40 something

It seems that right after any major break, there is a sigh of collective relief and then a counting down. That hasn't changed the entire time I've been here and the countdown has begun for the term. T minus 40 something days. I don't keep up to the day, but there are people here who know it to the minute. I have to admit I'm ready to be done to and with next exams 2 weeks away, it's only a matter of a few quick weeks before term break. I'm thrilled.

This block is a voluminous one filled with details and content, much either new to me or buried so far down in the recesses that retrieval is impossible. As always, I'll come up with what I need to succeed in two weeks, but this part of the process is so nerve wracking. Oh the pressures we put on ourselves.

But I have to admit that this stuff is great. I love the study, and the path has been particularly engaging with an interested, vibrant, totally engaging professor. Although I can't say that he has much competition...the others suck. I hope I didn't suck as bad when I was teaching. It's all I can do to stay awake and many, many of my colleagues have chosen to just stay home and study. One day it was me and 5 others in class. Frankly I don't blame them for staying home. Think the prof would get the message? Nah! There is only one thing worse than being an uneventful, uninspiring, boring professor...not knowing you are. It's sad. But our new dean says if they keep it up, they are out of here. They should be.  It's amazing how much medicine you can teach yourself, and lecture is such a terrible way to teach and learn anyway. I think I see the med school of the future :)

So we are on the down hill to the end of term, the rains of summer intermittently green up the lands and fill the cisterns, the heat is radiant off the poorly constructed cement streets. Thank good ness for the Caribe, the water and the small town diversions to keep me sane in the meantime. TGIFriday and the weekend promises some respite, catch up, and focus. Nothing much changes on an island, except maybe perspective.

It's Coming - Hide the Kids

Hey it's fun but it's a distraction none the less...it's Summerfest time! Impromptu parades that interrupt the neighborhood, lots of drinking and way too much gyrating...but you can't stop it. There are events for the next several weeks, filled with music, beer, parades, more beer, madness, mayhem, animal sacrifice...maybe not the animal sacrifice part. And don't you know that it coincides with exams. How much fun can a medical student have?

The more interesting thing about Summerfest is the costumes. Seems that some work on these objects of fashion for many months preceding the events. No wonder! Probably takes several trips to St. Maarten, and Duggins Market (upstairs of course) to get everything you need to create one. They are masterpieces of how to reveal as much skin as possible without being naked. They seem to fuel the sexual energy that pervades the event. And age has no limit....even the young are all decked out. And they wonder why the teenage pregnancy rate is soaring.

Ah, Summerfest...just another island excuse to not have to go to work, drink beer from green bottles and wander around half naked.

Ran Out

Only on Statia....I wen to the immigration office for this country island to renew my resident card (so I can stay on the island and finish my studies).

Guess what? They are out of ID cards and don't know when they'll be getting any in.

As I was leaving the clerk mentioned that maybe they should just issue a vehicle license plate to me that I could wear around my neck.

I don't think she was kidding. Whether I can stay or not, is still being discussed.

First Case of Swine Flu

When you are in a city of millions, a case of  H1N1 is news. When you are on an island of 2500, it's fear inducing. So was the first case of H1N1 on the island, recently confirmed by the health department in the Netherlands.  And while he has recovered, he is now teaching in the school, and I shook hands with him yesterday...before I knew he was previously infected. I can only hope that the salty waters of the Caribe are hostile to H1N1. I went swimming shortly after meeting him. I patiently await signs of the flu.

Harrison's Textbook of Pain and Punishment

The study of human disease is chronicled in great textbooks with names that every student of medicine knows...Sabiston's (Textbook of Surgery), Nelson's (Pediatrics) and Harrison's, Textbook of Medicine. As I study, I pick up these volumes regularly to get the full expose' of the disease rather than a summary analysis or "Diseases Made Ridiculously Simple" version. I regularly pick up Harrison's.

I love the extensive nature of the discussions. This is on the verge of a diagnosable mental disease in itself as most avoid books the size of mountains. But the descriptions are so complete, and so vivid, that it is difficult not to learn something. I only wish I had more time to read it so I can become the doctor I dream I will be.

But Harrison's, and the legacy of it's original editor (Dr. Harrison) is part of my problem with medical school today. I have said this before, but I was very lucky to have had some of the greatest professors of medicine in the world during my education as a physician assistant. I have been schooled by some of the best tactical clinical teachers who learned their craft from the best of the best. Dr. Harrison (of the textbook) taught one of my professors while he was the chair of Cardiology at the University of Alabama. I walked by a building named Harrison. So indirectly, I've learned from Dr.Harrison. Or at least I've had a glimpse of that greatness in the teachers I've had. I am reminded of that as I read the text.

But it is with that history, that I struggle with the sheer madness that is medicine teaching today. As if the art hasn't been practiced and has wonderful theoretical and practical foundations, I feel daily experimented upon...today, once again, I am the victim of disorganized thinking and presentation, random musings of the inappropriate, and painful presentation styles reminiscent of torture.

I will survive this because there is a grand goal, but I am totally understanding of the reasons why many people leave this experience angry, frustrated, bewildered and so willing to forget that this ever happened. I hope that is not the case for me. I do not want to fall into the that hopelessness of a failed romantic, still beaming with a love for the art of teaching in medicine, and the writings of wonderful teachers of teachers. And I can only hope that such wonderful teachers will continue to enter, and force out those that shouldn't be...back to research, or taking care of patients, or whatever it was they did before they took up the hobby of teaching.