5th Semester: Check!

January 21, 2015 § 8 Comments

I usually only write in moments of reflection. I find it is easier and faster when I am feeling inspired and when my thoughts sort of line themselves up without me forcing them to. I’ve been done for a week now and still haven’t found myself in a reflective state. It’s been on my mind that I need to write something soon; this is, after all, a chronicle of my time in medical school. Still, I’ve been putting it off and avoiding doing anything that feels forced. Exam period sucks you dry of any and every drop of motivation, strength, willpower, you name it. It takes days, possibly even weeks, to refill the stores when you’re finally done. Charlotte gifted me with a journal for my birthday last August and I have recently been consumed with the idea of finally starting to write in it. This blog has really been a journal for these past (almost) three years, but I need a place to process my more irrational and transient thoughts.

Last night I stumbled across my old journals. I haven’t really been consistent over the years, but I have kept everything I have written. When I moved to Norway, I couldn’t bring all the individual books with me, so I ripped out the pages I’d written on and placed the loose memories into the pocket of a larger, almost-finished one. I went to lunch with Charlotte this past Saturday and in the midst of a discussion on journaling, I joked that my journal entries from my grade school years would probably bring me to laughter now. And that they did! I didn’t read through everything; it was too embarrassing to read anything I wrote during my teenage years. I do think that it might be nice to one day “go on a date” with my past self, to grab a glass of wine (my current favorite is the Hungarian Egri Bikavér, meaning Bull’s Blood of Eger) and read through my past reflections. The earliest dates back to 1997, when I was 10 years old and friendship was my biggest worry (that and a subconscious fear of someone stealing our dog).

Journal1997

I also found some unfinished art pieces in a sketchbook I’d stored among my journals. I haven’t done a piece since I moved to Budapest, so I’m quite overdue. There are two pieces I would like to do before school starts, one for Skjalg’s grandmother and another for my mom.

Unfinished

Now, about those exams!

Pathophysiology – the last “big one”

After my last post, I had my exam in pathophysiology. The exam consists of 3 parts: (1) EKG analysis, (2) Case with diagnosis, (3) Two topics from the topic list. I had been feeling hopeless before my exam (again, as I always do) but pushed through it anyway.

We met up for our exam at 8:00. I was to be examined by the same examiner I’d had for my midterm. He took the 5 of us to the lab room outside of his office and we were each given an EKG and case and then allowed to draw two topic cards. I don’t think I had my exam until around 11:00, which meant I had 3 hours to sit there with my nerves and my exam topics. I was the last one to be examined and I was grateful that there wouldn’t be anyone there to overhear my exam.

(1) EKG – Diagnosis: Lenegré syndrome: right bundle branch block with left anterior hemiblock. When I started, I asked if he preferred the diagnosis right away or if he would rather me walk him through my analysis. He preferred the latter and while I did as such, he flipped through every page of my index book, examining every grade I’ve gotten in medical school. Talk about feeling vulnerable! When I finally said the diagnosis, I did my best pronunciation of “Lenegré”, laughed a little and then asked to be corrected. He smiled, tried out a few pronunciations himself, said that he didn’t speak French and then asked with genuine interest which languages I speak. There were absolutely no questions about the EKG. The same thing happened when I had my midterm with him during the semester.

EKG164

(2) Case: Cushing’s Disease. There were about 50 or so cases that we analyzed during the semester in our practicals and we could get any one of them for our exam. Rather than memorize the diagnosis of each, I made sure to really process the cases and understand them so that I would have the tools and experience to diagnosis it during the exam. I ended up getting a case concerning a topic that Skjalg and I had spent a long time one. I drew out the diagnostic algorithm shown below and that aided in my answering most of my questions (i.e. What is the role of dexamethasone? Why are there two different doses? What does the first dose show? What are the different causes of Cushing’s syndrome? Describe ectopic Cushing’s.). To start my presentation of the case, I made sure to describe the difference between Cushing’s disease and Cushing’s syndrome and then stated my diagnosis along with a short explanation of why.

Screen Shot 2015-01-21 at 11.41.57Screen Shot 2015-01-21 at 11.42.27

(3) Topics. I ended up getting two topics that I hadn’t had time to review before the exam. However, I learned that not reviewing them before the exam does not mean that I know nothing about them. This was a big lesson for me because I’ve always felt that, unless I’ve reviewed it specifically for the exam, that I don’t know it at all. Each of the topics consisted of a series of different points. I filled up about 2-3 pages of notes with information, but in the end, he only wanted details for one point from each of the topics (see the highlighted points):

Screen Shot 2015-01-21 at 12.20.49Screen Shot 2015-01-21 at 12.20.40

I messed up some details with Helicobacter pylori (which we covered extensively in microbio) and that resulted in my getting a 4 for the exam. It was a very friendly exam and felt more like a conversation. I got a little embarrassed at one point when he said, “I saw you weren’t so strong in biochemistry and there are parts of biochemistry that are very useful to know.” (I got a 2 first semester, 4 second semester and a 3 in the final exam.) I was able to laugh it off and not take it too personally and wasn’t afraid to tell him that I was embarrassed and a little thrown off by his little stab at my past grades. We talked a lot about Helicobacter and somehow got onto the subject of lactose intolerance (since I am lactose intolerant). He asked me if it was a disease (which I replied that it isn’t) and he shared that when he attended medical school, it was actually considered one. Apparently it was a point of huge interest for him and he ended up sharing the entire history of lactose intolerance. I learned that I, being lactose intolerant, am normal whereas those that tolerate lactose have mutated genes. “So you’re actually the normal one and I’m the mutant,” he’d said with a smile, hidden under his giant mustache.

For my second topic, I pulled knowledge I’d obtained whilst studying for my immuno midterm. I mentioned chronic granulomatous disease (resulting from deficiency of certain enzymes needed for oxygen dependent killing) and leukocyte adhesion deficiency. He seemed happy with that, though mentioned that he would have liked me to include Chédiak-Higashi syndrome.

In the end, I was pleased with my grade, especially considering that before the exam I’d believed that I wasn’t going to make it at all. I need to work on how I evaluate my knowledge…

Hungarian Final

We’ve had 5 semesters of Hungarian and with this exam behind us – we are finally done! The exam is split into two parts, the first is written and the second oral.

Written exam

Here is an example of one of the exams given to us by our teacher. Sorry for the poor quality! Photos were taken with my iPad and notes written in Notability.

Oral Exam

If we passed the written, we were free to go on to the oral exam. It consisted of 3 parts: (1) Introduction about yourself (where you are from, languages you speak, where you want to live after school, what kind of doctor you want to be), (2) Case – the examiner is a patient and you have to ask them questions about their symptoms and come with a possible diagnosis, (3) Describe a medically related photo. They are quite nice in this exam and really don’t demand too much. I did a poor job presenting my Hungarian knowledge and I still ended up with a 5. For my case, the examiner complained only of itchy skin, so I didn’t have a lot to go on. For the photo part, this is an idea of what we needed to know. These are my notes from class and an example of what I said for a photo.

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Internal Medicine

This was my last exam and I was seriously lacking motivation to study for it. I had four days to prepare and for the first three, I only read two chapters about history taking. On Day Four, the motivation kicked in!

The problem with internal is that we are assigned to about 20 different doctors, all of whom have different specialties, number of years of experience, techniques, etc. Sometimes it feels kind of like a free-for-all when it comes to what we are learning and how we are learning it. I haven’t heard of two teachers who do anything the same way! Our teacher is really strict and expects us to be fluent in Hungarian, at least medically. He also expects us to fill out a medical chart perfectly. If you can’t do that, you fail with him. Other teachers? May translate for you, may allow you to use Hungarian notes, or maybe don’t even expect you to be able to communicate with the patient more than a few sentences. Our teacher is the only one I know who has us filling out the medical chart. (Here’s an example from one of my previous posts.) The variation in teaching styles also manifested as a huge variation in the exam styles. In the beginning, most people were saying that it was such an easy 5 and that no one fails. Some people showed up without having studied, were asked one question and then sent home with a perfect score. Others, didn’t have it so easy. Ours was the latter…

We had an older cardiologist with glasses who seemed friendly at first. Well, he was friendly, but he was also particular. We were each assigned a patient and asked to conduct a full physical exam and take as much of a history as we could (he didn’t expect that we knew much Hungarian). I took my time with my patient, making sure to get a full history and hit every point of the physical exam. He was really friendly and I was able to communicate with him quite well.

After we had finished with our patients, we waited out in the hall for our examiner to return. One girl had her Hungarian exam scheduled at noon that same day and asked that she be examined first so she could leave. She went in with the examiner and closed the door. I sat down to write out my notes from my patient. Within seconds, she was at the door and told us that the examiner wanted us all to join. We soon realized that our individual exams had all started – at the same time. Each of us were asked to present our patient, were asked a slew of theory questions and then asked to perform a specific part of the physical examination. If we couldn’t answer a question, one of the others was asked. Some of our answers were challenged; he would ask us a question and then upon hearing our answer, he would ask if the others agreed with our answer. With the first girl’s exam, the rest of us (3 total) got very nervous. When she asked if she could have her grade and leave, he said he preferred to compare us all with each other at the end, but that he would make an exception.

My patient was out when it was my turn (I was the second), so we sat out in the hall and went through a round of theory. This went exactly the way I’d feared it would. My teacher is an endocrinologist and we have therefore not spent nearly enough time when it comes to heart examination. We do it, of course, but it is more thorough for those in the cardiovascular departments. We’ve heard one murmur this semester whereas they may have heard one every practice. When it came to covering theory for this part of the exam, I learned the classification of murmurs and the four main murmurs our teacher told us we should know (aortic stenosis and insufficiency and mitral stenosis and insufficiency). I’d read through the chapter in the book and covered the lectures, so I had a general understanding, but I didn’t intensely memorize all the points. It seemed outside the scope of what we were to learn this exam period: physical examination. (I’ll add that we had no topic list for this exam.)

He asked me maybe 20 or so theory questions, while sitting around a table with the other two examinees. I was able to answer a good number of them, but then we starting going deep enough that I had to admit to him that these were things that I had not been taught nor covered on my own and would have to logically guess the answer. I can’t remember all of the questions, but here are those I can:

  • Can different pulse rates be measured at different points in the body? (He said it is impossible if you can feel the pulse)
  • What are the possible causes behind different blood pressure values? (My patient’s blood pressure measured different in his right arm and his left) (1) Supravalular aortic stenosis (increased BP measure in the right arm), (2) Takayashi syndrome, (3) Aortic dissection
  • How do heart sounds change in heart failure? (1) S1 – diminished intensity, (2) S3 – normally not heard, but heard in HF, (3) Mitral regurgitation
  • What type of murmur is mitral regurgitation/insufficiency?
  • What type of murmur is tricuspidal regurgitation/insufficiency?

It was a little hard to communicate with my examiner. I’m not sure if he didn’t understand English well enough to hear our answers or if he was just a little strange. There were several times I had to repeat myself and that seemed to count against me. At one point, he corrected me by saying that the patient had had two heart attacks this year (I had said last year) and went to check in the patient’s history, “Yes, March of this year”, he’d said… It was only Jan 13th at this point, but still!

When my patient returned, my task was to examine the peripheral cardiovascular system. Luckily, this was one of the tasks I knew well. I had a little bit of a problem with the examiner when it came to feeling the peripheral pulses. There were at least 3 or 4 that he couldn’t feel that I could. I didn’t back down though. I didn’t want to change my answer to please him. I tried showing him where I felt it and yet he still didn’t feel it. I continued the exam as if I too hadn’t felt the pulse, so as to demonstrate that I knew what to do. There were a few hold ups where I didn’t really understand what he was asking me or where he was asking me something I had already answered. Also, when examining the carotid artery, I’d told the patient to stop breathing (in Hungarian) and the examiner thought I’d told him to stop talking. I repeated what I’d told to the patient and the reason for doing so (to hear for any turbulent flow without distortion by breathing sounds) and that seemed to appease him. He smiled constantly for almost the entire exam, which meant that you never knew if he was pleased or mentally noting a failure.

The whole process lasted for almost 4 hours. Once I was done with my physical exam, we moved on to the two others. I was feeling relieved that mine was over, but it really wasn’t. The questions were hard. At times, it felt like he thought we were fourth year students and not third year…

These were questions that I wrote down:

  • Tops two cases in which pacemakers are implanted.
  • How do the heart sounds change in heart failure and hypertension? What are the physical manifestations of these diseases?
  • How does the apical beat change in the case of hypertension? (1) Prolonged, (2) Circumscribed, (3) Increased intensity
  • What is the old term for late fine crackles? Crepitations
  • What are the causes of increased intensity of the second heart sound? How can you determine whether it is the pulmonic or aortic component responsible? What are the cases in which these components would result in increased intensity of the second heart sound?
  • What are the 5 causes of infiltration syndrome? (1) Tumor, (2) TB, (3) Pneumonia, (4) Pulmonary edema, (5) Pulmonary infarction
  • In what cases do we have non-pitting edema? Hypothyroidism (myxedema)
  • What are causes of non-productive, dry cough? (1) Left ventricular heart failure, (2) Drugs – ACE inhibitor
  • How do the bowel sounds change in the case of acute peritonitis and why? Decrease due to rigidity.

Afterwards, we gathered around the table in the hallway for our grades. He assigned a grade 3 to one of us, then looked at the other in the group and told her that she had the best individual exam and was barely a 5, but that he would give her a 5. He then looked at me and I flashed my biggest smile. I wanted a 5 so, so badly in this exam. At 7 credits, the effect on our GPA is quite significant. He told me that I struggled a bit in my individual exam, but that I rectified myself with answers I gave to questions during the exams of the other two. With that, I got a 5. Probably the hardest 5 I’ve had to work for, or at least it felt like it!

—————————-

That rounds up what feels like the toughest semester yet. I’m generally happy with the results, though bummed about my performance in pathology. I feel like I spent a lot of time this exam period learning exactly how to study for each of these subjects. At the start of third year, we began with a completely new load of classes – all of which required their own study technique. Before this next semester starts, I will lay out my “plan of attack” for this next semester. It is only going to get harder from here: next exam period we will be double what we had for this one. We will have our final exams in Pathology, Pathophysiology, Microbiology, plus smaller finals/semi-finals in Internal Medicine, Genetics, Medical Psychology, Medical Imaging and Basics of Surgery.Screen Shot 2015-01-21 at 14.26.59

To improve is to change, to be perfect is to change often

February 22, 2014 § Leave a comment

Someone asked me last week if I was planning on keeping up with my blog. What did that do? Well, it planted a little seed of guilt. Why? Because I am! Even if it doesn’t seem like it right now… I do update the anatomy facts every day! I think we’re almost at 70 facts now. Charlotte and I calculated that, by the end of the semester, we will have come up with a total of 1430 facts!

So far, this semester is going really well. With our schedule the way it is, it honestly feels like a hybrid between exam period and a regular semester. On Mondays I fit in 6 or 7 hours at the library, Wednesday allows for up to 14 hours of cramming for Thursday’s physio tests, and Friday allows for 9 hours at the library. The library closes at 20 and then it’s home for dinner, some down-time and bed. Friday night is date night, Saturday is chore/study day and Sunday is anatomy cramming day with Jannie. With a sleep average of 7.5 hours a night, things are feeling quite systematic! Just the way I like it 😉

I got the quote that I used as my title from Skjalg. I had just written an email reply to a blog reader (which ended up being way longer than I expected) and in it, I mentioned that my number one piece of advice to surviving here is to adapt. This degree is a lifetime worth of challenges wrapped up in a pretty little package. We will most assuredly not be the same people coming out at the other end as we were when we started. To make that transition, we need to be able to adapt to each new day, subject, semester, patient – everything! As we get older, it’s harder to do. We are more set in our ways and feel like things should adjust to us and not us to them. That’s when we need to remember that we are students. Now is the time to make mistakes, now is the time to be wrong, to learn, to be humbled and learn humility. We do this now so that we are tougher and prepared to face the challenges we will face as doctors.

On a lighter note, Skjalg and I just took a Grey’s Anatomy quiz. We know it’s not real, don’t worry 🙂 But I will say, watching it now is so fun. It seems silly, since it is so dramatic and polished, but understanding what they are talking about is exciting! It feels so good to know what they mean when they say things like “subdural hematoma”, “hypovolemia”, “atropine” and “push 20 of mannitol!”.  It’s our guilty pleasure…

Skjalg’s result:

SkjalgsGreysResult

My result:BiancaGreysResult

We make quite the pair if you ask me 😉

 

Put your pride to the side

November 27, 2013 § 4 Comments

Winter has arrived in Budapest. The cold air and snow flurries bring with them the promise of Christmas, cozy winter nights and…exam period. The obstacles we have to tackle to just get to the exam period are enough to make any one of us nauseous at the thought. It’s unbelievable how many exams we’ve had this semester. In one way, it is good because we have gotten used to having exams, on the other, we are constantly stressed and constantly studying. There is no chance for downtime and that means we will begin exam period completely exhausted.

Tonight is exam registration, which is quite possibly the most stressful event of the semester. At 20:00:00 on the dot, 220 2nd year students will furiously click away at the registration boxes for their planned exam dates. For some of the exams, there are only 20 or so spots – and those are gone within seconds! If you’re lucky, you’ll get all of your planned dates before the system crashes, which it always does. Skjalg and I spent an hour or so last night trying to figure out how our exam schedules should be. For the first time, we’ve planned to do our exams on the same dates. Hopefully we get them! Last time, Skjalg’s computer froze and he had to completely rearrange his schedule. Fingers crossed!

Tomorrow brings our dreaded tripple-exam day. Despite a decent study weekend and some hardcore studying on Monday and Tuesday, I’m not feeling good at all about our biochemistry midterm. I sacrificed going to several of the lectures in order to study for other exams, thereby risking not being able to prepare properly for this exam. Though it worked out for those other exams, I now have to face the consequences of my sacrifices – and it’s not an easy pill to swallow! I completely underestimated the amount of information we needed to cover for this exam – way more than what can be reviewed in only a few days time. The worst part is that I really, really like what we are covering in biochemistry this semester. I find everything so interesting and it is so frustrating that I can’t give it the time it deserves. Some light reading for summer break, maybe?

It’s difficult to motivate yourself to study for an exam when you are convinced it is not going to go well. My trick has been to focus on the semi-final and how studying for this exam will help me there. But that trick can only go so far. Last night I hit a wall and since then, I haven’t been able to get anything in my head. The prospect of going to three exams tomorrow, two of which I will most likely fail, is a miserable thought and a serious blow to my pride. With the amount of time and energy I put in to studying, it’s hard to believe that I am even in this situation. But what can I do? There’s no changing the past, so my only option is to use these lessons to make me a smarter student.

Skjalg once told me something that I use to comfort myself on a regular basis. I’m quick to associate my exam scores with my intelligence and therefore tend to assume that any low exam score means I have a low intelligence. It’s natural to be a little self-critical (or, let’s be honest, a lot self-critical) and this is definitely one of my big insecurities. So one day Skjalg said, “You’ve gotten into medical school in part by your intelligence. That is one of the factors in a complicated series of events that enabled you to get to this point. Everything after that point is about preparation. It’s not that you can’t learn any of this, only that you didn’t learn it – for whatever reason that may be. Someone knowing more than you about something doesn’t necessarily mean that they are smarter, it only means that they had the time to learn it.” I felt so good after hearing that because it forced me to focus on something I can change – the way I study – versus something I can’t – my mental ability. You can be an amazing artist, but if you can’t market yourself, it’s going to be hard to make a living off of it. So, I have to work smarter, not harder.

That said, I’m off to study for a short while before exam registration. The adrenaline rush from that should be enough to fuel me for a few hours afterward.

 

Ready to get back in the game?

October 8, 2013 § 2 Comments

Four days, 60 hours of sleep, and some bottles of cold/flu medication later, I am more or less back on my feet. I’ve allowed myself to sleep in today (“sleep in” being until only 8:15) and am missing Hungarian. It feels horrible missing any classes at all, but this is not something I can drag with me. I have no idea what I caught, but think it was a common cold or flu coupled with exhaustion. I have never in my life slept so much in such a short amount of time. It’s honestly pretty surreal to think about. My only symptoms now are a headache, stuffy nose and heavy “cold-breathing” (you know when you are sick and breathing feels heavier? that). I’m hoping that, with some nose spray and ibuprofen, I will be able to make it through the day.

My first class of the day will be biochem lecture at 12:30. Then I will have 4 or so hours to study before our physio lecture from 17:20-19:05. 7 hours is a long enough day to spend at school on my first day back, so missing Hungarian to save myself from an 11 hour day is worth it.

Yesterday was the worst day for me because I was starting to feel better and have more energy, but was still too exhausted/sick to do anything. That left me bed-ridden, yet unable to sleep – torture! Skjalg ordered me over the phone to relax and watch movies, but after already missing 3 days of studying, I was too anxious to enjoy my time of “forced relaxation” (as my mom likes to call it).

In the afternoon, when I was feeling particularly bad for myself, Jannie called and said she was coming over with coffee and muffins. She stayed for a couple of hours, which was perfect to get me out of my funk. After she left, I had enough energy to sit and “study” for a little while. I say “study” because it was more of me looking at the paper and reminding myself that this is what I need to do when I get healthy. It might not have been the most effective use of my time, but lowered my anxiety a bit.

My blind-siding cold could not have come at a better time. Both Jannie and Skjalg have reassured me that no one they have talked to did anything this weekend. After a heavy week of both physio and anatomy exams, I think everyone was pretty much left for dead by the time the weekend came. First year was hard, but this is twice that – if not more. People walk around like zombies and no one seems to have any true grasp of the material we are covering.

Physio comes in first on the priority list for most people (which is natural since we have weekly quizzes) and anatomy takes a close second. Though, since the topics for this next anatomy midterm are quite obscure and really unlike anything we’ve studied before, I won’t be surprised if people start to draw away from anatomy more and more. Our first midterm was general macroscopic gross anatomy of the brain – surface features (what are all the bumps and grooves called) and internal structures (what’s that artery/dark spot/white band etc). Our next topic is “Neuronal Organization of the Central Nervous System”, which is pretty much how the neurons in our spinal cord and brain are organized and connected. We get to look at pictures like this all day:

As for the neglected child, biochem, I’m not sure much anyone is spending time on it. I’ve overheard people asking each other if they have studied anything for it and many saying that they haven’t even opened a biochem book yet this semester. It makes sense since it is definitely the least demanding of all our classes. Plus, our biochem professor is so relaxed that it makes it almost a given that it falls by the wayside.  The attendance at the lectures says it all. This was last Thursday’s lecture. I didn’t count, but there couldn’t have been more than 20 people (out of 220 registered for the subject).

Uh oh, not feeling as good as I thought I was…might be time for bed again.

Ponderings of a 22-year-old me

March 11, 2013 § 4 Comments

While writing my most recent post, I went in search of a quote I noted down some time ago (I apologize in advance to those of you who have subscribed to my blog via email and are subsequently receiving a double load of emails tonight).

Though I haven’t kept up with it recently, I have a habit of writing down quotes I like and things that make me laugh in a little notebook that I always carry with me. It’s a habit I have had for years. My friend Nicole even presented me with a printed book version of my first little notebook for my 21st birthday.

Quote books

I am a sucker for a good quote, a quality I adopted from my mama. I spent countless hours during my childhood flipping through her books on quotes. A quote can describe exactly what you feel in a more eloquent way than you ever could. As for the things that made me laugh, I wrote them down because I wanted those moments to exist forever.

So, while writing my last post, I was reminded of a quote by the Dalai Lama about perception and how only you control your perception of others actions. Unfortunately, I wasn’t able to find it. However, I did find myself caught up in my past inspirations. Some of the things that once made me laugh are not so funny anymore, but their memory still holds meaning.

As I was finishing up my read-through of the first one, I stumbled across some thoughts I’d stuffed in on the last pages of the notebook. As I read them, I was transported to my first month living in Norway. It’s so easy to forget who we were before we became who we are.

Ponderings of a 22-year-old me

On learning Norwegian:

I feel an even deeper need to learn faster, fueled by the guilt I feel for how my lack of conversational skills hinders general conversations. Anyone in my presence will speak English out of respect, regardless of whether or not the conversation is directed towards me. I wonder about the awkwardness they feel talking to each other with their limited English vocabularies.

The language barrier is sometimes a test of my self-esteem. A lot of times I stop to wonder whether the person I’m speaking with simply finds me boring or if they have no idea what I am saying and are just nodding and smiling blatantly in response.

On seeing other Americans and wanting them to notice me:

I want so badly for something about me or on me to momentarily appear familiar so that the Americans will engage me in conversation. The man looks at me every now and then, possibly acknowledging my expression or recognition of a common language in my face. The girl however is fully engaged in her story and I find myself satisfied to simply witness her typical American phrases and slang.

Here I am, stuck at a bus stop in the freezing cold, with a typical Norwegian girl, two Americans, a young boy dressed in true American emo style, and a crazy lady carrying a plastic bag full of everything, including what appears to be the better part of a vacuum.

In a reflective state:

How easily accessible your memories are when you are experiencing a transition in your life. As I stare at the snow, my mind almost immediately begins to play the movie reels of my memories, almost as though my brain is trying to fill in the black space of snow I stare at.

How fearful we can be of the unknown. Almost as if we feel we aren’t good enough or strong enough to rise to the occasion.

Biophysics Midterm: Check!

March 11, 2013 § 6 Comments

I can feel myself evolving as we progress further into the semester. My expectations of myself have become more realistic (though not completely realistic just yet) and I am learning to accept the amount and quality of work I am able to produce. I still get frustrated when I don’t finish my over-enthusiastic to-do lists, but the frustration is less consuming.

This morning we had our midterm in biophysics. Before heading in, I jokingly asked the professor, “Are you looking forward to torturing our brains?” to which he replied, “Yes, yes I am.” We have a new professor this semester and he is amazing. He explains the theory well, is willing to help us if we need anything, and is quite funny (though, as Charlotte pointed out, his humor is often lost on people because he always jokes with a straight face). Last week, he was nice enough to hold a consultation for our group. I was the only one unable to attend, as it was the same time as Chemotaxis (an elective I am taking this semester). I had given my questions to Charlotte so that she could ask them in my sted and rather than relay the answers through her, the professor offered to meet me on Friday to discuss them.

The exam itself was difficult but fair. As always, I went into the exam thinking that I was going to fail it. The difference this time was that I wasn’t afraid of failing. No, failing is not a good thing, but you wouldn’t believe how common it is here. So much so, that there are 3 chances to pass each exam – even midterms (in all courses except anatomy). One group-mate was joking that our standards have completely changed over the months, from “I really hope I get a 5” to “I really hope I pass”. It may very well be possible to get 5’s on everything, but I have yet to meet someone who has accomplished such a feat. Passing is what’s in right now…

With a little under 2 hours of sleep, I was quite the delirious little nugget this morning. I found a playlist with songs that I could sing along to and sat in the guest room, singing and redoing calculations over and over again. The calculations we get on the exam are similar to, if not the same as, the ones we are assigned as homework, so it is a huge benefit to do each calculation several times. About half an hour before we were supposed to leave, I began my pre-midterm ritual of listening to my favorite motivational video. I’ve listened to it so many times that I almost have all the words down. Nothing gets me as pumped up and motivated as this. (I’ve probably shared it already, but it’s awesome, so here it is again).

So after listening to this a couple times, I came to a conclusion, which I immediately shared with Skjalg:

“The test is simply an evaluation of how I have been studying so far. If I pass, that’s great. I can keep on doing what I am doing and possibly make some further improvements. If I fail, yes, it will suck. However, I will be forced then to review the material more thoroughly, to learn it better and really understand it. In all honestly, I benefit either way. One way is just a little more challenging.”

It’s amazing how much mental power you have over your perception of a situation. Accepting that failure was an option and thinking of the good that could come out of it, rather than focusing on the bad, put me in control. Eleanor Roosevelt’s quote “No one can make you feel inferior without your consent.” applies, not only to other people, but to yourself as well.

Mindfulness: 1 ; Defeatism: 0.

Medical Communication: A Pleasant Surprise

March 7, 2013 § 2 Comments

I began writing this on September 7th, after our first lecture in Medical Communication. In a later post, I mentioned the draft and promised that I would post it as soon as I was finished writing it. As could have been predicted, I never found the time. Such is the case in med school. You never have time for the things you mean to do, only those that you need to do.

Medical Communication has quickly become one of my favorite classes. Each week we have been presented with a new theme: Hypnosis and Suggestive Medicine, Somatisation and Hypochondriasis, Communication with Sick Children, and finally, today’s topic, Breaking Bad News and Aggressive Patients. I feel really lucky that such lectures are a part of the curriculum, even at such an early stage. We may not be doctors for another 5 or so years, but it’s not too early to start thinking like one.

That said, here is the entry I began writing on February 7th:

universe blackboard

There are times that I get a rush of true purpose through my body, like all the planetary forms of the galaxy contained inside of me are aligned – and I know that I am in the right place.

Those occasions are not very common, but they are not necessarily rare either. They may not happen during seminars on the biochemistry of carbohydrates or a biophysics lecture on electrical circuits, but they happen. I am interested in everything we are learning – though it could even be just the actual process of learning that I enjoy – however, my passions for these newly learned topics vary greatly.

This morning began with our first Medical Communication lecture at 8:00. I was running late, so Skjalg and I had to speed walk to the lecture hall located in the gynecology department of one of the university’s hospitals, conveniently located a 10-15 minute walk from our apartment. We arrived flushed and out of breath, to a half full hall and an old radio broadcast playing through the speakers. The department in charge of our schedules has been quite unclear about the logistics of most of our elective courses. For this specific class, we have received two emails this week offering contradictory information: the first saying that practicals would begin in April and that there were only lectures until then and the other saying (quite vaguely) that there would be no classes until April. The lack of clarity of their part and the improbability of medical students getting up to go to an 8:00 lecture that they may or may not need to go to are most likely the driving forces behind the fact that only about half of the 250 freshman students were there.

The lecture hall is a modernized anatomical theatre. Here are some shots I snuck during yesterday’s Medical Professionalism lecture. (Attendance was taken at this one, so I believe everyone was there.)

MP Lecture 2MP lecture

I didn’t know what to expect of the lecture. We are already taking a medical sociology class, so it couldn’t have been communication in the sociological sense. I kept an open mind though, reminding myself of an interview I read with a former-student stayed at Semmelweis after graduating to teach his own anatomy class. In the interview he said (and I am paraphrasing here), “You will hear many people complain about the classes, saying things like ‘we won’t even need this’ or ‘why do we even have to learn this’. Don’t pay them any attention. I think the school knows better than you, a first year student, which curriculum will best prepares the students for their futures as doctors”. I am so thankful I listened because the lecture this morning was one of the best lectures I have ever attended in my life.

Why? Mainly the lecturer. He was so passionate about medicine, life and human behavior and interactions. His presentation was organized and engaging, and even included clips from different movies, comic strips and jokes to illustrate his points. The part of his lecture that impacted me the most, was this clip from Patch Adams (the clip says it all):

Back to today. We had the same lecturer again this morning. He started by saying, “What a beautiful cloudy day in Budapest! But you know, behind the clouds, the sun in still shining!”

I don’t know the curriculum of medical schools in other countries, but if they include such courses, then I have to say that I am really happy that they do. Perspective and awareness are such important tools in medicine and they are often overlooked. It really is a testament to the quality of education that we are getting here that they acknowledge the importance of medical communication and begin exposing us to it at such an early point. Unfortunately, there were only about 50 out of the 250 first year English students who showed up this morning. I’m not sure how far the message is reaching in that case, but I’m sure it will return to us in practice.

Enough blogging for now! Skjalg and I are spending our 4 hour break between biochemistry lecture and chemotaxis lecture at Costa Coffee. After class we plan on hitting the gym for some head-defogging cardio and then home to squeeze in a couple of hours of studying before bedtime.

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