One time I called a patient in from the waiting room, introduced myself as a medical student, and told the patient I would be taking him to see his doctor.

The patient nodded but then let out with this statement:

I refuse to go with you. I usually have some pretty girl take me.

 
So there’s that… At least I found out that I don’t look like a pretty girl…

It has been a while since I wrote anything. This school year has been hectic. Mostly because I’m actually putting in a lot more studying. It’s a big difference when you “know” how to study.

If you have been following my posts for any significant period of time, you know that I have had to work on my studying techniques. A few months ago I uploaded a video showing a sampling of my pharmacology notes. To be honest, my recent pharmacology notes aren’t as intricate, but I still try to incorporate some of those techniques in some form or fashion.

Recently I went to Kinkos to get these posters printed and laminated. They are each at least 24 inches wide and close to 28 inches tall. They hang side-by-side on my closet doors.

[Show as slideshow]

[View with PicLens]

The right side shows the six weeks leading up to and including an exam week. There I can circle and mark off lectures I have studied and am comfortable with or those that I need to spend more time on. The left poster is a black daily schedule. Each night I plan out exactly what I am going to cover during each hour.

I have found that this type of detailed planning really helps me keep moving. It is too easy (at least for me) to start studying and then get lost in the material and then realize that I have spent too much time on one subject. This process keeps me moving at a good pace.

Also, being able to visualize all the lectures really helps me in figuring out how much I need to study and how much time I will need to cover the material.

And that’s all for this posting. Test week opens with an exam Tuesday morning for Pathophysiology. Wish me luck.

@kwdodd posted this video on his Twitter feed and I just found this short 8 min clip fascinating. We briefly heard about these things called “mirror neurons” in neuroscience class but Dr. Ramachandran does an excellent job of explaining what these things are and why they are so amazing.

Hopefully some of you enjoy this.

Just woke up from a strange dream. It was a pretty convoluted “storyline” that started off with me running away from the “authorities” in some old-time setting. And by old-time setting I mean a couple hundred years ago. At least that’s how it felt because the people who were chasing me were doing so with swords.

Anyhow, the dream ended in a modern day setting where I was at a party. There were movie stars and I was some new person to the “scene.” My manager was worried about me and the press coverage.

Suddenly one of the ladies at the party started flying. But we knew she was on some sort of harness and it was all part of the entertainment. Something went wrong, though, and she slammed into a wall and dropped like a rag doll. I rushed to her side and started assessing the situation.

We didn’t want to mover her.

I believe I managed to intubate her.

It was a blur, and a flurry of action because along the way some good-natured person slipped her a pill while she was unconscious in hopes of helping her. I’m not sure when this happened but it must’ve been while I was otherwise occupied. This pill was causing her airway to close up and the reason I had to intubate her.

I just had to write this up because it seems like dream-me is progressing through my medical education faster than real-me. Which is alright, I suppose. Because at least real-me doesn’t have to run away with armed guards equipped from swords.

I’m not in the habit of adding music to my blog posts. So this is a special occasion — or just an opportunity for me to hunt down and try out a new plugin for my blog.

Yesterday I drove back to Loma Linda (from San Fernando) to get my H1N1 vaccine and to pick up some other things. This vaccine was the main reason. I received an email a couple weeks back saying that all students at Loma Linda University would be required to have the vaccination in order to register for Spring quarter. Last week (during exams), I received an email from one of my deans stating that I had not yet received mine and they wanted to know why and when I would get one. So, taking advantage of Christmas break (a time when the I’ve-got-to-study-every-minute-I-can feeling is slightly diminished), I decided to get my shot.

On the drive back I selected shuffle on my iPod and placed Apple in charge of my driving music. I frequently download music, add it to my library, and never listen to it. So there are plenty of songs that have a zero play count. But eventually I do get to hear some of the songs when my iPod shuffles to it.

Somewhere around Pasadena this song started playing (lyrics below). I think it was the first time I’d ever listened to it.

As the chorus played I thought about medicine — about the practice of it. I thought about the current healthcare reform debate. I thought about the seeming futility of trying to make a difference. I thought of all the practicing doctors who started out hoping to change the world but who have since become filled with cynicism. And I thought about Loma Linda University’s motto: “…to Make Man Whole.”

Can we make a difference on a grand scale? I don’t know. Through the optimistic lenses of my medical student glasses I’d like to hope that we can. I want to believe it’s possible.

But at the very least, we can start on the path towards changing the world by making a difference in the lives of one patient at a time.

Hope everyone has a wonderful Christmas.

If you’re a medical student, or any other student, I hope you get well-rested, refreshed, and ready to attack a new quarter come January.

If you’re out of school and working, I hope the office Christmas parties will have made you smile at least a little — even if it was to laugh at the foolishness around you.

And if you are a bum, I hope the chaos of the season will not be too overwhelming for you.

Change
Performed by Carrie Underwood
Album: Play On

What’cha gonna do with the 36 cents
Sticky with Coke on your floorboard
When a woman on the street is huddled in the cold
On a sidewalk vent trying to keep warm
Do you call her over hand her the change
Ask her a story ask her her name
Or do you tell yourself

You’re just a fool
Just a fool
You believe you can change the world
You’re just a fool
Just a fool
You believe you can change the world

What’cha gonna do when you’re watching t.v.
And an ad comes on
Yeah you know the kind
Flashin’ up pictures of a child in need
For a dime a day you can save a life
Do you call the number reach out a hand
Or do you change the channel call it a scam
Or do you tell yourself

You’re just a fool
Just a fool
You believe you can change the world
Don’t you listen to them when they say
You’re just a fool
Just a fool
You believe you can change the world
Oh the smallest thing can make all the difference
Love is alive
Don’t listen to them when they say
You’re just a fool
Just a fool
You believe you can change the world

The worlds so big it could break your heart
And you just wanna help
But not sure where to start
so you close your eyes
Send up a prayer into the dark

You’re just a fool
Just a fool
You believe you can change the world
Don’t listen to them when they say
Youre just a fool
Just a fool you believe
You can change the world
Oh the smallest thing can all the difference
Love is alive
Don’t listen to them when they say
You’re just a fool
Just a fool
You believe you can change the world

It’s been two weeks since we had midterm exams. I did alright; I didn’t reach my goal. But I can do better. Not getting down on myself at all — just trying to learn and improve.

I was talking to someone who I would call my coach. She talked to me about now moving on to Peak Performance.

What is peak performance? She gave me a few things to consider.

I told her that my final exams for the fall quarter would begin on the week of December 14.

She told me that she wanted me to be prepared for exams by December 10 and that the days between the 10th and the 14th would serve as relaxed, light, review. Furthermore, she wanted me to attack my studies with 100% intensity. Two weeks before the exams I am to drop down to 80% and then the final week before the exams begin will be down to 60%

That sounds great. But how do I do that?

Well she told me it would be tiring. She told me that I would be tired now. But it would pay off during exams. It’d pay off when, on the night before my exam, I can go to bed early and wake up refreshed because I don’t have to cram.

My coach is a big fan of sports analogies. And I think the analogies are pretty spot on — at least most of the time.

How do peak performers, people who are at the top of their respective games, prepare for the big day/game?

Well this is what she taught me of what Peak Performers do:

• Get ready way ahead of time.
• Strategize from day 1 — and in my case this means forming a study strategy for every single subject.
• Practice daily as if I am performing on the final day — For me, she wants me studying now at 100% intensity because that is the intensity I will need come test day.
• Go for the win; no other option is on the radar
• Be solution-focused. If they don’t perform well, peak performers reflect, learn, and then grow. they don’t stew/gripe over a misstep.

It’s a tall order. I’m a bit intimidated by it. But I want to. I see her this coming week and she is expecting me to give a study plan for each subject. I am supposed to look ahead in the class schedule and start planning backwards.

This weekend I will create a daily schedule — hopefully I will be able to stick to it. No, I will stick to it.

It’s 5 weeks ’till game time. And the preparation begins now.

Pastor Nick, a friend of mine, tweeted this:

Anyone else realize that they need to “chew the cud” when it comes to meditating on Scripture? (link)

As I read that tweet I had a mental image of a cow chewing. And chewing. And chewing. All to properly digest its food.

It reminded me of something that King Solomon is credited with saying, “Go to the ant… Consider her ways and be wise” (Proverbs 6:6, NKJV).

I tweeted back that Nick should write a blog entry titled “Consider The Cow,” but as soon as I sent that I wanted to use it. Because while Nick tweeted about needing to “chew the cud” in the context of meditating on scripture, I think it is also the very thing we need to do as medical students.

With the sheer amounts of information thrown at us it is very easy to try and speed through the various reading assignments. But when trying to memorize, repetition is the key. Slowing down and taking time is paramount (although one cannot be too slow). Without doing so, the material is quickly forgotten — or at least the details eventually slip away.

And as they say, the devil is in the details. It will be the little things that trip us up on an exam. When considering a clinical case, one little detail can mean the difference between a diagnosis of schizophrenia and schizophreniform disorder.

So go to the cow. Consider her ways, and be wise! Take time to process the material and linger a few moments longer on the little details that help to differentiate (and here I am writing this for me more than anyone else).

Now if the details are that important, if they can lead to making man whole — or at least helping them get better — then would that mean that God is in the details?

I suppose that would be a topic best left to the philosophy and theology bloggers…

Me? I’ll just put up my brand new cow poster. And every time I see it I will remember to slow down and properly digest my “food.”

“They” say that one way to aid memorization is to use drawings and diagrams (the crazier and more vivid, the better) because the brain more easily remembers spacial relationships that just straight lists. So as I have started this second year of medical school I am studying in a totally different way than I have in the past and using a lot of drawing/diagrams and writing out of my own notes.

Here is what my Pharmacology notes look like. It is the drug list for the autonomic drugs I need to know.

Sorry for the blurry video. I didn’t realize the video was out of focus until after I was done. The Flip Ultra doesn’t do very well this close to an object.

Hopefully I will be able to continue doing this throughout the year. I think it will really help me with the memorizing. If I can push through every day and avoid getting too far behind, I think the chances look good.

Again, sorry for the vid being blurry. If I do this again I’ll film from farther away or use my other camcorder.

Article: MSNBC.com: Facebook misconduct: Med students cross line

Sometime last year there was an article about students posting inappropriate things on Facebook and having to deal with administrative consequences from their school or lose out on a job because some potential employer decided to check up on the job candidates online.

Well in this latest story, medical students across the country are getting reamed for being inappropriate on Facebook. What kinds of things? Offenses included “posting unprofessional content online, including photos of drug paraphernalia and violations of patient privacy.” Even posting YouTube videos of practical jokes with a cadaver.

While I agree that medical students should conduct themselves appropriately with the dignity expected of someone in the profession and that some of the offenses should never have taken place (like being disrespectful with a cadaver or violating patient privacy), I will point to one section of the article:

Medical students are no different from other young adults, said Anastasia Goodstein, a San Francisco-based marketing expert who tracks youth trends on her Ypulse Web site. The generation that first embraced social networking still considers Facebook merely a way to connect with friends.

“Now they’re waking up to the reality of older people and people with authority over them, like deans, seeing their Facebook pages,” Goodstein said.

And I don’t mean to point that part out to make an excuse for the behavior, but just to offer an opinion (that isn’t necessarily mine) from the other side.

However, I do strongly believe that all patient-identifyng information should never be posted online. And that was a line young and old never have a right to cross.

Oh, and one part of the article kind of pointed out something else. One medical student was in trouble for friend-requesting a patient on Facebook. I understand the ethical dilemma. We discussed this in class — that physicians and patients need to keep the relationship professional. But as Facebook has become more and more commonly used as a means to communicate (in addition to staying in touch with friends), I think this is a gray area.

Why can’t doctors add patients as a facebook friend? Is it because the patient will be exposed to the physician’s less guarded, non-professional moment? Or what if the physician had a dedicated professional account? Anyways, not everyone who is a “friend” on Facebook is really a friend (i.e. people who add/approve anyone regardless of whether or not they know them personally).

And now, I must go dig through both this blog’s archive and my twitter account and selectively purge entries…. lol Kidding. Kind of.

I apologize for my completely lazy title. I’m tired. And it fits.

It’s the end of the second week of the sophomore year here at LLU. Some of you who have read my blog in the past might be wondering why I am writing about the beginning of sophomore year. Well because I am in the sophomore class — again. If you’re curious, check out my post titled “Back to Blogging” where I wrote about coming back to LLU after skipping exams and telling my dean I wanted his signature on my withdrawal slip.

It’s definitely strange. There is a sense of deja vu. Maybe it’s more than just a sense. I am hearing the same lectures for a second time. And I hope I can make the most of it.

But it is alienating to come into the lecture hall and see a totally different class. Unfamiliar voices and faces. And everyone there knows that you are a new face that was not part of the class 3 months ago — that you don’t belong.

I suck it up though. Because this is what I have to go through to get to where I want to be. And I’m not saying that my new classmates are unfriendly. They very well might be. And I have met a couple here and there that have been really nice. But I am definitely not the outgoing type. So that doesn’t help.

As I begin the second year for a second time I have to ask, what about me is different? Because if nothing has changed, then the outcome is likely to be the same frustration and anger that I felt before — which is definitely not a good thing. The last time it led to a failed attempt at withdrawing.

Well in short, a lot has changed. I am not the same student. Sure, I still want to goof off and procrastinate. But I have put myself on a schedule to keep myself on task. My break times, study times, meal times, and sleep times are planned out and printed out. I make a more concerted effort to focus and absorb/understand as much as possible from lectures. I cut down my internet/TV time. But the most significant change is probably attitude. I hate studying. I’ve said that before and I will probably be saying it many more times (or write it, for that matter).

But I have decided that I want to be a doctor. Yes, dear reader (intentionally left in the singular), I WANT TO BE A DOCTOR. And this process of spending hours with the books is NOT just a means to an end. Every opportunity to learn in medical school is a chance to shape the kind of doctor I will one day become. I don’t want to be some run-of-the-mill MD that just barely gets through, perfectly able to handle 90% of the problems 90% of the population see a doctor for.

The thing is, this will probably require me to throw my entire being at chasing a class ranking in the top 20% for this sophomore year (I’m not including the freshman year because mine sucked. I passed. But I’m definitely not proud of it.) Not for the sake of bragging rights, competitive residencies, or being “smart,” but because effectively soaking up everything I can in order to be the best doctor I can be will probably put me in that envied company as a serendipitous byproduct.

It’s a high challenge — especially for a life-long procrastinator and self-proclaimed loather-of-studying like me. Because it almost sounds like that percentile is my goal. And shockingly, that is the case. That’s what I am aiming for. In writing. On the Internet. For all (or one) to see.

In the end, should I fail to reach my goal, I hope that it is because I could not pull it off — not because I did not try hard enough or was not disciplined enough. Only time will tell, though.But the bar has been set high because one doesn’t achieve lofty goals without first being willing to set the goal behind daunting obstacles.

Wish me luck