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In the name of science

Giving blood is not one of my very favorite activities, but I don’t particularly mind it.  Most of the times I’ve had blood drawn it’s been for selfish health purposes, checking the levels of this and that, but recently I’ve also donated to a few genetic studies. As someone who wants to go into statistical genetics research, I know how important it is to have astronomical sample sizes, so I make an effort to participate, especially if I’m part of a relevant population.

One of the most interesting things about being involved in health research studies is that you become painfully aware of why it takes so, SO long to gather enough data. For the last study I was part of, I received a kit in the mail, complete with its own blood collection tubes and incredibly detailed instructions, in addition to all the standard questionnaires. If I wasn’t familiar with the healthcare system (or stubbornly determined to contribute), I’m not sure I would have made the visits or phone calls to figure out which labs were willing to draw blood for private research studies that weren’t associated with UM. Once you go in and explain everything to the phlebotomists, they’re of course happy to help, just still a little confused that they don’t need to put your visit into the computer system and that your name doesn’t appear on the collection tubes (only your anonymous study subject ID#).

There is something unexpectedly satisfying about walking out of the lab with your blood samples under your arm — packed in the protective Styrofoam and cardboard boxes — and heading straight to the nearest UPS to mail them off yourself.

March Music

Sunshine! There are still a few feet of snow on the ground, but the birds are singing and I’ve simply decided it *must* be spring.

The last month has been a haze of new coursework, research arrangements, and fantastic extracurriculars. A few highlights:

The Medical Arts Program put on yet another phenomenal event, one where we went to the photography exhibit “The Other Camera” and then to the play “The Suit.” Michigan’s Institute for the Humanities had kept the photo gallery up an extra day for our group, so we were able to have a catered dinner among the pictures of South Africans, getting an interesting inside look from community photographers attempting to reframe historical and societal issues.

Prepared by themes among the photographs, I was blown away by “The Suit” — without a doubt one of the most moving pieces of theater I’ve ever seen performed. I won’t be able to do justice to the message, but what I loved most was how much I learned about apartheid South Africa on an emotional and familial level. I found myself literally on the edge of my seat, enthralled by the history passed on through the story of a couple.

A week later, I helped host a “non-traditional” MD/PhD dinner, where we invited students and faculty who have pursued PhDs outside of the basic sciences. We ended up with a lively table of people interested in medicine and history, public health, anthropology, economics, psychology, and much more. For us students pursuing a non-trad path, it was both fun and encouraging to converse with people who have really made it work!

Then, finally, yesterday, we published the latest issue of The Hippo, the literary and arts magazine of UMMS. As always, I am blown away by the insight and talent of classmates!

Let it snow, let it snow, let it snow…

Really, though, it will not stop.

On the bright side, it’s kind of a lovely excuse to curl up with a book and study from home with hot tea. I woke up a few days ago to find beautiful ice crystals on the *inside* of my bedroom window; I suppose I could have predicted this if I’d thought much about condensation, but it still left me slightly surprised and bewildered. Perhaps I am still a California girl at heart, despite loving the snow.

After admiring my icy window for a few minutes, I got myself out of bed and studied downstairs for a couple hours before my first shoveling break. You see, it was snowing so hard and fast that if I’d waited until it stopped to clear the pathways, I’m not sure I actually would have been able to break apart and shovel out the two-foot-deep snow-ice. I’d decided not to drive anywhere (so didn’t need to fully clear my back pathway toward the car) but I did at least need to get out my front door.

Just before leaving for winter break, I spent a fantastic evening doing crafts with children at the Wayne County Family Shelter. Volunteering with “Project H” is such a fun way to make a direct impact on the family’s lives. (Plus, at the same Family Shelter, UM runs a medicine clinic that’s the only place preclinical students can see pediatric patients; I’m excited to go back to help at the clinic this spring.) It’s impossible not to smile as you watch a child run over to their father to give them a Christmas card they just finished. They have great personality, too, as most kids do. Before we cleaned up, one of the girls looked over at my paper and said “You are definitely drawing Santa all wrong.”

Over the holiday break, I was with my extended family in Maine. For the first time in years, all of BOTH sides of the family were together, so I saw all four of my grandparents, plus all my aunts, uncles, and cousins. It was a wonderful week, spent mostly curled up under blankets as we talked about the year and looked out at the frozen waves.

We did get out for some fun hiking, running, and snowshoeing, though. My mom had a goal of running 1,000 miles in 2013, so despite all the snow we went out on December 30th to get in her last three miles together. We ran down past the town dock and towards the little one-room library, passing these gorgeous trees that had crystalized with ice around their branches.

It’s good to be back in Michigan again, as we all get ready for classes to start up. It’s a great feeling when you realize that coming back to Ann Arbor really does feel like coming home.

Fully fall!

The last few months have been a blur of wonderful activity. Busyness is good, and I’m definitely more productive when my schedule is full. I’ve delayed M2 year, so I am actually focusing on math classes that are prerequisites for the PhD I will do in biostats. It turns out that most people going into that program over at the School of Public Health are either coming in with a relevant masters or were math majors during college, so I have a bit of catching up to do. The course I’m taking now is through UM’s math department, so it’s interesting spending time down on Central Campus for the first time. I like the bustle of activity on the quad and having small sections where everyone attends class, but being mixed in with undergrads can be funny at times. On the first day of class, the guy sitting next to me said, “Oh, you’re in med school? You must be old.” So that happened.

I’m still on the medical campus often, though, to study and review medical material and to spend time in the hospital. It’s been quite exciting to shadow in some of the clinics I’m most interested in and find that — even now, after finishing just M1 year — I can follow most of their discussions of diagnosis and prognosis. In some of the outpatient settings, I’ve gotten to start going in to take histories and do the physical exam on my own; it’s satisfying to start feeling so comfortable with patients.

And, finally, we’ve had some lovely autumn days and seasonal activities. A couple weeks ago, I went with a group of friends to pick apples and pumpkins (and, yes, to go for a hayride).

Teaching and Learning and Everything Wonderful

It’s worth it. It really is. For all the thousands of hours we spend studying medicine, it simply takes a few great patient encounters to remind you how much you love it all. During the first and second year of med school, it’s easy to get caught up in – or, sometimes, overwhelmed by – the endless details to memorize. All of sudden, though, you realize how much you’ve actually retained and how wonderful it is to go in and make a difference.

Earlier this week, I worked at the Delonis Clinic, which is in a homeless shelter operated by Washtenaw County. I walked over to the shelter wearing my white coat, entered through the main doors, and was immediately approached by an elderly man who grumbled, “Ah, you’re the lady I need to see.” Resisting the urge to say “No, no! I don’t know anything! I’m not a doctor yet!” I instead smiled and said, “Of course! Looking forward to seeing you this evening.”

I climbed up to the second floor, wandered through rows of cots, and found that I was the first student or doctor to arrive at the clinic that night. Once the attending physician, the physician’s assistant, and the other med student arrived, we went over logistics. I made sure I knew where extra intake forms were, practiced taking blood pressures, and looked through the list of patients who’d signed up for the first few time slots. With only one doctor each evening, most of the history-taking and face-time with patients is up to the med students.

It. Was. Awesome.

I talked at length with a woman who complained of knee pain, alcoholism, and STIs; I tried to deflect the awkward flirtations of a middle-aged man with an upper respiratory infection; and I consoled a man who’d just been discharged from the hospital, was worried about injecting his new blood thinner, and was confused about his prescriptions.

As I “presented” each patient to the attending, I realized there were certain parts of the history I was either skipping or spending too much time on and that I was embarrassingly unfamiliar with certain classes of drugs. By and large, I spent the evening learning. It’s important to recognize that for every one thing you can do there are a million that you can’t; being humble is really the only way to progress. I asked the other med student to help me find the pulse in the right place, I asked the PA how she’d decided an infection was viral and not bacterial, and I asked the attending if he’d remind me which pain relievers might be most harmful to the patient who had Hep C.

More than anything, though, I learned directly from the patients. Certainly the homeless shelter gives you a unique subset of the general population, but they impart wisdom that is generally applicable to medical practice. You can tell when you have their trust, when they enjoy talking to you, and when they’re beyond frustrated. I found that a lot of what we did was educate patients about how to help themselves. It’s a truly spectacular feeling to find yourself in a position to teach  patients how they might alleviate their pain, to explain the differences between medications, to encourage them to make healthy lifestyle changes, and to affirm how impressive you find the strides they’ve already made. Seeing patients on my own and finding that I’m able to make a coherent (albeit preliminary) assessment and plan is very exciting.

After the last patient left, the notes were completed as efficiently as possible. It was late, after all, and the attending was already behind schedule to get to his ice hockey game. I walked home with a huge smile on my face, knowing I’d remember each of those patients for years to come.