Island Med Student

A few days ago I was running with my friends through a slightly off-the-beaten path on the island toward some waterfalls. I got a little too excited when jumping over a log, slipped on a rock, and came crashing down on my ankle. As soon as I heard the loud cracking noise, I knew that I was in trouble. My ankle rapidly swelled up to nearly twice its normal size, and the pain was pretty severe. We had to cut the run short, and I sought medical attention the next day. The doctor at the clinic on campus wrapped my ankle, gave me a prescription for some pain meds, loaned me a set of crutches, and gave me an order to get an x-ray at the hospital. Unfortunately, the hospital is about an hour away, and me being the stubborn fool that I am, I decided to wait a few days to get the x-ray, hoping that it was just a sprain and that I’d be back on my feet in a few days.

Well, it’s now been a few days, and my ankle doesn’t look or feel any better, so I’m planning on going to the hospital tomorrow to get it x-rayed. It’s only been 3 days since the fall, but I’m already starting to lose it. The problem is that I’m a very active person. Not only do I run, swim, and work-out, but I generally move a lot during a given day. Whenever I study, I take a break about every hour to run around the room, or walk the trail by my house. I pride myself on the fact that I’ve lived on this island for almost a year without a car, and I’ve never used a taxi. I walk everywhere I need to go, even if it means strapping a huge back-pack to my back to carry all of my groceries. I also hate to use the “h” word (help) to get anything accomplished. I enjoy pushing myself to my limits to see what I can do on my own.

This means that the past few days have been a living hell. I can’t go running. I can’t even walk down to campus. Actually, I can barely even make it to the bathroom without help (gasp — the “h” word!) As I’m sitting here right now on my bed, I’d really enjoy a nice glass of water, but I know that it would either take me ten minutes (and a bit of pain) to get it myself, or ask my partner Micah to do it. Of course, he’d be more than happy to do so, but it would require me to swallow my pride and ask.

Of course, a sprained (or even broken) ankle is really not all that severe of an injury. Considering how many people must live their whole lives without one arm, or both legs, or hands, my injury seem quite miniscule. But nonetheless, it has given me a very interesting perspective. Luckily, my wounds will probably heal, but not everyone else is as lucky. I have the utmost respect for people who have to live with various physical disabilities, and I can understand how it feels to have to rely on other people for help. The next time I’m in a hospital (or anywhere else, for that matter), and a patient asks for help, I’ll try to not only remember to help them kindly, but also remember how it feels to be the one having to ask for help.

Click Here To View the Original Post on Medscape

It’s only been 24 hours, and it’s already happening. I’m beginning to lose my mind. I went to the health clinic today, and the doctor put an ace bandage on my ankle, wrote me a script for some pain meds, gave me a set of crutches, and instructed me to go the ER in Roseau (about an hour away) to get an x-ray. Of course, me being me, and me being a med student, I ignored the instructions. I’m still hoping that it’s not broken. At least the swelling and pain had decreased by this morning.

I’m very immobile. I don’t like it worth a bitsy. And I don’t know what that means. All I know is that I need to move. I want to go for a walk and watch the sunset. I need to feed my puppies dinner. I want to say hello to my friends. I want to swim in the sea. I want to be able to get to the bathroom in less than five minutes. I want. I want. I want. I need. I need. I need.

Does anyone out there know how to contact those evangelist folks? The ones where you can call in and send them $100 and they’ll heal you via the power of Christ remotely? I need one of those. I’m going insane in my invisible prison. And my ankle is quite uncomfortably numb.

PS: Pic has nothing to do with this. I just happened to find it. It’s me at our mannequin fluff party. Back when I still had two good ankles to stand on.

Caution: If you would prefer not to hear me bitch for the next few minutes, please stop reading now.

I have had a rough few days, and I think the only thing that could possibly make me feel any better, and prevent me from banging my head against the wall right now is to write down the current list of sucky things in my life. So, here goes.

1) My laptop broke a few days ago. Again, this sucks because there is no Mac store on the island, and my laptop is my life. I go to school on it. I write on it. I study on it. It connects me to the rest of the world. This sucks a big one.

2) I lost all the pics and movies from my trip to Boiling Lake. (Update, Micah was able to save them, but still, it sucks that I had to experience the emotional trauma.)

3) I lost my “special” notebook- the one with all my super special notes in it. I have no idea where it is. I’ve looked everywhere. This time, I don’t think it was stolen, but I must have misplaced it. Major suckage.

4) My puppy Molly lost her collar and ate my running shoes. Nuff said

5) I’m majorly behind in my studies, and I have four massive exams on the horizon.

6) I owe all of my friends and family many calls, emails, and hugs (not to mention the other pile of emails in my inbox awaiting replies).

7) Today, as I was running along a gorgeous trail, I fell and injured my ankle. At first I thought it was a sprain, but all signs are now indicating that it may in fact be broken. I’m in Dominica. The hospital is far away. There are no ambulances (that I know of, though there might be a bus or something). I have things to do. I don’t have time to deal with a broken ankle. Running is the only thing that brings me great pleasure. If I can’t run, or at least get all sweaty from exercise, I will rapidly spiral downward into a pit of despair. I don’t want to imagine med school without exercise. I can’t even fathom it. My break is coming up in three weeks. I might have to go on vacation with a broken ankle. This sucks immensely.

8 ) I lost my favorite (made by a cool Rasta guy) anklet.

Yes, there are worse things in life. But right now I don’t care about them. All I know is that I feel completely broken.

Okay, that did help a little.

I spent the past week or so diligently practicing for my upcoming clinical skills assessment. Thus far in medical school, I’ve taken many written multiple choice exams, and Shelf Exams, but I’ve never been tested on actual clinical skills. I was a little nervous that I’d completely freeze up when it was time to be tested, so I tried to practice as much as possible. Eventually, my partner Micah became tired of being percussed, auscultated and poked, so I felt that I was probably prepared enough to pass the exam.

Yesterday morning, I walked into the evaluation room along with seven of my classmates. A patient sat in the middle of the room on the examining table, and a professor and student assistant sat on the other side of the room. We all took our seats, and anxiously waited to get our assignments.

I was second in line to be examined. I walked up to the table in front of the professor and picked an index card randomly from the pile. I was assigned to take the patient’s blood pressure. Yay! I had lucked out and gotten the easiest assignment. I’ve taken blood pressure a bazillion times before in hospitals, so this should be a breeze, I thought.

However, when I approached the patient, I suddenly became overwhelmingly anxious. I realized that my hands were trembling and my face was starting to flush. I went through all the steps, and successfully took the patient’s blood pressure, following all the standard procedures and explaining each step along the way. But the entire time, I was quite nervous and terrified that I’d mess up.

I ended up getting an excellent grade on my performance and I didn’t make a complete fool out of myself, but the experience really got me thinking. I’ve taken blood pressures so many times in my life, that I can’t understand why I was so nervous this time. It’s such an easy procedure, and it should have been no big deal. I think it might have to do with the fact that I’ve always been lower on the totem pole while working in hospitals. If the doctor thought my reported blood pressure reading seemed way off, they’d usually take it again to make sure, because they had the ultimate responsibility for the patient, and not me. The doctor is the one who writes the prescriptions and has to make the important calls.

Now that I’m actually training to be a doctor, I realize that my responsibility to the patient is much higher. I will eventually be making the calls that will affect the course of the patient’s health, instead of just following the orders, and I think that makes me a bit nervous.

I hope that I can learn from this first evaluation, though. Hopefully next time I will feel much more comfortable and relaxed when being evaluated. But it’s nice to at least have this first obstacle out of the way!

Click Here To View the Original Post on Medscape

On Sunday, me and my bestest friends took a hike to the Boiling Lake here in Dominica. Eventually, I’d like to write a longer post about the adventure, but I’ll give the abbreviated version here. In short, the hike was AMAZING. We hiked for about three and a half hours there and back through the Valley of Desolation, sulphur springs, and up and down many hills. It was an intense hike to say the least. Really, words can’t describe the adventure, and neither can photos, really.

We took many wonderful pics and videos, but I had a catastrophe last night where my laptop broke and I lost all of them. We’re working on salvaging the pics using a special software, but it hasn’t worked yet. I really hope we can get them back because the photos will do a better job at conveying the beauty of the land than I can with words.

Not only was the scenery amazing, but I went with some of the coolest people I know. We painted our faces with sulphur mud, swam through an amazing gorge with a waterfall in the end, and jumped off a cliff into the sparkling water. In fact, if you’ve seen the Pirates of the Caribbean, Dead Man’s Chest movie, you’ve seen a glimpse of the gorge we swam in (the scene with the cages made out of bones.)

Thankfully, some of my friends did take pictures as well, so even if mine aren’t saved, I’ll have those to share. As soon as I get the pictures together, I’ll be posting an album. And hopefully, the video footage will be spared, and I’ll make a nice video.

If you ever come to Dominica for any reason, I highly recommend you do the hike. It was a life altering experience for me, and I’ll treasure the moments forever.

My run today will forever live on in the hearts and minds of Portsmouth, Dominica. Today at 4:00 I was supposed to go running with my running crew, but it was literally pouring mangos outside, since it’s now the rainy season in Dominica. The crew backed out because of the rain, but I decided to go anyway.

As I was coming around the corner in Portsmouth, my clothes were reaching maximal wetness. I was wearing a pair of cotton running shorts, with no waistband. I could feel my shorts getting heavier and heavier with rain, but I pressed on.

And then it happened.

As I leaped into the air to dodge a puddle, my shorts fell down to my ankles.

That’s right folks, I pantsed myself.

Of course, everyone noticed and let me know with their hooting and hollaring. I pulled my shorts up, and continued on my run. Well, there are only so many roads in Dominica, so I had to pass all the same people again on my way back. Apparently, they had not forgotten the incident, because they screamed at me as I passed by. I think I might be some sort of new Dominican national hero.

I recently got a chance to watch Michael Moore’s latest film, “Sicko.” I’m not going to launch into a critique of the movie, but I’ll say a few things. I think that in general, it was a wonderful film. While I don’t necessarily agree that socializing the American healthcare system is the panacea for our healthcare problems, Moore did an exceptional job of bringing the issue of our healthcare system woes to the forefront. Honestly, I cried during a good portion of the film, because I take the problems with healthcare quite seriously, and I couldn’t help but empathize with the stories of all the people who had lost so much because of our fragmented system.

When I decided to enter medical school to become a physician, one of the issues on my mind was the current status of the American healthcare system. As someone who has worked in both hospitals and for a healthcare association (not to mention being a patient), I’ve seen the healthcare equation from many different angles. And none of the angles look very promising. The American system is broken. I don’t believe it’s hobbling along, or having difficulty, or needs a “fixer-upper.”No, it’s really broken beyond repair. It simply doesn’t work. It doesn’t matter if you’re rich or poor or black, white or purple, you will have to come in contact with the healthcare system at some point. And chances are, it won’t be a pleasant experience.

So, deciding to be an employee of a system that is failing just about everyone was a very difficult decision to make. In fact, it was one of the reasons that I hesitated even taking on this monumental task. But I eventually decided that crippled system or not, I was going to be a part of it. Honestly, I think it was the dreamer in me that decided to go for it. I wanted to believe that if I did everything I could possibly do, I might be able to navigate the system and still help everyone who needs help. Of course, every day that goes by I see the realities of the system (and I’m not even in my clinical years yet), and the dreamer in me is beginning to lose sight of my dreams.

I don’t know what the solution is to our broken healthcare system, and I don’t know if anyone really does. But at least most of us do agree that it is broken. I guess that is an important first step. Perhaps within my lifetime, I’ll see the next step. Hopefully, someone will find a way to cure the sick system, and do it with the same sense of urgency that they would to cure a sick patient.

Click Here To View the Original Post on Medscape

I think I have a bad case of med school fever. This semester has really started to pick up, and because I let myself slack and have a good time a few nights this week, I’ve fallen slightly behind in my studies. I totally know that I can catch up, but it’s starting to all feel a bit overwhelming. I got my grades back from my second exam, and I totally rocked it. The material is not overwhelmingly hard, there’s just a lot of it, and I have some oral exams and clinical performance stuff coming up. I’ve been studying hardcore since 8:00 this morning, and I’m started to tire from the intensity of it all.

I only have two more weeks of instruction left, and then all kinds of exams. But it will all be over in about a month, so that is pretty encouraging. I just have to make it until then.

(The pic above is Mimi and Sayeh, the coolest first semesters in the world. We were all riding in a boat to a party at a place called Purple Turtle after our last mini.)

I love living out in the middle of nowhere on a small, isolated island in the Caribbean. Really, it has many advantages — the premium one being an excellent environment in which to study. Most students have to deal with all kinds of distractions constantly calling them like sirens from the water. Many students have to be able to put up with the distractions of movie theatres, malls, bars and all kinds of potential fun things to do. I don’t. There isn’t really much to do for entertainment on this island.

Today, I went to campus to watch my lectures and then I came home to begin my studying. After a short period of studying, the electricity went off in my apartment. This is not a rarity here. In fact, it’s a very common occurrence. The electricity here is as reliable as most things are: not at all. It goes off all the time, because if one of the grids fail, they re-route electricity to the capital city, which needs it the most. Well, I don’t live in the capital, so this means that when a grid goes out, all the electricity in my town goes out. There are only a few places that have back-up generators in my town, so I packed up and walked down to the local cafe, where I knew they’d have some electricity.

I was here for about ten minutes, and then I heard the sound, which strikes fear in my heart. The generator went out. No more electricity! Let me also remind you that living on an island in the Caribbean during July means that it’s approximately 98 degrees right now. Without air conditioning, you quickly melt into a pool of sweat, which can become not only annoying to you, but is also offensive to the innocent bystanders beside you.

There is only one place that I know of close by that still has electricity: my school’s campus. To the majority of the students here, that would be a perfectly acceptable place to study. However, I am one of those rare folks that hate studying in a large group of people. I can’t stand sitting in a cold room with a bunch of people who are losing their minds trying to memorize thousands of drug names and biochemical pathways. I end up comparing myself to them, and getting stressed out by watching them study. I will study anywhere else besides the library or any of the little cubicles available.

So, here I am, sitting at the cafe, with only 12% of power left on my laptop, which will soon be gone, and no Internet connection or air conditioning. The pool of sweat underneath me is starting to offend the girls at the table next to me, and I’m seriously considering going to the beach to study, because at least then I can jump in the sea to cool off. There’s nothing like sea foam covered notes and highlighters filled with sand. Wherever you are reading this right now, be thankful that you have precious electricity!

Click Here To View the Original Post on Medscape

Well, I’m back from the dead again. Not that any of you even knew I was gone, but I was. Yesterday I took the second ginormous, killer exam in my second year of med school. It was definitely a little insane, though I think I probably did okay. After the exam, as I celebrated with all my friends (aka drinking and trying to forget about the insanity of med school for a few hours), I had one of famous mini epiphanies.

Med School is kind of like the human sexual cycle (hey, we even learned about this in med school!). In the weeks before the exam, it slowly gets crazier and crazier and as time progresses, you can see the physical and emotional changes of all the students (the excitement/arousal phase). The week before the exam, the tension on campus is so thick you could cut it with plastic cutlery. And the final three days are so intense, you lose all track of time and space, and you are completely obsessed with the exam (the plateau phase). And then finally, the exam arrives. When you’re taking the exam, physical existence is forgotten, and everything but the piece of paper in front of you becomes a blur. You are consumed by it (the orgasmic phase). And then of course comes the post-exam high. You calm yourself down with a few alcoholic beverages and reflect on your accomplishment (the resolution phase).

So there you go. Who said med school wasn’t exciting?!

(The pic above is from last night’s celebration at a bonfire.)