Studied with AL on Sunday after visiting his church Calvary Chapel, Toledo.  Had some good conversation about one of the things I'm struggling with at this point -- how to glorify God in my studying and work.  At specific times in college, I remember being acutely aware of my God-given purpose and calling to be a physician... and having a profound sense of dedication of and motivation towards my studies and work for the glorification/honoring of God.  But, sometime over the past five years, that deep sense/feeling kind of passed... not sure how I got it in the first place...  And, although I'm still fairly motivated by specific career objectives (good Emergency Med residency, preferably in CA), I feel like I lack some intrinsic drive towards those goals...  I suspect, part of it is in my loss of spiritual purpose in my studies/work.  The root issue for me is how to translate my knowledge of my purpose into a heart-felt understanding of that purpose.  Unfortunately, while offering some encouragement and anecdotes from his own experience, AL could not offer any specific, pragmatic suggestions.  Well, BP should be back from his Wilderness Med elective, so hopefully we'll get to start meeting regularly again, so I have another person to bounce these thoughts off of...

One more day of Surgery lectures.  Each month of surgery, we get to have 8 hours of lecture the first two days.  whee.  fortunately, to some extent, the surgeons take these lectures as lightly as we do... they are frequently late and often don't show... today we had two lectures in the AM cancelled, which actually made the whole day a bit more bearable.  =)   Starting my month of Emergency Med on Weds.

Most of my former classmates (now 4th years) are back in town since Match day is March 18th.  Kind of neat to see what people have been up to, although I'm kind of bummed that my buds are graduating and I'm stuck for another year... and even though I'm not going to be in toledo all that much 4th year, it'll mean there'll be even fewer of my peeps around to hang out with.  ah, so sad.

Music Review (a bit late on these, but...):
1) Retro Box Set, New Order -- Great set of 4 discs, each mixed by a different person.  "Pop" (hits), "Fan" (collection of other significant tunes), "Club" (remixes), "Live" (collection of live recordings spanning their entire career).  If I were to make a significant investment into getting introduced to New Order, this would be a solid start.  "Pop" and "Fan" cover the majority of New Order's most popular work.  These two discs easily beat out "The Best of..." and "International" compilations (of which I don't see a significant difference between).  "Club" is a good addition, if only because New Order was one of the pioneers in Modern Rock, and it's probably important to appreciate their impact on club/dance/techno music.  But, I do like "The Rest of..." remixes better.  "Live" may be the best live album out... Not that Bernard Sumner ever had the most pleasant singing voice, but their first live album sounded terrible and I never bothered buying it... I hear the new BBC sessions double-disc is terrible too.  The box set itself is attractive, although not the best packaging material they could have used.
2) Who We Are Instead, Jars of Clay -- Great album.  Their release from November 2003.  I'm continually impressed by Jars of Clay's development of their sound -- just that they were willing to expeeriment with their music with each album.  They compare well to my benchmark band U2 in that sense.  This is a great album as they 'return' to their regional country/bluegrass roots.  Definitely a young country sound... reminds me of Nickel Creek to some extent.  Distinctively Jars of Clay lyrics and song structure, but they seem to do a good job (you'd have to ask a real country/bluegrass expert to know for sure) of incorporating their style into the country/bluegrass genre.

Oh yeah, on a disappointing note.  I can't sing with the Monroe Street Methodist Church Concert Series this year -- the concert falls one of the days of the SAEM Western Regional Conference that I'm doing a poster presentation at.  Just no way to be able to get back to Toledo in time...  A bit bummed out, I was starting to really like the Berlioz piece, although it was pretty dang difficult...
 

February 26, 2004

"Dinsdale" sketch, Monty Python:
Interviewer:  Was there anything unusual about him?
Gloria:  I should say not.  Except, that Dinsdale was convinced that he was being watched by a giant hedgehog whom he referred to as 'Spiny Norman.'
Interviewer:  How big was Norman supposed to be?
Gloria:  Normally Spiny Norman was wont to be about twelve feet from snout to tail, but when Dinsdale was depressed Norman could be anything up to eight hundred yards long.
Gloria:  Latterly Dinsdale had become increasingly worried about Spiny Norman.  He had come to the conclusion that Norman slept in an airplane hangar at Luton Airport.
 

Last task of this month of surgery -- our Surgery OSCE (objective structured clinical exam.... or... outright silly clown exercise) this AM.  went fine.  was happy to get out and get back to my apt in time to get some stuff from the UPS dude.

Good news!  Mercy has driven the heart of the Medicine clerkship director.  As I mentioned before, I missed the High Pass cut-off on the SHELF exam by 1 question.  However, when I decided to check up on my evaluations from medicine, and I found that the director gave me a HIGH PASS!!!!  whoohoo!  I dunno if it was a mistake or he felt pity in the depths of his soul and conscience, but I don't care... I was getting pretty down about just getting pass grades 3rd year... finally!  something is going my way..... =)  isn't that a song?

My evaluations from cardiology were okay, but not too impressive -- consistently, the MDs wrote that I needed to read more... I'm not too surprised, considering that the first half of the month I wasted studying for my family med exam re-take... and being the first month of 'real' medicine, it was something of an adjustment...  surprisingly, my attending from my last month of medicine gave me high marks, for whatever reason... weird, I felt totally incompetent during that month.  as for surgery, I'm expecting good evals from my sr. resident last month... unsure what to expect of my attendings the last two months... I don't answer many questions right... and like I said, my enthusiasm was kind of tailing off the last couple weeks...  =(

Self-evaluation:  at this my point, my technical skills (suturing, knot-tying, etc) are servicable... 'good enough for military work' as one attending would say... I should get a lot of practice during ob/gyn later so I'm not worried about that.  Still not that comfortable with managing my own in-patients... I feel like I'm at the cusp of everything clicking... like if I had one more month of general surgery or medicine, it'd all come together (A-Team reference: 'I love it when plan comes together').  this coming month of Emergency will be good since I should be fairly independent as far as seeing, examining, and working up my own patients...

Surgery thoughts:  I don't think I'm cut out for surgery.  I love the surgeries -- the technical aspects of surgery, the hands-on stuff, and the on-the-fly decision-making... I get a rush when there's an emergent surgery and I've got to drop everything I'm doing and GO... the ruptured AAA last month was COOL... I've been really impressed with the level of intelligence and depth of knowledge of these surgeons... I really believe the majority of the most intelligent residents I've met thus far have been surgery.  I'll also say that some of the surgeons I've met, although usually pretty hard-nosed, are some of the most compassionate physicians I've encountered.......  But,... I just don't think I have the patience or meticulousness for the insane amount of detail that they have to be attentive to... and the work... I don't think I love it enough to go through the five years of general surgery residency and then the extra 1-3 for whatever subspecialty I would go into...  it's tough and I'm not sure that I could handle that and whatever social/personal life I'd have in the future... If I really felt a real calling to go into surgery, I would do it, but I just don't... at least not at this point...

Spiritual life:  Had a good 10-15 minutes of prayer the other night while running on the track at the YMCA in Bryan... don't get inspired often to spend that much continuous time in prayer, but it was solid.  Interceded for several people on my mind recently, and I hope they recognize God tangibly working in their lives.

The OC review:
This week:  The trials of having two women chase you at the same time (I toooootally relate. ha ha).  Luke scores again... and again... and again...
Best line:  "Wonder Woman has an invisible jet... not an invisible boyfriend."
My take:  Ryan is being an asshole for moving in on his friend's fiance.  Teresa is being a flakey bitch for ditching her fiance to get some action with Ryan.  It was easier to empathize with Marisa this week... wasn't as neurotic/psychotic...  Will Seth ever make up his mind?   (whoa -- Robotech min-mei flashback if you can follow that one)

Issue of the day: The Passion of Christ
Who cares?  I don't know why so many people are making such a big deal about it... if you don't want to see it, don't see it.  I know many Christians are pretty excited since few things with overtly Christian content matter make it to the mainstream... although I am a bit worried that a lot of Christians are blindly endorsing the film without actually having seen it.  I don't think, and I certainly hope, that evangelical atheists aren't making a fuss of this 'cause that's just dumb  --  there's no subversion of rights going on with a commercial product.  Violence -- give me a break.  There's more violent films out there.  I remember seeing Saving Private Ryan in the theater and being in complete emotional shock for the rest of the night.

The only possible issue would be the Anti-Semitism deal.  Although this is certainly a concern, I think it has to be moderated by the following points.  One, Jesus was a Jew (although he's unfortunately very white in this film).  Two, by the nature of the text, there isn't much depth to the character of the peripheral figures in the gospels.  Just not a major point for the writers of the gospels... as a result, they are a bit two-dimensional by nature.  Three, well, unfortunately, since those events did take place in a Jewish community, the subject of Christ's death will always be a bit touchy with respect to this issue.  However, I think this is a difficult issue to navigate since I'm not part of a racial/cultural group that has been maligned and hated for millenia...

Am I going to see it?  Probably not.  From the reviews I've read and listened to, I'm just not interested in seeing Jesus being brutalized for like 2 hours straight.  Could it be a useful meditation or rendition of the death and sacrifice of Christ?  Sure, but not for me.  Give me a solid hymn on the same subject matter and I'll be in tears.  I think the violence of this film (and some other cinematographic shortcomings mentioned by some reviewers) will just distract me... I think I have a pet peev with white Jesus's anyhow.
 

Feburary 22, 2004

Fantastic save!  Tim Howard, Manchester United

"Advise to goats:  All goats should avoid: 'The Holiday Homes For Pets Pie Co. Ltd.'"
Monty Python

"You've been really obnoxious recently... you're fired."
The Apprentice, Trump dumping the latest person off the show
 

Well, this will start my last week at Bryan.  It's been a good three weeks so far.  Pretty satisfied with the experience.  Really got to participate in a lot of the bread-and-butter procedures in general surgery (lap-chole, hernias, breast biopsies, colon resections, EGD and colonoscopies)... which is good for the exam and getting a good idea of what a potential career in general surgery could be like.

I'm just a bit stressed about my grades and how that will reflect on my residency applications.  I'm a bit worried since my 3rd year grades pretty much blow so far...  and don't really bode well for my applications... however, if I do extemely well on Surgery and my Step 2 exam next fall, I may be able to pull my application out of the gutter... it just comes down to motivation... will I relentlessly study, nearly-totally forsaking leisure for the next month and the month+ when I take Step 2.  Ugg.  It's been tough because even though I've worked my ass off (taking extra shifts/patients, trying to be proactive) it hasn't translated, at all, to my grades... pretty discouraging... and so overall, I'm getting a bit mentally fatigued from 3rd year...

The OC review:
I'm thinking that I may review the week's past OC episode since I have nothing better to think about during clinic.  ha ha
Last week:  Seth and Summer get laid, Luke scores with a mom, Ryan hangs out with his ex-gf while Marisa freaks out.
Best Line:  "Mrs. Cooper, you are an amazing girl... I mean, woman... I mean, lady..." -- Luke trying to score with Marisa's mom
My take:  One of my housemates in Bryan didn't like how Ryan was being aloof and blew off Marisa during the whole episode.  Although I don't agree with his way of handling Marisa's post-near-death-held-hostage-by-psychotic-suicidal-gun-wielding-friend freakish behavior, it's understandable.  Ryan had a somewhat rough series of episodes where he was obsessed with figuring out this Oliver guy, trying to warn Marisa, being suspended from school, being shunned and dumped by Marisa, and eventually rushing to save her while talking down Oliver from suicide.  So his hanging out with his ex-gf, I think is an understandable re-action to this emotional trauma... a recoil from all the stressors in his new life towards the old and familiar.

Gay Marriage:
There's a critical issue that most people appear to ignore when discussing this topic.  Although the primary question certainly revolves around the fundamental definition of marriage, the question that immediately follows is:  'What is the purpose of law?'  If we conclude that marriage is defined as a socially and culturally validated union between a man and a woman, that decision may or may not matter depending on how you view law.  Is the purpose of law solely to produce civil order and protect civil rights, or does it extend to institutionalizing moral and cultural creeds?  In a theocracy, clearly, yes, law serves both secular and cultural/religious functions.  In a secular, republican government such as ours, I'm not so certain that is the case.

This is a critical point when we evaluate the legality of allowing/banning gay marriage.  For one, on the grounds of civil rights, there can be no doubt that same-sex civil unions are not afforded the same legal rights as married couples.  If you look at power of attorney, inheritence, next of kin, etc, pragmatically-married same-sex couples are unequivocally discriminated against.  It's blatantly obvious in medico-legal issues.  On the issue of preserving civil order, when >50% marriages end in divorce, it's difficult to argue prospectively that same-sex civil unions ascribed the title of 'marriage' will degenerate a cultural institution that is already degenerate.  [Anectdotally, the Ob/Gyn at Bryan hospital remarks that in his practice (conservative, Midwestern America, mind you) more newborns are born to single mothers than married mothers.]  Therefore, the only possible point that one could significantly argue against same-sex marriage is on the grounds that it has an inherent socio-cultural-religious value that must be protected.  Following, one must decide on the function of law in the United States.  Otherwise, even with an affirmative response to that issue, it would be mute in an absolutely secular law.

From the barebones I've studied on medico-legal issues, I believe US law has consistently shyed away from insituting law that may invoke specific moral/cultural beliefs.  The Court appealed to the right to privacy on the issue of abortion.  Groups with beliefs that may have detrimental health outcomes (eg Jehovah's Witnesses) are afforded significant, though not absolute, protections by law.  From my impressions, in general, US law is fairly reserved in its definitions and applications of "compelling interests."  It seems to lean away from John Stuart Mill-type paternalism and towards more Lockeian ideas of civil rights (this is where I'm getting a bit out of my element, it's been a looong time since I was in Lincoln-Douglas debate, so pardon my mistaken references, but you get the idea)...

For myself, despite my conservative beliefs regarding marriage, I have a hard time finding the grounds to deny same-sex couples the same civil rights and priviledges afforded married couples.  I have an even more difficult time trying to find any legal grounds for institutionalizing such inequality.  (I'm actually a bit skeptical that Bush really understands the implications of his idea of putting a definition of marriage into a constitutional amendment)  However, I need to consult a law student on precedents in US law.  Another issue is that I don't know what precedent there is for this in the rest of the world.  So, there are significant gaps in my understanding of the issue to come to a final, personal conclusion.
 

February 13, 2004 (five hours later)

I am sooooo sore!  I mildly strained my right quad early in the night... and kept on playing on it... now it hurts... and I'm dreading tomorrow morning... I dunno if I'll be able to get out of bed... ugg.  v-ball was pretty fun tonight.  my skeels are coming back slowly... faster than I expected... happy that my hitting was decent.  =)  just played 3's with several pretty solid guys... I was this one guy's beeeyotch all night... I swear I shanked his floater a couple dozen times straight... geez... I was finally getting a handle on it by the last couple games we played, but by then I was on fumes since I hadn't eaten anything since lunch and we played 3 hours non-stop.  One guy on my team was a pretty vocal guy... one of those 'motivator' types... in contrast, I just kind of get in my own zone and don't really talk or react much... I think he couldn't decide if I was awake or not.  ha ha   So afterwards, got meeself some taco smell and gorged on cheap meat and cheese product.  good stuff.  I miss SD and heading to Jamba Juice after v-ball, though...

Did I mention how great the OC is?  It's sooo funny!  what better is there than a show about a bunch of wealthy, neurotic high school kids?  Like last week, when Marisa finds out that Oliver was lying about having an ex-gf.  Then she decides, 'oh okay, gee, I guess I'll go back upstairs and confront my psychotic, suicidal, and highly emotionally labile friend who's been progressively spending more time with me, not to mention wanting to take me to Paris on a whim, and has been misleading me ever since he reappeared in my life."  Yeah, Marisa, that sounds SAFE.  ha ha

Semi-Deep Thoughts:
1)  One of my surgeons gave some insight into why having a president who is a vet matters to a lot of people.  "Until you see your friends getting blow away right beside you, you can't really understand [the gravity of sending people to war]."  This surgeon is obviously a Kerry fan.  He had some crazy vietnam stories... he was drafted as a surgical resident and was doing surgeries all by himself in MASH units... he says it was not uncommon for him to be operating with a textbook or two open right next to him.  ha ha
2)  Saying attributed to Billy Graham.  "You go to moutain peaks for inspiration.  But fruit is grown in the valleys."  Ref:  Psalm 23:4.  A bit trite, but for whatever reason it struck a cord when my pastor cited it a couple sundays ago.
3)  John Piper's Don't Waste Your Life.  Still working through the chapter about honoring God through secular work.  My impression so far... pretty good insights by Piper.  However, nothing is really resonating... so I'll have to re-read and think about this stuff a bit more.

Sports Update:
1)  US under-23 soccer team lost to Mexico 4-0 earlier this week and was disqualified from the Athens Olympics.
2)  I won my Sportingnews.com fantasy hockey season 1 league handily.  On to season 2!
 

February 13, 2004

Yay!  back in my own apartment for the weekend!  whee!

Surgery:
So, Bryan has been alright so far.  The good part is that I'm 1st assist in the surgeries... so I'm getting decent suturing experience... might get more if they had more complicated cases... mostly hernia repairs... breast biopsies... lap-chole's... so pretty minimally invasive stuff... nothing like those amp's and fem-pop bypasses last month...  Also, the docs are pretty laid-back.  They quiz me and give me homework, so it's making me study a lot... which is GOOD considering how awful I've been doing on those damn SHELF exams.  The bad part is that clinic is pretty boring stuff... I just follow the doc around all afternoon... no real chance to see patients on my own... also, not many patients to follow in the hospital... I need to take a pic of the hospital before I forget... I missed it the first time I drove there 'cause I thought it was too small to be a real hospital.  ha ha

the BEST part of this all is that we get free cable tv at the house!!!! whoohoo!  The OC on tuesday nights.  Smallville wednesday (need cable for the WB in toledo).  The Apprentice thursday night.  And Sportscenter all the time!  whee!  I don't think we get Fox Sports World, though... so no Premier League soccer matches... =(

Research:
Rejected by the SAEM annual meeting today.  Didn't expect to get accepted it anyways... oh well.  Still going to the Western Regional meeting in Oakland.  yay!  get to go back to CA!  I think MCO may be able to help out with some of my travel expenses.  =)    I'm really excited... partially to present my research at a conference, even as small as it might be... but also, hopefully, to smooze with some of the faculty from EM programs in CA... oy.... this will be tough...

Fat Belly:
I worked out for the first time since I was on Cardiology back in the beginning of November... oh man.  I am such a woosy...  sooooo weak... plus, I gained several pounds since last year and had to increase a notch on one of my belts... so I've got to get back into it... ugg.

Nothing particularly deep to say right now... perhaps after I get done with some errands on my mind (ie v-ball and laundry)...
 

February 7, 2004

Current rotation:  General Surgery in Bryan, OH
Best part:  free pass to the local YMCA.  I have a great excuse (and the time!) to start working out again
Worst part:  staying in Bryan OH during the week.  after detroit and columbus, this out of town stuff is getting a little tiring.
 

So, something fell off my car this morning...

... I was driving back from choir rehearsal this morning when I hit a bump and this annoying rattling sound started... As I was being annoyed by the sound, I thought to myself, "Dang-it, maybe the stupid thing will just fall off so I won't have to crawl around trying to figure out what the heck it is and how to fix it"... several bumps and about a mile later, the rattling stopped, and as I looked into my rear view mirror, this metal thing drops off the bottom of my car and bounces a couple times around on the road behind me... =)  hopefully it wasn't too important....

This week's been somewhat eventful.  The open gym volleyball turned out great!  It's at the Maumee Sportsmall.  Friday nights 700-1000pm.  $5.  They had three courts up when I went yesterday.  Two courts of 6's, and one court of 4's.  Mostly high schoolers there... obviously a bunch of varsity-level kids.  Pretty solid play.  I played on the 4's court with the not-so-young crowd.  It was great!  Man, can't believe it's been a year since I played v-ball last... I missed it soooo much.  But, it was the perfect level of play for me to try to get back into it... I'm planning to go every week.  I'm hoping that maybe I'll be able to get back up to speed sometime to the point where I might be able to play with those high school kids...  I had soo much fun... And, I am soooo sore today.  my legs ache.  my shoulders ache.  my back aches....

Also did an oral presentation of my research project on Student-Run Medical Clinics at a local research conference at St. V's.  It was a good experience... it's been a long time since I've done an oral presentation in front of so many people... I wasn't very enthusiastic about how it went.  I was a bit underprepared... but, it was good.  I find out this week sometime whether or not I'll be presenting it as a poster presentation at the national SAEM conference... already been accepted to the Western regional... will likely go to the Midwestern regional one... but, the big kicker will be if I can go to the national conference... that was be SWEET.... it'd be SO nice to finally get some sort of payoff for all the work I've put into failed research projects over the last three years... we'll see.

Update on my quest to go to the UK for an overseas medical school elective.  I spent a couple hours going to every website for every med school in the UK.  www.chms.ac.uk  also works.  See my entry in Medicine(3) for a handful of useful sites if you're interested.  Just found the site for Oxford University.  Newcastle too.  For whatever reason I had a terrible time finding any info at all about electives at a lot of schools... a couple med schools won't allow any overseas med students to take electives unless they've got pre-arrangements with specific schools... I think it was either Liverpool that was like that.  Imperial College and King's College in London have absolutely prohibitive costs... Edinburgh wants a criminal record check in addition to the rest of the application... good gravy, too much of a bother for me... So far, just applying to University of Glasgow.  Glasgow would be great.  If I could get into a Celtic soccer match, oh man, that would be brilliant!  =)

Today, went up to Ann Arbor with MT to study and have some GOOD FOOD.  Went to a Korean restaurant and had K-BBQ.  mmmmmm... bul-gogi... kal-bi... it was GREAT... and my clothes still smell like meat.... =)

Saw Honey with Jessica Alba this past week.  Think a mix between Higher Learning (that's the one with Michelle Pfeiffer teaching in the 'hood, right?) and Save the Last Dance (with Julia Stiles).  It was entertaining enough... although probably not for the reasons they intended.  ha ha

Also, got a new phone.  couldn't resist getting one with a camera just for the extra toy... I'm not going to continue the sprint pcs vision after the trial two months just 'cause it's not worth the $15/month for me.  the camera is fun... so if you've got a picture phone, let me know so I can send you the following pic while I still get spring pcs vision for free...

Is it freaky?  I hope so... that's what I was aiming for... ha ha