An Army of Worms

I thought I'd share some experiences from medical school. This first one is from last semester in the Anatomy lab. I love learning about the body and anatomy was a real treat. You may not want to read this before lunch, but I think it perfectly demonstrates how “different” a typical day in medical is. In Anatomy class after we finished dissecting the abdomen we bifurcated our bodies in half at the waist and then also through the groin. One of the legs was given to the podiatry students and the other we used for dissection. Before we began dissection we had to “wash” the gluteal region and end of the colon. It was a very interesting experience to be in a room full of medical students carting around legs like clubs over to wash basins and then back. We are just a different breed. We live on campus and in the library. The pace is fast. This semester we have a few remaining basic sciences and are also having our first semester on physical diagnosis.
We just completed our first month back and obviously school is picking up the pace. We have three exams this week and one of them was on microbiology. The last 10 days were spent learning about microbiological infections of the gastrointestinal track. This includes viruses, bacteria, protists, nematodes, cestodes and flukes. How many organisms can you name that cause diarrhea? How about a little game of know your diarrhea?

Match the organism with its symptoms:

1. Entamoeba histolytica	A) foul smelling, greasy, floating
2. Giardia lamblia	B) bloody mucus containing
3. Cyclospora	C) severe debilitating diarrhea in AIDS patients
4. Cryptosporidium parvum	D) profuse watery common by ingestion Raspberry seeds
5. vibrio cholera	E) rice water stools

6. Which one of the above fluoresce under UV light? ______________

Drum roll please and the answers are: 1-B, 2-A, 4-C, 3-D, 5-E, 6-cyclospora

Are you in a learning mood? How about some information on beef tapeworm (taenia saginata)? My advice COOK your meet. I know there was a good reason that I always preferred well done to medium rare. Beef tapeworms grow typically to 10-30 ft long and live around 25 years. It's like having a pet that lives in your stomach. Humans become infected when they eat beef that is not cooked fully. Prevention is easy. Cook beef until it is no longer pink inside because cysticerci die at 56 degrees Celsius. Also, if beef is frozen at -5 degrees Celsius it is considered to be safe to consume.

What Is the Life Cycle of the Beef Tapeworm?

The adult beef tapeworm is usually a whopping 15 to 30 feet long (4.5 to 9 meters) and lives in the small intestine. An infected person usually has only one or two worms. The tapeworms use their head, called the scolex, to attach themselves to the intestinal wall. They have 1,000 to 2,000 body segments, called proglottids, each containing 80,000 to 100,000 eggs.
The eggs can survive for months or years in the environment. When cattle or other herbivores (plant-eaters) eat egg-contaminated vegetation, the eggs hatch and burrow through their intestinal wall. The larvae burrow into muscles and form fluid-filled cysts, which are protective capsules. If humans eat raw or undercooked beef containing cysts, the cysts develop over a 2-month period into adult tapeworms. Adult beef tape-worms can live for more than 30 years.
Treatment for cestode infection can be done with the drug praziquantel. Praziquantel opens membrane calcium channels causing paralysis of the worm, aiding the body in expelling the parasite through peristalsis. In more simple terms you take a pill to paralyze the worm. It can't swim up stream in the intestines any longer and so gets pushed out with everything else. Nice, eh? You can read me about tape worms here: http://www.humanillnesses.com/original/T-Ty/Tapeworm.html

This past month also marked my first ice storm in the midwest. They had freezing rain and I woke up to around a half inch of ice covering every inch of my car. Of course I had to take a picture. It took a while to scrape off. I spent the first 10 minutes being carefull and knocking it off my door which was obviously frozen shut. I should also mention school was closed that day. Which meant that I had a day off, yeah! Except for the fact that the test we missed got rescheduled for 6:30am before lectures.
There were a few more big things this past month that happened. We had a school ski trip to Breckenridge Ski Resort in Colorado. We left the Thursday before MLK day. After a very rowdy drunken 13 hour road trip with 95 work-aholic medical students we arrived in Colorado. Breckenridge is an amazing resort. There were over 30 lifts and hundreds of runs. We could snowboard all the way from the top of the mountain right into the condo porch. It was amazing. I also got plenty of double black runs in.
They had a lift all the way to 13,000 ft (Peak 8 of the Ten Mile range). From there it was easy to get to some sweet back country extreme terrain. One of the four of us that went up wiped it on a double black and left his skis and rolled 250 ft down the mountain. He was ok, but it was interesting to help carry skis down while boarding. The nights were filled with hot tubbing, drinking games, and anything else to help forget school.

As if medical didn't provide enough things to do with my time. I decided that I should get involved more in the community since I'm already in health care I wanted to try something outside of health care. I had a few friends back in Portland who had done big brothers big sisters and I decided to try it. My little brother is a second grader I get to hang out with once a week. We read books, play games, or draw stuff. Last week we drew a red and green lizard. It had 3 red spots and had 9 toes. Very poisionous and mean. I have a lot of fun going. It is a welcome break from school!
That about covers it, except for one last thing. This is pretty big news as well. Not quite as much as last post (which was huge). As an aside the wedding planning is going as well as I could expect. Sandi promptly rejected my offer to elope and has proceeded to take care of the invitations, venue, food, cake, flowers, and many other things. She is truly amazing. Anyhow sorry about getting side tracked. The last big news is I'm now "Lieutenant Rhoades."
This past month I joined the Army National Guard. I'm really grateful to live in this country and have the oppurtunities that I have had. I have been truly blessed and I think that our soldiers need great care. I hope to provide that to them when I graduate from medical school.
I decided on the Guard rather than Active duty becuase I would rather serve when the nation is in conlict (like now fighting two wars) and maintain my normal job during peacetime. Don't worry though, I'm non deployable until I finish medical and become a board certified doctor. It would pretty scary to have me take care of people now. I only know a little enough to be dangerous.

Christmas and some really BIG news

For my two weeks off from school, I headed back to Utah. One of my classmates is from Idaho, so I decided to car pool back with him and his family. We split the 16+ hour drive into two parts and spent the night in Laramie with my Uncle. It was a long ride, but it went much smoother than I thought. I am really gratefull that his kids are so well behaved. I spent the ride in the backseat of a minivan sitting behind three and two year old girls watching Disney movies. I've now seen Up, Incredibles, Shrek 2, and Bolt. I've also seen them all three times each.

The first couple days zoomed by. I met up with a couple friends who used to live in Portland and we attended a BYU basketball game against Eastern Washington. We arrived a little late and the score was 31-2. A pretty boring game, but good to catch up. The next couple days I wrote and sent my annual Christmas letter and then just spent a lot of time catching up on sleep.
Sandi flew in on Christmas Eve and we did a quick hike up to Ensign Peak overlooking the Salt Lake Valley. We had dinner with her sister and her kids and then walked around temple square to see the lights with them.
We slept in a bit on Christmas morning and when we woke up my Dad took us down to BYU and we played racquetball. I hadn't played in a few years and was quite rusty. Luckily I was fortunate enough to go undefeated. We had dinner at 2pm. Spiral-Cut-Ham. I love ham. Yummy mouth watering salty goodness. My Mom is such an amazing cook, I'm coming home from Christmas carrying an extra 10lbs. After dinner we commenced the opening of presents.
The day after Christmas Sandi and I joined Robert, DeAnna, Justin and went to Brighton to do some snowboarding. My brother Adam was also nice and caught his horse for us and we got to ride around a little.
Sunday night Sandi and I drove up to Idaho to spend the night with my Grandma McKay. The next morning we went shopping at my Aunt Stacy's jewelry store. Yup, Ben was shopping at a jewelry store. Have you put 2+2 together yet? We're engaged!
The current plan is to get hitched on March 20, 2010 in Portland. (during my spring break)
Sandi is a truly amazing girl and my best friend. We've had a lot of fun together and I put a couple pictures of us doing all sorts of things together (I took the idea from my friend Mike). It has been a wild ride and I'm really excited. I just have to survive the next couple months of school.

Year in Review

Christmas Letter 2009:

As you might have guess I have had a handful of adventures this past year. It was a year of moves and readjustments.

Last Christmas was a workday at Intel in Israel, but luckily it was also a Thursday which meant it was “Friday.” The work week in Israel is Sunday through Thursday and the weekend is Friday and Saturday. So Thursday after work I drove down to the Red Sea with a friend from India and we spent two days scuba diving in the clear blue waters. It was great. Over the next few months I explored more of the holy sites in Israel and also the outdoors. I spent a couple weekends hiking or backpacking including a two day trip across the Negev desert. I completed my temporary assignment and moved back to Oregon at the beginning of April.

The next four months seem like a blur now. When I returned I was assigned at Intel to perform stepping work on Westmere (a 32nm processor that has been demoed at various conferences and is expected to be released in 2010). I took two classes at Portland State to complete my last premedical requirements. I put my house up for sale and tried to spend as much time outdoors as possible. This included an amazing trip down to the Redwoods and Crater Lake along with pushing my body to the limit and vomiting my way through an Olympic Triathlon. For those wanting to get into triathlons here is some free advice: Do NOT drink the too much lake water during the swim, it will come back up later.

In August I moved to Des Moines, Iowa to begin medical school. I am a first year student at Des Moines University. DMU is a private health professional school with a medical school, podiatry school, physical therapy and physician assistant programs. For those of you who have heard stories about the lives of students at medical consisting of nothing but hour after hour spent in the library. I will vouch for their truth. Classes for me start at 8am and go till around noon. Afternoons are spent in labs or studying. Most days I do not leave school until after 10pm and most weekends are also spent with my nose in books memorizing page after page of material. This first semester was filled with biochemistry, histology and my favorite anatomy. Five of us were assigned a table and cadaver and spent the semester working our way through the body and all the structures. It is one thing to look at it in a book or a power point slide, it is an altogether different experience to slice away with a scalpel and then spend hours removing fat and connective tissue to find a particular artery or nerve.

While 99% of life at school has consisted of memorizing mountains of material the other 1% has included intramural sports, celebrating after tests, and ten minute ping pong breaks. For intramural sports I played both basketball and volleyball. I also managed to do some running completing a couple 5ks, and a 7 mile cross country race through streams and mud.

I feel extremely blessed to have been able to see and do so much this past year. I am really grateful for my opportunity to return to school and to challenge my mind in learning the ins and outs of the human body. It truly is a remarkable creation.

In other news a particularly pretty friend of mine has had the opportunity to share many of the above adventures including visits to Israel, the Redwoods, and Iowa. What will the future hold?

Semester one is done

Hallelujah! It is nice to have a couple week break. Medical school is quite the ride. Most days it begins around 8am till somewhere around 10pm spent attending lecture, lab, and studying. The last three weeks after Thanksgiving, we have had 6 tests. I've had to add a couple hours extra per day of study time and take away a couple hours of sleep. The only things I manage to do outside of school has been working out a few times a week. But I'm happy to report that first of all I've passed all my classes and secondly it really is a lot of fun. We are learning to much so fast. I just love how much of a work out my memory is getting put through.
In my "vast" amounts of free time I have managed to do a couple things outside of school. There is an annual 7 mile cross country race here in Des Moines. It is held each year at the Living History Farms which is a museum recreating farm life in the late 1800s on the plains of the Midwest. The race crosses all over their fields and includes 8 or 9 creek crossings. It was a muddy mess, I loved it! Many people get dressed up. I saw girls wearing wedding and prom dresses. People in suits, I saw Santa, Batman, Little Bo Peep. It is just a great event.
The other physical activities have been intramural basketball and volleyball. For basketball, I am on a team of first year podiatrists (DPM) students. I am the lone med student. Our team name was "Khoa Nation". He was our honorary coach for the season. Too bad we didn't win to many games. But it was good to get some exercise.
The other team was volleyball. Our volleyball was actually pretty good. My volleyball team consisted of six medical school students and two significant others of students. We had a good season and lost only one game only to fall in the first tournament game.
We have also had quite a bit of snow in Des Moines. They actually closed school one day. We received somewhere between 12-18 inches in a 24 hour period following by 30 mile an hour winds and really cold temperatures. The wind and fresh snow made it a white out like conditions. The temperature hovered around 0 degrees with a windchill of about -15 degrees Fahrenheit. As I mentioned school was closed one day and so I hopped on my bike (yeah I'm nuts) and rode a couple miles to a friends house where I dug them out from behind a drift. Then I spent some time playing in the snow, drinking hot chocolate and then rode back home. I only spent one hour studying that day. But playing outside was such a welcome rejuvenating break.
The other trip of the last month and a half was to Portland. Sandi invited me to Thanksgiving with her family and I flew out and enjoyed some wonderful turkey and ham. I actually don't have any pictures of Thanksgiving, but the day before Thanksgiving I called a couple of friends and we hiked up to Pittock Mansion in the dark for a great view of Portland and then went for dessert afterwords.
Mostly right now, I'm happy to have some time to catch up on everything not school related. So I better get to that.

Fall in Iowa

Hmm, it has been a couple months. What is life in medical school like?
It is every bit as time intesive as you could imagine. Weekdays, I have class from 8am till noon, followed by labs in the afternoon and then studying till around 10pm. I also spend most weekends studying. Everything goes by so fast. The days and weeks blur together and all I do is study, study, study. Medical school is not something conceptually difficult. The hard part is the volume of information. I would agree with this, I spend almost all my time trying to memorize information. Whether that be bones, muscles, chemical equations, or diseases. It just keeps coming.

I have quite a few classmates who have families. It seems particularly tough for them. One of my classmates often goes days without seeing his kids. He leaves to school before they get up in the morning and then is studying until after they are already asleep. During the week many only see their kids if there wives bring them in at lunch. It seems tough. I guess there are benefits to still being single.
That said, learning is really fun. The material is very interesting. Learning all the structures of the body is a long process, but very fun. Last month we did head and neck dissection on our cadavers. How many people can say that they have held a human brain? Then last week we removed the heart and lungs. Fascinating!

Do I do anything outside of school? Well, I'm still trying to keep in shape. I usually run twice a week and lift weigths twice a week. The school has a very nice gym that I'm happy to make use of to take a break from studying. I also play in both intramural volleyball and basketball leagues at the school. I ran a 5k at the beginning of the school year and then another one a couple weeks back. Afterwords, I even got to treat some people using OMM (osteopathic manual manipulation).
Earlier in the year I took off and did a night of backpacking in the Woodburn State Forest. Iowa is really green and the scenery was nice and very hilly. However after a few miles walking through the trees nothing really changes. You go up 50 or 100 ft, and then down, and then up and then down. There aren't any view points and you see forest in all directions. It would be very easy to get lost. It was a fun trip and good to get away from the studies for a day and a half.
One funny story of the last couple months. I hit a deer while riding my motorcycle home from school. It was around 11pm and sort of foggy. I was driving home on Grand Ave and there were a couple shapes crossing the road. In the fog I thought at first it was just a couple people walking across the road. I slowed down a little and then as I got closer I saw that they were deer. When they saw me, they turned around (they were already mostly across the road) and then ran back across to my side of the road. I was going about 40mph. I slammed on my breaks and was able to slow down to probably around 10-15mph and my back tire was skidding out and I knocked into one of the deer. I stayed up and so did the deer. I had so much adrenaline coursing my veins that it took several hours before I could get to sleep.
The other nice thing was Labor Day weekend. We only had one test the week following labor day, and so I took the weekend off from studying.
Sandi flew out from Portland for a visit and we went to Carthage and Nauvoo.
I guess Halloween was just last week too, I ended up in Iowa City carving pumpkins.