Interview!

Well I got my first-ever med school interview today!

Right here! WAHOO

Unfortuantely it's on a wednesday that happens to be the one day off in a week of finals on Mon, Tues, Thurs, and Fri.

The icing, scraped OFF the cake. :-P

But it's an interview! So I shouldn't complain.

Also my brain is FRIED with a capital F-R-I-E-D from the physio test I took this morning...which is making it exceedingly difficult to study for biochem...which is tomorrow. Which I really REALLY should be doing but my brain is seriously in a huge fog. I tried watching TV, doing nothing, napping...none of it seems to work, all I want to do is NOT study. baaaaaaaah.

Hence this blog post.

The stress is building up because I know there's still a lot I need to study, but my brain is behind a very thick heavy curtain and it is having the WORST time finding its way out.

ok. I'm going to go for attempt 5 to study biochem. *sigh*

Oh hi there.

Can we say "seriously slacking"? Why yes we can.

So last time I wrote it was the end of block one....

and now we're about halfway through block 2.

this block is physiology and biochemistry...and since I am now taking 2 classes, the full med-student load, I have more than doubled my class time since last block. I have lecture every day from 9am-12am, lunch 12-1, and lecture from 1-2 or 1-3 depending on the day. Once or twice a week we have a conference or a lab from 1-3...so by the time I get back to my room every day I'm exhausted but I have to get right to work to avoid falling behind.

Hence my not writing. Because I'm not a person who feels particularly less-stressed after "expressing myself through writing" and so this blog takes time with no release, the way facebook and catching up on TV feels like my brain has relaxed a little.

This block's been really interesting...we went through all the metabolism of carbohydrates, and now fats, vitamins, and we're starting proteins...it's interesting because I don't have to memorize it. In undergrad that's all we did. We'd have test questions that would be like "draw out the (10 step) pathway of glycolysis including the structure of each molecule and the name of the enzyme that catalyzes each reaction" and it was zero understanding necessary. But now the professors are like "don't memorize this structure- I want you to understand that the body is trying to make this into this, and lets think about what would make sense for us to do in order to get there"

BECAUSE THE BODY MAKES SO MUCH SENSE!!!

In physiology we talked about respiration for like 2 weeks. Learned all about the lungs and how you breathe and how you regular your breathing and what happens in different lung diseases and how the body tries to compensate...awesome stuff. And everything is so perfectly logical. This block is the cardiovascular system, which I was in love with before and it hasn't disappointed me.

It's beautiful.

Incredibly complicated, but beautiful. I feel like we have a lecture and we learn something, and instead of learning thing linearly, we're learning in circles, and we keep drawing bigger and bigger circles around what we know...so that we keep talking about the same things but slightly more in depth each day. Which is really hard to do in a short time before you've had time to process the inside circle. But when I read a lecture from a few days ago, having at least a basic understanding of all the stuff I've learned in between, it makes that old lecture make a looot more sense. So it all works out I guess.

we had our first set of tests right before Christmas break, and then we started again Jan 3rd. 2nd set of exams is February 2nd, and then March 16, and then this block is OVER and we're back to only having one class, which is going to feel like a piece of heaven.

I've never studied so much in my life. I've never felt like I had to. I've never been so far behind while also knowing that just about everyone else was farther behind than me or at the same level.

This block I'm definitely just trying to truck along. I think I am less stressed about being behind than I was for the first exam set...which might be bad because I'm less likely to focus in and be really efficient that way..but that's life.

For example today I accidentally slept until 2pm. I didn't even go to bed that late! It was like 2...which I frequently do when I have to get up at 8 the next morning. I guess my body decided it was going to catch up.

I feel like this has been all over the place, so I'm just going to stop here.

Block 1 grades and old home videos

Grades are back!

Grades are great!

Might actually get into medical school this time!

I got an A in both histo and biostats (there is no A+) and above the medical student mean on everything that was graded. We took a nationalized test that I got a 94% on...a 90% is the 97th percentile so I am quite pleased with myself. My dad said "When you apply schools are trying to guess how you are going to do in medical school but now they have proof that you can do well" so yey for that.

Also, I've been watching a LOT of old home videos over the past couple of days and it is SO interesting to me...watching my parents with their same personalities as they have now interacting with me when I had no CLUE what their personalities were...hearing all the random background conversations between my aunts and uncles...watching Emmy be the big sister and showing me how to do stuff....some gold nuggets:

5-year old Emmy running up to my mom who was pregnant with Thomas and saying "Mommy when the baby comes out of your belly I'm going to grab its head and dance with it!"

My first day of preschool I did NOT want to go, Mom says "well we are going" and I said to her "well I am going to punch you in the belly" (she was NOT pregnant!) haha. So many things I'd forgotten...so many toys I remember having years later...so many toys I thought were Emmy's because she TOLD ME THEY WERE but I watched myself open them for my first birthday...haha.

It's also awesome seeing the house as I don't remember it...when we first moved in and tere wasn't even a second story, and when the kitchen was this tiny little thing stuffed with an enormous amount of stuff...and then as I do remember it- with the upstairs playroom and that weird blue flowery linoleum on the kitchen floor. I can see elements of my current self in my 4-year old self, and same with Emmy. It's just a very interesting thing.

So now I'm on break until thanksgiving. I havent done anything I was planning on doing yet...things keep happening! Eventually I will get around to pre-studying some biochem and physio, but for now I have to go downstairs and stain a billion pieces of molding for the door frames upstairs. things that should have been done 10 years ago when we put the extension on the house...but we are nothing if not procrastinators in this family (except of course Mommy).

Finals Week and the NBME!

So Monday and Tuesday I have things that are sort of like finals.

Monday is my histology exam #3, which is "cumulative" in that it "builds on what you've learned already" but not actually cumulative in that I don't have to remember the detail-y details from earlier in the year.

(As a side note, I HATE when professors give that speech about everything being cumulative because it builds. When I ask if a test is cumulative or not, I want to know if there will be specific questions on already-tested material or not. Maybe they do it on purpose so nobody can come up and say "but you said this wouldn't be on the test!" when really basic things are required as background)

anyway. That's Monday. Morning: Go sit in the lab with my microscope, get 10 slides with "unknown" tissue on them. Identify (just for myself) what each slide is and then answer a bunch of multiple choice questions like "On which slide would you find Brunner's Glands?"

Then a professor comes in and gives everyone a piece of paper with (the same) three things on it, and we have to find it, stick the microscope pointer on it, and call him over to check if we got it right.

Afternoon we take a long multiple choice test.

THEN TUESDAY is the part I'm slightly concerned about...the NMBE Histology (National board of medical examiners, or something) It's a standardized test which means I have no idea what the questions are going to be like or IF I WILL HAVE BEEN TAUGHT WHAT IS ON IT!

we just sort of have to hope we know enough to do well on it.

I have this book that's supposed to be a review for it and I'm looking at these questions going "Ihave never heard of this before. I was never taught that. what are they talking about??" and then they give you questions that go on and on about this 14-month old having lower respiratory tract infections and diarrhea and his mom used to have that when she was little and here's the lab tests they did, here are the results, here are normal values, it's probably involved with this protein that bla bla bla interacts with the negative charge on the cell membrane. What is responsible for the negative charge on the cell membrane?

Which is an easy question but you have to sift through a NOVEL to get to the question.

So here I am sitting on my bed reading through this book fa-reaking out so I decided to go complain to one of my roommates and her friend, who are 2nd years. Best idea ever, because they told me that's a typical question, just skip to the end and read the last sentence, you will never have to know the other stuff... and this particular book I have is known to be harder than the actual test, just go through it and if you're able to eliminate some of the answers and get a couple right you will be okay because the actual test is much easier.

So now I am okay.

Plus they had chocolate that someone probably stole from a small child's Halloween stash (how else do you explain a 24 year old guy with a candy bag with "Skylar" written on it?? :-P) so that made me feel better too.

Then I made coffee (also good) and decided I'm going to order myself Thai food tonight (win again!) so this day just keeps getting better. Also it was SO nice and warm today I shut the heat off and opened all the windows. This is how I know Jesus loves me.

Surgery?

So...my original "kind of doctor" i was always going to be was a surgeon.

Then for a while I was like "no...emergency medicine"
Then I would just tell people "either emergency medicine or surgery"

lately I've been feeling almost COMPELLED towards surgery. I don't know why, I've just heard a lot about it recently, a bunch of little reasons I can't really enumerate just make me lean towards surgery.
I've decided that though residency may be longer and more difficult, post-residency lifestyle has a much greater potential to be more lifestyle-friendly.  I've decided I would never get sick of cutting people open but I might get sick of the really stupid things people sometimes come into the ER for. And the thing I like most about the ER is trauma...and if you want to do trauma, you have to be a surgeon.  Yesterday I found a new blog by a surgeon who has done several short trips to mission hospitals with doctors without borders (or "Medicens sans frontieres" as they're called in the rest of the world) and just had awesome stories about doing surgery there. You make an much more radical and much more instant change in someone's life when you operate.

So right now I'm on a surgery kick.
For this week at least.

It's a good thing I have a long time before I have to decide, and that I will get to spend a while pretending to be each during med school so I can make an educated decision. Reminding myself of that is the only way I can silence my "i need to know EVERYTHING" brain whenever it decides its time to hash out all the pros and cons.

The problem is I can't even decide whether some things are a pro or a con. I also can't decide which specialty has a better *insert any number of characteristics here*. I am fully capable of convincing myself of whichever one I want to be convinced of this week, only to dismiss all that and be gung-ho towards the other a few days later. Then next month I'm back where I was before.

I think my brain keeps doing that because it thinks it's fun. I honestly think it enjoys this back-and-forth...because this thought process inevitably sends me to the internet looking for blogs or articles or whatever, on surgery or EM and my brain LOVES reading that stuff.

And so I enable it. Because my brain is me, and so I love reading that stuff too.

Alarming

My waking-up-in-the-morning skills are...sporadic at best.

Most days I'm fine....hit snooze a couple of times, eventually drag my still-tired self out of bed.

Many, many...MANY times I've tried to come up with more creative ways to wake myself up.

I've done the "put the alarm across the room" thing...but that just results in waking up, grabbing my phone, hitting snooze, and taking it back into the bed with me.

I set multiple alarms for a few minutes apart, but I get confused by which one is going off and which one has already gone off, and on more than 1 occasion I've shut both alarms off instead of snoozing and woken up with a start 20 minutes later and had to super-rush to get ready.

This morning, I set an alarm for 8, and one for 8:45. I figured if I accidentally turned off the 8am one, at least the 8:45 one would wake me up and I'd have juuust enough time to rush through getting ready and skip the shower for sticking my head in the sink, and run to class.

Bad plan.

Because when the 8:45 alarm went off (I have no idea what happened to the first one...) I hit snooze, turned it off, got up, took a shower...and THEN looked at the clock to see that my lecture had started 20 minutes ago. In disbelief I checked another clock...and then realized what had happened.

So now I have all this extra time because there's NO WAY I'm gonna be THAT PERSON who shows up a full half hour late to a lecture...I'll just wait for the scribe. (my school has a program where people transcribe all the lectures (minus the "um"s and "okay, so..."s)). Plus it was "the oral cavity" and that's not thaaaat exciting to me. :-P

The extent of Human Knowledge!?

So...last night I was studying for this big test I have on Monday

And I'm looking at diagrams used in the lecture slides...and diagrams in the text book...and they seem to be in conflict. They have different names for what appears to me to be the same thing...and the flow charts seem to disagree on how many steps there should be between point A and B, whether A branches off from B or from C....etc.

So I emailed my professor to ask what I should be taking as the "final authority" and is it even important in this case to know that level of detail and the answer he gave me was the exact answer I was hoping for- just focus on this and ignore that because we haven't really worked out how it actually happens yet.

Which brings me to the actual point of this thought train I'm having.

I'm learning stuff that is actually the extent of human knowledge in this field.

In high school bio, they'd be like "yeah...this is glycolysis" and they would draw a circle, and say "but you don't have to know anything except that it breaks down glucose and gives you energy"

We didn't have to know that because it was too complicated for the scope of the class.

Now, the things we don't have to know have nothing to do with being too complicated- in biochem we will have to draw out the whole process of glycolysis and know the craziest amount of detail about it, for sure.

But now, the things we don't have to know are because NOBODY knows them.

And that is really strange!

My whole life I've taken for granted the fact that we just know these things. My older professors will tell me about how when they studied this stuff we didn't know this, this, and this, which seem so basic to understanding biology to me. But really, there's a lot of stuff recently discovered, and there's a lot of stuff yet to be discovered. So it's really weird being in a class and having a professor of cell biology from a medical school tell you "you don't really have to know this, because nobody really knows how it works. People are working on figuring it out." Crazy. But Awesome.

La de dumm

Well.

I'm procrastinating.

Today has officially been labeled a non-productive day, and I guess my brain has a hard time becoming productive in the afternoon/evening if it hasn't been so during the day.

This morning I woke up at 1:00pm, because...I could.

I got up, read this case study about cholera outbreaks during the victorian era and went to class to talk about said case study...where the TA gave us all the answers off her answer sheet, basically. So...I don't know why we have to bother doing it now, since they know that we all know the answers.

but whatever.

Then I came home and was mildly productive and cooked dinner...I had chicken francese (store-bought...mine is several times better!!) and made green beans roasted with garlic and bread crumbs in a little bit of olive oil. YUM.

Then I really didn't feel like doing any work so I washed a large amount of the caked-on goop off the various removable parts of the stove top.

Then I went to the first CMDA (christian medical dental association) meeting, which was about 15 people. It was good...they put this huge emphasis on being short and not making people feel pressured to spend more than 45 minutes there because we're all busy, etc etc.....but I didn't really like that because the whole point of me going there is to sort of relax and hang out with people and have a Bible study...and as soon as they finished today everyone sort of got up and left within 1 minute.

so i hope that as people get to know each other better, or on a day we do an actual Bible study instead of just mostly introductory stuff, that people hang out more.

We had our first exam on Tuesday, and I was stressing out because my cousins were here all weekend and I had to figure out how to do the family time and do the study time...enough study time to do well but not so much that I missed out on family time.

I guess it worked out because I got 1.5 standard deviations above the mean. Wahoo!

I haven't been going to anatomy lectures recently because of the histo test, and they've been stuff that's relatively uninteresting to me...but starting next week they're getting back into things like (My heart literally skipped a beat when I saw this) "Clinical Correlations of Blunt and Penetrating Trauma"

AAAAAAAAAAAAAH!!!!! I CANNOT WAIT FOR THAT!!

and then they get into anatomy of the limbs and the musculature of the back and all that sort of stuff that I L-O-V-E.

Yesterday we had out first flag football game...I'm on a team called the rectus abdominators ( as in, rectus abdominus + dominators- love it!) and we played against this team of 2nd years that had two sets of people...they actually had a defensive and offensive team. And a girl who could throw ( = you get double points if a girl throws or catches a pass that scores a touchdown, or the extra points). My team had never played together before...so needless to say we lost, but not as bad as we could have.

PLUS it was POURING rain the whole time and everyone was sliding all over the place and soaked and muddy but it was a lot of fun.

Now I am sore and we've got another game tomorrow...probably also in the rain. So that's exciting.

ok. That is all. I am going to read about "Formation of Blood Cells (Hemopoiesis)(Hematopoiesis)"

(personally, I'm partial to "hematopoiesis", I think I just like words with more syllables.)

The beginning of the masters

Well everyone who was reading this knows I got home safely...otherwise you'd have heard that I died.

So there was supposed to be another last blog post about my last couple of days in Kenya in which I visited Nairobi Gospel center and all those people who I met in 2005 but i kept putting it off and now it's been so long I don'tthink it matters anymore.

It was good to be home.

It's still good to be home.

I am STILL waiting for some sort of culture shock-related experience to hit me...but it'snot happening. I think my brain has COMPLETELY separated the Africa experience from the America experience and there's NO crossover between the two. I remember Kenya like I remember a dream- vividly, but with some high level of disconnect.

When i got home my brain thought no time at all had passed. I asked Emmy why she was going back to the cardiologist so soon after her last appointment...when it had actually been a year, just like it was supposed to be.

and weird things like that.

So I spent some time at home, visited Ohio and the cousins there, we had a party at my house,...my dad and brother went to Haiti for a week to do construction-stuff...and then basically I started school!

So I'm doing a masters of biomedical science. Which involves taking some but not all of the first-year med school courses.

So I'm taking histology and biostatistics, and the med students are taking that plus anatomy and embryology.

My roommate and I have been going to the anatomy lectures because anatomy is AWESOME as well as the "foundations of clinical medicine" and radiology lectures. So whatever head start this program was supposed to give me, I'm multiplying it.

I LOVE what I'm learning. I spend all day, every day studying, basically...and I don't ever get bored. I put more time into histology now than I used to put into my whole courseload, it feels like. So I'd better get a good grade in this class!

and i expect I will.

When i started writing this post 5 hours ago before I was rudely interrupted by a lab group meeting and biostatistics class, I was going to write about the particular things that I'd found fascinating but now I've lost my motivation to do that and I'm just gonna go to the gym. I'll write about that stuff sometime soon..in theory.

In which I narrowly miss a nasty virus, and climb a volcano

Well once again I’ve been slacking…sorry.

We left off after we arrived in Laisamis. We did the clinic there in this awesome site that solved all of our crowding problems. There was some building that had a yard with a fence. So we set up registration right inside the gate and had perfect control over how many people came in and therefore avoided all crowding all day long. Perfect. :-D So the doctors got to sit on cushioned chairs inside a somewhat cool building instead of those fold-out canvas stools so that was nice. Our pharmacy was a tent with a few sheets used for walls to keep out the sun and prying eyes, since we were right next to the fence and kids like to congregate there. But we hid behind the sheets and had a very nice day dispensing meds with Joseph translating for us. We had an awesome system going for a while. The meds were all on tables in a U shape and Chrissy and I were sitting close to the corners and we decided we would fill all the prescriptions without standing up. It worked quote well for a few minutes. I would get the papers from the runner, and call out the drugs…whoever was closest would grab it and then I’d toss the pile on the table for Joseph. Perfect. J

When we were packing everything up that afternoon one of the Australian girls was trying on the giant necklace-thing that the Rendille wear so we all went over and were taking pictures. It was much harder getting it onto a mzungu head than the Rendille, they had so much extra room and the three of us that tried it on all had the worst time doing it. They tried to put it on me next and 3 people spent 3 minutes pulling it onm pulling my hair and skin around trying to slip it over my head and finally gave up. It hung around my forehead like a visor for a minute, then I gave it one tug and pop, it fell down around my neck. Ha!

That night, the terror began.
Alicia wasn’t feeling well so she didn’t eat dinner. Danny brought out a cooler from the car that had not been opened since we’d left Sunday morning. It had ICE COLD water and coke and diet coke in it. We all jumped on THAT let me tell you! Then Alicia started throwing up. Then the doctors decided she could use an injection of an anti-nausea medicine…but that didn’t help because she was still throwing up all night, and I heard it because my tent was right next to hers. By the time we went to bed her tent-mate was also sick. The next morning I found out that Chrissy and James, one of the Australians, had also been sick all night. So we had 4 people losing the contents of their GI tracts from both ends. We ha been planning on doing a half day of clinic, but because of the sickness we debated doing a ¼ day or not doing it at all…we ended up deciding to let in 200 patients and then stop. So we were missing half the team…that made it interesting. Alicia and Chrissy and I had been doing the pharmacy and now I was the only one left…so Lisa switched over from triage and together we did the pharmacy.

Everything is so much more stressful when you’re in charge.
The other days we’d unpack boxes and boxes from the car and we’d all say “Chrissy, where do you want this?” and she’d tell us. NOW everyone was asking “Danielle, where do you want this?” and I said “I DON’T KNOW ASK CHRISSY!” but Chrissy was back at the camp trying to keep her insides inside her.
Somehow through the grace of God we managed to get through the day.
No thanks to Dr. James, who sent me like 400 special orders (most of the drugs are already packed in little baggies with the dosage written on them, so we just grab a bag for each patient…but sometimes the doctors change the number of days, or times per day, or something…which jus t takes a lot more time) despite the giant pile of papers we had to get through, he also sent someone to me saying he needed the drugs for these three people now, so he could explain the dosing to them. Ok. I take the sheets and tol the guy to go back and tell James I was gonna kill him. He had like 4 months of twice daily 4 different drugs that we HAPPEN to not have any pre-packed…for EACH PERSON…I had to empty out a box to fit all the drugs he wanted. All the while stressing out at the huge pile of papers I felt personally responsible for handling!
So when we were done and the doctors came out, I chased him around the yard hitting him with my water bottle. It felt good.
We packed up all the drugs…and then unpacked half of them because one of the pastors left her cell phone inside one of the bins….i don’t know HOW that happened.
Eventually we got back to camp and loaded up the cars and high-tailed it home. Because everyone was miiiiiserable.
A couple of hours outside Nairobi Lisa and I were beginning to notice that Danny looked like he was trying really hard not to be the 5^th victim of the mystery disease…and he did quite well until about 1 hour outside Nairobi, when he pulled the car over into the median…which isn’t like medians in the US where there’s just grass and sometimes trees and bushes…this median was dirt and might as well have been an extra lane for all the cars that were driving in it. So it was a bit dangerous but the only option, as he jammed on the breaks, opened the door, stuck his head out with his foot still on the break and emptied his stomach on the ground. In between throwing up he yelled back into the car “Is the car in park?” It was.
After that we managed to get home without incident, we all crawled into bed almost immediately. I spent that whole day and night terrified I was going to get sick…every burp and every tiny rumble of my stomach made me paranoid that I was gonna be next but somehow I never got sick, thank you Jesus.

So that was the trip into the desert! The Australians all went on a safari after that, they were feeling better by the halfway point of our trip so I trust they had a pleasant safari.
We spent the next couple of days recuperating, being lazy, etc.

One day I went with some of the kids to a “water park” in the local shopping plaza…it had a bunch of slides but they were so slow it was quite easy to come to a complete stop in the middle….one of them I spent the whole time propelling myself down the slide with my hands. We tried walking up them because it was so easy to do and almost more fun than climbing down but we got in trouble so that had to stop. :-P

Friday we went to Mount Longonot- a volcano in the rift valley. We stopped in Limuru along the way to pick something up from the clinic so I said hi to all my old friends there. Then we drove to the volcano and spent an hour and a half climbing it.
MY GOODNESS. It was a ROUGH climb. It was really steep…and at 8000ft there’s not too much oxygen in the air…or at least that’s what I told myself as an excuse for my constant out-of-breath-ness. But if was GORGEOUS the whole way up, we even saw some giraffes wandering around on the way up. When you get to the top you’re exhausted and hot and yucky but the crater is beautiful and full of grass and the rim goes up in and out of the clouds and the breeze hits you and it smells so perfect and clean and misty it’s refreshing and just beautiful.
We were too exhausted to walk for another half hour around the rim so we sat for a little, ate a snack and went back down.

Going down was almost as bad as going up…because the same muscles that you’ve fatigued by making them pull you up the mountain need to lock every step you take when you walk down. So…it took less energy but it was just as tiring somehow. We were thinking it would be nice to have a sled so we could just slide down the side of the mountain but no such luck.
We made it down finally and then drove to Naivasha to drop off the things we’d picked up from the Limuru clinic, so I got to see my old friends there too. Unfortunately the kids were all at school, but I went and found Nancy and she was SHOCKED out of her mind to see me, and very excited, so that was nice. J
Then we went home and were crazy sore by the end of the day.

This is getting long…I might write another tomorrow or I might leave it until I get HOME because TOMORROW NIGHT I AM GETTING ON A PLANE TO GO HOME!!! !I AM SO EXCIIIIIIIIIIITED!!!
I am going to miss Kenya and all the people I’ve become friends with…a LOT. But right now I am just super ecstatic to give my family and friends giant squishing hugs! And eat some really fantastic food. :-D