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?

A Birthday Celebration

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Despite having very little time for anything other than studying, I did manage to have a relaxing Sunday with the girls several weeks ago! It was Amanda’s birthday weekend and we celebrated in style with a delicious cake brought directly from a favorite hometown bakery, a shopping trip to Target, and an absolutely excessive dinner at Texas Roadhouse where I threw as many peanut shells on the floor as is humanly possible. We had a night blissfully free of studying or anatomy talk…we were real people, if only for 6 hours!

I just loved the long candles Amanda's mom brought for the cake


To truly embarrass all those in attendance, I took an excellent video on my phone but I can’t seem to get it to upload here. Regardless, the cake distribution involved a lot of off-key singing and embarrassing close-ups.

About a week ago, our class composite was finally released.
Too Legit
Our composite hangs just outside of the library and I get a little thrill everytime I walk past the picture on my way to or from the library. It helps boost my positivity each time I see it–we’ve made it on the wall…I don’t think any of us are going anywhere at this point!

More updates to come!
-Lindsay
What I learned while watching “Sick Around the World,” a video everyone should invest time in to watch: the United States spends almost 15% of our GDP on healthcare as compared to Japan that spends a mere 8%.

A Long Absence

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I know, I know! It’s been forever and I have not kept up my end of the bargain in terms of blogging regularity! I’m so sorry if I’ve disappointed-I was disappointed to not be able to blog but these last few weeks of Anatomy owned my existence. But now, I’m thrilled to report, Anatomy is officially over! I know, I can’t believe it either. 11 weeks, 8 exams, and endless hours of studying have finally come to a close. I am relieved to have finished the course and finished on what I feel to be a positive note but I have been feeling somewhat conflicted since the end of the course this Friday at 9 PM when we emerged from our last set of exams. While Anatomy was stressful, absorbing, frustrating, and distressing, it was also the most illuminating 11 weeks I’ve spent in a classroom. I learned everything, practically, about the inner workings of the human body and I was inculcated into an elite group of people who are privy to the very complicated and unexplainable magnificence of the human form. I feel incredibly lucky and honored to have experienced this course and I am a little sad to let it go. I am so happy to be free from the smell of formaldehyde for a little, that’s for sure, but I know I will always reflect on Anatomy as the most influential and exciting course I take in medical school. I am so thankful for my cadaver, my professors, and my peers who helped inspire me and provide me with knowledge throughout this course. A special thanks to all of my family and friends who have put up with me, or my absence for that matter, over the past 11 weeks and for supporting me in this rather challenging endeavor. I am so thankful for all of the support I’ve been shown.

Rather than catch you up immediately on the going-ons of my life, I think I’ll backtrack several weeks to the start of head and neck and a picture I took on my way to the lab at an inappropriately early hour in the morning:

The Moon "Setting"


Although somewhat blurry, this is the full moon several mornings before our last anatomy exam. Mr. Moon was always up to greet me these past few weeks and although I am thrilled by the sight of the man in the moon, I will be very happy to awake in the light of day and not start my morning in darkness. Head and neck was by far the most challenging section of Anatomy if only because of the sheer amount of structures, nerves, and vasculature involved in the head and neck region. Despite being relatively small in surface area, the head and neck pack in an excessive amount of structures that are integral to the function of the human body. Memorizing the cranial nerves took on a whole new meaning…no longer was a mere acronym a sufficient or appropriate for “learning” the cranial nerves. We were responsible for every foramen, functional component, and every aspect of the course of the nerve from its origin to its final destination. Lemme tell you something…the cranial nerves are made to haunt medical school student’s dreams. They are crafted to annoy and irritate. As is the verterbal triangle, a small area containing an endless amount of structures and imperceptible fascial layers. While the head and neck was frustrating at times, it was also eye-opening and absolutely fascinating. I really appreciated the dissections we conducted and I have a definite appreciation for the challenge inherent in diagnosing and treating problems of the head and neck. Our exam was challenging, that’s for sure, but it was satisfying and exciting to take. Once 1 o’clock on Friday hit, there was nothing else I could do but try and display my understanding and knowledge of the subject material. It was almost thrilling in an odd way. Our essays required us to recount the entire path of the maxillary division of the trigeminal nerve, the anatomy of the larynx (ain’t as easy as it sounds), and the anatomy of the vertebral triangle. It was a doozy, and the lab practical was REAL difficult, but we all survived and I, along with the rest of the Class of 2015, cheered at the end of our exam. We made it…11 weeks later and we are one step closer to getting our MD degree. Along the way, we have developed amazing friendships and learned so much about who we are as students and future physicians. Pretty darn exciting stuff if you ask me.

I’m going to post another update this evening and hopefully one more this week to try and get all of you readers back into my good graces…for now, thank you for reading and sticking around as I navigate these first months of medical school!

Hope all’s well on your end!

Best,
Lindsay

What I learned while studying the pathway of the facial nerve in the middle ear…the best way to make it through a day of studying, is to have a little pumpkin by your side.

A Foray Home

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This weekend at home was absolutely perfect but way too brief. The three and a half hour trek seemed minimal as I caught up on the Top 40 tunes and relished the opportunity to do absolutely nothing. I can’t think of anything better in this world than the feeling I get driving up to my house after an extended absence. I love going home and knowing that my desire to sit on the couch and watch 2 hours of “Beyond Scared Straight” will be accepted and encouraged. My parents are so supportive and from the special dinners they planned to the time they afforded me to sit like a lump, this weekend helped rejuvenate me…and make me acutely aware of how absurd my “life” is right now.

This weekend was the first time I haven’t studied for the entirety of a day in almost five weeks. I ate meals while talking to other people and I fell asleep after watching TV-not after reviewing flashcards or lecture notes. It was surreal and I even found myself feeling guilty that I wasn’t studying. Pretty pathetic but the new normal has really taken over. I cannot wait for the next time I can go home-for now, I’ll relive the visit when I’m stressed later this week and hope it can keep all the anxiety at bay. Isn’t going home the best?

-Lindsay

What I learned while trying to master the scapular anastamosis, everything connects in the body (no duh) so what I thought I could forget, I have need to recall. The big picture is finally starting to materialize.

A Halfway Mark

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Halfway done with Anatomy! Can it be true?

We had our second exam this past Thursday and I cannot tell you how good it feels to be done. This material we just conquered, or attempted to, was by far some of the most difficult material we will cover and it feels pretty amazing to be able to put this chapter behind us. Now, on to the back and upper extremity! After an indulgent ice cream with friends to celebrate the completion of more than half of our course, I took care of all that has piled up over the past weeks while I holed up in the library. Laundry, dusting, dishes…all seemed to take a back seat to the perineum and abdominal cavity but have now been tended to. It’s sad when you begin to feel a sense of accomplishment when you are able to dust a shelf or do a load of laundry. Medical school sure changes expectations, that’s for sure.

I’m sorry I’ve been absent; the cadaver lab claimed any and all of my extra time in the past couple of weeks and I literally started almost four blogs only to have to discard them as they became outdated from sitting on my phone. Our next exam is actually two weeks from this past Friday—we don’t get three weeks before our next exam this time but apparently the material is a little more accessible than that we just completed so I’m not too concerned about the impending deadline just yet.

I’ve been reading some pleasure books before I go to sleep because I’ve been plagued by a terrible restlessness and insomnia if I don’t distract myself prior to hitting the hay. Most recently I started dreaming I was an artery running between the lumbosacral trunk and first sacral nerve…do you know how unnerving it is when you wake up and wonder why you aren’t filled with blood coursing through the greater sciatic foramen?! This intense studying does something to you; I’m convinced future studies will show that all medical school students have slight symptoms of insanity. My dreams would really encourage the exploration of such a hypothesis. For those in the know, I was dreaming I was the superior gluteal artery. Why that artery of all others I’m not sure but nonetheless, I was busy vascularizing the gluteus maximus instead of getting good sleep. Not a good scenario. In my attempt to dream of something other than anatomical structures, I have read The Help, Sarah’s Key, and most recently The Hunger Games Trilogy. I only read for about 20 minutes but I’ve been powering through these books and I highly recommend each and everyone. Motivation? Each is being made into a movie—it can become a full entertainment experience! Let me know if you have or will be reading them and what you thought…I couldn’t put The Hunger Games down. Talk about a page turner! Those books are nothing like Hollinshead’s Textbook of Anatomy.

After our exam, and what seemed like an interminable lab Friday afternoon, I went home for the weekend! It was the best visit and, though brief, was just the break I needed. Now it’s back to studying but I promise to update about my weekend home in the early part of this week. I already miss the Burgh…but how bout dem Stillers?!
Hope all’s well (and that you’re happy I’m back from my hiatus)!

-Lindsay
What I learned while taking my second set of exams, peanut butter and jelly sandwiches are not great snacks to eat while taking exams. I’m pretty sure some of my short answers have as much peanut butter residue as words written down.