Starting a new life...ROTATIONS!

So, you can only imagine how busy second year was judging by the number of posts that I have written..haha. That is about to change! Update in life...I PASSED BOARDSSSSSSSSSS (and am very satisfied with my score), and I've recently started my third year rotations and am loving every (...most) moment of it. I just finished my Neurology rotation, and just started my Psychiatry rotation today. Since I'm a month behind on my documenting, I'm going to try and do a bit of psych and neuro in each post.

I'll start off with my first day at psych since its fresh in my head. I'm currently on inpatient and got to see some super crazy (pun intended hehe) stuff today. But more important than that were the lessons I learned. I'll describe two, of many more to come, real briefly.

First was on countertransference. So what is it, you ask? Medically, its having a preconceived judgement of how a patient is going to act based on people or experiences that you are reminded of while interacting with that patient. For example, Billy bob a new patient that I met with today reminded me of Jackie, a noncompliant patient from years ago, and so my behavior towards Billy bob will be change and I assume that Billy bob will also be noncompliant without actual evidence from Billy bob himself. Believe it or not, countertransference is actually very common in doctors. My attending today emphasized heavily that the act of countertransference is not bad, however, it can easily crossover and become harmful if it goes unrecognized and starts getting in the way of doing your job.

The second lesson I learned was not really a lesson; it was more of an analogy: revenge and forgiveness. Revenge is like going to McDonalds and eating a huge meal that satisfies you only for a few hours. Forgiveness is like eating balanced and healthy meal throughout the day, that will keep you full and satisfied for years to come. Random? Yes, but lets just say it was medically related in that it involved the topic of physical abuse.

Enough of my psych lessons of the day. Lets talk Neurology! First and foremost...I MISS IT SOOO MUCCCHHHHH! I cannot get over how fortunate I was to have started off with such a wonderful rotation with wonderful residents and attendings. I went in with alot of interest because I have loved neurology since undergrad. The nervous system is such a vital part of your body and the fact that it controls every single thing that we do [from blinking to biking] just amazes me!

So, I want to briefly touch on a research topics that I had to look up and present on: Cortical spreading depression. Yeah, I hadn't heard of it either. Its defined as a self-propagating wave of depolarization (activation) of brain cells (neurons and glia) that spreads from the back of our brains (occipital region) towards the cerebral cortices. So...it doesnt seem that bad, right? WRONG. It is actually thought to play an important role in pain and auras of migraines. Pain is a result of the depolarization activating trigeminovascular neurons which in turn induces nociceptors (pain receptors) in the overlying meninges (coverings of our brain). In addition, auras are also thought to be related to cortical spreading depression.

For further information, check out: http://www.springerlink.com/content/q2882h12343u37q8/

That's all folks!