Anatomy, PBL, and a Visit to the Case Student Health Center

We had our first day of the renal block today, and so far I really like renal. I know it's heresy for me to like any other organ better than the heart, because CCF is the top cardiology hospital in this country. But I still like kidneys better than I like hearts and lungs. Sorry, but it's true.

In anatomy, we started looking at the abdomen today. Besides being much smellier than the thorax, the abdomen has many other notable features. One is that it is absolutely chock full of fat and intestines. I knew of course that our intestines are very long, but that kind of abstract knowledge still doesn't prepare you for when you look inside a cadaver for the first time and see loops upon loops of small intestine. The abdominal fat, as in the thorax, is bright yellow and kind of squishy. The women are a lot fattier than the men. We also saw the gall bladder in one cadaver, but not in another because the second one had apparently had his gall bladder taken out at some point. As I found out last summer when we visited the path lab, the gall bladder is bright green and full of none-too-appetizing bile. I also saw a stomach (larger than I expected it to be) and of course, our new friends the kidneys, which are much smaller than I would have expected. It's pretty impressive that such tiny organs can do so many different things. In the last cadaver, we saw a uterus and ovaries, which were impressive, and the pancreas and adrenal glands. Our prosections are now being prepared by urology residents, and they are pretty gung-ho about what they do just like the ENTs were last block. I have zero interest in being a urologist, but I could end up as a nephrologist one day, I guess.

My new PBL group is very different from the one I had last block. Two of my group members are the same, but the other five aren't, and it's amazing how different the sessions are based on who is in the group. I can already see that this group is going to be way more laid back than my last group was. We are doing several things differently than my old group did them, one of which is that we are going to try to make the learning objective presentations more into discussions rather than presentations. So even though we still have one person who will be in charge of leading the discussion, we are all going to read about every topic instead of just one person doing it. I am not sure yet about how well this will work, but I figure it's worth a try. If it doesn't work, we can always go back to making more formal presentations. My learning objective for Wednesday is about how the kidneys are able to filter out substances to start producing urine.

Right after lunch, I practiced the ear, nose, and throat exam with one of my classmates. We were both having some trouble seeing each other's eardrums, and a couple of the second years showed us how to do it again. Using their technique, it was really easy. For one thing, you have to pull on the patient's ear out, back, and up harder than we were. It also helps a lot if you hold the otoscope upside down and rest your hand against the person's head instead of holding it right side up. You have to hold it upside down when you examine children anyway, and there is no advantage to holding it right side up, so I plan to always hold it upside down from now on.

This is National AIDS Week, and there was an HIV+ speaker this evening. But I didn't go, because I had a doctor's appointment over at Case and I didn't feel like rushing back afterward. The Case student health center is right down the street from the Case medical school, so if I were on the Case campus, it would be super convenient. What impressed me the most was that the doctor was very thorough with getting my medical history. I don't know how much of this is that I'm more attuned to noticing how people take medical histories now, but I did feel like the people here were taking more time with me. The Case clinic is also pretty subsidized. At my old school, I would have had to pay a lot more for that same visit to student health compared to what I had to pay here. That was a very nice surprise.

It finally did start snowing yesterday, and it has continued snowing all day today. I got my new boots just in time.