Friday, August 19, 2011

Why I Stink

The blogposts about my travels are going to be on hold for a while.  I would love to write more about them, but I simply, honestly, truly don't have time.

I started medical school on Monday, and I do not want to miss the opportunity to write about that.  Also, I no longer have anywhere near as much time as I did.

Since it's Friday, I'll do Seven Quick Takes about Medical School, in honor of Jen at Conversion Diary.

I'm in medical school!  I have this realization every few hours and think once again how very lucky I am.  My dream is happening, and it's wonderful.

Medical school is hard.  

This semester, I am taking Biochemistry, Developmental Anatomy, Gross Anatomy, and Histology. This translates roughly to: 
Biochemistry - 
Chemistry on steroids and chemistry OF steroids,

Developmental Anatomy (aka "Devo") - 
A Baby Story: the Little Blastocyst That Could, 

Gross Anatomy -  
There are twelve thoracic vertebrae.  Each has two costal facets that articulate with the ribs.  These sit superior and anterior to the pedicle and lamina, which form the intervertebral fosamina, through which run the spinal nerves.  The greater dorsal nerve runs distally to the suboccipital triangle, made of the rectus capitis posterior major muscle, the obliquus capitis superior muscle, and the obliquus capitis inferior muscle.  The transverse process of the atlas runs laterally through the triangle, just inferior to the vertebral artery and the suboccipital nerve.
Didn't know this?  Neither did I, two days ago.  

Histology (aka "Histo") - 

The medical students I've met are uniformly brilliant, dedicated, and hardworking.  It's fun to be in class and know everyone there cares just as much as you do and is studying every bit as hard.

Much of what I learned in college about how to learn is wrong.  Well, it's right if you're studying math.  But it's not right if you're studying medicine.
Studying math is like trying to uproot a tree.  You have to know the layout and understand the theory of trees and think really hard and have the right tools, and then in a burst of effort, the tree comes out.
Studying medicine is more like finding that 10,000 weeds have popped up in your yard.  You work really hard and pull up all the ones you can find, trying to get the roots out but not spend too much time on any one.  The next morning, there are 10,000 weeds in your yard...

So I'm not doing as well as I thought I would.  My brain is honed to learn mathematics.  I'm counting on the flexibility of the human brain to let me rewire things posthaste. 

Being allowed to dissect a human cadaver is a supreme privilege like no other.  It's a tremendous honor to be allowed this form of intimacy with this person's body that even she never had.  

It's also a fantastic way to learn.

Being allowed to dissect a human cadaver makes you reek.  I've dedicated a set of scrubs and the lab coat they gave us to just gross anatomy lab.  When I'm not wearing them, they live in a sealed trash bag in my locker at the school.  
I don't think I can do much to get that smell out of my hair, though.

Medical school is taking my life from me completely.  I've abandoned hobbies, down time, and socializing to keep up with it.  
But I can give up those things.  I just can't give up medicine.  It's an easy trade.

Have a good weekend, everyone!

Friday, August 5, 2011

A Little Penguin's Hard Choice


As promised, here I will tell you what happens when we run out of medicine.

But first, giraffes!

The third day we were in Galana Ranch, our host arranged a treat for us after work.

So after we finished clinic for the day, our group piled into our Land Cruiser and Land Rover and set off across the African savannah.

One of our noble steeds

Looking over the top of the truck

We drove off the road for at least fifteen minutes with the general feeling that this was going to be a long, disappointing trek of nothingness while we were hungry and tired.  We saw a few DLA's and maybe a rabbit, but that was it.

Suddenly, the oldest Kenyan guide peered at the horizon ahead and shouted something to the driver.  The driver turned the truck away from the mountain and began cautiously steering the truck through the brush.  Occasionally we would stop and the Africans would peer intensely at various places on the horizon, then we would set off again.

I couldn't see anything.  There were a few tan-colored boulders up ahead, but nothing terribly exciting. 

Then one of them moved.

What I thought were boulders were elephants.  Massive, gentle, and beautiful, they stood in a group and eyed us warily.  A group of zebras stayed with them.

We even saw ostriches!

Here we were, deep in the African savannah, on safari.  There was one more animal in particular I wanted to see.  The elephants and zebras and ostriches had been so amazing, more than I'd ever hoped to see in my life. 

But I wanted so much to see a giraffe.  By this time, it was getting dark, but our guides decided to show us one more place where we just might see some wildlife.

We drove to a sheltered area near the mountain, and there they were.

Our pictures barely turned out, but we saw giraffes.  They were gorgeous, graceful, and timid.  They generally did not let us get very close to them, sauntering on as a herd whenever we approached.  But they were spectacular, and I'll never forget how they looked in the waning evening.

Later in the trip, we got up early before clinic and detoured to a spot on the river where hippos were known to congregate.  We kept our distance; hippopotamuses kill more people in Africa every year than any other animal.  One of our group recalled seeing a video (which I can't find right now; sorry) of a hippopotamus absolutely demolishing a Jeep.

These pictures use a lot of zoom; we were not this close.

This was an amazing way to start our last day of clinic.

Our last day of clinic ended on a much heavier note, however.

The last day of work at any given place on a medical trip like this involves some heart-wrenching rationing.  We cannot see everyone.  We moved into aggressive triage, where the nurses would send only the most complex cases to the doctors.  Most people were simply given vitamins and pain medication and a kind smile.
When we no longer have time to do even that, we each grab several packages of vitamins, parasite medication, and Tylenol and start giving them to people. Nothing could have prepared me for the reality of holding this medication and having to choose who it went to.  The ten-year-old or the sixty-year-old?  The sick baby or the nursing mother?  The working father or the growing child?

This is what happens when we run out of medicine, and it's heartbreaking.

On the way back to Malindi from Galana Ranch, one of the sweet young ladies on our trip got to talking with our guide, who told her that the whole Galana region was going into drought and devastating famine. 
Shocked, she looked up. "So what will happen to those people we saw?"

"Many will lose everything they have, and many will die." 

I'm a bit glad I only learned this after we left, not while we were still meeting people and playing with the beautiful children.  But this still haunts me after nearly two months.  I try to remember that we improved these people's health and gave them the best possible chance to withstand the famine.  At the end of the day, however, I simply have to offer up a prayer for them and try to get some sleep.

Next time: the last of Kenya and walking into a whole new world.