26 August 2008

What the doctor said

a poem by Raymond Carver, for our consideration as we think about the relationships we build with patients.

He said it doesn't look good
he said it looks bad in fact real bad
he said I counted thirty-two of them on one lung before
I quit counting them
I said I'm glad I wouldn't want to know
about any more being there than that
he said are you a religious man do you kneel down
in forest groves and let yourself ask for help
when you come to a waterfall
mist blowing against your face and arms
do you stop and ask for understanding at those moments
I said not yet but I intend to start today
he said I'm real sorry he said
I wish I had some other kind of news to give you
I said Amen and he said something else
I didn't catch and not knowing what else to do
and not wanting him to have to repeat it
and me to have to fully digest it
I just looked at him
for a minute and he looked back it was then
I jumped up and shook hands with this man who'd just given me
something no one else on earth had ever given me
I may have even thanked him habit being so strong

21 August 2008

I'm going home with the DJ...

Because she's my roommate...


16 August 2008

Medical concepts made easy: #1

According to Dr. R, it is very important that we understand the concept of diapedesis; a phenomenon observed in the inflammatory response. So important, in fact, that he acted out the apparent struggle of a neutrophil trying to squeeze through an endothelial cell to attack a microbe (played by an M2). Popping across the stage in apparent success he yelled "I have diapedesed!" Later that night I felt the very same struggle when trying to cross a packed dance floor to get a glass of water. I couldn't help it, when we finally made it to the edge of the crowd, I turned to my roommate and said "I have diapedesed!"

Scientific definition: White blood cells migrating across the endothelium due to injury or trauma.
Real world analog: Crossing a packed dance floor due to thirst or heat.

13 August 2008

Remixed: No Handlebars

[to the tune of Handlebars by the Flobots]

I do dissections with my Netters guide
My Netters guide
My Netters guide

Look at me, look at me
Hands in a guy who's so sad to be
And I'm an M1 student
Though my stethoscope's brand new you'll see
I can hear your heart go boom ba-boom
I can show you how to take blood pressure
I can take a full patient history
And I an almost tell you what it means
I watch all the lectures at double speed
And I take all my quizzes in the LRC
I know all the types of cell necrosis
And I'm proud to be at Michigan
Me and my friend saw a surgery
Me and my friend can place an IV
And guess how much we sleep
I can treat anything you got cuz, see

I can hear a murmur with no stethoscope
No stethoscope
No stethoscope

I see your MI on the EKG
on the EKG
on the EKG

Look at me, look at me
Cuz I'm on call but I'd rather be
In such a warm bed
Tired out with dictation to do
I won't make money in my residency
And I won't see my significant other
I'll be almost forty before I'm debt free
Almost a quarter million dollars
I will proscribe antibiotics
I will make your body function without your heart or lungs
I know how to check a reflex
And I can make you stick out your tongue, say ah
Doctors, surgeons and the patients
We all find insurance so frustrating
I see the slowing on your EEG
But no epileptiform activity

I can hear your problems but I'll never tell
But I'll never tell
But I'll never tell

I can thin your blood with IV heparin
IV heparin
IV heparin

Look at me, look at me
Learning and I won't stop
It feels so good to be an
MD, yeah a doc
My oath is global
My ethics secure
My profession noble
My job is to serve
I will hand out a million vaccinations
And give all my patients good explanations
And sew up so many lacerations
Perform post-surgical extubations
I can write a complete review of systems
Including your vital signs and
All of your medications in a list when
You get discharged and it's time to go

I can see your brain on the MRI
the MRI
the MRI

And I can stop the seizures with some Topamax
With some Topamax
With some Topamax

And I can fix blue babies with a full Fontan
With a full Fontan
With a full Fontan

12 August 2008

Introducing Pre-Mortem

I keep a book of things I would like to do before I die. Some are little: own a pet (not yet). Some are adventurous: skydive (done it). The book reminds me of the cool things I've done and the amazing adventures I have to look forward to.

I began this long before that horrible movie "Bucket List" (which no, I did not and never will see). Over the summer I began making the list electronic in case anyone wanted to follow along. Each post is a different goal; I will update them with photos and stories as I accomplish them.


10 August 2008

Orientation round-up

The first week of medical school is coming to a close and I thought I would run through the highlights. First, we were all coated and attended a rather awkward reception because no one knew anyone else. The chocolate-covered strawberries were delicious though. The next three days included an array of (rather boring) lectures acquainting us with the school, its policies and what was expected of us interspersed with some cool team building exercises and lots of provided food.

Thursday night was the traditional M1 bar crawl (the first day of class was also Thursday...coincidence... not exactly). We all wore pretty blue matching shirts and had drink specials at three bars in town. Pre-drinking chow at the Pizza House before shots and dancing and singing to Bon Jovi. Fun moment: asking directions from a law student. His reponse: what did you get on the MCAT?

Friday I missed the first hour of lecture (bad me) but did make it to a dinner party at a neighbor's house and a hip hop concert (6 acts!) in town. The DJ for the Blue Scholars is a phenom... I never thought I would hear Green Day turned into a hip hop beat, but it works.

Saturday we made a little mall trip, then a BBQ and a night of dancing at Live. Tonight will be Indian food for dinner... yummy!

07 August 2008


I have officially started medical school! I received my white coat and stethoscope from the Dean, stumbled my rather bewildered way through three days of orientation and am now in classes. I (already) have lectures and syllabi and assignments and quizzes... I am a medical student... weird.

School is modular, so every few weeks I will finish a module (organ system) and all its corresponding histology/pathology and anatomy. Year one is healthy organs, year two is sick ones.

First up: Patients & Populations (genetics) - 3 weeks.