I’m in my second week of pharmacology. Who knew there were so many drugs for glaucoma. So many that I have to forcibly memorize and come up with ridiculous mnemonics. All the mnemonics are usually memorable and dirty, yet half the time I remember the dirty mnemonics and not what it actually stands for. Cindy is Kinky So She Fs More Often… That was the TCA cycle right from biochem right?Something like that.
Anyway, this past week I was
irritated amazed by how many drugs I had to memorize for glaucoma. This doesn’t make me question the need for medical marijuana since there are many other medical benefits. I’m slightly biased from living in California where the medical marijuana is legal and you can find vendors pretty easily. Plus, the California budget is screwed up that prison guards are being paid minimum wage in over crowded prisons where prisoners are in tents (see NPR report). My old colleagues in San Diego County tell me that their “public health” jobs now include helping former prisoners transition back into the community, since the State is releasing prisoners early from their sentences to ease state budgets and help with understaffed, overcrowded prisons. The State budget could be salvaged by legalizing and taxing.
Back in November, NY times had a video about a medical marijuana college in Michigan. The Michigan law allows people to grow marijuana based on a caregiver system. You can go to school to learn growing techniques and when you find a person in need, you can legally become their official grower and supplier. Again, sounds like another win-win situation.
I forgot what hospitals smell like; that pungent urine, feces, rubbing alcohol, wasting smell that hits you immediately when you walk into a patient area. Just wait a few minutes to be desensitized, I tell myself. I walked into the surgical wing of St. Georges’ Hospital and braced myself for my first hospital rotation through orthopedics. Most of these patients aren’t inherently sick, they are just broken or recently fixed, non-septic, no infections, yet the pungent smell of bodily fluids still remain. Only this time it is mixed with raw sweat from the lack of air conditioning and salty marine outside smell from the tropical breeze.
We meet our patient lying in his ocean view bed, an 18-year-old Grenadian teenager with both arms wrapped up in a cast and gauze, slung over his shoulders. He has cuts all over his shoulders and back, yet seems pretty comfortable lying in bed in a Michael Jordan jersey listening to his Ipod that is attached to his arm with gauze. Our proctor, a local orthopedic surgeon, instructs us to take a full patient history then be prepared for a full physical exam. My group proceeds nervously; we’ve only had fake patients up until this point or practiced on each other in clinical skills. He is our guinea pig after a month-long winter break of forgetting the last 6 months of clinical skills and techniques. We come to find that he has both a fractured ulnar and humerus after being attacked by someone with a machete probably in a gang fight. He carefully explains his injuries in a soft tone as we lean in and take notes.
We struggle through the interview… trying to remember the right questions and mnemonics for describing pain, etc. We aim for order, comprehensiveness, cohesiveness and succeed without too much struggle. It was a collective effort at least. Our proctor then instructs us to do a head-to-toe musculoskeletal exam. It is amazing how much you forget in medical school. A medical professor once told me that medical students forget more than they learn in the process of learning. As a group we struggled to remember the simplest things like tiny muscles in the hand and their innervations (Which nerve was compressed? What muscle is innervated by that nerve? Which movements are compromised?), or specific movements of the shoulder (How do you test for internal rotation again?). We suffer through our mistakes and eventually yet haphazardly complete the interview and exam, encouraged by our first good experience with a real patient under the supervision of a real doctor. After a full morning of playing doctor in preparation for a lifetime of real doctoring, we left the hospital starving, sweating, but a little more experienced, knowledgeable and confident that we will be able to do this on our own… eventually.
4 months left on the island. 4 months left of basic sciences. 4 months of hospital rotations, pathophysiology, pharmacology, clinical skills and basic sciences integration. 4 months left of sleepless nights and relying on caffeine and the strength of eye cream.
4 long but it’ll-go-fast months until I go on lockdown to start preparing for USMLE Step 1.
It’s pretty exciting and shocking to me that a year and half has gone by so quickly being exiled in medical school prison. Don’t get me wrong, Grenada is a paradise. One that I cannot enjoy, but still paradise.