doc w/ Pen

When I thought to myself today, “Year 1 of medical school is done!” this familiar cartoon song immediately came to mind:

The Looney Tunes reference seems appropriate in more ways than one. Being in medical school certainly seems crazy at times. I had a successful career in publishing, and I’ve given that up to go back to the bottom of the professional ladder, to live on student loans in a dorm, to spend most of my recent hours at my desk studying and most of my future ones (for a time, at least) in the hospital. Why would anyone do that? Well, it could be that I belong in a Looney Tunes cartoon along with crazy Bugs Bunny and the bunch. Or it could be that I know this is exactly what I want to be doing with my life, and I’m willing to do whatever is necessary to make it happen. (I’m going with the latter, in case you were wondering.)

The cartoon reference also reminds me how important it is to laugh. This last year has been a challenging one. I’ve had to learn to study in a new way, to process more information than I ever thought possible. I’ve had to adjust to a new city far from my family and friends. That can take its toll. Remembering to have balance in my life — to eat well, to exercise, to spend time with people I love, to sleep in on the weekends, and to laugh — has kept me going.

Thanks to all of you who have helped keep me going this year. You are dear to me, and I love you very much.

And now, on to year 2 …

This past week, I had a couple of memorable medical school “firsts”:

• First heart murmur. We’ve just started our Physical Diagnosis module, and this means we’re going to the ACTUAL hospital to see ACTUAL sick people—not actors who are pretending to be ill. Each week, we have to take a patient’s medical history, do a basic physical exam, and then report our findings to our physician preceptor. Our group of four medical students was back in one of the patient’s rooms, where our preceptor was asking a few additional questions. He leaned down to listen to the patient’s heart. When he discovered a murmur, he waved us over to listen for ourselves. I stood there with my stethoscope on the patient’s chest, half expecting to hear nothing. I’ve been in situations before where a doctor has found a murmur, and I’ve listened, but not heard a thing. This time was different—the normal “lub-dub” heart sounds were replaced by a sustained “whoosh.” I know it will take a lot more time, and hearing a lot more hearts, before I can be confident of what I hear. But this was a good start, and a signal of progress—I’m starting to be able to tell “abnormal” from “normal.”
• 

  This image (which I found online) shows exactly what we did—use an ultrasound probe to place a needle in the internal jugular vein of a mannequin.

  First ultrasound-guided line. Ok, so this was done on a mannequin and not a real person. We’re obviously not there yet. But it was great experience to practice using an ultrasound machine on the mannequin’s neck to find the internal jugular vein, and then continue to use the machine to place a long needle in the vein (without piercing the adjacent artery or other structures). In real life, you would then place a catheter (hollow tube) in the puncture site. You might use this access point to administer medications that can’t be taken by mouth.

This first year, we spend most of our time in class or studying things we learned in class. For me, getting a taste of practical medicine has been a little terrifying at times, but also thrilling.

The Five Satins: The doo-wop band famous for “In the Still of the Night.”

The Five Statins: Drugs that help reduce cholesterol.

You know you’re in medical school when …

You scroll past the band The Five Satins (who wrote “In the Still of the Night”) in your iTunes list and think it says The Five STATINS. (For those not in medicine, statins are medications that aim to reduce cholesterol. Common statins include Lipitor and Crestor.)

And then in your head, you try to think of five different statins.

And by “you,” I mean “me.”

Oh boy. I’m not even through my first year …

Finding an element of humor in our medical school lectures is (1) entertaining, and (2) helps me pay attention. (Do what it takes, right?) Today, we started our GI (gastrointestinal) unit, and I was pleased to have a chuckle–at least to myself–within the first hour. The topic of the lecture was abdominal pain, which is one of the main reasons that gastroenterologists see patients both on an outpatient and inpatient basis. In describing the physical exam for abdominal pain, our lecturer talked about the importance of LOOKING before ever touching the patient. One thing he discussed was looking for surgical scars. Which sounds strange. And obvious. But apparently it’s not.

“The number of times the patient forgets they had surgery is insane,” he said. 

[Cue a minor chuckle.]

The physician went on to give a specific example of when this was important in his own practice of medicine. He recounted a time when he was called to the emergency room to evaluate a possible case of appendicitis. As he looked at the patient’s abdomen, what did he see? An appendectomy scar. So, not appendicitis, was his evaluation. 

[Cue a major chuckle.]

Lesson learned for the ER team, I would imagine. And for me, too.

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