As of this morning, first test of the year, check. Now, how many to go?
I had my fill of being measured (the exam) this morning so I turned the magnifying glass around and spent the evening doing the measuring. I measured heights, weights, muscle tone, bulk, strength, blood pressure, and so on. Today, I went out with a rural med doctor to do visits to the migrant workers in upstate, NY. They come every fall, the fruit pickers from Mexico, to the finger lake region to pick the bounteous harvest of apples, peaches, and such that blanket the area.
Did you check out that link? Because, really, that might be the point of this post...
And the other point...to report that it is awesome to be back in the patient setting. We were doing school physicals for children who just moved up to the region for the picking season. I love riding around the trailer park neighborhoods like I'm some kind of an ice cream/medical truck dude. The kids were actually really excited about their physicals. These exams were less examination and more celebration. One kid, RH, couldn't stop laughing during the hernia check. Whatever; I'm having fun if they are. The kids loved it so much, we hugged me as I and the doc split!
I left the house feeling some kind of a euphoria. It is a feeling that is hard to describe. Cautious joy?
The visit is great, you find that the kid is mostly healthy, you talk about the sports they are going to do in school, all the fun that awaits them, you tell them how great they are, because it's true, you can feel it; but what does the future really hold for the kids? What is the life of a migratory worker? The dinner table is decorated with a big jug of Sunny D and a 12oz can of Coca-Cola at each place mat (we interrupted their dinner). I leave wondering did I counsel them enough about brushing their teeth? Will they really reduce the soda in the diet? Why did I talk about this with the seven year old and not the mom? UGH! So I'm just learning, but is it right for me to chalk up someone else's health care to my learning? It is likely that another year passes before the kids or the parents are seen by a health care provider. Another year may pass without understanding the role their diet plays in their future health. Is it just another year closer to diabetes, or did the visit mean anything more than a formality required by the county/state/fed board of Ed. Only time will tell?
Monday, August 31, 2009
Monday, August 24, 2009
And We're Back
I wasn't prepared for this summer. I wasn't prepared for how fast it was going to pass, I wasn't prepared for how fun it was going to be, and I especially wasn't prepared for how depressing it was going to feel to return to my career, my life as a student. The drive up to Rochester is always beautiful but this time it was particularly gorgeous. I must have still been experiencing some kind of a traveler's high because the following day I experienced serious withdrawal. Tremors, panting, sweating, flushed face, etc. The realization that I was a student, not a researcher, not a traveler, not an explorer; yes, an abused, debt-riddled student was a little to much for my mind to handle.
And then it happened. I walked into class(we started back on the 10th), fifteen minutes late of course, just in time to catch the closing remarks of the Dean. Five hours later, I was feeling pretty good. And the next day, I felt even better. And the third day, I even got out a pen to take some notes. The notes came so easily and everything about my schedule seemed so routine that I figured being a student was a lot like riding a bike. Now that I think about it, there are more similarities than its ease to pick up again. Both activities make it very difficult to keep let alone gain any weight... Uh, well those are all the similarities. I'd say they were both detrimental to the crotch but the soreness is more generalized from studentry than with cycling. Oh, another similarity, they both are extremely tiring.
Not only the lectures (very tiring to listen to people talk; I thought I was a good listener but it turns out, no, not a core strength for me) but the assignments of a student are draining and are usually carried out in the wee hours of the morning. After merely three days of class, there I was on my living room floor working on a way to teach my colleagues about the circulation of the brain. Pictured below is my answer. I went to the craft store. Yes, that is true. I went to the craft store and bought enough pipe cleaners for me to practice building a couple of models and to cut up pieces for everyone in my group to build an arterial blood circulation model the following morning in our PBL group. It was a huge hit. One student who was not in our PBL asked me later in the day if he could buy my model. I laughed at the idea and offered him another for free, but hey, there is a business plan circulating here!
And then it happened. I walked into class(we started back on the 10th), fifteen minutes late of course, just in time to catch the closing remarks of the Dean. Five hours later, I was feeling pretty good. And the next day, I felt even better. And the third day, I even got out a pen to take some notes. The notes came so easily and everything about my schedule seemed so routine that I figured being a student was a lot like riding a bike. Now that I think about it, there are more similarities than its ease to pick up again. Both activities make it very difficult to keep let alone gain any weight... Uh, well those are all the similarities. I'd say they were both detrimental to the crotch but the soreness is more generalized from studentry than with cycling. Oh, another similarity, they both are extremely tiring.
Not only the lectures (very tiring to listen to people talk; I thought I was a good listener but it turns out, no, not a core strength for me) but the assignments of a student are draining and are usually carried out in the wee hours of the morning. After merely three days of class, there I was on my living room floor working on a way to teach my colleagues about the circulation of the brain. Pictured below is my answer. I went to the craft store. Yes, that is true. I went to the craft store and bought enough pipe cleaners for me to practice building a couple of models and to cut up pieces for everyone in my group to build an arterial blood circulation model the following morning in our PBL group. It was a huge hit. One student who was not in our PBL asked me later in the day if he could buy my model. I laughed at the idea and offered him another for free, but hey, there is a business plan circulating here!
Oh yeah, appreciate how the anterior cerebral arteries arch back to give branches to the cingulum and frontal lobes. Que Belleza!
uh, yep, this is really what we medical students do after everyone else has gone to bed
Saturday, August 15, 2009
It Takes Two, Baby
My absence on the blog suggests that I was kidnapped by the Shining Path, but fear not I am well (er, that is a tricky statement recognizing that I am back in medical school, back in my cage). It took surprisingly little to adjust from the Inca paths I grew so fond of this summer back to the medical-doctor-business trail. Before I move on to all of the "adventures" of medical school, I want to at least a mention of the adventures experienced in the later half of the summer.
We crossed paths with maybe a handful of people over our six days of climbing and descending mountains in the Vilcabamba range. The barren trails opened mountainside after mountainside to us; each one stood unique in its beauty, yet telling a similar story. They all seemed to say, "go back to where you came from, the land is too high, the rock too deep, the soil too dry, the air too thin, man does not belong here."
The Vilcabamba has always been a region of dry air and impossibly high peaks, fast flowing water, and dry, dry earth. There are very few people eking out a living among the condors and vegetation that now inhabits the Vilcabamba mountain range but this was not the case during the reign of the Inca civilization. They built extensive roads to connect their people and their resources. They built even more extensive waterways to irrigate their brilliant terraces (in Quechua, these are called andinos, hence the Andes). They built entire cities, green, sustainable cities atop mountains. In the day of the Inca, these mountains teemed with life, with running water, with crops year round and storehouses a plenty. The Spanish were never able to cultivate the land like the Inca, so the mountains returned to their uninhabitable state. It is a disgrace that the real caretakers of the land, the Inca, had to give it up to such an incapable, ignorant people.
What was it that enabled the Inca to thrive? Their civilization grew and developed so rapidly because of the unity of the society. Not to say that they were united in freedom--that concept was totally foreign to them--but everyone contributed in some way, whether it be to build the road system, farm terraces, weave clothing, everyone contributed and everyone ate well. Those currently living in this region now struggle on their own to feed their crops and their livestock. Their children are burdened with malnutrition, and despite their isolation, they are dependent on goods from towns that are days away by mule. Take home message: teamwork can lead to great things. The Inca civilization accomplished SO much and it was because they all worked together--we'll ignore the details of how people decided to contribute for now. Seriously though, as I hiked the remains of the Inca trails in the Vilcabamba mountain range for six days, climbing and descending, and climbing, I continually thought how miraculous it was that these people were able to thrive in such a challenging environment. Where it is hard for one man to breath, they were able to build and support an entire community.
So the Beatles had it right, as they always did: "Come together, right now..."
Now a few pictures to show the current state of the Vilcabamba.
HUGE DISCLAIMER: Blogger is pathetically diminishing the size and quality of the photos. Viewers, beware!
The end of Cachora, the beginning of the trek.
Plenty of vegetation, but no civilization.
We decided it was a nice spot to appreciate the barrenness over lunch.
In the interest of time, and storage space, I'll finish the rest of that trek with a quick summary. We spent the rest of day four, and the majority of day five hiking at the feet of glaciers. Day six was a gradual decent to the ceja de selba, or the "eyebrow of the jungle" in English. We reached Aguas Caliente by night and day seven was spent on Machu Picchu--I actually opted out of MP since I was there two years ago but hiked up a neighboring mountain, Cusiputu, instead.
We crossed paths with maybe a handful of people over our six days of climbing and descending mountains in the Vilcabamba range. The barren trails opened mountainside after mountainside to us; each one stood unique in its beauty, yet telling a similar story. They all seemed to say, "go back to where you came from, the land is too high, the rock too deep, the soil too dry, the air too thin, man does not belong here."
The Vilcabamba has always been a region of dry air and impossibly high peaks, fast flowing water, and dry, dry earth. There are very few people eking out a living among the condors and vegetation that now inhabits the Vilcabamba mountain range but this was not the case during the reign of the Inca civilization. They built extensive roads to connect their people and their resources. They built even more extensive waterways to irrigate their brilliant terraces (in Quechua, these are called andinos, hence the Andes). They built entire cities, green, sustainable cities atop mountains. In the day of the Inca, these mountains teemed with life, with running water, with crops year round and storehouses a plenty. The Spanish were never able to cultivate the land like the Inca, so the mountains returned to their uninhabitable state. It is a disgrace that the real caretakers of the land, the Inca, had to give it up to such an incapable, ignorant people.
What was it that enabled the Inca to thrive? Their civilization grew and developed so rapidly because of the unity of the society. Not to say that they were united in freedom--that concept was totally foreign to them--but everyone contributed in some way, whether it be to build the road system, farm terraces, weave clothing, everyone contributed and everyone ate well. Those currently living in this region now struggle on their own to feed their crops and their livestock. Their children are burdened with malnutrition, and despite their isolation, they are dependent on goods from towns that are days away by mule. Take home message: teamwork can lead to great things. The Inca civilization accomplished SO much and it was because they all worked together--we'll ignore the details of how people decided to contribute for now. Seriously though, as I hiked the remains of the Inca trails in the Vilcabamba mountain range for six days, climbing and descending, and climbing, I continually thought how miraculous it was that these people were able to thrive in such a challenging environment. Where it is hard for one man to breath, they were able to build and support an entire community.
So the Beatles had it right, as they always did: "Come together, right now..."
Now a few pictures to show the current state of the Vilcabamba.
HUGE DISCLAIMER: Blogger is pathetically diminishing the size and quality of the photos. Viewers, beware!
The town of Cachora is exploding with development due to the increased tourism to Choquequirao. Choquequirao is the sister city of Machu Picchu. Much larger, much more spread out, much further from civilization, much harder to reach (can only get there by foot), and much less of it has been excavated. The later reasons are why few go to check this place out. Lucky for us. Cachora is where you start the trek to Choquequirao. Got it? The picture was taken at the entrance to the house where we loaded up our mules and headed out on the six day journey.
OK, so exploding may have been a little strong to describe Cachora's development...
The end of Cachora, the beginning of the trek.
Behold, the barrenness
Yes, that is the barren trail you see
Barrenness, day two
Plenty of vegetation, but no civilization.
Where life once thrived, Choquequirao
this is what greeted us on day four upon reaching Victoria Pass; after climbing all afternoon the day before and the entire morning; from the river bed of the valley, up ancient Inca stairs, above seemingly all living things.
We decided it was a nice spot to appreciate the barrenness over lunch.
In the interest of time, and storage space, I'll finish the rest of that trek with a quick summary. We spent the rest of day four, and the majority of day five hiking at the feet of glaciers. Day six was a gradual decent to the ceja de selba, or the "eyebrow of the jungle" in English. We reached Aguas Caliente by night and day seven was spent on Machu Picchu--I actually opted out of MP since I was there two years ago but hiked up a neighboring mountain, Cusiputu, instead.
The view of Machu Picchu from atop Cusiputu
These stairs continued for about 100m. I took the picture on my way down.
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