Day 272: May 4, 2011 @ 11:17AM

Today's inane image of the day:

Sample of my written notes... here, I am trying to remind myself of the distinctions between the two main categories of lung cancer: small cell and non-small cell.

May 4, 2011 @ 11:17AM will always hold a special place in my heart -- it was the moment that I received my first medical school acceptance. It was a redeeming, beautiful, overwhelming moment; finally, all of the years of preparation and hard work opened the door to the next chapter of my life. It was the day that I realized I would someday be a doctor.

Time get back to the lung...

Day 271: Response to reader Qs

Today's inane image of the day:

Skimming through the Respiratory chapter of Rapid Review Pathology.

A reader left me a set of questions to answer on my FAQs page [prior to my template switch -- comments apparently cannot be left on pages anymore with the new layout -- BUT, I still love getting questions so comment on a post or feel free to email me!], and as promised, here is an entry with my responses:

1. One thing I like most about medical school.

It is really hard to narrow it down to just one thing that I like most about medical school -- I love almost everything about medicine [except maybe for the stress...]. But since you asked for one thing I'm going to have to go with the fact that every single day, I learn something new and fascinating about the human body. From an engineering perspective, the human body really has some incredible checks and balances that we try to mimic imperfectly. For example, although we have had the ability to stop the heart and place a patient on a heart-lung machine, it still isn't an optimized device -- emboli can be introduced occluding blood flow in a vessel and red blood cells are damaged as they run through the tubing of the machine [a reality that I became really familiar with while working at Terumo Cardiovascular Systems]. So yeah, medical school [and being in this profession, period] is awesome because everyday when I learn something new, I am reminded of how awesome our bodies really are!

2. Extracurricular activities/leadership roles I had prior to medical school.

I posted an abridged version of my CV on the blog to try to answer this question. But if I had to highlight a couple of them, I'd say that my involvement in the Society of Women Engineers [SWE] and planning/facilitating the Ypsilanti Middle School Engineering Club really stand out in my mind. Keep in mind that I transferred from Bard College at Simon's Rock to the University of Michigan after 2 years, so while I participated in a number of extracurriculars at Bard College, I don't usually mention them since they were so long ago.

SWE was a huge part of my life since I joined prior to starting at Michigan and jumped right into an officer position after 1 semester. The organization gave me the opportunity to organize and run a summer camp with one other person, network with corporate recruiters, build my interviewing and resume-writing skills as well as assume a leadership role as part of the Executive Board. Because SWE at Michigan is one of the largest engineering organizations on-campus, there was a lot of work to do to keep it running [we had 50 officers and 200+ members during my last year] -- but it was well worth it because the position taught me a lot about being a leader and working with a leadership team. Plus, I met and became close with some incredible people along the way!

The Engineering Club sticks out in my mind because I had to do a lot of preparation to plan each session for the students. Ypsilanti Middle School is a high-need school, so that means at least 50% of the students qualify for free or reduced lunch [while I was there, it was close to 90% of the students]. This posed a number of challenges for me -- recruitment, trying to accomodate for a range of learning styles and levels and building a relationship with my students were all hurdles I had to scale. In the end, I got a lot out of the experience and believe that at least a couple of my students did, too [one of my favorite memories of the club was when I asked who was interested in engineering and most of my students raised their hands -- this was huge for me since many of my students weren't huge fans of science or didn't know what engineering was].

3. How long I spent studying for the MCAT.

I wish I could remember exactly how long I spent studying for the MCAT... but I think it was at least a couple of months. I took it in January of 2010 during my Senior year so it was kind of tough to juggle a Senior Design project, classes and studying for the MCAT. The only resources I used to study were the ExamKrackers series, sometimes the Kaplan Comprehensive review book [there seemed to be a number of errata in this text so I don't think I used it much] and the official AAMC practice tests. I completed almost all of the prerequisites for the exam over 2 years prior to actually taking the test so the material wasn't too fresh in my mind, but I got through it.

I'm interested to see how the new MCAT plays out... but I guess it'll be a while before the AAMC starts administering it. I'm skeptical of it being a "better" test, but I do believe that the exam needed an overhaul of some sort so I think they're moving in the right direction.

Hopefully this answers your questions and as always, feel free to leave more for me in the comments section below!

Day 269: I am not a doctor

Today's inane image of the day:

Have you tried the new Mocha Cookie Crumble Frappuccino yet? It's like blended cookies and happiness all in a cup. Plus, you can get them for half off between 3-5PM from now until May 13. [Today's entry actually pertains to Starbucks...]

This morning started off like any other. I parked my car, walked into Starbucks and pulled up my iPhone app while waiting in line. The usual suspects were already there -- the elderly fellow that always flirts with the baristas, the business man with his freshly pressed suit and the tired-looking mother. As I approached the counter, I ordered my usual summer morning beverage and went through the motions to pay.

As I meandered toward the pick up counter, one of the baristas grabbed my attention: "Hey, Amanda! You're in medical school, right?"

I stopped in my tracks and turned my attention toward him. Immediately, I braced myself for the worst; in our Medical Humanities course, the professors warned us that upon entering the profession, family and friends would suddenly start turning to us with their medical questions. We were cautioned that because there would be no escaping the situation, we needed establish an appropriate response to the request. But never did I imagine that as a first year medical student, an acquaintance would turn to me for advice.

"Yes, but..."

He cut me off. "I have lower back pain that radiates down my leg..."

The gears in my head started turning. I thought back to my latest clinical experience -- one of our patients described a similar chief complaint and during our discussion with the preceptor, we discussed differential diagnoses for that particular symptom. I tried to clear the cobwebs clouding my knowledge of Anatomy and Neuroscience and considered the nerves that could be affected. I wondered if there was an inciting event that precipitated the pain. But in the end, although these thoughts raced through my mind, I never had any intention of sharing them.

"...and I was wondering..."

As I stood there listening to him, it struck me how entering medicine was almost synonymous with being entrusted with a stranger's thoughts, feelings and ultimately, their life. We are taught how to ask open-ended questions and how to probe for the whole story. We are told to trust our instincts if something just doesn't feel right. But for the most part, patients come prepared to talk about what is bothering them because it is embedded into our culture to have an unspoken confidence in physicians.

As medical students, we reside in a paradoxical limbo. In order to become competent physicians, we need to interview patients and suggest diagnoses. We need to try procedures or practice them to obtain perfection. However, because we have little to no experience, patients tend to shy away from our [supervised] care. Additionally, at this early stage of training, most of us do not feel confident in our knowledge to provide even basic explanations of diseases.

When he continued with, "...what kind of doctor should I go see?" I let out of a sigh of relief and directed him toward his internist. This time, I was posed with a question that I could answer. But the situation gave me an opportunity to consider how I would respond to future questions that I am not qualified to answer. In class, our professors explained that when faced with a medical question outside of the hospital, they defer to the patient's internist because they do not know the details of their medical history. Today, had I been faced with that situation, I would have responded the same way but with the added note that I am just a medical student; I am not a doctor.