one year later

So here we go again. Another attempt at documenting my life, my career in medicine. A few updates... just graduated, G' turned 2, and we're packin' up the truck and moving to our new "southern" destination. Found a nice place, green as can be. In another month, I will be just about ready to start. Med-Psych. 5 years. Gonna be old when I finally get started. But it will be nice to finally get started. After all of this. Thanks to everyone who has followed along. I will try, but I may go into remission again.

"Time is priceless, yet it costs us nothing. You can do anything you want with it, but you cannot own it. You can spend it, but you can't keep it. And once you've lost it, there's no getting it back. It's just gone."

Stinky feet

I did a consult yesterday on a guy with a dead foot. He was 70+ years old, had been apparently dealing with some podiatrist in Florida, and came here recently to spend time with his son. The thing I can never figure out is how a person's toes and foot turn black and pungent overnight. These people act like, bam!; all of the sudden, I woke up and my foot was dead. Perhaps it can happen that quickly, but when it does, be prepared, there is a vascular surgeon waiting for you, waiting to cut your foot off. There is really nothing else that can be done except amputation because the risk of systemic infection--which is usually well on its way--is a far bigger risk than trying to save a few toes or a foot. Anyway, this guys foot smelled so bad that I could barely stand there next to him. Sorry if you are completely grossed out.

Another lazy Sunday alone

When I started this med school thing, writing seemed a perfect way to recollect all of the trials and tribulations. Turns out, all I have noticed lately are the trials and tribulations. I have had a very positive experience overall at this hospital learning surgery. Had it been in Orlando, or better yet, St Louis, perhaps Springfield, I would have truly enjoyed it. Half of my time has been spent actually actively participating in surgeries. Many of these are far to gruesome to mention out loud. But for those of you who have seen me, or at least spoken with me, you know the gory details. I have also gotten a bit lax. For instance, today, I am on-call. Normally, after morning rounds, I would try to be involved--either going into the OR or helping out on the floors. But, instead, I took a daytime nap in one of the call rooms, and now I am watching the Cards play the Red Sox. I think I was dissuaded by the fact that one of the potential cases today involved a patient who is HIV positive and another who is potentially (due to IV drug use). I just don't like taking chances. You might say it doesn't matter when you take the necessary precautions, but I am still green behind the ears, and with a baby, I don't want to take even the slightest risk. Less than 2 weeks left! Yahoo!

Roosting birds

Being on-call is like when the birds go up into the trees for the night. As soon as there is a break, all of the med students and residents scurry to the call rooms on the 5th floor. Though the rooms are as small as any little walk-in closet, they are cozy and comfortable after 12-14 hours of surgery and floor work. As I write, I count the days til I am back in Orlando with Heidi and Gavin. Whew! I am counting this week over. 5 weeks to go!

Vascular and thoracic surgery

Tomorrow begins a new 6 weeks. Fortunately, this is the 2nd half of my final 6 weeks of surgery. I will be doing general surgery from here on out. July 2nd cannot come soon enough. As of now, I have been doing vascular and thoracic surgery. Most of the thoracic surgeries were in the first 2 weeks and consisted of observing the chest wall being opened up and exposed. Inside the heart could be seen beating, and the lungs could be viewed slowly rising and falling. The vascular surgeries were where most of my stories originate. Some were surprisingly bloody. Others were surprisingly not. Carotid endarterectomies involve opening up the neck, finding the carotid artery, cutting it open, and removing the calcification. Vascular surgeons need to be very meticulous, as they are often exposing arteries and veins. I've also been involved in numerous femoral bypasses, vein procedures, and amputations. Take home point: do not smoke, control your glucose levels, and try to watch your fat/cholesterol intake. As you know, these all contribute significantly to damage to the inside layer of arteries and can lead to ischemia and eventual loss of a limb.

My dear grandma

6 weeks down, 6 to go. Seems this surgery rotation goes on forever. I don't think it would feel so long if it were taking place in Orlando with Heidi and Gavin. Not being with them is definitely the most difficult part. Not knowing where I will live from day to day is a challenge as well.

I just returned to Worcester, Massachusetts, after being in St Louis since Thursday. My 92 year-old grandma died this past week, and because of that I got to see all of my family. She was a wonderful grandmother, and I will miss her dearly. She had aortic stenosis, and my dad made it possible for her to die at her home as she wished.

I have had a hard time so far dealing with her death. With this med school thing, I miss out on so much. That's what so regrettable about all of this. Although I talked to her often, I had not been able to see her very much recently due to the distance.

I used to go over to her house and watch the Cardinals while talking with her about life. Fortunately, I was able to see her on Skype a few days before she died. She was an instrumental part of my childhood, especially after she and my grandpa moved to St Louis from Michigan in 1978. We spent a lot of time together over the summers at their house. They used to take us to McDonald's and ShowBiz Pizza Place. We had so much fun. It will be strange once the realization sets in that she is not going to be present during holidays.

On to the next one

As you may have noticed, I haven't been motivated to write in a while. Things started off well in Orlando, but now it is time to move on. Unfortunately, it is just me moving on. Cross off Internal Medicine, Pediatrics, Psychiatry, and now OB/GYN. Less than one year left in the first leg of this long process.

Heidi and Gavin will be staying in Orlando until my return in early July. Three long months begin this Saturday morning when I say my goodbyes and head back East. Fortunately, they will be coming to see me in just two weeks. Perhaps it will go by quickly--with hours from 5 AM to 10 PM, I think my time will at least be occupied by things other than sadness and worry.

It will be a challenge doing a surgical rotation under the Harvard residents in Worcester, Mass, but as Heidi has said, it will be a great experience. I found out today that I will be rotating with U-Mass med students, and my first portion will be cardiology, I think. Thanks to Marty, I will have a place to crash my first night, and I will get the grand tour of St. Vincent's Hospital bright and early Monday morning.

Of course, my worries are not with this new rotation, they are with Gavin and Heidi. I worry how my absence will impact the Gavinator. These are special days of development for him, and I know how important a father's role is in a boy's life. My eyes well up thinking about being gone, hardly the tears I will shed during the long drive this Saturday and Sunday. Hopefully, the surgery audiofiles will make me temporarily forget all that I am leaving behind, of course, only for the moment and out of necessity.

More to follow.

in a flash

I'm on my last day of Peds. Perhaps it is time to go. When the frequent flyers start to recognize you, maybe it is time to move on. Much of the same all week, colds and the flu. I am proud to say that I can consistently diagnosis the influenza virus with just a few questions. Fortunately, I have been backed by the 15 minute rapid flu test. Monday I will begin to drive 37 miles each way to Orange City. I've spoken with the secretary of the psychiatrist with whom I will be working, and she seems very nice and enthusiastic--always nice to receive a warm welcome. Psych will be a good return to something that comes easy, something familiar, though I hope there is a chance to truly learn. From what I have heard, I think I will be in for a very positive experience.

Sick.

I'm angry. I've managed to avoid getting sick for well over 3 months by taking the usual precautions--frequent hand washing and other simple measures--like not getting in the line of a coughing fire. I've seen numerous kids lately with strep, the flu, and a myriad of other viruses and bugs. I haven't had one symptom. Now, after waking with a sore throat and a rumbling stomach, I realize I have caught the bug from the stupid doctor who selfishly came to the clinic sick. And Heidi "doesn't feel right"; Gavin is irritable, restless, and showing signs of something too. Sick.

"You Make Me Sick"

Why would a physician, who is obviously sick, continue to provide care to her patients? This is what I have had to deal with for the past two days: a sick doctor, wearing a mask, complaining continuously (with grave misperception), about nagging and off-base parents of child and adolescent patients. Not only is it unethical to continue to practice in a compromised state, it is also rude. Now, after spending two days under this lady's supervision, I have developed similar symptoms; and so has Heidi. (And therefore, so, too, soon will Gavin.) So, when you go to your doctor, take what you hear with a grain of salt. For some of what you may be told may be nothing more than nonsense masked by cold medication and a physician who shouldn't be working that day (or maybe any day) in the first place. More to follow.