Thursday, December 4, 2008

It's Medical School Stupid

I am an Idiot.

I should stop apologizing. I promised you my faithful readers (Mom) that I would do this thing at least once a week to let the general public know how an over-caffeinated, over-studied and overly-tired normal human being traverses medical school and becomes a doctor, you know, the iconic professionals who attain the stigma of being within the civil elite.

-Elite in terms of commanding respect within their community and society for ascertaining a knowledge few possess the drive to sit through, assimilate and apply-

I told you last that we had finished our Introduction to Osteopathic medicine course (7 weeks) and were 2 weeks into our first legitimate system ; Musculoskeletal.

It's no surprise to tell you that MSK system is important. The number one complaint for seeing a primary care physician (PCP) in this country is low back pain, followed by shoulder pain as a close #2. The word on campus was that although fundamentals shocked us into submission as to what medical school was all about, MSK would seem easy by comparison.

Look at what we had to go by:
Anatomy- we had dissected the thorax, back and abdomen

That left head/neck (reserved for neuro) and the upper and lower extremity. There are no parasympathetics going to the extremities and the structures (muscles, arteries and nerves) are all relatively large and bilateral. Piece of cake, right?


The hand and foot are some of the most fascinating yet complex anatomical structures you will ever have to dissect. I swear to whatever God you want me to, I never cared so much about a few millimeters in my life (Second to Brett Hull's foot IN THE CREASE). The structures are packed in so tightly you have such a small window for error that most of us on our first try completely severed the superficial tendons on the anterior wrist. It was fascinating to see the amount of structures (10 to be exact) literally jump out of the carpal tunnel. But still, hard as hell to dissect through. The forearm ain't no picnic neither. I swear i still cannot distinguish between extensor carpi radialis brevis and longus. And I loathe the brachioradialis muscle, it seriously needs to become absent in 100% of the cadaver population. I don't care what it's function is, pick one compartment, arm or forearm and stay there.

As much anger I have stored up regarding the hand and upper extremity, do not get me started on the foot. It's comparable to your, your girlfriends, your mother's and aunts purses put together. But 1/7th the size as current purse sizes go. There are so, so many structures of clinical importance within the foot I have a new love for podiatrists. If I go into primary care and foot injury comes through the door, the patient will be immediately TURFed to podiatry, regardless of injury. The plantar aponeurosis is a bitch to cut through, and immediately deep to it are tendons, muscles, nerves and blood vessels which I refuse to name...

Okay, I am angry. Yet, I am to blame.

I tricked myself into the hype that MSK was going to be a pushover, where i could study at a relatively comfy pace (~4hr/night) and not on weekends and still expect to do well on exams. Lesson learned. I got bit in the ass a bit. I didn't do poorly by any means and still was above the class average, but I have my own goals that I wish to adhere to at all costs and I let myself down.

Trust me, Nothing feels as bad as when you let yourself down. So never do it*

I've been fortunate in that I don't have many moments that I can readily recall where the only person to blame for my failure was myself. I usually rise above all those obstacles and do well. Is there room for improvement? Of course, no one is perfect, but I have goals in and out of class. I want to accomplish them and as long as I can accomplish them, look back and smile at a job well done, I'll be fine.

(I know I'm all over the board with my thoughts tonite, but it will have to do.)

There are a few things in which I wish to advise anyone pursuing and career. Mine pertain to medicine but I'm sure you c extrapolate these principles to fit any goal:
- Write your personal statement well, be funny, be intriguing, be yourself, and don't be a tool.
Have everyone who you are close with read it and comment on it, they truly know you and see you as you are, as the admissions committee (adcom) will, take their advice.

-Then write another personal statement for your eyes only. Dig deep and truly lay out what you wish to accomplish, what you really desire, how you wish to be seen in the community as a physician and the like. Leave nothing unturned. It can be a paragraph or a novel. Keep it with you, edit it throughout your travels, and reflect on it when you get overwhelmed with obstacles on your path (aka studies). Trust me, you'll once again realize why you are traveling down your path in the first place.

Back to this thing...

We are now into neurology. It's a bitch. It's the hardest thing I believe I will ever study. Sure, fundamentals was 7 weeks, neuro is 4 months long! I've told you before that the goal of medical school, well mine at least, is to understand the concepts behind the facts in each system so I can become an amazing physician. That's a view I still hold. Medical school is drinking from a fire hose, you can;t possibly assimilate every bit of information into your pre-frontal cortex, but you need to know a dabbling of everything. There are times when certain courses require you to memorize, and memorizing sucks. Other times, it will require mastering complex concepts with so many twists and turns that the pathway you draw looks like nothing more than a botched spin-art (remember that toy?) painting. Well, neuro is both of those. Neuro require memorization of not only structures in the CNS, but cranial nerves, (their nuclei, function, modality and submodality) spinal cord tracts, selected sulci and gyri and numerous other bold-faced words on the course syllabus. Our first test in in 5 days and I firmly believe those who know only 40% of the material will get honors.

It's that hard.

Stress, more comically how we handle stress, is one of the major tools in weeding out the prepared and confident students from those who seriously require a psyche checkup. I am in the middle somewhere leaning sane, but the feeling of anxiety that grips each and every one of us is very overwhelming. Right now, I'd feel better acting out "The Full Monty" at my high school reunion, at then my senior talent show. But what can you do? I keep pushing forward, you'll have to pull my Starbucks cup and highlighter from my cold, dead hands.

December 8th, 2008 at 3:01pm will feel so sweet.

Whoop Whoop,


*-Take home point

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