Well, Merry Christmas, folks. I know it’s still only Christmas Eve, but frankly I doubt I’ll be getting to the blog tomorrow (I mean, lets be real here. I don’t have anything to write about for the next two weeks, since all I’m doing is sitting around reading Narnia and getting fat on fudge and toffee. My life is far from interesting… and I LIKE it that way).

So, Merry Xmas. Enjoy the holiday of enforced spending. Bah. Humbug.

But seriously… merry christmas. Or happy holidays if PC floats your boat. Oh, and thanks mom and dad for the new tires. They handle great.

Raise your hand if you’ve performed a pelvic exam today. Scrubbed in on surgery? Ok, now raise your hand if you’ve felt someone’s aorta pulsing in between your fingers in someone’s peritoneal cavity. No? How about cut a suture?

How about CLAMP, STAPLE, AND SEVER SOMEONE’S SMALL BOWEL? Read on, dear readers.

I went in to see surgery today with my dad, who was assisting another doctor here in town with an ovarian tumor debulking. The woman’s tumor had metastasized all over her abdominal cavity, so the first order of business was to cut off her greater omentum, which is a loose apron of fatty tissue that hangs from your stomach. Her omentum was chock full of fibrous, nasty tumor. Unfortunately, the omentum also carries the blood supply to the stomach, so cutting it away involved meticulously clamping every single tiny artery, cutting them, and then tying them off. The surgery took the greater part of 3 1/2 hours.

Anyhow, the attending was really awesome about letting me be around. First off, he had me do a pelvic on the woman so I could feel the cancer through the vaginal wall, and then as he was performing the surgery, talked me through basically everything he was doing- all the anatomy, the techniques, everything. By far and away the coolest part was when he used a tool that allows you to staple two 4″ lines next to each other while simultaneously cutting down the middle. Essentially, you put a loop of small intestine in it, zip the tool along, and you are left with two severed, perfectly closed ends of intestine.

The tool is pretty easy to use though… so once he had gotten it into place he let me grab the handle and zip it through the bowel. Maybe I exaggerated before about how much I actually did (probably best, since it was surgery on a live person, and I am, in fact, just a 1st year medical student). But, my hands didn’t shake at all.

It was pretty much amazing- and at the same time, it got really boring at points. Once he had sutured the 12th small vessel leading from the stomach (and was still only halfway to cutting off the omentum) I was ready for something new. There’s only so many vessels you can watch ligated and still be interested. ‘Course, watching the small bowel part was amazing, and I wasn’t the one doing the work… that could be a big part of it. They have to do some really nifty tricks to get the small intestine hooked back up to the large intestine after a resection.

Surgery may still be in the cards for me- seeing all the anatomy I had just learned in such vibrant color was incredible… I really enjoyed it. Of course, it’d be more fun if I were the one holding the scalpel :-) Some day, perhaps.

So, finals are over, and I’ve been sitting around like a bum for the last couple days, cleaning the house, sleeping my life away, and generally feeling like I deserve to do absolutely nothing. I know school is going to come all too quickly… 3 weeks is nothing, really. I’ll be reading as many books and lying on as many couches as humanly possible before the start of next semester.

In other news, check out the “friends” pages on the right. I’m trying to put up pictures and little blurbs of as many people as I can, so that I can do stuff like this –> TJ is off in Michigan visiting extended family for the break, so I’ve got the house to myself, though Peas is still in town. If you feel like you should be on the roster and I don’t already have you up, shoot me a line.

I can’t help but be totally excited for these next 4 days. It’s like all the studying, all the hours that we’ve put in, are finally coming to fruition. God… the countless hours spent in lab, library, study rooms. Coming out of the library to find dark already fallen. Friendships strained by close quarters, difficult material, constant togetherness. And then suddenly, here are the tests. It’s all worth it. No more anatomy. You knew that being kicked in the posterior 10th rib on the left side is likely to damage the spleen. And frankly, right now? For me, that’s all that matters. I did it. I feel validated. Its an emotional rollercoaster and right now I’m on a high.

Also, I said my goodbye to my cadaver today during the practical. You’d think it’s wierd that you get so personally attached to a dead body, but our guy (he never had a name, though Court and I called him “Charlie” occasionally in reference to Lost)… well, he may not have known it, but there was a connection between us. I knew, for example, that he had an aortic aneurysm. He probably never would have had any symptoms from it, but it was still there. He also had polycystic kidney disease- also asymptomatic. He had the best thoracic duct of all the cadavers (usually the thoracic duct is extremly tiny and hard to see, but his was big and beefy) in lab. And when I came to our cadaver station during the practical? I smiled to see how beautifully they had cleaned up the structure we needed to ID (crus of the penis! I’ll call it beautiful, because frankly, it was. And, furthermore, it took FOREVER to understand where it was in relation to everything else. I’d say we spent about an hour and a half trying to dig it out).

*chuckle* watch me wax nostalgic over body parts. Seems kind of silly, I suppose, but then again, I spent hours and hours cutting, cleaning, understanding. I suppose at some point it didn’t even matter- we don’t get graded on dissections or on quality, so there technically no “point” to doing a good job. Still… I’m going to miss him. It’s almost indescribable how important I think that cadaver lab was for me. I’m so spatial; getting rid of 3-d bodies would kill me. I know a lot of medical schools are switching over to prosections (dissections performed by professionals) rather than student-based dissections. I think that’s a mistake. When Sarah sliced through Tom’s beautifully cleaned off facial artery? Yeah, we’ll never forget where the facial artery is again. Ever.

Actually, I don’t think I’ve ever told that story, and it’s pretty funny, so I should before I forget it. I also plan on uploading a couple pictures of the people I spend most of my time with so you can put a face to the names. I think it’s high time that I start using names. This will happen during the break when I have nothing better to do.

Anywho. The facial artery is very twisty (rather like cooked spiral macaroni) so that it can stretch when you turn your head without breaking. Courtney had spent 30 minutes or so cleaning it off on our side. It was beautiful. Tom then proceeded to try to clean his off (as, naturally, there is a bit of friendly competition between med students… you didn’t think it was all gone, did you?) just as nicely as Courtney had. Clean, clean, clean. Looks pretty good. He turns his back for a few seconds, and Sarah goes to help out a bit… unfortunately, she had a new scalpel blade.

*snick* *boiiiing*

There goes Tom’s facial artery. Note to self. Sharp scalpels cut through arteries much better than dull ones. Tom was piiiiiiissed.

Anyway, back to my waxing nostalgic about cutting into bodies. Thanks Charlie, for all your help.

I’ll miss you. Thanks. A thousand times over.

Good luck everyone!

On a more sober note, statistics say that some of our classmates won’t be coming back after this round of tests. That’s a scary thought. I really, really like my classmates. It would be very sad to see any of them go. Morbid much, Zac? Why are you focusing on failing right now?

So, for those of you who don’t know already, I was put on a yoga routine by a orthopedic surgeon for my sciatic pain. It has helped so much in the past few weeks that I’m not even taking any anti-inflammatories any more (I was taking 4 ibuprofens 3 times per day… to the point where I had alarms set on my phone for 8/4/12 to remind me). In my session today I touched the ground in uttanasana for the first time. It was amazing. I also can sit for hours at a time now (as opposed to 3 weeks ago when I went to the orthopod because I couldn’t sit for more than 5 minutes straight without searing pain down my back).

I will be prescribing yoga for patients in the future.

*edit* I do believe I’ve successfully imported my xanga stuff! Pretty painless, although I’ve lost all the comments and formatting. I think it’s worth it though, for the transition. Feel free to browse my old Italy posts while I work out the remaining kinks in wordpress (like the fact that “previous page” doesn’t work yet)

Its pretty funny to watch med students study anatomy. Frankly, it involves a lot of standing up with legs and arms outstretched, a lot of awkward touching (*points to groin* as he says “it inserts here”?) and, occasionally, a look of surprise when you manage to do juuuust the right movement to flex a muscle.

While sitting, feel the back of your knee, on the inside (right on your left knee, left on your right; posteromedial for all you medically minded people out there). Now tense. Feel those 2 hard tendons? Semitendinosus and adductor magnus, baby. Your body is your own cheat sheet on an exam… I got at least 2 questions right on the midterm because I had a hand sitting right in front of me I could study.

So here’s the first post I’ve got using the new server… for now, xanga has all the old ones. I’ll see if I can’t figure out a way to put all the old posts on here.

Sweet. I just registered a new domain name. I’ll be moving there soon (probably after finals… or sooner if I get really antsy).

www.agraphia.net

bookmark it. You know you want to. This will be the last entry on this site. I’ll miss you Xanga (except not really, because frankly I never liked Xanga). Oh, and currently agraphia.net redirects to Xanga, so go ahead and just update your bookmark if you’ve got one. It’ll be a seamless transition, no matter what host I end up using!

*edit* I just backed this entire Xanga up to word… 43 pages of Zac’s ranty goodness. Nice.

You know, I’m reading through some other med student/medical blog sites (www.lingualnerve.com being the one that convinced me it was a good idea to start writing in the first place) and it’s funny, there are some consistent themes.

Endless studying. You’ll never know what it’s like to be here. Difficult. No time for friends. No time for family. Eating badly. Not enough sleep. Not enough exercise. Swamped. No time to go to class.

Then, I look at doctor blogs. One entry that stands out in particular from Lingual Nerve is spacefan’s recent entry, where she (the older, wiser doctor) laughs at the idealistic premeds (i.e. me a year ago) for actually wanting to help people. Bitter. Cynical.

Anyway. I see a lot of what I’ve been writing about mirrored in other people’s writings. I know I’ve been focusing on the burnout, and the difficulties. I’m not really sure why, either. Day in, day out, I’m totally happy to be here. I love studying. I love the material. I learn something (many things!) daily that amaze me. That being said, when I come home at 11, I’m tired, and that is when this blog gets updated. I’ll try to remind myself to post positives here. Frankly, I’m surprised I don’t more often.

So, I guess this is my pre-finals apology to myself, and to my readers (whoever you may be… drop me an email sometime if you care!) for sounding as negative as I do. Maybe subconsciously I’m looking for sympathy, or acceptance, or appreciation. I hope that’s not why I’m writing all this. I’d like to think it’s because there is an awful lot of introspection and constant new new new that’s being thrown at me, and I need an outlet.

By the way. I got to practice laparoscopic surgery on the ASTEC simulator (UA has an incredible surgery simulation suite, including a full out patient model with pulses, full bladders (that’s right, I put in a Foley Catheter, wincing all the while) blood supply, full windpipe (with constricting vocal cords so you might need to do an emergency cricothyroidotomy in case the tube fails!) and full eye movements including pupillary dilation and constriction). It… was awesome. And, laparoscopic surgery is kind of like video games. Which is sweet. And with my past history of constant video gaming action… well, lets just say I’m not ruling anything out.

Anywho, that’s what I’ve got to say for right now. I feel pretty confident going into my exams, I’ve still got 4 days to study anything I missed, and frankly, I love where I am in my life. Note to self. Be positive in entries… because I always am during most of the day.

Oh. Quick note on the “no time for class” thing I mentioned above. Several of my colleagues (first time I’ve ever used THAT word) have just blatantly stopped going to class. They feel so overwhelmed by the amount of material to learn that they just… stop going. Class isn’t the “best use of your time” because you can get more done in an hour of studying than an hour of lecture. I, personally, think that sucks. Class for me is social. 8-3 class on Wednesdays means a 10-minute break at 9,10,11, and 2, plus an hour and 10 minute lunch. That’s roughly 2 solid hours of time I get to spend with my friends. Don’t really know where I’m going with this other than to say to you, my long-lost classmates: I miss you. Come back to us. We’re a rather fun bunch if you just spent the time to hang out with us. Books can be lonely by themselves.