Sunday, July 31, 2011

First Week in the Sticks

I flew back from the mother campus on Saturday and C has been orbiting me ever since.  She becomes so distressed every time I leave the room and runs through my legs just to ensure I haven't left her again.  Shelli packed almost everything the week before and by Wednesday morning we were cleaned up, packed up, and ready to move out.
C orbiting me includes wanting to participate in all my activities including preparing for church.

We crossed it!  I spent the rest of the trip puzzling out how traveling from west/east this could possibly have happened.
We finally rolled in on Wednesday night at about 9:00 pm local time.  There was an accident around the the interchange that put us back about an hour and a half, but Chiara was a champion traveler the entire time.

Thursday the students were required to attend orientation at the school.  The building is impressive and they have spared no expense.  They put in a 'bio-wall' which is a vertical wall of plants that is linked to the HVAC system used to clean the air.  But I believe that the most reliable measuring stick for a great facility which truly panders to its patrons is the state of the bathrooms.  My scale includes points for toilet paper, cleanliness, and graffiti (absence of).  An establishment can feign kindness, respect, and even take money with alacrity, but the state of the bathrooms tells how much they value my patronage.

These are nifty air blades that actually dry your hands in less than five seconds without touching anything.
The white coat ceremony and convocation was better that I thought it would be.  My interest in ceremonies and rituals is generally more feigned than real, but the opening of a new medical school attracts some very special people and I even put my inclination to celebrate privately on hold in response.  The mayor of the city came, as did the governor, a member of the state senate, last year's president of the American Osteopathic Association, and almost the entire population of the city.  Everyone has been so welcoming.

During the ceremony, all the students went up to the stage and stated their name and where they were from.  When one of the students said they were from Coos Bay, Oregon, I was very tempted to stand up and shout out, "I run this church for loggers!"

In church on Sunday I learned that five other classmates and their wives are in our ward.  There were about 10 kids in the nursery which was more than I expected given that the demographics of the ward were generally older.  Speaking of older, the high priest group leader asked me during my introduction in Priesthood meeting if I were a high priest.  This was the latest question in a two-year progression of deplorably insouciant inquiries about my age.  The first came from Heinrich, a friend from college, who when introduced to Lance, 7 years my senior, asked which of us was older.  More recently, Pollock, when introduced to Dad, 35 years my senior, asked which of us was older.  In this context, the normally innocuous question from the high priest group leader brought out my retort, "I don't have enough grandkids or know enough about retirement to be a high priest." :)

I realize I don't have as much hair as I did when I was 10, but I still have color in what's left.

Friday, July 22, 2011

Last Week

One test a week is rough, but two tests in one week is intense.  We had one on Monday and the final was on Friday.  We learned about 25 new techniques this week, but they were all pretty easy to remember and the knowledge required to execute them is mostly anatomical.  The lymphatic techniques were for mobilizing the immune system and treating congestion or swelling.  For example, during pregnancy as the fetus grows it begins to push against the lymph ducts leaving the lower extremities towards the venous return to the heart.  The increased pressure leaves fluid pooling in the feet and lower legs and creates swelling.  It was rather entertaining to watch Shelli's feet during Sacrament meeting while she was pregnant with Chiara and see the straps of her shoes disappear.

The second modality was myofascial release.  Contrary to popular belief, the largest organ in the body is not the skin but the fascia.  Fascia is what anchors the skin to the underlying tissues and is rather ubiquitous.  It also has some characteristics of smooth muscle and can contract in compensatory patterns responding to stresses like whiplash.  Essentially, this modality aims to release the contraction and reset the tissue.

Not only do they want us to know the material well enough to pass, they also want us to be able to teach the our first-year counterparts at the daughter campus.  The curriculum coordinators included some teaching classes into our course.  On Wednesday they had us prepare to teach some psychomotor skill.  We learned how to block a knife stab, break a headlock, the chicken dance, the Macarena, a salsa move, a beginning belly dance move, a yoga pose, and I taught how a singer ought to breathe.  The funniest part was C teaching a pose which apparently body-builders perform in order to show off their body before a competition.  It involves showing off the pecks, the biceps, the forearm, the gluteus maximus, and the thighs all at the same time which is tough to do.

We just got out of the test and are on our way to have dinner with the dean, but before I go I wanted to show you some of this place.

This is all the food I have left.  Not bad planning to run out on the last day.

This looks to me like the skeleton is checking us out.

The artistic statues that dot the campus.  Looks like stocks are down.

This one might be my favorite.  Turns out security guards get mad if you actually use it
 as a garbage can.  I guess it's all part of the display.

Strike the above caption, these statues are definitely my favorite.

H trying to make off with the old lady's purse.  

Saturday, July 16, 2011

Week Four

The saga continues.  Thursday was a rough day for lecture and I arrived home worn out.  We learned almost ninety counterstrain points and their corresponding treatment positions.  Most are grouped, but there are a few oddballs that strain nomenclature and acronym techniques of even the most creative students.  The treatments require rotating, sidebending, and flexing or extending according to how the muscle insertion is most relaxed and holding that position for about 90 seconds which can be rather daunting for small doctors treating bulky patients.

The test on Monday is only a practical and the new modalities are counterstrain and HVLA.  They usually test on new treatment and one old treatment from a former test, and we have nineteen minutes to do a complete exam plus the two treatments.

Thursday was also a watershed in that the instructor included me in the same category as the herculean Chase.  "Now if you are C, M, or Medical Student and can handle holding the person's leg in this position for the full 90 seconds, go ahead.  If you are a petite female trying to hold a large patient in this position, use your knee as a fulcrum and make yourself comfortable."  The class is finally taking note of my inconspicuous yet powerful muscles. :)

Also, it was only a matter of time before my weapon-grade hiccups became common knowledge.  I managed to hide them for three weeks.  Today, I let loose an ear splitting squeak during a lull in the conversation.  It caught me with my mouth open.  S immediately yelled out, "Who murdered a muppet?!"

This is our class of 14 students, 1 fellow, and the first-year curriculum coordinator.  You can tell which position everyone holds by the clothes they are wearing.  Dress code for us is basketball shorts above the knees and a shirt you can easily remove in order to identify anatomical landmarks.  When I first got here and before I knew anyone, I bought a hat to hide my sunburned head from the triple digit sun.  My hair is about as rare as a cactus in the Alaska and almost as far north.

Wednesday, July 13, 2011


The test on Monday went pretty well.  I wound up with a 92 which is respectable.  I woke up at 4:00 am on Monday morning to study for it, and crashed about three hours later.  Luckily, my alarm that I set for 8:00 gave me enough to time to shower, eat, and get to the testing room by 9:00.  The first portion of the test was written for conceptual, theoretical, muscle naming, etc.  The practical exam was much like the first, but with three times the treatments possible to be tested.  I was supposed to diagnose the dysfunction I suspected during the structural screening portion.  Thankfully, I even diagnosed correctly, but in my haste I treated the dysfunction as though it were torqued to the right instead of the left which if I had done in a clinic would have made the problem worse.  The way the exam was graded, I only missed two points for incorrect placement instead of all twenty points for the wrong treatment.

Hopefully, there won't be too many more days like that.  It was mostly an experiment to see how well I could handle getting up early to study.  The problem wasn't the early part, it was the lack of sleep preceding that.  Somehow, my mind couldn't shut down at 8 pm with the same rapidity it does at 10:30 or 11:00.  And all that happened was I spent the night dozing in and out of consciousness trying to force my body and mind to shut off.

After the test, we began learning high velocity low amplitude treatments which is basically glorified bone cracking.  It's not dangerous, but the positions required for correct results are often uncomfortable for a few seconds.  I've gotta admit that hearing ribs pop back into place for the first time because I did everything correctly made me feel like the first man must have felt who could make fire on command.  I wanted to stand up on the table, pound my chest, and throw my challenge to the world, "I am Prometheus and I make fire!"  It is so satisfying to assist in the healing process.

We finished HVLA today and started counterstrain techniques.  I still struggle with the theory behind it, but had to admit that even my first attempt was successful at alleviating pain in my partners neck.  The idea is that at the sensitive counterstrain points (we learned about thirty today but there are probably close to six hundred) muscles and the nerves that innervate them are firing too much and to decrease the firing rate, we put that point where it is most at ease.  Unfortunately, every point has its own position of ease so  not only do we get to memorize where the points are, but also the correct position for that segment.

Also, there was a SWAT drill on campus today so we had to come to class early to avoid the lockdown.

Sunday, July 10, 2011

Week Three

This was the shortest longest week so far.  We had Monday and Tuesday off for the Fourth of July which were very boring days with nothing to do except preparing for the next few lectures.  Once you have been a husband and father, holidays as a bachelor become extremely dull. :)  However unimpressive the beginning of the week was, the end of the week attacked with full force.  We finished the lessons for the entire first semester by Friday and have a monstrous test on Monday.

This week we learned what is known as muscle energy therapy which is a technique that uses the patient's own muscle groups to correct various somatic dysfunctions.  A simple visual example is my neck. I can only sleep on my stomach, but only on my right cheek facing left.  Needless to say, I have excellent left rotation for the cervical vertebrae, but comparatively poor rotation to the right.  If I were the patient, the doctor would rotate my head to the right to engage the barrier and while holding my head there, instruct me to try to return my head to a neutral position.  The goal isn't to win a wrestling match, only to contract those muscles against the doctors unyielding counterforce which produces isometric contraction (that is, contraction where the muscle tightens but without any distance changes between the two ends of the muscle.)  After a few seconds, the patient relaxes and the doctor will reengage the barrier which will be beyond the original. This is repeated until the doctor can sense normal rotation or motion in the joint of question.  The technique works due to the molecular nature of muscle fibers. The tightening 'uncrimps' the length between the origin and insertion of the muscle.  The difficult part is realizing which joint you are actually trying to engage especially with the rather unwieldy joints of the sacrum and pelvis.  Even more difficult is remembering how to position the patient so that the treatment is effective.

It is only the second week of medical school and already I have wanted to join my classmates and study on Sunday, but I feel it would be a bad precedent.  I have studied about as much as I could stand this week and I hope that will be enough.  I'm not sure why the planned the course this way, but we have another test next Monday as well.  I would rather have gone to school on July Fourth and fifth, be tested on Fridays, and go home a day or two earlier than have had the holidays.

Although our religion allows for some latitude on Sabbath day observance, I don't believe my ox is quite in the mire yet.

President Kimball said: “I hope students will use the Sabbath for studying only as an emergency. … I believe that generally, with careful organization of time through the week, most studying can be done on weekdays, leaving the Sabbath for worship. … There might be times when one would feel forced to study, when he might feel that it was an ox in the mire. I am expressing only my personal opinions on this matter, but since we are talking to students, it would be my hope that your studying could be done in the season thereof and not as a cramming process just before you go on Monday mornings” (Teachings, 227, 229).

Sunday, July 3, 2011

Dad's Dictionary

Batut (a rough transcription)(as in; Colder than a well-digger's batut): noun 1) Region of the body related to tupus 2) Often used in relation to weather; the word can also serve as punctuation much like an exclamation mark; Batut is used to indicate a superlative situation as in "Colder/Hotter than a well-diggers batut" means 'very hot/cold'

Bolivar Snodgrassnoun 1.) First and last name of a generally unpleasant person spoken not as an insult, but as a mask to protect the identity of the idiot it is applied to.

Boltar of the Rocky Crags: def. alias for Ray Warren Snyder; abbrev. Bolt

Chusa: 1) (This word has an unknown part of speech, could be a verb, noun, expression, or possibly all three at the same time) Used most often in a situation where lots of pain is unavoidable, seems to be directed at the entire situation, may refer to the one receiving pain or the one giving pain although some specialists say that it is an expression of relief that the speaker is removed from the situation

Crustsceans: noun 1) The region of the bilateral swellings of the occipital bone referred to by professionals as the superior nuchal line which marks the attachment site of the occipitalis, splenius capitis, and trapezius muscles. A perennially sore area due to hypertonic postural muscles.

Dirdisima madreexpression 1) Said in the exact moment when the worst possible thing that can happen, does.

Drizzle; noun 1) Liquid substance of unknown origin chemically related to both squizzle and squazzle expression 2) Said before or during impending catastrophe

Fine specimen of humanity: noun 1) Refers to anyone looking or appearing scraggly with strong irony, (see below) 2) Term of endearment

Fold your flagrant flippers: imperative 1) Phrase said shortly before prayer in imperative tense; Translation, "fold your arms."

Frederick: noun 1) Refers to a male married to Norma Jean for more than 100 years; also driving dangerous and/or slow

Gig verb 1.) Accompanied by a voiceless alveolar “hissing” sibilant [s] (fssssst!), gigging is giving a quick unexpected pinch with the intention of scaring, disrupting, or playfully provoking. Among experts it is seen as a 'gauntlet,' a challenge to wrestle.

Give him the bird: 1) Verbal expression said specifically during the card game Rook when the user would find playing the Rook card particularly advantageous

Mowhaucher: noun 1) Gender neutral term of endearment 2) also used to describe a person undertaking amazing feats with a lawn mower as in the following situations

Naval destroyer noun 1) See also gigged, gigger

Nayzle: def 1) Expression meaning 'no'; always said in a series of three repetitions as in "Nayzle, nayzle, nayzle!"

Negro b'chaunch (original spelling is lost, this is a rough transcription): expression 1) Related to chusa, but when used, the speaker is not removed from the pain

Norma Jean; noun 1) Elderly woman behind a steering wheel, usually drives slow and/or dangerously.

Puerco bachonexpression 1.) An expression of frustration reserved for situations when a valuable item breaks, something goes wrong, or the situation is severely disappointing.

Scum-sucking pot-licking well-digging mahole (rough transcription, actual spelling unknown); noun 1) Expression of exasperation directed at a person obstructing short term progress on the freeway

Squazzle: noun 1) Substance of unknown origin usually in a container known as a 'squazzle-bucket'


Squizzle: noun 1) Substance of unknown origin, usually accompanied by a terrible smell; Translation; stagnant water, swamp-scum; see also 'squazzle'

Tupus (pl. tupi pronounced; tu-pai) noun 1) Refers to the region of the body where the back meets the legs to avoid alternative crude words; Example of use "Don't squat with your spurs on or else you'll damage your tupus."

You look like the inside of a sow's belly: declaration 1) Phrase used to imply someone or something has seen better days 2) may be referring to a short-term and reversible situation of bad overall appearance;Translation, the object in question is 'over the hill', or has a 'bad-hair day'

Def 1

Def 2

You thought a chigger had you expression 1.) A victorious expression said after a successful 'gigging'

Friday, July 1, 2011

Week Two

It is now Friday 6:41 pm after the first week of medical school.  We had our first exam today and it had a written part and a practical part.  The written exam was fifty questions, multiple choice, and about half of the answers I knew off the top of my head without looking at notes.  The other half I had to go back to the textbook and powerpoints to get the information I needed. It was open book, open classmate, and overall was pretty doable.  The practical exam was set up as follows:

One student has 21 minutes to give another student a full screening exam which includes monitoring     walking, symmetrical orientation of the body, and range of motion checking for bone protrusions and muscle fullness. Then the student performs a regional exam of the back assessing texture of the tissue and spinal range of motion.  At this point, the student is given a segment (upper thoracic, lower thoracic, lumbar, or ribs) to diagnose a somatic dysfunction, choose the most prominent problem and perform one soft tissue technique and one articulatory technique.

I tried not to let me description ramble too far into vernacular, but I don't have the vocabulary to describe what we do in common parlance.  I felt confident with the test after spending hours and hours practicing the form of the requirements, but still a bit nervous never having taken a test in med school.  The results?.........98% on the written exam and 95% on the practical.  It is doable and that is very good to know.  It took a lot of hard work and long days which makes me grateful S wasn't here to endure my absence.

To celebrate the end of the first week, the class of fourteen wanted to go drinking.  One of my buddies in the class and I decided to go along to be sociable. We didn't drink, but we both took elbows in the chest from two drunks staggering out when we got there at 4:00 pm.  It was an interesting culture I have never witnessed first hand.  There was loud raucous music that everyone had to yell over to be heard, drunks playing a bazillion games of pool on one half of the very small hole in the wall, and one overworked female bartender helping with alacrity about twenty Hispanics become thoroughly inebriated.  Our group limited itself to one drink just to get a buzz and then we left.

We have Monday and Tuesday off for July Fourth so I have a few days to prepare myself for the next epic installment.