Thursday, November 29, 2007

It's My Turn To Shut Up

Thanksgiving break was a breath of fresh air - in more ways than one! A huge cold front moved in and dropped the temperature 40 degrees. Sweet! My down time was very much appreciated. There is a lot of talk about how we are so burned out with school, and now that graduation is a mere six months away, it is even harder to concentrate.

Now that I'm back in school, being around my classmates gives me stuff to talk about. For example, today's topic was How Nurses Don't Know What They're Doing And I'm Going To Be The Perfect Nurse Someday.

Nursing school teaches many things, but often what we’re taught doesn’t apply in practice. My favorite thing to do in nursing is procedures. I love doing dressing changes, fiddling around with catheters, and oh, the joy of putting a needle in someone’s arm. No, no, no. I don’t enjoy inflicting pain. What I enjoy is doing something with my hands and using my senses to do a job. As a cube-farm refugee, it is a breath of fresh air to do something with my hands besides type.

The problem with procedures is they can’t always be done the way it is taught to us in nursing school. When one is standing over a patient doing a procedure the reality is your pocket phone is ringing, a call bell is going off next door, you’re behind on checking on a patient who might be having a problem that is potentially life threatening, you’re trying to remember if the person you just talked to wants extra cream for their coffee or extra Ranch dressing for their salad, the person before that has shat himself and now he’s cleaned up, but there are no clean linens and you told the tech to see if they can get some from another floor but you haven’t seen or heard from her in about 45 minutes, and meanwhile he is sitting in a chair waiting for the clean linens so he can get back in bed.

What to do, what to do?

In that moment we prioritize. We decide what is the most critical thing we must do, and we go with that until the next critical thing happens and we have to rearrange the priorities and still keep track of the Ranch dressing issue.

In the next moment you begin to think about taking shortcuts. You know what the proper procedure is, but you realize that if you do this, you will be hours behind and the end of the shift is approaching. The nurse coming on to take your place will be highly irritated that you haven’t gone things done, so this creates tension between you and she most certainly won’t hesitate to vent this irritation to the other nurses on the unit. Next thing you know nobody will talk to you, and even worse, the story of your slackitude grows with every telling until everyone thinks you’re a pain in the ass to work with. Besides that, you haven’t done any charting and if you stay after your shift to work on it, before too long you will be invited to a meeting with your supervisor to discuss how you’re working too much overtime, and maybe a snarky comment or two about your time management skills.

So you begin to think of the steps you can eliminate from the procedure. You try it and it works great. You have cut 45 minutes off the time you would have spent taking care of the issue.

On good days you do all the steps you are supposed to, but the bad days are crowding closer together. More and more you use the shortcut until eventually you use it all the time. Nothing bad has ever come of it. The patients are happy. Your coworkers are happy. Your supervisor is happy.

Then one magical day, a nursing student appears on the unit. It’s an inconvenience, but it’s part of your job description and, hey, you remember what it was like to be a student and you made a promise to yourself to not be one of those nurses who is mean to students.

Off you go, the nursing student in tow, to do a procedure that you’ve done a million times. You are doing your thing when the student blurts out “aren’t you supposed to be doing it this way?” and she explains how she learned in lab that week.

I would like to treat that student to a mighty bitch-slap.

Nursing school is the soft, safe cocoon where everything happens the way it is supposed, hospitals aren’t hotels, we can focus all our attention on one thing at a time, and we have all the time in the world to listen to the patient talk about their concerns. Unfortunately reality is far different.

Because I have had experience with patient care, and now working as a nurse, I have noticed how people are dynamic and ever changing. They have moods. They have opinions. Sometimes they have body odor. What works one day won’t work the next. We always try to do the best we can, but we have a lot of things working against us. I have taken this understanding with me into my nursing school clinicals.

I stand back and watch. I get in there and help whenever I can within the scope of training I have to that point. I didn’t do a sterile dressing change until I was checked off in class. Then once I was checked off, if I see my patient needs a dressing change, I don’t wait to be asked. I tell the nurse I’ll do it since that’s what I’m there for.

Meanwhile I keep my mouth shut. If I have questions, I wait to ask it when things have calmed down. If I see the nurse doing something differently than what I was taught in school, I observe and learn from it. I might use that technique later when I’m a nurse. I just make sure I never say a word about it to the nurse. I may ask her about it later if I can sense she’s open to those kinds of questions. But I use tact and care with my question, and I never, EVER ask the question in front of the patient.

My goal is to make the world safer for student nurses who will come after me. I want the nurses to have a good experience with me so maybe they’ll be more willing to work with a student in the future. Nursing students who make themselves a pain make nurses not want to work with them. This is the only way we can learn is by watching and doing. If I see something I feel is unsafe or illegal, I take it to my instructor and let him handle it. I don’t feel it’s my place to address it. Chances are I’m wrong. If I open my mouth that nurse and I are going to have a bad day. Neither of us is thrilled to have to be together in the first place. I don’t want make the situation even more unbearable.

So I let my classmates talk about those terrible nurses and how they’ll NEVER do what they saw the nurse doing. I smile, keep my mouth shut and think “well, honey, wait until you’re a nurse.”

Tuesday, November 20, 2007

It Ain't Over 'Til It's Over

On this Eve of Thanksgiving Eve I thought I'd settle in for some quality time with my blog.

Let me just apologize for the terse mood of my last few posts. I'll spare you the details, but yeah, there's been stuff going on at my house that has been keeping me riled up. My *cough* in-laws *cough* will be leaving in the morning and I can go back to drinking coffee and eating chocolate in front of the Internet until I'm comatose. Of the many substances of abuse I have tried in my life, at least this addiction keeps me off the street, and I can still function at work and in school. If I am going to indulge an addiction, I don't appreciate non-relatives commenting on how I spend my free time.

Anyway, I broke the blogger code of ethics and went back to change some of the wording of my posts. Some of my meaning wasn't clear, and some of what I said came out sounding meaner than I intended. Even though I'm not all that fond of people, I really don't want all of humanity to be vaporized into a pile of dust. I have been auditioning some blogs to see if I want to add them to my blog roll. I don't know if this is how its done, but it's how I have chosen to build my blog roll. I want to see if the blog is one that is 1) active, 2) interesting, 3) entertaining, 4) has content that I identify or agree with, and if not 5) challenges my assumptions with solid science.

My blog intentions when we first met were to have a good time and to grow together. I feel like I have failed you in spite of all my good intentions. I still care about you and I want you to blog-love me and not turn me into a blog-ex. I'm insecure enough to want your attention and not go to some other blog to get your needs met. I had thought up some interesting blog topics but just can't spare the mental juice to blog them in a way that would keep you entertained. This doesnt mean our blog honeymoon is over. Even though this is the blog equivalent of sitting around in sweat pants for days without taking a shower, I hope you understand that I'm going through a difficult time.

Thank you for your patience. I know we're just getting to know each other, but I guarantee you that I'm worth the wait.

Winter break is coming up. I promise to get off this virtual couch, pick up those empty ice cream cartons, empty the ash trays, open some windows and run the vacuum. I will cook up some blog goodness that will keep you coming back for more. I will take a shower, shave my legs, do my hair, throw on some make-up and take you on an interesting blog adventure that will make you realize how truly special you are to me.

Thursday, November 15, 2007

I Said Shut Up - Part 2

I grew up in a large family and my social skills suck. A lot people think that growing up with lots of siblings makes you a better adjusted, sociable person. Far from being outgoing and sociable, I'm very much a loner and very snarky. I don't like being around other people for very long.....unless I'm paid to be. I can be sociable when forced, and I am polite enough to get invited back to things, but it's not my true nature. I can only do it for so long, and then I want to get back to my books, my CDs, the Internet, my MP3 or whatever amuses me currently. I guess my point is that wherever you fall on the aloneness-togetherness scale has more to do with the personality you're born with and very little do with whether or not you have siblings.

It's not just the presence of people, but all the goddam noise they make when they are around. My MP3 player gives me some relief. If I'm standing in line and someone starts complaining about how slow the line is, I slap those babies on and disappear into my own world. About 10 years ago I noticed this tendency for people to have to have some kind of freakin' noise going on all the time. Too often I get stuck in a situation where I am forced to endure what some people feel is their right to enjoy music at ear-splitting levels and just assume that I like their music as much as they do. For years I lived in apartments, and too often the neighbor's stereo would vibrate the pictures off the walls. I can't tell you how many times people have threatened to kill me because I asked them to turn their music down. I asked politely - I promise. Is there some connection between listening to loud music and being a homicidal maniac? I'm beginning to think there is.

Apparently I'm not alone. I found this article in Wired magazine where someone says that Hell is Other People's Music and I feel as though someone has heard my distress call. For years I have been complaining about the rise of personal noise that seems to get worse all the time. I have said for years that I would like to find the person who invented the subwoofer and subject him to a few hours of waterboarding.

Part of the problem is I think I have ADD. Back when I was a kid ADD wasn't invented yet. We were just "bad kids" and were made to sit down and our homework. I'm not just being flip - I really do think I have trouble concentrating. I've learned to adapt to it by sitting in the front row in class so I'm not as distracted. I have also adapted by keeping my environment quiet.

What is it with everyone else that there has to be some kind of noise going on all the time? Are your thoughts so distrubing that you have to drown them out?

And what happened to the rule about being quiet in the library? The other day I went to the library to study - because I've been invaded by nattering in-laws - and the other patrons talked to each other, and talked....and talked......and talked, as if they were hanging out at a party. Meaningful looks didn't work. Dirty looks worked no better. I finally went over to them and said "I'm sorry but could you keep it down I'm trying to study." They rolled their eyes, looked at each other and said "God! What's HER problem?" I settled back down to study when another disturbance erupted - this time it was the LIBRARY STAFF carrying on and laughing behind the desk. What the hell?

Just how bad is this phenomenon going to get? Maybe I'm the problem but I just can't get used to having constant noise going on all the time. Studies have shown that the effects of too much noise is detrimental to health - but nobody cares. They want what they want right now and don't care how their behavior affects others. I guess this is the result of a society that values youth - eternal adolescence; people seeing the world from their own perspective and having no clue about what other people might think.

Thankfully I only have less than six months of nursing school left and won't have to concentrate so fiercely. That will help. Meanwhile I hope people read the article and it introduces them to the idea that not everyone likes the same music you do. Maybe you should turn it down a little, or better yet, turn it off altogther and find out what you really think. You might be surprised.

In the words of the philosopher Jean-Paul Sartre, Hell is other people.

Tuesday, November 13, 2007

Brain Damage

Ahhhh. Much better! I took my neuro exam today and got an A. I feel like I turned that failing grade around in spades. I won't get an A for the semester, but at this point I'm just happy that I'm passing. This time I made sure I was all over that material waaaay before the test.

Pardon me while I get this off my chest. Remember my classmate, Jack? He is ENRAGED that he only got an 80. He calls himself the class nerd. He meets with a group of students who have formed a study group - one I've never been invited to join - and some of the students in the group got better grades than he. He had the audacity to say "I taught them everything they know about this subject and they still did better than me." Hmmm. Wouldn't be the text, the lecture, or the Powerpoint presentation? Nope it was all him.

He has these tirades whenever he doesn't get an A on a test; and lately that means he has a hissy fit after every test. The problem, as he sees it, is "the questions aren't worded right."

Nursing school exams aren't knowledge based. They give us the knowledge in the text and in the lecture, and then we are expected to apply the knowledge in a practical way. I can't give you an example of one of these questions because it is unethical, and I could lose my sparkly new LVN license. Let me see if I can think up a non-medical question to demonstrate this logic.

The first year of nursing school our instructors started feeding us questions that were worded more like what we'll see on our exit exam and, if we graduate, the board exam. They were trying to get us used to the idea that it's not a knowledge dump format. I struggled with this mightily. I went to public school, where the method of teaching is memorize and regurgitate with no real logic involved. I've had to overcome quite a bit, but after 3 or 4 tests I figured it out and got with the program. Many of my classmates fought this and kept arguing that "they were trick questions" or "you didn't teach us that in class". I didn't fight it because I'm too old and tired to fight authority anymore. I am too self-centered and lazy to try and bring the whole nursing education system around to my point of view.

Now in our second year most of us have gotten on board with this kind of logic. Somehow though, Jack is still stuck on memorize/regurgitate. He says that tomorrow he is going to complain to the faculty because these aren't fair questions. He claims that this test is not an accurate reflection of his knowledge; that he knows all this stuff and they are just trying to trip him up. A few tests ago when he bombed big-time, he swore that the computer "didn't save his answers right." He grumbled and complained loudly enough that a few other students soon claimed that the computer didn't save their answers right either. So two of the faculty sat through all the lectures and took the same test we did. Lo and behold, all of their answers were saved correctly. Everything that was on the test had been covered in the lecture. Most interesting of all, now that the faculty was looking at it closely, everyone else's answers were saved correctly too. It's a miracle!

I feel for the guy. I wish I could tell him that the sooner he stops trying to fight this, and does his best to adapt to this kind of logic, the better off he will be overall. I want to tell him that, really dude, you are not important enough for them to try and trip you up. You are a body in a seat that they are trying to get to graduation. It is not in their best interest for you to fail.

Mostly I just wish he'd get off this ego trip and let go of his view of himself as the class nerd. Yeah, maybe he does know a lot of data, but if you can't apply the logic, it doesn't matter how much you know. It just so happens that some of my classmates who maybe aren't that great at memorizing data, are geniuses at applying the information they do have. That means they will have a better chance at passing the board exam, and probably make some damn fine nurses.

It is important to know that if a patient is twitchy, has only peed 30 mL in 6 hours, their urine specific gravity is 1.045 and their serum sodium is 125 there is a problem. More importantly is knowing what the problem is and what to do about it.....and what to do about it FIRST.

Sorry bud. Being the class nerd won't save your ass when your patient who fell on his noggin yesterday is now circling the drain with SIADH. You can stand there and look at those numbers and impress people with your fancy book learnin', but you'd better cut that IV off and get on the phone and notify the doctor. Save the bullshit for later.

Friday, November 9, 2007

Hell Is For Children

I think parents take the blame too much for what happens to children. Mothers are especially picked on. Every mother has had the experience of unsolicited advice, comments on her choices and warnings that what she is doing will damage her children for life. Letting your child have a piece of candy before dinner once in a while is not going to hurt them. Letting them sit too close to the television won't hurt their eyes. Eating Pop Rocks and drinking Coke won't make their stomachs explode. If they cross their eyes they won't get stuck that way.

I've had experiences during nursing school where I was initially shocked by something but eventually became desensitized. I don't know if I'll ever get over what I saw today. I'm still haunted by it. I need to put it somewhere and process it. This seemed like as good a place as any.

Our clinical rotation was in an acute care hospital for children. Some of the children were there because of an accident; a child pushed down by a playmate and hits his head on the ground; a child with Down's syndrome; still another who suffered from a bacterial illness with a high fever that caused inflammation and swelling. These things happen and my heart goes out to the parents whom I am sure are suffering a great deal.

What I can't get over is the number of children who are there because the parents didn't take 5 minutes to make sure their child was buckled into a car seat. A large percentage of the children in this hospital were in this category. It is so senseless to me that these children will never wake up, never be off a ventilator, never run and play, never say their first words, or if they said them they are forever silenced. For some it is a cultural belief that car seats are an unneccesary expense. When your religion says you have to have all the babies God intended you to have, a car seat does seem like an extravagance. Does your religion intend for your baby to be forever broken and smashed? Your religion doesn't want you to use artificial means to avoid pregnancy, yet when your child cannot breath on his own you insist we use every artificial means invented by humans to keep the child alive.

Yet another child is there because she found her parents'crack stash and ate it. A beautiful baby with the biggest eyes and the longest lashes is forever brain damaged because her parents addiction meant more to them then their child's well-being. Long ago I learned to accept that for addicts their addiction is always first. It is heartbreaking but easier to get on with life once you know that. Today though, I am having a hard time accepting it. An adult can make the choice whether or not they want to have an addict in his or her life. This baby had no choice. This baby came into the world helpless and dependent on the people around her to make the right choices to keep her safe. She didn't get to choose. She couldn't leave her home and find some new parents who were better equipped to keep her safe and to put her needs before their own.

I am not so concerned about my tax dollars paying to care for them for years on end. Part of being a civilized culture means we care for people and do what we can to keep them alive. It's what separates us from animals. I am not so concerned that we have the technology to keep people alive beyond what is practical or useful. Those are ethical concerns that I am willing to let other people fuss over and evaluate. If I wanted to make it my business to worry about tax dollars or who gets to live or die, I would have run for office or joined the clergy. No. I am in the business of giving patient care to the best of my ability.

Nursing students have to go through the process of learning to put their personal feelings aside when it comes to patient care. We deal with people of different races, classes and sexual orientations than our own. If we are to be effective at what we do, we learn to put our feelings aside, at least temporarily, or come to some understanding of these strange, new people we may never encounter in our lives otherwise. If we never travel outside our own small circle, it comes as a shock when we find that some people would rather buy cigarettes than food if they can't afford to have both. We may have never met a person who doesn't go to their doctor's appointments are pick up their prescriptions because they don't have transportation - and no one in their circle does either. If we don't know people like that, it's easy to judge them from our cozy, comfortable perspective.

But I don't know if I could ever deal with the constant tragedy of parents who put their children's lives in danger. I might eventually learn to deal with it, just the same way I learned to be okay with the sight of blood and the smell of feces. This challenge is one I don't feel ready to take on just yet. I'm too heartbroken and angry today.

Thursday, November 8, 2007

Turn and Face the Strange

Today in class we learned a new term. It's "brain attack." Many of you know this as a stroke. Medical people have been calling this a cerebrovascular accident, or CVA, for years. Then someone decided that since most things that cause a stroke are things a patient can control, then it's really not an accident.

The problem is getting used to the new term. Our instructor even struggled through the lecture trying to say "brain attack" instead of CVA. I, too, am struggling to try and adapt to the new terminology. I ask myself "why can't they just keep saying CVA and leave it at that?"

We live in a world where technology changes rapidly, new things are being discovered and what we used to think was absolute is now shaky. It can be unnerving to try and adapt to the new knowledge. It is my belief that as humans, we would like to trust that the information we have is the final word. As we get older, it becomes more difficult to take in new information and rearrange what we already know.

This is frustrating when trying to educate a patient about their medical problems. For years diabetics were told that they can't have sugar of any kind at all. Now it has been shown that by allowing diabetics to have a little sugar now and then, they are more likely to stick to their diets. If you talk to someone who has been a diabetic for, say, 20 or 30 years, they can't wrap their brain around this new idea.

I've noticed that a person's age can give me a snapshot of what the popular medical beliefs were at some period on their lives, usually young adulthood. Once I understood this I realized that I am experiencing the same thing. The most recent example I know of is when low-carb diets were all the rage the past 10 years or so. When I was a young adult HIGH-carb diets were recommended. The thinking was that carbs are instant energy and we burn them more quickly. Fats are bad because our bodies have to process them into a form that can be more easily used for energy.....and this was bad. I was convinced I was right and refused to cave in to the low-carb diet fad and kept on eating the same way I always have.

Nowadays more and more experts are confirming what I thought; low-carb diets aren't a magic bullet after all. One great flaw in the diet is that it's one that is almost impossible to stick with. Not only that, but we need carbs, and most foods that are sources of carbs also have lots of B vitamins that our bodies need as well. The important thing is all things in moderation; that message has not changed. Eat a little bit of everything. I feel vindicated in a small way.

Where do we go from here? How do we educate patients and get them to accept the new information? I do my best to try and win them over. Like me, they've been on this planet long enough to realize that what I am telling them today will change again in a few years. How can they trust that the information I am giving them is accurate? How long do they have to remember this bit of information before exchanging it for a new bit of information? It's exhausting to keep up with.

I don't have the answer to these questions. I cope by focusing on results. I say go with what works. I am a fan of research. If research shows that a certain treatment has good results, then that's what I feel is best. I don't think we even have to understand why or how it works. The important thing to know is that it works, consistently, and that it causes no harm.

I fall back on the oath we take as nurses and our purpose for being here.......first, do no harm.

I would add keep up on medical research and keep an open mind.

Sunday, November 4, 2007

It's Only Words

In my long and winding post I mentioned setting off on my career path by taking medical terminology. This one class has done more to open up my world than just about anything else I've done.

I hear people complain about medical professionals using medical terminology to communicate, and feel that we do this as a way of making it hard for them to understand what we're talking about. Well, yeah, that is one benefit. We can discuss some scary issues that need discussing immediately without alarming the patient. But understand we aren't doing it to hide things from you. It's a shortcut; sort of like verbal shorthand, and unfortunately we get so used to doing it that sometimes we forget to revert to layman's terms when we talk to patients.

But that isn't the main purpose for the use of medical terms. The practice of medicine has been around for thousands of years. It has only been a couple of thousand or so years that someone put any thought to describing what is they're looking at and what it's doing. Without getting into too detailed a history of the medical field, it was in Rome that the art of medicine really took off. So naturally most things anatomical were given Latin names. For example "osteo" for bone, "cyte" for cell and "atrium" for, uh, a little room but is used to describe a chamber in the body, usually the heart.

Lately there has been a big fuss in the scientific community about naming conventions. Throughout much of history body parts were named according to their structure, location or function. More and more there is a trend toward naming things for people. For example the area in the brain that controls speech is called "Broca's area" for the fella who spent a lot of time in there.

Personally I'd rather like naming things for their structure, location and function. When I see a medical word,for example "suprarenal arteriogram" (and I just made that up; I don't even know if there is such a thing). I can figure out what the heck it is by analyzing the word. "Supra" means above or over something. "Renal" means kidney so I know that there is something above the kidney. "Arterio" is a combining form of "artery" so okay, I know that the thing in question over the kidney is an artery. Then "gram" is a diagnostic study. So AHA - this is a diagnostic study of an artery that is over the kidney.

If they had named this test or this artery for someone I'd be lost. Let's say Dr. Slim Goodbody spent his career studying arteries above the kidney and he figured out a way of looking at the artery with some cool instruments he had lying around, they could have called this a Goodbody Study or a Slimogram. Then I'd be forced to have to look up the word then make the effort to remember that a Goodbody Study is a way of checking the renal arteries. It's a lot easier for me to be able to analyze the word when I see it and not have to commit it to memory.

But that's just me.

The other thing I like about medical terminology is it's a great way of concatenating a whole sentence into one word. Orthostatic hypotension is a way of saying "when-the-patient-stands-up-his-blood-pressure-drops-and-he-passes-out." See? Isn't orthostatic hypotension so much better?

No? Okay. For your amusement I have created a list of medical words that describe everyday events and situations.

alopecia - I am bald
bezoar - I have a hair ball
borborygami - My stomach is growling
coryza - I have a cold
diplopia - I'm seeing double
dypnea - I can't breath
dysgeusia - everything tastes funny
dysmenorrhea - My periods are horrible
dysuria - It hurts when I pee
echolalia - Hey! Stop repeating everything I say.
epistaxis - My nose is bleeding. AAAAHHH! MY NOSE IS BLEEDING!!
eructation - Erp! Excuse me
flatulence - Okay, who floated the air biscuit?
hematuria - there's blood in my pee
hemoptysis - I'm coughing up blood
hirsutism - I am a woman with a moustache
masticate - I am chewing
melena - There's blood in my poo
menometrorrhagia - I bleed like a stockyard hog
orthopnea - I can't breath if I lie down flat
pectus excavatum - I'm a dude who's chest is caved in instead of out and therefore I never take my shirt off in public
piloerection - I'm so scared that my hair is standing on end
polyuria - I pee all the time
presbyopia - I need reading glasses now that I'm 40
priapism - I have a boner that won't quit
pyrexia - I have a fever
pseudocyesis - I have all the symptoms of pregnancy but I'm not pregnant
somnambulism - I walk in my sleep
syncope - I passed out
tinnitus - my ears are ringing
vertigo - I'm dizzy

Who knew that a four-hour erection could have such an interesting name?

Friday, November 2, 2007

Hush, Hush, Keep It Down Now.......

My classmates would like for me to shut up.

I read a blog somewhere but gosh darn didn't save it. The blogger told the story of a middle-aged female know-it-all in her class who never stopped talking and never missed an opportunity to tell stories.

She could have been talking about me, but I'm not sure. I do answer a lot of questions in class, but as far as I know I don't launch into long-winded stories about my personal experience and how it relates to the lecture. At least not on purpose. I, too, am annoyed by over-sharing in the classroom. I want to get the relevant information nailed down to what will be on the test and nothing more. I, too, want to get the heck out of the class just as badly as my bar-hopping, mini-van drivin', second-shift working, pick-the-kids-up-from-school classmates. Even if all I'm going to do is go home, take a nap and watch Oprah, I'm just as eager to get to that as they are to get back to their lives.

For the first part of the semester I was sitting next to someone who has a really bad habit of asking questions during class. Unfortunately she doesn't ask the instructor these questions. She asks the person sitting next to her.

It goes something like this.

This is what the instructor said.

"Gliomas are malignant brain tumors that are classified by their cell types or their location. For example astrocytomas arise from neuroglolial cells. And if you'll recall there are two kinds of nerve cells which are neurons and neuroglolial cells. Anyway, astrocytes are a kind of neuroglial cell. But what is important to remember is that astrocytomas can form anywhere in the cerebral hemispheres. Then there are oligodendrogliomas are usually only located in the frontal lobes, and they are distinguishable from other gliomas because they are usually calcified."

This is what I heard:

Instructor: Gliomas are malignant brain tumors that are classified by their cell types or their location. For example astrocytomas...
Classmate: What?
Me: Astrocytoma.
Classmate: What?
Me: Astrocytoma.
Classmate: How do you spell that?
Me: Um....(initially trying to motion that is in the powerpoint up on the screen four feet high in front of the classroom.....then giving up) A-S-T-R-O....
Classmate: Oh yeah. Okay. I see it now. Is that an A or an O?
Me: It's an A.
Instructor:.......because they are usually calcified.

I would like for my classmate to shut up.

Every time she asks a question and I turn to answer her, I miss the next four things the instructor says.

I tried body language.

Classmate: What?
Me: (Looking fixedly to the front.)
Classmate: (Nudging me) WHAT?
Me: I'm sorry, I'm trying to listen.
Classmate: Oh. Well. It's a good thing I know you cause I know you're really not a bitch.

I tried talking to her before lecture.

Me: I know there are lots of things you miss during the lecture, but could you raise your hand and ask the instructor? When you ask me a question and I stop to answer you I miss the next thing she says. Okay?
Classmate: Okay. Yeah. Cool.
Later during lecture........
Classmate: What?
Me: (Putting finger to lips and pointing to the instructor.)
Classmate: What?
Me: (smacking self in forehead)

Since I couldn't get my wish that she would shut up, I resorted to looking for another empty seat in the class. I found one probably six seats away from where we were sitting and moved myself to that seat about two weeks ago.

One day I bumped into my questioning classmate during break and we had this conversation.

Classmate: I noticed you moved and I bet I know why.
Me: I know. I'm sorry. I really hated to move. I asked you to ask the teacher questions instead of me. I really need to concentrate or I get lost during the lecture.
Classmate: (Look of horror on her face) YOU MOVED BECAUSE OF ME?!?!

I don't know what she meant when she said "I bet I know why." I figured we were thinking the same thing. I was terribly, terribly wrong.

She hasn't spoken to me since.

Thursday, November 1, 2007

Don't Have A Cow, Man

My poor blog. It's so empty lately.

I failed an exam this week and so today I was sent to the principal's office.

Actually it's called "remediation". We review our exam with the professor and figure out what went wrong. I've never failed a test before so this was a devastating experience. But not being one to wallow, I have put it behind me so I can focus on the next test.

The professor didn't get on my case too much. She told me "I know you know this material. You just made some silly mistakes." And boy did I! I made two silly mistakes on math problems by switching what the prescribed medication was with what was on hand, basically quadrupling the dose and killing the patient.

Let me just pause a moment and tell you that I love my professor. She was in the military for years and don't take no mess off nobody. A few tests ago when some of the students were protesting their lousy grades, she reviewed the test scores and said "the grades stand. End of story." Last week she was lecturing and told us that she was giving us some information for our benefit but that it wouldn't be on the test. As she talked a student raised her hand and said "would you repeat that?" The professor said "why are you writing this down? I told you I'm just giving you this information for your benefit and it won't be on the test. We're already behind on the lecture and I can't stop to repeat things. You just have to write faster."

I wanted to marry her on the spot. I love bossy women.

My personal life has been a gauntlet of stress and I haven't been able to study as much as I would like. But I've made some changes. I asked my boss to schedule me one less day a week and see how that goes.

I promise to come back to enlighten and entertain you with some fun medical words I've learned. Honest.