Mile 24417 + 1204: Shortie: The Final Leg

Above: Oddly found a four-leaf clover in front of the cath lab this month.

I MIGHT HAVE TO BRING
THE WHOLE HOSPITAL WITH ME.

That's what I said when everyone reacted with interest when I mentioned that I was heading south, with fall right behind me.

I'm about to head off to bed, but I just wanted to log that we're 1204 miles in. Tomorrow begins the trip to St. Petersburg, Florida, where my final rotations in Emergency Medicine and Obstetrics & Gynecology will take place. I'm looking forward to it. But first, time to rest, there's 17 hours of traveling ahead. I'll update you on some of my final adventures in Columbus soon, when I get an opportunity to stop on the road.

Mile 5855: Shortie: Whoa!

Above: Jurassic Park truly exists, Folks. Along I-65 in Kentucky.

THIS EXPERIENCE MAKES ME GO
WHOA!

I was talking to my friend Nik about not writing for 3 weeks, and I said to myself, "Wow, I went about 500 miles without letting you know where I went. That's kinda like going to Nashville and leaving you behind in Chicago."

Sorry. Let's get you caught up.

The last three weeks have been some of the busiest med schooling I've gotten so far. At a teaching hospital in Chicago, I'm currently doing Internal Medicine. The program set up is a shadowing of an intern both on the wards and in the ICU (depending on what patients are assigned to him). And I've done a lot of walking, writing, and paging (the last one's my favorite... I get to proclaim myself as a "medical student" on the phone!). I've seen some awesome cases at the hospital left and right, presented in front of interns and staff, and felt an intensity that I've been wanting to have in medicine for a while. Sometimes I get home with a load of primary literature I need to dig through!

But I'll tell you this, an intense rotation can be quite exhilarating, but it can also be more tiring too. All in all, the work here makes me love medicine so much more. My homework: get you some concrete examples of my experience this weekend. I won't leave you behind on the trip for much longer.

Mile 3288: Shortie - Nature & Nurture

Above: Jason Alexander as 2nd most popular motivational speaker in the USA, from the short-lived ABC series Bob Patterson in 2001.

"MOST OF US ARE
FAR FROM OUR POTENTIAL."
Dr. Angela Duckworth at the University of Pennsylvania

Folks, its been a busy week at the new clinic I'm at. So here's a quick shortie, and you'll get a full update on what's going on very soon.

The sacrifices that we make to go to medical school are large (both for U.S. and Caribbean students). For many of us, the sacrifices include a long time in school and being piled in debt that is miles high. For others, the sacrifices are greater, either from the demands of moving from place to place, and even trying to support a family during the demanding time schedule of school. Some of us have been more successful at balancing the plates than others.

One thing I've always wondered in such a demanding & competitive environment is whether or not there really is an advantage of background when going through medical school? Is the person who comes from a lineage of doctors going to be more successful from the student who comes from a farm-based community in Iowa who wanted to become a doctor to exit the world of agriculture? I know of many successful doctors who have come from families where mom, dad, or more relatives came from the medical field.

What truly determines our success, the drive or where we come from? One of my Facebook friends, Frank, posted a link to a New York Times article saying that motivation actually outweighs nature and nurture (background) in the long run. It's been a debate that has been going on for centuries. Some scientists are saying that genetics are not related to how well someone does in their own field. Others say that challenging environments make people better at their field by generating motivation. And finally, we still have people out there saying that families of people good in a field will foster future generations also good in that field.

After going through my Leadership Certificate training at the Illinois Leadership Center at the University of Illinois, I still believe it is truly up to the person to make themselves the "cream of the crop." And it is for this I want to somehow become involved in teaching, because I have always wanted to empower others to reach their potential; many people at the U of I have motivated me to make it this far, even as I'm not from a family of doctors. From my experiences, I think its a good combination of the right environment and self-motivation that can make someone the best that they can be. Talent isn't necessarily inherited.

I encourage you to read the cited article below to learn more.

Source: The New York Times

Shortie: Mile Zero

Above: My odometer start mark for my journey. Forgive the 0.1 on the trip counter - that was from the gas station. As for the seatbelt light - Contrary to the indicator, I do wear a seat belt regularly.

O' MEDICINE,
HERE IS WHAT I EXPECT O' THEE.

As I'm embarking on this second half of medical school, I've given great thought as hwo to approach the clinical side of medicine. I'm going to be expected to do things underneath objectives, rubrics, and my attending doctor's expectations. Well, I'm going to turn it around and put down here what my current expectations are for my next 2 years of medical school and residency. I understand that sometimes these expectations may not be met, but I want the best out of my education and want to be worked to my fullest potential.

Here they are (in short):
1. I want to be challenged (Please, no cakewalks!).
2. I want to experience the roller-coaster of emotions that doctors face day-to-day.
3. I want to interact with patients and staff first-hand.
4. I want to experience a variety of cases, from the most common to the most rare.
5. I want my experiences in medicine to be enjoyable.

Many of my following blog entries may deal with these expectations (and others I might come up with in the future too). And with that, the second half begins. My first stop for three weeks: Jackson Park Hospital in Chicago, Illinois for the first half of my Pediatrics Core rotation.

May the adventure continue... and start that odometer.

Shortie: Accumulating the Miles

Above: Summer 2009. my 2002 Ford Focus with 22500+ miles on it.

ROADS? WHERE WE'RE GOING...
WE DON'T NEED ROADS.

Wrong, Doc Brown. For my adventure we're going to need them, and lots of them.

Starting February 15th, you'll start to hear about some of my adventures on the wards. I'll be honest: I think its too cliche to measure an adventure by days, so I'm going to go out on a limb and do it in miles. You see, my Ford Focus is 7.5 years old and has been to many places and been through many things (inclusive of: high school prom, Walt Disney World, college, weddings, blizzards, and even into stupid potholes). However, even with all that, my car still just has over 22,500 miles on it (as I've been away from the U.S. for a while). So, to me, as much as this will be important for my car to get the miles, I see my clinical years as a rite of passage, as with each mile I get on my car, I'm a mile closer to getting my M.D. and hopefully my residency.

Most of my drives will be commuting, but there will be others which will be much more than that. So... Stay tuned. We'll get that odometer running soon.

Shortie: What about the Pigs?

Above: The American Pig's POV (Part 1, Airdate 4/27/2009)

I COME TO YOU TONIGHT FROM THE
ASSOCIATED ASSOCIATION OF AMERICAN PIGS.

A few weeks ago, I posted a clip featuring Craig Ferguson's serious side on his late night talk show (The Late Late Show) on CBS. Here, I've put a few clips of how this late show host can make a serious issue quite funny by shining a different light upon the subject. Ferguson brings up an interesting point of view of the H1N1 Influenza A Virus (aka the Swine Flu)... Have we really thought about the pigs? How do they feel? What is their point of view?

Well, Craig will make their case best, so enough from me, and watch the following 3 clips (above / below) from The Late Late Show with Craig Ferguson (which airs at 12:35 PM EST on your local CBS affiliate).

BTW - To those new to the show, "The Scottish Conan Guy" refers to Mr. Ferguson himself.

Above: The American Pig's POV (Part 2, Airdate 4/28/2009)

Above: Manfred, The ProfessNor of Dangerous Flus (Airdate 5/4/2009)

All clips above are (c)2009 CBS and Worldwide Pants Productions.

Shortie: That Late Night Alcoholic

Above: Craig Ferguson on his February 20, 2007 Telecast.

"IT'S A GREAT DAY FOR AMERICA."

... is exactly the way Craig Ferguson starts every single monologue.

There was a lot of hustle and bustle going on with late night TV shows at the time I wrote this entry (such as O'Brien overtaking Leno on The Tonight Show to Letterman's feud over sexual relations), but it reminded me to get connected again to one of the late night show hosts who gets my profound respect, and that's Mr. Craig Ferguson. I knew him from his previous stint on The Drew Carey Show as Carey's boss (his catchphrase: Carey, You're Fired!), but when he stepped up to The Late Late Show, I became a huge fan of his. What's most striking to me about him is how down-to-earth he is to his audience. Hence, when he has to strike up a serious point, he hits a home run, such as in his clip above.

In the monologue I attached, Ferguson tells the audience a few stories of his old alcoholic days and after a turning point, he turned sober... and has stayed that way for fifteen years. However, what got my mind thinking was his perspective on what the concept of an alcoholic really is, referring to the issue as "a thinking problem" and saying it doesn't end when counseling is over. In med school, we learn about the numerous effects of alcohol. Contrary to what many of us learned probably in middle school health class - it does much more than just damage the brain, with various systemic side effects like nutritional deficiencies, anemias, even liver damage (that itself opening up a potload of other effects). As doctors it would seem easy for us to use health-scare tactics say to other alcoholics, "Let's not have this happen to you. Don't drink." Ferguson says there's much more to that.

To me, it reminds me that no matter how much knowledge we have about the human body, it can only go so far. As doctors, we need to utilize our communication skills and our ability to build rapport with our patients to take care of their spirit. Body and mind do go together. We just can't forget about the latter, even though our minds are crammed with information from the former.

And with that, cheers to Mr. Ferguson for keeping his thinking straight for such a long time. With that accomplishment, I think, to him, every day that comes is a great one.

Shortie: Tuba Player

Top: One of the jazz greats, Louis Armstrong. Image found via Google Images.
Bottom: A CT scan of a kid with Parotitis. From the New England Journal of Medicine.

One of the biggest figures I associate with jazz during the 20th century is Louis Armstrong. Known for his quite exquisite trumpet playing and great scatting, I've actually associated him with another distinctive visual quality:

BIG CHEEKS.

February 2009. I remember logging into the New England Journal of Medicine website to start to see what the world of truly revolutionary science could be. I came across that day an article with a title was simple (at least more simple than I'd expect from a medical journal): A Tuba Player with Air in the Parotid Gland. Keeping it simple, the parotid gland is one of the glands that's critical for producing your saliva in your mouth.

When playing the tuba, one of life's truest physical properties comes true: If something gets trapped, it needs a way out. Playing the tuba requires physical air pressure in your mouth to get the instrument to play. However, because 1) blowing against a tuba (or other wind instrument) creates air resistance, and 2) Your body has locked the air in the oral cavity (keeping it simple again, your mouth), there's only one other way for that air to go... the force to play that instrument actually flies down the tubes that connect your mouth to the glands that produce saliva. The scientific name of this phenomenon is: pneumoparotid.

With the origin of the name including that for "air" (pneumo-), this diagnosis stays true to its name. The air that gets blown into those glands gets trapped, resulting in enlargement of the glands, with enlargements appearing around the point where your jaw pivots to open: the place that the glands are located.

Hence: Big Cheeks.

Folks, I guess I can come to this conclusion: If your kid can't play the tuba, your kid might be able to pull off the look.

Source: Mukundan, J. and O. Jenkins. 2009. A Tuba Player with Air in the Parotid Gland. New England Journal of Medicine Vol 360. p.710.

Shortie: How I Truly Blog

"HOW EXACTLY DO YOU BLOG?"

... is a question I have been asked by some of my readers. Well, here's a true screenshot of how I get my uploads onto Blogger. For more, click on the image.

(And yes, I do turn on my Doogie Howser, M.D. Theme music as I type).

Shortie: Family Values

Above: No other great family gathering than getting around greasy Chinese food.

Last sunday. I'm at one of the nearby Chinese buffets (which by the way are unbelievably unhealthy, but yet so irresistable). As my mom and dad are I having some healthy conversation on what's going on in my mom's workplace (which is always pretty entertaining), I look over and there's a pretty attractive girl sitting there with her family. There I am... staring... actually getting kinda distracted (okay, horrendously)... and then she pulled the ultimate turn off...

She yanks out her cell phone and starts texting in the middle of a family conversation.

And she keeps texting... and texting... and texting... Minutes pass by; minutes that I see precious enough to spend with family. Quite disgusting, if you ask me.

Folks, I'm not even close to married yet, and It feels weird to already have these warning lights flashing. It's just that the coherent concept of family is so important. I just can't stress the importance from family being the indestructible backbone of support to their kids to families keeping open channels of communication. And, how can I speak of this? It's because I experienced how critical family support has been in getting me to where I am right now.

In a world where communication devices (cell phones, e-mail... Twitter?) can bring people together and make the world a smaller place, I can see how they can easily take families apart. No: I'm not wishing every minute to be family-centric, as every teen should have the right to go hang out with friends and be young. Nobody's young forever, you know. However, in a society that's getting busier every minute and won't stop for anyone, I believe its definitely rewarding to give a few hours to have that quality bonding time with family.

Remember: your mom and dad's clocks are ticking too...

Bookstore Junkie

Above: Semester 1, November 2007, studying in the Dominica Anne Ross Library.

After hours of studying, and creating flowchart after flowchart of material that I still haven't got a gist of organizing, I look up at a giganormous mural of Mary Shelley, Walt Whitman, and some author who goes by Melville (sorry, I'm not a literary major, so all this does is remind me of Dominica's Melville Hall). As I stare with loads of information floating through my head (the loads of pharm, for instance, I've been going through lately), the mural, with its oil-like paint renditions of the three authors / thinkers seem to stare back at me with serious, yet welcoming expressions. Sometimes, though, I get so caught up into a staring contest with them that sometimes, it seems that they're whispering back in my ear, saying...

"ATTENTION BARNES & NOBLE CUSTOMERS... WE WILL BE

CLOSING IN FIFTEEN MINUTES."

I turn around and nobody's there. I think the PA system was feigning the voice of a low-fidelity impresison of a college-bound Walt Whitman. I'm back in the real world, sitting in the Cafe of my local Barnes & Noble (the latest thing open in the suburbs conducive to my studying). I look at my watch: minute hand at the three-quarter mark, hour hand about to hit the tenth notch on the dial. Then I grab my books, and I'm out the door.

---

I'll admit there's truth to "setting the mood." As I've turned into a "Medical Nomad" over the last several weeks, going from library to library, bookstore to bookstore, I've learned that being surrounded by stacks and stacks of books, pamphlets, magazines, etc. that are abound of information and by people who have a thirst for knowledge (even not medical) really helps me achieve that same thirst. That's one of the main reasons I can't exactly study at home: surrounded by a comfy couch, a big screen tv, cable internet, and a loving mom and dad (they definitely deserve credit)... I've declared home as a refuge for relaxation... and of course, typing up blogs.