Update!! And 57 more days...

Just a brief summary of what happened today. I sent out my application for 5th semester site selection. I applied for Michigan. And school tells us that we'll find out whether we get what we want on Jun 6th, which really means June 13th or later. But better late than never! :)

Back to studying...

Sick again... in this humid weather!

I woke up in the middle of the night sweating, so I turned on the air-conditioning. In the morning I woke up with terrible pharyngitis (sore throat)! Ugh... this is when I am not a fan of humid tropics. Temperature balance is hard to find...

On the other hand, school has been stressful. This semester is packed with information and higher expectations. Integrate, integrate, integrate. My brain is burning and so is my body! 4 consecutive semesters of med school without a good summer break really is tough (now I truly understand the meaning of a summer break)... and want one badly. My mind is screaming for a vacation that probably won't come till a year later. I am trying to stay motivated, stay balanced, stay rested - all of which are floating somewhere in the thin air.

We have a lot of Pathology for this Mini and my mind is messy. Microbiology is also filled with fungi and viruses. AHHH I am tired................................ I will dream about sleeping and doing nothing but resting...

One Gram Stain a day... keep the mystery away?

Histoplasmosis is fungal disease caused by Histoplasma capsulatum. Lungs are frequently affected, leading to acute pulmonary histoplasmosis. In human body at 37C, the organism is in yeast form. It is transmitted by inhalation of spores from soil. It looks like a pocketful of jewel inside the macrophage in the picture. Initially macrophages get infected and act as vehicles that takes the fungus around the body via blood, thereby spreading the infection. Cell-mediated immunity will eventually kick in and eradicate the organism, if the host immune system is well-maintained.

No puppy photos today... Good night!

You are my sunshine :)

The days have been rolling along nicely. Ever since the new additions to the house (the lovely puppies), my days have been brighter and better organized! Ironic, isn't it? Some may say that it is absolutely impossible to have puppies while in med school. But so far it has only affected me positively! A few friends of mine are also great examples (they have dogs as well). The best thing about the puppies is the love you can give them and the love they smother you with! While here in med school, the underlying stress I experience is relieved by the lovely little ones. The picture on the left is of Sera and the puppies.

Mini 1 happened on Monday and the Beach Bash was in the evening. It was nice to see all my classmates, who had all become hermit crabs during the exam week. It was rough. 4th semester is challenging due to its goal of information integration. Yes, think like a doctor... and you must... I still find the material interesting and thus will keep the motivation flowing. ICM this semester is also full of suprises and challenges. We have learned how to perform the rectal exam, male/female genitourinary exam, and the breast exam. These procedures depend a lot on the doctor in order to make the patient feel more comfortable in the most awkward situations. Certainly some of our fellow students do not feel comfortable themselves at all - one even asked 'Do I really have to do these exams?'... That left me speechless.

Soon we will receive the talks from each of the 3 sites: Dominica, Michigan, Miami - on what 5th semester is all about. Then we will be asked to pick our preference. Earlier there were a lot of students in my class who were going to Miami. But lately I have been hearing a lot more 'Michigan'. It'll be interesting to see who goes where. I think I'm going to try for Michigan. But I will keep everyone updated on the application process.

72 days till I am off the island :) Next step? To the States.

Viral? Bacterial? Canine?

School has been pretty even-grounded but the information flow does not stop. This is the semester to really bust it and start integrating all the knowledge scattered around in my brain. Oh yes I am trying...

Here is some uplifting news - we have new additions to our little home here in Dominica. After the tragic incident I had been meaning to get my land lady Sera another pup for her to love and who will definitely love her back. Well they have arrived :) The picture is of the two of them. The brown one is named Daisy and the white one is named Pearl. They are sisters from the same litter. Sera has not stopped smiling since. And that puts my heart at peace. Love heals all wounds, not time.

In the mean time, I am trying to stay on top of my classes. This semester I am tutoring with my friend Phil. We are doing all subjects for 3rd semester students. I really enjoy it and that's why I decided to keep tutoring during my last semester on the island. The courses keep getting harder but more interesting. I want to finish strong in the final months of my second year. Let's keep on trucking!

Smile at someone today :)

Life goes on.

Things are finally starting to return to normal again. Sera is feeling better and I am having flashbacks less often about what happened to Dixie. Now I can actually sit down with a clear mind and update you guys on my exciting experiences last week.

First thing we had was the Simman session. Like I mentioned before, Simman is a simulation model of real-life patient. He has pulses, heart beats, and lung sounds. He can talk, moan, vomit (sound effect), and cough. We can measure his pulse, EKG, temperature, respiratory rate, and blood pressure and read the results from a monitor. The facilitator that was leading our session controlled what symptoms the patient would present all through a small touch-screen computer according to the specific disease assigned to our group. It was a 1hr session, but it went by fast. No one in our group had any ER experience so it was a bit of a gong show at the start. But we quickly organized ourselves better. Under the guidance of the facilitator and the direction of a group leader, we bounced questions and differentials off one another. It was great. I almost felt like a doctor (I would have REALLY felt like one if I knew what I was doing)! I heard crackles in the lower lobe of the right lung (pulmonary interstitial edema) - got me so excited! Anyhow, with some help we diagnosed our patient - H1N1. Unfortunately none of us in the group wore a mask... so we were all 'infected'. Definitely a good lesson - wear gloves AND a mask! Our facilitator said to us, 'Congratulations, your patient lives... but y'all now have H1N1.'

Then on Thursday I went to the Princess Margaret Hospital (3 ICM groups) for our first rotation as a 4th semester student. We took a bus to PMH, which took about 1hr, and received our assignments for the day. I requested surgery but did not get it - apparently too many students requested for it! But I was assigned to Internal Medicine, which was amazing as well! The wards at PMH were old school: a dozen or more beds packed tightly together, separated my a curtain. The hospital appeared slightly run down but nevertheless tidy with some new renovation projects going on. The offices were small but the desks were still full with patients' charts. The doctors here recorded everything by hand, a system that is rapidly replaced by computerized sorting/recording in N.Am. hospitals. Our Internist was amazingly knowledgeable AND extremely friendly (I was surprised...)! We saw about 9 patients in 2-3hr or so and they all had different signs and symptoms. The beautiful part was that I have learned about most of the cases presented! What a wonderful review (and reminder of how much harder I should study)! By noon, I was already pooped. But I still had 6 more hours to go.

In the afternoon, we were divided up into even smaller groups to do our patient interview and physical exams - this time, it was real :) Due to confidentiality I will only mention that our patient was 2wk post-op from an AP (abdominoperineal) resection. He had a colostomy bag attached to his lower left abdomen. Long story short, we finished at around 4 30pm, met with the surgeon (super friendly, once again), and discussed the case. I had such a great day but was completely drained - hungry, and tired.

The bus ride home was long but I didn't mind it too much. Got home, took a nap, and got back to studying. Lots to learn... and I am looking forward to it!

ps. Enjoy a recent picture of Miho. He is so handsome!

Really hating the forced goodbyes...

This is when I miss civilization and justice. This is when I miss home. Yesterday I was at the hospital the entire day doing my first rotation in 4th semester. And I had an exhausting but great day, until I arrived home. As I was walking back from campus I saw a huge crowd outside of my house. And I thought something happened to my landlord Sera. Then I stopped... when I finally saw what had everyone's attention - our dog was lying in a ditch right outside the front gate, twitching as he saw me coming. He started blinking rapid and twitching some more. I wanted to go pet him but I could not - all these huge long gashing wounds all over his body stared at me like monsters in a horror movie. His skull was cracked open. You could see his pink flesh all over bleeding away. I bit hard on my lip and turned away to walk back into the house. On the balcony I saw Sera broken into pieces. Every drop of her tears hit hard on my heart and it was painful. This dog was her baby. As she lived alone by herself in this house at the age of 80, the dog was her only company. Us students who stay every semester - we are usually studying, barely home. Her and the dog are the only permanent residents here, and he kept her company.

From the bystanders and Sera herself I had the story of what happened - a local man walked by our house earlier in the afternoon and claimed that our dog bit him. He then left for a while and came back with a machete with the intention of killing the dog. And he did, using the machete and a big rock, right in front of Sera's eyes. Poor Sera. I wish there was more I could do. I wish I could turn back time and change this. Unfortunately that's impossible. Brutality like this makes me lose faith in this world and its people.

Anyhow, I am going to update everyone on the simulation session and the hospital visit I had this week, but maybe tomorrow - when my mind is less messy. Take care everyone.

Attacked...

Yesterday was rough. I had been super tired for two days prior with some unknown cause. Then yesterday morning I woke up and was hit by extreme nausea. I stumbled to the bathroom and nothing came out. Exhausted and bothered, I went back to my room and sat down on the bed, hoping the nausea will ease. While slowly it seemed to be disappearing I suddenly get a crazy gurgling sensation in my abdomen... Uh-oh, I thought, this signifies disaster! And yes, a disaster it was. I swear that it felt like I lost 2L of pure water from my body. Later on around noon I started getting chills and within 30min I had a fever spike. Well, I definitely couldn't read any more lectures for the day (I had trouble steadying myself even), so I went home and lay in bed shaking in sweat. It was pleasant... not. First week of the semester and I caught a bug. Luck or no luck? You decide.

While I was resting with a fever, my lovely friend Andra came by with juice and water for me and she actually stayed to watch one episode of House. That was very nice of her. After she left, I tried to sleep but couldn't - all I could think about were the symptoms I had and time of onset, trying hard to diagnose myself. I was happy that I finally understood the definition of ACUTE onset. When my fever subsided a little I skyped my mom and got her all worried (oops). But today I felt much better. The only thing that was still bothering me a bit was the dizziness I felt. But my tube was not leaking in either direction (think about it...)! Time to catch up on studies. Two more days and I'll be doing my first Simman session. Four more days will be my first hospital visit. Will update then!

Have a good day and don't catch any bugs!

Day 2, once again!

Not bad, first ICM session in 4th semester actually went really well today. Totally different from the ICM sessions I had in 3rd. This time the facilitator is quite awesome. He is so laid back and receptive to questions AND extremely knowledgeable. I am looking forward to this semester already (although I know I will regret saying this... or laugh at myself at least). Picture on the left is taken from Pagua Bay.

I emailed my students from last semester's tutoring - all of them made it to 3rd semester! I am so happy. Almost feel like a proud parent. I have tutored most of them since their 1st semester here at Ross.

Next week our hospital visits will commence. We have only two visits this semester to Princess Margaret Hospital (PMH) and I am quite excited about them. Two is better than none! I already know what my visits will be... Should I spoil it for y'all? I think I will! One of them will be Surgery and the other one will be OBGYN!! Hopefully I will get to see an actual surgery and a delivery. Ah, the anticipation...

For now, I will get back to studying... the almighty diuretics.

One more week of relaxation.

The break has been treating me well. I have been indulging in endless sleep. It is wake up, and going right back to bed. My body automatically wakes at around 6 45am everyday. But at least I could go back to sleep without feeling guilty. And that, my friend, is what awesomeness feels like. The rainy days are starting to arrive. Somewhat refreshing as the heat dissipates. But I am not so used to walking around with an umbrella any more. Gotta get back into it again.

Many first semesters have arrived one after another. Today is their orientation day with a fantastic BBQ following immediately in the evening. Of course, expect me there (where the free food is). Time went by fast. It has already been a year and a few days since I started here at Ross. I have been chatting with some first semesters who were excited, nervous, unsure about what was going to happen. And that reminds me of my first days here - the beginning of an adventure. Like any adventure, I told them, you just need to have an open heart and be prepared to test your limits. Afterall, there is a reason why they are called adventures.

4th semester is just around the corner and half way through it we will get to decide which site we would like to apply for: Michigan, Miami, or Dominica. Like I have mentioned before, Miami is also the default - ie. if you did not get picked by your preferred site, you will be automatically admitted by the site in Miami. Many people, however, apply for Miami to begin with (like some of my friends who are into urban life and hot weather). Don't blame them. Some of them really miss their BMWs and giant flat screen TVs ;) I think I will be tutoring again. I debated about it for a couple of days but then figured that I'd probably be unhappy and empty if I opt out of it. And what is the purpose of all this studying here if I am unhappy? Question answered.

Before I head to the BBQ tonite I am going to sell some of my books again. Missing my family and friends in Vancouver but also loving Dominica :) Good luck to everyone in whatever you are trying to achieve! Just keep on moving!