doc w/ Pen

journalist + medical student + artist

Category: Only in medical school

Only in medical school (#4) …

… is this set of transitions possible:

Test question about a tumor
novel ice cream flavor
Google image-aided illustration complete with
organic chemistry molecule sprinkles

But that’s exactly what happened last week as I was doing practice questions in advance of my medicine shelf exam. A question came up about pheochromocytomas, which are tumors usually found in the adrenal medulla. These tumors cause inappropriate secretion of catecholamines such as epinephrine. This can cause episodic headaches, hypertension, sweating, and a fast heartbeat. I don’t remember if I got the question right or wrong. What I do remember is that in the answer explanation, there was mention made about how these tumors can cause elevation in the urine of a catecholamine breakdown product called vanillylmandelic acid (VMA).

You have to understand that doing these questions is hard work. The questions themselves are incredibly difficult, often to the point of being demoralizing, and the detailed answer explanations require exquisite attention. It’s easy (and tempting) to get distracted. And on this particular evening, I did.

“If I owned an ice cream store,” I thought to myself, “I would name my vanilla ice cream flavor ‘vanillylmandelic.’ ”

I chuckled (probably out loud). And then, reluctant to return to the practice questions, I thought about how I might illustrate this hilarious (to a medical student) concept. I minimized the test question window, and brought up Google images. I found a luscious bowl of vanilla ice cream, in a turquoise bowl to boot. (Turquoise is my favorite color.) I also found the molecular structure for vanillylmandelic acid. (Whew, definitely brought back memories from organic chemistry.)

My sense (of dedication? guilt?) returned after perusing Google images though, and I went back the practice questions.

This morning, with medicine behind me, I finally completed my illustration: a bowl of vanillylmandelic ice cream with multicolored vanillylmandelic acid sprinkles. Here is the final result:


On a side note, I also learned today from Wikipedia that not only is vanillylmandelic acid a metabolite of catecholamines, but it is also a chemical intermediate in the synthesis of artifical vanilla flavoring. So really, my idea isn’t so crazy after all. Right?

Don’t answer that.

Only in medical school … (#3)

… will you come across the description “steamy cornea” and actually take it seriously.

I read said description this morning as I was doing UWorld practice questions in preparation for my medicine shelf exam. The description was in reference to the eye exam seen in angle closure glaucoma, which is also associated with a red eye and a nonreactive, moderately dilated pupil (see the photo below).

Just in case you were wondering.

What the eye looks like in angle closure glaucoma, a medical emergency that can lead to vision loss if not immediately treated.


Only in medical school … (#2)

The other morning, I was standing in front of my bathroom mirror, getting ready to head to the hospital. I had planned to leave at 6:50 a.m. It was already 6:45.  I felt rushed, running late. I still needed to put my make-up on. But in this moment, I was struggling with my hair. My springy red curls just weren’t sitting quite right around my face. So I grabbed a comb out of a bin on my bathroom’s narrow windowsill and with it parted my hair just left of center. I examined the new distribution of my curly locks.

“There,” I thought. “That looks better.”

But as I stared at myself in the mirror, I noticed that the hair on either side of the part wasn’t laying down flat. It bowed upward, each side threatening to defect to the other. I reached into that same bin and pulled out a bottle of hairspray. I spritzed the part and gently smoothed down both sides to prevent mutiny.

“That will keep my part patent,” I said aloud, to no one but myself.

I laughed. “Patent”? Who uses that word to describe hair? That’s a word we use in medicine to describe tubular structures in the body that are open and unobstructed, like healthy veins and arteries, or a stent that has been placed to keep a diseased artery open. Only someone in medicine would describe a part in their hair as “patent.”

Later in the day, I thought again about what I’d said, and how I should write this blog post. Again, I laughed, but for a different reason. I’d inadvertently applied one of my favorite literary elements, alliteration, to my inadvertent use of medical terminology in a nonmedical context. Alliteration is repetition of the same consonant letter (or sound) in adjacent or nearby words. In my statement: “patent part.” Only a writer would be likely to notice that.

In the busyness of clerkships, I find humor where I can. Sometimes, that means laughing at myself, and the funny fusion of my many facets.

Only in medical school … (#1)

Medical school is a unique environment. It’s also an immersion experience. As such, over the last 2 years I’ve had all these moments where I’ve said/thought/done something that seemed natural, but upon reflecting I’ve realized that my words/thoughts/actions were a bizarre product of medical school. I had one of these moments yesterday, and decided I should start recording these experiences here, going forward. I think they speak to how much medicine seeps into you when you’re steeped in it all day, every day. I also think they’re rather humorous, but I’ll let my readers be the ultimate judge of that. Here’s what happened.

Medical school affects how I think about everyday, nonmedical things — including how to describe the direction I cut my sandwich.

I was making my lunch, a ham-and-cheese sandwich on sourdough bread. I’d had the same thing the day before. And the day before, I’d cut the sandwich in half diagonally, a little offset from the corners, the way we’d done it at the sandwich shop where I worked one summer in high school. Yesterday though, as I stared at my sandwich, I decided to shake things up. Since I live alone, I have a habit of talking to myself out loud sometimes, and said this to no one in particular other than me, quite definitively:

I think I’ll cut it midline today.

I started sawing at the sandwich, then stopped halfway through, realizing what I’d said. Three years ago, I would have said something quite different, probably that I’d cut it “in half in the center,” or “down the middle.” But now I clearly think anatomically, like an attending surgeon discussing with his resident where to make an abdominal surgical incision. That’s what 8 weeks of rotating through surgery will do to you, apparently.

I chuckled as I finished cutting the sandwich and wrapped in foil.

I hope this brings a smile to your face as well.