Most of the people in my med school class were born in 1984.

I started talking to one of them last week as we were coming out of the subway station. Out on the street, in a large group of harried med students he asked "Do you live alone?" and without hesitation I said "No, I live with my partner."

He made a sour face. It was subtle yet unmistakable. I was surprised because I'd said it so many times since school started and no one had reacted poorly. He regained his composure quickly, stammered for a second and then we were back on track. But I was bothered by it, and immediately began to wonder about his. sexuality. He professes to be straight..

He might be. But he's definitely also homophobic. He told a mutual friend that he thought it was "weird" that I said what I did when he "didn't ask." She asked him what I was supposed to say in response to "Do you live alone?" He didn't have an answer for that.

The conventional wisdom is that extreme homophobes are closet cases. That might be true in this case, but I resist that explanation because it seems to let him off the hook somehow. I don't care if he's secretly gay or not; I just didn't appreciate that sour look.

Speculating on the reasons for his discomfort got old after a few days and so the mutual friend and I have decided to stop pursuing a friendship with him. Not that I have time for a new friend, anyway.

I hope he's going to deal with his issues, though, because I'm guessing his gay patients aren't going to want to see that sour look cross his face. 1984 wasn't that long ago. I guess maybe I should cut him some slack.

 

I exercised today. Only 15-20 minutes at 6:15 this morning, but still... it was something.

I put in 13-1/2 hours at school today and went home feeling like it wasn't enough.

It reminds me of working on a film production (the long hours, the camaraderie with a big group of people going through the same torture you're going through, the constant crisis management) except I could do that job with a hangover; I didn't have to try so hard to be mentally sharp all the time. And I got paid.

It's 11:07 and I can't go to sleep. Because then it'll start all over again tomorrow, only Friday will be one day closer.

 

I was going to do a quick video blog, but then I saw an image of myself and decided against it. I look a bit frumpy at the moment.

I think the quiz went well. I was certainly in a better mood once it was over. I even introduced myself to a classmate on the subway and had a long chat with another guy I'd met during orientation week. Drew and I went to the Jersey Shore (do you capitalize that?) and now I'm feeling -- once again -- like I'm behind and I'll never catch up.

So I probably shouldn't be writing this blog entry.

I studied so much for Friday's quiz that I didn't read the handout notes for the leg and the ankle and the foot. Which we'll be covering in tomorrow morning's conference. It's only thirteen pages, but there's so much information in every sentence it'll probably take me four or five hours to digest it properly. Then I'll get to conference and he'll throw up a powerpoint slide and say "What's this structure?" and I'll have no fucking clue what he's talking about. And yet half the class will mumble the answer as though it's too obvious to waste their breath with a fully articulated response.

Okay, I've had too much caffeine. The anxiety level is a bit too high in here.

Back to work now.

Oh, there was one line in the handout notes for the lungs that I thought was funny (warning: funny is obviously a relative term when used in reference to a gross anatomy handout): "Obviously as any fluid accumulates within the pleural cavity it will compress the lung and embarrass respiration." Embarrass respiration? I kept staring at that phrase. What the hell? Embarrass? But, in fact, my paperback Webster's dictionary listed "to impede; hinder" as the second definition of the word.

Yeah that's really not funny. I found it amusing in the moment, though.

 

Quiz #2 is tomorrow. Today was exhausting. I went to class and then lab and then I studied for eight hours. Drew's tired and wants to go to sleep but I need some time to unwind. I have to write this quickly, though. It's almost 11:00 and I need to be up by 6:00.

This morning when I got down into the subway station the express train was on the adjacent track. I'd never taken it before, but I saw some classmates on it so I thought I'd give it a shot. It was a bit awkward because I've never talked to them and I was so tired and all I wanted to do was watch an embryology lecture on my iPhone. So I didn't talk to them. I smiled at the one girl I recognized from anatomy lab, but I never said a word. Is that rude?

I don't know. I have a large group of people I'm friendly with and I just can't keep up the chitchat all the time with everyone else. There's so much anxiety out there (I've got lots of it, too) and usually people want to bond over that. Which isn't exactly what I want to deal with at 7:15 in the morning.

It got more awkward when we got to our stop, though, because I'd never been to that subway station so I didn't know where to go. So I pretended to search through my bag for something (or maybe I just took my time putting my iPhone away) so one of my classmates could take the lead. Then when I saw what direction they were heading I just took off and walked to school alone.

At the time it just seemed like an example of my social discomfort. Now that I've typed it all out I just seem like a jerk.

On that note, I have to try to get to sleep now.

 

I drank coffee after 5:00 yesterday. I slept two hours last night.

I'm exhausted.

I miss reading for fun. I miss exercising. I have to figure out how to make this work better.

My first exam is in ten days.

 

Week one is over.

It's so much more work than I ever imagined it could be. I love the way my anatomy class is structured, though. We prepare for dissection by reading the handout notes I showed in the previous post. Then we go to the lab and do the dissection and the lab instructor comes around a couple times and peppers us with questions ("What nerve supports this muscle? Which muscles control that movement?"). The next morning we have a conference in a small lecture hall with about forty students and the instructor calls on people with specific, more detailed questions about what we dissected previously. Then we have to go back to lab and show other students what we dissected and which parts are most important (a session the school calls "cross-teaching").

I explain all that just because it shows you how impossible it is to hide your ignorance in medical school. If you answer something incorrectly during the dissection you feel a little embarrassed. If a classmate asks a question during a cross-teach and you don't remember the answer, you think "Crap, I need to re-read that section." If the instructor calls you out during conference and you have to say "I'm not sure" and you're the only one who has had to say that all morning, then suddenly you don't have a problem studying anatomy for the next eight hours. It's totally different than the premed classes I've taken, in which you could hide your ignorance for a couple weeks and then cram for an exam. I like it, though. It keeps the pressure on everyone but not in a bad way. The instructors are all very nice about it. "I don't know" is actually a completely acceptable response, and if you do the work then you're always going to be on the same level as your classmates. It feels overwhelming at times, but the school did a good job of preparing us for this week by repeatedly telling us during orientation that many, many people have learned the stuff we're being asked to learn. It's not impossible. It just takes a lot of work.

I'm reading over what I've just written and realized that you're probably wondering what it's like to dissect a human being and why the hell I haven't mentioned it. That's been less of an issue than I assumed it would be. I guess that's because we're all so concerned with understanding what we're being asked to do and making sure we can keep up with the pace of the class. Also I guess there's already a certain amount of clinical distancing involved. I try to focus on what I'm dissecting at the moment without thinking about the fact that this is someone's parent/child/spouse. If I couldn't have that distance I probably wouldn't be able to do the dissections. It's hard to think about the person's family, and it's impossible to allow my mind to wander to the more profound issue -- the fact that until very recently this was a person and now that person is gone. All we know about our cadaver is her age at the time she died, her "ostensible cause of death" and her occupation. I will admit that I've had a couple of difficult moments. The bodies have been embalmed and so they're very wet. Every once in a while we have to flip them over in order to get to a particular area. At one point we turned our cadaver over and as we set her back down onto the table I got splattered. On my lip. Also, there was a day I had to remove something and as I did so I felt a wave of emotion that took me by surprise. They told us during orientation that we should feel free to talk about the feelings that come up during anatomy lab, because it would be abnormal not to have emotional reactions to this process. My lab partners have been great, though. They're all very respectful towards our cadaver and treat it like the privilege it is. It is pretty amazing that we're being entrusted with someone's body this way. You can read anatomy texts for hours and you can look at drawings and models, but seeing it firsthand in lab teaches you things you can't get anywhere else.

As a whole and individually my classmates have been amazing. I'm so happy with them. I've never been with such a group before. Not only are they smart and dedicated as students, but every single one of them I've talked to is clearly going into this career for the right reasons. It's inspiring, honestly. That's probably the biggest surprise of the week, because several of the more senior students I'd met previously had left me feeling somewhat less than inspired.

Drew and I went to New York today. I didn't study after yesterday's quiz and I only studied a couple of hours today, but I think it was a good thing. I think a good solid day of studying and one-and-a-half days of relaxing with Drew is probably the right balance.

We took the train to the city. I thought it was a two hour train ride, but it ended up being three hours. Our friend Helene was in New York so we met her at MoMA and then bought sandwiches and had a picnic in Central Park. I made plans to go out to Brooklyn to see my friend Molly and her family but we lost track of time and then Helene said it would take us close to an hour to get out there and we had to cancel. Madeline was alone at home and we didn't want to leave her more than 10 or 11 hours.

It was a great day, though, and a perfect ending to the week.

 

Addendum (from a month later): I do realize now that the posterior triangle is part of the neck (not part of the back as I mistakenly say in this video). Oh, how much a month of med school has taught me....

 

Mild panic. Only mild. I need to try to control it, and part of that control lies in not talking about it too much.

It started with the reading assignment for our first anatomy class on Monday. Words are thrown around that I'm not comfortable with: articular, morphological... the context doesn't always help. An excerpt: "Internal (medial) and external (lateral) rotation involves motion of a part around a superoinferior or vertical axis which is typically the part's long axis. Turning the anterior aspect of the part inward or medially is called internal or medial rotation, while turning the anterior aspect of the part outward or laterally is called external or lateral rotation."

So hard to picture, to form an image. And in seeps the panic.

Practice helps, and luckily I remember having this feeling before. Biology 220 was practice, I suppose. You have to be introduced to the lexicon. There's always that uncertainty in the beginning. At least that's how I'm comforting myself.

Yesterday they sent all of us home with this box:
There's a human skeleton inside. I took it on the subway. Only the first of many bizarre, bloggable things that will happen this year.

 

It started at 6:30, when I woke up to discover that my head cold had not gone away. Drew got up with me and made me a delicious breakfast; doubly sweet because he's not feeling so hot right now either.

I tried to play it cool, like this was any other day. I read the newspaper online. I drank some coffee. I took Madeline on a walk in the rain. It was kind of a silly charade; a routine can't be built in one day, and this day was anything but routine. Still, I tried to pretend.

I didn't want to get there too early, because I wasn't feeling well and didn't think I'd be able to make a good impression. For the past several days I'd been thinking about how I would handle myself with my classmates. I decided that I wouldn't make any judgments based on what happens this week. We're all under a lot of pressure and sometimes people let their nerves get the best of them. I decided I'd let my friends emerge from the crowd over time. Also, I didn't want to tell everyone I worked in reality television. It's too easy to brand someone early on, and I was pretty sure "The Guy Who Worked on That Tyra Banks Model Show" wasn't the brand I wanted. I love that show and I loved my job, but it's not exactly a credential that will get you far in the field of medicine.

I got to the subway at 7:50. The continental breakfast started at 8:00, and the dean's speech started at 8:30. I was cutting it close but figured I was still okay. Then, at the subway station I found out that you can't buy Septa passes with credit/debit cards. You have to have cash. So I went back out into the rain to find an ATM.

I got to school by 8:20, though, and everything was fine. I chatted with a few people.

Then, I was outed. Thirty seconds into the dean's welcome speech he said, I swear to Jesus, "There is one student I'd like to point out if I could. One of your fellow students was an editor, or a copy editor, in reality television. Is he here?" It took me a few seconds, because when he said "copy editor" I was thinking this person worked for a publisher or a magazine. Then I realized he was talking about me. Then I debated whether or not to raise my hand. All of this while the dean was searching through the crowd. I figured I had to fess up, so I sheepishly raised my hand and it got a nice laugh. I guess it's all fine. I don't think anyone will define me by that job. It did make it a bit easier to introduce myself to people later on, because most of them recognized me by my gingham shirt. And there are Top Model fans everywhere.

(The banner above the street is welcoming the Temple School of Medicine Class of 2011. I could have taken a clearer photo but then everyone I was with would think I was a dork.)

The rest of the day went really well. I felt exhausted by 4:00 so I went home before the end-of-day reception. I really liked pretty much everyone I met. People were so friendly and happy. I introduced myself to people and people were constantly introducing themselves to me. I made a concerted effort to talk to the jocks, the straight guys, because I have a tendency to avoid them. They were all very sweet, and none of them missed a beat when I referred to Drew as my partner. It was so refreshing to be with such a large group of people (there are 182 students in my class) who were all so excited about what we're getting ready to do. Speaking of which, here's a look at the room where I'll spend most of the next year of my life:

 

School starts at 8:00 Monday morning.

I'm not sure in what form this blog will continue; I'm going to prioritize it, because I want to document the experience for myself.

It would be so great if I could just have a few minutes to talk with my 2011 self, so I could see if (and how) medical school will change me.

I'm so glad I've got Drew here, and that we were able to set the house up so I could start school with a firm foundation. I don't know how I could have done it without him. It's unbelievable to me that he's been so open to the changes he's gone through this summer. It's taken away so much of my own anxiety. I love him so much.

I have a head cold now. I hope to god it clears up by Monday. Our friend Sarah is in town visiting us this weekend; luckily she's a low-maintenance houseguest.

*Okay, obviously my math was off there. Or I had the wrong day. There are actually 57.5 hours left.

 

NYT: "The Senate defied President Bush on Thursday and passed a bipartisan bill that would provide health insurance for millions of children in low-income families.

The vote was 68 to 31. The majority was more than enough to overcome the veto repeatedly threatened by Mr. Bush. The White House said the bill 'goes too far in federalizing health care.'

[snip]

Senator Debbie Stabenow, Democrat of Michigan, set forth the case this way: 'As lawmakers, we have a moral obligation to provide health care coverage for the millions of uninsured children. Health care should be a right, not a privilege, and covering every child is an important step toward this goal.'

[snip]

Senators of both parties said the bill would help Mr. Bush fulfill a promise he made at the Republican National Convention in New York City on Sept. 2, 2004.

'America’s children must have a healthy start in life,' Mr. Bush said then. 'In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for the government’s health insurance programs. We will not allow a lack of attention, or information, to stand between these children and the health care they need.'"

Awww SNAP!!