2 month is the amount of time since I last saw my boyfriend
2.5 months is the amount of time until I will see him again
60 is the number of times I think of him every hour
1000 is how much I miss him on a scale of 1 to 10
it's funny how sometimes seeing other people in love and together reminds you how much you miss somebody and love them
So,
I read this in someone else's blog:
"The divorce rate (according to some PBS documentary) is about 90% for people who marry in med school or during residency."
Does anyone know if this is true?
I know that divorce rates HAVE been linked to specialty choice but I'm not sure about timing of the nuptuals. I does make sense that things might get a little rocky during residency, especially if the person you marry is a non-medic, but I would like to see the hard facts!
I also heard that people who live together before marriage have a higher divorce rate, but this has been disputed. Anyone got any solid data?
This is not because I'm considering getting married anytime soon. Ben wouldn't fall for that trick! (but if we want to have an army of robot children we should start on that soon) But, I'd like to be better informed about my chances of surviving marriage intact. I come from a family with almost no divorces so that bodes well, but I also think I might want to be in Obs/gyn (a surgical specialty) , although I'm also considering famly medicine. Will this play a role in my choice of residency? Probably not, although maybe subconsciously.
So... I'm studying HIV/AIDS for ID tonight and I'm kinda bored so I'll take a study break and tell you about my procrastination techniques. First off, I conveniently started this blog right before studying for exams, genius. Second, I've been filling my library thing with all sorts of books that I've read in the hopes of finding some cool books I haven't read. Not that I'm going to get a chance to read them in the next couple of weeks when I'm cramming. FYI: I'm the only one who put the Sanford Guide on my library list (why am I proud of that? I'm not sure). Then I labelled my calendar with the number of days I have left to study ... not counting the day of the OSCE because I know all time not spent AT the OSCE will turn into nap time. By the way, anyone know how to do a focused shoulder/knee MSK exam? I gotta learn that tomorrow. We have a FOSCE (fake OSCE) on Wednesday put on by the 2nd years, I hope I get to examine Andy, that would be hillarious.
Oh, and for those who care, Meghan wrote the MCAT on Saturday. She said it had lots of Organic but I have all the confidence in the world that she'll do well because she's an engineer and engineers ace the MCAT. Why is that you say? Because we're logical and we can read. Many science kids get freaked out and forget to read the BS in that passage that contains almost all of the answers. Engineers know better because, let's face it, we're a notch above the rest.
Anyways, enough of the procrastination, must get back to it.
Zzzzzzzzzzzzzzzzz.......
Sometimes it's nice when it all comes together and you feel like you've actually learned something. Today in class we were discussing DIC (disseminated intravascular coagulation) via a case study. Beginning of the case was something like: 27 year old woman in the ER, 24 hour history of feeling unwell, 6 hour history of headache, photophobia and vomiting, widespread purpuric rash, stiff neck. Now... any doctor worth their salt should know what the problem is. But, as a first year medical student just finished studying the ID section of the course, the fact that meningococcal meningitis popped straight into my head was like a light shone down from heaven and assured me that the studying is worth it. Yes, there are lots of other more complicated things I need to know, but the addition that I could name not one but two antibiotics (ceftriaxone, cipro- for prophylaxis) effective against the organism was somewhat reassuring.
Then someone else in the class raised her hand and said "could it be because she's pregnant (the DIC)" I've never seen a prof stare at a student for longer before saying in a voice of disbelief "it's a classic presentation". The question girl (this time) strikes again!
and... back to the books!
If only medicine involved less hours of studying. Twice a year I become exquisitely lifeless and stressed and downright miserable. In the future I only see the amount of time spent in this state increasing because the hours needed for studying are going to increase. At least I don't go to other med schools though where they have exams every few weeks, what a bore. We have exams after each semester. That means that my exams in two weeks are on: MSK, Infectious Disease, Dermatology, Oncology and Heme. Everything to do with all of those subjects (everything I will ever learn about them in med school). Which I gotta say is a bit stressful. Especially because all I've managed to get through is ID (the biggest section, but still) and I don't even know it all yet. That means I'm not going to be sleeping for the next 2 and a half weeks until my OSCE (another walk in the park, not) and the week after that until my written finals. For those of you non-medical types I'll fill you in on the OSCE thing later but for now I'll just say that it's a practical clinical-based exam involving patients and scenarios. I don't mind the clinical stuff though so it shouldn't be as hard as the dreaded MCQ/short answer/stupid picture test combination.
Why am I blogging if I have so much work to do? Well, because I needed a break and I'm feeling sorry for myself. Someone want to bring me some ice cream?
So, I have the "chart" . Some people think the chart is a myth, I guarantee you it's not. This is the average salary chart in canada by province and by specialty (not broken down into many sub specialties though, sorry). This chart is 2001-2002. Please note that this is fee-per-service payments thus does not include deductions for office materials/overhead that family physicians pay. This is also pay before tax. Why am I putting this chart up? Because people keep asking me for it in class. Why do I think it's important to these individuals? Well, when you know nothing about different specialties and are being forced to choose your career path extremely early, what else are you going to base your decisions on but the almighty loonie?
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So, here's the question: is medicine a science or an art?
As a medical student it's pretty easy for me to answer this question: It's both! This is why I think so.
I spend tons of time learning the way the books tell it, numbers, names, disease after disease. Yet when I go into a case study group being led by a doc, I'm always amazed at how wrong I can get it when it comes to a patient's real case. Even when I have all of the information needed infront of me. Why?
It's because the art is in the integration. The science is about little pieces of the patient, disease A, disease B, risky behavior C, but patients are not a composite of their diseases. Real patients are more complex than that. The art of medicine is making sense of all of the inputs from the science side and the inputs from the softer side, the human side: someone's lifestyle, their attitudes towards certain things, their desire to know or not to know. The literature may give you a double blind study telling you what the best treatment is for shingles but if the patient can't pay for famcyclovir, what are you going to do? You're going to use the art of medicine to a) find a solution that you are both happy with b) do the best for your patient that you can. This may involve giving that patient in particular free samples or calling up the drug company to tell them your story (big pharma will be another topic). There is no book or journal article that will tell you how to do that.
There is also no journal article or book that tells you what makes this patient comfortable in your office and what you can do for them today. The art is in asking the right questions and listening long enough to get the whole answer. The art is also in knowing when a patient is not telling the whole truth. Patients may say they never lie but it's not true - we all lie when we think we're being judged or someone's not going to take us seriously, it's just usually called exaggeration or "bending the truth".
So yes, the evidence-based part of medicine is important and is definitely better than the paternalistic model from days of old, but the art will never be eliminated from practicing medicine.
Ok, there's one in every medical school class I'm sure. The question "guy" (or girl) is the person who can listen to someone explain something and then put their hand up to ask the person to repeat what they just said because they weren't listening. It goes something a little like this:
Professor: In Von Willebrand disease the amount of circuling Von Willebrand Factor (VWF) is low. Because the numbers are down the function of VWF will also be low. This makes the amount of factor VIII low because it needs VWF to bind to it so it can survive in the circulation. Unbound VIII is destroyed quickly so cannot contribute to the clotting cascade.
The Question Guy: Um, i see the term "Von Willebrand disease" in my notes, could you explain to me what Von Willebrand Disease is?
If you're not going to pay attention: a) don't come to the lecture or b) don't ask questions!
In addition, we all have the notes right infront of us that she's lecturing from... so he could have just read it.
I wonder how you got into medical school.
So, I recently finished a fantastic book. I'm not usually one to love a memoire but this one is just so eloquently written and if you've ever been told you're precocious (which I'm sure many medical types have) or been called a "doubting thomas"/have been told you ask too many questions, this book will make sure you wear those badges with honour. I guess I'd better reveal the name, undoubtably someone has already stopped reading by now, it's called "Too close to the falls" and is by Catherine (Cathy) Gildner. Go out and buy it, run, before the word gets out!
So, other than being a medstudent, I am also an avid cyclist. I actually used to hate biking with a passion... but then I actually tried it with someone fun and got into it. I'll try anything once if it's with a cute guy (said cute biking guy now happens to be my boyfriend, go me!) And hey, it sure beats running. I used to think that running would get to be more enjoyable the more I did it so I misguidedly ran for a year and hated every moment of it, then I decided I was going to stop torturing myself. I know that some people really do love it and all the more power to them, but I do love whizzing past them on my bike.
Anyways... back to the bike ride. Today I went on an amazing ride beside lake Ontario. It was about 20 degrees and sunny and was my first outing in shorts for the season. I also got to wear my new pink cow-girl inspired jersey with the words "giddy up!" on the back, something I've been wanting to do since I got it at the bitter cold end of last season. Oh, and did I mention it matches my cow-girl inspired cycling shoes? I currently own one bike, my first bike since I was 10, and it's not great but it's not crap either. Unfortunatley, I'm limited by the fact that it's a mountain bike. It's great for, well, mountain biking but when I want to go out on the open road it can be somewhat stunting. This summer I hope to invest in a little road-bike (little because I'm little).
Today I went out on a rural highway on my mountainbike, was promptly passed by a flurry of roadbikers, and resumed being on my own and enjoying every minute of it. There was an offshore breeze and it wasn't so hot I was sweating to death. Perfect warm womb-like temperature. There was only one thing to taint my ride, unfriendly road cyclists. I will never understand why other bikers are unfriendly on the road when I'm just minding my own business, following all the rules of the road, not being TOO slow and just generally loving the same sport that they do. I hate it when I nod and they don't nod back. I assume it's because I'm not cool and roadie enough, but give me a break, atleast I'm not your competition! Maybe it's just because they pass me too fast to notice that I even exist. I was feeling bitter but then on my way back through town a roadie did say hello to me and it made up for the other 5 silent-types, I guess.
Too end off I'll put in a sweet biking photo, unfortunatley not of my but of my boyfriend. He is much cooler on the bike than I am!
So,
I have decided to do a big of blogging about my adventures in medical school. Hopefully it will be somewhat amusing to those of you who have gone through it and not to appalling to those who haven't. I'm not sure what I'm going to put in it yet but I'd like to make sure that anyone who reads this knows that the "patients" mentioned are composites of experiences and all of my patients' details are kept confidential (I don't want to get into trouble now!).
Cheers
