Island Med Student

Today was my first day of rotating in a hospital as a medical student. I was assigned to internal medicine, and basically followed the attending physician and intern around the wards with two other med students. This is actually supposed to be a transition semester. I’m finished with the basic sciences, but don’t know enough about the clinical world to begin my official rotations, so I have 12 weeks to learn the ropes.

The hospital where I’m rotating is a pretty far cry from the hospitals that I’m used to working at in the States. The halls have no walls, since there is no air conditioning. Many of the beds and rooms are quite dilapidated. There is no MRI machine or even “nurse call” buttons. However, the hospital actually runs surprisingly well. The hierarchy of nurses and doctors is pretty similar, and many of the protocols are almost identical.

Since today was my first day, I had absolutely no idea what to do. Combine that with the fact that I was in a different country, with different rules, and you have one very confused Kendra. I spent a good 30% of the day just standing around with a confused look on my face, smiling at all the doctors, nurses, and patients as they walked by. A few patients approached me with questions, and of course I had no idea of the answer, so I had to redirect them to someone who would.

Eventually, I learned where to find the charts and started familiarizing myself with the various colors that are used for lab work, doctors’ orders, prescriptions, etc. I read through a few patients’ charts, and looked up the various drug names that I didn’t know.

As we rounded with the attending physician, she began to drill us on diseases, meds and tests. Because I have not picked up a medical book in over a month, I thought that I had most likely lost everything that I had learned. But I soon realized that I was able to answer most of her questions.

Later on, I observed the intern do a urinary catheterization on a patient who was somewhat demented and uncooperative. I could tell that she was having a hard time, so I instinctively grabbed a pair of gloves and helped hold the patient still and tried to calm him down. I could tell that she was pleased to see me jump up and help, without her having to ask, and afterwards I was glad that I hadn’t just stood there with a glazed look on my face.

So, I would say that although I felt pretty silly standing around most of the day, not really knowing what to do, I actually had an amazing day. I still feel pretty incompetent, and know that I have a lot to learn. But the desire to learn is burning inside me, and I think that’s probably the most important thing right now.

Click Here To View the Original Post on Medscape

Yesterday, as I walked from the grocery store to my apartment, I had an epiphany. Dominica is my home. It’s where I feel I belong. When I visit the States, I feel like an outsider looking in. When I’m in Dominica, I feel whole and happy. Once you get past some of the annoyances in the beginning, you soon realize that this is an amazing place to call home. The weather here is absolutely amazing. It’s warm all year round. The beach is never too far away. Gorgeous mountain ranges surround you. And then there is what I realized yesterday that I love the most about Dominica. There are no McDonalds, Targets, or Starbucks. When you run out of propane (like I did yesterday), you might have to do without it for a few days, because all the stores are all out. When you find out that the store is selling cottage cheese, you immediately jump for joy and buy several packages of it, because you might never see it again. You learn to appreciate the little things. You are bombarded by less marketing aimed at getting you to buy tons of things that you don’t actually need. There is a level of depravity. I could go on, but I think you get the point. I really, really do love my home. Now, just ask me if I feel the same way in three months when I’m jonesing for some sushi. I think I’ll still love it here.

Note: The pic has nothing to do with the post. It was taken a few weeks ago in the States. I just thought it was a sweet pic.

The past 24 hours have been an emotional roller coaster. I landed in Dominica around 4:30 yesterday, and got to my apartment by 6:00. I came home to find out that we had no water, electricity, gas, or Internet. I started freaking out because my hair was still pink and I needed to register today with normal colored hair. I desperately needed a shower, and had all kinds of paperwork to find before registration. Micah and I carried buckets of water from down the hill up to our apartment and I washed my hair with the bucket water. I tried to think of the experience as a story that would make me laugh someday, but I was just too stressed out from traveling to find the humor in the situation.

Luckily, things got straightened out and we finally got our water back. I dyed my hair to a dark brown/red color, took a shower, and unpacked my suitcases.

This morning, I went to the hospital to register and for orientation. It was a bit disorganized, but everything worked out in the end. I peed in a cup, signed up for my PPD, turned in my forms, got a locker, and got my schedule of rotations.

Right now, I’m as excited as can be. We don’t all get the same rotations, so I was thrilled to find out that the ones I got were the ones I wanted. Here is my rotation schedule:

Weeks 1 & 2: Internal Medicine
Weeks 3 & 4: Ob/Gyn
Weeks 5 & 6: Accidents and Emergencies (Emergency Med)
Weeks 7 & 8: Anesthesiology/ICU
Weeks 9 & 10: Psychiatry
Week 11: Exams
Week 12: ACLS/BLS Certification

I wanted surgery, but since I got anesthesiology/ICU, I’ll get to spend plenty of time in the OR. I also wanted path, but I can always do that as a rotation later.

As we toured the hospital, and learned the ropes, I realized how excited I was. On Monday, I will be walking into the hospital, wearing my white coat, performing exams, and learning all kinds of procedures. We even got a book to check off the procedures that we observe and perform. I doubt that we’ll cover even half of them in 12 weeks, but I’ll be elated to learn even a few. Who knows, maybe I’ll even finally get my white coat nice and dirty.

• Shibas and Stethoscopes: The Journey Begins
  (tags: blog)

Over the past week I’ve had an extraordinary amount of fun hanging out with all of my friends. I managed to catch up with almost everyone on “my list.” I caught up with T-bird, L-boogie, and my new pupil, etc. Yes, I have awesome nicknames for all of my friends. I still have a few more people to hang out with while I’m here. So I’m hoping to squeeze them in over the next few days.

The other night I went out with my friends Laura, Micah, and Ashley. We managed to tear the town of Baltimore up. I’m seriously not sure if other people have as much fun as I do when I go out. One recommendation that I have for having a good night is to always bring some sort of prop with you. It’s a great conversation piece, dance prop, weapon, etc. A good one is a huge plastic candy cane. You really can’t go wrong. Also, thanks to Laura, I have a new great way to make a creep at the bar leave me alone. Just turn around and fart on him. It works surprinsingly well.

• Doctors of the Caribbean
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I recently watched a video of presidential candidate Mike Huckabee responding to a question on whether or not he would support medical marijuana. In his response, he mentioned that narcotics could potentially be an alternative to medical marijuana for the relief of pain. This really got me thinking.

Before I delve into the subject, I’d like to say that I’m not necessarily for or against legalizing marijuana across the board, or even just for medical use. However, I am definitely for the relief of others’ suffering, and I also believe in anecdotal evidence, as well as findings from clinical research.

I can’t claim to be an expert on the subject of medical marijuana. But from what I’ve read, there seems to be a lot of research that supports the claim that marijuana can be effective in treating chronic pain, nausea, increased interlobular pressure, and a variety of other symptoms. It has been promoted in the treatment of diseases such as AIDS, cancer, glaucoma, and multiple sclerosis. Of course, on the other side of the coin, there has been research that supports the notion that marijuana can have some long-term negative effects. I could go on to list all the research for and against the use of medical marijuana, but that would require a much longer post, and it wouldn’t prove anything in the end.

The statement that Huckabee made regarding narcotics (and by narcotics, I’m guessing he meant opioids) really fascinated me. His comment would mean that morphine, for example, is a viable alternative to marijuana for the treatment of chronic pain. Any physician, or medical student for that matter, can testify to the fact that morphine is effective in relieving short-term pain, and some research supports its use in the treatment of chronic pain. However, if you’ve ever seen the consequences of the administration of morphine long-term, you can guess why I have a problem with this argument. There is no debate that morphine is physically addictive. I’ve seen it with my own eyes, and the drug seekers who show up in clinics and hospitals are first-hand evidence of the addictive potential of this drug.

Is marijuana also a physically addictive drug? Well, this seems to be a highly debated topic. I’ve seen evidence for both sides, but I think the preponderance of evidence favors the fact that it’s not physically addictive. Even if there is an addictive component, however, could it ever be as strong as the addiction to opioids? I guess that’s for all of you to answer.

Currently, federal law prohibits a doctor from prescribing medical marijuana to their patients. However, certain states have passed laws that allow doctors to prescribe marijuana for various medical reasons. I’m curious as to why certain doctors believe in prescribing marijuana for their patients, and how they would feel if they lived in a state (or country) where its use is prohibited. I also know very little about its use internationally. Do other countries have similar laws about the use of marijuana? I have years before I’ll be able to use a prescription pad, so I have plenty of time to think about this subject. But I wonder what I would do if I had a patient who clearly benefited from the use of medical marijuana. Would I prescribe marijuana if I knew it would relieve their suffering, and even aid in their healing? What would you do?

Click Here To View the Original Post on Medscape

I am no longer sick and am back to enjoying my vacation immensely. Over a week ago, I learned how to prepare and stuff a turkey for the first time. Micah’s mother taught me the ropes, and then I went about stuffing it. T’was strange at first, but it turned out to be a lot of fun.

A few days before new years, my friends Dav and Laura and I threw on some fun clothes and spent several hours dancing our hearts out. Laura and Dav are both awesome dancers, and are perfect for doing free-style improv types of moves. This is my kind of dancing!

Click Here to See the Fun Pics

After sitting on my butt for the past 4 days, I finally took my life back and decided to go for a long run. I made it 7 miles before my hands were so numb that I could no longer clench my fists. The cold air felt so good filling up my lungs as I ran my heart out. It occurred to me today that most people take vacations from cold places in January to warm places. I did the opposite. I’m not completely regretting my decision, but I’m definitely starting to get sick of this weather and sick of being sick.

Near the end of my run I slipped on some ice and fell on the sidewalk. This is not an uncommon occurrence for me, so I just picked myself up and continued along. When I got home, I realized that the blood had eventually stopped flowing, and was literally frozen to my leg. I think that’s pretty neat. Also, take a look at my knees in the picture above. So many scars, and so many stories. My poor knees have been through so much, and they just keep on truckin along, so I thought I should say a few words:

Dear Knees,

I’m so sorry for all the times I’ve tortured you, including: subjecting you to rug burns, running way longer than you would have liked, razor nicks, the sliding on my knees while playing air guitar move that I love to do, mud fights, and all the other abuses.

I hope that we can continue to be friends, and I hope that you can forgive me for my past desecrations. If you could just carry me along for another 60 years or so, I promise I’ll give you more bubble baths and knee pads.

Love,
Kendra
aka the body upstairs

Ben has tagged me with a “7 Weird Things About Me” meme. He mentioned that he had difficulty limiting the list to 7 things. I have the same problem. But here are some of the top ones I can think of in no particular order:

1) I never graduated from high school. That’s right folks, I’m a year and a half away from obtaining an MD degree and I never even finished the tenth grade. It’s a very long story, but the gist is that when I was 16, I dropped out of school, ran away from home, and then got my GED. I started attending college, and had my first college degree when I was 18. The rest is pretty much history.

2) I have a fear of free food. It’s difficult to explain, but I don’t like to eat food unless I paid for it. It just feels strange to me. I’m getting better about this, but I still have problems. It’s worse when I’m in a public place, or if there is a buffet involved. Buffets terrify me. For example, if I’m at a convention, and they suddenly announce that a buffet is open, I watch all the people running as quickly as possible, knocking other people over, all to get the first scoop of shrimp salad, and I run the opposite way in horror.

3) My hair has been every color of the rainbow. Actually, at times, it’s been many different combinations of colors, including “human” colors like brown and blonde. I’ve also had many different hairstyles, ranging from a mullet in 3rd grade to a mohawk a year ago.

4) I can’t drink warm fluids and eat warm food at the same time. I can do every other combination, just not warm and warm. Basically, this means that I can’t drink my coffee and eat a breakfast sandwich at the same time. I have to do one before the other (usually coffee first). I have no idea why.

5) In high school, I was unofficially voted the strangest girl in the school. Why is that? Here are just a few of the reasons: I would walk around with a cloth covering my face, wore buckets on my head, walked down the halls backwards, and zipped myself in duffle bags and threw myself down hills. Yeah.

6) I have finished almost (maybe 99%) of all exams that I’ve ever taken, first in my class (including standardized tests). I don’t know if it’s because I read so quickly, or read the question before the stem, or because I never change an answer, but I take exams at the speed of light (and I’ve tested myself on this before, I am more accurate and do better if I don’t slow down).

7) I am a horrible dancer who loves to dance. I consider dance to be a form of artistic expression. I have absolutely no rhythm or training or ability. However, when I dance, I do it from the heart. And oddly enough, many people have said that I am an incredible dancer. Muahahahaha, I have fooled them all!