Becky's brothers Dave and Paul after their ride from Seattle to Spring Training (1800 miles) for a cancer fund raiser. They are on the field for the first pitch.

Another great pose with the boys.

The whole family turned out (my dad and stepmom aren't shown).

The boys posed at Disneyland.

The boys and I at Disneyland after Becky's Graduation.

Becky and a proud hubby (me).

Becky and the Boys at her Concord U. graduation

Second week down...

Wow, these weeks are rolling right along. I aced the Neuro quiz on Monday (it was easy) and think I did ok on today's Immuno test. But after three nights of <5 hours sleep I'm burnt out.

In other words I'm way behind for Monday's Physiology test. It's on 9 lectures so there's a lot to cover in two days. I just hope I can rebound tomorrow and get focused Satuday and Sunday. Then I'll have a week to catch-up in neuro (on over a dozen lectures). And after that the real fun begins with test after test for a couple weeks.

Somehow I have to fit research, oncology club and the family into this too. Oh, and did I mention that my B-day (today as a matter of fact) my wife dragged to a road side sale of "purebred" Golden Retrievers. We now have a new addition to the family that everyone is getting used to. Cedar was pretty upset initially (throwing up and now eating are far from normal for him). Now they are pals and Cedar is teaching good manners and tug-of-war. Julie has pretty much taken over training him. And got to name him and after several attempts we agreed on Artemis, from the Artemis Fowl books the boys love so much.

As for my B-day, we took Colton to the NextCare clinic (just a virus), purchased an ice cream cake and opened that presents that consisted of collars and leases for Artemis. I'm also shopping for a notebook or Tablet PC. I also got reminded by my mother-in-law in a loving way (!) that I'm only 365 days to 40!

Let's see if I can finally get those photos I promised uploaded.

First week down

Finished the first week of third quarter. It was a lot of hard work and errands.

Neuroscience is going to take a ton of time if week one is any indication. I studied it exclusively for the first three nights. We have to learn a new language for the practical test (quiz) on Monday. Immunology feels like a new language too, so I've spent a couple nights on it; reading the text and struggling through the lectures.

I haven't even cracked the Phys notes yet. But found out why I did so bad on last quarter's final. I forgot to transcribe the last page of answers (4 questions) to my scantron. Since I had the correct answers circled, I would have had an 88% instead of 75%, raising my class grade to 94% vs. 92%. Live and learn.

I also got a whole bunch of busy stuff taken care of. For my research, I had the safety lecture, got my card for access to the lab and went through thawing cells into culture flasks a couple times. Dr. Jones is back on Tuesday, so I hope to run through it on my own then. In the meantime I'm supposed to read a dozen journal articles (about 10 to go) and a couple chapters in a cell culture protocols book. One credit elective seems awfully low at this pace.

Also, I'm the new President of the Oncology Club. I started the week as the VHF, but the Prez and founder is a SGA (student gov) officer and an MS-2, so he can't hold the office. We had a good meeting with a community support group and a couple of our deans about an Oncology/Chronic Care elective for next spring. Now, I need to organize some of Brian's ideas: anti-smoking campaign, opening membership campus-wide, inviting guest speakers to campus (Onc pharm, radiation onc, Peds onc, etc.) and any other ideas Dean Kosinski has. A fellow MS-1 is interested in being VP and a MS-3 going for Rad Onc is Treasurer. Dr. Jones might even be our faculty sponsor. So I hope to have a meeting this quarter to organize things and prioritize our objectives. I also hope to keep Brian involved in an unofficial capacity.

Anyway, Becky's brothers finished their cancer fund raising bike ride from Seattle to here and are going to be guests at today's Mariner Spring Training game. They entertained the boys yesterday (boys played hooky) and now I'm going to take some time off from studying to see the game with everyone. Dan (my bro) and Miho are going to attend to, then take the boys for an overnight sleep-over. Becky, her siblings and I are then going to have dinner somewhere. Should be fun and after studying hard all week, I deserve a break :-).

Tomorrow I'll be back at it: a lot of neuro, review the last immuno lecture and hopefully get started on phys. I'm liking no labs and getting off at 2pm. Maybe this week I'll be able to use some of that time for studying instead of just taking care of errands. I even rode my bike to school four days this last week. Oh, and Tuesday I have a new Preceptor to work with here in town, so no bike commute and tie/white coat attire.

Whew!

Aced my last couple tests!

Got my grades back. My Biochem was only 90% as that 85% on the last test hurt. My Physiology got knocked down to 92% from 95%, but the piss-poor 75% on the last test normally would have hurt a lot more. Ok results, but I am disappointed in those two tests. I reviewed my Biochem test today on campus; no big surprises. A couple dumb mistakes, several "studied the wrong material" questions and two that were very poorly worded. One a true/false, only 25% got it right! Now you know something is wrong there, but they won't change it. That department certainly deserved the negative reviews I gave them. I will be checking on the Physiology score next week when the Prof for the Dept is back in town. Something is wrong when I drop 20% on one test.

Better news on Histo and Gross though! I just about aced Histo to pull out a 92% even though I had an 85% going in from the one previous test. Gross I pulled out a 94% overall and about that on the final. I'm very pleased. My cumulative GPA went up .5. I'll never make the top 10 in the class, but I should be well above the mean. And hopefully, board scores will helped by my efforts now.

Finally, had a good meeting on campus today with my summer research sponsor, Dr. 'Buck' Jones and a representative of the Amer Diabetes Assoc. Sounds like we have a great shot at an Innovation Research Grant. Even better, he said that he hasn't heard of anyone doing similar research so we might in fact be onto something orginal enough to be publishable! As part of my Spring elective, I have to get started on writing my application for a school Fellowship and I have a tour of the research lab (including safety lecture) scheduled with Dr. Jones for Monday afternoon. I'm really looking forward to getting started on this. This will really help my CV and provide my the opportunity to master cell culturing, Western Blots and fluoroscopy. Having a paper published would be icing on the cake!

Now it's time to enjoy one of my last evenings playing Xbox for another quarter. I figure I earned it after finally getting off my butt and exercising. I road my Kestrel (first time in AZ) for about 25 miles and then hiked Thunderbird Park with the boys and Cedar for an unexpectedly long 1.5-2 hours. Oh, and last but not least,last night I organized all my binders, files and books for the new quarter.

I have definitely recovered from finals week and am eager to finish up MS-1 ;-).

Milestones

Last quarter was really hard on me. I started out with great grades and felt like I almost ruined them in the last week (still waiting on Gross, Histo & Biochem results). It seems crazy to get pushed this hard when we are supposed to be learning this information, not "binging and purging" it as the joke goes. They really need to look at using the free summer between MS-1 and MS-2 for classes or going five years IMHO.

At least I can say that I'm 1/3 done with didactics. I think I can make it four more quarters without going postal. Boy did I chew up some Profs on reviews though. Bad lectures and bad tests are extremely frustrating with this much effort and investment on the line.

So I'm still leaning towards radiation oncology, but I don't know if I have a shot as such a competitive specialty. This week I'll be doing a little research on it and my summer project. Hopefully I can get in some summer job shadowing to really check out radiology.

In the meantime, I'm reviewing Biochem and Anatomy. Knowing how my brain works I can't wait until even this summer to start reviewing. This quarter was a good reminder that I can be a good student given enough time to cover the material 2-3 times in depth, but I'm no genius that can pick it up in one quick review after lectures. I'm really beginning to question whether going to lecture is effective for me at all. Since I'm starting Immunology and Neuroanatomy I begin the quarter going to classes and see how it goes from there.

I hope it doesn't get any tougher than this quarter. I can't remember ever having felt so much stress. I'm still in recovery after gourging on sympathetics. My nails are nubs, I haven't exercised in weeks and I feel like sludge. To correct the latter two I'm getting my bike ready (riding to school is only 2 miles, but better than nothing) for commuting. For the former I'm not sure what to do. If med school gives you 8 lectures to assimilate in 24 hours between tests, you're looking at very little sleep and a lot of stress. There's not much you can do.

For all its negatives, I can't imagine being anywhere else than in medical school at this moment. So I guess I'm still in the right place. And I'm going to be very proud of getting through this and the effort I put into it. I've probably done more than most of my classmates and most Americans for that matter (boot camp/NROTC, MBA, Dot Coms, starting a company, kids, living in 7 states, married 13 years), but this is very likely the hardest thing I've done yet.

I'll upload some pics from the last few days shortly, but now I'm off to enjoy my kids and vacation a bit.

Two quarters down and time to celebrate

This one felt a real accomplishment. I'm done with Gross Anatomy, Histology, Embryology and Biochem!

Obviously I need to really this information better in the next year and a half before COMLEX 1/Step 1, but the formal instruction and grades are done. One caveat is that I haven't gotten all my grades back yet. The ones I'm most interested in are those classes listed above. I have a 90%+ in Biochem going in but the test was very hard. I think I'm close, but who knows. Gross and Histo was a real grind. I really wasn't sure if I was going to pass until 10am Friday, two hours before the tests started. Now I just hoping that I didn't blow my ~95% in Gross and I managed to pick up my Histo a bit (85% prior to the test).

Bottom line though, I made it through the toughest week yet. It was a bear! I hardly got any sleep and studied non-stop for over a week with stress up to the eyeballs. Cramming when you've been irresponible is one thing. It's another when you've been studying like crazy and still don't if you're going to pass in medical school. I can't imagine passing these if I or my family had health problems or some other unforeseen event come up in the last few weeks.

Gross ended with a nice ceremony thanking the people who dedicated their bodies to our use. Immeditately after we bagged the bodies and cleaned our areas I headed home to quickly pack. Julie has been a godsend these few weeks. She not only packed the kids, but has pretty much been their parent this last week while I've been cramming and Becky is finishing the Bar. Aunt Julie is doing a great job!

So we got on the road about 7:30pm and I was still awake enough to drive for awhile. I did manage to sleep a bit in the back row of the van while Julie drove but sheer exhaustion and the stress of the last week kept me awake for the most part. It was a joy and reward to allow my brain to wander and think freely. It was amazing how nice it was to free my thoughts from the discipline of the last few weeks.

We arrived in LA around 12:30am LA time and met Becky. All of us got up fairly early for the hour drive to Becky's graduation ceremony. She was equally relieved to done, completely done, with her JD and the bar. Two months wait until we hear her results, bt she doesn't need to pass it so we won't be biting our nails. (speaking of, last week the stress was enough that I started biting again and my nails are stubs!) Also in addendence were Becky's mom and one uncle, my Mom, Dad and Stepmother and one of our nieces.

The ceremony was interesting. Her class is definiately older than mine. And lawyers are just a different breed. The speaker was pretty good. He's the VP of Planning/Strategy for The Washington Post company that owns Kaplan and Concord University of Law. He was, of course, very pro-lawyer, but talked about how Becky's program was harder than many public schools where students didn't have spouses, kids and careers to juggle with school. He recommended a book call Hard America, Soft America that sounds interesting. The gist is that our schools are weak and our kids start way behind up until about 18 yrs old. Then universities and the "kick you in the butt" capitalist system we have forces most of the kids to grow up fast so that by their twenties and thirties, we are far more compeitive than most countries.

Afterwards, we had a nice lunch. Then is was a long drive home. The kids and most of the family had enough energy to go swimming at the hotel pool, but I crashed for two hours. I think the exhaustion finally hit me. And I hadn't slept very well, reliving at least tests in my dreams during the night.

We had a casual night at the hotel and ate too much. Sunday everyone headed to California Adventures at Disneyland for the day. Disney is way overrated, but I can handle one (very expensive) day every couple years. Colton was thrilled because he's finally tall enough to ride the big roller coasters (picture forthcoming). Even with the hassles of coordinating a big group amidst huge crowds we had a good time.

At 5:30pm or so we started the 5.5 hour drive home which included a stop at the airport to drop off most of the relatives. The drive was long, but uneventful. Monday I slept in until noon and got some of my To Dos done. Still working on them now, but making some progress. I definately need some down time too. Unfortunately Becky headed right back to work. Even thought it's a non-profit, she's part of the exectutive team working a big merger with another non-profit.

That's plenty of verbage for an update. The impact posting will have to wait.

Only Gross and Histo to go!

Ugh! This quarter is sooo much tougher. Four down and two to go in the worst test week I've ever been through.

I got an 83% on totally bogus Biochem test. I hope that I have enough pad to pull out a 90% on it, but it will ber very close. I think the whole class did poorly on it, but not sure if they were 10% below norm. The kicker is I studied hard for it and thought I was pretty well prepared.

Oh, I pulled out a 94% on OMM with a B on the written an a perfect on the practical.

I just checked my test against the key for ICM (clinical correlates) and think I got about an 80% there to. The dumbest class here. What a waste of time. Another one where I studied hard for it, but felt like I was in the wrong test room. I mean I was in the mid to high 90's in all these classes going into finals!

On a better note, I think I did well on the Human Behavior test two hours after the ICM one. I felt prepared and am enjoying getting into the more clinical aspects of the subject. And I just finished Physiology. I think I did very well. Especially considering I only started studying for it about 3pm yesterday. I managed to get 3 hours of sleep to :-).

Now it's time for a couple hours of catch-up sleep before hitting the books for Gross and Histo in two days. Yeah! We get a day off. And we're going to need it. This is easily going to be our hardest Anatomy test yet with lots autonomics, cranial nerve pathologies, etc.

I might even get to say to my kids for a change. Becky is in LA on day two of the CA Bar test at this very moment, so it will be nice to catch up tonight. I hope she's doing well. I took up all the study time the past few weeks and even with her sister here helping to take care of the boys, she hasn't had much time to study.

I'm definitely looking forward to her graduation this Saturday and Disney Land with the boys on Sunday.

Almost two weeks again?

I had imagined I would write here almost daily. Oh well, at least I'm fairly regular at it.

Today was the last day of Biochem, Gross Anatomy, Histology and Embryology lectures! Finals next week and those milestones are put to bed. But I should start from my last posting...

That miserable week and a half I wrote about previously took a long recovery period. Like most of my classmates I hardly studied at all the following week. I was plain burned out. Still am to some degree, but the sympathetics are pumping back in with finals rushing up. Let's just say that I wasn't alone in being WAY behind this week. I studied pretty darn hard and got fairly well caught up. Moreover, I finished OMM for the quarter.

Monday was the written which I did ok on (86%) but pretty poorly considering the amount of time I put in. The class sure got rebellious after it. About 2/3 of them didn't get legible to the last lecture since they were only the day before (Sunday) if you happened to wonder into the OMM lab. I think severla of them have filed a formal complaint to the Dean. Anyway, at least my efforts weren't in total vain. On Wednesday's practical I got 100% for a final grade of 92%. The practical had its own problems, we were taught mostly techniques this quarter (HVLA, muscle energy, counterstrain) and our review when 90% techniques, 10% diagnosis. However, the practical was 2 stations diagnosis and 1 techniques.

I sure feel like I overstudied and got ripped off on the written. Such is life at medical school though. Time to move on.

So this weekend is all about grinding it out for finals. I need to crash so that I can maintain a good 12 hours a day study schedule(!). I would have thought that insane a few months ago. Now that seems downright reasonable given the amount of material that I need to review for the first time since the lectures and solidify for Monday's Biochem test.

Btw, I managed to procrastinate most of last night by "perfecting" my Physiolgy case presentation on diabetics. Unfortunately I was so tired both last night and during hte presentation that I totally track of time (autopilot). I think I aced it but went ways overboard. The Diabetes research was interesting and hopefully will be relevant to my summer research. And that reminds me...

I have three more lectures to review in Biochem and they are on cancer. That is actually motivating me. I'm looking forward to mastering the material, much more so than all the ambiguous nutrition lectures Dr. Mann gave. I may just have a future in Radiation Oncology, if I can get into a residency.

Oncology is going to take a lot of work, but I'm hopeful that I have a shot even as a D.O. in a mostly MD field. My summer research should be applicable and would really be helpful if I can get published. Moreover, I'm not the VP of the newly formed Oncology club :-).

Night...

Black January is over!

I survived. Barely. I have never seen my classmates so burned out as I did this weekend. I was ever bit as bad. Sunday I did the smartest I could have and called it quits at about 9:30pm, got home and immediately went to sleep until 5am. That gave me two very productive hours before the Physiology exam this morning.

I think I did well, but if I missed more than I expect, I felt reasonably well today. Getting a good score on last Thursday's anatomy test didn't hurt either though. I missed three problems on the written and one on the practical. With four (out of five) bonus points I got 126 out of 130 points possible. Biochem seems to be my worst subject. I managed to get 91% on it, but was hoping for more padding going into finals. Three big tests in a week (including our hardest anatomy unit yet) and I'm happy with the first two. Hopefully Physiology will come through tomorrow.

Now we have a week until our OMM written final, and then a week until finals. So I'm taking tonight off and catching up a bit. Tomorrow I have an "academic appointment" schedule with one of the OMM fellows. I hope that will help me get cranked up for finals; this time it's a diagnose and treat practical that I'm not feeling too confident on.

Anyway, this quarter has involved a lot of soul searching. Radiology is looking more and more like something I'm interested in. Anything with interventional in it sounds cool, but radiology has more gadgets, as least as good lifestyle and pay (vs. say cardiology or urology) and a more reasonable residency. I even took and online personality survey tonight and it ranked radiology and nuclear medicine as my top two of 40 or so specialties.

Of course it's the specialty that one of my top achieving classmates is interested in too. He has had a LOT more science than me, so it's a bit intimidating. He aced the anatomy test for example; 135 out of 130. I'm hoping that 1) we don't go after the same residencies or 2) my consistent grades plus this summer's research (and my awesome personality :-) put me ahead.

Speaking of summer R&D, I need to get up to speed on articles so I can submit a fellowship application this month and cement my Spring research elective in.

Oh, and I'm now the VP of the Oncology club. I lost an election for the SOMA delegate, but wasn't too heart-broken (it more a networking position than anything tangible). The VP thing can't look bad on my CV and may give me a chance to do some interesting things. We'll see.

Time to watch a movie and read an issue of Wired magazine that has been on my desk for over a week.

Ouch

I've got one of those killer headaches that is keeping me up. So I'm writing when I should be sleeping or studying Physiology. Other than the last couple hours, today has been pretty good though. However, I will take a paragraph or two get caught up to date.

We had our 2nd Biochem test on Monday. I studied very hard for it and though I did very well. I only missed 3 multiple choice questions and one maching (rec'd 13.5 out of 14) for a total of about 91%. I was hoping for better, but I'll take this one.

Then is was a mad rush to prepare for our hardest Anatomy test yet. We had no Histology or Embryology, but neck, face, eyes and cranium was more than enough. The class has pretty stressed out this week to say the least.

The written portion this morning was hard. Many of my classmates agreed with me that they had never had so many question circled to review at the end. This is also the first time I've almost ran out of time. I hope I did well, but wouldn't be surprised to in the 80's on that part. The practical was easier than I expected. I know I missed one or two, but the bonus were pretty easy. I am hoping to have a solid 90% or more that portion to pull an A out. Anyway, it is over. Now on to our final, and from MSIIs reports, hardest Anatomy test yet. And that one will have Histology on it - my only chance to pull up my 86% from the first test.

After the test I cleaned the yard a bit, got a haircut and went for a run with the bog. First time in about three weeks. It felt great. Then I got caught up on e-mail enjoyed a dinner with the family (after missing several this week). I even had a glass of wine, which I may be paying for right now. I took a nap afterwards and before this headache started to flare up, I read some OMM and organized my notebooks for the push through finals.

Time for sleep now, and hopefully relief. It's going to be a long weekend and I need to be clear headed. I feel totally lost in vascular Physiology at the moment and didn't get the reading done tonight as I hoped. I missed 3 lectures to study for Biochem and Phys, so there's a lot of new material to cover.

Tomorrow is the end of week eight!

How time flies

January is flying by. I've been studying at the Student Lounge in the evenings and weekends when I'm not in a group session somewhere (usually the library). So I haven't seen my family or had a many hcances to Blog.

The MSIIs call this "Black January" for good reason. We've had tests every week. I've had to study pretty much everyday. Having my sister-in-law living here has helped. Becky can study for the Bar and I can still get in more study time than last quarter. I'm averaging at least 3% higher so far and hope to maintain that through the quarter (if not more).

I just finished my male invasive exam and second Physiology test. Both went ok, so I'm taking a breather and getting some research done for this summer's project, a Phys case and USMLE I. Well, I'm procrastinating by updating this first and hope to get to those before I nod off.

There's more details to update, but they will have to wait - hopefully not for another month to pass.

Family and in-laws toasting a nice Christmas Eve dinner.

The boys ready to open Christmas presents.

Back to school...

Wow, Xmas break is long gone. Heck, we just finished our first big test in "black January" - Physiology. It wasn't too bad, but I did study my butt off. Had 3.5 hrs of sleep last night. Since Sunday I've probably studied 40 hours for it in addition to class and everything else.

My sister-in-law moved in over the weekend to be our nanny, so that has freed up a lot of time for me. My boys were thrilled to spend some time with me tonight since the first we've had dinner together in three nights.

I should back up a bit since I have about two weeks to catch up on. Xmas was nice. We had my mother-in-law, her significant other and my wife's grandmother here. It was fairly pleasant here in AZ. And the boys did fine with presents. I didn't get finished helping them put together their new models, a "Visible Horse" and "Visible Human". We did finish assembling a large 3-D puzzle.

I also read a book entitled the "Ultimate Guide to Residencies". It got me really excited about Interventional Radiology. I read up a lot on it and other specialties online (e.g. SDN). It seems to be at the op of my list for the moment: lots of hands on procedures; reasonable residency; reasonable hours and pay; lots of cool toys to play with. However, lots of others still interest me too, like ENT, Plastics (burns), pediatric surgery, interventional cardiology and radiation oncology. I hope to get more exposure to some of these hospital-based specialies this summer on my own, since AZCOM's Clinical Ed. is focused on primary care only.

The only school work I managed to finish was some Biochem case research. After Christmas I spent two days interesting days with my Preceptor. We saw lots of interesting pathologies and stories. The Family Physician lifestyle wasn't overly attractive. But the specialty is intellectually challenging. The most interesting case we came across was a patient that came in with his son for some non-descript complaint.

My Preceptor went over his chart saying he was a bible salesman that had been treated for benign hypertrophy of the prostate. Recently he had complained of rectal bleeding and had been referred to a colorectal surgeon. The surgeon called her back afterwards saying in a surprised voice that he had "cured" the patient. He had removed a paint can from the patient's rectum!

Just before my Preceptor opened the door to the waiting room with this patient, she smiled and said; "I guess bigger is better"! Then I had to shake hands with the guy while keeping a straight face. Guess I wow the jackpot on bizarre patients!

I tried to study the next three days, before New Years Day, but couldn't get motivated. Instead I ran a few times, played with the kids and generally enjoyed myself. We even got in all extended versions of the Lord of Rings movies (an Xmas present for me).

New Years Day I started into Physiology pretty hard. I reviewed most of the fifteen lectures on the test over the weekend. Monday class started with no pause in the information "firehose". We covered a lot of the Lower Extremity in Anatomy and EKG in Phys. It felt pretty good. Tuesday I had to study like crazy, but luckily I didn't have to drive three hours roundtrip for my Preceptorship since I did that over the Holidays. I studied for a few hours with my old study group which was more fun than productive. Then from about 10pm until 2am I did a final review of all the lectures. I got up at 5:30am this morning to fill my short-term memory banks before starting the test at 7am. I felt better for this test than any one so far. And it wasn't just that I prepared or that the test was fairly easy. I just felt more at ease and less stressed. The first question freaked me a bit when I saw all the data for it in a table, but once I breezed through it I got back in my "zen" state and cruised through. I hope this means I've overcome the extreme stress tests have been putting me in up until now.

Afterwards I went home and slept a few hours. I spoke briefly with Dr. Jones who I hope becomes my summer research sponsor. He's pretty excited about my ideas for studying diabetic tissues. I hope this happens. It could be very cool, highly publishable and look awesome on residency applications (esp. radiology or oncology).

I made it back for the AMA President's lunch address to us. Dr. Thompson is a great speaker and treated us DOs as part of the team. It was the first time an AMA President has spoken at a DO school so that was cool.

OMM took up all the afternoon (like every other Wednesday) and was fun too. I spent some time talking with my favorite Adjunct Prof. and was saddened to hear he's moving to Colorado for lower malpractice premiums (Dr. Thompson's main theme ironically) and more outdoor activities. I'm totally envious of his lifestyle and skills. He makes great money doing just OMM and on very few hours compared to most Physicians. A quarter mill. on 36 hours a week with no call or rounds is pretty incredible in this day and age!

So FP with OMM is back on my list again :). But I'm concerned about not having the Jedi Knight like powers my guru does. He started in Family Practice only focused exclusively on OMM when other Doctors saw, heard about and experienced his OMM healing powers and told him he was wasting his time in FP. It's scary to think of going down the Primary Care road with the intention of focusing on OMM only to find out you don't have the skills to be very good at it (and get the referrals and committed patients it takes to establish a successful practice).

So, lots going on. But now it's time to hit Biochem and get some reasonable sleep. I have about twelve lectures I'm clueless on (including three difficult ones on hemostasis) to master by Monday plus finish my presentation on Alcoholic Liver Disease. Fun, fun, fun...

How can a Quiz be so intimidating?

I'm on Xmas break with a million things to do both for school and home. However, top of the list is a little Phys online quiz that I have until midnight tonight to finish. Nice of them to assign it over break huh?

Once you log in you can't log off, you have to finish it in one sitting. I imagine it won't be too hard, but I've been procrastinating. I'm not caught up in Phys and didn't feel like i got a good grasp on the Lambert-Eaton Myasthenia Syndrome we're studying. And then there's the very real fear that my PC will crash before I finish. Or maybe it's that the kids playing video games in the same room as my PC has me distracted.

Whatever it is, these dumb little things somehow turn into big obstacles.

Oh, I also got back grades on Friday's tests. I received 94% on Anatomy (88% class avg.) and 86% (class avg.) on Histology. I'm satisfied with the Anatomy, but a bit disappointed in the Histology. My ace histologist study had it right when he called this test our 2nd hardest so far, though it didn't seem like it to me at the time. On the positive side, Histology is only 1.5 credits this quarter and now it's half over. All the more reason to do this quiz, get caught up in Phys and do my objectives in Biochem.

Trying out the new camera on Uncle Dan.

Becky and Colton at Lake Poway in SD.

The boys' favorite activity at Grandpa's, getting in trouble from the neighbors for sliding down the hillside.

Buddies Jane Clare and Colton

Another of Connor and Cooper

Grandpa with the cousins

Connor and Cooper

The boys and their cousins in SD

Xmas Break

Still haven't received grades on Friday's Anatomy/Histology test. I think it went ok. I know I made some mistakes, but I did study very hard for it. Wednesday night was kinda fun since I studied with my old group. We had a fun time. Just like the old days (first quarter) we were too slow, but it was more enjoyable and kinda reinvigorated my study efforts.

Thursday I got 4 hours sleep and felt ok during the 3.5 hour test. Maybe I would have done a better job, like not mistaking the female UG triangle for the anal triangle (oops!) on one problem, but I doubt it.

Afterwards, I drove one of my study friends to his house and then the airport. I then picked up some clothes I had ordered at REI and packed for the 6 hour trip to San Diego. Becky and I weren't sure we wanted to go, but my Dad said he was really looking forward to seeing the kids. Twelve hours of driving (round trip) for about one day of visiting was expensive in terms of time and energy so I'm pretty sure this won't be a frequent weekend getaway.

We just got back a couple hours ago and both Becky and I are stressed about the amount of things we have to get done this Holiday break. She has to prepare for her mom and grandmother's visit over Christmas, study for the bar and work fulltime at St. Mary's. I have to get caught up in Phys and Biochem, do a bunch of stuff around the house, and finish off a long list of todo's.

The list includes finishing an online Phys quiz due tomorrow, finishing a Biochem presentation, researching a Phys case, previewing the Lower Extremity for Anatomy and (I really, really hope) getting my preceptorship check-offs done for the quarter.

Friday Dr. Hilts said I could come in a couple of half days over break which would free up every other Tuesday afternoon during the quarter and save me from the three hour round trip. That would be so great. I hate traffic! And what a waster; 3 hours of driving for a 1.5 hour preceptorship shadowing experience.

So time to get to bed. Lots to do over the next two weeks before "black January" starts. The MSIIs call it that and seeing how we have 7-8 big tests in the month of January, I can see why.

Becky and I are really going to be depending on her sister being a great nanny for us while I survive the hardest part of MSI and Becky studies for the California Bar.

It was a better week

I still didn't get as much studying accomplished as I would have liked, however it was definitely an improvement over the first week of the quarter. I'm doing ok in Anatomy. The big test is Friday, right before the Holiday break. So I have a few days left to prepare. I have a lot left to do, but since I can focus on just Anatomy it should be ok.

If it was a normal week and I had to keep up on Biochem and Physiology too I would be in trouble. I'm already way behind in Biochem. I'm so thankful we have two weeks over the Holidays to catch-up. I figure I have a good 40 hours of studying I need to put in. And that's with no review from last quarter at all!

Even better, my sister-in-law will be moving this month so come January, I should have a lot more freedom for studying. I still want to spend time with the kids and family, but I won't be forced to lose 5-9pm every night of the week.

Time to catch some shut eye. It's going to be a long week: Phys presentation, female invasive exam and the big Anatomy/Histo/Embro test for the pelvic and perineal regions (going to be glad to be done with this one!).

Totally forgot!

The reason I decided to write yesterday was that we had our "White Coat" ceremony at AZCOM. I wasn't going to make a big deal of it, heck I didn't even to my undergraduate or graduate school graduation ceremonies. But my kids wanted to come because they are proud dad is becoming a doctor. Wow, now was an unexpected benefit of this whole ordeal.

I didn't realize how cool it is, and motivating, to have your kids be proud of what you're doing. It may have helped me get a good amount of studying in today. I'm not caught up by any means after several days of limited studying, but at least Anatomy is under control. Hopefully I can a healthy dent in reviewing last week's Phys and Biochem lectures tomorrow.

As for the actual ceremony, nothing to write home about. Boring speeches from faculty, long lines and ill-fitting short white coats. Heck, the school didn't even have to pay for them. But if the kids enjoyed it, I enjoyed it. That's it, just a nice and unexpected result of getting this far.

Harder to get going this time...

The week started ok, but I've had a hard time getting back into the school/study routine. I can justify it by saying the Christmas shopping had to be done and just couldn't wait, but that wouldn't be entirely true.

I just hope that I can catch up this weekend. I have been doing some (probably too much) research for a Biochem presentation this evening. Tomorrow will be Anatomy. Then Sunday I need to get at least a review of my Phys and Biochem lectures in. I'm already feeling lost in those classes. The only bright spot is that I have the Xmas break to do some catching up.

Oh, and the Christmas shopping is mostly done :-).

Into the frying pan...

Two days and we're up to our eyeballs in information we have to know, projects we have to complete and tests we have to plan for. Wow.

If feels a little less stressful, but I think I'll be just as competitive and stressed about the tests this quarter. Maybe it's my nature or maybe it's the fact that I'm scared sh**less about the residency match. I don't know what I want to get into at this point, but staying here in AZ is looking better and better - if I have the option.

Well, time to review today's lectures and preview tomorrow's Phys. lecture. Hopefully I can get to bed in time to be able to run before class. Even though the temperature has dropped a lot (in the 40's in the morning) I'm trying to wear shorts still because they fit better. My jeans and pants are either stained and ratty or uncomfortably tight :(.

What happened to my break??

Two weeks since my last post? Boy did that go fast. It started out as expected. I got in a couple runs with my dog, caught up on sleep and met a couple classmates at the anatomy lab. We divided up sutures and starting trying to act like surgeons on our cadavers, but quickly realized we had no idea what we were doing. We planned to meet again after reading a guide or manual but events kind of took over for me.

My grandfather's prognosis worsened dramatically when we learned that his bowels were dead around the 14th. No one expected him to regain consciousness. So I booked a flight to Chicago for Thursday the 18th. My brother flew in late that night after I had a chance to see our family patriarch, Papa, in the hospital. I guess I missed the worst of it, when the gout was so bad that even unconscious he would just about sit up in pain at the slightest touch. By the time I got there, he was heavily sedated with Fentanyl. At that point it was just a matter of time, so the goal was to make him comfortable.

Friday I basically said goodbye to him and agreed with the family that we should disconnect his ventilator. Friday night I followed family tradition and got blitzed a bar near the hospital with a cousin and my brother. I spend time with my uncles, aunts and cousins Saturday and we all saw Papa one last time. He passed away early Sunday morning.

Becky and the kids flew in Sunday for the wake on Tuesday and funeral on Wednesday. We visited lots of my relatives (mostly a good thing :-) and showed the boys Sue (the largest T. Rex in the world) at the Natural History Museum. The wake was really a showing of Papa body in the funeral home. No memorabilia, no cheers or old stories. Papa looked horrible (totally unlike himself) and the boys were bored for the seven hours from 2pm to 9pm. I think he would have liked something much celebratory, even if it required some libations. We are a fairly typical Irish Catholic family :-).

The snow storm started Wednesday so it was a cold. As a pallbearer from Arizona, I was underdressed. A black suit with a parka didn't cut it. The procession was at least 30 cars long from the funeral home to the church and then to the cemetary. The Mass was ok except that the priest was new didn't seem to know anything about Papa (who had been an active member for more than 40 yrs) or how to do his job. The boys were gems in their new black suits and my dad, Papa's first son, did a nice talk on Papa's organization skills benefitting the church's Octoberfest's for many years.

At the cemetary we had to have a short ceremony indoors the weather was so bad. Two soldiers dedicated a flag to Papa in a nice ceremony that recognized his service to the country in WWII. In fact he was buried with his Purple Heart which he received over the Pacific in a B-25. He lost most of the muscle and flesh on his upper thighs from a flac shell exploding close to the plane, but managed to fly the plane another 380 miles back to base with his arms (the pilot had lost use of his arms but could operate the petals). We then met at Casey's, his favorite restuarant in Lombard. It was nice but hard to talk to anyone not at your table. And people left pretty quickly because the storm was dumping snow on the roads.

I got in trouble that evening with Becky for taking Dan to my cousins (and leaving here with the kids) to decompress as I like to call it. We played some dice games, had a couple drinks and then I returned to the hotel.

We spent Thanksgiving with my Dad and his wife. First we had a meal at Casey's and then went to my cousins to return her car. Talk about over-eating! But it was intersting for Becky and my parents to see Colleen's house. She's done VERY well in mortgages and has a 6800sf mansion beautifully decorated.

Yesterday we flew home after snowball fighting, one last "world's best" Ever Hotdog at Portillo's and a boring 4-5 hours at the airport. All-in-all we had enough Chicago hotdogs, chicago pizza and alcohol for many months (so much for losing weight over the break). But Papa would be happy that the family he anchored got together and shared many of our memories with him and created some new ones along the way. It will interesting to see how we do keeping in touch and getting together for family reunions now that he's gone.

Time to rush off to do some Xmas decoration and present shopping before Winter gets into full swing on Monday.

First Quarter done!!

I meant to write earlier but I've been in recovery mode since noon yesterday. I didn't do as well as I hoped on Biochem but the 88% was enough to squeak a 90% out of the class; 90.17% based on my calcs. (Amazingly they had our results back in about two hours. No wonder there wasn't any multiple choice!)

Anatomy and Histo/Embryo were similar. I had 88-89% on the finals and barely managed to stay in "A" territory, 92 and 90.8% respectively. OMM was pretty easy and I got a 95% even though I blew a rotation dx on L5. My partner got inominates and the Prof gave me L5 :(. I can hardly move L5 and probably should have just guessed a normal Type II dysfunction but NO, I had to go with what I felt :).

So that leaves Friday. After Biochem I studied a straight 12-13 hours with three classmates (gunners wouldn't be an inaccurate description). We seemed to clicking pretty well on Biochem, and this session seemed to confirm that we work well together. I just hope they help me pull my scores up a bit :). Most of the time was spent on ICM with about two hours on Human Behavior. Then I got up early and studied two more hours on the 8am Human Behavior final. Those 25 questions took me all of 15 minutes! It was such a joke that I didn't even review my answers. I found out later that 5 of the 25 questions had been thrown out. It's only 1 credit and I just don't care.

From 8:15 until 10am I studied ICM. I really feel like I got the information from lectures down pretty well. Some questions seemed out of the blue, but they were probably from the reading we were supposed to do. I think I did ok on it. It was the first test where we got to keep the questions so after reviewing them with fellow students I'm sure I got two wrong, which means I probably got 4-5 wrong total out of 40 questions. I passed.

Afterwards I hooked with a few of my old study partners at a bar in Scottsdale. We had a fun time as I unwinded with delicious Dos Gringos tacos and three marguaritas. They are a really nice group of people but just study at the level I like to. Unfortunately two of them will be decelerating, which I understand to mean retaking a few classes next year and doing Med school in 5 years. One guy is a really neat person with a great attitude that had to work through school to maintain healthcare coverage for his family. They have several serious and chronic problems so it's sad and amazing that he manages to keep his positive attitude. I really hope he finds a way to get out of work so he focus on his studies.

I got home in time to pick up the boys from school, take a quick nap, clean the house with the family and then greet my Mom as she arrived from Seattle. I also had the pleasure of reading the latest issue of Wired magazine. It's my favorite (SciAm is a distant 2nd) and it's been sitting on my desk for about two weeks.

Today I took two naps and walked/ran the dog for about 4 miles. It felt great. Man do I need to find a way to fit exercise into my schedule. If nothing else, it really helps me reduce the stress. I then went grocery shopping so we could host dinner for my mom, brother and his "girlfriend". Mom loved her and agrees he's crazy to hold out. She an adorable Japanese girl that he lived with in Japan for a year. It's obvious she came here for him and they still have feelings for eachother. He's driving her home at this moment, hopefully asking her to caravan with us to my dad's house for Thanksgiving. Then she'll have met the whole family - and I can get really be relentless about going ring shopping with him!

Two finals down...

These were pretty darn hard. I studied long and (I believe) productively for them, but as one of my smart study buddies said; "this was one of those tests where I never got into a groove".

I think I probably missed a couple on the practicals, but they didn't seem too hard. (Of course I'm knocking on wood as I write this) The writtens though, both (Gross and Histo/Embryo) kept me off balance the whole time. I never could get comfortable in a section feeling that I really knew the material. I'm not sure what that means for my grades, but at least everyone else seemed to feel the same way.

I passed. And I've recovered from getting way too stressed about the whole thing. I keep forgetting not to stress out about getting high grades. I want to do my best, but it's more than that. Maybe it's my competitive nature, or my fear that is my last chance at a career choice (Residency).

I celebrated by taking Cedar, my golden retriever, on a long walk. We explored unpaved areas (washes as they are called in AZ) so that I can try to start running again over the break. I desperately need to start exercising regularly again. I want to shed the few pounds I've gained this quarter, but more importantly, work off the stress this Med School thing generates.

On to Biochem for the next 60 or so hours. Then 24 hours of ICM and Human Behavior fun.

Goodbye First Quarter...

Tomorrow is the last day of my first quarter of medical school. Well, I still have finals next week, but instruction and week 10 are just about over. Wow!

It has gone so fast. And I've learned so much. And the next week of finals I had better learn a bunch more :). As part of a group of 10 MSIs MSIIs I went to AZ State U. (ASU) last night. We were representing AZCOM to the pre-med chapter of AMSA. Unfortunately there were only about 209 of them but they sure were jazzed about Osteopathy and AZCOM by the time we left. They want to meet again on the AZCOM campus and see the school and I expect word will get around and we'll have a lot bigger crowd.

Before we started a transplant surgeon from the local Mayo hospital talked and it was incredible. He was supportive of DOs which was cool, but his presentation on live donor liver transplants was awe inspiring. Their rejection rate is 3% (vs. 17% for cadaveric), 0% of donors have died and it only takes 2-4 weeks for both the recipient's and donor's livers to regenerate to full size! I hope we can get him to come to AZCOM and give his presentation to the SOSA club (including the video of one operation).

I also had lunch today with a couple PhDs Profs, a journal club they are starting up. I'm hoping to help with research one is doing this Spring (part-time) and Summer (full-time). I will be experimenting on PARC, an enzyme I know almost nothing about. However, it is crucial to managing P53 (and hence apoptosis), telomeres (aging) and several other pathways with huge pathological and pharmaceutical relevance. Sounds like we'll use UV energy to mutate specific regions of the enzyme. Bottom line is I make a few bucks, get some great bench time, hopefully get published and add some great experience to my CV for residency applications in a couple years (I've never done real research). Working with DNA and protein tools and technologies will be cool too.

Anyway, time to put the kids down and drive to the student lounge. I haven't gotten much studying this week so it's time to really hit the books. After the AMSA thing last night I crashed at 10:30pm and got a great night's sleep. I also did pretty well on my first OMM practical. I should add that I'm thinking more and more about family practice/primary care with some OMM. There are some real benefits - besides less stress in medical school.

Enough for now. We'll see how I'm doing after finals, while I'm enjoying two weeks of R&R.

First OMM Practical Tomorrow

The written test Monday was pretty easy. I got 94%, about 1/2% higher than the class LOL. Tomorrow is the Practical and that is a little more stressful. A complete structural run-down in 5 minutes and then a diagnosis for two of the four regions (cervical, thoracic, lumbar and inominates). On the latter you do a region survey, then they give you two joints to diagnose. It sounds like there's lots of subjective points and being our first Practical they won't be too hard, but it's still stressful.

This is the beginning of the end of the quarter. After this it's deep study mode for Anatomy on Monday, Biochem Thursday and then both Human Behavior and ICM on Friday. Luckily I've had a couple relatively easy days to rest up.

Saturday was traffic school all day which sucked as a way to spend my "free" time. Sunday I got a few good hours in on both OMM and Histo. Last night I got almost caught up on Histo. The plan is to get Histo done tonight and then spend the next two nights reviewing the last weeks of Biochem lectures. I'm not sure if that's going to happen though since I have to put the kids down and then practice for the OMM Practical. Plus I need more than 6 hours of sleep tonight.

Last thought, I went to a Family Practice lunch meeting today with three AZCOM graduates doing their residencies here in town at John C. Lincoln. It sounded pretty cool. I also got my first Hep B shot for my preceptorship required immunizations. This gave me more exposure to Family Practice at Midwestern's clinic. I am certainly not writing off primary care at this point. Even with managed care, it has a lot going for it.

Time to rock some sacrums!

Week 9 Over!

Wow, the first quarter is almost over. Lots still left to do, but I can almost touch that two week break over Thanksgiving.

I got my Biochem grade back and it was better than I expected, several points over the class average. Anyway, I hope to do better going forward and feel like studying in the student conference room vs. home during the week is helping. I got 4-5 good hours in on Tuesday and Wednesday. Tuesday I stayed on campus and studied until 1am. Wednesday I had an OMM mock practical review and ICM review (bp, ears and throat) then again studied until 1am. Last night I stayed after for an immunization workshop (gave my first shot!) and then intended to study a bit at home after spending a little time with the family. I was out by 9pm and slept 10 hours! (I probably needed it.)

Anyway, tonight we had a Halloween function on campus, so I picked the kids up early and took them for some games and treats. It was fun, but now it's time to read to them and get started studying. Tomorrow I have traffic school from 7:30am until 3:30pm, then a wine tasting party with Becky, so I probably won't get anything done tomorrow. And Sunday will have to be preparation for the OMM written final on Monday.

Not sure if I mentioned it, but the ticket was for almost running over a police officer as he crossed a crosswalk! I was so pre-occupied with school, fighting kids and my grandfather's condition that I had tunnel vision. The officer was angry at first but cooled off and was giving me tips on traffic school. Anyway, I'm paying for the mistake with a long day tomorrow (hopefully I can study flashcards thru some of it) and Papa is doing better. His aortic aneurism bled out and only quick action by his wife, nearby paramedics and his cardiologist who happened to be on at the Hospital saved him. He's recovering slowing now, getting off the ventilator for a few minutes at a time. But at 84 and after being opened stem to stern, he's lucky to make it this far.

I guess he's pretty agitated and after attending an intubations workshop at lunch today I can understand. Looks like no fun and a lot of discomfort. I hope he is well enough to see him over the Xmas Holidays with my brother and maybe my boys. It may be their last time to see their Great-Grandfather.

Feeling much better

The biochem test today wasn't as bad as it could have been. I haven't gotten my score back, but I know I passed and hope to get the class average or better. There was a ton of information in this unit and I felt very stressed out over it.

Last week I skipped class and got through all 16 lectures and 2 workshops by early Saturday morning. I then studied with two pretty smart guys on in the Library, but we got bogged down on minutiae and only worked through 4 of the lectures! I got a little down in the evening, but not much.

Becky was supposed to have all day Sunday to study while I watched the kids. I was so far behind though that I hired a neighbor to babysit for 4 hours while I hit it at the student lounge (my office now). Then it was a social dinner with my brother and his girlfriend. I managed to beg my way out at 8pm and studied another 5 hours at the lounge. During this time I ran through the full range of emotions:

I don't belong here
I can't take this torture any more
This isn't so bad
I may pass after all
Who give a crap about one stinking test?

Finally, an early this morning I put in another 1.5 hours at the lounge. I felt like I had the basics down on 2/3 of the lectures but I was really weak on 1/4. Luckily they asked questions that weren't too deep. I felt much better about the unit afterwards and my surprise myself with a score in the 80's.

Week 9 is already here. Time to get to bed so I can catch up on anatomy.

Man this is going fast

Well I've settled into Med School a bit more. Last week I was pretty stressed about the 83% in Biochem. I scored so high in those first few tests that I set a high bar for myself. I still think I should be above the average regardless of the fact that I have a family and career wife. But I'm not as confident that I can keep up with these high IQ gunners.

In other words, I'm not gunning for the top 10%. I'm just going to do my best. And hopefully I won't get as stressed out about life, school and tests that way.

We got back scores today from Monday's Anatomy test. Normally I would be happy with 94.4% in both Histo/Embryo and Anatomy, but the class average was very high. I don't have the numbers yet, but I might be under the average(!), especially the average of just the med students (taking out the 30+ podiatry students that I assume have a lower average).

Oh well, at least I'm in A territory - and enjoying studying more this week.

I haven't been to Biochem all week. I've spent a lot of time in the student lounge trying to catch up on lectures from the last two weeks. Talking about not feeling overly smart, I'm taking two hours to go through each one hour lecture the first time! Others are saying similar things, but not enough to make me feel like I have any IQ points over my classmates. Anyway, I'm on lecture 12 of 16 for Monday's test. That leaves four more to go and two workshops. Best case they'll be done tomorrow night, worst Saturday before noon.

That gives me most of the weekend to memorize the enzymes, cofactors, products, pathways, regulators, etc., etc.

This definitely turning out to be tougher than I expected and I'm more convinced than ever that I want to go into something procedural. But I'm in the right place and won't be too disappointed even if I end up in primary care. Especially since Osteopathy gives the option of specializing in OMM if I continue working on developing those skills.

We had a Peds Doc speak to us at lunch on Tuesday. I got some good information on pay, practice lifestyles and such. Surgery is still very tempting regardless of my age. In fact, I ordered some out-of-date sutures and needle holders on Ebay this week. A couple of us are going to get a little practice over the break on the cadavers which should be very interesting.

Frustrated...

We had a Boards & Wards evening that I helped arrange earlier this week. It helped to hear some upper classmen (esp. the MSIVs) talk about rotations, board test, grades, etc.

That made my mid-80's score in Biochem easier to take. I barely beat the average which is far less than I expect of myself. But I went to the review today to see what I did wrong.

First, I missed most of my points on one profs lectures (the dept heads) that I knew I hated. I failed his questions on the practice test and thought I had it down. Oops. Anyway, I don't think I'm going to Biochem lectures anymore. Definitely not the meidocre lecturers. Tomorrow, Dr. Yueh lectures and she's probably the best they have. So, even though I'd like to study Anatomy for Monday's test, I may go.

Speaking of Monday's test, we had two hours of heart embryology today, two days before the test! A hundred new terms and some pretty detailed 3-D development this late in the game sucks. I only got through a third of it tonight. At least I had both my Netter embryology atlas and the class text. It helped a bunch.

Time for a long weekend of studying. I'm determined to get back into the nineties and A territory. Oh, I got my PDA working on the school WiFi network today. Pretty cool. Time to learn how to synch up and load some medical software.

One more test down...

I knew I didn't do as well on the Anatomy and Histo/Embryo test last week before I received the grades. They were pretty close to what I expected, 85% in Histo and 88% in Anatomy. But I was surprised that the class averages weren't lower. I just met the average in Histo and beat it by 8 pts in Anatomy. In other words the tests weren't as hard as I thought they were, I just didn't study well for them.

Found out this morning that most of my mistakes were stuff I knew and just answered bad. I think I was imtimidated on the Histo written where the first 5-10 embro questions were from the last couple of lectures I wasn't familiar with. I got most of those problems right but I think it threw me off kilter.

Anyway, I changed study strategies this weekend. I studied in the library with a couple guys that aced the anatomy test (#1 and #2 top scores). We spent all of Saturday in a room drawing out metaboism flowcharts and going over lectures notes. It was a new level of studying for me. These guys are sharp and I was just barely able to keep up. But it really cemented the big picture for me. Then I spent most of Sunday at home reviewing lecture notes and filling in the details (like memorizing the emzymes).

I think it worked. I'm dog tired today, but the test felt great this morning. Problem #1 scared me a bit, but I skipped it and flew through most of the remaing 50 or so questions and 3 short answer. I went back to the three that stumped me including #1 and made decent guesses. I know I got one wrong, but what a difference this test felt like!

So, I need to study with smart folks, but leave plenty of time for me to focus on memorizing the new information - even if that means sacrificing time with the family and irritating the wife.

One classmate said that in the remaining 4 weeks of the quarter (plus finals) we have 8 tests. Yikes. But I'm starting to see the light at the end of this quarter's tunnel. Now though, it's time for sleep. I'm wiped out after a couple of 5 hour nights of sleep. For a down night tonight I read a couple chapters of Mosby's on lungs and heart that should help for ICM and anatomy. So it's enough for tonight given the state I'm in.

One more addition

Just remembered that I won a PDA on Ebay last week. Becky wants hers back and I wanted one with more memory, faster, a SD card slot (for MP3s as well as medical ref stuff) and WiFi for checking e-mail.

I was hoping for a smartphone to fill those requirements and be a cell phone to, but nothing like that is out yet. The Treo 600 has too small a screen, is pretty small and doesn't have WiFi. The Motorola MPX looks great, but it's been delayed until Feb 2005. This Toshiba model should arrive tomorrow, so we'll see if it's just a short-term solution or will carry me through pathology next year.

Whew, that was ugly!

I survived. Yeah, one of those tests. I was pretty stressed all week knowing that a) I wasn't as prepared for this test as the first two and b) there was a lot more material on this one.

I had a group study session on Saturday with a couple classmates that went really well. I felt bad that I was the furthest behind. But they got me up to speed pretty fast. I even copied some embryo notes because the class notes were so disorganized I was procrastinating. Sunday I was able to dive into all the lecture notes and memorize a lot of embryology. I also spent a fair amount of time going over histo slides. I had spent a lot of time up to Friday evening on the upper extremity (arm) anatomy in the lab, drawing structures and outlines muscles and vessel groups so I felt fine on that part. This morning I spent four hours of last minute cramming. Going into it I felt stressed but hopeful that the questions would be reasonable.

Those hopes seemed to come true in the practical test. The upper extremity anatomy test was fair. I'm sure I missed a couple, but there were about 40 questions, so I should do ok. Likewise on the histology/embryology practical. Unless I fooled myself I think I did well on it too. The written tests (anatomy and histo/embryo) however were very different.

I started with histo and the first 10 questions were esoteric embryo questions that we barely covered in the last lecture. They never really tested the basics that we covered in the first five (of six) embryo lectures. Anatomy wasn't any better. Very few freebies like what terminal branch of the brachial plexus innervates the extensor pollicis longus. Many more were asking relationships that you just don't cover in lecture or lab like which muscles the median nerve lies between in the antebrachial region or whether it lies sup/inf/med/lat to the brachial artery in the cubital fossa. Yikes!

At least I had company. Walking out everyone had the same "opossum caught in the headlights" look which was a little comforting. There were enough guesses on it that I could get anywere from a 70% to 90%, maybe lower. One classmate had the best line of the 4-hour ordeal; "Don't worry, I'm sure it will be easier when we take it again next year".

The main thing is that it's over. Now on to metabolism for next Monday's exam. Friday's Human Behavior exam should be a 2-hour cram session the night before. Biochem will be harder. And I can't get behind. The test will be up to last Friday's lecture. So if I focus on it exclusively I'll be a week behind in Biochem and Anatomy! Learning to be a professional soft tissue computer is such fun.

To end this overlong post I should include a silver lining. I am learning how to organize class information better. That is where the group studying is really paying off. I waste time on disorganized studying. But show me how to organize the data in a timeline, flowchart or color-coded picture and I'm a 90%er - at least with this crowd. I like that this school is a little less competitive. If I did end up going to OHSU or another allopathic school, I think the hyper-competitiveness would be a demotivator for me.

So if any Pre-Meds get this into reading this post, my impression is that ostepathic schools are every bit as hard academically as allopathic and more expensive, but you get more attention from profs and have a more mature, less high-strung class.

It's already been a week?

Hard believe that I haven't posted in a week. So here's go the quick review.

I did really well on the Biochem test. I'm averaging in the mid 95's now. Not sure how long I will be able to keep that up, but I'm going to try. This isn't a test weekend (thank goodness) so it's a chance to rest and catch up on lecture reviews.

The new content this week made it our hardest week yet. We had a bunch of metabolism, upper extremity (UE) and embryology (2) lectures. That's a lot of new information. I spent two hours this morning in the lab reviewing UE structures, then another two 2-3 hours at a coffe shop drawing the plexus, axilarry artery and overall vasculature a couple times. I'm close to having the muscles down, so I'm feeling ok about anatomy. Then I spent another few hours (with lots of interuptions) reviewing the first two metabolism lectures. I'm not sure I can get the remaining six done this weekend to be caught up, but it's worth a try.

With a Clinical Correlates (CC) test on Thursday and then Anatomy/Histology/Embryology on the following Monday, Biochem will be taking a backseat and I don't want to get too far behind.

Boring life huh? Well only 26 weeks of instruction and 3 weeks of finals left until I can have some fun again :). Actually OMM and the clubs are pretty fun. Next Saturday I'm going to do work study for a couple hours helping to give kids physicals. Becky and I are going to an Open House Residency Night at a local hospital to check that out. Yesterday we had our first Medical Spanish meeting and while I destroyed the pronunciations, the food was great. All in all, not a bad week. If I can get Biochem under control I'll feel much better.

The real stress next week is the CC test. The class has been SO disorganized that we have no idea what to study. It's really a joke. They say the structure and test are new due to the "Evidence-based Medicine" content, but I've learned more about that in one Biochem workshop than eight hours of CC class time and a couple hundred pages of a worthless textbook. At least the class isn't worth many credits...

Time to yell at the kids...I mean spend some quality time with the family.

Biochem

I'm just about to go to sleep, hopefully to a good night's rest before the big Biochem test in the morning. I've probably spent 25 hours studying for it this weekend! It's easily a quarter's worth of material we received in three weeks; 16 lectures and 3 workshops.

I was feeling confident until I tried the practice test. Yikes, those are hard multiple choice. I think I'll pass but am not confident I'll hit the 90's that I want. I was able to pull those off on the Anatomy and Histology tests, but we saw that information more frequently and I was better prepared. My time spent learning how to understand histo slides really paid off.

Anyway, three down and one weekend definitely shot. Just as bad the weather was terrible and our pool isn't finished so I got no exercise. Well regardless of how I do, I have picked up a few "best practices" to use studying for the next test.

Ok, that's enough for now. I'm exhausted and my brain cells need rem sleep to filter and process all these new protein names and signaling processes. Night...

First test is over!

On balance, it was as hard as expected. The anatomy practical was a little easier with only 20 questions on the back. Histology written was pretty tough though with some tricky questions. I'm glad I put in a good 15 hours studying histo slides because it that much time (for me anyway) to start developing the skill of recognizing structures, stains and relationships.

I'm sure I got the 70% needed to pass. I will be disappointed if I don't get at least one 90 or either below 80.

Our big sis's and bro's gave us presents afterwards which was really cool, especially considering how poor we all are. Sarah gave me a really cool clipboard/book stand that I'm already putting to use for lectures in our main lecture hall. I also received a nice AZCOM water bottle and some colored markers. Then they hosted a casual BBQ for us this evening. Even though Becky had finals today (2 out of her last 5 until she gets her JD) the kids dragged over to campus. We stayed for awhile and had fun socializing. Ok, they had fun running around and playing pool while I socialized.

Now it's back to Biochem. I just started reviewing the lectures from two weeks ago so it's going to be a busy few days until Monday's test. Basically two more years of heads down studying from here on out - but at least now I have a book stand to reduce neck cramps :-).

Studying for First Big Test

Week two ended fine. Muscles for spine for Anatomy and Histology won't be too hard. But signal transduction for Biochem went right over my head. This upcoming week is going to be LONG, studying for Tuesday's A & H test and then next Monday's Biochem test.

The upperclassmen were great and put on a mock practical test for us that helped me anticipate how the testing would run. Saturday morning was spent cementing the back structures in my mind on several cadavers (and deciding against trying to study with a cute girl I met there - not sharp enough). Saturday afternoon was going over Histo with an eclectic study group. I had a blast for my first time with them even though there was six of us. It was productive but I really felt behind in Histo. Sunday (today) I finished outlining Histo lecture notes on notecards (and getting those stinking stains straight). This evening I went through a bunch of slides. That is the hardest part. It's a skill and memorization won't help you much. You have to know the details that differentiate slides (ex. magenta stains are likely goblet cells or glycocalyx), but that isn't enough. You have to get familiar with the slides to know when you're seeing muscle, neural or connective tissues. Ugh.

As an aside, last week was club week. I joined too many, but will narrow it down as I see what they do: SOSA, SOMA, AMSA, AMA (I think), Medical Spanish, Peds, UAAO (OMM stuff) and Family Matters. The extracurricular stuff is going to get messy before I get it all sorted out. On top of clubs, we're already getting inundated with volunteer and work study opportunities plus preceptor stuff is starting up.

I'm finally over my cold, so it's time to get back into a workout routine. But the test and sleep take precedence for now.

Just a cold?

Well I was required to be a patient this evening for a second year needing practice doing History & Physicals (H&Ps). Not a big a deal but took time away from studying and the family.

I had thought I was getting over my cold from last week when she said my ears looked infected. An OMM fellow said it was still viral but I'm not so sure. I've stopped draining and my sinuses are about to explode. I took some decongestant and aspirin once I got home, but I'm having a hard time studying tonight because of it. My 'physician' also said that I have a couple verebrae out of alignment, once that was even sensitive to the touch. However, the latter one was cervical and she didn't feel ready to manipulate that area.

So tomorrow I probably need to go in to the school's clinic for an OMM treatment and some antibiotics. I need to feel better for this weekend because our first big test is a three hour exam on Tuesday (1.5 hr practical and 1.5 hour written). There's a ton I still need to memorize for it; anatomical, histological, spacial and physiological data. Ugh.

Well off to bed. Hopefully I'll be feeling better tomorrow.

First Week of Medical School

Getting a cold and hacking through 30+ hours of crowded lectures isn't the most enjoyable way to start medical school, nor the best way to meet your fellow first year classmates. However, I must say that it was an incredible week.

I am already beginning to appreciate: how great my big bro and big sis are; how the faculty really are pretty good; how the campus is outstanding; and how the coursework - while being every bit as hard as I expected - is going to be fabulous.

Yesterday we had our first real dissection of the cadaver. Very interesting stuff! We only got through the superficial muscles, tissue and vasculature of the back, but it was really interesting. OMM (Osteopathic Manipulative Medicine) on Wednesday was a real kick. It will be a great break from lectures in the middle of the week and the atmosphere is really fun. Even Biochem is interesting when taught from a clinical perspective.

There were more memorable experiences, but I'm pretty exhausted. Even though we don't have a test on Monday (Memorial Day) many of classmates are talking about studying 8 hours a day for the 3-day weekend! I need some rest so I can host my folks (they are staying with us for the weekend) and squeeze in a dozen or more hours of studying between my wife's work and study schedule. Yikes.

Oh, and it was "payday". My student loans check came through so tuition is paid and the extra is in the checking account :-).

Two days down...

Wow, I'm exhausted! And to think that these have been "short" days with lots of material I've had already.

Today we made the first incisions in our cadaver. It was quite interesting and not intimidating at all. The worst part was the ritual of rules and courtesies we had to go through. BioChem and Anatomy lecture have been a trial in mental endurance so far.

I need to get my brain cells back into shape! It feels like my brain is a sore muscle after concentrating for fours plus hours at a stretch. The only downside is that our main lecture hall has tiny foldable desks that are uncomfortable and require me to take the lecture out of my binder and place just them on the desk. Forget having room for books, binders or refreshments.

Other than that, everything it great. I really feel like this private school does the first two years, at least, right. It's going to be a ton of work, but I'm confident we're working on the right areas with the right tools and support. The class is pretty good so far too.

Well, time to bed for an 8am Biochem workshop, following by two hours of Biochem lecture and four hours of Osteopathic Manipulative Medicine lecture and lab.

Day 2 of Orientation

Today definitely had more substance. We received syllabi for Anatomy/Histology/Embryology and Biochemistry, our two major courses for the next two semesters. The warnings, congratulations and course overviews left me with two impressions:

1) This is going to be a lot of work, but I need to keep a positive attitude an not be dead set on a competitive specialty.

2) AZCOM is like a liberal arts college as a typical allopathic school is like a big state school. It reminded me of undergraduate education. I unfortunately chose UW over Whitman then, but made the better choice this time around.

Today also had more humor with Dean Cole and the Security representative winning the most laughs. Student Services got a little long-winded, especially since it was at the end of a long day and we were all hungry. I dashed to Challenge Charter, picked up the boys and we ate a quick dinner in the cafeteria before playing a game of pool.

One more day of logistics, paperwork and faculty introductions before the real fun begins.

Fist Day of Orientation

Kinda anti-climatic...

Met several fellow MSIs and learned all about the library (woohoo!) but most of the time seemed wasted on commercials for health insurance and diagnostic equipment. The former is provided (for me) through my wife's employer and latter I already purchased on Ebay from a UCSD student. At least I got to play with some of Welch Allyn's diagnostic stuff.

I left tired but excited to start my medical journey. I even spent some time researching more textbooks online, as if I don't have enough already. There's so much information to integrate if you really want to do well on the USMLE Step 1, which I'm going to have to in order to get into a competitive residency. Yeah, the stress and pressure has already begun sinking in.

Fun evening courtesy of SOMA

The Student Osteopathic Medical Association (SOMA) hosted a BBQ on campus last night. Even though Becky was tired after just getting back from her brother's surprise 40th B-day, she came with to meet some of my classmen and women.

It took a few minutes to loosen up and introduce ourselves, but it was pretty good. I sure felt old though. Lots of kids just out of undergrad. A few parents, but I suspect most of them didn't come since it started so late (7pm). We left just as things were starting to get real friendly to rescue my brother Dan from watching our boys.

Youth aside, there seeme to be some interesting stories in the mix about how and why people came to AZCOM. The upperclassmen seemed very willing to help us out which was really cool. Sarah was there and we chatted for awhile. I think she's much better at names than I am. I've already forgotten most of the names I was introduced to. Hopefully we'll have badges of some sort at orientation starting Wednesday (!).

It's Hot!

OK, for AZ it's not too bad; probably at 90 and it's midnight. However, without A/C in the house this whole day it feels like a furnace. A friend of or neighbors came over and said a motor is shot. If we're lucky, we might get out of this tomorrow for $250. Ugh!

On a more pleasant note, my brother, Dan arrived on Sunday and is getting settled in. The boys are loving it. Their school has started off well so far. No best friends yet, but they are social kids and starting to make friends. The academics seem good so far.

That's it for now.

Dinner with Big Sis

AZCOM generously provides each MSI with a Big Sis or Brother to answer questions and provide advice on how to prepare for the first year of medical school. Sarah and I have had many e-mails sent between, but last night was our first time meeting face-to-face. She came over for dinner with Becky, the boys and I. Unfortunately I burned the burgers because the grease residue at the bottom decided to light up, but otherwise dinner was pleasant.

After dinner, we talked for a couple hours boring Becky to tears with all the shop talk. One thing that sticks in my head is that Sarah praised my Blog effort saying that there is little time for reflection in medical school. This will help me remember the journey and my accomplishments along the way. It was a very nice evening and I hope we get to do it again.

Btw, I spent over an hour today doing an annual cleaning on the BBQ. It was gross, but long overdue. And the weather certainly cooperated; it was 85 and overcast. Tonight I BBQ'd ribs with Chef Matt's special sauce and it was yummy :-).

Vietnam

After seeing all the pictures I uploaded yesterday, I decided that some explanation is needed. I spent nine days in Vietnam in February of 2003. At that point I was pretty sure I wanted to become a physician having retaken two Cell Bio classes, being halfway through retaking the Organic Chem series and having some clinical volunteer time under my belt (Kaiser's ED and OHSU's Trauma/Neuro ICU). However, the Vietnam trip cemented my decision.

I had supported NW Medical Teams in the past and decided to give them a call to see if a non-trained civilian could participate in a mission. The Director said they don't normally utilize personnel without medical training, but a small team run by a plastic surgeon was returning to Vietnam. I got in touch with Dr. Dickason and he fortunately had a spot for me. After much planning and paying my way there, I managed to get 5 days in a Nha Trang OR where we performed on 3 cleft palates, 12 burns and a pair of webbed hands. It was amazing!

Suddenly high tech seemed so worthless. Here was something I do with my hands to drammatically and immediately improve people's lives. Being treated like royalty and living like a king due to the cost-of-living didn't hurt either. But even more important than the fresh lobster-sized prawns for pennies (Yummy!) was the people. They were incredible. I was impressed by the physicians, nurses and people I met in the street. I have over 250 photos so I'll try to post more in the future. In the meantime, I'll just say that I fell in love with the country and the people. They were friendly, courteous and happy in both Saigon where we flew into and Nha Trang, the resort town we operated in.

After seeing the Vietnam War museum and the pictures of Napalm kids and Agent Orange devastation, I thought Americans would be despised. Quite the opposite actually. The southern part of the country is embracing capitalism and the people generally love Americans. I never encountered any negative attitude or even jealousy. I can't wait to return, with my family next time.

Doctors make about $60/month in Vietnam, so to get by they work out of private offices on the street at lunch and after hours. Capitalism is strong in southern Vietnam at least.

The nursing staff was outstanding. With no English translators the majority of the time, they somehow managed to provide for our medical and dietary needs.

Spartan operating environment was a big improvement over the old hospital they had just moved from - A/C! The Belgian government helped fund construction so it is no surprise that most equipment was Belgian :-).

Our team performed a total 16 surgeries, including 3 cleft palates on young patients, over a week in Nha Trang, Vietnam.

This women had a several disfiguring scars on her nostrils that Dr. Dickason corrected.

Dr. Dickason is placing a piece of cartilage from the patient's ear under the skin where his nose was before a scooter accident. The patient gained a nose and improved breathing from the operation.

Our operating team with a young patient and a couple Vietnamese physicians. The women was an awesome anesthesiologist. Superstar that she is, she intubated every patient, even children, on the first try!

One of many hand surgeries that required a Z-plasti for the thumb and skin graft on the palm to re-gain flexibility in the hand.

Scooter's scar taken care of with a nifty Z-plasti. The patient will have to flex those toes now to get full mobility back.

Scooter's muffler scar resulted in this boy not being able wear shoes any longer.

Our luxurious operating theatre looked more like a jail cell. My OR cohort (pictured here) and I tried to keep our 6 military duffel bags worth of supplies organized for Dr. Dickason. It was all his surgical equipment and supplies he donated like antibiotics.

New technology sometimes requires instructions :-).

Scarring on the back of this person's hand required a skin graft and re-attaching a tendon for the thumb.

Boy's burned finger needed a skin graft in order to straighten out.

Scarred women could hardly move her head.

Scarred woman received a full thickness skin graft across her neck to improve her mobility and comfort.

Looking over Dr. Dickason's shoulder as he tries to converse across the language barrier

Freeing up a scarred foot with a partial thickness skin graft

Seperating a boy's web fingers

End of summer

We met the kids teacher's last night and the boys are getting excited to meet new friends. Uniforms are going to be a change, but the teacher's are happy and excited and the school looks great.

I need to finish up painting the inside of the house this weekend if possible. There's so many tasks to get done before I start medical school. Little stuff like license plates, sprinkler repairs, PC repairs, window tinting, etc., etc. At least I have a few days that they will be in school so I can focus on getting them done.

Last Sunday I drove back to Dan's mansion in Palm Springs for a tour on Monday of the Eisenhower Center. It was very impressive. I had a sobering conversation with a plastic surgeon about the profession and he gave me a DO to call in Ohio. I hope that pans out. We also saw some operations (I saw a knee replacement and hernia repair) and got the benefactor tour of the whole Center.

Also last weekend, I went to a B-day party for one of my friends from AZCOM. It was fun for the kids and Becky and I. It was interesting to get perspective from four MSII's and a few upperclassmen. Finally I met one of my classmates. The whole weekend gave me a lot of incentive to start calling DOs for preceptorships and electives for next summer. I still think AZCOM is going to be great, but I need to have some strategy going into MSIII or I'm going to have trouble in the residency match.

Oh, I've also conversed with many other AZCOM med students via SDN. It will be good to put faces with these names soon. My AZCOM Big Sis (15 years my junior :-) is coming over tomorrow for dinner with us. It will be nice to meet her face-to-face for the first time.

Well, time to get painting... I'll leave with a couple PG-13 photos from my NW Medical Teams mission to Vietnam in February of 2003.

Warming up to our house

We ended up spending two stressful nights in our house on the floor. ABF was late delivering our container, the A/C was only working intermittently, our new home warranty was paid for by the title company and we had a lot more damage to our stuff than I anticipated. Wood furniture was almost lit on fire by the friction in the container. Sure I had followed my own intuition and used shrink-wrap instead of following the "expert's" advice. Our TV now has a nice big viewing port on top, but it works ok.

Anyway, we eventually got things under control in the 110 degree weather. We even managed to paint the living and dining rooms. The neighbors were awesome and helping in tons of ways including entertaining our kids. Their kids and our became fast friends.

The best part however is that Becky got the job. She's now the Director of Finance and Technology for St. Mary's food bank, the largest non-profit in AZ. It ended up being a much better opportunity that she hoped for. The next few months will be crazy: Becky's new job; Becky's JD finals and Bar exam; and my starting medical school.

Saving grace is the pool. The kids and dog use it every day. Cedar has become a true water dog. And no bad sun burns!

Long road to Phoenix

Well it's been a few weeks and a lot has transpired since my last post. Let's start with the adventurous trek from Beaverton, OR to Glendale, AZ with wife, two kids, dog and 2nd car in tow.

I can't start without pointing out some of the interesting epiphanies that I realized while onroute.

1) Rest stop work in reverse with children. Kids are more energized and uncontrollable as you leave than when you enter, meaning as parents you're more stressed out!

2) Mini-DVD players are the greatest travel invention since air conditioning. There's no better way to occupy kids attention on long drives than movies and video games.

3) Currency for kids today (at least elementary aged boys) is in Yu-gi-oh cards. Those have real value. Money is infinite and has no trade value.

Ok, so I was packing our ABF container 4 weeks ago today. With some help I thought we were ready to head out early Friday the 16th of July. However, I could hardly sleep after seeing how pitiful a packing job was done by the kids we hired to help. While I had been side-tracked disconnecting the refrigerator and packing loose ends, the two teenagers made a disaster of the last half of the container. I spent the first half of the next day, the 16th, unpacking that half and repacking as best I could: hard sweaty work. After having spent most of the previous two weeks removing dry rot under our house, I was tired of Portland and ready to leave.

Cleaning the house so it was ready to show to prospective buyers took the rest of the day. We didn't head out until about 8pm and so only made it to Salem. After running into a bizarre Indian hotel manager we found a place we could hide the dog in. Towing an Accord behind a Mazda MPV isn't fun to begin with, but when parking nazis force you to do gymnastics that threaten your vehicles and your sanity (kids were asleep) it's time to move. The funny part was the place we ended up was a dive. We got a room with 3 beds, but the conversations in the parking lot weren't for children. Let's just say we could have rented the place by the hour if we chose.

The next day, Saturday the 17th, was spent testing the MPV's V6 up the Siskou and Grapevine mountains with the heavy Accord in tow. It did great even though it was very hot. I'm very impressed with this vehicle so far. We made it to our hotel in Salem Saturday night without incident. Sunday was more of the same and the boys did pretty well. We made it to Grand Dad's in San Diego late Sunday evening.

Monday the 19th we relaxed and spent time with the cousins. Becky had a final interview in Phoenix Wednesday morning so we left San Diego Tuesday afternoon for the drive to our hotel in Phoenix, with one stop. Riverside is a mess. Yuck. We made it to my brother's temporary residence in Palm Springs for dinner and a swim after a hot day.

The mansion Dan is staying in for his intership is pretty impressive. It's about 5,000 sf and on a golf course. We enjoyed the cool swim and Dan's hospitality. I promised to visit him and the Annenberg Foundation he's working at and he agreed to move into our guest room in Glendale for at least the first few weeks of last year at ASU (MBA/MHA). Tuesday concluded with the boring 4 hour stretch of Hwy 10 from Palm Springs to Phoenix. Thank goodness for caffeine and the Flying J truck stop.