Saturday, September 11, 2010

When You Try to Simplify Something That Isn't Simple

A Long Hard Look at the Nephron
So I tried to make myself a nice simple diagram of the nephron complete with what diuretics act where.

Turns out that is not possible.

Partly because I am as thick as the ascending loop of Henle when it comes to renal knowledge so every note I make on my drawing requires an explanation for myself. During 'firing squad' anatomy this week I couldn't remember what "closer to the top of the head" was in medspeak (pretty sure I said "dorsal??" *facepalm*). Sigh.

Turns out the school is giving us grades this year which is a bit of a drag. It's been so freeing having this pass/fail system because I could let myself indulge in being a human (nearly) guilt free, plus it made it hard for the annoying people who insist on shouting their grades from the bell tower.  That really pleased me. While we are on the topic of grades, can I just say that people telling me their grades feels almost equal to slamming my hand in a car door, while the car is still moving. I *painfully loathe* it. Partly because I never know how to respond, from either perspective. When I did worse than the Boundary-Free-Human then I feel frustrated that they had the urge to impart their numbers on me (unsolicited), when I did better than them it makes me feel awkward. Gah.

Hence, my avoidance of the whole GRADE discussion. Full stop.

But now we are getting our grades and I wonder how I will be able to avoid the inevitable score-card of comparison conversations that will erupt around me.

[Ok before this turns into an ego driven rant about my level of medical experience I am just going to hit the big "delete" button on that last paragraph. It made me sound really bitchy and petty. There, you all were spared.]

In other news, I took the day off. We had friends over for dinner last night and it ended up becoming one of those evenings where someone suddenly goes "shit! it's 0230h!" and we all wonder where the time and the wine went. So this morning Tobie and I slept in and then moseyed around the farmers market in town. Came home and had tea with one of my lovely friends, Emma, from school (who incidentally is doing brilliantly and has a 21 month old). Afterwards there was napping, Tom Yam soup making, and calling home. And I was reminded that I get too worried about too many things. I really want to play my mandolin, cook food, go for runs, catch pilates classes, visit friends, and talk to my family, not worry about what my grades are. Or what the future holds for me in terms of residencies, the USMLE, etc.

Emma, Rosie, and Tobie. They aren't thinking about the nephron, and look how happy they are!

And a complete non sequitur. Tobie has a crumb problem. I thought I'd document it here. Please click to enlarge the fall-out from a baguette and a bit of cheese. He comes by it honestly though, I've noticed it is a familial trait. He thinks I must have suffered a mentally scarring event as a child which is why I am able to eat without a foot of food-bits surrounding me. He clearly has no issues getting down to business.

Tobie thinks he looks like a street person eating at a soup kitchen in this photo.
But he did not prohibit me publishing this photo. So. 


Cara said...

Sheesh... and I thought the little bit of diuretic A&P/Pharm I had to do for nursing was complicated. I pity you. The problem I'm finding is that I cram this crud, write the test and (sorry) get a decent mark but find later that the area I'd crammed it into turned out to be only the "short term" section. I just don't recall it after the summer break (or even the next week).

Love your blog, and your perspective on life. Just found you the other day and I've spent ridiculous hours here reading already. :)

OMDG said...

On what to say, if you don't like the person, say: THAT'S IT? And walk away.

If you do like the person, say: You know, hearing about other people's grades makes me want to ram my head into a car -- in other words it stresses me out unnecessarily -- so please don't share your grades with me. I really just don't want to know.

I feel your pain re: the nephron. Try breaking it down ion by ion. Memorize where it goes in and out, and how it accomplishes that in each place. It was easier for me when I was able to compartmentalize.

Grumpy, M.D. said...

I did it with flash cards and A LOT of repetition.

I hate renal.

Christopher said...

Ah yes, the Loop of Don Henle. Personal favorite...allll she wants to do is daaance dance.

ertwro said...

oh, good. If only I knew how to draw...

there are people with high grounds of knowledge and people with high grounds of grades. Every single student should be a 5/5 student and know everything, sadly we don't. I blame beds, they are so comfortable.

And of course, eating in a messy environments it's good for the creativity.

Albinoblackbear said...

Cara--Yep, our anat prof (who is a neuroscientist/MD) tells us that if you don't actively revisit info within 6 weeks that you "pee it out". Gone. I can say that I also shudder at the amount of info from finals that I have forgotten.

And thank you! Glad to hear you enjoy the blog. I find it a good procrastination tool.

OMDG--That is much more mature than the sticking fingers in ears while yelling "lalalalalalalal" strategy which I planned. :) I will give that a try.

Grump--Ughhhh, when will there be a time in my life that is flash card free? My version of "Freedom 45" is going to be freedom from those damn flashcards.

Chris---HHAHAHAHAHAHAHAHA. Nice. Now you've ruined my ability to take the kidney seriously (a good thing) and put a bad song in my head (a bad thing).

ERTWRO--Agreed. Problem is my study has a bed and afternoon sunlight. BAD COMBO.

Sarah said...

I read this entry while I was working an ED shift overnight last night. I literally saw the nephron picture, shuddered as I remembered my trifold 18" x 9" drawing of the nephron in 8 different colors from medical school, and made a horrible gagging sound. My residents looked over to see what was wrong with me and had almost identical responses to the picture. We have all been there. When I finally peed out that knowledge in my fourth year of med school, I left it behind and replaced it with a sense of gratitude that my own kidneys work even if I couldn't remember exactly how. I imagine that it doesn't feel like it now, but I solemnly swear that the diagram memorization and the grade comparisons will eventually end. The most important thing is to have a life that makes you happy when this is all over. Well, that and not killing people. You know.

Albinoblackbear said...

Sarah--Hahah, awesome.

I had this great visual of a handful of people staring at a computer screen with looks of disgust and horror on their faces. One would expect they were looking at some crazy youtube video or website.

But no, it is just a drawing of a nephron.

Hehe, proves we all have our demons. Some are afraid of needles, heights, snakes...others...the clotting cascade, the nephron, neurophysiology. :)

"The most important thing is to have a life that makes you happy when this is all over."


Yes, thank you for the reminder. Needed to hear that.

Bostonian in NY said...

also hate will never make sense to me

Anonymous said...

I am sorry to hear about the demise of the pass/fail system!! It was so nice to know there was a fair, sane system out there last year as I struggled with grade angst (P.S. I think I did actually resort to the fingers in the ears lalalalalala thing a few times which, hey, you gotta do what you gotta do).

I was so lucky with renal. I wanted to hate it but our prof for the section was just so darn passionate about the kidney. Also funny, very, very funny. (He made us all kidney-shaped valentine's and sent out mass emails about National Kidney Month). I tried to focus on the drugs. That's stuff you will use in the clinic (how the diuretics, etc work), and it always helped me to try and pull out the practical information in such situations.

Good Luck! :)