Wednesday, September 22, 2010

Congrats, You Aren't Having a Heart Attack

Just walked out of a practical exam in which we are handed a clinical vignette and must tell our attending physician what treatment approach we'd pursue and, afterward, demonstrate a manual medicine technique on our partner.  The scope included cardiopulmonary cases with specific treatments aimed at helping to alleviate a hypersensitive parasympathetic or sympathetic influence on the heart, edema, and cough.

On my second case, I was reading the vignette and avoiding the piercing stare of my attending.  During practicals, he's completely stoic and poker-faced and, frankly, I get a little flustered.  After what seemed like an eternity, I decided that my 14-year-old fictitious patient had a viral infection and had an inhalation dysfunction of the ribs that was impeding the biomechanical aspects of getting full excursion on inspiration.  I stammered my way through my rational about why I thought the patient was medically stable in order to proceed with my course of treatment of the ribs to assist breathing.  I listed a few reasons for why I didn't think he was having a heart attack.  At the end of my list, the attending says "...and he's fourteen." This, of course, is in addition the fact that nothing in the vignette remotely suggested MI.

I turned to my partner and said, "Congratulations, you aren't having a heart attack."

Next stop, big test block tomorrow which marks the end of the respiratory / pulmonary system.  Gonna spend a ton of the night and tomorrow trying to get cancer presentation, genetics, staging, treatment, and microscopic identification into my brain.  (In addition to pulmonary embolism, deep vein thrombosis, occupational pneumoconosis, pharmacological treatment of asthma, various other "bugs and drugs.")  Woo hoo. 

Monday, September 20, 2010


I'm so much luckier than anyone has a right to be.

"Like melted gold."

Thanks, Winning Run, for taking this crazy ride with me and being the pillar that holds me up.  I absolutely, positively could not do this without your support.  I'm thrilled to be part of the pack.  

Thanks for seven amazing years; I look forward to many more on our adventure together.

Sunday, September 19, 2010

It's the New Normal

A couple of weeks ago, as I drove to Seattle to see Winning Run, I phoned a college roommate to catch up with him.  Some years back, he moved away from Atlanta and started a family and pursued his career.  Unsurprisingly, time, distance, and the general pull of life's direction prevented us from talking as much as we should've.  Over the past year, Drewbie has phoned me numerous times and just left voicemails to say something like "Hey buddy, I'm thinking of you.  I know you're working hard; keep it up."  What's uncanny about it, is that he'd always call exactly when I needed most to hear a familiar voice, to get a brief pep talk, to have some unsolicited, unconditional support.  I can't tell you how much these little nudges worked to get me over each hump.

During our conversation, he was telling me about what's been going on in his life with some familial health scares.  As much as I'm overwhelmed by school, in the grand scheme of things, I have absolutely nothing about which to complain; things are pretty much OK with me. 

As we closed our conversation, I told him that I wished we could talk more frequently and that the frequency of our conversations don't reflect my affection for him.  To which he replied something like, "Hey man, I get it: you're in your 'new normal.'  You don't have the time to call.  Your normal is that you don't have time.  That's okay, I get it.  I'm just happy to talk to when we can. When I call, it's just to let you know I'm thinking about you."

Here's to the "new normal" and the practice of deferred gratification.

Thursday, September 09, 2010

Sometimes You're a 1998 Mercury Sable ...

... and sometimes you're the fresh hood ornament.  Here's to being the Mercury Sable.

It would've looked better on a Thunderbird.

Tomorrow morning's test quickly approaches.  So far this week, I've managed to maintain my streak of being called on in each interactive session.  The week began with being first out of the gate in a pharmacology session.  You always want to be the first because the first question is typically easier than the subsequent ones and you get to relax for the remainder of the session.  Luckily, I answered the question correctly and proceeded to enjoy the hell out of the remaining hour and fifty-nine minutes of the session while some of my peers anxiously sweated it out.  Today culminated with my incorrect (or, rather, "non-indicated") answer of avoiding spicy and tomato-based foods as the most appropriate follow-up therapy for a particular patient with GERD.  Nice but no cigar.  Well, at the very least, I was thinking of a friend back home and using her to form an empirical plan of action.

Tonight, my plan is to get to bed at a decent hour (11pm? midnight?) and be back on campus at 6am for a final push into the test.  Then, after 70-seconds per question for about 140 questions, I'll be able to relax and do more studying.

La vida pura!

Thursday, September 02, 2010

Well, Doctor, If You Must

In light of my less than stellar performance on last week's pharmacology exam, I dropped by to visit my professor to review my study habits and seek guidance.  Not only is he one of the most intelligent people that I've ever encountered (read: freakishly genius) but he's also got an amazingly dry sense of humor that he quickly and deftly displays. 

During our discussion, I told him how I'm studying with others, discussing the mechanism of action of the drugs, picking a prototypical drug in a particular class to learn, and, then, comparing the prototype's half-life, adverse effects, and contraindications with others.  Then, I mentioned that I'm striving to find other materials that would help me to quickly assimilate the information.  Like many other times, the gulf between what I aimed to say and what I said was wide, my friends.  Here's how the exchange occurred:
"So, Dr. _____, I'm really trying to quickly inseminate the information," I say confidently.
[Awkward pause.]
"Well, Doctor, if you must," he says with a half-concealed grin.
"I think I'll just try to learn the material, sir."
Once again, victorious in the ways of oration.