Lives of Others

I like to talk to strangers.  I suppose that's the opposite of what parents teach their kids, but I've also found some very interesting stories.  I usually don't ask for people's names, but perhaps I'll meet one of these people again:

• While waiting for the plane, I met a couple from Alaska who just went to see their kid graduate from a Christian college to be a missionary in Japan.  
• I met this teacher who used to teach in Kentucky.  She's taught both lower income population and upper middle class kids.  She was describing how the new testing laws regarding grade school has put more pressure on teachers and kids.  While more effort is raised to bring kids up to par, it has also pressure more kids to drop out.  Hm, I wonder to what extent it's true.  Towards the end of the flight she told me she has MS and that's partly the reason she's reconsidering going back to work at Starbucks.  She was saying that although her condition is somewhat stable now, her last intensive course of medication wasn't doing anything, so now she isn't on anything.  The initial symptoms consisted of difficulty with balance and gait (foot drop).
• A couple where the wife is a pharmacy student and the husband considering changing careers.  
• This mother with a really adorable little kid.  Her husband actually works at my school and plays tennis!  We actually became facebook friends...haha. 
• A pilot who used to be the pilot for the director of some famous movie (sadly, I forgot who).
• Student in Utah who's going to college for degree in computer science and ballet.  Yup, he's a ballet dancer. 
• Child who travels alone back and forth via the plane every year because his parents are divorced.  When asked what his favorite hobby is, he says "computer games." Oddly enough, I sat next to him on the flight back.
• Somebody gave me the book he was reading, "Tao of Pooh."
• While I was in Korea...
• I met this British man while trying to figure out the bus system in Korea (not knowing how to read/write/speak Korean), who helped me find the right bus to reach Bukhan San (sp?)
• On one of the buses, I finally found a girl who spoke a tiny bit of English.  Turned out she's getting off the same stop as me, so she said she'd show me the way to the National Park.  Better yet, her mom is going to hike there too, so she told me to just go with her mom.  When she saw I had flip flops on to go hiking/climb a mountain, she let me borrow her shoes. They were kind of small, so it kinda hurt.  
• Hiking with the girls mom was amusing.  I didn't speak Korean, and she didn't speak English, so we had to mime most things.  I tried to learn a few words of Korean, but I think all I learned was "water"...which I'm still not sure whether it's "bul" or "mul."  The mom was so nice she even invited me to eat lunch with her after our hike.  
• While hiking at Bukhan San, I met one of the forest patrols for the park.  He spoke pretty good English! 
• The forest patrol guy had to go a different route, so then later I got directions from this other elderly man who once again didn't speak English, but he helped me take pictures :)
• On the way down from the hike, I ended up mostly getting directions/talking to this consultant (not sure what he consults).  Can't remember most of what he said, but one time he asked if I wanted a drink once we get down to the bottom of the mountain.  I thought he said "beer," so I said, oh no, I don't drink.  But it turns out it had been some other typical refreshing Korean drink that just sounded like beer. hahahaha...I think I kindly rejected the offer, and we parted ways after we reached the gate.  
• As I was walking through a traditional korean village (Namsangol Hanok Village) when I saw this white guy.  Having not spoken English for the whole day, it was nice to strike up a conversation in English.  Turns out he's half Korean and half Swedish, going to school in Sweden, and didn't speak any Korean either.  
• While in China we met this guy at one of the hotels who was just traveling through various parts of China for a couple of months.  He kinda tagged along with us for a little while at Yangshuo, and then we parted ways.
• While in Sierra Leone...
• While staying at one of the school's guest houses, I met this apparently popular Sierra Leone band. Sadly, I don't remember their names or the names of their band.  I didn't know they were well known in Sierra Leone until I later talked to my driver, Lahai, who started listing off his favorite songs by them.  
• There was a scientist from Belgium? Germany? (bad memory) who was also staying at the guesthouse.  He came to help out the Njala School's biochemistry lab for two weeks.  He also bought us drinks - how nice!  Although he did smoke - and I was half trying not to breath. 
• Some students from the states who were teaching the farming department how to properly handle livestock.  

SP POM II Final Exam

Phew, what a relief to know I passed an exam...need to remember to ask/do the following for future patients:

• Ask about diet/exercise
• Test for sensation
• Warn patient about thyroid exam/chest exam and ask permission to undrape
• Pull out and put back in leg rest
• Put patient's socks back on
• For chest pain, ask about nausea, if pain worsened by deep breath, listen to heart while lying flat.  Whether chest pain is exertional or positional.  Specifically write whether patient is or isn't taking aspirin.
• Ask/write age/gender
• Write negatives (e.g. no exacerbations)
• Write how other diseases (DM) are controlled
• Document abdominal exam and edema
• Sample differential for chest pain: 
• Acute coronary syndrome, MI, unstable angina,e tc.
• General angina, CHD, CAD, ischemia
• Pericarditis
• GERD, esophageal spasm, etc.
• Pulmonary embolism
• Aortic dissection or aneurysm
• Myocarditis

CMA reflections

Thankful for:

• Good rotation schedule: Although it wasn't what I had signed up for, it turned out to maybe even be better than what I had in mind at first.  I remember taking a lot of time trying to figure out what schedule would be the most advantageous, putting in all the permutations into the lottery, and asking a bunch of people what's good/bad.  But ultimately I guess God knows best.  What may work for everyone might not actually work for me considering I tend to be a slow starter.  So while many people said to start with Internal Medicine, it's probably for the best that I'm starting with Psychiatry, which appears not to be too intense (of course, that's relative).  Rest of my schedule: 
• Psychiatry, Neurology, Emergency Med
• Pediatrics, Ob/Gyn
• Internal medicine: BJC, Cardiology, Family Med
• Surgery
• Having a place to stay next year: Despite the uncertainty and slight drama, I'm thankful to have such good friends who I know won't abandon me, even though it may make their life a bit complicated.  But still have to figure out the details...
• Having a wonderful family and an adorable little brother who tells me riddles. 

Prayer for:

• Friends and their family: things don't always go as planned.  Even the worst things happen to good people.  It's always a mystery why God lets those things happen, and even though I know the answer is that "God has a plan for everything," sometimes, I want a better/clearer answer.  
• Family business: that my parents will be able to sell the house they're building.  
• Friends weddings - all the best to them, and that I'll be able to make it to them if possible.
• Step 1. Sighs.  

Things I don't understand:

• Job: reading about it is confusing. Even though I know he's supposed to show the epitome of being good and not forsaking God despite having so many problems - it seems like he still complains a lot. hm....

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.  

Different Kind of Swan Lake

In the words of Aunty L: "I don't think Tchaikovsky had this choreography in mind when he wrote 'Swan Lake.' How could anyone imagine a performance you are about to witness." 
Swan Lake...Amazing.

Message With A Bottle

There was a really cute/funny blog about a father who wrote various post-it notes during his first year as a father: Message With A Bottle.  Here are some favorites:
"Up all night, sleeps all night, pisses on himself for no reason - it's like a small version of me in college."
 "Remember to check the pee rag is in place....next time i try to kiss him in the stomach while changing him." 
"Parenting is a terrible job if you think about it: long hours, no pay, the boss is moody and demanding and benefits don't kick in until years later.  Ehh at least my coworker is hot."
"Baby loves watching me play video games.  What kind of dad would i be to deprive if i denied him that joy? One more game for the sake of the baby."
"Baby Fight Club!"
(Thanks, SD)

Adult?

By some state law, any adult by the following definition can give legal consent:

18+ y/o

Minor parent (for self and child)

Emancipated minor (married, military, or court decision)

Minor in case of pregnancy/STD/substance use

Anyone in an emergency.

The small group leader we had made an interesting comment about the above definition: "So pretty much, anybody who's done something terribly wrong is considered an adult and can give consent- and those who are being good kids and staying home can't."  A little ironic, eh?

Roommate b-day love!

What a lovely b-day surprise - random youtube video from roomies! Thanks guys! This is great cake!...
It has everything I've ever wanted: Asians, piggies, ABRAHAM LINCOLN, wishes, bubbles, and one HUGE SMOOCH. :D

On Dating a Med Student

Haha, this article about what it's like to date a med student is pretty funny, and true in many ways: http://www.foxnews.com/story/0,2933,452186,00.html.  Highlights would include: 3. Learn to hide your “ew, gross” reactions when they tell you all the stuff you never wanted to know about your bodily functions. 


5. Each week they will have a new illness. Some will be extremely rare, others will be more mundane. Doesn’t matter. They will be certain they have it (no second opinions necessary.) Med school can, and will, turn even the sanest into a hypochondriac. Date them for long enough, and you’ll become one too.  


11. They're expected to know everything. Everything! The name of the 8 billion-lettered, German sounding cell that lives in the depths of your inner ear, the technical term for the “no one's ever heard of this disease” disease that exists only on one foot of the Southern tip of the African continent. But ask them if your knee is swollen, or what you should do to tame your mucous-filled cough, or why the heck your head feels like someone's been drilling through it for oil for two weeks straight, and they won't have a clue. (MNZ)