Happy Belated National Coffee Day!

During one of my study breaks yesterday, I came to the happy discovery that today is National Coffee Day!!  Who knew there was such a thing.  To celebrate my new favorite day in September, I drank the last of my hazelnut flavored coffee from CTB. Mhmmmm it smelled absolutely delicious.  I actually brought some of this to the clinic this past Wednesday and everyone was SOOOO jealous of my amazing smelling coffee.

In order for you to fully understand my addiction to coffee, here is is a picture of my current coffee horde.  When I came down to visit Dominica in June, the first thing I scoped out was the coffee situation and found it to be horrific.  Hence me shipping coffee in my barrel and having my Dad bring down some more Starbucks when he visits.  These all resulted in my accumulation of a glorious amount of my liquid crack!  (It should last me the whole semester....)

I <3 coffee

Now back in the States, many places give out free coffee. I wish, wish, wish they had that traditional here in Dominica. Instead I had to satisfy my desire for free coffee by reading about coffee traditions....here is a neat article I cam across (Coffee around the world ).

My Typical Day

I figured I would write a post about my typical day so that everyone can get a feel for what a "day in the life of a med student" is like.  Be forewarned.....if you did not like the movie  Groundhog Day, you might not like this post.  My life strongly resembles this movie...take the below schedule and apply it to Monday, Tuesday, Wednesday, Thursday and Friday with slight variations on Saturday/Sunday (aka no class on those days).

Here we go....

6am:  Wake up (sometimes I will snooze until 6:30/6:45 which means I don't have time to shower.  I know Megan and Claire used to absolutely love my habit of snoozing for an inordinate amount of time).

7am: Make my coffee, find something to eat for breakfast.  I strongly dislike breakfast so it is always  chore to find something to eat.  If I don't have anything, I am absolutely starving by the time I get done with classes for the day.

7:30am:  Trudge to class (generally it is already 80 degrees).  Sometimes I am lucky and the shuttle drivers take pity on me and pick me up.  One positive of the walk is that I have a gorgeous view of the rain forest covered mountains.

8am-Noon: Class.  Sometimes we get lucky and start at 9 or 10 but sometimes we go from 8am to 2pm.

Noon to 1:  Lunch/Nap in my hammock

On Tuesdays and Thursdays I have either anatomy lab or just a lab demo.  If I have the actual lab, I can be in the lab until 5 or 6pm.

Once I am done with all my required parts of the day, its time to review the lectures and make a study product.  We are supposed to take between an hour and two hours to make the study product per each hour of lecture.  After making the product, you have to review material from past lectures and preview the next day's lectures.  So basically I am doing something academic almost every waking hour.  I don't let myself go to bed until I finish all the lecture material from that day (This hasn't caused any major problems.  I have been able to go to bed around midnight each night which is decent).

The weekends I have a little more free time because I am not getting any new information.  (This why I always video chat everyone on Saturday or Sunday!!)

So now you know my typical day.  I know you are all probably EXTREMELY jealous of my exciting life lol.  I just tell myself I am always chugging along to the goal of becoming an MD and that eventually I will accomplish my life-long goal.

Diabetes Clinic

After 4 straight weeks of extremely intense classes without any breaks, I was starting to lose my mind with the overwhelming amount of material.  So when the chance came to volunteer at a diabetes clinic right in Portsmouth, I jumped on it. I desperately needed to have patient contact to remind me why I am here.  

Diabetes is a major problem here on the island due to the increased super-processed "Westernized" food-(i.e. doritios, chicken nuggets, etc) and because the lifestyle is starting to become more sedentary. This clinic provides invaluable routine care to the known diabetics on this portion of the island.  It checks their blood sugars, checks for edema, and most importantly checks for any ulcers or lesions on their feet.  This allows for early detection of foot problems which hopefully will reduce the need for amputations later in life.

The Diabetes Clinic was definitely an eye-opening experience and really showed me 3rd World medicine.  I will never take the US healthcare system for granted.  When we pulled up the hospital, the first thing I saw was a large open double-door into the main hospital ward.  There were no rooms or beds, just cots with signs overhead saying "Female 1, Male 13, etc).  Walking into the hospital proved to be more of a shock.  The only waiting room consisted of long wooden benches that resembled church pews.  There were already 30 or so people already there at 8am.  We walked to the room we were going to do interviews and I was even MORE surprised!  The room was the hospital's old X-ray room which was approximately 5ft by 7ft, still had the old Xray equipment in it, and had lots of shipping boxes.  There were no patient records kept at the hospital and there certainly weren't any fancy-smanschy electronic records like we are used to. Instead, the patients keep their own records in the marbled composition notebooks that they bring each time they come to see the doctor. (All the patients clutch these notebooks for dear life because they know how important they are. The patients also seemed to be proud of their notebooks.)  We also did not have running water in our exam room because the only running water in the hospital was in the restroom and the doctor's room.

The set-up of the clinic worked so 3 of us students were in the old X-ray room doing the initial interview and blood glucose level, while the other 3 students were in with the Doctor, listening to her patient assessments. It was exciting to work one-on-one with the patients and have them call you Doctor.  I am extremely grateful for all of my EMS experience because not only was I comfortable with the patients but I could do blood pressures, blood glucose levels, and could take a basic history.  After today, I feel rejuvenated and excited again.  So all-in-all, it was a great experience!

Channeling my inner John Nash? (aka the crazy things med school makes you do)

Do you remember the scene in A Beautiful Mind, where John Nash is writing out his theories on his window?    I guess eccentrically smart (we will go with that label for this analogy) people use their walls, bathrooms, windows,etc to write out problems and search for the potential solutions.

Well tonight, after perhaps one too many cups of coffee coupled with too little sleep, I decided to try to write on my refrigerator (after all it feels basically the same as my whiteboard). After testing a small section and realizing that it easily erases, my life was forever changed!  Now I have a huge whiteboard that will help remind me of the key ideas I am supposed to be learning!  Granted if anyone walked into my apartment, I am sure they would be quite concerned about my mental sanity.  I wish I could be fly on the wall when my maid sees it on Wednesday! I am sure there will be some gasps and head-shaking.

John Nash writing on the windows

My refrigerator

You know you are a med student when...

1. Your friday and saturday nights are spent coloring anatomy pictures

2. You get excited for the weekend not because of the fun plans you have, but because you aren't getting any new material for two days.

3.  Your YouTube experience consists of looking up songs about glycolysis and the brachial plexus rather than music videos

4. Your kitchen/living room is filled with flashcards and notebooks

5.  You don't have coffee books on your table, you have biochemisty and anatomy textboks

6.  You wake up at 6am every day and consider sleeping in until 9am a luxury

7.  Your main drink of choice is coffee (well for me this is not a new development)

8.  Your "social life" consists of group study sessions

9.  Everything has a mneumonic associated with it (and generally, the dirtier the mneumonic, the easier it is to remember)

10. You get frustrated with medical shows because all you can focus on is all the inaccuracies

11. You're really frightened by the thought of some of your classmates becoming doctors.

12. You use extremely long words in your normal, every day conversations

13.  You "treat" yourself by going to sleep at 10pm instead of midnight or 1am.

Hypothetical Situation 1: What to do if you are chased by a bull

Today in my biochemistry class, my professor was entertaining us with a story from his nine years of living on Dominica. This is kind of how the story went....

"This one time I was walking home from campus on the lizard trail, when I came face-to-face with a giant bull.  And I made the mistake of making eye contact with the bull.  This set the bull off and it started chasing me.  My only option was to climb a tree, so I climbed a tree and waited until the bull ran off."

This had the entire class in absolute hysterics and I am sure many of us were thinking that this would never actually happen to in our lives.  But then, as I was leaving the Annex (where 1st semester students take their classes), I heard a giant MOOOOOO!!  I kept walking thinking that someone was just fooling around and being an idiot.  Then I heard it again....MOOOOO!!  I walk farther along the sidewalk and bam, there is a giant bull standing on the other side of a rain forest outcropping.  This bull had giant horns and thankfully was tied up.

Picture me as the guy in the tree.  Picture the tree a Palm tree.  Then you will have a picture of me running with the bulls in Dominica.  

However it got me thinking, what would I do if I got chased by a bull? First off I am going to avoid eye contact by all means possible. Second if a bull starts chasing me, I am going to run like hell to either a sturdy tree or to a nearby building and take shelter. Because in all honesty, there is no way I am going to use my "quick catlike reflexes" to jump aboard the bull and ride it like a professional bull rider would (even though this crossed my mind for a brief second). So in this hopefully hypothetical-only situation, I am going to find the nearest tree (ideally not a palm tree but instead one with lots of limbs and a thick trunk) and climb it!

If for some reason this happens, I can cross off one of the 1000 Things You Should Do Before You Die because I think running with the bulls is one of them.  While I know it is supposed to be in Italy, I figured running with the bulls in Dominica would be more than sufficient.   

 

"Open Chest"

Yesterday we had our first patient interaction!  We had a video conference with a patient who was in Roseau and had the opportunity to ask the patient questions regarding chief complaint.  During the course of the interview, the patient stated that she had suffered an episode of "open chest" when she was a child.  Now you say this to a room of brand-new med students and you couple it with a chief complaint of chest pain, you should expect the entire room to gasp and automatically draw the conclusion that the patient had an open chest surgery.  Nope!  Not at all! When my fellow students started asking the patient questions about the surgery and what exactly happened with it, the patient was utterly confused!

It turns out that "open chest" is a saying here in Dominica that means chest tightness/pain and is generally given to symptoms that are diagnosed as Costochondritis (which is basically a painful inflammation of the cartilage that connects your ribs to your sternum). Needless to say this condition does not have quite the same severity that open heart surgery has.  Once our teacher explained that "open chest" was not in fact open heart surgery but rather the painful inflammation, we were mildly embarrassed.  I think that this experience taught me that whenever my patient's say a phrase that I am not familiar with, I will ask them to elaborate.  This way I will understand exactly what they are trying to tell me and that I will not include faulty information their history.  I am definitely learning a lot about how culture factors into medical practice.