Idea for the show "Dirty Jobs" - rectal exam volunteer

This quarter we learned the basic physical exam. We are going to learn the advanced/full exam in second year, but I guess they wanted us to get down the foundation of clinical skills as we wrap up our first year of medical school. We learned it under the umbrella of our "Introduction to Clinical Medicine" course which we have been taking all year (and is completely amazing - see previous posts). We start out the physical exam sessions in the lecture hall where we watch a video segment of the part of the exam we will be practicing that day. Then one of our ICM professors goes through a powerpoint about the exam and some of the pathological findings for that part of the exam. Then we break up into groups of 8, 6 or 4 students and a 4th year student med student goes through the exam again and helps us as we practice that day's part of the exam on each other. We have varying levels of skills and different people are easier to perform the exam and find things on than others. So far I am really bad at being able to see the optic disk at the back of the eye. However, we are learning a lot and seem to be doing better each week. At the end of the quarter we will have to perform the complete physical exam (minus the breast and genital parts) on a fellow student in front of a faculty examiner within a 25 minute time limit. I think it might be a bit challenging. We practiced it last week and it took me 45 minutes and I forgot 3 things. Hopefully I will improve before the exam!

We practice all of the exam on each other except for the breast, rectal and genital exams. (whew!) The medical school pays volunteers to come in and allow us clueless med students practice the female breast and male genital and rectal exam on them. For the breast exam I was sort-of nervous and my hand was a little sweaty so during the exam my hand kept sticking to her breast. Awkward! However, the model was really nice and it went much better than I anticipated. Hopefully with a little practice I will be less nervous/sweaty when I do the exam on my first real patient.

The male genital and rectal exam model was really nice. He had been doing this for like 10 years and he was very calming and helped coach us through the process. That physical exam session definitely ruled out a specialty for me though - I now know that I can't do a urology sub specialty. My short stubby fingers aren't long enough to reach around to the top of the prostrate, which is a definite requirement for the practice of urology. Don't worry, I'm not crushed because I never wanted to do urology anyway. It was just an interesting discovery.

Anyway, after this last physical exam lab, it came to me that being a rectal exam volunteer for first year medical students might be a good episode for the show, "Dirty Jobs." Although our volunteer was very calm and extremely nice, it could hardly be comfortable to have your prostrate felt by 10 students in the span of a couple hours. It also could hardly be classified as a "clean job." Just a thought...

Pictures!

Here I am holding my sutured pig foot. Didn't I do a nice job? Ok, don't answer that unless you are going to say something positive. It is harder than it looks! :-)

Here is Erica, one of my first year classmates doing some stretches before the suture fun began. She was right across from me so I got lots of pictures of her.

This is Ezra, another one of my first year classmates. He speaks fluent Japanese and he and his wife have a couple of beautiful young children.


Fellow classmates are suturing.

Another table suturing.




This is my classmate, Erica, and her fiance, Jake, who is a second year medical student. Erica did really small sutures. Maybe she is destined for plastic surgery....



Sort-of unrelated. This is a picture of me with my preceptor for this quarter, Dr. Beard. He is really nice and an amazing family practice physician. I have learned a lot from him this quarter and I hope to work with him in the future.

Chickenpox, Pluto, and gas prices - feeling old

Each day I feel older and older. I guess technically, I am getting older each day, but there are moments when the realization of time passing suddenly strikes hard. For example, yesterday in microbiology we learned about chicken pox (Varicella zoster) and our professor told us it is now a reportable disease. When I was about 7 years old all of my friends and I got horrible cases of chicken pox. This was considered a good and normal event, because our parents wanted us to get it when we were young. A couple years after my week-long chickenpox nightmare experience, the chickenpox vaccine came out eliminating the need to go through this fortifying childhood experience. Now due to the vaccine, chickenpox is so rare it is a reportable disease, meaning that if a physician sees a case of it he/she has to notify the public health department. It seems just like yesterday that I was sitting home from school completely miserable trying not to scratch the hundred of red lesions all over my body. My, how time flies.

Chicken pox, which is apparently now a very rare disease to see. (picture from Google image search)


Another event that makes me feel old is the demotion of Pluto to a dwarf planet. I feel that learning about the "nine planets" was an important part of my childhood akin to learning the "ABC song" and how to count to 20. Now children learn about the 8 planets (see figure below). Doesn't it just feel so wrong? What are kids going to say, "My Very Excellent Mother Just Sent Us Nine ___(nothings because Pluto is no longer a planet to make the whole 'pizza' thing work) ___"??? There is no longer anything to serve and there are no longer nine things. Educational crisis. Maybe they should focus attention on trying to teach kids how to read and do math instead of devaluing innocent celestial bodies.

To cope with my grief, I joined the group on Facebook entitled, "When I was your age Pluto was a planet." If you are going through a similar planet induced age identity crisis I strongly recommend seeking out a similar support system.

New solar system classification system (from Google image search). Apparently there are now 8 planets and 3 dwarf planets for a totally of 11. I can't keep up with it any more.

Poor demoted Pluto (from Google image search). We old timers still care about you...

Lastly, I feel old (and slightly panicked) whenever I see a gas price sign. When I started college in 2000, gas was $0.98 a gallon at the Chevron Station across from the college I was attending. I looked up at the sign and thought that I should probably bring a camera with me the next day and ask someone to take a picture of me under this sign because the price of gas would probably never be under a gallon again. I didn't bring a camera, but I was right, gas prices were never that low again.

Gas prices are even higher than this now (picture from Google image search). I think it was around $3.79 a gallon the last time I filled up my tank.

Congratulations, Granny: Winner of Exciting Story Competition

Congratulations, Granny! She was the winner of my exciting story competition: "How Christy Broke Her Nose"

The following is a completely fictional story written by Granny:
(she got extra points for imagination and heroics on my part)

"Christy was observing her third autopsy at UW Medical School. She was one of those gathered intently around the unfortunate patient.

The patient suddenly shot upright and swung his arm outward and backward. All the doctors were frozen in horror at this grotesque event. Dr. Christine Harris' nose was bleeding, hit by that unexpected blow!

In spite of her pain, Dr. Christine knew immediately what to do. Taking charge, she firmly pushed the patient back down on the table. Everyone breathed deep sighs of relief. But they all had to pause to consider: Was this simply a dead man's reflex or are we autopsying a still-alive gentlemen? What do YOU think?"

Me and Julie and my broke nose :>)

Most people say that my nose doesn't actually look that different after it got broken. Thanks to my preceptor who bravely set it! It is a little swollen and slightly deviated to the left, but all in all it is pretty much the same. I still enjoyed going to the med school social at the Space Needle. Here I am with Julie.

I wasn't really ready for this picture and I was sort-of looking off to the side. However, I decided to post it anyway so you could get see some of my other med school friends. From left to right: me (spacing out), Julie, Maria, and Emily. So slightly funny story: I have had this black dress for a while, but I haven't really worn it anywhere because I remembered trying it on several years ago and thinking it was too low cut/immodest (you can't really see any cleavage in it, but if you were standing above me and just of at an angle, you might be to see a little bit). I told some of my first year friends before the party that I didn't know if I was going to wear the dress because I felt like it was a little on the scandalous/immodest side. But the night of the social came and I decided to wear it anyway. I got the the party and some of the other girls were eager to see the "immodest dress" that I had been worried about. They laughed pretty hard when the saw the dress I was wearing and sarcastically teased me the rest of the night about my 'immodest dress' and how I was pretty much ready to work the streets in that kind of clothing. It was pretty funny.

More about what we will be doing in Uganda (possibly)

I have found out a little bit more about what I will be doing in Uganda this summer. I will be going with a girl named Annie who was also a neurobiology major at the UW before starting med school. She has done 2 years of research and she traveled extensively in Europe and Asia. She is really nice and seems like a lot of fun.

We will be working out of Makerere University in Kampala, Uganda. (see picture below).

Picture of Makerere University complements of BBC world news. BBC says that Makerere University is considered the "Harvard" of Africa. People come from countries across the continent to study there.

Aparently, Annie and I will be engaging in something called the COBES program and also observing some clinical work.

The description of the COBES program from the Makerere Handbook is:
"It has been recognized over time that it is critical for professional education to include a time when you are trained in the community, students go for COBES internship for 6 weeks. Students are sent to different health centres in a rural setting all over the country. This helps appreciate how the majority of our populace lives, thinks and what afflicts them. Students get involved in activities that help them understand people’s needs and concerns.

They also get an opportunity to participate in any non-governmental organization (NGO) programs, which may be in place in the community.

The approach to education based on the principles of small collaborative group learning, applying critical thinking and problem-solving skills will be maintained during your community placement period. "

Another enormous benefits of spending time at Makerere University is being able to observe amazing clinical work on AIDS and other infectious diseases. I am really excited about the trip and I hope to learn a lot!

Now, you know everything that I know about what I will be doing this summer. That didn't take long, did it?

"Cute" - what people say when they can't say "cool"

I got a car over spring break! Exciting, no? It is my very first car. It is (are you ready for this?) a 2002 Kia Rio. It is white (see picture below) and is in really good condition.

The med school told us that a car is pretty much required for 3rd year. Third year at the UW med school is when we start doing 6 week rotations in different hospitals in various specialties. Sometimes med students get off very late (ie 11:00pm or 3am) and bus aren't running or it would be unsafe to take them, so driving is pretty much your only reasonable option. Also, in second year they have us doing some interviews at the VA hospital which is pretty hard to get to by bus (3 buses from my house). So overall a car is pretty handy for shopping, etc.

Anyway, I started looking for a car a couple months ago. When I say, "I" started looking, what I really mean is I asked my stepdad who is a mechanic to start looking for me. My goal was to find a small used car that would be affordable, good for the city, have low mileage and that would get good gas mileage. Initially we found some good deals but they turned out to be lemons. One car looked like a really good deal, but it was owned previously by a chain smoker and my clothes smelled like cigarette smoke all day after test driving it. After some disappointments, Andy found an add in the local newspaper for a car right down the hill from us. It had only been driven by a little old lady to her job and back for a few years and then sat in her garage after she retired. It only had 13,000 miles on it and was in great condition. I bought it and I have been very happy with it so far.

For some reason whenever anyone sees my car for the first time they say, "Oh, it is so cute!" Andy says this is because they can't say, "Oh, your new car is so cool!" because it is a Kia Rio and a Kia could never be considered cool. Therefore "Cute" is the next best thing to cool. It is true that my car isn't the fanciest thing on the block. It doesn't have air conditioning, electric locks or windows, and is probably outshone by the 3+ Mini Coopers that park on our street. But whatever, it works for me!






Here is my car. Isn't it cute?
_________________________________________________________
Epilogue by Stephanie: (See posted comment) :)

Thanks Stephanie for making my car "cool"!!!!

Thanks University of Rochester! I got to visit Stephanie in San Diego

When I was applying to medical schools I received 4 interview invitations. The first was from the UW School of Medicine (my in state school) and the last was the University of Rochester School of Medicine in New York State (I applied there because I thought they had a very unique and innovated curriculum). I felt like my UW interview was a complete failure. It was a very stressful interview with 3 men firing questions at me from behind intimidating black notebooks. One of the interviewers never smiled or gave any sort of encouraging look during the interview. Probably everyone who knows me has heard about how I struggled to answer when the interview committee asked me why the UW school of medicine should accept me if I was going to just take their education and go to Africa instead of serving the disadvantaged in Washington State. Anyway, after the UW interview, I was sure I wasn't going to be accepted at UW bought tickets to go to all of my other interviews. However, 3 weeks later I was accepted to the UW School of Medicine and decided to cancel my University of Rochester interview (and leave for Africa on a great adventure!). The airline couldn't refund the money for my flight, but they gave me a voucher that I used to fly down to visit my friend Stephanie over spring break. We had a really fun time as the pictures below demonstrate .


Stephanie and I on one of the many beaches of San Diego.

Stephanie and I went "rock hopping" to look over the tide pools. We looked for the octopus, but he/she was not to be found. We did see some very interesting other sea life.

Another picture of the tide pools (the tide went out a little after this so we could get to more pools).

Stephanie also took me up to see a national monument for the dude that first discovered San Diego (Cabrillo). There was also a very cute lighthouse up near the monument.


We also went to Balboa Park and the San Diego Zoo. It was really fun.

Exhibit of medicinal plants.

This is Tony, Stephanie's boyfriend. He is extremely nice and a perfect match for Stephanie. He works for the Nokia phone company as a software developer. He carries at least two cell phones with him at all times and is very eager whip out the Google map function on his cell phone(s) if you ever need directions.

Stephanie and Tony together. Ahhh.... aren't they sweet?

Me and Stephanie together.... Ahhhh.... Warm fuzzy memories. My nose got a little sunburned while I was down in SD

Exciting story competition: "How I broke my nose"

Today, while at my Family Medicine preceptorship I broke my nose. It was quite spectacular due to the impressive nasal vascular supply, however, the true cause was lame and embarrassing. In search of a better explanation, I decided to post an, "Exciting story competition" on my blog. Email me or post a response to this blog, with an exciting story I can tell when people ask me how I broke my nose at the family practice clinic. Extra points for heroic acts on my side.

What is the reward for winning the exciting story competition? I will your story on the blog and whenever I tell the exciting story to friends and people who ask about my face, I will give you credit. :)

Pictures from class

Just in case you all were wondering how I spend the majority of my life these days. Here are some pictures from class.


My friend, Julie, and me sitting in the back row (I usually don't sit in the back because it can be a little distracting sometimes, but I did it this day because I had my camera with me). Julie was my lab partner last quarter during histology. She also came to my Gospel Choir concert right before Christmas.


This is Kevin and some of the other student that usually sit towards the back on the left hand side of the class.
This would be your view if you were in our med school class. I usually sit in the middle of the class where the 3 people are sitting in a row. You can probably tell from the powerpoints up on the screen that we are going through so enthralling material.

Somebody sent this out through our class email list. Can you find the sleeping med students in our first year class? (answer below)
Sleeping students circled. I guess the long hours of class and studying get to you after a while. You have to catchup sometime!