Notes From a/Field

Act III. Scene 1 - The woes fade out slowly

2008-05-22T21:16:00.001-07:00

I've been back just over a week now. But this time it barely feels like I left in the first place. Most things went according to my grand plan for the transition to 3rd. Well, everything except rock diving* down Victoria Falls the day after the 2nd ended, and having to hobble home on crutches. I did, however, get to once again experience all the grandeur of both the Dominican and American medical systems. Let's just say that I unfortunately do not have greater faith in the latter, but that's a discussion for a later date.

I managed to register rather quickly despite arriving on the rock a few days late. Coming straight to campus from the airport, with all my clumsy boxes and stuff with me, I had to wobble across campus and through the hour-long bank line with an inordinate amount of junk. 'That was a long day' I thought as I wrapped things up with NBD.

I was stoked, thinking it was all coming to an end as I arrived at my steamy apartment around 5:00 p.m. I thought back to about 4:15 a.m. that morning, sitting in the airport terminal in Miami, burying the hatred of leaving my love in the intrigue of my first first-class seat assignment. And just as I had finished dialing back to that love, and proclaiming my safety, I began to flip some switches, and was greeted with more than just a little sweat. After 1,400 miles, 14 hours, 14 lines, a water-heater hose burst right in my face - literally. In the 15 seconds it took to get the water valve shut off, my entire apartment had become an indoor kiddie pool. I had been thinking of a shower, but this was ridiculous.

An hour and a half later, after mopping up buckets and buckets, and running a few older towels across the entire apartment floor, things began to normalize. At some point in that time frame a random guy actually came by to fix the bad hose. He finished the job, saw me and my failed attempt to turn my apartment into an ice-skating rink, and took off blazing-fast. He surely didn't want to get stuck mopping up anything. Lucky him.

Over the subsequent 3 days, I managed to catch up on the first week of lectures, and prepared for our first day of ICM. I actually managed ALMOST 2 completely normal days of class. My knee was even beginning to feel a little better, as I wasn't needing Aleve like clock-work.

And then on Tuesday afternoon, I was struck down by a good ol' Shack Attack! YEAH! Well, it's gotta happen at least once a semester. So I figure I might as well get it out of the way now. So that knocked me out of commission for another day and a half. Since, I've managed to catch up most of what I missed yesterday, and actually popped into one of today's sessions.

So at this rate, I'll be back up to speed tomorrow, and probably get a splinter or stub my toe or something on Monday or Tuesday afternoon. After that, I should be good at least until the end of the semester. As we approach that stretch, though, I'm totally getting that helmet that Chris recommended.

Oh, and I forgot to mention getting charged by mad mama cow...

...twice.

And in case you're wondering, yes, it's worth it.

Kelly, I love you with all my heart. Hang in there, I'll be home before you know it.

* rock diving : n. - the act of intentionally or unintentionally propelling one's body into or onto solid rock surfaces face-first; Eduardo went rock diving on the way down from Victoria Falls and hurt his knee, but being hard-headed, his cranium fared well.

Act II. Scene 4 - I bow my head to be cut down.

2008-02-14T12:13:00.001-08:00

So this afternoon, I took a break to walk up the hill, and down a rocky, puddled street, to get my hair cut. I waited patiently for my appointment time to come up, as I read year-old car magazines, and listened to my mp3 player softly. I considered it a break from the past week of intense studying of biochemistry of glucose and lipid metabolism, neuroscience, and GI and renal physiology. Not to mention that I was happy to be out of the anatomy lab, and out of the ischioanal fossa.

So when I finally got my chance at the chair, I politely requested my preference, and proceeded to sit quietly as I normally do, listening to the television set switched on and set obliquely above the refrigerator. BBC international went through two cycles speaking about Indian and Pakistani news. A brief aside discussed New Zealand Cricket. Then there was a long-winded discussion about Sudan, Darfur, China, and the Olympics.

Benji, the man with the scissors, asked from behind my head, "Isn't the whole purpose of the Olympics to be free of politics."

I wanted to nod in agreement but remembered the scissors at my scalp. "I totally agree. It's always about money, or politics, or something..." I mouthed with my chin against my chest. "People just don't take the time anymore." It began to rain, and the sound of the drops against the metal-panel roof echoed in the single-roomed shop.

Benji then asked me my take on the American election. I tried to explain how there was still plenty of time, that anything could happen; the whole thing had started way too early. There was some hesitation in my voice.

Silence filled the small 15' x 15' wooden building for a few minutes, except for the fan oscillating in the corner, and the rain both above, and on the short concrete path from the rocky road to the front door. The cage of the fan was rusted from turning back and forth, back and forth, back and forth, for who knows how long in this open-air business. I was content not having a drop of sweat on me. It only took 6 months.

As I was being swung around to slim down my sideburns, Benji switched to FoxNews. "I'm sorry," he said. For a moment I thought he might be apologizing for FoxNews, or for liking them. But it didn't matter, I wasn' watching the tube anymore.

Over the crackly, mono speaker, from the analog 19" CRT, came some hype-filled babble, once again about US politics, and it broke the silence between proprietor and customer.

"There's just a lot of questions that still have to be answered, and I think we have to get to know the candidates a little better - really get to know what they're saying," I said, trying to clarify and/or elaborate on my earlier answer.

In my left ear I heard half-hearted agreement, but it was more as if I spoke too fast or wasn't understood. So I thought I'd pause and listen. It wouldn't take long.

One of the talking heads said the word Clinton, and Benji scoffed under his breath. "After everything, and to have a no-name black man come out of nowhere and do that. You'd think she'd get the idea."

"Yeah," was all I could muster.

"But I bet everyone thinks Clinton was a great president, and made the country great?" The scissor-wielder came back, this time from the right.

I spoke what I thought was true. "A lot of people associate Bill Clinton with a good time in US history, with good economic times. But he wasn't all that good."

"What do you mean?" Benji asked, with genuine concern. He thought I would have instantly agreed that Bill was an almighty man.

I related that despite the economic prosperity, Clinton's presidency was mired by scandals, including Monica (which Benji brought up), mysterious deaths, and a long trail of shady business and personal dealings. I proposed to him, "Perhaps instead of Bill Clinton being such a great president, maybe Bill Clinton was just the president during a good time for the US."

And then I got a history lesson I hadn't been expecting.

"Well his regime was bad for our island." Benji came back.

It took me a second. I hadn't heard a presidency referred to as a regime. But I quickly realized it was the same difference. I asked if he could explain.

He related that it was under the direct influence of President Clinton, during a visit to a WTO meeting, that he personally influenced for the removal of a provision in trade agreements in which Dominica was a preferred provider of bananas to the US. At the time, the Dominican economy was based on bananas, and supported 75% of the population. Instantly, the market was opened up to large-scale (aka big business) producers in Central America, the international price of bananas plummeted, and with it went Dominica's economy. This was less than 10 years ago. Since, there has been an emigration of nearly 10% of the population of Dominica, simply because the economy, though improving, is apparently still playing catch-up.

"So, yes, we don't look too high to that regime." Benji said again, in a serious tone, but still managing to smile.

As I turned to look at my hair in the mirror, the lower profile made my widened eyes look even bigger.

I continue to be amazed at this world - so powerful to rise up storms, and tear down civilzations, yet made to feel so small by the actions of man.

Act II. Scene 3 - Worlds Apart

2008-02-06T14:27:00.000-08:00

In the heat of the moment, when I'm busy-busy-busy, I forget how far away I am from my love. But the days tread on, steady-steady-steady, as do I. And I remind myself why I love her so...

But that's not what brings these here words today, sirs and madams. I happen to be able to relate to you, the events of not so long ago...

Recently, I had the fortune of visiting one of the school computer labs during a rather busy time of day, and sending a host of documents into a rather long queue. As I waited for the queue to turn, and my papers to appear, I figured I would take some time and peruse the online offerings I could perhaps purchase for the impending day of romantic celebration. I sat quietly, one ear busy behind an earphone, and browsed a website selling things I had no use for, neither in medical school, nor as a man in the eyes of current American societal standards.

The voice next to me, then asked, "Who's birthday is it?"

I looked towards my right, at a gentleman I did not recall ever meeting, or ever being introduced to. "Valentine's day is on the horizon," I replied.

He looked at his analog watch, and then replied, sounding rather awestruck, "Oh, yeah, I guess it's almost that time."

At that point, I thought our pleasant conversational engagement would have ended. Perhaps it may have indulged in a formality or two.

He then turned back to me, and hoarsely said, "I'm glad I don't have to worry about that shit." He fumbled his last three words, as a child does when learning to hold a heavy object. But he spoke them nonetheless.

I was quiet for a second. Time slowed in my perception, as I attempted to conceive of a response. The reactions and collisions that occurred for me to attempt to conceptualize things in the same terms were simply too exhausting. I resorted to, "In the end, you get back what you put in."

The man, now no longer gentle, made a few more comments, attempting to make a humorous reference out of his original question, tying it to insinuations of personal preference for feminine items and privacy issues.

I replaced the second earphone... Some people.

Act II. Scene 2 - War Games

2008-02-04T14:44:00.000-08:00

About a week ago, I was walking home, keeping one eye on the bull in the field along the rocky road to my apartment. And off in the distance I heard the pounding of the waves. I'd heard and seen it before, last December, just before the gates were opened on our third trial. But it sounded more pointed this time, echoing through the night, and the moist air. Since then, it's been raining pretty steadily, so I haven't had much of a reason to venture down by the sand - expecting more of an uneasy sight than I would care for. But today, as a break from reviewing the Renin-Angiotensin-Aldosterone system, I strolled down to the beach. And as I walked along, eating an orange, over expansive piles of small, smooth rocks, and looked out at a calm, lapping bay, I stopped everything in my head. It felt right.

Luckily I brought along my umbrella in my back pocket, and the rain knew, and greeted me just as I turned to walk back. We called it a draw.

But this is just a temporary distraction.

The strategies start being drawn up as soon as I walk back through the door. I count days, review blocks, run scenarios in my head. I go about making dinner, and showering, drawing pictures on an imaginary dry-erase board, and planning it all out. There's two weeks left in this campaign, and it's a battle I must win.

Certainly there will be a battle after that one. One I will gladfully engage with all my heart. But for now determination settles about the intelligence, and makes itself at home.

ACT II. Scene 1 - They just go 'round and 'round.

2008-01-24T07:07:00.000-08:00

I was telling Kelly the other night that I seem to have forgotten my own advice not to expect too much from people over here... I don't think it's a novel dichotomy - that between the wonderfully pleasant and providing people, and those that just seem like they are in a careless, different world, it certainly can be documented back home. I just think the distance, perhaps, between the general standards of performance and expectation of service I'm accustomed, and the randomness of here, separates the two presentations so distinctly that I occasionally get flabbergasted. But I shouldn't dwell on the negative...

...It's been too too long since I've let loose some words here. I've been busy the last month or so, between the holidays, and wedding planning, and trips, and going back home, and coming back here, and trying to crack back into the books... you know how it goes...

And it just goes and goes and goes. School's getting more interesting with a more clinical slant to our classes, and a thicker workload. And now, with some sense of what was, ambitions begin, and the glimpses into the future embolden. But I work hard at what's in front of me... And the rest of the time I just try to sleep. Here's to Act II. Cheers!

When it rains, it tsunamis.

2007-12-05T05:44:00.000-08:00

I've had so many intentions in the last month and a half, some related to this blog. But most of those intentions have drowned under the workload of being a first semester medical school student, or at least the interesting experiences I've had along the way.

I probably sound like a broken record, but I literally have to stop myself every once in a while, and enjoy the sites, the cool warmth at the beach, or just the picturesque views around campus and town, which easily get hidden by persistent preoccupation with relating which muscles attach to the greater trochanter, or which of the superficial veins passes posterior to the medial malleolus, not to mention how one might calculate the LOD score of a family with an autosomal dominant disorder based on a pedigree and a given rate of recombinance. And that's not even scratching the surface. Oh wait, what do I want to eat for lunch? Yeah - that's how it goes. And before you know it, it's time to go to sleep. This is best done at home, and not in the library, face down, on top of your laptop keyboard.

And then the alarm clock goes off, and you drag yourself out of bed, put the coffee on the stove, shower to wash the fragmented thoughts out of your hair, and start the day fresh. You try to do all this in time to beat the 9:00 AM heat wave. There is no rush hour here. But by nine, the temp is sufficiently high that you'll drown in sweat 10 steps out the door. That'll slow you down worse than any bumper-to-bumper back home.

Where was I? Oh, stopping for a moment...right. So, a few minutes ago, I looked at my watch, and it said Wednesday. Well, it didn't actually say Wednesday, but you understand. And at that moment, I stopped and realized that there was but a week left before I was completely done with my first semester. And then all the highlights rushed back, as if I were watching them in 2x Mediasite. The earthquake played back a bit slower, though. Anyway...

There is so much that's been left unsaid, unseen, and to tell you the truth... I have to go study.

So much time, so little to do... wait, strike that, reverse it.

Time gets washed down with the rain

2007-10-28T20:26:00.000-07:00

I can't believe it's been 3 weeks since my last post. I mean, I guess I can believe it. But part of me can't. Part of me still relives the feeling of taking that first exam. It's still rather vivid, getting off the plane in San Juan and seeing my love again. And it feels all to real remembering realizing I was back on this island to do it all over again after just three days away.

And I've had my share of experiences since. And I keep meaning to come on here and share them, but something always trips me up. I even had a concept map of the blog in my head, and title worked out - it'll seemed like an awesome set of vignettes. Maybe I'll hold on to them and publish a book one day.

Interestingly, as I look down the barrel of my second set of exams, I feel eerily like I did the first time around: excited, sick to my stomach, and ready to get exhausted, all at the same time. But I'm a bit wiser now, and I'd even venture to say, a bit stronger. And I'm that much closer to making it happen, and coming home to my love.

So here's to another lap around the muddy track. ¡Salud!

Goals become memories.

2007-10-08T13:02:00.001-07:00

So I'm sitting in an unusually quiet library, having just taken my first Mini Exam, and I believe I may be getting a fever.

There're flyers posted around campus using words like booze, cruise, keg, party, late, night, etc., etc.

And somewhere inbetween, I'm trying to reconcile the accomplishment of actually getting through the first exam (I counted 4 emtpy seats, oh, and I think i did alright), with not only my present ill-health, but with the workload lingering just around the corner. Oh, and to add to the mix, today happens to be one of the most beautiful, clear, warm days since I arrived on this island 7 weeks ago.

Maybe I shouldn't think about how tomorrow I have an intricate dissection of the hand. And that there's still some PBL research, related to necro/azospermia, success of ICSI, the economic and psychological aspects of infertility treatment, and the ethical perspectives related to ART, that I've been putting off. Or the fact that I have lecture tomorrow morning too?

Perhaps I shouldn't jump straight into implementing the methods, strategies, and techniques I've developed over the last 5 weeks to help improve my comprehension and academic success?

Maybe I should just go buy my groceries, make some soup, and rest my stinging throat, stuffed sinuses, and thick head?

Hmmmmm, studying nonobstructive azospermia or resting and eating chicken soup? Tough choice.

I know, I'll do both. Haha, I love it!

Whoever said you have to love this plight was not wise, nor smart, but was speaking from divine inspiration. To those who support and defend people who have chosen this path, divine blessings surely grace you. And from that perspective - a goal today, a memory yesterday - all of it is love.

A week of weeks...

2007-10-03T16:03:00.001-07:00

So when I planned my big Sunday breakfast because it was going to be a big week I meant strictly school. It's three days later, less than 48 hours from my first anatomy practical, and this week had been full of interesting events.

Sunday:

First of all breakfast was terrific - french toast, bacon, juices, fruit, coffee - the whole spread. I was joined by a colleague, and we followed the meal with a fairly productive study session. Then it started raining inside the kitchen.

Okay, maybe I exagerate. So in the middle of a discussion about the contribution of DNA-protein interactions to the rate of transcription and translation, the roof started leaking. It wasn't that bad of a leak even. I called my landlord during our lunch break, and he promptly came over, investigated, and seemed eager to find a reasonable solution.

Later in the day, during a follow-up study session, it REALLY rained. And I mean 6" of standing water in the front yard kind of rain. Oh, and of course, 3" of mud along with it. But you see, we were still in the kitchen. And you guessed it, it rained inside. There were puddles even, about two feet wide. Awesome.

Buckets to the rescue! And back to the books.

Monday:

So the plan was to meet the two Johns in the anatomy lab for a 5:30 AM review session. Man I wanted to make in on time. But man, I didn't want to wake up at 5:00 AM. I made by 6:15. Oh, and I totally took the best nap that afternoon.

I might not have needed the nap so much if I wouldn'tve had to borrow a shovel from the construction workers across the street to clear the mud from the walkway to my apartment building. I didn't particularly feel like shoveling mud at 8:30 in the morning. But I felt even less like slipping on the mud and cracking my skull open on an island without a tertiary care hospital. So I shoveled away. By the way, have you ever shoveled wet mud from a textured cement path, in the hot sun, covered in, after standing around cadavers for several hours? Try it sometime. Tons of fun.

Tuesday:

Despite my STILL not wanting to get up at 5:00 AM, I realized the tremendous help the previous morning was, as well as the benefit of a quiet anatomy lab. So I got up at 5:15. And because I was still adjusting to the time warp shift of getting up so early, I treated myself to a morning nap on Tuesday.

Delicious.

Wednesday:

Yep, 5:15 AM again today. Smooth as silk. I mean, I didn't WANT to wake up, but I didn't mind as much today.

But the best part of today, speaking of construction workers, is the work that's taking place outside my apartment at this very moment. It's just after 7:30 PM. It's pitch black. And there are about 8 guys standing around watching a backhoe tear up the road completely. I am assuming it has to do with water drainage (remember the 6" of water in the yard). But who really knows?

The most amazing thing about it all is that it just happens. There's one road leading up the trail past my apartment. And they just tore it up completely. There are no barricades, no signs, no warnings, no 'watch out' for the little children, or for that matter, for the preoccupied medical students worried more about the insertion and origin of the extensor policis longus and it's innervation then where they are walking.

Luckily, the workers were nice enough to place a pair of 12' long, 2"x6" wooden planks across the 8' gap in the road, in case you don't want to take the 15 minute detour and walk all the way around the trail. Brilliant! Just brilliant!

Thankfully, I've got buckets for the leaks, plenty of food in case it floods (thanks folks & kel), and all the books and papers I need to finish studying for my exams. And even though I'm getting up at 5:15 AM again tomorrow, at least I won't have to walk the plank on my way to the lab.

Hopefully, because they're still working out there. *Crosses fingers.

The grind

2007-09-27T08:58:00.000-07:00

And no, I don't mean some crappy MTV hip-hop-themed dance show...

Exams are coming up strong - 1 week to go. And it doesn't stop. I love it though, as stressful as it is. I love actually learning the things presented during lectures. I dig getting things in my head, and then being able to get them out again. And I'm thrilled be not losing my mind in the process.

Speaking of learning, I'm still tweaking the way I approach studying. As we get further and further along, some of my earlier techniques (concept mapping for example), don't seem to help as much with memory recall as I would have hoped. It's definitely an amazing tool for visually organizing information (especially with some of the more disorganized lecturers).

I don't know if at this point it's a matter of not having the time to connect things the way I would want, or it's just that it's not as effective at getting it all in my brain permanently, but either way, I've switched gears.

Thanks to Kelly's latest contribution of dry-erase sheets, I've converted my kitchen into a study hall of sorts. And now I spend my afternoons, evenings, late nights, and sometimes mornings, drawing out as much information as I possibly can. That's right, I physically draw out mechanisms, structures, everything. Be it biochem, anatomy, histology, it all seems to work. It is unfortunately very time consuming, but it's the best way I've found to learn and capture the information that's thrown at me everyday.

Well enough about that, it's dissection time! Axillas beware!

Keeping my eyes open!

2007-09-24T06:51:00.000-07:00

1. Reading the water takes on a while new meaning.

I've been trying to tune myself a bit more to my surroundings, and from time to time it pays off.

Saturday morning, for some insane reason, I decided to go running. As I limped back the last 10 yards to my apartment, briefly imagining the warm beach sun, and the cool seawater on my sweaty skin, I felt some brief relief. I turned up the wavy path to my building, again thinking of my snorkel, and black sand, and for a second glimpsed down at the brook that runs under a section of the concrete walkway. The stream is constantly fed by the rain that falls in the mountains in the middle of the island, and slowly makes its way down towards the valley in which my building sits. Normally it's clear, slow moving, and silent. But this partly cloudy morning, it was mud - reddish-brown, and flowing just a bit faster. Despite the relative tame appearance of the sky, I bet myself a beer later in the day that I should just take a shower, that it would be raining by the time I got clean...

...I'm really starting to like Carib beer. It's clean, crisp, tasty, and light; definitely better than Kubuli. Maybe next week I can get to the beach?

2. Sit too close and you'll go blind...

In lecture the last week, I've adjusted my seating to a more "enlightened" position, and, at the same time, have gained a perspective as to what everyone has on their computers during class. Here's a list as close to the real distribution of what I've seen:

1. The PowerPoint of the current lecture (as to be expected).
2. Nothing. Long live crappy desktop pictures!
3. SOLITAIRE!!!
4. Facebook.
5. Freecell.
6. Google, Yahoo, or other search engines.
7. Gmail, Yahoo, Outlook, or other email programs.
8. Myspace.
9. ESPN (in various languages).
10. Chat programs (maybe used in accordance with any of the above).

I have been trying to keep my computer off, or at least asleep, during lecture. Basically, from the list above 90% of computer use is pure distraction. NO GOOD!

If you don't take a second sometimes, to look around at what's going on, you can get trapped, tripped up, or just stuck in the muddy water.

Triangulation nation

2007-09-21T12:24:00.000-07:00

This week's been interesting to say the least. First off, the adventures in food have gone full-force...but more on that later. One thing's for sure, there haven't been more triangles in my life since 9th grade geometry class. But now, instead of being on chalkboards, they're on cadavers. triangular, quadrangular, intervals and all; but the one that holds a special place in my heart is the suboccipital triangle.

Yes, this week marked my first actual anatomy dissection, and it was, for lack of a more complete word, exhilirating. I had been to a couple of anatomy demos previous to this past Tuesday, and had even spent the aforementioned "alone time" with a "silent instructor" in the anatomy lab reviewing the first week's material. However, none of it really compared to getting in there with a scalpel and forceps, and really digging in.

Sure, I wish we would've received better direction as to the final product we were aiming to produce, as well as the amount of connective tisue that stood in our way. But I guess that in itself was part of the experience. It's intersting that everyone assumed that our assignment was gonna be a snap - which was reinforced when the course director described it as "simple" at the start of the session. 2 hours later, several tables had barely identified the triangle at all. 4-and-a-half hours later, we finally wrapped on the day, with stiff necks and backs, from having spent so much time bent over such a small area.

Sure, I had to go home and shower. Sure, the smell was stuck in my nose the rest of the evening. And definitely the video doesn't do justice to what we went through that afternoon. But I have it all in my head: The smell of the preservation fluid as it swished around at my waist, students moving to and fro, the spotlight shining right down on the dissection area as well as the side of my neck, the delicacy & toughness of the neck as we awkwardly probed around for structures, the general thrill of confusion and completion.

Next week: Axilla. Awesome!

Keep up the heat. Steam just builds.

2007-09-15T12:10:00.001-07:00

It's hot & humid today. I don't know why I'm still surprised by such things? It's pretty much hot everyday. Unless it's raining all day long. In the case of the latter, it's not as hot. But then the humidity factor comes into play. Maybe it's just that I'm still not used to walking everywhere.

Yesterday, there were several points where I seemed to be operating on autopilot. But it wasn't the good kind. It felt like a I was in that VCR-style fast forward where you just shut down mentally, and time starts going by, and then suddenly you snap out of it, and it's three hours later.

I think several attempts at multitasking are party to my dissociation with time. Streamlining will be done. Definitely. Some other organizational activities will be forthcoming. I am especially excited about my forthcoming 7290. More on that when it arrives.

On another completely different note, I also had a couple of moments yesterday where I actively saw my life improving, even if the improvement was just a miniscule increment.

Firstly, I started using some new ice trays I purchased last weekend. MAN! What a difference a good ice tray makes. I know it sounds silly, but as the saying goes: "You never know a good ice tray until you find one." Or something like that.

Secondly, and more importantly, I acquired a nifty concept-mapping software package called CMap Tools. It's freeware, cross-platform, and has a pretty small learning curve. More importantly, as I was going through the help files as my tutorial, I actually learned a basic premise to concept mapping that I had not known, that had been lacking in my maps, and hence was slightly impeding my full potential use of such maps. Specifically it dealt with the use and expression of the connecting prepositions (or prepositional phrases) between map elements. Instantly, the map I had been working on went from just organizing general ideas to truly flowing information effectively.

Hopefully this weekend I'm going to get the opportunity to review most of my earlier material, and perhaps remap some of the more difficult concepts correctly.

This afternoon, I also went to the anatomy lab for some quality time alone with a cadaver. It's probably the best anatomy time I've had yet. The particular body I was at was particularly fatty, and well wrapped/contained, so the formaldehyde fumes were strong & got to me pretty quick. But I got used to it after about 10 minutes. Also, prior to getting my hands dirty, I was able to go through the lab computers and was really impressed with the radiology database program, and specifically one set of MRI images of the cervical spine. I think so far these past two weeks, the material presented in the radiology lectures has been the most interesting. However, it has also been pretty much the only clinically-oriented material presented, so that may be why I'm gravitating towards it.

And last but not least, we had our PBL introduction this week. As part of the introduction, the PBL director gave the majority of the first semester class what is typically given as the first part of a PBL clinical vignette. It's essentially a clinical problem or scenario with a very limited amount of facts, that is supposed to drive students to collaborate in research and differential exploration. What amazed me is that I think only one student mentioned part of a physical exam of the child. By the way, the case was essentially a young mother presenting to a doctor's office claiming her 3 year-old daughter's body had been shaking violently. Everyone immediately went into history taking, hypotheses, obscure diseases, and crazy diagnoses. Not one student mentioned a full physical and neurological exam of the child and verification of the stable vitals. I wonder how many of them know the number of potential answers and questions that can be had from the physical exam. I know we haven't been taught physical exam techniques, but c'mon. It's not that I don't think histories are important, nor that I don't appreciate all the potential factors involved, such as violent blows, allergic reactions, infections, or the febrile component...

...Maybe I'm taking it too personally? I just think the severity of a seizure or neurological condition warranted a little more attention to the physical condition of the patient, and from that point, stemming out to histories and other information. Yeah, that's the ticket.

Oh, and I was able to get a new locker today in some prime, library-centric real estate. I'm stoked!

Congrats to Ivonne & Anthony on the new addition to the family!

Well, lunch is about over. Back to the books.

Love y'all. And much love goes out to the Rodriguez-Perez Family, and the entire Rodriguez Clan. Titi Olga is in my prayers. May God bless her, Tio Yayo, and all of us in this difficult time. And may He grant us the peace and fortitude to overcome the grief and stress life brings us, and to realize the blessings of love and family He has granted us. Despite the heat, I think it's true what's been said, that He never gives us more than we can handle.

Eight legs? Keep your hopes up!

2007-09-13T06:15:00.000-07:00

The spiders struggle to sustain their resistance to my swatter. I may have to bring in the chemical weapons soon enough.

I wanted to opine about something often commented on and rumored here at Ross. There's rampant speculation as to the attrition/failure rate here in DA. But I've seen very few people point out all the resources available to students at this school, or the persistence with which certain offices peddle their services, all of which are aimed at the success of students.

There are free peer tutoring sessions, guided small-group study, one-on-one study & test-taking help, computer-based test skills practice, and counseling services, etc. There's also a plethora of student and service organizations that share experiences, knowledge, and tips as they further students both socially and professionally. And all of this is on top of the generally open attitude of the students of previous semesters, as well as teachers and TAs, on how best to succeed on exams, and life here on the island in general.

As with everything in life, if you don't, first, search it out, and second, do the work, you won't get the benefits. But like I said, they do a good job here of actually reaching out to students and introducing all the available services.

Don't get me wrong, it's tough. There's an amazing amount of material that's covered in a relatively short amount of time. And sometimes I still feel like I don't know what I'm doing. But the more I learn about how to study, how to learn better, the more effective and comfortable I feel. But I guess we'll see what it's all about at the end of the first Mini. If nothing else, I've learned that spiders are pretty darned fast.

A Whale of a Tale

2007-09-08T15:52:00.000-07:00

When the first group of the day got off the boat and said that they hadn't seen any whales I didn't let it get me down. First of all, the fisherman ALWAYS has hope. Second of all, you learn that just being out on the water is blessing enough, so if there isn't hope... it's a foolproof philosophy. Seeing the same people shrug it off as they walked away with two rum punches each in their hands didn't make it seem all that bad either.

I had been looking forward to today's whale-watching trip since Wednesday when I signed up. If nothing else, I was looking forward to getting away from campus, my apartment, and my books for just a little while. I wanted to have some time to myself to not have to think about study methods, or what was coming up in class this week, or what I was behind in. And my plan worked... for the first half of the trip anyway. What I forgot to realize is that if you put 40 people from the same school on a boat, eventually someone's going to talk about school.

And speaking of school. Today, for the third time, a complete stranger, on a sparsely-populated tropical island, after seeing my t-shirt that says FIU really big on it, asked me if we were the school that got into "that big brawl with UM last year." Now, part of me is disappointed that the only claim to fame of my university is the hijinx of a dyfunctionally premature football program. And well, another part of me is getting just plain annoyed. Maybe I'll write a letter or something. But anyway... As it turns out, the fine southern gentleman who inquired as to my t-shirt today was a 3rd semester here at Ross, who ended up sharing a wealth of information with me - one of the nicest people I've met here yet, and that's saying a lot.

In the end, we didn't see any whales. But I did have a great time back out on the water. The views (see photos) of the island were great, as was the weather, and I was able to really relax. And last but not least, I was fortunate enough to meet a couple of nice people along the way. Cheers!

A week like a lifetime

2007-09-07T14:09:00.000-07:00

They just redirted the dirt road outside my apartment, and it looks as good as ever.

I was just chatting with Kelly, and she congratulated me on completing my first week of medical school. I laughed a little inside when she did, because I actually hadn't noticed. At first I thought that was a little sad, but when I got to thinking about it, I think it's good that I'm already in a bit of a groove here, and thinking of other things.

The main thing on my mind today was WHITE COAT, and to a lesser extent, how hot it is when you're all done up for a white coat ceremony.

So for those who don't know, the white coat ceremony is a symbolic welcome and transition to the profession of medicine. They actually have a doctor put the coat on you, as you can see in the pictures below. We were also given a pin from the Arnold P. Gold Foundation for Humanism in Medicine, or the Foundation Pin as they call it here, and interestingly enough, then we all read a prayer, specifically the Morning Prayer of the Physician by Maimonides. There was also some pomp and circumstance which I won't bore you with (including a short speech by the Prime Minister of Dominica), but it did make it all seem a bit more ceremonious.

Oh, and the hot thing, well, you try getting all done up in a shirt and tie and climbing up a dirt hill at one o'clock in the afternoon, on a tropical island. But I won't linger on the negative. Let's just say I didn't waste too much time before coming home and getting into some more suitable attire for this climate (Thank the Lord for A/C).

At the ceremony I took the time to congratulate the few people I've befriended here so far. And I thought as I looked at the over 400 students, and considered the attrition/failure rate here, 'You really just have to enjoy every moment, and give it all you've got.'

I have to admit, as far as this first week of classes is concerned, parts of it were tough. Not necessarily the classes, but the whole adjustment to this new life, and I think I'm making strides. But there's still a long way to go. Interestingly, I've heard a lot of people say that also along the way you have to take care of yourself, and have some fun. So tomorrow, I'm going whale-watching. For now, I got my white coat, I've been through my first week of classes, and I'm starting to settle in.

I want to send a humongous hug to my family, and all the love in the world to Kelly. Thank you guys for all your support. I wish you could've been here today. But, at least, here are some pictures.

The Arachnid Confrontation

2007-09-05T19:13:00.000-07:00

The arachnids have REINFORCEMENTS! And I don't mean simply infantry, they have brought the big guys out.

This past weekend, after tolerating them way too long, I had decided to consciously try to do something about the number of spiders in my apartment. Earlier this week I took out the can of bug spray that turned out to be fogger, and while I read up on my intrinsic and extrinsic back muscles, treated the bathroom. Next, on a study break from the biochemistry chapter on proteins, I was sweeping and decided to have a non-chemical go at the group in the kitchen. The former was effective, of course, and left a pleasant odor of cardboard and baby powder in the air. The latter was also pleasantly to the point, taking out over 20 of the offenders.

Now part of me had been contented with this temporary victory, seeing for once, clean corners and edges in every room, and every ceiling. From spiders at least. The ants, those you can't beat. They are EVERYWHERE. That's a war I want to stay neutral from. Now getting back to the matter at hand...

They're repopulating the old battlegrounds, and developing new fronts. But I will OVERCOME!

Flows

2007-09-04T09:59:00.000-07:00

It just finished raining extremely hard on the metal roof of the Annex for a total of about 10 minutes. That means that the normally clear, slow-moving creek that runs by my apartment building is most certainly a faster, deep orange color.

Today I've been operating by the words on of our presenters mentioned during orientation. "You'd be amazed at how easy some things get done here." By here he meant the island of Dominica of course. As we all arrived, no doubt we all had a few experiences where we had a brush with the difference in modus operandi between DA culture and US culture - Just ask Kelly about getting food at Emerald Pool. Yet it's true that things also just happen, sometimes too easily, and I think it has to do with expectation and confusion.

Back home, I was used to being offered everything, gathering all the necessary information, making my choice, and obviously having that choice available. Here, well, there are choices. But usually whatever you want, they don't have. And as far as school is concerned, there seems to be various areas of disorganization, and an associated lack of communication. There seems to be just enough misinformation, or well-intentioned partial communication to throw things for a loop. (you know it's serious when the biochem professors get frustrated!). And as a result, you have a ton of people walking around confused, scavenger hunts for packets between classes, long lines in the sun... it's all actually pretty funny when you stop and think about it sometimes.

But if you just take a step back, slow down, read a little deeper, and instead of telling, once in a while just ask what they have to offer, I think this whole thing will run just fine...

just fine...

Well, it's raining again. More muddy water in the creek. And time to read more biochem.

Tires.

2007-09-03T19:45:00.000-07:00

I don't have a car anymore, but that doesn't mean that from time to time I don't feel like I'm spinning my tires.

I have to admit that the biggest deal the last day-and-half has not been my first day of classes at medical school, as I would've hoped it might be. And it wasn't even all the nifty bits I learned as I read my books after my first day of classes at medical school. But rather, the single most pressing issue on my chest the last 36 hours has been the departure of my dearest love, yesterday, back to Miami.

The same parts of my brain that went to class, and read those notes, and studied those chapters, and did all those things that had to be done, are the same ones that are telling me right now, 'time will take its course, and peace and patience will prevail.'

Meanwhile, the knot in my chest where my Netter's Clinical Anatomy guide says a person's heart is supposed to be every so often just wails out a deap, sorrowful cry. That's when my eyes start to join in, and my throat clenches up to try to keep the two parties from conspiring any further.

But the most amazing thing about Kelly, is that despite the fact that I do miss her so terribly, just thinking of her smiling back at me, shaded by a black umbrella, in her red and white striped tank-top, cradling her black-and-white polka-dot canvas tote purse, leaning against a table of fruit - smiling just for me - is enough to make me not only breathe deeply and smile, but rise tomorrow with a sense of purpose, and the knowledge that I have the love of the most beautiful girl in the world.

Goodnight. I'm tired.

Mammothness

2007-08-24T17:13:00.000-07:00

Everything's big these days: the heat, the sweat, the ideas, the walks, the hills, the plans, the tired.

I've been in Dominica for 5 days now. Part of it was a blur - a rush to beat a real and invisible deadline to be prepared. And it's only in the last 36 hours that I've actually had time to reflect on any of it.

<---- content edited for negativity ---->

...there's so much riding on all of this. At least for me. I know I've been thinking about, planning for, reading about, and looking into this move for the last eight weeks, or however long its been since I found out I got in. And it's so easy to get so caught up in it all. It's so easy to get frustrated when something we hold so dear doesn't go our way. And lord knows there's plenty of complaining, ranting, and "suggestions" floating around Ross.

But the tremendous positivity that exists around this school and campus is amazing. Between my neighbors, the people who greeted me when I arrived, taxi and transport drivers, and just random people on the street, I don't think I've ever met so many people who have been so eager to just give up information and help random strangers. Back home in Miami, I think I would've been ignored by at least half of them, and probably been intentionally misinformed by at least one. Here, several times, someone has smiled, and wholeheartedly said, "Welcome to Dominica." And whether it's a student helping me out on campus, or with information about school, or a local showing me the way to the church, I've never felt unsafe, or unsure about what I was here to do. And all that has given me the ability to take a few minutes to enjoy the finer points of my time here so far: from sharing a good beer with my father, a walk on the beach with Kelly, or just looking up at the mountains as I walk home.

The journey is just begininng, and there's much more here to speak of. Much, much more. And I'll get to it. Right now, though, I just want to revel in the positive, and enjoy our time here together.

3 days, 3 hours, 4 hours, some rain...

2007-08-15T09:06:00.000-07:00

Yes, it all seems to be going by WAY too fast. But the adventures never cease in the speed's midst.

Having to walk through a torrential downpour (w/out an umbrella) to reshoot forgotten passport photos might seem inconvenient. But as I strolled downtown Miami, with business-types hugging buildings to avoid the rain, I tried to imagine unpaved roads as I carried on towards Walgreens. A t-shirt, a towel, and a digital photo later, I was headed back to the Miami Passport Agency...

...I had been assured earlier there would be no problem; no major delay. When I arrived, damper, but no worse for the wear, a young republican reviewed everything, nodded, and tersely told me to have a seat. He quickly shoved a small, white, silky square ticket under the window, stamped A80016, and just below it, 1:06 PM. As my stomach began asking me when exactly it's midday reinforcements might be coming, I politely inquired as to how long I might be waiting.

"30-45 minutes maybe," The kid in adult's clothing came back.

After an hour of sitting in a hard fiberglass chair, under a high-velocity ceiling fan, in damp sandals and shorts, my fingers began to cramp from playing Texas Hold'em on my phone. An hour after that I had made about fourteen phone calls, and learned things crucial to my upcoming journey. 30 minutes after that they closed the doors to the passport office, and the 20 or so of us that remained all looked a little more frightened. The numbers on the flashing, scrolling, and sometimes flickering displays in the large, square, fluorescent room had begun at A79970. I looked at my watch, as I picked at what I thought was some food on a back molar, and read 3:42 PM. Then a piece of my tooth fell off. Then the numbers on the display, which had so far been steadily increasing towards the digits printed on my ticket suddenly jumped backwards.

I stopped for a second.

Okay, back to normal. A80016 was called at 3:57 PM. 12 minutes later I was outside on the street, looking for the nearest hot dog vendor.

Apparently, my tooth is fine. At my third consecutive daily visit to the dentist this morning, I was told what fell off my tooth was almost certainly a piece of the cement used to bind the filling I received yesterday. So look out lesser antilles, I've got a passport, and my pearly whites are ready!

The dining room table for anything but.

2007-08-12T21:36:00.000-07:00

We've begun earnest preparation, with Kelly continuing to be the amazing tag-team partner that she is, for our departure to Portsmouth in 6 days. And it's not that there hasn't been serious movement in the last six weeks, but it's all beginning to congeal. The to-do list has been completely revised and rewritten in fresh, dry-erase ink!

As I was walking away from work for the last time today, I have to admit that I really thought the balloons were a nice touch, unexpected, and the card with popcorn was priceless.
Later in the evening, as I was making a supply run at Target, the cashier asked me if I cried when I left TCS.
I said "no" rather flatly.
"You wanted to," she came back quickly.
She then continued her fast, muffled conversation with the other Red-Shirt hanging around next to her, and I continued thinking about my impending adventure, weight restrictions, and how I hadn't eaten dinner yet.