It’s finals season, the same frenzied cycle as undergraduate. The last few days have been hectic: long and cold nights of cramming wacky cell signaling molecules and disturbing genetic diseases, shutting myself in the library surrounded by fobby undergrads, getting hooked to cappuccinos and Lipton-based milk tea from the physician’s lounge, feeding glucose to my noggin at awkward times of the day, and just stressing out for a simple PASS. I’ve been getting my sleep, until a few days ago when I realized how little time I have left for the avalanche of topics I need to study and review. Two days ago, I slept for 3 hours, and that was miserable. In college, I usually felt fine on study marathons and pulling late nights, maxing out with 3-4 consecutive nights of minimal sleep; I just caught up on my sleep after the big exam. However, this week, I barely lasted a day, because the next day, I felt fatigued. Last night, I had a disjointed sleep session, taking a much-needed nap that lasted 2 hours and struggling to keep my eyes open until 3am when I was felt at little accomplished for understanding ADP-ribosylation in cholera and pertussis toxins. Being sick amidst finals is no walk through a blissful dream; my brain felt like gooey pudding.
Early this morning, I was still cramming last minute before my afternoon exam. I’m realized I never feel ready for exams, using ever minute possible to stuff important facts, just in case they come in handy; it works like a miracle in bygone days. Nucleotide metabolism, check. Autosomal dominant diseases like osteogenesis imperfecta and Marfan’s, double check. Receptor tyrosine kinases and Jak-stat pathways, oy! Cancer, DNA replication, homologue recombinations, holiday junctions and chiasma, ooph! Imprinting and epigenetics, oh lala… Antibiotics that do battle with prokaryotes, rock on!
The computer lab was an oven, more than just an easy-bake oven; I felt like baked chicken. Maybe that’s why I got dizzy in the middle and started nodding off. I told myself, “Okay, at least make it halfway through your 100 multiple choice questions, and maybe you can snooze.” I ended up zipping through all 100, marking a bunch that I did not feel like pondering at the moment. I fell asleep a few times during my test. My mouth felt dry and my eyes kept drooping; the levator palpebrae superioris was not doing its job. Seriously, what kind of model medical student am I when I can barely stay awake during a major exam?! I took a ‘bathroom’ break and dashed to the physician’s lounge for a quick cup of hot coffee to wake myself up. I came back, full throttle, and went through the exam 3 times before my time expired =)
Then, a surprise email from my professors; we all passed! During an anatomy review session, someone in the class read the email and shared the happy news. I checked my grade later, and once again, I did about average. Average for the exam was 85; on the midterm, it was an 88. I have a tendency to miss the mark, so nowadays I’m just an average student. I’m content; I’ve accomplished so much through college and now I’m in the final years of schooling. Numbers and A’s are not as important as they were for me in high school, since the pre-med mentality through college and a blooming social life mellowed down my fire. All I want to do is learn and do what I love- work in health care and heal sick people.
Right now, I’m drained. My mind is still swimming with genetic diseases. They are so interesting to learn, and yet, frightening. I appreciate my life, because 1) I’m thankful I’m not a mutant, and 2) so many things can go wrong at the cellular level before birth. Yes, mutations are rare, and that’s why we have complicated, well-regulated mechanisms to combat mistakes. We are typically born healthy, but we are error-prone and anything can seriously happen, at any time.
Programmed cell death, or apoptosis, is just as essential as cell growth in life. Mutations occur all the time, but with all the cellular checkpoints during replication and repair pathways, we bypass the harmful effects and disease. Many diseases lurk in the depths of human biology, and I only learned a handful (okay, 2 inches of color-coded index cards). Fragile X, Neurofibromatoses, Cri-du-chat, Down’s, Patau, Edwards, Marfan’s, Turner’s, Kleinfelter’s, Lesch-Nyhan syndrome, etc… it’s mind boggling to learn all the inheritance patterns and the molecular intricacies of each disease. What’s scarier is the fact that quite a bit of diseases result from spontaneous, or “de novo,” mutations. Once it happens, it’ll be inherited. And genetics is rather complicated, more than just Mendelian dominant vs. recessive. Let’s take autosomal dominant disorders are characterized by variable expressivity (the degree of symptom manifestation), incomplete penetrance (all or none phenotype when you have the genotype), high recurrent mutation rate, and late-onset. Then there’s imprinting, or gene silencing, mitochondrial inheritance, mosaicism, and trinucleotide repeat expansion with anticipation (the more repeats and subsequent generations, the more severe and the earlier onset of disease). I’ve only wet my feet in a puddle so far, but I also feel more like a doctor.
Eh, I change my mind… I feel more like a zombie right now. I’ve been fortunate enough to be sick the entire week, sneezing and wheezing. My nose has been bipolar, running one moment and clogging up the next. My sinuses have been filled with mucous, which shouldn’t happen in the first place because infections can spread and drainage is blocked; naturally, we are airheads as our head has many holes and passageways for draining and neurovascular bundles. I hate popping drugs, so I let my T-lymphocytes patrol my bloodstream and kill the invaders of my immune system. Throbbing headaches have been tiring me out, particularly the sinus ones that emanates from the occipital region. When air goes up my nose, there’s a fuzzy, sharp pain entering the back of my nasal cavity. Breathing never felt like such an effort, except maybe during yoga.
Now, 1 final down, 3 more to go… FOR ONE FREAKING CLASS. It’s the bane of my existence, a medical school horror show called Gross Anatomy. Three more exams: lab, written, computerized. I’m taking a breather today (yes, my nose has recovered its function). I’m going to sleep early after this late-night blog. I’ll wake up tomorrow, go to the gym, and kick some final ass at anatomy =)