Before Anatomy

It's two days before the anatomy midterm exam, and I'm looking out of the Levy Library windows over Manhattan on a excessively cloudy day when everything looks dull and white. At least days like this make me not feel so bad about being inside all day-- this is how it should be before every major exam.

I walk around Sinai and everyone is scurrying around me with nothing on their minds except the exam and how much more studying they have to do-- I really don't know why everyone is so stressed (it's even starting to stress me out just by being around them). Most of the people will do fine on the exam (most know this subject far better than I do). I think they are just making this a much bigger deal in their minds than it really is: it's an exam like any other, no bigger than an Orgo midterm or final, certainly less important than something like the MCATs. I think this exam, more so than the other exams we've already taken since we've been here, represents for them the essence of being in medical school, something they have spent so many years thinking about and trying to attain. I guess they just need to let it out of their system. I also think it doesn't do them any favors to freak out about something that is much easier to deal with when you are calm and collected.

I wanted to talk a little bit more about my patient at EHHOP yesterday before I get back to Rohen and Netter. I was thinking more about the advice we gave her, and more and more I think we did her a disservice. Essentially, we just gave her an antidepressant medication and sent her on her way, without giving her any other advice on how to deal with her problems and issues. When the senior clinician and I left the room he asked me if there was anything that I thought he had missed in taking her history, and I said that I thought we should have asked her about the other types of things that she was doing to deal with her stress, i.e. meditation, prayer, talking to someone like a counselor or friend, etc. In the end the attending did suggest that she think about going to an AA meeting because of her drinking problem (which had gotten much worse with the depression), but essentially we gave a person who has had a past history of addiction a drug to deal with her stress and anxiety issues-- a drug that she can become dependant on just like the alcohol. I would have felt much more comfortable giving her numbers to call of people that specialize in alcohol addiction, and suggesting she see a psychiatrist, and not just a social worker that would help her get insurance. I hope things end up being alright for her, but I think there was a lot more that we could have done for her.

But for now, I am resigned to focus my time with general visceral afferent fibers and referred pain.