Goodbye, med school notes ... or not!

In preparation for my move across town, I decided that I really needed to get rid of the stacks of medical school notes and journals that crowd my closet and overflow throughout our apartment.

Starting with my notes, I figured it would be easy as I haven't looked at most of those binders for the two years since I have been in the classroom. The information in them is easy to look up in any medical textbook (or with a quick Google or wikipedia search). The first binder was Pathology, and as I pulled out the pages, my hand hesitated to toss them into the recycling bin. Pathology was one of my favorite classes, the one I first learned about most disease mechanisms. Surely, this was the very foundation of my medical knowledge, and when I get confused about the different types of leukemias, there's nowhere else I would rather look. So, I put Pathology back on the shelf.

One by one, I went through the binders, and I was only able to throw out a few subjects. Some I never liked or found much use for beyond basic concepts, such as biochemistry and neurosciences. Others covered specific disease management, which changes every week with the publication of hundreds of medical journals. Looking through those pages, I was surprised to see how much is already outdated.

The journals were next. I had earlier made it a goal to read a journal a day for the last two months, but I realized that wasn't enough. I had at least two years worth of two weekly journals that my husband tries to keep in a few neat piles behind various living room furniture. He pointedly asked a few weeks ago if they were coming with us, and I assured him that they absolutely would not. However, I didn't just want to toss them. Not only had I paid for these subscriptions (albeit at drastically reduced student prices) but I also actually want to read them. They're good journals with great management-changing articles and illustrations, but during medical school, I just couldn't keep up for various reasons. So, I came to terms that I would never read these journals cover to cover and started tearing out articles.

All the medical knowledge I want to take with me is in a pile of 3-inch ring binders and a 3-inch pile of articles. Everything else is overflowing my apartment building's recycling bin. As I become more confident in my knowledge over the years, maybe I will feel comfortable tossing the rest, but I feel better just knowing that I still have with me those eagerly scribbled, multi-colored explanations that served as the foundation of my medical learning.

trying not to become stupid

it might be too late! maybe all that i've learned in medical school has already leaked out of my brain! is taking care of patients like riding a bike? even if you don't do it for a while, does it comes back?

well, i hope that's true. i'm not very good at riding a bike. i never learned as a child, but i bought a huffy at toys 'r' us after college. my husband has been giving me lessons every summer for the last four years, but i still have trouble turning right. each year, i start unsure of myself and sometimes have an incident before i become comfortable on two wheels again. early in the biking season one year, i rode into someone sitting on a bench! (that's a long story.) anyway, the point is that even my rather poor biking skills come back pretty quickly ... but not instantaneously.

i hope i don't get out of practice with seeing patients. i wouldn't want to be the patient equivalent to that guy on the bench. for my daily bus rides, i carry three reading materials in my bag--Dr. Lilly's Pathophysiology of Heart Disease, the New England Journal of Medicine from April 2006 with an article about trans fats, and a pleasure reading book. i'm sad to say that i've read three books for pleasure in the last month, and the poor journal and textbook have not yet been opened. i even read the free daily newspapers left on the bus rather that crack open the textbook weighing down my bag.

there are two reasons i can come up with why i shouldn't be sad about reading books for pleasure.

1. it's good for me. a physician i used to work for encouraged me to read non-medical books. he told me i would be a better doctor if i was more well-rounded, so he gave me a harry potter book as a going away present. i'm also not much of a sports fan, but i try to keep up with the sports headlines because it's something my patients are very interested in.


2. somehow everything comes back to medicine. i'm currently reading Malcolm Gladwell's The Tipping Point: How Little Things Can Make a Big Difference. i thought it would be more about sales psychology. it is, but the first chapter discusses reasons behind a syphillis outbreak in baltimore in the mid-1990's. the debate about healthcare--who gets it, how they get it, and who pays for it--is ongoing; it's inescapable in today's world. sounds like a topic for a future post!

i'm a goal-oriented person. it's hard for me to accomplish anything without a to-do list. so, here it is:

1. flip through one journal a day. i have a year's worth of NEJM's and JAMA's on my floor, and they are not moving to the next apartment with me.


2. read two chapters a week in my heart book. i should know all of it, so hopefully it'll go quickly.


3. continue reading one pleasure book a week. next week's picks: best food writing 2005 or mark kurlansky's salt: a world history. i recently read kurlansky's cod: the fish that changed the world, and it was a fun yet sobering read.

that sounds like a lot of reading, but i have a lot of time. that's also nothing compared to what i was reading my first two years of medical school. i have you all to keep me accountable!