anna in med school

Every afternoon, for the last two weeks of the semester, we watch a physician (top of his/her field) take a history and perform a physical exam on a standardized patient, who presents with anything ranging from cognitive impairment to vaginal bleeding to “belly pain.”  They pause during the examination to take questions from us, and we’re allowed to shout out what other information we’d like from the patient.  Then we break up into small groups with a preceptor in the given field of the case of the day, regurgitate information, throw out any possible explanation, and then narrow our differential.

To Us: May we continue to consider the zebras with the horses, and may we not be afraid to be wrong and strong as we start the on the wards.

Okay, I’m really fudging the number in an attempt at cuteness.  Throw me a bone.  I’m referring to the last two weeks of Mod 2…and if you consider it as Monday the 5th to Friday the 16, it kind of fits…

We’ve wrapped up pulmonary, and now we’re doing a sprint through the parasites and fungi in microbiology part 2 coupled with the more clinically-oriented “differential diagnoses” class.  I might never walk barefooted on a sandy beach again.  More to come…

A few snapshots from prom this weekend…will also try to steal more of Lucie’s pictures once I have her permission.

It was on a boat.  Sweater strategically worn at all (well, most) times in order to conceal gross wardrobe malfunction.

Coming home to the soft glow of a Christmas tree is the best!  The product of Doria’s first tree-decorating endeavor:

“There are no stupid questions, only stupid students.”

Wish me luck on my pulm final tomorrow!

The other day, an MS1 said something pretty great to me.  I don’t think she meant it as a compliment–I’m not sure it is one–but I’m using it to help my mind during this weekend leading up to our pulmonary final:

“It’s clear that you have a full life outside of school, and it’s intentional.”

Sometimes I worry that part of my motivation to maintain a life is to justify not being the most stellar medical student.  And I think about how much I want to be a great doctor (not to mention all the money throwing on my education)…am I wasting too many minutes/hours/days in a week not working to that end?  Is there any evidence that says that well-rounded individuals can be good doctors?  Or is it just a belief, a hope so many of us have?

Well, for lack of a better way to conclude, and needing to get back to the books, ’tis the season for believing.

I secretly kind of love the weekends before exams.  No new material, everything starts to come together (even if it doesn’t quite get there), and I studying on my own time, in my own way, focusing a little more on the topics I actually enjoy (so, heavy on the disease processes, light on the physiology).

Gee wiz, I swear, I used to have it.  Alas, all-nighter anna is no longer.

Also, while I used to complain that the undergrads start later and end way earlier than the med school (please note above: “now through final exams…Nov 28-Dec 11”), I kind of love the stillness that descends over the campus after the masses disperse.  Let there be peace on earth.

“All that wheezes is not asthma, and children are not little adults.”

The latter phrase was a common theme of yesterday’s lectures.  Here’s the thing–and this is not my opinion but more an observed general consensus among my peers–the lectures on pediatric asthma, pediatric bronchiolitis, and cystic fibrosis were…somewhat mediocre (I feel hugely guilty for being negative in writing, but there’s a point, promise).  Yet I thoroughly enjoyed them.

I like geriatrics.  When people ask why, one of the first things that comes to mind is that older individuals present the “same” diseases (bacterial pneumonia, for example) in more complicated and nuanced ways (not to mention the fact that there is frequently more than one illness or condition competing for attention in this population).  It’s stuff like this that makes work fun.  Now I’m starting to find that I’m attracted to pediatrics for much the same reason.

Of course, it doesn’t help that I just gave my final pediatric ICM history and physical exam last week.  Puddle of heart on the CHOP floor.  They sure are cute little germ bags, even when they cough in my face.

And random: happy first day of December!  I very happily listened to Mariah Carey’s “All I Want for Christmas” on my walk to class from the train this morning, and dreamed about celebrating the end of Mod 2 in 15 days with Love Actually and a stiff drink (or several).

Charles Dickens observed obesity hypoventilation syndrome in the 1830s…only over a hundred years before we knew anything about sleep disorders:

…and on the box sat a fat and red faced boy, in a state of somnolency…”Joe! Joe!”  He taps on his head with a stick and the fat boy, with some difficulty, roused from his lethargy.  “Come hand out the eatables.”  There was something in the sound of the last word which roused the unctuous boy.  He jumped up and the leaden eyes, which twinkled behind his mountainous cheeks, leered horribly upon the food.  (Pickwick Papers, 1836)

Today we learned about Beethoven’s representation of his own GI disorders in his Second Symphony, his mitral stenosis in his Ninth.  If his deafness was caused by conduction problems, he wouldn’t need a stethoscope to interpret the sounds of his own body!

These little tidbits brought to you by faculty members at Penn and Jefferson.  It’s a proud day to be an English and Music double-major.

Around this time last year, I took one of my last tests of Mod 1, ran home to pack (a.k.a. throw random shit into a poor, unsuspecting dilapidated carry-on), hopped an overnight flight to Rome, and met my husband in Florence.  We spent a rather unconventional  Thanksgiving in Sienna: no turkey; no family other than each other; about 4,000 miles from home.

This year could not be more different, yet it ended much the same: a very harsh awakening Monday morning; an oscillation between feeling completely overwhelmed by the work I pushed aside for the last 4-5 days, and feeling so emotionally fulfilled by the quantity of quality time spent with loved ones I see far too irregularly.  Instead of a nontraditional feast of sea bass, chianti, and fire-roasted chestnuts, we had turkey three times (at three separate Thanksgiving dinners).  John and I made up for our lack of family/friend-time last year by this year seeing ALL THE FAMILY/FRIENDS!  A quick midnight stop for me to fall asleep on the couch of Sarah and Scott while John actually caught up with two of our best friends.  Thanksgiving with two blood families, three surrogate ones.  Friday catch-up with my favorite first-year RA (who taught me how to wear UVA orange with pride), chill/study-time with the Blasingame-Packs (how they still put up with me, I have no idea), and Yaya-giving!  Roadtrip north with Erica and Dan (no need for radio or podcasts with these two) and puppy Meta (my backseat cuddler) early Saturday morning, followed immediately by John and my trip to the Baireuther Thanksgave in Lancaster, after which we stole Kathleen and Isaac for the return trip (I know Lancaster isn’t the hippest place to grow up, but since we can’t see one of our favorites at her Austin cottage nearly enough, we’re damn thankful she still has family a mere 68 miles from us).

Clearly, I haven’t done this weekend (and the people included in it) justice.  Can I blame lung cancer?  It is the #1 cause of death of any cancers, so I think I should maybe get cracking on learning a thing or two about it.  But, I do want to take a moment to say “thanks.”  As my last Thanksgiving day stop, I went to the home of my nextdoor neighbors growing up–they’ve been like family to me since I was three years old.  I got a chance to see my childhood home from the outside:

Thanksgiving might be my favorite holiday.  I think I had at least 20 years of Thanksgiving dinners in that house, and I miss the idea of the house always being there, should our entire family be able to reconvene for a holiday together.  It was a great home for Thanksgiving dinners, complete with a kitchen that so naturally opens up to the dining area and family room so that one can cook and converse at the same time, and it feels like the end of an era.  Still, as my dad and I took our traditional Thanksgiving morning walk together, this year through a small wood in Annandale rather than our typical jaunt over to Burke Lake, I was thankful for the things that have remained in the face of (good) change.  My sister was married two weeks ago, and my dad is to be married in March.  Holidays are not so simple anymore, but I’m thankful for the complications–and the med student in me sees them as a problem-solving opportunities.