doc w/ pen

a journalist becomes a doctor before your eyes

Month: August, 2015

Medical School: Expectations and Flexibility

It’s day 3 of medical school. Some things have been as I expected, like the fact that there is far more reading assigned than is humanly possible to finish—and certainly more than a person can ingest and understand. I was even prepared for meeting my cadaver yesterday in anatomy, and did not shy away (though the smell was more potent than I thought it would be).

 Oddly enough, these would become Cornell's colors in about 2 months

Examples of the types of annotations you can do in iAnnotate, an app for the iPad.

But life is all about flexibility. And one thing I’ve had to adjust is my note taking style. In a previous post, I said I would try using the Cornell note taking method. On the first day of class, I was prepared to do just that—with a clipboard and college-rule paper. During orientation though, each student in my class was given an iPad. I brought mine to class, expecting to use it to follow along with the slide presentations (which we have access to ahead of time) and then to take notes on paper. It was difficult to go from screen to paper though, and keep track of which notes went with which slides. So to my surprise, I’ve been annotating directly on the slides. It’s easy to type, highlight, underline, and draw with the stylus or your finger. In the app we use (iAnnotate, which I have actually been using for the last several years on my own iPad) you also have the ability to make little notes that you can “hide.” When a lecturer includes a list of learning objectives in the slide show, part of my review includes creating hidden notes with the key information on those learning objectives. My plan is to quiz myself later by trying to recall the information, then revealing the notes if I have difficulty.

We have our first quiz on Monday, so we’ll see …

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Exploring NYC: The Metropolitan Museum of Art

The Art Institute of Chicago is one of my favorite destinations in my former home-city. So I knew it wouldn’t be long before I visited The Metropolitan Museum of Art (“The Met”) to see what it has to offer. I was not disappointed.

Monet is famous for his studies of this bridge overlooking water lilies.

I quickly found The Met’s Impressionist galleries—a favorite of mine at the Art Institute—and felt right at home amid the masterpieces by Monet, Manet, Renoir, Van Gogh, Seurat, and others. Monet is known for creating a series of paintings of the same setting—haystacks, cliffs, a bridge overlooking water lilies for example—but painting them at different times of day or seasons to capture various effects of light and other environmental cues. It was fascinating to see the same subject as I’d seen at the Art Institute, but painted in a slightly different way. Like seeing an old friend who’s wearing a different expression on her face.

I wandered through the galleries until I came to a special exhibit called “China: Through the Looking Glass.” According to The Met’s website, in this exhibit “high fashion is juxtaposed with Chinese costumes, paintings, porcelains, and other art, including films, to reveal enchanting reflections of Chinese imagery.” The exhibit was breathtaking. Here are some photos I took.

In contrast to the very new haute couture, I also saw Assyrian relief scupltures that dated as far back as 800 B.C. That’s nearly 3,000 years old! What a feeling to be in the same room as something that ancient.

In the couple of hours I was at The Met, I saw only a fraction of the collection. I can’t wait to go back.

 

Exploring NYC: Central Park

The 843-acre Central Park is nestled among New York City skyscrapers, which peek out above the trees. Inside the park though, you almost forget you’re in a city at all.

It was gorgeous yesterday—sunny but not too hot or humid; just right for exploring my new surroundings on foot. The famed Central Park is less than a mile from my dorm, so that was my first destination. According to Wikipedia and the travel blog EF Explore America (and we know everything on the Internet is accurate, right?), this 843-acre park boasts:

  • 29 sculptures
  • 7 bodies of water
  • 25,000 trees
  • 235 species of birds
  • 136 acres of woodlands
  • 250 acres of lawns
  • 58 miles of walkways

Walking in Central Park …

Whether these numbers are completely accurate, the takeaway is this: Central Park is a big place, with lots of cool stuff to see and do. For example, I’m hoping to take in one of the free movies in the park before the close of summer—the perfect activity for a broke medical student.

And the truth is, facts can’t capture Central Park. As I walked along the paths, I was awed by the park’s enormity. In the midst of the largest city in the United States, people have a place where they can share a picnic lunch under the shade of a century-old tree, bird-watch, read a favorite book on a sunny bench, and play frisbee. When I need a break from the hustle and bustle, this will be a great place to unwind.

One of the mini lakes in Central Park, where people were sailing small boats on the Saturday afternoon I visited.

The White Coat Ceremony: My Rite of Passage

Taking anthropology courses in college, I found myself jealous of cultures with rites of passage. Birth, coming of age, and death – along with many landmarks in between – are celebrated with ceremonies that usher the participants into a new era of their lives. Besides weddings, I didn’t see anything like that in my culture. And as a college student desperately seeking her identity, I longed for something that would help me better understand my place in the world. Now 33, I have a much better idea of who I am than when I was 18. And at 33, I realize that these ceremonies are not just for the participants. They are also for the community members who have both helped the participants reach this point, and who will be working with them in the future. It is about both identification and celebration.

With last Tuesday’s White Coat Ceremony, I finally got my rite of passage. Esteemed faculty members helped my classmates and me don our short white jackets, which both identify us as medical students and symbolize the noble aspirations of our newfound profession. In this ceremony, the surreal became real. I am no longer a pre-medical student, I am a medical student, with all the joys and responsibilities that role entails.

Here is a selection of pictures taken at Weill Cornell’s White Coat Ceremony. Thanks to Weill Cornell for providing a photographer to take these, and for posting them for us to see and share. The whole photo album is available here. Photos © Monika Graff/WCMC.

 

My New Home

Having owned a two-story house with a full basement, living a dorm room, which I will be this year, is … an adjustment. But all things considered, my room is pretty nice. It’s much bigger than I expected. The closet is larger than the one at my last apartment. And with a corner room (and therefore two windows), there’s excellent daylight. I’m supposed to share a bathroom with one other person, but thus far no one has moved in next door. There’s a shared kitchen on the floor for cooking. I’ll live in this building my first year, then move into an actual apartment for second through fourth years. I’m certainly not going to complain about my living situation too much either way, because since it’s student housing it’s actually affordable — a rarity on the Upper East Side of Manhattan.

Here are some photos of my room and my views.

Day 1: Orientation and My First Patient!

It’s real now. I’m officially an MS-1 (first-year medical student) at Weill Cornell Medical College. And I have the ID badge to prove it.

Yesterday marked day 1 of orientation, which continues the rest of this week with various lectures, receptions, and our white coat ceremony.

Yesterday also marked day 1 of seeing patients. Yes, that’s right! I saw a patient. My job yesterday was just to observe. But before long, I will be working as a “junior clinician” as part of Weill Cornell’s Continuity of Care program. I have a specific patient (whom I met yesterday), and will be responsible for things like attending all of her appointments, making clinic follow-up appointments, providing emotional support via phone (she gets my cell phone number), documenting all our telephone calls in the electronic medical record, and serving as a liaison to the clinic physicians if she has medical questions (I obviously can’t give any medical advice!). As I learn to do things like take a history or perform a physical exam, I will practice those skills with her. The idea is that the patient (who has some complex issues) has an advocate, someone familiar with her situation and medical history helping make sure she gets all the support she needs, and ensuring that all the necessary issues are addressed. In return, I learn about managing chronic medical conditions and interacting with a patient — skills that can’t entirely be taught in the classroom.

When I got to the clinic yesterday for the appointment, the clinic coordinator told me I was “brave” for doing this on my first day of orientation. Perhaps she’s right. But the way I look at it, that’s why I’m here — to learn how to be a doctor. No time like the present.

Confronting Fear

Do the thing you fear the most and the death of fear is certain.
– Mark Twain

 

This post is about climbing out of the pit of fear.  Unless you're a stepnophobic.

This post is about climbing out of the pit of fear. Unless you’re a stepnophobic.

A dear friend, who is on her own pre-medical journey, just shared this quotation with me. It’s a good reminder as I head off into the unknown of my first year in medical school.

Embracing Change

Chicago skyline

For nearly a quarter century, the Chicago area has been my home. When I think “city,” in my mind I see a skyline like the one in the picture above. Navy Pier, Sears Tower (I’ll never be able to call it “Willis Tower”), Michigan Avenue, Art Institute, Field Museum, Millennium Park, Prudential Building, Northwestern University, University of Illinois at Chicago. And that just scratches the surface of the places I’ve worked and played over the years.

But as they say, the only constant in life is change. So I’m going to have to get used to calling another city home: New York City. Thus, this will be my skyline for at least the next four years:

New York City skyline

Clearly, there are key differences. New York City proper has more people than reside in the Chicago city limits (about 8.5 million compared to 2.7 million). There are different bodies of water, different landmarks, a different train system, different types of pizza. These differences will require adjustment on my part, of course, and there will be some uneasiness at first. I’m sure there will be days when I long for Chicago — Lake Michigan, the John Hancock Building, the El, and deep dish from Lou Malnati’s (with butter crust, of course). But I fully believe that before long, I will look lovingly at the East River and the Empire State Building. I’ll board the subway without trepidation. I may even be able to stomach New York-style pizza.

Change is scary, and it’s hard. I’m not going to pretend otherwise. But change is also good. It brings about new growth, opportunities, relationships, and interests.

The way I see it, I’m not leaving Chicago behind. I’m merely adding New York City to my repertoire.

Study Habits for Medical School, New and Old

This is medical school.

This is medical school.

Trying to absorb the vast quantity of information presented during medical school has been compared to drinking from a firehose. There’s simply no way to swallow it all. This means that I’ll have to prioritize information, and to maximize my time with excellent study skills. I’ve always been a good student. So I’ll be carrying over some old study habits that worked well in college and my post-bac. But I’ll also try some new methods that sound promising. It’s all based on knowing my personal learning style. Here’s my lineup:

During organic chemistry, writing out complex reactions on my dry erase board helped me understand the concepts better.

During organic chemistry, writing out complex reactions on my dry erase board helped me understand the concepts better.

Dry erase board. I used this extensively during my post-bac for everything from organic chemistry (drawing out structures and color-coded synthesis reactions) to genetics (creating a flowchart of the transcription process from start to finish). For me, the kinesthetic component of learning is key – I need to DO something with the information, not just read it or hear it (although audio and visual learning is important for me too). Seeing things written extra large, and with multiple colors, helps me remember them even better.


Scapple.
This is a new experiment. Scapple is a Mac app that allows you to make connections between ideas and concepts. I tried it out while reviewing the Krebs cycle a couple weeks ago, and really liked it (the screen shot below is part of what I created to represent the links between the different molecules, enzymes, and other players in the cycle).

The Scapple app allows you to make connections between different ideas.

Cornell note taking is a much more active process than regular note taking.

Cornell note taking is a much more active process than regular note taking.

Cornell note taking method. Another experiment, this note taking method incorporates reviewing, questioning, and summarizing into the process. It’s much more active than just scribbling down what the professor is saying. That kind of active participation helps me learn and remember, which is why I’m giving this a try.

Study groups. I’ve had mixed results with these in the past, but I’ve heard that studying in groups is really recommended in medical school. So I want to try it.

I’ve made it this far, so clearly have my share of good study habits. But with the game being stepped up in medical school, I think it’s important to experiment too. There’s always room for improvement.

Learning to Live Without a Car

Knowing that cell phone service is less than certain amid skyscrapers, not to mention the threat of my battery dying, I thought buying maps would be prudent. These Streetwise maps, which are laminated, got great reviews on Amazon.com. One covers Manhattan, one covers the multitude of transit options (NYC subway, Long Island Railroad, etc.), and the other exclusively covers the Manhattan subway.

In 2003, just after graduating from college, I bought my first car. I’ve owned one ever since. My car hasn’t been my only means of transportation though – while working at the University of Illinois at Chicago, I commuted on the El (short for “elevated train”), and have often taken the train into the city rather than fight traffic and pay $30 to park. But taking the train or bus to work is different than taking the train or bus to buy groceries, which is what I will be doing while living in Manhattan. The thought is a little nerve-wracking – that there will be no trunk, no back seat, to haul stuff in. No immediate wheels. No straight shot to where I’m headed. Add to that the complexity of the New York City transit system, and it’s overwhelming. I remind myself that I survived taking the bus everywhere (and not having a car) for five months when I lived in Chile during college, and that was in a foreign country where I had to speak a foreign language. So I can certainly do it in New York. Because as foreign as NYC might seem at times, I’m still on home soil. And soon enough, NYC will come to be my home too.

I’m especially excited about the foldable subway map.