients and families. Death transcends our professional lives by affecting our personal lives and our very humanity. Having to always be strong for our patients will take a toll over time and may even desensitize us to the seriousness that is the end of a life. Maintaining our emotional connection to life, our sanity, and our love of patients will be something we must all strive to keep for each other. Even the strongest can fall, but friends and the family we have at UC will get us through the worst times, both now and in the future.

I lost both of my grandmothers and an uncle in the span of one year when I was 10. That personal experience was my first real exposure to death and had a profound effect on my life and changed who I was. Time went by, and I experienced the death of other family members and helped my friends through tough times of their own. However, last year was the first time I dealt with death in my professional life. I was in Sri Lanka volunteering in the Emergency Department when a lady came in with obvious symptoms of a heart attack. She had had the symptoms for a few days and was pretty unresponsive when she got there. An airway was established, CPR was started, and they got a line in. They couldn't get her heart started, and there was no change in her condition after a few minutes, so the doctor in charge called it. Time of death, 1:22. I wasn't part of the care team and just observed. I remember staring and thinking "Someone just died. Right here. Someone just died." This was much different from my personal experiences with death, but the same universality of the situation was still there. I felt empathy for the family but there wasn't anything deeper. I understood that this man had just lost his mother, but I didn't feel emotional sadness. That lack of feeling worried me. Was I a bad person? Did I not care? No. I did care. And I knew that everything that could have possibly be done for that woman was done. She was afforded the best medical care available, but she was not meant to live. And that brings us back to the universal truth: death is a part of life. Will I feel differently when it's my patient? Yes. Will I remember every person that dies under my care? Probably not. Will I remember some for the rest of my life? Most definitely.

All of us will see death experience the emotional consequences both from ourselves and our patients. When something happens, talk about it with others. Many people have had similar experiences and there's no reason to be alone. There's no shame in needing emotional support. Shutting ourselves off from our emotions will help us cope, but it will take away our very humanity. Every death will not affect us in the same ways, but there will be some that touch us in ways we never thought possible. When that happens and you cry, don't feel ashamed because you should be able to handle it, but feel proud you can still feel those emotions after all those years.

Of all the things you learn and forget, never forget that you are human. Cherish it and know that it will hurt sometimes, but that hurt will make you a greater doctor than any class will.

Wednesday, February 18, 2009

Living in Gotham

I was trying to decide today whether or not I would live in Gotham City. On the one hand, you're in constant danger of being frozen, drugged to insanity, blown up, shot, or put in a ridiculously complex trap for the entertainment of someone who escaped from Arkham Asylum. But on the other hand you have two factors that totally override the constant threat of death: 1) You might see Batman. That's like every kid's dream, and there's a chance you actually get to live it. Honestly, if the Batmobile flew by me on the road, I'd be so happy, I wouldn't even mind Mr. Freeze making some horrible pun after he killed me. 2) You would be the most popular guy whenever you traveled. Imagine sitting in a group and all of a sudden you found out one of the guys was from Gotham. I'd have a ridiculous amount of questions, the first of which would be, "Have you ever seen Batman?" And if I was ever part of some evil plot by the Joker where the entire town was turned into a carnival, people would be buying me drinks all night. Living in Gotham would give anyone instant popularity and a lifetime of stories. And these aren't your grandpa's stories about having to pump water from a well, these are stories that start with, "This one time The Riddler lit my roof on fire to spell out of burning message to Batman."

Does anyone else use Google mostly as a spell checker? I do this all the time. And I read that doing two Google searches uses the equivalent energy as boiling a pot of water. That makes me feel bad when I have to look up the spelling of 'Arkham', but I can't think of a better way.

So you know how high school was so hard after grade school? And then college was so much harder than high school? And now we have med school. Why do we keep doing this to ourselves? Honestly, if I tried to pick the hardest things I could possibly do, they would be Quantum Physics researcher, Medical School, and not looking ridiculously white while dancing.

We need to turn the old R&R rooms into nap rooms. The couches in the study areas aren't particularly comfortable to sleep on, and I might as well get decent sleep if I'm going to sleep. Our class gift should be buying a bunch of comfy couches for those rooms.

Sunday, February 15, 2009

Boredom, Pride, and Remembrance

I'd like to say that I'm really proud that I called us all out for not knowing our left and right. As soon as I saw that question, I was like, "WHOSE RIGHT!?"

I've discovered a new type of boredom. It's the boredom we all get from studying. It's not the normal 'nothing to do' boredom, but a much more sinister 'a lot of not fun stuff to do' boredom. After looking at my Gross notes for so long, they just no longer interest me. And that's when I'm by no means ready to be done studying. That happened on like Sunday. I can't even say "I wish I had something to do." What I really mean is "I wish I had something to do that doesn't suck."

You know that thing they tell you when you get to college "Sleep, good grades, and a social life. Pick 2." Med school's kinda like that, but it's more like "Pick 1/2."

As excited as I am that Micro and Physio are over, I feel like I'm parting ways with old friends. They've always been there for us on the start of this journey, and now they're gone. No more looking at slides, no more pretending to care about ion channels, no more 1,100 page syllabus. Farewell dear companions! When we look back next year for boards, we shall curse you once more.

I remember...

I remember when going out Thursday, Friday, Saturday before an exam was totally fine.

I remember when I thought undergrad was hard.

I remember thinking med school was an endpoint, not a beginning.

I remember when I had time to cook.

I remember thinking I was smart.

I remember working out 12 hours a week.

I remember not having reading to do outside of class.

But, I also remember...

I remember when I didn't understand the endocrine system.

I remember when I used to suck at scrabble because I didn't know words like "fremitus"

I remember being amazed every day since I've been here.

I remember that this is a journey that we're all a part of.

I remember what I'll be doing in a few years every time I walk to Wall Street.

I remember that this is amazing, and there's nothing else I'd rather be doing.

Thursday, February 12, 2009

So like, right or the OTHER right?

My 'amount of profanity in a 2 minute period' hit the breaking point, so now I'm taking a break to write in here.

I can't look at anything anymore and not flip the right and left sides like I was looking at a person. If you tell me to look at the right side of a painting, I'll look at the painting's right, which would be my left. I do this all the time. The hardest question in the Gross notes was the first one on page 173. Seriously, it took me a minute to figure out why B wasn't the correct answer.

The other day I realized, with great sadness, that there is a phrase I would love to hear, but will likely never be said. "Let's move over to the other side and see what's being prepared by Iron Chef Schapira!"

I was thinking the other day that there are things I can do, but I don't know how. Not like, I can visualize that image being folded into a box, but more along the lines of, I can make blood. I guess I know how my body makes it, but only in a general way. It's like I have these little machines inside of me working all the time. It's kinda cool. I am sad however that I can't make more people. I can help, but I just don't have the proper facilities.

If I ever went back in time and brought a guy here from the past, the first thing I would do would be to take him to a grocery store. He would think, "Wow! In the future, doors just open automatically for you!" Then when I took him somewhere else, I'd watch him slam into the door. After that I'd take him to get ice cream, so all would be forgiven.

You know when you're by yourself you do weird things? Like sometimes I dance when I'm in an elevator. Well, I was doing that here one day when I realized that the elevator was glass. I think if someone were to have seen me, I would've just kept dancing. There's really no way you could play off doing the YOUUUUU part from Crank Dat without looking like a moron. I would just move right into supermanning that ho.

Saturday, February 7, 2009

Med School: The Ultimate Hazing

My brother and I were talking about this over break: Isn't graduate school just a bunch of hazing? I know a lot of the stuff we learn is practical, but Micro? I doubt I will ever again care how many muscle layers distinguish a small artery from an arteriole. Or the flow of blood through the spleen. More than likely my thoughts will be "Holy crap their spleen is bleeding! We should take care of that right away!" Even the doctors that come in tell us they pimp their residents on ridiculous stuff like what the artery in the round ligament is called that gives an negligible amount of blood to the uterus. Having to know that is not much different than "Dude, everyone's done the paddle gauntlet. Put the blindfold on, take your pants off, and just walk forward." And like half of our founders have their names put somewhere in the anatomy. "You will NOT call that the 'rectouterine pouch! Brother Douglas worked for years to find that, and you will show him the proper respect!"

You know when someone is walking towards you and they wave, but you have no idea who they are, so then you have to decide whether or not to wave back? This happened to me today, and I totally didn't wave back. Whenever I wave back, it turns out they were looking at someone right behind me and I feel like a jackass. There's no way to play it off if you wave because the person waving at you knows you weren't the intended target and that you have no idea who they are. If you don't wave, you can be like "Oh, I didn't recognize you. hahaha" It turned out that I didn't know her. Kurt-1, Unnecessary waving-0.

I hate how they don't really have pronunciations in our notes. Yeah, I could look it up online or in my medical dictionary, but I'm really lazy. You just kinda have to guess with things like "psoas" or "cotyledon". And usually you get it right, but sometimes Latin is a bastard. My favorite one was where I read the word 'contraindicated' but for some reason emphasized it "CONTRAINdicated", so it made no sense. That went on for like a year until my CFMP guy said it and I had one of those 'Aha! moments'. That's the kind of stuff we all do, but nobody ever talks about it.

Sometimes when I'm typing the word "thanks" I accidentally type "tanks". But I have to say, I'm not usually disappointed because tanks are awesome.

More words that are fun to say:






Thursday, February 5, 2009

Sex Comments and Legitimate Help

-Page 1217 of our Physio notes uses the term "intromission" which I'd never heard before. I thought I figured out what it meant, but then it said it usually lasts only 10 minutes, so it couldn't be what I thought. Those poor, poor women with 10 minute intromission sessions...

-I wonder how long it would take my roommate to start lactating if I consistently drugged him with prolactin. I wonder even more how long it would take before he told me.

-I have a much greater appreciation for the female reproductive cycle now after learning this. Now, I say 'appreciation' and not sympathy. It's completely ruined the mysticism, and now I know much more about female cycles than most of my female friends. At least I don't feel awkward when they ask me questions about it. "Oh, it's just endometrial lining." I remember when that used to be gross....

-You have to think that in some foreign country or even here there's some student who's learning about all this for the first time. "What do you mean females bleed from their vagina's once a month? Why have I never seen a woman bleeding? What do they use to stop it?" Can you imagine if someone asked that in class? I feel like I'd laugh a little, but someone would have to sit him down and give him the whole spiel. I don't think there'd be many volunteers.

I wonder if they figured out some of the dermatomes by different body parts falling asleep. Yesterday like half my inner thigh fell asleep, and it was about one or two dermatomes. From there do you think some doctor would intentionally try to compress certain parts to see what happened? I'm just imagining a doctor sitting in a lab tying off different parts of his body to see what started hurting.

Accidental HCl in the water supply.
I read this story the other day and it made me wonder if this was like a cartoon where Scratchy has the bottles for 'Shampoo' and 'Caustic Acid' right next to each other and Itchy just switches the lables. Why would you even have lots of HCl in a water treatment plant? That's like having a drawer full of loaded guns in a preschool.


-They shouldn't be called Hofbauer Cells, but JackBauer Cells because they kill everything trying to get to the placenta.

-Estrogen and progesterone both affect the pulses of GnRH, but in different ways. If you draw a whole bunch of cursive e's, you get Estrogen's effect: lowered amplitude, but same frequency. (A bunch of little loops close together kinda looks like the graph) If you draw a bunch of cursive p's, you get Progesterone's effect: same amplitude, but less frequent. (The tail of the "p" reminds you that it has a greater amplitude, and the "p" is a bigger letter to draw, so there will be less of them in the same space.)

-In Kallman's Syndrome, somebody killed the Man that Kalls the cells to the hypothalamus. Thus, they never migrate.

-LH stimlulates Leydig Cells (both have L's). If you have high levels of testosterone, you want to get Leyd (Laid). (Leydig Cells produce testosterone)

-The rami of the pelvis (ischiopubic and superior ramus of pubis) are like the grey and white rami of the sypmathetic trunk. It's the same word and they look like little connections. Bonus Dr. Giffin tip: "Ramus" comes from a Latin word for "Branch".

-There are two Rathke folds because Right Rathke fold has two R's with it. There is only one Tourneux fold.

Sunday, February 1, 2009


You know how you day dream randomly? Most of the time you save the day or do something awesome. As med school has gone on, I have more random thoughts about how I can do that as a doctor. Now, I want to go into Emergency Medicine, so that's rather easy for me. Bus accident where I totally call a tension pneumothorax, and it saves a kid's life. I see a car accident while driving and perform a tracheotomy on the side of the road. I'm curious as to what other specialties think about. Not to bash Dermatology, but did you see a small mole that looks like nothing, but you thought might be dangerous, so after the tests came back a week later, it really was malignant and you're the hero? As a Family Medicine doctor, do you notice a case of Ebola and prevent an epidemic?

Sometimes I have those moments where I hear something and all of a sudden something else will make sense. Not like, "I finally understand what a radian is!" after sitting through 2 weeks of calculus, but things that happen years apart. In Gross Lab Dr. Lowrie was talking about tantric sex as he was helping us dissect the clitoris. The inherent disturbingness of that aside, he mentioned that the artist Sting was famous for that. From somewhere in the depths of my head came the song One Week by Barenaked Ladies:

Chickity china the chinese chicken
You have a drumstick and your brain stops tickin
Watchin x-files with no lights on, were dans la maison
I hope the smoking mans in this one
Like harrison ford Im getting frantic
Like sting Im tantric
Like snickers, guaranteed to satisfy
Like kurasawa I make mad films
Okay I dont make films
But if I did theyd have a samurai

The exact same thing happened in my Japanese history class when we were talking about the director, Kurasawa. I wonder what else is in that song....

How cool of a disease is 'Thyroid Storm'? They mention it on House from time to time because it's just so badass. Seriously, that sounds like a superpower.

I'm greatly saddened by the end of football season today. My grades will slowly improve until March and then drop again as my bracket falls apart like a Chinua Achebe novel...

I hope you all have One Week stuck in your head for the rest of the day. I know I will.