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4th
Year
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hey people
long time, no bup.
my life has progressed tremendously since the last time. i'm now officially
a 4th year student (aka "M4" or M-IV (if you're roman)). it's a
nice place to be. this is the sweet year of medical life. 12 weeks of vacation,
everything is elective (i chose it) and pass/fail. we're treated special and
get sent home early alot. the only bad part is all the applying/interviewing
stuff we have to do. all that residency stuff starts pretty soon where i go
talk to strangers and make them think i'm interested in coming to their program
(asking questions, laughing at stupid jokes, lots of smiling), while making
myself sound good without sounding conceited. the entire time i'm being graded
and evaluated and judged. who do those people think they are? atleast the
food will probably be good. and the worst part is that you have to apply to
a bunch, since most places only have like 6-15 spots available. i think some
residencies average 20-30 interviews. luckily family is only about 10. and
there are only about 10 in the area i want to be.
so what's up medically? (rhetorical question to self) well, i started off
immediately after 3rd year with a 2 week PICU (pediatric icu) rotation. that
was really good. i had forgotten all my peds stuff, so it was nice to have
a refresher. and i enjoy icu medicine. very thorough and you focus on every
body system (since most have multiple problems), so you have to be constantly
thinking about all sorts of things. i guess it was a little sad too. there
was another little boy that i spent the entire 2 weeks with that i'd like
to adopt (coincidentally, with the same name as the other boy from my pedi
rotation). this one had an omphalocele repair (he was born with his guts outside
of his stomach), but had a bunch of other chronic problems. he was very fat
and cute. he was jaundiced too, so he had a nice yellow glow about him. but
he was blind and had a trach tube (tracheostomy) in, so he had a sad little
pathetic cry. there was also another little girl (who reminded me of another
kid i know) who started off with a little abscess (aka "boil" or
staph infection of the skin). well, it went from her butt and spread all throughout
her blood and into her heart and lungs and bone. she had fluid around her
lungs and in her heart. it was pretty bad. i did get to put another chest
tube in though, which was neat. it's a little different with kids, since there
isn't much room to stick your finger in between there ribs, but i learned
another way. by the time we were done with her, she had tubes coming out of
everywhere - chest tube, pericardial drain (fluid around her heart), IV, central
line in her femoral vein, catheter, and she was intubated. but thankfully
she responded well and made a full recovery. so that was nice. there was another
sad little boy, 1ish, who was found not breathing by his family. we had him
on life support for a while, but he was brain dead and we had to let him go.
technically it wasn't SIDS, because you have to be under 1 year old. with
his family background, it seemed like some kind of abuse, but nothing we could
prove. speaking of horrible parenting, we had another little girl who swallowed
and inhaled some hydrochloric acid. she was 3 (i think), and sleeping in her
grandfather's bed. well, he was a double amputee, so at night he had to have
a pee bucket (homemade bedpan) since he couldn't make it to the bathroom in
time. well, apparently they cleaned it with some heavy duty toilet cleaner,
but just left it in the bucket. so the little girl fell into it one night,
and got acid burns in her esophagus and lungs and her eyes. she should be
relatively ok, but her vision might be bad or gone. luckily it wasn't an alkaline
(base) ingestion. those things are bad, and keep eating away at the tissues
even after rinsed off.
then i had a "computers in medicine" course, which, in M4 talk translated
to "2 weeks of vacation". then 2 weeks of actual vacation. it was
relatively nice. i got to go to breckenridge and play a bit; fell down a mountain
and out of a raft. good times. but i also had a test to study for - the 2nd
part (of 4) of our licensing test. i just got the grades back yesterday, and
passed, so thankfully i'm through with written tests for another year and
a half. that's quite nice. studying now is just as i feel like it to gain
knowledge. no cramming. no useless minutiae. and the next vacation i have
will be completely thinking-free (the first one of those in a few years).
then i came back to temple, and eased myself in with 2 weeks of nuclear medicine.
that's basically radiology but with weird isotopes that are probably mostly
safe (i haven't got any extra toes or super powers. yet.) the lifestyle was
great though. i got there around 9ish each morning. didn't do anything (except
play solitaire on my pda - spider solitaire is way addicting) until 11ish,
because people have to get there at 8 and drink/get injected with the chemicals,
which then have to distribute through their bodies before we can image them.
so then i'd read a few studies, go to conference (free lunch :), and in the
afternoon read a bunch more until my day ended at 3:30. very cush. and i did
actually learn what goes on with all the tests i'll be ordering some day.
and now we come to the present. i'm in the middle of a 4 week cardiology rotation.
right now, i'm just doing consults. the benefit of the consult is that you
still get to see and learn from patients, but without having to worry about
admitting them and writing all the orders and then all the discharge paperwork.
it's been really good and i've learned a bunch. lots of chest pain and congestive
heart failure. nothing terribly exciting to write about, though. we do have
an ekg class every morning which is really great. the teacher is one of those
smart, funny old dudes that are just cool to listen to. and he's like the
yoda of ekg's. it's all he does throughout the day.
other than that, i don't have much to share right now. i haven't been able
to go to church here in a while, with vacation and being in college station
most weekends. my kids promoted earlier in the summer, and i probably won't
be able to help out with sunday school this year. i was studying ephesians
with some friends until recently, when one became a surgerical resident and
our schedules got jacked up. but that was good stuff (for a while), seeing
the sovereignty of God in all things. He not only had a plan for His creation,
but He had love by which it turned out for our benefit (because it gives us
redemption and makes us holy and blameless and sons with an inheritance) and
power by which He could perfectly carry it out. and the grace by which we
receive it is also beautifully described - "freely bestowed" and
"lavished on us". i'm starting 1 corinthians now, and i'm excited
about that.
k, i've got no cute phrases or words to end with
b