Time Flies...

So, I'm 2+ months into med school. And time really has flown. Having said that, I am *so* looking forward to Thanksgiving. (Minus the semester's only massive anatomy exams right before Thanksgiving. Seriously. Anatomy scares me shitless - I go through underwear faster when I think about that exam day. But that's neither here nor now.) Looking back on the first week of class (and especially orientation week), I miss it. It really wasn't so bad - compared to what's going on now. We've somewhat gotten used to the pace, and even during one of the semester's harder weeks, it doesn't seem so bad. Some people I know might even refer to it as a "hell week." But, I'm not said person. It's bound to happen and comes with the territory - physio (cardiovascular & respiratory), biochem/nutrition, and histo exams within an eight day period. The only real response to this week of exams has been group-coordinated grunting and disappearances into libraries for extended periods of time. The only thing that truly sucks is averaging 4-5 hours of sleep over the past two weeks. And I like my sleep. But meh - there are worse things in life. At least I got to work in a free clinic last Saturday. That's always nice. And this round of exams ends on Monday. :D

A few of the somewhat memorable things that easily come to mind from studying.

Biochem
The liver is amazing. Glucose regulation and homeostasis. The interplay between fatty acids and proteins, and their ability to contribute to body glucose. Glucose aside, don't forget about detoxification, lipid absorption/metabolism, serum proteins and whatnot. At one point I could go into ridiculous detail about most of these things. Not so much anymore.

Nutrition/Biochem
A lot of the pathways we learned earlier in the semester use enzymes. Obvious? Yes. Not so obvious, a lot of these enzymes have cofactors that are either minerals or are derived from vitamins. Kinda interesting to see how different deficiencies/excesses affect the body and/or biochemical pathways. Operative word: kinda. Iron, copper, B12, folate - they're kind of a big deal. Apparently so's a lot of other stuff though.

Physio
Evolution/greater powers are pretty smart cookies. The different mechanisms by which the heart maintains blood flow and blood pressure are damn impressive when you think about it. The different ways that variables are sensed - oxygen, carbon dioxide, pH, blood flow, muscle activity is pretty cool. Then there's the multitude of pathways by which CV homeostasis is maintained - heart contractility, heart rate, vaso/venoconstriction/dilation - with these changes affected through both independent and interacting mechanisms. Respiratory has a similar story. Again, the way variables are perceived and change is affected - pretty amazing. Even learning about respiratory muscle usage and recruitment, as a function of breathing needs, volume, and pathology, is kinda cool.

Anatomy
There are a lot of blood vessels supplying a lot of stuff. And someone felt the need to name everyone one of them. Same story with nerves, veins, and lymphatics. Our dissection table has come the conclusion that we're all going to name a structure, anatomical landmark, or tool after ourselves. "Illinaisa's point. Pain to palpation is indicative of possible appendicitis. Differentials may include bowel obstruction." I like the sound of it. Anyway, lab is pretty much where all the highlights have been. Mostly because I can't remember specifics of the stuff I've read. The liver (at least on our cadaver) is a surprisingly massive organ. The greater omentum is a 4-layered sheet of fat coming off the stomach that covers most of the intestines. Kinda freaky, IMO. It reminds me of a stage curtain. The small intestine is really, reeaaally long. The kidneys are surprisngly small, considering the amount of blood flow they get. On that same note, the renal vasculature is disproportionately large for the organs the supply. I could go into some detail about the "cool" details of anatomy, but I'll spare you. Anyway, some cadaver specific stuff. Our cadaver's stomach is insanely large. It seriously takes up 1/4 of our abdominal cavity. Not normal. And coming back to the theme of obesity. Working through ass fat is disgusting. There was probably about 5 inches that we had work through. And when I say we, I mean the lab professor. We ended up dissecting through fat for an hour and a half, and didn't actually get around to identifying any real structures. Oh, and to give you a better idea of how much fat there was, our prof was getting pissed about how much fat there was and how fibrous it was. Oh, and said fat broke two scalpel blades. Not cool.

Histo
There are a lot of cells in the body. And unfortunately, a lot of them look the same to me. That is, until I spend inordinate amounts of time learning to tell differences. Learning about the function of different organs/tissues at the cellular level is actually kinda cool. Some might even say I'm okay with it. For example, I don't mind learning hepatic and immune histology, as long as it's only function related. Slides and electron micrographs, not so much. Ah well, at least after Monday I'll be done with histo until next semester :D

So that's what I've been up to the past two weeks. Lots of physiology, biochem/nutrition, and histology. Physio and biochem/nutrition felt like they went okay. This weekend it's all about histo. Hooray histo. And then it's onto the massive freak-out/cram fest that will be 2+ months of anatomy in two weeks. I get the feeling that I will be smelling like cadaver a lot during that period of time. Unfortunate. But, like I said earlier there are worse things in life. And hey, after anatomy - Thanksgiving! Can't go wrong with sleep and food. I'm a big proponent of both.