Dermatomes

I always meant to post this:



This diagram shows dermatomes: areas of skin that are innervated by a single spinal nerve.  It is commonly known as the Thank You, Sir, May I Have Another diagram.

Well Done, Brain!

I actually remember things!  Most of biochem has been genetics so far, and since that was my first biological love, most of it seems to have stuck in my head pretty well.  It's nice to sit through a lecture and think "Oh yeah, I remember that" instead of of the usual "Oh god, what are you saying, why are the words so long, and why are they all in Latin?!"

And I don't miss dissection.  I actually did like dissection.  Sometimes.  It is definitely fascinating, and an opportunity I'll probably never get again.  But it also smelled bad and consisted on standing up for several hours straight while cleaning fat off of tiny nerves, trying to figure out which ones they were.

I'd like to take a moment to go on a small rant.  I just googled something and got a Yahoo answers hit with a health-related question, so I read it to see what sort of answers it got.  (Yahoo answers always amuse me.)  The "best answer" was a decent stab at answering the question, but still inaccurate.  The answerer listed their source as "I'm a pre-med student."  I've been a pre-med student.  And I know for a fact that it doesn't qualify you to answer questions about anything other than the introductory sciences.  I'm an actual med student now, and I'm still not qualified to answer any real questions other than "How many bones are in the hand?"

I've met pre-meds like that in real life.  You meet someone at a party and they try to impress you by talking about some ground-breaking new cancer research or the healthcare bill or what's wrong with psychiatry today, and they back it all up by saying they're pre-med and you're supposed to think they're very knowledgeable about the subject.  And then you tell them you're pre-med too and watch them suddenly realize that they can't bullshit you.

If you're a pre-med (or have been one), you know exactly what I'm talking about.  You've either been guilty of it at some point (I think we all have), or you know someone who does it all the time.  Every college has one.  That freshman who just loves telling people he's pre-med, like it means something.  It doesn't.  Anyone can be pre-med when they're a freshman.  If you make it through the MCAT alive and maintain a competitive GPA, you earn a little bragging rights, but you still don't get to cite yourself as a source for medical information.

It's quite humbling to get to med school and suddenly realize that you know next to nothing.  Even with some EMT training, I didn't have an edge.  I knew the word "calcaneus."  That was about it.

(See why I'm so happy that I actually remembered stuff about genetics?)

Thank You, Academic Gods

Looking through the lecture topics for biochem, I think I've studied many of them before in undergrad biochem.  There's certainly nothing new in the first few weeks.  The last exam block looks like it might be a little more foreign to me, but it will be nice to have at least a few weeks of mostly familiar material.

I think I should sum up what I learned about studying anatomy.  I did a lot of "what is med school like" reading the summer before I started, and if I decide to actively promote this blog, my thoughts might be worth something to someone.

• Spend some time looking at different anatomy atlases, then pick your favorite, buy it, and  make it your own.  I wrote and highlighted all over mine.  Looking at a diagram of just muscles is a good way to see how they align with each other, but writing in which nerve innervates each one (even if you don't need to know them all yet) will help you put more of the puzzle pieces together.  If you like group study, see if you can get a study buddy who has a different atlas.  I went with Netter's, because the artwork is beautiful, but I liked occasionally looking at Grant's as well.  Sometime's seeing a different representation of something will make a complex structure or body system click.
• If the topic is limbs or the pelvis, go to lecture.  Many schools record their lectures so you can watch them online, and I think just about every school provides their students with print-outs of the slides.  I frequently skipped class and learned the material on my own; lots of people do.  But you really need to see someone talk about limbs, because they'll probably move around to demonstrate the various muscle movements they're talking about.  (The video in our recorded lectures is of the slides, not the lecturer.)  And the pelvis is just ridiculously complicated.  The 3-D structure is hard to visual and there are a ton of arteries and nerves, so go see the diagrams on the big screens in the lecture hall.  Don't squint at an atlas hoping to find everything.
• Try flashcards, even if you're not usually a flashcard person.  The key to learning those weird anatomical terms is to drill them over and over and over.  You can buy anatomical flash cards (again, I used Netter's).  I used to see half the class flipping through them before a quiz.  It was my primary mode of study.
• Touch yourself.  No, I mean...  There's no good way to phrase that.  But seriously, when you're learning surface anatomy, find all the features on yourself.  When you're learning bones, feel for them.  (You'll count your ribs so many times in med school.)  When you're learning muscles, use them.  When you're learning dermatomes (areas of skin innervated by the same nerve), trace that area of skin on yourself.  It really does help you remember things.  Anatomy practicals were always kind of funny, because you could look around the room and see people flexing their thumbs or bending their wrists or chewing.

Humans Can Be Really Weird

After a week of relearning the developmental and abnormal psychology I learned in high school and college, I am once again reminded that brains are amazing.  I studied neuroscience in undergrad, so I knew that already, but actually getting to see interviews with real patients made me understand it in a new way.  I've known people with anxiety disorders and depression and bipolar disorder and eating disorders, but I'd never really spent much time talking about what it was like for them.  You can't say to a friend over dinner, "Say, you have problems with mental illness.  How exactly does your brain work?"  Well, you can.  But you shouldn't.

I'd never known anyone with true OCD, though.  Not OCD in the way that most people mean when they say they're obsessive-compulsive.  I always double-check that my keys are in my purse, even though I know I just put them in there.  And I like colored pencils to be in rainbow order.  Someone who genuinely struggles with OCD will tell you that's nothing.

Schizophrenia is also very interesting to see.  Watching a movie or a TV show with a mentally ill character is not the same as being in the same room as someone who really believes their delusions are true.  And you can't convince them otherwise.  How could you?  Someone would have a hard time convincing me that I'm actually dairy maid who only thinks she's in med school, because I know I'm in med school.  I'm certain of it.  People can be just as certain of their delusions.

Brains can distort reality and create fantasies in a gazillion different ways, and yet patterns still emerge.  The amazing Oliver Sacks has earned a ton of money and a huge fan following because of it.  I've always enjoyed Sacks, because his vignettes tell the stories of complete people, not just a mental condition.  You're not paying a penny to see the lunatics in Bedlam, you're learning about the life of someone whose brain doesn't always work the way yours does.  A similar work is Phantoms in the Brain, which doesn't focus exclusively on what we might consider mental illness, but rather the way the brain can err or be tricked, both in normal people and in people who have a particular condition.  I wish I had time to read more books like this, but I don't really have the time to read much of anything besides course materials anymore.

Finally Awake Again

Anatomy is done!  I passed.  It's amazing.

After the final on Friday, I essentially just collapsed.  Then went out and got drunk.  Then collapsed again.

The worst thing about anatomy exams: the practicals.  Every cadaver in the dissection room has something tagged with a piece of red string and a question asking what it is or what it does.  Everyone starts at one station, gets one minute to answer, and rotates to the next.  Practicals themselves are not awful.  Studying for them is annoying because you have to spend hours looking at cadavers.  The awful thing is that after spending 3 hours taking a written exam in the morning, you have to come back and spend another hour taking the practical in the afternoon.  It's like the professors think we actually slept the night before and can handle two exams in one day.

But it's over now.  I should stop complaining.  Next we spend a week on behavior and then start the next real class: biochemistry.  (Please, Academic Gods, please let med school biochem be the same as undergrad biochem.)

I Feel Bad for the Students in the Pharmacy School

I've been in med school for two and a half months.  My once nearly calligraphic handwriting has deteriorated to a series of squiggles that somewhat approximate letters.  I now fully understand why I have never been able to read a prescription with any real confidence.

What Happens When Part of Your Heritage Is Scandinavian

When shown a photograph of a person with one very pale hand and one more reddish hand, most of the class answered aloud that there was something wrong with the pale one.  And they were right; there was an occlusion of the artery.  I assumed there was something wrong with the reddish one, because the pale one was about the color of my own normal hands.  Oh, the joy of never tanning, always burning...