If someone told you they could allow you to bypass the next 4 months of your life while you were studying for Boards – but that you would die a year earlier, would you do it?

• Chlamydia, though traditionally sexually acquired, can spread on flies- to your eye.
• Plague (aka the Black Death) obstructs the gut of the flea biting you, causing it to literally throw up plague into your open wound*.
• Eating unpasteurized “health foods” is one of the easiest ways to catch a plethora of horrendously unpleasant bacterial infections.
• Medicalese: Malingering.
  Lay definition: faking it.
• Up to 50% of ectopic pregnancies can be directly traced to Pelvic Inflammatory Disease (PID) secondary to chlamydia or gonorrhea infection.
• Ladies, the vast majority of UTI’s are from wiping “the wrong way” or not washing after sex.
• Endometriosis is displaced uterine tissue that bleeds too. It may show up in the lung.
• Medicalese: Non-compliant.
  Lay definition: stubborn.
• Up to 90% of men older than 70 have BPH & trouble peeing.
• Diabetic mothers tend to have big babies.
• Sickle Cell disease protects against malaria.
• Lung cancer from smoking is more common than either prostate cancer in men or cervical cancer in women.
• While hemophiliacs are “bleeders”, the type of bleeding that you’re probably thinking about is actually associated with a different disease (Von Willebrand’s).

*gross. just… gross.

Statistics are funny.

Our notes mention endometrial carcinoma as the “most common invasive cancer of the female genital system”, even going so far as to claim that it has “supplanted cervical cancer as the #1 GYN cancer”. To be fair, the notes do go on to mention that this is due in part to a decline in cervical cancer- but as an afterthought*.

Look, cervical cancer is by far and away more common- we just CATCH it early as dysplasia due to Pap smears. This lets us stave off the inevitable development of invasive cancer… and trade it for *gasp* endometrial carcinoma 15 years down the line.

I suppose it’s in our nature as humans to look for another problem immediately after solving the first. If you stop fishing after catching a delicious bass you’ll only go hungry. Once we finally find a vaccine for AIDS**, no doubt some other STD will take its place. Still and all, I’ll bet medieval peasants would trade death by heart attack for death by bubonic plague any day.

*and for all you meddies out there looking to prove me wrong, the recent increase in estrogen replacement therapy has also contributed to the rise.
**Certainly postworthy in it’s own right, but I’m waiting to see if it actually works or not.

All medical students are a little bit neurotic. We need to be in order to survive medical school. We read through every single line in our notes over, and over, and over again. Every symptom, every side effect, every diagnostic tool may come back to bite us on exams or on the wards if we don’t learn it. This is why when our notes are crappily worded it annoys the hell out of me. For example:

Death cannot be solely attributed to failure of the kidneys since this clinical syndrome occurs in a setting of serious multisystem disease in which there are other malfunctioning organs but it is a major contributor to the overall demise of patients.

This is a run-on sentence. If the author couldn’t be bothered to edit their notes, why should I spend hours and hours of my life memorizing them? I know I’m going to anyway, but I’m frustrated.

You may wonder what it is about hospital personnel that allows them to move around with such effortless grace. Cruising along the halls of the hospital at speeds exceeding 45 mph, how is it (you ask yourself) that they don’t crash into people?

Patients smack into each other as they try to take the corners, sharky lawyers trip over their own glossy shoes, but the doctors? White coats flapping in their self-made breeze, they calmly sail by whilst winking at awestruck children.

What is their secret, you ask? How do they combine the grace of the gazelle, the sure-footedness of the mountain goat, the speed of the cheetah?

Convex mirrors.

You get really, really good at quickly checking the mirrors stationed around each of the corners in a hospital after your first few run-ins with other people. In my case it was a pediatric cancer patient in a wheelchair.

Bonus: you get better at using the side-view mirrors in your car.

A couple things…

1) HIPAA. How does it affect blogging? For example, if I blog about a patient and use no information that could possibly identify them, does that fall under HIPAA regulations? I ask because sometime in the very near future I’d like to start blogging about patient experiences. At what point does telling a story interfere with patient confidentiality? I look forward to your comments, dear readers.

2) I’ve updated to a new version of Wordpress (my blogging software), so hopefully the site will run a bit more quickly. I also moved the sidebars around a bit (I may even end up changing the theme around eventually).

I usually try to stay away from pointing out the silliness of individual classmates, but today it just has to happen. There is a person who asks a lot of ridiculous (usually quite funny and entertaining) questions.

Today was the most ridiculous of them all. We’re learning about hemorrhagic enterocolitis due to E. coli food poisoning. Usually this is from ground beef, though recently it’s been in the news as the Taco Bell Scare. This is because ground beef contains all sorts of grody stuff, including beef intestine, which is where the nasty little buggers are harbored. Since all the beef is churned up in a huge facility, the bacteria from one cow gets spread over thousands of delectable burger patties. When you undercook the burger, well, you’ve just won a free trip to Bloody Diarrhea World. Fun!

At one point the group leader mentioned that steaks were safe. In the off-chance that your steak has been contaminated, a couple minutes on the grill burns any offending microbes right off. The inside, no matter how rare, is safe to eat. And then it came.

So, ummmm… are we expected to distinguish between steak and burgers on the exam?

I lost it. The small group was painfully boring. We had been done – but couldn’t leave – for 20 minutes and were going stir-crazy. We were already taking odds on whether it would be better to have hemorrhagic enterocolitis or stay in the lecture.

You see, this is such a completely pointless question. The amount of brainpower it takes to formulate the question is more than it would take to mentally file away burger bad, steak good. Furthermore, there is absolutely no way the question would ever show up on an exam. If it did, it might go a little something like this-

A woman presents with hemorrhagic enterocolitis… of the ass. Which of the following is the most likely cause of her rectal bleeding?
a) A succulent, juicy New York strip.
b) A tender, grilled lamb shank with mint jelly.
c) A Morton’s gourmet hamburger, hand ground from rump meat.
d) Duck L’Orange.

I felt really bad but I could not stop laughing. Anyway, thank you, unnamed question-asker. You kept me entertained in a lecture that surely would have ended in my jumping out the 4th floor library windows.

I have a vivid memory of laughing hysterically at a sitcom when I was younger. The dialog went something like this:

Patient: What is it, doc?
Doctor: I’m afraid I have some bad news, son. It’s cancer. Penis cancer.

This morning we had a whole lecture on penis cancer, and I am here to tell you… it’s not funny. Not at all†. There is nothing funny about penis cancer. In fact, penis cancer is some of the most revolting, vile stuff we’ve seen so far.

†except for the word penis. That will always be funny.

Memory is a funny thing. The more you use it, the better it gets. I’ve noticed that certain things are easier for me to remember at this point in med school…

Phone numbers. 7 digits only take one repetition to be stuck.
Band names. I can usually name any song title and it’s associated artist if I’ve seen the words in iTunes.
People. I’ve always been pretty good with names, but now they stick like glue. Partly it’s because at the beginning of any medical interview it’s critical to remember who I’m talking to…
Random numbers. When I was researching these computers I looked up the model numbers for several computers. Still rattling around in my brain.

Now if only I could remember to send rent on time.

We just set up our boards study schedule. 5 1/2 weeks of studying hell- I’m actually kind of excited in a totally apprehensive, dreading sort of way.

I’m going to take the US Medical Licensing Exam!