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!