Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

Each day of my radiology rotation, I stepped into a reading room amidst the low buzz of residents and senior radiologists narrating their observations into Dictaphones at their computer workstations. There are no patients to be found in these dimly lit spaces, leaving medical students in the awkward position of seeking other targets of our rapt attention. So we would pull up a chair alongside a radiologist, their eyes trained on a triumverate of screens displaying digital X-ray and MRI images, and attempt to mentally reconstruct patients from their black and white anatomy.

During one of our morning observation sessions, I was surprised to hear a radiologist chide my classmate for retrieving details about a patient’s social history from his computerized medical record. It’s none of our business, she said, citing HIPAA (Health Insurance Portability and Accountability Act), the 1996 federal legislation that has become shorthand for a patient’s right to privacy. The law’s privacy rule requires that personal health information be accessed strictly on a need-to-know basis. It begged the question -- how much does a radiologist need to know about your personal life?

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

The headache occupies a unique place in our society, as both an over-worn excuse to avoid marital sex and a rare but often feared portent of brain cancer. We've all had one (mine tend to be of the caffeine-withdrawal variety), and they’re easy to write off. But for some, headaches represent a debilitating lifelong condition or a sign of an underlying disease process originating far from the head itself.

I chose to spend a morning in a headache clinic during my neurology rotation, in large part because the symptom carries such a fascinating range of implications. Plus, as medical students, the most bread-and-butter complaints are often the ones we feel least qualified to address, both in patients and in advice-seeking friends.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

During my recent transition from psychiatry to neurology rotations, I wondered how these two very different specialties would approach the same organ.

In a continuing nod to Descartes, psychiatry traditionally inhabits the realm of the mental, and neurology the physical, subsuming so-called "organic" brain diseases such as stroke and Alzheimer's. Neurologists use darting eyes and knee jerks to puzzle out the location of brain insults, then check their answers against the now almost requisite MRI or CT scan.

In psychiatry, diagnosis requires nuanced conversation with patients. But it is ultimately reduced to an exercise in clustering symptoms using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a cookbook-style compendium that’s useful as a standardization tool but recognized by many in the field as flawed.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

Countertransference, like many of the terms I've encountered on my psychiatry rotation at McLean Hospital, carries a pleasant Freudian musk and quickly lends itself to semi-ironic use in casual conversation. It refers to the emotions that a patient stirs up in a psychotherapist (whereas transference involves the patient's feelings). When we read a classic paper on countertransference in a recent teaching session, it was more than just an intellectual exercise.

Countertransference can be a hurdle to appropriate care and, when fully recognized, a diagnostic tool. For example, in the suicidal patients who unconsciously lessen their burden of self-hatred by provoking their doctors to hate them, the doctors' resulting avoidance can mean the difference between life and death. And the therapist's feelings of frustration, anger, and guilt when working with borderline personality patients have been all but written into the definition of the disorder.

Such topics seem right at home on the brick and foliage-defined, strangely idyllic liberal arts campus that is McLean. When we (the medical students) are not tending to mental status exams, medication adjustments, and MRIs on the locked unit, we're sitting outside on the lawn, drawing almost literary themes out of our patients' experiences.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

If surgeons are cowboys, then tending to the ranch has become just as central to their mission as riding off into the often unknown terrain of human anatomy. By the end of our three-month surgery rotation, this was a resounding theme: In the art and science of surgical decision-making, sometimes it’s better to wait.

Take the appendix, an evolutionary remnant that surgeons have been slicing out for nearly 125 years, whether it’s inflamed or merely encountered during another operation. Once the diagnosis of appendicitis is confirmed, it’s best to go right to the operating room to remove the organ before it bursts, we learned. But if the initial window of action has passed, and the disease process has produced a local collection of pus or a severely inflamed appendix, it’s often better to drain the site and wait 8 to 10 weeks to let the inflammation cool down before operating.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Joshua U. Klein, MD, is a fourth-year obstetrics and gynecology resident at Brigham and Women's and Massachusetts General hospitals.

Conventional wisdom dictates that hospitals should be avoided every July, the first month of the medical academic year. Like Cinderella in reverse, alarm clocks around the country erupt before dawn on or around July 1st (typically the last week of June), and yesterday’s inexperienced, naïve pumpkin -- medical student -- is magically transformed into Jane/John Doe, MD, the intern who will diagnose your heart attack or stroke and save your life in the emergency room.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

It's evident from the first cut of the scalpel, one of the earliest take-home messages from the OR: Surgeons inflict suffering in their work to relieve it. But unlike the diseased organ itself, the pain caused by operating on it is tough to definitively isolate and remove. My week-long elective with the Brigham and Women's post-op pain service (POPS) provided some insight into the challenges of this often under-appreciated pursuit.

Pain is subjective, the sensory experience of it closely tied to our emotions, thoughts, and memories. Attempts to measure pain -- whether they involve a line-up of cartoon faces wearing smiles and grimaces of varying intensity or even a pages-long questionnaire designed for research-level precision -- inevitably fail to capture these nuances.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Joshua U. Klein, MD, is a third-year obstetrics and gynecology resident at Brigham and Women's and Massachusetts General hospitals.

The threat of medical malpractice litigation looms large over much of the medical profession these days, especially in high-risk specialties such as obstetrics. Disturbing as this may be for attending (i.e. full-fledged) physicians, doctors-in-training (i.e. residents) can be in a particularly precarious position. Their professional standing entails a peculiar combination of limited experience with abundant front-line responsibility, which certainly can put them at risk of litigation if things don’t go well.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

When a page from my team’s chief resident invites me to watch TV in the OR, I know not to bring popcorn. He’s referring to the video imaging that has changed the way surgery is performed -- one laparoscopic procedure at a time.

In a matter of 20 years, laparoscopic surgery has evolved from gazing directly into the abdomen through a tube to a sophisticated gold standard for gallbladder removals and appendectomies. Though it comes with its share of risks, this minimally invasive technique leaves just a few 2-centimeter scars, and many studies show that it reduces recovery times and post-operative pain for the patient -- not to mention the visual treat for observers.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

My first job of the day is gathering The Numbers: heart rate, temperature, blood levels of sodium and calcium…Every morning, well before 6 a.m. surgery rounds, I spread out the records of each patient I’m following onto the nurse’s station counter and pen these values into the slots and grids I’ve carefully ordered on a notecard.

The order is key, the first thing to master — when I later recite the numbers to the team outside my patient’s room, breathless from our group-sprint down eight flights of stairs. Meaning will (hopefully) spring out of this predictable arrangement.

It’s not the most glamorous part of the surgery rotation — the suturing, stapling, and appendix removal (with supervision) make for better stories, to be sure. But analyzing the numbers lets the team decide if our patient’s bleeding risk is low enough to send him to the O.R., how much fluid loss needs to be compensated post-op with an IV drip, and when he can go home.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

It's my first week of third-year, and I'm on my best behavior. Not just because clinical work merits a new level of professionalism (to many of the patients I'll meet, I’m already Dr. Ganguli). But also because our class has entered a Strange New World, known colloquially as a teaching hospital. Learning how to occupy our humble place in its medical hierarchy is critical to our survival.

The etiquette demanded of this role comprised much of the orientation leading up to this week’s clinical debut. For the sake of our patients, we learned, we must be quick to admit our lack of knowledge and authority, and even more careful in phrasing this sentiment. So we went around the room last Thursday and Friday, graciously deferring judgment to a higher-up (chief resident, attending physician) in dozens of clinical hypotheticals.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Joshua U. Klein, MD, is a third-year obstetrics and gynecology resident at Brigham and Women's and Massachusetts General hospitals.

Most people agree that society has an obligation to train young physicians. In the U.S., academic medical centers -- "teaching hospitals" -- are the setting where this duty is discharged. Most physicians working at teaching hospitals are “academic faculty,” meaning, among other things, that they are responsible for teaching medical students and trainees (they also usually carry an academic title, such as "Professor of Medicine," rather than being known merely as Dr. Smith or Dr. Jones). These academic doctors are also the ones performing scientific research, lecturing in medical schools, writing medical textbooks, and being quoted by the local newspaper regarding the latest developments in their respective fields.

Generally, an implicit understanding exists regarding teaching hospitals. The deal works like this: If a patient wants to be cared for by the famous Professor So-and-So (the one who’s written the book on their disease, for instance), he/she should expect that trainees such as medical students, residents, and fellows will be involved in his or her care. Most teaching hospitals do include the fact that trainees may be part of their care team in the formal consent form that patients sign upon admission to the hospital. But these same consent forms also state that patients have the right to decline to have trainees participate in their care, if they so choose.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is about to start her third year as a Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

In the very-linear path to doctorhood, the Step I Board Exams mark the end of the classroom learning that has defined 20 years of our lives. This national licensing exam covers All of Medicine (as we know it) and is known to be the worst of the bunch (Step II, at the end of medical school, requires about two weeks of preparation, and Step III no more than the proverbial number 2 pencil, the saying goes). It also represents the first time we’re graded (Harvard Medical School is pass/fail). We need to pass the exam to graduate, but the score is a component of our residency bid in two years.

Preparing for this exam was the singular focus of our precious free time in the past few months, and the soon-weary excuse for skipping out on social events and neglecting the Important Things in Life. In our attempts to learn or relearn the vast amount of material covered by the exam, we clung to the tried-and-true review books, memorized inane mnemonics that often stuck longer than the content they represented, and clicked through endless cycles of online practice questions.

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Joshua U. Klein, MD, is a third-year obstetrics and gynecology resident at Brigham and Women's and Massachusetts General hospitals.

During most of my interviews for medical school, I was asked to explain my decision as an undergraduate to major in English rather than biology or another science, given that I had always intended to become a doctor. My canned answer revolved around the idea that learning to read well and write effectively helped me become a better communicator, and that good communication is the foundation of good doctoring. Despite the fact that at that point in my life the only doctoring I had ever done involved Band-aids and Tylenol, medical school and residency training have demonstrated to me that I was lucky enough to be right.

In Boston, language barriers pose a frequent challenge to good communication with patients. While my passable Hebrew rarely comes in handy (although the one Israeli couple whose baby I delivered loved it), I use my broken Spanish ("como estas?" "dolor?" "sangre?" ... and that's about it) almost daily.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

There’s not one right way to deliver bad news to a patient, one of a doctor's most difficult tasks. And I can imagine hundreds of ways to get it wrong.

The Patient Doctor II course directors at Massachusetts General Hospital decided eight years ago that it wasn’t enough for medical school admissions committees to select compassionate applicants -- some of these skills need to be taught. So they began taking their students to the Wellness Community, a wood-paneled oasis in Newton, where cancer patients and survivors come together to share their experiences and enjoy each other’s company. Our task was to talk with members of the community, role-playing those life-changing moments when a doctor first says the C word.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

More often than not, the patients we interview and examine as medical students (and beyond) are elderly. But there’s little frank discussion during our training about the particular challenges, and joys, of such encounters. Dr. Anne Fabiny chief of geriatrics at Cambridge Health Alliance, and her geriatrician colleagues at several Harvard-affiliated hospitals, are hoping to change that.

On Wednesday afternoon, our Patient-Doctor class paid a visit to the BIDMC simulation center, tag-teaming interviews with patient actors while preceptors and other classmates observed behind a two-way mirror. After a lecture on the dos and don’ts of elder care (eg. Speak with elderly patients with large volume and low pitch, since high notes are the first to go), we took a field trip to the Hebrew Rehabilitation Center in Roslindale to test these skills on real patients.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

In his newly released memoir, Intern: A Doctor's Initiation, New York cardiologist Sandeep Jauhar writes about the infamously arduous year of training that follows medical school. I invited Dr. Jauhar -- a fellow writer and friend -- to speak at HMS last Thursday.

The passages he read, before an attentive assembly of first- through fourth-year medical students, documented the loneliness of his experience at New York Hospital -- despite the hustle and bustle on the floors -- in harrowing detail. He described his first solo "road trip" taking an elderly woman for a routine MRI in the bowels of the hospital, a trip that left her in near-cardiac arrest and the young intern feeling helpless.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

David Cutler, Harvard healthcare economist and senior health policy advisor to Barack Obama, provided some fodder for thought as we head to the polling booths on Super Duper Tuesday.

He began with the broad strokes: Democrats pretty much agree on healthcare and tend to shoot themselves over minor differences, he told a packed audience of medical school students, faculty, and affiliates on Thursday. Republicans pay less attention to healthcare as a campaign issue.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Medical students spilled out of the classroom in which 23-year-fugitive and ex-convict Katherine Ann Power spoke last week about medical care behind bars.

Power -- who drove the getaway car during a 1970 bank robbery that resulted in the death of Boston police officer Walter Schroeder -- shared insights from her six years as an inmate of Framingham Women's Prison: tales I expected to hear, about little sympathy for the sick and the need for control trumping access to medicine, and others that surprised me in their positivity.

Prison came with some relative perks, she told us. For many of the women, this was their first opportunity to spend time taking care of themselves, a sad testament to their previous lives. Regular attendance at exercise classes shaved days off their sentences, providing tidy incentives for Power and her fellow inmates to stay fit.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Shadowing is one of the many singular experiences of medical training. Since working out the etiquette (Do I literally shadow the doctor or leave a good yard or two of personal space between us? How close is too close?), I’ve gotten to really enjoy it.

Years before they have opened an MCAT book, some eager pre-meds start following their pediatricians with the hope of gaining a sense of the profession and picking up useful medical trivia. As medical students, we do pretty much the same. But at this stage of the process, we have a few more skills to offer both the patient and doctor who let us in on their visit, and more to learn from them.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Red wine got another boost last week with the news that a concentrated form of resveratrol -- a compound found in the beverage -- lowered glucose levels of diabetes patients in a preliminary clinical trial. I first heard about the compound in last year’s biochemistry course when David Sinclair, one of the Harvard scientists behind the research, featured the compound in his lecture. Dr. Sinclair has connected resveratrol to longevity and prevention of age-related diseases in numerous animal studies.

When I took a study break to attend his dinner talk on the topic last Wednesday, I was reminded of a common theme in our medical training -- the tension between learning about cutting-edge science and mastering the basics that is perhaps inevitable at a prominent research university.

As we gear up to study for April's step I board exams, which place a high premium on the Well-Established Truths of Medicine (new and controversial topics fit poorly into multiple choice format), I find myself choosing the reliable over the new to stuff into my soon-to-be weary brain. It’s a shame, and I look forward to the day when I can easily juggle the two. In the meantime, I might as well reap the benefits of a little Cabernet (though of course, as Dr. Sinclair reminded us, one would have to drink thousands of bottles a day to match the doses in the study).

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Dr. Judah Folkman's passing has been deeply felt in the Harvard medical community and beyond. He will always be revered for his inestimable contributions to cancer research. We can also remember him as a genuine clinician and a gifted teacher.

I recall my excitement last spring when I discovered that our roster of lecturers included the famed scientist. And Dr. Folkman did not disappoint. His talk on congenital malformations was lucid and engrossing. He would present each bleak image of a newborn, organs spilling from an open stomach, and explain the child's condition with the calm insight of a seasoned professional. And then he would step away from the lectern and reflect on the bigger picture, sharing with us what he'd learned in his decades at the bedside.

One lesson in particular stuck with me. He told us to be constantly aware of parents' fear and suffering in the face of their child's debilitating condition. Whether or not we were religious, we would do good to remind parents that they had been chosen to teach, by example, the power of resilience.

In his 74 years, Dr. Folkman certainly set an example for the innumerable students, patients, and colleagues whose lives he touched. As we grieve his unexpected loss, we can aspire to do right by his wise words and gentle smile.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

In the isolating bubble of medical school, Washington, D.C., can seem far away.

But the prominence of healthcare issues in the 2008 presidential primaries -- with continual media reminders of the 47 million uninsured and polls showing that healthcare has risen to become one of the top voter concerns -- should convince even the apolitical among us to care about the race to the White House.

I’ve been watching with a great deal of interest (it’s like following sports, I decided, except that these results affect us beyond game day). And on Saturday morning, two classmates and I drove up to Nashua, N.H., to canvass for a certain unnamed Democrat in the presidential primary.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

After I spent much of winter break catching up on television, I returned to find that my hedonistic pursuits have some value in medical school. On our first day of hematology, Dr. Orah Platt lectured on anemia -- having too few red blood cells. The cases she featured, and tested us on using game-show style remote controls, were not her patients in the strictest sense. …

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

The results of the lottery for third-year hospital assignments were distributed on Friday morning, in thin envelopes reminiscent of medical school rejection letters. During a break between lectures, I made my way to my in-school mailbox, my stomach queasy at the imminence of this knowledge. I was happy to find that my piece of cream-colored letterhead said Brigham and Women’s Hospital -- my home away from home starting in May. The Brigham was my first choice, because it seemed to have a nice balance between classroom and hands-on learning. (72% of us received our first choice out of four, the rest our second, according to the letter.)

We clustered near the mailboxes, accosting latecomers with the inevitable question and doling out congratulations and consolatory hugs as if merit had played any role in the decisions.
Our assignments also dictate the 40-odd classmates we’ll be learning alongside, or at least passing in the hallways, in our year-long initiation into clinical medicine. By that night, Facebook groups had been formed, housing situations tentatively re-aligned, and plans for Brigham/Beth Israel mixers put forward.

One of the goals of the longitudinal approach is to give students a sense of solidarity and belonging within the vast Harvard medical system. In our pre-clinical years, HMS societies served that critical function. As we prepare to take on bewildering new challenges in third year, it’s good to have both the teams and the settings in place.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Balancing the demands of a career with those of family is a common theme in medicine — it plays out even in our early stages of training. Thanks to the combined effects of biology and slow-changing social mores, women bear a greater burden in the family arena; we are all too often faced with difficult choices, compelled to pick “or” instead of “and.”

I can’t say yet where I’ll draw my line, but I know already that something will have to give.

In the spirit of bringing light to such issues, some of my classmates have organized a panel of female surgeons to discuss the challenges of this balancing act in a male-dominated field. Another group has put together a dinner discussion on “work, relationships, and life in medicine.” The only problem is, both talks are scheduled for the same time this evening. Go figure.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

For most students, Thanksgiving break provides a much-needed lull during an intense fall semester. In the haze of turkey and pre-Christmas shopping, one might comfortably forget the nuances of Homer’s Iliad or the complexities of differential equations.

Not so for would-be doctors -- reminders of our academic pursuits are everywhere, in the requisite “how are you?” when greeting an aunt, or an offhand observation of a sibling’s cough.
Luckily for me, my relatives are willing and gracious practice models for my nascent doctoring technique. And occasionally I can do a little something for them at the same time.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Once a year for the past 101 years, Harvard medical students have exchanged stethoscopes for microphones and taken the stage to skewer professors and pay tribute to their class. This weekend, we present our version of the annual Second Year Show.

The requirements for this deliciously irreverent tradition? A convoluted but eventually resolved plot, mildly offensive, orchestra-accompanied song parodies, extravagantly choreographed dance numbers (at least one of which is Indian in origin), and a cast of nearly 100.

Traditionally, it’s our last hurrah and class bonding opportunity before we start studying for the board exams in the spring and hit the wards soon after. Our process began with a popcorn and wine-fueled brainstorming session in May, and after a summer of writing and a fall of rehearsals and meetings, we can finally present the fruits of our labors: “All I really need to know I learned in medical school.”

As the oft-proclaimed guinea pigs of the school's New Integrated Curriculum, we chose to represent our journeys through this uncharted territory in the guise of colorful characters who each worry that their presence at Harvard is the result of the first mistake ever made by the Admissions Office. From the socially awkward social medicine groupie to the dental student with bad breath, these misfits make their way through first year of medical school (which looks suspiciously like kindergarten) and realize that some lessons, and lesson plans, never grow old. (Sound like a publicity tagline? That’s because it is…As a co-producer and writer for the show, I have finally run out of new ways to describe it).

That leads me to my shameless plug: We have two more performances, tonight and tomorrow night at 8 pm, at the Roxbury Community College Mainstage Theater. Tickets are still available at the door and at www.secondyearshow.com.

More on the performances soon!

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

On Tuesday night, I witnessed a near-riot -- during yet another class meeting to explain how we’ll be affected by the med school’s new curriculum.

In the next two weeks, we’ll have to rank our choices for the hospital where we’ll spend almost all of our waking and sleeping hours in our third year of medical school. Though recent pilot programs have tested out the so-called longitudinal approach to our clinical training (read: spend the year in one hospital instead of several), it will be required for the first time for the class of 2010. This translates into what would seem an important choice.

But any merits of the new plan aside, the administration managed to ruffle some feathers in communicating this information to us.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

We finished neuro (-science, -biology, -anatomy) on Friday, and though completing a three-hour, hand-numbing final exam is always cause for celebration, I'm a bit sad to see this course go. Perhaps from their intimate understanding of the human brain, or else from pure chance, our neurology professors were particularly adept at tailoring material to fit into our brains.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Last week's needle-stick pseudo-scare has all but resolved itself. The on-call doctor never received my page, it turned out. This has happened before, and doctors at University Health Services are looking into the reasons for the miscommunication.

Ruffled by the lack of an authority figure's oversight, I picked the brains of my colleagues in training. These accidents happen fairly frequently at Harvard hospitals and elsewhere, I discovered. A friend at another medical school cited a classmate who had stuck himself twice and started prophylactic antiretroviral therapy for HIV both times, until he could be sure the needle's previous target didn't have the disease.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

I committed the ultimate medical faux pas last night -- sticking myself with a used syringe. I have yet to find out what the full extent of the precautionary repercussions will be, since I’m still waiting for the doctor on-call for blood-borne disease exposures to, ahem, call me back. But the situation doesn’t seem too dire -- and on the bright side, I’ve achieved blood-sister status with one of my housemates.

Early in the evening, I decided to check out a training workshop on administering flu shots so I could help dole them out to the Boston community. This represented the first time we’d actually get to puncture a patient -- until now, we’d done talking and testing, but no treating. So, on entering the classroom, I was relieved to see a cluster of citrus fruits next to the vials and disposable needles on the table. Apparently our first bumbling efforts would be endured by inanimate objects.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

As we head into our final weeks of neurology -- the first specialty we’ve really been exposed to -- we’re starting to hear the stump speeches of doctors eager to proselytize on behalf of their chosen field.

Neurology can be as difficult as, well, brain surgery, but the field is also elegant in its simplicity, as said proselytizers are quick to remind us. Despite recent leaps in our ability to image brains, the reflex hammers and lightly probing fingertips of yesteryear still take us most of the way to a diagnosis. And neurological deficits can be picked up in the subtlest changes of a patient’s gait or speech.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

For the past few weeks, I’ve been living off the bounty of my "altruism": Coffee, yogurt, energy bars, and soymilk from Boston’s Race for the Cure, t-shirts and fruit roll-ups from the Harvard University-wide Day of Service, and a little musical and comedic nourishment for the soul at the Boston 826 community writing center fund-raiser.

In Boston, there’s no dearth of do-good opportunities -- medical or otherwise -- and they come with more than a fair share of Free Stuff.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

As we learn how to perform the neurological exam, a string of prominent lecturers stand before us and offer us the versions of these techniques that they swear by. To test peripheral vision, one neurologist always asks his patients to point to his wiggling fingers, while another flashes numbers, and so on.

We’ve been practicing elements of the exam on our classmates for a few weeks now, but last week was our first chance to test our skills on actual patients.

My charge at Massachusetts General Hospital, Mr. B, had wisps of white hair and a permanently flexed hand that made him look much older than his 52 years. A stroke had paralyzed his right side and he now lived alone with occasional visits from a nurse. Mr. B was gracious though confused, and eager to chat.

Short White Coat is a blog written by second-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

I'm back from a summer’s hiatus from medical school -- the last we’ll get until graduation. With the recent start of a second year crammed with endless classroom hours and totebags of take-home work, as well as the vaguely looming threat of next spring’s Board Exams, training has shifted into high gear.

Last spring, I wrote about learning how to talk to patients, how to use empathic words to connect with them and accumulate facts about their medical histories. In our second-year version of Patient Doctor class -- in which we'll actually touch and probe our guileless test patients -- we discovered this week that we need to know why we're asking each question. It's called taking an "informed history," and it requires steering the interview toward a shifting target diagnosis. If asking about a headache complaint, we must suspect migraine, tumor, or hemorrhage (among other options) and ask questions that will parse out the true cause.

Short White Coat is a blog written by fourth-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

The phone calls started coming in even before I’d finished one semester of medical school. As the only person in my immediate or distant family to pursue a career in medicine, I often get calls from relatives with questions about particular drugs or treatments or ailments.

They don’t mean to bother me; if I were a chef, perhaps they would call to consult me about particular blends of spices. But with these phone calls, the stakes are much higher. The consequence for giving bad advice about paprika is a ruined meal, but the consequence for giving poor advice about blood pressure medication could be a heart attack.

Short White Coat is a blog written by fourth-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

The intensive care unit is the most aptly named wing of any hospital. Everything about the ICU at Children’s Hospital Boston is intense: the patients are acutely ill and many require the simultaneous monitoring of each breath and heartbeat. Caring for these patients is intellectually and emotionally demanding for the nurses and doctors.

Many of the patients in the ICU are intubated and sedated and therefore unable to speak. As a student, I visit and examine the patients I am following before rounds every morning. This ritual of pre-rounding is usually my favorite part of the day -— a chance to chat with the patients in order get to know them better, and also an opportunity to practice my physical exam skills.

Pre-rounding in the ICU, however, is different. One of the patients I am following is recovering from a neurologic injury so severe that she is unable to talk to me or even to open her eyes by herself. In the absence of speech, the many monitors chirp her progress. While in many instances the physical exam during pre-rounding feels perfunctory, in the ICU the physical exam is one of the few windows into a patient’s overall condition. I shine a light into my patient’s eyes and watch her pupils constrict, a reflex that reveals that the nerves that sense light and cause the pupil to get smaller are intact along their entire tract in the brain. Wielding only a red rubber hammer, I document the reflexes in her arms and legs. I am meticulous, because the smallest change in her physical exam could be the symptom of a larger change in her brain or other vital organ.

In the ICU, lifesaving drugs and advanced technology help keep my patient alive, but as one of her caregivers, all I can do is monitor her progress and wait and hope for her to get better. More than the machines or the array of illnesses, I think it is the collective waiting and hoping of parents and nurses and doctors that makes the intensive care unit so intense.

Short White Coat is a blog written by fourth-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

When is a wave not a wave? One of the first patients I saw on the pediatric neurology service at Children's Hospital Boston was a 12-month-old baby who had recently started raising her right arm when she became agitated. Her arm seemed to take on a life of its own, so sudden and repetitive were its movements.

While she had been developing normally -- she could pull herself up and was already saying a few words -- there was concern that her arm-raising might be the sign of something more sinister: partial seizures. When we examined her, she seemed perfectly normal. But a baby's brain can be hard to examine. A more conclusive test would be to monitor the electrical activity of her brain while she was waving her arm.

While the baby didn't seem to enjoy the sticky electrodes placed on her scalp, the electroencephalogram was much more physically taxing on the parents. They stayed up all night to monitor when she was having episodes of arm raising, so that the brain-wave recording could be correlated with the episodes. Even if her parents didn't have to remain wakeful and vigilant all night, I doubt they would have been able to sleep. The hours waiting for a test result to come back can stretch as long as the corridors of the hospital.

For my patient, the results were good. This baby did not have seizures -- just a quirky arm-raising habit when she got upset, perhaps the earliest signs of her personality emerging.

Though her neurologic work-up wasn't complicated, my experience with this patient and her parents reminded me that too often on the wards, we forget that every patient fits into a network of family and friends who worry and wait for every test result.

Short White Coat is a blog written by third-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

As a student in the operating room, there is ample opportunity to look around. And there is a lot to see: Inside each and every patient is a uniquely beautiful anatomy that tells stories of previous operations or illness; there is the long table with rows and rows of shiny instruments (often named after famous surgeons); there are the clear blue lines of demarcation between sterile and contaminated.

What you don’t see very much is the patient's exterior. Except for exposed skin where the incision will be made, most of the patient is covered up. A big blue drape creates a curtain that hides the patient’s head and the team of anesthesiologists who quietly toil to keep the patient comfortable and asleep.

Last week, I had a chance to venture behind the blue curtain as part of a one-week anesthesiology rotation. While surgeons cut a swath through disease, it is the anesthesiologist’s job to make sure the patient stays alive during the operation. The airway, the heart, the lungs, the eyes, and the skin are all carefully monitored for signs of discomfort or distress. Not unlike air traffic controllers, an anesthesiologist avidly and continuously surveys the patient for the first sign of something abnormal. There is a true art to staring at the EKG stream of a thousand normal heartbeats and then noticing the slight variation that portends of arrhythmia.

In the midst of watching all the monitors, on the anesthesia side of the curtain, I could also look upon the sleeping face of the patient I was helping. For some reason the patient’s face, more than the knee or liver or aorta that I could see and touch on the surgical side of the curtain, reminded me of why we were in the operating room in the first place.

Short White Coat, our blog about medical school, has a new blogger: Jennifer Srygley, a third-year student at Harvard Medical School. Jennifer grew up in Tallahassee, FL, and attended the University of Georgia, where she majored in genetics and creative writing. As a medical student, she tries to remain aware of the strangeness and beauty of her surroundings on the hospital wards, all while taking good care of patients. Her posts will appear here as part of White Coat Notes. E-mail Jennifer at jen.shortwhitecoat@gmail.com.

My day starts and ends with numbers. As a medical student on the surgical service, my first task every morning is to go to every patient’s room and record temperature, heart rate, blood pressure, fluid intake, and urine output.

With time, the numbers themselves have come to take on meaning. The number 102, for example, is alternately alarming or reassuring, depending on whether it is a temperature or a systolic blood pressure measurement. There are some patients that I have come to know not only by chief complaint or social history, but by their numbers: Mr. L’s heart usually beats between 70 and 80 times per minute. Knowing this detail is enough to recognize the earliest signs of dehydration when his heart rate climbs to the 90s.

And there is something else. I find it comforting to know exactly how fast the hearts of all my patients are beating. While my task of writing down the vital signs every morning and afternoon does not require any particular skill or training, I enjoy the sense of vigilance and duty that it provides.

The next step in medical training is to know what to do about each number, when to become concerned about the deviation of a particular number from normal, and when to act. The clinical skill of number interpretation will come with time, I hope. For now I am content to carry my patient’s pulses on an index card in my pocket.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. During Ishani's absence this summer, third-year Harvard med student Jennifer Srygley will take on the blogging duties. Her posts will appear here, as part of White Coat Notes.

First year ended on Friday with a final exam and a frenzy of packing and goodbyes. Though I’m still feeling my way through the medical system, this year has provided me a unique perspective on health and healthcare issues that affect us all and has led me to think deeply about disparities in the system, the patient-doctor relationship, and the science underlying both. Not to mention that I finally buckled down and figured out my own health insurance plan.

As my classmates dispersed to Boston labs to pipette their way to biomedical miracles, and to other continents to save the world one health survey at a time, I flew into Washington, DC, later that Friday with a slightly different plan: to write about such activities, making both medical research and global health news accessible to the public.

I’ll be spending my one summer break at Reuters, through the Kaiser Family Foundation’s Media Internship in Health Reporting. Though Memorial Day has passed, my white coat may get some strange looks at the DC Bureau’s health desk, so I’ll have to stash it for the summer. But I look forward to returning to Short White Coat in late August when I start my second year.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

In Patient Doctor I -- the art of taking a medical history -- several classmates and I intrude weekly into the lives of Beth Israel Deaconess Medical Center patients to practice our interviewing skills and bedside manner.

Last week, these skills were captured in all their glory on videotape as we interviewed "patients," portrayed by actors, about stomach pain and bisexual curiosity. I bumbled my way through the interview, armed with a year’s worth of reading about how far to sit from a patient, what tone to adopt, how to listen attentively, and when to stay silent -- more the stuff of a Miss Manners column than a class textbook.

Though we often joke about such inorganic means of teaching and implementing kindness -- "That must be tough for you" is one empathic statement that we deliberately overuse to the point of absurdity -—I’ve found that learning the vocabulary of human connection can be just as critical as the language of human anatomy and disease.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

As promised, a follow-up to the Society Olympics preparations I wrote about last week: Cannon didn’t quite bring home the pink flamingo on Friday, but we trailed the winning team by a meager four points out of their 88. Despite losing our chance at the plastic bird, and our voices from cheering so loudly, the day was well worth the sleepless nights preceding it.

Pranks came to a head on game day. After the distraction of morning lectures, the five societies braved the rain to enact elaborate processions before a panel of distinguished judges at the tennis court.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

I’ve worn the same T-shirt every day this week. It’s not because of my pressing need to do laundry so much as team solidarity —- this Friday, my medical school society (Cannon) plans to beat out the others in the Society Olympics, and our matching goldenrod shirts are just the start of our efforts.

Harvard Med is divided into societies named after big-time physicians of years past (Dr. Walter Bradford Cannon discovered the "fight or flight" phenomenon). For most of the year, the main differences between them are the quirks of society masters, the amount of toner in the society printer, and whether our food funds are directed towards post-exam ice cream or weekly lunches. On Friday, all five societies will be facing off in a series of epic battles to win bragging rights and, according to rumors, a pink flamingo.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Medical school has made a hypochondriac out of me. As we’ve been learning to sharpen our diagnostic acuity, I’ve self-diagnosed everything from blisters to brain hemorrhages -- and thankfully, I am almost always wrong. But now that we’re knee deep into microbiology, meeting the cast of minuscule characters that are harmless and insidious in turn, my paranoia may be slightly more justified.

We play with these bugs nearly every day in micro lab, staining them and feeding them in different ways to figure out their identities. The bacteria responsible for meningitis were taken off the roster this year (just in case), but I have to say, I’m not too thrilled about the notion of acquiring a skin-peeling staph infection or gonorrhea either.

Short White Coat is a blog written by first-year Harvard medical student Ishani Ganguli. Ishani's posts appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Now that lectures are videotaped, Harvard medical professors seem to be hamming it up for the camera, using song and dance to entice students to watch and learn.

Earlier this month, Shiv Pillai tried genres as diverse as the ode, the mantra, and hip hop to summarize and attach some sort of teleology to complicated immunology pathways while lightening up otherwise tedious lecture-packed days. His melancholy take on T cells: "Looking for antigen below and above, Many will die of unrequited love."

"Thread that peptide into TAP," he added with an enthusiastic shimmy, encouraging us to join in. "Everybody do the lymphocyte rap!"

Short White Coat is our new blog, written by first-year Harvard medical student Ishani Ganguli. Ishani's posts will appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

By now the statistics, and the photos that bring them to life, are familiar but no less jarring: Ten million people die each year from preventable and treatable causes -— mostly infectious diseases long forgotten in the developed world. Developing nations account for 90 percent of global deaths but only 10 percent of pharmaceutical sales each year, in large part because drugs aren’t affordable.

Our spring course on Social Medicine switched this year from elective to mandatory as testament to a growing emphasis on humanism in medicine. Headed up by such global health celebrities as Jim Kim and Paul Farmer, the class tends to be focused accordingly, on problems in the developing world.

On Thursday afternoons, Farmer or Kim, co-founders of Partners in Health, stand behind the podium, present such statistics, and ask us what we can do to solve these problems in an earnest tone that suggests that even they, despite their decades of dedication to the cause, have little idea.

Sitting in the lecture hall, it’s easy to feel overwhelmed and inadequate in the face of such challenges. But as our professors -- who began their global health work when they were classmates at Harvard Medical School -- know, students have a unique drive and capacity to effect change, especially on their home turf.

Short White Coat is our new blog, written by first-year Harvard medical student Ishani Ganguli. Ishani's posts will appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Who says medical school can’t be fun? I’m taking Human Sexuality in Medicine, a spring elective meant to supply future doctors with the knowledge and vocabulary to discuss this sometimes uncomfortable subject with patients. In previous weeks we’ve covered the anatomy and physiology of it, as well as what can go wrong.

During Thursday’s session, a sex therapist with effusive gesturing habits shared her experiences in the field with our predominantly female classroom.

Lessons learned: Talk to each member of a couple individually to root out the cause of complaints in the bedroom. Don’t be afraid to talk methods. And even 85-year-olds have concerns about sex (so ask).

Short White Coat is our new blog, written by first-year Harvard medical student Ishani Ganguli. Ishani's posts will appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

The air around the medical school quad was rife with the promise of autumn and movie stars last week.

Brightly colored leaves were plastic—taped to the branches of budding trees lining the quad and strewn on the surrounding grass last Tuesday for the filming of a scene in Columbia Pictures' "21." But besides Jim Sturgess, the star, the other actors in the movie (including Kevin Spacey, Laurence Fishburne, and Kate Bosworth) were nowhere to be stalked.

"21" is directed by Legally Blonde’s Robert Luketic and based on the best-selling book "Bringing Down the House: The Inside Story of Six MIT Students Who Took Vegas for Millions." It turns out one of the six gets into Harvard Med at the end of the movie, so the film crew arrived here before dawn to recreate an autumn scene.

Short White Coat is our new blog, written by first-year Harvard medical student Ishani Ganguli. Ishani's posts will appear here, as part of White Coat Notes.

Call it a testament to the media’s role in education, or total cluelessness on my part: I discovered today, when reading Liz Kowalczyk’s piece in the Globe on the white coat hierarchy and in a subsequent conversation with a fourth-year friend, that my classmates and I may be wearing the hip-length version of the white coat through our residency training and even as attending (senior) physicians. So much for the distinguishing mark of a medical student.

I will argue, however, that the true mark of a medical student can still be considered the wearing of said coat outside the hospital. Residents and even higher-up med students usually know better. While first-years are still enamored by the short-white look, my guess is that one wants to shed the garment as soon as possible after wearing it for twenty-four hours straight.

Short White Coat is our new blog, written by first-year Harvard medical student Ishani Ganguli. A short white coat is the hip-length garment worn by medical students to signify their place in the medical hierarchy. Ishani's posts will appear here, as part of White Coat Notes. E-mail Ishani at shortwhitecoat@gmail.com.

Under the mandate of Harvard Medical School's recently unveiled New Integrated Curriculum, my professors draw connections with fresh gusto, whether it is between disciplines or from benches to bedsides.

For one such integrated experience during my physiology course, I accompanied classmates to the intensive care unit at Beth Israel Deaconess Medical Center one day last month. Eight of us gathered in a meeting room outside the unit so that our professor could tell us about the patient we would observe and discuss, in an attempt to heighten our textbook appreciation of the lungs and kidneys.

As he finished describing a 45-year-old woman's unrelenting multi-organ failure and led us into her room, I mentally prepared myself for the sight. It wasn't my first time in the ICU -- I had been exposed as a candy-striper in high school -— but it was the first time I could bring any real medical knowledge to bear in such a setting, and it was a daunting prospect.