I'm going to stink for a very long time

Sorry so long since the last post. I don't really have time for this post, but I'm going to write anyway because I really need to do something pseudo-creative for a little while. :)

It's been an interesting week thus far. Lots of firsts.

On Monday I had my first "patient encounter" as a med student. Since I've worked in patient care for 10 years, this was perhaps not quite as profound of an experience for me as it was for others, but I was actually more emotional about it than I thought I would be. My clinical skills small group (3 people) and I walked together from the med school building to the hospital all dressed up and wearing our brand new crisp white coats, and it was kind of a cool feeling. Then I had a moment of weird disorientation because I was back in a hospital (yay, home!) but had no idea where anything was (oooh, scary!). Eventually we found the intern who was precepting us -- what a great guy. We chatted for a while and then he assigned us each a patient. These first interviews weren't really histories... instead we had a short list of questions to ask about the patient's perception of illness and health care experiences. I was assigned to a very nice lady who had just returned from something (a chest x-ray, I believe, but I'm not sure). They were just shifting her back into bed before I came in. I was a little disturbed to see that the transporter left her without a call light, with her Foley bag in the bed with her, and with her bedside table out of reach, but I got that stuff sorted and we chatted for a bit. The primary goal of this exercise was to get us to be able to achieve some sort of rapport with our patient. Goal achieved.


On Tuesday I had my first medical school examination in human morphology, both practical and written. Our first unit was on embryology and histology of tissues. The practical portion was thirty slides -- ten chick embryo slides and twenty cells/tissues. The written was a 12 page mix of short answer, matching, and multiple choice, and was worth 160 points. The practical went very well, I thought, and I've heard a rumor that everyone passed, though we haven't received our scores. I thought the written was rather challenging, although that could just be because, in my opinion, anyway, it didn't play to my strengths. Too much cartilage/bone/CT, not enough muscles, nerves, epithelia, and blood (and embryo, really -- I wound up being pretty good at the embryo stuff to my supreme amazement).

Today was my first cadaver lab. We had a meeting during lunch where a speaker came and gave a talk on the history of dissection, death and how different religious/social traditions deal with it, and how this is the experience that really sort of marks the transition from being laypersons to becoming physicians. Honestly, I think people were more freaked out after the talk than they were before. But it was quite interesting -- I find medical history fascinating.

Then we went inside, got changed into scrubs (sadly not provided by the school), and had to wrap our cadavers in cloth (for preservation), flip them prone, and change them into different bags. I really like my group but we were behind from the get go because our cadaver is very large -- not horribly obese or anything, but just very tall, broad, and solidly built. We had to recruit some assistance to get everything positioned and it took quite a while.

We are beginning with the muscles of the back. Our cadaver's back is probably twice the size of some of the others (ok, this may be a slight exaggeration -- very slight). And, of course, we were all very new so everything took a long, long time. I have a feeling that we are always going to be the last group done in lab. Which is fine -- I think it's an incredible opportunity and I am all about spending as much time as we need in order to make the most of the amazing generosity of this person's gift to us.

The infamous smell is both better and worse than I thought it would be. The odor is not horrifically unpleasant, I think -- I've smelled much worse coming from live people -- but it is insidiously, horribly, and unmeasurably pervasive. Hopefully my skin will forgive me for the long hot showers I'm going to be taking every night when I come home.

After lab the Humanism in Medicine group had cookies and milk (and leftover pizza from the lunch meeting) for us and were available if anyone wanted to discuss their experiences. Apparently in last year's class there were several people who were quite upset and crying the first day. They remarked that we seemed very laid back and calm, which I suppose we really were, in retrospect. We all just walked in, took a moment to appreciate the gift we had been given, and got to work.

So, I hope I'm done with firsts for a while, now. I really would like to be able to get settled into some sort of routine! I suppose there are two more firsts coming up -- the first biochem exam on Friday and the first physio exam on Monday... oh, yeah, and my first standardized patient interview next Friday -- but I don't think they'll be quite as dramatic as these ones were.

I like my biochem teacher a lot but he is not the sort of fellow who likes to simplify or demistify or, I don't know, make things terribly clear. Apparently his exams are all about application, but we don't discuss, really, anything related to application in class, so the exam will be interesting, to say the least. I went through Lippincott last night and thought it was very helpful, despite the fact that he wants to burn every extant copy. Yes, perhaps they oversimplify, but there is something to be said for working your way UP from the basics.

Well, that's what's new in my world, and if you've not heard from me lately, that's why. Hopefully I will be able to take some time this weekend to reconnect with people!!