So, there's the "Ultimate Workout," there's my not-excellent first official letter grade here in postbac, and then there's Harry Potter. I'll try to keep it intelligible, but I need to be speedy too.
Many many thanks to my dad and family for the gift card from Wal-Mart; this is a way for me to obtain goods without so much giving the big nasty mega-retailer my own money directly. And thanks to the mega-gigundo-chain for having a big stack of HP6's when I walked in, looking for a nice pair of $25 running shoes.
See, there's a lake in town, about 2 or 3 miles or something from the house on campus where we live this summer, I really don't know, and some of my housemates have been doing this thing where they run to the lake, jump in and splash around for a while, and then run back. This has been dubbed the Ultimate Workout 2005 (I suspect there may be exclamation points involved), and eventually I have to go along, because there's a fat guy inside me just dying to get out and, y'know, basically eat a lot of stuff. Hence my need for shoes, hence my being in the store I have decided I will now call Volde-Mart.
Hence my buying "the book" today, even though not 48 hours ago, I had been lamenting the idea that I would have a tough time staying spoiler-free, what with the very real and immediate need for me to study. To study a lot, actually. And more than that, to study in some way (yet to be figured out) that is more effective than what I had been doing that first five weeks, which seem so long ago but actually ended last Friday.
Mostly because if you get one grade on one course like the one I just got, it's no big deal, really, especially if it's for the first course and besides, you haven't touched chemistry or algebra for, no shit, about 15 to 20 years (shudder). But if you get a whole raft of grades like the one I got in this one course, you don't so much get invited to interview with the Mayo Med School, now matter how nice a guy you are or how flat your abs are supposedly going to be.
Anyway, staying spoiler-free will still be rough, because now my studying is going to work something a little more like this: get as far through Chapter 7's Chem problems as I possibly can, having read Chapter 7 but not yet having been to the class where we will be talking about it. Then, read some Potter. Re-read the Bio stuff we covered last week, since it's going to be on Tuesday's test. Then, read some Potter. Go through all the little figures in the Bio book and re-draw them myself, as a way to get more familiar with what stuff is and why I care. Then, read some Potter. Oh yeah, plus eat and sleep. Sometimes.
Sunday, July 17, 2005
Thursday, June 30, 2005
Addendum (plus whining)
NB: this is actually being written much later. But I like an organized blog, and this is too long for a comment on June 21, yet it makes no sense as a contemporary post. Anyone who gives a crap about this will want to see it here. Logical progression and such, you know.
For the record, when we got back our phthalate papers, The Prof pretty much hated the comparison to cyanide. I thought at the time I read her comments that hey, they're both ingestible/ ingested, and allegedly both poisonous, so if I were writing for TIME magazine's health section, they would totally let me argue from that perspective. And it's a powerful statement of what's being asserted, plus a nice punchy way to illustrate that there's a way to come at the issue and derive some facts. I liked it; I believe I did mention that she freakin' HATED it.
I have since learned something important. The key idea is, as much as that whole cyanide thing might be totally true and valid, strictly in terms of its being a helpful way for the non-scientist to come toward the ideas, here in Chemtown we don't cotton to that sort o' talk, mister. There are sufficient differences in the two chemical processes that I look like a dweeb if I try to talk even a little outside the scope of the problem under consideration. And it's my own fault for even going there, because I had a perfectly good science paper without it*. Cue head shaking and uncapping of the red pen.
Which is cool, and helpful to someone like me who's a parallel thinker, and a right-brain interactive learner, working to establish a contextual framework and hang a shitload of information from it. I appreciate the chance to bump up against things, make mistakes, and learn from them. It's good to work these things out and arrive at an individualized, personally meaningful understanding, one which will stay with me as I continue my studies. It's great to have a supportive, nurturing environment for these little bumps in the road to come up, without a need to freak out because every tiny little thing is under scrutiny and a potential source for bad grades, or the cocking-up of otherwise good grades...
Oh, crap.
Yeah, as will shock no one who knows me well: this style of learning, interacting with my own historically-favored style of thinking, is maybe not the best combination for this particular... um... life. I am sitting here for ten weeks at an all-you-can-learn buffet, and at times I've been trying to eat soup with a fork.
It's happened several times. I mis-typed "cytosol" as "cortisol" and got busted for it. Unlike out there in the world before, my knowing how to correctly spell both words gets me no points. In fact, with that instructor and in that instance it actually made it look like I meant to use the obviously wrong word; presumably the thinking would be that they're totally different things, but both exist and are within the realm of the topic. Again presumably, it never occurs to the evaluator that it was just a mental misfire, a neuron over in the verbal section grabbing the wrong term. Science people are, like, so literal, dude.
Plus people with PhDs can sometimes seem as though it's been a long time since they skied the bunny hill. Mixing the metaphor, newbies like us would prefer a quick sketch of the big picture, and a little arrow saying "YOU ARE HERE." This is not something that is often thought of as an advanced skill, but trust me, my experience on both sides of adult education confirms it is. One instructor said, on more than one occasion (and this is paraphrasing) "yeah, I realize this all makes no sense to you guys, and for the moment it's a litany of vocabulary words without meaning. But it'll make sense soon, trust me, so hang in there." The implication being, work on the information now, and find the knowledge later, on your own time.
The good news is things have already improved dramatically on that front. The material is different, the instructors have changed more than once, and most importantly, we are learning. We're not non-science students anymore. I'm surviving the Summer term well, and really have absorbed a lot. Plus I've been continually improving my own storage and retrieval system.
My war is not with The Man, and it's not with The System, and actually it's not even a war. It's an aggravating disconnect between how well I'm internalizing what is in many ways an excellent understanding of the most important points of the material, and how poorly I'm performing on certain measures, which are widely considered to show learning.
Okay, the gripe session is amusing but it's done now. Moving on, just after I say this. There are days I'd like to go back to some of the instructors I had in my arts education, who stressed the "flail until you fly" method of learning, and I swear to god just punch 'em right in the nose.
* No fun to read, if you ask me, but I'm a pre-med student now, and fun is calculating the formal charges on atoms in a molecule. Fun is naming alkenes. Fun is blowing stuff up in the lab (actually, that one really is fun). Anytime flair, style, or expression comes into it, that's great but it's probably not helping me.
For the record, when we got back our phthalate papers, The Prof pretty much hated the comparison to cyanide. I thought at the time I read her comments that hey, they're both ingestible/ ingested, and allegedly both poisonous, so if I were writing for TIME magazine's health section, they would totally let me argue from that perspective. And it's a powerful statement of what's being asserted, plus a nice punchy way to illustrate that there's a way to come at the issue and derive some facts. I liked it; I believe I did mention that she freakin' HATED it.
I have since learned something important. The key idea is, as much as that whole cyanide thing might be totally true and valid, strictly in terms of its being a helpful way for the non-scientist to come toward the ideas, here in Chemtown we don't cotton to that sort o' talk, mister. There are sufficient differences in the two chemical processes that I look like a dweeb if I try to talk even a little outside the scope of the problem under consideration. And it's my own fault for even going there, because I had a perfectly good science paper without it*. Cue head shaking and uncapping of the red pen.
Which is cool, and helpful to someone like me who's a parallel thinker, and a right-brain interactive learner, working to establish a contextual framework and hang a shitload of information from it. I appreciate the chance to bump up against things, make mistakes, and learn from them. It's good to work these things out and arrive at an individualized, personally meaningful understanding, one which will stay with me as I continue my studies. It's great to have a supportive, nurturing environment for these little bumps in the road to come up, without a need to freak out because every tiny little thing is under scrutiny and a potential source for bad grades, or the cocking-up of otherwise good grades...
Oh, crap.
Yeah, as will shock no one who knows me well: this style of learning, interacting with my own historically-favored style of thinking, is maybe not the best combination for this particular... um... life. I am sitting here for ten weeks at an all-you-can-learn buffet, and at times I've been trying to eat soup with a fork.
It's happened several times. I mis-typed "cytosol" as "cortisol" and got busted for it. Unlike out there in the world before, my knowing how to correctly spell both words gets me no points. In fact, with that instructor and in that instance it actually made it look like I meant to use the obviously wrong word; presumably the thinking would be that they're totally different things, but both exist and are within the realm of the topic. Again presumably, it never occurs to the evaluator that it was just a mental misfire, a neuron over in the verbal section grabbing the wrong term. Science people are, like, so literal, dude.
Plus people with PhDs can sometimes seem as though it's been a long time since they skied the bunny hill. Mixing the metaphor, newbies like us would prefer a quick sketch of the big picture, and a little arrow saying "YOU ARE HERE." This is not something that is often thought of as an advanced skill, but trust me, my experience on both sides of adult education confirms it is. One instructor said, on more than one occasion (and this is paraphrasing) "yeah, I realize this all makes no sense to you guys, and for the moment it's a litany of vocabulary words without meaning. But it'll make sense soon, trust me, so hang in there." The implication being, work on the information now, and find the knowledge later, on your own time.
The good news is things have already improved dramatically on that front. The material is different, the instructors have changed more than once, and most importantly, we are learning. We're not non-science students anymore. I'm surviving the Summer term well, and really have absorbed a lot. Plus I've been continually improving my own storage and retrieval system.
My war is not with The Man, and it's not with The System, and actually it's not even a war. It's an aggravating disconnect between how well I'm internalizing what is in many ways an excellent understanding of the most important points of the material, and how poorly I'm performing on certain measures, which are widely considered to show learning.
Okay, the gripe session is amusing but it's done now. Moving on, just after I say this. There are days I'd like to go back to some of the instructors I had in my arts education, who stressed the "flail until you fly" method of learning, and I swear to god just punch 'em right in the nose.
* No fun to read, if you ask me, but I'm a pre-med student now, and fun is calculating the formal charges on atoms in a molecule. Fun is naming alkenes. Fun is blowing stuff up in the lab (actually, that one really is fun). Anytime flair, style, or expression comes into it, that's great but it's probably not helping me.
Tuesday, June 21, 2005
Procrastination Theatre Presents
(first in what I am sure will be a series)
WHAT I SHOULD BE DOING: Writing about the questions of safety surrounding phthalates as additives to PVC plastic, especially in toys babies and kids chew on. It's due tomorrow, sleep or no sleep.
THE VERY BRIEF BLOG THING I'LL SAY NOW: Life is good. I've never worked so hard, and yet this sure beats working. Also, I'd like my financial aid money now, please...and so, a gaggle of students from the school where I worked would be sooooo amused. Then again, I have savings and know how to budget, so [impolite gesture #14a]. (That's the two-handed V-chop, sharply inward toward the groin. I saw someone do that last weekend and it was way funny.)
CRYPTIC BONUS: I think that was #74, who sort of accidentally stole a bike for a minute.
SNIDE REMARK IN CLOSING, AS I GET TO REAL WORK: Sodium Cyanide starts getting dangerous at 0.05 mg/ kg/ day. That would be 50 micrograms. Mean exposure for the 12-to-23-month olds in one 2004 study was 0.08 micrograms/ kg/ day. 99th percentile was 2.4 mcg/ kg/ day. Is this stuff 30 times more deadly than cyanide?
So, in short, my argument might be [impolite gesture #14a].
Got to go write now.
WHAT I SHOULD BE DOING: Writing about the questions of safety surrounding phthalates as additives to PVC plastic, especially in toys babies and kids chew on. It's due tomorrow, sleep or no sleep.
THE VERY BRIEF BLOG THING I'LL SAY NOW: Life is good. I've never worked so hard, and yet this sure beats working. Also, I'd like my financial aid money now, please...and so, a gaggle of students from the school where I worked would be sooooo amused. Then again, I have savings and know how to budget, so [impolite gesture #14a]. (That's the two-handed V-chop, sharply inward toward the groin. I saw someone do that last weekend and it was way funny.)
CRYPTIC BONUS: I think that was #74, who sort of accidentally stole a bike for a minute.
SNIDE REMARK IN CLOSING, AS I GET TO REAL WORK: Sodium Cyanide starts getting dangerous at 0.05 mg/ kg/ day. That would be 50 micrograms. Mean exposure for the 12-to-23-month olds in one 2004 study was 0.08 micrograms/ kg/ day. 99th percentile was 2.4 mcg/ kg/ day. Is this stuff 30 times more deadly than cyanide?
So, in short, my argument might be [impolite gesture #14a].
Got to go write now.
Saturday, June 11, 2005
tinkering
Messing with the fonts, layout, and colors. Fun for a humid Saturday here in the farmhouse. I'm looking for something that fills the space better, in terms of width. Lots of these templates seem made to mimic newspaper columns, and I use this more like letters or essays.
More changes will come, but for now I changed some colors and fonts I didn't like, from an otherwise excellent template. Yay for Blogger that I can do that in the first place.
Now I need to figure out the link issue, and maybe get some traffic back n' forth from friends with better sites.
More changes will come, but for now I changed some colors and fonts I didn't like, from an otherwise excellent template. Yay for Blogger that I can do that in the first place.
Now I need to figure out the link issue, and maybe get some traffic back n' forth from friends with better sites.
Friday, June 10, 2005
So, Here We Are
I live in Vermont now.
My backyard is a ten-acre meadow.
The place next door is a big stone mansion. It's the music building when regular school is in session, and it was also the inspiration for Shirley Jackson's The Haunting of Hill House.
I have eight housemates, and they all seem interesting and cool and impressive in their own respective ways.
We nine have the entire campus nearly to ourselves, until Fall.
Today I held a little chunk of pure magnesium in a flame, and as advertised, it glowed and sparked and totally burned right the hell up under the fume hood. This is my job now; playing with (and thereby learning) science.
There's much, much more, but I need to go put 24 beers into a cooler because there's a barbecue starting in about half an hour.
My backyard is a ten-acre meadow.
The place next door is a big stone mansion. It's the music building when regular school is in session, and it was also the inspiration for Shirley Jackson's The Haunting of Hill House.
I have eight housemates, and they all seem interesting and cool and impressive in their own respective ways.
We nine have the entire campus nearly to ourselves, until Fall.
Today I held a little chunk of pure magnesium in a flame, and as advertised, it glowed and sparked and totally burned right the hell up under the fume hood. This is my job now; playing with (and thereby learning) science.
There's much, much more, but I need to go put 24 beers into a cooler because there's a barbecue starting in about half an hour.
Friday, May 27, 2005
yarrrrgh
Yes, I still intend to update this, when there are things to talk about.
Yes, there are plenty of things to talk about. But there's no time, yo! I have, like, six entries half-written in the Drafts section. Someday they'll blend in and make it look like I wasn't actually blog-free for 8 weeks or whatever it's been. Sigh.
Hey, is it completely normal to have five days left before the lease is up, a burning need to reduce all of your worldly possessions to one carload and some limited storage space, and then to not really have started preparing at all?
Yeah, I thought not.
The plus side for right now is that housing is set until August, books are paid for and should be waiting for me out East, we're visiting the Leinenkugel brewery on the way, and everyone I know is happy and encouraging about my whole deal.
One quick observation from tonight. In my last shift at the ED for a while, a bunch of patients called me 'doctor.' Must be the appearance of smarts and skills. Which is nice, but I always correct people.
The calm and poise come from not worrying about it -- because my duties and responsibilities are well within my comfort zone. I guess people assume optimistically that said zone includes all the stuff they wish someone would hurry up and do, and I get swept along in the expansion of expectations. If I really were this cool while being tasked with (and trained to) reading C-spine radiographs, diagnosing heart problems, or evaluating a tendon repair post-op, then I guess I would be The Man after all. But I'm not, so sorry folks, you'll need to wait. Can I get you a warm blanket?
Also, tonight I heard Metoprolol called "Metropolis." Awesome.
Finally, extra bonus points to me, because I spelled the drug name right the first time. Okay, I'm going to bed now.
Yes, there are plenty of things to talk about. But there's no time, yo! I have, like, six entries half-written in the Drafts section. Someday they'll blend in and make it look like I wasn't actually blog-free for 8 weeks or whatever it's been. Sigh.
Hey, is it completely normal to have five days left before the lease is up, a burning need to reduce all of your worldly possessions to one carload and some limited storage space, and then to not really have started preparing at all?
Yeah, I thought not.
The plus side for right now is that housing is set until August, books are paid for and should be waiting for me out East, we're visiting the Leinenkugel brewery on the way, and everyone I know is happy and encouraging about my whole deal.
One quick observation from tonight. In my last shift at the ED for a while, a bunch of patients called me 'doctor.' Must be the appearance of smarts and skills. Which is nice, but I always correct people.
The calm and poise come from not worrying about it -- because my duties and responsibilities are well within my comfort zone. I guess people assume optimistically that said zone includes all the stuff they wish someone would hurry up and do, and I get swept along in the expansion of expectations. If I really were this cool while being tasked with (and trained to) reading C-spine radiographs, diagnosing heart problems, or evaluating a tendon repair post-op, then I guess I would be The Man after all. But I'm not, so sorry folks, you'll need to wait. Can I get you a warm blanket?
Also, tonight I heard Metoprolol called "Metropolis." Awesome.
Finally, extra bonus points to me, because I spelled the drug name right the first time. Okay, I'm going to bed now.
Thursday, May 05, 2005
What Occupies Me
At the bottom of the tax form, after your signature, you're asked to list your "occupation." I have always wondered, where does this information go? And where is it supposed to come from?
Recently, getting ready for the big move, I had a look at my tax forms from the past few years. Sure, job titles are good, but I don't always stick to them. The year I earned a $100 honorarium for being part of the "guest ensemble" (that's "chorus" to most of us) in a 3-month-long production at my favorite theater, I was also starting my job at the cool company (the one I just left after 7 years to go out East, back to school). That year, I listed my occupation as "Actor."
2004 was the year I started working at the hospital, in November. I was an "EMT" that year, and the next, if I'm remembering correctly. All of which is true, but maybe not entirely descriptive of where I spent most of my working hours. I was happy to be associated with the cool company, but as the years went on the day-to-day enthusiasm ebbed and flowed over time. Toward the middle there, I might have put "hapless cube-monkey" if I thought I could.
So I guess I will be a "student" soon, and that's both clear and accurate. It feels good to have no conflict to resolve. Just one more indicator, I guess, that it's time to do this.
Recently, getting ready for the big move, I had a look at my tax forms from the past few years. Sure, job titles are good, but I don't always stick to them. The year I earned a $100 honorarium for being part of the "guest ensemble" (that's "chorus" to most of us) in a 3-month-long production at my favorite theater, I was also starting my job at the cool company (the one I just left after 7 years to go out East, back to school). That year, I listed my occupation as "Actor."
2004 was the year I started working at the hospital, in November. I was an "EMT" that year, and the next, if I'm remembering correctly. All of which is true, but maybe not entirely descriptive of where I spent most of my working hours. I was happy to be associated with the cool company, but as the years went on the day-to-day enthusiasm ebbed and flowed over time. Toward the middle there, I might have put "hapless cube-monkey" if I thought I could.
So I guess I will be a "student" soon, and that's both clear and accurate. It feels good to have no conflict to resolve. Just one more indicator, I guess, that it's time to do this.
Friday, March 18, 2005
Web-headed happiness
Things I Love about the Spider-Man 2 Game for PlayStation2 (in no particular order):
* Jumping off the top of the Empire State Building, free-falling until the closest buildings are low enough to shoot a web at, and then swinging out over Fifth Avenue.* Approaching a citizen in distress and hearing Tobey Maguire's voice say, "Hi, my name is Spider-Man, and I'll be your superhero today."
* Bruce Campbell as the game's narrator/ tutorial voice. Helpful, yet sardonic.
* Knowing it's possible to stick a web to the bottom of a helicopter and hitch a ride out to Liberty Island (and I shall, oh yes, I shall).
* The unexpectedly poignant videogame moment when I went to the financial district and saw a big vacant lot with a dozen big spotlights pointing straight up, at the site of the World Trade Center towers.
* To buy upgrades for Spidey's web-slinging and combat powers, you walk into what is pretty obviously the Midtown Brooks Brothers. And all the little virtual people go about their business as if it's completely normal. Heh heh.
* Hot dog carts dotted around the island, including one in Battery Park. (Game designers missed an opportunity to make them do something, but that's okay.)
* They named the neighborhood with the fictional Daily Bugle building "Flat Iron."
* Random New Yorkers shout out to Spidey as he swings through the city. About a quarter of them say something obnoxious.
* The digital Guggenheim confirms my long-standing suspicion that the thing is right at home in a comic-book world. I fervently wish that at some point in the game, it's revealed that there's some arch-villain's secret base in there. (The game's been out most of a year, and I well know there isn't, but a guy can dream.)
* And finally, here's a game with the expansive open-endedness of the Grand Theft Auto games (which I also dearly love, don't get me wrong), but without the misanthropy and nihilism.
* Swingin' on a series of webs, you can get from Harlem to SoHo in, like, five minutes.
Friday, February 25, 2005
Mortality and morbidity, with garlic bread on the side
On a recent weekday, I had the day off from the office job, so I went to the 7:30am trauma room conference. The conference is a review of a handful of the more interesting critical cases that came through the most acute part of our emergency department over the most recent week, grouped around a theme -- one week there will be two different head injury cases, for example, plus maybe a seizure case or another "altered mental status" case, if the general theme is level of consciousness. Conference takes place in a basement room that is all very hospital-white. There's coffee, and bagels show up at some point during the hour.
I like going when one of the a cases covered will be one I worked on, partly because I like to know how things came out for the patient. This can be good news or bad, of course. Speaking of head injuries, I'll never forget the one where someone I'd been there for was presented, and after the head CT and a report from our EM resident (assigned to Neuro at the time) came autopsy photos of the same massive brain clot, this time frankly visible within the exposed top of our former patient's cranium, with a report from the medical examiner.
I also go to conference because it's a chance to feel connected to the learning part of the process; to take advantage of the fact that I work at an excellent academic center, and I am encouraged to attend. I also like to imagine being able to call on these experiences later on, as a helpful memory. Not so much for clinical info, although surely I'm picking some of that up, too. I like the idea that because I have the chance to do this now, settings and situations like the conference won't ever be foreign to me, and thus less intimidating. It's part of the whole 'non-traditional' student thing. Many staff physicians are close to my age, but the residents are only younger than me by a factor that's about the same as how far behind them I am in education. Thus, I tend to gravitate to the resident part of the room.
Today I also stuck around for the med student lecture, something I do most days I attend the conference. As I said to the 3rd-year resident I was sitting next to, this is an unusual time in my training -- there would be no consequences at all if I decided to ditch the lecture, since I am "invited" and "encouraged" to attend the conference, but the lecture is pure bonus material. Somehow, this seems to work out to having the kind of attention span for medical education I fear I might be lacking later on, when things are going to get a lot more compulsory and/or graded.
It helped that while this lecture was unusually well-organized and presented in a more academic, true lecture-style way than some of the lectures I've attended, it was also really good. It amuses me to think that if I am asked to strap a blood pressure cuff to a patient's ankle in the next few weeks, I'll know exactly what's up. (Actually, I would have been able to suss it out on my own, strictly in terms of "what does that tell us?" But this way, I'll know it's because the resident and I attended the same lecture.)
Something I've never done was hang around after the lecture, for the Mortality and Morbidity conference. Having checked my voice mail, and knowing that lunch with the gf was not happening as planned, I was curious about what's next. The residents were not entirely sure at first, so I soon found myself with a very narrow window to decide if I would stick around. Turns out it was indeed M&M.
Would this be interesting? Totally. Educational and helpful? Sure. Would I just be there out of prurient interest? Not at all. Would it be okay for me to be there, or was this a doctor-only kind of thing? Uhhh.... well, I took a look around. The RN's had taken off already after conference, since they tend to have, y'know, lives, and of course nobody from other services was still around. But med students were still there.
One of the big things I've learned is that med students are nothing special. And I say that even as I make huge personal sacrifices in the fervent hope that I will be granted the opportunity to be one.
Some are of course wonderful, and brilliant, and it's obvious to see the future doctor just beneath the surface. Many are studious, well-intentioned young people, who with some time and effort will be great. Many are exactly what you'd think, if you watch a lot of Scrubs. Seriously, I have never had what I've felt was the requisite awe and respect for medical people; that's one factor that kept me from joining up earlier. But most of my experience has not yet shown I was wrong. Students are just regular ol' people... some moreso than others.
So it was staff, residents, med students, and me. But what the hell. The boss-doc who was running things saw me, we made eye contact, he gave no indication it was weird or inappropriate for me to be there. And it turned out to be really fascinating. For those who are unfamiliar, the "M&M" is the big meeting where we talk about what went wrong.
First was a discussion of things that get screwed up, in general, in the practice of medicine. There was a big long list that the group had been working its way down, over several weeks or months. The boss-doc presented some examples of issues culled from several years' worth of cases, pointing out where studies that had been read as normal were truly not, asking difficult questions of the residents, and applying hindsight to point out things not to be fooled by.
Then, specific stuff from the week at our hospital was presented, by various people who had been connected with the issues. None were huge problems, most were not even noticed by patients, but all were important because the team chose to make them important. Here's the situation, here's how it might have been prevented, and here's how we make sure it doesn't happen.
How come every industry, business, and institution doesn't do this?
From TV and film portrayals of the M&M, you'd think it was a big auditorium with stone-faced old guys frowning down at a trembling young doctor in the hot seat. It's actually a discussion peppered with horrifying but comical stories from 25 years ago, when the gray-haired sage who now runs the show was a skinny little geek prone to rookie mistakes just like anyone, and chances for newbies to demonstrate the ability to learn from mistakes during, and even prior to, their commission. It's the healthiest, most honest, most real-life-no-BS-helpful way to make things better I've seen.
And that's sad, because I've been in the business world for what, 12 years? "Continuous quality improvement" sounds great, guys. Thing is, we've been doing it since Hippocrates. (I commented to GeekSpice once, more than a few months ago now, that I had found the word "we" coming out of my mouth when referring to medicine, and the way things work in that world. I did it again, just a couple of paragraphs ago, when I said "our hospital." Yep, I'm committed, now.)
As M&M wound down, food was brought in. I was ready to go home, and really, the next thing on the agenda was prep for board exams. If all goes well, I'll be getting ready for my USMLE Step I board exams at this time of year... six years from now. So, not so practical. But hey, free food. So I stood in line, where I talked a little with some staff docs about an issue that the M&M had addressed, then ladled up some ziti that had a nicely zippy sauce, one good-sized meatball, and then sat back down. Dammit, board prep started immediately. I was trapped.
And then came the best surprise of the day. The way the oral part of the boards is done is extremely similar to the way my EMT class had been run, as we practiced cases for patient assessment. There is an examiner, who guides you through a scenario, and you need to verbalize what you would do, what you would look for, etc. Bedside manner counts, following the standard of care counts, doing the steps in the right order counts. There are things you need to do and things you should not do, to earn full points or avoid failing the scenario altogether. The scenario is timed.
One first-year and one second-year resident were being quizzed by a third-year, in front of the group. Staff offered comments and gave pointers about the way things are structured. Sitting in our seats, my friend the third-year and I whispered about the food and he (correctly) diagnosed the problem in about 15 seconds. Me, I wasn't ready to go that far, but I knew what to do. I was shocked to find that not only would I probably not kill this imaginary patient, I might actually get a decent score on this scenario.
Now, this in no way means I would not wet my pants (figuratively or literally), if faced with a real situation. It doesn't mean I'm as smart as an intern. It just means I am on the right track, and the preparation I have done so far will directly relate to what I will be doing later. As someone who is racked just about daily by a very reasonable-sounding inner voice that questions the wisdom of all this, I appreciated the boost.
This is long enough, so I'm signing off, but that reminds me -- sometime I need to talk about that EMT class, and the imaginary patient I killed in one of those scenarios. She's the only one I've lost so far.
And I still think that even if I had asked about it, she might have denied taking the damn Viagra.
I like going when one of the a cases covered will be one I worked on, partly because I like to know how things came out for the patient. This can be good news or bad, of course. Speaking of head injuries, I'll never forget the one where someone I'd been there for was presented, and after the head CT and a report from our EM resident (assigned to Neuro at the time) came autopsy photos of the same massive brain clot, this time frankly visible within the exposed top of our former patient's cranium, with a report from the medical examiner.
I also go to conference because it's a chance to feel connected to the learning part of the process; to take advantage of the fact that I work at an excellent academic center, and I am encouraged to attend. I also like to imagine being able to call on these experiences later on, as a helpful memory. Not so much for clinical info, although surely I'm picking some of that up, too. I like the idea that because I have the chance to do this now, settings and situations like the conference won't ever be foreign to me, and thus less intimidating. It's part of the whole 'non-traditional' student thing. Many staff physicians are close to my age, but the residents are only younger than me by a factor that's about the same as how far behind them I am in education. Thus, I tend to gravitate to the resident part of the room.
Today I also stuck around for the med student lecture, something I do most days I attend the conference. As I said to the 3rd-year resident I was sitting next to, this is an unusual time in my training -- there would be no consequences at all if I decided to ditch the lecture, since I am "invited" and "encouraged" to attend the conference, but the lecture is pure bonus material. Somehow, this seems to work out to having the kind of attention span for medical education I fear I might be lacking later on, when things are going to get a lot more compulsory and/or graded.
It helped that while this lecture was unusually well-organized and presented in a more academic, true lecture-style way than some of the lectures I've attended, it was also really good. It amuses me to think that if I am asked to strap a blood pressure cuff to a patient's ankle in the next few weeks, I'll know exactly what's up. (Actually, I would have been able to suss it out on my own, strictly in terms of "what does that tell us?" But this way, I'll know it's because the resident and I attended the same lecture.)
Something I've never done was hang around after the lecture, for the Mortality and Morbidity conference. Having checked my voice mail, and knowing that lunch with the gf was not happening as planned, I was curious about what's next. The residents were not entirely sure at first, so I soon found myself with a very narrow window to decide if I would stick around. Turns out it was indeed M&M.
Would this be interesting? Totally. Educational and helpful? Sure. Would I just be there out of prurient interest? Not at all. Would it be okay for me to be there, or was this a doctor-only kind of thing? Uhhh.... well, I took a look around. The RN's had taken off already after conference, since they tend to have, y'know, lives, and of course nobody from other services was still around. But med students were still there.
One of the big things I've learned is that med students are nothing special. And I say that even as I make huge personal sacrifices in the fervent hope that I will be granted the opportunity to be one.
Some are of course wonderful, and brilliant, and it's obvious to see the future doctor just beneath the surface. Many are studious, well-intentioned young people, who with some time and effort will be great. Many are exactly what you'd think, if you watch a lot of Scrubs. Seriously, I have never had what I've felt was the requisite awe and respect for medical people; that's one factor that kept me from joining up earlier. But most of my experience has not yet shown I was wrong. Students are just regular ol' people... some moreso than others.
So it was staff, residents, med students, and me. But what the hell. The boss-doc who was running things saw me, we made eye contact, he gave no indication it was weird or inappropriate for me to be there. And it turned out to be really fascinating. For those who are unfamiliar, the "M&M" is the big meeting where we talk about what went wrong.
First was a discussion of things that get screwed up, in general, in the practice of medicine. There was a big long list that the group had been working its way down, over several weeks or months. The boss-doc presented some examples of issues culled from several years' worth of cases, pointing out where studies that had been read as normal were truly not, asking difficult questions of the residents, and applying hindsight to point out things not to be fooled by.
Then, specific stuff from the week at our hospital was presented, by various people who had been connected with the issues. None were huge problems, most were not even noticed by patients, but all were important because the team chose to make them important. Here's the situation, here's how it might have been prevented, and here's how we make sure it doesn't happen.
How come every industry, business, and institution doesn't do this?
From TV and film portrayals of the M&M, you'd think it was a big auditorium with stone-faced old guys frowning down at a trembling young doctor in the hot seat. It's actually a discussion peppered with horrifying but comical stories from 25 years ago, when the gray-haired sage who now runs the show was a skinny little geek prone to rookie mistakes just like anyone, and chances for newbies to demonstrate the ability to learn from mistakes during, and even prior to, their commission. It's the healthiest, most honest, most real-life-no-BS-helpful way to make things better I've seen.
And that's sad, because I've been in the business world for what, 12 years? "Continuous quality improvement" sounds great, guys. Thing is, we've been doing it since Hippocrates. (I commented to GeekSpice once, more than a few months ago now, that I had found the word "we" coming out of my mouth when referring to medicine, and the way things work in that world. I did it again, just a couple of paragraphs ago, when I said "our hospital." Yep, I'm committed, now.)
As M&M wound down, food was brought in. I was ready to go home, and really, the next thing on the agenda was prep for board exams. If all goes well, I'll be getting ready for my USMLE Step I board exams at this time of year... six years from now. So, not so practical. But hey, free food. So I stood in line, where I talked a little with some staff docs about an issue that the M&M had addressed, then ladled up some ziti that had a nicely zippy sauce, one good-sized meatball, and then sat back down. Dammit, board prep started immediately. I was trapped.
And then came the best surprise of the day. The way the oral part of the boards is done is extremely similar to the way my EMT class had been run, as we practiced cases for patient assessment. There is an examiner, who guides you through a scenario, and you need to verbalize what you would do, what you would look for, etc. Bedside manner counts, following the standard of care counts, doing the steps in the right order counts. There are things you need to do and things you should not do, to earn full points or avoid failing the scenario altogether. The scenario is timed.
One first-year and one second-year resident were being quizzed by a third-year, in front of the group. Staff offered comments and gave pointers about the way things are structured. Sitting in our seats, my friend the third-year and I whispered about the food and he (correctly) diagnosed the problem in about 15 seconds. Me, I wasn't ready to go that far, but I knew what to do. I was shocked to find that not only would I probably not kill this imaginary patient, I might actually get a decent score on this scenario.
Now, this in no way means I would not wet my pants (figuratively or literally), if faced with a real situation. It doesn't mean I'm as smart as an intern. It just means I am on the right track, and the preparation I have done so far will directly relate to what I will be doing later. As someone who is racked just about daily by a very reasonable-sounding inner voice that questions the wisdom of all this, I appreciated the boost.
This is long enough, so I'm signing off, but that reminds me -- sometime I need to talk about that EMT class, and the imaginary patient I killed in one of those scenarios. She's the only one I've lost so far.
And I still think that even if I had asked about it, she might have denied taking the damn Viagra.
Thursday, January 20, 2005
Surgical Deep Thoughts, part 1
The femoral head is the round bit at the top of your thigh bone, your femur. It's the ball in the ball-and-socket joint of your hip.
In a total hip arthroplasty (a hip replacement, in other words), a titanium rod gets inserted a little ways down the center of the femur*. That part is meticulously measured and the rod is planted solidly. After the rod fits and the artificial socket up on the cup-shaped hip bone fits (that's the acetabulum, by the way), then the last bit in is secured to the top of the rod; this is the artificial dealio, made of titanium or ceramic or some other space-age material, that will become the de facto femoral head.
The femoral head is (on most adult people) slightly larger than a golf ball, smaller than a cue ball. Sitting there in a little metal tray, it can look awfully bewildered. Even, dare I say it, a little sad. A minute ago, it was an important body part, and now it's been replaced by some fancy-schmancy bionic thing. It's suddenly become medical waste. Hard to preserve your dignity in that situation, but the femoral head is nothing if not practical. It does retain some of its natural poise and beauty, despite being totally irrelevant at this point in the operation.
I thought it was sort of like the way a pitcher looks, when the manager walks out to the mound in the bottom of the fifth, with only one out and two of their guys on base, and says "nice work today, kid, but we need more juice out here right now. Hit the showers, willya?"
Except with more awe and respect. Not enough awe to make my brain seize up, though. Too much musing on the thin gossamer thread of every human's mortality, or the sacred yet profane work of we the blessed healers, can get in the way of people doing their jobs. And people doing their jobs is worthy of respect and awe, right there.
So, uh... yeah. I've had the chance to do some shadowing. Surgery is very, very cool. It's interesting to be aware of myself as someone barely scratching the surface. I know the names of most of the parts, and I understand much of what's going on. Yet outsider-style ideas and observations still bubble up. I'm hoping that I can hang on to some of that, along with all the actual knowledge and skill I'll be needing, when I'm standing in one of those other spots.
Total hip info (complete with gory photos) can be found here:
http://www.wheelessonline.com/05/4971.htm
* Some marrow gets sucked out to make this work properly, and for some reason that part wigs me out more than all the rest of it -- including the part where the surgical team gets to be standing there in the first place, looking down into an open wound at the bones of a live person, like a bunch of guys eyeballing the half-disassembled transmission from a 1993 Ford Escort. And also, shaping the bones so they'll fit snugly with the implant. Shaping them with a saw. And a hammer and chisel. Ortho is cool as hell, and that's partly for the way it is not at all glamorous. It's clearly science and art, and one of the specialties that can make a person perspire from the physical effort of practicing it. As an Emergency kid, this is something I can respect.
In a total hip arthroplasty (a hip replacement, in other words), a titanium rod gets inserted a little ways down the center of the femur*. That part is meticulously measured and the rod is planted solidly. After the rod fits and the artificial socket up on the cup-shaped hip bone fits (that's the acetabulum, by the way), then the last bit in is secured to the top of the rod; this is the artificial dealio, made of titanium or ceramic or some other space-age material, that will become the de facto femoral head.
The femoral head is (on most adult people) slightly larger than a golf ball, smaller than a cue ball. Sitting there in a little metal tray, it can look awfully bewildered. Even, dare I say it, a little sad. A minute ago, it was an important body part, and now it's been replaced by some fancy-schmancy bionic thing. It's suddenly become medical waste. Hard to preserve your dignity in that situation, but the femoral head is nothing if not practical. It does retain some of its natural poise and beauty, despite being totally irrelevant at this point in the operation.
I thought it was sort of like the way a pitcher looks, when the manager walks out to the mound in the bottom of the fifth, with only one out and two of their guys on base, and says "nice work today, kid, but we need more juice out here right now. Hit the showers, willya?"
Except with more awe and respect. Not enough awe to make my brain seize up, though. Too much musing on the thin gossamer thread of every human's mortality, or the sacred yet profane work of we the blessed healers, can get in the way of people doing their jobs. And people doing their jobs is worthy of respect and awe, right there.
So, uh... yeah. I've had the chance to do some shadowing. Surgery is very, very cool. It's interesting to be aware of myself as someone barely scratching the surface. I know the names of most of the parts, and I understand much of what's going on. Yet outsider-style ideas and observations still bubble up. I'm hoping that I can hang on to some of that, along with all the actual knowledge and skill I'll be needing, when I'm standing in one of those other spots.
Total hip info (complete with gory photos) can be found here:
http://www.wheelessonline.com/05/4971.htm
* Some marrow gets sucked out to make this work properly, and for some reason that part wigs me out more than all the rest of it -- including the part where the surgical team gets to be standing there in the first place, looking down into an open wound at the bones of a live person, like a bunch of guys eyeballing the half-disassembled transmission from a 1993 Ford Escort. And also, shaping the bones so they'll fit snugly with the implant. Shaping them with a saw. And a hammer and chisel. Ortho is cool as hell, and that's partly for the way it is not at all glamorous. It's clearly science and art, and one of the specialties that can make a person perspire from the physical effort of practicing it. As an Emergency kid, this is something I can respect.
Saturday, January 08, 2005
Welcome to the Backwater
I recently commented at SpaceWaitress' place about blogs, and how they provide a skewed prism of a person (a persona, really). There's a discussion there about people "in real life" who get ahold of one's writing, or stumble across it subsequent to the ending of the actual acquaintance, and use it to build a mental bridge that allows them to think they know the writer. Not unlike fans who have "connections" with famous people.
Sometimes readers actually do know the writer, so friends and family who read a blog can participate in one more way in that person's life. This is undeniably cool. We've learned that Spacey's mom is even cooler in her head (and via her keyboard) than she's always seemed at those brief times when we've talked in person. We've seen evidence of why people are such good friends to one another, and it's always heartwarming (or, since it's kind of an intellectual thing, maybe it's "brainwarming") to see an affirmation of people who get one another so well. I had been impressed by Spacey's group of friends, and their loose-knit ability to stay connected and in synch, but now I have another view of that quality, and I have a sort of observer's affection and respect for it.
My contribution to the thread over there was the awareness that as I plod through the process of various applications -- to postbac (done!), med schools (the plan is for the 2007 app cycle) and eventually, residency programs (2011, god willing and the crick don't rise), I'm going to be asked to write and talk about a lot of stuff... which in many ways, I am thinking and writing about now.
Part of being a good tech is anticipating the need, and having the whoosit ready by the time it's asked for. The ambulance is due to arrive in five minutes; we're all gowned up standing around the cart and saying hello as though it's the first time (which it sometimes is). We're looking at each other's name tags. The ultrasound is right behind you, doc, and it's booting up now. The nurse's documentation sheet has the Hollister sticker and my signature on it, and it's in the bin ready for other paperwork to join it. Empty blood tubes are arranged like a multicolored pan-pipe by the phone, and my gloved finger will jab any speed dial you need. We're all set.
So, okay. Is this mental processing here at the humble little pseudo-blog going to be useful later on? Or will it just be one more thing I can be evaluated on later? And, if it makes me look like a clueless tool with delusions of competence, wouldn't that evaluation actually be more like what in the liberal arts we like to call "judging?" Ay, there's the rub.
But you know what? This is public, but it's primarily for me right now. Convenient, that, since almost no one else comes here. Still, that may change with time. The work so far is not on my own C: drive because I do want some elements of a conversation. I don't want to talk only to myself. And in the long run, even though it might bring some of the complications that Spacey notes now, giving over the ability for people to jump in to this place from various points in the future or past, I think it's worth it. There could be value in helping other non-traditional students get on the road. It might be amusing or interesting. There could be some worthy insight. And best of all, there's the chance that it might help establish a pattern that corroborates something positive a decisionmaker thinks they see in me at some point.
And really, everybody else has a blog. Maybe in the 2007 application cycle, it will be weird not to have one. And you gotta believe that a person's true colors show over time. Whether this is a footnote or the Lake Itasca of one segment of my eventual doctorhood, welcome to it. It might provide clues about letters to the editor I'll write in 2024, or things I'll argue about at national conferences, or how I'd give feedback as chief resident.
At the very least, yeah, it proves I am actually like this, and not just at interviews.
Sometimes readers actually do know the writer, so friends and family who read a blog can participate in one more way in that person's life. This is undeniably cool. We've learned that Spacey's mom is even cooler in her head (and via her keyboard) than she's always seemed at those brief times when we've talked in person. We've seen evidence of why people are such good friends to one another, and it's always heartwarming (or, since it's kind of an intellectual thing, maybe it's "brainwarming") to see an affirmation of people who get one another so well. I had been impressed by Spacey's group of friends, and their loose-knit ability to stay connected and in synch, but now I have another view of that quality, and I have a sort of observer's affection and respect for it.
My contribution to the thread over there was the awareness that as I plod through the process of various applications -- to postbac (done!), med schools (the plan is for the 2007 app cycle) and eventually, residency programs (2011, god willing and the crick don't rise), I'm going to be asked to write and talk about a lot of stuff... which in many ways, I am thinking and writing about now.
Part of being a good tech is anticipating the need, and having the whoosit ready by the time it's asked for. The ambulance is due to arrive in five minutes; we're all gowned up standing around the cart and saying hello as though it's the first time (which it sometimes is). We're looking at each other's name tags. The ultrasound is right behind you, doc, and it's booting up now. The nurse's documentation sheet has the Hollister sticker and my signature on it, and it's in the bin ready for other paperwork to join it. Empty blood tubes are arranged like a multicolored pan-pipe by the phone, and my gloved finger will jab any speed dial you need. We're all set.
So, okay. Is this mental processing here at the humble little pseudo-blog going to be useful later on? Or will it just be one more thing I can be evaluated on later? And, if it makes me look like a clueless tool with delusions of competence, wouldn't that evaluation actually be more like what in the liberal arts we like to call "judging?" Ay, there's the rub.
But you know what? This is public, but it's primarily for me right now. Convenient, that, since almost no one else comes here. Still, that may change with time. The work so far is not on my own C: drive because I do want some elements of a conversation. I don't want to talk only to myself. And in the long run, even though it might bring some of the complications that Spacey notes now, giving over the ability for people to jump in to this place from various points in the future or past, I think it's worth it. There could be value in helping other non-traditional students get on the road. It might be amusing or interesting. There could be some worthy insight. And best of all, there's the chance that it might help establish a pattern that corroborates something positive a decisionmaker thinks they see in me at some point.
And really, everybody else has a blog. Maybe in the 2007 application cycle, it will be weird not to have one. And you gotta believe that a person's true colors show over time. Whether this is a footnote or the Lake Itasca of one segment of my eventual doctorhood, welcome to it. It might provide clues about letters to the editor I'll write in 2024, or things I'll argue about at national conferences, or how I'd give feedback as chief resident.
At the very least, yeah, it proves I am actually like this, and not just at interviews.
Tuesday, December 28, 2004
If I'm quiet...
...it may mean that things are going on which will make awesome stories, but not yet.
Because things are too fresh in my mind, and need to be processed; because I need to think of cool pseudonyms for people I'll need to talk about; because I need to obscure identifying details; or maybe because I've been too dang busy to write.
The urge to blog is not insignificant. Someday this will be a sort of a record of selected impressions, opinions, and reflections from this particular part of my ongoing drama. And it will be a depository for amusing and maybe even interesting stories. Plus, it's practice for me, as I learn to formulate thoughts about these topics in a way that holds together.
But the urge to sleep is stronger, dude. No contest. So I'll just say I recently met some cool people, and I did some extremely cool stuff.
Hey, and I left a message for Turk. They need techs on that show, truly. Sassy, intelligent people who describe themselves as "low-life-techs," but who in reality make the place run well and help docs to be on their best game. It's TV gold, I'm telling you.
Because things are too fresh in my mind, and need to be processed; because I need to think of cool pseudonyms for people I'll need to talk about; because I need to obscure identifying details; or maybe because I've been too dang busy to write.
The urge to blog is not insignificant. Someday this will be a sort of a record of selected impressions, opinions, and reflections from this particular part of my ongoing drama. And it will be a depository for amusing and maybe even interesting stories. Plus, it's practice for me, as I learn to formulate thoughts about these topics in a way that holds together.
But the urge to sleep is stronger, dude. No contest. So I'll just say I recently met some cool people, and I did some extremely cool stuff.
Hey, and I left a message for Turk. They need techs on that show, truly. Sassy, intelligent people who describe themselves as "low-life-techs," but who in reality make the place run well and help docs to be on their best game. It's TV gold, I'm telling you.
Wednesday, December 15, 2004
things that make me laugh, with glee, on the bus
1) "Indie RnR" by the Killers came up on my iPod. I'd never heard it before, and it was awesome. It helps that yesterday, I read the essay that Rivers Cuomo wrote when he re-applied for admission to Harvard.
(to be continued)
(to be continued)
Monday, December 13, 2004
tonight's dinner
Just as a glimpse into the way I live these days, let me describe dinner for ya.
Arrived home a little after 5, already starving. Munched Corn Nuts while surveying pantry and fridge. (Side note -- Hanukah gift from mom was a giant bucket full of foodstuffs. Quite the care package. More of that when I go to school next year, plus some time in the Fitness Barn, and I'm in good shape).
Contents of fridge include skanky au gratin potatoes made from scratch four to five weeks ago, in need of disposal. Milk, past expiry date by more than 10 days, in need of disposal. Film on bottom of pitcher where sugarless "-aide" style drink evaporated. Rice and beans, made from scratch like the potatoes, and similarly skanky due to dearth of preservatives, plus lots and lots of time. Eggs, reading 'Sell by Oct 5.' Mushrooms, fresh two days ago. Shredded cheese, fresh two days ago. Onion, sorta fresh, sealed in zippy-bag. Leftover salmon-in-phyllo-dough deals made-- hm. Over a week ago.
Oh, and wait, some of mom's turkey-and-stuffing (another thing that I hauled home from the Open House of Lights this weekend), a goopy and delicious concoction that is more souffle-like than many other, inferior stuffings. But at the moment, I was not thinking of it much. It just sat there, looking bored. Also, jaunty seafoam green boxes containing vials of Enbrel, plus syringes for reconstituting and injecting the drug. Much as I'm pleased with what recombinant live cells derived from Chinese hamster ovaries can do for me, a dose costs my HMO like $200 to $400. So that's more a specialty item, not part a wholesome winter meal.
Pantry: pasta, instant brown rice, popcorn. Mac & Cheese mix, but that would mean going out for milk. Did I mention at this point it's about 15 degrees Fahrenheit outside? The guy from the TV Weather said (by way of the phone recording one can call) "Wind chill, 4 degrees." Four flippin' degrees. As I walked home from the bus, about 10 minutes previous to this, I had decided I'd be staying in for the night. If I'm going for milk, I may as well go to the airport and fly to a hospitable part of the world.
Inspected coupons for local chicken/pizza joint. Yes, I'm curious about the broasted chicken, but keep those eggs long enough and maybe I can broast one here. Feeling like cooking, dammit.
Inspiration: olive oil plus 'shrooms plus onions, over rice, little shredded cheese, there we go.
Checked freezer. One pork loin, frozen. Hallelujah. (Yes, I did say "Hanukah" earlier. Also, "cheese" and "pork.")
So, when all was said and done, I carbed it right up by oven-broasting the pork at 400 degrees for 35 minutes over a pile of the stuffing, which gave a nice moisture to the meat. I stirred the stuffing back together, the crunchy bits and the juicy bits, together with some of the sauteed mushroom/onion mixture, the rest of which adorned some rice. With cheese on top.
There are times, usually those rare occasions when I bring lunch in to work, when people talk as though I was a good cook. Maybe there's something to it. I really could use a bunch of steamed broccoli, I don't mind saying. And a tall beer.
But it is freakin cold out there.
Arrived home a little after 5, already starving. Munched Corn Nuts while surveying pantry and fridge. (Side note -- Hanukah gift from mom was a giant bucket full of foodstuffs. Quite the care package. More of that when I go to school next year, plus some time in the Fitness Barn, and I'm in good shape).
Contents of fridge include skanky au gratin potatoes made from scratch four to five weeks ago, in need of disposal. Milk, past expiry date by more than 10 days, in need of disposal. Film on bottom of pitcher where sugarless "-aide" style drink evaporated. Rice and beans, made from scratch like the potatoes, and similarly skanky due to dearth of preservatives, plus lots and lots of time. Eggs, reading 'Sell by Oct 5.' Mushrooms, fresh two days ago. Shredded cheese, fresh two days ago. Onion, sorta fresh, sealed in zippy-bag. Leftover salmon-in-phyllo-dough deals made-- hm. Over a week ago.
Oh, and wait, some of mom's turkey-and-stuffing (another thing that I hauled home from the Open House of Lights this weekend), a goopy and delicious concoction that is more souffle-like than many other, inferior stuffings. But at the moment, I was not thinking of it much. It just sat there, looking bored. Also, jaunty seafoam green boxes containing vials of Enbrel, plus syringes for reconstituting and injecting the drug. Much as I'm pleased with what recombinant live cells derived from Chinese hamster ovaries can do for me, a dose costs my HMO like $200 to $400. So that's more a specialty item, not part a wholesome winter meal.
Pantry: pasta, instant brown rice, popcorn. Mac & Cheese mix, but that would mean going out for milk. Did I mention at this point it's about 15 degrees Fahrenheit outside? The guy from the TV Weather said (by way of the phone recording one can call) "Wind chill, 4 degrees." Four flippin' degrees. As I walked home from the bus, about 10 minutes previous to this, I had decided I'd be staying in for the night. If I'm going for milk, I may as well go to the airport and fly to a hospitable part of the world.
Inspected coupons for local chicken/pizza joint. Yes, I'm curious about the broasted chicken, but keep those eggs long enough and maybe I can broast one here. Feeling like cooking, dammit.
Inspiration: olive oil plus 'shrooms plus onions, over rice, little shredded cheese, there we go.
Checked freezer. One pork loin, frozen. Hallelujah. (Yes, I did say "Hanukah" earlier. Also, "cheese" and "pork.")
So, when all was said and done, I carbed it right up by oven-broasting the pork at 400 degrees for 35 minutes over a pile of the stuffing, which gave a nice moisture to the meat. I stirred the stuffing back together, the crunchy bits and the juicy bits, together with some of the sauteed mushroom/onion mixture, the rest of which adorned some rice. With cheese on top.
There are times, usually those rare occasions when I bring lunch in to work, when people talk as though I was a good cook. Maybe there's something to it. I really could use a bunch of steamed broccoli, I don't mind saying. And a tall beer.
But it is freakin cold out there.
Monday, December 06, 2004
CALL-TURK update
I actually got through last Friday, and was able to leave a message. We shall see.
Also, I worked in the trauma room over the weekend. Just apropos of nothing at all, if ever I'm feeling weird and sort of dizzy, and a head CT at my friendly, competent, perfectly good small-town hospital shows nothing wrong but I'm admitted to the hospital anyway for other sorta-related neuro reasons... please make sure the staff doesn't let me sleep for like 10 hours straight without waking me for vitals, talking to me, or doing a crapload of neuro exams. Because, while I do like helicopter rides, and I love to take naps, I also like waking up.
DISCLAIMER: I actually don't know how this patient is doing today. Could be anywhere on the spectrum. Plus, there's not a lot of info about what happened in the case before the patient's arrival, and I may not have seen the whole chart. This is more a story about how things might go, sometime, somewhere... but back to our story.
Preferably, if I'm checked in with a nonspecific problem in the noggin, you'll room me with a noisy 8-year-old insomniac who is not actually all that sick. I say this because either playing Ratchet and Clank or plotting revenge against a tiny tormentor would be a higer brain function, and in times of neurological distress, I'll want a reason to practice those.
Like I said, the facts of the case are admittedly a little sketchy (which by the way helps me to obscure the identifying details; convenient!), but the principle here is like I was taught: "if you don't put it in the chart, there's no way to know it happened." And we know that the scan done less than 24 hours previous, at PGSTH, was read as normal while ours was really, really... not. Whatever the specifics, my part of the story ends with a CT control-room-ful of EM and Neuro docs anxiously watching successive slices of brain imaging come across a monitor screen, like really shitty cards being dealt, and going "arrrgh" in unison. That's just never a good thing.
One resident commented, later, that the systemic kind of bad luck is the kind that can sometimes really screw a patient. Hospitals with sprawling residency programs training new doctors, and with med students rotating through, sometimes get scoffed at. Sometimes the scoffing comes by way of well-fed, comfortable small-town docs who work in hospitals with fewer than 50 beds, and sometimes by way of their patients. But it's a fact that some poor schmuck intern who has to come see you at 11pm, then 1am, then 3am could be the one to notice something that, if noticed soon enough, might not kill you. Food for thought. And when the day comes when I'm that poor schmuck, I guess I've learned a little something about being glad I'm there.
Also, I worked in the trauma room over the weekend. Just apropos of nothing at all, if ever I'm feeling weird and sort of dizzy, and a head CT at my friendly, competent, perfectly good small-town hospital shows nothing wrong but I'm admitted to the hospital anyway for other sorta-related neuro reasons... please make sure the staff doesn't let me sleep for like 10 hours straight without waking me for vitals, talking to me, or doing a crapload of neuro exams. Because, while I do like helicopter rides, and I love to take naps, I also like waking up.
DISCLAIMER: I actually don't know how this patient is doing today. Could be anywhere on the spectrum. Plus, there's not a lot of info about what happened in the case before the patient's arrival, and I may not have seen the whole chart. This is more a story about how things might go, sometime, somewhere... but back to our story.
Preferably, if I'm checked in with a nonspecific problem in the noggin, you'll room me with a noisy 8-year-old insomniac who is not actually all that sick. I say this because either playing Ratchet and Clank or plotting revenge against a tiny tormentor would be a higer brain function, and in times of neurological distress, I'll want a reason to practice those.
Like I said, the facts of the case are admittedly a little sketchy (which by the way helps me to obscure the identifying details; convenient!), but the principle here is like I was taught: "if you don't put it in the chart, there's no way to know it happened." And we know that the scan done less than 24 hours previous, at PGSTH, was read as normal while ours was really, really... not. Whatever the specifics, my part of the story ends with a CT control-room-ful of EM and Neuro docs anxiously watching successive slices of brain imaging come across a monitor screen, like really shitty cards being dealt, and going "arrrgh" in unison. That's just never a good thing.
One resident commented, later, that the systemic kind of bad luck is the kind that can sometimes really screw a patient. Hospitals with sprawling residency programs training new doctors, and with med students rotating through, sometimes get scoffed at. Sometimes the scoffing comes by way of well-fed, comfortable small-town docs who work in hospitals with fewer than 50 beds, and sometimes by way of their patients. But it's a fact that some poor schmuck intern who has to come see you at 11pm, then 1am, then 3am could be the one to notice something that, if noticed soon enough, might not kill you. Food for thought. And when the day comes when I'm that poor schmuck, I guess I've learned a little something about being glad I'm there.
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