Inspiration and the Medical Student

My last post started with the idea of finding Inspiration, of the sort that drives one to create, to achieve, to question, to learn. The natural next question is what I plan to do with that Inspiration.

We’re told as children to dream big, that the world is ours for the taking. It’s no less true now—I’d be hard-pressed to find a better and richer environment in which to learn—but things have changed. As a high school or college student, I had the bandwidth to pursue those dreams. Sure, I still wanted to do more than I was able, but my internal checks and oft-waning interest for my latest obsession set up a sustainable way to balance my time against my passions. But as a medical student, it’s simply no longer possible to operate the same way. I realized this a few weeks ago as I found myself having ten conversations a day with my classmates commiserating about how 24 hours in a day is just too little, but it’s only starting to strike me now. 

I’ve certainly tried to do it all by going the extra mile to free up my time. But somehow, days blend into weeks, weeks to months, and I’m still sitting on that to-do list that’s gotten only marginally shorter. I want to be clear: I’m not saying that medical students don’t have the ability to pursue anything outside of their classes. Looking at the amazing things medical students are doing every day across the country would disabuse anyone of that notion. What I’m saying is that for very disparate career interests, even within the field of medicine, it’s exceedingly difficult to build solid skill sets as a student. For example, I have a strong interest in the innovation happening in the healthtech start-up world, I love writing and medical journalism, I’d like to pursue pharmaceuticals and drug engineering, and I want to do some academic research as well. These aren’t just passing interests; I would commit to doing all of these things as a career to better inform the way I care for patients and approach medicine.

To those reading, it would seem that I’m complaining about growing up. After all, it’s universally true that with adulthood come responsibilities and a narrowing of horizons. First with a college degree, then a focused graduate degree, and then often a more focused job.  I’m not presumptuous enough to think these issues are limited to medical students, or even students. But it’s a little different for us as medical students: we spend those formative 20s (and sometimes 30s), when much of our generation is exploring and trying and doing, in school and in training. Our capacity to extend and challenge ourselves becomes greatly diminished simply because our road consumes so many hours of our days and years of our lives. None of this is new, I realize. And none of this was new to me when I applied straight from college. I’m proud of my decision and excited for the future, but I need to have those difficult conversations with myself now. What do I want to do? Where do I want to make an impact? And as negative as it sounds, what doors am I willing to shut? Since I can’t both invent a device and revamp Medicare (I’m sure someone has, but c’mon, I have to play the odds), what next?  So I’m not complaining about growing up. Instead I’m realizing I can’t so easily take on the world anymore.

So to answer my first question: my Inspiration is being put to use leaving ajar as many doors and creating as many windows as I can. It’s far too easy to get bogged down by grades, and classes, and The Next Step. It’s even easier to shrug off goals because school is just too busy. To all my friends and peers with whom I’ve sympathized about running out of time, I get it. I don’t have the time either. But we have to make the time. We can’t sell ourselves short—the world is ours for the taking, remember?

To read more of my musings, follow my personal blog.

[Penn]WikiHow: How to Dissect an Eye

WE DISSECT EYES IN BRAIN AND BEHAVIOR!!! We also dissect brains, but I’m not sure if there are rules against taking pictures of them, whereas I’m pretty sure HIPAA doesn’t apply to cows’ eyes, so it seemed safer to skip the brains and go with the eyes for posting pictures on the Internet. I also didn’t want to get any of my camera-containing devices dripping in formaldehyde, since the brains are preserved.

Here’s how to dissect a cow’s eye in five easy steps, learning team-style:

Warning: This post is full of potentially graphic pictures.

Disclaimer/anti-warning: However, they were taken with my silly-phone (i.e., not smartphone), since I forgot to charge my iPad that day, so they might actually just be too blurry to see.

Plug for Penn, since it’s getting to be recruitment time: Every student gets an iPad! We take notes on them, instead of lugging huge stacks of paper around.

1. Three eyes per learning team magically appear in the first-floor Stemmler lab rooms.
   
2. Find the optic nerve and the extra-ocular muscles (muscles around the eye that control eye movement), and cut off the muscles.
   
3. Cut away the front part of the eye. Now you can see the lens (that round blob in the middle), and the vitreous humor behind it. The retina, which contains the photoreceptors that allow us to see, is in the wall around the vitreous humor.
   
4. Play with the vitreous humor. It’s surprisingly jello-like—on a scale of 1 to 10 where 1 is water and 10 is jello, I’d probably give it a 6.5. If you look through the vitreous at the lens from the other side, you can see a shape exactly like the Mercedes-Benz logo on the back of the lens. Nature’s form of product placement?
   
5. Look at the rest of the eye, without the vitreous humor. It’s blue in cows, which helps collect light that isn’t absorbed by the photoreceptors the first time around. That’s why they can see better in the dark than we can. However, it also means that their vision is kind of blurry. (Wikipedia has a better picture)
   

Ta-da! Basically, Brain and Behavior is super cool.

Hello From The Clerkships

Hello to everyone in the Perelman-verse:

My name is Sarah Ginsburg and I am a third year in the midst of my clinical rotations. Incredibly, I am almost 75% done with my clerkship year. As a quick primer on the curriculum here, pre-clinical classes run from the fall of first year to December of the second year. After that, the clerkship rotations run from January of second year (staring 4-6 months earlier than other medical schools) to December of third year. The remaining time before graduation (15+ months) is really want you want it to be - some combination of electives in the hospital, a research project (Scholarly Pursuit), residency applications/interviews, and whatever else you can think of. I'm quite excited to be nearing the "whatever I can think of" stage. It really is great to have the extra time for electives to aid in the process of figuring out what you want to be when you grow up.

2+ years of med school learning. With empty space
because there is so much more to go. And shelves
trying valiantly to hold up so much knowledge.
Metaphor, anyone?

I've been trying to think about the best way to describe "Life in the Clinics". The honest answer is that I really don't have an answer. Each week - each day even - is a different adventure. Your patients change, your team changes, your location changes. And even when all of those things stay the same for a few weeks, each day brings a new set of questions and challenges. You come into the hospital each day trying to find the best way to help your team, whether it be performing the initial history and physical on a new patient, calling a consult or tracking down old records. The clerkship year is about figuring out how to integrate yourself into the clinical team on the fly just as much as it is about learning the facts of medicine and developing rapport with patients. Each team has its own vibe and expectations for medical students. It is a whirlwind, exhausting, sometimes baffling, but ultimately incredible ride. Which is probably med school - and medicine - in a nutshell.

I will now sign off for the night after spending two paragraphs on clerkships without actually talking about the clerkships. Tomorrow, ridiculously adorable children await at my outpatient pediatrics site. As a student, I work one on one with a preceptor, first seeing patients on my own then presenting to the physician. We then formulate a plan (on a good day, the final plan hopefully resembles whatever I suggested in my initial presentation) and go see the family together. Which gives me double the opportunity to interact with said adorable children. After one week (with two more to go) my favorite age is 9-12 months.

More updates to come as the fall rolls along.
Sarah Ginsburg