Karate School

I'm Crazy For You But Not That Crazy

2004-12-11T13:34:00.000-05:00

Just a quick note for now, since I'm post-call. Delirious patients are quickly becoming my favorites to work with. I love watching their improvement on the MMSE - there is little that brings me as much joy as seeing a patient evolve from a state of total confusion to being able to recall objects after a three minute delay and being able to subtract 7's. Generally, though, I tend to be very protective of them, and I find myself getting angry when I overhear nurses and other docs making fun of things they said or did in their state of delirium. Sometimes, however, everybody needs to lighten up a little. So I give you the best patient response to a question I've heard all year, which came from one of my 3 ICU patients, who is just now waking up, 7 days after an attempted suicide by overdose.

"Do you know where you are?"
"I have a nickel in my ear."

"I Already Made Like Infinity of Those at Scout Camp."

2004-12-10T18:17:00.000-05:00

Can it really be five days later already? I guess so, because I'm on call once again. This time, I'm decked out in brand-spanking-new hospital scrubs, as opposed to the disgusting old ones I wear every other time I'm on call and which I stole from the Labor and Delivery floor of the hospital at home. Of course, attaining these new scrubs could not have been the simple process that one would imagine, but had to involve once again reliving my nightmare of being caught in a sterile hallway without a surgical cap or gown on, surrounded by hundreds of glaring scrub nurses and surgical residents, saved only by Catherine's materialization out of thin air and quick work at the scrub dispensing machine. Or something like that.

What I really want to talk about tonight, though, is this presentation I had the privilege of witnessing on Thursday morning, which served as the highlight of my entire time down here. Every weekday morning, at 7:30, all of the internal medicine attendings, residents and medical students gather in the conference room for Morning Report, which theoretically involves a case presentation by one of the teams, followed by interactive discussion and a brief presentation on a related topic. On Thursdays, the usual crowd is joined by a group of terrified-looking applicants for residency, which generally consists of 5-6 male foreign medical students dressed in identical black suits who speak very quietly and in broken English, 1-2 female foreign medical students inevitably dressed in some sort of beige pants suit involving frills, and 2 very bitter looking male American medical students with spiky hair and slightly more acceptable ties. Ideally, the team in charge of presenting that morning, which also happens to be the team that is on short-call for the day (in charge of admitting patients from 12-6pm) and therefore always seems to be slightly more frazzled than usual, as if the odds weren't insurmountable enough to begin with, is supposed to present a patient that they have taken care of recently that either posed an interesting diagnostic dilemna or that highlighted some particularly intriguing aspect of a specific disease. The other residents are supposed to formulate a differential diagnosis based on the presentation and try to figure out what is going on with the patient. Once everybody in the room has grown exasperated with this process, the power point gets revved up, and one of the team members offers a hastily put-together presentation on a related topic. I've attended about 12 of these sessions by now, and I have yet to see one that was not incredibly chaotic in some way, shape or form. I have even been a presenter on two occasions, waxing eloquently first on the topic of hereditary angioedema and later on the key aspects of alcoholic hepatitis. (My subtle humor has unfortunately gone largely unappreciated. Nobody seemed to understand, for example, that the name of my second presentation, "Alcoholic Hepatitis: Insert Witty Subtitle Here" was actually the intended title. This probably wasn't aided by the fact the three-quarters of those in attendance were ESL. (Go Molly Meek!)) Thursday morning's presentation was by far the best I have seen in four weeks. I think I had a preexisting case of the giggles going in, but nothing could have possibly prepared me for the hilarity of what would ensue. It was, honestly, the closest I have ever come to running out of a room in the middle of a formal talk because I could not control myself. If I had made eye contact with anyone in the room after the first ten minutes, I seriously would have peed my pants. Allow me to introduce the players:

The Attending: The role of the attending physician during this exercise is supposed to be one of pure observation. The day on which his team is in charge of the report is the only day that the attendings are actually required to be at the meeting. The attendings have no role in the preparation of the discussion, other than perhaps guiding the team towards the selection of particularly interesting cases. Prior to Thursday, I had never seen any of the attendings speak a word during the actual conference.

We'll call Thursday's attending Uncle Rico. I don't know the guy at all, but basically, I would describe his appearance by saying that, with a slightly different outfit, he would fit in unbelievably well at a gay leather bar. He's got the crewcut, the thick, bushy mustache, the sort of permanent scowl, and the broad shoulders. In terms of personality, he's clearly a little Type A, and he likes to have a handle on the situation at all times. He tends to be a bit old-school in his approach, and he's not beyond teaching by intimidation.

The Resident: Each team has one second- or third-year resident who is second-in-command. He is responsible for all the patients on the team and for dividing the workload between the two interns. During morning report, the resident generally guides the discussion, allowing the interns to do most of the talking, but summarizing when necessary and often taking notes on the board.
Thursday's resident, who we'll call Deb, is the lone American female resident in the department. She's a third year, and she knows her shit. She's a little bitter, though, because, for the first time ever, one of the current third years was asked to be chief, and it wasn't her. It was a foreign med school grad. If Uncle Rico is a little Type A, Deb is headed for a heart attack within the next 3 months. She likes to randomly call on people to answer questions during the presentations. She totally resents being stuck at the program down here, and she definitely has already become completely fed-up with the interns she was assigned, despite having only been working with them for 4 days.

Intern A: This is your token foreigner on the team, who we'll call Pedro. He is from an ill-defined country that may be located in either South America or Eastern Europe, or perhaps on the Mediterranean. It's difficult to say, really. What's important is that he does not speak English very well. He also perpetually looks like he got 1 hour of sleep the night before. And he is extremely happy to be here. I think he may be the only person in the program who has not yet had his naive idealism completely destroyed in a fiery pit of burning flames. This kid is always smiling. For no apparent reason. And he always tries to answer questions that he cannot even begin to comprehend. I'm not talking about attempting to formulate an answer after being called on, either. I am talking about voluntarily raising his hand and then saying something that either makes no sense or that has very little to do with the query and then laughing when he is unsympathetically refuted. All of these qualities make him by far the most endearing member of the team. He's the protagonist of this story.

Intern B: If you've caught on by now, you'll know that Intern B must be Napoleon. This kid is freaking sweet! He's American. He wears his scrubs hiked up the his midepigastric region, with the top tucked in tightly to the pants. He wears dirty white sneakers that are definitely not name brand. He parts his hair. On the side. And there's a cowlick in the back. He has a vagina goatee. And he assumes bizarre postures that occasionally make me wonder whether or not he's suddenly gone catatonic. When he stood up behind the podium, I seriously expected him to start talking about the Japanese scientists in Scotland who tried to blow the Loch Ness monster out of the water and how a group of wizards had formed a cirle of power around the lake to save our beloved Nessy. I also really wanted to ask him for some tots.

God, this post is freaking longer than a Kuhn entry. OK. Thursday's presentation was somewhat unique because it involved two distinct cases. Pedro was presenting the first, which involved an upper GI bleed, with Deb taking notes. This was to be followed by a presentation on Upper GI bleeds by Pedro. This was supposed to last for approximately thirty minutes. Following this, Napoleon was scheduled to briefly summarize the case of a patient with tophaceous gout and then discuss this rheumatologic phenomenon.

The morning began typically enough. Pedro discussed the case of a 50 year old man who had presented with Upper GI bleed, had been scoped but not cauterized, discharged on an H2-blocker, resumed use of NSAID's at home and presented 1 week later with massively bloody stool. At this point, Deb took charge. Targeting one of the disgruntled preliminary interns who clearly would rather have been anywhere else that morning, she asked for a differential diagnosis. "He could have some sort of perforation, I guess." Poor choice of words. This angered the Russian attending in the audience, who demanded to know what the intern meant by perforation.
"You know, he could have an ulcer with a massive vessel at the base."
(Imagine the worst Russian accent you've ever heard in a James Bond movie) "This is not PERFORATION! You tell surgeon perforation, they ask what the hell you talking about! Perforation is between two things. It is issue of semantics." (The rest of the room, at this point is dumbfounded. The Russian hardly ever speaks. He usually just sits at the table picking his nose and making incredibly animated movements which involve some sort of attempt to wrench the skin off of his face whenever someone says something that isn't correct. He later gets up, still in the middle of the presentation, walks over to the intern, who really could not care less about the earlier interaction, and apologizes loudly enough for everybody in the room to be distracted from the speaker.)

The rest of the first case presentation was pretty uneventful. Deb interrupted Pedro at least ten more times to point out minor discrepancies, and continued to demand answers of the other interns in the room, who were clearly not amused. There was also a great exchange between Deb and Pedro towards the end.

Pedro: When the patient came into the hospital, he was on Indomethacin, Prevacid, Ranitidine, and HCTZ. He was---
Deb: The patient WASN'T on Prevacid when he came in.
Pedro: Right, he was on Prevacid. He also---
Deb: No, Pedro. He wasn't on Prevacid.
Pedro: OK, so the meds were Indomethacin, Ranitidine, HCTZ and Esomeprazole.
Deb: Pedro...Esomeprazole is Prevacid.
Pedro: Yeah, that's what I said.
Deb: He wasn't on Prevacid. That's the whole point of this case.
Pedro: Are you sure?
Deb: Yes.
Pedro: OK. Patient's allergies are....

After the case was solved (this actually happened immediately, when the initial intern was called on, as he rephrased "perforation" as "Dieulafoy's Ulcer" (Deb was clearly pissed at this point, since the whole reason for presenting the case was that it posed a diagnostic quandary)), Pedro began his Powerpoint presentation on Dieulafoy's Ulcers. Actually, Pedro seemed to think that the topic was Upper GI Bleed, because that's what he titled his presentation. Let's begin by saying that Pedro chose as his powerpoint backdrop "Mountain," an option I had seen the day before during the preparation of my presentation. (I settled on "Pulse," a Bruce-dog specialty.) "Mountain" consists of a blue background with a black silhouette of a pine tree, cabin and mountain peak at the base of every slide. I can not possibly imagine what this has to do with GI bleeding, but a the time, I thought that nothing could have better epitomized the thinking of the presenter. Pedro's presentation was supposed to last five minutes. It was supposed to describe the etiology of Dieulafoy's ulcers and talk about possible treatment options. It was supposed to be brief enough to allow time for Napoleon's case presentation. Pedro began speaking at 7:55. By 8:10, he had not mentioned Dieulafoy's ulcers. He had, however, almost made me spit out my smoothie on at least five separate occasions. There had been a recent trend of incorporating Boards-style questions into presentations in order to encourage audience participation. I had been guilty of doing this the day before. These questions were generally centered on vital points associated with the topic that might arise during the Step 2 or Step 3 exam. Usually, the questions presented a brief case and asked either for a treament decision or for a diagnosis. Discussion was usually stimulated as the resident's debated the potential merits of various options. It seems that Pedro did not grasp all these intricacies. Here is a sampling of his questions.

1: What is the incidence of GI bleed?
A. 1 in 100
B: 1 in 1000
C: 1 in 10,000
D: 1 in a million
E: 1 in a zillion

(Sadly, he actually read each option out loud, waiting for people to raise their hands. I supported Answer E simply because I honestly don't think I've heard anyone use the word "zillion" since fifth grade.)

2: What is the most likely site of bleed during endoscopy?
A: The stomach
B: The duodenum
C: The ear

(I can't make this shit up.)

3: What is the treatment for Upper GI Gleed?

(I have no idea what the options were. That's his typo, not mine. The moment I saw that, I literally started shaking in my chair. I was biting my lip so hard that I actually drew blood. I do not know how no one in the room managed to let out a sound. As I write this now, a day later, I am still audibly cackling in the library.)

At this point in the presentation, at 8:10, Uncle Rico piped up for the first time. "Pedro, do you have any slides that actually talk about Dieulafoy's ulcers?"

Pedro literally had to scroll through 30 more slides to get to the ones on the case topic. I would give anything to find those lost slides. He discussed Dieulafoy's ulcers for another 10 minutes before Uncle Rico simply started clapping, in the middle of a sentence, and basically yanked him off the stage with a shepherd's crook.

Uncle Rico: Napoleon will now talk about tophaceous gout in seven minutes.
Napoleon: (Bitterly, under his breath) Seven minutes? Maybe I will. GOSH!

Napoleon began his presentation with a disclaimer about how Powerpoint is an inferior client and he would never choose to use it, but that he had to make do since it's the only program supported by the conference' room's computer. (Worst program ever, what do you think?!) He then assumed a posture whereby he stood in front of the podium but crossed one leg so far behind him that his left foot was actually behind the podium, and thrust his pelvis forward, perhaps in an attempt to accentuate his green on green scrubs combo. He was about 30 seconds into his presentation when Uncle Rico interrupted.

"Why don't you just do it as a slide show?"
"I'll get to the pictures in a few minutes."
"We're running out of time.
"Fine. Geez." (Pounds the space bar way too aggressively.)

Napoleon: This patient is a 50 year old black woman. (The picture on the screen is clearly not the hand of a black woman. It is the whitest hand I've ever seen. Minor details, I keep telling myself) She--
Uncle Rico: That picture is terrible.
Napoleon: I'd like to say that I'm much better with film photography than with digital. I find that-
Uncle Rico: What happened to the pictures I took?
Napoleon: I couldn't get them to load on the computer at the library, so I went back up and took some more pictures. I think that the wrist here-
Uncle Rico: I mean, you can't even see anything. My pictures were really clear and showed the tophaceous deposits excellently. These are like the worst pictures ever. (There's no way you could even know that.)
Napoleon: This picture is of the elbow, which highlights-
Uncle Rico: Wow, that is so blurry!
Napoleon: The elbow here clearly has evidence-
Uncle Rico: I don't think you can really say "clearly."
And......SCENE!

Afterwards, Uncle Rico publicly reiterated the superiority of his pictures while Napoleon bitterly ejected his floppy disk. Deb had a "private" conversation with Pedro, which I'm pretty sure was overheard by everyone in the room, during which she offered many condescending tips for future presentations. I immediately ran into the hallway and exploded in a fit of hysterics.

They Say You Curse at Girls

2004-12-05T21:49:00.000-05:00

Oh man! On call again! Tonight is progressing slightly better than last week - I've already seen one patient, and I just had dinner with my resident at Blimpie, despite the fact that it's 10pm. I'm getting very close to achieving my quest of sampling every meat, cheese, topping and dressing that Blimpie has to offer. My personal favorite combo so far is turkey and provolone cheese on whole wheat bread with lettuce, tomato, pickles, and horseradish dressing. Nothing says "heart healthy" quite like that. Not much to report here. I continue to spend most of my free time at Barnes and Noble. I drove back home for the soccer game last night - I'd love to say that it was worth the 2 hour trip back that left me with 5 hours of sleep on my pre-call night, but I really can't. In fact, it was a heartbreaking disappointment and I was seriously saddened. (Don't worry; I managed to not cry about it.) Last night's game did represent a noble effort on my part to overcome a problem that has been plaguing me recently. My reaction to specific incidents during the previous week's game had highlighted for me once again the fact that I have somehow managed to adopt an embarrassingly liberal use of profanity in public, a problem that is apparently refractory to all my efforts to control it. This is not a new issue. For years, I was constantly reprimanded for screaming obscenities in front of Jeff's little brother during heated Nintendo battles. (As far as I know, Ryan suffered no ill effects from my episodal Tourette's). I would then point out that Jeff's reactionary destruction of 5 N64 controllers was probably also not setting a good example, but the point was well-taken nonetheless. The kid was 9 years old, and probably did not need to hear "Fuck!" that many times in a 20 minute period. More recently, there have been some equally offensive moments. As alluded to in an earlier post, there was the time I screamed "Jesus Christ!" in the finals of the doubles ping-pong tournament in front of the extremely pious Dean of Students. There was also the time, during med school orientation, when I went bowling with one of the Mormons and honestly dropped the F-Bomb every single time I rolled the ball, always turning around immediately to realize that he was standing directly behind me. Last weekend's soccer game, though, was the culmination of this trend. I got to the game late, having driven all the way from NJ in the pouring rain, so I was packed in tightly to the family sitting next to me. I struck up a conversation with the Dad, and was inquiring about the action I had missed. It eventually came up that I was a med student and had been at the school for 7 years. Upon this revelation, he turned to his 8 year old son and said, "You hear that Bobby? This guy's going to be a doctor. He went here for college and medical school." Turning back to me, he noted, "My son is crazy about this school. He'd do anything to be able to go here." I said Hi to the son, smiled, and turned around just in time to see our defense get beaten by the right wing. "MOTHERFUCKER!" was probably not the best choice of follow up comments, but it's definitely what came hurling out of my mouth. I sheepishly turned to the family and apologized. They were understanding and admitted that it was a terrible play on our part. I managed to keep my outbursts in check until the game went into Penalty Kicks. Despite all my will power, there was simply nothing I could do to control myself once the game came down to a series of instantaneous outcome-changing events. UVA was kicking first. Here is my monologue, which I'd like to say was internal, but was actually about as far from internal as one could get.
"FUCK!"
"OH SHIT. SHIT. SHIT"
"WOOHOO!"
"Yeah, Motherfucker!"
"YES!"
"Goddamnit!"
"YEAH!"
"Jesus Christ!"
"Thank God!"
"Son of a Bitch!"
"WOOHOO!"
"DAMN!"
"No way, Holder! You Fucking Suck! Motherfucker!"
"Oh My GOD! Holy Shit!"
"Yeah Baby!"
"Holy Fucking SHIT! Holy Shit! WOOHOO!"

I didn't get a chance to say goodbye to the family for some reason. I turned around to slap the Dad high-five but they were gone.

This really is a sort of humiliating problem. I don't think I curse that much in general. I tend to use a lot of profanity in the blog, but that's more for dramatic hyperbolic effect. And because it makes me feel more like David Sedaris. Of course I curse a lot as part of my rap career. (For those of you who have not heard this hilarious aside, my mother actually said the word "Motherfucker" for the first time ever after she came to see us play in August. We were discussing my use of profanity onstage, which she clearly was not very pumped about, and she was asking me why I felt the need to use such language, which she found extremely offensive. I explained to her that I didn't find such words objectionable, as they held no particular meaning for me, and were simply multi-functional global parts of speech. I added, however, that there were certain words I would never use because, given my particular demographics, I could never claim ownership of them. To which my Mom briskly replied, "So you feel like you own 'Motherfucker?" I think my Dad spit his Chinese food all over the dining room table at this point.)

-----I got called away. It's now 16 hours later, and I've had another 2 hours of sleep.------

With regards to the rapping, though, that's more of a stage gimmick and not really reflective of me as a person. The uncontrollable outbursts during times of excitement are really a problem, though. I need to get a handle on this shit. This weekend's game was a moderate improvement, as I managed to only slip up on 8 or 10 occasions. I can only hope that next season will bring a renewed sense of self-respect that will render me unable to curse in public, or at the very least, that we won't fuck up as much at crucial moments.

Don't Wake Me - I Plan on Sleeping In

2004-12-01T16:00:00.000-05:00

There's nothing quite like being post-call. It's 4 pm in the afternoon, and aside from a brief 2 hour nap from 4am-6am this morning, I have been awake and going strong since 6am yesterday morning. This is really minor compared to some of my fellow med students' achievements, but it's quite a milestone for me, as someone who never pulled an all-nighter in his life and whose longest episode of continuous consciousness was 30 hours during the trip to Paris, at which point I nearly passed out in my bowl of delicious pasta prepared by an 11 year old. The last 36 hours have been insane. Here are some highlights:

I sat in the library of the hospital for 8.5 straight hours last night waiting to be paged. My only objective during the entire time I was on call was to admit at least one patient so that I would have someone to present on rounds this morning. My resident was supposed to page me as soon as the first patient came in, as he had assured me that I wouldn't be staying very long and I could go home and sleep for most of the night, since he remembered how much it sucked being on call as a med student. Let's see how that worked out for me. Here's a timeline:

5:45pm - Stumble out of my dorm room, which is located on the sixth floor of the hospital. That's right. I live in the freaking hospital. You have no idea how depressing this is until you realize that you haven't been outside for 96 hours straight. It is somewhat nice, however, to be able to roll out of bed in the morning and appear at your patient's bedside 5 minutes later, no doubt sporting an awesome hairstyle. I'm feeling nauseous at this point, but we'll get to that later.

5:50 - Page my resident from the library, located on the 1st floor of the hospital to ask him where we are going to meet. He tells me he'll page me when he decides.

5:55 - Start reading article in American Journal of Psychiatry.

7:45- Finish reading entire Journal of American Psychiatry as well as the special addendum on Disaster Mental health. Still no word from the resident.

8:00 - Feeling slightly less nauseous, head to Blimpie, located on the Ground Floor of the hospital for delicious nightly dinner and hilarious interaction with workers who neither speak English nor understand how time could possibly be an important commodity in a hospital setting.

8:10 - 8:20 - Eat sandwich and watch The Parkers with awesome cafeteria workers, one of whom answers her cell phone, "Who this?!"

8:30 - Page my resident to find out what the hell is going on. He informs me that not only has the team decided on a meeting place, but they've also already met, discussed all the old patients, and admitted and worked up three new patients. "We'll let you know when we get a good one."

9:00 - Check email for the 6th time in less than 2 hours. Resort to reading Zach Braff's old blogs. Jesus, I am fucking bored out of my skull.

10:00 - Decide that I should probably do something productive while I'm in the library. Go back to my room and get an Internal Medicine Boards book with 1100 questions.

12:00 - Realize that I've done over 100 questions and all I've learned is that you should avoid barbiturates in acute intermittent porphyria.

12:05 - Remember that I learned that in psych.

1:00 - Start walking laps around the library, which is approximately the size of my apartment, because I'm starting to develop restless legs secondary to lack of sleep and excess caffeine.

1:30 - Converse with security guard who comes by to inspect the library for the fourth time.

2:30 - Page my resident.
"Hey, it's S-"
"Who?"
"Your med student."
"Oh. You're still awake?"
"Yup."
"Man, you're persistent."
"Uh-huh."
"So what's up?"
"Did we get any new patients for me to see?"
"Oh yeah. Yeah, we just got one in. You can come up and we'll talk about her."

2:35 - Arrive on floor. Find my resident.
"Hey."
"Hey, man. She's in that room. You can go interview her. Here's my note. Round on her in the morning and then you can present her unless we get to her while you're still at morning report. I'm going to bed. "
"Fantastic."

So, back to the nausea. I'm still not sure what that was all about, but throughout the course of the night, I managed to convince myself at various times that I had viral gastroenteritis, a gastric ulcer with concomitant upper GI Bleed, positional vertigo and impending Boerhave's syndrome. Given the fact that I ate 6 pieces of pizza for lunch and just had a mammoth smoothie, however, I'm now hanging my hat on a parasite of some sort. I'm personally hoping it's a trematode, because how cool would it be if I pulled an earthworm out of my nose during my patient presentation? Huh?

Speaking of smoothies, I'd like to point out that it's very hard to look professional when you are wearing scrubs and Dansko's, curled into a ball, sitting in a cushiony chair in the lobby, shivering and sipping smoothie through a straw. Trust me.

Finally, perhaps as a result of my progressive delirium, I cried in the hospital for the first time today. Thankfully, it was not one of those "Oh my God my life sucks and I hate surgery" cries that everyone else seems to experience on a pseudo-daily basis (That would be kind of weird, after all, considering I don't do surgery until April, but you never know.) I was standing by the bedside of one of my elderly patients, watching him have a second heart attack as I spoke to him, and listening to the cardiologist explain the various options to his 50 year old son, who has stayed in his father's room in the SICU for the past three days. The son looked at the cardiologist and said, with tears in his eyes, "You're the doctor. I trust you. I just want you to do whatever you'd do if that was your Dad." I lost it. It wasn't one of those embarrassing scenes where I threw myself on the patient's bedrail and started having convulsions. But there were definitely tears involved. I don't think anyone really noticed though, given the fact that the person next to me was potentially dying. But it relieved me in a way. I've found lately that I get easily emotional during vicarious experiences. I think it started with Big Fish, but it's been getting ridiculous. Of course I cried at Garden State all three times. And I cried at the end of The World According to Garp. I even cried on the drive back here the other day listening to The Shins. But, until today, I haven't cried at anything real in a long time. I've had patients tell me the most heartbreaking stories you could ever imagine, and yet I don't shed a tear. It's nice to cry at something real, though. It's nice to be able to feel alive on your own, without any help from mass-produced media. It's nice to not always feel so numb. And most of all, it's nice to be reminded from time to time of why you chose to be a doctor, and to remember exactly what kind of doctor you want to be - the kind that doesn't have to ever be caught off guard by that family member's request, because it's how you operate anyway. God, when did I get to be such a depressing blogger? We'll return to regularly scheduled programming soon. I promise.

The Heat is On (Omigod, do you get the double meaning?)

2004-11-28T21:49:00.000-05:00

Wow, talk about news. First of all, I'd like to send a big shout-out to my newest group of readers, the trauma surgeons! Great to have you in the house. I always enjoy increasing my readership and diversifying the demographics a little bit. I look forward to working with all of you in April and introducing you to the Mini Mental Status Exam. It's awesome, I promise. You'll love it. Seriously. And I didn't mean any of that stuff I said about surgery. You guys rule. Instant gratification, etc. I'm down with it.
For those who haven't heard, some serious shit has been going down in the blogosphere. In a way, I'm largely responsible, but, have thus far remained unscathed. The final verdict, though, is that I'm basically not allowed to mention where I live, what affiliations I have, or talk about my patients in any detail at all. This, clearly, leaves me with very little about which to ramble incoherently and make fun of. It seems that, despite books like House of God and Complications, and far more successful blogs such as Pushfluids.com, my daily (ok, pseudo-weekly) discussions may be in violation of patient confidentiality rules, and I could potentially get kicked out of school, die, or even worse. All this because some damn resident wanted to have a party at the freaking Flower Market! It's a crappy space anyways - be warned. And the floor is slippery.
So I'm back to living in a depressing dormitory in some bunk town. I decided tonight that I'm going to spend every free hour at the Barnes and Noble. It's bright, has kick-ass foccacia sandwiches, and apparently employs every single gay man in this town. The level of sass is nearly unparalleled. And I've already established repor through my attempt to borrow a pen.
That's it for now. I thought I was going to write a big entry, but the heat in the computer room is jacked up to 100 degrees and I'm about to sweat through my khakis, so I'll leave it for another day. Suckas!

We Gotta Get Out of This Place

2004-11-09T13:28:00.000-05:00

It's my next-to-last day in the burg and I've got an hour left in my lunch break. The caterer for the office is on vacation this week, so it's fast food for all the docs. Yesterday was Pizza Hut and today was the most magnificent buffet of KFC I could ever imagine. I had 4 biscuits, 3 breast pieces and some mashed potatoes. I think I might vomit so I apologize if I have to cut this post short. What if I vomit in a patient? I had a great interaction with one of my patients this morning. He is a 50 year old man with hypertension and diabetes who was in to have a genital lesion checked out. (Score!) I often forget to take myself out of psychiatry mode. This is a problem. I need to learn to recognize that open-ended questions are not optimal for every patient. I should have realized this early on in the interview, when he was relating to me a ten minute drama regarding his job interview last week, after I asked him how he was doing. I mean this guy talks almost as much as fourth-year-Maggie. I'm persistent, though. And I honestly like to hear patients' stories, which is mainly why I love being a doctor. So, unfortunately, I failed to keep the questions direct in an attempt to adhere to my fifteen minute timelimit. Instead of asking him, "Is your diet generally low in cholesterol and sugars?," I queried, "What's your diet like?" Signal fire alarm noises. Here is the reply as best as I can remember it.

"Oh you know it's good I mean like for example now in the morning for breakfast I usually eat you know some wheat cereal but I don't use sugar because I use cinnamon instead and sometimes I mix in some of that fiber cereal too you know like that health food Oriental stuff or whatever and I mean I like cereal that's usually what I eat and I'll have maybe a bowl or two of that first thing in the morning and sometimes I'll have like a third bowl except on Sundays when my wife makes bacon and eggs because I figure you know that I'm allowed to have bacon and eggs at least one day and then after breakfast I'll usually eat some fruit like an apple or something and I really like apples or maybe an orange but you know it's getting cold and all the oranges are coming from Florida and I don't really like the Florida oranges so much and I know you're thinking that I should be eating more bananas but I eat a fair amount I mean I usually have one in the morning and maybe another one later on so I guess I don't really eat very many bananas but that's still probably more than most people don't you think because I was talking to my friend Bobby and he doesn't eat any bananas but he gets leg cramps something terrible and I told him that he needs to eat more bananas cause they've got like some anti-cramp chemical or something and I mean I like the taste of bananas alright it's just mainly that I like other fruit better you know and apples are really my favorite and then for lunch...."

"OK, that's great. Let's see that penis lesion."

My interaction with this patient was also notable for the fact that he was the most excited patient I've ever seen who has just been told he may have genital warts. The doctor I was working with was explaining in rather grisly detail how he would like for the patient to test for hidden genital warts by wrapping his penis in a washcloth dipped in a solution of 1 part vinegar and 6 parts water. (Seriously, this is the type of shit they are recommending in the burg. Can you imagine if I started telling this to patients in the C-spot? I mean, there were hand motions involved and everything.) The doctor explained that any warts will stain white with this solution and can be more easily visualized. Before he had even finished talking, the patient exclaimed, "COOL! That is really neat to know!," with enthusiasm that suggested he might have been considering taking a shortcut back home so he could see the magic for himself. And I'm sitting there like "What the fuck?" But different strokes for different folks I guess. I feel like this advice is going to spread like wildfire though. I mean, there is no way the patient is keeping that to himself. He's telling everyone he knows as soon as he gets home. I have this disturbing image of all the mechanics in the burg going home tonight, mixing the solution wrong, and causing serious damage to their genitalia. At least I won't be around to see the destruction. Suckas!

Our Aspirations Are Wrapped Up In Books

2004-11-08T18:32:00.000-05:00

Seeing as not one, but two fellow bloggers have posted about The Curious Incident of the Dog in the Night-time within the past 3 days, I figured I should weigh in as well. I borrowed the book from my grandmother the last time I was home, after noticing its prominently stenciled red cover amongst boring-looking hardcover books by Peter Jennings and John Grisham. When I picked it up off of the coffee table, Gram scoffed and said, "You can have it. I hated it. It's one of those weird books." Now, normally, my grandmother and I have pretty similar tastes in literature, although she goes a bit more for the historic biography than I do, and I'm probably a slightly bigger fan of Bret Easton Ellis. And there's the fact that she absolutely despises Harry Potter. On the other hand, we both love Truman Capote, and we both like to make fun of people who read The DaVinci Code. So I was a little skeptical, but the back-cover blurb was very enticing and the author looked just gay enough for it to be a must-read. I ended reading it in a sort of whirlwind session on my second day down here in Lynchburg, having finished I Know This Much is True the previous evening, and determined to beat Beestang's AIM record of 13 novels so I could sculpt a scene of me lying by a lake reading at our next Clinical Reflections. I've noticed that recently, one of the most important factors for me in judging a contemporary, hip author is the number of times I laugh out loud. Dave Eggers blows everyone else out of the water in this respect, because his sense of the bizarre is so well-honed and because his jokes are sudden. I can't tell you how long I laughed when Hand in You Shall Know Our Velocity writes "Here I Am...Rock You Like a Hurricane" on the pieces of paper. I was literally crying and my chest hurt so much I thought it was going to explode. Other authors that seem to have a similar ability include David Foster Wallace and David Sedaris, which leads me to think that my brother Dave got seriously screwed in the sense of humor department given his name. I mean, by all accounts, he should be fucking hilarious. Mark Haddon is no Dave Eggers. He's slightly less ironic, better looking and far more gay. But he does have a pretty good sense of the tragically absurd. Like the idea that the most crushing moment in the life of a child with Asperger's Syndrome, a disease related to but distinct from Autism in which the patients are higher functioning and slightly more socially adept (according to my Bible, the DSM-IV-TR), is not when he finds his next door neighbor's dog dead in the yard, not when his Mom dies (I'm not spoiling anything, don't worry), but when he realizes that he can't be an astronaut. Or the fact that he barely talks at all, but yet is able to defeat the local pastor in a spontaneous debate about heaven in front of his fellow special-education classmates. I was also impressed by Haddon's treatment of the disease. I agree with Vickie that it's become a bit cliche to create books and movies told from the perspective of people with mental disorders. As a budding psychiatrist, though, I must admit that I am generally fascinated by such attempts, as long as they refrain from beating the reader over the head with stereotypes (I feel like this was one of the few faults of I Know This Much is True, as Wally Lamb really tried hard to cram every single detail he read about schizophrenia into the character of Thomas, and while I'm sure it was very educational for the general population, I kept thinking to myself things like, "Why the fuck does he have to have his psychotic break his freshman year at college? Couldn't he be atypical in at least one department?") In this respect, I thought Haddon did an admirable job of portraying life from the point of view of an Asperger's child without torturing the knowledgeable reader. I found Christopher to be an engaging protagonist, and I'm pretty sure I gave a crap about what happened to him, which is always a good way to judge these things. I was legitimately scared when he was about to be run over by a Tube train, so there's that at least. The third and final thing I really liked about this book (Jesus, am I writing a fucking eighth grade book report?) was its use of math. I love math. I miss math so much. I'm not talking about addition and subtraction or fractions or even prealgebra, all of which is great, but all of which I still use on a day to day basis and therefore can't feel any sense of nostalgia for. I'm talking about word problems and trigonometry and calculus. I never knew how good I had it in middle school and high school. I was a Mathlete once, for God's sake. Actually, I was on a quiz bowl team. Actually, I was captain of my quiz bowl team. There is little that has filled my life with such excitement as racing furiously against the smartest kid at Lawrenceville (Kenny Easwarn where are you?) to determine what x and y are. Christopher loves math even more than I do, and that makes me happy to no end. And there are real live math problems in the book. Shit that I could actually sit down and try to figure out. And there's a whole chapter about a problem that appeared in Ask Marilyn in parade, a column that I have actually mailed in responses to. (Oh my God, seriously, this could be the most damaging post yet.) So, in the end, TCIOTDITN-T is not a masterpiece. Mark Haddon is not the next Barthelme. He's not even the next Nick Hornby. But he is a pretty tight author with a keen wit and a good sense of character development, which makes him sort of rare these days. So, if you have a few hours to kill, I'm putting in my recommendation for this book, even if Vickie disagrees with me and revokes my Tres Coloures trilogy.
I'm currently reading The World According to Garp after about 1000 recommendations, the latest of which came from someone whose opinion I can't ignore. Initially, I really disliked it. I only confessed this to Vickie, because I think everyone else would have attempted to lynch me. It's grown on me, though. I don't think Irving will ever be one of my favorite writers. He is too deliberate, his jokes are too drawn out and eventually predictable, and he tries a bit hard to be shocking. He does manage to create some truly amazing characters, however, and I think he may be one of the best observers of human nature I've read in a while. I'll let you know my final verdict later this week, before moving on the Midnight in the Garden of Good and Evil. Anybody read either Garp or Haddon? Anything else I should add to my list? Angela? Suggestions?

Home: Where I Wanted To Go

2004-11-03T18:56:00.000-05:00

Well, what can I say? I'll be halfway through my five year residency by the time we get another shot. I'm left with an overwhelming sense of failure more than anything else. I haven't felt like this since the day of my 17th birthday, right after I backed over the giant orange cone while attempting to parallel park my father's enormous Chevy Caprice Classic at the DMV on Route 1. I worry about our generation in the aftermath of this election. Our apathy in 2000 was a huge embarrassment, but it seemed like we had been given a chance for redemption. I think that for the past 2 years, most of us really thought that we would make the difference in this race. Active interest in politics reached levels I had never seen before across the campus. Med students were reading the newspaper and discussing relevant issues, rather than just beginning every single conversation with, "Dude, what rotation are you on?" The Class of 2002 was blogging furiously. Jordan was watching C-Span 4 hours a day for Christ's sake! And yet, for all of our efforts, we are left with the same dismal scenario. I worry that this massive disappointment will create a phenomenon of rebound apathy that will extend well into the next few decades among my peers. Perhaps I have far too little faith in our generation.

If there is one consolation I take from the results, it is the sense of belonging I feel amongst the C-town community. More and more over the past year, I've started to think about permanent career plans, and I have begun to realize for the first time how hard it would be for me to leave this place. Over the past seven years it has become my home, and despite the constant efflux of my friends, there is no other place in the nation where I would feel that comfortable. I know that if I have my way, I will stay for residency and beyond. After all, we've got a Thai restaurant, an independent movie theater, and wonderfully intelligent voters who supported Kerry by a margin of 72% vs. 27%. That is an astounding number, and it fills me with a sense of warmth and hope that not even the "Not gay!" chant could diminish.

Hail to the Thief

2004-11-01T18:54:00.000-05:00

Well, I'm still in the burg, and there isn't a whole lot to report, but I figured I should post something seeing as this is the eve of what is potentially the most important day in my 4 year medical school career, and when people read my blog 50 years from now, they may be curious about my thoughts regarding the buildup to the election. 4 years ago, I was probably sitting in my room in Lambeth with Jason, listening to Limp Bizkit or some shit on his computer, and confident that my own disgraceful voter apathy would not cost Gore the election. Thousands of other liberal college kids across the country were unfortunately probably doing the same thing. I remember the next night, watching Dan Rather's coverage of the election results with my roommate, Matt "TV Vampire" Day, and hearing that Florida had gone to Gore. I called Jordan, who was at school in Daytona Beach at the time, to celebrate the victory. I went to bed around 11pm and fell asleep without a problem, blissful in my ignorance of the impending doom. At 2am I was jolted awake by some asshole frat kid running around Lambeth Field screaming "Woohoo! Fuck you liberal fuckers!" at the top of his lungs. And that's when I realized we were (how apprepeau) fucked.
A lot has changed in four years. I'm still sitting in a dorm room at my computer, but now it's a sketchy nursing dorm and a laptop on loan from the school. I'm still listening to music, but now it's Diana Krall. And instead of feeling secure despite inaction, I'm feeling terrified despite knowing that I've done everything I possibly could to influence the outcome, short of locking Steve Smith in my closet (which I tried, but his skin is really too slick to hold onto.) Tomorrow's election, for me, is not about Iraq. It's not about terror. It's not about health care. It's not even about My Pet Goat. It's about basic human rights. It's about the right of every man, woman and child in this country to live the way they want to, to express their full beings, to be free. It's about women being in charge of their bodies rather the government. It's about 10% of the population (and that's a gross underestimate, really) being able to publicly display love and receive the same benefits accorded to the other 90%. It's about black people in Florida being able to vote for fuck's sake. And finally, it's about the separation of church and state, a concept that seems to be in serious jeopardy when the leader is going around claiming that God is speaking directly to him and influencing his policies (which, by the way, would be automatic criteria for admission to the psych ward in most ER's.)
I like to attack Bush. It's easy. Sometimes, I think he may be retarded and should probably be wearing Velcro shoes. But it's not even about his lack of qualifications or the way he manages to make his mouth disappear when he tries to think really hard or the fact that he choked on a pretzel or his inability to say the word "nuclear." It's about his megalomania, his complete lack of tolerance for women and minorities, and his innate sense of entitlement. It's time someone took Daddy's credit card away from him.
But I won't move to Canada if he wins tomorrow. I'll probably drink a few beers, cry a little, and go to bed. And I'll wake up on Wednesday ready to start fighting for 2008.

Bob Packwood Wants to Suck Your Toes

2004-10-25T19:04:00.000-04:00

Yeah, yeah. I know. Quit bitching and create your own blog. I'm stuck in the burg, writing this blog from the dark cave that is the hospital's physicians' library. I'm staying in a nursing dorm that's attached to the hospital. It's awesome. About as awesome as the nursing students that inhabit it, like the lone male nurse who wears a cowboy hat, hoots and hollers at 1am consistently, and is going to need serious therapy later in life when his homophobia-driven defenses break down. There's also the middle-aged woman with the Captain Kangaroo haircut who supervises the dorm between the hours of 3:30 and 11:30pm, and who manages to bust out of some random-ass doorway and scare the crap out of me every time come in late at night. I've managed to have some fun down here though. Last week, I cleared out the common room by popping in an episode of Real Time with Bill Maher and letting nature take its course. I've also been blasting Walking Back to Jesus Part 2 by The Broken Family Band with my door open, which I think is confusing the hell out of people, who can't equate the lyrics "I love you Jesus Christ" with Bill Maher talking about Mary Cheney's strap-on collection. It's a beautiful thing.
By far the most exciting part about the burg, though, is the fact that Jerry Fallwell lives here and is the president and founder of Liberty College, the national dumping ground for dimestore hookers and junior car thieves whose parents happen to be overzealous, hyperreligious cultists. Last Thursday, for my birthday, Molly Meek took me to Scaremare, the annual haunted house put on by Falwell's followers. I knew it was going to be fantastic from the start. First, we waited in line in a cornfield for an hour and 45 minutes, listening to some DJ on some broke-ass radio station broadcast live from the event. As we approached the ticket booth, we were able to pick up not only brochures about Liberty, but also an actual application, from a girl who looked suspiciously like Lisa Beth Sandstrom. The first two questions on the application asked for the name of the church you belonged to and the pastor. Minor details, such as GPA and SAT scores were number 15 and 16, respectively. I was really disappointed, though, that there was no essay question, because I was pondering some really killer topics. For example:

1. If God gave you a single lightning bolt, would you smote an abortion doctor or a faggot? What if the abortion doctor was Muslim?
2. If you were a saint, who would you be and why?
3. Abraham begat Issac. Discuss how this proves that gay marriage is against the law of God.
4. What would Jesus do?
5. Choose one of the following literary masterpieces and discuss how it has made an impact on your life: The Bible.

Ok, sorry. So eventually we got to the actual haunted house. I was the first in a group of 8 people, which included Molly and 6 Liberty students who literally called each other gay 278 times during the wait in line. And they were playing a game whereby the tried to hit each other in the penis when they weren't looking. I can't make this shit up. First, we were led through the woods by this not-very-scary man in white face paint. We were greeted by your usual nondescript drama majors in white lace dresses who moaned and such. Boring! The main part of the haunted house was in an old abandoned warehouse. If nothing else, I give the whole thing an A+ for darkness. Seriously, that was the best job of blocking out light I have seen in a while. If I had my eyemask on, I couldn't have done much better. Basically, the whole experience was windy hallways and college kids jumping out at you and screaming. Oh yeah. And the abortion room! There was a room filled with aborted fetuses. They were actually fetal pigs with white gowns on them, which is perhaps far scarier, but they were meant to represent the horror of abortion. And this was supposed to be the scariest room. Seriously.
But then, the best part. Up until the very end, things had been somewhat anticlimactic. The abortion room was somewhat of a consolation. But I wanted real, genuine, crazytalk. I wanted purple teletubbies burning in the pits of hell. I wanted Larry Flynt getting lynched by the Pope. I wanted Bert and Ernie lying peacefully in bed together with Satan suddenly popping out from under the covers between them. And man did I get what I wished for.
As we were exiting the haunted house, we had to walk through the woods to get back to the parking lot. There, for all to see, in the middle of a circle of spotlights, was Jesus Christ. Nailed to a wooden cross. Draped in a barely concealing white gown. With a crown of thorns. And druids surrounding him. No shit! I was so excited I nearly peed my pants. I honestly might have been jumping up and down. I was interrupted, though, by this kid who asked Molly and I if we wanted to join him in a tent to learn about the man that made this all possible, the namesake of progressive multifocal leukoencephalopathy, himself, the big JC. Molly looked terrified and was clearly about to say "No thanks", but luckily I was able to shove her behind a tree and scream "Would I?! Would I?!" We gathered in the tent with about 10 other people, only 2 of whom looked as horrified as Molly Meek. The kid who was herding us in took a deep breath and began speaking at a rate and volume that seriously had me debating the merits of Depakote vs. Valproate in my head.

"DoesanyoneknowwhyweareheretonightweareherebecauseGodcreatedheavenand
earthandhecreatedAdamandEveandhecreatedtheuniverseandthenthousandsofyears
lateramancameandthatmanisthemanyousawnailedtothecrossjustnowdoesanyone
knowwhothatmanis-"

"Mark Profitt."
(I am on the floor at this point)
"Ummm...ummImeanwhoherpresentsherepresentsJesusandJesusdiedforoursinsand..."
I kind of tuned out at this point, but there was some praying, and the kid asked us basically to reveal to him in private whether we had sinned against Jesus, and I thought about reminding him of the fact that is was very sinful to interject yourself into matters that are between God and another individual, but I was tired, so I left that battle for another day.

I leave you with a wonderful quote from my new hero, Bill Maher: "9/11 wasn't a triumph of the human spirit. It was a fuck-up by a guy on vacation."

Buzzkill (Not About Kate's Boyfriend)

2004-10-04T15:03:00.000-04:00

I was all excited to come home early and write a hilarious blog about my experiences as a volunteer at the mock disaster yesterday, but something happened just as I was getting ready to leave the hospital. I started on the GI service, today, which was an experience in and of itself, including a 45 minute firing squad pimp session with the attending, and we had been running around all day, going to various lectures and draining straw colored fluid from patients' abdomens and such, and I hadn't yet gotten to see the patient that my team assigned to me. I had read the guy's entire chart earlier, and I thought I had a pretty fair idea of who he was - older guy, former alcoholic with cirrhosis of the liver who now had hydrothoraces which we were attempting to drain. He was on contact precautions, though, and I didn't really feel like gowning up, so I had postponed going to say Hi until the end of the day. As I walked to his room, I realized that he had family visiting, and I was going to just say "Fuck it" and wait until morning to meet him, but I decided to go in and at least introduce myself. As I begrudgingly put on my gown and gloves, I was looking at the woman sitting in the rocking chair, but nothing registered. Until I walked into the room and saw the patient. Suddenly, I was transported back to psych 5 weeks ago. Holy shit. This guy who I wrote off as some poor, self-destructive alcoholic is the same wonderful, charming man I interviewed a month ago on a psych consult as part of his workup for liver transplantation. 30 days ago, he was sitting up in a chair, laughing and reminiscing about his experiences as a coach of four different high school sports, flanked by his supportive wife and daughter. Now, he was lying in the hospital bed, unable to sit up, barely able to speak, and in a great deal of pain because his chest tube has been displaced and the surgeons haven't gotten around to fixing it yet. And he's probably dying.

There are a few important points to this story. For one, the man who now carries a diagnosis of alcoholic cirrhosis, and who everyone now seems to write off as a guy who fucked up his own life wasn't really an alcoholic by all accounts, any more than you or I are alcoholics. He went out with his friends from work once or twice a week and had 5 or 6 beers. Sound familiar? Now, certainly, it may be a different story when you're 45 vs. 25, but he's clearly not the gutter drunk we all think of when we read that diagnosis - in and out of 5E constantly for detox for years and years.

The second point is the idea of patient continuity. As in it doesn't exist when you're a med student. I think all of us create in our minds these fantasy lives for all patients after they leave the hospital. For some of them, we know that the future looks pretty bleak, and we would almost expect to see them back in the hospital should we return to that service during our fourth year. For others, though, and in fact probably for the majority, we think that everything about their lives will be fabulously carefree once they are discharged. That's certainly what I expected five weeks ago for my psych consult. I presented him to the attending, Aamir did an impersonation of his mental status exam, we went to see him, and that was it. As far as I was concerned, his donor liver transplant was magically going to arrive within the next week, he was going to fully recover from the operation, and he was going to return to coaching girl's youth basketball and live happily ever after. My bubble got burst today, though. And it sucks. But it inspired me to do something I might not have done otherwise. On my way out of the hospital, I went down to 4C, the cardiology floor, and stopped by to see my 71 year old patient from last week who is awaiting cardioversion later today. He's doing fine. And, hopefully, he will continue to recover, and he'll be able to go back home to take care of his ailing wife. In the meantime, though, I'll be keeping an eye on him.

There's a Tear in My Beer

2004-10-02T01:46:00.000-04:00

Drunken blog. I've just returned from South Street, where I had a fantastic time with Paul, Catherine, Lauren, Allie, and Vickie. I'm sitting in my room, eating Ramen, drunk to the point of hypersomnolence, listening to my iTunes playlist. And something Ben Kweller said just hit me hard. "You are free if you can sleep at night." I think I'm finally getting there. I've been running on 7 hours per night all week - quite a change from my former average of 9.5 hours, which I managed to maintain throughout undergrad and the first two years of med school. The amazing thing is that I feel great and that I no longer require 30 minutes of restless tossing and turning prior to falling asleep each night. I hit the pillow and I'm pretty much out for the night. Finally, after all this time, I'm free. And it's amazing.
I love my iTunes list. Here's what I've been hearing:
Death Cab - Expo '86 - Awww. Ben Gibbard is the bomb. I'm such a happy drunk.
LL Cool J - Mama Said Knock You Out - Good lord, I'm actually shadowboxing. This video is fucking awesome by the way. Poor LL. What happened to his career? Headsprung?! I think not.
Blink 182 - All the Small Things - When the fuck did I download this song? I think Jason must have put it on my computer. Seriously, this band is terrible in terms of lyricism. But that song about suicide is pretty sad I guess. My mom thought so at least. Seriously, we had like a 30 minute conversation about it one time.
Gimme a Break Theme Song - Skip. Why the hell do I keep 256 TV Theme Songs on my playlist?
The Darkness - Friday Night - Interestingly apprepeau. Thanks to Catherine and Tom though, all I can really think about is the weird tattoo that may or may not be elaborately sculpted pubic hair on the lead singer. Who totally looks like Tiny Tim by the way. I actually thought Tiny Tim had a new video out when I first saw I Believe in a Thing Called Love on MTV. Speaking of which, my Mom totally thinks Fang hASSELHOF looks like Tiny Tim. Another 30 minute conversation. God, why don't we ever talk about anything normal?
Jack Johnson - Cookie Jar - Too bad he got way too political on the second album. Seriously, I liked him way better when he was just some surfer with fun drum beats. Once he got into discussing oil drilling and television violence, I kind of lost interest. Next.
Sufjan Stevens - In the Devil's Territory - Never heard this before. Ooh, I like it. What is this song about? Hmm, the end's a bit repetitive, but overall still good. Is Sufjan Stevens Indian? Because it damn sure sounds like it and I always picture some guy with a beard playing the sitar. I'll have to burn it tomorrow.
Mulholland Drive Soundtrack - Llorando - I'm done. Saddest song ever, hands down. David Lynch is a fucking genius. Goodnight.

Oh Snap! I Need a PT and a PTT!

2004-09-30T20:36:00.000-04:00

God, I am such an asshole. I picked up two patients earlier this afternoon, which means I'm pretty much done for the day, so I've kind of been dicking around since 7, stuffing my face with free Chinese food (how is it that doctors are constantly provided with what is seriously the most unhealthy food on the planet) and wandering around to various rooms chatting with random patients. According to the laws of the cardiology service, every time a med student is on call, they have to admit 2 new patients. Once you're done with that, you are free to go as soon as your resident says you can leave. My resident happens to be awesome, so he basically told me I could go anytime starting like 2 hours ago. Finally, after an exciting chest pain incident with one of my new patients (see below), I decided I could probably head home and not feel too guilty, since it was only 6 hours earlier than the time Danielle left last time she was on call. So I'm like skipping out into the hall singing "Ooh Baby I Love Your Way" for no apparent reason, and I'm stopped dead in my tracks by this poor, poor couple who are standing outside of the CCU hysterically crying because someone in their family has probably either just died or received really shitty news. And there is this horrible, awkward, painful moment when they look up and see me, and see that I'm smiling, and stare directly into my eyes. We are frozen in time, my singing and their sobbing interrupted for a split second, and then we quickly turn away to hide our respective shame. I want so badly to go and comfort them, but instead I am hiding out in the student call room, unable to leave because they are standing in the elevator portal that I need to use, and I know I could never face them, now that I'm that dickhead who they will always remember, singing fucking 1990's pop as they experience the most heart-wrenching moment of their lives. Seriously, shit like this always happens to me. I'm just going to start being morbid and dressing in black and smoking clove cigarettes and whatnot (thank you Stephen Merritt) and that way I'll always be prepared for tragedy and not have to worry about being that kid.

In other news, I had a moment of clarity earlier tonight. For the past two weeks, I've been really thinking hard about whether I want to try to do a dual residency in Psychiatry and Internal Medicine, or whether I should just do a residency in Psychiatry. There's about 563 influencing factors, but it basically comes down to a decision about education, because either way, I most likely will only be practicing Psychiatry. In other words, the extra training in internal medicine would be mostly for personal edification, so that I could continue to learn about general medicine and feel more competent addressing the medical issues of my psych patients. For example, it seems unfathomable to me that tomorrow could potentially be the last day I ever do anything related to Cardiology, and I could go the whole rest of my career without having to determine whether a QT interval is prolonged. I don't want that to be the case, even though I know that it's not what i want to do every day forever and ever amen. I just want to do it for another half decade or so. I tend to rapidly fluctuate on the issue, but earlier today, I was leaning towards straight Psychiatry, especially as I watched my intern, already struggling at 9am, mentally try to prepare himself for his 36 hour shift. Tonight, though, my perspective changed a bit. I remembered for the first time in a long time, why I came to med school. One of my patients, a 71 year old man with extensive heart disease who presented earlier today with shortness of breath, started to have chest pain. There's a whole protocol that we run when this happens, and it involves staying with the patient, at his bedside, until the chest pain lowers in intensity to a 1/10. As we stood there at his bed, I watched my intern rapidly make decisions and integrate various bits of information. And something strange happened. I got excited. I was calling out lab values and medicine allergies from memory, and I was actually doing something helpful in an acute setting. This doesn't happen much as a med student. Usually, you're there to gather information and mostly to learn, often at the expense of the resident's time and effort. When you do something "important," it's usually just a matter of saving the team the hassle of having to do it later. There's very little that you do that wouldn't get done if you weren't there. Tonight was different (At least, in my current state of heady narcissism, I like to think that it was. Really, it probably wasn't.) And I realized that, although psychiatry is what I want to do for the rest of my life, I wouldn't mind a couple years of making quick medical decisions and managing acutely ill people. I want to call for some Morphine stat. I want to scream, "What's he satting at?" I want to run a goddamned code. Because, deep down, I want what every med student wants. I want to be George Clooney.

Naked Baby Photos

2004-09-27T15:22:00.000-04:00

First of all, let me update you on the whole MMSE saga. So, this morning at rounds, we were on our way to see one of the new admits from last night, an 80 year-old woman who came in with several episodes of fainting and some chest pain. My intern was presenting her to the whole group, which includes our senior attending, a cardiology fellow, 4 residents, 3 interns, one fourth year med student and 3 third year med students. Halfway through his report of the physical exam findings, my intern is suddenly interrutped by the attending, who asks, "What is the patient's mental status?" I am so shocked that it takes me a minute to process this question, but as my intern frantically flips through his notes, looking incredibly flustered and a bit sweaty, I blurt out, "22 out of 30 on the Mini-Mental!" OH SNAP! There is a moment of shocked gasps as everyone looks at one another in disbelief over the fact that some asshole actually did an MMSE. Then my attending turns to the fellow and asks, "Is that bad?" I then basically got to explain the MMSE score profile to the white-haired attending, who seemed somewhat fascinated by the whole concept. I've been on a high since this morning. Not that it meant shit in terms of our treatment or anything else. After the explanation my attending just turned back to the intern and was all, "The edema was 2+ pitting?" Nonetheless, I think I scored 1 for the Psych dept.

In other news, this Mormon in our class just emailed 4 emails worth of graphic pictures of his baby being born. I was sitting here in the library and started opening them. Bad move. I was frantically shutting windows and freaking out with pretty much the same intensity as if beastiailty porn had been popping up on my screen. Talk about graphic. Seriously, if you're going to send pics of your new child, I want to see some blankets and knit caps on those fuckers. Screaming, naked, blood smeared alien forms is not a comforting image to have pop-up on your public computer. I swear there might have been vagina in one of the photos. Some warning would have been nice. I've done the OB rotation and I'd like to think I've permanently made my peace with such images and moved on. Furthermore, there is an alarming prevalence of touchy-feely emails going around in SMD'06. A brief paragraph about the birth would have been fine. I didn't need to know the far-reaching ramifications in terms of family dynamics, nor did I care to hear the method of delivery of all of your children. I think some modesty would be appreciated by your wife. I'm going to hell, so I'll stop for now.

You Down with MMSE...Yeah You Know Me

2004-09-26T21:42:00.000-04:00

Hour fifteen of my Sunday call is progressing fabulously. I've been entertaining myself all day by doing Mini Mental Status exams on all the patients we're admitting. I've done 9 so far. Generally, the MMSE is used primarily for Psych patients, although that is mainly because other specialists are too lazy and stupid to utilize it (I'm going to stop apologizing for my sweeping generalizations at this point.)
Side Note: I just got actually called away from the computer to take an urgent phone call from the lab. I have no idea what's going on, but I apparently need to report this value to my team ASAP. They even took my name down. Bitches.
So anyway, the MMSE is this brief exam which tests various mental functions and is used as a serial assessment for cognitive disorders, such as delirium and dementia. Considering that 40% of elderly patients admitted to the hospital become delirious at some point during their stay, you would think it would be a highly utilized method of analysis, but then again, considering that 40% of doctors are dickhead surgeons, I guess not. Nonetheless, it's very fun to perform, as you get to come up with various objects for patients to try to remember, and you get to see the ridiculous things people come up with when they are asked to write a random sentence. The maximum score is a 30, and scores of 23/30 or lower are particularly worrisome. I had a woman today, who carries no cognitive diagnosis, score an 11. Guess who's getting a new diagnosis on her discharge summary courtesy of yours truly. If you guessed that woman, that was a very impressive use of logic, but the actual answer is likely no one, seeing as I will probably be laughed at to no end when I present MMSE scores as part of my physical exam at rounds tomorrow morning. I plan on making a big deal of it though.
Nothing else much going on. There is this awesome nurse on the floor here who wears an old-school nurse's outfit every day, including a white cap, a white styrofoam hat and a fitted one-piece dress. She is the bomb-dig. I pointed her out to H-dawg one time on Psych consults and he proceeded to relate a 30 minute story to me involving his experiences as head dinner boy for his dorm at Oberlin College. It was awesome. Then he threw a book at some resident. Just kidding. Because he's Buddhist.

Not Quite as Cool as Slap Bracelets

2004-09-24T17:17:00.000-04:00

I never would have thought that I'd be this wildly excited to be off for 36 hours, but when I think of the poor surgery people, I'm thankful for what I've got. For those of you who haven't seen me in a while, I've become that guy. You know, the one in khaki pants, a polo shirt, flip-flops....and the yellow bracelet. Yup. I'm wearing a f'ing Lance Armstrong LIVE STRONG rubber ring around my forearm. Trust me - I'm as shocked as you are. Normally, I'd expect be subject to gut-wrenching nausea every time I saw somebody wearing one of these things on grounds. I mean, seriously, there are few easier targets. I feel like it's one small step away from pasting a giant American Flag sticker on the front of my car. Somehow, though, it's sort of empowering and inspiring. I was first introduced to the #1 fad of the summer by Ante's brother, Thys, who, apparently is a huge Lance fan. (This revelation came, I believe, immediately after the wonderful reenactment of Ante's Mom's pantomime of "rodeo" during a family game of Cranium, which involved elaborate stacking of couch cushions, rocking back and forth with one arm in the air, and Ante's father repeatedly screaming "That looks familiar.") Thys is, of course, a pretty cool guy, and, as far as I know, does not own any apparel featuring images of deer, so I figured the bracelets couldn't be all that bad. Next, I went home and found Jeff wearing one. He explained that the money went to charity, and added that many people from Lawrence High "think they are gay." Score 2 points for the bracelets. The clincher, though, was the fact that Allie's Dad bought 100 of them for Allie to give out to her Peds patients in Fairfax. Not only did I find this to be one of the most creatively generous ideas ever, but it meant that I didn't even have to get off my lazy ass and figure out how to obtain one for myself. And so I wear my LIVE STRONG bracelet proudly for the world to see. I still cringe when I walk by a group of drunk frat boys harassing some geek-chic English major on a Friday night and realize that they are all wearing the same accessory, but then I remember that it's all about the positive message. And I frantically roll down my sleeve in case anyone sees me.
In reverence to Lance Armstrong, I leave you with this story passed down from Doug's dad, a practicing psychiatrist.
He was on the wards the other week and got called down for a psych consult on a newborn baby with giganticism of the testicles, which totaled 4 lbs, who was potentially withdrawing from maternal narcotics. He evaluated the infant and called the peds attending.
When asked what his diagnosis was, he replied, "The kid's half nuts."

In Which the Title is Ridiculously Pretentious

2004-09-23T16:34:00.000-04:00

Don't call it a comeback! OK, well, actually, maybe you should, but don't tell LL. Good Jesus! It's been a while. As most of you know, I've been on a psychiatry whirlwind for the last six weeks, and I'm thrilled to report that someday, regardless of what else happens, I plan to be board-certified in Psychiatry. I did pretty much nothing except talk to patients for the entire time, and I've never felt more gratified in my life. I can't imagine getting paid to do something you enjoy so much - it seems like an odd concept, which I guess is good, considering I pretty much won't be making any money for at least another 7 years. It was wonderful to wake up every morning, knowing that I was going to be doing what I love for the entire day. God, I sound like some fucking LDS (Latter Day Saints, DICK!) commercial advocating community service. Sorry. Anyway, I'm now onto the first of 2 weeks of cardiology, which so far I must say is somewhat less exciting, if not also about a gajillion times more incomprehensible. So what does this all mean for the blog? Obviously, Psych is bad for the blog, judging by a my post rate, which is weird considering it's potentially the slackest of all rotations. The problem, though, is that, if you actually enjoy it, there's a ton of stuff for you to do and you can manage to work long hours and spend most of your free time reading about it. (I know, I know, Nerd alert). I think that speaks very much to the attitude of psychiatrists vs. other docs. Psychiatrists are generally the most laid-back people I know - they all love what they do, and if you love it too, they will adore you to no end. If, on the other hand, you're some orthopod construction worker, they respect that, and see no reason why they should punish you or go out of their way to try to convert you. It seems as though other specialties don't share this attitude. Surgeons, for example, seem to feel that everyone needs to suffer through the most intense rotation ever, regardless of whether they have any interest whatsoever in the field. I find this odd, because, in my opinion, surgery is the least universally applicable specialty in medicine and psychiatry is the most. God, when is this post going to get entertaining. So here's the breakdown: I'm on medicine for the next 11 weeks. During that time, I'm going to try to post for 15 minutes each day. That's a valuable chunk of my nightly pleasure-reading time, which means I could take an extra month to get through I Know This Much Is True (who the hell knew that an Oprah Book Club book could be so well-written?), but I'm willing to make such sacrifices for my readers.
So I've got 3 minutes left. I was driving through the Harris Teeter parking lot earlier today and realized what a complete disaster zone that place is. I was thinking to myself how surprising it is that there's not an accident every five minutes, because there are some terrible, terrible drivers that do their shopping at Barrack's Road. In the span of 30 seconds, I had to break for a sorority girl on her cell phone driving an enormous SUV and drinking a Smoothie King smoothie, 5 Mexican guys in a Honda blasting salsa music, and some asshole frat boy who had a Phish sticker and a W sticker on his ugly Jeep. I think I have some scary premonitory ability, because when I came out of the grocery store, sure enough, in the middle of the aisle were 2 cars who had just backed into one another. Seeing the occupants, though it wasn't all that surprising. Both were guilty of driving while Asian. One was this East Asian chick in her black BMW with the annoying kid in the back, and the other was this Indian woman dressed in a sari who was screaming at her husband the whole time. I don't know what the point of the story was other than the fact that I love stereotypes and so I present the Top 5 worst driving groups:

5. Sorority Chicks in SUV's
4. Gay boys in VW Beetles
3. Asian Men in Hondas
2. Asian Women in Hondas
1. Asian Women in fucking Toyota Camry's

I'll hit you up tomorrow. Peace out.

I Saw You With a Ticket Stub In Your Hand

2004-07-29T15:03:00.000-04:00

Quick note - If anyone is interested, Phish's last show ever will be broadcast live at the Regal theater in Ballston on Sunday, August 15 at 5:30. I'll be there, dancing in the aisles. Tix are $20 and available on Fandango.

And If You Don't Like It, Then Hey, Fuck You!

2004-07-23T12:30:00.000-04:00

Sometimes I wonder if I should be using all this down time to study for my exam in 2 weeks, but then I remember that the answer is always either preeclampsia, placenta previa, or placenta abruptio, and I'm reassured. Surprise, surprise - there is nothing of interest going on in clinic. Actually, this morning was probably the busiest clinic day I've had in the past 2 weeks - I managed to see 6 patients in 3.5 hours. I thought now would be a good time to recap recent pop cultural goings on.

On the music scene, I've been listening heavily to 2 amazing hip-hop CD's - The Streets' A Grand Don't Come for Free and The Beastie Boys' To the 5 Boroughs. This is pretty significant, considering that I haven't found a rap CD I could listen to repeatedly in its entirety probably since Mos Def's Black on Both Sides, and I haven't legally obtained a rap CD since Biggie's Life After Death. This is in stark contrast to back in the day, around grades 7-9, when I would literally spend every last penny of my allowance money on rap CD's. Every Friday night, I would convince my Dad to take me to (Nobody Beats) The Wiz, which always managed to somehow offer CDs for at least $5 cheaper than all their competition (I long suspected a Crazy Eddie - type set up, in which all of the merchandise would later be discovered to have been stolen off the back of trucks). It didn't matter if not a single new CD had dropped that week - my goal was to own every rap CD in the store, and for a while there, I was well on my way. At that point, rap hadn't gotten so enormous that this was a totally unrealistic goal. Snoop had just hit the scene, and all 230 members of the Wu-tang Clan (The RZA, The GZA, Ol Dirty Bastard, Raekwon, U-God, Ghost Face Killer, Inspector Deck and M-E-T-H-O-D Man) were still together. Man, did I buy some crappy CDs back then. I didn't care if I had never heard of the group - all I wanted was quantity, baby. To give you an idea of my collection, here's a few names I found on my shelf the last time I was home: Hoodratz (both albums), Ya'll So Stupid, The Artifacts, Smif N Wessun, The Goats, Da Bush Babies, Da Lynch Mob (3 CD's), and the follow up Kriss Kross album (not the one featuring possibly the greatest song ever written - I Missed the Bus). By the time I reached 10th Grade, though, my music tastes had matured, and I began listening exclusively to country music, largely thanks to the influence of my older brother. That phase also represents an amazing collection of terrible, terrible CDs. My point in all of this is that it's been a hell of a long time since 2 rap CD's received such heavy rotation on my stereos. The other interesting thing is that the two CD's I'm currently listening to couldn't be more different. First, you've got The Streets, aka Mike Skinner, an MC/DJ out of Brixton, England, who apparently blew up a couple years ago with his debut album, although I hadn't heard of him until recently. Without a doubt, he's got some of the nastiest beats I've ever heard, but what's even better is the way he constructs his stories. It's been a long time since rappers wrote songs about something other than how much bling they have or why they're the greatest MC, but Skinner puts together narratives that, I dare say, rival Slick Rick in terms of plot line and flow. The whole CD is one long recounting of his failed relationship, and by the end of it, you feel intimately attached to the guy. He's not just some flash-in-pan who hired Kanye or Rick Rubin to drop a dope beat and then combined all of his greatest two-liners into his one-hit song. This guy's a poet in a much truer sense, and it's been a long time since we've seen that. As someone whose written a fair share of, albeit ridiculous, rap songs, I know that it's pretty damn easy to write a bunch of nice rhymes about random shit like how much people are going to dance when they hear your track or why every other rapper in history is wack compared to you. What I've never been able to achieve is to tell an interesting story while maintaining a vocabulary beyond monosyllabic words and rhymes like Yo/ho. It's just not that easy, and yet Skinner does it consistently for 11 tracks, all the while rhyming with this adorable British accent and saying things like "The queue's outrageous" and "Yeah, yeah you are fit and yeah I do want it / But I stop sharkin' a minute to buy chips and drinks." This makes it especially great for white boys, who can cruise around in their Saab's with the windows down (I'm speaking hypothetically here) and not be embarrassed by having these beats blasting out of their car, because the guy is pasty and British, for Christ's sake. There's not a bad song on the whole CD, but the real stand outs are tracks 1, 7, and 10. I encourage anybody who hasn't heard this to go out and buy it now - it's currently my vote for album of the year.

Also on heavy rotation and repping it once again for the Caucasians are The Beastie Boys, who, with their latest album, hit a high note that they haven't come anywhere near since License to Ill. I'm not saying it's as good as License to Ill - it's not. Then again, License to Ill is probably my favorite rap album of all time; not only is it the first one I ever heard, but it also includes the first track I ever performed live (Paul Revere, in third grade, for my advanced reading class, following encouragement from my teacher (At the time, I remember being really confused by what the hell Adrock did with that whiffle ball bat)). In between, The Beasties have put out some solid material. Some would argue that Paul's Boutique is a phenomenal CD, and while I would generally agree, I don't think it fits together as a whole as well as its predecessor. Check Your Head also has some incredible tracks (if I had to pick one all-time favorite B-Boys song, it would almost definitely be So Whatcha Want), as do Ill Communication and even Hello Nasty to some extent, but nothing has ever grabbed me the way that first listen to License to Ill did. Until To the 5 Boroughs. From the first horn blast of Check It Out, Mix Master Mike's insane beats, combined with the just plain stupid rhymes about Star Trek and Mr Belvedere put a smile on my face that I just can't get rid of. There are some bombs, for sure. I never really loved it when The Beastie Boys got too political, which they tend to do a lot on this album, and MCA rapping about the Kyoto Treaty on It Takes Time to Build just really doesn't do it for me. Nor does the painfully sentimental An Open Letter to NYC, which is almost unforgivable in its need to actually name all 5 Boroughs in the hook. Overall, though, such lapses are made up for by some of the most slammin' tracks in years, notably 3 The Hard Way and Hey Fuck You. It's been a long time since there's been a musical moment that gets me so consistently pumped as when Mike D shouts "I just yell 'Pull' and Mike drops the beat" on Hey Fuck You, just as Mix Master indeed follows the command. Overall, To the 5 Boroughs may be the album of the summer, in terms of fun, happy, driving music, and if you haven't checked it out, you need to go spend the $13 in change that's in your sock drawer.

A-shush

2004-07-22T14:24:00.000-04:00

Man, there is seriously nothing going on in clinic. I just packed this woman's C-section wound, and I've been sitting here in the resident room for the past 30 minutes staring blankly at my newly purchased First Aid for Step 2 book. Back to the weekend recap, since there clearly isn't anything of note occurring otherwise.
So I'm pretty sure that Junzhong spotted me at least once during the evening, despite my best attempts to dive under tables and hide behind stacks of Amstell Light bottles. Surprisingly, though, and much to my relief, he didn't attempt to converse with me, and generally seemed to be acting relatively normally. Perhaps our fourth year represented one of those experimental stages, and once he tired of harassment and diving headbutts, he went back to being a normal physics grad student, contemplating the existence of a fifth dimension, or whatever it is that physics grad students do. Actually, it seems to me that, based on my experience, they must spend a lot of time practicing how to minimize the use of articles in their everyday speech and staring at prismal light beams.
Another highlight of Friday night involved being repeatedly interrupted by this guy at the next table over, who seemed to be one of those types who assumes everyone at the bar is there with the hopes of being engaged in his witty banter. Periodically, he would turn to Naomi, Catherine and I and shout cryptic statements at us. Basically, the conversation went something like this:

Catherine: I can't wait to go to Dr. C's house. He loves us. I mean, he loves us. You guys, Vickie and I saw him yesterday and he waved. He loves us.
Me: Uh-huh. I just feel bad because-
Random Guy (to me): HEY! You know the code, right?
Me (Figuring agreement is the best option in this situation): Yeah. (Turning back to our conversation) I feel bad for-
Random Guy: Protect the code! You would never give up the code, would you? Tell these women that you know the guy code and you would never give it up.
Me: Yeah, honestly, I have no idea what you're talking about. Sorry.
Random Guy: The code! You don't know the guy code?
Me: Nope.
Random Guy: Guys have a code and we'll never give it away! Never! (Turning to Naomi) Girls have a code. You'd never give let a guy know your secrets.
Naomi (Winning the "Ain't Takin' No Shit" Award for the evening): Listen, nobody knows what the fuck you're talking about. Why don't you just go back to your own conversation. (Turning back to Catherine and I) Jesus, are we in The Matrix?
Catherine: Dr. C loves us.

The excitement continued on Saturday with a public demonstration of Dr. C's love for his other POM group. Segue to quick background story.

Last semester, for my POM class, which meets in small groups of 6 with a physician mentor, I had Dr. C as my mentor. As it turned out, one of the other mentors had to take an unexpected leave of absence, so Dr. C picked up a second group, which happened to include Ante, Vickie, Catherine and Ashish. After the first week, no one was all that keen on his very serious, by the book approach. Several Starbucks sightings and long conversations about the military later, though, opinions were suddenly changed. Unfortunately, though, Dr. C's own attitudes regarding the two groups veered in somewhat different directions. This was perfectly understandable, seeing as the original group consisted largely of very quiet, well-trained students, who generally didn't know each other very well, while the adopted second child was this playful ball of crazed if misplaced energy, 4 of whom spent most weekends getting drunk together. It wasn't long before every Wednesday became yet another opportunity for me to hear about the wonderful show-and-tell items Dr. C had brought in that week, all the while wondering why our session the day before had featured no such items and, in fact, no conversation at all that did not directly relate to the case at hand. Joon, Danielle, and I were lucky enough to be spotted by Dr. C around town with various members on Group 2 on several occasions, and therefore managed to elevate ourselves above the remainder of the group. My extensive knowledge of poisonous spiders also earned me bonus points as I won the paperweight contest over Jennie Edwards, bringing the total score, as Ashish so eloquently put it, to "Wednesday POM: 50 billion; Tuesday POM: 1. Even my stunning victory, however, could not break down the wall completely, and Dr. C refused to share with us the incredible stories of his fossil collection, such as the time he outbid Newt Gingrich for a giant T-Rex skull. This was really somewhat sad, seeing as Lisa Hermann would continually ask him about archaeology, and was probably the only student in the entire two sections remotely interested in the subject a priori. Wednesday POM, however, faked total interest from the beginning, although to their credit, it probably became pseudo-real enthusiasm at some point, and managed to find out numerous details about his fossil collection. As a result of all this, Dr. C emailed Vickie recently, designating her as the spokesperson to invite Wednesday POM + guests over to his house for a tour of his fossil collection before he sold it all. While I technically was not invited, I assumed, as was clearly the case, that a momentary lapse had resulted in me being left off the email to Vickie, and showed up nonetheless.

End side story. At 7pm on Saturday, Vickie, Jon, Matt, Joon, Naomi, Ante, Catherine and I rolled up to Dr. C's house. When I say "rolled up," I use the term literally, as Naomi managed to very swiftly take out a good-sized rose bush with her enormous Jeep as we pulled into the driveway. Matt and I saw this coming a mile away, but declined to warn her, preferring to listen to Catherine's maniacal cackle for a good 5 minutes. I think it's safe to say that we all expected Dr. C's collection to consist of 20 or so fossils, which he would display to us over the course of an hour. In actuality, as per Vickie's blog, he has over 1000 fossils, spanning the entire history of life on earth, and had prepared a 40 page packet with accompanying six-hour presentation. Things got off to a great start when he allowed us to hold a piece of the world's oldest rock, part of a meteorite that scientists have dated as the most primitive object ever. This was clearly a huge miscalculation on his part. As he was describing how ancient this rock was, Jon dropped it on the floor, and everyone watched in horror as it rolled under the table, luckily hitting Catherine's feet before it could escape behind the couch. The look on Dr. C's face was priceless, as he suddenly must have realized what a terrible mistake it had been to allow a group of med students such as ourselves anywhere near his million dollar fortune. I seriously could not keep a straight face for the next ten minutes, and I felt like a second grader giggling uncontrollably anytime I made eye contact with someone else. Honestly, though, it was bound to happen at some point - I was convinced it would be me - so I offer that Jon really shouldn't feel at all embarrassed. I did increase the level of care I took with objects from then on, and when we were served Fresca in collector's edition Star Wars glasses from McDonald's, I was literally squeezing mine so tight that I am surprised I didn't shatter it with my bare hands. I did manage to severely numb my hand, however. Now would probably also be a good time to comment on the fact that Dr. C basically lives around his fossils, and has one of those semi-creepy houses with lots of dead things prominently displayed in large glass cases. Were he not like the nicest man ever, I might have been scared. Essentially, for the next 3+ hours, we were given a guided tour of evolution beginning with single-celled organisms and ending just before dinosaurs came onto the scene. I learned more that night than I probably have in my entire OB rotation thus far, and we didn't even make it up to anything I had heard of. The highlight of the night, by far, was getting to scope out the doc's DVD collection, which included the complete 1st-4th seasons of Buffy, Dirty Dancing, Joe vs. The Volcano, Splash, and The Mummy Returns (cue Brian's kung-fu noises). We also learned valuable lessons about how to attract mountain goats with your urine and how to cause cerebral edema in raccoons using basic household chemicals. We also learned that Dr. C owns a hairdryer, a purchase which almost led to his house being burnt down, thanks to the efforts of the aforementioned deceased raccoons. After pointing out a worsening eye-glaze on all of our faces, Dr. C concluded the evening with an astronomy lesson, in which we learned about Sidereal time and such. If anyone knows where we can buy a watch that displays Sidereal time, let me know, because I want to win the "Dr. C's favorite student of all time" award. Just before we left, Vickie was declared the winner of special editions of The Iliad and The Odyssey due to her display of such knowledge as the fact that all other primates besides humans have a penis bone, and moreso due to the fact that she organized the whole thing and seriously would have kicked the ass of anyone who didn't vote for her. We left, assuring Dr. C that we would return for the stunning conclusion at some point, and indeed such an event is in the works for Monday night.

Smelly Food

2004-07-21T11:32:00.000-04:00

I'm counting down the minutes to my next free lunch. We're currently at 27. Things in clinic have been pretty God-awfully slow lately, so there's not much to report on the medicine front. I figured I'd recap the weekend, instead, since it was significantly more exciting.

I thought clinic was going to be ridiculously relaxing, since it has the fewest hours (about 45/week) of any rotation I know of, but by the time Friday afternoon rolled around, I was still pretty dead. I spent most of the evening making peanut butter bars for Saturday's potluck, an activity that marked the first time I had ever baked anything in my life (OK, there was actually no baking involved, whatsoever, but there were many other chef-like activities, such as mixing, stirring, spreading and melting, so I'm pretty sure it counts.) I thought they were going to be a huge disaster, seeing as I spent well over an hour attempting to mix a bunch of sticky solid things together, and I kept thinking that I must be missing some crucial liquid ingredient that my grandmother had accidently left out of the recipe. Eventually, though, I was able to create a paste with minimal enormous chunks, and managed to transfer it to the appropriate pan before adding the melted chocolate sauce. Let me just say that food preparation in general is not only tiring, but also really messy. Seeing as I'm the kid who abandoned my best friend permanently in kindergarten after he got peanut-butter on my hand in the cafeteria, I'm not sure it's really going to catch on as a fun pasttime from my perspective. I like the idea of creating something that other people enjoy, and I also like the idea of being self-sufficient to the extent that my dinner choices will include more than pasta and take-out when I'm 30 years old, but I'm not so sure I can handle the sticky fingers. I know what you're thinking - not all food involves peanut butter and confectioner's sugar - but, let's be honest, is it really food otherwise? In the end, the bars turned out pretty good, although I managed to burn the chocolate slightly (I honestly had no idea that it was even possible to burn chocolate), and I didn't have to face the shame of bringing my mom's brownies to the fifth potluck/barbecue in a row.
After I finished my inaugural food preparation, I ordered Chinese food from Panda Garden, which I hadn't done in quite sometime, and was instantly reminded of why that hole-in-the-wall was once my favorite restaurant in C'ville. Thankfully, Naomi called me after that, because otherwise I likely would have passed out on my couch in a food coma for the rest of the night. We went out for drinks at Mono Loco and later at Blue Light with Catherine, Paul, Maggie and Mike Hanley. Overall, it was a pretty exciting time. I couldn't really drink because I was still on Azithromycin prophylatically for Whooping Cough, thanks to one of the nurses on Labor and Delivery who had potentially exposed everyone on the floor the week prior. As it turns out, the only contraindication for drinking with the antibiotic is that chronic alcoholism will decrease the efficacy of the drug in actually treating pertussis, should you be infected, but I figured I was destined to get Stevens-Johnson syndrome if I had more than two drinks. I was driving, as well, although I kept forgetting this and I'm pretty sure I would have ended up abandoning my car had I not been on the antibiotics, since I'm so used to never driving when I go out downtown. Nonetheless, the night had its share of highlights. The first involved a continuous effort to avoid being spotted by Junzhong, my insane housemate from fourth year who we successfully turned into a raging alcoholic and who ended up getting arrested and placed in handcuffs while Jason and Brian were playing Dreamcast in the living room ("Excuse me, could you move a little to the left, please?), after he threatened to kill our roommate Paul. Junzhong, who was never formally convicted of the stalking charges, was apparently enjoying a night out with his grad student friends, who seemed to have no idea that the cheerful FOB with whom they were sharing drinks was a terrifying individual who punched you in the back repeatedly at Disco Biscuits concerts after paying for your ticket and who drank entire bottles of 151 by himself, all the while spouting such epiphanies as, "You wanna fuck J-Z? Fuck this." I just wish Brookshire had been there, because he definitely would have gotten all up in Junzhong's grill and started yelling at him. Ah, memories. Free food is upon us, so I gotta run. I'll finish the weekend recap later.

Are You Sure That's Where the Speculum Goes?

2004-07-16T12:43:00.000-04:00

Just a quick one - I don't have much time before I have to get back to sitting around and doing absolutely nothing in clinic. First of all, I'd like to thank my three faithful blog readers. I'd also like to point out that I am amused to no end by the way in which med students are preprogrammed to only ask certain questions. We get so used to memorizing certain important points we need to address in the history and physical that we have no idea what to do with information we haven't specifically been asked to gather. In the clinic, for example, when a patient presents for a prenatal check, we have to ask about contractions, vaginal bleeding, vaginal discharge and fetal movement. Any more info from the patient, and we all of sudden regress to the medically intellectual level of a fourth grader. Here are some examples of conversations I've heard this week between residents and med students, some of which may or may not have involved me:

Med. Student: So, her past surgical history is notable only for an operation to remove a tumor in 1996.
Resident: OK, and what kind of tumor was it.
Med Student: Um, well...I uh...Let's see (frantically flipping through chart in the hope that someone who actually knew what they were doing documented this)...hmm...well, she showed me a scar on her abdomen, so it was probably something in there...I'd have to say...ovaries maybe?

Med Student: She said she's not currently sexually active.
Resident: OK, and when was the last time she was sexually active?
Med. Student: Yeah, well I didn't ask her, but I'd say it's been a while. Probably years. She's pretty old.
Resident: OK, well why don't you go ask her just to make sure.
Med Student (returning from patient room): 4 days ago.

Resident: What are her G's and P's? (this refers to the number of times the patient has been pregnant and the number of live births she's had)
Med Student: Well, I know she has two kids, so she's probably a G3P2002.
Resident: OK, well according to her chart, she's had 7 miscarriages, and we're treating her for incompetent cervix.
Med Student: Oh right. I forgot about that.

It's kind of scary to think about what would happen if we ran the hospital for a day.

It's the Pants, I Swear

2004-07-14T12:25:00.000-04:00

Another day, another free lunch. This time, it was barbeque chicken sandwiches, Greek salad, and chocolate peanut butter pie from the Biltmore, courtesy of Pfizer. My favorite part about these events is the little talk that the drug reps are required to give in order to justify the bill. Today, this alarmingly overeager 30 year old man named Pete, who had one of those really unfortunate laughs that you know earned him an adolescence full of wedgies and swirlies, spoke to a group of OB/GYN residents about why Eletriptan is a better choice for migraines than Sumatriptan. Nevermind the fact that sumatriptan is quoted in everything I've ever learned as being the best first-line treatment for migraines. My question is this: Why the hell does this issue matter to people delivering babies? It's not like migraines are a major complication of pregnancy, and all triptans (in fact, pretty much every migraine treatment save Tylenol) are contraindicated in pregnancy anyway, if I'm not mistaken. None of this matters, though, because the whole point of these talks is classical conditioning. With enough effort, residents will associate Pfizer with free food to the point where just the mention of the company's name will elicit salivation. Next comes positive reinforcement, whereby an increasing number of prescriptions written leads to an increasing number of free pens and Viagra ties and friendly appearances by Pete, which ultimately leads to more and more scrips. It's an ingenious plan, really, on par with some of the more elaborate plots devised by Mumra on Thundercats. I, personally, plan on never prescribing Sumatriptan, for fear of being cut off permanently.
Other than lunch's excitement, things have been pretty Dullsville as of late in clinic. Yesterday afternoon, I spent the majority of my time sitting on one of the whirly-stools in the resident's room, determining the most aesthetic positioning for patient interviewing. After numerous contortions, I've settled on a semi-reclined, butt forward and slightly sideways, legs extended and tightly crossed, right arm draped over the back of the chair approach. I found that this says "comfortable yet interested, equal yet somehow superior" and really does a good job of accentuating both my tie and my matching belt-shoe combination. While it's true that a more upright, legs-very-loosely-crossed-so-that-they-form-a-triangle pose is more advantageous for taking notes, I believe it says things that I don't necessarily want to suggest, such as "I play football" or "I may own a Kenny Chesney CD." Conversely, an upright, tightly crossed posture not only compresses certain vital organs, but it also tends to create the illusory pants tent, thus making it somewhat uncomfortable for both myself and the patient. If you would like to suggest poses you have found may work well, please do.

Come Back to Katerina

2004-07-12T13:29:00.000-04:00

I'm now finished with Labor and Delivery, and I just spent the first morning of my OB/GYN clinic rotation watching numerous women being subjected to colposcopy. Those of you who complain about your Pap smears should be thankful they continue to come back normal. Colposcopy is yet another one of those fantastic procedures that only women are forced to endure, where a speculum is used to hold open the vagina while a long metal instrument that basically resembles a modified staple-remover collects cervical samples for biopsy. If you're extra lucky, and the biopsy shows a higher grade lesion, you get to have an electric cauterizer stuck in there and a giant cone-shaped piece of tissue removed. Thank you, Dad, for the Y chromosome.
In a way, I'm kind of sad to be done with L&D for good, as it means that I will probably never deliver another baby in my life. As much as OB has exceeded all my expectations thus far, it's probably not what I'll be doing for the rest of my life, although it's comforting to know that even if I absolutely hate every other rotation I do for the rest of the year, I'd be pretty content being an OB/GYN.
I am psyched, however, to be done with call for the rest of this rotation, and the hours involved with clinic are a lot nicer - my 75 hour work weeks, will now become 45 hour work-weeks. Best of all, I get a full hour for lunch now, which means that I might actually be able to blog on a semi-regular basis. Maybe. I'll continue to relate some of my more memorable moments from L&D.

That's Not a Junior Mint
Prior to starting our first rotation, we received 2 days worth of training in techniques such as urinary catheter insertion and IV placement. Highlights included me incredibly not getting sweaty and nauseous when Ashish drew my blood (I was basically in a horizontal position, though, as I was slumped so far down in my seat with my legs extended that the fabulously sassy phlebotomist, Adrianna, ("Ain't none of ya'll walk on water....You will blow a vein - I have been doing this for eight-teen years, 3 of them here...I blow a vein Every...Single...Day!") actually thought I had passed out at one point and came to check on me), and disrobing in front of Biv-Dog to be the volunteer for the ECG demonstration. Throughout the two days, I had the privilege of being in the same group as Tim Bouck, who I believe is pretty accurately summed up by his nickname - The Camel - and is definitely one of the more unique and oddly endearing characters in SMD'06. This kid owns what is honestly the tightest collection of clothes I've ever seen on a non-Eastern European, and walks in such a way that his chest enters the room about five minutes in front of the rest of his body. He's totally awesome, though, despite such setbacks. He also happens to ask more questions than anyone I've ever met, and his queries tend to reflect the interesting thought processes that must go on inside his head. The high point of the training session came during the course on surgical scrub technique, when the tech, in an attempt to make us all feel better about our ignorance, pointed out that we shouldn't be scared of making a mistake or doing something wrong in the OR, because there is nothing we could do that hasn't already been done before. With zero hesitation, Tim piped up and asked, completely straight-faced, "What if we vomit in the patient?" Needless to say, I was on the floor, and the tech was staring at him, dumbfounded.

Are We Sure About This One, God?
My second day on the floor, I was sitting at the aforementioned computer terminal after rounds, again trying to figure out what exactly I was supposed to be doing. One of the third year residents walked by and asked me if I had gotten to see any circumcisions yet, to which I regretfully replied, "No, but I'd really like to see one." Now, what I meant by this was more like, "I would greatly prefer to go through my entire life without having to witness any sort of live genital mutilation, given that I can't even watch that scene in Stand By Me where Gordy pulls a leech off of penis without totally freaking out, but since the packet says that I might actually have to, God forbid, perform a circumcision when I do Peds in the noke, I guess I should begin the desensitization process as soon as possible." I had heard, too, from what I thought was a reliable source, that the procedure was very modern and involved lasers, and I figured that if an 80-year old Rabbi who can't see well enough to read the newspaper can do it in about 3 seconds, it can't be all that involved. This tragic thought process led me to follow the resident down the hall, into the nursery, and then into the smallest room ever, where I was greeted with the following sight: A baby was laying on the table, draped in a sterile cloth, screaming loudly, while a resident hovered over him and tightened a metal clamp onto the head of the penis, which was covered in blood. I've never had a problem with watching gross things or with other people's blood. I love horror movies, I was fine in anatomy lab, and I had just scrubbed in on a C-section the night before, where I was in charge of continuously suctioning blood out of the woman's abdominal cavity, which caused me no discomfort whatsoever. Right away, though, I started to have that familiar feeling that I get when other people, generally phlebotomists, attempt to take my own blood. I figured I could tough it out, though, and I would just look away if it got too bad, so I took a seat on the wooden stool in the corner of the room well away from the procedural area and sort of leaned back against the wall to prevent any sort of major injury when I slipped into unconsciousness. Apparently, once my body gets going, however, there's no stopping it, because even with my eyes closed, I started to sweat profusely and generally feel like I was going to projectile vomit. Despite the horrible feeling of nausea, at this point, I kept laughing hysterically during the circ, because all I could think was, "What if I vomit on the baby?" I got some strange looks, mostly from the attending, who clearly thought I was insane, but everything was manageable until the nurse asked me to move because she needed to get something behind me. I stood up and was preparing to just excuse myself from the room when the other nurse must have noticed that I looked like Powder (the movie character, for clarification) and had successfully sweated through my scrubs. She immediately abandoned the baby all together, sat me down in a chair and begin fanning me excessively, placing numerous soaking wet cold paper towels on the back of my neck. I was of course mortified and convinced that I would never pass my OB rotation. This continued for a good ten minutes, during which time the resident finished up one circ and began on another, so that i got to witness additional joyous scenes such as the injection of lidocaine into the baby's penis and the clamping-on of several straights to the foreskin. Eventually, i recovered enough to sheepishly apologize and leave the room. Apparently, in the end, the attending didn't even remember what had happened, as he asked me the other day if I had seen a circ yet, at which point I expressed dire urgency to perform a mag check on one of the patients and ran away. In an attempt to desensitize myself by January, I have now begun looking at pictures on the web, some of which can be found here. As for my personal view on this apparently controversial issue, I still feel that it's a procedure that ultimately involves minimal pain for the baby, despite appearances, and, given the reduction in the risk of infection and penile cancer, should continue to be performed under elective circumstances. Unless it requires my presence in any way, shape or form, in which case, suck it up and deal, kid. Chicks love it when you unleash the dragon.

On a final note, if you read this blog, leave a message. I keep hearing about random people who read my blog, and I want to know if it's true. My ultimate goal is to have Ella reading on a regular basis, so spread the word and help make that possible. The more feedback I get, the more motivated I'll be to post, and the more infinitely entertained you'll be in the upcoing years.

Girls on Film

2004-07-11T22:57:00.000-04:00

Long overdue, here is the link to my photo album from Paris. I found out that my camera does indeed take really nice artsy shots - it's just a matter of the photographer knowing what the hell he is doing and then basically distorting the entire image on my computer once I get home. Photography is such a noble art.

It Was Supposed to Be So Easy....

2004-07-10T16:02:00.000-04:00

Holy crap! I'm back. So apparently third year isn't quite the magically carefree time that we all envisioned, with afternoons spent frolicking in the lush grass and so forth. It actually involves work. To the point where even if you don't have to read anything at night, you're still so worn out from being on the wards that all you want to do is watch a movie and veg out for an hour before it's time for bed at like 9:30pm so you can start all over again the next day. I keep thinking that I'll blog every day when I get home from work, but just turning on my computer at 6pm gives me a headache. So here I am, 2 weeks into my OB/GYN rotation, and I haven't posted a single time. The trend would have continued indefinitely if not for the current severe lack of activity up on the 8th Floor. I spent the last 5 hours reading my OB book in the back room and coming out every 30 minutes or so just to let the residents know that I'm still alive and available to help them stare blankly at the fetal heart monitors if needed. OB is crazy. I've been on the Labor and Delivery ward for my whole rotation thus far, and I'll be here through tomorrow morning at 8am. Then it's on the clinic on Monday, where I'll try to set a new SMD'06 pap smear record over the next two weeks. I could potentially get called away at anytime, so I apologize in advance if this post gets interrupted. I've got tons of stories, so I'll just start from the beginning.

The First Time
I started my rotation on Monday, June 28. Thanks to the unending luck that ensues when your last name appears at the very beginning of the alphabet, I drew the first night on call, in addition to being the only med student with the eventual privilege of being on call for four nights rather than three during the course of the rotation. Call, itself, is an interesting institution. Long gone are the days when med students and residents alike worked beastly 36 hour shifts, and sign-off was straight out of Dawn of the Dead, with a bunch of zombies stumbling into crap and coming very close to killing people. Now, thanks to labor laws, call consists of a far more humane 29 hours, which is like, "Come on, why don't you challenge me? 29 hours doesn't even require me to pick up a cocaine habit on the side." I'd also like to point out that med students love it when attendings talk about how ridiculous the change is and how call no longer builds character, because clearly medical ability should be judged on the basis of skills such as resisting sleep, which obviously makes Steven Tyler the most qualified doctor on the planet. I digress.
After a ton of orientation crap all morning and most of the afternoon, we were shuttled off to our units in our little groups of 4, which by the way should be enough fodder for a whole extra post. Basically, my "team" hung out on Labor and Delivery for about 30 minutes, most of which was spent chatting with the residents and wandering around aimlessly, before the other three got to go home. So it's now 5pm and I'm alone at the desk console that looks like it belongs on the starship enterprise, trying to figure out what in God's name I'm supposed to be doing. All of a sudden, this girl that I've never seen before (who incidentally has bright red hair that I would later learn was the result of a terrible dye accident (don't worry - it's better now)) comes tearing out of one of the patient rooms, grabs my arm and says, "Follow me." Upon entering the room, I see a lady lying on the bed in significant distress with her husband and several nurses standing around her screaming, "Push." The red-haired girl, who I now find out is a resident, tells me to get gowned and gloved. This is terrifying. I'm like frantically rifling through packs of gloves looking for my size, nurses are shouting, the woman in labor is moaning and the resident is like running back in forth in tight geometrical patterns. Thankfully, somebody has opened my gown for me and is now holding it up, because otherwise, I literally would not have been ready for at least another 20 minutes. I step into the gown and instantly have like 4 nurses descend on me, tying strings and snapping buttons and generally creating way more commotion than you would think was necessary. This, by the way, is nothing compared to what happens when I have to scrub in for surgery later that night, but we'll get to that. Eventually. Maybe like 3 months from now at this rate. The simple act of maintaining sterilization while putting on gloves is infinitely more complicated than anything I've had to do in the first 2 years of med school. First, you have to open the plastic package and grip the paper inside by one of the corners. Then you have to fold back the corners, being careful not the touch the inside of the paper and also somehow not allowing the paper to fold back to it's original position, which it has been compressed in by an air tight seal for years probably. This whole time, by the way, your hands are still inside the sleeves of your gown, so you have zero finger dexterity. You then lay your right glove upside down on your right forearm, grab the outside, which has been cuffed over and therefore is now the inside, with your left hand, and pull the entire glove onto your hand in one swift motion while simultaneously extending your right hand through the gown cuff. After 8 tries thus far, I have never gotten more than one finger correctly positioned without severe readjustment needed. You then repeat with the other hand, except you can't make any adjustments to the right hand until both gloves are on, so you're now working with one finger if you are as uncoordinated as I seem to be. Finally, like 5 minutes later, my gloves are about as well adjusted as they're going to be, which means that at least 8 of my fingers are correctly placed and I have no more than 6 inches of excess latex hanging off any given fingertip. As far as I know at this point, I'm just going to watch the resident deliver the baby, so I kind of stand off to one side so as not to interfere or possibly disrupt the sterile instruments when I faint. The resident clearly has other intentions, however, as she again grabs my arm and pulls me alarmingly close to this patient's genital region. "You're going to deliver this baby." I turn around to see who she's talking to. Oh crap. She gently takes my hands and places them on the baby's head, which is at this point just barely visible, thanks to some impressive effort by the patient that had been going on while I was completely preoccupied with the wonders of medical garments. The resident places her hands on top of mine and instructs me to relax and do everything she tells me to. At this point, I am totally reassured by the father, who looks at me and says, "Dude, are you going to faint?" I assure him that I'm fine despite the fact that I am currently giving myself 10:1 odds. The patient informs us that another contraction is coming on and everybody again begins shouting "Push." This is totally more exciting than the Krebs cycle. The resident then starts counting out loud, so I naturally join in enthusiastically. I think this is like some sort of reverse countdown until the baby's born, so I'm treating it like freaking Dick Clark's Rockin' New Years Eve and yelling, "FIVE!....SIX!!!!...SEVEN!!!!!" (Notice the increasing number of question marks I have used to express building excitement - this is an excellent technique you too can apply to your blog writing.) I'm apparently screaming so loudly that I don't notice when she stops at ten and continue on my own until about 14 or so. I then sheepishly apologize. This intermittent counting continues for another 5 minutes or so, the entire time during which my hands are not visible. Finally, I notice that the baby's head is moving. At this point, I must have had an out-of-body experience, because the next thing I know, I am pulling the legs of the baby out of this woman and cradling him in my arms. Now, clearly, I must have received and followed numerous instructions during my lapse, because there are like 20 different steps involved in the delivery, none of which I was aware of doing at the time. I mean, this stuff is complicated. You have to flex, rotate, suction, extend, rotate the other way, etc. I have absolutely no recollection of doing any of this. What I am aware of, however, besides the fact that I am now holding this screaming alien life-form in my hands, is that I show no evidence of having passed out, my face free of painful lacerations, and nobody fanning me excessively. (Tomorrow would be a different story). I hand the baby the awaiting NICU team, and turn back to the father, who is congratulating me on my performance. I then have the joy of delivering the placenta, which consists very gently holding the umbilical cord until you feel it go loose and then pulling this large sac of blood out of the patient's uterus. This is an experience to not be missed. Finally, I watch in awe as the resident crochets this woman's vaginal walls back together. When she's finished, I degown (a process which is considerably easier than gowning), and walk out of the room feeling exhausted. Good thing, too, because I only have another 15 hours left on my call.

Back to work. Incidentally, hASSELHOF is playing Starr Hill on Saturday, August 28, so make your plans now to be in town that weekend. We'll be performing our first ever original rap song, in case you weren't one the 7 people who heard it at the first year barbeque.

I Tried Really Hard to Come Up with a Good Title, But This Was the Best I Could Do

2004-06-21T20:56:00.000-04:00

Back in business. There’s so much to talk about; I don’t know where to begin. Boards were pretty much what I expected in terms of the actual exam, although the whole experience was a little harrowing. I got to the test center 30 minutes early, as instructed, and expected to just kind of chill out in the lobby for a half hour and maybe look over some stuff one last time. Instead I was immediately ushered in and told I could begin. I was frazzled and felt like I had to begin right away, so I like was like tearing off my sweatshirt and cramming all my crap into my locker and basically running to the computer terminal for no reason. I was planning to skip past the tutorial to save an extra fifteen minutes for break time, but I kept getting the message, “You have unanswered questions. Are you sure you want to exit?” and totally freaking out. What questions? The practice questions in the tutorial? Why the hell is it asking me to fill them out? Is this the first block? Shit! I finally convinced myself to click “OK” but then I was paranoid the entire day that I had skipped an entire block and left 50 questions unanswered. Then, about 15 minutes into the first block, I was suddenly like, “Holy shit! This is the real exam and not some Kaplan practice test!” Eventually, I calmed down and, thankfully, the remaining six blocks were much easier than the first block. My only other point of interest was how completely ghetto the entire testing center was. I was taking the exam at Sylvan Learning Centers, and I was one of only 2 kids taking the boards. Everyone else was taking the SAT’s or GRE’s or some exam that had way too many questions involving shapes and patterns (textile sorter’s entrance exam?) There was only 1 bathroom in the whole building. I was anticipating this being a huge problem, given my stomach’s track record on exam days, but thankfully I seemed to be the only person in the center with any sort of digestive or urinary tract and never had to wait in line. The most annoying thing was that you weren’t allowed to eat anywhere in the building. The whole purpose of my breaks was to eat, so every time I finished a block, I had to go to my locker, grab some food stuffs, run outside and cram said food stuffs into my mouth while sitting on the sidewalk. I swear I looked like a well-dressed homeless person. I was surprised no one threw change in my direction. Also, there was a fabulously sassy black woman (think Loni Love) monitoring the examinees via video camera, who apparently caught some girl sneaking a drink of water during the exam. All of sudden she screams, “Oh no she didn’t!” while I’m frantically digging for my breakfast bar, and proceeds to bust into the exam room and confiscate the beverage. There was a significant amount of head wiggling upon her return and that really made my day more than anything. Now I get to wait until July 15 to find out if I passed. If not, I will be quickly yanked from my OB/GYN rotation and blessed with a month off to study and try again.

Another exciting thing that happened that same day was that I went to Katmandu for the first time with Jordan and Jeff. Katmandu, of course, is the world-famous bar/nightclub/meat market in beautiful downtown Trenton, NJ. Not surprisingly, it was Jeff’s idea to go, although I will hold myself partially responsible since I mentioned to him the night before that I wanted top do something to celebrate my achievement, and I should have known better than to not clarify with specific suggestions. Actually, I’m not really complaining, because I’m sure it ended up being more exciting than the Scrabble tournament that probably would have ensued had we not gone out. We went over to this tangential kid’s (well, the kid himself isn’t really tangential (generally, he’s kind of quiet and his conversation usually seems relevant), but his relationship to me is tangential and thus his name doesn’t get to grace the pages of this blog) house and had a few beers. We had an enlightening discussion about the Iraqi prisoners and the first American who was beheaded with a drug-dealing, gun-toting member of the Young Republicans of Lawrenceville. Apparently, what we did to the prisoners was fine since “it was just some homos in the Army doing stupid shit,” but the beheading is completely reprehensible and justification for an all out war with the Middle-East, although not quite reprehensible enough to prevent the kid form watching it eight times on his computer and eventually saving it to his hard drive so he could show his buddies. Also, liberals all hate America and should be shot. Who knew? This same kid then pointed out that I wouldn’t be able to get into Katmandu wearing flip-flops due to the dress code. Are you fucking kidding me? I’m all for a dress code in upscale establishments in well-to-do urban areas, but when you are the bouncer at some crappy nightclub in Trenton where multiple people have gotten shot, I don’t think you are in any position to be telling others what appropriate clothing consists of. Complacently, though, I borrowed a pair of Stan Smith’s from Jordan (apparently, these were border-line questionable according to the shoe guru, but probably acceptable) and we headed over. The club itself was sort of uneventful. I realized immediately, that I had forgotten my sunglasses, my 2 bottles of gel that I should have applied, my soul patch, my white button-down shirt with cowboy deigns opened halfway down the chest, my dark jeans, my gold necklace and tooth, and my enormous pecs. Damn, I swear I always leave something at home. Basically, Jordan and I stood against various walls for 3 hours while Jeff ran into 500 people that he knew from high school. Every so often, one of these people would also remember Jordan, leaving me to walk long laps around the outside deck and pretend I was looking for somebody. We did get to see a viciously one-sided fight, which, given my excess of free time, I was able to spot in the making long before it erupted. After the club, we went and ate at Crystal Diner for old time’s sake, and the ensuing nausea and stomach cramps were just as fantastic as I remembered.

Wow, I’ve covered like 12 hours of my 2.5 week break and this entry is already a fucking novel. Seriously, I need to cut down on the verbosity.

Let’s see. Allie and I went to Paris for a week. I’m working on uploading the pics to Shutterfly or something. The trip was excellent – we got to see a ton of art and lots of old cathedrals, eat way too much cheese, and make fun of German people. We stayed in the servant’s quarters of the former apartment of Prime Minister Mitterrand. Seriously, I need to start making friends with rich people. The place was awesome, save for the minor plumbing issues. First of all, the shower and sink were in a normal sized bathroom, but for some inexplicable reason, the toilet was in this random closet. I should say, the toilet was this random closet, because it literally took up the whole thing. You could not physically be in the room and close the door. There was a small space in front that you could conceivably cram your lower legs between, except for the fact that the burning hot water pipes were running up the wall at this exact location. As a result, Allie did not use this toilet the entire trip, opting instead for public restrooms only. (But not the weird ones on the street that you have to pay for, unfortunately, because my secret plan was to block her exit and determine if they really did flood after every use) For my part, I got to pee through the doorway while standing in the hallway. This was incredibly fun. To add insult to injury, the water was completely turned off the whole first morning we were there, so we awoke to find ourselves unable to shower or brush our teeth. Actually, Allie did apparently somehow shower using the like 5 drops that were still in the pipes. Basically, I recommend Paris for its plumbing fun alone.

During our five days in the city, we saw Musee D’Orsay, The Louvre, The Eiffel Tower, The Pompidou (Modern Art Museum), The Rodin Gardens, Notre Dame, Sacred Heart, and my personal favorite, the Erotic Art Museum, conveniently located in the sex district, directly across from the Sexodrome, which we also visited, although we opted out of the live sex show offer. I learned a lot on the trip, including the fact that Adult Videos in Europe are outrageously priced at something like $75-85 per DVD (This, I discovered in the Sexodrome, while Allie was inquiring into the various types of shows offered.) Overall, it was a spectacular trip – I’ll report more on Paris as well as the rest of my vacation tomorrow. Right now, I’m off to Catherine and Allie’s place for some cupcakes and beer. Tomorrow we learn to insert catheters. On each other. Or on Darc-dog maybe. I hope she wears a jog bra under her jumpsuit.

"I Don't Know, Lloyd. The French are Assholes."

2004-06-01T16:48:00.000-04:00

I'm pathetic. I know. Here's the deal. I have been locked in my room studying for Boards for the past 2 weeks. I leave for DC in an hour, and then on to NJ tomorrow. D-Day is Thursday. After that, it's my nephew's baptism on Sunday and off to Paris on Monday. Back to Lawrenceville for a few days, then up to my aunt and uncle's house for a pseudo-vacation and then back to school to start delivering babies at the end of June. I promise I will be better about updating come June 21, when every waking moment isn't being spent cramming random bullshit that our professors failed to teach us into my head. Later.

I Shall Call It "The Opposite of Not Not Forgiven"

2004-05-22T02:02:00.000-04:00

I just watched Unforgiven with Mike and Paul, and am happy to report that the film festival continues to exceed all of my expectations in terms of the caliber of the movies I randomly selected. I think I really dig Westerns. It's kind of weird considering I feel like I should be totally opposed to the genre, since it's basically one big testosterone fest with so much machismo oozing out of everyone's pores that Razor Ramon would be shamed. Something about those movies, though, seems to fulfill this empty void in my life - a void that I guess must be composed of some deep inner yearning to speak in grammatically disastrous sentences and where tight denim. I took an English class back at Lawrenceville (see last night's entry - yikes) called West of Everything, where we read a bunch of Western novels and watched a film once a week. We read All the Pretty Horses (before it was a terrible movie), Desperado, and some Louie Lamour novel, among others. The highlight was those Spaghetti Western films, though. We saw Butch Cassidy and the Sundance Kid, Magnificent Seven, The Wild Bunch, etc. This was way before I got into film, back when Forrest Gump was the height of cinematic sophistication as far as I was concerned, and there was no way I was sitting through anything not in color or that required reading subtitles. Despite my ignorance of the media, I remember those movies really grabbing me in some intangible way, and every week I was totally engrossed in whatever was happening on screen. (This was all the more impressive given that I could barely sit through an episode of Home Improvement without changing positions 20 times at that point in my life. (And don't try to say that Home Improvement wasn't exactly the most captivating sitcom, because you know you were shocked every week when Wilson had a solution to Tim's problems and on a related note you were totally devastated when JTT failed to come here. (Can you use triple parentheses?)))

More recently, I had a similar experience when I went to see The Missing, Ron Howard's totally underrated Western from last December starring Tommy Lee Jones and Cate Blanchett. I remember it being the night before the Path exam, but for 2 hours, I was completely lost in the landscape, my mind free of actinic keratosis horns and painful envisionings of testicular torsion. I guess more than most other genres, Westerns really get to the heart of the Good vs. Evil issue without any pretensions or pussy-footing around. There's no women to distract the story into a complicated humanistic thread, and there's never any ambiguity about who you root for. I think Westerns probably require the least possible amount of effort on the part of the viewer, which probably explains their popularity in certain sectors of the country.

So back to the lecture at hand (I stole that line from Snoop.). I should have realized earlier that I would love Unforgiven since it's an Academy Award-winning Western, but I failed to recognize this obvious point until it popped up on my Netflix recommendations. Then, I let it set on my 243-movies-long-queue for approximately a year before Paul mentioned it as a film he'd like to see at the festival. Finally, tonight, I got to see it. (I know, I know, we've been over this already). What I liked most about it was that it's sort of the Anti-Western. Now I will admit that Eastwood at times hits you over the head a bit too strongly with this point, as if to shout, "Look at how clever I am! Do you realize what I'm doing here?," but generally he executes his mission in a relatively reserved and subtle style. The whole movie is all about the de-glorification of the Old West, but then at the end, he totally turns it on its head, culminating with one of the most stylistic and lionizing (shut up, you totally use Microsoft Word thesaurus, too) showdowns ever. Basically, he's saying, "The Old West was so fucking cool that you can take away all the Hollywood hype and strip it down to its bare bones and at the end, it's still the most bad-ass thing you've ever seen." And he's right.

Even as great a movie as Unforgiven is, though, and as much as I enjoy Westerns in general, you can't help but notice the absurdity of the basic plot. There are all these random elements that absolutely have to be thrown in. And why does this take two hours to depict? I think you could have gotten most of the messages across in five minutes. Here you go:

Characters:
Bill Munny - Clint Eastwood
Little Bill - Gene Hackman
The Schofield Kid - Jaimz Woolvett
Ned Logan - Morgan Freeman

[Film opens on the shadow of a tree with some banjo music in the background that basically sounds like the theme from Deliverance slowed down quite a bit.]

[Cut to Bill Munny working on his farm. Show him falling down completely unnecessarily at least 5 times, so the viewer clearly understands that he is a feeble old man.]

Bill: I done lost my wife. I used to be a bad-ass cowboy though. I done killed plenty of men. My wife done did save me though. Now she is dead. I don't drink no more neither. Did I mention that my wife passed on? I haven't shot a gun in ten years. I will now go and try to shoot a can off a fence post and miss horribly 6 times to illustrate the point that I haven't shot a gun in ten years.

[Cut to Little Bill building his house]

Bill: I'm the sheriff. I'm from Texas. I kill bad guys. Isn't it ironic that my name is Little Bill and the other guy's name is also Bill? Can you guess yet who will win the final showdown?

[Some random-ass prostitute in Little Bill's town, which by the way is miles and miles away (and I think even in a different state) from where Bill Munny lives is slashed across the face with a knife by one of her Johns.]

Bill Munny: Well, I haven't done anything but raise pigs in over ten years but now that this woman has been cut, I guess it's time for me to come out of retirement and avenge her injury. It's a good thing I don't get much news around here, because otherwise I guess I'd have to spend all my time killing people who abuse prostitutes, seeing as I'm apparently obliged to them for some unknown reason. I should go see if my Black friend is interested in helping. Morgan Freeman is always looking for another Oscar nomination. I should also get a young, arrogant, no-holds-barred cowboy to accompany us so he will see over the course of the adventure that violence is not glorious, and that human life is precious.

[Bill, Ned, and The Schofield Kid ride into Little Bill's town looking for the man. Ned gets caught by Little Bill. Little Bill ties Ned to the jail cell and whips him, in a scene that uses archive footage from Roots.]

Little Bill: What is your name? (CRACK!)
Lavar Burton as Ned: Kunta Kinte!
Little Bill: Your name is Ned. (CRACK!) Do you understand me? (CRACK!) What is your name? (CRACK!)
Lavar Burton as Ned: Kunta Kinte!

[Ned is killed offscreen, while Bill and The Schofield Kid kill the guy who slashed the prostitute. The Schofield Kid learns a valuable life lesson while Styx plays in the background. Sylvester Stallone delivers a public service announcement about gun safety. This has been an ABC After-School Special. We now return you to your regularly scheduled programming. Bill comes back to the saloon where there is of course some town meeting going on and every single person from the film is gathered in this one room. Bill has a final showdown with Little Bill.]

Bill: Hello. My name is Bill Munny. You killed my Black friend. Prepare to die.
Little Bill: Let's settle this with a showdown.
Bar Tender: I've got a better idea. Why don't you two just pull your dicks out and measure them?
Bill: Ha! I win! What the hell did you expect? I directed the fucking movie, for God's sake.

See, it totally could have been done in five minutes.

Insomniac

2004-05-21T03:42:00.000-04:00

God, what the hell is wrong with me? I'm blogging because I can't sleep. It's freaking 3am on a random Thursday night. I have absolutely nothing to do tomorrow except study some more for the boards, which is 2 weeks away. Why the hell is my circadian rhythm such a disaster? Maybe this is actually a good thing, considering the pathetic lack of entries I've been posting as of late. I guess boards studying is not quite as footloose and fancy-free as I envisioned it. I thought that 8 hours a day was going to be ridiculously lax, but when you factor in an hour for lunch, an hour for dinner, an hour for exercising and showering, an hour of daily website checking, an hour of Freaks and Geeks, an hour of Queer as Folk and a 2 hour movie, your day gets somewhat limited. In the immortal words of Jessie Spano, "There's never....enough....time!" So I apologize to my legions of readers who depend on me for their daily 5 minute reprise from their otherwise glum and torturous existence, and I'll try to post more frequently. On to the recap.

The First Annual 1309 Film Festival is in full effect. For those of you not spending your glorious spring evenings in this beautiful town, the festival is a 14-day extravaganza featuring the best films that I haven't seen in at least ten years. It kicked off Sunday with the exception to the rule, a screening of The Wizard of Oz accompanied by Dark Side of the Moon, and has so far also featured Serpico, Casablanca, The Apartment and The Princess Bride. Of these, I would have to say that I was most impressed with Casablanca. I've long put off seeing it, since I didn't think I was really into the whole black-and-white-American-love-story-in-Africa genre (that sounds like it far more aptly describes Jungle Fever), but I happily discovered it to be an outstanding film, so much so that I watched it for a second time the following day. I would dispute its place as AFI's second greatest film of all time, but it certainly deserves to be somewhere in that list and I actually think it's a better film than #1, Citizen Kane (not better, however, than #3, The Godfather). I think I was most awed by the fact that it won me over without any stylish direction or particularly innovative shots. It's simply a damn good story fleshed out in one of the best screenplays of all time. The dialogue is so perfectly real, and the delivery is beautifully timed. I also loved it for its minimalism - the soundtrack is never intrusive, Bogart's hero is so understated, etc. If you haven't seen it, you really need to.

Speaking of which, go out and rent Freaks and Geeks! I can't believe they canceled this show after only one season - it's almost as much as a travesty as what happened to My So-Called Life. This was my middle-school experience more than any show I've ever seen, and I suspect it would have been my high school experience, too, had I gone to public high school. (As it was, it closely approximates my experience, except middle-class suburban white kids who major in clique-formation replace ultra-rich yuppie suburban white kids who major in clique-formation, drive beamers and snort lots of coke.) I can't believe there was finally a show on TV where the hero is a kid who wont hit puberty until at least the tenth grade, and I didn't even know about it when it was on. Seriously, who sold the rights to my story? If only I could have watched it 10 years ago and realized that no matter how much high school sucks, it has no impact on your future social life. God, I hated high school. And I didn't even know it! I fucking wrote in my yearbook "Thanks for the best four years of my life." WTF?! Dont get me wrong I love Lawrenceville for the school it is, for the education it gave me, and for introducing me to water polo. Some of the professors who teach there are the best instructors I've ever had and all-around amazing people. What I hated was the social scene and the fact that all anyone cared about was climbing the ladder. Why is it that you can put 200 complete dorks in a school, kids who clearly got picked on for being nerds in middle school, and you still get pompous assholes who think theyre the shit? The captain of the lacrosse team apparently was the butt of every joke in middle-school and a total loser, and yet he comes to Lawrenceville and is the grand-marshall of the Kinnan Klan. How does this happen? How do marginally attractive eighth-graders suddenly become the focus of every senior's wet-dream? ("He better watch out or he'll get AIDS when he date-rapes her.") The worst part was that I was totally absorbed in the whole thing. We got half a page for our yearbook entry. I used up valuable lines to give shout-outs to kids I barely spoke with by the time senior year rolled around. I didnt get reciprocal shout-outs from them, but I did get shout-outs from the two kids I had been steady friends with throughout all four years. The shitty part - I cut those two out of my entry to make room for someone cooler. I don't speak regularly with a single person from high school. I wish I could say that the stupid kids I hated in high school are pumping gas right now, but unfortunately they are all working on Wall Street and pulling in millions. Whatever. They probably shit on their wives.

It's getting late. I feel like I might be getting tired. I better jump into bed and hope its time.

The Final Countdown

2004-05-15T16:43:00.000-04:00

EBSP has come and gone and I didn't even puke once. I rule! My biggest fear about the event was that it would fly by in a drunken blur and I would have no beautiful memories to hold on to for the rest of my life. Thanks to the 3 hours of sleep I was working on, however, it turned out to be the longest night EVER, and I swear to God that it was 10:30 for like 4 hours straight. The preparations started off fabulously, with my first trip to Mykol, the official hair stylist of SMD'06. Thanks to Vickies directions ("Its right next to Starr Hill"), I almost wondered into the salon with a gigantic picture of Patti Labelle next to a product line-up featuring Soul-Glo in the window, but I thankfully realized that this wasnt the right place. I found West Main Hair Design, got a full-on shampoo, and ten minutes later had my hair sectioned off into seven compartments, each containing a hair clip. Unfortunately, I think Mykol was withholding some of his sass, since I'm sure I'm one of the few guy customers he gets, but I could tell he had lots of potential. There was a brief encounter with an assistant who asked him to move her car, and I could see the claws ready to come out. This would not be my only encounter with Mykol for the day, as he of course showed up later to EBSP with his fireman boyfriend who apparently has oily skin, but refuses to get facials despite Mykol's constant urging. Mykol ended up doing a formidable job with my hair, so I think he will become my official hair stylist, sadly replacing the 50 year old bald man in Lawrenceville who has cut my hair since I was 11.

After some drama involving fashion choices, I finally decided that, seeing as EBSP is sort of like the giant frat party of med school, a polo shirt with the collar turned up and tucked in ever so slightly at the front waist to accentuate my choice of belts, along with a pair of Aviator sunglasses would be appropriate (this was intended to be a satirical social statement, given the clear ridiculousness of such an outfit, but I think, sadly, it was largely accepted as a perfectly normal thing for someone to wear). We barbequed at Mikes and Naomis before heading over to the Flower Market. Davis and I discussed the potential merits of Shall We Dance, and I finally admitted to myself and the world that I secretly want to see it. Thankfully, Davis was driving to EBSP, so we didnt have to walk the like 1.2 miles to the Downtown Mall.

The party itself ended up being excellent, save for a few minor details. For one, the bar line ran directly through the middle of the dancefloor, leaving little room for a whole party phenomenon such as the Thriller dance (see below). Secondly, somehow, $2500 worth of alcohol lasted exactly 1 hour, 15 minutes. At 9:15, the open bar became a cash bar, with the most expensive drink prices Ive ever seen in Charlottesville. A can of Budweiser beer cost me $3.50. I saw Tovia drop $20 on three gin and tonics served in tiny plastic cups. Needless to say, the whole alcohol aspect was such a disaster that it literally took like 4 hours for Joon to get drunk, and the kid doesnt have a single molecule of aldehyde dehyrogenase in his entire body.

This entry is getting kind of long, and I would like to do something else at some point today, so I'll hit some highlights. Heres a timeline:

8:30pm Arrive at the party. Lots of Mormons are there. Kenny G is blaring over the loudspeaker. Dean P and his wife are awkwardly standing by the starry sky backdrop desperately looking for someone to talk to. People are voraciously attacking the hors d'oeuvres as if they havent seen food in days. Sarah Williams and Ella are starting bizarre conversations with randoms left and right. Vickie is moderately flushed.

9:15pm Free alcohol runs out, after I've stood in line for 30 minutes without moving. Said line gets noticeably smaller. Just as I'm asking when the DJ is going to start playing, I hear that opening breath sound of Hot in Heeeeere and scream "Ohhhhh!" in perfect time. Everybody starts dancing. Vickie is a light pink.

9:30pm Baby Got Back comes on and Matt Alexander comes booty-shaking across the dancefloor. I get caught in the middle of a Tara Glennon / Sarah Williams grind and decide its time to leave the dancefloor.

10:00pm As I'm talking to Dave Beckert and drinking my beer from a plastic cup, I become aware of this disgusting sensation at the back of my mouth. I realize that I've apparently taken in a bug with my last sip and that it is now trying to crawl back into my mouth from my throat. It feels like a rather large bug. I attempt to cough it up but am unsuccessful. I run outside while Dave is in mid-sentence. The bug is now in the middle of my throat and still attempting to ascend. This is the most uncomfortable sensation I have ever experienced. Missy begins shouting "Swallow! Swallow damnit!," and I am furiously swallowing with all the strength I can muster. Paul seems very confused about what the hell is going on. After a few minutes, I finally swallow the bug. Vickie is nowhere to be found.

10:30pm I realize that I haven't made any requests, so I go upstairs to the DJ and request Thriller. He gets very excited and gives a high-five but unfortunately I am holding my sunglasses in that hand. Awkward.

10:35pm Thriller comes on. Catherine starts screaming when I tell her what song it is. Ashish comes running from somewhere. I expect an organized dance, much like in the preview for 13 Going on 30, but apparently Ashish and I are the only ones who know any of the moves, so it's more like the two of us dancing independently with everyone else taking pictures. We do a lot of the shimmy-clap move and the monster-claw. I think the dance probably involves more than just these two moves, but whatever, ours is way cooler. Vickie is magenta.

11:00pm Borderline comes on. I go crazy doing the Footloose dance. Floor is slippery. Im wearing flip-flops. Man down.

11:15pm Ante arrives and begins her quest to catch up with the rest of us in terms of drunkenness. Allie is continuing her quest to talk to every single random person in the building. She will eventually fall one short, failing to secure a conversation with Sarah Jones.

11:30pm I turn around to see what all the shouting is about. Holy shit! The crazy dancing guy named Michael, of post-December-exams Wild Wings fame is in the middle of the dancefloor surrounded by an enormous circle of onlookers and doing The Hustle. Clearly, he is the only person here who would possibly know how to do The Hustle, other than, perhaps, Chris Lippincott. My feelings about this guy are summed up in the following Franz Ferdinand lyric: Beautiful boys on the beautiful dancefloor / Michael youre dancing like a beautiful dance whore / Michael waiting on a silver platter / Nothing matters now. Vickie is amber.

11:45pm Ante has achieved her goal.

12:00am Why is my butt sore? Oh right. The Borderline incident. Vickie is fire-engine red.

12:15am God, this is the longest party ever. I'm waiting in line for the bathroom with Lauren. Again. Apparently our bladders are on coordinated schedules. Beestang is sitting on the steps with no shoes on. She looks rough. Come to think of it, everyone here looks rough.

12:30am Where did Vickie, Paul, Danielle, Joe, Bridger, Jon, Fitz and Catherine just wander off to? Oh. Fitz's headache is gone. Vickie is pale.

1:00am The dancefloor is broke. It's seriously busted. Lets see weve got Sarah Williams and Ella still going strong, Kate Briddell and her buzz-kill boyfriend, Marcy, and, of course, Michael. Julie Humsi is smoking a cigarette. This is definitely weird. Lets get out of here.

1:30am We are walking along Main Street. Heres a sample of the conversation:

Joe Bean: The guy who wrote the pharm test went to buttface school.
Bridger: So wait, if we are doing that tomorrow and you guys are also doing that at the same time, we should totally combine our forces.
Danielle: Yeah and then we can go see Troy.
Paul: Seriously, please don't do that. Wait for the video. Im begging you.
Catherine: Full frontal Baby!

2am I come downstairs after my shower. Some kid I've never seen before is sitting in the rocking chair. Mike Hanley is in our kitchen complaining that we have nothing to drink and continuously telling Ante that he wants a beer. Ante is making Tysons chicken nuggets in both the microwave and the oven. Catherine is only allowed to eat the microwaved ones, but at least she gets barbeque sauce. Naomi is stumbling into walls. I'm going to bed.

I Don't Wanna Be An Old Man Anymore

2004-05-14T13:58:00.000-04:00

Holy Shit! We are done! I thought this day would never come. And let me tell you, it couldn’t come soon enough. I mean, it’s scary and all to think that we are halfway to being physicians, but if I had to memorize one more fucking drug, my head would have exploded. As it is, I was not too happy to see that neither of my favorite two drugs, Abcixamide and Eptifibitide (the alphabet drugs) made it onto the exam. I love these drugs because they remind me a lot of Easter European last names, which always seem to contain an unnecessarily large number of consonants. And I mean, what’s more fun to say than Eptifibitide? Do it. Do it. Shockingly, I should point out that I am again drinking alone in my room, since we still have no beverage options. Thank God for Blue Moon, the official beer of SMD’06.

The past 10 days have largely been an exercise in maintaining sanity in the face of preposterous study goals, and I came really, really close to failing that exercise last night. I’ve been joking all week about having racing thoughts, but last night I literally started to go insane. I was doing fine at around midnight, or so I thought, so I decided that I’d study for another 30 minutes and set my alarm for 7am, so I could do a final review before the exam. I decided not to have anything to drink, since I had trouble falling asleep the previous night after a single beer, and finally understood what the hell Dr. H was talking about when he said that alcohol actually disrupts your sleep patterns. Anyways, I knew I was still pretty wide awake at 12:30, so I read for a bit and then attempted to go to sleep. A little while later, still awake, I got up and read some more of the New York Times summer movie preview. I tried sleeping again around 1am. At 1:30, I became acutely aware that I was vocally mumbling about parasites invading my gastrointestinal tract and was totally disoriented, but definitely not asleep. This continued for a good three hours. I had like fifty songs playing in my head uncontrollably and various drug facts flashing in and out of my mind. I was literally burying my head under the pillows to try to escape the pain. I also had a throbbing headache and was convinced that I was having a subarachnoid hemorrhage. At one point, I kept thinking that I was inside a cave and I was freezing cold so I had to wrap myself in my sheets like a freaking caterpillar. Finally, at 3:30, I got up because I honestly thought I was having a mental breakdown. I took a 30 minute shower and managed to regain a semi-cognizant state. I passed out sometime shortly afterwards and woke up to my alarm at 7am. I’m not really sure how to classify the experience from a psychiatric perspective. It definitely wasn’t mania despite the racing thoughts, because I was terrified the whole time, and my mood was very dysphoric. I guess it was a semi-delirious state, with borderline psychotic features. Overall, I think it was a positive experience, since I now have a better understanding of what my future patients have to deal with everyday, but I’m kind of worried that I’m predisposed to some horrible psychiatric disease and that this was just a preview of things to come.

Last night was also notable for the ridiculousness of the pneumonics I was coming up with during my last-minute cramming. Many of you know that, thanks to Allie and Lauren, I made every antibiotic, antiviral, antifungal and chemo drug into a person. This started out very organized, with various groups of people representing various classes of drugs. For example, guys were renally excreted, girls were heptcally excreted, Caucasians were taken orally, minorities IV, right-siders were cidal, left-siders static, etc. (Those of you wondering what drug you are should keep in mind that there are no hepatically excreted cidal drugs taken IV, so I apologize Vickie, Naomi and Danielle, but you didn’t make the cut. Also, I’d like to point out that, due to the overwhelming number of WASP’s in our class, I had to expand minorities to include Mormons, Jews, kids who dropped out of school, kids who ride unicycles, kids who wear jean shorts, Sarah Williams, etc.) I started out just using people in the class, but I ran out eventually and had to add people I lifeguard with, first-years, famous people, etc. The best part about this whole system was the random coincidences that would occur. For example, Beth (itraconazole) and Lauren (erythromycin) can’t be used together. And, my personal favorite, Mem (doxycycline) and Zolak (tetracycline) are contraindicated in pregnancy, so those two better not have any kids. Often it’s not that simple though. So last night I found myself coming up with pneumonics such as this: Madonna (primaquine, an antimalarial) and Lori Ann Nelson (chloramphenicol, an antibiotic) are BFF and hang out at the cafeteria together all the time (this was to remember that primaquine, like chloramphenicol, causes hemolysis in G-6-P deficient patients). Ashish (bleomycin) is impotent and has testicular cancer. And Christy (Allie’s roommate, vincristine) is totally dating Mike Hanley (didanosine), since they both cause peripheral neuropathy, while Ashley (stavudine) is dating Tupac (Paclitoxel) for similar reasons. This is the entertainment that has been filling my life all week. God, I need to get wasted. Conveniently, tonight is the biggest party of our entire med school careers – EBSP. Our class has spent $10,000 on this party. No joke. There’s a laser-light show. And a sign that says “DANCE.” And balloons, which I won’t be blowing up. And Asian Millhouse is scheduled to appear.

Some of it is just transcendental, Some of it is just really dumb

2004-05-12T11:44:00.000-04:00

OK, I know I said I wasn't going to post, but this requires immediate attention. Go here and watch the preview for this new God-awful-looking Richard Gere movie. Pay attention to the music that is largely obscured by the voice-over about 2/3 of the way through. What's that you hear? It's a fucking Peter Gabriel cover of The Magnetic Fields' Book of Love! How absurd is that?

I Can't Do My Work!

2004-05-11T14:24:00.000-04:00

3 down, 1 to go. This is going to be a quick post, since I have the joyous task of memorizing 609 drugs ahead of me. I apologize for the recent lack of entries, but the past 4 days pretty much sucked and I anticipate more of the same until Friday. The panic finally hit me hard last night (I think I managed to avoid an earlier onset largely by going to the wedding last weekend), and I had my first manic episode. I seriously couldn’t do anything for like 30 minutes because my mind was racing so fast. For the previous two days, I had been on a frantically-paced 15-minutes-per-lecture schedule, and after 22 hours of this, it was difficult to slow down. Fortunately, I experienced neither psychosis nor hyperactive sex drive, so apparently it was a mild case. I finally managed to fall asleep/pass-out with the help of a few beers. Incidentally, I am currently drinking another beer while I write this, and I am alone in my room at 2:30 in the afternoon, which probably means that I am either a) really, really thirsty and pathetically have no other beverages left now that my supply of lemonade-ice tea is gone or b) am becoming a true physician. Hooray for self-medication! I have to say that the Pathology exam, despite taking me the full 4.5 hours to complete, was better than I anticipated, and seeing the hytidiform mole really brightened my day.

I saw that the fourth-year med school play is this Saturday at 4pm although I anticipate that I won’t be attending as I’ll probably be either asleep or severely hung-over/vomiting. I don’t think I’ll be missing much, though, since the title is License to Heal and there is a James Bond logo on the movie poster. Come on, people. The whole spy movie parody is a little played out at this point, do we not think? In light of this horribly lame idea, Allie and I have decided that we will be writing and directing and starring in our fourth year play. (We haven’t really confirmed this with whoever might be in charge (I guarantee it’s Marsha C) but I don’t foresee that being a problem. Who else is going to do it – Kate Dupnik?) At this point, we know the following. It’s going to be a musical, obviously. I’m thinking probably 40-50 backup dancers, a giant float of some sort, a jungle sequence, etc. I also guarantee the following: Mike Hanley doing an Irish jig, April Ehrenreich holding her scowl front and center for 5 minutes at the end of Act 2, Lisa Hermann performing a monologue about the invention of her hand-raise, JDT hopping around on her peg leg, Maggie Kuhn doing jumping-jacks, and Maggie Bivens wrestling Jenny Edwards in pudding. So that’s something to look forward to. Don’t bother checking this site until Friday. Really, you’ll just be disappointed every time. And leave me some comments, damn it.

What Did Poor Dick Clark Ever Do Wrong?

2004-05-07T11:40:00.000-04:00

2 down, 2 to go. I'll spare you the tired Bon Jovi lyric. We had the Practice of Medicine exam this morning. This is the class where we are supposed to learn the most directly applicable information for the wards next year, and yet no mention of the rectal exam spin technique anywhere on the exam. I bet Mike Duggan was disappointed about that one. I'm not complaining though, because the best part about this class is that there is absolutely no need to study until a couple days before the exam, since the professor (who, PS, looks exactly like Joey Buttafuoco which is disturbing given that half the girls in our class have a thing for him) holds a review session AFTER he has made up the exam and literally goes through question by question giving every answer. I mean, he does it in a way that minimally disguises the fact, since he pretends to be going over the problem sets, but you tend to catch on by the fourth time through. Some psycho girl brings a laptop and transcribes the whole thing and emails it to the class. You could seriously get at least a B by never reading any other notes. Unfortunately, I didn’t fully realize this until this past quarter.

Nothing much else to report since I haven’t really left my room in 5 days and don’t plan to for another week. I would like to point out that Michael Moore is a genius. Whatever your opinion of him as a political analyst or a documentarian, you have to admit he is a shrewd bastard. His new film, Fahrenheit 9/11, which explores the ties between the Bush and bin Laden families, is slated to debut at Cannes this month and was supposed to be released by Miramax this summer. Word broke yesterday that Disney, which owns Miramax, is trying to block the release of the film. Now, apparently, Moore has known that Eisner won’t release this film for over a year, but has waited until now to go public and raise a big stink. He’s claiming (in a rather convincing argument, I must say) that Disney fears backlashes by Jeb Bush in terms of the tax cuts he gives to a little theme park down in Orlando. Eisner, of course, vehemently denies these allegations, purporting instead that Disney simply doesn’t want to be caught in the middle of a huge political issue and wants to remain non-partisan. Eisner is also accusing Moore of using the whole situation as a massive publicity stunt. Uhh, no shit. Harvey Weinstein, for his part, is not surprisingly siding with Moore and currently plans to release the film through the independent side-label he created during the Kids controversy back in the 90’s. Apparently, Eisner is trying to block this as well, although I don’t really see that happening. So, end result – Moore, who’s been pretty out of the spotlight since his Oscar speech last year, as his recent book was largely overshadowed by that of a much better liberal political author, Al Franken, is suddenly back as CNN’s top story just days before his film debuts across the ocean. While I tend to think that he’s a bit overrated (Roger and Me, if you take away the rabbit scene and the guy who says, “Yeah, this place isn’t open that much. It’s only open on Monday…Tuesday…Wednesday…. Thursday….and…uh…Friday,” really isn’t that entertaining or even well-made) as a filmmaker, and a terrible, terrible writer, I have to give the guy credit. He’s doing his part to guarantee that the voting public sees this film shortly before the election, and so, provided he doesn’t openly support Ralph Nader again and fuck up the whole election for the second time in a row, I’ll thank him for that. And don’t get me wrong – if Farhenheit 9/11 is anywhere near as good as Bowling for Columbine, it will be making my year end Top 10 list.

Oh yeah, and I'm glad I'm not this guy.

And This Picture is of Me Killing the Bear....

2004-05-05T11:15:00.000-04:00

One exam down, three to go. Unfortunately, the one that’s finished is the only one I actually enjoyed studying for, which doesn’t make the prospect of 8 more days very enticing. I was pretty happy with the psych exam overall, although I’m always a little disappointed when “urine alarm” fails to show up anywhere, and when I don’t get to point out that the treatment of Borderline Personality Disorder should include an avoidance of sex with the patient. I was lucky enough to obtain a copy of a fellow student’s essay on my way out of the exam, so I figured I’d post it here to let the general public get a better idea of what we are learning in med school. You might know the author. He has this mug…

Essay 1: A 32 year-old man presents to the ER with persecutory delusions that his father is trying to kill him by poisoning his medication. He has a history of Schizophrenia and cocaine abuse. He is treated with Haldol and his agitation dissipates over the next few days. He denies any current delusions or hallucinations. You are considering discharging him. Detail your risk assessment.

Dude, this guy is fucked up! Seriously, you should just commit him to the state hospital right now, because he is definitely psycho. First of all, he’s a crackhead, so that should tell you something. He’s probably all emaciated and shit. I saw this crackhead one time on the street and he asked me for some change. He didn’t even have any teeth. I was all “Get the fuck out of here, bitch! Get a goddamned job.” I bet this guy sells crack to children, too. On top of that, he’s a total schizo. Not one of those cool ones like in that movie A Beautiful Mind, either. I bet he’s one of the real whackjobs who walk around town with a sandwich board and tell everyone they’re going to hell. Not that there’s anything wrong with preaching The Good Word, but you should at least put on a clean shirt. And he has delusions about his dad. He probably wants to have sex with his dad. Oh man, that’s disgusting! He’s got some nasty paraphilia and shit. So, he’s already got two strikes against him, but I guess I’d ask him some more questions to enhance my case for committing him. If he’s like a poor minority, he’s clearly going to shoot somebody at some point, whereas if he’s like this rich white dude who fell upon hard times, I’d probably cut him some slack. (He’s still crazy though.) Plus I’d want to know if he hears voices and shit, because then it’s like Case Closed: You’re going to the loony bin. I’d probably make him sign one of those lame contracts, too, just to cover my ass if he does anything. As for treatment, you should load him up with more Haldol – I don’t buy that whole atypical antipsychotic bullshit – I want the strongest stuff we’ve got. If he’s catatonic and drooling and what not, he ain’t gonna be killing nobody. I know we’re supposed to assess suicide risk as well, but seriously, I’d be like “Good riddance.” If this guy wants to off himself, that’s one less problem I’ve got to worry about. I know if I were him, I definitely would be in that 10% - how the hell can you stand 500 voices having a running conversation in your head. That shit would drive me crazy. I’d be all, “Next stop, the Brooklyn Bridge.” So, in summary, I’d assess his risk factors and then commit him either way.

Dude, Those Shorts Are So Metrosexual!

2004-05-04T12:28:00.000-04:00

I just remembered that I forgot to submit my RAKS essay – It’s been sitting here on my desktop for over a week. That’s disappointing, because I was really hoping to win a gift certificate to the Lucky 7 – where students, tourists and car thieves meet. Since it wasn’t included in Jacob’s email, I figured I’d post it here so you guys could read it. For the unitiated, RAKS stands for some shit that no one knows and is basically this group of do-gooder pansy med students led by this kid who (I love you Jacob) dresses up like a clown and rides a god-damned unicycle down the street and has the ability to play several songs of equally annoying caliber on his car horn. Anyway, they were sponsoring this essay contest to raise our spirits or whatever in the face of upcoming exams, and you could submit a paragraph detailing what you are thankful for in your life or some shit. They randomly selected 4 of the entrants and those lucky bitches got gift certificates to a store on the corner of their choosing. It was so predictable who was going to win – the girl with the weird hand-raise, the token Jewish kid, etc. Totally fixed. Anyways, here is my essay about what I am thankful for.

I am thankful for so much in my life. I am thankful that my God is not the kind, gentle, forgiving God that some people talk about, but instead a smoter of doctors who perform abortions, feminists, fags, men who have sex with men, and men who engage in oral-anal contact with men. I am thankful that I can talk about my God to no end, even in situations where it is completely irrelevant and use my God to defend every single opinion I have, regardless of how ludicrous or tragically misguided it may be. I am thankful that I can capitalize my God when I refer to Him as Him. I am thankful that we live in the greatest country ever in the history of the universe where I am free to do whatever I want, including persecuting those who are different and less fortunate than myself, such as Muslims, Jews, metrosexuals, homeless people, and short people. I am thankful that our president recognizes the threat posed by outsiders and that he is willing to sacrifice all of human existence to preserve our freedom. I’m thankful for my 2 shotguns, my glock, my 9mm, my Colt .45, my AK-47 and my assorted collection of hand grenades and bayonettes. I am thankful for my keen fashion sense, which includes upturned collared shirts, seersucker suits, lots and lots of bowties, jean shorts and high-top sneakers. I am thankful for my Southern accent, be it real or fake. I’m thankful for institutions like the Charlottesville police, who are willing to go through the arduous task of racial profiling, performing DNA tests on every single black man in the city in order to find the serial rapist. I am thankful for the sanctity of marriage, which is clearly demonstrated in shows like Who Wants to Marry a Millionaire, which incidentally appears on the network I am most thankful for: FOX. I am thankful for Michigan legislators who recognize that gays and other weirdoes don’t deserve medical care at all and are willing to allow doctors to refuse care on the basis of moral grounds. Most of all, I am thankful for my frat brothers and fellow members of the Young Republicans, without whom there would be no one to discuss my prejudices with.

Daddy Would You Like Some Sausage?

2004-05-03T11:20:00.000-04:00

So I went to Suzy and Ben's wedding in Connecticut this weekend, and I must say it was one of the most fun events of the year. I guess anytime you find yourself doing the Roger Rabbit to Love Shack in the middle of a circle which includes Jack Lemmon's son and grandchildren, it's bound to be an exciting evening. But I'm getting ahead of myself.
I left for DC on Thursday after a disappointing loss in the doubles final of the ping-pong tournament. To top it off, I beat out Paul for the loudest expletive uttered in the heat of battle. I chose unwisely. I was concentrating so hard on not screaming “Motherfucker” every time I hit a poor shot that I chose “Jesus Christ!” instead. I usually caught myself before I said anything audible, but at one point I definitely shouted the good Lord’s name at a moment of complete silence. I don’t think this impressed Dean Pearson very much, who, as you may recall, had us all praying for rain at his house last year. I hope that doesn’t go in my letter. My only consolation was seeing Kevin Tran sitting there with his leather-cased paddle, looking devastated after not being picked to enter the Dean’s challenge.
The drive to DC was pretty uneventful, although I should mention that Vickie's condensed version of Magnetic Fields 69 Love Songs is probably one of my favorite CD's of all time and I can't wait for their new album on Tuesday.
Friday morning began at 6am, as Becca, Jamie, Naomi and I piled into Becca's enormous truck to begin our drive to Hartford. By 6:15, Jamie was already talking about Texas Catheters and gigantic penises and how her experiences as an ICU nurse in Fairfax have rendered her unable to ever eat sausage again. Becca then peeled a banana and fed it to her.
Friday night, Julie and I had dinner at this Irish pub in town, which had excellent peanuts and French fries, but not much else. I ordered a sandwich called the Philly, which was advertised to consist of warm roast beef, cheese and red peppers. I was a little confused as to what these ingredients could possibly have to do with Philadelphia, but I figured that the Irish population in Hartford might not be completely up-to-date on their food-city associations. Turns out that by roast beef they meant a Steak-Um and by white bread they meant a Kaiser roll. It was a terrible sandwich and it smelled very much like the White Castle hamburgers they serve on Amtrak trains which they microwave for 30 seconds in front of you, which meant that I almost puked every time I tried to take a bite. Needless to say, I ate a lot of peanuts.
Next up was the cocktail party at Ben’s parents’ suite, where we got to meet many of the colorful characters on Ben’s side of the family.. We went out to this bar/club called Blu afterwards, where we got hooked up with free passes to the upstairs dancefloor. At first they were playing that crappy rave/techno music where its just some beat with lots of sirens and some guy shouting “Blow my whistle, bitch!” (really, this is an actual song...I’m gonna have to download it), so we stood around watching Kill Bill Vol. 1 which was being projected onto one of the walls, but then the hip-hop broke through and we made our way out on the dancefloor. For some reason, we positioned ourselves in a corner directly in front of the entire speaker system and my ears were ringing for the next 24 hours. At some point during the evening I ended up essentially underneath this scary girl who was grinding on a platform wearing a cutoff jean mini-skirt which she physically lifted up to allow this unbelievably short androgynous Asian person to look up it. Said person stood next to me (I was facing the opposite direction, believe me) and stared at this girl’s underwear? (exposed genitalia? Who knows, I was convinced that my eyes would be burned out from my skull if I turned around) for a good 3 songs. Somehow, Omur and Tim kept getting more and more Aspen beer, to the extent that they would each have 3 beers in their hands every time I saw them, but were still constantly handing them out to the rest of us. They were also rocking their free Aspen T-Shirts on top of their button-downs which made for a nice fashion statement. As we left the club, we almost lost Juan, who had stopped to buy a hot-dog, which prompted Omur to ask Jamie in his thick Turkish accent “What, is my sausage not good enough for him?” Jamie ran away screaming.
We thought the night was over at this point, but as we exited the elevator to head to our room, Becca, Jamie and I realized that we were being trailed by Ben’s totally weird cousin Mike, who’s only conversation the whole night had consisted of yelling “Yeah!” at random points during the evening after the DJ played the Usher/Lil Jon song. Here’s the conversation that ensued.
Mike (Whispering for no reason): Hey…uhh…wow….uhhh…I didn’t think the evening was going to end this early………
Us: Uh-huh
Mike: Yeah…so…I have to share a room with my parents and uh…..
Us:………..
Mike: Do you guys have like any water in your room…I could really use some water…
Us:………..
Mike (Pulls the largest bottle of water I have ever seen out of the pocket of his tight-ass tapered jeans (I still don’t understand how this was physically possible)): Oh sweet…Where did this come from…ok, well, see you later
Us (Running down the hallway):….
The actual wedding was Saturday at 4:30pm. We arrived halfway through the ceremony. I didn’t think this sort of thing actually happened. Hugh Grant made it on time to all 4 weddings despite the fact that he woke up an hour late each time. We did get there in time to hear the corn story though. Apparently this brother and sister planted some corn in these fields they inherited from their father and then went to deliver the corn to each other and met in the valley. And I’m pretty sure they had sex. And this was a metaphor for Ben and Suzy’s marriage.
Of course we made it to the reception on time. My plan for the reception was that I wasn’t going to drink, since I knew we had to leave early on Sunday. 6 gin and tonics later, I was saying my goodbyes. And who knew weddings were just one big dance party? Seriously, it was a 1009 party with a slightly higher average age and fancier outfits. And different music. I was informed by Suzy that Back That Ass Up was not appropriate wedding music, so I went up to request Hey Ya. The DJ gave me a blank stare, so I said to just play any Outkast song he had. No change in expression. “OK, well then just play the most recent song you own.” Five minutes later, I’m vibing to Ace of Base. I was also the slow-dance whore for the evening, being the only single guy in our group, so I’m pretty sure I was getting dirty looks from a lot of the old men who were forced to dance with their wives to every power ballad.
Then there was the garter toss. At my sister’s wedding, Max actually had to throw the garter twice because nobody attempted to catch it the first time. The second time it was about to hit my face, so I threw up my hand to block it and inadvertently caught it. This time, I strategically positioned myself away from the angle of projection. Plus, Jack Lemmon’s granddaughter, who was 15 or 16 but looked about 22 had caught the bouquet and I was pretty sure I didn’t want to have to put the garter on her in front of her mom and dad, even after we bonded during Love Shack. Unfortunately, Ben’s throw had some wicked curve and headed straight for Omur and I. Luckily, it only sat at our feet for about 5 seconds or so before the youngest Lemmon child dove and grabbed it.
The reception had its share of drama as well, as one of the bridesmaids disappeared into a locked Bridal Suite with the groom’s friend about halfway through the party. The best part was that the girl’s Mom was there and of course found out about it like 5 minutes later, as these things tend to spread pretty rapidly at weddings. The Mom was waiting for her daughter as she came down the stairs at the end of the night and a colorful conversation with lots of hand gesturing ensued, much to the delight of the rest of us. Later, when we went out to bars with both of the involved parties, there was a noticeable lack of interaction.
Wow. This entry is ridiculously long. I guess I should probably start studying for those finals.

Are You Talking To Me?

2004-04-28T20:21:00.000-04:00

So I watched Taxi Driver the other night for the second time, but really for the first fully-conscious time. The other time I watched it was fourth-year in Maywood with Julie, and I remember being pretty hung-over and tired and having Cheerleader Jason walk in and out the room at least 20 times, each time offering enlightening commentary on the status of his knee injury or how much he had just bench-pressed at the gym. This time, though I really watched it. And I was blown away. Maybe it was partially the ecstasy of not having to study for 2 hours, but it was seriously one of the best movie experiences I've had in a while. Everybody knows that DeNiro's performance is mind-blowing and that Schrader's script is brilliant, but it was Scorsese's direction that really got me. Here's a 25-year old directing his third major motion picture, a guy, mind you, whom Tarantino basicaly just called "washed-up" in an EW interview, and he's got better shots than almost any veteran director working today. And the end. Jesus! The final showdown is possibly the most intense 5 minutes of film I've ever seen. Take your Requiem for a Dreams and your Fight Clubs and they pale in comparison to this sequence. And this is after they filtered the color to get the R rating! It always amazes me when films are able to stand up like this after nearly 30 years. I look at a movie like Rosemary's Baby or even Citizen Kane and I admire it's technical achievements, but I'm not transformed by the experience. Taxi Driver is different, though.
What I find most amazing about the film though is how it almost cost President Reagan his life. This is seriusly one of the most bizarre stories ever, and I'm just beginning to put the pieces together. So, basically, you have John Hinckley, Jr. this paranoid schizophrenic living in the mid-west. He sees Taxi Driver 3 years after it's released and decides that the movie is about him. In his delusion, he is Travis Bickle, and Jodie Foster, no longer Iris the prostitute, but instead the real Jodie Foster, is the girl/woman that he is in love with. He watches the movie 43 times. Now, in the film, when DeNiro attempts the assassination on Senator Joe Palantine, it's essentially unrelated to his quest to rescue Iris. In Hinckley's delusion, however, the two are linked and he decides that the only way to impress Foster and prove his love for her is by successfully completing the assassination. So he follows various political figures around the country, almost attempts to assassinate President Ford, and finally settles on Reagan. He moves to New Haven, where Foster is attending Yale and begins leaving notes in her mailbox. He is too shy to approach her though, given his paranoid personality and schizophrenic distrust of social interactions. He waits and waits for a reply. Nothing happens. He leaves New Haven and goes back to DC on a whim, finds out that Reagan is speaking at a conference in the city that very day, pens a note to Jodie and heads to the building with his brand new gun. Five bullets later, Brady's got the basis for his bill and Reagan's 2 inches away from a fatal gunshot wound. All because Paul Schrader lived alone for six weeks after his wife divorced him. Kind of. I mean, you can say that if Taxi Driver wasn't made, Hinckley maybe would have aimed his aggressions elsewhere. Maybe. He's got clear grandiosity and erotomanic delusions, so chances are his outburst would have been big-scale either way. The point is you've got a severe paranoid schizophrenic with numerous warning signs of violent potential who is receiving no treatment whatsoever. That is a psychiatric disaster, and it's society's and the government's responsibility to get him help, not to universally filter the potential stimuli he might be exposed to. What's that noise? Oh sorry - it's my soapbox crumbling beneath me. I'll stop now.

Hit Me With Your Best Shot

2004-04-27T15:51:00.000-04:00

Thanks to Catherine for figuring out how to post comments. Go crazy-go-nuts.

You Look Like You Gonna Kill Somebody!

2004-04-27T15:22:00.000-04:00

OK, I've calmed down. Somewhat. I'm focusing my negative ping-pong energy on the doubles bracket. Frist of all, some things about the blog:
The fact that there's no comment section really sucks. Because, i mean, what's the point of unmitigated narcissism if you can't even keep track of who's reading your posts? So I'll work on that. there's some third-party clients I can try to hook-up, although it seems to involve writing in some sort of code, so don't look for that anytime soon. In the meantime, just email your praise for my daily witticisms.
Secondly, if you're under the age of 14 and I am either your babysitter or lifeguard, you may be shocked by my liberal use of profanity. Stop reading, fucker! Or at the very least, realize that I'm only a role model during the sumer on on breaks and don't arrive at the dinner table all "Pork again, bitch?" For my part, I'll try to keep things PG-13.
Finally, if you're Andrew Bond, you may be thinking that this completely confirms your accusation that I used to post an online journal with my daily thoughts on my UVA webpage and would say things like "It was sunny today - I saw a flower growing in the park." You are wrong and I still don't know what the hell you are talking about.
So not much else is going on - I had my last-ever lecture today. It was kind of sad, although not really considering that I pretty much stopped going to class 2 years ago, but at least it ended with clowns juggling. No, really, I kid you not.

2004-04-26T23:34:00.000-04:00

So apparently this is where I post my ridiculously self-indulgent thoughts and you add it to your favorites list or link it to your own blog and check it like 6 times a day and get pissed off when i fail to post something and then, after a particularly long drought, forget about it completely or replace it with the blog of some 24 year old politico whiz-kid from Adam's Morgan who wows you with his in-depth analysis of Donald Rumsfeld's latest memo and his liberal use of the word "emo." Or whatever.
So in today's news:
Ashkenazi Jews: Could they get dicked over any more in terms of fucking genetic predispositions? I mean, Jesus! Or, I guess, Moses! As if the 500 random diseases that only they get weren't enough, they have the breast cancer gene as well? That sucks.
Ping-pong: Fucking side-spin. So I lost in the second-round of the med school ping-pong tournament singles division and I'm bitter as hell. I mean, it's not like I had any delusions of winning (although I did have this nice mental image of being hoisted onto the shoulders of my classmates and holding an enormous trophy while wearing a headband), but I at least thought I would lose to Matt or Brent or someone respectable. But Kevin Tran? The K-Train? Come on. The kid has no game except for this freakin' stupid-ass serve that is impossible to return. Seriously who the fuck uses side-spin? I mean top-spin is obviously the way to go and backspin is at least respectable provided you don't use it on every shot, but side-spin? that's ridiculous. And he has his own paddle. With a butterfly on it. And a leather case. So now I' that guy who lost to the pussy with the leather cased-paddle. Awesome.
that's it for the night. i can see this blog is going to do wonders for my studying.