I’ve been in medical school for just a few weeks, I thought I’d leave some highlights and help document my own memories:
Intubation is an emergency procedure usually done in the emergency room to secure the airway of someone who can’t breath on their own and you have some trepidation about them drowning in their own secretions. My medical school, more specifically emergency medicine interest group at my program, had an open opportunity to anyone who dared to try to intubate an anatomical dummy. A few weeks before I started medical school I got caught up in the show Boston Med, in that episode a fresh MD intern tried to intubate a patient and failed to do so — I know this is a skill you need down because time is the essence in both saving the figurative patient and reducing co-morbidites. So, what better than to get an idea of how hard this procedure is then by trying it as a first year with absolutely no training except the crash course 30 second mini lecture I received beforehand. The procedure is straightforward, but not without it’s caveats:
1. Place laryngoscope into oral cavity, hooking the tool towards the basement of the tongue. Ultimately, the purpose is to reflect the tongue out of the way.
2. Push and lift the laryngoscope, being sure not to roll the tool backwards as this will either break the patients teeth (best case scenario) or crack the maxilla (bad news). The point of this movement is to expose the trachea (the vocal chords end up being a dead give away, no pun intended).
3. Once you’ve located the trachea, you stick a tube with a balloon attached down their trachea, you must be sure to not insert the tube down the esophagus (ultra bad news). Within the tube there’s a stiff, but pliable, rod that will keep the tube from collapsing as you’re trying to gently/aggressively shove the tube down the trachea. Once you’ve done that, you put about 10 cc of air into the tube to both keep the tube in place and prevent fluids from the patient from regurgitating up and going into the lungs (also bad news).
4. Then while holding onto the tube, you pull out the rod, and place either an attachment to bag to manually ventilate for the patient or the ventilation machine.
It’s pretty straightforward, though performing it is another story. I failed the first time, I wasn’t aggressive enough to expose/open the trachea. I then took a mental break and tried it again, this time I got it but after a brief struggle. Finally, after gathering my experience and thoughts I tried again and this time I intubated right away! I’ll definitely will be practicing this more in my 3rd year in the clinical skills laboratory. I never really thought of myself as a hands on person, despite constantly working with my hands, but I liked it and I’m excited for my future emergency room rotation on the wards as a 3rd year.
Signed up to shadow trauma surgeon
You never really know what you’ll do by the time you finish medical school, at least that’s what I’ve been told repeatedly. I suppose this hit home the most when, during my interview, one physician spoke to us about her own experience in medical school until now. At first, she couldn’t see herself doing anything but primary care, now she’s a trauma surgeon. She said to us during our interview, “If you come to this school be sure to contact me if we’re interested in shadowing in trauma”. So, I did followed through and contacted her, I have my first shift sometime next week. Let’s see who that goes, my primary goal is to not get in the way.
The naming of gross anatomy proves that science people do have a sense of humor. Interestingly, it’s not so much the person or the physical anatomy that grosses medical students out. Instead, it’s that we’re inclined to like people and I won’t lie, a lot of us are quite sensitive emotionally (at least it’s that way in our class). The person who donates their body is the most beautiful and inspiring person you’ll never meet (unfortunately, postmoterm). For medical students this is a rite of passage, we all deal with the emotional and psychological impact in our own way. For me, it was with a pint of ice cream — though, I didn’t finish the ice cream yet as I was too tired to physically raise the spoon to my face. Last week we prepped the donor (and ourselves), this week we started dissection on her. Like most medical schools I’d imagine, we started with the back as they have huge muscle groups and there’s a lot of room for error due to the nature of the back, they have you start with the back first so you can learn how to work a scalpel. This is a huge effort, and requires a lot of team work. There are 8 members in my team, but only 4 of us are there for a session — but we are one unit. One team starts, then another team comes and finishes. In between, there’s something called “transition of care”, this is analogous (and purposely so) to patient hand offs in the hospital. Each day there is a team leader (from the 4 person cell) who’s responsible for making sure the next team leader (of the other 4 person cell) knows what’s going on and what issues have come up. If we don’t finish our objectives, it’s the whole teams responsibility to self schedule a team to finish the work before the next dissection assignments. Today, I was part of the first team and all of my awesome team members worked together and achieved our goal today.
We Start Seeing Patients this Week
A lot of medical schools try to get their medical students into clinical thinking as soon as possible, typically with mock patient interviews from skilled patient actors. Our 3rd week into medical school we’re already schedule to start doing rounds with either residents are MS4 medical students and seeing real patients. Our responsibility is to take their medical and social history (probably from the nth time), and present out information to our superiors. I’ve already received my white coat, but it’s not in my possession because I gave it back to the school to get it embroidered as required. I’ll get it back this week before I start seeing patients. Around the same time I’ll be receiving my stethoscope and otolarynscope, both of which I probably won’t realistically know how or need to use for some time. For now, my focus will be on seeing patients, and learning how to build a report while gaining skills at getting an accurate and informative history from patient interviews. I’m a little nervous about missing information more than anything.
Survived My First Medical School Exam
The school crunched what would be a semester in undergraduate of Histology into 5 days (literally) followed by an exam. As I’ve never formally taking Histology I was a little apprehensive about this, as were many of my classmates, many of whom have never had experience in the subject matter either — though, it should be noted that some of my classmates were savvy enough to have taken a masters post bacc course (or post bacc with no degree) Histology course for 7 weeks prior to this. I mention this because if you’re of those people who’re doing post bacc work you should know you’re work isn’t going to waste, those people were comfortable with the cram session. For the rest of us, it was a gratifying torture, but we got through it. My school is a pass/fail school, though we can personally see our own scores so we can know how we’re doing. I passed with a comfortable margin, in fact the class average was rather high considering the circumstances. I should mention that the biggest difference between medical school and undergraduate work is that you really need to work with others to make things work, there’s just too much for you to think you can cover by yourself in too short of a period of time. I go through this period by planning studying groups, crashing study groups, and showing up to office hours. Without my class I’m not sure if I’d be sitting so comfortably right now as I write this blog, instead I’d likely be panicking and wondering if I’ll make it — turns out the signs are positive.