anna in med school

The kidney.  Thank God there are are two of them, ‘sall I gots to say.  And no wonder the higher powers at Perelman have elected to devote not one but two four-hour testing blocks (this Friday and Monday) for our examination pleasure.  There’s a nice symmetry to it.

So, at some point, I’ll be back here to share, among other things:

• my VC debut…cliffnotes: I’m awkward, but at least others can now appreciate this quality at 2x.
• leading Doctoring with Derek on palliative care, hospice, and physician responsibilities toward a dying patient and his/her loved ones.  Trust me, read this letter.
• exciting plans for our fall break!
• some little tidbits about the kidney…it’s actually mildly interesting at times, and not only when it’s covered in cysts.
• apparently we find out the order of our clerkships on Monday!  !!!

doesn't begin to do it justice

Looking forward to being a better blogger!

On Sunday, Julia and I took a quick jaunt out of the city to take a yoga class at Crossing Vineyards.

Good little med students that we are, we went home to study acute kidney injury, forgoing the complimentary wine tasting.  A partially shot afternoon…well worth it for this view during supta vajrasana:

The picture, of course, doesn’t do it justice…to be fair, it was taken from a phone while my head was upside down.

One last thing, then I need to start acting like a student and prepare my case for tomorrow: maybe one of the hardest things about med school for me is missing the outdoors.  I just can’t justify spending nearly as much time as I would like to outside, and the weather has been teasing us with intermittent beautiful crisp fall days recently.  One more week until the end of renal!

I’ve noticed that I get easily overwhelmed when I’m exhausted…shocking.  And then I remember that today I was taught about glomerulonephritis by four nephrologists who are hugely invested not only in research and patient care, but in our education as well…and they’re really flippin’ good in all three domains.  And then I learned about and practiced with ultrasound.  And then I performed an abdomenal and neuro exam on a standardized patient who was not shy about speaking up when he thought I could do better.  And then I went to one of the best damn (free) yoga classes.

And for some reason, when asked, I said that today was an “eh” day.  a) What the hell is wrong with me?  2) It’s a pretty sweet life, this whole med school thing…

A dear friend is collecting data on the use of the Myers-Briggs Type Indicator as a tool for organization management.  She asked the Y’s & Co. to take this test and then share with her.  At our high school, we all had to take a longer variation of this test in ninth grade, and then I think we were theoretically supposed to take it again as seniors and observe how our personalities might have shifted.

I don’t remember taking it as a senior, but I do distinctly remember my 14-year-old type: strongly ENFP (“the inspirer”—uh, sure…).  At some or multiple points in the last 13 years, it seems I’ve shifted to INFJ (“the protector”).  I would like to preface, I am not someone who puts a lot of stake into so-called “personality tests,” and I’d like to reuse my friend’s description: “your typing is really just a zip code for your personality, it’s not an exact location.”  Yet, as many of us discovered today, I found the description of my type surprisingly on the money…and the subsequent contemplation of it has been a profound (though perhaps somewhat enlightening?) time-waster for “the guardian” Eric and me today.

Don’t want to bore you with the details, but I found this part reaffirming as I struggle through renal: “In the workplace, the INFJ usually shows up in areas where they can be creative and somewhat independent.  They have a natural affinity for art, and many excel in the sciences, where they make use of their intuition.  INFJs can also be found in service-oriented professions.  They are not good at dealing with minutia or very detailed tasks.”  Well, that explains my impatience with the nephron.  Get me to the clinics please!

Also, John, I think you can attest to this point, no?  “They are usually right, and they usually know it.”  <llllllllllllllll…>

So…what does Myers-Briggs say about you??  So curious I am…

I am ready to be done with lecture.  Today was my second meeting with my Peds ICM preceptor…basically, each MS2 has these mandatory pre-clerkship one-on-one sessions with a physician at CHOP to help learn how to perform a pediatric history and physical exam.  For me, right now, it’s just a great reminder of so many of the reasons why I want to do this with my life.  I think I could be very very happy spending most of my life in the hospital.

Of course, it also helps that CHOP is a magical sort of place, the kids are adorable, and my preceptor is the best!  May I share a wonderful compliment I just received from her via email??  Forgive me, I’m exchanging tact and thoughtfulness for excitement and joy!

The one thing that my medical school impressed on me most was that the best
thing a physician can do is love his patients like himself.

You are a caring and compassionate woman and I feel lucky to be part of your
education.

On an entirely separate and sobering note, real stories such as these help me keep things in perspective when I get anxious about my own health or want to give up on gaining any sort of understanding on the kidney.

Women make up 51% of the U.S. population, yet they…

• comprise 17% of Congress,
• hold 3% of clout positions in telecommunications, entertainment, publishing, and advertising,
• make up 16% of all writers, directors, producers, cinematographers, and editors.

Not to trivialize these discouraging statistics, but at least the class of 2014 at PennMed is representative: 51% female.  It will be exciting to participate in the shift in the number of women who hold leadership positions in medicine…it simply must happen.

Or, as we call it to sound doctor-y, nephrolithiasis.

One potential risk factor is a rise in oxalate, a metabolic endproduct without physiological function.  Dietary sources of oxalate include the following: spinach; rhubarb; soy products; black tea; peanuts; and chocolate.  I’m screwed.

What do you call a cobblestone street, made out of wood?

One of the things I love about dates with John:

J: What are two things about Camac Street that make it unique?

A: It’s one of the prettiest streets in the Gayborhood?

J: What are three things about Camac Street that make it unique?

A: Spill!

J: It’s the only street in Philadelphia that’s a palindrome…you like palindromes!

A: …

J: It’s the only street in Philadelphia that’s made out of wooden cobblestones!

A: That’s a thing??

J: Yes!  They did it in order to reduce the noise from horse trotting down it.  But it turned out to be a terrible idea.  Wood is porous, so it soaked up all the horse urine and dung and smelled…well, like urine and dung.  They decided to keep it as a relic.  It’s horribly expensive to maintain.

Did I mention that John went on a 12-hour free tour of Philadelphia last week?

This sucks.  I just got some of the best, most insightful, most constructive, most applicable feedback of my professional and academic life, and I’m not even allowed to share it due to a confidentiality agreement we have as a learning team.

Bottom line: my learning team is the shit, and I will be a better student in the clinics because of it.  Bring it, clerkships.

The kidney is like the 18th century novel.  Dense.  Convoluted.  Boring.  So very unfortunately necessary…magnificent.

As John hugged a defeated Anna on his way to work this afternoon: “Don’t worry.  What you’re learning about is important, and it will come together and get better.  And then maybe you can reteach me what you discover.”

Five happenings from the last week to appreciate:

1. A long, familiar dinner with Doria.  We used yummy veggies that I bought from the Mennonites at the farmer’s market near school.
2. PennMed Yoga’s first yoga class taught by fellow MS2 Katie O.  Nothing better than falling asleep in savasana…even if that’s not really the goal.
3. Practicing techniques of performing a physical exam, and having friends who are kind and perceptive enough to insist a quick departure from school before meltdown ensues.  These two things go together, really.
4. One of my closest friends interviewing at PennMed…and he loved it (and I suspect they loved him)!
5. A fantastic night out with Eric and this couple.  Mediterranean fare, truffle fries, Olde City Fro-yo, and a gluten-free, Israeli cone.  I even wore heels.