Med School Junkie

The Horror ...

2007-04-03T18:49:00.000-05:00

Not again. Anything but this. I would've been happier had ANYONE but Florida won the NCAA basketball title. But for Ohio State to lose to them, AGAIN -- when does it stop?

Thankfully, both Florida's football and basketball teams are going to lose a ton of players to the NFL and NBA. Neither team has any chance of making a big postseason splash next year, and if Oden decides to rejoin the Buckeyes for one more go-'round, then a 39-0 national championship season for Ohio State isn't out of the question.

One thing can be said for the basketball team, however -- they played against a superior talent and didn't give up. The football team spent seven weeks sizing their rings and ordering championship gear that was surely to be hand-delivered to them once they stepped foot on the field. To be so much alike in terms of (horrid) outcome, the two national championship games this year were polar opposites. These "baby Bucks" weren't even supposed to be in the Final Four, but they ended up representing our school and our city very well. I guess 35-4 isn't such a bad year after all.

Ohio State vs. Florida, National Championship Game, Part 2

2007-03-31T23:22:00.000-05:00

Here we go again ...

Monday night, April 2, Ohio State and Florida will battle for the 2nd time in 12 weeks for a major collegiate national championship. I won't speak again of what happened in January, but I hope for the sake of all that is good in this world that OSU can exact some measure of sporting revenge against its newest rival.

Prediction

Ohio State: 76
Florida: 65

Jealousy

2007-03-29T14:34:00.000-05:00

I get a little bit jealous every time I go into my local comics store. Admittedly, I have a rather extensive collection of comics dating back into the 1980s, but over the last year I've branched out to sample some other odds and ends, and all this has made me want more. I have a subscription to 10 monthly comic books and a few bi-monthlies through the store (10% discount with 10 monthlies = swell!), so each week I have 3-4 issues waiting for me when I walk in the shop.

Other guys, however, have stacks of 10, 20, and sometimes even 30 books, and they spend their time browsing the racks for more. Before you go getting all worried, I cannot fathom spending $35, $65, or $100 PER WEEK on comics -- all hobbies have their limit, and mine stops way before that. But it does make me exceedingly greedy when I see these guys walking around with a stack of comics that could keep a small army in supply for a few days; oh, the fun I could have spending an entire day reading nothing but cartoon captions!

I can see my set-up now -- a sun chair out in my freshly mowed backyard, a radio broadcasting the afternoon major league baseball game, and a cooler full of Cokes, waters, and Gatorade. I could construct a comics stand out of cardboard and our leftover TV box, and Sula would bring me a cheeseburger and some fries from Wendy's at my beckon call. Then, after I get sunburned (usually about 15 minutes in the early summer), I could come inside to a new episode of Gilmore Girls or Grey's Anatomy and fall asleep on the couch, my lymphatics bursting with chylous (digestive) fluid reflecting my extraordinarily fatty meal and my brain buzzing with the post-Coke caffeine rush. Then I would make a token attempt to study, decide its not worth the effort, and then drive to Whetstone Park and throw the Aerobie with Sula until dusk.

What a day ...

Three More Bite the Dust

2007-03-29T14:31:00.000-05:00

Endocrine, reproductive, and gastrointestinal path tests all found their way into Thomas' "Passing Score" examination collection today. Hip, hip ... oh, wait ... there's still more to be done? Good grief.

Final Four!

2007-03-24T20:47:00.000-05:00

OHIO STATE ADVANCES TO THE FINAL FOUR!!!!

Ohio State -- 92
Memphis -- 76

Joey "The Mouth" Dorsey, he of recent fame by calling OSU freshman phenom Greg Oden "a lot overrated," had a huge contribution in the Tigers' blowout loss by chipping in with 0 points, 4 rebounds, and 4 personal fouls. Oden, playing David to Dorsey's self-proclaimed Goliath, scored 17 points, grabbed 9 rebounds, and participated in cutting down the nets in San Antonio after winning the South Regional final.

Ohio State punched the first ticket to the Final Four and will play the winner of tomorrow's North Carolina vs. Georgetown matchup in the East Regional final.

[p.s. -- my other national title game pick, UCLA, beat West #1 seed Kansas tonight to earn its place in the Final Four ... shoulda put some money on this bracket!]

TN Trip

2007-03-24T20:42:00.000-05:00

This last trip down to TN to visit the family was an interesting one. Grandparents feeling better, 80-degree weather in March, and spending almost an entire Buckeyes basketball game without really knowing what was going on is a bit strange for me. We finally saw Buzz's TTU dormroom and met her beautiful black-and-white shorthaired feline, Blossom. Thursday afternoon at Rock Island was a blast. Friday night's fire was too. Too bad it all had to end so soon.

Updating the Tourney Picks

2007-03-19T19:00:00.000-05:00

Poor Sula. In a previous post I wrote a few comments about some pretty outlandish tourney picks she made (Wisconsin in the title game, Holy Cross in the Elite Eight), and both came back to bite her in the butt. Not that it really matters ... one of my Final Four picks, Texas, got ousted last night by Southern California, and my national champion -- Ohio State (who else?!?) -- needed a last-second desperation 3-pointer to squeak by giant-killer Xavier. Play like that against a better opponent and OSU will be watching the Final Four from the couch.

After the first weekend, when everyone's brackets are already busted, "getting it right" doesn't really concern me anymore. Sula and I have watched most of the games on sportsline.com's MMOD viewer, including Holy Cross' valiant effort that fell short, and we've had a pretty darn good time doing it. I think I want to keep it that way.

Next up: Ohio State vs. Tennessee in the Sweet Sixteen, 9 pm on Thursday. Divided loyalties? Not a chance -- scarlet and gray all the way!

Steak Night

2007-03-19T17:18:00.000-05:00

Tonight's menu:

1. Two ridiculously monstrous T-bone steaks

2. Two buttered, salted baked potatoes

3. A heaping plateful of vegetables

4. Italian dinner rolls

5. Peaches

6. Coke

7. After-dinner chocolate (and lots, at that!)

Bad Moon a Risin'

2007-03-18T22:54:00.000-05:00

Being in the 11th hour of my Med-2 year is a frightening thing. A lineup of what has to occur over the next 43 days:

1. 8 ISP exams -- endocrinology, gastrointestinal path, reproductive path, ophthalmology, neuro path, psychiatry, hematology, and rheumatic & musculoskeletal pathology

2. Advanced Cardiac Life Support (ACLS) training -- two full 8-hour days in April and an exam for certification

3. PCM exam -- April 13

4. CAPSTONE x 4 sessions

5. PD/PCM OSCE (a kind of "hands-on" test where we interview standardized patients and conduct physical exams as well)

6. CAPSTONE exam -- April 25

All of these things have to happen BEFORE I can really start digging into my Step 1 board preparation. I've started using the First Aid series (a nationally recognized prep tool) in my tradition studies in order to familiarize myself with the layout of the texts, and sometime next week I hope to begin the process of working through 2,250 USMLE-style Q-Bank practice questions.

Should I somehow mess up and survive the imminent three-month-long nightmare, I have one of the hardest rotations in all of medicine -- Surgery -- waiting for me on the other end. Yippee.

Predators Blow It

2007-03-14T20:42:00.000-05:00

After spending much of the season firmly entrenched in first place in the Western Conference, the Nashville Predators were humiliated in back-to-back games against archrival Detroit on Tuesday and Wednesday nights. The losses (5-2 and 4-2) drop Nashville into second place in the Central Division and into the 4th seed position in the upcoming NHL playoffs.

Superman #660

2007-03-14T20:03:00.000-05:00

Taking a break from the Arion/End-of-the-World/Armageddon arch that has encompassed the last five or six issues of Superman, this month's addition finds the Man of Steel in a more "comic" predicament. An absurd gangster known as Nitro G, who has the ability -- imagine this -- to magically create explosive nitroglycerin (NTG) out of thin air, seeks help from long-time Superman nemesis Prankster in order to knock over a couple of Metropolis-based banks. The Prankster's role in this comic is quite generic: create a laughable diversion so Superman comes running in to save the innocents below, all while Nitro G and his band of thugs can go and steal millions in diamonds and cash.

Fool Superman once -- shame on you. Fool him twice -- nah.

Who didn't see this ending coming? After Nitro G threatens to kill Prankster with a flaming ball of NTG, Prankster succumbs to his demands, only to (literally) expose Nitro G and thoroughly embarrass him -- with Superman's help, of course.

Ah, the hilarity of it all. Sometimes I wonder why I pay $2.99 for a couple of new comics every week, but the sheer ridiculousness of the stories and the joy I get out of reading them more than makes up for the price.

End o' Quarter Doldrums

2007-03-14T18:10:00.000-05:00

After waiting 10 weeks for the end of the quarter to arrive, the next-to-last chapter in my 6-part preclinical sequence is finally finished. The undergrads have finals this week, with Spring Break commencing just as soon as one walks out of his/her last exam. ISP students, on the other hand, have no such thing as a spring break to tide us over until the next round begins -- the knocks keep on 'a coming whether we like it or not. Next week's trip to TN with Sula will help stem the malice of ISP's rigorous springtime demands, but even there I'll have to work mornings in the TTU library simply to "keep current" on what is going to turn out to be the most furious two-month period of my life.

All that being said, I find the end of this quarter especially bittersweet in terms of my hobbies. The very first week saw football come to a crashing halt, and now basketball season's winding down, leaving me with no school sporting activities to keep up with on a near-daily basis. Unlike most other fans, baseball season takes a while to wind up for me -- by about mid-May I'm usually really into it, but April is still cold in Columbus, so I'm unable to join the Boys of Summer until my skin turns a bit darker.

March Madness is nice, and April's showers suit me just fine, but give me Sula, a Barq's Root Beer, two lawnchairs, and a wide-open stretch of beach to help these winter blues roll away. Catch you on the flipside.

Time for OB/GYN

2007-03-14T07:16:00.000-05:00

Today I'll dedicate the entirety of my study time to obstetrics and gynecology.

Let the joking commence.

Fill Out Your Brackets

2007-03-13T23:17:00.000-05:00

Two nights ago Sula and I filled out our NCAA Tournament brackets:

TC3MD's Final Four:

Oregon (3 seed, Midwest)
UCLA (2, West)
Texas (4, East)
Ohio State (1, South)

Sula's Final Four:

Wisconsin (2, Midwest)
Pittsburgh (3, West)
Boston College (7, East)
Ohio State (1, South)

Championship game picks:

TC3MD -- OSU 66, UCLA 63
Sula -- OSU 89, Wisconsin 88

Of note: Sula also picked 13th-seeded Holy Cross to fall in a tight game against Pitt in the Elite Eight. I love you, babe, but it ain't happening!

Both brackets include a Sweet Sixteen matchup of 5th-seeded Tennessee against Ohio State. If this happens, I see OSU dominating the paint and Oden pouring in at least 27 points.

Surprise, surprise that at least half the sports writers on CNNsi.com, ESPN.com, and cbs.sportsline.com are picking the Florida Gators to bring home the hardware on April 2. My bold prediction is that Florida doesn't make it past the Elite Eight.

Two years ago I correctly picked the national championship game (North Carolina over Illinois), but last year's tourney busted my bracket after the first weekend. Never, ever, ever will I pick Florida to win any sort of championship, not even if my mortgage or school loans were on the line. My upbringing as a die-hard Vols fan surely prevents it, and I'm pretty sure my dad would hemorrhage out if I ever tried such a thing.

I think we'll try to keep the old man around a few more years before attempting anything risky ...

OSU Wins Big Ten Tournament!

2007-03-11T19:06:00.000-05:00

The rubber match between #1 Ohio State and #3 Wisconsin left no doubt as to the identity of the better team this time -- after splitting two games with the Badgers by a total of four points, Ohio State steamrolled to a 66-49 victory in the championship game of the Big Ten Tournament.

Curiously, #5 Florida -- a 21-point winner over Arkansas in the SEC tourney -- secured the top overall seed in the NCAA tournament, which begins this Thursday. When did the NCAA basketball selection committee start rewarding teams of one sport based on the championship game successes (or, in the Buckeyes' case, failures) of their football teams?

Hat Trick

2007-03-09T17:24:00.000-05:00

Conference freshman of the year and defensive player of the year Greg Oden scored 22 points, grabbed 8 rebounds, and blocked 4 shots in leading #1 Ohio State to a 72-62 victory over Michigan in the quarterfinals of the Big 10 basketball tournament earlier this afternoon. The win caps a 3-0 season against UM in men's basketball and means Ohio State will finish the 2006-2007 academic year without a loss in the three major sports against its arch rival.

The Difference a Week Can Make

2007-03-09T17:18:00.000-05:00

Another Friday, another Capstone class, another day of feeling bad about ... no, wait! I actually knew what was going on in all the cases today! How did that happen? I think knowing what to expect from the course now helped me calm down enough to let my instincts take over. I'm beginning to be able to sort through all the different tests, signs, symptoms, etc., etc., and arrive at a decent differential of diagnoses. They're not always 100% accurate, but progress -- substantial progress -- is being made as I type this. Neurons forming new pathways and connections, glial cells cleaning up all the garbage that doesn't belong, Vince trying to climb walls ...

[Abrupt ending. We've got a rotten cat on our hands here, folks.]

Torture on TV

2007-03-08T22:00:00.000-05:00

Sula sent me an article this afternoon that makes mention of certain groups of people who think Jack Bauer is too violent for primetime television.

These people likely will not wake up in the morning.

Wit

2007-03-05T23:25:00.000-05:00

This gem of a movie from Emma Thompson (2001, HBO Home Video) tackles head-on the issue of physician insensitivity in a medical field increasingly dominated by poor bedside manner. Thompson plays the role of a hard-nosed English professor whose otherwise brilliant career in academia parallels the obstructive roles professional hubris and lack of compassion can have in medicine as well. Playing a difficult role as a patient slowly dying of stage 4 metastatic ovarian cancer, Thompson initially delivers each line with the poise expected of an unforgiving professor but becomes more and more human as her life painfully comes to an end. She is the embodiment of what we loathe in college ("that" professor whose mother you would love to slap) and a reminder of the humanity behind the falsely fabricated mask of intellectual self-importance. No matter their past, present, or future, patients certainly deserve more from us than this.

Gears of War Obsession

2007-03-04T23:10:00.000-05:00

The only video game I've played for the last four months is Gears of War on the Xbox 360. Normally I don't obsess over one game for such a long period of time -- even Halo 2 and Knights of the Old Republic didn't garner this much attention. In terms of dialogue and offering wide-open gameplay, Gears is below average. Missions must be completed in sequence, and the ever-annoying "sudden appearance" phenomenon (e.g., when the player crosses a certain imaginary threshold or changes rooms, new enemies suddenly appear out of nowhere) is used way too often for my tastes. Weaknesses aside, however, this is one of the more perfect system-based shooters available, simply for its over-the-top grotesque presentation, super-tight controls, and addictive adrenaline-pumping action. Blowing an enemy to shreds with the Torque Bow or chainsawing monsters in half with the Lancer rifle's supersweet bayonet never gets old.

Printing Party

2007-03-04T23:06:00.000-05:00

Tonight Sula and I participated in our last printing party -- 228 pages of pure musicological goodness is now finalized and ready for binding, courtesy of Prior Health Sciences Library!

BooksBooksBooks

2007-03-04T21:47:00.000-05:00

One thing I haven't held back on purchasing in medical school is books. Many of my peers prefer to obtain required learning resources online (either free through the library or in purchased e-book format), but there's something about the smell and feel of brand new books that I find highly appealing. Perhaps I'm a bit old-school, but flipping through page after page of unforgivably dense text and finally finding the answer to your question(s) is more rewarding to me than using an auto-find feature on a web browser.

In other news, I just celebrated my 75th birthday and am currently telling tales about how "there was no such thing as toys when I was a kid" ...

Tax Season Tactics

2007-03-04T15:58:00.000-05:00

I'm a fan of getting my taxes done early. Way early. It helps that OSU's due date for FAFSA (Free Application for Federal Student Aid) submission is March 1 and that the FAFSA requires one's tax information from the previous year, but it's also much less a headache and source of stress than waiting around until April 15.

Apparently, most of my fellow countrymen do not share the same sentiment. The IRS is now reporting that an estimated $300 billion in due taxes goes unpaid every single year -- an average of $2680 per household. In other words, this amount is more than enough to cover the national deficit, pay for Pres. Bush's overseas mistakes, and help rebuild New Orleans. About 70% of that amount comes from underreporting on the part of individual Americans while the remainder can be tagged to businesses, both big and small.

I fail to understand the sense in this. Perhaps it's the fact that I've never made enough money in a year to require a hefty pay-in during the spring, or the fact that my parents raised me better than that (when all else fails, blame it on a good upbringing!), but it seems one of the most moronic things you can do is expose yourself to an audit that potentially could destroy your finances for the rest of your life. Don't get me wrong: I loathe the fact that we as a people allow our government to fleece us for nearly 40% of our collective income by requiring as much in payment for its below-average services, but hasn't the old adage, "Give to Caesar what is Caesar's," been proven most wise already?

Ohio State Beats Michigan ... Again

2007-03-03T21:52:00.000-05:00

Since I've been at Ohio State, the three major varsity sports -- football and men's & women's basketball -- have beaten the University of Michigan like there's no tomorrow. This afternoon was no different. The #1 Ohio State men's basketball team came from behind to win its 14th consecutive game, this time over Michigan 65-61 in front of a loud and supportive crowd in Ann Arbor to finish 15-1 in conference play (the lone loss coming Jan. 9 at Wisconsin) and with a final regular season record of 27-3. The other two losses were at North Carolina (without then-injured superstar center Greg Oden) and at Florida (in one of Oden's first games back).

The question of Ohio State's recent sporting dominance over UM is starting to pop up in local indie newspapers -- "Has this gotten old yet? CAN this ever get old?" Both can be summed up quite succinctly: No. During the '90s Michigan owned OSU in football, and until the latter part of the decade the same could be said for men's basketball as well. Now the pendulum is in full swing back toward Columbus, and most sports fans in town couldn't be happier.

It would be ludicrous to expect such good fortune to last forever (next year's football game, in addition to be played in Ann Arbor, will be OSU's first without Wolverine-killer QB Troy Smith since 2003 [perhaps not so ironically, the year of Ohio State's last loss to Michigan]), but rest assured the entire state is enjoying what has been a long time in the making.

CAPSTONE

2007-03-03T20:44:00.000-05:00

The "final course" of the first two years of medical school at Ohio State is called CAPSTONE, a class designed to put the finishing touches on pre-clinical medical learning and prepare the student for life in the trenches next year. Last Friday (2/23) was my class' first CAPSTONE meeting, and I left feeling absolutely stupid. The entirety of the first two years of medical school is spent learning physiology and disease states in a 'unidirectional' manner -- i.e., name of disease, etiology (aka "causative agent"), epidemiology ("who gets it?"), pathophysiology ("how does it work to cause disease?"), signs and symptoms, and treatment. I've trained my mind to work fairly well in this manner, as reading through a course packet or a fairly dense pathophysiology textbook is no longer the chore it once was.

But here's the thing about CAPSTONE -- now I have to "unlearn" everything I've learned about medicine and start applying it in reverse. Last Friday we were given six packets of patient cases; in each of these packets are summaries of four fictional patients with a wide variety of current medication lists, presenting symptoms, physical examination findings, and relevant histories. Our job now is to apply what we've learned since August 2005 and find out exactly what is causing the problem. Easy, you say? Think again.

The only analogy I can think of is this: imagine learning to play the piano without your hearing. Your ears have been plugged, and the only things you can rely on to play this instrument are (1) your manual dexterity, and (2) your sense of sight. You certainly would be able to read the music and process your visual sensations into specific finger movements after a good deal of training. That part is like being a Med-1/2 student.

Now imagine your ears have been unplugged for the first time since your piano training began -- except now your vision is taken away in return. Part of the skill set you used to learn the material in the first place is gone, and now you need to teach your ears what your eyes already knew using only the memory of movement and placement ingrained in your fingers. The only problem is that you need to do this quickly. And flawlessly. Why? Because your grade and subsequently your chance at a prestigious placement in postgraduate training depend on it. This is akin to being a beginning third-year medical student.

Ready for a breather yet?

Despite the overwhelming nature of the course, I think CAPSTONE will be of great benefit to those of us willing to take it seriously. The learning curve is steep, but in the wake of "solving" the first case (see below), I believe our group of six students has taken the first step in the process of transforming our thinking. And that is a very good thing.

Case 2a -- 3/2/2007

Middle-aged white paraplegic female with a history of breast cancer with spinal metastases presents with a 2-day history of progressive dyspnea (shortness of breath) and tachypnea (increased number of breaths per minute). Patient has difficulty completing a sentence without stopping to catch her breath and has difficulty eating and drinking. Patient denies chest pain but does have a dry cough.

Medications:

Naproxen 375 mg po BID
Percocet 5/325 mg po q6h
Duragesic patch 75 mcg q72h
Xeloda (dose unknown), per protocol

Physical Exam:

Temp. -- 100.4F (normal 98.6F)
Respirations -- 40 per minute (normal 12-20)
Heart Rate -- 149 per minute (normal 60-100)
BP -- 90/40 (normal 120/80)
Pulse oximetry on room air -- 89% (normal 99%)
Pulse oximetry on 100% oxygen -- 93%

Due to her immobility, history of malignant cancer, heart rate > 100 bpm, and increased respiratory rate, our group diagnosed this patient with a pulmonary embolism resulting from deep vein thrombosis (i.e., a clot resulting from stagnant blood in the deep veins of the patient's legs broke off from its site of formation and traveled through the venous system into the right side of her heart; since blood from the right side of the heart is pumped into the lungs for re-oxygenation, this clot became lodged in pulmonary vessels leading to the lungs and is causing her shortness of breath, increased rate of breathing, and decreased arterial oxygen content).

It seems easy in hindsight, but when first confronted with this illness script after learning about pulmonary emboli in the way described above, it was a bit daunting, to say the least. Several different diagnoses have to be considered and discarded before finally settling on the most correct one (the process of developing such a list of possible problems is called "formulating a differential diagnosis"), and eventually it will have to be done within a matter of seconds. All the possible disease states this patient could have -- pneumonia, pleural effusion, acute pulmonary edema, sudden inflammatory response syndrome, congestive heart failure, etc. -- have to be thought of, considered, and ruled out before the doctor can begin discussing treatment options with his/her patient.

I was lucky to be able to come to a conclusion after an hour of re-reading through textbooks and study guides. Your doctor is able to do this in less than 15 seconds.

I've got a long way to go ...

Hey Coach Amaker ... Shutup!

2007-03-03T19:20:00.000-05:00

Michigan coach Tommy Amaker was called for a 2nd-half technical foul in this afternoon's Ohio State v. Michigan basketball game; apparently Amaker was incensed that OSU center Greg Oden was not called for a foul on the other end.

First of all, if there was a foul committed, it would've been ticky-tacky at best. Second, Amaker's goons were all over Oden the entire game: he ended up with four fouls simply for playing in the same way Michigan's hackers were doing.

Next time, Tommy Amaker, do yourself a favor and keep your mouth shut. Until your verbal diarrhea, you benefited from some major home cooking and were on your way to an upset of #1 OSU. Now you find yourself not only the loser of a game you should have won, but you quite possibly cost your team a spot in the NCAA tournament. Way to go!

Yarn Store Outing

2007-03-03T12:57:00.000-05:00

Today's adventure will be to the yarn store (with Sula -- I've only made one solo trip and am frightened of doing so again) and to Kroger. I find knitting adventures to be somewhat cathartic, but I'm always able to fill right back up again with a little junk food from the snack section at Kroger.

Only three hours left in the 4th season of 24 -- terrorists have just released the warhead-containing rocket into the sky, Jack Bauer's caught the ire of the Chinese government for his attack on their U.S.-based consulate, Audrey's ticked as can be at Jack, and the Tony/Michelle tension is starting to ease up a bit. How can Jack possibly take down the rocket, win back Audrey, and save his own skin all at the same time?

After several consecutive days of near-springlike weather, a small snowstorm again blanketed the area this morning. Ahhhh, winter in Ohio!

The Strangest Film

2007-03-02T22:49:00.000-05:00

I love the Gilmore Girls. There, I said it. Laugh, point, smirk, and whisper your good-for-nothings behind my back -- I'll just be sitting here enjoying sass and wit and pure weirdness, the likes of which you can't begin to imagine. In one of the past seasons, Kirk, perhaps the most eccentric of all residents of Stars Hollow, CT, produced and displayed a film he created co-starring the equally odd Mary Lynn Rajskub (she of 24 fame as CTU agent Chloe O'Brian). This 2-minute masterpiece is so bizarre it makes me uncomfortable and slightly hiccupish. Especially noteworthy: the out-of-place "I love you" delivered to Kirk before entering the house.

Last PCM Ever!

2007-03-01T20:55:00.000-05:00

Today I attended my last PCM small group ever -- patience and perseverance are not two of my strongest qualities, but somehow I managed to pool two years' worth of both into accomplishing this single task.

PCM (Patient Centered Medicine) is a class Ohio State offers in addition to the core curriculum that focuses on the doctor-patient relationship and its importance to the student. The two components of the course, lecture and small group, offer different takes on a given topic within the current subject (i.e., Ethics, Substance Abuse, etc.). The lecture component generally introduces the topic to the class, then the small group session serves to further elaborate on it in a more "intimate" environment.

I don't know what it is about PCM that bothers me so much. The facilitators have all been excellent, the material is clinically relevant, and I enjoy hearing my classmates' opinions on different -- often controversial -- medical matters, so what could be the problem? Maybe it's my own impatience shining through, or the fact that the core curriculum seems so much more important right now, or that my ISP status effectively is negated by the small group attendance policy (only one "allowed" absence per year). Whatever it is, there's a kind of je ne sais quoi about the whole affair that leaves a bitter taste in my mouth.

New Release Day

2007-02-28T21:13:00.000-05:00

This week's return of Action Comics (after a 3 and 1/2 month hiatus) climaxes with Superman's banishment to the Phantom Zone by General Zod. How will the Man of Steel escape from a prison that exists outside the realm of time and space? What will happen to the new child from Krypton, the murderous Zod, Lois Lane and Jimmy Olsen, and Metropolis itself? And where the heck did all those new Kryptonese travel pods come from?

I cannot bear to wait any longer. Someone get me those last 9 issues of 52 pronto.

Good Stuff (or Not So Much ... )

2007-02-28T21:09:00.000-05:00

Today's topics of study: gastrointestinal cancers, constipation, and the many varied causes of diarrhea. For some reason, the words "secretory diarrhea" or "infectious diarrhea" used in combination seem as if they should be stricken from the record and purged from the collective social conscience. Not that many among us have our minds on diarrhea at any given time ...

Chugging Along

2007-02-27T18:55:00.000-05:00

Today marks the beginning of my foray into gastrointestinal pathophysiology -- I finished reading through the endocrinology course packet yesterday and have been working on "Disorders of the Esophagus" this afternoon.

My new Rowenta iron got a good workout last night and this morning with well over two hours of use. I think my entire wardrobe has been freshly pressed, and perhaps every pair of Sula's dress pants has had the same fate.

Late night at The University tonight; Sula's teaching and I'm slaving away under fluorescent lighting that makes my skin look like some fantastic shade of yellowish purple. Jaundice with diffuse ecchymoses -- could be liver cancer ... or hepatobiliary obstruction ... or ...

Self-diagnosis is a dangerous thing, especially for students ...

Time to Rock My World

2007-02-26T19:15:00.000-05:00

Tonight's undertaking: season 4 of '24.' Jack Bauer is what every red-blooded American male dreams of being.

Typical Study Day

2007-02-26T00:04:00.000-05:00

A "normal" study day for me usually consists of two different phases: at school (anywhere from 3-10 hours a day) and at home. Longer days at school translate into longer study days -- it's not uncommon for me to spend 12 hours studying one day, then only four hours the next day. This breaks up the monotony of deciphering hundreds and hundreds of pages of medical-ese in order to finish a page or two of notes.

Since the ISP pathway has no lecture-based learning for the main portion of the medical sciences, my daily reading becomes my "lecture," and I have to prepare for that much in the same way a professor would prepare to deliver a talk on a given topic. On average, three to four hours a day are spent reading the material, and another three to four are spent making notes, reviewing pertinent x-rays/MRIs/CT scans/angiograms/etc., and printing flash cards for rapid review of more difficult subjects. Long days at school are divided between a computer lab in Sullivant Library and the ISP library in Meiling Hall; the change in scenery provides a much-needed breath of fresh air and the chance at a 20-minute walk across campus on a daily basis.

Monday will be a medium-length day (about 6 hours on campus), though the plans are to study for 10 hours tomorrow. Actually, most days from here until the end of May will be at least 10-hour workdays, as prep time for Step 1 demands an even tougher schedule than what I already have in place.

Two Big Wins!

2007-02-25T22:05:00.000-05:00

#1/#2 Ohio State knocked off #2/#1 Wisconsin this afternoon in Columbus, 49-48. Two Big Ten championships in a row!!

Sula took me to the Predators vs. Blue Jackets game tonight at Nationwide Arena, and we had a great time. The arena itself is a beautiful, clean facility, although the scheduled entertainment during timeouts and at intermission leaves much to be desired.

The Predators jumped out to a 1-0 lead on a Paul Kariya goal, but Columbus tied the game on a power play a little over a minute into the 2nd period. Nashville came right back, scoring two goals to close out the 2nd, and had a 3-1 lead 5 minutes into the 3rd. Two quick Columbus goals tied the score again, and the Predators looked absolutely lost on offense throughout the remainder of the period. Overtime was much the same, as Nashville had zero shots on goal and gave up several scoring chances to a lesser team. But, in the end, goalie Chris Mason turned away all three of Columbus' shots in the shootout, including Rick Nash's fabulous backhander to win the game, 4-3.

It's kind of a shame that we've never taken the time to go to a Blue Jackets game in the three years we've been in the city. Glad I have a wife who helps me stop and smell the roses every once in a while ...

Marvel's Civil War

2007-02-24T23:49:00.000-05:00

This past week Marvel concluded its famed 7-part Civil War miniseries with a showdown between Captain America and the Iron Man in the streets of Midtown Manhattan. What had the chance to be a dramatic send-off for one or the other of Marvel's all-time greatest characters ended with the arrest of Steve Rogers (aka Captain America) after a "change of heart" in the middle of the battle. After several months of exciting buildup, the denouement of the Civil War absolutely fizzled, paling in comparison to the epic Superman/Superboy Prime clash in chapter 7 of DC Comics' Infinite Crisis. Color me biased toward Clark Kent and Bruce Wayne, but I am wholeheartedly disappointed with Marvel's cop-out conclusion (and wouldn't mind having my money back).

Q-Bank

2007-02-24T23:24:00.000-05:00

A big part of Step 1 preparation involves hours and hours of online practice questions designed to simulate USMLE testing conditions. The largest provider of such materials, Kaplan's notorious Q-Bank, consists of over 2,000 practice exam questions and costs $499.99 for a 3-month subscription. My subscription to Q-Bank begins on Thursday, March 1, and between this time and May 30 (my Step 1 testing day), I will have spent the better part of 150 hours reading, reviewing, and memorizing aspects of every single item. And just think -- that's less than half the study time required to really score well on the exam.

Did I mention your doctor had to pass THREE different USMLE Step Exams simply to become eligible to sit for even more specialized examinations?

Huge Predators Win

2007-02-24T23:19:00.000-05:00

Nashville vs. Detroit, first place on the line -- and a 4-3 OT win. Tomorrow night we're going to the Preds vs. Blue Jackets game here in Columbus, so hopefully another win is on the way.

Renal/Respiratory Exams Finished

2007-02-24T15:02:00.000-05:00

I had a big testing week this past week -- respiratory pathophysiology and renal pathophysiology are now finished. I did exceedingly well on the respiratory exam and better than average on the renal test, so all's well that ends well.

Next up are endocrinology, gastrointestinal pathophysiology, and reproductive pathophysiology. The Independent Study Program at Ohio State allows for multiple tests to be taken on one exam day, and finishing all three within a relatively small amount of time is imperitive is you want to stay on schedule. I almost always take all the exams for a given block on the same day; spreading the material out over two days is more of a hassle than it's worth.

The most frightening part of second year is the ever-looming presence of the USMLE Step 1 Exam. This beast of a test is an eight-hour examination of all the knowledge a medical student accumulates over the entirety of the first two years -- everything from biochemistry and anatomy to pathophysiology and pharmacology. Finishing all the school requirements before late spring is essential if enough study time is to be had for the Step 1 test.

Ohio State vs. Wisconsin TOMORROW!

2007-02-24T13:46:00.000-05:00

I'm a sports fanatic. Football, baseball, basketball, hockey ... you name it, I'll find something to get rabid about in a hurry. For 12 weeks this fall I had a dream existence -- #1 Ohio State rolling through a relatively subpar Big Ten schedule all the way up to a showdown with then-#2 Michigan in Columbus last November. Over 900 yards of offense and 81 points later, Ohio State emerged as the conference champions and secured a berth in the BCS National Championship game in Glendale, AZ.

Then reality struck back. After getting blistered by a less-talented but substantially more hungry Florida Gators team for 41 points on the sport's grandest stage, the mass of scarlet-clad humanity here in Columbus entered a period of mourning. The very next day, our basketball Bucks went up to Madison and got smoked by a better and more experienced Badgers squad. It couldn't get much worse at that point.

Which brings me to tomorrow afternoon -- what makes me think OSU stands a chance against a Wisconsin team coming off a humiliating conference loss at Michigan State? Call it loyalty, stupidity, intelligence, intuition -- whatever you want, really -- but know this: it's the exact same thing that drives my confidence of a Bucks-Gators title game rematch next season. Except this time, we're scoring 60.

25 Alive

2007-02-24T13:38:00.000-05:00

My wife, who just finished successfully defending her monstrosity of a master's thesis, turns 25 today. Happy birthday B!!!

I purchased a new Rowenta AutoSteam iron this afternoon. Pure happiness.

End of an Era

2007-02-24T02:01:00.000-05:00

Approximately 20 minutes ago my old Apex 20" flat screen TV died during the middle of a very violent Gears of War session. I bought the thing when I was an undergrad in Nashville (in 2002, to be exact) from Wal-Mart for $125.00, so I guess I'm fortunate it lasted this long. Still, to have a primary mode of entertainment fizzle out in the middle of winter is a harsh reality, indeed. Now I really have no excuse not to be studying all the time.

Welcome!

2007-02-23T17:15:00.000-05:00

First post, first blogging attempt -- I'm still not quite sure what the big deal is, but perhaps I'll catch on at a later time. Until then, you're privy to a few glimpses into life in medical school. Want to know what your doctor really went through to be able to care for you? Click back often!