Friday, September 19, 2008

Christmas Is Christmas I mean cadavers

So this week was interesting. We had a 'patient panel' on Tuesday which consisted of one patient (No, I wasn't attending class at Drexel, my school makes mistakes too). It was a lecture about obesity from a patient's prospective. I was intrigued to see if the man would change my opinion on obesity, but he didn't. Basically he was a 6' athlete that gained over 180lbs over the course of roughly 5 years and then tried to get it all off in 9 month spurts of exercise and diet. Well that didn't work, so after his daughter begged him for the sake of her unborn children to get a medical procedure to correct it, he finally did. I wanted to ask him questions to test his attempts to lose the weight, but I opted for keeping my mouth shut. I might have asked "Why didn't it work after 9 months of attempting to lose weight? Did you hit a plateau or did you give up?" or "Did you really expect to lose all the weight you gained in five years in 9 months?" I am not ready to stand out like that quite yet. If I was, I would have asked the Surgeon General, in front of a full auditorium a few weeks ago, "How is it that one day I will be on the phone with some 18-year old kid who works for an insurance company, telling me how to treat my patient because what I want to do isn't in the penny-pinching, actuary-produced flow chart that he is using to decide what I can and can't do?" But again, I am not ready to stand out like that quite yet. Those questions will not get me anywhere I am hoping to go. A lot of my thoughts are better kept in my head.

I know what it is like to lose a parent, but I cannot imagine the pain and frustration of watching your parent willingly (these were the patient's words) let him or herself get to the point that they would die a premature death. Three different times he was told that he would die within the year. But still he did nothing. There are so many people out there fighting cancer, and other unfortunate things they cannot control and to see someone who isn't willing to fight to prevent something they can control is disheartening. The people fighting cancer would love for the doctor to tell them, "All you have to do is exercise, and eat right and you will be fine." The patient said he knew what he was doing and he knew what it would take to lose the weight. Every time his daughter would say something, he would just eat more. I felt sorry for him and I am glad he was able to lose weight, surgery or no surgery. I do feel more sorry for the rest of his family though, but I am glad he might one day be able to run around with his grandchildren. He has lost about 80 pounds, but has hit a plateau which he wants to ask his doctors about. The procedure he had is more of a tool then and fix. I think it would also be very frustrating to be his doctor. You tell him, he does nothing, you tell him, he does nothing. It wasn't until he had that moment of clarity (him weighing in at 380 at the doctor's office) that he realized he needed to do something...anything. I can understand that, but that is tough. I have to say that sometimes, as a physician, there will be nothing more I can do. I will have to let fate take its course and at the end of the day just be able to feel confident that I tried my best and did everything I could to right the situation. I think this is definitely one reason I am so drawn to sports medicine. If the patient is an athlete, they will be somewhat healthy already, and they will be willing to to whatever it takes to get back onto the playing field again. I like the sounds of that patient.

We had a clinical didactic and practical exam on Wednesday which was nerve racking. It's one thing to take a multiple choice exam, but to have to answer and perform in front of a physician/observer/grader and mock patient in three minutes is difficult. Either you know it or you don't. There is no help if you draw a blank. They just stare at you and write notes on their paper. We also did some mock interviews. When you are at the doctors office, it seems like it is second nature to them to be able to ask questions, but what I never realized is that it is very awkward. I know it will come with time, but for the first interview, it was challenging.

Yesterday was my first taste of a medical school final exam. It was 4 hours long and I am pretty sure I was looking forward to this moment for the past six weeks. I seriously spent 5 minutes trying to figure out if my calculation of the range was wrong or if the professor didn't proofread his work. I chose for the latter. That is frustrating. We are under a lot of stress and when you have a question and do not give us the right answer, we begin to second guess ourselves. "Wait, I know this is correct. The range is not hard to calculate. But 18 is not there! 19 is. 25 - 7 is 18 not 19. Did he forget to make the 25 a 26? They should take away his preventive medicine title. He can't prevent a mathematical error.(Just kidding) You know, I was told once that the Challenger blew up because of a misplaced comma, but I am pretty sure our teacher was trying to get us to get into the whole grammar thing. Oh wait, I am supposed to be taking a medical school final not an algebra final..." I swear, if I get a 'calculate the mean, mode and range' question on the boards, I am going to ace it. I was more nervous about our clinical didactic and practical exam then I was for the final. I felt that after six weeks of information I couldn't learn much more. I had to use my time to refresh the things I once learned for the previous exams and make sure I had those things down. I didn't sleep much last night, not because I was so worried, but because I was 7 again and Santa was coming in the form of the musculoskeletal section. For the first time this year I hope that things will begin to make sense. Instead of some Russian dude telling me how much he is in love with cytokines, Tumor Necrosis Factor, and IgG (or is he saying IgD? maybe its IgE? I can never understand his accent) I will get to see some cool things. And by cool things I mean the cadavers. I am so grateful that we have this opportunity and I am grateful that someone was willing to donate their body to science.

I had an all-time high of 27 visitors to my blog two days ago. I am hoping that it was because a few of those visitors googled "Drexel University College of Medicine". Hey, one can dream.


  1. This takes me back a few decades to the one time I was "fortunate" enough to actually see a cadaver in a med school. I was enthralled.
    However, that night, I:
    A. Couldn't seem to forget the sight of the body as it was lifted above its vat of formaldehyde, wrapped in gauze cloths to keep the skin protected until it could be peeled back (too much like a Frankenstein film)
    B. Couldn't seem to get the smell of the formaldehyde out of my clothes, hair, etc.
    C. Couldn't stop dreaming that the cadaver was chasing me down the street with his skin flapping behind him.
    OK, so now you understand why I don't go to any movies where anyone screams, "No, No, please No!"??
    You're obviously perfectly suited for all of this with your ability to stay analytical and your gratitude for the person who allowed his body to benefit others.
    I'm glad you're there...and... have you heard from that Drexel lady yet??

  2. 27 blog readers is fantastic! And I promise it's NOT just your mom and me each getting on 14 times!!!
    I miss you, Mr. T. (You're still anonymous, right?) I really do...
    No one stops by my desk to ask questions about MY blogs anymore. You were always so perceptive when reading my stuff.
    And, that is why you are where you are! Medical school is for smart folks like you.
    And you, NO DOUBT stand out even if you don't SHOUT OUT!!
    Ho ho ho!