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.

Mile 7166: Teaching the Ropes

Above: A well deserved 7000 mile car wash.

I LOVE IT WHEN
THE TABLES ARE TURNED.

At points in the last four weeks, I've felt like I've become the intern at times.

Traditionally, every four weeks during our twelve-week rotation, we switch interns and teams to give us an idea of how rotating in a residency program feels. However, for the first switch after my first four weeks, we didn't switch teams. If we had, it might have been a mortal mistake.

Why? The caveat was that the timing of the switch matched to the time my hospital injected new interns into the 4-week rotation last month. When I say new, I mean "Just-Out-of-Match-2010" new.

Many of the interns at the hospital I am at had just simply survived a week of orientation at the hospital, and were all of a sudden thrown into the "real world." I have heard many of my friends who have gone through residency talk about the adjustment into residency and how hard it is, but here I was, along with six other medical students to see it first hand. I haven't seen as many blood shot and baggy eyes at any other point in my life than these four weeks! Some of them started to even question what they got themselves into (that was part of what I termed the post on-call syndrome.)

In some ways we knew more than the new interns.

Working four weeks at the hospital was actually four weeks more than some of the interns. Over the first four weeks, our rhythm on the wards was finally taking shape, we knew how the different rounds were scheduled, we knew where to grab the empty forms when needed, and we even knew the secret places in the hospital to get coffee. However, the most important thing that I saw during the intern switch up was how well we knew the patients on our teams; had we done the traditional team switch, that continuity of information may have been lost.

But over the last few weeks, it was odd to be teaching interns the "ropes" of the hospital. I mean, the interns knew a lot more about medicine (they finished school!), but I guess the working mindset is what we needed to teach them. The hospital world is now theirs, but now it it is time for them to make it their own. Each one of us medical students made sure that we gave the interns a framework to build on to make sure that their time at the hospital was successful. It was an odd way of learning for us students, as the last few weeks was a great lesson in learning how to teach.

Well, four weeks have passed. My intern has not only survived, but has changed since the first few days at the program; he's more comfortable with the ropes and is starting to get his rhythm with working the floors. But it's time for a new intern, and because not all the new interns for the residency IM program here have been on the floors, it's time to teach again for a second time around. It felt awesome to have been a part of my interns first four weeks in residency, and it felt awesome to be an intrinsic part of a medical team.

And here begins my last four weeks of internal medicine. I'll admit, its getting rather bittersweet.

Mile 2740: Roadgeek Alert

Above: I am appalled to see so many signs about Dix on the road.
(SB I-57, Illinois Mile Marker 103)

I LIKE YOUR SUNGLASSES...
BECAUSE OF THE GREEN TINT.
Attendant at an Effingham, IL Gas Station

Even with long shifts, eating crappy fast-food, not looking debonair, sleeping on beds that aren't mine, and seeing my eyes dyed a crimson red at the end of the day, I still feel like I'm enjoying where my life has taken me. No, I'm not describing what residency is like: It's how to experience Americana through a road trip.

Whew. 1438 miles done and set.

I've actually made it to my Family Medicine core rotation, which takes place at the Miami Jewish Home & Hospitals in Miami, FL. With only a weekend from the end of my last pediatrics rotation and my family medicine rotation, I've been on a rush to make it from one part of the country to another. However, its good the route is actually not foreign territory, so 2 days went by no sweat.

Our family has visited the state multiple times and are yearly visitors to the legendary Disney World. My mom and dad have accompanied me on these trips, and even when as I was just 6 years old, I was the navigator of the trip, looking through road maps to keep us en route. In 2003, just after getting my drivers license, I added onto my duties, taking over my dad at the helm of our van for my first trip. To me, that drive to Daytona Beach in 18 hours from Chicago was one of my rites of passage.

I ended up loving road trips, and not only for the sights at my destination. I discovered a few years ago that the best way to describe my love for the road is with the term "roadgeek." I'm not alone either. There's many other people who are amused when an expressway comes to a stoplight, a 5-level stack carries cars in multiple directions, or trying to explain how poor designs of interchanges leads to traffic jams. I'm also the type of person when, if I have the time, would stop at every hole-in-the-wall restaurant, and little point-of-interest along the way. And finally, but not least, I love road trips because of the people I meet. On the way down to Miami, I chatted with one of the cashiers at a Wendy's in Georgia, a clerk at a gas station in the middle of Illinois, and another clerk at a Winn-Dixie here in Miami. Learning about how other people communicate and their respective culture can be done most of the time with a simple hello. Just keep the attitude that being on the road isn't just a long car ride. With an open mind, you find out its an awesome experience.

Anyway, tomorrow at 8:30 AM, I begin my next six weeks of the journey... Provided nobody blasts through a red light here and hits me, I should make it to May.

Mile 1125: Writer's Block

Above: The Robert Ross Parkway that runs in front of Ross University in Dominica.

"EASY READING IS
DAMN HARD WRITING."
Nathaniel Hawthorne

One of the reasons I started up this blog is I wanted to get used to writing about myself. And a year later, I feel that I've definitely opened up to the web with my experiences (it's still a work in progress, however). I'm not perfect though, and I'll be the first one to admit it. Here are several bad writing/proofreading habits I'm prone to:

1. The pothole - Some entries I type a lot of stuff, without thinking. Then I'll have a great idea, and think that putting a whole bunch of ideas somewhere else would be better. Ctrl+C... Click cursor in appropriate place... Ctrl+V. Then, my mind will have another great idea... and soon I'll forget I just forgot to fill the hole I just made with something. Well, now you know what happened when I started talking about medicine and probably ended up jumping to talk about potato chips, without a transition.

2. Circumlocution - A strategy I had in trying to talk Spanish rears its ugly head with writing. The concept is that if I can't find a word, I try to word around it. For instance, if for odd reason I couldn't come up with the words "potato chip", I'd probably end up saying "thin-sliced potatoes that are fried." So, if you see some unbearably long parenthetical expression or phrase (that could be defined as one word), this is why.

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With a whole slew of students starting to write their personal statements for residency, I decided to put my pen to paper (or in the digital world today, more like my hand to the keys), just to see what would come out. Even after months to write about myself, I found it hard to start something. I had many ideas, so many, that I wanted to put them all together. But nothing still came out.

Some people have mastered the art to writing about themselves. To me the challenges are, making sure I can present myself in a concise manner (okay, circumlocution is something I need to work on), selecting the right qualities of myself to present in that short essay, and writing something that doesn't seem like another "personal statement." It's tough to write, but fortunately in the digital age I only need to click and delete, making writing better a much faster process. I won't be killing trees by free-throwing my failed drafts one-by-one into a wastebasket.

At least I know I'm doing the environment a favor. Awesome!

Starting next week, I'll be starting my drive down to Miami, FL for my next rotation for Family Medicine. More on that soon...