Medicine :

Med school is coming to a close. Next week is my last week of my last rotation as a med student. 3 work days separate me from freedom for at least a couple months. Things are coming together, medical license application in, contracts signed and returned, etc. I even received the 'unfinalized' schedule of my intern year. First rotation- ICU. "Out of the frying pan and into the fire." fits the situation.

These last two months of Neuro-Ophthalmology have taught me vast amounts about neurology and management of Neuro-op patients. Aside from getting a crash-course in the ophthalmalogic exam (something that isn't taught in med school), I've had to really apply myself to learn vast amounts about an extremely difficult subspecialty. My attendings place a premium on knowing and understanding physiological pathways associated with Neuro-op. Their mantra seems to always revolve around "Localize, before you generate a differential".  I've been told this through all of my neurology and related rotations. Though never really embracing this previously, I am now understanding the how and why they were so insistent about this.

Diplopia, for example, has only 6 localized causes, starting distally: Neuromuscular junction, Extraocular muscles, Nerves to these muscles, Extraocular muscle nuclei supplying these nerves, Interconnections between these nuclei, and higher order functions that provide input to the nuclei (supranuclear). Once broken down into such categories, you can generate a differential based on which of these categories appear in and are relevant to your physical exam.

Thankfully this method of approaching a neurological patient is salient and applicable almost universally across medicine.

Gym:

Squat: Did some suit work. 405x2 raw, suit on: 585 for a single. Went up fast and easy. I think I could get mid to high 6's pretty easily. Maybe I'll try in a month or so.

Floor Press: 315 for a couple doubles. Got pinned by 335 after that. I'm going to stick with FP for a cycle or two and see how it helps my bench press. I'm quick off my chest, but stick mid position, which FP seems to hammer hard

Overhead Press (OHP): I'm feeling the effect of increasing my conditioning work. 205x3 reps (should have been 5).

Deadlifting: I'm feeling pretty weak in the deadlift. Between doing Kettlebell/dumbell swings, my numbers suffered this week. 405 for a couple sets of 5. 465 for a double. I've decided to add power-shrugs in place of power-cleans. Worked up to 365x20. 

I decided to start this blog while lying on the floor of the gym unable to move today after a 'conditioning' session... I'll try to get this thing up to date as far as my life is concerned as time permits...

Workout: 20min of sprints on the recomb bike, followed by 15 minutes of KettleBell swing intervals (@~50lbs? only heavy KB my gym has...)

This is the first time I've done KB swings in roughly 5 years, so it was quite the experience... I'm always reluctant to do 'conditioning' days as they always seem to diminish my number for the upcoming strength workouts. I've always been a thick guy, and I see conditioning as a necessary evil to keep me from becoming a wad of lard... but I do absolutely hate it. Absolutely. I rate conditioning right up there with getting my thumb smashed with a hammer, or stapling my nutsack.

Academic-wise: I've submitted my second draft of an article on nystagmus that is to be published in Nov 2012 (Current Opinions in Ophthalmology) to my attending (AKA: The supreme overlord of all things eye-movement related).  I'm fully expecting to get it back looking as if it were dunked in a bucket of red ink...  Oh well.

2 more weeks of Neuro-ophthalmology left until I'm done as a medical student forever...  I graduate on May 3rd; then internship starts in July.  Awesome. That 2 months off will be paramount, as my girlfriend and I just signed on a house; and we should be moving within the next month and a half or so...  Loads of stuff left to do...