medical school

it's amazing, the first two years i've been *yawn* w/e when my classmates starting sounding careerist, and now i'm getting totally mercenary about planning my future.

I was just at a Surgery Interest talk thing last night and they were like "honestly it doesn't matter when you do what you're planning to do; any reasonable instructor is going to know that people doing a rotation early are still going to be mostly clueless, and adjust accordingly." And man did I ever need to hear that. (All of the panelists were coincidentally people who did surgery 1st to get it out of the way and then loved it way more than they had expected.)

Most of the awesome docs and fourth years I've ever talked to were just like "Show up, be enthusiastic, work hard, and admit when you don't know what you're doing", whereas most of the people who are like "behold my secret formula" were kinda douchebags. Hopefully that means something.

that IS reassuring tbh.

Also I would assume your disinterest in studying for GI is because it is SO BORING. At least the pathology, anyway. I think we are going to get some lectures on parasites in the next couple days and hopefully that will make up for all the pathology.

I kinda like GI???

Basically the digestive and reproductive systems are only interesting to me as sources of metabolic and hormonal imbalances, so from like the diaphragm to the pelvis I just kind of endure it. (Although I guess the adrenals and a lot of the spine are also in that space, and I do enjoy the adrenals and the spine.)

ok i am in small group and all we're talking about is farts, it's hilarious

LOL, in his efforts to make sure N. and I never went to med school, N's dad was extremely fond of playing an old reel-to-reel tape from 1949's International Crepitation Competition.

Maybe the U of M has a copy?

aaaaaand apparently someone did a study here (that got published in NEJM) to investigate why we have floaters.

as in poop floaters?

yup

CW was that they were fatty/oily, apparently they are full of air!

BOAK well then, that lamb curry can wait...

99 POOP BALLOONS

to add to the list of med school band names:

TOXIC MEGACOLON

I would listen to a band called Volvulus, unless they were prog-rock.

Additionally, a bunch of my friends play various medical school functions under the name "Palpable Thrill".

oh volvulus is a good one

https://www.youtube.com/watch?v=6ZF9DLwKlb0

wowwwww someone's getting a call from the ~professional standards committee~

There is a really decent chance that two years from now, the schedule will work out today so that the 2012 class Match Day falls on the first day of the NCAA tournament. That will be like the best day.

btw did u kno it is

SPRINK BREANG TWENTY THOUSAND TEN YEARS OLD!???!?!?!!?????!!!!!!

Ugh so jealous! Ours is in a week and a half. I feel that NCAA tournament day 1 + Match Day should be a holiday at all med schools, though. It is such a joyous day! (Except at Vanderbilt, lol @ Murray St)

patient records can pass seamlessly from doctor to specialist to hospital, helping avoid the kind of dangerous slip-ups that cost the lives of an estimated 100,000 people in this country each year.

Are you fucking kidding me? A hundred grand A YEAR??

From NYT.

I think the classic number quoted (from an IOM study in 1999 called To Err is Human) is 98,000 per year, or "a jumbo jet falling out of the sky every day."

I dunno how that number has changed over the past decade or so.

aaaaaaaaaaaaaaaaand peace

went str8 to the gym swam for 90 mins came home bros on the porch drinking bears got sum indian food slept for like two hours listening to graceland going to see a friend dj 2nite fridge is full of beer all the windows are open and the breeze is coming in ~relaxed~

I AM DONE

lamp let's party

dude!!!!! on my 2nd beer already tbqf

wish u were here cuz its a p sweet time but may the next few weeks bring u nothing but happy trails and smoken climber chix ^_^ also u nvr returned my email about that book!!!!

Oh look here is what it looks like when I am envying u guys

Although to be fair today I finished my 2nd of 4 exams for this quarter, then went over to the undergrad campus where they had hella free food and a moon bounce. So today was rad but STILL, now I am back in the library trying to finish the final assignment for our terrible terrible ethics class.

yeah i have had two beers now already, and it is nap time

leaving tomorrow for Devil's Tower, if the weather improves

C-L: that is a bummer, man, hang in there

also wait did you send an email to my ilx acct? it is a dummy :(

*checks*

c-l, ive heard from both med and fellow pharm students that ethics class tends to suck, which is bumming me out cuz I was looking forward to it next semester

anyway 4 finals to go

Yeah at least for me, there are lots of well-meaning educational attempts throughout med school that are just so poorly done that they become incredibly frustrating, and Ethics was the most grossly inept of all. It was esp frustrating since I had the good luck in grad school to see the social sciences and medicine work well together, mostly driven by med anthro dudes who were big about resolving their fieldwork research with the day-to-day of medical practice. And then I got to med school ethics and it was just all absurd hypotheticals and vague platitudes with no takeaway for real life.

I cannot be the only person who wants to spend time during Standardized Patient exams trying to break the 4th wall, right? It is just so tempting to be like "It cannot be very fun to do this all day long for three straight days, can it? I hope they are paying you good." We kinda got to do this with the standardized genital exam patients last month though, which was cool. Apparently once you get over the whole finger-in-butt thing, a prostate exam just feels like someone touching any other part of your body.

In related news, I appear to be very susceptible to dropping the rest of a thorough H&P once I see an opening for potential diagnosis. Especially with standardized exams, where all answers will either be essentially "You have asked a correct question" or "You have asked for information I was not given". Basically once I get on a thread of correct questions it is like a shiny set of keys being jingled in front of me and I forget to be like "So do you have any family history of this issue" or whatever.

oh man I was pretty fast and loose with the fourth wall, esp when it came to doing mental inventories. I would just blatantly sidebar to run thru my checklist for the PE

also just did some major scheduling judo.

med 1
board studying/vacay
anatomy TA
ortho
surg1
peds
peds surg
spring break!!!
EM
fam med
~three weeks of mystery~
OB
away rotation
infectious DZ
med/peds
ultrasound!!
neuro
psych
med 2
intl rotation
...
profit!!

It loses a little something when you take out the giant "I <3 Hot Nurses" profile photo, but I am like 95% sure from the date of this openbook selection that this dude ran into my classmates after we had finished with Shelf exams:
http://i49.tinypic.com/mvt0zm.png

Step 1 studying is the f'ing worst, btw.

To address his claims: A fairly decent number, Yes, Some of them, Sort of.

so here we are, INTERNAL MEDICINE

first night of call tomorrow yaaaaaaaaaay

Dang you guys are already in 3rd year? Congrats!

T minus 8 hours to my Royal College exam. Written tomorrow, OSCE Thursday. Last hurdle after 9 years of medical training.

I'm optimistic.

you are fake

Fake what? It's real optimism. And it better be a real exam, the registration fees were ridiculous.

cool

hey do any of you guys know about the Bohr effect? I've been practicing Buteyko breathing lately and I don't know if it's the placebo effect or what but I feel my energy levels have been upped a bit by not breathing so much. also I went swimming yesterday and got fatigued less easily when I breathed after every third stroke instead of after every stroke.

I know of it, but tbh only as far as it takes to knock out the Hemoglobin curve questions on an exam (acidity and higher temperature and increased DPG concentrations shift the curve right, decreasing hemoglobin's affinity for oxygen! Increased pH and reduced temperature and decreased DPG shift the curve left, increased hemoglobin affinity for oxygen!)

Since increasing pCO2 reduces pH (with a 10 mmHg increase in pCO2 roughly correlating to a 0.08 drop in the pH, until metabolic compensation can retain enough extra bicarbonate to turn the drop into about 0.04ish), and reducing pH increases the dissociation of oxygen from hemoglobin, it makes sense that you'd be distributing oxygen more efficiently, but exactly how much of a difference this makes in a practical sense, I do not know.

(Note, everything in parentheses in this post was primarily written to reinforce knowledge that I should have going into Boards. Using ILX to study is fun!)

similarly, this is why free divers hyperventilate before attempting long dives: blowing off co2 induces a mild alkalosis. your body actually polls the co2 levels in your blood, not the o2 levels, so lowering them by breathing heavily will give you more time before the drive the breath becomes overwhelming. the trade off is that if you blow off TOO much it's possible that you'll pass out from hypoxia underwater before yr brane says "surface now!"