My Bad, Folks. My Bad.

So I pretty much failed at my goal to post regularly on my blog. I'm feeling positive about my intentions and I almost posted a few times in the past few weeks. I couldn't seem to force myself to sit down and make it happen! Don't get me wrong, I did a lot of sitting down, typing, internet surfing, and reflection but none of those happened simultaneously enough to be represented as a blog post. So, my bad.

I am an official survivor of Medical School: Year One, Quarter One!!! Yeah that sounds like something silly to celebrate but it felt like a tremendous accomplishment after finals were over.

Finals. Something I completely underestimated. What seems to be my constant approach to medical school is that I underestimate it. I start thinking I am the bee's knees and I dominate all of my tests and then finals week comes along and humbles me. My poorest test performances were during finals week. I used to actually enjoy finals because I like the "big picture" stuff and that seemed to be the theme of comprehensive finals.

Example: Undergrad Finals week was similar to if you read a book and took a test on what that book was about. What were the general ideas? What was important to learn in that book that will prepare you for the next book in the series? Those sort of tests were nice because I could answer them confidently, knowing that I had the big picture by then.

Example: Medical School Finals Week was as if I had read the book and they wanted to know what happened on page 16 and how that related to paragraph 7 of pg 708. It was terrifying! I felt very under-prepared for my first final. I passed just fine and got an A in the class but I was doomed to study non-stop for the rest of the week. I stopped thinking that it was going to compare to the undergrad tests that I so dearly loved. So I pulled a few almost-nighters and one all-nighter and got straight A's for my first quarter! Work was the only defense I had against the tests that so brutally mistreated all of my classmates and me. I had never heard so many people talking after the tests with so much surprise at the difficulty and detail of the tests. At least I wasn't the only one doing the underestimating!

I have been consistently studying with two guys from my ward. Rob Root and Christian Anderson, both from St. George, Utah. Rob is one of those lucky people that can use a large percent of their brain to remember everything they read, see, smell, and taste and can then synthesize and analyze all of the data then write a 40 page essay on how it all relates to everything I don't know. In short, he is my pick for the spot at the top of the class after the first two years. It is nice to study with the genius kid. Christian and I just sit back and let the professor explain the hard stuff while I come up with ways that a kindergarten teacher would explain it and then I'm good to take the test!

On why testing methods and content seem to be somewhat impractical and overly detailed, Rob has a great theory. If they were to test us on the most practical application of the material presented in class, everyone would get 100%. If they just tested us on general ideas, and essential knowledge, everyone would be getting such high scores that no comparisons between students could be made. Then the light bulb goes on. So medical school is a new filter system on our paths to becoming physicians! Many have thought, as I have, that the filters would stop after undergrad and MCATs and personal essays and interviews. But nay! The filtration continues! But medical school filtering is much more subtle in that you only have to pass to become a doctor. Some second years have taken the phrase "Seven Oh, Dee Oh" meaning a 70% means you will still become a D.O.. I am way too obsessive and competitive to be happy with 70 so I will continue to play the intense, sleep deprived game of getting 90's on the ridiculously difficult tests.

My new question is this: When does the filtering stop!? Does it stop in Rotations? Does it stop in Residency? Will it stop sometime during my career? Have I chosen a profession that dooms me to a lifetime of weeding-out?? I wonder...

After the dust settled on Friday last week, and after I slept for two days, I have been on vacation! I have never been so thankful for Pilgrims or Native Americans or turkey in my entire life! The headaches are gone and my eyes aren't bloodshot anymore! I'm excited to head back to school (disturbing, I know) but this week of hanging out with my girls and relaxing (recuperating) has been totally awesome. I'll be better about posting next quarter. I promise!!!

Tensegrity Info/I Might Be More Popular Now

Since my blog appears to be "googleable", a word that needs to be inducted by the dictionary people, I had a few comments from people that are incalculably smarter than most people. If you are wanting to learn more about tensegrity and its biological applications go to www.biotensegrity.com. Dr. Stephen M Levin is not only my favorite kind of surgeon (cause they get to use stainless steel hammers) but is, essentially, the leading scientist behind tensegrity applications to our anatomy and physiology. He also may be a new fan of my blog (I wish) since he left a comment.

So, to correct some of the things I mentioned in my previous post, the "Harvard boys" that I mentioned, should more appropriately be referred to as the research of Dr. Donald E. Ingber, M.D., Ph.D., professor of bioengineering at Harvard. You can find info on his research by clicking here. It was also incorrect for me to say the "Harvard boys" came up with the tensegrity idea too, an example of my combination of ignorance to the subject and inability to stay fully conscious during a lecture in a warm room with dim lights.

Other very awesome links are in the comments to my post, "Remotivate, Relax, Relapse."

Thanks for commenting everyone, scientists and non-scientist people alike!

Remotivate, Relax, Relapse

It has been way too long since I posted, and for that, I sincerely apologize! My lack of posting is only a sign of my increased workload in school and not a disinterest in posting. I am running on residual testing-fuel (caffeine) and thought I would give an update.

By the way, I changed the comment setting so COMMENT if you tried before and couldn't!

Since the last post, the Secret Society of Study Stuff has contributed a biochemistry test packet, an anatomy test packet, and a histology test packet. We have had overwhelmingly positive feedback on the packets and major compliments to everyone that contributed. We also learned that we have a ton to work on in order to make the "packet assembly" more effecient and less stressful. By the time we sent out the third (histology) packet, we were feeling pretty good about efficiency and stress levels were low. Consequently, stress levels were so good, at least for me, that I got my very first 100% on a test! Now that may sound like bragging, so let me explain the significance.

I have NEVER received a 100% on any significant test in medical school OR undergrad! I always figure out a way to miss one or, on average, two. I thought I was cursed. But the evil curse was lifted and I dominated the Histology test! I had a Biochem test this morning, arguably the most complex/clinically applicable/time consuming test that I have had yet. I felt great, but the 100% is 100% not possible on this one. But at least I know the curse can't be permanent!

I have been very distracted lately. Not in the "I wish I could play video games with my brother and friends" but in the "what am I going to specialize in?" and "what am I going to do now to better my chances at the best residencies for that specialty?" I borrowed a book from a classmate of mine that helps med students self-analyze and assess their own personalities in comparison to the personalities/job-descriptions of almost every specialty out there. It is an awesome book that made me excited and made me scared half to death! I have no idea what I want to do!

I am immediately drawn to surgery. Mostly, because it is very outcome oriented (fast results) and not a whole lot of long-term patient relationship stuff. I won't be caring for people from cradle to grave, which doesn't sound interesting enough, but rather I will be meeting new people all the time and I won't have to keep up with them over a long period of time. I read some specialty descriptions and most were not surprising, i.e. Orthopedic Surgery, ENT Surgical, and Plastic Surgery were all obviously attractive to me. The scariest one, the one that is keeping me up at night, is Neurosurgery.

I always joked that if I really didn't want to have a family, I would go into Neurosurgery. The frightening reality is that when I read the Neurosurgery description (about 8 pages of stuff) I felt like I was reading a letter sent just to me. Even now, I feel awkward writing that Neurosurgery might end up being my specialty. Neurosurgery is for geniuses ("It's not Rocket Science/Brain Surgery"). I am absolutely NOT a genius. I'm an average med student with a super goofy personality with an outrageous imagination that can take over from time to time. But there have been few times in my life where I felt like something (someone) was speaking to me from within my soul.

I can't get it out of my head now. There is a lot to be experienced before Neurosurgery becomes a valid option, i.e. neuroscience I, II, III, IV, but I have to make it a priority to find out if that particular specialty is right for me. It's a tough one to match into for residency so my preparation has to start NOW to give me any sort of a decent CV.

Besides that, I have finally reached a rest phase from tests! I only have an "easy" test on Monday and only two quizzes this week! I won't have another test until next Monday! Which sounds like it is not a break but a Friday without a test is going to make Thursday feel like Christmas Eve!

I have also been struggling with the osteopathic side of my medical education. I went into school with a ton of enthusiasm and faith in osteopathic theory and practices. The theory and principles are easy for me to love, the practices were proving difficult to LIKE. That all changed yesterday during a Founder's Day lecture (founder = AT Still, the founder of Osteopathy, founder of my school). Ever heard of tensegrity? Well, i hadn't either. But you want to know who has heard about tensegrity? Some of the boys at Harvard (they came up with it), top of their fields mechanical engineers, and everyone that sees the tensegrity example on the mall of Washington DC (needle tower).

To shorten the hour long lecture in a few sentences, tensegrity, applied to biology by an MD, PhD Pathophysiologist at Harvard Medical School, is the physics, biology, and chemistry behind some things that A.T. Still tried to describe around 100 years ago. Before yesterday, I was still under the impression that the only way to think about our skeleton is that it is a frame for muscles and helps us do things in response to gravity. Now, the spine and everything attached to it becomes a beautiful, intricate balance of tensile forces that essentially defies gravity rather than just simple adapting to it. One of the most important principles of osteopathy is that the human body is a unit that constantly works to maintain homeostasis or balance. Any part of that system that takes a beating, the whole unit will react, and adapt to the change. A key osteopathic practice is the treatment of somatic (body wall or musculoskeletal) dysfunction can directly prevent disease and dysfunction of the body's organs and tissues. It all seemed pretty hokey to think that realigning someone's back or working out the knots of muscles could help lower risks of cancer, diabetes and other diseases. But the Harvard crew has an extremely detailed and convincing hypothesis as to how our genes might even be activated to change things in the body simply by moving things around everywhere else in the body, i.e. realigning the spine. SO AMAZING!

To think that it would be an MD, PhD from Harvard that might be doing the scientific research that proves that D.O.'s receive training that every doctor needs to have to be most effective.

So longest post ever! Sorry. I'll be done now. Caffeine is pretty much metabolized and I'm getting tired!

Overwhelmed Yet?

It's go time! This week has been awesome and crazy. I could say that it was crazy awesome. The next two weeks will be a test of my mind, body, and spirit (Osteopathic Principle).

The SSSS (Secret Society of Study Stuff) has a new ally, Mr. Tim Tucker, who is the student resource guru and a heralded couselor to students who needed help learning how to study in med school. He and I met on Tuesday and then he attended our first SSSS meeting that evening. It was awesome to have him there. If we can stick with this and implement our ideas, we could have a model that can be applied to every medical school. It will simulaneously help people to learn more effectively and build a team mentality among the students, reinforcing the principle of collaboration that is becoming more essential in medicine.

We have a biochemistry test tomorrow morning for which the SSSS has supplied its first study packet! It is clear that we will be working out painful kinks in the process for a while. I was so stressed out as I studied for our Osteopathic Theory and Methods tests and for Biochem and tried to get a bunch of study material out to the rest of the class. It will be invaluable to get some structure implemented so I can effectively delagate the various tasks so my brain doesn't melt.

OTM is a strange part of the D.O. road. Compare everything to M.D. training and we are nice and equal. Then you add OTM and it gets a little annoying. It is scary to know that I can fail my boards or not graduate from medical school if I don't score well on the OTM stuff. The problem lies in the fact that we have yet to apply what we are learning. It is more hocus pocus than a real diagnostic tool at this early stage. I know that it will become more fun and applicable, but I'm just recording my feelings on this whole adventure as I go.

I am also increasingly grateful to have been elected. It will be an amazing experience to be involved in the student government aspects of school. I'm planning on staying involved every year if I can. I find that medical school is bringing out some surprising sides of myself. I get excited thinking about serving in a more political position as a physician. I love to be outspoken and get things moving with structure, protocol, curriculum, etc. Administrative aspects of medicine are very appealing these days. I also love the educational side of medicine, i.e. visualizing concepts, thinking of new ways to approach the same old material, figuring out better ways to present information, etc. I love brainstorming! Brainstorming is like my own personal sporting event. Consequently, I always win when I play by myself.

I have to start studying again. It is pretty relentless. I overheard some students talking about how often the think about how nice it would be to drop out. It occurred to me that the very elements that make med school so difficult are the very same that make me love it. I am constantly pushed and challenged. How many careers can give you that feeling of constant opportunity for progression? Not many. Yeah, it is overwhelming at times. Yes, certain classes feel like mosquitos rather than warm blankets of science. However, embracing the intensity can only make medical school awesome. I am still loving it, although it takes my sleepy time away.

Thanks for reading, folks! I leave you with a diagram I made to help remember eukaryotic DNA polymerases. Enjoy!

The People Have Spoken

The results are in! I will be the First Year Class Vice President! I'm super excited. It is the first time I have ever been voted into something. It is an awesome and slightly humbling experience. I am flattered that the majority of my classmates believe in me but humbled at what they expect from me. There isn't a ton of stuff I can mess up as the VP but I still feel responsible for representing our class in a respectable way. So, a new chapter starts in medical school. Now we can track a class officer in medical school (me).

Another awesome thing is that the Secret Society of Study Stuff (SSSS) is coming into form quite nicely. We have 14 contributing members, 2 peer-review consults, and a few people ready to contribute to only one subject of their choice. If you are foggy on the goal of the SSSS see my first email that I sent to my class.

KCOMers,

I have been kicking around an idea for how to make med school studying easier and more fun (original, I know). I want to try something, an experiment. With all of the different study guides, spread sheets, drawings, etc, that circulated before the last couple of tests, I had an epiphany. I know that there are those among you that share my love of making study guides, diagrams, and anything else that feels helpful. I want to join forces to make study materials for the rest of the class. You know that you are already going to make them yourselves, why not form an alliance with fellow study guide makers?

Advantages:

• We can have a small group, the Secret Society of Study Guides, to check each other's study stuff, offer suggestions, and refine the stuff before we send it out to the rest of the class
• We will offer the study materials as a packet a day or two before a test rather than several random emails the night before the test (although that may happen in addition to our packets, thus allowing for sudden bursts of creativity).
• Combining the different types of study materials. All of you study guide makers will have your own style and there will be a fan base for your particular style. Putting them all together gives all of us the ability to see things from new perspectives, ie I love to draw and I will most likely create monsters that represent the cells in Histology and Immunology so we can think of them as something goofy, hopefully making it easier to remember.
• I will most likely make a t-shirt to show our unity in the society. It will be like a gang. Like a gang of nerds with spreadsheet and hierarchy tattoos.

Disadvantages:

• You will most likely be more popular.
• You will have to study a little earlier than just the night before the test in order to make the "cut" for the packet.
• You will be helping others beat you on the tests and they will ask you what you got on the test expecting that you did really well but you actually bombed it and should have studied that one section better so that you could have not looked like a tool in front of the kid that beat you.
• You might start to think that run-on sentences are funny.

All in all, this is an experiment. I think it could be super cool and really helpful to the rest of the class. We are all in this together and we might as well help each other out, ya know?

SO... if you are interested in becoming a part of the society, please respond, offer suggestions, etc.

Have a lovely weekend.

I sent a few more emails after that but the tone of the emails has stayed the same. It has been a big hit round these parts. I'm having a ton of fun getting to know everyone. I feel like I am finally in a situation where my personality just fits and I can make a big impact for the better.

The academic side of school is picking up pace despite what I believed to be possible. Anatomy is getting heavier in my mind. We study anatomy by a regional model, meaning we study all the structures in specific regions, i.e. the thorax, the back, upper limbs, etc. It is a great way to learn but it amounts to a ton of information and a short time to learn it. I am pushing myself not to just learn it to get an "A" but to learn it to make me a better doctor. It's a very different feeling than from undergrad. Cramming just doesn't cut it, ethically.

Dissection is still the best time of the week, however, it does get overwhelming when we have four hours of stuff to dissect. I start getting antsy!

I just thought I would get those few updates out there in the blogosphere before I go to bed tonight. Keep leaving comments! It makes me feel like people actually read this stuff!

Secret Societies and Politics

I have mentioned before that I submitted my letter of intent to run as class vice president (or in Spanish: vice presidente de la clase). Elections start Monday and close on Tuesday. That makes Tues the 22nd the day I find out whether I'm popular enough to get the majority votes. That is really all that anyone has going for them, popularity. We just got here and we haven't even been in school for a month! How should we know who to vote for, let alone if we should run? But I want to run anyway. So fingers crossed.

I also have started into motion something that might really be awesome. I have (hopefully) created the Secret Society of Study Guides. I just sent out an email to the class of 2013, inviting those that would be interested to form a secret society. Yes, we all know about the evils of secret societies, but it won't really be a secret, hence the mass email. But it makes the group sound so much cooler! The goal is to team up with other students who, like me, love making study guides, diagrams, drawings, etc in order to help simplify complex concepts and make it more fun if possible. We will peer review each other's submissions prior to the test and then distribute the separate study guides as a packet of educational gold to the rest of the class. I dream that every student will eagerly wait for the Society's packet to hit their inbox and then they will see several pages of study materials to break up the boring textbook/lecture note studying. It could be... amazing. I am already thinking of t-shirts for those that put in the time and effort into making the study guides and studying early in order to get them out a day or two before the test. It will make me a little more proactive and help fight the temptation to cram, all while having fun seeing what other people come up with to learn the same concepts. I'm really excited and figured I'd share it with my readers.

I finally made it into the thoracic cavity of my patient today in dissection!! My dissection team and I removed the left and right lungs and checked out the heart. I have to say that I never felt like anything was ACTUALLY beautiful in our cadaver's body until I saw the heart. All I could say was, "beautiful." I have seen a bunch of hearts. Pictures of hearts, pigs hearts, even human hearts in cadaver lab in undergrad. But it was the act of removing muscle, facia, and bone that made the uncovering of the heart so breathtaking. Arguably the second most vital organ in the body, absolutely beautiful. Turns out it was humongous, probably due to left ventricular hypertrophy, a comorbidity of obesity. It may have even been the reason for her unexpected heart failure. We won't ever know. Dissection is the greatest thing I do every week.

The worst thing I do every week is not sleep. I feel so tired every day! I need to get more sleep! Which is why I will end this post right now as it is 10:30 PM and I have no tests or quizzes tomorrow, finally!

The End of One Era, The Beginning of Another

It was late last night that I got the news. My grandfather, as so many do, fought in and out of "getting better" and "getting worse" until his body wanted a rest. I was studying for my anatomy test that I took this morning. I tried to memorize spinal nerves through tears. I miss him. He was the last of three grandfathers to whom I had the honor of being a grandson. It was difficult, it is difficult, to be so far away, so busy. But in the challenge lies the reward.

It is clear that medicine will never get a day off. Whether it be a test, a surgery, a patient visit, my life is secondary to the lives of those I serve, those that come to me for help. It was a harsh lesson in the first month of medical school but a clear one. My future patients will deserve nothing less than all of my focus, concentration, and attention, despite the events of my personal life.

I think I did great on the test, although I didn't sleep much. I have a hard time vocalizing my feelings, especially sadness. So I chose to write something instead of trying to talk it out. I want this to be my way of saying goodbye to my three grandpas, who I did not get to say goodbye to.

Craftsmen

For My Grandfathers

I can’t think of a more noble title to bestow on a man;

Craftsman.

Three grand men shared the title; Three grand men shared a grandson.

If there are better lessons to learn from a grandfather;

I don’t know of any but those that my grandpas,

The craftsmen, taught me.

Attention to Detail,

Exactness in execution,

Perspective given to a job to be done,

Passion for a job well done,

Love for family

Love for creation

Faith.

A craftsman lives on in his creations;

Design, Cut, Build, Refine.

We may have not been aware of it,

But they did the same with us.

Design, Cut, Build, Refine.

They live on in us.

My grandpas live on in me.

Our eldest and perfect brother,

Died so that we could live again.

That was his purpose.

His hands bear the marks of his sacrifice.

I’d like to think that the calloused hands of my grandfathers,

Toughened skin from years of hammer, wood, saw, metal,

Would also remain calloused after they live again.

To represent their trade, their calling

Their gifts to us.

How humbled I am to have been given three of these noble men.

Nate left before I could properly get to know him,

But his abilities and essence are a part of me,

A hand to guide my own.

It was Fred that stepped in and took up the mantle.

Nate would be pleased,

Only a craftsman can fill a craftsman’s shoes.

A second hand to guide my own.

And finally, it was Perry;

Who embodied the title of a craftsman from the day he could pick up a hammer.

A third hand to guide my own.

It seems that I am destined to be like them,

but cursed to never be there to say goodbye.

I can find solace in knowing that every cut of the scalpel,

Every stitch I make,

Every stroke of my charcoal,

I have three,

Calloused hands,

To guide mine.

“The first son of my first son,” says Nate.

“Eric, make the lines straight, see the product,” says Fred.

“Hey Tiger, measure twice, cut once,” says Perry.

Thanks Grandpa.

Week 3: Bone Crackin', Test Takin', Tennis Watchin'

Well then, week 3 was a week of historic proportions. Before this week, I had never watched the US Open while studying Biochemistry. I had never used a chisel that you could buy at home depot on a dead person's vertebral column. Most importantly, I had never taken a test in medical school.

I passed my first test! I really did not study for the Biochemistry test as I would have liked to. It seems that the more conceptual something is, the better I can test on it. The more abstract and mathematical the course material is, I have difficulty finding the concepts to make it clear WHY I am doing the math. Biochem walks a fine line for me. It is, in my opinion, very applicable to physiology among other important courses that I will take. So the WHY for me is easy. What challenges me is the rote memorization of amino acyl residues and their chemical structures (all 20 naturally occurring ones) and the somewhat disjointed concepts tied into this first test. With all of that, I decided to try something new. I did what most people would consider "concept mapping". I figure, if there isn't a clear concept, I'll make one up. Turns out, I didn't have to study as much as I thought I did! I will make a recommendation to everyone that is currently in a challenging course for school or in a nursing/law program (Nate, Mike). MAP THE CONCEPTS IN YOUR COURSES BEFORE A TEST OR QUIZ!!! If you go to class, your brain might have been listening while you were chatting on instant messenger with me. Map out concepts of material for the test, making that spiderweb-looking thing with interconnected ideas and you will be surprised how quickly you can isolate the areas that you need to study more and the areas that you know really well. TRIAGE!! It saves a massive amount of study time. I ended up with a less-than-wonderful 85% on my test, but the ice has been broken and a "B" ain't bad!

I had dissection TWICE this week! I absolutely love that time of my week. The only real let down was that we were planning on using the power saw to cut open the vertebral column this week, but upon inspection, the cuts had been made by what were referred to as the "lab gremlins." After I had scoured the lab, looking for the said gremlins while holding a scalpel, I returned to my deceased patient and we were handed chisels. Yeah, chisels. It was a little wild to hammer and chisel at the vertebrae like that but the carpenter in me absolutely loved it! I stepped back and oversaw the procedure after a bit of chiseling, I was the designated leader that day so I quizzed everyone on what we were seeing. Our goal was the spinal cord, which now is my favorite part that we have dissected. It was frightening/awe-inspiring to see the somewhat fragile thing that makes all the difference in our lives. The amount of connective tissue, protective tissue, and white and gray matter that separates a walking, breathing individual from a ventilated quadriplegic is not much more than the thickness of surgical tubing. The nervous system is beautiful. I'm excited for head and neck next quarter!

First anatomy test is on Monday. That brings me to my medical student realization of the week. Medical school is a lot of work. It is not just a lot of material to cover and a lot of difficult concepts that require a lot of time studying. It is a lot of meetings, orientation, activities, surveys, assignments, labs, service, balancing, and...fun. I pause to say "fun" because it is amazing how the "fun" somehow consistently/daily emerges as the phoenix from the ashes. I have joined the medical Spanish club, the surgical club, the intramural tennis league, the intramural softball team, and I just submitted my letter of intent to run for class vice president! I also get to give a talk on gratitude on Sunday in church. So where do Ashley and Bostyn fit it? They are literally and metaphorically the mortar in between the bricks of my schedule. I can't imagine a better break from it all than to come home to kisses from two beautiful girls. But the BALANCE is the real challenge of medical school. Ash and Bostyn are doing great and are being very good about letting me throw myself at school. Ash said she can tell that I am finally where I should be. I can't tell you how awesome it is to be able to give 100% in study, effort, and attention and know that I get back 100% of what will make me a more successful doctor. Not just studying to "pass" or to get an "A" but to study to be a great doctor and to better help my friends, family, and other's friends and families.

Med School is Awesome! GO ROGER FEDERER IN THE FINAL ON MONDAY!!!

Week 2: Welcome to Medical School.

So all of that orientation was a little confusing as they made it sound like they were orientating us to med school. Clearly, I was mistaken. I have officially started the "fire hydrant" phase of school.

I have to warn you (as well as myself) that I will be brutally honest in my blog, no matter how stupid it makes me look. I went through last week, week 1, like school was still warming up and that the real school would start sometime this week. What I am now embarrassed to admit is that I was under the wrong impression.

Background: Undergraduate school was pretty easy. I studied a lot before a test and as long as I went to class a few times, I got an "A". I was pretty good at memorizing things as long as they had some conceptual/visual element to them, i.e. physiology and anatomy. I also was trained to take notes and remember everything when the professor said, "Now, on your test..." I loved those moments because it was like cheating! Only the professors told us so it was only sort-of cheating.

Reality: Medical school is not easy. Take all the "stuff" that you see in your undergrad text book. Try and think back to course lectures when the professor would include an FYI or a brief in depth explanation of something only to further illustrate the testable concept. Try to remember what it was like to have a list of what you DON'T need to study along with the MUST study stuff. Medical School surprised me. It was this week that I realized that the whole time that I was waiting for someone to say, "Now on your test you will need to..." or even a "Everything that we talk about today will be on your test," what had really happened was that they assume that you were told that you have to know EVERYTHING! I'm not kidding.

Take Anatomy for example. I know my anatomy (and yours too!). I have had about four courses in anatomy in undergrad. That adds up to about 14 credit hours of anatomy. That is almost a full load for a semester, just in anatomy! So when we started anatomy last week and all we talked about was embryology and the development of body tissues, I thought we were in the preface! I thought we were just being warmed up for anatomy! I convinced myself that school hadn't started yet due to the ridiculous amount of detail they were throwing at us about something so (in my opinion) unrelated to anatomy that we deal with as physicians. HA HA! Joke was on me, folks! It is absolutely the truth if they wrote on the syllabus in big bold letters: LADIES AND GENTLEMEN, KNOW EVERYTHING OR FAIL. Welcome to medical school.

But despite my assumptions and ignorance to reality, I'm not overwhelmed quite yet. First test is next Friday. We will talk about overwhelmed then. I am, however, elated! My first patient gave me my first lessons today. Here are some lessons that she taught me today:

• Exercise= surgeons can fix you a whole lot easier if something goes wrong.
• Exercise= your body hates you if driving to McDonald's is your exercise.
• No matter what anyone says, beauty is not only skin deep. Beauty is actually attached to the fascia that connects to the skin but it runs all the way to the bone. Dissection was Beautiful!!!
• I am a cutter. No matter what direction medical school takes me, I love to cut, rip, pry, search, and identify. I spent three hours in there and could have stayed longer. Awesome.
• I am also glad that I can make mistakes. It is so hard to find certain things and I end up hacking something that I will have to find later while looking for something else.
• Always have a plan. Even more important than having a plan, have a plan for what you will do WHEN the original plan fails. At least that lesson pertains to dissection. I don't think any of us were expecting having to rip away 15 or so pounds of skin, fat, and fascia in order to START the dissection, let alone how hard it would be to find the tiny veins, arteries, and nerves that we had to identify.
• A dead body has a ton more juices than you would think and they splatter on your fellow dissectors. This does not make them happy.
• I love dissecting. I think I already said that though.

We only dissected the back today, but it was still really cool. I'm getting excited for the internal organs and bones. I'll be back in the lab next Tuesday!

One last thing that I'm really loving. I am so impressed, proud, surprised by the osteopathic elements of my medical education. No where else would I begin to be a clinical doctor my first week of school. I have already role played an office visit! We have a course our first quarter about doctor/patient relationships and how to ask effective questions. I don't even know what the answers mean yet! I love the OMM training. We haven't done the actual manipulation, but the sneaky part of it all is that we are being numbed to the awkwardness of touching a stranger. I have a partner that I didn't know from Adam a few days ago and today he had to lie there while I dug my fingers into his butt cheeks to palpate the ischeal tuberocity of the pelvis. I am not kidding when I say that it doesn't phase me at all. I really don't feel awkward at all. But as I looked around the room at 172 students grabbing each other's butts, I had to laugh. Where else do you go to school and get to do that as an assignment! (no play-on words intended with ass-ignment).

In the end, (there it was again) I loved my second week. I know I have one day left but it only gets better from here!

My First Patient

So day 2 became the most surprising yet. We had our intro to anatomy and dissection today (among a few other classes). I'm feeling pretty confident that I will enjoy anatomy and score well enough to distribute my stress among the other classes that I have this quarter. The anatomy intro was pretty straight forward and was mainly a syllabus breakdown. The Dissection intro was what caught me off guard.

It started as a brief history of human and animal dissection. Human dissection has been a wild ride over the past 500 years (pretty much 1000 years). The history was interesting and I doodled the whole time so I felt like I was back in school again. Then things took a different direction. A professor stood up and gave a lecture on the emotional and spiritual side of human dissection for the purpose of medical training. He had an awesome European accent (possibly German) and he had my attention immediately.

I anticipated the lecture on respecting the bodies of the people that donated themselves for our educational purposes. It is a very necessary and helpful discussion that I have has before while in human anatomy in my undergrad. So I wasn't expecting anything too different. I could not have been more wrong.

He began very straight forward about the privilege of having the cadavers as students and how being respectful of them was so important. He then described how the cadaver is, in a special way, our first patient. We owe the person's body all of the respect, care, and attention that we would want to give all of our future patients. He read a poem written by a medical student that described the emotional and intellectual battle that goes on as a med student learns from the cadaver. How one minute you are making the cold and scientific assessments of the body and its condition, but then consider the person's story. Did she have a family? What was his legacy?

My doodling had stopped completely by then. He had me. He delivered the next part so perfectly that it changed me forever. I was contemplating how great it is to think of the cadaver as your first patient when the professor added something more than just "great". To show us what the cadavers really should mean to us, he read a card that was sent to our school. It was sent by the family of one of the people that had donated their body to the students here. The card was a 3x5 card with short messages from a spouse, children, grandchildren and friends. "Please take good care of my blue-eyed soul mate", "It is our hope that one of your students can find a cure to that cruel disease: cancer", "We love you for the profession that you have chosen", "Please take care of my grandpa".

I couldn't look at the card after he began to read. I tried desperately to return to the safety of my doodling. I could hear tell-tale sniffs all around me. I fought harder than I have in a long time to not get choked up. It was in that moment that the cadaver that I was going to be dissecting over the next six months became a person who was giving me a selfless gift. Every person that I treat will owe the donor of that cadaver for helping me, a brand new student doctor, learn about the amazing human body.

The professor also included a thought from a movie that was made decades ago, starring Carey Grant. He played a doctor who was followed around by the spirit of his cadaver from medical school. While he treated his patients, the spirit would remind him of things he had learned from the body. I pondered that idea.

The students were all sent to the anatomy lab to then meet our cadaver. Four people to a cadaver. We walked across the campus to the building and climbed the stairs. It was a much more reserved crowd. Not solemn but reserved. I found my designated table and body. Another member of my team and I unzipped the bag and unveiled our first patient. Out of respect for my first and perhaps my most important patient, I will not share further details about her. Before we covered her back up, my partner had stepped away for a moment and with foggy vision I thanked her for being the one that would teach me. For being the one that would make me a better doctor. For being my first patient.

Now, while nobody is watching, I can let a few of those tears loose. It was a deeply moving and powerfully spiritual thing for me. I touched her skin and pictured her, looking on from a better place, pleased that she will be giving us such a priceless gift. It will be an honor to learn from her. I will be eternally grateful to her. She is... my first and most special patient.

Day 1: Seriously???

So I thought it more than appropriate to report on the first day of the 1,000 + days that I'll be in med school. That first day was today. I shall now report.

I showed up one minute late and the entire classroom was busting at the seams with eager med students, eager third year med students, some faculty and a few members of the administration. I was forced to sit in the back. I hate sitting in the back of the class! It was apparent to me during my undergraduate studies that a direct result of me sitting in the back was laziness (usually nap time), restless leg syndrome, and texting. Needless to say, I was really calling on the higher powers to help me pay attention to the third welcome speech/ slide show I have had in the last four days. Sheesh! I feel welcome for cryin out loud!!

The "welcome" was mainly the history of osteopathy and a plug for A.T. Stills, the founder of my school and the master-mind behind osteopathy as a compliment to medical practices of his time. He was an amazing man and way ahead of his time. A major reason that I'm so stoked to be educated and trained as a D.O. is the philosophy that a physician ought to treat the patient and not the disease in order to heal for life. Basically, not being satisfied to simply mask and manage pain and discomfort, but rather provide a pathway for the body to heal itself and return itself to equilibrium. This is a spreading philosophy among M.D. institutions and many other health professions. Our bodies are totally amazing and we owe it respect!

After the history lesson, the proverbial poop hit the fan. As the brilliant biochemist, all-bright research scholar, fired away about acid-base mechanics and solution terminology, I was horrified. I can't believe how rusty the chemistry and organic chemistry have become while sitting in my little wrinkled brain. Looks like I already found the 1st quarter course that will punch me in the epididymas.

After the rousing BioChem lecture, we had a... yes, another free lunch! I haven't had this many free meals since being a missionary! It's all part of some plan to fatten us up before we completely destroy our bodies with energy drinks, lack of sleep, and study snacks. They are doctors for heaven's sake!

After lunch, things became even uglier. For those who don't know me really well, I am a self-proclaimed "recreational philosopher" who would have majored in philosophy and ethics had I wanted to start med school after my thirtieth birthday. We had a small presentation about the evolution of ethics and morality in a person as they become more educated and age. Then we had a comparison made between physicians, by specialty, on how they score on morality tests during and after med school. Orthopaedic Surgery Residents scored the highest and internal medicine folks scored. Nobody has any idea why. So why share the info??? Then the worst thing happened. We were given a standardized test that was going to score our moral compass, I think. See, that was the problem, there was no mention of anything beyond, "read these situations and rate the 12 issues as either of great importance, more importance, some importance, little importance, or not valid." As someone who takes the ethics and morals of people pretty seriously, I was flabbergasted as people were done with this test in a matter of minutes! Was anyone considering all points of view? Was anyone asking themselves about slippery slopes or universality of their choices? I doubt it. Was it super confusing as to how to rate the issues? Yes. Where the issues vague and poorly worded? I thought so. I just got worried that the ethical and moral issues weren't going to be addressed in med school as I would hope for. I'm probably being way too nuts about this but it got me warmed up for the final activity of the day.

We ended our first day in one of the most strangely performed patient simulator experience that I could have imagined. It was like a predictable movie. Our group of ten students, called our society, was divided into two groups and we stood awaiting instructions outside two patient simulator rooms. We were handed a clip board with the patient/situation information for us to read aloud. The smug second year student was dripping with snooty-ness as he clearly knew something we didn't. After finishing the reading we were pushed into the room and there were two attending physicians standing over the rubber body of the patient. The only thing they said was, "What do you do now?"

Taking all things into consideration, our first year of med school is infinitely better that KCOM is exposing us to clinical situations from our first day rather than wait till our third year rotations. Patch Adams would love this school! But what the heck does a first year med student know on their first day? One of the guys in my group was a music major. What on earth was he going to know?? !!! I know they weren't expecting much but our group had a pretty cool couple of attendings and they made the experience a very educational one. What got me all riled up was what happened in the debriefing meeting afterwards.

The other students in our society asked us if our patient lived or died. We had no idea how to answer because as we progressed through the methods of diagnosing the plastic man and then worked out treatment options for him, we were called out for the debriefing. They were a little unnerved at the fact that their synthetic patient bit the dust (some one turned him off). They didn't seem very "educated". During the debriefing we analyzed what we could have done better. Of course, being the smart-ass/sarcastic person that I am, I wanted to say that being doctors would have been super helpful. But it was good to look back and see how much stuff I have learned in undergraduate, scouting, and even lifeguarding that helped me so pretty well in the simulator. I just think they should have prepped us better to role play. How can I answer the question, "How does he look?" when all I see is a very unconscious rubber man on a hospital bed? My only answer was, "He looks like he may need to be rebooted." It got a laugh, mind you, but I want to be a serious doctor, not a class clown. But it is impossible to be serious when they play the "look how little you know you little med students" game. I'm in school to learn this stuff. Surprise!! I imagined trying to make fun of Bostyn when she starts learning to read. "HA HA! See how you can't read now! Bet your excited to learn so you don't ever have to feel like an idiot ever again!" I'd put the other groups experience on the "ineffective" list.

Never the less, I am even more excited to get things going in school. I talk pessimistically but I hide the much more prevalent optimism cause you already know that I'm excited!!! I've been waiting to be a doctor for as long as I can remember! I just like to be a critic.

I just filled out my seventh freaking survey and I'm going to bed! I finally get to wear normal (non-suit and tie) clothes tomorrow. I'm totally wearing a wife-beater and some jean cut-offs tomorrow. See if they ask me any questions then! Laters.

Some Pics!

Here is a small taste of the white coat ceremony. I need to lose some hair or go grey to be a respectable doctor. I pray for the latter. :)

I dawn the mystical jacket of healing.

A beautiful but tiny woman meets me outside to congratulate the student doctor.

Another beautiful woman joins her.

I am surrounded by some other people that happened to be there too.

This was the scoreboard in the gym where we had the post-ceremonial picnic. Class of 2013, 172 students in the class, 1st year. Neato!

Intro

Much to my disappointment, the tragedy of forgetting both the username and password that was associated with my other blog has lead to my adoption of this replacement. The bright side is that instead of just letting everyone see the twisted mind of me, they get to see the mind get even twistier as medical school invades my life. Brace yourselves.

Orientation: Days 1 & 2

I have been somewhat of a nervous wreck this weekend. I'm not really the nervous type but the stomach was doing back-flips starting late Thursday night before my first orientation experience. I know what you are thinking, "how does someone get all worked up over something like a simple orientation?" I have no answers for you. I have no idea why I was nervous, just that I was. As if I half expected there to be some sort of test to fail or a moment of embarrassment that I might face. Thankfully, I was neither embarrassed or tested in any way. I was, however, challenged by the act of sitting properly for my school photo. I blame glamor shots. They always let me pose however I wanted.

I was able to make awkward conversation with several people whose names I will have to request again when I see them next for awkward conversation two. I love making friends but I hate getting to know them first. The whole process is exhausting and it makes me grateful to be married and not have to date ever again. Making friends is slow and I am somewhat impatient. The result is my preference to be really goofy, loud, and, at times, inappropriate to get those "blind date" jitters out. I throw the reserved first impression right out and display the thirtieth impression instead. I hope it worked!

We received a whole doctor's office for our parting gifts (that I paid for). It came with a stethoscope, sphygmomanometer, and other stuff that you weren't supposed to touch in the exam rooms while waiting for the doctor. Totally awesome. It felt a little like a creepy Christmas or birthday but I enjoyed it all the same.

Today was the best part; we had the white coat ceremony! That was an amazing experience that I will never forget. I felt like I had my ancestors that has come before me standing there, cheering me on to complete a dream that many of them had or fulfilled themselves. The pomp and circumstance of the affair was enough to make me smile from ear to ear as I walked down the aisle to the sounds of trumpets and loud, boisterous music. It was like we had slain a dragon, or fought a war and were returning home. The journey here was tough and the whole experience today made me reflect on how I ended up here in Kirksville. Simply put, I am convinced that I am exactly where I am supposed to be!

We had a huge picnic afterwards with all of the families and faculty. Then we split up, families to one room, students to the other. This is when orientation took an unexpected turn. It was as much a celebration for the second year class as it is for the first year class. The second year class ran the show, and by show I mean an actual show. From the opening song/skit to the 15 minute presentation on the tradition of the Osteo-stache, a mustache that is grown between the first and second years of med school. It is a right of passage and I will have to keep with tradition. Sorry, Ash.

We played "get-to-know-you" games and those are usually so awkward but I enjoyed them, thankfully. The second year class was super cool and they made it fun for all of us noobs.

I'm a great mix of excited and nervous after today but one thing has developed that I can rely on for the next four years, I am sure, with all that I know, that I am supposed to be a doctor and that I am supposed to be here in Kirksville to learn to be one. Type at ya soon, folks!