Internal Medicine:

Or how I stopped dithering and learned to love the nerds...

I decided on Internal Medicine after my third year of medical school rotating through each of the different specialties.  At some point or another I thought about doing all of them (except surgery those folks are crazy).  And I actually ended up with something that is pretty narrowly focused instead of Med-Peds or Family Medicine.  My favorite part about internal medicine is how nerdy everyone is and it is not a bad thing...in fact there is so much respect for the crazy smart that are also a little too enthusiastic about learning at the same time.  You also need a little swagger because medicine residents respond to codes.  I mean obviously they aren't trauma surgeons but you gotta do some procedures on the fly...intubate, central lines or in the words of Dr. Fearrington "hook 'em up to the house current."  Probably more on that choice later but here are my nuggets of wisdom for medical students:

1.  No one really cares where you are.  You can get away with not being present but I spent a lot of my time thinking I was being missed when I was attending legitimate meetings or going to class.  Eventually, I realized no one was looking for me...conveniently about the time I had surgery rotation.

2.  Medical Student advice for a code situation: Codes are crowded at the beginning but the crowd thins out eventually so stick around and learn as they go through all that they can do.

step 1: put on gloves

step 2: wait around until people doing chest compressions get tired (only people probably going to do this job are students or nursing assistants) and they really might need you

step 3: YOUR TURN! Don't be scared just put your hands on there and go to town just like they taught you

step 4: Breathe while doing compressions. It is hard to remember.

step 5: stop when you become less effective..there should be more people to help out

step 6: if they make it...rejoice (I haven't personally seen that happen yet) but if they don't you can take a moment to be shocked and mourn...a code is a crazy thing to be a part of.

3.  Study.  What do you think this is? Dental school? (j/k the dental students seem very nice and probably stressed out at times)

New posts will have more pictures as I start 4th year and the slide toward finding out where to go to residency!

love.

This is why you had to sit in the hall in Elementary school

First of all, this past weekend I survived the tornadoes of Eastern NC but it was far scarier than all the tornado drills of elementary school made it out to be. I mean it was the mountains, I didn't realize it was a real risk.
So, I went to the Roller Derby in Raleigh at Dorton Arena. Which is awesome in the first place. But then! They came over the PA and said "Usually we start the derby with this air raid sound but we aren't going to use it this time. If you hear it please exit and go underneath the stadium" I thought there was no way this would happen. But 4 jams into the derby the air raid horn goes off and everyone kind of scrambles down into the tunnels below Dorton Arena. We are just hanging out. I am excited because the Rollergirls are rolling around like "among the people" which I think is awesome. But then they come through and say "When we say GET DOWN, face the wall and cover your head with your hands." Again I didn't think it would actually happen but then we heard it echo down the tunnel to "Get Down!" Babies start crying, someone seems like they might have a panic attack. And then this gush of water comes through the ceiling like feet from us. We scramble up the slope of the tunnels. Eventually everyone starts to relax because you can only sit in such an uncomfortable position and be in fear for your life for so long...maybe 5 minutes tops.
Eventually we get to go back up and watch the best roller derby I have ever seen! Carolina Rollergirls win!


Studying over Easter break..mostly looking at weird skin pictures because I have dermatology right now. Wish me luck!

A peek into next year

So, yesterday some of the third year medical students came to tell us how things are next year. Provided we pass our giant Step 1 exam and generally keep our sanity through the end of the year. We have 6 rotations each lasting 2 months and here is a summary of what was said:

If you like standing up all day and talking in front of patients and people who know way more than you then Internal Medicine is the specialty for you. Show up every single day. Yes that means weekends rounding at 8:30. (Well since we aren't really that useful we do get 5 days off...)= Please no weddings March and April next year.

If you like getting outside your comfort zone and trying procedures on patients because you are the only hospital for 100 miles then Family Medicine is for you! Away rotations and a lot of worksheets make this one fun for everyone who likes not sleeping in their own bed.

If you like asking women if they mind you messing around in places that most strangers DO NOT get to mess around in Obstetrics and Gynecology is for you! 7 days of "night float" is good for the night owls, 12 hour days for anyone who likes coaching women through pain.

If you like having the strangest stories at the cocktail party Psychiatry is for you. The crazier the better you say? You have your calling.

If you like nice people that smile a lot and you like to smile a lot it seems like Pediatrics is for you. Bow ties and more relaxed dress code seems to be the best.

If you like the hours of 3:30-5:30 AM and reading frantically the patient history before you spend a couple hours holding their organs then surgery is definitely for you. Tips given by experienced third years: Don't lie to the attendings and always looking at the wound. 8 weeks of gaping wounds.

This is all pretty much in jest. I am actually very excited about next year, all of it sounds amazing. So, excited in fact that it is difficult for me to keep focused on looking at power points for 8 hours a day which is what I do most of the time.

A week in the mountains

I was home this week in Waynesville shadowing at a family practice. Lessons from the week are these:
1) I have learned something in the last 2 years. BUT I have much more to learn. Especially that no one uses the generic names of drugs. And that drugs are VERY important to the arsenal of what doctors can do.

2) Saw some cool physical findings, which is exciting to me because most of the time we only see "normal" so, finding something good means it is worth it to try and examine every patient. Tough things were heart murmurs and some lung rales. However I got a good look at interesting eardrums-scarred, full of nasty pus etc. Also saw a couple cool procedures chopping off skin cancers and lancing a cyst.

3) Loved the variety of people we got to see. People with lots of education, people with only a little education, poor people, wealthy people. People I knew, people I didn't know. It was great to wade into every room and expect something different but also to get to talk to very different people.

4) Got to toughen up for a final push of studying for my Boards during the summer (June 15th)

Picture from Ecuador mountains looking over the jungle but enjoyed the mountains of WNC this week!

Off the Map? Off the Mark

Hey guys,

Dad encouraged me to keep writing on my blog here in case people are still interested in what people who look at power points 7 hours a day do with their lives.

I thought I would start with the new ABC Show


Off the Map

I watched the pilot and have refused to watch since. It presumably takes place in the jungle of South America. Having been there for awhile it is of course beautiful but I was so disappointed in how they portrayed American doctors.
A) NONE of the new american doctors spoke Spanish. Every doctor I interacted with in Ecuador spoke Spanish. You cannot be a doctor if you can't talk to people and at least understand a little bit about the culture. These people they brought in were idiots. We are taught to fit our medicine to the culture of our patients and that sometimes culture is a much stronger influence on health than we ever will be. Why are they not at least TRYING to learn Spanish?

B) They don't NEED to be there. The governments of these countries have outposts into the jungle. Far better than any Americans could decide to do it. There is a health system there. They don't have everything that we have but they don't have to chop down coconuts to make a saline solution. So while they do need supplies they most certainly do not need doctors who don't understand the language or the culture.

That is my rant on Off the Map. I do continue to watch Grey's Anatomy...I mean after this long I am just getting old and can't bear to let it go.

I also study...but more on cool diseases later.
Let me know if you want to keep hearing about medical school!

Back in the USA

Thanks so much for reading along. I made it back to the US and I am very glad that everything is in English and I can drink water from the tap. I had some delicious Mexican and Italian food already. I will update some blog posts with better pictures and video once I settle back in and start organizing.

Hopefully I will see most of you soon to let you know in person all of the amazing stories that happened along the way.

Mud Colors

I feel like today was Get Back Day up at trail. We went on a long hike into the jungle and did not have any amenities like showers or beds and then today we did a long hike back out. I could seriously taste the lunch chocolate chip cookies during the whole hike. It was a lot longer than our get back hikes usually are. Definitely took a triumphant mud splattered photo once we returned.

These people live literally a 5 hour HARD hike into the jungle. The trail isn't exactly maintained (there were a couple bridges) so it is just a giant mud slide basically. I learned a lot about mud this week. There are many many different kinds. First, there are different colors: white, orange, brown then more interesting like green, purple and pink. There is mud that supports your weight even when you step down hard. There is mud that sucks in your boot and doesn't let you out. (I often felt like the poor horse in the beginning of The Neverending Story...ATREYU!!!) There is mud that clings to your boot so that you have a cement block to drag behind you. Also a note about the jungle boots (they are knee high black rubber boots= do not breathe and smelly feet) but they are pretty much the national shoe of Ecuador everyone in the jungle has them.

So, the cool stuff I did in the jungle. Learned about medicinal plants. One flower numbed your tongue if you nibbled on it a little bit! Then others are poisonous and are used to kill fish for food or worms under the skin. Another poisonous one that is to be used only for emergencies is for like huge machete cuts or bites to stop bleeding but its leaves are very irritating to the skin. Then another if for snake bites and inside that one lives these lemon ants. And they taste just like little bits of lemon. They were really good. You kind of lick them out of this little pod you crack open on the plant. We also hiked to a waterfall. The kids there LOVED the bouncy balls I brought with me and I got to play Equavolley. Like volleyball but...better. Pictures will come eventually. I am packing to head back to Quito and then home. I will miss my host family very much here but I am excited for some food that does not involve rice or plantains/bananas.