October 27, 2010

Trial by...?

This somewhat follows my previous entry, "Reincarnation."  Intrinsic to the idea of reincarnation is the concept of being born anew on a different plane of existence. It is not simply living another life, but ultimately the goal is to learn something from what had happened before and use this in the next life.

Part of medical school is remaking yourself on a different plane of existence, this time on a different social plane. As a doctor, you are expected to transcend social niceties because it suddenly is your job to worry about someone you've never met's sexual history and practice; suddenly you are remiss if you do not inquire into drug use or marital status or infections previously endured. In a way, this is why we need the socialization and the standards of professionalism written into our curricula: our teachers are there for us to model ourselves after, so that we can learn to properly guard this trust given us by virtue of our position, by virtue of our profession.

There are few other relationships held as sacrosanct as that between a physician and her patient; those that come to mind are lawyer-client and parishioner-priest. In the same way, the physician guards secrets and knowledge and intimacies that even couples do not share with one another.

This was particularly on my mind last week--the things that must remain unspoken after the visit is over, after the examination. In some ways, this is a paradox: the physician should keep careful notes of what she observed, what the patient said, how the patient felt, what findings can be cobbled together to support a diagnosis of the etiology of the complaint. At the same time, however, for the nascent physician--more specifically, the medical student--there are things which are not considered.

I was shadowing a geriatrician last week, and a patient came in complaining of persistent diarrhea. The doctor examined the patient in many typical ways, but he also decided to examine the woman's rectum. He put on a pair of gloves and used a little lubricant to test for the tone of the woman's sphincter, to make sure there was no damage there. He then told me to put on a glove so that I, too, could examine the woman.

I did as he asked.  He squirted a dab of lube on my finger, and I rubbed it around to spread it across my finger.  I gently probed the patient and felt her muscles tighten around my finger.  I quickly withdrew and stripped the glove away.  

Several thoughts went through my mind at once as I was doing this.  First, I was surprised by the willingness of the patient to let me do what the doctor was doing.  Second, I was surprised by the fact that I was able to do this without an outward reaction (with the possible exception of tearing off the cuff of my glove as I was putting it on).  Third, I felt guilty, as if I were violating this woman because I didn't actually know what "normal" would be--so my attempt at the exam was really just me prodding and poking at things I had no knowledge of.  Her trust in me, a medical student, told me more about the position I had come into than anything abstract ever could.

I have yet to tell any of my M1 friends at school about this; many of them have shadowed one or another physician here (lots of them our psychiatry professor who works with veterans).  But somehow, this seems too personal, as if I shouldn't talk about it.  I don't know if that says more about my relationship with my classmates or more about how I feel about the experience.

October 21, 2010

NaNoWriMo = Yes or No?

So there's this website called onepageperday.com.  And I decided to use it and write something every day.  But while exploring the site, I realized that National Novel Writing Month starts on November 1st, and suddenly I have been stricken with a desire to participate.

Hmm.  50,000 words in 30 days?  That's...slightly less than 1700 words a day.  I just wrote an entry for 406 words in about ten or fifteen minutes....so that's not too bad, right? Less than an hour a day...(but biochem! anatomy! development! showering!  All important, time-consuming things...)

Also, I don't know if I have an idea yet.  Maybe I will wait and see if one pops up before November 1st.

October 20, 2010

Reincarnation

Med school is like reincarnation.  Today, as part of our psych education, we had a developmental interview with a classmate's wife and 10 month old baby.  She's still in the phase of exploring the world around her--or really not even quite there yet.  She's looking around, crawling, peeking into places and trying new things, but she's certainly not very secure.

In the shower just now, I realized that as a medical student I'm doing the same thing the baby was doing.  Medicine is like starting a new life as a baby: you have to learn to communicate, to use your senses to decipher what is going on around you, and eventually you work your way up to manipulating your world (i.e. patients) and participating in it.  Especially on my mind was the fact that I will be shadowing a geriatrician tomorrow as part of my mentor class.  I will just be observing--or maybe, he will let me talk to the patients a little.  I probably won't know very much about what is going on with their health conditions, but I hope to learn something while I'm there.  I have my own "toy"--a stethoscope--which I may get to use, but I still don't quite know what I'm listening to.

I was also thinking about what I should wear tomorrow, and it occurred to me that just as a little girl tries on her mother's heels, jewelry, and makeup, so too have I noticed myself observing the unwritten codes of appropriate, professional dress.  The clothes themselves aren't really an issue, but I am definitely curious about shoes.  Men are so lucky, their shoes seem to be for the most part comfortable and serviceable and definitely useful for walking.  Women's shoes are either pretty or useful, but rarely both.  I have a pair of low, sling-back heels that I'll have to wear tomorrow, but honestly they're a little worn and I need to go shoe-shopping.  So, what to buy?  I have already deduced that Dansko shoes are the way to go: neutral colors of classy footwear designed for professionals to wear yet built for standing and walking.

In keeping with the "infant" M1 status, I also learned two suture stitches today.  I feel inordinately proud of myself but at the same time, I still feel a little like I'm pretending.  When does that feeling go away, I wonder?  After your fourth year?  After your intern year?  After residency?

October 19, 2010

Fall shenanigans

Last week was insane.

Five exams in five days--the M2s warned us that block 2 was the hardest, and they were right.  Not that the next two blocks will be that much easier, but there was just so much to know.

On the bright side, I passed all tests and did well on anatomy.  No honors this time around but that's okay.

Friday, we went apple picking in Fond du Lac.*  They also had a corn maze!

Saturday, I chopped a peck of apples and made apple butter all night (well, I didn't really do that much.  The crock pot did all the work).

Saturday night some of my classmates went down to the Chancery.  There was some low-key frivolity but it eventually ramped up into carousing.  There were blue liquids in shot glasses.  I drank a beer with a pickle in it, which was salty and tart and improved the way Miller Lite tasted.  Plus I got to eat the pickle after.

Sunday, I canned the apple butter.  This was exciting.  I've helped my mom can apple butter before--almost every year when I was little up through high school--but I'd never done it all by myself.  Even last year, when the girls and I made apple butter, we just put it in small tupperwares because we knew we'd eat it before it needed to be kept from spoiling.

I did the whole shebang: boiling the jars and lids, emptying them out, filling them with a little head space, then processing them for ten minutes.  I left the jars upside down for a day to help the seal form (I think everything's gone well!  I guess I won't know for a while).

My friend ER came over and we made apple bread/muffins with MORE apples that we had picked on Friday.  It was a pretty apple-tastic day.

I rounded out the weekend with a nice dinner (risotto and a glass of wine), a leisurely bath and plenty of watching Weeds.



*NB: Unlike in Missouri, here in Wisconsin all the French names are actually pronounced somewhat close to their intended pronunciation.  Sure, Wisconsinites tend to say "Prairie du Chien" as if it were "prairie du chine" and "Fond du Lac" as if it were Fond de Lac, but hey! I'm excited they have the nasal sound going on.  I mean, come on, Missouri, we really have a town pronounced "Vur-sails" and spelled Versailles?**

**Using NB for nota bene always makes me think of orgo and dear old Vlad.  Also, I've been using it a lot in my biochem notes recently.

October 10, 2010

10 things about 10/10/10

1. It was unseasonably warm today--80 degrees!
2. I studied in the park and watched highlighter-yellow leaves on the trees.
3. I actually got things done in studying for my week of exams that starts tomorrow.
4. On my way home from the park, I stopped at the Spice House and bought sweet smoked Spanish paprika.
5. I made a delicious curry-roasted cauliflower & yellow split pea soup for dinner.
6. Gomer the cat sat on my lap while I studied and purred at me.
7. I got to sleep in this morning!
8. I've been watching Weeds, which is ridiculously addicting and is impeding my studying a little.
9. I just took a multiple intelligences survey that told me my top three strengths are Musical, Linguistic, and Spatial learning.
10. I am feeling really optimistic with regard to my exams and life this week.

Overall, a good day!