My name is Derrick Antoniak, and this is my blog about medical school.
So part of medical school is figuring out what you want to do when you graduate medical school. Unfortunately, in the third year, you only get to rotate through six specialties: family medicine, pediatrics, general surgery, internal medicine, psychiatry, and OB/GYN. By the end of the third year, you pretty much have to have made up your mind so that you can schedule the correct rotations early in the 4th year and get letters of recommendation in time to turn in with your residency application. So if your interests lie outside one of those six specialties, you have to spend significant time in the first two years exploring other specialties on your own time.
Today I took advantage of the holiday and spent the morning shadowing a neurosurgeon in town, and it was quite amazing. His first procedure was scheduled for 7 AM, "cranial vault reconstruction for severe multisuture craniosynostosis", you know, that old chestnut. An adult head is a pretty small area in which to operate, but this procedure was done on a 2-month-old, and she was TINY! When the surgeon's hand is the size of the patient's entire upper body, it's tough to imagine being able to do reconstructive surgery on the head, but, despite my concerns, the first cut was made by 8, the biggest piece of the skull had been carefully dissected away from the brain and removed by 8:45, and by 9:30 the reconstructed skull had been screwed back in place and the scalp closed back over it.
It seems like a strange job. Get to work real early, make sure the patient is ready for surgery, go to the staff lounge and have coffee and relax until the OR calls and says they are ready (which will not happen until the patient is actually under anasthesia), open someone's head and fix some problem (anything from cancer to congenital malformations to bleeding from trauma), close the person's head, leave to see the next patient (without waiting to see the miracle of the first patient actually waking up after you cut open their skull), back to the staff lounge to wait for the OR to call, etc, etc.
Monday, January 18, 2010
Friday, December 18, 2009
Being an M2
My name is Derrick Antoniak, and this is my blog about medical school.
In the first semester of the M1 year, I wrote over 20 posts on this blog. I steadily slowed down, because school became progressively more mundane. Whereas in the beginning of last year, I was in a whilrwind, trying to get to know my new classmates and my new school, not to mention every last little detail of Bootstrap's anatomy (we could not resist the urge to nickname our cadaver), the second semester and the first semester of this year were much less interesting to write about (let alone read about). People like to hear stories from the gross lab; after all, how many people ever get the opportunity to look inside another human's skull, see the brain that made him human, dissect the fat away from the tiny little nerves that made his eyes move, pull the lungs out of the chest and see the emphysema that almost certainly made him short of breath for his last few years on this Earth, I could go on and on. But since then, med school has been a lot more like college, and who wants to hear about that.
The numbers would agree. There were four tests in anatomy, and a score in the 90's would put you off the charts. The numbers were just not that high. You could pass with a 60, and the class average was in the 70's, pretty consistently through the core. Biochemistry (core 2) had two exams, and there were a few outliers scoring over 90, but not many. Physiology (core 3) started to see averages creeping towards and into the 80's, with lots of people reaching the mid 90's. In neurosciences (core 4) we were back to the lab to dissect the brains we had removed from our cadavers in August, but the scores still rose. A summer off, and we were back this fall for the Intro core (core 1 of the M2 year) and the averages were in the mid to upper 80's, with a couple of people even scoring 100% on one or two of the exams. People are either getting better at taking exams, or med school has become more predictable over the course of a year. I suppose there's probably an element of both.
So, I want to try to keep up with this blog, but I don't want it to be mind-numbing. So I think I'll try to post interesting stuff whenever it happens to me and leave it at that.
In the first semester of the M1 year, I wrote over 20 posts on this blog. I steadily slowed down, because school became progressively more mundane. Whereas in the beginning of last year, I was in a whilrwind, trying to get to know my new classmates and my new school, not to mention every last little detail of Bootstrap's anatomy (we could not resist the urge to nickname our cadaver), the second semester and the first semester of this year were much less interesting to write about (let alone read about). People like to hear stories from the gross lab; after all, how many people ever get the opportunity to look inside another human's skull, see the brain that made him human, dissect the fat away from the tiny little nerves that made his eyes move, pull the lungs out of the chest and see the emphysema that almost certainly made him short of breath for his last few years on this Earth, I could go on and on. But since then, med school has been a lot more like college, and who wants to hear about that.
The numbers would agree. There were four tests in anatomy, and a score in the 90's would put you off the charts. The numbers were just not that high. You could pass with a 60, and the class average was in the 70's, pretty consistently through the core. Biochemistry (core 2) had two exams, and there were a few outliers scoring over 90, but not many. Physiology (core 3) started to see averages creeping towards and into the 80's, with lots of people reaching the mid 90's. In neurosciences (core 4) we were back to the lab to dissect the brains we had removed from our cadavers in August, but the scores still rose. A summer off, and we were back this fall for the Intro core (core 1 of the M2 year) and the averages were in the mid to upper 80's, with a couple of people even scoring 100% on one or two of the exams. People are either getting better at taking exams, or med school has become more predictable over the course of a year. I suppose there's probably an element of both.
So, I want to try to keep up with this blog, but I don't want it to be mind-numbing. So I think I'll try to post interesting stuff whenever it happens to me and leave it at that.
Sunday, November 2, 2008
Week 10 of 10
My name is Derrick Antoniak, and this is my blog about being a first-year medical student.
So, the first core of medical school is anatomy, and it lasts 10 weeks. This was week 10.
We finished dissecting the lower limb and spent the rest of the week studying. It was actually an interesting week outside all the studying. On Tuesday we had the first meeting of the 'Medical Humanities group', which was only attended by about 8 people. We read and discussed passages from Walt Whitman's "I Sing the Body Electric", which actually had relevance to our anatomy experience and the field of medicine in general. Whitman was a nurse during the Civil War, and probably had to detach himself somewhat in order to do his job, much like we focus on learning anatomy to forget about the fact that the cadaver we are dissecting was a person with a family and a job and hobbies and emotions and worries and strengths and weaknesses of character and all those other things that make us human. Good poem, though, if you ever have a chance to google it. The lady presenting the poem talked about the book Body of Work by Christine Montross, which I read over the summer and have been meaning to dedicate an entire blog to at some point. If anyone really wants to know what the first year of med school is like (or at least anatomy), I think her book is right on point and a good read for anyone.
Also on Tuesday, my mother's significant other had an aneurysm in his brain operated on, so she's been staying at the hospital, and I've been staying at her house with Harry. Sadly, Harry, who never used to leave my side when he lived with me and followed me everywhere, doesn't even like me that much anymore. He's also gained about 20 pounds in the two months he's been living here, not surprising given my mother's track record of fattening up her pets.
I also signed up for the student senate elections this week, so I'll spend the next two weeks campaigning and hopefully get elected. I also went to an informational meeting for this honors program called EMET on Wednesday, so hopefully between those two things I'll be able to keep busy outside of class.
My grandpa moved from Fremont to Bellevue and is living at the new Eastern Nebraska Veterans Home, and I went to visit him yesterday. Here he is looking out the window, which I am convinced he does whenever I'm not there, because that's what he's doing every time I arrive.
Here's a picture of the two of us. We pretty much just walk laps whenever I'm there, and I ask him lots of questions, and he gives me mostly one or two word responses. The weather was phenomenal yesterday, though, so we took a walk outside.
I took Harry home with me yesterday, and we ran into my other grandpa, who lives next door but still only sees me every few weeks. I thought long and hard about this last night, because there are people a lot younger than me that never have the opportunity to see both grandpas in the same day, much less on a normal Saturday afternoon without it being a holiday or special occasion. Grandpa had his tree groomed over the summer, and now it is turning the most beautiful colors, so he wanted me to take a picture of it. That's him in the foreground, and those bland yellow trees in the background are the ones in my front yard.
So, that's how I celebrated the end of anatomy. Visited with both grandpas, went to dinner with Joanna, and watched some football from the comfort of my mother's couch. Unfortunately, the College of Medicine didn't give us much time to revel in our accomplishments, as they handed out the note packets for core 2 on the way in the door for the last exam of core 1. I'm going to try to relax a bit today, but at some point I'll end up in the library studying for the clinical exam coming up this next Saturday and previewing for tomorrow's first lecture of Core 2: Cellular Processes.
Wednesday, October 22, 2008
Pelvis and Lower Limb
My name is Derrick Antoniak, and this is my blog about being a first-year medical student.
So, another test in the books, and another week of new dissections before we get our grades back. The written portion of the exam was not very difficult at all, but the lab practical had a lot of tricky pins. My goal, like for the head and neck exam, was to get all the easy points (PBL, living anatomy, radiology, cross sections, and embryology), and I think I was relatively successful in doing so. I'll find out on Friday, as usual, but for now, we're moving on to the fourth and final unit, Pelvis and Lower Limb.
Interestingly, because of the way we develop (as a species that is), part of the male reproductive system was covered in the abdomen unit (namely the testis and associated structures). So, the first two days of this unit had us looking at the entire female reproductive system and what was left of the male (essentially the penis). The area dissected is actually called the perineum, which, if you don't know, is quite an intimate area (I won't describe its borders here, you'll have to look it up). In Body of Work, a book I read over the summer about the author's experience dissecting a cadaver as an M1, she talks about the difficulty she had running the scalpel over such structures as the fingers, and lips, and other uniquely individual structures. She grapples especially with the idea of making the midline incision in the perineum, a cut that would include the clitoris and labia and, in general, skin that is seen and touched in only the most intimate of circumstances. We were spared that dilemma, however, not only by drawing a male cadaver, but also by the fact that the perineum was given as a 'DEMO' (The demo's are basically dissections that are either too difficult or too time-consuming for us students to do, so the instructors dissect, in this case, a male and a female perineal area, and give us about a 30-45 minute demonstration of all the structures revealed). The perineum was similar to the thorax and abdomen in that there are small, hard to distinguish structures all in close proximity to one another, making their identification difficult. Today's dissection, on the other hand, was much more similar to the upper limb, if not easier. We started on the anterior and medial thigh, an area with big, fat, long blood vessels and nerves, huge, easily-separable muscles, and, most importantly, enough room for all four of us to dissect at the same time, which hasn't happened for about six weeks now. So, lab is going good, and we are down to five dissections remaining, so it's really sinking in this week that we'll be out of there soon.
Meanwhile, this week is complicated by the fact that we have our ICE midterm on Friday, so a lot of anatomy study time is being redirected to that right now. Some of my classmates are worried about ICE, but all the M2's I've talked to say they didn't study for it until two or three days prior and it wound up being their highest grade for the semester. In general, I feel very comfortable with my ability to keep up with the curriculum, and I have pretty much stopped worrying about grades.
Joanna is pretty much working from 8AM to 9 or 10PM every day except Sunday, when she 'only' has to work noon to 8, and we both can't wait for election day to come and go. On the other hand, I've been calling the hours I spend walking precincts and delivering signs with Joanna 'extracurricular activities', which they are, and I've put in quite a few hours, and once the election is over I'll actually have to get more involved here on campus. I don't mind that, except most activities and organizations here cost money to join, and, in the words of Sir Mix-a-Lot, "I ain't down with that."
I had my fourth of five preceptor visits to Dr. Roy Monday, and she said she thinks I'm learning a lot. I had a real nice interview with one of her adolescent patients, saw some more ears and noses and throats, gave some flu vaccines, and felt very comfortable overall. I don't go back now until December 16, so I am going to try to fill up some of my free afternoons with shadowing in the ortho clinic and elsewhere. I did a little test on this website called Careers in Medicine over the weekend, and, based on my responses to like 90 questions, they matched me to 'general surgery', so that's another department I may contact this week to try to set up some shadowing.
Anyways, that's enough. I'll put some pictures up next time. This blog is probably getting boring.
So, another test in the books, and another week of new dissections before we get our grades back. The written portion of the exam was not very difficult at all, but the lab practical had a lot of tricky pins. My goal, like for the head and neck exam, was to get all the easy points (PBL, living anatomy, radiology, cross sections, and embryology), and I think I was relatively successful in doing so. I'll find out on Friday, as usual, but for now, we're moving on to the fourth and final unit, Pelvis and Lower Limb.
Interestingly, because of the way we develop (as a species that is), part of the male reproductive system was covered in the abdomen unit (namely the testis and associated structures). So, the first two days of this unit had us looking at the entire female reproductive system and what was left of the male (essentially the penis). The area dissected is actually called the perineum, which, if you don't know, is quite an intimate area (I won't describe its borders here, you'll have to look it up). In Body of Work, a book I read over the summer about the author's experience dissecting a cadaver as an M1, she talks about the difficulty she had running the scalpel over such structures as the fingers, and lips, and other uniquely individual structures. She grapples especially with the idea of making the midline incision in the perineum, a cut that would include the clitoris and labia and, in general, skin that is seen and touched in only the most intimate of circumstances. We were spared that dilemma, however, not only by drawing a male cadaver, but also by the fact that the perineum was given as a 'DEMO' (The demo's are basically dissections that are either too difficult or too time-consuming for us students to do, so the instructors dissect, in this case, a male and a female perineal area, and give us about a 30-45 minute demonstration of all the structures revealed). The perineum was similar to the thorax and abdomen in that there are small, hard to distinguish structures all in close proximity to one another, making their identification difficult. Today's dissection, on the other hand, was much more similar to the upper limb, if not easier. We started on the anterior and medial thigh, an area with big, fat, long blood vessels and nerves, huge, easily-separable muscles, and, most importantly, enough room for all four of us to dissect at the same time, which hasn't happened for about six weeks now. So, lab is going good, and we are down to five dissections remaining, so it's really sinking in this week that we'll be out of there soon.
Meanwhile, this week is complicated by the fact that we have our ICE midterm on Friday, so a lot of anatomy study time is being redirected to that right now. Some of my classmates are worried about ICE, but all the M2's I've talked to say they didn't study for it until two or three days prior and it wound up being their highest grade for the semester. In general, I feel very comfortable with my ability to keep up with the curriculum, and I have pretty much stopped worrying about grades.
Joanna is pretty much working from 8AM to 9 or 10PM every day except Sunday, when she 'only' has to work noon to 8, and we both can't wait for election day to come and go. On the other hand, I've been calling the hours I spend walking precincts and delivering signs with Joanna 'extracurricular activities', which they are, and I've put in quite a few hours, and once the election is over I'll actually have to get more involved here on campus. I don't mind that, except most activities and organizations here cost money to join, and, in the words of Sir Mix-a-Lot, "I ain't down with that."
I had my fourth of five preceptor visits to Dr. Roy Monday, and she said she thinks I'm learning a lot. I had a real nice interview with one of her adolescent patients, saw some more ears and noses and throats, gave some flu vaccines, and felt very comfortable overall. I don't go back now until December 16, so I am going to try to fill up some of my free afternoons with shadowing in the ortho clinic and elsewhere. I did a little test on this website called Careers in Medicine over the weekend, and, based on my responses to like 90 questions, they matched me to 'general surgery', so that's another department I may contact this week to try to set up some shadowing.
Anyways, that's enough. I'll put some pictures up next time. This blog is probably getting boring.
Thursday, October 16, 2008
Unit Three Sucks
My name is Derrick Antoniak, and this is my blog about being a first year medical student.
So Saturday is the big 'thorax and abdomen' test, and, if today's mini-case session was any indication, I have a ways to go. The anatomy seems easier than the head and neck, but for some reason I feel less confident (could have something to do with the fact that I've had exactly 1 dedicated, efficient study session in the entire three weeks). If that's not bad enough, I had to spend almost two hours in Dr. Carver's office yesterday (student counseling) because my backgroung check looks like that of an alcoholic (at least enough so that entering the medical profession will require me to prove that I'm not). We had a really nice conversation, and he said he wasn't too worried about me, but in the end, I had to take a questionnaire, and, pending the results, I may end up in a more formal alcohol dependency assessment or even outpatient treatment (to the tune of several hundred dollars I'm sure). This is a pre-emptive move on my part (at the suggestion of Dr. Hill). I know without question that I am not an alcoholic, and it's been almost 5 and 8 1/2 years since my two run-ins with the law, but when I graduate, if I haven't done anything to prove it, any residency program I enter would probably send me to rehab just based on my backgroung check and family history, so, I guess it's better to get it out of the way now, while I'm really not that busy (at least that's the theory). It is frustrating, though, and, honestly, a little discouraging, especially when you see how some of my classmates act, not only on days like this Saturday after the exam, but also on just any night of the week. Oh well. So, as I make my daunting transition from a one-beer-every-three-weeks guy to a no-drinks-ever guy...
We have the exam Saturday, and, although anatomy is winding down, we have exams much more frequently overall in the near future. This weekend is exam 3, next weekend is ICE midterm, the following weekend is the last anatomy exam, the following weekend is the OSCE (objective structured clinical exam), one weekend off, then the first exam for cellular processes, which is the next class after anatomy. In reality, I don't care. I think it's going to be downhill after anatomy, and, besides that, I've had some success setting up shadowing experiences in departments of interest, and I think that will be my focus, with the hope that I will meet enough people and get enough experience to really decide what specialty I want to be in and pursue it regardless of competitiveness.
So Saturday is the big 'thorax and abdomen' test, and, if today's mini-case session was any indication, I have a ways to go. The anatomy seems easier than the head and neck, but for some reason I feel less confident (could have something to do with the fact that I've had exactly 1 dedicated, efficient study session in the entire three weeks). If that's not bad enough, I had to spend almost two hours in Dr. Carver's office yesterday (student counseling) because my backgroung check looks like that of an alcoholic (at least enough so that entering the medical profession will require me to prove that I'm not). We had a really nice conversation, and he said he wasn't too worried about me, but in the end, I had to take a questionnaire, and, pending the results, I may end up in a more formal alcohol dependency assessment or even outpatient treatment (to the tune of several hundred dollars I'm sure). This is a pre-emptive move on my part (at the suggestion of Dr. Hill). I know without question that I am not an alcoholic, and it's been almost 5 and 8 1/2 years since my two run-ins with the law, but when I graduate, if I haven't done anything to prove it, any residency program I enter would probably send me to rehab just based on my backgroung check and family history, so, I guess it's better to get it out of the way now, while I'm really not that busy (at least that's the theory). It is frustrating, though, and, honestly, a little discouraging, especially when you see how some of my classmates act, not only on days like this Saturday after the exam, but also on just any night of the week. Oh well. So, as I make my daunting transition from a one-beer-every-three-weeks guy to a no-drinks-ever guy...
We have the exam Saturday, and, although anatomy is winding down, we have exams much more frequently overall in the near future. This weekend is exam 3, next weekend is ICE midterm, the following weekend is the last anatomy exam, the following weekend is the OSCE (objective structured clinical exam), one weekend off, then the first exam for cellular processes, which is the next class after anatomy. In reality, I don't care. I think it's going to be downhill after anatomy, and, besides that, I've had some success setting up shadowing experiences in departments of interest, and I think that will be my focus, with the hope that I will meet enough people and get enough experience to really decide what specialty I want to be in and pursue it regardless of competitiveness.
Thursday, October 9, 2008
The student should be able to:
My name is Derrick Antoniak, and this is my blog about being a first-year medical student.
At the beginning of the semester, we all received a huge package of nicely three-hole-punched handouts for lecture, lab, and embryology, intended to save us the hassle and money of printing it ourselves (it's literally two three inch binders worth for the first 10 weeks alone). The lectures are each one hour long, so the handouts for a typical single lecture include about six pages of notes, the end of which will say, "The student should be able to:" followed by a list of anywhere from 8 to 12 ridiculously complex learning objectives, each of which has entire textbooks dedicated solely to that subject. Keeping in mind that we have several lectures a day, I thought that was humerous (maybe you had to be there).
Anyways, we were given a surgical demonstration today by a 'surgical oncologist' named Dr. Are. Oncology, if anyone is actually reading this, is a field of medicine dedicated to cancer, so Dr. Are's field is a surgical sub-specialty dealing with the surgical removal of tumors. For the past few years, they have been trying to give students in the first two years exposure to more and more clinical aspects of medicine, and the surgery demonstrations in the anatomy lab are part of that effort. They demonstrated the exact same operation for last year's class, but apparently today was the first chance they had to demonstrate on a so-called 'lightly-embalmed' cadaver. A few interesting notes on the operation: 1) The light embalming process keeps the cadaver feeling much more human, which was an interesting twist on the dissection process. 2) Dr. Are was pointing out landmarks to look for, talking about how they go about finding things, and making sure they don't injure things they don't want to, etc., and it became immensely obvious how important the work we do in the lab really is. The dissection we did today involved two hours of digging through the abdomen in search of maybe 6 or 7 arteries, which could have seemed like a trivial task, until we watched a practicing surgeon open the abdomen and point out each of those arteries in succession (among others), and talk about how important it is to get this one out of the way before you start cutting, and using that one as a landmark for finding this other structure, etc. It was a really nice re-inforcement of what we're doing in there this semester. 3) The operation demonstrated is called the Whipple procedure for resection of pancreatic cancer. When someone is diagnosed with pancreatic cancer, you have to say to them, there is about a five percent chance you'll live five years. But if that person is lucky enough to live close to (or somehow have access to) a place like UNMC, or Johns Hopkins, or one of several other places around the world that does a lot of these kinds of things, that number goes up anywhere from 15-30%. So, for my part, I thought the demo was real fun to watch and a good learning experience.
The other interesting thing is how often cancer comes up this semester. It seems like in all three units so far, we get cancer over and over. I think it has to do with the way they are trying to teach us anatomy. One of the big keys to clinical anatomy is knowing relationships, not just knowing where a structure is, but what lies anterior, posterior, inferior, superior, lateral, medial, what is the blood supply, what is the nerve supply, etc. So cancer really fits into that learning system pretty well. Cancer and trauma. Test questions are always like, "A man gets stabbed with an ice pick in this really specific location", or "A woman with a tumor in this area of wherever", and then ask some question about their deficits, and we have to know all the structures, muscles, arteries, nerves in that area to be able to answer the question. So with cancer and trauma they seem to be able to ask us like 15 questions in one, and, if I had to put my finger on the biggest difference between undergrad anatomy and anatomy here, that would be it.
In other news, I'm going Monday to shadow a surgeon in the sports medicine clinic, and I am pumped. I don't know what I want to specialize in, but if I had to pick today, based on my interests and background, orthopaedic sports medicine would be it, so we'll see over the next couple of months if that's something I really want to pursue. They said once I come into the clinic and see some patients, if there is an operation they schedule that I find interesting, I can say, "I'd like to be there and see that operation". So we'll see.
At the beginning of the semester, we all received a huge package of nicely three-hole-punched handouts for lecture, lab, and embryology, intended to save us the hassle and money of printing it ourselves (it's literally two three inch binders worth for the first 10 weeks alone). The lectures are each one hour long, so the handouts for a typical single lecture include about six pages of notes, the end of which will say, "The student should be able to:" followed by a list of anywhere from 8 to 12 ridiculously complex learning objectives, each of which has entire textbooks dedicated solely to that subject. Keeping in mind that we have several lectures a day, I thought that was humerous (maybe you had to be there).
Anyways, we were given a surgical demonstration today by a 'surgical oncologist' named Dr. Are. Oncology, if anyone is actually reading this, is a field of medicine dedicated to cancer, so Dr. Are's field is a surgical sub-specialty dealing with the surgical removal of tumors. For the past few years, they have been trying to give students in the first two years exposure to more and more clinical aspects of medicine, and the surgery demonstrations in the anatomy lab are part of that effort. They demonstrated the exact same operation for last year's class, but apparently today was the first chance they had to demonstrate on a so-called 'lightly-embalmed' cadaver. A few interesting notes on the operation: 1) The light embalming process keeps the cadaver feeling much more human, which was an interesting twist on the dissection process. 2) Dr. Are was pointing out landmarks to look for, talking about how they go about finding things, and making sure they don't injure things they don't want to, etc., and it became immensely obvious how important the work we do in the lab really is. The dissection we did today involved two hours of digging through the abdomen in search of maybe 6 or 7 arteries, which could have seemed like a trivial task, until we watched a practicing surgeon open the abdomen and point out each of those arteries in succession (among others), and talk about how important it is to get this one out of the way before you start cutting, and using that one as a landmark for finding this other structure, etc. It was a really nice re-inforcement of what we're doing in there this semester. 3) The operation demonstrated is called the Whipple procedure for resection of pancreatic cancer. When someone is diagnosed with pancreatic cancer, you have to say to them, there is about a five percent chance you'll live five years. But if that person is lucky enough to live close to (or somehow have access to) a place like UNMC, or Johns Hopkins, or one of several other places around the world that does a lot of these kinds of things, that number goes up anywhere from 15-30%. So, for my part, I thought the demo was real fun to watch and a good learning experience.
The other interesting thing is how often cancer comes up this semester. It seems like in all three units so far, we get cancer over and over. I think it has to do with the way they are trying to teach us anatomy. One of the big keys to clinical anatomy is knowing relationships, not just knowing where a structure is, but what lies anterior, posterior, inferior, superior, lateral, medial, what is the blood supply, what is the nerve supply, etc. So cancer really fits into that learning system pretty well. Cancer and trauma. Test questions are always like, "A man gets stabbed with an ice pick in this really specific location", or "A woman with a tumor in this area of wherever", and then ask some question about their deficits, and we have to know all the structures, muscles, arteries, nerves in that area to be able to answer the question. So with cancer and trauma they seem to be able to ask us like 15 questions in one, and, if I had to put my finger on the biggest difference between undergrad anatomy and anatomy here, that would be it.
In other news, I'm going Monday to shadow a surgeon in the sports medicine clinic, and I am pumped. I don't know what I want to specialize in, but if I had to pick today, based on my interests and background, orthopaedic sports medicine would be it, so we'll see over the next couple of months if that's something I really want to pursue. They said once I come into the clinic and see some patients, if there is an operation they schedule that I find interesting, I can say, "I'd like to be there and see that operation". So we'll see.
Monday, October 6, 2008
I Stuck a Needle in Someone Today
My name is Derrick Antoniak, and this is my blog about being a first-year medical student.
So, I'm going to keep these short to try to avoid the long delay between posts, because this really is supposed to be a journal I can look back on, and a lot of the day-to-day from head and neck got lost because I went so long without posting.
Today I had my second preceptor visit in as many weeks. Dr. Roy genuinely (at least seems like she) likes me and wants me to get the most out of her clinic. But today was a test of her patience. I'm not a guy that likes to use phrases like 'emotional rollercoaster', but we certainly had some high and low moments this afternoon. I don't know how, but after the first two or three appointments, the waiting room was full. And she doesn't run her clinic like the hospital, where a nurse brings you back, then a med student comes and talks to you, then you see the doctor for five minutes. She does it all. She calls the kids back, and (with my help) gets the history, performs the physical exam and any other testing, makes the diagnosis, discusses the plan with the parents, writes the prescriptions, and sets up any follow-up. So all of a sudden, we had the entire afternoon's patient roster sitting in the waiting room and it was just the two of us.
Anyways, besides that, I thought I was getting good at looking at the eardrums, but I totally blew that. I looked, saw the membrane, looked at the other side, saw the membrane, told Dr. Roy that it looked normal, which it ultimately did. But when she came behind me to look, she said, "You see the tubes?" "No." "Look here." So, fully expecting to see some microscopic color change or something, I was stunned when I instead saw these massive, blue intertube-looking rings that wound up being in both ears. I was pissed off, to be honest.
But, I kept practicing. We were in a huge hurry, but I kept insisting on looking in each and every ear, and she kept letting me, and she kept teaching me, at all times, discussing the problems in lay terms to mom and in (slightly) more medical terms to me. And, by the end I was feeling a little better. The last appointment was a guy with his three sons all in need of flu shots. I've seen Dr. Roy give plenty, but so far she had only let me give the nasal mist flu vaccine. But today I was promoted from the guy holding the legs down (kids don't like shots, it's by far the worst part of pediatrics so far) to the guy giving the injection. When I finished, Dr. Roy said, "different than chicken, right?", knowing that's what I had practiced on at school, but honestly, other than the insanely loud screaming and crying, the injection felt remarkably similar.
So, I'm going to keep these short to try to avoid the long delay between posts, because this really is supposed to be a journal I can look back on, and a lot of the day-to-day from head and neck got lost because I went so long without posting.
Today I had my second preceptor visit in as many weeks. Dr. Roy genuinely (at least seems like she) likes me and wants me to get the most out of her clinic. But today was a test of her patience. I'm not a guy that likes to use phrases like 'emotional rollercoaster', but we certainly had some high and low moments this afternoon. I don't know how, but after the first two or three appointments, the waiting room was full. And she doesn't run her clinic like the hospital, where a nurse brings you back, then a med student comes and talks to you, then you see the doctor for five minutes. She does it all. She calls the kids back, and (with my help) gets the history, performs the physical exam and any other testing, makes the diagnosis, discusses the plan with the parents, writes the prescriptions, and sets up any follow-up. So all of a sudden, we had the entire afternoon's patient roster sitting in the waiting room and it was just the two of us.
Anyways, besides that, I thought I was getting good at looking at the eardrums, but I totally blew that. I looked, saw the membrane, looked at the other side, saw the membrane, told Dr. Roy that it looked normal, which it ultimately did. But when she came behind me to look, she said, "You see the tubes?" "No." "Look here." So, fully expecting to see some microscopic color change or something, I was stunned when I instead saw these massive, blue intertube-looking rings that wound up being in both ears. I was pissed off, to be honest.
But, I kept practicing. We were in a huge hurry, but I kept insisting on looking in each and every ear, and she kept letting me, and she kept teaching me, at all times, discussing the problems in lay terms to mom and in (slightly) more medical terms to me. And, by the end I was feeling a little better. The last appointment was a guy with his three sons all in need of flu shots. I've seen Dr. Roy give plenty, but so far she had only let me give the nasal mist flu vaccine. But today I was promoted from the guy holding the legs down (kids don't like shots, it's by far the worst part of pediatrics so far) to the guy giving the injection. When I finished, Dr. Roy said, "different than chicken, right?", knowing that's what I had practiced on at school, but honestly, other than the insanely loud screaming and crying, the injection felt remarkably similar.
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