Archive | September, 2010

where credit is due

30 Sep

In my last post, I mentioned that I thought my conversation with the standardized patient went okay.  First of all, I have plenty of room for improvement.  However, for the times during which I asked pertinent open-ended questions, allowed for brief silences, restrained myself from interrupting, and displayed general conversational competence, I really have the Y’s & HMC to thank.  Over ten years of being a Ya-Ya, and a lifetime to go.  I’m still consistently non-threateningly socially awkward, but I’d like to think that I listen and communicate better because of my relationships with these good people.

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Standardized Patient

29 Sep

I chatted with a good friend briefly last night and mentioned that we had had our first session with a standardized patient that day.  “What’s a standardized patient?”  Oh…right, I forgot that not everyone dates someone throughout his four years of medical school.  Anyway, I hope you all know how important accessibility is in this blog experiment, so please let me know if you would ever like me to clarify anything–I want to be able to share my med school experience with you!

A standardized (or simulated) patient is an actor trained to behave like a real patient, imitating symptoms and presenting an often detailed history.  At this point in the game, we’re at the basics, simply trying to have open discussions with the patients, getting them to open up to us about their chief complaint, medical and personal histories.

“Hello, my name is Anna and I’m a first-year medical student.  Would you mind if I speak with you for a few minutes before you see the doctor?  What brings you in today?”

Open-ended questions is the name of the game.

And all this exercise is done in front of our respective learning teams and preceptors, who can call time-out to give feedback.  After about 7-10 minutes, the scenario ends, and everyone (especially the patient) gives you feedback.

It sounds so basic, but it’s challenging (at least for me)…and totally invigorating!  I cannot wait to get in the hospital, to begin clerkships!  I think I did okay.  And, apparently, when I’m nervous, no one can tell that my hands are frigid or that my stomach is doing flips…which I take as a good thing.

snacks and a concert

29 Sep

If you’re a student either living in or visiting Philly, forget the tired dinner-and-a-movie date night.  Instead, check out one of the many FREE CONCERTS at the Kimmel Center, which is where I went tonight with a bunch of classmates to see the Philadelphia Orchestra and Joshua Bell.  There was even a reception held afterward in the lobby catered by Wolfgang Puck.  And Verizon Hall is shaped like the inside of a cello.

Don’t think you can make it until 10pm to enjoy free dinner?  With happy hour until 7pm and just two blocks away, Tria is a great option, especially in the middle of the week when the crowds are minimal and the service is super fast.  Order a $5 Happy Hour special of their house wine, the Mission Figs stuffed with Gorgonzola and Prosciutto di Parma, and the fennel spiced almonds.  Trust me.

John’s at a conference in Las Vegas (and otherwise living in Boston), so my dates were Jon and Jamie (another pair of old married farts like us), Doria, and Christina.  Somewhere in the middle of J. Bell’s delicious rendition of Mendelssohn’s Violin Concerto it occurred to me: I have friends here…actual friends.  I think Philadelphia is becoming my home.

take a backseat, netter’s

28 Sep

Right now I’m taking a break from anatomy.  I am reading about the tétons de Venus instead of the mammary glands.  I am studying how to remove cartilage around the boned joint of beef rather than how to reflect back peritoneum.  All thanks to Caitlin and Chris, who just surprised me with the best care package ever, complete with Caitlin’s homemade brownies, gourmet olive oil, and this book.

It was waiting for me at my door when I returned from the library.  This week suddenly turned wonderful.

interrupting our regularly scheduled program

27 Sep

I’m trying to cram as much biochem into my head as possible right now.  I was just rewatching part of a lecture on gluconeogenesis, the metabolic pathway that results in the formation of glucose from lactate, glycerol, or amino acids.  Let’s take a step back for a sec: I mean, we’ve been talking about gluconeogenesis like it’s no big deal, but how amazing is it that our body is like, Whoops!  Out of glucose again.  We need some fuel to function, so let’s just make it ourselves.  WTF!  But, yeah, it’s a pretty common occurrence, so we talk about it like it’s no big deal.

Anyway, during the first few minutes of the lecture, our professor interrupted his regular spiel to tell us about how a student asked him, very politely (he specified), a few years ago why we even bother studying gluconeogenesis, since it’s a pathway we really rarely use…because when are we ever starving except during Yom Kippur.  Lllllll.  Well, I guess I’ve said my share of insensitive things.  Anyway, my professor took a few minutes to, again very politely and not at all patronizingly, explain that people in the world are starving.  One person dies every second as a result of hunger.  In 2007, there were roughly one billion hungry people in the world despite the fact that the world produces enough food to feed 12 billion people.  Behind heart disease and cancer, malnutrition is the third leading cause of death.  And, he concluded, as a scientist, this issue is one he grapples with a lot.  We devote so much time and energy to discovering new ways to treat and cure interesting but considerably less critical, on a global scale, diseases, while malnutrition is something that we can fix now.

Okay, I know all you out there with considerably more global health and public policy know-how are probably reeling because starvation around the world is certainly a complicated problem, and curing it is far from simple.  My point is not that it isn’t, and not at all to trivialize it as a topic of conversation by brushing it off for now (because I would enjoy getting into it further), but I love that I’m learning from scientists that both care deeply about the larger humanitarian concern and go so far as to question the very funding of their own research in light of it.

In other news, we cut out our cadaver’s heart today…he has a HUGE heart.  Seriously, I’m not really sure how he breathed.  His lungs were also significantly calcified.  It’s amazing to me how 2-3 hours in the anatomy lab can fly by in the blink of an eye.  The human body is incredible.

encouragement by way of another classical crush

26 Sep

There’s a lot about Yo-Yo Ma to love.  For one, he freakin’ kicks ass at the cello and looks happy/friendly doing it.  He is, by all accounts, kind, generous, modest, and a pleasure to work with.  He contibutes a lot to modern “classical” music by making it accessible and culturally relevant.

And he says some pretty smart stuff too; I’m thinking of two instances in particular.  When I saw the Silk Road Ensemble perform (for free–thank you McIntire Dept. of Music!) at the Paramount in 2006, Mr. Ma earnestly called Harvard “the UVA of the North”–adorable.  But the words that I keep coming back to this weekend, which I’ve spent hopping between anatomy lab, libraries, and coffee shops (with a latenight jaunt at Doobie’s for a $4.75 gin martini), are some I think I heard during a BBC program a number of years ago.  Yo-Yo was relating his relationship with the cello to those of children everywhere trying to keep up with an instrument, despite the labors of practice.  One of the kids, I think, asked him if he liked practicing.  He said something to the effect of (this is not a direct quote): Well, it’s a funny thing.  I find that I really dread practicing.  And I put it off and put it off.  But then, once I’m doing it, it’s not so bad.  I kind of enjoy it.  And I love the result, that I can improve my ability through practice.  The tough part is getting started.

I feel similarly about studying.  I’ve been so frustrated with myself recently for not being productive, for not getting enough done, for being behind.  And I’ve really put off studying, partly because I know how long it takes me.  I’ve been discovering that I’m just going to have to be one of those med students who studies longer–this science stuff is not at all intuitive for me, and I really feel like I’m drowning in it.  But, as I was reading though lectures of physiology in the Fine Arts Library yesterday, I had this one moment of Hey, this might be hard as s— for me right now, but it’s interesting…this is how our body functions, how rad is that?! Once I get going it’s not so bad…now if I can just get to the point where I’m just a little faster and focused so I can sleep more, that would be swell!

And speaking of getting going, I should get back to it.  Oh!  And another thing I love about Yo-Yo Ma: how adorably he essentially “lip-synched” his performance at Obama’s inauguration.  Mr. Ma–frozen fingers, out-of-tune instrument, and all–way to tough it out for your country!

When it came time for John and I to have a “first dance,” your solo “Appalacian Waltz” was the only one that we could agree on.

three articles

25 Sep

So…I have been terrible about reading anything that’s not on a flashcard or in review notes recently.  Luckily, I have super smart friends who are both well-read and cultured…and they’re thoughtful enough to share articles that they think I would enjoy, which takes away all the risk of spending time reading something potentially boring or annoying.  I love my friends.

Anyway, below are three favorite articles that you should check out from the last several months:

Doctor’s Orders: Eat Well to Be Well

All Joy and No Fun: Why Parents Hate Parenting

What Broke My Father’s Heart

And some friends are writers in addition to their day jobs (I know, right?  My friends = not ambitious in the least).  Recent publications:

Lower Occoquan Watershed Plan Moves Forward

Where did our CT scan go to medical school?

And finally, I know I toss this article around a lot, but because I get to see Joshua Bell–only my classical musician crush!–perform FO’ FREE this Tuesday:

Pearls Before Breakfast (BTW, I was singing at St. Dominic’s just a few blocks away when all this was going down.)

Shocking no one recognized him…