Happy Christmas everyone! Hope yours is filled with warmth and family...and maybe some chocolate-y cheer!

I'm in Palm Desert, CA this holiday. Missing everyone in Portland and VCU'ers around the country!

I promise a real post before the New Year.

<3 to you all!

Just a quick note, as we have our last anatomy practical exam this week. Yesterday was our last official day in the lab (of course, you will still find me there studying intermittently this weekend). I am really glad it was an optional dissection (of the ear); instead my group opted to review and say a few last words of thanks to Bernie. He's been a great learning tool and he couldn't have given us a greater gift!

I am also a little sad to be leaving my anatomy group. Table 19, it's been swell. I may not have given my all every day, but as a group I think we all worked together pretty well and it was a pleasure getting to know you better! Jeff, if you are reading this, you know way too much about MM. Get a life (I jest)!

4 more days of studies, 1 day of exams, then I'm off to SoCal for break!

Another year older! I have to say, 25 treated me well. I was accepted to and started medical school, which is going pretty well, I must say. I moved to Richmond (!!) and have been making a lot of new friends. Not to mention, I have some of the greatest friends at home cheering me on. I'm feeling the love!

I have been reflecting a lot on school thus far. I'm amazed at how quickly it goes. Test after test, week after week, and before you know it we are almost done with our first semester. I found this entry particularly amusing, as we are now quite literally doing battle with fat (of the cadaveric nature).

Right now we are wrapping up the second section of anatomy dealing with the thorax, abdomen and pelvis. After Thanksgiving, we start Head and Neck anatomy and then it's Christmas break just two weeks later! As much as I like anatomy, I can't wait to ditch my smelly scrubs and take a break from this madness.

Anatomy exam 1 was touted to be the most difficult exam of the course, and it came with a great deal of stress. In just 2 weeks we covered all the bones, muscles, nerves, arteries and major veins and ligaments of the back, some of the neck, shoulders, arms, hips and legs. We spent much of those 2 weeks tracing nerves and arteries from their major outlets in the shoulders and hips down to their endpoints in the toes and fingers as they dove in and out of the surrounding musculature. I was starting to enjoy the class as the language became more familiar to me, but the sheer volume quickly made the class a stressful sprint through musculoskeletal system.

Now, on the downhill slope into thoracic and head and neck anatomy, I feel like I can slow down and enjoy what we are learning. We removed a large piece of the ribcage and began dissections of the lungs and heart yesterday. Not only is the material more interesting, but there is so much variation between the different bodies. It's like we are really starting to get to know our new "friends" as we learn more about their bodies. My group's cadaver seems to have had a quadruple bypass surgery, while a cadaver nearby had an extremely enlarged heart. Also, our cadaver's lungs were pink and soft, while another was riddled with white, lumpy tumors. It's definitely a privilege to get to know someone in this unique way!

For now, I am sighing a major sigh of relief for passing the first behemoth of an exam, and I am excited to take this trip through the thoracic cavity. We'll see if Bernie is has any more interesting anatomy to teach us!

This is more or less my life right now, aside from the boiling of flesh, dogs, and silly hats. 6 of my classmates and I make up table 19 and every day we cut a little deeper into our dear friend, Earl Bernard Stratford III*, or Bernie as we call him.

Anatomy is a much anticipated course in medical school and I am happy to be participating, but it is also the hardest thing we have encountered thus far. I have seen a lot of stress and tears from my classmates (I am certainly not exempt from the stress) due to the speed and volume of information we are responsible for. So if you don't hear from me for a while, worry not! You will most likely find me on the 10th floor, wrist deep in a cadaver. The joys of medical school!

*Bernie's name is completely made up, for the record. I am in no way violating his or his family's right to confidentiality.

Free weekend! Those two words have been said many times in anticipation over the past few weeks. We haven't had one since our first exam back in August! And now that it's here, everyone scrambled off to visit family or travel or whitewater raft in frigid West Virginian waters. I intended to go on an all day hike today but it was hampered by bad weather. Not that I am opposed to hiking in bad weather, I mean, I'm from the Northwest...we hike in rain and snow alike. However, when one is deprived of weekends (and the relaxation they usually bring) one tends to want to curl into a ball and do nothing. Because one can.

I certainly haven't done -nothing- but it's nice to do everything with less urgency and less--oh, i can't, i should be studying right now--thoughts. Friday was a pretty wild post-exam celebration for both M1s and M2s. Saturday a group of us M1s headed out to the Healing Eagle Clinic on the Mattaponi Indian Reservation to volunteer at their monthly clinic. Although clinically, I don't think I learned a lot yesterday, it was a good experience meeting the patients and other volunteer healthcare workers, all wonderful people (warm fuzzies!).

Today I intend to spend most of the day in the kitchen cooking up pots and pots of warm fall goodness and cleaning up around the house (a chore that sadly gets neglected in the daily hustle).

Hope everyone is doing well!

A great weekend of diversion was had! An Oregonian meet-up of sorts took place in Washington D.C. this weekend, as we convened at a craft fair in Adams Morgan called Crafty Bastards. We all had fun and I enjoyed spending quality time with some familiar faces.

view of the Washington Monument from the fair

I am also thrilled that fall is near. The air is getting cooler and I am starting to cook more hearty, fall dishes. My favorites! It's still nowhere near the likes of fall on the west coast. It's still hot in the afternoon, and I hear this kind of behavior can last all the way into November. I wonder if I'll even need to wear my new winter coat before Thanksgiving...

Things are starting to wind down in terms of biochemistry and genetics. Only 2 weeks to go until completion! Then we launch into our next block: anatomy!

Just a quick note since I am up before the birds today! Fall weather is finally landing here in Richmond. Yesterday was the first time I have felt a chill since I got here. The change in clime makes it just a little bit more bearable to be inside all day studying. I even got my first hot coffee yesterday (I much prefer iced, but when it's cold(er) out, one must sacrifice). Bring on the flannel sheets and fall jackets and falling leaves!

Exam #3 is on Monday: Biochemistry and our new course, Human Genetics. Back to the books I go!

Well, the exam on glucose metabolism (see previous post) came and went. Silly me thought it would all be downhill form there. Much stress and anguish (and a fabulous exam score!) later I have come to realize that it was just the start. We are now slogging through fatty acid metabolism, which is still part of that crazy diagram, but feels like a completely new ballgame. While I learned glucose metabolism in my undergrad biochem courses, I have no recollection of the current material. Hence, I spent all of yesterday pampering myself in preparation for this week's battle with fat.

Aside from making every effort to keep my nose in the books, there have been a few clinically-related happenings that are keeping me motivated (eyes on the prize). We began our genetics course this week (population medicine ended with last Monday's exam), and they do a really nice job of bringing the clinical side of genetics to us. Friday afternoon they brought in some people with Down Syndrome and their families to share their experience with their healthcare providers and in general. It was definitely moving to hear their stories, both good and bad. We have also been learning to take blood pressures and I'm trying to work on some volunteering or shadowing opportunities. I think it's important to keep reminding myself why I'm here, because sometimes sitting in a cubicle reading course syllabi just isn't all that fun, believe it or not!

Finally, I am really excited about some upcoming trips! In October I'll be heading up to DC for a craft fair where I hope to meet one of my favorite crafters as well as possibly participating in Race for the Cure in Virginia Beach! Then in November I signed up to attend a conference for Physicians for Human Rights at George Washington University and I'll be spending Thanksgiving in New York with my best pal and her mom! Lots to look forward to!!

This slide was in today's lecture, marking the start of a series of lectures on metabolism. I swear, biochem professors just love to torture us with these kinds of diagrams!

View of downtown RVA from Jefferson Park...on the right is VCU medical center/school.

Click on the photo for a better view, the thumbnail is pretty awful looking!

Second week down and our first block exam as well!

All of our exams are in blocks, so whatever classes we are taking at a given time, usually 2 (that is, 2 core classes, not including some that run through the year which are not included on these exams), are both tested on the exam. They are really easing us in, giving us ample time to finish, but I heard a rumor that they gradually shorten the amount of time we are given per question. All of this is, of course, in preparation for the boards next year.

I am thrilled with my score and now I have a taste of what I should expect and how to stay on top of the material! It's a great feeling to know that I can now tuck away those 300 pages of syllabus (not burn them, as I heard one classmate suggest) and move on to the next round.

Just as a reference of how fast we move here, I believe in undergrad we spent somewhere around a week studying the lac operon in bacteria. In this course we covered approximately the same depth of material in 2 syllabus pages, or around 6 powerpoint slides! The material is really condensed and I do feel lucky to have taken biochemistry and molecular biology classes before. Some of my classmates are not so lucky!

I'm off to enjoy my last free weekend until October. These rare and special weekends after Friday exams are termed "golden weekends" because we essentially have no new material to learn over the weekend!

I now have one week of medical school under my belt. This week they eased us in with just our first two classes, Medical Biochemistry and Population Medicine. Next week Foundations of Clinical Medicine is thrown into the mix as well as our first exam covering the first two weeks of Biochem and Pop Med. Time is already flying by!

I am already noticing an improvement in my study habits. My ability to focus has increased over the week and I am able to cover more material in a shorter amount of time. It's been over three years since I was in school, so this is a huge relief. Still, I'm not quite ready for the added classes and demand for my time. So it goes.

Other than school, I am working hard to achieve a good balance of working out, eating and sleeping. So far so good! Outside of that, well, there isn't a whole lot outside of that. I guess that's what I signed up for! Work, eat and sleep. That is my life now!

Well folks, orientation week is about to wrap up. Meeting my 200 new classmates throughout the week has been exhausting and fun, but next week this gets real. No more 'for fun' quizzes or lectures about dealing with stress--on Monday at 9am we crack our phone book of a biochemistry syllabus and there's no turning back!

Yesterday, my classmates and I were cloaked in our first white coats in front of 1,000 of our parents and friends. I felt the pressures of being a pre-med melt away as the new pressures and responsibilities of being a student doctor and future physician were literally placed on my shoulders. During the ceremony we took the Oath of Hippocrates:

I do solemnly swear by that which I hold most sacred,

That I will be loyal to the profession of medicine and just and generous to its members.

That I will lead my life and practice my art in uprightness and honor.

That into whatsoever house I shall enter, it shall be for the good of the sick to the utmost of my power.

That I will hold myself aloof from wrong, from corruption, from the tempting of others to vice.

That I will exercise my art solely for the cure of my patients and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it.

That whatsoever I shall see or hear of the lives of men and women which is not fitting to be spoken, I will keep inviolably secret.

These things I promise and in proportions as I am faithful to this my oath, my happiness and good repute be ever mine, the opposite if I shall be forsworn.

Today it all begins...with a lot of mundane activities: id card, bus pass, TB test check, picking up my white coat and orientation schedule, roll call, a history lesson...

Followed by a meet and greet of sorts and a night of bowling!

Let's do this thing!

I am finally home (away from home) in Richmond! The road was long, but the trip was well worth it. My mom and I traveled over 3,000 miles, got to attend my grandparents' 60th wedding anniversary, visit my aunt in Spearfish, SD, see Mt. Rushmore and the Badlands, the world's largest ketchup bottle, and Santa Claus, IN (among other things). What an adventure! I will post more pictures and things when I have time to upload them and/or have a good internet connection.

Today I finally got to see my house and meet my roommate and landlord for the first time. The house has great character, is in a great neighborhood, and I look forward to getting to know my roommate better. The next few days will be busy buying, well, everything! I moved all my stuff in a Mini, for crying out loud! Orientation starts Monday and classes the following Monday. By the looks of our calendar, life is about to step into high gear. Goodbye lazy days of summer, hello doctor training!

I am beginning my cross-country journey in exactly one week! I am equal parts thrilled and terrified. Lately, the terror side has been more obvious. More frequent stomach irritation, less sleep, and I think I am more irritable...

The anxiety isn't helped by the amount of stuff that needs doing this week: PACK! (so far I have but one box ready), prepare for the going away celebrations, catch up with friends before I embark, print maps for cross country travels, make sure housing and school documents are all in order...Lots to do!

As an aside, I just finished the book Complications: A Surgeon's Notes on an Imperfect Science, and I highly recommend it to anyone, especially those of you who are going into the health care field. The topics Gawande covered were both inspiring and frightening. I also started reading When the Air Hits Your Brain: Tales from Neurosurgery. The tag line for the book is, "when the air hits your brain, you ain't never the same." Probably holds true for most interventions, I think. Vertosick paints (in my opinion) a more realistic picture of surgery than Gawande sometimes, the stories he chooses to highlight don't always end with bunnies and rainbows. Patients will die on my watch and that's just part of learning to be a doctor.

Home, sweet home!

That counter (lower right) is sure ticking fast! I have exactly one month until orientation week begins, or until life as I know it is turned upside down. In even less time, my mom and I embark on what I am calling The Great Trek. My mom and I will load up my bitty car and drive just over 3,000 miles in about 6 days, and we'll see parts of the country neither of us has seen before. I, personally, have never driven east of Idaho! We'll stop at some key landmarks like Mt. Rushmore, the Badlands, and Montana Ale Works (that's key, right?). I am really looking forward to it, and I hope when the time comes my mom is too!


If you have suggestions of other places of interest along the way, please let me know! We don't have many stops planned after South Dakota, so if you have any suggestions for Omaha, St. Louis, Louisville (is Independence, MO worth a stop? I remember purchasing my oxen and wagon there in the Oregon Trail game) or anyplace else, please leave a comment!

In other news, I think I finally found a home in Richmond! My roommate and I will be living in the Church Hill neighborhood, just a mile or so from school. It's a historic neighborhood undergoing revitalization/preservation and is also the site where the largest Civil War hospital was located (according to wikipedia)! The church the area is named after was also the site where Patrick Henry famously declared, "Give me liberty or give me death."

I apologize for not updating frequently, for now I am spending most of my time getting organized for the move and enjoying my mini summer vacation. I'd hate to bore you (y'all) with tales of laying by the lake and cleaning my closet!

To the left is Dr. Costanzo, an actual faculty member of Virginia Commonwealth University School of Medicine (the school I have chosen to attend), standing over all of the course material for the first two years of medical school. There are no fancy bindings or covers in that stack, just raw information in the form of course syllabi. I wonder if she is standing on a stool....

Needless to say, the challenge ahead is significant. I know 99% of the time that I am ready for this task, but one percent of the time I have my doubts. How will my brain cope with the floodgate of information about to be released? What if I don't retain any of that information once I've studied it?

Mostly though, I am just trying to enjoy my time before school starts in August. This week I saw my friend's band play, went to the strawberry festival, hiked to the beautiful Ramona Falls, and today made waffles with fresh cream and strawberries, strawberry jam and strawberry shortcake for my dad. Happy father's day dads out there!

With a little over a month left until medical school begins, I thought it appropriate to begin a new blog. Rather than continue any previous, personal blogs, I wanted to start fresh as I feel momentous changes are coming my way. Hence the title, synaptic reorganization. Not only a phenomenon I have recently studied in the laboratory, but I also anticipate some serious neuronal changes as I am forced to digest an absurd amount of information over the next four years.

I hope you will follow along with me on this journey, but be forewarned. I am not squeamish and am fond of the grotesque and absurd. If I see something disgusting or strange, I will probably not hesitate to write about it.