Tigers Watch
Tigers lose
tonight 5-4 to Minnesota. Fighting fate, the Tigers ran off 3
straight wins (after 10 straight losses) to keep their hopes alive to avoid
becoming the absolutely worst team in baseball history. With two
games to go, Tragic Number (to tie record) = 1; Tragic Number (to
be the worst ever) = 2.
Tim Howard Update: How's the young American faring across the pond as the starting goalkeep for Manchester U?
Women's
World Cup Update: US women 2-0 heading into their last game of
the prelims...
So, I finished Pediatrics today. Glad it's over with. 6 weeks goes pretty fast... too fast when you're working and studying for a comprehensive test at the same time. Plus, living the midweek in Detroit got tiring after a while...
Final thoughts about Pediatrics:
I enjoyed it a lot.
My attendings were quite a bit of fun to work with... my last four at the
Henry Ford outpatient clinic were all women, and it essentially felt like
working with four moms/big sisters... so, I played the part by asking if
I could do invasive procedures on kids with benign stuff like rashes and
pretending to whine when they wouldn't let me, so by the end I got them
to virtually scold me, like, "No Derrick, no intubating!" ha ha
I liked the NICU the best. Real difficult and complicated patients,
real life/death/permanent-disability stakes. Never did get to do
an umbilitcal line, although I booked it down 10 floors and across the
entire length of the hospital to get to several deliveries only to find
out that the newborns were perfectly healthy... How inconsiderate!
ha ha Finally, as I'm sure I've mentioned several times, I like talking
with kids more than adults... quite a bit more entertaining... and easier
to ignore when they're annoying. ha ha
Overall, I appreciate the place of Pediatrics (like Family Med) in primary care. But, I don't want any part of it. ha ha Just dealing with neurotic, controlling parents... doing well-visits all day long... beating a horse after it's dead with apathetic, unhappy teenagers about stuff like, "Use condoms. STD's are very bad."... just don't want to do that stuff all the time... all of my life... And, going through a Peds residency (3 years) and doing all of that stuff, just to get into something I kind of like (NICU), just isn't worth it...
So, I still dig Emergency Med...
Deep thought of the day:
I'm being pulled overseas...
Okay, I admit that I'm an
idiot... I actually dug the overdramatized and simplistic portrayal of
medical missions in subsaharan Africa in ER. I really thought
that doing surgery by generator light while mortar shells were exploding
all around was pretty cool. ha ha
I've always known that short term medical missions will be part of my future, but I think I've recently gained additional insight into why. This past thursday, I learned that my chief attending at Henry Ford's Peds clinic was a teenager during the revolution in Iran... in her words, "Oh it wasn't that bad. It got worse after I left..." ha! "not that bad" That's an understatement if I ever heard one... oh yeah, as if the revolution in Iran wasn't one the most significant socio-political upheavals in the later 20th century... That totally blows my mind, that she was there! she, risking her life, participated in protests! Amazing... I realize that I'm surrounded by people who have lived through and survived some of the most trying experiences imaginable... my attending... my dad and the Communist revolution in China... some of my friends have parents who were in the US internment camps during WWII...
When I think about these people and their experiences... when I contemplate medical missions in destitute areas of the world... I think I feel incomplete... not sure if that's the right word... but, taking Africa, for example. We are witnessing, arguably, one of the greatest human tragedies in history... the utter personal-social-political-cultural devastation of an entire continent. And, here I am, sitting... reading my newspapers... watching my BBC World News... all, as a passive observer. I feel this incredible compelling pull... this need... this absolute necessity in my heart, soul, and mind... to participate, to witness, to somehow try to positively affect these events. There is like a giant wave of history that is moving, and I want to be a part of it, rather than watch it pass me by. When my children ask me about what Africa was like as AIDS progressively tore apart hundreds of millions of people, thousands of cultures, dozens of countries... I would like to be able to say, yes, I saw the suffering, yes, I tried to help, yes, I can tell you the names and faces and stories of some of those people... And, so without those experiences, I guess, in this sense, I feel incomplete...
There's quite a lot I would love doing besides medical missions, like join up with Army Reserve to get an inside track into a DMAT team... so when something like Isabel hits when I'm a physician, I'll be one of the first ones there trying to help those communities... I think that's pretty cool: getting a call/page and within several hours, dropping everything, packing a duffel bag, jumping onto a loaded C-130 transport plane and heading out to a disaster area... or another possibility would be like Doctors Without Borders to get into the political activism part of all of this...
Well, this is all pretty
idealistic (almost to a nauseating degree) and at least several years into
the future, so we'll see how it all pans out... I think I'd better start
praying that my future wifey will be a strong support (or even coworker!)
of these God-established leadings of my heart.
September 20, 2003
Congratulations MAC Conference
for kicking the a** of top 25 teams this weekend.
Marshall (WV) beats Kansas
State (6) -- 27-20
University of Toledo beats
University of Pittsburgh (9) -- 35-31
N. Illinois beats Alabama
(21) -- 19-16
Miami (OH) beats Colorado
St. -- 41-21
Bowling Green (beat Purdue
(25) two weeks ago) loses, but should have beat Ohio St. (5) --
17-24
TIGERS WATCH
Tragic Number: 3 more
losses to go...
September 19, 2003
Sorry to those who tried to email me with the form on the "Contact Me" page... I didn't realize, until today, that IE 6.0+ doesn't support the "mailto:" command anymore... so, I'll work on it after my exam this coming Friday...
TIGERS WATCH
The Detroit
Tigers must win 5 of their last 10 games to avoid becoming the worst
baseball team IN HISTORY.
Tonight's
game: Tigers (Bonderman; 6-18, 5.49 ERA) at the Twins (Milton;
0-0, 3.60 ERA)
Mike Maroth became
the first pitcher to lose 21 games in 29 years.
I had one of the best meals I've had in the last several months yesterday. I found a hole-in-the-wall Korean place while I was in Sterling Heights, MI and had some bibim bap... and man, it was the best... I mean, I've had better bibim bap before, but just the whole experience... a hole-in-the-wall run by some Korean mom and grandma... the metal bowls... being mistaken as Korean... all stuff I miss from being in CA... it was nice... just being able to chow down good, simple Korean food, and enjoy the nostalgia...
Diagnosis of the week:
Wimpy White Boy Syndrome.
Apparently, if you had a
choice of ethnic background to be a premature baby, don't be a white boy...
according to the NICU nurses, they seem to go down the toilet pretty easily...
on the other hand, black girls tend to survive pretty heartily...
Temporary Roommate Update:
I've had it.
He decided to play "show-and-tell"
again this week. Monday I worked 700am-600pm, and after grabbing
dinner and studying a bit, I returned to the apartment around 800pm pretty
much ready to read and relax the rest of the night... Once again,
as I entered the bedroom to change, my roommate, who again had been off
work for 4-6 hours before me, sez, "Oh yeah, Derrick, I totally forgot...
I had a little problem with the toilet earlier... I tried flushing it a
couple times, but... I must have... Hirshsprung's disease... hehehe"
(an inaccurate and unamusing joke)... He then proceeds to try to
flush the toilet... and only after the water (and unknown quantities of
his fecal bacteria) starts flowing out of the toilet does he exclaim, "oh
shoot!" and runs to the kitchen, while tracking toilet water through the
apartment with his shoes, to get paper towels... At this point, I was quite
unhappy, and said, "Okay, I'll be back when it's all fixed." and left for
a couple hours.
I give up. I can't stand how freakin' lazy this guy is! Or how he somehow can't think on his own... I swear his wife must wear the pants in the family 'cause I don't see how anything would get done if he were calling all the shots... Am I expecting too much? That if you make a mess, you'd be responsible enough to clean it up? Now he just irritates me... how he sloshes on his aftershave so the entire apartment smells of it... how he tries to make small-talk at 600am in the morning when I just wake up even though we've established that I don't talk in the mornings... and just what a stick in the mud he is in general -- we were waiting for our rotation director to get back from a meeting doing some practice questions, and there he was complaining about how he hadn't eaten anything all day. Despite my persistent encouragement, assurance that our meeting with the director was informal, and reiteration that we had an hour to wait, he couldn't go ACROSS THE STREET and get some food.
Thank goodness my Pediatrics rotation in Detoit is over next week.
NICU: So I really
liked it. Really critical, complicated patients. The unit was
run by one physician and several nurse practitioners. They were actually
going to let me do an umbilical line if there was a preemie who needed
one. As things panned out, all, except for one, of the deliveries
that week while I was working produced perfectly healthy kids. One
potential moral problem that I did not run into was stupid parents... all
the preemies that I knew about had good parents who just ran into some
medical problems during the pregnancy and had to delivery early.
No crack kids that I knew of. Another potentially emotionally disturbing
event was missed -- I picked up a 22-weeker (yup, not even third trimester)
on Monday, but she died several hours after I got off work, so I was not
present to witness the resussitation effort. Oh yeah, my two kids
were quite stable through the end of the week. Appears that they
will both do well.
September 12, 2003
So, I arranged to stay on at the NICU next week, instead of going to the outpatient clinic at Henry Ford, to follow the management of my two preemie's... I'll be able to check up on my 1-week old (26 wks gestation) and my 2-week old (32 weeks gestation) Sunday night. Hopefully the 26-weeker made it through the weekend... she was doing pretty well through two days... My 32-weeker is totally crazy... Her psychosis is almost endearing... She's always screamin' and shakin'... well... at least until she eats or goes to sleep... kind of sounds like some people I knew in college. ha ha
Book Review: American Gods, Neil Gaiman (Hugo and Nebula Awards 2002)
As mentioned before, the basic premise of the book is: What happened to all the mythology, folklore, and religion of all the cultures that were brought into America through exploration and immigration? What if all those 'gods' were living and trying to survive in the US today?
As expected, through the book, Gaiman makes a few statements about place of religion in our society. One, that in the US, 'traditional' gods are being replaced by 'new' gods of technology, media, etc. Another appears to be that the extent of the power of religion, mythology, and folklore is only that which man imparts to it. He's got some thoughtful opinions about the subject, some original, so not as original, but all presented in a pretty novel manner. There's still some parts of the book that I need to re-read to try to sort out some of what happened. Actually, I still haven't figured out who or what Shadow is... or what he symbolizes. There's a pretty odd episode at the end of the book and... um... hopefully, the mystery reviewer I'm reading these books with will have some ideas...
Existentialism seems to be the strongest theme of the book. Repeatedly, Gaiman appears to feature episodes where in the absence of religious truth or purpose, the most valuable and worthy aspect of a character's life is not the end of their choices/actions, but rather, the choice/action itself. Of course, this could all change once I figure out what Shadow is, but that's my observation right now...
Overall, the book was a good read. It's fairly thought provoking and accessible at the same time. It'd be pretty easy to make the prose on this subject pretty trite and silly. Gaiman pulls it off pretty well. I found the generally irreverent attitude of the main character Shadow pretty amusing. Some pretty disturbing images, though. But, in all, the book was pretty enjoyable.
Thoughts from Pediatrics:
1) Circumcision is kind of a curious cultural ritual. Assuming that you'd wash your kid once every couple years, there's absolutely no medical indication for it. In fact, it's arguable that there's medical indications against circumcision: 1) inflicting pain on the infant, 2) removing erogenous tissue, thereby significantly reducing the male's sexual stimulation potential. So, the argument is fundamentally between minimizing physical harm vs. potential social difficulty. The physical harm of male circumcision is certainly not of the brutality of female circumcision, but it still begs the question: How much physical pain and disfigurement is social acceptance worth?... when considering the objective benefits and harms of circumcision, it seems a bit odd that it would be so prevalent in our contemporary culture and society.
2) I've decided that
there's basically two types of pediatricians: calm and gentle, and
frazzled and neurotic. Gee, that doesn't remind you of any mothers
you know, does it? ha ha
September 10, 2003
Just picked up a new pt yesterday -- a 1 day old preemie, born at 26 weekks... I just arranged with the rotation director to stay at the NICU next week to follow the management of this kid. Day 1 went okay. She's pretty stable, but tomorrow and over the weekend (which, unfortunately, I won't be in detroit for) may get hairy... just waiting to see when and how bad she's going to crash on us...
September 4, 2003
Why I like Pediatrics:
1) Kids are easier
to put up with than adults. See previous entries. But, basically,
a lot of kids a pretty fun to mess with. In addition to that, if
they're brats or screamers or whatever, you can just kind of ignore their
behavior (in contrast to adults whom you might offend, whether or not they
deserve it) or just pass it off as due to their teenage angst.
2) Kids are hard to
blame. Unlike adults, they are extremely susceptible to their physical,
economic, and social environment. Unlike adults, they lack the ability
to reason and freedom to act independently for a while. Thus, unlike
adults, I can't attribute blame to them, and despise how pitiful they are
and what a drag they are on my practice.
3) Kids are often
pretty darn helpless (see #2). I find myself drawn to the most critical
situations... probably one reason I'll end up an emergency doc. And,
the stakes and difficulty and pressure are pretty high in pediatric emergencies
or critical care. For whatever reason, in those circumstances, I
want to be there. Partly because I like the challenge. Partly
because I feel like I've got the personality and ability to function well
in those situations. Partly because I want to be able to make a real,
tangible difference in patient care... and not some vague, theoretical
impact like, "great job! we've got your blood sugar consistently
under 140 for the last six months. and wow, your HA1C looks great!"
or some bull-crap like that.
4) Kids have hope.
Unlike adults, there's a substantial measure of thoughts like, "hey, this
kid has a chance to have a good life." I like being in a mentoring
position... that somehow, maybe, possibly, some kid might actually look
up to me or something and change their life in a positive manner because
of that.
5) "It's because they're
cute." Dr. Zahir's universal answer to, "Why do pediatric patients
differ from adults in [insert condition]?"
So, in the end, this has no effect on my career choice. ha ha I can get all this in EM. And, I hate primary care, anyways. And, though you could argue againts #4 in EM, I can do that anyways in whatever church or university I end up at eventually...
Next week: NICU
August 29, 2003
Hey, the IRB finally passed my research proposal. Great. it only took them FOUR months!!!!
Current Rotation: Pediatrics
through Henry Ford
Medical Center, Detroit. Starting at NICU/Nursery next week.
Best thing about this
rotation: the neat thing about kids is that even if they totally
hate you or completely apathetic, it seems a bit easier to put up with
than adults of the same demeanor... maybe that's just 'cause I haven't
had any really bad screamers yet...
Worst thing about this
rotation: too much outpatient stuff. Of the 6 weeks, 4
are outpatient... feel like I'm not getting experience with what seems
to be an essential part of pediatrics. But, then, talking to students
in Toledo, their experience isn't much better.
Current Attending MD:
Pollack, Rodrigues, Matra, Soliven, Raman
Am I ambitious or just
a big retard?: spending my Labor Day, which would otherwise be
a day off, in a Pediatric
ER (Henry Ford Fairlane) because I wanted to shadow a pediatric emergency
doc to see what that was like.
How I know I'm in med
school: realized how poor I am recently -- from all that traveling
last year, all my car problems, etc etc... I'm on a self-imposed
spending-freeze: no new CDs, DVDs, leisure books, dining room table,
clothes... so sad so sad...
Biggest gripe: Since
I went to that soccer match in England, I've been following the Fulham
club and man... could they be taking it up the butt any more? First
they've had money problems and aren't even playing in their own stadium
(due to delayed rennovation)... next, they let go of their top defender
(Finnan) during the off-season. Now, one of their top midfielders
(Sean Davis) decided he didn't want to play for them and then a couple
$8 million transfers fell through 'cause he failed physicals, their #2
striker (Marlet) left for a French club 'cause he decided he didn't want
to stick around, and Manchester City scooped up Claudio Reyna (US national
team captain) even though Fulham had come to a verbal agreement with him...
Actually, my gripe is that my fantasy football team really stinks because
of the stupid autodraft thing, while my friends who could do the draft
manually (ie weren't working at the time) have some pretty stocked rosters...
at least I wasn't the only person to get screwed.
Best thing to happen
to me recently: see ego-inflater below (Aug 26)
Next meaningful leisure
activity: Cedar Point in a couple
weeks? Still like Magic
Mountain better, but CP's got some pretty cool rides...
Current books I'm reading:
American Gods (Hugo and Nebula Awards 2002)
My opinion:
Still chuggin' along. The little vignettes of the experiences of
'gods' in various points of N. American history are pretty neat...
Deepest thought recently:
I'm on the verge of figuring out why I like Pediatrics... I don't think
I'd do general pediatrics for the same reasons that I don't like family
med... but... there's something about taking care of kids that I like...
so maybe NICU/PICU or Emergency pediatrics? dunno, just trying to
keep my mind open...
Political thought of
the day: In Detroit, I don't have TV and can't get access to
the Internet regularly, so I barely know what's going on... although it
has been pretty hard to miss all the talk and pics of the Madonna-Britney
kiss at the MTV VMA's... okay, so Britney is obviously a hottie.
But, was that really necessary? seems to me she's really reaching
for publicity if she needs to try to be really outrageous to get attention.
Christina is just a supa-freak.
August 28, 2003
Toledo, OH makes the news.
Golfer Phil
Michelson is trying out for the Toledo Mud Hens (Detroit Tigers' AAA
Baseball team). I don't think I like what that says about Toledo....
oh boy....
August 26, 2003
So I had dinner with a friend from school this past weekend. I had been a bit lazy and had about four days' worth of facial hair... she told me that the scruffy-look was "very becoming"... aaaawwww jeah! watch out ladi--... oh... wait... I'm still in the midwest... <sigh>
Okay, my roommate redeemed himself two days ago. He got up to Detroit several hours earlier than I did on Sunday night and vacuumed the apartment. That was cool. I'm glad he took the initiative to clean and that my first impression of him was wrong... or at least mostly so. ha ha
Our Pediatrics rotation breaks down like this: 2 weeks at Sterling Heights Medical Center (outpatient clinic in the wealthier northern suburbs of detroit), 2 weeks at the Henry Ford Medical Center outpatient clinic (in the ghetto), and 2 weeks of nursery/NICU at HFMC. I've been at Sterling Heights these first two weeks and it's been a bit of a mixed bag. Since the school year just started for most kids, I've been doing regular and sports physical exams like crazy... ugg... more days of wanting to throw myself out the window... the two redeeming qualities of this rotation so far are 1) some of the doc's are pretty good teachers and 2) kids are way more interesting to talk to than adults. My favorite thing to do is saying something outrageous like, "hey I can see all the way to the other side" while looking at a kid's ear, and then watching their absolute exasperation that I could be such a total retard. ha ha
American Gods has been an interesting read... I'm only to Chapter 7 or so... the premise is pretty interesting: that of all the folklore and mythologies of Europe, Africa, the Americas, East Asia, etc, none of them have seemed to survive the immigration to the United States. And, so this book is a fantastical story of these mythologies and their existance in the US.
An excerpt:
"'Says
he will see yolu in Kay-ro,' tokked the raven. Shadow wondered which
of Odin's ravens this was: Huginn or Muninn, Memory or Thought. .
. .
The raven
cawed from the edge of the clearing.
'You
want me to follow you?' asked Shadow. 'Or has Timmy fallen down another
well?' The bird cawed again, impatiently. Shadow started walking
toward it. It waited until he was close, then flapped heavily into
another tree, heading somewhat to the left of the way Shadow had originally
been going.
'Hey,'
said Shadow. 'Huginn or Muninn, or whoever you are.'
The bird
turned, head tipped, suspiciously, on one side, and it stared at him with
bright eyes.
'Say
'Nevermore,'' said Shadow.
'F***
you,' said the raven. It said nothing else as they went through the
woodland together.
"Someone who thinks logically is a nice
contrast to the real world."
August 20, 2003
Tonight I was reminded why I'm sick of having roommates. Me and another 3rd year are sharing an apartment on the campus of Henry Ford Medical Center. So I got off from work (a 1/2 hr drive from the campus) late at 730pm, grabbed a quick dinner, studied at Barnes & Noble for an hour and so didn't get back to the apartment until 930pm... upon my arrival, I find my roommate lounging in bed studying, and then he me a mess of dirt, debris, and maybe fecal pellets all around our bathroom with two holes near where the toilet attaches to the wall. Well, so after he describes how "dirty" our apartment is and how "maybe" we should call maintenance, it occurs to me that he's been at the apartment both during lunch and a good 4+ hours before I got back... did he bother cleaning it at all? no. did he bother calling maintenance? no. did he even try to figure out if maintenance exists? no. did he offer to do any of the aforementioned actions? no. Did he notice me wiping up the bathroom floor by hand? apparently not, since he jumped back in bed by the time I finished. I had to tell him straight out to call (or just talk to them -- they're working in the complex constantly) tomorrow since I'm not returning to the apartment at all after work while he'll be around the whole day (he's at the hospital right now).
how helpless can you be?! Keep in mind this guy is married. good god...
he also drives like an old lady.
Current Rotation: Pediatrics
through Henry Ford
Medical Center, Detroit. Sterling Heights Medical Center.
Best thing about this
rotation: a 4 month-old tried eating my stethoscope...
Worst thing about this
rotation: no free food yet.
Current Attending MD:
Pollack, Rodrigues, Matra, Soliven
My attending:
Dr.
Matra (in a South Indian accent): "So do you want this (tetanus)
shot?"
16 yo
pt: "No."
Dr. Matra:
"Too bad, you don't have a choice."
16 yo
pt: "Is the shot going to hurt?"
Dr. Matra:
"Of course it is."
How I know I'm in med
school: One of my jobs today while working with Dr. Matra was
to push her personal chair from room to room.
Biggest gripe: my
lazy roommate (see above)
Best thing to happen
to me recently: Found a good tie at Express for Men that matches
my chinos well.
Next meaningful leisure
activity: none
Current books I'm reading:
American Gods (Hugo and Nebula Awards 2002)
My opinion:
Um. really interested premise. I still don't understand what's
going on, though. Pretty weird book.
Deepest thought recently:
After a 10-hr work day, it's pretty tough getting motivated to study.
Political thought of
the day: If it worked for Minnesota.........
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August 17, 2003
So, this weekend I actually
had the time to watch a handful of movies...
S.W.A.T. -- pretty
much what I expected... campy lines, lots of cool shootout scenes, generally
predictable plot... hehe... pretty funny stuff (unintentionally)
sometimes though... come on, when the evil, international mafia guy keeps
on saying "One hon-dred, mil-lyon dollarz!" who isn't thinking about
Dr. Evil? ha ha ha
American Pie -- decided
I wanted to watch it again for the cheap laughs... forgot that it was actually
a decent and somewhat novel teen-flick... and that John Cho of Better
Luck Tomorrow was "the MILF guy"... ha ha!
Animatrix
-- highly recommended. I was prettty skeptical at first, but the animation
is top notch... there's a really enjoyable mix of styles... some very clever
visions and portrayals (I swear I can't spell anymore) of the Matrix...
the Jabowrski... jabby-dersky... jabba-babba-dabba... oh whatever... those
guys provided most of the original storylines and then the animators (some
of the current top Anime peeps) kind of did the rest... Until they
mentioned it on the DVD, I never made the connection that the Matrix has
a very Anime-feel to it... it really works well. American voice actors
(what little I heard) still stink. So, watch it with the Japanese
voice actors (lots of familiar Anime voices) and English subtitles...
Current Rotation: Pediatrics
at Henry Ford Medical
Center, Detroit