I don't have anything big to say this week. Just lots of little
things. Some funny. Some serious. Some inconsequential. Some pretty important, I think. Take a look.
As
mentioned in earlier posts, we've done a lot of dissection the past few
weeks. This week, we dissected the GI tract. When I read, "cut open the
cecum (part of the colon) and wash out the contents," this was me 100%:
I mean really. Who wants to cut open
the intestines? There's a 0.3% chance that there is going to be
something other than a bunch of poop in there. Why can't we just imagine
what the inside of the colon looks like? Next time I design a lab
dissection curriculum, I'm definitely taking that part of the dissection
out. On the bright side, we did get to dissect the heart and lungs this
week, too. IT WAS SOOOO COOL. I'll spare all of you non-medical people
the details, but using the electric bone saw was one of the funnest
things I've done yet in med school.
So...at some point this past week, I started wondering how much a cadaver costs to purchase. While I was trying figure this out, I ran across the web site, cadaverforsale.com (See how much you're
worth on http://www.cadaverforsale.com/). According to the site, I'm worth $4,125,
or approximately the Kelly Blue Book of a 1987 El Camino. Which would
you take? Me? Or the El Camino? Tough call, but personally, I would take
me. El Camino credit: BK Motors. Apron credit: http://www.flirtyaprons.com/.
Have
I told you I live in the most gorgeous place on earth? Because I do.
Even when the weather isn't perfect, it's still stunningly beautiful:
So,
there are actually quite a few Mormons here at UVa med. I don't have an
exact count for the other classes, but we have 5 in our class of 154,
which puts us at about double the U.S. population average. Not too
shabby. When I came to take a second look at UVa last May, I stayed with
Ben Ogden, who is a fourth year LDS (aka Mormon) student here at UVa.
Prior to my visit, I was really unsure of where I should go to school.
After a great visit and lots of prayers, I received a definitive answer
that I should go to UVa. And that's how I ended up here! Anyways, Ben is
a fantastic artist. He just finished some anatomy drawings that are
incredibly realistic and very anatomically accurate. Here are a few:
Last
week, I was in the cadaver lab (which, as you've probably figured out, is basically where I live now),
when one of my classmates came up and asked me a completely random question. He asked, "Nate, you're Mormon, right? Is Brandon Flowers
(lead singer of the band "The Killers") a Mormon?" Slightly caught off guard, I laughed and told him
that Brandon Flowers is, in fact, Mormon. Did you people know that? Well, he is
and here's what he has to say about it:
For
those of you who haven't listened to radio the past decade and aren't
aware, the Killers are a great band. Below is a music video of my
favorite Killers song. It was filmed at Goblin Valley State Park, a
place I visited last summer. Looks like Brotha Flowers and I have a few
things in common. Here's the music video and a picture from my trip (Can
you find me??):
Last thing for this post. The video
below made the rounds on social media a few weeks ago. I loved it the
first time I saw it, but, after finding out that the kid in the video
suffers from Osteogenesis Imperfecta (aka brittle bone disease), it
became even more meaningful to me. Osteogenesis Imperfecta is a genetic
disorder that messes up the formation of collagen (the main fibrous
component of bones). This results in bones that are extremely weak. To
give you a little perspective, people with OI can break a femur just
sitting down onto a couch. Often, they have hundreds of breaks during their
lives. HUNDREDS. I can't even imagine. It's a serious disease, one that
takes a heavy toll, mentally, physically, and emotionally. Which makes the
kid in the video all the more impressive. If he can have such a positive
attitude, we all can! Here's the video. Give it a watch:
[Insert clever, introductory joke here. I would, but I got nothing. The picture below describes how my brain feels right now.]
Why does my brain feel like that? Because I just finished exam week! This week was the last week of the Musculoskeletal system. This was good and bad. Good because it meant that I was on the brink of surviving another system. Bad because it meant that me surviving another system was contingent on passing my final musculoskeletal system exam. I've had a lot of friends and family members ask me about exams/exam preparation, so here's an honest, slightly dramatized version of my typical exam week.
One week before exam:
I'm not looking forward to studying day and night for an entire week, but I know it'll be good for me. I learn/relearn/superlearn a lot of important information the week before the exam. Still, I can't help but feel like Mr. Michael Scott:
My sleep schedule goes craaaaaaazzzy. Most weeks, I'm on a "go to bed at 11 pm, wake up at 6 am" type of schedule. During exam week, though, I'm all over the place. Studying till 1 am. Up at 4 am. I really feel like the lost boys from Peter Pan:
Which results in this happening during class. Photo credit to my classmate, Daniel. Nap credit to me, Nathan:
Three days before the exam:
My room gets really messy. And before anyone calls Homeland Security, complaining of a bioterror threat, I said my room gets messy, not dirty. For whatever reason, my will to keep my room neat and tidy just tanks. I figure that as long as I have clear paths between my bed, computer, and bathroom, I'll survive.
I stop communicating with the outside world. My texts sent per day total goes from like 100 to maybe five. The only calls I accept are from my mom or President Obama. So, if you aren't either of those individuals, don't expect to be hearing back from me till after I take my exam.
I eat out more often. It saves precious time and energy that could be spent studying for my exam. This is what goes on in my head almost every day of exam week.
Irrational Nate: "You should stop at Five Guys right now."
Rational Nate: "I can't. I'm poor. Remember the whole taking out loans thing?"
Irrational Nate: "If you don't, you might fail your exam and future medical career will be in serious jeopardy."
Rational Nate: "Well. Uh. Um. Uh. When you put it that way...."
And just like that, I'm standing in Five Guys, popping peanuts in my mouth, waiting for them to finish my delicious burger. As you might imagine, this situation happens pretty frequently during exam week. Everytime it does, I feel like Kronk arguing with his shoulder angels:
Day before the exam:
I study. A lot. It's go time. I usually study the entire day. By this point, my butt usually hurts from sitting so much over the course of the week. I know that probably sounds terrible. Which it should. Because it is. I'm a pretty big nerd, but even I'm sick of studying by this point. Which inevitably leads me to do the following:
I consider possible career changes. Is all this studying worth it? Maybe I should do something else. Lots of possibilities have entered my mind: Watch salesman. I like watches. Why not? Food critic for the food network. Yeah. I would seriously love that. Car mechanic. Seems interesting and manly and stuff. Plus, I would no longer have to sell organs on the black market to finance getting my car fixed. My current favorite, though, is Park Ranger at a National Park. I love visiting national parks. Who wouldn't want to do this every day?:
As tempting as a career change seems at this point, I just suck it up, watch a Law and Order SVU rerun on Netflix, and keep studying.
Day of the exam:
Sometimes I study more. And sometimes I don't study at all and just take the test. It all depends on how I feel about life. If I feel ok, I study more. If I feel like the clip below, I usually just go ahead and take the thing.
So, then I take it. Our exams usually take about 2 hours and are composed of 100 clinical scenario based multiple choice questions. The questions can be really, really tough, but when you only need 60% to pass, it's very doable. It's always really nice to pass an exam. It means a) I can do this whole medical school thing! and b) no exam for three more weeks! And, naturally, this is how I feel:
When I started medical school more than six months ago, I was full of expectations. I expected to study a lot. I expected to stare at MRIs and radiographs and CTs and ultrasounds for inordinate amounts of time. I expected to memorize long lists of viruses and bacteria and protozoa. I expected to learn all the nerves and muscles and veins and arteries in the human body. And I expected that, after all this work, I would become a successful physician.
The last thing I expected, though, was failure.
For me (and most of my slightly OCD classmates) failure at anything is not an option. You can chalk that up to my upbringing or genetics or societal pressure or whatever. I'm not sure why I am the way I am and, honestly, I'm not sure it matters. The longer I'm in medical school, the more I am compelled to believe that failure is a very necessary pill for a medical student to swallow. I don't always get good grades on my exams. I don't always get through all the material I need to get through. I don't always feel confident in my ability to apply medical principles to clinical situations. And that's the way it's supposed to be. Failure is the antidote to pride. It's the vaccination against apathy. It's the prescription that increases desire to learn. It's the drug that deepens resolve to do better next time.
Don't believe me? Sit down, kids. Grandpa's about to tell you a story.
One of my heroes is Russel M. Nelson. For those of you who don't know him, he is a Mormon Apostle (Yes, Apostle, like in the Bible. Click here for an explanation.) and world-renowned surgeon. Here's a picture of him.
I've always known him as the man who pioneered open heart surgery, served as the president of various surgical organizations, and won countless awards for his contributions to the medical community. To an aspiring doctor like myself, he's nothing short of a super hero. What I didn't realize though, is that all the success he has seen in his surgical career can be traced back to a pivotal moment of failure. In his words:
"Those
first days of open-heart surgery were, “like sailing an
uncharted sea,” with moments of euphoria but with despair as well, when
surgery was unable to save a life. Brother Nelson describes one such
instance early in his career: “In 1957, a couple brought their third child to me for repair of congenital heart disease. Their
first child had died from congenital heart disease before the advent of
cardiac surgery, and their second also died after an unsuccessful
open-heart operation that I performed. I operated on the third child,
but she died later that night."
“My
grief was beyond expression. When I went home, I told the story to
Dantzel (his wife) and said, ‘I’m through. I’ll never do another heart operation as
long as I live!’ I wept most of the night. All I could think of were
the faces of those two parents, and I could still see those pathetic
children in my mind, blue-lipped and with clubbed fingers, yet with
smiles of confidence and hope. I determined that my inadequacies would
never be inflicted on another human family."
“When
morning came, Dantzel finally said, ‘Isn’t it better to keep trying
than to quit now and require others to go through the same grief of
learning what you already know?’ I listened to her counsel. I returned to the laboratory to work a little harder, learn a little more, and strive further.”
So there! Failure is not only important. It's 100% necessary. The key is not to avoid it but to grow from it! Don't be afraid to fail! Have the courage to get back on the horse and get better!
I'll end with a quote from J.K. Rowling's 2011 Harvard commencement speech:
“Some failure in life is inevitable. It is impossible to
live without failing at something, unless you live so cautiously that you might
as well not have lived at all. Failure taught me things about myself that I
could not have learned any other way. You will never know your strength until
you have been tested by adversity.”
Funny Non-methodical Stuff
Medical fact du juor: In an emergency, coconut water can be used as IV fluid. It has roughly the same ionic concentration as blood. Don't ask me why this is useful information. Ask this guy:
I was called on to answer a difficult question a few days ago in class. The question had various transverse cuts of the spinal cord that looked like this:
The question had to do with the locations of the cuts in the spinal cord (aka "Is this cut from the thoracic or cervical or lumbar region?). In nothing short of a miracle, I correctly matched all of the cuts with their proper locations. My triumphant moment was cut short, however, by the professor asking me to justify my answer. Uh. Um. Hmmm. Yeah, that was asking too much. I mumbled something to the effect of "I am, unfortunately, unable to justify my answer," at which, everyone in my class laughed. With me? At me? Still not sure. haha
I got ahead in my studying last week and decided to take a road trip up to DC with my friend, Lauren, this weekend. That's right! You can still have fun as a medical student! It was magical. I got to wander around the National Institute of Art (the Impressionists were my favorite, but there was some bizarro modern art that was pretty cool as well), try a tiramisu shake at a drive-thru ice cream place aptly named the "MooThru," be evacuated from the National Aquarium (no idea why), taste my first frozen hot chocolate in Georgetown, dance my socks off while playing "Just Dance," and, best of all, I got to see a lot of my best friends. Shoutout to Jason, Lanae, Paris, Catherine, Trevor, Jessi, and Ella for making my visit absolutely incredible! Here are a few pictures from the occasion.
I have my final musculoskeletal/integument exam this coming weekend. Hopefully, afterwards I feel like this:
And not like this:
To be honest, though, thinking about studying all day every day this week makes me feel like this:
So...I'm assuming everyone besides my classmates and immediate family has no idea how my school schedule works. Safe assumption? I think so. Ok, so here's what it is. Instead of individual classes like physiology or pathology or histology that run all semester long, we have systems that run anywhere from 6 weeks to 14 weeks. Examples of systems include "Cardiovascular," "Renal," "Pulmonary," etc. And within each system, we have classes that cover the physiology or pathology or histology that specifically relates to that system.
The idea is that, when it comes to actually practicing medicine, instead of thinking in terms of classes and subjects, doctors (and med students!) have an easier time thinking in terms of the systems of the body. So, with a systems-based curriculum, instead of having to integrate info from lots of classes on the spot when diagnosing a patient, it's pre-integrated for you (Sounds like an late-night infomercial. "Pre-integrated medical knowledge for your convenience!"). So, that's how school works for me.
Ever since we got back from Christmas break, we've been in the Musculoskeletal-Integument System. Spoiler alert: I love it. It's definitely been my favorite system so far. Along with starting cadaver dissection (and memorizing the endless lists of nerves and arteries and veins and origins and insertions and innervations and actions that goes with dissection), this week we started learning how to do a physical exam. At the beginning of the week, I knew next to nothing about doing a physical exam. One week in....well....I still know next to nothing. haha I'm sure I'll get the hang of it. Eventually. Hopefully.
On Thursday, my clinical group (A group of six students and two mentors that help us with... you guessed it!.... our clinical skillz) and I headed to the clinical skills development practice center place thing (I don't think that's the official name) to learn how to do our very first lower extremity physical exam. The clinical skills center (or whatever it's called) is a place where people from the community come in and volunteer (or are paid) to be our pseudo patients. This way, we get to practice with people who are not real patients before we make an attempt on real patients. As anyone with a brain would attest, this is very, very good idea.
Once we found our patient's room, we went though the exam with the help of step by step instructions. All the while, we asked our mentors a million questions such as "What is that?" "Where is that?" and "How do I do that?" Between the fact that A) we were reading step-by-step instructions and B) we were totally confused, our patient probably felt
like a trampoline that was being assembled by Four-year-olds. It was quite the experience. Even though I currently feel like this:
I think I'll get the hang of it soon enough. I mean, that's what med schools for, right? Well, that about does it for the post. I have to get ready for church. I'll end with a few other things that happened this week.
The Weekly Rounds
Instead of studying for my quiz on muscle actions last week, I played this for an hour instead. 7.9 meters. Oh yeah. Beat it. http://www.foddy.net/Athletics.html
It snowed this week! It's been a little chilly this week (Or warm, if you ask my Russian classmates. Or colder than the dead of space, if you ask my Floridian classmates.) Either way, the snow was really pretty. Here's a picture of my house:
My anatomy text book listed a stab wound to the lateral chest as one of the likely causes of injury to the long thoracic nerve. Good to know. Next time I'm in a knife fight, I'll be sure to ever-so-slightly medially rotate my torso if I'm stabbed in order to avoid that. Thank you, anatomy text book.
For all you Dr. Pepper fans out there, Dr. Pepper was a real physician who went to UVa Med back in the 19 century. Cool, huh? (Oh and p.s. despite false rumors to the contrary, Mormons can drink caffeinated drinks. If you're curious, here's what we do and don't do: http://www.lds.org/topics/word-of-wisdom?lang=eng)
Study song of the week: "Bleeding Out" by Imagine Dragons. Several of the band members are Mormon and I actually saw them while I was at BYU. Very talented.
