January 21, 2008

Chatter and silence

There was a delightful amount of chatter in our classroom three weeks ago as everyone converged for our first lecture of 2008. Fresh from winter break where many people went abroad, friends reunited to share their holiday events with each other.

Strangely, I found myself in the midst of this exchange of excited words and gestures with my nose buried into the papers of the day's lecture notes and the future lecture schedule. I found this surprising... normally, I'm very talkative, but I didn't feel like participating in any discussions. I felt lazy. I felt unmotivated. I felt blase and boring.

Was I turning into an introvert?!? Last semester, I had to study nearly 10-15 hours/day without any breaks on the weekends just to keep up with the material. Neuroanatomy, Half of Robbins, Neuropathology... that was the "bonus" material we had to study in addition to the typical case material and Anatomy/Path labs. 10-15/7 (almost 24/7, accounting for food, sleep and bathroom breaks) left very little time for socializing. When it was over and winter break started up, I felt very burned out. I didn't want to call up my friends to hang out. I slept in until 11 or 12 on a regular basis, just because I could. I wasted as much time doing as little as possible. Looking back, it was a reaction to the pending realization that THIS would be the last restful break I'd ever have.

I heard the horror stories of third-year clerkships. I knew about the restless nights of being on-call.

I withdrew into my shell.

Now, I can honestly say that I am breaking out of that shell.
I've moved into town so I'm closer to school.
I've got myself an outgoing upperclass roommate.
I've been sticking to my resolution to spend more quality moments with my family, having dinner, playing games, talking, etc.
Heck, I've been going out twice a week! Whoa... that's pure heaven for the typical med student. The downside is that I feel like I'm drinking a lot of alcohol. I'm a social drinker (read: not a big fan of EtOH, but succumbs easily to peer pressure). Guilty pleasures, indeed. I've met a lot of new people and old friends in the past three weeks that I feel happier now than I ever did in my first year of med school.

That's not to say that I wasn't happy before... but I definitely wasn't taking care of my "goose" as much as I should have. (FYI, UH med school has a running gag about caring for your "goose", so it continues to give you golden eggs.)

A part of my neglectful goose has been this blog. I'm sad that I posted more as a pre-med than as a med-student.

The silence ends now. I'm going to reorganize this blog and turn it more into a commentary on my life. I'm going to make myself more transparent. No more "pseudo-anonymity" from me! I'm going to be participatory in my favorite feeds. It'll mean more work, but I want to contribute to the cyberverse of medicine and such.

January 20, 2008

OLD PAM's menstruation

Sometimes, young women are reluctant to talk about their female problems. It is important for primary care physicians, then, to ask OLD PAM some screening questions about her menses.

Onset: When did your menses begin?
LMP: On what date did you last menstrual periods occur?
Duration: How often do your menstrual periods occur? How long do they last for?

Pain: Is there any pain associated with menstruation?
Activity: Are you sexually active?
Meds: Are you practicing any form of birth control?

Questions gathered from
Seller. Differential Diagnosis of Common Complaints. 4th ed. 2000. (the purple ddx book)

January 06, 2008

Cold Shock

My watch went off at 6:30am this morning and I toyed with the alarm to give myself another 15 minutes of respite before my blessed winter break ended. Ugh. Fifteen minutes can pass by all too soon in the flashes of REM-lidded sleep. My dreams fled as the bleary edges of reality set in. I needed a shower to wake up.

My feet slid across the carpet, licking the polyester edges and I gathered up a towel, soap and scrubber.

waaugh!!! frick, that's cold water. i would have sworn if i could, but the chill knocked the breath out of me. i slammed the water off and toyed with the knob some more. was there some sort of trick to this? at home, the solar water heater takes a while to heat up the pipes. i tested it again. ice cold.what was i doing here?!? i've got hot water at home. is it really worth trading in a 30-45 min drive to school everyday for this?!?

i felt unprepared to move out of my parents' home all of a sudden. perhaps after close to two decades in the place, i had grown accustomed to everything. i couldn't tolerate the changes. the reason i was tired in the first place was that i was tossing and turning all night in this new, empty cottage. this foreign place i staked a claim for as if it were my own.

with the water a bare trickle, i focused on the sensation. describing it.raw nerve endings tingling, sending salty electrical signals up my ALS. What does that stand for? Amyotrophic, Lateral Sclerosis aka Lou Gehrig's.... but that was a different ALS.
What? oh yes. anterolateral system.
erector pili muscles across the entire surface area of my body strain in unison to raise the hairs on my body.
my skin puckers and quivers from the cold shock of the water.
my body quakes violently to burn excess ATP, wasting energy to generate excess heat. it just makes me feel more like a fool.
the anterolateral system conveys signals of pain and temperature. sometimes it doesn't tell you which one.

as my medico-scientific perspective unfolded, the water grew more bearable. was it actually getting warmer? i couldn't tell... i already finished my shower.

maybe i could get used to living in a cottage as well, parents or not!

January 05, 2008

Homework setup

I just moved into a new place in downtown near punchbowl. I went shopping for a desk and office chair for my room (the old one was too big) and I found this great computer desk by orispace for only 90 bucks @ Fisher Hawaii!
I like the multi-tier corner idea; it really clears up the room. Dual-monitor setup allows me to surf the web or pull up a journal article on one screen while I work on the other.

[edit] Typing on a cell phone keypad with word guessinng leads to some delays and spelling errors... not sure if I'll continue to use this blogging method, as accessible as it may be.