Mile 9363: Countrified 4 - Growing Culture

Above: Nothing beats a tall set of golden arches to greet you on the road. Gilman McDonald's, Exit 283, on Interstate 57 in Illinois.

"I ROAMED THE COUNTRY
SEARCHING FOR ANSWERS TO THINGS
I DID NOT UNDERSTAND."
- Leonardo da Vinci

4:40 PM, Sunday - My friend Don and I were driving back on good old Illinois Interstate 72, after visiting an elective site I'll be attending this upcoming January. I-72 is a four-lane corridor originally designed to connect the mid-sized cities of Springfield, Decatur, and Champaign, Illinois. We got to talking about places that seemed so "perfect," that they were "too good to be true." And for some odd reason, that got me on a mantra to talk about what I liked about Champaign, a city I spent a good 4 years of my life in. To me, it was an example of perfection, but there seemed to be no strings attached to that experience.

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The debate is still hot. Even though it has been just over a year since I've written anything on this topic, it's still something I do think about. I'm still attracted to the sense of urban sophistication that's given in the larger cities like Chicago, but something also pulls me towards the growth and potential in smaller cities found away from metropolitan areas.

I drove down to Champaign this past weekend to spend some time with my good friends Neal & Christine, who I've always wanted to spend time with (more than the 13 hour stop I made last time I was in town in May). On a cold Saturday morning, I whipped down I-57 and made it from the Chicago Area in a very efficient 2.5 hours (without speeding, and with a McDonald's stop for coffee placed in there). When I got into town, seeing a good chunk of people outside at 8:30 AM doing their morning jog on streets made me smile. It was good to see at a metropolitan area of about 100,000+ people (without the students at the University of Illinois) still had that sense of freedom that comes with safety. I soon found myself in the outer rim of the city, entering the "suburb" of Savoy where Neal & Christine live. I smiled when I noticed that when I looked to my left, I saw houses, but on my right, I saw the beauty of endless fields of corn blowing in the wind.

With a lot of smaller cities, especially those home to colleges, there is an investment into downtown areas, to infuse culture, improve the quality of life and to show that these cities have identity. The Champaign-Urbana area has exactly been doing that, and every time I come back, there's something new or something improved about the area. When I first visited the U of I in 2002, I saw the potential in the area, as this was when the improvements were beginning in the cities. And 8 years later, I can see there's something for everyone, with everything from a Weekend Farmer's Market in Urbana to fancy eating in the downtown area of Champaign to summer festivals that complement any social outing quite well.

No, this isn't a post to simply limit my future to be here in Illinois (although I would love to be), but an example of a place I would love to live. I look at other large college towns, like those in Bloomington, IN, Madison, WI, and somehow that "oasis" of urban-ness within miles of rural terrain pulls me to places like those too. From a professional standpoint, the mix of people coming from a city-life and from the rural areas to receive health services makes this an attractive patient base to work with in my future. For me, there's always something about a city that is with vibrant growth that will entice me to live there.

So, although I got some R&R by hanging out with my friends in Champaign, I also got to learn a little more about what I wanted too. And that's what made this past weekend quite awesome.

Mile 8895: Keep on Moving

Above: I do miss the 6 AM rush hour.

ALTHOUGH I MISS INTERNAL MEDICINE,
THE ADVENTURE MUST CONTINUE.

And just like that... it's over. One of the odd ways I've thought about the last 16 weeks is, I've been at the hospital 4 weeks longer than the current interns.

My last 16 weeks at Westlake Hospital were absolutely amazing.

Some of the biggest lessons that I learned during my time in Infectious Disease weren't even in infection (although, with the amount of cellulitis cases that we got called for, I would almost consider myself an expert in cellulitis now). When comparing my 12 weeks on the floors, where we took care of just about every single aspect of our patients, my 4 weeks on infectious disease were simply focused on that. I still remember the first day when I was on "floor mode" - as I liked to term it - and wrote just about every single assessment and plan on the patient I could in my note. I quickly learned that was quite inefficient considering I was on a consulting service. But this is one reason that I couldn't see myself - at this moment - going into a subspecialty; I feel odd treating only one aspect of a patient.

One thing that I really enjoyed was that my Infectious Disease rotation came right after my Internal Medicine rotation and at exactly the same hospital. I knew how the teams worked along with who worked the teams, which not only made the transition easy, but I appreciated how the tables turned. On the floors, my intern would let me know what consults I need to pull, but now the interns were coming to my doctor and me with new consults. I'm going to miss the rhythm I started putting together with the interns, seniors, and students, but I must keep moving...

It was with this program that I appreciated some of the aspects of smaller community programs, getting to know everyone's face, seeing common cases repetitively (i.e. like the cellulitis above), working with tight knit teams, and sometimes seeing patients over and over again. I've been a big fan of the "make a big world a small one" concept, and community-type residency programs attract me in that manner.

For the next 3 weeks, I have them off, but starting in late September begins my Psychiatry rotation at Jackson Park Hospital. But I tell you, I surely am going to miss running up and down those floors.

A huge thank you goes out to the attendings, residents, and students at Westlake.

Mile 8652: (Cue Marching Band)

Above: Rush University Medical Center's new Advanced Center for Emergency Response. From Rush News.

I FELT LIKE I WAS IN AN
AIRPORT TERMINAL...

I learned this week a situation where clear, accurate documentation is critical for monitoring a situation. Let's just say this, figuring out whether or not someone has a "critically morbid chronic condition" from hearsay isn't the best way to handle it. With medicine, a certain line of things need to be done to confirm or rule-out whether someone has a condition. If those tests aren't done in order, it breaks the chain, and a degree of uncertainty (which is never good) hinders the line of treatment for the patient. Nobody wins if things are not documented and tracked appropriately.

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A few weeks ago, the Infectious Disease team that I am a part of goes to the Infectious Disease grand rounds that go on at Rush University near the heart of Chicago. My attending picked me up from the hospital and we soon walked into a series of tall buildings, a facade of steel and glass. We soon were walking down a hallway with large directional signs and a walkway that could support a flow of a huge crowd (making me feel like I was about to catch my 9 AM flight). After going up to the fourth floor of the building we were in in the middle of a slightly crowded conference room that holds about 50-75 people, I watched several presentations from residents of some fairly interesting cases that they ran into. As the attendings, fellows, residents, and students chatted amongst themselves (and myself with my attending) to discuss each case, I felt that the openness to discusssion I observed to encourage each other's understanding of the concept was amazing. When I look back to my several hours there, I honestly saw myself as a kid in awe at a candy store.

And that's what is really attracting me about university programs when I'll match (next year). The variety of cases that you get to see there, their reputation for being at the forefront of medicine and research, the resources that are available, and not to mention the aura of academia (which I enjoyed after my 1.5 years in a Masters program at the University of Illinois) are just astounding. I really feel that a university program would easily satisfy me academically and open me up to even more new opportunities in medicine. However, aspects of community programs also reach out to me, and I'll tell you more about what attracts me to them in the next post.