Wednesday, November 26, 2008

Chugging Gatorade

The weather has transformed into the cold, bitter gray that is winter. For the last couple of days, I've been under the weather, chugging Gatorade and lemon-lime flavored carbonated beverages, while curled up in a ball on the sofa, staring aimlessly at the coagulation cascade page of the syllabus.

It definitely does not help when you know a little about the differential for fever, fatigue, headache and myalgias. You just start thinking way too much about which bug it could be.

Thankfully, I'm feeling much better in time for Thanksgiving. By tomorrow, hopefully, I can eat my fill of home cooked food.

We'll see...

Sunday, November 16, 2008

M3 Mania I

After today, we should now be able to complete a head to toe physical exam (theoretically). In our last patient education/physical exam session, we learned about how to complete a clinical breast exam, which involves a visual inspection (from four different views), lymph node palpation (in the axilla and near the collar bone) and the breast exam. Like the female and male pelvic exams, we were taught by patient educators who demonstrated the exams on themselves before walking us through each step of the exam, as well as teaching us important points about establishing rapport.

The breast exam is not just about the breast as we think of structures contained in the bra. In performing the breast exam, it helps to think of an imaginary rectangle drawn around the breast, starting from under the arm going up to the clavicle along the sternum and down just below the breast. Using a light, medium and deep palpation with the pads of our fingers, we feel the fatty and glandular tissue of the breast as we move our fingers in a cork-screw pattern vertically on the tissue.

As I performed the exam, I said aloud "light, medium and deep" to help coordinate my actions. To completed a thorough exam, when you are learning, it takes some time (more than 2 minutes). And it's always hard to make sense of what you are feeling; everything feels kinda of lumpy and bumpy. "Like a bunch of grapes," said our patient educator. And every patients tissue will obviously feel different.

In explaining the exam to our patients, our patient educator made a good point- we perform a thorough exam to establish a baseline, which will serve to us detect any change (the other "C" word), not just for cancer.

In completing my first breast exam, I know it will take lots of practice to master the fine art of detecting subtle tissue changes that may come in the form of pea-sized lumps. "One day, you may be saving lives," our educator said as we closed the session. Maybe.

Other than performing a clinical breast exam on one of the nicest and warmest days in November, I spent my Sunday indoors preparing for our first M3 exam. We transitioned from Infectious diseases to the mechanisms, methods and malignancies block, formerly known as the cancer, bench to bedside, block.

Preparing for this exam has been partly a walk down undergraduate memory lane, taking me back to the days of when I majored in genetics and studied cancer as part of my research. Revisiting the genetic basis of cancer and the molecular biology of tumorigenesis has been interesting, especially as we learn the connection and see how the science relates to the clinical picture of a disease that impacts so many people.

Having been personally affected by cancer, it is sometimes difficult to read about the studies that predict five-year survival of patients on certain drugs, or learn about how cancer can recur or metastasize to other organs. It's hard to focus on the biology of a disease, when you can't help but see a face of someone you love who has suffered from the disease. And at the same time, it is promising to hear about the advances made in treatment and understanding the disease.

All in all, this has been a somber block. And Studying for the tomorrow's exam has been especially difficult (story of my medical school life).
M3 Mania continues...homestretch!

Friday, November 7, 2008

What a Week!

This has been one amazingly busy week! Perhaps, one of the most epic weeks of medical school and history.

Tuesday was unbelievable. With the swipe of a magic black marker, I cast my vote early in the morning, braving the cold and lines. I proudly wore my "I voted" sticker all day, knowing that we may make history.

During pediatric preceptorship, I completed my first pediatric neuro exam on a one and half year old girl, who was fast asleep when I arrived. She did not like tracking my penlight, but she did like the fluffy teddy bear. Later, we listened to a presentation from a pediatric cardiac thoracic surgeon, who spoke about how to repair congenital deformities involved with babies born with large vessel switching.

We did make history on Tuesday! I was brought to tears, as I watched the election results unfold. After 8 PM, when it was announced we had elected Barack Obama, I was elated. I am excited this welcome change.

Wednesday we made medical school history with our annual class play- MDTV, which was remarkable. I don't think I have ever laughed that hard. The mix of music videos, live skits, performances and video skits (that featured classmates, faculty members and first years), was one awesome production. I made an appearance in a couple of the video skits, namely a video titled "Girls gone Mild." (I really hope it does not end up on youtube).

I was also part of the final dance number, which was set to the song "Bye Bye Bye," with rewritten lyrics. After rehearsing (for what seemed like forever), we finally performed to a crowd of screaming medical students and faculty members (and the stage lights are super bright). It was quite an experience...I would love to take a dance class (if only I had the time).

After the end of the dance, we stayed on stage for the Final song number- "Seasons of Gloves." It was so heartwarming be in the company of my classmates as we sung (a slideshow of our first year flashed behind us as we swayed). The final hurrah that is our class play was extremely memorable. Now the curse of topping our class play gets passed to the Class of 2012, who must now hit the drawing board to devise an even better play.

Thursday was another long day. I taught my first cardiac MSP session. We moved from the anatomy labs to the chalk boards in the classroom. I taught cardiac anatomy, one of my favorite topics. I truly hear the the heart (seriously).

Friday is here. And the weekend, which means catch-up time and learning the language of cancer. I'll be spending time with family this weekend, so we'll see how much gets done.

Cheers to an unforgettable week!

Bye Bye Bye - Lyrics by Ning

We're done with this tonight
It's time to turn on the lights
We hope you thought it was tight
Hey baby, come on
We worked on this endlessly
So that we could help you see
That you're not in this med school business alone

We know that you can't take no more
It ain't no lie
You laughed so hard your abs are sore
Baby, bye bye bye

Right now everything's so new
But before you now it you're an MS2
It seems crazy, but it ain't no lie
Baby, bye bye bye

We know that this med school's tough
You probably feel like you already had enough
But you'll all make it and it ain't no lie
Baby bye bye bye

Just hit you with the truth
Life's better as an MS 2
I'll give you some good reasons baby, come on
No more anatomy
Just Life Cycle and I3
We study, take the boards and then we're gone
Goodbye to the Essential Core
It all flew by
We'll see what third year has in store
Baby, bye bye bye

All of us were just like you
But we all made it, now we're MS2s
You'll all make it and it ain't no lie
Baby, bye bye bye

We know that this med school's tough
Learning how to use a blood pressure cuff
You'll all make it and it ain't no lie
Baby bye bye bye

Sunday, November 2, 2008

Being DNA Polymerase

One genetic degree and two years of medical school later, I am amazed at what I have become. For Halloween, I probably selected one the most nerdy costumes (of all time). I was DNA Polymerase, the enzyme that replicates DNA.

My costume was complete with a homemade sign, spandex, loop earings, a replication fork necklace and an oversized shirt that read "How do you express yourself?"

It was funny watching people reading my sign and trying to figure it all out. My costume only works on the UCSF campus or around my science/medical school friends. So, I did have the perfect daytime and nighttime outfit.

I know...look what I have become- pretty scary!

Happy Halloween!!!