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*