It’s (Reflex) Hammer Time

This week I traded in my scalpel for a reflex hammer and began a 2 week stint on the neurology service.  The verdict? Well, aside from the fact that everyone on the neurology floor seems significantly more well-rested (and by extension nicer), I’m finding that neurology deals with a level of detail and intellectual exploration that surgery never even began to broach.  At the risk of sounding trite, neurology is far more… well, cerebral.

Somewhere along the line in the first two years of med school you are taught the neurological exam by rote. You memorize the exact maneuvers and mechanics of all those weird tasks that doctors ask patients to do (finger to nose, walking heel to toe, etc), but whose purpose you never quite understood, and still at that point don’t understand.

Remarkably, when done correctly and with a keen eye for the subtlety and nuance of patient reactions, these tests are elegantly designed to pinpoint specific neurological deficits, and have the capability of localizing a lesion in the nervous system, such as a stroke, to an incredible degree of accuracy.  All this without using invasive measures!

And yet, before the actual experience of working with patients whose exam findings are abnormal, it’s hard to have any real appreciation for this.

As far as I’m concerned, the neurological portion of the physical exam is the figure skating of diagnostic medicine: looks simple, but is anything but.  Things like eliciting a proper reflex, which look so easy to the untrained eye, can easily turn into a clinical nightmare.  With multiple failed attempts and disgruntled patients tired of being hit with a hammer, the finding of an absent reflex inevitably brings up the self-doubting question: does the patient really not have the reflex for neurological reasons, or is it just a reflex that you weren’t able to see due to lack of skill.  Of course at this stage of training (or lack thereof), the latter is much more likely, and often leads to awkward moments during morning rounds when you have to admit as the lowly third-year medical student, that you’re not quite certain what the status of the reflexes were.

Nonetheless, this is all part of the process. And with a supportive team of residents and an attending who’s willing and eager to teach, the technical challenges of performing a good neurological exam become less of a threat and more of a way to prove  and improve your clinical skills.

Whereas surgery is primarily concerned with fixing the problem at hand via physical manipulation or removal of diseased tissues or abnormal structures in the body, neurology prides itself on merely identifying abnormalities, often with limited resources to fix the problem once it’s elucidated.  And if there’s one detractor from the field, it would have to be that: the fact that there are few magic bullets or total cures.  It seems that all-too-often – take the case of stroke for example – neurologists are happy with partial improvement over time, even if it’s not full recovery to baseline, or at the very least, are content with preventing a recurrence.

From a personal standpoint, neurology is appealing in that it encourages and demands extensive thought and logical thinking, and takes into account various aspects of a patient’s life that other areas of medicine often shirk, making the process both impressive and entertaining to watch.  A skilled neurologist examining a patient is tantamount to a seasoned detective gathering clues and lining up a series of possible diagnoses as culprits responsible for the problems that the patient is presenting with.

At least for the time being, I’m pretty excited to be filling the position of gumshoe under these detectives.

Pleasant Surprise

Every time I check my e-mail, there’s about 80% newsletters/spam, 10% work related things, 9% personal, and 1% completely random surprises. Today the 1% came up, and apparently I received the Association Award for $1000! It’s weird because I applied like a LONG time ago (in the e-mail, they even begin with “I truly apologize for long delay in providing notification to you”), so I was really surprised to see this in my inbox this morning. Ah what a good morning so far.

Classes started this week, and as you probably know or might have intimated I have the tendency to go beyond what I think I can handle. To my surprise, I made it through my first week of classes (no classes on Friday, I love block scheduling).

I’ll just be brief to save my sanity, but nutrition and cell biology almost talk about the same thing (proteins, lipids, carbohydrates) so when I sit in both of the classes, I feel like I’m studying and learning the same material for the other class (an amazing feeling because less work for me). My Asian Studies class is so…interesting. I chose to take that class because no one really talks about love, sex, or marriage in Asian cultures. We read The Economist and chapter 2 of Lovesick Japan (the latter is truly SICK). I had no clue what we’d be discussing in this class, and the few discussions we’ve had cover things I have never thought about: this is one of the reasons I love college, especially at UIC. Since UIC is so diverse, you get a full spectrum of thoughts and ideas. When we were discussing the definition of marriage, some people questioned if it had to even be with people. Someone said “yeah, my cousin married a tree…” or “I heard an Asian guy married a pillow, and another who married a video game.”

Fiction is nice so far. We haven’t done too much besides talk about the difference between fiction and poetry and how awful our classroom is at BSB because there are no windows and there is a huge echo when someone talks, or moves. Yesterday we went outside to enjoy the weather, although the sun was kind of blinding and burning our skin. My professor (erm, graduate student?) was talking to us with focus and then suddenly “yeah so when we think about short fiction and its relation to poetry…” (stares at my shirt) “you have AK47′s on your shirt…cool. Anyway, when I write poetry…” It’s funny that he just randomly stopped in his train of thought to say that phrase and moved on so quickly. I just happened to be wearing my light blue Rogue Status shirt. Sometimes I forget I have guns on that shirt, but oh well. Freedom of expression!

Music therapy was really cool, and our instructor said if we knew how to play an instrument, we could volunteer at Rush to play for in-patients! I really want to do it because I think it would be more meaningful than the volunteer work I do now (well, I am currently on hiatus).

Finally, organic chemistry. Our professor is really cool and even asks students to go up to the front and draw lewis structures and all that jazz. This class is the only one I have not read the book for, only because I wanted to make sure I got my act together with everything else. This weekend I’m planning on studying organic chemistry a lot.

Well, I better get back to work, although I don’t have much to do at the moment…afterwards I’m going to research! I need to find two samples of mine that have gone missing in one of our refrigerators (might take me a bit).

This is what the graphics office looks like in UIC Campus Housing! Across from us is SRH 330, where people who write graphics proposals pick up their posters.

Oh yeah, and apparently next week Lupe Fiasco is coming to Spark in the Park. I am so excited.

So What Classes You Taking??

Good morning UIC!!!!!

Frenzy everywhere as students hit classes for the fall semester. So to everyone!– here’s my class schedule with class description. Next week I will hand you guys my secret Top 5: Tips to Get Higher Grades.

CME 315: Soil Mechanics

Soil mechanics are part of the spectrum of Geomaterials in which it lay the foundation for research towards chemically amended soils, recycling wastes and byproducts, high water content materials, Geosynthetics and more.

CME 302: Transportation Engineering

Studying Traffic on Roosevelt road near UIC South Campus

In this class we design, operate, and plan transportation systems utilizing various technologies; in addition, practice our methods to the transportation system throughout Chicago in efforts to resolve urban gridlock.

CME 216: Environmental Engineering

Actually, this a guest lecturer from CME 315 speaking about ASTM (American Society of Testing and Materials) and the various supervising environmental committees

We explore common environmental engineering challenges and create designs for waste and water problems while accounting for the effects of man-made projects on resources.

CME 205: Structural Analysis

Not really a structures class picture-- but the JST Staff creating a pyramid using a common truss support system found in statics books

Classic analysis of truss supports, beams, and frames utilizing common methods such as displacements, shear, and bending moments.

That’s all for this week again! Comment and post with what classes your taking!!!

TOPIC NEXT WEEK: ”Top 5: Tips to get higher grades”

LAST WEEK ANSWER: Last date to drop a class without a withdraw is next Friday September 2nd, 2011 (UIC Catalog)

QUESTION OF THE WEEK: What was the previous name of SCE (Student Center East)?

 

“Why Medicine?”

The dreaded question at a medical school interview is, “Why did you choose medicine as a career?” the catch being that under no circumstances whatsoever should you answer that you want to help people.

Heaven forbid those words left your lips — let’s just say as an unfortunate consequence of the adrenaline and anxiety of the moment — you’d likely find yourself spending the rest of the interview trying to crawl out from the ever-deepening hole you’d created with that initial response.

“Garbage collectors help people, don’t they?” one professor always used to retort when given the answer in the course of a discussion “Why not be a garbage collector?”.  What often followed was a messy string of qualifications, the likes of which was anything but coherent, and which did little to demonstrate any true sentiment as to why someone really had chosen to dedicate their life to such a grueling profession.

All this is not to say that a desire to “help people” isn’t a part of many physicians’ motivations to enter the field; undoubtedly it is the cornerstone upon which many have pursued their careers.  Rather, the inaptness of the answer, and the whole mind game of the “Why medicine?” question, seem to have more to do with assessing whether or not a candidate for medical school has thought through the gravity of the endeavor they’ve chosen to undertake.

From the rigorous pre-med curriculum, replete with cut-throat classmates and all night study sessions to the exhaustive nature of med school itself, with more cut-throat competition, late night studying, and long hours spent on the wards (all with behemoth exams like the MCAT and USMLE Steps 1,2, and 3 thrown in), a medical education is no walk in the park.  All this, with hundreds of thousands of dollars of student debt piling up all along the way and 3-5+ years of minimal pay thereafter too look forward to during residency – one resident described the process as seeing what you think is a light at the end of the tunnel, only to realize that the light is in fact an oncoming train.

Morose, no doubt, but the realities are harsh and demand at least a temporary suspension of levity when considering medicine as a career choice.  It’s not all helping and healing people; sometimes what we do ends up causing the patient s more pain and suffering, and sometimes you come up against bureaucracy and political obstacles that you feel deep down isn’t in the best interest of the patient, but are confined nonetheless to the mandates of the hospital and the profession.  And so, realizing that medicine is grayer than you ever thought before, you start to delve a little deeper, asking yourself, “What is it that makes me want to wake up early every morning, stay up late every night, sacrifice my weekends, give my time and energy to others such that I tax and strain other relationships in my life?” “What drives me into this profession where I am surrounded by people afflicted with ailments of all sorts, confined to the insular, “sterile” environment of a hospital, putting myself at risk by caring for the sick?”

It is these questions for which, “I want to help people” just doesn’t suffice.

For me, I found myself compelled to be an advocate for patients who otherwise may not have a strong voice of their own, and for those who have been traditionally under-served by the medical system.  I wanted to pass on the knowledge that I’ve been fortunate enough to accumulate in the hopes that from this knowledge would come empowerment and changes that would spur a better life for my patients, in terms of health and otherwise.  I aim to comfort them when they are anxious, reassure them that I am dedicated to fighting for them and with them against their disease.  I aim to ensure that they have every single right afforded to them and are aware of every option regarding their treatment.  I want to help them, yes, but in such a deeper sense than allotted by that four letter verb “help.”

And of course there are the detractors.  Though intellectually fascinating, it is mentally and physically exhausting, with some serious ups and downs.  And it is a long road.  Admittedly, at this point in the process, the pursuit of a medical career seems like mountains beyond mountains.  But to this point, every peak has been worth scaling, every fall along the way, character building, so for me it’s obvious.  Why medicine?  Because  I’d never be happy or fulfilled doing anything less all-encompassing.  I was meant to climb endless mountains

Good Practice.

Due to my interest in practicing medicine in addition to illustrating it, I signed up to shadow some clinicians and volunteer at a local community center in Chicago this semester.  A few days ago I shadowed a doctor who works the evening shift for family medicine.  Dr. W, I’ll call him, is a great family doctor because of the effective way he communicates medicine and health to his patients.

Many of the patients at the clinic have zero health insurance.  Many of them also don’t have the time, money, education and health literacy to always get the best care, not to mention to manage their own health.  Health literacy has been described as “the ability to understand and act on health information.” (Jibaja-Wiess, 2007)  I’m curious if the health literacy of a patient is actually related to how healthy they are.  Because we all know that donuts are bad for us due to the fat content and hardly any nutritional benefits, yet we eat them! (or I do at least, any chance I get) Apparently our country runs on donuts.

In one instance, Dr. W treated a young patient with a history of anemia who was having dizzy spell during sports practice.  (I’m maintaining anonymity with names, gender and other specifics for privacy purposes.)

Dr. W asked the patient if they had been taking the 3 iron pills prescribed to them a day, and the patient responded, “not really.”  He found that the patient was only taking one, maybe two pills per day.  This was a bright high school student with an education that probably included basic sciences.  But the patient didn’t take all three pills because they didn’t have a firm grasp of the point of taking them.

Dr. W asked the patient if any doctor had every explained to them how the iron pills were related to the dizzy spells.  The patient said no.  So he spent about 5 minutes explaining the role of iron as a carrier of oxygen in the circulatory system, and how feelings of dizziness and weakness directly correspond to the low levels of oxygen being delivered to the patient’s muscles, tissues and brain.

Afterwards, the patient said, “that makes so much sense!”  So, in the ten minutes it took to treat the patient, Dr. W had used science to convince the patient to take their pills.  It was like a light switch being turned on.

The problem is that many doctors don’t take the time (or have the time) to explain the science behind the health to their patients.  Some health care workers hand out informational sheets that, according to Dr. W, end up “lining the bird cages.”

One alternative to teaching patients about their disease is something like a disease management program in the form of a DVD or computer interactive.  Management programs can teach patients about their condition and how to treat it.

My masters project will be to create some 2D animations for a diabetes management DVD, for low health literacy patients.  The animations will, as clearly as possible, describe the role of insulin and glucose in diabetes.  The point is to show patients what their medication does and why it’s essential to warding off diabetes.  It will eventually be implemented on computers in clinics and hospitals so that patients can see and learn directly before or after their doctor’s appointment.

Lucky for me, shadowing in the clinic is a great way to see where exactly a disease management program can fit into community health care!

 

Jibaja-Weiss, M. L. (2007). Utilizing computerized entertainment education in the development of decision aids for lower literate and naive computer users. Journal of Health Communication, 12(7), 681-697.

I Don’t Want No Scrubs

The jade green scrubs given to operating room employees (surgeons, nurses, house staff, etc) are anything if not uninspiring.  What seems comfortable in the hazy hours of the early morning (we’re talking sometime around 4:45) ends up feeling like a grimy, sweaty encasement by the end of the long, grueling day (anywhere from 12 to 16 hours later).

And while some seem to love it – “It’s like wearing pajamas to work!!!” being a common sentiment – I found myself losing a piece of my identity.

In terms of utility it makes perfect sense.  In the case of emergency, there’s no diverting to the locker room to change into operating room attire; as a result, everything becomes a little more streamlined.  But from a psychosocial point of view, it can start to feel a little like the prescribed outfit in an authoritarian society.  The way one dresses is no longer a means of self-expression when everyone is relegated to these jade colored Mao Suits.  So I asked myself: what can I do to make these scrubs my own?  And with a little imagination and the inspirational words of Project Runway’s Tim Gunn in my head – “Make it work!” I set out to find a few ways to give some individual flare to the humdrum surgical scrub.

A few rolls of the sleeves gave the illusion of a tank top.  Similar folds on each leg yielded an 80’s high-rolled look.  Trading in the ratty gym shoes I’d been wearing around the wards for a more stylish pair made all the difference in the world, but still didn’t quite do the trick.

I just couldn’t get over the fact that I enjoyed and missed dressing up in the mornings and representing myself through my wardrobe.  In the clinical portions of my first two years of med school I’d learned that even within the rather conservative field of medicine, it’s still possible to change things up with regards to what you wear; the key is nuance. As such, I strive to put a little extra thought into it every day, hiding a god amount of personality in the details.

The type of tie (skinny vs traditional), the particular matching or contrasting of colors, and the thoughtful use of accessories (a loud pair of socks with an otherwise dulled down outfit certainly makes a statement) all come together to speak to who I am underneath the short white coat.

And so, I guess I can say that jade isn’t really my color, and that, given the choice, I’d rather not wear pajamas to work.  Aside from that, I’m now more appreciative of any chance I get to wear what I want.  And whether heading to a meeting or just running out to the grocery store, I’m more likely to be dressed to the nines than sporting sweat pants.  After all, I don’t want no scrubs.

5-Day Countdown

UIC!

Here’s a snippet of my past 5 days through the eyes of JST.

**Day 5: Last Day of Training (Monday)

After Integrating Academics Into Your Community session, RA/PMs assembled at the South Athletic Fields for FIELD DAY.

**Day 4: Last Minute Preparations

I went around helping RA/PMs with bulletin boards and door-decs. Afterwards I went around JST seeing my staffs awesome bulletin boards and door-decs.

**Day 3: Freshman Opening

I supervised the South Campus Move-in Crew and welcomed hundreds of freshman residents and parents into JST.

After moving in and the freshman floor dinner, they were brought to the Freshman Dinner with special guest Jim Compton, former graduate of UIC and now Executive Vice President and Chief Revenue Officer for United Airlines.

Following the Freshman Dinner, residents were invited to floor programs such as the one depicted above titled, “Game Night.”

**Day 2: Continued Move-in Day


All other residents are now welcomed to move into JST. We had the JST Parents Association table setup as well as those interested in JST Hall Council.

**Today: New Student Days Activities

Listed below were New Student Days activities that continued throughout the week starting that Thursday. Take a look at what we have in store for residents.


I will be attending various NSD session throughout Friday.

That’s it for the week. Feel free to say hey to me on campus!

=============================== 

TOPIC NEXT WEEK: First Day of Classes

QUESTION OF THE WEEK: When is the final drop date for classes?

ANSWER LAST WEEK: If your favorite color is red, your ambitious, passionate, excited, and courageous.  

 

 

 

 

 

 

Hello Inflammation

I stayed up with my brother last night until 4am, reading the first chapter of my cell biology textbook. I figured since I’m taking so many classes that will require intensive reading, I might as well be a week ahead of everything! I have no clue how organic chemistry will turn out so I want to make sure I have everything else down. My brother, on the other hand, was obviously not studying anything because he’s not crazy like me. Instead, he was sewing up a stuffed plushie panda, very similar to one of our t-shirt designs. As for why he was sewing (extremely rare activity for him), his friend’s birthday is coming up and he just decided to conjure up his old life skills home-ed type knowledge to make something oddly cute.

Unfortunately I did not get much sleep since I had to wake up this morning around 9am to see my previous boss since she wanted to take me out for lunch at noon, and to also help out the new girl who needed to upload a .exe file on the website (took a long time but FTP program saved us). Either it is my lack or sleep, or perhaps something I ate, that has made my face and body become really red all over. It is eczema, and lots of inflammation. I really hate flare-ups. I seriously don’t understand why it happens and I am pretty sure I have been staying away from things that cause allergies for me. I take a Zyrtec each night to help, but maybe I should switch brands. I’m a feeling a little down, even though school is starting and I should be excited, but I’m scared I will have trouble coping with so many classes.

I wonder when the Chicago weather will change again. Summers are nice but short, and winters are long and crazy cold. Spring and fall are perfect, but not if you’re like me and dying from the allergy season! :(

I haven’t been up to much this week besides promoting iiClothing and going to the research lab. I finished collecting my cells, although I made another mistake which made me slap my forehead again—however, mistakes are necessary to learn. Ever since that other mistake I made (not clicking a button), I always make sure to click it, and so when I do another bone marrow isolation, I’ll be sure to not the same mistake twice.

Education in a Flash

Adobe Flash is used to create interactive programs, either web-based or on their own.  Any time you see a pop-up add online that says “click here for a better body!” or something like that, Flash was most likely the tool to create it.  So in that way, Adobe Flash is resented by a lot of internet users.  But I have grown to really like the program, because as with most things in life, it can be used for good as well as evil. (ok maybe “evil” is overkill for describing online pop-up adds, but they are really really annoying sometimes.)

Flash has a bouquet of capabilities including painting, drawing and editing tools, capacity for vector and bitmap images, means to create 2-D animations and it’s very own language, Action Script.  While I am far from being an expert in code languages, I have learned a little bit of html and css, and Action Script seems to be more straight forward than the others.  Using the language, you can tell animations to “start” or “stop” at the click of a button, to navigate through the pages of an interactive program or website, and way more complex things like to do something (say, play a certain happy song) on the condition that five other things are done, and if all five aren’t done, then doing some thing else (say, playing a sad song.)  I have found to really enjoy writing Action Script and troubleshooting with it. It’s like a puzzle that I have to put together, and if one piece is missing, the interactive just won’t work.

Here are some images of the interactive I made.  I created it to target a female audience, and specifically those who might be suffering from a disorder called Pre-menstrual Dysphoric Disorder.  You can read more about it here http://www.womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

…but for now I’ll just show you some images of the interactive, which teaches a little about what foods to eat and lifestyle choices to be made during the two or so weeks before your period.  It has four total pages, the last one being a quiz that you take after reading the information.  I hope that soon I can post the actual interactive so people can click through it and take the quiz!

Home page with options to click through the interactive.

"Diet" page, listing food recommended for those suffering from PMDD.

"Lifestyle" page, listing activities recommended or to be avoided.

"Quiz" page, where you can solidy your understanding of diet and lifestyle choices.

“It’s not a dorm, it’s a residence hall!” -Campus Housing

Hey UIC!

Freshman Move-in Day is in T-minus 5 Days!– RAs and PMs all over campus are scrambling all of their creativity to place door-decs, bulletin boards, welcome letters, and room goodies!

The RA/PM staff training is near the end. Below is the picture of the JST Staff at a lunch meeting with the FIR (Faculty in Residence) and doing door-decs and bulletin boards in the C Tower Lounge.

JST: Resident Director, Senior Staff, RA/PM Staff

JST Staff creating bulletin boards and door-decs while watching a movie

This is my first year being on Senior Staff for Campus Housing. The supervisor role is definitely a fun learning experience. Since RA/PM Training is nearing to an end. Here’s my:

Top 3: “Things I Learned From RA/PM Training” (Resident Assistant/Peer Mentor)

3. Policies and Procedures
There are many policies outlined in the Resident Handbook and RA/PMs have to know and be able to identify them. If in any situation arises, the RA/PM has to familiarize themselves on how to resolve each policy on a case-by-case basis.

Policy and Procedure Review Game By Resident Director Amanda

2. Safety on Campus
We were introduced to the UIC have a Campus Advocacy Network, Crisis Hotline, Wellness Center, and UIC Police. A former Chicago Police Officer also presented on how to react if shots were fired on campus, a reality that every campus must be prepared for in case it does happen.

1. Behind Closed Doors
Signifying the true test of every RA/PM is what we call “Behind Closed Doors.” For nearly 5 hours, we exercise the abilities of an RA/PM to resolve any given situation. This can range from common to extreme scenarios– roommate conflict, party/drug situations, to an active shooter in residence halls.

Boundaries Training

That is all I have this week! See you next week!

TOPIC NEXT WEEK: Freshman Move-in

QUESTION OF THE WEEK: What is your favorite color?

 

 

Page 58 of 60« First...1020305657585960