Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for December 2009

Goodbye new/old? Friend

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Been meaning to write this post for a while.

On December 9th, we dissected Frank for the last time. The first time I glimpsed his muslin covered head, I felt a tightness in my chest and a flip in my stomach and I hurried out of the anatomy lab. When it was time for our first Lab meeting and we actually began dissecting, we did our best to expose only what was necessary.

By our final day, we were peering into his bisected, dis-articulated head with focused detachment. Too busy learning pathways and finding nerves and trying to remember what passes through which foramen or fossa or sinus to be bothered by the fact that we were handling a severely mutilated human head. “Where are his eyes?” I remember asking at some point during the last few days. There is a strange familiarity that comes once you start to cut. My lab partner who liked to keep his hands covered? She skinned the one we dissected.  We had jumped ahead of most of the class and started skinning his face before most people had even uncovered theirs. People would stop by our table and then… stop. “Oh! You’ve started on the head…” they would say, or something to that effect, processing that it would soon be time for them to take that step too.

One of my table mates held Frank’s brain in his hand, right after we removed it. “This is Frank,” he said. “Every thought he had, every memory. This is it.” That didn’t ring true for me, even though it was true. That really was Frank. That really was what made him who he was. But we never knew who he was. We only knew him as a cadaver, so for us, his body was him in a way that doesn’t feel so when a person is alive.

So many experiences I wish I had blogged more about. The table next to us being fascinated that Frank had teeth, because theirs had none. The fact that Frank smelled fine to me but bad to other people who weren’t working on him. All Frank’s strange little anatomical variations (which ones do I have that will likely never be known?). His surgeries that have left signs yet that we know little about.

I thoroughly enjoyed Anatomy lab, though by the end it had started to be a bit of a chore. Being in lab was almost always a great time but I did not enjoy the getting dressed before and after lab (I really wish the locker rooms had showers). I realize that surgery of some sort is still a distinct possibility for me. Though I have little interest in the lifestyle, I enjoy the hands on things and I had a wonderful time dissecting, and I am incredibly thankful for my three table mates (Table 18 forever! whoo!)  who were great to work with.

The Radiology component to our class was a nice touch, but I still currently have little interest in the field.  It is strange to think that for those who do not go into a surgical specialty, those kinds of images will be their only way of looking into their patients. And with lots of the laproscopic advances, many surgeons will only have a very small view too. We are moving toward a “less barbaric” approach to medicine again.

But as students, we still get to cut and prod and pick at and saw and hammer  human bodies. And that too may change.

Written by Aba

December 29, 2009 at 9:59 pm

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Funny thing about being a Medical Student

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My priorities are constantly in flux. Ugh, what’s with all this classroom learning? I want to be in the hospital already! Aw man, we’re practicing patient interviews in the hospital on real patients today? But I have to study!

Though I do have to say that in general, being done with a successful patient interview, Standardized or Real, is incredibly satisfying. Being done with a test? Relieving, but not really satisfying. It’s almost like giving to charity versus paying taxes.

I’ve really enjoyed interviewing patients so far. My two Standardized patient exams went very well (I confess though that I have not yet convinced myself to watch the videos, as valuable as I know it is to do so). I wasn’t surprised by the almost entirely positive feedback I received (my only negative feedback was for addressing my first SP by “her” first name; no idea why I did that. Not my usual style), but I was surprised to find that I didn’t come across as nervous and hesitant as I often felt. I’m an introvert by nature and I can be shy. I can also be awkward in that sometimes I neglect to step outside my mind and interact appropriately. But I’m good in formal settings. I like defined roles and I interact well within them.

Earlier in the month, I had a chance to interview a patient in the hospital completely on my own (with a fourth year present) and that was an amazing experience. Up until then I’d been underwhelmed by our hospital sessions. I had only been able to do a tiny part of the patient interview, or just the physical, or taking notes, or worse, just observing. But this time I got to do everything, the interview and the physical. Ah, HIPAA. I can’t really say much detailed about the case, but it was rather interesting and convoluted and she was quite the talker. It was good practice trying to keep the timeline straight.

Some people argue that there’s no point in learning clinical skills during your first two years, but I like the reminder of why I’m in Medical School at all. There are some (several) aspects of the curriculum that are attached to the clinical skill learning that I disagree with, but the concrete practical skills? Those are great. I gain confidence with practice, and also with the positive feedback. Makes me feel all warm and doctor-y.

Written by Aba

December 27, 2009 at 6:50 pm

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Rethinking Christmas

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I’m going to be talking about Christmas here;  I’m Roman Catholic, and it’s my favorite holiday, but I think a lot of this is generalizable to other holidays.

The issue of presents has been an odd one in my household these past few years. No one’s really sure what to get anyone and gone are the days when all six of us were back in Ghana in time for Christmas day itself. Twice now my second brother, the Resident, has missed Christmas and so we pushed back present opening till he arrived. This year, two of my brothers won’t be here yet. We’re also not just six anymore. My oldest brother is married (and with a newborn baby!) and the second is engaged, and bringing his fiance.

In the US, and probably in most of the Christmas celebrating world, the overall commercial aspect of Christmas hasn’t changed much. Now though, there are lots of counter movements. There’s the religious ones, and then there’s the ones that may or may not be religious, but that still try to captivate the warm, family message without the price tag and store bought aspect. Some people are turning their backs on gift giving altogether, and others are trying to focus more on giving handmade things, consumable things, and/or experiences.

I go back and forth between ideas. My parents are actively practicing Catholics, and so family Christmas always means mass in the morning; that won’t change. After mass there’s usually brunch, at home or out at a hotel. And then either that day or a few days later, we open presents.

As a very little kid, the magic of Christmas did have a good amount to do with the presents, but honestly, I think a lot of it was also just that everyone else was happy and excited and we were all together. Christmas is a festive change of pace; how could I not love it? I don’t remember most of my presents that clearly, and I don’t have a single, “Christmas was awesome because I got X” memory.  And I loved Easter too and my household was not big on commercializing that holiday. We would travel to Abidjan, go to church (in French; but the cathedral was gorgeous) and spend time together. I have vague memories of an easter egg hunt in the US when I must have been four, and memories of one in Adbijan, and that’s it.

So holidays can certainly be special without the gifts.

I can’t help but want to hang on to the Christmas gift giving though. My family is rarely together for each other’s birthdays and generally we just call each other. This makes Christmas the one time a year we are guaranteed to exchange gifts. Is gift giving necessary at all? Perhaps no, but I enjoy it a lot. I think it is one of my love languages (see: The five languages of love) and I’ve only recently started trying to give gifts myself (usually my brothers and I gave joint gifts; read, my oldest brother bought gifts that we all put our names on). I’m finally taking part, and yet at the same time our Christmas is evolving and I’m not sure what’s going to happen in the end. Are we nearing the end of a family Christmas? I want to hang onto it for as long as I can. My older brothers were out of the house by the time I was eleven so Christmas has always been a special time for me as it is also the one time of the year we were all guaranteed to be together.

So I’m trying to develop my own gift ethic. I enjoy crafting, I enjoy cooking, and I also enjoy trying to shop for the right gift. I’m particularly fond of the combination of food item + book. Last year I infused my own liqueurs and made peppermint bark, and I think this year I made peppermint bark and a version of almond roca.

I think there is nothing inherently wrong with giving gifts for Christmas, so long as all parties are happy with the idea. I think some people would maybe benefit from realizing that maybe gifts don’t have to be big and expensive, but simply well thought out and well suited to the receiver. Last year my boyfriend and I decided to skip giving gifts to each other because we were both stressed at the time and one fewer person to give a gift to was a welcome change. We’re also skipping gifts again this year (though we are exchanging cards, which will both be varying degrees of late). It feels more okay doing that with him than with my family, since we do celebrate each other’s birthdays with gifts, and we also have our anniversary (for which I think we’re going to make a tradition of  an agreed upon joint gift + smaller inexpensive individual gifts).

Such a long post, all about Christmas and presents! Obviously, this is something I’ve thought a lot about. I’ve even started thinking about what I want to do next year! :) Yeah, I’m definitely going to keep going with gifts.

Written by Aba

December 23, 2009 at 2:29 pm

Posted in Uncategorized

So that is what it feels like

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I had an amazing lecturer in my biochemistry class yesterday (he also apparently taught the class before this past one, but I was not there).

Honestly, I think I’d forgotten what it was like to truly enjoy a lecture class. I’ve liked lecture classes and I’ve had a good time in them before. But to enjoy the class and actually learn the material at the same time? In a class whose material I don’t like to begin with? Essentially unheard of.

I kind of want this guy to teach all of medical school.

This is not to say that my other lecturers are bad. No, not at all. Many of them are very good (some even great), most of them are good, and even my least favorite ones are generally adequate.

But excellent? No, that is rare. Excellence in general is rare.

Why do I love this lecturer? It’s not simply that he was entertaining. If he was entertaining but at the end of the lecture I was still completely at a loss to what he was talking about, then he was not even really a good lecturer. The reason I’m so impressed is that I all but hate biochemistry so far. There’s all these little details and pathways that I’ve been having trouble grasping. And yet he managed to explain some biochemistry pathways in a way that even though I had not looked at the material before the class, and I have still not looked at it, I actually remember a good deal of it.

I am reminded why lectures exist at all.

Written by Aba

December 2, 2009 at 2:15 pm

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Sexism in choosing a doctor: a problem or no?

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I recently learned that some people do not believe in patients being able to pick their doctors. At least, I’m going assume that’s the overall view, because where do you draw the line?

I have always preferred having a female doctor. Some people may argue that I am somehow sexualizing the patient physical, but I have had this preference since I was child. I had no choice in my pediatrician, but I was much happier when I had a woman than when I had a man. Now, as a young adult, I will consciously choose a female doctor for any sort of physical; whether it’s just for a check up, or for a gynecology appointment.

I feel this is obvious, but maybe I should say it anyway: I only really care when it comes to more primary care situations. I couldn’t care less beyond those settings. If I have an emergency or I need surgery, my doctor can be as different from me as possible, so long as they’re competent.

So I thought this was all good and well, until I encountered an argument online (in an ob/gyn resident forum) where the majority of people were against women choosing female doctors. They thought it was sexist and akin to someone choosing a doctor based on race, which would be racist and therefore wrong. I was incredibly taken aback by the force behind these assertions. I had no idea this was an issue, let alone such a heated one.

Honestly, I feel that if a patient has the freedom to choose, then they may choose whichever doctor they want for whatever reason is important to them. If they do not have a choice and they are unhappy with their doctor, then they must either accept the situation, wait till they have options, or leave and accept that they will then not get the care that they want (but what if they need the care? Hm. Should a doctor be forced upon them?).

I am having trouble properly articulating why it is somehow more okay in my mind to pick a doctor based on criteria that it is generally unacceptable to use (in fact, I feel like the only time it is socially acceptable for us to be picky is in the gender of our romantic partners, and to some extent, the age). I think I feel like it’s just too crucial of an area to start arguing about being politically correct. Should we force patients to be seen by doctors they don’t want when there’s the wiggle room to let them choose? Trust is such an important component of the doctor-patient relationship, and if the patient doesn’t trust their doctor, or even simply isn’t comfortable with their doctor, so much can be lost.

Ideally, people wouldn’t care what age, sex, race, religion, etc their doctor is, but they do, and until they don’t, why not give in when we can? I don’t feel that the hospital or the doctor’s office is the place to fight this battle quite so strongly. I definitely am all for talking patients through their concerns and trying to convince them that maybe this black doctor is amazing or that this male ob/gyn is the best ob/gyn ever, but I don’t think I agree with forcing the issue unless it’s critical to the patient’s immediate health.

Written by Aba

December 2, 2009 at 1:44 am

Posted in Uncategorized

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