pictures... (maybe)

Some of the Chapati and eggs cooking action. Daren and Jennifer (from the Global Health Resource Center), if you are looking at this blog entry, yes, I did get permission before I took the picture.

A breakfast joint we ate at in Jinja. It is essentially like Denny's only the food was way better. We got a really good egg, tomato, and cabbage chapati for about $0.66, yes, yes, I know you are jealous.

Me waiting in Kampala for a minibus. Good times.

The fabulous Annie in our minibus on a day excursion to Jinja to see the source of the Nile.

Me in the back seat of the minibus with two of the Swedish Medical Students - Sofi and Theresa. They are really nice and lots of fun. The Swedish medical education system is different from ours. But Sofi and Theresa are 5th year medical students so they are essentially first year residents in the US system.

Annie and I in our sunglasses enjoying the view of the Nile and relaxing a bit.

Update:

Today Annie and I went to the hospital for what we thought would be our first day observing in the trauma ward (we were prepared for an exciting and scary day). However, it turned out to be a national holiday ("Hero's Day") and all of the senior medical personnel took the day off. Note to the wise: DO NOT get injured in Uganda on a national holiday! Our coordinator at the Hospital met us and introduced us to some medical students from Northwestern University. We got a short tour of the hospital and a motherly talk from the coordinator about safety in Uganda. This talk included a Strong emphasis on if we wanted to "enjoy ourselves" in Uganda to be sure and use a condom because there is lots of HIV and STIs here. It was pretty funny. Don't worry, I don't plan on "enjoying myself" in Uganda that way. However, it seems like the coordinator has had some experience with students who have. I guess sometimes travel abroad students don't make the best decisions.

Birthday pictures

The afternoon before I left for Uganda I got a surprise birthday party at my house from some of the girls in our first year medical school class. It was so nice! They called me up and asked if it would be OK if they stopped by for a minute to say goodbye and it turns out they had a whole party planned! It was a welcomed distraction from my packing mania.

Don't worry Mom, we are drinking lemon soda, not alcohol. :) From left to right Julia, Maria, me and Amy. Julie was taking the picture and Nelly was just off to the right.

Julie even made me a homemade chocolate birthday cake. It was so sweet. They gave me a signing card a some things to take to Uganda with me. Thanks everybody! It was so nice!

I am in Uganda!

About 4 hours ago I landed safely in Uganda (via an Ethiopian Airlines flight from Addis Ababa, the capital of Ethiopia). Annie, the UW med student I will be working with in Uganda, and a driver picked me up at the Entebbe airport. We drove about an hour to Kamapala (the capital of Uganda) and put my luggage in the flat we will be staying in. Annie and I will be staying in a flat with 3 medical students from Sweden. They are all really nice and lots of fun. We have cold running water and electricity most of the time. We are about a 30 minute walk or a 5 minute mini-bus ride to the Hospital where we will be working.

Starting Monday Annie and I will be observing in the Trauma ward of the hospital. (Sort-of like the emergency room in US hospitals). I guess it gets a lot of car accidents and things like that. I will tell you more after our first couple of days.

After a week Annie and I will start our rural experience (called a COBES rotation) where we will be observing the Uganda health care system in a rural clinic. As part of the UW medical student program I will have to come up with a project to implement in the rural area during our 4-6 weeks in the rural area. I think it will be lots of fun!

Whoo! paying $9.99 for 2 hours of internet

I am currently waiting in the DC airport. I have already have had 5 hour flight from Seattle to Wa DC. My next flight is to Rome. his flight continues on to Addis Ababa (for a total flight 16 hours). I will then stay overnight in Addis and take a flight to Uganda in the morning. Since I am relatively behind on my email and other computer/internet to-do list items, I decided to pay for the internet during my 2 hour layover in the DC airport. I a slight case of sticker shock - it is costs $9.99! Yikes! That is my new way of passing judgment on airports I visit - whether or not it costs money to use wireless internet. It costs about $8 in Seattle and apparently it is even more expensive here. However, it was free in the Portland airport. Apparently Oregon is even more generous than its lack of sales tax.

It is interesting how the introduction into East African culture begins even before you get on the plane. Sitting in the waiting area there are numerous individuals of Ethiopian origin who are waiting for the flight. There is a very beautiful older Ethiopian woman sitting across from me who is dressed in the traditional clothing. (I guess Ethiopians frequently dress up for the flights). She has a little red sign hanging around her neck that says, "Please Help. I don't speak any English. If I am by myself, help me find where I should go or someone who speaks Amharic." However, I don't think this woman has much of a chance of getting lost, as she is surrounded by about 5 younger Ethiopians who are talking to her and bringing her things. I think it will be a fun flight. :)

MY CLASSES for fall quarter. Yikes! it is getting worse!

HUBIO 540: Cardiovascular System (6 Credits)

Interdisciplinary approach to cardiovascular medicine, including anatomy, physiology, radiology, pathology, medicine, and surgery. Function of the cardiovascular system in health and disease.

HUBIO 541: Respiratory System (4 Credits)

Interdisciplinary approach to the respiratory system, including anatomy of thorax and lungs, ventilation mechanics, blood-gas transport, gas exchange, acid-base balance, and the physiology and pathology of obstructive, restrictive, and pulmonary-vascular diseases.

HUBIO 542: Introduction to Clinical Medicine (4 Credits)

Advanced instruction in interview technique, history taking, and physical examination, with emphasis on detection of abnormalities.

HUBIO 543: Principles of Pharmacology I (5 Credits)
Includes general principles of pharmacology and the specific pharmacology of major drugs acting on the autonomic and cardiovascular systems.

HUBIO 544: Endocrine System (3 Credits)

Normal, gross, and microscopic anatomy and physiology of the endocrine system. Illustrations examining the clinical relevance of homeostasis, feedback, and other controlling mechanisms previously learned. Endocrine integration of metabolism. Clinically important endocrine pathophysiology.

HUBIO 562 : Urinary System (4 Credits)

Anatomy, physiology, and pathology of the kidney, ureter, bladder, and prostate; pathophysiology and treatment of common fluid and electrolyte problems; renal pharmacology; major clinical urinary system syndromes, with current diagnostic approaches and therapy.

HUBIO 567: Skin System (2 Credits)

Gross and microscopic anatomy. Physiology, protection, temperature control, pigmentation, and photosensitivity. Pathology and genetics of skin abnormalities, including tumors. Introduction to clinical evaluation, including physical examination and illustrating examples of inflammatory, vascular, immunological (including drug hypersensitivity), and neoplastic diseases.

MHE 511: Medical Ethics (2 Credits)

Ethics course designed especially for first-and second-year medical students. Study of ethical problems arising in clinical setting of medicine, introducing students to philosophical analysis and argument in practical contexts. Seminar-discussion format with readings from contemporary authors.

PEDS 505: Preceptorship in Pediatrics (1 Credit) At the Pediatrics Infectious Disease Clinic at Children's Hospital.

I don't know how many credits that is because I can't count that high. I think it might be over 30 or something like that. Gosh - medical school is making me dumber.

I am really looking forward to the peds preceptorship.

Happy People

So this weekend I was studying for a concurrent exam, that is, a test in all of our subjects at once. We have had then all year and they are very stressful to study for. However, this weekend it was particularly difficult. After weeks and weeks of rain, wind and cold dreary weather we had an absolutely beautiful weekend (the curse of spring quarter). It was sunny and in the 80s. It was perfect weather for going outside for walks, boating, or doing just about anything outside. Unfortunately, the first year med school class couldn't appreciate the sunshine like the rest of the world - we were studying for an exam covering 3 weeks of material in both of our classes: Neuroanatomy and Microbiology. Both classes are challenging, but for me Microbiology is especially difficult to study for because it involves memorizing countless details and can bee a bit overwhelming at times.


On Saturday morning I was sitting in the Health Sciences library studying micro. (Editor's note for understanding context of this blog entry: with a few modifications the UW Health Sciences Library could double as a a dungeon in a 14th century castle. It is dark and dreary and and the air smells a little stale.) I just happened to be sitting at a desk next to a window with a particularly good view of the Burke-Gilman trail that runs through Seattle. In my state of studying delirium, I kept getting distracted by all the people who were walking, biking, running, etc out on the trail. They all looked so happy! A man and a woman jogging together pushing a cute little stroller with a baby and laughing as they were enjoying the weather, girl walking her dog, a group of friends biking together. After looking up from my microbiology notes for the 100th time to see the wonderful glow of happiness spread across their faces I started to resent these people who dared enjoy the weather while I was stuck inside studying. I sort-of felt like I was in prison. There was no way that I could go out and enjoy myself like all those happy people and still do well in my classes this quarter. Then I thought: I actually voluntarily asked to place myself in this prison of learning! What was I thinking? At this point I actually had a very vicious thought: These happy people could get skin cancer from spending the day enjoying the sun. Then the happy people would regret this blissful Saturday of sun enjoyment! (Mwahahahaha = evil laugh). They might even have to come to a physician who spent their sunny days inside studying like me. Then those people would me thankful that I had spent my beautiful Saturday sitting the health sciences library and becoming vitamin D deficient while studying dutifully for my Medical school courses! Oh, yes, it could happen. Or perhaps, they are wearing sunscreen and will be able to completely enjoy themselves without the risk of any adverse health problems... probably more likely. *sigh* I really can't win.


Epilogue: I decided to leave the depressing walls of the health sciences library and return home to study out side on our little square of grass in our front yard. I probably didn't get as much studying done but I was much happier and I still passed my classes so it all worked out.

Important note: Although I really do enjoy complaining, I am still very glad that I am in medical school and there is no other place I would rather be. I look forward to the day when all my days sitting in class and studying will actually pay off and I will be able to help sick people and make the world a better place (or something like that).



(note: some times my blog entries get published after I start the first entry because it is waiting for some finishing touches, come back to look at old entries if you want to make sure you don't miss any).

My Super Smart Cousin = Hannah

This weekend I went to my cousin Hannah's graduation party. She graduated from St. Martin's with a Bachelor's in both Mechanical Engineering and Math. She is super smart and had so many hoods and honor cords she could barely stand up!


Here I am with Hannah! Our cousin Crystal and her family flew out too. Thanks to all of Aunty Deborah's family who put on the party.

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.