Sudden Death Academic Probation

Decade

2011-09-11T22:39:00.000-07:00

All day long, I've felt uneasy, unfocused, unsettled. I suppose that it'd be terribly easy to blame it on being bombarded with images from that horrific day a decade ago. In some ways, I thought I that I was a little further along, that the scab would hold. I didn't lose anyone in the attacks, don't have any amazing story of survival, or any first-hand account from that day. My stories from NYC are apocryphal; they're the "friend of a friend" ilk. Still, like most everyone, I remember exactly where I was, exactly what I was doing, and exactly how uprooted the world felt to me in the span of a few short hours. As I climbed into a coworker's car and fled home, I remember the certainty that anything was possible, that maybe the bomb threat on our office building in Atlanta was another imminent attack. That evening, I remember being struck by a news correspondent's grace and composure as she walked the ash and paper-filled streets of lower Manhattan. I remember the haunting silence in the skies near Hartsfield International Airport. I remember getting drunk and reading Hemingway, identifying more than ever with his lost generation.

The decade since has been kind to me. Several weeks after 9/11, I met the woman that I'd later marry, the woman that now carries our child within her. I've grown as a person, as a husband. I've mourned the loss of dear family and friends and have celebrated the arrival friendships and family anew. I've abandoned the corporate world in favor of chasing my dream to be a physician. I've left family and friends on the other side of the country to strike out on this crazy endeavor with my wife and my dog.

In many ways, I feel courageous more often than not. I feel humble, thankful. I am luckier that I deserve to be. Still, when file through the images from that day so many years ago, when I hear the sounds of the chaos, it still fills me with dread, with terror, with anguish.

Go hug someone you love; tell them what they mean to you.

Le Circ

2011-08-15T10:00:00.000-07:00

I've performed (under close supervision) two circumcisions. One was on an 8-day-old; another on a 16-day-old. It's a crazy, crazy thing to do. After administering anesthesia, removing adhesions, installing the correct Gomco clamp, you just do the damned thing. Generally, the babies tolerate it pretty well without very much agitation. One of them slept through it.

On another note, I'm giving up calamari for a while.

On Being a Part of It, In Good Times and Bad

2011-08-13T12:15:00.000-07:00

Another week has flown the coup. I am having an amazing time in my Family Practice rotation. Part of it stems from the fact that I'm working with preceptors who are near my age and who love to teach. They're great at encouraging me to be a part of their day and to help them with patients. It makes a huge difference, believe me. One of my docs does a lot of pediatrics and women's health care, which is pretty interesting. In all, I've been seeing a lot of good cases, meeting interesting patients, and getting better at the art of being a physician.

The Bad
It's interesting to be in the room, to work with someone, and to be privy to such personal information. I've heard things that spouses might not hear from their loved one. I'm trusted to inspect areas of concern on a body that few will ever be given permission to examine. There are few things better than to be there when you know the solution for a malady, when you're able to offer comfort, solace, a remedy. Antithesis to the joy is being the bearer of bad news, the worst news.

I spoke with a preceptor about how he'd discovered what was likely lung cancer in a patient who'd had a non-remitting cough for some time. The patient had to be begged to get a chest X-ray. Being in the room while the doctor delivered the news was, to say the least, humbling and crushing.

Last week, I was helping with an OB exam. We got the bedside ultrasound and doppler and were going to do a check for a patient complaining of bleeding and abdominal pain. We saw the fetus but no heart flutter. We couldn't find fetal heart tones with the doppler. Standing there in the darkened room, watching the woman's face strain with the comprehension of the images on the monitor was absolutely crushing. I can still see her bathed in the light of the LCD panel, eyes widened with fear, tears welling. It was an awful, awful silence. At times, I don't know if my heart is large enough for medicine.

The Good
Mostly, though, I get to deal with sick people that can be helped and who's understanding of their body is, let's say, unique. A couple of days ago, I met with an obese gent who told the female nurse that he had an eye problem that wouldn't clear up. (It's likely allergies.) When I met with him, he confessed that, although he was too embarrassed to tell her, he was here for a rash on his penis that wouldn't go away.

He'd been to see someone about it before and, when they recommended treatment and another circumcision, immediately considered them a quack. He was convinced that a salty discharge from was drying the skin on his penis. Also, he also was certain that his penis was shrinking. I explained that his recent weight gain likely changed his perception of his penis but it was doubtful that it was going anywhere. The physical exam showed that he had a infection that likely stemmed from a hygiene problem worsened by extra penile skin. Another circumcision that completed the job would probably remove the bacterial breeding ground and prevent it from recurring. As it stands though, treatment with topical and oral anti-fungal meds will likely do the trick for him. Weight loss will do wonders for his ego ... and ruler.

On Free Lunch and Ethical Comprimise

2011-08-01T09:00:00.000-07:00

On my last rotation, drug reps would provide lunch for the office in exchange for a little face time with the doc to discuss their products and garner feedback from the prescribing physicians. As I was essentially glued to his hip, I attended these lunches also. The more experienced reps seemed to have an easy-going relationship with the doc: they'd known one another for a long time, they'd talk about the drug, and, thankfully, would intersperse normal conversation. For many of these, it was informative and beneficial. Here's new information about a drug, here's a new combination with a synergistic drug, here's some news about pricing or insurance coverage that will help your patients, and ask for information about how the physician prescribes it. Also, they'd stock the sample shelves. So, it's a good way to get information. As a student, it was a great way to learn a little more pharmacology involved in family practice and save some cash on lunch.

Occasionally, however, I'd meet a rep that really made me feel icky, that reminded me of a caricature of a used car salesman. On one particular day, a slick dressed gent who wasn't particularly humble was pitching his wares and doing his best to sell his drug. He was trying so damned hard that, at one point, he actually says "Boom!!! Take that, high blood pressure!" about his drug's ability to lower pressure.

I sat there amazed but thankful for the best catchphrase I'd hear in quite some time. Personally, I'd love to see it in some ad campaigns.

Boom! Take That, First Rotation!

2011-07-31T21:35:00.000-07:00

For most of July, I worked in a Family Practice clinic with a doc who uses OMM (osteopathic manipulative medicine) for some of his patients. After two years of having my face in a book, it was exhilarating to actually be in a clinic and working with patients. There were times when I felt like an actual doctor and, as expected, many times when I realized just how little I know. It seems that most of the patients we saw had the problems you'd expect: diabetes, hypertension, hyperlipidemia. My doc was a former flight doc and a great guy. Literally, he'd bound down the hall and into a patient room. Often, I'd have to run to remain hot on his heels. He taught me a ton and didn't make me feel like an idiot. Occasionally, I'd do that on my own.

Valsalva and the Fluid in the Ear
One patient came in with a complain of fluid behind her ear. After taking a brief history, I looked in her ear. Sure enough, I was able to see a little fluid bubble behind her ear drum. My doc asked me to have her perform a Valsalva maneuver and see if the tympanic membrane fluttered. I thought it a little strange but, as I was looking in her ear, I asked her to "bear down" with her abdomen to increase pressure. She looked at me a little funny. "Bear down," I repeated. "Sort of like when you're having a bowel movement." Her face looked at me with the same confusion that I felt inside. What the hell does a bowel movement have to do with an eardrum? Why do a Valsalva for this? I made eye contact with the doctor who was staring at me like I was a total moron. As he walked over and took the scope from me, he said to the patient, "Just hold your nose and swallow."
"I didn't know that was also called a Valsalva," I whispered.

Passed.

2011-07-30T07:51:00.001-07:00

Didn't want to jinx anything by writing. I've passed my Step 1 boards. The silence is over. I'm back with stories from the field.

T-Minus 14 Days

2011-06-09T11:16:00.000-07:00

Boards in 14 days. Heads down studying. Doing very little else other than jamming so much shit into my brain that I am neglecting to grocery shop, see or talk to my wife, go outside, drive well, dress well, and so forth.

I feel like a penguin on an iceberg watching others jump into the water and feeling rapid cycles of fear, anticipation, terror, and exhaustion.

In other news, if "Music of the Night" from "The Phantom of the Opera" pops into your head at midnight while you're studying, DO NOT, under any circumstances, create a Pandora station to listen to it. If you do, I promise you, your efforts will end like this: three tunes later, a song will play - maybe it will be "Circle of Life" from "The Lion King," maybe it will be "One Day More" from "Les Miserables," maybe it'll be "Memory" from "Cats." Rest assured, a song will come on and it will grab you. You'll be alone at nearly 1 o'clock in the morning, alone, singing aloud, tears streaming down your face, dripping onto your Pharmacology notes.

Grrrr, manly!

Out of the Forest

2011-05-13T11:16:00.000-07:00

Second semester done. Boards looming. No longer walking into the forest. Running terrified out of it.

That's Pure Hell

2011-04-15T23:13:00.000-07:00

Another week in the record books; another system completed. Today marked the final exam of the reproductive system. I'm relieved and quite tired. Sleep beckons but I've got a story to tell...

This Is Probably Going To Sting. I Mean Really, Really Sting. Badly.

This week, all the students did a male genital exam. This consists of doing a physical inspection of the genitals, palpating the testicles for masses, feeling for hernias with the old "turn your head and cough" maneuver, and the prostate exam. For these male and female genital exams, the school hires "patients" who are compensated for their time in helping further our education. Let's just say that these folks come from various walks of life: some are dedicated to helping us learn, others are on tough times and need the money. Regardless, it's a pretty unique thing and, for sure, is one hell of a tough way to make some money.

When it was my turn to go, I was grouped with two other students and a preceptor who would oversee the process. We walked into the room and saw our patient: a young man in an exam gown, a little nervous looking. He was pretty fit and looked like he'd seen some scrapes in his life as evidenced by some visible scars and plenty of tattoos that covered his arms. He reminded me a little of a down-on-his-luck Manny Pacquiao. Behind us on the counter was a box of gloves, a few tubes of Surgi-Lube, and a paper towel with a huge mound of gel (similar to what you might see when you're preparing to insert a catheter).

After a little chat, the exams began. The first student started out, asked the patient about his health history, did a fine job with the exam, and was cruising with no hiccups until it was time to do the digital rectal exam. He grabbed a tube of lube from the counter and fumbled with it a little while trying to get it on his fingers. To make matters worse, the patient wouldn't quite bend over far enough on the table to allow for a easy exam. (Honestly, can't say I'd blame him.) Undeterred, [student 1] continued and the patient did his best. Prostate examined, hands washed, sighs of relief sighed.

The next student moves in to the repeat the exam and, as expected, sort of built on the what we've just seen by incorporating feedback in real time, if you will. He was very precise in his exam and his technique. When it came time for the prostate portion, he turned to the preceptor and asked if he should just use the lube on the paper towel. The preceptor gave his approval and the student easily got his finger lubed up and ready for the exam. He asked the patient to bend over and, confidently, began the exam. As he conducted his exam, [student 2] asked the patient to relax and tried to reassure him.

As I stood there with the first student, I noticed that the patient's toes had curled under his feet, and that his hands had clenched the table, and that his arms were quivering. Truly, his feel had curled up so damned much that I though [student 2] was going to be wearing Dorothy's ruby slippers. We looked at each other for a split second and the first student asked the patient if he was uncomfortable or if he was doing okay.

"I think ... it's ... alcohol," the patient said through gritted teeth.

Everyone in the room gasped and blanched, including the second student who, by the way, immediately ended the exam. We all leaned over the paper towel on the counter and smelled the mound of hand sanitizer on it. It was never lube! Someone had prepped a bunch of hand gel and left it by the lube ... while we were doing prostate exams. Needless to say, we apologized profusely and asked if he needed some time to go wash up or if he was still in pain. He said that he was fine and that we should continue.

"Holy crap, this dude is prison strong!" I said in my mind as I gloved up.

I will admit that it's a hell of a thing knowing that you're batting cleanup and having to do another exam on a patient who's just had a bolus of Purell introduced into his rectum. During the genital exam and hernia check, I talked with the patient while explaining what I was doing on the exam. When I asked him about the prior hernia that he mentioned, he pulled up his gown to show me the scars on his chest from the repair of a surgical hernia after he'd been shot. "Shot," as in "with a gun."

"Damn," I thought, "[student 2] is gonna get his ass killed tonight."

When I got to the prostate check, I made sure to grab the tube of the lubricant and apply a liberal amount. I did the exam, discarded my gloves, and, with the other students, thanked the gentleman profusely for his time and involvement in our education. We offered our most sincere apologies and left the room. He mentioned that it was like something from SNL and told us his nickname as we were leaving.

After our debriefing session with the preceptor, the three of us students walked, shell-shocked, back to our study carrells. [Student 2] remarked about how I charmed the guy and how we were best buddies by the end of the exam.

"It wasn't that hard, really. All I had to do was not put a handful of Purell in his ass and we were buds."

It really is the simple things, isn't it?

Dr. D.R.E.

2011-03-30T18:25:00.000-07:00

Class continues to progress. Board exams relentlessly approach. In a few months, I'll be in the hospital on rotations. This journey seems so far from where it was when I quit work some years back and began this endeavor. As I'm in the midst of what is the craziest bit of studying that I've experienced, I've not written very much lately. Do, however, feel free to check out Scholarly Photos, a photo blog that I've created to provide some creative outlet in lieu of writing. (See the links to the right; you'll know the one.) I look forward to posting more regularly in the near future. In the meantime, please accept the following yarn as a down payment on future posts.
-- The Scholar

Yesterday, I shadowed a doc at an Urgent Care clinic. In the past, I have been stunned at the variety of things that I've seen, amazed at her prowess in diagnosing and treating, and thrilled at what I've seen. Late in the day, we saw a patient who presented with prostatitis. We took a history, did a physical exam, and asked him for urine. The doctor got a gown for him and asked him to change into it because we'd need to do a rectal exam. Pretty cool, I thought, as I walked out of the room.

A few minutes passed and, during a break, she asked me if I'd done a rectal exam. She asked if I wanted to do this one. I let her know that I'd never done one but I'd love the opportunity as it would be a great learning experience. As we went back into the room, I was pretty amped from the adrenalin and anxiety. Like a hawk, I watched everything she was doing. She asked the patient if he'd allow the student to do the procedure as a learning experience and he consented. Immediately, I threw on some gloves and was overcome by a sudden urge to roll my freaking sleeves up as far as I could get them. Seriously, if I was wearing a muscle shirt, the sleeves still wouldn't have been up high enough. No worries, I was going in!

The doc gave me another quick demonstration which I pantomimed in the air. I can only imagine the look on the patient's face as he overheard me repeating everything; poor guy must've been mortified. Next, the doc and I tried to put a dollop of lubricant on my finger. Turns out, the tube of KY was nearly empty. Honestly, it was like fighting to get the last bit of toothpaste out of tube that should've been thrown out a week ago or, more specifically, exactly like someone nervously trying to get adequate lube on their finger before doing their first rectal exam on a patient. Once successfully prepared, I approached the "entry zone," began the exam, and did my best to act out her instructions, being careful to try to listen with my fingers for any abnormalities.

After, I ditched my gloves, maintained my professionalism while I left the room, and, grinning, washed my hands as furiously as Lady MacBeth.

In addition to that patient, I helped suture a hand laceration, removed an embedded foreign body from someone's eye, did a few physicals, practiced OMM on two patients (a respiratory case and a shoulder rehab), and saw a bunch of sick kids.

My day was awesome.

I. Love. Medicine.

New Neighbor, Same Old Crazy

2011-02-23T20:20:00.000-08:00

So much to share, so much has happened. First, however, the most recent gem...

Several months ago, my crazy upstairs neighbor moved away. Since then, things have been, frankly, far less crazy. Don't get me wrong, it's a good thing. In fact, it's a great thing. The new tenant is a pretty nice guy. He's an older gent who's renting the apartment while he's in town for some continuing education courses related to his job. In start contrast to the previous tenant, Batshit McCrazy, he's a friendly, "with-it" kind of guy. On numerous occasions, we had conversations outside. He's got a knack for remembering who the hell I am and what it is that I do. To top it off, he remembers Winning Run and a bit about her as well. I suppose that he's just a nice guy who enjoys conversation. Anyway, it's a nice change from the previous who, each time she met you, seemed happy to be meeting you for the first time.

Last week, on the eve of the President's Day weekend, I was packing my car to head to Seattle to see Winning Run. As I'm putting the last bag inside, I see him walking across the parking lot toward his apartment and say "hello." We begin to talk. After a short while, the conversation drifts toward current events and to the upheaval in Egypt and other countries in the vicinity.

"It's pretty crazy what's going on over there, right?," I asked.

"Yeah," he said. "It's a mess. We need to watch out."

"Tell me about it. Oil prices are going to go through the roof," I offered.

"Uh huh. We need to be aware of what we're doing; they're watching," he explained.

"Yeah, we use too much oil. I guess the government does need to watch out. We need to wean ourselves off of it, don't we?," I offered.

He looked a little puzzled. "Government? No, man, the UFOs are watching us."

[Silence.]

"Huh?," I asked, unsure of how we moved so quickly from unrest in the Middle East to extraterrestrial monitoring of our affairs.

"Yeah, they're out there," he exclaimed while pointed toward the horizon. "I seen 'em flying. I know planes and what I've seen are not planes."

"Okaaayyyy," I said while trying to put on my best poker face.

"It's started back in World War II when we built the bomb and brought all the Nazis over to work on the space program. We had the power of death, the bomb. They started watching."

"Really," I said, moving toward my door.

"I've got friends who work for nuclear power plants. Sometimes the guards will go outside and see their ships hovering outside. Sometimes they shut the plants down, just turn 'em off, to let us know they're watching us."

"Guess we'd better behave, then," I told him. I wished him and good evening and ducked into my living room. "Well, that got effing crazy really, really fast," I said to the emptiness.

My favorite part of the conversation was how he looked at me like I was the crazy one for suggesting that the government, not aliens, were watching us. Priceless. And completely, utterly wacko.

Long live Batshit Crazy McGillicutty..

Maybe It Isn't Really About The Baseball

2011-01-04T21:23:00.000-08:00

A few weeks back, I commented to my classmate that I'd noticed a bunch of young guys in the town wearing Atlanta Braves apparel. Being so far from home, when someone sports a hat or jacket from my hometown team, it's my first impulse to shout "Go Braves!" at them, or at the very least, to introduce myself and chat with them. Hell, Winning Run and I did the same to some people in Seattle who were decked out in UGA gear one Saturday in the fall. They were pretty friendly. For some reason, however, I've been hesitant to do the same with the folks I've seen around town here. "I'm pretty sure that these guys aren't baseball fans," I mentioned to my buddy.

Which brings me to today's lecture about gangs...
During what was an informative lecture about gangs that included several cringe-inducing security camera videos of homicides and assaults, I connected a few dots. (Those dots, by the way, were not about why we were having this particular gang discussion as part of our medical school education. It was informative, engrossing, terrifying, and heartbreaking but lacked the ties to medicine that I would've preferred.) A local faction of major gang sometimes leaves graffiti tags using a three letter abbreviation or numerical equivalent. The officer giving the lecture mentioned these numbers. Immediately, I recognized them as an area code from the Atlanta area. Then, I made the leap to Atlanta apparel. When I asked the officer about this connection between the "area code" and MLB clothes and hats, he responded as if it were a novel idea to him. "I guess they could be doing that. It fits. We'll look into it," he told me enthusiastically. "Considering that I've seen more Braves gear out here than I did back in Atlanta, that might be a good idea," I said. Then I returned to my seat and planned what I would say to the crowd when the mayor inevitably presents me with the key to the city.

In other news, I'm glad that when I saw the first of these cats, I didn't start yelling and doing the Braves chop ... or running through my pitch signs. They might not be as nostalgic as I am for the Sid Bream slide.

Twenty Eleven

2011-01-01T00:00:00.000-08:00

To ATL and Back

2010-12-31T19:09:00.000-08:00

Best Christmas Card Ever

Winning Run and I never got it together enough to send out holiday cards this year. We aiming for a "Happy New Year" card. That's our plan. She did, however, give me a fantastic Christmas card that incorporated a photo of a snowman I made for her and recent events. Photo and card below...

The rare 4-globe snowman.

Winning Run's hand-drawn card, for the win.

Southern Snowpacalypse 2010

Early on the 25th, Winning Run and I hopped a flight back to ATL. Our original 6am departure had been canceled by Delta supposedly for the weather but, in my opinion, to consolidate less than full flights into ones more profitable. The people watching on the flight was pretty good. The "My Love" lady whose children sat across the aisle from us was priceless. We overheard her say "Now I can't sit with you, my loves, because I have to sit with daddy. You stay here and behave, my loves. Mommy will check on you." Then, she waddled four rows up and wedged herself into a middle seat with her husband, leaving her 8 and 4 year old kids alone to do as they chose. To their credit, the kids were pretty good. As a result, "My Love" lady visited only a few times during the flight but each visit was a precious Christmas gift to Winning Run and me. At one point, she stood in the aisle bent over her brood, her ass inches from my face, and started doing hip stretches. I managed to cry a single tear and whisper toward Winning Run: "God bless us all, every one."

When we touched down in ATL, snow was falling and, I'm certain, all the milk, bread, batteries, and kerosene in the city was in very short supply. Thanks to the Duke's expert driving, we made it to Winning Run's family Christmas dinner and gift exchange extravaganza. Their place was coated in about 3 inches or so of wet snow. News outlets reported that it was the first White Christmas in Atlanta since the 1880s, I think. The evening was great but traveling from SEA to ATL was quite tiring. When I turned in to bed that night, I fumbled in the dark looking for the bedroom light switch. When turning on the light, I was greeted by a doll lying on the bed, staring at me, peering deep into my soul. Although it was my mother-in-law's dear childhood plaything, the damned thing scared me. Even worse, I awoke during the night and it was on top of me, eyes glowing red, whispering a Latin incantation; I peed the bed, fought it off of me, and went outside to sleep the remainder of the night in the snow.

The SoulCatcher 5000

A few days later, we went to visit my parents and share some time with them. While there, I did a bunch of OMM treatment on my mom and it seemed to help her out; guess I'm learning something. :) We even managed to catch up with a bunch of friends and share some beers at a local watering hole back home. It was too brief visit but I'm glad we went. Sometimes, just being around those people who really know you can be a great boost for the spirit.

Winning Run's Fist vs. the Mouth of a Teenager with Braces*

2010-12-23T07:00:00.000-08:00

*The following story has been invented to add intrigue to the details surrounding Winning Run's accident. It is not true. For the true story, you'll need to hear it from Winning Run herself.

The other night on the bus back from the Picasso exhibit, some rough looking teenager on the bus kept mouthing of at us. Really harassing us. We moved seats a few times to get away but the kid just kept it up. After an eternity, we reached our stop. As we were exiting the bus, the punk reached at Winning Run's bag. Naturally, she jerked away and the punk started swinging at her. She clocked the idiot in the mouth but the punk's braces cut her hand.

We made a quick to the ER and got her stitched up. Meeting with a hand specialist later today to ensure that no tendon damage occurred. Personally, I don't think it did.

And now, some action shots from the hospital...

Pre-stitches.

Irrigating the wound.

Post-stitches. Yum.

3 Semesters In and All is Well

2010-12-22T23:01:00.000-08:00

Late last week, I wrapped up my third semester of medical school. In retrospect, it's pretty hard to believe that it's gone by so quickly. Actually, some weeks last what feels like months, hours become says, fifteen minutes is enough time to accomplish so much. Other weeks, however, fly by so quickly that I seem to move in slow motion while everything speeds by me. So, there's that. Time is elastic; it moves quickly and slowly but rarely constantly.

Next semester begins in January and brings with it a maddening push through remaining subject matter, toward the boards. Then, in July, I'll begin rotations in the hospital. Insane.

For now, however, I'm going to enjoy a few days under the same roof as my wife, studying less than I should.

It's a Little Less Funny Today

2010-11-29T21:36:00.000-08:00

In 1982, after each episode of "Police Squad" aired, I'd get on the phone and call my grandmother, "Bamba," to discuss it, relive it, and laugh about it even more. At this point, I don't even remember all of the gags on the show but I'm not sure that it matters. (They've been recycled time and again through all of the "Naked Gun" films, anyway.) I do remember the two of us in hysterics about the shootout between some miscellaneous hood and Frank Drebin, each taking cover behind trashcans no more than two feet apart. That scene really killed us; I mean it just brought us down, made us laugh until we cried.

So, I guess I owe those memories to a short-lived television show starring Leslie Nielsen. The measly six episode run allowed a 9-year-old kid to get on the phone with his grams and to just laugh it up, to be fans, to be lovers of slapstick, goofy comedy.

Thanks, Mr. Nielsen. Rest in peace.

Hands Off The Chic-Fil-A

2010-11-28T07:00:00.000-08:00

As I was getting into bed some time after Winning Run had gone to sleep, she announced in a whispered voice "I just invented a game called 'Hands Off the Chic-Fil-A.'"
"That sounds pretty interesting," I told her.
"Yeah. I'm not exactly sure of the rules, though," she replied.
"Well, I can think of two of them," I offered.
And, with that brief exchange, she was back off into her dream, a magical land full of games played with delicious Chic-Fil-A sandwiches.

So Long To Pinky, Here Comes The Thumb.

2010-11-27T14:54:00.000-08:00

...and it's nearly December. Seriously, I cannot cannot cannot believe how quickly the time has flown since the semester started. We've completed Cardiovascular, Respiratory, Renal, Hematology/Oncology, and looking to wrap up GI in the next few weeks. Here's a very, very brief recap of some of the goings-on since my crazy-assed neighbor decided to rappel from her balcony on Christmas lights...

I'm a Professional Twice Over

For Halloween, several of us decided to dress as the cast of Arrested Development. The "costume contest" took place during a pot-luck luncheon at school prior to an interactive session. I went as Tobias Funke. Initially, I dressed in cords, a funky shirt, and Birkenstocks but quickly stripped down to "never nude" attire.

David Cross as Tobias Funke

from "Arrested Development"

After winning the costume contest, I attended class in costume. I must say that being mostly naked in class (and being called on to stand and answer a question) was as near as I'll get to realizing the recurring nightmare of being in class naked. My wife was so proud, she cried tears of "joy" as she tried to remove her wedding ring.

The Best Week of Medical School I've Experienced

As part of our clinical skills training, we worked an emergency case on a simulated patient or Sim Man. The whole thing was pretty intense as, despite our efforts, it desaturated and was transported to the ICU after we intubated it. Still, I walked away from it thrilled to be a medical student and anticipating the applied practice of medicine instead of the didactics. Later that week, I passed my tests with flying colors. Generally, I felt pretty good about myself and my performance as a student which, based on how the semester has gone thus far, has been a pretty fleeting feeling for most of my classmates.

Snow-Drive

A couple of weeks ago, I went to Seattle to visit Winning Run and accompany her to a dinner party hosted by a coworker friend. I applaud wonderful food and great conversation but, shit, dinner parties should be fun and not so damned serious or pretentious. At first, I thought we wandered into some sort of liberalism pissing contest that delved in and out of "foodie-ism" which, by all accounts, can be equally pretentious. Luckily, libations seemed to loosen everyone up, make the gang more approachable, and the conversation a little more organic and natural.

The next day, at Dick's Drive-In, Bill Gates pulled into the parking lot and stood in line behind us. This is the absolute, honest truth. We noticed him, confirmed that it was him, and decided to just let him have a little peace. Plus, I was convinced that had I attempted to speak to him and shake his hand, a sniper would've taken me out on the spot.

Once again, I was reminded that I'm no longer in the southeast with my drive back from Seattle. I had to go by chains for my car to get over the pass and had an amazingly terrifying drive (for me). After getting over Snoqualmie Pass, the rest of my drive was spent in blinding snowfall with accumulation on the road. In the silence of my car, I kept repeating part of a Samuel Jackson monologue from "Pulp Fiction," telling myself aloud that I was like a little Fonzie: "And what's Fonzie like?" "He's cool?" "That's right, he's cool."
On successfully making it back, I noticed that my ass had been clinched so tight that I'd drawn up my seat into a permanent cone, an inverse vortex, a physical sign of my stress.

Thanksgiving

Winning Run made it in on Thanksgiving morning. That afternoon, we had dinner with several classmates and their families. In all, it was pretty fun and nice to be away from the books for a little bit. Now, it's just a downhill slide to holiday break before the uphill climb to the work of next semester, boards, and rotations. Yippee.

Batshit Crazy McGillicutty Escapes A Wintry Grave*

2010-10-25T22:55:00.000-07:00

*By a "wintry grave," of course, I mean that temps are expected to dip overnight into the mid-30s.

Preface: I now live in an old apartment with a crazy-assed landlord and, other than the two other medical students I have as neighbors, a motley assortment of peculiar tenants. My upstairs neighbor, who's name I cannot remember -- and never will because the rules of decorum dictate that far too much time has passed to ask her (a misdelivered parcel is my best hope for insight) -- anyway, whenever I see this neighbor, she always asks if she's making too much noise. I politely tell her not to worry because I'm not home too much, that I'm often on campus studying. We share a little polite, if awkward, laughter because, truthfully, she's exceptionally loud and she knows it and because I feel too bad about forgetting her name to be honest and tell her that I think she should practice her godforsaken Irish dance at a time later than 5:30am. After the awkward laughter that trails into an even more awkward silence, she'll ask a little bit about medical school, about Winning Run, about my dog. Wash, rinse, and repeat the exchange almost verbatim the next time we bump into one another which is typically about every two weeks. The last few times we've spoken, I think she's been especially sauced as she's been a little more emphatic than normal (and slurring her words a little) about being sorry for the noise. I've been a little shorter with her because, well, it's a charade with which I've grown tired. For the love of all things holy, you make noise; it's a crappy old apartment, it goes with the territory, so, when you see me, please just smile and say "hello" or nothing at all. In summary: she's kinda* crazy (by "kinda" I mean "without a doubt, full-on, batshit crazy"), a semi-cougar, a lush with a boyfriend, a live-in daughter, and sometimes a granddaughter, who does laundry every day, and loves, loves, loves Irish dancing or clogging or jumping jacks at all hours of the day.

So, with the back-story complete, let's step back in time to an hour ago...

I was in my office with my headphones on and the door shut trying to settle into a study groove for the evening. As the temp has been getting pretty brisk overnight, I'd been closing the doors and using a space heater to warm the rooms instead of turning on all the baseboard heaters. So, I was in the office doing my thing and hanging out with Dylan who's with me while Winning Run wraps a major deadline on her project. All of a sudden, Dylan freaked, got really agitated, paced, and kept staring from me to the door and back. When I took off my headphones, I heard someone pounding on my door. It wasn't the forceful pounding knock of an authority figure but something, I don't know, a little crazier but just as urgent.

On taking a few steps into the hall, I heard a voice pleading for help, for me to open the door. Naturally, my adrenaline went through the roof. Then, I realized that it was from my back door and not the front like I'd expected. It was a woman's voice; my upstairs neighbor, I thought. As I pulled back the vertical blinds, I was a little freaked out by what I might see. To my surprise, I saw my neighbor in her sock feet, jeans, a fleece standing there beating on my sliding door, still pleading for me to open it.

I cautiously opened the door a little.

"Oh thank God," she said. "I've been locked out on my deck for two hours. I'm freezing, I can't feel my feet."

"What? You've been locked on your balcony?," I asked. "How'd that happen?"

"I went outside without my phone or my keys and I got locked out. I've been out there for two hours. I'm so cold. I was yelling for help and throwing stuff down to get your attention."

"I've been in my office on the other side of the apartment, with my headphones on studying. I thought you were just moving furniture or something."

"I was throwing all sorts of stuff down and yelling for help."

"How'd you get down?," I asked.

"I through about throwing some concrete through my sliding glass door but I ended up using my Christmas lights to do a MacGyver and climb down."

"What?" I leaned forward to look past her and, sure enough, a single strand of Christmas lights hung there limply, a remnant of a seemingly festive escape. "You climbed down on that?"

"Yes. Oh my God, I'm so cold. I can't feel my feet. I think I have frostbite."

"I'm pretty sure that you're gonna be okay," I offered. "I think that, for frostbite, it's got to be pretty cold, like below freezing."

"Really?"

"Yeah, you'll probably make it," I assured her. "Now, how the hell did you get locked out by the sliding glass door? It's got a thumb latch on the inside."

"I don't know, it just locked me out. Can I use your phone to call someone to bring me my keys?"

"Sure."

I got my phone and let her make a couple of calls. Her lifeline tonight (other than the Christmas lights) was her recently (like a few hours ago) ex-boyfriend. I offered to make her some tea to help her warm back up but she declined.

"You must think I'm crazy. I mean, really, who does this?"

I pondered my response for a minute. "Ahhhhh...well, I'm just happy you didn't hurt yourself when you climbed down." (Why, yes; yes, I do think you are a big bowl of crazy.)

"I'm sorry to interrupt you. Just go back and study and I'll just stay here until he comes with my keys."

"Thanks but I'm just gonna stay here with you until he comes." There was absolutely no chance in hell that I was going to go in the other room and leave her unattended. Who knows what I would've found when I returned? Hell, she probably would've managed to get herself inextricably wedged in the over-sized chair in my living room or to simultaneously shatter all of my picture frames. So, I stayed in the room, maintained a safe distance, and opened the front blinds so that we could see when her spare key arrived.

"So, what do you do?," she asked. "I notice that sometimes, you're dressed in medical clothes."

Luckily, her near-fatal frostbite prevented her from seeing the look of disbelief on my face as this was a topic that we'd covered many, many times before. I had a sneaking suspicion what was on the horizon but I chose to play along.

"I'm a student at the medical school here," I told her.

"What are you studying to be?," she asked and she didn't mean what specialty.

"A doctor," I said.

"Oh, that's great."

"Yeah," I replied.

"I hope I don't make too much noise upstairs," she said.

"It's okay," I lied.

My goal was to get her the hell out of my apartment as fast as I could. Luckily, after ten or fifteen minutes of this, her newly "former" boyfriend arrived with her key. As I was going to open the front door for her, I turned to see her yell thanks and bolt right back out my sliding door, stumbling and nearly falling on her way out.

"What the hell just happened?," I asked the newly silent room.

And that, my friends, is why you should not do drugs or drink.

Stress Stress Stress Burnout Burnout Burnout

2010-10-18T18:27:00.000-07:00

A blink of an eye and November is nearly upon us. Among other things, med school has been great for really making time elastic: in some cases you can do a world of things in fifteen minutes; in others, months rush past unnoticed. So it is. I'm closer to the end of this semester than I am to the beginning of it.

Honestly, I have no idea where the time went. Quite literally, I feel like my face has been shoved in a book since the semester started, frantically trying to coax the words from the page and into my memory. Anyway, it's now October. Post-season baseball. College football. Crisp, cool mornings with amazing amber light that makes you miss your grandparents, miss being a kid.

Tomorrow, I'll take the last test in our renal system and, in doing so, try to illustrate that I know a little bit about renal tumors, treating hypertension, acid-base disorders, identifying stones, proteinuria, and maneuvering the choppy waters of anti-hypertensive medications. (These among other things.)

I feel like a stranger to myself, to my family, and my close friends. This weekend, I'll head to Seattle to see Winning Run and try to be a normal cat for a few days. Perhaps in jest, a classmate sent the warning signs of burnout to the class. Rather than run down the litany of signs, it should have a single requirement: second-year medical student. Seems about right.

Back to the grind...

You're Talking About a Song?

2010-10-05T12:48:00.000-07:00

In a brief respite from studying for my upcoming Renal exam, some friends and I went to hear one of our classmates perform a local venue. We grabbed some drinks and a spot and listened to her set with a ton of students from the 1st year class. We were chatting with one of the 1st year students when, randomly, he asked if we liked masturbation.

"Sure, man, I'm all for it," I said. My friend SJ piped up that she was also a fan.

"Yeah, it's a pretty good song," he replied.

"Oh, you're talking about a song..."

"Yeah, 'Masturbation' is one of her songs," he offered.

"Don't know it," I admitted. "Never heard it."

He looked a little perplexed but said, "You'll know it's the song when you hear something really uptempo."

"And you'll know it's the other if my hand is in my pants," I said.

He looked like he was about to say something else before he thought better of it and just turned around. Conversation over. What can I say, I'm a winner.

Aside from that comedic gem, nothing else is happening or has happened other than a ton of studying. Tomorrow is my first exam covering the renal system. I have tons of stuff to get through in advance of the test. As I didn't see Winning Run over the weekend, one of the little bits of joy has been getting Hipstamatic for my phone. Here are a few shots:

The view from my desk.

A car hit the house across the street in the middle of the night.

Hops field at sunset.

Sunset from my apartment. Mt. Adams is in the distance.

Congrats, You Aren't Having a Heart Attack

2010-09-22T14:30:00.000-07:00

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.

Seven

2010-09-20T05:00:00.000-07:00

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.

It's the New Normal

2010-09-19T22:11:00.000-07:00

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.

Sometimes You're a 1998 Mercury Sable ...

2010-09-09T21:48:00.000-07:00

... 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!

Well, Doctor, If You Must

2010-09-02T11:56:00.000-07:00

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.

Well ..

2010-08-28T11:49:00.000-07:00

Cardiovascular system exam is over. Based on my previous pharm scores, I was thinking that I'd be able to prescribe Skittles. Today, I am certain that if I tried to do that, someone would swat the damned things out of my hand and give me a stern look. So, I'll be limited to making poultices, probably with mustard or eucalyptus.

"That Sonofabitch Just Might Make It"

2010-08-24T15:52:00.000-07:00

It's the week leading up to our second exam and everyone around me is equally haggard. Last night, I got four hours of sleep and (actually overslept until 5:45). Tonight, it'll probably be the same. As I've intimated previously, I think the pace is pretty ridiculous and that the amount of info that's washing over us at any given hour is incomprehensible. That being said (again), it's effing amazing what actually makes it into your brain, what you can actually learn when pushed. It has, of course, been a week of peaks and valleys but, thus far, the peaks have been pretty cool.

Epiphany

Last night around midnight, my buddy and I were on campus almost ready to wrap up for the day. We were reflecting back on a case study exercise that we'd done earlier. (As a group, you and your peers are given info about a patient and must interview the patient for relevant info to complete a history, determine what lab values and physical exam findings are pertinent, identify areas for further assessment or diagnostic exams, and formulate a plan of action. Then, you have between 60 and 120 seconds to provide an oral presentation of this information to the attending physician.) Essentially, these studies are an integration of academic material, clinical scenarios, and the skills of speaking aloud to your peers aka preparation for 3rd year rotations.

So, last night we start talking the day's case. A while later, we realized that, without any provocation, we'd been thinking and speaking like practicing physicians. It was pretty cool; a step along the path to reforming my self-image into that of a doctor.

Go Suck It, Digoxin-Induced Hypokalemia.

Two interactive sessions today, both on Heart Failure. This afternoon, I seemed to do much better on the questions: my rationale seemed to be based on some sort of reality and grasp of key concepts instead of how a third-grader might approach pharmacology. When I was called on, I stood and correctly answered a question regarding hypokalemia as induced by a drug-regimen. I went with my gut, stuck to my guns, and didn't look like as much of a clueless dick in front of my peers.
The Scholar: 1, Pharmacology: 248K.
I'm hoping this was my Dave Roberts moment. The crowd goes wild. (By "crowd," I mean me.)

On To The Next One

2010-08-17T16:49:00.000-07:00

" ... Don't be mad 'cause it's all about progression.
Loiterers should be arrested."
'On to the Next One' from Jay-Z's "The Blueprint 3"

Another week, another trove of insurmountable tasks to complete. I wouldn't quite call them Sisyphean but it definitely feels vaguely similar. After the last week of doing nothing more than studying, it should come as no surprise that this week is yielding more of the same. As will next week. And the week after. For the foreseeable future. [Sigh.] It is, however, pretty damned cool.

Brush That Dirt Off Your Shoulder

One of the major learning experiences of second year, thus far, has been the attempt to become comfortable with standing before your peers and attempting to respond to questions. You know, a whole "stand and deliver" routine. In addition to learning the course content, we're being given the opportunity to become more comfortable with failing spectacularly in front of our peers. This is a task for which I just might earn honors. What can I say? Everyone excels at something, right?

We've been given little remote controls called iClickers (the hottest technology of 1999) that we use to respond to questions during class for real-time tallying. Prior to seeing how your peers respond, though, a student is randomly called to answer the question and, if you're really, really lucky, some follow-ups in front of your peers. Luckily, I was called on during a Pharmacology session to answer a question involving the selectivity of a Beta-antagonist. Being the exemplary pharmacology whiz that I am, I punted and guessed something that stuck in my head. Wrong. I looked to my peers who whispered the correct answer and called it out. Wrong again. I looked to other peers for more choices and tried to follow the prof's coaching. Wrong again. After what seemed like an hour, I stumbled on the designated response and was allowed to return, licking my wounds to the anonymity of being a less-active participant in the lecture.

I am never going to earn a prescription pad. Mark my words, I will be forced to "prescribe" Skittles to my patients. If those don't work, we'll move to either M&Ms or Reese's Pieces. The options are pretty much unlimited.

This Is War

2010-08-12T20:34:00.000-07:00

Not that I'm finished collecting my thoughts about my first year or anything, mind you, but it's day 4 of the 2nd year and I'm feeling like I've been in the trenches for months. All that bullshit "pie-in-the-sky" thinking that I'd be able to sneak off to see Winning Run in Seattle are teetering on the edge of the sinkhole that is being a med student.

Seriously. Day 4. Monday. Tuesday. Wednesday. Today.

In other news, I feel like I've learned a bunch in these four days. It is stunning what you can learn when terrified / trying / overwhelmed / sleep-deprived / enjoying it.

More from the front lines, soon. I promise.

Phound Photos

2010-07-27T15:30:00.000-07:00

I finally looked at my SD card from Hawaii and the cross-country drive and stumbled across a few other shots that I like.

Moon-rise over Manua Kea.

Some photos from the cross-country drive:

Dylan looking at corn fields, 80mph.

Sunset in Nebraska.

Dylan at scenic overlook.

Picking burrs off of Dylan's face after he hunted field mice.

How To Fail at Business (Without Really Trying)

2010-07-27T13:41:00.000-07:00

A few days ago, we were in the park with Dylan and happened to meet some other dogs for an impromptu dog congress. Turns out that one of the people there with a dog had a dog walking business. It also turns out that we're looking for a dog walker to let Dylan out during the day and get him a little exercise.

We met the other dog owners and got a business card from the dog walker. She seemed nice enough: sort of a hippie-type with plenty of wrist tattoos and unkempt hair. About two minutes had passed after she gave us her card when we heard her suddenly exclaim: "Where's my dog? Have you guys seen my dog? She was right here a minute ago..."

Everyone around started looking around for her dog and calling for it.

"She's across the street!," the dog-walker announced. She instructed everyone to refrain from calling her dog. As she ran across the road to her pooch, she kept telling it to stay there.

Winning Run and I made eye contact and pantomimed our disbelief. We agreed to promptly lose her card. She wouldn't be getting our business.

Manifest Destination

2010-07-19T13:47:00.000-07:00

Last Thursday, we made it to Seattle after a fun four-day cross-country drive. If you're ever driving cross-country with a pet, you'll be happy to know that all Motel 6 locations are pet-friendly. You can, of course, find other places that are nicer and more expensive but it's comforting to know that this ubiquitous chain is there and will take you in for a modest little price. Depending on where you stop, you might have to contend with their progressive, hard-hitting "No Smoking" campaign designed to stop anyone from even thinking of lighting up in the room.

What deters smoking more than an overturned ashtray with a sticker on the bottom?

Hard to say ... an in-room lighter, maybe?

Mostly, we drove 12-hours a day with exception of the 3rd day when we drove a leisurely 7 hours into Salt Lake to visit Big Mike, my college buddy, and his lady. We took in an outdoor concert, had a great time catching up with the two of them, and enjoyed the break from the highway. The next day, we woke, had breakfast, and pressed on from SLC into Washington. Along the way, we stopped at a great overlook near Pendleton to drink in the horizon and let Dylan harass some field mice.

After a brief stay at my apartment near campus, Winning Run and I headed to Seattle to prepare for moving her into the apartment. I knew that she'd like the place but it's pretty cool, if tiny. A few blocks away is a great park on the shores of Lake Union with great views of downtown, loads of people flying kites, and plenty of seaplane watching. Compared with the weather we left in Atlanta (100 degrees, 1000% humidity), the climate here is amazing (early morning temp in the 50s, afternoon high in the mid-80s). Dylan loves it.

More pics:

A windswept rest area in Wyoming.

Overlook near Pendleton, WA.

Dylan in the morning.

Dylan in the afternoon.

Cool kite at sunset.

All in all, it's pretty nice to be in a big city again. I love the energy of it and the people in it. After a year with my wife and dog on the opposite side of the country, I can tell you that having them in the same time zone feels like I've pulled off a coup. It's freaking amazing.

Next, I'm off to move into my apartment and to hear about Winning Run's first day at hear new job.

Good Morning, America, How Are Ya?

2010-07-12T05:58:00.000-07:00

In the immediate aftermath of finishing summer semester and passing my finals, I had little time to revel in the joy of officially becoming a second-year student. Instead, I had to pack my things, move them out of my apartment, and get them into storage before I left for vacation. As I abhor moving, it was only natural that I'd be spending the majority of my summer break moving myself into a new apartment, then going home and moving my wife across the country to Seattle.

After an endless week, I managed to shove the last bits of my things (mostly the remaining 300 rolls of toilet paper from a Costco pack) into the storage bin and get the hell to Seattle onto a plane to Hawaii for a week of R&R with my wife's family. I cannot explain how amazing it was to actually be in the same place as my wife for more than 48 hours. Good stuff, indeed. Two vacation shots:

Moon rise from the Joint Astronomy Center at Mauna Kea.

Waterfall at our lodging near Hilo.

Swimming was great but the water was frigid.

After the vacation, I returned to ATL to help empty our house and, once more, drive across the country. In case you didn't know, the housing market sucks for sellers and we were beginning to really freak out at the prospect of having an empty unsold house. A few days before we left, however, we found some tenants for our place...big sigh of relief. The rest of the time, we spent on the "Winning Run 2010 Farewell Tour" seeing friends, visiting family, and eating and drinking too much.

We began our drive on the 11 JUL with our dog and hope to be in Seattle by the 15th. Yesterday, we drove 700 miles and have stopped in central Missouri.

Gateway to the West.

I gotta say that it's pretty damned strange and a little unnerving to be in a motel with your dog. In good guard dog fashion, he's barked occasionally at strange noises which is followed by pleading cries of "Shh!!!! No bark!!!!" by the two of us. Guess it's not like the first night in any hotel is ever restful, I suppose.

If You Look Too Far Ahead, You'll Trip Over What's Right Before You

2010-06-11T11:10:00.000-07:00

On a short study break but thought I'd recount today's hilarity (so far):

Today, I have three finals: Genetics, Medical Spanish, and a big ol' Path exam. I rocked the Genetics one. For the record, I have a degree in Spanish which makes me feel pretty good about my proficiency. My hubris has been increased by the fact that an overwhelming majority of my classmates are beginning speakers. I quickly completed my Spanish exam, handed it in, and triumphantly strutted from the room to join my peers in the lobby in post-exam bliss.

"Congrats on being done," I offered.
"Thanks, man. You too."
"How'd it go?," I asked.
"Pretty well. I thought that one matching section was a little tough."
Silence.
"What matching section?," I asked.
"The one right before the anatomy terms."
"Come again?," I asked.
"The anatomy terms," he repeated.
"How many versions of the test were there?"
"Just one," he said.
"How many questions were on it?"
"Fifty."
More silence.
"I only did 30; I gotta go," I said as I literally dropped all of my stuff and walked away.

I tore back into the room, quickly explained the depths of my idiocy to the proctor, and did the remaining portion of my exam in five minutes.

Here's hoping that I'm more careful on the keystone exam of the day.

Worth a Thousand Words...

2010-06-09T07:12:00.000-07:00

Three days left in the semester and, after, a little freedom* for a few weeks. Meanwhile, I found another great visual metaphor for med school.

It never gets old.

It Takes an Ocean Not to Break

2010-05-23T20:12:00.000-07:00

So, the afterglow of finals was ridiculously short-lived. A few celebratory drinks were hoisted. Then, it was off to the races to get to Valdosta, GA for Crazy Greg's (and, by marriage, "Crazy" Meg's) wedding. Road construction had me miss the red-eye out on Friday night. After taking the first-flight out on Saturday, I landed in ATL, dove into the car Winning Run had waiting, and sped toward south Georgia. I arrived with enough time to put on my tux and rush to join the wedding party. Seattle to Valdosta, GA with thirteen minutes to spare. That's cutting it too close for comfort.

After the wedding, we hauled back to ATL. I slept in my bed with my wife for a few hours before hopping a plane back to WA to begin the summer semester. Now, I'm thoroughly embedded in the work of a few new classes and some remediation work for a few of the old ones. And, for some reason, I thought that this semester might be a little more relaxing. Evidently not.

To top off it all off, I came down with a horrible stomach flu shortly after arriving: up at 3am with projectile emissions from both ends for a few days. Ah, what could be better?

Between all of the running around and stress and loose ends that I'm trying to tie, I've not had a true chance to reflect on the goings on from the year. When the dust settles, if the dust settles, I share my thoughts. Until then, some good news: Winning Run was offered (and accepted) a job at her top choice of Seattle firms. I'm really proud of her, my rock.

Ahhhh...

2010-05-14T11:59:00.001-07:00

Yep, that's about right.

Now, for some celebratory libations and sleep before hopping a plane to GA for Crazy Greg's nuptials.

Well, That's a First....

2010-05-14T07:04:00.000-07:00

Three finals left this morning and they're the biggies:
Physiology
Pathology
Gross Anatomy

Last night, got to bed around 1am. Up at 4 to shower and make the final push.

So effing stressed about these tests that, five minutes ago, I ran to the bathroom to wretch in the toilet. WTF?

Living on Coffee and Flowers

2010-05-13T10:42:00.000-07:00

Finals are in full effect. So far this week, I've spent roughly 15 total hours at my apartment. Rising around 5am, hitting the rack somewhere between 1am and 2am, and spending the hours between buried in books is taxing at the very least. It sucks. I'm exhausted. I've miles to go before tomorrow's exams (and the remaining ones this afternoon). This shit is medical school, is the best.

From "Conversation 16" by The National:

I think the kids are in trouble
Do not know what all the troubles are for
Give them ice for their fevers
You're the only thing I ever want anymore
Live on coffee and flowers
Try not to wonder what the weather will be
I figured out what we're missing
Tell you miserable things after you are asleep

Standing

2010-05-05T23:41:00.001-07:00

Another day, I’ll sleep in a lonely, empty bed. I won’t hear anyone breathing next to me, won’t move the covers to escape their body heat. In the morning, I’ll wake at a ridiculous hour and will lumber unsteadily into the shower and let the warm water rouse me. Standing in the kitchen alone, I’ll drink black coffee and eat eggs on toast. The only sounds I’ll make will be the rattle of the dish in the metal sink, the resonance of the fork skipping around. Before turning toward my desk, I'll take another long look out the kitchen window at the gray, wintry sky. Perfectly, it displays how I feel: vast, uniformly barren, cold.

Still, I’ll take another sip of coffee, shrug my shoulders and sigh to slough off the loneliness, and bear down on another difficult day. I do this for me. I do this for us.

Green Team!

2010-04-25T09:42:00.000-07:00

This past Tuesday, my plans to organize everyone on my side of the room to wear green paid off. Like the last few weeks, my buddy and I wore the same thing. This time, however, everyone surrounding us wore green shirts also. It was pretty cool.
Then, people started commenting on how cool it was that I'd duped everyone into wearing green on 4/20, the holiest of stoner holidays. I got a pit in my stomach and constantly tried to reassure everyone that, really, that wasn't the plan. Hell, since January, I've not really been aware of the date more than once or twice. I know what "day" it is by what classes I have. Dates, not so important to me at the moment.
In one lecture, our prof took a moment to eye us and ask about the occasion for our unity before making a 420 reference. So, in addition to struggling academically with some of my classes, I'm sure the faculty are aware that I was the one who inadvertently organized a dress-up day for 420. Great. Perfect. Grand.

Fashion Police

2010-04-13T17:59:00.000-07:00

Guess I realized today that I've been mailing it in when, for the third Tuesday in a row, I've worn the exact same thing as the guy who sits next to me. Keep in mind that these aren't scrubs that I'm talking about, these are our civilian clothes that we wear once a week. Khakis and an olive button-up shirt. Guess we're not reaching too far back in the closet for something different. Based on how wrinkled we looked, I'd say that each time we get home, the clothes go right onto a hanger until the next Tuesday.

I've attempted to organize everyone who sits nearby to wear the same damned thing as us next week. That way, my idiocy can spread.

London Calling

2010-03-24T07:45:00.000-07:00

During my break, Keytar Rob's email account was hacked. Everyone in his contact list got a message begging for immediate wiring of funds. Naturally, I created a dummy account and goofed around with the scammers a bit. I was, after all, on break.

Subject: Stuck
From: Not Keytar Rob
Thu, March 18, 2010 11:09:25 AM

How are you? Honestly I'm doing pretty awful. I'm visiting London for vacation and so far a lot of crap has been spewing.I got robbed by a gang of Lebanese at the train station last night,the
cold,wet,darkness didn't help things and everything I had on me including my wallet,passport and cell phone got stolen.It was a traumatic experience for me and you can't imagine how scared I was when it happened.I'm completely paranoid and all garbled in my mind right now and am just waiting for a miracle to happen.I've just been to the Consulate and luckily after standing in line for what seemed like hours,I got to a customs agent and she said they can issue a replacement passport so I don't have to be stuck here for weeks.I'm tight up here and need to clear my hotel bills so that my luggage can be released by the hotel management.I'm just wondering if you can help out by loaning me some money so that I can sort things out on time and catch a flight back home today,I promise to refund you as soon as I arrive home.
Pls get back to me Asap.

Not Keytar Rob
________________________________________

Subject: Re: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Thu 3/18/10 12:49 PM

Rob,

Just got off the phone with the gang and heard that you'd been mugged on vacation. Sorry that this is going to put the damper on the amazing party that we'd scheduled for Saturday but if you feel like you can't hang around, I totally understand. We're about to head out to the airport to make it to Skinny's for the par-tay but wanted to know if we could swing by your apartment to take care of anything (CC cancellation numbers or anything). I'm happy to help, let me know what I can do, brah.

-- jd
________________________________________

Subject: RE: Stuck‏
From: Not Keytar Rob
To: Jean Deaux
Sent: Thu 3/18/10 12:55 PM

I'm having such a hard time here and I'm just about to get into a line up at the consulate in order to get my replacement passport stamped.It's been so embarrassing for me but I guess it's just this post-9/11 world we live in and the government lines that suck.I just need you to loan me 870 British pounds,that's equivalent to $1270.00,you can send it by going with cash to any Western Union location close to you or sending it online via the western union website.

Here is my information you need.

Name: Not Keytar Rob
Location: 27 Leicester Square, London. England
Zipcode is WC2H 7LA

I will need the pickup number which is also called the MTCN number to receive it here,and also let me know how much they charge in sending fees.I will refund you the full amount as soon as I arrive home.

I really appreciate it.

Not Keytar Rob
________________________________________

From: Jean Deaux
To: Not Keytar Rob
Subject: RE: Stuck
Date: Thu, 18 Mar 2010 13:01:53 -0700

No shit? Hey, so that I can make this fly with the 'rents, can you give me more of an itemized breakdown for the $1300? It'll be a tough sell unless I can let them know more specifically what it's going toward, you know? By the way, they're pretty sorry that you got mugged.

So, other than getting mugged, how has the trip been? I trust that you met up with that bird you'd been emailing. Tell me you shagged her, brah.

When you get me an itemized list, I'll talk with the folks and get back to you ASAP. Hold tight, Robbie, help is on the way.

-- jd
________________________________________

From: Jean Deaux
To: Not Keytar Rob
Subject: RE: Stuck
Date: Thu, 18 Mar 2010 13:17:50 -0700

Robbie,

Just spoke with the parents again since I've not heard back from you. Hope all is OK. I think they're game to send the money just wanted to know specifically what it's for. They'd been on the phone with their bank transferring some stuff around, getting it ready to send over. So, when you can, get back to me and we can probably have you home by the Sunday.

-- jd
________________________________________

RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Thu 3/18/10 2:05 PM

Robbie,

Know you're probably swamped at the consulate but when you wrap up, get back to me ASAP. Mom and Dad are heading out and wanted to stop by the Western Union prior to their show.

-- jd
________________________________________

From: Not Keytar Rob
To: Jean Deaux
Subject: RE: Stuck
Date: Thu, 18 Mar 2010 18:02:49 -0400

Ohk...I just got back from the Consulate and it was a big drag.Anyway, I'm still hoping to make
tonight's fight.How soon can I get the money? write me back asap.
________________________________________

RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Thu 3/18/10 4:06 PM

Mom and dad were going to go ahead and book the return flight in your name; that way they can redeem some frequent customer miles for you. And with Mom's connections at the airline, you'll likely be in first class. How's that for big pimping, huh? Now that you've got your replacement passport, it shouldn't be a problem for you to check in and board.

Also, which airline were you thinking so I can let them know? (I'm assuming that you were planning on returning to JFK.) I'm not sure when the last flight departs but it's probably rapidly approaching.

So, unless we can get something worked out, you'll likely be overnighting it. If you're staying at 27 Leicester Square, we can send a car for you in the morning. Does this work? It seems a little less complicated but, if necessary, we can still wire you the money; just wanted to get your thoughts.

Let me know what you're thinking or give me a call.

--jean
________________________________________

From: Not Keytar Rob
To: Jean Deaux
Subject: RE: Stuck
Date: Thu, 18 Mar 2010 19:10:13 -0400

Yikes. I've been holding up here waiting for the details to pick up the money.I've just been to the
health center t get some drugs,i also need to clear the hotel bill,can you get the money to my in the next 30 mins?
________________________________________

Subject: RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Thu 3/18/10 4:27 PM

Sorry, man! Guess that the shops are all closing; doesn't look like we'll get the money to you
tonight. In the morning, though, perhaps we could send it to:

Eurochange
33 Coventry Street
London, W1D 6BS
GBR

Also, you'll need to send me new total. How much is it that you need? 840USD?
________________________________________

From: Not Keytar Rob
To: Jean Deaux
Subject: RE: Stuck
Date: Thu, 18 Mar 2010 19:42:59 -0400

Bummer!!! The problem now is that i don't have a hotel room for tonight and to make things even worse i got into misunderstanding with the hotel manager and he called the police on me and i got to know that Brits are vile animals.I'm going through hell here and am starting to feel sick- of writing back and forth,can you just try to send it online via the Western Union website.
I can pick the money at any Western Union location here by presenting my id,i'm really counting on you now,all I need is 870 pounds.
________________________________________

Subject: RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Thu 3/18/10 4:53 PM

Sorry, brah. Try to stay positive and think of being back in my loving arms.

Did you mention to the consulate that you were having these problems? If not, I'll contact them;
they're able to step in and offer some diplomatic assistance in situations like these. Also, if you
get thrown in jail, try not to make too many friends or too much money! You know how it turned out when you got pinched for public drunkenness last year. Shit, how many numbers, did you get? Am I right? Am I right?

Dad's on the phone with the gang at his law firm and is contacting the London office. Let me know where you're at and he'll have a rep over there shortly to bail you out and take care of everything. At the very least, they'll take a look at you to be sure you're not being roughed up or anything. Also, I think that he's been talking to the hometown paper (Joey's aunt works there) and they're working on a story about the ordeal you're having.

Stay strong. Send me your whereabouts.

-- jd
________________________________________

Subject: RE: Stuck‏
From: Not Keytar Rob
To: Jean Deaux
Sent: Fri 3/19/10 4:45 AM

Do you understand that I'm stuck and stranded here, try to get the money to me in the Morning.
________________________________________

Subject: RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Fri 3/19/10 6:50 AM

Sweet mother of all things holy! Robbie, everyone has been worried sick about you. Where are you? Are you in jail? Did you work things out with the hotel? What color knickers are you wearing? Sorry, you know it's our inside joke. Thought it might cheer you up a bit.

By the way, I'm sure that you're just tired and cranky but your grammar and punctuation has gone to hell; you must be really stressed!

Also, and I know this is the last thing on your mind, but did you get a chance to see Mr. Robert
Pattinson at the premier? Does his skin sparkle in real life? Does he smell of lilacs like we
discussed in the hot tub?

Get back to me, quick, and we'll send the car for you.

--jd
________________________________________

Subject: RE: Stuck‏
From: Not Keytar Rob
To: Jean Deaux
Sent: Fri 3/19/10 6:59 AM

Oy! I don't understand what is going on now.I'm getting really pissed with this whole thing.Just go to a WU agent and send me some money now.I don't need a car sent to me now.

Robbie
________________________________________

Subject: RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Fri 3/19/10 7:19 AM

I can understand you're pissed! Sorry about your frustration. Try to imagine yourself on Team Edward and you should calm down a little. Here's your mantra: sparkles and lilac, sparkles and lilac, sparkles and lilac. Say it a few times and you're sure to calm down.

You'll never believe what's happened! We just got invited to go to a birthday party at the kids next door! They've got a moonwalk and ponies! Should be amazing! I'm taking all five of our cats with me! It'll be purrrrfect! LOL!

Sorry about the confusion. Airline ticket is booked and car is headed to L Square. Dad was saying that Walmart is probably cheaper and more convenient for transfers. Plus, you know how he's against unions. Can you get to a Walmart?

--jd
________________________________________

Subject: RE: Stuck‏
From: Not Keytar Rob
To: Jean Deaux
Sent: Fri 3/19/10 8:06 AM

Alright, that's fine. Go ahead and send via Moneygram,Walmart.I'm not trying to pass blame or guilt to clear my mind it's just that I'm really frantic and nervous and am starting to feel a bit "out of sorts".I'll really appreciate it if you can reply with the Reference # I need to pick up money at the Walmart desk here.

Best,

Rob
________________________________________

Subject: RE: Stuck‏
From: Jean Deaux
To: Not Keytar Rob
Sent: Fri 3/19/10 8:32 AM

Well, this is just classic! Dad just came in while I was emailing you and found all those old pictures of us on my computer! Thought he was going to kill me! I told him that it wasn't what it seemed like but he was sooo angry! He started yelling and throwing stuff around. He ripped apart that giant stuffed bear that you won for me at the fair and my signed "Jersey Shore" poster that you got for me. I could punch him for that. I'm crying so much that I can hardly see the keybrdoa. My cats won't even come to me. What should I do, Robbie?

I think that I'm going to be grounded for a long, long time. Now, they're saying that they're going to cancel the flight for you! What can I tell them, Robbie? What can I tell them? You know my Dad, how can I get him to change his mind? He said that after seeing that picture of you and the muffler, he's not going to Walmart until he knows what's going on with us. Tell me what to tell him. I need you back here sooo badly.

I'm sooooo upset. I knew I shouldn't have taken pictures of us snorkeling. What's wrong with me? My heart is breaking.

-- jd

End of transmission.

Home

2010-03-23T21:54:00.000-07:00

Spent a great week at home in my city, in my bed, with my wife. I slept late, didn't do a damned thing, and failed to turn in any productive study time. As a result, my return to school has been fraught with the same depression and panic as every other time that I go home and then return. Five tests to go this week. Yippee.

By the way, I love this car that's always parked by a gas station back home. Homemade vanity plate made from mailbox stickers from your local hardware store. Yep, that's keeping it real; ATL style.

Once Again, Anatomy Lab is the Coolest

2010-03-12T14:40:00.000-08:00

(Or "Just Go Ahead and Stop Reading If You're Queasy")

So, we've finally made it to the "Head and Neck" unit of our anatomy course. A couple of weeks ago, we wrapped up the "Lower Limb" section and moved up to the head. By the end of lab that day, I'd scalped a person, removed the skin from the face, and examined facial muscles, nerves, and vessels. Again, it's pretty damned amazing how our bodies are put together. You'd be awed by what simply surrounds the eye and allows you to blink or squint.

This week, however, entailed cleaning up the dissection table and moving everything we'd previously dissected to the collection bin, and yielded a work station with only a head and neck and a few tools.
For the record, it isn't the easiest thing (either psychologically or physically) to use a hacksaw to remove a head and neck from the thorax. To add to that, I'll say that if you're the one holding the head while members of your dissection team clean the workstation, your forearms will get a little sore and fatigued after about fifteen minutes. For the next few days, this soreness will be a macabre reminder that you have racked up experiences that few others have.

Scarecrow

The part of the semester is the beginning of the point where Gross Anatomy and Neuroscience converge. As we ready for our brain dissections, we harvested the brains from a few of the cadavers. During lunch hour, several of us hustled to the lab and removed a few. All I can say is that this was an unbelievably amazing experience.

One starts by putting a rubber band around the skull as a guide, making a scalpel cut through the soft tissue down to the bone, and using a cast saw to make a cut around the circumference. If you've been to the dentist and had a filling, you probably remember the smell that goes along with having a tooth drilled; it is the same odor that accompanies sawing through a skull. During spin class several hours later, I discovered that it is, quite literally, a scent that stays with you; all I could smell was the familiar burning bone smell. No amount of blowing my nose or flushing it made it go away. It was, for a day or so, part of me.

After the saw cut is complete, you pry off the skull cap which is a hell of a lot harder than you'd think. The dura that covers the brain and spinal cord is far more resilient than I imagined. After pulling and prying and cutting and praying and pleading, the cap just sort of pulls off and you're staring at the top of the brain. Then, you take an especially long scalpel, make several cuts including some relatively blind ones at the brainstem, and sort of roll the brain out of the skull and into your hands.

And shortly thereafter, you realize that, in your hands, in your very own hands, you are holding a human brain: the epicenter of motion, of bodily control, of emotion, of knowledge, of memory. And, you realize that words fail to capture what an awesome and emotional experience it is to have just done what you've done, to hold what you're holding, to be so intimately connected with a perfect stranger who made you the recipient of the gift of their body. Time stops and you go inward to your own history and your own unwritten future. Could you be so selfless? Could you be such a teacher? Where do we go when this machine shuts down? In the blink of an eye, you're back in the present and you turn to a fellow awe-struck student and carefully, tenderly place the brain in their hands.

Just a Little More...

2010-03-09T21:27:00.000-08:00

Spring break is about 48 hours away and I can taste it, can feel it tearing me away from my books, can feel it softly whispering "Screw it, leave it alone" into my ear. Two nights from now, I'll have my ass on a plane back to ATL. Let me tell you: I cannot wait; I cannot wait have my feet on the red Georgia clay, to wake in the same bed with my wife, to lay on a couch with my dog. Bliss, here I come.

Never Look to Chocolate For Help

2010-02-21T10:15:00.000-08:00

Ask a Dove chocolate a question and, when you unwrap it, you just might have an answer! Granted, that answer will be dialogue from a LifeTime Original movie but it will be inspirational in some bizarro world where chocolate is a therapist. Regardless, here is a conversation I had with candy, in the form of an advice column.

Dear Dove Chocolate,
I'm really getting my ass handed to me by my studies. Is there anything that I can do to improve?
-- Sincerely, The Scholar

Dear Dove Chocolate,

Thanks, but I'm not sure that you understand the writing style of my texts or my lack of time for pleasure reading. Anyway, I guess I feel like I'm just not retaining things like I used to. I'd appreciate any suggestions.

-- The Scholar

Dear Dove Chocolate,

I don't know; I definitely feel like I'm having to scrap for every little bit of knowledge that I'm gaining these days. I'm just feeling burned out and like my self-confidence is really shaken. Do you think what I'm doing is worth it?

-- The Scholar

Dear Dove Chocolate,

Really? I am?

-- The Scholar

Dear Dove Chocolate,

Okay, I feel pretty now; thanks. But really, though, I'm getting thrashed by my courses. Any strategies or other test-taking advice for me?

-- The Scholar

Dear Dove Chocolate,

Good one, Dove Chocolate. Hope you're being funny because, clearly, "trusting my instincts" isn't working out so hot for me. I've done precisely that and have crashed and burned. Spectacularly, I should add. Seriously, I should just go full Costanza and do the exact opposite of my instincts and see how that works out. I could probably look like a freaking genius. What'cha think about that?

-- The Scholar

Dear Dove Chocolate,

Really? What's with the "good enough" bullshit all of a sudden? You know that, at this point, I'd kill for passing grades, right? Not superlative grades, just passing grades. Got me? I am failing. I'm dying here.

-- The Scholar

Dear Dove Chocolate,

Now you're just screwing with me, right? It's so dark, I can't see shit. I'm in a cave that's wrapped up in a blanket that's been put in a box and buried. It is dark, dark, dark. You read me? You get it, chocolate wrapper?

--The Scholar

Dear Dove Chocolate,

What are you talking about? Who said anything about singing? Are you screwing with me? Have you been listening to me sing? Should I sing my answers during my exam? WTF?

--The Scholar

Dear Dove Chocolate,

Are you referencing Lee Ann Womack lyrics now? I'm starting to feel like you're nothing more than random quotes jotted down by members of Ellen's studio audience and slapped inside chocolate wrappers. Hell, fortune cookies make more sense that you and they suck. You know what, Dove Chocolate? Screw you; we're done. It's only 9a.m. but I'm gonna start drinking. Thanks for nothing, prick.

--The Scholar

Do I Even Belong Here?

2010-02-20T22:21:00.000-08:00

Royal Tenenbaum: That's just not right, damn it. You used to be a genius.

Margot Tenenbaum: No I didn't.

Royal Tenenbaum: Well, anyway, that's what they used to say.

From Wes Anderson's "The Royal Tenenbaums"

Another tough week in the bag and I am damned sure not going to be earning honors in any of my classes. If I can't improve my performance, the only thing I'll be earning is a bus ticket back home. What the hell, man, I'm not even halfway through the semester and I'm feeling like I'm running on empty, on fumes. I'm burned out and tired of not passing exams.

Shit, I'm tempted to host a coloring exam where all anyone has to do is take a single crayon and color in a giant rectangle. That's it, just fill in a rectangle with a crayon and, hell, just stay mostly in the lines. Do it and you pass. Bingo. A+. Honors. Ticker-tape parade. Confetti. Bells. Whistles. Bullshit.

Last week, during a four day weekend. I took about 8 hours to myself excluding the hours I slept, of course. On average, I've been getting about 5 and a half hours of sleep a night. I've lived in a study room on campus, coming to my apartment only to sleep. I knew that yesterday's exams would be a challenge. Hell, no matter how you approach it, Neuroscience is tough stuff; it's amazing but tough. Immunology, too. And OMM. And Pharmacology. All told, though, I didn't expect another "O-fer" day. "O-fer" as in I was zero for four on passing anything. Here's the best part: I was absolutely sure that I was going to rock my Pharmacology exam. Absolutely effing positive. When I'd answered all the questions, I clicked the proceed button, saw that I'd failed miserably, and felt my countenance morph from a smarmy, shit-eating grin to a stunned, distant look of shock.

I hate working my ass off and feeling like I'm just spinning my wheels and getting nowhere. Still, I keep attempting to get up, dust myself off, and dive back into the fray. That being said, it sure would be nice to have some sort of a win in the near future; I hate feeling like a big bag o' fail.

Shopping Habits of the Overly Stressed Medical Student

2010-02-19T05:52:00.000-08:00

Pretty good summary of consumption as the next round of tests approaches.

Caffeine, dark chocolate, energy shots, and antacids.

Missing: diaper.

Evolution of THE Man

2010-02-12T08:00:00.000-08:00

In honor of Charles Darwin's 201st birthday on the February 12th, we held a few celebratory events at school. In addition to the scavenger hunt and a lecture that touch on a few evolutionary adaptations in human anatomy, we had a cake baking / decorating contest. I managed to take home the prize for most creative with my "Evolution of The Man" entry.

For some, Burt's face on a cupcake is a good weight management strategy.

Others end up with cake in their lap.

Although few people saw me bring them in or set them up, most everyone knew within a second that I'd brought them. What's best is that my anatomy prof quickly (and without provocation) quoted a line from "Deliverance" that didn't involve Ned Beatty, mouths, or squealing. It was bliss.

One younger classmate, however, remarked that he thought "Kurt Russell" look pretty strange after all the years and surgeries. I told him to put down the cupcake, get the hell away from me, and never to confuse Russell with Burt Reynolds ever, ever again.

I Have a New Nephew

2010-02-11T21:09:00.001-08:00

My sister finally had her baby boy! For the fourth time, I'm an uncle. This is, however, the first grandchild on my side of the family. And, really, it's pretty special when your sibling has a child. Throughout her pregnancy, we chatted about a ton of stuff related to her health and to the approaching delivery. So, we were pretty frank about things because it sort of went along with some of the development and other things that we learned during the semester. That being said, however, I was unprepared to be scrolling through photos that she'd sent and seeing her breastfeeding. Seriously, could've used a heads up on that one guys. You cannot unsee certain things, like your sisters' boob for example. Pictures of the little man to follow.

Could've Done Without That

2010-01-31T11:45:00.000-08:00

Our winter formal was last night. As Winning Run was not here with me, I had been dead set on not attending but ended up going with a group of friends. After showering and shaving, I grabbed a suit and went to get dressed. Evidently, I put on (and am still carrying) holiday weight because I could barely get the pants buttoned. Mind you, this suit and my gut provided three labors as penance for my holiday gluttony: an inside button, a metal clasp, and an outside button.

I blew out all my breath, sucked in my belly, and prepared for battle. Somewhere in the process of getting the pants on, I managed to slice the hell out of my finger on the metal clasp. Luckily, the blood only started gushing out after I'd got the pants buttoned and zipped. It's the little victories in life, you know.

The most dangerous thing in my pants.

So, at several points during the night, I had the pleasure of explaining that I cut my finger while putting on my pants because I'm a fatass. Can't wait to get back in the gym.

I Am Unqualified to Brew Coffee

2010-01-30T16:14:00.000-08:00

Evidently, the stress and fatigue of the semester is starting. As is my routine, I prep my coffee maker before going to bed and set the automatically brew a little earlier than my alarm. Call me a Folger's commercial but I love waking to the smell of freshly-brewed coffee. So, I hit the snooze button a few times and really noticed the amazingly fragrant coffee aroma wafting into my bedroom. Still hazy from sleep, I clumsily made my way into the kitchen and turned on the light.

"What the hell is that brown towel on the floor?," I asked myself aloud. A moment later, I noticed that the same "brown towel" was curled on the counter and snaked down the cabinets to the floor. Finally, my brain caught up with what I was seeing and confirmed that it was, indeed, not a towel but my morning cups of joe. "Nice job, idiot," I said to myself.

I can understand not putting the coffee put all the way under the brewing basket or something to make it spill out. My coffee pot was 5 feet away, in the dishwasher. How the hell am I going to survive being on call?

A Meanness In This World

2010-01-19T20:39:00.000-08:00

Nothing quite like preparing for a session on the "internal male genitalia" and "bladder and urethra" and, fifteen minutes before class, finding out that they changed the order of the topics. And, more importantly, that today will be an interactive session in which you're expected to stand and deliver your differential diagnosis if called to do so. Super.

And, just for the hell of it, let's add to that the development of the brain and frakking cranial nerves for Friday's test block. And, some immunology. And, for the surprise of the week, Pharmacology. We're having our first exam for a class two days after we have the first class.

Grrr.

On To The Next One

2010-01-16T20:48:00.002-08:00

Week Two is in the books and what an eventful one it was. Again, it has been another week where the pendulum moves from the crushing stress of new classes to amazingly distasteful jokes in anatomy lab. I feel like the clock has been tightly wound and, as a result, is flying by now only to slow down at the end of the semester.

My Bamba Surfs Internet Porn In My Dream

Earlier this week, I had a dream that I walked in on my grandmother surfing porn on the internet. As would be the case with most grandparents, she got a little flustered when she couldn’t close the browser. In fact, it took her a ridiculously long time to close it down. All the while, she’s saying stereotypical grandmotherly things like “Oh Dear” or “My Goodness” or “I Was Just Looking for Recipes,” simultaneously fumbling with the mouse, and clicking errantly all over the screen before becoming hysterical with laughter at herself. After looking away for as long as I could and trying to maintain the illusion of normalcy, I spent about ten minutes teaching her how to quickly close windows on her computer by simultaneously pressing the Alt and F4 keys. She was grateful.

Seriously, what the hell is wrong with me that my dear Bamba is surfing porn in my dreams instead of me?

Dissecting the Va-Jay-Jay Is Tougher Than You Might Think

For this section of Gross Anatomy, I'm paired with a few of my good female friends. Needless to say, they make ridiculously inappropriate comments that have me swallowing my laughter and trying as hard as I can to keep it together. This week, we had the pleasures of dissecting the Urogential Triangle on our female cadaver. Being the only male in the dissecting team, they tried to make me blush a few times. At one point during the dissection, they called one professor over to help identify a landmark on the external genitalia. When he took a moment, one of the gals, J, says to him in a complete deadpan, "I thought you were pretty familiar with the vagina." He waited a beat and came back with, "I usually have the lights off."

The next challenge came when we attempted to identify the crus of the clitoris, a tissue synonymous with the corpora cavernosa - an erectile tissue. As the name might imply, there is a relationship with the clitoris.

To locate this tissue, one can use the clitoris as a landmark and, then, dissect laterally from it to locate the crus. After some confusion on locating the "big C," I told the team how great it was that it wasn't only men who had a tough time finding it. Apparently, the gauntlet was thrown because they challenged me to find it really quickly. Without missing a beat, I told them to give me some room because I was going to have to climb on the table and get my face down there. Our laughter prompted the professor to return and ask us what was going on. Just being inappropriate and trying to earn low marks on respectfulness, I assured him. Sometimes, dark humor is just what you need to get you through a situation.

Immunization Certification: Epic Fail

This morning, I attempted to get a certification for giving immunizations. The course was mandatory for second-year students and optional for us lowly first years. Although I didn't really expect to pass the damned thing, I thought of it as a free play: throw it up in the end-zone and maybe someone would come down with it. After all, it had a lot of material from a class that I've not even taken at this point.

Let's just say that I'm pretty sure that I can deliver an IM or SQ injection but, obviously, have not memorized the vaccination schedule as required to successfully pass the test. Luckily, I only spent a couple of hours studying for it. Out of the approximately 90 people who showed up to take the exam, only a handful of people passed the exam and advanced to the practical side of giving injections. Evidently, at this point, if a 13-year-old walked in a provided a list of the vaccines that she'd received at 6 months, 12 months, and 6 years old, I would be unable to determine from memory what vaccines to give her. Although I failed the exam, I scored as well as many of the second year students (and better than a few). That being said, if the pass rate for an exam is ridiculously low, maybe all of the blame doesn't belong on the students. Just a thought.

Off and Running

2010-01-10T10:05:00.000-08:00

The first week back in classes is behind me. This go-around, I think, will be a long and brutal campaign toward June. I'll say that the addition of Neuroanatomy, Pathology, and Pharmacology to the mix adds an exponential amount of stress and difficulty to the mix. My "old" classes haven't been slouching either: we're starting Gross Anatomy this semester with the pelvis and have spend a good deal of the week on the Anal Triangle.

Yep, it's as awesome as you'd imagine.

Back to the Future

2010-01-03T18:14:00.001-08:00

After arriving back here in advance of school, I caught up with a few classmates and we decided to go see a movie. Being that I'm not exactly in a metropolis, there aren't that many selections to choose from. Typically, I tend to shy away from blockbusters and head toward more independent fare but, like I said, I'm not exactly in a metropolis. So, we decided to go see Avatar. I was curious to see the spectacle and didn't really expect too much from Cameron's story line. Typically, I think he tends toward underdeveloped characters and incorporates a little too much cheesiness into his pictures. No matter, I was willing to plunk down my cash and see the "game changer" that he'd unleashed.

One dilemma of seeing movies here in the Palm Springs of Washington is that the theaters take cash only. Their online ticketing is, shall we say, a little behind the times. In true 1988 fashion, we headed over to the theater yesterday evening to catch the 6pm showing. When we got in line for tickets, we noticed after a few minutes that all remaining showings for the night were sold out. By the way, this was scrawled on a whiteboard hanging on the ticket window. No worries, we'd catch it today. This morning, the gang got together for brunch and decided to head over immediately after to buy our tix a full hour before the start time. Once again, on walking up to the ticket line, the whiteboard noted that the next two showings were sold out! Seriously, the last time I wasn't able to buy tickets online and actually walked up to the theater to find the movie I wanted to see was sold out was twenty years ago when I was in high school. Seriously, what the hell is wrong with this town? Anywho, we bought our tix for a show nearly four hour later. It sold out shortly after we got our tickets. Forty-five minutes prior to showtime, our friends called to say that they were in line to get into the theater and would save us seats.

Finally, we made our way into the theater and watched the damned thing. I'll just say that the animation was amazing. It makes the animation in Robert Zemeckis' CGI flicks look like stick figures. So, for that alone, it was worth the money. The 3D was pretty stinking amazing also. When I was a kid, all the 3D movies were pretty gimmicky with only a few scenes with objects flying at you. That this entire film was in 3D still amazes me. Keep in mind, however, that I've not pulled the trigger on seeing any of the spate of recent films offered in 3D; this was my maiden voyage. So, that being said it was an entertaining movie. The technology behind it was amazing. The visual world Cameron's team created is unlike anything you've ever seen in cinema. I think it really has moved the bars for digital animation. Was it the best movie I've ever seen? Hardly. The story, in itself, is compelling and can easily be viewed as a parable for any number of issues (both current and historical). A few of the plot points, though, were heavy-handed and some were far-fetched even for an imagined world which I had no problem buying into. That being said, I'd recommend seeing it on the big screen just to be a part of the spectacle of a world-wide blockbuster.

If you can, buy your tix online, show up fifteen minutes before show time, and let me know how that feels. I miss the new millennium.

2010? Really?

2010-01-01T19:35:00.004-08:00

Seems like just yesterday that the eccentric, fanny-pack-wearing IT security guy at my old software job was withdrawing the money from his bank accounts, stockpiling goods, and preparing for the looming Y2K technology meltdown.

Winning Run and I had a great lunch at Muss and Turner's with Tainted Hummus' own "Keytar Rob." Later, we made a stop-in at a small get-together with some friends. Finally, in bed by about 11:30pm because my flight left ATL this morning at 6:30am. First to Cincinatti, then on to Seattle. Most of my New Year's Day was spent cramped into seat with a wailing toddler directly behind me kicking my seat for most of the flight. Hooray me! Really, I'm not a parent but I'm pretty sure that quietly pleading with a toddler to stop crying is an ineffective strategy. I'm pretty sure that a bouncing stroll up and down the aisle might've been a better option. Needless to say, it's only the first of the year and I've already exceeded last year's crying-child-on-a-flight stats by about 1000%. What can I say, I piss excellence.

Also, I had my first experience with snow chains on the drive over a mountain pass with a classmate. Best part of it was when some guy in the car behind ours at the chain-up area, came up to me with questions on how to put them on his tires. "Man, I'd love to help you but I'm from Georgia and this is the first time I've ever touched a snow chain. I'm afraid I can't help you," I told him laughing. He shrugged his shoulders and went back to his car to figure it out himself.

Near the top of the pass.

So, now I'm back at my crappy apartment. Alone. No television. No wife. No dog. No old-friends to meet for a drink and a visit. No black-eyed peas. Or collard greens. Or ham. Just me and the thoughts that all this hardship is worth it: that 2010 will be better than 2009. That it will be the foundation for better years to come.

Happy New Year.

Put a Fork in 2009

2009-12-31T15:45:00.001-08:00

Boy, this one got out of here fast, didn't it?

I finished finals on the 19th, cracked open a bottle of Blue Label and had a celebratory toast. Let's just say those damned things were pretty tough. I focused most of my efforts on Physiology and BioChem. As a result, I pulled up those grades at the expense of my Anatomy grade which fell. All told, though, I passed everything so I'm thrilled. For a while, it seemed doubtful. After the dust settled, I packed my stuff and got my ass back to Georgia for the holidays and have been doing as little as possible. Seriously, my goal has been to stay in my pajamas as long as possible each day and watch the worst television possible (reality programming excluded).

What I Learned During My First Semester in Medical School

Nobody can truly prepare you for the shitstorm that you are entering. Seriously, people told me that it would be tough but that I could succeed at it. After I'd started, it seemed like all of my doctor friends changed their tune to "Yeah, it's pretty tough but you've got to gut it out and get through it." Today, I really think that I can make it. For the first few weeks, however, I was waiting for my bus ticket back home.
Your closest friends and family really have no idea what you are battling through on a daily basis. People can empathize and sympathize but, unless someone has done it, people don't truly understand. At times, this is great because having a conversation with someone who is "in the real world" is awesome. The outside is a balance to the all-consuming world of being a student; it's beneficial. At other times, it can be pretty lonely when you are trying to recount an anecdote who's primary audience are med-school dorks like you.
Sometimes, a class member can yell out "Anal Sex" in class and be courteously dismissed by the professor and thanked for a good guess but an incorrect answer.
When strangers find out you're a med student, they will tell you things that they don't confide to others; it's the blessing and the curse of the profession. For example, the guy who cuts what's left of my hair dropped some heavy personal medical information on me during a visit. The best I could do was listen, remind him that I was seven weeks into my first semester of school, offer to track down some information for him and try to give him some resources. I was flattered and frightened by his confidence in me.
I can do this; I will be a doctor. Early in the semester, I wrote a few notecards for myself and posted them around my apartment where I'd see them each day. "Kick Ass Today" on the back door. "You Can Do This" on the bathroom mirror. The one that gets me going the most: "Do This For Bamba and Granddaddy." Sure do wish that those family and friends who have passed on could be here to experience this with me.
Friends, old and new, get you through it. I'm now in a fraternity with my classmates. We've been through the hell of the semester together and have seen each other at our best and worst. They're the day to day crew that help you get over the peaks and valleys of the coursework. Of course, my wife, family, and friends back home helped me more than I can articulate. Cards, voice messages, quick emails or texts give me so much motivation to keep studying for another ten minutes, another half hour, another hour, another day.
You will be isolated by what you know. Lots of acquaintances will glaze over when you get into the second sentence of your description of med school. Others will laud you with "fact" that are absolutely untrue. Seriously, people will repeat things that one would think are too absurd to pass along as fact. People just don't think about what they're saying. I was walking my dog with a guy at the park who told me about a lady who "cured" her cancer simply by thinking positive thoughts. After listening to as much as I could, I sort of unloaded on the error of his thinking and of the tremendous gaps in the retelling of his story. Without a doubt, a positive attitude and strong support network is beneficial when fighting illness but I'm not sure that it's the only thing. After spending most of every day thinking critically and doing your best to rationalize through things, it's a little more difficult to suffer fools and foolish comments. At a minimum, people should research things; snopes.com is a great start.
Classmates will drunk-dial you over the holidays to remind you of that one time when a microphone fell into your ass in front of the entire class.
Some classmates might get a little uneasy at jokes involving hobo hunting (for sport, of course) and jokes involving Bea Arthur's sexual magnetism.

Here's looking forward to next semester.

Staying Positive

2009-12-14T19:00:00.001-08:00

One class final (Histology) and one practical exam down.

One practical exam, one presentation, and exams in Community and Behavioral Medicine, Medical Microbiology, Clinical Skills, Medical Physiology, Osteopathic Principles and Practice, Gross Anatomy, and Biochemistry to go.

You've Got Mono!

2009-12-09T17:47:00.004-08:00

I just got out of an essay exam in Microbiology. Essentially, we were given an infectious condition and expected to identify the causative agent, describe the etiology of the causative agent, discuss the pathology of the condition, identify transmission methods, describe hallmark symptoms, describe any pertinent incidence/fatality rates, and discuss treatment options. All of this in a pseudo-cohesive essay per condition, within an hour.

Our prof had given us a list of five possibilities: bacterial pneumonia, bacterial diarrhea, burn wound infections, infectious mononucleosis, and urinary tract infections. Of these five, two would be drawn from a hat at test time. We'd write a third essay on a condition of our choice that was not included in the original five.

So, as the week has drawn on, everyone has been busy trying to learn everything for all the conditions, some of which have what seems like a gajillion causative agents. (Google some of the causes of bacterial diarrhea; there are seven serotypes of Escherichia coli alone.) A few days ago, I started asking people what their wish list would be for the exam. Most everyone, would say either bacterial pneumonia or diarrhea and infectious mononucleosis. Mono is caused by the Epstein-Barr virus and, compared to the others, is easier to quickly understand and memorize key points. As the rigors of the week continued to mount (we have two tests tomorrow and finals next week), people became more hopeful that we'd all get mono.

"I don't know ... I really hope we get mono!," someone would tell me.

"Yeah, that'd be pretty sweet," I'd concur.

Today, everyone made the final push on studying for it. Like most exams, the room was buzzing with nervous tension in the minutes before the test. One of our classmates picked the topics from a jar. We were on pins an needles as our prof, unfolded the first one and announced that one of the topics would be bacterial pneumonia. Everyone sighed. In my gut, I knew that we'd be getting Urinary Tract Infections.

His hand rattled around in the jar for what seemed an eternity before he drew out a folded yellow slip and handed it to the prof.

"Your. Next. Topic. Is. Infectious Mononucleosis!"

No shit, the room erupted with yells and applause. All 75 of us were cheering and carrying on like we'd just won the lottery. It was ridiculous. Hell, I personally was pumping my fist and screaming "Mono!!! Yeahhhhh!!!" without being at all sarcastic or ironic. For five minutes after the cacophony settled, I sat there with my eyes closed laughing silently. I smiled and chuckled during the entire thing. Afterward, I headed to a conference room and laughed about it with a classmate until I cried. Instead of studying for Histology and Anatomy, I'm writing this because it still kills me. Damn, I wish I had it on video. Classic. Absolute classic.

That's what it's like to be a medical student: the absolute effing highlight of my day involved cheering with joyful abandon for mono. Honestly, it felt like my team won the big game on the final play with no time left.

Microphone Check, One, Two, One, Two...

2009-12-06T12:01:00.007-08:00

In one of my classes, students are regularly used by instructors to demonstrate certain techniques and practical skills to the class. Typically, the student, playing the role of the patient, will be examined by the instructor on an exam table on a small stage in the front of the class. Overhead video cameras are used to ensure that everyone gets a great view of the treatment technique being addressed.

So, my lucky day was last week. I was to be used to demonstrate how to identify and treat certain tender points on the posterior lumbar and sacral areas. Normally, male students are shirtless and wear only a pair of running short. The room was cold, however, and I got away with a pair of running shorts and a t-shirt. During demonstration of the technique, the attending doctor had me slide to one side of the table so that he could manipulate my leg in order to demonstrate the treatment technique. The following image shows how I was splayed on the table in front of my peers.

For the record, I wasn't wearing a sports bra. Also, my shorts were much shorter.

While the professor was lecturing, he leaned over to move my leg. His microphone fell off and dropped right into my ass-crack. My shorts served as a thin, nylon barrier but, for all practical purposes, it was a direct hit. Hell, I probably couldn't have placed it so precisely myself.

Precision and accuracy.

On feeling the impact and hearing the broadcast, muffled sounds of a microphone rumbling around in my ass, I quickly raised my head and flashed a confused expression to my classmates. I was greeted with laughter, some stifled, most raucous. Although I couldn't see him, it seemed as though it took the professor about an hour to gingerly pluck the microphone from my crevasse.

Never in my life had I been so happy to not have farted into a microphone placed in my butt. (Not that this scenario has presented itself before, mind you.) Had I done so, I would've immediately thanked everyone in the room, gather my things, and left, never to return. As it stands, I'm not sure that I'll be volunteering much more.

Down

2009-12-01T08:27:00.001-08:00

Last night as I headed back to campus for a Physiology recitation, the moon perched in the sky, peeking through the clouds, winking at me, whispering "There is more. There is more." I had dressed in too light a jacket for the cold foggy day and wore the same into the night. Sometimes, I like to feel the stinging cold air rip through my shirt and chill me to the core. Sometimes, it's what I need to remind me that life exists outside the walls of this building, away from the formalin that leaps from an old, gray body to bury itself in my skin, apart from the pages and pages of text that I hunch over. It heightens my senses, puts a snap in my step, pushes me urgently into these halls toward the tasks at hand.

I thought that Thanksgiving break would replenish me. I thought that I could go home and be fully recharged. Instead, I feel the pain of transition anew: parting is such sweet sorrow (again). On my return, I discovered that those tending the fire had busied themselves splitting kindling and, on seeing me, dumped armloads onto the flame. The heat is too much, is suffocating. I want to wade out into the river and let the cooling waters pull me down, pull me down.

Culinary Delights

2009-11-19T16:29:00.003-08:00

After nearly a semester of dissecting a cadaver, it's safe to say that my culinary horizons have narrowed slightly thanks to the sights, smells, sounds, and tactile experiences I've gained. Recently, I had to really coach myself through some tasty carne asada; so I guess that beef is probably off the list for a while.

Based on today's lab where we removed the GI tract and opened various structures, I can firmly say that I'll be hesitant to make a meal of only Oreos and pesto sauce.

Heal Me, Nature

2009-11-08T16:54:00.007-08:00

Still licking my wounds, I headed into the canyon for a little "me" time to get away from things and to put something in front of my face that wasn't ink on a page. So, I headed into the river canyon for a short hike to get away from things, climb a ridge, and get a fresher perspective.

I drove fast in the canyon, leaning into the curves, glimpsing the river down below, seeing the rain clouds move in from the horizon. On reaching the trailhead, I ditched the car, grabbed my gear and heading across the river and into the thicket. I picked the steepest trail that I could find and attacked it. Within five minutes, my legs were throbbing and my lungs were on fire. I pushed onward, upward and, eventually, was rewarded with fantastic view of the canyon.

On the plateau, I lost the trail but managed to pick up a game trail and follow it for a while. Ten minutes later, when I was precariously perched on the seriously steep mountain side, I realized that I was not and had never been a mountain goat capable of comfortably walking on such stupidly sloped mountains. Carefully, I picked my way along the hillside for the next thirty minutes, pausing often, shooting some pics, and scouting my route. Eventually, I worked my way around the canyon and back to some landmarks that I'd noted that were on a proper footpath. Then, with quivering legs, I headed back to the car. I left the parking lot as the rain moved in and drove home tired and happy.

That Stung a Little*

2009-11-06T14:00:00.000-08:00

*By "Stung a Little," I mean that it knocked me on my ass and hurt me badly. A brief rundown...

Community and Behavioral Medicine:

I'm in the white trunks.

Medical Microbiology

Here I am, taking the hit.

BioChemistry

Once again, I'm on the bad end of the business.

Medical Physiology

That's me in the role of Marcellus Wallace.

The Beauty of Sleep Deprivation

2009-11-05T06:55:00.009-08:00

While shower this morning, my sleep-deprived brain took made the jump from "I need to shave" to "Billy Mays had a strange beard" to "I wonder how much cocaine he did?" to "what if he was in 'Scarface' as Tony Montana?" to me actually doing the final scene in Mays' pitch man style.

Dress it up with a little Mays' flair...

Do you want to play games? I bet you do; the good new is that I'll play with you!
Do you like to play rough? Have I got a surprise for you!
Say 'hello' to My Little Friend(TM)!

Comedy gold.
(Comparison photo not available, obviously.)

Call me Hollywood ... before I get some sleep.

Friday Nears.

2009-11-04T22:13:00.003-08:00

Awesome. Can't wait.

Yep...this about sums it up.

Week 12 : Done

2009-10-30T21:26:00.010-07:00

The weeks continue to roll on by and the end of the semester looms ominously. Week 19 will be here before too long.

Anatomy: Still the Winner
Just wrapped up the thorax. Again, the dissection was incredible. I held a human heart in my hands. (!?!) The prof wasn't so thrilled when I reenacted "Temple of Doom."

Wearing the costume to class might
have been a little over the top.

I Am Amusing, Insensitive
So, the H1N1 flu has made the rounds at school. It seems to have abated now but a couple of weeks ago, tons of people were out. I didn't see one of my classmates for several days and just assumed that he had the swine flu (la gripa porcina). When he finally made it back to class, I we had the following brief conversation:

"So, man, are you back from the dead?," I asked innocently enough.
His face twisted in a funny sort of way that immediately made me feel a pit in my stomach. His was an expression that foretold that this conversation wouldn't end well for me.
"I'm not dead ... my wife's grandmother is the one who's dead. I was at the funeral," he tells me.
"I. Am. So. Sorry," I offer. "My condolences. I thought you were out with the flu."
"No, we were at the funeral."
"But I thought you had the flu...that's why I said...," I spoke, trailing off into awkward silence.

We nodded at each other and went our separate ways.

Next Week: 5 Tests!
So, my Halloween plans have been replaced. Instead of rocking the Charlie from "It's Always Sunny in Philadelphia" costume, I'll be attending a party at my desk and dressing as an overstressed 1st year medical student with five tests next week. In true dedication to the costume, I'll keep my stinking face in a stinking book.

Next Friday at about 12:05pm PST, however, I'll be dressed as a guy with a thirst for beer who's ready to ride the wings of the dragon through the cosmos.

Happy Birthday to Winning Run
Wish my sweetness was here. Or that I was there.

Love is a dress that you made
Long to hide your knees
Love to say this to your face
I love you only
For your days and excitement
What will you keep for to wear?
Someday drawing you different
May I be weaved in your hair

Love and some verses you hear
Say what you can say
Love to say this in your ear
I'll love you that way
From your changing contentment
What will you choose for to share?
Someday drawing you different
May I be weaved in your hair

"Love and Some Verses" - Iron & Wine

Tough One

2009-10-26T07:11:00.003-07:00

So, last week in our Community and Behavioral Medicine class, we had a few lecturers come and speak to us about Child Abuse and how we, as physicians, can recognize signs of it and take actions to safeguard the children. I gotta say that after sitting through three hours of photos and case studies of physical and sexual abuse, I was ready to form a posse and dispense some frontier justice.

Seems like everyone was in a pretty good mood going into the class and just crushed and defeated at the end of it. Guess this being a doctor thing has its share of grim reality, huh? It isn't always a sunny outlook before the end credits roll and the commercials air.

Kudos to the folks out there who are fighting this stuff and working to protect kids on a daily basis.

Rodeo Daze

2009-10-20T17:09:00.002-07:00

Today's shit was so far over my head that I took the rodeo approach: try to hang on for 8 seconds before you're thrown off. Then, quickly dust yourself off, run like hell for the fences, and let the clowns take over.

People were wondering why I was dressed like a bull-rider. They were even more confused when I sprinted from the room after 10 seconds of lecture.

Probably Not Going to Be Eating Crab Legs for a While...

2009-10-08T15:21:00.002-07:00

Today's anatomy lab was another first for me. We removed the arms from the cadaver and put them with the other parts in the bin. It was pretty strange to use a hacksaw to cut off a limb and stranger still to put them in a RubberMaid bin with everything else from the body.

Afterward, we removed the front of the thoracic cage so that we could get to the lungs and remove them. Part of this entailed cutting the ribs with a pair of pliers or snips. Let's just say that based on the auditory and tactile experience of cutting human ribs with a handheld tool, it's going to be a long, long time before I sit down to a plate of you-crack-'em crab legs. It sounded and felt EXACTLY the same.

The lungs, however, are super cool. Even without drawn butter.

So, I Might Be a Little Tired...

2009-10-08T07:59:00.003-07:00

After a late night to studying, I got up, showered, and lumbered into the kitchen to make coffee. I pulled out the filter and began to fill it. When it was halfway full, I noticed that instead of ground coffee, I was loading it with Splenda which has no coffee aroma and is the exact opposite color.

Nothing like a hot cup of freshly-brewed Splenda water!

Three on the...Right?
Yesterday in anatomy, our prof lectured about fetal lung development and, generally, about the structure of the lungs in the thoracic cavity. At one point, he mentioned utters the phrase "three on the right" and throws three fingers on his right chest. Supposedly, he meant to give us a quick way to recall that the right lung has three lobes versus the left's two.

Based, however, on the fact that I co-invented "three on the left" signal to indicate that one had "Turned the Fun Corner." Obviously, "three on the right" is a clear indication that someone needs an ass-beating. I let him slide this time. Next time, however, the gloves come off.

Disbanding the Army
Today in Anatomy Lab, we're supposed to detach the arms from our cadaver and put them in the body bin. I'm really honing my skills here. Hobos beware.

Almost Halfway Through the First Semester

2009-10-04T11:03:00.006-07:00

Monday marks the beginning of the 9th week of this semester, approximately the halfway point. Honestly, things are all running together. Weeks seemingly fly by but, strangely, an hour can seem like an eternity to get something done. For example, a good fifteen minutes can be prime study time to review something in advance of a test or to get in a great, refreshing nap. That time seems to be moving on a couple of different scales is a little odd. It is what it is, I suppose.

Every Week Is Finals Week
Part of the struggle is that each week has a few exams. Seems like feedback from last year's class led to some changes which led to some unexpected consequences for my class: major tests almost every stinking week. A few days ago, someone remarked that they were trying to explain the stress to some friends. They approached it like this:

"Remember how we'd get all stressed out and study like crazy for finals? That's every week for us."

Personally, I think it's an accurate statement.

So Long, Frank the Farmer
For the "upper limb" section in anatomy, I'd worked with a new group on "Frank, the Farmer." A muscular older gentleman with a well-preserved body. Simply put, the shoulder, arm, forearm, wrist, and hand are amazingly complex but perfectly assembled. Seriously, the brachial plexus that sends nerves to everything in the region is amazing. The musculature is kick-ass. Obviously, you can feel how the tendons from your forearm make their way into your hand to control how your hand and fingers move. To see and tug on these things during dissection is another matter: ultimately cool. It really was like looking at a marionette or something.

That's me holding the paper and looking over might right shoulder at you.

My only problem during dissection was cutting into the hand. Specifically, removing the fingernails made me gag a little. My eyes started to water and, while talking, my voice did the funny "I'm about to throw up" sort of gurgle. Luckily, my team did a little distraction (obvious but effective) while they removed the nails so we could get down to the bones of the finger without the added insult of me vomiting on the cadaver.

The lab exam for this section was intense but so stinking cool. At one point, I walk up to a body and the only thing exposed from under the sheet was a dissected forearm and hand (positioned as if gripping an invisible tennis ball). Easily, it could've been a scene from a horror movie but, now, it's quite normal. As I walked up to it for my 60-second attempt to ID the tagged body part, I thought about how effing cool it is to be doing what I'm doing. Pretty awesome. Then, for my answer, I wrote "femur." I'm sure I passed.

Apples In Stereo
On Saturday, several of us went to a local apple orchard with our Medical Spanish group to visit with the migrant workers and get a better understanding of their daily jobs. We took hot coffee and pan dulce from one of the local shops. Holy smokes, these people work so hard. Offer a little thanks the next time you eat any fruit or vegetable, migrant labor got it onto your table.

Tree full of apples.

We weren't supposed to eat the ones off this tree.
I did and became embarrassed of my own nakedness.
(My classmates, however, were already weirded out by my nudity.)

In the orchards, everything is harvested by hand so as not to bruise the apples. These guys and women (some several months pregnant) wear bags that they fill with between 30 and 50 pounds of apples before carefully unloading them into a huge crate. It takes about 30 sacks full to fill a crate. In a day, a fast picker can fill 10 crates. Not only do they work quickly, they're expected to pick the apples without bruising them or breaking off the stems. If they do either one, they get a "demerit," three demerits gets you a "slip." If you receive a couple of slips, you're looking for another job. If I had no quality control levels to hit, I could probably fill three or four crates before falling onto my ass from exhaustion. Afterward, I'd likely be unable to move for days due to intense back and shoulder pain. It was amazing to witness. Be thankful for what you've got, you know.

Up This Week
Exams in Microbiology, BioChemistry, Epidemiology, and Physiology! Friday will be here before I know it.

Cereal Fail

2009-09-27T19:14:00.002-07:00

Tonight, my dinner of champions is a bowl of wheat flakes cereal with dried berries in soy milk. As I opened the box of cereal, the scent that rushed out of the inner bag and hit me in the face was the exact one that I get when I open up a body bag in cadaver lab.

Puzzled, I paused for a moment to be sure that I wasn't hallucinating and was really in my apartment and that a well-preserved hand wasn't in my cereal box.

I'm eating it but every damned bite smells like formyl preservative. I just wasted four and a half bucks on this shit. Fail.

When It Rains...

2009-09-22T18:54:00.006-07:00

After a wonderful weekend in which my wife, parents, sister, and mother- and father-in-law visited for my white coat ceremony, I've been getting ready for this week's exams. Last night, however, I came down with what I presume is the flu. Today, I stayed home and huddled, shivering under the covers most of the day while I tried to sleep and, in the process, get every bit of sweat out of my body. As night has fallen, I've been increasingly stressed out about class and exams and sad about missing Winning Run's building opening.

My plight was quickly put into the proper perspective when, a short time ago, I found out that a buddy of mine from my old neighborhood softball team, the East Atlanta Pillage, died either yesterday or today from a fall while hiking Lava Rock Falls in the Grand Canyon. Needless to say, my heart goes out to his family and everyone who was touched by his endless cheer and wonderfully unique outlook.

Stand and Deliver

2009-09-15T15:07:00.005-07:00

Or Holy @$*!, They Know Our Names
Today's BioChem lecture found us with a new prof for the next several weeks. Today's lecture was on the intricacies of conservative DNA reproduction. Easy enough, we thought...until he started calling people's names from memory and asking them to answer questions. The tension was overwhelming. The first time he called on someone, we thought that maybe he simply knew them as their faculty advisor. The third time it happened, we were terrified. Each person's eyes were wide with fear; everyone screamed through closed mouths "They know our names! It is not safe here." You could hear the seat cushions being squeezed by room's collective ass clenching.

Like everyone else, I willed myself invisible, declined to make eye contact with him, studied his slides intently, and took amazing notes. It was to no avail: As he strolled around giving his lecture, he asked a question and then said my name. From me seat, I yelled the answer because he was on the other side of the room. The heads of everyone in the class spun around to look at me because, evidently, he was talking to someone else with my name. He casually looks at me, correctly states my last name, and asks me to stand and tell the class the answer. Well, for some reason, I geeked out and totally changed my answer to one less correct before turning beet red, peeing on myself, and sitting back down in my seat.

Next time, I'll wait for him to call my last name prior to spazzing out and yelling an answer.

This is awesome; it's not like I wasn't stressed out before. Super.

Nobody Puts Baby in a Corner...

2009-09-14T20:32:00.002-07:00

...even in heaven.

RIP Swayze.

Man, We Make Our Own Movies

2009-09-13T11:00:00.004-07:00

The Hold Steady's "Slapped Actress" has gotten me through the last few weeks. Holy smokes, I love it.

Don't tell my sister about your most recent vision.
Don't tell my family; they're all wicked strict Christians.
Don't tell the hangers-on.
Don't tell your friends.
Don't tell them we went down to Ybor City again.

Don't tell the dancers; they'll just get distracted.
Don't tell the DJs; they already suspect us.
Don't mention the bloodshed.
Don't mention the skins.
Don't tell them Ybor City almost killed us again.

We are the theater.
They are the people dressed up to be seated, looking upwards and dreaming.
We're the projectors.
We're hosting the screening.
We're dust in the spotlights.
We're just kind of floating.

Don't drop little hints.
I don't want them to guess.
Don't mention Tampa, they'll just know all the rest.
Don't mention the bloodshed.
Don't tell them it hurts.
Don't say we saw angels; they'll take us straight to the church.

They queue up for tickets to see the performance.
They push to get closer.
Looking upwards with wonder.

We are the actors.
The cameras are rolling.
I'll be Ben Gazzara, you'll be Gena Rowlands.

Sometimes actresses get slapped.

Sometimes actresses get slapped.
Sometimes fake fights turn out bad.
Sometimes actresses get slapped.
Some nights making it look real might end up with someone hurt.
Some nights it's just entertainment.
Some other nights it's work.

They come in for the feeding, sit in stadium seating.
They're holding their hands out for the body and blood now.

We're the directors.
Our hands will hold steady.
I'll be John Cassavettes, let me know when you're ready.

Man, we make our own movies.

Five Weeks In: Cracks Are Starting to Show

2009-09-12T12:25:00.003-07:00

I guess the end of this week brings it to five weeks in medical school. So far, things has been barely manageable. Last week, my anatomy practical was the latest hurdle. This week, it was major tests in Physiology, Microbiology, Biochemisty, and Epidemiology. Next week, it is Histology.

Yikes. Any of these alone would be enough to have me drawn tight enough to devote all my time to it specifically. Together, however, it's a lot like being on The Tonight Show and keeping the spinning plates going: everything is precariously balanced and threatening to spin off into destruction. So it is with me: things are beginning to hit the floor.

When I Said I Wouldn't Have Time to Call or Write, I Wasn't Lying
Recently, I had a pretty big argument with someone dear to me. Conversation started fine enough but, I felt, turned into a questioning of how I'm spending my time and some guilt-laden pressure to stay in better contact. Naturally, I took umbrage at this assertion. Honestly, I have unreturned phone calls and unread email messages from friends and family. It is no joke: I HAVE NO EXTRA TIME. The first week of school was, in retrospect, pretty damned leisurely. Since then, it's been a steamroller that is crushing me.

So, I beg you not to take any lack of communication or of response as a personal slight. Often, if I'm not in class I need the time to recharge my batteries by doing something mindless, by sleeping, by being quiet, or by doing nothing. If I don't take care of myself, I'll be in no shape to be successful at this.

Please consider that I'm under some phenomenal stress here. Not only am I fighting to achieve a goal toward which I've worked for the last several years, I'm trying to do it in a place without the immediate support structure of family and friends.

Think of not hearing from me as "no news is good news." That being said, feel free to drop me a line or leave me a message if you're thinking of me; I love getting cards, messages, and email messages. When I can, I'll get back to you but it might not be for several weeks.

Labor Day Weekend
Last weekend, I went to L.A. for my buddy K's wedding. It was ridiculous. The hotels were fantastic, the food was great, the company was better. I loved seeing family (Winning Run!) and friends and letting them talk me off the ledge and give me some perspective on things going on in the "outside world." Needless to say, I didn't get much studying done for the four exams that I had yesterday (and it showed!) but I wouldn't trade the experience for anything. Nothing beats having an "In & Out Burger" catering truck show up after your reception to feed those guests who had so much fun dancing and taking advantage of the open bar. In other words, I enjoyed my double-double animal style.

Deep Inside Walter's Back

2009-08-28T22:06:00.004-07:00

Or Why I"m Taking a Break From Eating Butter
(Or: Why I'll Never Again Look at a Wood Chisel the Same Way)
A couple of weeksa ago in Anatomy Lab, I used a wood chisel and a hammer to perform a laminectomy on Walter. We removed part of his vertebral column so that we could take a gander at his spinal cord. It was ridiculously cool but it will forever make me think of Walter whenever I see a wood chisel.

Also, during dissection, fat cells seem to "weep" their contents into your work space. While I was trying to clean around some muscles in the neck, these yellow fat cells kept oozing greasy fat. If I wasn't already a little put off by them, I certain was when one of my teammates remarked that it looked like melted butter. I immediately grabbed a dinner roll and, then, puked.

Overheard
"Aww, man...these nuts taste like my cadaver smells."

Advising my classmate to stop eating the nuts seemed like a sensible reply that, if nothing else, completely let go of the comedic gem of his statement. He should consider it a freebie.

The Matrix and BioChemistry

2009-08-22T18:02:00.002-07:00

You know what I really, really want right now? I want to live in a Matrix-like world where I could just have someone download BioChemistry into this thick-assed noggin of mine. I just cannot seem to get a toehold on this subject; I think that I'm still carrying some resistance from Organic Chemistry (recap here) that is preventing me from opening up to BioChem. Nonetheless, I'd love to pause for a second or two until the download was complete and, in my best Keanu voice, look up and marvel "Whoa...I know Bio Chemistry."

Sorry, Walter, This Might Hurt a Little

2009-08-20T18:43:00.010-07:00

Another week of medical school in the books. I swear, some days are awesome and others just humble you; so it has been for another week. Once more I stare at an approaching weekend with little more than studying, doing laundry, and catching up on sleep on my list of things to do.

Another week in the books. The gloves are off, now. I am still running on adrenaline: staying up until midnight or 12:30 studying and getting up at 5:15 or 5:30 to, surprise, do more studying. I'm starting to feel a little run down. Guess that's part of what I signed up for, isn't it?

Classes were good. This week, we practiced doing a patient interview and taking a patient history which was pretty damned hard. Seriously, how the hell do you meet someone, figure out why they're seeing the doctor, get more information about their "chief complaint," take a medical history, make a diagnosis, and form a plan of attack in about fifteen minutes? Pretty tough to do. I have a great respect for those folks who make it look easy.

Anywho, I'm still struggling to keep up with the reading and make sense of everything covered in class. It's a battle that I don't imagine will end soon. At the very least, I hope to get used to the discomfort of it all.

My First (Human) Dissection
Today was our first dissection in anatomy lab. All day long, everyone was buzzing with excitement. Some were really looking forward to it, others were cautiously excited about it, and still others were pretty apprehensive. Prior to lab, we had to watch a video specifically about removing skin. Funny, when I mentioned wanted to hear "The Killing Moon" and made vague references to "putting the lotion in the basket," people didn't seem to know that I was talking about. It's a cultivated sense of humor, I suppose.

As the time neared for lab though, the joking seemed to dissipate and everyone got a little more serious. Our tasks for the day were to get to lab, flip our body onto the stomach, skin the back, and dissect some of the superficial muscles. Seriously, think about this for a moment: we were tasked with skinning a human back. Not really something that you do every day.

I grabbed a lab coat and joined my team at the dissection table. Everyone was really amped. I mentioned that I'd like to call the cadaver Walter and explained that, to me, he really looked like a Walter. One of my teammates confessed that, she too, had been thinking of the name Walter for him. I thought it was a little uncanny that we'd both thought the same thing but it was settled; we'd be working on Walter.

Our first task was to remove Walter from the body bad that we'd put him in the prior week and roll him over. Prior to doing this, though, we put some socks on his hands and feet and sprayed them with a moistening solution to prevent them from drying out too badly. Then, we need to put a wet cloth on his face and plastic bag over his head for the same reason.

As we're working on his hands and feet, I guess that we shook him a little. While I was staring right into Walter's lifeless eyes, the top of his skull pulled off to reveal that his brain had been removed. Immediately, I felt myself flush and felt beads of sweat on my forehead and upper lip.

"Why's it so hot in here?," I asked. "Seriously, are you guys hot?, " I asked, feeling a little lightheaded. "I'm really hot." Afraid that I would soon hit the floor, I tore myself away from Walter's vacant stare, replace the top of his head, took several deep breaths, and tried to think of something else. Within a few moments, I felt fine; crisis averted. In retrospect, I think that getting really freaked out and almost hitting the deck is pretty normal when staring into someone's eyes and their head comes apart. Hell, you're just not supposed to see that, you know?

With the help of a few other folks, we turned Walter onto his belly and worked a prop under his neck so that he wouldn't be laying on his face. Then, it was time to cut. Everyone else in our group was a little tentative about making the first incision, so I readily volunteered. Our job was to make a series of incisions in order to remove the skin from the back and get access to the musculature.

A guide to making incisions
from our dissection manual.

I thanked Walter for his gift to us, apologized to him, plunged the scalpel into the base of his skull and cut a line from his neck to his ass crack. Then, I carved around the top of this glutes, up to his armpits, down his arms and, finally, back up to his neck where we started. I must say, it's a pretty damned unnatural thing to do.

During the skinning, I felt like I was the king of the "finger hole," a technique that allows you to put a good bit on tension on a piece of epidermis that's being removed. Again, in any other context, it would be quite disturbing to think about but, hey, it's what goes on in lab. Finally, we got the skin off of his back and attempted to remove additional fatty tissue in order to get down to the superficial muscles. All the while, we kept pitching parts of Walter into a bin. During the semester, all parts of a cadaver are kept together so that, when the dissection is complete, the remains will be cremated and returned to the family. In all likelihood, I probably won't be eating steak for the near future (or, for that matter, visiting my local butcher).

Behold: the "finger hole."

After an eternity, we finally removed enough tissue to clearly identify the superficial muscles. We saw his atrophied trapezius muscles, his latissimus dorsi, his rhomboids, and a slew of nerves and arteries. It was pretty damned cool, I must say. During the dissection, I was trying to get a piece of fatty tissue off of the back when it tore loose and flew straight into my eye and onto my face.

Afterward, my fingers were tingling from the formaldehyde (through the gloves); my clothes stank of it. No matter how much I washed, I couldn't seem to get the smell off of me. I guess we're bonded now, Walter and me. BFFs or at least until the course ends and he goes home to his family after completing one final awesome deed.

Med School Is Like Golf

2009-08-18T15:06:00.004-07:00

(Or How Thinking About Taking A Dump Gave Me Hope)

After a weekend spent trying to catch up on sleep and determine the best approach to studying, I find myself nearing the middle of week two. So far, the only constant is that the peaks and valleys are still there. One day, I feel like I'm about to get voted off the island. The next, I think that this crazy-assed plan just might work: we just might win this dance contest and save the old folks' home with the prize money.

In a lot of ways, it's like the game of golf. Or, more importantly, it's like the game of golf is for ME. I'm okay at it. During a typical round, I feel like I'm having to work hard just to be a moderately bad golfer. Just when I'm considering throwing in the towel, I hit a nice shot that lands in the fairway. Hell, if I'm lucky, I might make par on a hole. It's just enough, exactly when I need it to make me put the clubs back in the car instead of heaving them into the nearest water hazard.

Same thing with school. After a series of "defeats," something - some little insignificant thing - clicks and you think "I can do this. I'm going to make it. I'm going to be good."

Today's tiny victory came during Histology. After a great day of Physiology (diffusion, active transport, and action potentials), Biochem (protein folding and the health problems associated with incorrect folding), Gross Anatomy (lecture about the structure of the spinal column), we moved into Histology for a lecture on Epithelium and Connective Tissues.

Biologically speaking, one of my favorite cells is the goblet cell. Essentially, it's a single-celled gland, shaped like a wine glass, that secrets mucous in various places in your body, such as your esophagus and other places in your gut. Our professor was showing slides of goblet cells and happened to display one of a goblet cell in the colon. He described how, initially, one would encounter only a few goblet cells in the walls of the colon but as you move through it, you'd encounter an increasing number until, near the end, there are a substantial number. (I am, of course, paraphrasing a bit. A proper scientist might pick this one apart.)

He asked, "Why would you encounter an increasing number?" Then, silence.

"To help you poop more easily," I whisper to classmates around me.

Although nobody, including me, offered an answer, he confirmed what I'd said, albeit in a more eloquently stated manner. And I got to take down the following words in my notes:

Going down through colon: more and more goblet cells.
Needed for lubrication to aid removal of fecal matter from the anus.

All hail the goblet cell.

That was my victory for today. I shall try again tomorrow.

God Bless Skype

2009-08-17T19:13:00.003-07:00

Made a few video calls this weekend to Winning Run and to my friend who's on active duty in Germany. Holy smokes, it's pretty damned cool. Really, it's the technological promise of the future. Next, I want my jet pack, dammit.

Back to the studying. I've scratched my ass twice today and those small insignigicant actions have got me behind. Boo me.

One Week

2009-08-14T15:03:00.000-07:00

If anything, this experience has been about the emotional ups and downs that accompany being a new student in a med-school program. One day I'm thrilled and really positive that I'll succeed; the next day I'm pretty convinced that I'm going to fail everything and be asked to leave the program. So far, it's been a study in control and stress management. I worked with a guy who would describe it like a duck. "A duck?," you might think. Yep. A duck: on the surface it might look calm but underneath, it's paddling like hell.

So, I'm like a duck. Except I might not look as calm.

The Honeymoon Is Over
After the glorious "ease-in" of the first day, I've definitely been freaked out about everything. The volume of information is, as they put it, intense. If I've heard the phrase "it's like trying to take a drink of water from a fire hose" one time, I've heard it a thousand. It is, however, a pretty good way of looking at everything.

Here's a quick rundown of my classes with the official descriptions:

Clinical Skills - This course is designed to teach the students how to perform a proper history and physical examination. He/she will be assessed not only on the knowledge related to this activity, but also the practical skills related to (1) interviewing and history taking, (2) performing the physical examination, and (3) making clinical judgments. The course will teach the various systems and how to understand the importance of the history and physical examination for detecting pathophysiology. The student will learn to make a differential diagnosis, leading to the selection of "definitive" laboratory studies and then ultimately to diagnosis and treatment.
Community and Behavioral Medicine - This combination lecture, small group and problem-based learning course will focus on topics ranging from the behavioral sciences to health care systems management and public health. The emphasis will be to develop the student's process of clinical decision-making. PNWU curriculum goals regarding lifelong learning, self-care, ethics, and social and community contexts of care will be addressed. Other topics include biological correlates of behavior, personality, learning and behavioral change, life-span development, communication and interaction, group processes, family and community socio-cultural patterns of behavior, behavioral risk factors and disease, study design and biostatistics, and medical jurisprudence.
Physiology - This combination lecture and laboratory course is a comprehensive study of normal human physiology and neurophysiology. It will focus on properties and functions of living cells, tissues, organs, and organ systems with special emphasis on integration, control, and pathophysiology. The course includes an overview of normal and pathological physiology of the human nervous system as it relates to perception, behavior, and the control of bodily functions.
Biochemistry - Students will learn the structure and function of the human body's most basic constituents and the role of these components in normal body function and pathological processes. Major elements of the course include key concepts in biochemistry, nutrition, molecular biology, immunology and genetics.
Gross Anatomy - This combined lecture and laboratory course introduces the student to the macroscopic structure of the human body using a regional approach. Emphasis is placed on the correlation between anatomical structure and function, embryonic development, clinical application, radiologic interpretation, and usage of correct anatomical terminology. Study of the emergence of human form is oriented towards its relation to gross anatomy, on the one hand, and to the pathological conditions that have a developmental basis on the other. Resources used during the laboratory portion include cadaver dissection, radiographs, MRIs, CT scans, OPP, and orthopedic clinical correlation.
Pathology - This combined lecture and laboratory course explores functional anatomy principally at the light and electron microscope levels. Study of basic cell structure, the functions of cellular organelles, and the relationship between ultrastructure and cellular function will be emphasized. This course further highlights the intimate relationship between structure and function through the study of functional morphology of diverse cell types, their organization into tissues, and the properties of these tissues. In addition, this course examines contributions made by coherent organization of tissues into organs to human form (gross anatomy) and function (physiology) and provides a foundation for how its distortion correlates with disease.
Osteopathic Principles and Practice - Osteopathic Principles and Practice I is a combined lecture and laboratory course comprised of formal didactic lectures ("cognitive component") in an amphitheater setting, small group "problem based learning" (PBL) sessions ("cognitive component"), and clinical skills training (CST, "psychomotor" component) conducted in a large teaching laboratory setting. The skills and knowledge that will be taught and examined are done in a cumulative and comprehensive manner. The course will familiarize the students with the history of osteopathy, the research contribution, the future projections for the profession, and the anatomical and physiological basis of osteopathic medicine. The students will also understand the biomechanics of the various joints of the musculoskeletal system and how to manage them. The student will understand how to integrate osteopathic principles with clinical medicine, surgery, pediatrics, and gynecology/obstetrics.
Microbiology - This combination lecture and laboratory course presents virology, bacteriology, mycology, and parasitology from a medical standpoint and will emphasize microbe morphology, physiology, life history, pathogenicity, epidemiology, diagnosis, therapy, and prevention. A case history / problem-solving approach to infectious diseases will be incorporated throughout the course and will emphasize such clinical aspects as etiology, patient management, specimen collection, laboratory tests, pathologic findings, and prognosis. Most basic science concepts will be discussed via analysis of clinical case studies.
Current Issues - In this lecture course, osteopathic primary care physicians and other professionals will present lectures on specifics topics related to the present day practice of primary care medicine, especially in rural or underserved areas of the country.

So, as you can imagine, I'm a little busy with stuff. So far, I've had about a gajillion pages to read. I've literally gone to bed at around midnight or later and gotten up at about 5:30a.m. to begin the day with a little coffee and "light reading." Wow. This stuff is intense. And, they took it easy on us this week. Yippee.

I Met Walter, Our Cadaver
On Thursday of this week, we had our first official Gross Anatomy lab. During the course of the year, we'll be dissecting a human body. We've been reminded to think of the cadaver as our first patient, the one who will teach us so much more about medicine and about the body than we'll ever learn.

I'll admit that I was pretty anxious about going in there on the first day. Hell, with my luck, I would be the one to pass out or drop the body or set something on fire or throw up or something. Various scenarios ran through my head, you know. Anywho, we met in the lab to "unpack" our bodies. Our group of four cautiously opened the hood on the stainless steel table and looked inside. There, in two giant, plastic bags was our cadaver. Our task for the day was to remove the plastic bags, drain the preservative from the body, and put a body bag on it. Really, there was nothing to do but to dive right into it. I cut through the first bag and the smell of the formyl got really intense. If you've ever dissected a fetal pig or anything, magnify the scent by about 100. Then, we cut the second bag away to reveal the naked, preserved body of an older (maybe 70s) male.

So, a minute later, I'm there with a lab partner, wrestling with a preserved human body, trying to slide a body bag under it, occasionally glancing at the vacant eyes that keep staring at the ceiling, looking at the stubble on his face, and trying not to get the fluid all over me. Had the setting and circumstances been different, we could've been acting out a scene from a Scorsese film. Instead, I was surrounded by 74 other students trying to do the same thing to 19 other bodies. It was one of the most amazing things that I've done and I've not even started a dissection...this was just unpacking day.

I couldn't help thinking that this person had been someone's friend, somebody's husband, a father, a grandaddy. I thought about what we'd be doing to this body, how we'd be getting to know the most minute secrets it held and I couldn't help but be amazed by the beauty of the person's gift to us medical students. Dissection, after all, is not easy; it is a highly organized destruction of a body. To know what occurs during dissection and to still make the ultimate gift of yourself is nothing short of amazing. I've decided to call the cadaver Walter. (I don't know, he just seems like a Walter to me.) Anywho, thanks Walter. Look forward to spending more time with you.

The General Freak-Out
So, everyone is pretty much freaking out. We're right to do it, too. Already we're feeling behind in class and feeling that there is no way in hell that we'll be able to survive any of the testing. It's pretty funny (or not) to put 75 mostly Type A personalities in a room and watch their anxieties about grades manifest. The funniest are the youngest people who are fresh out of school and are terribly stressed. That being said, I need to quit writing and get some more studying done. I'll try to post as frequently as possible.

One Down...

2009-08-10T19:35:00.002-07:00

Well, I made it through the first day of school: about four hours of Clinical Science and another three of Epidemiology. My brain hurts.

Gotta go read.

Ready, Set ...

2009-08-06T17:14:00.005-07:00

Got back from an orientation retreat on Thursday afternoon and joined a friend and his wife for dinner. I must say, everyone that I've met -- both students and faculty -- have been really friendly and genuinely excited about the school.

We spent the orientation at some cabins at Camp Prime Time,
a camp for seriously ill children and their families.

A lake near Camp Prime Time.

There are 75 of us in the incoming class. I've probably had a good conversation with about 65 of them. The other ten or so, I've not really gotten to know just yet. There are, however, a crap-ton of interesting people. For example, one guy used to train honeybees to identify landmines. (Apparently, they're also being trained to find dead bodies and meth labs.) Pretty stinking cool. Seriously, he used to train bees to find landmines. I still can't get my head around how freaking cool that must've been. Several have just left the military. One, I think, is fresh out of college.

Like me, several folks are without their wives and families. One friend just left his wife and two kids (3 and around 1) back east; they won't be out until next June. Strength in numbers, I guess.

I'm neither the oldest or the only person without a hardy science background.

I am not alone. (I knew I wouldn't be but still.) I am happy(-er).

Someone's Going to Show Up and Take It All Back
I've picked up about a ton of books, some scrubs, a stethoscope, and other diagnostic gear. I put it on and, next week, will wear it to school on certain days. At this point, I feel like they're a bunch of props for some costume party. Isn't someone going to come and take them away from me? It's all so new and strange.

Freshly unpacked, oversized scrubs.

Putting on the gear.

Seriously, my self image hasn't come up-to-speed with where I am in this process. I'm still holding on to my former identity as an instructional designer / software consultant or, at the very least, an applicant. Holy crap, I am a medical student; it's here.

The Crushing Weight of Study
I'm right on the precipice of my "Oh Shit Moment," where I'll absolutely lose it and freak the hell out. As expected, the faculty met with us during orientation to describe some typical study schedules and how we should expect to spend between 60 and 80 hours a weeks on coursework (in class and self-study). As expected, their plan to motivate everyone to begin their studies has worked. I've started to substitute Pepto Bismol for the half and half in my coffee.

Based on their professional estimates, I can probably have about four hours of waking time to myself. Subtract the time that I'll need for meals and stress-related bowel movements and I should have about 20 minutes per day. Holy smokes, what have I gotten myself into?

Scrambled Eggs; They're Calling Again

2009-08-03T14:43:00.006-07:00

Last Tuesday, I met Winning Run in Seattle. She'd come out for a few days of R&R and to speak with a few firms in the area. I made the drive from Yakima to the Sea-Tac airport in a little over two hours; it was a very pretty drive. I'm still amazed at the change in topography: the closer you get to Seattle, the greener everything becomes. I really am in the high desert, I suppose.

View from the drive toward Seattle.

We drove from the airport to our meager hotel in downtown Seattle. In any other time of the year, it would've been just fine but, considering that Seattle was in the grips of a triple-digit heatwave, a Euro-style hotel without air-conditioning wasn't going to work out for us. So, we dipped into Pike Place Market for a bite to eat, to get a glimpse of the sunset, and to prepare ourselves for a restless night in a 9th floor sweat box.

Pike Place Market

The next day, we toured some interesting buildings: the Seattle Public Library and the Experience Music Project. The library rocked. I was sort of cool on Gehry's Experience Music Project / Science Fiction Hall of Fame. Like some of his other works, I think they're interesting at a distance but, up close, the detailing sort of detracts from everything.

Inside the library.

A view of the Experience Music Project.

Seattle's Space Needle.

Space Needle, The Scholar.
The Scholar, Space Needle.

Later, we stumbled across a gem: Maximus Minimus, a mobile BBQ joint. They served up some ridiculously good sandwiches and lemonades. Lucky, indeed!

Maximus Minimus, a rolling BBQ stand with kick-ass wares.

Portland, OR
Thursday evening, we headed down to Portland for more explanation and interviews. This city was amazing. Although we don't have the photos to show for it, the scale of Portland was great: smaller building, cool neighborhoods, and friendly people. Of course, we bumped into our share of homeless folks with severe mental health issues. Apparently, Meth is a helluva drug.

On our way back to Yakima, we drove along the Columbia River Gorge and we're awed by everything we saw along the way. Holy smokes, that river is amazing. The gorge is amazing. Oregon knows how to put in a freeway: make it run along stunning scenery. Two thumbs up.

We took a detour and headed down to Mt. Hood for a little sightseeing. It rocked. I'm looking forward to getting in some quality snow time in the future.

Back to the Yak
We made it back here late Saturday afternoon. Winning Run inspected the apartment and decided that it wasn't as bad as she expected. So, we've been trying to unpack and make it "homier." It's a big, big help to have her out here; it doesn't seem so bad when you're sharing it with someone.

Orientation starts tomorrow!

File This Under Strange

2009-07-27T20:50:00.004-07:00

So, I've sort of talked myself off of the ledge of despair. Today, I had a technology orientation where we received our laptop and learned all of the various software programs that will make hard subject matter a little bit cooler. During the session, I met a few other classmates and had some nice conversations. After the session, me and this guy, Mike, decided that we'd grab a bite and a beer in the evening as his wife is also back home.

So, we stroll into the Second Street Grill, take seats at the bar, grab beers, and start chatting. Thirty minutes or so pass and there is lull in the conversation. In the break between topics, I take a minute to look around the bar and take in the surroundings. I recognize the guy sitting next to me: Jeremy from Atlanta, a friend, an accomplice of Dr. J3K, and a mountain-biking buddy. He is the very last person that I expect to randomly bump into on a Monday night ... at a sports pub ... in Yakima freaking Washington.

"Jeremy???"

He looks up from his meal. Stares at me and just freezes before muttering something like "What the hell is going on? Who are you?"

We were both good and freaked out for about ten minutes.

Evidently, he's here on a consulting assignment and, at this point, has lived in the city longer than I have. As we see each other mostly when Dr. James Three Thousand is in town, I'm not sure that he was aware that I was moving here. Needless to say, it was a freaky-ass thing to experience. I'm still a little weirded out by it. It is, by far, the strangest thing to happen to me in a long, long time -- excluding, of course, the incident at the hobo convention with the duct tape, squash blossoms, and commemorative Obama plates.

What Not to Do When You're Homesick

2009-07-25T23:45:00.000-07:00

Just for the record, a good homesickness cure is not to ask your wife to put you on speaker phone and let you talk to your dog.

The words "He just picked up his toy and started wagging his tail" will break you down into a heap of choked sobs and streaming tears.

How the hell am I going to do this without them?

#1 Dad

2009-07-25T21:24:00.006-07:00

This afternoon, I put my dad on the shuttle back to Seattle for his flight. On my drive back to the craphole, I fought back tears. After arriving, I managed to wallow in my own homesickness for a little while. Holy shit, I was one step away from watching "Of Mice and Men." That would've been happy-go-lucky. Anywho, it made me reflect on the past week.

On our cross-country drive, we were listening to The Moth podcast. A woman was telling a story about her mother and made the comment that "parents are so much more forgiving of their children than children are of their parents." It stuck with me and made (makes) me want to be a better son, to be more patient with them, and the like because no matter how old you get, you're always their child and, if you're lucky, the beneficiary of their unconditional love.

At this point in my life, I've lived away from home for as long as I ever lived at home. Since I left for college, this road trip has been the longest time me and dad have spent together by ourselves. It was a pretty fun drive, I must say. It was pretty damned cool seeing dad excited, like a little kid on a family vacation drive. If I had a dollar for every time he called my name and pointed to something he saw on the freeway, I'd be a rich man. It's nice to see your folks full of wonder.

Checking out St. Louis from the arch.

Snapping shots of the "fireball dropping out of the sky."

Studying the roadside, getting ready to point out something.

I suspect that, in part, this trip was something that Dad really wanted to do as an adventure. I also suspect that the equally important reason was that he was the family ambassador sent by Mom to come with me on this journey, to lay eyes on me and this strange new town so many miles away, and to once again turn me loose to the world.

I am lucky.

You Have Died of Dysentery

2009-07-25T20:18:00.007-07:00

Friday, we woke and started final leg of the trip with promises that we'd be in-bed and well-fed early in the night. It seems like all week long, we ended up driving really late and going to bed hungry. In retrospect, it seems like more punishment than was necessary but, at the very least, dad was a great sport about it.

The stars of the show.

On reaching Oregon, we were constantly amazed by the scenery, the mountains, and the farmland. At one point, the highway rounded a mountain and opened into an utterly staggering vista before dropping for six miles at a six percent grade. Once more, the descent was harrowing in a moving truck towing a car. Dad and I both got a chuckle out of the fact that my mom would've been absolutely unglued had she been in the car with us.

Click on the image to enlarge it.
No matter the size, it won't do it justice.

Best Rest Stop in the Country: Weatherby, OR
In dire need of "rest," we stopped at a rest stop in Weatherby, Oregon. After narrowly avoiding ruptured bladders, we wandered about the place and read about the Oregon Trail (the real one, not this one) which passed through those very mountains...with horse-drawn wagons...a hundred and sixty years ago. Ridiculous.

The next time you get pissed that you have no bars on your mobile phone in the middle of nowhere, think of a family spending six days trying to navigate one single stinking mountain while watching loved ones die. We're sissies every one of us.

View from the rest stop at Weatherby, Oregon.
Dad was checking out the educational signs.

He Was Right
A few rest stops we bumped into some folks that, evidently, were traveling the same route. They were the grungy, black-clad, dread-locked, pierced hippies. Dad walked by them on the way to the can. On returning he says, " Sax was right, they are dirty hippies. That girl had dirt and grime all on her elbows. She stank." Classic.

Arrival and the Great Underwhelming
At about 3:30pm on Friday and 2682 miles after starting, we pulled into the apartment. Did I mention that I rented it sight-unseen? Did I mention that it was half of a duplex, the other half of which is occupied by four female second-year med students? Did I mention that I was hopeful that it would be great?

To say that I was underwhelmed would be a fantastic understatement. To say that I simultaneously wanted to choke the shit out of the landlady and weep with frustration would be getting warmer. The place was dirty, strewn with dead insects (beetles or something, not roaches). The kitchen has a terrible drop ceiling with plastic lighting tiles. It has about 17 bazillion light switches that control something non-intuitive. It has a pair of metal exterior doors in the middle of the living room wall that lead into the other apartment. It has teal effing carpet with matching cheap-ass honeycomb paper blinds. It has the DSL modem and wireless router for the girls on the other side. It has the mailbox where all the mail for the duplex is delivered. It has a 1/5 share of all the bills for the duplex but no untilities of its own. It has a toilet that constantly runs. It has a garage that can easily accommodate a 16-foot moving truck and, I assume, an RV.

It does not, however, have a happy tenant. I'm not unpacking just so that I can entertain the notion of moving the hell out of here after Winning Run arrives on Tuesday. Wish me luck and patience.

Salty Lake and Potatoes

2009-07-24T07:16:00.008-07:00

Yesterday, we finally made it out of Wyoming following a stay at a motel in Green River and a breakfast with the weirdest waitress ever. She looked like she'd just come from a fight club boxing match and answered "You Betcha" to everything with a saccharine sweet laugh.

Another wind farm in Wyoming.
Notice the truck near the base of the turbine in the foreground.

We headed into Salt Lake City to visit with Big Chief Mike, a friend from college. Driving into the city, we headed down a few steep grades. When we finally got to Mike's place, smoke was still coming off the brakes of the truck which was a little disconcerting. During lunch, I phoned the roadside assistance to bring a new tire because we'd noticed an increasing bounce in the front. When the guy showed us the tire, it had worn clean through to the tread. He told us it was a good thing that we called when we did because he didn't think we would've made it too much farther on that one. So, we got to visit Mike with the ability to stop and without having my things scattered all over the highway courtesy of a high-speed blowout. I feel like a winner.

After a fantastic lunch that Mike had whipped up, we headed out and, after an eternity, made it to the north side of Boise, Idaho. Today, we've got around 500 miles to get into Yakima. Hopefully, it'll be uneventful.

States Covered
Wyoming, Utah, Idaho

Through the Arch and Into the Plains

2009-07-23T08:07:00.008-07:00

On Tuesday, we crossed into Missouri and decided to stop at the Arch. I have to admit, it was larger and much more interesting than I thought. We searched for a parking space and decided to take a break, walk over to it, and ride to the top.

Approaching the St. Louis Arch.

For the record, if you are the least bit claustrophobic do not even think about riding the trams to the top of the arch. Imagine being stuffed into a coffin with four other people and making a slow ascent 600 feet up a metal arch. It was pretty cool but maybe a little unsettling.

Dad about to get into the tiny coffin-sized tram to the top.

After leaving St. Louis, we headed up to Lincoln, Nebraska to visit with my dad's first cousin. It was pretty nice to meet him and the rest of the Nebraska family and to see my pop so excited to just hang out with someone.

Corn is King
Driving west through Nebraska, one thing becomes readily apparent: corn is king. Unless you live in the heartland, you really have no idea about the scale of the farms in this country. By the way, I don't pretend to have a great idea from only driving through a few states but I will say that it's staggering. In western Nebraska, corn seemed to give way to wheat. Amber waves, indeed.

Wyoming is Big
We were pretty amazed at how the topography changes pretty quickly after entering Wyoming. Plains change to rocky, rolling hills. You climb some hills and descend into an enormous plateau. Hell, at one point, we drove absolutely straight for about 10 miles before a tiny curve in the road. Our country is enormous. The terrain is pretty cool and you eventually tire of seeing so damned many antelope just grazing, grazing by the highway.

A monument to Lincoln on the Wyoming Roadside.

The plains of Wyoming.

Storm cloud and the setting sun.

Dad shooting the sunset.

The Green Initiative
In addition to being awed by the vast emptiness of the state, we marveled at the wind farms that we crossed. On television, the turbines look big but that pales to being near them. The photos don't do justice because there isn't really anything to determine the scale or the distance and I didn't have a lens wide enough to get the hundred or so into a single shot. They're pretty damned cool.

Wyoming wind farm.

Another view.

The Gas Miracle
Our fuel was running low as we neared Laramie. Somehow, we didn't exit the freeway because we thought there was one more exit for the town. With fuel dwindling, we hit the Garmin for info on the nearest fuel station and headed west toward it. The fuel light came on as we approached the abandoned gas station. Luckily, there were a couple of guys there working.

"How far to the nearest fuel?," Dad asked.

"Which direction?," the weathered guy replied.

"West."

"80 miles," he said with almost no expression.

"How about east?"

"20 miles."

"Okay, thanks."

Dad and I looked at each other uneasily and headed back toward Laramie.

"Hope there are three gallons in the tank," dad said.

"Me, too."

On the ride back, we drafted an semi to conserve fuel and lamented that it was uphill most of the way. Personally, I used my Jedi mind trick to keep that damned truck moving. The twenty minutes back was silent and tense. Inside 10K, I knew that I could run back to the station for fuel and began to rest. After an eternity, we coasted down the hill into the gas station, sighed with relief, and laughed a bunch.

We put 32.1 gallons of fuel into a 32-gallon tank. Close one.

States Covered
Kansas, Missouri, Nebraska, Wyoming

The Man of Metropolis Steals Our Hearts

2009-07-21T05:02:00.004-07:00

Boy, leaving is ridiculously tough. I'd done pretty well in getting ready and telling most of my friends goodbye. As expected, I got really emotional when I was leaving Winning Run and absolutely blubbered when I said goodbye to Dylan.

At the truck rental place, I was pulling the car onto the car carrier when dad and the rental guy started dancing around and yelling at me to stop. Turns out the trailer wasn't connected to the truck and had come unhitched with me on top of it. Awesome.

We stopped for the night just outside of St. Louis and will aim for at least Lincoln, NE to stay with dad's cousin. Fun stuff.

My finger is still bleeding from the nailbed and is unusable; unloading should be interesting. I'll post pictures later with forewarning for the gore.

Highlight: the giant Superman statue in Metropolis, IL.

Truth, justice, and the American way.

Handy camera work from a perfect stranger.
(Not Balki.)

States covered: Georgia, Tennessee, Kentucky, Illinois.

westward bound

2009-07-20T07:53:00.001-07:00

Just nearly cut off my finger on the moving truck. About to start the drive.

Yippee.

Winning Run, For the Win

2009-06-28T05:30:00.005-07:00

Last week, I joined Winning Run in Pittsburgh because I'll be unable to attend the opening of her building at Carnegie Mellon University, courtesy of being in class on the other side of the country. For the record, I knew that she the firm she's at does incredible work as evidenced by the Wang Student Center at Wellesley College. This building, for which she's the architect managing the project, is unbelievably impressive: around 210,000 square-feet of well-designed, inspiring architecture. My photos do not do it justice; I'm sure that professional photog with the widest of lenses would have trouble. Here are a few of my feeble attempts.

A panoramic view created from composite images.
The building does not curve; it's just how the images are stitched together.

Another panoramic image I stitched together.
Again, no curvature on the building; it's only the image.

One of my favorite views of the building.
The bridge that leads to the building in memory of Randy Pausch,
a CMU professor and author of "The Last Lecture."

For more on the building, go here.

I'm nothing short of awed by the building and having nothing to adequately describe how proud I am of Winning Run and her work on this behemoth.

More from the rest of the week to come.