Luckily, our anatomy lecture that afternoon was given by an incredibly entertaining radiologist that bribed us with candy (that never stops working, apparently). The talk was on the basics of reading x-rays and CTs, specifically in the thorax, as that's all the anatomy we are expected to know so far. One of our first exercises was to try to identify a structure from the three cross-sectional images below.
We tried to apply the skills we had just learned to make educated guesses. Looks like a tube. White is dense material; black is air. Deformed bone? Nope. Calcified vessel of some sort? Wouldn't be that thick... Messed-up kidney? Is "messed-up" a medical term?
I'll let you think about it. Clue: you all know this structure. Click here to see the answer.
We also discussed the common pathological findings of the anterior mediastinum, which are remembered by the dumbest mnemonic ever: the 4 Ts. These are thymoma, teratoma, thyroid, and terrible lymphoma. Does that last one seem like a bit of a stretch to you, too? Here the professor asked our class of ~200 to raise their hands if they knew someone who had had the most common lymphoma: Hodgkin's. (I raised my hand along with probably a quarter of the class). She then asked us to keep our hands up if they were immediate family. At this point I gesture to her that I had in fact had it myself. You could tell she was stoked that I was there to make her point.
Dr. R: What's your name?
Me: Christopher
Dr. R: I don't want to violate HIPAA [class chuckles], so how about you share with the class.
[passes me the mic]
Me: Actually, I had Hodgkin's lymphoma.
Dr. R: And how are you doing?
Me: Pretty good.
Dr. R (to class): He looks pretty good to me.
Dr. R (to me): Would you call lymphoma "terrible?" [I tentatively shake my head] I mean I'm sure it wasn't fun and you probably called it many nasty things, but you survived, yes? [I nod]
Dr. R (to class): You see? Lymphoma, as far as cancers go, is very treatable and almost never terrible. This is why I hate that mnemonic.
Dr. R (to me): Here, take some candy and pass it down your row.
So cancer perk #56: Get's you candy for sharing in class!
After this we had smaller group sessions to go over the radiology. Our group was taught by the chief radiology resident from Westchester Medical Center, who was very nice and down to earth.
Then it was off to the grass in front of the pediatric trauma helipad for the first flag-football games of the season! The medical, public health, and physical therapy students field over a dozen teams each year for a weekly co-rec flag-football league.I helped ref the first game with one of my roommates (please always be nice to volunteer refs in any sport) then took the field with people who I had mostly just met to battle it out. After a promising 12-12 halftime score, the other team got on a streak and eventually won 42-12. The game was not as lopsided as it would appear though, because any goal scored by a girl is double points and their girls were quite good. Lots of fun and a good study break.
My roommates and I made it back to the apartment at around 8. It was here that my day took a turn for the worse and I only have myself to blame. I (being stupid) decided to sign up as a scribe for the school's student run lecture transcription service. We type out notes from recorded audio tracks and are paid for our time. The only problem with this plan is that I can't type quickly - at all. It took me 6 hours to type and format a 35 minute lecture. Never again.
Today, we had another clinical skills session where we learned more of how to do a physical exam. To be clear, all we're really learning at the moment is how to look like we know how to do a physical exam. For instance, today we learned how to palpate (touch), percuss (tap), and auscultate (listen to) the neck, chest and back. Theoretically, this would enable us to examine the lungs and heart, but as we have no idea what normal or abnormal sounds like yet, we're really just playing doctor - albeit very accurately. A common, if disconcerting, motto for clinical learning is "Fake it 'til you make it."
In the afternoon, we had our last anatomy lab before our first test on Monday (both a written and practical). It turns out that our cadaver continues to be the best body in the room. Our person's heart had an interesting and surprisingly common birth defect, a patent foramen ovale. This is when there is a hole between the right and left atria of the heart. During fetal development, this shunt allows the oxygenated blood from the umbilical cord to skip the developing lungs and perfuse the rest of the growing body. Usually the shunt closes after birth, but in 30% of people a small hole persists into adulthood. As long as it's small enough not to dramatically affect the heart's circulation, the person would likely never even know until someone listens with a stethoscope (like we did this morning!) and hears the associated murmur (unlike we did this morning...).
TIL: A flail chest is when 3 or more ribs on one side of the chest are each broken in two or more places. This causes a portion of the chest to move in paradoxical motion. (Warning: The video is... unsettling)
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