Takin' Care of Business

Well my winter break starts today, and before I whisk away to a snowy Christmas far away from here, I thought I'd give a round-up of what my quarter looks like. Here are the classes I have:

Clinical Medicine II: This is part 2 of our "bread and butter" medicine class where we study various groups of disorders, their signs/symptoms, pathophysiology, and the current treatments, including medications. We are starting the quarter off with various and sundry cardiac conditions: hyperlipidemia (aka high cholesterol), endocarditis/pericarditis, ischemic heart disease, valvular heart disease, heart failure/pulmonary edema. From there we move to pulmonary conditions: embolisms, deep vein thrombosis, peripheral vascular disease, chronic obstructive pulmonary disease, bronchitis, pneumonia, asthma, tuberculosis, coccidiomycosis (aka Valley Fever), lung cancer, and insterstitial lung disease. Then it's on to kidney disorders: urinary tract infections, pyelonephritis, glomerulonephritis, polycystic kidneys, actute/chronic renal failure, benign prostatic hypertrophy, and incontinence and then wrap up the class with some genitourinary disorders -- prostrate cancer, etc. and finally some endocrine and adrenal hormonal abnormalities. Part of this class included a weekly small-group case session where we follow a hypothetical patient throughout his/her life -- each week represents them coming to see you with a new set of problems, and we have to brainstorm the possible diagnoses and then write up a SOAP note, complete with prescriptions on a "real" prescription pad.

ECG -- this is an entire course designed on being able to analyze and interpret ECG strips. You wouldn't believe how much you can gleam from these. Very detail-oriented stuff -- luckily for me, I have my trusty ECG calipers to help me wade through the intricacies. Even the heart rhythms can be tricky -- not only can heart beats be irregular, but they can be regularly irregularl or irregularly irregular (kind of like how the Detroit Lions are having the perfectly imperfect season -- one more game to go until infamy! Just when you think they've hit rock bottom, they dutifully don the miner's hat and plumb the depths a little further. Here is a pretty good synopsis of the misery that is being a Lions fan: they are 31-95 over the past 8 seasons & have won just 1 post-season game since Henry Ford's grandson purchased the team 44 years ago! The only salve for that kind of pain is that the Pistons have done reasonably well in the last decade, and Detroit is home to the NHL's greatest franchise in the Red Wings, an organization from top-to-bottom that is the complete antithesis of the chronically hapless Lions)

Microbiology -- this is more of a medical-oriented Micro -- no wet lab, though most of us have already had that experience as an undergraduate, which was a great lab -- taking all kinds of swabs and then growing cultures overnight. This class is very practical, and so far we've learned about the various gastrointestinal disorders (in other words -- any of the viruses or bacteria that cause an involuntary fluid loss from both ends, if you catch my drift) and now we're starting to explore various parasitic worms. We also got a good lecture on how the various classes of antiobiotics work -- some attack the cell membrane (penicillin), some disrupt nucleic acid synthesis (rifamycin) , some inhibit protein synthesis (tetracyclines) , and some act as antimetabolites (sulfa drugs). And then there are the antifunglas and the antivirals ...

Physiology II -- part 2 of Physiology -- in this course we are starting off with Renal function and acid/base function, moving into GI function, and finishing with a whirlwind tour of the endocrine system, covering all of the various hormones. Luckily for me, Dr. G gave me really good preparation for this course.

Clincal Laboratory Medicine -- not to be confused with my regular Clincal Medicine class listed above, this class covers all of the various diagnostic tests we will be expected to order and interpret once we start practicing. We started off with the CBC or Compete Blood Count, with differential -- basically studying abnormalities in red blood cells, white blood cells, and platelets. Next is Urinalysis and then the CMP or Complete Metabolic Panel, which includes glucose, electrolytes, and BUN (or Blood Urea Nitrogen). We actually have homework in this class where we receive various lab reports and have to come up with possible diagnoses.

Pharmacology -- this will likely be the hardest class for me. The first section was not really about any drugs in particular, but rather an exploration of pharmacodynamics & pharmacokinetics, which in a nutshell includes how drugs act on the body as well as how the body absorbs, distributes, metabolizes, and excretes them, all in painstakingly great detail. Very heavy on biochemistry, although now I think we are going to move into various classes of drugs which should be a bit easier for me to tackle.

Therapeutic & Diagnostic Skills -- well, each quarter we have a "fun" class, and this one fits the bill this go-round. This is a lab class where we learn various skill-based medical procedures. So far we have had an eye lab where we practiced removing foreign objects, using eye flushes, and using fluoroscein dye to look for corneal scratches and abrasions. The second session involved going to the anatomy lab and learning how to scrub in for surgery. We had an local heart surgeon (Israeli-born who trained in England for 10 years, practiced in Europe, and eventually came here to consult and work) explain the do's/dont's of the OR, and then we actually scubbed in -- did the nail scrub, handwashing, and put on surgical gowns, masks, hats, gloves and got a rundown on surgical instruments. Some of the future sessions include practicing venipuncture and administering shots on eachother, as well as learning sutures and surgical knots (we will be practicing on pig ears!)

Clincal Track -- Independent Study -- this is basically for the Master's component of my degree. While we only meet for a few session over the quarter, there is a project involved that we need to be working on our own, turning in various parts of it over the quarter. We got to choose a topic and then we can either do a 10-page paper or 30-minute presentation on it. I chose the presentation as I have written my share of papers over the years and think getting up in front of my peers and practicing my public speaking will be more beneficial. Thanks to a suggestion from Rachel, I will be doing my presentation on CTCL -- Cutaneous T-Cell Lymphoma -- a very serious disorder which often gets misdiagnoses early on as it resembles more benign skin conditions like eczema or psoriasis. The presentation includes making handouts and developing a Power-Point program.

Interdisciplinary Core -- this is the only class that I have to just show up for. It only meets every other week, and it's meant to just expose us to the various disciplines. Each week a different program is highlighted -- Dental, D.O., P.A., Nurse Anesthesia, Cardiac Perfusion, etc.

In case you weren't counting, that is 9 classes (well, Core class is not really a "class", but attendance is mandatory). I think I counted up 20+ tests alone this quarter, along with my Independent Study presentation, homework for ECG/Clinical Lab, and Clin Med small group write-ups. In other words, I am busier than ever, if that is possible. The program director only half-jokingly said that most students mentally break down in mid-January to early-February, and that we should come to them or see the school counselor when, not if, that happens. I have to say, if I didn't love what I'm doing, it would seem insurmountable.

I'll reward you with some funny for wading through that academic diatribe...