Mile 5318: Exploration - Part 2

Above: Capturing the Louisville, KY truss bridge on Northbound I-65.

A PICTURE TELLS
A THOUSAND WORDS.

Yup, that's an overused cliche phrase, but I'm going to throw some pictures here because its much easier to tell some of my highlights of my week-long adventure with a few pictures. Enjoy.

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Stuck on the Beach
After being sucked into driving on the beach (and seeing other sedans doing it too), I decide to go and drive on the beach in Volusia County. Unfortunately, "traction control" doesn't do the trick in sand... so after parking in a spot on the beach, I found my front, 1/8 a tire deep in sand. With the help of the Volusia County Beach Patrol and two random civilians, we got the car dug & pushed right out. However, you're gonna have to ask me how my car got stuck two times more after it was dug out the first time.

11 Countries, 2 Hours
At Epcot at Walt Disney World, my favorite theme park of all time, I decided to take the "Around the World at Epcot" tour, where I was trained to ride these nifty two-wheel devices called Segways (takes a little adjustment). Then a guided tour on the Segways was provided by the Guest Relations staff around the World Showcase of 11 nations (while it was closed to mainstream guests). I totally enjoyed slaloming through the pillars at the Italy Pavilion.

Up Close & Personal with Atlantis
Knowing that the Space Shuttle Mission was coming to an end, I decided to take an upgraded tour at the Kennedy Space Center to visit the space shuttle the closest most civilians could visit it (about one mile away). Apparently, being that close to the shuttle during launch would lead to my death (the vibrations and sound would kill me).

Seafood Galore
One thing about Florida was the abundance of fresh seafood. After eating at the Boston Lobster Feast in Orlando, FL (I ate a lobster, pictured above, that would have killed me first) and D.J.'s Deck in Port Orange, FL (under the Dunlawton Bridge), I got a serving of seafood that I would have not enjoyed as much at home. On a side note about food, it was awesome to stop at places like Shoney's and Western Sizzlin' to get my steak urge satisfied... but also to experience dining in a Southern cultured environment too.

Revisiting Undergrad
Visits to my alma mater of the University of Illinois at Urbana-Champaign & a big ten university where I spent some time to do research (Indiana University - Bloomington) reminded me of the times I enjoyed during undergrad. It was good to see good friends, my former supervisors & research advisers (I actually saw one of them in Miami!), and places where I worked. The landscape have changed (e.g. like the skyscraper apartments pictured above on Green Street in Champaign), but the culture at both institutions still is something that has not changed.

Road Time
I love the road. There were points in my trip I found myself in the middle of nowhere, like in the picture above of Indiana State Route 46 between Terre Haute & Bloomington, IN. Driving through the country with the windows down is something I always wanted to do. My adventures included those to small towns such as Adel, GA and Manchester, TN. I even passed through a recovering Nashville, TN (from recent flooding).

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So folks, those were the best parts of my week off, but not even those highlights encompassed all that I did and the excitement I had during each of my excursions. However, I can't really put it in words yet, but I feel that I learned more about myself somehow through the explorations on the road. I hope that I can share my stories with patients with my next rotation and the future: the one, the only, the big one (at 12 weeks in length): Internal Medicine.

The adventure continues tomorrow.

Mile 5318: Exploration - Part 1

Above: One of the best highlights on the road was the "All Jacked Up" truck on Northbound I-65 in Indiana.

MYSTERY CREATES WONDER, AND WONDER IS THE BASIS
OF MAN'S DESIRE TO UNDERSTAND.
Neil Armstrong, Apollo 11.

At the Kennedy Space Center (KSC), I met Bob Springer, an astronaut that participated on a couple of Space Shuttle missions with NASA. At the KSC, guests are able to interact with real astronauts and ask them questions. With my curious (and sometimes over-curious) personality, I decided to pull a question on him and immediately raised my hand when the floor was open for questions.

A man with a microphone walks over, and puts the black device in front of my face. Looking up at him on the stage from my seat, I then asked, What types of medical monitoring are done on astronauts in space?

As the man pulls away the microphone, Mr. Springer on stage starts to talk about the types of research astronauts have performed in space. Although he probably misinterpreted my question (I was asking about measuring heart rates, respiratory rates, etc.), he produced a very intriguing answer as he started talking about how astronauts have studied the effects of bone density in space, the concept of "space motion sickness," and effects of gamma radiation on astronauts in space. I couldn't tell you how much that stuff started to spark my medical neural pathways.

I got to meet Mr. Springer firsthand at a photo session afterward. After he told me that I asked a great question, I told Mr. Springer that I would definitely look some of this research up when I got home. The task is still on my list.

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After leaving Miami last Friday, I had a week off between rotations. I decided to take it to explore places, do things, and basically not be a medical student for 1858.7 miles on my journey. (If you were wondering why I didn't blog for a week, that's why.) I did everything from learning to ride on a Segway, getting my car stuck in the sand on the beach, seeing the space shuttle on its pad ready for launch, seeing how airlines train their pilots & staffers, and even meeting a cashier at Wendy's named Zzyzx. I took a week to do stuff I would never get to do in the hospital.

But my journey wasn't just about what I saw or experienced, it was also about the people I got to meet along the way. I visited people I haven't seen in a while, friends and former supervisors/advisers that really made my experience on the trip. I thought that a hearty visit would be more than appropriate to thank them all for all that I have done so far. But for me, when getting involved in loading my brain with medical info, I have found it easy to forget myself. Seeing all of them was a good refresher, as many of them reminded me of who I am as a person and what personal qualities helped me get to where I am today.

At first it might seem rather superfluous to include my vacation miles on my journey, but for me, time to explore more about myself (and be myself too) is a huge part of my development as a doctor. I'm not just a doctor or a provider. I'm also me. So, tomorrow, I'll tell you more about some of the specifics of my journey, but for now, my Ford Focus and I are going to get some sleep. There's a lot to process from my week retreat.

Mile 3452: Answers on the Asphalt

Above: I-95 Northbound near Brickell. An overhead shot of this strip was used in the TV series Miami Medical.

FOLLOW-UP PATIENTS
ARE MY FAVORITE.

A patient that I saw a few days ago comes in for a follow-up. He/she looked excited to see me, and that brought a smile to my face. A firm, solid handshake confirmed the camaraderie. A few weeks ago, I saw this patient in a much different state, rather sick with severe pulmonary & cardiac symptoms. Earlier in the rotation, I said to myself that I hated the idea of moving on, and well here was another case of it. The last time i saw him/her, the patient had smoked for more than 20 years and didn't want to quit. Now, he/she was just starting to quit, and I was so proud of the initiative, I had to shake his/her hand. Gosh, I was about to build a good patient-doctor relationship here, and now I have to leave. I started to get to know the patient's family, culture and more, and I would have loved to see the progress that he/she was having to reclaiming his/her own life from smoking...

I'll admit that interaction today was a good ending to a wonderful rotation in Miami. My last two weeks were spent at a more conventional medical center in the Miami area. However, our attending taught us a lot of practicality in medicine while we went through it (why we avoid certain medications, the business aspects of medicine, and just to be more confident in what we do). Now, I know how it feels to start to "want to do everything." I got hooked to treating adults too. I'll admit, that its still early in the game for me, but I hope that a week on the road can give me some answers. Driving has always been my way to think deeply about all that goes around me... There are times I think so much that I just let the dashed white lines in the road come to a blur.

Road? Yup, I'm about to start on a mini-vacation, to be myself for a week (not a medical student), think on the road, and get ready for 12 weeks of Internal Medicine which will take place at Westlake Community Hospital near Chicago. Throughout my trip, I'll be seeing some time at campus I've been at (the University of Illinois and Indiana University), meeting a few folks that helped me to get where I am today, and exploring the world in ways that I haven't been before. It's going to be exciting. However, as much as I love to travel, I miss Chicago. It's my town, Chicago is.

Thank you Miami for a wonderful experience. May the travels begin.

Mile 3374: As If "Yes" Wasn't Enough

Above: I-95's southernmost exit that leads Key Biscayne. After this exit, I-95 ends and merges onto the busy U.S. 1, Dixie Hwy.

If there's one lesson that I'm going to have to walk away from Miami with, it would be,

A RECIPROCATED QUESTION IS A GOOD THING.
(MOST OF THE TIME)

And how exactly did I come up with this conclusion? I thought of it as I was observing several of my preceptor's teaching styles.

Case 1: One of my doctors at my previous mini-rotation looked me in the eye after I asked him, "Is the diagnostic glucose level for Diabetes at >125 mg/dL?" He then said, "Is it?" I nervously replied (with more confidence put into the last word than the first), "I think it is." He nodded and then said, "You are right." I sighed a breath of relief.

Case 2: This week, a patient with rheumatoid arthritis walks in, and I noticed the patient had a neck injury in the past that caused lower body paralysis. In a rather naive tone, I ask the doctor, "Is that caused by atlantoataxial subluxation?" As he was entering patient data into the computer, he asks me, "What do you think?" I just ended up throwing a Hail mary by shooting out a "Yes" from my lips. He nodded with me as I began to feel the sweat near my forehead and said jokingly, "That's right... Why do you ask questions to which you already know the answer?" This was a rather deep point that simply brought a smile to my face. At that point in time, I just didn't know why.

I'll admit that getting a reciprocated question always makes me second guess, but I found that my preceptors are trying to see how confident I am in my answering. However, a reciprocated question has other uses than to say "you're correct." I've seen myself and other students get reciprocated questions, and the question is designed to develop the student's case for diagnosis & management of the patient. I've been through times where I'll explain my case completely, and the doctor will then tell me otherwise, with the consolation of acknowledging my train of thought made sense, but probably wasn't practical.

Making a strong case is of the valuable qualities of being a doctor I'm still trying to work on, as it is important to defend what I think is best for my patients. I'm glad Miami got me started to work on it.

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After writing underneath my pen nickname "TENergy" for the last year, I've decided to put my real name down just so my adventure can have a real face to it. Thanks for reading!