The Calm Before the Storm

Well hello!

I am currently writing from the middle of a CFM week - one of the weeks where I get to actually feel like a "real" doctor. The two big tasks this week were to learn the abdominal and musculoskeletal (MSK) physical exams. The former is rather simple - you look at the abdomen, listen to it with your stethoscope, percuss it, and finally palpate. As long as the person doesn't have a big liver or spleen, they're generally OK. For the MSK exam all that one does is go through each joint of the body, move it every which way, as well as try a few specialized tests for the rotator cuff, cruciate and collateral ligaments, and the menisci. Although it seems brief, what I've just written is the distilled essence of both exams, simple and straightforward.

With all of my extra time this week I've taken the time to connect with old friends (I chatted with Daniel Ericks, one of my best friends who I've known since preschool and hadn't talked to since November), spend time with new friends (last night people came over - we played N64 and board games), and catch up on sleep (the past two days I've taken "strong" naps - 2.5 hours long!)

Additionally, tomorrow I am leaving for Spring Break. Around 45 medical students are going on a 4 night cruise that leaves out of Port Canaveral, Florida. We're going to be heading to the Bahamas. I've never been to the Caribbean and have never cruised, so I am quite excited. Don't worry - I'm packing plenty of sunscreen. I and a couple of other friends are roadtripping down, camping along the way. We're stopping at Jones Gap, SC as well as Little Balboa Island State Park. Here is our route:

Yet after Spring Break is over, that is when the real work of the first year of medical school begins. I am currently enjoying the calm before the storm. We have the hardest three sequences all in a row: Immunology, Central Nervous System, and Infections Diseases. The last is particularly notorious - a 5 week long crash courses on bugs: viruses, parasites, and bacteria. I'm looking forward to the challenge.

On another note (or more like 88 notes...), I've finally tuned my piano! Instead of paying a tuner, I bought the wrench (for less than it would have cost to have the piano tuned) and did it myself. (Even though I do not live in West Michigan anymore, I still cling tightly to my Dutch roots!) After 7 hours of tinkering (misery?) and one broken string later, the instrument is finally in tune! I've started learning a new piece: Earl Wild's transcription of the Gershwin song Embraceable You. If you click on the following link, you'll hear a bit of what I'm hopefully going to sound like: http://www.youtube.com/watch?v=7D4nocoFeJM&feature=related

Cheers,

John

Hitting a sweet spot

Well hello!

The middle of the winter, which hasn't been like winter, has finally arrived. That dreaded month, February, is finally here. It's odd for the first time being away from the West side of the state for an entire wintertime - the absence of snow is somewhat startling. Compounding my confusion about the weather is the fact that temperatures have regularly topped 50 degrees. Turning to look out the window, it's a sunny, 48 degree day. To tell the truth, I miss the quiet, deep feeling that comes from having nature enveloped in a blanket of snow. Yes, the sunshine is nice, but winter does not feel like winter to me unless I look out the window and all I see is white.

School has been going well. We just finished up with the Gastrointestinal sequence, which was one of my favorites. Yes, memorizing all of the biochemical pathways was a bit tedious, but after they were learned I was able to take a step back and appreciate how fearfully and wonderfully we are made. Everything is connected. Additionally, the anatomy of the gut was my favorite material that I have learned thus far in medical school. Over 30 feet of plumbing is inside the abdomen - seeing it all is quite an amazing experience.

The new sequence that we're starting is a short one - Endocrine/Reproduction. In short, there are a bunch of little molecules floating around in your blood that are released in response to certain events, and they act all over the place to cause your body to respond properly. Eating and absorbing sugar is an incredibly complex and important process.

Outside of school and the weather, I am being blessed. Recently I joined a small group from my church, Grace Ann Arbor, and although I have only been to one meeting, I know that I will grow from being in the fellowship of other believers. Our apartment is hosting a Super Bowl party this upcoming Sunday, which should be a marvelous time. I'm still getting to play the piano every day - Rachmaninoff Preludes are my most recent project. God is good!

On an aside, I'm going to be back in Holland on Wednesday! I'm excited to see my family!!!

Cheers,

John

Hello 2012!

Well hello!

In case you haven't received the memo, it's 2012! How exciting!

Since early December, much has happened. Christmas break, three weeks of freedom (boredom?), departed as swiftly as it came. I'm trying to recall what I did the entire time, and to tell the truth, I did not do much. Yet in the slowed-down rhythm of life that comes with a long break, I had a marvelous chance to spend time with my grandparents, catch up with my brothers, and read for pleasure. All of these things I do not get to do with any frequency here in Ann Arbor. So although the break seemed tedious after around a week, it was healthy for me to have an enforced season of rest in my life. By my count I only have one more opportunity for this for the rest of my life. After Christmas Break of my M2 year, the rubber finally hits the road. I am excited.

It is not like I sat around and twiddled my thumbs for the entire break, so I'll give a brief summary of what happened:

• Playing Scrabble with my Grandma Betty
• Competing at board games with my cousin Bruce
• Staying up far too late reading (the Hunger Games is a bad book to begin at 10 pm...)
• Meeting up with old friends

Here at medical school I am a week deep into the gastrointestinal/liver sequence. The material is fascinating, especially the anatomy. There is over 20 feet of plumbing inside a human stomach, and how it is all wrapped up inside is incredible. Of all of the material to date, this has been the most fun and exciting. However, there have been two big happenings of the past week: I now have a piano and a house for next year!!!

and...

The piano I purchased with money from my grandmother for Christmas. In the house I will be living with Hope/Calvin alums who are now medical students. The house is RIGHT where we were hoping for a great price. It's the kind of place where we envision staying for at least two years. Thank goodness that we don't have to go through the headache of finding an apartment/rental house in Ann Arbor in the near future.

On an aside, pianos are extremely heavy. I would not recommend moving one up to the third floor of an apartment building that does not happen to have an elevator.

Cheers,

John

It's the most wonderful time of the year...

Well hello!

Somehow December has arrived. Yes, I've swapped out my shorts for pants, my sandals for wool socks and shoes, my t-shirts for Cabela's coat, but all of these choices were made with a desire to stay warm in the cold weather without the concurrent realization that 2011 is almost over. It's just hit me: it's December.

Associated with December are so many wonderful tings: Lights, music, friends, and family. Potlucks, concerts, snow, and gift-giving. In the past week I've eaten with friends five nights, watched the Messiah and the London Philharmonic, and visited with a friend from Hope who was in town for a race. This coming weekend the Christian Medical Association Christmas Party is being hosted at our apartment. (Cookies, a Christmas Movie, White Elephant Gift Exchange, Ugly Sweaters, and the like - it's going to be a wonderful time!) Indeed, Christmas is the most wonderful time of the year. Academically these next two weeks are relatively light; we're learning about the Kidney. The difficulty in medical school is not in the nature of the material, but in the quantity. As such a two week sequence is roughly a quarter as difficult as a four week sequence - there is simply less that needs to be remembered.

The most eventful happening of the past week was the Intermural Broomball Championships. I was on the M1 team, the Not Docs. We rolled through the playoffs, shutting out every team that we played. Yet the competition that we faced was not too stiff - waiting on the other side of the bracket was the formidable M2 Broomball team. We met last night at midnight in the championships. Despite a valiant fight, the M1 team fell in a battle, losing 4-1. We held on 2-1 until the last 5 minutes, at which point our aggressive play led to two easy goals. To fire up the team and fans (there were around 25 M1's as 15 M2's at the game to support their respective classes) I got a haircut for the game. And Dad, don't worry - I "fixed" the haircut this morning.

On an aside, I'm going to be home on the 17th!

Cheers,

John

The (first) home stretch...

Well hello!

MSK is now over and this past week was Thanksgiving break! It was my first time being at home for a significant portion of time since July, and it was absolutely marvelous. Some highlights:

• Dinner at Daniel Erick's new HOUSE! It was wonderful get a little slice of his married life in Hudsonville
• Spending time with David Giles, a med school friend originally from Oregon who came to our house for Thanksgiving break
• Trying to make up for months of missed board game time with Bruce Kraay, my cousin
• Visiting with my grandparents! It was so good to see them!!!
• Thanksgiving at the Holleman's house. It never ceases to amaze me how such a large quantity of
  excellent food can be consumed at one location by 20ish people. Thank you for hosting, Uncle Kevin and Aunt Lynne!
• Walking along Lake Michigan on Friday - it was a blustery cloudless day; the sound of the lake was all-enveloping as I took a stroll along the water's edge.

The most exciting thing that happened during break was the big game: U of M vs. Ohio. (That other school from Colombus doesn't even get the dignity of being called by its proper name.) One of my best friends, Matt, and his wife, Casey, came out for the game on Friday night. On Saturday morning there was a bit of a mishap: I could not for the life of me find one of the tickets. I scoured my entire car and apartment twice, and the ticket did not turn up. Depressed and downtrodden, we set out for the tailgate party under the assumption that I would watch the game back at my apartment while Matt and Casey were in the Big House. We got around a minute away and Matt said, "John, we need t

o look for the ticket one more time".

To make a long story short, the ticket was found inside my sweatshirt pocket. I have not been so excited for the longest time - I sang the Hallelujah Chorus bounding down the stairwell. After a couple of other mishaps we got into the game, which was an absolute blast. In my past I have not gotten into games, but this game was unlike any other in the past. Before Saturday, Michigan had not beaten Ohio for seven years. Entire graduating classes of Wolverienes had not witnessed a U of M victory. When Michigan came out on top on Saturday after the harrowing finish the entire stadium nearly exploded. Students rushed the field, Sweet Caroline blared over the speakers, and the entire city celebrated.

On another note, I'm on the (first) home stretch: 3 weeks until Christmas break! If you'd like to hang out or visit, let me know!

Cheers,

John

MSK hits home

Well hello!

I am now writing from the other side of the Cardiovascular Sequence; my life is no longer confined to the beating of the heart of the inspiration of the lungs but to the extension, flexion, abduction, adduction, rotation, and circumflexion of joints. Innervations, origins and insertions, not electrical waves or pressure gradients, are now the things that consume most of my waking hours. It is a welcome change: I truly enjoy anatomy. We are in the labs three times a week dissecting, finding muscles, picking away at fascia, and tracing vessels or nerves. The sheer amount of memorization is a bit staggering at times, but fortunately for medical students, most of the names are somewhat intuitive. For example, the flexor digitalis profundus is the deep muscle that flexes the digits. The extensor palmaris longus is the longer of the two muscles that extends the thumbs. It would have been helpful to study Latin, but I am getting along just fine.

One of the reasons why MSK has "hit home" was an event that happened two Saturdays ago. I was riding my bike downhill down Division street and a car passed me. (Here is where the details go a bit foggy.) I remember the car turning out in front of me into a driveway, and before I knew it I was flying through the air off my bike, landing on my right forearm, and then slamming onto the ground onto my back. (All that the driver said was "I'm sorry" and "I didn't see you".) The wind was completely knocked out of me, and my forearm had felt better, but other than that I was fine. After a brief trip to the First Aid station, an ice pack, and 600 mg of Motrin later I was in the stands singing Hail to the Victors. Unfortunately the swelling on my arm had gotten rather large during the game:

The arm was so massive that I decided to take my roommate's good advice and go into the ER, after I was finished cheering on U of M to a victory. I got an X-ray taken:

The good news: my arm wasn't broken! The bad news: I was feeling intermittent tingling on my fifth digit, or pinky. The line on my arm above the massive bump is my ulna, which is on the pinky side of the arm. On that side is the ulnar nerve, which provides information about what's going on relating to the skin on that side of the hand. Because there was so much blood (or, a hematoma, if you want to be technical) in that area of the arm compression of the nerve was happening, causing the tingling sensation. Coincidentally (or not) this was exactly what we were covering in lab last week: innervation and muscles of the forearm, anterior compartment.

Also, I'm guessing this wasn't in mind when UMMS said that they encourage "active learning".

On an aside, I'm going to Louisville, KY this Thursday-Saturday for the Global Health Missions Conference. I couldn't be more excited.

Love,

John

P.S. MY ARM IS COMPLETELY FINE! THERE IS NO PERMANENT DAMAGE!

Lifeisablur

Well hello!

It's funny how time gets away from you, especially when you are busy. Class, labs, studying, meetings, small groups, and the like. Last post I made a promise that I wouldn't be delinquent about writing, and here I am, a month after my previous entry, writing again. (I apologize.)

Cells and Tissues is long gone; Clinical Foundations of Medicine flew by; and two-ish weeks ago I took my deep breath before the plunge that is the Cardiovascular/Respiratory sequence. Each sequence has a different quality and reputation, and the current one is reputed to be one of the best. Gone are the long lists of acronyms and cellular pathways, here are models of how the heart and lungs work. It's all variations on a theme: there's a pressure or concentration difference and everything goes downhill.

I've been taking most of my quizzes on Friday so weekends have been blissfully free. Two weeks ago my cousin Bruce came out with a friend Robbie, which was wonderful. This past weekend was jam packed: Fall Ball (a medical school formal) was on Friday night; on Saturday I went to Akron, Ohio with my friend from my class, Nicko, for a concert; yesterday afternoon I went apple picking with around ten other people from my class. Sometimes I think that I tire myself out on the weekends more than I tire myself out during the week!

As far as this week, things are looking great. I've got a dissection and am pumpkin carving with the Galen's Medical Society tomorrow, am hosting a potluck for members of the Christian Medical Association, and my roommate (Nick Holst) and a friend from undergrad (Rob "RIB" Peterson) are coming to visit for the weekend!

On an aside, I've been in Ann Arbor for 2 months and 22 days. Lifeisablur.