You can tell a lot from...

The inside of someone's fridge. I borrowed this idea from a friend who had a pretty atrocious [inside of a fridge] situation. Yes, Varun, I'm talking about you. I would post pictures from his atrocious fridge, but I don't have permission. Yet. Get some real food, dude. Let's take a look at mine!

Done guessing what they all are? Labels below. 

(click for a bigger picture)

I know what you're thinking. What the fuck is argula and why does this clown have it in his fridge?! Well let me tell ya:

Eruca sativa (syn. E. vesicaria subsp. sativa (Miller) Thell., Brassica eruca L.), also known as rocket or arugula, is an edible annual plant. It is a species of Eruca native to the Mediterranean region, from Morocco and Portugal east to Lebanon and Turkey. ... It is used as a leaf vegetable, which looks like a longer leaved and open lettuce. It is rich in vitamin C and potassium. It is frequently cultivated, although domestication cannot be considered complete. It has been grown in the Mediterranean area since Roman times, and is considered an aphrodisiac. ...It has a rich, peppery taste, and has an exceptionally strong flavour for a leafy green.

Now you're probably thinking - Damn, did I just get told?

Yes. By Chef D.

(Chef D likes to hide his face from the public.)

Actually, towards the end of medicine they had this vegetarian sandwich with cranberry sauce and spinach and it was hella awesome. So I decided I would make a sandwich with cranberry sauce (and argula) and it was epic:

Your final thought - Why does D have a glass of whiskey next to his sandwich? The sandwich is for me, the beer, not whiskey (Samuel Adams, because I cannot stand beer as it tastes like shit) is for the fruit flies. They love it. Ahh, sweet death. 

My final notes:

• I love marmalade. Is it obvious?
• I got that apron from Ikea. Manliest apron I could find. 
• Argula is fucking expensive.
• That white splotch on my plate is mayo.
• Mrs. Bairds Honey Oat bread is pretty damn good.
• I went to Kroger and saved $6.18 using my card. Total bill : $18.44. That's 25% off.
• There is another honey dew melon, some oranges, a few potatoes, and a few zucchinis in my vegetable drawer below.
• I'm a pretty bad cook.
• Tomorrow's lunch is going to be epic. 

Now if only I had better teeth. (To be fixed soon!)

武士道

The japanese have a saying in 武士道 something called "The Lesson of a Downpour." I remember reading/hearing about it a long time ago from when I took JPN at UT (greatly missed).

I'll paste an exerpt from a PBS documentary (I haven't seen it yet, so I can't recommend it) -

Fear not the Rain

One must know the so-called "lesson of a downpour." A man, caught in a sudden rain en route, dashes along the road not to get wet or drenched. Once one takes it for granted that in rain he naturally gets wet, he can be in a tranquil frame of mind even when soaked to the skin. This lesson applies to everything.

Calm and tranquility. Don't get the wrong message or anything. There aren't any downpours in my life (right now) but there is one going on right now outside.

Actually there are a lot of interesting aspects of samurai* society that could probably be applied to medicine. Take the 8 virtues which I've shamelessly lifted off this site:

•  A sense of Justice and Honesty.

•  Courage and Contempt For Death.

•  Self-Control.

•  Sympathy Towards All People.

•  Politeness and Respect For Etiquette.

•  Sincerity and Respect For One's Word of Honour.

•  Absolute Loyalty To One's Superior.

•  A Duty To Defend The Honour of One's Name and Guild.

They could all be applied pretty well to medicine in someway, although I'm not really sure we defend anything. But you know, the overall theme seems to be one of complete, benevolent control.

It's important to (and I will soon) make a short list about things that matter, and everything else be damned. List comes soon. For now, I'm going to get back to reading in one of my favorite Houston study spots which no one knows about. Because it's totally empty. Because it has been totally empty everytime I'm here. Because no post is really complete without a picture.

*: If you, for some reason, think this is rooted in anime, gfy.

Dessert

Few people are unaware of the multiple chaotic sectors in the world the British Empire left behind. Yet, in their conquest, the Brits may have a redeeming quality:

Good English custard, in the truest, most authentic sense, is a difficult dessert to make. Almost everyone screws it up somehow (and I'll try to point out common mistakes). Just remember kids, the point is, to not fuck up.

1. You need this. There's no need to order fancy custard powder online, although you might be surprised at how expensive this might be (I believe it's imported). Be sure to reseal. This powder is hygroscopic. Like... all powders.

2. You also need some sugar. "Did you really need to put in a picture of sugar?", you ask. Yes, because I like to show off my fancy container. Which I got from Ikea. Which was $2. Fancy.

3. So this is an important step. You must make a primer. Ever watch me get some coffee? I always make a primer. Let me comment on that. There are people that go apeshit over a lack of "stirrers" - those plastic things that solo makes billions of.* 

First of all, just take some cream and sugar and drop it in your cup first, then swirl it around for a few seconds. 

Second, add some coffee and swirl it around some more. 

Third, lift that coffee pot as high as you can (comfortably) and pour it into your cup. No stirring necessary. Now stop wasting plastic. 

Back to my procedure. You have to make a primer and you can't have any residual clumps of powder at base of your primer. But even if you do, when you're mixing in your primer into your milk, make sure you skim it off the top, not to get any clumps. Microwave for 30 seconds, skim off 2 spoons of primer and mix it in. Repeat. Also, you may want to microwave at 20-40% power.

FUCK UP MOMENT: DO NOT LET IT CLUMP AT THE BOTTOM

4. Watch this like a hawk. It's going to heave and lurch like a chronic alcoholic who's had his last drink, but you mustn't let it throw up and die!** This is where the microwave power limits come in. Don't nuke it. Negative style points.

FUCK UP MOMENT: DO NOT LET IT DIE.

5. Finally, after 6-7 minutes, it'll be done. Let it rest quietly. 

FUCK UP MOMENT: DO NOT SKIM THE TOP OFF REPEATEDLY. POINTLESS. 

6. Prepare your fruits. You can throw in anything in custard really, as long as it's soft (and not something weird like.. meat or pasta). Technically, it's now called fruit custard. Fresh fruits are better. Strawberries and mangoes are awesome. Blueberries and blackberries, fruits that generally tend to disintegrate with time are a bad idea. It's best to preserve the original custard color. But really, I only threw in this step for this:

FUCK UP MOMENT: DO NOT THROW IN ANYTHING HARD. LIKE APPLE PIECES. PEARS MIGHT BE OK DEPENDING ON HOW RIPE THEY ARE. 

This is the main fu moment. Also, make sure they're more/less the same size. And bite sized. Now cool everything down. 

And in the end, when you do finally get around to having some, I think you will concur - this is a mover and shaker. Like Physics and Medicine and Red Hot Chili Peppers, add English Custard to the list of things that can really bring peace. It's even halal. Now, come on Brits, spread the wealth!

*: Ending a sentence with a preposition. Bam!
**: Admit it, you did not get this reference when you read it. Some of you will never get it.

Abacus energy has a few dumbasses working for them.

I checked my mail today, and found this. I was irritated. Please GFY, abacus energy. I should get a discount for having to put up with this bs.

Of course, the date says 5/15, and nothing was disconnected. Still.

Poll: Should D throw a shitfit? And to what magnitude?

Fuck youtube.

I always get stuck on some series of videos.



Yep. Admit it. It was good. I also know how to say "Eddie marries bush bitch" in German.

MURPHY GIFTER SIG MED DJUNGELBRUD. I guess I learned something.

I went to a tattoo and body art exhibit this last weekend. It was pretty wild. I'd say more people were getting tattoos (or had gotten one there) than not. Also, they kept telling me to KEEP MY PHONE DOWN, so I wouldn't sneak any pictures. And I didn't really try since there were these huge biker gang people near the entrance waiting to pounce on the unsuspecting / running med student.

I was also horribly out of place. NASA cap, BCM "eat, sleep, medicine" tshirt, jeans, tennis shoes.

But you know, I think I'm eventually going to get a tattoo, I just haven't made up my mind yet. Someone once told me you need 3 good reasons? "Wanting one. Check." Now I need two more. I remember one guy at the VA had his last name tattooed across his lower abdomen. He was also encephalopathic and almost smacked me*, but that's another story. He was also going through 3-4 Type 6 stools** a day and the nurses would tell me, in broken english "HE SHIT THREE TIMES ALREADY", so I suppose they didn't like me either.

Fun times.

Back to the tattoo. It has to be something fucking cool like.. a science tattoo. I'm rather partial to the DNA helix wrapped around my upper arm. Or maybe something physics-y. Then people would say "wow, you must have gone through a lot of work/effort in physics to put that ink on you in the 'NEVER FORGET' kind of mentality huh?"

"Well, maybe, but I just got bored one day," I'd reply. Or maybe just stare off into space with a disaffected look, which I'm still trying to master, because there are a lot of boring people out there.

*: Don't worry. D > pt afflicted with hepatic encephalopathy.
**: I forgot the name of the scale, so I just googled "Bristol poo". Thx, google!

Day in the life of.

For most people that'll read this, this is going to be pretty routine. Everyone else, including [Future D], maybe not so. He will have forgotten what it was like.

That's YELLOW. 20th floor YELLOW is where I did most of my work. SLEH is a maze. I theorize it's because patient rooms need windows and hospitals love to expand. 

For most of my SLEH days, I get there at 630 or so. Not because it takes me a long time, but the walk can get hot and sweaty if I leave any later than 615.

1) Log onto a computer, review overnight and morning labs, see if you have any news for the patient, see if you have anything you need to focus on.

2) Wake up your patient. Some of them are up watching TV already. If they are, these people become my main source of news every morning. I learned of the NYC car bomb through one of my patients (and the next day he told me how utterly retarded the criminal was). I openly tell my patients that they're my main source of news. They feel useful, I get my dose of happenings outside the hospital.

3) Rounds usually start at 8AM. 8AM-9AM rounding. The attendings pretty much knew everything. There wasn't much pimping. But a fuck-ton of interesting facts. For example, 2 lectures on the history of chemotherapy. And did you know the nausea, vomiting, diarrhea can occur even before chemotherapy started? Maybe you did. But do you know which patient populations are most susceptible to it? I didn't.

4) Incredibly important is a cup of coffee. Here is my hand, holding a cup. I need a manicure. One of the many good things that came out of my SLEH experience was a GI tolerance to coffee. BRING IT. No more gastro-colic reflex. 

5) Sometime around 858, I start heading down to the basement to 9AM-10AM morning report*. Which consisted of a lot of napping with my eyes open, although retrospectively, I should have been paying more attention. Somewhere down this long ass hallway + a few turns = morning report room. That purple poster on the wall is about brain aneurysms and clipping/coiling techniques.

6) One of the most irritating things about the SLEH experience was the number of lectures. I usually had one hour after morning report to do whatever (usually finish up a note or finish reading an article). Then, on most days at 11AM, there was some sort of lecture. Sometimes ABG interpretation (done horribly), sometimes heart sounds (done well), sometimes an assortment of random lectures. Lunch is at 12PM. 

7) Another great thing about SLEH was the food. Sometimes we had a choice. I'm not a terribly big fan of choosing what I have to eat, since I'm ok with 99% of everything out there. Actually I'm going to end that discussion here and pick it up another day. It's a post in itself.  Here is some orange-ginger-chicken.

8) At around 1PM, I go back to YELLOW, 20TH floor. Maybe eyeball my patients once again for a second set of rounds with another attending at 2PM. Get another cup of coffee and wait in the meeting room, get some more reading done. Picture of me waiting minus me. 

Yes, I carry a travel sized bottle of Listerine in my white coat. God knows what you'll get for lunch. Also, I love onions. Listerine is a lot quicker at a temporary cleansing of teeth and breath. You'd have to chew gum for a good 5 minutes. Also, walking the hallways chewing gum makes you look like a fucking moron. 

9) Well, my day usually ends after 2-3PM rounds. Sometimes a bone marrow biopsy is required. Sometimes the intern likes to teach. Definitely by 4PM. 

10) On Thursdays we have grand rounds at Baylor at 1215PM. Here is a picture of a random naked man near Methodist. Zoom in by all means. The guy is completely naked. 

Did I miss anything?

*: Will talk semi-extensively about morning report another day.