Bugs, Drugs and Intestines

Excepted from an online study session:

友達:  quiz me on helminths
go
自分:  what do you use to treat taenia solium infection?
友達:  mebendazole, since it treats cestodes and trematodes
自分:  okay, i should have given more info
pt. presents with seizures and neurological symptoms and has cysts in brain and taenia solium eggs in stool
what do you use to treat?*
友達:  hm
自分:  what is taenia coli?**
友達:  i should know it
and i keep saying it
but i cannot remember
自分:  it sounds so familiar
友達:  haha we’re idiots
the three bands of the large intestine
i kept thinking it had to be a bacteria or something
cuz of coli
自分:  me too
i was just looking at the list of microbes
they should’ve named it something else

* According to Lippincott’s Pharmacology Review, for this case, you’d use Albendazole, which is the drug of choice for this type of infestation.

** We just learned this, last semester in anatomy. What is wrong with my brain?

How to Survive Semester 2

When other students tell you that semester 2 is tough, they’re not lying. Even the people I know who passed with flying colors can attest to moments of misery and my Mini III neuro grade was like a chess gambit that could have gone horribly wrong (but didn’t, thank God!). Even though the course work builds on what you learned in semester 1, semester 2 is a whole new ballgame. Here are some tips that might help you play it better than I did.

• Kill the Practicals!

The practical exams in Anatomy, Histology and Neuroscience may not seem like big deals but doing well on them can save you a lot of stress and grief when it’s time for the shelves. Try to knock them out of the park or at least get a nice healthy B. For anatomy, spend time in the lab, go to TA sessions (and ask your pals about their TAs! Not all TA sessions are created equal; just because you’re assigned to one session doesn’t mean you have to attend it. Shop around!) Also, spend some time with skulls and guts. You can check out a skull from the anatomy secretary (if you sign one out on Friday afternoon, you can have it for the whole weekend!) For guts, you’ll have to wait until that dissection. For neuro, the TA sessions are also very informative (again, shop around – different TAs have sessions each night). The neuroscience society holds a mock practical (mocktical) before the first practical and it is well worth the $5 EC admission fee. For histo, ask around for the labeled or powerpoint slides.

Inside Out

Is everyone's rectum this red?

Pictured to the left is a particularly vivid visual from a fascinating lecture we had yesterday on the ischio-anal fossa. The puborectalis is a part of the levator ani muscle – innervated by the by the perineal branches of S3 & S4, it forms a sling around the anorectal junction and keeps it closed so that the contents of the rectum don’t fall out (as they would if it were in a straight orientation). It relaxes during defecation, allowing the anorectal junction to straighten so that movement and expulsion of feces can occur. It also provides support to the bladder. Paralysis of this little sling could cause all sorts of problems, including rectal prolapse. Yikes! Although, it kind of reminds me of I.R. Baboon…

Gamechangers

Confession: Sometimes, I’m not overly fond of the first semester students.

On an individual basis, they seem to be nice enough but what gets my goat is the fact that they love to congregate in Classroom 5, the designated Second Semester domain (all of our classes are scheduled in Classroom 5). When I was a first semester, I would never have dreamed of camping out in a classroom that was reserved for another semester (although The Annex is the designated realm of first semesters, my study areas of choice were the fishbowl and Classroom 1, an unassigned quiet study space near the ocean) but for some reason, this new crop of first semesters likes nothing more than coming to our classroom and sprawling out like they own it. I get a perverse sort of pleasure whenever we have classes after 1:00 and they have to pack up their lunches and leave. I know it’s a silly peeve, but there you have it. That’s what annoys me about first semesters.

However – yesterday, the first semester students had their first anatomy lab practical*, practically on the heels of Mini I (we were lucky last semester; our practical was scheduled ahead of the Mini). As a pal and I passed them lined up anxiously outside of the anatomy lab, my pal snickered and said, ‘Don’t you feel sorry for them?’ I nodded, because I did.

終わりの始まり – The Beginning of the End of Semester 1

After an insane amount of hassle and confusion that made me wonder if it was perhaps some sort of divine warning against air travel, I have finally managed to book flights to return home for break. Initially, I thought I could make it until December but, as lovely as Dominica is, it’s no paradise – I need to come back home, even if only for a couple of weeks. So, I will be back in Queens from August 20th – September 7th, spending time with friends and family, clearing up health issues and stocking up on island essentials (school supplies, snacks and cute cotton dresses!). Extra special thanks to my father – I take it for granted that not everyone’s dad is there to help out when one is essentially frozen out of one’s funds because of assorted issues to do with living abroad and banking domestically. I’m extremely lucky that even though I am technically a grown woman, I can still count on my parents to come through in a clutch. If fathers were graded, they’d have to come up with a new letter to convey my daddy’s awesomeness.

This may be the last update until after I’m back in Queens, or at least, until I’m waiting for my flight to board at the airport. This Thursday, we have the anatomy and histology lab practicals (back to back). Mini III takes place on August 14th and the comprehensive final will be held on August 19th (that’s right – we get 5 days to study 4 months of material). In fact, I should be studying right now! Okay, I’ll get back to work. Wish me knowledge, confidence and luck – I’ll need them for these final battles.

Failing Tests

What a harrowing fortnight it has been! With the histology lab practical, Mini II, a health crisis (averted–for now) and an unexpected reappearance of an entity I’ll refer to as Jason (as in, the killer from Friday the 13th 2-12 that just keeps coming back), I am mentally, physically and emotionally apoptotic.

I haven’t received my official scores yet but I am very worried about my performance on Mini II. In some areas, such as Histology and Physiology, I think I may have done respectably but I’m not so sure about Anatomy or Biochem this time around. What rankles is that I studied even harder for this exam than I did for Mini I. Granted, my focus was split by the health crisis but doesn’t hard work and diligence count? All those hours in the library…what did they earn me? I suppose we’ll see when the scores are sent. There is still a pair of exams to go (Mini III and The Final) and about a month left in the semester. I know I’ll come out on the other side but the fear of failure is giving me nightmares.

Rumors, Lies and Chromosomal Abnormalities

Can you find his deltopectoral triangle?

It’s week 3 at Ross and the pressure is on. It has become readily apparent how easy it is to fall behind and why some of us aren’t going to make it through. The amount of material given to us is snowballing and whatever we don’t cover in lecture is our responsibility to learn before Mini I, the first big exam. With all the work and the rampant rumors about how treacherous the minis are (how they’re designed to weed out half of the class, how professors lie about what and what not to study), I’ve been feeling a bit overwhelmed. Add to that some sad news from home and a longing for familiar company and…well, I really could use a big hug.

But all is not as dismal as it sounds. Even though I’ve been studying for 5~6 hours a day, my eyes have not yet begun to bleed. I’ve created an intricate schedule that is designed to maximize my study time and I’m currently working on ways to improve efficiency. I’ve found a good study group for biochem and am in the process of organizing another for anatomy. And even though it still feels like we’re all acquaintances, I’ve found a few people here that I can laugh with, which is my chief criteria in selecting friends. Hopefully, instead of becoming desolate, I’ll be forged by the difficulties ahead and remain steadfast and focused. I didn’t come here to get sent home after the first exam.

Today, I had my first Problem-Based Learning (PBL) session, which is easily the most enjoyable class I’ve had so far. In PBL, a group of eight (or so) students must discuss a case or scenario and ultimately, diagnose a patient. We’re given information about the patient in bits and pieces (today, we received 3 pieces of the puzzle) and each case is discussed for three weeks. At the end of the third week, we must reach a decision about what we think is wrong with the patient and recommend a course of treatment. It’s really quite fascinating. I’d love to tell you all about our case (it’s a really interesting one) but even though it’s theoretical, we’re not permitted to discuss it with anyone other than our colleagues (doctor/patient confidentiality!), so I’ll just mention what my research topic is for next week’s discussion: viable chromosomal abnormalities and mental development of individuals who present with them. Trust me, it’s scintillating!

I’m excited about tomorrow’s dissection of the scapular region. It won’t be as easy to see the muscles as it would be on Mr. BBQ Muscles above but I’m definitely looking forward to the challenge…

Politics and Bags of Meat

Today was my first Gross Anatomy lab. When we entered the laboratory and the lab techs began to unwrap the bodies, I thought I might cry. There was something surreal about it; an odd atmosphere of anxiety and excitement. Our cadaver was an 87 year old male who’d died of congestive heart failure. Our task for the day was to dissect the muscles of his back.

We share our cadavers with other groups and the group who’d gotten first crack at ours had left him supine, abdomen open. I tried not to look at his face. We turned him over to do our initial palpations for the occipital protuberance, vertebra C7 (that’s the one you can feel sticking out of the back of your neck), the spinous processes of the spinal column, the sacrum and iliac crests. Then, we cut open his skin. I was a bit hesitant at first but by the time it was my turn to wield the scalpel, I was flaying flesh from subcutaneous fat like a pro. Scooping out orange chunks of adipose tissue, trying to separate deli-thin slices of muscle from fascia, I somehow shunted the part of my tender heart that was quietly grieving for the lives that had belonged to the bodies in our lab and focused on respecting them by making clean cuts and learning what I could. Once you’ve folded back half of the trapezius or run your finger along the iliocostalis, you’ll never forget where it is.

After changing out of my scrubs and taking some time to recalibrate, I returned to campus. A 3rd semester student started a conversation with me and I asked him for advice on how to keep afloat and do well. He mentioned a number of underground study aids – in-depth histology CDs, textbooks on pdf, etc. I asked how one could obtain these things and he let me in on a little secret – apparently at Ross, “it’s all about politics.” He said that when looking for help and support, one should look to people who “look like you”… I found something a bit fishy about that. But perhaps that is the way things actually work at Ross, and in the world at large…I’m kinda naive about these things. In any case, I smiled, thanked him for his advice and went on my way, promising to attend the BSA opening meeting. I’m not really keen on affinity groups but if it is all about connections and who you know, and if people want to help me for no reason other than shared ancestry, that’s fine with me. As long as they don’t expect me to talk a certain way, think a certain way, or adhere to a certain agenda because of it…