anna in med school

A very short sliver of Art Caplan’s opinion from his talk in bioethics today…

It’s official.  I’ve become my grandmother.  Although, instead of stealing sugar packets, I mainly stick to Splenda.

Today I reached a new low.  Four and a half days of gluttony in Tuscany came at a price, measured in both euros and waist circumference, so I’m going to try a little harder to take advantage of free lunches when I can.  I still don’t feel comfortable going to meetings in which I don’t have an interest just for the free food (there’s definitely a possibility that might change), but I was lucky that today was a talk hosted by the Bioethics Interest Group discussing the ethics of hospice referrals (could it be more up my alley?).  Free Indian food from Tandoor.  And then–this almost never happens–there was free Mexican left over from the Physician Advocacy and Social Medicine Seminar this evening.  TWO free meals…made me feel a little less guilty about the exorbitant cost of buying sparkling water at Au Bon Pain today (I know, I know, I caved!).  When all was left of the Mexican fare was chopped onions, cilantro, and lime slices, I asked Atu whether I should go ahead and throw the rest out.  “Nah, leave them for a little while.  Who knows, someone might want to take them home as condiments.”

Hunh.  Not a terrible idea at all…and I don’t mind if I do.  So now my gym clothes smell vaguely of onions and cilantro (hey, it’s better than formaldehyde, right?), but my fridge is stocked with fresh seasonings.  Not bad, Anna, not bad.

Just got home.  My circadian rhythm is confused.  Tomorrow’s anatomy will be painful.

Good morning!  John and I are about to galavant around Florence for a few hours before taking the train to Rome.  In the mean time, a few pictures from our excursion to Cinque Terre yesterday…disclaimer: John’s pictures are better.

The entrance to the Via Dell’Amore:

Stopping along the path for a quick “cappucci:”

Coming up on Manarola:

Vernazza (a.k.a. heaven on earth…and we had it all to ourselves!):

My mom, born in what is now the Czech Republic in 1943, grew up predominantly in the South of France, on the northern edge of the Pyrenees.  I think maybe most parents tell stories of their childhood habits that are slightly foreign or unconventional to the next generation–little things, like coming home for lunch daily rather than staying at school–but I got the impression pretty early on that some of my mom’s were just a little further from the norm.  There were the extremes (“my sister and I used to take this shortcut to school to avoid getting stones thrown at us by kids who thought we were German”; or “and then there was that time my friend and I were supposed to take a school trip to Paris, but we lied and went to London instead”) and the more mundane (“my mom tried to forbid me from playing with gypsies because she was worried I would get fleas”).

A lot of the more tame stories were of food traditions, some of which, luckily for me, spilled over into my own childhood.  It wasn’t at all unusual, for example, for me to show up to school with an end of baguette and a large piece of dark chocolate shoved in the middle as a lunch when we were out of deli meats (mom: “With the salt content and fat of cafeteria food, who would dare argue that a piece of good bread with chocolate isn’t leaps and bounds more healthy?   And don’t get me started on that Wonder bread crap.”).  I thought it was so charming that my mom used to buy freshly roasted chestnuts on the streets on her way to school in the winter; the purchase would serve two functions: keeping her hands warm en route; being a satisfying mid-morning snack between arithmetics and Latin.  When they became more available in grocery stores stateside (fresh chestnuts, none of that canned or jarred goop), we would split and “roast” them in the toaster oven.  They were okay, good even, but definitely not the same.  Until Siena, I has never had a true roasted chestnut.

After a full day of exploring the Gothic streets of Siena, taking in the Duomo and the Piazza del Campo, indulging in a Thanksgiving feast of bruschetta, smoked salmon, sea bass, and chianti, we trudged up the cobblestone path back to the bus, and John noticed a street vendor that I didn’t: “Should we get some roasted chestnuts?”  I think the speed and assertiveness of my answer caught John a little off guard, and we gladly paid the gentleman 3 euros as he scooped up maybe 20 or so chestnuts, still sizzling over the hot coals.  As we waited for the bus, it took some maneuvering to pry a chestnut or two from the bag John was using to keep his fingers warm.   We polished off the bag at breakneck speed on the ride back to Florence–sensational.  Quite possibly the only slightly conventional element of our holiday meal, but in a totally un-twenty-first century American setting.

Looking forward to sharing with you our adventures in Florence and Cinque Terre.  Happy Thanksgiving!

I guess I’m not very productive, am I?  One more test (epidemiology), and then Italy and John and GELATO!  I’m going to try to get a good solid hour of studying in, but right now I’m not concentrating, so…

Not to be too terribly cheesy, but I thought, in the spirit of this national holiday I’m missing to be in the most charming city with my partner in crime, I would like to give thanks.  Most definitely, I have a lot for which to be thankful (family, first and foremost–an extremely broad definition of such [y’s included, of course]), but I would like to recognize something new.  I’m truly grateful that I’m able-bodied.

It’s probably no surprise that I should be thinking about physical health in medical school, but being physically able is something I take for granted pretty much all the time.  Yesterday I ran my third half-marathon, yet I couldn’t help but feel disappointed that I didn’t perform better.  In the weeks leading up, I complained of minor physical annoyances, and at one point I even burst into tears (shocker, right?) out of frustration that I might not be able to run the race comfortably.  At PennMed Yoga today, I glanced at my neighbors…during pigeon, the woman to my right was so neatly folded over her crossed leg, I felt myself become envious of that kind of flexibility and agility, a mastery over the details and precise movements of one’s own shape.  God, sometimes I want to slap myself!–give it a flippin’ break.  I mean, my body lets me do pretty much what I damn well please, do I really have to highlight every potentially shortcoming?

For John and my first Thanksgiving in Boston, I ran the Feaster Five in Andover–you finish five miles, you get a free pie–and we ordered sushi.  Among the many annual runners of the race was Team Hoyt.  Talk about inspirational.  If you ever need motivation, just peruse the collection of videos on them on youtube.  Through the use of a computer aid, Rick (the son) once indicated that, if he could do one thing with his body, he would want to push his father through a marathon or iron man, for a change.

Hmmm…not entirely sure why I entitled this post “Shibboleth”…probably because I would like to be curled up at home watching this season two classic episode of West Wing…Paul Revere, a pardoned turkey (named Dillon?  unclear), pilgrims, and Chinese refugees (ooo, almost got that quadruple alliteration thing going)…epic.

In case I don’t get a chance to write much in the coming week, I wish you and your loved ones a very happy Thanksgiving.

Internet connection, please return to me.

On the upside, perhaps this limited access to the outside cyber world will force me to be a more productive studier for tomorrow’s immunology exam.

The “downside”: Planet Earth on DVD is way more tempting…oh David Attenborough, could you please speak to me of interferons and immunoglobulins, about which I still know frighteningly little.

Dear readers:

I have not forgotten about this little project. My Internet has been down for the last couple days, though I can’t really complain since I’ve been swiping it from a neighbor. Topics for tomorrow:

–follow-up on playing dress-up in anatomy lab

–have I mentioned that I am taking a bioethics class?

–a visit from the lovely ladies Herrmann

–Lauren’s 30!!!

–why Planet Earth is the best study break ever…oh, if only I could use it’s music as the soundtrack for my life…

–study buddy Jon, and his nice and tall wife Jamie

On a 70-kg person, roughly 1 kg is bacteria.  I understand there’s a lot of good, necessary bacteria, yeah yeah yeah.

Still…one kilogram of bacteria…icky.

A thought: anatomy gets an unfair amount of attention in the first year of medical school…by the students, by the faculty, by the innocent bystanders who have to put up with us talking about anatomy until the cows come home.  Just a thought and, though not one with which I ultimately agree, one I’d like to explore just a little.

First of all, I feel I should apologize to my family and friends for the outpouring of detail I give you about the anatomy experience.  In my own excitement, I think it often takes me a minute or two to remember that people might not want to talk about discovered inguinal hernias or inches of deep fat flaking off into the palm of my hand…over dinner, for example.  Perhaps being married to a man I can fart in front of, who sees so so much in his own line of work that there is quite possibly nothing I could do that would disgust him, I’ve become…well…a bit lazy when it comes to social tact.  This is all to say, I don’t want to filter too much of what I write in this space, but if I ever get too informative in “real life,” please let me know if it’s not appreciated.

So, what is the fixation on anatomy?  Okay, maybe a stupid question.  Yes, there are cadavers, we get to use scalpels, we get to see the human body up close and personal in a way not many do.  But you could argue that the other classes we’re taking now are just as exciting.  Immunology, for example: the study of how our immune system works, how our bodies stay healthy, fend off diseases, and heal themselves.  Or epidemiology: the study of patterns of health and illness in the population, the cornerstone for creating evidence-based medicine.

Still, it’s hard to get away from the difference a body makes, and I’m not only referring to the cadavers.  We are learning about the human body, and not at all in the abstract.  This last block was on the upper and lower limbs and the back.  We could actually pull on a tendon and observe it’s action.  Did you know that there are eight muscles acting on the thumb alone–eight! And there’s one long nerve that starts in the lower spine, runs down the thigh and leg, and innervates a small webbed patch between the big and second toe at the top of the foot.  I mean, who came up with that?

Another thing that’s truly great about anatomy is that it never changes.  Well, I think someone mentioned that we might have potentially discovered an extra thymus…anyone have anything to add on that topic?  And so we’re learning clinically relevant information that almost certainly will not be obsolete before we finish residency.  No wonder my peers are putting three times the man-hours into studying for anatomy.

Finally, and simply put: it’s just really cool shit.  I think this point is pretty much just an extension of the last, but I like to talk about stuff in sets of threes.  For anyone who’s ever been pre-med or took a college-level bio class, you understand the neat-factor in being able to understand why something works the way it does and why certain symptoms correlate with particular conditions.  Who could go through a few weeks of genetics, for instance, and not spot like a dozen tall people with long fingers in the crowd who you’ll swear must have Marfan’s Syndrome?  I walked out of the practical (and second) portion of my second anatomy test at 11:30 this morning and–I kid you not–if the next man I saw walking out of university hospital did not suffer a lesion to the superior gluteal nerve (that innervates the gluteus medius and minimus; a lesion would cause a pelvic sag while walking on the opposite side from the lesion), I would be shocked.

I would love to share with you a little more tomorrow about the second anatomy exam…but for now, here’s a teaser:

I hope you’re having a fabulous day.  Thanks so much for checking in!