Charlie goes to Medical School

Another year has passed, in more ways than one.

Three years ago, I was ready to start out on my new career. A change that I was not completely ready to make, but wound up having to make a quick choice. Luckily at that point, I had thought about medicine for a long while. The choice that I had to make was an easy one. Wife was by my side. For my birthday that year, she took me to one of those themed restaurants where the knights joust and sword fight each other. I entered school unprepared mentally and struggled a bit under the stress. However, thanks to some hard work and the well-stuck lessons taught to me by my high school science teachers, I succeeded at transitioning into my post-bacc work.

Two years ago, I had finished my first year of my post-bacc work. I was excelling at my classes, and was starting to prepare to take one more class over the summer before studying for the MCAT. When that did happen, it was me, a card table and several very thick books. I was strung out and playing video games every 4-6 hours just to maintain my sanity. One evening, I cooked Wife a meal and sliced through my left index finger. Wife was not there, so I had to drive myself to the quick care where Wife met me. Wife nearly passed out because she was so concerned for me. I did well on the MCAT. In the fall, I started to take some of the more recommended courses. And I applied to many, many medical schools.

One year ago, I got accepted to one of those medical schools. Wife found a new job and followed me here. We moved here over the summer and I matriculated. I ran headlong into a wall of knowledge. I tried to absorb everything. I drank from the fire hose. I did well in class. I did well in group discussion. I did well in lab.

Today, Wife and I have been married for three years. I have finished my first year of medical school. We are struggling to get our old place sold on a soft market. She drives longer than she should for a job that is not quite what she wants to do. She definitely could have found an easier life for herself. She has stuck by me as I picked myself up from a career that I hated and stumbled into a new career that I love.

Happy anniversary, Wife.

Sorry for the downtime folks.  We’ve spent a couple of hours this afternoon updating the blog and getting everything together.

The short version of the story is that Wife totally outed the site in casual conversation about a month ago in front of a few of my classmates.  I really didn’t want this site to be a place for people I see everyday to come and find out my inner thoughts about our daily lives.  This was supposed to be more for random people who stumble across the site and some of you folks from back home.

So when I started getting a few questions and comments, I took the site down for a bit.  In fact, given some of the news stories about some medical bloggers being real morons and writing completely inappropriate stuff, I think it might be best to at least disclose the blog to our honor council so if word ever does get out it won’t be a surprise.

Today I wanted to bring it back up because the Cadaver Memorial is tonight and I want to write a bit about it.  I also need to fill in the gap.  My last post was in February.  Since then, we’ve covered the heart and lungs in the Cardiopulmonary module and the GI tract, accessory organs and kidneys in the GI module.  Now we are in Repro/Endo.  This module has one test and then we have our finals for the entire year.  At the beginning of the last test, the course director hung a big powerpoint slide on the big screen that said “25 Hours Left” of our first year.

I’ve been accepted into a summer research program for us first year medical students.  I may not talk about the specific research, but I will tell you that I’ve just spent the last 2-3 weeks getting my project written up for our IRB.

I’ll be keeping my tech officer post for the class, but I’m working to rearrange some of my duties to include a little more organizing with our sister campus so that some of our activities can cross over (Road trip!).

On a personal note, there was spring break.  Wife and I went to the coast and met up with a high school friend and his girlfriend.  Pretty low key compared to some of my classmates.  Then again, I’m in my 30s now, so just walking around and having a few beers with my fried seafood platter is about my appropriate speed.  The last day, I had a pimento cheese and chili on a cheeseburger and I think I felt my heart gasp.

So each of these little nuggets probably has enough material for a few blog posts.  We’ll see how that goes.

Hope all is well with everyone.  Peace out.

Charlie White Coat

Over Winter Break, I plan on catching up on the blog a little bit.  In doing so, I will try to hit some of the highlights of the past four months which for one reason or another…mainly because I was busy studying…I did not find time to write about.  What is probably the greatest shame is the fact that I did not post about White Coat Ceremony when it occurred.

The White Coat Ceremony is a fairly common occurrence at medical schools these days, and with good reason.  Although the sheer magnitude of coursework does serve as its own reminder that one is in medical school, it does not serve to remind the medical student of the professional responsibilities associated with entering the field.  One thing that does jump out as a symbol of that professional responsibility is the white coat itself.

Although the short white coat of a medical student does stand out among the longer coats of the doctors of the physician, to the average person coming through the hospital it may not even register that there is a difference.  By wearing a white coat, a medical student shoulders a great amount of responsibility, especially on the grounds of the hospital where any patient might not be able to tell the difference.  He or she may not be able to do much with regard to treating illness, taking a physical exam…or even very much of a history (I’m still stumbling through my review of systems), but in professional clinical attire the student represent the hospital as much as anyone else in a coat or a pair of scrubs.

The White Coat Ceremony is a relatively new institution in medical schools as they have begun challenging their first year students to start thinking about professionalism from day one.  The actual ceremony usually takes place about a month into the first semester, to give students time to reflect on the responsibility that they are about to take on.  At my medical school, one exercise they put us through was to have our class actually write the oath that we took after accepting our white coat.

Our actual ceremony happened shortly after labor day.  We had finished our second test and completed the first fundamentals module.  The ceremony was planned during the college’s Parent’s Day with other activities occurring around the campus.  I believe the PA students also received their coats that day.  Earlier today I happened to drive by the church where the ceremony was held as the medical school did not have an auditorium big enough for the class and families.

I was fortunate that my family could make it down.  Wife and I were very happy to have my parents and my sister there for the big day.  After a morning reception at school, I drug my folks over to a local burger joint where the staff had apparently gotten to know me well enough to start harassing me in front of my wife and family.

At the church that day, we were instructed to get in single file according to a number which was emailed to us earlier that week.  I stood there for a few minutes before I realized that we were in alphabetical order much like our assigned anatomy groups, so I started introducing myself to the people ahead and behind me.  The four of us have been working together once or twice a week since.

We filed in and took our seats.  When my turn was up, I handed a card with a phonetic spelling of my name to the Associate Dean of Admissions, I walked across the red-carpeted stage, held out my left arm to be placed into the coat being held by the Vice Dean of Academic Affairs, got the coat around my right arm, straightened it and then shook hands with the Dean of the Medical School trying to face forward for any pictures that my family might have been taking at the time.  I then walked down the center aisle back to my seat and then as professionally as possible, tried to take a picture of the embroidered names and sewn on patch with the logo of the college.

The names were mine and “School of Medicine”.

As I recall, the oath was administered after the coating.  That was the only time that I saw the final draft.  Perhaps once a little time passes, I’ll post it here.  Following this, I believe that I was about to have a migraine from dehydration, so I actually bolted to the reception before most everyone else to grab a few diet cokes and a few waters as I didn’t know where to find any medicine at the time.

To cap off the day, my family ate at the small inn down the street from our little apartment.  I believe that I had a steak, but I only remember this because I was insisting that we go to a steak house and the restaurant at the inn was the best compromise for everyone.

Since then, I’ve worn the coat a half dozen times.  Some people have put logo buttons on them or sewn other patches on the sleeves signifying some other research lab.  The second years also wear them but usually with a lab cheat sheet or a reference guide in the pocket, sometimes with their stethoscope tucked in the pocket instead of around the neck.  Third and fourth year coats usually hang a little lower after the months of toting around the stethoscope along with other various reflex hammers, pen lights and some even oto/ophthlamoscopes.  The neck and pockets have given in and sag under the weight of medical student clerkship.

At some point, this white coat will be shoved into the closet next to my robe from college graduation and my Hawaiian shirts and will probably be taken out for moves or when someone’s kid wants to dress up as a doctor for Halloween.  Maybe I’ll hang it up at the office or God forbid someone future-me knows wants to go to medical school and is looking to me for guidance.  I’ll pull it out and talk about responsibility and weight and ring around the collar.   Then I’ll put it back up and show them the neat toys that doctors get to play wi….I mean use responsibly.

So, I am a few weeks behind on posts and I have successfully lost the post-it with four back posts that I need to write.  I know that one of those posts was to be about the last module and our upcoming module, so I think that would be a good checkpoint to go back and talk about.  This post will be a two part post with the first talking about the end of the Fundamentals module which completed a couple of weeks ago along with what was covered as well as the upcoming module that I am actually about to have the first test for, Tissues/Muscloskeletal.

There was also a family day event which I will talk about in more detail in the next post which marked the end of our first module as well as the first month of medical school, but more about that later.

Fundamentals module did wrap up two weeks ago.  Looking back at the material, I can see everything from a much different perspective especially since the material was so well integrated.  Even though the lectures were covered in a somewhat discrete manner, the lecturers that we had did an excellent job of conveying a concept in a manner that would lead up to future topics and tie in to stuff from previous lectures.  This also speaks to the success of the faculty in organizing the new integrating curriculum.

It’s funny when you think of my high school freshman Advanced Biology class starting on the macromolecules, AP Biology, Gen Bio I and Biochem in post-bacc.  The first few days at medical school were exactly the same…macromolecules.  Well, maybe it was a bit more in depth.  We covered a good deal of biochemistry, genetics and cell biology.  All of the material was tied into clinically relevant correlations and vignettes.  In total, it was five weeks of material with two tests.  Everyone in my class successfully completed the module and the director for the module said that the average for the second test was pretty high.

So what’s next?  Well, we are starting on the systems-based modules which will continue for the rest of this year.  First up, we are learning about Tissues and the Musculoskeletal system.  The landmark event here is that we are starting our labs, both histology (i.e. microscopes) and gross anatomy.  In lecture, we are starting to cover a bit more development and physiology as well as moving right into the cellular biology coverage of tissues.  Following this, we are going to jump right into energy metabolism including glycolysis and Krebs/TCA.  From a physiological/histological perspective, we will be learning about osteons and sarcomeres.  So far, we have just been learning about tissue types and more specifically epithelial and connective tissues.  Histo lab has followed this along pretty closely.

I’ll talk more about gross anatomy lab later.  It is obviously a delicate and important subject.  Someone left their body to the school so that I could learn medicine.  Gross anatomy lab is so important to medical students that I feel like I would need to cover it here, but in doing so I must be respectful of that gift.  We have been told to treat our subject like our first patient, so I won’t be discussing any details of the subject.  I will be covering some of the process involved in the dissection, but in the most respectful way that I can.

Histo labs are a little less intense.  It is basically sitting in a room with fifty other students looking through a microscope while our instructor guides us over a PA system.  My one real disappointment here is that we don’t get to do any of the mounts.  So far, I’ve only ever done wet mounts.  The slides that we are reviewing have all been fixed to preserve them before staining and mounting.  There is a great video of this during a CSI episode that I saw one time.  Sorry I can’t remember which one.

Alright, I have to get back to studying.

Since I’m about to start telling people about this blog, I think it is time to answer the question I get the most when I tell people that I’m going into medicine.  Why medicine?

Unfortunately, this story will take much more than one blog post.  If I could tell you in only one blog post, it probably wouldn’t be enough to get me into medicine.  I could probably write a few blog posts about why I want to work with computers, and I’ve left that career behind.  For tonight, I am going to focus on the period when I was actually deciding on leaving my job and start taking pre-medical classes.

So here’s a story.  I was changing careers and trying to decide what I wanted to do.  I was going to leave my old career working in computers for something else.  I was thinking about academia and I was still thinking about getting an MBA.  However, I still couldn’t see the path that I wanted to be on.

Eventually, I started sounding things off of people and I got a lot of really good advice and suggestions.  Eventually, someone suggested a career in medicine…as a doctor.  I put it off as being too hard with prerequisite courses and relevant experience both lacking in my department.  However, the person who suggested this told me of a friend who had been through a post-baccalaureate premedical program.  They let me know that it was an attainable goal if it was what I wanted.  The idea really resonated with me, but I didn’t know if I wanted it enough.

Looking back, I’ve asked a lot of doctors for advice.  Once hearing that I’ve decided that I want to go to medical school, the number one thing I hear from doctors is, “You don’t want to do that.”  Medicine is a huge investment in time and money, and it is extremely easy to burn out before being able to start practicing as a physician or even early in one’s career.

So I spent a couple of months thinking about it.  Did I want to be a doctor, or maybe was I supposed to go into some other field?  Life went on.  Eventually, I wound up going to my brother-in-law’s Eagle Scout Court of Honor.  Of course, I happened to forget that as an Eagle Scout I would be standing and renewing my Eagles Scout promise along with the rest of the Eagle Scouts present as my brother-in-law was making his.  Remaking the promise that day was sort of a pivotal moment.

At the time, I spent most of the time working from home or on the road.  At the office, I spent most of the time in small rooms crammed in with other people, but not interacting a whole lot.  As far as my extracurricular life, I didn’t have time for a whole lot and an inconsistent routine made it hard to find a regular time to do stuff outside of work.  I wanted to start helping people.  I wanted it to be my job.

So, I started volunteering at a hospital.  From that point, there was no turning back.  The first night I had a small kid thank me as I was making beds in the ER triage area.  It turned my stomach thinking about how much more rewarding wiping down beds was than what I did 60 hours a week at work.

It also happened that I was the proud guardian of a pair of sneakers all night.  A patient was admitted and was transferred without possession of his footwear.  I found them underneath a hospital bed as I was cleaning it off.  The whole night I was asking around about the sneakers, ambulance bay, the triage nurses, the charge nurse…  It’s a lot harder to find a patient with the sole identifier “the guy whose shoes these are”.

As I was getting ready to leave, they told me that they had tracked the shoeless patient down.  I dropped off the shoes upstairs, headed back down to tell the head nurse that I was taking off, and walked through the trauma ward.  As I passed through the hall, the sound of a heart monitor sounded around two different corners hitting my ears just out of sync.  The ECG beep in one ear and the echo in the other.  It was 11 and I had to be up and running the next morning at 5:30, and I hadn’t even eaten dinner yet.  I was tired and I was resolved.

I could barely walk and all I could think about was how I could start the long journey ahead of me.  I wanted to be a doctor.  I wanted to be that tired at the end of the day after helping people.  I wanted to learn for the rest of my life, and I wanted to enter a new professional field.  I wanted to be a doctor.

Pretty weak story, huh?  That’s three or four occurrences over the span of several months.  I didn’t know what I wanted to do with my life and then some guy was missing his shoes.  There are easily dozens of stories like this.  I help someone cross the street.  I pay attention in class.  I study on a day other than the one before an exam.  I think about stuff in my free time.

And I blog about it.

Alone each story isn’t enough.  String enough together…