Friday, November 25, 2011

Step 3, Done!

In truth, I have had my secondaries for medical school (step three (this round) in this step process. One was another round of MCATs and round two was the primary application) done for a while, I just haven't had time to write about it lately! There is also that lurking worry that I won't get in this time around (with as much as I have changed my application to be more competitive (yay better MCAT score!), I sure hope this is not a problem!)

I am not sure if I have mentioned it before but this is yet another round of me attempting to get into medical school. I was really close last year, interview and a spot on a waitlist! Unfortunately, in a fairly unusual event, the waitlist I was on did not move.

I think it is things like that that worry me the most. So many people are applying to medical school that even really qualified people are not getting in, people who have just as much merit as those who didn't. Many of my friends who are in medical school this year (I miss you guys!) have even said sometimes it seems like a crapshoot as to who gets in and who does not.

So needless to say, this whole wait to hear back thing does not suit me well. I don't the waiting thing well. Perhaps why I enjoy things like surgery and emergency medicine so much, because there is little waiting in those specialties. You get in, you figure out what is wrong, you fix it, the patient (is hopefully) better (minus complex cases that have so much back history it seems like one thing builds on another).

Anyways, I am now stuck waiting for step four (interviews) to happen or not.

Please let it be this time!

Thursday, November 24, 2011

Happy Thanksgiving!

Hope everyone is having a good one! Stay safe, don't let family stress you out, and eat lots of tasty turkey!

Tuesday, November 22, 2011

Why family can sometimes be really helpful

Often times EMS providers can find family more of a hinderance than a help. Sometimes I will tell family members if they can find a medication list or a bag for the patient, in part because it is helpful but more often than not it is so I can talk to the patient without interruption or fear of outside influences.

Now, there are times when having the family around is absolutely essential.

We get dispatched for an altered level of consciousness at the local incredibly frustrating apartment complex (its a nightmare to get anything other than a stair-chair in and out of) and find a worried family with an elderly man lying on the back bed.

First impressions for me where that he was very ill (medically speaking) or that he may have had a stroke. Then the family pipes up. "He fell down a full flight of stairs to the basement and a neighbor brought him back up. He normally is not like this."

Hello red flag! He fell down a flight of stairs?! And he was moved?! Now this is no fault of the family themselves, they were not present during the fall, but one of my biggest pet peeves is possible head/neck injuires that decide moving is a brilliant idea (more on rugby players at a later date).

A quick assessment gets me very little response from the patient, something about chocolate was all that was audible. His vital signs are stable but I do not like the fact that he is so out of it. The ALS that is on the way is not getting canceled at this point.

I get my partners to hold C-spine and go grab the backboard. I start asking the family more questions (including that drug list!) as we start to get him ready to for transport. Beyond his current state, he sounds pretty healthy. The wail of sirens lets me know that ALS is here and I start mentally prepping for the report as the family tells me this lovely detail: "He is typically more lucid than you or I." Red Flag! Red Flag!

I do a quick hand-off to the medic and am getting quizzical looks as to why my partners are now trying to get a C-collar on this poor man. The medic even tries to shoe them away and not call it a trauma, as if I am crazy and don't know my own BLS protocols.

I may be less experienced than you but I do know this, when family says that this is vastly off his normal mental status AND that he fell, I am NOT letting you take off that collar. After a quick re-emphasizing of those two points (especially how off this is for him from his families standpoint), the medic gets it and agrees with me on the board and collar.

We of course help ALS carry him down the stairs (they may not be my favorite medics from that station but I am not one to let personal taste get in the way of professional care) and he is off to the local trauma hospital.

Even when you are out ranked and have less experience, when the family is rattled by his lack of mental awareness, or rather the sudden drop in it, you list to the family hands down. If it were not for them, I would not have been nearly as persistent as I was with the medic. If it were not for the family, I am not sure anyone would have realized he may have been a head trauma until it was too late.

Sometimes, family is your saving grace on a call.

Thursday, November 17, 2011

Molecular Biology

One of the few sciences where flicking is an acceptable form of mixing, alcohol is the be all end all of cleaning materials, and Carnation instant non-fat dry milk is the preferred protein solution to blot a Western Blot protein assay (though BSA is swiftly becoming even better).

As frustrating as it can be to be working on cells/proteins/DNA that I can't even see, the things one can discover from a single experiment can be immensely rewarding. This can be where the basic cause of a disease can be found or where a seminal discover on how a cell works comes to light.

And then the next day you can be cursing an experiment because you have no idea what just went wrong, just that it didn't work! Or you bacterial plates that had antibiotics on them decided to grow mold :) Too bad we didn't add anti-fungals to the plates!

Monday, November 14, 2011

Standards and PIs

"There are professional standards and then there are personal standards, both of which are good but one of which that typically gets the better of me. My personal standards for dealing with work and volunteering are quiet high, so when I mess something up I usually take it out on myself. It could be a little nothing or it could be huge, both end up getting the better of me. I want to save everyone, make it to every meeting, do everything right even though I know that in reality, there will be times when I slip up or the patient was simply beyond me. Yet it is the little things, like missing a meeting that I had no excuse to miss simply because I got caught up with what I was doing that particularly annoy me. I should be better than this, I should be able to do everything. I know I am human and I always do my best, but sometimes I feel like nothing wants to work out in my favor."

I wrote that a month a half ago. I was incredibly frustrated with myself over a very little something. I can smile at it now because I have since A) had an even worse day than that one that ended in a mental breakdown and a great roommate and B) have come to terms with my perfectionism (at least for now).

Now, the first thing to realize is that I am a perfectionist in only certain parts of my life, cleaning is not one of them. My poor room is constantly a disaster (of clean clothes) and the apartment bathroom sorely needs cleaning (bless my roommate for putting up with me). Oddly, the kitchen is almost always clean. Anyways, the point is that in lab and on the ambulance, I am a perfectionist. If I can't get something to work right, I get very upset at myself.

This is in part why I want to be a doctor because I feel there is so little I can do as an EMT. I know I am capable of more if people just let me! I have some what come to terms with my limited practitioner skills at this point, though I am finding that I need to crack my own whip again soon and beef up on those provider skills.

But lab, oh lab still gets me when it comes to perfectionism. I know I have the skills and the brains to do well so it drives me nuts when I can't get something to work! I feel like its all my fault when in truth, it is the nature of science and research. Rarely do things go correctly the first time. I get so frustrated that I forget I have the brain and the ability to troubleshoot.

This is where my current PI is a blessing. He has yet to get mad at me for something I couldn't do in lab. He has taken the attitude of helping me troubleshoot my way through an experiment, from literature research through design, execution, and data analysis. Of course, he had to tell me that this was his plan otherwise I would have been incredibly frustrated at myself for not being able to do anything. Once I got that through my head, late nights with nothing working stings less. It stings no doubt, but it is bearable.

So the point of all this rambling is that perfectionism and the frustration that goes with it is a double-edged sword. It can, if I am not careful, make me destroy myself, but, when managed, it can make the most beautiful results.

Friday, November 11, 2011

Gloves: Its Always Your Size They Are Missing

In my case, it is always the small gloves. And its both the ambulance and the lab.

At one point I was even taking pairs from the hospitals we transported to because we never had any of the good gloves at our station. We had small latex gloves, but they were first off latex and second off so old that as soon as you touched anything with them on they tore, shredded, ripped or otherwise tried to disintegrate on you while you were wearing them. Completely useless darn things.

Thankfully after a few months and some polite asking, new small gloves were ordered and I haven't had much problems at the station since. I did recently run into the lack of gloves problem in my newest lab (they only had large and extra large! Massive problem!) but thanks to some polite asking, I was able to "requisition" some gloves for use.

But what about the gloves themselves? Perhaps I am pickier than most, but I actually do care what kind of gloves I am wearing for what "job". Granted, I care more that I have gloves or not and that they are smalls more than anything else. But if I have a choice, I will exercise it.

Ambulance: Oh the high cuffed glove! How I adore thee! Sometimes you are fairly thick and you do make finding a pulse difficult but you do such a great job at protecting my arms from gunk, particularly in the summer! Touch wise I like the Cerulean blue gloves that seem to have taken up home at my station. They fit reasonably well (as in not super baggy) and they give me great textural input without being too think and breaking.

Lab: This gets broken down into about three categories depending on what I am doing.

For mouse work, give me tight fitting gloves that are fairly thin. I need the grip they provide to hold on to those little buggers when they squirm! Not to mention, tail vain injections with a 27 gauge needle work oh so much better when I have fine dexterity control that the thin gloves provide. Now due to the short cuff, this means I also typically punch holes in the paper gown I have to wear and stick my thumbs through so that the gown stays down on my arms and my gloves stay affixed over the gown. No mouse or mouse parts are making it up my gloves!

For gross organ processing I like those nice thick purple gloves! Great for keeping everything I am doing off my hands, maintain most of my dexterity, and can last for hours on end, a requirement when an experiment takes all day! Sometimes these feel too thick though and can tire out my hands if I need to do fine dexterity work.

For molecular biology work, give me my latest find in gloves! Super thin but incredible textural feedback! Somehow also super durable! I have only ripped maybe two gloves and it was under severe duress! Granted, I will wear the extra small in these gloves because the smalls are a bit to baggy, but it means that I never get my gloves stuck in microcetrofuge tubes or drop anything due to excess glovage! I think these would also make great gloves for the ambulance but I haven't been able to test that yet. Another point for these gloves is that they don't make my hands sweat nearly as much as other, a major bonus when I am in and out of gloves all day!

Anatomy Dissection: Now this is where I am torn. I like a thinner glove because I am not only double gloving but I need some serious dexterity control here. However, I like to stay covered as possible and having my hands not smell like cadaver at the end of the day is great. Sometimes it depends on the dissection, where I will risk thinner gloves for greater dexterity. Either way, these buggers had better be tight fitting! No getting stuck in dissection scissors for me!

Overall, I like a tight fitting glove that has good textural feedback and dexterity. I dislike extra glove floating around my finger tips. But at the end of the day, I they have to hold up and not break so that I can actually get work done!

What are your likes and dislikes about gloves? Ever had a great moment where you didn't have the gloves you wanted?

Wednesday, November 9, 2011

Accomplishments of the Day

Work for grant figure - completed (until we decided what to add for the supplemental)
Downloads box - emptied
Printer connection - established
To do list for lab research - growing to epic proportions
Apparatus - cleaned and detailed
Patients saved - pending...
Lecture presentation - waiting to be worked on

Yes, I live in two/three very different worlds: researcher/student , EMT, and professor :)

I love them all