Clinicals… Yay!

It’s been over a month already since beginning 2nd year medical school. Two weeks ago, I finished a back-to-back death match between microbiology and pharmacology. I studied microbiology until my pupils dilated, sucking in all the pictures made ridiculously simple, as if I were on atropine. Microbiology really teaches you to sanitize every 5 minutes. It also teaches you that you are filled with dormant viruses and merry bacteria making a home of your body. It teaches you the world is a dangerous place and microscopic organisms are capable of killing anyone who’s immunosuppressed, young, and old. Microbiology makes you a paranoid medical student.

I spent a whole month drawing pictures to memorize all the wild microbes out there. Do you know how many brown poop going into the mouth to represent fecal-oral transmission in enteric bacteria? Too many. Do you know how many crotches (in blue) and vaginas (in pink) I drew to represent urinary tract infections (UTIs) and sexually transmitted diseases (STDs)? An awkward many. By now, I’ve perfected the art of doodling lungs for respiratory infections, brains for meningitis and encephalitis, and the GI tract for diarrhea. Oh, diarrhea … those were very animated pictures. Pictures will be taken and posted soon for general amusement.

Anyway, I studied hellishly for microbiology and crammed all of pharmacology (autonomics, immunosuppressants, corticosteroids, vasoactive peptides, analgesics, opiates, and anti-microbials) following micro. This is where I say being a medical student sucks. The feeling of being screwed and fucked for the exam. I was hopeless. The hour before my A.M. pharm exam, I was in despair, cramming in slides and scraps of information from First Aid. Yeah, some emergency drugs were necessary to put me out of my misery =D In the end, I still got the same grade for both. I don’t know how that happened, but I should’ve scored higher for micro, where I studied more intensely, and not down to my pharm grade. Oh well…

Now, what I really wanted to talk about was clinical site visits! Yesterday, I visited Mather Hospital in Port Jefferson, where I’ll be practicing differential diagnosis, in addition to history taking and physical exams. It’s a small community hospital set in a beautiful, quaint area. It’s nothing like the grand scheme of Stony Brook Hospital. There, I was partnered up with my good friend Lisa, who also happened to be my partner at Stony Brook last year. What are the chances?! When you’re an Asian at the end of the alphabet, you are connected at the hips for a long time.

Here’s the thing. I have terrible timing. We got there late. I did not end up having a hard time finding the place. It was rainy, and I simply drove slow. Even then, we still had a good 5 minutes to find parking and enter. However, I was looking for parking and got tricked into the ‘free valet’ parking. And there I go, driving past the entrance, expecting valet parking. Except, there was no valet parking. There were no spaces up front. So I turned around and got stuck behind this granny who drove like a snail. Yes, a snail. I said, “Why is she driving so slow!!!” I asked my friend, “Should I honk? I’m afraid to…” She laughed, “Yes. Yes you should.” HOOOONK!!! I honked her several times. She totally deserved it. There was no cloggage up ahead, she was just driving like an old tortoise.

Both Lisa and I were assigned to Dr. Sokol. He was amazing! Picture him as your typical grandfather who likes to teach you how to play Scrabble and make you cupcakes. He offered us cupcakes at the end of our session, but we kindly declined. He didn’t make it, it was some party at the hospital. Medical centers always have parties and celebrations somewhere… He looked at our pictures and said to me, “Did you take this picture when you were in preschool?” My medical school composite picture that will follow me throughout my career at Stony Brook was taken last year. I had short hair and no glasses. I have a habit of changing my looks every year, so I will always look different. He looked at me in person compared to the picture, I do not look the same. Now, I wear pink Versace glasses and sport long, curly hair. Who knows, maybe next year I’ll sport a pink mohawk or a blond bob?

Anyway, he was an incredible teacher. He took us to see our first patient. One person does the interview and physical exam, while he sits with the other student to watch and listen. I volunteered first, and boy did I get a chatterbox. We were with her for 2 hours. But I really liked her. She was jolly, extra talkative, and friendly. She went on and on with her stories. And I mean, she had long stories. Her list of medications and surgeries went on and on… Dr. Sokol said, “We could keep chatting if we had 48 hours in a day.” Because he was her doctor, she would be making eye contact with him as she told her stories. Several times, the doctor had to remind her to look at me and pretend he was not there. Lol… She was adorable and perky. I wish every patient would be as merry as she was =D After probing her around, Dr. Sokol said to her “Now, I hope I see you on the streets and not the sheets next time!”

Her case was cellulitis. It is a skin infection, usually along extremities like the arms, hands, legs, or feet. Typically caused by Staphylococcus or Streptococcus pyogenes, cellulitis infection manifests as red, painful, and tender rashes. Easily treatable with antibiotics, unless the problem of resistance pops up.

Ah, by 4:30 pm, we were all done and good to go. Back at the conference room, we were told about a ‘special patient with an interesting rash.’ In the emergency room, another 4 students from our group were also with their preceptors, waiting to see this ‘mysterious rash.’ In my head, I was already thinking “Oh, this could be Rocky Mountain Spotted Fever… maybe syphilis… or Coxsackie…”  So the guy has had a two week history of rashes. He has fever and a major headache. The preceptors were also curious, and one mentioned a ‘Christmas tree’ pattern. Turns out, the doctors were guessing it was pityriasis rosea, a harmless skin rash with an unknown cause. It starts off as a herald rash on the trunk and spreads over the body by 2 weeks. It can be itchy and flaky as well. Funny thing, the doctors were all looking on Wikipedia for the answer. Wiki, woot woot!

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