the mother is starting to pressure her daughters....

I visited Berkeley this winter break. When I got back home, my mother started talking about some of my Berkeley friends whom she had seen.

....

Me: Yea, [guy at Berkeley] is pretty good-looking.
Mom: You should introduce him to May! :D :D
May thinks: WOW MOM WOW

Later, via Gchat, after I told Friend the previous conversation....

Friend (a girl): Ahahaha.
Friend: Introduce him to me too, please.
Me: Guy at Berkeley refers to [Name].
Friend: Eeeee.
Friend: All May's.

sick...

May: E, are you going to the Christmas potluck?
E: Of course not. I feel and look like crap.
May: Actually, you look normal.
E: ... Thanks a lot.

oops

Gah. Today, while attempting to trace the hypoglossal nerve to its origin in anatomy lab, I broke the nerve.

Yep, definitely not going to be a surgeon.

"How is it going?" in anatomy lab

Six days before the Anatomy Head and Neck Test:

Fatima: At the beginning, when we ask each other how it's going, we reply, "It's going...." Now we say, "Oh f*ck."

_________________

Me: How's it going?
Jonathan: Bad.
Me: I like your honesty.

_________________

When Charlie and I ran into each other, the first thing he said to me was, "We are so screwed."

lonely

I am an island.

dark knowledge

Over the past two months, I have learned two to three ways to effectively and "safely" commit suicide. Of course, anyone could have found out this information through the Internet, but in med school they hand the info to you.

One method, if done correctly, could bring instant death. However, if the person makes just a slight error out of ignorance, he could end up a quadriplegic--a fate worse than death, perhaps.

Maybe this contributes to why the suicide rate of doctors is higher compared to other professions--doctors have the knowledge to ensure that the suicide attempt succeeds.

I wrote this entry because I was in a bad mood again. Will I ever kill myself? Even though I am often depressed, I don't think so, and I hope not. Two of my reasons for staying alive: 1) to spare my parents grief, and more importantly, 2) to continue growing toward holiness in order to honor God. Matthew 6:20--But store up for yourselves treasures in heaven, where moth and rust do not destroy, and where thieves do not break in and steal.

My heavenly treasures, which I interpret as anything I say or do or think that pleases God, are very meager. But once this life on earth ends, there will be no further opportunity for growth and treasure-storing. Hence, we need to grow toward holiness as much as we can while we are still here, so that when we face God after death, we can receive the reward God has promised to His disciples. James 1:12--Blessed is the man who perseveres under trial, because when he has stood the test, he will receive the crown of life that God has promised to those who love him.


Lastly and most importantly, we only grow because of God's gift of salvation. We hope for a crown only because of His grace.
1Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ, 2through whom we have gained access by faith into this grace in which we now stand. And we rejoice in the hope of the glory of God. 3Not only so, but we also rejoice in our sufferings, because we know that suffering produces perseverance; 4perseverance, character; and character, hope. 5And hope does not disappoint us, because God has poured out his love into our hearts by the Holy Spirit, whom he has given us. Romans 5:1-5

Thank God for the Bible, that gives hope for the future. If I weren't a Christian, it is possible I would have killed myself a long time ago. (But then again, maybe not; if I weren't a Christian, I would avoid suicide because I would be afraid of death).

It's beautiful!

Last week, I took the Anatomy Practical on the thorax and abdomen, a test for which we had to identify marked structures on the cadavers, and one which induced much stress.

However, during the practical, I was particularly struck by one display. I had seen the inferior epigastric artery before, but it had always been severed from its source. During the test, however, one cadaver displayed a beautiful dissection of the artery--I was delighted to see, for the first time, the artery clearly branching from the external iliac artery, then running between the rectus abdominis muscle and rectus sheath to nestle neatly within the lateral umbilical fold. Several other dissections were also very notable--such as the greater splanchnic nerve connecting to the celiac ganglion, the cystic duct running from the gallbladder.... The clarity of the dissections made the bodies beautiful, and was a testament to both God's awesome creativity and our professors' dissecting skills.

I found moments of delight amidst an intense exam. I know my classmates felt the same--I heard some discussing the beautifully dissected splanchnic nerve after the test. Even though we study laboriously in the cadaver lab, sometimes the beauty of the dissections does strike us, and we pause from our mad studies to praise it.

To me, such moments are like a welcome gulp of fresh air, before we are plunged again deep into the swirling torrents of material that is Anatomy class. I may miss Anatomy after all.


Edit: So that you guys don't think I am a super sappy nerd: There was another display on the Practical for which I could not make out the structure at all. I was plagued throughout half the test with the thought, "Just what the hell was that?" (It turned out to be an artery the professor said we normally would not see in dissections due to its smallness. In that cadaver, however, it was abnormally large. The prof's statement threw me off.)

a legitimate reason for marriage...

Jean: I would like to marry a Chinese girl so she can cook me Chinese food.
John: That's what [our professor] did. He married a Chinese.
Jean: For the food??

sacrilegeous

Right before entering anatomy lab:

Me: I really wanted to dissect today, but I realized what the topic is; and decided maybe I'll hold off [the topic was the male reproductive system].
Gretel, a classmate: Well, we all have been holding human hearts in our hands for a week now. I don't think we can violate people any more than that.

Incidentally, the two other girls in my anatomy group dissected the scrotum today--one testis for each girl. One of the guys was wincing the whole time. Hmm.

oh you potential med students

Me: Have you seen the people in suits that are interviewing here for next year?
Gretel (a classmate): No, I have been avoiding them.
Me: Why?
Gretel: I don't want to pretend to be positive.

diagnosing passersby

While walking outside, I noticed another pedestrian with a particular gait walking in the opposite direction. I turned around to observe her from behind and saw my classmate Andrew.

me: I think the person who just passed by us has drop foot.
Andrew: Wow, I did not notice at all.
me: Yea, she lifted one foot really high while walking and did not dorsiflex [bend the foot upward].
Andrew: So she has damage to the deep peroneal nerve. That is funny--you are diagnosing people already.

In Final Exam, Dr. Pauline Chen wrote that while in public, she could not help but mentally deconstruct strangers' health based on their appearance. Today I did a little of that. It made me happy, actually--I guess I am learning a little something after all.

Crossover with CMDA round 2

Yesterday I volunteered again at Crossover free clinic. While in the back room waiting for the clinic to start, I looked at the front counter, and whom did I see but the patient from last time! This was the first patient to whom I gave a flu shot, and also one of the first I interviewed, when he visited Crossover last month.

My reaction: momentary terror. I went back to the back room really quickly because I did not want him to see me, and I told the doctor, "Shoot, it's the patient I saw from last time!" (Actually, I may have said "Crap" instead of "Shoot." There goes professionalism). Why was I so afraid? Probably because I remembered how diffident I was when examining him last time, and he knows I am just a novice with minimal skills.

Then the clinic started and someone handed me a patient's file. Of all the files I could have received, I just had to have that very same patient. Fortunately, I really did not have to do much--just take vitals, conduct a brief interview, and summarize the findings to the attending, and she did the rest (explanation, treatment, and paperwork).

At this stage, volunteering at clinics benefits me educationally far more than it benefits anyone else. The second-year medical students who were also at the clinic conducted the interview and the physical exam all by themselves before presenting to the attending, while I did not know anything about the physical exam. I yearn to be useful like them, instead of merely tagging along and observing them. I hope that when (and if) I become a second-year medical student, I will be as good as they are.

anatomy inside jokes

During discussion group meeting in Anatomy class:

Billy: I think I will go to Starbucks today and order a tensor fasciae latte.

Andrew: Oh, speaking of that, Starbucks is offering free drinks this week because they are doing bursitis training. Argh, I said bursitis. I meant barista training.

____________________________________

Anatomy is seriously consuming our lives.


For you non-anatomy people:
tensor fasciae latae--a muscle on your thigh
bursitis--inflammation of bursae, which are sacs of fluid between bone and bone or tendon that reduce friction

I've got a job option for you buff guys....

... be a photography model for anatomy textbooks (at least, for the muscles section).

the lady with sickle cell anemia

Today a person with sickle cell anemia came and talked to my class. Because sickle cell is a disease of the blood cells, it affects every part of the body that has blood flow, which means basically everywhere. A person with this disease is in pain almost all the time, and can go into "crises" of severe pain (8 to 10 on a ten-point scale) that necessitate hospitalization.

Even though the lady got out of the emergency room at 2am from one of her crises, and came to speak to us eight hours later at 10am, and was still in pain from the crisis, she was so very cheerful and humorous. She joked with us and we all laughed several times. In fact, judging by her contagious good spirits, no one would have guessed that she still hurt physically. (Many sickle cell patients have gotten so used to pain that they show no signs of it even if the pain is a 10 on the ten-point scale).

She told us that because sickle cell patients often seek large doses of pain medication out of necessity, they are wrongly derided as "drug-seekers" or "dopers" by their healthcare providers, sometimes even within earshot. "Don't do that," she said. "It hurts." That is more reason not to talk down to perceived drug-seekers--because they may actually be misunderstood people with sickle cell. (Even if the drug-seekers are real, I still don't want to disdain them, since I myself am a drug-seeker of sorts. My drug to escape from reality is the Internet).

"Between Virginia [her nurse's name] and the Lord, that is what has kept me going," the lady stated. I want to have some of her joy in the pain.

Yay medicine!

Meet Dr. Costanzo, renowned physiologist, professor, coach and cheerleader of first- and second-year medical students as they study for their board exams.

Meet Stack of Syllabi--material medical students have to master in the first two years of medical school before taking the board test.

All this knowledge is making me excited. I wish I could remember everything.

people

My mood fluctuates widely. I am happy when I have conversations with people, when I have friendly and pleasant interactions with them.

I am miserable when when I am alone in my dorm room at night, when I have no one to talk to, and when my social discomfort raises its ugly head while I try to make friends.

I can't live like this--I can't let my mood be constantly dictated by the quality of my social life (or lack thereof). There is something missing here.

It's rather funny, actually. In high school and the first few years of college, I was actually rather aloof. In psychological terms, I even characterized myself as "ambivalent" (somewhat more distant and independent from others), as opposed to "secure" (normal and healthy relationships) or "anxious" (clingy). Yet now I would say that while my behavior may still seem ambivalent and that I sometimes act aloof, my heart is becoming more and more clingy to people in general.

Actually, in junior year of college I took a test offered by my psychology professor to determine what I truly was. To my surprise, my results were in the "secure" range, and my "anxious" score was slightly higher than my "ambivalent" score. I was expecting the result of "ambivalent," but the test said I was normal. But now I am not feeling normal at all. Sometimes I want to go out and do stuff without having to wait for others; other times, I have such deep longing for human company that it is ridiculous.

When did it all start? In the last semester of high school, for one reason or another the usual group of people I ate lunch with disbanded. So I either ate alone or floated among the other social groups. However, while the new groups I ate with were still my friends, I did not feel to be part of their established in-crowd. That was the semester when I was so lonely, so lonely.

In college, I was tremendously blessed by my Christian fellowship. God gave me very dear and very close sisters, and brothers as well. I remember calling my mom during the first semester of freshman year and telling her "I am happy." I think I was mostly happy every year in college except for the third year, when I studied for the MCAT and applied to med schools. That year, I was burned out, and most of my friends were also busy. I medicated myself against the fatigue and the loneliness by procrastinating. But when my last semester of college came around, I increased my participation in the fellowship, and seeing my friends more was one reason I was happy again (the other reasons were that I learned wonderful things from my new discipler and took very enjoyable classes like martial arts).

Now, most of my college friends are living in a different space-time dimension. Different time zone, I mean. I miss them dearly. I do talk to my new classmates, but most of the interactions have been cordial, not deep. I do thank God for the few good friendships He has given me here, but I thirst for more most of the time that I am alone. This can't be right.

But I am sure people can relate to this longing for camaraderie. Why else would the theme of so many mangas (Japanese comics) be friendship? In fact, the word "nakama" (which I gather to mean friends/comrades) is very frequently used. The four most popular mangas--Naruto, Bleach, One Piece, and Fairy Tail--all have friendship as the central theme, as if it is the most important thing in the world. Naruto strives constantly to get his friend Sasuke back, Ichigo in Bleach fights bad guys to protect his friends, the pirate crew in One Piece sticks together through thick and thin, and so does the guild of magicians in Fairy Tail. (The fact that I have read all these mangas and more is another topic I shall not discuss here).

Perhaps I am falling into idol worship, with people as my idol. My need is to be affirmed, and having friends affirms me of my social skills. I also need to feel secure, and having a group of people I can rely on certainly helps. But should not God be enough? Should not He be my sole source of affirmation and security? And in fact, He is. Yet, yet, why do I not grasp this truth and still long for people with an unhealthy intensity? While God did make us as social creatures that need each other, am I blowing this natural desire out of proportion so that it displaces God's place in my life? I think the answer is yes.

zest-less

I stumbled upon the blog of a 22-year-old girl suffering from leukemia. She has a fervent desire to keep on living. She wants to be allowed to take part in the future.

If I have a terminal illness, would I also want to fight to live? I don't currently have much zest for my own life, pampered and comfortable as it is. Certainly, there are times when I relish it (such as during my mission trip this past summer), but I often also want it to be over with. Sometimes, I think the only reason I keep on living is that, were I to die, my mother would be devastated, and I wish to spare her this.

I think it is because I am easily worried and can't even handle the small uncertainties life brings. Or I am too ungrateful toward God, the one who gave me this life.

Or maybe I am just in a bad mood right now as I write this entry.

needed: confidence

This Saturday, I volunteered at a Crossover Clinic, a free clinic that provides health services in the name of Jesus. Because all I have learned so far is taking blood pressure and interviews, I was not that useful. I tagged along with a second-year medical student and watched her do most of the work. We saw two patients total. I did take one patient's vitals, conduct most of the interview, and present the interview results to the attending. However, during my presentation, I did not feel confident at all.

Cecilia, the M2, conducted the physical exam with familiarity. Sometimes she instructed me to do as she did. Her hands, while checking the patient's body, were firm, while mine were limp and diffident. I certainly did not apply enough pressure while feeling for the patients' lymph nodes or insert the probes far enough into the patient's nose and ears. Basically, I was a bit afraid to touch the patients; which is okay right now, I think, considering I didn't even know what I was looking for in these exams. However, I do need to be more assertive to learn better.

There were a few patients who needed flu shots. The doctor who works at Crossover offered the med students the chance to give them. I declined giving the shot at first because I was afraid to mess up, so Cecilia did it. But soon it was my turn. I thought, "Oh gosh, I can't even properly stick a straw through the plastic cover of a Tapioca drink, and you want me to stick a needle into live flesh?" But it was actually very easy! The patient did not even bleed (but I think that is due to his physiology, not my skill). Afterward, I felt really accomplished, even though it was a small task.

To the poor patient who was my guinea pig: You are the first real patient I actually interviewed, the third for whom I took blood pressure, and the first I gave a shot. You never complained or showed signs of discomfort, even though I was not comfortable myself. Thank you.

some timeline

August 2005--started college at UC Berkeley.

May to December 2007--shadowed doctors, volunteered at health-related places, somehow officially decided to be a doctor

December 2007 to December 2008--the Dark Ages: studied for the MCAT, applied to medical schools

December 15, 2008--learned of my first acceptance to a certain medical school while in Valley Life Sciences Building at UC Berkeley; entered uncharacteristic, gleeful, and silent screaming fit, because I was in the library. Went to sushi place with Christine, Holly, and Holly's sister that night.

May 20, 2009--graduated from UC Berkeley

June 17 to July 24, 2009--mission trip to Taiwan: best summer of my life

August 4, 2009--moved across the country to the opposite Coast

August 10, 2009--Orientation started at said med school.

August 17, 2009--Classes started at said med school.

October 4, 2009--wrote this entry because I wanted to play with my new blog.

Halloween Costume

I received some items from my new school. Now I know what I can wear for this year's Halloween!

WHITE COAT

+

STETHOSCOPE

=

DOCTOR (in-training)

On a serious note, even though I now don a white coat when I volunteer in clinics or attend workshops, I do feel like a sham dressed in a costume, since I of course don't know anything about medicine at the moment. It's like that proverb: "Wolf in Sheep's Clothing," except I am "Ignoramus in White Coat." Will the sham turn into reality? Let's find out in four years.