You shoulda seen the other guy...

This is my dog, J-dog. This picture was taken some point in time prior to last Friday, December 16, 2005. That was the day he had an unfortunate run-in with an American Bulldog who slipped his leash and pounced the unsuspecting 20-lb terrier. For once in his raucous little life, J-dog was not the initiator of the fight, and actually was the innocent bystander.

This is J-dog now:
















This is his right hind leg, where he had stitches. The holes are teethmarks:














He had X-rays which showed nothing broken, so he just had a stitch or two and was sent home with pain pills (woo!) and antibiotics (nasty dog mouth germs). We're going over to talk to the owner of the bulldog tonight, but she has already offered to pay his vet bills. She seems to actually care that her dog mawled ours, which is nice (the caring, not the mawling).

I think we're more upset by this than he is. The cone is cramping his style way more than the leg is. He's already learned how to walk, jump, climb up and down stairs, and use the cone to effectively beg for food and attention. If only we all had such steep learning curves!

_________________________________________________________________

In other news, I finished my tests. They sucked. The end. Then, I went shopping! and bought a scarf to match my hat at the Gap (both in the pink stripe) and a cute black blazer at Target (properly pronounced tar-JAY when purchasing clothing there). I also purchased tons of birthday presents for friends; I just need to get my mom and stepdad's gift purchased and headed on its way up the Lonely Mountain.

That's about it. We leave for Arkansas on Tuesday, where we will visit the fiance's family. On Wednesday, we get to see Trans-Siberian Orchestra! And eventually, we will open many presents, hop back into the hatchback, and head back home. Good times.

Ew

In reading about fungal causes of meningitis, an infection of the tissues which surround the brain:

"Grossly [seen], a slippery brain with gelatinous subarachnoid exudate."

Gross is right. This, children, is why we wear condoms when we have sexual fun, so we don't get AIDS and end up with a slippery brain with gelatinous exudate.

Back to the endless study.

Edit: I just had another thought. Isn't the brain already slippery enough? (Not that I ever dropped one or anything... at least it landed in the bucket). How do you know the brain is more slippery than normal? I'm picturing brain races, similar to the pickle races in "Billy Madison". Would a brain slide down a window, or could you scoot it across a floor? Could you remove the cranial nerves to make it more aerodynamic and decrease wind resistance?

I am truly losing my mind here.

Not Gonna Make It

More than once, on car trips as a child, I'd announce that I had to pee, usually right after we had left our street. Exasperated parents would start looking for a restaurant while I desperately prayed to the gods of the Kegel and attempted not to wet the seat. I always KNEW I wouldn't make it, yet somehow I did. Disaster was always averted, somehow.

This was my really lame attempt to convey how panicked I am right now. Tests start next Friday, 9 days from now, and STILL all I know is Gross. Which would have been great last year at this time, but not so much now. I know renal and pulmonary path, but not neuro; the lecturer was so unintelligible, and skipped so much of his syllabus, that I don't even know where to begin in neuropath. In pharm, I'm well versed in pulmonary drugs, since I have almost all of them in my medicine cabinet (upper and lower respiratory), but I'm not so good at Parkinson's or epilepsy drugs, having never taken those (yet). Diuretics? HA! Behavioral ought to be pretty easy, fortunately. That ol' BS in BS (psych) is sorta paying off (still not worth the $50,000 it cost, but hey, I never thought it'd be worth anything). FCM is a strange conglomerate of path, physio, pharm, and real doctoring, all rolled into an adorable Spanish doc with an accent like Antonio Banderas. If only I weren't still about 8 lectures behind in that class... Physical Diagnosis shouldn't be too difficult, test-wise, but I still have 3 full H&P's (History and Physical exams to the uninformed) to complete and write up--in the week before tests start. Last but not least, PBL, my old nemesis, continues to throw patient cases at me and makes me write learning issues on the "Involuntary Commitment Process".

I'm a little panicky.

Oh, and I will be in the gross lab a good deal this weekend, since the first years have their Gross exam next Monday. Therefore, my last weekend before tests begin, I will spend studying SOMEONE ELSE'S MATERIAL. Never mind that I volunteered for this, never mind that I (supposedly) will get paid for my work in the lab. I just want to whine, and curl up in fetal position in a corner, and scratch my eyeballs out.

Only 7 months until the BOARDS. It's only going to go downhill from here. *sigh* I think alcoholism sounds like an acceptable alternative (to losing my mind). That, or I'm going to go drive buses again.

Invisible Medical Studentitis

Picture the eager medical student, left to watch "Seinfeld" on a couch in the L&D on-call room while the residents gossip and then leave the room suddenly, without inviting her to tag along. Picture the OB residents passing out hot chocolate packets without offering one to the student, or apologizing for not having enough. Picture the student feeling more and more frustrated--after all, I can sleep in my own bed much more comfortably than on some nasty couch at a hospital.

I will never be a resident or attending like that. If an overeager medical student shows up, I will either be straight from the beginning--"It's a slow night, go home and sleep"--or I'll take them with me to see some gore and guts. I'll acknowledge their presence in the room instead of ignoring them. These residents were all like, what are you doing here? I'm all like, this is a freaking teaching hospital, I'm here to see some gore. I'm here to watch a delivery. I'm here to see if I'm really willing to stake my future on a specialty that involves low sleep and high malpractice. I'm here to be inspired so I can hopefully make it through the upcoming 6 tests I have starting Dec. 9. Above all, I'm NOT here to be ignored. I know how to stand in a corner, I'll be quiet and out of the way.

And who cares if I'm just a second year? Who cares if I'll "see plenty of OB next year"? It's NOW I'm worried about! I'm scared to death I'm going to get as burned out as I did last year, and want to quit school or worse.

Bah. Time to get some sleep and quit my whining.

Paradigm Shift

We're on the other side now. We cannot go back, it's too late. We can only go forward.

I bought a wedding dress.

Yes, indeed, I have made the purchase, and bought the dress, veil, shoes, petticoat, and fabulous bustier. I'll go back in January, with the altered bustier, and try on the dress for alterations. The bustier, which is the key to the whole system, came from the most FABULOUS lingerie store in the world. I walked in, said I needed a bustier, and the lady took one look and brought out the right one. In the right size. In the right fit. And she's going to alter it to fit even better, accentuating my waist and hips. Tres French. This is even more amazing considering the bra was a size 36 DDD/E and she just happened to have it in stock. And it's beautiful. I also bought a beautiful French bra and panty set that is jaw-droppingly beautiful. Wow!

Just One of Them Days

Did you ever have a day where you find yourself speaking like a person with Tourette's, in coprolalia? Like when I left my Nalgene bottle in a room on the other side of the building, and I was racing back for it, I was saying things like "Shit Fuck Damnit!" Or when the bus didn't come and I was freezing my ass off outside and I was just repeatedly saying "Fuck YOU bus! Fuck YOU!" Or when my preceptor didn't show up this morning, or when PBL sucked, or when people kept asking me "What is this thing? What is that thing? See this tiny piece of tissue? What is it?" today in gross lab (in other words, asking me to do my job)... I just kept saying things like "Son of a WHORE!" and "Fucking shit fuck damn shit godammit!" all day.

I need a bigger vocabulary of curse words.

Cheap Date

Students have a Cheap Date @ the Angelika!!!!!!!

Every Monday, students get a FREE Large Popcorn & FREE Large Soda, upon presentation of valid student ID at the Box Office. We also have a student price of $6.00 per ticket for all shows during the week (not just Mondays). FREE Large Popcorn/Soda offer only good with purchase of film ticket on Mondays.

Woo! So my friend "Basia" and I are going to go see "Pride and Prejudice" this evening, no boys invited.

Also, I may have to go see Harry Potter 4 this weekend... AT THE IMAX!!!! I am a superdork! But how awesome, to watch the dragons and the school champions at the fucking IMAX!!! Yay!

Good stuff.

I'm currently re-reading The House of God. I'm always amazed at how much more relevant it gets the more medicine I know. For those of you who've never read it, it's not a book about Jesus, it's a book about a medical intern in a Jewish hospital called "House of God", a thinly disguised Beth Israel Deaconess Hospital, affiliated with the "Best Medical School (BMS)", a thinly disguised Harvard. Roy, our hero, is subjected to inhumane call schedules, inhuman residents, and a system of LAWS such as #1: Gomers don't die. GOMER = Get Out of My Emergency Room, referring to an elderly person who is senile, demented, and basically lacking that which makes a person. There are moments when this book makes me laugh out loud, just totally crack up, like when they ask gomertose Mr. Rokitansky, from the Orthopaedic height of his adjustable bed, if there's anything else he'd like to say, and he says yeah, and they wait for it, and he says "KEEP THE LOWDOWN LOW." Hilarious! Plus, there are super-raunchy sex scenes, which are not so relevant but always entertaining.

This book was written in 1978 and it is still so amazingly powerful. Doctors now bitch and moan all day about the 80-hour resident work-week. I've heard reasoning like "these residents are just lazy", "they won't learn how to practice medicine", or "it interferes with patient care". What they don't acknowledge is that working >80 hours a week is fucking BRUTAL, and that the only reason they want residents to go back to that is because they went through it, so everyone else should suffer too. Maybe building more medical schools and educating more people to be doctors, earning a little less $$ but killing fewer patients would be a good idea. One reason there is a huge influx of people entering nurse practitioner, physician's assistant or nurse anesthetist type fields is because there are spots to be filled. Since the market can't create more doctors, as medical schools must be built and licensed by the government, the market will create more doctor-like positions. Psychologists push for the right to prescribe medication because psychiatrists are hard to come by and extremely expensive. At my school's counseling center, the psychiatrist is available from 9-noon, Friday mornings ONLY. For several thousand students, this is the only psychiatrist available at the school. Unless you're an inpatient at a psych hospital, you're not very likely to see a psychiatrist; instead, you're more likely to get your SSRI's from your family doctor, who may not know very much about them. Family docs are not trained to counsel, as psychiatrists are (but mostly don't do). If, like me, you believe in dual therapy, with SSRI's and counseling, you end up seeing two doctors: the psychiatrist to deal the drugs, and the therapist to mop up the tears.

Gah, why did I get off on this tangent?? I am still stinky from gross lab, I have to shower and eat dinner, and get to cheap date night!!!

In case you were wondering...

This is what I do when I tutor gross anatomy:
Trust me, it doesn't look much better on the white board than it does in MS Paint. I draw an awful lot of penises, and vaginas, and labia majora with lots of hair, and anytime I draw a hernia I make a little "speech bubble" type window that says "POO" in it (since hernias are usually bowel, which is full of said substance). Today, we were in a PBL room using their ghetto whiteboard, since our school was too cheap to install real white boards. Thus, things you write/draw in the appropriate dry-erase markers don't often erase that well. Are you seeing where I'm going with this? I'm saying that tomorrow, a PBL group will arrive in that room to find poorly erased penises, ante and retroverted uteruses, perhaps a bulbospongiosus muscle somewhere, and big words like "PELVIS", "PERINEUM", and "1 HAPPY TUBE".

I think my girls think I'm the best anatomy tutor ever.

BRBPR

... is an actual medical abbreviation, meaning "bright red blood per rectum". Just think, this happens often enough that it gets its own abbreviation. Woo. In just 7 more months, I will get to handle that BRBPR and do a guiac of said BRB, which basically means smearing poo on a card to make sure it's got blood in it. Woo. I love how doctors who have to deal with actual shit, namely residents, and nurses, get paid the least of anyone in health care (except the janitors), while the people who don't have to deal with shit get paid more. An attending can send his resident (or even better, 3rd year medical student who is too scared to say no for fear of the dread P grade in his chosen field) to do that guiac, or rectal exam, and comfortably drink coffee in the physician's lounge. Oh, how I long for that day!

It's not really quite that bad. The attendings still get some shit, after all.

The shit starts now, in the lab known as gross. And oh, is it. I have a strict "no poo policy" with my tank groups, meaning that I simply won't deal with shit. I had to last year, and now I'm earning the big bucks to watch the first years deal with shit. That's probably enough said, as I've been nauseated all day, and typing what I was about to type was making me feel sick. If it was making ME feel sick, any poor reader (all 2 of you) who is not in medicine (1 of you) might really get sick. Suffice it to say, there are times in lab now when I just have to turn away. There have even been times when I have to walk away. I'm going to be known as the wussy pedagogue who knows nothing and won't even deal with poo. Damn.

I would type more, but I've been staring at this computer screen for several hours now (yes, on a Saturday night) and I'm feeling queasy again. Time for beddy bye bye.

Texas, Our Texas

So at 9:38 pm, the count statewide is 75.66% for Proposition 2 and 24.34% against. I can't believe there are so many people in that state who feel so threatened by homosexual marriage that they would amend its constitution to outlaw something which is already fucking illegal. Seriously, how does the civil partnership of Susan and Sally threaten the wedding of Sam and Sarah? If your marriage is on such shaky ground that you need to keep truly loving couples who happen to be homosexual from getting married, then perhaps you should take advantage of the state's no-fault divorce laws. At least I have faith in Austin: as of now, 60.11% voted against Prop 2 in Travis County.

Dammit. Since when is a constitution in our country a vehicle for religion?

A friend brought up an interesting point tonight, one which I had considered at the time of the presidential election in 2004. Our country is currently divided almost on 50/50 lines, Democrat vs. Republican, conservative vs. liberal. The bitter feelings surrounding the 2004 election (and the 2000 election as well) point out how a bare majority is taking a "mandate" to trample the rights of the bare minority. Our system is supposed to be designed to present that, but at the moment it is failing. My friend pointed out that the first Civil War began this way, and that perhaps we are on the brink of a war. I had wondered the same thing myself watching the "red state, blue state" maps: What if the "metro" and "retro" groups divided? Instead of being a simple difference of North vs. South, we now have cities vs. suburbs and rural areas. Urban areas have different values. Austin was 60% against Prop 2; Ector County, in West Texas, was 89% for Prop 2.

It goes beyond a simple "urban" vs. "country" way of life, or conservative vs. liberal. I consider myself somewhat of an independent, reluctant to call myself liberal because of economic policies and conservative because of social/religious policies. I know people who fall into the classic camps, but I know many more people who identify with one side or the other to back a particular issue. I know an awful lot of people in the middle, people who try to be fair and see both sides of even the most heated topics. None of us can divorce ourselves from our beliefs. Once we have those beliefs, in order to keep our faith we must believe the opposing belief is wrong. If I am anti-abortion, I must see the pro-choice activist as wrong in order to be right. Trying to see both sides often just gives us headaches.

These are issues with no definitive right/wrong answer. I can't pull out Webster's or the PDR to look up the definition of "the right answer to the question of abortion". It doesn't exist. These are questions where science cannot provide an answer: science can tell me that the heart beats at 22 days post-conception, or that a fetus does not feel pain before 29-30 weeks, but it cannot tell me whether it is right to terminate that pregnancy. We look to religion, or feelings, or what other people tell us, to determine our beliefs in this arena. I personally choose to straddle the fence, so to speak: I know I could not have an abortion if I got pregnant tomorrow from my premarital "sins" with my fiance, as I would feel attached to the child-to-be from the instant the stick showed a "+". However, I am now in a position where I could *roughly* support a child if I got pregnant; had I gotten pregnant 2 years ago, with no money, I might have made a different decision. I realize that other people have different circumstances, and so I believe that the right to choose is very important. Therefore, I am anti-abortion but pro-choice, and an official fence-straddler. If I am to counsel a patient on her rights, I must present her true facts: I would not lie about the 22 days' heart beat or the 29 weeks' pain. I must try to keep my personal beliefs out of my advice, whether my patient wants an abortion or refuses to terminate an unviable pregnancy (for instance, anencephaly).

So in considering the attitudes in our country now, it's now easy to see how the South felt when they seceded. Their needs weren't being met. If a large percentage of our country feels disenfranchised, and can't do anything about it, perhaps these thoughts will become more than a rambling idea in a blog. Or perhaps not. God help us if this leads to more war. One of the biggest splits we have is in the feelings about Iraq, the last thing we need is more needless death, more waste of our young men and women. Because I believe that this war needs to end, I find myself looking down on those who are still fervent about it (few though they may be). I'm okay with people disagreeing with homosexuality on religious reasons, but I find myself despising people who voted for Prop 2 simply because of the tradition of marriage, or because someone told them to, or who would look a gay couple in the eyes and look down on them.

I try to control these feelings, because I'm afraid of arguing with people. I try my very hardest to see both sides, to play devil's advocate whenever possible. I tried to avoid politics as much as possible for a long time, because to believe is to get hurt. To believe is to be disappointed when a staunchly "blue" state votes firmly for a discriminatory proposition that never stood a chance of being voted down. To believe is to feel disenfranchised when no one in the government stands a chance of listening to you because "your representative" is too busy listening to the majority, or the $$, or the PAC's. Our "democracy", our "republic", doesn't work when no one is there to listen to a lone voice, or to 49% of the population. When 73% says yes, who cares what the 27% says? If 73% vote to kill the 27%, do we listen?

Bah. Politics. Apathy was so much less painful.

I blinked and a whole week went by...

I swear, it was just like yesterday that I wrote about all those poop jokes, then got home and took my dog to the new Bark Park. Where did the time go? I'll tell you: most of that time was spent in the gross anatomy lab. I started 'pedagoguing' this week, which is a (poorly) paid position for second year med students to teach first years in the gross lab. I was lucky enough to get stuck with Block 3, which involves the abdominal, perineal, and pelvic dissections, which basically means A LOT OF POO. I'm also tutoring two students in gross anatomy, which basically means that I know way more gross than my own subjects at the moment. (In med student speak, the course of gross anatomy will hereafter be referred to simply as "gross", which may or may not be a play on words.) I have been in the gross lab every day for the past 5 days and continuing into tomorrow. I'm also walking in the Heart Walk tomorrow morning and tutoring tomorrow afternoon.

My fiance and I spent the evening at a dinner hosted by a Catholic organization at my school. They have one of these events once a year where the resident priest and nun try to recruit good little Catholics to come study there, attend Mass at their church, etc. However, for the dinners, you do not have to be a member of the organization, or even Catholic, which is how I've ended up going for the past 2 years. Free food and booze, since Catholics like to drink when they get together. I grew up Southern Baptist, so I still get weirded out watching a priest drinking Budweiser. It's cool, though. I think we were the only 2 people there who did not cross themselves when they said grace, and I know I referred to the "minister" who will be wedding us, so I know the priest pegged me as a Protestant. Eh well. Free food and booze! We had lasagna... *is still drooling*

Speaking of this evening's festivities, I owe a classmate a huge apology (sortof). I wrote a post about a young man I referred to as "KU", for "Kiss-Up". This same young man was present at this evening's festivities, and he was clearly on his best behavior. There were two small children present, and KU actually interacted quite well with them. He also carried on very normal conversations at dinner and referred to getting drunk last weekend. This is a big step for a guy who started damning homosexuals in front of a large group of my classmates last year--including a lesbian. He also needed to go "pray for them" when we had an AIDS awareness week last year that involved passing out free condoms. In light of this new data, I have decided to rename KU to "Annoying Boy", as it may or may not be less harsh.

So what is it about getting married that makes me an interesting person now? I know people mean well, but it's like people I barely know are just going nuts when I mention that I'm getting married next summer. It's also causing me some anxiety, kind of like mentioning the BOARDS, because people expect me to be so much more prepared than I already am for this whole wedding thing. "What is your date?" "What is your color theme?" "Will your roses be matching your dress?" "What designer is doing your dress?" (to which the answer is "David's Bridal"--I'm getting married on my student loans, here, people, I can't afford Vera Wang, and even if I did, I don't think she makes anything in my size) and, the worst question of all, "Can I come to your wedding?" Ouch. We're probably getting married in the Rocky Mountains (I keep saying probably, but we haven't looked anywhere else), and we're getting married on a strict budget. Therefore, everyone who comes to the wedding is costing us $$. I want the people who matter and NO ONE ELSE. Even some people who kind of matter won't be invited. To solve this dilemma, we're having a party here after we get back from the honeymoon for everyone who couldn't come. Still, I feel bad saying "We're having a very small wedding", which basically means "You're not worthy of being invited". Yes, I have guilt issues. I just have issues in general, actually.

So now I need to wade through the pile of crap that has accumulated on the floor during this hectic, crazy week and try to clear a path through it so I can *attempt* to get caught up this weekend. *le sigh*

Girliest Shopping Trip EVER!!!!!

So for the ladies who read this, and guys too if you want, I am going to be trying on wedding dresses this Sunday at 2 pm. We'll meet at or near my place and I'll drive, since we're heading south. I want as many people to come as possible so we can be totally frivolous!!! Woo! So get out of church, we can grab some lunch, and go be girly!

Freudian Slip

Murphy's Law would state that whenever there is an opportunity to make an ass of yourself, it will present itself, and you will take it. If the opportunity is there, you will take full advantage of it. As Murphy's Law is as big a player in my life as the Law of Gravity, which always makes me fall down, I am usually never in need of an opportunity to look foolish.

That being said, today someone else (not me, for once) made a fool of themselves. It was beautiful.

Today in PBL, yet another unnamed classmate (and extremely liberal friend) was asked to read a page from the case out loud. Yes, it's like kindergarten, only with longer words. So he's reading the results of our fictitious patient's echocardiogram, until he gets to "55-60% ejaculation fraction."

"Ejaculation fraction", not "ejection fraction".

Get it?

Since med students are all about 5 years old, we laughed for about 10 minutes, and proceeded to badger the poor boy for the remainder of the class. Yes, we're all going to hell.

On a related note, we found a copy of the classic children's book Everyone Poops in the school library today. Apparently some girl's family donated it in her memory after her death. The 5 year old med students just see the word "Poops" and have fits of hysteria again.

Wow, today is poop day. My friend Metro (see previous post) just arrived back in the library and, in between fits of laughter, related a bathroom adventure he just had that was similar to the scene from Austin Powers where he runs into Tom Arnold in the bathroom and gets attacked while Arnold thinks he'd just eaten bad Mexican food. This prompted yet another laughing attack, in the "quiet section" of the library. Wow. I guess the world really is all about dick and fart jokes.

Medical Studentitis

One of our professors recently told us of a new disease, called "Sophomore Medical Student Syndrome". This is a special disease of medical students who know just enough about the really bad shit that can happen to a person, that every time they get a headache or a tummy ache they picture all this really bad shit happening to them. It's a special form of hypochondriasis, really, with imaginary disorders floating all around and a smidgen of real science backing it up.

A good example is my friend, whom I'll call "Metro". Metro is the ultimate metrosexual man, wearing $40 designer Italian boxers under his Seven jeans. Metro has also experienced more fictitious disease than almost anyone in our class. Last year, he "suffered from" testicular cancer, cirrhosis of the liver, strokes, and a heart attack. Mind you, the man is 23 years old and in good health. Perhaps he should just have sought treatment for anxiety.

I can laugh at his experience because I've had my own experience with SMSS. Last year, I was convinced I had hypothyroidism. I even went to the doctor to get checked, and lo and behold, I had a diffuse anodular goiter (with normal thyroid function tests). Then, last summer, I SWORE I had gastritis all summer, in addition to my usual (self-diagnosed) GERD. Only my H. pylori test was negative, and eventually the Prilosec did its job.

So this morning when I woke up with a splitting, throbbing headache, my first thought was "hangover"--from the one beer I had last night with dinner. Ridiculous. After I took 600 mg ibuprofen and woke up 7 hours later, still slightly achy, I started thinking flu, cold, virus. My throat was definitely scratchy, but that could have been from dehydration due to sleeping all day. Then, I got all hot, then cold. Fever? I frantically palpated my neck looking for lymphadenopathy, and possibly found some. So am I going to die? Doubtful at this stage. I probably caught some virus going around. This fact doesn't change my searching for new symptoms, or wishing for a thermometer so I could document any fever, or asking my fiance to check my mouth for tonsillitis. *sigh* Med school makes you pathetic in many ways, including ways you would never have imagined when signing up for it.

Vote No in November

In 1787, the United States Constitution was drafted; a Bill of Rights was added less than 2 years later. Citizens felt they needed certain rights to be enumerated and specifically protected. It wasn't enough to simply declare independence for "life, liberty, and the pursuit of happiness"; Americans wanted to protect themselves against potential governmental excesses, like those they had suffered under English rule. The Constitution set out the functions of the federal government, which can pass laws to govern its citizens, and the Bill of Rights gave citizens protection from that same government. In other words, constitutional amendments are the "laws" which the government must follow.

Obviously, the men who wrote the US Constitution could not anticipate all of the ways in which the world would change after their time. They could not foresee women's rights, for example, or the development of the technology to put a man on the moon. The Constitution was written to be a basic document upon which to build a country; laws are more flexible and can be added or stricken as situations change. Amendments to a constitution, national or state, should only be used in cases where the existing document fails to protect the rights of the citizens or properly define the role of the government. Even though the world today is very different than when any of these constitutions were written, these basic documents still apply.

In Texas, the Constitution is already burdened with hundreds of amendments, 174 of which have been defeated by voters. On November 8, 2005, you have the opportunity to defeat a constitutional amendment which would limit the rights of certain citizens unnecessarily. HJR 6, or Proposition 2, would define marriage as "the union of one man and one woman" and prohibit the state of Texas from "recognizing any legal status identical to or similar to marriage." If amendments to a Constitution are intended to protect and expand the rights of citizens, then this Proposition is antithetical to the very nature of a just amendment. As this amendment would also prohibit the recognition of civil unions legal in other states, it also violates Article IV of the United States Constitution, which specifies that individual states must honor the contracts issued by other states.

Voting against Proposition 2 will not legalize gay marriage in the state of Texas; homosexuals are not currently allowed to marry or enter civil unions here. If you believe this is a situation that deserves change, there are ways to fight for expanding rights for homosexual couples, and voting No in November is certainly a first step. However, voting against this amendment is not necessarily a vote for gay rights. Voting against Proposition 2 is a vote for keeping discrimination out of our state's constitution; it is also a vote for keeping religious beliefs, even those of a majority, out of our government. Conservatives should vote against this amendment to limit the excesses of a large government, and liberals should vote against this amendment to protect civil liberties of the citizens of the state of Texas. Without a constitutional amendment "defining" marriage, people in this state can continue to define marriage in whatever way they deem appropriate, legally, emotionally, and spiritually.

Keep unnecessary and discriminatory amendments out of the Texas state constitution. Vote No in November.

Positive Feedback Loop

Nature may abhor a vacuum, but she also abhors positive feedback loops. Most biological reactions are set to monitor themselves. A reaction's product may inhibit the very enzyme which makes it. Negative feedback loops control most of the metabolic processes which run our bodies. On the other hand, positive feedback loops are self-perpetuating, never-ending; they throw the system off-balance, spiralling out of control and away from that ever-present goal, homeostasis. Consequently, they are much less common.

That being said, I have discovered a new positive feedback loop in nature. I may have to publish a journal article.

What is this loop, you ask? I'll tell you. It all started with a conversation between two persons engaged to marry one another. These two persons decided "it's time to think about setting a date" (after almost 2 years of engagement). This sparked a chain of phone calls to parents, friends, potential guests, and potential members of the bridal party, to let them know "we're thinking about setting a date in June." Even at this early stage of the pathway, the reaction is amplifying itself. Note that no official date has yet been set, yet the process has taken over. Phone calls led to internet searches for wedding dresses, photographers, sites to hold the wedding, the reception, and the rehearsal dinner; internet searches led to emails, not only between the bride-to-be and her mother, but also between Inns with Beautiful Views, places with Wedding Experience and Sumptious Food, and sites with trees and chipmunks. Emails led to further phone calls and considerations of the price of invitations, save-the-date cards, bouquets, boutonnieres, hiring a salsa dance instructor, and serving brunch versus dinner at the reception. Barely a week after deciding "to think about setting a date", the betrothed couple is immersed in making appointments for dress fittings, and picking a color theme for the wedding, and considering asking a good friend to officiate so as not to offend religious family members when they offer their own pastors.

Watch as this system spirals out of control, totally unchecked. Watch as the extremely modest budget for a very small ceremony and reception is stretched out of all reality. As the chain of phone calls expands into a vast web, and the email accounts of involved parties are filled, and infinite numbers of pictures of cozy bed-and-breakfasts and dark mountain cabins and lake/mountain views crowd the bride's brain, she realizes there are over 8 months left before this event will occur in which to totally lose her mind. Is it too late to elope?

Head Like a Hole

The Nine Inch Nails concert rocked so much ass, I can't even describe it. He played "Terrible Lie", "Closer", "Hurt", "Eraser", "Head Like a Hole", "The Hand That Feeds", "Only", "Sin", "Reptile", "Burn", "Suck", "Wish", "March of the Pigs", "The Frail" + "The Wretched", "Love is Not Enough", "You Know What You Are", "The Line Begins to Blur", and a couple more songs that I can't seem to identify from my humongous playlist, although they seemed familiar. It was a jam-packed 2 hours of music, with no talking between songs. It was fucking intense. "Terrible Lie" was so fucking intense and sweet, I can't describe it. It was like having a 2 hour orgasm. Holy god, it was so fucking amazing.

And as we left, we found out the Astros won Game 6 and are headed to their first World Series. It has been a good night.

Smells Like First Years

I've been helping tutor first year students in Gross Anatomy for a couple of weeks. It's funny how quickly time moves here. Just a year ago, I was in their shoes, losing my mind over the upcoming Gross test and Biochemistry. Now, I barely remember those classes as more "doctor-y" stuff has taken over: better classes, preceptorships, the BOARDS. Gross? No biggie. But last year, these things scared the hell out of me, and so I'm trying to remember that feeling. It's like when I give tours to interviewing students who are desperately trying to get into medical school, and I am so out of touch with their stress. Getting in here? Easy! Getting out of here will be the hard part. I am not so upbeat about the BOARDS, you see. I registered for the test the other day, and I thought I would hyperventilate. The TEST to end all tests, determining my fate, etc. Dammit, I'm probably going into primary care; I'm not going into Derm in New York or at Johns Hopkins. My board score will not matter too much, especially if I keep my grades where they've been at. But because medical students are inherently Type A and neurosis-prone, I worry. This test is not for 7 months, but I'm already freaking out.

I've added a new stress to my life: planning for a wedding. I've been engaged for 1.5 years now, and we're just now getting to where we can set a date. We're looking at June 2006, right after I take the BOARDS. Some weekend soon, I'm going to go have a girly day at David's Bridal and try on wedding dress after wedding dress, hoping against hope to find one that doesn't make me look like a short, wide snowman. I may find one with an accent of color, just so I don't wash totally out (white is sooo not my color, I'm way too pale). I think we should have brunch first, then go be girly (girlie?).

That reminds me of a funny funny story my sister told me earlier. She and I are both wicked, wicked spelling and grammar fiends. Put a page of type in front of either of us, and our eyes immediately jump to the one misspelled word on the page. Their/they're/there errors make me wish to claw my eyes out, as do its/it's errors and improper apostrophe usage. So the story: she got an email from a fellow employee which gave some complicated directions, then said "Sorry for the incontinence." Oops. Someone who relied upon spellcheck accidentally told the entire City of Lubbock (who read their email, which means the small percent of city employees who are actually literate) that he was sorry for the accidental release of urine or feces. This, chilluns, is why they teach us spelling and vocabulary in elementary school.

Well, I thought it was funny, anyway.

So what is it with medical students who can't read? Seriously, there are some kiddoes in my PBL groups where we have to read out loud who sound like they're being tortured at the stake. Some people will skip words, or read the wrong word instead of the correct one, and not realize it until later in the sentence when it makes no sense. Some consistently leave off the ends of words or syllables in the middle of words, like "cellular" into "cellar". These are all minor offenses, I admit, but they are repeated so often that they just grate into my poor little OCD soul. Pronunciation is a huge issue, too. Medical terms are complicated. Try saying "dysdiadochokinesia" twenty times fast, or "metoproterenol". I love these words, however. For the most part, these words come from Latin or Greek and are pronounced phonetically. I can't believe I just admitted that aloud (or in writing, anyway), because now I am officially a SuperGeek. Yes, I like to say medical words because they sound cool. Is there a 12-step program for this?

One more observation for this post: Never underestimate the power of medical students to make you feel badly about yourself in some capacity. We all have such huge egos that we are never, ever satisfied with what we've done. Case in point: I make good grades, and I know a lot of fellow students who HATE me for that. They also hate that I leave tests early (I'm a fast reader), and like to point this out to me. In turn, I feel like a horrible person every time I hear some other student talk about this or that huge charity event they sponsored, or the medical mission trip they took over the summer. One of my friends was in the Peace Corps for a whole year. It makes me feel like an ungrateful middle-class Caucasian. Actually, I do quite a bit of volunteer work, but not nearly as much as I'd like to. Other medical students are well-traveled, taking random summer trips to China, Thailand, South America, Europe, etc. I feel so incredibly uncultured and poor. I went to Germany and Austria once on a band trip, doesn't that count? A 4th year said the other day "I try to leave the country once a year". Damn, isn't that expensive? And a hassle? (Yes, I realize that's a sentence fragment; let's get past that, shall we?) So, I'm a nerdy, untraveled, uncultured, ungrateful, uncharitable white girl. *sigh* I just regret too much. Every road I've never taken, I regret. Any opportunity I could have had and missed out on, I miss. Especially, now, the opportunity to do anything with my life other than medical school. (Actually, not, but I had to lighten the mood somehow.)

Now, I will go cook dinner, and go see Nine Inch Nails(!!!!!!!!!!) this evening in concert. Jealous? You should be!

Tidbits

So I thought I would christen my blog with some random tales from medical school. They'll be short and sweet, and may contain gratuitous gross anatomy references (not for the faint of heart).

• Our class has a gentleman whom I shall refer to as "The Cropduster". He is a fairly obese young man with an apparently chronic gastrointestinal disorder (he farts all the time). The odor of his flatulence was such that his own gross anatomy tankmates told him "if you're going to do that, GO SOMEWHERE ELSE." So, about halfway through the semester, Cropduster would wander the 7 tanks of the D section, admiring bodies and dissections here and there, and allowing his pungence to overtake the unsuspecting. I swear, the stench of his farts was such that one day, all 5 of us at my tank fell silent in mid-conversation (we were usually extremely loud) and stayed that way for several minutes, as we were all afraid to open our mouths due to the smell. You know a fart is bad when it overpowers the subtle scent of cadaver.
  
• One of my most vivid memories of gross lab was from the day we hemisected the pelvis. To the uninitiated, this means cutting inward from the hip to the navel, then down through the perineum, removing an entire leg from the hip down. Our sophisticated removal tool was a hacksaw. My tankmate FunnyGuy was hungover, and the only one of us with the balls to volunteer for the job. When the saw finally made it all the way through B's skin, we were left with a very dirty leg. Other tanks were washing their legs in the sink, so I carried a human leg to the sink, rinsed it off thoroughly, and carried it back. We did things to our cadavers in anatomy lab that the lay population would be arrested for.
  
• Gross anatomy lab had an unexpected side effect: for some reason, nothing stimulated my appetite like working in the lab. Someone told me formaldehyde increases the appetite. I don't know, but I was always STARVING when I left the lab. Then, also, we found ourselves occasionally comparing our cadaver's flesh to cuts of meat: ribs, wings, etc. God help me, but I had never wanted BBQ ribs so badly in my life as when we dissected the thoracic cavity.
• Eli at Ah Yes, Medical School has a fabulous post on hypertalkers. Our class is almost entirely the opposite in actual lectures. Usually, a lecturer will ask "Do you have any questions?" at the end of a lecture, only to be greeted with PGA golf course silence. However, we do have one exception. Let me call him "Kiss-Up". KU decided to be the "tech guy" for our class, racing to the front whenever something went wrong with the portable mikes, the laser pointer, or the computer hookup for the PowerPoint slides. At first, he fulfilled his duties with disgusting enthusiasm, licking a little ass on the lecturer while he replaced batteries, turned off lights, etc. After a while, though, he grew weary of his duties, preferring to play computer games on his laptop (he sits in the front row, so everyone can see that he's playing games during lecture). He'll get so absorbed in his games that the batteries will go out, the lecturer will go silent, and nearly 100 people (out of 205) start hollering "[Kiss-Up]!!!" He's the same guy who got up and blatantly moved away when the AIDS patient came to class to talk about life with HIV. He's the same guy who was practicing taking a blood pressure on my friend, and left the cuff inflated for 5 minutes, while my friend watched his arm turning blue. KU also asked out about half the girls in the class during the first few weeks. When one girl turned down his invitation to hear the Star Wars theme music played by the Symphony due to her status as an engaged woman, he became outraged and demanded to see her ring. I like to add, at this stage in this story, that 1) it was gross anatomy day, so she wasn't wearing her enormous ring, and 2) this was going on in the middle of a lecture. This same fine upstanding citizen gets through with tests early and CLICKS his mechanical pencil lead down, SLAMS his seat back, stretches and yawns, then BANGS the chair in, flutters his papers around, and finally proceeds to the front to turn in his test. This guy is going to be your future doctor, people. We're all praying he hears the call of the pathology lab when choosing a residency.
• We had a class argument one day in a lecture about "Asking Religious Questions in the History and Physical Exam". If this wasn't doomed to failure at the get-go, the lecturer was a super-nice lady, far too nice to halt an argument in its tracks. What was the argument? Whether a doctor should witness to his/her patients. By witness, I do mean "sharing the Gospel of Jesus Christ our Savior" to the patients. We had one gentleman who heatedly claimed his right as a spiritual healer, not only a physical healer, who said he would surely tell his patients about God. It got so out of hand that the course director added a question to the final exam: "True/False: It is appropriate to share unsolicited personal religious beliefs with a patient during a visit" (hint: the answer is false). Other members of the class couldn't figure out why a patient might get nervous if, while waiting to enter the operating room (OR, for those who watch "ER"), a doctor asks if he might pray with the patient prior to surgery. Mind you, this is a patient with whom religion has never been discussed. "But how could that possibly offend anyone of Jewish/Muslim/Buddhist/atheist beliefs?" Also your future doctors, people.
• We were all disappointed to learn one day that the famed G spot does not exist, according to a histology instructor. Apparently, G spot stimulation produces friction in the urethra, which is actually painful but interpreted as pleasure (similar to chili, I suppose). I had to conclude, based on personal experience, that the lecturer had never experienced said stimulation and/or orgasm from the G spot, or she would never have been able to say this while keeping a straight face.
• We were also saddened to learn that the Y chromosome is a "genetic wasteland" full of "junk DNA". The only thing the Y chromosome does is make an XY zygote a male. It also carries the genes to give a man hairy ears. That was an exam question.

So much of what happens in med school can be so funny, but the outside world is either unamused or appalled. I will vent later about my feelings about the first year of medical school and how utterly useless it is. A big milestone of the first year is gross anatomy, where they expect us to come to terms with death. Most of us do it with humor. Our cadaver's "name" was B, and we decided that she liked to play bridge with the other cadavers when no one was looking. How else do you forget that your cadaver died younger than all of your living grandparents? When we rolled her over onto her back after the first lab, and discovered that she'd had a double radical mastectomy (her card said "60 year old female, breast cancer, brain metastasis, multiple organ failure"), we had to joke about having no boobs, how lucky she was to have no breasts in her way, and make fun of other tanks with random breasts floating around in their water. Otherwise, it was too sad. I think we learn to detach too far. At what point in the middle is safe, safe from depression at the death and tragedy but also safe from the coldness?

To save the philosophy for another entry, one more quickie humorous moment: a classmate found an article for PBL about using different sexual positions to resume an active sex life following an MI (heart attack). You can find the abstract here. Of course, I should add that I find it amusing that such an article was funded and written, NOT the fact that the patient in the case was concerned about her sex life. Another of my classmates was decidedly amused that a 50-year-old woman, post-MI, would be concerned about her sexual abilities. Wow, man, I hope you are never 50 years old and wanting to get laid. Of course, in his mind, I suppose it's different, since guys have Viagra, and nobody wants to sleep with 50-year-old women. No, I'm not bitter. Not at all.

Obligatory First Entry

Here's where I say hello, world, nice ta meetcha, welcome to my corner of the blogosphere. Ugh. Brief intro: 23 yo med student, engaged, living in sin, have small dog, will travel. I hope to use this to vent stress about med school, although I cannot hope to be as funny as those who have gone before me (the underwear drawer, I pay homage to you). I also hope to write things that matter to me, better than my old livejournal.