Tuesday, February 19, 2008

Call of the Sirens (Part III)

{Here, we have the ongoing saga of what it was to go through medical training way too many years ago. Don't worry, this yammers on about the second year, which had little gore and no glamour. The second year is like that for many things: Too young to be of consequence, too old to be novel. Dull and sadly forgettable. Pimply and annoying. Best just gotten through. Sort of like the crust of a mass-produced pizza, without any dipping sauce. If you missed the prior chapters, that's what the side bar's for, isn't it?}

Between the first and second years, we had our last summer vacation, ever. Some of us (like me and my pal, Lisa, (Hi Honey!) got hitched). Some went on vacations. Some got jobs. All of us reconvened in the fall in the same damn place we'd left a couple of months prior, but at least it was all so very familiar.

And so we come to the second year, the year of pathology. Having spent pretty much all of the first year learning all about what normal was, we finally got to the really sexy part: The Diseases.

Buuuuuuuuuut, not so fast, grasshopper. The first 6 weeks or so were spent in a little side-step of torture known as 'Bugs and Drugs'. Spoken of by those who'd gone through in ashen-faced whispers, often accompanied by the rapid slamming of several shots of cheap liquor, Bugs and Drugs were what broke most spirits. 8 hours a day, 5 days a week, 6 solid weeks of nothing (and I mean nothing) but microbiology and pharmacology.

Now, I've always loved microbiology and what doc-to-be doesn't love the idea of those enticing drugs, but even a steady diet of chocolate can make you ill and this was more like a steady diet of partially corroded batteries washed down with concentrated bleach. To make matters worse, there was no context, just volume and pain. We were taught thousands and thousands of tiny microbes, some deadly, some benign, most we'd never encounter in our long clinical lives (and if we did, we'd just look them up). Many of the drugs hadn't been used in decades, but were thrown into the mix. Yohimbine (WTF?) next to metoprolol (vital) next to cisplatinum (vital if you're off to do battle with cancer as an oncologist, not if you're an orthopedist). So we learned them all, sorta, and promptly forgot them as they were at that point meaningless. We weren't to encounter patients in a theraputic setting for almost a year, so we really couldn't even use the information until then. It'd be like taking driver's ed as a 13 year old.

After Drugs and Bugs, I recall a loud party with the class band, Mostly Large Cells, named after a histologic description of something, probably some sort of lymphocyte, on a slide. Sort of a party of desperation. If it's a false memory, then that's a shame; there should have been a party if there wasn't. No better way to clean out all that recently sort-of-acquired fragile information, thus making way for the next bolus, than by lots of alcohol and dancing.

The rest of the year was spent in blocks of pathophysiology--what can go wrong with the heart for 4 weeks, the GI tract for 3 weeks, the lungs for 3+1/2 weeks, etc, etc, etc. An exam at the end of each section. 8 hours a day, 5 days a week, for 8 months. All in an amphitheater that was identical to the chilly, gray, flourescently-lit cement cave of the first year, just rotated 180 degrees (the first and second year classrooms sat parallel, foot to head), in the Basic Science Building.

But, at least no formaldehyde. And no good stories, at least none worth remembering. More interesting but less novel. Same instructors. Same classmates. Same everything, just rotated 180 degrees.

Ok, maybe there were a couple of good stories, but mostly it was just a grind.

There was a bright spot toward the end of that year, though, and that was that we had some classes in actual physical diagnosis, where we practiced using our stethescopes and reflex hammers on each other on Saturday mornings in the abandoned patient care rooms in the outpatient clinic building of the University Hospital. Yes. That's right. Go ahead and snicker. We played University-sanctioned 'doctor' with each other. We also had two rather awkward evenings where we learned the male and female exams with people paid to be clumsily examined by 90 med students, many of whom were blushing furiously or madly pretending that they weren't at all flustered by it all. The male paid-patients were just average joes, and just stood there, buck nekkid, but the females were 3 local nurse practitioners who knew exactly what we should be feeling for and would tell you, "No, that's not my ovary....no......closer...to your left.....no YOUR left......there! That's it! Make sure you get a good feel so you know what it feels like." Good, but decidedly disconcerting. Of course, you were graded on your exam skills and bedside (drapeside?) manner. If you didn't pass, you had to do it over and over until you got it. Which makes sense.

We also spent time each week in one of the primary care clinics (I was in the University's Family Medicine clinic) talking to real, live, actual patients, learning how to gather their histories about their sore throats or their baby's diaper rash or other similar concerns. We started learning how to do formal presentations, the backbone of the upcoming years of attending rounds, and how to start filling in the shoulders and shoes of a physician. It was cool. We were hot. Even if we looked uniformly dweeby, stubby and fat in our short white coats, stumbling over the words that we tried to make sound natural.

We were also scared to death as we knew that as of July, we would be released into the assorted clinics, inpatient wards and operating rooms. Pity the poor souls who were assigned to us. Pity them, indeed.

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Blogger Christina said...

I am always amazed by the amount of work Med students do on such little sleep. But, it goes to show you what it truly means to be dedicated and passionate about what you want to do.

10:59 AM  
Blogger listie said...

I'm exhausted just reading about it.

11:55 AM  
Blogger The Rotten Correspondent said...

I'm catching up - so sorry for my absence. But what a story to start catching up with. I love this series.

Back in my days of being an artist's model (in my first degree go-round) I accepted a job once at the USC School of Medicine as a body model. My ovaries never entered the picture, but a bunch of second year (maybe??) med students took a sharpie to me and diagrammed me to within an inch of my life. It took me weeks to get all of that marker off.

I was cold and being written on, but I was in much better shape than they were. Poor things.

12:54 PM  
Blogger Rozanne said...

Wow! I have to wonder how much those patients were paid? Probably not all that much. I tense up (still!) even when being examined by a seasoned professional (AKA your mentor Dr. H!).

4:47 PM  
Anonymous Christie said...

I'm having flashbacks!!!!! Three months into PA school we got thrown in with the second year med students, so my memories are similar. The boobie fairy had visited my physical exam partner way too many times which can make for an interesting cardio exam. We had to actually say during our test, okay, now would you mind lifting up your left breast so I can finish listening to your heart.... Red faced and snickering...it was hell. HELL.... And then we got to practice on prisoners since our hospital had a contract with the local slammer. As if we weren't nervous enough just touching live people...these were live people that were shackled to the bed. Fun times baby, fun times!

6:08 PM  
Blogger Jocelyn said...

I'd like to thank a minute to thank all those brave paid volunteers who have kept me and my husband from being "firsts." Yikes, baby.

8:43 PM  
Blogger Mother of Invention said...

It must have seemed like a long haul and so much to cram in. My friends who were all studying to be vets at Guelph,would be up all night trying to write down info on long butcher paper taped up the whole length of the residence hallway basement.
It is really true that if you don't use it, you lose it and I'm sure they had to re-learn it later when they actually were operating on animals.

I hope some of your old classmates read this!

11:36 PM  
Blogger Jen said...

I confess, I would have loved Bugs and Drugs, but only because it's so much "cleaner" than anything I studied in forensic anthropology.

I know I wouldn't have been able to do the "nekkid patient" thing.

And the best part is, you made it through! You're still here to tell the tale!

7:06 AM  
Blogger Dumdad said...

Crikey, by comparison my journalistic exams (law, shorthand, local government etc etc) were a doddle!

1:55 PM  
Blogger Sweet Irene said...

I understand now, why some people make good medical students, while others don't. I got sheer exhaustion when I read your post and couldn't imagine long tedious days of study like that.

It makes me appreciate the medical profession all over again. My brother in law is a cardiologist and I know he had to go through this also and it really makes me respect him.

Aren't you happy to be out there practicing now?

10:32 PM  
Anonymous Anonymous said...

And yet you managed to get and stay married. You are really amazing. And Charles was in or about to enter grad school. I am impressed, but then I am your Da.

The Ole RF-er

7:34 PM  
Blogger CarpeDM said...

I could never do this and have a ton of respect for doctors and mothers for that matter. People who do stuff I have no desire to do!

"Steady diet of partially corroded batteries washed down with concentrated bleach" made me laugh.

6:37 AM  
Blogger Teresa said...

This doesn't sound the least little bit like Grey's Anatomy!
I liked the explanatory sentence "It'd be like taking Driver's ed as a 13 year old."

7:24 PM  

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