It sounds like a Dr. Seuss story, doesn't it? Anyone remember the Lorax? Anyone?
But it's not...no Sneeches, no clear-cutting, no Grinch. Just the human trunk--the thorax, which is what we're currently looking at in anatomy.
On Friday we opened up the rib cage to get at the stuff inside. It was simultaneously fascinating and off-putting in that 1) It's not every day you get to look at real, honest-to-Buddha lungs and hearts, but 2) It's also not every day that you go at a human body with a SAW. And bonecutters, which are essentially larger and more specialized versions of wire-cutters. And in a way, it did feel like to sort of breaking and entering people generally get up to with wire-cutters (I can't say I've ever heard of anyone using wire-cutters for anything respectable, thought I'm sure it must happen--It can't all be stealing bikes and getting into chain-link fences). Instead of entering someone's compound, however, we were entering someone's chest. I was elected by our group to do the first few cuts of the ribs (again with the if-you're-squeamish-skip-down-a-bit warning) and I have to say, it was hard work, and made a sound that could be described as either disgusting or highly satisfying, depending on your bent. The clavicles and xiphoid process (the end of your sternum) we went after with a saw, since apparently they're too tough for even bonecutters to work (yes, it was essentially a saw just like the kind you'd use on wood, with the exception that it was bright yellow and due to someone previously doing a less-than-stellar cleaning job had bits of...something organic on it). I'll admit it made me a little woozy, and I handed over the cutters as soon as I'd done my requisite couple of ribs.
I didn't actually see the heart; it's covered by pericardium, really very well veiled by filmy white tissue, which seems appropriate--who wouldn't guard their heart a bit? Don't we all do that, not just anatomically but metaphorically and emotionally? The lungs were on full display, however, with their covering of slippery, whisper-thin pleura, and as springy and pink as the various preservative solutions would allow (soft tissues have a tendency to harden in the presence of preservatives, which is advantageous in many ways but not so great in others). One of the neighboring tables' cadavers was a long-time smoker...needless to say, there were dark spots all over and the lungs weren't nearly as pink and spongy as ours. Perhaps medical school will finally cure me of my smoking addiction once and for all--nothing like looking at the actual, physical results of your particular vice to get you to "straighten up and fly right," as my father would say.
Sunday, August 31, 2008
Wednesday, August 27, 2008
overwhelmed? who, me?
Not by courseload, necessarily, but by sheer volume of information. Each class is actually multiple classes, with multiple sections: one course is comprised of physiology and histology together (and histology is both a lab and a lecture course); anatomy is a lab, and a lecture, and has some radiology thrown in for good measure, and the 'doctoring' course has a seemingly infinite number of sections, subsections and small groups. In a few weeks I'm sure I'll be fine; for now, I'm basically just buzzing with a combination of excitement and anxiety.
Not to mention the information our instructors are actually trying to convey to us INSIDE lectures and labs--and the fact that while some of it is hard and fast (insert your double entendre here) a lot of it is open to interpretation--for instance, when one of our anatomy instructors looked over our cadaver today and told us,
"I'm going to say that's the deltoid branch, but someone else might tell you it's the clavicular, and really it could be either." (Yes, I cut an artery by mistake and then we couldn't tell where it was supposed to be branching. "You're going to cut important things," she added. "It happens. Some people get really bent out of shape, but if you just expect it to happen, it's not that big a deal." What? Someone not advocating rabid perfectionism? Hot damn, I did come to the right school!) Same in histo. "Is that a macrophage?"
TA: "It could be. It could also be a plasma cell; it's not a textbook example of either one, though."
What I DON'T say: "So how helpful is the textbook then? And how can anyone ever be sure--like pathologists? Let's talk about the epistemology of the macrophage and the illusory nature of nomenclature and classification."
What I do say: "Also, could you tell us what this structure is? It's not in the lab manual."
TA: "I have no idea."
I kid, I kid. The TAs are great, the instructors are awesome, and I couldn't be happier to be here. It's just that enzyme kinetics AND all the structures of the thorax AND the classification of cartilage, bone and epithelium AND biostatistics (even though it's not called that) AND how to take a history and physical...all at once...is a lot. Check in with me again a week before midterms and no doubt I will laugh at the naive and spoiled me of August who wrote this entry; but here it is.
Not to mention the information our instructors are actually trying to convey to us INSIDE lectures and labs--and the fact that while some of it is hard and fast (insert your double entendre here) a lot of it is open to interpretation--for instance, when one of our anatomy instructors looked over our cadaver today and told us,
"I'm going to say that's the deltoid branch, but someone else might tell you it's the clavicular, and really it could be either." (Yes, I cut an artery by mistake and then we couldn't tell where it was supposed to be branching. "You're going to cut important things," she added. "It happens. Some people get really bent out of shape, but if you just expect it to happen, it's not that big a deal." What? Someone not advocating rabid perfectionism? Hot damn, I did come to the right school!) Same in histo. "Is that a macrophage?"
TA: "It could be. It could also be a plasma cell; it's not a textbook example of either one, though."
What I DON'T say: "So how helpful is the textbook then? And how can anyone ever be sure--like pathologists? Let's talk about the epistemology of the macrophage and the illusory nature of nomenclature and classification."
What I do say: "Also, could you tell us what this structure is? It's not in the lab manual."
TA: "I have no idea."
I kid, I kid. The TAs are great, the instructors are awesome, and I couldn't be happier to be here. It's just that enzyme kinetics AND all the structures of the thorax AND the classification of cartilage, bone and epithelium AND biostatistics (even though it's not called that) AND how to take a history and physical...all at once...is a lot. Check in with me again a week before midterms and no doubt I will laugh at the naive and spoiled me of August who wrote this entry; but here it is.
Monday, August 25, 2008
Cadavers, Humanity and Faith
So our first day in the anatomy lab was today.
Today I made my first incision into another human body.
It was at once sobering and exciting, this rite of passage, a threshold every future physician has to cross and probably remembers for the rest of her life. It was also just incredibly, utterly cool.
The face, hands and feet--probably the most human parts of any body--were covered with stockings, both to make it easier for us to do what we had to do and to protect them from desiccation.
The body itself was that of an eighty-ish man, who died of complications of heart disease; he was a middling-sized man, not the wasted habitus you sometimes see in old age or advanced infirmity, but not huge. I thank him for his gift to my learning.
We began by cutting flaps of skin on the chest and reflecting them back, then working away the fat until we could see the superficial fascia (tough coverings) on the pectoralis major, serratus muscles, and deltoids. There was a fair amount of fat to cut away from the ribs; we worked a little too far inferiorly and ended up exposing a little bit of the rectus abdominus as well (the abs, for those of you with any passing familiarity with SHAPE magazine et al). I never realized how much fat there is in the average body--not just in a large person, but in a person period. It made me feel a little better about my latest body composition stats. The people with female cadavers sectioned the breasts to get a look at the lobules and such that comprise the milk producing tissue--no one found much, considering that most of the donors were fairly advanced in age and the lactation apparatus etc. sort of atrophies (ie shrivels up) with age--nature is quite parsimonious, and what you don't need you generally don't keep. One group did have a female cadaver with breast implants--I lacked the wherewithal to actually handle one, first because I think breast implants are gross in general, second because (spoiler alert, if you're squeamish skip to the next paragraph) they were covered with grease from the aforementioned abundant fat.
It's difficult to walk the line between remembering that these were once human beings aand as such are inherently due respect and compassion (and depending on your religious and moral bent, still are people--I got called out on this at the Christian Medical Association meeting, where one of the participants 'reminded' me that "They aren't people anymore--the soul has departed, they're corpses." I'll write more on the CMA later--it's not the best fit I could have hoped for, as it seems populated primarily by mainline and right-leaning Protestants that would probably have heart attacks if they knew the extent of my interfaith Episcopal/Quaker/Wiccan/Buddhist hippy-dippiness. However, they're nice folks, and when I go to their meetings they feed me, and the lingo--"glorify the Lord," "the things of the world," "being a witness for Christ"--reminds me of the church I went to in elementary/ middle school, which is simultaneously comforting and kind of painful) and jsut focusing on the anatomy, doing what you need to do, and forgetting for a little while that you're working on a person. Selective attention, I guess you could call it, or selective numbing. You can only focus on so much, and while of course I never want to treat anyone or any body (pun intended) I meet as just a hunk of flesh, for the purposes of this course I think I'm going to have to depersonalize the cadaver, at least a little, at least for a while.
Today I made my first incision into another human body.
It was at once sobering and exciting, this rite of passage, a threshold every future physician has to cross and probably remembers for the rest of her life. It was also just incredibly, utterly cool.
The face, hands and feet--probably the most human parts of any body--were covered with stockings, both to make it easier for us to do what we had to do and to protect them from desiccation.
The body itself was that of an eighty-ish man, who died of complications of heart disease; he was a middling-sized man, not the wasted habitus you sometimes see in old age or advanced infirmity, but not huge. I thank him for his gift to my learning.
We began by cutting flaps of skin on the chest and reflecting them back, then working away the fat until we could see the superficial fascia (tough coverings) on the pectoralis major, serratus muscles, and deltoids. There was a fair amount of fat to cut away from the ribs; we worked a little too far inferiorly and ended up exposing a little bit of the rectus abdominus as well (the abs, for those of you with any passing familiarity with SHAPE magazine et al). I never realized how much fat there is in the average body--not just in a large person, but in a person period. It made me feel a little better about my latest body composition stats. The people with female cadavers sectioned the breasts to get a look at the lobules and such that comprise the milk producing tissue--no one found much, considering that most of the donors were fairly advanced in age and the lactation apparatus etc. sort of atrophies (ie shrivels up) with age--nature is quite parsimonious, and what you don't need you generally don't keep. One group did have a female cadaver with breast implants--I lacked the wherewithal to actually handle one, first because I think breast implants are gross in general, second because (spoiler alert, if you're squeamish skip to the next paragraph) they were covered with grease from the aforementioned abundant fat.
It's difficult to walk the line between remembering that these were once human beings aand as such are inherently due respect and compassion (and depending on your religious and moral bent, still are people--I got called out on this at the Christian Medical Association meeting, where one of the participants 'reminded' me that "They aren't people anymore--the soul has departed, they're corpses." I'll write more on the CMA later--it's not the best fit I could have hoped for, as it seems populated primarily by mainline and right-leaning Protestants that would probably have heart attacks if they knew the extent of my interfaith Episcopal/Quaker/Wiccan/Buddhist hippy-dippiness. However, they're nice folks, and when I go to their meetings they feed me, and the lingo--"glorify the Lord," "the things of the world," "being a witness for Christ"--reminds me of the church I went to in elementary/ middle school, which is simultaneously comforting and kind of painful) and jsut focusing on the anatomy, doing what you need to do, and forgetting for a little while that you're working on a person. Selective attention, I guess you could call it, or selective numbing. You can only focus on so much, and while of course I never want to treat anyone or any body (pun intended) I meet as just a hunk of flesh, for the purposes of this course I think I'm going to have to depersonalize the cadaver, at least a little, at least for a while.
Anatomy, Day 1
So today's the first day of anatomy, and I have 3 primary goals for today (I always knew those goal-setting seminars I went to in high school would have a purpose beyond giving the counselors work to do and me a way to get out of class):
1. Don't hyperventilate, pass out or throw up in the anatomy lab. I'm usually not that squeamish--I watch the surgeries on Discovery Health on occasion (at least at my parents' house, the only place I've lived in the last year that had cable), but there's a big difference between sitting on the couch with a bag of pretzels and actually being gloved up standing next to a no-longer-living person. More on this later, no doubt, after I've actually done my first day.
2. Don't cut myself, or anyone else, with the scalpels. I'm talking accidentally, of course--It's not like I'm going to have to be restraining myself from spontaneously dissecting my tablemates (although I've heard that, as a profession, medicine harbors one of the largest percentages of serial killers. Creepy, huh? I guess it's the combination of God Complex, poor pedagogy that presents the body as a piece of meat rather than a human being, and the sort of cunning--and I use that in the nicest way, just to mean 'smarts'--that drives people into this particular calling).
3. Manage to get changed and spritzed with perfume (to cover up the eau de formaldehyde I'll doubtlessly be exuding) in time to meet my clinical preceptor on the inpatient unit this afternoon. From anatomy scrubs to clinic-ready wear (which kind of feels like drag, to be frank...but more about that too, no doubt, as time goes by) in forty-five minutes, with time for a lunch talk from the AMA in between? I think I can. I know I can. I am the little train that could.
1. Don't hyperventilate, pass out or throw up in the anatomy lab. I'm usually not that squeamish--I watch the surgeries on Discovery Health on occasion (at least at my parents' house, the only place I've lived in the last year that had cable), but there's a big difference between sitting on the couch with a bag of pretzels and actually being gloved up standing next to a no-longer-living person. More on this later, no doubt, after I've actually done my first day.
2. Don't cut myself, or anyone else, with the scalpels. I'm talking accidentally, of course--It's not like I'm going to have to be restraining myself from spontaneously dissecting my tablemates (although I've heard that, as a profession, medicine harbors one of the largest percentages of serial killers. Creepy, huh? I guess it's the combination of God Complex, poor pedagogy that presents the body as a piece of meat rather than a human being, and the sort of cunning--and I use that in the nicest way, just to mean 'smarts'--that drives people into this particular calling).
3. Manage to get changed and spritzed with perfume (to cover up the eau de formaldehyde I'll doubtlessly be exuding) in time to meet my clinical preceptor on the inpatient unit this afternoon. From anatomy scrubs to clinic-ready wear (which kind of feels like drag, to be frank...but more about that too, no doubt, as time goes by) in forty-five minutes, with time for a lunch talk from the AMA in between? I think I can. I know I can. I am the little train that could.
Saturday, August 23, 2008
Medicine and the humanities meet...and the result is poetry
This morning
Walking down Euclid, that name
which puts me forever in mind of angles and arcs,
I saw a young boy walking with his mother,
'Spastic,' the official term,
so monstrously unfitting:
His arms were kept
clenched closely to his body,
As if he were cradling himself;
His face was like an empty plate,
that youthful newness
still aching to be piled with good things--
Skin china-fine, and equally as pale,
through which I could see his bones
and the meandering tributaries
of his veins.
His geometry was warped,
angles acute,
The delicate spine's arc
twisting to the right--
and yet he walked on two
straight, honest legs
past me and on
into the morning light.
-AG
Walking down Euclid, that name
which puts me forever in mind of angles and arcs,
I saw a young boy walking with his mother,
'Spastic,' the official term,
so monstrously unfitting:
His arms were kept
clenched closely to his body,
As if he were cradling himself;
His face was like an empty plate,
that youthful newness
still aching to be piled with good things--
Skin china-fine, and equally as pale,
through which I could see his bones
and the meandering tributaries
of his veins.
His geometry was warped,
angles acute,
The delicate spine's arc
twisting to the right--
and yet he walked on two
straight, honest legs
past me and on
into the morning light.
-AG
Tuesday, August 19, 2008
I sing the joys of biochemistry
Today was our first official biochemistry lecture--or, as it's called here to make it sound clinically relevant and less like a rehash of that class you took during your killer 21-credit-trying-to-get-into-med-school-junior-second-semester, "Molecular Foundations of Medicine."
There was the "two semesters of gen chem and organic chemistry and biochem--each" crammed into an hour, and then we talked about prions and prion-related diseases, which are actually pretty cool. People thought Stanley Prusiner was a total whack job when he first said, "Hey, these aren't viruses and they aren't bacteria--maybe they're just misfolded, infectious proteins." I would imagine they told him, "Stan, you're a misfolded protein." But now that guy down the hall who made fun of him when his paper was rejected hangs his head in shame every time he's reminded of those comments, and Stanley has a Nobel Prize, so ha freaking ha. Chase your dreams, kids. Don't be disillusioned.
We also had a Practice of Medicine, or "Doctoring" class, and got to watch a sample interview/physical, where we learned such gems as (I'm actually not being ironic--moi?--some of these were things I'd never even thought about, or had thought about but will likely forget when I go in for my first interview smelling of sweat and hand sanitizer and fear):
-Introduce yourself, and sit down. Studies have shown, one of the clinicians noted, that when you sit down with patients they feel like you've spent more time with them, and hence they are more satisfied with the whole experience. Also, you're not towering over them (not that my 5'4" self would be doing much towering) and even further emphasizing the power imbalance inherent in the relationship.
-Tell the patient what you're doing before you do it and as you do it. Don't lunge at people without explaining what's going on. With adults, you'll make people uncomfortable; with pediatric patients, you might get bitten.
-Listen. What a concept. Don't barrage the patient with questions. Segue to the topics you want to cover in a SMOOVE manner. If you're good at macking on people, apparently, you will likewise be good at getting histories. Please don't mix the two and mack on patients, by the way, especially if you're an OB/GYN. Because it's not just creepy, it's an ethics violation.
-Wash your hands.
-Warm your stethoscope and hands. And if you're using one, the speculum (since I'm 99.9% sure I won't be going into OB/BYN, I'll say this simply as a woman...there is nothing like a cold speculum. And not in a good way).
-Ask follow-up questions. Ask people to clarify. "I used to party..." could mean anything from getting funky with birthday cake and those paper cone hats to snorting crystal and having sex with other men. Obviously one is a risk factor for a lot of things, and the other isn't so much (OK, maybe diabetes if you eat a LOT of cake).
-Related vein: don't assume risk factors--or anything, really--based on appearances alone.
-Wash your hands.
-Be friendly. Smile. Say please a lot. This person is giving you access to their life history, their secrets, their body. Be compassionate and polite.
-Wash your hands.
Oh, yes, in histology yesterday we had our first "Joke at the Psychiatrists' expense."
"As for the people who never learn to identify anything under the microscope, we just hope they go into psychiatry or something." I wanted to say, "Really? This early you're hating on the psych folks? REALLY?" I guess everyone just pimps everyone else and I should get used to it, but come on now. It's a little early to be establishing pecking order, isn't it (I say "establishing" as if psych weren't sort of entrenched towards the bottom...but at least people TALK to them. Pay quite a bit to talk to them, in fact. Let's see any other kind of physician, even a sparkling conversationalist, who gets paid just for their words).
There was the "two semesters of gen chem and organic chemistry and biochem--each" crammed into an hour, and then we talked about prions and prion-related diseases, which are actually pretty cool. People thought Stanley Prusiner was a total whack job when he first said, "Hey, these aren't viruses and they aren't bacteria--maybe they're just misfolded, infectious proteins." I would imagine they told him, "Stan, you're a misfolded protein." But now that guy down the hall who made fun of him when his paper was rejected hangs his head in shame every time he's reminded of those comments, and Stanley has a Nobel Prize, so ha freaking ha. Chase your dreams, kids. Don't be disillusioned.
We also had a Practice of Medicine, or "Doctoring" class, and got to watch a sample interview/physical, where we learned such gems as (I'm actually not being ironic--moi?--some of these were things I'd never even thought about, or had thought about but will likely forget when I go in for my first interview smelling of sweat and hand sanitizer and fear):
-Introduce yourself, and sit down. Studies have shown, one of the clinicians noted, that when you sit down with patients they feel like you've spent more time with them, and hence they are more satisfied with the whole experience. Also, you're not towering over them (not that my 5'4" self would be doing much towering) and even further emphasizing the power imbalance inherent in the relationship.
-Tell the patient what you're doing before you do it and as you do it. Don't lunge at people without explaining what's going on. With adults, you'll make people uncomfortable; with pediatric patients, you might get bitten.
-Listen. What a concept. Don't barrage the patient with questions. Segue to the topics you want to cover in a SMOOVE manner. If you're good at macking on people, apparently, you will likewise be good at getting histories. Please don't mix the two and mack on patients, by the way, especially if you're an OB/GYN. Because it's not just creepy, it's an ethics violation.
-Wash your hands.
-Warm your stethoscope and hands. And if you're using one, the speculum (since I'm 99.9% sure I won't be going into OB/BYN, I'll say this simply as a woman...there is nothing like a cold speculum. And not in a good way).
-Ask follow-up questions. Ask people to clarify. "I used to party..." could mean anything from getting funky with birthday cake and those paper cone hats to snorting crystal and having sex with other men. Obviously one is a risk factor for a lot of things, and the other isn't so much (OK, maybe diabetes if you eat a LOT of cake).
-Related vein: don't assume risk factors--or anything, really--based on appearances alone.
-Wash your hands.
-Be friendly. Smile. Say please a lot. This person is giving you access to their life history, their secrets, their body. Be compassionate and polite.
-Wash your hands.
Oh, yes, in histology yesterday we had our first "Joke at the Psychiatrists' expense."
"As for the people who never learn to identify anything under the microscope, we just hope they go into psychiatry or something." I wanted to say, "Really? This early you're hating on the psych folks? REALLY?" I guess everyone just pimps everyone else and I should get used to it, but come on now. It's a little early to be establishing pecking order, isn't it (I say "establishing" as if psych weren't sort of entrenched towards the bottom...but at least people TALK to them. Pay quite a bit to talk to them, in fact. Let's see any other kind of physician, even a sparkling conversationalist, who gets paid just for their words).
Friday, August 15, 2008
And So It Begins.
I've just finished orientation at a certain well-known and fairly prestigious medical school in St. Louis. The white coat ceremony was today, and I have to say I enjoyed it; we read the oath we (as a class) crafted, stating our intent not to shaft our patients, our faculty, or each other, listened to several speakers tell us 1) how awesome we are 2)how awesome Wash-U (damn, I let that slip) is, and 3) that there are wonderful benefits--and grave responsibilities--that come with being a physician.
Somehow I am anticipating that the "y'all are fantastic!" may not carry very much farther into the semester, so I aimed to enjoy it while it was available. Then again, I have a tendency to anticipate the worst and expect people to turn on me without warning or provocation, so that could just be my own neurosis speaking.
The following are some quotes that sum up what this week was all about for me.
"Hi, I'm X. What's your name? Where are you from? Where'd you do undergrad?"-everyone
So I learned that people here are friendly, outgoing, and in some cases (although I think I only met one...) eager to let someone know they went to Harvard.
"If you fail an exam, I'll know, and we'll have a warm and fuzzy chat about how you're doing."
-One of the deans
So it seems people here aren't primarily interested in nailing you to the wall, but rather in ensuring you do well and checking in with you if you're not. I pray to Christ, and Isis, and Buddha, that I don't ever have to have a "So you're screwing up academically" warm-and-fuzzy-conference; however, the overall feeling of someone watching out for you--not in a creepy, Dick-Cheney-who-would-put-cameras-in-every-American's-bathroom-if-he-could way, but in a caring sort of way--is reassuring.
"Additionally, if you have to be taken by ambulance to the ER for alcohol poisoning, I will know that too. And we will have a different sort of chat." -the same dean
Well, I'm on my ass after one drink. The probability that I would drink myself into ethanol toxicity is approximately as remote as the likelihood that all my electrons would suddenly shift phase and transport me to Aruba, a la the Philadelphia project (seriously, the whole Philadelphia project was really cool. Google it, please). Also, Dean X's knowledge and sight is truly without limit, and her reach knows no bounds. Who knows what evil lurks in the hearts of medical students? Dean X knows, and she will totally file a professionalism concern form on your ass.
"I woke up on X's couch this morning and didn't know where I was. It took me a full five minutes to figure out what the hell happened last night." -a fellow first-year
So apparently there are others with greater capacity for drink than I, and additionally our class has already begun to bond to the point that we're crashing drunkenly on one another's couches. That's the sort of camaraderie that I think orientation week is meant to foster, no?
Somehow I am anticipating that the "y'all are fantastic!" may not carry very much farther into the semester, so I aimed to enjoy it while it was available. Then again, I have a tendency to anticipate the worst and expect people to turn on me without warning or provocation, so that could just be my own neurosis speaking.
The following are some quotes that sum up what this week was all about for me.
"Hi, I'm X. What's your name? Where are you from? Where'd you do undergrad?"-everyone
So I learned that people here are friendly, outgoing, and in some cases (although I think I only met one...) eager to let someone know they went to Harvard.
"If you fail an exam, I'll know, and we'll have a warm and fuzzy chat about how you're doing."
-One of the deans
So it seems people here aren't primarily interested in nailing you to the wall, but rather in ensuring you do well and checking in with you if you're not. I pray to Christ, and Isis, and Buddha, that I don't ever have to have a "So you're screwing up academically" warm-and-fuzzy-conference; however, the overall feeling of someone watching out for you--not in a creepy, Dick-Cheney-who-would-put-cameras-in-every-American's-bathroom-if-he-could way, but in a caring sort of way--is reassuring.
"Additionally, if you have to be taken by ambulance to the ER for alcohol poisoning, I will know that too. And we will have a different sort of chat." -the same dean
Well, I'm on my ass after one drink. The probability that I would drink myself into ethanol toxicity is approximately as remote as the likelihood that all my electrons would suddenly shift phase and transport me to Aruba, a la the Philadelphia project (seriously, the whole Philadelphia project was really cool. Google it, please). Also, Dean X's knowledge and sight is truly without limit, and her reach knows no bounds. Who knows what evil lurks in the hearts of medical students? Dean X knows, and she will totally file a professionalism concern form on your ass.
"I woke up on X's couch this morning and didn't know where I was. It took me a full five minutes to figure out what the hell happened last night." -a fellow first-year
So apparently there are others with greater capacity for drink than I, and additionally our class has already begun to bond to the point that we're crashing drunkenly on one another's couches. That's the sort of camaraderie that I think orientation week is meant to foster, no?
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