McBride's game-winner, Fulham 2 -- Tottenham 1

Toledo Music Venue Review:
Jackson's, 233 North Huron -- they have live jazz a couple nightss a week.  clean, classy place.  I don't feel quite as out of place as at Murphy's, although that's a great jazz club too.  good food

Movie Review:
The Debut -- watched the whole thing, and it picked up a lot.  Pretty solid Asian Am film, addresses cultural tensions in 2nd gen AAs.  It does it in a pretty upfront way, unlike the subtlety of Joy Luck Club.  Acting is pretty good.  One of the actresses was a regular on a soap.  Music is good.  The film actually features a number of FA musicians.  The dance 'battle' is a lot more believable than the one in She's All That and other teen flicks... just 'cause music and dance is so much more important to FA culture than white American culture.  The DVD is pretty neat, it includes the co-directors' film projects from undergrad, Loyola and Long Beach.
 

January 31, 2004

Went to rehearsal for the first time this year... missed the first rehearsal last week because I was on call that morning.  Anyways, this year, we're doing Berlioz's Messe Solennelle.  Fairly big change from last year's Mozart Mass in C Minor.  Whereas the Mozart was fairly simple.  The Berlioz is a pretty technically difficult piece.  Lots of cut time, dramatic tempo changes,... and the diction... good lord... this morning I regressed 25 years, singing 'da-da-da do-do-do' half of the time...  I think the piece will grow on me.  The first section, the Kyrie, starts very melodic and solemn, but slowly builds to an intense, passionate end with a lot of crisp, punctuated notes and phrases...  It's really powerful.  Kind of parallels some worship experiences I've had -- solemn meditation and reflection on the mercies and graces of God... and as those thoughts begin to permeate my mind and my heart slowly appreciates the magnitude of His blessings, my soul becomes stirred until my worship becomes whole-hearted and it feels as if my full being embraces this emotionally joyful response to my knowledge and understanding of Christ.

hmmm... hard to describe this stuff without sounding really artificial.  bleah.  oh well, puke if you must.  ha ha

Another interesting event.  Prayed with a patient for the first time yesterday.  A patient asked to pray with the doc b/f the operation, but since I knew she'd probably be under anesthesia before he arrived, I offered to pray with her, and she accepted the offer.  That's about it.  Pretty neat coincidence (?), though, considering I was just thinking about related issues just a couple days earlier.

So done with my hardest month of the year.  It wasn't too bad.  Wasn't hard working a 70-80 hour workweek.  It was hard having a life and having the mind to try to be proactive and excel during the rotation with that much work.  Last day my senior resident was trying to convince me that emergency medicine sucks and that my personality fits ENT (Ears-Nose-Throat) better... Nothing about EM I haven't heard before.  The ENT thing is new, and it's a field I think I'd enjoy, but it's not really a choice since my grades and scores don't measure up to what I'd need to get in.

Overall, a great month.  Had great residents, good attendings.  Wished I had more opportunities to work on my surgery skeels, but otherwise I think I learned a lot... pretty much quadrupled my suturing experience this past week.  Still like surgery a lot, although I don't think I have the calling to do it for my career.

Dude, trying to attach files to a email message, but it keeps on screwing up.  don't know why Yahoo mail is always so gimpy when I try this from my dial-up connection.  how annyoing.

Also, have I found a place for open gym volleyball in Toledo?  I earnestly tried looking for places over the last 3 years, never finding anything... but stumbled on this website while in pre-op killing time...I was thinking of checking it out last night, but I was really tired from work, was realy cold, and just wanted to chill at home eating a gyro and watching movies... man, if this place is decent and I can go regularly.......... Praise God!

Soccer News:
Brian McBride scores the game-winner in his Fulham debut

Movie Reviews:
1)  Swimming Pool -- didn't know much about this movie bbefore I watched other than it got good reviews and has a substantial amount of nudity in it.  It turned out to be a pretty neat drama.  Actually reminds me a bit of 25th Hour in terms of the progression of the reality/surreality.  Story progressed pretty cleanly, in contrast to some other mind-bending movies like Solaris or Vanilla Sky which seemed a bit ponderous at significant points.  Still can't completely figure out what happened at the end, although I think I've nearly got the idea.  Several pretty prevalent themes including voyeurism and sadism... lots of imagery and symbolism.  Pretty good stuff.
2)  The Debut --  This is what I started watchiing before getting bored and switching to Swimming Pool.  Recommended to me by MG, a Filipino American urology resident at MCO.  FA movie about second-generation, coming-of-age issues...  kind of a teen flick.  Acting is decent for the 20 minutes I watched... Couldn't figure out where in LA it's supposed to take place.  Think it would be more interesting if I were FA.  I'll finish watching it this weekend sometime.
 

January 28, 2004 (1900 EST)

Current temperature with wind chill = 1 degree F

Maybe it's too cold to be sick -- this week has been exceptionally light... I mean, I've had two days this workweek already where I've had a couple hours of free time in the day to catch up on reading and naps... I had two days in a row, sun-mon, where I had three meals a day... Sunday, I actually slept in until 930am.  Good lord, what's the world come to?  =)  madness, I tell you.

Sunday was nice.  slept in, got 10 hours of sleep.  spent a good hour playing guitar for the first time in months and months. took MT out to dinner for her b-day + several weeks.  But, even with a day off, I'm pretty pooped.  really lost a lot of my enthusiasm that I started this month with... just physically and mentally tired.  getting a bit lazy.  seen a lot of the break-and-butter vascular surgeries... without actually getting some practice myself, the novelty is getting a bit thinner...

I'm currently reading Don't Waste Your Life, John Piper, for my devotional times (Thanks, DC).  His book Desiring God has been the most influential inspirational book that I've read over my lifetime...   So far, only through chapter 3, so not too much that's new.  chapter 2 was something of a summary of a lot of his theses in Desiring God.  I think this book may be particularly appropriate at this time.  Recently, I've realized that I really have close no idea how to approach my profession as a Christian... how I view my work, study, interactions with colleagues and patients... I think it's been particularly striking this past month, when I've been so busy, I really don't have the chance to take moments to reflect... I mean, when my muscles are cramping from holding a leg up for like 15-20 minutes in an amputation surgery, I'm really not thinking, "Hmmmm, how do I glorify God as pain is searing through my arms... oh wait, no, my arms are just going numb..."... what I'm thinking is, "Damn this hurts."  So, realizing this, I really wonder how much of my mindset and actions are influenced by my Christian worldview... to what degree it's truly integrated into my life and manifests in my daily thoughts and work.

I dunno.
 

January 24, 2004
 

"If I went around saying I was king just because some watery tart threw a sword at me, they'd put me away!"
Peasant addressing King Arthur, Monty Python and the Quest for the Holy Grail

Current temperature (430pm EST) = 16 degree Fahrenheit
 

Back from my last night of call for this month.  Either it was a remarkably slow Friday night, or the two residents on call totally forgot about me... I got I think 7 hours of sleep last night after seeing my last patient around 900pm.  Actually more sleep than I get when I get to go home for the evening!  Although this month has been fairly managable, I'm pretty pooped.  I can't wait to sleep in tomorrow morning for the first time in two weeks... I think 12-13 hour days, 70-80 hour weeks, + not eating between breakfast at 500am and dinner at 700pm+ gets a bit wearisome... ugg, I think I need a nap before dinner... got to get some work done tonight, but it may be too painful to do it right now while I'm so tired... oy...
 

Amputation week:
Dude, I think I was in at least one amputation operation every day this week.  My job was usually to hold up the limb of interest as they sawed and cut away... it's a pretty brutal operation when I stop to think about it... so I don't... nor do I dwell on the smell of burnt flesh and bone...

Another anecdote showing why medical students are quite nearly useless:
There was an emergency operation for some guy who had a ruptured AAA (mortality 50%, of the half that survive 50% are significantly debilitated).  So I was scrubbed in and I suppose trying to help out.  Most of the time I was pretty much just taking up room at the OR table and getting in the scrub nurse's way.  My most useful contribution -- standing next to the attending physician so he could, every so often, using my shoulder to push his glasses back up his nose after they'd slid down a bit.  I have to say, he did do that FIVE times...  big time stuff, I'm telling ya'.  Oh yeah, I also got to cut open a chunk of colon they had to take out too.  yay.

Impressed:
I have to say, besides the cardiologists I was around in Columbus, I have never been around more confident MDs as these surgeons.  It's pretty infectious, actually.  That combined with the thoroughness of their training, their surgical skill, and general breadth and depth of knowledge, it's an attractive field.  If they didn't work like dogs for their entire lifetime, I'd be really tempted to go into surgery.

Why docs are being driven out of practice:
1)  Friend of one of my attendings is a general surgeon in Akron, OH.  His malpractice insurance cost of about $40k last year.  This year, it is about $150k.  To give you an idea of how ridiculous this is, the salary of most family physicians, general internists and pediatricians, and MY starting salary fresh out of residency are 10's of thousands of dollars less than that.
2)  Read about one of the more dramatic events, complete closure of the only trauma center in Las Vegas a year and a half ago.  One error on the link website, annual visits to the Las Vegas ER are 110,000+, not 11,000.
3)  West Virginia OB/GYN attempts to sue trial lawyers.

The Sharks don't suck anymore?
Can it really be?  That my hometown Sharks are leading the Pacific Division again?  That they have more points, except Detroit, Colorado, and Vancouver, than any other team in the Western Conference?

Soccer News:

1)  Fulham signs Brian McBride, US striker from the Columbus Crew
2)  Fulham signs Bocanegra, US defender from the Chicago Fire
3)  Hannover signs Clint Mathis
4)  Fulham, under severe pressure from both parties, loses top striker Louis Saha (third in the Premier League in scoring) to Man U, but profits about $15 million in return. How will they fare without him?  Saha says 'he's sorry.'

Movie Reviews:
1) How to Deal -- Saw this movie 'cause I think teen flicks are funny and Mandy Moore was good in A Walk to Remember.  This movie sucked.  In fact, the movie was about having a sucky life.  The whole movie was just Mandy Moore and her friends and family having one crisis after another... and Mandy Moore having some crazy mood swings and emotional meltdowns... and civic hatchback-vs-tree accidents where the driver and car escape unscathed, and only Mandy Moore gets hurt... and random dancing in hospital hallways... and by water reservoirs...
2) Down With Love -- Ewan McGregor and Renee Zellweger.&  I really liked this movie.  Chick-flick, but chick-flick doing a good job of mimicing and poking fun at 60's style romantic comedies.  By the way, I watched Breakfast at Tiffany's once and still don't quite get it...  anyways, DWL isn't an earth-stopping movie, but certainly an enjoyable one in its simplicity and charm.
 

January 17, 2004
 

How to Rub Your Stomach Up Against a Traffic Warden (From Monty Python):
"I've done it myself on numerous occasions.  Hold the newspapers in front of your stomach, until the traffic warden approaches the meter where you're crouching.  Then, as he draws level with you, fling the papers aside and spring up with a mighty yell and rub your stomach up against him.  Surprise is the essence of this method, and I personally don't recommend it if you have bladder trouble."

Dude... what duh frick just happened?
I got home around 1230pm today.  If you include the 1 hour of sleep I had last night, I worked 30 hours straight.  Impressive.  You'd be surprised how many "second-winds" you can get over a 30 hour period.  ha ha.  But man, I really need to set an alarm when I'm post call... I ate lunch, started reading on my futon and ended up passing out for like 4-5 hours... it's almost bedtime again.  Anyways, this isn't the worst I've had it.  When I was an EMT right after college, my company decided to squeeze every possible bit of work out of me before I left... my last two weeks I was working 100+ hours/week.  That was pain.  I have saturday off, except for an hour lecture at 900am.  Then, I work Sun-Sat with two nights of call (sun and fri).  Whee!

I still like vascular... it's been a great rotation.  The worst thing is that some really crazy ethico-legal sh-- is going down... it's looking pretty ugly.  actually not sure how things will shake out over the next week or so.  I'm just glad that I wasn't involved in either case... so I can just lay low and stay out of it...

But, as far as surgery... I actually could partially see myself doing it.  I enjoyed those painfully long surgical cases last night.  Even when I had a break early in the evening, I decided to DO WORK and see some of my patients.  Good lord.  I think there's still a part of me that is super-masochistic-nerd-boy... despite my years under the soothing San Diego sun, there's still a part of me that apparently likes to work like crazy and finds satisfaction in mental and physical pain.  I guess I feel that there's some sort of honor or pride involved... whatever.  I hope that goes away quick.  Just thinking of going through a surgery residency gives me a headache...

Recent OR conversation:
In the context of a discussion of cultural traditions, such as jewelry and dress
Dr. C:  "You know, Americans have their own cultural traditions..."
Anesthesiologist:  "Like prom night..."
Dr. C:  "... or pre-emptive strikes on Middle-Eastern countries..."
 

January 9, 2004 (2130 EST)

"Ultimate executive power derives from a mandate from the people, not strange women lying in pools distributing swords."
Peasant addressing King Arthur, Monty Python and the Quest for the Holy Grail
(I think I got it right, hard not mixing some of these things up)

When to take a bathroom break during LOTR (still worth reading)
 

Ugg.  I'm weak sauce.  I got home around 100pm after being post-call and running some errands.  I was sooo tired.  I tried to study... think I got 10 minutes in before passing out for about 1 hour when my alarm woke me up, and then I ended up passing out for another hour after that.  Now, I'm totally unmotivated to study.  I suppose I've at least been pretty productive today -- got a lot of bills paid, caught up on email, worked on my research project, did grocery shopping, picked up a package from UPS.......  probably going to pass out again in an hour or so... maybe I can practice my surgical knots a bit while chilling out to my new CDs... that seems brainless enough.

Surgery's been cool so far.  The attendings are pretty intense, but nice guys.  I got killed on anatomy questions during a fem-pop anastamosis.  I think the doc gave up on me after I got the first question, but was right out on the next two.  My two residents are very cool.  Schedule's not bad (see below).  I was expecting worse.  It's looking like I'm going to get a lot of quality OR time... hopefully I'll be capable of closing surgeries by the time I'm done with this month.  Probably the drawback of this service is that it's so busy that teaching time looks pretty sporadic.

Did I mention that I found out fourth-hand over winter break that my ex-gf of two years ago is engaged now?  This related to surgery... really.  =)  I've realized that I'm pretty glad, actually, that I'm not stuck on someone right now.  Man, I am so exhausted some days and feel so much pressure to spend my waking hours studying, it's nice to be able to concentrate on med school and chill in my apt with no other worries.  When Dr. C asked me if I was married and I answered that I was single, he said, "Cherish it."  ha ha

Come to think of it, hearing that my ex-gf got engaged was as much "fun" as doing my first foley cath a couple days ago...  For those of you who don't know, foley catheters are "placed" whenever pts are unconscious (eg surgery) so they can pee... so hearing that recent news was about as much "fun" as shoving a long, rubber tube into a guy's penis.  yay.   Although I have to say, the news wasn't as bad as being on the receiving end of a foley cath.  ha ha

Other recent, positive engagements are one of my roommates from soph year in college (ML) and one of my best friends (DC).  Weird.

Bad luck:  I don't understand what bad karma I've been dragging around.  Got my Medicine SHELF score back today.  Raw = 73.  Percentile = 49%.  I needed a percentile of 50% to get a High Pass for those three months.  What a crappy deal, missed a whole grade by one question.  geez.  My chances of getting back to CA are looking dimmer and dimmer... So, for all of you Christians out there, I'm nearly serious about getting you guys to start intervening for me via prayer.

Schedule (for non-med school people)
4:30am -- wake up
5:30-6:00am -- arrive at hospital depending on how long I lounge in bed, zone out in the shower, and red lights I hit on my commute
6:00-7:00ish -- see my 2-3 patients.  write progress notes.  help out residents if I happen to bump into them.
7:00-6:00pm+ -- a big hodge-podge.  Scrub into surgeries as 2nd assist.  Vascular surgeries last anywhere from 2-4 hours on average.  When not in surgery, round with residents and attendings on patients as time permits.  Do admissions in the ER.  Grab food whenever I have a break.
6:30pm+ -- get home, scarf down dinner, study for a couple hours
10:00-10:30pm -- pass out

Call schedule = q5 (overnight call every fifth night)
 

January 7, 2004

1)  I was second assist on an AAA repair today.  It was friggin' amazing.  Dude, I could palpate the pt's pulsating abdominal aorta and his spine after we opened him up.

2)  I'm cold.  Yesterday the high was 10.  With wind chill, the low was -18.  The doors of my car froze shut in the morning.  I had to defrost them with a bucket of warm water.

January 2, 2004

"For being a foreigner, Ashima is beginning to realize, is a sort of lifelong pregnancy -- a perpetual wait, a constant burden, a continuous feeling out of sorts.  It is an ongoing responsibility, a parenthesis in what had once been ordinary life, only to discover that that previous life has vanished, replaced by something more complicated and demanding."
The Namesake, Jhumpa Lahiri (2000 Pulitzer Prize winner)

"Sometimes he feels so small
he turns to alcohol
she doesn't like the taste
but then it's better than his face."
"Like No Other" Twister Tenderness Electronic

Post-Winter Break Update:
This may have been one of my best trips home that I can remember... Didn't really do much besides hang out in coffee shops or loitering in asian restaurants catching up with friends.  It was just so refreshing to spend a lot of quality time with my close friends in CA.  Many of you know that it's been a somewhat difficult period of living for me in Toledo -- besides BP, I really haven't met any people who I've been able to relate to well in terms of my Christian beliefs, cultural influences (CA and AsianAm), worldview, career ambitions, etc... Man, I miss being able to hang out with all of them.  I hope I can match in CA next year.

Christmas loot = Lots of popcorn (I don't get it either), "Arrogance" poster (www.despair.com), Monty Python desk calender, Electronic Twisted Tenderness, Club Monaco shirt, cash

Good motel run by really nice people = Kettle Motor Motel, Anaheim

Music Reviews
1)  Big PHAT Band -- saw a live gig at the Jazz Bakery (great venue) with a friend (of whom I will refer to as the Black Thumb from this point forward) while I was in LA.  Great, solid big band sound.  Impressive precision and crispness of their sound.  Props for supporting local band programs.
2)  Electronic Twister Tenderness -- third and last release before recent New Order album.  Increased influence from Johnny Marr.  I like the sound.  KW doesn't.  Bernard Sumner's lyrics continue to have their characteristic haunting melancholy.  As it has always been, it's still a bit difficult to follow Sumner's lyrics when he mixes up narrations and voices.  Like tracks 1, 6, 7 especially.

Movie Reviews
1)  LOTR -- The third movie was a disappointing, continued departure from the characters of the book.  I think two of the more grievious misrepresentations were Faramir and Merry.  I do give substantial credit to the film for bringing to life the sheer magnitude of the battle at Minas Tirith.  I didn't expect it, but when the riders of Rohan made their charge, I felt like jumping out of my seat.  Still don't think Liv Tyler is all that hot although it would be cool (or just weird) if you could talk in a perptual breathless whisper with reverb and effects...  the Black Thumb said one of her straight, guy friends remarked that Orlando Bloom was more beautiful than any of the women in LOTR.  Unfortunately, I think I agree.
2)  Peter Pan -- Saw it with my mum.  good moviie.  Entertaining, enjoyable.  Good child acting (as opposed to certain George Lucas movies).  MILF present.
3)  Master and Commander -- solid film.  Russell Crowe is one weird dude, but he's a darn good actor.  Although I'm not much of a pre-1900's Europe historian, it seems as if they did their homework as far as costume and casting.  Fascinating and complex relationship between the captain and ship's doctor.  Portrayed the moral and ethical dilemmas well.  Makes me interested in picking up the novel series if I ever have the time...

Fantasy Sports update:
Thanks to Pavel Datsyuk recently opening a can of whoop ass on the NHL, my Sportingnews.com hockey team hit the top 500 out of 22,500+ teams.  That put me in the top 0.25% or so... even if I can't keep this up, this redeems my awful fantasy football season.

Deep Thought:
So my biggest self-realization of the last several months is that I realize that I really don't like to share.  After having my lucid moment in columbus regarding being a bad roommate my sr. year roommate and corresponding with my two older brothers to a greater degree this past year, I've come to understand that I really don't have all that much experience or comfort with sharing space... belongings... my personal life... I trace some of these causes to growing up a virtual only child with my brothers being so much older than me.  I never really had to share a room with either of them.  Always had my own toys and stuff.  Never was forced to live with someone whose opinion or beliefs I would have conflicts with.  If I ever had a conflict of opinion with anyone in my family (eg parents), I could simply isolate myself in my room (which I often did) and that was the end of that.  Being an introvert certainly enforces some of these behavioral tendancies.  So, bottom line is I'm a pretty selfish guy that needs his personal space.  How bothersome.  The application is that I need to continue to try to be contiually self-aware and self-critical of my behaviors and I need to keep praying for my future wife that God may bless her with the gift of mercy as we will likely have to work through a lot of these issues.
 

Dates:  January 6 to...

Current Rotation:  Vascular Surgery, St. Vincent Mercy Medical Center, Toledo OH
I expect:  Pain for the next 8 weeks.