Here's another view of my soon-to-be-former residence - I'm not kidding when I say that this island is the jungle. Annoyingly, when it rains, that little trail you see there becomes completely submerged, and I try not to think about what the cows have been doing as I slosh through in my flip-flops. We've already had enough parasite lectures to scare me away from walking barefoot on the beach for the rest of my life.
Here is perhaps a better view of the campus than I've ever posted before - it quite nicely captures the essence walking around down here. All of the buildings are covered by the same, white, hurricane-ready roofs, and none of them are more than three stories tall. Most of the student buildings are squat auditoriums, straining even now to contain the ever-swelling student body. The unspoiled beauty of this island is undeniable, but the greeness is almost oppressive at times - hulking, forested mountains loom everywhere. I'm glad I live on the sea.
This is the pathway to the Shacks - I don't know who this random guy is. Those taller white-roofed structures on the right shade a small eating area, and down those steps just above random guy's head can be found the aforementioned Shacks - the little eateries run by the locals. "Shack attacks" - our affectionate term for debilitating bouts of gastroenteritis - are probably just a myth; I've never gotten sick from eating here. Every single day I buy spiced chicken and rice with tomatoes and cucumbers from this gentleman named Nelson. I've gotten to know the guys who work for him, and I suppose I'll miss them when I'm gone. I also buy juice (mango, if I'm lucky) from Addison, down on the end.
Here's the view of the Shacks from the street - Addison's is that first one on the right. Some other shacks sell wraps, others fish dishes, others pizza - they try to cater to us. There's also one little lady - Mrs. Betsy, right next to Addison - who sells fresh fruits and veggies. It's nice to be able to get some shopping done right here on campus.
This sprawling piece of land here is where Ross holds their version of intramural football. I guess we all still need some semblance of normalcy this far from home, and so many of us turn to sports. Those two buildings on either side house classrooms for students, faculty offices, and the elementary school
This picture was taken just to the right of that last picture - it's the playground for all of the elementary school kids. Ross is fairly non-traditional -it's outside of the US, for profit, and has incoming classes of 500 students - so it attracts nontraditional students. Many of them are coming to medicine as a second career, and many of them come with their children. I don't know how the educational system is, but I don't think it's hurting anyone (I just know that the principal and I share a similar taste in heavy, slightly dark movies). This would be a great place for a kid to spend a couple months - ideally before they're 7 or 8, and after they can read - before returning to the states to get an education. I take my hat off to the folks who manage to be a full-time parent and full-time med student - I can barely take care of myself down here.
I cannot concentrate, and there are tons of things I should be doing - one of the most pressing being my second hospital interview write-up. (HPI) Last Tuesday, I went back to PMH for the second time, and I expected much better. Last time, I stood around waiting for the OBGYN to show us something interesting. This time it was more of the same, but with the orthopedic surgeon. I did get to see a gentleman who'd completely torn his quadriceps tendon - but it wasn't that interesting. Last time, I interviewed a patient who was in nearly perfect health, save for being smacked in the back of his head with a rock and losing his sense of smell - that made for an elegant, simple HPI. This time, however, I interviewed an 80 year old man who'd had scarlet fever and dengue fever, an appendectomy at the age of 13, 7 total hernia repairs, an open heart surgery, gall-bladder removal, and who now presented with arthritis in both knees. Everyone in his family has some cancer or other - and so I am not looking forward to writing this HPI. Perhaps it's a blessing that I'm getting sent to Miami - at least it'll be more interesting.
I cannot concentrate right now, and I don't know why - It's not like I've been doing nothing but working. I've just taken a step forward technologically, because I have the coolest thing ever - an Ipod touch. Sure, it's a touch screen Mp3. player, but it's sooo much more - you see, Amazon has released a Kindle application. Kindle is Amazon's wireless, electronic reader - you purchase a book and download it to your kindle. I drool at this idea. However, the Kindle is $350, and I'm years away from being able to justify that expense. However....with the addition of this Kindle app, I can now download and read any Kindle-ready book on my ipod touch! I'd known about this app for quite a while before I realized how cool it was.
I'm an absolutely voracious reader, but two things have kept me from indulging down here. Firstly, I am in medical school, and there just isn't the time or mental energy to put into pleasure reading. Second, Amazon doesn't like to ship down here. I've ordered a few online and had my family ship them down, but that's just not at all cost-effective. I've realized, though, that my escaping into some literary creation, my "getting out of my own head", is something that helps maintain my sanity. Just before the first semester final, I'd picked up an Alex Cross novel by James Patterson, and I couldn't study until I'd put it down. This hasn't been a problem here - reading doesn't get me in trouble - but it is something I feel I need to do to unwind. I scoured tattered paperbacks in the student activities center, only finding a few to my liking, but I also searched for free ebooks online (once again, not finding too many). With the advent of this Kindle thing, I can read almost whatever I want - it's like Christmas all over again! I've just finished Assassin's Apprentice by Robin Hobb. And you know what? It was a free download!
Speaking of staring at tiny screens, though, I think my vision is going. I noticed it a semester or two ago, and just figured it was my time for glasses. I paid attention to it for a while - things were suddenly fuzzier at certain distances than they'd ever been before - and realized that it was only after prolonged bouts of studying. I guess my aging lenses are becoming stiff, and aren't adjusting as easily as they used to. It's a little ironic - the ICM practical is coming up, and I'm practicing visual exams.
I can't concentrate, but not everything I've been doing has been frivolous - as I said, the ICM practical is upon, but it is also upon the 3rd semester folks. Last Friday, Nicole and I volunteered for an AMSA sponsored workshop over the physical exams. We had a small group, and just had them run through their stuff -BP assessment, precordial exam minus auscultation, respiratory exams, jugular venous pulse - etc. They were, for the most part, much more prepared than I was at their point in this game. That's why Nicole and I have started practicing earlier this time around; we have significantly more to review and learn. In addition to performing neurological examinations, we're also charged with diagnosing heart pathology from heart sounds on Harvey heart simulator - it's pretty cool, but I know that, when I'm under pressure of the examination, all of those murmurs will start to sound alike.
Yesterday, I held a TA session for more 3rd semester folks, this time reviewing the anatomy of the posterior abdominal wall. I truly enjoy these - I must be the only person on this island who becomes nostalgic at the smell of formaldehyde. It's different as a 4th semester, though - in addition to teaching the second semester kids, I'm helping out a 3rd semester TA I work with. They've changed some things around, but my advice on various classes and professors still holds water. I briefly considered working as an academic TA, but that would mean more weekly reviewing. Sure, it would have been a great way to brush up on old info for the shelves and even the step, but I've got cares enough of my own, and, since this is my second time TAing anatomy, I don't have to review as much.
Have I mentioned how swamped we are? It seems like the professors are trying to cram as much as possible into what little time we have left here. Generally, we'll move through powerpoint slides while the professors explain things - instead, they're sometimes reading through them as fast as they can. I'm getting tired of all of this - I'd gotten good at learning in class, but now, with the profs talking as fast as I can hi-lite, I really don't get much out of the lectures, and find myself tying to find time and plan when I'm going to teach everything to myself. There truly aren't enough hours in the day - I've got my physical exam practical on April 7th, and then a week after that begins my final onslaught of tests and examinations for my basic sciences years of medical school.
One thing I forgot to mention - a week ago yesterday we had our fourth semester banquet. It was held at the mansion of a man named Astaphan, an hour away from campus, and at the top of a mountain. Folks get all dolled up and go hob-nob with the professors as popularity-contest-obsessed student activities coordinators put together pat-ourselves-on-the-backs slideshows and superlatives. It was fun at first - Nicole and I got a nice bottle of wine and sat down quietly with another couple. A lot of the other students, though got smashed and proceeded to make asses of themselves. We left before the dancing started, but even then it was feeling way too "undergrad" for me. From what I heard later, folks behaved so badly that 6 professionalism cards were handed out (for what, I'm not entirely sure). Oddly enough, most of the folks there were probably the 1st, 2nd, and 3rd semester dates and friends of 4th semester students.
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