Last day of medical school and paper #7 published!

Doctor and Patient: Reinventing the 3rd Year of Medical School

For nearly a century, the third year of medical school has been a pivotal point in training, a crucial step in the development of professional skills and attitudes toward patients. Recently, however, the tradition of monthlong “rotations” – a speed-dating introduction to the major disciplines of medicine and the issues patients face – has come under fire. During their third year, medical students are under constant pressure to perform for an ever-changing group of senior physicians, who in turn must evaluate the students based on brief interactions. Sailing through as many as six disciplines in just under a year, students have opportunities for only transient relationships, garnering mere snapshots of their patients’ illnesses and lives. Not surprisingly, studies have shown that these experiences result in “ethical erosion.” Students’ sense of empathy and bedside manner deteriorate, and many begin to refer to their patients not as people but as diseases, that dehumanizing shorthand of the wards.

This is an important issue. During my third year, at times it felt like I was speed-dating through some of my core rotations. Some rotations like Ob/Gyn, Pediatrics and Psych were only 6 weeks long, Family Medicine was only 4 weeks and Surgery and internal medicine were each 12 weeks. These short-lived experiences can really determine what field you end up choosing. Among my friends, it varied greatly with each hospital. For example, Ob/Gyn at one hospital really deterred most of my friends, including myself, from considering a career in the field. Whereas in a more “friendly,” positively involving program, more people chose that field. With USMLE Step 2 CS and CK hanging over you and preparing your ERAS application at the end of third year, these rotations can make or break what you apply in if you haven’t quite found your niche yet.

Harvard Medical School-Cambridge Integrated Clerkship, which assigns every third-year medical student to a “panel” of up to 100 patients to care for over the course of the year, seems like an interesting concept. I would imagine that following a patient for the course of an entire pregnancy or throughout the course of their disease, would be humanizing and inspiring. But I would worry about what you might miss out on. Part of balancing many patients with multiple diseases, is learning the tenuous balancing act that you will have to practice in your future career. Plus, for me, the more exposure to different illnesses, the better and more confident I became at handling the work-up. Part of this involved learning more about their specific disease or conditionn,which ultimately helps in reviewing for boards as well. I feel very lucky that in my internal medicine rotation and sub-I, I was empowered to manage my patient’s care from admission to discharge (overseen by my resident and attending, of course). While the patient turnover was pretty quick, it was challenging to learn the balancing act. However, I felt that I was able to have more than adequate interaction with my patients.  But it certainly wasn’t like this in every rotation. In general, my advice would be to make it a goal to really get to know your patient well, beyond just their disease. Third year is the time to really discover where you might see yourself in the grand scheme of medicine, and help you decide how you want to spend your fourth year electives. It’s a time to learn, connect with patients, get a sense of responsibilities of being a doctor, and hopefully, a time to continue to be inspired along the way.

On Match Week 2012

Childhood dreams

To say that this whole thing started just a few months ago with the start of my ERAS application, interviewing, rank lists and whatnot, would be severely short-sighted of me. For me and for most people, this whole thing began as a child, having some idea of what I wanted to be when I grew up. Match week is a culmination of innocent childhood dreams, struggles and let-downs along the way as “non-traditional” students, late nights of studying, long zombie-like mornings after a rough 24-hour surgery call, and post-exam/end of rotation celebrations with amazing friends. For me, it was week where I spontaneously cried tears of complete happiness, relief and gratitude.

My path to medicine has been a long, winding road with rough terrain, detours and it seems that at times, my GPS was busted. From humble beginnings as a child surgeon, medicine meant saving lives by repairing detached limbs and performing (Sharpie marker) “cataract” surgery on Monkey-Key, my most beloved stuffed animal (made of love just like the Velveteen Rabbit).  My first grade autobiography clearly predicts that not only would I become a doctor, but I would also find the cure to AIDS and subsequently become BFFs with Magic Johnson, drive a red Mazda Miata and only wear red dresses under my white coat. In fact, this highly predictive autobiography states that I was triple-boarded in pediatrics, neurosurgery and cardiology, while also being the premier hairstylist to the stars. No joke, I was living the dream.

Both fortunately and unfortunately, it wasn’t as easy as my 6 year-old mind imagined. In high school I started working in hospice care, providing comfort and happiness at the end of life. It gave me a completely different perspective on medicine and what saving lives really means. In college and graduate school, I worked part-time as an emergency room technician in Chicago. At first, it was exciting to be in the footsteps of Noah Wyle and George Clooney, but I also learned that medicine can be quick, dirty and often, devastating. I found myself questioning whether this was the right path for me and at that time, it surely wasn’t. After completing a master’s degree in public health, I set off on a journey to improve people’s lives through health education on prevention. Yet, I still felt this strong desire, perhaps calling, that I could make a greater impact with a combined background in medicine.

In hindsight, medical school itself seems to have flown by. Going through the first two years was not without pain and suffering (and seriously, it was emotionally and physically draining at times), yet looking back it wasn’t as bad as it seems.  I can say that now since the end is within reach! To say that living on an island thousands of miles from my family and close friends in the most stressful time of my life was rough, cannot even begin to encapsulate this experience as a whole. But throughout the rough patches, I found friends that became surrogate family, whether it was celebrating Thanksgiving dinner, caring for my frequently injured friends, or cutting up oranges as a basketball mom. I found extraordinary future physicians along the way and developed friendships for a lifetime. Without St. George’s University, perhaps our paths would not have crossed and for this, I am ever grateful.  

I am thankful for having such a supportive and incredibly patient family that were and are always there for me, even when I was stressed out of my mind and clearly, a huge pain in the ass. My family kept me going with their relentless support, as my mother’s words to “keep going” seemed to play on repeat in my head. They never gave up on me and never let me give up on myself.  A worn-out birthday card from my grandfather, continued to remind me of family who have passed before me whose dreams I also carried with me.

It is a strange feeling to think that in just a few months, I will be a doctor.  I am thrilled to have matched into a wonderful program where I know I will be happy. While I may not become a pediatrician-neurosurgeon-cardiologist-hairstylist, I know that I am steps closer to fulfilling my childhood dreams.  And who knows, Magic Johnson and I may still become BFFs someday!

Got this from a friend. Actually very true especially the unnecessary highlighting by medical students! Thank goodness for electronic medical records.
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Got this from a friend. Actually very true especially the unnecessary highlighting by medical students!

Thank goodness for electronic medical records.

My first case report is finally published!

And I have four + more to go! Kinda exciting.

Top 10 Reasons to Become a Doctor

On Medscape’s Differential, one of the medical student bloggers posted a great story responding to a former pre-medical student advisor and trained physician’s article, “The Top 10 Reasons Why You Should Not Go To Medical School…and the Single Reason You Should,” who has chosen not to practice medicine.

I think he really has some great points. There were and are times in medical school where I seriously thought, why am I doing this to myself? I definitely lost touch with some old friends and family. I see my friends continue on with their lives and grow up whereas I sometimes feel l like a perpetual student. I felt out of shape, I was really sick sometimes and just straight up exhausted. But, with the end in sight (May 11, 2012!!!!!!) honestly, it’s worth it. Time flies by in hindsight.

Last year, I made pretty extensive new year’s resolutions to be in better contact with my friends and family, make time to read books, cook, volunteer, knit, workout, write, and go out with friends, etc. And it’s been one of the most gratifying years for me. I really got to do all of these things during one of the busiest years of medical school, and write several journal articles (Four of which, will published in 2012, so far!). Better time management really allows you to whatever you want PLUS really feel like you are learning and helping people in a meaningful way. So many of these reasons not to become a doctor really disappear…but you have to really want it, remind yourself why you got into it in the first place and try.

Death and dying on the wards

I received this paper in my email, Medical Students’ First Experiences with Death. Admittedly, usually with these Medpage articles I usually read through the ones I’m most interested in right away and wait til the end of the day or week to read the rest. But this time it seemed very fitting.

I’m in the first week of my medicine sub-internship and I admitted my very first patient on my first day. On day 3, we are questioning whether this man will survive. It’s strange to me since when I did his admission and even on day 2, he didn’t look especially ill. He seemed happy; he was laughing and making jokes. But today on the third day, he looked progressively worse. My attending asked me if I felt comfortable talking to the him and his family about code status. And honestly, I’ve never had this conversation. I’ve asked about code status during initial interviews but my only experience was when my own grandmother was in the same situation. I was the only one from the family available since I had stayed overnight. She had decompensated quite a bit, and at that point the doctor pulled me aside and asked me how invasive I wanted them to be if something were to happen. Would I want them doing compressions on her very weak chest? Would I want them putting tubes down her throat to make her breath if she stopped? I had no idea. I didn’t know what I was supposed to do.

I told my attending that even though I had some experience working in hospice before medical school, I didn’t exactly feel comfortable talking to the family. So we discussed it in morning rounds and my resident told me to go ahead and start the conversation with the family. So I went in and started to talk to the two grown children about their father. Despite my explanation of his grim prognosis (he had stage IV lung cancer with mets to bone and liver, disseminated zoster with MRSA superinfection and health-care associated pneumonia), they were incredibly optimistic that he would make a grand turnaround. They explained to me that they “didn’t want to feel like they were making the decision to kill him.”

I left the hospital on day 4 (of his stay and my own day 4 at the hospital), and became very sad in the car on the way home knowing that he may not make it. It was hard whether it was because I felt hopeful for him and his family or that he’s my first fully managed patient. I saw him completely deteriorate in fromt of me despite all the best available treatments I carefully researched. It’s a tough thing being in this situation where you have to be the person to deliver the news that their loved one is dying, and hoping that they will accept that when I can’t even accept that on my own. It’s hard to encourage someone to put their family on comfort care when you know that they have some glimmer of hope that their loved one will make it through. Even I share that same glimmer of hope but have to keep it internalized, especially when other residents sign out to me in the morning that my patient is “circling the drain.”

I don’t know at what point in my career, especially because I have an interest in geriatrics, to which something like this becomes easier. And in reality, I don’t want it to become easier. While I may not feel as attached to all of my patients, I don’t want to lose my sense of humanity in the process.

My patient made it through the night. When I came in the next morning, he was no longer speaking and barely reacting to his family. At that point, we knew he probably had little time left. Eventually the family switched him to comfort care to ease his silent suffering. He died peacefully the next day with his family around him.

Perhaps medical students and clinicians aren’t adequately prepared for end of life care. Most medical students I had spoken to don’t know how exactly to deliver bad news and approach end of life care. It’s something that they just don’t teach you in medical school. A recent paper showed that that undergraduate medical education is currently failing to prepare junior doctors for their role in caring for dying patients by omitting to provide meaningful contact with these patients during medical school. This lack of exposure prevents trainee doctors from realizing heir own learning needs, which only become evident when they step onto the wards as doctors and are expected to care for these patients. There is little formal teaching about palliative or end-of-life care in their new role and the culture within the hospital setting does not encourage learning about this subject. With the growing geriatric population, it becomes especially important.

So this was my first real experience with death in medicine.

Planning out my 4th year and trying to figure out what I want to be when I grow up.
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Planning out my 4th year and trying to figure out what I want to be when I grow up.

Discover Magazine Vital Signs: Education All Around

Interesting new Vital Signs article on women’s health, medical students and misconceptions about pain.

On medical clerkships

Now that I am 6 months into my clerkship, I feel like I have some bits of wisdom to pass on as I continue to be a sponge for learning everything I possibly can. My advice after 6 months:

1. Eat when you can, you never know how busy it will get on the floor or in clinic and being hungry can make you tired, cranky and unpleasant to be around.

2. Don’t complain. Everyone around you has probably gone through what you are going through or are going through it at the same time. Complaining becomes annoying and a real downer. You don’t want to be the Debbie Downer in the group.

3. Get to know your patients. Not just the lists of things to ask but really get to know them and they will remember you and cooperate with your care. Try to understand your patients and it will help to know where they are coming from, or at least try to come to an understanding WITH your patients.

4. Don’t be late. Ever. As my brother would say, “If you’re not early, you’re late.” And if you are late, be accountable and professional. Don’t just show up late and think no one notices, they may not say anything but they notice.

5.  Be nice. And not fake nice. Patients, med students, attendings, residents, nurses, techs, aids, etc. can see through your saccharin-ness (my favorite word for being fake sweet).

6. Always look for ways to improve yourself. They know we don’t know everything or forgot most things, but I try to continue to look for ways to know more.

7. Be open to other options. Maybe you know you want surgery but don’t totally dismiss every rotation. I’ve seen other students proclaim they want to be a surgeon and blow off all their other rotations as not as important and get bit in the ass for it. To me, every rotation is important, especially if you are not certain about what you want to do.

8. Enjoy the time you have off. Seriously, time off is your time to sleep, explore and do fun stuff. Take advantage of time off.

9. Don’t take out your frustrations, stress, sleep deprivation and crankiness out on those you care about. It’s easy to project onto your friends and loved ones, but they don’t deserve to be crapped on if you were crapped on. They are your support system and won’t support you if all they get is the cranky, unpleasant version of you.

10. Exercise. I’m trying to keep to a regular schedule and it’s tough but it really helps to balance you.

11. When you see something really interesting, go home and learn everything you can about it. I’m not just talking about rare zebra diseases but common illnesses, learn about it since you’ll see it over and over again and you should know about it. And after you read it, re-visit it the topic again since you’ll forget stuff.

12. Look nice. As my aunt, a retired physician, told me, “Even if you are tired and having slept for 36 hours, don’t look tired. Fix your hair, put on lipstick. No one wants to see you looking exhausted.”

13.Take advantage of free food. Go to Grand Rounds of course to learn, but make sure you get there early to get lunch too.

14. If you don’t know, ask. My residents and attendings kept telling us, there are no stupid questions. 99% of the time, this is true. If you really don’t know or can’t find the answer on your smartphone, just ask.

15. Be professional and introduce yourself or you will just be called “medical student.” They may forget your name or may still just call you medical student but it’s good to try.

16. Be concise when you present patients. Provide good details but have a good format and cut out the anecdotal crap.

17. Take care of yourself. Take vitamins or Emergen-C or something. I was sick for about 3 weeks during my pediatrics rotations. Kids will cough in your face and throw up on your shoes. Protect yourself!

18. Make sure your white coat is clean, before someone tells you it needs to be cleaned. It looks gross and gets smelly when you don’t wash it. Try not to roll it up in a ball in your locker since you look like a wrinkled mess.

19. Utilize apps on your smart phone. I love some of the Iphone apps and they are really helpful for quick reference.

20. Have fun. It really goes by fast.

….

No longer scared of babies! I am halfway through my pediatrics rotation where I had 2 weeks on the floor and one week in nursery so far. A few days before my nursery rotation, I admitted to one of the 1st year residents that I was terrified of babies since they look so delicate and difficult to hold.  I really wasn’t looking forward to going to the well-baby nursery despite all my medical student friends saying it’s a great week since you get to play with the babies all day (which did not particularly sound that fun). After that first day, I was pretty traumatized by the birthing experience. It’s gruesome, messy and painful. I really felt like I was watching Alien, especially since it was a meconium baby (essentially, covered in baby feces since the baby happened to have gone number 2 during the birth). By the end of the week, I was receiving babies right out of the womb. One even reached out and grabbed my glasses and face mask off my face (yuck!) after we harvested it. Granted, each time, my heart raced a little and I repeatedly prayed that I wouldn’t drop it in the OR in front of the mother… but still, it really got easier. Now, I can change diapers pretty easily and quickly without cringing every time and nearly vomiting in my mouth at the seedy, tar-looking stool. I can pick up the babies and hold them in one hand while checking for red reflex with the other hand. I can make them stop crying with just my pinky (the best possible trick I’ve learned this week!) I am almost halfway through this pediatrics rotation. I have 2 weeks of clinic and one week of pediatric ER left. It’s been a great rotation so far. I’m not sure if I want to do pediatrics but at least I’ll leave this rotation having learned quite a bit and not scared of squirmy little babies.
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No longer scared of babies!

I am halfway through my pediatrics rotation where I had 2 weeks on the floor and one week in nursery so far. A few days before my nursery rotation, I admitted to one of the 1st year residents that I was terrified of babies since they look so delicate and difficult to hold.  I really wasn’t looking forward to going to the well-baby nursery despite all my medical student friends saying it’s a great week since you get to play with the babies all day (which did not particularly sound that fun).

After that first day, I was pretty traumatized by the birthing experience. It’s gruesome, messy and painful. I really felt like I was watching Alien, especially since it was a meconium baby (essentially, covered in baby feces since the baby happened to have gone number 2 during the birth). By the end of the week, I was receiving babies right out of the womb. One even reached out and grabbed my glasses and face mask off my face (yuck!) after we harvested it. Granted, each time, my heart raced a little and I repeatedly prayed that I wouldn’t drop it in the OR in front of the mother… but still, it really got easier.

Now, I can change diapers pretty easily and quickly without cringing every time and nearly vomiting in my mouth at the seedy, tar-looking stool. I can pick up the babies and hold them in one hand while checking for red reflex with the other hand. I can make them stop crying with just my pinky (the best possible trick I’ve learned this week!)

I am almost halfway through this pediatrics rotation. I have 2 weeks of clinic and one week of pediatric ER left. It’s been a great rotation so far. I’m not sure if I want to do pediatrics but at least I’ll leave this rotation having learned quite a bit and not scared of squirmy little babies.

Just one day in nursery…

…and I may be traumatized by the miracle of birth. I saw a c-section and vaginal delivery today while working in the nursery. The nursery babies are quite adorable but I actually feel pretty frightened by labor and delivery. Frightened meaning scared, pretty grossed out and all around kinda horrified. Maybe after a few more weeks seeing this and after my Ob/Gyn rotation I’ll be desensitized but for now, I was very much traumatized today.

Medical school is a humbling experience.

It’s been well over a month now that I’ve been at school and there are so moments where I realize how little I know and how much I have to learn. I have anatomy wet and dry lab on Tuesday mornings. We discuss clinical cases, look at X-rays, MRIs, etc. to better understand the anatomy and when the anatomy goes wrong. After meeting in small groups, we essentially get interrogated by professors and our physician teaching assistants to make our differential diagnoses.

Last week may have been the most embarrassing moment for me so far but closely followed by this week.

“Doctor, what do you think of this case?” says our professor looking directly at me. Out of instinct, I look directly behind me imagining my TA (an actual physician) was standing behind me. In my head I’m thinking, he can’t be speaking to me I’ve only been here a month and still find wearing scrubs a novelty.

“No, you there with the ponytail. Doctor, I’m speaking to you. What do you think of the case?”

Holy crap, I say to myself. He is talking to me! I try to get my wits together. I just reviewed the X-rays and know that the patient probably has an anterior dislocation of the shoulder. I reply with confidence, “Sorry, based on the X-rays, you can identify the following structures… The patient has dislocated his shoulder.”

“Is that all you can tell me from the X-ray? What would you do before identifying the landmarks and structures and diagnosing.”

I scramble my brain and look towards my team for an answer. “Um, well, the X-ray is an anterior view and…”

He interrupts before I can finish. “Well, doctor. In my hospital, we like to take a patient history before we go straight to the X-ray.”

Ouch that was rough.

Determined to not be embarrassed this week, I stayed up later reviewing abdominal landmarks and clinical issues. We read a case about a 45-year-old man with abdominal pain. He has jaundice and lab results indicate dark urine and strong smelling, light colored feces.

Immediately, I write down some notes….

-Dark urine and jaundice—bile duct obstruction
-Bilirubin in urine

-Fatty poo—possible steatorrhea

-Abd pain—gallstones?

My TA comes around and we discuss the case. I explain to her my differential diagnoses and tell her that I think he has gallstones that are possibly obstructing the bile duct which can account for the dark urine, abdominal pain, jaundice and fatty poo.

“What does that mean?” She looks at me like I’m not making sense. “I don’t understand your notes as she points down at my bulleted point about steatorrhea.

“Based on the patient’s history and case information, the patient’s bile duct is likely obstructed by a gallstone so he doesn’t have the bile acids to break down fat. Hence, he has fatty poo.” I tell her with my most serious doctor-looking face. I am certain I am right this time. 

“This doesn’t make sense. What is this word?” She points at the word “poo.”

I look at her thinking to myself, seriously this woman doesn’t know what poo is? But, I give her a chance. “I’m sorry, my handwriting is terrible. It says fatty poo. Steatorrhea is when you have fatty poo due to lack of bile acids or defects in pancreatic juices or possibly defect in mucosal cells related to nutrient update.”

She looks at me with that same look as if I am speaking nonsense and then cracks a tiny smile. “Honey, you are going to be a doctor. I know you have 4 more years of school but from now on you can’t say poo or no one will take you seriously. It’s called stool or feces. Don’t ever call it poo!”

Ouch, point well taken. Poo will forever be stool or feces from now on. Pooing will forever be bowel movement. Wow, I am learning so much.

I’ve been requested to write about what my day to day is like here. I suppose that in my brief postings, I’ve written about the pretty parts of the island that are picturesque, exotic and fun, but not as much about what my every day is like here. Today is Wednesday, normally I would be in Anatomy lab until noon, but with exams this week they changed the schedule. Today is basically my typical Monday.

6:17 am

My alarm clocks ring and I snooze for about an hour. Between my phone ringing the most wretchedly annoying buzzer and my $3 dollar battery-operated alarm clock from Target, I eventually wake up to start my day. At one point in time earlier in the semester, I woke up at 6:17 am but now that I’ve grown accustomed to studying until 2 am, 6 am wake-ups are a little more painful.

Eventually I stumble out of bed to boil 2 eggs and boil water for my Tazo Awake tea. I’ve tried to only take espresso for the days that I really think I cannot feasibly stay awake. So for now, I drink green tea or Tazo tea. I get in to shower for a quick shower (I skipped on actually washing my hair this morning since I went to the gym last night and showered right after) more for a wake-up than cleansing.

After a quick shower, I scarf down some cereal, usually standing over the stove or by the door. Then head out the door after assuring that I pack my keys, phone, eyeglasses and tea. I get a text from a friend that she’s headed over to Histology lab.

7:52 am

Immediately, I know it’s going to be a humid day by how my sunglasses react. If they are super foggy and I wipe them up and they get foggy right away, then I know that it will be an exceptionally humid day. Today happened to be especially humid. I tell myself, it’ll probably rain at some point since my achy knee is also telling me that.

8:00- 9:47 am

I sit through an hour of histology lecture then an hour of rapidly viewed histology slides showing every part of nervous tissue and every imaginable part of a cell body or ganglia. We literally zip through probably 100 slides that eventually I will have to memorize and know like the back of my hand. It is painful. I wish that I had slept a little more. I take over 10 pages of notes that are slightly legible since I partly fell asleep or at least allowed my eyes to roll to the back of my head while I still take notes. It’s amazing how well I’ve gotten at sleep-notetaking, where things still make sense and my notes are still coherent.

After some discussion with my histology group, our TA releases us into freedom.

9:50 am

We drag ourselves up the hill to the top of the True Blue campus. It is Wednesday, so the fruit guy is here. I pick up half a watermelon, a bag of starfruit, a bag of passion fruit and a bag of strange oranges that will probably last me until Friday if I’m lucky. I’ve been known to eat 5 passion fruits in one sitting, especially when reviewing biochemistry.

10:14- 10: 29 am

I sit in my room, check email, read whatever headlines I deem lucky (What the hell is happening in the stock market??), then I usually opt for a nap until noon if I don’t sit at my desk reviewing anatomy before class at 1pm. Indeed, today is a day for a nap.

12 pm

My friend wakes me up via text message well after my alarm clock was supposed to. No worries, I’m just in time to prepare my lunch and snacks for the afternoon. I gather my wits, get dressed and prep for the daily chunk of lectures. I happened to make chicken spinach pasta salad last night so I have snacks for the afternoon. Usually, I make myself a sandwich at this point or eat a vegetable Roti (basically an Indian burrito), but today my roommate happened to be making egg and cheese sandwiches. We eat our delicious sandwiches quickly, practically in silence, then head out the door to Charter Hall.

It’s hot and humid still and I still can’t wear my sunglasses since they are foggy.

1- 5pm

I have back to back lectures all afternoon everyday with changing topics. Today I have two histology lectures on the digestive system and two anatomy lectures on GI and peritoneum. We get 10 minute breaks between classes, where I usually take a seat outside the lecture and eat usually a half sandwich and fruit over the course of 3 separate breaks, but today I have pasta salad and starfruit.

5 -7: 30pm

Right after class, I walk with my roommate to the local coffee shop, Mocha Jumby to review what I just learned and read the textbook. I treat myself to a white chocolate mocha for 10 EC ( 4 bucks). I read and notate until 7:30 pm, walk back in the dark to eat dinner then head back out to study.

Usually on Wednesdays, I attend two DES sessions on anatomy and histology, 6 and 7 pm respectively. These are optional small group sessions to go over classes in groups with an upper termer leading. But since we just hand an exam, I skip the sessions for some readings.

We walk home past Taylor study hall. I peek through the windows to see how crowded it is.

7:36 – 8: 25pm

Time for dinner and shower. Seeing that we are oven-less and pressed for time (any time not studying is just time lost), we decide on curry fish, being frozen fish and  curry packet. Mmm.. delish.

I take a shower since the day was too humid not to and now my bangs are permanently stuck to my forehead.

8:30 pm-

I head over to Taylor Hall to claim my window facing cubicle to review anatomy notes from today and read about the digestive tract. My goal is to get through it all before 1 am.