I just got back from a week-long family vacation at Edisto Beach, SC. If you haven't been to Edisto, it's a great beach. The week was restful and enjoyable. Mostly it was fun to hang out with my family and spend long days in the hot summer sun. We had great weather all week--we didn't have much rain (if any), and it was consistently around 95º. I played a lot of hearts (our family game) and watched a lot of movies. We even got to go into Charleston for an evening (I saw HP7P2--i.e. Harry Potter 7 Pt. 2--on an IMAX). The vacation was just what you'd want from a week long trip to the beach--seafood, sun, and whole lot of doing nothing.
Today was a special day at the medical school as the new medical students had their first day of orientation. I was busy in the lab, so I didn't get to sit in on any of the events, but I did manage to see some of the new students (including my brother). I don't know that many of them, but the students that I do know are really cool people. I'm always impressed with Quillen's ability to attract such high quality students/faculty/staff. And of course, the family atmosphere of the place is hard to beat. I have to admit, as I watched the new students meeting and greeting, I was envious. All I could think about was how I wished I could be where they are. Hopefully, I will be soon enough.
We ran a couple of trauma and surgery scenarios today. The surgery rotations are always interesting and complicated cases, so I enjoy being there for surgery days.
Funniest moment of the day:
A professor was walking us (third year med students and the interns) through airway. We were talking about intubating and when it is appropriate/necessary to perform a cricothyrotomy. The professor performed a cricothyrotomy on the sim-dummy and set up the tube in the trachea. He asked, "Alright, what do we do next?" He was fishing for the answer, "We bag him." But instead one of the third years quickly responded without thinking, "We bag him and tag him."
There are some pretty exciting things coming up in the lab. I just found out that I'm going to be making my acting debut tomorrow. We are filming a demonstration video for ATLS purposes. Apparently, it is an important video as all of the interns are going to dress in full surgical gowns. Look out Hollywood, here I come!
Also, my boss is setting up a time for all of the interns to listen to a retired physician come and speak to us about cardiology. And we might have a doctor come and show us how to read and decipher X-rays as well. I'm looking forward to both talks. In particular, I have found X-rays to somewhat mystifying. When we run scenarios, some physician will look at an X-ray and immediately recognize that something is wrong with the patient. To me, the X-rays look pretty much the same as all of the other ones. . . Unless its something exceptionally obvious. So hopefully I can learn a lot from both talks!
There isn't too much else to report. I finished my book, The Brothers K, and would highly recommend it to anyone. I have been thinking about the book for over a week now, despite finishing it. It definitely makes my top ten of favorite books, although to be fair, I haven't read as many books as I probably should have.
I am also preparing myself to go back to Durham in less than two weeks! I've been told that I will be working on the BMT ward at the hospital, so I am very excited about that. I am so fortunate to have some of the opportunities that I do and I'm surrounded by wonderful people.
Much tanner than last week,
Peter
Monday, July 25, 2011
Wednesday, July 6, 2011
Halfway Done & On the Other Side of the Glass
It hadn't really occurred to me until very recently that I have only four more weeks of my summer internship left. I know it's terribly cliché―but I can't believe this summer has gone by so fast. And while I have loved working in the Sim Lab, I'm very eager to get back to Durham as well.
The past few weeks have been an amalgam of different activities and people coming through the simulation lab. Our most consistent visitors to the sim lab are the nurses in training (specifically LPNs). We typically have two or three groups come through the simulation lab to run different scenarios for the nurses about every week. Usually the scenarios are designed to improve the nurses assessment skills―so we emphasize that the nurses get good patient histories and pertinent information (such as allergies, medications, eating/sleeping habits, etc.).
We had a group come through this morning. The most remarkable thing about the simulation lab is that when you are sitting behind the glass (i.e. helping run the scenario), it is easy to become hypercritical. In fact, you start to notice every little mistake―down to the most trivial minutiae. Somehow, you convince yourself, "If I were in this simulation, I wouldn't make that mistake. . . " In short, it's difficult to appreciate the pressure of the simulations until you have participated in them (on the other side of the glass, so to speak!).
Fortunately, the newer interns were given just such an opportunity today. After the LPNs finished up, some of the older interns decided that they wanted to run some simulations for us. Naturally, we agreed―mentally preparing ourselves for our inevitable success diagnosing and treating a patient. And naturally, we looked like idiots shortly afterwards.
We ran at least four different scenarios (A patient with significant bradycardia, a trauma patient with tachycardia, hypotension, and a tibial fracture, a COPD patient, and a patient in anaphylactic shock). The first scenario, my team (the new interns) was completely disorganized―we didn't communicate well and nobody took charge of the situation. But as we did more, we learned to communicate better and discern our roles within the team. We bungled our way through most of the simulations, but we learned from our mistakes and gradually became less inept.
For me, it's easy to understand why the simulation lab is so valuable for nurses and medical students (even physicians!): You learn from your mistakes in the sim lab in a way that simply cannot be replicated. That is, when you make a mistake―or have some lapse in judgement, or accidentally forget something within the lab―and kill a patient, you tend to remember your mistake. I know, I know. . . this sounds obvious. But it's true.
It's ok to make mistakes in the simulation lab, because you are only "killing" a dummy. But in the back of your head, you can't help but think, "What if that had been a real person?" Thus, there's more poignancy in these sorts of learning situations.
That's not to say that we didn't have any fun with the simulations. Two of the most memorable/funny moments from the simulations:
1) On the trauma scenario, the patient was (understandably) freaking out and complaining of terrible pain. Well, we (the interns) knew that the patient's SpO2 (oxygen saturation) was very low and that we were going to have to secure his airway (i.e. intubate) the patient. Typically, in situations like this, the patient will receive a drug called Versed which simply calms the patient down and ensures that they will not remember the intubation process. As we were discussing whether or not to intubate the patient, one of the interns said, "Let's just knock him out and intubate." As you can imagine the patient did not respond lightly to this comment. Haha. We learned a valuable lesson there.
2) On the anaphylaxis scenario, we were trying to decide whether we should give epinephrine to the patient or not. This time, one of our interns simply suggested, "Let's just give the epinephrine. If it kills him, it's a lesson for us. . . " The intern was kidding, of course. But I'd hate to run into a doctor that was really that cavalier about administering treatments.
Besides the simulations today, the lab has been pretty relaxed the past couple of days.
I've finally got some pictures from the internship that I've posted here (mostly from our camping/outdoors excursions):
The past few weeks have been an amalgam of different activities and people coming through the simulation lab. Our most consistent visitors to the sim lab are the nurses in training (specifically LPNs). We typically have two or three groups come through the simulation lab to run different scenarios for the nurses about every week. Usually the scenarios are designed to improve the nurses assessment skills―so we emphasize that the nurses get good patient histories and pertinent information (such as allergies, medications, eating/sleeping habits, etc.).
We had a group come through this morning. The most remarkable thing about the simulation lab is that when you are sitting behind the glass (i.e. helping run the scenario), it is easy to become hypercritical. In fact, you start to notice every little mistake―down to the most trivial minutiae. Somehow, you convince yourself, "If I were in this simulation, I wouldn't make that mistake. . . " In short, it's difficult to appreciate the pressure of the simulations until you have participated in them (on the other side of the glass, so to speak!).
Fortunately, the newer interns were given just such an opportunity today. After the LPNs finished up, some of the older interns decided that they wanted to run some simulations for us. Naturally, we agreed―mentally preparing ourselves for our inevitable success diagnosing and treating a patient. And naturally, we looked like idiots shortly afterwards.
We ran at least four different scenarios (A patient with significant bradycardia, a trauma patient with tachycardia, hypotension, and a tibial fracture, a COPD patient, and a patient in anaphylactic shock). The first scenario, my team (the new interns) was completely disorganized―we didn't communicate well and nobody took charge of the situation. But as we did more, we learned to communicate better and discern our roles within the team. We bungled our way through most of the simulations, but we learned from our mistakes and gradually became less inept.
For me, it's easy to understand why the simulation lab is so valuable for nurses and medical students (even physicians!): You learn from your mistakes in the sim lab in a way that simply cannot be replicated. That is, when you make a mistake―or have some lapse in judgement, or accidentally forget something within the lab―and kill a patient, you tend to remember your mistake. I know, I know. . . this sounds obvious. But it's true.
It's ok to make mistakes in the simulation lab, because you are only "killing" a dummy. But in the back of your head, you can't help but think, "What if that had been a real person?" Thus, there's more poignancy in these sorts of learning situations.
That's not to say that we didn't have any fun with the simulations. Two of the most memorable/funny moments from the simulations:
1) On the trauma scenario, the patient was (understandably) freaking out and complaining of terrible pain. Well, we (the interns) knew that the patient's SpO2 (oxygen saturation) was very low and that we were going to have to secure his airway (i.e. intubate) the patient. Typically, in situations like this, the patient will receive a drug called Versed which simply calms the patient down and ensures that they will not remember the intubation process. As we were discussing whether or not to intubate the patient, one of the interns said, "Let's just knock him out and intubate." As you can imagine the patient did not respond lightly to this comment. Haha. We learned a valuable lesson there.
2) On the anaphylaxis scenario, we were trying to decide whether we should give epinephrine to the patient or not. This time, one of our interns simply suggested, "Let's just give the epinephrine. If it kills him, it's a lesson for us. . . " The intern was kidding, of course. But I'd hate to run into a doctor that was really that cavalier about administering treatments.
Besides the simulations today, the lab has been pretty relaxed the past couple of days.
I've finally got some pictures from the internship that I've posted here (mostly from our camping/outdoors excursions):
Me getting ready to make smores on our last camping trip.
Me and A
At the Beauty Spot
At the Firetower
Intern Love
Suturing up NOELLE the simulation dummy.
In brief non-internship news:
I went to Charlotte this last weekend to visit two of my best friends from college. I had a great time. Charlotte is a fun place to be, for anybody considering the option of living/working there.
I am currently reading this book:
It was given to me by a friend. I thought I'd share the wealth by telling you all about it. Admittedly, I am only a little more than halfway through the book, but already it is the most enjoyable read that I can remember in the past couple of years. The book is both funny and poignant. Check it out.
Alright, I have had enough rambling for one night.
Still happy,
Peter
Sunday, June 26, 2011
Clerkships and the BEACH!
Ok, so I'm making this a quick update. I've been getting a little behind on my posting, but I think things will settle down for me a bit in the upcoming weeks. I have had some significant hoops to jump through in terms of my medical school application (for anyone thinking about applying to med. school, I'll go ahead and warn you that AMCAS is a major pain!).
Alas, I have finished and my application is finally submitted.
While I do love my internship, the highlight of this last week for me was going to Amelia Island, Florida. My family goes just about every year and it's A-W-E-S-O-M-E. I had a great time getting some R&R, and eating lots of good food.
In internship update news:
For this last week, all of the interns got to sit in on clerkships for the second year med students as they transition to their third years. It was great for me and the other interns because the med. school did a lot of "basic" reviews for the students. I got to sit in on a number of really interesting lectures and classes: I heard a lecture on reading EKGs and ABGs. I found this lecture intriguing but, as usual, a little beyond me. Although, I got better at determining and reading some of the EKGs. We had a couple of practice cases where the lecturers gave the students a chance to tell them what they noticed about different EKGs. I got to the point where I could tell when something was wrong (or different from a "normal" EKG, at least).
ABGs are pretty interesting too. I found those to be a little more easy to grasp (at least for the purposes of our practice cases).
Over the clerkship, I got to sit in on a class on ATLS, pediatrics, and airways.
One of the more memorable classes, at least for me, was a class on suturing. The med. students were given pig's feet and practiced suturing and stitching with those (pig's feet are similar to the feel texture of human skin). The knots we learned were really basic. The other interns and I had to wait until all of the med. students had the opportunity to suture up pig's feet until we were allowed to practice. While stitching up a pig's foot might sound gross or boring to some of you, it was a good time. I can't say that I'm particularly good at suturing, but I'll have plenty of time to practice, I'm sure!
Anyways, it was another crazy week and I'm sure next week will be more of the same.
Expect a longer update next time!
Extremely tired,
Peter
Alas, I have finished and my application is finally submitted.
While I do love my internship, the highlight of this last week for me was going to Amelia Island, Florida. My family goes just about every year and it's A-W-E-S-O-M-E. I had a great time getting some R&R, and eating lots of good food.
In internship update news:
For this last week, all of the interns got to sit in on clerkships for the second year med students as they transition to their third years. It was great for me and the other interns because the med. school did a lot of "basic" reviews for the students. I got to sit in on a number of really interesting lectures and classes: I heard a lecture on reading EKGs and ABGs. I found this lecture intriguing but, as usual, a little beyond me. Although, I got better at determining and reading some of the EKGs. We had a couple of practice cases where the lecturers gave the students a chance to tell them what they noticed about different EKGs. I got to the point where I could tell when something was wrong (or different from a "normal" EKG, at least).
ABGs are pretty interesting too. I found those to be a little more easy to grasp (at least for the purposes of our practice cases).
Over the clerkship, I got to sit in on a class on ATLS, pediatrics, and airways.
One of the more memorable classes, at least for me, was a class on suturing. The med. students were given pig's feet and practiced suturing and stitching with those (pig's feet are similar to the feel texture of human skin). The knots we learned were really basic. The other interns and I had to wait until all of the med. students had the opportunity to suture up pig's feet until we were allowed to practice. While stitching up a pig's foot might sound gross or boring to some of you, it was a good time. I can't say that I'm particularly good at suturing, but I'll have plenty of time to practice, I'm sure!
Anyways, it was another crazy week and I'm sure next week will be more of the same.
Expect a longer update next time!
Extremely tired,
Peter
Wednesday, June 15, 2011
Anatomy Camp
Ok, so it's been a while since I updated. I have been pretty busy finishing up my medical school application and a little bit scatterbrained between getting a job and doing some other stuff. In any case, I have done so many things in the past week in a half or so, that I will not be able to talk about it all.
**Reader Alert**
Since I haven't been able to update for a while, this will be a long post! I don't want to ramble on, but I really should have updated more frequently the past week. In any case, if you don't want to read, you don't have to (obviously).
Also, I have been immersed in a lot of medical jargon recently. So for those of you who are not in medicine, I apologize for the overabundance of technical terms. I'm a nerd, so I love learning these terms. But, I realize that not everybody feels this way! Sorry if they bother you.
I'll start with Monday of last week.
In the morning I arrived to the simulation room to find a "syndaver" laid out on a bed. A "syndaver" is exactly what it sounds like, a synthetic cadaver. After working with real (and smelly) cadavers, I was a bit skeptical of synthetic replications. But, I have to admit, the syndaver was pretty real and pretty smelly itself. Instead of the formaldehyde smell that you get with real cadavers, the sydaver smells like seafood or something. I'm not sure which smell is more gross! Just to add to the weirdness, the synthetic materials used to make the syndaver muscles look like the skin of crayfish, or lobster or something. The muscles are kind of spotted and pinkish, just like crustaceans.
However, as I was saying the syndaver is remarkably realistic. And I even overheard some of the doctors talking about how syndavers might replace the need for cadavers in medical schools (although, I think this is unlikely. . . then again, I'm not a doctor). Also, it's hard to imagine a synthetic cadaver ever truly replacing an actual body, no matter how realistic it is.
Anyways, the point of having the syndaver was that we (the interns) got to learn and practice ATLS (Advanced Trauma Life Support) skills. ATLS skills are the kind of procedures that you really hope you never have to have or do to another person. Of course, the surgeon who came in and showed us all of the procedures has to perform these sorts of things on a fairly regular basis. Dr. D demonstrated to us how to place a chest tube to relieve a tension pneumothorax (a condition where pressure builds up in the pleura and can result in an inability to breathe, or more importantly kink the inferior vena cava such that your heart cannot pump blood), a DPL (Diagnostic Peritoneal Lavage), and a procedure to remove the blood from the pericardium with a needle (although she said that surgeons hardly ever did this procedure).
All of the techniques were really cool, but I really enjoyed putting in the chest tube. It's a pretty violent procedure, to be honest. But there's a reason it's a trauma procedure. Dr. D was awesome. She was clearly knowledgeable about all of these techniques, but she was happy to carefully teach us all of them. All of the interns got a chance to practice the different procedures. I felt pretty comfortable doing them, but I was hardly in the high-pressure, high-stress kind of situation that a trauma would be.
After we had punctured most of the syndaver's intercostal spaces for chest tubes, A (the other intern) and I helped run some simulations for training LPNs. It was interesting, but nothing too out of the ordinary.
Tuesday, was my favorite day I've had in this internship. The morning started off "Anatomy Camp." Anatomy Camp is a special four-day long event that Quillen runs for CRNAs from VCU. I'm not really sure why we have people come in from VCU, but the camp is awesome nonetheless. First Dr. K gave a lecture for about an hour and half on the anatomy of the airway (larynx, pharynx, etc.). The lecture was really fascinating, but probably a bit over my head. For obvious reasons, the lecture focused on what nerves controlled what parts of the throat (extremely important for anesthesiology). I can remember Dr. K cracking some corny joke in his lecture: He said, "If I asked you the question, 'what nerves control three out of the four infrahyoid muscles?", could you give me the ansa?" (The ansa cervicalis is the loop of nerves that does this).
After our lecture we went to the gross anatomy lab and looked at the airways on a couple of cadavers. The lab was really helpful because they had people lined up at eight different stations explaining different parts of the anatomy, etc.
In the afternoon, I had some pizza for lunch, courtesy of anatomy camp and helped run a couple more simulations for the LPNs.
Once we were done with the simulations we had another lecture on neuraxial blockades. All of this lecture was, of course, extremely fascinating and mostly over my head. Although, by the end of the week I was starting to remember more and more, and to understand what was going on.
The rest of the week was much of the same stuff. I'll go through some of the highlights.
Wednesday was another day of lectures and labs. We focused on interscalene and supraclavicular blocks.
After our day of lecture/lab, we had a party over at Dr. E's in the evening. The party was great. It was really fun meeting some of the CRNAs and just hanging out with some of the other doctors and interns. Mostly it was just fun to talk to some of these people outside of an academic/medical context.
On Thursday we talked about the brachial plexus mostly. The brachial plexus is fairly complex and I was pretty confused by the whole thing at first. But after seeing it multiple times, it's starting to stick. I even practiced drawing it the other day. It's pretty difficult to draw considering all the posterior and anterior divisions/cords/branches, etc. I'm starting to learn some of the nerves and which regions of the body are innervated by those nerves. For example, Dr. K told us that any time you are dealing with the shoulder, you are dealing with nerves C5 and C6 (cervical nerves 5 and 6).
Friday, I had the notable honor of allowing 20 - 30 CRNAs ultra-sound my femoral. Needless to say, it was a little bit awkward. The femoral artery is REALLY close to genitalia. Despite my anxiety, it wasn't that bad. Everyone was there to learn. . . Besides, I'll probably never see many of those CRNAs again. Even if I do, who cares?
That concludes Anatomy Camp. It was an amazing week and I learned an incredible amount from it. Really, I was pretty spoiled to be able to sit on all the lectures and labs.
Now for a non sequitur:
I've been learning a lot of nifty mnemonics for different parts of the anatomy. Here are the ones I can remember.
Randy Taylor Drinks Cold Beer - This is for remembering the subunits of the brachial plexus: Roots, Trunks, Divisions, Cords, Branches.
NAVEL - This is mnemonic for what you run into in the leg, lateral to medial: Nerve, Artery, Vein, [Empty Space], Lymph
SLI - The three muscles of the erector spinae (medial to lateral): Spinalis, Longissimus, Iliocostalis
SITS - The four rotator cuff muscles: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis.
PAD from the inside out - The layers of the spinal cord from deep to superficial: Pia Mater, Arachnoid, Dura Mater.
I'll be more up-to-date in the coming weeks.
Happy to be a camper again,
Peter
**Reader Alert**
Since I haven't been able to update for a while, this will be a long post! I don't want to ramble on, but I really should have updated more frequently the past week. In any case, if you don't want to read, you don't have to (obviously).
Also, I have been immersed in a lot of medical jargon recently. So for those of you who are not in medicine, I apologize for the overabundance of technical terms. I'm a nerd, so I love learning these terms. But, I realize that not everybody feels this way! Sorry if they bother you.
I'll start with Monday of last week.
In the morning I arrived to the simulation room to find a "syndaver" laid out on a bed. A "syndaver" is exactly what it sounds like, a synthetic cadaver. After working with real (and smelly) cadavers, I was a bit skeptical of synthetic replications. But, I have to admit, the syndaver was pretty real and pretty smelly itself. Instead of the formaldehyde smell that you get with real cadavers, the sydaver smells like seafood or something. I'm not sure which smell is more gross! Just to add to the weirdness, the synthetic materials used to make the syndaver muscles look like the skin of crayfish, or lobster or something. The muscles are kind of spotted and pinkish, just like crustaceans.
However, as I was saying the syndaver is remarkably realistic. And I even overheard some of the doctors talking about how syndavers might replace the need for cadavers in medical schools (although, I think this is unlikely. . . then again, I'm not a doctor). Also, it's hard to imagine a synthetic cadaver ever truly replacing an actual body, no matter how realistic it is.
Anyways, the point of having the syndaver was that we (the interns) got to learn and practice ATLS (Advanced Trauma Life Support) skills. ATLS skills are the kind of procedures that you really hope you never have to have or do to another person. Of course, the surgeon who came in and showed us all of the procedures has to perform these sorts of things on a fairly regular basis. Dr. D demonstrated to us how to place a chest tube to relieve a tension pneumothorax (a condition where pressure builds up in the pleura and can result in an inability to breathe, or more importantly kink the inferior vena cava such that your heart cannot pump blood), a DPL (Diagnostic Peritoneal Lavage), and a procedure to remove the blood from the pericardium with a needle (although she said that surgeons hardly ever did this procedure).
All of the techniques were really cool, but I really enjoyed putting in the chest tube. It's a pretty violent procedure, to be honest. But there's a reason it's a trauma procedure. Dr. D was awesome. She was clearly knowledgeable about all of these techniques, but she was happy to carefully teach us all of them. All of the interns got a chance to practice the different procedures. I felt pretty comfortable doing them, but I was hardly in the high-pressure, high-stress kind of situation that a trauma would be.
After we had punctured most of the syndaver's intercostal spaces for chest tubes, A (the other intern) and I helped run some simulations for training LPNs. It was interesting, but nothing too out of the ordinary.
Tuesday, was my favorite day I've had in this internship. The morning started off "Anatomy Camp." Anatomy Camp is a special four-day long event that Quillen runs for CRNAs from VCU. I'm not really sure why we have people come in from VCU, but the camp is awesome nonetheless. First Dr. K gave a lecture for about an hour and half on the anatomy of the airway (larynx, pharynx, etc.). The lecture was really fascinating, but probably a bit over my head. For obvious reasons, the lecture focused on what nerves controlled what parts of the throat (extremely important for anesthesiology). I can remember Dr. K cracking some corny joke in his lecture: He said, "If I asked you the question, 'what nerves control three out of the four infrahyoid muscles?", could you give me the ansa?" (The ansa cervicalis is the loop of nerves that does this).
After our lecture we went to the gross anatomy lab and looked at the airways on a couple of cadavers. The lab was really helpful because they had people lined up at eight different stations explaining different parts of the anatomy, etc.
In the afternoon, I had some pizza for lunch, courtesy of anatomy camp and helped run a couple more simulations for the LPNs.
Once we were done with the simulations we had another lecture on neuraxial blockades. All of this lecture was, of course, extremely fascinating and mostly over my head. Although, by the end of the week I was starting to remember more and more, and to understand what was going on.
The rest of the week was much of the same stuff. I'll go through some of the highlights.
Wednesday was another day of lectures and labs. We focused on interscalene and supraclavicular blocks.
After our day of lecture/lab, we had a party over at Dr. E's in the evening. The party was great. It was really fun meeting some of the CRNAs and just hanging out with some of the other doctors and interns. Mostly it was just fun to talk to some of these people outside of an academic/medical context.
On Thursday we talked about the brachial plexus mostly. The brachial plexus is fairly complex and I was pretty confused by the whole thing at first. But after seeing it multiple times, it's starting to stick. I even practiced drawing it the other day. It's pretty difficult to draw considering all the posterior and anterior divisions/cords/branches, etc. I'm starting to learn some of the nerves and which regions of the body are innervated by those nerves. For example, Dr. K told us that any time you are dealing with the shoulder, you are dealing with nerves C5 and C6 (cervical nerves 5 and 6).
Friday, I had the notable honor of allowing 20 - 30 CRNAs ultra-sound my femoral. Needless to say, it was a little bit awkward. The femoral artery is REALLY close to genitalia. Despite my anxiety, it wasn't that bad. Everyone was there to learn. . . Besides, I'll probably never see many of those CRNAs again. Even if I do, who cares?
That concludes Anatomy Camp. It was an amazing week and I learned an incredible amount from it. Really, I was pretty spoiled to be able to sit on all the lectures and labs.
Now for a non sequitur:
I've been learning a lot of nifty mnemonics for different parts of the anatomy. Here are the ones I can remember.
Randy Taylor Drinks Cold Beer - This is for remembering the subunits of the brachial plexus: Roots, Trunks, Divisions, Cords, Branches.
NAVEL - This is mnemonic for what you run into in the leg, lateral to medial: Nerve, Artery, Vein, [Empty Space], Lymph
SLI - The three muscles of the erector spinae (medial to lateral): Spinalis, Longissimus, Iliocostalis
SITS - The four rotator cuff muscles: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis.
PAD from the inside out - The layers of the spinal cord from deep to superficial: Pia Mater, Arachnoid, Dura Mater.
I'll be more up-to-date in the coming weeks.
Happy to be a camper again,
Peter
Thursday, June 2, 2011
Start of the ETSU Patient Simulation Lab
I started up my internship at the ETSU Patient Simulation Lab yesterday. . .
I honestly don't know where to start, or how to talk about everything I've experienced so far. But I'll do my best to describe some of the better experiences.
We started off yesterday with a small orientation. It was really basic and we just looked at the calendar and discussed what we would be doing throughout the summer. Right from the start, I knew the internship was going to be awesome: The calendar was filled with multiple opportunities to observe and learn from physicians. For the summer, we will be helping prepare cadavers for medical students, assisting in running a camp for high schoolers interested in medicine, listening in on lectures by various physicians, and much more.
Orientation was fine, but unremarkable. After about an hour, our program coordinator told us we could either leave or go down to the Gross Anatomy Lab and work with cadavers.
I knew I couldn't simply leave, and I was really excited about working with the cadavers (as weird as that may sound to some people), but I was apprehensive nonetheless. Before we went into the lab, our coordinator kept reminding us to sit down if we felt light-headed or dizzy. I wasn't really sure how I would react to the bodies, and I could feel myself getting more nervous as we approached the lab.
As we stepped into the lab, however, I suddenly didn't feel as nervous. It's still a little bit surreal to me, but I actually felt more calm and comfortable once we got into the lab with the bodies. We all put gloves on and grabbed our tools (scalpels, hemostats, scissors, etc.).
Before I go any further, I should talk a little about the "cadaver experience." In my opinion, there is no way to get around the fact that cutting up a dead human body is a bit creepy. Let's face it, if someone didn't feel a little weird while they were working with a cadaver, that would be really creepy. Ultimately, you simply have to come to grips with the fact that all of the bodies in the lab belonged to someone.
But something weird happens when you start working with bodies. You learn to dissociate yourself from the cadaver. So while I acknowledged the fact that I was dissecting a human body--a body that had a life and history--I didn't dwell on that reality. It's hard to explain. There is a way that I can appreciate the person who donated their body to science, and be grateful for the opportunity to learn from it, but push aside the unpleasant thoughts of cutting into a human body. Weirdly enough, you get so caught up in concentrating on what you are doing, that you almost forget that you're cutting up a body. I know that sounds crazy, but it's true.
In any case, within an hour of orientation, I was given the green-light on a cadaver. My assignment was to expose the brachial plexus, a network of nerves located in the upper part of the arm (essentially the armpit/shoulder area). As I began removing tissue and fat, I remembered having heard that your finger is the best tool you have in dissecting a body. The first few minutes, I was pretty timid. I would grab the forceps and a scalpel and carefully remove pieces of tissue. Well, it didn't take long for me to realize that I was going to be in the lab for a long time if I continued to cut that way. As I grew bolder, I began to use my fingers to tear apart muscle fibers and remove layers of fat.
Nerves are a relatively easy find in the body because they are long yellowish-white fibers, hidden behind a layer of muscles. They are great for novices like me too, because they are virtually impossible to sever unless you took a pair of scissors to them. Essentially, you won't break them if you are simply poking around with your hands.
I was fortunate enough to rope in a fourth year medical student, R, to help me with the dissection. I was so surprised by her willingness to help. I expected her to give me a few pointers on how to remove some of the tissue, but instead she hung out at my table for a solid hour to hour and a half.
After we finished up in the gross lab, one of the other interns suggested we go swimming in the Nolichucky River. I had nothing better to do, and I was curious to meet some of the other interns for the summer. So J, A, R, and I went to a spot called "Big Rock" on the Nolichucky. The place was really cool, but my fellow interns were even cooler. It was really fun to just hang out and get to know each other better.
All of this was just my first day.
We did even more stuff today, but I'll give an abbreviated version:
In the morning I helped with a laminectomy. This is a process where you remove the dorsal part of the spine (the lamina) from the vertebral column. Next we exposed the nerves running from the spinal cord beneath the ribs (the intercostal nerves).
I held a brain.
We helped run various OB/GYN simulations for the medical students. Then we listened to a Doctor H debrief on the various scenarios to the students. These debriefs were filled with lots of stuff that went right over my head, but were extremely interesting nonetheless.
After the simulations, I learned how to intubate someone ( I practiced on our sim lab dummy) and how to start a catheter in a vein. I also learned BLS (Basic Life Support), which essentially amounts to CPR.
I've had two jam-packed days, I can't wait to say more about it. But this post is already getting a bit lengthy, so I'll save my thoughts for later.
I still can't believe I held a brain today,
Peter
I honestly don't know where to start, or how to talk about everything I've experienced so far. But I'll do my best to describe some of the better experiences.
We started off yesterday with a small orientation. It was really basic and we just looked at the calendar and discussed what we would be doing throughout the summer. Right from the start, I knew the internship was going to be awesome: The calendar was filled with multiple opportunities to observe and learn from physicians. For the summer, we will be helping prepare cadavers for medical students, assisting in running a camp for high schoolers interested in medicine, listening in on lectures by various physicians, and much more.
Orientation was fine, but unremarkable. After about an hour, our program coordinator told us we could either leave or go down to the Gross Anatomy Lab and work with cadavers.
I knew I couldn't simply leave, and I was really excited about working with the cadavers (as weird as that may sound to some people), but I was apprehensive nonetheless. Before we went into the lab, our coordinator kept reminding us to sit down if we felt light-headed or dizzy. I wasn't really sure how I would react to the bodies, and I could feel myself getting more nervous as we approached the lab.
As we stepped into the lab, however, I suddenly didn't feel as nervous. It's still a little bit surreal to me, but I actually felt more calm and comfortable once we got into the lab with the bodies. We all put gloves on and grabbed our tools (scalpels, hemostats, scissors, etc.).
Before I go any further, I should talk a little about the "cadaver experience." In my opinion, there is no way to get around the fact that cutting up a dead human body is a bit creepy. Let's face it, if someone didn't feel a little weird while they were working with a cadaver, that would be really creepy. Ultimately, you simply have to come to grips with the fact that all of the bodies in the lab belonged to someone.
But something weird happens when you start working with bodies. You learn to dissociate yourself from the cadaver. So while I acknowledged the fact that I was dissecting a human body--a body that had a life and history--I didn't dwell on that reality. It's hard to explain. There is a way that I can appreciate the person who donated their body to science, and be grateful for the opportunity to learn from it, but push aside the unpleasant thoughts of cutting into a human body. Weirdly enough, you get so caught up in concentrating on what you are doing, that you almost forget that you're cutting up a body. I know that sounds crazy, but it's true.
In any case, within an hour of orientation, I was given the green-light on a cadaver. My assignment was to expose the brachial plexus, a network of nerves located in the upper part of the arm (essentially the armpit/shoulder area). As I began removing tissue and fat, I remembered having heard that your finger is the best tool you have in dissecting a body. The first few minutes, I was pretty timid. I would grab the forceps and a scalpel and carefully remove pieces of tissue. Well, it didn't take long for me to realize that I was going to be in the lab for a long time if I continued to cut that way. As I grew bolder, I began to use my fingers to tear apart muscle fibers and remove layers of fat.
Nerves are a relatively easy find in the body because they are long yellowish-white fibers, hidden behind a layer of muscles. They are great for novices like me too, because they are virtually impossible to sever unless you took a pair of scissors to them. Essentially, you won't break them if you are simply poking around with your hands.
I was fortunate enough to rope in a fourth year medical student, R, to help me with the dissection. I was so surprised by her willingness to help. I expected her to give me a few pointers on how to remove some of the tissue, but instead she hung out at my table for a solid hour to hour and a half.
After we finished up in the gross lab, one of the other interns suggested we go swimming in the Nolichucky River. I had nothing better to do, and I was curious to meet some of the other interns for the summer. So J, A, R, and I went to a spot called "Big Rock" on the Nolichucky. The place was really cool, but my fellow interns were even cooler. It was really fun to just hang out and get to know each other better.
All of this was just my first day.
We did even more stuff today, but I'll give an abbreviated version:
In the morning I helped with a laminectomy. This is a process where you remove the dorsal part of the spine (the lamina) from the vertebral column. Next we exposed the nerves running from the spinal cord beneath the ribs (the intercostal nerves).
I held a brain.
We helped run various OB/GYN simulations for the medical students. Then we listened to a Doctor H debrief on the various scenarios to the students. These debriefs were filled with lots of stuff that went right over my head, but were extremely interesting nonetheless.
After the simulations, I learned how to intubate someone ( I practiced on our sim lab dummy) and how to start a catheter in a vein. I also learned BLS (Basic Life Support), which essentially amounts to CPR.
I've had two jam-packed days, I can't wait to say more about it. But this post is already getting a bit lengthy, so I'll save my thoughts for later.
I still can't believe I held a brain today,
Peter
Monday, May 23, 2011
First post!
This post officially marks the commencement of my blog. I have to admit that I'm new to "blogging"and I've resisted the whole thing for a while. But I don't think it will be too difficult to learn the ropes and it's a good discipline for me.
For those of you who don't know, I recently graduated from Duke University. I had a wonderful four years and made some wonderful friends for life. I'm going to miss so much about Duke: the incredible opportunities, the intellectual challenges, the library. But mostly, I'm going to miss the beautiful campus, amazing weather, and people. However, just like all good things/experiences, "nothing gold can stay." So my college career has come to an end and a new chapter of my life begins. Ultimately, I'm hoping to go to medical school at some point in the future. I haven't really set a definitive timeline. But my post-Duke plans are centered on going to medical school in the next couple of years.
And while I'm sad to be leaving Duke behind, I'm excited for my future. Also, it's hard for me to get too sentimental about Duke as I'll be back in Durham for next year. Next year I will be participating in a fellowship through the Duke Chapel--the Pathways Fellowship. I will be living with other fellows and students in a house in intentional community while discerning my vocational calling and goals. I have an internship with two doctors who teach within the Duke Divinity school: Dr. Barfield and Dr. Kinghorn. I honestly cannot express how excited I am to be learning from these two, and I am extremely grateful for such an opportunity. Over the course of the internship I will be exploring the relationship between theology and medicine. Generally, this next year I will be studying medicine and the healing process from a holistic and human perspective. I already know that the year will be an awesome experience and I eagerly look forward to getting back to Durham.
In the mean time, I'm home in Johnson City, TN for the summer. This summer I will be working in the ETSU Patient Simulation Lab. Once again, I am so fortunate to have an exciting and educational internship ahead of me. The Sim Lab offers great hands-on experience and valuable practical medical knowledge. This may not sound that exciting to some of you. . . . But I am thrilled to be working there this summer.
I suppose I should explain the purpose, or end, of this blog. It's really pretty straightforward. I figured that I'm going to be learning and experiencing a myriad of different things this next year. Rather than simply relying on my memory, I hope to catalog some of those experiences here. Essentially, this blog will function as a place for me to reflect and ruminate. From time to time, I might update it for other purposes. I can't make any promises about what this blog will be, or become. Also, I can't promise you that it will be interesting. . . Although, it will be useful for me! I'm sure the blog will evolve over time and I'm sure I'll get into a routine, but for the time being, I'm still trying to figure it out.
Officially a blogger now,
Peter
For those of you who don't know, I recently graduated from Duke University. I had a wonderful four years and made some wonderful friends for life. I'm going to miss so much about Duke: the incredible opportunities, the intellectual challenges, the library. But mostly, I'm going to miss the beautiful campus, amazing weather, and people. However, just like all good things/experiences, "nothing gold can stay." So my college career has come to an end and a new chapter of my life begins. Ultimately, I'm hoping to go to medical school at some point in the future. I haven't really set a definitive timeline. But my post-Duke plans are centered on going to medical school in the next couple of years.
And while I'm sad to be leaving Duke behind, I'm excited for my future. Also, it's hard for me to get too sentimental about Duke as I'll be back in Durham for next year. Next year I will be participating in a fellowship through the Duke Chapel--the Pathways Fellowship. I will be living with other fellows and students in a house in intentional community while discerning my vocational calling and goals. I have an internship with two doctors who teach within the Duke Divinity school: Dr. Barfield and Dr. Kinghorn. I honestly cannot express how excited I am to be learning from these two, and I am extremely grateful for such an opportunity. Over the course of the internship I will be exploring the relationship between theology and medicine. Generally, this next year I will be studying medicine and the healing process from a holistic and human perspective. I already know that the year will be an awesome experience and I eagerly look forward to getting back to Durham.
In the mean time, I'm home in Johnson City, TN for the summer. This summer I will be working in the ETSU Patient Simulation Lab. Once again, I am so fortunate to have an exciting and educational internship ahead of me. The Sim Lab offers great hands-on experience and valuable practical medical knowledge. This may not sound that exciting to some of you. . . . But I am thrilled to be working there this summer.
I suppose I should explain the purpose, or end, of this blog. It's really pretty straightforward. I figured that I'm going to be learning and experiencing a myriad of different things this next year. Rather than simply relying on my memory, I hope to catalog some of those experiences here. Essentially, this blog will function as a place for me to reflect and ruminate. From time to time, I might update it for other purposes. I can't make any promises about what this blog will be, or become. Also, I can't promise you that it will be interesting. . . Although, it will be useful for me! I'm sure the blog will evolve over time and I'm sure I'll get into a routine, but for the time being, I'm still trying to figure it out.
Officially a blogger now,
Peter
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