Monday, October 6, 2008

Kevin falls, David watches

As many of you know, the second year of medical school is traditionally far harder than the first. We’re preparing for the USMLE Step 1, whose effect on our ultimate career opportunities makes the MCAT look like a third grade math quiz, juggling more clinical responsibilities, and incorporating significantly more pathological correlates into the basic science curriculum. To top it all off, the Candyland-like existence of Pass-Fail grading from first year has been replaced by the cruel Sorry-esque wasteland of the Honors-Pass-Fail system (stay tuned for more H/P/F musings from me soon).

This added pressure forces most people to adjust their study habits. Many students work harder, longer, or find methods to increase their academic efficiency. I’ve adapted by preparing myself for the inevitable career switch to some sort of trade school. Kevin, unfortunately, has fallen prey to a far more sinister path…



Recently during lecture, one of our professors relayed a humorous anecdote about his freshman year of college. In preparation for an exam, he had taken an ill-advised number of caffeine pills to gear up for an all-night learning extravaganza. Tears, as is often the case when anyone labels anything an “extravaganza,” were around the immediate corner; he was jittery, unable to study, and couldn’t even hold a pen in his hand when he entered the test completely sleep-deprived the next morning. Most people would react to such a story by learning a valuable lesson about using caffeine in moderation. Kevin? Not so much.

I’ll let him describe his thought process:

"Hmm...the professor is saying something, maybe I should listen. I like words! Caffeine pills to study for a test? That sounds like a good idea. Let me do a cost-benefit analysis. I'm already spending quite a few dollars buying coffee day in and day out. Why not switch to the pill form? After all, it’s considerably cheaper and more convenient, with the only difference being the stigma attached to taking a pill. I'll pick up a small bottle of No Doz over the weekend and use it as necessary. And, in other news relevant to this particular internal monologue, I’ve reached the obvious conclusion that David is far superior to me in many ways. I’ve come to view him as something of a demigod amongst the mere mortals that populate this particular institution. Self, let me enumerate the ways in which he brightens the world. Number one…"

Ok, so I may have fabricated some, or all, of the preceding stream of consciousness. Yet after Kevin brain-birthed the severe preemie that was this particular idea, I bore witness to the ebbs and flows of his No Doz-fueled journey. Here’s a running timeline of my observations:

Monday

1pm: Kevin is visibly tired. He’s nodding off a bit in class and mentions that he had to wake up extremely early to prepare for a lab meeting. His week is off to a good start.

2pm: Kevin puts his plan into action, taking one No Doz and washing it down with a Coke.

3pm: Kevin is taking notes like a madman. Holy crap, he’s a learning machine. How much knowledge can one man accumulate? Maybe he’ll remember me when he’s President of Medicine…

11pm: Kevin is online, working on an abstract he needs to submit for his research project. He indicates that it’s going to be a really long night. Good thing he had that No Doz earlier.

Tuesday

1pm: Kevin was up all night working on the abstract and only got a few hours of sleep. The solution? You guessed it - No Doz II: Son of No Doz. And he’s off to that rarified air of godly productivity most people can hardly fathom…

Midnight: Kevin is online. He has to get up early tomorrow yet again, but hasn’t been able to fall asleep.

Kevin: Ohhh noooo…I think I’ve made a terrible mistake.

Wednesday

12:30pm: Kevin, apparently unaware of the causal relationship between No Doz and his deteriorating QoL, stumbles into class on the strength of sheer willpower and an early-morning No Doz.

Kevin: I think I should’ve paid attention when they talked to us about D.A.R.E. in 5th grade.
David: I’m pretty sure we saw your story on a PSA. Except your name was Johnny…and then you died.
Kevin: …
Kevin: …
Kevin: …
David: If you develop an arrhythmia, can I listen?

2pm: Kevin is struggling. His head is on the desk. Hm…what should I do? Send him my notes? Try to wake him up? Or I could just poke him. Yeah, I’ll just poke him.

Julia: Uh, is Kevin OK? Maybe you should po-

David: Already on it.




2:30pm:

David: Are you OK?
Kevin: I need to leave class to go take a nap.
David: So this is how it ends, huh?
Kevin: It’s been a good run.
David: RIP, good sir.

5:30pm:

Kevin: I'm going home to sleep. Sooo tirrred.
David: Why is your eye twitching?
Kevin: Maybe this wasn't such a good idea.

---------------------------------------------------------------------

Luckily, after a few nights of rest, Kevin was back to normal by the following week. His No Doz days are now behind him. He’s a little bit older, a little bit wiser, and ultimately not much worse for the wear. Plus, I’ve inherited some No Doz…

24 comments:

julia.cunningham07 said...

Wednesday, early evening: Kevin was strewn across the living room floor of our apt in a desperate attempt to be a good friend/host to a visiting comrade... If only he could lift his face from the throw-pillow he has lodged beneath it...

Thursday, 1:30pm: David is suspiciously seen taking something from a small plastic baggie Kevin has passed him. Upon noticing his observer, David is seen to get immediately defensive, shouting "Look away! It's horrible!"

3:30pm: David is spotted by the vending machines. Casual inquiries regarding his apparent attack of the munchies result in a sheepish grin and rushed, guilty exit from the scene...

D said...

I admit nothing!

K said...

Hi my name is Kevin and I've been clean for 8 days now.

Dragonfly said...

Hehe. NoDoz in my experience is a bad thing...I used it once during a week of working two jobs (both pretty much fulltime). The week culminated in packing up and moving out of my apartment, going to a cocktail party, spending an extra day (out of semester time - I was invited by my mentor) in surgery, and catching a flight at 6am on the Saturday (then another flight at 12noon). Needless to say I was a wreck by the time I got on the plane. In fact I had an air hostess who used to be a nurse spot me on the security camera while making my way to the international gate, come and collect me and help me onto the plane with all the folks in wheelchairs. I was kinda lucky she didn't freak out that I might have SARS or anything. Needless to say the headache was massive and I went off caffeine for 2 months completely (even chocolate).
On the other hand...in my first year of uni I discovered Red Bull concentrate....(which I have not been able to find since...probably a good thing).

SuperBadJack said...

A few things.

As a physician recruiter, and you can trust me on this one, if you end up passing Step 3 and are able to get a license , you will never want for work.

Ever.

Number 2, this advice is long down the road, but, all, never let your boards lapse...please?! you're gonna get them probably within 5 years of graduating (Residency), and if you do like some aggravating docs, you'll let them lapse because "Well, Hell I have 10 years experience, who the hell cares about boards!"

I'll tell you who cares about boards...guys who have MD's behind their name but only carry clipboards around.

Number 3, you gotta learn how to live with caffine! :'(

My average dose is about a gram, (yes, 1000mg) along with about 300mg of sulbutamine, and if I really need to focus I throw some phenibut in there with a touch of l-theanine [<--No jitters].

Yes, being a headhunter requires long hours...but it's all worth it in the end.

scalpel said...

SBJ = right on all three points.

K said...

SBJ I have no idea what you're talking about

SuperbadJack said...

Kevin,


I was just venting... while on the previously mentioned dose of stimulants.

In my never ending attempts to staff Emergency Departments nationwide, I'm running into a crapload (Thats a scientific term, dammit) of Doc's who were Grandfathered ABEM and let them lapse.

This is a big problem because groups lose contracts and EM Docs are pretty much out of a job. When they begin looking for a new department, sometimes (far to often) they can't get credentialed because of their board situation.


...It's a convoluted problem... I should just staff CRNA's.

ER Docs are just to fun to give up on though :-D

medicine girl said...

Caffeine no longer works for me. Two words: receptor downregulation.

btw, the USMLE is a basic exam w/straightforward "we're-really-NOT-trying-to-trick-you" questions. The more you read/see & integrate the better you'll do.

medicine girl said...

SBJ: Damn, 1000mg caffeine at one time. How's your A-fib treating you?

SuperBadJack said...

Aha, due to the effects of receptor downregulation, I don't suffer any cardiac effects from caffine unless I take into the 1200-1800 range.

I've only ever taken more than 1 Gram once, it was a very scary experience.

I use other stimulants such as Sulbutamine to give me the kick when I need it.

Plus when you add in l-theanine to the mix, it's a completely different deal. Check out like 300mg of caffeine and 150-200mg of l-theanine.

I've been (ab)using caffeine for many years, I didn't start out by taking a gram. :-p

julia.cunningham07 said...

Ok, SBJ is officially scaring me now.

On sooo many levels.

SBJ said...

Eh I love my chemicals.

D said...

Isn't sulbutamine a stimulant popular among body-builders during workouts? Clearly Kevin should've been killing two birds with one awesome stone...

K said...

Are there any drugs popular among bodybuilders that dont require working out?

D said...

They probably consume a lot of caffeine. Maybe you should try some No Doz.

mulberrystreet said...

Regarding your switch to trade school, isn't medical school just a glorified trade school?

And I've heard caffeine is more effective with constant blood levels, rather than big spikes and drops. So your illustration is apt: a coffee infusion is probably the best way to stay awake.

Ericka said...

i told him not to do it....

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