seagulls

I went to the lake today. I played the song "Rock Back and Forth" by Fourtet, and sat on one of the slabs of cement they decorated "nicely" around the rim of the lake. I gazed at the sky and was hypnotized by the the seagulls flying... and it was one of the most beautiful moments I've experienced in a long time.

I should be more excited.

I finally passed over one of the largest humps in med school, and probably my life: USMLE, Step 1. I took it on June 18th. That exam, as well as the 35 days leading up to it, were way too intense for me. Luckily, I scored above my "unrealistic goal", and feel like all that hard work had paid off. yay! So now starts the new era of medical school where I actually feel like a pseudo-doctor (technically a student doctor). I'm 3 weeks into my first rotation: Psychiatry. I'm placed in the child and adolescent psychiatry unit, and I have to say, it's pretty laid back. I'm currently following 2 patients. The first one has undifferentiated schizophrenia who keeps hearing voices, and the second has bipolar disorder with her most recent episode being mania. It's quite interesting. I have more to say, but I'm lazy.

Speaking of being lazy, I feel like medical school has turned me into an anhedonic and uncultured person. I feel more out of touch in reality with less interests in activities that I formerly had interest in. Make it stop!!! I'm turning into a zombie.

OCD

So, today I read about obsessive compusive disorder, anorexia nervosa, bulemia nervosa, anxiety disorders, and panic disorders. I find them all highly interesting, and I wonder if it's because I can relate to these diseases more than, say, congestive heart failure or megaloblastic anemia. OCD is amazing. How the hell do people end up with this? The disorder is defined by having certain obsessions or compulsions or both.


Obsesions are recurrent and persistent thoughts, impulses, or images that are experience at some time during the distubrance -- they are intrusive and inappropriate and cause marked anxiety or distress. Examples include:

• A patient fearing he would scream out, "I want to buy an 18-wheeler!" in a conversation with friends, even though he has no intention on purchasing one
• A patient having disturbing thoughts about how she's going to kill her sister

Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. Examples include:

• excessive hand-washing in fear of germs
• excessive checking of the stove to make sure it's shut off and not being able to sleep because of it
• repeating prayers over and over (um. catholics? I think rituals and superstitions have a lot to do with OCD)
  

OCD is often subtyped by symptom clusters. Patients with aggressive, sexual, relgious, or somatic obsessions may have a "checking" compulsion. One of our professor's patients had obsessive thoughts that she would drown her baby in the bathtub unintentionally, and she would constantly check that the baby was okay. Patients with symmetry obsession may have ordering/arranging, counting, or repeating compulsions. There was a patient who accidentally burned her right thigh with a curling iron and she had to burn herself on the left leg so it would match. (!!!) There is also contamination obsession with cleaning compulsions (I can relate to this... and all of the ones stated in this paragraph).

I've had textbook OCD at age 11, and though it died down after a year (thanks to some unavoidable, non-formal cognitive behavioral therapy), I'm continuing to notice other quirks about myself as I progress through life. I'm an obsessor, of sorts. I'm a weirdo. And I also still find remnants of my OCD.

Anyways, reading about these psychiatric disorders is making the field of psychiatry sound more appealing. Integrative medicine is still applied to whatever I do. I really don't know what's going to happen, but I look forward to the future every day (after JUNE 18th!).

Oh yeah, I scheduled the big day.
June 18th = USLME Step 1 (United States Medical Licensing Examination)
This test will cover everything I learned the first two years of med school... and I'm sure more. I'll be obsessing over this day. And my approach and studies for it will be very ritualistic and superstitious.

Year 2

Too much time and too little motivation. I'm already getting screwed.

h00t!

Every Wednesday night is Hooter's Trivia Night, and a few med students have turned this event into a tradition (a tradition that only exists for two weeks after a big test). Trivia can be entertaining... and so can the atmosphere. The whole aura of Hooter's is both primitive and joke-like. (I fear I sound condescending.) But the number of big American trucks in the parking lot was almost vomit-inducing. Actually, that couldn't compete with the gazes of men towards spandex-clasping butts. ::vomit::

Why why why??? What the hell compels girls to work at Hooter's? Please, explain. Maybe they feel comfortable playing the role of a sex object clad in spandex, 80's scrunchy socks, & hi-tops serving greasy food and tending to greasy men. Wait, but why? Do women feel satisfied when they know they've fulfilled the visual fantasies of men? when they feel they have grabbed man's attention, or perhaps put them under a "spell"? Are looks (or big boobs and blonde hair) the only methods women use to gain whatever social control is available in this male-dominated society? In Foucault, Feminity, and The Modernization of Patriarchal Power, author Sandra Lee Bartky takes Foucault's notion of docile bodies.... [how we're constantly regulating our bodies to conform to society] a step further and talks about "gendering" our bodies. Bartky uses an image of a model prison (the Panopticon [ironically also the name of my ophthalmoscope]) set up where no prison guard is needed (somehow due to its architecture), and says that women today are figuratively in these prisons (because of their "inferior role" in society) and constantly are self-policing themselves... there is no police system out there telling women how to dress, what weight to be, the type of pointy shoes to wear, the boob job to get, the blonde hair-dye to purchase, etc. We are the ones regulating it ourselves. We are constantly under the "internalized male gaze" and use that to police ourselves. Strangely enough, women find it rewarding when they can live to this idealized standard that the male is making (i.e. orange spandex, revealing shirts, and Denise Austin-esque aerobics footwear? sheeit...). Bartky labels this phenomenon as "repressive satisfaction" because we are getting satisfaction by keeping ourselves in the inferior, object role.

I have to admit -- these orange boots are way hotter than the scrunchy socks & hi-tops at BR's Hooter's.

What kills me even more about the need to look a certain way is the pounding of this mindset by magazines, movies, and more media. I have to admit that I fall into this same trap that many women do. It's fun to dress up and look nice (sometimes). But who am I doing this for? for myself? for my friends? for social acceptance? Actually, ever since med school started, this has been a smaller issue for me, and I've been caring less ... actually, ever since high school. I don't know, I also find it to be immature in a way. I do find it interesting to see the great measures taken by women to "look nice."

OKay, so let's tie this into med school. After a long conversation with a fellow med student, I learned that these socially established gender roles should be taken seriously as part of the professional aspect of being in medicine. This means that looking sexually ambiguous is out of the question (perhaps symbollically compounded by the fact that, clinically speaking, sexual ambiguity (and ambiguous genitalia) is denoted by physical defects and also carries negative connotations with it, especially if it's associated with congenital adrenal hyperplasia). I think it's also strange though to see myself (d?)evolve into someone who's "okay" with these established gender roles... or maybe I just don't care anymore because there are way too many other things to worry about. I do, however, notice more of Bartky's "internalized male gaze" phenomenon going on among people in my class. Then again, I do have to give props to the females for entering in a field that used to be dominated by males.

Next subject... this block in Physiology we're covering Endocrinology. I'm enjoying it, mainly because the subject matter is straightforward (for the most part), and I find hormones fascinating. They dictate a lot of "who" we are and how we function. I definitely believe that hormone production is greatly affected by nutrition, an area I wish was covered in more detail in the course. the extent of nutrition covered is: "this is what happens after a meal" (too general) or "if you eat too much licorice you can get hypertension" (who eats lots of licorice?). of course, we do learn how things like sleep (which I should put more value in), stress, trauma, infection, and tumors can affect hormones. (Okay, so now Endocrinology is being added to my list of future options, which includes Gastroenterology, Integrative Family Medicine, and Preventive Medicine. Integrative medicine will be involved with anything that I plan to do.)

A lot of the observed behavior at Hooter's last Wednesday was dictated much by hormones. But how much? There is constant debate on the social vs. biological basis of behavior. However, one side cannot exist without the other. The intimate relationship between both forces serve to create who we are... but how? and to what extent? (side note: many times I wonder what it would have been like if I went to grad school in gender studies.)

Neuro... always fun. The Mize Mania has subsided as the past couple of blocks included many clinical application type lectures from guest lecturers.

Biochemistry... I'm becoming a slacker. I haven't been going to class lately, save one class this week simply because the guest lecturer was Japanese.

Right now is crunch time as exams are creeping up. More reflection on this past semester will proceed once craziness recedes.

Oh, and speaking of being all girly girly, Cadaver Ball was last block.

Obscene theme, continued...

I'm not sure what the deal is with our neuro professors and their tendencies towards displaying obscene gestures, but the other prof (not mize) proceeded to perform some sort of full-body copulatory motion to demonstrate the concept of "fixed action patterns." This is a type of reflexive pattern found in animals, where higher order inputs are not needed to generate movements. Example clearly found in the praying mantis. When a male mounts a female and is not exactly doing a good job, the female will bite the male's head off, resulting in "...a reflexive motion of perfect copulation." The demo definitely grabbed my attention. Yeah, my attention in class has been waning as of late. Obscene gestures help. I love neuro.

It's been awhile since the last post. I'm going to stop saying that, actually, because it will always be a while between posts. I'm in med school. We just had a big exam last week for Block B, which covered pulmonary physiology, phosphomania and its phospho-related ditties via glygogen metabolism, lipids, cholesterol, and more in biochem, and the sensory systems in neuro. One of the major highlights of last block included Dr. Levitsky's flatus lecture ("levitsky" is purposely mispelled). This covered the synonyms, definitions, statistical occurances of farts (FYI, according to levitsky "fart" is by far the best word to use out of all of them... and we also fart on avg 14 times/day) and the volume/frequency/buttocks mass/jambalaya tests and pictorial depictions of the demonstrations that went along with them. For neuro, I also can't forget Mize and his describing everything as "beautiful".

The following is a photo from Levitsky's flatus lecture.

The PPT slide is depicting a subject farting into a fart detector. Levitsky's in the hardhat.

This block seems a little more boring right now. The nephron isn't providing much excitement... but I am looking forward to the GI segment. Digestion fascinates me for some reason. I'm not sure how I feel about polyps, though. I like steroid hormones and their effects on secondary sex characteristics. However, while the biological causes of masculinization/feminization are presented (to a certain degree), my curiosity of their intermingling potential with the environment is yet to be satiated. Anyways, steroids will be covered more next block I think in endocrinology. Sociology? never... med school is sadly not the "ideal" site for enlightenment. Actually, anywhere can be great site for enlightenment. I still need to give med school a chance.

The more med school goes on, the more I learn to take advantage of the "free time" I have. Ever since last Monday (Exam #2), I've spent almost every night watching bands perform in Baton Rouge and Austin. This is mostly attributed to the SXSW music festival in Austin and the many bands' resulting tour stops in BR. An amazing time fer sure. Tonight I will once again prolong the limited freedom I have before next test by seeing Ted Leo + The Pharmacists.

Happiness ensues...

Coronal Sanders

Why I like Dr. Mize:

• He gives away free opera tickets to the class to see Placido Domingo (one of the Three Tenors)
• He refers to the class as "an incredible diversity of rainbow"
• He could possibly be the lovechild of Barf from Spaceballs and Colonel Sanders

• He's comfortable with showing slides of cartoon slugs with sunglasses

Something about these slug illustrations disturb me.

• His wife is Turkish
• He has nice PowerPoints

Other news:

I've been getting this vibrating feeling on the plantar surface of my left foot. It has the same vibrating pattern as a cell phone (but just a lot more subtle in nature). Out of the eight foot vibrating episodes I've had, I could've sworn that during five of those times my cell phone was vibrating under my foot. I think my lateral plantar nerve is acting up. I blame it on sitting with my legs crossed a lot and compressing my tibial nerve. I actually have no idea what I'm talking about.

I've been feeling more ancy about moving the med school back to New Orleans for good come fall semester. I was actually okay with Baton Rouge last semester, but this semester I'm disliking it more.

I consumed potato jello for the first time.

Obscenity in the Medulla

I have 4 days before the first big exam of the semester. This is my first post in like three weeks... I'm obviously procrastinating. I do have to mention that one of my neuro prof's talked about how he has been making obscene gestures when describing various parts of the brainstem. Today, he proceeded to perform two of these gestures. When describing the crus cerebri (which are supposed to be the "legs" of the, um, midbrain) he used those going "in and out" arm gestures: bended elbow, closed fists, you get the idea. Next, when describing the appearance of the solitary nucleus and tract in the rostral medulla (the dark circle, being the tract, is located inside a larger lighter circle, the nucleus), he showed how the tract is "inserted" into the nucleus. I'm sure you can figure out the gesture he used for this one with his hands and fingers. It's the famous Bill Clinton gesture. You have to see this for yourself!

I will post pictures when I'm not lazy and in dire need to study.

Back in the pool... or ocean?

[Deep breath.] Back in the good old BR. Classes started, and I have to say that things are off to decent start. The classes seem more interesting and more familiar (Physiology, Biochemistry, and Neuroanatomy). I still don't know how I feel about the new profs. I know that they do make me miss our old professors. Though, the neuro guy has been pretty amusing. So far I know he likes the Christopher Guest film "This is Spinal Tap" and likes to quote Woody Allen. The following was the last slide of his presentation today:

Pretty funny if you ask me. I think Donatello was all I needed to have a good day.

I've noticed that there are semi-cliques in med school. The Asians tend to congregate together. Is it because we all understand what it's like to have a crazy Asian mother. Or perhaps we communicate with a common, unspoken subtext? Regardless, we still have fun. A group of us celebrated Tian's bday at India's restaurant and Jason's house. I love all my med school peeps.
Studying in med school is analogous to swimming in what seems to be a vast, never-ending body of water. There is no option to just sit there, unless, of course, you want to drown. Therefore, I am truly grateful for all the amazing people I've met thus far at this makeshift med school.

Boys

Yeah, boys. What should a person like me do about them at this present moment?

Med School Revival

Things are starting up again in the med school world. While classes do not technically start til 01/09, our preceptorships started this week. The American Heritage Dictionary defines preceptorship as "a period of practical experience and training for a student, especially of medicine or nursing, that is supervised by an expert or specialist in a particular field." Basically, I dress up in a white coat and pretend I know what's going on in the clinic. I decided to follow my aunt, who's a rheumatologist. So far I've seen patients with cases of rheumatoid and osteopathic arthritis, lupus, schleraderma, mixed connective tissue disease, Sjogren's syndrome, and fibromyalgia. I've conducted heart and lung, head and neck, and abdomen exams. Today I picked up an inspiratory whistle in a patient, which indicated signs of early bronchitis. Seeing a lot of these cases really does inspire me to become a doctor. I realized that I truly enjoy the one-on-one doctor-patient relationship. I think I deal best with people on a one-one-one basis. (Besides being a redundant person) this goes back to my personality. I tend to revolve the way I act around the person(s) I am around, and it's easier for me to be myself when I'm dealing closely with one other person. When I'm by myself in a cubicle or lab or standing in front of a group of people, my ability to exhibit that true relatable/personable aspect becomes more dampened. And I enjoy exhibiting that true relatable/personable aspect of myself. But it's not only this. Most of the patients I've seen today were extreme victims of hurricane Katrina - most lost their houses. So in addition to diagnosing the patient, you also serve as a sort of therapist-like angel. My aunt provided a shoulder for at least 3 crying patients. I think I would find so much fulfillment in helping the overall health - physical and psychological - of an individual. Is psychiatry calling my name? Don't know, but the plan right now is Family Integrative Medicine.

I continue to learn more about myself everyday. Oh, and today marks a big day in my single (single in the context of not dating) life. I'm the most single I've ever been since February 7, 2002. I'm experiencing a strange feeling that encompasses both depression and liberation. I think that strength is probably the best result.

I should continue my stream of consciousness writing again... right brain is aching for more stimulation. Don't worry Vonnegut and Rachmaninoff - you're helping, too.

breaking (apart?)

Wow, it feels so wonderful to be a lazy bum. Haven't been doing anything too exciting during the heart of the break besides eat a lot. Last night I enjoyed a hearty meal with a few other fellow med students. It's quite refreshing to hang out with a group of amazing people when everyone is not going crazy from stress and major obligations to study.

A few days ago, my dad, my sisters, and I went to go check out my aunt's and great aunt's houses in Lakeview. 'Twas quite a depressing experience. Here are some pictorial examples:






Yes, and the mold didn't smell terrific either.

I need to continue to prevent my brain from rotting. I'm aching for some good philosophical conversations. I hope to present/develop some life views... soon. I also need to go Christmas shopping. Yikes!

Winter Break

I think it's ironic to have a blog devoted to my time spent in med school for it to only come to life when I'm not in school. But perhaps that's not so ironic, because I now actually have free time.

Christmas was the day before yesterday, and it was a pretty simple one. Less presents were exchanged, not as many relatives were seen (due to a slight geographical separation from Katrina), and less stress was had. I enjoyed it. My best gift was from my youngest sistser -- a t-shirt with a faux screen print of an old school stereo and underneath it the word "PLAYER". Because that's what I am... a music player. Or am I really a player? I do like to play. Play with people's hearts? No, not really. However, I could do a better job at taking care of others' hearts. I make myself very unreadable.

Goals for winter break:

• Read at least 4 Vonnegut books
• Perfect the 3rd movement of Rachmaninoff's 2nd Piano Concerto
• Perfect Mendelssohn's Rondo Capriccioso
  
• Sleep a lot
• Run everyday
• Get in touch with long-lost friends

How does one become a better writer?

Darn it.

I'm done... I did it. I finally finished my first semester of med school. I feel like I deserve another Bachelor's degree or something. It was quite an experience -- dissecting cadavers (ours was named "RockSteady"), facing the devastation from one of the nation's greatest natural disasters, evacuating to two small Louisiana towns where half the people are related to each other, learning to study for 17 hours straight (um, literally), transporting a med school to a different city, living with a host family in Baton Rouge, making life-long friendships, pushing myself harder than ever both mentally and physically, partying harder than ever, and learning to appreciate life much, much more. I regret not having kept a detailed/humorous account of all the happenings and torturous moments. I hope to do a better job next semester.