"I See All Leads"

Well it appears that I am now (successfully) three quarters through my first year in medical school. Block III Physiology is complete, and I'm assuming Dr. Goy will find it in his heart to pass me. Summer work is all set up. Trips to Peru, Vegas, and Scandinavia are booked for the Spring/Summer, and the 5 Star Nerve DVD is well on its way to completion. But as most of my extracurricular activities are winding down, EMS is winding back up again. This past Wednesday was my first shift with the Parkwood Volunteer Fire Department: my attempt to start applying the knowledge I'm acquiring in the classroom back into the real world. Of course I couldn't wait until 3rd year; I'm way too impatient for that. And I wasn't disappointed. My first shift back got me excited about medicine again.

After undergrad, I had some choices to make. I was offered a couple positions in labs here at UNC, perhaps with some opportunities to get my name on a paper while I southern blotted, gas chromatographied, and watched centrifuges spin heterogeneous mixtures; or, I could put my EMT-Basic certification to use. Of course I chose the faster life of the latter (impatience is a virtue). If I were going to take a year off, I was going to at least enjoy what I was doing, and so I started volunteering for Cary EMS that summer. The difficulty was, pre-meds are frowned upon in the EMS world. This is somewhat of a generalization, but many career EMSers I've met have a negative disposition toward those who might be "using" this work to get into med school. For me, riding the ambulance was something that I wanted to do for a long time. I didn't want to use the system; I wanted to learn from it. So, I didn't mention applying to med schools, and the difference? Medics were more willing to teach, and more willing to let me get experience on my own. Like I said, this is a generalization, but it is an attitude I've encountered in the counties where I've shadowed and volunteered.

As a med student, I'm in a much different situation. Now that I'm back, the only reason for my continued volunteering is for my own edification. I'm already in school, so my motives can’t be misinterpreted. Since physicians and the providers who work in pre-hospital care don't always get along, the medics I work with can either be cynical, or they can help shape my education, teaching me what they think I should know, not only about medicine, but about the whole emergency process. And that's exactly what I got on Wednesday; it was awesome. I ended up working with a medic who loves cardiology. First call we went on was an 85 year old hypovolemic patient in atrial fibrillation. After the call, we spent 2-3 hours talking about how to interpret an EKG, how to read the V-leads, the steps taken to make a STEMI diagnosis, and why I need to know a ton of cardio to be an ER doc. After learning some basic cardiology earlier this Block, some things just clicked after reviewing the material and applying it in a meaningful way. The more calls I run, the more I go back and review physiology. Why do you put a COPD patient on CPAP? What are the code drugs? Which ones do you use for different code rhythms and why? Goodbye Molecules to Cells; hello real world.

So it's great to be back. On Monday I start Community Week back at the pediatric practice in Boone, and then it’s off to Peru bright and early next Saturday morning. April 1st is the debut of 5 Star Nerve. April 8th is my first bachelor's party for JVA in Vegas.

Life is good.