Happy Tuesday

November 18, 2014 § 3 Comments

This morning started with our second lecture of the week (followed by our first practice of the week) in internal medicine. The topic of the lecture was Nuclear Methods in Medical Diagnosis. It was a bit of a heavy topic for 8:00 a.m. and brought back a lot of memories from biophysics (which we took during first year). The topic is a bit out of place…we’re not really in a place in our education where we can truly understand the applications and we won’t be tested on it, but I guess it’s good to get our feet wet.

After lecture the ten of us that had attended headed immediately over to change into our white coats for the practical. Today was the first day that we didn’t see any patients. Instead, our doctor sat us down and did a detailed run-through of how the exam will be and how to properly fill out a Hungarian medical chart. There is a lot to remember – and that is just on the medical side. Having to do it in Hungarian is something else entirely. Our doctor said we will be paired with a patient whose information our examiner knows intimately. We will then be left with the patient and have to do a full exam and fill out the chart. Once we are done, the doctor will review the chart and see how well we did. Our doctor is probably the most strict doctor (at least from what we’ve heard) so I am really happy we won’t be having him on our exam. He kept mentioning things that are an “easy fail”. Because this is all common sense, right? He is not so much a stickler about the medical part (he knows we are too inexperienced to properly diagnose a murmur) as he is about the Hungarian. He believes very strongly that without Hungarian, we can’t learn internal medicine.

These are the scribbles I managed to get down during the practice, just to give an idea of what we need to know and focus on.

I ended up skipping this afternoon’s lecture for microbio in order to go home….and study microbio. We have our midterm in two weeks from Thursday and I’m considering taking it as one of my first exams this exam period. The lecture falls in a block of about 4 hours and I decided that I would get more out of that time by studying at home. I’ll of course have to make up the lecture later – all in due time!

For this micro midterm, we have to know about 25 bacteria. After today, I’ve studied all but two, but will need time to review and commit to memory. To study each bacteria I’ve been watching SketchyMicro videos, reviewing notes written by a teacher in the department, reviewing the slides from our practicals, reviewing lecture slides and finally, reading in the textbook. No wonder it takes me so many hours to cover one bacteria!

SketchyMicro is a great tool for visual learners. They create a picture with a bunch of memory stimulating components specific to the bacteria. I save a copy of the image on my iPad and then add in the notes as I watch the video.

This is what I have for the bacteria Staphylococcus Aureus. It’s a big one, so there is a lot more information for this one that others.

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Now, while reviewing, I’m putting all the info into a table. It’s forcing me to pick only what I think is the most important and will be much easier to review than reading through my notes again. Gets a little messy when using so many different sources 😉

Screen Shot 2014-11-17 at 20.34.00Ok! Bacteria tables await!

 

 

Success first, happiness second?

November 16, 2014 § 1 Comment

I’ve allowed this semester to consume me (and take my sanity hostage) and now I need to actively work to get it back. It’s not like I’ve gone crazy, or that you would even notice that I am where I am mentally, but inside my head, when I am at home studying, it’s a mess. This past week I have been pushing myself especially hard, which means studying until I physically can’t anymore (when everything hurts and I can’t see straight) and getting up earlier than I should. It never works. It just leads to hysterical burn-outs.

On Thursday I was a total zombie by noon and feeling the initial symptoms of Skjalg’s cold. So, I took the rest of the day off (my day was supposed to go until 21:00) and went home to not study. That night, I told Skjalg that I need more routine. We’ve slowly slipped away from going to bed at 22:00 and waking up at 6:00. I’ve gone completely off the radar on that one, Skjalg is a little more regimented. I also suggested that I study in the guest room, which has been more or less Skjalg’s man-cave since we moved here. He’s been spending more time studying out in the living room and since the space is not a familiar space to me, it might be a good spot for me to get quality studying done. Our apartment has also taken Murphy’s law to a new level – and it is impossible to relax in that kind of chaos.

While at school on Friday, Skjalg hit the reset button for us. The class for which I am a teaching assistant in anatomy (I am only joining for the histology practicals this semester) had their histology midterm. I arrived earlier and stayed about an hour later to help grade their exams. On the way home, Skjalg texted me to ask that I pick up some dinner for an impromptu date night. My brain played around with the panic switch as I thought about how exhausted I was and how it was not going to be a fun night (I’d envisioned us eating dinner while watching an episode of Parks and Recreation, then having to clean the apartment for however many hours until bed). Instead, I came home to a glittering clean apartment alit with candles and a glass of wine waiting for me. I actually teared up when I saw it and spent the rest of the night telling Skjalg how amazing he is and how much I needed that reset. (Yes, med school is so stressful that a clean apartment elicits tears of joy.)

Yesterday I spent the day studying at the Parliament library with my friends Hanna (who is actually a childhood friend of my friend Stian, from Oslo, and in 5th year), Suvi and Synnøve. Our second microbiology midterm is coming up soon and it is going to be a big one. While studying at a café a couple of weeks ago, Amir and I formed a microbio “support club” to help us get going. We have been doing 1-2 topics from the topic list every day and then text-test each other in the mornings. I’ve been spending so much time on those topics that all the other subjects have kind of been pushed to the side. So yesterday was all immuno! We had our midterm in immuno a couple of weeks ago (I think during week 8) and I might be eligible for the competition. It depends on how they set up the qualification. I got 31/40, so if they take the top 70/75% then I’m in! We have 6 exams this exam period and it would be so nice to get one out of the way ahead of time.

As for the title of this post, it’s meant to be a little reminder for me of how not to think. Skjalg and I have been trying to read non-school related books before bed (we were successful for the first week or two). We started by both reading Meditations by Marcus Aurelius. It is amazing and enlightening… but also so, so heavy to read before bed. So, we’ve switched over to The Happiness Advantage after being inspired by this TEDtalk:

I was reading it last night before bed and it set me in the right mental place before ending the day. Why? Because even in the first couple of pages, it was exactly what I needed to remind myself of. The point was that success does not lead to happiness, but rather happiness to success. Here are some of the quotes that I highlighted:

But with each victory, our goalposts of success keep getting pushed further and further out, so that happiness gets pushed over the horizon.

 

‘The Mind is its own place, and in itself can make a heaven of hell, a hell of heaven.’ John Milton, Paradise Lost

 

They felt overwhelmed by ever small setback instead of energized by the possibilities in front of them.

Only five pages of that book was enough to ground me (that plus a clean apartment, amazing boyfriend and productive study day). It is so easy to get caught up in the stress of the moment, in the fear of failure and in general insecurity, that I forget how hard I’ve worked to get here. Where I am now is where I have wanted to be my entire life. It’s hard because I want challenge. And happiness needs to be part of the journey. I am happy and I still take time each day to appreciate my environment – the falling leaves, the barbecue and hot wine smell from the winter market, the gorgeous winter sunrises – but it takes work to remember. I receieved two comments on my last post, one from my wise Grandpa and one from Aswini, a doctor in India, and they both meant a lot to me to read. It is always inspiring to hear from people who are similar to you and who have traveled the path before you. Their experiences yield great insight and can help direct you towards the right path.

On that happy note, I’m off to make protein pancakes for my man 😉

It’s going to be a great week

October 26, 2014 § 2 Comments

Sunday night and I am giving up. It’s the end of a long weekend (four days total) and I have done nothing but study – and it has made me quite the bitter little student! I left the apartment once and that was only a 20 minute trip to return my stylus – for the third time. Yes, I use it so much that I have already gone through three. This model is battery operated and works amazingly for the first few days. The battery life is terrible (go through a AAA once per day, so we had to invest in rechargeable ones) and after a week or so, the entire stylus simply shorts out. They obviously didn’t have medical students in mind when designing it… I ended up getting a different one this round and am really hoping it lasts. Going back a fourth time will make me look like a lunatic.

So, why the four days locked inside studying? Immuno midterm on Wednesday and pathophysiology midterm on Friday. The best part? The immuno midterm is worth 40% of our grade (something I didn’t know about until last week). The weight of that didn’t really sink in until yesterday morning and when it did, my happy little study bubble popped. This feels like exam period all over again!

At one particularly low moment, Skjalg came in to the bedroom (where I’ve holed up these past four days). His little speech inspired the title of this post. He told me that this can be a great week if I want it to be. It can be a week where I face challenges head-0n and grow stronger, no matter the outcome. It can be a week of treating my body well, eating healthy and going to the gym. It can be a week of balance, a week of learning, a week of strength. My response at the time wasn’t so receptive. I told him that every comment he made elicited the same response in my head, “40%”. 40%. 40%. 40%. It’s not always such a nice place in there…

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By 19:00, I was so wound up that I decided to stop and steal the night for myself. I took care of some bank things (someone in Indonesia apparently has a copy of my credit card, luckily the bank stopped the transaction of 3 million IDR and notified me right away), answered some emails and am now sitting in the massage chair writing this blog. Hopefully a little time to myself, a good night’s sleep and a trip to the gym in the morning will set me straight for the week ahead.

In other exciting news, there was a large demonstration that passed our apartment today. It was the largest we’ve seen since we lived here and concerned a very big topic: Hungary might be the first country to tax internet usage. Read more: http://www.thedaily.hu/hungary-plans-to-impose-internet-tax/ and http://www.cnbc.com/id/102111147#.

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A week in pictures

October 26, 2014 § 4 Comments

To accompany a *slightly* negative post I’ve written today (pre-exam jitters), here is one with photos from this past week. Didn’t feel right to mix the two in one post 😉

On Saturday, October 18th, Skjalg and I had our 5th anniversary. It was a Friday schedule for school, so we started the day with classes (unfortunately). After that it was an afternoon of EKG studying and then our official date started at 19:30. We enjoyed an evening-in with way too much sushi, some champagne and a good movie (The Good Year). It was nice to escape for an evening and enjoy each other’s company.
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On Sunday Amir came over to study. He brought presents with him – of course! He once gave me a present for giving him a present. Let that sink in. Our present this round was a taste of home and a taste of home away. He brought with him some homemade bread made by his grandmother, olive oil made by his family and a special herb mix to make a dish of which I have forgotten the name (even though I asked him 20 times). That was the taste of home (he is Palestinian-Israeli). As for the taste of home away, he brought two bags packed with Hungarian pogácsa from a local bakery. There is a bakery in his building that has a bag with his favorite breakfast – mákos rétes – ready for him every morning after he’s finished at the gym. This specific bakery was closed that day (it being Sunday) but he had picked up the treats at a place that played a close second.

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Amir preparing his special dish from home. The olive oil is mixed with thyme and sesame seeds and spread over homemade spiced bread. Then it is placed in the oven and, as Amir said, “it’s ready when you smell it.”. He told us that this is the perfect time of year to eat this dish and that it is normally enjoyed with the family while sitting outside under the trees. It was really, really yummy – and made even more so by the special feeling that came with it.

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During a little study break, we started discussing languages. I’m in awe of just how complicated Hebrew and Arabic are! He wrote our names in both languages, showing us how the word changed with a placement of a simple dot or comma. For Arabic, the spoken and written languages are different – I can’t even imagine what that’s like!

2014-10-19 15.31.202014-10-19 15.32.44  On Tuesday I made my way to the gorgeous Parliament library. I had to leave earlier in the afternoon than I had planned because I wasn’t feeling well. Luckily, the clouds had cleared (mostly) and the walk home was warm and beautiful.2014-10-21 15.06.23  2014-10-21 15.08.052014-10-21 15.09.31Wednesday night was a really special night – a surprise birthday party for our friend Mads! For the celebration, we planned for some cocktails at our place and then dinner at Pomodoro (which was amazing – I’d never heard of it before!). Skjalg was really inspired after our last cocktail night and it showed! The drinks he made were fantastic and so special.After physio TA class that day, I stopped at the gas station at Kalvin for 8 bags of ice – yes, 8! – which I had to carry with me home. By the time I got through the front door, I was exhausted. The sight that awaited me didn’t help – there was coconut EVERYWHERE. Skjalg’s first drink, pina colada, was to be served in real coconut shells. In the three hours before I’d gotten home, Skjalg had been hacking away at coconuts and gotten only three or four done. I spent at least 45 minutes vacuuming just the living room. There was coconut in the couch, in the carpet, on the window sills. Some had even made it’s way across the room into our bedroom! It all came together in the end though – and the night ended up being absolutely perfect!

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Skjalg created the perfect cocktail playlist and had Casablanca playing (without sound) in the background.

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Our First Heart Murmur, Ascites and Micro Midterm

October 14, 2014 § Leave a comment

Our first microbiology midterm approaches and I can’t wait for it to be over. There are two microbiology midterms this semester and this one is the “easy one”, since it covers basic lab topics and facts we have learned. For the next one, we will be tested on systemic bacteriology, which includes names of bacteria, their morphology (form, structure) and diagnosis and treatment of diseases associated with infections by those bacteria.

I’ve been a bad student these past two days and skipped lectures in order to get some time to study. I really didn’t get into a good study groove until Sunday night and I need more time than what is allowed in my hectic schedule. Yesterday, Skjalg and I left school after our pathology practical (which ended at 13:00) and headed straight to the library. We missed our weekly immunology lecture and our elective, Social Media in Medicine (which ended up being cancelled, lucky us!). Then today, we skipped the microbiology lecture in order to create a 3-hour study gap between our internal medicine practical and our next classes (Hungarian for me and pathophysiology for Skjalg). I really don’t like skipping lectures – it’s the only way I keep track of where I should be – but right now this midterm is the main priority.

In internal medicine practice today we got to listen to our first heart murmur and learn how to investigate ascites. We had just had our lecture on heart murmurs this morning and were very lucky to get to listen to one immediately after, especially since heart murmurs are quite rare (according to the doctor we follow around). The patient with the heart murmur actually had an artificial murmur. He/she had had an aortic valve replacement some years before and the murmur was being generated by that mechanical replacement valve. When we listen to the heart sounds, there are are supposed to be two that we can hear (there are two more, but those are really only in children or pathological situations). These sounds are normally a sort of tapping sound and when there is a murmur, there is a sort of whooshing sound between the two tapping sounds.

The patient with ascites was very friendly and informative (which we were able to gather after translation by a Hungarian-speaking student in our group). He/she had had a double leg amputation due to issues related to diabetes and it was a bit hard to watch the patient struggle to turn around in the bed during our physical examination (he/she had to use a rope tied at the end of the bed to first sit up and then lie down on the instructed side). The appearance of the patient’s abdomen was almost identical to image on the wikipedia page I linked to above. We learned how to tap around the abdominal area, first starting at the umbilicus (belly button) and then radiating outward, and noting the change in the sounds created by our tapping. The patient had to turn to different sides so that we could observe the change in sound as the fluid moved.

The tapping method we use to determine the location of the fluid/size of organs, etc. Termed percussion in clinical practice.

The tapping method we use to determine the location of the fluid/size of organs, etc. Termed percussion in clinical practice.

When the patient was lying on his/her back, we also investigated the wave-like movement of the fluid by placing one hand on one side of the abdomen and then pushing gently with the other hand on the other side. It really felt like a wave moving inside of the patient!

Now I am home and ready to study! Need to get at least 3 hours of good work in for me to feel like I’ve been good today. After that? Bed, up at 6, gym and then library. I’ve already received permission to miss tomorrow’s physiology TA class and will be skipping tomorrow morning’s patho lecture and immuno practical *bad Buda-B!*. I’m going to have a lot to make up for with these missed classes – hopefully it will be worth it!

Here are some shots from yesterday! Gotta enjoy Fall while it lasts!

Sunny Sunday

October 12, 2014 § Leave a comment

Today marks a week of getting up at 6 a.m. every day – even on the weekend – and going to bed before 22:00. The original plan was to stop studying by 22:00, but we started heading to bed by 21:00 and then spending that time reading. Feels a little “dorky” (for lack of a better word) to go to bed so early, but honestly, it’s amazing. After such long days, it’s not like I am really able to get a lot out of those few hours in the middle of the night. I can push myself, yes, but I don’t think I’m really as effective as I think I am.

Yesterday morning was tough. Normally I let myself sleep as long as possible on Saturdays. With such a heavy schedule during the week, that has meant sleeping until 9:00 or even 10:00. By 11:00 yesterday, however, I had already been up for 5 hours. I’d had an easy start with some coffee and an episode of Modern Family, done a load of laundry, studied EKG interpretation for 2.5 hours and crammed in a back and bis workout at the gym. All that in the time that I would have usually just had a cup of coffee. Waking up early also means going to bed early – and sometimes really early. Last night, I was in bed at 20:30 and asleep by 21:00! Skjalg went to grab a glass of wine at Di Vino with Suvi and Mads. I had originally planned on joining, but was completely exhausted by 20:00 – so bed it was!

After yesterday’s workout and an hour of relaxing at home, we met up with Suvi and Synnøve to study at the Parliament library. I’ve never been there before, but have always wanted to try it. Some of the libraries here make you feel like you are at Hogwarts – and this is one of them! Getting in was an experience of it’s own. We had to present our passports to a guard, who radioed in our details to check that we were allowed access. He gave us instructions on how to reach the library and we began our little quest through the outdoor corridors. At the front door to the library, another guard was leaning against the large wooden door frame. The Budapest marathon was going on and part of the race was passing parallel to us on the street level. When I looked back to the library entrance, the guard was gone. Once inside, we had to do a run-of-the-mill airport security check-in, without the shoe removal part. We were then given special electronic passes and directed through yet another set of large wooden doors to the reception desk. Since we are only using the library to study, we are allowed to use it for free. The interior is absolutely stunning!

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This week we have our first microbiology midterm on Thursday and Hungarian midterm on Friday. We have two Fridays this week. Yes, two Fridays. We have Thursday and Friday off the following week due to a holiday and in Hungary, they turn a Saturday into a Friday when this happens to make up for the lost time…

Ok, now it’s time to study! Been wasting away too much of the morning on protein pancakes, Godfather III and blogging.

Suvi also has a blog! Check it out: Borta bra men hemma Budapest. For those who can read Finnish or trust goggle translate 😉

 

Work hard, play… some

October 5, 2014 § Leave a comment

It’s a partly sunny Sunday morning – a perfect day for studying microbiology and immunology! I’m trying to convince myself… Midterms start the week after next and I have been spending all of my time studying pathology and pathophysiology. The department we are in for patho (our year is split between two) does not have midterms and our pathophysiology midterm will take place in week 8.

As I’m writing this, the Balatonman Triatholon is going on outside. Our apartment location makes it so easy to feel like we’re a part of the city.

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This week went by way too fast, just like all the others. My week load is so heavy that the weekend is here before I even know it. I still haven’t figured out the best way to balance everything and I am really going to need to work on it if I want to avoid burning out. Skjalg suggested that I implement a “no studying after 22:00” rule, no matter what. I’m thinking about giving it a try because it might push me to be more efficient and will then leave me some time to sleep. My “will power” (hard to find the right word/phrase) is like a separate entity within me and it does not regard sleep as a priority in any way. This means that if there is something, anything, that needs to be done and it is time for bed, bed loses. So, here goes my first shot at a week of nothing past 22:00.

Though this week went by fast, there were a lot of things that made it stand out.  On Tuesday, Skjalg and I were left alone to interview and examine a patient in Internal Medicine. For this class, we have two lectures and two practicals a week. In the practicals, we are together with a doctor in groups of anywhere from 3-9 people. For every practical, we meet the doctor in his ward and he takes us to see some of his patients. From the stories I’ve heard, it seems like these practicals vary greatly depending on the doctor you have been assigned to. Some groups focused on theory for the first weeks and are just starting to see patients, others have not even had regular practicals, while others still, simply look on as the doctor speaks and examines the patients. Ours expects us to communicate with the patient in Hungarian and translate what we think they have said when they respond. In the first couple weeks, he would tell us what to say to the patient and then translate his/her response.

On Tuesday, we were split into 3 groups of 2-3 students, each of which was assigned to a patient. Skjalg and I were together and had to take the patient’s history and ask him questions about his urine, stool, appetite, weight gain/weight loss, allergies and medications. Then, we had to examine him. This included asking him to remove his shirt and sit-up/lie down depending on what we were examining. So far, we’ve learned how to take proper pulse and blood pressure measurements, palpation (using hands to examine body parts), percussion (analyzing sizes of organs based on the sounds produced by tapping with our fingers) and auscultation (listening with stethoscope) of the heart, lungs and bowels. After having been alone with the patient for almost 45 minutes, the doctor returned and asked us to give him details of the patient’s history, diagnosis and our findings from our physical examination of him. There is still so much more that we need to learn, but it is finally feeling like we are, ever slowly, becoming doctors. We even have to wear doctors coats and stethoscopes to our lessons!

In Thursday’s microbiology class, we got to see the culture of bacteria we had collected at the previous week’s class. I’d heard about the culture preparations from my friend Mads, who has the same lesson on the day before ours, so before leaving home that morning, I’d washed my hands and used antibacterial gel. On the way to class, I proceeded to touch everything I could: escalator handrail, metal bars and handles on the metro and door handles. For my second sample, I did a sample of my iPad and one from under my fingernails (our teacher told us it is especially gross under there – note to those of you who bite your nails!).

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On the right is before washing my hands (after touching everything on the metro) and on the left is after washing my hands with soap and water and using antibacterial gel.

After microbiology, we had autopsy practice in pathology. Our cases are usually in the age range of 70-90, but this one hit a lot closer to home: an 18 year-old female who had died from cancer only the day before. I can’t really describe the affect it had on me, other than to say that it gave be such an acute awareness of time, how fleeting life is and how lucky we are to be alive. That night, I thought a lot about the life I have lived these past 9 years and how every day should really be appreciated one at a time.

Last night we had cocktails and dinner with Skjalg’s former groupmates and their former anatomy professor. For the first two years, we are confined to a specific group and have all of our classes together with those people. Skjalg was a bartender for 7 years before starting medical school and wanted to have people over for drinks before heading to dinner at Iguana. It was a really, really great night and I hope that we get the chance to do it again soon. I take for granted how talented Skjalg is at making drinks!

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We finally hung up some of the drink series pieces I did a few years ago. There is one more somewhere in the apartment of a drink Skjalg invented that won a couple of contests – just need to find it!

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