On to the next one

Third was a tough, tough semester, but thank God I passed.  It is considered by many students to be the toughest on the island.  Microbio was really a struggle.   But hey struggles help you reaffirm your motivation for embarking on the journey in the first place.  I excelled in micro in undergrad, but this was a whole different beast entirely.  We are expected to know which media to grow the microbes on, classifications (oxidase, catalase positive or negative, etc.),  which toxins they produce, and signs and symptoms, whether a virus is single or double stranded, enveloped or non- enveloped, segmented or non-segmented, etc.  For microbiology I would recommend relying heavily on sketchy micro, picmonic, or making up your own mnemonics.  With microbiology, you can not simply understand the concepts like with physiology, you are forced to come up with some creative way to distinguish the features of a specific bacteria, fungi, or virus.   The first block, fundamentals, was also heavy on the conceptual fundamentals of pharmacology, such as drug distribution and absorption.  Our other blocks were renal physiology, GI pathology, and reproductive physiology (why do women have to be so complicated?).

Boiling Lake

We made it to the summit of Boiling Lake.  The fog is the background is from the sulfur gas rising from one of two Sulfur boiling lakes of that size in the world (according to our tour guide).  It was worth the couple days of sore legs afterwards. 

3rd Semester

Others students have said that 3^rd semester would be the semester that it starts to feel more medically related and how one would expect medical school to be.  This was not the case initially, but in these past few weeks I have found that sentiment to be somewhat true. For me it has been because of the greater emphasis on our patient interviews and a focus on identifying the underlying signs, symptoms, and treatments used to address a certain disease.  As opposed to the first couple of semesters, when we were more focused on the normal physiological functions of the body, not pathology.  I find myself becoming more excited about beginning rotations later in the (not-so) distant future.

Salybia Mission Project

I got an opportunity to participate in the most popular club on campus, Salybia Mission Project.   I participated on behalf on the special men’s clinic that emphasized prostate health, sexual health education, and occupational injury prevention.  It was by far my favorite club experience thus far.

It is the only club that caters to the Kalinago people, the natives of Dominica.  I was surprised by how large the clinic was.  There was a lunge room, waiting room, and about 10 or more other rooms including a currently unoccupied dentist room.  Our team from Ross included a couple of doctors, a chiropractor, and about 16 students.  At the clinic were a nurse and doctor and other staff that work at the clinic during the week. 

We began by presenting a rectal model to the patients which allowed them to visualize how the digital rectal exam was done.  The model had multiple types of prostates that can be replaced, some with lumps some normal so the patients could feel for themselves.  This was done in hopes of easing the anxiousness of the patients and improve understanding.  And yes, some of us got an opportunity to preform a digital rectal exam.  The patients were very gracious in allowing us to learn how to feel for the prostate on them.  When I first placed my finger into the patient’s rectum, I tried to keep my face straight to no avail, good thing the patient couldn’t see my face.  My finger slid further until I felt lumps as I slide my finger to the left and right.  The first patient’s prostate was more enlarged on the right side. Therefore, the doctor ordered a PSA test to help determine the possibility of cancer.  His case was of specific concern because the prostate was more enlarged on one side than the other.

One of the things that the vast majority of men will deal with, especially men above 55, will be an enlarged prostate.  This can disrupt the flow of urine, which can lead to common symptoms including: frequently waking up to pee at night (nocturia), polyuria, a feeling like the bladder isn’t fully emptied after urination, dribbling of the urine, or a thin stream of urine.  Sometimes these cases are related to an infection of the prostate, which led us to explaining brochures of different sexually transmitted diseases.

Overall, the clinic was a huge success and seemed to run very smoothly. 

Horseback Riding

We went horseback riding this past weekend with Valerie through Rainforest Riding and had a blast.   The rain made me fairly skeptical about whether we would be able to ride, but the guide assured us it would be fine, so we threw on our ponchos and geared up for the ride. I had been on a horse once before, but didn’t ride it very far, so this would be a new experience for me.  I greeted my horse, Lucy, as I hoped on her back.  Lucy was a race horse from St. Lucia in her glory days. 

Our only instructions were to control our horses and follow the stallions.   That would’ve been reasonable, except we had no previous significant experience riding a horse.  I assumed she said control the horse as a formality, as  I would surely be helpless if Lucy decided to take off or buck me off her back, so I took it to mean that the horses were well trained and not much controlling would be necessary.  This proved to be the case.  There were moments when I channeled my memory of horse movies and whipped the rains while yelling “yah, yah”.  Lucy responded by turning around pursing her lips and snorting, as if to say “you can’t be serious right now.”   She would then take a bite off the grass and proceed to move when she felt ready.  Only later did she start to respond to my commands, as I gave her a firm smack on the hind leg.

We split up our big group into two, one group went a couple hours before us, and there were three people riding in my group.   We were instructed to follow behind the stallion and not to pass it, as the stallion has a huge ego and will attack the other horses if “disrespected”. 

We rode up a trail high into the mountains through to an area dense with trees forming a high-rising canopy creating a cooling mist from the rain.  It looked like a scene out of Jurassic Park.  We heard the noisy national birds, a green parrot, with red underneath its wings, as they found shelter in the tree barks.  We caught glimpses of them flying away, flapping vigorously through the wind.  After exiting the canopy, we overlooked Cabrits (two volcano elevations where the remains of an old English fort are located) and the beach.  We made stops along the trail to view sugar cane plantations where Dominican slaves used to work.  We also stopped to collect bay leaves and cinnamon leaves and bark to make tea.  We also ate fresh cocoa off the tree.  The white outside layer surprisingly tastes like a sweet/sour candy while the brown inside is grinded to make chocolate.   It was a great experience, enhanced by the rain.  After all, what’s a rain forest without rain?

Intramural Football

My football squad, now 2-0.  Nice to get some competition and exercise as a study break.  I got a couple of interceptions in the video.

Portsmouth Clinic

On Sunday morning, RAF held a clinic at a local Portsmouth church.  I got my morning boost of energy, not by caffeine, but by this man yelling outside of his balcony at us.  It took a while to understand what he was saying to us, but we figured it out eventually.  He was apparently frustrated because the children at the church had been doing some type of drill activity in the morning called “Pathfinders” so I guess they were making too much noise for him. 

We set up different stations for the “patients” to navigate.  They would start at the check-in where we gave them a check-in sheet, proceed to get blood pressure checked, auscultate for heart and lung sounds, check BMI, and finally go to my station to get their blood glucose checked.  I had to be the bad guy of the day, pricking the tips of fingers to measure the blood glucose.  I don’t know if it was more painful for them or for me, as I had to watch these kids contort their faces in vivid anticipation of a horrible pain that never came.  Most of the patients didn’t feel much.   Other times I may have held the small needle in too deep or too long… oops. 

It’s fun for me to be able to see trends along the patients BMI, glucose, and BP and predict what the sugar will be.   I also get to find out slight lifestyle differences between those with higher blood sugar (fried white flours) and those with lower blood glucose (usually eating provisions, fish, or rice and beans for breakfast).  I keep on anticipating hearing breakfasts more typical to America, but usually their breakfast is not much different than their lunches may be.  A better alternative to the cereals, bacon, sausage, we are used to.  I also noticed that they don’t eat much dairy.