Charlie goes to Medical School

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Hey, I just spammed a bunch of people about my facebook page which links to this site, so I wanted to welcome anyone that showed up.

This is my blog.  The post on FaceBook says it all, really.  I’m writing this blog to document my process of going to medical school.  I originally started doing it to keep focus while applying to schools, but it has become a way to let people know what I’m up to and hopefully reach out to any premed students who would be interested in the process.

I am posting here anonymously, so if you do know me please don’t give me any full name shout-outs.  Otherwise, leave a comment (they get moderated, so there is a delay) to say hey or subscribe to my RSS feed or whatever.  I’ll also be announcing some other social media integration later, once I work out the kinks.

Again welcome to Charlie goes to Medical School and thanks for stopping by.  Don’t for get to fan the FaceBook page if you don’t mind.

So I got a comment on my about page which I am deleting.  The only reason that I am deleting it because I thought I had turned off the discussion on my pages to begin with, but I do not want to dodge the question.

why so much anonymity, you are not doing any crime by pasting the matter on this blog and on twitter. You should be bold and social with your real identity. So who are you? what is your name and where is your snapshot? What can you contribute by this blog to the world? -dishant

I did put some of this in the About and Blog Policy pages, but looking back at those pages I’m not sure that I did a good job of explaining the decision.

To start out with, I just wanted to publish and maintain the blog anonymously.  I’ve seen a ton of bloggers doing this and then get stressed and quit once their identity was outed by others.  If I were to write as a career, I would feel differently.  However, the name that I am hoping to make for myself is in medicine, not in talking about satchels for my ten-speed.

This blog is supposed to be about my personal experiences.  I will hopefully feel a little more honest about discussing my personal process of going to medical school if I am posting anonymously.  I don’t think it would hurt my future career to discuss any issues that I have during the process, but I do want to feel completely free to share them.

I also want to make sure that I do not represent anyone else with the blog.  In the past, I have worked for companies that have insisted that employee’s blogs not include anything which could be misconstrued as representing the company instead of the blogger.

Through the process of becoming a doctor, I will be putting myself into the hands of several institutions.  I will not be posting anything in this blog that would bring any harm or discredit to the institutions that I will be working with or for.  However, the easiest way to provide assurance is to also maintain the blog anonymously.  Sometimes, just posting as yourself is enough to link you to the places that you work, and the views expressed here are meant to be mine alone.

Additionally, down the road I also will be dealing with patients for whom privacy is mandated by law.  I will not be discussing patients on the blog at all, but maintaining my own anonymity provides another layer of protection for the people that I will interact with in my career.

I’m going to go ahead and say that one again: I am not going to be discussing patients at all.

I know that posting anonymously on the internet can have negative connotations, but for right now I think it is the best thing to do.  Especially since privacy is not something that is easily gotten back once you no longer have it.  I am not going to be going to any great lengths to protect my privacy.  I will not be posting anything on here that would cause anyone to want to track me down and if anyone does try to out me I will simply deny it.  I am telling people that I know about the blog and asking them to pass it on to prospective medical students or people in the field, but I am also asking them to respect my privacy.

I do think that it would be very interesting to start out my new career being able to say to my classmates that I am publishing a blog, but that is just not the approach I am taking with this.  Maybe someday I will go ahead and tell people who I am, but really the blog is more about the process than about me.  For now, I’m just going to be “Charlie” to all my readers out there.

It Lives Again! by Frumber

So, the screen on this laptop seems like it wants to die (possibly as a response to me putting money into upgrading the laptop).  The LCD on a laptop is not unpossible to swap out, but at that point the laptop would become slightly less reliable.  One of the top needs that I have from a computer in medical school is that it be reliable, so at that point buying a new laptop would become necessary.  The screen hasn’t died yet, so I should get six months out of it…maybe a year.  If not, I’d at least like to get to the Windows 7 launch or hopefully a few weeks later.

As of right now, the screen has only gone out under certain circumstances (like when the monitor shuts off due to inactivity, which I’ve shut off) and I can bring it back by suspending and unsuspending by shutting and opening the laptop.

It Lives Again: http://www.flickr.com/photos/frumbert/ / CC BY 2.0

Rear Rack by davidlendrum

I need to go back and do another writing sample from the old blog.  During post-bacc, I walked to school.  For a brief period, I tried biking.  However, I wound up going back to walking quickly because a mile is too short a trip for me to pull out the bike.

For medical school, I will be living a little further away.  I have no problem walking for a mile or three in a row, but the time constraints of a busy medical student (busy as in should be studying) prevent me from allowing two hours a day to plod down the road.  So, I will be dusting the bike off, greasing the chain, pumping up the tires, replacing some rusted bits and finding a more masculine sounding bell.

One thing that I am going to try to fix on my ride…or more to the point, affix…is something to hold books and my laptop while pedaling up and down the avenue.  I have had a steady recommendation from few local bike enthusiasts, and that is to get some panniers.  Rear racks are pretty common enough that you should already have a picture in your mind just with me saying “rear rack”.

If not, there is a picture to the left that should clear things up.

Rear bike racks are useful for a number of reasons, not the least of which is to provide an attachment location for panniers which I can only assume comes from the Latin word for saddlebag…or apparently bread. Panniers are side bags that attach over the rear wheel of a bicycle and provide quite a large amount of storage for a bicyclist.

Brottasche Panniers by benjib

Panniers come in an assortment of shapes and sizes.  I’m mainly interested in finding a situation that would easily convert from a pannier to a sizable backpack/laptop carrier.  Most of what seems to be available in the local stores are either simple and big panniers, open baskets, waterproof bags, and those that convert into messenger bags.  I am going to do a little more research and see if there is something available in the wide world of the internet that may be a little bit more suited for my needs.

If buying bag things weren’t reason enough to ride a bike, we got another reason last night.  After the last stop on the bike-shop tour, Wife and I hopped in the car and turned the key in the ignition and …nothing.  After attempting twice to jump the car unsuccessfully, it became apparent that the battery was shot.  The fine folks at the autoshop two blocks away concurred and we got a friendly reminder of what the cost of not biking could be.

Sorry.  This post is sort of two-thirds exposition on bike commuting with a laptop and books and one-third still pretty ticked about the new battery.  I’m also having a slight amount of trouble with the formatting.  Luckily, I can add two sentences about formatting to take care of that.

For the rack…for now at least, I’m going to buy a rack that is on sale for 10 bucks online.  The panniers are going to require a little more research (i.e. asking local bike enthusiasts more questions) to find something that fits my specific desires.  I’m going to post a little something about what I wind up going with when it gets attached to my two-wheeler.

Rear Rack: http://www.flickr.com/photos/davidlendrum/ / CC BY 2.0
Brottasche Panniers: http://www.flickr.com/photos/benjib/ / CC BY 2.0

It is time for another podcast recommendation.  This is going to be a quick one.  This podcast is a little over my head at the moment, but is a very great resource for learning terminology and starting to make connections between symptoms and the different related systems.  As a personal note, this was the podcast that I listened to while waiting to vote last in last fall’s presidential election.

Image and Podcast by Merck & Co., Inc.

The Merck Manual of Patient Symptoms is a reference guide geared towards use by medical students, physician assistants and nurse practitioners in their work with patients as well as being a refresher for experienced clinicians.  I have no experience with the book except through the podcast, but I’m sure I will check it out once when I get a little further along in my career.  Merck & Co., Inc. is a pharmaceutical company which also publishes a number of medical reference manuals geared toward a number of audiences and on a variety of topics.

The podcast is based around the book, but they do bring in physicians who present the information with some context around it.  Each podcast episode discusses one specific symptom or one symptom under a certain circumstance (i.e. Nausea and Vomiting in Early Pregnancy, Cough in Adults).  The symptoms is discussed along with the likely conditions which would cause that symptom.  The discussion will go briefly into exam and testing which would differentiate between the causing conditions and into severity of those conditions.  However, the podcast is fairly concise so there is not a lot of time to go into detail, especially considering that some symptoms can be caused by a large number of conditions.

I don’t have a lot of experience with the podcast.  It still is quite a bit over my head, so I am definitely not getting everything possible out of the episodes.  However, I will often put this on in the background while I work on other stuff.  Again, it is a good source for learning terminology, so I will go back and forth between whatever I am doing and Wikipedia while listening to it, if I can.  Otherwise, it is good for just trying to make connections between the different systems.

This is not the first podcast that I go to right now, but I do try to make sure that I listen to it occasionally to continue trying to get that information in my head.  I know it will be beneficial to even have a loose familiarization with the material when I have to formally learn this information in a classroom or clinical setting.  The modern approach to learning medicine is regarded as a continual process, so it is good to start dipping into the deep end early and often.  This podcast definitely cannot tell you everything that you need to know about a symptom. However, earlier on in your career, it can help you start outlining the approach to dealing with patients. Later on in your career, it can serve as a quick reminder to help guide you through the large amount of information that a medical professional must command.

Just a quick post about some recent happenings:

• Wife and I had lunch with Commenter Evan and Mrs. Commenter Evan at the local burger-serving place as they passed through on their way home from vacation.  I wouldn’t have thought to post this, but we did talk about the blog and he did mention me referring to him as “Commenter Evan.”
  By the way, if you would like to get a pseudonym on the blog, feel free to comment on the posts.  Just a quick forewarning: your pseudonym is probably going to be “Commenter _____”.  Real left brain action happening here, isn’t it.
• Wife had a job interview, so we are keeping our fingers crossed.  YAY!  This was the impetus for a road trip to our new city for the interview and where we…
• Took a driving tour looking at prospective housing.  Everything sort of depends on the job situation for Wife at the moment, but we have our contingencies in place for when everything shakes out.  It would be nice to already have a place lined up, but we will be able to move quickly on a place once the picture gets a little clearer.
• Some personal drama was cleared up as we got a hold of our wedding video this week.  It’s the one hold-out issue from the wedding that has finally been resolved after a few years.  Wife and I had a bit of fun reviewing footage this week.  I’m also putting together a slide-show of honeymoon sightseeing.  The soundtrack for this is Come Fly with Me by Frank Sinatra and Africa by Toto.
• I had some administrative stuff that I cleared up yesterday.  I need to get better at tracking this stuff, but I’m practically in vacation-mode, so it is hard to get the motivation.  Gotta start working on that.

Photo by Milosz1

Since it has been discussed somewhat in comments (i.e. mentioned twice) it is probably best to move right on into Gen Chem II.  Where Gen Chem I was an introduction into Chemistry itself, Gen Chem II is more like a survey of advanced topics in chemistry.  Several of the topics introduced in Gen Chem I are discussed in greater detail.  A few new topics are introduced.

To start off, the class will cap off the discussion on the properties of the states of matter by continuing on to liquids and solids (Note: This is where my semester broke into Chem I and II.  Your experience may vary).  Liquids behave much differently than gases, so this won’t be a continuation of the section on gases from last semester.  This section will cover basic properties of liquids.  One example of this is the Clausius-Clapeyron equation for expressing vapor pressure mentioned in the comments from the last post.  For solids, we actually just briefly talked about ionic and network covalent formations.  Solids stay still and are pretty boring that way.

The next few sections will be based heavily on (but not limited to) aqueous solutions.  A more in-depth look into the different types of solutions will start off this group of chapters.  This will be followed by sections on kinetics (reaction rates) and dynamic equilibrium (how far a reaction goes).  After that, there will be a few sections on quantifying solubility and pH, describing weak solutions as dynamic equilibria and describing some acids and bases as well as water itself as weak solutions.  This last bit with the acids and bases is where Henderson–Hasselbalch comes into play describing the pH and pKa of weak acids and bases.

The last two chapters that we covered in my class are a natural stopping point in most books.  They are required to understand things in future classwork…even if much further down the line.  The first of these continued the earlier lessons on thermodynamics.  Even if a reaction gives off heat energy, it may not necessarily be a spontaneous reaction.  This is where an understanding of the second law of thermodynamics must take place for the chemistry student.  Because our universe tends to move towards randomness, there is a difference between the heat energy that gets released from a reaction and the free energy that we can use from it.  In the poker game of life, entropy is the rake.

The chapter after that uses these concepts from thermodynamics and introduces the concept of reduction potential to introduce electrochemistry.  If you take a given reduction/oxidation reaction, one side of the reaction must want to be reduced more than the other for the reaction to be spontaneous.  If that happens, then electron exchange takes place between the reduction and oxidation sides of the reaction.  If you are very good at this, you can use this reduction potential by passing a reduction/oxidation reaction over conductive wires and running your iPod on it.

It also dawns on me that I haven’t talked about reduction and oxidation reactions, which can be a sticking point.  Reduction/oxidation reactions are coupled chemical reactions by nature of moving electrons from one atom or molecule to another.  Reduction is the gaining of electrons and oxidation is the loss of electrons.  This throws people a little since reduction means gaining something, but in actuality you are reducing the charge of something. If you reduce oxygen to water, the charge on the oxygen atom goes from zero (0) to negative two (-2).  Oxidation is named so because adding oxygen will generally increase the charge on an atom because oxygen is always negative.  Carbon dioxide is carbon in a very oxidized state.  An easier way to remember this is that LEO the lion says GER.  LEO - Loosing Electrons, Oxidation; GER - Gaining Electrons, Reduction.

There are also some mnemonics for the reduction/oxidation and cation/anion, but I can’t remember them and there are some differences with different types of electric cells (depending on whether you are using the reaction or driving it).  Best just to learn this straight up.

The class will probably end before you get to the end of  the book.  The uncovered chapters still hold some important information though.  If you are taking any kind of standardized test covering this material (e.g. the AP exam, the ACS exam) you should flip through the first part of the chapter on Nuclear Chemistry.  Understanding how the reactions work and knowing the notations used in writing nuclear reactions will help.  They are just like regular chemical reactions except the atoms can change from element to element by gaining or loosing special particles; matter is conserved at the subatomic level…mostly.  Be able to identify alpha and beta particles as well as fission and fusion reactions.  No test should ask you anything beyond that.  The first part of the organic chemistry chapter should also be reviewed before the AP exam, and the whole thing is a great introduction into your organic class and any petrochemistry you might come across.  My book also had a separate biochem chapter which might be good to look at for a biochem class…except your organic book will probably have a better biochem chapter.

There were also chapters in my book (I would imagine these all vary) on the different groups of elements that I never had the time or the need to review and a chapter on complex ions and coordination compounds which I flipped through when writing my lab report on complex ions and coordination compounds.  You will probably never crack to book open to any point in these chapters, ever.

This class involved much more complex math than Gen Chem I.  If you weren’t honing your study skills during Gen Chem I, then now is the time to start.  The conceptual stuff is much more complex here and there isn’t a lot of room for error in the packed syllabus.  My Gen Chem II lab was part of this course and counted towards the overall grade (like Gen Chem I).  The lab had less one-off labs in lieu of a larger project which involved producing a compound and then using quantitative techniques to figure out the chemical formula for the compound.  Do all your homework, keep ahead on your notes/flashcards, study for the tests and don’t get behind on the lab work.

Next I think we’ll be talking about Gen Bio, but I may take a break on the prereqs posts for a little before then.

Chemistry Picture: http://www.flickr.com/photos/mikolski/ / CC BY 2.0

So, acceptance to medical school can happen as late as May.  School starts in July and August.  If your school requires Hep A and/or B vaccines, getting your vaccines up to snuff can take up to seven months.  If you are waiting for your six month Hepatitis booster or the titer that occurs after that, then you will be dealing with holds on your registration…and temporarily lifting that hold during registration.

If you are thinking about a medical program, it will require a lot of immunizations.  The Hepatitis A and B shots are now available together in one series of shots, but it takes three shots over the period of six months and you may be required to get a titer to show that you have sufficient immunity built up.

Go ahead and get started on at least the Hepatitis A/B series during the application process so you don’t have to deal with this stuff.  Most of the rest you should have gotten as a kid…or can be updated with a single shot.

Admin Cat needs one more test post.

o hai.

o hai!