Quote of the day:

"Beginning in the left upper quadrant, pass the jejunum and ilium between your hands and appreciate its length, position, and termination."

-Grant's Dissector

All I can say is: ewwwwwwww.

We've finished the abdominal dissection, and it's my least favorite dissection so far. It's gross, things are not nicely arranged, there's a lot of variable anatomy, and well, it's gross. And not only is it gross, the smell reminds me of seaweed, which is a food I enjoy, and the gallbladder leaked, so half the intestines are green, and there's this frothy bubbly stuff floating around from melted fat. All in all, it sort of looks like a totally revolting little ocean in there. The only thing it has going for it is color. It's definitely the most colorful dissection we've done so far what with the yellow fat, green bile and red coagulated blood against the the general greyish and whitish rest of the body.

We did see some interesting x-rays today, though. There was someone who had a Sky vodka bottle lost in their guts. That must have been really painful beause those bottles are enormous. It took up so much of the abdomen. And I really wish I knew what kind of explanation the patient gave for that.

Some Haikus AND the Dance of Many Cloths

This is a bonus double post since I haven't posted in so long.

Anatomy lab.

Question: S'pose we need this thing?

Likely not. Whack. Oops.

Invisible lines,

Black on black and white on white,

Radiology.

The Dance of Many Cloths is not as romantic as one might guess from the name I've given it. It involves many props:

1. A balloon with some tubing, two strands of red yarn, a strand of yellow yarn, a strand of green yarn, and a strand of blue yarn attached. This will represent a testicle and all the vessels and nerves trailing along with it. There is the vas defrens which is the tubing. It has its own dedicated artery, which is represented by one strand of red yarn. The second strand of red yarn is the artery for the testicle. The yellow is nerve, green is lymphatics, blue is vein. So this should be a sign. If you don't want to read about testicles, you should stop reading now.
2. A sheer, gauzy white cloth. This is the transversalis fascia.
3. Three striped clothes. These will represent the tranversus abdominis muscle and the external and internal oblique muscles. The stripes indicate the directionality of the muscle fibers. Transversus abdominis and internal oblique fibers run in the same direction, and both are perpendicular to the external obliqe.
4. A fleshy colored cloth somehow formed into a sac. This is the scrotum.
5. 6 people. One person per prop.

And now to setup for the dance. One person holds the testicle aloft. He or she will stand in the back because the testicle develops prety much right up against the back in the area where the heart is (actually, the ovary does this too). One person holds up the transversalis fascia. This is the layer of connective tissue between the abdominal wall and all the guts inside. The muscles will be held up in this order from back to front: transversus abdominis, internal oblique, external obliqe. Transversus abdominis needs to be held slightly higher than the others. The fibers of external oblique point down and towards the middle. Lastly, someone will hold the scrotum.

After all the setup, the dance is actually quite brief. The testicle, plus its associated dancer, moves forwards. As it does, it acquires a covering of everything except for the transversus abdominis, which it passes under. After acquiring all these layers, it then is dropped into the scrotum. And so here we have it, the Dance of Many Cloths, and interpretation of the descent of a testicle.

Quote of the day:

"Did you guys eat lunch?"

The rest of the medical school class has joined us MSTPs in anatomy lab. We've completed dissections of the arms, legs, and back in the three or so weeks we've been there. After seeing how dissected The Body was, someone asked, "Did you guys eat lunch?" I laughed pretty hard. We've done about 40 hours of dissection on our body. If only we could have done it over lunch. Sighs. Only one and a half months of anatomy left to go.

It's not actually that I dislike it. It's just such an inconvenience. You smell repulsive until you shower. You have to change in a locker room with a bunch of other people at least twice a day. Things get gross and you want to prevent as much cross-contamination as you possibly can between the stuff that goes into lab and the stuff that doesn't. And it just takes such a long time. If I felt more free then it would probably be better, but as it stands, I'm trying to make living arrangements, I still need to clean, do laundry, cook, and run errands. It's been two months since I moved here and only this week did the mailbox get fixed.

So, I'm not sure when this turned from a post about anatomy to a rant about all the things I need to do, but in conclusion, there's such cool stuff in anatomy, but I just feel too busy to enjoy it properly.

Oh, and dissection is much better than the week of looking at embryology cross-section slides on the computer that we just finished.

Overly Poked

Today we learned how to give each other injections! I am now richer by 1mL of saline solution and three extra holes in my body.

We did intramuscular injections and subcutaneous injection. I hate being poked with needles. My heart rate goes up, I get nervous, and I might actually breath a little fast, but it's never as bad as I'm expecting it to be. Perhaps it's good that my expectations are always so low. It hurts, but not terribly. I think menstrual cramping is worse. It's just that this is a voluntarily accepted pain and it's a foreign, pointy, scary-looking object piercing your skin.

The intramuscular injection needle was LONG. Maybe two inches? Because I try not to look when people are giving me injections, I was under the impression that only part of the needle goes in, but actually the whole needle ends up going into your arm. I was so scared when I found out. In fact, I still shudder to think of it now. It turns out that most people have more than enough deltoid muscle to prevent the needle from getting to bone. Even anorexic girls can get shots this way. I got injected first, and it actually wasn't more painful than the injections given to me by experienced nurses. Then it was my turn to give an injection, and when I actually started concentrating, all I saw was this skin and needle. There was a certain detachment that came from this rather narrow field of vision, and giving an injection was also not as hard as I thought it would be. It also helps that you don't have to push very hard to get the needle in, so it doens't seem like you should be causing much pain. The needle is very sharp. *shudder* I still dislike the idea of getting a length of metal stuck into me.

Next were the subcutaneous injections. They actually hurt more than the intramuscular injections. I was surprised because I figured that getting stuck in the fat shouldn't hurt as much as getting stuck in the muscle, but there you go.

We also learned how to take blood pressure, vitals, and how to do a skin prick to test for blood sugar. My blood pressure was 110/70 (hooray!) and my blood sugar was 119 about an hour after eating dinner (also good).

Oh yeah, in case it wasn't clear, we gave a half mL injection of saline per practice shot, which is why I'm now 1mL richer in saline solution.

BLS training

BLS training is Basic Life Support training, though I personally like the name Basic Life Sav,ing training better. Essentially, we learned what to do if a person's heart isn't beating or if they're not breathing, or both. While it may not be obvious at first glance, there are actually a few amusing points in here.

If someone conscious and choking, you're obligated to ask them first before you help them. Let's see how this would go:

"Hi, are you choking?"

Person can't reply because they're choking, but they're making the Universal I'm Choking Sign. (This is a very important sign to remember.)

"I'm a medical student with BLS certification. Can I help you?"

Person shakes head.

"Are you really, really sure? I mean, you could choke to death if someone doesn't help you."

Person shakes head.

At this point, you'd actually be obligated to wait until the person passes out before helping them, but after they pass out, you can do whatever you need to do.

The second amusing point is the first step of the algorithm they give you to determine whether you should do full CPR or just rescue breathing. The first step is to check to see if they're actually conscious and not just napping. Can you imagine the number of overzealous BLS trained people who started giving CPR to old people napping in the park in order for them to make this into an official first step?

Humor aside, the test for certification was pretty easy. There was a written portion, a multiple choice exam which took about ten minutes. Each question had at least one choice which sounded ridiculous and was obviously wrong. The practical was on practice dummies. Proctors would give you various scenarios and ask you what to do and to demonstrate on the dummy.

Easy as this certification was, I do feel a little more competent and accomplished. At least if anything this bad happens, I'll know, in theory, what to do which gives me a mild sense of security. I imagine that in practice, it's probably difficult first to get past the disbelief and freaking out, and second to guage whether you're pushing hard enough or breathing properly.

update on Squeaks

She is definitely bigger than she was when she got here just three and a half weeks ago and getting more adorable every day. She's learned how to sit on my shoulder and experimented briefly with sitting on top of my head. This second endeavor ended in disaster. She's also discovered paper bags, so I get to have a lot of fun dumping her into a paper bag along with a little mouse toy or something.

Educationally, she's learning (very, very slowly) that she isn't supposed to jump onto table tops, which brings me to the question of, how much water is it okay to spray on a kitten whilst trying to train her? She's also figured out that she isn't supposed to climb into the dirty laundry basket, mess with electrical wires, or chew on my shoes. See how smart she is?

Unfortunately she still screams, I means squeaks, really loudly sometimes when I leave her, like for showering or cooking purposes. I think I've been able to hear her from outside. Hopefully the neighbors can't hear.

A Vegetarian (but delicious!) Dinner

We went to Green Zebra to celebrate someone's successful PhD defense. It's a vegetarian restaurant (she's a vegetarian) that is pricy but fortunately correspondingly tasty.

First we started off with this and bread:

It's a complimentary bite of a cherry and corn salad type thing. I think I tasted some fennel in it. It was alright. The thing was that it would have been significantly better chilled, which is such an easy thing to do that I was disappointed.

On the other hand, the bread was gorgeous. It was a whole wheat bread with just the right amount of crustiness on the outside and soft on the inside. Unfortunately, I didn't think to take a picture before eating it up with a healthy swipe of butter

Here's the menu:

I ordered the beet salad and the roasted shitake rolls.

I apologize for the poor picture quality. It was one of those dim, atmospheric restaurants.

The salad was the better of the two, and it was good, with a sigh of contenment added at the end. It helps that I like beets, lemon, and goat cheese, all of which were included. It wasn't too light or rabbit-foody because of the beets and friend goat cheese, but the peppery greens and preserved lemon peel kept it fresh and bright.

The shitakes were good but not spectacular. The mushrooms were really well seasoned and cooked, the greens were good, and the potato wrap was good, but it just somehow wasn't that exciting. I think it was because texture was sort of bland, if that word can be used to describe a texture. The foam on top was also a little odd. It actually reminds me of fat foam, so it was a little off-putting.

For dessert I ordered dark chocolate beignets with bananas foster and creme fraiche ice cream. I'm a little sheepish to say that I ate most of it before I took a picture, but that was because it was DELICIOUS!

Anyway, you can still see the important components. The beignet is in the back left, the remaining lump of ice cream is in the back right, and a couple bananas foster are in the front. The bananas themselves were on the green side, so it wasn't too sweet, the ice cream was tart and was a good match for both the bananas and beignet, and the beignets had some melty dark chocolate filling on the inside.