Gerlad's Blog of Awesomeness

worst day ever

2008-09-22T22:03:00.002-05:00

fucking dumbshit ass patient

...

inconsiderate ass full-o-shit mfker i won't name because i don't want to get in trouble.

blah

fdsafdsa

2008-08-20T00:44:00.005-05:00

man. my VAcation has turned from a chill 8-3 to an annoyingly busy 8-5. I dunno why patients keep coming in. we need to hide the signs or something. I am totally spoiled by the schedule here. Every minute after 3 hurts! I keep looking at the clock thinking wtf i'm still here?!?!..

primary care i think, is not for me. now i know why House always hated clinic duty... because it totally blows, that's why. outpatient cases are so boring. i want me some real medicine. getting sick of seeing obscure back pains we can't cure. Getting xrays or bloodwork and then handing off to specialists. or maybe i'm just bitter because i'm doing 4/5th the same job as our interns while there's a 110k differential in salary/tuition.

...

lately i've been trying to figure out if my former subi is hitting on me. we've been chatting it up a lot recently and she keeps insisting we NEED to go out for some drinks together. which doesn't compute because i'm a big dork and she's cute with a gargantuan rack. i keep thinking, it's a trap- grab an ax! i mean i can be a charming pig, but come on...

and oh yeah i guess i should mention she has a boyfriend. but they're practically married. well except for the long distance thing. but he is damn rich.

i guess it doesn't compute because i don't usually get that vibe when we're hanging out (not through these insecure and blind eyes anyway). and i know i don't give that vibe out because a) i'm a coward and b) i never really looked at her that way, well except when the eyeballs would wander cuz of the aforementioned goods.

so i'm honestly 95% sure she's not interested. which is good except for the 5% chance of a desperately needed ego boost. but i wouldn't want to fuck someone else over like that anyway. and i think we make pretty awesome just friends.

it is hard to find a good medschool friend who is totally on the same wavelength as you- similar smarts, cynicism, laziness and procrastination ability. she's my new 'smart' friend now that my man-crush step1 betting partner took a year off. it's great. we can totally blow off 3 hours talking shit about stupid/mean/ugly/douche classmates/interns/residents/attendings/patients. but it's obvious we both still really care about patients and gay shit like that.

it would never work out anyway, for a number of different reasons. besides i'm totally in love with my previous subi. i just need her to get back from her away rotation so that i can make my move. and by move i mean i plan to club her on the head and drag her into my cave.

...

fuck i keep coughing. i think i have TB. i will go through my records and execute all of my former patients if i ahve TB.

...

i really need to study. i really really need to study. i feel like everyone is getting smarter than me and it's pissing me off. this upcoming shelf exam is starting to scare me and this damned step up to medicine book is bigger than my step1 first aid review book.

what i need to do is stop looking up reading up on dumb shit like wrestling and mma fighting news.

but check out fedor snap like a cobra and maul the shit out of tim sylvia. what an f'n assassin. hands down the scariest and most badassed mfker on the planet. (ffd to 5:30 if you want just the action):

Fedor Emelianenko vs Tim Sylvia Affliction Banned sélectionné dans Sports et Extrême

Ruling shit out

2008-08-13T17:06:00.006-05:00

definitely no urology for me. I've touched more than enough foreign penises within the last couple of weeks to last for this lifetime. that would be 2. which is about 800 too many. So gross.

I think i would do a better genital exam if i strapped a gas mask to my face. it's hard to focus when you're in the presence of nasty-smelling genital funk and you're so acutely aware of alien penis molecules eating through your gloves and entering your trachea on their way into the depths of your soul.

a close second to nasty male genitals has got to be diabetic feet. or dried out edematous statis-dermatitis'd ungroomed old-person foot. especially when you yank off the sock and it's like someone setting off a little dirty-bomb with little bits of dried up foot falling to the ground and untold getting aerosolized.

so gross.

you're sitting there and you realize your hand is on your face and even though you gloved and washed and what not you start thinking about where it's been you start imagining you can still smell it on your hands and now it's all up in the pores of your face.

maybe i'll be desensitized eventually and get used to this sort of thing. i dunno though... i'm still scared of spiders after 27 years.

maybe it's a sign i should really go into radiology. or perhaps the sterile OR field will be different.

...

i'm getting pretty sick of outpatient at the VA. you know you're spoiled when being let out at 5 is a long ass day. i'm sick of looking knee pains and foot pains and ambiguous back pains. i'm tired of doing physicals. i want some damn daily blood values and some followup on patients with more acute illness.

i'm kind of sad that internal medicine is coming to an end in another 6 weeks. i feel like i need another oh... 25 weeks or so. i feel like i still don't know shit. i certainly haven't seen much on the floor. and it's disturbing that i may not have a chance to come back to this stuff which seems like the most important foundation of medicine.

...

I think i need to work on my patient rapport. i'm pretty sure my patients like me but i think my act is getting boring. i'm too busy focusing on being a good listener and empathetic and what not... i think i need to try to inject some humor into my routine. not to the extent of being insensitive of course but i just feel like my attitude is too serious esp during physical exam and they could probably use a lighter atmosphere.

things just seem much happier when the attending or chief is in there doing their thing... they're so much more comfortable in what they can say or do. the patients know they're talking to a bonafide MD, they're more relaxed and smiling, and the interviews are much shorter because i've done all of the dirty work. i feel like i'm playing good cop / boring cop.

...

what i really want to do is work in the "hmmmm... i've never seen that before" comment to get em really worked up. which is true for almost everything i look at.

...

ok i ran out of things to say

asdfg

2008-08-10T23:37:00.008-05:00

life is pretty blah right now.

i feel kind of like how i do when i'm doing a physical exam on patients. don't really know what i'm looking for and i'm more or less just going through the motions. blah blah blah. waking up, tying my tie, going in, seeing my patients, going home, think about reading, read up on sports/olympics instead, consciously avoid any real news stories that don't involve celebrity gossip, maybe catch up on some inane tv show, go to bed 2 hours too late, rinse and repeat. i do a good job i suppose but i'm waiting to feel inspired by something... or anything.

outpatient is super chill though. in fact if i only had an actual positive income and didn't have to feel guilty about not reading... by-golly it might actually be a pretty sweet job.

the VA is really lonely though. at least at the main hospital i would run into people on other rotations whom i could shit-talk with or about. i miss my last two subi's. we were so on the same wavelength, so laidback and chill about everything, while still caring and smart. didn't hurt that they were also pretty nice to look at. but it's nice having that 4th-year student buffer who you're not as worried about bothering for time. my interns were pretty chill but they were so damn busy i felt bad everytime i asked a question. plus i have serious MD-envy so it creates tension from my end.

it's always weird when you start on with a whole new crew and you're not sure about the individual levels of anal-retentiveness and you're wondering how far you can go with your jokes and such.

on the plus side one of my new attendings is taking computer science courses cuz she's a total cool uber-nerd and we're hitting it off well, i think. we were shooting the shit about CS stuff and it was cool until she started talking about least squares and algorithms and unix crap that was all over my head. former math major and obviously way smarter than me so i had to do my head-nod thing to pretend like i knew what she was talking about. dammit even in my own field i'm an idiot. way to rep cs.stanford.edu

...

the VA is pretty hilarious though. now i don't claim to be an expert... or even know jack shit... about universal health care and what not, but if government run health-care means anything like the VA... well god help us. The VA is like... going into DMV (not cali dmv which is actually pretty smooth sailing the last time i was in there).

the place is like a ghost town before 8 and after 3. i mean the official hours are like 8-5 but once it hits 3:30 people are packing their shit up. can't miss the shuttle. just try to get any labs or imaging done on a friday afternoon. i mean why stay late and put the extra time in when you are salaried.

the f-ing cafeteria blows too. we need more drug reps dammit. if i were running the show every week i would threaten to change PPI's on the damn pharm companies to make sure we have food every day.

...

i don't understand belligerent patients. don't they realize that when you're mean nobody likes you and when nobody likes you people don't go the extra mile to make sure you're happy and healthy. that no one's gonna lose any sleep making sure you got the correct correct diagnosis that might be way down on the differential list because you're out the door in a day anyway because you're not acutely sick anymore. or stay that extra hour to make sure all of your questions are answered. it boggles my mind why you wouldn't be nice to the people who have your life in their hands.

baffling because some patients are just so sweet. they might have metastatic cancer all up in their fuckin eyelids or wahtever but they're still smiling or making jokes or even if they're crying you can tell they're fighting and appreciate your help. and you leave the room wanting to donate your kidney to their cause.

so why would you want to be THAT guy? that guy who when I come in at 6am i find myself secretly hoping you coded to the ICU or left AMA so i don't have to waste extra braincells on your daily paperwork. i know your life sucks and whatever and you probably go home to a broken family but don't take your shit out on me. the attending, maybe. but me? heck my life is probably worse than yours. certainly more pathetic.

...

because i'm a retard i watched all of top chef season 4 this weekend. i <3 that show. i love how those judge chefs were so badass they were like, "this was so good, i think i would not even mind having seconds". i can't wait til i'm eating at 4-star restaurants and not finishing my plate so i can say shit like that.

man i need to upgrade my eats.

...

RIP bernie mac and shaft. i never watched your tv show because it seemed pretty lame but your kings of comedy routine was a goddamn classic.

...

eww the new facebook is kind of gay. not that there's anything wrong with that. but i think i'll wait until they force me to change like my.yahoo did after 3 years. now the new my.yahoo is really really gay. not that there's anything wrong with that.

...

before i get to my song of the week i just want to say how much more i love my iphone since the sdk/appstore came out. well except for all of the cool little games which keep me from doing any studying at borders.

the coolest app has to be "Shazam" which will record 10 seconds of whatever song is playing in the car, send it to a server, analyze it and then tell you what the artist/title/album is with cover art etc. i don't know how many times i've used this thing in the car. the other day we were at a restaurant and a new song started playing which nobody knew and i was like a hero after i whipped out my phone.

epocrates ain't bad either. i seriously don't know how i lived pre-iphone. it's like i can never not-know anything anymore when i have instant access to wikipedia on my phone.

anyway i found two cool songs on the radio today which inspired this techno-boner rant. so we have 2 songs of the week since this blogging thing is so sporadic..

and here they are for you my 3.5 readers to enjoy:

1) the "cool" song - O.A.R. - Shattered (live)
If you like the song and don't mind a little criminal activity you can find the whole album here

2) the "fruity/sweet" song - Plumb - In My Arms (i think this is actually a christian band):

mp3 here(rapidshare)

i swear one day when i have a decent income i will get around to actually paying for music... one day.

...

dammit i'm gonna have to shave tomorrow. i miss being able to walk around like a dirty hobo.

tired

2008-07-31T20:48:00.003-05:00

medicine is so tiring. i rounded for 5 hours today post call. so many new patients. I kept having this raging internal debate in my head as we went over patient after patient- am i more sleepy, or more hungry?

especially tiring when you're running around like a headless chicken and you feel like you're getting in the way more than you contribute. it's exhausting being so stupid and incompetent.

i guess i just have to take it on faith that eventually... i'll get there. but i feel so stupid compared to our subi's. who seem so stupid compared to our interns. who seem so stupid compared to our residents. who seem like total dumbshits compared to our attendings. maybe i've just had two extra fabulous attendings.

all of that knowledge to accumulate... sometimes you just think, fuck it, what's the point. it's like after two years of busting your ass and all of your rapidly disintegrating knowledge base isn't worth jack shit.

i'm lost in a sea of trade names i have to pick up, dosing levels, abbreviations... all that crap. then having to remember patient names and doctor names and nurses names.

i find it all very exhausting. there's not enough victories in medicine. so many dumbasses putting themselves into the hospital for the nth time because they can't stop drinking. so many f'ing drug addicts. it's like every patient we need to start a goddamn withdrawal protocol.

and then you finally have the people who don't want to be sick. it makes you sad when despite all of the smiles and time spent and the caring and wanting to help you realize there's nothing you can do. that you spent a week and a half working towards a diagnosis and being there 3 hours late answering questions... and when you finally get a diagnosis you realize your patient can't get the fucking curative surgery anyway because they don't have any health insurance. you feel like you're doing a good job and then shit like that just ruins your day.

i wish there were more victories. More curing instead of discharging people a little less sick than they came in.

I watch my attending everday and how awesome and patient she is with everyone and I'm just amazed. how much she cares and how she might be the nicest person i've ever freakin met. i wish i could be that caring. because honestly sometimes i just want to slap some of our patients.

she's probably just faking it. she probably goes home and clubs her dogs or something.

I find myself leaning more and more towards doing radiology. And it feels so dirty and cheap.

i think my problem is i'm a lazy overachiever. i'm always willing to put the work it... but i hate myself as i do it. I care too much about my patients... or maybe my grade, who knows... but then i go home and whine about how tired it made me. i wish i could either just embrace the laziness or be an earnest hard worker.

...

i need to stop whining. randy pausch died. :( i need to be more positivbe.

...

peace

...

Song of the Week - M.I.A. - Paper Planes (Remix Feat. Bun B & Rich Boy)

I Felt Like a Doctor Today

2008-07-21T20:40:00.006-05:00

As a med student on rotations with theoretically zero authority, nothing feels better than spotting an error in logic or medications, or coming up with a different diagnosis that results in a tangible change in medical management.

nothing is more vindicating than showing the powers that be above you that you were there to catch screwups which they with the md behind their signatures are ultimately responsible for. me, a lowly msiii.

sure, maybe it was my poor h&p that led us in the wrong direction. yeah, in fact that's exactly what it was... but who's counting?

i mean, if i hadn't caught my own fuckup, where would they be? shit up the creek without a diagnosis, that's where.

the key is making the error under your unsuspecting first attending. then catching the error after hours and then calling up your brand new second attending who's taking over the case and now thinks, 'damn, this kid is dilligent'

score!

...

I sent in another one of my H&P writeups to my preceptorship last friday and i got back an email today from him which said only the following:
"Suboptimal, Gerlad. See comments"

ouch! that kinda really hurt my feelings...

it's okay though because i purposely set my writeup standards low so i can trend upwards. i even turned it in 2 days later than the other two in my group. still it was a little harsh.

i don't understand why they expect us to write 50 freaking pages up in grand detail when in reality all of the real docs write 2 sentences in ineligible chickenscratch. get real.

...

On the other hand i met with my (first) attending today for an evaluation-vs-self-evaluation session. Self evaluation is a very tricky business. You always want to underestimate yourself. But then again you don't want to be so thoroughly convincing in the explanation area that they agree with your score assessments. I gave myself all satisfactorys except for motivation, which i put as excellent. I think it worked as he upgraded my grade for every category and kept the excellent for motivation. score! i almost shed a tear in my pants when he told me my knowledge base was definitely above average.

...

I'm having this inner battle to decide how much I care/should care. On the one hand, I spend a lot of extra time in the hospital in talking to and caring for my patients. I'm usually there on average over an hour or two later than my counterpart. Not sure why that is but it always ends up that way somehow.

On the other hand, I'm consciously aware of the fact that I spend way too much fucking time in the hospital. Going back to make sure their pain meds got ordered like you asked (they were). Annoying the tired ent doc to make sure your less than sane patient's ridiculous request gets made like you ridiculously promised. Spending extra time with my patients to answer their questions and make small talk and letting them know someone kinda cares while I glance at the clock and realize I don't have any time for reading again tonight. Which begs the question- do you really care if you resent/hate the fact that you care?

Sure it makes the patient feel better (maybe) or the attendings residents realize your dedication (doubtful they notice). But then again most of the time I come home look at the clock, think about how tired i am and conclude it probably wasn't worth the extra effort.

Third year is freaking tiring. Or medicine in general. This whole business is like a mirage. People always just keep telling you to temporarily self-sacrifice and that there's light at the end of the tunnel. but then you look around at all of the doctors and they're all still self-sacrificing and miserable and how many are all that happy.

...

Yesterday me and the subi tracked down the source of the popsicles we saw our chf patient snacking on. it looked so good i almost sntached it from him. I had been obsessing about the damn thing for the last week. now I'm determined to smuggle a popsicle every day until i make back my 65k. nice too because it's freaking hot up in hurr.

...

in other news step 1 is my bitch afterall.

...

Song of the Week - Leona Lewis - Run.mp3

One Week

2008-07-13T14:40:00.000-05:00

I've come to the realization that I kind of suck at this. I am bumbling around like a headless chicken and I feel like I am mostly just getting in the way.

I think my main problem is my very-short-term memory. I've always been more of a conceptual person and when it comes to remembering names, numbers etc I tend to forget crap like that within seconds of being told.

I will go to a computer, read up on a couple of lab values, write them down, have it straight in my mind what I want to say and what the relevance of each value is, but as soon as I have to report to anyone my findings I lose track of what I wanted to say, I forget key points and I talk all jumbled and garbled. I'll have one or two simple questions I want to ask a patient but after getting through the small talk I'll forget what they were.

I think I'm just not very good at following directions or ordered tasks. If I give myself or someone else gives me a couple of tasks to do I have to keep reminding myself what the next task and I'm terribly inefficient.

I'm not very good at doing evaluating physical signs (still mostly going through the motions), I can't keep up with all of the clinical jargon and drug regiments and crap flying left and right...

I think my only real strength is my understanding of organ system pathophysiology. The only problem is, when someone asks me a question directly I turn into a complete freaking moron- my mind blanks out. I was asked how to identify a-fib at the bedside (DUH- irregular irregular rhythm) and for some reason I started reasoning out heart block instead. god I felt like such a tool.

When he asks someone else or asks the group a question, I can almost always come up with good answers first but Im too timid to blurt out answers until there's a silence. I'm always coming up with very intelligent questions but I very rarely ask them on rounds because there's so many patients to get through and I don't want to annoy our interns.

So basically I think to any objective observer I'm performing about average or below. I'm most definitely not standing out.

Dammit, this has to change. I need to figure out a way to get myself, my thoughts and my huge overfreaking crowded pockets organized. I need to stop staying up so late for no good reasons and showing up tired without enough time to keep myself from panicking collecting data during prerounds. I need to start reading like a fiend. I probably need to stop blogging...

...

So far I don't like 3rd year all that much. Too tiring and I feel like I don't learn much in a day. People are too busy to teach you stuff and it's mostly learning through osmosis, which is pretty inefficient. Talking to patients is fun and all but you don't learn much medicine from them. I get home and I'm tired and I soo don't feel like opening up a book so I end up watching more episodes of how i met your mother or something.

And everyone is so busy. You can only hang out with people for like 30 minute intervals. Don't even bother asking any surgery friends to hang out, their bedtime is like 8:30 pm.

Ok maybe if I stop whining I can actually get some reading in today. Hopefully I can turn a corner this week. It's probably better this way... don't want to set the bar high, you start off slow so they can see more improvement.

still alive

2008-07-10T19:54:00.002-05:00

survived my 2nd full day. hmmmm what to say.

gina if you are as busy as our interns then god bless you. i find it pretty amazing how much responsibility they give interns that are fresh out of chilling and vacationing all of 4th year.

rounds i think are my favorite part of the day. i just hope i get better at keeping straight patients. i often can't focus for the 20 or so seconds of a presentation and so by the time i finish telling myself "focus" i've missed the chief complaint and i'm trying to piece the story together from the family and past medical history. that and i space out pretty often. i find it pretty amazing how attentive the attendings are to keep track of so many freaking patients down to the little details. even the interns who are doing all of that plus a shitload of gruntwork.

i hope that is something that comes with time. as it is people's symptoms all seem to blend together in my head as we go from one patient to another.

rounding is fun because i still have all of this step1 stuff fresh in my head and when it comes to getting pimped on useless pathophysiology (2nd messengers etc) I can answer a heck of a lot more than the interns and our senior resident... who are fatigued and riddled with actual useful knowledge. and happily, i am smarter than my teammate. I hold myself back and always let the residents answer first though because they told us during orientation not to be the annoying knowitall.

the frustrating thing is that my step1 knowledge is disappearing at an alarming rate (almost zero recollection of drugs already after 2 weeks) and i suck suck suck suck at presenting.

i really need softer shoes.. my feet are killing me!

maybe it's just my school but nobody seems to want to give me any scutwork... outside of my two patients... which is pretty nice, i think. i really thought i would get used more.

of course that's probably because i am ass-slow and i'm so afraid of messing up i keep asking for micromanagement and it is twice as fast for them to do scutwork without me.

medicine is kind of sad. i spent two hours today talking to an adopted patient because i wanted to get to know this person better instead of presenting on people i've never really spent time with, which is what i've been doing. this person ended up crying to me several times. the sad thing is i'm probably the only person that's really taken the time to talk to this person.

not that that makes me a saint, really who the f else has the time. when i am an intern will i care about anything more than discharging patients and lightening the workload and getting some sleep? will i take the time when i am on call with 30 other patients to find out if said patient really has the diseases on her chart, to figure out some way to reduce her 14 different medications? heck no. will i distrust and assume half of my patients are drug seeking addicts? probably.

hopefully i've neutered all of that to be a hippaa non-violation. i would write more but i've got to read up on freaking ekg's

oh yeah my schedule! 6 days a week unless we have call saturday, in which case i have zero days off! "Sunday is a reading day, we expect you to devote a significant portion of the day to reading"... wtf!!! i don't even have lunches off bc of damn noon conferences.

i miss second year. when classes were optional and i could go a whole week without shaving... :(

oh yeah if you IM me and i ignore you, it's because i'm stealing off of my neighbor's shoddy ass connection which keeps disconnecting. i didn't pay my dsl bill during step1 madness and they freakin cut my line. gonna take a week to get it back up... those fuckers.

iphone app store coming out tomorrow!!!

Long Ass Update

2008-07-07T01:01:00.005-05:00

Whoa. I just vacuumed my apartment for the first time in... don't ask.

...

Step1 was... an experience. I ate a hugeass burrito the night before and I think it delayed the absorption of my zolpidem because I couldn't fall asleep for a good 5 hours. Even after upping my dose to a full pill from my usual half pill. I guess I should have read the captialized bolded "TAKE ON AN EMPTY STOMACH" part of the instructions more carefully.

Anyway it was a horrible, horrible 5 hours. Between my anger and the paranoia of having my sleeping pills kick in during the middle of the test I was wide awake and freaking out. I tried sleep relaxation techniques I read about online, I called my mom and had her tell me stories for an hour, I tried reverse reverse psychology, I tried... um yeah. I tried everything. I would get to about 90% asleep and then I would think "hey i'm almost asleep" and wake right up again.

How did it go, I honestly have no freaking clue. My goal prior to the exam was to stay within $100 bucks (silly $5/point bet we made last year) of my friend whom I can all but guarantee will get a 260+ score. 240 = happy, 245 ecstatic, 250 worth selling my soul for. 500 hours and 2 nbmes and 2000 questions later I even got delusional and started dreaming of beating my friend, because of the psychopaths on sdn projecting usmleworld scores.

The test itself... one of the most godawful experiences of my life. No excuses on the sleep, I got a solid 4 hours of sleep in under the influence, 4 hours more than I had for the mcat. I brought a whole bunch of caffeine with me too but I was so amped up I think an extra caffeine boost might have killed me. I felt like I had malignant hypertension throughout the whole 8 hours. I thought I was gonna leave the test center with a buffalo hump from all of the stress.

I literally spent 15 minutes on the 4 minute tutorial (usually you try to finish fast to save your break time) because I was too afraid to click on the "Done" button to start the test. The first 10 minutes of the exam were the absolute worst. I kept thinking "omg, this counts, omg omg omg this counts, focus gerlad focus, omg i can't focus omg if i get this wrong my score it counts, focus dammit focus" over and over again. I had to reread the first 8 or so questions about 10 or so times before I finally calmed down.

The rest was a blur. Eight hours is way way way too fucking long for an exam of that magnitude. But whatever I've done it so every poor bastard that comes after me should suffer it too hehehe.

It was not fun. I think I would have done a lot better if I was more relaxed and wasn't second guessing myself so much. I felt so off of my game because of the pressure. The hard questions I felt panicked on and even the easy questions I had to double-think and reread because I would think "are they really asking such a simple question?" (the qbanks rarely ask gimmes so it was a changeup) As a result I was constantly time-rushed to finish and didn't get a full relook on all of my marked questions which is usually my bread and butter for getting separation. I've found that usually when I'm not sure my gut is more often right the second time around.

It wouldn't have been so bad if during hour 5 the bitch to my right hadn't literally begun coughing up her lungs. It started as a regular cough and then I think she aspirated something and started to choke. It was SO FREAKING LOUD I couldn't hear myself think and I started getting so pissed off. Read 5 words, anticipate loud ass cough... read 8 more words, anticipate cough. FINALLY she walks out of the test center but by that time the vicious cycle of my pscyhoticness had grown exponentially and I had to give myself a timeout and the end of the block to walk around the building and calm myself down. I know I wasn't the only one pissed off because I could hear other people getting annoyed and sighing really loudly. I felt sorry for the girl but I also kind of wanted her to choke to death so that I could get some peace and quiet.

I even complained to the test moderators after my walk but the desk chick just gave me attitude and said "unfortunately we can't make her stop coughing". Yeah, I freaking know that. I didn't expect them to do anything I was just hoping for a sympathy "I'm sorry." My freaking life is on the line and some chick taking some meaningless mail-in finger-painting certification exam is coughing into my right ear!!!

...

aight i had to step away from the keyboard because i started reliving the moment.

Anyway, i really thought i would leave the test center feeling some semblance of happiness. I felt annoyed more than anything. I mean, after 6 fucking weeks of straight studying... and that was it? Just some dinky little printout with a stamp on it. I wanted like a hi-five or something. It just felt so frustrating. All of that work... and you leave feeling like they tested you on everything that you didn't study. It felt like a wasted 6 weeks. I wish I had gone to Hawaii.

I keep telling myself everyone feels that way, including the hardcore gunners on sdn but it doesn't seem to help. Then I looked up a bunch of hard questions I remembered, realized I got most of them wrong and that REALLY didn't help. Especially the antimalarial side effect question which is not in ANY standard resource and I TOLD MYSELF to play it safe and go with the 'quine' drug which I knew 90% of people would pick based on the name but I decided to go for the glory on a bad false memory and got it wrong.

...

So in summary, how did it go? My best answer- it's fucking over. My new expectations are just to prepare to be disappointed on the 16th. I think it's a defense mechanism to reverse psychologize myself into keeping an ounce of optimism. dammit I just don't want to be in the midwest no mo.

The aftermath was pretty anticlimatic. People kept telling me to go get wasted or whatever afterwards but there wasn't anyone to celebrate with. Everyone was either done and out of town or still studying. Which was probably good because I didn't much feel like celebrating.

So instead I did something really really gay. My friend had some friends in town for some conference so we went and got sushi at a "really good" restaurant (in the midwest that means shitty and overpriced). Then being the only male in the group i was "dragged" along to see Sex in the City the Movie. First I made them swear not to tell anyone this was how I celebrated being boards-done or that I happen to know all of the character names. I thought it was pretty hilarious actually, a lot better than I thought it would be. But then again, my brain was pretty fried. And at least it was free.

I'm really surprised more guys weren't jumping to see this movie when it first came out. The girl-guy ratio was ridiculous. And what is better than 200 wannabe samanthas leaving a theater with sluttiness = feminism thoughts in their head.

...

...

I had a mini 10 year high school reunion last thursday. Goddamn I'm old. I didn't really want to see anyone (never kept in touch with hs friends) but they asked me and rearranged it around my vacation (real thing is august 2nd, which I can't make) so i guess i had to go.

I was so much smarter than everyone at my craptastic high school, I guess I just expected to have something more to show after 10 years. Coming out of high school I really thought I would discover something big or start a company, or have millions of dollars or otherwise have made a mark in the world. Instead it was like "hey, what's up, yeah i'm still in school and 100k in debt." Damn you stanford for humbling me.

It was actually pretty fun though and a real trip seeing people after so long.

...

...

So anyway tomorrow begins my first day as an MSIII.

To be perfectly honest, I am scurred out of my FREAKIN MIND. For all of my bitching I never appreciated how awesome preclinical years were. Didn't have to go to class if I didn't want to. Didn't have to stand on my feet all of the time. I could stay up as late as I wanted to. No pagers. I could be late all of the time. Now I have to always be early and pretend to be happy all of the time. And according to ruth, i need to show cleavage.

Objectively the first two years sucked cock but dammit, after two years, that's what I'm good at. I always joke about it but deep down inside I have this real fear that I will actually turn out to be one of "those" people who are only good at answering multiple choice questions. For one thing I'm really shitty at remembering names and all of my preceptorship patients started to blend together after a week. Not good signs.

Another part of me is excited about what lies ahead. I've come to the conclusion that I'm just not a very good person anymore. I've always sort of assumed I was a good person but then I sat down one day and tried to come up with reasons why. I couldn't come up with much.

I've been at this stage in my life where I'm pretty much just dead weight. I can't help out my family anymore. I don't contribute to society. I do nothing. The only quantifiable good I do is the occasional buck to the homeless dude on the freeway exit. I guess I'm just a sucker for guys with 1 arm, I want to help them acquire booze.

Other than that, what? I always try to help people out at school and I like teaching people stuff. But those are just selfish ways of getting people to like me and me wanting to feel smart... I always say bless you. I'm polite and I hold the door open for people. But I also get pissed off when people don't say thank you in return. I courtesy jog crossing the street in front of cars. I wave after I cut people off. I smile at people in hallways. I feel bad when bad things happen to good people and vice versa. I feel guilty for being lazy. And that's it. That's all I can come up with.

On the other hand I swear a lot, I constantly talk shit about people I dislike, i want to kick certain persons in the face and there's almost nothing too tasteless for me to joke about. Doing the tally makes me realize I've never really been a very good person. I'm just another dude who isn't outright evil. But at least when I made money or had someone to take care of, at least I felt productve. Now I just sit around studying, procrastinating and accumulating debt.

I guess I'm holding out hope that I'm going to discover some sort of passion for helping people or something, but I'm so damn cynical these days I'm not sure I see it happening. The last few weeks I've been very seriously considering just selling out completely and doing radiology and it really really bothers me.

I got into this stupid field because someone once convinced me that I was patient, that I had a good heart, and that I would be a great doctor someday. And I was sure that I wanted to help people when I got into this. But these days half the time I feel like it's just not worth the trouble.

I've been trying to decide how hard I want to try this upcoming year. I've turned into such a gunner over the course of the last year. I feel like I was more laid back first year, even if my grades weren't as pristine. What's the point... what does it all add up to. So I get into a competitive residency and then what? When does it end... I'm just so tired of having to compete.

...

damn this was a long ass blog entry. I think I was inspired after watching some 21 episodes of "How I met your Mother" today, which my brother got me hooked on. OG blogger Doogie Howser (Barney) might just be the most hilarious sitcom character ever invented (even better than the seinfeld characters as individuals). I highly recommend it.

shit

2008-06-25T23:54:00.001-05:00

it appears that my crazy retarded brain is more powerful than an ambien pill plus a 20 minute run plus a 20 minute hot shower.

6 more hours left in this fight... argghhhhhhhhhhhh

Scared

2008-06-25T06:37:00.000-05:00

I need a hug :(

mmmmmwwwwrrrraaaaaaargggghhhhhhhhhhhhh

2008-06-23T20:45:00.005-05:00

i have never worked this hard before for anything in my entire life. not even close. i have put in 12 hours a day for 6 straight weeks, no days off, not counting the 3 or 4 days last week where i was burnt out like hell and hit the wall and totally out of it. i have so much useless bullshit memorized in my head it's not even funny.

2 more days...

please, God, please let this go okay.

sleep update- my sleeping pills are working great, my only gripe is that i had some serious trouble focusing during my first round of questions this morning. i still did pretty well and i've been getting my highest scores ever today, so all in all i think a little drowsiness up front is much better than getting two (or zero) hours of sleep.

mfker

2008-06-15T02:57:00.001-05:00

cannot freaking fall asleep

@%(@)*(!)*%!)_(@*%)!(@*%)!(@*%)(!@*%)(!@*%)(!*@%)(@!*#*%u#*!!!!!!!!!!!!!!!!!!!!!!!!!

HHAPPPy!!!!!!!!!!

2008-05-16T17:34:00.003-05:00

Broad Based Buds

Chlamydia ABC (African Bastard Children (aka Blind Chronic))

...

my life has been reduced to this pathetic existence where i spend my hours memorizing retarded mnemonics. which is often almost as difficult as memorizing the actual craps themselves

For example naked RNA viruses are CPR.

the P stands for Picornaviruses. Of which are PERCH - polio, echo, rhino, cocksackie, and HepA. Which wouldn't be too bad if there weren't hella P-starting virus families (paramyyxo, picorna, parvo, papiloma, polyoma, pox)

Hep B is a double stranded circular dna virus. part of the hepadnavirus family. why it isn't called hepBdnavirus family, i dunno. now i have to remember to remember that it's counterintuitive. which makes me have to remember that some other shit wasn't counterintuitive.

Trying to keep in my head hundreds of bugs and drugs and diseases I've never seen before, many of which I'll never see ever.

Who really cares if a virus is icosahedral or helical?!?!?! Does that have any clinical relevance??? It's all gonna get spit out of some damned dna analyzer anyhow.

UGH!

ok end bitch session

:)!

I Passed!

2008-05-10T23:11:00.006-05:00

I was pretty happy today after taking a practice exam (supposedly these damn expensive $45 practice exams are the best approximators of your score) and I actually passed. Woohoo!!! Now I have 6 full weeks to hone in on that target 285 score. Quite exhausting just doing 200 questions, today. I don't know how i will maintain my stamina studying and doing questions until the real thing.

The bad news is apparently I am off the charts baaad in Behavioral Sciences...

"An asterisk indicates that your performance band extends beyond the displayed portion of the scale."

...but seriously who the heck comes up with some of these questions:

more at twiigs.com...

Seriously, what the hell is the correct answer to that question??? I picked the 3rd answer which is probably wrong since I got everything in this category wrong.

Anyway, yay i'm done with 2nd year!

that's all for now since i should be working on my research crap...

Last Day of Year II

2008-05-08T20:33:00.002-05:00

Tomorrow.

Hard to believe.

Then boards.

Then real patients.

Scary.

...

Song of the week - Aslyn - "That's When I Love You":

tuesday

2008-04-22T23:51:00.004-05:00

i couldn't think of a clever title...

thanks for all of the wonderful comments on my last post... esp jer

my internal medicine excitement has been tempered a bit. last week's sweet old lady was replaced by man with rather unpleasant stank. here i am trying to do an abdominal exam and half the time i'm straining my neck to keep my tie from hanging over and interacting with said patient's crotch and its rather pungent musk. why do they make us wear those things anyway?? actually i rather like wearing ties. i really just wish i didn't have to touch anyone.

still going through the motions, palpating and prodding and percussing and auscultating like I know what I'm doing. I don't. Really I'm just focusing on just getting the nodding part down so it looks like I know what I'm doing.

oh yeah, note to self: next week throw in a cheesy 'do you concur?' joke to my partner. that will so own.

I was pretty happy because we were listening to dude's heart for like 10 minutes and although honestly we were pretty lost I vaguely maybe kind of thought i heard a holosystolic murmur and after our attending came down to listen he confirmed a "very faint" mitral regurgitation... score!!!

...

i'm like in a weird stage of medschool limbo/hell right now. i hate learning but i don't quite want to be done with school. i'm having fun studying for boards but i'm not ready for it to be upon me just yet. And I am deathly afraid of 3rd year. As much as I hate 2nd year, I am good at 2nd year. After 2 years I should be. If there wasn't the uneasy stress of the impending boards, I would be having a lot of fun. My ping pong is just at another level right now. I even got a compliment on my improvement today from the 1st year jedi pingpong grandmaster in the lounge.

But maybe 3rd year won't be so bad after all. Getting pimped is actually kind of fun. I know it's unrealistic to expect all attendings to be so cool, but it's sweet when you're getting pimped by someone because they like to teach versus demean (I strive to one day be a cruel attending who does the latter).

It's kind of like jeopardy, only you're not getting quizzed on 15th century literature and other crap you've never studied before. You don't even have to know all of the answers... just more than the guy next to you. My biggest fear is that i'm going to be rounding next year and like in poker, i won't be able to figure out who the sucker in the group is... in poker i've learned, it's usually me.

...

what i really want to do is get a cane. so i can be like House MD and shit. Or perhaps more like costanza and people will think i'm handicapped. I just get so tired standing around all of the time. It's like being in line at disneyland, without fastpass. and if there's only one chair available in the patient's room, you can't be the loser calling attention to yourself by sitting. so it usually remains empty... what a waste.

i really need to find some good dress shoes that feel like sneakers...

Song of the Week - Usher ft. Young Jeezy - Make Love in this Club.mp3

What to do???????

2008-04-17T01:03:00.007-05:00

We've picked out our 'tracks' for clincals and i'm sad that almost all of my friends or even just people that i like are in the opposite track as me. which means i won't hardly see them again. :( i'm stuck in the track with more hard core gunners (in quantity and quality- we actually counted).

I'm trying to figure out WTF it is I want to do for the rest of my life. Because I honestly don't have a freaking clue. I like everything. I can see myself hating everything. So i figure i might as well just free write for a bit on the pros and cons of the different options so i have something of a reference to look at.

General surg

um, fuck no. i came into med school sure i wanted to do something surgery, but then i took a laparoscopy elective and i realized there is no way in hell i want to work with these kinds of personalities. i mean come on people, didn't we all learn to share in the 3rd grade?

it used to be that surgeons were universally top-dog smart but now unless you're the exception or in a subspecialty you're more than likely just an overworked grump who likes to work with your hands. I refuse to suffer and be stepped on through 5 years of residency only to be left with the most boring body parts to operate on.

Internal Medicine

the more i think about it the more this makes more and more sense. I started to seriously consider IM after taking our renal class which I love love loved (not coincidentally our professor was awesome). I love physiology and almost every other specialty except maybe path or EM just seems like a collossal waste of 2 years of grueling preclinical education. I can't stand the thought of having all of this bullshit I memorize on a daily basis going to waste. One of the biggest reasons I went into medicine was so that I'd be able to take care of my family if any health problems ever came up and this is probably the most useful specialty for that sort of thing.

You get to use your brain (it's kind of like on House) and you also get to talk to people. The other day we spent a couple of hours talking to and physicalling an uneducated but totally sweetheart old lady. I actually stopped and told myself, if all i did all day was talk to and help out sweet and grateful old ladies I could totally be happy. We'll see how I feel after a year of dealing with druggies and such. But my family's had enough experience with grumpy/jerk docs and I'd like to prove that I can be different.

Cons: prestige, $, general healthcare industry bs, having to compete for fellowships

Emergency Medicine

Less pay but less work. <40 hour weeks sounds damn damn good. Skiing on weekends. Shiftwork. And I have to admit I'm big on the hero factor. I'd like to think that if the situation arose I'd be the best person to deal with an emergency, whether it's someone having a heart attack or sticking a pen through someone's throat. You know a lot about everything. And did I mention 36 hour work weeks?

Cons: disrespected by other physicians, working with homeless, druggies, thugs and the like.

Pathology

I think they're all creepy bastards. Cruel bridge trolls who make us memorize microscopic minutiae that we will never ever see or need to know about. If I had it my way 75% of pathology for med students would be limited to conceptual cartoon drawings. Actually most of our pathologists are super nice but the whole field still creeps me out.

Opthamology

Supposedly very happy and the jesus factor is definitely there. I totally dig the idea of restoring ppl's sight... that's the kind of thing people name their kids after you for. But goddamn what a waste of med school. We've had maybe 10-20 hours total of eye/eye-related lectures in 2 years. Renal, gi, resp, etc... all down the toilet. I'm also deathly afraid of fucking up someone's eyes. Not to mention it's super competitive.

Anesthesiology

I feel like a bitch to even mention this, but I won't lie and say I'm not seriously thinking about it. You get to sit there and read... books, comics, porn whatever. Imagine that!... reading... for pleasure! on the job. sure it occasionally is stressful or whatever, but comeon how smart is the average anesthesiologist. i'm sure i could learn to deal. They have like a 100% match rate for people with passing board scores. Sure you aren't the brains of the operation and you don't get any respect but you get to go home at the reasonable hour while the surgeon keeps toiling. I just don't get why it isn't more competitive. GREAT money, great hours, great lifestyle, all shiftwork. Seems too good to be true. I could open up a pain clinic with some other greedy bastards and rake in 1 million/year. I wish they made all anesthesiologists take huge paycuts so I wouldn't have to consider this.

Orthopedics

Seems kind of cool. Also seems like a lot of work. Very competitive. Need more data.

Urology

Another one of the big 4 ultracompetitive surg subspecialities (ent, ortho, urology, optho). Seems pretty damn cool. Except for the whole working with penises part. I flinch (and cry) everytime a big 8-foot chancred penis is projected onscreen during reproductive lectures. Not for me.

Obgyn

Fear of densitization. When I see a vagina, I want to want to have sex with it.

Neurology

Neuroanatomy was probably my favorite class this year, but i really can't see myself dealing with crazies and people going into freaking seizures right in front of me. I dug the whole mental gymnastics with lesion diagnosis but in the end how much can you really help those people. It's like, hey guess what dude, I just deduced you have korsakoff's psychosis! You won't even remember this conversation. booyah.

For me the biggest perk would be getting mistaken by laypeople as a neurosurgeon. Maybe if someone promised me a future million/year position in their sleep clinic...

Neurosurg

Seems like the coolest job ever. But why put myself through that kind of fatigue? THe whole "it's not brain surgery" joke will probably get old after 10 years or so. Which is about how long training lasts.

Dermatology

I've been thinking about this lately. Why? Because we're getting derm lectures this week and 3/4 have been pretty darn hot looking (med school goggles notwithstanding). Nothing sexier than a girl in high heels who can run circles around you intellectually. The only problem here is that derm lectures are boring as fuck and the whole field seems superficial and lacking in substance. Pimple poppers, indeed. Outside of your melanomas and what not, you treat everything (with marginal success) with steroids, creams, antibiotics, vitamin A and constant prayer. Then there's the whole issue of me not being smart enough... damn!

ENT

I guess if I had to pick right now this would probably be it. You get medicine and surgery. You work with people and cool toys. And if you believe the party line, it's supposedly hard not to like an otolaryngologist. They're all happy and hold hands and what not apparently. Not bitter and resentful like general surgeons. You get to operate on the coolest body parts outside of the 2 CNS specialties, and compared to neurosurgery, the lifestyle is "Every Night Tennis". Downside here is the competitiveness and my fear of being the village idiot. I also have no idea if I will even like surgery. There's also way too much material to learn in the head and neck.

Radiology

Seriously, seriously seriously tempthing the shit out of me. My friend's sister is a PGY2. Supposedly year 1 residency was 7-5. Year II 8-5. IN FREAKING RESIDENCY. If I sell out, i might as well sell out all the way and do something like this and make more money vs anesthesiology. With my software background I'm pretty good thinking in 3d and always got the highest or one of the highest scores on the anatomy slide exams. The hours are supposedly good, the pay is ridiculous, and I could probably do some computer science hobby stuff on the side. Sure there's no patient interaction... but I can get probably get good people satisfaction when I give them rides in my M3 and pay for their dinners and such. Helping people? I can roll up on a bum and afford to give him a benjamin.

Peds / Family Medicine

I'm in a lot of debt. End of story. Pride factor comes into play here too.

...

I probably missed a couple and forgot some big points but I have to go to bed soon and fix my retarded sleep schedule. So far it looks like:

ENT
Internal Medicine
Emergency Medince
Radiology

with maybes for
Ortho
Anesthesiology

Sunshine

2008-04-08T00:57:00.009-05:00

I changed the wallpaper on my iphone yesterday and now I get a big smile on my face everytime I click my phone on or am greeted with a phone call from someone. Kind of like how I can't stop grinning each time after watching nick robinson's shot:

Hands down the cutest, baby... ever.

Well, ever since, 1980-83ish when I was a baby. But she had a much better personality than I did and she was by family concensus the cutest baby my mom ever took care of.

I miss our kids. Abigail, Sally, Natty, Chris, CJ, Jordan, Devin, Monica, James, Binky, Marissa, Michael, Graham (may your soul rest in peace), Gheanna, Alia, Webbo, and the one super chubby little girl whose name I forget (all of the stupid shit i have in my head these days) who had the sweetest sweetest personality ever and I always felt bad she was so chub and is probably getting teased to death in school now. Probably half a dozen more I'm forgetting. Except for maybe those 2 devil kids, who shall go unnamed and whom I don't particularly miss at all. Well, maybe a little. But they were pretty evil.

I wish I had more pictures of them all. They were all like my little brothers and sisters. I loved those kids. Even the evil two. Hard to believe some of these kids are now graduating high school and going on to college now. A couple of them I know can definitely beat me up. And sad to know they don't remember me at all. Damn I'm getting old.

...

I ran today for the first time since October... of 2006. Probably ran almost 3 miles... albeit very verrry slowly. It was actually pretty refreshing. We'll see if I can keep it up.

...

i doubt it

...

trying to figure out what rotations to schedule for 3rd year, but goddamn i seriously have no freakin clue what the hell it is i want to do.

...

i'm getting sleepy so i will continue this train of thought later...

test week again so i'll probably be blogging pretty frequently.

damn my legs are already sore.

Respect

2008-04-06T22:58:00.004-05:00

People give me way too much respect just because I am in medical school. All of these old filipinos that my parents only sort of know are always trying to talk to me after church is over. Which would be cool if they had hot young daughters which they never seem to have. Or if they wanted to ask me for medical advice which would be cool... at this point in my medical education I think I can generally fake like I know what I'm talking about with laypersons.

But instead they usually want to talk to me about their daughter's friend's friend who used to go to medical school or something completely unrelated to... anything, really. Not that I necessarily mind listening to boring ramblings from which I can't escape. But where were these people 3 years ago, when I was 'just' a software engineer but probably a nicer person. Is my head-nodding now that much more appealing to others, because I'm heading into a 'noble' profession?

...

Everyone wants to marry a doctor, but What's so great about doctors anyways? They're way too busy, for one. And it's no secret that I don't think the average physician is all that smart. I'd wager the average computer science grad student at a good school like stanford is much smarter. I go to an average school with very above average board scores so I think I can tell.

But my friend and I were talking about this a few weeks ago, thinking through our class of 170 people with nearly 100 guys, and we could not come up with little more than a handful of dudes who weren't so flawed in some way or another from a superficial distance that we'd be comfortable with them dating a theoretical younger, eligible sister. That's 7 or 8 people, including, perhaps out of courtesy on his part, each other.

That is, to say, not much better or worse than the general worthless population, 90% of which is, according to the wise Jerry Seinfeld, "UNDATEABLE!"

...

In general, I think I probably make for a poor admissions committee member. To steal a line from the departed, I don't trust people with an immaculate record. Or maybe I'm too forgiving of people with flawed records. Take the kid with A's/A-'s in lecture ourses but C's in labs. Explanation? Just wasn't interested. At this point most people begin to shake their heads, wonder "what happens if they come across a class in medical school they don't like?" etc. My take? That is EXACTLY my kind of dude. Labs are seriously stupid. Especially premed labs, my god...

The dude with the shitty grades but the awesome MCAT? Could be a mad genius, let's take him! Mediocre grades and MCAT, interesting hardship/background? Take him. Completely mediocre applicant who sounds just like I did? Let's give him a shot!

I guess it's a good thing I'm not in charge of this sort of thing. I mean you gotta have some standards. There's probably no better way. I just find it disgusting how coachable the whole thing is. And despite the numerous qualified decent people you get through, you also select for quite a few of the arrogant paper-resume'd ass-kissers that i completely despise. The kind that tend to get selected for committees and such.

One thing about medicine is that few people quit once you're sucked in. You're just too far invested. Time, money, etc. So the person with 5 shadowing experiences doesn't know any better or worse that they want to do medicine than the person with only 1. They're just as likely to be a bitter person who wants a return on their suffering. So why make the good people suffer jumping through hoops in order to weed out a few bad apples? They're going to suffer enough once they get in. We're just putting lipstick on pigs.

...

...

i wrote all of that on the plane 2 weeks ago and then forgot to post it. i realize i am quite the cynical bastard hahaha.

amusing how homogenous our flight got after our stopover in LA. It was like going from a quilt of different cultures to then being a plane full of whites, a few blacks, me and a couple of others.

LA from the sky is a concrete freaking jungle.

must get back... to california.

Song of the Week - Leona Lewis - Bleeding Love.mp3 From the british 'x-factor' winner. She's pretty hot too. More here (angel and better in time are very good)

Ughh youtube won't let me embed so - http://www.youtube.com/watch?v=sF84pIhP5UM

...

edit: ohyah i forgot to add, congrats to my protege julius aka strong-side for being done with his mcat! Over-bitching about school is a stupid little hobby of mine but in all honestly despite my constant whining I actually like it quite a bit and i'm very happy I made the big leap.

End of the Road?

2008-03-08T19:38:00.003-06:00

I think this blog in its current form is going to come to and end sometime soon. We had a talk last week about medical malpractice and professionalism which made me realize how potentially stupid having a blog like this can be. I mean the last thing I want after a poor outcome on a case is to have an 8 foot blow-up poster hanging up in front of a jury with a screenshot of this blog detailing how obvious it is that I hate fat people, or that I'm sexist, racist, homophobic or something of that nature. At which point in my defense I'll stand up and yell out, "that's not me, that's some dude named GerLad!"

Which means that this blog eventually needs to come to an end. I say too many stupid insensitive things in here and I need to start a phase out period soon to let things slowly disappear from the long reach of internet search engine caches.

As much as I enjoy this little creative hobby of mine, the risk probably isn't worth it. Every residency program and admissions committee likes to google people these days and the last thing I need is to get further screwed in a match ranklist because I aired some stupid laundry thoughts online.

The other alternative would be to erase all of my old entries and make this blog totally PC but that would make it totally boring. Not to you, my faithful 3 readers... you doubtlessly already think this blog is boring and so nothing would change. But it would make it unbearably boring for me and I write with the main goal of entertaining myself. And I gotta keep it real.

Besides, what do I get out of this blog? A sympathy comment here and there. An adsense click every week or so, probably the majority of which are from myself. My suspectedly hot new jersy reader won't even identify herself. Bitch. Really this blog is just an egotistical exercise I use to broadcast anger, glorify stupid thoughts, kiss my own ass and send subliminal updates to my best friend I never talk to. And procrastination. Seriously. Get a life, gerlad.

And so I will probably update a few more times or so and then stop, coinciding with the end of my preclinical education (WOOOOOOOOOOFREAKINGHOOOOOOOOOOOO!!!!!!!) I know 3rd year I will not be able to resist the urge to violate all kinds of HIPAA rules and talk smack about weird cases and irritating superiors and coworkers so that'll be good for me and besides I'll probably be too busy anyways.

...

In other news I witnessed an autopsy yesterday, so mark another check off the checklist of interesting things to witness/do. It was boring more than anything, and then stinky once they opened up the stomach. Not that it wasn't interesting in parts, it's just such a low yield experience because it goes so slowly. Much like anatomy dissections.

I understand the arguments for conducting these things but honestly I can't see myself ever trying to advocate for one of these to a family member of a patient. Why, for peace of mind? Maybe for extremely complicated cases. To add to an epidemiology statistic? It's just striking to me how casually they toss and mangle and drag the bodies around, by the head or whatever's convenient. I'm no religious nut but it all seems so unnecessarily brutal. I finally understand the meaning of "currant jelly" though.

I probably would have a much different opinion altogether if they had just played some decent music on the boombox.

One thing that really struck me was just looking at the face of the dead person and realizing that this person had been alive just hours ago. And now the life was just... gone. And despite the eviscerated abdomen, the face looked so real, so human. You almost expected the eyes to open again and the person to start telling you a their life story. Very sad and disturbing.

I had a similar moment of reflection once during my neuroanatomy practical exam, staring at a brain with a pin through a temporal lobe gyrus, thinking how every miniature wrinkle and axon in front of my fingers once held part of a thought or experience or memory. That if we were smart enough, there'd be a life and a story there we'd be able to decode. It was a very deep moment of reflection. And then the buzzer sounded and ruined it and I had to move on to the next station.

Moral of the story- pathologists are creepy freakin weirdos.

Awkward Turtle

2008-03-05T21:06:00.000-06:00

I'm at st louis bread co right now reading up on diabetes. A table away from me just sat down one of my standardized patients... I massaged dude's balls and had my finger up his bunghole...

weird

I guess he doesn't recognize me... was I really that forgettable? :(

I suppose that's all I had to say... I really need to grow up lol

New Favorite Show

2008-03-04T01:27:00.007-06:00

My pretty good dancer friend got me into this show which may have temporarily unseated Top Chef as my favorite reality TV show- America's Best Dance Crew.

There are few things I appreciate more than some really sick dance moves. People keep telling me I'm a really good dancer (probably because of the nerd outfit) but we were at a bar/club place Friday and these 3 black dudes started breaking it down real nasty in a circle and all I could do was just stop and watch and say wow. Dem peeps gots some rhythm.

What's cool about this show is that the two clear top groups are asian or almost entirely asian. The rest of the groups fast being eliminated were more bootie shakers, back flippers, "girl power" chick groups and some gay dudes on roller skates. Actually some of them are really pretty good but these two asian crews- JabbaWockeeZ and Kaba Modern are head and shoulders better than the rest.

I already know I'm being a JabbaWockeeZ dude for halloween next Xmas so I can break it down phantom of the opera style. They probably have the sickest moves overall but Kaba Modern has some cute chicks which gives them a different flavor. They also have some pretty tight choreography if perhaps just a tiny notch down from JWZ in the illness department. And amazingly their group doesn't seem to have any filipinos. Show is 1000x better than the Dancing with the Stars crap. It even has Mario Lopez aka AC Slater hosting it. So you KNOW it's legit. Anyway I've been watching these vids all day so here are the requisite clips (the show is only 4 episodes old). You can actually watch em straight off of the MTV website the day morning after (Thursday nights I think):

Kaba Modern 1:

JabbaWockeeZ 1:

Kaba Modern 2:

JabbaWockeeZ 2 (trying to figure out how dude does those moves to start the 2nd half of this one):

Kaba Modern 3:

JabbaWockeeZ 3 (sick sick ending to the challenge):

Kaba Modern 4 (best skit of the night finally outshined Jabba):

JabbaWockeeZ 4 (kind of a let down for me honestly but only because their last two weeks were so crazy):

...

Had a small BBQ Saturday to take advantage of the 65 degree weekend weather and to celebrate the coming Spring weather... too bad it snowed today and all of this week. Bought a $10 table-top grill at BigLots and between building the damn thing and trying to keep the flames alive in the gale force winds we didn't each lunch until 5pm. But it was damn worth it. We have a $X00 gas grill at home but honestly nothing quite beats the taste of good old coal carcinogens seared all up in your proteins. Even on a cheapo grill. It was pretty exciting especially since some really dry grass nearby caught on fire and I had to quickly stomp it out with my shoes and I honestly thought for a second we were going to burn my apartment complex down.

I don't know if I can ever eat a steak in a restaurant again. I'm almost always disappointed after spending the usual 15-45 bucks and this was literally one of the best steaks I can remember eating, ever. Definitely top 5, maybe top 3. The long wait might have had something to do with it but still, not bad at $30 for a 5 pack of NY strips at costco. I will have to report back once I strongarm my neighbor into giving up his marinade recipe.

I'm getting hungry just looking at the pictures again...

Simple Things in Life

2008-02-26T00:34:00.006-06:00

Milk + Peanut Butter + Jelly + White Bread (not that multigrain crap, but the ultraprocessed bleached white bread)

=

MMMhhmmm sOoooo good.

PB&J might just be my favorite food. I mean, really... what beats it? It's so simple and yet so perfect. Especially when it's 1am and you know you shouldn't be eating saturated fats this late at night because you know it's just going to go straight to your thighs.

I mean yeah there may be tastier 5-star dishes at your fancy restaurants and waht have you. But can you pack that lobster tail or foie gras or sashimi for breakfast and eat it in lecture every day and not get tired of it? I think not. My spaghetti is damn good but that takes like an hour to make.

I defy you to name something better. Bananas?? Pssssh.

Literally every time I unwrap my pbj sammich and take that first bite during class I literally do a double take and i'm like *queue samuel jackson voice* "MmmmmHmmmmm!"

The simple goodness always takes me by suprise. Okay, I guess I have run out of things to say. Hence ends my tribute to PB&J

...

okay i probably have better things to do...

...

i'm now getting adsense for "stupid people"... sweet.

Open Letter

2008-02-24T13:15:00.006-06:00

To the asshole ER doc who was mean to my family. You fucking asshole. Where do you get off rolling your eyes at patients like that. Where do you get off judging people like that. Not everyone went to medical school, not everyone knows what "just inflammation" is or what exactly antibiotics are and what they do. Not everyone has been desensitized after seeing thousands of patients like you have. Not everyone knows what constitutes a bona fide genuine medical emergency. But this wasn't just some stupid head cold. You couldn't have been meaner to nicer people.

I will NEVER be like you. Ever. No matter how late it is or how many shifts I've been on. Asshole.