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September 26, 2004

 

“Hit’s away!”:

Anyone get the movie reference?  Sent away my first bolus of residency applications last night… man, it took hours and hours online getting all that stuff organized…

CA – Highland, USC/LACounty

OR – Oregon Health Sciences Univ

IL – Uchicago, Cook County, UIChicago, Northwestern

MI – Henry Ford, Sinai-Grace/Wayne State, Detroit Receiving/Wayne State, St. John’s

OH – St. Vincent’s, Ohio State

PA – Temple, Hahnemann, UPenn, Jefferson

MD – UMBaltimore, Johns Hopkins

DC – George Washington

MA – BostonU, Harvard

CT – Yale

NY – Jacobi, Bellevue

 

My other CA app’s are a bit delayed – waiting on our residency app-lady to reply to my question if I should send a CA-specific personal statement or not.  Also, got another handful that I’m not entirely sure of… like Cincinnati – one of the best programs in the country, and I’ll have a bit of an edge coming from an Ohio med school, but dunno if I’d really want to live in Cincy.  Same with UCSF-Fresno.  I already threw out Pittsburgh and Indiana for those reasons.  A lot of those Northeastern programs are probably throw-away applications – great programs that I have no connection to whatsoever…  I’ll likely be applying to a total of around 35 programs…  There’s a bit of a financial incentive to limit my applications – after #30, it’s $25 per program.  Not a big deal for a handful of extras, but pretty pricey if I’m getting closer or over 40 (as I originally had planned)…  My research advisor told me that 20-30 was good for me…

 

My resident interviewer at USC told me to not apply to/rank any programs that on Match Day, I’ll be dreading opening the envelope and thinking, I wish I didn’t apply there.”  That kind of stuck with me.  Along with Cincy and some other potential back-up MI/OH programs, I’m debating applying to Stanford and Loma Linda… I haven’t been impressed with Stanford from what I’ve seen and after interviewing at Loma Linda for med school, not so high on the Inland Empire  ugg.  Hard to figure out how badly I really want to get back to CA…  My last two months home were GREAT… was really spoiled with the time I had to spend with friends and at great Emergency programs….

 

 

September 22, 2004

 

Things I’ve Learned at the ER:

1)       Good Idea = Bringing your pill bottle(s) to the ER so that your docs know what medications you’re taking.

Bad Idea = Bringing the pill bottle to the ER that you use to stash your medications,… weed,… and crack rock.

2)       Good Idea = Minding your own business.

Bad Idea = “Minding your own business” out on your porch or at a bar at 300am in the morning when “some dude” just punches you for “no reason.”

3)       Good Idea = Being comfortable with your sexuality.

Bad Idea = Being so comfortable with your sexuality that while taking Ecstasy and pleasuring your more rearward orifice with a vibrator you lose control and it gets stuck inside and runs until the batteries die because you’re at a county ER where you have to wait 18 hours in the lobby because as uncomfortable as it is, it isn’t an emergency.

 

 

September 20, 2004

 

Interview #2:

Interviewed at USC/LAC today.  I was underdressed – only one out of five guys who didn’t have a suit.  Ah, I don’t think they cared.  If anyone wouldn’t, it would be ER docs.  At Highland, only 2 of 7 guys had ties on.  Anyways, if it could be possible, this one was even more informal than the last.  They basically just took questions and pushed the program.  Again, my interviewers were too friendly… can’t read them at all.

 

I think, overall, I did better… I said what I aimed to say, asked some decent questions, and don’t think I said anything embarrassing.  (“I meant what I said.  I said what I meant.  An elephant’s word is 100 percent.”)

 

These residency interviews have been very different from med school interviewing.  Still nerve-raking, but significantly more comfortable.  Not sure what it is… I think it’s in part having some real goals and specific questions for these programs vs. talking nebulously about medicine at random medical schools I have little or no information about… maybe I’m getting more mature?... maybe it’s the knowledge that I will match somewhere, and I am a decent candidate vs. instead of absolute desperation (sorry GL, I know how it is)… maybe it’s a sense of fatalism about the whole thing – resignation to the all-powerful Match and some weird destiny in the Midwest.

 

But, uptight premeds still make uptight med students… geez, how annoying.

 

Anyways, so, at least my rank list is now 2 programs.  =)

 

 

September 17, 2004

 

Show and Tell:

I was the show and tell object at my friend’s 5th grade class in San Leandro.  The kids are (mostly) cute.  I answered questions from “Why did you want to be a doctor?” to “What do you do if you get something stuck up your nose and can’t get it out?” to “What’s your favorite football team? (which led to an argument about whether the Raiders or Lions suck more)”… it was fun.  =)  She has some bright kids.

 

Interview #1:

Good to get one under the belt.  I don’t think it mattered too much anyways – my impression is that after seeing me for the whole month, they have a general idea of how they’d rank me, with or without the interview.  And, I don’t think I have much of a shot here… I wasn’t the weakest student, but definitely not one of the top ones either.  Too hard to read my two interviewers – both are really nice people.  They made it really easy to talk a lot – not sure if I said anything worthwhile, though… think I had a nightmare about it last night… anyways.  My biggest problem is that I still have that Asian self-deprecating thing going… way too much self-qualification and talking about my weaknesses… I think I explained things well enough, but very dangerous to be balancing modesty with appearing unsure of myself.

 

Pretty close to sending out my residency app’s… definitely within a week… just will give me essay one more look + write up some CA and program-specific ones…

 

Two more swing shifts, and I’m done.

 

 

September 15, 2004

 

Update:

The kid died.  All three of us med students that were on during that shift have had dreams about it since…  Kind of a trial by fire thing, I suppose.  Kind of crazy.  Something totally out of ‘ER’.  Took me about a day or so to really calm down from seeing all that.  Now I have a really interesting topic for our student ‘grand rounds’ tomorrow.

 

 

September 14, 2004

 

Rough Day (Why I’m glad that I drink now):

Watch for this making national news.  Yesterday the assault gun ban lifted.  Although it’s likely a coincidence, it’s a good news story.  The second link is SF Chronicle which is a bit more descriptive than the Oakland Tribune…

 

Around 500pm, a trauma was wheeled in through the ER doors… some random deaf guy who crashed his motorcycle… nothing too severe, but me + a couple nurses were the only ones there for a good half-minute+… so, I went ahead and started a large-bore IV… pretty satisfying actually, since I’d been screwing up IVs endlessly since I’ve been at Highland… an ER doc came in to run the trauma and the trauma team dropped in shortly after…

 

Feeling pretty self-satisfied, I was going to continue working on a guy who had a deep cut on his leg from a circ saw, when the ER doors burst open, I hear shouts of “Shooting in the hallway!  Shooting in the hallway!,” and some dude is running in with a kid in his arms with a mangled arm… someone yells, “Four more coming!”… Doc JG (of whom I respect infinitely more now) yells, “Secure the doors!  We need officers at the entry!” and starts directing people to set up 5 trauma rooms (there’s actually only two)… With the kid being swamped by the trauma team, and the second trauma room filling quickly, I throw on some gloves and head to the fifth trauma room… I remember seeing JN (med student) just arriving looking at me, and I just said “Glove up” while heading to my trauma room.

 

We didn’t know what was coming in.  There was only the resident, 1-2 nurses, and me at first.  Fresh off my successful IV stick, I figured I could start a line… A bloody gurney burst through the doors of the room with I can’t remember how many people on it… doing chest compressions… bagging the woman… I took one look at the arm, totally pulseless and pale, and in despair didn’t even get past opening the IV needle… figured I’d only get in the way if I were mucking up the IV when a much more experienced RN could do the job.  So, I ran to the other side of the gurney and took over chest compressions for the triage nurse who was breathing pretty heavily at this point… I don’t have any idea how much time passed… the resident intubated her… some surgery residents finally arrived (I heard later that they called for ALL house officers to the ER.  Even our ED chair on the 7th floor came down to run one of the traumas)… these guys and one of the ER attendings had a real hard time getting any IV lines on her… one was getting ready to crack open the chest when one of the trauma attendings called it.  She was just totally pulseless and down for who knows how long before getting to the ER.

 

We covered her and wheeled the gurney to a secluded hallway in the ER (we needed the space for any more that were coming in).  I went back into the 3rd and 4th trauma rooms to see if they needed any more hands… by this time, there were plenty of people around, and I wasn’t going to be of any use, so spent the next 10 minutes catching my breath, and changing out of my bloody scrubs…

 

What I found out later was that it was a gang shooting.  A target was driving in a car with a bunch of relatives (five total) when there was a drive-by with semi-automatic weapons.  Apparently, one of the medicine interns took a look and said the car was totally riddled with bullets… like out of a movie… The driver was unscathed enough to book it to where he knew to go – the Highland ER.  Unfortunately for them (fortunately for us, it would have been a total disaster if he crashed through the hospital lobby), it was the old ER.  He crashed through the barrier and made this frantic rush of triage nurses running to get the shooting victims and running them back to the new ER.  There was another shooting only 1-2 hours later… but fortunately for us, they diverted most of the victims to other hospitals…  The kid was still alive last I heard, but lost his arm and leg.  The woman I worked on was the only death of the five that came.  I don’t know the other three… all the information gets kind of mixed up…

 

I went with the residents out for a drink after our shift.  We actually didn’t talk about it for too long, but it was really nice to get a drink, commiserate a bit, and then laugh about other stuff…

 

I have a really hard time with kids… kids that are really f***ed up…  I ended up weeping one night in Peru after seeing a 6-month-old that was probably blinded and MR for life after an infection that could have been prevented with the simplest of health care… The kid that rolled in last night was tough… I’m kind of glad that I wasn’t able to help out on him… it was pretty disturbing… although the woman I worked on was only like 18 or 19…

 

I also have the day off… I slept in (I think I deserve it)… and just have to do some work and then heading to the city to meet up with LH who I haven’t talked to in like 4 years…

 

 

September 13, 2004

 

Busy:

Distracted by work and my residency applications… it’s kind of irritating when every couple weeks another literate friend tells me that my personal statement blows (in a friendlier tone, usually)… anyways, I’m sending it out by the end of this week, regardless, + one letter of recommendation… then, just have to work on gathering the four other letters of rec, and take my Step II exam in late November… wait for interviews to accumulate and arrange my interview trips in dec/jan

 

I’m having semi-informal residency interviews at Highland on Thurs and USC/LAC on Monday.  Pray for me.  I haven’t interviewed for anything in years, so I’m going to be quite nervous… I’ve got to be friendly-confident-Derrick instead of introverted-self-depricating-Derrick… ugg. 

 

Say No to Pediatricians:

Went to a shin-dig that one of the 2nd year residents had at her place this past weekend… there were a bunch of Children’s pediatric residents there… it quickly segregated into Highland ER and Children’s groups… it was awkward enough for me to barely know the handful of residents (and being the only student there for a couple hours), but trying sustain conversation with these pediatricians was torture… I’ve decided that if I am, in any possible way (age, level of education, etc) below a female pediatrician, I automatically become “kid brother”… pretty annoying… oh well, had some good conversation with the Highland folks and random person from South Pas… and practice trying to meet random people…

 

Want to Play:

Getting kind of tired from the rotation.  Not that it’s been particularly difficult… the 8-hour shifts are much much easier than those 12-hour ones at LAC.  Just losing the enthusiasm… seems like the other students I’ve talked to feel the same way… I just want to… plllaaaaaaaaaayyy!!!!  Get my half-week off next week… only counts as half a week because I have that interview, gotta fly back to Toledo and run tons of errands to get my apt functioning again… but, get to bother my SoCal buddies one last time before Jan.  ah, so sad.  These two months have passed so quickly…

 

 

September 6, 2004

 

Catching up… not on sleep:

Last week has thrown me off a bit… I got 10 hours Saturday night… took a 2-hour nap Sunday afternoon.  Now I’m up at 430am in the morning after only sleeping 4 hours  weird.  I hope I can get at least two more hours of sleep this morning before I head back to Oakland for my swing shift this afternoon.  After thinking about it, I was up for 30 hours straight from Friday afternoon to Saturday night… I was nodding a little while doing some work on my residency applications on Saturday, but other than that, this was the longest span of wakefulness I’ve ever had… crazy.

 

Anyways, been able to hang out with more people I haven’t seen in a long time.  Some of my friends have had ridiculously difficult years this past year...  really unbelievable stuff… I try to thank God every time I hear about those things that I’ve been able to have a pretty “uneventful” last couple years…

 

New Job:

My friend KW just asked me to be his best man in Feb.  Lord have mercy.  Kind of dreading the work ahead, but I’m glad to do it (I think)…  Actually, this works out perfectly.  I’m planning to be in San Diego Jan-Feb doing chill rotations and staying warm somewhere not-Midwest.  And, actually, if I had forgone my MPH/year off (or going even further back, not gone to MCO), and been an intern right now, I wouldn’t have been able to help him out (and they’ll need help with a short engagement) nearly to the extent that I will be now as a 4th year med student killing time until Match Day.  Honestly, I still don’t totally, truly buy into the idea that God has been in control of the events of my life over the past 5 years, but the evidence is accumulating…

 

Cars:

Looked online with a buddy trying to figure out what kind of car I want when I get out of med school.  He really sold me on the Volvo S40 – it’s a great looking car… and the turbo is really really fast.  Being a Volvo also gives it a bit of name-recognition subtlety that I appreciate, as opposed to like BMW (although I wouldn’t mind a 3-series, but the M3 is kind of out of my price range).  I really like the Audi A4, but it’s really underpowered compared to other similar cars.  The Turbo Mini is actually a definite possibility if I move to NYC or Bostonotherwise, the un-utility of the car is kind of a problem for a first car.  The SLK is definitely do-able as maybe a mid-thirties-I-finally-have-a-REAL-paycheck toy.  The Nissans have good specs, but kind of ugly or, at best, unimpressive.  I’ll probably give the Acura TSX and TL a good look.  Infiniti has a nice looking car.  I’ll probably check out the WRX, although it’s a bit lacking in the comfort area.  I don’t think I’m a coupe type of guy… like a TT or Z… but I’m willing to give it a try…  =)  I’ve spent much too long living practically…

 

I decided a long time ago, that to be totally happy with my cars, I think I need about 7…

1)  Commuter Car – a hybrid… gotta be eco-friendly.

2)  Fun Car – My big toy.  Something fun enough, but I don’t need a monster (eg Porsche or NSX, although those would be fun).  Something I can take to the track and beat up… could be anything like a Turbo Mini or Lancer or WRX or M3…

3)  Going-Out Car – for fancy nights out with my wifey.  Some sort of nice sedan, like a Mercedes.

4)  Roadster – for those week-long jaunts down PCH or in the fall in New England.  SLK, no question.  It’s gorgeous.

5)  Trip Car – for trips to Tahoe or camping or whatever.  4wd Volvo or Audi turbo wagon.  I don’t like SUVs or minivans.  And those turbo wagons are super fast.  I can take on Asian punks in their rice rockets with any of those wagons, fully loaded with skis AND the entire family.  Ha ha

6)  Dumpy Car – Kind of a back-up commuter car.  Definitely for my kid(s) when he/she’s in high school.  Probably whatever my first car ends up being or a civic.

7)  Wifey Car – My wife gets ONE.  =)  Considering the disproportionate amount of driving I’ll be doing, I think that’s appropriate.  =)

 

 

September 4, 2004

 

Feeling a Bit Better:

My shift last night went rather smoothly compared to the rest of the week… in fact, after asking the attending physician for any comments or suggestions, she didn’t have anything in particular to offer… =)

 

Got to hang out with my coz from Cal and watch the England-Austria match.  Typical England – gets out to a lead, and then plays sloppy and blows it…  But, it was fun, although a smaller and more subdued crowd than the Euro 2004 or opening weekend matches I’ve watched.  Still amusing to listen to Brits curse at their team.  =)

 

I’m pretty pooped, but don’t dare take a nap until after dinner… I’m coming up on 24-hours of wakefulness right now… oy…

 

 

September 3, 2004

 

Taste of ER Burnout:

Having a rough week.  I like the night shifts in general – nice feeling of independence, but… Feeling generally incompetent and useless… just missing really no-brainer things on my patient work-ups… feeling really careless… too many stupid mistakes… plus, I’m getting stuck with these complicated lacerations that eat away at least half of my shift… frustrating when I feel like I really need to work on my patient management more than suturing!... found myself hating my patients last night – I was in a pissy mood, and my two patients were these losers… one idiot who got cut by a machete, who knows how because he was totally plowed the entire night… and then some washed-out drug abuser who came in complaining of back pain, but of course the back pain wasn’t bad enough that he wasn’t falling asleep every 5 seconds – a big f***in waste of time…

 

I need a mental break… really need to get on my knees and pray before my shift tonight…

 

At least I get the weekend off… can get into a regular sleeping pattern again.  Actually taking my cousin from Cal to watch the England-Austria World Cup prelim match at Britannia Arms in Cupertino, meet up with my bro and sis-in-law for dinner, and then my once-a-year meeting up with AC on Sunday.

 

 

September 1, 2004

 

Dirtbags:

Was threatened by a patient for the first time last night.  What a dirtbag.  Dude had a Boxer’s fracture (ie broken bone in your hand because you punch like a pussy)… was pissed because the ortho clinic he went to in the morning couldn’t see him today, so he takes off his splint (bad move) and ends up in our ED basically demanding immediate treatment and pain meds.  I was trying to examine his hand when he flinched and said something to the effect of “I might strike you if you try to hurt me.”  Right.  Nice.  So, my resident actually gets to the point where he’s offering to set him up with an appointment at our ortho clinic and vicodin.  And he decides to take off.  He also decides to take with him the nurse’s charting and when the nurse asks for them back he rips them up.  Nice.  I think that deserves a time-out in the corner.  Oh yeah, and he had his 5-year-old son with him the whole time.

 

I had been at LA County for 4 weeks and never had a single belligerent patient… about a week in Oakland and…

 

Otherwise:

Still not totally on the ball with my complicated patients… ugg.  I feel like I’m really lagging…

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