Anatomy exam 2 came and went. I did better on this exam than I did on the last one, which pleases me, but not as well as I would have liked (of course, anything less than a 100 is 'not as well as I would have liked,' given my inherent OCDish-perfectionist tendencies, so this is somewhat less than surprising). So the limbs are done. And the pelvis, and the perineum. On to the head and neck! Onward and upward to the Circle of Willis, I say! And on to a biochem quiz!
One problem.
I don't wanna.
Woke up at 3:30 this morning, couldn't get back to sleep, and I don't wanna. Don't want to go to my PCP preceptor's office this afternoon; don't want to study for my biochem exam (though I have been, don't get me wrong); don't want to learn physiology or biochemistry this morning. And yet I will do all these things. Because that is what adulthood in general, and professional school specifically, is about. Mostly doing things that you're excited about, but on some days, when you just want to stay in bed and look at cuteoverload.com or maybe watch an Eddie Izzard DVD or finish that painting you've been putting off...going into lecture or lab anyway. Bleargh.
Showing posts with label biochemistry. Show all posts
Showing posts with label biochemistry. Show all posts
Thursday, November 13, 2008
Monday, October 13, 2008
Let the games begin!
In high school, I wasn't sporty. In middle school, yes, and in college, but not in high school.
I had band letters and academic letters (and debate) for my letter jacket, but no sports. So it struck one of my teachers as particularly funny when I described finals as "my Olympics." Seriously, I practically ran around the school in a tracksuit and headband emblazoned with "pi"--shouting, "1,2,3,4, I know what adrenal glands are for! 5, 6, 7, 8, and who won the Lincoln-Douglas debate!" DORK. Then as now, though now I am comfortable with and embrace my dorkdom. The popped collar and Chanel handbag contingent can be who they are, but I am who I am--someone who thinks enzymes and cell structures and clotting factors are pretty damn cool.
So, kids, I'm about to go do the first leg of this week's Olympic marathon--that is, midterms. MFM (which you may remember as "biochem, but interesting," not least because the prof is awesome) is this morning, in approximately half an hour. I've studied, as Holden Caulfield might say, "like a bastard," and I've gotten a good night's sleep (OK, a slight exaggeration, seeing as I never have 'a good night's sleep,' but as good as I ever get) and had a hearty oatmeal breakfast, and I'm wearing my lucky shirt. We do what we can. Let's see who comes out on top--me, or 100-odd questions about enzyme kinetics and metabolism. For once, I'm actually NOT nervous. But that could very well change in, say, 25 minutes or so.
I had band letters and academic letters (and debate) for my letter jacket, but no sports. So it struck one of my teachers as particularly funny when I described finals as "my Olympics." Seriously, I practically ran around the school in a tracksuit and headband emblazoned with "pi"--shouting, "1,2,3,4, I know what adrenal glands are for! 5, 6, 7, 8, and who won the Lincoln-Douglas debate!" DORK. Then as now, though now I am comfortable with and embrace my dorkdom. The popped collar and Chanel handbag contingent can be who they are, but I am who I am--someone who thinks enzymes and cell structures and clotting factors are pretty damn cool.
So, kids, I'm about to go do the first leg of this week's Olympic marathon--that is, midterms. MFM (which you may remember as "biochem, but interesting," not least because the prof is awesome) is this morning, in approximately half an hour. I've studied, as Holden Caulfield might say, "like a bastard," and I've gotten a good night's sleep (OK, a slight exaggeration, seeing as I never have 'a good night's sleep,' but as good as I ever get) and had a hearty oatmeal breakfast, and I'm wearing my lucky shirt. We do what we can. Let's see who comes out on top--me, or 100-odd questions about enzyme kinetics and metabolism. For once, I'm actually NOT nervous. But that could very well change in, say, 25 minutes or so.
Wednesday, September 17, 2008
Ativan, much?
So last weekend was our first official quiz in Molecular Foundations of Medicine (ie biochem).
The first time I went to take it (I was really hoping to only take it once, but we're allowed to retake them once if necessary, which turned out to be a very good thing) I totally psyched myself out. I was concerned with making it the best possible time to take it--that I'd gone for a run and had the post-workout sense of well-being, that I'd had a protein/carb snack to get those neurotransmitters in top shape (speaking of which, I really need to start taking my fish oil again--those omega 3s and 6s really are good for brain function, as I'll prove to you by posting a link to an actual scientific article when I can be assed to do it), that I'd had the optimal nicotine to caffeine ratio--not so much as to be jittery, but enough that the neurostimulant effects were out in full force. There was an article in the NY Times recently that said caffeine has both mood elevating and cognitive enhancing effects--to which any college student or working person will respond with an exasperated "duh."
So I put on my white noise machine to block out the workaday sounds of my apartment complex (and my roommate, who had family visiting) and sit down to take the quiz online. Yes, it's online. Closed-book, do-it-alone, online. I don't know how many of my classmates actually did it that way; I don't know if the professor is really that inherently trustful of human nature (though one would imagine that with 40 plus years of experience on planet Earth she must have considered the remote possibility that driven, type-A people, which medical students are almost by definition, might...bend the rules) but I did the quiz myself, just me and my computer, and lo and behold--I bombed. I literally felt like I'd been gutshot. I went downstairs to get myself the beer I'd been planning to have (either in a congratulatory or consolatory capacity) and damned if my roommate didn't ask me, "Are you ok? You don't look so good." I looked over my answers--the program lets you review them after you've taken the exam--and I had clicked the wrong boxes, I had missed words in the questions...a fustercluck. I'd just been so freaked out; about halfway through, I started thinking, "This is the first thing that really counts. This will be recorded for a grade, for posterity. This determines whether or not you will be able to pursue your chosen career." And of course I froze, and screwed up. At the same time, the sane and rational part of me (it exists, despite the numerous neuroses I vent here and the voluminous evidence to the contrary) was yelling at this critical, needling voice: "Shut up shut up shut up for Chrissake shut UP!" Did I say sane and rational? Sorry.
So I spent part of Saturday considering whether I should call the dean Monday and go in to say, "I'm sorry, I'm too stupid to be here. Obviously there was some sort of mistake. I should probably go." But instead, I studied up a bit more, did some yoga and meditation before I took the quiz again, and lo: my grade went up 20 points. Which goes to show: there is not a single human situation that cannot be helped dramatically by chilling the eff out. In fact, I repeat it to myself, mantra-like, sometimes: Freak not. I've always imagined that if angels came to people nowadays, like they did back when Jesus was roaming around, they'd have updated their language--and instead of saying "Fear not," like they told the shepherds at the first Christmas, they'd say, "Freak not."
So the anatomy exam is in less than 2 weeks. It's on the 29th, a day that for various reasons is one of the crappiest days I can imagine to have to really crank out a good performance. I spent several hours today going over the material (ie, two days' worth of lecture notes...which means I only have another 5,000 hours of material to get through). For me, the real sticklers are the heart and the autonomic nervous system. First, just the idea of the autonomic nervous system: that my brain is getting up to things without me being aware of it (though I guess it's good I don't have to think about breathing or having my heart beat--hey, cerebellum and brainstem, I'm not being ungrateful, I'm just saying...). And the heart, well, there's just a lot going on, especiallywhen you throw embryology and congenital defects into the mix. But I'm sticking with my mantra. And taking Ativan occasionally.
The first time I went to take it (I was really hoping to only take it once, but we're allowed to retake them once if necessary, which turned out to be a very good thing) I totally psyched myself out. I was concerned with making it the best possible time to take it--that I'd gone for a run and had the post-workout sense of well-being, that I'd had a protein/carb snack to get those neurotransmitters in top shape (speaking of which, I really need to start taking my fish oil again--those omega 3s and 6s really are good for brain function, as I'll prove to you by posting a link to an actual scientific article when I can be assed to do it), that I'd had the optimal nicotine to caffeine ratio--not so much as to be jittery, but enough that the neurostimulant effects were out in full force. There was an article in the NY Times recently that said caffeine has both mood elevating and cognitive enhancing effects--to which any college student or working person will respond with an exasperated "duh."
So I put on my white noise machine to block out the workaday sounds of my apartment complex (and my roommate, who had family visiting) and sit down to take the quiz online. Yes, it's online. Closed-book, do-it-alone, online. I don't know how many of my classmates actually did it that way; I don't know if the professor is really that inherently trustful of human nature (though one would imagine that with 40 plus years of experience on planet Earth she must have considered the remote possibility that driven, type-A people, which medical students are almost by definition, might...bend the rules) but I did the quiz myself, just me and my computer, and lo and behold--I bombed. I literally felt like I'd been gutshot. I went downstairs to get myself the beer I'd been planning to have (either in a congratulatory or consolatory capacity) and damned if my roommate didn't ask me, "Are you ok? You don't look so good." I looked over my answers--the program lets you review them after you've taken the exam--and I had clicked the wrong boxes, I had missed words in the questions...a fustercluck. I'd just been so freaked out; about halfway through, I started thinking, "This is the first thing that really counts. This will be recorded for a grade, for posterity. This determines whether or not you will be able to pursue your chosen career." And of course I froze, and screwed up. At the same time, the sane and rational part of me (it exists, despite the numerous neuroses I vent here and the voluminous evidence to the contrary) was yelling at this critical, needling voice: "Shut up shut up shut up for Chrissake shut UP!" Did I say sane and rational? Sorry.
So I spent part of Saturday considering whether I should call the dean Monday and go in to say, "I'm sorry, I'm too stupid to be here. Obviously there was some sort of mistake. I should probably go." But instead, I studied up a bit more, did some yoga and meditation before I took the quiz again, and lo: my grade went up 20 points. Which goes to show: there is not a single human situation that cannot be helped dramatically by chilling the eff out. In fact, I repeat it to myself, mantra-like, sometimes: Freak not. I've always imagined that if angels came to people nowadays, like they did back when Jesus was roaming around, they'd have updated their language--and instead of saying "Fear not," like they told the shepherds at the first Christmas, they'd say, "Freak not."
So the anatomy exam is in less than 2 weeks. It's on the 29th, a day that for various reasons is one of the crappiest days I can imagine to have to really crank out a good performance. I spent several hours today going over the material (ie, two days' worth of lecture notes...which means I only have another 5,000 hours of material to get through). For me, the real sticklers are the heart and the autonomic nervous system. First, just the idea of the autonomic nervous system: that my brain is getting up to things without me being aware of it (though I guess it's good I don't have to think about breathing or having my heart beat--hey, cerebellum and brainstem, I'm not being ungrateful, I'm just saying...). And the heart, well, there's just a lot going on, especiallywhen you throw embryology and congenital defects into the mix. But I'm sticking with my mantra. And taking Ativan occasionally.
Monday, September 1, 2008
What the hell is hemoglobin, you ask?
This is heme. It's part of hemoglobin (well, actually just attached to hemoglobin, which from now on will be abbreviated Hgb, by the way), the protein that carries oxygen and carbon dioxide in your blood and ushers it where it needs to go. Gorgeous, no? The whole Hgb protein is even more impressive; this is just the metalloprotein accessory group that makes the whole shebang possible. See, Fe (iron) likes to bind oxygen, but oxygen likes to (duh) oxidize things, including iron. So what's an aerobically respiring organism to do? Bind the whole thing up in a protein environment (ie, the interior of an Hgb protein--not a molecule, by the way, because it's made up of four individual parts. It's called a tetramer, from tetra for four--again the geniuses with the dead languages thinking no one will know what they're up to) where oxygen is prevented from oxidizing anything. Seriously, google hemoglobin. I urge you. Even if only to look at the pretty pictures. Just think--right now YOU are producing that. You, sitting there in front of the computer with your bag of potato chips (and, somewhat ironically, a diet Coke) are spinning out these amazingly complicated, intricately turned proteins. Damn. More on the coolness of Hgb to come.
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).
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