Master Plan

A quick random note: Thanksgiving break was amazing...did nothing but sleep, eat, and drink. Very much needed, most definitely enjoyed. Aaand now the slap in the face that is med school welcomes me back this week. Ah well.

A little over a week after our anatomy exams, I'm left feeling 1.) still a bit violated 2.) amazed at the body. I'm choosing to focus on the latter.

As part of anatomy, we cover some embryology. In doing so, we learn about how some of the major organ systems develop. And in taking a step back, it's actually kind of amazing how things happen. The four chambered heart that we know and love starts out as a tube. And through some magical signaling, the heart decides to fold a few different ways, along with different partitions appearing out of nowhere. And then you have yourself a heart. The development of the respiratory system is not as complex, but is linked to a bud from the esophagus. The entire respiratory system. From a bud off the esophagus. The lovable domed muscle that is the diaphragm has four different structural embryological origins that converge to form it. The abdominal contents all develop with a certain initial embryological relationship. Throughout fetal development, the intestines, mesenteries, and viscera are rotated and shifted - leading to landmark structures and spaces that persist in adults. I guess the main thing that I'm getting at is it's pretty amazing how things can change so much from fetus to adult.

Even more awesome is how all this development and rearrangement occurs without a hitch most of the time. The first thing that comes to mind is the heart. There are in an insane number of ways that heart development could mess up. There are the more "common" defects including specific ventricular and atrial septal defects, along with patent ductus arteriosus. There are a lot of stages where kidney and urogenital development can go wrong as well. Similar stories are true for the other organ systems as well.

Another thing that amazes me (in hindsight) is the complexity of the autonomic nervous system. Seriously, working through how different areas/organs are innervated and interact was a task. The way nerves off the spinal cord rearrange into sympathetic chains and then proceed to recombine with other sympathetics, parasympathetics, and/or somatics...still not sure if I fully understand it all. And the nerve plexuses. (I maintain the plural should be plexi, but that's my own battle). I don't appreciate anterior rami nerves' need to branch apart and rearrange into different distinct nerves. *ahem - brachial, lumbar, and sacral plexi* And naturally, the abdominal autonomic system felt the need to follow a similar path...celiac, inferior mesenteric, superior/inferior hypogastric plexi.

I suppose what I'm getting at with all this is I'm amazed at the human body. Science intrigue from a med student?? Shocking, I know. But seriously. The more I learn about medicine, especially anatomy and physiology, the more I wonder...damn, evolution (powers that be/intelligent design) is a smart cookie.

The Time Between

So, I'm in med school. In Chicago. I'm a bit biased, but I think it's a pretty sweet town. Sadly, I haven't had as much opportunity to check out the city as I'd like to. Here are the few places that I actually have been to over the past month or so.

Harold's Chicken Shack
A fast food type place to get some fried chicken. The chain apparently originated from the south side, and has slowly been working its way north. It's definitely a different tasting type of fried chicken, compared to KFC and Popeye's. I can't really describe how it's different other than it's different in a good way. Apparently the thing to do is take some fried chicken and fries, both smothered with their sauce, and make a sandwich out of everything (they give you two slices of bread). I, however, was not that ambitious.

Captain Hook's Fish and Chicken
This may or may not be a Chicagoland chain. Either way, I hadn't heard of it until a few weeks ago. Anyway, think Long John Silver's for this restaurant. Except for a few differences. A lot more food options, more food per portion in general, and better food. As a fan of catfish and shrimp, this place has got both of those down pretty well. And any place that does those two well earns themselves a return customer.

Bob San
A pretty nice sushi place. And I mean that both in terms of the food and the actual restaurant. Seems like the restaurant was a pretty happening place, with a decent number of near-formals in the restaurant. The food - the rolls are actually decently sized...but will cost a bit. An overall nice vibe to the place with good sushi to boot. Only thing that sucks is finding parking...we ended up having to grab valet.

Tango Sur
An Argentinian place with some really, really good filet mignon. Sure it's one of the more expensive cuts, but I've heard it's the signature dish to get. No disappointment there. The mashed potatoes were only okay though. Spinach mashed potatoes sounds kinda cool, but I didn't really taste spinach as much as I tasted weirdness. Oo, if you're going to get an appetizer, grab the shrimp "something whose name I can't remember" one. Only a few shrimp, but the sauce is really good for bread dipping. If the food doesn't do it for you, the place is BYOB. Luckily, I wasn't in charge of the acquiring the wine...mostly since I probably don't know/appreciate wine as much as the average person.

Portillo's
If you're ever down for some good hot dogs, this is the place. Not having had a chili cheese dog in a while, I was a big fan of their offering. And when you're getting fries, get the cheese sauce. I've heard they've got pretty good burgers, ribs, and whatnot as well. If you're not in the mood for that, the downtown one shares space with an Italian place and an alcohol stand. The cool (?) thing about the place is when you get your number called. The lady calling out your number comes up with some sort of rhyme for whatever number you are. E.g. "Seventy-eight....looking great!" Sounds kinda lame, but it's more entertaining in person while waiting on your food.

United Center
Yeah, most people know of this place. However, I mention it because I knocked out two "first-time" birds with one stone. One, I made my first visit to the United Center. And two, I saw my first pro hockey game there - Hawks vs. Blues. It was actually really fun. And in the interests of furthering anecdotal evidence - a lot more fun than watching a game on TV. I think part of it has to do with being able to see everything. Part of it is also due to the atmosphere. Having said that though, the place was probably only 1/2 full. Kinda surprising, considering it's Chicago and it was a Friday night.

A note about the United Center - it's a lot bigger than I thought it would be. Still, most of the seats seem to offer a pretty good view of the ice. I was at center ice in the 2nd row of the third tier of seating. I didn't feel like I was too far from the action at all. About the game - it was pretty entertaining (as a casual fan). A surprising number of blue line slapshots actually scored. And the Blues had a tie game after being down something like 3-10 in shots on goal.

And the one weird moment was getting "carded." Yes for alcohol, but that's expected. I walked through the entrance gates and saw that hats were being handed out. As I extend my hand in anticipation, I get asked how old I am. After a puzzled look on my face, "22" was my response. Apparently that's the password for hat receiving. As I look at my new Hawks hat, I see a Bud Light logo emblazoned on the back. Sweet. I just "carded" for a hat. I thought it was pretty funny actually. Your mileage may vary.

Sooo, that's a little bit of what I've been up to outside the realm of med school. Not a whole lot and nothing too special, but it's still nice to have new and random stuff like this every now and then. Just wish it happened more often.

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.