July 20th and 21st

I have extremely spotty internet in my room and last night it took nearly an hour just to get one page to load, so that's the reason for the delay. Yesterday we began rotation at Universitas hospital. I was with the group that went to cardiology. We saw one patient who had previously had a heart attack and when he came for a routine follow-up, it was discovered that he had a heart murmur as well. The doctor came in and was telling us about the different types of murmurs and how to identify them. I learned that there are four things you must check for when listening for a murmur and they are timing, volume/pitch, area of greatest intensity, and whether or not the murmur can be heard in other areas. The next patient had a collapsing pulse, which means that his radial pulse is weaker when the arm is lowered and stronger when the arm is raised. We didn't have time for the students to get a history or perform an examination, but the plan is to go back and see him again later in the week. We then got a chance to listen to what each heart sound and murmur is supposed to sound like with the help of a simulated patient. I was able to listen to the different murmurs and while I couldn't identify them, I could definitely hear a difference in each one. It was fun getting a chance to experiment with different heart sounds and feel for each pulse. Later on we went to hematology lecture and discussed the mechanism and effects of aspirin and NSAIDs. We also talked a lot about various bleeding disorders, how they occur, and what can be done to treat them. After class I talked with the woman who was in charge of my building to figure out a plan for me and I am now in the room that I will be in until I leave. The room itself is fine, it's just quite chilly and the internet is very unreliable, but I'm happy to finally be settled. I have a roommate now, and she is also an international student. She is from the Netherlands and will be here studying law for this entire semester. I actually met her last weekend and she's very friendly. We had our first building-wide meeting last night. It was mainly a welcome back kick-off to a new semester. The building I'm in is just girls and the guys from the building next door actually came over and serenaded us, which was very entertaining. The girls here have been really kind and welcoming as well.

Today I was with the same group and we began the day in the pulmonology ward. As soon as we got there, our group was split in half and were each assigned to a patient. Together, each group performed a full respiratory examination on their respective patients. They were left to examine the patient without the help of any doctors or more experienced students, and it was really interesting to watch them figure out what to do on their own. It was an opportunity to put to use what they had been studying for the past two years and it makes me excited to do that myself someday. After the examination, they compiled the signs and symptoms and presented them to the doctor. We then had a short break before going to the cardiology ward. Yesterday we received a list of interesting cases that we should go take a look at if we had time. We went to see a teenager who had Graves disease, but she had already been discharged by the time we got there. We tried seeing another patient from the list, and when we got to his room we learned that he had just been transferred to another hospital, so we didn't get to see him either. We then went back to the cardiology ward and spoke with the head of the department. She told us all about cardiomyopathy, what causes it, what effects it has, and how to diagnose and treat various heart conditions. It was incredibly informative, but it was also a lot to take in. She's a brilliant woman and it's evident that she genuinely cares about the students' learning. After cardiology, we had lecture on radiology. We talked about the different types of screening and diagnostic imaging, such as CT scans, mammography, MRI and ultrasound. I got lunch in the cafeteria and then went back to class for a pediatric lecture. Today we learned about fetal physiology, hypothyroidism, and neonatal jaundice. I'm learning so much through the hospital rotations and through attending lectures, and it's making me excited to actually be in medical school and start becoming a doctor. This evening, I went with my roommate to join the other international students and we cooked dinner together and then spent some time chatting. I'm very much enjoying spending time with the international students, and I'm glad that I've made some other friends.