The thrill remains

Hey L. You still owe me a dollar, don't you?

No, I gave you your dollar last Wednesday. You don't remember?

Oh. Well, I'll give you back that dollar if you go to Cadaver Prom with me...

Oh. Ok. Well, I'm watching a movie right now.

Ok.

I'll call you back.

I'm going to sleep in an hour, so make your movie quick."

L. calls back, and says YES, to my amazement!

Launry Detergent Thief

Two months ago, I realized that someone was stealing the laundry detergent that I keep in the communal laundry room. Every week, another three loads' worth of detergent would disappear. My half-full bottle would be nearly empty when I needed to use it. So before I left for Italy, I took the nearly empty bottle of Tide Free and filled it up with vegetable oil. Looks exactly the same. That'll teach them.

When I got back, I was shocked to discover that 1/3 of the bottle was gone. This means that the person did MANY (like 8) loads with vegetable oil. They didn't notice something different about their clothes?

I filled up the bottle again with more vegetable oil. And when I checked it a few weeks later - the same thing. WTF?

I'm not sure if I should just keep filling up the bottle with vegetable oil, or if I should write on the bottle "You've been washing your clothes in vegetable oil for the last two months, you detergent-stealing asshole!" Thoughts?

Pro-Choice Rally

Today is the 35th anniversary of Roe v. Wade. There's one student in my class, Student L, who is very active with Medical Students for Choice. In the hall today, she persuaded me to attend a rally that abortion rights proponents were having later in the day. At first I was non-committal, but finally agreed to (she's kind of cute).

So I showed up wearing my white coat. It was drizzling out and slightly above freezing. I was expecting a stage with a speaker and a bunch of people cheering. A rally, right? Wrong.

They were standing on the busiest street in town. As I approached, someone handed me a sign (I held the Roe part of the Roe v. Wade HONK!" sign complex). A woman advised me to stand as close to the curb as possible because anti-abortionists would probably come and try to stand in front of us. So I stood there, holding my sign and waving a flag every time someone honked, which was not that often in the Bible Belt. A woman came up to me and asked if I would be willing to be interviewed by News Channel 4. Sure, I said. More people showed up. My gloveless hands were already numb. The drizzle intensified.

Student L as well as several other med students (including Student E) finally showed up, 20 minutes late. Making their signs had taken longer than expected.

Only a few anti-abortionists showed up. One guy stood behind me (I was right next to the curb), and constantly muttered something about the "value of life."

There were plenty of honks after a while. All (maybe 40) of us formed a line on the curb that was hard to ignore. One passenger in a car leaned over to honk the horn, causing the car to swerve. Another minivan drove by, all six kids emphatically giving us the thumbs down. Guess the parents didn't use birth control.

Student L asked me "Do you really think we're actually accomplishing anything?" "No," I said. "We're probably just pissing off the religious folk."

"Yeah, you're right," she said. "But that's ok by me."

"Me too... Me too."

Ears, Nose, and Throat

The doctor looked into the medical student's ear. "Too much ear wax." She looked into the other ear. "Wow, even more wax! Who else wants to volunteer to be the patient?"

I rose my hand, sat down in the chair, and the doctor inserted the otoscope. "Beautiful tympanic membrane with almost no wax. Your ear canal is unusually straight. Ought to be perfect for demonstrating."

"Q-tip every morning" I said. "That's probably not the greatest idea" she responded.

Student E grabbed the otoscope, peered in, and said she saw the eardrum. Mission accomplished.

Student L then took the scope. She couldn't see anything, so her solution was to insert the scope farther with a quick jabbing motion, which evoked a sharp yelp from me. She appologized profusely.

Then it was off to the nose. The doctor inserted the speculum and peered in. "Hmm, slight deviation of the nasal septum to the right. Now you guys take a look. Just remember NOT to close the speculum before removing it, or you'll take out some hairs."

Student L took a look without complication. Then student Y did, but apparently forgot the doctor's instructions in the intervening 30 seconds. He closed the speculum while taking it out, taking five nose hairs with him. You could see them still attached to the speculum.

"Owww! Goddamnit" was my reaction. My right eye started watering. Student Y appologized profusely and got me a tissue.

I asked the doctor why pulling nose hairs caused tearing.

"It's called pain" she responded.

Natchez Trace

Today I drove to the natchez trace and took a few photos. It was bitterly cold, especially on the bridge with the blowing wind. Normally I would have ridden my bicycle there, but it was just too cold today. Then I drove to Wal-Mart to buy some 3X5" index cards to study pharmacology.

Earlier today was parent's weekend at school. My parents and I got there at 7:45. I'll bet the school spent well over 100K on everything. There was a huge tent, zillions of servers, wonderful food, a lot of speeches, etc. The highlight was the "organ recital" that the pathology professors put together for the parents. They were shown lungs, kidneys, hearts, etc., all with varying stages of diseases. Tonight is a dinner for everyone, which I won't be going to since my parents can't make it.

Standardized Patients

I was walking out the door when I ran into my psychiatrist neighbor. I said "I'm going to interview a standardized patient today!" He said "what's a standardized patient?" I was a little surprised. I said "It's an actor who's paid to pretend to be a real patient. We get to practice on him." He said, "I my day, we just interviewed real patients. There's plenty at the mental health cooperative that would be jumping at the chance to get interviewed for 15 bucks an hour." Hmm.

So I left for school. The patient was a 40 year old man. The presentation was so classic I almost started laughing. Unilateral headache, "shimmering" visual aura, slowly progressing, pounding pain, lasting about a day. Nausea.

A migraine headache. Case solved. I reassured him that he didn't have a brain tumor, which he was worried about. It was kind of thrilling actually. Putting all that I knew together and making a diagnosis, even though it was a fake patient. I even knew how he should be treated.

Hopefully the next one will be more challenging.

Standardized Patients

Today I had my first encounter with a standardized patients. These people are actors who are paid to simulate real patients. They are given a list of symptoms, and act like real patients while we interview them. The first was depressed, the second had classical angina, and the third had carpel tunnel syndrome. It's great that we can interview these patients and hone our skills without actually having to deal with any real patients. If we screw up, it won't actually mean anything. Plus they can give us feedback on how we did.

Today I spent three and a half hours in the gym. I did cardio, lifted with Kam, and then played squash with him for a long time. He and I are almost perfectly matched.

Nupitals

C. is his name. He's a short, balding man in his 40's, full of energy. He's been working at the condo for the last 8 years. He moved here from Wisconsin after he was "saved" by the Pentecostal church.

He lives 30 miles away in the country with his wife, who has a rare form of cancer that will eventually slowly kill her. So rare is the cancer that C. and his wife had to travel all the way to the Mayo Clinic in Minnesota because no one here could diagnose it. Here, they just wrote her off as crazy.

His son is getting married at the age of 20 in a few weeks. Weddings in C.'s family are a big affair. His wedding had over 250 guests, and his son's will have over 500 (basically the sum of two separate congregations and 100 family members). As such, C.'s family is in charge of the wedding shower. The big hangup now are the name tags that designate where the guests will be seated.

C. is a man of many talents, but computers are not one of them. But he's learning fast. A few weeks ago I taught him how to write formulas in Excel. He now manages the condo's check book and credit card with the program.

But tonight was a more difficult challenge. The name tags (not exactly tags, but pieces of paper that are folded in half and sit on a table) had to be exactly 5.5 by 8.5 inches, with the name printed in a certain font and in the exact right place. Microsoft Word just wasn't designed to do such things. An hour and a half later, we finally figured out how to make it work.

His next project will be to get hundreds of water bottles, carefully remove the labels, and then apply customized labels bearing his family name.



This is such a different conception of marriage from my own. I view marriage as a formality, merely confirming what already exists. And if you're confirming what already exists, what's the point? Do you need a ceremony to confirm that you love each other? To show the world that you're committed? Does anything real actually change afterwards? Britney Spear's 55 hour marriage is sacrosanct?

There is no need for pomp and circumstance. There's no need to invite hundreds of people, who come only for the free food and booze. After all, it's just a piece of paper. What's real and important lies far, far beneath that.

A Night in the ER

Ten o'clock. I wasn't there for ten minutes until I heard a call on the radio. A helicopter was on the way. Major trauma. 15 year old kid riding his bicycle, hit by truck going 50-60 mph. Found him at the scene unresponsive. The nurses in the helicopter had already given him all the blood they had on board, and his blood pressure is still dropping fast.

They call the "trauma team." I counted 17 people in the room getting everything ready. Emergency doctors, trauma surgeons, an anaesthesiologist, nurses, a radiographer. The resident I'm with is in charge of managing the patient's airway. Everyone, including me, wears what amounts to a blue trash bag and face shield.

There's a tv in the ER that monitors the helipad, and another that monitors the dedicated elevators. We see a light appear on the helipad, the helicopter swoop down, the stretcher rushed to the elevator.

They wheel him into the room. 10 people simultaneously pounce on him in perfect synchrony, inserting needles into his groin, arms, legs - any place they can pump more fluid into him. The team leader stands at the foot of the bed directing everything. They examine every inch of him. The kid has a tube down his throat, another in his lungs. A nurse breathes for him with a squeeze bag. They give him medicines to relieve pain, to paralyze his muscles, and to increase blood pressure. Every drug is loudly called out after it's given. I look sheepishly from the corner of the room, and start to feel light-headed. I have to leave the room and sit down.

After 15 minutes, he's no longer actively dying. They quickly wheel him to the CT scanner with a nurse chasing after him, holding all the bags of fluid above him.

The table moves back and forth, passing the kid's limp body through what looks to be a giant donut. Within three minutes, I'm looking at a reconstruction of his entire body, slice by slice. We can see the full extent of his injuries - broken everything. Broken neck. Lung, liver, and spleen contusions. Broken ribs. Damaged major lung blood vessel. Shattered pelvis. Broken femur, etc. No wonder he's bleeding so quickly. Head looks ok though. I silently wonder if he was wearing a helmet.

They prepare an OR. The surgeons will be working late tonight.

Long Hunter State Park

I took the dog to a park by Percy Priest Lake today. It was a good day for it - tee-shirt weather in late November. We walked 8 or so miles, seeing only one other pserson the entire time. Mid-way through, my parents called from Key West, Florida, where their cruise ship was docked for the night. They'll return to Miami tomorrow and start driving back home.

I think I'll spend tonight in the Emergency Room with my friend Kam. There's always interesting stuff to see on Friday night there.