Week of Ups and Downs

What a week of ups and downs! I went from feeling fairly confident about the results of the Advanced Lab Diagnostics/Endocrinology midterm results to shock when I looked at the results. Holy Cow! I've never studied so hard and felt confident about a subject only to earn a score that was cause for a bit of self-disappointment! Looking at my answers, I thought, "How in the world could I answer that way?!?!"

Upon reviewing the exam with the class, our professor made the point of stating this was a tough exam by design and endocrinology is one of the toughest topics for both students and practicing doctors. There are so many influences on the human body--environmental and emotional stressors, sleep, diet, and exercise--all of which can, over time, take a toll. The exam was geared, both in the question portion, as well as the two cases, to generate thought and come up with the single best answer. The cases were quite general in nature with no specific complaint other than fatigue or inability to sleep. We were required to look at the small factors in each instance to help with the tests we would order, our diagnosis and treatment plan, based upon the Therapeutic Order of Naturopathic Medicine. Ultimately, our professor gave us the advice that sometimes we learn more from our mistakes than we do when we "ace" an exam. Did I mention that humility is a trait that is well utilized in medical school? Lesson learned; that was a hard "pill" to swallow though! (pun intended, hehe).

Well, immediately after I left Endo Class, I had my first "head-to-toe" physical examination of a patient as a lab practical. This practical examination was held in the teaching area of our clinic. Here's the setup: Eight medical students in eight separate examination rooms with a patient for each student and 45 minutes to complete the exam. No professors are in the room as the physical exam is monitored remotely via camera. We performed a head-to-toe physical intake in a predetermined order on our patient as a culmination of each of the regional examinations we learned to Week 8 of the trimester as well as those learned in previous classes. This was a "show me what you know" sort of practical, followed by a quick write-up of a randomly chosen (by the professor, of course) portion of the exam you performed, along with any findings. 

During the exam, we could go back and complete any exams that we might have forgotten or re-perform exams that we knew we could have done better, as long as we were within our 45-minute window. While some points could be deducted, the process was as much for learning the entire procedure as well as for grading. This is the nice part of the clinical studies portion of our curriculum. We are still graded meticulously, and we continue to be taught even during our lab practicals. So, back to the practical. The teaching portion of the clinic was still pretty warm from a power loss (and subsequent loss of air conditioning) during perhaps the hottest days Chicagoland has seen in years! Some are saying we are in a heat wave, but again, I'm from the South and this is normal weather for me. I'm in a shirt and tie with a patient in a gown for a physical. I'm trying to keep my cool, but remember, I just came out of some disappointing news on a previous exam; I'm now setting up and performing the absolute first 'scrutinized' physical exam of my medical career and starting to sweat buckets. What did I do? Stuffed my pockets full of tissues, offered some to the patient to keep him comfy, and in between different steps of the exam, I completed the "time honored forehead swipe" that one sees performed by docs on just about every TV show from the early days of the tube until Grey's Anatomy! The patient ended up being very happy; I was OK, though a bit dehydrated after completing the physical exam; and I think the professors were OK with my performance. A nice boost after a bit of a dip just a few minutes before.

I suppose this is the "take away lesson" this week. Don't get too dejected if an exam doesn't go perfectly; stay steady and be prepared for the next exam. Despite all the preparation, study, memorizing, theorizing, and compartmentalizing, one can have a bad moment, hour or day. Those tough moments are only in that particular window of time. As I sat here by Janse pond writing this entry, I was fortunate enough to have three friends sit and chat with me on a beautiful afternoon. This was a good time. I'm thankful for both and hopefully learn from each moment, whether good or bad.

Knee High by the 4th of July!

Regarding the 4th of July (Independence Day), I'm thankful for the founding fathers' courage to draft and sign the Declaration of Independence. That first step provided the foundation for our great nation and the optimism that I believe still exists enough for people to continue to desire to immigrate to the U.S., plant their roots, and live out their destiny as they choose.

2012-07-10_garden

Now, for the "knee high" reference. Around here in Illinois, the saying goes for corn, "knee high by the 4th of July." Check the picture! July 6th and our corn is well over 6 feet tall! Can you find me? Now granted, this is a variety of heirloom corn called Southern Gentleman, appropriate, that is best suited to the hot, humid weather of the southern United States. I'm not sure if my roomie and I have green thumbs or we have simply been fortunate (and lucky) enough that we planted this corn during the hottest summer on record in Northern Illinois! I am grateful that nature has smiled upon our garden though. See if you can find me in the photo!