Thank you so much to everyone for your support and kind words since my last entry. I can’t even count how many texts, calls, e-mails, and Facebook messages I received from friends and family who checked in regarding the difficulties I experienced back in July and who extended prayer, advice and their best wishes as I transitioned to my M1 year. It is a tremendous blessing to have all of you in my life.
I haven’t written an entry in months. I’m excited to be back to entertain you with some of my adventures as a first year medical student so far, but first I’d like to give a
Brief update on my medical status
I finally met with a primary care physician in IL regarding my pituitary adenoma. The nurse who called to tell me this news back in July did not say that it was non-cancerous, and urged me to see a physician who could clinically evaluate the “lesion” that the neuroradiologist described in the report. Fortunately, I am fine.
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| Image taken from: http://pituitary.ucla.edu/pituitary-adenomas |
Abnormal hormone levels could be an indication of a growing tumor in my pituitary gland. Other signs could also assess the pressure of a growing tumor on nearby structures; these include headaches and vision loss. My doctor asked me some questions that could point to any irregularities in my hormonal activity, then ordered a blood test to take a closer look at some of my levels, including my ACTH. I’m confident that everything will be alright. Chances of the adenoma busting a groove in my pituitary and expanding at an alarming rate are very, very slim.
Winter Break
We had our last final exam for Radiology last week, and I’ve been all over the place since then. On Friday, I flew out from Chicago to DC right after the exam. Once I arrived in DC I took an overnight bus up to NY. (Earlier I tried changing my flight to go straight to NY but Southwest didn’t have any going from Chicago to NY on that Friday).
After that weekend I left to take a bus down to MD to stay with my sister.
So, the sequence of trips over a period of only four days was: Chicago --> DC --> Manhattan --> Bronx --> back to Manhattan --> MD
This coming weekend we’re going to NJ (and Brooklyn) to celebrate Christmas with family. Then my sister and I are coming back to MD. Then I’m going back to Chicago to celebrate New Year’s with friends there :)
Brief Reflections on the Fall M1 Curriculum at Loyola
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| Anatomy lab group on our last day with our wonderful instructor! |
I’m honored to be a part of Loyola’s Class of 2020 with 159 other brilliant classmates, many of whom have become good friends of mine. I can’t believe we’ve reached the halfway point of our first year.
Over a period of about five months, we coursed through Molecular Cell Biology & Genetics (MCBG), Structure of the Human Body (Anatomy), Behavioral Medicine & Development (BD), and the first part of Patient Centered Medicine I (PCM I) and Topics in Clinical Medicine (TCM I; Radiology) which are both four-year courses. In the Spring we’ll start Function of the Human Body (Physiology) and Host Defense (Immunology), and continue with PCM and TCM.
Anatomy is my favorite course that we’ve taken so far. Hands down. The content from MCBG is important, and it’s essential that every physician understand the molecular and cellular basis of disease, as well as the molecular tools that are used for diagnosis, but Anatomy is more clinically relevant, and Physiology (which we’ll take in the Spring) even more so.
Over a period of about five months, we coursed through Molecular Cell Biology & Genetics (MCBG), Structure of the Human Body (Anatomy), Behavioral Medicine & Development (BD), and the first part of Patient Centered Medicine I (PCM I) and Topics in Clinical Medicine (TCM I; Radiology) which are both four-year courses. In the Spring we’ll start Function of the Human Body (Physiology) and Host Defense (Immunology), and continue with PCM and TCM.
Anatomy is my favorite course that we’ve taken so far. Hands down. The content from MCBG is important, and it’s essential that every physician understand the molecular and cellular basis of disease, as well as the molecular tools that are used for diagnosis, but Anatomy is more clinically relevant, and Physiology (which we’ll take in the Spring) even more so.
Others may find other methods useful; some of my classmates take the time to type up their notes, draw and diagram things out, and even rely heavily on online resources and textbooks to learn the material. Everyone learns and studies differently. I live by Anki. Sometimes I’ll diagram something I need to visualize a bit better, like the brachial plexus or the arterial branches of the abdominal aorta. But for the most part I just import images into my Anki deck and study those. I can’t draw for my life, so there’s no point in wasting time trying to hone my sketching skills when I could be studying someone else’s perfect sketch of the lumbosacral plexus. When we begin Physiology in the Spring, and especially Path and Pharm next year, unfortunately there won’t be enough time to take copious notes and draw everything out, so I've made Anki my primary study tool this year.
Our Anatomy lectures were fun. The course Director (who was also one of our Professors) was especially entertaining. He had a habit of picking on students (out of good humor), giving us little gifts from his house and garden when we answered questions correctly, and cracking jokes that ranged from crass to gut-busting.
Reflections on Shadowing experiences
One of the things I absolutely love about Loyola is the plethora of opportunities to be engaged in organizations and programs that are committed to service, personal and spiritual development, and exposure to the many specialties of medicine. I admit that the free food served at the Anesthesiology and Interventional Radiology general interest meetings, for example, was a major (ok, the primary) reason why I attended, but even though I don’t intend to pursue these particular specialties, I welcomed the opportunity to learn more about the fields.
I spent some time shadowing at the main hospital, outpatient center, and the Edward Hines, Jr. VA Hospital right across from our school’s campus. I shadowed specialists in Infectious Disease, Neurology, Anesthesiology, Neuroradiology, and General Internal Medicine.
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| Loyola University Medical Center Maywood, IL |
The Medical Spanish Program and the Chaplain Mentoring Program (through our Patient Centered Medicine I course) also gave me the chance to shadow a medical Spanish interpreter in the outpatient center and a chaplain at the main hospital in the NeuroICU.
(Loyola is a Catholic medical center whose religious tradition includes providing pastoral care, or chaplain services, to patients. Chaplains are trained in a particular healthcare service area to give additional spiritual and emotional support to patients and families. Before coming to Loyola I’d never heard of a chaplain before. This shadowing experience informed my understanding of the importance of emotional connection between a healthcare professional and the patient).
At Loyola, M1s have much more time to shadow and pursue extracurricular interests. This past Fall we completed two major science courses: MCBG from August through mid-September, and Anatomy from mid-September through December. PCM, TCM, and BD lasted the entire Fall term but were not as rigorous as our science classes. M2s are overwhelmed with curricular demands – Pathology and Pharmacology are taken concurrently throughout the entire year; they’ll hit you like a ton of bricks come August. The sheer amount of material that the M2s are responsible for is unfathomable to me right now because I have not yet experienced that level of rigor.
Anyway, I’ll go ahead and share a couple of stories from my clinical encounters this past Fall term. Patient names and personally identifiable information are of course omitted.
(Loyola is a Catholic medical center whose religious tradition includes providing pastoral care, or chaplain services, to patients. Chaplains are trained in a particular healthcare service area to give additional spiritual and emotional support to patients and families. Before coming to Loyola I’d never heard of a chaplain before. This shadowing experience informed my understanding of the importance of emotional connection between a healthcare professional and the patient).
At Loyola, M1s have much more time to shadow and pursue extracurricular interests. This past Fall we completed two major science courses: MCBG from August through mid-September, and Anatomy from mid-September through December. PCM, TCM, and BD lasted the entire Fall term but were not as rigorous as our science classes. M2s are overwhelmed with curricular demands – Pathology and Pharmacology are taken concurrently throughout the entire year; they’ll hit you like a ton of bricks come August. The sheer amount of material that the M2s are responsible for is unfathomable to me right now because I have not yet experienced that level of rigor.
Anyway, I’ll go ahead and share a couple of stories from my clinical encounters this past Fall term. Patient names and personally identifiable information are of course omitted.
In the NeuroICU
On a Saturday morning during the week of our Thanksgiving break I decided to take a break from Netflix to shadow a Neurologist in the NeuroICU. I stayed for about three hours as he and a resident rounded on the patients.
One patient in particular suffered a massive MCA (middle cerebral artery) ischemic stroke. He'd been transferred from another hospital. The neurologist (let’s call him Dr. X) broke this news to the patient’s wife and son. It seemed they had not understood how serious the situation was because they were shocked to hear this. Dr. X started a neurological exam to check the patient’s status, but it couldn't be completed because he was quite comatose. Dr. X talked to the family a little more, regrettably sharing that their loved one would be unlikely to regain complete functioning of the right side of his body; he would also exhibit some cognitive deficits, behavioral changes, and speech impairments. The wife and son solemnly nodded their heads but did not make eye contact with Dr. X.
I was suddenly aware of my own presence in the room and I felt like an intruder. I was a useless M1 clothed with what felt at that moment like a meaningless white coat because I couldn’t even do anything for the family. I was only benefiting myself when I decided to come in that day to learn a little neuropathology at the expense of patients and their family’s suffering.
Before I knew it we were out of the room and moving on to the next patient. Dr. X ran to briefly answer a page and my eyes fell back on the stroke patient through the glass window to his room. The wife and son chatted with the nurse for a little bit, then I caught a glimpse of something that made me tear. The son leaned over the bed and pressed his cheek up against his dad’s, whispering something in his ear. The wife looked on lovingly and patiently. When the son lifted his head back up, his face was red and his eyes wet with tears. I was stunned, and a lump began to form in my own throat. I didn’t expect to get emotional. I can’t imagine the pain of seeing a loved one degenerate cognitively or physically before my very eyes. One moment your father is completely fine, the next he’s suffered a severe stroke which will leave him with many defects, unable to regain full independence and functioning. What a heart rending misfortune.
A quote from Dr. Lissa Rankin’s “Mind over Medicine” has entered my mind. She shares her motivations for pursuing a medical career: “What drew me to the practice of medicine was the desire to touch hearts, to hold hands, to offer comfort amid suffering, to enable recovery when possible, and to alleviate loneliness and despair when cure wasn’t possible.” I wanted to walk up to the wife and son, lay my hands on their shoulders, and apologize for what they were going through. I didn't though. They would have every right to slap my hands away and ask who in the world I was. I chose to silently comfort them instead.
Intubating a patient
I signed up for our school’s Anesthesiology Preceptorship Enrichment Program (APEP). To be honest, I probably won’t pursue Anesthesiology, but this program is a great way to learn about the specialty and gain more clinical exposure. On my first day shadowing in the OR, my mentor told me that I was going to intubate a patient. I was terrified. ME? Intubate a patient? I’d just started medical school four months prior! What did I know about intubating a patient?!
Luckily, I was able to calm down when my mentor and one of the residents patiently talked me through it. Even though I was told that if I inserted the tube into the esophagus (ventilating the stomach) instead of the trachea (to ventilate the lungs) it wouldn’t be the end of the world and they would simply fix my mistake. I was told that I'd have several minutes to intubate the patient before they start to crash. In other words, I could afford to make the mistake of pushing the tube down the wrong hole without running out of time and killing the patient. But I didn’t feel right about it. I wasn’t completely confident about where to place the tube. At that moment, I decided to defer the task to my mentor rather than risk pushing the tube down the esophagus.
I am comforted by knowing that we'll have plenty of opportunities down the line to hone our skills. The greatest thing I appreciate about this APEP experience so far is my mentor’s adamancy about my learning by doing.
Books
I try to read for pleasure to keep my mind stimulated and to satisfy my interests in many different arenas. Since August I’ve only been able to finish a couple of great books as part of my 2016 Goodreads Challenge:
"I Shall Not Hate: A Gaza Doctor's Journey on the Road to Peace and Human Dignity" by Izzeldin Abuelaish. Dr. Abuelaish is a Palestinian physician who was nominated for the Noble Peace Prize for his efforts to bring peace between Israel and Palestine. In this book, he shares his inspiring yet tragic story of growing up in the Gaza Strip of Palestine, becoming a doctor in Egypt, and moving back to the Gaza Strip where he crosses the border daily to work at a hospital in Israel. His three daughters and niece were brutally killed by the Israeli military in 2009. He shares that the deaths of his loved ones further galvanized him into fighting the ongoing conflict between Israel and Palestine.
"Do No Harm: Stories of Life, Death & Brain Surgery" by Dr. Henry Marsh. Dr. Marsh is a retired neurosurgeon from the U.K. who shares his journey through medical school and residency. Aside from the personal anecdotes and patient stories, Dr. Marsh delves into his cross-cultural encounters in Ukraine where he helped revolutionized neurological surgery, and shares with us valuable and profound life messages. Such a great read!
I want to savor the next week or so of break that we have left, but I also want to be more productive. I can't even count how many Friends episodes I've watched since last week. Besides writing this entry, this break so far has not been as productive as I hoped.
Have a Merry Christmas and a Happy New Year!
On a Saturday morning during the week of our Thanksgiving break I decided to take a break from Netflix to shadow a Neurologist in the NeuroICU. I stayed for about three hours as he and a resident rounded on the patients.
One patient in particular suffered a massive MCA (middle cerebral artery) ischemic stroke. He'd been transferred from another hospital. The neurologist (let’s call him Dr. X) broke this news to the patient’s wife and son. It seemed they had not understood how serious the situation was because they were shocked to hear this. Dr. X started a neurological exam to check the patient’s status, but it couldn't be completed because he was quite comatose. Dr. X talked to the family a little more, regrettably sharing that their loved one would be unlikely to regain complete functioning of the right side of his body; he would also exhibit some cognitive deficits, behavioral changes, and speech impairments. The wife and son solemnly nodded their heads but did not make eye contact with Dr. X.
I was suddenly aware of my own presence in the room and I felt like an intruder. I was a useless M1 clothed with what felt at that moment like a meaningless white coat because I couldn’t even do anything for the family. I was only benefiting myself when I decided to come in that day to learn a little neuropathology at the expense of patients and their family’s suffering.
Before I knew it we were out of the room and moving on to the next patient. Dr. X ran to briefly answer a page and my eyes fell back on the stroke patient through the glass window to his room. The wife and son chatted with the nurse for a little bit, then I caught a glimpse of something that made me tear. The son leaned over the bed and pressed his cheek up against his dad’s, whispering something in his ear. The wife looked on lovingly and patiently. When the son lifted his head back up, his face was red and his eyes wet with tears. I was stunned, and a lump began to form in my own throat. I didn’t expect to get emotional. I can’t imagine the pain of seeing a loved one degenerate cognitively or physically before my very eyes. One moment your father is completely fine, the next he’s suffered a severe stroke which will leave him with many defects, unable to regain full independence and functioning. What a heart rending misfortune.
A quote from Dr. Lissa Rankin’s “Mind over Medicine” has entered my mind. She shares her motivations for pursuing a medical career: “What drew me to the practice of medicine was the desire to touch hearts, to hold hands, to offer comfort amid suffering, to enable recovery when possible, and to alleviate loneliness and despair when cure wasn’t possible.” I wanted to walk up to the wife and son, lay my hands on their shoulders, and apologize for what they were going through. I didn't though. They would have every right to slap my hands away and ask who in the world I was. I chose to silently comfort them instead.
Intubating a patient
I signed up for our school’s Anesthesiology Preceptorship Enrichment Program (APEP). To be honest, I probably won’t pursue Anesthesiology, but this program is a great way to learn about the specialty and gain more clinical exposure. On my first day shadowing in the OR, my mentor told me that I was going to intubate a patient. I was terrified. ME? Intubate a patient? I’d just started medical school four months prior! What did I know about intubating a patient?!
Luckily, I was able to calm down when my mentor and one of the residents patiently talked me through it. Even though I was told that if I inserted the tube into the esophagus (ventilating the stomach) instead of the trachea (to ventilate the lungs) it wouldn’t be the end of the world and they would simply fix my mistake. I was told that I'd have several minutes to intubate the patient before they start to crash. In other words, I could afford to make the mistake of pushing the tube down the wrong hole without running out of time and killing the patient. But I didn’t feel right about it. I wasn’t completely confident about where to place the tube. At that moment, I decided to defer the task to my mentor rather than risk pushing the tube down the esophagus.
I am comforted by knowing that we'll have plenty of opportunities down the line to hone our skills. The greatest thing I appreciate about this APEP experience so far is my mentor’s adamancy about my learning by doing.
Books
I try to read for pleasure to keep my mind stimulated and to satisfy my interests in many different arenas. Since August I’ve only been able to finish a couple of great books as part of my 2016 Goodreads Challenge:
"I Shall Not Hate: A Gaza Doctor's Journey on the Road to Peace and Human Dignity" by Izzeldin Abuelaish. Dr. Abuelaish is a Palestinian physician who was nominated for the Noble Peace Prize for his efforts to bring peace between Israel and Palestine. In this book, he shares his inspiring yet tragic story of growing up in the Gaza Strip of Palestine, becoming a doctor in Egypt, and moving back to the Gaza Strip where he crosses the border daily to work at a hospital in Israel. His three daughters and niece were brutally killed by the Israeli military in 2009. He shares that the deaths of his loved ones further galvanized him into fighting the ongoing conflict between Israel and Palestine.
"Do No Harm: Stories of Life, Death & Brain Surgery" by Dr. Henry Marsh. Dr. Marsh is a retired neurosurgeon from the U.K. who shares his journey through medical school and residency. Aside from the personal anecdotes and patient stories, Dr. Marsh delves into his cross-cultural encounters in Ukraine where he helped revolutionized neurological surgery, and shares with us valuable and profound life messages. Such a great read!
~*~
Have a Merry Christmas and a Happy New Year!
