everyday I'm shufflin #5: clinical breast exam

 #5

These past two weeks we've had to learn the breast exam. I'd say this is the first block we've started to encounter awkward clinical situations like taking a sexual history, saying the word orgasm in a patient interview, conducting clinical exam of the breasts. sidenote - I dare you to say orgasm ten times fast without laughing. Anyways, thought this might deserve a running diary. 

--

10:00 AM: I should probably learn how to do a breast exam before I have to do it on the standardized patient. 

lawnmowing

10:01 AM: Just googled breast exam.

10:02 AM: Regoogled clinical breast exam.

10:10 AM: Watched a breast exam on youtube. That was awkward. Is that appropriate for youtube?

Should it be awkward? Should it feel normal? No, I'm pretty sure it should feel awkward. Why is anything related to sex so uncomfortable to talk about? Think about it, when's the last time you talked about sex with anyone? Even with people you have sex with?

1:30 PM: Staring at pictures of placenta. I hate the placenta. I wish I knew what a chorion was. Every day I study embryo I move farther from a potential career in the NICU. 

3:15 PM: Pelvic exam training at the simulation center. Shove fingers into rubber vagina. This seems brutal. I can't imagine doing this on an actual woman. "Howdy ma'am, let me just cram my gloved fingers up your vagina."

4:40 PM: Dean's reception. Tons of free food. Tons of med students flocking there. Best food - chicken fingers and artichoke dip. Observing some flirting going on. sidenote - I wonder how many intermedschool couples we'll have?

4:55 PM: Only rumors I've heard about the breast exam. Not as long as scheduled. Not that bad. 

5:10 PM: Arrive for breast exam. Hope I get a dude.

5:15 PM: Everyone is super chatty before we split up to go to the exam rooms. Overcompensating for being nervous?

shoutout

5:25 PM: Break into individual groups and walk over to rooms. 

5:26 PM: Our preceptor is sick and not happy about it. She does not want to be there. Our standardized patient is in good spirits though, and she's joking around with us. Apparently, she's the infamous standardized patient who was told her breasts are "not remarkable" by a student last year. Not pleased. 

5:30 PM: After the preceptor runs us through the breast exam she asks who's going first. Greeted with silence. 

5:32 PM: First student goes. To no one's surprise, it's a woman. Guys are too nervous. 

5:43 PM: Guess I'll go next.. Ken: I'm just going to inspect your breasts.

Patient: Don't use the word inspect, it sounds too sharp.

Ken: Yeah sure, sorry about that.

sharp

5:45 PM: Ken to patient: Can I ask you to move your gown so I can inspect your breasts? 

Ken to self: every damn time..  

5:47 PM: [touches breast] That wasn't so bad. Pretty much like touching any other tissue. Talking about breasts is by far the most awkward part.

5:53 PM: Next student goes. He'd actually seen this standardized patient last week in small group when we took sexual histories, which lead to this conversation:

Patient: Oh I remember you you're the student who helped me with my sex problems.

Student: Oh right, hope you're orgasming well.

Patient: Yep, it was fixed in a week. Thanks for your help.

Student: I do what I can. 

Doctor patient relationship, violated. 

6:07 PM: Student: So what words should we not use?

Patient: When you're observing the breasts, don't say "sag" or "droop." Especially with older women. "Feel" is also awkward. Just use examine. 

must have been epic

Talking about breasts is awkward. I feel like there's a half-baked idea here. We should be trained in talking better. Especially good for introverts. 

6:18 PM: Guys in peanut gallery whispering inappropriate breast jokes. Woman student not laughing. 

6:32 PM: Last guy finishes up his exam: "Ok, I'm going to go over and tell your doctor that nothing looks remarkable here." 

6:40 PM: Leaving. Not as bad as everyone thought.  

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

NBA Wednesdays: An Open Letter to Jeff Green

that ain't safe

Dear @unclejeffgreen,

Thank you for being you:

First of all, thank you for being a Celtic.

You are only 26 years old, yet two years ago you underwent major surgery to fix an Aortic Aneurysm. While recovering you went back to school at Georgetown, a top 25 university, to finish up your degree in English and theology. Thank you for repping education. I wish I could discuss philosophy with you. 

On the court, some nights I watch you and you're unstoppable. Channeling your inner LeBron James and driving hard to the basket. Spotting up for corner 3's like Ray Allen. Big enough to post up small forwards, and way too explosive for power forwards to slow down. Playing the kind of D that could slow down LeBron James. Thank you for being a fun player to watch. 

jeff green doing jeff green things

Some nights you aren't quite at the high expectations I peg you at. There's many a game I wish you could rebound more. There's other nights when I wonder where those ballsy drives to the basket went. But KG said it best, "He's so good that sometimes we just forget he just went through major heart surgery. That's what you forget." 

And it's true. I forget that all the time. When I really think about it, it's crazy that you're playing basketball at all, let alone at an NBA level. 

And since Rondo went down you've upped your game to another level. I watched you drop 31 on the Suns and loved every minute of it. 

You are such a baller that Kevin Durant once dedicated his season to you. 

A million times out of a million I would rather root for a scrappy team with bleed-green vets like KG and Pierce, than any team of collected superstars. I want the teams I root for to like playing with each other, to care about playing great basketball, and I'm glad the Celtics are that team. 

You are inked to the Celtics for the next 4 years, and I'm glad to have such an inspiring human being on my favorite basketball team. Please keep doing Jeff Green things.

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

half-baked idea: 3 yr MD

Just saw this article on an unnamed med school blog I follow. Sounds great, lots of relaxing and fun vacation activities. I'm sure it's nice after three years of working yourself into the ground. 

I have a handful of friends that are fourth years, and their life is indeed a glorified vacation. Everytime I go into the lounge to heat up my lunch and go straight back to eat at my desk, I see them hanging out and watching TV. I see them laughing at us while we're going for that second pot of coffee, obsessing over the vertebral level of the superior mesenteric artery. Is it L1? L2? L1/2? Somebody tell me. 

L1. It has to be L1. 

Except, there's one problem. You are paying money out the freaking window to take this vacation. Now that subsidized Stafford loans are a thing of the past, every year counts. The cost of med school has to be one of the biggest detractions to med school. It pushes away talented could-be doctors, and simultaneously pressures young MD's to chase high paying jobs so they can pay off their loans. One of the attendings at a bible study I attend has four kids, his oldest is 12, and he just finished paying off his loans. 

So here's my half-baked idea: what if we shortened med school by a year? 

There are already schools (Duke Emory, Baylor, University of Vermont, UPenn, UVA, Lerner, to mention a few) that shorten the 2 clinical years and the 2 basic science years by just enough to give you a free year to pursue an independent project ranging from bench research to community outreach. This idea if GENIUS. At Stanford they give you every Wednesday off so you can pursue an activity of your choice, which I've covered here. What a great chance to think about what you can do for the world. So I love the idea of having a free year, but what if we just cut out that year entirely?

It would work out logistically. Given how unimportant the pre-clinical years are, there should be no problem with cutting out some M1/M2 time. sidenote - If you don't believe me, look up NRMP residency match statistics. The only things that really matter - step 1 scores and third year clerkship grades. 

First - we'd cut out M1-M2 summer (3 months), a resume-padding waste of time. We'd limit biochemistry to only a few fundamental concepts, cut out 75% of it, and you'd learn the rest of the stuff as needed (1 month). We'd get rid of OB-GYN and peds as req'd clinical rotations (2 months). So you'd only be required to do the fundamentals - surgery, internal med, family, and psychiatry. Then you'd remove half of 4th yr (6 months), which we've established is a long vacation. 

The money you'd save by spending one less yr in school is huge, but the MD appears much more doable as a 3 yr degree. At that point it's just as long as law school, and they're flooded with applicants.

The only possible downside - you're a year younger, so you'd be slightly less mature and prepared for actual medicine. This is where I'd combine this idea with my half-baked idea of mandatory year off between undergrad and med school would come in, so you'd be the same age when you graduated. 

3 yr MD. Sounds great?

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

Relationships in med school pt 10 - So you think you know Tripp Mostertz

The lovely couple. 
Bryn is a first year peds resident at MUSC.

An interview with the one and only, Tripp Mostertz.

Ken: So let's start with where you've lived.

Tripp: Ok, so I was born here in SC and went to grade school here, but then my parents decided they wanted to move, so we went to Utah. Salt Lake City. 

Ken: How was that?

Tripp: It was ok, I think my parents weren't huge fans of it because they didn't like the mormon feel and it was hard to develop deep relationships because they weren't mormon. They eventually decided to move back, I lived here in Charleston for a year. I went to Wando HS, actually. Then I moved up to Clemson where I met Bryn.

K: Yeah, let's get to that. How did you guys meet?

T: Well, we were both band geeks. Bryn - she was really goot at flute. We met right away, but we didn't date until our senior year. I also loved marching band, and I kept doing that at Clemson. We played for the basketball games and all that. 

K: So what else did you do at Clemson?


T: I was an electrical engineering major. I didn't know what that was, but I really loved music and I think I just figured I'd start a recording studio or some crazy shit like that. 

K: And what happened to that track?

T: Well I had this internship my junior year, in this power plant. And it sucked. I didn't talk to anyone, we just worked on fixing obsolete parts. I was thinking my life is over, and that this was going to be the worst thing ever. I had never thought about an advanced degree, and I'd never even really thought about the future, but after that internship I had to think. 

I started taking some bio classes and ended up in this great bioE class where I studied lower limb fractures, and coming up with a quantitative way to interpret the recovery. I ended up turning that into graduate work at Clemson. 

K: And where was Bryn during all this?

T: We went to Clemson together, but when I stayed at Clemson, she moved to Durham to work in a cancer lab at Duke. 

K: So you dated long distance - how was that?

T: It was a challenge that we needed to know this was right. I'm not one to give advice or anything like that, but I think it's important. Like, maybe if you can't survive it, maybe it's not right. I'm not saying there aren't other marriages that don't work out, but at least for me it was good to see. 

K: And then at what point did you get married?

T: Well let's see. We got engaged the winter before she started school, so that must have been around '07. That was right before I defended my graduate work, then I moved over to Durham to work in a lab up there. Then, she started med school in fall of '08 and we got married on New Year's Eve 2008. 

K: That's fun, why New Year's?

T: No reason really, it was just convenient since Bryn had a break. And no one ever has real plans for New Year's so we figured we'd just give everyone a reason to come together and party. 

Actually there was a funny story with the party - I didn't care about much with the wedding. Except the music. I was a stickler for the music, and I subdivided the night into hours with different themes of music. One night Bryn was looking through it and she accidentally deleted the playlist. And I was like ok, I think I can remember what was in each section. And Bryn saw that as a big reassuring moment of us getting married. She was like - "You didn't get mad after I deleted all that music." It was funny but it was a big moment of commitment. 

K: Probably more funny in retrospect.

T: [laughs] Right, right. 

K: And why'd you decide that was the right time?

T: Well, we dated a long time. Like 2001 to 2007 or something like that. And we knew we'd be in the same place for the first time since college. I guess I proposed because I just knew. It's not like I had a checklist or anything like that, but I kind of had an internal one, and I eventually reached the point where I didn't think there were any more checks until I could be sure this was right. I was sure this was what I wanted. 

It's like from When Harry Met Sally, which is actually our favorite movie, but they say something like, "When you know you want to spend the rest of your life with someone, why not make it now?" Actually, and this is funny, but the pastor that did our wedding actually mentioned that movie, and we hadn't even talked about it, so it was like fate or something. 

throwback

K: And how about coordinating the simultaneous move of you to MUSC med school and her to MUSC peds residency?

T: Yeah, so that was hard. I felt like I could get in somewhere, and I really liked MUSC. My MCAT was in the range, and I was really strong in other things. I had good research experience, I did graduate work in bioE, volunteering, all of that. And she was supportive, but at the same time there's no couples matching at this point, so she had to know what I was going to be doing before she had to set up her match list. 

I remember it was a whole complicated process of figuring out when I had to move to South Carolina so I could get in-state tuition, and have a better chance of getting in. In the end it just ended up working out, I got in here, she set up her match list, and of course she had no trouble getting in. 

K: And here you are now. Any last things you want to say?

T: Man, what I don't enjoy is when people complain about studying. Because I fucking love studying. Yeah, some of the material's a drag, but still. I get up in the morning, make some coffee, and I can't imagine doing anything else that I would love more. I took a long route to get here, it was so hard. And this is just philosophical, but dude, this is not bad. All you do is work hard, and you come out with a cool job. This is not bad. 

K: preach.

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

youtube Fridays - Kanye/Jay-Z's 'No Church In The Wild'

Literally spent 2 hours analyzing this video and song. Expectedly, this came while I was doing a Bacro lecture. Came across this interesting article by a sociologist that studies religion and hip-hop. Anyone have any insight on it?


See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

Everyday I'm Shufflin #4: hospital visit running diary

 #4

aka hospital visit, aka shadowing a nurse

5:20 PM: Depart home for unnamed hospital. 

5:43 PM: Arrive one hour before hospital visit starts. Open Net Anatomy to get a head start on studying. 

5:45 PM: Instead, research Chris Paul vs Kyrie Irving stats. 

6:28 PM: I should really do something... Back to Net Anatomy.

..what?

6:45 PM: Lost in the hospital, trying to find unnamed hospital unit. That's how often M1's are in the hospital. 

6:47 PM: Arrive at unit. Can't find charge nurse, stand around awkwardly hoping someone will ask me something. 

6:51 PM: A bunch of doctors converge around this one patient's room. Follow them around like a puppy dog. Hope they do something cool. Wait, I hope they don't ask me any questions..

6:58 PM: The doctors stick a tube down this guy's throat. I think that's called an intubation, but, not really sure. Everyone disperses. 

7:11 PM: Still waiting for charge nurse. 

7:16 PM: Watching one of the bitter residents skyping with his son. That must be fun.

7:23 PM: Charge nurse arrives: "I don't have any patients tonight so I can just show you around for a bit, then you're free to leave." 

Ken to self: "Don't screw this up."

7:25 PM: We see a patient that has some high tech catheter contraption running up from the back of his knee into his abdomen that bombards blood clots with radio waves to destroy them. 

modern medicine

7:28 PM: Ken: Do you like your job?

Nurse: Yeah, I used to be a chem major so this is a big change. When I was younger I never thought I'd be a nurse and taking orders, but I really like it here. In the ICU you get to do some thinking as a nurse. The doctors give you a little more autonomy, and it feels like they treat you more like a comrade than their slave.

7:32 PM: Ken: Any complaints about doctors for a med student?

Nurse: Your life is probably going to be hard, you have to listen to nurses bitch at you for the rest of your life. At the same time, you should listen to nurses. Also, don't be afraid to ask for help because you don't know everything. 

7:37 PM: Going around the unit to calibrate instruments while talking more bullshit about working in a hospital. 

7:41 PM: Walking out the door. So clutch.

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

NBA Wednesdays: 5 bullet points about All-Star weekend

no he didn't

1) This was an embarrassing moment for Chris Bosh, but let's remember for a second that Chris Bosh is (right or wrong) an All-Star starter. It's not like he's some scrub, he's still Chris Bosh. This moment really speaks to Chris Paul's game. 

It counts for something that on All-Star night, when the best 10 players in the world are on the court at the same time, CP3 dealt out 15 assists, scored 20 pts on just 10 shots, and had the testes to nutmeg an All-Star. You know Chris Bosh will remember this in Game 7 of the NBA finals when he gets switched on a pick and roll. Obviously, CP3 was already at the 'guys I would go to war with' level, but nights like this definitely remind me: wow - this is a special player. 

The Clippers have to move Bledsoe for a big man. Whether or not CP3 stays in Clipper land, this might be the only shot for the Clippers to get to the Finals in a long time. Jamal Crawford isn't having miracle seasons like this on a regular basis. Otherwise, he wouldn't be Jamal Crawford.

dunking

Faried's shot chart

2) Kenneth Faried had his coming out party. 40 pts and MVP in the rook/soph game, had a 50 pointer in the dunk contest, early darkhorse All-Star for next year. He even made a corner 3. 

3) Kyrie Irving played crunch time in the All-Star game. There's no doubt everyone knows he's a star. His only downside: of all NBA superstars he gives the worst interviews. Every other answer I heard from him was a one word answer. He talks like a guy afraid to screw up. This is a man that wanted to bet $50,000 on a one-on-one game against Kobe Bryant. He has interesting things to say. Let's hear it.  

4) KG is staying in Boston. He believes the team has a shot, his no-trade clause remains firm, and I love him for it. The Heat are probably unstoppable, but all I know is I wouldn't bet on the Heat over. Most recently, the Celtics without Rondo showed up LeBron et al 100-98.

Arne Duncan vs Usain Bolt

5) In the celeb All-Star game you get to see the fastest man in the history of the world going up against the Secretary of Education. Only in the NBA. 

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

half-baked idea: mentored day off per week

I threw out a half-baked idea last week about taking a mandatory gap year between undergrad and med school. Part of the motivation for the gap year would be to help med students develop passions. Here's a second half-baked idea to go along with it. 

Half-baked idea: Mentored day off per week. 

I'm sure I don't need to sell med students on a day off every week, but hear me out. 

the hub

Stanford, probably the best at innovative med education is already on this train. They give their students every Wednesday completely off from med school obligations. sidenote - Palo Alto would be one of my top career destinations if not for the cost of living. Absolutely insane. One of my friends did an away rotation there, and he told me his attending rented a house there because he couldn't afford to buy. I can't remember what specialty he was in, but the average doctor makes six figures easily. Probably looking at $200,000+ per year. And he couldn't buy a house... Durham or St. Louis it is.

Anyways, back to Stanford. When I unsuccessfully interviewed there, I met a student working on an Immunology PhD, another that tutored undergrads in anatomy lab, and I heard of others that took literature courses at Stanford undergrad. sidenote - Abraham Verghese (Cutting for Stone, Tennis Partner, My Own Country) teaches undergrad writing courses at Stanford. Would love to take those classes.

can I just hang out with you?

I love this idea of giving students free time, but let's face it. Do I have time for this? No. I have to figure out what the hell a uterus is. I have IP assignments to do. 

Med students are busy. If I had one day off from class I'd definitely just study more. So here's the added caveat for the day off -  meeting with a mentor. sidenote - Atul Gawande wrote this great article about the need for coaches in medicine. 

At MUSC there are 280 faculty members in the dept of general medicine, 100 in the dept of surgery, 160 in the dept of peds, 240 in neuro/psych, and 30 in ob/gyn. Between those 800 diverse faculty members, we could assign each med student to a faculty mentor. Every incoming student would choose one of these specialties, undecided students will get thrown into general med, because statistically the most students will end up there. 

We could even add niches like doctors interested in working with minorities, teaching on the wards, writing and interweaving humanities, using social media to reach the uninsured, being pregnant while in med school, you can use your imagination. 

So every Wednesday during the school year, the student and faculty mentor would meet for 30 minutes to chat over coffee and break down life. They'd mainly focus on what they're doing with their Wednesdays. It would double as career mentoring and therapy. The faculty mentor would decide if the student was doing a satisfactory job of meeting the 'Wednesday' requirement, which would be a given. 

rosie

And what would students do on these Wednesdays? Well, here's one half-baked idea within a half-baked idea. Rosie Taam, from my small group, took a gap year and became a yoga instructor. Wouldn't it be a cool way to develop as a doctor to teach something 'alternative' as yoga? I always wondered how she could work this into her life as a physician, and on Wednesdays she could keep teaching yoga one day a week and develop a vision to weave yoga into her practice. What if she ran a private practice where she taught a yoga class to her patients? I guarantee there would be a patient population and investors interested in backing that practice. Why shouldn't med schools be helping students come up with ideas like this? 

If nothing else, it just seems like a good idea because a lot of us young med students are confused. I bounce between interests in specialties every five minutes. I also want to have a family, and would love some advice from older doctors. Doesn't it just make sense for us young confused people to have contact with established slightly less confused older people?

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

Relationships in med school pt 9: So you think you know Amulya Iyer

"Rules of being best friends: 

No two people are better than us.  We fucking rock.  No one can beat us." 

          - Mindy Kaling

from our wedding
(Katie and I's)

If you read sidenote you may have noticed me obsessively referring to a mysterious character: Amulya Iyer. He's my best friend (other than best friend Katie) from back home in Needham, MA. Since then we've gone to all parts of the world. I went off to college in the middle of nowhere Ohio to Kenyon, and he in the middle of nowhere Western Mass to Williams. We started out as math majors, but switched to pre-med/biology. Since college we ventured off to the great unknown. He went to Houston, TX and I went to Portland, OR. We love analyzing everything that's wrong with med school, and I still have dreams of riding his coat tails when he's a Dean of Medicine. My plan is to be the Dave Jacoby to his Bill Simmons. 

Which brings me to the core of our relationship. If there's anything I love, it's randomly speculating on ideas. We did a lot of that in the summer of 2008, I was waiting tables at a ranch in Wyoming, and he was living in Cape Cod. Since we were so far apart, and I didn't have cell phone reception, we resorted to emails. We had an email chain that went back and forth for the summer, with the challenge that each email had to be longer than the last. We analyzed our girlfriends, introspected our deepest qualities, and discussed our dreams.

The ideas developed in that email chain have/do serve as the core of sidenote. For that, I give thanks. 

We have a similar endless email chain today, it's not quite as epic but I swear we rack up the 100 mark on gmail at record breaking pace. Anytime I have anything even remotely interesting to say, I'm shooting an email to amulya.m.iyer.

sidenote - three random fun things we do: 

1) We constantly throw out bold predictions on just about anything. Most recent - OKC over Bulls in the finals.

2) Over unders on random things. Best recent one: years until Amulya marriage. +/- 5 in case anyone's interested. 

3) Back in high school we would do fantasy drafts of our classmates based on who we thought would have the most success. Literally, everyone else was working on some calc problems and we were in the corner making a hierarchy of our classmates. I have no idea how we got away with this. 

this might be illegal

We've also done a series of bold fun things together including getting tattoos of David Foster Wallace's commencement speech This is Water.

Another awesome thing we did - last year he came to Portland so we could run the Eugene Marathon together. And when I say together, I mean side-by-side for four hours. I can't quite remember which one of us came up with it, but it stemmed from some of our high school running adventures. Here's the transcript of the story Amulya told at Katie and I's wedding:

--

It was the fall of 2005, our senior year of high school, and our cross-country team had one of its final meets of the season at Elm Bank Reservation. Ken was one of the faster runners on the team, and I was one of the slowest, but on this fateful day that was going to change. 

During warm-ups, for whatever reason, Ken approached me and he told me - he didn’t ask - but told me that he was going to run with me, and more specifically let me draft off him for the entire race – breaking the wind for me and allowing me to run faster. 

At first I thought Ken was kidding, actually. As the race began, I started off in my usual position at the back of the pack. But with Ken leading the way I felt myself getting stronger, mentally and physically, with every stride. Together, we continued passing runner after runner until the finish line, and when it was all over I had surpassed my personal best by more than two minutes. As euphoric as I was in that moment, nobody there was happier than Ken. 

Never before, and not since, have I felt that same exhilaration of exceeding all of my own expectations. My best friend helped me realize something I never thought was possible and more importantly, reminded me of the incredible power of relationships. 

like a boss

--

Years later, running side-by-side again, we miraculously pulled off being at the same fitness level, even though we were training 3000 miles away from each other. This cannot be understated, we barely talked about how much/little we had trained, the last time we had ran together was probably six or seven years ago, and we ended up being almost the exact same fitness level. Must be a sign.

Next up for us: ultramarathon, separately qualify for the Boston Marathon then run it together, co-dean the next big med school. I don't know his birthday - I think it's in August or September but he's too cool to put it on facebook, so this will have to do. To the best friend I could imagine:  

No two people are better than us. We fucking rock. No one can beat us.

Happy birthday.

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

ken explains the hidden curriculum: I should be a gunner

A new segment on sidenote where I explain the hidden curriculum because, well, I know everything. You're welcome. 

I just wrote a running diary about the stress of med school peaking on the day before the exam. And it raised a lot of internal frustrations. I feel like I'm having an identity crisis. 

sidenote - shoutout to DWill, who inspired this post:

I hate caring about med school tests. I hate grades with a passion. I know they're complete bullshit. I've already spent 4 yrs in undergrad proving to myself that I'm smart, I shouldn't need any med school grades to tell me I'm smart. 

But I want that honors carrot. And I hate myself for it. I wish to God I didn't care about it. The day before the exam, all I could do was get stressed out about cramming more knowledge in, and wondering how I would score, not compared with myself, but compared with all of you. 

The hidden curriculum wants you to care about getting honors so they can control you. They want to mold you into the kind of med student they want you to become. They want you to spend all your time studying, following orders, ditching anything resembling creativity. They want you to become their bitch. 

Who is they? They is everyone that wants you to be boring. They is everyone that wants you to live in a white picket home instead of a hut in rural Haiti. They is everyone that wants you to become rich instead of great. 

My biggest question: Am I being stupid for not giving into They? Is my life an idealistic fantasy trying to fight the power? 

Why shouldn't I just leave sidenote behind? Some days I love it, but other days.. is it worth it? 

I know I'm smart. I can look at my MCAT and undergrad grades for three seconds and know that. If I took all the time that I invest in relationships with friends, relationship with wife, writing sidenote, following basketball, working out, and funnel all those hours into studying I know I would crush med school. 

On one side, my pride is yelling at me to leave everything else behind, get on that adderall and gun for AOA and 260 on Step 1. And some days, the other side just doesn't feel as loud. 

See you on the other side,

from ken

taking requests for future blog posts. please comment or email.

Everyday I'm shufflin #3 - pre-exam day running diary

#3

A running diary of the day before exam day, the craziest day of study week. Enjoy,

5:20 AM: Wake up. 

5:21 AM: 5 pushups. Need to train for library muscle club. Also I made up a theory that if you exercise in the morning you can adapt your circadian clock. I really want to be a morning person. 

6:03 AM: Arrive wellness center. I've always wondered.. couldn't they just call it the gym? Also, can they build more basketball courts?

6:55 AM: Arrive library. Open internet.

7:25 AM: Start studying.

7:50 AM: First friend comes over to chat about Henderson Hasselbalch equation. Day of social studying officially begins. 

8:07 AM: Just finished my tea. I think I'm a little dehydrated from Taco Tuesday last night with Katie. $3 tacos and Coronas, come on. What should I do to retain more water.. !  Consume salt to upregulate ADH. Start eating chips. 

8:49 AM: Receive second question about Henderson Hasselbalch. 

11:35 AM: Calling every possible phone number at the med school I used to work at to try and figure out how to get them to mail me my W2. I hate talking to administrators. I hate taxes. No wonder so many rich famous people get arrested for taxes. 

12:04 PM: Back to studying neural signaling of hunger. Freaking out a little bit. So many acronyms. What the fuck is ARC. I hate neuro. 

12:33 PM: Back to procrastinating. Just read this interview question with Dirk Nowitzki:

1:37 PM: Play Calvin Harris - 18 Months for the fourth or fifth time in the past two days.

1:42 PM: Pissed off at world. 

2:43 PM: Group ME studying. Everyone dying. Send help.


3:15 PM: Three people sleeping on couches behind us. Everyone zonked. 

3:24 PM: The last time we had an exam was before Christmas, almost two months ago. There's a TON of material on this exam. So much stuff I haven't covered. I could focus on the anatomy, the renal, the biochemistry.. this is going to be a hard test. 

3:42 PM: There's a soccer game on in the corner. These commercials are more interesting than nucleotide metabolism. 

Tripp: Dude, getting to dUMP is difficult. Dump is definitely going on the test.

3:56 PM: Debating giving up for the night. Should we just give up? 

Daniel goes home to take nap. Two students behind us still napping. 

4:23 PM: Going over caffeine lecture. Need more coffee.

4:38 PM: Should we be studying in a room? We're being kind of loud, gathering six chairs and sitting around to talk shit. 

5:06 PM: Going over defense mechanisms. Why are we tested over these poorly defined terms? What's the difference between denial/suppression/repression. 

Paras throws crumpled paper at trash can, misses. 

Keith: You suck at basketball. 

Sudeep: It's ok Paras, Keith is just projecting at you. 

5:30 PM: Percussing ourselves. Sudeep has reticuloendothelial disease. 

5:38 PM: Did you know - if you have white poop you might have pancreatic cancer.

5:38 PM: 13 med students surrounding each other and freaking out. Do intercalated ducts modify secretions? The syllabus says BOTH things! Serious crisis occurring. Everybody yelling at me to stop blogging about it. Richard egging on chaos. 

5:50 PM: Mass migration from library, everyone burned out on library chaos.

5:51 PM: Library push up set. 

5:56 PM: Girl glares at us. Getting too loud. 

6:10 PM: Jonathan busts out break dancing move. Wish I was that cool.

6:30 PM: Depart for home. Drink beer. Study FPC, histo. Pray.

Hope you survive. 

See you on the other side,

from ken

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