I <3 Second Hand Books

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The derm notes that this medical student left in her book as she studied for boards.

I bought this First Aid for the USMLE Step 2 from the Tempe Public Library for $1 two years ago after I took my Step 1. What I didn’t know at the time was that the student who used this book before me included her own set of notes throughout the book. I’ve begun final revisions and finishing up the practice questions that I have. As I sifted through the pages of this book tonight I felt connected to her as I studied the same materials and noted her own side notes: “Pityriasis rosea looks like seconday syphillis. SJS – NSAIDs. She circled and highlighted the information implicating niacin in significantly elevating the good cholesterol called “HDL.” I wished I could high 5 her for noting that, and teach her more about the form that wouldn’t cause flushing, the form that could cause liver enzyme elevation and how taking aspirin or vitamin C with it could reduce flushing.

Reading used books, especially used books with notes in them is one of my favorite pleasures in life.

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A new perspective on NPLEX

One of the doctors I had the pleasure of shadowing this past year is a huge fan of walking meditation. In fact, he did an entire presentation on it this year at the AANP in Colorado. My hypnotherapist-RN mother taught me how to do walking meditation at a young age. I’ve been taking the long way lately to the recycling bin and mailbox in our complex, meditating on my breath and the feeling of the ground against my feet. It’s incredible, love it, I can see why Priessnitz (the founder of hydrotherapy) stressed the importance of walking barefoot on grass covered in morning dew.

Anyway, here’s what hit me yesterday during my long walk on a surprisingly humid evening in the desert. I’m so grateful that we have a 3 day, 8-hours each day licensing exam. Although, I hear everyone leaves feeling like they’ve failed, and I hear the questions are absolutely absurd, I’m glad that they’re requiring that we have a standardized amount of knowledge before we can practice medicine.

Imagine if they didn’t? Imagine if we weren’t required to know what to do should a patient on calcium channel blockers have an adverse reaction to a magnesium push? Or if we got white powdery stuff in the mail and we didn’t know that you HAVE to treat suspected anthrax immediately with doxy or cipro.. Or if we didn’t review how to triage patients during a medical emergency, or if we didn’t know how to deliver a baby properly. Or imagine if we didn’t know drug-drug interactions/drug-herb interactions or black box warnings of drugs our patients seem to always come in on? ETC.

Do you feel me? So, even though it feels like this exam is my arch nemesis, it’s actually an ally.