A Long Week

Mood: Relieved
Music: Cage the Elephant - "Ain't No Rest For The Wicked"
Medicine: Anatomy: Pelvic Cavity

This last week (maybe about two weeks ago at this point?), I sawed off a leg. I bisected the pelvic cavity right down the middle, spliced through the center of the abdominal aorta and the sacrum/lumbar spine, and cut the abdomen transversely down the level of the 3rd lumbar spine.  Out of all the other times I've dissected, this by far took the cake as being the most disturbingly disgusting cut ever.

It may seem strange to you (or maybe not, if you're into this stuff like I am), but I was initially excited by the task: really, it isn't every day you are allowed to chop off a leg from another human body!

But let me tell you something; it is not pretty when you have to chop the rectum, the bladder, and the vagina RIGHT down the center.

The dissection started out great; the abdominal contents (namely, the GI tract w/ liver, spleen, and pancreas) had already been cut free from vessels and connective tissue, so those were easy to move out away from the pelvis, to give us plenty of room to work. This revealed the floor of the pelvis: with a transverse slice of the rectum (this was done earlier to detach the GI tract) and the urinary bladder, along with a eclectic mix of blood vessels, tubes, and nerves (iliacs, ureters, obturators, yada yada). Our lady had had a hysterectomy, and thus no uterus. Immediately we knew our task: saw the pubic symphysis, the rectum, and the bladder right down the middle. This was expected, so when we opened up the bladder to see urine, I wasn't too surprised. The rectum was a little different, but I still wasn't extraordinarily surprised. It was gross, but expected nonetheless. Using a scalpel, I deftly bisected the rectum and the bladder. I might say, I did pretty damn good too ;) The urethra was completely preserved. The cut revealed the tube traversing down its entire length to the external urethral opening. I'm awesome. And as morbid as it may sound, sawing the pelvic symphysis down the center was extremely satisfying. By the way, I am not a mass murderer. Just saying. Don't you judge me!

Then came the part that caught me by surprise. Sorry, if you don't want to be grossed out, you should probably avoid reading this next paragraph. If you're bold enough, read on!

First off, it was no surprise that i would have to cut our female cadaver's vagina right down the center. That was a given. But let me paint you a slightly more vivid picture so you can imagine what I was dealing with: our cadaver is a 200+ lb woman who apparently wasn't very big on hygiene. At least on her lady parts. To avoid getting too graphic, we'll just say that the "juice"from her "juicebox" had remained in place after she had deceased. Initially, I was blissfully unaware of this fact. I was using my scalpel blade to cut through the tissue, you know, through the center, and I paused for a moment to take a breather. Inadvertently, I rested my scalpel blade on the labia majora... and it scraped the side. I glanced down at the scalpel to see some dry, white, sticky powder of some sort on the blade. I thought it may have been skin at first. "Why is it so white?" I said aloud. Oh. OH. It wasn't skin at ALL. She had a thin white filmy layer on the surface of her lady parts. Yeast? Excretions? I don't know. I'm trying not to think about it.

With that, I must say my hat goes off to all the nurses and doctors in OB/GYN.

After finishing with the "chopping the leg off" part, it was really cool dissecting out the vessels. It's frustrating EVERY time, because you have to clear the fat away, you have to go digging for the right path of the vessels without slicing them up, and it definitely isn't instant gratification. But with a little patience, all of your hard work pays off. And you forget how annoying it was in the first place.

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So, I wrote the above last week, and have been meaning to complete it, but of course anatomy consumed all of my time up until this point. Took the test this morning, and I'm so. so. SO relieved to be done. And I am also oh so very tired from the experience. I'm struggling to keep my eyes open as I write this. But before I wrap up for the night, I wanted to describe this past week before the anatomy exam. Let's start with Tuesday, because honestly, that's when it gets nuts. As in seminiferous tubules.

Tuesday

This was one of the harshest days of the week, as far as scheduling goes. I may have gotten about 3 or 4 hours of studying done this day. But let me explain. I woke up at 8 am to head over to the lab, where I was to present my previously mentioned dissection to my classmates. This is an informal process, usually, as we walk through the list of things to identify, show everyone what we dissected, explain why our dissection is good, and mention other cadavers with other great dissections that should be visited. With each dissection, we must present to three different groups. It's good, because by the end of the day, we have the anatomy of our cadaver down to a tee.

A little aside, "Down to a tee" is an abridged version of an old English phrase, "down to a tittle," which means "to the smallest detail". Thought you might want to know. I just googled it since I was curious (oh my distracted mind)...

Anyhow, around 11:30 am I had to extricate myself to change out of my scrubs, run over to my car, change into a suit IN my car, and then run over to a meeting at 12:00 pm with the Flying Sams. Why a suit, you may ask? Well, every Tuesday we have a class called "Clinical Foundations," in which we learn how to examine and interact with patients. It's quite fun, actually. It makes me feel like I'm actually training to become a real doctor. Who'd have thought. So, shortly before the meeting at noon ended (around 12:40), I had to excuse myself yet again, scarf down a sandwich, and run to the main medical educations building to prepare for Clinical Foundations (CF). It was the week for my group to present the physical examination. This is actually kind of a big deal: there are 9 different groups, and each time we learn some new examination, a groups explains to the rest of the class how to perform the physical examination. In other words, we have to know our stuff and not mess up. On a sort of teleconference, we were streamed live to our classmates showing how to perform observation, auscultation, palpation, and percussion of the thoracic wall to appreciate lung sounds. It sounds all fancy and stuff, but really you're just listening to a person breath, feeling for an abnormal masses in the chest and back, tapping their chest, and comparing different sounds of the lungs. But still, it was unnerving to perform live in front of our class on the techniques of the physical examination. I was pretty nervous, but from what Jim told me, it sounds like I did okay. I think I blacked out, because I don't remember much of my explanation.

Alright, so that brings us to about 2:00 pm. From then until 4:00 pm, we saw patients and practiced eliciting information effectively (the art of medicine). After CF, I had a little time to organize my thoughts and study, but then darted off to the gym for a rowing class at 5:30 pm. That definitely revitalized me. After the class ended, I grabbed a quick bite to eat, devoured it tenaciously, and embarked on my journey to the anatomy lab once again. From 7:00 pm to 9:00 pm I was tutored by second years. During this time, they run through a list of things we need to identify using different cadavers. They have mnemonics, tips, and tricks, so it's definitely helpful to attend!

Finally, from 9 until about 12, I studied. Whew. What a day. Onto the next.

Wednesday- Friday

Altogether, I think I clocked in an entire 40 hours work week of studying. Easily. Nearly 8am-1am every day (with a couple breaks to run errands, off course). Let's just say I lived off coffee. But I only spent about 7 hours in lab over the span of three days, surprisingly. Saturday makes up for that.

Saturday

Spent the morning in the lab. It was actually surprisingly fun. The other med students are absolutely amazing; everyone is witty, smart, and gracious. They are willing to help, make hilarious wisecracks that keep you sane, and are extremely good at explaining and understanding all the information we've had to cram into our heads. Several times throughout the day, I heard a couple people say that they love medical school. And I echo their fondness. As difficult as the days get, this is the most amazing experience I have ever had in my life. I count my blessings that I have been so lucky to be in this position.

Anyhow, we listened to music (from alternative rock to house beats) while identifying anatomical parts from 8 to noon. Then, Jim and I went out to grab some lunch, and promptly jetted back to the lab for another 3 more hours. After that, it was cram/study time. After spending that time in the lab, I was able to cram in another 6-7 hours before my brain shut down.

Sunday

Woke up around 9:30, had a nice leisurely morning, then back to campus. Though I had been studying with my usual group over the past week, we all seemed to study on our own this last day. Mostly because we all knew exactly what we needed to study, and when you're getting down to the grindstone, you're studying specifics that others don't need to focus on. So, we focused on our own stuff. I bailed out early (around 7 pm) to exercise, make myself a good dinner, then focus for another 3-4 hours before I called it a night.

And that brings us to the test, and then to right now. The test went well. 8:30-10 was the written, 10:15-11:45 was the practical in lab. After the test, I took care of some errands, took a nap, played some racquetball, and took it easy. It was well deserved after such a long week.

Welp, now it's off to sleep, so I can wake up tomorrow morning and start cramming for all the Physiology that I've neglected due to Anatomy.

"Oh no there ain't no rest for the wicked, until we close our eyes for good"