Musculoskeletal Exam/ Erb's Palsy

The beautiful brachial plexus.  This plexus is a source of frustration trying to memorize the many branches, and great appreciation of the intricate engineering once it is dissected out.  One of the injuries to the C5 and C6 roots cause Erb's Palsy.  This leads to a medially rotated shoulder and extended arm called "waiter's tip."  It's one thing to see it in a book, but it's a totally different experience to see it in person.

During our musculoskeletal exam lesson during our introduction to clinical medicine class, one of our tasks was to palpate the clavicle to the acromioclavicular joint.  As i was palpating my partner, I noticed that his left AC joint was significantly lower than his right due to a broken clavicle as he was pulled out during birth.  This clavicle fracture impinged his nerve, leading to Erb's Palsy.  He was unable to completely flex his arm or abduct his shoulder.  His biceps muscle, the main supinators, were not working properly.  He also couldn't abduct his arm, or lift it to the side.  It was exciting to get a chance to see it in person and develop another perspective on the disorder.

Visiting Physician

Once or a couple times a semester we have a visiting physician who comes to give a presentation of their experience in medical school, doing well on the USMLE, and life as a practicing physician.

I had the opportunity to talk to a visiting physician, a pathologist, during her office hours.  She started off getting a Master's degree in microbiology but later decided to go to medical school.  Pathology naturally became her interest because of the ability to incorporate her microbiology degree.  She mentioned that her routine consisted of going to school from 5pm to 5am most days; her way of avoiding some of the classmates she found annoying as she jokingly stated.  Her work days vary widely as some days are normal hours and some days she's going in very late.  She claimed to be in a lot of debt, but isn't concerned because of some loan forgiveness plan.

Part of what attracted her to medicine is the diversity in what she's able to do.  Such as clinical trials, teaching, research, public health, etc.  She plans to transition into private practice soon.  It's always nice to get a perspective who's already "been through the fire."

First Mini

I had my first mini on Monday.  Well second first mini I guess, as I am repeating the semester.  Thank God for a second chance.  I passed it for the first time with a 77%.  It's not as high as I would like but it is a start in the right direction.

A few days before that I was vomiting on campus.  I tried to go to a review that Friday, but I couldn't stay long, so I just went home and got some sleep.  After lab on day I had got very sick and nauseous after anatomy lab on day.  The first time that had happened.  But it only lasted a few days and I felt better after resting.  I think it was the formaldehyde that got to me this time and I got nauseous.  That's what I get for not eating very much before lab.

Our cadaver was a fighter, she lived 102 years old.  She had a pacemaker and the report listed her cause of death from general in-balance.  Sounds like they weren't to eager to investigate the cause of death.  I have really started to enjoy going to Anatomy lab, because I have a greater appreciate and understanding of the anatomy after repeating the course.  Our last dissection was the brachial plexus.  It was very tedious, trying to identify all the branches coming off the lateral, medial, and posterior cords.  However, it definitely is amazing to see the engineering of the nerves and the routes they travel to innervate the body.  I've seen the youtube video of drawing the brachial plexus in 10 seconds and that's been my go to video for learning.

Island tour

Today, I went on an island tour with the incoming 1st semester students.  I didn't go on this tour when I came in last semester, so it was great to get a chance to see more of what the island has to offer.  We went to Trafalgar falls, which was beautiful.  Scott’s head was the most interesting destination.  It was on the south side of the island.  There’s a small strip of land that separates the Caribbean  Sea from the Atlantic Ocean.  The Atlantic is very rough but the Caribbean Sea is extremely calm.  The water was a comfortable temperature.  We also went to see a small boiling Sulfur pool.  Unfortunately, no one jumped in.  It was a nice chance to "make peace" with the island.  However, the honeymoon was over the next day.  Time to rise and grind!  More pics below.

Oh, how I love LIAT

I've heard stories of long layovers, delays, and misplaced baggage on behalf on Liat, the Caribbean's major airline.  Today I had the pleasure of experiencing all 3.

My flights went smooth from Burbank to New York.  I ended up seeing a couple of my classmates on the flight to St. Martn.  Then at St. Martin many of our classmates were waiting to get onto the flight to Dominica.  A friend and I were just saying how thankful we were that nothing has went wrong and cockily saying that we haven't had any trouble with Liat so far, and now we were on the home stretch.  The flight from St. Martin to Dominica is only an hour, so we figured we were pretty much there.

Then we heard that the flight would be delayed because of technical difficulties with one of the planes. Then we ended up boarding the plane about an hour and a half later.  The plane was completely attendant was going over the safety rules and we were good to go, until up the stairs runs another student saying someone's in her seat.  As no one follows the designated seating of Liat, the attendant then checked everyone one by one to see if they had boarding passes corresponding to her list.  The culprit was found, but she was arguing with someone and refused to leave.  She finally got off the plane and we were set to take off.  Then the fight attendant oh so jubilantly announced that we be stopping at her "beautiful home of Antigua," because it was too windy in Dominica.  We responded with moans and groans.

When we arrived at Antigua, I was looking for my check-in baggage, but it was not on the plane.  Hopefully, I receive it when (if) I arrive in Dominica.  It is now 3:22 AM and I am in a hotel that Liat arranged for us to stay in.  We leave to the airport at 4:00 AM.

Hopefully a major airline decides to start sending planes to Dominica soon.  If not, I may just decide to start my own airline in a few years.  Maybe I'll call it the Tail Airlines, Liat spelled backwards, so people know to expect everything opposite of Liat.

Things Learned over the semester

There are a few things I learned about myself throughout a semester that knocked me out cold. I'll keep it simple:

1) Isolation can prevent advancement, someone else always has something of benefit to offer
2) A "life balance" isn't overrated
3) The ability to simply present intricate information shows true understanding
4) Make every day better than the previous
5) Success should be measured hourly or daily
6) Keep an open mind, try new things
7) Professors are you best allies
8)  No resources should be taken for granted
9) You learn the most when you're the most vulnerable (don't be afraid to look stupid)
10) Your gut feeling is usually right, don't second guess yourself
11) More resources is not the answer (you won't use most of them anyway)

End of the Semester

It has been one rough semester, and one full of learning experiences.  I have to repeat the semester, as I failed by 2 points.  Pretty much nothing went as expected.  I could've made many reels similar to The 500 Days of Summer movie scene showing the disparities of his expectations vs reality.  Mainly the whole semester was a blur as every day seemed pretty similar.  A basic overview would be: eat oatmeal, go to the Annex and mediasite the lectures, eat lunch, make my study product, eat dinner, finish making my study product, get ready for bed. The first week was already overwhelming with the number of power point slides we were presented with each day.  It seemed like by the time I was done writing down my summary of the notes, there wasn't enough time to actually take time to retain the notes I was writing.

There wasn't much that was too memorable that semester, because I didn't take much time out to enjoy the island, or get involved with clubs, or really take time to develop meaningful relationships with my classmates.  Orientation week was awesome, but it was pretty much downhill after that.  Beach bash was fun, even though I arrived late.  Some classmates cooked a surprisingly very tasty Thanksgiving dinner.  I enjoyed going to the market and surveying the different foods they had available.  As my results were consistently subpar, I tweaked how I was studying.  I tried using the whiteboard more, making flow charts, cornell notes, etc. but nothing seemed to help.

Towards the latter weeks of the semester, I got a fungal infection that caused itchiness of my skin and dryness.  A friend gave a solution of sulfur and coconut oil that temporarily helped, but the itchiness persisted.  A medication prescribed by the doctor also gave some temporary relief.  I also developed what my physician called a minor case of vitiligo around my eye and other areas on my face.  If it gets more severe, I might skip med school and try my hand at doing Michael Jackson performances in Vegas.  I also had problems with the maid, as she was not cleaning the bathroom or kitchen thoroughly, causing added stress.  There was also mold found in mine and my neighbors' apartment that lived on my floor.

Throughout the difficult times there's always things to be grateful for.  I'm grateful that Ross Christian Fellowship is on campus, it helps to remember things more important than test scores and forget about the stresses of the semester.  I'm also grateful for the relationships that I actually did take the time to cultivate.   Despite my struggles, the information was interesting and I did enjoy studying it.