The end of the Renal Era!

For some reason, post-exam workouts are the best, perhaps the optimal therapeutic way to release tension and anxiety. We spend so much time talking about the sympathetic nervous system, which is responsible for activating the “fight or flight” physiological response. We got more of this in renal since there is an intricate interplay between low and high volume states and renal compensation through a sympathetic system mediated response. We learn all the gory details about this carefully controlled mechanism, including what activates the sympathetic nervous system and how your body responds to the signals. I am still amazed when I get to purposefully activate my sympathetic nervous system every time I work out and get my muscles working, heart pumping and lungs ventilating.
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Renal is officially over. Grades have not been officially released, but we work under the assumption that if you failed you would have known by now (via e-mail). I guess no news is good news. So, if you have not heard anything, it probably means you are in the clear. These past few days were like being sucked into an abyss of endless renal exam preparation—reviewing (or learning) everything from nephron physiology to modes of drug action to the electrolyte disorders to kidney diseases and their respective pathologies to treatment of kidney disease to the drugs for hypertension to all the specific nuances of how the kidney functions under volume depletion and volume overloaded states (and this just a short list of things we learned over the last three weeks). Needless to say, it felt like I was eating, breathing, and dreaming everything renal. Now it’s over and I can’t help but feel relieved and exhausted. What a way to culminate our organs block (saving the hardest for last)!
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Despite the challenges associated with decoding the cryptic renal language, learning renal is pivotal to assess patients with chronic conditions. You need to have a basal comprehension of kidney function markers, signs and symptoms when you are assessing patients with hypertension, diabetes, hyperlipidemia and the other chronic conditions we will see in our patients. Before renal, it was difficult to read a set of lab results and understand the significance of important markers such as creatinine, BUN, electrolytes, UA, and CBC . Now I feel like I am equipped with the knowledge to decode these numerical values and see where they fit in painting a picture of a patient’s condition. We have come a long way, haven’t we?It was odd. After I turned my exam in on Wednesday, I was running through my mental planner looking for the next thing “to do” and the next place I needed to be. And to my surprise, I really had nowhere to be. The feeling of having nothing to do is a rare sensation in medical school since we are so used to a rigid and structured schedule. It was so nice to actually be free, even if it is only for a few moments.

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I finally got to reconnect with my classmates outside of class. Lunch was spent sipping green tea and venting about renal with classmates at The Vegetarian. Dinner was another exciting reconnection time with my advisory college at a local Ethiopian restaurant followed by celebrating a classmate’s birthday.
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With the end of renal, we have been graciously given the rest of this week off—our first interblock break. It’s nice to get some time for ourselves. A big chunk of our class will be spending the four days braving the snow, skiing and snowboarding in Tahoe. Others will be staying in the city or heading out to visit family and friends. I am en route to Davis to spend time with family and friends. I think it will be actually nice to get out of the city and enjoy the company of the people closest to me, before lunging back into the seven-week Metabolism and Nutrition Block that starts bright and early on Monday morning.
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With these four days, I am going to work on being more spontaneous with my time (although I do have my share of pre-planned adventures laid out: writing a review of the Diving Bell and Butterfly for the San Francisco Medicine Magazine, contacting professors to find a lab home for the summer, advising pre-med students at my alma mater, and most importantly- spending time with my family and friends). Aside from these events, I look forward to a semi-productive and non-eventful four day vacay!