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Monday, October 27, 2003
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BREAK YOUR NECK at the C5 level
Exactly a week from now, we'd be having our semestral exams... it's much more like TORTURE TESTS if you'd ask me. The Faculty has given us 18 days to study 11 or 12 mind blowin' subjects. Right now, I'm receiving a lot of messages from my friends [and strangers even] not to enroll on Wednesday in protestation of the upcoming exams.
Everything going-on in med school right now is just nuts... and ironically, I'm paying a lumpsome of money just to be involved in it. :-(
By Doc Broks @ 5:07 PM
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Sunday, October 26, 2003
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as usual...
Hedonist Jade overpowers sensible Jade.
Okay, I admit it, I'm one of the worse students. I ruined my study schedule last week and I know I'm gonna pay for it later. So God please help me stay disciplined and focused tomorrow onwards, and please help me remember what little I can cover. Pls let us all make good marks in this semestral exams.
By jadetv @ 7:37 PM
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Thursday, October 23, 2003
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Starbucks coffee and semestral exams
Ok, so what's the relationship between starbucks coffee and studying for the semestral exams? Hmm... the answer is... NONE OF COURSE! hehe.
but if you would ask about the association of starbucks coffee SHOPS with the upcoming neckbreaking semestral exams, now that's a different story. For the past two weeks, i've set up a "study desk" @ Starbucks West Avenue just to prepare for exams. Several of my med friends have studied with me, though most of the time, it's Berna who meets me there. Before this so-called "semestral break", we have created a schedule of things to study. 11 subjects just for eighteen days. I need a miracle.
Angelfire discovered that I'm stealing bandwidth and deleted my account, so i settled for villagephotos. I'm currently working on my personal blog... even created some buttons. Well, i should be studying though, but bloggin is more fun... hehe. I even created a logo for starbucks reviewers:
hehe. To all of us who would take the semetral exams... GOD BLESS! :-)
By Doc Broks @ 1:24 PM
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Tuesday, October 21, 2003
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The Power of Defense Mechanisms
Having gone through Community and Psychiatry module gave me a lot of things to think about. While our class was still in Community module, everyone anticipated the _____stink of Smokey Mountain. And I could really atest to that
By Jitney Girl @ 2:43 PM
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Monday, October 20, 2003
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aesthetic?
I've just come from consulting the micro/reconstructive surgeon. His advice is to wait till further disturbance. He says it's not tendon cyst, it's some other pathology. Hence, he doesn't want the risk of resecting at this time. He asks me, " do you want that risk just for aesthetics?" No, thank you. It was the pain I had hoped to correct, not the almost unnoticeable deformity of that very small joint. I decided I'd rather live with the paresthesia, pain/painkiller than risk paralysing my hand (like say, if surgery hits some vital structure) for aesthetic purposes. * I can see that this hasn't much to do with life as a Medical student. Maybe I'm posting it for the sake of completion, as a sort of "Course in the Ward" section of a medical history?
By mjc @ 9:04 PM
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Friday, October 17, 2003
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A wise God
It's not carpal tunnel syndrome. It's tendon cysts (two of them) compressing a small (very small?) branch of the median nerve going to my right index finger. Good. History-
Aug 2001/Bates module: Ester was paired with me in skills lab and she was able to elicit a (+) Tinel's sign when she tapped my wrist to assess the median nerve. Dr. Dee-Chan suggested I see a neurologist. I thought maybe it was just freshman hypochondriasis, so I didn't go.
April 2002/Summer: I was helping my grandmother cook lunch. I was peeling potatoes and pulling leaves off cob corn, when a sudden painful sensation shot through my right arm. It felt like my fingers were on fire, and the fire had traveled very quickly along my hand, forearm & elbow, where it burned itself out. I consulted an orthopedic specialist the next day. He said I had to do some wrist exercises, and use a neoprene wrist support for a month.
May 2002: everything normal again.
July 2002/Respiratory module, 1st 2 weeks: there was a quiz, where the questions were projected onto the screen and we had to write our answers fast. My hand was stiff, the pain was back suddenly, I lost grip of the pen. I got through the quiz, holding my left hand over my right hand (& the pen), so I could write. I couldn't analyze anything, and I felt disappointed with the way I took the quiz, but more importantly, I was scared. I called my dad, and he told me to see a neurologist as soon as class let out.
July/continue Respiratory module-Aug 2002/Genitourinary module: I had to wear a metal wrist brace. I learned to write with my left hand. I was sad. Angry. "Come back in two weeks," he would say. I went back every two weeks, always hoping to be told "You're fine now. You won't need the brace anymore." Sometimes, when he would do Tinel's or other tests, I wanted to say "No tingling sensation, I'm okay." but it's not a good idea to be telling falsehoods to your physician...
Sept 2002/Gastrointestinal module: around 2nd week, I had EMG-NCV (electromyography-nerve conduction velocity) done. Normal, except slow ulnar F-wave. Dr. Diaz explained that that meant the median nerve was normal. Maybe the pain was coming from smaller fibers, considering my occupational history (I played piano at age 3, violin at age 11), I was at risk for repetitive stress injury (RSI). My neurologist said "rest the right arm, brace when carrying heavy books/loads, use pain medications as needed." That was it. I was "chronic".
He said that since the big nerve was ok, and only the small nerves were affected, if he would resect at the wrist the risk of damaging the big nerve was too high to make it worth trying to correct the affected small nerves. I was told I'd have chronic pain and would have to live with it. I'm 23 yrs old, and I didn't like the idea. I didn't like it that to write notes in school, I had to use my left hand (too slow, too ugly handwriting). I didn't like the bruises from using aspirin, so soon it was on to more selective medicines. It's also painful when I accidentally sleep on my right hand, so I sleep on my left side as much as I can. Sept 2003/Psychiatry module: I discovered percutaneous pain medicine. It's a patch/sticker that delivers medicine to just the local area where you tape it, so side-effects are minimal.
One less thing for me to be sad or angry about. It's October. Sembreak 2003.
Tendon cyst is good news to me right now. The tendon cysts are probably on a digitorum muscle (flexor or extensor), that's why the signs/symptoms can masquerade as carpal tunnel syndrome. CTS is chronic. Tendon cysts can be surgically removed. If all goes according to plan, surgery will be on Monday. The timing is also good because it's sembreak. I have two weeks to get well. From this I learn that God is wise. Also, that it's a difficult experience to be informed of having a chronic health condition. I hope this experience makes me a more compassionate doctor ( if / when?) I graduate.
- - - - - - - - - - - - - - - To: section C 2005 -
In many different ways,
courage & help were given
to me through you,
sometimes unexpected,
at other times depended on,
but every single time
a deed well done.
Thanks! In Christ,
Ian
By mjc @ 10:40 PM
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Wednesday, October 15, 2003
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seize the day
The coming November 3 to 7, 2003 semestral exams is the case in point. It is a challenge in that some or even most of our faculty perceive us in poor comparison to European, especially German medical students. It is said that they are very industrious while we are less so.
Can Filipino medical students, provided with a list of exam topics, and given 4 days, 2 weeks (of what is still called semestral break although rightfully a study period) be as disciplined and industrious as their counterparts in Germany? It remains to be seen.
By mjc @ 9:26 PM
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Neuro grading
I can't remember if I got a can-do grade (or better) for Neurology module. If I got it right, then the results of Neuro's make-up sessions will pull our grades down (I'm sure I'm not the only who did LOTS of "educational guess"). Why not use the module grade for our subject grade? It's not like Patho, Biochem, Pharma, etc which don't have their own modules? What are they gonna do when they find out that (more probable than not) majority of us flunked those exams? I thought what they figured out for us would be to our advantage.
By jadetv @ 2:19 PM
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Saturday, October 11, 2003
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second cent
Pillbox members post at least twice a week. If I cannot commit to the ground rules, something unpleasant should happen. So far, nothing has.The paradox of Medicine is that the choices we make do not always deliver the expected outcome. In Thomasian-speak, "Life is choices. God gives grace." The Latin version is engraved on the facade of the UST Medicine Building.
By mjc @ 9:33 AM
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Friday, October 10, 2003
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Living a Life
I like it when med students or doctors act like they are not doctors at all. Take for example last resident's night when doctors sang and danced like there was no tomorrow. When med students gather at the lru and play computer games or oggle at friendster.com or write essays as bloggers, these are all positive signs for me. I like seeing med students huddle in one corner and laugh like hyenas or enjoy a cup of coffee or eat ice cream like little children. Just goes to show that we are humans after all. We want to enjoy life and study medicine on the side.
To say that a doctor has a great responsibility is an understatement. We have to play so many roles and be so many things to so many different people. Honestly, it scares me. I don't think I'll ever be prepeared. I often think that I might just like the idea of being a doctor but in reality I'm not cut out to be one. What's worse is I might realize it too late.
But when I see doctors and med students acting like ordinary people who laugh, cry, joke around, get pissed off or be angry, I realize that one of the most important things in our profession is to remember that we are human beings after all. While it is true that we have a superhuman task ahead of us we can not be superman or wonderwoman. And though we have tons of books to read and endless hours to study, let us not forget to be happy with what we do and enjoy the life we live. Let's live a life and let it be extraordinary.
By carmela @ 10:07 AM
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Thursday, October 09, 2003
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SPEAKING OF BEING A DOCTOR...
William S. Osler describes in his book Aequanimitas the character and qualities of the ultimate, bigtime, idealistic... and non-existing physician. I've read it and evaluated myself to see if i measure up:
imperturbability. the ability to maintain extreme calm and steadiness
presence of mind. self-control in an emergency or embarrassing situation so that one can say or do the right thing.
clear judgment. the ability to make an informed opinion that is intelligible and free of ambiguity.
ability to endure frustration. the capacity to remain firm and deal with insecurity and dissatisfaction.
infinite patience. the unlimited ability to bear pain or trial calmly.
charity toward others. to be generous and helpful, especially toward the needy and suffering
the search for absolute truth. to investigate the facts and pursue reality.
composure. calmness of mind, bearing, and appearance.
bravery. the capacity to face or endure events with courage.
tenacity. to be persistent in attaining a goal or adhering to something valued.
idealism. forming standards and ideals and living under their influence.
equanimity. the ability to handle stressful situations with an undistrubed, even temper.
ok... so how did i go. let's see.. i have #1 definitely, 2...well..sometimes, 3...i think, some of 4, less of 5, lots of 6, a little bit of 7, 8...i hope, 9 slightly, 10 barely, 11 ("the living under their influence" part is not so true for me), 12... yes... hmm... i think I'm really gonna be a physician, hehe...
ok, so i'm not THAT perfect... these ideals, as Sadock says, should be strived for...but they are rarely reached... someone who'd have all of these FOR REAL should put on a cape and might as well save the world.
My med friends and I are working on PROJECT GEEK... it's an 18 day schedule of studying and being stylishly "geeky" in preparation for our upcoming semestral exams. 18 days to study anatomy, histology, physiology, biochemistry, pediatrics, radiology,internal medicine, pathology (of the heart, lungs, GU, GI tract), surgery I&II, OB-Gyne, and neuroanatomy. Sounds ambitious, right? hehe... yeah.
Anyway, this sembreak would be ONE HELL OF A BREAK(down... you know... like a nervous "breakdown"? hehe).
time to put Osler's definition of "bravery" to the test!
By Doc Broks @ 4:11 PM
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AWARD WINNING
Just last September, my sister won an essay writing contest for the Ramon Magsaysay Awards. It was an amazing experience. She won two sets of computer with printers and a cool sum of money just for writing a beautiful essay. Hers was about, guess what, DOCTORS. Her inspiration was a woman doctor by the name of Dr. Ruth Pfau, a European who decided to go to Pakistan to cure lepers. Her other inspiration was, of course, her beautiful sister, (ahem, ahem) and that is me! And here is a short story how it all came about...
I joined a major medical mission in Isabela last March. Of course I was ecstatic about it since I got to assist major operations among others. It was a 1 week event which was also very tiring. When I got home my sister was the first one to see me and instead giving me a sweet hug for coming home alive she nagged me! I tried to tell her about my experiences and all she said was, "Yuck. I don't like blood. Stop it." I was hurt. I felt as if I was alone in this journey through med life and that nobody among my family will understand about what i'm going through. I cried. Then, she understood.
She realized her mistake and to compensate she wrote about me in her winning essay. By reading about the life of this amazing and courageous woman, Dr. Ruth Pfau, she understood me, a fledgling in the medical profession. She also appreciated all the doctors out there who are risking their lives to save others. She realized the impact of one doctor in bringing hope to millions of people. After reading her essay, I cried again and this time I understood.
This is the life I want to live. This is the life I choose to live. I am a DOCTOR.
By carmela @ 3:34 PM
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Wednesday, October 08, 2003
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2x a week
2 cents worth each week, 1 cent right now. Yesterday, my brother turned eight years old. I wasn't planning to go home at first, but in the end, I did. Being in Psychiatry module may have had something to do with it. Forming a positive childhood experience.
By mjc @ 11:59 AM
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Sunday, October 05, 2003
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Acrophobia & Airline Travel
I'm afraid of heights. If I'm on the escalator going up to the top level of Rob Place, I can feel the tachycardia and my palms sweat. Shangri-La Plaza? Fugghedaboutit! I'll avoid the escalators entirely and take the stairs. I've been afraid of heights for as long as I can remember. My dad says the earliest he can remember me displaying such a fear is when we were climbing the stairs in the Statue of Liberty. That was either in 1982 or 1983, I was 4 or 5 years old at the time.
I can't recall any cause, but my dad thinks this stems from an incident when I was very very young. I fell down a flight of stairs, from top to bottom when I was a child. My dad rushed me to the emergency room. No physical injuries of any kind. Mental trauma? Hmm. Enough to cause a lifelong fear of heights? Maybe.
Funny, I'm afraid of heights but am more or less fine on Airplanes. The only times I feel anxious are takeoff and during spots of turbulence. Takeoffs are relatively mild, but when you hear the engines roar up to full power and you feel the acceleration down the runway, that's when the anxiety takes hold. After climb-out and when we reach cruising altitude and the flight attendants start serving drinks, I'm okay.
Turbulence and "Air-Pockets" I seriously hate. Small bumps in the road and clear air turbulence is fine. Serious "Please fasten your seatbelts" - "Flight Attendants please take your seats" turbulence takes years off my life. I can only seriously relax when my plane is heading Northwest over Fire Island on final approach into Kennedy Airport or over Manila Bay heading East Northeast or over Fort Bonifacio/Taguig heading West Southwest on final approach into NAIA.
Perhaps I need some hypnosis sessions or a nice prescription of a Beta antagonist to end this once and for all.
By Rafael @ 9:00 PM
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Friday, October 03, 2003
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another & then -
Friday is going home day. I am one of them, students who find the daily commute bothersome and decide to rent a place near school, returning home to visit on weekends only. The self-realization is an opportunity that I am grateful for. I enjoy the flexibility & relative independence of my current living situation. Efficiency in study habits. That was the reason I gave my dad when I asked to be allowed to rent and why he let me. Dad is coming to fetch me in a few minutes. It is the end of another week. I switch priorities and become a daughter, sister, granddaughter again. Instead of simply a student. Say, a friend? Yes, I would like to believe that I am a friend and that I have friends in school. However, that is another matter altogether!
By mjc @ 6:18 PM
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Specific Phobia
All this time I believed that I have a specific phobia. I always that I was claustrophobic since the time I encountered the word in the dictionary (which was way back in high school). I always feared closed places. I feel some shortness of breath, feel nauseous and feel like choking, my heart starts beating fast, I start coughing and I know that if I wont avoid it I'd would be close to having syncope. I had this feeling of wanting to get out.
It happened to me a couple of times already. But instead of feeling relieved that I haven't fulfilled the DSM-IV-TR Criteria, I somehow feel disturbed. So, what were the feeling I used to have? Are those just a product of my imagination. I had them since I was a kid and it disturbs me that I don't qualify as having a phobia. It's such a waste.
By Jitney Girl @ 4:10 PM
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The Psychiatrist is in
One thing I've realized is that Psychiatrist will have more and more patients. The degradation of the morality of the society is to blame. Although genetic and biologic factors are involved in the etiology of Psychiatric disorders, we can see that the environment of the patient plays a major part. We see broken families everywhere, people have become tolerant of many immoralities. So what have we got? Legislators unfit for the job, more perverts, delinquents, crimes, etc, etc... o ya, and more victims.
By jadetv @ 3:44 PM
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CHOCOHOLIC
they are almost everywhere...these people with brown-bordered mouths gobbling up a big chunk of chocolate to their heart's delight. yup... they're substance abusers alright (there should be a separate DSM Criteria for this people)... the chocoholics.
how'd you find them? http://aoi-ryuu.net/chocoholic/ gives a very interesting read on these people:
choc-o-holic (chô'ke-hôl'ik, -hŏl'ik) adj. Abbr ch., cho. 1. Of pertaining to, or resulting from chocolate. 2. Suffering from chocoholism. --n. A person who eats chocolate habitually and to excess, or who suffers from chocoholism.
To find out ask yourself these questions? Do you constanty crave chocolate? Do you hide chocolate under your pillow? Are you constantly having to clean your pant pockets because your hershey's bar melted? Will you eat anything if it's covered with chocolate? Is your freezer stocked with chocolate ice cream in different varieties, chocolate cake, chocolate cream pies, chocolate covered bananas, fudgsicles, etc.? Do you know more thirty or more brands of chocolate? Is Chocolate Misu (from Sorcerer Hunters) your favourite anime character for reasons you can't put your finger on? Do you worship Cioccolato, the God of Chocolate? If you have one or more of these symptoms, you may be a chocoholic....
yeah, right, whatever. A chapter on substance abuse in Kaplan's book made an interesting note on this. Chocolate is derived from the cacao bean (everyone knows that i presume)... it contains anandamide, a physiologic substance produced by the brain that stimulates the same receptors as marijuana. It contains also the amino acids tryptophan and phenylalanine which improve mood. A bar of chocolate contains like 25-35 units of caffeine (mg)... if you gobbled like 250mg, you're in for an autonomic disaster: restlessness, nervousness, excitement, insomnia, flushed face, diuresis, GI disturbances, muscle twitching, tachycardia, psychomotor agitation, etc.
as if i care... *gobbles some Zoops*
By Doc Broks @ 10:34 AM
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Wednesday, October 01, 2003
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psych or neuro?
The 1st quiz in psych is at 8am tomorrow. The neuro remedial class is at 1pm today. There are 4 topics to study for the quiz, or around 200 pages to reread, if anyone's finished all that reading in the first place. Choice? I believe there's always Choice. It's the narrowing of options that's hard to deal with.
By mjc @ 11:55 AM
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Still Psyched out!
This would be my first historical post.
I was skimming and browsing over Kaplan and Sadock's "Synopsis of Psychiatry", 9th ed when I came across page 531, about Culture-bound syndromes... sub-topic on Psychotic Disorders... brace yourself, puritans! :
Gilbert Herdt's book Guardians of the Flutes is the best known series of ethnographies on cultures in a region of New Guinea (the semen belt) where male homosexuality is a universal aspect of adolescent development, and the symbolic framework involves the belief that semen must be absorbed, usually through fellatio, although also in some cultures through anal intercourse, for a boy to become a man. Among the Samba studied by Herdt, boys engage in homosexual activity exclusively beginning at age 7 to 10 and continuing until they are married in their late teens or early 20s. They must suck the penises of postpubertal boys as often as possible until they go through puberty, after which they are fellated very frequently by younger boys. It all proceeds in an atmosphere of extreme misogyny and of hypermasculine preparations for warriorhood and hunting. At the end of the period, they marry and BECOME EXCLUSIVELY HETEROSEXUAL HUSBANDS AND FATHERS in ALMOST EVERY CASE - a challenge to several theories of homosexuality and an answer to the obvious darwinian objections to such an apparently maladaptive pattern.
talk about cross-cultural syndromes. I'm just glad I'm not part of THAT tribe! It brings a rather interesting perspective on masculinity though... that it is a choice... and that it is bestowed.
My friend from highschool developed bipolar I Mood disorder. When I began studying Psychiatry, i didn't realize that it could be THAT real. I think should pay attention to those epidemiology studies in my book...
By Doc Broks @ 11:49 AM
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