Dr. John

2009-05-18T12:18:00.000-07:00

<-- Liquefactive Necrosis
Hello again everyone. I wanted to take a few minutes to write and tell you about the start of semester 3. The first week saw four eight hours days of class right off the bat. That was long but it was all highly interesting. Pathology is at the top of my list. The whole first year of medicine is how the body is in its normal state. Now we get to the good stuff..ur...the bad stuff: how it all goes wrong. So far we've tackled the four types of necrosis and inflammation. Here are a few pictures to give you an idea: Coagulation necrosis

Caseous Necrosis: mmmmm....Cheesey...literally!

Fat Necrosis:

I know you guys are as excited as I am to see this stuff.

Today we had Intro to Clinical Medicine (ICM) Lab. What does this mean? It means we got to examine an actual patient!!!!! It was worth the wait!! Amazing to actually face another human being and find their pulses, examine their eyes and oral mucosa, etc. In the afternoon I conducted my first interview on an actual patient. Equally amazing.

All this is what I have been waiting for. It is what I thought medical would be like!! It's been a remembering of why I got into this in the first place.

Thanks for reading!

John

2009-05-06T16:54:00.000-07:00

Thus begins another semester and yet another blog entry. Let me first begin by summing up last semester. I came into the semester charged and ready to fight my way into the battle of long days, late nights and the handing over of my hours to the pursuit of medicine. Let me begin by saying that God was so faithful to me all the way along. Looking back, I can see a point in the semester when something shifted in me and I went after this thing with everything I had. Most days began at 645am and ended at 1130pm. The extra class (neuro) was initially very challenging and figuring out how to manage more work with less time was difficult. After a while you learn to adjust, to not waste time and use well the time you have and you learn to streamline the material. All along the way God has given me courage, strength, resolve and grace. I kind of view medical school as trench warfare: you hunker down in the ditch, prepare and endure (lecture and studying) with occasional assaults on the enemy line (Mini Exams and practicals).

At the end of the semester we had to take our third Mini exam and three practicals (histo, neuro and anatomy). On top of these we had 5 "Shelf" exams to take, and all of this (9 exams) in 14 days. Shelf Exams are national exams that are given to all 2nd and 3rd semester students. There is one for each subject and most medical schools take them. Here's the catch though: most medical schools do NOT count them toward grades and most medical students do not take all the exams. For us, the shelf exams counted for 20% of our grade in each subject (except physio which was only 15%) and we had to take all five exams (Anatomy, Biochemistry, Neuroscience, Physiology and Histology). The pressure was on. Strangely enough, I felt myself gaining momentum and charging through to the end. I can only attribute this to The Lord. He supplied me with exactly what I needed to make it through and to do well. To top it off, I did exceptionally bad in Biochemistry on Mini III. I really was afraid I might not pass. I ended up with a C (fine by me) as well as a B and four A's in my other subjects!!! I am so grateful!!!!

So...the first year of medical school is over and done with! I can hardly believe it at times. Briana and I talk about how, in some ways, it seems like yesterday we were gathering all we owned and packing it away in storage to head down to Dominica. We have tread many miles in the past 9 months. Speaking of Briana, she has been my constant companion, cheerleader and friend on this journey. Medical school would be so much more difficult and so much less enjoyable without her. I love my wife!!

Now it's on to 3rd semester. We have all new classes: Pharmacology, Pathology, Behavioral Sciences, ICM (kind of like a skills practicing lab) and Microbiology. It's going to be a tough semester and I want to ask you to continue to pray for me as I take more steps on this journey. Thank you for your prayers and support to this point, and thank you for reading.

John

2009-03-15T15:19:00.000-07:00

Hey everyone. Again...sorry for the long pauses between posts ( I could make a medical joke here about apnea, but I'll save that for the medical people here). So above you see a picture of some of the vessels of the abdomen which supply the pancreas, duodenum, stomach (reflected up in the picture), spleen, jejunum and part of ileum. Right now in lab we are actually looking at this stuff. It's pretty amazing to see it, identify it, trace the loops and branches. The intestine is lengthy.

God has been very faithful to me this semester. This past Mini exam was an answer to prayer. Mini II was, far and away, the most material we've had in any one stretch so far. This semester we often have lecture from 8-5. It doesn't leave a whole lot of time for study. Coming to the Mini I was really needing to do well in Biochem. Neuro was worth less and my grades in anatomy and neuro have already been very good, so I wasn't concentrating on them as much. I asked God is he would pick up the slack and help me through anatomy and neuro (not to mention Biochem, physio and histo). Neuro has been particularly difficult for me. There are a lot of pathways to memorize and many of them intersect and do multiple things. Hard to keep it all straight in your head. I got a C in anatomy (which was fine) an A in physio, high B's in histo and Biochem, and an A in neuro. There really is no other explanation than God's help there. Most people (including myself) spent less time studying neuro because it wasn't worth very much. God is good. He gives us beyond what we expect and hope for. I am thankful.

I wanted to ask for your prayers in the coming five weeks, in two particular areas. The first is with school. I am feeling pretty tired as most of the week I see 16 or 17 hour days. Not only do I need energy but also motivation. The second is at the end of this semester we have something called "Shelf" exams. It is a test in each subject that looks at the entire 1st two semesters of med school. It is going to be difficult and it is worth 20% of our grade in each subject. Please pray for diligence on my part and high scores.

Hope everyone is well. Thank you for reading.

John

2009-02-06T09:38:00.000-08:00

Well friends....sorry it's been so long since the last post. I am on to second semester and truly the glory goes to God for that. I am so grateful. He was there to help when I was exhausted or unfocused. When I was discouraged there would be a good chat with someone or a verse that was aimed directly at where I was.

So now I am one month into 2nd semester. Wow! is it so much better than first. The classes are so well put together and in synch with each other, overlapping and interweaving in many places. That alone has made learning all of this stuff easier.

This semester we have an additional class -Neuroscience- along with Gross Anatomy, Biochem, Physiology, Histology and Doctor, Patient and Society. Time is in shorter supply as many days we have class from 8am-4pm, and all that before studying time. It is forcing me to be intentional and strategic in how I utilize my time. Still need some prayer in that department.

Neuroscience is a challenge. Before this semester started I was really dreading it. I'm not sure why but I decided a long time ago that I didn't like it. I don't know if it is just the complexity of it or what, but the semester started out with me in a bad mood about it. As the semester has gone on and with the help of one teacher in particular (Dr. Welke) who teaches us almost all our neuroscience classes, I have found myself really beginning to enjoy neuro. It is definitely tough, there's a lot to know and a lot of it is fairly ambiguous at first or counterintuitive, but it is also fascinating and miraculous how the brain and central nervous system work.

Here's a picture of one of the slides we're learning. Imagine that we not only have to identify the different sections and the different gyri, but we also need to know what they do, where they travel and where they cross (because many of the fibers cross in the brain, pons, medulla or spinal cord). Once you start getting it though, it becomes really fun. Anyway that's all for now. I'm about to go take my first neuro practical now. Thanks for reading!

John

2008-12-04T18:48:00.000-08:00

Here a couple of pictures that illustrate well the extremes of the past couple of weeks. Thanksgiving was a low point for me; probably the lowest of the semester. I was feeling discouraged about the amount of material and my lack of understanding in biochem for that week. A lot of this is due to unrealistic expectations on my own part (expecting myself to know it right off the bat) and also ... it's just med school!

I had a dream that I was trying to merge onto the highway and I was waiting for this huge semi to pass. It took forever before I finally saw the end of it. Analyze that one all you psych majors.

So (as you may well have guessed from the picture) there have been a lot of late nights. I think I took that photo around 12am. "Sweatshirt on a tropical island," you ask. Well let me say that the classrooms are kept at near polar conditions which necessitates the use of a large (preferably hooded) sweatshirt. Anyways, I digress...

This semester has been all about learning. "Duh" you might say, but let me expound upon this idea. Sure there is a ton, and I do mean a ton of information thrown at you. Not only are you learning about all things medical, but you are learning to funnel and strain all that information into what is important and what is testable. That's really only the platform. This semester has also been about learning how to study, how to manage your time, how to persevere and also figuring out the maximum amount of caffeine your body can take without going into some kind of cardiac arrhythmia.

There's also the part about having to face your weaknesses and learning how to combat and even change them. That one has personally been a raging battle.

Thought I was done....but no: spiritually it is also a learning process. Will I really trust in God or abandon Him or accuse Him at the first sign of trouble? Will I stay in the fight on a daily basis and will I continue to move, especially when I least feel like it? Will I make time for God or will I attempt all this on my own? These are daily, even hourly questions for me. That is the difficulty and also the beauty of going through an experience like this.

The last picture is of a hummingbird I rescued. I believe it was a gift from Jesus. I rescued him from inside a building. He was exhausted and he just perched on my thumb like that for about 3 or 4 minutes before buzzing off like a miniature fighter plane. Amazing experience. Beyond words really.

I would ask you to really be praying for me in these last couple of weeks. Our 3rd mini is on the 11th and the final (yes it's cumulative) is on the 16th. Pray for my preperation time beforehand, and for the tests themselves. Thanks for reading.

John

2008-11-18T13:02:00.000-08:00

Picture yourself in a long, rectangular room; windows on the long sides; the smell of formaldehyde in the air and what sounds like a large social gathering in full swing. Now picture 14 cadavers scattering around the room on tables and yourself standing over one of these cadavers. In your right hand you hold a scalpel and in your left...a human heart. If you can picture this you will have some idea of how my 1pm anatomy dissection went today.

Some might feel weak in the knees at the thought of this. Some might be less than impressed, and some (like myself) were in awe. Visualizing the human heart out of the chest, and also holding it in your hand is a thing of beauty. Strange to say so? Maybe, but when you begin to think about how the heart works and how it is a an exquisitely designed piece of machinery that beats for 70-80-90..yes even 100 years in some people, you begin to see and appreciate the miracle that it is.

I have been interested in the heart for some time. I developed a passion for EKGs while working in the E.D. I've done chest compressions on people and literally watched a man's vessel close off (on an EKG) just minutes before he was whisked off to the cath lab.

This past week we have learned about the physiology behind circulation and heart pumping and today we began again with something called "baroreceptors." Baroreceptors are what help your heart adjust to changes in blood pressure. They are what keep our hearts in homeostasis and with every beat they are tweaking blood pressure up or down, depending on what the body needs.

We split up the dissection and my turn was in opening the left atrium. After making a small hook-like incision, I reflected back the sides of the atrium and put my finger into the chamber, through the mitral valve and into the left ventricle. Incredible!!!! The man to whom this heart belonged to died at a fairly young age and he had something called Left Ventricular Hypertrophy ( a thickening of the muscular wall of the left ventricle. I also reached in to the aorta down to the aortic valve. Now, the mitral valve opened without a whole lot of resistance. The aortic valve, however, was almost like cartilage from the knee or shoulder - hard and resistant to my finger going through. "Aortic stenosis!" I announced to my group, and then one by one they each felt the valve. We had figured out the pathology (at least at our present knowledge) of this man's LVH.

My time in 1st semester is drawing to a close. There are little more than 3 weeks of class left, followed by Mini 3 and the final. Please be praying for focus, stamina and drive for me in the coming weeks. Thanks for reading.

John

All Ants

2008-10-22T10:46:00.000-07:00

This blog entry is dedicated specifically to the ants of Dominica. You got your flying ants, you got your medium-sized-hard-to-kill ants and your size of the head of a pin ants. Briana and I have had to deal on several occasions. Often at night, when I'm in the throws of studying and the large, neon light is buzzing overhead, we get a rush of these flying ants that the locals call "rain ants." They are attracted to the neon. We have a large fan set up in the room and the ants (once they enter the room) are blown back and pile up on the floor, bed and anything in between. Early on I realized that a hefty dose of OFF killed these on contact. Whenever I'd see one or two start to filter through the screen I'd shut the windows, reach for the off, head out on the balcony and go to town.

Often we will come into the kitchen at night or early in the morning and find what looks like tiny pieces of pepper scurrying around. They are, in fact, ants and the only real solution is get rid of them. Initially, I felt bad about it: "They're just being ants; just doing what their meant to do," I said to Bri one night. Her reply: "And we're doing what we're meant to do: have dominion over them." I had to laugh at that one. It came right out of the mouth of someone who's had to deal with ants getting into everything. After the ants invaded my backpack (to the point where when I got to class and unzipped my bag to get something I'd fine 7 or 8 going crazy) I lost the mercy I had for them and it became all out war. Lesson learned: don't put blopops in your backpack overnight and expecting them not to be devoured.

I quick update on school:

Things are very busy. I did not do as well on the first exam as I had hoped. Initially I was really discouraged by this. After talking with fellow students who performed in much the same way, I was greatly encouraged and realized that I have to learn from that, not be brought down by it. What did I learn? Well....#1 thing: med school is not undergraduate school. Of course I knew this, but I still had some old habbits and some poor ways of doing things. It's all about high yield in this biz. You've got to plow through the stuff and create a study product. It is easy for me to get too involved in a subject I really like which can be very detrimental to other subjects needing attention. The Lord has me in His grip in all this; not letting me fall off the path. He has truly been there for me and been faithful in what I like to call "keeping me honest." Not only that, but He has given me great friends and a community of believers in RCF. I am grateful.

Well, time for bed now. I've been at it for a solid 7 hours. Hope you all are well. Thanks for reading.

John

2008-10-07T17:42:00.000-07:00

"Ways to Manage Pre-Test Anxiety"

1. 75 push ups @ intervals of 25

2. 100 air squats @ intervals of 50

3. Turkey bacon, water melon, train mix, and peanut butter and jelly

4. PRAY!

So I am writing to say that thing went fairly well on the first Mini. Thank you all of you who were praying. During the test I felt at peace and I felt focused which were both things I asked God for beforehand. Thanks to Briana, I had an amazing lunch and a lot of help with flashcards. The test itself was 120 questions in the subjects of enzymatic rxns, DNA Replication
Transcription and Translation, Chromosomal Disorders, DNA mutation, HIV reverse transcriptase infection and its components, cultural competency, prevalence vs incidence of injuries, anatomy, injury types in anatomy we've studied thus far, cell biology, the nervous system and amino acids. It was a lot, to say the least. We'll see how I did.

Afterword, we went over to our friend's Josh and Allison's place for Cajun food: jambalaya and creole-style potatos. It was awesome. Had some beers, watched some football and called it a night.

I am so thankful for the ways you all are journeying with me and I am grateful to the Holy Spirit for going with me each step of the way. That's all for now. Thanks for reading.

John

2008-10-03T15:30:00.000-07:00

This post is dedicated to my wife - Briana. I have been praying and asking God to show me how to love her better, and what I am finding is that he is opening my eyes to the way she is loving me. She has cooked meals (which includes going to the store every week and figuring out what to get), washed our clothes and so much more. She has made it possible for me to really focus on medical school. All this she has done with love and I am blown away by it. I am greatful.

I
am proud of Bri in the picture of her putting a GIANT walking stick on herself for the picture. The picture of her on the bed is a typical pose for her when she's working online. I had to snap a quick photo. To sum it up: I love my wife.

2008-09-23T14:47:00.000-07:00

First off, let me say that Briana and I celebrated our one year anniversary on the 22nd. YAH! I am learning more every day the blessing God has given me in Briana. Life here would be far different (and much more cumbersome) without her.

As you can see, the rain has been coming in droves. We had a tropical depression swing through that changed the road we take into a river. Nothing shorts and flip flops can't handle.

Classes this week have really piled on the material. We're learning transcription and translation (pro and Eukaryote), the epithelial cells (more complex that you might think), chromosomal diseases, DNA technology, enzymes, connective tissue and rounding it out with the Brachial Plexus/axilla and arm/cubital fossa in Gross Anatomy. Truth be told, it has been far more stressful than the previous two weeks. The amount of data being thrown at us is amazing. Not much time for extra curricular activities (although Bri and I did go out to Sister Sea Lodge for Blue Marlin and the trimmings).

In the midst of the "drinking from a fire hose" analogy, there have been many things I have really enjoyed and been fascinated by in these classes. Some of them have to do with drugs, tissue layers and how they interact and the different disorders that arise from genetic complications. The one I wanted to tell you briefly about is the picture at the top of the page. This is DNA being replicated. You can see the double helix and a bunch of other stuff around it. The "other stuff" is two things: 1). a protein called DNA Polymerase (differentiated per leading and lagging strand) and 2). sliding clamp. What's interesting (at least to me) is the fact that the sliding clamp (Proliferating Cell Nuclear Antigen or PCNA for short) aids the Polymerase in speeding up the replication process. In our body's cells, transcription can happen in multiple aspects of the DNA chain (called Replication bubbles). This clamp speeds up the process. After all, the DNA strand can have 220 million (!) base pairs (A,T,G,C). Anyway...I thought that was amazing.

I appreciate your prayers and would ask that you continue to pray as the first Mini (first exam) is coming up on Oct. 6th. Thanks for reading.

John

2008-09-13T15:36:00.000-07:00

Friday, the 12th of September was the big day; The White Coat Ceremony. It's a tradition started in 1993 in the U.S. and is significant in that, besides being accepted to medical school, it is really the first real opened-armed welcome into the medical field. It also serves as an invitation and call to excellence, passion and perseverance; the symbol of what we are all working for.

I climbed the long hill to the Annex where the meeting was held and I had two things with me (besides my water bottle): the "little doc" (a Case brand knife with a blade and a Pharmacist tool for counting pills) that my Father gave me and a tie around my neck, given to me by my friend and mentor -Dr. Billings- before he died. I wasn't carrying those things so much as talismans, but more as symbols from people who belive in me and as gifts to spur me on to strength, steadfastness and what I like to call, "putting down roots" (which is really just a way of saying commitment).

There were Dominican heads of state, including the Prime Minister, the entire Ross faculty, Dean of Students and the President of Ross there for the ceremony. They seemed to take this ceremony seriously -as a call to us- as well as take pleasure in being there as well. Maybe some of them were remembering their first days as med students. There were speeches (some good, some funny, some awful), charges and even prayers throughout. My favorite line was from the Invocation. The Chief of Pathology was talking about the amazing design of the human body and all the processes that accompany us in this life -birth, death, sickness, sorrow, happiness, pleasure, even death- and the glory all of it gives to God, and the phrase he used to describe all of this (in his deep gravely voice) was: "The web of life." I love that.

Anyway, it was an honor to attend the ceremony. It only served to sharpen my focus and engender an inward sense that this is where I am meant to be. I am greatful.

In other news...the first week of medical school is over! I can't believe how fast it went. The routine I'm settling into goes something like this: 5:30am - run; 6-7 - read my Bible, pray and eat; 8-12 class; 12-1 lunch w/Bri; 1-6 study; 6-7 eat dinner w/Bri; 7-10 study. Never in my life have I dedicated this much time to study. Never have I enjoyed so much of what I'm looking at. There are definitely times when I feel like I'm swimming in a Pacific sized ocean of information and that can be overwhelming. And there are many times when I feel excited, energized and engaged. Anatomy lab, in particular, has given me cause to worship. The human body, in all its intricacies, inner-workings and cooperation leads me to awe. I'm hooked. Plain and simple. I can't help but marvel at God's handiwork. The sheer complexity is enough to inspire in my book.

I have started to make some connections with classmates too. In the picture you'll see Vahe, Kyle, Dan and Josh. They seem like good guys and good study partners. Thank you for your prayers and support. Keep them coming as things are only going to get busier. Thanks for reading.

John

2008-09-08T16:14:00.000-07:00

5:30am is the time Briana and I woke from the cool of the night and the warmth of the sheet (no covers or quilts here). We went running early to get a good start on the day because, after all, this was the first day of classes. I headed out the door after a bowl of oatmeal w/almonds and cranberries that Bri made, and put in my ear buds. The song I thought would most prep me, most focus my will and intuition to the journey I was about to set foot to was none other than "Kinky Reggae," by Bob Marley. That's right people. You need to download this song. It actually made me laugh as I headed out.

The morning began with introductions of professors who read their syllabi's with German, Middle Eastern, Californian and I believe Indian accents. The profs were actually really funny and I like them so far. After that began classes from 9-12 with breaks in between: Gross Anatomy, BioChem and Doctor Patient and Society. I really enjoyed them all which was a little bit of a surprise. I expected mostly to be intimidated and afraid. Maybe this has something to do with heading into something I love and maybe it has something to do with the time Briana and I have spent in prayer and reading God's word. It has really been impressed upon me in these last few weeks to remain in the vine as Jesus talks about in the Gospel of John. Of course, I am still learning what the heck that means. I can say that I truly believe that I need God in this process. But it is deeper than that because the more I walk with Him the more I begin to sense, in the small moments, His desire to travel with me through it. It is my prayer that both Briana and I will come away from medical school with a deeper understanding of how much God loves us and how much we love Him. A small example of His journeying with me came today while studying.

So the first thing we're learning in anatomy is: the back. Sounds simple enough, but the fact is: it's complex. Not only am I responsible for knowing the names (in Latin mind you (that's right: be impressed)) of the muscles, but also each one's function, origin and insertion (where it arises and where it attaches again), its blood supply, lymph drainage and its innervation, or, which nerve supplies and controls the muscle. So for example: the erector spinae is a muscle that, really, is a group of three separate muscles: the spinalis, longissimus and iliocostalis. While each serves the same basic function and innervation, not all have the same blood supply, insertion or origin.

Around 5:30 I began to find myself getting heavy lidded. I prayed and asked God for courage and energy. A few minutes later I found myself energized and excited about what I was learning, even in the face of many, many new flash cards to make and memorize. Some might call it coincidence, but I believe it was the Holy Spirit. God cares about the small details.

So I'm signing off for now, not because I want to but because the books are calling my name: "John...John! oh how funny it is that you think you're done." Thanks for reading.

John (first day Med Student)

2008-09-07T16:45:00.000-07:00

The pictures are as Follows: Trafalgar Falls, the hike up Scott's Head, eating ribs @ Peter's Ribs (Local restaurant), and swimming in The Fresh-Water Lake (elevation...way up in the mountains). Bri and I spent one more day (sorry can't get the underline off) touring the heights and depths of Dominca. Scott's head was maybe one of the most amazing coral reefs I've personally seen. I saw 15 parrot fish, three squid (who when they saw me changed colors to a deep purple), puffer fish, schools of all kinds of fish I didn't know, and one really large fish (about 3 basketballs) I still can't figure out. I also swam with a school of 60 or 70 Needle Fish. On the far side of the reef there was a drop off that went down into a blue-black abyss. Beautiful and scary at the same time.

Tomorrow begins the first day of classes. I'd be lying if I said I wasn't nervous. I tend to shift between being excited and enthrawled with the material and overwhelmed with the sheer mountainous quality of it. I would graciously appreciate your thoughts and prayers for me and for Briana during this time. Signing off for now. Updates are coming. I'll have to take some study breaks! Thanks for reading. John

2008-09-01T05:45:00.000-07:00

These next two posts are combined. The lower is Syndicate Falls and this one is The Emerald Pool. Both were really fun.

Syndicate was really fun but The Emerald Pool was far and away what I have enjoyed the most so far. It's in the middle of an inland rain forrest on the Atlantic side of the island. The falls is about 30 ft high and it fills a pool 50 x 30 feet. The water is cold at first, but you get used to it. I hiked down stream a ways and explored several other falls and smaller pools. It's the kind of place I could spend an entire day; sun up to sun down. Unbelievably beautiful. Thanks for reading.

John

2008-09-01T05:31:00.000-07:00

2008-08-28T18:22:00.000-07:00

Today marks another day in what I have termed, "The Two Goals of Life on Dominica."

These two goals consist of 1) graduating from med school and doing well and 2) catching everything that moves.

Today we went to
Ft. Shirley in Cabrits. It was a British built and manned fort that at one time had 35 cannon (each one could shoot out about a mile and 1/2 out into the bay or so said the sign). The best part was hiking on a trail into the jungle with our friends. Hope you enjoy the pictures. We can't wait to go back on the trail. There was a mutiny of the slaves here (info on picture) and eventually they won their freedom. Dominica was one of the first British colonies to be emancipated en masse. Tomorrow we're taking a day off the excursions and catching up on some much needed rest. Thanks for reading.

-John

2008-08-27T16:45:00.000-07:00

The Title of this photo is: "30 SPF ain't enough." Actually, it doesn't look too bad in this picture. Feels a little different in the real world. Today Briana and I (along with 40 or so other Ross Students) went to Toucarie Bay to do some snorkeling. I saw brain coral, fan coral and some others I can't name. There were many multicolored fish, a needle fish, an eel and some species of Scorpion fish. I wasn't really out that long but the sun here is intense.

I spent the rest of the afternoon studying Histology, which today was mostly reviewing the cell and its components. Actually, I really enjoyed it (aside from the girl who was avoiding studying and talking in what she might call a "whisper" to everyone who was there). Classes won't start until the 8th of Sept., but the upper classmen here are saying it's a good idea to start reading now.

Aside from the fun and the cranking of academic gears, it has really been impressed upon me how important it will be for me to stay connected with Jesus. As much as my classmates and I are going to bond over this experience, it is also going to be competative. In the end, I'm the one who has to memorize the material, spend the hours between book ends and, pencil in hand, take the exams. This kind of thing definitely brings up the questions of "who am I," and "what am I made of?" I was listening to a song the other day and one of the lines was a quote from St. Irenaeus: "The glory of God is man fully alive." That is my meditation as I lean into all that is ahead. Thanks for reading.

John

2008-08-26T17:54:00.000-07:00

The Common House Gecko (as I like to call it in the British accent of nature shows) is so named because he infiltrates our apartment (much to the chagrin of a certain wife). I can't help but enjoy him.

We spent the day in Roseau (pronouced Rose-oh) with four van-loads of fellow Rossians and spouses. Bri and I headed to a local Walmart equivolent called Astaphan's. There we purchased foam for the bed, a coffee pot and groceries. After that we went to the Roseau Botanical Gardens. Giant and beautiful trees there.

We have started to meet some people here which has truly been an answer to prayer. There is one couple from Milwaukee -Kyle and Kim- and another couple from Philadelphia - Burke and Renuka. We had dinner at a local Chinese restaurant tonight - "Hong Kong Restaurant." Very spicy and very good. I am looking forward anxiously and expectantly to begin forming study groups. People (students I mean) seem to be very cool so far.

Until next time.... John

2008-08-25T10:38:00.000-07:00

So here is Bri in front of the Hotel we stayed at in San Juan: The Coral Sea Hotel. We missed our flight by about 2 minutes and had to reschedual for the next day. That was an ordeal at first because the ticket counter was telling us they wouldn't be able to get us to Dominica; only to Antigua. From there, who knew because the flight was full. We waited for over two hours while a lady helped us to get on a flight. We prayed and asked God to help us get there because we really didn't want to go to Antigua, spend another night and spend more money on food and lodging without knowing when we'd actually get to Dominica.

Thankfully, everything came together and they got us a flight out and to Dominica! We were so relieved.

Dominica is a beautiful island. Tropical in every sense of the word. Out my balcony window I can see large palm trees and green in every direction. Out the front door there is a view of the Creole named mountains (which I don't yet know). They rise up from green forrest beards to brooding tropical rain clouds that keep the view behind shrouded in darkness.

Truthfully, it has been an exhausting process so far. I am dealing with culture shock, the "inconveniances" of not living like an American (which is actually helping me get in shape), trying to decipher the Dominican patoi, getting our apartment together, figuring out how and what to eat here, figuring out how to go about getting things together for school....the list goes on. I find myself exhausted after 3 or 4 hours of being out. I know my time in Kenya has helped me, at least in understanding that the exhaustion is normal.

I've heard a lot of talk about starting studying now. 3rd and 4th semester students have each talked about doing this. They say that between 100-150 students drop out by the end of first semester. I know that some of that is due to the work load, but I also think some of it has to do with being in a foreign country. There are actually a lot of people who have never been outside they're home state.

Anyway, I'm rambling. More to come. This week Bri and I have signed up for all the free tours and trips sponsored by the University. Thanks for your prayers.

John

2008-08-23T11:45:00.000-07:00

So we're here (!) and the operative word so far is: "sweat!" That's right, sweat. It is definitely a different climate. It rains multiple times in a day quickly followed by sunshine. The fruit is amazing and I've walked everywhere I've gone so far.

Our appartment is good and is getting better (thanks mostly to Bri's foresight) and the locals have all been friendly so far. Much more to follow (including a brief on the getting here excursion). Thanks for your prayers so far. Talk with you soon.

John

Awards

2008-07-08T06:12:00.000-07:00

So...Briana and I accepted our loan award ammounts for the first three semesters. It's at once a jolt of reality to see how much money we'll be borrowing and a feeling of excitement as the time to begin all of this draws steadily closer.

2008-06-26T13:49:00.001-07:00

Well...Friends, Family, Fellow Students...
This is officially the first blog post of this journey into and through Medical School. For those who don't already know, I will be attending Ross University School of Medicine which is located on the Island of Dominca in the Caribbean (Google Earth is a good way to look at it). Briana and I will be moving down there on the 20th of August. We'll spend 16 months there followed by a 3 month clinical stint/jump start in Miami with the remainder of rotations spent in the U.S. (TBA).
It's been quite a journey to this place. Thank the Lord that the MCAT and Physics is over. I've been working at a hospital here in Nashville for the past 5+ years to gain some practical experience. 4 of the 5 years have been spent in the Adult Emergency Department and it has been a crucible for me to grow, learn and be challenged. It is amazing how much I have learned just putting in 36 hrs a week, not to mention the people I've grown to know and love. This is also where I met my mentor and friend Dr. Josh Billings. I truly believe that I wouldn't have made it this far without his guidance, his encouragement and his belief in me. He made it 95 years and passed a the Sunday before Briana and I were married, September 16th.
Some of the best news so far is that I was approved for my loans. Phew! What a relief. There's mountains of paperwork still to do, books and school suppliesto buy, packing to do and the gradual process of saying goodbye to friends and family. Every step Briana and I take toward this adventure fills us with excitement, awe and gratitude to The Lord for His guidence and provision. Signing off now. Much more to come....
Dr. John