dong ([info]dongstyle_ltd) wrote,
@ 2006-11-15 21:33:00
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Current location:Melbourne, Australia
Current mood: chipper???
Entry tags:daily life, visual art

Time flies when you're having fun
Well, I kinda disappeared off the net for a while again...so much for doing a pic-a-day. Also, I'm running out of wasted paper (thanks to too many out-takes). But yeah, I might as well regale you a brief account of the exams anyway:

On Wednesday was the written HP exam, for which I vaguely remember saying something like I needed to study something about associative agnosia...but schizophrenia proved to be a more pressing issue as by the time I got around to it at about 0430, I realised it was a HUGE topic. And well it should be, as it is an area of major focus in neuropsychiatry (and thus one which I may be devoting much of my time to next year!) I was somewhat worried when I went to that exam as there were no past papers, but when I did go to the exam, it was, for the most part, straightforward (except I got caught out by one written question and a few of the multiple choice questions as they covered tutorial and not lecture material that I thought was coming up in the practical examination...) It must be said however that I seem to be the only medical student on campus that actually enjoys sitting HP examinations by virtue of liking the subject. Although I tend to do pretty poorly because of my shoddy examination technique...

Friday was the paper I had been dreading all exams. I was well past my endurance limits for a start (I still am now), and on Thursday I spent most of my time bludging around, failing to look at any anatomy whatsoever, watching an extract from some action movie- a fight between Tony Jaa and Lateef Crowder, and thus thinking maybe I could dig up some Rael-vs-Arael sparring crap. So that's what I did- or at least started. The character lineart was done in short order- by that evening, although I struggled with the perspective, as usual (working on it!) Then the next morning, weary and groggy eyed, I hauled my ass out of bed to sit that damn 3-hour written.

When I sat down, I remember having that sinking feeling and almost the accompanying drop-a-load-in-your-pants that I had last semester- some of those questions looked really difficult because...surprise surprise, I had not studied them! After getting over a massive case of diarrhea (which you did not want to know about), I then proceeded to try and nut out the examination, thinking that I was going to fail anyway and why would the 3 hours not pass any faster. By the end of the examination, I had actually surprised myself- from having my previous expectations almost completely shattered to actually maybe even meeting them. However, something dawned upon me immediately after- the exam was in fact an excellent reflection of what we would be expected to know were we to be well-rounded clinicians. "Random" questions, such as 20 (of 180) marks devoted to Trisomy 21 (Down's Syndrome), and significant portions to geriatrics, geriatric pharmacology, menopause and hormone-replacement therapy left much of the student cohort reeling as we belatedly found our examination technique woefully inadequate.

But it was in reflecting on the wording of the questions that it dawned on me that they were written such for a very good reason: "A 36 year old woman and her partner have just had a child after an uneventful pregnancy. However upon examination it is noted that the baby does not 'look normal' and tests reveal that the baby has Down's Syndrome. The couple have presented to you and as the doctor, they want you to answer the following questions."

Uhhhh, oookay...

"What causes Down's Syndrome?" (10 marks)

This is my cue to feel ashamed of myself. I don't know how to answer that question (not 10 marks' worth anyway) despite knowing that with the advent of the development of our understanding of genetics comes such things as screening and awareness of aneuploidies etc. This frankly made me feel somewhat disappointed in myself- not only had I failed to take advantage of the obviously more integrated format of the course which I had been hoping for as an opportunity to exercise my knowledge in a coherent manner such that exams would not require simple compartmentalisation and rote-learning that medical students in general habitually engage in, but I had also failed to appeciate the versatility and greater wisdom of the co-ordinators and lecturers. Ah well, I guess I learnt my lesson this time round- better late than never.

After that, I had several days which seem to have passed largely in a blur of unproductivity. I did some practice for my clinical exam on Tuesday- involving learning several physical examinations from the ophthamology to the minimental to the physical and neurological lower limb examination. As usual, I am rather nervous about that component but go perfectly well on the day (my examiner was so good as to tell me directly that I passed without problems...probably because I was taking too long deliberating over the question "a lesion at the root of S1 causes what deficits?" uhhhh S1 goes to the ankle right...?) Rather, it was the oral short-course that, as usual, I managed to screw-up.

Well I'm not even sure if I screwed it up. Previous semesters, I usually start fine then get worried about the time and start rushing through the signs and checklist, only to be told I should probably "just chat". This time, I'm presented with a garrulous elderly man (an actor) who has had a "stroke" 14 weeks ago, and presents for his scripts. Easy scenario- but a bit slow going as the man was a bit slow in the speech, and I was not sure just how comfortable he was with me (comfortable enough to start using expletives, at least.) Five minutes in, I had just finished picking up the cues about familial issues and was going to explore the possibility of depression when the 1 minute warning bell went. So it turned out that what I thought was five minutes was actually eight...fuck! I panicked and stumbled my way through summing up and was just wrapping up when the final bell went and my examiner said "okay, you're done, thank you" but I wasn't done yet! So I kept going and the examiner just kept repeating "thank you, you're done" and I stood up really too hastily and probably left the "patient" looking a bit bewildered as I was ushered out the door by the supervisors...argh!

If I read all that right, it meant business as usual: at least I didn't fail. But I wish for once that I'd actually *click* and come out feeling like it was more than just 'nine minutes of drill'...I suspect for that, I'd require a full 15-minute consult type exam.

After that shamble, I wandered around aimlessly following people around, eventually alighting in the pathology museum whereupon I...started drawing again, trying not to eavesdrop on the conversations beacuse I had NFI what anybody was talking about and going out to grab a drink. And that pretty much takes it up to this point, where I'm sitting on my ass way past my bedtime because there was nothing much to note from then till now, except, I guess, to say that with sex-scandals and suicide attempts being all the rage on the media as scrutiny kicks up a notch, the public has descended into the practice of what can only really be described as demagoguery. "Let me make this clear," some senator shouts in response to the Orkopulous affair- "if you are a pedophile, I am your enemy!" I doubt he even knew what the actual definition of a pedophile was. Were I in a bad mood (and were I not a pacifist), I would probably deck the next person whom I see saying "I find this a disgusting, morally vile act" because frankly, chances are they would be saying so to pander to the mob-mentality and thus feel good about themselves, without any actual reflection given on the matter. Other irritating news is since the election time comes round for the US, so too must it for Australia...and Beazley has taken the Labor helm again. Problems: John Howard really knows how to pull the ropes and bullshit his way through any election- his backpedalling on Kyoto and the carbon emissions trading proposal are plenty enough evidence of it this time, and hopefully this time the Greens will hold more sway as their criticism that this is a token gesture seem rather valid. And as for Beazley? Either he has no solid policy to speak of, or he really has a gift for saying not a whole lot "it's a simple choice. Either you choose Howard's unfair system, or you choose my fair one." They didn't dub him Australia's most ineffectual politician several years back for nothing. Beazley being a non-event wouldn't be such a problem if Howard weren't obviously eroding the pillars of democracy through his new industrial relations laws- basically the Commonwealth can override the state in matters of workplace policy, effectively silencing unions. It is up to the working class now to decide whether these policy changes will hurt them enough, or, as I suspect Howard is thinking, whether some cash-in-hand bait is enough of a decoy. I don't know how long he expects to keep on getting away with it, but I do not think, despite the mounting pressure from both Costello (poor bastard) and portions of the public, that he had any intention of retiring, and when he finally does so- it will be firmly against his will, given that he has been busy in the process of making himself dictator ever since the coalition gained majority in both houses.

Now, finally, I also did manage to finish that pic I mentioned earlier- so I'll blab on about that now:





First off, I'm testing this sparkly new VCL feature that I remember Ch'marr (the administrator) mentioned some time back before I even had an LJ...it's basically the beginnings of a cross-posting comments system. I just want to see what it looks like, since I do not think I'll be enjoying any "additional exposure" as such a system would probably bring- audience on both LJ and anywhere else is small, and I'm not sure whether I'd actually want people commenting on the journal through VCL or what, because, as you can see, I tack everything in the same place. Either way, it's a thumbnail so CLICKY THE LINKY THINGY (yay, I get hits) because the full size pic is pretty large- it has to be.

Anyway, so this is yet another Rael-vs-Arael sparring pic (well, I haven't posted many online, but I have a collection going.) These seem to share the following characteristic features: a) Rael is always on the back foot, b) they spar in a grassy clearing surrounded by fairly dense foilage, c) ...I can't think of a third feature, uhm, it's always a motion-filled pic? That'll do.

One reason I do not draw the half-dragon characters nearly as much as I used to (back when they were my ONLY characters) is because the wings are a real pain in the butt. However, since anthropomorphic characters aren't realistic by any stretch of the scientific imagination, I've become a little less anally retentive about it...and also I am getting a bit better at the anatomy as well as appreciating principles of motion. Since I was watching Lateef and Tony have at it, this scribble has a distinct capoeira influence. Rael is hitting the deck while Arael sweeps overhead in what would probably have been a triple 540 (outside cresent right, inside crescent left and finish with a jacknife). All very showy and stuff.

As a result of that, the background (which takes the most time as usual) is divided into two parts- as an exercise in framing. Rael's motion is vertical, whilst Arael's is more horizontal, or perhaps radial to some point below the bottom of the picture. Then there's the perspective from somewhere directly behind Rael's left foot. All in all, something I haven't tried before, and I'm not altogether displeased with how it turned out. The tint was the result of several hours of trying to fiddle with the settings in grayscale before giving up- I thought since I already tampered with the background digitally, why not that too.

A final side note- I decided to dispense with niceties and gave Rael a slightly anatomically correct touch- mercifully obscured by motion blur. However, I was not intending to do the same with Arael (I'm not referring to the breasts, although they look more appropriately placed for a moving body than previous attempts), but very sloppy penmanship did it for me. I couldn't be bothered correcting it as this page had too much white-out on it already and it was written on the back of my anatomy notes anyway. I mean, whatever!

Okay, now it is so far past my bedtime that I will have to set the alarm, lest I fail to wake up and miss my exam...which would prove most displeasing.

Dong, out.




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[info]chmarr
2006-11-15 05:16 pm UTC (link)
Hey Dong... thanks for trying out the comment link thing :) Nice technique in the drawing, too... great to see artists using methods other than the common :)

(Reply to this) (Thread)


[info]dongstyle_ltd
2006-11-16 12:24 am UTC (link)
Wow, thanks :D *temporarily lost for words*

Thanks also for taking the time to implement the comments system (as well as fixing the hit statistics)- I've been meaning to express appreciation on the forum but I seem to have a bit of a lingering issue with the account name and sign-in (I'll e-mail about it shortly).

(Reply to this) (Parent)(Thread)


[info]chmarr
2006-11-17 12:13 am UTC (link)
You're most welcome! :)

I still haven't received that mail. I'll find your account and instruct it to send you your password. If you don't get it then... well, just write to me at admin@vclart.net and I'll fix things for you.

(Reply to this) (Parent)


[info]indigo_the_cat
2006-11-15 10:04 pm UTC (link)
Thought I'd stop into Dong's World and say hello.

Those exams sounded pretty enduring. Though I think I could take a fair shot at explaining the Down's Syndrome question, relaying in particular that the older a women is when she gives birth, the easier it is for complications to arise (one of those complications is fraternal twins as well, as the ovaries are attempting to expell the remaining egg cells before menopause). Sometimes a family history of it will make it easier to occur as well. Trisomy 21 is actually the shortened definition of Down's Syndrome, meaning that when the DNA strand split inside the cells of the embryo, the 21st chromosome pair ended up splitting into a trio instead of a pair, thus resulting in the reason for 47 chromosomes, and affecting your child in the way it has.

Though I may not look it, I thoroughly enjoyed Biology (with special attention to heredity and pedigree), and probably should have taken the first semester of Advanced Biology in school instead of Advanced CP Chemistry, though I'm picking up in that class now. I was scared away from science majors because of my mathematics issues. (I'm not cutting out the possibility of a science major yet though!)

Anyways, it's been a few days since this entry was posted, so I hope all is going well. You usually know how to pull yourself out of a bind, and execute the pulling successfully.

I think in relation to that question, the hardest part is, what you have definitely noted, how to tell the couple in a way that they understand what happened. Obviously some people will have a lot of knowledge in the areas concerning what was going on, others may know only as much as how the baby was born in the first place. It's a matter of simplifying language and taking the ones involved through the process, just as teachers and or proffessors do when they first teach us.

If I remember correctly, you have told me yourself, that sometimes you find it hard to talk to others or to know how to communicate something. Though I don't think so, it comes with time and practice. Let's look at an example of working with a customer:

"Hello sir!" (greet friendly with volume, but not shouting, and slow enough with clarity to let the customer know that they can come to you at ease. You must speak in this manner throughout the entire conversation with the customer for the best understanding and optimum results)
"Hi, I have a problem..." (if the customer stops talking, let them know they may continue)
"What seems to be the trouble?" (facial expression and voice tone are key here)
"I want to buy this {item} but I have purchased these {items} here before, and everytime they have given me all sorts of trouble" (note the voice tone, accents, slurs, and word emphasis of the customer. Does he sound upset, concerned, worried? Is he making inferences that the store is lousy, the product the store holds is faulty, or that he has not been helped properly before?)

A simple example of what all customer serving employees are supposed to either be trained or know is not too much different from social strategizing and acting. You have to pay attention to all of those signs and details in order to know what is going on, what is being understood, and if the conversation is progressive or recessive. To talk to a patient or a companion of the patient is not totally opposite, it just presents a different situation. A person who has excellent skills in social behaviors will be able to adapt to most any situation and carry out the necessary business. Often times, it is the person that everyone likes that gets to the top, or the person that knows where correct application of social strategy can increase odds in their favor. (Both types of application are necessary in the executive business world.)

I realize I bounced into a new topic... heh.

Well, I'd better be finishin' up. Best of luck always!

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[info]dongstyle_ltd
2006-11-16 12:16 am UTC (link)
A few days since the entry was posted? I wrote it before I went to bed and I'm looking at it just 8 hours later...anyway. Other people had issues with trying to word the question due to its framing- me, I couldn't think of enough to say to even give myself the semblance of a bedside manner!

Yeah, the thing was I wrote pretty much all what you said for Down's Syndrome. Problem is that was probably worth maybe 3 or 4 marks...out of 10. But that's water under the bridge, provided I pass this next exam coming up in 20 minutes... *shifty eyes*

Also, thanks for those tips, but I'm perfectly well aware of aspects of communication skills- it's not like I'm ignorant or completely inept at them (you could see for yourself were that an option), and I believe I've detailed my strengths (body langauge) and weaknesses (speech and facial expression) in a previous post. The issue here mainly was time: trying to elicit facts about the presenting problem, drugs and medications, previous illnesses, lifestyle (diet, alcohol, smoking etc.), family history, living situation and relationships and other social issues, economic issues and patient's other and pressing concerns in the space of 7 minutes (9 minus one each for introduction and summing up). I just don't know how one can elicit all that in 7 minutes!!!

Right, now 15 minutes before I report in. I better toodle along quickly now.

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[info]lemurstew
2006-11-15 10:15 pm UTC (link)
Are you still in exams? They sound rough, so I thought I'd just give a thumbs up and "worry not too much," because as Star Wars ahs taught us, bad grammar can solve any difficulty.

As witht he above poster, I've actually leanred more about Trisomy 21 than many disorders, as while in biology I was more interested in genetics than most of the other sections.

I have no idea what S1 even refers to, however.

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[info]dongstyle_ltd
2006-11-16 12:18 am UTC (link)
13 minutes till I report in now for my last one :D Bad grammar ain't solving any tricky multiple-choice question though :P

Genetics is really where a huge proportion of medicine is at- whatever field you want to go to. S1 refers to the first spinal root of the sacral spine- i.e. the lowest part of your spine that starts below the small of your back.

I should probably head off now... c..c

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[info]lemurstew
2006-11-16 02:03 am UTC (link)
Well, it's a little late but best of luck. I mean, mutliple choice, if you gat -that- stuck just answer C the whole time *winks* I'm sure you did quite well.

So S1 it the first bit of the sacral spine then? That being the highest spinal root yes? I know C1 and the rest refer to the first..root or vertebra or whatever it is the chiropractor is poking about at.

And Genetics is just fascinating.

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