Monthly Archive for January, 2007

one day, one room (season 3, episode 12)

HOUSE: Perjurer.
CUDDY: Felon.

CUDDY: Is that Vicodin?!
HOUSE: Breath mint. Thought you were going to kiss me.

CUDDY: How can we make this more interesting for you?
HOUSE: How can we make the sky green? How can we make the tall short? You cannot make the uninteresting interesting.

HOUSE: And you’ve never seen an afterschool special? Dawson’s Creek? How do you get to 30 and not know about condoms?
CLINIC PATIENT: Oh God, I have an STD.
HOUSE: No, but you will. Every patient who comes in here for an STD test has one thing in common: they had SWS: sex while stupid.

And he swallowed something stuck to a fridge. Darwin says let him die.

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grand rounds 3.19

Read all about consumer-driven healthcare at this week’s Grand Rounds up at Envisioning 2.0.

compulsive studying disorder

Do you…

…feel the constant need to memorize things?

…feel that everything you do is wasting your time if it doesn’t involve memorization of obscure facts?

…always carry some sort of book with you just in case you get bored enough to study (for me, it’s First Aid for the Wards even though wards is still a good long while away)?

…try to apply obscure things that you’ve learned to everyday life?

…look for something new to study once you finish whatever it was that you were studying before?

…feel that your life lacks purpose when it isn’t spent studying?

…think the world would be a better place if only everyone studied?

If you answered yes to three or more of these questions, you may be suffering from compulsive studying disorder, or CSD, an extremely rare but serious condition in which patients find life pointless if it is not spent in the pursuit of knowledge.

CSD is characterized by periods of study mania, defined as prolonged and feverish studying, followed by periods of study inertia, characterized by prolonged slacking off and an inability to study despite the mental urge/need to study. Studies have shown that periods of study inertia often coincide with and intensify right before important exams, which can be quite debilitating. Studies have also shown that periods of study mania often follow important exams when patients feel let down by the fact that they no longer need to study and want to cling to the sense of purpose that studying imparts on them by seeking out new studying materials.

Treatment for CSD includes providing patients with things to study in conjunction with psychotherapy. Refractory cases may respond to antidepressants.

Case study: MLMP is a twenty-something-year-old MD/PhD student who has just passed her qualifying exam, which was characterized by a four-week period of study mania followed by a five-week period of study inertia then followed by a three-week period of extreme study mania. Now that MLMP is done with her qualifying exam, she finds that she now lacks a sense of purpose and is seeking something to study. She is looking into studying for and taking the USMLE Step 2 CK to fill the void. Comment: MLMP is suffering from classic CSD. She should be encouraged to pursue the USMLE Step 2 CK if it is in fact feasible. If it is not, it is suggested that she study her basic science material from her first two years of medical school in preparation for her return to the wards.

my first guilt-free weekend in ages

So I’m not here.  Be back Monday!

curses, why did they have to give me such a good candidate?

And I was so excited too. But you see, what I’m fighting for here are the numbers. I want our future physicians to have the numbers first and foremost. Anything else is just icing on the cake. I hate this whole mentality of we’ll-let-subpar-numbers-slide-because-they-did-all-this-other-stuff-or-had- a-lot-of-shit-going-on. I’m sorry, but I had a whole lot of shit going on when I was an undergrad and I didn’t screw up my numbers. So why should anyone else get away with such a dumb excuse? If you were really smart, you would be able to deal with a lot of shit and not screw up your grades. But I digress. That issue is another post for another day.

In this case, I really wanted to strike some cocky bastard down. Knock him/her down a peg or two…or ten. But I didn’t get to do that because my victim was neither cocky nor lacking in numbers. Nope. In fact, quite the opposite. I couldn’t find anything wrong with them at all.

And yet it was still so hard to write the report. As much as I joke about what I would do once I had someone’s life in my hands, when it actually did happen, I couldn’t help but take it seriously. One misinterpreted word on my report and my interviewee could be screwed even if I didn’t mean it that way. So instead of it taking forever for me to write my abstract (on nonexistent data) for an upcoming retreat, it took me forever to craft this interview evaluation.

Sad, really.  Give me someone I can ream next time!  Please!  I don’t want to go soft now.

inspirational music for the graduate student 1.12

Back before my crazy-cramming-for-quals days, I used to partake in a little anime-watching. My absolute favorite anime (for the moment) is Bleach, which is about a high school student who finds out he has shinigami powers. Yes, that probably doesn’t make sense, but there’s really no way I can explain it, so you’ll have to check it out for yourself if you’re interested. Anyway, they have really great opening and closing songs and my favorite, which I’ve chosen as my song for this week is Sunset Swish – My Pace. It’s a really catchy song about living life at one’s own pace and not giving up, which I think is very appropriate for this week because that’s just what I did when it came to quals–I chose to take it when I did myself (albeit later than most) and I didn’t give up studying or run out of the exam screaming (though you don’t know how tempted I was) and it worked out. Hopefully, this whole going about my thesis project at “my pace” will also work out.

In the meantime, feel free to send your song suggestions to me here.

the qualifying exam: arguably the scariest experience (so far) in my life

After a sleepless night (try as I may, I just could not sleep), my husband (who consistently drags his ass out of bed a full 20 minutes after me) jumped out of bed before me.  I couldn't believe it was already time to wake up and prepare for this dreaded day.  In fact, I stayed in bed for another good 20 minutes thinking self-defeating thoughts before finally dragging myself out.  We then went to get some bagels and coffee to feed my committee.  My husband kept insisting that I eat a bit, but it's just not my style to eat before exams and besides, I didn't want to end up so nervous that I perhaps would throw up on my committee.  It really was surreal.  I've never felt so nervous before in my entire life and that includes a whole lot of med school interviews, presentations, and the USMLE Step 1 (which is one of the most important things not to screw up if you want your pick of specialty).  I don't know why it seemed like such a monstrous, unsurmountable mountain to me, but it did.  Honestly, I've never walked into anything before in my life thinking that I would fail.  Sure, I've been scared, but I've never fully believed that there was the possibility of failure.  Here, failure seemed to be inevitable.

So off I went to my doom.  I left nice and early in order to have some time to gather myself beforehand but was foiled by the fact that the location of the exam had been moved.  After barely settling in, I was joined by the chair of the committee and then Replacement Committee Member, who was very talkative.  Which was good.  But still.  I just wanted some silence. 

And do they really have to make the whole thing so nerve-racking?  After everyone in the committee arrived, I got shuffled out of the room so that they could discuss how they were going to proceed.  Those were the longest minutes of my life.  I was trying so hard not to freak out, but I couldn't.  I tried rehearsing my talk in my head, but couldn't get past the introduction, which only served to freak me out more because it made me think that I had forgotten it all.  Then I tried reading some of the stuff on the bulletin board, but realized that I wasn't reading but rather memorizing the stuff, which was distracting from my attempts to not forget my talk.  So then I tried pacing, but after a few circles, I started getting dizzy.  So I couldn't do anything but stand there and wait while my fight-or-flight response went wild.

Then I'm finally called in and the pain begins.  First, there was my talk.  They did not let me finish it at all.  Not even close.  And they asked me questions that would have been explained had they only let me finish.  Needless to say, that lack of control over even the beginning threw me off.  Then onto Replacement Committee Member, who got the first shot at me.  Of all things, pericytes!  I didn't even study anything remotely close to pericytes.  AT ALL.  I was lucky to even remember what they were.  And how do you expect me to design experiments having to do with brain slices when I have no experience with such things?!

When that torture was finally over, I was so shaken up that I couldn't even remember crossbridge cycling anymore!  I had carefully gone over this topic too because I was sure that I would be asked about it.  Had they asked me my name at that point, I'm pretty sure I wouldn't have been able to spit an answer out.  And I still had three more people to go.

The next purveyor of doom happened to have conjunctivitis for the occasion and was wearing sunglasses!  Just imagine walking into an interview to be greeted by someone wearing dark sunglasses who then did not take them off for the duration of the interview.  Talk about creepy.  Not to mention her off the wall questions.  It was at that point that I started accepting that I was probably going to fail.  And I still had two more people to go.

Onto Evil Committee Member, who strangely enough, wasn't quite as evil as she was when I met with her.  But still, I couldn't wrap my head around the Frank-Starling length-tension relationship, no matter how hard I tried, even though I did know it.  It was quite pathetic, really.

And just when I was down to my final committee member, Conjunctivitis Member decided that she needed a bathroom break after I'd decided that I just wanted to go straight through (I figured that no breaks would mean that I wouldn't have time to sabotage myself with self-defeating thoughts in between).  So we take a break.  And then, finally, it's the chair's turn.  Her questions were nice and easy.  Well, easy if you think tracing motor and sensory pathways is easy.  Which I do.  Because I like that kind of stuff.

And then it was out of the room for me while they discussed my fate.  No pacing this time.  I spent the time trying to build up a strong front for when they failed me.  I mean, really, after that fumbling performance where even I wanted to fail myself, why would they pass me?  I was surprised that no one stopped it in the middle and just kicked me out for being an insult to PhDs the world over (though I've never heard of such a thing happening).  I figured that if I didn't burst out in tears that I would then at least have some of my dignity left.

The moment came and the chair walked out with a smile on her face.  For a moment, I marveled at how evil she had to be to be smiling about someone's failure.  But then she told me that I'd passed.  And I almost responded with, "WHAAAAAAAAAAAAAAAT?!  Really?!"  But I didn't.  Instead I walked in to have everyone congratulate me.  I thought I was dreaming.  And I still can't believe it now.  I can't believe that I passed.  Or that it's finally over.  Only now do I realize what kind of burden it was to be dreading this test for over three months.

But trust me.  I would never do this again.  Ever.  It really has been the worst experience of my life.  So far.  I'm sure things will happen once I return to med school that will be far worse.  But for now, the PhD qualifying exam is the reigning champion. 

robot nurses!

Scientists in the EU are designing robot nurses.  Looks like they'll be pretty cute.  And that they'll be taking care of the more tedious tasks (like mopping up spills and guiding visitors to patient rooms), hopefully freeing up human nurses for more pressing patient matters.  Unless, of course, they malfunction…