August 6 – I saw a hemi-thyroid removal performed by my mentor. My mentor’s mentor’s mentor’s mentor was the person who invented the procedure. I might have written an extra mentor in there, but I’m not so sure. Anyhow, my mentor’s mentor had performed apparently over 4,000 such cases; the procedure is old, but seems to work well. There was also a 4th year HMS student there, so my mentor explained a lot of things to him as he performed the surgery, which made sense considering the med student would know more about the procedure and parts of the body than me. It was nice to get to see how the body differed so greatly from the picture in the anatomy textbook–I would not have realized what was the thyroid gland unless someone told me. But it was pretty enlarged–I felt it the lady was cut open and I could feel the bump in her throat. It was quite obvious. Even though the surgery seemed simple, the hardest part was taking out the thyroid without hurting a nerve (which was apparently white–I’m guessing because it’s myelinated, but I couldn’t really tell what was what in the body even though my mentor and the med student seemed really sure about seeing it) that would have changed the woman’s voice (made it lower). Later, I went to the pathology department and saw that it didn’t really look like cancer under the microscope, but further slices were needed for observation. Basically in the pathology department, quick slices are first made within a few minutes (they froze the mass then shaved it with a machine) and placed onto a slide. There is a group of microscopes all connected to one main microscope that the pathologist looks through, so you can watch along.

Side-note: I learned from the med student a mnemonic to remember what the adrenal gland produces and where: the deeper it goes, the sweeter it gets. Aldosterone, cortisol, sex hormones.

August 19 – I saw the removal of the left adrenal gland. This was pretty cool. It was a laproscopic procedure and it was actually quite fast. The cool part was that the adrenal gland was huge–6cm! It was about the size of a small kidney and it looked like one. My mentor cut open the adrenal gland (made a slice) after it was removed (put into a bag in the body and then pulled out of one of the small holes) and it just looked weird. They had guessed it was an overproduction of cortisol, so that explained the yellowness of the mass, but there were apparently hematomas littered throughout the mass. So, it was basically a kidney-shaped and sized yellow mass with big dark red dots throughout the mass. When my mentor and I went to the pathology department, the pathologists in the beginning thought it was something renal–something from the kidney had produced the mass and it was affecting the adrenal gland. But under further observation with the microscope, it did seem like it was just an overproduction of cortisol.

August 24 – I observed first-year med school students at HMS with a simulation. This was their second simulation and it was quite funny. My mentor was in charge of the class, so he acted out the patient, nurse, doctors, etc. and was in charge of the manikin (adjusted its blood pressure, condition, etc.). In the beginning, I thought the med school students were actually pretty good, because they seemed pretty thorough in taking the chief complaint, history of present illness, differentiation, etc. but then I learned it was just because they had a simulation like this already and they learned from the previous simluation. Apparently in the first one, the students who had watched the medical TV shows were the ones who became the leaders of the group–HA! “They would ask all these questions that weren’t really relevant.” The exercise was meant to show the students where they should be by their residencies, so it shows how much more the students have to learn. Since I wasn’t even in medical school yet, it showed me too how much more I have to know.

Both simulations that I watched were heart attacks (anterior and inferior myocardial infarctions), so I learned some things about the heart too. Fun fact: A lot of people can have heart attacks on the right side and not know until they get surgery later because when you get a heart attack in let’s say your right ventricle, your heart can still work (whereas when you get it in your left, the blood gets blocked up and goes back into the right, which hurts the right and therefore the entire heat) on the left and so a bit of your right will die, but eventually your heart will work again. It’s only later in surgery when people see that part of the heart is not working that surgeons can determine that the person has had a heart attack before.

One thing I did realize was that med school students aren’t that different from someone like you or me. But they are very interested. I was happy to hear someone say, “Wow, the heart is just amazing” after one of the simulations and learning about what had occurred in the heart during the situation. I love being in an environment where everyone is so interested in what they do–it makes me all the more interested and excited!

In an attempt to be more on track, I had prepared my dinner as well as much lunch yesterday. This way, I could finish my dinner in lab and then head straight to the library. Unfortunately, after all the summer school kids leave this week, the library will have drastically shortened hours and so I will not actually be able to use the library. Thus, I want to at least get the most out of this library for this week.

After spending close to four hours in the library, I only managed to finish one chapter in my MCAT book. That was pathetic. Previously, I had finished two chapters in four hours. But this time, I kept on losing focus and would reread the same line over and over again, and then forget the entire anatomy of a system or part of a system and then have to reread everything in a certain section.

Why is it that I focus so much better during the school year? I remember last semester, I really forced myself to study, but I could actually study efficiently and feel accomplished after the hours I put in.

I should be excited to study this stuff. At least, the biology section. I know my efficiency will drastically decrease when I get to physics (which I think I’ll leave for last), but I should at least start out strong with biology.

It doesn’t help that I think I am forgetting my orgo already.

Anyway, I need to finish another chapter by tonight. That way, after two more chapters tomorrow, I will have finished the biology section. Just in time to meet my mentor at the hospital on Thursday, during which time he will be giving me an anatomy textbook to read before I watch surgeries.

But it’s one in the morning currently. And I haven’t started the next chapter. It’s going to be a long night….

We went to Rockport, MA, where there were several beaches. The weather was beautiful and the beach was beautiful–truly blue waters. There was also sand at the beach (it wasn’t incredibly rocky, as most northeastern beaches are). However, the water was freezing cold. No one could really swim in that water. I managed to dunk myself in, but then came out and decided to just wade in knee-deep water for the rest of the time. Then, we spent a long time just sitting on rocks because the tide was coming in and the water was definitely too cold.

We did eat some good food though. For lunch, each of us ate a lobster (the total meal came out to be around $17 per person) and for dinner I ate a Middle Eastern wrap (basically a wrap with hummus and other vegetables inside).

I should have taken more pictures, but I actually dislike taking pictures when I’m out doing something. I want to have fun and not have to be the one documenting everything. But, I was the only one with a camera. I guess I’ll take more pictures next time….

But, I guess I should write more. Even my pre-med mentor told me to document my experiences in shadowing (which is smart and sensible to do). I always said I was going to…now I really should.

In terms of the lab, it’s been a lot of qPCRing. It gets so incredibly frustrating because it seems my results are the direct reverse of what it’s supposed to be. I guess I really should start using a 96-well centrifuge; I really need to talk to the lab a floor above my lab. Yeah, I should get on that…. Otherwise, lab is normal. I realized that I actually don’t know that many protocols–I’ve just been trying to perfect the ones that I do know, and it’s taking an incredibly long time. Extraction, PCR, qPCR, and gel making are basically the only things I learned. And yes, by now after so many times, I do have them memorized. I have the numbers memorized.

On the shadowing front, I have shadowed three surgeries so far. The OR was a lot different from what I expected. No, it’s no Grey’s Anatomy. It’s much smaller and not as dramatic looking (in Grey’s, it seems that the only light that there was shown down on the thing that was being operated on; in reality, the entire room is lighted up and there are lights–like dentist lights–shining down on the incision area). I also realized that most of the surgery is performed with burning the flesh with electricity rather than cutting, which makes sense because it stops the bleeding. But oh, it just makes me realize how deceiving all the medical dramas are.

So far, I have witnessed a paraesophagal hernia repair (stomach goes past the diaphragm that has too big of a hole and goes into the chest cavity–the stomach had to be wrapped around the esophagus to prevent this from occurring again), a right breast removal with insertion of a tissue expander (I think this is my favorite surgery so far, because the plastic surgeons for the tissue expander seemed to actually be happy and somewhat enjoying what they were doing instead of being focused so seriously on the surgery), and a colostomy (removal of the colon and redirection of the small intestine outside of the body for the time being into a poo bag; I didn’t really like this one because I couldn’t see much, and I got sick of the smell after the surgery).

After watching these surgeries, I think it gave me a clearer idea on if I want to become a surgeon or not. I am now leaning against becoming a surgeon. Even though it’s more active than the other fields, in the sense that as a surgeon, you get to work with your hands and you are really making split second decisions in certain cases (a resident told me that his most interesting case was a gunshot wound to the face; they had to take the thigh tissue and place it over the face), but it seems so exhausting. I know that there is no such thing as an easy route in life, but I don’t know if I want to have 6AM-10PM work days and an even tougher residency. I guess it’s because I haven’t seen any really “oh my god” cases that outweighs the cons right now. I want to see an open heart surgery, a bypass surgery, and a baby being delivered. I think those will be more interesting. I also want to shadow a doctor for the whole day rather than just going to see random cases, because I think that would give me a better idea of how the life of a surgeon actually is, rather than taking snapshots through cases.

I do really appreciate all that my pre-med mentor has done in order to give me these opportunities to shadow. I seriously think he’s one of the best mentors ever–one of the best mentors I’ve ever had. He actually helps and guides me, which is really new to me in terms of mentorship. I’ve had mentors before who didn’t care at all; I also understand that, because mentors are usually really busy people and a mentee is way down their list of priorities. So, I am happy with how lucky I was!

In studying, I haven’t been doing that well. I really need to study more, especially since I can’t study in July, but it’s so hard to focus. I’m trying to finish all the MCAT material (the reading material) by the end of this month so I can spend the rest of the time just doing practice after practice. But, I’m not really one schedule with the material…which is incredibly annoying. I think the only subject I actually like studying is biology. I think I actually really do dislike studying physics and chemistry. I also like doing organic chemistry problems, but I don’t actually like studying it. Verbal is actually kind of fun because I’m getting most questions right (for a change; unlike SATs…), which boosts up my confidence.

So, that’s the recap of the last few weeks. I’ll try to write one blog entry per shadowing experience form now on.

Also, tomorrow, I think I’m going to Six Flags with friends. Woot! Okay, I do need to play hard some times. I think playing hard will help me focus and work harder too.

Thus, I have decided to undertake the challenge of 750 Words on this blog in private entries. This is supposed to get my juices flowing for the day. Who knows? Maybe I actually will be more productive and creative if I decide to voice everything out.

In July, I will be going to China to participate in the China Synergy Program for Outstanding Youth (CSP) that I was supposed to have gone on last year. However, due to the dratted swine flu, it was canceled. Having it in the middle of my summer is not the most convenient, but I guess it will be giving me a welcome break from the studying and researching I will be doing.

In the meantime, I will also be studying for the MCATs that I would hopefully take at the end of August. It’s really bad that I haven’t had a full length practice test yet–I am planning on doing this tomorrow. Hopefully, the diagnostic test won’t be too bad. I have been reviewing some of the biology, physics, chemistry, and verbal sections for a few days, but not nearly enough. I need to get my studying into full gear; I have been delaying all this way too much.

I am also going to shadow surgeries this summer to see if surgery is an option I would like to pursue in the future. I also have to teach five Red Cross courses to fulfill my agreement with becoming a Red Cross instructor last semester.

This all means that I need good time management skills and that I cannot waste time!

But on Sunday, my psychology professor decided to post the scores for the midterm we took last week online. I checked my score first thing in the morning when I went online. I wasn’t especially pleased with the score I got, but it was okay. I would just do better next time for the “A” I must get in this class.

Three hours later, my psych professor sent out a mass email saying that there was a mix-up with the scores and he uploaded a new version of the accurate scores online. So I went back to check my score and became devastated–I was more than a standard deviation below the mean. Obviously, the first thing I did was write an email to my professor to ask if there was any mistake, and in five minutes I received the reply, “I am afraid that is your score.”

I was in shock. On one hand, I still did not fully believe that was my score because I didn’t feel I performed that poorly, but on the other hand, the professor had written to me that it was my score. I tried to move on and study for the midterm I had on Monday, but I couldn’t focus.

An hour later, another email appeared in my inbox saying the scores were messed up again and that they had been taken down from the website. I had tears falling in relief and frustration.

Three hours after that, the scores were uploaded again and I had the same score I had in the morning. Three hours from that, my psych professor wrote to me, “You actually got ___, an excellent score. Hope you didn’t jump off anything tall.” I had to smile at that.

This really does give a whole new meaning to “psych.”

So how do I get through the day having to study one course after another? I manage to find some retaining interest in the material. Here is what I think (or I will myself to think) about these courses:

Psychology: It’s psych. It’s about humans such as me. It’s interesting, although very skewed to the western world. But it’s interesting.

Madness and Medicine (History of Science): It was kind of bland in the beginning (you should really like asylums before taking this course), but I like learning about history and we are getting to the effect of psychiatry on war veterans. That’s interesting.

Physics (electromagnetism): Although I am not one for physics (simply put, physics ranks the lowest of the three sciences), the material is somewhat interesting. It explains how the electrical/digital world works, which is pretty cool considering we are using so many electrical appliances. People should know about how things around them work, so this course is pretty crucial to just understanding the world.

Organic chemistry (biochemistry): I actually really like this course. The material relates organic chemistry to reactions that occur in our body, which is pretty neat. We have examples of things that actually occur, so that captures my interest. Plus, it’s definitely not as hard as last semester’s organic chemistry class, which is a sigh of relief. It might be because my study habits improved, but I also think that the material is easier to understand.

Obviously, there are things I don’t like about each class too, but I find that I am much more productive when I think about how a class is cool and interesting rather than how it’s boring and tiring.

In the morning of this blizzard, I was in the science center listening to a lecture on capacitors, resistors, and physics in general. As an anecdote in relation to learning about the ground acting as a big capacitor, our professor told us a story about what happened to him when he was cleaning out his garage.

Basically, as he was wiping this metal screen in his garage, he suddenly could not control what he was doing anymore and just felt himself shaking. He continued cleaning and felt himself shaking again. In the beginning, he thought that he was having a seizure, but then became wiser and thought that maybe he felt an electric shock. So at that point in time, he took out his voltmeter and measured the metal that he was cleaning and an aluminum trashcan nearby. Sure enough, charges were going from high potential of the metal to the low potential of the trashcan.

At this point in time, the whole class was bursting out in laughter. Only a physics professor would (1) have a voltmeter handy (2) measure conductance after feeling an electric charge.