You Know Finals Are Near When...

1. You sleep through your alarm and in your haste to get out the door on time, you put your shirt on backwards and don't realize it until after lunch. (That was last Friday).
2. You sleep through your alarm again on Monday, even after sleeping in all weekend (perhaps because you are so used to getting up at 6 am that you don't ever sleep past 8 am even on weekends).
3. You have no milk so you have your granola cereal with water (Monday and Tuesday).
4. You eat all the buffalo stew you made and start in on the frozen dinners (Wednesday).
5. You forget/mis-remember a good friend's birthday (sorry!)
6. You don't understand your own cryptic notes. I looked at something I had scribbled in the margins during a case presentation-- LR6SO4-- and could not figure out what it referred to. It had once made perfect sense to me, so much so that I wondered why our ophthalmology professor had said it was the last thing her resident said to her before walking out the door to take his boards. I remember thinking it was so obvious that no one would ever need a mnemonic to remember it. After much searching, it stands for the extraocular muscle innervation. Cranial nerve VI (abducens nerve) innervates the lateral rectus and retractor bulbi. Cranial nerve IV (trochlear nerve) innervates the dorsal oblique (superior oblique). Cranial nerve III (oculomotor nerve) does everything else. And so LR6 stands for lateral rectus muscle cranial nerve VI, SO4 for superior (dorsal) oblique muscle cranial nerve IV. All this to help me try to remember on tomorrow's test that abnormal deviation in the position of the globe of the eye can look like ventrolateral strabismus (lesion involving oculomotor CN III), medial strabismus (lesion involving abducens CN VI) or rotation of the globe (trochlear CN IV), which can be difficult to see if the pupil is round because the deviation in the position of an elongated, ellipsoid pupil is the easiest way to assess whether the glove of the eye is rotated (otherwise one is forced to look at the position of the retinal blood vessels on the back of the eye, the fundus). All that just for the eyes! And cranial nerves are just a small part of a neurological exam, there is so much more to the nervous system and so much more to just a basic physical exam (especially when one considers species ranging from chickens to alpacas to cows)!
   

Pre-Exam Drudgery

I've been studying since noon, it is now past 5 pm. I'm about to eat dinner and then head into school to meet up with a classmate to study for a few more hours.

I'm tired of studying. On the up side, I got to spend the afternoon at home curled up with my cats.

On the down side, I have a stack of flashcards a foot thick.

I'm busy re-learning all my large animal terminology that I once memorized for tech school and then forgot. Wether is a castrated adult male goat. Farrowing is when a pig gives birth. Etc.

I'm also reviewing all my histology. From Peyer's patches in the ileum to arcuate arteries in the kidney.

Last night I did get a bit of a break. Where was I last night? On the necropsy floor. I like necropsy. It's interesting. It's also a break from spending every evening studying.

Back to the grindstone.

My first exam is Friday. I then have exams the following Monday, Tuesday, Wednesday and Thursday.

There are moments when it is grey and rainy and I have been studying all day when I wonder why I didn't choose to go to a vet school in a warm, sunny location. Or a vet school that gives multiple choice exams (seems like they all do except for Cornell).

Instead I am about to experience one of the most grueling and infamous exam periods of any vet school in the country.

Addendum: My favorite word of the evening-- 'British term for a yearling sheep of either sex.' You guessed correctly if you guessed HOGGET. Uh huh.

Picture Perfect Weekend

We had lovely weather this weekend-- warm and sunny. I was studying most of the time but did get outside to go to the farmers' market and for a run. Above is me last weekend at the farmers' market with my friend FishVet, also from California, who is going to be a fish veterinarian (you guessed it).

Below is my house and another view from my window.


One week till finals. I'm trying to remember everything I learned. My favorite today-- when asked to name the specific area of the superficial leaf of the greater omentum where the short gastric arteries run from the spleen to stomach and I was able to say, gastrosplenic ligament. There is also apparently a duodenocolic fold or ligament. Who knew?

I've been enjoying cooking with my crock pot. It's perfect for my busy schedule. After doing a buffalo stew last week I am preparing to do a lamb with green tomatoes stew this week.

Fall In Ithaca

Above: The view behind me as I pulled out of my driveway at 6:30 am Friday morning to go to school.

Below: The view driving up my road to come home from school Friday afternoon.



Above: The view looking down from the road onto my favorite running trail's entrance taken this afternoon (Saturday) on a study break when I went for a run.

Below: The view running back towards the trailhead at the end of my run.


Below: Me at the trailhead with a German shepherd belonging to a hiker entering the trail-- for the entirety of my run I was the only person on the trail!




Above: The view out my bedroom window behind my desk of the fiery orange leaves of a tree in fall.

Below: Simon and Lindy curled up on my bed.

Week 9: First Patient, First Snow

I spent the afternoon practicing physical exams on horses. I was mostly listening to gut sounds, but here it appears I am ausculting the heart or lung sounds (or both!)

Last night I had the opportunity to be a student clinician at the low-income veterinary clinic run by Cornell for the first time.

Today it snowed for the first time.

I'm tired. I miss the sun and warmth of California.

I am busy learning all the muscles, nerves and vessels of the limbs.

12 more days till my first final!

Week 8: Back In The Saddle Again

Above: Me in my bovine abdomen lab today. One of my professors commented that I must enjoy the hands-on labs because I smile so much during them. It's true. Like he said, I like getting to actually touch the animals. I miss working. I miss putting my hands on a patient. I know I picked the right career because I am happier doing it than studying!

I'm in the middle of week 8 and it's back to the frenetic pace of the first semester of vet school after a luxurious long weekend.

So what have I been up to lately?

• New York State Veterinary Conference-- I went to a session geared towards students and learned some of the pluses of being in a small, rural practice and of owning one's own business, both of which I hadn't given serious thought before.

• I also attended a fabulous talk by Dr. Bonnie Campbell, DACVS who spoke on the "Amazing Omentum." The omentum facilitates hemostasis, releases angiogenic factors (new vessels invade omentalized tissues within six hours), releases neurotropic factors that promote re-innervation and help modulate pain (algolytic products), is involved in immune surveillance and can absorb fluid via peritoneal lymphatic drainage (thereby acting as a physiological drain). To take advantage of all these amazing properties, one can increase the size of the omentum by releasing the ventral leaf from where it attaches to the greater curvature of the stomach or one can reflect the omentum cranioventrally and release the dorsal leaf from the dorsal body wall. To further elongate the omentum one can make an L shaped incision in it. One then places the omentum over the desired site or you can even tack it in place. One can tunnel omentum through subcutaneous fat to non-healing axillary wounds. One can even omentalize the brain and spinal cord. Pretty darn cool.

• I helped paint part of the OTS house as my pledge promise. Friday is my initiation. All I know is that I am supposed to wear coveralls. Only in a veterinary fraternity does one have to wear coveralls to events.

• I went to the farmer's market and bought a ton of vegetables and made a vegetable stew kind of like the ones I enjoyed so much in San Jose last fall. I got to test my brand new crockpot, which is great because I don't have to pay any attention to the stew while it is cooking (I've been a bit of a space cadet in the kitchen lately and that has posed something of a fire hazard).

• I enjoyed the cat-dog interactions in my house, watched the cats and studied while the cats and dogs watched me and the whiteboard I draw on intently.

• I tried to get outside and enjoy some of the good weather that we had on Saturday.

• I got a flu nasal spray in an effort to try to avoid the seasonal flu this year (the H1N1 flu vaccine is not yet available).

• I caught up on sleep.

• I got in some nice runs on nearby trails.
  

Bovine Fundic Exam And End Of Week 7

You might get the idea from looking at these photos that examining the eye of a cow is not easy. Well, that's not true. I'm just a novice though. And direct ophthalmoscopy (which I am practicing here) is much harder at first than indirect ophthalmoscopy but apparently indirect ophthalmoscopy is not frequently used on cows.

I was able to see the blood vessels on my fundic exam but a little disappointed that despite several attempts I could not visualize the optic disc and white stringy thing coming up from it whose name I forget but which is an embryonic remnant of the vessel that fed the lens I think.

In other news, I finally got my midterm back and so have a feel for how I am doing in the course, which is just fine, and so am much relieved. Up until yesterday, professors kept asking me, 'So how do you feel you are doing?' and I would say, 'I honestly don't know. I'm lost in the abdomen' (which is what we are currently studying). What I really felt like saying was, 'Isn't it your job to tell me how I am doing?!' I mean, after all, for most of my academic career I got frequent evaluations. But Cornell does not believe in that. Exams are few and far between. There are lots of thought provoking questions in class and in the worksheets in the Modular Resource Center but never any answers. We are supposed to learn to decide for ourselves how we are doing and to evaluate for ourselves the level of detail to which we must delve in order to be good clinicians. Needless to say I find this quite challenging (euphemism for frustrating).

This afternoon I got my first chance at ultrasound, on a dog abdomen. I LOVED IT! After all these years of watching ultrasonography, I had a feel for what I was doing and was able to quickly find all the structures that the radiologist asked me to look for (quite rewarding) though I wanted to hunt for the pancreas, unfortunately others wanted a turn and I had to let that go.

Now it is back to the books. I have a short break this weekend and I will probably spend most of it studying as the weather has now really turned cold (New Yorkers of course laugh when they hear me say that as they consider this 'early fall' weather). I am going to look into finding a swimming pool I can use, that is my next project outside the classroom.