<-- 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

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

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