Monday, November 30, 2009


Yesterday I volunteered at the Opthamology Specialty Clinic at the Arbor Free Clinic. Most of the patients we saw were there for a diabetic retinopathy screen, if you have diabetes, you should have your eyes examined once a year to check the blood vessels in your retina, because if there is any sign of early hemorrhages or extra vessel growth, you can have surgery to avoid blindness in the future. It's one of the modern miracles of medicine. Previously, diabetic retinopathy was able to be diagnosed, but there was no treatment, now with early diagnosis and surgery people are able to retain their vision before it is even impacted. Opthamology is neat because so many gadgets are involved, I had a great teacher, Dr. Shahinian.

Now back to the library to study the derivatives of the ectoderm, somites, and limb development....

Wednesday, November 25, 2009

Scrubbed in to my first surgery!

Luckily it wasn't "my" surgery. I got to scrub in on a lap chole this morning at the VA (laparoscopic cholecystectomy aka removal of the gallbladder). To say the least, it was AWESOME. I got to maneuver the camera for most of the time. Surgery went smoothly, patient should be out of the hospital in time for Thanksgiving dinner tomorrow. Now THAT is something to be thankful for!!!

Tuesday, November 24, 2009

Sad day

I shadowed rounds in an inpatient oncology ward today. It was so sad. My heart absolutely goes out to all the individuals and families battling cancer. I had the unfortunate opportunity of witnessing a death today, she had fought breast cancer for 5 years and that battle ended this morning. Life is not fair, nor just.

Monday, November 23, 2009

Humans: Are we like differentiated cells or stem cells?

Disclosure: Yes, I'm studying over Thanksgiving Break. I must. I spent too much time working on cool projects rather than studying the last month and now my break is paying for it. At least what I'm learning is interesting!

Humans as differentiated cells
Do we start out all equal, capable of anything and everything? Then, over time, progressively restrict our goals, hopes, opportunities and dreams?  Does every little choice we make steer us towards our final destination, in sequential order? Meaning that if we didn't make choice A and B first, then we couldn't arrive at C?


Humans as stem cells
Not only do we start out with the world at our feet, but we have this ability throughout our lives. Are we constantly capable of reinventing ourselves? With the right mix of opportunity and timing, can we become anything we want to be? We can self-renew, be bold. But we need might need the right environment, the right parents, the right nurturing in order to have this ability.

I love biology metaphors. I think we might be something in between. Mostly differentiated cells, but under the right conditions we can be changed into stem cells, like inducible pluripotent stem cells!

PS. I shadowed Dr. Verghese today, it was pretty much totally awesome. Tomorrow I'm going on oncology rounds. So thankful for these learning opportunities...

Saturday, November 21, 2009

Schools out!

Sort of. I still have my final exams the week of December 6th, BUT I have no more classes until January!!! How lovely :) This week I will be shadowing in the OR, catching up on Dev Bio, shadowing some hospital rounds, and making sure I know all my anatomy. And of course, celebrating Thanksgiving!

Since I've finished up my classes for the quarter, let me reflect:
Anatomy: The smell got worse, not better, over time. I think I like real people a lot more than dead people, which is why I'll take surgical anatomy next quarter (unfortunately still dead people).
PoM: Brushed up on my quant skills, feel more comfortable analyzing the statistics of research papers. I have my basic taking a medical history skills down, but still need a lot of work!
Genetics: Still want to get my genotype sequenced, all the fear-mongering didn't work on me.
Dev Bio: Development is just really cool and fascinating
Cost Effectiveness Class: Presentation completed! I can't get away from approaching all topics from a cost benefit or cost effectiveness perspective now that I know about it.
In all: I don't feel like I am now 1/6 prepared for the boards or my clinical years, but I am much more knowledgeable of my ignorance, and much more exciting to dive in to more shadowing and volunteer opportunities. I look forward to working with patients every single day. I still believe that this is 100% the path I'm supposed to be on. I still love medical school but am very thankful for the break!

Monday, November 16, 2009

Today was a fabulous day

I love my life. Today was a great example of why that is. I start class at 8am, to hear about the history of Exubera, the first inhaled form of insulin, from Rob Chess. Then I work on a project to understand the costs and benefits of IVF with blastocyst or two, for several hours, arguing over what the analysis is sensitive to. Then I race over to the Palo Alto VA to shadow my E4C mentor, who is Chief of Internal Medicine, get to see the amazingly cool VA electronic medical record in action as well as meet with a patient and learn about a bladder ultrasound. From there I race back to campus, singing to the country music on the radio, to grab a quick lunch and meet up with my group to discuss Project Easy, an initiative to include patient safety and quality improvement into Stanford's medical education. Then I get free, delicious dinner, learn about Stupak's abortion amendment that is currently in the House Health Care Reform bill, listen to my British anatomy professors tell stories of their experience caring for women in Britain who took the choice to have an abortion into their own hands before medical abortion was legal, and write letters to my senators, Harry Reid and President Obama urging them to allow the public option and insurers taking part in the national insurance exhange to receive government funding for safe abortions. Today was a fabulous day.

Thursday, November 12, 2009

Knot Tying Skillz

I learned how to do a surgical square knot today, one-handed and two-handed. It's really fun, and very similar to cross-stitching and needlepoint.

Wednesday, November 11, 2009

Got a New Book in the Mail!

My order came in, my new nighttime reading is Walking Out on the Boys, a true story written by Dr. Frances Conley about her days as a neurosurgeon at Stanford and what lead her to resign from her tenured faculty position.

Tuesday, November 10, 2009

Time flies

I'm in disbelief that there are only 6 more days of class in my first quarter of medical school. Does time really past that quickly? Will I really have learnt 1/6 of what I need to learn before starting clinical rotations (answer: no, they take it easy on students during the first quarter!). I still haven't figured out an adequate schedule, a way to continue running, to study effectively, to not go crazy but also not get behind. But, I am enjoying all my classes still, I love getting to know my classmates, figuring out all that there is at Stanford. Stanford is amazing, there are so many opportunities, areas of research, talks, seminars, volunteer opportunities, it will take me at least a quarter to figure out all that is going on here before I can start to hone in on what I would like to work on, devote myself to. Tomorrow I get to learn knot-tying, Saturday I'll learn how to "scrub-in" to surgeries. Now when I look at someone's arm, I can imagine all that lies beneath, but when I look at someone's face I just see it as a normal person would see it. I'm both humbled and nervous that this ability to view the body as a "normal person" does is leaving me, week by week because of anatomy lab. It's getting chillier here in Northern California, but boy do I like it when "chilly" is 50 degrees and not 30! A Cartoon Guide to USMLE Step 1

This is a shout out to one of my dearest friends, Lilly Zhang, who recently created a website to help medical students prepare for the USMLE Step 1 Exam (giant standardized exam taken at the end of 2nd year). Check it out!!! Let me know what you think!

Friday, November 6, 2009

Oh boy

Med School final exam #3 is tomorrow morning. Up to Bat: Biochemistry, aka Hyperammonemia, Hyperglycemia, Myoglobinuria, Lactic Acidosis, Methemoglobinuria, ketogenesis, Glycogenolysis, Gluconeogenesis are all on the brain tonight! I think I like biochemistry after all, it's really interesting to learn how all the pathways intersect and the ways in which different diseases present (and now I can understand why that is!)

Can you tell I'm having a little too much fun learning all these long funny sounding medical terms?