The skull beneath the skin

September 28, 2012 § 2 Comments

The weight of the third week rests heavy on my shoulders. Rather than rejoicing at the tangibility of the weekend, I am busy devising a plan that will maximize this opportunity to catch up. Midterms are only a week away and the list of exam topics within each subject is enough to cost me sleep at night. There is simply not enough time to be on top of all of the classes – and this is something I am not alone in. The level of information thrown at us each day is unlike anything I have ever experienced. I am forced to adjust my study tactics daily and have to accept that perfection is not an option. All you can do is strive for your best and accept the level to which you performed during that time. There is no time to rewrite your notes or make up a missed anatomy lecture.

In anatomy we are focusing on osteology for the first five weeks. In the first two weeks, we learned the bones of the body: humerus, radius, ulna, hand and wrist, scapula, clavicle, vertebrae, rib cage, sternum, pelvic bone, sacrum and coccyx, femur, patella, tibia, fibula, tarsus, calcaneous and foot. For each bone we need to be able to orient it in the body and describe the surface features, including which bones it articulates (moves) with. Here is an example of the parts we need to be able to identify and describe for the femur, the thigh bone:

We were expected to memorize the surface features and orientations of every bone in the body within the first two weeks of school – how is that for pressure? Then comes the skull. The crown jewel of all bones. A structure so complicated that we need three weeks to study it. Three weeks for the skull vs. two weeks for the rest of the body. Not only do we need to know the names of the surface features, but we need to know to where and from where the different holes and canals lead.

The worst part about studying the skull is actually getting time alone with a real skull. It is such a complicated structure that 2D pictures and books fall short. The plastic skull that Skjalg and I purchased a couple weeks ago is a great tool, but lacks the smaller, less defined details and the passageways through the skull are not complete. During our anatomy labs, we have access to three skulls that must be shared among the 15 members of our group. My group is great when it comes to sharing and helping one another out, but one-on-one time with the skull is really the best way to learn it. After my medical chemistry lab yesterday morning, I headed straight for the anatomy museum, intent on filling the 3 hour break between my lectures with a human skull. Alas, all the skulls were taken and I settled on a pelvic bone and temporal bone (a part of the skull). All the tables were taken, so I had to ask two Hungarian students if I could join them at their table, which was pleasantly situated next to a case displaying twenty or so deformed fetuses in jars.

Study me! Learn my parts!

The anatomy museum closes for lunch and I made sure that I was at the front of the line when they opened again. I was going to get a skull, no matter what! When I entered the museum, I saw they had spread all 15 skulls on the entry desk, rather than place them back in the case (skulls are popular these days). Because of this, I was able to pick the best one and then settle in for a nice, cozy 4.5 hour study session. I ended up skipping my 45-minute statistics lecture, after checking with Skjalg that I could get the notes from him later. In case anyone is wondering, yes, the bones smell. Especially the skull. It has a musty, sour smell that really tests your study motivation every time you pull it closer to your face to inspect a groove or canal. I was feeling a bit bad for myself until I watched the attendant open a case and pull out an entire preserved arm – complete with muscle tissue and dangling veins and arteries – which she then passed off to a gloved 2nd year student. I’m sure my cleaned skull smelled a lot better than her dissected arm.

Speaking of fun smells, we had quite a great find in our anatomy lab on Wednesday. Our anatomy labs take place in the dissection rooms where we use the dissection tables as desks until we begin dissecting in week 6. The tables are cold metal with grooves from all corners descending towards a large hole that opens over a red bucket – the discard bucket. Several minutes into our lab, I noticed an odd smell. A quick glance at the student seated next to me confirmed that I wasn’t the only one smelling it. We both looked down to the red bucket under the table. It was half full of human remains from a previous dissection. You really can’t complain about something like that when you are in medical school, I mean, that’s why you are there, right? We allowed ourselves a small cringe of disgust and then resumed our lab with the bucket of remains hanging out at our feet.

It’s now Friday night and I’m off to work on my lab reports for the labs we did today. After last week, I’ve learned that finishing them the same day is a huge time saver. I spent almost 5 hours on Wednesday night trying to figure out my calculations for my medical biophysics Optics of the Eye lab – time wasted! It feels a bit weird to be sitting at home working on lab reports while what seems like the rest of the city readies for a fun Friday night. But honestly, with the amazing company that I have, there is no place I would rather be 🙂

Hump Day(s): Round III

September 27, 2012 § 2 Comments

For those not familiar with the term hump day, it is a reference to Wednesday as being the “hump” of the week – that is, everything is down hill from Wednesday. This is not the case for the members of EM1 Group 12… We have class from 10-15 on Monday and Wednesday and only from 13:50-16:30 on Tuesday, and then our week gets fun. Thursday isn’t too horrible (we have lectures from 9:20-18:00 with some breaks in between) but Friday is a life drainer! As I’ve posted earlier, our Friday is simply lab, after lab, after lab, and finally lab. So, here we go! Thursday morning and we’re only at the start of the climb…

The good part is that I am almost back to my healthy form again, save some bothersome sniffling and coughing. I’ve rationed what remains of our Dayquil/Nyquil reserves since Hungary operates under the same “get better by resting and not by using cold medication” philosophy as Norway does.

Drinking fluids is proving to be harder than I would like it to be. We are not allowed to have food, drink (even water), or gum in the Anatomy building and don’t always have time between our long classes to take restroom breaks. Sometime I will come home and realize that the last fluid I ingested was my single morning coffee, which pretty much makes me negative for fluids for the day. It also doesn’t help that they are doing construction on our street and the water came out like this yesterday:

Would you like a drink? It’s rust flavored!

Definitely not a “get your 8 glasses a day” motivator…though it went away after we ran the water for a minute or so.

Ok, enough dilly dallying – off to school we go!

 

Where’s a doctor when you need one?

September 20, 2012 § 2 Comments

My throat started getting sore almost immediately after stepping foot in the apartment after school yesterday. I had planned on staying at school until 18 so that I could study bones in the anatomy museum, but felt too light-headed after my medical latin terminology class. We’ve been pushing ourselves every day: waking up early to study, going to school, and then coming home to study some more. It only makes sense that pushing oneself too hard results in some less than satisfactory consequences. Skjalg had class until 20, so I sat down to work on my lab for medical physics. Our lab this week is “Optics of the Eye” and we are required to write our lab reports before class and then supplement it with the data, calculations, and conclusion after the experiment is complete. What should have taken me only an hour or two ended up taking over four hours. I’m not sure whether it was because I am sick or because the English in the lab manual doesn’t make sense. I watched four videos online about the eye and managed to write a page and a half about the theory, but got totally thrown off when I got to the calculations section:

The formation of the image by refraction at a spherical surface separating two media with different indices of refraction results following equations in both cases: D= n/o + n’/i.

Even now, I have no clue what they are trying to say here. I know it has something to do with how the light rays reflecting off of objects we are looking at are refracted at the lens’ in our eyes…and then something something different distances. It’s hard enough going to med school in the first place without having to guess what the professors are trying to communicate to you. I should honestly just be happy that I can speak English good well 😉 There are plenty of students here that are struggling with even basic level English. I can’t imagine what this is like for them…

My sore throat kept me up all night. Breathing dries it out, making it more sore and more painful. I drank water steadily through the night to keep my throat moist, which granted me enough relief to sleep for 20 minutes or so before I needed to go to the bathroom or take another sip. I was such a zombie this morning that Skjalg convinced me to stay home. Luckily, today is just lectures (which they don’t take attendance for) and Skjalg and I share all of them. Fridays are the heaviest day of the week, so I need to get better by tomorrow morning:

  • Friday Schedule
    • 8:00-9:30: Histology Lab
    • 9:40-11:10: Biostatistics Lab
    • 11:20-12:30: Biophysics Lab
    • 14:00-16:40: Medical Chemistry Lab

So today will just be drinking a lot of fluids and studying. My throat is too dry for me to sleep, so I may have to venture out for some cough drops later. Wish me luck!

Hello, entrance exam examiner…we meet again.

September 19, 2012 § 1 Comment

My second entrance exam back in June was quite brutal, to say the least. While scouring the university webpages for lecture slides and other helpful info, I came across the profile of the head of the anatomy department. “He looks oddly familiar..,” I thought to myself. “He was probably one of the people we were introduced to on Freshman Day or another one of the school functions.” Fast-forward to our anatomy lecture today. There we were, sitting in the middle front row and prepping for our lecture on the cranium. A buzzer rang to signal the beginning of class and we all rose to greet the lecturer – Dr. Csillag András himself. “That’s the head of the anatomy department!” I whispered to Skjalg.

He was probably the best lecturer we have had so far. He wrote most of the difficult words up on the board, spoke slowly and clearly, and engaged us with fun side stories and connecting points (rather than inaudibly present 50 packed slides in a 45 minute lecture). Though I was enjoying the lecture, I couldn’t shake the feeling that I had met him before. I told Skjalg that I was almost 100% sure that he had been my interviewer  at my second entrance exam. I then sat and debated with myself for the remainder of the lecture. Unable to let it go, I jumped up after our applause and raced to the front to find out if I was right. 

“Excuse me, professor?”

“Yes?”

“Hi. I was wondering if you were perhaps in Oslo, Norway for the entrance exams in June?”

“Yes,” he smiled, “I was there.”

“I thought so. It’s nice to meet you again,” I extended my hand to him, “My name is Bianca. You were my interviewer.”

He hesitated and motioned that he wanted to shake my hand but that it was dirty from the bones handled during the lecture. I said it was fine and shook his hand anyway.

“I just wanted to say hello and thank you for the lecture and for putting in a good word on my behalf. I’m here now!” I smiled.

“You are welcome. I hope that, if we meet again in the exam room, that we have the same outcome that we had last time.”

If I do get him as my examiner, it will be interesting to compare his examination techniques. I still can’t believe that my entrance exam interview was with the head of anatomy for the university…talk about pressure!

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Our lecture on the cranium included an intro of the skull and its different parts and then a closer look at the sphenoid and ethmoid bones (there are 29 total bones in the skull). This was covered within a 45 minute lecture.

Sphenoid

Ethmoid

 

Do you have a strong enough faith in your knowledge to bet your life on it?

September 16, 2012 § Leave a comment

Our first week of medical school is over and we feel it in every ounce of our beings. Our legs are sore from hustling back and forth between classes, office depot, and the anatomy museum; our backs from carrying god-knows how many kilos of textbooks; our eyes from the thousands of words that have fluttered in and out of our range of view; and our hands from cramping around the body of our pens in desperate efforts to log as much of our light-speed lectures as possible. In a single, introductory lecture on medical chemistry, our professor covered at least a year, if not two, of general chemistry. This is the big leagues, B. Welcome.

The freshman class is quite possibly the most varied, eclectic group of people I have ever encountered. Students range in age from 18 to 30, from almost every country I can name without looking at a map, and with every kind of background. Many have degrees within the sciences – neuroscience, biology, microbiology, chemistry, pharmacology – whilst some are fresh out of high school and others recently finished with military service in their home country. It feels strange to share such a pivotal passion with so many different people. We are all here for the same reason. We want to be doctors. We want to be really, really good doctors. Which leads us to the title of my blog post: do you have a strong enough faith in our knowledge to bet your life on it?

In order to explain this title, I have to give a little background. Destination? Our Biostatistics and Informatics lecture on Thursday afternoon.

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“Why are you here?” the professor asked a blonde girl, seated in the 5th row of the packed 250-seat lecture hall.

“I want to be a doctor…” she smiled shyly.

“Good. You want to be a doctor. And you?” he pointed to a male student seated behind her.

“Well, I want to be a good doctor.”

“Yes. A good doctor,” our professor laughed, “and what makes a good doctor?”

After several students threw out answers like “intelligent”, “up-to-date with technology”, “nice”, “empathetic”, and “strong”, he returned to the front of the room. “You are all here in hopes to enter a field that says to the world: I have a never-ending desire to expand upon my knowledge. There is no end to this study. These next six years of your life are just the beginning of a lifetime of knowledge. You must be able to doubt, to question, and to think in a scientific manner. Being a doctor requires a special attitude – a very, special attitude. As a doctor, you will have the right to look into the personal lives of sick people. And you will have to make decisions that directly affect the outcomes of these people’s lives.”

“So, is faith in our knowledge strong enough to bet our life on it?” he asked as he changed the slide on the projector:

He went on to tell of Murillo’s Adoration of the Magi, Károly Simonyi’s work with Hungary’s first linear particle accelerator, and then of how we should always make our own mathematical calculations when doing an extreme activity such as bungee jumping.

“Doctors make decisions.” he said. “Nurses can draw blood, administer medications, and care for the patients. But doctors, doctors direct the treatment. It is doctors that must diagnose and make the decision – and that is where you will need statistics.”

As he continued on into his statistics lecture, I found myself stuck on the fact that one day, I will make a decision that determines whether or not someone lives or dies. And not just that one day, but many times in the days after. Being a doctor goes beyond wanting to help people or wanting to work with the human body. By becoming a doctor, you are confirming your faith in your knowledge, in your ability to heal. You are making a promise to your patients that you have prepared yourself to the best of your abilities and that you trust in those abilities so much so that you would stake your own life on them.

It’s scary to think about it now, to think that the things I am learning are putting me in that position. But rather than being intimidated by it, I find myself embracing it. As much as I fear the implications of my future decisions, I know that now is the time to prepare myself for them. I have to do my best every day, at every lecture and in every practical, to ensure that, when I am done, I have maximized the years of preparation leading up to the day when I will make my first decision.

Welcome to medical school!

September 12, 2012 § 3 Comments

I expected that school starting would mean that there would be a lot to do and little time to do it…but I underestimated just how much there would be to do. Talking to my mom on the phone after my first day, I told her that I had the same feeling that you get at the beach when you get sucked under by a wave and struggle mercilessly to orient yourself. Day 2 was better – but not because there was less information. I love my schedule, get along with everyone in my group, and enjoy all my teachers so far. The English competency of the professors varies greatly, but I think I will get used to their dialects soon enough. Some of the classes are so fast-paced that all you have time to do is furiously scribble down key-words. We are expected to cover a lot of material outside of class and at a much greater degree than I have ever experienced. Midterms are already only less than a month away and we need to know A LOT of info. For example, for our anatomy midterm we need to know every bone in the body, including the skull. Sounds easy enough, right? But, it’s not just the names of the bones we need – it’s all of their grooves, parts, holes, etc.

Humerus

Radius and ulna

Yesterday and today we spent most of our free time at the anatomy museum, where you can check out three bones and study them amongst the labyrinth of glass cases displaying jars of various preserved body parts. We aren’t allowed to take pictures there, but I found these online:

This is actually the table we were studying at today

Must be during finals because there aren’t normally people sitting on the floor.

(For more pictures from the anatomy museum: http://www.ana.sote.hu/galeriak/muzeum2008/index.html)

Our anatomy lectures takes place in this amazing lecture hall that is over 100 years old. The lecture feels so much more official sitting in a room with such history, to have such a direct connection to the advancement of medicine over the past century. We are to conduct ourselves in a respectful manner when in the anatomy building. We enter the room only when invited by the lab technicians (who prep the lecture hall for the professors, hanging up anatomical paintings specific to the lecture, setting slides, and cleaning the blackboard). When the lecturer enters the room, we must all stand and cannot be seated until they have acknowledged our show of respect, and when the lecture is over we must clap. In addition, they are very strict about no food, drink or gum and we are not allow to take notes on a computer or iPad – only by hand.

Lecture of Professor Lenhossek (1909)

(Picture credit: budapeststudent.com)

Lab technician preparing the room between lectures

Before our first lecture

Ok, enough fun. I’m off to learn all of this (below) before my next anatomy practical (did I mention I have 5 other classes too?). Our anatomy midterm is in less than a month!

(By the way, I’m not kidding – we need to know all these parts and be able to identify them on the spot by Day 3.)


The Promise of Tomorrow

September 9, 2012 § Leave a comment

It’s early Sunday morning and I’m up pondering what tomorrow brings. Skjalg took Nyquil (American cold and flu medication) before he went to bed, so he will probably sleep for a couple more hours – which he really needs. I could have stayed in bed a little bit longer and enjoyed the last morning where I can sleep in with a good conscience, but my brain honestly just doesn’t work that way. I’m the type of person who, as soon as my eyes open in the morning, starts to think about all the things I need to do and how much better my day will be if I get an early start on it. So here I am, left alone to the mercy of my thoughts.

The theme of my thoughts this morning is tomorrow – not just my tomorrow, but tomorrow in general. It’s fascinating really, how much the nine thousand or so tomorrows of my life have varied from each other. It can be an exciting day with friends, a day of pure relaxation, a day of errands, travel, joy, challenge…the list could go on forever. I must admit that in my short life I’ve had many a great tomorrow. Tomorrow I am graduating from high school. Tomorrow I am moving to Los Angeles. Tomorrow I am moving to Norway. Tomorrow I am celebrating two years together with my best friend. Tomorrow my brother and I are leaving for a trip that will take us around the world: Hong Kong, Los Angeles, San Francisco and back to Oslo. Tomorrow I am taking the entrance exam for medical school. Tomorrow we are moving to Budapest.

All of these tomorrows represent hard work, dedication and everything that goes into making a dream a reality. But this one, this big one that is approaching faster than I can process, this tomorrow is a day more than 7 years in the making.  All of the tomorrows that I have had in my life were just steps to bring me to this tomorrow. And I am finally here. Tomorrow marks the culmination of each one of my efforts, decisions, challenges and successes. Yes, there are bigger tomorrows on the horizon but this one is, without a doubt, the grandest tomorrow of my life thus far.

In the spirit of tomorrow and the promise it brings, I feel some inspirational brain fuel is in order.

YouTube video: Rudy and the Janitor

“And, when you want something, all the universe conspires in helping you to achieve it.”
― Paulo Coelho, The Alchemist

“I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.” – Michael Jordan

“You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You’re on your own. And you know what you know. And YOU are the one who’ll decide where to go…”  ― Dr. Seuss, Oh, the Places You’ll Go!

“Listen to the mustn’ts, child. Listen to the don’ts. Listen to the shouldn’ts, the impossibles, the won’ts. Listen to the never haves, then listen close to me… Anything can happen, child. Anything can be.”
―Shel Silverstein

“Success is not final, failure is not fatal: it is the courage to continue that counts.”
― Winston Churchill

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”
― Marianne Williamson, Return to Love: Reflections on the Principles of “A Course in Miracles”

Where Am I?

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