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Today’s inane image of the day:

Just 1 more month left of this…

In the last hour, I suddenly became overwhelmed with just how many choices we make in a day. We choose whether or not to wake up in the morning to drag ourselves to school [some might argue that this isn’t a choice… but let’s just go with it]. We choose what to eat when we’re hungry. We choose which lane to drive in. We choose how we spend our time [such as right now — I am actively choosing not to study]. In life, we make a lot of choices that we don’t think twice about because for the most part, they are trivial.

But if you really think about it, some everyday choices we make affect those around us. Something as simple as smiling at a stranger as you hold the door open could be the highlight of someone’s day. Cutting someone off as you merge into another lane could ruin the rest of that person’s day. Sometimes, I think we forget just how interconnected we all are; most of the time I think I am just minding my own business and living in my own little world, but there’s no such thing. We all end up influencing another human’s life at some point in time, whether we acknowledge it or not.

In medicine, our choices hold even more weight. This thought is exciting and chilling all at once; our choices can lead to bringing a new life into this world or ending one prematurely. Our words can tear a family apart or bring tears of joy to a patient. Our actions truly impact the life of our patient, whether we like it or not.

This is the path we chose. We want to help people. We want to heal people. But in the end, there is no escaping the reality that we won’t always be right. Most of the time, there is no such thing as black and white; there is just an expanse of gray that will only morph into clarity retrospectively.

Today’s inane image of the day:

This was the view from Starbucks when I was in California… definitely was a fan of the palm trees and mountainous horizon!

Not quite sure if my title makes much sense, but hey, let’s just go along with it. Alas, the last week+ has been filled with EKGs, pharmacology and trying to determine what I don’t know. One of the hardest things to adjust to [at least for me] has been the fact that I can never really know what to expect. With this exam being an NBME one, at least I know these are standardized questions that are unlikely to test minutiae that appeared in one slide and diseases that only affect 1 in 1,000,000,000,000 individuals [just kidding — our exams have never been that bad] [plus, I think the Boards actually like those diseases because they’re more readily identifiable and thus, testable].

We have our Anatomy Practical Examination today and our Final Exam on Friday. Hopefully, all goes well!

On another note, a popular topic around the blogosphere has been about maintaining an online presence as a medical student. I hope to expand on my own views in the near-ish future [don’t expect this website to be taken down anytime soon!], but I’ll leave you with “5 Reasons Mind on Med Won’t Disappear for Interviews,” “My Social Media Manifesto,” and one of my favorites, “Pioneering Unchartered Territory.”

Happy Tuesday!

A little while back, my first patient experience narrative was posted on KevinMD — from that, I was offered the opportunity to write responses for an AspiringDocs.org fact sheet. Today, it went live! Check it out here.

Today’s inane image of the day:

[From earlier this week] Albeit beautiful on all of the bare branches around campus… the ice was quite scary to maneuver during my commute to school.

The summer after M1 is well-known as the “last” moments of true freedom. After this summer, we will be busy with boards, clerkships, residency applications, and ultimately preparing to bear the weight of adding MD to the end of our name. As someone who has always loved filling my warmer months with academically-related or volunteer activities, I know that I could not just sit around and do nothing for 2+ months. But at the same time, I do not foresee applying for the most competitive of residencies and thus do not feel the great need to secure a research position in a particular field. Every summer I’ve ever known has been filled with some kind of need, whether it be classes or research or an internship or community service. But this summer, I have a relatively clean slate to work with.

Beaumont is offering 6 week long internships to us and I applied for one of those. But there are more of us applying than spots so there’s always the chance that I won’t be selected. Furthermore, even with the internship, there’s time to do something else — that’s where I feel lost. I want to do more research into the intersection of technology and medicine. I want to learn more about the business of medicine. I want to volunteer somewhere and actually apply my medical knowledge.

What to do? What to do?

Today’s inane image of the day:

Manter and Gatz [our Neuroscience textbook] broke my highlighter!

With so many students starting to compare their medical school acceptance offers, I thought it would be an appropriate time to make a case for OUWB. Keep in mind that deciding on a school is all about fit — I selected a school based on what I thought would be best for me, and I think it’s pretty clear from my entries that I’m happy with my selection. Moreover, I believe that if you find yourself at a school that you genuinely love, you’re more likely to be successful. With that being said, here are the reasons I love OUWB:

Community/culture
It’s no secret that Dean Folberg boasts about building an OUWB culture — so far, I have to agree that there is definitely a distinct feeling tied to being a part of the “OUWB fam.” Within the class, everyone knows everyone and we have all interacted with one another at some point. Faculty and staff know each and every one of us by name [they all have a cheat sheet with our photos…], which is really quite a nice change from my experience at the University of Michigan [it’s almost comparable to my experience at Simon’s Rock].

Curriculum
I’m sure that most of you have already read my review of our curriculum thus far, and recognize that I am pretty happy about how things have been going so far. A couple of highlights:

• Integrated/Systems-Based Curriculum
  The integrated part really helped me make the necessary connections to commit the material to memory and I am really enjoying our first system course [Neuroscience] despite the organizational issues we encountered. It makes a lot more sense in my mind to learn about everything from one system rather than bits and pieces of each one — for example, I love that in our Neuroscience block we started off with CNS/PNS Embryology, Histology, Pharmacology and Anatomy then delved into the Neuroscience portion of it. Sometimes it feels like there’s all too much information coming at us at once, but eventually the moment comes when things start clicking into place and it’s wonderful.

• Team-Based Learning
  Keep in mind that we do not only do TBLs… they are scattered here and there [maybe one every couple of weeks, on average]. I really enjoy them since they break up the lecture time and also offer a great way to really drill a clinical pathology into our memory. I still remember details from most of the clinically-based TBLs we’ve done!

• Capstone
  Although I am torn on how much lecture we should be getting from this course, I still see it as a great way to give us an advantage when applying for residencies. Furthermore, I am really excited about my own Capstone project [I’ll just say that it’s Social Media based!] and can’t wait to see what it becomes over the next 3ish years.

• Medical Humanities
  I was a bit annoyed by how this course was graded last semester, but it has changed to an H/P/F system and the topics we have been discussing [Experience of Illness, Physician-Patient Relationship: Basic Skills, etc] are more applicable and interesting… so now I really do enjoy this course a lot more.

• Art and Practice of Medicine
  This course is still a constant reminder of why I decided to put myself through all the grueling hours in front of a textbook or in the classroom. Last week we did a Neurological Examination [see! everything is integrated!] and we had a very informative Standardized Patient. It was a great experience. Also through this course we had real patient contact in our first semester!

Beaumont Hospital
Having been born at Beaumont, I am a bit biased on the subject, but that doesn’t change the fact that it is still the only level 1 trauma center in Oakland County and is consistently highly ranked nationally. It also has a great reputation as a teaching hospital [anyone I’ve talked to who did a rotation at Beaumont raved about how positive their experience was]. And all of the Beaumont physicians I have interacted with are extremely willing to take the time to help in any way they can [the residents, especially!].

Aside from how great the hospital itself is, we have our very own Clinical Skills Center at Troy Beaumont, which is modeled exactly like a clinic would be, but with extra gadgets such as video cameras to record our patient interactions for review.

Finally, another perk of being in a medical school with a designated hospital is that there is absolutely no question about where I’ll end up for my rotations. While students at most other schools have to enter into a lottery to determine where they’ll end up [and keep in mind that some of these clinical locations could be many miles away!], we know that we’ll be at Beaumont. No anxiety over a lottery for placement. Whew.

Faculty and Staff
I still find it incredible that the majority of OUWB faculty and staff are friendly, compassionate and 100% invested in our education. Where else will you find professors who are primarily concerned with teaching you? Not sure… but there aren’t too many places that can boast about this!

Student Organizations
I haven’t had many opportunities to highlight the student organizations already off the ground, but there are a bunch already. Not only do we have the best AMWA branch [Like us on Facebook!], ever [ha, I had to!], we also have Radiology, Surgical, Emergency Medicine and Anesthesia interest groups that are offering awesome opportunities for us to get hands-on experience. Plus, even though they don’t fall under the designation of a “student organization,” our medical student government [MSG] has represented our student body effectively.

Opportunity to make a difference
By joining OUWB at an early stage, you will have the opportunity to influence its history. You will mold the school’s future. Plus I’m always pleasantly surprised by just how quick the turnover for change is — sometimes we see a difference the next day.

As you can see, there are a lot of great things going for this school. Are there times when I am frustrated by how the newness sometimes translates into disorganization? Yes. But ultimately we are the guinea pigs — subsequent classes will definitely find things running much smoother. Furthermore, it’s almost impossible to find the “perfect” school — students will find something wrong regardless of where you go [this goes for more than just medical school!]. The most important thing is that the little bumps along the way have not changed my opinion of the school.

So, to all of you trying to decide where to call home for the next 4 years, the most important thing is to ask yourself is this: is OUWB the right fit for me? If not, look elsewhere. Otherwise, welcome to the family!

Today’s inane image of the day:

My tower of empty Starbucks cups… [and yes, I decided to hop onto the Instagram bandwagon to spruce up my photos a bit].

Soon after I transferred to the University of Michigan I decided to get a job at a coffeeshop. I won’t say which one because I didn’t have the most positive experience there and things could have gotten better since I last visited. Anyway, I learned a lot about the different kinds of coffee beverages [it was a lot of fun making up new ones too] and thought that I’d share some of my knowledge. Here’s a run down:

Brewed coffee
The classic coffee beverage that pretty much everyone knows how to make. There’s not much to say on this…

Iced coffee
We used to use double the coffee grounds when we made the base for our brewed coffee, then just poured it over ice. So keep that in mind if you ever get iced coffee without the ice… it’ll really pack a kick!

Red eye
It’s called a “red eye” for a reason — there’s an added kick of espresso included with your brewed coffee. I personally cannot handle how strong this beverage is, but I had a regular customer come in every morning and order a large quad red eye [4 shots of espresso + 20 oz of coffee]… that adds up to a lot of caffeine.

Americano
These are are like an “upgrade” on brewed coffee — it is just hot water with espresso shots. I haven’t tried an Americano before, but now that I think of it, I might have to… by using espresso the coffee is fresher [plus I like the taste of espresso better]. I’ll let you guys know how this goes…

Café au lait (or Caffè Misto)
For individuals who have sensitive stomachs and cannot handle black coffee first thing in the morning, this is the solution — coffee with steamed milk. I used to love the vanilla soy milk at the coffeeshop I worked at and often made myself a soy café au lait [most coffeeshops use vanilla soy milk so keep that in mind if you’re trying to cut back on sugar or calories!].

Latte
This used to be my beverage of choice — espresso with steamed milk. When I first started frequenting Starbucks, I always got a tall nonfat vanilla latte. Well, that was a number of years ago when I could afford extra calories and sugar in my diet… so I gradually cut back on the number of pumps of vanilla then finally one day just cut the vanilla altogether. Now I enjoy the way lattes taste without the extra add-ins.

A Mocha is essentially a latte with chocolate sauce. Most coffeeshops get creative here since you can add a variety of different flavors [mmm peppermint mocha…] and mask the coffee flavor completely, allowing for quite a marketable product.

Iced latte
Still my beverage of choice in the summer — you start with ice, add milk then put the espresso over it. For anyone in warmer climates… this is the best way to cut milk calories out of your diet because you end up using less milk to make this [woohoo for ice!].

Cappuccino
This is my current beverage of choice — espresso with half steamed milk and half foamed milk. I started getting cappuccinos when I wanted to find places to cut back on calories — although it doesn’t make a huge difference, baristas usually don’t use much milk to make a cappuccino which translates into a stronger coffee taste and less calories. I think this is the lowest calorie option my stomach can handle first thing in the morning!

Macchiato
I’ve never had one of these, but it’s espresso with foamed milk. Not sure why people enjoy macchiatos [it definitely is a European thing]… but I guess if you get a barista that really takes the time to foam the milk well then this could be a fun beverage [when you foam the milk you’re supposed to minimize the number of bubbles and get it to almost a whipped cream consistency… I was quite proud of my milk-foaming skills].

[FYI — the Starbucks Caramel Macchiato is essentially a caramel latte…]

Tea latte
This doesn’t actually have any coffee in it, but I loved making these — it’s just hot tea topped off with steamed milk. The most popular kind is a chai tea latte, but I’ve found that most places use too sweet of a base so I generally try to avoid them [unless it’s for dessert… then I ask for less chai mix]. My favorite thing to make was a soy earl gray tea latte with a little bit of almond flavor — it’s amazing!

Caffeine content
I think it’s important to know that the caffeine content in a 12 oz brewed coffee  [~250 mg] is significantly more than a 12 oz latte with 1 shot of espresso [~75 mg]. While it is true that espresso has more caffeine when you compare the same volume of liquid [say 1 oz of brewed coffee vs 1 oz of espresso], but usually you don’t drink 12 oz of pure espresso. So, the next time someone notes that you’re ingesting a lot of caffeine in your venti latte, tell them that it has much less caffeine than a tall coffee [~150 mg — keep in mind that a venti latte only has 2 shots of espresso in it!].

I think I covered all the major ones… let me know if i missed anything you were curious about!

Today’s inane image of the day:

Pink pens make everything better. Well… okay, maybe they just improve my mood when I’m tired of staring at lecture notes.

Still kicking over here. Lots of studying to do for Monday… but at least this time we don’t have 2 exams in one day!

Sadly, I view this semester’s exams as a lot more high-stakes than any of the ones from last semester because remediation will be in the middle of June. Yes, that means no real summer plans if we fail even one exam.

Anyway, look forward to a couple of fun posts next week — I have a light-hearted “things you should/should not do in your first semester of medical school” list in my drafts and will be writing an entry primarily targeted at admitted students trying to make their final decision [but anyone who’s interested in our school would probably enjoy it!].

[Have a wonderful weekend!]

Today’s inane images of the day:

Usually you can see the gym relatively clearly from this view…

The empty parking lot first thing in the morning. Note the fuzzy lights.

Driving a route that you thought you knew like the back of your hand in extremely thick fog really is an experience. Suddenly, the green highway signs that you usually ignored pop out at you from nowhere like amorphous monsters. The streetlights all pose angelically with halos around them. Traffic lights hide behind a mask until the last minute. Let me assure you, this morning’s drive had me on edge.

Anyway, need to study for this quiz…

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!

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.]