Monday, April 25, 2005

time til end of MSI: about three weeks.

it's been a couple of weeks, so i should definitely update my lame-ass medical blog life:

-this weekend i will be working the medical tent at coachella. i'm doing saturday only, then coming back sunday to just hang out and see some good acts. i figure the big patient complaints will be dehydration and drug ODs, maybe some allergies and asthma attacks. i just hope no one gets really sick, because no one should have to leave coachella for the hospital, mmkay?

-found a place to stay in DC! i can't believe it, but i found it through craigslist. i was a bit weary of putting an ad on there, since i figured i'd get responses from frat boys, pimps and serial killers. but no shit, the person sounds downright normal, and the house looks fantastic. she's a retired doc, and has other lodgers there. i will get a nice big room, and a bathroom to myself, which suits my love of pooping in private.

-we're going to new york for our anniversary! the mr. and i have never been to the east coast, and decided we are both old enough to be fucking losers for not having been to a whole section of our native country. we've been all over europe, yet have never been new york or boston- what the hell is that about? this year, thanks to a gigantic tax refund (single zero and 33 grand in tuition is the only way to fly baby) and one week between my last final and starting at NIH. and here, a word of advice: hire a tax preparer. spend the money! if you think you could possibly get more than $500 back, they are worth their weight in gold. we have friends and family hopefully to put us up, but we're also looking for a cool hotel that isn't 400 a night. although part of me is like "fuck the money! let's stay at hotel gansevoort!" that's the same part that was screaming "woo hoo! his and hers vespas!" when we walked out of the tax preparer's office. but no, we are responsible adults now, and we must pay off debts and be frugal. so, i'm waiting until hotwire gets a little cheaper for that boutique four star in midtown east, which is the W.

anything more i can say? i gotta get dressed for school. we have a group report to do on aromatherapy. i figure we'll just turn in some apple cinnamon candles and nag champa and call it a fucking day.

Monday, April 11, 2005

looks good to me!

neuro is done! what the hell am i supposed to do with my time now?

oh, right. OMM

it's funny how OMM tends to be my least favorite part of school. 2 days a week we have to dress in shorts and sports bras (or no bras for those with penises) and check for somatic dysfunction, aka you done fucked your back/ribs/pelvis. then we try to fix it, using various methods ranging from shit that is basically massage to hardcore neck crackin'. it's the only class we've done straight since last august.

just so you know : i believe i run halfway between "i'm only doing this shit cuz i couldn't get into an MD school" and "oh my god who gives a fuck about biochem? let's find your cranial rhythm!" on the osteopathic student spectrum. some of it is complete bunk, and some of it works really well.

that being said, something that bothers me is how subjective our diagnoses are. although you can't deny that some of us are running around with dysfunctions (i happen to have a massive rib/scapula thing going on right now), it's pretty fucking obvious that there is some fudging going on by the students when we diagnose and then retest after treating. simply put- we move our hands when our hands are suposed to move- "hey look! a positive standing flexion test!" and we don't move our hands when they aren't supposed to move -"hey look! the patient's tranverse processes are equal at T6 after i treated them!"

i see it happening, and feel it when i'm the patient. i have had scoliosis, an anatomical short leg, my entire ribcage stuck down on the left, and too much paravertebral fullness to quantify. i can tell you all of those are bullshit diagnoses, although the short leg somewhat satisfied my desire to be more pirate-like. some things do come up over and over, like a flattened thoracic kyphosis and my left shoulder being higher than the right in comparision to my head. these things i'm sure really are there. when a classmate (very much an OMM master) found my bad shoulder/rib thing today, i was ecstatic not merely because it hurt and i wanted it fixed, but because i hadn't told him where the problem was.

and i know i must fudge shit all the time, especially when i'm finding a diagnosis hard to ascertain. it's totally unconscious for the most part for all of us, but it's disconcerting to say the least. it's just like back in my neurodiagnostic days when we had a borderline EMG, and depending on the doc, it would either be a positive finding or a negative finding. the thing that always bugged me was that the result affected the patient's outcome, sometimes being one of the factors that helped the orthopaedist decide on whether to do surgery or not.

this early on in my career, thinking that a diagnosis i give can have such a serious effect on the patient's clinical course it frightening. when i was volunteering at one of our clinics a couple of weeks ago, i checked a new patient's BP. lo and behold, it was high. we presented to the doctor, and she went in, talked to the patient, and was writing up a scrip for an anti-hypertensive when i asked her sheepishly to re-do the BP reading, just in case. she did, and the reading was almost exactly the reading i'd gotten. i felt stupid for being such a pussy and doubting my skillz, but i also didn't want any patient to walk out the door with a prescription they didn't really need for a malady they didn't really have.

since OMM was our first clinical exposure and continues to be most concentrated doctor thing we do, i think it's natural at first to let what you should find influence what you do find. i just hope we can find the real shit in a couple of years, when it's important and not a matter of getting it done so we can the fuck out of our sports bras.

Friday, April 08, 2005

whiny self-serving post with pointless links!

it's friday night, and i haven't studied one bit for the final exam i have on monday. although the house of god and scrubs have done a good job of describing the intern year (i'll know this for sure in about 3 years), i haven't seen a really good account of med school itself, especially the pre-clinical years. there are some intangibles like the scary i-know-i-have-to-study-but-i-just-can't phase i'm going through right now. pointless self-destructiveness! my reasoning resembles the makings for a bad hangover: a good score on the last exam, the NIH coup and most of this exam being path (which is my fucking subject dawg) and i just can't be bothered. it's a bad, bad attitude to have.

knowing this doesn't mean just yet that i can fix it just yet. i thought i was being all pious and gunnerous when i begged out of the last night ever for a good 60s soul club, but i am sitting here writing a blog post and not studying the reticular formation.

and my inertia is making my writing suck. have you read this shit? i'm saving this post to remind me that medicine is much more of an option than being one of those blog darlings. no go fug yourself for me.

Wednesday, April 06, 2005

site feed

ok, i'm still getting used to all this shit so i hope the site feed works. i had put in a request to be included in medlogs and was wondering why it never showed up. it seems that it's just because i'm a dummy with all this internets stuff.

sometimes i totally wonder about my computer abilities. although i think i'm fairly savvy with technical stuff i know i totally got shafted when it came to the all important computer basics when i was wee. stupid LA public schools! i mean, we had those crappy apple IIs that with the amber screens and scary buzzing sound effects, but all i seem to remember doing on them was some fraction bullshit and playing the oregon trail. i will admit that shit was dope, although i got to oregon for the first time a only couple of years ago using an emulator. in third grade i just couldn't maintain my concentration long enough to kill animals for food or plan ahead for inclement weather. so i usually ended up leaving missouri in the late summer, drowning my team of oxen while trying to ford the river (cheapskate i am i wouldn't dare pay an indian guide to help me), getting all my clothing and wagon wheels stolen in the middle of the night, or losing all my travellin' companions to snakebites, dysentery and broken legs. i had never even seen the last part where you ride down the columbia river dodging rocks before! i was perfectly content killing myself and four other people over and over for hours on end, little obsessive monkey that i am. same thing happened when i tried to play everquest. i didn't care to go on quests with other players-i just spent hours killing bats in front of the castle and sexually harassing any player who was dumb enough to come up to me until i got bored.

i'm not sure how i this post lapsed into musing about nerdy video games. must. study. now.

and now to bring the scary DO agenda to a medical journal near you!

i have been accepted for a summer research fellowship at the NIH!

this is a very very big thing for me as a DO student, since we historically don't get a tremendous amount of research experience in school. we had one student from our school get a NIH fellowship last year, and this year myself and one other person have had offers. my classmate decided not to accept his offer, but i jumped at the chance to do it. the NIH summer fellows tend to be of the harvard and johns hopkins variety, which makes me a bit nervous to be honest. but it's a chance to see how much (if any) we differ, and hopefully i'll be able to put the whole "MD vs. DO" argument to bed for the benefit of all those nervous pre-meds on SDN. i will be working at the National Institute of Neurological Disorders and Stroke, which is very cool because i heart the brain.

it pays well, it is the kind of work that i wanted to do, i get fantastic experience at one of the best research institutions in the country, and i get to spend the summer on the east coast. since i've never been further east than atlanta, georgia (not that i haven't traipsed around europe quite a bit), i honestly don't know what to expect. i have some friends to see in DC and new york and will be hitting the mutter museum in philidelphia, plus spending random time with the hubby when he flies over for a couple of weeks mid-summer.