A bone-us!
And that was your Halloween joke for this post :)
Updates
Autumn is in full swing, and as I am a big fan of sweaters, I am on board for it. Already more than halfway through the final semester of the first year! A couple weeks ago we received the schedule for our clinical rotations, here’s what mine looks like:
Rotation 1: Jan 2- Feb 10 - University Health Center - Bridgeport, WV
2: Feb. 13- March 23 - Marietta Memorial Health System - Marietta, OH
3: March 27 - May 5 - WVU East - Martinsburg, WV
4: May 8 June 16 - Allegheny General Hospital - Pittsburgh, PA
5: June 19 - June 28 - Westmoreland Medical Examiner's office - Greensburg, PA
6: July 31 - Sept 8 - Ruby Memorial Hospital Autopsy - Morgantown, WV
7: Sept 11 - Dec 15 - Mercy Health St. Elizabeth - Youngstown, OH
After we got our schedule, Michelle and Justin gave us the full run-down on (just about) everything we could possibly need to know for our rotations. Prof. Falcon walked us through the handbook and each rotation site. They also gave us a packet with the paperwork we would need to complete for each site, which I am eternally grateful for. Knowing that I will not have forgotten a critical piece of paperwork will help me sleep next year. The only things we really need to organize for ourselves is getting our physical bodies to the sites and making sure we have a place to stay when we get there. While that is still a lot to contend with, it could be a lot worse. There are plenty of healthcare programs out there that do not organize your rotations for you, so having these sites prepped and ready to go for us is a gift.
Trying to find housing for 2023 so far has been… chaotic, but we will get there, one way or another.
I had my last gross room “rotation” day a few weeks ago as well. On the same morning I also had my first oral exam. The exam went well. For gross room the specimens I got were:
Day 1: A lung segmentectomy for malignancy (and another specimen I can’t remember)
Day 2: A splenectomy, an ischemic bowel, and a skin punch. It was slower that day so I also just shadowed a 2nd year student too.
Lastly, next month we are going to have our frozen section practical. Learning the cryostat and how to cut rapid sections has largely been a self-taught experience. While this has been frustrating at times, it’s been nice to be able to make all my mistakes without anyone watching, and this way I can’t compare my progress to anyone else’s, and thus stress myself out even more.
Quite a bit of my time these past few months has been spent in physical therapy for neck pain. Between my previous work at microscopes and now the volume of studying, my cervical spine has taken a beating as you can see in my X-ray (The yellow line is how my spine should be curved, the red is where is was back in July). A fun little phenomenon called "forward head posture" that is embarrassingly common, also nicknamed "text neck" since hanging your head forward to look at your phone can contribute to the problem. This was causing me a lot of headaches, neck and TMJ pain. Even though I've been diligent with my PT, fixing my posture, and bought a new ergonomic pillow, it still makes it hard to study for long periods of time. It seems like everyone in grad school ends up with some sort of physical ailment. You simply cannot put yourself in such stress and not pay a price of some kind. The sliver lining is that now I look like a very distinguished librarian when I study with my head held upright, looking down through my glasses as they perch on the end of my nose.
Reflection
There is only one thing that I am sure of about 2023: It’s going to be challenging. Knowing this and not letting it freak me out has been crucial. One way that I’ve done this is by reflecting on my motivations for being here, and reminding myself why this profession is important to me. I’ve been re-reading my personal statements from when I was still in the application process, previous posts to this blog, job
postings, and just looking back at how much I’ve learned this year. All of these things have helped me put things back into perspective. Also making a massive spreadsheet for logistics… that also soothes my nerves.
My meditation practice has also played a big role in mentally preparing myself for next year. Reading books by Pema Chodoron, Jack Kornfield, and Thich Naht Hahn have reassured me that no matter what happens next year, how many mistakes I will make in rotations, how bad a living situation might be, how stressful to move every 6 weeks, I will have two feet on the ground and a brain in my head, and that is a powerful thing.
Disease of the Day!
Fibropolycystic disease of the liver - Robbins page 860
Fibropolycystic disease of the liver is a categorization of various abnormalities which are primarily congenital malformations of the biliary tree (aka the bile duct and gallbladder system). Oftentimes these abnormalities are not discovered until late childhood or adolescence. The three main findings in fibropolycystic disease are as follows:
Von Meyenburg complexes: These are extraneous small bile ducts found within the liver. It’s normal to find a couple of these in healthy people, but too many is a sign of FPD.
Biliary cysts: These can be single or multiple, intra- or extra-hepatic. When there is a large number of cysts within the liver it is called Caroli syndrome and can give the liver a very dramatic appearance.
Congenital hepatic fibrosis: The portal tracts of the liver (the collections of artery, portal vein, and bile duct) are surrounded by thick bands of collagenous connective tissue that separates the functional areas of the liver parenchyma. This is similar to cirrhosis, seen in chronic liver damage, and can similarly lead to portal hypertension.
Fibropolycystic disease also increases a patient’s risk of developing carcinoma of the biliary tree- termed cholangiocarcinoma.
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