Professionalism

Being in medical school, the term ‘professionalism’ is emphasized, underlined, and capitalized on the very first day. When I first started medical school, that term was so daunting. Professional. Cue in montage of men and women in business suits looking sternly at you with judging professional eyes. Yikes!

No one ever taught me how to be professional in college or in life. Yet somehow I passed their bar for professionalism during the interview process. A true whodathunkit. When used as a noun, to be a ‘professional’ is to simply be an expert at something whether it be medicine, law, baseball, or paper airplanes. But as an adjective, I’ve realized that being ‘professional’ is the grown ups word for the ‘golden rule’ but in a totally serious manner.  To be honest, I still don’t get it but have caught on to this dance. For example, I make sure to say my ‘thank you’s and ‘your welcome’s because being nice is apparently part of being professional. I resist releasing gas in front of my peers because that’ll get you in serious trouble! And don’t even think of murmuring the dean’s full name in the hall ways.

Seriously though, just be  nice, courteous, and don’t touch your patients ‘that way’ and that should get you through at least third year!

First Aid

When mentioning the words ‘first aid’, a lay person would think a box or bag full of bandages, gauze, alcoholic in emergency situations. Well the ‘first aid’ to medical students is for an emergency situation per se, but it’s not boo boo related; it’s the national boards! Help! Whether you’re an MD or DO to be, the ‘First Aid for the USMLE Step 1’ is a must once second year comes around because at the end of it, our basic knowledge of EVERYTHING we’ve learned during our second year is tested. It’s a lot. That’s why there are hundreds of resources out there that willingly take our money…I mean…offer us help in battling this beast called boards.

Let’s talk money for a moment. Below is the amount of money I’ve spent on board related expenses:

2009 First Aid: $31.46

USMLE Step 1: $495

COMLEX Part 1: $465

USMLE World Qbank 60 days: $135

Used BRS Physiology: $10

Rapid Review Pathology: $35.05

Used Kaplan COMLEX review books: $85

Losing your social life for more than a month of so:  %&#(@#*#!!!!!!

So, we’ve accepted it reluctantly. We’ll just take out another loan to pay for this and the large amount of coffee and caffeine to sustain ourselves.  No big deal. Now comes the time to actually go through First Aid and we realize that all this sounds familiar but do we really have to know this detail? The answer is yes and more! Unfortunately, the First Aid doesn’t have it all. So we write on the margins, highlight the whole thing, and tag it to death. By the end, if your First Aid doesn’t look beat up and broken then you’re doing something wrong or you’re very neat and if that’s the case than good for you.

Break

Whether it be Spring, Winter, or Summer Break, after finishing that last final, a medical student is left to wonder of what to do now. See, usually after an exam some medical students would go out, have a drink [See previous post], but still have the next day’s busy schedule buried deep in their subconscious. However, that nagging feeling of responsibility is replaced by this sudden exhilaration and happiness for two whole weeks of freedom that is, ironically, mixed with feelings of confusion as well. Why the confusion? Well, what do we do now that our time is not occupied with studying?!

Medical students refer to life before medical school as our ‘previous life’. During break, we’re forced to remember what we did in our spare time in our previous life. It can be a slow process and require baby steps for some cautious medical stuents that are still under the whiplash of break. But in no time, we readjust our minds towards general relaxation mode.

We enjoy sitting, eating, sleeping, you know the normal things mortals do. We also like to go out to get our daily dose of Vitamin D, but hurry back in as to prevent skin cancer. We’re really paranoid now thanks to our knowledge of diseases. Of course, some medical students are more adventurous than others and actually stay out longer than one hour.

Here’s to break and…hey Judge Judy is still on TV…

Post-Exam Revelry

Have you ever wondered while passing a full bar, why the hell are there people drinking in the middle of the day on a Monday? Wonder no more! It’s 1) alcoholics or 2) students, particularly of the medical variety. There is nothing more beautiful than just taking an exam and having the rest of the day to veg, to catch up on Tivo-ed shows, to wash clothes, to heal relationships, and of course, to party. Who said medical students don’t know how to party? You’d be surprised. After being cooped up in a room for days (you don’t want to know what happens behind those doors), our fried brains seek comfort. Be it ice cream, the gym, video games, or ethanol containing beverages, we want nothing more than to relax our muscles into full brain-dumping mode.

More importantly, what post-exams mean to many of us is catch up on sleep. If possible, we stay up long enough to drive ourselves home, work very hard to not break any traffic laws or hit inanimate objects (Humbling Moment #4), and roll ourselves in sweet sweet bliss. It’s so spectacular! A thing many take for granted! Truly heaven on earth!

Good night America! I just had an exam and I need me a martini with an fluffy pillow on the side.

Laptops

So you’ve been accepted to medical school? Congratulations! Getting accepted to medical school is like getting a huge tax return. You’re excited for all that money you’re getting and you’re ready to buy that nice waffle maker as a treat for yourself! However, you realize that you’ve been paying too much to begin with and feel kind of ripped off. Guess what? That feeling doesn’t go away, and the bad part? You don’t get a tax return. (But of course, you’re getting a medical education which is priceless)

The excessive spending begins with your first purchase of a laptop. The following statement may seem like an exaggeration, but it really isn’t: Without a laptop, you are nothing. A laptop becomes your detached organ of knowledge. There’s no symbiosis here. You just plain need it. You need it to check your email ten times a day. You need it to study powerpoints. You need it to watch recorded lectures. You need it to read online books and review for exams.

A new laptop evokes much excitement from your peers, much like a new baby. We start to crowd around it, take pictures, hold it at night. We are very attached to our laptops. And a broken laptop or a lost laptop is a tragedy. People will offer their condolences and ask if there’s anything they could do. It will hurt every time as every heart break cuts deep. But nothing can replace that knowledge, those memories. Until you get a new one, of course.

(By the way, I wrote this with a laptop. See?!!)

“Diagnosing” Ourselves and the People We Know

Obsessive-Compulsive Disorder, according to the DSM-IV (The big book of psychiatric disorders), defines obsessive as “recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate [ie persistent dread of failing] and that cause marked anxiety or distress [yes and yes]” and compulsive as “the behaviors or mental acts [ie excessive studying and consumption of coffee] are aimed at reducing distress or preventing some dreaded event [dropping out of medical school! Ahh!] or situation.”

The above definition pretty much sums up the average medical student. But that’s aside the point. Really, above is an example of the one in many scenarios in which I’ve found myself diagnosing–myself and the people around me. Learning about psychiatry is really interesting because (1) Psych is kinda interesting, (2) Psych is mysterious, and (3) Psych makes you realize that you and the people you know are really borderline in some psychiatric disorder. Number 3 can be both eye-opening and/or shocking, yet may allow you to understand why a person acts the way he or she does (and that may be more than you’d like to know).

However, it doesn’t stop in psych, through every system that we learn, we find ourselves realizing that one of our family members or friends may have this. “Oh! Uncle Jim totally has urinary incontinence…and now I know why.” Sometimes knowledge can be a dangerous thing. Even our family members and friends start to approach us with medical questions that would usually be socially unacceptable to ask, and it always seems to be related to cancer. “Is this mole cancer?” “My poo has been green, is that cancer?” “I think I have a lump on my breast, can you check if it’s cancer?” What people don’t realize is that–we’re medical students! We’re just walking textbooks that have yet to be molded into competent doctor figurines!

Even so it’s still fun trying to diagnose that mole, poop, and breast lump because we’re all a little narcissistic.

Studying While Working Out

Learning about diseases that could be prevented by lifestyle choices highly motivates some medical students to stay fit while other students resort to the Wii, which by the way hasn’t been found to lower cholesterol, diabetes, or risk of heart attack…yet. However, there’s the issue of not having time since doing absolutely anything else really cuts into studying time. How do we solve this dilemma of working out versus studying? Well, we study while exercising of course!

You’ve probably seen it before at the gym. A person attempting to jog on the treadmill with a gigantic textbook in front of them. I say “attempt” because all the vertical movement makes it quite difficult to focus on the words. To resolve this, one might stabilize oneself by leaning forward onto the treadmill, thus allowing movement in the lower extremities while completely locking one’s back and upper extremities. The problem with this is that we look ridiculous, but we do it anyways because it’s oddly effective. We get our 30 minutes of cardio in while reading roughly two paragraphs, albeit over and over again. But by the end of that 30 minutes, we know those two paragraphs by heart and that’s two paragraphs less to read! Hey anything counts.

So the next time you see someone studying while working out, just hope they don’t trip, fall, and rip their pants right off (Humbling Moment #3). Because I’ve seen it happen before and it’s just sad.

Color-coordinated Notes

Have you ever sat in on a lecture with medical students? If you have, then you must have heard clicking sounds that bothered you for the whole hour. The constant clicking noise that you witnessed was simply an innocent multi-colored pen being switched from one color to the next. Do not be shocked by this unusual act, it is only the medical student’s way of feigning organization as he/she scribbles “know this” and “important” on the side margins of printed powerpoint lectures.

To look at a medical student’s notes is to look into an organized chaos of thoughts. Like our creative mnemonics, we find color-coordinated ways to visually remember the endless capsules of knowledge that float in our mind. Looking at written notes is like looking into insanity and looking at highlighted books is to see the color spectrum sprinkled over the pages in a very specific manner that only the highlighter could understand (ie blue = noun, pink= verb, etc). It’s almost like an art form really, a very nerdy and modern art form if you can appreciate it.

And like the mnemonic there is a dilemma in the coordination as well. Once we take the test, there’s a common mishap of remembering the color of the thing we’re supposed to know, but not remembering that very important slice of knowledge. “I know it’s within the shade of pink that I highlighted in Chapter 4, but what is it!?” It’s amazing how we are able to pinpoint the exact location in the book but fail to remember the contents of that sentence.

So if you ever happen to see a person highlighting almost every word in a book in different colors, just understand that it somehow makes sense and don’t ever ask to borrow a highlighter from this individual.

Coffee

Coffee. What a wonderful discovery. With a couple sips (or cups), a plethora of stimulating synapses occur in the medulla and cortex allowing us to focus on speech and roads. It’s not surprising that medical students would be huge supporters of this dark caffeinated magic. Each of us sport a lovely thermos as an essential accessory and consume coffee in great, possibly unhealthy gulps. All to stay even remotely conscious during our eight in the morning lectures about anti-psychotic drugs.

The lecture is when staying awake becomes an impossible battle between body, mind, and nature. Our body and mind long for the comfort of sleep so much that we’ll be willing to put three chairs together as a makeshift bed in the middle of student commons (Humbling Moment #2). However, we realize that we are indeed in lecture and our levator palpebrae muscles have this tendency to follow gravity. Unfortunately, our drool follows gravity as well.

A John Hopkins scientist claims that coffee is addictive and causes agitation and depression as some withdrawal symptoms. I say withdrawal symptoms can be prevented if you just keep drinking coffee at a steady rate. The use of an IV is recommended before a big exam in this case.

However, if you are indeed an addict and find it hard to kick the habit, there are millions of people just like you! And there’s help out there if you’re wiling to accept your ‘problem.’

Cheers to staying awake America!

Standardized Patient Encounters

When medical students were little seven year olds, we were serious about medicine already. Of course, our parents were full force brain washing us at this point, so were exulted that their brain washing worked when we expressed interested in this profession. So they quickly bought us our first Fisher Price medical kit at the next birthday. We loved to play doctor on all our friends and stuffed animals and insisted that they call us ‘dawcto.’ At that time, toilet paper was the gold standard for all aches and pain. Yes, those were the good ol’ days of playing pretend. Well until we really did follow that path of medicine, and realized that we’ll be able to play pretend all over again in Standardized Patient Encounters!

The Standardized Patient Encounter, or SP, is when medical students get to practice working with ‘patients,’ who are actually paid actors. They throw us in there, hoping that we’ll be able to learn how to do a history, physical, build rapport/trust, make differential diagnoses, and have a plan, all while showing empathy within 15 minutes. We get to play fake doctor to our fake patients within those 15 minutes, but we end up feeling more like beaten raw meat and realizing that we suck at this (Humbling moment #1).

Raw meat or not, we do enjoy SP encounters and here’s why:

• We love wondering what the actors do in real life. We think of them almost like unworldly beings. We’re in shock and wonder when we see them at the Walmart or Albertsons. We especially wonder how much they make for working as an SP and wonder if we could work as an SP as well.
• We enjoy figuring out all the physical exam ‘clue cards’ that help us make the right diagnosis. It’s like playing detective and doctor at the same time and we appreciate that it mimics real life. We especially find it helpful when they give us pictures of what their condition is supposed to look like. “Oh yes, it looks like your leg is swelling” And like any good doctor, you thoroughly exam that leg picture so well that any physician would be proud!
• And lastly, we love getting the right diagnosis (future post)

SP encounters are truly an invaluable resource to all medical students of the world. Call us nostalgic, but we love playing pretend. And you know what they say, “You gotta fake it, till you make it!”