Monthly Archives: November 2011

A Patient For Once

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Hello all!

I promised I would write about what I had briefly mentioned in my most-recent post as the Patient Project. One of our first year requirements is to follow a patient with a chronic illness and learn about the process of disease and the affect long-term illness can have on a patient’s lifestyle and day-to-day activities. We are assigned partners, from amongst our peers, and given the name of our patient and their home address. Beyond that, we are left in the lurch! Very few people learn of their patient’s diagnosis until long after the first visit. The purpose of the program is to initiate training in humanism and encourage us to take a perspective on medicine in which we view the patient first and the disease second.

My partner and I met with our patient for the first time yesterday afternoon. I wasn’t sure what to expect-I was looking forward to finally seeing a patient and getting away from studying and the classroom but I didn’t know how uncomfortable it would be to barge in on someone in their home and start barraging them with questions. Prior to visiting our patient, my partner and I had discussed how we wanted to handle the first interview, what questions we wanted to ask, and what our aim was throughout the process. For our first visit, our goal was to get to know our patient without asking any pointed questions about his condition. We wanted to know what he liked to do for fun, whether he had family nearby, and what he did for a living. Everything else was secondary or at least we felt we would be able to address all of his health issues at a later day. For the first day, we just wanted his autobiography–as he wanted to share it.

I have never been more pleasantly surprised or thrilled by an experience. Our patient was welcoming and eager to have us in his home…we were greeted with snacks; does life get any better than a homemade sugar cookie? He has participated in the program before, which is a true asset for us. He know exactly what he is getting into and he allowed us to pester him with our questions and was happy to elaborate on a lot of the issues we were hoping to discuss. While HIPAA prevents me from sharing his condition or any specific patient details, I can express my premature thanks for the establishment of this program and for dedicated and kind individuals like our patient. We are learning so much from him and his lifelong struggle and recognizing how we want to treat our patients in the near future. While spending almost 8 hours a semester driving to and from the interviews and organizing our eventual presentations and final papers may seem like one more commitment added to an ever-growing list, I cannot imagine a better diversion from the everyday or a better way to bring me back to why I am studying ion channels and struggling through secondary messengers. There is a very bright light at the end of the tunnel and through these brief moments of patient interaction, I remember why I was drawn to medicine in the first place. For me, it will always be about the patients and if memorizing one more cellular cascade or comparable minutiae will help me serve them, then I fully intend to push through to that point.

After visiting our patient, I spent the remainder of my evening in the hospital shadowing my clinical skills adviser and sharpening some of my physical exam skills. 8 PM to 1 AM is a really interesting time to be waiting for new hospital admissions and I was able to see some really fascinating cases and learned a lot in a mere five hour stint. Our clinical skills advisers are assigned at the beginning of the semester; they are family medicine or internal medicine docs, primarily, who are eager to help medical students hone their diagnostic skills and gain exposure to the implementation and practice of medicine. It was a really wonderful experience and I’m already looking forward to our visit to our adviser’s medical practice for another session!

Well, that there was part of my break for the evening! Back to learning about DNA before taking a much-needed break for my favorite television show (and simultaneous study aid) “Bones.” If you haven’t, watch it. If you do, I’m quite literally obsessed–challenge me on any trivia fact about this show and I can produce an embarrassing amount of knowledge on the topic. I’ll say it; what a nerd.

Talk to you soon!

A Saddening Situation

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I don’t have very much time to blog today between researching intimate partner violence for an upcoming Social Influences of Health presentation, preparing to meet my patient for the Patient Project (explained in a post to come), and trying to understand DNA sequencing but I just wanted to take a moment to express my sadness for those families and individuals affected by the recent sexual abuse allegations brought against certain individuals in the Penn State Department of Athletics. In light of the harrowing events, there have been many expressions of solidarity for Penn State as an institution, alongside a denunciation of the actions of those involved and the feigned ignorance that has cast an even darker shadow on the circumstances. I myself am proud to be a Penn State student…my heart goes out to the victims and their families and I thought it would be appropriate to share this blurb that has been buzzing around Facebook since earlier this week:

WE are Penn State, and we have always been more than just a football team.
We are… sad.
We are… grieving with the families and the victims.
We are… brokenhearted.
We are… trying to make sense of things.
We are… confused.
We are… over 94,000 students strong.
We are… ranked among the top 15 public universities.
We are… the largest student-run philanthropy in the world.
We are… over 8,500 top-ranked faculty.
We are… hard working student athletes in many sporting events with NO connection to former events.
We are… more than 2 university officials and 2 athletic department members.
We are… more than this scandal.

WE are Penn State, and we have always been more than just a football team.

Here’s to hoping the guilty will step forward and take responsibility for the heinous crimes they’re charged with…Penn State can only grow from here.

A Hectic New Start

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So CMBMP, Cellular and Molecular Basis of Medicine, our next course in this whirlwind first year of medical school, is already well underway and already distracting me from my blogging commitments. Our first exam is this Monday and after two weeks of material, I’m ready to see how we will be tested in this course. CMBMP is completely different from Anatomy in many ways; everything from the way in which I process the material to the manner in which I study has changed to accommodate the different requirements and format of information within this new course.

To begin with, PowerPoints now dominate my desktop, both virtual and physical. I no longer spend hours coloring or poring over Netter’s Anatomy Atlas searching for relationships while reeking of formaldehyde. What I felt were permanent circles that had taken up residence beneath my eyes have now all but disappeared. The greatest difference between this course and Anatomy is the time we are afforded to study and just exist. We spend far less time in lectures and without a lab, I feel like I actually have some control over my personal existence. Working out every day has gotten a lot easier and making dinner no longer feels like an unnecessary waste of time. For these very simple reasons, I like CMBMP a lot better than Anatomy. The material is just as challenging and I spend a comparable amount of time studying but it’s having time for myself incorporated back into my days that truly makes the course enjoyable. I’m sure it will become a lot more challenging and time consuming as we start another course, Problem-Based Learning and as our additional clinical projects begin to pick up but for now, I am so happy to be able to stop studying on the Saturday before an exam at a somewhat reasonable hour and watch an hour of mindless television…and update you all on what I do with my days.

CMBMP truly covers all of the basic sciences in two courses, the first 8 weeks long and the second 6 weeks long. This course will dominate our academic calendar well into the Spring Semester when we will start BBD, or Biological Basis of Disease, another basic science course focusing on the scientific background we will need for our blocks next year. Now, we’re focusing on the very basics of biochemistry, pharmacology, histology, and chemistry. It feels a little like déjà vu in lecture everyday–I took biochemistry in undergrad and all of the pre-requisites mandated to enter the medical program have prepared me well for this course but it’s also unbelievable how much I am able to forget. We talk about reactions that I used to know every enzyme for and the reaction rates and I can barely remember the overall product of the sequence! Thankfully, I’m incredibly anal-retentive and have kept all my notes from previous courses–one brief scan and everything starts to come back to me. Granted, I need to spend a lot of time doing that “brief scan” but all of the fundamental information is still somewhere in my brain…it’s just about accessing it. It’s like searching for your car keys when you’re in a rush to get somewhere. You can almost remember where you put them but it just eludes you…yea, that’s the frustration I sometimes feel overwhelmed by! Share in my aggravation!

My grandfather was a pharmacist and I recently spoke with him on the phone and while I’ve always been impressed by my grandparents and their accomplishments, I have never been more impressed with my grandfather than of late when I have been trying to memorize countless drugs with similar names, pathways, and functions. Who needs 32 different anti-fungal creams? Glaxo-Smith Kline and the other big pharma companies have about one billion reasons why…

Pharmacology is a fascinating field and with the advent of new biotechnologies, our generation of physicians is sure to see a revolution in the way we administer medication and approach diseases. It’s really fascinating, and challenging, and it makes me that much more excited to be approaching a career in such a dynamic field.

Even though I have a little more time in my life, I’m still held by the constraints of my own conscience and now that I have taken a bit of a break to write this, the secondary structure of proteins is calling me back to my studying. I hope all’s well on your end and I’ll write again soon…after this exam! Wish me luck!

-Lindsay

What I learned while investigating Ras proteins…it takes 12 to 15 years to patent and get FDA approval for a drug and about one billion dollars to get to clinical trials. Any takers?