Slave to the Grind

When I first thought of tracking my journey through med school on a public blog, I made a promise that I would write every day just to keep the writing muscles in my brain from atrophying and as a way to keep a little bit of sanity in all of this craziness called Basic Sciences.

Hard as I try and much as I would like to write every day (in a sort of surreal Doogie Howser wrap up) I just can't squeeze another hour into the day; I have tried. So I am guessing that these posts will come as sporadic as my sleeping schedule. Now don't get me wrong I am definitely not complaining, I love being busy and love always having something to do. At least this way I have a nice reward at the end of this road, compared to the other roads that I have traversed.

Time, as I have said before, has become a precious commodity. If you are trading sell, sell, sell cause I'm buying. I am figuring out this balancing act for now, get up, run, shower, , have a granola and an apple on the walk to school, class, study, eat, study, lab, (wash stink of formaldehyde off) study, eat, study, study, read some Chuck Palahniuk, sleep for 6 hours do it all over again. At least it is the same thing everyday, no surprises -- which is nice. Only have to do this for 570 more days and then I can really get started.

The first block exams are upcoming, in only 5 short days. There is a frantic energy emanating from most every waking soul around, all heads are seen bowed in an ostensible reverence over their notes, computer screens or homemade flashcards. The lab is open for extended hours and there is almost always at least two cadavers uncovered and undergoing more scrutinizing dissection. It is feverent. So no big adventures to tell of, other than the recurrent monotony of sustained studying.

I'm breaking a bit of the daily ritual today though, gotta get away and let some of this sink in. Gonna ride the Orbea up to the French side into the Lowlands and make the loop around the million dollar homes. Check it out--the loop follows the beaches Baie aux Plums and Baie Rouge

White Coat Ceremony and a Morning Bike Ride

Last night was the formal induction of the incoming May 2009 class into thier physician training at AUC. Dubbed the "White Coat Cerermony", the induction and the donning of the white coat by one of our professors symbolized the transition of our former civilan life into that of a professioinal health care provider. There were many eloquent speakers that all spoke of thier own white coat ceremonies and the struggles, experiences, and rewards that their own education bought them. If you care to watch the ceremony it is available via webcast at http://www.ustream.tv/recorded/1511669 the highlight of the event is around 2:00:20 ;-). The following is an excerpt from an article about the white coat ceremony writen by Dr. Ellen Rothman:

"The white coat ceremony...was intended to herald our introduction into the medical community. while no the long coat of a phyusician or residen, the white coat signals our afiliaion, and differentiates us from the civilian garb of visitors and volunteers.

Yet as a first year medical student, this is not an affiliation I am necessaarily tready to claim. After anatomy, pharmacolgy, physiology, genetics, and embryology, I am more deeply impressed with how little I know than how much I have learned."

It is hard to imagine how much knowlege we truly lack, until we expose ourselves to new experiences, new countries, new people, new challenges, all the while remaing on the path that we have chosen to lead us for the rest of our lives.

Shortly after the ceremony we were all bussed into Maho for a fantastic dinner provided by AUC at the nightclub Tantra, the dinner was catered by an Italian resturaunt named Sopranos. The nightclubs here do not open until 1100 so we had the place to ourselves until then. Met alot of new people, spoke with alot of professors. And even traveled 2000 miles to meet up with a guy that I worked with in Baton Rouge who is in his 3rd semester here. Pretty cool huh!

As soon as the 1100 hour rang it was time for me to go, the tables were being cleared out and the ravers were coming in. Wondering how I was going to get back through the dreaded golf course in the middle of the night without loosing all of my possessions, I was met with another surprise outside. The school had also arranged for transportion back to the school with the campus police, who by far has the greatest motto I have ever seen on a law enforcement vehicle.

Safe and secure back home, I found the apartment complex was lit up quite nicely. Which encouraged a short swim before getting some sleep. It is so nice to be on a regular schedule!

Today was all about the bike, I awoke with a new task on hand. Get the Orbea put together and tuned up and ride, ride, ride. Except not alot of forethought went into my packaging of the bike, I did not pack any means of inflating the tires, so I had to ride up to the bike shop on about 40 psi of air in a tire that normally takes 120 psi. I made the journey without incidnet and met the owner of the shop in Simpson Bay, who tried to encourage me to come to the races tomorrow. Apparently every Sunday is race day in St. Maarten. The owner said that there was an "80 km race through the mountains tomorrow, but all of our races are very causal" 80K and mountains has never sounded casual to me, maybe the week after our first block exams (which are on May 25th so light a candle or whatever you can think of to get me over this first big hump), unless I implode before then.

After the ride, I made my way down to Mullet Bay Beach where the American Medical Student Association was having a welcome BBQ/recruitment party. Since being reverted to near poverty living on loans and a tight budget I can never turn away free food, no matter what it is. The weather was great, and it was a good way to get the mind off of the task at hand for a little while. As the rest of the day was observed from the confines of my little apartment study area, trying to decipher the nerves of the brachial plexus and tracing it back to the correct areas in the spinal cord.


Later and thanks for following my adventure.

A Very Full Week

So far so good, well at least for the first full week of class and all that accompanies it. It is quite amazing how much a mind can absorb in such a short time. But for a mind that has been starved for a lifetime of what it really wants to know, I do not find it so difficult to comprehend.
The pace has definitely picked up to a nice tempo, but it is manageable. Nothing that 6 or 7 hours of studying a day cannot handle...The most consuming is the Anatomy which is also the most interesting at this point. We began dissecting on Monday which was quite an experience in itself, much more fantastic than discovering some deserted beach or dragging the mangled muffler of a tiny silver car half away across a Caribbean Island.
I have discovered that the body is like a landscape and with the proper map and the proper tools and a little determination one can find many of its secrets. How the muscles attach to the various bones and make us move and how the nerves and vessels all thread themselves through everything to drive all these muscles is mesmerizing. We had a good architect somewhere along the line, did we not!
Time has become a precious commodity, sleep, study time, class time, time to decompress, time to wash clothes and dishes and even time to eat have to all be balanced...completely. One can not overpower the other, time cannot be diverted from one to appease another.


I did make another discovery today, this island plays host to some enormous snails. This guy was right out my apartment door chewing on a discarded chicken leg and growling, easily 6-7 inches long

New Study Hall Discovered

The four walls of this empty feeling apartment have a tendency to close in and no change of avenue or bodily position has the ability to make the words go from the page and into my brain. A new srategy had to be developed: I realized that I can read down at the beach just as well as I can read here. So the trusty backpack and I (along with my neighbor/study partner here) loaded up on some snacks, books and lots of water and made the short walk down to the beach at Cupecoy. The sand was comforting, the souds of the waves crashing on the rocks had the perfect amount of white noise in the back ground, the cliffs provided the perfect amount of shade, and the cool water offered the perfect study break. Despite the random passing of a nude and obese octogenerian or 2 it was a wonderful afternoon (they can be lurking aound any corner so one has to be prepared to deal with this at any given moment) and I actually absorbed a lot more information than I thought I would scoring quite high on the online practice test.

On the road back home I discovered that if left unharvested and untouched cotton and cuckleburr plants can get quite enormous.

Till Later

Goodbye Relaxation, Hello Registration and all that Follows

The end of the vacation phase of this journey has ended for now, Registration was on Monday and the pace has definitely picked up from last week's beach hunting mode. The incoming May 09 class is about 91 strong with 53 men and 38 women from 26 states in the US and countries all over the world. I have met people from Egypt, Poland, Russia, Uzbekistan, Vietnam, Canada and plenty others. What a diverse experience this is going to be!!

Most of this week (until today when the real classes began) has been about orientation, how to function as a medical student and more importantly how to functionas a medical student on an island such as St. Maarten with its many distractions. The chief prosecutor from the Dutch Police Force came and spoke to the class about the quickest ways that you can go to jail while residing here. They seem to be quite unaffectionate about personal weapons of any sort, firearms of any kind are strictly forbidden as well as a simple can of Mace. Both will land you in jail with no questions asked or explanations entertained. The psychologist for the school's wellness center gave tips on how to cope with life here away from everything and most everyone and deal with the pressures of a professional school.

As for the reason I am here, the education, began today at a mediocre pace only 2 chapters of medical genetics to know by tomorrow and begin to memorize all the bones, nerves, vessels and muscles of the spine and the back. The faculty is impressive the Genetics professor studied at the University of Edinburgh in Scotland (where Darwin rose to fame) and one of the Anatomy professors is from New Zealand and helped develop the process of plastination. If you have seen the events of "Body World" that draws so much controversy, that is platination. First day in the cadaver lab today, and that's when it really hit me that I am really here and really doing this. (I may have caught a glimpse of that bear)Still can't believe it. Sitting in an ice cold room that smells of phenol and other chemicals with 12 cadavers kind of put everything in place for some reason. Entering the lab where the cadavers were present was a very somber and reverent time for everyone, the professor spoke softly and we spent several moments in silence with our heads bowed silently thanking these people for donating their mortal remains to benefit our education. Very ethereal.

Anyway for those that aren't quite sure where I am in the world there are a couple of maps below and photo of the front of the school. The island of St. Maarten is about 200 miles southeast of Puerto Rico and is a part of the Netherlands Antilles, the school is located in the the area known as the Dutch Lowlands in the city of Cupecoy, on the southwest corner of the island, and rests on the shore of Simpson Bay Lagoon.

Till next time

Paradise Found

As the antithesis to Milton's epic droning i have found the little slice of paradise that i had been searching for. I was on the wrong side of the mountain the whole time and no one here understands a Louisiana accent well enough to understand what I was even talking about. So I threw out the map and the gps (repudiate your possessions and then you can see the bear) and just went by the direction that i knew the beach to be in. All that i knew was that a dirt road near a recycling plant that ended on an old coastal foot path that ran along the cliffs and then over the mountain.

Propelled by the raw power of the sweet 4 cylinder Dihatsu, I just started making lefts and rights out of the village named Cul-de-Sac that lies on the extreme northern end of the island. I knew the path to the hidden beach was close and had I discovered that I had been right on top of it on my previous journey, the only problem was the the road was now paved and I had been looking for a dang dirt road. I began to see signs for the recycling plant and recycling stations and began to get excited. After topping an enormous hill I saw the coastline at the bottom and over to my left the recycling plant. Alleluia!!

The road did in fact become dirt at this point as I drove closer to the ocean, after about a mile the road abruptly ended with no warning. Determined at this point i donned my trusty ancient and worn backpack, loaded it up with water and apples and struck out in my flip flops (which i later discovered are not the best foot attire for transversing mountain terrain).

Ha!! I FOUND THE PATH, right at the edge of the ocean and right at the base of the cliffs, I knew I was going to make it finally. With my feet sliding to and fro in the ill-prepared flip flops, I started making my way over the rocky path, that occasionally took all 4 appendages to successfully navigate.

I met some friends along the way, the sea urchins were trapped in the rocky cliff base after the tide receded

Lots of sea urchins trapped

The road began to point a little skyward--up and over...

And continued

..and continued

But the view along the way was fantastic

I was beginning to wonder if these circling Brown Pelicans were trying to alert the carrion eaters of my exact location.

There was a nice rest stop along the way fashioned by some early Baroque era Hobo I believe if I recall my Hobo architecture accurately



And what appeared to be a marker for someone that just couldn't make the journey. ;-)

And then suddenly after only 40 minutes of hiking and 1.5 liters of water as I overcame the last small rise in elevation,there it was...Petites Cayes. Amazing what a little determination and effort will reward you with isn't it.

After playing Robinson Crusoe for a little while and just enjoying the solitude, I began the journey back along the rocky path with the setting sun to my back.

Every worthwhile accomplishment, big or little, has its stages of drudgery and triumph; a beginning, a struggle and a victory.--Gandhi

Before I go I have to tell the perfect end to the perfect day...

After a day like that how could any thing or anyone do anything to change the quantity and quality of the emotions I was feeling. But oh Fortuna why have you forsaken me as you have. My trusty and valiant steed failed me on the way back home...

Between the village of Cul de Sac and the French town of Marigot there is an enormous hill that requires some special preparation for you (well at least me and my sweet 4 cylinder 22hp ride) to undertake. Get as much speed as you can in 3rd gear at the base of the hill, switch off the AC and jam it up into first (don't ask how i discovered that this was the only way to make it up this hill). Well I had performed this maneuver numerous times on my trips around the island, but on this particular day Fortuna decided I had had enough fun for one day.

As I made the change from 3rd to 1st gear KAAAAAPOOOOWWWWWW!!!!! The awfullest racket that you ever did want to hear came from directly under me, quickly followed by the sound of metal dragging on pavement and my trusty and once valiant silver steed began to sound like a log truck on hwy 33.
Now to set the scene a little better I must inform you that there is no DOT in St. Maarten, hence the shoulder of the road is non existent and the road itself is at best undesirable littered with potholes that could be mistake as bomb craters

So i have no where to pull over...for at least 2 miles until i make it to the town of Marigot where i pull off and have a look under the car.

Just as expected the muffler had blown off during the massive power transition of changing gears, but Fortuna kept dealing the hand better and better. There was no more than 3.5 inches of clearance between the roadway and the bottom of the car and better than that the muffler did not fall off on the rear section as most do it fell off from the manifold end. What a conundrum! With no tools and no way to get under the car to tie the thing up (or anything to tie it up with) I made the executive decision to press on. Muffler dragging, sparking and making all kinds of noise.

The people walking on the streets of Marigot are still telling the story of the little silver car flying through the streets leaving a trail of sparks and muffler pieces behind it and the driver that seemed unaware of their continuous attempts to flag him down. Its a rental, I have insurance, and I am having a great day, so down the road I go smiling and singing along with Bob Marlyey.

Until the noise becomes aggravating and I know I can't drag this thing around all the way back to the Avis station, so a plan begins to from in my devious mind. "the muffler is facing forward and made of flimsy metal use the pot holes to your advantage", it says to me. So, haha, i begin driving toward the bomb craters and centering the car over them....it only took three attempts to successfully dislodge the malfunctioning muffler without a single tool or even getting out of the vehicle. Now to just conjure a story to tell the Avis folks as to the location of their muffler.

SWEET RIDE!!

Wind Surfers

Lunch again at the Sunset Beach Bar looking over the western seas. Grilled swordfish and Carib Bright to wash it down.

Most of the morning was spent at Orient bay watching the kite surfers and enjoying even more watching those take lessons being drug across the surf (what masochists) it looked fun once you got the hang of it but learning seems brutal. As with the preceding days today is also met with many places completely closed down because of Carnival and the lingering effects of Queen's Day which was yesterday. So all i am able to do is wander aimlessly along the 37 beaches that circle the island and read while trying to keep from contracting skin cancer. The winds give the illusion that you are in no danger of frying which i have found out the hard way that you do rather quickly. So much for today, not much to to tell. I"m about to go in search again for the elusive Petites Cayes that i couldn't find the other day.

enjoy