Time Stops For No One

Welp, here we are again. The beginning of yet another rotation.

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I start my Neurology rotation tomorrow and judging by the email I received over the weekend regarding scheduling and the expectations of this new rotation, it’s going to be a really busy four weeks. Well, technically I’ll be in this clerkship for six weeks thanks to our two-week long Winter Break. So in all honesty, this rotation is going to be very manageable and I’ll have ample study time to dedicate to the upcoming shelf exam. However, in an interesting turn of events, the shelf exam isn’t worth as much in this rotation (only 10% of grade) as it usually is in the other ones (usually about 20-25%). Instead, there is apparently a quiz or set of quizzes based on lectures that will be given to us during the rotation that is worth 30% of our overall grade. Yeah you read that right.  THIRTY PERCENT!!! Why this is the case, I haven’t a clue. Kind of reminds me of the first couple of years of med school, with the lectures and tests and all. I guess I’ll have a better sense of what this strange curriculum is all about during Orientation tomorrow. I’m also going to be going back to a 6 AM starting time starting on Tuesday for the inpatient service this week…I literally haven’t started a shift at 6 AM since the beginning of October during my first couple of weeks in Pediatrics. That’s going to be fun.

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But then I work in the outpatient setting next week, where I’ll be starting around 8 AM! And then I’ll go back to a 6 AM start time the week after break and then alternate yet again to an outpatient setting the final week of the rotation. So as you can see, there’s going to be quite a bit of hustle and bustle in these upcoming weeks. Hopefully I don’t show up in the wrong place at the wrong time at any point during the rotation! I’ve definitely done that before in the past, and it wasn’t a fun experience. 😅😂

The Psychiatry shelf exam I took this past Friday to finish up my Psych rotation wasn’t too bad of an exam overall, although it was a bit more challenging than I was expecting. Actually, let me rephrase that. There were some tough questions asked that seemed to have come from nowhere. Tough as in I would not have ever known to review that specific material, because it was random as hell. But for the vast majority of the test, I did feel adequately prepared and I ended up having a very generous amount of time leftover to review the few questions that gave me trouble. As for the week leading up to exam day, I spent it observing psychiatric interviews in the outpatient setting in the mornings and helping out in the Emergency Department in the afternoons/evenings. Both of those settings made way for some valuable learning experiences, and I was reminded about the fact that you just never know what people around you are going through on an everyday basis.

During one of the afternoons last week, my whole class had to attend a mandatory meeting in order to discuss what scheduling for fourth-year rotations, residency interviews and Step 2 is going to look like.

Wait a minute. Hollll’ up.

FOURTH year?!? Step TWO???

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Like, how?? I’ve just recently gotten the hang of the third-year lifestyle; ain’t no way in hell I’m ready for residency applications yet! And Step 1 may have been like eight months, but that doesn’t mean that I’m all gung-ho about taking another one of them marathon exams! I don’t even know when I should take Step 2 yet, but the time is already ticking to register for both the Clinical Knowledge and the Clinical Skills parts! 😰Thankfully, the true purpose of the meeting was to just make us aware about the timeline of events that will be taking place soon and was not intended to make us nervous or anything. Regardless, I am now acutely aware that time is starting to move a bit too fast for my liking…

Speaking of time moving fast, I’m going to go ahead and wrap up this post because I need to eat dinner and enjoy the rest of my night before diving headfirst into my next rotation. One quick sidenote before I finish though. Believe it or not, I saw the Nutcracker for the first time this past weekend! To be honest, I only went because my girlfriend wanted to see it, so I got us tickets as an early birthday present for her. I literally didn’t know it was a ballet until I was on the site about to purchase the tickets lol. The show definitely exceeded my expectations, and I didn’t realize how many Christmas anthems came from this one production! I was really impressed at the choreography of the dancers, and at just how well they synced with the music of the orchestra throughout the whole show. I didn’t think that I would ever appreciate a ballet as much as I did last night, but that’s exactly what happened. We then got some hot chocolate at a nearby bakery and “enjoyed” the winter wonderland that we were left with after this weekend’s snowfall.

Be sure to have a ravishing week! And get yourself ready for the holiday season! 😄😄😄

“That which we persist in doing becomes easier, not that the task itself has become easier, but that our ability to perform it has improved.” – Ralph Waldo Emerson

– Black Man, M.D.

You Think You Got It Bad?

And just like that, it’s shelf week.

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Even with the week-long break in the middle of the rotation, time managed to fly by really fast. Like, it’s already December! We’ll literally be in 2018 at this time next month! Hopefully it proves to be a better year than this one has been. However, we gotta finish 2017 off on a strong note! With that said, I plan on perfoming as well as I can on Friday’s upcoming exam and on marching through the first two weeks of my Neurology rotation on solid footing. Speaking of the exam, I’ve come to realize that there’s only so much that can be tested on the Psychiatry shelf exam due to the fact that the specialty itself isn’t as broad as something like Internal Medicine or Pediatrics. But on the other hand, there are a TON of guidelines that are used to diagnosis the pathologic conditions within Psychiatry, so it’s important to make sure that I keep them all straight in my head. Also definitely can’t forget the various drug classes and specific drugs that are used to treat these psychiatric pathologies. As always, I just hope my study efforts allow me to do as well as I would like to do on the test!

I was on the Psych consult service this past week and our main task was to answer the questions of healthcare providers on other services in the hospital who called us to see if we thought that their patients needed psychiatric help. There were instances where we helped manage patients with conditions such as bipolar disorder or major depressive disorder, but a good amount of the calls we received were usually because of an offhand comment that a patient would make relating to suicide. In those instances, the patient tended to become annoyed that we were asked to talk to them and usually insisted that they weren’t really suicidal after we would explain that we took comments like that very seriously. Being on this service allowed me to appreciate the routine frequency of which psychiatry is consulted, commonly for reasons that we would fix with a simple conversation with the patient. I’ll be sure to keep this in mind when I work to treat patients in an inpatient setting in the future and will think twice before consulting psychiatry for something that I could probably take care of on my own.

On one of the mornings during the week, I was given the opportunity to take part in treating patients via ECT (Electroconvulsive Therapy)! You know, just like what you see in the movies where we shock people in the head with electricity! Just like FRANKENSTEIN!!!

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Okay I’m just kidding lol. It’s not really what you would expect. Yes, we did shock people with electric currents in order to induce seizures, which in turn would work to help treat severe psychiatric conditions. However, these people being shocked would lay perfectly still while the current zapped through their brain. The only thing that would move would be one of their feet, which was made possible by tightening a blood pressure cuff around their ankle. The rest of their body would be paralyzed by medications. Pretty nifty huh? We performed ECT on about 5-7 people that morning (the whole procedure would take about 20 minutes max) and I actually was asked to press the button to zap electricity into someone’s head! Guess you can call me a MAD SCIENTIST NOW!!! MUUUUAHAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!!!!!!!!!

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Something else that I was able to appreciate this week was the unbelievable power that addiction has on the lives of people. We participated in a discussion about the topic during a lunch session at some point last week, where the paradigm of “Use, Abuse, & Addiction” regarding drug use was reinforced. Interesting fact alert: If someone mentions that they could quit using whatever substance they’re routinely using or doing whatever activity they’re routinely doing at any time they want but just choose not to, they’re probably addicted. We were also taught that an addiction is almost impossible to control and that the first step in recovering from addiction is to understand that one is powerless in trying to control an addiction. A day after that talk was given, I had the opportunity to actually sit in on a group therapy session for recovering addicts. It was part of an intensive outpatient program that served as a bridge between the inpatient unit and outpatient 12-step programs such as Alcoholics Anonymous. While at the group therapy session, I directly witnessed the incredible power that this type of treatment had on these people and watched as they displayed a wide range of emotions while describing their personal experiences with the destructive force of addiction. It was such a powerful, eye-opening experience. The disease of addiction is very real. I really appreciate being able to learn from that experience and the people at the session also expressed gratitude about the fact that we as medical students are able to attend their sessions, because it forces us to understand the reality of addiction and it will help influence how we treat our future patients. I was also asked by one of the group members to check out “The Big Book“, which I’ll look into at some point in the future.

One more thing and then I’m done. Promise!

Right before writing this post, I was volunteering with the H.O.P.E. (Help Our People Eat) organization of Winston-Salem. Me and a few other classmates helped out by delivering lunches and fresh produce to the kids and adults of some low-income neighborhoods in the city. The food was stored in a big green van that we followed around in our own car and as it blasted the same New Orleans-influenced “When The Saints Come Marching In” song over and over again, kids would come running from all directions to pick up food for themselves and their families. It was like they were running to the ice cream truck…except that it was nutritious food that many of them relied on each and every week. For some of the kids, these lunch bags were the only things that they would be able to eat on the weekends before going back to school for lunch! That is so wild to wrap my head around. It’s just unbelievable that without an initiative such as this one, these kids could very well starve on the weekends. Participating in this organization for an afternoon is a required part of our longitudinal Health Equity curriculum throughout third-year, and I’m very happy about that. Requiring us to interact with the appreciative residents of these lower socioeconomic communities certainly allows for us to gain appreciation for what we have in our own lives and also shows us a perspective that some of my classmates have probably never appreciated before in real life. It also ties into the physician-patient relationship in that we’ll be able to better understand the circumstances that some of our future patients will be living in. Overall, I’m sure that the H.O.P.E organization has made a critical difference in the lives that it has touched, both volunteers and food recipients.

Alright, I’m all done now. Gotta get prepared for this last week of my Psychiatry clerkship! Y’all have a magnificent week!

“Let us rise up and be thankful, for if we didn’t learn a lot today, at least we learned a little, and if we didn’t learn a little, at least we didn’t get sick, and if we got sick, at least we didn’t die; so, let us all be thankful.” – Buddha

– Black Man, M.D.

P.S. – You probably realized that I hadn’t mentioned the Clemson-Miami ACC championship game that I witnessed in real life with my own eyes yesterday in Charlotte. It’s because I’m still grieving about the annihilation that we suffered through. It was so, so, soooo sad. Smh. Welp, at least we’re playing in the Orange Bowl. It was a good season overall. We’ll come back even stronger next year!