Tag Archives: Anatomy

Diagnosis?

I’m back!

I am happy to say that my classmates and I survived winter quarter! It was grueling, but after making it through close to 15 hours of finals a few weeks ago, I can look back and say that it was an invigorating sort of grueling.  Although I’m not a runner, I imagine that winter quarter could be compared to an endurance race where you test your limits and, in the midst of everything, find your second and third wind.

So, I am here to say that you can indeed survive the following :

  1. Neuro.  As a fusion of neuroanatomy, neurophysiology and neurobiology, this course both challenged me and taught me a lot of amazing things (including the knowledge needed to understand why we do what we do in the neurological exam).
  2. Practice of Medicine II.  It seemed like a daunting prospect at first, but I learned how to perform a complete physical exam!  The clinical sessions were very well-done, and a big thank-you to our wonderful E4C faculty, staff, and Standardized Patients!
  3. Intro to Human Health and Disease. This was our “bugs and drugs” class on microbiology and pharmacology, and I learned everything from what causes summer colds (enterovirus!) to the different manifestations of pneumonia and tuberculosis.
  4. Clinical Anatomy.  We dissected the head and neck this quarter, which was a profound journey.  My donor, I never knew you in life, but thank you for giving me this amazing opportunity and showing me what it means to believe in the future and to give selflessly.

“A society grows great when old men plant trees whose shade they know they shall never sit in.”

– Greek proverb

Spring quarter is now underway (it’s hard to believe that today finishes off the second week of spring classes!), and so far I love the material.  We’re learning about the respiratory system right now in Human Health and Disease, and in Practice of Medicine III, we’re integrating the history taking/physical exam skills we learned during the past two quarters into a streamlined, cohesive whole.  I am so excited to begin learning how to form differential diagnoses!

I’m hoping to post more later, but in the meantime, a little vignette…

Chief Complaint: Belated blogging

History of Present Illness: Patient presents with intermittent blogging. Intervals between blogging vary in frequency, but have increased in length as the first year of medical school progresses. Patient denies a loss of interest in writing and often thinks about blogging but has difficulty making time to sit down and write posts. Associated symptoms include periodic sensations of regret.

Patient Perspective of Illness: The patient’s main concern is that everyone who comes across this blog will wonder why there hasn’t been a new post since the beginning of the previous quarter.

Family History: Family has healthy writing capabilities.

Past Medical History: The patient has experienced bouts of writer’s block in the past.

Social history: The patient is a medical student.

Review of Systems: Negative.

Week Two, Quiz One

I am a little more apprehensive than I thought I would be as I sit in the classroom, waiting to take my first quiz in Molecular Foundations of Medicine.  Although it’s only our second week of medical school, we’re already halfway through Mini Quarter and heading quickly towards our final exams later this month.  It is hard to believe we have already reached the halfway point.

This quiz, given under final exam conditions, will help me to evaluate my med school study skills, and I am both eager and anxious to receive its verdict.  We have covered a prodigious amount of information in the past two weeks, and I am still trying to determine which study strategies would be best to use.  Flash cards?  Additional online resources?  Reading and re-reading lecture notes?  Drawing things out?  It will probably be a mixture of them all, and I am hoping that the combination I have chosen over the past fourteen days has been the right one for me.

The rows of tables which usually span the classroom have been rearranged so that we are sitting in pairs.  I take a drink from my water bottle, dig through my backpack to find my watch, realize I have forgotten it, and locate the clock on the wall instead.

Only a few minutes until we begin.

Turning in my chair, I glance around the room at my classmates.  Although I’m still working on learning everyone’s names (something I really hope to accomplish by winter break–I think I’m about 66-70% there), the faces have become familiar.  We are all in this together, I realize.  Our shared hopes and goals have brought us together on this Friday morning, and suddenly, I feel a little less nervous.

About half an hour later, it is over.  I follow several classmates to the elevator, wondering what they think about the past thirty minutes.  While the quiz has been challenging for me, I am satisfied overall with how the morning has gone.  Entering the hall, I move on to the next part of my day–lunch, a meeting, our weekly journal club, histology lab.

Coffee break.

Dinner.

As the sun sets over Stanford, I receive a notice that our grades are up.  Fingers crossed, I log onto our course website and click the link to my gradebook.  My eyes flick across the screen, honing in on a number written in black 12-point font.

I have passed!

Now, on to studying histology…

Image

And in closing, a few random thoughts inspired by my week:

You know you’re an anatomy student when…

…You go out to dinner with a fellow med student and find yourself discussing bone saws and preserving fluid while waiting for your meal to arrive.

…You watch dissection videos while eating lunch.

…You realize that one of the highlights of your day was mastering the attachment points of five different muscles.

…You are looking for a scalpel and accidentally tell your classmate that you can’t find your scapula.

Have a great weekend!

First Week

I saw his hands for the first time on Thursday.  

Before then, they had been protectively gloved in light cloth mitts, as if they held a story I could not yet hear.  Since Thursday was only our second day of anatomy, I had not expected to glimpse our body’s hands for a while yet, but we needed to abduct the arms in order to dissect along the midaxillary line that afternoon.   Since I was the closest to the hand on my side of the dissecting table, I reached over and rolled the cloth away from the skin.

The hand was larger than mine, bluish.  Gently reaching in, I grasped it, feeling its cold, firm touch against my own.  There was something almost waxen about it, as if it had been carved from a fusion of marble and earth.

For a brief moment, I locked my hand with his, trying in my own way to connect with this life I would never meet.  I will know no details of this man’s story, but I wondered whether a child once held his hand in the way I did now.  Did this person have children who looked up to him in the same way I look up to my dad?

Who were you?

I like performing dissections—in undergrad, I enjoyed my zoology course, and I continue to be fascinated by the intricacy of surgery.  Anatomy is no exception; it is so amazing to peek into the human body, and although the thought of learning so many nerve and muscle names can seem rather daunting, I am up for the challenge.  At the same time, part of me feels vaguely disconcerted by the fact that although I will know the details of this person’s inner being more thoroughly than any other, including my own, I will never know this life.

That is why I am so glad that our class took a moment of silence before our first dissection lab on Tuesday.  The thrill of exploration merges with the gravity of the gift I have been given, like treble notes and bass notes coming together into a musical score.

A musical score which, at the moment, seems to be composed mostly of 32nd  notes.

We are in mini-quarter right now, which is a five-week period of intense coursework designed to ensure that everyone begins medical school on the same page.  In addition to anatomy (which will continue for two full quarters), my classmates and I are taking a month of molecular biology and histology.  I love my classes, although at times this week I’ve felt like I’m going down a freeway at 65 mph while trying to glimpse the details of the edge of the road (as a passenger, I might add, since I prefer to arrive at my destinations in one piece).

Thankfully, even when the edge of the freeway is a blur, the horizon remains clearly in view.  Through the patient experiences integrated with our coursework, I have glimpsed how the details of molecular biology fit within the context of health and disease and have witnessed the very real and human side of all we are learning.  The patients who have given deeply of their time, energy, love, and lives to speak with us are the words to the musical score I am learning, this music of medicine.

To them I dedicate this haiku:

You shared your story
With me and in that moment
Your life helped shape mine

To all those supporting me on my journey to physicianhood—those both present and past—thank you.