Posts tagged clerkship

Today…

…is my last clinical day of medical school.

…is my last day seeing patients before residency.

…is my last day introducing myself to patients as a medical student.

Though I still have a month plus change of classes before school is officially over, I am both excited and terrified of what is to come.

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Sushi Night.
It was the end of a very long day. We had skipped lunch to catch up on our patient load and I was famished. I hopped into my car and proceeded to the nearest restaurant I could find, a sushi joint.
I made a beeline for the take out section and found what I was looking for: a party platter. 
"Do you need chopsticks to go?" asked the cashier.
"Yes, please."
"How many sets?" I paused and pondered. Should I be honest? Just say one? No, I will look like a pig. Just lie to not look desperate.
"Um…four."
She started packing my purchase for my supposed night of fun and games with friends.
Nay, there would be no such thing. Just a stack of study books, sushi, and four sets of chopsticks. 

Sushi Night.

It was the end of a very long day. We had skipped lunch to catch up on our patient load and I was famished. I hopped into my car and proceeded to the nearest restaurant I could find, a sushi joint.

I made a beeline for the take out section and found what I was looking for: a party platter. 

"Do you need chopsticks to go?" asked the cashier.

"Yes, please."

"How many sets?" I paused and pondered. Should I be honest? Just say one? No, I will look like a pig. Just lie to not look desperate.

"Um…four."

She started packing my purchase for my supposed night of fun and games with friends.

Nay, there would be no such thing. Just a stack of study books, sushi, and four sets of chopsticks. 

Post-CaRMS Sentiments.
I have had the pleasure of meeting a number of my classmates while on rotation. We discussed not just our match results but also how our respective electives were going. With the anxiety and tension of CaRMS gone, the sentiment has been universal: boredom.
To be fair the learning on service is impeccable and the opportunities great. But having reached the climactic finish we have worked towards for the better part of year, there is now the slow creep of impatience. The effect is only compounded if one is not on a service they have matched to.
"Are we there yet?"
74 days until graduation.

Post-CaRMS Sentiments.

I have had the pleasure of meeting a number of my classmates while on rotation. We discussed not just our match results but also how our respective electives were going. With the anxiety and tension of CaRMS gone, the sentiment has been universal: boredom.

To be fair the learning on service is impeccable and the opportunities great. But having reached the climactic finish we have worked towards for the better part of year, there is now the slow creep of impatience. The effect is only compounded if one is not on a service they have matched to.

"Are we there yet?"

74 days until graduation.

Cannot Sleep

I have quiet time on call and I cannot bring myself to sleep. I feel like a zombie.

Regular Customer. 

I walked into the busy Starbucks within the hospital to make my order. It had been a rather sleepless night before. As I made eye contact with the barista at the counter, I had barely opened my mouth before she cut me short. 

"A tall Americano with room, Tom?" 

I was taken aback. Not only did she remember my name, she remembered my order. 

"Um…yes, that’s right," I said, surprised. She quickly had my order ready. The entire process was seamless. While slick, it highlighted something about my routines. 

There is no better gauge that I come to Starbucks too often than when orders happen before I even speak.

Regular Customer.

I walked into the busy Starbucks within the hospital to make my order. It had been a rather sleepless night before. As I made eye contact with the barista at the counter, I had barely opened my mouth before she cut me short.

"A tall Americano with room, Tom?"

I was taken aback. Not only did she remember my name, she remembered my order.

"Um…yes, that’s right," I said, surprised. She quickly had my order ready. The entire process was seamless. While slick, it highlighted something about my routines.

There is no better gauge that I come to Starbucks too often than when orders happen before I even speak.

Cultural References

  • Doctor: You see this wiggly thing? That's a camera. It lets me look inside your nose!
  • Child: Ew! That's yucky!
  • Doctor: Do you remember that episode in Magic School Bus? When Ms. Frizzle's bus gets all teeny tiny and goes exploring Ralphie's nose?
  • Child: What's the Magic School Bus?
  • Doctor: The...it was this awesome show on television...hmm...(to the mother) you know what I'm talking about, right?
  • Mother: Haha, yes. I used to watch that a lot when I was babysitting my neighbour's kids.
  • Doctor: ...(to me) you watched Magic School Bus, right?
  • Me: I did.
  • Doctor: Phew...thought I was ancient for a moment there...ahem. Anyways, this is going to be like that.
 Cranial Nerve VII.
Lacrimal gland
Pterogopalatine ganglion
Motor nucleus of cranial nerve VII
Superior salivatory (lacrimal) nucleus
Nucleus solitarius (rostral gustatory portion)
Spinal nucleus of trigeminal nerve
Internal acoustic meatus
Stylomastoid foramen
Petrotympanic fissure (chorda tympani nerve)
Submandibular ganglion
Submandibular gland
Sublingual gland
Six branches of cranial nerve VII of head and neck expression
Temporal nerve: Frontalis muscle
Zygomatic nerve: Orbicularis oculi muscle
Buccal nerve: Buccinator and orbicularis oris muscle
Marginal mandibular nerve: Orbicularis oris muscle
Cervical nerve: Platysma muscle
Posterior auricular nerve: Occipitalis muscle

 Cranial Nerve VII.

  1. Lacrimal gland
  2. Pterogopalatine ganglion
  3. Motor nucleus of cranial nerve VII
  4. Superior salivatory (lacrimal) nucleus
  5. Nucleus solitarius (rostral gustatory portion)
  6. Spinal nucleus of trigeminal nerve
  7. Internal acoustic meatus
  8. Stylomastoid foramen
  9. Petrotympanic fissure (chorda tympani nerve)
  10. Submandibular ganglion
  11. Submandibular gland
  12. Sublingual gland

Six branches of cranial nerve VII of head and neck expression

  1. Temporal nerve: Frontalis muscle
  2. Zygomatic nerve: Orbicularis oculi muscle
  3. Buccal nerve: Buccinator and orbicularis oris muscle
  4. Marginal mandibular nerve: Orbicularis oris muscle
  5. Cervical nerve: Platysma muscle
  6. Posterior auricular nerve: Occipitalis muscle
A thorough physical exam was deferred as patient was noncooperative and threatened to spit and defecate on me.
A vivid consultation report.

Pocket Supplies for Students

  • Anaesthesia: Alcohol swabs
  • Cardiology: ECG calliper
  • Dermatology: Gloves
  • Emergency Medicine: ATLS reference cards
  • Gastroenterology: Lubricant
  • General Surgery: Lubricant, gauze, and tape
  • Gynaecology: Chaperone (will not fit in pocket)
  • Neurology: Reflex hammer and penlight
  • Obstetrics: Naegele's wheel and measuring tape
  • Ophthalmology: Cotton swab
  • Orthopaedics: Measuring tape
  • Otolaryngology: Tongue depressor
  • Paediatrics: Toy
  • Psychiatry: Duress alarm
  • Respirology: Face mask and throat swabs
Service Pen.
Serving me since 2010, the BIC 4-colour ballpoint pen has been my pen of choice while on service. I carry a set of two or three with me in my bag in case I lose one, or if my attendings need to borrow a pen for the day. It writes well, gives me multiple highlight colours for different priority issues when reviewing my patient list and comes at a reasonable price. 
The above is a quick sketch I made of the iconic pen while I was on call.

Service Pen.

Serving me since 2010, the BIC 4-colour ballpoint pen has been my pen of choice while on service. I carry a set of two or three with me in my bag in case I lose one, or if my attendings need to borrow a pen for the day. It writes well, gives me multiple highlight colours for different priority issues when reviewing my patient list and comes at a reasonable price. 

The above is a quick sketch I made of the iconic pen while I was on call.