Awards

Today we had the 'Distinguished Service Teaching Awards' at school. Which mostly translated into 'free reception snackies and diet Coke...and alcohol, but no alcohol for you, because you're trying to cram another hundred renal facts into your cranial vault in the next twelve hours, and champagne will not help you do that.' So, in the spirit of such awards, let's hear it for The Body Systems, Organs, Diseases, and General Medical Stuff Awards! Yay! (Sponsored by Valtrex).

Most alarming symptom that's usually fine: Rectal bleeding. Notice I'm NOT a doctor, but rectal bleeding, especially when accompanied by pain, is usually hemorrhoids--and you'll usually be fine in a couple days if you get your hands (well, not your hands exactly...) on some hydrocortisone suppositories. Yes, suddenly being confronted with unexpected blood--particularly from this region--is distressing (as I *almost* said to my physician when she asked 'how much' bleeding I was having, "I don't think there's an acceptable lower limit for ass blood"), but it's nowhere near as bad as, say, vomiting blood.

Most innocuous condition that makes me wish I were dead: It's a tie between menstrual cramps and migraines, both of which feel like I have tiny angry elves inside my body trying to hack their way out with pickaxes. Sometimes I get both at once (oh joy! It's fairly common, apparently, and has to do with all those shifting lady hormones), and all I can do is stay perfectly still in my dark, dark, bedroom with earplugs in and a heating pad on. Oh, and take Ultram. I don't think it's a narcotic...

Grossest-looking infection that is in no way dangerous: Onychomycosis, or for those playing the home game, fungal infections of the nail bed. The thing is, it's not limited to people with poor hygeine, either...sometimes you'll be at the pool and some cute little twentysomething will walk by and only when you look down do you notice that she has, not to put too fine a point on it, toenails like corn chips. Fritos.

Prettiest-sounding infection that's actually quite gross: Chlamydia.

Most recent disease to be stripped of eponym status: Wegener's Granulomatosis, now ANCA+ vasculitis or granulomatosis (because it turns out Dr. Wegener was a Nazi, which is actually really not cool).

Laziest 'organ'- The appendix. Yeah, that's right, I put organ in scare quotes.

Overachieving organ: The liver. It does everything. If you've been reading this blog for any length of time you know my love of the liver is vast.

Organ so large and in charge you don't even think of it as an organ: The brain. More than a traditional dish in the zombie-American community; it's what keeps everything running smoothly.

Today's Lessons...

Not necessarily related to class--though some are.

1. No one ever has pheochromocytomas (tumors that produce excess adrenaline and noradrenaline), but lots of people have the symptoms. The symptoms are really common and vague--palpitations, flushing, jitteriness. As an intern, you will run lots of labs trying to track down a "pheo," imagining the 'House'-ready moment when you present your off-the-wall find to your attending and are crowned with laurels and fanned with palm leaves by the more junior medical students. One problem: you will not find them. They are the Easter Bunny, the end of the rainbow. Never there. Oh, and fun learning point: "Pheo" is a root meaning 'dusky.' Guess the tumors are dusky colored.

2. According to several people in my class, "Snickers are the healthiest candy bar. The most protein, the most fiber. No, seriously." I would say that if your eating habits have reached the point that you are SERIOUSLY considering the nutritional merits of Snickers bars, you have bigger problems than that extra 2 grams of fiber can address.

3. Not even the promise of cupcakes was sufficient to lure--I mean, encourage--more than 5 people to come to the Medical Students for Choice meeting. Why? Because another interest group was having a meeting and serving lunch. Since when does lunch beat cupcakes? Especially cupcakes with that layer of frosting that's so thick and firm you can pick it off the pastry and eat it by itself? Damn, now I'm all hungry.

4. In low-bloodflow situations, tissues (including the heart!) are capable of entering a 'hibernating' state where oxygen need is reduced and metabolism slows; upon reperfusion (ie the return of blood to the area) metabolism picks right up again, albeit with modifications--including modifications that are protective in the event of future ischemia! We are truly adaptable creatures.

5. I'm a soprano and all, but hitting a high A (as in, a ledger line above the staff) is...difficult.

6. When you're a medical student, you dissect the aorta and appreciate how thick it is, how muscular while still being elastic and distensible. When the aorta dissects itself--as in advanced syphilis or Marfan's syndrome--it's really, really bad. Rupture and exsanguinate (isn't that a great word? Better than 'bleed out,' in my opinion) in a matter of minutes bad.

7. Waiting for 45 minutes at the reproductive endocrinologist's office with only a People mazagine for company reinforced several things I already know about myself:
a) I think those over-sized sunglasses are a horrible, horrible trend, mostly because I associate them with Paris Hilton and Mary Kate Olsen. Also, they make people look like bugs.
b) I am a fundamentally impatient person. I have a need to be doing SOMEthing at all times. Maybe the Universe is teaching me to be more chill; I don't know.
c) I am out of touch with popular culture, and this does not bother me. I know who Jon and Kate are solely from check-out-stand magazines; I do not care about their family because I have other things to care about, and also because I am strangely immune to the 'cuteness rays' children emit. I spend evenings reading textbooks and writing sonnets rather than watching TV. Does this make me a better person than someone who watches Wheel of Fortune or streams cat videos on YouTube? Yes. Yes, it does.
d) There is no way to make a gyn exam not suck. There are, however, ways to make it suck less--and the rules for an easy exam are surprisingly similar to the rules for good sex. To the patient: relax. Speak up if something hurts. Breathe. For the doctor: Go slow. Explain what you'll be doing before you do it. Warm the speculum, or use a plastic one. Have lube handy. Don't be in a rush, but don't hang out in there forever.

I know I am a medical student because

I get nearly 100% of my fluids from caffeinated beverages.

I have gone out drinking after an anatomy exam...at 11 in the morning.

I spend more time on my cadaver's body on a given day than I do on my own in roughly a week.

I have skipped class...in order to study.

I have learned so many mnemonic devices, I have trouble keeping them all straight (and they all have to do with drinking or sex--especially the ones I've written for myself).

I can now eat a meal while discussing dissection technique (and in fact did so on Sunday night...thanks for the dinner and calvaria-removal talk, Dr. Ginder!)

I have realized that while showers can wait, and laundry can wait, anatomy waits for no man (or woman).

I have had dreams about the brachial plexus.

I have come, after almost a semester of medical school, to realize that I have more to learn than I could ever have previously fathomed. This is both very humbling and terribly exciting.