Pilot

09/23/12

In three days I will have been on Dominica for an entire month! One way to think about this is, of course, 1 month down, 15 to go! (Hopefully after my first four terms here I will be happily on my way back to Saginaw for fifth semester and then in Michigan (or somewhere else I want to go) for the remainder of my time in med school.) The other way to think of it is: I've survived a month here! During that month I have learned so much-- from the origin and insertion point of the serratus anterior muscle (lateral portion of ribs 1-8 and the anterior surface of the medial border of the scapula, respectively) to what it's like living in a country much less developed than the United States. 

It hasn't been without its challenges-- the school or adjusting to island life. 

It is entirely true what they say about medical school--it is really, really difficult. It remains pretty astounding to me that there are such bad doctors out there. The sheer amount of information you need to know to pass should all but guarantee a smart and informed doctor. Though, based on some of the behaviors of my colleagues, perhaps it is easier to understand, but more on that later. All the time on the internet you see animations and cartoons about med school...and so far I find many to be pretty true. My favorite so far is available at: 

Med School

A day in my life basically includes:
6:00AM wakeup. It is really hot here on Dominica, so locals tend to head to sleep early and get up at the crack of dawn. I've been trying to do the same, mostly because at about 10:00PM I can barely keep my eyes open! Up at 6, take an extremely cold shower (there is a hot water heater switch, but of course no actual temperature options. It will heat up...during the 100 degree heat of the day, but otherwise it's pretty cool. Helping me to be environmentally (water consumption) friendly!), eat some breakfast, and head to the lecture hall. Usually I need to preview my lectures for the coming day. I could watch the lectures in my room online, but I find I really like being there in person, as well as the social interaction it affords me. Sitting next to my friends, joking around, it definitely makes it a little more fun.
8:00AM Lectures start. On a typical day we'll have four 50 minute lectures. Sometimes a particular lecturer will get 2 hours, etc. I am currently in a "Fundamentals of Medicine" block, which basically consists of biochemistry, cell biology, genetics and anatomy. 
One note about this, one thing I really miss is other non-science subjects. I was a humanities major, I love books, I love politics. I miss other things! In my glycolysis lecture, about alcohol breakdown, was a Shakespeare quote from Macbeth:

"It provokes the desire, but takes away the performance." 

and it made me miss literature, humanities, and other subjects so much!
12:00PM Lunch! Finally, a break! If I head home to my apartment, I usually take a little TV-and-lunch break, but I also like eating at school. "The Shacks" are these little restaurants on campus with all manner of different foods...a reasonable imitation of italian food, wraps, pizza, and my personal favorite at Nelson's Grill:

After lunch, things tend to vary a lot depending on the day. About once a week I have cadaver lab that runs from about 1PM to 5PM. This lab is one of the most exciting, and challenging parts, of being in medical school. On one hand, it really helps so much in understanding how our muscles work and what is where...you wouldn't want to take Cerebral Spinal Fluid (a spinal tap) from the wrong place (you take it from the subarachnoid space, in adults around L4+/-1), but on the other hand, it is really oddly creepy. The way my dad told me to get through it was to think of it as purely mechanical--like working on a car. Just parts. This does this, that does that. Some days this is easier than others. Out of respect for the bodies we only expose what part we are working on (the shoulder, for example), but in my lab last week, we worked on the shoulder. To do so we had to abduct the arm (take it away from the trunk) about 45 degrees. Consequently, there were dead hands and arms reaching from each table. Talk about the opening sequence to a horror movie. Though I felt perfectly comfortable in lab the first few times, I am growing increasingly uncomfortable there. Last time I left feeling genuinely ill. The strangest thing about lab though is that the chemicals that the bodies are preserved in tend to stimulate a response that makes you feel, out of all things, hungry! Pretty strange to rush out of lab after working on bodies to go find food. 

Other afternoons have other activities. Sometimes we have patient interviews (arranged over skype, basically we get to ask real patients questions about their medical question, medical history, etc, to learn to write basic patient reports. One a week we also have small group learning, where we are given a patient case and have to go through the process of using data to form an analysis to creating diagnoses. My first session was last week; it was quite interesting. The best part though was, though we get homework, my assignment is looking into the epidemiology of Downs Syndrome and maternal age. I am really interested in epidemiology and public health, so it is perfect for me!

In between all of these activities, it's hard to find time to study! After all of these activities, I typically head home for dinner and settle in for a long night of studying. I feel like I can never be fully caught up. They say medical school is like eating a plate of pancakes; each day you are given 4 pancakes. Now, that is a lot of pancakes. But you have to eat all four. If you leave two, tomorrow you have 6 pancakes, etc. You have to keep up, but in between all these activities and learning (basically just memorizing) the lectures, it is definitely a full time job.

I have been doing my best to do other things though. At the beginning of the term I attended yoga classes everyday, but have recently become more interested in zumba! Zumba is offered three days a week, and while the classes aren't like the ones I had at home, I really enjoy going to dance for an hour with the music pumped up! I am also looking forward to exploring the island a bit more. I have promised myself that a few times a semester I can do other things. In a few weekends I am hoping to do a half-day moderate hike with a 15 ft cliff jump and natural waterslide at the end. Later in the semester I will be doing a full day hike to one of the highest points on the island which overlooks a famous boiling lake. I am looking forward to those trips as well as a few other extracurriculars. To be an active student (part of my mission to create a life for myself here), I ran for a position in the Honor Council, which helps enforce the Student Honor code and deals with any student violations. I was elected! So far the other council members seem extremely nice and the older students are definitely willing to lend a helping hand to younger students. I also enjoy working as part of the student government; those of you who know me know that I'm extremely interested in politics and may even pursue that as a career someday. I am excited to be a representative of the student body. I also have joined the oncology club. I do still believe I would like to be a pediatric oncologist. The club seems great; they have a lot of events that will help me learn (seminars on giving bad news to patients, practice taking a bone marrow sample, and doing cancer screenings in the community) and everyone so far seems really nice. They also have a trip off island, to visit an oncology facility on a neighboring island that hopefully I will be able to do as an older student here!

So far, school has been really hard for me. I don't necessarily find the subjects too difficult, but the sheer amount of memorization is tough for me. Anatomy in particular. But I am committed to giving it a little extra time each day; it will not best me! Unfortunately, I did have my first exam and I did not do too well. I performed below the average (which I am trying not to be too hard on myself about; like my parents reminded me, I am not only way younger than most people here, but I only have an undergraduate degree. There are many students here with masters degrees and even phds!), but above the typical "failing mark." I need to improve my performance, but I hope that with learning from the previous test (how questions are asked, how concepts are tested) and a little additional studying, I will do much better on the subsequent exams. I am a little nervous about being able to continue here; if I fail a "block," the first five week fundamentals section for example, I won't be able to continue here. I could retake the semester, but I doubt I will do that. I really hope it won't come to that, but the statistics are not on my side. Something like 40% of students who do poorly (i.e. me) on the first exam fail at least one of their basic science semesters on the island. I know I should be here, I know it's right! I will not quit. I will do better on the next exams and practicals and someday I will laugh about that first test that thought it beat me. There is certainly a lot of work to do, but I want to do it. 

Regardless, all I can think of is a quote from (my favorite TV show ever, Buffy the Vampire Slayer of course):

The Master: You were destined to die! It was written!

Buffy: What can I say? I flunked the written.

Island life is also pretty challenging at times. There is no hot water in the mornings, you're not supposed to drink the tap water (or at least, it gives me a stomachache, that is for sure!), the grocery store has different things every time I go there, and it is basically really hot, really rainy, and really mosquitoey all the time. I have to wear bug spray in my apartment (next semester I am totally going to invest in those candles that keep away bugs, or one of those things I can attach on to my best). I do use deet-free natural spray, but I still don't think it's good for me! The grocery store is one of the most frustrating things for me. I go in with a list of things I want--bread, turkey for sandwiches, lettuce, apples, and they will have bread. Last time I went to the store they didn't have lettuce! You also can't ever get attached to a product; they don't have fresh milk here, and while I found an almond milk I like, it was gone the next time I went to the store. It really encourages impulse buying, but in a way I do kind of appreciate the spontaneity of it. Keeps things interesting. Plus I'm feeling pretty spoiled this morning; got my NZ kiwifruit and chocolate ice cream in! The ice cream is...not quite as good as home, but I am happy to have it! I've heard you don't want to drink "fresh milk" here, as the cows aren't tested for things like TB...but I don't know if I can go without ice cream my whole time here! 

Island Ice Cream

All in all, the food here is terrific, but definitely not like home. You have to be a lot more careful about things, like washing lettuce with salt water for a minutes, to kill any bugs that are in it! 

That's it for now, I definitely have more stories to tell but I will get to them soon, for now it's back to glycolysis. (And all I can think of for this is, why didn't I just memorize it super well in college? Definitely would have made it easier on myself!)

Here's a few of my favorite pictures from Dominica so far! It really is a beautiful country.

 This is a sunset from my apartment! So gorgeous here, virtually every night. I can briefly look out at it from my desk. Study study study. The sun sets really early here, about 6:30.

 Very tropical! This is along the Indian River by where scenes of Pirates of the Caribbean 2 was filmed.

 On the Caribbean.

 A beach less then a 5 minute drive from my school.

 Tropical flowers everywhere, I love the colors of the flowers and the houses!

 And the sky at sunset.

 Along the Indian River.

Trafalgar Falls.

Hopefully I will have more updates, much sooner than it took me to get this one! I was really unsure about doing the blog thing again, but I did really enjoy writing it (and looking back on it) while I was in New Zealand! It definitely is a cool outlet and way to connect with my very-much-missed friends and family back home!