How a movie, physics and my day-to-day nerdy life combine

Patrick and I went on a date tonight to see the movie about Stephen Hawking, The Theory of Everything.  I have been wanting to see it since I saw the preview a couple months ago and finally we had some time (read: I have a treatment planning exam this week and am on call next weekend, so I wanted to be “normal” and also simultaneously procrastinate).

I was impressed.

Not only did I get to nerd out a little bit (although science and/or medicine weren’t the main focus of the movie), but it was at times funny, and heartwarming and sad, much like life is.  It was quite a journey.

Seriously though… I would watch it again.  Happily.

Then, we went home and spent an inordinate amount of time nerding out in a different way by looking into how true to life the movie really was, how the actor learned to portray gradual motor neuron decline so well and all that good stuff.  Apparently, it is pretty close to life, although there were, of course the odd composite characters and embellishments or sugar coating.  And the actor studied a ton with dancers and videos and such to get the movements (or absence thereof).

All in all, a good movie.

And now I want to read the book (written by his ex-wife, Jane).  In fact, I saw it while we were out and about today and I almost told Patrick I couldn’t see the movie before I read the book (since that is my general life rule), but I decided against that.  And I need to read his book too, because I like to be well-read and because I love science and physics (and I do firmly believe that much of it does point to God).

Also, it reminded me that physicists are some of my favourite kinds of people.  Seriously… I work with a ton of them… Not cosmologists or theoretical physicists, but medical physicists who are equally nerdy and insanely intelligent.

This in turn reminds me that before I read these books I should probably study my physics and radiobiology so that I pass them this year (although that is improbable because as a rule that doesn’t happen and we repeat them in 4th year).  And that in turn makes me continue to put that stuff off because it is way too early.  And as I said, I have a treatment planning exam this week that I need to study more for because it is on prostate and I haven’t worked with a doc who treats prostate in almost 2 months, so I am way rusty (and realistically never got the hang of it particularly well).  There is, of course some physics in there, so I guess it all relates back.  Kind of.

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June!

I found this gem on the walk to pick up some groceries on the way home from work.  I am totally impressed with whomever put a bird house in a park.  It is very June.

I found this gem on the walk to pick up some groceries on the way home from work. I am totally impressed with whomever put a bird house in a park. It is very June.

It is June!

I know, it was June yesterday. But, yesterday was church day (for which I was on set-up duty), in-laws visiting day and finish my freaking molecular genetics presentation day. It was not a blog posting day.

I feel like the end of April and all of May was that brand of chaos that comes from having too much stuff to do all piled on top of one another in sequence. After my presentation today (ps, the molecular genetics of brain tumours is super cool), June feels like a reprieve. Journal club is the only bigish work project this month. Sure, we are getting my support group project ready for publication (I got two emails about it in the time it took me to write this). Sure, I am starting a new project looking at radiation for lung cancers. But, there are no giant epic mountains of manuscripts, presentations and exams to worry about. That could change if I failed physics. Let’s not talk about that.

In other things June not to talk about, there are the June bugs.  I don’t like shelled insects.  Exoskeletons give me the heebie jeebies.

I quite like June. It is my birthday month, but I’m not too huge on birthdays, so that isn’t really a big deal. It is the month where the weather becomes nice enough to go outside and do stuff. It is the end of the school year for Patrick. And it is the end of the residency year for me.

It is tough to believe that I am one day away from starting my final rotation of PGY-2 (so long as I pass everything) and thus also finish what is our ridiculously long rotating internship of sorts. And then I will be on-service. Agh. I don’t even know what I will do with myself when that happens. Crazyness.

Tonight, we celebrate with the Child and D survival of the insanity that was May and 2 days of June. We will eat (and eat and eat) and play Munchkin (which is an awesome game… Check out the Tabletop video below (and know that Tabletop is also awesome)).

Then maybe we will enjoy the fact that our house is not full of extra people for a little bit. We will enjoy that I am not continuously operating on a new deadline (realistically, that never happens in residency, so I don’t know why I dream that big). I can get back to the gym, although maybe not running quite yet (heck, maybe that darn toe will stop hurting).  Maybe…

How Did That Happen?: How Did I Pass That Exam?

I have that sleepy and yet high energy feeling that comes from a post-exam hangover. Yes, ladies and gentlemen, I am done junior physics (minus the exam review) so long as I pass that exam.stethoscopes1

That brings me to this week’s “How Did That Happen?” post – how did I pass that exam?

Pick the answer you actually want to pick. My thing today (although passed exam is still kind of up in the air) was in one of the multiple choice questions I had to select an energy for an electron beam to cover a tumor but not kill the spinal cord. I misread the question initially and puzzled over it thinking photon beams (for everyone except the, like two people who understand this, photon and electron beams behave pretty differently). Then, when I was checking the exam over, I noticed my error and did the very simple math to pick an appropriate beam. I was debating two answers, then circled one as the person came to pick up the exams. I walked out and realized I had circled the wrong one. The definitely wrong one. Minus one point. The big question is did I pass that exam?

Don’t change answers. Someone told me this in undergrad and I struggled to believe it. Odds are, your first instinct was right and whatever you change it to is wrong, unless you are certain of your error. I had to do a mini analysis (because heaven forbid I believe things at face value, I say that makes me a true scientist), but it is true.

Get the right exam questions. When I wrote the MCAT, it was the first year it was offered on computers (that dates me) and there was some weird computer error where one of my verbal reasoning passages did not correspond to the questions at all. I just guessed all of my answers.

Efficiency or gas masks. I have a terrible taste (and smell) aversion to bananas. All through med school, the guy who was after me in alphabetical order liked to eat a banana part way through every exam. He ripped it out when he was about to check over his answers.   After having to sit through his banana stench once or twice, I developed a system. I would do the exam as fast as possible and bail before he ate the banana. It worked for almost every exam.

More efficiency.  There are time limits.  If you are like me and always finish exams early, stick with that because the one time you start to run behind, that will be the time that they will make you stop writing at the right time and act all unforgiving about it.  At least that is how my neuroanatomy exam went down.  Also, when you aren’t used to being there at the end, you do what I did today and pick the wrong answer because you get weirded out by the exam being over when you are just finishing checking it.

Choose your seats wisely. Because I am a creature of habit, I always sat by banana guy, even when I had options. I had a friend with OCD who had to sit in a seat based on some internal numbering system. I had another friend who couldn’t have anyone within eyeshot.  During part one of the LMCC, I sat between two friends, one of which had a bunch of candy we binge ate before the exam started.  Delightful.

Go in the room. During the LMCC, one of the doors to one of the rooms was sticky. I went to knock and go in the room and it wouldn’t open. I body slammed it and it still wouldn’t open. I started to panic. Then, I charged at the door and went bursting out the other side to almost land on the “patient.” Whoops.

Show up, preferably on time. I always want to punch the late person who makes things start late in the face. Or the person who fails to show up and makes things late. Don’t have me want to punch you.

Talk fast.  Many medicine exams are verbal and you need to cover a ton of information in not a lot of time.  In preparation for OSCEs, I had a few friends who I studied with by practicing old stations and suggested stations from textbooks. We timed ourselves and did every station at least twice as patient, examiner and student. As a result, we had memorized most possible stations and responses. I went into one room and hammered through a long exam, differential and a question in what was probably record time to have the examiner laugh at me because he hadn’t heard someone speak so quickly before. Its a gift.

Don’t whip the patient. Same OSCE. Just got done a psychiatry station which meant my stethoscope was in my pocket and not around my neck where the person could hypothetically strangle me (seriously, pro tip: you got points or lost points for this, can’t remember which). Next station was a cardiac exam. Whent to haul out stethoscope and it got caught in my pocket. Somehow then came sailing out to smuck the med 1 (because they make the best cheapest exam patients).

Tell them what they want to hear. Oral exams are probably one of the more daunting exams in med school. There is something bizarre about explaining your way through hypothetical cases. Someone once told me to include all details you think are relevant and do it in a systematic way as if there was a patient in your face. This becomes more challenging when you have the peds sick and can barely speak and then the fire alarm goes off.

Do what they say. If someone says wear a lab coat or bring a calculator, do it. I have heard of people who failed or lost significant marks for professionalism for not wearing a lab coat, not bringing a stethoscope or not having the stuff they need to actually do the exam.

Turn off your phone/pager. Seems simple. There is almost always one. Nothing sucks more than being that kid with the pager going off while everyone is writing the exam. And not thinking it is yours until someone pinpoints your bag. Then, having to creep forward to turn it off from the very back of the room while people stab you with their eyes.

Study the right material. Seems simple most of the time. I had an anatomy exam in the middle of our course in med 1 where the instructors failed to communicate and included a section we had barely covered and omitted another piece of anatomy we thought was on the exam. That makes for some mighty angry med students.

Put your name and student number on the exam. Why is this still an issue at this level of education? Looking back, I didn’t put my name on last year’s physics exam… Good thing there was only two of us.

If at all possible, read your examiner’s mind. The good old “guess what I’m thinking.” Agh. Sometimes, you can perceive the nods or redirects in an oral exam, but written or a stone faced examiner are more challenging. Psychic abilities are always helpful when trying to figure out what someone is actually wanting to know in that question or why the person administering your oral exam keeps cringing (is it just indigestion or is it my stupidity?).

What are some of your exam conundrums and how did you pass?

Physics Avoidance

I have been eaten by physics.

Okay, I really like physics, but I have this exam coming up on Thursday (unless someone decides to move it again).  And unlike last year, I have to pass it this time around.  Silly world expecting me to actually know stuff.

Needless to say, I goofed off all last week on vacation with my parents visiting and such (and before that it was manuscript writing), so this week is hammer time with the physics books, well, that and showing up to my Molecular Genetics classes and labs and watching playoff hockey (please don’t let tonight be the last game for the Habs, please!?!?).

And yet, I am here, writing a post.  It will be short and sweet and simply some randoms.

I finished The Rosie Project by Graeme Simsion on Sunday night (it was my final act of vacation… That and staying up late to watch the hockey game, but I do that during the playoffs without vacation, so it doesn’t count).  It was one of the better books I have read recently.  I can relate to the main character who has a Sheldon Cooper-like (and thus, in some ways, a Trisha-like) personality.  Very funny, very easy read.  You should check it out.

The Child and I, after about 2 years of playing Super Mario Brothers on the Wii have made it to level 3.  If you can’t guess based on the timeline, we die a lot.  And level 3 is filled with us screaming “PENGUINS” and then dying.  I think it makes the death more fun.

My “nephews” turn 12 next week.  They are the same age as the kids Patrick teaches.  That makes me feel so freaking old.  It also makes me remember I need to get them cards.

I have discovered during this Molecular Genetics rotation that DNA is beautiful.  Especially when being analyzed by FISH or SKY.

Spectral karyotyping. I love the pretty colours.

BCR/ABL is an abnormal fusion gene that is found in leukemias. Image from Wisconsin State Laboratory of Hygiene.

My herbs are sprouting!  I have no clue what is what.  Hopefully that will become more clear as they mature.

On another plant related note, Jeter killed our orchid.  Snapped it clean in half.  Jerk.

Jeter broke a mug at 3am.  Well, we assume it was him.  Or we have a poltergeist.  Or a clumsy thief who forgot to steal stuff.  Really, this is another reminder why we shouldn’t leave stuff on the counter.  It is also why I am grateful that I sleep like I am dead because Patrick had to wake up and deal with it.

Speaking of my destructive cat, the Child showed me these videos on YouTube called Simon’s Cat.  I find them delightful.

Patrick is going on a field trip this week with his class overnight.  He is excited.  I can think of few things I would want to do less than hang out at a camp with a ton of 11 and 12 year olds.  That is what makes us different.

Being a Leisurely Commuter

It was a good morning.

I was seeing some consults at another hospital and I was told to show up at 9:45.  That is basically halfway through the day.

I got up around the same time and went downtown for coffee and some physics studying.  I love doing work with caffeine, food and the bustle of people heading out for the day.  Especially with a good view and Eddie Vedder playing in the background.IMG_0036 IMG_0037

I then commuted using the ferry.  Yes, the ferry.  I never get to travel by ferry.  It is more awesome than the subway, in case you are wondering.  IMG_0040

I then took a more scenic walking trail to the hospital.  Although, I did get a bit lost, it was worth it.IMG_0043

I concluded I could do this.  Be a ferry commuter, specifically.  If every day was as sunny and leisurely as this morning.  But when the weather sucks (or I just want to sleep as late as reasonably possible), I am glad I am close to the hospitals I usually work at.

Really, I am a commuter.  I take the bus or walk every day now that Patrick has a real job that sends him an hour out of town every morning (meaning he leaves at 7 in the morning every day).  That kind of commuting just isn’t as novel to me.  The having a husband with a REAL teaching job (at least until the end of the year) is, though, so I like it nonetheless.

Even finding out my physics exam was rescheduled AGAIN couldn’t ruin my morning.  Okay, it did have me agitated most of the day, but it is a growing experience.

Disappointing Scores (overachieving and underachieving simultaneously)

Over a month ago now, I finished our junior physics course with a giant, awful feeling exam.

You see, in our program, junior physics is for the first and second year residents.  At the end of the course each year, there is an exam.  The pass mark is obscenely high relative to normal standard 65 or 60% and is 70%.  We are told and treated as if it is impossible to pass in first year because, well, it is basically a ridiculously challenging course and first year is too busy and everything is too new to really do well.  In second year, you have to pass.  But, first year is pretty much a get out of jail free card.  Everybody talks as if you are just expected to be in the class next year.

Having a physics background, the course wasn’t as horrific as I had heard.

There was a piece of me who planned to pass in first year.  I mean, I did some of it before.  I love physics.  And I would study.

But, then the unthinkable happened.  Okay, that is an exaggeration.  The thing that I have been anticipating for years happened.  My grandfather got sick just as I was supposed to take some much needed vacation.  He died and all of the related festivities lasted until the weekend before I had to go back to work.  I also had a manuscript for resident research day due.  And that was supposed to be finished before vacation or at least at the start.

So, I didn’t start studying for physics (minus reading a textbook while chilling out listening to my grandfather struggle to breathe and listening to the staff in the hall debate my age) until after all of that stuff was done.  Just a few days before the exam.

I tried.  But, grief is a crappy thing that sucks the life out of you.  Especially when the week before was so busy you barely had time to process all that went down.  Plus, I was back to work, which was busy too.

The day of the exam came and I felt like I wasn’t ready.

It was the first exam I ever walked in to knowing I wasn’t ready.  I had tried and I knew some stuff, but probably not enough.  Nonetheless, I thought maybe I could stick things together.

I didn’t tell the program that I was dealing with all that stuff as an excuse.  I don’t think that is fair.  To make excuses.  If I had to, I should have studied before all of that went down.  I could have skipped the research day thing (though there was a ton of pressure to do that too).

So, I wrote the exam.

And it was bad, but not terrible.  I could have passed.  I also probably didn’t.  I sat there like the big nerd I was and added up my possible worst-case scenario score and my best-case scenario score.  Best-case, I passes with a good 6% to spare.  Worst-case, I fail epically.

The physics instructor asked how it went when I was done.  I laughed.  Apparently, that was the other resident’s response too.

It was not the first exam I walked out of feeling terrible.  It was the first that I knew that I could have done better had I studied more.

Patrick reassured me that I did indeed try my best.  It is not what my usual best was, but it was the best I could do given the situation.

I wasn’t in a rush to get the exam back.

I got the results on Friday.

I, for the first time in my life failed an exam.  In fact, it was indeed the worst score I have had on an exam (minus probably my IB history exam where I answered an entire question based on a misread version).

The email informed me that I scored 65%.   According to our policy, you require a 70% to pass and therefore will be required to repeat the course during your PGY2 year.

I don’t know why, but this seemed harsh to me.

It wasn’t.  I just have never failed anything before to know what it is like.

I got the paper copy of the exam.  I actually got a 65.2%.  That means I was only 4.8% off.

Bring on the what-ifs.

I mean, it isn’t a big deal.  It is what I expected, having to redo the course and rewrite the exam.  Nobody has passed the exam in first year.  It is more like a practice for the year after.  And it doesn’t matter at all in the grand scheme of things.

Except I still feel like I failed myself and my goal for this year.

I know I could have passed.  I know I could have easily had those extra 5% if I could have focused more or read through the notes one more time.

I could have asked to move the exam.  But, I am too proud to do something like that.

But now, I have that behind me.  And I will redo the course next year.  Because that is what we do and what is expected.

I guess the other thing is that it bugs me that it is a 70% pass mark.  I have taken courses with 80% pass marks too, but also ones with 50% passes.  If it were 65% I would have passed.  Barely, but still.  And I know people want doctors who know lots of stuff, but this is just a piece of our baseline knowledge in a very specialized area.  And we do more than just one course.   And usually I am all about more than passing.  But this year, anything would have been okay, I just wanted to get that 70.

I will call this a growth moment.

I have learned yet again that I am not perfect and that I am not immune to life getting in the way of something that, in the grand scheme of things, is unimportant.  And I will do better next time.  And maybe be more honest about how I am doing in life outside of the sheltered walls of the hospital.

And heck, almost passing an exam deemed unpassable is, in the grand scheme of things, pretty good, I think.

July 1

It is July 1, which means it is the first Monday of the month and thus, Medical Mondays, a day to link up with all blogs medical.  If you want to check out other fantastic medical blogs (which you should), click the button below…

It is also Canada Day, which means a long weekend for me (okay, I worked overnight Friday and all day Sunday, but still I am not working on a Monday, so that is pretty huge).  I am not a very festive person, but am pumped to be heading to watch the Tattoo (aka this awesome military related show) this afternoon.  Check out this video below if you want to see why I think Tattoos are awesome.

And lastly, and most importantly (for me, at least), it is the start of a new year of residency.

A piece of me feels like I should celebrate like these guys. Image from bmaycreative.wordpress.com.

For those of you non medical people, residency training in North America follows a strange calendar year from July to July (just to make sure that we don’t actually align with other post-secondary or life related time markers).  July 1 is the official start date.  Thankfully, here, every year that is a holiday, so many get to delay the inevitable until the 2.  That being said, there are always the unlucky souls who have to start out with call on the 1st.  I was grateful to not be one of those.

So, I have survived a year of residency.

Don’t worry, I am not about to give a self-help first year survival guide. If you were looking for that… It isn’t here. Image from jeffwerner.ca.

That is 13 blocks of rotations, which for me worked out to 9 different specialties and 11 different departments or areas of departments.

I worked in two different cities.  I spent 55 nights on call, thankfully only 24 of which were spent in the hospital.  That really isn’t bad for a first year residency.  It makes me grateful for many months of home call and three rotations with no call.

She looks better than I did some nights. Image from tumblr.com.

I went through at least 10 pager batteries, two pagers (one for each city), two pairs of “work” shoes, one triplicate prescription pad and enough pens to supply a classroom for a year.

I wish my pens were that pretty. Image from penguyart.com.

I can now pull out all sorts of drains and staples, do a lumbar puncture, do a paracentesis and releluctantly sew up your wounds.  I would rather not, but I can do those things.

I have a permanent ink stain on my right ring finger.  And I still, for some strange reason prefer doing paperwork over procedures (see the previous paragraph).

I am still scared of my pager.

Image from teen.com.

I still feel like I don’t know anything.  In fact, I think I know less.  That is just the beauty of being in medicine.  The more you learn, the more your learn you don’t know.

We are still married and are still happy about it.

I still love my specialty, even though I so rarely actually see it.

So, now we move on to PGY2.  Which, for me isn’t that different from PGY1.  I am off service even more than I was last year.  But, at least this year’s off service stuff feels more relevant and likeable than last year’s off service stuff.  Some more of it is oncology related.  And, I get to cover call for my home service when I am on some of these rotations.  Not that I am excited about call, but at least I get to do it from home and with the patients/staff I will work with some day.

Other than that, things are the same.  Wandering from rotation to rotation, but getting to stay longer sometimes.   The lost feeling remains.  I am taking the same physics course again this year.  I am working on the same research (I quite like it, so that is fine).

The cool part of it all is that I can now say I am a PGY2.  Apparently, somewhere in there, I am supposed to be growing up.  I am not the baby of the residency program any more.

Unfortunately, I am not actually getting taller. Image from claireyhewitt.blogspot.com.

Hooray for a new year and for a new step in training.  Just 4-5 more years to go.

Congratulations and good luck to everyone else who is starting or moving on in residency.

You just wouldn’t believe, you just wouldn’t even know…

Some friends of mine and I have this inside joke saying “You just wouldn’t believe, you just wouldn’t even know.”  Sounds normal enough.

You see, we were on a camping trip (at a campground in our own city) when a couple of our other friends stopped by.  One of them went into the tent to find something without a flashlight and started screaming, “It’s so dark in here, you just wouldn’t even believe, you just wouldn’t know.”  It was hilarious.  Partly because we all could believe, partly because of who said it and partly because of how loudly the person was screaming this at 1 in the morning in a family campground.

From then on, whenever something obvious or not so obvious would happen, one of us would sometimes state a “you just wouldn’t believe, you just wouldn’t even know.”  This could be in reference to something as simple as darkness or as huge as something epic happening in our day.

We haven’t said it a whole lot lately, but something in physics class made me think of it today (clearly, looking back on the past two months , some of my best Thursday thoughts come out of physics class – see here and here).

You see, we were learning about treatment planning, namely the physics behind CT scanners and talking about how quickly the x-ray source and detector can spin around the patient.  We were saying how it would be cool in theory if the casing for the scanners was clear, so you could see it (the problem being this would totally freak patients out).  They are fast “like you just wouldn’t even believe, you just wouldn’t even know!” We then watched this video to illustrate.watch?v=CWnjqeB7Mk8

The even crazier part to us (beyond how fast that thing spins at top speed) is that 50,000 other people in the world have watched this video.  I know compared to some other videos on the site (like Gangam style that has 500 million hits – we checked) it isn’t much, but for a weird CT related nerd video, that is huge.  “Like, you wouldn’t even believe, you just wouldn’t even know” kind of huge.

Other big win from physics today is that I remembered to bring my coat, so I didn’t freeze completely.  Oh, and because I had half day this afternoon and there was a clinic the other residents didn’t want to go to in the morning I got to go to clinic and half day and someone else covered the floor calls. That made me happy “like you wouldn’t even believe, you just wouldn’t know”!

There are other nerds out there.  I believe and I know.  But it is still fun to say that other phrase!

My Bragg Peak

This week’s writing challenge from the Daily Post was to use metaphor or simile in your writing.  I wasn’t planning on doing it.  I feel like I am doing well to post at all this week.  But, then, I had this physics lecture.  And I knew what I had to do…

I have a Bragg peak.

I function on a general level of energy deposition.  I have a high baseline, but it is pretty stable.  I can putter along flitting and yammering and getting all sorts of things done.  Eventually, I do this for so long that I get rather wired.  Sometimes because so many things have to be done or because I get even more encouraged by what I am doing, I end up doing a whole bunch in a short period of time.  And then I crash and want to do nothing.  Kind of like when I am on call.  There is a low point around 3 or 4 in the morning, but otherwise, you kind of putter along and do more and more as time goes on.  By the time everybody gets in to round, you have a “second wind” or a burst of energy and productivity (or silliness), just before you crash down to sheer exhaustion and sleepiness.

I think of these two events as the Trisha Bragg peak phenomenon.

Image from ptcri.ox.ac.uk

The Bragg peak is something physics people use to describe the energy loss of ionizing radiation (like protons or ions) during its travel through matter.  When these particles move through matter, they deposit energy along their path.  As their energy decreases, they interact more with the things around them. Thus, just before they run out of energy completely, they react a whole bunch, leading to a sharp peak of energy deposition just before they stop.

And thus, I have a Bragg peak.  I go along and put more and more of myself into things until I reach a motivated point where I do a bunch and then have to stop from fatigue (or just plain being out of tasks).  Or I have energy that suddenly peaks before I burn out completely.

To sum things up, I am kind of like a charged particle.  I have a Bragg peak.  Surgery is most definitely proving this fact.  Physics half-day just confirmed it.