Sunday, September 27, 2009

Focus. Focus.

Shout-out to UnsinkableMB: I have your avatar on the back of my hospital ID! Back when The Hair was still growing out--before it had become its own separate lifeform with its own desires and demands--I looked something like the woman with the coffee cup. It gave my patients pause.


Tomorrow starts class. The first couple of days will be cardiovascular stuff. If what I remember is what's going to happen tomorrow, it'll be horrendously dense, full of all sorts of things I probably ought to remember from school (how long ago was that, exactly?) and all sorts of things I never learned properly in the first place.

I have a confession to make: I never learned exactly how many chambers the heart has, how it repolarizes, and why exactly it beats. I'm not even sure any more how blood goes from one place to another. Seriously. Might be the pull of the moon, might be the contraction of one of those "ventricle" thingies that people are always talking about, might be the will of Jello Biafra. I don't know.

This fits in with my hypothesis, not yet disproved, that people who really get CV stuff rarely really get neuro stuff, and vice versa.

Anyway, my CV knowledge is built on an extremely shaky foundation. I know that there's something pumping away in the left-center of my chest; I can feel it. I know that there's a similar something in other people's chests; I've felt it there, too, going at various speeds. I know that that something that's bonking away in there has a lot to do with whether or not you keep blinking and breathing and scratching the eight hundred mosquito bites you got yesterday while mowing the lawn even though you were wearing Deep Woods Off and what the hell is that all about, anyway, did they import mosquitoes from Alaska? but I'm not real clear on anything beyond that.

Plus, after two days of CV Hell, we start intensive Neuro Hell. The internship group will be splitting up for that, with the CVCCU folks going off to learn more about that mysterious bonking thing in the chest, and those of us in Neuro CCU staying to learn more than we ever wanted to know about neuro anatomy, infections, tubes, machines that go beep, and complications. There are two of us going into the Neuro CCU; I do not expect to be able to hide in class.

But oh, my blessed (prize to the first person besides Beloved Sister who can identify where that phrase comes from), I am distracted.

It is cool out, finally. Although it hasn't rained enough to relieve the worst drought in central Texas in my lifetime, it's rained enough to make things resprout and turn green. The Hill Country is almost, almost pretty. North of the Hill Country, the weird mesa-like outcrops are covered with oak trees that, from a distance, look kind of healthy. It's cooling off. (Note to self: take next year's vacation in late September.) The days are beautiful and clear, and the nights have just enough chill to them to make me thankful for two cats at my feet.

My nose is waking up after a summer of air-conditioning and dust. This can be inconvenient, as smells that have nothing to do with critical care tend to lodge in there. I want to make soup, go to Central Market and buy marinated roasted long-stemmed artichoke hearts, and make a pilgrimage to Fort Worth to feed the koi in the botanical gardens.

And to top it all off? I'm sure this is news to nobody but me, but guys? Rock.

Focus. Focus. Calcium channels and independent wiring and aorta here and ventricle there and atria on top somewhere and somehow blood gets reoxygenated through the lungs. Yep. Lungs. Heart. Lungs. Heart.



little d, S.N. said...

Neuro still scares me more than cardio, but maybe that's because I spent a semester on Tele, and havent even SEEN a neuro unit. That's the problem with nursing school: where you get sent for clinicals drastically impacts what you wind up actually KNOWING.

IrasciblePlatypus said...

I first encountered the phrase "oh, my blessed" in Jacob Have I Loved, by Katherine Paterson. Really wonderfully good book.

Suzie said...

4 chambers. :)

cardiac cycle: Atrial contraction, Isovolumetric contraction, ventricular ejection, isovolumetric relaxation, ventricular filling.


horsetech said...

Is anyone else's brain starting to torture them with a version of "The Wheels On The Bus Go Round And Round" (and we never even sang that one in kindergarten, it was always "Do Your Ears Hang Low?" and "If You're Happy and You Know It")?

The blood in the chest goes round and round, round and round . . .

LaLa said...

"but oh, my blessed..."

sounds a bit like "Just So Stories" and "The Jungle Book" - not the Disney sanitized version... Rudyard Kipling's books. ;)

I'm most likely wrong, tho. I usually am.

Anonymous said...

I hear ya. My neuro is pretty shaky, stroke stuff is relatively fresh, but anything too complex is not my bag. CV on the other hand...that 4-chambered thingy in your chest? That's my bag baby. But really it is simple: just remember these words of wisdom a very wise anatomy teacher imparted: air goes in and out, blood goes round and round - any deviation from that is a bad thing.

Good luck!

Penny said...

I mention this only because fellow student Betsy, who has a previous master's degree and graduated Valedictorian of of that class and is currently leading her class in the one-year BS-to-BSN Official Program From HELL ITSELF didn't grasp this until I pointed it out to her.

Blood doesn't travel directly from the right atrium and ventricle to the left atrium and ventricle.

In all seriousness, this genius woman, who completely dusted everyone else in my A & P class, could NOT figure out how the blood goes from the right to left side until I pointed out to her that it goes to the lungs first.

Beyond that, I have absolutely nothing to offer you besides beer and hugs.

Maha said...

I'm in the camp of the neuro incompetents - numbness, drooping and loss of gait is bad. Also, don't get hit in the head and neck. Ouch.

It took me three weeks to prepare for a unit test on neuro for my first degree and the experience left me so damaged that in nursing school I silently wept in the neuro lectures. That of course left me even less knowledgeable in all matters neuro. So now whenever a patient of mine has a neuro consult, I fake bad English and quickly scurry away from the nursing station and google profusely :P

Kim said...

Man, this is a really bad sign. I always can remember the flow of blood and the heart chambers, but the brain stuff just will. not. stick. I blame the fact that they save the brain for end of A&P I when you're all burnt out.

But I hope this doesn't mean I'm meant for cardio as I find neuro far more interesting! I guess I'll find out in about a year.

Denise Nohner said...

Nothing to do with brains, hearts, or neuro-anything. Try Off Active next time. It smells VERY nice (almost fruity), and keeps them buggers away. =) The mosquitos (national "bird" of Minnesota) are huge here, too...but they don't like this stuff. Oh...and apply liberally. Cheers!

Anonymous said...

I'm a nursing student who just went through her first patho test which was on the CV system. I really found these links very helpful in understanding exactly what was going on physically and electrically. (flash) (flash)

It helped me a bit to go over pathology before I went over the basic functioning...I think because what is wrong tends to stick in my head (I find it more interesting) than what is right. You also might try drawing out a heart & circulatory system and/or getting one of those coloring books that they have for anatomy students.

Also, because I also just don't really "get" CV, it helped to break up the cardiac cycle (iso contraction, filling, etc.) and then put exactly what was happening electrically and physically in each category. Ooh, your prof SAYS that the test can't be passed by memorization alone but just hammering the information into my brain helped a lot.

Anyway, good luck!