Author: Amanda Xi

Day 155: Promoting good health

Amanda Xi

Today’s inane image of the day:

This is the second set of chocolate cupcakes I made over break… they’re significantly darker in color and more rich in chocolate flavor probably because of the addition of coffee [I also used more butter…]. [Yes, I realize that I am opposing the title of this entry with this photo. My sincerest apologies… everything in moderation!]

Instead of spending our day off [thank you Dr. King for your positive impact on our society and this wonderful 3-day weekend!] from classes sitting around and reading books [we do have a quiz tomorrow!], a number of us spent the morning or afternoon volunteering to do health screenings at a local Forgotten Harvest drop off site. At the location I went to, each of us rotated through 4 stations: blood pressure, blood glucose, flu shots and BMI. It was a wonderful opportunity to give back to the community, as well as practice our skills.

After returning home, I found a wonderfully illustrated and well-timed video entitled, “23 and 1/2 hours: What is the single best thing we can do for our health?” — I promise it’ll be worth your 9 minutes!

And here’s one more awesome video making a staircase more appealing than the escalator:

P.S. I started using Tumblr to reblog other interesting posts [all medically-related]. For the time being, I will stay faithful to the Blogger platform for my personal entries, but you should still check it out [and follow me if you have an account!]: http://amandaxi.tumblr.com/

Day 151: Perspective

Amanda Xi

Today’s inane image of the day:

My first attempt ever at making chocolate cupcakes over break was a success! They were fluffy, chocolatey and amazing… I just had to post this image because I devoured the last one of this batch a couple minutes ago.

Even though we did a lot of waiting around [bah! lack of productivity makes me grumpy!], I definitely thought that overall the day was a positive experience. Our course director for Neuroscience is a great lecturer [albeit not as skilled with technology as the brain and scalpel] and in APM we learned about, and practiced, a full ophthalmologic [definitely had to autocorrect that one] examination. And when I say full, I mean like fully dilated pupils.

Let me preface this with the fact that I have never had my eyes examined by an ophthalmologist and have never had my eyes dilated [woohoo for good vision]. So it makes sense that I was concerned about essentially losing control [ha, totally type A medical student personality here] of my vision in one eye and it didn’t help much to hear that someone once fainted from receiving the drops. Obviously I’m still here, and I’m able to [somewhat] write this entry, so it all worked out… but it’s still an uncomfortable feeling.

[Yes, my left eye is still dilated…]

This experience and a couple of other things made me think about different perspectives. Trying to focus on my name badge with my dilated eye was painful and made me feel uncomfortable — going from normal vision to lopsided and distorted was literally like losing a part of me. A huge part of me, too. It was a completely novel perspective on eyesight — yes, prior to this experience I understood how difficult it would be psychologically to lose sight — but actually [even partially] experiencing it really made a huge difference. And the fear that accompanied the sensation came as a bit of a shock to me.

In so many ways, medicine is forcing me to see how resilient, yet fragile, we all are.

[Of course, the best part was actually being able to visualize the optic disk and fovea. Dilation really makes a world of a difference in seeing the retinal structures.]

Day 149: Brief musing on specialties

Amanda Xi

Today’s inane image of the day:

This was the sky’s “Good Morning” today — this photo was taken from a study room in O’Dowd [I highly recommend these rooms early in the morning… so peaceful to watch the sun rise].

For our PRISM session next week, each of us is required to complete the 150 question MSPI-R assessment on the Careers in Medicine website. Not surprisingly, the speciality it said I was most compatible with was OB/GYN. Huh, you ask? Haven’t you been raving about interest in anesthesiology, radiation oncology and cancer genetics? Why did you know you would get OB/GYN [beside the fact that the survey asked predictable questions]?

Well, first and foremost, I really enjoy working with the female population [which is probably why I was so involved in the Society of Women Engineers and now the American Medical Women’s Association]. Women indeed have different needs and I find it fascinating how distinct males and females react to problems or emotional expression. I love the connection and the firsthand understanding. And babies are absolutely magical.

But, I don’t know if I really want to dedicate the rest of my life to women’s reproductive health. Maybe after my clerkship I’ll change my mind. Or maybe it’ll push me more toward breast cancers. Or maybe I’ll be back here exactly where I started [hopefully not that last one!].

Bah! It stresses me out not to have a more concrete idea of where I want to and hope to be after medical school.

Day 148: Back at it again

Amanda Xi

Today’s inane image of the day:

I’m back at that whole studying thing… what happened to break?

The good thing about this new semester is that this morning’s drive wasn’t pitch black like it was the last couple of weeks of the Fall semester. I am impressed at myself for making it to the other side of winter, when the sun peeks its head out from below the horizon at a reasonable hour and actually greets us when we walk out of O’Dowd [not quite sure we will see the sun later today, but hey we’re getting there!].

We’re starting off Neuroscience with a quiz in Anatomy tomorrow… although there are only 5 questions, I counted something like 18 images with labels that we have to memorize.

I’d write more this week, but we have our first AMWA Speaker Series Discussion tonight [with our very own Dr. Nuzzarello] and a lot of planning for the future happening. At this point, I’m trying to solidify my travel plans to California for spring break and something for the summer. Oh, and I’m narrowing down my options for a Capstone project… so many things to straighten out!

Day 145: Things are moving along

Amanda Xi

Today’s inane image of the day:

MSG [Medical Student Government] got all of our white coats embroidered over the break! Now we look official. Thanks, MSG [really hard not to read that as monosodium glutamate…]!

Things this week have been relatively hectic…

Remediation
I took my remediation exam on Tuesday and… passed BFCP1! Woohoo! Interestingly, I thought studying for the remediation exam was more difficult than the original exam, primarily because all of the material was already at least familiar. It was hard to gauge what I actually still remember [S. aureus = gram positive cocci in clusters!] and what I only sort of remember [Turner syndrome = 45X — for some reason this fact was more difficult for me to drill into my head]. Regardless, that hurdle has been surpassed and I was able to spend all of Wednesday not staring at books or lecture notes!

At the time that I realized I had to remediate, I was definitely frustrated with the idea that my entire winter break would be spent with this dark cloud over my head. Furthermore, the remediation exam is, in a way, a higher-stakes exam than the original because failure automatically requires course remediation over the summer and that is the last thing I want to be doing. But looking back, I do see the utility in the process and appreciate the extra push to review the material that I was weak on. I still wish I had passed the exam the first time around so I could have focused on all of my weak spots instead of just specific sections from one exam, but I guess that’s what the summer is for.

Lovely company
Mike has been home since mid-December and it has been absolutely wonderful. Although the LDR thing has been rough, things have settled down a bit and I’ve adjusted [somewhat]. Of course I would much rather just have him around, but I can’t change our current situation and in the end there are pros to the distance that I’ve come to appreciate. I plan on writing up an entry [at some point…] with tips for long distance relationships between medical and non-medical students.

Start of a new semester
We delved right into class again yesterday — it felt like an eon had passed since we last had class, but it was nice to see everyone again and catch up. There were a couple of bumps with getting the semester started, but administration is right on top of smoothing things out.

I’m not sure I’m ready to delve into the extremely deep depths of Neuroscience yet…  but there’s no turning back time at this point. Hopefully I’ll get back into my studying [and regular blog updating] routine relatively quickly since I won’t have any time to spare.

[Many of us discovered our unofficial transcripts and realized that last semester’s courses totaled to 36 credits and this upcoming one is 40 credits… I’d say that this sounds about right.]

Day 139: Oh, hello 2012

Amanda Xi

Today’s inane image of the day:

Every winter, I find myself knitting for stress relief — something about the redundant motions and forming a pattern from string just seems magical and very appropriate for the season. This particular pattern is called Ripple Stitch.

It’s amazing how the new year seemed to creep up on me — it couldn’t have been more than a couple weeks ago that I was tossing and turning in bed waiting for my first day of medical school to begin. It feels like many years have passed since I sat at a pump of a gas station and squealed in delight when I saw an email from OUWB inviting me to interview. I remember noting how dirty the snow looked and how biting the air was when I finally got out of the car to fill up my gas tank, but the excitement was overwhelming and I can look back on that memory fondly.

2011 was filled with multitudes of contrasting emotions: heartache and excitement; stress and relaxation; fear and serenity. Not surprisingly, the year will be filed away in my memory as a crossroad in my life.

Last year
Around this time last year, I was sitting next to a fireplace at my favorite coffeeshop listening to Ben Harper and tapping away at my OUWB secondary essay. I remember feeling like I had nothing to lose by submitting the application [well, besides the $75 application fee] and let my words flow in response to the two prompts. I remember digging through the website to try to find any more information and recognizing Dr. Sabina as my tour guide during the 2010 Applicant Visit day. After finally submitting, I succumbed back into the waiting game.

Interviewing recap
As the interview invites slowly rolled in, my excitement morphed into fear. True, I had made it this far, but interviewing meant that I had to articulate in spoken words what brought me there. Although OUWB was my second interview invite, due to scheduling issues, it ended up being my first interview. I think the worst part of the experience was just getting into my car at the end of the day and feeling completely helpless and discouraged. I knew that I wouldn’t be getting a call from Dean Grabowski.

My second interview [NYMC] was tied with a much needed trip to New York City. Although I had a really good feeling about that interview, a couple months later I received an email notifying me that I was on the waitlist. Even though the decision was met with anguish, from where I’m sitting now, I really only remember catching up with my friend and how much fun it was to roam, see, smell and hear everything in the city.

My third interview [Wayne State] required that I miss class. It wasn’t particularly memorable except for getting momentarily lost in Detroit and catching up with a former classmate over coffee. I remember walking out of the interview and returning a smile to a homeless man passing by. Maybe that little gesture was what tipped the scales in my favor, because a little over a month later, I received my first acceptance. Thank you Wayne State for being the first school to pronounce me worthy of a medical education.

My last interview [MCW] was for a waitlist position. Although I hadn’t thought much of the school, after meeting a few students and conversing with my two interviewers, I fell in love. I’d guess that if home were closer to Wisconsin that I might be there right now. Regardless, it was a tough moment to call the admissions office and withdraw my application.

Everything else
Although my interviews were what stood out about the first half of 2011, I cannot disregard the fact that I was still finishing up my Master’s degree, was part of the SWE executive board, running a middle school club, peer advising and enjoying Mike’s company. We were taking the exact same classes during our last semester and I cannot imagine how difficult it would have been to get through the problem sets and projects without him by my side the entire way. I remember  the night we discussed where he should do this PhD and knowing that he would choose California over Michigan. Although I knew we would be in a long distance relationship, the fact didn’t sink in until I started classes.

Intermission
The summer was a perfect mix of everything I needed before starting medical school. In a lot of ways, it was my first real break from everything academic — for the first time, I didn’t have to worry about taking classes, research or volunteering. It’s not that I didn’t enjoy these things, but for the first time in my life, I didn’t have to worry about getting into medical school. I also had a fun job, great coworkers, and ample time for myself in the evenings.

Oh, and the road trip! Since I haven’t traveled much, this was a much needed experience. No words can describe peering into the Grand Canyon or the Hoover Dam. And relaxing by the pool in Palm Springs. And the plains really are plain [but are nice to drive through!]. And seeing Hollywood for the first time. And so many new things!

Starting a new chapter
Leaving California, I was eager for the start of school. More and more updates came from OUWB and medical school was finally starting to feel like a reality. I didn’t know what to expect, yet I knew that it would be something amazing. Things were rough at the start and I still have some loose ends to tie up [remediation], but I know that I’m in the right place because I still love the school, the people and the material.

What’s next?
I’m starting the new year with a sense that things will work out… otherwise, why would I want to leave my warm bed each morning? Things have been tough with school and the long distance thing, but it worked out this last semester and will just have to work until the next crossroad. I’m not one to have new year’s resolutions, but I do want to try to stay positive this upcoming year. After all, this time next year, I’ll have to worry about setting up a study plan for the boards [eeek!].

Thank you
When I started this blog over the summer, I never expected to have more than 10 dedicated readers… but it looks like we’ve come a long way since then. Thanks for reading my rants and providing supportive comments during the rough patches — my success can be attributed in part to you!

Day 138: Exposing the spinal cord

Amanda Xi

Today’s inane image of the day:

When I was in high school, I was a part of the robotics team — this is what we came up with the second year I was on the team.

During our last BFCP2 Anatomy Lab session, we worked in teams [things were a bit scrambled since the physical therapy students were no longer joining us for lab] to expose the spinal cord. I didn’t really think much about the dissection until I walked into the lab and was greeted by saws, hammers and chisels. The sounds and scenes brought back fond memories of when I was a part of my high school’s robotics team — back then, I was all too familiar with using power tools to construct a final product, but I had never used those tools to do the opposite: uncover/reveal a structure.

Each of us [that wanted to — understandably, there were a few people who were uncomfortable with the tools] took turns reflecting the back muscles laterally to expose the spinous processes and laminae of the vertebral column. Once the bone was visible, we got the go-ahead to plug in our saws and start cutting into the laminae. Once again, each of us [that wished to participate] had the opportunity to direct the saw through the tough bone. I remember being surprised by just how tough the bone was and wondering if the blade we were given hadn’t been sharpened enough. Oddly [at least to me], the sound of saws cutting through bone didn’t seem that different from a ban saw cutting through wood.

Once the spinous and transverse processes had been divided, we took to our chisels and hammers to separate the two pieces. Quite a bit of force went into this [we let the males take over at this point], but eventually a strip of bone, ligament and other various structures was pulled away to reveal a grey-ish spinal cord wrapped in loose dura mater [the process of preserving the cadavers results in the loss of cerebral spinal fluid from the subarachnoid space]. Apparently, we were overzealous in our sawing because all of the dorsal roots were severed. Regardless, Dr. Forbes came over and excitedly pointed out an intact denticulate ligament as well as the pinkish-tinged filum terminale.

They say that exposing the spinal cord is one of the rites of passage of medical school, and I’m going to have to agree with that one. Even though the whole process took nowhere near the full 2 hours we were allotted, it will definitely remain a substantial memory to reflect back upon.

Day 137: Shadowing a cancer geneticist

Amanda Xi

Today’s inane image of the day:

Very late, I know… but this was from the [South] entrance of Beaumont that I’ve grown so used to walking through to get my caffeine fix at Starbucks.

A couple of weeks ago, I had the unique opportunity to shadow a cancer geneticist. Prior to meeting the program director (Dr. Dana Zakalik), I was completely unaware that cancer genetics was even a specialty option. But after coming in to give two fascinating lectures, I thought it would be interesting to see what a day in the clinic would be like.

The clinic team on the day I went in was composed of Dr. Zakalik and a few genetic counselors. Although the only cases I witnessed were patients concerned about breast/ovarian cancers [which make up the bulk of the patients that come in], the clinic also sees patients for hereditary colon cancer [e.g. Lynch syndrome, Familial Adenomatous Polyposis (FAP)]. The general procedure went something like this: a patient would come in for genetic testing [many times in the BRCA1/BRCA2 genes which are directly correlated with a significantly higher lifetime risk for breast/ovarian cancers], undergo a genetic counseling session, decided if a test is right for them, do the paperwork and the blood draw then return a couple of weeks later for the results and discussion with a genetic counselor and a physician. I’m really distilling this process down a lot, so please forgive me.

A couple of things really struck me about the experience: first, was how incredibly detailed the genetic counselor was during the preliminary session. She used a great analogy for what testing the BRCA1/BRCA2 genes means [I might be reproducing this slightly differently, but it’s the same idea] — basically, the genes are like an instruction book that every person has. Usually the book is spelled correctly and the genes can be transcribed/translated into their protein product. But in some cases, there is a misspelled word that leads to genes that don’t function properly. In the case of BRCA1/BRCA2, they are tumor supressor genes so a misspelling can lead to a higher likelihood of developing breast/ovarian cancers. Thus, the genetic test is like a spell check that lets you know if you have a misspelling.

Second, it really showed the importance of an accurate family history. Each patient is asked to provide information on first degree relatives and by the time the patient arrives for their counseling session, a pedigree is drawn up to show if there are any patterns. After seeing a few pedigrees, it became really apparent how much information can be gathered from the tool.

Third, it amazed me just how many people [it was a really busy day — there were so many patients to see!] yet how few people were aware of genetic testing. One patient was really disappointed that she hadn’t been referred by her physician to the clinic earlier on. Although not all hospitals are equipped with a cancer genetics clinic, awareness among physicians about these life-saving preventative measures could really make an impact in the long run.

Overall, I thought the experience was enlightening and really interesting. I was in the clinic for over four hours, but it felt like only an hour had passed. At this point, I’m really drawn to oncology but am still not sure where I want to go with it — although the shadowing experience piqued my interest in the specialty, I do still want a bit more of a patient relationship. I guess we’ll see what else is out there [after all, I do still have quite a bit of time to decide]!

Day 136: Doctors of osteopathic medicine (D.O.)

Amanda Xi

Today’s inane image of the day:

A photo from my road trip last summer — I find that taking the time to reflect upon moments of serenity and happiness really helps when the bleak winter starts to settle in.

A recent commenter posted on my “Contact Me” page asking for my thoughts on doctors of osteopathic medicine (D.O.) and I thought it was an appropriate topic for an entry. This being said, I don’t want to reinvent the wheel, or do my D.O. colleagues an injustice by trying to explain exactly what osteopathic medicine means, so I’m going to refer you to a guest post at Mind on Medicine [one of my favorite med student blogs] entitled, “My Doctor Has A D.O., What Is That?.” DrJonathan (currently a Family Medicine resident) does a fabulous job explaining what it means to be a doctor of osteopathic medicine.

As for my personal thoughts, I think that just noting that my own pediatrician and internist are D.O.s says a lot. As for why I didn’t choose to pursue osteopathic over allopathic medicine, well there a couple of reasons. Although it really is possible to go into any field of medicine as a DO, the osteopathic philosophy  goes hand in hand with primary care specialties such as Family Medicine, Internal Medicine, Pediatrics and Obstetrics and Gynecology [as DrJonathan notes in the post] and I wasn’t sure that I wanted to pursue primary care. Furthermore, there aren’t an overwhelming number of colleges of osteopathic medicine [although I seriously considered applying to MSU COM] and I preferred to stay in the area if possible. Basically, I do believe in holistic medicine and fully respect my osteopathic colleagues, but didn’t think it was the right fit for me.

Hopefully this answers your question!