Championship Sunday

Jets and the under, Saints and the over.

6 for 8 last week.

I haven't posted in 4 months. I've been really busy. Too busy to have time to come up with a funny, witty post.

All I can do right now is try to update a little. Since my last post, I started my time on the orthopaedic service. I am about to finish my first three months. Compared to general surgery, it has been great. There are less patients in the hospital to take care of. The call is not as busy, and I can leave the hospital if it's not busy. I get to wake up a little later every day, and I get home a little earlier. Not looking forward to going back to general surgery in January. At least it's only for 3 months, and then 4 years of orthopaedics.

I have done about 50 cases. In a select few of them, usually clinic patients, I've been the main surgeon. Most of them I'm just assisting. But I do get to suture the skin closed in most cases, which I still find very cool. Mostly because I am getting to use my hands to do something, which is the reason I got interested in surgery to begin with.

Life outside the hospital has been pretty crazy. It would take hours to get into it all, so I'm just going to skip it for now. Maybe I'll go into it some day, but not now.

The Yankees won the World Series. An eight year hiatus while I was in Philadelphia. They won senior year of high school, then nothing for college and med school, and then as soon as I came back to the tri-state area, they win again. It's obvious that my proximity to the team is their source of winning, so it would be in your best interests, Hank and Hal Steinbrenner, to give me season tickets for life.

Life is pretty good right now. It has to be, because it's going to be this way for the next 4 years.

Residency

It looks like I'm going to be posting in here even more sporadically than I have been. There's just not enough time in the week.

Work has been good. Really tiring, but good. I get in a little before 5 AM, and I'm usually out between 6 and 7. But the day flies by. There's so much to do that I have no time to sit around and be bored. When I have free time, I go in and just say hello to my patients. I've been told by many a person that I have excellent bedside manner. I'm sure that's hard for most of you to believe, but it's true. There are a lot of aspects to this job that I'm not good at yet, but my relationship with my patient's is not one of them. I've even gotten a few little gifts from some of them to show their appreciation.

And because of that, I love my job. Not the gifts, the getting along with my patients part. Part of the reason my hours are so long is because after we are done for the day, I go back and see how all my patients are doing before I go home. The nurses have told me that I would stop doing that after the first week, but I haven't. It has also helped me to get along well with the nurses, because they see that I'm a genuinely nice resident who cares about his patients.

The downside to getting close to my patients is that when someone dies, I take it hard. And since I've been in the ICU for my first months, I have seen a few of them die. I started tearing up when I had to tell a gentleman's wife and daughter that wanted to send him to hospice care because we didn't think there was anything more we could do with him. And I after I saw a 2 year old kid die in the ED, I was almost in tears. That one will probably stay with me forever, and I cant see anything else being worse than that was.

I work a lot. I have to be in the hospital Monday to Friday, so I can't take call during the week. All my call when I'm in the ICU is on the weekend. I get one full weekend off a month, and then usually 2 Friday and 2 Saturday calls. There's nothing else to say about it except it sucks. I just have to suck it up and deal with it, because it's the same for everyone who rotates through the ICU. At least I get my two hardest months out of the way first, and my schedule should be a little easier starting in September.

I just have one more week in the ICU, then I move to General Surgery, where I should get a chance to get into the OR, which I'm also looking forward to. I get my first vacation week in September, which I'm also looking forward to.

The residents are pretty cool. That also makes the day more enjoyable, working with people who are cool. There are a couple bad seeds, but for the most part everyone gets along. I spend most of the day in the ICU, and the nurses are good. They have taken to calling me the Greek God, so you can tell they're very perceptive. The residents went to a minor league baseball game this past week, which was fun. Obviously much different than a Yankees game, but it was baseball, so what do I care?

It's an adjustment, but I'm getting used to it. Better days are on the way.

Vacation

I returned from my vacation last week. My last vacation EVER. Not really, but it seems like it was.

This was a very nostalgic vacation for me. Last time I went to Cyprus, two years ago, I went by myself. This time, I went with my mother and my sister. Back in the day, I used to go with my mother, brother and sister every summer. My dad even came one year to surprise us. Those were great vacations. Torturing my brother and sister, driving my grandparents, going different places, the beach, the village, shopping. And we used to go for a month. The last two times I've gone, I've only been there for 2 weeks. I spent a lot of time thinking about how much fun these vacations used to be, and how much they've changed.

Logistically, I don't know when I'll be able to go back. We only get a week off at a time as residents. That means the longest I could stay in Cyprus would be 8 days. It would be even less in Ikaria, because we have to take a 7 hour boat ride, and it doesn't leave every day. It's not impossible to go, but I don't know if I'm going to be going every year. And one week vacations suck. I barely have time to get adjusted to the time difference.

It's a part of my life that is gone; being a kid on summer vacation. It might be 5 years before I get to take a real vacation again. By that time, I might have kids of my own. The dynamic is going to be different. Not that it's going to be bad, it's just going to be different. I always get sentimental about change. I miss high school, I miss college, I miss parts of med school. I miss my summer vacations.

Now I'm getting ready for the big move to New Jersey. Taking care of furniture, cable, internet. Buying a flat screen TV, which is awesome. I'm going to be moving next week for orientation. Orientation! I was playing Rock Band earlier today. I just finished two bowls of Peanut Butter Captain Crunch. Next week I'm going to be learning Advanced Cardiac Life Support.

Graduation

It's funny that when I have lots of free time, I'm too lazy to post. And when I'm busy with school, I make time to write something down. Yeah, I guess it's not that funny.

You probably know by now that I ended up at Monmouth, my number #3 choice. I put it ahead of two New York programs because I thought it was a better program, so I guess being in New York wasn't the most important thing to me. I think I'm in a good place. I'm close enough that I can come home on the weekend when I'm off. I'm right on the beach, which I am so excited about. And the real reason I liked Monmouth so much was because I thought they had the best group of residents, in terms of personalities. If you go back a couple of posts, the guys who were talking about playing beer pong instead of paying attention to their girlfriends were from Monmouth. I'm going to have a lot of fun these next 5 years.

I haven't been spending much time thinking about residency. I've always been the type of person who deals with problems as they come up, not by planning things out years in advance. For example, I'm leaving for Cyprus on Sunday, but I haven't packed or gotten anything ready. And I'm not planning on doing it until Saturday. We read The Grapes of Wrath in 10th grade, and even though I skipped a lot of it, there was one line that I still remember. Ok, I'll be honest. I just spent 10 minutes trying to google the quote and I can't find it. Essentially one of the guys says that he crosses bridges when he gets to them. And since I'm not starting residency until I get back from Greece, I'm not going to worry about it until then. I guess the quote wasn't as memorable as I thought.

The one thing I have been doing is looking for a place to live. It's a good time to buy because interest rates are low, the housing market is down, and first time home owners get an $8,000 tax credit if they buy something in 2009. So I was looking at condos, and I found a really good one right on the beach, but it was a little too expensive. I really think it would have been a good investment, and I would have made money when I left in 5 years, but I couldn't do it on a resident's salary. It bothers me because I think it's important to always keep an eye out for good opportunities because they don't come along every day. And I feel like this was one, and I can't seize it. So I'm going to rent a place for the first year. It's on the beach and close to the hospital, so it's definitely not a bad deal. And we'll see if I find something better after I move out there.

And I'm graduating on Friday. I'm too lazy to really think about what that really means. I've been in school for 20 years. I like school, I'm good at it. I'm going to miss it. Also, I don't think graduation is that big of a deal. I understand what it means for my family, to see me achieve something like becoming a doctor. Especially in my family, where my parents came here with nothing and sacrificed a lot so I could get to this point. That is the value of graduation, for me. It's not all the jokes people are going to make. That stuff doesn't mean anything to me. It's fun, but I don't think it's something to be proud of. All it means is I passed all my classes. I'm proud of my Step 1 and 2 scores, I'm proud of matching into orthopaedics, I'm proud that in 5 years I'm going to be an orthopaedic surgeon. Those are tangible things. Doctor means a lot to my parents, but it doesn't mean much to me. This is a weird analogy, but it's like getting birthday wishes on facebook. It doesn't mean anything to me that you signed on and got a notification that it was my birthday and wrote on my wall. I do it because everyone else does. It means something when people call me, or e-mail me, or IM me to tell me happy birthday. Those are real things. I don't know, either you get it or you don't.

Actually, the more I think about it, I could be wrong. I guess people who aren't in med school don't know how it works. Getting a 247 on Step 1 was so much more difficult, and so much more important, than graduating. That's what I should have been congratulated on. But no one knows that. It's my own fault too, for not explaining it. Anyway, I never know what to say when people congratulate me on finishing. My first response is always to be honest, and I want to say "It's really not a big deal, you could have done it too." But that would make me seem pretty average wouldn't it? I guess we don't want that. Ok, you can say whatever you want to me on Friday, and I'll appreciate it. I know it's your way of congratulating me not just on graduating, but on everything I've done in the last 4 years. And if you want to slip me some money while you're shaking my hand, that will be alright with me.

Match Week

Well, here we are. Match Week. Tomorrow I'll be finding out where I'm going to be spending the next 5 years of my life. Seriously, when you subtract sleeping, I'm going to be spending more time physically in the hospital where I match than physically in my own house.

I could write for hours about everything thats been going on the past few weeks. I'll skip ahead to the week leading up to Match Week. I've been really nervous. What I wanted to do was stay in, just relax, not do too much, not talk to anyone. That's pretty much what I ended up doing, going out Monday, Tuesday, Thursday, Friday, and Saturday. But I took Wednesday off so it's all good. It actually was a lot of fun, it took my mind off of things, and it made the week go by much faster than staying home. Good times.

As an aside, my body responds very oddly to stress. I never consciously feel stressed out. I am a chill guy. But when things happen in my life, my body responds with somatic complaints. For example, first year of med school, we had a family medical crisis. We actually had quite a few, but one big one. It's not like I spent all day thinking about it and worrying. My life went on as normal. But what started happening is that I would go to sleep, then wake up a couple hours later and be wide awake. I was completely unable to fall back asleep. So I would go to bed at like 12, wake up a 2 and then be up for the rest of the day. That went on for like a month until the situation resolved itself, and then never happened again.

More recently, back in September, when I was doing my orthopaedic rotations, trying to get good grades and letters of recommendation and get my application ready, I started having coughing problems. I initially thought it was just a cough, then I noticed that I would only cough after I would eat. I remember being with Tom and Rahtbone's one night and having a coughing fit after eating. Very bizarre. I thought I might have gotten TB. I went to a doctor who, very perceptively, thought I had a case of acid reflux. I've never had heartburn before, but since it happened after I ate, and I've always had a problem frequently clearing my throat, so that's what he thought it was. I talked to a resident at Mount Sinai who said he started having reflux flare-ups when he got stressed out about something. And lo and behold, it just went away after my rotations were over. I never even took medicine for it. And it recently came back as it starter getting closer to Match Day, although now it's since gone.

Sunday was just a countdown day. Monday at 12 PM we get an e-mail saying whether or not we matched. Twenty-four hours to go. Twenty-hours to go. Twenty-three hours and 30 minutes to go. And so on. Rock Band makes the time go by faster. I didn't sleep well, but I never do before an important event. I had to drive back to Philly because anyone who doesn't match has to meet with the Dean to figure out what they're going to do next. I wasn't confident that I was going to match so I had to go just in case. I won't get into the mathematics of it all except to say three things:

1) There are more applicants than there are spots for competetive specialties
2) Every year better candidates than me do not match
3) Every year worse applicants than me match

It takes a lot of work and a little luck. For me, it took 6 years of work and a little luck. I probably looked at my watch 100 times between 11 AM and 12 PM. I got to school around 11:40, and decided to stay in my car and check my mail on my phone. I didn't want anyone to see the look on my face if I didn't match.

The e-mail came at 11:50. I was expecting the title to either be "Congratulations, you matched" or "Sorry, you did not match." The title of the e-mail is "Did I Match?" which really threw me for a loop. I opened the e-mail and the first line is "Congratulations! You have matched into a residency position!" or something like that. I don't remember what it said after "Congratulations." I shreiked like a little girl. I'm not embarassed at all. I ran out of the car, huge smile on my face, and started calling people. My mom, my dad, my godbrothers, my godfather, friends from school. I had secretly planned out the order I was going to call people, even though I had to fight myself from being too optimistic. The only two times I have ever been thath happy during med school are when I honored the Pharm and Micro finals on the same day, and when the Giants beat the Patriots in the Super Bowl. Both occassions included a scream and a jump.

It's very cliche but it is so gratifying to see your hard work finally pay off. I'm not exaggerating when I say it's been 6 years. Since I decided to go to med school, I've been working towards this goal. I knew I wanted to do orthopaedics, and I knew how hard it was to get into. I feel bad for the people who didn't match, but I have spent a lot of Friday and Saturday nights home studying. People who read this know how I used to be, never going out, and then not even enjoying myself when I went out. I spent so much time thinking about the next test or the next class or everything I still had ahead of me, I could never just enjoy myself in the moment. I've had numerous people tell me how much more fun it is to hang out with me these days. Part of it is a conscious effort by me to be cooler, but a bigger part is that med school is winding down and I have nothing left to think about. I can concentrate on making funny jokes and being awesome.

As it stands, 12 more hours until I know. For one moment I will be Christos, Drexel Student, funny, handsome, Greek, good at beer pong, awesome at life, and in the next moment I will be Christos, orthopaedic resident at.....

Child and Adolescent Psych

Currently on a child and adolescent psychiatry rotation. So chosen because I thought the hours would be easy, and I'm a second-semester senior. It is my right to not have to work hard.

I was right, the hours are easy. It runs 9 am - 3 pm, Monday through Friday, no weekends. It's an outpatient facility for kids who are having problems in regular school. Things like aggressive behavior, attention problems, not doing homework, being withdrawn, and the list goes on. While they're here they do group work, individual therapy, and family therapy. They have fun activities for them to do, like reading to a trained dog that comes in, learning magic tricks, they even have a Wii that they can play on Friday if they behave during the week. Basically they get rewarded for good behavior and eventually hope to get rehabilitated back into school. I must say it's a good set-up, although I hope I never have to use something like this for my kids.

It's very sad to see the situations these kids are in. Pretty much every kid whose story I know has some issue with their parents. This could be divorced parents with one parent out of the picture for good, abused by parents, given up for adoption, multiple foster parents, etc. All of these are things that a kid has no control of, and just has to deal with the consequences, which in this case is difficulty learning appropriate relationships with other people. You can't really blame them, since they grew up never seeing an appropriate relationship in their house, so how can they be expected to learn how to form one outside the house? I've spoken to a couple people who are getting married since I started the rotation, and told them, half-jokingly, whatever you do, do not get divorced because I'm seeing the end result of that right now. Not that anyone gets married with the intention of getting divorced, which is why it's half-joking.

On the other hand, my insanity came about even though my parents are together, so you never know.

There's one kid in the program who has Fetal Alcohol Syndrome. As the name implies, his mother drank alcohol when she was pregnant. Sometimes you can't blame people for getting divorced, but drinking when you're pregnant is pretty inexcusable. Obviously, some pregnancies are the result of alcohol. But you've got to take some responsibility once that is even a possibility. It's one thing to learn about FAS in a textbook, but it's another thing to see a 7 year old kid who can't spell his first name.

The other thing I noticed since I started here is that I probably could have been in a place like this when i was their age. Ok, I probably should have been in a place like this. I think the reason I didn't was because I was so smart, people let my behavior slide. Kind of like how an artist who is crazy is always described as "eccentric," while a homeless guy who is crazy is just "nuts." Smart people get a little more slack.

Anyway, all my report cards in elementary school were all marked Excellent, except for two categories: obeys rules and regulations, and shows self-control. My grades in these two categories were either "Needs Improvement" or "Unsatisfactory," the two worst grades possible. The only thing farther down the scale was N/A. So every quarter when we got report cards, I would skip all the stuff about math, science, spelling, go straight for the last two categories, and be disappointed to see that my grades were unchanged and I would be lectured when I got home. On the back of the report card was the "Comments" section, and every report card had the same basic comment: "Christos is a very bright and intellectual young lad. He picks things up very quickly, and has no problems completing all his coursework. He is probably some kind of boy genius. But he continues to have problems calling out in class and being disruptive." They should have put that on a rubber stamp to save them time. And my mom would always right back "I have spoken to Christos at length about controlling his behavior. He has promised me he is going to do better next quarter." I have these report cards at home if you want to see them.

This is probably a surprise to anyone who met me after elementary school. For some reason, at the beginning of junior high school, I became very quiet and introverted. That can be the subject of another post. But before that, I called out all the time, disrupted everyone around me, distracted people, bothered the teacher, and anything else you can think of that would ruin a teacher's attempt at running a normal class. I think I wanted to prove to everyone that I was smarter than them, so I could call out the answer all the time instead of raising my hand. Or finish my work as fast as I could and then get up and walk around the room and tell other kids the answers. I got yelled at a lot. There were a few times when my teachers would tell me to go stand outside the classroom. That doesn't sound like the best place to put a disruptive kid, where I could go from disrupting one class to an entire floor of classes. There was one time in kindergarten, that's right, kindergarten, which is basically a room of 30 kids yelling and screaming for 6 hours a day, when I was put into exile. I was annoying the teacher so much, that she moved my desk (which was ironically in the front row, the second closest seat to her desk) all the way into the back of the room away from every other student. Oh, she moved it WHILE I WAS STILL SITTING IN IT. She was so fed up she stopped the lesson and pushed the entire desk/kid/chair combination from the front of the room to the back. I remember thinking it was an awesome ride at the time. That's how I learned the meaning of the word "exile."

Thankfully I grew out of it. Looking back on it now, as I see other kids who are having trouble at school, I can see a lot of similarities between me and them. I wonder what it must have been like for my parents to hear about how bad I was. They probably thought I was nuts. I am hoping that hyperactivity, like intelligence, is largely genetic, because I'm looking forward to seeing the same genius/total disrespect for other kids/teachers combo in my future son.

Things I'm into right now: Tucker Max, kittens inspired by kittens, bottled water.