I totally just woke up from a 3 hour nap, and it was delicious. Three hour naps only happen when I'm exhausted by the way, and considering this week felt like a whole month I'm not really surprised.
Anyway, now that I'm relatively rested I can write about my neurosurg shadowing, which was really really cool. I got there in the middle of clinic hours, so the doctor was with a patient and I waited in the workroom. I never really thought about how these things worked, but the place looked like a normal doctor's office with multiple exam rooms and one of the rooms was a physician workroom. That's where I was. So the doctor walks in after about 10 minutes and immediately goes to one of the computers to look at a CD of scans. There was a 3rd year rotating student following the doctor as well. I kinda stood there awkwardly for a while, which is what I do well. Once the scans were up and working, the doctor told me to come look at the scans, and I seriously didn't stop thinking or learning for the next two hours.
That patient had a recurrent tumor growth right behind his temple. The tumor was a little larger than a quarter and was right next to his optic nerve. Scans from a couple years before showed that the tumor was not growing. We all went and the doctor talked to the patient about his options. The amazing thing for me was that the patient seemed completely normal. You'd think the tumor would affect something, but not so much. He was also incredibly nice and didn't really seem too phased by the whole thing, he just wanted to know what to do. Apparently, the thing to do in this case is not take out the tumor, but get scans done twice a year and only operate if the tumor begins to grow. Which is crazy talk. The man had a giant tumor in his head. I guess operating put his vision at too much risk, but I think it's amazing that someone can live perfectly fine with a brain tumor.
Then we went straight back to the workroom and prepared for the next patient. This patient had some sort of spinal damage with a fancy name I don't remember. The one symptom was a strong, painful spasticity due to a lack of inhibition of a motor reflex arc (simple and cool nerves, wiki it). So they could give the patient a pill that would increase inhibition and decrease the spasticity, but I guess this has a bunch of side effects. Instead they implanted a pump into the person's torso (above the hip, below the rib on the side) that delivered the drug directly to the damaged site, which only required 1/1000 of the original pill dosage. This patient needed to have the pump refilled with the drug. This was my first experience watching someone have something poked into them, in this case the needle that delivered the drug to the pump (the pump pretty obviously sticks out of the stomach, so it's pretty easy to do). Again, this patient was actually joking around and really cool about everything, which is amazing considering how debilitating the condition was.
The third patient was really cool. This one had undergone the Gamma Knife surgery for a tumor in the auditory canal (just inside the brain). Gamma Knife is non-invasive and pinpoints gamma radiation at a tumor and kills it. The tumor then just stays there and is slowly reabsorbed. I don't quite know how this works, because gamma radiation was the really bad one they told us never to mess with, but apparently they use it for surgery now. The check up showed the tumor was still there, but smaller and everything was ok. The patient had this tiny hearing aid because the tumor was in the auditory canal and messed some stuff up. The hearing aid was bluetooth enabled though. It was like the coolest thing ever. . .I'm kinda looking forward to hearing loss now.
Patient 4 was in for a 1-month check up after a major surgery to repair a herniated disc. Fun-new fact: apparently they also don't immediately do surgeries on herniated discs because most of them are treatable with medicine. Only the really bad ones have to have surgery. This patient actually looked really good and didn't really have much pain, along with a goofy sense of humor that I really appreciated.
Patient 5 came to have some modifications done on a drug regimen. My brain had stopped absorbing much information at this point so I'm not sure what was causing the pain, but it was in the patient's legs. The doctor basically upped the dosages of most of the meds because the patient reported an average pain level of 6, which is a completely subjective pain measurement, but it's really the only way to do it. Patients in that much pain are generally pretty accurate about how they feel. Oh and the scale is from 1-10, with 10 being the worst pain you've ever endured, so 6 is pretty high. The drug regimen is pretty crazy too, I think the patient is taking roughly 20 pills throughout the day. The doctor upped the dosages to try to get the pain down even more (3 or less is optimal) and a surgical alternative is available, but that also seemed like a last resort.
Overall I learned a crazy amount of information in a short two hour period. The doctor even threw a couple of questions my way, which I couldn't answer from the sheer shock of being put on the spot by a neurosurgeon. Talk about surreal. I lucked out too and the neurosurgeon was a really good doctor. He was incredibly warm with all the patients and informed them thoroughly about everything he was doing. I want to shadow other doctors, but I think I might tag along with this one a couple more times and learn more from him. Hopefully he doesn't hate me...
Friday, September 14, 2007
Wednesday, September 12, 2007
Stuff's actually happening, shocking!
You all can rest easy now. The work has picked up, and I finally feel like I'm in med school. . .that's still so weird. Anyway, I'm already kinda behind on my studying, but I'm learning a lot about various diseases and ethical issues in medicine. We have one class where patients come in and talk to us about their conditions and experiences with doctors. It's actually pretty amazing listening to these people. All of them so far have chronic diseases like thalamic pain syndrome (more on that later), severe asthma and non-Hodgkin's lymphoma (lymph node cancer). It's crazy hearing their stories because their lives completely changed when they got these diseases, and they're so honest and optimistic about it. It's seriously amazing how strong some people are.
Also, I'm more sure than ever that I'm going into neurosurgery, because apparently I totally can. Yeah, you heard that right. It's a hard field to get into because it is super small and everyone kinda knows each other, but I guess this is where going to a private school really helps. Everyone here is incredibly helpful to students. There's a neurosurg interest group that works directly with the neurosurgeons. I'm actually shadowing one tomorrow in the clinic (I can also go into the operating room whenever I want as well, I'm so fucking excited about that). I'll be shadowing a doctor that specializes in treating pain and brain tumors.
I didn't realize, but pain is becoming a huge issue because now we're understanding the biological basis of it more and more. The thalamic pain syndrome patient actually can't have surgery because the thalamus is deep inside the brain. . .and surgeons can get to it, but they have no idea what to cut out. So she can somewhat manage the pain with drugs. Now there's a big debate about painkillers and they might become harder to get, which really sucks for someone like her. Stupid puritanical country.
At the interest group meeting, the faculty adviser gave a short presentation on neurosurgery. Now, I've noticed this a bit, but it became clear after this presentation, doctors like referring to their specialty as something they 'get off on.' Ask a doctor why he likes functional neurosurg versus vascular neurosurg, it's because he didn't 'get off on' the vascular stuff. I think I finally understand this, because neurosurg 'excites' me. I don't exactly get off to. . .er, on it in a literal sense, but it's spec-fucking-tacularly mind-blowing and I like that. And cue Amanda making an incredibly inappropriate yet hilarious masturbatory gesture. . .now. :)
I can see myself doing it for the rest of my life. Even if less than 10% of all neurosurgeons in the country are female. Like in California, out of about 550 neurosurgeons, 40 are female. 40. That's kinda depressing. But the one female neurosurgeon at Northwestern is out on maternity leave, so apparently I don't need to be alone and super macho for the rest of my life. That's a good thing, because I don't think I do macho very well. . .I should stop there.
Anyway, this can all change tomorrow at clinic, but be sure that I'll write about the experience even if you all find this incredibly boring. I'm just that kind of blogger.
Also, I'm more sure than ever that I'm going into neurosurgery, because apparently I totally can. Yeah, you heard that right. It's a hard field to get into because it is super small and everyone kinda knows each other, but I guess this is where going to a private school really helps. Everyone here is incredibly helpful to students. There's a neurosurg interest group that works directly with the neurosurgeons. I'm actually shadowing one tomorrow in the clinic (I can also go into the operating room whenever I want as well, I'm so fucking excited about that). I'll be shadowing a doctor that specializes in treating pain and brain tumors.
I didn't realize, but pain is becoming a huge issue because now we're understanding the biological basis of it more and more. The thalamic pain syndrome patient actually can't have surgery because the thalamus is deep inside the brain. . .and surgeons can get to it, but they have no idea what to cut out. So she can somewhat manage the pain with drugs. Now there's a big debate about painkillers and they might become harder to get, which really sucks for someone like her. Stupid puritanical country.
At the interest group meeting, the faculty adviser gave a short presentation on neurosurgery. Now, I've noticed this a bit, but it became clear after this presentation, doctors like referring to their specialty as something they 'get off on.' Ask a doctor why he likes functional neurosurg versus vascular neurosurg, it's because he didn't 'get off on' the vascular stuff. I think I finally understand this, because neurosurg 'excites' me. I don't exactly get off to. . .er, on it in a literal sense, but it's spec-fucking-tacularly mind-blowing and I like that. And cue Amanda making an incredibly inappropriate yet hilarious masturbatory gesture. . .now. :)
I can see myself doing it for the rest of my life. Even if less than 10% of all neurosurgeons in the country are female. Like in California, out of about 550 neurosurgeons, 40 are female. 40. That's kinda depressing. But the one female neurosurgeon at Northwestern is out on maternity leave, so apparently I don't need to be alone and super macho for the rest of my life. That's a good thing, because I don't think I do macho very well. . .I should stop there.
Anyway, this can all change tomorrow at clinic, but be sure that I'll write about the experience even if you all find this incredibly boring. I'm just that kind of blogger.
Sunday, September 9, 2007
I don't feel like writing in sentences
I've basically been a massive sloth/glutton this weekend, which gave me time to think some deep, deep thoughts. So here it goes.
Things I like (in no particular order):
- Mac & cheese, and I will eat the whole box of it in one sitting. Yeah, that's right.
- Gchat, for obvious reasons.
- America's Next Top Model marathons on MTV.
- Cats. If I ever saw a lion, I'm pretty sure I would go up to it and try to pet it. It'd be worth the loss of limbs.
- My playstation
- Stealing music
- Trader Joe's
- Good wine/beer
- Coffee flavored ice cream
- Dancing around, generally in my apartment by myself, pants optional.
- Minesweeper
- Comedy Central
- Good books, even if they're depressing, they're generally pretty fulfilling.
- My funny, clever friends, and their fucked up senses of humor. Greatest thing ever.
Things I don't like:
- Kanye West sampling Daft Punk. I hope he dies a slow painful death for that.
- MTV at all other times. The VMAs also sucked hardcore. MTV actually is dying a slow painful death, which is fortunate.
- People on the street not moving to the side when I'm walking toward them as far to my side as humanly possible. Use those two legs and move to the right, fucker.
- People with lasers. They're just annoying, especially when they point the laser in my apartment. . .way to be creepy.
- The news. Could it be any more depressing?
- People who get easily offended by jokes or who don't like cursing. . .soo serious.
- Mondays. In addition to innately sucking, it's also my busiest day of the week.
So yeah, that's all I've got for now. :)
Things I like (in no particular order):
- Mac & cheese, and I will eat the whole box of it in one sitting. Yeah, that's right.
- Gchat, for obvious reasons.
- America's Next Top Model marathons on MTV.
- Cats. If I ever saw a lion, I'm pretty sure I would go up to it and try to pet it. It'd be worth the loss of limbs.
- My playstation
- Stealing music
- Trader Joe's
- Good wine/beer
- Coffee flavored ice cream
- Dancing around, generally in my apartment by myself, pants optional.
- Minesweeper
- Comedy Central
- Good books, even if they're depressing, they're generally pretty fulfilling.
- My funny, clever friends, and their fucked up senses of humor. Greatest thing ever.
Things I don't like:
- Kanye West sampling Daft Punk. I hope he dies a slow painful death for that.
- MTV at all other times. The VMAs also sucked hardcore. MTV actually is dying a slow painful death, which is fortunate.
- People on the street not moving to the side when I'm walking toward them as far to my side as humanly possible. Use those two legs and move to the right, fucker.
- People with lasers. They're just annoying, especially when they point the laser in my apartment. . .way to be creepy.
- The news. Could it be any more depressing?
- People who get easily offended by jokes or who don't like cursing. . .soo serious.
- Mondays. In addition to innately sucking, it's also my busiest day of the week.
So yeah, that's all I've got for now. :)
Saturday, September 8, 2007
Bring it
Ok, I don't know why, but I love this image. I think it's that look of "bring it" on the blackberry's face. Or the fact that there are two cell phones that are going to fight to the death with nunchucks and a knife.
Anyway, I got this from a Slate article on the superiority of the Blackberry as a smartphone over the iphone. Clearly the iphone gets knifed in its heart/power button. link: http://www.slate.com/id/2173481/nav/tap1/
Anyway, I got this from a Slate article on the superiority of the Blackberry as a smartphone over the iphone. Clearly the iphone gets knifed in its heart/power button. link: http://www.slate.com/id/2173481/nav/tap1/
Wednesday, September 5, 2007
Private school is weird, stop 'guiding' me so much people.
Sometimes I forget that I'm going to a private school. I've just always kinda clumped medical schools all in the same category, without differentiating between private and public. If anything, I've just categorized them as California schools and then all the other ones. It's weird. I knew going into this that med school was going to be different from undergrad and a lot harder, so I appreciate a support system and working in small groups. This, however, is overkill.
This is my 3rd week at school. The first week was an 'orientation' week, where people talked at us all day and we were supposed to socialize at night. Apparently, we were supposed to remember all those people that talked at us, because they later sent us an online evaluation form to fill out. Every daytime session was listed with a numeric scale and a comments section. We had to fill out the comments section for every single one. I eventually gave up and started to put 'I don't remember' for most of them. . .because I didn't. They all just kinda blurred into a vast nothingness. That's how useful that was to me.
Last week, we took the course on medical decision making, which actually wasn't that bad. The only annoying thing was that they kept alluding to the second and third part of the course which we take later. . .so it kinda felt useless, but it was new enough that I was ok with it.
This week, we're starting all of our 'real' courses, except for the labs. We have 2 hours of structure-function/basic science lecture every day. We have a patients, physicians and society (PPS) course twice a week and a course where we do case studies twice a week. So today we had the PPS course. They broke us into small groups of 9-10 people, and each group has a doctor that's leading it. We're doing ethics. I have no problem with ethics. But when we take 20 minutes to designate 'rules' of discussing ethics for our own group. . .I get kinda annoyed. And then when we spend another 20 minutes discussing 'What is ethics?' when the instructor told us all what this class was about in the beginning, I get pretty frustrated. And when they assign us a short essay to write about one time I've lied and been lied to and how I felt. . .I want to shove a spoon down someone's throat. Please. . .stop babying me.
Our class of 170 is also broken down into 4 different colleges. Each college is lead by a doctor that is supposed to be our mentor. It's really cool and really weird at the same time. It feels like some weird private school crap. We had a one-on-one session today, and he asked me if I had any questions about the curriculum or exams or anything. I guess I just don't know what to do in that situation. I think I said something like, 'Exams are hard, right?' Seriously, I don't get what I'm supposed to do there. It's the third week of school. They've been telling us over and over that they're taking it slow and easing us into it. What am I supposed to ask here? Perhaps I should be more interested in case I need more recommendations when applying for residencies. . .but I don't wanna.
I guess all the support is a good thing, but I am a little too independent I think to really enjoy some of this. I guess soon enough I'll be too engrossed in my work to really care, but let's get started with some of this work, shall we?
To make up for the massive ranting. . .here's a picture i took of the city while walking along the lake. Sooo calming. . .
This is my 3rd week at school. The first week was an 'orientation' week, where people talked at us all day and we were supposed to socialize at night. Apparently, we were supposed to remember all those people that talked at us, because they later sent us an online evaluation form to fill out. Every daytime session was listed with a numeric scale and a comments section. We had to fill out the comments section for every single one. I eventually gave up and started to put 'I don't remember' for most of them. . .because I didn't. They all just kinda blurred into a vast nothingness. That's how useful that was to me.
Last week, we took the course on medical decision making, which actually wasn't that bad. The only annoying thing was that they kept alluding to the second and third part of the course which we take later. . .so it kinda felt useless, but it was new enough that I was ok with it.
This week, we're starting all of our 'real' courses, except for the labs. We have 2 hours of structure-function/basic science lecture every day. We have a patients, physicians and society (PPS) course twice a week and a course where we do case studies twice a week. So today we had the PPS course. They broke us into small groups of 9-10 people, and each group has a doctor that's leading it. We're doing ethics. I have no problem with ethics. But when we take 20 minutes to designate 'rules' of discussing ethics for our own group. . .I get kinda annoyed. And then when we spend another 20 minutes discussing 'What is ethics?' when the instructor told us all what this class was about in the beginning, I get pretty frustrated. And when they assign us a short essay to write about one time I've lied and been lied to and how I felt. . .I want to shove a spoon down someone's throat. Please. . .stop babying me.
Our class of 170 is also broken down into 4 different colleges. Each college is lead by a doctor that is supposed to be our mentor. It's really cool and really weird at the same time. It feels like some weird private school crap. We had a one-on-one session today, and he asked me if I had any questions about the curriculum or exams or anything. I guess I just don't know what to do in that situation. I think I said something like, 'Exams are hard, right?' Seriously, I don't get what I'm supposed to do there. It's the third week of school. They've been telling us over and over that they're taking it slow and easing us into it. What am I supposed to ask here? Perhaps I should be more interested in case I need more recommendations when applying for residencies. . .but I don't wanna.
I guess all the support is a good thing, but I am a little too independent I think to really enjoy some of this. I guess soon enough I'll be too engrossed in my work to really care, but let's get started with some of this work, shall we?
To make up for the massive ranting. . .here's a picture i took of the city while walking along the lake. Sooo calming. . .
Sunday, September 2, 2007
Saturday, September 1, 2007
Go Bears!
One week down. This week we took a course on medical decision making, which basically taught us that we're all innumerate. Although it wasn't the most exciting course, it was kinda neat because I never really thought about most of the stuff they taught us (using past tense because this was just a one week course). Basically we value literacy, but for some reason not numeracy, which leads to a whole lot of superstitions and gullibility. So yeah, if this hasn't bored you to death, then you should probably read Innumeracy by John Allen Paulos. It's a quick read and easy to understand (and it'll explain things way better than I can) so do it.
I honestly can't really remember much of this week besides class. It was a bit crazy. I did notice that I was running low on memory for my computer, which is weird because I just go it. Sooo, to cheer myself up I bought an external hard drive online that was on sale. It came with free shipping, so I thought I'd get it sometime next week, but it got to my place less than 24 hours later. Honestly, I don't think I've ever gotten service like that. It was a very pleasant surprise. The hard drive was also made for me. There was nothing to install, I didn't need to read a manual to figure out how to use it, and it took less than a minute to set it up. Needless to say, I am in love with the hard drive. Oh and it has 465 gigs of available free space. :::drool:::
Yeah, that's sexy. :)
For the big surprise of the week, I actually was sociable yesterday. I know. Shocking. One of the girl's that went to Berkeley had her birthday yesterday, so a couple of us took her to Grand Lux (the nicer version of Cheesecake Factory). I apparently found my fellow lushes. We all ordered drinks, a massive individual entree and individual desserts. Seriously, I was so full I nearly threw up. Afterward, we all headed to a social thingy for the entire class that had a keg and pizza. I came the closest to throwing up when I smelled the pizza. You could see that all of us were suffering too as we were standing and talking to people. So much blood had drained from our heads and moved to our stomachs that we couldn't stand straight (I was swaying). Eventually I left so I could lie down and finish digesting. Yeah, it was a lot of food.
Also, Cal beat the crap out of tennessee. This makes me incredibly happy. I want to have Tedford marry Justin Forsett and me. That would be freaking awesome.
I honestly can't really remember much of this week besides class. It was a bit crazy. I did notice that I was running low on memory for my computer, which is weird because I just go it. Sooo, to cheer myself up I bought an external hard drive online that was on sale. It came with free shipping, so I thought I'd get it sometime next week, but it got to my place less than 24 hours later. Honestly, I don't think I've ever gotten service like that. It was a very pleasant surprise. The hard drive was also made for me. There was nothing to install, I didn't need to read a manual to figure out how to use it, and it took less than a minute to set it up. Needless to say, I am in love with the hard drive. Oh and it has 465 gigs of available free space. :::drool:::
Yeah, that's sexy. :)
For the big surprise of the week, I actually was sociable yesterday. I know. Shocking. One of the girl's that went to Berkeley had her birthday yesterday, so a couple of us took her to Grand Lux (the nicer version of Cheesecake Factory). I apparently found my fellow lushes. We all ordered drinks, a massive individual entree and individual desserts. Seriously, I was so full I nearly threw up. Afterward, we all headed to a social thingy for the entire class that had a keg and pizza. I came the closest to throwing up when I smelled the pizza. You could see that all of us were suffering too as we were standing and talking to people. So much blood had drained from our heads and moved to our stomachs that we couldn't stand straight (I was swaying). Eventually I left so I could lie down and finish digesting. Yeah, it was a lot of food.
Also, Cal beat the crap out of tennessee. This makes me incredibly happy. I want to have Tedford marry Justin Forsett and me. That would be freaking awesome.
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