1/6 done!

I am now 1/6 done with second year. Five more tests and I'm done with pre-clinical medicine. Well, that's not completely accurate, since after those five tests I have to pass that ONE HUGE TEST to actually be able to get into third year... but we'll worry about boards later.

Test went well, although I couldn't fall asleep last night and so consequently went through 8 hours of testing feeling woozy and tipsy. I guess that's what residency is going to be like, so maybe I should get used to it now? On the bright side, I proved I can pass a test being the equivalent of half-drunk, but how does that translate to patient care? Will I only successfully treat 70% of my patients when I'm half-drunk? How about when I'm full-drunk? A recent issue of JAMA was devoted to the theme of medical education, and it was chock-full of really interesting articles. One of them, a study of interns' compliance with the 80-hour work week regulations, cited a study that found that being awake for 24 hours causes performance decreases comparable to a blood alcohol of .10 (JAMA. 296(9):1063-1070). Scary stuff. (By the way, the study found that 84% of interns in the study period reported ACGME violations.) If any of you are JAMA-ers, I highly recommend the Sept. 6 issue.

Another article in that issue discussed the value of pre-medical requirements. Dr. Emanuel of NIH proposes dropping physics, calculus, and orgo from the pre-med curriculum and instead adding biochem, genetics, molecular biology, ethics, and statistics. Then, we should drop some of the unnecessary biochem, genetics, and molecular bio from the medical curriculum (eg, Krebs cycle) and make more room for biostatistics and medical ethics. Overall, I think his proposal is great. I, for one, certainly could have done without two semesters of orgo (OK, OK, it was three...), and I think some more biostats would do most of my classmates some good. Emanuel calls physics/calculus/orgo what they really are: weed-out classes. Granted, if the powers that be think weed-out courses are necessary, then biochem can certainly fill that role. But wouldn't it be nice if we fostered humanism in medicine at the pre-med level (that would be the ethics part), rather than creating gunners gunning to get into med school, then arriving in med school planning to gun their way through the next four years?

Anyway, that's enough heavy thinking for one night. Especially a night that has me feeling half-drunk.

In other news, it's been raining all day today -- thunderstorms, too. We're under a tornado watch until 2 am. Tons of lightning and thunder, but it's not bad on a night I get to stay inside, snuggled up on the couch or in bed. I'm just afraid that my car is going to be flooded tomorrow -- the convertible top has finally kicked the bucket, and one of the seams is wide open. I keep duct taping it together, but it keeps opening back up... It's going to cost me $700 to get a new top, but I don't think I have much of a choice right now. Mechanically, it works great, especially since I just sank $700 into it a couple months ago to fix something under the hood.

Finally, my last comment, and then it's time to have a glass of wine and watch Will and Grace:
The Grey's Anatomy premiere was last night. Medically, it's pretty much crap. They use nursing stethoscopes. The surgical residents are constantly in the ER or NICU or some other odd place -- I do NOT understand that. Does that hospital only have those 5 residents? Oh yeah, there is Callie, the one random ER resident. Plus, bubonic plague is NOT spread by person-to-person contact. Maybe if McDreamy had cut himself while doing head surgery on that woman and their blood had gotten all mixed up, then there would have been a risk for contamination. But otherwise, the plague is spread by the fleas that live on the rats, and you only get sick if you hang around the fleas or the rats. So the quarantine storyline was a bit implausible. However, there was one golden moment in the whole episode. Callie is talking to Finn, and she is explaining why Meredith is a dating idiot. "We're socially retarded. Four years of high school, four years of college, four years of medical school, focusing on science. Then we graduate and we're 28 years old and we have no idea what to do. We're all 17 years old. This is high school with scalpels." Great line. Great concept. How true.