Not your garden variety infected anal gland...
Claimed and proven today - gastroenterologists are very desensitized. Uninhibited in the words of our lecturer. I have certainly never seen so many pictures of diseased anal orifices; and all before lunch.
One of my classmates found this concluding the entry about Gas / Eructation, Flatulance on the online version of the Merck Manual at merck.com

"The following piece appeared in the Gastrointestinal section of past editions of The Merck Manual, and is being reprinted here because of reader demand.

Flatulence, which can cause great psychosocial distress, is unofficially described according to its salient characteristics: (1) the "slider" (crowded elevator type), which is released slowly and noiselessly, sometimes with devastating effect; (2) the open sphincter, or "pooh" type, which is said to be of higher temperature and more aromatic; (3) the staccato or drumbeat type, pleasantly passed in privacy; and (4) the "bark" type (described in a personal communication) is characterized by a sharp exclamatory eruption that effectively interrupts (and often concludes) conversation. Aromaticity is not a prominent feature. Rarely, this usually distressing symptom has been turned to advantage, as with a Frenchman referred to as "Le Petomane," who became affluent as an effluent performer who played tunes with the gas from his rectum on the Moulin Rouge stage."

The curriculum at this university, if you don't know, is systems based. After a breeze through fever, sore throat and otitis media we are well into the new combined blood and gastrointestinal unit. This is the result of a reshuffling of the curriculum that took a couple smaller individual systems and combined them into bigger courses. Which means right now we, the first year class, is taking GI before the second years have. This is the only explanation I can find for a couple of incomprehensible lectures last week. There must be a couple of lecturers that are used to giving their spiel to students already 16 months into med school, not three weeks. Whatever the reason, the result was a lecture that might as well have been in Spanish for all I understood. It was probably a good thing because, for the first time, I am honestly scared, always a good motivator for getting your butt in gear for studying well ahead of the tests. With the longer courses we don't have one that counts for anything until well into October. I have a feeling my usual cramming won't be appropriate.

Most of our lectures so far have been pretty interesting but today we had an introduction to pharmacology. Despite the fact that it was 4 hours long (I think I now have a suggestion if George W was looking for a different method of torture to get around all those pesky rules and laws; something involving 130 people overcrowded in a overheated room with only really bad coffee available), I stayed awake and even alert. It helped that the lecturer is a researcher with an office right across the hallway from my lab so I had the added motivation of personal embarrassment if I dozed off. But it was also very interesting, not nearly as dry as I was expecting. I think the thing I liked the best was that it provides a whole different view of the functioning of the body. It has always fascinated me that a lot of what we know about the physiology of depression came from figuring out how the drugs that relieve it work. The lecturer also gave a little talk about the advertising and drugs. I had given some thought to the good and evil of advertising before but I think I was underestimating the patients. The argument in my mind was mostly whether the patient asking the doctor for these drugs was good because it is an opening for discussion or bad because it might pressure the doctors perhaps leading to over or inappropriate prescribing. Another potential problem is that an over-exposed, over-cynical patient population might become skeptical of drugs that had been advertised and even spread this skepticism to all prescription drugs. The thinking being that the prescription has more to do with profits and free golf trips then their well-being. I should have thought of this as well. I have a friend that believes all of the concern about avian flu is a political manufacture perpetrated by the Bush government to maintain hysteria while deflecting attention from the war(s) in the Middle East.

It is now the beginning of day three and I was just about to edit my previous post. But in the interests of being accurate I will just admit I was wrong. The school stuff is already drowning me.

I am still attributing the majority of my confusion to the fact that my schedule is chaos. I am never entirely sure where I am going or what I am doing or how that is going to change an hour from now or if there is anything I should do to be prepared for the next hour or the next day. However, this I share with the rest of my class. We end up searching through the many different printed schedules we have so far received and then following each other around like sheep. We have been promised that this will all be sorted out when we receive our palms and the schedule is on the internet information system. Which will happen sometime in the next 1-3 weeks.

It is somewhat comforting that we are all in this confusion together. The case is not the same with the lecture material. I was right in there with the first lecture. Delivered by one of the neuroscience faculty about thermoregulation in regards to fever, I knew almost all the terms and could follow the flow well. The next lecture was basically on immunology, my understanding of which was (or should I say is) at about a junior highschool level. It was an excellent REVIEW lecture for most of my class. Not so for me. I am off to do some reading.

My first day of classes came to a close a few hours ago. It was quite a relief after three days of orientation last week. I would be the first admit that I am not one to go for large shows of group devotion but it wasn't too bad. The get-to-know-you events were fun and some of the sessions were informative. By the end, however, the whole thing got a little too tribal for my tastes. Most of the people in my class seem like really interesting, smart people but I can' t buy the repeated assertion that we are all so 'special'. There are lots of great smart creative caring people out there that aren't medical students. Some of them, god forbid, aren't even in healthcare. And I understand that bonding with our classmates is important so that we can help each other out during the intense workload ahead but I resent the implication that we all have to be 'pals' to do it. Often it is easier to work effectively with someone you aren't sharing drinks with every other night. All in all I think that I can adapt to the social aspect of med school. At the moment I am more than a little overwhelmed with the actual school part of medical school. But I am sure that will pass with a little time as well.

I am now a day away from being a medical student (barring some confusion over my registration). I am surprised to find that I am actually nervous. Despite the gruelling first day orientation schedule including nothing more daunting than meet-and-greet, lunch, a tour and a sophisticated version of a pep rally, I have butterflies in my stomach.

Oh yeah, there is also a pub crawl. Aside from the fact that it has been many years since a pub crawl actually sounded like a good time to me, I spent three days this weekend partying until 3 in the morning at the Folk Fest. I don't think I am up to a night of drinking with a bunch of type As a good 5 years my junior. At my (slightly) advanced age a pub crawl translates to a good chance to people watch at best, and a long night of babysitting at worst. I think I will drag my husband out to the evening of learning what life as a medical is like. We can be the jokers making wise cracks at the back of the class. Just because I am 'mature' doesn't mean we always have to act like it. That practically sums up why I married him.