Sunday, February 27, 2011

Flashcards: "Kingdom" Protista

The last set of flashcards for this Friday's exam. There are some more really neat pictures here. Algae, amoebas, parasites, all that good stuff.

Flashcards: Prokaryotes

Another set of flashcards for this Friday's bio exam ... this one also has some cool pictures, so check it out!

Flashcards: Cladistics

I've got a big biology exam coming up this Friday (March 4), so in preparation I've been making more flashcards. Here is a set on cladistics. I will also post sets on prokaryotes and protists. If any of you out there are in my class, hope this helps!

- Lorien

Physic-al Discomfort

Last December, I tried out a fun Facebook app called "My Top Words of 2010." It (supposedly) went through all my status posts from the year and came up with a list of the words I used the most. My top word? PHYSICS. (I used it 11 times, in case you're interested.)

For those of you who have been following this blog for some time, or who know me personally, this should not be a surprise. It's not that I don't like physics. I actually find it quite interesting. But I also find it quite difficult.

Case in point: the homework we were assigned to do a couple of weeks ago on electric fields and point charges took me at least 6 hours to do, if not more (and 2 of those hours were spent at a tutoring session). I understood it by the end, but it took a lot of work. And a lot of help. (Which, by now, I'm not afraid to ask for.)

A week and a half ago, we had our first exam of the semester. Prior to that, my professor handed out a set of 49 (that's right, 1 fewer than 50) optional practice problems. Doing well on these physics exams is not so much about being able to solve the problems, but being able to solve them quickly. And the only way to build up speed is to practice, practice, practice. So, being the dedicated (and slightly insane) student I am, I did every one of those practice problems. All 49 of them. For several days leading up to that exam, I went to bed thinking about physics problems, and I woke up thinking about physics problems. I breathed physics problems.

Come exam day, though, I still felt unprepared. After my professor handed out the test, I looked at the first problem and blanked out. Knowing that I had no time to waste (we had 7 multiple-part problems to do in 50 minutes), I skipped it and moved on to a problem I could quickly do. I worked to the end of the exam and finally circled back to that first problem. I answered it as best I could and handed in my test at exactly the 50-minute mark. Done. Thank god.

As the adrenaline wore off, my mood plummeted. I had felt rushed the whole time and was sure my answers were riddled with stupid errors.

Well, I got the exam back Tuesday afternoon: 93%. Mine was one of four As between both physics sections (about 40 people total). The class average was in the 70s.

I talked for a few minutes with my professor about the exam, and he said he was able to tell from his post at the front of the classroom who had done the practice problems and who hadn't. He said he could tell I was one of the few who really knew what I was doing because I worked through the problems quickly, without hesitation. (Which was a bit funny, considering I sure didn't feel I knew what I was doing!)

It's clearly a confidence issue for me. And one I don't have in my other classes: biology and chemistry exams don't fill me with the same kind of dread, nor do I leave them thinking that I flunked.

I have pondered this a great deal, and here is what I have come up with: physics is out of my "comfort zone," if that makes sense. It's not the kind of science that I'm used to, and it involves a very different way of thinking about the world. (Literally.) So I have this niggling doubt that perhaps, maybe, I won't be able to "get" it. Which, of course, I've proven wrong to myself over and over. (I got a high A last semester, and have an A so far this semester as well).

I really see taking physics as an important learning experience for me. And I'm not talking about the material, although that is obviously necessary for doing well on the MCAT. What I'm talking about is developing a different attitude and approach toward material that perhaps isn't my strength. Not fearing it, but embracing it as a challenge, and still retaining confidence that if I put my mind to it, I will succeed. Obviously, I haven't quite grasped this concept yet ... but I'm working on it.

I had a fantastic journalism professor in college who told us it was our job as journalists to be uncomfortable, to step out of our comfort zones and learn and experience something new. Well, I'm no longer a journalist, but that professor's advice still holds true: you really do learn something about the world, and about yourself, when you put yourself in that kind of situation. In short: you grow. And isn't that what life is all about?

Sunday, February 6, 2011

Flashcards: Mendelian Genetics

In a previous post, I mentioned that I had found a great iPhone / iPad app called Flashcards++, which allows you to create digital flashcards and import them to your Apple device and study on the go. (Always a good thing for us busy students!) You can both make the flashcards directly on your iPhone / iPad, or make them on one of two Web sites ( or and then import them. I use I discovered yesterday that I can "embed" the flashcards in my blog. So I thought that I would do that and share a bit of what I've been studying: Mendelian genetics. (That, among many other things!) Feel free to flip through the flashcards if you like. It's kinda fun, in a really nerdy and geeky way. But then again, if you're going into medicine, you have to embrace that inner nerd, right? RIGHT?! Enjoy.

Saturday, February 5, 2011

The Art Of The Medical History

While translating this week at the free clinic where I volunteer, I helped out with two back-to-back intake appointments. "Intake" meaning brand new patients to the clinic, and meaning the medical practitioner had to take an entire medical and social history before getting down to what was bothering the patient that day. I had translated for intakes before, but never back-to-back ones. Working with them in such high concentration really got me thinking about the importance of taking a good medical history: how it very often provides the tools for making a more complete diagnosis and understanding what is going on physically, and psychologically, with a patient. And how without it, you would be lost.

The first patient, a middle-aged woman, came in with wrist pain. Suspecting tendonitis or carpal tunnel, the doctor asked whether the woman had ever worked in anything where she did repetitive motion. Turns out she used to work with jewelry. Turns out she also had surgery on her other wrist for carpal tunnel many years back. Bingo! The doctor then prescribed anti-inflammatory medication to try and relieve the symptoms, with the hopes that the patient wouldn't need another surgery. Had the physician not known about the patient's past, it would likely have taken much longer to make a diagnosis and to find something to bring the patient relief.

A nurse practitioner saw the second patient, a younger woman with rheumatoid arthritis who had been taking a high dose of steroids to relieve her arthritis pain. When it came time to do a "review of systems" -- to check her health (literally) from head to toe -- she responded with a "yes" when asked if she had a problem with nearly every area mentioned. Headaches, blurry vision, the list went on. It became quite clear that it was the long history of taking steroids that was likely causing all of these problems. The solution? Taper off the steroids and start another arthritis-relieving medication. Again, had the nurse practitioner not asked very detailed questions about her medication history (which he did), there is no way he would have known that her problems were a result of the steroids, and no way he would have been able to (hopefully) resolve the situation.

There are so many things you need to know about a patient, so many things that could affect their well-being. So many questions, many of which may not be pertinent to one patient, but may make the difference for another patient's treatment. For example, if you know someone has a family history of diabetes, you can keep closer tabs on their sugar levels, and also impress on them the importance of eating right, exercising, etc. Not that you wouldn't do that for every patient -- but you could emphasize that there is added risk because of the family history. And that might help convince them to take their health more seriously.

Listening to the physician and the nurse practitioner take those medical histories gave me a better sense of what I will need to do when I become a doctor. It was good experience for me to be exposed to not only what questions to ask, but how to ask them: with compassion and sensitivity (especially the more delicate questions). Luckily, as a former journalist, I am an experienced interviewer. So I have that going for me. What I am learning is a new set of questions, and how to interpret a new set of answers.

Thursday, February 3, 2011

Health In The Headlines: On Forcing Americans To Buy Insurance

"A second federal judge ruled on Monday that it was unconstitutional for Congress to enact a health care law that required Americans to obtain commercial insurance, evening the score at 2 to 2 in the lower courts as conflicting opinions begin their path to the Supreme Court."
- from the New York Times (click on the link for the whole article)

The provision in President Obama's health care bill referenced in the above quotation is set to go into effect in 2014. Republican-appointed Judge Roger Vinson, who made the ruling, also found the rest of the health care bill unconstitutional. The whole matter is surely destined for the U.S. Supreme Court, as the Times article suggests.

I don't pretend to be a constitutional scholar. So I don't feel I can comment on the "constitutionality" of the health care bill, nor on the specific provision requiring all Americans to purchase commercial insurance. Nor do I want to get into a debate regarding party politics. Those of you who know me know where I stand politically, and this blog post is by no means a political party statement. So don't even go there.

That said, I have an opinion on the efficacy of the health care insurance provision, based on my own experiences working in the medical field.

First of all, I believe all Americans deserve proper health care. In our convoluted health care system, that means (most likely) having insurance of some sort, be it individually-purchased insurance, or government-provided insurance. But forcing people to buy insurance on their own dime is another matter. Here is why I think that is a problem.

I work at a free clinic in Chicago where the only requirement to be a patient is that you have absolutely no insurance. That means no private insurance, no Medicare, no Medicaid. This clinic is for the people who fall through the cracks: the people who can't afford insurance on their own and who don't qualify for government assistance, either because they are undocumented immigrants or because they don't meet the income "poverty" requirements the government sets forth. I don't know exactly how many patients the clinic has, but I do know that the extensive filing system in the clinic's office is full to bursting, and that doctors and nurse practitioners do new intake appointments every day. There is clearly a need for this type of service in the Chicago community.

But these people, who are people, let's not forget, not numbers, nor statistics on a chart, do not come to this clinic by choice. They are there because they need this service. Because many of them can barely afford the basic necessities of daily living, such as food, electricity, the bus fare to get to work (if they are lucky enough to have a job -- probably a minimum wage one -- at all). 

Asking them, nay forcing them to buy health insurance (or face a penalty), is forcing many of them to give up something else that they desperately need. Food, electricity, the bus fare to get to work. The list goes on. 

While the government is planning to expand Medicaid eligibility (according to the same NY Times article), I doubt very much whether that supposed "safety net" will safely catch all of these people.

This provision of the health care bill is well intentioned, I understand that. It is meant to make sure that people receive health care when they need it, and don't wind up with enormous out-of-pocket expenses when some horrible illness strikes. The formation of "health care exchanges" is also meant to drive down rates for people who have to purchase insurance on their own. Those are obviously good goals, and I support them.

But what has not been taken into account is that there are scores of people who literally cannot afford even $25 a month per person in their family for health insurance. I have met many of them. And I cannot, in good conscience, support such a provision. 

Constitutional? I have no idea. Conscientious? Not according to my experience in the real world. And that, I believe, is what many politicians lack: real-world experience. Or at the least, they are so far removed from it that they have forgotten what it's like out there in the real world. And that's just plain sad.