My return to the blogosphere

Hey guys (is anyone actually even reading this nonsense?)

So it’s been a while since I’ve written on this site so I thought why not provide you with a little update of my life. We just got finished with another course:GI. I wasn’t expecting to like it as much as I did, but I found it to be extremely interesting and now realize why it’s such a popular field to go into once med school is all said and done. We began the Endocrinology/Genitourinary course today and it is the last system/course I will ever have to take as a student…EVER. I may be making it out to be a bigger deal than it really, but when you’ve been in school for the last 20 years of your life, its nice to say you’re actually about to be finished with the traditional classroom based learning (as if I go to class haha-thank the Lord for podcasts) that you’ve always known. Although I don’t think I’ll ever stop learning, and why would I want to? I really think that I found out how to truly study when I got to medical school. I think I really just skated by in college to be honest, and I thank God that my school actually gave me the chance to become a student here even though there were probably many more qualified candidates than me at the time of admission. I’m not going to say medical school is easy because it isn’t. But its definitely easier to handle this year than it was last year. I’ve learned how to study and how to prepare for exams and focus more on how/why things happens vs. the random rote memorization that I was able to get by with in high school and most of college. 

History and Physical

Well I just got done presenting my fourth History and Physical to Dr. W. on a pt that was recently admitted to the medicine ward nearly two weeks ago. She was a 72-year-old white woman that presented to the ER last week after sustaining a lower back injury while unloading clothes from the dryer. After waiting two weeks in pain and pretty much bedridden in her home, she finally decided to come to the hospital to see what was wrong. As usual I performed a detailed history of her present illness, physical exam, review of systems, etc. Now based on the patient’s age and my very limited background in musculo-skeletal disorders, I had a feeling that this was most likely due to some fracture/osteoporosis/musculoskeletal related pathology (Don’t all old people have brittle bones?!). However, as I was performing the exam and the review of systems, a physician from the Heme/Onc. department arrived with some questions of his own for the pt and instantly instilled a doubt in the back of my mind that this was more than just age-related osteoporosis. What was also interesting about this pt was that in addition to her lower back pain, she was also very concerned about an incidental lab finding that her GI doctor had discovered a few months prior: an elevated creatinine level. She was supposed to have a kidney bx performed, but her lower back injury had delayed the procedure. It seemed to me that patient was very concerned with this finding because her father had died of renal failure secondary to diabetes. But back to the Hand P now. I wasn’t able to finish the physical exam that same day because I didn’t have an otoscope with me. So the following day, I made my way back to the patient’s room to finish up the exam only to learn that her  recent workup and bone scans had revealed the possibility of multiple myeloma, which is a cancer of the plasma cells of the bone marrow. To my surprise, she didn’t seem very upset though and to be honest, I think she was actually relieved to have finally gathered some insight on what had been causing her symptoms over the past couple months. I was briefly able to meet her husband who was visiting at the moment, but he left shortly after I arrived so that I could finish my exam. The patient then disclosed to me that her husband had not taken the news as well as she had, and at that moment, the situation suddenly appeared much more real to me. I ended the encounter by thanking the patient for her time and patience and then left the room.

As usual, I felt that my presentation to the doctor was less than stellar because once again, I seemed to focus more than I should have on a secondary complaint of elevated creatinine level. Although her major back pain was a major component of my presentation. However, I forgot to rule out neurological pathology and make for a competitive argument that this was undoubtedly bony fracture related. So basically the key reason for this journal entry was to show what it’s like to feel like an inadequate noob while in the earliest stages of a medical career, and also that it’s important that the presentation an HPI clearly indicates what you are trying to prove  (based on clinical suspicion, history and physical exam findings, labs, imaging etc) what you think may be causing the chief complaint while at the same time also using these same findings again to rule out other etiologies that may cause the same/similar signs and symptoms. Wow that was a run-on sentence. Until soon.

-N

How I feel sometimes…

Another update

I feel like all these blogs that I have been writing have been less than great. I want so badly to be a good writer but every time I read my latest entries on this site, I find myself constantly critiquing both the style and content of my writing. BRIEF PAUSE. So it only took me a day but here is where I’ll pick up from yesterday. Today I kind of woke up in a panic because I when I looked at the clock, it said 11:14. I then realized that I must have pressed the snooze button 3 or 4 times until finally it just stopped going off altogether. I hate waking up this late in medical school because I feel pressured that everyone else (aka my classmates) is out there absorbing the material while I’m wasting the day away in a comatose state in my bed. Paranoia really does get the best of you in professional school but at the end of the day, or course I should say, as long as you have a passing grade, you’re golden. But anyways, we are in the respiratory portion of Mod 3 (God I love systems-based learning!) and it’s not that exciting, but I guess that probably has to do with the fact that I haven’t really had a chance to go over the notes that I’ve taken. Also before I forget, I am going to New Orleans this weekend with all my friends for the Saints game on Saturday and the National Championship which takes place on Monday. The city of New Orleans is going to be nuts and I can’t wait! My goals this weekend are to get drunk, eat as little as possible (I’m currently on a diet but its been a diet over almost 10 years it seems haha), and to budget my spending since I spent so much money last month during the ski trip to Winter Park, CO and then on going out for New Years in New Orleans. But anyways I really need to knock out this Specian respiratory lecture so I can go work out before sushi tonight with the Fab 5 plus Julie minus Steven and Julie. Until next time.

-N

Quick Blurb before I go to sleep

Today marked the return back to medical school for me. I still cannot believe this is my final semester of “textbook learning,” but to be honest I’m actually ready to get out the classroom and start putting my knowledge to work, even though I believe that it’s scant and very unorganized. We just began learning about the respiratory system and today’s two lectures were not too mind-exhausting fortunately. I just want to finish this course with an A and finish off my GPA with above a 3.4. Is that so much to ask? But moving along… Tonight, we gathered at Caroline’s for a Eurotrip reunion and actually had almost everybody make it to enjoy delicious European food, wine, and about a 1000 of the trip pictures displayed on the television. It was really nice to reminisce with these great people and remember all of the crazy shit that happened during our travels abroad. I will always remember Amsterdam and the beer bike tour, Belgium with How and Dreamy at our surprisingly clean hostel, and the final night out in Paris that was an absolute shitshow. Sorry this is so short but I’m tired and really should try to get to bed, a task that is usually easier said than done for me. Until the next post.

-N

NYE 2011

So I finally finished A Clash of Kings! Dopamine levels in my brain were at an all time high with the closure of the last chapter where Bran, Rickon, Osha, Jogen, Hodor (Ho-doh), and Meera decide to leave the burning remnants of Winterfell. So on to the next book I suppose. I just hope it doesn’t take me an eternity to read it with school fast approaching. Last night I went to Rock-N-Sake for sushi with Jen and the tier one friends, and the sushi roll that I chose was the Dragon Roll, which actually made for an excellent decision (I really wish I would have taken a picture of it). However, the dinner ended sourly because after they separated the checks for us (me Jen Jolie and two of Jolie’s trashy friends), I was left to cover the leftover 20 bucks that didn’t get paid. It was nice to have dinner with Jen but her friends really are awful and I don’t plan on hanging out with them again for a long time.

But moving on, Corey Buis Grant and Gavin showed up towards the end of dinner and we made our way to Dumaine Street where Steven and Caroline were pre-gaming. I was well on my way to getting drunk as I proceeding to chug 2 bottles of champagne as we walked the 20 minute journey from the restaurant to Dumaine Street (which was surprisingly close to the French Quarter). After we finally met up with the couple, we then headed towards the Gold Mine, which was pretty dead when we got there. However, we started taking Flaming Dr. Pepper shots and getting progressively drunker so it made for a fun time. Also at 11:59 as the DJ was counting down the seconds to the new year, I found a really attractive girl on the dance floor and asked her for a New Years Kiss and the bitch said yes! You could imagine my surprise. The night then progressively got blurrier and blurrier and we ended up cabbing it back to Courtney’s new place where we passed out shortly therafter. Anyways, I don’t really feel like writing and I’ve eaten like a fucking pig so I’m going to remedy the situation and go work out at AnyTime. I’m heading back to Shreveport tomorrow and school starts the day after so one more night of freedom before Respiratory begins.

Until soon

-N

Today

Today can be described best with one word: uneventful. I woke up around 10:30 to a Group Me notification whose subject matter was probably 100X less important than the state of sleeping I was enjoying at the time. This break has been a combination of both good and bad, with the good being that  I haven’t had to open up a single Powerpoint or worry about falling behind in lecture material. The bad part of the this break though is that I am going to sleep later and later at night and thus waking up much later than my normal 8AM (and sometimes 9AM on really lazy days) arousal. Things will start  to fall back into routine though by next Tuesday or Wednesday though so I’m not sure why I just ranted about that. Anyways, I did manage to get a few things done today including a trip to gym for some cardio, a new brake tag/inspection sticker for my car, and a drive to covington->slidell->back to covington in the vain search for a new pair of gray New Balance shoes which unfortunately, I was unable to find. I did, however, manage to buy a new suitcoat (it was Michael Kors- so I guess you could called me a ballin’ gangSTER, although I wouldn’t recommend it) for New Years Eve. I’ll be heading to NOLA for the celebration of the new year with some friends and hopefully will enjoy a night of shenanigans, debauchery, etc. Also, tomorrow I am finally going to visit the Abita Brewery for a tour to see where one of my favorite beers, AKA Andy Gator, is made. I have been meaning to go for quite some time and I’m glad that the time has finally arrived. But I don’t feel like writing anymore so I guess this little blog-ita will have to suffice.

Until next time…

-N

First Post

The sole purpose of this blog will be to improve my writing skills. I have never been confident in my ability to write…ever. This includes elementary school, high school, undergrad, and even medical school (fortunately there is not much writing required in med. school aside from the occasional H&P and for that I am eternally grateful-also thank God for spellcheck). Therefore, I will devote much more time (well as much as school will allot me) to my budding career as a writer. It is my goal to become a great writer and gain the literary confidence that I have never been able to in my short 24 (and soon to be 25) years of life. If you happen to stumble upon this blog, please let me know how I am doing and leave suggestions for great books, essays, stories, etc. that you think may capture my attention. Until the next post.

-N