Now you're cookin' with gas!

Things I've Learned During Residency

2010-07-24T17:16:00.001-05:00

Just a quick post to express some of the things I've learned so far in 2 years of residency...I'll post some more pearls of wisdom as they come to mind.

1. Negative 17 degrees Fahrenheit is pretty damn cold (corollary: Chicago winters can really suck!).

2. On the other hand, nothing beats sunny and 75 degrees in the middle of July (though it ain't always like that during the summer here).

3. Pagers and IP phones are the work of the devil. They must be taken to the Land of Mordor, to the Fires of Mount Doom and cast into the furnace from whence they came for their evil powers to be destroyed!

4. Doing anesthesia ain't like dusting crops, boy! (A Star Wars reference for you fans out there)...it actually requires a lot more thought and planning than I initially appreciated.

5. Nothing like a nice propofol shortage to make you learn about other methods of induction such as mask induction, methohexital, thiopental, etomidate, etc, etc.

6. Nothing like a shortage of the other drugs I've just mentioned (as well as shortages of ketamine, vecuronium, and just about every other stinkin' drug we use) to make you appreciate the power of sticks (here Mr. Jones, bite hard on this 'cause this is gonna hurt like hell!), hammers to the cranium, and good ol' fashioned ether-soaked rags.

7. When things go bad in the OR, they can go bad really fast! Hence the saying that anesthesia is "long hours of boredom interspersed with moments of sheer terror".

8. To be a really good anesthesiologist requires about six eyes and fourteen arms, and the ability to turn over operating rooms in about eight microseconds.

Blog resurrection...

2010-07-24T17:13:00.000-05:00

...Or just a fluke blip in this blog's hiatus, which has lasted, well, for over 2 years now? Right now, I dunno. Residency has been a busy, taxing, at times rewarding, at other times a hellish time...which means that things like this blog tend to get put on the back burner...sometimes for a long time. Now, I know that I have friends in far more taxing residencies than I'm in who update their blogs on at least a semi regular basis. Take for instance, my classmate Leslie from UTSW who is in the middle of a neurosurgery residency--probably one of if not the most brutal type of residency program one could be a part of.

So, why the hiatus? I guess the long and short of it is that when I do get some down time I just haven't been inspired to write anything...not that I need an excuse to write or not anything on this blog ;-). Something did happen not too long ago, however, that has given me the inspiration/excuse (or whatever you want to call it) to revive this blog (at least temporarily) after an extended period of dormancy. My wife's parents were in a terrible motorcycle accident about a month ago while riding together...her dad suffered some pretty severe injuries to his left leg (and is now on bedrest for several weeks while that heals), and her mom was nearly killed (she sustained a life-threatening head injury requiring emergency surgery as well as multiple other injuries). For a number of days following the accident, the situation was touch-and-go, especially with Jen's mom. I am happy to say, though, that both her parents are now on the mend and while they have a long way to go in their recovery, the progress made since the accident (especially her mom) has been remarkable.

First off, I'd like to say thank you to the friends and family in Chicago, Dallas, South Carolina, and elsewhere that have prayed for and supported Jennifer, me, and her parents during these difficult circumstances. We covet your continued prayers for Jennifer and her sister as they have put both their lives on hold to take care of their parents. Also, for Jen's parents as they recover and recoup...the complete healing process is going to take a long time yet.

Secondly, the accident has caused me to think about several things, not the least of which is the reminder that our lives can be changed and/or taken away from us in a flash...at some point sooner rather than later I do need to think about the "what ifs" in case something were to happen to me. Also, I am reminded of how great God's provision is...it's sometimes hard to remember that when life is "stuck in a rut" so to speak, but during the past few weeks this thought has been at the forefront of my mind due to the outpouring of support and prayers from friends and family, as well as the fact that my mother in law is now walking with assistance and has most of her memory and cognitive ability back...considering the nature of her injuries, I find that to be a true miracle.

I hope I do find/make time to keep this blog updated at least on a semi-regular basis; time will tell how successful I am at doing that. In the meantime...

Coming soon...

2010-07-12T21:26:00.002-05:00

Some new blog posts...stay tuned...

Graduation and a shout-out to the class of 2008

2008-06-01T17:55:00.004-05:00

Note: may contain overused cliches and "sappy stuff".

Last night, I received my Doctor of Medicine degree from UT-Southwestern Medical School. Yes, indeed, I am now officially a doctor. I can now write "MD" after my name. It's kind of a strange feeling...I don't really "feel" like a doctor right now, and frankly, I don't know if I feel any smarter than the day I started medical school. I don't say that to knock my medical school's teaching...I received a great education from some of the finest physicians, faculty, and fellow students you'll find anywhere. I say that comment because I do feel a bit apprehensive and scared about taking on my new responsibilities as a resident...I am now expected to know things about taking care of sick patients, and I do bear some actual responsibility for how things go with my patients. It's a heavy, weighty responsibility, and I'm sure that there will be times over the next few months (as I start out as an intern) when I feel overwhelmed and think, "what in God's name am I doing...what the heck made me think I was qualified to do this?"

A couple of days ago, my wife and I attended the premiere of our senior class film (each year the graduating med school class at my school produces a movie, typically meant to be a spoof on one or more topics related to medicine). Before the showing of said film, one of the fourth-years who was emcee-ing (is that a word?) the pre-film festivities shouted out, "So, who's ready to be a doctor?!?!" After a few seconds of silence, the whole crowd burst out laughing...I take that as a testament to the fact that most everyone in my class to some degree has the same feelings of "not-readyness" (for lack of a better term). I've heard it said that as a fresh MD graduate, if you're not scared to some extent, you won't make a good doctor. In a sense, I suppose that's an encouraging thought. I just hope and pray that I don't let fear overtake me to the point where I'm rendered ineffective as a physician (I now think of John Dorian in the first episode of Scrubs, who hides in a supply closet when he receives his first page as a resident, but I digress...).

As I close out this chapter in my life and prepare to haul all my stuff to Chicago and start residency, I do wish to express gratitude first and foremost to God, who has placed me where I am right now, and who is the source of all that has blessed me in my life. Secondly, I'd like to thank my wonderful wife Jennifer. Jennifer, if and when you read this, I want you to know that I love you and I appreciate your support during the past four years, even during the rough times. To my mom and dad-in-law--thank you for being there to support Jennifer and me in the multitude of ways y'all have done so during the past several years. I also cannot forget to thank my mom, dad, my brother David, and my sister Mary for their support and thoughts from afar...I know it's tough not being able to see me nearly as much as you'd like. Just know that I love and appreciate y'all, and I wish the best for you.

I'd also like to express gratitude for my fellow classmates...I could not have asked for a better group of people to go through the trials and triumphs of med school with. I've met some phenomenal people in my class who have inspired me not only to be a better doc, but a better person overall. I'm thankful for the friends I've made while in med school and for the people I've been able to work with during my different rotations. Each one of you has added something to the person I am. If I have one regret, it is that I didn't get to know a lot of my classmates as much as I would have liked. Being an introvert makes it tough at times to even say "hello", even to someone I know relatively well. I haven't quite figured out why that is. At any rate, I wish everyone who graduated with me tonight nothing but the best...good luck and Godspeed.

For my blog readers, I can't make any guarantees concerning how often I update this blog. The next couple of weeks are going to be packed with all sorts of moving-related fun, then I get to start internship a few days after I arrive at our new home. For those not in the medical field, internship can be extremely busy at times (to put it mildly), and I want to be sure that I have my priorities straight when it comes to my free time (which will be quite scarce at times)...this may mean long stretches of time without any new writings. Just be patient. I am thankful for those that do read and who have encouraged me to keep this up.

OK, time to go save some lives!!!! Ready, BREAK!!!!!

-Stuart, MD

Flip off!

2008-03-27T21:26:00.001-05:00

Now, before you get pi#$%d at me for giving you the proverbial rude finger gesture, please stay calm and continue reading...

This is just a post to give tribute to Ernie Brown and Jay MacFarland of Ernie and Jay Mid-Day on KRLD 1080 AM in Dallas. These folks are on the air from 10 am to 2 pm on weekdays, and in addition to talking about the issues of the day, they really crack me up sometimes. It's hard for me to explain without telling you to give them a listen. I think many would agree with me that my favorite part of the show comes during the noon hour when they have the "Twelve o'clock Flip Off", where listeners have called in to gripe, groan and whine about things that they need to gripe about. If you'd like to hear what some of my fellow D-FW residents are complaining about nowadays, just click here and give it a listen.

I must say that before a few years ago, when I started listening to KRLD as one of my primary sources of getting the news of the day, I never thought that I'd be a regular listener of AM radio (so 1970's), much less talk radio. I must give credit to the folks at the radio station for getting me to listen to them on a regular basis. Now, before anyone starts thinking that I'm a complete dork for listening to AM talk radio, that's not the only thing I listen to...

Now for a disclaimer: neither KRLD or Ernie or Jay have paid me anything or given me any incentive to give them a plug (OK, except for the nice 57 inch, 1080p Pioneer plasma TV that Ernie & Jay had shipped to my door). Nobody at the radio station knows me from Adam (nor is there any reason for anyone at said radio station to know me). Just a fan giving a shameless plug for a radio talk show.

Match Result

2008-03-26T00:02:00.003-05:00

This past Thursday, I found out where Jen and I are going to be for the next four years as I conduct my residency. Yes, I did match; fortunately, I didn't have to scramble for a residency spot. If you're reading this (and you don't know the match result already), you're likely wondering where that is. I'll get to that in a minute. I just thought I'd write some meaningless stuff here just to annoy you before getting to the real point of this post. Isn't it amazing the stuff I can come up with on the fly? Roses are red, violets are blue, what I write next might in fact surprise you! It rhymes; isn't that amazing?!?!?!?!?

OK, enough nonsense.

I'm heading to Chicago, Illinois. The "Windy City". Home of the Cubs, Da Bears, Da Bulls, the White Sox, and yes, the Blackhawks. Home of some really frickin' tall buildings, including the tallest in North America.

So...how does that make me feel? First off, I'll say this...I'm ecstatic that I matched into an anesthesiology residency. I'm going to get trained in the specialty that I want to be trained in, and I'm going to a very good program at which all the residents seem very happy. Secondly, I feel blessed in that I know I could be happy at any of the programs on my rank list. I must admit, though, that this is going to be something completely new to Jen and myself, (she has never been to Chicagoland, and the only time I've been there (aside from layovers at O'Hare) was for about 24 hours last December when I interviewed there) and because of that, she and I are a bit nervous (maybe even a little scared) about the upcoming move and transition. I've never experienced a winter like those in Chicago where there can be snow on the ground for months at a time, and I don't think I've ever experienced sub-zero temperatures.

So...all in all, we both have mixed emotions...both nervous and excited...after all, this is a new "adventure" for us...

On the positive side, I keep hearing that Chicago is a fabulous city...from what little I know about it, I can believe that. Also, I've been told that there are many great churches up there, so I know that Jen and I can get plugged into a solid Christian community when we get there. Most of all, though, we know that God is sovereign in all things, and he has a purpose in sending us to Chicago for a few years...it'll be interesting to see what he has in store for us during this time.

Anyway, to those of you who read and follow this, your thoughts and prayers through the residency application process have been appreciated (more than you know); your continued prayers and thoughts will be appreciated as we move on to this next phase in our lives. To my friends starting residency this summer (wherever you ended up), my thoughts and prayers are with you. Good luck, and Godspeed.

Until next time...

Anesthesia on!

2008-02-18T15:29:00.002-06:00

You may have seen this commercial during the Super Bowl (can I say that without having to pay a huge fee to the NFL?!?!?). Just thought it would be apropos to include it in my blog given the nature of what I'm going into...

MY MACHINES!!!

2008-02-14T22:23:00.003-06:00

OK, so I came up with a reason to post...I haven't watched very many episodes of "Scrubs", but while perusing the Student Doctor Network forums the other day, I came across a post with this YouTube clip from the show...I've must have played it at least 20 times, and I still laugh every time I do...enjoy!

Yep, still alive...

2008-02-14T22:12:00.002-06:00

Haven't posted in a while, so I'm doing so now to say that I'm still here...

Just haven't had much to write about in a while. Thanks to everyone who's read and added a link to my blog (for what it's worth) to their piece of the blogosphere.

I promise to write something more substantial when the inspiration comes. In the meantime, just stay calm and try not to have a nervous breakdown as you wait on the edge of your seat for something new to come to this webpage...

OK, I know that you probably have better things to do than to wait with bated breath for a new post from me, at least I hope so :-P

All done...

2008-01-27T23:37:00.000-06:00

...with interviews for residency, that is. My last two interviews took place, oddly enough, in the same city where I had my first interview...Houston. I interviewed at both Baylor College of Medicine and UT-Houston for preliminary internal medicine positions.

So, now comes the task of ranking all the programs at which I've interviewed...got about a month before I have to have my final list "certified". Not going to be an easy decision...I interviewed at a number of great programs, and it's going to be difficult to figure out which programs to put where on the list.

Well, that's about all that I can say at the moment about the residency application process...Match Day is on March 20, and I'll know at that time where Jen and I will spend the next four years of our lives...kinda nerve-wracking when I think about it.

Anyway, on a different note, my 6-week "vacation" from medical school has come to an end...I actually start on a cardiology rotation tomorrow morning. Don't know much of what to expect, besides the fact that I'll be seeing patients with heart issues (and likely reading EKGs and stuff). Will try to update a little later on how that's going.

Almost home...

2008-01-12T21:49:00.000-06:00

Well folks, the time has come where I'm nearing the end of my residency interview trail...since I last posted about my interviews, I've been to San Antonio; the Mayo Clinic in Rochester, Minnesota; the University of Kentucky; and to my home medical school in Dallas to interview. That wrapped up my pre-Christmas interviews...the day after my Dallas interview, my wife and I travelled out to South Carolina to see my family for Christmas.

After Christmas...my wife flew back home on New Years' Eve, leaving me back in South Carolina...she needed to get back to work. I stayed because it would be cheaper (and less of a hassle) to drive to some interviews in Tennessee (Vanderbilt and UT-Knoxville) and Atlanta (Emory) than to make multiple flights out to those places. All in all, the interview trail has been fun, but I'm ready to get back home, to see Jen for the first time in two weeks, and to sleep in my own bed. Everyone who's been through the interview trail says that by the end, you just get tired of it all...THEY ARE RIGHT.

I will say, though, that through this time of travels to places all over the country, there have been some memorable/strange/laughable moments...a few that come to mind include...

**Trying to help a passenger on one of my flights find her engagement ring at the gate when she had gotten on the plane and realized she had dropped her ring...unfortunately, our efforts were in vain (at the time), and I hope she got her ring back; however, I did have a certain feeling of gratification from trying to "do the right thing".

**Striking up a short conversation with an employee at a Barnes & Noble in Rochester, MN, after she had "called me out" on not being a local...she discovered that instantly when I said the word "ma'am" to her in response to a question.

**Getting to see some fellow applicants multiple times on the interview trail (and getting to meet fellow applicants in general)...it's pretty cool to meet fellow med students from across the country and to get to know 'em a bit.

**Also, I've met a couple of people who grew up in the same area of South Carolina as I did...small world, isn't it?

There were some others, but I can't recall them off the top of my head at the moment...perhaps I'll mention them in a future post.

For now, I'm going to say "ciao" for now and get ready for bed...got a few hundred miles to drive tomorrow before I'm finally home for the first time in weeks :-)

After getting home...only four more interviews, all in Texas, all for preliminary internship or transitional year positions...finally seeing a light at the end of the tunnel.

Some days just sukk...

2008-01-06T21:38:00.000-06:00

If you've ever listened to an oldies radio station, you might have heard the song at one time or another that goes like this:

Momma said they'd be days like this
They'd be days like this
Momma said...

I don't know the rest of the lyrics (I'm sure I could Google the song and find out, but I'm not feeling proactive enough to do that now), but hopefully I've made my point...some days just downright stink.

I just had one of those days. OK, so the entire day didn't stink...

Just the portion of the day that happened when I got stung by some evil flying insect (which I hope dies a slow, torturous, and painful death)...I was taking a walk outside on the campus of my alma mater, Furman University (in Greenville, SC) when all of a sudden I felt something tickling my ear...thought it was some harmless bug like a fly, but when I reached behind to shoo it away, I found out differently. Felt the feeling of 10,000 red-hot pokers on the right side of my neck...YEEEOUCH!!! (actually, that's not all I said, but I won't repeat those words here...).

So, after that, I go to the nearby Publix (grocery store) and buy some Benadryl and some meat tenderizer to help with this sting, thanking my lucky stars in the process that I don't get anaphylactic reactions to insect stings. I do what I need to do to help take care of my sting and then begin my drive back to Spartanburg (~30-40 minutes away), where I have been staying while in SC to see my family (and to go to some residency interviews in the Southeast...more on those in another post).

Along the way, I find a shopping center with a couple of possibilities of where I could grab some food...I start to slow down to make my turn into the shopping center...my right front tire scrapes up against the curb and I have a BLOWOUT! Part of the tire is shredded with several large holes in the sidewall. Can't go further without changing the tire. Luckily, that was ALL that happened with the truck...glad I didn't wreck it or anything by driving like a dumb@$$.

OK, so after much frustration with finding proper jack placement (and thus getting enough LEEVERAGE so I could gain enough clearance to get the frickin' huge and heavy spare tire on), I get the flat changed out and I'm able to go on my merry way. (No worries, the truck's fine).

A part of why I'm posting this is because I do want to mention a silver lining in all of this...the tire incident was obviously a stressful one and despite having some issues with changing out the tire, everything was OK in the end, and I was able to keep my cool. I think if this had happened even a year ago, I would have reacted differently...I might have cussed up a storm and been really angry for a while before gaining composure enough to deal with the problem at hand. While this all may seem trivial to some, this is a big deal for me...I have a history of having a hotter temper than I should, and this evening showed me that I indeed am capable of handling stressful situations with a cool and calm head.

I also saw that God does provide even in these stressful situations...when I bought my tires a year ago, I did get a road-hazard warranty that covers incidents such as tires getting destroyed by "curb checks" at too high of a speed...so I should get a replacement tire at no cost.

God is good. He works in depraved sinners such as myself to mold and shape us into what He desires. He does this even when I am faithless and when I turn my back on Him and on His truth. His name is worthy to be praised, even during sukky evenings such as this.

Thank you, God, for your patience, perseverance, and provision.

Goodbye 2007, Hello 2008

2008-01-01T00:03:00.000-06:00

Happy New Year to to all my adoring fans!! (all 6 of you!!)

I know I haven’t posted in quite a few days, so I thought I’d do a quick post now. I’ve been pretty busy travelling to interviews and to South Carolina (where I’ve been for the past week and a half or so) to see my family. I do have a lot of thoughts about this past year and hopes for this coming year, but that stuff will have to wait, as I’m too tired to write about that stuff now. The main thought I’d like to share now is that I hope that I’m a better man than I was a year ago…and I pray that God continues to mold and shape me into the man He wants me to be.

Anyway, I hope you (and anyone else who may read this) had a Merry Christmas, and may God’s grace and peace be with you through this upcoming year.

Chicago

2007-12-12T17:18:00.000-06:00

Some pictures from my recent interview trip in Chicago...a lot of these come from Millenium Park along Michigan Avenue. Very cool city...makes Dallas (as large as the D-FW area is) look quite small. Yes, that is snow on the ground.

Will post more later about my travels on the interview trail. Enjoy!

Oklahoma City, OK and Charleston, SC

2007-12-06T19:56:00.000-06:00

WARNING: Long post with several relatively high-res (read: lots of bandwidth) pictures...

It's been a while since I've posted anything about my interview travels; since Galveston, I have been on a couple of other residency interviews. About a week ago, I drove up to Oklahoma City to interview at the University of Oklahoma Health Sciences Center. They have a really good set up at that program...an internship that's been called one of the best you'll find anywhere, plus good numbers of cases and good benefits. Also, everyone seems really friendly and approachable. It is a program in which I could see myself fitting in well. Unfortunately, no pictures to show from OKC...didn't really have the opportunity to get any good shots.

Drove home to Dallas after my interview in OKC; two days later, I flew to Charleston, SC to interview at the Medical University of South Carolina. I was excited to get to go there, since I am originally from South Carolina, and I think that Charleston is a really great city. I spent a month in Charleston between by junior and senior year of high school when I had the privilege to be a part of the Governor's School held every summer at the College of Charleston. Since then, I had only been back once (during my senior year of high school). So, it had been over 10 years since I had been in the Holy City (I actually am from the Spartanburg area of SC, which is about 3-3.5 hours from Charleston).

I arrived at the airport and picked up my rental car, after which I drove toward downtown. I then proceeded to drive over the Arthur Ravenel bridge (the new Cooper River bridge), simply because I had never seen it in person...driving over it makes you feel like you're driving toward the sky through a tunnel created by the cables and towers on the bridge...it's kinda neat (and can be kinda eerie if you're not used to driving over really tall bridges). After that, I proceeded back toward downtown and parked the car at a garage near the Fort Sumter Monument and the South Carolina Aquarium, so I could get out and walk around.

Before checking into my hotel, I spent some time walking around the peninsula and taking in some of the historic sites and places that brought back some memories of when I had been in Charleston in the past. An interesting side note...I was in town on the day of the Charleston Christmas parade, which meant that many of the streets downtown were packed with people, vendors selling stuff, parade floats, and shops with open doors inviting people to come in and browse around...pretty cool stuff! Anyway, now to the pictures (along with some commentary)...

Masses of people along King Street downtown before the parade.

Battery Park at the very southern tip of the peninsula.

Rainbow Row and the seawall along East Bay Street. From what I hear, the people who own houses along Rainbow Row have to periodically repaint their houses to preserve the color.

Pineapple sculpture and fountain at the Waterfront Park.

Another fountain at Waterfront Park...in the summer, you'll find people playing in this fountain to stay cool.

The Arthur Ravenel Bridge as seen from Aquarium Wharf.

Signpost taken at Aquarium Wharf, near the aquarium and Fort Sumter national monument. Fort Sumter itself is about four miles out in Charleston Harbor.

The historic Charleston County Courthouse at the corner of Meeting and Broad Streets (this intersection is known as the "Four Corners of Law", since the courthouse, a church, and other historical government buildings are located at this intersection).

The South Carolina Society House...just one example of the many historic buildings and homes on the peninsula.

St. Michael's Episcopal church at Meeting and Broad, across from the courthouse.

My mom made a cross-stitch depicting this church for my grandmother some years ago...this is the French Huguenot Church located at Queen and Church Streets. It is the only remaining independent Huguenot congregation in the United States (yes, it still houses an active congregation); once a year, it holds a special service in the French language. A bit of family history...some of my ancestors were Huguenots (French Calvinists) who came to the US due to persecution in France. I think that one of the things I'll need to do at some point in the future is attend a service at this church...I wouldn't be surprised if some of my ancestors were among the founders of this church during the late 1600s.

The Dock Street Theatre (currently undergoing renovation) across the street from the Huguenot Church.

Through this building lies the core of the College of Charleston...

For those of us in medical school...this could have been our motto!! (Found on a sorority house at the College of Charleston)

I have a lot more pics, but I didn't want this post to be too terribly bandwidth-unfriendly...

After a couple of hours of walking, I checked in to the hotel and later went to dinner with MUSC residents. As far as how my interview at the Medical University went, it was a good experience. MUSC seems like an up-and-coming program with a pretty bright future ahead of itself. Soon (in a couple of months), it will be opening a new cardiothoracic and GI (gastrointestinal) hospital; there is also a plan to construct a new children's hospital in the next few years. The program itself has recently expanded, and there are plans in the works to add several fellowships in the next few years. Overall, a solid program that I feel would prepare me well for post-residency practice.

Next up: interviews in Chicago and San Antonio within the next week. The forecast for Chicago calls for temperatures in the upper 20s-low 30s during the day with possible intermittent snow showers (BRRRRR!!)...in the meantime, it'll be near 80 degrees here in Dallas over the next couple of days.

Cheraw 58, Chapman 14

2007-12-01T19:52:00.000-06:00

Final score of the SC State Championship for 2A high school football. Unfortunately, my alma mater was on the losing end...

However, I do feel incredibly proud for the Panthers and their efforts this season. They have made their school and community proud, and I do think there's a good chance for a repeat trip in the next few years if not next year. Kudos to Kevin Farmer, the coaching staff, and to the players for a memorable year.

201.5

2007-12-01T16:05:00.000-06:00

That number was the reading on the bathroom scale (in pounds) when I stepped on it last night. Time for Stuart to lose some weight, like, now.

Go Panthers!

2007-11-20T16:00:00.000-06:00

No, I'm not referring to the Carolina Panters, the Florida Panthers, or any other professional or college "Panthers" teams (though I wish them luck in their respective sports)...

I'm talking about my high school alma mater, Chapman High School in Inman, SC...their varsity football team has made it to the State semifinals for Class 2A, which is the farthest the team has ever advanced in the state playoffs. By now, I'm sure you've figured out that their mascot is the Panthers. If they're able to pull off a win against Columbia High School this coming weekend, then they will get to play in the State Championship Game for the first time ever.

With that said, good luck to the Chapman Panthers football squad! You've made your school and community very proud!

UPDATE (11/24/07): Yesterday, Chapman defeated Columbia 28-12 to advance to the Class 2A State Championship...they will be playing Cheraw High School at Williams-Brice Stadium in Columbia on Saturday, Dec 1. Go Panthers!!

CLARIFICATION: Okay, so the game on 11/23 was the second time that CHS has made it to the state semifinals...they were in the state semifinals in 1988. This is the first time, however, that they made it to the State Championship.

Radiology, Day 1

2007-11-19T17:38:00.000-06:00

Well, I began my radiology rotation yesterday, and I must admit that I think this will be a nice "break"...only a couple of hours of lecture per day (and no stresses about missing lecture due to interviews), a great opportunity to learn skills that will be of tremendous help in my medical career, and from what I've seen so far, lecturers who will be quite entertaining! No studying for board exams, no stressing out about patient placement, no call...if only residency were this easy! Oh, well, guess I'll have to live it up while I can!

Having said all that, I do anticipate learning a great deal about reading x-rays, CT scans and the like...I feel as if I've already learned a lot even after only a couple of hours of lecture yesterday. I eagerly anticipate being able to "impress" on rounds next year after having been through this course. Speaking of which, guess I'd better get ready to go to school for lecture, so I'll end this for now. Ciao!

Found on a bumper sticker in Galveston, TX...

2007-11-18T21:02:00.000-06:00

"Galveston Island...because life is too short to live in Houston!"

Saw that last week right after arriving in Galveston.

Galveston and the USMLE Step 2 CS

2007-11-18T20:26:00.000-06:00

Last week, Jen and I drove down to Galveston for my interview with the University of Texas Medical Branch Anesthesiology residency program. The program put us up in a pretty swanky hotel on Galveston Island (see below), from which we were able to get some cool shots of Galveston and the Gulf of Mexico. Interview day went pretty well; it appears that UTMB has a very well rounded program both clinically and didactically. After the formal interviews, a couple of residents took us to a nice restauraunt (unfortunately, I can't remember the name; it was "something and Paco's", I think) on the Strand. Chocolate eruption...mmm, good stuff!

After the interview in Galveston, Jen and I drove up to the north side of Houston so I could take the Clinical Skills portion of the US Medical Licensing Exam, Step 2 (AKA, USMLE Step 2 CS). This is where I get to essentially "play doctor" at a mock clinic seeing mock patients who are presenting with various complaints. Not much to say here except that I'm glad it's over, and I think I did well...at least I hope I passed so I don't have to do it again (and shell out an ungodly amount of money for the "privilege").

Anyway, enough talk...on to the pictures of Galveston...

View of the San Luis Hotel (Galveston, TX) from the beach:

View down Galveston Beach (seawall side):

Images of Galveston from the 5th floor of the hotel:

The Gulf of Mexico:

Birmingham, AL

2007-11-07T13:48:00.000-06:00

AKA, "The Magic City"

AKA, "Pittsburgh of the South"

AKA, "City with that big statue thingy on top of a hill" (OK, so I made that last one up...for anyone native to the area, you likely know what I'm talking about).

I had my second residency interview a few days ago at the University of Alabama at Birmingham. I didn't get to take as many pictures as I did during my time in Houston, but here are a couple of pics of the city skyline...

From the window of the Courtyard Marriott where I stayed:

From the plane as I was taking off to come home to Texas:

I noticed on Monday as I was landing in Birmingham something that I hadn't seen in a while...I saw trees with fall colors! It was surely a neat sight to see a carpet of trees colored in green, yellow, red, and orange all over the landscape...we don't get too much of that in Texas, as most of the trees aren't those that change color this time of year. Too bad I wasn't able to get any shots of the trees from the plane.

All in all, a fantastic anesthesiology program. The main facility is a brand-spanking-new hospital completed in 2004, complete with HUGE operating rooms and the latest technology. Also, like Houston, the majority of the facilities in which residents rotate are located in a cluster in the middle of the city, which makes for a rather large medical complex. The aspect of the program that struck me the most, though, is the people...I got to meet a number of residents during dinner on Monday as well as during the day Tuesday, and they all seemed very happy and enthusiastic about their program, as well as friendly and eager to answer any questions we medical students had. Also, the faculty members were very laid back and open, in particular to areas where they see the need for further improvement.

I also got the chance to set up a last-minute appointment with Internal Medicine (UAB is an advanced program that requires a separate internship before starting their anesthesia program)...I got to spend some time with one of the Medicine chief residents after my interview with the Anesthesiology department. That turned out to be a pretty cool interview...it turns out that this particular resident is a member of a PCA (Presbyterian Church in America--which happens to be my "denomination") church in Birmingham, and it was neat to hear him talk a little bit about how he came to where he is in life (not only as a physician, but as a follower of Christ) and about how God has sovereignly worked out the events of his life. It served as a reminder to me during this time of uncertainty that God is completely in control, and that he indeed does work things for good for those that love him (see Romans 8). I find that I constantly need reminding of that.

I'm also happy to report that I'm done with the "written" portion of the USMLE step 2; I have the "clinical" portion (or USMLE Step 2 CS) in Houston next week. I'll be so happy to have these step 2 exams behind me...I'm frankly to the point where I'm sick of studying for 'em!

Oh yeah, the "statue thingy" I was referring to in the beginning of this post...that would be the Vulcan statue that is on a hill overlooking the city...it's a tribute to the city's history as a steel-making town. Supposedly, it's one of the larger metal statues in this country other than the Statue of Liberty. Unfortunately, no pics from me, but I'm sure you can find plenty online.

Houston

2007-11-03T15:02:00.001-05:00

I got back from my first residency interview in Houston, TX a couple of days ago...I interviewed at one of the programs associated with the Texas Medical Center, a huge medical complex consisting of a bunch of hospitals (including MD Anderson Cancer Center, Ben Taub General, Memorial Hermann, Texas Children's, and others) and 2 medical schools all located on about 800 acres just outside of downtown. In fact, TMC is the largest medical complex on the face of the planet. The place is enormous, and no pictures that I could show you could do it justice. Overall, I think the interview went very well; I was impressed not only by the facilities there, but also by the faculty members and the residents in the program.

OK, on to the pics...first off, a random shot of the downtown skyline:

The next several shots were taken at Hermann Park, a large park/"green space" located next to the medical center. Not only is it a good place to jog/bike ride/do other sorts of outdoor activities (when it's not 1000 degrees with 1000 percent humidity like it can get during the summertime), but it also houses the Houston Zoo as well as the Museum of Natural History.

Cool looking fountain:

Palm tree:

Reflection pool:

Statue of Sam Houston:

Random shots in the park:

Houston MetroRail--recently, Houston approved an extension of the Metro's light rail line to places beyond downtown and the medical center.

Above the treeline is Memorial Hermann Hospital, the main teaching hospital for UT-Houston.

Shots of Texas Medical Center looking southbound on Fannin Street...again, these pictures don't give any justice to the immensity of the place. The MetroRail light rail line runs down the center of the street.

Next up...Birmingham, AL in a couple of days.

Happy Halloween, part 2

2007-10-31T18:47:00.000-05:00

Jen had a special lunch (for lack of a better word) at work today, today being Halloween. Everyone in the office was asked to bring something "creative"; this is the bread dish that she brought to the gathering. Can you tell what it is?

This is just one example of my wife's creative side...I must admit that she has more creative and artistic skillz than I can ever hope to have :-)

And, in case you're interested, here are just a couple of more photos of her past artwork...her specialty by the way is sculpting (especially flowers), and she's darn good at it!

Happy Halloween

2007-10-31T18:06:00.000-05:00

Well, I didn't know what else to title my blog at the time, so I guess you'll have to live with it :-P

Just a few random musings...

Just joined Facebook not too long ago and already I'm finding it pretty cool...it's enabled me to get into contact with many people that I haven't seen in quite a long time and hopefully it'll help me keep in better touch with friends and family.

Now, having said that, I will say that I do believe in the more "old-fashioned" forms of communication (ie talking on the phone, letter writing, etc), and I don't wish for sites like "Facebook" to replace that for me or for that site to become a replacement for normal human interaction. Even so, I do think that sites such as Facebook are/can be good in that they can enable people who haven't been in touch with each other in a while to reconnect. I've already been able to reconnect with some old friends from college, for example, and to my great happiness, I have discovered that one of them is moving to the Big D in a few months! Anyway, those are my thoughts on sites like "Facebook" after having been on the site for a few days.

OK, residency interview update...

Right now, the tally stands at 13 anesthesia interviews after I decided to cancel one that I had already scheduled. Going on my first interview tomorrow (actually, will be travelling to Houston tomorrow; the actual interview's in 2 days). Not feeling very nervous yet, but I'm sure I'll start to feel that way in a couple of days as the interview proceeds.

To my readers--your prayers for safe travel and that I represent myself well while interviewing will be appreciated. Will keep in touch about how it goes.

Corollary to ZZZZZZZZZZZZZ.....

2007-10-26T16:25:00.000-05:00

In the spirit of my previous post, I thought I'd attach this video...enjoy!

Credit goes to some med students at the University of Maryland who put together a series of these videos that parody the Budweiser "Real Men of Genius" commercials.

ZZZZZZZZZ.............

2007-10-25T18:54:00.000-05:00

You know how in high school yearbooks you have superlatives such as "most likely to succeed", "most intelligent", "cutest/best looking", etc, etc?

Well, I got an email today stating that my med school class has voted me "most likely to fall asleep in class" and "least aware of his surroundings". I think the first one is appropriate...I know myself to often have problems staying awake during lectures and sometimes while I'm reading, at church, or even at a movie if I'm tired enough. In fact, I'll go so far as to even say that...ZZZZZZZZZ.......

Man, that was a good nap!

Anyway, as far as the second "superlative" vote is concerned, I'm not quite sure what my class means about "least aware of surroundings"...perhaps that's why I was voted for that...oh well...

---Interview update---

So far I stand at 14 interviews scheduled for anesthesiology programs, 2 prelim internal medicine programs, and 1 transitional year program. I consider myself lucky that I've received so many invites...in fact, I'm pleasantly surprised. I didn't think I'd already have 14 gas interviews lined up by this time. First one is in about a week and a half in Houston. Let the fun begin!

GOOOOOO TIGERS!!!

2007-10-20T16:08:00.000-05:00

Clemson 70, Central Michigan 14

70...the most points Clemson's football team has scored in 26 years (since their national championship in 1981). This is a good win for the folks in orange and white after what they've been through the past few weeks (::shudder::)...hopefully this represents a bit of a turnaround for the Tigers that they can build upon the rest of the season. Next up...Clemson at Maryland...

FREEEEEEEEEEEDOM!!!!!!!!!!!!!!

2007-10-19T16:26:00.000-05:00

At least for the time being....

I finished my Internal Medicine subinternship yesterday afternoon (after yet another exciting call night), and boy was I ready to be done! Not that my team was bad (I was lucky yet again to have a really great resident and attending), but working at the VA for the past month was...how should I put it...painful at times! Having to call nurses, the lab, radiology, etc, etc to make sure things were done in a timely fashion; having some of the nurses try to get an attitude with either me or others on my team; important orders not being carried out...by the end of this rotation I was just sick of it all. I guess I should get used to it though...this is exactly what I'll be facing as an intern next year (::shudder::).

All that aside, I'll now segue to the part where I state that every cloud has a silver lining (you know, you should avoid cliches like the plague, right?)...I did manage to get some interesting patients to take care of during this rotation from which I learned a great deal. For example, I had a patient who presented with a blood sugar low enough to put a lot of us in a coma, and despite slamming him with amps of D-50 (i.e. 50% glucose solution) and a D-10 drip, his sugars wouldn't get anywhere near normal levels! Eventually, by considering the patient's history and social situation, along with researching literature and recommendations for this type of presentation, my resident and I were able to come up with a solution, which happened to work quite well! Patient ended up being discharged two days later doing quite well. I also had the chance to work on presenting patients both during call and during regular rounds, and despite my feelings sometimes on the whole dog-and-pony show aspect of academic medicine, I know that this will be valuable for me as an intern and beyond. For what I did manage to learn, I will be grateful.

Another thing I had to face during the past few weeks is (yet again) dealing with feelings of anger and frustration...boy, were they prevalent in me during the past few weeks! I had to learn to deal with the frustrations inherent in working in a system such as the VA; frustrations in managing patients who despite our best efforts seemed to take forever to get into a position where they were ready for discharge; and frustrations at myself during the many times in which I felt totally incompetent and incapable of ever becoming a good doctor. Hopefully facing these frustrations and coming through them has taught me something...

I was reassured yesterday by both my resident and attending physician on the rotation, who both had nothing but praises for my performance on this subinternship. To hear from my attending that I was really on top of things with my patients, really organized, etc. was really reassuring to hear, especially considering all the self-doubting that I have experienced since the beginning of clinical rotations over a year ago. I guess it really is true that for those of us going into medicine, you really never feel completely competent, and for residents and attending doctors who are responsible for the very lives of their patients, that can be a really scary thing at times!

Well, I (thankfully) have a month off from school coming up. It won't be a vacation by any means...still gotta prepare for the USMLE Step 2 (clinical knowledge and clinical skills) exams that I'll be taking in a few weeks, and residency interviews will begin for me in two weeks. It's still going to be a very busy time, but at least I won't have to go to campus or to the hospital every day.

For the vast audience (all 3 of you!) who keep up with this blog, your thoughts and prayers as I go through this application and interview process are greatly appreciated. Will keep you posted.

Don't know what to title this

2007-10-11T20:08:00.000-05:00

Well, I feel like doing an update on this here blog, but at the moment, I'm not sure what to write about. I'll just improvise. It's been a pretty rough week, and my brain's pretty fried right about now. I'm just counting down the days until this Internal Medicine subinternship is over and I can finally have some time off. Only about one more week of this left...maybe when my brain's not in such a fog, I'll be able to tell more about why I feel at times ready to pull my hair out :-(

This week's not been all bad, though. Jen and I did get to go to a get together with the Department of Anesthesiology of UTSW at the program director's home Tuesday evening. It was a nice time to get to chat with some of the anesthesia faculty, residents and other classmates interested in being gas-passers. Also to drink spiced tea (yummy!) and eat fun finger foods. It was nice to chill for a while on a really nice evening and have a few laughs with people who may be my future colleagues.

An update on the interview process...now I'm at 14 anesthesia interviews, 3 interviews for preliminary internal medicine positions, and 1 interview for a transitional year spot. First interview is in about three weeks. It's starting to get to the point where I may start cancelling interviews to fit in programs that I may be more interested in (as I get invites from them). Will keep my huge fan base posted.

You know you've been in medical school too long when...

2007-10-06T17:31:00.000-05:00

You get one of these foam fingers at a sporting event....

and you instantly think, "gee, if this weren't made of foam, it may be the perfect tool for doing a RECTAL EXAM!" (And/or not-so-pleasant memories of doing said rectal exams enter into your mind.)

Got this foam finger when my wife (a very avid Stars fan) and I attended the home opener of the Dallas Stars last night...we walked from the DART station to the American Airlines Center and walked through the new Victory Plaza area where they were doing a Dallas Stars pregame / Texas-OU party, complete with cheerleaders from both Texas and OU along with already drunken Longhorn and Sooner fans mocking and screaming at each other. Fun!!

Anyway, we did have fun at the Stars game as they beat up on the Boston Bruins 4-1. Jen even got to laugh at me as I played with those "thundersticks" for a good part of the game. A good way to spend some precious time off.

Just in case you were wondering what anesthesiologists actually do during surgery....

2007-10-03T19:42:00.001-05:00

Watch and learn...no wonder so many want to go into gas :-P

Another funny video by the same guys (warning: contains language considered inappropriate by some):

Call numero dos

2007-10-03T18:21:00.000-05:00

Phew...glad that this call is finally over! It actually wasn't too terrible but certainly was not as easy as my first call of my medicine subinternship where I didn't get paged during the night at all.

I actually got paged twice during the night last night (just when I thought all my patients and cross-cover patients were nice and tucked in and I could get some sleep)...

First page came at about 2:30 in the morning, and I was being called about someone who I was not covering for...went sort of like this...

Me: Hello, this is stuartcmd, I was paged...

Nurse: Yes, I'm calling because the lab wants to report a "critical value" for one of your patients.

Me: Can you tell me what the "critical value" is?

Nurse: No, all I know is that the lab has a critical value to report.

Me (thinking): Oh, boy, here we go!

Me: What's the patient's name?

Nurse: (mutters something that sounds vaguely like the name of one of my cross-cover patients)

Me: What's the patient's medical record number?

Nurse: XXXXXXXX (number that doesn't match up with any of my cross-cover patients or my new admits)

Me: Ohhhhhkayyyyy...that doesn't sound like one of my patients...can you say the name again?

Nurse: (states name a little more clearly)

Me: (repeats name that nurse states)

Third year medical student in call room with me: That actually sounds like one of my patients...what's going on?

Me: Lab has a "critical value"

Third year MS: It's probably her sodium...we already know that she was admitted with an absurdly low sodium!

Me (thinking): grrrrr.....

Me (to third year MS): Can you remind me of our new intern's last name and pager number?

Third year MS: (gives me info I asked for)

Me (to nurse on phone): Hello? I think you actually need to talk to the intern on my team, not the subintern...

Nurse: Okay, thanks!

Me: Thanks! (hangs up)

Me (thinking): and I'm paying how much to apply for a job next year that'll have me responding to tons of stupid pages like this?!?!?!?

Okay, so that only lasted a couple of minutes...no big deal...I'm able to lay back down for about another hour until I get my next pager call...this time it is for one of my cross-cover patients who in his state of dementia has removed his IV access. The IV team has failed to regain access, and so the nurse calls me to come to the rescue, which is kind of ironic, since I have far less experience starting IVs than the IV team at the hosptial! Oh well, I call the night float resident (a real MD, nonetheless) and we get to work trying to establish access. Unfortunately we were unsuccessful and had to leave the task for the patient's primary team to take care of once they came in in the morning. After all that, it was about 4:30 and time for me to see my patients before morning rounds.

I guess the benefit of being up that early was that I was able to get a head start on some tasks that needed to be done today before I went home, but the lack of sleep during the night sure made post-call rounds a painful experience! I hope my attending doesn't look down too much on me for being awake probably only about 25% of the time during rounds this morning! Ugggh! Internship year is going to be so much fun (note scathing sarcasm present in that remark).

On a brighter note, the interview invites keep coming in...one yesterday for a transitional year at John Peter Smith Hospital in Fort Worth, one for a preliminary internal medicine year at my home medical school, and one for an Anesthesiology residency in Atlanta. Brings the tally up to 11 gas interviews. Not bad!

To think about all this from another perspective, though, I guess I shouldn't complain too much...I do feel really lucky and grateful to God that I'm in the position I'm in. Despite all the red tape and other crap that physicians have to deal with on a daily basis, I still can't imagine myself doing anything else. There is still that gratification that comes from knowing that I am actually doing something good for other people with the talents and abilities the Lord has given me. I'll have to try to think about that more the next time I'm cursing the computer system at the VA and/or the staff for not getting necessary patient care orders taken care of... :-)

Double digits!

2007-10-01T16:48:00.000-05:00

I've finally made it up to 10 gas interview invites...heard from Vanderbilt today. Brings the tally up to 10 gas interviews, 1 prelim interview, 0 transitional year interviews, and 0 rejections yet. Kewl.

I'll have to find some way soon of spicing up this blog...like pictures or something. Maybe soon. For now, peace out!

Subinternship...week 1 (aka...ARRRRRGH!), Gas passing

2007-09-30T19:38:00.000-05:00

Well, I've just finished my first week of my medicine subinternship at the VA medical center in Dallas, and I must say that it's been an interesting and sometimes frustrating week. Fortunately my frustration stems not from my residents, attending or fellow medical students...in fact, I consider myself lucky to be working with the people I've been with so far. I've also had the chance to see some pretty interesting patients, including one who was basically just chillin' despite having some quite serious radiographic findings in his lungs...he reported no problems whatsoever but fortunately understood why he was in the hospital. The main thing that has frustrated me this week is the SYSTEM...let me 'xplain. First off, the computers...everything at the VA is computerized...the patient records there are virtually paperless. I am a proponent of electronic medical records--if done right they can save tons of time, money and resources for any healthcare setting. However, most of the computers are S....L....O.....W, painfully so. Heaven forbid you run into a setting where a computer is "locked" and you have to restart the system so you can write orders or input a progress note...you might as well go buy a cup of coffee as well as have a smoke break while you wait for the #^$% machine to get to the point where I can even log in! (by the way, no, I don't smoke...very nasty habit!)

If the computers were the only thing that made me want to pull my hair out, I could probably just grin and bear it. I'm used to slow computers by now...a lot of the computers at "the lands" must be at least 10-15 years old (okay, maybe that's a bit of hyperbole there). Another thing that I've run into is the fact that unless you're really on top of things, things tend to get done at a snail's pace at the VA (if they get done at all). A couple of days ago, I was working on trying to discharge a patient (who turns out to be homeless) only to find that we had to have a "travel consult" placed before our patient could get on the bus to where he was planning to go. This might not have been so bad had we known about it more than ONE HOUR before the bus was to pull out of the hospital. This was also in addition to the fact that no one seemed to be in a hurry to get this patient's discharge paperwork and medications ready. Well, my resident and I scramble to get everything taken care of before the bus pulls out and just at the last minute we think we have him ready to go. Then, we find that for reasons I won't get into here, he can't go where he was originally planning to go. Okay, moving on to the next topic...I think I've ranted enough here about the SYSTEM for now. At the very least, my first call day/night was not so bad...everything ran pretty smoothly and I was able to get a little bit of sleep. I'm not under any illusion, though, that all my call nights this month will be that easy.

Before starting this subinternship a week ago, I had spent a month at Parkland with the anesthesia folks as I did an "acting internship". Basically I was assigned to a room each day with a faculty member and resident (or CRNA) and I spent my day in there helping out in whatever way I could and at times sitting in the "pilot's seat" at the anesthesia machine. All in all, it was a good experience as I was able to meet some of the faculty and residents and learn about what is involved in running a case in the OR. I also had the chance to take call with the chief of the department for one night, and I did get to see some pretty interesting trauma cases throughout the month. My month doing anesthesia, I think, served to further cement my thoughts that anesthesia is a good fit for me in terms of career path after I finish med school.

Speaking of after finishing med school, the interview tally still stands at 9 anesthesia programs and 1 preliminary internal medicine program. Will update on that as more invites come in (at least I'm assuming more invites will come :-P ).

Anesthesia Applications

2007-09-26T21:47:00.000-05:00

Just an update on my residency applications...I submitted my application about 2 weeks ago to 27 different anesthesia programs as well as 13 preliminary internal medicine and 7 transitional year programs (prelim and transitional programs are one-year internships that fulfill the "clinical base year" that some anesthesia programs require me to go through before starting anesthesia training). So far, I've heard back from 9 anesthesia programs (10 if you count the one saying "we'll get back to you after November 1") and one preliminary (internal medicine) program--all of them inviting me for interviews...yeah! No rejections so far, so that's a relief. Now it's a matter of trying to get everything scheduled in the midst of working my tail off in my medicine subinternship at the Dallas VA (to be commented on in a later post). That ought to be interesting...

Nehemiah 8

2007-09-23T23:19:00.000-05:00

There are times when it suddenly occurs to me..."wow, God still loves and cares for me despite all the %$#& I've done and the stuff I've neglected to do." This weekend was one of those moments in time...I kind of randomly decided to plop down on my bed and (for the first time in a long while, I'm ashamed to admit) read some out of my Bible. I started reading at Nehemiah 8 (seems kinda random, I know...it's picking up where I left off in my quest to read the entire NIV Bible from front to back...a quest that so far has taken me over five years to get to where I am...). I got to verses 8 through 10, which read thusly:

8 They [the Levites] from the book of the Law of God, making it clear and giving the meaning so that the people could understand what was being read. 9 Then Nehemiah the governor, Ezra the priest and scribe, and the Levites who were instructing the people said to them all, "This day is sacred to the LORD your God. Do not mourn or weep." For all the people had been weeping as they listened to the words of the Law. 10 Nehemiah said, "Go and enjoy choice food and sweet drinks, and send some to those who have nothing prepared. This day is sacred to our Lord. Do not grieve, for the joy of the LORD is your strength."

A little bit of context...Nehemiah takes place during the Old Testament time right after some of the Isrealites return to Jerusalem and Isreal after 70 years of exile. In chapter 8, we find Ezra the priest reading from the Book of the Law of Moses. It seems to me as if the people are weeping because they are struck by the words of the Law and how far they were from fulfilling what God had required. As a matter of fact, the reason (in a nutshell) for the exile was Israel's disobedience and sin. Even so, God restores a remnant of His people after a time of darkness and exile; He does not forget His own. Despite the grief the people are feeling, Nehemiah tells them not to grieve; in fact, he tells them to go celebrate! Why is this? Why does Nehemiah state in this context "the joy of the LORD is your strength", therefore one shouldn't grieve?

Whatever the answers to those questions may be to anyone who reads this, it reminds me that God does in fact take delight in restoring his people, no matter how far we have fallen, no matter how far away we try to run. I find it astounding as I read through the Old Testament how the Isrealites time and again disobey God and at times give him the proverbial middle finger, even after shouting as a congregation that they hear and will obey the words that come out of His mouth! I then turn an inward look at myself and realize that I do the same thing daily. I often have a self-centered, woe-is-me, attention-seeking attitude; I have a tendency to waste time doing things that cause me to neglect more important items that need to be taken care of. My prayers and time in Scripture are areas that have sorely been neglected for a long time now, and it not only has affected me, but it has had an effect on Jen (my lovely wife) and our marriage. I am encouraged, though, that God forgives and delights in taking me out of the quagmires I often stumble into and guides me onto the road leading to righteousness. It is my prayer now that I continue to make prayer and Scripture a much greater priority than it has been...despite the fact that it's often not easy to do that as a medical student, I know that it isn't going to get any easier to carve out that time in residency. Yet at the same time, I need to be disciplined in that not only for myself but for my wife and future family.

Well, I probably ought to get to bed since it's now way past my bedtime. Gotta get up in the morning and start my Internal Medicine Sub-I at the VA. Planning on writing some updates on my Anesthesia sub-i, residency applications (I've 2 anesthesia interviews lined up thus far...yay!) and all that jazz in the not-too-distant future. For now, adios!

Neurology

2007-08-26T23:11:00.000-05:00

I know that all my adoring fans (all three of them) have been drooling at the prospect of hearing something new for a while, so here's something new to chew on...

Just finished my Neuro rotation at the VA hospital, and I had my last "shelf" exam this past Friday. First of all, thank goodness that those "shelf" exams are out of the way. For those of you not in med school, the "shelf" exams are insanely difficult tests that I've had to take at the end of most of my rotations thus far...bad thing about these tests is that I've managed to destroy a perfectly good "A" grade in some of my clinical rotations by not doing well enough on the shelf to earn said "A". Anyway, enough griping...I'm glad to be done with 'em. From here on out, my clinical rotations are all pass-fail...YESSS!

Anywhoo...I must say that I enjoyed Neuro more than I thought I would. It might be partly due to the fact that I had an excellent attending and residents on my team in addition to some pretty cool classmates. We really tried to help each other learn (as well as do what needed to be done on the wards and in clinics), and all in all, I think we had a good time doing it all. Oh yeah, I did learn some stuff that I'm sure will prove useful later on.

Well, now it's on to my subinternship in anesthesiology...the specialty I'm planning on going into. Should be fun! Will update on that later. For now, hasta luego!

What's it like to be a med student's first patient?

2007-07-06T20:12:00.000-05:00

Found this article on msn.com today...very interesting account of a standardized patient and what it's like to be the first person that 23 med students practice their physical exams on. Reminds me of a time not that long ago when I was a second year med student just starting to learn physical exam skills...

Playing Doctor

Enjoy!

First Post

2007-07-04T20:40:00.000-05:00

Ah, yes, another one of those "blog" things! What have I to add to the bagillions of blogs, webpages, and such out in the World Wide Web? Well...maybe not too much, but at the same time I thought it'd be a fun project for me to try at the very least so friends and family could have a little insight as to what's going on, especially since I often don't get to keep in touch with friends and family as often as I'd like.

My name is Stuart, and I am just starting my 4th year of medical school (yes, I know, the website has "MD" in the url but I am most certainly not one of those...yet). I suppose since I mentioned med school, I'll give a little synopsis of how things have gone so far. Med school, for those who don't know about the process, consists of two years of classroom teaching and two years of clinical rotations in which you actually participate in patient care. The first two years for me consisted of classes in such topics as anatomy, physiology, pharmacology, pathology, and the like. A lot of studying, a lot of tests. That's all I'll mention about that for now...if anyone's interested in hearing more, I'll be happy to divulge a little more in a later post. Third year is when the real "fun" begins...that consists of clinical rotations in core specialties, i.e. internal medicine, psychiatry, ob-gyn, pediatrics, family medicine, and surgery (and depending on the medical school, any other required rotations). Yes, there are still lectures and exams (often called "shelf exams") that have to be taken, but the vast majority of the time is spent in the hospital taking care of patients, rounding with the care team (residents and attending doctors), and depending on the rotation, taking overnight call. At times it's fun and exciting; at other times it can be exhausting and downright "not fun", especially if you're being dressed down by an attending doc for not knowing a minute piece of knowledge when asked about it. Thankfully, I'm almost done with the core rotations...just one more to go (neurology); I'll be taking that in about a month. For the most part, fourth year is a lot less stressful than third year--this consists of mainly elective rotations that are graded "pass-fail" as opposed to the "A, B, C, F" system used by the core rotations. This is also the time when students such as myself begin investigating and applying to residency programs...I'm sure I'll have more to say about that in later posts. Tomorrow I start a month-long rotation where I'll essentially spend a month with a private family doc at his practice. I'm actually pretty excited--hopefully this will offer me the chance to hone some of my clinical skills without the added stress of "shelf" exams
and being put under the microscope like I was during core third-year rotations.

Anyway, just some random thoughts and musings as I begin my fourth year of med school...looking forward to posting some more in the near future. For now, arrivederci!