Sunday, February 28, 2010

Trinidiom #81

"You are bouncing all over the bottom floor like a ping pong ball!"

Friday, February 26, 2010

Trinidiom #80

"You're between a hard place and a wall."

Wednesday, February 24, 2010

Trinidiom #79

"I'm on my last legs!"

Monday, February 22, 2010

Trinidiom #78

"Sorry for being such a pain on the side."

Saturday, February 20, 2010

Trinidiom #77

"I'm covered from tip to toe!"

Thursday, February 18, 2010

Also present on New Years Eve...

Romy was the most fun to take pictures of...but there were a few other people there =).

My gorgeous cousin Jossie.
My aunt Linda, Mom, Dad, Ron and directing the scene...Romy.

Last but certainly not least...I got to spend a wonderful afternoon with my grandparents on New Years Eve. It was great to see each other again!

It's Dec 31st!

Speaking of adorable little's Romy! I can't believe how much she's grown and changed since last time we saw each other.

Trinidiom #76

"Suck it for all it's worth!"

Tuesday, February 16, 2010

Chocolate is important

I love Trader Joes 72% dark chocolate. Love it. Plus, it's good for you. And, that's a great justification.

Lucky me, they sell it in "pound plus" sizes, so one bar lasts quite a while. Unlucky me, we ran out the other day. This upset me.

We do not live with easy access to Trader Joes, but desperate times call for desperate measures. I figured out if I took two buses and walked about ten minutes I could get there.

Relieved to see a full supply of them, I loaded ten bars in my basket and got in line. The woman behind me in line said, "Wow! That's a lot of chocolate! What are you going to do with all that?"

"Eat it." I said, totally straight-faced.

"Oh!" she said, nervously laughing. "Well, enjoy!"

"I will." What's wrong with these people. This is awesome chocolate. Why would I need to "do" something with it?

I get to the checkout. The clerk says, "Oh my! 10 lbs of chocolate! Are you having a big party or something? Fondue?"

"No. I just like it. We ran out."

"I'd say so!" Same nervous laughter. Weird, what's wrong with everyone here.

I walk in the door with ten lbs of chocolate in my arms. Ron looks at me, a little surprised, but with a huge smile on his face and says, "maybe we shouldn't have sent you there this time of the month."

Trinidiom #75

"I'm falling off my job."

Monday, February 15, 2010

White Coat

It's the strangest thing. The white coat has power. It gives entrance to the most private parts of peoples' lives. Someone you've never met lets you look inside their ears, listen to their heartbeat, take off their clothes and touch them. It's a weird amount of power. I think I notice it so much because I feel so wholly unworthy of it.

When I'm in the exam room I am not a person, a woman, a wife, a daughter...I am a doctor. When I greeted a teenage boy patient...I have never been looked at so utilitarianly in my life. It was as though I was the most uninteresting thing in the world. I wasn't a girl, I was a doctor.

I think it says something about how we rationalize the gross invasion of privacy. I go to the doctor, he is a man, I am a woman...about the same age. In any other circumstances him instructing me to remove my clothes, then touch, look, ask probing questions...this would be totally inappropriate. But, when it's a doctor, it's ok. Even when you're little and they teach you about stranger danger and everything...they say no one should touch your bathing suit areas, except your doctor. It's really intimate. So it's like everyone involved compensates by detaching. I, the doctor, see you as this machine that needs fixing. You, the patient, see me as the mechanic who can help you figure out this problem. So, I think it's a little weird.

Sunday, February 14, 2010

Trinidiom #74

"I'm gonna throw trash at you!"

Saturday, February 13, 2010

Cadaver Thoughts (last week or two of Anatomy)

We removed his brain today. The only thing I can imagine is like it is watching a baby be born. Emotional, amazing, scary, wonderful, supra-human.

I want to hold it! I want to love it. I want him to know it's going to be ok. God is so incredible.

This nerve between my fingers is how he could smell. This right here is how he saw the world for 83 years. This one gave him the ability to wiggle his tongue.

This was him. All of him. In my hands. I want to love it and hold it.

What an incredible honor. An intimacy beyond all intimacy.

Friday, February 12, 2010

First day in clinic!

I get to spend one afternoon every week following around a family medicine doctor, wearing my white coat, my stethoscope and pretending I'm totally official!

I feel like such a fraud. I walk in the room, introduce myself to a patient saying, "I'm a first year med student" meaning - I know nothing! Don't trust me! Don't believe anything I say! The patients hear me say, "I'm basically a doctor." I find this unnerving.

My teacher-doctor will put his stethoscope on the patient's chest and I'll mimic him and nod knowingly. The first time I couldn't hear anything. Turns out I had my stethoscope on backwards.

One of my fellow students said it perfectly the other day. "I go to do the heart and lungs exam and basically when I hear the beat, I think to myself - he has a heart, check!"

Everyone has to start somewhere right?!

I have to say though, I am learning so much. It is fascinating to watch it all come together. We have spent the past many months absorbing incredible amounts of information. To see why it matters and how it fits is wonderful.

Trinidiom #73

"Don't bust with me right now!"

Wednesday, February 10, 2010

Cadaver Thoughts (November-ish)

Our poor guy. He's had a lot of surgeries. Given all the creative re-plumbing, his intestines are very confusing. But, they're his. We're studying for the practical and even when the tables get moved around, I always know when we're with our guy because of his look.

I find myself holding hands with or gently touching the head of whoever we are studying on. These bodies don't scare me anymore. They are wonderful, interesting and sometimes I think a little lonely. Probably not really. But, just in case, it doesn't hurt to quietly hold a hand while we identify the splenic artery.

In order to do the pelvis dissection we have to bend his knees into the stirrups. This requires severing the patellar tendon. I'm cutting it. It gives way and what in the world is that?! It's metal! He had a knee replacement. No way! He was holding out on us. I didn't know that. It feels like I just found out that my cousin Jossie got to go to the mall alone before me and didn't tell me.

Tuesday, February 09, 2010

It's Dec 23rd!

We got to spend December 23rd with two of our all-time favorite people...Melia and Joe.

Found a couple more priceless ones...

There were other people there too...

It was so wonderful to be home and spend time with our friends. We miss you so much here on the other coast.

Aaron and Holly

Melinda and me.They're still the stars of the show =).
It was

Trinidiom #72

"The bug in my boo."

Monday, February 08, 2010

Cadaver Thoughts (October-ish)

We're done with Back and Limbs - the first of three sections of Gross Anatomy.

Today we need to remove his chest wall to visualize the heart and lungs. His ribs need to be disconnected to get the chest wall off. No one wants to do it. It doesn't bother me. I feel increasingly close to him. We have all spent a lot of time together. He's ok with this. He knew exactly what was going to happen to him when he decided to give us this ultimate gift. I can almost see him winking at me as if to say, "you ain't seen nothing yet."

We lift off the chest wall. OH MY GOSH. I can hardly catch my breath. It's the most amazing thing I have ever seen. Oh my gosh. I have tears in the corner of my eyes. I look over and one of my lab partners has them streaking down her cheeks. It's his heart! It's his lungs! I finger his lung lobe; it's soft and spongy. His heart is like a centerpiece. The aorta feels like a rubber hose. It is so strong. It's tough. This is his heart!

Heart removed and we can hold it. I had no idea it would feel like this to hold a human heart. And it's not just "a" human heart, it's his heart. It's strange how we all feel increasingly close to him. It's like he keeps inviting us in farther and farther.

Next lab, we open the abdomen and there's no omentum! I'm still a little rusty on exactly what the greater omentum does, but I'm pretty sure there's something missing. And, where's his stomach? They told us in lecture it is often a lot smaller than you imagine. I ask my lab partner. We can't find it. I feel dumb asking a prosector to show me his stomach. They just posted the cause of death on the board. Do we want to look?

He's 83. He died of stomach cancer. He's 83. I'm so glad to know. He has no stomach. They took it out in a surgery. Someone has seen this before. Weird. Some surgeon had his hands inside our guy. How violating. I'm sure that surgeon didn't love him like we do. Did I just say "love"?

Saturday, February 06, 2010

Trinidiom #71

"You're like a drunk in a crystal shop."

Wednesday, February 03, 2010

Cadaver Thoughts (September-ish)

I didn’t expect to feel much the day we met our cadaver. I took Anatomy in college, studied on a cadaver. I remembered that each day my heart would catch in my throat when I first glimpsed a skinless body from the door. But, one deep breath later, I saw Flexor Digiti Minimi, not someone’s finger.

I walk in the room. We unzip the bag. It’s a man. His legs, stomach and arms don't trouble me. Fingernails. Earlobes. Forehead wrinkles. It isn't passing. He still looked like he, not that. We gently wrap his hands, feet and head to preserve the delicate structures. I can’t help but wonder if we aren’t covering up the most “human-looking” parts of him to make it easier for us to begin cutting into him.

This man lays before me, a wonderland of learning. The pinnacle of biology, chemistry, physics, all wrapped up into what was…a life. I’m going to get to do something no lay person gets to. I get to look inside. I get to see how it works. Touch it, feel it, look at the actual inside of a human body. It’s amazing.

The first cut is the hardest. Piercing the skin seems violating. His outer shell now has this penetrable opening. Task at hand is removing the skin of the back. We’re trying to “find a plane” and not cut anything too important. Not a lot of time to feel how weird and gross it is that we are taking the skin off a person. Not until I close my eyes to go to sleep. The dreams aren’t upsetting, and that’s upsetting. It’s so matter-of-fact to visualize skin systematically removed.

By the second lab, removing skin isn’t a big deal. It’s a hassle, and we are flying through it.

Third lab, we are dissecting his Axilla and Cubital Fossa. I don't have any idea where that is. The armpit. Why can't they just say armpit? To get to his armpit and visualize his Brachial Plexus, we have to put a rope around his wrist and tie it to the post at the head of the table. I'm holding his hand as I'm awkwardly trying to tie up his wrist. It feels good and strange all at once. I drop my tweezers and as I bend over to pick them up, his hand slips into my scrub pocket. I jump, and laugh and the whole thing is just so weird. How am I supposed to feel about a dead man's hand in your pocket?

The experience of lab feels increasingly normal. Ron has to remind me to take off my scrubs before I come in the kitchen because I don't notice the smell anymore. I don't know his name. We've taken to calling him "our guy." Officially he's Pod 1, Table 1, but by the time we've reflected his biceps brachii, it seems like he's ours.

Tuesday, February 02, 2010

Thoughts (Later October-ish)

I think the human body is amazing. It is utterly complicated, yet filled with elegant patterns. It’s inspiring. I think it’s because it’s so immediate. The concepts are so instantly relevant. Where does my Sartorius attach? Where does the cleaned blood from my liver meet up with the inferior vena cava? What happens to the triglycerides I ate at lunch? Unlike a lot of my classmates who are so eager for the “clinical correlations” (aka what can go wrong with this part of the body), I’m eager to understand how it goes right. It really does seem like a miracle that eating top ramen doesn’t completely throw off my sodium/potassium balance, that drinking toxins (alcohol) doesn’t poison me and don’t even get me started on how in the world a baby comes to be and be born. Points for creativity there, but whoa. Not exactly run of the mill.

It’s intoxicating. The wonder of it all. I like to glory in the wonder. I imagine next year, which is devoted to pathophysiology (what goes wrong) might leave me a depressed, hypochondriac mess, but for now, I’m soaring.

The only interruptions to my ecstatic happiness are the occasional exam and the beginnings of clinical instruction. As they say over and over, “During your career, most of what you learn in medical school will become obsolete, but anatomy never changes.” So, the material stands alone. It is the obturator internus. Lining the inside of the obturator foramen, pierced by the obturator nerve. That’s just what it is.

But, what about teaching us to interact with patients? The same approach is taken and I find it a little offensive. There is a way. A professional, best practice, code of conduct way to interact with patients. But, patients aren’t body parts. They’re people. “Yes, of course. That’s why we’re teaching you Human Behavior in Medicine. We’ll cover the typical personality types, methods for handling them and ‘anomalies’ you might encounter.” Really? I’m already impressed and upset that you can teach me the entire anatomy of the human body in sixteen weeks. But, now you’re going to logically and coherently explain to me human behavior!?

I don’t buy it. I understand that there’s a level of professional distance that must be developed and maintained to function as a physician. But, my humanity must be tempered so I can do my profession?

Monday, February 01, 2010

Snow! (It's Dec 20th)

Thank goodness my Neuroscience midterm forced us to delay our flight from "today" (airports shut solid) to "tomorrow" (airports all clear). We enjoyed our first big Nor'easter!