I'm insane.  Even though I'm on spring break, I decided to pick up an extra shift at the ER because I wanted to get a little more experience before I was through with it... plus to score a few extra brownie points.  Uh, it went okay.  Pretty tired overall.  I think my lesson for today is that I may be too nonchalant and chill for my own good.  There is one PA student that was too crazy... just running around constantly, jumping in with any and everything that came through the door.  Not too annoying, so I think she gets away with it... it also helps to be friendly, cute, and blond, I think.  For future reference, I need to remember to be proactive about asking questions and getting involved in stuff when I do my away rotations.  Just quietly working my butt off isn't enough, I think.

Going home Thursday.  Going to the Western Regional SAEM Conference in Oakland this weekend to do a poster presentation on my research on student-run medical clinics.  Good chance to meet some of the faculty at programs in CA and hopefully, get my face and name out there...  Even though my research isn't the sexiest or even that directly applicable to emergency medicine, I think I can possibly make something of an impression if I'm enthusiastic enough about it and can emphasize the positives of my project.

It will be a nice trip, even if I'm only actually able to be home-home for a day... going back to CA always gives me feeling of comforting nostalgia...

Until next week, cheers.
 

March 28, 2004 (1100pm)

Man, what a great day!  Even though I overslept, I still made it to church this morning.  Cleaned my apartment a bit.  Watched an HK flick (So Close).  Then, played 3 hours of some really great v-ball (makes up for a crumby two hours on friday).  To top it off, I met a nice, pretty, Christian, studying-to-be-a-nurse, volleyball player today.  AM I DREAMING!?!?!?  =)  Invited me to check out her church.  Ah yes... probably mostly inappropriate motives for visiting, but oh well.  Since I still haven't found a church after 3 1/2 years, maybe this will be the fit.

Talking to nice, pretty people makes me happy.  =)
 

March 27, 2004

Monty Python, Silly Vicar - Reverend Belling
"You know, there are many people in the country today who, through no fault of their own, are sane.  Some of them were born sane.  Some of them became sane later in their lives.  It is up to people like you and me who are out of our tiny little minds to try and help these people overcome their sanity.  You can start in small ways with ping-pong ball eyes and a funny voice and then you can paint half of your body red and the other half green and then you can jump up and down in a bowl of treacle going 'squawk, squawk, squawk...'  And then you can go 'Neurhhh!  Neurhhh!"  and then you can roll around on the floor going 'pting pting pting'..."

What duh?...
I think I'm going out of my freakin' mind.  I actually went out last night without any guilt or dark, brooding menace (ie shelf exam) following me around every corner, at every hour of my waking and sleeping...  Good lord, I'm even planning to get out of town for multiple weekends next month!  possibly to visit friends in Chicago and Columbus... going back to CA for my bro's wedding...  perhaps most disturbing is that my apartment may actually get clean...

CA dreams:
Just got an acceptance letter from Highland Hospital (Alameda County) for an elective this coming August!  Wasn't expecting it, if only because after submitting my application, they emailed me back saying that they required both my surgery and ob/gyn grades... the first of which I wasn't going to receive until end of April, and the second, perhaps not until September or August.  So I had already been expecting to spend that month in LA, preparing applications for such...  but, I got Highland, and I'll be damned if I don't take it... if I can work my a** off that month and get a strong letter of recommendation (not easy)... man... my residency application should be pretty damn strong regardless of my grades...  I'm a little bummed that I can't be in LA with my mates, but perhaps it's better if I save the vacation and socializing until later...

Worth Following:  Constitutionality of "Under God" in the Pledge of Allegiance
To the chagrin of the mayor and other conservative elements in Toledo, his guy actually showed up at University of Toledo Law School last week to give a talk... wish I knew about it and didn't have that damned test to study for...  Even though I think that it's a waste of time from the moral standpoint, I think that it's a fascinating case because since the argument against the phrase's constitutionality is pretty strong, if the Supreme Court were to rule in favor of retaining "under God," it would be absolutely fascinating to read their line of logic and reasoning...  The ruling itself may help set a moral precedent and agenda for the country as well -- perhaps towards the overt public atheism of France (recently tried banning headressings from pulic schools, most directly offending French citizens of Arab decent.  Can't remember if it went through or not).
 

March 26, 2004 (400pm)

Just finished my Surgery SHELF exam... f***, that was hard...
 

March 22, 2004

A First:  Getting Yelled At For Working Too Hard
I worked the 600a-600p shift today.  But, when 600p rolled around I still had three patients that needed a lot of follow-through left before they would be admitted or sent home -- one urology consult, one surgery consult, and one patient that was just being a bitch.  Since I felt bad for dumping these patients on other students, it was crazy busy, and it was my last shift, I decided just to stay... figured it would help out a little... take a little of the burden off the other students and nurses.  When I finally took off around 730p, my attending was actually pissed that I stayed too long!  Go figure.

Why I Just Need to Keep My Mouth Shut Sometimes:
Oral Surgery Exam last Friday.  After answering a series of questions correctly about lower extremity occlusive artery disease...
Dr. S:  "So what are synthetic prosthetic grafts made out of?"
Me:  "Uh, you mean umbilical [veins]?"  (which is a correct, although rare and expensive answer)
Dr. S:  "No.  I'll give you a hint:  They make clothing out of it."
Me:  "Uh, Wool?"
Dr.  S:  "No.  Goretex."

Match Day:  Last Thursday
What a crazy day.  It's so haphazard and unpredictable.  It worked out surprisingly well for a lot of people.  Like AW, who, after suffering through four years in Toledo, finally matched in Anesthesiology at USC (no small feat) and finally gets to go back to CA, within 30 minutes of home, no less.  KW's girlfriend matched in town, even though it wasn't her first choice program, so they're both pretty happy.  On the other hand, there's MG and EC, both who had ridiculously high scores and grades, who didn't match at all and didn't match at his first choice program where he should have been overqualified for, respectively.  I ended up picking up a friend from the Match Day reception early who was too upset and depressed to stay around and socialize...  Crazy.

I think the lesson for me is, despite the hope that AW gives me, I really need to keep my expectations low so I'm not too crushed when I don't match in CA next year... ah, we'll see... what a load of fun to look forward to... =P
 

March 17, 2004

Snow in March?!?!  So pretty... until it melts and turns into nasty grey slush...

From Morbidity and Mortality conference this morning:
"Hypotension despite fluids and pressors is adrenal crisis... unless Jesus is standing in front of you... and then, you become Hindu."
 

March 16, 2004 (100am)

Okay, this isn't working...
...after getting off work around 900am, I decided to tough it out and stay awake as long as possible to get back onto a regular sleeping schedule... Still passing out while trying to study after 3 cups of coffee and one floofy blended mocha thing, I watched Romeo Must Die and finally lost my willpower around 500-530pm (26 hours awake) and went to sleep expecting to wake up 12 hours later...  Well, I woke up around midnight, tossed for about an hour until now... so... this is not good.  physically pretty tired, but man, am I awake.

Career thoughts:
1)  Getting sh*t on as a ER doc --  During some down time, my jaded attending cautioned me about going into emergency med.  Specifically, that ER docs get sh*t on by everyone... they get sh*t on by patients... they get sh*t on by other docs... they probably get sh*t on by everyone except maybe EMS guys and ER fans....  So, this isn't anything I didn't know before, but certainly something I need to think through more thoroughly before I get set on EM as a career.  I think I've already deferred some of this worry by telling myself that I've got a lot of second-career options in ER as far as fellowships, research, teaching, and admin...  but, definitely need to think through it a bit more...
2)  Research --  I think I might be headed downn the clinical research road.  I won't go into the details, but during my last shift, I thought there was a questionable use of an expensive diagnostic test in a low-to-no risk patient... After going through my MPH and Cardiology, I'm a pretty big fan of evidence-based medicine, ie reason-(vs intuitive)-based usage of materials and resources... this one situation seemed a bit iffy to me, so I need to do a lit search on my question (my advisor wouldn't give me a quick and dirty answer. poop on her)... bottom line is that if I had the time and resources, would I design and run (even seek the grant funding, lord help me) a clinical trial to answer my question?  Yup.  As disappointingly nerdy as it sounds, that would be pretty cool.
 

March 14, 2004 (400pm)

Last night shift tonight.  Just looked at the weather report.  it's supposed to snow mid-week.  good gravy.

ER vocabulary of the day:  "O'Brady"
Prefix "brady" means slow (eg bradycardia = slow heart rate). "O" for moaning.  Therefore, "O'Brady" = guy who's moaning slowly and regularly... vs "O'Tachy" etc.

Stories from the ER:  You know "Drunk Girl" from SNL?  That was one of my patients last night, except she was middle-aged and had a blood alcohol level of 0.28 and opiates in her system.  would be thowing these fits, yellin' at the top of her lungs how she wanted to die, and then totally quiet asking "I'm okay.  Can I go home?," and then if the nurse or I asked her about if she wanted to kill herself, she'd start yellin' and moanin' again... It was so pitiful, but god, I couldn't stop myself from laughing at her CRAZY mood swings.  And, then there was a frequent flyer who drinks himself into pancreatitis all the time... I was seeing a patient when I heard this weird yellin' and moanin'...  it was kind of this neandrethal-like (sp?) loud groaning... and then all I saw looking out the door was the crazy-lookin' dude dragging the charge nurse behind him -- barely hangin' on by his arm... All I could think was, "Chloe? (my dog from college)  Is that you?"

God, it was a stressful night.  Not extremely busy and no critically ill patients, but geez, I swear there was a person yellin' or moanin' the ENTIRE night...  Really got to me by the end of my shift...  Besides crazy-suidical-drugged-drunk-lady and crazy-drunk-pancreatitis-man, there was drunk-annoying-got-punched-at-a-bar-kid who was yellin' when he got his tetanus shot.  What a freakin' baby.  I also had a dude with dementia who was just totally confused... didn't know where he was... what was going on... I really hope I'll find a wife that will be patient with letting me vent about stuff like this...  I think I'll go insane otherwise.

I will say that in the middle of all this mess were two respites of humanity.  My dementia dude was moanin' constantly... he'd be in and out of confusion... moaning partially because of chronic pain, and partially because he was totally confused about where he was and totally frustrated that he couldn't do anything about his confusion or pain... still moanin' continuously a couple hours after initially getting to our ED, I finally decided to try to calm him down... considering how much time the ER nurse had spent talking with the guy earlier, I was pretty unenthusiastic about my chances... but I sat down with the guy for a good 5-10 minutes, tried to adjust his pillows so he was comfortable, and just tried to tell him to relax, that the best thing he could do for himself was just to calm down, that I understood that he was confused and upset, that even though he didn't know what was going on that he was in the hospital with doctors and nurses that were really going to look out for him... I don't know if it really worked or not, but he was pretty quiet from then until the end of my shift, still moanin' and mumbling things, but not as loudly or painfully as before... still can't believe that it might have helped.

My last patient was a guy with ankylosing spondlyitis.  It's a fairly rare, but terrible disease where every single joint in your body aches.  He had a bad exacerbation of his pain.  I dropped in his room just to do a 1 minute check to see if there was anything urgent to take care of since there was a couple patients that needed to be seen before him... when I told him that it might be a while, he reacted angrily, threatening to take off if he didn't get seen within a 1/2 hour and that it was typical that we'd be treating his pain like it was a joke.  Suffice it to say, my 1 minute check became a 1 second check.  My attending was pretty unimpressed by his threats as well.  After seeing my patient ahead of him in the queue, I finally went back maybe 15 minutes later to talk with him at length... after a measure more of verbal abuse, when he finally realized that I was (somewhat) concerned, that I was listening to him, and that we were actually going to help him out, he actually became fairly congenial despite the pain he was in... when the attending came in to the room with me and displayed genuine concern, he was actually fairly tearful, being frustrated with his chronic condition, not having any control over the pain or the condition (slowly rendering him disabled)...

It's pretty tough to care about people who take out their frustration on you... I hope I won't get so jaded that I can't see through the physical and emotional duress of my patients...

I have to say that so far, I've had a number of great examples to follow (mostly surgeons and ER docs) of docs under some significant stress and fatigue who still show signs of sympathy and real concern for their patients...  It's encouraging that despite being jaded, tired, pissed, or unappreciated, they can still care for their patients who are really suffering...
 

March 13, 2004 (400pm)

Breakfast at 400pm, that's something new...

Stories from the ER:  A trauma came in -- a fellow while attempting a robbery, was shot multiple times... with his own gun.  I still can't figure out how that one happened.  Lucky for him, things all evened out -- even though he was shot FOUR times (chest x 2, abdomen x 1, arm x 1), nothing hit anything important.

Simple Joys:  Got to use my trauma scissors for the first time since buying them when I was an EMT before med school.  heehee, it was too much fun.  Lady lost her leather jacket... Bummer, but I suppose that's what happens when you try to drive after getting drunk and stoned on marijuana...  Her car was impressively mangled, but she'll be okay too.
 

March 12, 2004 (200pm)

How obvious is it that I hate studying?  Have 7 hours to kill before my shift starts.

The Unknown:
        One common type of patient that comes into the ER is the person with vague, chronic pain, who's basically fed up with their family doc because they haven't been able to diagnose their problem.  They have pain that is definitely present.  But, it has no control.  It has no predictability.  It has no name.  These patients are often frustrated, upset, and angry.  Notably, for the most part, their pain is neither debilitating nor lethal.  It's simply a persistently nameless and faceless irritation.  And, to their misfortune, a significant number of medical problems are unexplainable and, in order to invent some measure of control, medicine invents garbage can diagnoses (eg Irritable Bowel Syndrome) for these pathologies that lack real definition.  In a related fashion, a number of my friends have experienced or are experiencing something of a pre-mid-life crisis, in which they struggle with defining their purposes and goals in life.  Following school, which has tangible end-points, some have entered jobs with little of the personal or career direction that college offered.  In both these cases, I think the negative emotional and psychological reaction stems, significantly, from this basic fear of the unknown.
        The fear of the unknown, although a trite phrase, is one of our most powerful, basic visceral reactions.  Good horror flicks use it well.  Should the teenage cheerleader open the door out of which is coming blood-curdling screaming and oozing blood and goop when the freaky music starts?  Of course not.  But, she does, and we will her to because we need to know.  The nightlite doesn't prevent monsters, it allows us to define them when they pop out of the closet.  One reason The Ring/Ringu was so effective for so many people, is that it really played on the fear of the unknown and unseen.  Only at the very end do we even have some real images of what's killing people... even then, the actually killing is masked, horrifically undefined.
        One of my stressors is the Match next year.  I miss my friends in CA.  I miss the culture.  I miss the Christian fellowship.  There is a known life and lifestyle in CA that I want.  But, the Match is inherently unpredictable.  I'm entering a highly competitive field with unspectacular credentials.  I may land anywhere from Des Moines to Manhattan to San Antonio.  This last month of Surgery is pretty mentally stressful because I'm grasping and clawing at one of the few avenues of perceived control that I have, my grades.  Although applying to med school was difficult as well, but the relationship that I was in at the time, in giving my life a certain known purpose, mitigated a lot of the indefinition.  This time, although my career is relatively guaranteed, all the details surrounding it are completely unknown.
        There's roughly three reactions to this fear: acceptance, despair, and ignorance.  These are pretty evident in the hospice setting.  Death is probably the greatest unknown.  In facing it, there are some people that die very well -- comfortably and happy.  Whatever their metaphysical beliefs, they comfortable with them and are able to enter death with a measure of acceptance.  They may have answers, but they may not.  What they have is primarily some sort of acceptance and understanding of the fundamental unpredictability and inexperience of death.  In contrast, some people die terribly, in utter fear and despair.  Confronted by their beliefs about death, they are completely deficient.  Now inevitable, these persons have no sufficient and satisfactory answer.  Perhaps the worst reaction to the unknown is ignorance.  The persons I worry about the most are those who simply dismiss significant issues in their lives by ignoring them or distracting themselves.  The persons who actively wrestle with their fears, at least have a greater likelihood of finding conclusions.  Those who live in ignorance, when faced with no escape, often find terrible despair.  I remember, poignantly, some self-labeled religious persons who, although they should have had some definite conception of death, had been kidding themselves their entire lives and ended up fighting desperately and futily against the inevitable.   I've discussed a very grave issue here, but this concept certainly applies to all aspects of life, including my struggle with whether or not I'll find a socially and spiritually comfortable environment in residency location.
        Even as Christians, we're not guaranteed much definition or predictability in our lives (see Ecclesiastes and Job).  But, once we have a reconciled relationship with God and seek fellowship with Him, we have assurances that should carry us through our fears of unknown and unchartered circumstances.  From my own experience, the following passages have been of some power in difficult times.  In sober moments, MATT 6:25-34 and PHIL 4:6-7 reminds me to remember the abundant blessings of God in my life.  Too often, the few stressors in my life obscure the more numerous and significant blessings that I have.  When emotionally distraught, PSA 6:6-9 helps me know that God knows my despair. 1COR 1:18-22 reminds me that, in contrast to the unpredictability of people and circumstances in my life, God is trustworthy and ever-present.  God promises us comfort and peace (JOHN 14:26-27, PHIL 4:6-7) and that difficulty is sometimes purposeful (2COR 1:3-11)  PHIL 1:6 perhaps means the most to me out of all these passages.  In my worst periods of self-doubt, it reminds me that God does not forget me and continually purposes to grow my character, in spite of whatever problem I'm in.  Perhaps, this is why the simply lyrics of Jars of Clay "Sing" speak poignantly to me:

"[verse 1]  I love the way, I love the way you carry on.  You make me wanna say, you make me wanna sing another love song. . . .
[verse 2] Bury my head for the shame.  You pick me up.  You say I look like you.
Though it makes no sense to me, You make me believe that I could trust someone."
 

Okay, gotta go study now.

But first, amusing Maxim "study" on how slow women are.
 

March 12, 2004 (1201am)

Trying to stay up as late as possible... start 3 consecutive night shifts tomorrow, so if I can sleep and wake up as late as possible tomorrow, it'll make it a little easier of a transition.  Luckily, there's been decent TV on tonight, and planning to watch some movies (the studying is getting painful at this point)... probably LA Story, a classic that I have never watched in full.

Ghetto-style:
To facilitate my mid-day sleeping over this weekend, since I don't have heavy curtains, in order to block out all light into my bedroom, I taped cut-up cardboard boxes over my window.

Barry Melrose (ESPN Hockey analyst, former LA Kings coach) on the Todd Bertuzzi hit:
" . .. the league did the right thing in sitting him down until at least the beginning of next season. Colin Campbell and the rest of the NHL brass acted swiftly and decisively to send a message. This sets a precedent by telling players that crossing the line with their on-ice behavior is unacceptable, and it should be a good lesson for everyone. . . .
This situation isn't necessarily a black eye for hockey, though, because anyone who doesn't like the physical nature of the sport is going to bash it anyway. It's amazing that Major League Baseball cannot get its players to submit to drug testing and has pitchers who throw at guy's heads, yet people zero in on one unfortunate incident in hockey and point to it as an example of what's wrong with the game.

Those who know hockey understand that a line was crossed and that what Bertuzzi did is should never be part of the game. . . ."

Madrid, Spain:
Geez...
 

March 11, 2004

"Bury my head for the shame.  You pick me up.  You say I look like you."
Jars of Clay, Who We Are Instead, "Sing"
-- simple... understated... a wonderful picture...

Monty Python:
Your Silly Candidates
Kevin Phillips-Bong
    Stood in the 1970 General Election--as the Silly Candidate for Huyton.  Polled no votes at all.  Hopes to double that this year.
Jimmy Tabernacle
    Ran for the Dull Party.  Intends to make Chartered Accountancy compulsory.  Is reading a book which has no pictures in it.
Mr. Paul Fox of the Slightly Silly Party
    He could split the Silly vote.

Things patients forgot to mention after being asked about past medical problems in the ER today:
1)  Chief complaint = back pain.
    Item = being SHOT FIVE TIMES last fall, including once or twice in the BACK with a shotgun.
2)  Chief complaint = abdominal pain.
    Item = KIDNEY TRANSPLANT

Nerdy Moment:
For Surgery Grand Rounds, one of the ENT MDs talked about his research which deals with flow dynamics in the larynx, ie how laminar and turbulent air flow interact with the vocal cords and surrounding tissue to produce sound.  As nerdy as it sounds, It was absolutely fascinating.  I'm really drawn to medical disciplines that have a strong physical-mechanical element to them.  Although all human physiology has physical principles at work, certain ones more overtly apply and utilize these mathematical/physical principles.  Take cardiology.  The pathogenesis of atherosclerosis has a lot to do with flow dynamics in the vasculature.  I think the draw is not the pure math or physics (b/c I hated those subjects), but rather the potential for predictive and logical models of certain disease processes.  So much of medicine is guesswork and based on annecdotal/incidental/empiric evidence... thus the 'art' of medicine, right?  Certainly, we're supposed to be trained to gain some mastery of these intrincaces.  And although that decision-making in a setting of complex, unpredictable, and unknown factors is one of the primary draws to medicine, it's nice to have a bit of reprieve from it and be able to explain and understand a medical problem with some certain clarity.
 

March 9, 2004

Monty Python:
"Vote Wisely.  Vote Silly.   The Silly Party.
Support the Silly Party.  The only part that is publicly committed to:
*raising prices
*destroying industry
*causing inflation
*ruining the economy

A Silly Government would:
*raise the school-leaving age to 43
*encourage naughtiness in high places
*maintain confidence in British Silliness abroad"
 

Like a virgin on prom night...:
I had to get fitted for a tux for my bro's upcoming wedding at the Men's Wearhouse, plus I had to go buy some snazzy dress shoes, too.  So, I figured, since I was there, I might as well buy a new suit for interviews next winter and any conferences I might be going to until then.  Even though I still really like my old suit, it's a bit old (5+ years?) and I've gained a bit of weight since college.  Boy was I ready to get taken advantage of...  First of all, the suit prices were dirt cheap.  Not that I should be surprised since I bought my old suit at a Men's Wearhouse in LA JOLLA, but still... back then, I was looking at suits in the $600-700 range and finally settled on one around $350.  I didn't see a single suit today that was over $300... most <$250.  So that opened up the possibility of buying two to adjust to specific situations (pretty fashionable, huh?).  Second, my pop occasionally randomly gives me some cash for school expenses, so I had a significant amount of fundage for a school-related cause.  Finally, I don't like shopping for more than 1 hour... and I defer decisions at every opportunity (one life lesson learned in med school -- SIMPLIFY -- added responsibility just makes lifee more stressful than it needs to be)... So, as a result, I was a very agreeable customer with a fairly loose wallet.  (Pretty naughty double-meanings, eh?)  ha ha

Ended up with:
1) Snotty suit -- Dark grey with pinstripes.  Sinngle-breasted with two buttons.
2)  Hip, youthful and snotty suit --  Dark blue/slate/grey.  Single-breasted with THREE buttons (really getting rebelious here).
3)  Bostonian dress shoes that will double for the wedding and my snotty interviews.
4)  Cool looking shirt/tie ensemble = Cream shirt with grey/cream tie to match snotty suit #1.  Hard to describe, but it looked too cool/unique to pass up.

Also, if you ever need an ego boost, just go to a Men's Wearhouse.  Dude, those salespeople make you feel way too important.  I can't even count the number of times this guy apologized for not getting to me faster...  geez, I felt like a surgeon with his peon med student at his beck and call.
[Monty Python and the Holy Grail reference, forgive the rough quotation]
God:  "What are you doing?!"
Arthur:  "Averting our eyes, oh Lord."
God:  "Well, stop it.  Everytime it's, 'I'm sorry, Lord, this' or 'Forgive me, Lord, that'..."
 

Issue of the day:  Conservative Christians and Addressing Homosexuality
I think a significant number of Christians may not appreciate the gravity of addressing this touchy issue with their gay friends.  The central issue is this:
Homosexuality as a anomaly vs. pathology.
a)  Homosexuality as a choice vs. state of being.  By now I think anyone not living in ignorance would acknowledge that homosexuality is NOT absolute choice (though maybe exceptions), but a multifactorial condition -- created by an interaction between a tremendous number of genetic, personal, social, and cultural factors.
b)  Homosexuality as a normal vs. abnormal state.  I think as well that it would be fair to say that homosexuality, in the purely physiological sense with no moral value attached, is incompatible with the proliferation of the species, and therefore an abnormal condition.
c)  Therefore, the question is if homosexuality is an anomaly or a pathology.  Clearly, homosexuals view their condition, at worst, as only an anomaly.  Conservative Christians would say that homosexuality is a pathology, a condition that would be comparable to a disease (eg kleptomania or nymphomania).  That even if the condition is not a choice, it produces behavior that is morally unacceptable.
d)  Here inlies the primary emotional problem -- stating that a person's condition is morally pathological when they themselves do not view it that way.  This is... let's say, inevitably abrasive.  It's analogous to saying that your very state of being, your very existence, in inherently morally decrepit.  That's not easy to agree with if you're not a Christian (see (e)).  The closest annecdote that I can relate are specific moments in my life when, in response to some behavior or belief of mine, someone said sardonically, "you're not Chinese."  I remember being absolutely infuriated that they would basically invalidate the essence of my cultural identity.
e)  To this reaction, the Conservative Christian should respond that our very existence, regardless of sexual orientation, is pathological (Romans 1-3).  Therefore, homosexuality is simply being addressed or viewed as another sin.
f)  If you buy that, the following problem is that if homosexuality is simply 'just another' sinful state... why is it such a big deal?  Ah!  A very good question.  One, I'm not sure many Christians (including myself) have worked out...  detrimental to the conception of family?  baloney, the insitution of marriage has already gone down the toilet in this country.  encourages immoral behavior?  weak slippery slope argument.

This is where the argument progression stops because I haven't worked it all out for myself yet.  In fact, I'm going to take the easy way out of this whole issue by saying that I simply haven't studied Scripture thoroughly enough to come to definite conclusions about my beliefs regarding homosexuality.  However, there are some applications to this incomplete discussion...

1)  To homosexuals with conservative Christian friends -- if your friends have a proper conception of the fall of man and sin, they do not view you or themselves as any more or less sinful (ROM 3:23).  Just give them a break... even if you think they have a warped sense of reality, if they've bothered to be a true friend to you (not unremarkable considering that homophobia is sometimes marketed as 'religious conviction'), chances are they truly value you and the friendship... and that's actually worth something.
2)  To conservative Christians with homosexual friends -- if you feel led to address these issues with your friends, be extremely sensitive.  I'm not sure we can appreciate what it's like to be considered and told that you are morally degenerate your entire life, and invalidated as a human being, to the degree that many homosexuals have.  Just like, unless we have had the actual experience, we probably can't appreciate the impact of being hated and attacked (eg Jews) or distrusted and disadvantaged (eg ethnic minorities in the inner-city) for the entirety of one's entire lifetime.
 

March 8, 2004

This month: Emergency Medicine at MCO
Shift schedule for the rest of the month (total = 10 shifts over 21 days):
Thurs    3/11    600am-400pm
Fri        3/12    900pm-900am
Sat       3/13    900pm-900am
Sun      3/14    900pm-900am
Weds    3/17    1200pm-1200am
Fri        3/19    1200pm-1200am (oral exams in the morning)
Sat        3/20    600am-600pm
Tues     3/23    600am-600pm

So far:  Had two shifts... pretty slow.  Mostly garbage --  frequent flyers, paper cuts and bruises, people with vague chronic pain coming in 'cause they're basically fed up with their family doc.  But, at this point, as a med student I'm pretty content with sorting out this junk because it makes me useful.  =)  can't exactly run a trauma, but I can take care of all this non-urgent stuff so that the doc can spend their time with more urgent cases.  I did get to work up both ends of a low-speed car crash.  That was kind of fun.  I can't wait until this weekend's night shifts.  Hangin' out with the crazies!!! whoohoo!

Fellowship:
BP came back from the Wilderness Medicine elective.  Man, after talking with him and the other three MCO students who've gone... it's tough to not want to go... I've been planning to spend my Feb 2005 in San Diego... but it's just that it sounds like... SO MUCH FUN!!!!!  Playing with rescue and field gear... search and rescue exercises... a five-day hike in the gorgeous Tennessee smokies (I think)...

Good catching up with BP.  We hadn't been able to hang out since... maybe November since we were both out of town frequently... So I did actually get his consult on my (lack of) motivation thing.  His take is that it's not that uncommon and that being jaded is typical for med students.  =)    Seriously, I realize I have no internal motivation anymore.  I used to have a calling to medicine and being a physician... God-given even... I distinctly remember specific moments in college where I was driven to study/work my butt off in college because I knew I was being called to be a MD and that I was glorifying God through my work.  Now, my primary motivator is FEAR.  I wake up on time b/c I FEAR getting sh** on by my attendings and residents (more during my first month)... I force myself to study b/c I FEAR matching at some dumpy emergency med program in the middle of nowhere...  Sad, but true.  BP sez it'll probably change once I'm an intern and actually have responsibility for patients and not subject to this endless progression of unnecessary exams...  he suspects that a lot of it is due to the initial idealism that some med students have entering med school just getting beaten out of us... Well, unfortunately, the means to some sort of resolution is the ambiguous, nonspecific action of prayer... so I'll start praying about this and we'll see if I gain any form of insight in the near future.

Tough Issue:
Conservative Christians and their gay friends.  A friend and I talked through problems that one of his friends is facing with one of her gay friends.  Apparently the whole gay marriage thing incited some inflammatory conversation at one med school leading to some severed friendships.  Like Jews and and the crucifixion of Christ, this is kind of one of those inherently touchy issues.  I'll write more about this later, still have some significant studying to get done tonight.

Peer pressure:  So far, of three persons whose opinions I highly respect, two have recommended seeing The Passion and one has not.  So, I'll probably go watch it sometime after my surgery exam at the end of the month... it's just too much of a time and emotional involvement right now... plus it may give some time for my presuppositions to water down.

I'm sorry, but I have to say it:  Girls who play volleyball are hot.  Athletic... fit... poised... but not overtly intimidating hulks like softball or basketball players...

The OC
Best line:  "Do NOT insult Journey."  Sadly, I know two people (KW and my older bro) who might say this.  ha ha
My take:  Okay, that was a weird, abrupt way to wrap up a lot of loose ends.  Overall, not very entertaining.  Sad that that Anna would be so emotionally distraught that she would give up SoCal for Pittsburgh.  So sad.