I’ve moved!
I finally got around to buying a domain! http://www.thursdayborn.com is the new address for this blog. If you go to https://thursdayborn.wordpress.com, it will automatically redirect you to the new domain, but it cost me money (12 whole dollars!) to set that up, and being a broke medical student, I may or may not decide to pay for another year when it runs out (november 2011).
So please, change any links! And change the blog you’re subscribed to in google reader. I thought my old subscribers would be seeing the posts on the new domain, but I just found out that they’re not, so please change your subscription!
Again, new address = http://www.thursdayborn.com
Bottled Mead!
I finally got around to bottling my first two gallons of mead! These are the sum of the sterile, properly bottled ones that should be safe to store indefinitely (but I think I will encourage them to be drunk soon because I don’t think this recipe really improves much with age and I let it get exposed to air quite a bit as I was siphoning them into the bottles). I also really underfilled one of the bottles, but that one’s going home with me for Christmas so it will be opened soon. There’s two more of the smaller bottles (200ml) and a small 4oz nalgene container in the fridge, that were not bottled under sterile conditions and should be consumed really soon.
It was a very messy and sticky process, and I think I need to invest in an auto-filler. I’m not sure how people manage to actually pinch off the tube between bottles by hand, because the best I could do was sort of slow the flow, but not stop it. Still, I have to report that this recipe is amazing and while I do still intend to try at least a third recipe (there’s a second one still finishing up in my pantry), I think this will be my go-to recipe. It’s just so easy and it tastes so good. I might try little variations, but I don’t really have the time to seriously get into brewing anyway, especially recipes that need much more rigid handling.
I’m in love with my bottle capper though. There’s something nifty about being able to cap bottles just like the ones you buy in the store! I can cap any bottle that takes a standard bottle cap (so not the twist off bottles). I decided not to invest in a corker, and instead bought some fancy “Zork” corks that you just push (or hammer) into the wine bottle. They’re also easier to open than normal corks (hilarious commercial about this), and they turn into a wine stopper once the seal has been removed. They’re definitely more expensive than real corks, but for the volume of mead I plan to make, I think these are a reasonable investment.
Owning a capper kind of makes me want to try making beer, except I still only vaguely like beer. I have the yeast to try making hard cider though, and I’ll probably do that after Christmas break. Hard cider is a very simple process of add yeast to apple cider, wait ten days, then drink your hard cider.
Engaging Teachers
While a good majority of my medical education is lectures, there are some small group sessions. A good majority of those small group sessions are a bit more like mini-lectures, but every now and then I get lucky and have a small group leader who really engages us.
A month or two ago I had that experience in a one-time radiology session. About ten of us and one radiology resident, plus a bunch of chest x-rays. He made each of us take a turn talking through the x-ray, asking us questions, then asking leading questions when we floundered. It challenged us, but it didn’t make us feel like we were idiots. I was expecting yet another lecture with a ton of slides, so I was pleasantly surprised with how it turned out, and how much I enjoyed it.
My GI small group leader does pretty much the same thing, and he’s great. Usually I can just sit silently, listening but not really absorbing what’s going on. I think I understand but then when I look at the material again later, I realize that it went in one ear and out the other. I’ve started to bring my laptop (since I take notes now! :D), and I’m really glad I do; he goes around the room and asks us questions based on the cases, and he doesn’t just ask us the questions we’re given ahead of time. I find myself having to look things up during the session so I can answer what I think he might be asking when it gets to be my turn, while also paying attention to what’s currently going on. And I’ve been making sure I’m caught up with the material and that I’ve read the cases the night before. But it’s not a hassle, and I don’t grumble about how he makes us all participate. I love it. I love feeling like I’m actually learning medicine and understanding what’s going on. I love not feeling completely lost because the questions are only being answered by people who really seem to know their stuff; instead, I’m seeing other people struggle and realizing that it’s okay not to know so long as you try to think it through.
And I’m thinking that maybe I’m not wrong to look forward to third year, if this will be central style of teaching. I can do this kind of learning. Where I really need to prove that I know something instead of just being able to pick an answer out of a bunch of choices. Grades have never been a good motivator for me, but not wanting to look stupid in front of others? Wanting to look smart? That’s the right kind of fire to light under me that gets me up and moving (or rather, down and studying). I admit, I’m still a bit scared of third year, especially since we know nothing about it. At first I thought it was going to be really hard, and then I thought maybe it wouldn’t be so bad, and now I’ve been hearing that no, actually, it will be pretty difficult. In about two and a half weeks we have another class meeting with the career counseling office (first and only other one was last year) so maybe they’ll shed some much needed light on Step 1 and third year, because so far we’ve been relying on each other and upperclassmen, with next to zero official information.
P.S. Just wanted to brag that I normally don’t spell check my entries, but I decided to today, and no errors! Well, minus the fact that it thinks I should hyphenate “much needed.” Huh.
Third Block! – GI, Endo & Derm
And so begins our third block! My collection of course books is growing quite rapidly…
This block, at only 4.5 weeks long but only a little smaller than last block, has been fairly intense. Very long days of lecture, which has made keeping up difficult (I just finished last week, but there’s enough time left tonight that I might be able to catch up through today if I focus). I really like the material of this block, so far. I guess I find Crohn’s Disease and Diabetes more interesting than Pneumonia and Myocardial Infarctions. All of my grades but Cardio from last block are in, and I’m happy with them, especially if the second years really thought that it, the CPR block , was the hardest of the six. I can do this! I haven’t been as good about reading First Aid (the main Step 1 review book that most people at least start with) after I finish each topic as I meant to be. I still haven’t read the Renal and Pulmonary sections, but I have a flight coming up for Thanksgiving and when’s a better time to catch up on some reading than when there’s little else to do? Reading the Cardio section didn’t send me into a panic though, so I’m feeling good about the correlation between what they teach us in school, and what I need to know for the test. I’m not very interested in any of the competitive specialties so I’m not aiming for an astonishingly high score, but I want it to be good enough to feel like I have options when it comes to applying for my residencies. Who knows where I’ll want to be for those 3-7 or more years, but I’d like to have a good shot at getting in wherever it is.
After my exams but before this block began, I had a chance to make some cheese fondue. This was only the fourth time I’ve had it (and all times it’s been home-made), and it was just as delicious as the other times, if not even better. I’ve always used Gruyere and Emmenthaler, but this time I used Jarlsberg instead of the Emmenthaler, and I cut the wine in half and substituted in some chicken stock. We had are it with bread and apples, with some spinach on the side.
But once the block started, it meant meals were going to be less fancy and more centered on “how quickly can I make it and how many nutrients can I pack into it?” Which leads to meals like black beans (canned), and sweet potato (microwaved) on a tortilla (this one was corn), with some cheese and salsa. Very quick to throw together, and one can of beans and one decent sized sweet potato means enough leftovers for 3-4 more meals. Guess what I ate for dinner/lunch most of last week? Sorry about the bad picture. Not the prettiest meal to photograph in the first place, and I’m not always good about turning on enough lights in my room before I take my pictures.
But sometimes, you need to find the time to indulge a little bit. I made a fish soup about two months ago that unintentionally was very close to a Ghanaian dish called Light Soup. It was very good, but I had meant to make something a little creamier and less acidic. Then my roommate made a simple thai coconut soup and I decided to see if coconut milk would give me the consistency and flavor profile I was looking for. Finally, this past Sunday, I got around to trying this idea. I used this recipe for inspiration, but I cooked my vegetables for a while first, then added the liquids, and then I let it cook until the vegetables were soft. At the end, I added the fish, let it sit for five minutes, and voila! Delicious, wonderful, thai coconut and lemongrass soup! I remember the first time I had a soup like this, and I fell in love with it. Except then I only had it maybe three more times. Well, now I can make it myself! And it’s so easy! Honestly, I prefer it on its own, but my classmate-neighbors overcooked some noodles and didn’t want to eat them, so I’ve been working my way through them.
I confess, it’s still not quite what I was looking for, but it was a happy misstep because I love this soup! Next time I will try making something closer to the first batch, but decreasing the presence of tomato and adding either skinned zucchini or eggplant, as my mother suggested (I might throw in the skins separately though, because why waste perfectly edible vegetable matter that my diet really needs?). Anyway, I really recommended making a variation of this Thai version. You can make it really quickly like the original recipe, or you can do what I do and let things simmer longer so you can get some other errands done until you get hungry enough and can invite your neighbor-classmates over for lunch.
My ingredient list:
~3/4 of 1 huge yellow onion
~1 cup of carrots
~ 1 tomato
1 container of button mushrooms
1 19oz can of Coconut Soup that specifically said “For Cooking” on the can.
16oz Perch
2 shrimp bouillon cubes
1 fish bouillon cube
~ 2 cans of water (ie, I used the coconut soup can to pour in the water; at some point I decided it was too thin and let it boil off for a bit. I’d say start with a 1:1 ratio, then thin as desired)
~ 1 tablespoon of garlic paste
The leftover ginger I had in the fridge which looked to be close to two tablespoons
My best guess at two tablespoons of lemongrass (don’t chop it up like I did; it’s touch to chew so you want to remove it before you serve)
1 cup and a bit more of frozen chopped red, yellow and green peppers from Trader Joe’s
Handsqueezed juice of 1 lime
Zest of about half of half of 1 lime.
Some extra salt and a bit of black pepper to taste at the end.
When I remember, fresh cilantro leaves right before serving.
Tests, Studying and Food
Exam week has ended! Got good grades on two of them, waiting to hear about the other two. During exam week and a bit before, I did find the time to take some pictures, and now I have the time to post them! Except I don’t really have the time, and I need to drag myself into bed immediately because I already have several hours of lecture to catch up on. Second year moves quickly!
Before exam week, I bought 20 pounds of Gala apples from the Farmer’s Market. The result? Several jars of apple butter! Mostly eaten in greek yogurt, which I’ve only recently decided that I like. I think in the future I might just start with plain apple sauce plus some real apples, unless I find a ridiculous deal on apples. Still, I rather like the stuff. It’s a bit sour because I refused to pour cups and cups of sugar into it, but the fat content of the yogurt cuts the acidity nicely.
The apple butter is also pretty good in oatmeal! My roommate, Hao, and I bought a watermelon about… a month ago. She cut it open before my exam week and it was still delicious, so that was exciting in and of itself, and also good timing for me. And in addition to my 20lbs of Gala apples, I had 5 pounds of Fuji apples. Oatmeal, watermelon and apples. Not bad for exam week stress eating! (Though I’m more of a stress non-eater than a stress eater.)
Hao found this amazing recipe for pumpkin bread, which she hasn’t blogged about yet and I don’t have the link to the recipe, but seriously, it’s really good. Instant coffee with powdered non-dairy creamer (ran out of soy milk and no time to go buy some) + pumpkin bread = good night before the exam “need to stay awake just a bit longer!” snack.
Peppermint tea! My stomach goes crazy when I’m stressed, so exam week equals mug upon mug of peppermint tea.
Which I also take to school with me and sip during my tests. And since it was a renal exam, twice people commented that it was “tea colored,” but it is in fact tea, and not a very large and strangely packaged urine sample…
Fun with my new camera
I’ve been experimenting with actually using the features my camera comes with, instead of just leaving it on one setting for all pictures.
Grilled cheese sandwich made of brie and homemade apple butter. Honeycrisp apple cider in the background. It was good, but sharper cheeses would be better. At least some good cheddar. Someday (possibly soon) I will re-create the Cosi sandwich my boyfriend Ahmet had the first time we interacted one on one, without others around. He had taken care of my rabbits over Thanksgiving break and I had just returned and no one else was really around, so after he gave me back my keys, we went to Cosi to eat, and he got this five cheese and marmalade toasted sandwich and it was delicious! I don’t even remember what I had. His was better.
Success! I just googled the sandwich and found a blog post that lists the five cheeses, so I’m good to go! Brie, provolone, cheddar, Swiss, and parmesan. It apparently has an insane amount of calories, but my version will likely be quite a bit more modest.
Eggo waffle (I was too lazy to make crepes, which are how I usually eat this combination) with hazelnut butter and fresh strawberries. Always a winning combination. Seriously. If you must, use nutella instead, but I prefer the pure hazelnut variation. Don’t get me wrong. I love nutella, but it’s a very strong flavor and I love it best on bread, by itself, like how I grew up eating it by mooching off my classmate’s lunches when I was six.
I wasn’t actually trying to turn my waffle in Pac Man, or the cut would have been deeper. Still, I looked at my plate and realized I had an almost pac man, so I took a picture, of course.
Random fire spinners I don’t know, at a drum circle. Fancier cameras can get even more amazing pictures of fire spinning. Still, neat though, right? I’ve been spinning a decent amount lately (but not recently, due to school) and realizing that not only do I have lots of techniques I want to learn, but I also need to work on style, because I don’t really have much of a style right now, and I could put on a decent performance even at my skill level if I just added a bit of a flare and some easy transition moves. Unfortunately, medical school kinda comes very far ahead of “looking cool while playing with fire.” Speaking of medical school, back to the kidneys!
Re-considering (sort of) Research
I have exams again on Monday. Starting with Pathology of the Heart, Kidneys and Lungs on Monday, Renal Pathophysiology on Tuesday, Nothing on Wednesday, then Cardiovascular Pathophysiology on Thursday and Pulmonary Pathophysiology on Friday.
However, despite the fact that us second years have exams next week, and that we were the majority of the students who did summer research, the Summer Research Poster symposium was yesterday. I wasn’t looking forward to it, right from the putting the poster together to having to stand by it for an hour yesterday, but it turned out to be okay. Putting the poster together didn’t take too long, my summer research team approved of the first draft, and printing did not take an hour as I was told to expect. I also rather enjoyed chatting with my “faculty reviewer.” He was a neurologist whose first question to all of us was “What was the coolest thing about your experience this summer?” His questions made it clear that his main interest was to see if the summer research had inspired any of us to think about research as a career. I don’t think I’ve ever had someone so genuinely try to recruit me into research. It wasn’t all that hard of a sell, but I could tell that he really enjoyed research and that he really feels that there need to be more doctors taking more of an evidence based medicine approach to their practice and doing clinical research at least on the side, if not primarily.
I did really enjoy my experience over the summer. It was only six weeks, which isn’t long enough to really accomplish something, but it gave me a chance to see a much different lab environment from where I worked for a year before medical school. The lab was very friendly, and there were many different labs all working in the same office area, with a very open and warm collaborative environment. It almost felt more like an office job than a research job, but I liked that aspect of it. Still, while I had a lot of fun pretending to be a programmer (and succeeding at programing!), it’s just not what I had in mind when I decided I wanted to be a doctor. There’s certainly nothing wrong with doing something different from what I expected, but if something’s going to change my path, I don’t think this is it.
And now back to studying. I really should have a better grasp at reading EKGs by now but I’m still fumbling in the dark a bit (a lot).
Even Women Doctors are still People Too
About a week ago I went to a Women in Medicine lunch talk . There were five different women doctors on the panel, and the entire talk was question and answer format. Essentially all the questions had to do with marriage and having children (2 of the 5 did not have children; one could not, the other seems to want to but hasn’t started planning to yet), yet despite that, one of the main messages I got was simply that women doctors are people too, just like women are people, and doctors are people. Women Doctors are not some special grouping of human. Some of them enjoy four months of time off with their newborn babies and hesitate to go back to work. Some can’t wait to be back after just two weeks. Some are single mothers. Some are part-time doctors (one had a ~20hr/week contract). Some are part-time doctors but work full time, doing other things on the side (and not necessarily research, which was cool to see as an option. I really like the idea of doing public health and other community things). They are heads of their departments. They are married to doctors or to non-doctors.
Some of the other things they emphasized:
1) Don’t worry about finding a significant other. You will. It may take till you’re 35 (as in the case of one of the doctors) or older, but it will happen.
2) Think about how much time you actually want to spend with your children. It varies from person to person.
3) A nanny can be a wonderful thing.
4) Don’t pick your career (ie, specialty) based on lifestyle. You can make your life work with whatever you want. (I think this was a bit misleading though. I think the real thing is to know what makes you feel fulfilled and prioritize that, and if that thing comes along with a demanding career, you’ll make it work).
5) None of them really felt that they were discriminated against or had any specific hardships that were because they were women.
I’m always interested in learning what the life of an actual doctor looks like, woman or man, so I really enjoyed the talk even though I didn’t come away with any grand epiphanies or revelations about my future as a woman doctor. I think one of my favorite things to learn about was doing part-time work not just so that you can spend the rest of your time raising children, but so that you can do other non-doctoring things that you want to do.
And before you go, I just wanted to show off my delicious dinner from the other night, through a much better picture courtesy of the camera my parents bought me for my birthday. It’s the newest version of my previous camera, so it’s somewhat familiar, but has some nicely updated features, and all in all, I’m happy with it. 🙂 The fish was a frozen tilapia fillet broiled in my toaster oven with a butter+mayo+olive oil+ parmesan +seasonings sauce. Not my usual way to cook fish, but I was wanting something cheesy since a few nights before I’d thought I was going to have pizza for dinner and I didn’t. This didn’t quite get rid of the craving, but it certainly was healthier.
Staying healthy
Second year has been incredibly time consuming, and I’ve been cooking less often. There was recently a sale on sardines at Aldi’s ($0.79 a tin!) so sardines and crackers have been a rather frequent meal. Still, now that I’ve been pretty reliably feeding myself for two years, I’m trying to focus more on eating a proper variety. I do eat pretty healthily, but there’s definitely a distinct daily lack of enough fruits and vegetables. While I’m not a big fan of frozen meals, largely because they get expensive really quickly, I am a big fan of frozen meal components. Above is frozen spinach + frozen broccoli, mixed with paremsean, mozzerella, olive oil, salt, black pepper, about a teaspoon of butter, and a tiny bit of garlic. The result? Absolutely delicious. And in the other bowl is Trader Joe’s gnocchi, which I think I added black pepper and maybe a bit of garlic to. The next day I repeated most of the steps, but no broccoli, and I mixed the two dishes together. Even better!
I even made Ratatouille two weeks ago, which was a great way to get in a nice variety of vegetables everyday. Although I’ve seen and loved the pixar movie of the same name, I was still a little unsure exactly what Ratatouille is. In short, it’s a variety of vegetables, cooked individually, and then simmered slowly together. Seasoning is surprisingly minimal, given how flavorful it turns out; just some salt, some olive oil, a bay leaf, garlic, black pepper, rosemary and thyme. Mine had one eggplant (well, what was still edible of my eggplant), one zucchini, two yellow squash, four small red peppers, two or three small green peppers, a tomato or two, and approximately one yellow onion. I loosely followed this recipe, but borrowed some ideas from this recipe as well (mostly, the taking of the liquid from the main pot and boiling it down in a separate pot, to concentrate the flavor without overcooking the vegetables). I unfortunately did overcook mine a bit, because I hadn’t cooked the squash for long enough on their own, but it was still delicious, just a bit mushy and indistinct and not terribly photogenic. I also confess that I probably added way more olive oil than is reasonable, because I tend to be a bit heavy handed with olive oil. It doesn’t help that my cast iron pan really needs re-seasoning.
A few days ago, my friend Amrita sent me an email with a link of simple, healthy breakfast ideas. I hadn’t had breakfast yet and I’d been wanting to bake for a while, so I made the Scottish Oat Scones pretty much immediately. I forgot to actually mix the dry ingredients before I added the wet ingredients, so there was something very slightly unbalanced about them, but they were still pretty good! I might make these again. I’d be inclined to make multiple smaller ones though, instead of just one big large one, and I’m tempted to see what would happen if I let the oats soak in the wet ingredients before adding in the other dry ingredients. I love oatmeal though, so these were guaranteed to be at least a moderate success. They tasted best with my strawberry jam, but were okay with my peach butter. A cup of tea on the side is almost mandatory.
And back on the theme of staying healthy, I’ve started working out, sort of. I generally try to stay mindful of keeping active, and will do little things like trying to take the stairs most of the time (I live on the sixth floor of my apartment building) or walking home from school when the weather’s nice (1.8miles). Although I’ve been fire spinning again and I have a ballroom class once a week, I’m still a lot more sedentary than I’m used to because I spend a lot of my day sitting in front of my computer and watching lectures and reading notes. So I’ve started the One Hundred Push Ups workout (I’m doing knee push-ups), and I’m also doing Two Hundred Sit Ups. I like them because they’re really minimal and simple programs. I don’t like exercising just to exercise, but I’m finding that I almost enjoy this. Almost. I at least don’t mind it. And aside from missing two workouts last week due to my second older brother’s wedding (which was wonderful!), I’ve been really good about keeping up with it. I’m not sure what I’ll do once I’m done, or if I’ll do anything else, but it’s been nice so far. I definitely am noticing more muscle, which is strange and unexpected, but really nifty. I had wanted to do their Squats program too, but my knees have always been a little odd and they creak in a way that bothers me when I do squats and lunges. I’m not sure if it’s actually bad for my knees, but I’m going to respect their apparent desire to be left alone.
I’m really looking forward to being done with all this sitting. I like being on my feet, as long as I’m walking around (standing still = lower back pain), so I can’t wait to be in the hospital doing rotations.
Your Doctor Doesn’t Know Everything
One thing I keep noticing in medical school, is that there is a lot that we aren’t explicitly taught. Yes this is obvious, but… there’s a lot I was expecting to be addressed that I’m realizing is nowhere in the curriculum (at least, not through till second year). There is a lot more that we will learn during third and fourth year, information that can’t/shouldn’t/simply isn’t taught through lectures and textbooks, and that will likely cover some of what I’m noticing is missing. Internship and residencies will take care of yet more information. And once we are properly out in the working medical world, we will still keep learning, because there is always more to know.
But there’s a lot that I think people assume doctors know, that we really don’t. Little gaps that you might think, “Well, she’s a doctor! Of course she knows the answer to this question!” No. Don’t assume that. Not unless the question is, “Is it okay if I take my aspirin and ibuprofen together?” or “What are the major side effects of this drug?” Questions like, “Do I really need to drink eight glasses of water a day?” or “Is high fructose corn syrup actually bad for me or is it okay like those commercials say it is?” Those are questions that some of us may be willing to answer, but I can’t guarantee that our answers will be right, because we don’t have much more information than you on these topics. A registered dietitian knows much more about food than we do. A physical or occupational therapist knows a lot more about how your body moves and should move and what you need to do to get it optimally functional.
And even in the realm of information that we probably should know, there’s a chance we weren’t taught it. That we never came across a patient with your problem before so even though it exists, we’ve never heard about it or read about it before and can’t immediately help you. We want to help you, but maybe you’ll just have to be that first patient who inspires us to look a little deeper. Or maybe we’ll fail you and decide it’s all in your head or nothing to worry about and never think about your problem again.
I’ve been coming across this a lot as a medical student. My knowledge is very textbook so when people ask me more practical questions, Do you think this cut will need stitches? Should we ice this bruise?, I’m answering from a similar knowledge base to what they already have. Or I’m using the same resources (the internet!) to find out the answer. I admit I’m more driven to find out the answers now, so if someone asks me something I don’t know, I’m more likely to research it than to say “I don’t know” and leave it at that.
But the answer is always going to be “I don’t know” to some of these doctor-type questions, because I can’t know it all. And neither does your doctor. Trust us, and still ask us, because we do (I say we like I count, but I don’t just yet) have a wide knowledge base to draw from and we might be better able to find the answer. And I think it’s best to trust a doctor who occasionally says, “I’m not sure but I’ll look into it” than doctors who give half answers that show they’re just guessing and they’re not going to bother looking into it later. I’ve had those doctors before, as a patient, and yeah, they’re annoying.
Thursday Born 