Inertia is the tendency of a body in motion (or at rest) to remain as thus until acted upon by some outside force which must necessarily be proportional to the mass of the body. Inertia also applies to non-bodies; it applies to sluggish economies as well as to the minds of students just returned from Christmas vacation. It's very difficult to jump right back into the information after coming back from a break - those 2-3 weeks of waking up late, relaxing, working out frequently are something all parts of me - conscious and unconscious - are loathe to let go of. I had so much fun over this break, that I still just want to sit around watching TV, reading my novels, and working out everyday. Every semester it's like this - every semester, it's harder to get back into it, and every semester, it's more essential that I get back to it right away. It generally takes a few days to get back into the swing of things, and I think that how long it actually takes is generally a reflection of how intense it was before the break.
Semester 4 started off with a bang - cardiology. We started with vessel pathology and the approach to a patient with heart failure, infections affecting the heart and antihypertensive medication. I wanted to do well on everything else because I want to be a good doctor, but this time around I have a bit more of an incentive. Since I'm the child of a cardiologist (how many other 9 year olds know about the Vena Cava?), I've got a little bit to prove. That's just as well, because this is the first semester in which I'm more concerned with the actual learning than the number grade. Sure, those grades are all important - I'm getting ready to start preparing for the USMLE step 1, and the structural integrity of my cluster bridges will soon be all that matters. However, the things we're dealing with now feel much more important. In the first semester, we studied gross anatomy and biochem -not that high-yield, but necessary. Neuroscience was added in the second semester, and it was interesting - but not that practical (unless you become a neurosurgeon). Third semester heralded the beginning of the theoretical understanding of pathology and pharmacology, as well as microbiology. Now, though, the stakes are higher - every doctor will see patients with cardiovascular issues; every doctor will see patients taking nitrates, beta blockers, Calcium channel blockers, or some diuretic (unless they're pediatricians). This is important.
The facts that we're being presented with now are the things we all as physicians (speaking of my class) will use when we treat people. We're no longer talking about some extremely-rare-but-cool condition like cystic ovarian teratomas, but rather biggest killers of everyone in the developed world. This is no longer just school - this is real; this is the awesome gravity of realizing that what I'm studying right now will matter every day for the rest of my life. This is the ambivalence - the excitement that I'm finally spending my time meaningfully, and the fear of inadequacy that comes with that responsibility.
Though the applications of pharmacology and pathology will have far-reaching implications, the heavy-hitter this semester is Introduction to Clinical Medicine (ICM). You know those old movies, where someone gets hurt, and some other guy says "Is there a doctor in the house?" Yeah, well that's because doctors know stuff - lots of stuff -and are expected to, if not be able to fix any situation, at least be able to make it a whole lot less serious. That knowledge they're (soon to be we're) expected to hold is not arcane or, for the most part, that conceptually difficult; there's just so much of it that it seems that way. In a few weeks, I will have a practical exam, in which a fictional patient presents complaining of chest pain. Instead of just asking questions this time around, I'm going to have to know what to do to get more information, and suggest treatments and interventions. I'm going to have to know, from those signs and symptoms, how serious their condition is. Sure, if it was just chest pain, it wouldn't be so bad, but doctors are supposed to know how to do that for EVERYTHING that a patient can present with.
I think I'm really starting to enjoy this "medicine stuff".
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