17 Dollars

to tan or not to tan

In path, we're currently (or more accurately, just finished) learning about skin disorders, including skin cancer. This has left me with quite the predicament! If you've ever seen me, you'd know that I'm a pretty pale person. In fact, if I haven't been outside in a while, it's probably best not to look at me in direct sunlight, if you wanna keep your vision. When I was younger, people used to joke that it was hard to tell where my socks ended and my legs began. So, before coming to St. Maarten, I used to go tanning every other day or so. My roommate actually thought I was black the first time he saw my picture on facebook (which is ridiculous, because I was never that dark)! When I return home, I plan to start tanning again, so that I don't look so much like Casper.

But, that's where the problem comes in. UVB rays are the best kind to get you darkest the fastest, and so most good tanning beds have bulbs that put out primarily UVB. Unfortunately, these waves are also the best at causing all kinds of skin cancer. Some of them are pretty benign, others are not. So, do I continue looking tan (and much better, in my opinion), running an increased risk of developing skin cancer, or do I stay pale and maybe not develop skin cancer? Say what you want, but I'll probably keep tanning....

My logic may be totally off, but I do at least have some logic. If you burn, you greatly increase your risk of getting skin cancer, particularly melanoma, which is very nasty. If I remain pale, I'll most likely burn when I'm outside. But, if I tan and control my sun exposure, there's a much slimmer chance that I'll burn, and thus a lesser chance of skin cancer. Although continued UV radiation is a risk factor for squamous cell carcinoma, it's the burning that leads to melanoma. If given a choice, squamous cell carcinoma is definitely the better of the two. If I am wrong, please allow me to continue to bask in my ignorance, as I bask in the UVB rays of the tanning bed :)

Odd day in med micro

It would appear that the professor from U of MD was a little too much into the clinical aspect of things and not quite enough into the USMLE aspect of things, as he is no longer with us. Instead, when we got to class today, we were told to basically disregard the notes we got from him, and Dr. B (from immuno) is re-doing everything (only a couple days worth)! Although I personally liked the guy, I've heard from Dr. S, and upper semesters, that whether or not the details are important in clinical practice (they're probably not), they ARE important for the USMLE. And, since we need to take the USMLE before any clinical practice happens, that's what we've got to learn. We haven't had Dr. B since last semester, so it was at least a nice change of pace. Not that there's anything wrong with Dr. S, but it's just nice to switch things up every once in a while. Med Micro is actually the only class we've had with just one professor for almost the entire semester. But, I suppose it makes sense, since Dr. B is the immuno expert and Dr. S is the micro expert. Also, since they're re-doing the last couple days of class, it will give me a little extra time to get better caught up on all things diarrhea (what we're currently learning about).

On an unrelated note, I've gotten comments that my blog has changed. Well, yes...it has, but I think it was for the better. It's probably a lot less humorous than it was (for some people), but it's also much less offensive to others. In the long run, less offensive seems the way to go. However, I will do my best to keep things interesting.

Good news / Bad news

The good news is (for some of us) that we have a new Med Micro professor for the remainder of the semester. Some people, including myself, like his teaching style, and others apparently do not. Maybe one of the reasons that I like him so much is that he was a professor at the University of Maryland med school...the place that I would have loved to have attended, if I had any choice in the matter. The other huge reason that I like him is that he emphasizes the things that are clinically relevant, opposed to the tiny little details that nobody will ever remember after basic sciences, and that we will never use in practice. Although we haven't had a test from him yet, he told me that his emphasis is definitely on recognizing symptoms, determining what's probably wrong, and knowing what tests you'd have to order to confirm that, as well as necessary treatments. However, much of the class is used to Dr. Shupe's teaching style, and some people don't do well with change. To each his own, I suppose, but I'm happy.

The bad news is that the schedule for next semester has come out. Opposed to last fall semester, when we had two days off, and both were Fridays (giving us 3 day weekends, and an opportunity to fly home), both days this year are Tuesdays, which is mostly useless. The two holidays are St. Maarten Day and Antilles Day. Now, I do understand that the school is located in St. Maarten. But, I also understand that probably around 95% of the school is American, and most of the rest is Canadian. It would seem to make a lot more sense to me that we'd be given off for Thanksgiving, a holiday that almost every one of us celebrates, instead of two holidays that not a single one of us celebrates. I'll never complain about having a day off, but it would be nice if AUC gave us Thanksgiving off, or at least Fridays! Oddly enough, despite not giving us off for Thanksgiving, they did give us off for the 4th of July this semester. Odd....

Mac/PC

PADI Advanced Open Water

This past Friday and Saturday, John, Chuck, Eric, and I got our PADI advanced open water cert! It was a long weekend of diving, but a lot of fun. To get the certification, you have to make 5 specialty dives: two required, and three that you choose. Our 5 dives were navigation, search and recovery, night, deep, and wreck. We did the first three on Friday and the last two on Saturday. One dive is tiring...5 is exhausting!

I originally though the navigation dive was going to be very boring, but it would up being pretty interesting. To make it though, you have to rely on your buddy a lot, as one person reads the compass and the other counts kicks to try to gauge how far you've traveled. Towards the end, Eric and I thought we were way off course, but wound up being right on. The search and recovery dive was also pretty interesting. We learned how to find stuff underwater, tie knots underwater, and hoist things to the surface using lift bags. The night dive was probably the best of the 5. I was a little hesitant since eels come out at night and I am not friends with eels. However, it wound up being pretty amazing. It's a very neat feeling being down there in the pitch dark, just following the light from everyone's flashlights. At one point, we turned our lights off for about 5 minutes and sat there. Once your eyes adjust, you notice all of the photoluminescent stuff under the ocean, which is pretty much everything! When you touched the sand, it looked like sparks were shooting out of your fingers.

Saturday was deep and wreck, although both wound up being wreck dives. The deep dive was a 250' wreck which sat in about 110' of water. We did math problems at the surface and underwater, to see if Nitrogen affected our ability to think straight. I wound up doing better at 110', which either speaks highly of my ability to do math underwater or poorly of my ability to do math on the surface! The second wreck, at a more reasonable depth of 40-60' was The Gregory, which was a site I'd been to before. However, we spent more time exploring the reef than I had before and it was also a very good dive.

We completed all the diving at Dive Octopus, which is now under new ownership. The new owners, Chris and Sally, are a ton of fun to dive with. They've also changed their prices for us and give us very good dive rates (the best on the island). They're the third dive shop I've gone diving with, and easily the best.

Who said med school was all studying?

Patriotism

Congress overrides Bush's Medicare veto

And I couldn't agree more with congress. Until recently, I had no idea that in the next couple years, physicians' reimbursement through medicare is set to drop 11%!!!! So, while primary care physicians are already underpaid, leading to the current situation where there is a huge shortage of primary care physicians and less and less medical students will consider the field, they want to lower reimbursements even more! If they want to make more primary care physicians, lowering reimbursements is certainly NOT the way to do it. How can they expect anyone to go through 4 years of college, 4 years of medical school, and another 3 years of residency (for IM), when they may be able to make more money as a nurse!?

In any case, this bill fortunately will prevent the pay cut. Unfortunately, it does not provide an increase, which is really what is needed. But, MUCH better than the alternative. Instead of cutting doctor's compensation, they will be cutting payments to private insurance companies, who are already rolling in money. I sometimes wonder if most people are aware that insurance companies hire people specifically to find reasons to deny insurance claims, or that even if a doctor's office hires someone specifically to make sure insurance paperwork is in order, 30% of the claims will still probably be denied. Basically, they make money off of denying physicians the compensation they deserve, making patients pay more, and preventing access to necessary treatment. So, I don't think that anyone should feel bad that their pay is going to be cut a little.

But, Bush (in his infinite wisdom) did feel like he should cut physician pay, and continue to let private insurance companies make more money. He argued that he was doing it for the elderly, to give them more choices, despite the fact that the AARP was 100% behind the bill. Fortunately, congress disagreed, Republicans voted over party lines, and his veto was overturned. Score 1 for democracy. You can read more about it here: http://www.reuters.com/article/newsOne/idUSN1529466020080715?rpc=64&pageNumber=1&virtualBrandChannel=10179

Good to be wrong + Sim Man

Without thinking much about it, I just assumed that this block was 5 weeks long (like the last couple), plus another week for finals, meaning we'd have over 5 weeks left of the semester. However, I was reminded today that this block is actually only 4 weeks long, and we're over half way through the first week. So, we only have a month and two days left until 3rd semester is over!! In this case, it was very nice to be wrong!

Today, the people from Laerdal are coming to campus to show us the Sim Man. For those who don't know what sim man is, which is likely most of you, it's a training dummy that can do basically anything. He displays rhythms, responds to treatments, can be intubated, etc. etc. It's one of the best tools you could have for training, aside from real patients. The AMSA people were able to convince the company to come down and give the students and faculty a demo. Hopefully, a lot of the students will show up, the faculty will like it, and we'll wind up purchasing a bunch of them (at around $50,000 a pop). Apparently, the school is willing to make the investment if people here are interested. So, PLEASE show up and show that you're interested tonight. There will be free food!!!

Yes, I've been gone for almost 2 weeks

Sorry about that. Not sure why I've been so lazy about blogging lately, but I'll try to pick it back up. Unfortunately, the next block exam is coming up this Monday, and I've got a ton of studying to do between now and then, so we'll see how it goes before next week. For now, here's some things that are on my mind:

1) Wow we have a lot of studying to do this block!! This is very possibly the hardest block that we've had so far, in terms of the volume of information that we've covered. In med micro, we've covered all of the respiratory, urogenital, and cardiac bugs, of which there are a TON! In physio, we've done all of respiratory, which is probably the least amount of info from a class this block. In path, we've done all of neruo, respiratory, and cardiovascular! That sounds almost like a semester's worth of path...but it's just 5 weeks! It will be interesting to see how these exams go.

2) I'm back in St. Maarten (obviously) after a great weekend at home for the 4th! It's always very nice to get home. On the 4th, I was in the Annapolis 4th of July Parade with Heather and my parents. We were right behind the police and the parade official, in front of the Governor! We were riding in the antique Buick that my father has just finished restoring. It was a long time in the making, but worth it. You can check it out at facesofvalorusa.com. You can see even more pictures on his .mac gallery. It looks good in the pictures, but better in person. I also saw my grandparents, which was nice, since I don't see them often.



3) New version of iTunes and iPhone firmware, including the App Store, became available today. I'll be waiting until the new firmware is unlocked before I download it (probably the next day or so), but I've already downloaded a couple apps and a bunch of them are going to be great! Epocrates is already available for free download, and there is a new Netter's application, which is pretty exciting. Netters is pretty much the gold standard atlas for medical school students, so it'll be extremely nice to be able to just carry it around. Unfortunately, this one is not free. Apple is having some issues getting the new MobileMe service up and running, but push e-mail is already working and man is it fast! Bye bye, Blackberry.

4) Ugghh...so much studying to do before Monday :(