JACKIE: Psych Wards

To be honest, I thought the inpatient Psychiatry ward would sort of resemble “One Flew Over the Cuckoo’s Nest.” Alright, I didn’t really think that, but I did expect my experience on the ward to be much scarier than it has been thus far. It appears that psych patients, for the most part, are relatively gentle, despite their severe depression and hallucinatory psychoses. They are interesting people with intriguing stories and fascinating minds. No matter how many schizophrenic patients I encounter, I still find it hard to believe that people can “hear voices”, have full awareness that no one else can hear these voices and that the voices are only in their own heads, and yet the mind continues to produce these voices. Why does the mind insist on creating hallucinations when the patient knows they aren’t real? And why is there such a drastic difference in the insight patients possess? Some completely understand that they are psychotic, others resolutely believe that what they are hearing and seeing is real.

I didn’t think I’d be interested in Psychiatry, and I am not yet convinced that I am. Still, this is the only second clerkship I have done thus far, and I am entirely convinced that there is something to be gained from every moment I spend on the wards. Interacting with patients, learning the practice of medicine, pondering the depths of the human mind, examining my own response to hierarchy and stress and expectation- what could be more exciting…

JACKIE: The Sweetness of Accomplishment

To follow up on my comrade Tony’s somewhat embarrassing moment in small group, as told below, I will describe my incredibly awesome experience at OPEX. OPEX stands for “Outpatient Experience”, and is the part of our curriculum where we each go to a different outpatient clinic every other week and shadow a primary care physician for the afternoon. This interaction is one-on-one and can often lead to feelings of utter dismay, since one’s preceptor might ask one questions that one never knows the answer to.  However, the other day I had an OPEX moment in which I felt like a complete medical genius (as opposed to feeling like a kid in a dunce cap as per Tony).

We are now studying Psychiatry in class, but we just completed our study of Neurology. Neurology involves numerous questions that require you to “localize the lesion.” This means that you gather a set of symptoms (e.g. numbness on the left side of the face but not the forehead or weakness of the right leg from the knee down) and use them to determine where in the brain, midbrain or spinal cord the lesion has occurred. Lesions range from stroke to infection to transection.

Last Wednesday at OPEX, I fully localized the lesion and made the correct diagnosis all by myself! I was able to recall all of the information I needed to adequately do this, elicit the relevant symptoms and history, and make a proper diagnosis.

I’ll tell you what, folks: medical school can be a discouraging, frustrating experience. There is too much to know and not enough time to learn it. But the fact of the matter is, it just takes awhile to truly gain medical knowledge and be able to apply it. This explains why it takes at least 7 years to become a doctor. But, as overachieving students, it is hard to remind ourselves that in our second year of this 7-year process, we must not expect to know everything yet! I know this may seem obvious, but it’s just not that easy to keep in mind, trust me. And since we can’t always keep this in mind, we endure moments of major frustration. Yet those moments when you DO know the answer, when you are actually able to help someone in real life; ah- it makes it all worth it.

JACKIE: Atlanta is Super Fun

This past Friday we had our Endocrine Module exam. The weekend/week after an exam is always (relatively) care free and super duper fun. To give y’all a taste of what super duper fun there is to be had here in the ATL, I thought I’d give you a play by play of what I have done since the exam ended and what I will be doing the rest of the week.

Friday after the exam: A few friends and I had a celebratory slice at Fellini’s- an outdoor, delicious pizza place in Candler Park. We dropped one of our comrades off and headed to a surprise birthday party for a fellow classmate at a glorious apartment complex with a pool where there was lots of great food from Dusty’s, the local BBQ place near campus. After we had eaten and swam to our heart’s delight, we took a trip to this cool bar, Aces, in Kirkwood and played pinball and other such arcade games. Finally we skidaddled over to Shout, a cool place in Midtown where they have (relatively) good music and a nice outdoor patio. I know: outdoors in the summer in Atlanta? Insane. But actually the weather has been fantastic here for the last four or five days.

Saturday: I slept until whenever I wanted to get up (which was late and I won’t share the embarrassment of the exact time). After a leisurely breakfast, I lay by the pool, listened to music, and read for fun (a rarity). Then my two fun friends came to pick me up and we went to get bubble tea on Buford Highway. Delicious bubble tea initiated a hunger for further consumption, so we went and did a little post-test celebratory shopping. They dropped me back off at home and I soon took off for this cool outdoor wine bar on Krog Street, and then went out to dinner at this delicious Greek restaurant called Avra in Midtown. Full from dinner, I went to a friend’s house to sit on the couch and watch the Olympics. Finally, I ended the evening at a classmate’s house playing Rockband.

Sunday: I woke up early to head to the Scott’s Antique Market–a great market that takes place once a month a little south of the city– and then I went to lunch at Carol Street Cafe in Cabbagetown. Somewhat exhausted, I went home and watched some more Olympics while cleaning my apartment (the week of an exam the ol’ apartment tends to decline in cleanliness quite a bit). Later that afternoon I went to Park Tavern (it’s a restaurant/bar on Piedmont Park), sat outside and listened to the live music while hanging out with good friends, and then I went to a BBQ at another good friend’s house. Sunday ended with some of the folks at the BBQ trying to teach me to play Halo, which didn’t work out that well, but was rather fun.

Now it’s Tuesday and I am studying Hematology, but…tonight I am going to the Braves game, last night I went to a fun dinner at P.F Chang’s, tomorrow night I am going to watch 3 hours of Project Runway, and Thursday night I am going to a play. After that, it will be Friday again!

Ah, medical school is so fun…

JACKIE: An awkard situation that wasn’t awkward at all

How many of you future medical students are afraid of the moment when you must perform your first rectal or pelvic exam? I’ll tell you what: I certainly was. Actually, I suppose fear isn’t really the right word to describe the feeling that overcame me when envisioning my first rectal exam; it was more like dread. Super major dread. I just did not want to do it. I know that may be childish and/or unprofessional, but given the facts of the act, I simply would have preferred to never, ever do it.

I am pleased to report that our practice sessions for the pelvic and rectal exams were far from fearful or dreadful. In fact, these sessions were enlightening, anxiety-releasing, edifying experiences. We were given careful instruction with videos, demonstrations, dummies, little plastic prostates and breasts, and all the rest of the nine yards, and then we were broken down into small groups in which we each practiced the exam on a standardized patient. I know, it sounds like it would be awkward, but somehow it really wasn’t. Each of my classmates exhibited a perfectly appropriate mix of nervousness and professionalism that I admired. The patients were extremely helpful, giving feedback and assuaging our concerns. All in all, it was quick and painless and way better than I thought it would be. I now feel confident that I could adequately perform a pelvic or rectal exam if ever called upon to do it. This feeling is obviously way better than the dread I felt before these practice sessions.

My take away message in this short, pithy story is this: Don’t spend too much time worrying about these exams. Someone will teach you how to do it, and you’ll do it and it will be totally fine. I promise.

Welcome to medical school…

-Jackie

JACKIE: Kids are great, aren’t they?

I just got back from participating in one of the cooler things that Emory med students do (in my humble opinion, of course). As a member of YSEP (Emory SOM’s student run Youth Science Enrichment Program), I went to an elementary school in town to teach a class of fifth graders about the body. The premise was that we all (the class) worked for the “Human Body Corporation” and our company, like all companies in our glorious economy, needed to cut back on the number of workers it employed in order to save some money. So, the class split into 6 groups and I assigned each group an essential body part. Each group had to come up with a list of reasons why their assigned body part was absolutely necessary for the functioning of the Human Body Corp and therefore could not be laid off. (The premise seemed a little sophisticated for fifth graders if you ask me, but hey, who knows with kids these days.)

I have to tell you, I felt uplifted and inspired watching the kids brainstorm everything they knew about the human body, and then try to come up with reasons why their part was needed for the body to work. I know, I know- such a dorky med student thing to say- but when you spend so much time surrounded by people who have dedicated their lives to serving the human body, you forget that the average kid thinks it’s pretty fascinating too. When I briefly explained to them how each part worked, I was speaking with this super enthusiastic tone. Who knew that talking about the lungs oxygenating the blood could be so exciting!

Anyway, it was one of those moments you cherish during the day in, day out of medical school- one of those moments when you remark to yourself, “Huh- this stuff is pretty sweet.”