the kirksville times

2010-08-03T09:38:00.000-05:00

(via Tim Nied)

"I can hear ticking clocks..."

2010-05-03T00:12:00.002-05:00

Something Corporate recently announced their reunion this summer and plans to tour with The Bamboozle tour. They also released "Played in Space," a greatest hits album. Needless to say, I've been listening to it essentially non-stop. I'm digging the unreleased track, "Wait." So I'm thinking about driving up to Chicago post-call to see them for the first time since undergrad. Anyone else interested?

Shaping up to be a good month

2010-03-30T05:17:00.002-05:00

mmm...

Productivity Break

2010-01-05T20:59:00.001-06:00

The new Vampire Weekend album is online and streaming in its entirety (and it is pretty darn good). Just thought I'd let you know.

Merry Christmas!

2009-12-25T22:13:00.002-06:00

Merry Christmas, everyone! I'm alive. I'm on call in the NICU and I have lost all concept of time. I'm not allowed to wear a watch because it may bring in all sorts of nasty bacteria from the outside world. I'm in a call room that doesn't have a clock. It has been dark for a while now so it could be 6pm or 10pm. I'm not really sure.

It's this or Zelda. I wish I could say Zelda was winning.

Spring This...

2009-03-25T12:27:00.002-05:00

Illinois can be so annoying sometimes... the weather, especially.

Update

2008-12-18T14:05:00.003-06:00

Happy holidays! I know I have been MIA of late, but things in Peoria are going well. I had a very busy, but enjoyable month working with the Trauma service and am back in the Emergency Department again. I was just doing some research about local dining in Peoria and came across this webpage about the Peoria Riverfront. The juxtaposition and mild irony was too good not to share.

delightfully tacky, yet feeding your sense of good taste and adventure

2008-08-30T22:32:00.000-05:00

Today's Chuck Norris FACT:
Rather than being birthed like a normal child, Chuck Norris instead decided to punch his way out of his mother's womb. Shortly thereafter he grew a beard and slept with 3 nurses.

just something I came across on my day off.

house broken

2008-08-23T20:40:00.009-05:00

Wow. After six months, I finally am getting around to putting up some updates in my life. Since March, I have traveled across the country in nearly every direction before ultimately settling in Peoria, Illinois. Spending April and May in Hawaii was such a great way to end medical school. It capped four years of hard work and I was able to celebrate the milestone with my roommates and closest friends. After graduation, it was a mad dash to find a house in Peoria and rapidly pack and move everything Eastward. I was fortunate to find a nice house that has more space than I know what to do with.

I moved in a couple weeks before orientation for residency and was able to settle in a little bit. When I was looking to buy this house, there were only a few things that I knew I would need to fix up. The most significant of them was to update the walls as nearly all of them are covered in a stucco material. Every resource I consulted suggested that I first try to sand off the texture. Much to my dismay, I discovered quickly that even my newly purchased orbital sander would not make this job go any faster. So, I consigned myself to troweling layer after layer of joint compound over the walls until there was a smooth, even finish. After almost 200lbs of joint compound, the guest bedroom and office are finally finished.
After finishing the office, the rooms remained fairly barren until I spent one weekend staring at the numerous paint swatches that covered my floor. At some point, I just grew tired and possibly dizzy from all the choices. In some amount of serendipity, I landed on a color palette when I went to buy furniture. The set of living room furniture only came in one color - a light forest green. With this as a starting point, I quickly narrowed down the field of choices. The guest bedroom is shaded by a tree in the backyard and gets a bit of warm morning light so I chose a lighter, cooler color. The office gets a lot of bright, afternoon light, so I decided on a richer color. So, the before and afters are above and below. I still have to finish the walls with some pictures and shelves, but I am pretty happy with the results so far.As stated above, the living room was probably the first room to take shape. I think this was mostly out of necessity as I initially nested here as I could gently fall asleep to the warm glow of the TV. When I ran down to St. Louis to reclaim my belongings, I reassembled my bed in the living room as the other two rooms were under construction. As nice as that was, I thought it would be rather awkward to have guests over and chat on or around my bed. So, the bed was relocated after I bought some tables and things online and through craigslist. Among other new tools and appliances, I bought a brand new (delicious) Dyson vacuum to take care of all the carpet in my house. I wasn't until I finally forced myself to purchase a lawn mower that I truly began feeling domestic.

And, in the ultimate journey into making this place a permanent home, I have one last addition to my repertoire of domestications. I am very happy to announce that I have started a family! Well, thank goodness there will be no college plans for my new addition, but there will certainly be another mouth to feed, medical expenses, and perhaps a few months worth of obedience classes. I have been on the hunt for a dog for several weeks now and I finally matched with the perfect dog! It was like residency applications all over again. A surprisingly involved process, I adopted my new beagle, Marty, and went to sign the paperwork yesterday. He is a shy, but very charming 1.5 year old beagle mix and tips the scales at 50lbs. It seems like he is adjusting well, but I am bracing myself for the unfortunate reality that one day I may smell the fragrant odor of excrement and urine emanating from his kennel.

tomorrow smells of a lester cade...

2008-03-21T01:47:00.004-05:00

So it was brought to my attention that I haven't written anything here for quite some time now. In fact, it has been almost half a year since I have had the time to put any of my thoughts down in e-writing. It is hard to believe that the last time I sat down to organize myself here, I had just finished taking my board exams and was starting to think about interviews. All that seems like ages ago and so much has happened since.

Interview season has come and gone. Although I am now very thankful that it wasn't particularly busy for me, I remember being extremely worried and preoccupied with thoughts that all of my friends and classmates were being offered interviews left and right while my application seemed to gather dust. In retrospect, I am very lucky to have interviewed with the programs that extended me the opportunity and I felt that the programs were genuinely interested in having me work in their hospitals.

Amidst all the chaos of traveling and interviews, I became deliriously unfocused and managed to completely wreck my car. It was such an unsettling feeling - finding out that my car was "totalled" and in the end I could blame no one but myself. It really struck me as a case of "why do bad things happen to me?" Regardless, I was fortunate that my parents are extremely understanding and very prepared for such situations. With their help, I was able to work through and find a new car and am currently very happy with the purchase.

So, following that incident, the new year has been fairly uneventful. I finished an emergency medicine rotation at Maricopa Medical Center in January. Although I was initially very overwhelmed by the reputation of the program, I believe that I quickly met the challenge and was as competitive of a rotator as they have had previously. So imagine my disappointment when I realized that their interview season would be over halfway through my rotation. I spoke with a few residents and attendings and while it sounded like there would be hope of a late interview or special consideration for the match, I was always uneasy about their perception of me as a candidate for internship. Knowing this, I worked even harder and fortunately it seemed to impress some attendings but the result seemed to yield very little as I finished my rotation without an interview. Again, continuing the trend of how sad my life had become.

Now, fast forward a few months to today. The match was this week and we finally received our residency matches today. When I received my notice, there was a brief moment where I was disappointed. I had hoped that despite all improbabilities, I would be able to match with Maricopa. Unfortunately, that was not the case. Thoughts of packing, moving, snow, cold, and giving up all the luxuries I have been afforded immediately stormed through my mind. To move back to Illinois - what a terrible fate. Then I heard from several others. People who had not matched or were matched to areas that were even less favorable for them. Immediately, my problems were far pettier and I was almost ashamed to be so resentful of what I had been given.

It was at this moment that I realized that my entire journey to this point has been truly remarkable. Though brief moments have been filled with hardship, the outcomes have always been favorable. Yet, during those moments I always find myself wondering why I am forced to face such difficult obstacles. It seems so easy to magnify the hardships I encounter and minimize the blessings I have been given. Throughout my rather brief adult life, I have already lost count of the number of times we casually refer to "Murphy's Law." However, it is always funny that we become so oppositional when things "go wrong" to us. It seems so easy to forget that unfortunate events are occurring all around us so why is it so surprising when it happens to us? Although I didn't match to my first choice, how lucky am I that I didn't have to scramble for an internship? There are far worse things that fate could have dealt me and I should recognize how fortunate I am to be given such opportunities.

In truth, this applies to much more than just residency. The past weeks have been hectic and stress-filled for everyone and I often felt lost in the rush of the days. Struggling to be noticed, I often sat stewing in the sense of being unappreciated and taken for granted. Yet, thinking hard - is that truly bad? Isn't it the ultimate complement that you are expected to be responsible, helpful, or forgiving? Sometimes I forget that these feelings of entitlement and worth are simply ancillary to the truly important concepts such as respect and trust. I become so focused on things I "deserve" that I neglect the many blessings I have been given.

Lately, I feel that I have neglected the needs of my friends and for that I ask forgiveness. Over the past years, I have noticed a startling trend of dissolving relationships and friendships that have faded away - people I should have fought to hold on to and friends with whom I should have kept in better touch. I, myself, will strive to appreciate all that I am given and not take the friends I have been blessed with for granted.

count on futures...

2007-09-22T04:01:00.000-05:00

so at last, the USMLE has come and gone. I'm somewhat ashamed to think that I had spent the week studying a fair amount - and clearly could have studied more - and left the test with an unsettling feeling that I could have done better. I'm not sure if that is just a gut reaction of if that is the result of kind of the recent emergence of my previously inhibited type "A" persona. it really is an ugly side of me that I usually keep in check - mostly through keeping occupied and interacting with my friends. it just seems like the past few weeks have been devoid of either amusement and thusly it was able to rear its ugly head.

I left the testing center today with a lingering feeling of uneasiness, a fraction of what has been evolving over the past few days. it is really just that feeling that my future is absolutely out of my control and is solely in the hands of people I will never meet. it is now clear to me that this will not change regardless of the amount of stress I burden myself with throughout the upcoming days. so now that I have reconciled this, why is it that I still feel like I could be happier?

I guess it is the lingering feeling that things are rapidly changing around me. sure, I'm committing myself to a future in emergency medicine so I should be capable of handling change. it is just that in the arena of emergency medicine, I expect the unexpected. I anticipate every possibility. it is in the social atmosphere that I feel the most inept. how do I interact with people? exactly where does that fine line that separates selfish and sacrifice fall? how can I be both supportive and assertive? at what point does sacrifice become submission? yes, I seem to be rambling, but when I am left alone to my thoughts, these are the themes that run through my head. life seemed simpler a year ago and I can't say exactly what has changed. it just seems like my mind has been preoccupied with these conflicts for the past week. I don't know how they haven't come to mind before, but I hope that their resolution will not only induce spiritual growth, but also allow me to become less conflicted and more focused.

so, as it is 2:15am in Arizona now, I seem to be slightly relieved. I know that I have good friends surrounding me whom I can depend upon. though I may have wavered in my beliefs before, I feel confident that I have friends that would also gladly offer the same level of sacrifice and altruism that I would for others. though these are not bonds I share with many, I will always protect them with every conscious action and thought. despite my often labile and swaying emotions, these are the people that I will seek out the moment I open my eyes in the morning. despite the rapidly changing social climate here, I hope that these ties never diminish. even now, it is hard to imagine my life without my friends here. as described earlier, the feelings of isolation and abandonment can be overwhelming. it is my hope that I can recall this moment when I begin to feel frustrated or forgotten.

train conversations are passing me by...

2007-09-20T00:58:00.000-05:00

the last few weeks have been filled with such absolute ups and downs that I've almost felt the necessity to stop, look in the mirror and watch as my hairs either turn grey or start falling out. can you believe it? I'm a mess.

I remember saying three weeks ago that after ERAS was submitted and COMLEX was over, my stress would seemingly taper and dissipate after I took my USMLE. well, it appears that moment has arrived and it doesn't seem to be getting any better. I have never felt like such a novice in my life and quite frankly its a bit unnerving. I'm so used to traveling at the pace of life and adjusting so effortlessly to obstacles that not knowing what to do and who will stand beside me has become evidently unsettling.

I suppose I was just naive to believe that fate would continue to prepare everything for me and I could continue to coast through my career. this became startlingly apparent when my evaluation for my ER rotation in Peoria arrived in Phoenix. it wasn't catastrophic by any means, but I am basically forced to settle for "good" instead of "great." at this point, I don't know how much this will truly affect applications and interviews, but I have been so used to excelling that this came as a bit of a shock. I left Peoria feeling like I was on top of the world and the evaluation was a stark reminder that sometimes my standards can fall short of other's expectations. on the other hand, the first of a couple letters of recommendation have filtered in and I am very fortunate to have had attendings be gracious enough to extend their support. it is upon my interactions with these faculty that I can bolster my hopes for a future in emergency medicine.

so, as that news struck, many things just seemed to tumble and grow on top of another. I started to notice the conscious need to keep myself focused, reigning in the scattered thoughts about grades, the future, interviews, other rotations, and the tangential aspects of daily life. waking up became a chore as I knew I would have to wage war against the denizens of the highway at 7am. stagnancy on the highway was just as taxing as weaving from lane to lane trying to get to the VA faster. my frustration would continue to multiply time crept away while I sat helpless in my car. fortunately, this morning dose of infuriation would be reduced when Ben and I began carpooling and taking advantage of the HOV lane. this, however, would bring about its own set of problems. while at the VA, the mornings would speed by and lunch would mark the end of a productive shift in the clinic. however, it almost always heralded the beginning of continued frustration.

I came to realize in the past few weeks that I am clearly obsessed with the concept of time. this was obvious as I commuted in the morning, but became overtly clear during the afternoons in clinic. while carpooling in the morning meant was hardly a sacrifice for me, I realized that there is nothing more frustrating than being stuck in the VA, staring at the beautiful weather just on the other side of the thick, glass windows. because there was seldom work to be done after lunch, the afternoons were fairly pointless as we sat around waiting for work to presented. this often resulted in two or three hours of wasted time and an eventual dismissal around 4pm. I know. poor me, getting done with work at 5pm. my frustration didn't come from waiting as much as the hell it must have been for Ben as he was frequently done around 3pm. I couldn't imagine the torture of sitting around that cesspool for two hours waiting for me to get done. so, suffice to say, I found myself leaving the VA with what I expect to be a colony of new gastric ulcers and possibly a new aneurysm or two.

having explained that situation, I am left to wonder, "when did I change so much?" I guess I have always hated traffic and dislike being late, but when did I ever let it take control of me? it has been a frightening realization that I have been trying to work out for the last few days. I suppose I've just been caught off-guard by how much our lives are in fact changing each day. I don't mean the small things that define 8am from 9am or Wednesday from Thursday. I realized that so many of our actions today can in fact alter our futures - not on the order of hours or days, but years, decades, and possibly entire lives.

for example, I remember submitting the ERAS application three weeks ago and making the joke that it seemed so easy. now, I think back on how crazy we were to be clicking through the site without regard of its ultimate significance. sure I researched programs and noted that I would be hopefully attending one of those programs for residency, but moving the mouse and pushing the buttons seemed like such a game at the time. apply to harvard? why not? yale? stanford? chicago? sure! its a mouse click away! it is as if some defense mechanism switched on inside me and the gravity of the situation was muted. now, the thought of waiting for residency is more daunting each day.

I'd be lying if I said I know what to expect these next few weeks. it seems like I am standing alone while the entire world is rushing past me. everyone around me is buzzing with invitations to interview while my applications appear to be hanging in limbo, likely buried deep in a pile on the tables of residency committees. it seems I haven't moved from studying in the house while the days passed and now USMLE is about a day away. the house is eerily empty at times and I am left staring at the ceiling fan, contemplating how not to self-destruct. it seems like friendly faces are rapidly shifting in and out of phase as they fly in and out of the area for rotations. the sense of stability that was once here during third-year has clearly left.

not to sound like a coward, but this sense of chaos smothers me until I am on my back in bed, looking up at the ceiling wishing it could be simple again. yes, at times it is bad enough that I wish I could just go back and repeat it again. I wish I could just step out the front door and anticipate closing my first abdominal surgery. I wish I could get lost walking in the halls of Phoenix Childrens'. I wish I could look forward to seeing all our friends at Rosie McCaffrey's on Friday night. obviously I can't turn back time, but I hope that this oppressing exasperation will soon pass and I can return to work with the same enthusiasm and excitement as I did last year.

winter, spring, summer, or fall...

2007-08-29T22:32:00.000-05:00

These past few days have been a complete whirlwind of all my future responsibilities. Fortunately, I've been able to keep on top of most everything as best I can tell. Studying continues albeit at a slightly less frightening pace as previous days. The qBank seems to be less daunting every day and the results I get have been fairly consistent - in a good way. I feel prepared and yet a part of me remains absolutely mortified that I should be torturing myself with endless hours of studying. Well, whatever the case, I think the big concerns will be over after this weekend. With COMLEX-CE and ERAS out of the way, I can spend the hours I usually devote to joy and happiness to studying for the USMLE-CK. Well, not so much. But at least it will seem like a lot less pressure with only one big fire to put out.

Even with the amount of work to be done these past weeks, I'm fortunate to have the support and love of my friends and family (hi, mom and dad). I sent out my personal statement for ERAS this past Monday to a bunch of people and have gotten such great feedback and revisions from everyone. I am sure that with all that help, it will progress towards "masterpiece status." In addition, when studying becomes too taxing or overwhelming, I have a more complete complement of friends here to share time. It has been a real sanity saver to have everyone here. Another such case is Ben, Rose, and I went out to the middle of nowhere on Monday night to watch the lunar eclipse. It was awesome to see and I'm glad I got to experience it with such good company. Here is a picture captured as the moon became fully eclipsed. Anyway, hopefully, these next 48 hours will go as quickly as the past ten days and I will emerge refreshed and ready to carry on!

still alive...

2007-08-23T17:21:00.000-05:00

Just dropping a line to let everyone know I am still alive. Just mostly studying for boards and finishing up my ERAS application. Ok. Really, I'm just letting my parents know I'm alive... and studying!

doing the time warp again

2007-08-20T18:30:00.000-05:00

So apologies on the lack of recent posts. As you can see, that last post was about one month in the making. I sat down after I got back from Peoria and just didn't seem to have the energy to finish it. Unfortunately, it doesn't truly reflect a lot of the developments from that month, but as it was already reaching an epic length, I figured it best to cut it short and move on.

It is surprising that an entire month has already lapsed. Time seems to move faster day. It could be because these weeks promise to be the busiest and most stressful of the entire academic year. I recently finished my MICU rotation at the VA Medical Center. It was a great rotation and even better since the lectures and morning rounds provided the motivation to start studying for my rapidly approaching board exams. The work days went fairly quickly, but I definitely am glad to be done with the rotation. It wasn't so much the fact that the rotation was long, boring, or "bad" in any way but rather the fact that I hadn't be privy to a formal vacation or day off since winter vacation. I look back and think it might have been wise to have taken the week off between third- and fourth-year that most of my friends enjoyed. Even so, here I am now, enjoying my two-week "vacation."

Well, "vacation" may be stretching it. I'm taking one of my vacation weeks to start prepping for my first board exam (COMLEX-2) on August 31st. It isn't so much the work that I am happy to be free from rather the driving. I can wake up a bit later and move into the kitchen, my new study area. If that gets to be boring, I can move down the street to the coffee shop - which is where I happen to be at this exact moment. It is reminiscent of those last weeks of seventh quarter where I basically rolled out of bed and moved to the treehouse to study for Step 1.

Anyway, COMLEX-2 will be on the 31st. Then, our residency applications will be released for submission on September 1st. This includes updated CVs, personal statements, etc. So, that needs to be in progress and finished within the next few days. Then, I will take my USMLE-CK on September 21st. After that, there will be one last exam standing between myself and graduation, the COMLEX-PE scheduled for November 12th.

So that is kind of the big issues that are on the horizon. Other than that, the last four weeks have been great just to get back into the habit of living in Arizona. I haven't been getting out to the gym or running so much as before I left. This is mainly because the first few weeks were filled with a strange fog of fatigue and I was sleeping a lot... kind of like Rob. Other than that, I've been going out to play volleyball a bit more frequently as Jen and Dan found a place close to their house that is free and open on Tuesdays. So, between Sunday, Tuesday, and now Saturdays, I've been trying to keep somewhat active. Maybe as it cools down, I'll get back out running, but these next two weeks will probably see a continuing slothfulness. And that's pretty much it for now... except for the fact that Jen and Dan have ten baby tortoises in their backyard.

how I feel by the end of the day...

2007-07-27T00:26:00.000-05:00

so another year has come and gone. I know it probably feels that way for the millions of people with whom I promised I would keep in touch. I truly apologize that for many of you, this sad, sad blog is your only source of information. anyway, thank you to everyone that wished me long-distance birthday happiness. I feel like I've been somewhat melancholy the last few days. I suspect that it is mostly due to coming down from what was one of the greatest months of my life, but also the stark realization of the gravity of the upcoming weeks. so, I guess I should start with the good news first and work my way towards my ridiculous return to Arizona.
so when I last wrote, Ben and I were just leaving Tempe. the trip out to Pittsburgh was rather uneventful and both of us spent most of the plane ride asleep. we arrived in Pittsburgh to a glorious sunny day complete with cool breeze and fresh air. the weather paired with the overwhelming amount of plant life and greenery was nothing short of awesome. as always, Ben's parents whipped up amazing meals and were the most gracious of hosts for our two-day stop. unfortunately, the weather rapidly shifted to an impressive downpour which prevented us from watching Ben play baseball with his team. even so, we managed to sneak in a quick nine holes of golf the next day before seeing Ben's dad's band play a show at Carhops in Pittsburgh that evening. needless to say, it was a good night and I once again learned that left-handers can drink just as much as right-hander - a theory that may need further investigation in the future.

benny's boys out on the prowl

so after an all-too-short stint in Pittsburgh, we headed out to Cleveland to visit our good friend, Jake. the drive out to Ohio was a fairly easy prelude to our trip to Peoria, and it shaved off two hours of driving on Sunday. also, we had the good fortune of finding Santosh in the area. we walked around downtown Cleveland, were accosted by a strange man who had apparently abandoned his daughter in a homeless shelter to panhandle and sell Streetwise (by the way, never, ever trust a man who's idea of a really good burger is McDonald's), and eventually made our way to a nice steakhouse. the wait was somewhat unbearable, but it all worked out since Santosh felt the overwhelming urge to walk an extra sixteen blocks. after dinner, we headed over to some of the local establishments and managed to find none other than Frankie Muniz at one of the bars - he looks a lot scummier and less Malcolm-y in real life. the night concluded with a trip to Howl at the Moon. there, we witnessed such amazing feats including "Tony the guy that drinks the beer," beautiful women completely disinhibited on their last night of single living, and an amazing tower of empty 64oz beer bottles.

after many loud sing-a-longs with the pianos, we parted ways with Santosh and managed to make our way back to Jake's apartment. the next morning, we set out for the promised land of Peoria. the drive was relatively uneventful and clearly easier for me to say that since Ben did all the driving. outside of driving straight through Raper Country, the trip - as with most trips through the Midwest - was fairly uneventful. we managed to get into Peoria around 7pm and met with one of the residents that escorted us to our dorm. much to our dismay, we quickly learned that the dorm had very few luxuries and only a handful of amenities. to note, there really wasn't much in the way of unrestricted internet access. even so, with room and board provided, we realized that at least we would be comfortable.

at this time, we were fairly hungry and were elated to discover a Bennigan's nearby. now, ordinarily this wouldn't be such a huge discovery, but for the past few months, we had been trying to locate a Bennigan's in the Phoenix area, but most had closed down and there would be no place for me to spend my gift card. so, we proceeded toward the Bennigan's with great caution as I attempted to command a manual transmission truck for the first time since high school. after minimal whiplash and an amazing 0% stall rate, we arrived at the restaurant only to find that they had closed earlier than their posted hours. realizing our journey was for naught, we were given directions to a local pub/tavern, Hoops. we were greeted by a diverse array of locals as well as a plastic lawn goose. already, we could feel that this would be a good month. after partaking of the local wares, we attempted to make the room a bit homier by furnishing it with random items from the nearby Wal-Mart; a carton of strawberry malt whoppers, a gigantic tub of sour gummy ropes, and a random assortment of toiletries. much to our chagrin, we noticed the gumball machine filled with Homies placed strategically at the exit and obviously, nothing makes a room homier than an army of Homies! again, the stars seemed to be lining up and the month was only just beginning. shortly after our adventure at Wal-Mart, we returned to the room and settled in before an early morning.

the next morning, we awoke to the sounds of the alarm clock signaling the arrival of 6am. we quickly made ourselves presentable and headed down to the Emergency Department for our first day and orientation. the day went relatively quickly and we had the pleasure of making new friends. Sherly and Lindsay are students from the University of Illinois and we also worked with Sarah, my friend from undergrad. especially meaningful for me was working with my friends Fletch and Mark, whom I haven't seen since undergrad. Fletch is now a third-year resident and Mark a second-year.

the days went by and our time in Peoria were over faster than I could have imagined. the first days seemed so long and arduous as I tried to find my place and get into a rhythm with a highly functioning department. what I first noticed was that despite my bumbling and general intrusion into the department, the attendings, residents, and staff were so forgiving and even interested in helping me progress through the rotation. this was overlaying an already established feeling of hospitality extended by the residency office. anyway, long story short, the month was well spent and I will always have great memories from this rotation.

like a herd of turtles!

2007-06-21T06:35:00.001-05:00

Well, it is 4:30 in the morning and Ben and I are officially off to Peoria, Illinois via Monaca/Pittsburgh, PA and Cleveland, OH. I'm getting pretty excited for my first official Emergency Medicine rotation of medical school and even more so that it is at my old stomping... uh - state and I get to be in great company while I'm there. Well, off we go.

a lucky man who made the grade...

2007-06-14T02:04:00.000-05:00

I took the qBank today, oh boy.

I'm going to go ahead and guess that the smart people haven't started studying yet. Oh, well - at least it is a start. In other news, I am Peoria-bound in one week. Mark it on your calendars.

just over that green hill...

2007-05-28T01:12:00.001-05:00

Amazing to believe that medical school is officially 75% over. Sure, there is residency and fellowships and all that stuff about life-long learning, but I'm going to keep on believing that that will all be fun once I'm in the profession.

Looking back, it has been an amazing blur of a year. Though trite, the axiom of "time flies when you are having fun" has never seemed so appropriate. Sure there have been days of overwhelming work or being spread so thin that you are just emotionally spent, but those times have been clearly outnumbered by the days and nights that our friends have been able to enjoy the change in scenery, atmosphere, and pace of life. Whereas our lives in Kirksville were primarily centered around the ultimate importance of studying the science of medicine, this year has seemed to be more of a time to learn about how to live a life in medicine. Although we continue to have didactic sessions with our clinical faculty, we also have a more fraternal dialogue about how each different specialty affects family and social life. In that respect, we were given a lot more time to spend as we pleased, whether it be study, sleep, or play.

So the year has flown by at an alarming pace and so much has seemed to change just as abruptly - marriages, divorces, births, deaths, relationships, and breakups. To me, I imagine that this has been going on for the last three years, but the pace of medical school has kept me too preoccupied to appreciate the true impact that these events have on a person's life. Now, with the tiniest additional time on my hands, it seems that these emotional stressors have more opportunity to cause significantly more impact than in previous years. So, in addition to living our lives as pseudo-doctors, we have been learning to field and diffuse the seemingly multidirectional onslaught of our various social and familial relationships. It is fortunate that support network between our colleagues here has been so strong and no matter the problem, there is always an attentive and sympathetic ear to listen.

So, as I am crossing the threshold into the fourth and final year of medical school, I hope that I have been able to learn from all the experiences that have seemed to blur together into a cloudy memory of this past year. It seems as though most of the next year has been well planned out. Most of my rotations have been finalized, but I'm still working on a few after the new year. Here is the work in progress:

May 27 - June 23, 2007: Neurology @ North Valley Neurology; Scottsdale, AZ
June 24 - July 21, 2007: Emergency Medicine @ OSF St. Francis Medical Center; Peoria, IL
July 22 - August 18, 2007: Critical Care @ Carl T. Hayden VA Medical Center; Phoenix, AZ
August 31, 2007: COMLEX II
September 2 - 15, 2007: Nephrology @ Carl T. Hayden VA Medical Center; Phoenix, AZ
September 23 - October 20, 2007: Inpatient Pediatrics @ Phoenix Childrens' Hospital; Phoenix, AZ
October 21 - November 17, 2007: Pediatric EM @ Phoenix Children's Hospital; Phoenix, AZ
November 18 - December 1, 2007: Pulmonology or Anaesthesiology (TBA)
December 2 - December 29, 2007: Cardiology (TBA)
January 6 - February 2, 2008: Emergency Medicine @ Maricopa Medical Center; Phoenix, AZ
February 3 - March 1, 2008: Pediatric ICU @ Phoenix Childrens' Hospital; Phoenix, AZ
March 2 - 15, 2008: Radiology (TBA)
March 16 - April 11, 2008: Family Practice (TBA)
May 17, 2008: Graduation in Kirksville!

my life to music

2007-05-08T00:17:00.000-05:00

so the past couple weeks have just been absolutely crazy. its been ups and downs and I can only imagine that this is the stuff that soap operas are made of. regardless, I think the worst is over and I look back and think that
I had a lot of time to think. one of the many random things that floated through my head as I tried to sort things out is that our brain is such an amazing creation. even when it is working absolutely perfectly, it can still contort and color our lives in such drastic ways. it can turn a completely sane person into a babbling mess and a turn fantasy into logic. like I said, its been a wild week, but I think having time to think about a lot of things has really lifted the haze that I have been in.

the funny thing about all the chaos of the last week is that at times I would think about times when things seemed much simpler - not really any specfic time of my life, but just certain memories that have been permanently imprinted in my brain as happy or some variation thereof. the interesting thing about it is that each had some sort of musical component to it. here are a couple of examples that immediately come to mind.

"Fantasia on a Theme by Thomas Tallis" by Vaughn Williams: This is such an awesome piece of classical music. I mostly associate it with Arizona, but also with the great times I had in high school. Yes, I was an orchestra nerd which I think is just under "band geek" on the high school social heirarchy. Anyway, I distinctly remember this piece because we played it the year we went to The Midwest Clinic. Somehow, we made a connection with the orchestra from Dobson High School in Mesa, AZ. I don't remember the exact details, but we somehow wound up taking a Spring Break trip to Arizona to do some sight-seeing, but also to do an exchange with the Dobson HS Orchestra. It was the perfect piece. Two orchestras separated by half a continent playing together on one stage.

"She Will Be Loved" by Maroon 5: Nowhere near as complex a story as others. It was the song that was programmed into my alarm clock in Kirksville. Kinda funny that it can generate such a great feeling considering it was what goaded me to class nearly every day for an entire year. I don't know. I guess in a way, Kirksville was a simpler time. The schedule was set and we pretty much knew exactly what was coming our way everyday. Nowadays, studying is like taking shots in the dark. What I read at night may not even be in the right organ system as the pathology I'll see the next day.

"Livin' on a Prayer" by Bon Jovi: Shotgunning beers outside Henle Village during the thirtieth minute of the Chris Kreeger's Power Hour. How could anyone forget?

"Homecoming King" by Guster: Driving back to Champaign from Washington, D.C. via Baltimore via Pittsburgh. Best part was the fact that we were in Champaign for two days and the entire road trip lasted about four. Travelling companion on this crazy sojourn? None other than Matt Bassett.

"Rainbow Connection" by The Muppets: More orchestra nerd memories. But this song specifically stirs up memories of my good friends Tina Myers and Dave Hunsberger. Sadly, I have not kept in touch with either as often as I had thought, but there is still time to change that.

"Kiss Me I'm Shitfaced" by Dropkick Murphys: Part of the Ben Munroe/Andy Jou Power Hour masterpiece which occured not too long ago here in Tempe, Arizona.

"All I Want For Christmas Is You" by Mariah Carey: You know, it isn't a particularly good song, but when you are in South Africa and you can't quite remember the name of the guy driving your convee, you best just bop your head along and enjoy it.

"Question" by Old 97's: Some more Kirksville memories. This one is a bit more vague than others. It isn't so much of a specific time, but more of the times I spent with Dusten Wessel, John Epema, and Jeremiah Mason. The four of us practically lived in the breakout rooms at school for the entire first year in Kirksville. Between studying, ping pong, and the finale XBox session in the Breakout 4 we had a great time. I think this song has specific connotations because it is also the song that Dusten played for his wife Nicole the night they got engaged. As a side note, Dusten thought about his song first.

"Don't Stop Believin'" by Journey: Kirksville. Dukum. Lots of singing at the top of my lungs. Colored by the strong presence of Jake Shannon but also Ben Munroe, Nate Scherer, and Jeremiah Blankenship.

"Three In One:" With the Chief retired, I don't know what will happen to halftime. Not only does this remind me of Illinois, but also of all my good friends that I worked with at Illini EMS. I think being rooted in an organization so intimately involved with the University really made undergraduate special for me. It also gave me the foundation for a lot of what I am doing now.

"Johnny Can't Decide" by Jonathan Larson: If I remember correctly, this was just starting to make an emergence during my senior year at University of Illinois. The entire Tick, Tick... BOOM! soundtrack was in my car for a long time that year as I was getting a lot of my rejection letters from the first round of medical school applications. I guess that's kind of depressing in a way, but now that I'm in Arizona, I guess it also serves as a reminder that things did eventually work out. For some reason or another, it also reminds me a good friend of mine, Dave Wehby.

so now you can see the crazy way my brain works. neat, huh?

so shady, so beautiful...

2007-05-06T06:05:00.000-05:00

I know it has been a long time since I put anything up on this site, but I needed to document this before the details of the compete saga left my mind. So, our house has been on a fairly rigorous hunt for a nice TV for our living room. It included looking online and several craigslist hunts and culminated in an offer too good to refuse. So let me walk you through today.

I responded to this ridiculously shady ad on craigslist for a 42" plasma TV - as Ben pointed out, no brand names, no descriptive features. It was pretty much as vague as you could get. The price was $800 and to me, that screamed for further investigation. After an e-mail, I got a response this morning with quite a few more details. I called up the guy and he was fairly forthcoming about everything. It turns out he's "moving out of town" and needs to sell is trying to sell "his" things. Here comes shady detail #2 - he says he's got it in one of his storage garages and we could swing by to take a look at it. Who sells stuff out of a storage garage, or multiple garages? So anyway, I thought he said he would bring it to this one garage and we could take a look at it there. Fortunately, its pretty close to our house and in a pretty decent area of town.

Ben and I drive down there and pull up to a Public Storage facility. There is a huge, electric gate between us and a woman who is frantically trying to organize a alleyway full of stuff. We call the guy and he's there, too. He opens the gate and drives out in his Mitsubishi Montero. Shady detail #3 - we exchange our plesantries and he says to us, "so, the TV's at my other place - do you want to hop in or follow me?" I'm thinking that there isn't a chance in hell that you are getting me in your car. You could at least entice me with candy or something if you're going to be that obvious. So, we tell him that we will follow in the car and he says that he will drive slowly to prevent us from getting lost. With that, he takes off down the road at a speed limit shattering 50mph. Please note that this was not the freeway and the posted limit was 40.

So we think, how far could this place be, right? I mean, he's "moving" out of town so he probably keeps his stuff close together. Shady detail #4 - the thought that it would be close by slowly fades away as we are driving further and further away. This was especially true as we were cruising East down Highway 60. After about fifteen minutes of driving, we finally arrive at the second storage facility, (shady detail #5) a house? Hmm. Well, we think to ourselves, "at least we can see what kind of living environment he has." Surely if he is strung out on meth or speed all the time, his house will be a wreck and we can duck out graciously. Shady detail #6 - as we are walking up the driveway, Ben asks, "nice place, is this your house?" The response being, "no, this is one of my friends' place." Nice. Especially awesome since the door is locked and after knocking a couple of times, the guy that opens it is this rather generously hefty looking Mexican guy. Hm.

So he walks in and pulls out a really nice looking TV. We run it through the gamut and make sure that it works and the picture is good and everything else. So, time to make sure this is really legit - or at least to test exactly how thorough this guy's fencing outfit is. We ask for a paper copy of the warranty and receipt of purchase. Shady detail #7, he says, "its totally covered under a warranty. I don't know exactly where the warranty is." Nice. So what you are really saying is that you didn't buy it. Hm. He swears up and down that a warranty exists and has us call Best Buy. There is a whole seperate story about Best Buy, but it essentially pares down to us driving back to the Public Storage and talking several times with Best Buy customer service. In the end, there did not seem to be a warranty at all.

So we get back to the Public Storage where another person was supposed to be taking a look at the TV. We break the news that Best Buy didn't think the TV was under warranty. Again he swears up and down that there is a warranty and we basically say that since another guy was taking a look at it this afternoon, he could deal with it. If the guy didn't buy it, he could look for the warranty and I would call him back tomorrow. After this, we said our goodbyes and parted ways.

A couple hours pass and we get back from the gym. I give the guy a call and he says that the other interested party didn't wind up buying it. I asked if he had located a warranty yet and he said "no." So, I said to him, "well, maybe if you can find it tonight, we can talk tomorrow about buying the TV." Shady detail #8 - "Oh, we had a change of plans," he said, "we're taking off tomorrow morning." Riiiiight. So I say, "well, I don't think I'm comfortable buying it without a warranty." So he says that he will run over to Best Buy and have them prepare all that paperwork. Sure enough, I get a fax and an e-mail from Best Buy not ten minutes later. I call the Best Buy and they confirm that they talked with him and that he explained what was going on.

Great, so I call him back and say everything looks great. We could probably pick it up tonight if he liked. I bring up the logistics of paying him and say, "will two checks be ok?" Shady detail #9 - "No, man. Cash only. I don't do any business with paper." Sure. That's totally reasonable. Let me go to the bank and pull $800 out of the ATM. Shady details #10, 11, and 12 basically revolve around his complete rigidity on paying with cash. We offer a money order or cashier's check. We offer half check, half cash. We offer half money order, half cash. We even offer bank transfers. No, no, and no. This is crazy. So I say that I don't think we can work this out. He immediately says, "Wait!" He puts me on hold and then comes back with shady detail #13 - "How about a credit card?" At this point, I don't think - I say, "Hell, no. I am not giving you my credit card number." Eventually, Ben comes up with a thought about paying through PayPal. Great, we offer half through PayPal and half cash. After a little wariness, he agrees. Amazing - pretty reasonable.

So, we eventually settle all the details but there is a small snag. The PayPal account belongs to his "friend" who happens to be a "police officer." "He sells police surplus on eBay," he says. I'm thinking, "awesome. Why do I need to know that?" Anyway, he says that he will call his "friend" to confirm that we had made a transfer and would call us once he got the ok from his "friend." Shady detail #14 - the guy's name apperas on the PayPal transfer record and the seller and his "friend" share a last name. WTF? Sweet. This really has the workings of a family fencing operation. Anyway, it takes him about an hour and several goading phone calls before he agrees to have us pick up the TV. The rest is pretty much history. We have a super-sweet, super-huge TV that will bring much joy to our house. Rest assured that I left out all the sordid details that were important for covering our butts like warranty transfer and ensuring that the unit worked. Swing by to see the new toy.

top ten...

2007-01-01T02:30:00.000-06:00

started working on this on New Year's but never posted it... enjoy it only three months late!

websites for the year:
10. Retro Junk: What were the lyrics to the Perfect Strangers Theme Song? What was the name of the Lawson's nosey neighbors on Small Wonder?
9. wikipedia: truthfully, it is much more entertaining than some of the other sites, but there is a little too much intelligence behind it. interesting entries include those for scientology, riding shotgun, and doorknob/safety.
8. Steve Spangler Science: home of the mentos geyser.
7. natalie dee: strange humor that lays waste to my neurons... and bowels?
6. Married to the Sea: even stranger humor that delights my senses... mostly sight.
5. the Phat Phree: I suggest the stunning works of Mike Polk including "Look at my Striped Shirt!" and "Why, Male Cheerleader?! Why?!"
4. the Travisty: a tried and true source of mindless entertainment!
3. Instructables: I'm a nerd. But, who can resist throwies and trebuchets?!
2. Olde English Comedy: Newly revitalized with fantastic sketches such as "Project Runway" and "The First Date."
1. Google Video: The wide array of videos makes it hit or miss, but it earns bronze for hosting some of my all time favorites such as "Women Police in Iran" and "Indian Thriller."

tv shows of the year:
10. deal or no deal: become quite the household staple at the Broadmor House.
9. heroes: guilty pleasure since the O.C. will be ending soon...
8. mythbusters: blowing things up? yes!
7. everyday italian: watching the food channel and eating at the same time is so gluttonous.
6. adult swim: yeah, its not a show but there are so many cartoons!
5. family guy: what? more inappropriate than me?
4. scrubs: I love zach braff, but the ridiculous hiatus was just a bit too infuriating.
3. house, m.d.: what? more sarcastic than me? impossible!
2. lost: many hours wasted during my second year of medical school trying to catch up. I think I watched about nine episodes of the first season in one sitting.
1. grey's anatomy: no, rotations are not just like the plot line of grey's anatomy. unless you are a certain someone, there is far less smut.

movies of the year:
10. x-men 3
9. snakes on a plane
8. fearless
7. apocalypto
6. the davinci code
5. pirates of the carribean: dead man's chest
4. talladega nights
3. borat
2. the departed
1. lucky number slevin

that's it for the kiddos

2006-12-26T01:30:00.000-06:00

another rotation come and gone. man, I might as well just change that to another year come and gone! where the heck did it go? while some days seemed to draw out into eternity, others seemed to end as soon as they began. the last weeks at Phoenix Children's was more the latter with each day ending with me scrambling to get everything done. I honestly felt as though each child I saw cast some sort of spell on me and I lost all track of time while in their presence. I am truly sad to be leaving such a great work environment.

along that line of thought, I am now desperately struggling to find another inpatient pediatrics rotation that will be willing to mme before I get too far into my fourth year. the problem is as such: in order to do advanced sub-internships in pediatrics such as PICU or pediatric ER, I need to have done a "proper" inpatient pediatrics rotation including shelf exams and morning/afternoon didactics. I guess that makes sense - I mean no ward team in their right mind would want some dufus fourth-year who had no concept of ward medicine to work on their team. unfortunately, there is no wiggle room when it comes to this prerequisite and I guess while I have received a solid rotation and didactic education from my preceptor, it isn't going to hack it anywhere. so, here I am struggling to fix something that truthfully should have been taken care of this year. to be completely honest, it has been overwhelmingly frustrating as I had a fairly well-rounded schedule planned and now I have to completely rework it to try and meet prerequisites that I thought would have been fulfilled. even more so, out staff appears to be completely inadequate in solving this issue. I'm under the impression that resources have been exhausted, but it is just something that our school in unfortunately lacking. so, as stated before, it is just something that requires me to abide by that old addage to leave the things I cannot change.

well, that was a bit of a rant. on the upside, I've got some time off and have been able to head back to California to visit with my parents. its been great to be here and sleep in and all that jazz - especially since it seems that I only have actual physical contact with them little more than once a year.

that's pretty much it for now. although I'm enjoying the break, I'm really getting antsy to start back on rotations. I think its more that I want to get this blasted OB rotation over with. I imagine it will be super interesting, but I'm honestly dreading the daily commute. here's a small taste of it (courtesy of maps.google.com):

yeessss... two-hour round trip commute... and that's not including traffic!

so, to end things on a happy note, here is poco.

awwww.

I blame the babies...

2006-11-22T01:11:00.000-06:00

"... they make you toxic."

That is the summary of my first day in pediatrics - the bulk of which was spent on a furious information scouring mission for my 48-day old patient who had no collateral sources of information. fun.

"dre" is not someone's name

2006-11-15T16:13:00.000-06:00

so, its time again for a rather long and drawn out story about my last rotation. this time around, I have an actual reason for not posting anything for over a month. I guess I should pick up where I left off in October.

psychiatry was surprisingly fun. the last post pretty much occurred at the beginning of the rotation and as the days went by, the field of psychiatry grew on me more and more. the phenomenon was pretty similar to that which I experienced in surgery - it was so much fun to go to the hospital and interact with patients and work with staff that seemed to truly enjoy what they were doing. surgery was fun, but it was also intense - at least it was intense in the OR. I don't want to say things were real lax in psychiatry, but it was just more easy going. the workplace was just as professional as any other that I have worked in, but humor played a bigger part in the daily schedule. there was always work to do, but there was also time to sit and really absorb what was going on around you. in retrospect, I probably spent just as much time people watching as I did writing progress notes and doing assessments. so, unlike my previous beliefs, a future in psychiatry might still be possible.

now, after being at the veteran's affairs medical center for over three weeks, it is almost time to move onto my next rotation. having been bred in the field and ER, I was dreading Internal Medicine even before day 1. I remembered that when I was getting home from psych and even surgery before that, Buddy and Ben hadn't even thought about coming home yet. fortunately, the rotation has not been even close to as bad as I thought. though the hours and work is demanding, I'm keeping fairly busy and the days seem to go by quickly. the attending physicians here are great. despite being ridiculously intimidating with their vast amount of knowledge, they have been incredibly genial and helpful. not to discredit my experience in medical school, but I have learned so much about pathophysiology and disease process here. my attending is particularly supporting of evidence-based medicine. learning to do all that research has been taxing, but I feel like it has been a great way to think about diagnosis and treatment. just as the other rotations before, its already been four weeks and I feel like I just got started. I'd be lieing if I said I wasn't anxious to move on to my next rotation, but I think I will miss the routine and work I've been doing at the VA. so, as another suprise, medicine is still on the list of possible careers - not at the top, but at least still there. now, I only have another half hour of freedome before we start taking call for patient admissions so that is what is going on for now. next rotation: pediatrics.

its dry heat

2006-09-29T00:17:00.000-05:00

so once again, another post begins with "I'm still alive." after nearly one month since the last post, I am one rotation closer to graduating. surgery was amazing. I remember dreading rotating with a general surgeon that specialized in bariatrics, but in retrospect, I wouldn't change it for anything. I learned so much - not only about surgery, but also about internal medicine, gastroenterology, and radiology. it was like four rotations all in one! the hours were long, but went by so quickly. I really shouldn't say long because I often got to go home before my preceptor did. for perspective, I generally got to the hospital around 6am and was pretty much working until about 6 or 7pm on a regular basis. plus, there was only one weekend of call. granted, that weekend led to twelve straight days of work, but it went by quickly.

most notably during the first month playing doctor, I got a lot of flashbacks to working in Illinois and DC. I guess that's what made it so enjoyable. it was like reliving the experiences I had as an undergrad without the constant stress of 7am tests and a full day of classes after I got off work. it was so great to get back into the clinical setting - both interacting with patients and working with people that reminded me so much of those that reared me as a healthcare provider. its strange to imagine that even though my surgery rotation was only four weeks long, when it came time to do my evaluation and change to psychiatry, I felt as though I had worked there forever.

so now, I'm on psychiatry - a completely different world from surgery. monday was especially awkward. the world that I work in now is much more relaxed in a way. with a couple of exceptions, there isn't the same sense of urgency as with surgery. time never really seems to be a point of concern. truthfully, it may be because the patients themselves often lack a firm grasp of time. however, there hasn't been a constant concern that organs will rupture or a source of internal bleeding needs to be identified. it has been a careful, almost meticulous investigation into what has casued a patient to become so mentally disturbed. so, after getting over the internal need to cut open every patient, psychiatry has become more and more interesting. I have become more interested in it as I spend my days trying to sort out everyone's pathology and that is what I will be doing for the next three weeks.

every new beginning

2006-08-21T08:28:00.000-05:00

So it is about quarter after 6am and I just can't seem to fall back asleep. I could be anything, but it is most likely the fact that I am about to officially begin my third year of medical school. It is only orientation this week, but I cannot shake the sensation that I am starting what may be one of the most important and most memorable periods of my life.

Its been a while since the last post so I will try to briefly summarize the last couple of weeks. The trip down to Arizona was uneventful. I made the drive down from Kirksville over three days stopping in Witchita, KS and Albuquerque , NM. I made the trip down probably a week ahead of most just to get settled into our new place in Tempe, AZ before heading out to Jeremiah Blankenship's wedding in Dahlonega, GA. Fortunately, the temperature difference between Kirksville and Tempe was not too drastic. It was actually fairly surprising to remember how similar a humid 92 degrees and dry 105 degrees felt.

Jeremiah and Dorielle's wedding was amazing. It was my first time in Georgia for any memorable length of time and it was truly a great place to start building memories. Esther, Kirbi, Kristi, Paul, Nate and Kristen Scherer, and I stayed in a cabin furnished by Bend of the River Cabins. It was amazing to stay in a cabin that was right on the Chestatee River. I wish I could go into great detail about the wedding, but the entire weekend was beyond description. We had such a great time meeting all of Jeremiah's other friends and family and the ceremony was amazing. So, I will stop there and leave the rest up to your imagination.

So, after getting back into Arizona, the rest of the Kirksville pack began trickling in. For the most part, all of us are situated fairly close to each other. Each of us has been exploring our new home and I think it will be a great change of pace for us to be in such a diverse and populated area. For some, it is a return to civilization and for others it might be a new experience. I guess that's it for now. I say that meaning that it is literally time for me to go because we have to be at orientation in a little over an hour and we have - for the first time in two years - a significant commute. More to come...

on the road again

2006-07-22T21:43:00.000-05:00

wow. now that's what I call a blogging hiatus. so hopefully I have been in touch with most people who regularly read this blog so you haven't gone the last three month's thinking that I have died.

in fact, the last few months have been incredibly exciting. first of all, the south africa trip was amazing. it was such a great experience working with all of the ADP staff again. for both trips, the volunteers and staff of Atlantis ADP served as our hosts and rapidly became like our family while we were in South Africa. in addition to working with the ADP staff, it was a humbling experience to return this year as a "senior" participant and be somewhat responsible for a team of first-year medical students. in some ways, it was interesting to see if an extra year of preclinical education would truly make that much of a difference in the clinical setting. I was happy to discover that the extra year of studying had some benefit - more so clinical decision making rather than the "absolute diagnosis" category. working with first-years was also humbling in this respect because as one of the seniors in the group, I felt like there was a certain level of expectation for us to answer all the questions. evaluating over twenty kids each, I quickly remembered how to say "I don't know." in addition to the clinical challenges, this trip was also a great exercise in teamwork. not only did we double the size of the group on this trip, but we also added four dental students, colleagues that specialize in a subject that we as medical students are more or less in the dark.

so, upon returning to kirksville, we immediatey began our last quarter of preclinical education. it was basically a whirlwind tour all of the organs in the head. I would be lying if I said I took away something concrete from either the ophthalmology or otorhinolaryngology courses, but I think I'm going to attribute that to the fact that we would have about four hours of one subject each day. in my opinion, that is a lot of any one subject when the weather is telling me to go fishing. regardless, classes went well and I am proud to say that the preclinical portion of my medical education is officially over.

in a slightly related topic, just as the quarter ended, I got another useful tidbit of feedback. USMLE scores were reported a whole week ahead of schedule. as soon as I found out that they were released, every trip to my mailbox was like a death march. I can honestly say that I almost vomited in the hallway several times as the days went by. fortunately, when the envelope finally appeared in my mailbox, it brought some good news. I was absolutely relieved to find out that I passed. it was a slightly mixed moment because I wish that I had done slightly better, but on a deeper level I was happy just to have passed. so, now I'm just waiting to hear about the COMLEX.

so, that pretty much leads up to the last couple of days. even though I have been packing for the past three weeks, I was shocked when I was confronted with the mounds of clothes, books and knick-knacks that were still loose in my apartment. fortunately, I had most of this past week to organize everything before comprehensive testing on thursday. despite that fact, it still took me well into friday night to get packed and it wasn't until this afternoon that I was ready to ship off. I can't even count how many times I said "I just don't understand where all this crap came from." other events of note include the fantastic surprise birthday party my classmates threw for me on thursday night. it was great to see everyone one last time before we all headed out our separate ways.

now, I'm in wichita, kansas after getting out of kirksville a little behind schedule. I figured that six hours of driving would be enough for today and I will make up time tomorrow. if everything goes well, I will be able to make it to new mexico by tomorrow and then have a short drive to arizona on monday.

When going to hide...

2006-05-26T18:36:00.000-05:00

So, "Into the Woods" once again brings such useful words of wisdom. Its been a whirlwind of a day. How trite. Well, my brain is fried so I revert to these things. I'm camped out at a Panera Bread after taking the COMLEX Level 1 today. Why am I writing here instead of studying or doing more qBank? The Kaplan site is down. Well, the test went as well as can be expected I guess. The first half definitely felt easier than the second half. I'm not sure if it was fatigue or shear difficulty of the material, but I certian felt more incompetent when it came down to the last 150 questions. Even thinking about it now is mind-blowing. I just spent five hours this morning answering 400 multiple choice questions. 400 questions stands between me today and my future as a physician. Weird. Now, I'm going to challenge myself to do the same thing tomorrow. Don't worry - it's only 350 questions for the USMLE Step 1.

Oh, those words of wisdom? "When going to hide, know how to get there... and how to get back... and eat first." If you need more details, I'll fill you in when I get back.

48 hours...

2006-05-24T21:36:00.000-05:00

Yes, I know - its not quite as dramatic as 24 hours, but for me it is just slightly more widespread panic than drama right now. I can only equate it to standing in the line of a meteor or plane crash or stampeding herd of elephants or whatever inevitable disaster you can imagine. I have this deep-rooted sense of uncertainty despite having prepared for both board exams for the past six days. At the end of the day, I take another 100 questions and feel very comfortable with going home around 6 or 7pm only to be overcome by a sense of fear around 9pm. That pretty much initiates a panic cram session for a test that I can't conceivably cram for. So, what happens in the next forty-eight hours when there isn't time to cram? Well, I guess you let panic take over and hope to sleep well. Maybe I can let the light at the end of the tunnel bleach out some of that worry and hope that I won't have to come back to Kirksville in October to retake the exam...

guess what I learned today?

2006-05-23T14:58:00.000-05:00

amidst the learning, I have had some interesting conversations. here are some samples:

Aaron: we meditate on the mandala of manicoti
me: yes.
me: which at this point appears to be a worthless skill.
Aaron: but i stopped after the oriole...
Aaron: NO.
Aaron: it's awesome
Aaron: go be a seal clubber
Aaron: jerk.
me: I should.

Jeremiah: from the online medical dictionary: tamponade
Jeremiah: The insertion of a tampon.
Jeremiah: (05 Mar 2000)
me: nice.
Jeremiah: so how does that hurt your heart
Jeremiah: nurse, the patient's in tamponade - pass me a tampon, stat
me: I think the tamponade is a result of a tampon.
me: if the patient is in tamponade, you need to pull the string.
Jeremiah: sickening

I felt that those were immediately post-worthy. Back to studying, I guess.

livin' on a prayer...

2006-05-23T09:54:00.000-05:00

Things may be looking up... In nothing short of a miracle, I did well on my first qBank for the day.

hopefully that's not a fluke.

In other news, this is the saddest video I've seen in a while - which translates into some of the funniest footage I've seen in a while.

tear it apart and start again...

2006-05-19T19:46:00.000-05:00

So it is official. Seventh quarter has come and gone and I am so close to third- and fourth-year rotations that I can taste it. I know there is a daunting challenge facing me, but I feel as though I deserve a little break before I hit the ground running. I tried studying this afternoon and I was just so exhausted that I almost believe that the five hours would have been better spent catching up on sleep. So, with only one - well, two obstacles between me and rotations, I'm going to take the night off.

I've packed a change of clothes...

2006-05-19T12:59:00.000-05:00

So, seventh quarter is semi-officially finished. "Finished" in that the last final exam as been handed in and I'm no longer studying for classes. "Semi" in that I am waiting for the last final to be graded. Not exactly a precarious position, but not completely finished in the literal sense. With that being said, I'm pretty much in full gear to go after board exams. I'm feeling pretty good about the COMLEX on Friday, but I'm starting to get nauseous thinking about the USMLE on Saturday. At present, I am debating the merits of rescheduling the USMLE for later in July. At this point, though, it's time to move on...

it's an ugly thing

2006-05-18T17:49:00.000-05:00

desperation, that is. finals is almost over, but you know you are in a bad state when you actually consider the feasibility of pitching a tent up in the anatomy building. seriously. I thought of everything including using the emergency showers located up in the microbiology department. hey, if you can camp in the city, surely you could camp in kirksville.

anyway, one week and counting.

the slotted spoon...

2006-05-16T23:58:00.000-05:00

so, it is seriously crunch time. almost two years after I started medical school, this is truly the first time I have felt anxiety or uncertainty. with finals almost over, the grim reality is that the board exams are quite literally around the quarter. despite my best preparations, I can't help but succumb to this overwhelming feeling that something horrible will go wrong. I guess it might stem from that weird paranoia that I think everyone experiences - you know, the one where things have been going so well that something catastrophic is bound to happen soon. all I can do now is hope that I can focus in the next nine days and something good will come of it.

still alive

2006-05-01T10:48:00.000-05:00

Well, I just wanted to drop a quick note to say that I'm still alive. As boards rapidly approach, the stress level is mounting. I seem to be in a perpetual state of confusion, often somewhere in between "completely overwhelmed with the need to study" and "sense of hopelessness due to the short time left." It is often so bad that I would equate it to manic-depression. So, with that, I should get back to studying. However, I will leave you with the coolest thing I have found on the internet since Flickr. That would be this little guy. A sweet paper cutout that seems to follow you everywhere.

don't take your eyes off him.

I highly recommend going to the website and downloading your own...

keep believing, keep pretending...

2006-04-03T22:34:00.000-05:00

Well, suffice it to say, I made it back to Kirksville ok. I truly intended on finishing my stunning narrative of Spring Break, but it has been complete chaos since getting back to school. So, I guess I'll pick up where I left off... After the dreadful loss of my camera, I was a bit bummed out. Buddy and I woke up fairly early the next morning to check out the house that we were really interested in. I was a little remiss when we arrived and the realtor was about fifteen minutes late. Even so, the place was nice. It was still getting some last minute renovations but the space was big and it looked like it would be a comfortable place to set up. We took a couple rental applications from the realtor and told her we would think about it.

So there we were at the crossroads. We could pretty much negotiate terms with her and set up a decent place to live or we could continue looking around for a place that really impressed us. We wound up driving all over Phoenix, Tempe, and parts of Chandler to get a feel for the neighborhoods before heading back to the hotel to check out. At this point, we were pretty worn out. We called a couple more realtors, but it seemed as though it was really going to come down to the last house or postponing finding shelter for another time. We started making plans for leaving Tempe and decided to contemplate over a late lunch. As we were ordering, Buddy got a call. It was someone he had called from an ad. The place sounded promising - northeast Tempe, four bedroom, two bath and he was willing to negotiate terms of the lease. We were thrilled. Maybe this would be the place. He said that he would arrange for us to take a look at the place that day. As we ate, we decided that we would leave tonight and start heading up to Colorado. As soon as we saw this place, we would head out and either drive through the night or camp out at a truck stop. It was then that we got a call from the tenants that said they could meet us later tonight. With a little back-and-forth, we were able to convince them to let us come right at that moment. We immediately left the store and rushed over.

As we were pulling up to the neighborhood, everything looked great. The roads were clean and close to the highways. We could pull onto the highway, but there was no exit traffic onto the street. The roads in the subdivision were wide and the lawns were all well-kept. As we pulled up to the house, we were amazed. The house was not unlike others that we had seen from the outside, but there was something about it. As we walked in, I was immediately taken. Unlike our first experience with house tours, it was pristine. As we walked through the place, I couldn't believe it. I pretty much felt like this would be the place. Now my job would be to convince everyone. The rent was a bit more expensive and we would need to start paying early. Fortunately, we were able to postpone it a bit and start paying halfway through June. We snapped a couple pictures and I got them onto the internet for Ben and Rob to see. I called them right away and pushed my bit. Buddy was a bit more reserved, but I think he was pretty stoked about the place, too. We decided to head out on the road and think it over before making any decisions. We were able to make it out a couple of hours before parking it in a rest stop.

The next morning, we woke up in the familiar reclined position in the front of Buddy's Subaru. We headed back on the road and were able to make it back to his parent's house around noon. While there, we were able to share our experience with Buddy's mom. As we described the place and kind of the situations that led up to that point, she said that it sounded like this was the one. It was like everythign was falling into place. Even so, we left the house with the decision that we would still mull it over for the night. We headed out to his parent's condo in Silverthorne and got settled there. We made a bit of dinner and pretty much sat around and waited for Paul, Kristi, Jeremiah, and Dorielle to arrive. Eventually, Paul and Kristi showed up and Jeremiah and Dorielle arrived shorther thereafter. Dorielle, Jeremiah, and Paul decided to go skiing while Buddy, Kristi, and I planned on hanging around the trails by the condo. So, we all went to bed in preparation for a relaxing day.

So the next day, I woke up just as Paul, Jeremiah, and Dorielle were heading out. I changed and the remaining three of us decided to go snowshoeing around the area. I knew it would a good workout, but I had no idead that it would be nearly as strenuous as it was. We would literally move about fifty yards and I would be winded from the incline. Maybe it had to do with altitude, but I suspect it had to do with me being ridiculously out of shape. Even so, we managed to hike through the woods and got fairly far along the path. After about an hour or so, I was literally drained. Fortunately, Buddy and Kristi were kind enough to call it quits. We headed back to the condo and waited for the ski crew to return. In that time, Dominic and Lindsay stopped by before they headed down to the city for the roller derby.

After a long decision-making process, we decided to make dinner at home before heading out for the St. Patrick's Day madness. Kristi and Paul cooked up one of the best soups ever in about half an hour and we were eating within the hour. After eating to our hearts content, we realized that we really weren't too thrilled about battling the drunken masses at the pubs. So, we stayed in and watched a movie. Yes, thank you everyone, we're old. I accept that fact.

As the days went by, we became more comfortable with the thought of signing a lease at the last house we visited. It seemed right and too much of a windfall to turn our backs on it. So, we called up the manager and started the process for signing the lease. Other than that, the next couple days were fairly uneventful and Buddy and I got back to Kirksville without any problems. I pretty much collapsed in my apartment and was very excited to be sleeping in my own bed.

The next morning was pretty much a whirlwind of waking up, getting to class, and taking that monstrous NBME exam in the afternoon. I don't know whether it was just the post-break fatigue or the exam itself, but right around the 120th questions, I was ready to tear the whole thing up and scream. Nevertheless, I managed to finish and rapidly evacuated to my apartment.

---this was a draft that I never finished... suffice to say, it has been long enough that I have completely forgotten what happened next. --andy 5/1/2006

the cost of mindlessness

2006-03-14T23:48:00.000-06:00

I wish I could say that our silent night camping was interrupted only by the soothing sounds of the wind blowing and the owls hooting, but that be ignoring the sound of a search helicopter swooping by our camp about five times - seemingly lower with each pass. Regardless, I awoke a couple times during the night to readjust the "Nalgene heater" to warm my feet. I hadn't planned to sleep in such frigid conditions and I was a bit unprepared for the 32-degree weather. So, it wasn't surprising that I was out of the tent the moment the sun peeked over our rocky surroundings.

I walked over the crunchy, snow-covered rocks toward Paul and Kristi's tent to wake them for the view. I then hiked a little further east and climbed some rocks to get the full view of the valley. It was amazing how much the landscape had changed as the sunlight spilled over the mountains. I snapped a couple pictures as Kristi and Paul joined me. Paul brought out his stove and started working on cups of coffee. I'm not exactly sure if the coffee was warming me from the inside or if the sunlight started to heat the air, but the cold seemed to disappear as we started moving around. Even so, as I looked about the landscape, I noticed that my leg was still a bit cold, as if the wind was piercing my jeans. I looked down and noticed that I had somehow caused a small defect in the crotch of my jeans to grow into a full-blown, five-inch tear down the inseam. I was strangely relaxed about the ordeal and Paul graciously donated some duct tape to make myself decent again. As we enjoyed the sunrise, the Sheriff's search helicopter alerted us that the search continued for the two missing girls.

Around 8am, we broke camp and headed back down the trail. The rocks that were covered with ice last night had begun to warm and the ice was melting away. Many of the rock faces trickled with water that had melted away from the snowy summit. We crossed paths with several hikers making their trek up the trail and were notified that the search and rescue team had organized at the trailhead and were still actively searching for the two missing girls. The path was far easier to follow under the bright sunlight and we made it down the trail easily within an hour and a half. Back at the trailhead, we discovered that the two girls had been found. As it turns out, they got lost last night and were forced to camp overnight and follow a different trail back to the trailhead.

With that news, we headed back to the cars and I had nothing more on my mind than to change my pants and charge my phone. I quickly emptied my pockets and placed my camera on the car before heading to my backpack to get my phone charger. I plugged my phone in and ran to the pile of clothes I had displaced from my pack last night. It was time to change into shorts! I ran into the public restroom and changed out of the somwhat ruined jeans. As I headed back, everyone was rearranging their things and had put out a small bag of trail mix. We snacked on the mix for a bit before deciding to head into Tempe for coffee. Buddy and I had a couple of appointments shortly after the noon hour. So, we packed up the car and headed out back towards civilization.

The drive went slowly and my somewhat restless night was evidenced by my brief lapses or consciousness as we drove in the broad daylight toward Tempe. I awoke as we pulled into a parking lot on the north side of campus. I got out of the car and started to gather my things together and noticed that my camera was not in its usual spot in my backpack. My stomach sank as I realized what must have happened. Did I leave it on top of the car? The answer became evident as we searched the car without any success. Even worse, we had just driven forty minutes from the trailhead. If we went back, there is no way we would be back in time for our 12:30 appointment. In a desperate attempt to salvage the camera, I called the realtor and pushed our appointment back half an hour. Hopefully, this would give us enough time to go back, scour the parking lot, and drive back.

So we headed back toward the trailhead. I was acutely awake at this point contemplating what I was more upset about; losing my camera or losing some of the greatest pictures I have taken. We got back to the trailhead and saw the same deputy that greeted us as we left the trail. Unfortunately, he said that no one had turned in a lost camera and the impression I got was that the chances of that happening would be fairly slim. I guess deep down, I knew that would be the case, but I had hoped that one brief moment of mindlessness wouldn't end like that. Disheartened, we headed back toward Tempe to look at another property. Despite pushing back the appointment, it didn't look like we would make it in time. So, I called to see if he could wait just a bit longer. He said that he was taking off and maybe we would be able to reschedule for tomorrow.

With that, we headed towards the other property we looked at yesterday. When we arrive, we noted that once again, the workers were not there and we would not be able to walk through the property. I called the realtor and set up an appointment for 9am tomorrow. Only later would I realize that an early appointment would mean that we would need to stay in the hotel again. So, we repeated our ridiculous hunt for a hotel room and wound up encountering the same issues. We wound up back at the Days Inn and Buddy and I set up next to the pool to utilize the wireless internet. I didn't have much luck with any other properties but Buddy found a couple. He also got in touch with another realtor that may have some promising results.

Paul and Kristi headed out to Scottsdale where there was some renowned brewery with about 130 overpriced beers on tap. They called us and we tried to finish up our last bits of business. Unfortunately, after we finished and showered, they were on their way out. So, they decided to meet us back at the hotel so we could make plans for dinner. We eventually met up with Sandra Till for Ethiopian food at the Blue Nile and beer at Four Peaks Brewery. I was exhausted at this point and it showed as my eyelids began drooping at 11:00pm. After becoming near-painfully full of food and beer, we retired back to the hotel.

the twilight zone...

2006-03-14T02:50:00.000-06:00

So we woke up this morning and managed to file everyone in and out of the shower. After checking out of the headed over to campus and were once again met with the gruff front desk personnel. After identifying ourselves to them, we had a long conversation regarding the differences between the medical school and the health sciences school. We also got some pretty useful tips about locations that would suit our needs. As we continued to do research, Paul and I decided that today would be an ideal day to find an In-n-Out and indulge in some double-double goodness.

As lunchtime rolled around, we found the nearest location on the internet. We were astonished that the nearest In-n-Out would be a mere four blocks away. We committed the location to memory and headed out in our search for fast food. Though we held our course steady, the In-n-Out could not be found. We became so befuddled that Buddy and I eventually had to pull over for gas. Conveniently, this gave us the opportunity to ask for directions. This proved invaluable as we had underestimated the distance and the In-n-Out was off the road just five blocks away from campus. With renewed resolve, we rushed toward the fast food mecca and were greated by the fragrant aroma of ground beef on a griddle.

Lunch was as expected - unhealthy nearing toxic, yet unexplicably delicious. We left the In-n-Out and headed toward REI, where we would be gathering some last minute items for our evening hike and camp. Having slept on Paul's Therm-a-Rest pad last night, I was convinced that this was something I needed to have. So, I looked around for one and found a pretty sweet deal on a similar REI model. With purchase in hand, Buddy and I headed off to our first house showing just a couple of blocks away.

We arrived at a mediocre looking house just outside the ASU campus. From the road, it looked cozy and livable and we were eager to see the interior. That soon changed as we walked into the front common area and saw what appeared to be the aftermath of an undergraduate orgy. There were cups and bottles strewn across the floor. Dirt had accumulated in the corners as well as in random splotches throughout. Things only got worse as we travelled through the kitchen and dining area - dirty dishes, leftover food, and empty pizza boxes riddled the countertops and table. As we headed outside, the scene continued by the pool. We were, however, amused to find that parts of the patio furniture had been submerged in the pool. Needless to say, we both knew that this house was not going to rank highly on our list.

We left that property with slightly sunken spirits and hopes that the other houses would be significantly better. We headed a couple blocks south where another house was being renovated and was open for walkthroughs. We arrived in a small cul-de-sac and were in the company of other people looking at the house. The floorplan was slightly bizarre. The house is a four-bedroom, three-bath with one bedroom and bath being enclosed in a studio apartment setup in the back corner. Otherwise, the house was bright and looked like significant improvements were being made on the property. This was a great relief as we realized that there was hope in finding livable space.

The last property we looked at today was just a few blocks from the last. We were told by the real estate agent that there were renovations being done and we would be able to walk around while the workers were present. We arrived at 3pm and much to our surprise, the door was locked and nobody was at the house. So, we took a look around the outside and peered through the windows to get some previews of the interior. It looked promising. In addition, we spoke to one of the neighbors about the neighborhood and area and felt very comfortable knowing that we would be in good company in this community. So, without any way to get into the house, we decided to contact the realtor to set up a time for her to give us a tour and call it a day.

We returned to the Mesa campus and started working on tomorrow's schedule. Paul and Kristi researched the best options for hiking and camping tonight and eventually met us at school. We chose to hike up the Peralta Trail through the Superstition Mountains about 40 miles southeast of Phoenix. It was getting dark but we were optomistic about hiking under the near full moon. The trail spans about 2.5 miles and an elevation of about 1700 feet. This was promising to be a very exciting experience.

So, we left campus and headed out to the trailhead. The dirt road that led to the trailhead was not very well lit and had several suprises in store for us. The most notable was a corral jailbreak that led to a standoff between our car and a huge steer. After the cattle retreated, we were able to continue our trip to the trailhead. A mere four dollars allowed us to park and camp for the night. We packed our gear and snacked on some sandwiches before heading off onto the moonlit trail.

The first leg of the trail was fairly easy. It was mostly a well-trodden gravel trail that cut through the cacti and desert brush. The moon was more than enough to illuminate the path. As we headed deeper into the trail, some more significant brush appeared and some taller ground cover made the path somewhat more obscure. At one point, we wound up slightly off-course, climbing rocks and traversing streams. However, we managed to find our way through thick bushes back onto the trail. The next leg was more arduous with the ascent up the mountain becoming more apparent. In addition, we started seeing signs of the snow that had dumped over the mountain last night. About halfway up the trail, I started to get get winded and could feel my lungs burning up. Surprisingly, it wasn't so much the muscular fatigue as the cardiovascular. I needed to take a break. There seemed to be programmed rest points on the trail, where the view was breathtaking. I would periodically sit down to take a couple pictures of the amazing rock face that was set in front of the clear, starry night sky.

Nearly two hours into the hike, I was absolutely confused. Is it possible that we overshot our goal? Surely it wouldn't take us this long to get to our destination. In addition, the trail was becoming more precarious as it narrowed on the mountainside and ice laminated most of the rocks. Upon reaching an overhang with a significant flat, I thought that this would probably be the end. However, after a significant break, we decided to continue a bit further with hopes that the summit would be close. Fortunately, we were close. Within about 500 yards, we reached the top of a small mesa.

The view was amazing. There was snow everywhere and we were able to walk around freely without fear of tiny crevasses. We found places to set up camp and were quickly enervated by our surroundings. It was surreal. The air was fairly dry and almost warm. However, as the night progressed, the temperature would quickly drop to near-freezing. We didn't really have anything except take in our surroundings. I took several surreal pictures on a thirty-second shutter speed. We were surprised when we heard voices approaching our location around 1am. As it turns out, two girls have gone missing from a hike this morning. With that frightening bit of information, we decided to turn in for the night. Paul went to work boiling water to place in our Nalgenes. We have stuffed these rudimentary heaters into our sleeping bags in hopes that they would provide a source of heat during the frigid night. A simple and amazing plan that will hopefully keep me from losing my fingers and toes as we sleep in the wintery Superstition Mountains.

so it begins...

2006-03-12T22:58:00.000-06:00

As expected, Buddy and I woke up to the chilly morning air and sunlight pouring through the humidified windows. Much to our surprise, the parking lot at school was rather full and campus seemed to be fairly busy for a Sunday morning. Around 8am or so, we crawled out of our sleeping bags and did our best to appear somewhat presentable before heading into the school. The building is quite different to the structure we call "school" and we were caught off-guard when we were asked to sign in at the front desk and present identification. It was a very different feel than the open campus we were used to in Kirksville. After clearing the front desk, we immediately setup a base camp within the student lounge on the first floor.

One of the first items of business was to secure housing for the evening. I immediately called the Econo Logde in hopes of finding a vacancy. I must admit that I was surprised when the front desk informed me that there were vacancies, but even more so when he said he was too busy to take my reservation on the phone. He suggested that we come in around 11am. With that, we began our furious housing search. We managed to locate the name of a real estate agent as well as some promising properties over the internet. We left some messages and sent some e-mails and hoped to hear back from these leads by the afternoon.

Right around that time, we decided to head out to the Econo Lodge to actually reserve a room for the evening. Paul and Kristi were also coming down so it was going to be a incredibly economic four-way split for the room. Imagine my surprise when we walked into the lobby and the front desk said that they had just booked their last room fifteen minutes ago. So, we were consigned to pursue the other hotels in our search for shelter. Fortunately, we came across a Days Inn with a vacancy and quickly snatched up the room. The best part about having a hotel room was that we would finally be able to take a shower. We quickly moved our belongings into the room and washed off the last twenty hours of our road trip. We then headed out refreshed and revitalized.

We picked up a map and newspaper at the gas station and returned to the school to continue searching for properites. We were ecstatic to receive return phone calls from a couple property owners near ASU. We set up an appointment for tomorrow and felt as though we were well on our way. While on campus, we ran across a few more properties on the internet as well as several advertised through the classifieds in the paper. We started making a list and began calling people for appointments. After several hours at school, we decided to return to the hotel in search of dinner.

Making our way back to the Days Inn, both Buddy and myself had an unexplained craving for mexican food. I know we have mexican food in Kirksville, but there was something about having it so close to the border. It sounds stupid, I know, but we were both fairly sleep-deprived and it's difficult to explain exactly how our brains were operating at the time. After driving around for a few minutes, we discovered Salsitas, a little place next to the hotel. So, we parked the car outside our room and walked over to the little stand. As expected, the food was cheap and delicious. After finishing a most satisfying dinner, we returned to the room and awaited Kristi and Paul's arrival. I can't say that I was conscious the entire time we were waiting and all we could do was turn on the TV and let our bodies enjoy some much needed relaxation.

Kristi and Paul finally arrived around 9:30pm and we made plans for tomorrow. We will head over to school in the morning and get a little bit of information in the morning. Mostly, we will touch base with student services here and try to see if they have any leads on housing. Then, we're probably going to head over to REI to see if there are any last-minute items we need before camping tomorrow night. Then, Buddy and I will go and take a look at a couple places before we head out to the campsite. So, that's the plan for tomorrow and I have a sleeping bag calling my name.

under the stars...

2006-03-11T23:37:00.000-06:00

So, we are in Arizona. The drive was most unique as we went from dry, cool Colorado Springs to warm, sunny Albuquerque to cold, snowy Flagstaff to rainy Phoenix. It was apparantly the first bit of moisture the metro Phoenix area had seen in about 140 days. Unfortunately for us, the foot and a half of snow downpouring on the highway extended our drive nearly two hours and finding lodging was pretty much impossible. We had hoped to stay at the Econo Lodge, but that, like every other hotel we came across was booked full. It was nearly 1am and we were facing some serious sleep deprivation and the only thing we could do was to pull out our camping gear. Not knowing the area, we couldn't possibly find a campsite. So, we decided that it would be best to find a safe place to sleep in the car. I thought that the only place we could honestly stake claim to would be the Mesa campus of ATSU. In the back of my mind, I had hoped that the building would be open and we could possibly find the Arizona equivalent of The Dungeon and possibly plop ourselves on a sofa or two. Unfortunately, we arrived on campus and found a completely dark building and vacant parking lot. So, we found an out of the way spot, parked the car, and put both front seats into full recline mode. We have unrolled our sleeping bags and will wait for the sun to wake us up.

on the road...

2006-03-10T23:19:00.000-06:00

The whirlwind of quarter 6 is officially over. As best I can tell, I passed all of my classes and may have done even better than last quarter. Although this is great, it is somewhat surprising given my utter lack of motivation these past days. Even so, classes are done, finals have been taken, and I am halfway to Arizona.

For the most part, Buddy and I left right after the Principles of Medicine final this morning. Because he needed to drop off his dog, he volunteered to drive his car. Given my history of mid-trip narcolepsy, I gladly yielded. We were immediately faced with a couple of obstacles. First, Buddy's car radio went on the abberantly stopped functioning; no static, no signal - nothing. We thought we were saved when it magically sprang to life about twenty miles outside of town but were then dealt a cruel trick of fate when we were pulled over by highway patrol and Buddy was forced to turn off the car. As is Missouri custom, the trooper had him sit in the car as he went through the ticketing motions. The radio would not be reanimated for the remaining miles of the trip.
This would be bearable if I were able to make conversation, a skill in which I am deficient. It was like an awkward twelve-hour haircut where I sat silent as the barber made painstaking efforts to start a conversation. I felt even worse as my eyes began to feel the weight of sleep deprivation. Before I knew it, I would be unconscious with my head dangling aimlessly from my torso. All I could imagine was the mind-numbing boredom I must have been providing.

Regardless, we have safely arried in Colorado in the gracious care of Buddy's parents. We plan to have a short breakfast tomorrow before continuing the drive out to Arizona. Hopefully I will provide better company following a restful night of sleep.

tomorrow is a long time...

2006-03-05T20:23:00.000-06:00

As the end of the quarter gets closer, I'm confronted with a bizarre mix of excitement and panic. The last few weeks have been horribly trying and I am eagerly anticipating the upcoming break.

Although the upcoming week is actually finals week, I'm fairly certain that last week was far more taxing that this week will be. As always, I was fairly busy with a couple committments in addition to the regular coursework. Although classes were fairly light, we had an exam every day. When we weren't taking an exam, most of us were studying for nearly ten hours straight. It was that cycle that we as medical students are all too familiar with - wake up before sunrise, take an exam, and study until bedtime. Although we have become very familiar with this routine, I think this past week was the first time that we have been expected to repeat it so frequently.

In addition to the normal stress and pressures that come along with the exams, this week had a very unique set of stressors that I had not noticed before. Because I had various commitments that required me to be a little more flexible with my schedule, I was attending classes on a more unpredictable schedule. This included coming in late, leaving early, or not even attending at all. Having been a traditional "class-goer," this made me really adapt my studying habits. It was really strange to feel like I was losing touch with a lot of the people I have become so accustomed. It was an awkward feeling of isolation and dissociation.

What made that even more stresful was that I was getting a strange sensation of cabin fever. The number of exams had pretty much forced us to our habitual study grounds. As most of us have marked our territory in our favorite study areas, we grew familiar with another group of people. While we often spend six hours of each day in class with the same people, this past week was absolutely mind-numbing with the amount of time spent with the same people. Often times, I was spending nearly every waking minute with the same people, studying in the Anatomy Building. There was almost no reprieve from the quirks and idiosyncracies of our classmates. It was a strange juxtaposition of losing touch with one group and spending so much time with another that cause some sort of potentiation, an additive effect. As the end of the week approached, all I could think about was curling up in my bed and think of nothing other than oblivion.

Fortunately, we were blessed with a string of great weather. Wednesday was exceptionally warm and sunny. The wind was steady, but gentle. I headed over to the study lounge after our Pharmacology Exam where Nate Jenson and I decided that there was absolutely no way we would be able to stay inside. Although I had planned on spending the entire afternoon in there again, I walked into the room, dropped my backpack on the desk and knew there was no way I could possibly spend another twelve hours plastered to the wooden chair staring at my pathology notes. We drove off to Thousand Hills to enjoy the sun and weather. We wound up finding an area on a hill by the lake and sat there, contently looking over our notes. Esther and Ben eventually joined us for a long overdue change of scenary. Although it was only four hours, I strongly believe that that brief move out of the Anatomy Building gave us the ability to refocus and recharge before heading back to the grind.

By the time Friday had rolled around, I had become such a ridiculous ball of nerves that I could do nothing but relax. It was time well spent. After a great lunch at Il Spazio, Aaron, Jeremiah and I joined Nate Scherer at the Dukum and played shuffleboard over Guiness for nearly four hours. I can't say that I noticed the time pass, possibly partially due to the volume of Guiness, but more so due to the fact that we weren't studying. It was another great instance of time well spent. The day ended with a birthday dinner for Danielle and Buddy and the post-dinner at Dukum. It had been such a long time since I had been out and it was long overdue.

I spent most of yesterday recovering from the week. I slept in until about 9am and ran a couple of errands. Sadly, this included attending to an oversized pile of laundry that had been accumlating in the hallway. I had even gone so far as to move the laundry bin into the hallway to remind me that this had been long overdue. Surprisingly, the dishes were done - a fact I attribute to the ridiculous amount of fast food that I was forced to ingest during the hectic schedule of the previous five days. After taking care of my apartment, I headed across the street to print off several additional materials I would need to start studying for our actual "finals week." There was a little tutoring after that, and a little volleyball - the first bit of physical activity I had allowed myself during that week.

That night, I was fortunate to spend time with my friends from the "left side." I find it funny that I constantly categorize my friends by the side of the classroom they sit on. It's actually a common phenomenon in our class. Anyway, we were at Dusten and Nicole Wessel's for a very different Saturday evening of drinks and cards. It was a great experience to interact with the guys I spent most of my time with last year. It was especially nice because they, like I are typically "class-goers." Because of my unpredictable schedule, I haven't been able to walk into class and sit in my usual spot next to them. In addition, I haven't been able to get into school during the typical times to study with them. In a sense, I had the uneasy feeling that we were losing touch with each other despite being in the same class with them. So, being able to hang out with them was such a great time.

With that being said, I'm sitting on my couch on Sunday night. I called it an early night for studying and I will likely be up early tomorrow morning to review for the Surgery final. One thing I will say that has been a great inspiration is a video I found while poking around the internet. It's called Kintaro Walks Japan. I was watching it and was instantly reminded of those words from Dr. Vick's wake that I alluded to earlier; "Go somewhere - anywhere. Do something - anything." The past couple days have been filled with some uneasiness about the upcoming trip I planned out to Phoenix for apartment hunting. I hope to take some time out at the end of the trip to visit Zion and Arches National Parks. I've been there once with my family on a summer vacation, but I suspect that I was too young to fully appreciate it. So, in the vein of both Dr. Vick and Tyler MacNiven, I hope this small road trip will be inspiring and invigorating.

the trials of life

2006-02-26T12:09:00.000-06:00

Well, I guess it has been a while since I have written anything, and to tell the truth so much has happened and I honestly haven't had the time to sit down and write it all down. So, while I have a brief moment to spare, I'll try and recapture it all.

It's been over a month since the last post so I guess that puts me right around the end of board review weekend. That in itself, is somewhat interesting as I'm looking down the barrel of another 18 hours of board review this weekend. Anyway, the drive to study for boards has since diminished a little. After that last round, I was exhausted! Fortunately, the faculty was kind enough to grant us a 24-hour reprieve and reschedule our Cardiology exam for Tuesday. So, I spent whatever energy I had left on Sunday studying a bit for the exam. Then, I spent all of Monday in class as you can plainly see from the previous post. And, obviously, that went so well. Anyway, I desperately tried to study that night, but having spent most of the weekend in books, I was far from motivated. Against all expectation, the exam went well and I was finally able to take a brief moment to rest.

I can't say with any certainty that anything riveting happened over the next couple of days. I wound up taking the weekend to just sit around. I stayed in Friday night, sat around Saturday and studied for part of Sunday. It was really just a good way to get away from school and get my bearings after spending 11 consecutive days in classes. Between classes, finalizing details for the Advanced Airway Lab for ER Club and some of my Student Government commitments, it just seemed like the best thing for me to do was to stay at home and recollect myself.

So, at that point, I still had plans to return back to Champaign on upcoming Saturday to renew my Illinois paramedic license. I figured I would take off Friday after class and get into town around 9pm. Because there were some meetings on Saturday, I wouldn't have time to stick around Champaign and would need to drive back right after critical skills making for a truly hectic drive there and back again. As the Airway Lab got closer and closer, I started to think about how feasible it would be to drive for nearly four hours on Friday night, get into Champaign around 1am, wake up at 7am, drive to Danville, do Critical Skills and turn around and drive four hours back to Kirksville. Typing it out now makes it seem so obviously irrational, but at time something inside me kept telling me to do it. So with only hours before the Airway Lab, I called up my good friend and mentor Mel and had a long overdue talk with her. For me, it was a good way for me to say the things that I have been thinking about for a long time. What was I hoping to accomplish by relicensing? I was trying to hold on to something tangible, some sort of validation that I had dedicated the past six years to something I felt was important. After talking with Mel, I realized that even with the lasping license, that part would always be a part of me, though abstract, something I carry with me every day. Just because a piece of paper says I no longer have the license to practice does not mean that I do not still have the skills and knowledge I needed to obtain it. So after a long talk with Mel, I realized just how insane the whole trek out to Champaign would be. It was another moment of truly understanding what my goals are and repriortizing my life so I could accomplish them.

Other than that, life has been fairly busy with classes and tests. It seems odd that while the information in lectures is interesting, classes seem to be grating on most of the students here. I can't say that I haven't skipped a lecture here or there to prepare for a test. I guess it's just more prioritizing. I've been doing well on all the tests, but sometimes lectures just seem like such an inefficient use of time. In the fifty minutes it takes to get the material off the powerpoint in lecture, I can read through the powerpoint as well as read most of the textbook material. So, that's the class situation.

Last but not least, Dr. David Vick, a professor in the OMM department passed away this past week and several of our class attended his memorial yesterday. It was a bit of a surreal experience, sitting there thinking about how we were under his tuteledge last year and yet knew so little about him. It was also such a humbling experience to listen to his colleagues and family talk about their interactions with him and all that he had accomplished in his life. Out of all this, I was most moved by the last words his wife had to say about him. She said that if he ever had a motto for his life, it would have been "Go somewhere - anywhere. Do something - anything."

afternoons and coffespoons

2006-01-23T21:31:00.000-06:00

I haven't written anything in a while, but I suppose it's because things have been relatively unmonumentous of late. So, with that, I bring you the small victories that have occurred.

I recently rediscovered ThePhatPhree.com. Unfortunately, it was in the middle of our Women's Health iLecture today. So, on a brief aside, I would have to say that iLectures have got to be the biggest, lamest excuse I have ever seen for not one, but two professors not to lecture in front of students. The "iLecture" is basically a Quicktime movie that was projected onto the screen in our classroom with audio that can only be described as OB/GYN and Pathology meets Saturday Night Live's "The Delicious Dish." Seriously. If I could post a link to the file, I would. So, that was about 90 minutes of grueling audio narrating some fairly foul pictures of female genetalia. Don't get me wrong, as a student doctor I have nothing against female genetalia, but I'm only allotted so much "cottage cheese exudate" and "skin tags" in one day and that lecture definitely put me over my limit. So, as the last minutes wound down, I found this article to which my only response could be "Sweet Mother of Mary! Its the Holy Grail!"

So needless to say, after a couple [dominating] rounds of ping pong it was decided that King's Buffet was in order. As always, small children were starving in Nambia while I crammed fork-full of greasy goodness after fork-full greasy goodness. After sufficiently gorging myself, we were delighted to unwrap the prognostic goodness that is the fortune cookie. Much to my surprise, this is what I found inside mine:

oh really. thanks.

So, that was pretty much the highlight of the day... or past couple of days. In the meantime, the board studying continues.

the day off

2006-01-16T21:37:00.000-06:00

If there is one thing I have discovered while attending medical school, it is that three-day weekends are the best time to get away from books and work on falling behind on studying. As predicted, the "study more" new year's resolution has been broken. However, it was good to have finally have the time to get away from textbooks, medical school, and most of all, Kirksville.

I managed to get out yesterday for a little exploring. I was playing around with Google Earth recently and noticed that there was access to a part of Thousand Hills State Park from the south part of town. Since it was sunny and in the mid-60s, I figured it would be a great day to go and check out the area. Of course, on Google Earth and maps, it appeared as though there was an access road that led straight to the water. Much to my surprise, the road ended at a trailhead nearly eight miles from the lake. So, I managed to hike about five miles in before I turned around to avoid being stranded in the dark. It was nice to get out and take some time to just walk without any true purpose or distractions.

Sunset in the Big Creek Conservation Area

We capped off the long weekend with a trip to the Red Rooster in La Plata tonight. We heard some good rumblings about this place and decided it would be the perfect opportunity to check it out. The food and service was astounding, but I think the most amazing aspect of the dinner really had nothing to do with the food at all. It was, in fact, the ridiculous hand dryers in the bathroom. That's right, hand dryers. I was actually disappointed because I didn't bring along my camera to take pictures or video of these amazing, gale-force generators. From the manufacturer's site:

"Hand dryer motor shall be a series commutated through-flow discharge vacuum motor/blower (5/8 HP / 20,000 RPM) which provides air velocity of 16,000 LFM (linear feet per minute) at the air outlet and 14,000 LFM at the hands (4 inches [102 mm] below air outlet)."

Now, much of my math skills have left me since starting medical school, but I do believe that translates to a speed of just under 3 miles per minute. 3 miles per minute. As best I understand it, Turboprop jet engines produce air velocities between 300-400 miles per hour. These handryers were pushing air around our hands at approximately 1/3 the speed of a jet engine. Ridiculous.

tear it apart and start again

2006-01-15T21:49:00.000-06:00

So, I've been avoiding a big dilemma for about four months now. Having carried the title of EMT for over seven years and paramedic for just short of four, I am faced with the decision of whether or not to renew my license. It's easy to say that being two years away from being a doctor, I should just let the license go and get on with my life. But having devoted so much time and energy into that part of my life, it is difficult imagining my life without it. In Kirksville, most of my friends know me, in part, as "the paramedic." I also feel as though I may somehow disappoint the people I worked with if I don't continue to put in the effort required to keep up my license; as if I would be doing them some sort of disservice by discarding the one thing that brought us together. So, it turns out that what may seem like an obvious choice involves very complex and personal factors.

In the interim, I had to make another difficult decision. Much like the standing issue regarding my licensure, I have been thinking about my connection to the National Collegiate EMS Foundation. During my first years in undergrad, I became very interested in NCEMSF and immediately got both myself and IEMS involved. To this day, IEMS remains one of the most active agencies in the North-Central region. In some way, I feel like I was a large part of this and have remained involved with NCEMSF as their North-Central regional coordinator. Last year, the position was a great way for me to stay in touch with Campus EMS programs and that aspect of my life. In addition, last year was slightly different in that I had enough time to devote to the position. This year, I found myself just trying to keep up with my duties and often flaking on some meetings. So, in trying to keep focused on my ultimate goal, I decided to resign my position. The exact date is uncertain, but I will still be performing some small tasks here and there while a new coordinator is found.

Having made the decision to temporarily break away from collegiate EMS, I am now faced with the dilemma regarding my paramedic license. As ironic as it may be, as I write slowly type about these issues, Grey's Anatomy prattles away in the background. Although the show is somewhat vacuous and unbelievable at times, it comes up with some pretty interesting closers once and a while.

"who gets to determine when the old ends and the new begins? it's not a day on a calendar - not a birthday, not a new year. it's an event - big or smalll, something that changes us. ideally, something that gives us hope. a new way of living and looking at the world. letting go of old habits, old memories - what's important is that we never stop believing we can have a new beginning. but its also important to remember that amid all the crap are a few things really worth holding on to." -Grey's Anatomy

I swear I started writing this before Grey's came on.

turn the city upside down

2006-01-12T23:44:00.000-06:00

It was nearly six years ago, but I remember hearing that I would never "make it" in medical school. Slightly disheartened, but otherwise undeterred, I continued trudging through application after application. Even after an unsuccessful first attempt, I persevered and was very fortunate to find my way to Kirksville. Even then, I still believed that my greatest challenge would be succeeding in the rigorous academic schedule that was presented to me.

It wasn't until recently, that I realized that academic success would not be the only challenge presented to me. Coming from a large undergraduate university, one of the major unexpected obstacles is living in this tiny microcosm. It isn't so much the community of Kirksville as much as it is the community of KCOM. Don't get me wrong - it isn't a miserable experience. It is just something that has taken me a while to get used to. The only way I can explain it is like being roommates with 360 of my best friends. Being in class for over five hours every day, much of the interpersonal interaction I have is with the same people day in and day out. Although I enjoy the company of many people here, after the amount of constant contact we have with each other, there are always those little idiosyncracies that manage to push the wrong buttons. Being able to recognize these and not allow them to develop into huge, public issues is really taxing and becomes the major consumer of emotions and energy.

In addition to the monotony of people, there is the constant stream of classes, the routine of lectures. Although the classes are much more interesting, they are much less interactive. I can't think of any appealing job that requires almost six continuous hours on your butt listening to people talk. Although the information being taught is vital, just being able to stay seated in my swiveling, plastic chair for that period of time just compounds the monotonous atmosphere of medical school.

With all that being said, it sounds pretty hellish, huh? I guess it would be if I didn't have ways to work off the stress and the means to change the scenery once and a while. I am incredible fortunate to have great friends here that I can always rely on. I can always find someone here to relate to. When I feel like school is starting to stifle me, I find solace in the fact that others often feel the same way. People just like me and people that couldn't be more different. In some ways, it really is as the addage says: "misery loves company." Somehow, we keep each other motivated, often reiterating the fact that we will soon be free from this seemingly meaningless routine. Whereas I remember hearing that I would never make in medical school, I am reassured that as a group, we certainly will.

what you wish for...

2006-01-08T22:37:00.000-06:00

I managed to survive the first week of the new calendar year. I guess that wouldn't normally be such a feat, and in all reality, it shouldn't have been any different than surviving it last year. This time, however, it seemed a bit more hurried, busy, and stressful. I guess it was mostly due to that darn diagnostic test. On that note, I suppose I did ok. It was weird to think that 50% would be an acceptable score, but I suppose I have another four months to absorb this monumental amount of material. I still find it a bit disconcerting that the diagnostic report said that I was on the borderline of "potential risk for failure" and "possibility for passing." I guess its just important to keep in mind that I have almost two entire quarters of medical education before I have to take this exam and many, many hours available to study for it.

In other business, I'm already looking forward to the upcoming departure from Kirksville. More than likely, the move to the Phoenix area will also involve living with roommates. I'd be lying if I said that I wasn't worried that there will be a massive roommate debacle, but I'm hoping that having more time to consider options and being much more experienced and understanding will make the group living much better. So, the housing hunt has begun and I'm eagerly awaiting the prospect of starting that part of my medical education.

hide and seek

2006-01-03T23:00:00.000-06:00

So, it was back to school today. It was a bit easier than I had thought after two weeks of the sedentary lifestyle. Six hours of classes came and went, we made more headway on drafting the Honor Code, and I managed to pretty much plan out my schedule for this month. That was until I found out that we would be having our 4-hour COMLEX I diagnostic tomorrow afternoon. That's right. Its the "find out how much studying you need to do between now and May" exam. Even though I know it doesn't count for anything, it makes the thought of taking Boards much more real.

Along with Board diagnostic exams comes Board Review weekends. These entail about eighteen hours of lectures on one subject over the course of 72 consecutive hours. This pretty much shakes out to four hours on Friday, and seven hours on Saturday and Sunday. Now that's a riveting time to be sure. So Day 1 of classes in the New Year has pretty much come out even with some setbacks and high points, including the broadcast of the new season of Scrubs and Rose making a huge pan of spinach lasagna.

"where are we? what the hell is going on?

the dust has only just begun to fall..."

So this is the New Year...

2006-01-01T20:17:00.000-06:00

So another year, and more specifically another winter break, has come and gone. As the end of December grew closer, things started getting more hectic and it was nice to be able to get away from it all to spend time with my family. This was the first year that the entire family wasn't together as my brother was busy with orientation at the Urbana Police Department.

I can't deny that things were very different at the house this Christmas. I had a couple items I needed to do for school so I spent a lot of time in my room on the computer. I tried to pop out every now and then, but I barely finished everything I needed to do before Christmas and the arrival of my cousin and his wife from Boston and his mom from Taiwan. Things pretty much were standard family happenings after that. It was good to see all the third generation family and so interesting to see how fast they grow! I saw Megan just after she was born when I was still at Georgetown and she is already walking and developing quite the vocabulary. Nickolas and Jason are as energetic as ever and seem to be growing up faster and faster.

I did learn a fun little bit of culture while out in California. It is a worldwide phenomenon called Geocaching. We went to a park where my cousin Sam had located a cache and opened it up. I guess its kind of like a high-tech scavenger hunt. The premise is that there are these "caches" hidden at certain locations that are given by latitude and longitude only. That way, people can locate them using GPS. They are hidden in public places, usually parks or trails and you find the container and sign the log located within. Some caches are large enough that people can leave small trinkets for future geocachers. There are also little Travel Bug Dog Tags that are meant to be transferred from cache to cache and the mileage is logged on their website. Its a pretty neat concept and I was surprised to see that this phenomenon even exists in Kirksville. I actually spent today roaming around Kirksville and saw a couple areas that I hadn't seen despite living here for over a year. Its a neat program and something I intend on looking into a bit more in my last few months here.

In other news, after getting back into Kirksville, I made my standard call home to let my parents know that I had returned to my apartment unscathed. It was during that call that I had one of those "so... what does it mean when" moments. My mom asked about "a person" who had trouble moving one side of their mouth and had problems closing their eyes. Immediately, the paramedic in me flipped my brain to "stroke." The question continued with what to do about it and if it could possibly mean anything else. I started to get the uneasy sense that this hypothetical person wasn't too hypothetical at all. In fact, it wound up that my mom describing the acute onset of symptoms my father experienced shortly after I left - almost 48 entire hours prior at that point in time. I will have to admit that this was probably one of the scariest moments of my life. The mere thought that my dad was having a stroke and I wasn't there turned my stomach. I obviously suggested that he either make an appointment with his primary care doctor or go to the ER to get checked out and he reassured me that he already called his doc and was going to be seen that afternoon. From Kirksville, that was all I could do and I hesitantly said good-bye and demanded that he call me the minute he found the cause of his symptoms. So, after two hours or so, I got a return phone call from my mother and she assured me that the doctor was not convinced my father was suffering from a stroke. Now that a stroke was out of the picture, my mind immediately swung to Bell's Palsy, which was shortly confirmed by my father. Upon hearing that news, I was much relieved and astounded by how emotionally exhausting that entire ordeal was.

So, that pretty much brings me to today. It is Sunday and I'm having the typical post-vacation denial that school will be back in session in less than 48 hours. I've been lounging around for the last seven days and I have to start thinking about getting back to a life of rigorous studying. Even more so, adding on the daunting task of studying for Boards and some miscellaneous other tasks that I need to finish before March. Well, that's it for now. Oh, except for the obligatory New Year's Resolution(s). So here they are in no particular order:

1.) I need to exercise more and eat less crap.
2.) I want to try and call at least one person I've lost touch with every weekend.
3.) I guess I really ought to study more. (If there is one that will be broken, this is it.)

christmas update

2005-12-24T21:47:00.000-06:00

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

2005-12-23T21:20:00.000-06:00

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

California, here we come...

2005-12-20T21:09:00.000-06:00

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

2005-12-12T14:26:00.000-06:00

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

2005-12-10T23:52:00.000-06:00

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

2005-12-08T17:11:00.000-06:00

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

2005-12-05T00:36:00.000-06:00

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

2005-12-01T22:30:00.000-06:00

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."

all for one

2005-11-30T23:27:00.000-06:00

So, I'm back in Kirksville and the madness that is medical school has begun again. Thanksgiving was a great time and I got to meet up with the gang again. It was somewhat surreal to be back on the Georgetown campus again, but it was great recounting old memories with the people that I shared one the best years of my life.

the three musketeers...

We spent Thanksgiving at Mary's and at a delicious Thanksgiving dinner cooked by Mary and some of her classmates. It was really interesting to talk shop with students from other medical schools, not to mention students from allopathic medical schools. Although I know that I didn't need to prove anything, I was nice to be able to represent the osteopathic profession intelligently and have productive conversations with other medical students.

So, here I am back in Kirksville again. We started our sixth quarter which promises to be interesting and much less stressful than our last quarter. We start our clinical courses and board exam preparations this quarter. In other school related news, I am starting to think about applying for a fellowship position in medical education. I'm a bit torn because I would really like to get on with my life and be done with school, but I think it would be a great opportunity to learn the dirty details about how medical school is run and work with our professors in clinical education. More on that as it develops...

To Do:

2005-11-17T00:17:00.000-06:00

In a recent exchange of e-mails, a couple of my friends had put together a "to do before you die" list. I thought this was a great idea until I realized that my list was basically things I needed to do in the next couple of weeks:

1. Finish OTM final/Pass OTM
2. Finish Neuroscience II final/Pass Neuroscience II
3. Get haircut
4. See Harry Potter IV
5. Read Chronicles of Narnia (again)
6. Georgetown Reunion in DC
7. See Rent
8. Plan ACOEP skills lab
9. Finish Honor Code
10. Watch Chronicles of Narnia

So, those are the plans for the next few weeks.

At Long Last...

2005-11-13T13:49:00.000-06:00

That's right. Walleye Slayers of America.

pictures by dominic gargiulo... because my hands were full...

For a full explanation, go to previous blog entries...

Two Points for Honesty

2005-11-11T08:51:00.000-06:00

#1. Bring on the finals
#2. I have a myspace.com account. That is how far I have fallen.

Jealous of the Moon

2005-11-09T21:10:00.000-06:00

"You've given up the good fight
You're as strong as anyone
You're back where you started from
I see you're back where you started from..."

I guess it is time for my periodic "I'm still alive" post. Its been just under a month and not too much has changed. I remember coming back to school fearing the dreaded Fifth Quarter, where clinical faculty begin their quest to break medical students. Even so, things have been going so well that I almost worry that I'll wake up someday and the burnout will suddenly hit me. Worry not, parents, it doesn't seem like that will happen soon. Maybe its the fact that I've finally figured out how to study or perhaps its the prospect of starting clinical rotations in a brief eight months. Whatever the reason, life as a second-year medical student has been far more enjoyable thus far than I had imagined. Its not to say that the ominous approach of board exams isn't on my mind, I just choose to delay obsessing over it until after the holidays.

On that note, I've been lucky to get down to Columbia in the past two weeks to see a couple of my favorite bands. The first, of course, was Guster. We ran down to The Blue Note in the middle of one of our hellish weeks and I can honestly say, that was probably one of the best ideas I've ever had. It gave a bit of a break to the crazy amounts of studying we were doing for the past ten days and truly re-energized our minds. The venue is great. It is big enough to get a good-sized crowd and small enough that there really aren't any bad spots. The acoustics are great from any spot and since it is open and standing only, there really isn't a bad view. Just yesterday, I ran back down to see Nickel Creek perform one of the best shows I have ever seen. Again, music has been one of the major ways I have been staying sane amidst the books and diseases. Last night was no exception as I stood immersed in every note and word.

Nickel Creek at The Blue Note

So that was fairly fragmented approaching verbal diarrhea, but I guess that's what medical school does to you...

this is my life

2005-10-15T00:34:00.000-05:00

After much distress, it seems as though I have survived another week of studying and testing. In fact, I did quite well on today's Pharmacology exam... I'm kind of waiting for what I feel to be dumb luck to wear off. I guess I am studying more than I did last year, but only because I realize that the time I have off is more precious and comes quite infrequently.

So, following the advice I give most of the new students as well as the candidates interviewing here, I took most of today off from the bondage of books and note packets to relax and hopefully recharge the medical school fuel cells. I actually am hosting a candidate tonight and I figured it would be good to get him around town and check out the laid back side of medical school. I felt it was interesting that Janet Bunch's words to us as we were leaving the Admissions office were, "Luke, keep him out of trouble."

Well, he did that and I tried to get him into most of the places I'm at when I'm not studying. We were fortunate to have the opportunity to go fishing right before dusk at Craig's place in Atlanta. The weather was great and the fish were obviously hoping to get their last meals in before the deep freeze. Pretty much everyone pulled something out of the water, but Jeremiah and I both were astounded at our ridiculously large walleye we managed to pull in. Believe you me, pictures will be forthcoming.

the fantastic sunset at craigs...

After fishing, we had dinner at Patterson's and headed out to Theta Xi and Dukum - pretty much the places that have been keeping me somewhat sane throughout the madness that is medical school. All in all, it has been a great day and hopefully, I will be refreshed enough to start tackling the next major fire, Neuroscience.

medical school pearl of the day

2005-10-11T23:51:00.000-05:00

"...they have teeth and they're more dangerous when they have teeth."

-dr. neal chamberlain, infectious diseases

regarding the appropriate time to discontinue breast feeding

medical school pearl of the day

2005-10-10T21:41:00.000-05:00

"by telling a star runningback that he can't play football that year would be a wise thing to do and then of course, leave it up to his parents to destroy... I mean, to make his life better or worse."

-dr. neal chamberlain, infectious diseases

spinning into control

2005-10-10T00:37:00.000-05:00

after a whirlwind of activities these last two weeks, it was about time we got a long weekend. it was well-deserved and much-needed. between working on student government, having meetings with alumni, setting up a big lab for ER club, and the regular medical school rigarmarole, my head was spinning about a million miles an hour. its something I haven't felt in several years - pretty much since undergrad when I was working multiple jobs and sleeping about twenty hours a week. I guess old habits die hard.
the only difference is this time, I've managed to stay focused and stay on task. despite all the crazy things that have been going on, I still managed to stay above the curve on my exams and coursework. it honestly feels like things have just been falling into place. granted, I could be spending more time exercising, but it honestly felt like I was stressing out enough to burn off all the crappy junk food I've been eating since I didn't have much time to cook.
even so, it looks like I've got a short break here before it all picks up again. our next exam is friday, but that starts a huge string of exams and preceeds the big AOA conference in Orlando. so, things look bright and sunny now, but we'll see how things work out as the end of the proclaimed "hardest quarter" comes to an end.

these are the best days...

2005-10-04T22:14:00.000-05:00

today, Dr. Uray gave our Neuroscience Group a verbal gold star... it doesn't sound like much, but my life has stooped so low...

the fall line-up

2005-09-26T17:24:00.000-05:00

so, after weeks of not posting anything, it is time for me to check in with you all to reassure you that I am in fact alive. school has become an all-consuming black hole for fun and entertainment and I can honestly see why people warned us last year that we would be praying for death during fifth quarter. fortunately, I managed to do well on the first neuro test of the quarter and I hope that it bodes well for the remaining weeks of this hellish nightmare.

anyway, just about the only thing I can do to stay sane is salivate over the new fall tv line-up and wait until the weekend where I study and reward myself with over six hours of prime-time television that I taped during the week. however, there are certain days that have shows that I just cannot resist and here they are:

Sunday:
Family Guy: self-explanatory
Grey's Anatomy: its like er, but smuttier and more sexual relations that would never happen in real life

Monday:
Arrested Development: probably one of the best things since kids in the hall.

Tuesday:
Supernatural: because I can't seem to get enough of WB's sci-fi crap

Wednesday:
Lost: I didn't catch any of the first season, so I'll try to figure out what's going on... which may ultimately end with me either studying while its on or falling asleep.

Thursday:
The O.C.: its like taco bell, I just can't seem to get enough...
CSI: the original, of course.
ER: I'm becoming increasing disenchanted with this show now that nearly all the original cast is gone. we'll see what happens.
clearly, nothing gets done on thursdays.

Friday:
pretty much open now that sci-fi's line-up is in reruns until January...

it would seem fitting that my first post in weeks would be about tv.

no, it's not easy tonight

2005-09-14T12:33:00.000-05:00

So, I survived Quarter 4 which means really very little except for the fact that I am actually in my second year of medical school. It is kind of shocking when I think about it. One year ago, I moved to Kirksville and at the end of this year, I'll most likely be moving out. This quarter has been deceptively laid back thus far, but I'm starting to get a little leary of the upcoming weeks of exams. That and trying to coordinate all the other stuff that's going on has become a bit more of a task than I had expected it to be. For now, I'll attribute that to having to get most of the start up stuff, well, started up. I suppose it will all settle down once things get rolling. That's it for now I guess. More news as it develops.

So, I'm Back

2005-08-11T22:00:00.000-05:00

That's right, after four weeks of being back, I finally feel like I'm caught up! I apologize for not getting up my other musings about the last week of the trip to Cape Town, but things picked up towards the end of the trip and journaling every night became increasingly impossible.
Just to fill in the blanks, after we left Atlantis the group headed out to a hostel in Camps Bay for two days. This was pretty much the transition period before the first wave of people had to head out for various reasons. It was kind of an up and down time but all in all, we got to do all the fun, touristy things we wanted. Table Mountain was awesome and Greenmarket Square was crazy. The houses around Camps Bay were ridiculous and the beaches were beautiful.
After we settled things at the hostel, the people left went to a retreat/camp sponsored by Africa Jam. It was amazing. We met up with Jena's friends, Ellen and Quinton (and the adorable Maya), who are basically the founders of the Africa Jam program and fantastic people. The camp was beyond description and we were even reunited with some of our friends from Atlantis. We were there for three days and enjoyed every minute of it... including bringing the deadly game of "Red Rover" to our friends in South Africa.
From camp, Rose, Santosh and myself went back to Atlantis to stay in the townships. It was a great experience, despite the fact that I was pretty much feeling the full effects of my cold. Rose and Santosh went out and I stayed in, attempting to fight off the illness. On Friday (which is Safrica Day 18, if you are keeping count), we stayed in Matilda's house. Her husband prepared the most delicious stew I have ever tasted. The poiki was cooked over an open fire for several hours and it was worth every minute. It had meats, veges and tubers all cooked soft and tender. Rose and Santosh went out with the group while I played it safe and stayed in again. I was starting to feel better and didn't really want to chance a night out at the bar.
I woke up on Saturday feeling better than I had for days. We had a fantastic breakfast and packed up all our things. After saying goodbye to Matilda and her family, we headed to the airport to pick up Buddy, who had left for Durban. We then headed to Table View, where we were graciously housed by one of Carlo's friends (who shall remain nameless at this time because I don't know how to spell her name... but it sounds like El-Nisha). The flat was unbelievable and a short walk to the beach. Our stay in Table View was the perfect way to end the trip. We had some good times out with Vuyo in Gugulethu and Dr. Petersen visited for a final dinner.
So that was the last of South Africa. After we got back to the states, I had a couple days to recuperate before going to the week-long cranial osteopathy course. It was a great time to get back into the routine of school and refine my skills in an area that I didn't get much practice in during the regular school year. Since then, "real school" has started and two weeks have already passed! Its amazing to think about how fast time has flown already. Next week, the new class of students will be here for orientation and starting classes. I remember almost one year ago, I was thinking I would never survive the first year of school.
This time, the ever-daunting thought of Boards is occupying a lot of my thoughts. That and all the extra things I've gotten myself into: SGA, the ER and Sports Medicine groups, etc. I'll try and keep my head screwed on. So that's what's on my mind now - more news as it becomes available.

Safrica Day 11

2005-06-30T23:30:00.000-05:00

Late again. Now there is a surprise. You would think that we would be on-time for one of our last days working for ADP. We wound up staying up pretty late by the fireplace doing nothing. The three-minute showers followed by breakfast on-the-run have pretty much become a routine around here.

Regardless of our late start, we managed to make good time on the trip over to the office and out to our respective sites. It looked as though Dominic and Santosh would have another day full of kids as they were already lined up in greater numbers when they arrived. Jenny and I looked like we would have to make up yesterday’s relatively slow day as well. We started whittling down our line of children and fortunately were able to work through those kids before 10:30am. However, they started transporting kids over from the other sites to us to redistribute the work. They were moving about twenty-five kids at a time – all crammed in the same van we took on a daily basis. It was quite the site. We were able to work through about three transports full of children before lunch. We had planned on taking a lunch break, before receiving another load of children, but decided it would be much more prudent to have lunch in the taxi as they moved us to other sites. So, we piled they last sixteen kids we assessed, a couple of the ADP workers, Jenny and myself into the van and carted us off. Jenny went to help Dominic and Santosh in Saxon Sea and they took me to Masakhane to help Jena, Rose and Elana with the massloads of toddlers they had there.

We got to Masakhane and it truly was chaos. I thought I was going to eat when I got there, but it rapidly became obvious that there was just no time for lunch. There was a preschool full of kids that needed to be assessed. Kids were screaming and playing in the back while others were lined up to be examined. Luckily, most of these kids were fine, but there were also the complicated cases that were further drawn out by the fact that these kids were so young and needed a more comprehensive exam. That and being one of our last days of exams, we were nearly out of most of our disposable equipment. Otoscopes were dying, speculum tips were becoming a valued commodity and we had managed to break nearly every mercury thermometer we had. Despite these issues, more and more help arrived and we managed to clear out the daycare in a timely fashion.

Having completed all of our business for today, we again headed back to the ADP office where they gave us the update of which sites had been finished and which still had children that needed to be evaluated. The sties that hadn’t been completed would be finished tomorrow during our short day of work. They also informed us that there was some sort of debacle at the radio interview this afternoon. When we first arrived, they told us that the local radio station had requested an interview with some of our group. So, Dominic said he had some broadcasting experience and would like to go. Aaron also expressed interest so he also went. Since there was already some tension building in the power-struggle arena, I thought it would be prudent to have Jena go as the third person. So, I don’t know what happened, but I’m sure we will find out at some point in time.

The staff then also informed us that they had arranged for us to have transportation to Canal Walk, a nice mall area, for dinner. We had thought that this meant that they would be joining us but we found out that this was not the case. This met with mixed reviews as we had wished to spend more time with the workers. However, it became apparent that while the idea was a good one, we would not be able to arrange transport for the volunteers from Atlantis to Canal Walk. However, we were able to treat our driver, Isaac, whom we have terrorized and undoubtedly annoyed with our chronic tardiness. The restaurant, Ocean Basket, was delicious and by the end of dinner, we were all stuffed and somewhat lethargic from all the food.

Upon our return to the hostel, we found ourselves in our familiar places in front of the fireplace in hopes of soothing our bloated bellies by the fire. There, we noticed Claudia cutting cardboard boxes into poster-sized sections. She said that her mother asked her to fashion signs that would aid in directing participants to the UFO convention tomorrow. We were initially puzzled and wondered if she actually meant something else when she said, “UFO.” In this case, she didn’t. Betsy was helping run a UFO convention. All weirdness aside, she recruited us to help with signage and we gladly obliged. It was a fun detour from our usual routine and by the end of the night, we had helped create ten original masterpieces.

Safrica Day 10

2005-06-29T23:30:00.000-05:00

In what has become a near routine for our group, we all got off to a late start today. The majority of us rolled out of bed around a quarter to nine and the van arrived to take us to Atlantis at 9am. We barely had enough time to cram down our breakfast before we all piled into the van. It was especially a task because we needed to pack away Karysse’s luggage since she was heading off this evening.

When we got to the ADP office, we discovered that we would be heading out into new areas. Jenny and I were going to be working in Kerria, a school classroom that was being used as a medical assessment point while the school children were on winter holiday. We saw maybe about twenty kids before lunch and the rush pretty much dropped off after that. Not only did we have time for an excellent lunch, but also had the opportunity to walk around the area. We stumbled into a public gym and got to watch a small assembly program for the kids. They had a talent show and both Jenny and I were amazed to hear these kids sing.

After our lunch break, we went back to the classroom and decided to wait an hour to see if any more kids were going to show up. As fate would have it, none showed up so Jenny and I went to Protea Park to help Dominic and Santosh with the rest of their kids. I was of very little help because the first boy I saw wound up taking more time than most of the other kids. Lucky for me, and very much unfortunately for him, his testicle had not descended and he needed several more operations to fix that. I say lucky for me because this problem was the last topic of discussion during our case presentations with Dr. Peterson. By the time I was done with that case, Dominic, Santosh and Jenny had pretty much clean up every other case and we were ready to head back to the ADP office.

So, we packed up our things began driving. While I thought we were headed back to the office, we actually wound up at a youth center where members of the Africa Jam group were hosting an event for local children. Several members from our group had been there for quite some time already and everyone was utilizing this opportunity to relax. I figured this would be a great opportunity to catch up on the mountain of paperwork that I still needed to finish from earlier this morning. So, I sat in the corner and kept on writing away. I paused once and a while to look around my surroundings, I noticed that the kids here were much more forward with their interest in our presence. I say that because I noticed flashes strobing through the kids as they pleaded for their pictures to be taken. Kids surrounded each of us as they danced to the thumping music. Even several were running up to me as I sat in the corner. As the numbers of children steadily increased, I consigned myself to the fact that I would not be able to make as much headway on the paperwork as I thought and joined the others in one of our few moments to relax.

We made it back around 5pm and we fairly exhausted by that time. We had planned for a brief dinner at the school which was to be followed by a short presentation by Dr. Petersen on HIV/AIDS in the Atlantis community and South Africa. Since the dinner was planned to start at 6pm, we were given the opportunity to run to the school’s computer lab and try to get onto the internet. Most of us needed to check the status of our loan consolidation paperwork and others needed to send out e-mails to let everyone know we had arrived in South Africa and were still alive and well. This met with mixed success since all the lab computers we subject to firewalls and did not allow us to use any e-mail sites, including our school accounts. Eventually, we all relocated up to the ADP office and commandeered one of the office computers. All thirteen of us took our turn using that computer and managed to finish off most of our urgent business.

As the last few people returned from the computer, dinner was dished out and we all returned to the familiar setting of the conference room for Dr. Petersen’s AIDS talk. Although we all admitted to the possibility of forgetting many details from Biochemistry, it was comforting to be able to recall all of it based on his powerpoint presentation. As he surveyed the group for answers, we were able to intelligently discuss disease process and treatment options. He concluded his presentation with a very Elephant Man-esque patient parade. He brought up patients of different ages and discussed how they presented to him, how he treated them and their current progress through therapy. Most of us were discouraged that we really didn’t have much time to interact with the patients or have any sort of personal dialogue with them. The talk was otherwise really beneficial for us to dispel some of our misconceptions of how AIDS was being treated and viewed in South Africa. It was also good to see the current statistics for the epidemiology of the virus and how those numbers were changing. The entire talk was concluded with a short goodbye for Karysse as this was her last night with the group. Dr. Petersen presented her with a small gift we can only assume to be a CD of some sort. With that, we all piled back into the van and headed back to the hostel. When we arrived, we all had our opportunity to wish Karysse a safe journey back to the states before she was taken to the airport.

After being completely exhausted by the Africa Jam celebration and the AIDS talk, we all returned to our familiar positions by the fireplace. We pretty much all had been wiped out by the drive to and from Addo coupled by our long day. Rose, Santosh, Dominic and Elana, however, headed out with Ranier and Claudia to the Cape Town bars. They promised to be back early since tomorrow was another work day, but I’m still dealing with this cold I caught the last time I went out and I know tomorrow is going to be far busier than today was. Who knows when they are going to get back and how they will wake up in the morning, but I’m perfectly happy with my spot next to the roaring fire.

Safrica Day 9

2005-06-28T22:36:00.000-05:00

Because of the semi-debacle surrounding our trip up to Addo, we decided to make an effort to leave the park early in hopes of arrive back in Melkbosstrand at a decent hour. We were able to organize ourselves and be on the road by 9am. Since we had already visited a winery on the way to Addo, the only remaining tour stop we had was to do some whale watching before sunset.

The trip back was fairly uneventful. We had some visual exchanges between the vans, but I think I will blame that on the monotony of the road. As time passed and we noticed the sun drifting closer to the horizon, it appeared that we had grossly underestimated the time it would take us to reach our destination… again. When it became apparent that we had missed our opportunity, we blazed forward toward Cape Town. The new plan was to have dinner at The Africa Café.

The dinner promised to be a unique experience with courses from all over the continent. We started with a soup and some small finger foods. After that, we enjoyed a couple of main courses including a chicken and ostrich dish. At this point, there were also a group of workers that were parading through the eating area singing and dancing to the beats of dueling djimbe drums. The dinner was concluded with a delicious dessert and hot tea. After we settled the bill, which was about $20 per person, I looked through the gift shop. I was pleased to find a cookbook with all of the recipes and quickly purchased a copy.

From there, we traveled back to the familiar confines of the Melkbos Backpackers Hostel and Betsy’s welcoming promise of hot tea and a warm fire. We didn’t have much time to enjoy either as it was nearly 10pm when we had gotten back and we had to get back to work tomorrow morning.

Safrica Day 8

2005-06-27T23:30:00.000-05:00

After an eventful day and restful evening, we were afforded a late start. So, most of us crawled out of bed around 11am and got to work on a fajita brunch. We had two cabins working on cooking up the chicken and vegetables and within the hour, several plates of filling and hot tortillas were ready. We quickly consumed our fill and made plans for the rest of the day.

While some people decided to take a guided horseback ride through the park, the rest of us decided to drive through the park a second time. This was mainly in hopes of spotting a lion or two, but I wasn’t going to get my hopes up. As we drove through the park, new veterans from our experiences yesterday, we spotted more of the same wildlife we had seen previously. We drove through some different terrain and scoured the grounds for signs of slumbering predators. We searched until we were forced to head out of the park before the gate closed. Despite the apparent absence of lions, we witnessed another spectacular sunset on the open plains of the park.

Having found such great comfort around the fireplace in Melkbosstrand, we decided to continue the tradition here in Addo. We made a fire in the grill area outside our cabin and huddled around the flame, attempting to stay warm despite the frigid cold of the outdoors. Having spent nearly a week in South Africa, we were able to think about how our lives have been changes in our short time here We were also able to set our goals we hoped to accomplish in the week to come.

Much more importantly, we were able to sit and talk with Carlo about his experiences in South Africa. Not only growing up during Apartheid, but also how his job affects others in the present. Carlo is intimately involved in the process of making reparations to those displaced by the forced movement of Colored and Blacks from their homes. It was a sad story to hear, but it also helped us gain an understanding about the community that we are serving through this project. Although it appears the government is taking an active role in acknowledging and healing the mistakes of the past, it is hard to imagine that the injury could ever be completely forgotten.

Safrica Day 7

2005-06-26T23:43:00.000-05:00

Waking up at 9am was such a challenge this morning. Despite it being two hours later than we were used to for the last few days, the work we have done left me pretty much exhausted. Even so, Buddy and I woke up and stepped out onto the balcony and took in the vast expanse of our new backyard. It was pretty surreal to stand on our balcony and watch the packs of warthogs run through the brush.

Breakfast was pretty much a flashback to the cafeteria. We were cooking a dozen eggs at a time on the stove and everyone else was making peanut butter and jelly sandwiches on the table for the afternoon. It was scrambled eggs on toast for everyone, mainly because we didn’t have the foresight to realize our two plates were not going to be enough for fourteen people.

After breakfast, we headed to the main area to book our evening tour of the reserve. The evening tour sounded the sweetest because not only were we told we would see both day and night animals, but they also would feed us cheese and alcohol. So, you can pretty much see why we chose that tour. We had a couple of hours to waste before the guided tour started and decided that going though the park on our own would be fun. We set out in our van and drove through the park. It was pretty much a run-of-the-mill park tour. We drove around and saw some wildlife. I was astounded that most of the animals were wandering so close to the van except that we had driven for nearly two hours and had not seen an elephant. That is, until we started towards the gate and three elephants poked out from behind the bushes near the exit. It was truly awe-inspiring to see these elephants just a mere yard from the van window. Unfortunately, we were rushed to meet the tour bus so we had to take in as much as we could before speeding out toward the meeting point.

As we pulled up to the meeting point for the sunset tour, it was clear that the guide was less than pleased with our tardiness. That and there were two other people booked to this safari and they seemed to be in a rush to get into the park. After a great deal of complaining on their part, we left for the safari, nearly leaving Karysse behind. As we entered the gate, the same three elephants were still slowly enjoying their evening roadside meal. We pulled up next to them and were had ample time to take photographs and think about how surreal it was to be mere feet from one of nature’s largest creations.

The tour continued with more of the same safari-type events. We saw more wildlife and the guide imparted his sage wisdom as we passed each one. In addition to the wildlife, we were treated to a spectacular sunset. As the sun drifted beneath the chance clouds, the sky turned a brilliant orange and cast a rusty hue on the brush and wildlife. Just as sun passed the horizon, we drove into the midst of a herd of elephants. This was one of the most awesome experiences of the trip thus far. We were literally inches away from over twenty elephants. It was like the Discovery Channel in three dimensions. Two young elephants were playing behind the jeep. A small family was pulling leaves off of the trees to our left. In front of us, five elephants were releasing an unbelievable volume of urine. It was surreal to say the least.

After the herd dissipated, we drove onto the next watering hole. There we were able to step off the jeep and enjoy the snacks and wine. As we were chomping on some biltong and chips, we were amazed to see that the herd of elephants had actually followed us to the watering hole and were going to take a sunset bath. As this was happening, it began to get dark and a cold wind quickly gathered strength. Before long, it was time to get back onto the jeep and head back to the gate. It was only a short drive, but the biting chill wind made it seem like forever.

By the time we had exited the game area, most of us were frozen to the bone and ready for dinner. We all headed to the restaurant and sat down for what promised to be an excellent meal. In the spirit of adventure and trying the local culture, I had a Kudu steak which was absolutely delicious. I only had about half of it, but that was more than enough to fill my entire stomach. We all enjoyed our dinner and capped it off with coffee and copious amounts of Malva Pudding. After we paid our bill, we headed back to our cabin to relax and reflect on the days events.

Safrica Day 6

2005-06-26T02:00:00.000-05:00

It was a miracle. We had set out to depart for the Addo National Elephant Park at 9am and we were packed and outside the hostel at 9:10am. We were nearly on time. Unfortunately, our van was not. In fact, not only was our van late, but when it did arrive, we soon discovered that it was about two seats too small and reluctant to start. So, we phoned the rental service and requested that they drive a van that was breakdown-free and to change the reservation to include a trailer, or “boot” for our luggage. The only bright side of this story is that the rental company offered to give us two smaller vans for the same price. Of course, that would delay us another hour. It was nearly 12:00pm when we finally headed out to Addo.

The trip was not without its own obstacles. For me personally, I had woken up with a vicious sore throat. It was as if my tonsils had swollen to the size of a grape and swallowing became quite the task. We were already running three hours behind schedule and the drive was slated to last about eight hours without the small stops we had planned. The first stop was at a winery to do some wine tasting and to possibly pick up a bottle or two of local wines. We eventually settled on a winery and headed toward the tasting cellars. The wines were great and the tasting price was reasonable. In fact, it only strengthened my belief in the previous statement, “alcohol is ridiculously cheap in South Africa.” I wound up buying a couple of bottles of quality red wine and will probably have one or two to bring back.

After the wine tasting, it was back on the road. Don’t panic. We were civilized wine tasters and spit out most of the wine we tasted. As we traveled onward, we noticed that the drive along the coast from the West Cape to the East Cape was bound to take longer than eight hours. I can only make it from Illinois to Pennsylvania in eight hours. It wasn’t long before we encountered sunset which was rapidly followed by darkness. Nightfall had crept in and we weren’t even halfway there yet.

We wound up driving for another six hours and reached Addo National Elephant Park around 1:00am. Just as we were sure that pillows and beds were within our reach, we noticed that the gate was down and nobody was staffing the entrance to the park. We were assured that we would be able to access the grounds at any hour, but we weren’t sure that midnight was ever in the minds of the preserve staff. We backed out toward the entrance and headed out of the park. We were brainstorming with ideas about how to handle this situation. We decided to return to the entrance and hope that the ranger was just napping in the office. Sure enough, as the high beams penetrated the office window, a head emerged from the darkness and the door opened. We received our keys and were on our way to dreamland.

We split into pairs and ran towards our respective cabins. I had no idea how nice the accommodations would be. We were paying R200 each night which roughly converts to $30. This was for a beautiful cabin which abuts the fence to the preserve. We had warthogs feeding literally feet from our patio. We were very fortunate to have come across such great housing. With that, we all are tucking ourselves into the beds as jackals and hyenas wail at the moon. Sweet.

Safrica Day 5

2005-06-24T23:40:00.000-05:00

Learning from my mistake yesterday, I woke up early today. It’s kind of silly to think that waking up early here entails rolling out of bed 7:00am. I blame it on the time zone difference and the jet lag.

We eventually rolled out of bed and were able to make it out to our 8:30am meeting in Atlantis on time. From there, we split up to our respective clinic areas. It was really interesting to hear about Wit Sand, the new site that we staffed today. This was the first township that contained only Black families. Buddy and Vita were the first to experience the madness that was the culture for the area. Jenny and I went back to Chatsworth and were surprised to find that the clinic was open and the Sisters were staffing for the day. So, we went in and began talking with the Sisters and figuring out exactly what goes on in the clinic. In South Africa, they refer to the nurses as “Sisters.” When in training, they are called “nurses” and as the progress in their vocation, they are called “Matrons.” In actuality, the Sisters are more the equivalent of the US nurse practitioners. They staff the clinics and are able to dispense antibiotics and other medications. Seeing as though we could not dispense any medications following our exams, we decided to leave the Sisters to what they do and head out to join Buddy and Vita around 10am.

So, as we left Chatsworth, we heard more about the Wit Sand area. It is apparently the “impoverished” area where we were likely to see the crazy zebra-type illnesses. Even with that warning, we weren’t quite ready to see the masses of children with the illnesses they harbored. For example, I was assessing a patient with abdominal pain early this afternoon. As I was obtaining the basic history and asked her what she ate last. I was certainly surprised to hear the translator report that she couldn’t remember what she ate. Further interview revealed that the patient hadn’t eaten in over a month. I guess I should have seen that coming. I mean it is an underserved, underprivileged area. It was still an eye-opening revelation. Even with ten of us there, we were not able to forage through the seemingly growing line of children. We eventually were forced to resign to our transport at 2:00pm and head back to Atlantis.

Back in Atlantis, we were scheduled to have a lunch session with Dr. Petersen and his colleague Dr. Reinquist. Dr. Reinquist wanted to give us a talk about their private practice and how they managed treatment for the surgeries and medical cases. Following this lunch meeting, we were taken on a brief tour of the public hospital nearby Dr. Petersen’s clinic. It was interesting to hear about how the public hospital functioned in the socialized healthcare setting. I admit that I had idealistic conceptions on how healthcare was delivered in this setting. I was saddened to hear the stories of local patients being queued and being told to wait several weeks for desperately needed acute care. Although healthcare was being subsidized by the government, it was clear that the people in this area still were not able to access comprehensive care.

Following the hospital tour, we continued to the HIV/AIDS clinic that was associated with Atlantis ADP. In addition, many of the patients that were part of this clinic were patients of Dr. Petersen. It was heartbreaking to hear the individual stories of the patients that were not only receiving care, but also volunteering their time as a major part of the support structure for new patients. We saw patients of all ages: adults, children, infants born to HIV-positive parents. It was a sight that I still feel I was unprepared to see. In the face of all this, the patients were still warm and receiving. While talking with each patient, never once did I get the feeling of hopelessness or despair. This clinic was truly a testament to how Atlantis ADP has positively impacted the community.

Back at the Fairview school, we had a quick debriefing session with Dr. Petersen. He had reviewed our patient evaluation forms from yesterday and selected a few cases to review. It was eerily similar to attending Morbidity and Mortality seminars at work. We went through several cases which were more informative than any series of PBL’s than I have had at KCOM. It truly makes me wish that we had organized this trip better and had details laid out for administration before we left.

Anyway, the lecture went well and we soon left for the hostel where we would be hosting various affiliates for a barbeque dinner. Being the fun-loving bunch that we are, we decided that we needed to go out to the local store and fetch some spirits for the evening. If there is another thing to add to the list of reasons to go to South Africa, it would be that the alcohol is ridiculously cheap. So, that being said, we bought some bottles of beer and walked back to the hostel. There, we were greeted by Dr. Petersen and Wally, the Headmaster of the Fairview School where WorldVision has its office of operation. Several WorldVision staff were also in attendance. It was a great experience and a great way for us to talk with our mentors outside of the professional atmosphere.

After the party had subsided, we realized it was our first weekend and free night in Cape Town, South Africa. So, the opportunity to head out and see the night life was an offer I couldn’t pass up. That was my first mistake. The next mistake was crawling into a taxi with four other people. As if that wasn’t dangerous enough, we sat there like a can of sardines shooting down the Cape Town highways at about 150kpm. It was like a bad movie. However, it was a cheap night at the bar and there was some pretty great dancing out at the clubs. It was a great cap to the week until the group split for the return trip to the hostel. One group took a different taxi back and we went with Claudia, Betsy’s daughter. Much to our surprise, we were stranded because the gear shifter was locked and we were stuck in reverse on the incline of a hill. It took us nearly an hour to locate and obtain a key and get on the road. Much to my amusement, the taxi that had left before us had become hopelessly lost driving back to Melkbosstrand and we had to locate them to caravan back to the hostel. Before we knew it, 5:30am had rolled around and I desperately needed to head to bed.

Safrica Day 4

2005-06-23T22:15:00.000-05:00

I remember priding myself on my ability to roll out of bed and get ready within five minutes. Amazingly, we managed to shove breakfast into our mouths and run out the door to catch our ride back to Atlantis. There, we received a quick briefing and schedule for today.

After that, we were shipped off to our respective areas. Jenny and I were dropped off at the Chatsworth clinic and we were ready to tackle the next day of seeing patients. We blazed through the morning and managed to assess twenty-eight patients before our afternoon break. I saw a couple of amazing cases and was blown away by some of the ailments that I thought I would never see in real life. Shortly after I saw my last patient, we were told that one of the other sites was becoming overwhelmed and needed an extra person. As such, Jenny left to help and I was supposed to talk with Dr. Petersen about this morning’s cases.

When all was said and done, it was 2:00pm and Dr. Petersen arrived to review our cases from yesterday and council us on treatment courses. The concept was basically that anyone who wasn’t deathly ill was going to wait until next week to be reevaluated. With that, he rushed passed patients and drove off. It was surprising to me that we had a near riot when I told everyone that they would not be seeing Dr. Petersen and would instead be referred to the local clinics and hospitals if their condition warranted further care. Until that point, everyone appeared so content with their care – it was semi-heartbreaking. It was good to see that once we explained to everyone the situation that they appeared to be fine with our decision. After I ran through the eighteen patients we had told to come back today, I was ready to call it a day.

We ran and picked up the rest of the crew who appeared equally tattered and worn-down. We were ready for a hearty dinner. Lucky for us, we had been invited to have dinner at the house of a local Atlantis resident. The story goes that this family had a large part in the religious aspect of the WorldVision program we had recently joined. Dinner was fantastic and I sat in amazement that one woman could cook up dinner for eighteen on a single stove. Not like a four-flame stove, but a single electric hot-plate. We concluded with a gigantic plate of Malva Pudding, a local specialty which was reminiscent of warm chocolate cake drenched in a thick egg custard. It was truly a blessing to have been given the opportunity to see that side of Atlantis and eat with such fantastic people.

Safrica Day 3

2005-06-22T22:45:00.000-05:00

We woke up early this morning to the smell of fried eggs and warm bread in the toaster. This hostel is simply amazing. It blows my mind that we are staying here for only sixty Rand, or US $10 each night. The beds bunked, but comfortable and the rooms are just warm enough. As everyone rolled out of bed this morning, it was surprising to find us all eager to get to work despite the obvious jet lag that had followed us from the US. We sat down and savored every bite of breakfast before our ride to Atlantis arrived.

We piled into the van and retraced our route to Atlantis. After about ten minutes, we arrived in the Atlantis area and pulled into the school that serves as one of the offices for Atlantis ADP and WorldVision. We were introduced to the staff and were ushered into a conference room where we received the final bits of information before heading out to the rural clinics and schools. We met with Dr. Petersen, the medical director for the Atlantis ADP program and he carefully detailed his expectations for this mission. It was thrilling to hear that he expected us to see patients in each township and provide assessments to people who desperately needed medical care. We would then return our evaluations to him and devise a treatment strategy that would be comprehensive, effective and be easily accessible to the citizens in each area. This seemed nearly identical to my preceptorship and I was eager to get to work.

Despite being freshly energized by the morning talk, it didn’t prepare me for the patients that we began seeing in Chatsworth. Even before we arrived, people were lining up outside the clinic. Within the first hour, we had twenty-one kids signed in to be seen. Jenny and I started seeing patients together and we realized how limited our care was as medical students. We were still being stumped by rashes and swollen lymph nodes. We saw an inordinate amount of ear infections. We saw some really sick children. We started to worry about the possibility that we could miss something. One year of medical school is a lot to rely on when you are charged with formulating a differential diagnosis for children who may be dying from HIV or AIDS. We had no medical records to rely on and a limited patient history that we could decipher from the translators. However, even when we were not able offer a definitive diagnosis, the patients and families seemed so grateful for whatever we could provide.

It was exhausting. We finished around 4pm local time and headed back to Atlantis for a quick debriefing. After planning tomorrow’s follow-ups with Dr. Petersen, we returned back to the hostel. Upon our arrival, we were instantly treated to the aroma of fresh-cooked dinner. I feel the necessity to reiterate, this hostel is amazing. After being thoroughly stuffed, several resigned themselves to bed while others walked to the beach. The beach is a mere five-minute walk and has an amazing concentration of moonlight. Tonight is the full moon and it is hanging above my head, casting light upon our group as we each scribe our thoughts of the day’s events. The beach is empty and it is just the six of us under moonlight with the ocean waves breaking in the background.

Safrica Day 1 & 2

2005-06-21T23:30:00.000-05:00

We left Kirksville this morning at 7:00am for Chicago O’Hare International Airport bound for Cape Town South Africa. The number of stumbling blocks that occurred prior to leaving the state appeared to herald a rocky start to this journey. I set my alarm for 6:00am in hopes of waking up and packing up the last items into my backpack and heading out to meet Rose in the driveway. Conversely, I awoke to Rose knocking on my door and using my computer. Fortunately, I had packed a great deal and still made it out the door on time.

Following that debacle, we headed out of town on Missouri Route 63 North. About five minutes on 63, Rose realizes that her ATM card is likely still flapping in the breeze at the ATM. So we drive back to US Bank and scour the general ATM area for her card. We admitted defeat and headed out of town and thought of the better times ahead of us. As a side note, on our first pit stop for food, we found another US Bank and Rose was able to obtain another card.

So the rest of the drive up to O’Hare was fairly uneventful and we pulled up to the terminal around 3:00pm. We did have to stop one more time to ask for directions to Parkson’s house from an old lady in Moline. Parkson was kind enough to feed us and drive us to O’Hare to spare us the ungodly long term parking charges we would have incurred for our three-week stay.

We reunited with the rest of the SAfrica crew outside the ticket counter at O’Hare and it was official. The SAfrica Trip was on. We checked our bags and got through security without much trouble and made it to the gate. It wasn’t but a few minutes before they began boarding our massive 777 Jet to Amsterdam. The first leg of the journey went quickly. The eight-hour flight seemed like nothing since we had just driven six hours before reaching Chicago. I slept for most of the flight waking up only to eat and use the fabulous aircraft toilets.

After eight hours in the air and a seven-hour time zone difference later, we arrived in Amsterdam at 8:00am, June 21st. The layover was a new experience for me. I had never flown into Amsterdam and the airport was completely different than any I had seen before. There was a museum, several sleeping lounges, and of greatest interest to me, a meditation room. At first I thought this was a loosely translated chapel, but upon investigation, it truly was an area for people of any religion to seek refuge from one of the fastest-paced locales in the world. Intriguing as it was, our stay in Amsterdam was short-lived as we boarded our second plane for Cape Town at 9:30am.

This second aircraft, while smaller, was much newer and obviously more advanced. Each headrest had a screen placed inside to give each passenger their personal entertainment options. I wound up watching The Grudge, National Treasure and a couple foreign films. In addition, I played a couple rounds of chess with other passengers and thoroughly perused the other game selections. I opted to stay awake for most of this flight to make the trip to bed easier when we arrived in Cape Town. Despite the variety of entertainment, this trip was noticeably longer. The entire flight lasted the better part of eleven hours and we arrived in our destination; Cape Town, South Africa at 10:00pm.

After deplaning and exiting through customs, we were greeted by several members of the Atlantis Area Development Program (ADP). These were people that Jena had worked with and were the basis for our planning the mission trip out to Atlantis. On the drive to our hostel, we were given the quick history of the area and the current living conditions. We stopped once for gas (petrol) at the station near the airport and we began talking with one of the attendants at the station. I was nearly shocked to hear the attendant, a pure African ask if some of the ADP staff were “Black or Colored.” It brought up in such a casual manner that it defied all logic set forth by the conservative society that we came from. However, the lines of descent are very clearly drawn in this are where “Blacks” are citizens of pure African descent and “Colored” are citizens with mixed heritage. There is language barrier between most Blacks and Coloreds and the easiest way to decide what dialect is appropriate is simply to ask.

After that experience, we continued our drive to our hostel in Melkbosstrand. Betsy, the lady who runs the hostel, was there waiting for us with hot cups of tea and coffee. I briefly looked around and noticed that we had obviously left the shambled confines of Atlantis and traveled to a seemingly affluent area of Cape Town. Houses appeared manicured and detailed, surrounded by shiny wrought-iron gates. Large placards blazed “Chubbs Security” and “Team Management.” It was fairly intriguing to find such different living conditions within five minutes of each other. We happily unloaded our belongings and retreated to the beds within the warm walls of the hostel.

over and out

2005-06-16T23:04:00.000-05:00

And so goes my last shift at the PCRMC ED. It was an awesome time and a great, laid-back last shift. I'm spending my last night in Rolla, Missouri and suprisingly enough, am thinking about coming back.

Now, just as an aside, I will be out of reliable communication for several weeks while I am in South Africa. My cell phone will be off until July and I may check my e-mail intermittently.

almost over

2005-06-15T22:24:00.000-05:00

I only have one more shift in the Phelps County Regional Medical Center Emergency Department and in truth, I'm a little sad. It has only been two weeks and I have had such a great time working here. Surprisingly, the twelve-hour work days have gone with amazing speed and I have learned so much every day. Everyone has been a great help and I learned a great deal from every member of the staff. It truly has opened my eyes to areas of medicine I had long closed the door upon. My previous experiences had biased me so much and it is such a relief to have new experiences to balance old prejudices. To be specific, the surgeons here have been some of the best physicians and teachers I have met. The ED physicians and staff have given me such great opportunities to practice skills I would have had to learn in my third year. It has been an awesome trip and I will never forget it.

In a less serious note, I also learned a great deal about the paperwork part of medicine. As part of our two-week rotation, we had to complete several patient encounter forms. These forms were completed on the internet and we were to assign a diagnosis code based on the International Classification of Diagnosis (ICD-9) guidelines. So tonight, I was searching for the code designated for "pelvic inflammatory disease." The following screen came up:

Sweet. Handgun. Who knew?

After a bit of research, the 900 group is designated for "Accidents or Injuries." I still think it would have been pretty sweet to diagnose someone as "Handgun."

I love my life

2005-06-10T00:51:00.000-05:00

I remember people always told me to find a job that I love doing. These past few days in Rolla have been showed me that I will love my job. I knew as an undergraduate that I would be in healthcare. I often thought about just living life as a paramedic. I loved that job and still think about it often. However, this first week of "internship" at the hospital has given me an all new perspective on my future.

For the last seven days, I have been in a shirt and tie for half the day, people have been calling me doctor and I am doing things I dreamed about four years ago. Its a weird feeling that I didn't expect to have for another three years. I've been suturing wounds, working 16-hour shifts and scrubbing in on surgeries long after the end of my shift. Even more than that, I can't seem to get away from the hospital. The staff is great and I get to share this experience with my classmates. What a great deal.

I was in the ER this evening and there was a massive pile-up on the local highway. A mass-casualty (multiple EMS) incident was declared and our ER received a slew of patients. I remember running drills at the hospital back home, but luckily never had to actually put it into action. It was amazing. Doctors everywhere. Nurses everywhere. Radiology and respiratory techs everywhere. Patients in every room. Staff from every department was there taking care of patients. I love my job.

Afterwards, I just didn't know what to do. We were three medical students who had just seen a whirlwind of healthcare providers receive, comfort and care for so many patients. I was so drained but I just couldn't leave. We sat in the hospital like it was our home. We talked about what we had seen and done. Then, Keya delivered another baby. This job rocks.

today is the first day...

2005-06-03T19:27:00.000-05:00

Ever heard that before? Well, sure enough - its true. I had my first day of my two-week rotation today and it was awesome. I seem to remember the wisdom imparted by that time-honored show, Grey's Anatomy. That's right - I went there and the view from the other side is truly spectacular.

I got to the ER at 8am today. This was the pre-arranged time - I wasn't late. The day shift had only been on for an hour and it was looking to be a miserable day. Four patients in beds, three in triage and another two rolling up in ambulances. Seriously. One doctor, four nurses, one medic, one tech, and non-patient care staff were supposed to tackle this. Holy crap. I need to find another specialty.

However, I soon learned that from a student's perspective, busy = fun. Ok. Maybe fun isn't exactly the best term, but I did more than I thought I would for Day 1. Granted, by more I mean a bizillion rectal exams and a bizillion + 1 male hernia checks, but I guess that's why they make us say "penis," "scrotum," "anus" and "rectum" until it isn't funny in school. Other than that, it was great. The attendings had me doing physical exams, writing patient histories and presenting cases. It was like being a doctor. Isn't it fun to pretend? So now I can look forward to finishing school.

still alive

2005-05-19T18:43:00.000-05:00

So, I am still alive. Thanks to everyone for their concern regarding the possibility of colonies of anal bacteria overtaking my life, but I am still managing. Since then, I have received my lab results and there was nothing abnormal running around down there, but my throat swab was a little more interesting.

Neisseria or Moraxella... interesting.

So one would think the faculty would give you a way to distinguish between "normal flora" or gonorrhea. Thanks.

the circle of medicine

2005-05-03T21:59:00.000-05:00

it is kind of like the circle of life, only more hateful and filled with irony. for example, I remember way back as an undergrad when I had to stick my hand up patient's rectum to get stool samples and disimpact them. believe you me, they hated it and I hated it. well, nothing says irony like a microbiology lab where I have to insert a six inch q-tip up in my butt to see the evil things that are growing between my cheeks.

imagine this bad boy going 'round and 'round

so yes, tomorrow, I get to see what evil lurks in the butts of men.

my legacy

2005-05-02T11:12:00.000-05:00

KevSul: <tear> in a year there will be probies that don't know me.
KevSul: ha, oh well.
Unknown GERM: oh that is so sad
Unknown GERM: although you could be one of those infamous germs who is talked about long after they gradute
KevSul: maybe, but name one infamous germ that you know of who has graduated...
Unknown GERM: andy jou

wow. who'd have thunk.

Jesus in a Jar

2005-04-18T11:31:00.000-05:00

I guess it is kinda like "Christ on a Bicycle!" but this phrase is quite literal. That's right. Some lady in South Dakota believes she has put Jesus in a Jar - a 14oz. jar to be exact. Seriously, who comes up with these things?

Now selling the Holiest of Fragrances: Jesus

I think I'm going to look up some passages and make a line of Jehovah perfumes and colognes.

the destruction begins

2005-04-11T22:27:00.000-05:00

The assignment in anatomy lab today: rip off someone's head. I would really like to say that statement is an exaggeration, but seriously, we took a chisel and hammered it in between the cadaver's skull and vertebrae in attempt to "disarticulate" it. Ideally, I would like to paint the picture that this was done gracefully and elegantly, but I believe that to be impossible when we were using a hacksaw and hammers for the majority of lab. This was culminated by the rather brutal separation of head and neck at the end of lab. However, to paint this in an academic light, after three hours of manual labor, we did save all of three structures: the transverse ligament of the atlas, the greater occipital nerves and the vertebral arteries.

its a cruel world...

2005-04-07T00:02:00.000-05:00

I knew that medical school was going to be brutal, but I had no idea that it would ever be this bad. It was not a good day for tact in the medical profession. First, in a cervical spine treatment lab, my female partner was told by one of the instructors that she had a "fat neck" and I would need to attempt to treat her with alternate techniques. After making said comment, the instructor paused, realized what she had said and realized that there was no recovery from this obvious insensitivity. This experience obviously desensitized me to any sense of inappropriateness as I proceeded to reveal my stereotypes for all the cliques in our class (e.g. "The Dirty Granolas," "The Dirty South," "The OBs" [yes, like in Scrubs], "The Sorority," "The Boy Sorority" [formerly referred to as "The Fraternity"], "The Mormons," etc...) over lunch... in public... in the hospital cafeteria. Yes. But it doesn't stop there. We then had a small group session with a clinician where we reviewed videotapes of a simulated patient encounter. Our doctor singled out one of the girls (out of five people in the room) and said that her school ID picture looked nothing like her. I will say that she attempted to tactfully state that the student had obviously lost some weight and she looked thinner now. However, as astute clinicians, we were able to translate "you look happier and more... mmm... relaxed now" to "holy crap, you lost a shit-ton of weight." So, yes. Today was not a good day for tact in medicine.

they will pay...

2005-04-05T23:23:00.000-05:00

they've taken away my instant messenger... I don't know how, I don't know why, but someone is going to pay...

mcat and medical school

2005-04-03T23:18:00.001-05:00

"here is what I know: if you are willing to take the chance, the view from the other side is spectacular." -grey's anatomy.

I'm a nerd but it is basically what keeps me going. I hate it when my life is basically a soap opera. well, good luck MCAT-ers! keep thinking about that life!

screw studying

2005-04-02T20:08:00.000-06:00

the fighting illini are victorious once again... we'll see you in the championship.

april fool's for medical schools

2005-04-01T20:43:00.000-06:00

so of all the days to wake up late. I open my door and what do I see? saran wrap... loosely applied, but covering my entire door. of course, because I'm sleep deprived and still foggy-eyed after putting my contacts in, I'm wondering what the hell happened and how spiders managed to encase my entire door in cobwebs. on the bright side, the pranksters paid with a little retribution I call "KY Jelly."

happy easter!

2005-03-27T23:06:00.000-06:00

during the easter season, everyone has their rituals. for some people, it is the end of lent. for others, it is watching the ten commandments at least six times before easter dinner. for me, it is sharing this picture with everyone.

sorry kids, easter is cancelled. more fun at pwasoh.com

so there it is. I hope you have enjoyed it as much as I do every year.

best fundraiser ever

2005-03-25T12:07:00.000-06:00

what are you doing tonight? bet you wish you were here...

kirksville: not looking so bad right about now.

I'll report on how it goes in the morning...

medical trivia

2005-03-21T14:31:00.000-06:00

the joy of going to medical school is that you learn all sorts of important facts from charts.

from Dr. Sargentini's lecture today...

that's right. you may have noticed it, too. over 2 million people are dying of diarrhea every year. that has to be 1.) the absolute worst way to die, 2.) some sort of explosive diarrhea that results in spontaneous combustion.