In the spirit of poetry...

...a new favorite.

Pursuit

Each thing I do I rush through so I can do
something else. In such a way do the days pass -
a blend of stock car racing and the never
ending building of a gothic cathedral.
Through the windows of my speeding car, I see
all that I love falling away: books unread,
jokes untold, landscapes unvisited. And why?
What treasure do I expect in my future?
Rather it is the confusion of childhood
loping behind me, the chaos in the mind,
the failure chipping away at each success.
Glancing over my shoulder I see its shape
and so move forward, as someone in the woods
at night might hear the sound of approaching feet
and stop to listen, then, instead of silence
he hears some creature trying to be silent.
What else can he do but run? Rushing blindly
down the path, stumbling, struck in the face by sticks;
the other ever closer, yet not really
hurrying or out of breath, teasing its kill.

-Stephen Dobyns

i used to be bigger than this -
really
i was high flying high ballin'
in a high powered car

used to roll down the streets
glasses low hair gelled music on the stereo
hey baby - want a ride?

walking through the streets like twas nothing
i owned these people, these streets
mister - shine your shoes? mister - that drinks on the house
that drinks on me - mister

easy breazin easy ridin
the days and nights away
long gone now
no power no people no friends
as if they were ever

just me and this room
this cold dark room
with the roaches and the rats
and the screaming next door - christ, will you ever shut up?
no momma here no, boy
just you and me and everyone else

only time can tell

Seeing red

We agreed, we decided - we made contract to leave at 6pm, because Coldplay is playing at 8pm and I want to be there early. Doors open at 7pm. But N isn't here yet. I am about to see red.

Strap on whenever it seems appropriate

Many things have happened since we last talked. Yes...it's been quite a while, hasn't it? Let me tell you: grand things have transpired in the moments we have been apart. Like the fact that I am running a half marathon July 27th, right here in the streets of M. And the fact that I am actually going to a Coldplay concert in Connecticut this summer. But the real nitty gritty of the issue for today, ladies and gentlemen, is this: I went nuts last semester. That's right - I went stark raving mad. I was a raving lunatic for all of 16 weeks and I did not realize it fully until the semester was over and sanity spoke reason into my rabid mind. And by sanity I mean the voice of reason. This being, of course, my mother.
Probably, the seeds of my madness were sown towards the end of the first semester when I decided that my entire existence would cease to be if I Did Not Get Honors. Many a night was spent plotting and scheming to avoid this end. "So, I got an 88 on this last test....if I get at least a 95 on the next test and maybe a 92 on the last test, provided, of course I get 100% on the final, then maybe I could get honors. Cross fingers, knock on wood, throw salt over left shoulder, consider putting soul on lease." It was bad I tells ya. Bad. It so happened, that I did get honors that first semester. My ego was officially inflated. Life was good. The seeds, however, were starting to germinate.
Next semester came on by with its Anatomy and its Physiology and its Histology. Perhaps people in my class decided they really needed to get focused. Perhaps I became a little bit dumber. Perhaps it was a combination of the two. The fact of the matter is, I was getting *gasp* median scores. Me! How was this happening?? In desperation, I studied harder. I began to eye my classmates with suspicion. Who was this 34501 who kept getting 97% on every test, while I, surely, an honors student, was struggling by with 87's?? Was this fair? I deserved better! Did God hate me?
But the demon of the gunner is an insiduous and nefarious predator. Slowly I had breathed life to it as it crept into my nostrils. Quietly it had infiltrated the dark depths of my growing dementia. Before long, I was possessed. I was possessed with the demon of the gunner and I had gone mad. I studied because I wanted to get honors, I wanted to get 100% on that test, and damnit, if it was not going to be tested, why learn it? I forgot what it was to enjoy being in class, soaking up the sweet medical knowlege as it was taught to me. I lost sight of why I was in medical school, of whom I had begun this whole process of education for - the patient. (I had forgotten the face of my father.) In short, I was turning into the type of physician you would never want to treat your Aunt Mildred.
The semester ended and I did not bother to check my grades when they were posted. I knew there would be no honors beside my OCED number. However: I did not cease to be. I was alive and breathing and although I began to think murder in my mind when my Mom asked me for the eightieth time, "What's happened to you? You used to love going to class!" I was still in Medical School and I still had a second chance.
To further my learning experience, I discovered, after talking to the Course director for last semester, that, although my test average was mediocre (average of 88%), my PBL instructor must have loved me because I got a 95% on that baby. Turns out, I could have gotten honors if I hadn't been so doolally. 1.6 more points would have been just enough. But I would still be mad.
This is not supposed to be about grades. In fact, this is the last time I will ever refer to my grades in a post again. It's about how I became a gunner and then learned to live again. Or, how I learned what Medical School is really all about. Or maybe even, 10 things not to do in your first year of Medical School.
Today, now, I will study because I enjoy it and because I want to learn. If I need to spend an hour of my time looking up something I don't quite understand but probably won't be tested on come test, then so be it. I go to Medicine, Patients and Society because it is an important part of my growth as a physician and not because attendance is taken. I participate in small group discussion because I care, not just to get 'noticed by the facilitator'. Because sometimes you need to strap on whenever it seems appropriate.

Break time

It is 9:45pm on a Saturday night. What is your beloved drc doing? The answer of course, studying Anatomy. What else?
It is two weeks into the semester and already we are moving at break neck speed. I have an embryology exam on Tuesday (thanks to Martin Luther King for giving me an extra study day) and my first Anatomy exam the Monday after. Yikes. Just thinking about it is making my heart race. I have not dared to take a look at the material for next week - to see it all at once, all million white stapled sheets, is to cause heart failure. Instead, I will look at it one day at a time. This way, I hope to preserve my sanity and make it out of Med school alive.
This time last semester it would be bedtime for me. I would have studied all that I had planned for the day, with time to spare. Alas. It is not so this semester. I set my glutes down at the library about 10am this morning, got up at 3pm to eat lunch and was later kicked out when it closed (it really should close later on the weekend, not earlier) at 8pm. Right now I am in the anatomy study room and I am not done with what I had intended. The debate in my mind right now is.....should I sleep late in order to accomplish my study goal for the day, or should I just set my study goal lower?
Break is over.

Anatomy 101: How to be a gunner

1. As soon as you walk into lab, begin dissection on the cadaver as though it was meant exclusively for your learning purposes. Group members not there? That's okay - they can just learn by osmosis from you.

2. Ensure that you hog the scalpel. Other student's hands were not destined for glory as yours were. Besides, they can only hope and dream of the academic heights you will attain.

3. When a faculty member comes around to see if you need help, dazzle them with your intellectual prowess. Act as though this is the exam, right then and there. This way, you are sure to be placed on their teacher's pet list.

4. If the faculty member likes to show you structures by asking questions, be sure to scream out as many responses as you possibly can in the shortest time frame. Never mind if s/he asked for a muscle - throw in a few blood vessels and nerves for good measure. Don't worry if you mention a few structures that aren't in the part of the body you are dissecting...your faculty member will understand that you are merely being didactic.

5. Insist that you correct everyone in your group when they do not know or give the wrong answer to the questions. Be patient - not everyone is at the level you are, and they may misunderstand your altruism. However, you are doing this for them. Always remember that.

6. If you can, tuck the anatomy atlases and dissection books under the cadaver where they cannot be seen. As in 5 above, you are only doing your group members a favor - how can they learn if they have the answers right in front of them? (Be sure to take a peak at the book yourself when they are not looking. This is only so you can better serve in your capacity as anatomy group coordinator).

7. Elaborate on your study techniques, how and why they work for you - preferably to the whole class. Explain that this is the tried and tested study manual for them. You will soon be publishing it and you are doing them a favor by letting them have it free.

8. Always leave the lab last. In order to be a leader, you must first be a servant. (Remember to make sure the faculty observe this).

May you continue to gun as you have always gunned.

November 8th, 2007

So I turned 23. Big whoop. Now back to studying...

Notes to self

Next week I will...

1. Go to the gym every single morning. No more snooze button. That extra half hour is just not worth it.
2. Sleep no less than 7hrs a night.
3. Not drink any coffee. No matter what.
4. Understand how to calculate volume/osmolarity/electrochemical equilibrium problems. Even if it kills me. (Possible conflict with points 2 and 3)
5. NOT spend all afternoon munching on skittles, so as to stave off hunger and keep myself studying.
6. Spend time with friends that is not study group, class, small group or PBL related.
7. Drink plenty of water. (Not so much as to change the osmolarity of my cells).
8. Organize the leaning tower of class notes and handouts placed hither thither on my floor.
9. Learn how to take vital signs properly. This "I'll do it better next time" attitude is not working.
10. Did I mention go to the gym every single morning?

The lack of sleep/caffeine dependence cycle of pain

Consider the simple medical student. He or she must strive to keep a balance between the positive and negative factors that are plentiful in his or her day to day life. These factors in the most loose sense can be defined as such:
Positive factors: Any such thing which ensures the health of the medical student. (Sleep, free food, free books - free anything, really, time at the gym etc).
Negative factors: Any such thing which may be detrimental to the health of the medical student. (Lack of sleep, stress, ultra-competitive cut throat classmates etc).
It started out innocently enough - happenings that in themselves did not pose any serious obstacle to the health of this medical student. A desire to attend Neurosurgery grand rounds the next morning; a shocking amount of material covered in lecture that day and the next; a dramatic increase in the amount of work to be accomplished in lab that night, a presentation in the next morning's class....in fact, a total of 6 negative factors combined to be the straw that broke the life-balance camel's back. A series of unfortunate events, if you will.
I worked late into the night, hoping to get both my studying for the day's lectures AND my reading for tomorrow done while working in lab. A free dinner would have been a bonus but I didn't plan on spending an hour at a meeting, no matter how good their food.
By 12am I was done studying, had completed my work, but hadn't read for class the next day nor practiced my presentation (which, by the way, is only for an informal PBL small group presentation, but if I don't practice I tend to suck at it. A lot).
Of course I had to get up early the next morning (5am instead of 6:40am) in order to avoid the slippery slope that is Falling Behind In Medical School. (A catastrophe of cataclysmic proportions) I did my reading for that day's lectures and practiced my presentation with time to go to the gym. In order to stay awake during lecture, however, the smoky brew of coffee was necessary. With even more lectures gushing forth material surely to be covered in the next test, lab work, studying and reading to be done, the allure of the brew became too strong to resist.
Now, one week later, I am slowly weaning myself off the brew and enduring many a gaping yawn. I'll see how next week goes...

Cells are awesome

In doing my reading for tomorrow's classes, I stumbled upon this delicious fact and I just had to post. Generally speaking, the more complex an organism tends to be, the larger its genome (the total amount of DNA in its cells). Yet, while the human genome is 200 times larger than a certain species of yeast, it is 200 times smaller than a certain species of amoeba. Yes, amoeba. Those amorphous jello like creatures with water for brains.
How amazing is that??
One more thing....each human cell contains an extraordinary amount of DNA. If stretched end to end, this DNA would be 2m long. But, deadrocketcow, you say. The cell is so small, how does all that DNA fit in there? The nucleus of the cell with a diameter of about 6x1o^(-6) - 6 millionths of a meter - achieves this remarkable feat by creating a series of supercoils and loops of DNA, all bunched up tight. This, according to 'Molecular Biology of The Cell' by Alberts, is 'geometrically equivalent to packing 40km (24 miles) of extremely fine thread into a tennis ball!'
If that doesn't make you almost vomit with excitement....I dunno, you're missing out on the fun.
And since I am posting even though I should be dilligently reading....we had our first Histology lab on Wednesday. It was cool to see sections of duodenum and liver and trachea and actually get a visual of all the stuff I read about in text books. When I realised that those pink stained dots in the cytoplasm of the liver cell were actually pink because of a stain for carbohydrates and connected that with learning 'the liver stores glycogen' in the text book, I had this huge burst of excitement. Glycogen! I almost yelled. It has to be glycogen!
And then....we looked at electron microscopy pictures of the very same liver slides, and we could actually see the rough endoplasmic reticulum with the *gasp* ribosomes sitting right on it. It felt like I had been given private access to a secret world, one that I could only have imagined. Awesome-ness, I tell ya.
Back to reading late into the night, with possible over-sleeping rammifications for tomorrow.

Random thoughts

I had my first test today. It was short - (12 questions) - more of a quiz than a test, but still. I studied hard and I am glad I did. It required quite a bit of thinking what with the pKa's of amino acids and different pH environments. I had immediate gratification too (or not), because we went over the answers together in class, as this was only our first test.
I was angry with myself, of course, because I missed a question I ought to have gotten correct. If only I had.......but of course 'if only' doesn't count. A wrong answer is a wrong answer. How many times must I tell myself not to obsess over having made a mistake, but rather focus on learning from that mistake and moving on? And when will I truly believe that I am learning material so I can better understand the basic science behind disease (hopefully to be a great physician) and not just to ace an exam? Give me strength!

In other news....I work in a lab at night in the hospital affiliated with my school and I often have to pick up samples from the nurses. Last night, I was standing at the nurse's station waiting for one of the nurses to come back from seeing a patient. I was looking around at all the neatly labelled files and cubbyholes wondering what 'patient request form' and 'meal agreement' meant, when I happened to see 'report of death'. For a moment I was stunned. How could such an appalling proclamation be so casually placed next to 'meal agreement'? How could one line mean so much? I wondered how many families had been affected by the filling of that report. Was there someone right at that very moment heading towards being another name on a piece of hospital stationary? Of course I know that many people die every day in hospitals, and yet, seeing a visible and tangible reminder of that fact was somewhat of a shock.

I have three more allosteric enzyme inhibitor drugs to understand, *cough* memorise *cough* before I sleep.

On traffic lights and making it to class on time

So far, every morning for a week and a half, I have woken up at 6:40am so I can squeeze in a half hour at the gym, eat breakfast and make it on time for my 8am class. On each of these days, I have left the building where I live at 7:50am (give or take 5 mins - mostly give) and turned right to walk down the block toward the traffic lights. Every single time this happens, I am forced into stress mode. Why is this? you might inquire, with raised brow. Let me tell you.
The light is always red. The little stick man in white is on, telling me it's okay to cross the road. He's giving me the right of way. No mind that I am halfway up the block at this point. Who cares that I am right at that awkward distance where I can't really give up on making the light but I am just a little too far to make it without breaking into a run? Not you little stick man!
There I am, thinking furiously in a panic, 'Should I walk faster? Can I make it in time?'
I break into a stride, with my eyes fixed on the road. I am picking up speed, navigating my way around parking attendants, innocent bystanders and incoming people traffic. In my head, a mantra is being repeated 'Please don't change, please don't change, please don't change'. Will I make it?
When I am a few feet away from the curb, when I am almost certain that I will, in fact, make The Light this morning, the orange hand flashes.
Yes...this happens every single morning. I falter, all my fears confounded. What now? This is too much to bear! If I cross, the lights will surely change mid-peregrination, putting me in the direct path of 50 raging yellow city taxis. And yet...do I dare...?
I tell you, I die every morning.

Disturbing

I hope this (or something similar) doesn't happen to me.

I make this vow freely and upon my honor

Some of my favorite moments during Orientation (which ends tomorrow) thus far have been little, seemingly insignificant things.
Monday night I saw the statue of liberty up close for the first time. It was an awe inspiring few minutes. Looking upwards from the boat, with my mouth slightly agape, I couldn't help but feel inspired. The hand held aloft, the many folds of her robe, the seven pointed crown and the sheer enormity of the statue combined to reduce me to a revered silence. There was no way to capture that moment, nor would a picture have done it justice.
My white coat ceremony was a small affair, with parents, friends and significant others invited. We were seated alphabetically and after a short speech, were called down to the front in fours where faculty helped us into our coats.
Right before we walked down, the dean of the College read to us the WCMC version of the Hippocratic Oath. I found myself thinking about how sacrificing the calling of medicine is and how, right at the very beginning, we are expected to lay aside our personal differences, in order to learn to serve patients with selflessness and humilty.
Especially thought provoking was the last line of the oath, 'I make this vow freely and upon my honor.' I was not coerced, or sweet talked into applying to medical school. I decided on this career because of my interest in learning about the body and a desire to be of service to others in need. Every action I make during the next four years of medical school must be done with this goal in mind. And in order to keep this in mind, I must not forget people.
I have hope that learning to be my best, whether it be from my classmates or admitting my mistakes, rather than ignoring everything save my grades or position in class will be my main strength.

New time, new direction.

I was on the phone with my Mom a day or so ago, excitedly telling her about the short white coat I recently aquired at the Student Affairs office. With the coat came free medical advice/inspiration in the form of a book titled 'On Doctoring' and information on Orientation week which starts on the 25th. She suggested that I remember these few days before the start of medical school. I think this is excellent advice.
In a few weeks, when I am bogged down with how much studying I have to do, how there is so much minute detail to be committed to memory and when I am questioning why I would subject myself to such torment, I can read this post.
Yes, I am a lowly MS0 (a term recently gleaned from many odd-hours spent reading through Student Doctor Network medicine forums and medical blogs) but I can't help it. I am incredibly excited. I cannot wait until the first day of class. I cannot wait to meet my new classmates. I am psyched and I am pumped - just writing about it has caused a huge grin to appear on my face. I can't help but feel I have been waiting and preparing a long time for this moment.
That said, I know medical school will be tons of work and discipline. I know that I will often be stressed and impatient with myself. This is part of the reason I chose WCMC, because it has a reputation for being laid back and less stressful than the average medical school. (Cross your fingers).
So...in the interim, I will continue to be delighted when I find a new medical student/resident blog. Although I have restrained myself from reading through my Undergrad biology text books, I am severely tempted. I am relaxing as though there is no tomorrow.

Christ brings me sunshine in winter

In Grade 11, a few weeks after prefects were selected, my classmate died. We had been friends on and off when we were younger, and sometimes studied for the Grade 7 exams together, but as we got older, we drifted apart into different circles of friends and became acquaintances at best.
She got sick and I, like the other people in my class, thought nothing of it when she did not come to prep that night. She was just one more person who had the misfortune to get malaria. We all assumed she would get better. And she did get better, at least - for a short while.
I passed her in the corridors, a Friday, as I made my way to supper. She had just taken a shower and was walking to her room where she was a prefect in charge of 10 girls. She was wrapped in the brown towel she always used. I glanced at her, wondering if I should offer to get her supper. Instead, I asked if she was feeling better. I can't remember what she said, but I know she smiled. I smiled back and that was that.
I wonder now, if something extraordinary inspired me with that moment of altruism. I wonder now, if it would have made a difference had I offered what I intended. What parallel universe would I be in now? Would I, in just three short weeks be starting medical school? Would she be dead?
She swam in the school swimming team, was cute, bubbly, short. A popular girl with popular friends. She was light skinned, paid attention in class and got good grades. My mother knew her mother.
I was sitting on my bed one night, when a day scholar spoke into the window, giving all of us in the room a fright. "[B.....] is dead, you guys". I stared stupidly at the window. She had just gone home that weekend. I had seen her, smiled at her two days ago. But it was true.
That week we had a memorial service for her. I sat in the hall, thinking about the nature of death, the fragility of life for the first time. Just like that. She was dead. I kept thinking, I saw her on Friday, smiled at her. I saw her.
I thought of her parents, having lost their only daughter. I thought of her brothers, having lost their only sister. She was only 15. Yet, her life was over. In days, she would be buried and there would be no more [B.....]. In a few years, she would be reduced to bones in an uncaring earth. I couldn't get over the finality, the suddeness of what had happened. Even now, it makes my heat skip a beat.
At the funeral, I saw her in her coffin and for the first time I cried. She was laying there, in her makeup, in her church dress with her eyes closed. She could have been sleeping. Her mother was there, crying. I wanted to say something, but could not find the right words. It was so unfair. So unforseen. Whenever I remember the song we sang on the bus there, I grow cold.
I think of her mother now, 6 years later. Does she grieve? How could she possibly have gotten through such a time?
I think of [B....]. What would she be doing right now? Where would she be?
I remember singing on the bus. I can only remember that one line, "Christ brings me sunshine in winter".
I remember her.

Yes, I'll have the Terry Pratchett with a side of Tolkien, please.

I just got done reading Stone of Tears (again), the second book of what is now an eleven part series called the Sword of Truth by Terry Goodkind. For those of you who are ignorant in these matters, I urge you - proceed to your nearest bookstore and purchase Wizard's First Rule. If you are unsatistfied with the contents, I will refund you the full price of the book, no questions asked.*
This renewed desire to read all things fantastical and magic was born after July 21st, (which I am sure you know to be Harry Potter Day) when I consumed Harry Potter and the Deathly Hallows. What should I read next? I am left with a lingering desire to immerse myself in lands filled with mythical beasts and the continued battle of good versus evil (may the good spirits protect us). Perhaps I will go ahead and buy Blood of the Fold (again) after having left most of the books half way across the world.
Or should I venture forth into unknown territory in order to feed the beast within? I do not wish to be disappointed...the buying of an atrocious book is a grave error that cannot be undone.
Perhaps a little science fiction (can you say Asimov?) to whet the palate. Maybe a short foray into the Dark Tower series for a little comfort-read. Then a sweet treat of a Discworld novel. So many books, so little time...

I need something to read. Something new.


*Let it be known that the above mentioned statement is null and void. deadrocketcow will not be responsible for any claim or request of refund be it in money, store credit, or objects of equivalent or lesser value. Sucker!

No more music

He was sitting there, as he had always sat there, stooped and grey, in his faded yellow armchair, with his hands folded neatly in his lap. The light from the faux chandelier turned his carefully combed strands of hair into gleaming wires of hair gel. With his meticulously pressed shirt, trousers and spit shined shoes, he could have been a walking ad for personal cleaniness.
Softly, in the background, a record was playing. The same record that had been playing for the past 7 years since Maggie had been taken away pressed on and delivered its soothing melodies. In the dimly lit room, with the chairs around the table arranged just so and the framed pictures on the mantlepiece lovingly positioned, the record could have played forever in an endless loop. Time, it seemed, within these four walls, had stood still.
What had become of those people whose pictures were so lovingly polished every night without fail under the dining room light? Who were they, these ghosts that carried within their every cell half a copy of their lost father's dna? And where were they now? Where were they?
She sighed. He must have fallen asleep after his evening meal. She reached forward to clear the table. The bowl of soup in front of him, however, was cold and untouched.
Somewhere, in the back of her mind, a voice told her what she already knew, but she had to confirm. With two fingers on the side of his neck she was sure.
In the sparse and scrupulously cleaned room where he had played his records all those years, she lifted the stylus off the spinning record and silence filled the air. There would be no more music.

Classes? Yesterday's headlines

Yesterday, at 10:45am, I put down my pen, got my stuff together, handed in my exam and walked out the door and into freedom.
Well...it was really two doors and two floors, but who's counting?
Ladies and gentlemen. In as official a tone as I possibly can manage of an un-official matter (it's not official till I am clad in cap and gown) I do declare that my undergraduate education is over.
Now don't be jealous. You'll have your moment. In time. Smirk.
And yet, although it has barely been 24hrs since the discovery of this freedom, I find I am already bored. I guess studying for class does have its uses.
So...what to do? Should I go invade the library of all its books for one last time? Take up residence at the Omac and bid a slow farewell to the cybex weight machines? Or discover my inner party whore?
I think I'll flip a coin. Or a rubik's cube, on account of having more than two options.

Can you flip a rubik's cube?

I kill with my heart

I do not aim with my hand; he who aims with his hand has forgotten the face of his father.
I aim with my eye.

I do not shoot with my gun; he who shoots with his gun has forgotten the face of his father.
I shoot with my mind.

I do not kill with my gun; he who kills with his gun has forgotten the face of his father.
I kill with my heart.

-Gunslinger's Creed