Family Medicine Shelf

I got my scores from my Family Medicine rotation. I didn't study nearly as intensely as I did for Step 1, but I did fairly well. Looking at how I did based upon my score as compared to the national average for U.S. medical students and the standard deviation, I did better than I did on the Step. This is motivation to study even harder for the OB/GYN shelf in six weeks!

Flood Warning

We had our last day at the free clinic on Friday. I really liked working there and I am sad to be finished. I really liked the autonomy at this clinic and I think it has helped me grow as a medical student. On Friday, I was in a room with two other students: one is in 6th semester (like me) and one in 5th semester (preparing for her boards). I am really not that far past the 5th semester student; however, I feel my history and physical exam skills are so much greater than they were just a few months ago when I was a 5th semester student. I haven't felt like I've learned a huge amount this semester, unlike when I was on the island and every day I felt like I learned enough for a lifetime; however, I think I am mistaken. This rotation has taught me a lot of practical knowledge and I am much better at doing a focused physical exam and knowing which questions to ask, Anyway, the three of us went into see a patient who was depressed and implied her husband was abusive. After screening the patient for depression and asking the patient if her husband was abusive, we found out that she was depressed and that her husband wasn't physically abusive, but he was psychologically abusive. It was a hard day. I wish we could have done more for the lady, but she wasn't ready to leave. The patient kept saying that her husband was a good man, and one of the medical students stopped her and told her a personal story about abuse in her family. I was blown away by my friend and peer's story. I had already decided that she was great with patients, but on Friday I knew that she will be an amazing doctor.

After finishing up at the clinic, we headed over to drop off a paper and some paperwork to the mail organizing site for the rotation. Since we were halfway to Costco, Farley, a friend and I decided to go to Costco. As we were driving north, the sky got darker and darker. We ran into Costco and by the time we left there were lakes that were 6-9 inches deep throughout the parking lot. We all were soaked up several inches past our ankles. Once we finally made it to our cars, took off our socks (and rang them out), and took our shoes off, we turned on the radio and found out that not only was there a flood warning from the storm, there was also a tornado warning in effect. No wonder we were soaked sock people.

Farley wanted to go to Sport's Authority to get some work out equipment, which was just a bit north of Costco, so we headed in with our soaked shoes and all. After that we found our next rotation spot and headed to the grocery store before going home. It was nice to turn in the paper and have some time to relax this weekend.

Weekend Relaxation

I was so tired that I ended up going to bed at 9:30 on Friday night. I would have gone to bed at 7:30, but I didn't want to be up at 5:00am! Saturday was such a nice day. Since on Friday Farley and I had gone to the free clinic that we will be working at next week, I had a list of drugs that they prefer to prescribe so I looked them all up to review each of them (I feel like Pharmacology is one of my weaker points). Since it is a free clinic, they have to be careful with what drugs they prescribe. Unless there is a real emergency, they try to stick to the list of drugs (or other generic drugs) because they are on a budget and need to make the dollars stretch. Anyway, I reviewed all of those drugs and relaxed for a bit before getting ready for Saturday night Mass.

I was so tired that I ended up going to bed at 9:30 on Friday night. I would have gone to bed at 7:30, but I didn't want to be up at 5:00am! Saturday was such a nice day. Since on Friday Farley and I had gone to the free clinic that we will be working at next week, I had a list of drugs that they prefer to prescribe so I looked them all up to review each of them (I feel like Pharmacology is one of my weaker points). Since it is a free clinic, they have to be careful with what drugs they prescribe. Unless there is a real emergency, they try to stick to the list of drugs (or other generic drugs) because they are on a budget and need to make the dollars stretch. Anyway, I reviewed all of those drugs and relaxed for a bit before getting ready for Saturday night Mass.

I went to St. Patrick's Church on Miami Beach. It was built in 1926 and was the first Catholic Church on Miami Beach. They have a grade school and other buildings near the church and they are all beautiful. The church itself was smaller on the inside than I expected based upon the outside of the church. This church has six masses per weekend, which is a lot for a parish church. Apparently they also have an award winning choir, but they only sing at the morning services (I wanted to be able to sleep in, which is why I went to the Saturday night Mass). Anyway, I was shocked when the organist started playing the pipe organs: he was amazing. Many of you might not know, but I had a scholarship for piano performance when I started college and I am not a pipe organ expert; however, even I know enough about the pipe organ to know that this organist was exceptional. The Cantor was a tenor and his voice was so strong and beautiful that I wondered if he was trained in opera. I wasn't so sure if I'd like the priest at first because he seemed a bit more conservative than I am; however, I really liked his homily and he had a nice sense of humor. My dad would have loved him: he was a super fast priest. This priest was a no-nonsense mover and shaker. He finished Mass in 45 minutes (and no, he didn't skip anything nor did he rush anything). I think he was able to finish so quickly because he started the Eucharistic prayers as the ushers were doing the collection rather than waiting for the collection to be finished, he didn't sing any of the prayers, nor did he recite any of the prayers in Latin (which I LOVE). Despite all of this quickness, he still managed to give a 10 or 15 minute Homily. Overall, I liked the church and I plan on making it my adoptive parish while I am living in Miami Beach. There are a couple of other Catholic Churches that I'd like to check out (one historic Jesuit Church in Downtown Miami especially), but St. Patrick's has many services and is conveniently located just about 5 minutes from my apartment. Below are some pictures of St. Patrick's Church.

After Mass, I picked up Farley and we ran to Target so he could find a pull-up bar. Then we went to Marshall's and I was able to find a brown and black pair of dress shoes. I have brown and black dress shoes that work with dresses and pants; however, they have never fit just right. They are Clarks, which are suppose to be comfortable for standing, but they are horrible. When I bought them, I bought the size that was a little snug (thinking they would stretch) since the next size up was loose on my foot. They were okay last semester, but never great. I didn't wear them much during my break from school (I have much cuter and more comfortable shoes at home), but started to wear them again at the start of this rotation. I knew that it would they would take a little getting used to, but they were hurting more and more rather than getting better. It is amazing how painful feet can become and how much they can impact your day. I didn't want to spend the money on more shoes, but I got a great price and I think they are going to make a huge difference in my days. Oh, and when I compared the new shoes to the old ones, the old ones are visibly smaller than the new shoes despite them both supposedly being the same size. Perhaps my problem the whole time has been that they are too small.

Next we ran to the grocery store. The yucky winter is greatly affecting the prices of produce in Florida. I used to buy a large bag of green beans that would last me a week for $1.50-$2.50 (depending on the exact weight). Now, I cannot even find the same size bags that I used to see and I buy a much smaller bag for $2.60-$4.00 (really I only buy the $2.60 bag, but they are now priced as high as $4.00). After the grocery store, we had a nice dinner and then Farley asked if I'd make cookies. I made a peanut butter and chocolate chip cookie, which turned out great!

Sunday was a beautiful day so Farley and I decided to take a walk. The Food Network was having a food and wine festival so we looked into tickets to a food tasting. They were $185.00 to $215.00 per person! I really thought they would be $10.00 - $30.00 per person; needless to day, we did not go to the food tasting. The wine tasting classes and tastings were $85.00 per hour! That just seems a bit crazy to me. So, we decided to go walk down to Lincoln Road and look at the fancy shops and restaurants. There were many chain stores, Gap, Banana Republic, and Starbucks, but there are also many boutiques, designer stores, and local restaurants. We went into Books and Books, which is a local book store. I really liked it because they divided the store into one main room with smaller rooms off the main room. The smaller rooms were the size of a large bedroom and they had books of a specific genera in them. Books and Books was obviously smaller than a big chain store, but they had more unique authors. I found several books that I really wanted to read, but I am in the middle of one book and have another waiting so I decided not to buy anything right now. I forgot my camera so I'll have to go back to Lincoln Road and take pictures later!

After going to Lincoln Road, I started baking and cooking. I have been wanting to make a walnut and Gorgonzola cheese bread and I had the time to do so yesterday. While the bread was rising and such, I decided to get a head start on the week by making lentil soup and sweet and sour meatballs. When the bread was almost finished, I started my pasta with meat sauce. We had a great dinner, if I do say so myself! After dinner, I had to hit the books again and I reviewed some information for the Monday.

All in all it was a great, relaxing weekend. I can't get too used to these!

Family Practice Clerkship: Week Two

The Family Practice Clerkship is six weeks long. At the location I am doing my clerkship, we are sent to different clinics every two weeks. The idea behind this is to expose us to different aspects of Family Medicine. The first two weeks, I was working with geriatrics patients. I believe the average age of the patients at this geriatrics site was 85 years old! There were many, many patients in their 90s and 100s and some of them still had excellent memories. I really liked working with these patients, especially those with the excellent memories because they have seen so many changes in their lives and it was fun to hear their stories.

For the next two weeks, I will be working at a homeless shelter's free medical clinic. I am really excited to be able to help out people who would otherwise have no medical care. Farley and I stopped by the free clinic yesterday after we finished at the geriatrics locations. They told us that they give medical students a lot of autonomy. We will be given a patient, do a history and physical, come up with a diagnosis and treatment plan then present to an attending physician, who will see the patient and either agree or disagree with our diagnosis and plan. We will even be given the chance to help with procedures, such as draining abscesses, under the supervision of the attending physician. I am really excited and scared to be able to do more hands on work. One of my personal doctors once told me, that they never let students do anything they are not ready for but at some point you have got to learn. I guess I am ready!