Preparing For The Tomorrow Today

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Well, in all honesty, I should be studying right now. Cami has up and gone visiting teaching and I think our agreement was that I would start studying whilst she was away. However, I don't think that is going to be physically possible. So I am blogging instead. My midterms are next week and there is a considerable amount of information that must be learned in the mean time.

I spent a good percentage of the day in the fruitless pursuit of knowledge. I spent most of the day studying for physiology. A very interesting class, but very detailed. Little did I know that your body is swimming with equations like Q = ΔP(πr4/8ηL) and Jv = LPA(ΔP-σΔπ). Yeah, apparently there’s a lot more to this human body thing than I had previously suspected. So, anyway, I’ve got lots of studying to do and you might not get a letter from me next week.

This week, I met and spoke with Dr. Hilary Brodie, head of the Otolaryngology Department at UCD. As it is currently my career ambition to become an otolaryngologist (ENT) myself, I knew that there were a number of things I would be expected to do to get accepted into an ENT residency. Other than good grades, good looks, good USMLE scores and charisma out the wazoo, it is pretty much anticipated that most applicants are involved in some type of research. Dr. Brodie does quite a bit of research, and I contacted him (don’t let the first name fool you, Hilary is a man) and arranged a meeting to discuss possible research venues for myself.

The meeting went very well and it looks like I will be headed back to the cadaver lab this summer. The project I have essentially signed on to do sounds really neat. To sum it up, he wants me to help him compile a database of 3D images of inner ear structures. This will involve using high tech equipment, cadavers and lots and lots of practice. If things go according to plan, I will enroll in a course with some ENT residents to learn to do a temporal bone surgery which I will then perform on cadavers in order to gain access to these teeny structures. Having gained access to the inner ear, I will photograph the structures from each of the microscope’s two lenses. These two lenses will record images at slightly different angles, which will enable the viewer (through the assistance of glasses with special polarized lenses) to perceive the images in 3D, as a surgeon might while performing inner ear operations. If none of that made sense, then I’ll sum it up by saying this: I am spending my summer making an elaborate, anatomical Viewmaster (if you remember what that even is). It will probably be pretty tedious work, but the whole idea sounded really fun to me and I am looking forward to it.

Last week in my doctoring class we did the breast exam. That went well and without incident. This time, our model was not a professional. In fact, she signed up for the job without knowing what exactly she was getting into. Fortunately, she had a good attitude and made the process much less awkward than it could have been. To ease us into doing a real breast exam, the school provided us a fake boob to practice on. It was silicon but it had all these different kinds of lumps in it that you were supposed to be able to palpate. This week we are doing the female pelvic exam. I’ll be honest with you, this one is not going to be fun. I pity the poor woman who walks into our exam room on Tuesday.

This week Dad turned 60. I don’t know about you but that seems pretty old to me. It sounded like he and Mom had a fun time doing Birthday stuff. Just like me, his wife got him an electric nose hair trimmer. Aren’t Birthday’s great?

Practical Applications

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I spent today working at the Paul Hom Asian clinic. Every Saturday, medical students put on a free clinic for under served populations. Since we’ve been learning how to do physical exams these past few weeks, I figured it would be a good chance for me to go and practice my stuff on real patients. The clinics usually run most of the morning and I spent the first half of the day in the lab. I was on "needle duty," which meant that I was responsible for doing the blood draws.

I did that phlebotomy workshop last week and figured I’d be alright poking other people. Little did I realize that most people, especially little Asians, don’t have the same big, easily accessible veins as the classmates I practice on. Three patients offered me their arms and three times I ended up with a patient full of holes and empty vials with nary a drop of blood. I felt really bad. I guess I just have a whole lot more practicing to do. I pity the poor souls who end up being my pin cushions.

After I got done torturing those poor little ladies, I actually got a chance to try playing doctor. It was actually a lot of fun. I saw a patient who had GERD, hypothyroidism and a gall stone all at once! It was fun doing all the exams, noting the heart sounds and palpating the abdomen. After you’ve finished the initial consult, you present the patient’s information to a real doctor and then they see if you’ve done everything right. After that, they help you decide what to prescribe and that’s pretty much it. It had fun doing it, but I was pretty tired by the time the clinic was over.

When I got home I wanted to make myself some quesadillas for lunch. I go into the cupboard and there were about a bajillion ants all over the butter dish. I loathe ants. The little stinkers came through electrical outlet above the microwave. I took the butter dish and dropped the whole thing into a bowl of water and drown the blasted buggers. We’ve had all sorts of ant problems in the past. I sure hope they’ve learned their lesson.

Tuesday was an interesting day as far as Tuesdays go. I told you that we were starting to learn the “art” of the male genitourinary exam or "melvic exam," as I like to call it. I had been wondering where they were going to get somebody to agree to receive repeated rectal exams. All my questions have now been answered.

We showed up at the hospital where we usually do our Tuesday night class and were greeted by an extroverted 62 year old man named Steve. The man is, believe it or don’t, a professional anatomical model who has spent the past several years offering his “anatomy” to various medical schools across the state of California. I repeat, this man earns a living by receiving repeated prostate examinations and apparently makes fairly good money. By his own account, UCSF pays him $75/hour for his services. UCD doesn’t pay by the hour, rather gives him $20 for every exam he receives. Considering the fact that he was the recipient of 17 (seventeen!) exams on Tuesday alone, he is making fairly good money. When all was said and done, I think the man made about $1,000 dollars last week. That, my friends, is a literal butt-load of money.

Now, as a professional anatomy model, Steve has sat, or stood rather, through quite a number of melvic exams. So many, in fact, that he actually taught us how to give the exam by performing it on himself. I kid you not. The man disrobed in front of ten perfect strangers and proceeded to give himself a complete physical exam, all the way down to turning his own head and coughing. I think this guy was more comfortable in his birthday suit than most people are in a business suit. He just went through the exam giving us all pointers as if it was just a regular day at the office.

The absolute kicker was when, in an effort to show the females in the audience that they could be firm with him, he grabbed his penis and squeezed so hard that he started to shake all the while saying through clenched teeth: “See! That doesn’t hurt!”

As soon as his demonstration was over, we all got the chance to give him a melvic while everyone else watched. Lucky us. My exam went pretty much without incident. My friend Fernando wasn’t so lucky. Fernando was beginning the prostate exam. He lubed up his finger and was just about ready to begin the exam when Steve farted. The look on Fernando’s face was priceless. Though I was trying my best to remain professional, I am afraid I laughed out loud when that happened. All in all, I’m glad the experience is over, but I sure will never forget how to do the exam. We do breast exams next week and female pelvics the week after. I am hoping the experience will be a little tamer.

That was probably a little disturbing to read, but believe me, readin’ ain’t got nuthin’ on seein’ it.

Cami’s been out of town all week. She’s been in St. George babysitting her sister’s kids while her sister’s been gone. Cami will be back tomorrow night and I will be happy. She sure leaves a lot, but I guess she doesn’t really have much keeping her around here anyway. She applied for a job at Joanne’s Fabrics and will probably get it. I think that will be good. It’ll give her something else to do and a chance to earn some extra money and it’ll give me a shot to study in the evening without feeling all too guilty.

A Good Day

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I was very happy today, because my oto-ophthalmascope arrived in the mail Saturday morning. What a thing of beauty. I have already thoroughly inspected Cami’s ears. Her tympanic membranes are both intact and well. Cami enjoys looking in my ears and seeing all the earwax that she really wants to be able to clean out. The ophthalmascope is a lot trickier to use, but from what I can tell, she doesn’t have any clots.

On Friday, the Family Practice Student Interest Group put on a phlebotomy workshop for any interested students. First of all, who on earth came up with the word Phlebotomy? Did some scientist say to himself, what is the strangest word I can invent to describe drawing blood? Ah yes, Phlebotomy, it’s perfect! Ok, I just looked it up and phlebos is the Greek word for vein. Though it makes sense, I still think it’s a stupid word. Anyway, the group had us watch a ten minute video and then we all got to stick each other with needles. I was a little anxious, but it ended up being a lot easier than I had anticipated. I was surprised how easy those needles go in! The most difficult parts were the things I thought would have been the easiest. I had the darndest time tying the stupid tourniquet and also ran into problems trying to pierce the rubber stopper on the vacuum, collecting vial. Other than that, it went well. I am not an expert by any means, but at least I can say I’ve done it. I almost had to laugh remembering Heather, who is getting her RN, tell all her stories about how they had to practice everything and get lectures on doing this kind of stuff and we had a student group show us how to do the thing in 15 minutes.

My classes are coming along well, I guess. There is a lot of work to do. I am enjoying my physiology class (I learned how to take and read an EKG) and my histology class isn’t too bad. I am really enjoying my doctoring course. Thus far we’ve done the basic pulmonary and cardiovascular exams. That has been a lot of fun, but I am still having a rough time finding Cami’s dorasalis pedis pulse (I am starting to doubt she even has one). I like percussing things (and believe it or don’t, there really is a difference in resonant tones as you move across the lungs and abdomen). On Tuesday we practice the GU exam. My understanding is that we’ll first get the chance to poke around on some dummies and then onto paid actors (I really don’t think you can call what they do “acting.” It’s not like their agent is calling them and saying: “Tina baby, have I got a gig for you!”). Which begs the question: How much would someone have to pay you to allow know-nothing medical students the opportunity to repeatedly probe your body cavities? Yuck. I hear that the “actors” are paid a flat rate with something like $20 per poke. Whatever it is, it sure isn’t enough.

Cami is going to St. George to baby-sit for her sister Stephanie for the week. I guess that’s ok, because Cami will get paid for it and it’s easier for me to study when she isn’t around. I do have a lot of catching up to do. We are in the middle of a three day weekend and I always feel like whatever studying I have to do can be put off until tomorrow. Alas, that is the curse of the three day weekend.

Last night, Sean and Fernando both brought their out of town girlfriends over for dinner at our apartment. Sean and Fernando are both younger than Cami (they’re 23), but I never think of them that way. I was, however, shocked when I discovered how young their girlfriends were. They are, both of them, 20 years old. They graduated in 2003. That makes them even younger my little sister. That was a shocker to think about. Anyway, we had a lot of fun with them. We ate homemade pizza and went bowling at the MU (the on-campus UC Davis hangout). We all had a good time.

One Quarter Century

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I guess this will be the first letter you’ve gotten from me in awhile. Things have been a little crazy, seeing as how I started school again on the 2nd of January. I was a little disappointed to have to go back to class one day after the New Year. Suffice it to say, I wasn’t able to write you a letter last week because I was going back to Sacramento. One week later, I am in Merced again and have decided to use this time to write you a little letter. Cami wasn’t able to start subbing this week because schools in Woodland don’t start until the 9th so she came back to spend time with Ashley before she goes back to BYU this weekend. I came back to pick her up.

Well, that wasn’t the only reason that I came back today. In the words of die Prinzen: “Heute ha-ha-habe ich Geburtstag.” Today I celebrate a quarter century of existence on this little planet. Twenty-five years! Wow. I came home yesterday right after school got out. We had some cake and dinner then I opened some presents from Cami. She got me a nice shirt and tie and an electric nose-hair trimmer. How thoughtful!

Dad bought me an otoophthalmascope for a Christmas/Birthday present. It hasn’t come yet, but should get her shortly. He got me a nice stethoscope for Christmas too. This quarter in school we are learning how to do physical exams. This week we started with auscultation and percussion of the lungs. I’ve also been taking everyone’s blood pressure here at home. Next week we begin with female breast and pelvic exams. I really enjoy learning how to do this “real” stuff, instead of just book stuff. I even have a phlebotomy workshop next week.

All of this stuff makes for an interesting quarter, but there sure is a whole bunch of stuff to learn. This quarter I am taking Histology (microscopic anatomy), Physiology, Biochemistry and Physical Exams. That is a whole bunch on my little plate. It is only the first week and already I feel overwhelmed. I’ve heard all sorts of horror stories about how rough this quarter will be. I guess I’ll just have to hold on and be grateful that UCD is just pass/fail.

Dad and I just got finished watching the BYU vs Utah basketball game. BYU won by 12 and that was good to watch. Now I am just watching some random NFL game on TV. I guess I’m not really watching the game, it’s just sort of on in the background. Really, I am just trying to do things other than study. Histology just really isn’t that interesting.

In about an hour we are all going to eat at this Korean restaurant in Merced and then Cami and I will head home. I have to teach Sunday morning so we can’t stay the whole weekend. I guess that that works out fine, seeing as how I can’t bring myself to study at home and I do have a lot to do.