Yayness!

So this week has been a good week, so far. We are finally on the brink of getting a rental house - perhaps by tomorrow we will know for sure whether or not we get the current candidate. My patients this week have been fairly good learning cases. I got to watch Interventional Radiology place three draining chest tubes in one of my patients. I am glad I wasn't him, though, it looked like he was in terrible pain for most of the procedure. With the tubes still in place and draining into measured containers, the tenderness remains. One of those sites drained 100cc's of pretty nasty looking fluid at the time of tube placement - that's a fair amount for lung tissue - and it was up to me to deliver it to the lab myself. He has also had his hand "drained," a couple massive lymph nodes in his neck drained, etc. I don't think there is anywhere else we can poke the poor guy. He is, however, in a much better mood now that he isn't in respiratory isolation, cut off from the world outside his tiny hospital room. Then there are my other two patients, both of which aren't very mentally oriented, but for different reasons. One is an older demented man with some psychiatric and movement disorders that have faded over the last few days, but their etiology remains unknown. I don't know that there is much we can do for him other than send him home under the care of someone else or a nursing home. The other man was self-admitted for detoxification from his alcohol and cocaine use. With constant Ativan sedation, he isn't very responsive to loud speech or even touch. Surprisingly, unknown to him or anyone else before now, his kidney function is less than optimal, so we need to figure what the problem is while he's there. To top it off, Dr. Andreoli is planning on taking us students out to lunch on Friday. I am curious as to his choice of restaurant and whether we will run into any Nobel laureates on the way.

The second reason for a good week is the USMLE. In retrospect, most discussions about the USMLE weren't necessarily pessimistic, but nonetheless about the tiring task of weeks of studying. Now, the scores have returned, and the work was well worth it. I scored a 254 - but let me put this into perspective. Every year, the average is between 200 and 220, with a standard deviation of about 15. So, even if the average this year is at the higher end at 220, my score is still more than two standard deviations above the average. For those less familiar with the Gaussian curve, this means I should have scored between the 95th and 99.7th percentile. This makes me very happy, to say the least. My goal was to score a 240, and I thought that might be pushing it. Surprises sometimes come. Our class as a whole, though, didn't score as well as classes past and future, as is our apparent inescapable fate.

One final thing is a job opportunity that has come my way. That's right, a job whilst in medical school. I don't know if I will get the position yet, but here's how it works. I will be a technician for the cornea bank at the eye center. I will be on call for a week at a time, but only rarely will it be two weeks in a row. It's beeper call, which means I can go home, go out to eat, sleep, etc. and just go in when needed. The call hours last from 4PM to 8AM. If and when I go in, here's what I do: for those patients listed as organ donors, or least after having expressed desire to donate their corneas, I go see these patients in the morgue after they have passed on. It is my job to enucleate (remove) their eye and then transport it back to our lab. There, I will remove and process the cornea for storage in the cornea bank. The pay is acceptable - 20$ per night on call, $110 for every case done or $65 for every half case done, and mileage. Since these are dead patients, they can work around my schedule and the other three techs, the doctors, and residents are all very understanding of my position as a medical student and my priority to my patients. While sleepless nights happen occasionally, they aren't all that common. Better yet, this is right down the alley of what I want to do and it will look great on a resume. I'm pretty excited about what the next few days/weeks will bring.