Random Challenge

So my friend Hari Krishna, has challenged me to what can only be described as the blog-equivalent of one of those "get to know you" chain emails. Seeing as I've got and hour and half until rounds and nothing to do except study, I have decided to rise to her challenge.

So here are six random things about me, appropriately in random order...

1. I am daily amazed at how blessed I am. Sometimes it takes my breath away.

2. I have a borderline unnatural interest in dragons. Had it not been for finding cool friends in elementary school, I might have ended up being a third level wizard in the local Dungeons and Dragons club. Instead, I just spend too much time reading dragon related books and watching dragon based tv shows and movies (think Harry Potter, Eragon series, DragonHeart, etc).

3. Despite the fact that I have completed approximately 5/8 of my medical career, I am still scared to death of getting my long white coat, more specifically the responsibility that comes with it.

4. I love the holiday season, especially Christmas. I love hearing the same cheesy Christmas songs sung by the "original" artists (think Frank and Bing) a thousand times. I love candlelight Christmas Eve service. I love the twinkling lights. I love the cold. And, secondary to this love of Christmas and my present state of free time, I have already started decorating my house. Just the inside. I figure that I don't exactly entertain on a weekly basis, so I can get by with starting to deck the halls with bows of holly, and no one but me will know the difference. I won't consider this abnormal until I start doing it before Halloween.

5. Sushi has become a staple in my life. Every time the Cutest Boy in the World mentions eating out, my first thought is always sushi. I try my hardest to suppress this so that he can enjoy some variety in his diet, but somewhere deep inside as I stuff my face with cheese dip and chimichanga, I feel disappointed that its not sushi. I'm pretty sure I could eat it, realisitically, three times a week. Yum....

6. I think Ann Taylor Loft should pay me a small advertising fee. Thanks to my recent need for professional clothes, my wardrobe is almost entirely sponsored by the store. Don't get me wrong, I go shopping other places. But I always end up getting scared by the trendiness or overwhelmed by the selection or disgusted at the prices. Therefore, I head back home to the Loft.

ElectroShock Therapy

Electroshock Therapy, or as it is properly known in the medical community ElectroConvulsive Therapy (ECT), seems very archaic, medieval even. It's a form of therapy that has been used in psychiatry for over 70 years to, well, basically knock the crazy out of people with a jolt of electricity. Most people probably think of One Flew Over the Cuckoo's Nest, with Jack Nicholson being forced down to have metal probes attached to his head while he's desperately fighting against restraints when they think of ECT. Or maybe they just imagine a mild form of an electric chair that leaves the patient a zombie instead of a corpse. I'm not going to lie. That's what I thought.

Until today.

ECT is still commonly used in psychiatry to treat patients when all medications have failed. So, I followed down two of our patients as they went for treatment. As it turns out, the patients are sedated and given muscle relaxers. Then metal electrodes are placed on their heads, only causing their face to tighten into a deep grimace as the electricity is administered. It's actually a very benign procedure. The only evidence of the seizure being induced is one foot, that has the muscle relaxers blocked by a blood pressure cuff, which goes into myoclonic seizures... Just flapping around until the seizure ends.

Here's the kicker though...

I administered my patients' ECT. I held the metal electrodes to their temples. I caused that electricity induced seizure.

I think I can safely say that my ignorance and misconceptions surrounding ECT is no longer...

Dictation

I did my first dictation this week. Here's a glimpse of how it went...

"The patient was admitted on 11/1/08 with the diagnosis of.... uh..... with the diagnosis of.... uh.... (pause system)... ... ... ... ... (unpause system)...
Axis I major depressive disorder... next line...
Axis II borderline personality disorder... next line...
Axis III none... next line...
Axis IV none... next line...
Axis V GAF 40 out of 100... next line...
to 7 west under the care of... uh.... uh... Dr. Smith... wait, error, scratch that... under the care of... uh... uh... Dr. Jones... period. (This continues for a long time)

Dictated by Lindsey Miller, L-i-n-d-s-e-y M-i-l-l-e-r, M-3. End dictation."

It was a pretty painful experience.

DayLight Savings Time

I've got one word for it: Phooey.

It's 8pm and it looks like its 2am outside, which means my body thinks that its at least midnight... And that means it's way past my bedtime.

I'll say it again... Phooey...

Reunion

I went up to 7West today, the inpatient psychiatric ward, to finish off my psych rotation. Well, for the last three weeks, we've been sending patients from the ER up to 7West for extended stays. That means today was like a reunion. All my old friends from the PES and me, together again for the next 3 weeks.

Fun Crazies

Some of the crazies I've seen in the PES are just plain fun. I mean, I realize that they do suffer from an illness and it's not anything they asked for or can help, but I'm sorry, some delusions are entertaining. Here are some of my favorites thus far:

-Thinking the reason people bump their shopping cart into yours at the grocery store is because a voodoo man has cursed you

-Watching TV and then the preacher stops, looks at you, then puts his ear against the TV screen to listen to what you are saying to him

-Carrying around a bag of roots and branches because you recently remembered that a few hundred years ago you were a Native American

-Looking out your kitchen window to see three dinosaurs playing in your backyard



(This post will hopefully have an addendum before the conclusion of my psych rotation.)

Back of the ER

Every Thursday night at 9pm on NBC for the last fifty-two years, the show ER comes on. This program is full of fast moving, life-and-death action as gunshot wounds, stabbings, car wrecks, and the like pour through those sliding glass doors into the trauma rooms. And during my surgery rotation I saw a glimpse of this. I was in the room as codes were run, both successfully and unsuccessfully, arteries squirted blood across the room, amd bones stuck out of people's skin at unnatural angles. That was my life in the ER, and I wouldn't have been shocked if Dr. Carter or Dr. Benton had walked in at any moment.

Now, I'm back in the ER, but life has changed dramatically. I'm in the Psychiatric Emergency Services (PES): three bare rooms with uncovered windows and a small nursing station in the very back corner of the ER. It stays quiet back here, except for the bihourly floor buffing. We are so isolated from the rest of the ER, I wouldn't know if all the victims of a 12 car explosion on State Street were being rolled in as I type.

I just sit back here in the PES, part of me hoping that some weirdo will walk in off the street complaining of being chases by pink elephants and part of me hopes nothing will disturb our little corner of peace and quiet, but always wondering what's going on in the real ER.

Psych

I see crazy people...

One for the Textbooks

"If you hear hoofbeats, it's probably not a zebra."

In medicine this phrase means anticipate the exotic, but expect the obvious.

In Family Medicine, my current rotation, I find myself chasing zebras daily...

High blood pressure, sweating, insomnia in a nervous woman? Probably just anxiety, but I had my money on a pheochromacytoma.

Sore knee in an 18 year old volleyball player? Most likely just twisted, but I swore it was gonoccal arthritis.

But, today, we had a woman who woke up this morning with an extremely tender neck and throat, and completely unable to swallow. Strep throat? Oh no.... We ended up sending her to the ER with the possibly fatal condition of epiglottitis. This is when the epiglottis swells, closing up the throat and eventually the airway. It is most often caused by a bacteria that is now vaccinated against, but this lady was 80 years old, so she missed the vaccine boat.

Epiglottitis is something we read about in textbooks all the time, but as it turns out, this was the first time my attending had ever actually seen a case. Guess my African safari skills finally paid off.

In The Words of Mark Twain

The rumors of my death have been greatly exaggerated.

I'm still alive. I'll update my faithful reader soon.

Pimp Slapped

Today on formal rounds with the attendings, I had to present a patient who has been a resident of the VA for over a month. I stumbled through my presentation semi-triumphantly, only to be hit by the pimp sessions of all pimp sessions.

I was pimped on drugs. I was pimped on procedures. I was pimped on physiology. If your wildest medical imagination could dream it up, I was pimped on it, for 20+ minutes. I could actually see my fellow M3s pleading to the attendings with their eyes to stop the brutality. But I actually thought I did decent... I mean, I knew, maybe... half of the answers....

I can remember the days of my life when I used to know all the answers, routinely make 100s on tests. Nowadays, however, knowing around 50% is something to celebrate. Oh how times have changed...

It All Comes Down to Poop

My time on General Surgery can really be summarized in one word: Poop.

Every morning I go in and see my patients, and they want to tell me about all their problems. But all I really need to know is if they have pooped. Then, depending on the patient, I might be interested in the color, quantity, or quality of said poop.

And at least a few times a week General Surgeons get pooped on. For example, during one rectal prolapse repair last week, our patient opted not to finish her colon cleansing dose of Golytely, and throughout the case we had to stop the case to clean up while she pooped on us.

So, I guess it's not hard to guess that my opinion of General Surgery might also be summarized in one word: Poop.

Life's Too Short

When I was in Italy, I spent the day at a gorgeous vineyard in Tuscany. The mansion on the hill that was once owned by the Medici family overlooked hundreds of hundreds of acres of land arranged in the perfect rows of grape vines. Here we had a wine tasting, which is really just a socially acceptable excuse to get drunk in the middle of the day. At the end of it all, I came home with many bottles of wine, but my favorite was the Malenchini Bruzzico Toscana.

Now, for three years I've been saving this bottle of wine, thinking to myself "I'll open it for a special occasion." Well, when special occasions have arisen I have either forgotten about the wine or sheepishly decided to wait for something a little bit more special. Until this week.

This week, I decided that life is too short to save wine. Wine is meant to be enjoyed amongst people you care about, or sometimes people you've just met. Moral of the story, it's meant to be enjoyed. So I popped open my bottle of Bruzzico this week, and enjoyed every sip of it with The Cutest Boy in the World. It reminded me of all the fond memories I have from my time in Florence, but, as I believe was this bottle's purpose in the world, it opened up all the possibilities of the next time I go to Italy.

Wine Tasting at Malenchini.

Beginning and End

There are a few milestones in a surgery case. First, the patient rolls back to the OR. This signifies that case is a "go." Then the time out. This is when all involved agree upon what patient, what surgery, and what site is about to be performed. Next comes the first incision. The case has officially begun. The final milestone is closing, this means the case is over.

This week, I made the first incision. I started a case. I asked the nurse for the scalpel, announced "incision" to the room, sliced, and drew blood. Then, I closed the case. I sutured the skin shut and dressed the wound. I was the last person to have my hands inside this patient.

How much I participated in between... Well, that's beside the point.

Not Just Another Night On Call

Usually after a night on call I think of all the funny or crazy things that happened that I want to share. Of course, I have yet to find the time to do this. But, this past Tuesday something terrible happened.

At about 8:30pm, a child was brought in that had been attacked by a pit bull. The child was in asystole. It was my first time to see a true code, chest compressions and oxygen desperately attempting to keep this child alive. Forty-five minutes later it became my first time to see a time of death called.

Watching death win in front of your very eyes despite the overwhelming efforts of doctors and nurses alike is tough enough. Add in the fact that this was an innocent 3 year old, it makes it truly devastating. My heart broke in that trauma room that night.

Bud Light Lime

At my alma mater, I had a friend that, thanks to his love of starting his nights with a bad decision in the form of a tequila shot, always had lime on hand. Playing off his love for Corona with lime, much to the amusment and ridicule of his friends, he started putting a lime in his Bud Lights.

This weekend as I turned back a few of Bud Light's newest craze, I realized this man apparently possessed inginuity before his time. If only he had patented it when he had the chance.

So, here's to you, the originator of making Bud Light a little more exotic.

Don't call it a comeback... You've been here for years.

Fitting for My 100th Post

I realize that I haven't posted in a while, and I would like to blame that on the fact I've been trying to come up with a post worth of my 100th. Unfortunately, I'm terrible at lying via the typed word, and must admit that I have just been too darn busy to update the blog. But, as Providence would have it, my 100th post is an exciting one.

The results for the USMLE Step 1 exam have been released... and I passed!

Years of worrying, months of procrastinating, and weeks of studying relentlessly finally payed off. I am one milestone closer to tacking on those two sweet letters behind my name. Did I doubt myself? Yes. It seems like scores were passed out at random, with people you not only never expected to fail but those you expected to blow the thing out of the water receiving a failing score. Seeing as if you fail, you are pulled off your M3 service, this exam was like a diluted form of the Rapture. One day you're writing progress notes next to someone, next day they are gone.

But, I survived. And now I am just left with the daunting task of just deciding what I want to do when I grow up.

24 Hour Call

My original intention for my first 24hr call was to jump on the computer every hour or so and put in an update on what I had done. That didn't work out so much, seeing as I'm getting the reputation around the Surgery Lounge as being a cursed medical student because no one ever sleeps when I'm on call. And, come to think about it, if I even think about sleeping the trauma pager goes off. So, because I think this was still such a great idea, I'm going to work on a 24hour log of the day (that actually turned into more of a 40 hour day) and post it. So please refresh this page every 30seconds until that appears...

The New Nicorette

The last two days I have followed Dr. Pittman, UMC's Head and Neck attending surgeon. In the OR in order to remove mouth cancers we removed half of patient's jaws. We inserted tracheostomys, and biopsied tumors. At the Cancer Institute in clinic I saw a range of patients, from age 25 to 85. I saw patients breathing out of holes in their necks, speaking out of holes in their necks, and disfigured by tumor removal.

The common link between all of these patients? Smoking.

I think the Surgeon General's warning on packs of cigarettes should include pictures of these consequences. Instead of classy red designs with manly logos or sleek blues that are suppose to make women feel sexy for carrying them around, how about packages with a picture of someone missing half their face?

And then, when you buy your 100th pack, you win a free trip to the Cancer Institute to see and meet yourself in a few more years. I think it'd work better than Nicorette.

Beat Up By A Girl

Today I broke a 16 year old boy's nose.

Okay, so yes, it was part of a deviated septum repair and rhinoplasty, but the fact still remains it was me on the other end of that mallet and chisel.

Otolaryngology

My ENT rotation is more than a little bit different than the surgery I am used to. Instead of getting to the hospital at 5am to write notes on patients, I roll in at 7. Instead of following patients pre and post op, I just follow a resident from one surgery to the next. It's a great way to get a taste of what an ENT gets to do, without being tainted with what all an ENT has to do.

Frostbite

I have broken my toe...Yes, its one of those times in your life when you wish you could tell some amazing story that involves saving babies playing with puppies from a fire. Unfortunately, it was nothing that dramatic. I was rushing through my living room to grab a textbook as I was hurrying to my first day of ENT, and caught my sweet little baby toe on the ottoman.

I've stubbed my toe before, this was different. I heard a crack. It immediately started swelling. I stuffed it in a shoe, and headed off to the hospital. But walking was miserable, and I watched it slowly turn purple. It is now a nice necrotic diabetic toe color, or for those who are not blessed to know what this looks like, think serious frostbitten toe, with a pretty intense margin of blue.

But, surgery stops for no toe, so my toe and I spent the day in the OR.

Surgery Arcade

After finishing rounds and writing countless orders on our patients, my resident took me to the holiest of holy places for the surgery residents, the Simulation Lab. Only surgery residents are allowed in to practice laparascopic skills and techniques in this roomful of arcade-like games. I felt as if I should take my shoes off before entering.

So, he described to me the different laparoscopic "games" including dropping a bean into a cup, running the "bowel" (which is actually a rope), and the ultimate challenge loading a needle, suturing, and tying, all laparascopically. And, yes, I went for the granddaddy of all challenges.

Surprisingly enough, I owned it. Within 20 minutes, I had finished a knot from start to finish. This is something that 3rd year surgery residents still have trouble with. Now, I realize that this was mostly beginner's luck (because it then took me another 40 to merely throw a second knot without all the suturing), but hey, at this point in my career, I'll take luck.

Whipple

The Whipple procedure, technically known as a pancreaticoduodenectomy, is when you remove a patient's duodenum, part of the stomach, gallbladder, and part of the pancreas. Then, you reconnect everything to a part of the small intestine farther downstream. It's a massive procedure, the surgery lasting 6+ hours. And it doesn't happen everyday. Some residents go through their entire residency without seeing one.

And I helped on a Whipple. I scrubbed in; I suctioned; I helped tie the anastamosis of the stomach to the jejunum. It was absolutely amazing. I had my hands in a patient's abdomen, nearly up to the elbows. I felt a beating aorta. I held intestines. And strangely enough, 7 hours flew by!

First Call

Every morning as the M3s walk into a darkened surgery lounge with residents, interns, and students sprawled across the couches catching precious moments of sleep, we dread the day it will be us. The first question we ask our fellow M3s is "how was it?" quickly followed by "did you get any sleep?" Well...Tuesday night I took my first night of Trauma Call.

I picked up my pager at 4:30, sat down to look at the surgery consult sheet sheets that I'd be expected to fill out. This was the only time I sat all night. The pager started beeping, and it didn't stop all night long. We had two kidney transplants, a GSW/knife wounds, an assaulted prostitute, a ligated ulnar artery, lots of bloody vomit, a scrotum the size of a canteloupe, and a little boy that swallowed a nickel. I didn't even have time to look at one of the couches longingly.

So, 31 hours later, I got to sleep. I put my swollen feet up and slept through the Loo barking up a storm at the mailman, the UPS man, and whoever dropped off the phonebook. It was probably the hardest I've ever slept. Then, entirely too short of time later, I got up, and went back to the hospital. Yep. Welcome to medical school.

When It Rains, It Pours..

So, at the end of last week I was a bit more than a little frustrated at my experience as an M3. Or, to be more accurate, my lack of experience. But, today has compensated and then some. Today I was in the OR for 11 hours plus. My feet hurt. My arms are sore from retracting. But, I must admit it was fun. I got to scrub in, have someone hold open the sterile gloves for me. I got to suture and staple the wounds that I will be required to check tomorrow morning at 5am. It was pretty freakin' cool.

Organ Donation

Seeing as I am the M3 Transplant Team for another week, I feel it is my obligation to make a plug for organ donation. Basically, I'm not going to try to convince you one way or the other, although my personal thought is I'm not going to need them once I've gone on to happier hunting grounds, but I think you should know about some new legislation in MS.

As of July 1, 2008, the First Person Consent Law will take affect. This means if you have that little heart on your Drivers License, you are officially in MORA's (Mississippi Organ Recovery Agency) website as an organ donor. So, no matter what you're family, power of attorney, or great aunt Marge thinks, you're organs are going on to help those in need. (Compare this to when that heart was only a suggestion of your wishes.) In case you haven't registered with the DMV, you can still go to msora.org to be put on the registry.

Thanks. This public service announcement was brought to you by milk. Milk, it does a body good.

Nurse, Scalpel.

We know we are complete and utter nerds, and as green as Granny Smiths, when the talk of the surgery lounge today was the fact that I got to do an I & D today.

An I & D stands for incision and drainage. This is just a fancy way of saying that I drained an abscess today. I donned my sterile gloves, injected local anesthetic although this didn't stop the patients wailing, grabbed the scalpel and made a 3cm incision. Oh, and then came the floodgates of blood and pus. Gross? Yes, maybe to some. But to me, it was a chance to cut. I realize its only my second day, but I've got to admit, I think I like that feeling.

Blog's Namesake

After a riveting day yesterday of M3 Orientation where I was reminded about the rigorous rules of HIPAA, and the incompetency of the UMC Financial Aid Department, I donned my white coat today for Surgery Orientation. We talked about HIPAA a bit more, learned how to throw some knots, and, the highlight of the day, we learned how to wash our hands.

Now, almost everytime anyone does orientation in a hospital setting they are taught to wash their hands before and after coming in contact with patients with soap and water. But, today, I got the mother of all handwashing lessons. I learned how to properly scrub in for surgery. Yes, the count method. Scrub ten times on every surface starting at 2 inches above the elbow. A rough estimate, that is about 6800 scrubs for each surgery.

So, now, I meet my resident to go on transplant rounds at 6:30 tomorrow morning. I have no idea what I'm suppose to do. I barely know where I'm suppose to go. But, if all else fails, I'm going to remember to wash my hands.

The Grass is Greener on the Other Side

I'm done. I have made it to the other side of the Step 1. And it's a lot like going through Post Traumatic Stress Syndrome.

First there is anger. Yesterday I was pissed off at the exam, frustrated at the things I didn't study and even more at the things I did and weren't on the exam. I found myself taking this anger out on random people and things, as just a way to relieve some of the pressure that had been building up for the last month.

Then, I went numb. My brain just quit working. Last night I couldn't figure out how to order a pizza, pick a beer, or even remember my birthday at dinner with the girls. It was like I just completely shut down.

Next were the flashbacks. I had dreams about the questions on the exam last night. And, where I couldn't remember more than 2 specific questions when I walked out yesterday, today they have been coming back to me like a flood. Questions I got right, or got wrong, or even worse, changed from right to wrong.

If this pattern keeps on, next up should be either psychosis or recovery. I'm hoping for the latter. I'm thinking I might clean my house today, run a few fun errands, then go out to dinner with The Cutest Boy in the World. No more worrying, no more studying... At least for the next week.

And I Shall Do No More.

360 Clinical Vignettes...

250 Flashcards...

320 pages of First Aid...

26 pages of hand written notes...

314 pages of other review books...

2190 Qbank questions...


That might look like a lot of studying to you, but to me it looks like a poor excuse for trying to prepare myself for the Step. But, it's all I've got. I'm done. I'm out like the fat kid in dodgeball.

So, I'm taking the night off to watch movies and tv, and tomorrow I shall put on my bravest face as I go to face the music.

Call 911!

What is the absolute worst thing that could happen to an M2 only 36 hours before taking the Step?

Power outage? No, I could embrace the ways of the Amish and study by candlelight.

The entire city of Jackson being out of coffee? Bad, yes, but I could switch to Amp or Vault or cocaine.

Being hit by a car? Actually that might be nice. Maybe the USMLE gods would have mercy and let me post-pone taking the exam.

No, the worst possible thing to happen to an M2...

QBank is down!!

Fourth Quarter

At the beginning of the fourth quarter of every Alabama game, all the Crimson Tide fans hold up four fingers. This, probably a tradition set forth by The Bear himself, is meant to signify, "We own the fourth quarter." It is a rally. There is plenty of ball game left to come back from behind or stomp the opponents farther into the ground.

I have four days left before the Step. Although I am constantly on the verge of tears induced by stress, feelings of imminent failure, or intimidation by the vast amount of knowledge I am being tested on, I have decided to take a deep breath, and boldly hold up four fingers. I own these last four days.


"If you believe in yourself and have dedication and pride - and never quit, you'll be a winner. The price of victory is high but so are the rewards." -- Paul "Bear" Bryant

Six Days

God created the entire universe in six days. Light, dirt, water, birds, humans, the shiny slime slugs leave behind... everything. So it should be chump change for Him to help me learn the entirety of man's medical knowledge to date in the same amount of time. Here's praying...

A Letter to Microsoft

Mr. Gates,

I realize that your engineers are probably all working on the disaster that was Microsoft Vista, but when you get a moment, I have a request. Microsoft Internet Explorer has a feature called "Favorites" and I would like you to please change this. I believe this is a misnomer. You see, everytime I have to go to that tab to go to Qbank to practice more USMLE Step 1 questions, and inevitably be reminded that I might forever be an M2, I cringe at the thought of calling this website a "favorite." It is far from it. It is a nemesis. A bane in my very existence, albeit only for another week (fingers crossed.) In conclusion, I would like to recommend the name "Frequently Visited Websites" as an alternative. Thank you.

Sincerely,
A Stressed Out Medical Student

Addition to the Family... Almost

During a leisurely day at Dogwood with The Cutest Boy in the World this weekend, we wandered over to the bank parking lot to see the puppies for sale. This was a dangerous undertaking to begin with in light of my history of impulse puppy buys (Heidi "Trailer Trash" Ho.) But, it turned out I wasn't the one we needed to be worried about...

The Cutest Boy in the World has always wanted a blue Great Dane, and as luck would have it, someone was selling blue Great Dane puppies. Oh, he held one, loved on it, and got lots of puppy breath kisses from it. Had he not have been leaving for two months, I could almost guarantee that the Loo would have a little sister right now. Whew... That was a close call...

Back to C-Town

In one of those strange freaks of medical school, I have found out my schedule for September before finding out June. But, as luck would have it, I am returning to my old stomping grounds for my 4wk Family Medicine Preceptorship. I can almost guarantee that this trip down Memory Lane will probably just remind me why I'm glad I left. Even if I do only live 30min away, it's basically like another area code compared to the Twilight Zone that is Clinton, Mississippi.

News Flash

The Miller clan, including the annexed portion of the Canizaro clan (e.g., David), met this weekend to celebrate family, motorcycles, and food. In light of the CEOs of Miller Inc relocating the home office to Chattanooga, TN, this was the last of such gatherings in the stinky state of Louisiana. Also, owing to the upcoming loss of free time of the youngest Miller and Ashley's current shortage, time coordination will also become more difficult. Therefore, no expense was spared to make this past weekend fun for all...

David opted to try the once popular jiggle method of weight loss by riding his motorcycle 5 hours down to Zachary and back. Sources say he reports a two inch loss from his ass, although statistics have not been released whether or not this results from the 5 hours of compression or the vibration.

Popscicle made Miller family history by not being called into work for the first time during a Canizaro visit. Of course, after turning in his resignation and missing a 10 o'clock phone call, Entergy might just finally be getting the hint.

Ashley has embraced her inner Pam and was seen purchasing multiple leather garments at the local Harley store. With this large of a cowhide purchase, insiders are questioning whether she has actually taken to moonlighting as a dominatrix.

Numpsey still waits patiently for her Mother's Day gifts. Sources say she has been seen peering out the front door windows waiting for the UPS or mail man to bring her the very large box she knows she is getting.

In unrelated news, Al Copeland, the owner of Copeland's Cheesecake Bistro has recently purchased a private yacht. Although no official statements have been made concerning this extravagant purchase, he is reported to have claimed to have had "a very profitable weekend."

Keys to a Good Residency

At the ACOG conference (yes we actually did go to meetings), program directors of various residency programs gave tips on how to stand out as an applicant. Here are the top five, and I'm not making any of these up for entertainment sake.

1. Find a mentor.
This presents a problem seeing as I have no clue what I want to do. Plus, its not exactly like I'm a baby bird in a Dr. Suess book that can go around asking every moving being in a long white coat, "Will you be my mentor??"

2. Have overcome a debilitating personal struggle.
Examples were given such as "having a dead parent," "losing a limb," or "surviving cancer." I feel rude asking one of my parents to keel over to help my chances of having a good Match Day. And, I've become rather attached to my limbs. But, I do have a habit of not putting on sunscreen so maybe all those years of worshipping the sun gods will pay off on the cancer front in the next year.

3. Be a single parent.
I guess this one is do-able. I'm 24, which means in Mississippi I'm borderline advanced maternal age. Even if I could skip the whole 9 month gestation thing and pop out a kid today, he/she'd still be the one with the "old mom."

4. Climb Mount Kilimanjaro.
Completely disregarding the fact that I get winded climbing three flights of stairs to my classroom, I'm not exactly sure when I'm expected to squeeze this into my schedule when I'll soon only be getting one day off every seven days. I mean, by my calculations, even if I took a plane to Tanzania, a helicopter to ten feet from the zenith, climbed to the top, slid back down those ten feet, took a helicopter down, and flew back, I'd still be late for rounds the next morning.

5. Be a normal human being.
Now this one I think I could maybe manage. If for a few hours during interviews, I can hide the fact that medical school has brought out my inner control freak, has left me so stressed out I find myself crying when I can't find a parking spot, and has reduced my sense of humor to using such one liners as "I'm so hungry I could go Leish-Neihn on my hand." I am worried however that for some people in my class this one is just as unattainable as the Mount Kilimanjaro thing.

Howdy Gyneroos!

The last few days of my life have been filled with speculums, contraceptives, and hurricanes.

Yep, I've been at the American College of Obstetricians and Gynecologists Annual Clinical Meeting in N'awlins, Louisiana. Needless to say, when you check cervixes all day, you know how to have a good time after work. Good times were had by all.

Viva Las 'Dega

Talladega has come and gone, but the pictures will last forever. (The memories might have already been partly washed away by the beer.)

The homestead. Two campers united under Old Glory and Hendrick Motorsports.

Our half of slice of heaven. This was basically the same position we stayed in all weekend, although most of time our hands were full of beer, our mouths were full of food, and discussing the status of the black water.

They make such a sweet couple.

"Fat man in a little car." We were afraid we were going to have to get the Jaws of Life.

The Cutest Boy in the World, looking oddly out of place in his pink Polo, but I guess it brought him luck because the fool picked the winning driver, Kyle Bush.

Numpsey and Popsicle enjoying a day at the races.

Selective Hearing

My dog will go crazy at 3am because a cat has wandered into our front yard...
But she will watch in silence as a squirrel eases its way closer and closer to the open back door.

She will protest any loud vehicle on our street, the next street, or even the interstate...
Yet she will have no idea that a car has pulled into our own driveway.

The Loo will bark like somone is literally breaking into our house when the mailman steps on our front step to put my countless AMA fliers and magazines in the mailbox...
But she won't even move from her spot in the sun when The Cutest Boy in the World comes over until he actually rings the doorbell.

Words on a Page

After two weeks of nearly constant studying, I had hit a point where my brain was full. I could not have learned one more fact without it immediately oozing out my ears. I found myself just staring at black print in symbolic shapes on paper, not absorbing a word of it. My eyes hurt, my neck hurt, and needless to say, my head hurt. There were a few times when I truly didn't think I was going to survive.

But, although we lost a few good men out there (mostly hours of sleep and sanity), I made it through. And now after the most relaxing weekend imaginable (pictures to follow soon), I'm back. Back to the library, and back to the grindstone. But, surprisingly, I have somehow found more room in the ol' noggin. I'm wondering what got pushed out... I'll probably go to get gas this afternoon and discover that I no longer how to turn the pump on.

The Tally

Seven down, two to go!!!

Sad Day

My friend Emilee passed away today. Please pray for her family.

It All Comes Down to Poop

As I spend my weekend delving into the word of pathology, discovering ever minute detail about nearly every disease the human race has ever been inflicted with, I have come to one clear conclusion. Half the planet must have diarrhea.

Okay, maybe that's exagerrating, but at least 95% of the people in the hospital do. I'm surprised the floor isn't covered with it. Or you don't have to dodge flying diarrhea as you walk down the halls.

Not only do I find myself greeted with diarrhea under every Clinical Manifestations heading, but it must be adequately described. Here are some adjectives (and if you are a medical student, as you read them the name of the causitive organism/disease process will miraculously appear in your head):

"frothy," "particularly foul-smelling with bits of undigested food," "like rice water," "bloody and mucoid," "partially formed stools," "coffee grounds"

Heck, I don't even think I know what rice water is.

The other 5% of the people in the hospital aren't blessed with normal bowels however, they're just suffering from obstruction, anticholinergic syndrome, or opiate overdose and they're constipated.

No Time to Celebrate

I have just finished a week of exams. Normally this would mean joyous outbursts of jubilation, tickertape parades, and enough beer to drown a cat.

Not this time.

I'm in the library, on a Friday afternoon, gearing up for Round Two.

My Best Friend

If you're a product of the 90s like me, then this catchy commercial jingle will ring a bell deep in your childhood subconscious:


My Buddy, My Buddy
Wherever I go, he goes
My Buddy, My Buddy
I'll teach him everything I know
My Buddy, My Buddy
My Buddy and me!

Back then, this infectious tune brought images of three-foot tall Chucky-esque dolls complete with blue jeans, collared pullover, and a baseball cap, that could finally give form to your imaginary friend. Although I was never so lucky in my childhood as to own a My Buddy doll, or his counterpart Kid Sister, that void has finally been filled. Now I have a First Aid Review Book.

First Aid is the M2's red badge of courage; we carry it around both proudly as if to say "Behold! I am M2!" and grudingly, like a heavy burden that only we can bear. Everywhere I go, school, library, dinner, gym, my First Aid won't be far behind. It is covered in sweat, coffee stains, water damage, a tear or two, and even a little bit of blood, thanks to that period of time when Lanie's tail liked to bleed on everything. I will be surprised if my First Aid makes it to the Step. By then it will be probably taped together, or just a box full of loose pages. Oh, what a bittersweet day May 29th will be when I have to say goodbye to my dear friend...

A Place To Call Home

With Jackson being the home of Tougaloo College, Jackson State Univeristy, University of MS Medical Center, Belhaven College, and Milsaps College, you'd think you wouldn't be able to swing a dead cat without hitting eight to ten suitable places to study. Wrong. Let's review...

UMC Library- You could cut the stress in the air with a knife. Even if you feel good about an upcoming exam, the panic is infectious. Plus, distractions (or maybe just irritation) abound when you're surrounded by the same people you've been around for the last two years day in and day out.

Barnes & Nobles, County Line Road- Acceptable. Not the best coffee, but the acoustics allowed for less irritation toward the non-studying patrons. Plus, large tables and electric outlets were more numerous than fleas on a junkyard dog. Unfortunately, closed for business.

Willie Morris Public Library- Minus the occasional deaf geriatric screaming at the clerks trying to get his/her library card replaced, overall very peaceful. Coffee is available, although it might be drink at your own risk. Downside, the place has converted to the way of the Amish and closes when the sun goes down.

Starbucks- Not a single table with a radius larger than 12" and even these have cushy chairs that aren't suitable for causing pressure ulcers while studying. The pain reminds you that you're alive, and you need to keep studying.

Cups- Good coffee, best in the city if you ask me. Small though with terrible acoustics, anyone's business is now your business. Also, they only upgraded to the 20" table to get a small one-up on Starbucks. The rumor is there is a secret "library" perfect for studying hidden away in the back, but I'm pretty sure there are more people camped out waiting than for the premier of Star Wars Episode I.

Barnes & Nobles, Renaissance Colony- This new location does not even compare to its former glory. Although the cafe area is larger, the promise of Cheesecake factory treats can not overcome the fact that all the tables are two-seaters and there is only one electrical outlet in sight, which, ironically, isn't even near one of the tables. The few larger, "study" tables scattered throughout the store are electrical islands, unless you bring a 100'+ extension cord.

Borders- Adequately sized tables are usually easy to come by, although only one offers the promise of electricity. But, be sure to get there early, this is a haven for junior high kids drinking Javakulas with extra whipped cream while waiting for Mom to come pick them up and Tuesday night knitting club. Also, the staff (not deserving of the title "barista") are prone to think the world is their stage and their shift is an 8hour comedy show for the patrons enjoyment.

The Final Hoorah

The last seven months of M2 Preceptor-ship has finally drawn to a close with the completion of my witnessed H&P. After countless times of silently standing in the corner of the room while my preceptor engaged patients, asking them questions and performing physical exams, the tables were turned. It was my show. Unfortunately, this is only my second true full history and physical, so it wasn't quite the moment of victory it sounds like. I was sweating like Michael Jackson at a tee-ball game.

But, I pushed through. Yes, I forgot to do things. Yes, I forgot to ask important questions. But, its over and that's all that matters right now. And, my preceptor seemed fairly impressed. Maybe because I did a good job, or maybe because he was amazed I did decent despite the lack of instruction he gave. Either way, I'm one step closer to being an M3.

Words of the Day

phud-dy dud-dy [phuhd-dee duhd-dee] noun, one who possesses a PhD degree, and therefore has no understanding of clinical medicine; lectures are known to be composed purely of useless basic science knowledge that will never be of help to a practicing physician

mud-phud [muhd-fuhd] noun, one who possesses both an MD and a PhD degree, therefore they once knew actual clinical medicine but have long forgotten it in order to barricade themselves in a laboratory doing research; known for making outdated and ridiculous comments, for example "spider bites are sustained by rolling over in bed, putting on socks and shoes, and carrying boxes out of a dark basement"

They Say Its My Birthday...

Today is the 3rd anniversary of my 21st birthday (yeah, that's how I'm going to think about it... you do the math.)

It has started off quite well. The Cutest Boy in the World came over this morning, brought some staple groceries (milk, eggs, cheese) that I lost due to power outages, and made me breakfast of cinnamon rolls and scrambled eggs. From this alone he might have elevated himself to status of The Cutest Boy in Solar System. Then he gave me just what I wanted, and asked for (gotta love a boy that listens), a pretty cookbook and a food processor. This is worthy of being called The Cutest Boy in the Universe. Yes, to some this might sound extremely domestic, and I realize that it is, but cooking is my hobby. So, homemade pesto for everyone!

Then, tonight I think my family (minus Daddy, but he'll be with us in spirit) is going to PFs... Oh I love birthdays...

Jack-town Twister.. and that's not a fancy new martini

First off, me and mine (meaning the Loo and The Cutest Boy in the World) have survived The Storm of 2008 unscathed.

But, Friday, I knew according to the Weather Channel's Local on the 8s that Jackson was expecting some severe isolated thunderstorms. So, I went home at lunch to let the girl out before the rain came. After eating, I sat there studying some whatnot. All of a sudden, like God spilled his Diet Coke on the sun, it got real dark. The power went out and the wind started blowing in sideways. I watched all this from my back living room, feeling overcome with the feeling of "this ain't good." Well, I had to run out to my shed to close the door that I had left unlocked and on the run back I was getting hit by pea-sized hail. "This ain't good at all." In the next 5-10 minutes, I stood frozen, watching with bated breath to see what Mother Nature was about to do. But, almost as suddenly as it began, the spookiness ended and it merely started to rain.

I was expected at clinic at 1, so I collected my effects and headed to the car. The scene that met me was staggering. Trees were uprooted everwhere, or snapped off on top of houses and power lines. My house was actually the first on my street that did not contain a new pine tree fixture in the living room. But, being the dedicated medical student that I am, I drove under downed power lines, around trees and roof debri, and through nonfunctioning traffic lights from my house to clinic. Of course, clinic also was without power and I was told to go home after 40minutes of just sitting around wasting oxygen.

Supposedly, a tornado passed directly over my house. Reports say that the damage was worse than what hit Jackson during Katrina. All I know is that God Himself protected my home that day.

A Lot to Learn

Yesterday I donned my dreaded short coat and my "dressed to the coat" clothes, and headed to 5 South to interview a patient. My first challenge was to find said 5 South, which, this being my second time in the new hospital, was a bit more difficult than it sounds. Then, I went in to do a full H&P on my patient. It took an hour and a half, and I still walked out and realized I had skipped a lot of stuff (checking lymph nodes, CN VIII, asking about allergies, etc). So, here I am, hopefully going to be a M3 in a few short months, and I can't get a simple history and physical on a very nice lady with colon cancer right. I sure hope this all "comes to me" soon...

A Confession

The following post might be offensive to any devout sports fan.

This year I did not fill out a NCAA bracket.

Oh, it gets worse than that.

This year I have not watched a single NCAA basketball game.

Wait for it...

This year I do not even know who is in the Elite Eight, Final Four, or whatever level the tournament is at now.

Toad Strangler

As the weather warms up to the level of palpable humidity that defines Mississippi summers, my goal is to start talking the Loo for her daily walks early in the morning before the heat sets up shop. This plan seems perfect, except for the early morning part. Needless to say, I won't be winning any "Early Bird Gets the Worm" awards anytime soon. This morning, however, was the exception. The alarm went off, and 5:30am, I'm out the door with Lanie in tow (or maybe more accurately with myself in tow, but let's not get stuck on specifics.)

The first thing I noticed was the occasional distant flash of lightning followed by low rumbles of thunder. "No big deal," I thought. "Lanie needs to learn to handle thunder anyway." And she was fine. Then, it started to sprinkle. So, we stopped in the middle of the road while I evaluated the situation.

Lightning. Rain. Metal choke collar.

We needed to head back home. No sooner than this thought had taken shape in my mind, the bottom dropped out. Every ounce of rain the meteorologists have been teasing us with for the last week fell out of the sky. The Loo hates the rain, and I'm fairly certain had I let go of her leash she would have headed straight home, but the fear of her just heading to the first carport and refusing to budge loomed in front of me. So, we jogged home, soaked to the bone.

I think maybe that was divine intervention telling me this early morning thing should be kept for the birds.

Makes Me Smile...

A man in Topeka , Kansas decided to write a book about Churches around the country. He started by flying to San Francisco and started working east from there.

Going to a very large church, he began taking photographs and making notes. He spotted a golden telephone on the vestibule wall and was intrigued with a sign, which read "Calls: $10,000 a minute."

Seeking out the pastor he asked about the phone and the sign. The pastor answered that this golden phone is, in fact, a direct line to heaven and if he pays the price he can talk directly to God.

The man thanked the pastor and continued on his way.

As he continued to visit churches in Seattle , Dallas , St. Louis , Chicago , Milwaukee , and around the United States , he found more phones, with the same sign, and the same answer from each
pastor.

Finally, he arrived in Alabama . Upon entering a Church in Tuscaloosa he saw the usual golden telephone.

But THIS time, the sign read "Calls: .35 cents."

Fascinated, he asked to talk to the pastor, "Brother Jones, I have been in cities all across the country and in each church I have found this golden telephone and have been told it is a direct line to Heaven and that I could talk to God, but in the other churches the cost was $10,000 a minute. Your sign reads only .35 cents a call. Why?"

The preacher, smiling benignly, replied: "Son, you're in Tuscaloosa, Alabama now, home of the University of Alabama, Crimson Tide Football, The Million Dollar Band, Bob Baumhower's Wings, and Dreamland Ribs. You're in God's Country. It's a local call."

M3 Schedule

It's finally that time of year when the administration has decided that we don't have nearly enough stress and things to worry about. It's time to make our our schedule for third year.

Now, this is a very complicated process. It is not as simple as signing up for the classes you want. There are 8 pre-set schedule options that one hundred plus medical students are vieing for, and names are chosen randomly for selection order. So a strategy must be chosen wisely. Do you rank the schedules in order of the most appealing to you? Do you try to plan around an upcoming event? Or do you try to swing being on the same rotations as your friends?

Any upperclassman has a bagful of tips, tricks, and advice to offer, but I truly think my sister gave the best. She told me, "Eh, don't worry about it. It's a crapshoot. You probably won't get what you want anyway, and you'll just have to make it work." (Not a direct quote, or she'd be suing Tim Gunn for her catch phrase...)

Saving Lives

When I began medical school, I referred to any time spent doing related activities (studying, going to clinic, attending class, studying more) as "saving lives."

"Wish I could go out tonight, but I've got to go save lives."

"Yep, meeting with my preceptor this afternoon to save some lives."

The closer third year approaches, my attitude on this phrase is changing. First off, I'm not saving lives. Nowhere close. For example, yesterday in two hours with my preceptor I touched one patient. I did an eye exam on a normal 14yo AAM. Not only did I not even pretend to save that boy's life, I didn't even address his chief complaint.

Mostly though, I'm starting to see that in my contact with patients now and in my next year, saving lives is not my goal. I just don't want to kill anyone. If I actually manage to help somone, bonus, but I'm just hoping not to be the reason their heart/kidneys/lungs stop working.

So next time someone asks my what I'm doing, I am prepared to say "Trying not to kill anyone."

Pott-ah Parties

Last week The Cutest Boy in the World was introduced to the world of Muggles, Quidditch, and all things Potter when we watched the first of the series, Socerer's Stone. He is addicted. In the past four days we've watched the next three movies. And tonight, we are joining the Canizaro's to watch the final released film, The Order of the Phoenix. His Hogwarts mania doesn't end there. He is already making plans for the sixth movie release and reading the entire collection of books. I've created a monster.... A basilisk maybe? Or a Norwegian Horntail?

Revenge of the Nerd

I am a nerd. While most medical students were using last weeks as a mental and physical rest, ignoring all things medical, I went to the Our Body: The Universe Within exhibit in Mobile. This is where the proverbial "they" take real human cadavers and preserve them with polymers, allowing the public to view the inner workings of the human body.

Most visitors to the exhibit were in awe of the fact that the entire exhibit was composed of real people; I was amazed that "they" somehow managed to label the infraspinatus muscle incorrectly. Most people were grossed out by the sections of a body, showing you the relationship between the different organs; I was intrigued by the massive splenomegaly in that particular person.

In general, the exhibit was fantastic. It reaffirmed my love for medicine, the wonders of the human body, and my nerd status.

Still Breathing

Just wanted to quickly report that the Loo made it through the weather and the drugs safely. It was morbidly funny to watch her stumbling around, eyes all droopy, and barely able to lift her own head like she had had too much too drink at the office party. But this morning she seems to be coming back to normal, if not a touch groggy. Of course, I do need to sign her up for an AA meeting.

Doggie Prozac

A week or so ago it stormed in Jackson from 2:43am to 4:11am. I know this because my dog felt it was neccessary to protect me from the thunder between these said times. Well, let me say that she probably would have protected me longer, but 75mg of Benadryl finally kicked in.

According to the weather channel, it is suppose to storm this afternoon. Call me a bad mom, but I'm going to Animal Health Products this afternoon to buy some Doggie Prozac, or horse tranquilizer, whatever it takes to calm her down. So, be warned that I might be posting tomorrow that my dog has OD'ed.

M3 Prep

One of our professors took 5 minutes today to tell us what we're expected to do/know as an M3.
Some things were simple: How to get around the hospital, where things are, how rounds are run.
Some things were a bit more in depth: Know everything and then some about your 2-3 patients that you are assigned, be able to come up with a tentative differential, assessment, and plan for said patients.
In general though the whole talk made me sick to my stomach.

Patient Presentations

Some people may find it intimidating to tell a stranger in a white coat all their personal business. But today we have a lady in class telling her medical, family, social, and surgical history to not just one, but one-hundred plus strangers. No shame either. I guess you have to be very confident in your constipation to be able to boldly talk about it to an amphitheatre of students.

Symphony

The Cutest Boy in the World and I went to the Mississippi Symphony Orchestra for a lovely performance of Beethoven's Violin Concerto and Brahm's Symphony No. 4. I know very little about classical music, but I still enjoyed the evening. We got all dressed up in our finest, and mingled with the classy people of Jackson... And a lot of UMC students who were also there because the tickets were free. The evening was pushed from enjoyable to perfect by a trip to Brusters for ice cream afterwards.

Yes, I'm officially cultured. Mark that off my list of things to do this week.

It Takes a Whole Family to Raise a Curtain

The goal of this weekend was to get a new curtain rod hung in my room. Sounds simple? Oh... You'd think that..

First, it took 45minutes at Bed Bath & Beyond for me and my Mother Numpsey to choose the correct curtain rod. It's not that we had problems picking out a stylish one, that is not a problem at all, but the task of deciding what type of curtain rod we needed almost caused a few lacunar infarcts.

Then, came the hanging. It apparently it takes five people to replace a curtain rod. Me, Ashley, and my Mother Numpsey were their to offer our opinions and almost superhero powers of eye balling a level line. David, being a seasoned curtain hanger, was on hand. And, The Cutest Boy in the World offered to help with the manual labor, but he over estimated my preparedness and assumed I had a lot more tools then my meager collection of hammer and drill had to offer.

Moral of the story, three hours later, I have curtains. Well, one curtain. We still haven't figured out a way to hang the sheer, but we might have to save that for another weekend.

Asking for a Prayer

I found out today that one of my campers from Camp Rainbow is not doing well. She was diagnosed with Ewing's sarcoma about a year and a half ago, and has been fighting it bravely since then. But, the cancer that started in her vertebrae has moved to her brain.

I believe in miracles, that God could heal this little girl. But, more than that, I believe that God has a purpose for everyone. And, maybe, this little girl has fulfilled her purpose here on earth.

Please pray for her, and her family.

Circle Death Match

The last few months, I have been attending Briarwood Presbyterian Church. I really do love attending, but I am not exactly the typical member of the congregation. Mostly, I break the mold because I'm under the only member who wouldn't receive a senior citizen discount at the after-Worship Service lunch.

The women of Briarwood Pres are involved in monthly Bible Study groups called Circles. Being the new, young blood of the church, I am apparently a well sought after commodity for a Circle. Last month I was invited to join Circle 2, a Monday night circle for the "workin' girls." Since then, I have been invited to join three other Circles. This often occurs in the presence of a Circle 2 member, in which Circle 2 is reprimanded for "snatchin' up" the new girl before anyone else had a chance to meet me. It is actually quite flattering. Of course, I'm hoping things stay civil though. I don't want anyone to break a hip.

Dead or Alive?...

...As my dearest Mother Numpsey would have undoubtedly asked by now if I had neglected talking to her as long as I have this poor blog...

Exams were last week; I survived. Barely. It was actually probably the roughest round of exams I've experienced thus far. But, its behind me now. I can't change the past, so I better just gear up for the future. Thankfully, the Cutest Boy in the World has exams this week, and so I'll be forced to keep on top of things, which is actually fairly unheard of. I usually take the first week off after exams, only to realize that a week "off" actually just translates to being a week behind.

Lanie Update

Because Lanie rarely gets a chance to play on the internet, I thought I'd give everyone a quick update on the girl.

For the last month she has taken to refusing to go into The Dog Room, an entire room in the house dedicated to her. She will not enter to lay on her futon, to eat, or to drink water. Since I was afraid she was going to starve, and her growling stomach was disrupting my study time, I have taken to feeding her on the first step just beyond The Dog Room gate. She now stands in the kitchen, grabs a mouthful of food, and carries it to the living room. She has also found an alternate source of water in the gutter drain in the backyard. I am trying to break her of this habit, and therefore am forced to drag her into The Dog Room twice a day to make sure she stays hydrated.


I recently decided to try to order some bones off the internet for her, mostly because PetsMart is running a racket on those things. She prefers the natural bones over rawhide, and I do too because they leave an easily vaccummed mess instead of a carpet cleaner, brush, and elbow grease mess behind. So, I placed my order and we both waited patiently for our package. I ordered 20 "ham bones" that ended up being about 8inches in length, a nice quick snack for the Loo. The other ones, however, were called "mammoth bones" and they weren't lying. These things are 3 feet long femur bones of one huge, but 3-legged, cow. Without even removing it from the plastic wrapping, Lanie was drooling over the treat. They are nasty looking, and smell of beef, but they are worth it. After three days of at least a couple of hours of chewing a day, she has barely made a dent. Best $5 unit price I've ever spent on the dog.

And today, Lanie went to The Dog Wash for a nice bath and nail clipping. She knew something was up when I got dressed for school and then put her on her leash and loaded her up. She normally loves car rides, but she shook like a leaf today. It tore my heart to bits, but she smelled, and my olfactory sense won out. We got to The Dog Wash, and she seemed excited until we walked in. Then she knew. So she assumed the Bambi position, all four legs splayed out on the concrete floor refusing to move anywhere. The people told me to go ahead and leave, that the dogs sometimes calm down once their owner is out of sight. I can't believe I left my girl there. But, I've got my phone right next to me in case she decides to break out and head home (it's only a block and a half away) or if any other problems arise.

It's That Time Again...

Life is full of cycles and rhythms. You wake up; you go to sleep. You gain weight; you lose weight. You are born; you die. It's just how life works. The circle of life... (Feel free to now sing a short chorus of the theme from the Lion King.)

So, here it is, once again, exam time. I knew it was going to happen. It always does. Exam time has been a truth in my life for the last 17 years, but it still somehow catches me off guard every time.

Float Like a Butterfly...

But look like you've been stung by a bee...

Last night I got into a wrestling match with my dog. She won. She sauntered away unscathed and I am now look like I have angioedema with a fat upper lip.

Corneal Abrasion

After a freak accident involving a rogue eyelash, I have been left with a minute scratch on my eye. It has not left my eye bloodshot at all, but it hurts like the dickens. Henceforth, I have been winking at random people for two days, and I'm pretty sure I have at least three dates for Friday night.

Mirror Time

I joined the YMCA recently, and enlisted the help of a trainer to set me up on a weight lifting regime. After a few meetings with Igor, my Ukranian trainer, I have about 7 exercises each that I do for upper and lower body on alternating days. Keeping in mind that each exercise entails three sets, and a short rest between, my gym time usually lasts about 45 minutes.

Here is what amazes me, however. In the time it takes me to do an entire upper or lower body work out, I will watch men stand around and complete maybe a total of 5 sets. The rest of the the time they either yak it up with their buddies, or their personal favorite, stare at themselves in the mirror as if those 5 sets have dramatically changed the landscape of their bodies since they stared at it for 30 minutes in the mirror that morning at home.

Vanity and laziness would be an easy explanation for this behavior, but here is my theory. In our society, thanks to ceaseless women's rights and discrimination fights, there are no longer many (if any) true Men's Clubs. Men no longer have havens of cigar smoke and leather bound books to retreat to. But even though YMCA, the Young Men's Christian Association, was forced to give equality to the sexes after a few lawsuits, the weight side of the facility is the closest thing these Y chromosomes have to a sanctuary of peace. So these men are not going to "work out" to see results (because 5 sets won't accomplish that) but rather to get away. And somehow, as I have ventured to that side of the Y and infiltrated one of the last of the remainding secret societies, I feel like Jane Goodall observing behaviors never before recorded.

Blizzard '08

Call the governor! Shut down the state! There is a millimeter of snow on the ground!!

I joke, but as soon as I heard it was snowing I put on my snow clothes (a sweater, a scarf, and my NorthFace jacket) and ran around outside in the flurry. I guess its okay to get excited when it only happens about once every 7 years!

If you look real close, you can see what appears to be some dandruff in my hair... but that's actually snowflakes!

Ten Minute Rule

I don't know when it was that I first heard of the Ten Minute Rule in relation to tardy professors. It might be an innate truth that might actually be encoded in our very DNA. Or, more likely, it is one of those things you learn so early in life it becomes part of your very being, like brushing your teeth in the morning or pulling your pants down before you go to the bathroom. So, I would go as far to say that the Ten Minute Rule is a universal truth of the universe.

So, how is it, that my Neuropathology teacher completely ignores this Law of Nature? When his lectures start at 8am, he blames it on the early hour as he walks in at 8:14am. And now today, when lecture was scheduled for 10am, he sauntered in at 10:18am. And, to put a little bit of icing on this unnatural, and downright rude, cake, he then assumes that he has the right to run-over on his allotted time since he started lecturing late. I do not know what illogical universe he is living in.

I guess though, he has learned of another universal truth through experience. Medical students are nerds, and we will wait 18 minutes for the professor to show up. And, we are too respectful to get up and leave at the scheduled ending time. I guess that's what you get for trying to pin down the universe with simple truths...

Signs of Aging

It is sometimes said that we start dying the day we are born. But, excluding maybe the ova population of a young female child's ovaries, this is medically not very accurate. Children's bodies and minds are growing. Their cells are dividing and living. At approximately age 18, however, things start going downhill.

Scientifically speaking, those cells that seemed to be capable of infinite division start to slow down and die. We reach our maximum height, and maximum IQ. You'll never be in better shape or have more hair than when you're 18. True, there might be a bit of mental curing left to do (because despite what you told yourself, riding on the hood of a car is NOT a good decision), but you are officially aging.

I think the true sign of aging is when your habits and thoughts about the world start to change. All of a sudden, I find myself wishing they wouldn't play the music so loud at the bar. I get angry at the cars that fly down my street. I see the stylish new jeans in the magazines, but can't believe that anybody would wear that, and find myself happy with the style that was popular in the late 90s (this is my theory on why so many women are still sporting the to the rib cage, popular in the 70s style.. they just can't let go of what they gre up with). And, I am looking forward to the best possible way to spend a Friday night that I can imagine: eating take out and watching a movie, all while wearing soft pants.

Where's MY Pager?

Please be prepared, this will be an installment of Peter Griffin's "What Really Chaps My Ass..."

Each M2 is assigned a full-fledged doctor to be their preceptor. This preceptor is meant to be a clinical mentor, someone who can help us newbies learn to stand on our own two feet in the hospital. His duty is to show us around the hospital, the physical exam, and basic patient care.

My preceptor, however, is under the impression that I am at his beck and call, a short white coat slave. He emails me a few hours before he expects me to meet him. He tells me to page him when it is time to meet, but has the attractive habit of just not answering those pages. And then, the icing on the cake, he really is not a wealth of clinical knowledge. He prefers talking about exams, tests, and patients in theory, not actually seeing and doing these things.

So here I am, feeling that my blood pressure is uncomplicated Stage 1 hypertension ranges, if not higher because once again I have been beckoned. I will have one hour to get to my car, drive home, change clothes, eat lunch, and come back to the hospital to meet him. Then, I'll be expected to listen to his rantings for as long as he deems appropriate, probably in the ballpark of 4 hours.

That really chaps my ass.

Vignettes from a Road Trip

The band at Cafe Firenze was just good, until out of no where, they pull out the secreat weapon. A mild mannered dude, who when given a microphone could wail and entertain the crowd without a single pit stain. We were in the presence of greatness..

My pledge sister, Sally, blew me away with her renowned one liners. My favorite from the night, "I was cleaning the hair out of my shower drain, and I found the girl from the Ring. Oh. There you are."

The belugas were my favorite. With the large number of transvestites running around the aquarium coming in a close second.

We took the VIP Behind the Scenes tour. Yeah, we're kinda a big deal.

At this point in the tour, we are standing above a 6.3million gallon tank filled with more than 50,000 animals. But you know... we played it cool. Impressed? Nah.. I've seen bigger...

Our tour guide tells us a rather graphic tale about two young Beluga whales who meet, fall in love, and attempt to consumate their relationship to the horror of all the children in the gallery.

Another M1 Flashback

Walking up to school today, I bumped into my M1 buddy. At the beginning of this year, I had infinite tidbits of wisdom to give this fresh young mind about how to survive the first year of medical school. But, this morning, I found myself at a loss of words. I had no advice on how to tackle the second year. But, I did have this...

Nine More at No Extra Cost---- Top Nineteen Signs That You are an M1

--You have ever gone to class to hear Dr. May laugh, to see what colorful short sleeve button-down Dr. Hostler will wear with his pleated khakis, to hear Dr. Galli use naughty words, or to hear Dr. Ard… wait, who am I kidding, you can’t hear Dr. Ard….
--You have ever been jealous when someone says they got six hours of sleep the night before.
--You have a favorite cubical in the library (or room in the classroom building) and feel strangely insulted when someone has gotten there first.
--Your knowledge of the defecation process exceeds the average person’s knowledge of the entire human body.
--You routinely wake up sharing a bed with Frank Netter or Henry Gray.
--You have ever placed a bet on how many donuts Dr. Sinning will eat during one Saturday review session.
--Despite the fact that you are in medical school you won’t be able to perfrom basic life saving skills until after April because your last name is near the end of the alphabet.
--You have to justify taking time away from studying for everday activities such as showering and grocery shopping.
--You have ever thought about starting up a round of “bobbing for kidneys” while studying in gross lab.
--In the line at Wal-Mart you diagnose seven different people with genetic disorders that occur in less than 0.02% of the population.
--You have seriously considered the possibility of sleeping in the classroom building.
--For some reason the words “now I have a video to show you” strikes fear into your soul.
--You can plot the test schedule with either your blood pressure or the facial hair growth of the guys in the class.
--You have ever looked at a living person and wondered what it would be like to dissect them and not thought that was morally wrong.
--Your idea of “suction” includes paper towels and a turkey baster.
--You look very important in your full set of scrubs and ID badge but when someone asks directions in the hospital, you have no idea what they are talking about.
--The only white coat you ever get to wear is actually more of a yellowish brown color.
--The only thing getting you through the final/board season (also known as the holidays) is anticipating with bated breath to see who will win the Great American ‘Stache Off.
--You have ever verbally cheered when you correctly guessed a diagnosis while watching Grey’s Anatomy.
--After a breech in the large intestine, the term “colon cleansing” has taken on a whole new meaning.

Step One: Cut a Hole in the Box

In less than six months, I take what is probably the biggest and most important exam in my life, the USMLE Step 1 Exam. It's there, in my near future, looming like a guillotine over a French Revolutionary's neck. As if every medical student from the day of acceptance did not know that this day that could decide the rest of our medical future is awaiting, our professors have taken to reminding us approximately every 15 minutes.

From all this, you'd think my life was devoted to reviewing, re-learning, or in some cases learning for the first time, every ounce of information that has been alluded to in the last 18 months of medical school. But, instead, my First Aid Step Review book, and about twelve other review books provided by my sister, are all still sitting peacefully on my bookshelf, with no more than a crease in their fresh paperback spines. I guess it's about time to stop worrying, and start opening books.

House of Miller

Mississippi Blues Marathon

I'd like to take a moment to congratulate my classmates, especially Shelby, Molly, and Mary Allyson, for running and completing the Mississippi Blues Half-Marathon. Lanie and I made an appearance somewhere between miles 10 and 11 to cheer on our friends. Here is Lanie showing her support:

It was tough. We had to get up at 6:30am on a Saturday, make signs, stand in the cold, and watch people run. I was exhausted...

The Grindstone

The holidays are over, officially. I say this not because Wal-Mart now has Valentine's Day decorations up, or all the stores are having after-holiday sales. The holidays are officially over because I am back in school.

Keep in mind, although I am back at school physically, my mind is a little slow to follow.

Happy New Year!

The two thousand and eighth year of our Lord is here. I rang it in with a riveting round of Power Twenty Minutes and an interesting game of Battle of the Sexes at a place of my past, The Lakehouse in Bolton. Good times were had by all... But, let it be said, who ever stole my lavendar down blanket from The Lakehouse sometime in the past 6 years... Revenge will be had!