Fourth MedPrep Shadowing

It's FINALLY a bee-oo-tee-ful day in St. Louis! Happy Halloween everyone and take advantage of the SUNSHINE!!~

List of patients from last night:
- 78 yo b male with a sharp pain in the left buttock. Possible gout, no sign of fractures from xrays. Fell a month ago and injured left hip. He was very certain he knew me, but I have never seen him before. How darling : )
- 62 yo b female with sharp knife-like pain that comes in bouts, described as "heart spasms." COPD (emphysema), CHF
- 52 yo b male with CHF, ready to go home
- 81 yo w male with an awesome German name that my resident could not for the life of him pronounce haha, h/o dementia, bipolar (seemed fine and alert to me), was just released from the hospital 3 days ago but experiencing chest pain again (heart trouble)
- 63 yo b male with depression, he seemed pretty content at first since he looked like he was smiling. There was no room in EM-1 so they stuck him in a wheelchair outside room 8. After a while he just broke down and it was so heartbreaking watching him cry. He was saying things like "I'm about to lose my godd*** mind" and "I need to go to the crazy house." He apparently reeked of alcohol and after a field trip to TCC, he was collapsed on the floor. He had fallen out of his wheelchair and several doctors helped him to a bed. Poor, poor soul. I really wanted to go over there and hold his hand and comfort him but I knew it wasn't my place. My resident didn't really seemed concerned. I suppose a life of medicine makes your empathy harden a lot.
- 47 yo w male with urinary infection (catheter) and and weakness in both legs. He was unable to lift either leg higher than a few inches. Waiting on MRI results.

Heroes: Season 4 Episode 6 "Strange Attractors"

Okay, random change of topic to the nitty gritty. Okay, I admit I watch TV now, and quite a bit more than I probably should with my workload. But as a crucial keystone in American culture, IT IS ADDICTIVE. This past summer, I watched all 3 seasons with mixed feelings (major props to Season 1, indifference/boredom towards the other two).

- Spoiler Alert -



So in Season 4 (Volume 5: Redemption), I have been relatively unimpressed until now. There seem to be a ton of unnecessary CG effects that I roll my eyes at because it only screams, "Hey, we ran out of good ideas for the script. Better luck next Monday!" I mean, come on, the rainbow swirlies that are supposed to be synesthesia? I have friends who see colour with sound and they definitely did not describe such a flamboyant phenomenon. It's actually supposed to be more like a large spot in the visual field of a certain colour. There have not been many introductions of new abilities, and they have all seemed relatively lame. Ooh .. I can make a big hole in the ground and split earth. Fancy schmancy-pants. The tattoo girl Lydia is strikingly beautiful, but what kind of a weirdo ability is that? Stalking people via magical ink? I was waiting for NBC write something worth watching.

So it came. In "Tabula Rasa," there was the much anticipated ClairexGretchen in full bloom. I read an article before Season 4 even ran about Claire Bear's new lesbian love interest and I scoffed during the preview, dismissing the article as uncouth for lack of a better term. Then it happened, in front of my very own saucer-sized eyes. Whattttt. REALLY!? I could not believe what I was seeing and yet I couldn't tear myself away from the screen. Not that I get excited from seeing girl-on-girl action, but I just could not believe that NBC was going to pull an OC. I don't even know what to think of this now, as an attention getter with something new, some social commentary on college experimenting, or just a pathetic last-ditch effort to get actions down into script. In "Strange Attractors," the love story plays out like a junior high crush, painfully awkward but at the same time, calling for a big bag of popcorn. Speaking of which, what's with Drew Barrymore and Ellen Page kissing? I was too scared to read the article in Marie Claire ... they CLAIM it's to promote their new movie ... what kind of twisted culture do we live in if you have to do that (and are willing to so cheerfully) just to reel in a few more million for premiere weekend?



I also thoroughly enjoyed Matt's attempt to try to rid his mind of his Sylar issues with plenty of alcohol, only to have the tables turned on him even more. I must admit, Zachary Quinto has been absolutely fantastic in his role - it's true actor's talent through the crazy frenzy of roles and personalities he's had to adopt on the show. I noticed Janice lost a lot of weight, which was kind of weird ... but not necessarily a bad thing.

Samuel (aka pissy Father Earth) definitely has a very familiar-looking face, but I couldn't place it. Turns out, he's an actor I've never seen before, but he certainly looked the role of grown up goth kid. I don't really know what the writers are trying to say with his quest to search for another memory of the family, always, but I'm sure a lot of the scenes shown thus far can relate to religious references, though I won't go there.

When Jeremy accepted punishment for his wrongs, it was moving and stupid at the same time. However, some people are really like that - they will voluntarily pay for the consequences of their actions even if there's an easy way out. He reminded me almost of the 5 young boys who confessed to the rape of the Central Park jogger some years ago when DNA evidence proved that they had absolutely nothing to do with the victim's assault. The gruesome image of the 17 year old healer/killer having been dragged along the asphalt was brutal and yet probably an accurate reflection of "don't mess with me" Southern attitude. I know in Oklahoma, if you are on someone's property when you shouldn't be, you will find the long barrel of something unpleasant pointed between your eyes faster than you can say "cow-tipping." It's pretty disgusting how "an eye for an eye" still applies today, even if it's for your neighbor down-the-street's eye, nowhere near yours. However, I don't think there is any good way to punish criminals. Letting them rot in jail only eats taxpayers' money, lethal injection seems too nice, electric chair too cruel. Easy solution: start behaving! The rules of order and chaos won't allow it, but it would be nice.

I know I might have caustically and very sarcastically put forth some viewpoints, but what's writing without some fire? Comment on what you think about Heroes so far or anything else you have in mind : )

Campus Y Catalyst: Physics at BMS

Today, I went with Catalyst to Blow Middle School in the week-long persistent drizzle (I know, just an awful name for a school) to teach the kids some physics. The group consisted of about 12-15 African American students. I think my favourite was James, who upon our entrance stood up to compare heights with one of the other volunteers. Our team leader, one of my good friends, said "Well, at least you're taller than Angie." To my surprise, James came to my defense, asserting that he "should be nice to girls since we all came from a girl." What a darling. He also made everyone laugh by pointing out another friend's red highlights as "flamboyant." I think I really took to him because at the end of class, he asked me to draw a cartoon of Bart Simpson and Peter Griffin doing science experiments and I promised dutifully.

We reviewed the three Newtonian Laws, which I never learned properly in middle school, and certainly don't remember the details from AP Physics, so I actually learned along with the kids. Then we taught balanced forces vs unbalanced forces using examples of cars and fat (sorry - "heavyset" as per James) people being launched out of a cannon. I was surprised how much the students retained from 2 weeks ago and how they could state the First Law verbatim. It's kind of difficult to explain hard science in terms children can understand, so I understand how teachers may struggle with "dumbing down" a subject. However, I didn't want to underestimate their abilities, so I tried to relate some of the principles to equations like F = ma, since they understood the concepts of mass and force pretty well.

I think children should always be challenged to be better than what they can be satisfied with. No matter how many school lobbies have security checkpoints and guards on duty 24/7, no matter how many free lunches are handed out, it shouldn't and doesn't stop children from striving. I heard some of the students today talking about university as a future goal and James fervently encouraged his classmates to listen to us because we are "such educated people." I don't feel like I deserve such a pedestal. Sure, I can name all the steps of glycolysis easily, but I didn't even know the difference between unbalanced forces and balanced forces before today's session. I think volunteering is a really humbling experience, as much as that statement is cliche, it is definitely true. You realize that you are absolutely better than no one else deep down. You realize that you can learn more from bright-eyed children than from all the college textbooks in the world.

Catalyst: Campus Y Volunteering

Today, I went to my first session of Catalyst volunteering at Lift for Life in downtown St. Louis. My team leader drove the broken down white Mitsubishi, equipped with caved in roof, automatic seat belts, and powerless everything. Along the way, we met some traffic on the highway and a broken down school bus, which meant all cars in line had to three-point u-turn. Disaster averted?

When I arrived, the classroom was filled with maybe 7 - 10 girls, all African American, all with their own style. Today we applied the scientific method to the infamous and outrageously fun Mentos + Soda experiment. I goofed on explaining independent vs dependent variable ... (way to go, college student), but the girls didn't care. They wanted to watch some fizz.

We brought 5 2-liter bottles of soda outside into the grassy area at the far end of the parking lot (there was a cute little pond with water lilies too and the ladybugs were out on this BEAUTIFUL day): Schnuck's knock-off brand style - Ginger Ale, Sprite, Coke, Diet Coke, Cream Soda. When we dropped in the first Mento into the Sprite, the girls didn't expect the soda to explode like some crazy volcano. Cue squeals and laughter. They all rushed and shoved to drop in more Mentos as we tried to get them to observe the scientific patterns - caffeine vs caffeine free, amount of sugar (or sweetener), amount of sodium. Turns out, the minty outer layer of Mentos reacts with the CO2 in the soda and boom! I've always watched Youtube videos of the synchronized Diet Coke and Mentos fountains but it was nice actually doing the experiment. We also got the girls to lick off the outer layer of the candy before dropping them in, and to their dismay, there was no explosion. Some of those sodas rose 1.5 feet up from the bottle opening. I miss when science felt so exciting and hands on, not like the sheer terror of being marked off points in Chem Lab.



While we were conducting the experiment, I think there was some shady business going on in the back alley next to the grassy area. That makes me reflect again on how spoiled we all are compared to these kids. The front door to their school is locked at all times, and drug deals are taking place during class? That's not how elementary kids should grow up. I felt very happy watching those girls learn science and have fun, totally disregarding whatever socioeconomic hardships they may have to deal with. I will definitely be returning to volunteer and give back to the community, as cheesy as it sounds, but honestly (and selfishly), it feels so good to share the love!

MedPrep: Third Shadowing (TCC)

Today is Fall Break - the day of well-deserved rest and laziness, spent sleeping in, eating food at a table instead of grabbing cookies on the run, and ... shadowing. I have to admit, I wasn't the most alert during my three-hour session in Truama/Critical Care and kept glancing at the clock. But then my resident said his shift is 7 PM to 7 AM, so I stopped mid-yawn and looked at more charts. It's really a great privilege to be able to watch physicians as they work, so I definitely don't deserve to be a bratty, pampered bored student.

Here's the rundown of patients:
- 21 yo b male with GSW to the face and arm. Looking at CT scans, the bullets were located in the neck and chest areas, but very luckily missed major arteries and the lungs.
- 19 yo b female with ulcerative colitis, blood in stool. Prednisone and imupan
- 27 yo b female with HIV, current bacterial infection that is making her ill and weak
- 55 yo b female with IBS and every pain complaint and allergy (even epinephrine?) you can think of, recently recovered from pneumonia, refused to take tylenol
- 50 something yo w male who was run over by a van. Fibula fracture but seems fine and alert
- Digging out a sample from the biohazards bin that was accidentally disposed of by someone. It was pretty funny watching my resident and the ortho surgeon going at it with OB/GYN forceps.

MedPrep: Second Shadowing (EM-2)

Tonight, I shadowed in Emergent Care 2 at Barnes Jewish Hospital as a finale to my crazy stressful 2-week examfest. I went on a pretty empty stomach, so I was intensely hungry by the end of my shift. My attending gave me a piece of chocolate, which I wolfed down immediately, but it didn't last very long after having to see one of the patients extensively. St. Louis gets dark really early nowadays - about 7 PM, it is already pitch black. This makes walking around at night very shady and intimidating (I have this irrational fear of getting shot now, but at least I'll be close to the hospital).

Patients observed:
- 41 yo b male with a brown recluse spider bite. There was a ring of flesh melted away from the venom. Diameter of bite maybe 3 inches. He was quite happy to show me the wound and was just sleeping in his bed when he was bit.
- 96 yo w female who fell while getting out of bed. Right hip rotated, possibly fracture in right ankle. Complained of headaches, was generally quite out of it.
- 70 yo w female, hyperglycemia (diabetes I) w/ finger stick blood sugar > 500. Constant vomiting brown-red liquid, complained very often of being cold and thirsty. Later, blood sugar dropped to 260 but still vomited. When urine sample was analyzed, found she had blood in her stomach.
- 39 yo w female, deaf, first pregnancy but quant hormone levels indicate she was miscarrying. Very very early pregnancy with mild bleeding and cramps. Test to see if she needs Rhogam to make sure she is not immuno-rejecting the embryo (rh+), or if the embryo implanted outside the uterus (fallopian tubes)
- 27 yo w male, 106 lbs (extremely thin) with Crohn's disease, which creates problems in the intestinal lining (inflammation). Had surgery and open wound started leaking fecal materials after eating a hamburger. The wound was ~ 5 cm deep and at least 6 inches across. This was the most graphic part of my evening - the whole room smelled of bowel after a while. What surprised me the most was the young man's tolerance for pain. He was also allergic to many antibiotics, so treating for the bacterial leaks into his stomach is difficult.

I am so tired! However, I really have no right to complain after seeing how hard emergency medicine doctors work day and night. Nevertheless, TGIF! I am ready for a low-stress catch-up weekend before the next round of mental bombardment.

Dropping a Course: Learning to Say "I Can't Handle It"

This semester, I've already met a lot of difficulties, primarily in the time management and academic category. Last Friday, I had a Chinese midterm (moved from Monday, you'll see why), followed by a Cognitive Psychology exam at 10 AM and the first Organic Chemistry exam later that day. Wednesday (still the same week), I managed to fail my first college exam (49 in Calculus 3 is an F) because of lack of preparation. This is a huge shocker for me - I'm still adjusting to getting B's but an outright fail only waves a giant STOP sign. So stop.

During calculus, I felt extremely ashamed picking up my handwritten questions in person (the professor was handing them out lovingly). I didn't know how to graph in 3D because I didn't study for it. I glanced up at the Powerpoint displaying the curve and I was on the low end of the tail. I'm really not used to the panicked "I don't know!" when I open an exam packet and flip through the pages searching for something I know how to solve. It's a terrible feeling that I've only experienced a few times before: during the ACT Science section, Calc BC AP exam, and my Chinese final last semester. This past week, I had plenty of freaking out from Orgo (highly distracted by background noise like a girl's clanking bracelet) to Calculus (choices A - J aren't exactly conducive to getting full points on multiple choice by guessing. I knew how to do each problem, but it just wasn't clicking with the numbers. I was tired. Dead tired.

During lunch, I suddenly realized that Calc 3 might just be my problem. I don't like math, especially calculus, and no matter how much effort I put into attending to lecture, it just doesn't click like it does for other people. I originally thought Chinese was the problem child, with all the crazy memorization of vocabulary and all-too-frequent quizzing. But I actually really love learning languages and feel proud when I do well in Chinese. So I emailed my four-year advisor and my MedPrep professor (who does med school interviews at WashU Med) about my dilemma and they both agreed that the doomed "W" is better than an overall 2.0 semester GPA.

I felt so much relief and HAPPINESS for the first time the entire week! That was quite possibly one of the better feelings invented for this universe. I called my dad later that evening and we talked for 2 hours. He gave me motivation to continue pushing through to look forward to medical school and used cute analogies like "You're a new car now. Remember to change your oil and don't just keep gassing the pedal if you need to stop." He's absolutely correct. If I stress out and get sick now, what happens in 10 years won't matter anymore. I miss my parents and really appreciate how much they support me these days. If it weren't for their upbringing, I probably wouldn't expect this much out of myself, but if it weren't for their support now when I really need it, I'd hate to see my state of mind.

So the game plan is to take Calc 3 some other time, either at WashU or UCSD to replace that "W" if I can. My MedPrep professor said that some med schools view it as an automatic F while others don't care at all. So if I can't replace it, come time for med school interviews, I'll be ready with the truth: sometimes you really need to stop comparing with everyone else and know your limits. Those crazy international kids were put through intellectual boot camp since they were swimming in amniotic fluid - the environmental influences are definitely different.

I'm going to work hard to do my best in all my classes now that I have a slightly lighter course load. There is less room for stress, and more time to live the good life.