How to prevent disaster?!?!?!

I've learned that no matter how big the hospital seems, it has the potential to shrink at just the wrong moment. Today I was reminded about how important it is to carefully monitor everything you say, regardless of what your intentions are. I seem to find myself asking questions in the wrong manner or venting about a less than optimal experience at just the wrong time. I somehow managed to disparage an entire medical specialty today with one simple question.

The question was innocent enough, but it's all about context. It is impossible to predict what reaction someone may have. I think the difficulty is that you are constantly being evaluated as a medical student, in a way that you are not really sure what to do sometimes. I don't have any desire to be disingenous about my goals or career plans, but at the same time I want Attendings to know that I take their rotation seriously. You want to be eager without being over the top. You want to be interested without being patronizing. You want to learn without fear of a negative evaluation.

It is interesting that sometimes learning and the process of evaluation don't coincide, and may even conflict. Studying for the test, and being prepared for life aren't necessarily the same thing. In medicine, you hope these two line up. You also hope that ultimately truth prevails regardless of context.

Will I really miss surgery?

As I transition from surgery to outpatient internal medicine, I am dealing with mixed emotions. Surgery is physically and mentally demanding because the days are long and you never really feel completely on top of what you are doing. You come in early and stay late, and you're lucky to get a break to grab a bite to eat at any reasonable time. But, I enjoyed it. I am interested in doing surgery as a career and it's almost like a rite of passage to go through this type of life. However, as a student, it's nice to have a little bit of a break to catch up on reading and doing the things that you've had to neglect because time and exhaustion do not work in your favor. It's also weird to just leave patients that you've worked with over the past month to another group of students who are not up to date with all that has been going on in the lives of these patients. As I had a chance to catch up on some rest this weekend, I actually started to mourn the death of my surgical experience. I know I will have the opportunity to do more as I approach my Residency choices, but I was surprised that I had such a visceral response to this rotation ending.

Time for the good stuff

So, now that I have taken (and passed) Step 1, it is time to move on to the fun stuff. I started surgery rotations on Tuesday and thus far it has been fun. Tonight (as I sit here at 4:28 am) is my first night of call. It has been an interesting experience, though not as crazy as it might have been. I have tried to make it through the night without sleeping because that is what hard core people do. I will probably regret this at a later date, but it has been fun learning new ways to get around the hospital and surviving on Mountain Dew. I really don't have any major cool things to mention other than the fact that I am closing in on finishing my first night of call, which will certainly not be the last.

Why Can't I Focus?

I take my USMLE Step 1 exactly 2 weeks from today. I have been pretty good about being productive and staying on task. I have two more organ blocks to review before I do my final "memorize everything under the sun" thing the last few days before the exam. For some reason, I am having a lot of difficulty getting back into things today. I think part of the reason is that after about 2.5 weeks of being quite productive, I am just sorta bored with the whole studying thing. I guess I feel like my score is going to be in a certain range no matter how much I do between now and the exam. I also think a lot of it depends on what form I get and how well I know that particular set of questions. If it is heavy on Micro, then I may be screwed, but I have Path, Pharm, and Phys pretty much down cold. I guess I figure that taking a few minutes to post here will kill my boredome long enough for me to regain focus on my studying.

Bittersweet

Being an older medical student certainly has its advantages and disadvantages. Maybe later I'll expand on what I think that means, but I think one issue that I deal with here are those moments that are truly bittersweet. These times are when you get to revisit some semblance of your past, when life was normal and you get to see the light at the end of the tunnel. However, at the same time, you realize how much you left behind and currently don't get to do as a medical student because you spend so much of you time studying or in clinic. Obviously, these experiences are both good and bad. We had an event last night to celebrate finishing 2nd year of medical school, marking a huge achievement and transition into what should be a more fun time. It was at an awesome estate with tons of food and drink. It's not like I used to go to parties like this on a regular basis, just that my former life granted the opportunity to do that more often. Despite the nostalgia the experience stirred, it also served as a great source of motivation to keep plugging along and to know that soon enough, I'll be there again and this time won't be haunted by the thoughts of "what might have been" if I had only chosen another career path.

What I should be doing

So as I am sitting here trying to work on this and watching the ACM awards, what I really should be doing is studying for USMLE Step 1. I am taking the test in about 6 weeks so I should probably be a little more stressed than I am right now. I only have 1.5 weeks left in school, so I guess right now I am just looking forward to finishing that up. I am also heading to the OBX for a few days when school is over to decompress before I start the hard core study mode. Maybe when I have a little more motivation for school, I will post some interesting tidbit about medical school or medicine in general.

I need more of this:

Less of this:

Second Post Ever

I promise the titles won't continue to be numbered. I am still trying to format the page the way I want and figure out what elements to include. The page looks a little empty right now with just one entry, so basically I am just adding this to fill up the page and see what it will look like with more than one entry.

First blog post ever

So, I figured I'd give this blogging thing a try. It's not that I think I am that interesting or anything. For anyone curious about the origin of the name, I am a medical student and always thought toxic megacolon was one of the coolest complications of a disease. I also thought it would be a great name for a hard core rock band, but since I am not that musically inclined, I figure the best way to stake my claim to it would be to create a blog. However, I am sure someone else has already used it because the address toxicmegacolon.blogspot.com was not available for me to use. Anyway, I am not sure how much I will use this, but here is a start.

You may find various pictures of toxic megacolon at: http://images.google.com/images?hl=en&q=toxic+megacolon&gbv=2