Advanced Physical Exam

Who would've thought that my most intimate interaction with anyone would be in a small room with two other students watching me? Yup, it's called advanced physical exam.  Every year, 120 or so confused medical students split up into teams of 3 to learn how to do a breast exam, pelvic exam, genital exam, and rectal exam on a real, live, standardized patient (these people had better be paid a good amount of moolah).*

Anyhow, I was paired up with two other guys, and so I got to go first with the breast and pelvic exam.  The whole thing was very professionally handled, but still, there were times where I couldn't believe how hard I had to press to milk for discharge or how difficult it was to find an ovary.  It also didn't help that I, being curious and having a tendency to ask way to many questions, was in the middle of a manual pelvic exam when I started asking all these questions of how exactly was I supposed to feel an ovary when my hand was twisted in the most awkward position ever.  But I suppose during the time I was so focused on the logistics of everything, I didn't have time to think about the strangeness of my situation.  Temperature test, forefinger in, middle finger on top, middle finger down, press down, insert speculum, retract fingers, keep speculum pointed down, open clamp, scrape os, close clamp, retract speculum while inspecting sides.  Then lube and insert fingers as above, test cervix mobility, turn fingers, move uterus, feel for uterus size, side sweeps for ovaries.  Although I wasn't able to find the sneaky little bugger (aka, the os) while my fellow students did, I was amused watching them struggle to remain calm during this ordeal as their hand shook and beads of sweat formed on their forehead.

It was also partly comforting and partly unusual when the male SP (standardized patient) told us that he had done many of these and had traveled around the country doing these.  In fact, the female SP said she enjoys being an SP - especially when she gets to be mean (oy!).  Anyhow, as the male SP was talking, he just casually dropped his trousers and continued talking to us as if nothing happened.  Observe, lymph nodes, pulse, check posterior, shaft, scoop and grasp cord, palpate 3 things, pull down skin to test for inguinal hernial with opposite finger, bare down. This time I learned being first wasn't good, so I got to go last.  Having watched this exam 3 times, I was confident.  "Lube, use thumbs to examine, left hand to retract, warn about cool sensation, touch, insert..."  But as the SP was walking me through the exam, his phone went off.  While I patiently waited for him, he reached for his phone and fumbled it until he finally managed to silence it.  Then he continued the exam as if nothing had happened.  "...sweep 360, press down and in, tell the patient what to expect, there, you've found the prostate, retract, squeeze, done."  I quickly said a thank you, and rushed to get out, unaware I had opened the door when the SP was still lacking his trousers.  Thankfully he just smiled and said they were all family anyways.

I'm thoroughly grateful for the SP's who have, in a sense, given up their body for science.

*Note: No SP's were harmed in the making of 120 med students.  

Please Vote for 6Dot!

My roommate from undergrad invented (yes, invented!) a portable Braille labeler for the blind, and she has asked me to forward this on.  She's taking time off grad school for this, and it really has made a difference in people's lives (if you can't tell, i'm so proud of her!!), so if you don't mind taking a bit of time, can you help her out by "liking" her video for a competition she's in?  It would be much appreciated! (Please see email below):

----------------------------

Hi All!

We are in a competition for our startup company, which is developing a portable Braille labeler that will change the lives of blind people around the world. We need your help to pull up in the rankings! Please do these FOUR QUICK STEPS to help us out!!

1. Go to this link, then click the word "LIKE" below the video: http://www.youtube.com/watch?v=VNUCJ1Ps_ng

2. Go to this link, then click the word "LIKE" next to the title "MIT 100K Entrepreneurship Competition": http://www.facebook.com/mit100k

3. Scroll down until you can find the video of 6dot Braille labeler, and click the word "LIKE" below the video. If you can't find our video, you may need to click "Older Posts" at the very bottom of the page.

4. Forward this email to any friends who wouldn't mind to give us a minute of help!

Thanks!!!
Karina Pikhart & Trevor Shannon

6dot Innovations Founding Team

I Went to Jail!

Yesterday I got to go to jail.  Yes...when I got there, the lady asked why would anyone want to go to jail? Well, you see, I had committed this heinous crime, and I could do community service, or go to the "Hilton" of jails.  Okay, just kidding (if you haven't figured that out already).  I was there on a tour with an interest group.  Apparently, the jail I went to was the "Hilton" of jails because it has one of the best healthcare/facilities of all the jails in the country.  Isn't that nice?

Buzz Westfall Justice Center

We had to read this info sheet that was for medical students who wanted to rotate there, and there were some pretty funny things like:

Cosmetics: Make-up should be complementary to skin tone and not in extreme contrast to the complexion. This includes foundation, blush, eye shadow, lipstick, etc.

I guess it makes sense security has to be tight...but make-up?  Really?

Anyhow, apparently this jail has had some pretty high profile people ranging from people who didn't pay their parking tickets to murderers.  Every door we went through had to be unlocked from a secured area that had one way mirrors.  And for us to go open the next door, we had to wait for the previous door to close and lock.  The visiting rooms really are just like those in the movies - thick plexiglass like material + a phone.  And the building is designed so there's no way for visitors to contact the inmates.

We checked out the infirmary - and apparently only 130 or so jails have infirmaries that are certified/up to par in the U.S.  There was a psych ward and a general medicine ward.  There were two negative pressure rooms for patients who might have TB or other airborne diseases.  And there was one rubber room that is literally all covered with a thick rubber for the really out of control.  There were two chairs for strapping out of control people in - but apparently those were rarely used.  Considering the huge percent of inmates who have psychiatric disorders, it was impressive that only 3 had committed suicide in the last 10 years.

We visited a pod - which is a central room that was surrounded by cells on two floors.  People have free time to come out from their cell and interact in the central room, and I believe they get at least 1 hr in the rec area/day.  There are also classes held for people in the CHOICE program, which is to get people off drugs/alcohol.  I hear they are required attendance, or else they go to prison.  During the time when everyone is out in the center, there's only one guard.  But apparently if he presses a button, within 10 seconds, a bunch of guards would come.  Our guide, the medical doctor, said he felt so safe at the jail that he actually prefers working at the jail compared to the city clinics because the clinics are so chaotic and boisterous.

We also visited a woman's pod, where the upper level has the highest security cells.  As we went up, the inmates stared at us - probably wondering why we were dressed so nicely, and why we would in our right minds want to go check out a cell.  Anyhow, we actually got to go into one of the high security cells.  It was very bare with a bed, a mat, a ledge for a table, and a sink-and-toilet-in-one.  There were no chairs b/c they could be used as weapons.  These single cells were meant for the troublesome inmates who don't behave.  They get one hour out of their cell a day, and one book or magazine, if it's subscribed to them.  They are also fed through a slot in the door.  But the good thing is there's a TV in the center of the pod that they might be able to see through a window.

The whole tour was quite eye-opening.  I really had no idea what to expect when I was going in, and even still, I'm not sure I quite understand what goes on in there.  It's like a whole different social structure.  Some of the inmates may have a higher status and can request certain rooms, while others who are more boisterous have to be sequestered.  Meanwhile, some can be put to work within the jail to help with cooking, laundry, etc.  And yet others, like child molesters have to kept in smaller pods, not so much because they are dangerous to others, but they are often in danger themselves.  Anyhow, I'm glad I got to see a glimpse into our justice system.

Stabbing Classmates

We recently got to draw blood from our fellow classmates for the first time!  It was quite exciting!  At first I was a little concerned that my partner had dark skin, so I might not see his veins, but I was relieved to find that his veins were quite enormous.  I could have probably done it my eyes closed - okay, that's a stretch.  But it was pretty funny nervous I was, and how my partner was even more nervous.  As I was going to stab him with the needle, his arm kept on drawing farther away. Haha. And when I was pushing the glass tube into the back of the needle so that the tube can fill with blood, I might have moved the needle a bit (you'd be surprised how difficult it was to push the tube in), and that caused some squirming.  Sorry-oh!  When it was my turn, it was done spectacularly! Woot!  Well...almost.  When our demonstrator showed us how to do it, he pulled out the needle along with the tube (so not the tube first), so it ended up with some blood dripping about.  Sorry again!  But at least it wasn't as bad as what happened to some other classmates...

One classmate forgot to untie the tourniquet before taking the needle out, which resulted in a blood squirting everywhere (well, not as bad as kill bill), but it was quite surprising.  And later, the vein bulged so much the bandaid over it looked like a mini hill.  There were even more unfortunate stories of classmates who's veins were too small that their partner had to poke in their arm multiple times.  But it was all in vain (no pun intended) - even the professor wasn't able to draw any blood from them.

Anyhow, overall, it was fun - I doubt we'll really ever draw blood when we become doctors, but I guess it's a good skill to know.

Karina's 6Dot Podcast

Karina is so amazing!  Checkout the podcast she had with David Weekly about her startup: 6Dot - new portable Braille Labeler!  Imagine being blind and not knowing which CD is which, which drug is for what, which buttons do what...

My Dad is So FOB: Autocad Program

Dad: "What's the difference between the word for able to eat and the word for being able to edit something?"

Me: "Well, one's edible and the other is ediTAble."

Dad: Thinks for a while..."Oh...that's why they were so confused when I told them the Autocad program is edible."

Dad Stories: Karma

My dad is a funny character.  He's awesome in many ways such as being the fastest (not running - but just in general) person I've ever met - but at the same time, that also means he ends up with many funny stories to tell me whenever I come home to visit:

He was telling me about how he gets angered/judge quickly (tell me about it...), and he was saying how there's this neighbor who's son keeps on riding his motorcycle in the middle of the night at tops speeds causing everyone to wake up.  It's not just one "ZOOM" - he would zoom back and forth in the road in front of our house creating an enormous raucous.  Anyhow, my dad became annoyed at the neighbor, developed pent up anger, and started praying that he would go away.  

Well, one day my dad really needed to get to the construction site he was working on, because the inspector was there and needed to sign off some papers.  However, as he was about to leave, the car wouldn't start (maybe lights were left on overnight?).  We were on good terms with the neighbors across the street from us, so he went to ask them.  But they weren't there, so my dad went to ask another neighbor.  All the while, my dad was avoiding the one neighbor he had developed a resentment against.  Considering the father of the motorcycle boy was mowing his lawn, my dad was extra careful to avoid him while crossing the street to ask the other neighbors.  Unfortunately, none of the neighbors were at home, so my dad reluctantly went over and asked the one neighbor he really resented.  But as he went to the neighbor, my dad found him to be an extremely nice, down-to-earth guy.  The neighbor readily drove his car over to our garage to jump my dad's car.  From then my dad thought of them as awesome neighbors.

But of course, one lesson is never enough.  My dad, despite being very quick and often careless, is a very clean and orderly person.  So naturally, he disapproved of one our neighbors who always has an unkempt front yard.  Well, it's not really unkempt - it's just that the neighbor enjoys fixing cars, so it is often piled up with various parts and such typical of a mechanic.  Anyhow, unsurprisingly, one day my dad needed to get to his construction site again, and his car failed to work.  He luckily found that one particular neighbor available, who was able to fix up his car for that trip.  Not only that, later when he had more time, he pretty much did a tune-up on my dad's car and made it run much better (perhaps that's also why the car failed in the first story?).  My dad found the neighbor to be very friendly and they chatted a while about past lives and stories.  ...And that's how another set of neighbors went from foe to friend.