Dias De Los Muertos

Yesterday was my first official day of medical school. I boarded the express bus promptly at 7:07 a.m. and made my way toward campus, loaded down with my supplies for anatomy lab: a pair of scrubs, spare socks, an undershirt and an old pair of tennis shoes. I also brought an extra pair of boxers (all of this was recommended by a 2nd year student), but that turned out to be overkill. In order to explain the reason behind all the extra clothing, I would like to quote the brilliantly talented Hugo Weaving in his role as Agent Smith: "It's the smell!"

I was warned beforehand that the smell of the embalming solution (formalin/formaldehyde) was overpowering at best. I've never really had an issue with strong odors, so I figured that it wouldn't really bother me. As it turns out, the 2nd year students weren't exaggerating. Though "overpowering" is certainly an appropriate adjective, I personally like to think that "kangaroo kicking you in the face asphyxiating" would perhaps better portray the relentless olfactory assault.

But in all seriousness, the smell really did make the entire experience very rough. The actual smell is very difficult to describe. It has that distinct "chemical" smell, and while it isn't a particularly offensive odor per se, it is super potent. I actually felt light headed for the first few minutes. And even with all of the precautions I took with extra clothes (that we leave in the anatomy lab changing room), the smell still stuck with me after I left: simply running my hands through my hair in the shower brought it back. The weird part was, even after the smell was physically gone (I took a very thorough shower), it seemed to stick with me psychologically. Every time that I even thought about the lab, particularly when I vividly pictured the cadaver, I could distinctly smell the formalin. In fact, it came back most strongly (virtually as potent as if I were actually in the room) while I was watching a video demonstration of the dissection for the following day. Clearly the smell had a profound effect on me.

In fact, the entire experience affected me more than I had anticipated. Going into the lab, I didn't think I would have any difficulty looking at/working on the cadaver. Though I had only (briefly) seen a cadaver once before, I really didn't feel like I would be emotionally moved by the experience--at least, not significantly so. However, as 123 students simultaneously uncovered 32 cadavers--and literally jumped immediately into the dissection procedure--I found myself much more taken aback than I had expected.  Now, don't get me wrong. It wasn't as if I passed out, threw up, or became immobilized with fear--in fact, I didn't even miss a beat, and jumped right in to help flip over our cadaver. Nevertheless, as I stood there, in the middle of a room filled with bodies of all shapes, sizes, genders and ages, I did feel...something. Something both unpleasant and unnerving.

So, from the very beginning, our first lab was tough. And it only got worse from there. The procedure focused on the back, which was a fairly simple dissection (in the sense that you couldn't mess anything up too badly), but VERY time consuming, especially since we were all beginners. Our first task was to remove the skin. In preparation for the lab, our instructor had told us that this should take about 8-10 minutes. So we went ahead and got started, timidly started making our initial incisions. Two...and...a...half....HOURS later, the skin had been removed. And it wasn't just our group that found the task so difficult. Though our group was probably one of the slower ones, it wasn't by much. So, here we found ourselves, fifty minutes PAST the time our lab was supposed to get out, finally getting to the actual meat of the dissection. Literally. The rest of the lab (identifying, dissecting and reflecting various muscles of the back) took almost another two hours. By the end, I was absolutely EXHAUSTED. My back hurt. My feet hurt. My brain hurt. I smelled terrible. I wanted nothing more than to go home and shower. The fact that it was hot outside made it even worse. All in all, the whole experience left me wondering how I was going to do this for 11 weeks. I had enjoyed the lecture that day, and I was really getting into the material, but I was left so drained after lab that I was a little discouraged.

This too shall pass...

And so it did. Today, my second day of medical school, was absolutely fantastic. Lecture was great once again. Though two hours is pretty long for a single lecture, it has flown by both days. And then came lab. Today we dissected the spinal cord out of the vertebral column. It was incredible. A seasoned surgeon pointed out to us during the procedure that we should enjoy ourselves, because this was the only time in our lives we would get to do/see this. I thought about it....he was right. What an unbelievable privilege. In less than the full two hours, we had finished the dissection--not perfectly, but sufficiently. But we were curious to see if we could do even better, if we could find some of the more elusive structures that we had missed. So we stayed. We kept working, we kept learning. We ended up finishing with not only a better looking dissection, but a better understanding of the structures themselves. It was profoundly enlightening. And incredibly fun. I left the lab feeling totally rejuvenated. THIS is what medical school is supposed to be.

And frankly, though I'm studying a lot, and will soon be studying a whole lot more (since we only had two days of class this week), it's not all that bad. In high school and college, I only studied for the sake of studying. I was always focusing on the next exam, the next class. Now I'm studying for practical reasons, learning things that I will be using for the rest of my life. It has a completely different feel. I never even liked anatomy in the past, but I'm really enjoying the material so far. And while I realize my enthusiasm and optimism is bound to fade--at least at times--in coming weeks/months/years, right now, this feels good. It feels right.

Freddie Mercury Said It Best...

Accompanied by my good friend Miguel de la Ryan, I made my first trek (ha ha ha) via bicycle to the OHSU campus this morning. After significant heated deliberation, we decided against attempting to ford the river (to avoid losing any precious oxen), and chose to take the Ross Island Bridge instead. The ride was actually pretty reasonable; we made it to the base of the tram in a brisk 23 minutes, with the entire door-to-door trip rounding out at about 35 minutes. I am now officially 1/30th of the way to receiving my sweet "commuter all star" $50 bicycling incentive! Woo!

On a related note, I will personally offer a 1000-point "avid reader incentive" to the first person to correctly guess the reason behind my recent purchase of the stylish eyewear seen below. LET THE GAMES BEGIN!

White Coat Ceremony

Hello there. Are you tired of your current appearance? Have you grown weary of your day-to-day routine? Does your wardrobe exude an air of apathy, poor taste and questionable judgment, consisting solely of a lackluster array of uninspired outerwear for the [insert age demographic] on the go? Well, those days are over, my clearly low self-esteemed friend! What if I told you that you could instead look just like an official, full-fledged doctor, emanating confidence and success from each and every pore? How, you might ask, is this possible!? Just follow our patented* three step method!

• Step 1: Suit and tie? 

Check.

• Step 2: Official ID badge?

Check.

Now what was that last one again? Ah, yes...

• Step 3: Spiffy white coat?

Check!



DUN DUH NUH NUH!

Congratulations! You've now joined the ranks of 'first-year-medical-students-who-are-mistaken-for-real-doctors-and-treated-as-if-they-actually-know-something' all over the country. Don't worry. I'm sure you'll catch on quickly enough.

Now that I have been endowed with my official white coat, I need only to receive my stethoscope in the mail, at which point my ensemble will be complete. Patients, here I come! I'm told that if I act confidently enough, I'll be treated like a real doctor from the very start. Empowering? Certainly. Terrifying? ...A bit.

*Patent pending

CHAPTER 1: The First Steps

"A journey of a thousand miles begins with a single step."

--Chinese Proverb

I had initially intended on starting this blog before beginning orientation, but alas, here I find myself already a failure in the expectant eyes of my (future) faithful readers. Forgive me. As a consequence, I have a few updates that need discussing. For those of you who don't know, I recently moved to an apartment in inner SE Portland so as to lessen my daily commute. Thus far the experience has been quite exciting. I'll probably post some pictures in the near future.

As I mentioned previously, yesterday, August 16, 2010 was quite a momentous event in the epic tale that I am preparing to tell you. In fact, it was the introduction, the very beginning, the opening sentence. Though it was neither the best of times nor the worst of times, it was a time: 7:57am, to be precise. Our dashing hero found himself--on time, of course--five dollar bill in hand (...no change? damn), taking his first steps onto the non-air conditioned bus to his future. As he stepped off the bus, nearly missing his stop, and walked into the atrium, he boldly announced to his peers, "Call me Ishmael." ...Or something.

Monday was the first day of my orientation to medical school. This Friday I will undergo my official "Transition to Medical School", during which time I will be presented with my very own (both ceremonial and practical) white coat. And finally, next Wednesday marks my first official class (more on my actual course schedule to come). Most of the orientation thus far has certainly been informative, though not very titillating. It has, however, been fun and exciting to interact with other students in my class (class size = 124). I have a few more days of orientation and a couple more last minute things to get in order (equipment, books, drug test), and then I will be physically, emotionally and mentally prepared to continue my journey through space and time (well, mostly just time). And you'll all be right there with me, along for the ride as my partners in crime, my faithful sidekicks, my bathroom buddies.

All in all, everything has been going really well so far and I am super excited for the next chapter of my story to unfold.

PROLOGUE: At Long Last, The Journey Begins

As most of you probably know, becoming a doctor has been an aspiration of mine for quite some time. In fact, ever since I officially made the decision to pursue medicine, my life has essentially been devoted entirely to that cause. And now, many years in the making, the day where all of my past efforts come to fruition has finally arrived: on August 16th, 2010, I will finally begin my journey into the realm of medicine. 

A good friend and mentor of mine at the University of Oregon made me assure him that, upon entering OHSU, I would give him frequent updates so that he could "experience medical school vicariously through me". Many others have made similar requests. In fact, people are constantly asking me questions about the process of becoming a doctor. And frankly, with my first medical school class mere days away, I still find my own knowledge on the subject wanting. The fact is that medical school is simply mysterious. And for many, that gives it a certain mystique, causing them to wonder "what the heck are they doing behind those closed doors, and how come I wasn't invited?"

And that, my friends, is where this blog comes in. I stand (sit?) before you today to officially offer you an invitation into my exclusive club. I decided to document my endeavors over the next 4 years so that my friends and family can enjoy the ride right along with me. Unfortunately, I can't promise that I'll have time to update often. I will, however, be sure to hit all the major events, experiences and milestones: clinical rotations, exams, boards, my first stress induced meltdown (likely sometime in the near future), residency applications, the first time I touch a heart (both beating and unbeating), mentors, friends, foes, my first diagnosis, and so on down the list...

So, my avid readers, let us embark together on this journey of discovery. Over the next few years, we shall explore the life of an everyday medical student, slowly uncovering the mysteries that await when one finds himself in pursuit of medicine.