Yesterday in lab, we dissected Emelia's hand. There is something different about the hand than much of the rest of the dissections. Emelia's fingernails were still neatly manicured with a few chips that likely happened after her death. Her knuckles were worn, slightly crooked and likely arthritic as could be expected from an 83 year old. There is something uniquely human about the hand, which may be part of why it is harder to dissect.
The hand is amazingly complex. After dissecting for a few hours I realized why hand surgeons have such a long training. There are so many tendons, nerves, blood vessels, and muscles that allow us to do all of the small motions with our hands. I was fascinated by the complexity inside the hand. If the training weren't so long and ridiculous, I think being a hand surgeon would be rewarding and challenging and something I would enjoy. The training and the lifestyle that come with that specialty choice rule it out for me though.
Today marks the halfway point to our first exam. Two weeks from today I will have my first anatomy exam which will cover the back, the upper limb and the lower limb. The limbs also include where they attach (shoulders and hips). There are a lot of muscles to learn in those sections. We have to know where all of the muscle attachments are on the bones, all of the different parts of the bones, what nerve innervates the muscles, and what arteries supply the muscles with blood. We also have to know where everything is in relation to the other parts. Which parts are superficial, which parts are deep, etc. We are also expected to be able to put everything together. If they tell us that the median nerve is damaged, we should be able to say every structure that would be affected and how it would be affected. Also included on this exam is the first four weeks of development of an embryo. I'm looking forward to that first exam being over. I want to see what the exam structure is and how I can more effectively study. I'm also definitely looking forward to having a weekend off!
I also just bought the medical equipment that we need for patient exams. I bought a stethoscope, and oto/ophthalmoscope (eyes and ears), and a few smaller, less expensive pieces of equipment. These costs add up so quickly! We start practicing physical exam techniques on each other starting next week and have a taped standardized patient interview (basic history of present illness) in just two weeks!
Friday, August 28, 2009
Tuesday, August 25, 2009
A New Mindset
I've found that I have a whole new way of looking at the human body now that I've been studying human anatomy pretty intensely. I took anatomy in undergrad, but it wasn't this intense and it didn't include cadaver dissection.
I can no longer just move my arm, leg, hand, head, etc. Every movement is accompanied by the thought of all the actions that have to work together for every seemingly simple movement. What muscles are involved? What nerves make those muscles move? What blood vessels supply the area? What blood vessels drain the area? What parts of the brain coordinate everything? I look at my wrist as it moves and think about what Emelia's wrist looks like and wonder if my muscles look the same as hers (though hopefully fully alive). I see the veins in my arm and think about their names, what areas they drain, and what arteries are nearby. I raise my arm and think about the entire grouping of muscles that were necessary to make that motion.
I can't help but think about the whole system and wonder how it ever works without things going wrong.
I'm sure this sense of wonderment will gradually decline I get further from anatomy in these next few months and get lost in the more microscopic processes but I hope I never lose my awe of the workings and design of the human body.
I can no longer just move my arm, leg, hand, head, etc. Every movement is accompanied by the thought of all the actions that have to work together for every seemingly simple movement. What muscles are involved? What nerves make those muscles move? What blood vessels supply the area? What blood vessels drain the area? What parts of the brain coordinate everything? I look at my wrist as it moves and think about what Emelia's wrist looks like and wonder if my muscles look the same as hers (though hopefully fully alive). I see the veins in my arm and think about their names, what areas they drain, and what arteries are nearby. I raise my arm and think about the entire grouping of muscles that were necessary to make that motion.
I can't help but think about the whole system and wonder how it ever works without things going wrong.
I'm sure this sense of wonderment will gradually decline I get further from anatomy in these next few months and get lost in the more microscopic processes but I hope I never lose my awe of the workings and design of the human body.
Friday, August 21, 2009
OSU Football!
Far more exciting than anything that happened in class today: I picked up my football tickets!
I think these games will be a fantastic form of stress relief! Most of the M1s (first year med students) sit together for these games which will make it even more fun!
I think these games will be a fantastic form of stress relief! Most of the M1s (first year med students) sit together for these games which will make it even more fun!
Thursday, August 20, 2009
Emelia Didn't Drink Enough Milk
Today in lab, I learned a few more things about Emelia. She was 83 years old when she passed away and her cause of death was a heart attack. She also had coronary artery disease (accumulation of plaque in the arteries around her heart), hypertension (high blood pressure), and osteoporosis. Personally, I'm impressed that she lived to 83 with the heart problems and the fact that she was fairly obese.
For the purposes of our dissection, it was nice that Emelia didn't drink enough milk (it's not quite that simple) and had osteoporosis, because part of our task today was to crack open her spinal column. We literally broke her vertebrae with a chisel and hammer and removed the back half of the spinal column. There is something very strange about intentionally cracking someone's bones and ripping them out.
In this picture, the arrows are pointing to approximately where we put the chisel in, except we were a little more towards the outside (left and right) of the vertebrae to expose more of the cavity. The view of this image is as though someone is lying on a table and you are standing by their head (or feet) looking down their spinal column. The part of the picture that is pointing straight down is called the spinous process, and is the ridge that you feel when you run your fingers down someone's spine. Each of our vertebrae have one of these "spines" that together make up what we think of as the spine. That white triangle in the middle of this picture is the space that actually contains your spinal cord. Our entire purpose in cracking Emelia's vertebrae open was to expose the spinal cord and see it all the way from Emelia's neck to her hips. Seeing and touching a spinal cord and all of the nerves that attach to it was very interesting.
I'm not going to post about every dissection we do, but I will mention particularly interesting ones - such as exposing the spinal cord, removing the heart, removing the brain, etc.
For the purposes of our dissection, it was nice that Emelia didn't drink enough milk (it's not quite that simple) and had osteoporosis, because part of our task today was to crack open her spinal column. We literally broke her vertebrae with a chisel and hammer and removed the back half of the spinal column. There is something very strange about intentionally cracking someone's bones and ripping them out.
In this picture, the arrows are pointing to approximately where we put the chisel in, except we were a little more towards the outside (left and right) of the vertebrae to expose more of the cavity. The view of this image is as though someone is lying on a table and you are standing by their head (or feet) looking down their spinal column. The part of the picture that is pointing straight down is called the spinous process, and is the ridge that you feel when you run your fingers down someone's spine. Each of our vertebrae have one of these "spines" that together make up what we think of as the spine. That white triangle in the middle of this picture is the space that actually contains your spinal cord. Our entire purpose in cracking Emelia's vertebrae open was to expose the spinal cord and see it all the way from Emelia's neck to her hips. Seeing and touching a spinal cord and all of the nerves that attach to it was very interesting.I'm not going to post about every dissection we do, but I will mention particularly interesting ones - such as exposing the spinal cord, removing the heart, removing the brain, etc.
Tuesday, August 18, 2009
Meet Emelia: My Cadaver and My First Patient
Today was the first day of dissecting. My group named our cadaver Emelia. There isn't really reasoning behind the name, it just seemed to fit.
Nothing really can prepare you for that first day of dissection. You walk into a room full of cadavers with classmates who know just as little as you do and are expected to act as though you are not cutting human flesh. There is some degree of dissociation necessary to be able to complete the tasks we are asked to do. Conversely, you can't dissociate entirely because you have to learn everything in the context of a living human body and you also can't dissociate because you have to treat the cadaver with a lot of respect, just as you would a living human. Before we ever see the cadavers, their heads and eyebrows are shaved to dehumanize them to some extent to make it a little easier for us to handle initially.
Today we removed all of the skin from the back, back of the neck and the back of her arms to expose the muscles. We also had to remove the layer of fat between the skin and the muscles. Emelia probably enjoyed good cooking and relaxing because she is much larger than most of the other cadavers - which makes dissection difficult, but my group readily embraced the challenge.
I found that I handled the dissection well as long as I was actively doing something. The moments when I was standing by and others in my group were taking a turn, it was much harder to not react. Having a task to distract me from the idea of what I was doing was extremely helpful. A few times I did get a little light-headed (probably partially from the overwhelming smell), but a short break to sit or take a walk down the hall helped. I'm sure, like most things in life, dissection will get easier as the exposure increases. Despite more time in the lab increasing comfort level, I've heard from many med students that the hardest dissections to handle are the face and hands - since those areas are what we generally associate with "being human".
I hope to learn a lot from Emelia. I hope to learn a lot from all of my patients, but I think my first, Emilia, will teach me the most.
I won't be in the lab dissecting every day. There are eight of us assigned to the table, but divided into two teams of four. We rotate which day we are dissecting so I don't dissect again until Thursday.
Nothing really can prepare you for that first day of dissection. You walk into a room full of cadavers with classmates who know just as little as you do and are expected to act as though you are not cutting human flesh. There is some degree of dissociation necessary to be able to complete the tasks we are asked to do. Conversely, you can't dissociate entirely because you have to learn everything in the context of a living human body and you also can't dissociate because you have to treat the cadaver with a lot of respect, just as you would a living human. Before we ever see the cadavers, their heads and eyebrows are shaved to dehumanize them to some extent to make it a little easier for us to handle initially.
Today we removed all of the skin from the back, back of the neck and the back of her arms to expose the muscles. We also had to remove the layer of fat between the skin and the muscles. Emelia probably enjoyed good cooking and relaxing because she is much larger than most of the other cadavers - which makes dissection difficult, but my group readily embraced the challenge.
I found that I handled the dissection well as long as I was actively doing something. The moments when I was standing by and others in my group were taking a turn, it was much harder to not react. Having a task to distract me from the idea of what I was doing was extremely helpful. A few times I did get a little light-headed (probably partially from the overwhelming smell), but a short break to sit or take a walk down the hall helped. I'm sure, like most things in life, dissection will get easier as the exposure increases. Despite more time in the lab increasing comfort level, I've heard from many med students that the hardest dissections to handle are the face and hands - since those areas are what we generally associate with "being human".
I hope to learn a lot from Emelia. I hope to learn a lot from all of my patients, but I think my first, Emilia, will teach me the most.
I won't be in the lab dissecting every day. There are eight of us assigned to the table, but divided into two teams of four. We rotate which day we are dissecting so I don't dissect again until Thursday.
Monday, August 17, 2009
First Day of Class!
Med school classes officially started for me today! There were four one-hour lectures this morning from 8am-noon. Each lecture was on a different topic and was taught by a different doctor. Being done at noon is really nice. I came back to my apartment and had a nice afternoon break to eat lunch and relax by the pool before studying.
The first lecture was just a general intro to anatomy and to the course. We were told about supplies and procedures for the anatomy lab among other general information.
Our second lecture was about a specific case study with a patient suffering from a herniated disk which was intended to help us see the purpose for what we will be learning. Understanding basic anatomy is crucial for a lot of diagnosing and problem solving.
The third lecture covered some embryology and went through the first two weeks of development after fertilization. It's amazing how much happens in those two weeks. (It's also amazing how many terms there are to memorize from those two weeks!)
The last lecture for today was an overview of the different imaging options available in medicine. We went through the basics of x-ray, CT scans, MRI, PET scans and some other options. The technology available to doctors is incredible and always developing.
Dissecting in the anatomy lab starts tomorrow. We only have one lecture tomorrow morning followed by three hours in the anatomy lab.
I don't want to bore everyone with summarizing every lecture that I have this year, but I thought a run through of the first day would be helpful for knowing what med school is like (at OSU at least). I'll probably do more general updates about how things are going after today (instead of summarizing everything that happens) and include updates on any significant events or memorable experiences that happen.
The first lecture was just a general intro to anatomy and to the course. We were told about supplies and procedures for the anatomy lab among other general information.
Our second lecture was about a specific case study with a patient suffering from a herniated disk which was intended to help us see the purpose for what we will be learning. Understanding basic anatomy is crucial for a lot of diagnosing and problem solving.
The third lecture covered some embryology and went through the first two weeks of development after fertilization. It's amazing how much happens in those two weeks. (It's also amazing how many terms there are to memorize from those two weeks!)
The last lecture for today was an overview of the different imaging options available in medicine. We went through the basics of x-ray, CT scans, MRI, PET scans and some other options. The technology available to doctors is incredible and always developing.
Dissecting in the anatomy lab starts tomorrow. We only have one lecture tomorrow morning followed by three hours in the anatomy lab.
I don't want to bore everyone with summarizing every lecture that I have this year, but I thought a run through of the first day would be helpful for knowing what med school is like (at OSU at least). I'll probably do more general updates about how things are going after today (instead of summarizing everything that happens) and include updates on any significant events or memorable experiences that happen.
Thursday, August 13, 2009
Moving and Orientation
I apologize for the delay in posting an update, but lately things have been a little more chaotic than I anticipated. (That will likely be the trend for the next few years!)
I moved to Columbus on Aug 1 and moved in to my 2 bed/2 bath apartment with one roommate. I took my time unpacking and finally got everything unpacked and organized just in time for orientation to start the next week. (Once orientation started though, the organization and cleanliness of my room quickly deteriorated!) I wanted to have a bit of a relaxing week as well since I know it will be one of my last weeks for a long time where I will have lots of time to relax! My apartment complex is really nice and has a pool, a 26-acre lake, tennis courts, a sand volleyball court, a work-out room, and a nice community rec room. While I've been in Columbus, I've also gotten my OSU ID card (BuckID) and my OSUMC (OSU Medical Center) ID card.
Orientation started on Aug 10 and was Monday through Thursday of this week from about 8am to 4pm. The first day of orientation kicked off with some professionalism talks and other lectures but in the afternoon we had what is known as the "White Coat Ceremony". This ceremony is when we are given our first white coats that doctors are known for wearing. Because we are students, our coats are shorter than physicians' coats. We also gave our medical oath at the ceremony (an updated version of the Hippocratic Oath). The rest of orientation consisted of various talks on what to expect in med school, how to take care of ourselves, and how we should behave.
Classes start on Monday (Aug 17). Classes for the first two years of med school are divided into two main parts. We have our "core" class - which is the class that takes about 90% of our time. This core class is separated into blocks. Our first block is Anatomy (with a little bit of Embryology mixed in) , which lasts ten weeks. After Anatomy, we have Cell block, then Host Defense block, then Neural Science block for our first year. Each block lasts about ten weeks and will have three exams within that time. The second year's blocks are a little different in structure than the first year and are typically divided by body system (urology, cardiology, etc) and are shorter blocks (4 weeks).
In addition to our core class, we have a course called CAPS (Clinical Analysis and Problem Solving) which runs all four years of med school. In our first two years, our CAPS small group meets once a week to cover the things important to becoming a physician that aren't covered in basic science classes: Things such as how to interview patients, how to do physical exams, and how to integrate what we're learning into a clinical setting.
There have been a lot of social events going on constantly since I've moved to Columbus. Some are officially hosted by the med school and some are unofficial gatherings hosted by various students. Since our class has 220 people, there are tons of people to meet and get to know!
I'm not sure how frequently I'll be posting updates on here because it depends on what's going on at that time. If you're curious about something with med school, post it as a comment on here and I'd love to answer it.
I moved to Columbus on Aug 1 and moved in to my 2 bed/2 bath apartment with one roommate. I took my time unpacking and finally got everything unpacked and organized just in time for orientation to start the next week. (Once orientation started though, the organization and cleanliness of my room quickly deteriorated!) I wanted to have a bit of a relaxing week as well since I know it will be one of my last weeks for a long time where I will have lots of time to relax! My apartment complex is really nice and has a pool, a 26-acre lake, tennis courts, a sand volleyball court, a work-out room, and a nice community rec room. While I've been in Columbus, I've also gotten my OSU ID card (BuckID) and my OSUMC (OSU Medical Center) ID card.
Orientation started on Aug 10 and was Monday through Thursday of this week from about 8am to 4pm. The first day of orientation kicked off with some professionalism talks and other lectures but in the afternoon we had what is known as the "White Coat Ceremony". This ceremony is when we are given our first white coats that doctors are known for wearing. Because we are students, our coats are shorter than physicians' coats. We also gave our medical oath at the ceremony (an updated version of the Hippocratic Oath). The rest of orientation consisted of various talks on what to expect in med school, how to take care of ourselves, and how we should behave.
Classes start on Monday (Aug 17). Classes for the first two years of med school are divided into two main parts. We have our "core" class - which is the class that takes about 90% of our time. This core class is separated into blocks. Our first block is Anatomy (with a little bit of Embryology mixed in) , which lasts ten weeks. After Anatomy, we have Cell block, then Host Defense block, then Neural Science block for our first year. Each block lasts about ten weeks and will have three exams within that time. The second year's blocks are a little different in structure than the first year and are typically divided by body system (urology, cardiology, etc) and are shorter blocks (4 weeks).
In addition to our core class, we have a course called CAPS (Clinical Analysis and Problem Solving) which runs all four years of med school. In our first two years, our CAPS small group meets once a week to cover the things important to becoming a physician that aren't covered in basic science classes: Things such as how to interview patients, how to do physical exams, and how to integrate what we're learning into a clinical setting.
There have been a lot of social events going on constantly since I've moved to Columbus. Some are officially hosted by the med school and some are unofficial gatherings hosted by various students. Since our class has 220 people, there are tons of people to meet and get to know!
I'm not sure how frequently I'll be posting updates on here because it depends on what's going on at that time. If you're curious about something with med school, post it as a comment on here and I'd love to answer it.
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