Examinating...

2 down, 4 to go!

Question on the Infection & Immunity exam a couple days ago:

Mr. X presents to you with eggs in his feces and segmented flatworms crawling out of his anus. He is otherwise well. Mr. X is infected with

a) Taenia saginata
b) Taeniasis soliem
c) Diphyllobothrium latum
d) Hymenolepis nana

Now, if like Mr. X you too have segmented flatworms crawling out of your back end, today is your lucky day. The organism in question is (a) and you get it from eating undercooked or raw beef.

Answer key:
Taenia saginata - found in undercooked beef. characterized by it's motility: since cows don't eat the grass around their poo, the organisms need to be able to move onto clean grass (after being pooped out) in order to complete their life cycle. hence, it has been known to crawl out of people's ... ahem... bottoms.
Taeniasis soliem - found in undercooked pork. don't need to be motile because apparently pigs eat *everything*.
Diphyllobothrium latum - found in undercooked fish.
Hymenolepis nana - transmitted through fecal oral contact... kids get this a lot.

Medicine is such a grand, noble profession. Apparently, finding cysts of parasitic organisms in stool samples is a lot like digging for a needle in haystack. And for some species, you need up to 5 negative samples before you can conclusively rule out an infection... so it's like looking for a needle in... 5 haystacks so to speak.

Everything comes down to poo.

A Real-y 'un-Real' Experience

The immunology exam is tomorrow. It makes me want to cry. Very much. Right now I’m banking on the fact that it’s pass/fail. Sigh…

On the more exciting side of things, we un-quarantined ourselves again today! Why at the 11^th hour did I decide to go out? You see, a couple weeks ago, we were given the opportunity to sign up for these ‘patient simulation’ experiences. Basically, it was a chance for us to practice our “clinical-decision making skills” on a robot – or SimMan as he is called.

I was scheduled to go into the robotics department at the hospital at 8:15 in the morning with three other people in my class. So I went up to this really swanky, modern office to sign in (clearly there’s some bucks going into this area). One of my group members was just behind me, so we went up together to the next floor where the simulation was to occur. Right away, it was very strange. Lots of computers, lots of medical equipment…essentially lots of expensive looking stuff with buttons that made me afraid to touch them for fear of breaking something. Stuff & computers don’t exactly mix. Anyhow, one of the admin people came to talk to us about the ‘case’ we were being given, as well as the introduction to SimMan. After watching a video, we were told we were going to be dealing with a trauma case, and were handed trauma/isolation gowns and gloves (ooo, how Grey’s Anatomy – I felt very Christina Yang-ish). Gloves! I didn’t know it would be that realistic. Then we were led to the ‘simulation’ area where the ‘patient’ was lying. Our facilitator, who was a doctor in real-life, was acting as nurse in this case. So first impressions? Extreme confusion. I had no idea what to do. And yea it was pretty dang realistic. Blood? Check. Patient talking? Check. Breath sounds, pulse? Check, check.

The ‘nurse’ right away asks us what we want to do. Uh….I gots no idea man! Luckily, some people in the group asked for IV lines, some EKG leads. And we were underway.

Throughout the experience, I had this weird urge to laugh. It was pretty realistic but at the same time, kinda artificial. I think this really was because I was completely LOST, and if this was truly real-life, we’d have killed the guy 5 minutes in. For example, the ‘patient’ was bleeding, and really tachycardic (fast, fast heart rate). When prompted how to deal with this, one guy answered – “um atropine.” Atropine? Guys, atropine actually has the exact opposite effect. We tried it out. The ‘patient’s’ heart began to beat faster and his blood pressure went down even more. So, atropine not such a good thing in this case. Another thing? I have no idea how to give meds. The ‘nurse’ got this syringe for morphine and told me to ‘administer’ it. I thought, yea, I can do this. So I happily started pushing down on the needle, giving the patient the FULL dose. Again, not the best idea. Basically, the whole thing was a lot of trial and error. And lots and lots of time outs.

But we weren’t complete dolts. When we were giving the blood transfusion, I noticed that two of the units had different names and ID numbers than our patient’s. Ah-ha! Can’t fool Stuff! Caught it in time so that we didn’t give SimMan a major haemolytic reaction. Hehehe…no, no. Truffles, wouldn’t Dr. RBC-transfusion be proud?

In the end we didn’t kill the patient. We actually managed to save him, I think. I thought it was a cool experience. I’ve never ever done anything like that, so it was sort of good to have done this before we actually try it out on a real-live person. A lot safer for the patient too I guess (uh, atropine?). It was sort of like throwing us to the sharks, considering I had NO IDEA what to do 99.999% of the time, but it’s part of the learning curve. I only wish it was longer…and not right smack in the middle of exam time. Anyhow, wish us luck for tomorrow! The bacteria are calling out to me.

A simpler time

Sorry for the lack of updates, but we’re currently in our “exam-study period” or for me, self-imposed quarantine. 6 exams upcoming within the next week, so it’s pretty much crunch time right now. It’s a bit disconcerting when you open your notes and realize that you don’t remember ANYTHING from the past semester. Sigh…so much for learning for life huh? I guess we know who the questionable admission is.

So studying has been going slow…very slow. I had set up a schedule for myself, but as always, things don’t always go as planned. The respiration section was much too long and I haven’t even gotten to ENT. And Cardio? Well good ole cardio is once again painfully slow. The only saving grace in the whole matter is that it’s pass/fail so at least it will (hopefully) not be so miserable.


Anyhow, you know me and studying. I can’t help but…ahem…distract myself while I read. So what is the choice of amusement for this week? Other than caffeine? Okay, this is super, super, majorly off-topic but I’ve been watching Road to Avonlea and Anne of Green Gables on DVD and YouTube. Because, hello, these were/are my favourite shows when I was younger (or maybe even now).

The idyllic settings are sooo pretty, so much so that I wish I was studying somewhere in PEI rather than looking out at the car park of my building (which is so depressingly annoying).

And don’t get me started on the romance factor. Anne and Gilbert? Felicity and Gus Pike? Sigh....

Okay, fine that had nothing whatsoever to do with medicine. But then again, I’m the best at finding odd connections between random things in life and medicine. So here goes:

- Gilbert was a doctor (haha!)

- Felicity went to medical school!

- Last but not least, the whole series was set in a rural location…and guess what our class is doing in ~1 week? We’re being sent off to rural communities around the province to do clinical observerships for a week. So Ha!

There you have it. My usual exam post on procrastination. Till next time! Until then, it’s angina drugs for Stuff… There’s nothing more sleep-inducing than a lecture on calcium channel blockers.

Pick me, pick me, pick me!!!

Whoa. I feel old. I’ve always felt that even though it’s been more than 10 years since I’ve left elementary school, it seems just like yesterday. In fact, most days I don’t feel like an ‘adult’ even though I’ve long since passed that age where I can be called a teenager. Most days (and especially when we’re talking to “real doctors”) I feel like a fraud…like I’m acting that I’m all grown up when in fact I’m just a kid playing dress up in their parent’s clothes. So it was a strange feeling to be back in an school today where the ‘real kids’ are (aka not the 20-somethings who still watch cartoons, drink juice boxes and wear colourful rain boots).

You see we are currently in our last week of lectures for 1st year med (Woot!! And wow did time fly by), which is on skin. Or if you want to be more professional, “dermatology.” It’s one week of intensive, and I mean intensive lectures on rashes, bumps and weird skin disorders that make me feel really itchy and eww. I think I’m more grossed out by most of this stuff than say watching a cardiac surgery where they have to saw open a person’s chest. Yeah, I’m weird that way. Anyways, so this week has been extremely condensed and INTENSE! As a guy in our class said, it’s been like:

Doctor-Lecturer
[slide with random rash] Absorb. [30 seconds…next slide with a million different diseases] Absorb. [30 seconds…next slide with another random rash] Absorb [rinse, recycle, repeat]
Class
[EVERYONE'S eyes are glazed over, mouths hanging open]

Hey docs! We’re med students, not sponges or miracle workers. Too many rashes! Gah!! They all look the same!!!

Anyways…I’m totally digressing...so our block assignment for this section was to go to elementary schools around the city and talk to kids about sun safety. You know, sun = bad, sunscreen = good. High SPF?? Even better! My group had four people. Me, Doodles, and two other guys. So today we went to the school where we were supposed to talk to these grade 4 kids in the afternoon. First impressions on being back in an elementary school? Weird…very weird because as I said, if felt just like yesterday when I was 10.

After setting up, their teacher brings the kids in. Boy were the small! I wasn’t that small was I? At 9?? Then again I was a giant (I just stopped growing when I was 11. So in other words, I am currently short). We start the presentation and the kids are pretty excited. Oooo pick me!! Hands up everywhere. Ahh, if only WE were so enthusiastic during lectures. All in all I think we did a pretty good job. The kids answered lots of questions. Most of them were repeated but hey they’re not rocket scientists right? Although there was this one kid who seemed quite bright. He answered with some unexpected stuff. Like why is the sun bad – Heat stroke. And what does it do for your eyes – glaucoma! GLAUCOMA!! I think he was also one of the ones who said he wanted to be a doctor [actually, only 2 or 3 kids put up their hands when asked if they wanted to be a doctor when they grew up. Isn’t this a cool profession anymore or has our secret identities as nerds been discovered?]. And at the end when their teacher asked if they had any questions, he actually asked one where we couldn’t really answer – can burning yourself from the stove give you skin cancer like a sunburn? Really I had never thought about this. Note to self, good research question for future, hahaha. Most of the kids were more, um, simple. Like one boy put up his hand just to tell one of the guys that his cousin was too named *John*. Another one went up to the other guy in our group to tell him that he had the same name, and that he wanted to be a travel agent so that he could travel places for free. Very cute. Their teacher then asked us what kind of doctors we wanted to be. I didn’t want to scare them by saying ICU doc (like how was I supposed to explain that? Where all the REALLY sick people go and sometimes uh, die? They're 9 people, 9!), so I said a cardiologist. Then one kid asked if that meant I was going to cut people open and take out their hearts. Um, yes…

So all in all a good session. We had a good group. Lots of different personalities, which is useful in this case. One guy used to be a teacher so he worked really well with the kids. Also, another lesson learned is that if you tell kids that you’re going to show something scary or gross, they’re going to want to see it more. We had this picture of a basal cell carcinoma which was pretty disgusting so we pre-warned them, but the kids got super excited and ‘eww, eww, what’s that, oh eww!’ when they saw it, while jumping around to get a better look. Although there was this one boy who was scared and closed his eyes, and thank goodness *John* recognized this and went to comfort/shield him. Yup, so fun day. I hope they actually learned stuff and weren’t only excited because we gave them candy. Yay for bribing!! And yea I feel old. Now excuse me because I have to go feed my 15 cats then rub some ointment on my corns & bunions, while watching me shows....kidding!

A Grand Ole Time

Last night was our class’ last formal event of the year. It was held at this swanky little club downtown, which was pretty nice. It wasn’t a sit-down dinner, which was a tad disappointing at first (because c’mon food = number 1) but they did serve some yummy hors d’oeuvres and…wait for it… CHOCOLATE FOUNTAIN!!! In the end I think that’s what convinced most of us (I’m looking at you Truffles) to go.

The event was scheduled to start at 8, with food coming out at 8:30. I had the afternoon off so I technically had plenty of time to get ready. Um, wrong. Lesson learned, when you’ve managed to live the last year everyday in sweats and tees, getting ready for a fancy night out will take you an exponentially longer than it did before. I started getting dressed at 5:30, but didn’t finish until two hours later. TWO HOURS!! Talk about reinforcing stereotypes. Part of the problem was that I couldn’t decide what to wear – safe old LBD, which had been worn multiple times before or my new white flowery one, which was pretty but sort of daytimeish and short. In the end I decided to bite the bullet and go with the new dress. What boldness! With some creativity (involving a belt, some jewellery and heels) I got it looking appropriately clubby. The only thing was that I felt very, uh, uncovered. These legs have not seen the light of day in a while. After finally finishing, I headed over to Truffle’s to help her get ready (aka makeup…and yay for success because one, I did not poke her in the eye with mascara or eyeline, and two, it looked nice if I do say so myself…maybe I should be a surgeon with that hand precision, hehe).

So we leave (T, cramberry, Doodles, Doodles’ bf, and I) for the place and get there on time. So in other words, early. Getting out of the car, I was again concerned with my hem length, and it didn’t help with the random guys hooting at us from their car. Uh, eww. But onwards we went. When we got there, we realized we were the first ones there. No fashionably late for these girls.

Wow, this is getting long. Okay, long story short (shorter): It was a fun time. Good food, although I’m slightly upset that I only managed to get ½ of the mushroom tart. Boo. Some dancing, lotsa pictures, and chocolate fountain!!

General observations from the night:
1. EtOH makes people do funny things. We saw everything from interesting dance moves, to yelling in people’s ears (ugh, my ears are still ringing…not impressed), to incoherent babbling/laughing while wandering around bumping into people. Yes, a few of those future doctors definitely killed some brain cells last night.
2. Our class has some weird affinity for Journey. Man, those people really perked up when “Don’t Stop Believing” came on. I don't get it…

3. Insulting a girl is not the way to get into her good books. I’m looking at you ‘Socially awkward boy’ (hereby known as SAB). Can you not touch Truffles’ head anymore?? Girls don’t like that. Nor do they enjoy negative comments on their outfits. ‘Controversial question guy’ was also there, looking creepy as always. But these people are for future posts (Truffles your turn, haha).

So all in all it was a fun night. And I planned on going to class today but alas my alarm clock didn’t go off! I did, I did! I’m sorry for abandoning you T!! I’m sure the “baked goods crew” who live in my building went though. They always go. Darn them for being so well-rounded (can you detect my jealousy?). Anyhow, must prepare for small groups this afternoon because as much as I would like to, I can’t skip the entire day.

The Call of the Wild

Wow, only Truffles, cramberry and I could entertain ourselves so much with such everyday things. Some background knowledge is required in this situation. Our medical school is attached (literally, physically connected) to one of the citiy's main hospitals. Walking to school everyday, we take this route that takes us through the hospital to go to class because we are vampires, and hate the sunlight & also because we are lazy and don’t like stairs. Anyhow, next to said hospital is this river with a whole bunch of trees, and nature-stuff. It’s a strange dichotomy to see this beautiful, organic living scene next to the concrete jungle that is the hospital building and two, yes TWO car parks. So as we trek along to school, we always pass by this interesting little piece of nature.

Recently, we started noticing that there were these GINORMOUS fish swimming in this little river. I’d probably say they were 12 inches in length. HUGE! So we started looking at them as they tried to swim up the river, and I have no idea why, stay put once they get to the other side (these aren’t the smartest fish in the world, clearly). Now, this is something we (T, C and I) find inexplicably entertaining. Everyday we’ll stop by the bridge (with cars rushing past us no less) to look at the dim-witted fish floating around, and these extremely adorable Canadian Geese & goslings. Today, for example we spent half an hour looking at the fish trying to cross this pylon thing. We were very amused. Then after ethics class in the afternoon, Truffles and I spent another 30 minutes looking (and taking pictures) at the fish and ducks and its 12 DUCKLINGS! Incessant giggling over the cuteness ensued. Then we spotted a bunny. And took a pic of that. Clearly no one does procrastination better than these med students.

Countdown: 2 more weeks of class!

The other side of the hill

Throughout the year, we’ve had a couple discussions on alternative/ complementary medicine, role of culture, traditions in a person’s health. There were a few lectures on acupuncture, one presentation on aboriginal health, some discussions on herbal meds, and even a session on hot yoga (and yes, it was VERY HOT, i.e. lakes of sweat, not pretty). But we’ve never actually seen first hand what this meant. I mean it’s one thing for someone to give a PowerPoint presentation or for us to do some research off the net. But it’s a totally different thing to actually see for yourself how important these factors are in people’s health.

For our small group session today, our facilitator took us to the city’s aboriginal health centre. Basically, it was a place for First Nations people to seek medical care, counselling, dieticians, social workers, etc. What was most interesting about this place was that they also provided their patients access to a traditional healer.

After giving us a tour of the centre, one of their traditional healers came into speak with us about his role in patient care, as well as what their traditional medicines entailed. He spoke about and showed us some of the natural herbs and medicines he used, as well as some of the prayers, rituals performed. He then explained how they were concerned with the person as a holistic being, and that healing meant fixing the spirit, the mind, all the while telling us some amazing stories from his own experiences. It was incredibly enlightening because I had never thought of some of these things from the perspective he gave. How experiences in a person’s life can lead to disease, and by treating their mind, you can heal their whole body and person was very interesting. A lot of what he had to say related to the belief that people were all inherently good and kind, and that by giving them hope, many things could be treated. Wow. It was a wonderful experience, and it really helped that he had one of those stereotypical story-time voices. I swear I could have listened to him all day, he was that mesmerizing.

So I think today really demonstrated the importance of a person’s culture and traditions in their health and healing. Clearly, there are many things that modern medicine cannot explain. Not that I’m saying I don’t believe in Western medicine (of course I do, I’m studying to become a doctor right? And evidenced based med, woot!) but at the same time I feel that as humans our complexity is sometimes utterly mysterious. I sincerely believe that the two can and should work together. Even the ‘healer’ shared this opinion. But I guess that’s what makes ‘healing’ and treating patients so interesting. And in the end we all have a common goal, that of giving our patients the best care possible.

[N.B. When asked the question how a person can become a healer in the traditional sense (Ojibway in his case) he said that a person is chosen, picked. They do not pick themselves. It comes to them, whether through their own dreams or from the elders. It is, inherently I suppose, a calling. Again, wow. Could it be that as medical students training to be doctors, we were chosen, called? Things happen for a reason right? Darn, I really should pay attention to my dreams more often – (although, somehow I don’t think that last one about Orlando Bloom counts =S)]