STEP I

Is coming sooner than I want to acknowledge. I just submitted my app. (Before I only got my Q-bank)

Yesterday

Was the day. The male UG exam. Remember how I said I was nervous? Well I wasn't nervous. I was really really nervous. So nervous I thought there was a grand possibility I might throw up or cry. I don't really know why. Not like I've never seen/touched a naked guy before.. even in the hospital setting. But the SP's make me nervous. And the cameras, and the possibility of getting a jackass for a student partner. Alas, all went well. I was originally assigned to a really irritating guy who was supposed to be my student partner... but the coordinator switched me to be with another girl in my class who seemed almost as nervous as I was. So it worked out well.

I'm not sure what I was worried about exactly. That I'd eff up and hurt the guy? That he would be so hot that I would get nervous and not be able to concentrate? That I would laugh? That he'd get an erection and I'd be embarrassed? I can say this is officially the first time I examined a guy's goods this closely while simultaneously praying he wouldn't get an erection.

Anyway, I survived. Lets just say I didn't have to worry about any of the things I originally thought... as I am fairly confidant my SP had no attraction to women what-so-ever... and when I began the exam without asking him to "bear down", he just shrugged and said "that's ok. I'm an expert at this".

Whew.

Tommorow

Doing my first Male UG exam. Ugh. Not going to lie... a little bit nervous. I just know I'm going to get the (really) old guy.

Today...

I got to see Dr. R (see side for description). She's awesome. I want to be her. And I still love love love love Emergency Medicine. How do I know its for me? This convo took place between her and one of the other chief residents:

Dr. R: So if you really like doing tedious things like calculating osmotic gaps, EM might not be the place for you.

Resident #2 : What's an osmotic gap?

Dr. R: I don't know. I saw it on a research poster in the hallway.

This is so me it's ridic.

How To Keep On Truckin'

I've received a few emails asking how on earth I managed to keep my morale up when I failed as a pre-med. Like failing an exam, bombing an MCAT, hearing disparaging "advice", and whatnot. I guess the answer is that I didn't. I mean everytime something happened, I was distraught. And totally devastated. I started combing through my back up plans, applying to random grad school programs, looking up internships, and fantasizing about running away to the peace corps or becoming a writer or a chef or an FBI agent. It was awful. Awful because I had little perspective or knowledge that the path to becoming a physician is a long journey... marked by failures and successes. I'd see a few classmates or colleagues get right into med school with no sweat, and so I thought it wasn't meant to be for me. And so I'd head in another direction... like research, or public health, or epidemiology.... something that I THOUGHT would make me happy... as these are parallel fields to medicine.

And sure enough, these fields would keep me interested for about 10 months. Then I was bored. Soon I'd find myself back in the med school mode... tagging along with physicians, fantasizing about med school, plotting my next attempt at the MCAT or applying to med school. It was a series of try, fail, hibernate, heal, plot, try, fail, hibernate, heal, plot, try, sort of succeed (YAY!), try harder, fail, blah blah.

So I guess the answer is this.

1) Try to keep "success" in perspective. Know that when you're "up" you should enjoy it while it lasts because there will be "downs" too. And when you are "down" know that it's just temporary until the next "up".

2) After a "down"... don't be too hard on yourself, and don't make any drastic decisions that will alter your med school plans. The feeling of wanting to quit is soooo intense you can often fool yourself into thinking that you don't want to do medicine anymore.... even if you actually do. Give yourself some time to really regroup, re-evaluate, and make a better plan of attack. Immersing yourself in "parallel" fields like public health, etc. are great because they help strengthen your application while you regroup and get your ducks in a row.

From One of Our Profs.... AFTER Thanksgiving :)

PATHOLOGIES RESEMBLING FOOD

FOOD PATHOLOGY	DISEASE	NOTES
Anchovy paste liver	Liver abscess	Amebic
Apple core lesion	Colon cancer
Banana Sign (cardio)	Hypertrophic Cardiomyopathy
Banana Sign (neuro)	Arnold-Chiari malformation	Abnormally shaped midbrain & elongated cerebellum
Bread and Butter	Pericarditis
Café-au-lait spots	Neurofibromatosis (I &II)
Caseous Necrosis	TB, histo, coccidio, crypto	Casesous = Cheese
Cherry Red appearance	Carbon monoxide poisoning
Cherry Red spots	Tay-Sachs, Niemann-Pick, Retinal artery occlusion	Macula
Chocolate cyst	Endometriosis
Coffee ground vomit	Upper GI bleed, PUD
Grape clusters	Hydatidiform mole
Hamburgery Sign	Uncovered vertebral articular facet
Honeycomb lungs	Eosinophilic granuloma, DIP, UIP, interstitial pneumonitis associated with collagen vascular diseases, asbestosis, berylliosis, sarcoidosis, LIP, DAD, recurrent aspiration, allergic alveolitis
Lemon Sign	Spina bifida	Scalloping/overlapping frontal bones
Millet seed appearance	Military TB on CXR
Nutmeg liver	Chronic liver congestion
Olive (sign)	Congenital pyloric stenosis
Onion skin arterioles	atherosclerosis
Onion skin (musculo/skeletal)	osteomyelitis, osteosarcoma, Ewing sarcoma
Peau d’orange	Carcinoma of the breast
Pizza pie	CMV retinitis
Popcorn sign	Fibroadenoma of breast
Port-wine stain	hemangioblastoma
Red-currant jelly	Intussusception, Klebsiella infection (sputum)
Rice grain calcification	Taenia solium infection
Rice water diarrhea	Cholera
Strawberry Tongue	Scarlet fever
Sugar-coated spleen	Chronic serositis