christmas update

in case you didn't get the memo...

Season’s Greetings!

I hope this card finds you all well and in good spirits. This past year has been both exciting and busy and the upcoming year promises to be the same.

As most of you know, I completed my Master’s in Physiology at Georgetown University in July 2004 and returned back to the Midwest to attend medical school shortly thereafter. I have been in Kirksville, Missouri for the last year attending the Kirksville College of Osteopathic Medicine. It was an amazingly smooth transition and I have met some truly amazing people here. I have been very active in several special interest groups as well as the student government. I currently serve as the 1st Vice President for the student body and the Vice President for the Emergency Medicine Interest Group and participate in the Sports Medicine Club. I am also working with the National Collegiate EMS Foundation as their North-Central Regional Coordinator.

I also have been very active in planning a medical mission trip to South Africa. I was part of a group of thirteen students from our school to initiate a program with the community of Atlantis, a large suburb of Cape Town that is home to many people displaced after Apartheid. Obviously any medical mission trip is unique and undoubtedly life-changing, but having built this experience from the ground up, our group has become very attached to our friends overseas. Though we were only in our clinics for two weeks, we saw over 2,000 children and were able to provide referrals and healthcare access to a large population that would have otherwise gone untreated.

Outside of classes, Kirksville has been a great place to continue with some of my other hobbies. Most notably, I have started fishing again. There are a couple of great spots for bluegill, crappie, and largemouth bass fishing as well as the occasional walleye. In addition, I’ve started playing volleyball again and have been trying to get out and run everyone once and a while. Exercise has become an increasingly important pastime since most of us find ourselves packing on pounds when we have a long string of exams or finals.

Even though it seems like a lot has changed, I still spend a lot of time thinking about how lucky I was to have been given the opportunity to do everything I did before medical school. Most notably, every tiny bit of clinical experience I received has been of unbelievable benefit. I’ve tried to reiterate to everyone I know throughout the years the importance of remembering all the people that helped them along the way. Even today, I think about everything that I learned from my experiences in IEMS, GERMS, Covenant ER and Pro Ambulance. I was so lucky to have people take the time to teach me the trade secrets that have made me a pretty savvy clinician even before I hit the wards.

So that’s pretty much it for me. My parents are both still somewhat retired out in the San José area in California. My mom just started volunteering for the City of Milpitas working with the Chinese community. She’s mostly spending her time translating complaints of the non-English speaking citizens for the City. My dad is still a workout fiend and I am sure he will be swinging into action when income tax time rolls around. My brother recently left his job with the Carle Foundation Hospital Advertising and Marketing Department in Urbana, Illinois to pursue a career in Law Enforcement with the Urbana Police Department. He graduated from Police Academy in September and has been on orientation at UPD.

I know that for many of you, this is probably the first communication you have received from me in years. However, I hope that the upcoming months will be more conducive to communications. If nothing else, I invite you all to send me an e-mail or check my web log at http://andyjou.blogspot.com. I know these seem very impersonal, but I hope to speak with you all very soon.

Sincerely,

Andy

fate is giving me the finger

it would stand to reason that since I'm on holiday, I'm getting sick. balls.

California, here we come...

Well, I suppose I was doing fairly well with blogging, but then medical school happened - or more accurately, decided to get worse. Anyway, since last Monday, we had the match for rotations and I matched to Arizona with about 80% of my closest friends. So on the plus side, I get to spend what should be the most enjoyable two years of medical school with many of my really good friends. On the other hand, I will be further away from the other fifth of the people I have gotten to know and love. Its kind of a mixed blessing I guess.

So, that was Monday. Other than that, I was relieved to have done well on a ridiculously difficult Pharmacology test on pretty much every antibiotic ever invented. I also managed to ridiculously awful on what should have been a really easy Cardiology test. The week was then closed out with a great Neurology written by one of the best professors I have ever seen. So that was pretty much the culmination of three weeks of medical school.

To celebrate the end of Truman's fall semester and the end of Neurology, Kirbi, Aaron and I drove out to Kansas City, Kansas for a Death Cab for Cutie concert. Unfortunately, we left a bit late and missed Alkaline Trio, Hot Hot Heat, et al. Much to our dismay, the KC crowd was pretty sedate. Seriously, the crowd just stood there. They were pretty much unresponsive to anything except for the heavy hitters off the new album. There wasn't even any mindless swaying going on. Well, except for the threesome behind us that kept making out. Thank you, Kansas City, for ruining what could have been an awesome concert. Go home and watch Laguna Beach you worthless bags of flesh. On a positive note, we stopped at a really awesome coffee shop on the way back. Small, good staff, and most importantly open until midnight... and it had a super-sweet bathroom. Really, I almost took a picture.

So we got back from KC around 3am on Saturday morning and I managed to crawl into bed and pass out until about noon. Saturday was spent cleaning and packing for my trip out west. By the time evening rolled around, Esther, Ben, Kirbi, Aaron, Vita, and I headed out to luxurious Leisure World for a round of bowling. We managed to choke down about one hundred tator tots as well as a veritable Whitman's Sampler of fried goodness. After bowling, Vita, Aaron and I went back to Vita's place where we watched "Say It Isn't So" until about 2am and then continued with random feats of internet interest.

I woke up Sunday and got ready to drive to Champaign to visit my brother. I packed everything into my car and headed off. I was thoroughly enjoying the 70mph speed limit on Route 63 and completely forgot the 60mph speed limit on Route 36. This proved to be pretty unfortunate as a Missouri patrolman zipped past me, made a U-turn and flipped on his lights. I knew immediately that he was coming for me. I pulled over and he came up to me and did his routine. I was shocked to hear him ask "you know your registration is expired?" My heart sank and I was waiting for him to flash the handcuffs. Fortunately, he told me that although he believed I was going a bit fast, he was going to write me a ticket for my expired registration. I could have jumped in his trooper pants and had an awkward moment with him right there. Seriously, a $67 ticket versus a $84 and an inevitable trip to driving school. Thank you, Mr. Trooper. Needless to say, from there on out, it was cruise control on 70mph.

So, my brief stay in Champaign was highlighted by trips to my favorite hangouts. This is basically a long day of errands at Meijer, Schnucks, the Saturn dealer, Barnes and Noble, and Pages for All Ages. I also briefly visited at Pro and Covenant, but things looked pretty busy in Emergency-land so those visits were fairly brief. Great Harvest was unfortunately closed so I will have to bring baked goodies when I head back. I also missed out on a trip to Friar Tuck's, but I think I'll head that way before I head back to Kirksville. So, if you have liquor requests, shoot me an e-mail before the 28th.

Now, here I am, finally back in sunny California. Some little ponderings that I would have scrawled into a Moleskine if I had one:

• Holy, Jebus. There are a lot of Asians in Champaign. About half the flight out to O'Hare didn't speak English. Not English as a primary language - English at all.
• O'Hare either needs more functional power outlets where I can plug in laptop or less people who want to plug in their laptops to watch NC-17 DVDs.
• Fox has truly done a service to the rest of the world by creating the series "The O.C." For anyone that hasn't spent five minutes in the area, real life is just like the series. People are really as ridiculous as they appear. I sat on my flight from John Wayne Airport to San Jose listening to these ridicuous women talk about how they prefer to let the "white trash" to the "heavy lifting." I felt so helpless with my only socially acceptable recourse being to leave the window shade open so the sun could add a couple years to their already wrinkled, plastic-surgery laden skin.

Fortunately, I'm better now. I just had a gigantic bowl of spicy beef and tripe noodles. That's right - tripe. I love tripe. I don't care if you are yacking your brains out right now - its delicious.

Also - thanks to Dave Koslowski for the hint on SomaFM. I've pretty much been listening it non-stop. I highly recommend the Xmas in Frisko, Secret Agent, and Indie Pop Rocks streams. You can also find them on iTunes if you look hard enough.

well, that would suck

So, I find out where I will be spending the next two years of my life in about two hours... so, please forgive my inability to concentrate. Instead of being diligent in Pharmacology, I've been looking up some codes for the International Classification of Diseases (ICD-9). The following were some that gave me a good chuckle during class:

E928.2 Accident or Injury due to vibration
E917.6 Crushed or pushed by a human stampede
E918.0 Caught, crushed, jammed, or pinched in escalator
E923.8 Accident caused by explosive missile
E928.1 Exposure to noise
E996.0 Injury due to war operations by fireball effects
E831.2 Beauty parlor personnel crushed by lifeboat after abandoning ship
E844.4 Skywriter sucked into jet without accident to aircraft
E882.0 Fall from or out of flagpole
E885.9 Fall from other slipping, tripping, or stumbling on moving sidewalk

More on rotations as they become available.

sheer madness

so, the busy saturday is finally at an end. I woke up at 6:30am to throw a lasagna in the oven for APO's Adopt-A-Child. The event basically revolves around a central part where we take the kids shopping with a $30 APO donation and whatever else we want to contribute. Anyway, I went back to sleep for about an hour or so before showering and getting ready to get to the TCC for the event. Overall, the event was a good time despite my somewhat disenchanting experience with my adoptee.

So, after Adopt-A-Child was over, Titus approached me about going to Thousand Hills with him to help "in case anything happens." That's right - it was just around freezing and Titus decides it would be a good idea to go swimming in the lake. Typical. I agreed and headed out to Thousand Hills armed with blankets, hand warmers, and a whole lot of Emer-Gen-C. I thought I had some extra bags of LR lying around, but I was semi-shocked to find them all frozen solid as they had been sitting in the trunk of my car.

this was the sight at thousand hills... perfect for a dip in the lake.

One by one, people started showing up at the boat launch. Much to my surprise, Titus had recruited two more people to participate; Aaron and Nate. It was at this moment that I started to go into a bit of a panic mode. I had planned for two swimmers, not three. I can't begin to describe the series of emotions that set in as my mind started to race with the contingency plans of hauling a frozen body out of the water. Thoughts of having to perform life-saving measures on my friends flooded my brain - something I had hoped to never experience again. All three had put on wetsuits and started to slather vasoline over their exposed skin. We were getting ready to start. At this point, I was basically at DefCon1.

We started to launch the boat to the side of the dock, where there was minimal ice coverage. Fortunately, this was a shallow area with very little rock coverage. Unfortunately, this was exactly where the park restaurant dining area looked over the lake. It was official: we had an audience. The ice was too thick to pierce but too thin to walk on. We could only hope to scoot across the ice using what I imagine to be the most ridiculous-looking implementation of Newton's Laws of Motion. Eventually, we did make it to the open water and the current immediately began pushing us back toward the ice. I thought to myself that this was absolutely insane - and I wasn't even in the water.

At this point, Titus, Nate and Aaron began their approach to the water. They warily stepped out onto the ice as we floated nearby. Unexpectedly, the ice gave as Titus plunged into the water. It was like a scene out of a bad movie. Fortunately, he immediately surfaced and let out a yelp as he commented about the frigid water. With one body in the water, Aaron and Nate immediately followed. After a few strokes, Aaron's brain must have finally comprehended the insanity of this whole ordeal and turned back for shore. Nate and Titus continued on and we realized this was actually going to happen. Not a second went by where my brain wasn't contemplating the process of hauling one of them into the boat. All I could think was "dear God, let the shore be closer than it looks."

This whole endeavor continued as Seth and his wife paddled us along side Nate and Titus. We would periodically shout encouraging comments at them. This was apparantly wasted effort as we later discovered they never heard us. It was about ten or fifteen minutes before we caught sight of the shore. At this point, Aaron jumped back into the water to finish off what he had started. For the last five minutes all three headed back to the point where warm blankets and hot water awaited them. Dr. Lovy, Vita and Jeff were at the ready as all three staggered out of the frozen water. As we landed the boat, we quickly ran up to help with the rewarming process.

So, needless to say, there were no casualties and we were very fortunate that everyone seemed unscathed by the entire endeavor. And that, is pretty much the average weekend in medical school.

thy fate is sealed

So its hard to believe that its actually time to think about next year. We had to turn in our site selections for our third and fourth year today. From here on out, its pretty much "random." Its really somewhat scary to think that since site selection is over, the only real steps left in this journey are boards and rotations. Who would have thought that the days would go by so fast? So here they are in order:

1.) Arizona (Mesa, Phoenix)
2.) Genesys Regional Medical Center (Grand Blanc, Michigan)
3.) Grandview Hospital and Medical Center (Dayton, Ohio)
4.) Atlantic Health System (New Jersey)
5.) Colorado (Grand Junction)
6.) Des Peres Hospital (St. Louis, Missouri)

So, I hope to be out in Arizona next year - but there is pretty good chance that I won't be able to get that site since pretty much everyone I hear talk about rotations in our class is buzzing about Arizona. So, all I can do is wait and hope that luck is on my side - especially since I declined a perfectly good opportunity to secure that site through the fellowship program. Sigh.

growing up sucks

I have to admit that it has been a while since I was nostalgic and thought life would be so much easier as a ten-year old. The last couple days have been just so emotionally draining and have really forced me to grow both emotionally and spiritually.

Obviously, the first scenario involves the prospect of staying in Kirksville for another year to work as a Medical Education fellow. First and foremost, I should say that I declined the fellowship. While I still think it would have been a great opportunity, I just don't think it fits me right now. When faced with the decision to choose between money and my friends, I chose my friends. Having the support of my parents when making this decision was also very comforting. Although I had already made my choice on Friday, they called on Saturday and left me a voicemail that pretty much echoed a lot of my thoughts. I can't say that the limited amount of time I had to make the decision was of any help, either. The timeline seemed so rushed and communications regarding the program were vague and abrupt. While I am happy with my decision, I still find it worrisome that I the people that interviewed me are still very much in charge of my education. I know that they are professionals and should still be objective, but I imagine it is hard to make that disconnect when you go out on a limb to support someone and they return your efforts with a rejection. Anyway, how this story unfolds still remains to be seen.

In other related events, there has been a great deal going on with one of my other projects. Unlike my undergraduate and high school lives, I have been very involved in roles of leadership and decision-making. I know that the purpose of medical school is to provide the educational tools to create knowledgeable and practical physicians, but these past few days have been wrought with obstacles that are not often included in the curriculum. Things like responsibility and keeping professional lives separate from personal. Recent events have also brought to light exactly how one person's actions can directly affect the lives of others. In my specific scenario, it was the irresponsibility of one person that caused a serious debate, perhaps a near argument. At this point in my life, it is still hard for me to make the choice between professional and personal lives. Obviously, you want to be everyone's friend, but it is so hard when you are not sure if people take advantage of that. Rules are broken and you don't want to hurt anyone's feelings so you turn the other way or allow standards to be bent "this one time." I just infuriates me that I would allow someone to put me in the position that I would have to choose between keeping a friend and following the rules. Just because you choose to associate with someone, should you compromise your standards to accomodate them? Surely not, but easier said than done.

now here's a pickle

So, I seem to get in this rut of making life just ridiculously difficult on myself. Before Thanksgiving, the next three years seemed so simple; finish the second year of medical school, go out to rotations, and graduate. Now, I've gone and screwed things up.

So during Thanksgiving Break, a mass e-mail went out to our class regarding a new pre-doctorate fellowship program that would focus on medical education. It is a new fellowship program with four open slots. Normally, this wouldn't be any big deal, but here's the rub. When you participate in the fellowship program, you are guaranteed that you will do your clinical rotations at your first choice. In addition, you are given a pretty good stipend for the year you are committed to the fellowship. Finally, you are given a tuition waiver for the fourth year of school.

Initially, that sounds great, right? Additional experience and you wind up getting paid about $43,000 including the tuition waiver. I thought it would be a no-brainer, too. However, out of all the reasons to go, I'm still held back by my almost primal need to be done and graduated. I've waited so long to get into medical school that I'm already two years behind all my friends from undergrad. That and I've been so hungry to get back into the wards and clinics that its nearly driven me insane. If I took the fellowship, I'd pretty much be volunteering to submit myself to another year away from patients. Not to mention that one of the major draws of getting out into the wards is to work with the people that roughed the first two years of medical school with me. I mean, that's half the fun, right? Make great friends and future colleagues so you can kick back on the weekends, talk shop, reminisce about how awful that biochemsitry test was and smile with the gratification of knowing that we helped each other through it. Is that something that I will be able to do with this new class? Is it even possible that I can make the same bonds with a class that seems so distant from ours?

So there is the pickle I'm in... the best part of this all is that I have to make this decision in the next 72 hours. Awesome.

"Again we fail to make amends
And wend our way between intents
And looking back, not moving on
Oh but something's always wrong."