Step 2 Boards Studying

In the tune of "99 Bottles of Beer":

1800 practice questions to do, 1800 practice questions
You click on one and you read the explanation, 1799 practice questions to do!

142 pages of more tips to read, 142 pages of tips!
You read one slow and remember it, 141 pages of tips!

300 pages of review book to go, 300 pages of review!
You read and think and read and think, 299 pages of review!

15 more days until the test, only 15 more days!
I am screwed I am screwed I am so screwed, 14 more days to go!

what was the point of her life?

This was one of my patients in the hospital last month during my Family Medicine rotation:

She was gray-haired and in her mid-50s, although one could mistake her to be older from her appearance.  She was fat, or, as the medical terms would put it, "super morbidly obese."  She was admitted to the hospital because she had abdominal panniculitis, which means that the fat on her belly had become infected with bacteria.  Her abdomen looked red and angry, and she became septic from the infection, necessitating a stay in the ICU.  She eventually began recovering from the infection and was transferred to the regular hospital floor, which was when I met her.

She was unable to get out of bed, not because she was in the hospital, but because of her obesity.  Her large abdomen rolled over and covered the top of her legs, which were stubby and stuck out as if they were out of place.  She lay in bed all day, dependent on the hospital staff to arrange her food tray table in front of her so she could eat.  After the sepsis and infection began resolving, her hospital course was beset by other problems.  She developed thrush of her mouth and tongue.  She was found to have a urinary tract infection.  She had severe nausea and vomiting.  She experienced an allergic reaction to one of the medications, resulting in a swollen tongue and slurred speech that made it difficult for her to communicate.  She developed large purulent ulcers on her skin. She was sometimes delirious, jumbling the time and recent events.  And, judging by what we could get from her own confused account, she was severely constipated, as she had not had a bowel movement in the twenty or so days she had been in the hospital.  Yet, when questioned about constipation, she always stated that she felt fine.

Because of her obesity, she was derided behind her back by her doctors, who said she became so large because she was "JFN"--Just Fucking Nuts.  I once tried to ask her what she was like as a child, in order to determine the etiology of her obesity, and she simply stated "I had always been large."  Before I could continue, however, we were interrupted by an orderly who entered the room.  According to my attending physician, she would tell him that she did not overeat, but then he would see Twinkies wrappers filling the trashcan.  I asked who brought her food at home when she was not even mobile, and the attending said her family--they were the Enablers.  Because she was also bedbound at home, she was on Disability and had 24-hour care--the attending dryly noted that "We pay for it."  Because of her constipation, we ordered laxatives that need to be inserted rectally.  I told the ordering doctor that the nurses probably would not be able to insert it, as I had already overheard the nurses stating the patient was hard to turn, and the ordering doctor simply said, "That is their problem."  

Overall, however, she was getting better and better.  With all the medical interventions in the hospital, her abdominal infection and sepsis completely resolved, her thrush disappeared, her UTI cured, her nausea and vomiting abated, her allergic reaction to the medication improved, her ulcers healed, and her confusion cleared. The last time I saw her, she looked as healthy as could be, and was feeling great.

A few days later, however, my attending physician told me that she died.  Her death took me by surprise, as she had improved significantly in the hospital.  According to my attending, as she was being transferred to another facility to manage her obesity, she suddenly turned ashen gray and her blood pressure bottomed out.  My attending theorized that the prolonged constipation probably caused her bowels to perforate, leading to her sudden demise.

I know I had taken care of her for only a few days.  Most of my talks with her focused on her physical symptoms; I never had a real conversation with her about her personal life.  I did not know her personally.  I knew that she did not present as the nicest person--her interactions with the nurses could be rather curt.  With what I do know--that she lay in bed all day and was unable to do anything, that she was disrespected by some of her physicians, that she was very sick and developed many medical complications because of her obesity, and that she ultimately died unexpectedly at a relatively young age--I do wonder:  

What was the purpose of her life?

Things I want to do if and when I have an income, free time, and motivation

In no particular order,

1. learn guitar
2. practice martial arts, especially yong mu do
3. fly a kite
4. bake
5. cook 
6. ride a hot air balloon
7. draw
8. learn Korean
9. have a vegetable garden?
10. plant a few fruit trees (although not as many as my dad, who has 71 fruit trees in the family yard by our last count.  By the way, we live in a suburban neighborhood, not a farm).
11. hike hike hike
12. aquarium
13. take rock-climbing classes
14. watch action movies
15. read for fun for once
16. quilt?
17. travel? (road trip!)
18. learn to shoot? (I think I know someone who will like this one).
19. learn to lock-pick