Can You Locate Your Ischialrectal Fossa?

Well thanks to OMM I can...and also on other people. Essentially, it's a potential space just below the pelvic diaphragm, used to treat edema (possibly from fluid build-up post surgery) or to monitor pregnant patients. You know those bony protusions you feel in your tush when you sit down? Well, those are your ischial tuberosities. And the ischialrectal fossas/spaces are located just next to those bony prominences. Suffice it to say, I've bonded with my OMM lab partner. There's no turning back from there.

So why did I bring up this frisky little gem of an OMM moment? Just proving my point that sometimes it's hard to really get across what it means to be an osteopathic medical student. Just seeing the word "rectal" in the title incites a certain amount of awkward discomfort and an automatic response of hands moving to protect personal space. When I first saw the lab handout describing this particular technique my first thought was "My hand goes where?!?" and then "Her hand goes where?!?" But when it's put in its clinical context and you hear how it's helped improve a patient's health, it makes sense.

Jump ahead a few weeks and I find myself hanging out with some medical students from a well known medical school in the city (they're allopaths *gasp*, a.k.a MD students). I was a little hesitant, thinking that they might not accept me and my brand of medical studies, but they were welcoming and interested. But when they asked about OMM lab, I found myself struggling to find just the right words to accurately describe the body-is-a-unit/structure=function aspect of it, and not come across as someone studying crazy voo-doo medicine. And when they likened it to orthopedics, that's when I knew I had failed. I had let down A.T. Still, founder of osteopathic medicine. I could just imagine him throwing his hands up in the air and shaking his head with disapproval. I had let down my people....

But it got me thinking, is this how it's always going to be? When I start clinical rounds in a few years, will I have to include a brief history and philosophical summary of osteopathic medicine when I introduce myself to patients? Will I ever be able to portray all that is good about osteopaths in a coherent sentence?

Some of my med student friends often talk about the potential of not being taken seriously when we're out there in the real world, wielding stethoscopes and reflex hammers and such. We hear stories about patients refusing treatment by D.O.s or allopathic physicians looking down on their osteopathic colleagues. Of course, these are just rumors and should best be taken with a grain of salt, but I think there's a little defensive spirit in us that gets all riled up whenever we're asked about osteopathic medicine.

But a rose is a rose, whatever its name (shout out to Will Shakespeare!), doesn't that hold true for allopaths and osteopaths? Should it matter which letters follow our name? At the end of the day, it's the doctor who's doing everything possible to give the best treatment to the patient. Whether it's M.D. or D.O., we have the same goal. (By the way, did you notice that the first two letters of "doctor" are "D" and "O"? Not to be biased, but I'm just saying...)

So maybe part of the osteopathic medical student experience involves a little touchy-feely action, it's just another opportunity to make some lasting memories (and fodder for some hilarious stories). But, I know this is where I belong. I just need to work on coming up with better answers for osteopathic medical questions. I'm thinking skip the verbal response and head straight for demonstrations. Who wouldn't want their ischialrectal fossa monitored?

Brain Boycott

My mind has thrown in the towel. Think "Information Over-Load" in red flashing lights. I had big study plans after the six week exam-a-palooza. I was not only going to catch up with reading, I was going to get ahead. I know, I know....maybe a little ambitious, but certainly possible. Possible if my brain cooperated with the plan that is. But every time I opened a text book, my thoughts wandered to simpler things like wanting to read glossy magazines with their short sentences and big pictures. And I did all I could - instead of studying at home on the weekend, I hiked it over to the school library (perhaps all I needed was a scenery change) and listened to music with just the right amount of "go get 'em" rock beat. I guess it kind of worked...it only took me 12 hours to get through five chapters of biochem. [insert sigh here]



Honestly, all I want to do is make a yummy frittata and watch back-to-back episodes of Greek. (By the way, I've recently become hooked on this series. Maybe I'm just vicariously experiencing the more average college lifestyle - for those who know me, you'll understand given my more unique undergrad experience. Anyway, I digress...) So, that's what I did. This morning, I was planning to finish the remaining 130 pages of dense anatomy reading and hit the lab to miraculously fill my head with all-important knowledge of the abdominal aorta and the small intestines. This afternoon, I came back home after slogging through 20 pages of dense reading and no lab time. When you find yourself re-reading the same paragraph for thirty minutes, you can't kid yourself anymore. And then I made myself a super yummy frittata and watched back-to-back episodes on Hulu.

Hibernation also sounds good. Staying in bed instead of getting up early into the very cold morning, stuffing my face with carbs and chocolate and gooey cheese, and avoiding anything intelligently demanding. [insert two sighs here]

But there was a bright spot in this haze of brain doom. I spent a lovely Sunday afternoon with a bunch of grade-school kids during a "Fun with Medicine" event. It was refreshing to experience the excitement of becoming a doctor through a child's perspective, from "pin the bone on the body" to the "scrub relay race." These kids were thrilled to gown up and head into a pretend operating room, their smiles said it all. The day was a much needed break, but more importantly, it was a great reminder of why I just need to push through this mental fatigue. Deep down I'm just like those little kids, all giddy and psyched to be in med school, it's just that that feeling is buried under the rubble of renal physiology and histopathology of the integumentary system. But it's there....

Alright, enough already! There are only 4 more weeks left in this semester. Wow, I'm re-reading that sentence and I can't believe it, it's really flown by! But I'm going to get through this, even if it means brain implosion at the end of it. There's always winter break to recover, right?

Med School Singleton

So, I think I've resigned myself to the idea that I'm going to be alone for the rest of my life. I like to think of myself as an optimist, but I also try to maintain a sense of reality. Let's face it, med school ain't doing much for my social life. And for the kind of career I dream of, I don't know when I'm going to find the time to hit the dating scene. I suppose I should try before I throw in the towel, heck I've even contemplated speed dating, but honestly that's just not for me. If internet dating is your kind of thing then by all means go for it, it worked for one of my closest friends, but I'm more of an old school kind of gal. And by that I mean 19th century old school, when the man of your dreams was a dashing yet mysterious gentleman who you met at a ball and swept you off your feet with just one brooding look.

Yes, much of my childhood was spent reading the Victorian classics. But is it too much to ask for some hand-written declarations of love written with a quill and sealed with a wax stamp?

Back to modern day....most (if not all) of my friends at school are either with a very significant other or are married. Come to think of it, most of my non-school, known-them-for-most-of-my-life friends are coupled up. So when they talk about date nights and meeting future in-laws, I don't really know what to say. I empathetically listen as any friend would, but I don't have pearls of wisdom to share because I don't have much experience from which to draw. I've always been school-focused/career-focused, so much so that I think I missed out on that part of life. And now that med school is my main focus, I wonder if I'll ever get to fill-in that missing part of my life. I've always been told that I'll meet someone in med school, but now those same people are saying I'll meet someone when I start working in the hospital. At this rate, I'm probably going to meet this dreamboat of mine in the retirement villa during a rousing game of bingo. I can see it now: our hands touch as we reach for the same plastic chip, I coyly smile hoping that my dentures don't slip out of place, he smooths down the few wispy gray hairs he has arranged in a classic comb-over as he calls "Bingo!" with a slight wink at me. Love amidst soft foods and orthopedic shoes....I can't wait.

I look at my coupled-up friends at school and think of how great it must be to have that kind of support. To go home to a husband/boyfriend and know that someone is waiting for you, thinking of you, ready to listen to you talk about your day. Of course the grass is always greener on the other side, right? In fact, one of my fellow classmates recently emailed a link to an article about dating med students, and it's pretty bang on. So as much as I wish I had a boyfriend I could call at a moment's notice and share with him the latest exciting disease I just studied, a small part of me is glad I don't have that extra pressure of being a good med student and a good girlfriend. But still, I'm a sucker for romance. And just once I'd love to have a real Valentine's Day, and not tell myself that "this day is about loving all of the important people in your life, not just spouses and the like." But most of all, it would be really great knowing that there's someone rooting for me and has my back, and it would be even better knowing I was that kind of support for someone else.

So maybe this is my way of putting it out there, an order placed in the cosmic market - one dashing yet mysterious gentleman (a British accent wouldn't hurt either, but I'm not going to push my luck). In the meantime, I've got plenty of dates with textbooks and coffee to keep my nights occupied...

Well there goes that plan.....

Who's the world's worst blogger? That would be me. Yeah, so much for posting an update each week with a rousing tale of life in med school. But I have a good reason. For the past six (yes, 6) weeks, I've been in exam hell. Each Monday brings one, sometimes two or three, exam(s) and its own set of anxiety-ridden nerves. Every weekend has been spent locked up in my apartment and studying from dawn til' dusk (and probably later than that). Don't worry, I open the window to get my requisite fresh air (or as fresh as you can get in NYC) and sunlight for making vitamin D, and I'll gaze at the people below, enjoying their free time and lesiurely weekend doing normal people stuff. And then I'll look back at the mess that is my kitchen table and remember that I only 24hrs to teach myself the respiratory system.

I think it was around week 4 that I hit the wall. I was sitting on my couch, neat piles of anatomy notes surrounding me like soldiers guarding a fort, and it all came crashing down on me. All of the big worries of failing and retaking classes and being horrible at med school while everyone else is getting 100% on everything, and the little worries of realizing that I ran out of milk and I don't have the time to go to the store to get milk because I have to use every minute towards studying and I'll probably develop osteoporosis, and the medium worries of how am I ever going to meet someone and get married and have a family when all I do is lock myself in my apartment and study while my prince charming is off meeting some floozy with a regular 9-5 job who probably isn't squidgy from eating chips and doesn't have dark circles under her eyes from lack of sleep. So....I'm going to be a spinster med school flunkee with brittle bones. Start the waterworks.

And after a few minutes of hysterical sobbing, I said "oh well" and went right back to studying. I've found that the stress can build up, and before you know it, it's literally coming out of you...and in my case, my lacrimal glands. You just have to get it out, get rid of the tension so that you can continue. And I knew that this exam period was going to be tough. I spent the latter part of September stocking up my freezer with prepared meals so that I wouldn't starve, like a squirrel foraging for the winter. I warned my friends that I would be MIA all through October. I even compiled a list of encouraging quotes to get me through it (hey, whatever it takes). But when you hit that wall, you just need to get the stress out. And you know it's bad when you're cursing like a sailor and your dad (your dad!) tells you that you need a drink.

But exams are almost over, just one more on Monday and we'll be done for this round. Then we have a few weeks to get it together before finals come around. I can't even bring myself to think about finals because my brain will implode. But during this time away, I've often thought about this blog. So much has happened, and I've written posts in my head...and I just didn't make it to the keyboard. But knowing that there's a space for me to collect my thoughts and share it has helped. Though it's also made be feel a little guilty that I haven't been keeping up with it as much as I'd hoped. But whatever, I'm not wonder-woman...yet. So now that I have some less stressful days coming up, I'm hoping to regale you with a month and a half worth of stories: from cracking skulls in anatomy and getting very personal in OMM lab to learning how to find nirvana in med school. World's worst blogger no more!

What It Means to be a D.O.

As osteopathic medical students we go through the same rigorous workload as any other allopathic medical student, but with the added class of Osteopathic Manipulative Medicine. I've already written about the lab component, but I have to admit that though I was self-conscious the first few times about revealing so much of myself to strangers, it's not a problem anymore. And I owe much of that comfort to the lecture aspect of the course.

Once a week our class meets to discuss various aspects of osteopathic medicine. At the heart of it lies the four basic tenets:

1. A person is a unit of body, mind, and spirit
2. The body is self-healing and capable of regulating health
3. Structure and function are interrelated
4. Osteopathic treatment incorporates the aforementioned principles

The first principle of the osteopathic medical philosophy seems pretty self-explanatory, but I think it's often taken for granted. If you think about it, everything we do affects our health. The way we carry bags on our shoulders, the decision to skip breakfast because we're running late, or even the happiness that comes with acing a test. It all affects our physiology. So why shoudn't we take that all into account when we think about our health? But OMM class constantly reminds students, who are just beginning their career in healthcare, that patients are more than just lab results and prescriptions. Patients are people and everything that is encompassed by a person.

The human body has so many built-in back-up systems, it really can maintain its own health. In Anatomy we just learned about a vascular structure in the brain called the Circle of Willis. And just as its name suggests, it's a circular connection of blood vessels that supplies blood to the brain. But should one of the arteries become narrowed, or even blocked, blood will still be able to reach the brain because of that cyclical arrangement. Isn't that amazing? It's so smart, so clever. And that's just one of the many checks-and-balances that keeps our body going.

Now, what about this structure/function thing? Well, here's where I can get really geeky and talk about my favorite organ, the kidney. For most students, the heart or the brain is the most exciting organ to dissect. It was unbelievable to hold the cadaver's heart in my hands, to hold this integral part of his body and study it. But the kidneys have always fascinated me. I remember learning about them in my undergrad Intro Bio course and seeing the human body in a whole new light. The kidneys' main function is to filter blood, to keep the molecules the body needs and to remove the excess. But if you think about it, these two little bean-shaped organs at the small of your back know when your body needs to hold onto more water or get rid of extra salts. And it does this through about a million tubule units. Blood courses through these tiny mazes of tubes, and filters it all. The kidney is about maintaining equilibrium, and does so by its design. And if you think about it, that's the general idea of the human body. Keeping it all balanced...

The human body is truly inspiring. And yeah, I've talked quite a bit about the stresses of medical school. But I'll let you in on a little secret. I love this.

I. Love. This.

I go to school everyday and I learn a hundred new weird, wacky, wonderful facts about the human body. There's so much that goes on in order for us to function. Imagine if we had to consciously control every single heart beat or even how our immune system fights off infection...all while trying to do the everyday things like walking down the street or engaging in a conversation. Just the thought alone is enough to make my brain hurt. But that's the genius part. Our body, this incredible design, does all of that for us so that we can experience everyday. Our bodies let us live so that we can can live life.

It's a huge honor for me to be a part of medicine, but it's even more special to be a part of osteopathic medicine. Though I may have to explain what a D.O. means from time to time (sometimes in a slightly defensive tone to the skeptics), I'm learning what it means to be a D.O. Someday soon (fingers crossed) those two letters will come after my name, and I can't wait for that day.

Comments!

A note to the reader -

I changed the setting so hopefully anyone can now leave comments, not just members. I always appreciate any feedback, and I welcome you to comment.


Cheers,
Aneesa

Consumption and Coping

It feels like I've been away from this blog for months. Funny how med school can warp time like that. I get so wrapped up in studying that the days meld into one another. If there are gaps in my weekly posts, you can be sure that I'm in the middle of an insane exam time. And that my living situation resembles my harried mental state, which means that the sink is filling up with dishes, I'm down to my last apple, and the dust is piling up on the table.I just finished up a crazy four day schedule packed with three lecture-based exams, one OMM practical, one quiz, and one recitation. It was a marathon, people. As soon as I finished one exam I would have to move onto preparing for the next one. No stopping, no looking back. Just keep moving forward.

It's so easy to get consumed by medical school. After all, this is the path towards my intended career, so I should make this my number one focus, and it is. But the constant routine of locking myself up in a study room trying to absorb minute medical details, and the guilt of not studying that slowly overwhelms me when I'm taking a mental break or eating or sleeping....well, it's enough to make me feel like I'm losing a sense of myself. The me who enjoys flipping through cookbooks and trying out new recipes, the me who rereads Brontë, the me who watches the Travel Channel and dreams about visiting new parts of the world....that part of myself gets pushed to the back while Anatomy, Physiology, and Biochemistry are brought to the forefront. And I guess that's the way it should be. After all, I'm not in this for myself. Every time I read a clinical scenario or research a new disease, I'm reminded of why I'm doing this. The answer to why I've put myself in this high pressure, super stressful situation is always looming in the back of mind. My future patients. They are why I'm here, they are why I'll continue, and they are why I will fight through this and fight for this no matter how difficult it gets.

In my Preventative Medicine and Public Health class we learned about stress and coping mechanisms. I think it's a bit of an understatement to say that medical school is stressful, but at this point (week seven) I've moved past that. There's no point in fixating on that idea because it won't get me anywhere. The only thing to do is accept it and cope with it. You know, it feels like I've gone through my own Kubler Ross cycle. I guess that's to be expected when huge life-altering events happen. So what do I do to cope with it all?

I'm fortunate to have a rooftop deck that comes along with my apartment. I used to come up here everyday after school during the first week. Lately that's dwindled down to maybe once a week, but hey, it's better than nothing. Up here I feel like I'm above it all, above the anxious chaos of school life, the noisy chaos of city life....up here it's quiet and peaceful and I can breathe again. And on sunny, clear mornings like this one, I can appreciate it all. So even if it's for a few minutes once a week, I know that there's something I can do or somewhere I can go to find clarity and regain that lost sense of myself.

So now my apartment is clean and shiny from top to bottom, the dishes are washed and put away, the fridge is stocked with food once again, and my white-board calendar is clear....for now. Medical school is a marathon. It's all about pacing yourself, and from time to time, pausing to enjoy the view, even if it's from a rooftop deck.