From the home office in Wauwatosa, WI . . .

A fine tradition in blogging from Bob Marley State has been the semi-annual Top-Ten List of quotations from professors and students alike, all vying to earn a coveted spot on the list. The competition was rough, all participants eagerly offering intensely popular opinions on various subjects, from sex to drinking and even some medical school in between. I hope you enjoy the offerings. And, to celebrate the ending of our journey in Grenada, the Top-Ten, for the first time ever, will officially have TEN+ quotations. Without further blathering from your host, the final Grenadian Top-Ten Quotations:

1. "It's not the Jolly's pool, we pay rent here and we own the pool." - Mrs. Rooney, wife of a professor. A dear friend of mine secured housing in a duplex with a pool in the backyard. Unfortunately, the first time we attempted to use said pool, the upstairs tenants objected heartily to this intrusion of the property. This become a constant mantra throughout the term as she was mocked mercilessly for her attitudes.

2. "When I was a boy, my father took me aside and said, 'Look, Boy, it only takes a few minutes.' Now, you labor for four hours and still want longer." - Dr. Hans Baer, professor of pharmacology, explaining the benefits (or apparent lack thereof) of Viagra.

3. "If any of you want to be rheumatologists, I'll kill you. You have loans to pay, you don't want to be rheumatologists." - Dr. Jimmy Lawrence, professor and practitioner of rheumatology, which is essentially the study of joints and connective tissue diseases.

4. "Our team is like herpes - we're always hanging around." - Andy, discussing the ability of his team during a rousing round of flippy-cup, and illustrating the great applicability of medical knowledge to everyday life.

5. "See, this is more fun than anatomy. I bought the twisted pleasure kind." Dr. Francis McGill, during an incredibly informative lecture on birth control. She proceeded to pass around said condom, along with several IUD's, and later apologized for not bringing a dental dam.

6. "Actually, I've been told when I buy suits that my arms are a bit longer than my legs should indicate. So, I blame that on operating on fat ladies all the time and leaning over the operating table." - Dr. Theo Welch, 80 year-old professor and surgeon, explaining how fractures can stunt limb growth.

7. "Technically we're winning because we're the only ones drinking." - Jeff, explaining how his losing effort resulted in a win during a party we labeled "Football Saturday" early in the semester.

8. "My girlfriend's mother has an HDL [cholesterol level] of 120. She is never going to die." Dr. Manny Suarez, professor of geriatrics, explaining life expectancy, while his girlfriend was in attendance.

9. "If I wrote a book one day regarding how to get through your first year in residency, the title would be Don't Fuck Up." Dr. Suarez, describing what should be our first priority in residency.

10. "For example, after this lecture, I'm going to go back to the hotel and I'm going to start to drink, to try and recover from this experience." - Dr. John Saldini, during the middle of his first ever lecture, explaining the balance of salt and water in the body.

And finally, last, but probably the most memorable quote from our entire term, oft repeated for no apparent reason at all hours of the day:

11. "Guuuuuurrrrrrrrrrrrrrlllllllllllllllllllllll . . . yo' baby's turnin' blue!" - Dr. Lawrence, perfectly copied, during an explanation on anaphylactic shock and the patient's friend's reaction.

Stay tuned for further updates as my classmates and I prepare for the United States Medical Licensing Examination (USMLE - Step 1) and the likely hijinks that will ensue.

An Open Letter to selected islands...

Dear Grenada:

You earned a quick laugh for yourself. An EC$50.00 charge to leave your country is a clever way to earn a buck. You know that everyone wants to leave at all times, so the best way to make money is to charge people for their most coveted option. Brilliant - I shall endeavor to charge my patients in the same way: cheap visits and consultations; cheap lab tests and x-rays; but when it comes to the cure, milk it for all it's worth!

But that's not all. You worked your magic on the airlines, too. As I waited in the airport for my final flight from the island, it became to clear to me that I would not be free of your grasp anytime soon. Oh no, you cleverly arranged for a late arrival and departure from your humble airport.

I tried to leave my worries behind, but when my Air Jamaica flight arrived to collect me, it was an hour late! Normally, on my way home, these are not problems which concern me. However, when my connection from Jamaica to Chicago is scheduled to leave only 45 minutes after my arrival, I start to have doubts. Your promise of "The Spice of the Caribbean" rings hollow to many a young student's ear.

Dear St. Lucia:

How I would like to love you. Your beaches appear lovely from the air. You have mountains and valleys and lush vegetation. You have golden sand, gorgeous sailboats and friendly people. You apparently also have an airport. Unfortunately, I am only familiar with the runway and taxiway of your airport. I imagine that many would ask why. Many would wonder how this applies after my first letter to Grenada.

As it happens, Air Jamaica has jet-planes. So, I was flying with real power - none of those wimpy prop-planes that plague the American Airlines fleet. No, I was in a real position to have a safe and quick flight - with meal service, free champagne and the knowledge that I was flying toward Chicago at over 500 miles per hour with over 100 of my classmates. What I did not know is that you, St. Lucia, had the power to draw my beautiful jet-plane toward your island to board two extra passengers.

So, you successfully managed to take a flight that was already an hour late and lose more time to my rapidly decaying good mood.

And Dear Jamaica:

So many before me have been lured by your beaches, by your carefree attitude and by your bobsled team. But, in the end, you are no better than your comrades before you. As we taxied toward to the jet way and toward freedom, it was announced:

"All flights have been held and are awaiting boarding except those to Chicago, Atlanta and LA."

And so, it was unceremoniously that I learned there would be no America that day. There would be no snow. There would be no family. There would be no friendly faces. There would only be more sand, more saltwater, more "Ya, mon", more customs scrutiny (all my medical supplies were scrutinized and they needed to x-ray my chocolate bars twice to ensure . . . well, I have no idea what they were ensuring - it was chocolate) and 24 long hours of waiting for the next flight to depart for Chicago.

And even when I arrived at the airport the next day, you did your best to keep me there. Keeping my plane on the ground, while we sat in our seats, for an extra hour, we waited for some ubiquitous "customs paperwork" that was apparently missing. Of course it was missing - everything is always missing; everything is always delayed (except, clearly, on the previous day, when the flight obviously had to leave on time); everything runs on "Caribbean time" - to the very end.

But, when I stepped off that plane and froze my fingers and toes off, I had the last laugh. I was in America - the land of milk on the grocery stores; the land of choices in cereal; the land of clocks and schedules; the land of driving on the right-side of the road; the land of dollar bills; the land of couches and real ESPN.

So, you see Jamaica and St. Lucia and Grenada, you had your laughs for a day, but I will have mine for a lifetime. And, as I wash my laundry, lie on the couch and enjoy the food in the pantry, I know who's laughing now!

Sincerely yours,
Patrick Meloy, Unlicensed Medical Professional.

Four More Months . . .

Well, it has been a long and arduous journey to make it here to the final four months of my first two years of medical school. I spent a short and beautiful summer making new friends, seeing old friends and hanging out with my family. I also answered far too many questions about how I liked Grenada and how much fun it must be to "be drinking mai-tai's and living on the beach." I tried to be polite, but I really should have directed everyone to the blog to read about the police, the effort in collecting my packages and ridiculous adventures I have had just trying to get here!

And, speaking of ridiculous adventures, I, of course, have another fun story about my journey down to Grenada. It all began in the spring, when the university decided that we would no longer be attending classes on the island of St. Vincent, but would instead be traveling back to Grenada to complete our second year of school (holy crap, we've almost been here for two years!).

Well, since the decision to switch islands was made so late in the school year, everyone in my class needed to scramble, not only in finding a place to live, but also to find plane tickets to get back to the island. My normal carrier, the hated American Airlines, was booked solid a week before and a week after classes started. And, since I was not remotely interested in doing the "island tour" of which I am so familiar, I decided to try a new airline - enter Air Jamaica.

Many of my friends have flown Air Jamaica several times and are very happy with them. Champagne service, hot meals and direct flights are the norm and so I was ready to actually enjoy my trip (for the first time!). So, I booked a flight on a Saturday morning for a 6.40am flight to Montego Bay from Chicago and a direct flight from there to Grenada a few hours after landing. I was thrilled.

Many of my friends are also aware of my unhealthy obsession with working at the Wisconsin State Fair. Having been a fixture in my life for the past 12 years, I am confused as to what will happen in my life if I were to actually stop working there. Unfortunately, working this job also means 16-hour days and a serious lack of sleep leading up to my final rush of seeing friends, family and packing! (As an interesting aside, I believe that I only ate two meals in my home in the last 14 days before I came back to Grenada - how sad is that?).

So, despite all this work and the shopping and packing and breakfast meetings and lunch meetings and dinners at the Fair, I managed to be prepared to leave by Friday afternoon for my early Saturday morning flight. Recall, if you will, that my flight on Saturday left at 6.40am. As a seasoned traveler, I understand the ridiculous nature of air travel and the reasons for being at the airport two hours early for my flight. So, my lovely mom and I agreed to be up by 3.00am and leave the house by 3.30am in order to arrive at O'Hare by 5.00am. These decisions were made on Friday around 8.00pm.

Around midnight, on Friday, we again reconfirm the details of our morning excursion. Mom says, "I'll set the alarm for 4.00am and we'll be out of the house by 4.30am." Without thinking, I completely agree and we both head to bed. Recall, again, my flight leaves at 6.40! Everything in the morning goes smoothly, but we don't get out of the house until at least 4.45am! However, we are completely unfazed, and continue on our merry way, oblivious to the fact that we have left over an hour late!

After we stop for gas and get back on the road by about 5.15, it occurs to me that it is actually 5.15 - and we are still approximately one hour from O'Hare! So, I start driving in earnest. As usual, there is serious construction in Illinois, along with horrible toll-booths every few miles, but I am completely unaware of anything around me . . . except the clock! My mom leans over in the front seat and declares that she never even thought my little car could go that fast! Flying through tolls around 100mph, all I could think is that this is just another in a long line of problems that I have in reaching Grenada without incident. All flights were booked to the island for another week, so missing this one would be devastating.

We cruise into the terminal around 6.05 and by the time I sprint to the counter, it is 6.10! I am, obviously, the only person there trying to check in for an Air Jamaica flight 1/2 hour before departure. The agents' only instructions are, "Run!" And so, run I did! I get to security with my little bags of liquids all separated out and my medical supplies in my carry-on. The liquids go through fine, but the TSA officer has a real problem with my stethoscope and other pieces of equipment. I can't believe it. He wants to know how all the pieces work!

Finally, he finishes with his inspection and I grab my things (shoes still untied) and book toward the gate. I run up to the counter and hand my ticket in as I see the plane sitting at the gate - I'm going to make it! As I ask where to go, I realize, there are still a lot of passengers at this gate, but I am assuming that they are waiting for another flight.

False! The flight hasn't even boarded yet! I am saved! And I look like an idiot for running to the gate while everyone else is still waiting! Sweet! Eventually, we board the plane a few minutes late and set off for Jamaica. I suppose it wouldn't be the same trip to Grenada without a significant incident (see any previous post about travel for more information). I would hate to hope against hope, but it almost seems as though my Karma has shifted. Why, you ask? For the simple fact that my luggage made it with me and I did not even have to spend any nights sleeping in an airport!

Sorry for the weakness of this story, but it's just another example of the Grenadian adventures I have come to know so well. Check the pictures page in a few days for shots of the new house and a new blog soon regarding the amazing ability of our new semester to be so much like the old. Stay cool and use the a/c as often as possible in my memory (as we no longer get it for free!).

Return of the 'Top-Ten'

As so often happens at Bob Marley State University, I tend to lose track of all things in time and space. Actually, I think the real problem is that I happened to live close to the construction that was going in these recent terms – this causes a tremendous amount of marijuana to come floating through the air and into the rooms in which I reside. I say “rooms” as it becomes increasingly clear that I have not lived in an apartment or dorm, but rather, a cell that has stifled all creativity and destroyed my will to write and entertain those faithful who rely on my messages of encouragement, including Capt. Hutchens and his older-than-God son.

So, now that I am in full-recovery mode back in Milwaukee, WI, (which, although not technically Canada – in fact, it doesn’t even border Canada – is absolutely freezing. I think I have actually suffered frost-bite on two occasions already and I am working on a third), I am ready to write about the pleasantries that have occurred during the latest six-month streak on the tropical paradise that is Grenada.

To prepare for the onslaught of information that is the combination of 3^rd and 4^th terms in Grenada, I thought that I should begin with the Semi-Annual BMSU Top Ten List. Without further ado, let’s get to the quotes:

1. “So, when a 53-year-old CEO goes downtown to see his dominatrix and gets whipped on the bare buttocks while licking a toilet, that may reinforce the behavior.” – This was said by Dr. John Pettus, course director of the Behavioral Science class in Term 3. He was discussing conditioned stimuli and conditioned responses and chose to use an extremely colorful description. It was not just that he used this particular description, but he has the tendency to speak in an unbelievable monotone, and was able to say this with a straight-face and move directly onto the next topic. Needless to say, we were quite impressed.

2. “Can you remember the three items I gave you?” – Interviewer in a video demonstrating senile dementia.
“Ball, car and something to do with dope?” – The patient responded to the questions with amazing accuracy, considering that the three items were “ball, car and grass.”

3. “Saturday I’m going to get drunk like it’s my job.” – This was my roommate Jeff when discussing what we would do after our final exams were finished in 3^rd term. It is not just the fact that we were planning on drinking that weekend, but that there was a particular party we were planning on attending; namely, the 80s party. I myself am not a fan of the themed, dress-up party, but for some reason, the school’s 80s party has found its way into our hearts. To see for yourself, the glory that is the 80s party, check out the pictures in my album.

4. “A 35-year-old male from Ohio. He likes birds . . . I’ve said too much.” – Dr. Sukumbi. A former professor from the African continent, Dr. Sukumbi often had trouble with the English language (he once used a skunk in an example question and immediately said, "Skunk? What is skunk?"). Famously, the pathology class is rife with examples of diseases that, although they are highly variable in the real world, have only one answer in the exam world. Histoplasmosis is just one of these examples wherein, according to the class, one can only catch it in the Ohio River Valley, especially around bird droppings.

Now, this next one is not for the faint of heart (seriously, don't read this if you're as old or older than my roommate Andy) . . .

5. "Sometimes you need to be discrete, like when you're molesting young girls." - Dr. Stephen Vogel, neuro-pathology professor. I'm still honestly not sure what in the name of God he was referring to, but it definitely caught everyone's attention. We were discussing the way various lesions in the brain appear in a gross specimen and he was trying to get students to see the finer points. There is no doubt that we all missed the point entirely as we were all trying to fully appreciate this particular level of discreteness.

Well, as usual, I was not capable of finding ten actual quotes. However, I am not making any of them up (especially the level of discreteness required to see a disease). Stay tuned for some great stories of Fish 'Fryday', the Cricket World Cup and more. Also, check out the pictures page for more hijinks from the 80s party and other great extra-curricular activities.

Semi-Annual Top Ten

Second term is an interesting time at SGU. There is slightly more free time, but this is spent taking naps and worrying about which class to study for next. We spent about the same amount of time at the beach, the same amount of time goofing off and the same amount of time studying our butts off for the next exam. But, now that we are all second year medical students, it's time to reflect on the good times that we just experienced. And, without any more boring introduction, I present the second installment of the BMSU 'Top Ten':

1. "You're going to have to come back; she's in a bad mood." - A registration clerk. A friend of mine was trying to straighten out some information regarding his registration. Unfortunately for him, it seemed the clerk was not having the best day, so the best advice the neighboring desk could give was to simply go away. It's hardly a surprise given the strenuous work ethic . . . oh, who am I kidding, there is no work ethic, but its such a great response to someone seeking help.

2. "You can't buy that right now because we haven't scanned them into the computer." - The check-out lady at the local campus store. In order to streamline the process of buying simple goods on campus, they installed a scanner and computer register over the summer. Unfortunately, they had not figured out how to actually use this technology and were unwilling to actually type in the price (since the prices remained the same) so that I could purchase a bag of chips. Just another example of Grenadians working hard to please.

3. "All neurons have one thing in common: they are small." - Dr. House. A classic line from one of the few good professors we actually had this term. This was our first lecture about neuro-transmission and it helped to have a little brevity to begin the day.

4. "Last night, when I went to use the toilet before bedtime, I found that a crab was inside my toilet! And it helped me to find a good use for your physiology textbook; I slammed it onto the toilet seat and started flushing like mad! My heart started pumping at a much faster rate and my sympathetic nervous system was activated soon afterward. Just imagine if I were describing two-point discrimination in class today!" - Dr. Pontus Persson. He was one of our lecturers for physiology and taught all the material relating to the physiological responses of the heart to various stimuli. I can honestly say that this is an experience I have not yet had!

5. "A 10 out of 10 on the pain scale is like being in Grenada, metaphysically." - I actually said this during a discussion amongst the roommates about how every patient who walked into St. Michael's Emergency Department had a 10/10, no matter what the actual ailment. I was trying to describe what an actual 10/10 would feel like and it seemed the most appropriate at the time.

6. "Have you ever heard of a pharyngeologist? No. Have you ever heard of a kidneyologist? Yes. Then study that." - Andy Hutchens, my roommate. During our 2nd term, various students could apply to help teach subjects to those people who were taking them in their 1st term. Andy was in the anatomy lab as a demonstrator, helping 1st-term students to gain a better understanding of what to study and pointing out various structures on the different cadavers. One of the students came to him and asked a very detailed question regarding whether or not a certain structure located in the pharynx would be on the exam. Andy simplified matters by offering this easy explanation.

7. "B is the new A." - Sandy Sicular. In discussing our final grades for the semester, this short phrase was uttered and has taken on life of it's own since then. Sandy gets credit for saying it first, but you hear it all the time around campus as everyone is laughing when they say/hear it. Its only fitting that we would have such a slogan here at BMSU.

Well, I've noticed that I've again left this list far-short of the ten required for an official top-ten countdown. I guess it is a good thing that I am not terribly concerned about this situation at all. I hope you have enjoyed the wrap-up of 2nd term and are looking forward to more stories as I enter into my second official year of medical school. I'm just hoping it is filled with a happy abdomen, more fiber and interesting stories (I'm definitely convinced that my first visit to the Grenadian mental hospital will come with it's share of oddities).

Finally, I have posted pictures of my new housing on the island of St. Vincent. Its not quite completed, but our land-lady insists that it will be done by February and will be fantastic. I have no reason to doubt her and am looking forward to our new home (and the beautiful views that come with it).

I Fought the Law...

As has quickly become a tradition here in Grenada, after the end of our exams, we decided on having a nice dinner at the Beach House, the best restaurant that we can find locally. It was, as always, a rousing success. I have even uploaded photos, which can be seen on my pictures page, of all the people who were there and you can tell how much fun we had.

I myself, feeling much better after all the issues with my stomach over the recent months, was so happy to be hungry and was more than ready to eat a decent meal that did not include the use of my microwave. If you're ever in the neighborhood (and you really shouldn't be!) try the seared tuna; it's out of control.

As there were twelve of us at dinner and it seemed that everyone on campus was celebrating on that same night, dinner took exceptionally long, but we all enjoyed ourselves and the time spent relaxing in each other's company. We told stories, took pictures, laughed, drank and ate until it was time to move onto a more suitable bar to accommodate our increasingly loud conversation. Those of us who remained until the end managed to pile into two cars (sitting on laps and squeezing wherever possible) and headed back toward one of our more favored bars near campus.

As luck would have it, I was in the front car, driven by one of my neighbors across the hall. As we traveled along 'Airport Road', the other car, or so we thought, came up behind us and started flashing the brights and driving erratically. Well, naturally, the carful of idiot students that we are, we decided to offer some less than polite gestures out the windows and through the back window of the car. After it became clear that our 'friends' were not going to pass us, we simply sped up toward campus and headed down the long road that takes us into SGU.

It was at this point we discovered that the car behind us was, in fact, not our friends, but a non-descript pick-up truck driven by a man dressed in fatigues and his friend in sweatpants and a cut-off black shirt. They rapidly overtook us, pulled in front of our car in order to stop us and demanded that the driver hand over all his information and that we all be detained! They also demanded that the driver exit the car to be searched by these two men.

Well, for those of you who have never been, Grenada is a third world country at best, and it's law enforcement, or more appropriately, lack thereof, is abysmal in its top form. These two men repeatedly refused to show identification and continued to berate everyone in the car for our 'disrespect', yet offered no reasons for having pulled us over and offered no proof that they were in fact, officers of the law. For all intensive purposes, this had the look of a tourist robbery and we were the prime targets; inebriated students with no recourse!

The boys immediately got out of the car to assist the driver while the girls got on their phones and began calling everyone they knew. We had the embassy, the SGU security department, our friends, some peoples' parents and just about the entire campus alerted to our situation within minutes. And still, these two men, continuously yelling and making demands, refused to identify themselves except to say that they were police and we needed to do what they said.

While we were arguing over our rights with the supposed officers, more disconcerting activities began happening around us: other cars began pulling up and joining in the discourse, which at this point turned into yelling; these "officers'" friends drove around us and completely surrounded the car, were walking around and just yelling to "arrest everyone." Meanwhile, no one had yet to show a badge and no one had yet to wear anything more identifying than mesh shorts and cut-off t-shirts. It was safe to say things were starting to get out of hand!

At this point, we had all exited the car in question and were waiting for the SGU security team to come help us sort out the situation. Finally, they arrived and, surprisingly, confirmed that all these men were, in fact, police officers. So, we had been fighting with them the whole time when we should have been obeying them - yet still, no IDs were shown.

We were instructed to drive to the nearest Coast Guard station where questions would be asked and we would find out the punishment for our actions, despite no one actually yet explaining what we had done to be pulled over! With SGU security in tow and friends on the phones, we piled back into the car and made our way to the station.

Our driver and one other person were taken to an office and I was left with four girls at the car, to be guarded by the men with shotguns and M-16s. We knew they weren't going to shoot us, but perhaps the overzealous guarding could have been avoided in order to not screw with our heads.

As it happened, the boys in the office were being apologized to by the captain of the police force for the poor way in which we had been treated. It turns out, we were right to ask for IDs and these men had far overstepped their bounds in trying to force our compliance. Outside, nothing had changed; we were not recipients of apologies nor did the force required to keep us near the car change. In fact, at one point, I was called into the garage, away from the four ladies, to be asked where we were going, as though the guy in an athletic shirt was holding court with me in the garage!

It was all obscene and so over-the-top as to almost be comical. Except that it was not comical at all and could have been avoided in the first place if they had produced identification (as required by Grenadian law) or had a police car, flashing lights, etc. We were escorted back to campus and rehashed the whole scenario over several drinks, laughed a little, yelled at each other a little and reminded ourselves that Grenadians will always resent everything we do, no matter if it's a simple matter of going to school or a more complicated matter of driving home from a restaurant.

Part IV: Radioactive Eggs

After arriving back at school, it was decided by my friends that we would hold the Summer of George (reference Seinfeld) in order to recover my “deliciousness,” as it were. I have since posted pictures of this glorious day, which included wake boarding and other fine adventures, somewhere on my pictures link to the right. It was a fairly excellent day and evening and since we had all finished midterms (I had to retake the physiology midterm that I had missed, but survived unscathed) it was a nice day of relaxation as we prepared for the onslaught of the second half of the term.

Sadly, the recovery of my internal stability did not go as well as we had hoped. In fact, I continued to deteriorate. And so, it became increasingly clear that I needed to again head home and receive more medical attention. To ensure that I could not find what I needed in Grenada, I again headed to the clinic and was advised that there was nothing they could do except a blood test, that wouldn’t be drawn for another three days and then we would wait for the results. I politely declined.

My weight-loss notwithstanding (I had now dropped 30 pounds), the rest of my days were suffering from lack of food and drink and I was simply unable to function in a normal capacity. And so, the week before Thanksgiving, it was back to America to seek medical help for whatever was making my life miserable.

After the first round of blood tests came back negative, it was time for some more interesting methods. And so, I headed to the lovely St. Joseph’s Hospital in Milwaukee for some radiological studies. I had my first abdominal ultrasound followed by the most interesting test to date: a gastric emptying study.

I ate an egg that was scrambled with radioactive material and then placed in a machine that would measure the distance and speed with which the radioactive particles moved through my system. Finally, a test came back with some interesting results: my stomach empties at a rate which is 1/3 of the normal person’s.

The only problem with all this testing is that there is no definitive reason for why this should be happening. That is, now that we know the stomach empties at a slower rate, we still have to find out what is making it do that and how to make it go faster!

In the midst of all this testing, I was fortunate enough to be able to have Thanksgiving at home. I missed what purported to be the best Thanksgiving dinner ever cooked by my friends Jeff and Nick back in Grenada, but I think I got the better end of the deal. Rotisserie chicken with sweet potatoes, veggies and pumpkin pie for dessert and I was just about in heaven, even though I could only eat a child’s portion.

And so I began on a new round of drugs in the hopes that I would start feeling better. Finally, after two and a half weeks at home, lying on the couch and being force-fed by my entire family, I started feeling like I could eat more and was even hungry for food at some points.

With things starting to get better, it became clear that I needed to head back to school to try to recover and save what was still left of my second term of medical school. It seemed a daunting task. By the time I would return, I had missed a total of four weeks of lectures and was so far behind that I pretty much thought it would be an insurmountable amount of material to cover and recover in time to actually pass my classes.

As luck would have it, I found plane tickets for a Friday flight to Grenada. And, as my luck would also have it, there was a massive blizzard in Milwaukee and Chicago that night, grounding all flights from Chicago and pushing my flight plans back to Sunday. I was starting to cut it close as there were only seven days before exams began. Well, Sunday went well and I even met my roommate Jeff in San Juan as he was returning from his sister’s bat mitzvah.

We boarded our flight and made it back to Grenada without issue. After a week of painful studying and cramming, I managed to pass my classes and officially finished my first full year of medical school. I’m thousands of dollars in debt (made more clear by my woefully inadequate insurance plan), but I’m feeling better, eating more and starting to live my life again. I can only offer many thanks to my friends and family who helped my recover and are still supporting me now.

To recap my recent adventures:

- 1 complete abdominal CT with contrast.
- 1 series of chest x-rays.
- 1 upper-endoscopy.
- 1 colonoscopy.
- 2 IVs.
- 1 abdominal ultrasound.
- 47 separate blood tests.
- 1 urinalysis with culture.
- 3 stool samples for parasites, ova, cysts and cultures.
- 1 gastric emptying study.
- 11 separate plane flights.
- 6 separate doctors.
- 7 total prescriptions (including my now daily fiber dose - yes, I'm an old man now).
- 0 final diagnoses.

I know these last few entries may have been on the more boring side, but they were an important part of my life over these last four months and I believe this entire experience will only make my future career more empathetic and rewarding for both myself and my patients. I can also guarantee that the semi-annual “Bob Marley State Top Ten” and the story of our last night of exams will be more than enough to keep you reading into the new year.

Part III: Gallbladder Disease

It was at this point that most people I think would tend to quit. Andy and I had tried our best to secure diagnosis and treatment for some disorder that was affecting me, and yet, our efforts were thwarted at each turn. With a heavy heart I turned toward my family and advice from home to help recover from whatever dastardly disease was attacking my insides.

Hope was restored after speaking to a doctor in the States. He recommended a series of blood tests and x-rays that would help determine the extent of my difficulties and hopefully guide some sort of treatment plan while still allowing me to remain in Grenada and study for my various exams.

So, after completing my Neuroscience midterm after only 1 hour (those of you who have never taken neuroscience should scoff lightly at this remark – with 80 questions all requiring some serious second and third order logic and mental capacity, it was no small feat) I proceeded again to the on-campus clinic.

Armed with notes from my doctor and more information, I got to see a different doctor than the one who originally prescribed antibiotics for my virus. After reviewing what I told him, this doctor decided that the gastroenterologist at home was mistaken, and instead of the tests my doctor wanted preformed, I would instead be receiving an ultrasound of my gallbladder in order to rule out gallbladder disease.

Normally, I wouldn’t mind such a simple deviation from the plan, but the fact that he completely ignored everything I had said and just made his own plan, I was a little upset. Additionally, getting an ultrasound required getting an appointment somewhere in the city, taking the bus, getting copies of the exam, bringing them back the next day and hoping the doctor would read them and find the problem.

The last straw had been reached and broken. After consulting several students and family members and doctors, it was decided I would fly to Miami to see a real doctor and be treated in a real hospital. I booked the tickets, got my walking papers from the university saying I would be missing a few days and left the next morning.

My mom met me in Miami and we went to the nearest recommended hospital where we were met by a GI specialist recommended by my doctor from Milwaukee. He admitted me to the hospital and ordered a series of tests designed to test my mental stamina. Well, actually, I had to drink the contrast for an abdominal CT, which was horrible, and then prepare myself for an upper-endoscopy the next morning, all while knowing I had not moved my bowels in ten days. Needless to say, I wasn’t feeling well at this point.

The CT went well and the contrast worked miracles on my slow-moving intestines, increasing their secretion and moving fluid very quickly from one end to the other. This adequately prepared me for the new experience in the morning. The endoscopy was pleasant; I don’t remember a thing.

But, as a result of my slow moving bowels and the lack of information from the blood tests and a negative scope and cat-scan, I was given a wonderful medication called magnesium citrate. This works to essentially remove everything from your insides. I can say that after two doses, I was lucky to have insides left!

Unfortunately, after all this work, the doctors in Miami did not understand the fact that I did not live in Miami and needed to get back to school at some point. After arriving on a Wednesday and having my round of exams, they wanted me to leave the hospital on Saturday and come back on Monday for another procedure. I explained that I didn’t exactly have that luxury; they just suggested I spend Sunday in the hospital and have the exam on Monday anyway.

My mother and I had hit another last straw. We decided to head to Milwaukee to be treated by doctors who knew me and would be willing to help. Sadly, this was on the same day that I was still working out the magnesium citrate, and it was still working. It was an airplane ride that I am not interested in remembering!

After returning to Milwaukee, I saw my GI specialist and he recommended that I have what would come to be my most fun procedure yet: a colonoscopy. The truth is that I have absolutely no memory of the procedure (but the pictures from inside my bowels are pretty sweet), but I have a complete and horrible memory of taking the Fleet’s phospho-soda the night before and preparing my body for the procedure. The Fleet’s works about ten times better than the magnesium citrate and it works a lot faster. I was in some pure agony about twelve hours; then I got my versed on the table and was out. My next memory is of my dad asking if I thought I could walk to the car.

After all these tests and all these doctors, no one had found anything. It was suggested I head back to school with some new medications and tough it out until the end of the semester. Since there were only two months left, I thought that it shouldn’t be too hard and that I would be able to handle the regimen of medication and get through it.

What a foolish thought.

Part II: The Downtown Medical Centre

When we last parted ways, I was recovering well from a viral or bacterial infection in my throat. The good news is that, in Grenada, we don't need no stinkin ' lab tests to determine the actual nature of the illness, we just indiscriminately treat with antibiotics. I'm sure that my local intestinal flora and fauna were thrilled with that decision.

Medically, after recovering from this illness, I was doing pretty well. I was enjoying, as much as could be expected, my second term at medical school. This current term has a more interesting schedule than would be considered common for most university students. We take Neuroscience and Physiology for the entire semester, one lecture of each of these classes per day. Additionally, for the first three weeks of classes, we took Genetics. This entailed two lectures of per day. We then took the final exam in genetics and are officially the world's most knowledgeable geneticists, or something like that.

We swiftly (as in, the morning after our genetics final) transitioned into Immunology. So, at that point, we were taking Immunology, Neuroscience and Physiology, one lecture in each class per day. We were lucky enough to finish Immunology on Monday of this week with our final exam. This of course transitioned smoothly into Parasitology, a class in which I had my first two lectures this morning. We will finish Parasites in three weeks and then have a week of solely Neuro and Physio as we prepare for their respective final exams.

One could assume that this has been an interesting schedule to follow. Rest assured, we have also continued to randomly have Clinical Skills this term, and they have continued to impress, canceling lectures without informing the student body and demanding written reports of cases that they have, in fact, already written for us. It's been great!

So, during all of this greatness, I began noticing some problems with my digestive tract. Specifically, I was becoming increasingly nauseous, both during the day and during the night. I would wake up at night and feel like throwing up, but nothing would ever happen. It was like being stuck in the worst hangover, without a headache, just totally unable to eat. In fact, when I felt hungry and tried to eat, it just made things worse. It felt as though my entire intestinal system was rebelling against me and there was nothing I could do about it.

After several weeks of increasingly bad symptoms and the lack of any sort of recovery, I, along with the help of my friends, decided it was time for action. Instead of visiting the on-campus clinic, I would make my way to the Downtown Medical Centre and see a competent doctor there; someone who could order blood tests or x-rays or general medical things and get me back on my feet.

And so, on a Wednesday, I called the clinic and scheduled an appointment with Dr. Friday, for Friday. Already I was feeling better. It was almost as though I couldn't lose with this sort of luck, having a doctor named after one of the best days of the week. I even called back on Friday morning to confirm said appointment:

- "Hi, my name is Patrick and I'm calling to confirm my appointment with Dr. Friday this afternoon."
- "No problem, just come on in."
- "So, the doctor is there seeing patients right now?"
- "Yes, and you are on the schedule."

It's as though all my cares were vanishing in the wind. Only one problem remained.

- "So, where are you located?"
- "Well, do you know the market hill? Near the big hill road?"
- "Oh, of course, are there any other landmarks you can give me?"
- "Sure, it's down the block from the jewelers."

I can already tell that this is going to go well. So, Andy (who has graciously agreed to drive me, while using Angie's car) and I hop into the car and attempt to navigate our way downtown. In Grenada, there are only about three named streets, and everything else is just by landmark. To get downtown, one must follow the Main Road around the Carenage and through the Tunnel. Well, we managed to find the tunnel on the second pass of a one-street, going behind a grocery store and through an alley. Fortunately, the one-way tunnel took us right into the heart of St. George's and we were able to drive straight through the entire city center without once seeing the Downtown Medical Center.

Finally, we found it. It was located on a hill (big surprise), right next to the huge outdoor vegetable market (another amazing discovery). The big problem at this point was that there were no places to park. So, after all the work we put into actually finding the place, we decided to drive back out around the Carenage (leaving town by about two miles) and catching the Reggae bus back downtown. All the while, of course, I was feeling sick and the two of us should have been studying for the neuroscience midterm we were due to take the following Monday.

Finally, we were able to find the clinic and entered through a non-descript door on the second floor. I walked to the receptionist, said I was there to see Dr. Friday, gave my name, and she politely told us to have a seat while waited. This was at approximately 2.00pm. Finally, around 2.45, she said, "Are you hear to see Dr. Friday?" Almost speechless, I responded, "Yes, I had an appointment."

"Oh," she replied, "Well, the doctor isn't here right now, but he should be back at 3.15." I seriously thought I was going to have a heart attack while sitting in the waiting room - and I was there for my stomach! Andy and I briefly conferred and we decided since it had been so much work getting down there that we would stick it out and wait until the doctor arrived.

As 3.15 turned to 3.45, the receptionist thought it would be a good idea to ask another pertinent question, specifically, "Are you here for medical treatment?"
- Wait, what? "Yes, I'm here to the doctor."
- "So, you need medical attention, is that why you're here?

Oh my God. "Yes, I am here to see the doctor about a medical condition." For those of you who haven't been to Grenada, this might seem confusing. Wait, this is confusing. What the hell was she saying?
- "Oh, OK. Well, he still isn't here, but it should be soon. Can you please fill out this card indicating your contact information and why you are here?"

Again, Andy and I decided that we would wait slightly longer to see what would happen. Finally, a doctor walked through the door and went into his examination room. I asked the receptionist how long she thought it would be before I got to see him (keeping in mind that we still had our neuroscience midterm the following Monday). She replied that although he indeed was a doctor, he was actually the dermatologist and would be seeing all the other patients in the waiting room before me. If I still wanted, I could pay the fee and see him after he was finished with everyone else in front of us.

It was at this point that we decided it was time go! We took the reggae bus back to the car and headed back to campus, having accomplished nothing but frustration during the entire afternoon and falling further behind on our studying. Welcome to Grenadian health care.

Part I: The Virus and The School Clinic.

This is a picture of 'Happy Patrick'. How did he get such a picture with Mama Meloy, yet still manage to be enrolled in classes at St. George's University? This is an excellent question. A question that will require some explanantion, but starts all the way back in August, with the onset of a severe throat virus.

I am not a person who overreacts when I catch a cold/virus/infection or what-have-you. I tend to take my lumps, as it were, and try to ride out the storm until I feel better. I have rarely been known to complain about ailments, and even tried to convince my parents not to take me to the hospital after I had fallen 20 feet out of tree and fainted from the force of oxygen being expelled from my lungs.

This being true, after I contracted this virus, I was not overtly concerned; that is, until it did not leave my system. I said to myself, "Self, you're in medical school (see former posts for an explanation). Why don't you go to the clinic at said medical school and get some treatment for this sore throat. Perhaps you can use your superior anatomy and diagnostic skills to check your throat in the mirror to see if it is something more serious."

Well, myself did just that, and noticed (along with my always competent roommates Andy and Jeff) that there were some serious spots located on the 'hangy downy thingie' in the back of my throat. Except, using my anatomical knowledge, I said "Whoa, Patrick, there are some serious spots on your hangy downy thingie!" My roommates immediately noticed the same and it was then decided; I would head to the clinic in the morning.

Not having been to the clinic previously, I solicited advice from my fellow classmates who had been sick in previous time on the rock. Ruby had previously been sick, what did she have to say? Well, it turns out that Ruby had contracted a stomach ailment in her first term at school. This entailed the constant emptying of her stomach contents in a manner that was not compatible to eating, drinking or living in general, for almost an entire week. Dragged to the clinic by her good friends Judy and Nick, she was told by the physician extender (read: not a physician) to go home, drink some Gatorade, and she would feel better. Nick and Judy are no slouches, they demanded an IV, fluids, medication, and the gentleman staffing the clinic actually laughed. Ruby would not be getting any other treatment than his sound advice today; it was, after all, Saturday!

Ruby doesn't actually remember this conversation as she was completely asleep in the examining room while her friends pleaded for mercy from the controller of the fluids. Nope, they then had to drag poor Ruby back across campus to her room where the force-fed her Gatorade and water until she finally felt better a few days later. Now, having worked in an emergency department, I understand that sometimes a patient needs to spend some time in bed with a good book and some soup, but after a week of that treatment, one wonders about getting some actual medical attention. Not that Ruby would know; she was too exhausted!

So, I was slightly concerned that I would not be taken seriously with my sore throat, of all things. But, I headed over to the clinic looking like a vagabond in order to get a little better attention (you think I learned nothing from St. Mike's?). The clinic on campus is staffed by some fairly special doctors. It's possible they went to school in Grenada, hopefully not BMSU, but one never can tell around here. Anyway, I walked into the clinic, filled out a form, and began my wait.

And did I wait. I waited for over two hours to be seen for my throat. The nurse took my vitals in a room down the hall, and then sat me outside of different room, where I waited again. But, since I had gone to get my vitals and thought I was next, I now had lost my reading privileges when I left the year old issue of Esquire in the other waiting room. Damnation! After some more waiting, finally, I was to be seen next by the doctor.

Despite not being someone who gets bent out of shape when I get sick, I am always nervous and conscious of strep-throat, which I seem to have more often than the average population of humans. This being true, I went in with some expectations of what would happen: the doctor would do a quick physical exam and culture my throat, but then prescribe some penicillin and I would go to the pharmacy and in about 24 hours, would miraculously feel 100% better.

This is not precisely what happened. Despite the very technical exam I had performed the night before with my roommates, discovering the infection on my uvula (and you thought I didn't learn anything last term!), the doctor said she did not see anything. Well, after almost making me gag several times, she decided not to do a throat culture. As I would later discover, they never do a throat culture in Grenada. There simply are not the resources to carry out said operation. So, she continued to explain, "I don't see anything in your throat at all. It does look a little red, so I'm going to prescribe an antibiotic for your infection, even though I don't see anything. Actually, I think it's viral as there has been something going around campus."

- "It's viral? Then why are you prescribing something?"
- "I am just protecting you in case it is a bacterial infection. So you won't have to come back if it doesn't go away on just fluids and rest."

Well, seeing as I can't argue with that, I go get my prescription filled, begin taking the antibiotic and wait to feel better. Over a week later, after I had finished the entire course of antibiotics, I began to recover from this illness. The remedy provided by the clinic had done nothing more than contribute to the ever-growing population of antibiotic resistant bacteria causing so many problems in the world. I'm so glad I was able to be a part of this trend!

"What is the moral of this story?" one might ask. Well, this lays the groundwork for an even more fun trip to the clinic, both at school and in downtown St. George's, and even a trip to Miami! If you thought that the lack of knowledge was impressive here, than you'll have to wait to be amazed.

In other news, I am in the process of posting a TON more pictures. They are all available under the My Photos link to the right of this page. Also, I added some new and interesting features to the blog recently. If you look on the right side and scroll down to the button marked Geo-Visitors, you can click to see where in the world people have clicked onto the blog. It is pretty interesting to see visitors from Japan, the UK, South America and all over the states who are reading the posts. You can also see some of the other blogs that I like to read when I am postponing my studying.

Finally, I must apologize for the lack of material, so far, this term. It will all come out in the coming few weeks with the telling of my medical story, so don't give up on me. I finally finished all my midterms today, despite being well-past the actual mid-point of the semester, which factors into my lack of writing ability.