Thursday, February 19, 2009

Farewell to MSP

I taught my last MSP session tonight. Potassium balance. It's hard to believe how fast the monthes have gone by. I've grown with my students, walking them through the first week of anatomy through the cardiovascular block through pulmonary block through the last renal MSP lesson. Tonight I bid farewell to MSP.

Teaching has always been a fresh breath of air in my learning and an opportunity to tell really unfunny jokes. Thanks to teaching MSP session, the first years actually know my name and invite me to their parties (I even received an invitation to an upcoming End of the Organs party on Saturday). It's like being a popular nerd. In a way, I have been reliving the first year vicariously through teaching and interacting with my students, as I address their questions and concerns about exams and life as medical student. The first year has become something of a blur, but becomes more clear when I interact with my students, who take me back to the first year.

It has been a privilege to work with such talented and bright students. They have taught me so much of myself and my capabilities; I can be funny (usually this in unintentionally and still deliver an education message). I will truly miss MSP and my students. Teaching has definitely been one of the most rewarding experiences of medical school thus far. I walk away with some new friends and a unique set of experiences that will ground me through my future educational endeavors.

On Tuesday, while I was teaching about potassium disorders, such as hyperkalemia and hypokalemia, I was thinking about the stages of development through pregnancy, infant and childhood. The reason being, I was in the process of studying for our second Lifecycle midterm that was on Wednesday. So, Tuesday was one long night, as I bounched from teaching renal physiology of potassium balance to studying the physiology of labor and congenital heart defects.

My mind is still racing. The exam is over. MSP is over. Surgical Skills, the elective I am coordinating, will wind down next week with the final lecture and scrubbing and gowning session. As I relinquish all my responsibilites, I still feel as though there is always something that needs to be done. Perhaps, I was just born this way-- born to be persistently active.

I am also in the process of inventing the perfect third year schedule, which involves ranking my preferences for the order of rotations and site. In the end, the schedule will be generated by a computer through this elaborate "lottery" system.

There is this one other thing that requires my complete attention-- studying for the boards. This has been a challenge, like no other, more a test of mental endurance. My strategy has become to minimize memorization and maximize understanding through integration, which is almost impossible with lots of memorization. It's a Catch-22. I knew that.

My mind is always trying to make sense of all these floating facts and trying to find the logic behind the complex disease processes; some have clear pathways, while other explanations make little or no sense. And sometimes, what we learn boils down to these bizarre mnemonics that are just memory tools to remember all those details we will inevitably forget. Sigh.

Studying continues. At least I will remember somethings from teaching MSP.

Thursday, February 5, 2009

Don't Break my Hearts

"Don't break my hearts." These were the closing words of our pathology lecturer.

We made our way to the pathology lab to examine a number of delicate hearts. It's ironic, we were instructed not to "break" these already broken hearts. Some hearts were the size of walnuts, while others barely fit in my palm. Each heart had some sort of congenital heart defect. Everything from holes in the walls of the chambers (atrial septal defects and ventral septal defects) to hearts that were missing an entire ventricle (hypoplastic left heart syndrome) to hearts that had the incorrect vessels paired with ventricles (transposition of the great vessels). These hearts had once beated inside the chest wall of developing fetuses and infants and eventually could no longer perform the job of a heart.

I was lucky to have met a five year-old child, who had a hypoplastic left heart on my pediatric preceptorship. When I had met him, there would be no way to know that this child, who loved Sponge Bob Square pants, had undergone numerous surgeries to repair his little heart. Today, I got to see what his heart looked like at one point in his life.

Using our examination skills, we attempted to identify each pathology. I have to say that this was my favorite pathology lab. I am simply fascinated by the heart. And seeing hearts with congenital heart defects reminds me about the complexities involved in developing the pump of our body.

This week has taken through pregnancy to birth to development. Earlier this week, I held a placenta in my hands. The flat structure, which looks like a really flattened cake, serves as a fetus' life line, providing nutrients and oxygen.

In lecture, we had the opportunity to meet families with young children. We were given the task of guessing the age of an infant and a child. It was hard to pay attention to the lecturer with kids in the room.

Today in small group, I played the role of pediatric resident as we ran a mock code that involved resuscitating an infant in respiratory distress. Although our infant was a stuffed gold and yellow tiger, we walked through the crucial steps required in managing the ABC's- airway, breathing and circulation, a task that awaits us in the wards.

Tomorrow, my doctoring group and I will be presenting an autopsy case about a 63 y/o female who suffered a myocardial infarct with a mysterious liver problem. We examined her gross specimens that had been stuffed in a white plastic bucket, including her heart, liver, spleen, lungs and GI tract, along with histology slides. As we pieced the organs together, we worked through a long differential to put together her medical story. I'll be sharing the liver part of her story.

On Monday, I helped teach instrument ties and suturing to first year medical student during the surgical skills elective. I also learned the horizontal mattress and this new suturing technique. It was so nice to finally work with my hands for a change.

The week has been extremely busy. My mind is definitely on overdrive (in a good way). I've squeezed in some board studying when I can, but I must admit there has really been no time. We all feel overextended. As we think about the boards, we simultaneously studying for lecture and ranking our program choices for our clerkships.

All in all, I look forward to the weekend. Although, I already know what I'll be doing...

There a break for some in site. Prom 2.0 will be held tomorrow night at the Academy of Sciences with an open bar. The oversold event promises to be even better than Prom 1.0. I have opted out of attending the festivities. Guess, I won't be breaking any hearts tomorrow.