Old and Busted --> New Hotness

I slept from 2am to 640am last night, had a 7am appointment at the dealership for maintenance (and a cleaning!). I don't trust their "inside-cleaning" job. Anyone recommend something for wiping down ( --> "new") leather seats? Does Armor-All work? I'll let you guys know.

Regardless, "New Hotness" is back.*

I learned a lot of things today.

1. Crop dusting. (http://www.urbandictionary.com/define.php?term=crop+dusting) Absolutely hilarious.

"i crop dusted my way down the aisle at the grocery store"

2. Anchovies are fish. Anchovies are fish. Anchovies are fish. I used to think they were some sort of vegetable, probably because they sound like "chives". Then I realized that Pizza Hut offers anchovies on their pizza and it blew my mind. They put fish on pizza!? (I know they do all sorts of crazy stuff in Japan, but this is here! In Plano!) Mind blowing.

3. An "A" package consists of oil change, tire rotations, and not much else. Comes out to be about $100 in parts (yeauz @ full synthetic!). The rest $120 is probably for "labor" and let's be real, pretty awesome service. I'm due for a "B" in 12 months. $440. (lol)

4. Roadside assistance from Mercedes Benz is better than AAA. I was told to cancel my membership. Comes with the cost of the vehicle, so, "free". No more worries driving to Houston about running out of gas! Probably not the best strategy, since I always see a burning cross in the distance when I'm on my way down.** Have you guys seen that movie No Country for Old Men? There's a 150 mile stretch from Dallas to Houston that feels like that.

Do I want to meet this guy on the road while waiting for gas for New Hotness? No thanks. What a creepy character. The pneumatic-make-holes-in-people's-faces thing was well played.

It'll be almost 2010 in a day. Here's to bright, sunny skies ahead.

"When you get sad, it always seems to rain"

                    "Lots of people get sad when it rains!"

"It rains because you're sad, baby"

                    "...It's not fair"

"Never is."

*: I have a feeling facebook doesn't preserve formatting when importing. See www.piotrrcola.com
**: sort of.

2010

Damn, has it been 10 years already? I am so old. But, hurrah on 5+ years of blogging! I have old posts somewhere in my email (from 2003), which I just found, which are terribly embarrassing.

Am I ever going to release them? Maybe. In spurts.

It's that time of year again. Time to make a list of resolutions. You can dig up my old ones from December 2008. So how did I fare? Pretty well actually.

List for 2010:

1. Take care of myself, for a change. In all aspects.
2. Continue without internet or cable tv.
3. Stop pirating ____/____
4. *

For those of you that know me semi-decently, you know I haven't had internet for the last 6 months (ever since I moved into my 1/1). It sucked for the first month, then I just got used to it. I still have internet on my phone, so it's not completely gone.

*: lol.

End of an era.

I've been in school since, what, 6 y/o? Earlier? There are a few stories roaming around in my family folklore talking about when they tried to send me to pre-school and I threw a shitfit until my grandfather came back. I wasn't the best kid growing up, either.

Enough Hx. I think the last few posts have been mostly about things I've noticed, not enough about me. Let's face it, news happens all the time. Stuff about me? Not so often. Except these days.

I will say - 18-19 years of classroom education came to a close an hour ago. I'm still in kind of a daze, but I'll also say a few words about what's been going on. If I've come to realize anything in the last month, it's that life is about Battles. Yes, bolded with a capital B.

Let's begin with a list of battles to fight. Daily.

1. Battle against coursework. Keeping up with ARTS / Genetics / EBSE. Keeping up with knowing it at a personally satisfactory level. The EBSE thing is an epic fail waiting to happen.

2. Battle against administration for my project. Currently to remain unnamed until things become more official. I suppose only a few people know. Come on, department heads, get back to me quickly. I do have Baylor's support for the most part, but an unnamed-department likes to run things independently. Lots of strings to pull. Lots of pitches to throw. Lots of people to convince. Convince them that the M1's actually need this. Convince them to donate time. And equipment. And moral support. And a presence.

3. Battle against research. Getting my proposal / grant / rec letters. Trust me, it is another shitstorm. Also, money is on short supply these days. Even getting everything in on time and perfect doesn't mean terribly much. FML? Yeah. F.M.L. I swear I've been given a new paper to read every week.

4. Battle against ongoing physical fatigue. I'll admit, I bring this one upon myself by not eating right, eating at odd times, allowing things to cut into my sleep. This has got to change. I've spent the entire morning coughing and I can feel it in the back of my eyes every time I cough.

5. Battle against personal goals. I haven't been able to work an ER shift in the last 2 weeks. Or do anything. I've been good about volunteering every week since Fall 2 started, except for recently.

6. Battle against personal obligations. Helping a few people through their careers. Through tough times. Probably one of the hardest battles, as I have very little control over what anyone else does. But I can hope. And that's important.

7. Battle for a certain countess. Well, this last one I can't really talk about.

Well, what's the solution? Sleep comes so easily these days. I've never quite felt the wind knocked out of me, except for these recent days. Sum up all those strifes, most of which increase as the day progresses, and you might get an idea.

I scarcely have time for meetings, only a few passing words to the silently manipulating Gold Buddha in the mornings.

I find myself saying "well, today was 3 parts crappy and one part awkward. Tomorrow will be better." It doesn't work the first few times you say it, but slowly after that. 

There's only a few things I feel I can do.

1) Stick to my principles and stand your ground. Remember all those sayings about principles? A man without them is nothing at all? It's probably the 3rd thing my parents taught me. The first was archimedes' principle (buoyancy). The second was that "energy is the capacity to do work". I remember the first day in Mr. Smith's chemistry class at Jasper. I sat by myself in the awkward table in the middle of the class since I showed up late. He asked what energy was, and I blurted that out like I had been doing that dance my entire life. Mr. Smith went on to expect a lot out of my sister when she went through. :P

That was probably one of the first realizations that my parents were right about many things. And back then, I really could do that dance. These days, I have to throw cutouts of feet on the floor.

2) Smile when things go tough. What else are you going to do? 

3) Take care of people. Again, what else are you going to do? I suppose this counts as a principle. A few people openly consider me profoundly reliable. That's always nice. 

A lot of these battles will end December 18. All of these battles will end on January 1st.

And on January 4th, if the silently manipulating Gold Buddha allows it, 2 months Ob/Gyn will start, and a whole new set of battles will begin, and you will know all about them. I should be good. It's time to start learning by doing rather than reading, by allowing streams of knowledge and consciousness to meander rather than inundating the landscape with information, and by finally being able to make a difference.

I relish that opportunity to fight, just as I relish the battles above. Not everyone has the opportunities to fight for what you believe in, or what you want.

A new kind of dance starts January 4. One I've been preparing for not for the last 18 months, but for the last 18 years.

Saddle up. Lock and load.

12d + After

What a bundle of win! Also, an appropriate time to post a few pictures:

Let's start with Chase's pictures of 12d.

If you missed it, well, fail.
Bitch, please. It was awesome.

The afterparty was fun too. "Bambou." lol. I wanted to leave a bit early (my calves were killing me* from the dancing), but I was reprimanded on how lame it would be if I left early. (1230 didn't seem early). I purposely didn't take my credit card.**

And then as usual, a few drunkards had to be taken home. :)

I woke up at noon, with the most intense jonesin' for a Vietnamese sandwich, evar, west of the Mississippi.***

So I made it happen.

It was glorious. Mmm, you can almost taste the awesomeness.

Then I went to the business center of my apartment, working, chatting, etc.

All of a sudden:

   me:  FUCK THEY LOCKED ME IN

This is not the first time. I'm usually in a corner hidden from the entrance. So I clamored, and they let me out. It was either that, or throw a chair through the window and rappel down the north wall, NOC-style.

One day, in another life, maybe. (The NOC thing, not rappelling around the apartment complex, already done, kthx).

Plan for rest of the day. RHCP + do laundry. 

*: Not a +Homan's sign. I checked.
**: "Purposely", meaning I assigned some purpose to losing it in my apartment.
***: Respect, if you get this reference. Without Googling it.

Punctuation and communication

I'm going to start out with an email response I got from a certain unnamed genetics professor.

I asked a question. What I asked is probably not important, so I'm going to cut the bullshit and get to the response:*

I'LL ASK YOU A QUESTION: YOU'RE 12 YO PATIENT HAS A MOTHER WITH COLON CANCER DX AT AGE 32Y. WHAT DO YOU NEED TO FIGURE THIS OUT? WHY DOES THE MOTHER HAVE COLON CANCER THAT YOUNG. IS YOUR 10 YO PT AT RISK? HOW CAN YOU FIGURE THIS OUT? YOU NEED MORE INFO ABOUT HTE MOTHER FIRST AND ABOUT THE FAMILY. IF THE PATH SPECIMEN SHOWED MULTIPLE POLYPS THEN THINK FAP. YOUR PT MAY NOT HAVE POLYPS YET. ARE YOU GOING TO WAIT UNTIL THEY SHOW UP "CLINICALLY" OR WILL YOU GET A DNA TEST FIRST??? 

Let's begin.

1. All caps? Really? Sounds like you're shouting. Only John Wilson can get away with that, and only because he teaches so well, with kickaess drawings. Also, he has a booming voice. We all miss John Wilson.
2. Please don't answer questions with questions. It's like looking up a word and finding other words to describe it.**
3. The triple "?'s" in the end. Totally unnecessary. It's like getting all up in your face. huh? Huh? HUH? Like the donkey, from Shrek.

Still, you gotta give it to the prof. She has 2 genetic syndromes named after her. And that is why I will go back into my corner, and memorize all her slides. FML, son.

\\

I think I'm slowly going to transition away from GTalk (except for a select few, you know who you are), and just make phone calls. Want to talk? Pick up the phone. More personal, more time saved (GTalk wastes so much time.), less convenient (You're not that busy - get over it, have a picnic.)

Far too much text these last few posts. Next one will have a picture.

*: 18 months of med school will help you appreciate this sentiment. And if you really wanted to know, I was asking about a FAP Dx tree.
**: Not exactly, but you get my point. Dictionaries should be massive picturebooks.

Wardrobe

I finally bought a pair of jeans. It's been a long time coming.* My last pair was 5 years ago, and profoundly tight. Like, cut-off-blood-supply-tight. I know a few people that writhed in agony seeing me in those jeans.

These actually fit pretty nicely, but every once in a while, the seam looks a little shiny. Yes, I made sure they were a men's pair.

Well, here go some first impressions:

1. Why does this pair cost $49? (after a discount, ON Black Friday) I can get 2 shirts and a graphic tee for around the same price.

2. What's with the 99% cotton, 1% spandex? I don't have anything with spandex in it. Should I be worried?

3. There are a lot of seams. And they're all on the outside. (Should I be worried?)

4. To be honest, the thing lacks symmetry. A coin pocket on the right side, not one on the left as well. The more you look at it, the more profoundly ugly it looks. What is this? Ford automotive? Fuck Fords.**

5. At least the thing lacks an obnoxious 4 inch dragon-creature-thing characteristic of Express. Showing that off, although not the pinnacle of douchebaggery, comes pretty close.

I guess you can come take a look in about 6 hours.

*: Just as clinics start. Yeah, fml.
**: Fuck domestics, actually. Recently they've been trying to go the Honda/Toyota/MB way with their looks. Really, just... stop trying.

thanksgiving

This break is slowly coming to a close. It's important to emphasize / know the things you're thankful for. I know everyone thinks of me as a mildly spoiled-Plano loving-brat, but whatever.

I actually do realize the relatively privileged position I reside in.

List of things (feels like I'm doing a lot of those these days):

The list is ordered from least important to most important. If I was to part with something, I'd rather have it cut off from the top than the bottom.

1. My C280

2. My iphone

3. My laptop

4. A decent apartment to live in, furnished and paid for.

5. Always having a great city to call a home.

6. A lack of worries about bills, rent, tuition, gas, food, etc.

7. A lack of worries about my own health.

8. A lack of worries about anyone else's health, for the most part.

9. Having a great family and a great set of friends, both responsive and honest.* People to tell me my flaws and help me improve.

The shit-storms come and go (it's shit-storm season), but these people are here to stay. <3

Randy Pausch's lecture was good. I really only liked one part, where he talks about the importance of introspection. Much to the irritation of a few people I know, I probably introspect more than I should. It's important to stand back and tweak the system, provide continual, minor, palpable changes.

I liked the bit about karma too. Something I've come to believe and trust in over the last year.

What a mushy post.

\\

In other news, I've lost 11-12lbs over the last week and a half without changes in eating or exercise or anything of that sort. Negative travel history. No meds.

So I either have TB or cancer.

*: Say aww to yourself. I don't want to hear it.

What do I want?

I was thinking about that today while absent-mindedly staring off into space (and whoever happened to cross my path).

I have no idea. Although, I will compile a list of things I think are awesome, in no specific order, and by no means exhaustive.

THUS BEGINS THE LIST OF KICKAESS:

1. dimples.
2. people that use their eyebrows when they talk.
3. heterochromatism.
4. tattoos that can be hidden by professional clothing.
   
5. blue eyes.
6. green eyes.
   
7. appreciating the insights of star trek.
   
8. trails on dresses.
9. not judging professors daily.
10. not judging people daily.
    
11. not wearing gold.
12. not playing games.
    
13. wearing simple things.
    
14. a desire to burn things. thank you, Austin.
15. losing the flab at a steady rate.
16. a maternal need to feed anyone and everyone.
    
17. mixed chicks.
    
18. not recycling clothes.
19. eternally hopeful.
    
20. a Dutch heritage.
21. an appropriate level of loyalty.
22. an ability to rattle off weaknesses.
    
23. a graduate education
    
24. tempered spirituality.
    
25. yellow highlights.
26. being diplomatic.
27. not wanting to get drunk repeatedly.
    
28. starting conversations with hello, rather than interrogatives.
    
29. not wielding a bullhorn for a mouth.
30. modestly perfumed.
    
31. listening with eyes.
32. a classy british accent.
    
33. holding on in the throws of maelstroms.
    
34. not using your religion as a defining factor for yourself.
35. uniformly colored toenails.
36. a few ounces of mystery.
    

Exam week

Notice the exam week sleeping arrangement.

And the cherry coke zero I've been downing. (not mine)

Aspartame can give you osmotic diarrhea.

LAP.

I got it.
2-3cm to the right of my hyoid bone.
Unilateral lymph gland enlargement.

Shit.

It's all about improving lymph flow (keeping your fluids up). Also, I'll be doing some stretching and pushups to keep my muscles going.

So, quite literally, I'm going to flex and flush this thing out.

[cue battle cries]

Why are you.. the way that you are...

MS Word 2010

"What the hell is cretonne?", you ask.

Cretonne - (taken from Wikipedia) - Cretonne, originally a strong, white fabric with a hempen warp and linen weft. There are literally 6 sentences in that entire article.

Google hits on cretonne : 184,000

Google hits on creatinine: 5,210,000

Because "cretonne" seems much more in use than creatinine.

Will Microsoft ever release occupation-specific dictionaries? Seems a lot more useful than "Notes View."

Studying at BCM.

Sometimes, my life sucks a lot.

Sometimes.




-- Posted from my iPhone

Frying chicken.

Finally, the darth vader hand so I don't get burned. If you think jeans mess up my skin, trust me. Hot oil is worse.





-- Posted from my iPhone

Win & Things that go bump.

I had an awesome day. Free Chickfila.

The day before school starts is peaceful. Calm before the storm.

sitrep:
My apartment : clean.
My laundry : done (clothes not yet sorted..).
Belly: full.
Fridge: empty.
GTA4 : caught up with 2 more missions. As well as some interesting healing techniques. :D*

I still have some extreme transference issues with my bed, so I may be transitioning to the living room over the next 2-3 weeks.

Speaking of sleep issues - things that scare the shit out of me. I have a pretty active imagination. Let's begin.

1) Clots. Throwing a clot is the equivalent of the universe punishing you for being lazy. You're just sitting there, and BAM! -you lose sight out of one eye because of CRAO. Or it hits your pulmonary circuit and you get a PE. Or it hits your coronary circuit and it's an MI. Or it hits your left MCA and you can't say "Original Sandwich and 2 honey mustards plz" nor can you point to it with your other hand.** Of course, there'd have to be a few predisposing factors (FVL). Still. It could happen. I recommend gently sitting down on your couch to minimize endothelial injury if you know you'll be sitting for a while.

2) Things I don't get. How did that girl come out of that well? AND OUT OF MY TV? Fuck it. I'm going to run. Oh wait, she can move pretty quickly too. And what's with that pasty pre-Kawasaki's syndrome*** young Japanese boy and his creepy meows? fml.

3) Things that show up behind me when I raise my head up from the sink after brushing my teeth. I swear to god, you creepers, I'll just swing my arm back there in a reflex motion and break every bone in your body. Unless it's intangible, which brings me to my next point.

4) Intangible things. For example. If you woke up and were casually staring off into space when you see someone move in your hallway. Um, I live alone? Who's there? Intangible things (or even, the threat of intangible things) can really mess with your head. Creepie crawlies/boogey men that can poke and prod (i.e. tangible) and make ruckus are usually only terrifying for the first time, then just become annoying. And, as alluded to earlier, the third time, I'd just bash their faces in with a bat.

More interestingly - things that make me go meh.

1) Psychos. Are you kidding me? They're only human. I'll just lock myself in my room and drink 3 Monster KHAOS oranges, turning me pretty psycho too. Bring it. I will mess you up.

2) Zombies. Not. scary. at. all. Just sit there quietly without making sounds or turning lights on. Zombies are like psychos with half a brain. Just get in your car (15 feet away, for me) and go.

What an odd post. Can you tell I've had a Monster already?


*: Never gets old.
**: And let's be real. If it's going to hit a cerebral, it's going for left MCA. Doing the most damage, evar. Most things in the world are out to get you. There's a DSM4 Dx somewhere in the last line.
***: He would run away if you threw steroids at him. I hope.

Lack of Internets

Seriously sucks. So I'm at a public library. (MGSL) But you know what, they made doctors before the Internet. Ok, enough complaining.

Burkitt's lymphoma's starry sky.

I get lost in these starry sky cytological pictures.

Meanwhile, I wish I had a pair of headphones on me. I'm getting a "Ride of the Valkyries" craving. Send in the cavalry.

Dinner fail (extreme fail)

At midnight.

Dinner (fail)

So it begins.

Fitness

Hell yeah!

Hit up DD's happy hour. It's like, the best thing on earth. You'd think that with my intense sugar cravings at times, the filled doughnut (2nd column) would be the best, but no! I've been jonesin' for some Cruelers/Kruelers these days. They're quite magical.

Next time you get one, bite into it to make a radial cut and peer inside. It looks like there's butter lining the walls! Then you start to wonder - damn. That's why it's so good. Being all satisfied with your own reasoning (just by looking at it), you test it out. You take that theory, which is probably about 99% correct, and get that 1% of empirical tactile evidence. So you stick your tongue out to taste the butter, BUT IT'S ALL SOLID. WHAT THE HELL IS THIS WITCHCRAFT.

Seriously though, happy hour kicks ass. The Japanese have a way of describing rain and snow, using the verb "furu", which means "fall from heaven" (historically). Indeed, happy hour ga futta.

Actually, before I found out about boon, I've been hitting a few gyms in Plano, being away from my convenient (but painfully small) apartment gym. I figure I'd just do the 7 day membership trials on each one.

But, let's be real, this is not some expose. I've only been to 2 Plano area gyms.

LA Fitness:
Very nice, 2-story facility. It seemed like their machines were customized for LA Fitness. Wide variety of machines. Full blown snack/juice bar (even though I'm a bit wary of all the booster powders they throw in). Also, had a friendly staff that didn't creep me out. I suppose the only con was that it's kind of south of my comfort zone to still keep calling it Plano. (It's near the Bush tollway).

Cost: Apparently, $30 a month. (!!!)

Vibe: Urban professionals who work out after work and semi-retired* people pumping some serious weights (much more than me).**

24 Hour Fitness:
A seriously ghetto place. I saw 2 people on staff there, both equally creepy. People kept dropping weights all over the place. What's with the mirrors on every wall? Even the pillars? Seesh. The machines were clunky and there's a limited variety. People keep dropping weights all over the place. Did I mention that already? That was seriously annoying. The parking lot made me worry for my vehicle.

Cost: About the same, $30 a month.

Vibe: Gangbangers who were pumping up for their "hits" and drug deals later in the day.***

The biggest problem is really, that I left my gloves in my apartment.

*: Retired people who realize that they still contribute to the world. Hard to define, easy to spot. Kind of like pornography.
**: Sigh.
***: I've been watching The Sopranos these days. I'm starting to talk like them. However, New Jersey still sucks. And always will. What an armpit of a state. Kind of like Austin. Fuck austin.

Clowns (painful FAIL)

Everyone knows that bustling community to the north (Frisco) is full of crap. All new developments, a hospital with a pathetic emergency center*, built around commercialism, which amounts to sucking North/West Plano's money.

Naturally, that city is full of clowns capitalizing on the cheap real estate. (There's a reason why it's cheap, I just haven't figured it out.)

Also, (naturally) clowns drive like shit. I was backing up (relatively carefully) and there was no one there in the rear view (I checked the camera and the mirror) so I kept backing up, checking my sides when - BAM!



This clown came out of nowhere! I realize "that's what they all say", but honestly, if you see someone backing up (aka, backup lights are on) DON'T PASS BEHIND THEM, ASSHOLE.

I've had to slam on my brakes for countless people that think they can snake past. Fry's Electronics is notorious for people trying to snake past. This one didn't get by.

I don't think the idiot even knew that parking lot fender benders are equal liability accidents.


I've blacked out my license plate #, in case you were wondering.

Ugh! What a painful accident. I ended up with a few paint scratches. His ugly corolla had a nicely carved metal dent. Guess which one costs more to fix! Maybe you'll keep your eyes open next time, clown.

I could have been more careful. $230 to fix. There's a story on that, too -

I went to Maaco to ask about the paint touchup job. I had my Accord repainted there a few years ago for about $700 or so. I get a quote that's $680!** So I ask him - it costs you $700 to paint the entire car, but you're going to charge almost just as much for a touch up?

He went into some explanation about the paints being different, etc, etc. Also, kind of with an attitude. Come on, it's 830AM, and you're already irritated? Was that such an unreasonable question anyway? I know nothing about paint.

I then went to Park Place Lexus and they gave me a quote for $230. Much more reasonable (I guess...?).

I can also stick around and consume all the Mountain Dew / cookies / coffee / newspapers I want, instead of sit in a waiting room-attached-to-the-sales-office and get charged 50 cents for a can of Shasta cola.

Fuck Maaco.

*: Plano has 4 (MCP/Presby/Baylor/Children's). WIN!

In fact, Frisco's medical services are so pathetic, they have more animal hospitals than human hospitals. Good god.

**: I have another car-repair story I'll write about soon.

Colors*

I was in one of those pretentious Central Market-ish stores** and I wasn't going to buy anything. Hell, I wouldn't know what to do with half of them. A few things are interesting. Newflower sells things like solar powered cell phone chargers (very tempting, except for the $80 price) and stuff.

Even still, nothing except the honey roasted peanuts called to me. I started getting bored, so I tried something new.

All those pretentious hippie (but really, not) labels are so colorful. So I just took it all in. Just focused on the colors, not the text. It's interesting. Sort of like being in a foreign country.

I think we spend so much time reading text that we forget to look at the strategically placed colored backgrounds and nuances.

*: Great song:



I'm going pretty crazy with this rediscovered 'embed' feature.

**: Hard to describe. Sprouts is kind of like one. Central Market for sure. "Newflower" on Preston Rd. is another one.

Back to The Sopranos.

Ice cream.

Does it really go bad, having been in the freezer since January 17?
More importantly, why has no one eaten it since then? (Dutch Chocolate!)

I consulted Yahoo Questions.

http://answers.yahoo.com/question/index?qid=20060611201556AAcSQqM

I then read the comments to amuse myself. I learned that "ice goes bad too" and "it will taste like frozen plastic."

It bugs me a little that I'm eating something described to have "freezer burn" and "frost bite" on it. It really does taste gummy though.

That reminds me. I remember a long time ago when school started, everything just looked like one big mush to me. "Parenchyma" or "mesenchyme" as people called it. It seemed like there were a few important things in this bag of water people called a human body, and the rest of it was just mush, filler, gunk, etc.

I suppose it's expected for this to change. It has. Although, fat still looks like gunk. Whatever. Enjoy the picture of the gummy ice cream.



That's my hand, near the top.

What a senile post. This is the kind of useless shit I've been doing over break. Talking about ice cream and taking pictures of my hand. I'm bored. When is class going to start already.

I'll fuss about something tomorrow.

Rockstars

Man I love this commercial:

The Chinese one? Not so good. Pretty horrible actually. He has masked facies like a Parkinson's patient. What did he invent to have such a smug look?

I was in the ER the other day (not as a patient)* and the first time the attending** chooses to remember my name, she yells "Glove up! and get ready to tradeoff on compressions!"

A second later I felt a light jab in my stomach - a nurse handed me a pair of gloves. It's too bad they called it before I had a chance to get in.

Mid-40s, MVA, respiratory and cardiovascular collapse, they were doing CPR for about 20 minutes. The thing is, MVAs come in all the time. Trauma rooms are populated all the time. If you really want to know if something serious is going down, look for the religious liason standing outside.

*: I used to ask "Have you ever been to the hospital before?" in my interviews. After a few interviews, I started adding "as a patient". Somehow, "hospitalized" sounds too clunky and serious, like they took a trip through the ICU or something.

**: Rockstars.

Videos on break

Pardon the imaginative title.

Year 1 of med school ends. I don't feel any different.



I was watching this video of MJ. I think "Beat it" and this song are the only ones I actually like. Someone the other day said that it was "all about the package"* and I was trying to figure that out. The dancing/singing/performance act.

Well. People need to calm the fuck down. I'll admit, it was a good performance. I just can't see myself going that crazy for an artist.

Probably the most annoying set of videos I've ever watched has CNET's Brian Tong on it. He hosts this segment on CNET called "Prizefight" Here's a clip:



Congratulations, douchebag! You look like a small animal. The kind I stress my suspension over trying to avoid on the highway, but probably shouldn't. I just can't take anything you say seriously. Probably due to the fact you look like one of those IC2 assholes.**

I realize the AzN thing was a fad a long time ago. It's over. Seriously. Flatten down the hair and act civilized. Also, your vehicles are weak. Tong should use his "skills" to photoshop himself into the "You Got Beef?" music video. Preferably into one of those really fly Dodge Neons.

lol. Rappers.

*: There's a kiddie porn joke somewhere in there.
**: I have not been able to figure out what exactly they do.

Start out the summer with a BANG!

Quite literally. Yesterday I was coming up a flight of stairs, pretty
quickly, preoccupied with a few things. Well. My leg got caught.

And I have a meeting at 1pm.

DDx:
Ligament damage (95%)
Talar fracture (5%)

My parents want to come down and baby me. I hve a ton of shit to do
too, so that might be convenient. But damn.

I'll do it by myself.

LAME.

:'(

2 MONTHS.

It hurts me more than you, trust me.

"My Ramblings" will be back. July 1.

Enough with the laziness

I've always been a fan of human spaceflight, and infinitely critical of the slowed progress we're seeing these days. Kennedy made his famous space speech in 1962, and we were on the moon 7 years later.

Today, to do the same thing, it is taking 15 years, more than double the time. Bush decreed that we go to space in 2004 and the proposed manned launch date is 2019. 15 years!

We should be able to do it in less than 7. It's not like we're building a base on the moon (yet).

Perhaps Burt Rutan can convince you. (link)

Maybe one day I'll delineate what the real problem is, when I get bored of studying.

Huzzah!

I sometimes think med school should start in the clinics first. Without this pre-clinic class business. I guess I'm fortunate I only have 8 months or so left. 

I was at preceptor a week ago, and this 14 y/o girl came in with a massively swollen right leg. Apparently her muscle had been hurting for two weeks but the night before, her leg started to swell. Ankle reflexes, peripheral pulses intact. So why was the leg swollen? The doctor spent a few minutes looking up numbers for lymphangitis centers and getting a few consults when I was like - "What about vascular issues?"

She ended up being transported to TXCH ER with a possible DVT in her right leg. If you don't know what that is (long-haul airplane passengers should), it's a clot in the venous return that may become an embolus and go to the lungs and block off blood supplies (pulmonary infarct) or the coronary vessels (myocardial infarct). Her legs were swollen from venous obstruction. 

In my mind, I kept screaming 'CALL FOR A CHOPPER!'

But, I guess the mother driving her there was good enough. 

At first I didn't think much of it, and I still don't, but I guess I played a minor part in that story, more than the usual "Oh, your foot hurts? Let me get some details so I can do my write-up."

I should get back to studying so I can be of more use. 

Microsoft makes a comeback

Except, come on. 

http://www.youtube.com/watch?v=EIS6G-HvnkU&feature=channel

Lauren walks in the store...

And she walks right back out, having checked out the 17" laptop. NOTICE THIS, same guy! Maybe she has really fast eyes. 

Last Day

Today is the last day of a glorious month.

I turned 23.
Battlestar Galactica ended gloriously.
I have re-discovered ST:DS9 due to a glorious find at a certain awesome website.
My room's a mess. A glorious mess.
I have started gloriously biking again since the weather improved.
I got a glorious new set of legs for my wobbly glass table.
I have three glorious weeks left to study for tests. :'(

That's about it. Turning 23 was not that eventful.

Civic fail

I've discovered the "delay post" feature of blogger. Hence, I can impose some order onto my Blitzkriegs.

Every once in a while, they have these commercials -

http://www.youtube.com/watch?v=opYFn99TGjg

I'll admit, interesting premise. But 36 mpg highway? How is that a selling point? I looked up the engine sizes on the Civic - 1.3L to 2.0L, all I4 engines (inline 4). The civic is a crappy vehicle. All the other Honda models are orders of magnitude better (except for Fit and Element, god damn)

I only say this because...

BAM!
34.6MPG

That's me, driving back to Plano. Average speed - 69mph. Mileage - 34.6 (it climbed to 35.2 as I was merging onto US75).

So, having a slightly larger car, with a 2.4L V6 and a significantly faster pickup, I can still manage 33+ mpg everytime when I'm on the road. Thank you, 7 speed transmission.

Come on, Honda. Step up your game.* Don't get me wrong, I'm a big fan of Honda.

One more thing, see that "C" next to D? I was leaving TMC the other day and I decided to take the long way around, changed from 'Comfort' to 'Sport'. At 3AM.

It was legendary.

*: Meaning, roll out the FCX already. I will buy this when it comes out.

Twitter

I finally joined Twitter.

You can check out what I was doing last time I updated. I guess it's a bit faster than Facebook status (even though it's essentially the same thing). I figure, a ton of Senators (read, old geezers) are on it, so I might as well join.

Twitter

Children are hilarious patients. They have one of three answers. "Yes", "No", and [blank stare]. Does your leg hurt? Yes.
How does your leg hurt? Yes. (...)
Does your face hurt? Yes.
How does that hurt? Yes.

The mothers usually just stand there with either the "well, fix him!" or "gosh I don't know what's going on" look. So I tried something new.

This one kid came in and the mom warned me that he was being combative and doesn't actually know where he hurts (but hurts everywhere you ask him) and he was in some apparent distress. Go figure.

So, I came down to his eye level and I asked him - "Where does it hurt?"

Silence.

After a few seconds, I told him that if he couldn't tell me, we couldn't help him.

More silence.

Finally, he tells me that it doesn't hurt at all right now. That's what I'd been waiting for. Of course you're not hurting. Your face has no sign of grimacing and you were bullying your sister when I walked into the room.

Now let me go check if your immunizations are completely up to date. I am cruel.

Fog this morning

The Pad

Before I start rambling again, the blitzkrieg of posts will begin now. I usually have an aim of 4 a month, but I'm clearly feeling a little behind (content-wise, not quantity) and once I start writing, I usually can't stop - something about crossing over the activation energy to get this ball rolling. Right.

There are few undeniable truths to life. Regardless of whether I would become a physician or not I always imagined that prescriptions would be written on a pad, and the doctor would hand you this piece of paper, which summed up years of training and some sort of a guarantee (or belief) that whatever's on that piece of paper would work for that ailment. It's symbolic! I'd call it "pre-treatment." Best not lose that piece of paper because there's some *important* stuff written on it!

Now, everyone is transitioning to EMRs. This one part in Tampa is going completely paper-less. Call me old fashioned (these last few days haven't helped) but I'd like to write my own prescriptions on a piece of paper, thank you. 'Authorizing' a pharmacy to dispense a medication isn't nearly as powerful as putting some semblance of that power in the patient's hands through a handwritten note.

It's like whenever I'd go to a doctor's office and near the end of my own rambling about my illness, he'd pull out that pad and scribble something illegible and say something like "I'm going to give you something for your strep throat."*

Now, it's "Which pharmacy would you like me to send this to?" and if the patient didn't know, he'd get a printed piece of paper with the medication clearly written on it, dosage and all.

CEFTRIAXONE 200mg

CIPROFLOXACIN 50mg

CLARITHROMYCIN 10mg**

They would all look the same If I wrote them on a piece of paper.

Actually, the real beauty of all this is that the pad is like a magical encryption tablet which only the doctor and the pharmacist (hopefully) can read. Do I really want my patients looking these drugs up on Wikipedia and asking me about all the dangerous side effects? (Most of them include DEATH, ironically, to be on the SAFE side)

Not to the extent most people take it, no. Trust me. You'll be fine. (I think..)

*: I had this a lot. Fuck streptococcus.

**: Random dosages. Real doctors, please don't get on my case.

Aye Kewk

Some chicken, some beans, and an arsenal of spices I use to assault my taste buds. Very simple stuff, actually.

That silicone thing is so awesome.

Ha..Ha...

A bunch of people were at the bus stop today and when the bus came, we all started getting on. One or two entered through the rear door and the driver says - "Please don't enter through the backdoor" and I blurted out "That's what she said" and a bunch of tired nurses just stared at me. Not one laugh. Not even one small pity chuckle.

I have yet to grow up. But you know, being a student is all about change. I'm limiting my computer usage to 2 hours a day outside lecture (so, 6 total).

Perhaps I'll finally get some work done.

austin

Haha,

I'm in austin. Nothing has changed, except for the new BME building.

austin still sucks.

Time's off

Something really freaky is going on. My computers (and the rest of the world) is an hour behind. I went back to Plano this weekend and found myself going to sleep earlier and waking up earlier even though I felt normal, but I didn't think anything of it. 

Then, I get to my apartment, and my computer says 10PM, while my alarm clock says 11PM? The same alarm clock that used to wake me up for school! How can it be an hour ahead? (Same thing with the oven/microwave/coffee maker.) 

All the appliances and myself are running an hour ahead. For example - I'm used to waking up at 7AM. Like clockwork. For the last 7 months. I thought I did today. I looked at my alarm clock and it says 7AM (like it should) except my phone says 6AM. And my computer says 6AM. wtf?

So either I'm an hour ahead or the rest of the world is an hour behind. We're no where near DST time-changing dates, so it can't be that. There's only one explanation for this - Aliens.*

Someone please throw some ideas out there. Especially explaining how my alarm clock, which I've been using to wake up (as recently as last week) is an hour ahead, randomly.

Maybe this is how stress interfaces with my life. Time synesthesia? If only I could see colors like Feynman. Ahh, screw him. (Yeah! I said it!)

This is kind of starting to freak me out.

*: I've ruled out a power short at exactly 11PM that would reset my clocks to 12AM, since Aliens are more likely. 

Browser wars, my ass

The next person to tell me that Firefox has brought them salvation is an ass. Firefox crashes on half of the streaming tv websites, Google Chrome messes up CSS rendering more than it should and Safari (until today) didn't work with gmail very well. Internet Explorer is the only stable, reliable browser, given you know how to use a computer. 

If you don't and have this pathological need for 200 extensions (which just slow down your browser) then go ahead and try something else. 

I use all four.

Also, it's valentine's day on Saturday and my roommate has his gf over and they're tickling each other like monkeys. Yeah, I said it. 

My day at BTGH-EC

The first thing you really notice is how much trouble you have to go through to get to Ben Taub (from Baylor). Down a ramp, then up a floor in an elevator. Having card access to Ben Taub rocks.

*Beep* [Light flashes green + almost imperceptible click of the door lock]. So satisfying. The next thing you notice is the old BCM logo plastered along the corridor. What a horrendously ugly logo.



Ugh. Are you srs? Yeah, they're serial. The new logo is awesome though - simple, with a great color scheme. Midst the quiet, the third thing you notice before you get to the emergency center is the smell. Faint hints of nausea, vomiting, sterility, and cleaning fluid, all mixed in one.

This is the first year they started this program, and I had the first shift evar - Midnight to 4AM. I had done ER shifts before (at Medical Center of Plano). 12 hour shifts, and I got to see almost nothing - a few drug overdoses, alcoholics, maybe a case of acute angina. 4 hours at a Level 1 facility is far far different. Three GSWs, a few stabbing victims. Ambulances were coming in almost every 30 minutes and a Code 3, almost every hour. Crazy! We had "heard" of Code 3 (full lights and sirens) in Plano, but I never got to see one.

Ben Taub runs at 150% capacity and to put things into perspective - it's a bit bigger than the ER at County General.* But man, Houston is so ghetto. In the 4 hours that I was there, there were 2 GSWs, a few stabbings, and one person that got run over (maliciously..).

More importantly, I got to start a few IVs. I feel sorry for my first IV patient though. I haven't treated patients in a long time and it's really something to hear "Ok, you watch this one, and the next one is yours." 10 minutes later, the nurse was handing me a chart to call a patient back to the IV area - NVD symptoms, and I was looking at her and I felt a little sorry for the short period of pain that was coming.

It's good to just stick in the lancet and get it over with. I was going slow, so she was squirming in pain the entire time. The nurse told me to stick it in there and flip the catheter forward. I have to admit, it was satisfying seeing that flash of blood** through the proximal portion of the lancet, indicating a good cannulation. Those NEJM videos really do no justice to the initial difficulty of starting an IV.

So many things can go wrong. Put on some gloves, take out the J-loop, flush it with saline, lay it on a piece of gauze, take out the 20 guage, unsheath the cap, loosen the catheter, lay it on a piece of gauze, take out an alcohol pad, identify a vein, rub the area with alcohol, wait for the vein to appear or be able to feel it, find a straight segment in the vein (or make one by pulling on the skin), insert the lancet along the straight segment, keep inserting until you see the flash of blood, push the lancet 1-2mm along the vein, flick the catheter forward, compress the vein proximally, affix the J loop to the vein, flush with saline to confirm a good cannulation --> ending steps.

It takes practice. The great thing about it is, there's a clinical/basic science reason to each one of these steps and you can think about it all you want, but until you really start doing the procedure, you have no idea what they *really* are.

The subsequent IVs were better and I was promised an arterial stick next time. Smaller and deeper vessels.

I also learned how to do an EKG and a quick interpretation of it. The attendings kick ass. A 20 minute explanation and she doesn't even know who I am. Which, if you think about it, is pretty cool, in that they're willing to teach anyone.

My next shift is Saturday early morning, midnight to 4am. Bring it.


*: If you don't know what I'm talking about, google it. Then watch all 15 seasons.
**: Serial-killer-ish. "Do no harm" becomes "Do more good than harm".

Figuring shit out

So I decided to shadow this Ob/Gyn guy today, as part of my "figuring shit out" sub-task (part of the "transition to awesomeness" campaign). It was hilare supreme, and I have never seen so many ectocervixes in my life. Actually I hadn't even seen one through a speculum until today.

I'm not going to say anything shattering like it was "liberating" or whatever, but I did learn how to do a pap smear. Ob/Gyn seems to have a strong surgery / clinic / basic science component to it. I'm starting to appreciate the clinic portion a lot more - just as long as it doesn't become the least bit redundant, like family practice or pediatrics.

Pretty cool.

Over the next year, I'm going to be trying out different specialities to see which one I can successfully discount, which is the most I should hope for. I'm not expecting - nor willing - to settle on one just yet.

I have no idea how people have already settled on certain specialities. 'Liking working with children' is not the same as 'liking pediatrics'* I mean, I'll admit, I thought of myself as settled on trauma (or plastics, lol), but explaining things to patients has its own virtues. Plus, I couldn't live with making a ton of jokes every day.

Oh and...

http://www.youtube.com/watch?v=unBACOHFXes

What the hell is up with this "mars lander business"? Haha.

*: I have odd ways of pronouncing this. I say the "ped" in pediatrics like pedophile-ped, not PEED.

Preceptor

Actually before I get into some stuff, I just want to say - my resolutions are going perfectly. I've cut out canned food, which leaves about 30 cans in my cupboard or so, most of which are fruit cans, which are the worst (sugary syrup...).

I've been spending more time outside, although I have yet to invade the Baylor courtyard (the one that's locked from the Luby's entrance). I'll find time to sneak out the other way and just watch everyone behind locked doors.

Most of the time, preceptor is very ho-hum. Yes, it's interesting applying clinical skills for the first day or so, but once you know how to do them, it gets boring. Especially if every other kid has a fever and strep (and cries after swabbing their throat).

Some of them are very nice about it though. Actually it's not so bad. Most of those kids are afraid of the white coat and the syringes that accidentally find their way into my pockets.*

The moms though, completely vicious. One mother bitched for 20 minutes about how the doctor was late and she'd been waiting for 30 minutes. 20 MINUTES! What am I supposed to say to that? "Yes. Uh huh." Actually I remembered the relationship-building phrases from the other day - [in robotic monotonous voice] - "Yes. *beep beep boop* I completely understand."**

Another mother told me the doctor "poked her child last time he was here." Of course my mind is constantly in the gutter, so I tried hard to keep from laughing.

Another time, I was looking into one of the kids' ears and I saw a very fine pearly-looking tympanic membrane and upon viewing this marvelous specimen, I said "hrmph." Instantly the mother looked at me and said "What? what's wrong?" I told her there was nothing to worry about (about the ear drum anyway). She asked the doctor multiple times later if the kid's ear drums were normal.

Jeezus. Calm the fuck down.

Really though. Preceptor is great. The drive back? Not so great.***

*: or so they think.
**: my impression doesn't quite show up well on the interwebs.
***: has improved significantly though. :)