Tuesday, April 25, 2006

I ♥ Midwest Airlines

I flew home from Philadelphia using Midwest Airlines with a layover in Milwaukee. The first flight was on their Signature Service, while the second was a Saver Service flight. In case you have never had the pleasure of flying Midwest let me tell you a little secret: THEY SERVE YOU FRESH-BAKED WARM CHOCOLATE CHIP COOKIES MID-FLIGHT! I was so excited by this. On the Signature flight, all of the seats were leather and there were only two to a row with a wide armrest. I wasn’t expecting the cookies on the Saver flight, but there they were—just as warm and fresh as on the first flight. Another bonus of the cookies: for at least part of the flight, the gross B.O. smell that comes with having over a hundred passengers crammed in a large germ tube gets covered up temporarily!

I was just discussing this with my friend, but do you know what I hate? When you bite into a cookie, fully expecting the semi-sweetness of chocolate chips and you end up tasting raisin. And, just when I thought that the oatmeal cookie fake out was the ultimate travesty, she one-ups me with this one—there’s nothing worse than biting into a chocolate muffin and ending up with bran: YUCK!


On a happier note, this afternoon I took the last exam of my medical school career, assuming I passed anyway. Just a week and a half left of rotations and I'm DONE!!!

Monday, April 24, 2006

Photo Tag

Chris, of the-world's-longest-website-address-ever-.com photo tagged me a few days ago, and here's my results. I've never done this before, and while I have friends who blog, and friends who have digital cameras, I can't think of anyone who has both to tag next.

Something that I made:

This is a counted cross-stitch project I've been working on since late 2001, so technically I guess I'm still making it. It was supposed to be a gift for my father's birthday in August of 2002, so one year it'll be an ever big surprise that I got it done!

Something that was given to me:

This is a very soft and warm scarf that was made by my friend, Ru. Now that I'm moving away from the desert, it will get even more use!

Something strange:

I adapted this category to someone strange. I spotted this guy last spring during a rotation in New York. Tighty-whities in Times Square, now that takes some balls (Pun fully intended)!

Something with a pig:

Believe it or not, I couldn't find any photo-worthy pigs in Philadelphia! This is a sugar bowl in our house... the curly tail doubles as a serving spoon. This is the first sugar bowl pig I've ever seen, but maybe it's a common household item?

Something unique:

This is a bud vase that was hand-carved so that a small test tube fits inside. It was originally given to my great-aunt by someone in her assisted living complex. I think that it is darling, but at age 103, she has outlived him, too.

Sunday, April 23, 2006

Philadelphia, part 2

Unfortunately, the majority of my day yesterday was taken up by my exam. I woke up at 5:30 am and tried not to think about how it was really 2:30 back home. The exam went well enough, orientation videos and registration took almost 2 hours in itself. Most of the cases were pretty clear cut—I think my greatest problem was probably with the first patient I saw. The case itself wasn’t bad, I just hadn’t gotten into the swing of things yet, and was nowhere near finished writing my note when time was called. I have heard that they only evaluate 10 out of the 12 cases, so hopefully that one will be dropped. Since it is pass/fail, I feel pretty good about the whole thing. My school just requires us to have taken the exam prior to graduation, but passing it is a requirement for licensure.

After the exam I drove downtown. When I woke up yesterday, it was raining, and it still hasn’t stopped. Traffic was extra slow, in an already busy part of town overcrowded with tourists. I had downloaded a walking tour for my iPod before arriving in Philadelphia, and despite it being rainy and 47o, I went ahead and did it anyway since my only other option was to get up super early and attempt it in the morning. Luck was on my side, as I diverted from the tour route to duck in to the Liberty Bell Center, and was able to see the bell 15 minutes before they closed!

I have never downloaded a tour onto my iPod before, and I think it was a nice option because I was able to get around at my own pace, without having to return to turn in equipment. Cost was approximately $15.

However, by the end of the walk my jeans were completely soaked through, as were my poor socks and sneakers. Luckily I was carrying a leather messenger bag, and cows are waterproof, so the bulk of my stuff stayed dry. Note to self: the umbrella was smart, but next time extra socks and shoes if you’re going to walk around in the rain.

After the walk, it was off to The Franklin Institute where I had tickets to a Body Worlds exhibit and an IMAX movie on the human body. Body Worlds was excellent (unfortunately, no pictures allowed). The dissections were truly amazing and somewhat humbling compared to the work we did during first year. They did not give any information about the donors, but I was kind of curious about that, since most of the bodies had excellent musculature and seemed to have come from younger persons. There were a couple of animals on display as well, shown completely by the outline of their blood vessels. My only complaint was that the exhibit was clearly male-dominated, with probably about 80% of the bodies being male. It was funny though, that uh, genitalia was either dissected and arranged to flow with the motion of the exhibit, or simply whacked off. There were also many thin slices on display, but after looking at so many CT images and textbooks, it was hard to remind myself that they were real.

Although I finished my night at 10:30, it wasn’t until almost midnight that I returned to my hotel. It was only 10 miles away, but between the crazy weekend traffic, and the rain, I ended up all disoriented and turned around. It was impossible to make out any of the lane lines in the road. I never did quite adjust to the time change and ended up having dinner at Dunkin Donuts at about 11:00 pm. My next workout is going to suck.

This morning, I woke up completely exhausted, and though I would have liked to walk around downtown for a few more hours—there are several statues I would have liked to have seen, the rain dissuaded me. I also didn’t get to the Philadelphia Museum of Modern Art—apparently Rocky ran up those steps (I don’t know, I never saw any of those movies.)

So there you have it, my haphazard mini-vacation. I don’t know that I will seek out a trip to Philadelphia anytime soon, but there’s certainly much more to do!

Friday, April 21, 2006

Philadelphia, part 1

I made it in ok last evening. You know what's funnier than driving a Chevy Aveo around town? Driving a sea-foam green Chevy Aveo around town!!! I swear I have a bridesmaid's dress the exact same color in the closet of my old bedroom at my parent's home... and no, I will NEVER wear it again! At least I didn't have to worry about someone stealing my car!

This morning I drove an hour away to see an Ansel Adams exhibit at a museum. I've always liked his work, and I saw a few scenes that I had never seen before. One featured the arch of a rainbow across a waterfall that was strange to see in black and white, and in another he captured a black sun--I can't currently remember if that is a solar eclipse or a lunar eclipse. There was also a portrait of an old woman looking out from behind a screened door that I really liked because of the way that both she and the grid of the screen were perfectly focused.

After that, I went downtown to the Mütter Museum, which features an anatomical collection that is pretty extensive. I didn't see the signs that no cameras or videocameras were allowed until I was in the second room, so here's a bootleg shot for you:

Luckily for you, I have no shots of the colon from a patient with Hirschsprung's disease that contained over 40 lbs of feces when he expired! Also featured were shrunken heads, various fetuses with congenital anomalies, specimens taken from John Wilkes Booth and Grover Cleveland, etc.

For dinner, I had ate at Bookbinder's at the recommendation of a friend. It was pricey, so I stuck with New England clam chowder, a salad, and a glass of wine.

Not too much else to report. I hope to spend more time roaming around town tomorrow after my exam.

Tuesday, April 18, 2006

Let's Get Physical

I don’t believe I have whined about this one yet…

On Thursday, I leave for Philadelphia. The powers that be in this country have recently added a fourth component to the medical licensing exam. It is now required for all US medical students to spend a full day being video-taped conducting histories and physicals with mock patients. It’s kind of like that episode on Seinfeld where Kramer got hired to pretend like he had gonorrhea for a medical school, only bound to be less entertaining. I will have 12 patient encounters, and I’ve already been forewarned by others that one of them will be a jerk to test how I interact with difficult patients. I guess maybe the whole thing wouldn’t be so annoying if it wasn’t costing me $1500, including travel expenses.

While I do think that it is important that future physicians be evaluated on their bedside manner and ability to communicate, I think that could have easily been objectively evaluated by certified preceptors at some point during my last two years of clinical evaluations. The test is also bogus, as something like 97% pass on the first try, so it’s really not even a valid test. Even more agitating to me is that my classmates have told me that my evaluation will be just pass/fail. So the day won’t even be a learning experience for me, as I’ll have no idea what I could improve on.

Whatever. My exam day isn’t until Saturday, so I plan on making a mini-vacation of it and exploring Philly on Friday as I have never been there before. The other bonus is that tomorrow will be my last day here. It really hasn’t been that bad, just boring.


The other day we discharged “Old Blue Eyes”. He had brought in by his “caretaker” who insisted that he was demented, having increased falls at home, and needed to be placed in a nursing home. First off, it turned out that his increased falls were due to alcohol. Then it turned out that this woman was not even a family member or his medical power of attorney. She was just some stranger who had found him passed out in his car in the parking lot of their apartment complex on several occasions, and has made herself his personal nurse. Since OBE wasn’t drinking during his hospital stay, we found him to be completely lucid. Several thorough investigations by the physical and occupational therapists found that he had no trouble balancing, or getting around with his walker. She insisted that he couldn’t be left at home alone, and that she was exhausted from continually caring from him. Basically, the guy refused to go to a care home, but his “caretaker” made a big stink about it. I think she had several issues of her own, but that’s a whole different story.

I guess my whole point in bringing this patient up, is that one can’t force someone to get help. Sometimes, the best you can do is provide information and hope that people will follow your advice/recommendations. Unfortunately, it is not a crime for an adult to slowly drink themselves to death. People choose their drugs/drink over their family and their own personal health. I think that the depression that results from those losses just feeds their habit more. As long as a person is mentally competent and not putting anyone at risk with his/her habit, there is nothing that we can do about it. My psychiatry rotation last year was with an addiction specialist. We had several patients who just didn’t do very well with the program because they were simply interested in fulfilling a court-order or proving something to someone else, rather than being interested in seeking recovery.

Memory Lane

Going back to my hometown is always somewhat of a surreal experience. Things still change in a small town, but at a much s-l-o-w-e-r pace, almost as if the earth’s revolutions slow down in just that one spot. Hence, I still know exactly what buildings are where, but maybe the paint color has changed, or a new sign makes things just different enough to feel foreign.

I never thought much of it at the time, but when I was in high school, you could recognize people by their vehicles. A certain pickup meant a close friend, while another body style barreling down the road meant trouble. When I left for college, it took a while to stop waving at vehicles I thought I recognized. It gradually sunk in that there were people that owned a yellow slugbug other than my English teacher.

Another strange thing about that town was that when we first moved there, you only had to dial a 7, followed by the last four digits of a person’s phone number. Our phonebook was the size and thickness of a comic book, and it included at least two other towns!


I ended up driving down immediately after work on Saturday night. I took the longer route, driving down from the north as it was already after dark, and I’m of the opinion that it is a wee bit safer. When I left, an almost-full orange moon was behind me. After turning south, it appeared on my left, seeming to race me towards Mexico. Despite my best tries, the moon ultimately won out—although I blame the angle of the highway for that one.

Twenty miles north of my hometown, I was greeted by multiple sets of flashing lights. This time, it wasn’t the Sheriff’s Department, but only the Border Patrol. I always forget about their little checkpoint. It’s been a recent addition in the last two years. To be honest, their presence there pisses me off. I’m not leaving the country, so why should I be forced to slow down so that they can peer into my vehicle or punch my license plate number into a computer? And what kind of profiling are they doing to base their searches on? I’ve never been stopped—perhaps because it would be difficult to smuggle more than one person in my car’s trunk—but I doubt that’s true for my darker-complexioned friends who live in the area.


On a lighter note, Easter dinner was great. I ate too much, as is the norm at holiday dinners. I had brought down Gewurztraminer wine to go with the ham—this was at the recommendation of several websites, don’t think I am cultured enough to know anything about wine! It went over well, and I’m only mentioning it here so that next time I’ll be able to find the name of it again.


After dinner, I left early enough so that I could take the route east back. This involves driving across reservation land along a bidirectional highway with many turns, and no shoulder. To this girl, no shoulder means one thing: no hidden cops! So, I did what anyone would do—I cranked up the music and criss-crossed back and forth across the double lines, straightening out the curves like my father taught me to. I was pleasantly surprised to find that the highway had recently been repaved, and my car sailed over the small dips like a boat at sea. I regret that I had but four cylinders to give!

It has probably been about ten years since I had been on that highway, and the drive brought back memories of many trips to away games during high school. The only thing bad about that road is that there are scraggly cows that wander free along one section of it, so I don’t like to drive it at night. Along the way, I was a bit startled by the numerous small, white crosses that flanked the road. A classmate and a teacher of mine have both been claimed by the local highways, and the small shrines I passed with votive candles lit for the holiday were a sobering reminder.

Monday, April 17, 2006

Picture Pages

I installed Moxilla Firefox today, so hopefully less problems with posting. So far, so good. No cameras were allowed in the caverns; these pictures were taken during our hike after.

Saturday, April 15, 2006

Back on the Wagon

Sorry, I haven’t dropped off the face of the earth, I’ve just been feeling a little lugubrious lately. I don’t really know what my problem is. I have a lot of things to look forward to in the upcoming months. Every now and then, I seem to just slip into “blah” mode and it takes me a week or two to emerge.

On Monday, I attempted to run 3.5 miles, but ran out of steam after 2.25. It’s my own fault as I think I only went to the gym three days last week. Today, I pulled it off. It took me 38 minutes, but I did 3.56 miles! I guess I just need to push myself a little harder to get back on track.

My other issue has been with my laptop. Although I’ve been picking up a wireless signal here for the past 3 weeks, this week Explorer has been giving me headaches. I have pictures from last weekend that I’ve been trying to post, but despite multiple attempts, it just isn’t happening.

I’m back out of my slump now, and am looking forward to seeing the PU’s (parental units as my friend calls them) and the older brother, W and his wife, D on Sunday for Easter dinner. The little brother (I suppose I shouldn’t call him that as he’s 6’5”) is currently in Kenya with the Peace Corps. My family is not the touchy-feely type, but it’s been weird not seeing T at holidays and birthdays this year. I think he still has about 15 months to go. My immediate family has all been in the same state since we moved here in 1989. It’s kind of funny though, as us 3 kids are now all leaving at once. I will be leaving around mid-June and W & D are currently applying to do a year of teaching English in Japan. I moved out of my parent's home at 18 when I left for college, but I suppose I've always had a 250-mile safety net.

Sunday, April 09, 2006

Sunday Spelunking

Unfortunately, my current rotation involves working six days a week, so getting home on weekends to see my friends has been a little daunting. To cheer me up, my best friend came out for a visit last night after I had finished work. We saw “Thank You for Smoking” and ate all sorts of things with no nutritional value.


This morning, we got up at 5 am and drove down to this place, which was way cool. The park has been in existence for less than twenty years, and there is much more effort being put forth towards preservation of the caverns than others that I have visited. And, although I was already familiar with stalagmites and stalagtites, today I learned about helictites, soda straw formations, and troglobites just to name a few.

We currently have a disagreement going on about the word spelunking—she says it specifically means scuba diving in caves, but
www.m-w.com just gives the brief definition of cave exploring, so I’m using it!


After the cave tour, my friend and I went a hike, with this one being about 4 miles long. Once again, it was in the noonday sun, but for most of it we had a good, strong breeze.

Wednesday, April 05, 2006

A Time to be Born...

Sometimes everything just flows together with everyone on our whole, sloppy planet seeming to be entwined. The same subject spoken about with a friend appearing as the segment of a daily talk show. A lecturer discussing treatments for alcoholism the very morning that my alcoholic patient dies, surviving less than seven minutes off the ventilator.

What can I say? Some say it is coincidence, and some say it is God. And, some say it is simple statistics that out of the thousands of statements one hears or says in the course of one day, a subject is bound to be repeated. At the same time, once my attention is drawn to a subject or person, I no doubt notice it again and again, or even seek it out.

I don’t really know where I was going with that thought, but that was how my day started out.


Yesterday, I decided to do something nice for myself and bought a cluster of stem daffodils while at the grocery store. I wasn’t sure quite what they would do, if they would open at all, or slowly and progressively, like one firework at a time.

This is what they looked like yesterday:

When I got home this evening, I came home to KA-BOOM!!!

I didn’t expect almost all 20 to go at once!

They’re practically duking it out for space!

I have always liked watching vibrant flowers emerge from seemingly dead, dried-up bulbs. One year for my mother’s birthday, I spent hours digging up the strip of dirt along the driveway and planting a mixed bag of about 80 daffodils. That spring, and every year thereafter, they come up and put on a show like clockwork.

That’s another thing I’m looking forward to about getting my own place in a few months… houseplants, and maybe a garden.

Monday, April 03, 2006

8 5 3

I am disappointed with myself. I am guilty of failure to act, and frankly, it is not the first time. Sometimes opportunities to help people present themselves so quickly that I am caught off guard. However, this time I definitely could have said something.

My friend and I were out for a late lunch the other week, and there was a woman in her thirties not ten feet away from us. She was dressed nicely, her hair and makeup were done—everything appeared to be in order. However, as she moved forward in the line, it was then that we noticed her arms. All along both arms from shoulder to elbow there were bruises in different stages of healing, with most of them being along the inner, medial aspect of her arms. This was not an accidental pattern of injury. There is no way that those bruises could have been the result of a one time fall. And if she had fallen, it’s unlikely that both arms would have been bruised so symmetrically.

My friend and I looked at each other. We both agreed that the markings had to be the result of violence. The woman walked off. She appeared to be alone but still, neither one of us said or did anything.

Here’s a few statistics I try to keep in my head:

-One in eight women will develop breast cancer.
-One in five women will be victims of domestic violence at some point in their lives.
-One in three women will develop ischemic heart disease.

At the time, I didn’t know what to do. I did not want to embarrass or anger her by a comment on her appearance. I also felt somewhat at a loss for words as I don’t even know the names of any of the local women’s shelters or support hotlines. It can be frustrating to deal with these types of situations, but I still should have at least said something to her. Ultimately, everyone makes their own choices in life, but at least if I had drawn her attention back to the issue, it might have been the start of a decision to change her situation.

For the rest of that day, I felt pretty bad about the situation. Although it’s becoming more of a distant memory now, my inaction still bothers me. At the same time, I know that it is pointless and ineffective to keep dwelling on the incident. But really, what kind of doctor sees someone in need, and then does nothing? I was again reminded of that afternoon when I ran across this little gem the other day: “But if anyone has enough money to live well and sees a brother or sister in need and refuses to help—how can God’s love be in that person?” 1 John 4: 17

The best I can do now is to determine how I could have better handled the situation. For starters, I think a simple, “Are you okay?” would have done nicely. That way if she didn’t want to talk about it, it gives her an easy exit. At the same time, hopefully it doesn’t come across as judgmental. And a little research on local shelters is definitely in order.


On a much lighter note, today I ran 3.27 miles—which is a new record for me. I wasn’t sure I’d be able to add another .25 miles as I had kind of backed off a little on my workouts this past week, but I did it!


I don't know if you can appreciate this from the picture or not, but see those shower curtain rings? Those are actually binder rings, like from an office supply store. This apartment is wacky!