Sunday, March 25, 2012

Every Sunday School Lesson...Ever

My diseased status last week meant I could choose to make up the first neuro test. Usually make-ups are scheduled within 3 days of the test, but since the test fell on Friday and the following week was spring break, I take it on Tuesday night instead. That means I had more time to study for it than anyone else. Also, I go into the test knowing that the median score was a 68% and the average was only slightly better at 71% which means more than half the class failed. The standard deviation was about 10 points so about 8%. I like knowing what the stats are going into it and with all my advantages my goal is at least two standard deviations above the mean. Stay tuned.

The week was way more chill than usual. I spent the mornings at home mostly playing with C and building snow princesses. She decided our first attempt looked like mamma so she referred to it as the "Mamma Princess." The last time it snowed this much was 1991 and I was right to forbid any use of the car while the snow was around. 

From nap time to dinner time I was on campus meticulously studying and restudying. I miss the highest proportion of questions on the drugs. There are over 50 cholinergic and adrenergic drugs on this test arranged by classes, but with various lengths of actions for different reasons, stimulating different receptors producing opposite results, and some even have vastly different effects based on dose. Keeping them all straight is difficult. I generally learn lists like this with mneumonics, but remembering a mneumonic with 50 different elements is about as difficult as memorizing the things in the first place.

Sunday, March 18, 2012

Infanticide vs After-Birth Abortion

I read an article this week that made me sick. Usually there is enough of a distance between me and the object of moral dilemmas, but this one hit a bit too close to Noelle. This article from The Journal of Medical Ethics advocates the use of after-birth abortion. The premise is that there is nothing magical about a baby passing through the birth canal, so logically if the abortion of a fetus is permissible, why not the abortion of a newborn? I agree with the logical progression; there is nothing magical about birth that makes a fetus more of a person than it formerly was. I have a serious problem with the assumption that baby, whatever the stage, is less of a person than you or I.

Other gems from this disaster include changing the term 'infanticide' to 'after-birth abortion' to demonstrate that there are "circumstances where killing a newborn is ethically feasible." There's also this: "In cases where the after-birth abortion were requested for non-medical reasons, we do not suggest any threshold, as it depends on the neurological development of newborns, which is something neurologists and psychologists would be able to assess." In lieu of their reluctance to propose an age, allow me to pick....26. That's the age that the government has decided that kids have claim on their parents for health insurance, sounds fitting to let parents decide whether the kids live or not.

On top of all that, this surfaced from a couple living near Portland - a family suing for wrongful birth. They love their Down's Syndrome baby girl very much and asked for $7 million (awarded close to $3 million) to help raise her, but they would have aborted if they had known she had the condition. I'm not arguing the doctor and lab techs didn't make mistakes, just that it would take a whole lot more money than that to state on public record where all my children can hear that I would have aborted one of them.

Sunday, March 11, 2012

Professionalism and a Fifth of Beethoven

I am sick of the word 'professionalism.' Unfortunately for me, this is the favorite word of the people in the long white coats. I didn't begin disliking it until medical school. I knew I was going to be a professional doctor - as opposed to an unprofessional? doctor. The idea is silly. I know they are referring to the proper way in which doctors carry themselves. What they mean is, "Don't act like banshees when potential donors come visit the school. You are our little goldfish - look pretty and don't get in the way. That way, we get more money, you get better stuff, and we'll all be happy." I'd much prefer the 30 seconds of honesty to the hours of lectures - they'd save time and get the same results.

The strange part is, if I took my complaints to the administration about the length of time dedicated to professionalism lectures, it would be complaining and unprofessional. If I were to use a passive-aggressive blog post to complain, I would not be actively confronting the problems I see which is unprofessional behavior. If I were to say nothing, then I'd too afraid to call the emperor naked which I'm sure is somehow unprofessional. Joseph Heller himself couldn't have come up with a better quandary.

We've been doing neuro for a week and a half and we have our first test on Friday - a great way to kick off spring break. About 70% of the test is going to be neuroanatomy and it is coming back to me. The advantage of having taken it before is that I understand the importance of tract decussations (nerves crossing over to the other side of the body) and how that helps localize lesions. Everyone else gets to wikipedia what a decussation is. It's times like these when a gunner like myself should wrongify or obscure the entries of the neuro tracts within wikipedia to give myself an advantage.

Dr. B was a fantastic teacher and I learned quite a bit from him, but there's a big difference between having taken it and remembering all of it. I still put in long hours and I'm only slightly better off than the rest of the class. In fact, if we were all patients in the hospital, you might say that I'm the healthiest person in the ICU. We'll see how thing go on test day.

Sunday, March 4, 2012

Large Numbers and Fibonacci

Blood and Lymph is officially over. Studying for the final was a chore and the test stressed different aspects than the first test did. The first test required being able to identify a disease based on the clinical presentation and blood smear and the treatment for moderate and severe disease stages, but the second test asked more about details of the disease process like what is the life expectancy for Acute Lymphocytic Leukemia at an intermediate stage. I haven't seen the low side of average for a while and it doesn't feel very good. I like large numbers beneath me.

However, the system we are in now is Neuroscience which happens to be what my undergraduate degree was in. I do love the brain, but already I am missing Dr. B and Dr. S. They were a pair of fantastic teachers; you've gotta be amazing if you can take a dry subject like neuroanatomy which requires naming various structures in cross sections or the microcircuitry of the hippocampus and keep it engaging and interesting. I don't remember everything they taught, but I'm light-years ahead of those trying this out for the first time.

I call that the Law of Second Exposure - even if you believe you don't remember anything from a class you took years before, the process of relearning the material is simplified by knowing what to look for, what is important, and the way in which questions can be asked. This has proven true many times for me: the electromagnetism portion of the calculus-based physics class I took in high school and got a C in wasn't accepted as college credit where I retook the class and got an A, the first time I took first semester organic chemistry I got a B- and the second time I got an A, and the fourth year of marriage was a whole lot easier than the first three.

This has nothing to do with anything except that I found it way more interesting than the boring lecture.