Thursday, January 31, 2008
Next up on the menu is seasoned rice, a banana, and passion fruit juice. Other days, I grab some spicy chicken to go along with it, but I figure that this, in addition to my multivitamin, more than fullfilles my fruit needs for the day. Funny story: so our nutritionst, at orientation, told us that when people went to the Shacks (the little local food places near the exit to Ross) and came out with diarrhea and GI distress, it may not be the food - maybe it's just that they've gone for a large passion fruit and mango juice, and some oranges and guava - all very high in fiber. After lunch, we sat and listened to two lecture - one on fetal alcohol syndrome, and one on sickle cell anemia. The FAS lecture was one of those things they ought to show kids in high-school - it's so easily preventable, and offers the 100% guarantee so elusive in medince: don't drink, and your kid won't get FAS.
As soon as that was over, we ran over to James store for some groceries. I'd called Momt to get her recipe for Jamaican Rice and Peas - the delicious dish you see before you now. It's not as good as hers, but I spiced it up a bit by tossing in some cubed turkey ham. Not bad for the first meal I've cooked on the island! (So there you go, Mom -three balanced meals, plus coffee and the obligatory protein shake). After that, it was back to school to go over today's lectures before the first anatomy TA session. Those are going to be incredibly helpful, but I'm really enjoying anatomy - it looks like it'll be something I have an easier time forcing myself to do than, say, enzyme kinetcis. We went over everything we've done so far - bony landmarks and muscles of the back; the spinal cord and dural sack; and the suboccipital triangle. I don't know...maybe there's a surgeon in me somewhere.... Although, if there is, he really has to step up his game; I've decide that I'm going to know every dissection so well, I know it better than the people who actually did the cutting.
After that, I went to the gym. During orientation, they went out of their way to let us know that we ought to keep up with the exercise - some students come and throw themselves into their studies with such manic vigor that sleep and exercise are cast aside like hindrances. That tends to get folks out of whack; balance is necessary in everything. I've known since before MERP that I'd no longer be able to spend two and three hours in the gym like I used to, and so I've had to condense those workouts down to 45 minutes. It's like a reward, now; what do I get for studying hard? I get muscle aches!
All joking aside, this balance has only just begun to show up in my studying. The first week was all anatomy; then there was a stint of biochemistry, then it was cell bio, then back to biochem - I tend to spend the lion share of my study-time going over the topics I feel the shakiest on. However, the fact that we're doing different things in class every day - and getting a new professor about every 3 days - is making me realize that I need to just stay on top of everything, all the time. I have a list of things I need to get through, but I tend to either (1) focus on the things I like and blow off the boring stuff, or (2) focus on (not read too closely) the things I don't like and blow off those with which I feel a bit more comfortable. I've got to get better at scheduling things, managing my time - it's a little difficult since I've had no quizzes or tests, but hopefully I'll be on top of it.
Tuesday, January 29, 2008
To perhaps make these posts a tad more interesting, I figured I'd share a few things that I'd learned each day (so you'd believe I was really becoming a doctor and not a beach bum). I don't want to bore you with the kind of rote memorization I've gotten myself shackled into, so you won't see anything about eEF1 or 2 (elongation factors in protein synthesis) or tiny ligaments (like the transverse one that holds the odontoid process in place against C1), but rather, I'll try to pick out the cool stuff. This is kind of diffuclt, because, here at the beginning of the basic sciences years, there's little of clinical relevance. I'll say this, though - any disease they throw out to us make it easier for me to pay attention to the myriad names of enzymes. That being the case, Tay-Sachs disease is a deficiency in the enzyme Hexosaminidase A, which breaks down glycolipds in lysosomes. It's prevalent among populations of Eastern European heritage, and is characterized by rapidly declining mental functioning, paralysis, and eventually death, manifesting after the first few years of life, and marked by rapid decline.
It's only the third week of class, but I feel I haven't really gotten into too much that's new - I saw so much of this in MERP, but I guess that medicine builds on medicine. The information is just going to go deeper and deeper, and It's my job to keep up with the nit-picky detais doctors may never use. I've put together a high-energy play list to pump myself up when I'm writing/typing notes - it helps keep me in the zone (although, when I'm actually studying, I need serious quiet and concentration). The point, though, is not only to get it all stick, but to make all of the pieces fit together so that the human body - and what can go wrong with it - make sense to me. Where I stand now, I have a few pieces of the puzzle - but as I stand in front of that fire hydrant, those pieces should beome clearer, and I'll be better able to see how they fit. Somewhere down the line, I'll see what DNA replication, Gap junctions, apoptosis, and the suboccipital triangle have in common.
Tuesday, January 22, 2008
On Monday, I noticed that the bowl protecting my ceiling light had somehow filled with water. Hmm. See, in the US, I've never had to drain my light. So I took down the bowl dumped out about a quart of water, and just left the bowl on the floor. Later that night, Nicole and I went to print out some lab notes. First, her log-in wouldn't recognize the pen drive. Then my log-in wouldn't work (and I say log-in because we both tried about 3 computers each). So, we went to try to just buy a copy card - but guess what? No copy cards. So we had to sit and wait while the library attendant printed them all up for us. This wouldn't have been so annoying were it not for the fact that it happened somewhere around midnight. Then, yesterday, I went and told the front desk that I needed the light taken care of. It's still off.
The big hoopla Tuesday was the arrival of our barrels, which resulted in not a whole lot of studying getting done. Nevertheless, it was loads of fun - see how big they are? Nicole actually fell into one back in Miami when we were packing them, but I missed it when I went into the office to take care of business - so, she kindly put on a one-time encore performacne. It's great to finally have all of my utensils, and here is a brief list of some of the other things we sent - don't laugh: 10lbs of honey, 6lbs. of protein power, 10lbs. of peanut butter (each), 10 lbs. of coffee and 10 lbs. of creamer (each, since they don't have any coffee on the island), 3 bags of trailix, flashlights that run on kinetic energy, something on the order of 30lbs. of canned chicken breast, 10lbs. of frijoles negros, sheets and hangers, bug spray and batteries, somewhere near a gallon and a half of extra virgin olive oil, pots and pans, cups and plates, cosmetic stuff, and, yes, 50lbs. of rice. Because we don't have that on the island. I've been joking that, if we'd had more time, she'd have tried to cram some sunshine and sand in between the toilet paper and soap just because...you know.....you never know what's down here....
Wednesday was the one I was really looking forward to - my first day of dissection! I'd been SO excited to finally get my hands dirty. I started reading the first dissection instructions, which covered the superficial back muscles, but, lo and behold - I was in the second group. So no cutting open the back (the thought of which had been making me salivate) - but instead, my group was scheduled to do a laminectomy. This is a procedure in which the spinal column is cut off at the lamina of the vertebrae, exposing the spinal cord. Grant's Dissector called for chisels and mallets and 45 degree angles - but I'd heard rumors of bone saws. Does it GET any better!?
I got to the lab 10 minutes early, all dressed in my scrubs - only to find that the lamina had already been removed.
Needless to say, I felt cheated, but looking back, I suppose I can understand - here's a room full of people who've probably never had their hands inside someone before, and you're going to ask them to do the equivalent of serious orthopedic surgery? I guess I can see their point. They just had us identify the imporant little pieces ( Dura, arachnoid and pia mater; spinal nerves, denticulate ligaments, and the filum terminale). The cut was made from about T3 down to L2, so we didn't get to see the cervical enlargement, but it was interesting nonetheless. One of the parts of the lab organization that I really appreciate is the demo - after each dissection, the group who got their hands dirty demonstrate the dissection and explain the clinical relevance to the other two groups. Folks kind of trickled in and out whenever they wanted, so over the course of about an hour, I explained the whole thing about 6 times. Another interesting part of this process was that, after each dissection, the group has to make a short video, explaining the actual process and identifying the salient structures (not quite as in depth as the demo).
You know, my serious thinking about medicine has always kind of been directed to psychiatry - I was a psychology major in undergrad, and I read psychiatric case-files like some people read romance novels (crazy people give me a warm, fuzzy feeling). However, in recent weeks, I've realized that I may not be happy with psychiatry - I think I'm going to need something in which I get to work with my hands. Now, I've never really given too much thought to being a surgeon, but I've got to tell you - I love this anatomy stuff!
Sunday, January 20, 2008
Saturday, January 19, 2008
I got to check out Ross' gym this week - it left much to be desired. I'm a big bag of muscle aches right now, though - after not having really done anything physical except for hiking a few weeks ago, I went overboard and somehow managed to squeeze in something every day this week. Can I get three cheers for lactic acid buildup? Yeah....didn't think so...
Wednesday, January 16, 2008
This morning's lecture in biochem was a little dry - not only did the professor seem to overcomplicate things, he also went out of his way to stab at the Intelligent Design argument. That may be what everyone believes, but I take issue when a theory is passed off as fact. Honestly, the whole argument reminds me of two children arguing in a sandbox - neither of whom have any real proof (But I digress - I probably shouldn't start a rant. Noet yet). Not off to a great start there - I dislike stereochemistry enough as it is. I'll just put my nose to the grindstone and treat it like prison -keep my head down, do my time, and get out.
Anatomy, on the other hand, looks like something I'm just going to love! I read through the backbone stuff yesterday, and it looks like the text goes into much greater detail than the lecture. I'm looking forward to getting my hands dirty. That won't happen until next week, though - this week is all introductory technique and such.
After a lunch of 2 bananas, passion fruit juice, and some seasoned rice, I sat in on another anatomy intro - palpations and terminology (dorsiflexion, ab/adduction, etc). Good stuff; it'll all be relevant when we get to the anatomy lab and the exam room. Unlike biochemistry. After that, there was a cognitive skills discussion - it's all stuff I've heard before, but it was worth sitting in on, because this is definitely the most intense study I've ever done. I need a routine, I need to manage my time better - I'm still getting back on the horse. My difficulty comes when I'd rather study the information I like, instead of what's difficult and dense.
Fine then. Biochem tonight.
Monday, January 14, 2008
Today is the first day of class, yet I shall spare you the gory details (and gory they are indeed - one professor remarked "Biochemistry is a clean science. Unlike anatomy, there are no cadavers, or brains floating in formalin. So we won't have labs.") Much of the beginning few minutes was spent introducing the class to our audience response units, during which time (I'm sure) a few IT guys in a dark, little room somewhere were typing like mad, trying to work out the bugs. They threw us right into a little back anatomy and biochemistry - I think that part of the reason I enjoy medicine is that I enjoy big words: Transversospinalis, etc. It wasn't anything amazing, but then again some joke that "Ross" stands for "Rely On Self Study", so I figure that the meat and bones'll come from the time spent with my nose in a book anyway.
As we were packing our barrels, I forgot one of the coffee makers, so I had to pack it in my checked luggage when we came to Dominica. Big surprise that it got banged around, right? So the actual water container leaked fiercely for a few days (I had to sit it in a pan and keep refilling it with our precious drinkable water - the Pur filters have yet to arrive). Anyway, despite the fact that there are no outlets in my kitchen or bathroom, I was able to fix it with a little of Nicole's clear nail polish. Now I can turn it on from bed!
After that, I went to make sure all of the financial stuff for my loans was all worked out. That's what I get for waiting until the last minute - it's always like that. So my tuition will get paid on time - I guess that's all that matters. Nicole and I hung around for a mindfulness orientation, put on by the associate dean of students. There was a lot of mediation, and it was actually quite relaxing, sitting there on the lower deck by the sea. However, first of all, I didn't learn anything new - it was all the same kind of relaxation I'd done. Second, I probably should have waited until I was actually stressed - when I left, I was so relaxed I was ready to go to sleep. After that and picking up some snacks at Jame's Store Grocery, I squeezed in quick workout - some pushups and dips, and a quick swim in the ocean (since the gym is now unavailable). Then Nicole and I went and studied some anatomy and biochem in this big, emtpy study space down the way. And there was evening and morning, the First Day.
Saturday, January 12, 2008
After I called my parents to ask what exactly I should do with a passion fruit ( they didn't know either), Nicole and I headed out to hike the Cabrits. A picture on my first blog post depicts two mountains out in Dominica's Prince Rupert Bay that bear an uncanny resemblance to a whale -that is the Cabrits. An 18th century British military fort that has been turned into a national park, the Cabrits was our destination for the day. On the way, I asked the bus driver how exactly he would eat a passion fruit. He said that no one eats them (much to my relief), but that you have to put the viscous fruit-seeds into a blender, throw in some water and sugar, blend nicely, and then strain. Good man. Anyway, we hit the bottom of the Cabrits, and decided to take one of the more rigorous trails. The view from the top was breathtaking, and ironic - upon first seeing the red-roofed fort from the Portsmouth Beach Hotel on our first day in Dominica, I turned to Nicole and said "That doesn't look very defensible". Please note the rather large cannons.
We continued up the trail, eventually reaching a point of breathtaking view (once again), at which point I realized how much it really must have sucked to have had to drag tons-heavy cannons up mountains. Now, though, I have to introduce you to what is perhaps the coolest thing I've seen thus far in my Dominican stay. Since landing on the island, I've been a little disappointed with how different it is. The birds look familiar, the people are easy to get along with ( must be my Jamaican blood), and the fruit (with the exception of the untruthfully named passionfruit) are relatively familiar as well. That being the case, I was on the lookout for something of particular awesomeness as we ascended the Cabrits. There was a rustle in the leaves beside the trail, and I looked down, expecting a lizard of the kind I'd seen moments ago - but what I saw was infinitely more interesting. There was what appeared to be a fat, legless lizard swimming through the leaf litter! Cross my heart - they didn't scamper and scurry like other little reptiles, nor did they do the hipless-serpentine shuffle (like the one snake we actually did see) - they had this sinuous, piscean wriggle I've only seen in large schools of silvery tuna on the Discovery Channel. Thus, I call it The Dirtfish (more scientifically known as the Galliwasp. Thanks, Google).
That was the highlight of the Cabrits - I don't care what anyone else says. We hiked around the ruins of the commandant's quarters and ancient batteries, and took some amazing pictures from areas that we probably shouldn't have been allowed into. There was much more to explore, but I'm glad that we went up and did some fun/touristy things before class began. The island tour was supposed to be today, but for some reason it was moved to tomorrow. Somehow, I doubt whatever happens tomorrow will be able to compare to the Day of the Dirtfish and the Alien Snot Placenta. After coming back down from the Cabrits, we stopped in Portsmouth to pick up big ol' Dominican Flag beach towels (sorry Mom - none from Jamaica), and then we went home and sat on the beach for while, until it started to rain. Then we sat on the balcony, eating oranges and watching rainbows.
The day seems so much longer when you're up before the sun - but I don't plan to make it a habit. Yesterday wasn't like that at all - we sat in on more professionalism lectures. I'm feeling something of the Devil's Advocate on this - the higher-ups are calling for a zero-tolerance policy on academic dishonesty. The moderator took comments from the class, and I said that it was a difficult place to be in - having gone through undergrad away from home, we have come to see our peers as extended family, and, per that culture, loyalties run deep. No one wants to be responsible for ending someone's career. However - we are also paying hundreds of thousands of dollars to be allowed the chance to hold ourselves to a higher standard - perhaps one of the highest known to man. The most salient point that our moderator made was that getting to that standard is a process - something we'll have to seriously work on. After the brief session and the scavenger hunt to pick up the first week's packets, we went to pick up our books and supplies! What I mean, is that we walked back to our apartments to retrieve our large rollerbags, and used them to ferry home $1500 worth of medical supplies and books. See my new suit? It's eerie to see myself like this - I can almost taste it. As the trendy student shirts say "Trust me - I'm almost a doctor". Instead of ordering the dissection kit they suggest, I'm going to use my father's - my name is already on all of the instruments! Class begins on Monday - go time.
Wednesday, January 9, 2008
We spent the morning in more orientation, and then broke up to go to mini orientations. The Foods of Dominica lecture was the most interesting, in part because it was the most novel. A clinical psychologist gave his argument for preventative medical care. It's good advice, but he came across as arguing for preventative care, instead of surgical interventions - dangerous advice.
I'm going to complain a bit - that's kind of what this is for. They're fixing the water downstairs, so last night we were out of cold water - that's right, we only had hot water. So it was too scalding for anything but washcloth wash-down and a tepid rinse from a water jug. You know, this is the Caribbean, and I know I shouldn't complain - but when it's this hot and I'm covered in bug spray and sweat from walking around, I kind of look forward to that shower. Hopefully it'll be better today. Oh, and another thing - I don't have any outlets in my bathroom. So, if I want to use anything other than a cordless shaver, I have to use it on the other side of my room: cutting my hair will be very interesting.
After those little sessions (IT, wellness, library resources, etc), we had our Welcome BBQ. They offered hamburgers, chickenburgers, and veggieburgers - and since they don't really have a huge meat industry on this island, I figured I'd grab what might be my last taste of beef in quite a while. I'd been planning all day to take pictures of the foods of Dominica (a chance I missed at the morning's lecture), but have just decided to push it off until tomorrow - I'll have to ask permission, and we were in a rush anyway. I also want to take some pictures of the people of Dominica, but that may have to wait. The sunset here is fantastic! Here's a picture taken from the end of the hallway on my floor. It's a little surprising to me how few students are running around with their cameras - it's just me and Nicole really. I mean, are these kids used to it already? Maybe they just don't appreciate it as much. Sometimes, sitting in those sessions, I feel like this is freshman year all over again, and I don't like it at all. Perhaps I shouldn't go into this deciding not to like people, but that's just something I need to work on. At least tomorrow's early registration will leave most of the day open for something fun!
Tuesday, January 8, 2008
First of all, we're in Ross' Annex. This lovely, bulging structure is about a five minute walk uphill from the actual campus - which would not be a concern, were it not for the fact that it was only supposed to be a four minute walk (not a ten minute stroll). However, I really can't complain; they're running shuttles back and forth.
They started us off yesterday all cheery and happy, with loads of welcomes and well wishes. Then, today, we got down to the nitty gritty: grades and promotions. I'm not concerned, since among MERP alum there's a 0% attrition rate - while the rest of the student body enjoys a 30% rate.
There were, however, some interesting issues raised - we're going to have to start digging up and examining our long-held beliefs on ethics and honor. Seeing as how we're going to be doctors, things are going to have to change with some folks around here. What should be done about cheating colleagues/peers? I feel like most people either don't want to be responsible for ending someone's career or really getting someone in trouble; or they don't want to be seen as a snitch - someone untrustworthy with under-the-table information. Does it surprise you that I'm considering running for the honor council? I'll drop the hammer on 'em!
After that, Nicole and I went out for lunch at Perky's Pizza. Surprisingly we actually managed to get all of our chores taken care of (groceries at Tina's, fruit from Miss Dees). I haven't been eating particularly well, so I'm trying to make sure we get some serious fruit into our diets, and I haven't worked out in a while, so I'm going to try to see if the temporary gym is open today (they were supposed to be finishing up construction on the main gym, but they randomly decided to add a third floor. Now God alone knows when it'll be done).
After lunch, I don't remember much; it must not have been that important. I know there was something about financial aid and student health. Here are a few things I might look into, just because it would be stupid of me to think I'm too smart for help:
1. Peer tutoring - a previous semester's student who has all A's will tutor those of us trudging through a particular subject. This sounds like an excellent idea, because it reminds me of the SI sessions I attended at MERP - nearly all of which were very helpful.
2. Mindfulness - This almost sounds like a guided meditation thing, but focussing and being really intentional when I pay attention in class couldn't possibly be a bad thing. I focus much better when I pay attention - go figure.
Those are just a few of the things I'm considering. This weekend, Nicole and I are going to the Caribantic - the place where the Caribbean sea meets the Atlantic (I'll be sure to take tons of pictures!) . Hopefully it won't be that bad; it's an all-day affair, but I haven't done any tours yet, so it'll be fun.
I'm going to be a doctor. Studying is going to be really interesting. But you know what? I'm all over it.