The very core of my being rebels

After 6 weeks of traveling and interviewing and holiday celebrating and friend-visiting and excessive eating and sleeping in, I have experienced a severely debilitating reaction to going back to school.

This very violent response ensued the day (just one week ago today) that I had to wake up early and show up to Neurology orientation: the very core of my being rebelled vehemently against what it knew was about to ensue: lots more waking up early, lots of progress note writing, lots of history taking and physical examinations, lots of patient presentations to unamused attendings, lots of feeling guilty about my sub-par neurologic knowledge, and worse than anything, a whole lotta lack of motivation to fix those knowledge gaps.

But I decided to dive in, much to the amusement of my core being. We are required to take 3 days of evening call and one full weekend of call during the two weeks we are on the inpatient Neurology service. As it turns out, my weekend of call was my first weekend, which means that effectively I would have no days off the first 11 days of my rotation. As excited as I was about this, I decided to sweeten the deal by volunteering for call my very first night. It was actually kind of fun, but it was more than anything, an exercise in how to NOT get ahead in medical school.

Not only had I forgotten both my pager and my hospital ID badge the first day, but when I showed up to meet the on-call resident at 5 pm, I did not have my white coat (which contains all of my little reference tools) or my stethescope (in my defense, I thought I was going to be able to go back to the workroom to fetch these things). And then... THEN... when I accompanied the resident on the first consult of the evening, I forgot to bring a pen. So there I was, a medical student on her first day of Neurology, who not only knew nothing about neurology, but had no white coat, no stethescope, no pager, no identification, nothing to look anything up in, and, inconceivably, not even a pen or a piece of paper. I was like an utterly useless plain-clothes tourist. A dumb one who barely understands english. Let me just say, an impression was made.

But despite having to set my alarm again, I find that I am slowly getting back into the swing of this medical school thing. Neurology is pretty cool. I get to watch people have seizures and work with stroke patients. The battle against the debilitating disorder known as senioritis rages on. I have a feeling I will not be the winner.

Tomorrow I am doing a presentation at Epilepsy Conference on focal cortical dysplasias. For those of you who don't know, FCDs belong to a class of malformations of cortical development (MCDs), which are caused by defects in the embryonic proliferation, migration, and/or differentiation of cortical neurons. I have prepared a fascinating and very over-simplified handout to distribute to the regional epilepsy experts. I'm sure it will be much appreciated. Lets take a look at my schedule for tomorrow:

8 am - Grand Rounds (the topic: Prognostic Factors for Survival in Patients with Malignant Astrocytoma)
9:15 - Epilepsy rounds (in which I present on my 2 epilepsy pts)
11 am - Epilepsy Conference (in which I present to a lot of very smart neurologists about a topic I know very little about)
12 am - Alzheimer's lecture
1:00 pm - Ward rounds (in which I present my ward patients, which right now includes a very nice gentleman who was rendered mute by his recent stroke).

So, if I am interpreting this correctly. I have approximately 15 minutes of free time to see my patients between 8 am and 2pm. Which means I have to see them all before 8 am. Which means that I should go to bed.