Sick...again

Spartacus: Blood and Sand...my main diversion from studying

So to prove the old belief that stress-->lowers immunity-->leads to illness...I am sick once again. Except my battle is not with a virus or bacterial infection it is once again with my self..ie. Allergies. I am now on a heavy dose of prednisone for the next 10 days, starting with 6 pills a day for the next 4 days and then tapering down the dosages. As a result I not only feel fatigued, have a headache I also have arthritic pain in my knee joints. I am officially an 80 year old woman. God, I hate medical school sometimes. It is nice to be able to go to bed at 10 pm every night though, I haven't had this sleep schedule since I was like 9 years old.
In other news, if I do make it through the next 2 weeks of hell I will have survived my first semester of medical school in the 3rd world! Yippee!
If not, well that thought haunts the back of my mind every day. In fact I have heart palpitations just thinking about the consequences. Scary!
My goal is and will be for the next 12 months to pass and earn my freedom back to the U.S.! It's a crazy goal to have, but it's the price you pay for going to school in the middle of the Caribbean Ocean.
My goal for this weekend is to catch up on the massive amounts of lecture materials that I couldn't get during my bout of illness/allergic attack. So far I have a lot of physio to do...bleh. And even more anatomy..double bleh.
These are two of my favorite subjects but the profs who taught them for the past few weeks were awful. Especially the anatomy prof. I'm convinced they hire the worst profs for this subject..which is lame considering this is the first time most of us have studied gross anatomy.
We had our last dissection on Monday of the semester! Hooray! But I have a mocktical (mock anatomy practical) tomorrow, yes, on a Saturday at 11am to prepare me for the real thing on Tuesday.
The anat practical is supposed to be cumulative (everything from shoulders to toes, literally) but luckily that's not feasible as it would take 2 days to get through with our class size.
So instead we "only" have to know everything from the waist down + heart +pleura + lungs (so all thorax). Fun times. I did get to perform the internal heart dissection which was wicked cool! Hearts are amazing and squishy too! Love it. Lungs a pretty gross though, especially because our cadaver was a smoker in life and his lungs are very large and very black. Blech.

Wish me luck on the end of this part of my journey! Hopefully I will be healthy before my exams come around! Ta ta for now!

More later...

P.

Saturday in Roseau

Woke up at 7 am today to meet up with Swati, Vishaka and Sara to head down to Roseau, the country's capital city. The ride was free, provided by Ross U and was fairly smooth. We passed through the mountainous jungle terrain and by the edge of the coast over looking the Caribbean Sea.

When we got there our friends wanted to just shop so Swati and I split up. We went into a cathedral that was built in 1864. It was nice; stain glass murals, painted depictions and some gold-leaf trim around the ceiling (nothing compared to the cathedrals I saw through out Peru).

The rest of the day was spent...

1. Eating lunch with Dr. Beevers (Chris) at a Chinese restaurant. It was the best chinese food I have had here so far; pricey but worth it! I had Miso soup + curry chicken...and plenty of leftovers for dinner!

2. Bought some really shiny, awesome flats at "Bijoux" the only upper-class store I've seen so far on this island for a mere 25 US bucks.

3. Hanging out with the Spiceman ("l'homme") and Cameron a young local guy who sells the spices. I tried their home-distilled rum: passion fruit and coconut flavored. After building a repoire with both the men and buying a small bottle of the coconut rum I asked Cameron if I could see the pet boa constrictors he has in the cellar. He had 4 of them and also a coy pond. The Spiceman, whose name terms out to be Serge, can be described as a modern-day pirate. He's charming and has long dreads that go down to his back, a gold earring on each ear, a gold-bar eyebrow piercing, and small gold rings imbedded in his dreads. He was very charming and knowledgable about Indian culture. We had fun talking to both of the men. The Spiceman really liked Swati (a little too much, haha) and he soon took to me when I asked if I could try the boa that they had the on menu. He showed me how he cooked and all the spices that went into the curry/sauce: coconut milk, his secret spice mix, chili pepper, thyme, garlic, ginger, and sprinkled some nutmeg on top for flavor. The sauce was gourmet. The snake, was chewy and reminded me of under-cooked or raw octopus. Not my favorite and I couldn't taste the meat at all because of the strong curry. He said he prob should have just fried the snake and put the sauce on the side. Next time I guess!
  

We took pictures with the Spiceman and continued on our way. What an awesome experience, hanging out with the locals. Swati and I are definately coming back!

4. Bought frozen food (Lean Cuisine, Hot pockets) from the Safeway; sad but I'm really excited about it! It's so hard to find basic things where I live.

At the end of the day we took a local bus back to Picard for 9 ECs.

All in all it was a great day. We definately felt refreshed and satisfied with taking a small vacation away from this tiny strip of land we live on. Hope we have another chance to go back soon! It's such a relief for me to know that we Can leave this tiny town and go somewhere different and fun. It gave me a real sense of balance and the whole experienced was very chill and relaxing for me.

More later!

Salybia Mission Clinic

Today, Saturday, I woke up at 6:30 am to get ready to leave for my first experience working at the Salybia Mission Clinic, located in "Carib territory" in a town called Salybia that is up in the jungle-filled mountains.
The transportation was an old 1970s bus with no suspension and sitting on the seat on top of the wheel turned out to be a bad idea. I got motion sickness halfway through and my friend had to have the driver pull over to the side of the road to vomit. Everyone turns out was taking dramamine.
The drive is 1 1/2 hours and the route starts by passing through Portsmouth and passing the airport, climbing the steep (one lane) mountain road to the jungle.
The infrastructre was very impressive, a good size yellow building, made of concrete not aluminum. It was nicer than my PP clinic back in Austin in that sense. It was also new.
Dr. Andrews was the only physician working today and she specializes in Emergency medicine. This became apparent during two of the cases. She was great at allowing us students to do the entire patient history, present it to her in front of the rest of the group and allow us to treat the patient if possible.
My partner and I had a patient who came in with a large ulcer on the medial side of his ankle. He had had the ulcer for 23 years and it started small but now was significantly large and covered in necrotic tissue. My partner and I got to use a scalpel to scrape away the necrotic tissue, thoroughly clean the ulcer, and dress it.
Another patient came in with a large, infected abcess on this hand. The students working with him had to make a small incision and drain the pus. This was very painful for the patient and I felt incredibley bad for him and tried to comfort him.
Other students saw patients with more minor or general health concerns. We ate our home-packed lunches and by the time we were ready to leave it was already 3pm. We returned to campus around 5pm and I had slept on the way back after borrowing some dramamine from a friend.
I then walked to the Diwali puja and dinner with Swati and Nitisha and after returned to my apartment tired but content.



More later!

Nicest Oblique Popliteal Ligament Around!

So I know I say this every week but...this week was actually, literally the longest week so far. I have my 2nd major exam on Monday and although I intended to study for the exam after class I had some extracurricular (as in mandatory, scheduled event) to attend every single day this week. These have become the bain of my existence, especially the Friday "problem-based learning" sessions which require research and typed papers each Thursday. The biggest obstacle in med school is lack of time. Sure the material is difficult and you are expected to master concepts in hours rather than days or weeks but all of this would just fine if I actually had the time to do it!
On the plus side, my dissection of the knee joint (capsule) was proclaimed "really good" by our anatomy prof. today and will most likely be used on the next anatomy practical. Sweet! That's one less body that I will have to worry about identifying! By the way the knee joint is freaking awesome! It's a really clean dissection and everything looks mechanically and aesthetically beautiful in there. Also, I finally got to see that famous ACL (anterior cruciate lig.) that all my soccer team pals ruptured at some point throughout the course of my soccer career. The gastronemus muscles are also fun to play with :)
The coolest thing about anatomy lab is that you get to use your hands to "cut" fascia, separate muscles and play around with body parts that most people will never get a chance to see. It's amazing how much damage/dissecting can be done with your hands...it's also very scary that a few quick cuts with a scalpel can disable you. And the scariest part is that I can probably tell you exactly what presentation you will have if you injure any nerve from your neck down to your toes. And I've only been in medical school for 2 months. Scary.
Halloween will be celebrated here by the way or rather on the coast on Monday night and my friend and I are discussing skipping class Tuesday to go island hopping next week. Wednesday is Dominica's independence day so the university will be closed.
Will post more pics when I get a chance.
Bye!

Oh yea; THIS is why I want to be a physician!

For the past few weeks I have really been wondering why I am here. (And by "here" I don't mean in the existential sense of the word, I mean "in Medical School".) :P
Today I walked to the other side of campus to help run a free clinic in a parking lot outside of the local "Starbucks" (called Rituals). The clinic was run by an organization I recently joined called OLAS (Org for Latin American Students). Of course I would. Hey it's a chance to practicar mi espanol! Anyways, I worked the Glucose-reading station from 9-noon, helped set up etc.
As the patients started coming down I was reminded of Why I love Medicine. I love love love patient-interaction and educating others about healthcare. When I came to Ross I was really bummed because I missed my clinic back in Austin. I missed taking patient histories, doing counseling, education and engaging with the patients. I also missed doing blood-draws and all the other tests. This seems ironic now considering the hectic nature of the low-income clinic and how exhausted I was at the end of each day. At Planned Parenthood we had many patients and only 2 education rooms, this in addition to the patients' anxieties about exams, fear of blood-draws and of course pregancy test results meant I was burnt out by closing time. But I miss my co-workers, nurses, MAs, office clerks as well as the "team mentality" of support and efficiency.
Today I was able to get some of that familiarity back as I engaged with the local men, women and children. I love how people are so laid-back here, and I'm impressed with the level of awareness that they have about their health. It definately competes with the low-income Latino community back in Austin. One man looked guilty as he admitted to me that he used to drink beer but now watches what he eats and drinks. I tried to reinforce the positivity of him no longer drinking and he was very pleased with himself. :) He is a construction worker and his skin was so callused that it took me twice as long to draw blood out.
The clinic today was a wonderful start to this Saturday and I'm really glad that I went out on a limb to meet other students and help out. I hope I get more experience/training this semester!
Next weekend I plan on helping out at the Kids Sports Clinic. I guess I should learn how to interact with kids eventually :)

Thanks for reading!
More later!

"Beach Bash" Friday October 15

Me, Swati and Christian: celebrating passing Block 1 at De Champs bar

Beautiful Dominican Sunset as viewed from my apt window

Portsmouth Beach

Medocrity is the name of the game

So I found out that I did indeed Pass the First Block of medical school which means that I Don't have to repeat the semester and Can continue as a medical student. Hooray!

I don't know if I will ever get used to the fact that "Passing" is an achievement in medical school. I miss having B's and A's...those are much more gratifying than high C's :(
Hopefully eventually I will be able to start pulling my grades up. I think it will take some time to figure out how best to prepare for exams here, especially since testing is my greatest weakness.
Time to go celebrate mediocrity! Tomorrow is "Splash Bash" an awesome all day/night event held on the beach by Ross. They provide food, entertainment (kayaking, boating) and at night there is a beach bonfire! Of course there are a few parties afterward. We will see how burnt out I am by the end of this week. We all got pretty crazy after the last mini on Monday night :)
I am starting to miss Austin, my family and friends more and more. On the other hand I'm missing the conveniencies and luxuries of the U.S. less. Although I'm still bitter about how much stores rip us off for chocolate here.

More soon! Ta!

Still alive!

Yes! I am still alive!
Right now I'm just trying to keep my head above the water.
Between classes and labs and problem-based learning sessions I barely have time to feed myself before studying until I'm too exhausted/mentally-wasted to stay awake. Then I wake up the next morning, hurl myself out of my apartment, catch the shuttle (hopefully) and start all over again.
It's been very rainy/stormy here and I'm finally getting a chance to use all my gear; full-length raincoat and boots. Umbrellas are useless here.
Classes are held in the "Annex" which is prob. about a mile away uphill so shuttles are preferable but I've had to walk on a few occasions that I overslept my alarm (not fun in the heat, even at 9 am).
Food is...well it's taken me up till now to find food that is healthy and won't upset my stomach.
I buy overpriced vegies from small shops and stands and try to cook (when I have the time) pasta or chinese food for the week. I supplement these meals with food from "the shacks", the string of shack restaurants on campus run by locals. Chicken is the main meat (no dairy cows or fresh milk here) and I've started to find tofu in select grocery shops. It's rough.
Classes are insane and I'm still in awe about the amount of information we are expected to retain, memorize and apply on a weekly basis. We have major exams (called Minis) every two weeks and this week I get a special treat: Friday I have histology lab practical, Monday I have my 2nd Mini followed by my first Anatomy practical. Kill me now.

Basically if I survive this semester it will be a miracle!

More later!

Never Eat Lettuce in Dominica

My parents left early this morning at 4:30 a.m. Later around 7 a.m. I awoke from a horrid, graphic dream that my classmates and I were hiding behind trees in a forest of man-eating bears. I was crouched down behind a shrub while packs of grizzlies through the woods eating people whole then retreated behind the hills. I woke up feeling horrible. I've been sick since yesterday; stomach cramps, headache that won't be assuaged by motrin. And I start classes on Monday. Great.
A biochemistry prof. gave a nutrition lecture the other day and told us how to clean lettuce that we buy from street vendors. My mom and I followed these instructions to a "T" yet here I am with intestinal cramps and a persistent headache. Moral of the story is: never eat the lettuce in Dominica.
I spent the majority of the day drinking lots of water mixed with EmergenC, napping, attempting to read lecture notes for Monday and watching bad chick flix on TV. Although I feel unproductive I also think I need to give myself a chance to heal before I hit the ground running (or in this case weakly stumbling) towards my first week of medical school.
I suspect that my condition is in part due to the poor choice I made to go out on Thursday night. The started with hanging out with my friend's friends in an apartment across the street from mine. We then proceeded to walk towards "De Champ's" the local bar/med. student hang out. The hills in Dominica are serious hills. (hills=bottom portion of mountain-sides) Around the time that our group became a larger group as more and more people joined us on our trek up to the bar, a local guy drove up to us and offered us a ride in the back of his pick-up truck.
Most of the girls and guys were "stoked" and jumped right in. Camron and I looked at each other and decided to play it safe by sitting inside the truck. God, I thought I left all this behind in Texas!
In the end taking the ride was worth it because the bar is located on the very top of the longest, steepest hill I have encountered in Portsmouth.
I have to admit I was surprised and a little impressed by the place. So many people were there and I felt a strong sense of camaraderie among my fellow classmates.
Unfortunately my body later punished me for drinking an amount of alcohol that would have barely left me tipsy back home. That in combination with contaminated food leaves where I am right now. I truly hope I feel at least 50% better tomorrow or else I'm screwed for this week.

On one last, positive note, I am really excited to start medical school! The first two weeks will be a review of basic concepts and our first "mini" exam is 2 1/2 weeks away (too soon!)
My courses are 8am- 3pm or later for labs. I have about 30 minutes for lunch in the middle of the day. This semester I'm taking: biochemistry, anatomy lab, histology, anatomy, and simulation lab where we practice clinical skills on one of the six super high-tech human simulators ($45K a piece). Apparently they contain realistic body fluids, react to medication and have other physiological characteristics like a heartbeat and working lungs. Creepy yet amazing. I can't wait to work on one! I'm a little nervous about dissecting my first cadaver but I'm sure I'll get over it soon enough. I'm looking forward to joining an organization that provides volunteer health care in the town clinic too.
Keep your fingers crossed that I get better by Monday! Thanks for reading :)

More later...

Dominica

So I made it!
Last night my mom and I stayed in a resort hotel that was practically on campus, in a nice bungalow with A/C. At night the jungle comes alive and the noise from the night creatures in the trees is so loud I only got a couple hours of sleep last night. Oh and the roaches are large and healthy looking (nooooo!!!!)

Ross Blvd.: The main road leading to campus; The white building ahead is my apartment complex.

At the moment I'm in my new apartment at Lucy Villa. It's located across the street from campus and the Ross University Housing department. It is spacious with two full-sized beds, nice-size bathroom with shower and Western toilet (thank the gods), full kitchen with a mini gas stove, microwave, fridge, cupboards, etc. Looks like I have enough storage space. I also have a TV with full cable and DSL internet. So I really can't complain.

A picture of Ross University campus:
white tin roofs and unimpressive architecture with hi-tech learning facilities inside

Looks like my classes will be a 5-15 minute walk away. During the day it has been hot but breezy and lovely in the shade. The ocean is only 5 minutes away, at the back of campus. This town reminds me of a town in India; the post-colonial way of life is strong here, people drive on the opposite side of the road and the majority of goods are imported (barring fresh fruit, veggies, bread). Even milk isn't fresh! All the milk is canned or bottled with preservatives. The islanders are nice and small talk goes a long way for better service and easier communication. Everyone speaks English with a thick East Caribbean accent which hasn't been much of a problem for me so far but it will take my ear some time to adjust to it.
I have only met a couple of students so far as neither classes nor orientation has begun.

Orientation Day 2: Me with my new medical student ID badge on campus

Most of the other students are here with their spouse or are married with their spouse back in the States. Strangely some of these students are only a few years older than I am. Other students are here with friends/former roommates from undergrad.
I am really looking forward to starting classes and getting into the groove of medical school. Can't wait to check out the library/study areas *adjusts glasses nerdily* I'm also looking forward to joining an organization or two to meet people/future study buddies.
Because the program is only 16 mos instead of 2 or 4 years like other grad. programs, the "seniors" are the 4th semester students who are finishing up coursework and getting ready to go back to the States to study for the USMLE 1.
I've bought a few things for the fridge and have started to unpack my bags (I had to remove 60 lbs of stuff in Austin because of strict luggage weight restrictions for the flight to the island).
Tonight will be my first night in my apartment and hopefully I will be able to sleep.
More later!

Packed and ready(ish)!

I'm all packed (all 5 suitcases plus a carry-on) and ready to start orientation for medical school!
Packing was quite a feat; I constantly went back and forth in mind trying to talk myself into only bringing 2 bags but in the end I sided on bringing too much. I figure I need to be comfortable when I'm in medical school and creature comforts are necessary when one is under stress. Therefore...I'm bringing everything.

Moving on from packing...my madre is accompanying me on my initial trip. We have to stay over in Puerto Rico for one night because there aren't any direct flights to Dominica. My father will join us later. It feels weird having my parents with me but it will give them a good chance to see where I'll be living for the next 2 years and also they qualify me to bring more checked bags (haha).
Don't know what to expect at all as far as living situation, culture-shock and most importantly medical school-shock. These are the 3 main burdens on my mind right now (two of which a U.S. student never has to worry about). I'm "looking forward" to only having to stress out about medical school!
And so the adventure begins.
Stay tuned for more! :)

PaCE and Hope for My Educational Experience

I received an email today that informed me that I have been accepted into the PaCE program at Ross. Essentially this program will provide me with more opportunities to hone my study skills, prepare for exams and work in individual student groups on case-based learning. I am happy that working my butt off in undergrad gave me an edge in the first two years of medical school. Although I am optimistic about the program, I won't know for sure how helpful it is until I get there later this month.
Only 2 weeks until I leave Austin. That will mark the first time in my life that I have attended school away from my hometown...out of state AND out of country. Scary.

Logistics

My job at Planned Parenthood ends on Monday and I'm looking forward to having some time to prepare for my life as a med student on Dominica.

What I have accomplished thus far:

• buying a plane ticket to the island and a return ticket for December back to the States (very comforting to know that I have a way back in a few months)
  
• mailed a deposit for my new apartment at "Lucy Villa" which is about 3 minutes away from campus...the only apartment that was available was on the ground-floor. I was apprehensive about this at first given the flooding situation but from what I have heard these apartments do not flood and rainy season will be mostly ending by the time I arrive. Also I have an agreement with the landlady that she will let me move into an apartment on a higher level as soon as it becomes available *fingers crossed*
  
• mailed my VISA application (compling all the documents and medical records for this took me months so they better not gripe about some minor discrepancy and make me redo it)


• bought the essential school supplies including my brand-spanking-new laptop which should be shipped to my house soon (!)
  

What I have a month to accomplish:

• LOANS (evil but necessary)
  
• class registration


• textbooks


• hurricane gear including but not limited too: a nice rain coat from REI, a headlamp and iodine tablets


• packing all of my necessary possesions


• opening up a new bank account with Citibank (the only bank on the island)

Getting Ready!

Over the past couple of months I have been preparing for my journey and epic adventure studying medicine at Ross University School of Medicine in Dominica. The island (gained independence from Britain only 30 years ago) is located 30 minutes South of San Juan, Puerto Rico and is the middle of the Caribbean Ocean.

• Big Questions:

1. Will I survive?
2. Will I be well-equipped to pass the first Board exam? (goes along with question 1.)
3. What are my chances of becoming a Caribbean-doctor-pirate?
4. Will I have any time at all to do the outdoor adventuring that the island is known for?

This is what I know so far...

• Living situation: All apartments are a 5-10 minute walk from campus and are located at addresses like "Hill Top Road" and other vague directions which highlight the rural nature of Dominican life. I expect my new home of the next 16 months to be akin to Brownsville...with less recreational activities. Damn. At least there will be plenty of fresh fruit and vegetables being sold at local stands on the main road outside of campus. Oh and the beaches do look amazing.
  
• Weather: Two seasons...rainy and sunny...average yearly temperature of 80 degrees F. Possible hurricanes and definitely expect torrential rains at some point.
  
• School: best to buy school supplies ahead of time because all foreign imports (paper, pens, etc) have heavily inflated prices due to import tax...about 3 times U.S. price for basic U.S. goods. CostCo here I come! The classrooms look super hi-tech and I'm excited about the prospect of videotaped lectures (in case I have to miss class for some reason).
  Student demographic: from the "welcome videos" and interviews looks like there will be lots of Indian kids *shudder*, 90% Americans and some foreign students. I was hoping there would be more diversity but I guess I'll just have to try extra hard to find non-stereotypical, cool people. Okay, that's a bit harsh and premature, but I really just hope that I can meet others who are as eccentric and non-square as I am.
• Dominican culture: formerly a French colony, fought over by the U.K. Natives speak Patois (a creole French dialect) which looks very similar to basic French except for the "r's" are pronounced like "w"...I know I am oversimplifying but this is all I've been able to find out from the web so far. Of course basic every day words like "mother", "father", "friend" have more African and creole twists on them that differ from pure French. Either way my Spanish abilities will not be useful on this island. Perhaps some of my 1 semester of college French will come back? *gulp*

I arrive in Dominica for medical school orientation on August 27th and will be spending my 23rd birthday on the island. Hooray?
**National Geographic fact sheet about Dominica