Practicing the knee exam

I thought I would share some fun pictures with you all. I have discussed in previous blog entries how our ICM II small group is our little med school family that we go to the hospital with and practice parts of the advanced physical exam with.

This quarter the second year med students are taking the musculoskeletal system (basically the anatomy and the most important stuff that can wrong with the arms and legs). Coinciding with our musculoskeletal course, last week we learned the "advanced knee exam" in our ICM II small groups. It was quite humorous in many ways. However, one of the most entertaining things was some of the positions you have to take with your "patients" to examine their knee for stability, etc. In one test you have the patient lay on their back with their knee bent and you have to sit on the patient's foot while you pull forward on their knee. In another test (the Apley Compression Test), you have the person lay on their stomach while you get up on the examining table with them and place one knee on their thigh while you pull and rotate their foot and then push and rotate their foot (looking for mensical injury). It made for some pretty fun pictures:




Here is Tara performing the Apley test on Sarah and Linnea performing the Apley test on Daniel. It was pretty funny.
Here are some close ups of Linnea and Daniel. Daniel's face is priceless!
Here is another pic of Linnea and Daniel. Again, the face!

Carmen

I went home to see my family over valentine's day weekend and our family's golden retriever, Carmen, was very sick. She was bleeding out her rectal/vaginal area, and her stomach was bloated and tender. She wouldn't get up, eat, or even wag her tail when you scratched her head. I was sure that she was about to die. Although there are many other things to be upset about in the world, I was really sad that our family's best pet was going to pass on - she was a really good dog. I made an appointment for Carmen to see the vet and told my mom to make sure that all the kids got to say goodbye to her before they took her in to the vet, because they were probably going to have to put her to sleep.

However, the vet examined Carmen and determined that she had an infected uterus (apparently is fairly common in golden retrievers who have never had their uterus removed). Although she was really dehydrated and ill, the vet thought the could still save her. They put Carmen on an IV, performed a hysterectomy the next day, and put her on some strong antibiotics. Now she is doing great and back to her normal happy self. My family sent me this video of Carmen so I could see how much better she is doing. As you can see from the video, even recovering from surgery (a little over a week ago), does not stop her from wanting to play fetch all the time!






(OK, I know that I am totally turning into an old grandma type when I start putting videos of our dog up on my blog)...

The best ICM II small group ever

Months ago I promised I would post a picture of my Introduction to Clinical Medicine II small group. Well, here it is (better late than never). Every second year medical student at UW is part of an Introduction to Clinical Medicine (ICM) small group. Once a week you go to the hospital with your group and practice interviewing patients (some weeks you get together and practice parts of the advanced physical exam instead of going to the hospital). The ICM II small groups are sort of like your own little miniature medical school family. About 5 or 6 ICM II small groups make up a College - a larger group of Med school students and faculty that do functions together and have peer advising together. (I think that some of this is a real effort by the university to make sure that med students don't feel lost in the med school system). The ICM II group's mentor is each student's own personal clinical teacher for each second year student within the group. Our mentor, Sam, is an awesome mentor/clinical teacher. He is nice and encouraging, but good about giving feedback when you need to improve on something.

Here is a picture of our ICM II small group (our miniature second year med school family). In the very back (with his face being blocked by my head) is our mentor, Sam. In the next (standing) row from left to right we have: Avi, Linnea, Sarah, and Me. In the next row from left to right we have: Julia, Daniel, and Tara.

Last year I posted a picture of Sam, Avi, Sarah, Tara, and myself. This year has been even more fun because Daniel and Linnea joined us as second year students from Alaska, and Julia expanded to our class from the third year class. It is so much fun spending time with them. We really do have the best small group ever!

Underserved pathway mentor, and all-round inspiring person

Do you ever meet someone really inspiring? I mean, really, really inspiring? I meet inspiring people all the time: teachers, volunteers, members of my family, there are tons of people who are dedicated to making the world a better place. I written in the past about people I find inspiring (check out my blog entry that I wrote last year 'Milly, my newest hero'). Since beginning medical school I have meet even more inspiring people. In particular, I have found people who are dedicated to providing medical care to Seattle's poorest and most disadvantaged populations very inspiring. Last year, I posted about how much I enjoyed my preceptorship with Dr. Huntington at the Haborview Family Med Clinic. A large portion of the population the Haborview Family Med clinic sees are immigrants (particularly from Somalia and Ethiopia), some homeless individuals and some poorer African American and Spanish speaking populations. Anyway, another physician who also works at the same clinic as Dr. Huntington is Raye Maestas. Dr. Maestas is the head of the Denali college and helps teach the Introduction to Clinical Medicine I course that med students take during first year. From these situations I already thought of Dr. Maestas as an incredible person, but as I learned more about what she did with the underserved I was even more awed.

Over half a year ago, when I started second year, I decided that in addition to the Global Health Pathway, I also wanted to do the Underserved Pathway because of my amazing experiences at the Haborview Family Med Clinic. When I filled out the Underserved Pathway application I asked if I could possibly get a mentor who works with immigrant populations or was from the Haborview Family Med Clinic and I included Dr. Maestas's name along with Dr. Huntington's and some other physicians who worked in the office. I was so incredibly fortunate that Dr. Maestas agreed to be my underserved pathway mentor. She is so inspiring. I have really enjoyed talking with her more and hearing about her advocacy work that she has done on behalf of the disadvantaged (she has done a lot with domestic violence and several other similar areas) and how she worked to influence policy on a larger scale.

Throughout recent experiences and seeing what amazing things family physicians can and have accomplished within poorer communities, I find myself being drawn more towards family medicine. I still might do peds (let's face it - kids are awesome!), but I really enjoy spending time with elderly individuals as well. There is something so calming and fun about seeing older retired people and hearing stories from the Great Depression and World Warr II. Also, it seems like it would be nice to be able to take care of an individual's entire family. Although it is not as high status, family medicine is also completely compatible with international work and being able to handle a wide variety of situations overseas. In another fun experience, we had a family physician come talk to our class from the Country Doc clinic in Seattle (it is a community clinic that also serves a poorer population). He was enthusiastic about what he does and told us that many people think that family docs don't specialize, but they are wrong. He said that as a family doc working in that clinic he become a specialist in poverty medicine. Which was a fascinating concept. I think that if I do have to split my time between working internationally in Africa and here in the States (for licencing requirements,etc), when I work in the states I want to work with poorer immigrant populations such as those seen at Haborview and the Country Doc Clinic.

We will see as I enter clinical rotations next year if I am still leaning towards family medicine. I am still keeping an open mind to all residency possibilities. I just thought I would update you on where my current thinking is.


A picture of my underserved pathway mentor, Raye Maestas, and me. She is also the head of the Denali College which our ICM II small group belongs to.

Among many other accomplishments she was recently honored in the University of Washington Libraries Women in Medicine Exhibit as a "Local Legend." Here is the link if you are interested:

http://www.nlm.nih.gov/locallegends/Biographies/Maestas_Ramoncita.html

"U.S. Assisted With Attack on Ugandan Rebels"

Here is a NY times article about the US helping the Ugandan army with an attack on the Lord's Resistance Army (the one that was attacking northern Uganda). This attack went awry and resulted in more civilian deaths. Here is the web address:

http://www.nytimes.com/2009/02/07/world/africa/07congo.html?_r=1&hp

This is a quote from the article:
"No American forces ever got involved in the ground fighting in this isolated, rugged corner of Congo, but human rights advocates and villagers here complain that the Ugandans and the Congolese troops who carried out the operation did little or nothing to protect nearby villages, despite a history of rebel reprisals against civilians.

The troops did not seal off the rebels’ escape routes or deploy soldiers to many of the nearby towns where the rebels slaughtered people in churches and tried to twist off the heads of toddlers."

Sigh, I guess some things don't changes (look at my earlier blog entries in 2007 to see what I think about the violence caused by the Lord's Resistance Army).

Carmel: Brother, Grandparents, Presentation and the Beach!

This last weekend I went to Carmel, CA to present a powerpoint presentation on my shoe project in Uganda. As you can tell from the pictures below, I endured terrible agony down there. (Did I mention that it snowed briefly the day before I left Seattle)?

This is the view from the hotel we stayed in. It was 65 degrees and sunny most days. UW paid for all of the student's airfare and hotel stays to encourage us to present our abstracts.

Saturday, after I presented I went for a 20 mile bike ride with some of my classmates down "17 mile road" and back. We were riding along the beach almost the whole time and it was really beautiful.
UW also put on a welcome dinner for us at Mission Ranch (Clint Eastwood's restaurant in Carmel). As you can tell from the picture, the food was pretty as well as delicious).


This was our program for the conference. OK, so I know this is a lame picture.
I also got to see my older brother and my grandparents while I was down in California. Here is a nice picture of Granny and Spiro.
Granny and me. We had fun walking outside even though granny had knee surgery recently.
sSpiro and me. I really enjoyed talking with Spiro again and hearing some more of his stories from the Great Depression. It is crazy how much our grandparents have been through/seen!