The past few weeks have been pretty busy for me, but this past week has definitely been the highlight of my medical school career thus far.
All the students in ICM have to rotate 5 times at the hospital here. So on Thursday, I went for my first one - paediatrics. We (four students) were introduced to the two doctors on the floor, who then took us around to all the pre-nates in the hospital wing. A few of them were contained in incubators while others were in glass cribs. They looked so tiny and fragile. As we visited each baby, the doctors explained to us why each of them had been admitted to the hospital. The cases ranged from HIV-positive mother to jaundice to suspected viral infections. The doctors asked us questions pertaining to the conditions unique to each individual. It was a very straight forward visit and within the hour we were done and made it to class before the end of the first lecture.
On Friday, we had our internal medicine rotation. The doctor greeted us and took us to see a few of his patients. Unlike the babies, these patients responded to our questions, which then prompted much discussion of differentials from the presented symptoms and patient history. It was much more detailed and thorough, and by the end of it we were all scratching our heads and pondering on a diagnosis. Internal medicine is more about treating the root cause of the symptoms, and each case is like a mystery that has to be solved, and all the clues come from the patient. So far the two rotations have only made me realize how much more I have to study before I am ready to write the Step!
On Sunday (today), I went to the hospital to meet with one of the ER doctors, who is also one of the professors for ICM. I had asked her earlier that week for an opportunity to shadow her at the ER and she enthusiastically agreed to let me and another student come in for the day. We were supposed to be there for 4 hours from 11-3, but we ended up leaving close to 7 PM. First thing when we got to the hospital we were greeted by the Dean and the CEO of the school himself, followed closely by two men with a lot of heavy photography equipment in tow. We quickly realized that we weren't just going to be in the ER that day. They told us that they (the school) wanted some footage of students in the hospital and interacting with patients. So we spent a good chunk of the morning filming and interviewing. I'm excited to see the finished product. After that we were ushered to the ER and we got to work seeing our patients for that day. We saw about a dozen patients in the span of seven hours. There were two patients that needed stitches, three patients with viral infections, a young woman with Dengue fever, a man with a bad case of constipation and suspected pancreatitis who was in so much pain he needed to be given pain killers IV, two patients with bronchiectasis, a child with a broken clavicle, and a few kids with mild GI complaints. Nothing too dramatic. But after seeing the distressed parents of young patients, I realize that for them it is serious and upsetting. The first goal of the doctors was to stabilize the patient before assessing the condition. What surprised me a little was that even though it was the ER, there wasn't really a feeling of urgency. Nothing was rushed. Everything was done at a steady pace, and the doctors spent time explaining to patients or their caregivers before discharging them. It was probably because none of the cases were too severe that there was no need to rush. There was a steady flow of patients to the ER and the time passed by without us even noticing it because we were kept so busy. It was very interactive and definitely my favourite rotation so far. I plan on going back after block 2.
At the end of the day, we went to Maho to get frozen yogurt and then watched the sun set behind the waters in Simpson Bay before going home and collapsing into bed!
So turns out today is a holiday (Good Friday), and many places are closed. (Apparently a lot of classes were cancelled today, but none of mine were!) No wonder there were so many people at the grocery store yesterday; it won't be open until Sunday since Saturday is Sabbath. The only places open today are the Chinese stores (obviously).
I am currently conducting a mini experiment with my avocados. So you know how there is more than one way to speed up the ripening process. Since I have two avocados, I wanted to see which method works better. So last night I put one avocado in a brown paper bag and folded the top so it was mostly sealed. The second one I put beside a bunch of yellow bananas (4 of them to be exact). Day 1: both avocados are still hard as rocks.
In other news, my supply of turkey bacon is running low. But that's because I've been feeding it to my cats instead of eating it myself. Well I was getting sick of eating turkey bacon every day (I had bought a family pack size of 3 regular packs), and the female cat is having kittens soon so she needs the extra food that I'm giving her. I can't wait for her to pop them out so I can play with them! The male cat is obnoxious as ever, keeps banging on my door and meowing frivolously whenever I come home from class. The third cat, a medium sized one that looks like an offspring of the two, lurks around as well but from a safe distance. I noticed that she has a limp whenever she walks and carries her right paw gingerly. It doesn't look injured, but she won't let me come close to take a better look at it.
Yesterday in Neuro class we watched a documentary that showed several emergency cases in the ER that involved use of brain imaging. The first was of a guy who was stabbed in the skull by a butcher knife. He looked like something from a Halloween costume party, with the hilt of the knife sticking out of his head and blood seeping copiously onto the white blanket of his stretcher. He was still conscious despite the visible trauma. After running a CT scan, the images showed that the knife was fully lodged, all six inches of it, with the tip reaching the roof of his mouth. Fortunately for him, no major arteries had been severed, so haemorrhaging wasn't a problem, and the doctors went ahead and operated on him, removing pieces of his skull until the brain was exposed so that they could remove the blade as safely as possible. And it came out, surprisingly clean and bloodless. I wish the documentary told us how he had ended up with the knife in his head (someone must have really had the intent and strength to kill him to sink it so deeply in), and how he did in his recovery. I suppose his case would be reminiscent of the famous documented case of Phineas Gage who had a metal rod penetrate and exit his brain, resulting in full blown Frontal Lobe Syndrome despite intact motor abilities and everything else typical of a normal, functioning human being. Any student who has ever taken first year psychology should be familiar with the story.
Another episode showed a 14 month old baby who was brought in after a car crash. She was resuscitated four times and had to receive a blood transfusion before doctors ran a CT scan on her head and realized that the damage done was irreversible and fatal. She had a fracture to the frontal portion of her skull and blood was seeping freely from the severed meningeal arteries, forming an epidural hematoma. The contained bleeding had surrounded her entire brain and was putting a lot of intracranial pressure on the vital organ, as well as producing much swelling to the head. She died almost immediately after in the scanning room. There were a few more episodes from the ER. It was a really good documentary that piqued my interest in the ER. Would be very exhilarating to work under so much time pressure. I wonder what the hours are like.
The documentary reminded me of the time when I volunteered at Sunnybrook Hospital in the ICU Trauma ward. One day I visited a patient, an elderly woman who had a massive pond fracture centred on the front portion of her skull. Her entire forehead (where her frontal lobe should have been) was caved in as if someone had squished it with a large round object. Now that I think about it, it's quite an enigma as to how she received that. A pond fracture usually occurs in babies before their skull has hardened fully and is characterized by a concave dent because of this. Any blunt trauma to the skull in adults would result in a fracture and subsequent splintering of the skull. Hmmm. Yay it's Friday!
The past few weeks have been pretty busy for me, but this past week has definitely been the highlight of my medical school career thus far.
All the students in ICM have to rotate 5 times at the hospital here. So on Thursday, I went for my first one - paediatrics. We (four students) were introduced to the two doctors on the floor, who then took us around to all the pre-nates in the hospital wing. A few of them were contained in incubators while others were in glass cribs. They looked so tiny and fragile. As we visited each baby, the doctors explained to us why each of them had been admitted to the hospital. The cases ranged from HIV-positive mother to jaundice to suspected viral infections. The doctors asked us questions pertaining to the conditions unique to each individual. It was a very straight forward visit and within the hour we were done and made it to class before the end of the first lecture.
On Friday, we had our internal medicine rotation. The doctor greeted us and took us to see a few of his patients. Unlike the babies, these patients responded to our questions, which then prompted much discussion of differentials from the presented symptoms and patient history. It was much more detailed and thorough, and by the end of it we were all scratching our heads and pondering on a diagnosis. Internal medicine is more about treating the root cause of the symptoms, and each case is like a mystery that has to be solved, and all the clues come from the patient. So far the two rotations have only made me realize how much more I have to study before I am ready to write the Step!
On Sunday (today), I went to the hospital to meet with one of the ER doctors, who is also one of the professors for ICM. I had asked her earlier that week for an opportunity to shadow her at the ER and she enthusiastically agreed to let me and another student come in for the day. We were supposed to be there for 4 hours from 11-3, but we ended up leaving close to 7 PM. First thing when we got to the hospital we were greeted by the Dean and the CEO of the school himself, followed closely by two men with a lot of heavy photography equipment in tow. We quickly realized that we weren't just going to be in the ER that day. They told us that they (the school) wanted some footage of students in the hospital and interacting with patients. So we spent a good chunk of the morning filming and interviewing. I'm excited to see the finished product. After that we were ushered to the ER and we got to work seeing our patients for that day. We saw about a dozen patients in the span of seven hours. There were two patients that needed stitches, three patients with viral infections, a young woman with Dengue fever, a man with a bad case of constipation and suspected pancreatitis who was in so much pain he needed to be given pain killers IV, two patients with bronchiectasis, a child with a broken clavicle, and a few kids with mild GI complaints. Nothing too dramatic. But after seeing the distressed parents of young patients, I realize that for them it is serious and upsetting. The first goal of the doctors was to stabilize the patient before assessing the condition. What surprised me a little was that even though it was the ER, there wasn't really a feeling of urgency. Nothing was rushed. Everything was done at a steady pace, and the doctors spent time explaining to patients or their caregivers before discharging them. It was probably because none of the cases were too severe that there was no need to rush. There was a steady flow of patients to the ER and the time passed by without us even noticing it because we were kept so busy. It was very interactive and definitely my favourite rotation so far. I plan on going back after block 2.
At the end of the day, we went to Maho to get frozen yogurt and then watched the sun set behind the waters in Simpson Bay before going home and collapsing into bed!
So turns out today is a holiday (Good Friday), and many places are closed. (Apparently a lot of classes were cancelled today, but none of mine were!) No wonder there were so many people at the grocery store yesterday; it won't be open until Sunday since Saturday is Sabbath. The only places open today are the Chinese stores (obviously).
I am currently conducting a mini experiment with my avocados. So you know how there is more than one way to speed up the ripening process. Since I have two avocados, I wanted to see which method works better. So last night I put one avocado in a brown paper bag and folded the top so it was mostly sealed. The second one I put beside a bunch of yellow bananas (4 of them to be exact). Day 1: both avocados are still hard as rocks.
In other news, my supply of turkey bacon is running low. But that's because I've been feeding it to my cats instead of eating it myself. Well I was getting sick of eating turkey bacon every day (I had bought a family pack size of 3 regular packs), and the female cat is having kittens soon so she needs the extra food that I'm giving her. I can't wait for her to pop them out so I can play with them! The male cat is obnoxious as ever, keeps banging on my door and meowing frivolously whenever I come home from class. The third cat, a medium sized one that looks like an offspring of the two, lurks around as well but from a safe distance. I noticed that she has a limp whenever she walks and carries her right paw gingerly. It doesn't look injured, but she won't let me come close to take a better look at it.
Yesterday in Neuro class we watched a documentary that showed several emergency cases in the ER that involved use of brain imaging. The first was of a guy who was stabbed in the skull by a butcher knife. He looked like something from a Halloween costume party, with the hilt of the knife sticking out of his head and blood seeping copiously onto the white blanket of his stretcher. He was still conscious despite the visible trauma. After running a CT scan, the images showed that the knife was fully lodged, all six inches of it, with the tip reaching the roof of his mouth. Fortunately for him, no major arteries had been severed, so haemorrhaging wasn't a problem, and the doctors went ahead and operated on him, removing pieces of his skull until the brain was exposed so that they could remove the blade as safely as possible. And it came out, surprisingly clean and bloodless. I wish the documentary told us how he had ended up with the knife in his head (someone must have really had the intent and strength to kill him to sink it so deeply in), and how he did in his recovery. I suppose his case would be reminiscent of the famous documented case of Phineas Gage who had a metal rod penetrate and exit his brain, resulting in full blown Frontal Lobe Syndrome despite intact motor abilities and everything else typical of a normal, functioning human being. Any student who has ever taken first year psychology should be familiar with the story.
Another episode showed a 14 month old baby who was brought in after a car crash. She was resuscitated four times and had to receive a blood transfusion before doctors ran a CT scan on her head and realized that the damage done was irreversible and fatal. She had a fracture to the frontal portion of her skull and blood was seeping freely from the severed meningeal arteries, forming an epidural hematoma. The contained bleeding had surrounded her entire brain and was putting a lot of intracranial pressure on the vital organ, as well as producing much swelling to the head. She died almost immediately after in the scanning room. There were a few more episodes from the ER. It was a really good documentary that piqued my interest in the ER. Would be very exhilarating to work under so much time pressure. I wonder what the hours are like.
The documentary reminded me of the time when I volunteered at Sunnybrook Hospital in the ICU Trauma ward. One day I visited a patient, an elderly woman who had a massive pond fracture centred on the front portion of her skull. Her entire forehead (where her frontal lobe should have been) was caved in as if someone had squished it with a large round object. Now that I think about it, it's quite an enigma as to how she received that. A pond fracture usually occurs in babies before their skull has hardened fully and is characterized by a concave dent because of this. Any blunt trauma to the skull in adults would result in a fracture and subsequent splintering of the skull. Hmmm. Yay it's Friday!
