Friday, July 28, 2006

Does that make me crazy?

Probably.

First off, let me say that I'm still doing the thing I always do in med school. Namely, wanting to specialize in whatever we're currently learning about. Currently, I'm considering the life of a pathologist or psychiatrist. I guess that just means I enjoy the material. Hooray! Moving on...

The first lecture of SBS was sort of a psychopathology overview, and one of the subjects discussed was the MSE. That's Mental status Exam, not Materials Science & Engineering. According to the notes, "The mental status examination is a psychiatric equivalent of the physical examination." I'll point out that the MSE involves slightly fewer rubber gloves, but slightly more turn-your-head-and-cough's.

For the most part, the MSE is quite simple. Who are you? Where are you? Do I look fat in these pants? How old are you? Does this look infected? Who's the president? What is this (while holding up a simple object)? Seriously, I think it's infected, can you take another look? Of course I know I'm the doctor, but can't you just help me out? Have you always been such a jerk? What did the five fingers say to the face? You know, pretty standard. And a lot of the exam is just to check out a person's demeanor, posture, moods, etc.

But then you get into some more complex stuff. Knowledge, math, abstract reasoning, vocabulary, filling out W-2's. These things help rule out (or in) Alzheimer's, certain kinds of strokes, mad cow, and other such witchcraft and devilry. I gotta be honest with you - I think I'd fail some of these sections depending on the questions I was asked. I consider myself to be (mostly) mentally competent and stable, but damn. Check out these sample questions from the notes:

Information
These are just used to assess what you know, or at least what you can remember off the top of your head. (answers courtesy of Wikipedia)

Where do we get turpentine from?
Um...the hardware store? Nice try, smartass. Did you know the real answer is pine trees? 'Cause I sure didn't.

When is Labor Day?
I will never, ever remember this. I will be on my death bed and my dying words will be, "Wait, when is Labor Day again?" I've been trying to lock this one into memory for 22 years, and it never works. It's the first Monday in September. See, I forgot already.

How far is it from New York to Chicago
Too far to walk? A million billion miles? I would guess 1000 miles, because it's nice and even. The correct answer is 719 miles. I should've guessed 1 mile. Then I'd be closest without going over. Unless some jerk guessed 2 miles. I hate when they do that....

Who wrote "Paradise Lost?"
I only know it's Milton because this was asked in a video shown in class. Most Americans would never get this, and they'd probably attack you for insulting their intelligence.

Who invented the airplane?
You said, "The Wright Brothers," didn't you? Wrong. But I'm sure that's the answer they're looking for. The real answer (debatably) is Clement Ader, who successfully flew 13 years before the Wrights in 1890. But he was Freedom, so nobody cared. And if you answered Clement Ader to the physician, they'd probably think you're crazy. It doesn't even sounds like a real name.

Who discovered the South Pole?
What the hell? I'll go ahead and guess Sualc Atnas, which is just Santa Claus spelled backwards. The correct answer is Roald Amundsen, from Norway. Another fake sounding name and another wrong answer.

The rest are pretty easy (how many items are in a dozen), but these are no good. They probably exist just to see how you respond to difficult questions. If you start crying or stab the interviewer, you probably have an underlying condition.

Vocabulary
Testing to see if you know the definitions of words. Again most are easy, but look at these:

chattel - I knew this one because I'm weird, but I imagine most people probably wouldn't
dilatory - yep. that's a good word.
flout - I actually got this one wrong playing Cranium
amanuensis - you know what? go to hell.

Abstract Thinking
This portion of the exam tests your ability to interpret proverbs. Proverbs such as "don't count your chickens before they're hatched." Most of them I've heard of, but some just boggled my mind.

As the twig is bent, so is the tree inclined.
Really? Good to know. Is it a critique on the flaws of one person being reflected on society as a whole? A commentary on many mistakes adding up? A cruel joke by a botanist?

The tongue is the enemy of the neck.
Never heard this one. And it took me forever to even form a hypothesis for the meaning. After a full class of noodle-scratching and chin-stroking, I devised one. The tongue represents speach and the neck is in reference to beheading people, which is a representative of trouble in general. So running your mouth off gets you in trouble. But it took* me quite a while to figure that out, much longer than any doctor would allow. especially if you're on an HMO. They'd probably say the proverb, then say "did you understand that? Yes or no only, please."

Penguins trampling radios never sell baguettes on Labor Day.
Oh, come on! That doesn't even make sense! And I already told you I don't know about Labor Day!



There's some other questionable material, but I don't care to write about it. So I'd do pretty well on a mental status exam, but not as well as I would hope. I think I'd be considered psychotic and slightly demented. That makes two medical examinations I'd fail: physical and mental. And I'm not looking too good on the spiritual front either. But we haven't had that exam yet, so I've still got time to study...

*EDITOR'S NOTE: the first time I wrote "it took," it came out "tit ook." Just thought I'd share.

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