In high school in the states the famous novel "1984" is frequently included in the curriculum, and is discussed in class and after. This novel captured my imagination and certain parts of it I discussed at length with a very good friend of mine at the time. The subject of "room 101" came up. If you are unfamiliar with the novel, you won't know what I'm talking about, but the long and the short of it is this. Room 101 contains "the worst thing in the world", it is a customized torture room that contains within it whatever the worst thing in the world is to you, something that you would do anything to prevent happening or experiencing. The logical question was then asked "what is in your room 101". My answer to this, well thought out after quite a while, was to be alone in the ocean, treading water, in water so deep you can't see the bottom and with no land in sight. For a long time this idea clenched up my core, making me fearful even to consider it. Up until a few weeks ago.
I was taking a brief vacation from life and staying with my girl at the time at a seaside resort down island about an hour from here. I had been snorkeling a lot with some shiny new gear I had picked up, and I decided, rather randomly, to face the biggest fear of my life. I picked up my courage and my snorkeling gear and hit the water. I swam straight out to sea for what seemed like an eternity. The waves were a bit rough and the water getting cole. I looked down into the water and saw nothing but blue. I stopped at what may have been a quarter mile from shore. Not a long distance, but far enough for my experiment. I took off my mask and started treading water. I turned to face out to sea, so that I couldn't see the land, and I refused to think about the land, or turn to see it. I decided not to worry about how far I was drifting out.
At first I was afraid. I couldn't see the land, or the bottom. Then something strange happened. I wasn't afraid any more. Maybe I was exhausted and dehydrated or just tired from a day of swimming, but I started to become more than calm. I relaxed completely and realized that I was finally in the place I had been so afraid of for so long, and then I realized that I had always been there, and it was ok.
The sun started to set, and I watched the sky change colors.
I realized that I had been afraid of that place for so long because it seemed like certain death. Once I got there I realized that death was certain, and I was apprehensive about going back to the places where everything else is uncertainty.
I swam back ashore as my legs got tired, and collapsed exhausted onto the sand. Back to the rest of the world, but I knew what that one part was. That part at the end, I felt like I was a bit more comfortable with it, a bit less afraid. It's everything before then that I was still afraid of.
The process of medical education is a bitter and grueling one. Students at any medical university are challenged with vast amounts of material, the highest academic expectations, and are nearly systematically broken down, and must find within themselves the will, desire, and aptitude to become something new and mysterious. This process has been very hard on me, and at times motivation has been scarce. Just recently I have suffered perhaps my greatest blow to motivation, a terrible test score. However, in these last dozen hours my self evaluation and search for motivation has finally come to fruition.
As a young boy, like many nerds before me, I found the fantasy of magic and sorcery most compelling. Many adolescents like me enjoyed role playing scenarios in which they could learn the ways of magic, cast spells, and affect the world around them in profound and arcane ways. I find, in a very strange way, that this fantasy is finally being realized in my life.
I sought out clinical experience during my undergraduate years, and came to view medicine as a highly technological investigation. My job included the ordering of laboratory and radiological studies, and it was through this lens that I viewed medicine during my first year of basic sciences. It wasn't until just recently that viewed medicine through a much more accurate light.
Clinical acumen is now and has always been the standby of medical practice. As a unit clerk, I saw the ordering of studies as critical to diagnosis. A recent experience of mine has thrown all of my current knowledge into a new and fascinating light. When a clinician orders a study, it is to confirm what he already knows. Though in many cases, a host of blood labs and images provide the knowledge base from which a doctor can make his diagnosis, the physical signs the patient displays will have already narrowed down the possibilities to a mere handful.
The patient in question was paid to come to our behavioral laboratory session. Our task was to interview her, in hopes that we could hone our interview skills and perhaps come to some medical conclusion about her primary complain. During the interview process, I noticed the clubbing of her fingers, and the xanthomas around her eyes, even though her complaint was not cardiac in nature, I was able to pick out parts of her history that, combined with these physical signs, suggested the beginnings of congestive heart failure. Of course, were I her doctor, I would order a series of studies to elucidate this condition, but this was not the capacity we were working in. I had seen something by merely looking at her, without conducting a physical exam, that others around me perhaps missed. I felt as though I had divined some hidden truth, as though I were privy to knowledge arcane that the layperson was ignorant of.
As I sit here with leatherbound tomes elucidating the finer points of physical examination, and voluminous text books illuminating the spectrum of treatments and conditions, I feel very much as though I am learning the disciplines of divination, alchemy, and more. I've stopped seeing my microbiology text book as an examination of science, but more like a catalog of strange and dangerous creatures. Immunology is now the study of mystical and obscure defenses, which must be understood in order to identify the demonic assailant that plagues a given patient. Pharmacology is no longer "applied biochemistry", from now on it is the bizarre and elusive art of mystical compounds, alchemy by which mysterious diseases can be battled. Pathology is now an arcane discipline of how diseases can attack us, and what their weaknesses are, and the skills of physical examination and interviewing are not mere procedures to me any longer, they are now the lofty art of divination, allowing me to view my patient with eyes of faith, that I might see more than symptoms and signs, but find the disease hidden within their body.
Perhaps, dear reader, this strikes you as strange and perhaps even silly. And perhaps it is both of these, but mark my words, there is something otherworldly about the tools of medicine, even in this technological age. Perhaps, despite my years of work and dedication to get to this point, I have finally fallen in love with medicine.
Grades finally came in, I pass.
The last week has been just as exhausting as the week of exams before it. It has come to its conclusion but, for some reason, it seems to be 'work' for me to relax. I need to spend some time away. Away from campus, away from the internet, and away from everything. Problem is, being broke, the most 'away' that I'm going to get is either my apartment, or the beach. And it's raining. Hard.
Heaven met Earth and I survived Judgement. It's time for rusty to recover, and get ready for the next round.
Semester is finally over. Everything is changing, just as Jack told me it would.
The girl and I have decided to stay in touch but no longer long distance date. My mother has moved, and I'm *hopefully* about to move out of subjects in school that I am familiar with.
I'm finally getting used to being in Dominica. It was a tough adjustment at first, but I've sort of assimilated now. I'm staying here over the break to save money, and it's already almost a ghost town.
The goal for break? Stay busy. At least until grades post.
Among my many projects is a database utility based in teh intarwebs to facilitate learning objective oriented study. Everyone I've spoken to about it seems really enthusiastic. So. I have a prototype in OpenOfficeOrg's Base program, which is basically SQL lite. Problems? It's a bit buggy, and web connectivity is going to be...weird. Also, it requires installation and manual placement of a driver in order to work, just from the client end. So....though it looks nice and does what I want, it's probably going to have be built in something more powerful. And that's where one project has asploded into a task that may take the entire break. PhP and MySQL and possibly JAVA together are robust enough to handle everything I want, most importantly placement on a server. It's really a simple database, but accessing it from every computer (PhP) on campus would be nice, and commercial servers could handle MySQL better. Besides, it's time for me to move out of Access and it's clones and into something less user friendly and more powerful.
So. Learning PhP and MySQL over break...yeah. Well, I won't be aware of time passing for sure, and grades will be posted in no time.
Well, Jack and I went to France!
Who knew that france was right here in the caribbean. It turns out that while the remnants of british colonies are impoverished for the most part, it seems that the french remnants are still quite french. Islands of les saintes, guadaloupe, and martinique are still entirely french, with french people, french food, and french. We avoided the run down genarmierie nationale building, Jack was unsure about a run in with them.
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Well, Jack and I are halfway through semester two, and he's never far away. I finally figured out how to study, and it's...actually kinda fun. I don't get to spend as much time talking with the girl or friends back home, but I think everyone's behind me on getting my studies done. However, my nemesis seems to have finally reared it's ugly head. The human brain.
Let me share something with you, dear reader, about brains. They're evil. They don't make any sense. And the people who study them don't make any sense either. At first it was fairly straightforward, this is your brain, spine, and all this other stuff. Then we got into the 'grey areas', and it got wacky. I think I might fail 'brainiology', if jack leaves for long. Hopefully not. Let's summarize
Your brain is doing whatever it wants. It occasionally talks to the brain in your guts, which is also doing whatever it wants.
The brain is divided up into bumps and ditches, and from studying crazy or sick people, we've sorta figured out what these things are.
All brains are different, so it requires an 'eye of faith' to find the landmarks. In other words, guestimate.
If something breaks, you'll be miserable or insane or both for the rest of your life.
The part of the brain keeping you away from uncontrollable insane rage is the size of your pinky finger nail. or smaller.
Almost everything in the brain switches sides before taking effect. No one knows why.
The brain directly gives and receives attention to everything above your collar bone. Everything else goes through one or more 'filters', like the spinal cord. Kiss her face. Go on...DO IT!!!!
And the rest is mush.
Well, this is long overdue. The rest of the semester went fine I guess, I was burnt out almost the entire time. I managed to just barely pass everything, including the ridiculously high minimum passing scores that we were set. Either my entire class is way smarter than the last three, which is unlikely, or the school really is trying harder to fail us out, which seems very likely. That's fine, my ghost pirate has my back. I got the exact grade required to pass anatomy, which is my problem subject. Whew. One more question wrong and I'd be repeating the semester for that one.
Home is...a mixed bag. Don't get me wrong, I'm loving civilization and friends, family, and the Girl, but not having any money to speak of makes this a rather more stressful visit than I had hoped. Also, I haven't gotten any real studying done since I've been here. Yeah I know, I'm supposed to be relaxing, and I'm really trying I promise, but I can neither focus enough to study nor can I actually relax at any point. This next semester is really intimidating me.
One thing has finally sunk in though. I belong there. I feel like I've finally proven that I can make it in medical school, even though it was the easiest semester and I barely passed. It's a good feeling. I finally feel like all I have to do is keep my nose to the grindstone for a few more years and then I'll have the life and job that I've wanted for so long.
Stick with me Lucky Jack, we're almost there.
The famous lucky pirate is definitely involved in this one. I randomly ran into a faculty member today while heading into campus to get some food. His face lit up when he saw me and he ushered me into his office. He pulled a well worn book from his shelves and handed it to me. Just paging through it was incredible. Anatomy is one of the most difficult classes here, because the lectures are shallow and a really really good anatomy text is near impossible to find. Even Gray's anatomy doesn't really measure up to what I had in my hands. The most detail, the most explanation, the best diagrams that I have ever seen, and I have a stack of anatomy books. The prof smiled real big and explained that this book is out of print, and can't be gotten from the bookstore, and that I should guard it with my life for the rest of the semester.
I'm so glad that I got into Gryffindor. I was just given a time turner. This book will save me countless hours of study, and break down what I need to know into a very learnable format. 3d drawings are very, very rare.
That wily pirate has outdone himself this time, if you see him buy him a drink on me.
The great physiologist Dr. Starling states that as the volume of the heart increases, so does the force with which it contracts.
I think I've noticed the same thing with me.