FINALS

So I have been abusing myself lately. With finals, get your minds out of the gutter. I'm not a high stress person. I don't let tests or worrying about whether some tiny detail on the coagulation pathway will determine my success in life. I think a lot of that is bull shit. On the other hand, I am a person who enjoys knowing things. I like being able to spout of pathways or the pathophysiology of a disease. My finals studying becomes a combination of learning what I want to learn and learning what will be on the test. People who try to "game" tests by figuring out what is on them and asking excessive questions to that motivation drive me crazy. We should be interested enough in the material to learn it and learn it well. We should want to be the most competent people we can be in order to help patients. I know this is idealistic and many will argue this mode of learning just doesn't work. I'll just have to disagree with those people.

I am looking forward to escaping the medicine/science world for a while after finals. I'm trying to make plans for NYC over New Years. We'll see how that works out. I won't know what to do with myself without having material to learn. I am a freak. We all are.

Turkey Day

I am tying up the last few strings for this semester as the holidays are coming around. I have issues with holidays. There some cruelty to them. Everyone is expected to act certain ways and have certain components in their life: family, friends, wealth enough for a banquet. Many don't enjoy these things. Many people are products of broken families, either by choice or by difficult circumstances. Holidays provide an impetus for many to believe their lives are wrecked. After all, if you don't enjoy the common, American rituals there must be something wrong with you, right?

I'm a big fan of constantly enjoying the people around you and the people who are important to you. We shouldn't need holidays for that. So as the holidays come, I would like to encourage those struggling. We are all one community. I hope everyone has a happy holiday that doesn't revolve around rituals that contain little meaning.

Arrhythmia

I've developed a bit of a rythm to my Sunday mornings. I wake up around 9, check email, watch something online (most likely daily show), work out, clean my room, listen to some NPR. It is the only rythm to my life. I find comfort in it for whatever reasons.

Reflecting on this, it is odd to me that I have chosen a profession in which I hope to have no rythm. As an academic physician, I hope to be pushing boundries, treating new patients, and progressing my field. This course is not at all regular among physicians. There seem to be so many routes and such disparate lifestyles to be had within medicine. Some specialties I feel to be so adverse to the things I want to do and be, all under the umbrella of medicine. I could just as easily see myself being a fisherman as being a plastic surgeon or a dermatologist.

The rythm of being a physician is an important factor to me. I don't want to spend too much time fighting insurance companies or filing for payments. Our depleted, ruined system has taken so much of the life out of working in medicine. I wonder how much more dedicated and excited caregivers would be if this was not the case. Would quality of care go up? Would costs go down?

I have a month now to get into finals rythm. Pathology last week was quite an exciting test. The time given for the test was not enough. Classmates were running from room to room to look at slides and think about what exactly leads to subendocardial infarcts. I will be using the month to study and write papers, hopefully with some coherent rythm.

Immunocompromised

Took an immuno test this morning that covered virtually all of the basis science behind immunology. Fun. Immunology actually is fun because it is very clinically relevant. Clinical case presentations go a long way to understanding the mechanisms behind immune response. One more test in a couple days on Pathology and then its cruise control until finals.

On another note, I performed my first physical examination last week. It was a bit impromptu. The physician walked me through it and held my hand at every step. It was still quite strange acting like a doctor. It felt a bit like I was being asked to go through the motions for a play rather than examining another human being for signs of disease. I did learn a lot, though. I believe becoming a practicing physician will take much repetition before I feel as though I am not a complete poser.

Switching gears: Unabashed Obamamania

My first round of mid terms have been put to rest. I have a few weeks of test freedom until the next round comes crashing in. I will be taking this time to write a couple of papers (writing this is a warm up). While I could disgust any possible readers of this blog with the exciting tales of pathology, genetics, immunology, and anatomy, I'm sure everyone is more focused on a little upcoming election.

A bit of personal history first...I was raised in two locations: Texas and rural Colorado. My father is from the panhandle of Texas; he is as white and conservative as they come. My mom is of Mexican decent and was born and raised in a border town. Our interal family dinamics, looking back on them now, are phenomonally strange. When visiting my father's side of the family it is not rare to hear blatantly racist garbage, sometimes even directed against the very race that myself and mother constitute. These events aren't offensive to me, I understand that they do not see me as a member of the groups they attack. They see me as grandson, nephew, cousin; not mexican, spic, ditch digger. I don't know how these these conflicting ideas present in their minds. For me, forgiveness and an understanding that they lack the experience with culture to understand the harm they cause rule out any anger or grudge I may harbour. I was raised primarily with these Christian, conservative ideals when it came to my politics. As I matured and explored ideas/perspectives outside of these boundries my own belief systems formed.

And this is the part where I gush about Obama. I doubt that I will ever relate to another political figure as I do to Barack Obama. I understand that this could be construed as being not different from the people who vote for a candidate on the basis of "I could sit and drink a beer with that guy", but I can't help it. Barack's speach on race after the Rev. Wright fiasco hit so close to home for me. Growing up in primarily white America, I struggled with identity. To this day, I am forced to adjust and often ignore ideas that Mexican's come in certain boxes. As though pursuing academics or not knowing how to salsa dance exclude me from my racial background. That, to me, is the most damaging feature of race. Those not in the racial majority are expected to follow cultural roles that the minority is seen to reflect. Growing up white means that you have a cultural get out of jail free card, you can pursue what interests you and what you relate to. Being a racial minority in the United States means that you are expected to be deeply anchored in that culture, work with that culture, enjoy only those cultural activities. If you do not, than you are an Oreo or worse. I am non of these things, I enjoy Spanish language and Mexican food, but I am not Catholic, I do not go out of my way to find hispanic areas of the city. I understand and empathize with the plight of immigrant and Mexican issues, but science and medicine are of much greater interest to me than those social issues. Barack explains these ideals and perspectives. I truly believe he understands the ethnic components of America. He doesn't come from a background of white and black; he sees communities in constant modes of balancing race, family, and work. He understands that we are all in this together.

In addition to this more personal reason for supporting Barack Obama, his policies are absolutely needed. Our current economic situation and the immense gap between the super rich and poor in this country should absolutely put the Republican "trickle down" economics completely to bed. The idea simply does not work and has caused a horrific amount of damage to so many Americans. Barack Obama is not an elitis, but he certainly has an elite mind. His campaign has been focused and really transcedant in these bleak political times. His health care plan is light years better than anything coming from the other side and I think he will more capably drive us away from our dependence on oil. On social issues (abortion, same-sex marriage, gun control) I will always lean to the left. I believe that the past few decades the conservative movement drove policy drastically to the right. While the free market is most certainly the best economic system, there obsolutely must exist balances in the form of regulation to keep middle and lower class Americans from slipping to the bleak level they are at right now. Ok, I have been on my soap box enough this morning. Time to get back to medicine. Get out and vote!

Autopsy

My nights have been getting later and later. I don't think this is because of overwhelming work load or stress. I'm not sure what's going on. I do find myself dwelling on things I need to do or want to do. Tonight I'm thinking about how early I have to get up to go to autopsy review. My program is one of the few in the country that still incorporates autopsy participation in the first year curriculum. We are able to do so thanks in some part to the small size of the program. Great, one may think, hours with dead bodies.

I found my first autopsy a couple of days ago to be a bit of a transforming experience. I have been in anatomy lab for a couple of months now, but this was different. A technician roughly dragged the body onto the table and began preparing. This wasn't a corpse to me. It was a person last night. A person with hope and aspirations for the future. The technician swiftly cut open the chest cavity and began loosening the upper respiratory tract from its bindings. The normal, mondane activities of this man's everyday working life was entrancing. The sites were surreal. Much in the same way I couldn't believe a live bull was chasing me through the streets of Pamplona a few months ago, I couldn't quite comprehend what I was watching. The feeling lasted around 15 minutes before the medicine and education engulfed me again. The moment summed up a lot of my more ruminant feelings about medicine. We are practitioners of the most humane profession in humankind, but must often suspend bits of our own humanity. We want nothing more than to connect at the deepest levels with patients, but our own experiences and points of view often compromise any ability to relate. Yet the overwhelming feeling I recall now in watching was that of utter empathy. That empathy is what has driven many of us to this point. We can and must do tings outside of the norm. We must tell families things that will break their hearts, and our own in the process. We must because it must be done, because these things are necessary to directly help individuals and future generations.

Testing the funny bones

Just finished an anatomy exam. Boy was that fun...Cool tricks for the family with anatomy: put strong pressure on either side of your wrists on the palm side, if you put enough pressure on the correct spots your palm will start turning white because your are cutting off the superficial and deep palmar artery arches from the ulnar and radial arteries respectively, when you release your palm will flush pink. Also, gather the guys in your family and ask them to lift up their chins. Ask which of them have scars under there chins. Turns out that around 40-60% of males have scares under there chins from falling, getting punched, or saying the wrong thing to the wrong girl.

Now I will start the process of forgetting everything I know and knocking out some brain cells. Maybe I will sneak in some reading of normal literature or thinking about some non-medicine stuff.