"Most peter treatment that Jenny saw was done to soldiers."

-The World According to Garp, John Irving
This weekend was amazing. Friday night was homecoming, the bonfire was so great and enormous. I got to watch it in the presence of great people with whom I could laugh, hug and share body heat. Special thanks to Quynh, David and Nick haha. Then we went to Dewey Lot and hopped on a yellow school bus. We went to the Coolidge Hotel in WRJ. Good job distributing bracelets, Julia and Chris :)

The red wine was tasty and the DJ was awesome. I had a lot of fun dancing around - the sillier, the better. At midnight, we hopped back on the bus and I hung out at Nick's with the host, Ashley, Quynh and Jo Ling. It was awesome to sit around and talk about nothing in particular but have an amazing time. There was a cameo by Dan, which was stellar. Then at 2 am, Quynh drove me home before we met up again in the morning to the NP tailgating party. (Sadly, Dartmouth lost to Harvard). I had a veggie burger with an assortment of chips and carrots. Yum. I went to the library with Keith and eventually Chris. We got through a lot of interesting things - medical school related and not. Then my roommates convinced me to go out with then and we went to the Canoe Club. Wesley and Robert bought me a Allagash White beer each, and my verdict is that it is gingery and delicious.

This morning, I went with Wes to Price Chopper and bought ingredients to bake a pumpkin pie. It turned out spectacularly. If you ever find yourself in face of a watery batter, have no fear - it still comes out super wonderfully. Then tonight, we had our final dance lesson at our professor's house. Next week is our pseudo-semi-formal :) I just came back from the gym with a better mentality and an optimism for the week. Every day is a new day, as Emily wisely told me.
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"The U.S. Army would not begin to benefit from the discovery of penicillin until 1943, and there were many soldiers who didn't get penicillin until 1945. At Boston Mercy, in the early days of 1942, peters were usually treated with sulfa and arsenic."

"Few jokes were funny to Jenny Fields, and certainly not this one; no peter jokes for Jenny, who was staying clear of the issue."

-The World According to Garp, John Irving

"me:  what are your thoughts?

you could be be the cookie monster

or oscar the grouch

or snooki

 David:  Snooki is like #2 this yr

I should be the guy that punched snooki in the face. Then I can punch all the snookies!"

I loved the start of today. I wore my black sweater and peach skirt to fit in today's Friday theme of wearing black and orange for Halloween. Drs. Fab, V.Lyons, J.Lyons, and Catlin threw candy at us and we got so excited haha. I kind of love the homelessness that is medical school. As I walked down the aisle, I got a big hug from Nick, which always makes me feel better. We took a class picture of those who participated. Then in lab, Bijan, Dan, Quynh and I were pretty efficient and found everything we needed. Dr. J.Lyons came over after Dan and I high fived each other and wanted to participate. To see such a highly esteemed physician who used to be the head of surgery at Mass Gen high-five and pound us made my ENTIRE MONTH. I taught him how to pound and explode out - he lit up, which makes me light up. Dr. V.Lyons quizzed us and collectively, we knew all of the organs and fossas and ligaments in the pelvic cavity. Thank you Dan for saving us with naming the detrusor muscle (the smooth muscle in the bladder), I won't be forgetting that one anytime soon.

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"She had seen the trouble peters could get into; babies were not the worst of it. Of course she saw people who didn't want to have babies, and they were sad that they were pregnant; they shouldn't have to have babies, Jenny thought--though she mainly felt sorry for the babies who were born. She saw people who wanted to have their babies, too, and they made her want to have one. One day, Jenny Fields though, she would like to have a baby--just one. But the trouble was that she wanted as little to do with a peter as possible, and nothing whatsoever to with a man."

"'Hospital! Hospital!' he cried."

-The World According to Garp, John Irving

I like days like these. I slept for 11 hours last night. I had felt sleepy and unproductive so I wanted to nap at 8 pm. I never woke up, and I slept through the night until 7 am this morning. I think it was needed. Sometimes I feel like I have been completely sleep deprived with a sheet of tiredness blurring everything I have to do - very much like the Claritin commercials. I felt clearer this morning, like I could sit through lectures, I wanted to talk to people and I felt like the day was something to soak up - rather than to just get through. The ob/gyn who came to talk to us during our core luncheon was amazing. I felt like all her "shortcomings" whether they were her empathy, perfectionist tendencies, or priority of family, were my own and I felt validated in having them. It's just a matter of finding a setting and people that will be opened to them. After class, Keith and I went Halloween shopping. It was a long road, but I think we managed to find some things that work. I had some chats with Emily, Meera, and Savita, which were needed - fyi guys, "Home is whenever I'm with you" and I think that will always be the case. Then Quynh came over for dinner and we talked about a lot of things, and I feel really good to connect to someone so well. It's nice to feel affirmed in a safe space. Above and below are pictures from Occum Pond, poor Paul - I made him point his finger and stay in that position because he had been pointing out the DOC house. I thought it looked adventurous in new terrains or something...

I love autumn.

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"'The Peter Bent?' the cabby asked. That was the closest hospital. 'It's worse than bent,' the man moaned. 'I think Molly bit it off!'"

"And another hospital was the Peter Bent Brigham, which was called the Peter Bent."

-The World According to Garp, John Irving

I love days when:
your hair falls just the way you want it to.
the sun is shining.
you can help someone out.
someone helps you out.
someone tells you something new you didn't know before.
there are no pimples on your face.
you can sit with someone and talk about anything for hours.
the pressure to excel isn't too great.
when people know what you're feeling and can be there for you accordingly (I appreciate you, Jess and Quynh).
you have a moment where everything comes together.
you can reason things out.
someone waits for you.
you get a hug for no reason.
people show or tell you they care.
the person you need to talk to most picks up the phone.

...and I like remembering that there will be days like those again when I'm not feeling the like I'm having one of those days.

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"One day, the joke goes, a Boston cab driver had his taxi hailed by a man who staggered off the curb toward him, almost dropping to his knees in the street. The man was purple in the face with pain; he was either strangling or holding his breath, so that talking was clearly difficult for him, and the cabby opened the door and helped him inside, where the man lay face down on the floor alongside the back seat, tucking his knees up to his chest."

"'My mother,' Garp wrote, 'was not one for making fine distinctions.'"

-The World According to Garp, John Irving

My preceptor is a family medicine doctor. On the daily, she sees patients with things ranging from scabies, annual physicals, and pain. I always feel like the last is tricky because you do not know if you are prescribing opiates to treat pain or to feed an addiction. My preceptor said that you have to trust your instinct and figure out whether you can rely on the information given to you by your patient. You can get burned. She has, but you have to do what you can to treat your patients, who may very well be confiding in you their pain and suffering.

Since I have to learn it, so should you. Bruits: turbulent blood flow causes vibration in blood vessels producing sound. Left ventricular pressure rises as left ventricle contracts and when LVP rises LAP, mitral valve closes. The S1 sound (lower pitched) is mitral valve closing and S2 (higher pitched) is aortic valve closing, aortic pressure rise distinguish sounds. Sternal Angle (of Louie) is continuous with second rib. The intercostal space on the right side is aortic area, left side is pulmonic area. The 3rd and 4th are known as tricuspid area or right ventricular area. Apex of heart is felt for apical impulse in 5th intercostal space. The base of heart is the pulmonic area and aortic area.

Palpation
Pulmonic Area: hypertension
Aortic: stenosis
Sternum: RV hypertrophy
Precordium (chest wall in front of heart): Apical impulse to palpate in intercostal spaces to feel it.

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"One striking difference she might have seen between clams and people was that people had some sense of humor, but Jenny was not inclined toward humor. There was a popular joke among the nurses in Boston at that time, but it was not funny to Jenny Fields. The joke involved one of the other hospitals in Boston. The hospital Jenny worked in was Boston Mercy Hospital, which was called Boston Mercy; there was also Massachusetts General Hospital, which was called the Mass General."

"Jenny asked for a book about clams."

-The World According to Garp, John Irving

It's funny how things can work out. What seemingly seems obtainable can fall short and lie just beyond the tips of our fingers. I have gotten comfortable in my situation, which is pretty bad considering there are factors beyond the realm of DMS that dictate a lot more than I can control.

For now, all I feel I can do is quote:
"Love life, and life will love you back."
-Arthur Rubinstein

I had a plan today: to study, to work out, and to eat. I woke up at 8 and studied a bit but not long after, I fell asleep for two hours reading physiology notes. Waking up at 1 pm, I just decided the time spent napping replaced the time that I would have spent sweating it out. I made rice, broccoli and a vegetable burger patty from Boca's with sun-dried tomato Gouda cheese. Then studying some more, I got through a lot of what I wanted. I am so tired... I'd like to say it is a visceral pain radiating throughout my head and body. It is dull and unlocalized. It is hard to explain, except I'd much rather go to sleep than learn about signaling pathways and the anatomical structure of the kidney. I even did my laundry as a form of procrastination.

The weather gets me down when it rains. I feel pressure weighing heavily on my body, and it feels like a burden. Maybe it's the barometric pressure. Maybe it's the impending quizzes tomorrow. Maybe it's all in my head. I suppose you can't fully appreciate the sun without days like these.

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"She read all about them: how they ate, how they bred, how they grew. It was the first live thing she understood completely--its life, its sex, its death. At Dog's Head Harbor, human beings were not that accessible. In the hospital, Jenny Fields felt she was making up for last time; she was discovering that people weren't much more mysterious, or much more attractive, than clams."

"The most mysterious thing she had been allowed to investigate on her own, when Jenny was a child, had been the cellar and the great pottery crock which every Monday was filled with clams."

-The World According to Garp, John Irving
today i woke up at 10:30 am. it was amazing to have so much sleep after a hard week. i reheated my spicy black bean burger with avocado and roasted red peppers for brunch. i helped mette clean up from the party and collected many bottles for beth's homemade beer. then i reheated the fries and bread at 350 degrees for seven minutes. they were wonderful with ketchup. i tried to study but daft punk was playing too loudly so i studied at baker berry with keith until we went to the gym. pretty productive i would say - though the couches are too comfy. i curled up in my one-sy and studied biochem and physio. will i ever fully understand? i just can never be too sure. then i was driven home, but not before we took a minute to fully appreciate the full moon.
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"Jenny's mother sprinkled cornmeal on the clams at night, and every morning they were rinsed in fresh sea water from a long pipe that ran into the basement from the sea itself. By the weekend the clams were fat and free of sand, they were growing too big for their shells, and their great, obscene necks lolled on the salt water. Jenny would help the cook sort through them on Fridays; the dead ones did not retract their necks when touched."