A Glimpse Into My Madness

Championship Sunday

2010-01-24T12:22:00.000-08:00

Jets and the under, Saints and the over.

6 for 8 last week.

2009-12-05T20:15:00.000-08:00

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

2009-08-23T14:10:00.000-07:00

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

2009-06-10T21:01:00.000-07:00

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

2009-05-11T18:02:00.000-07:00

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

2009-03-18T19:35:00.000-07:00

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

2009-02-23T13:21:00.000-08:00

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.

The Times They Are a Changin

2009-02-02T19:38:00.000-08:00

I stayed in a motel for my interview at Temple, and I was flipping through the TV before bed. I've grown so accustomed to using the guide that comes with satellite TV to find what's on that I was completely out of my element looking through channels with no idea what I was looking for. It's probably been 10 years since I did that, or used a TV Guide to see what was on.

I felt so nostalgic. Usually I just scroll through the guide, focusing on the channels I know are my favorites, and I end up watching the same shows and the same channels all the time. Boooooooring. When you used to flip through each individual channel, you never knew what you were going to get. You could tune into a channel that was in a commercial, and never know what was on. Or you could tune in during an exciting scene, and have yourself a new favorite show.

And that's what I did. I watched some "The Soup," which I've seen before, took a shower, and then flipped through some more channels before I came upon a show called "Tool Academy." I have a general idea of what the show is about; a bunch of "tools" (guys) who are having relationship problems compete in events that are designed to bring these problems to the surface and help the couple work them out. Awesome show.

What originally caught my attention was the name they flash on the bottom of the screen when one of the tools is talking. It's not they're real name, but rather a nickname that I guess is given to them on the show, maybe in the first episode. I remember seeing "Greek Tool" and I think "Shirtless Tool." How could you not keep watching after seeing that?

I don't even remember what the episode was about. They had to help each other build a bed, with the girls doing the physical work and the guys reading the instructions to them. Plenty of couples screwed up, one guy got so enraged he picked up the couch he was sitting on and chucked it. It was riveting TV. I've heard from other people that the show kind of has a cult, underground following, but the people who watch it really love it, and I can see why.

The sad thing is that since that magical night, I haven't seen another episode. Since I've been home, I just use the same method of scrolling through the guide and focusing on the same channels and shows I always watch. VH1 is like channel 300, and I usually skip from 280 to 500, which is HBO. So I'm missing Emmy award winning television. All because I don't have a long enough attention span to click through each channel like we did back in the old days.

I just wanted to bring this up as an example of how technology is ruining our lives.

Interviews

2009-01-14T16:27:00.000-08:00

The last 4 weeks have been some of the laziest of my life. On days when I'm not interviewing, I wake up sometime after 1 and do some combination of watch TV, play video games, and eat the rest of the day. Some days I will run on the treadmill. I've decided that this is what I want to do for the rest of my life.

The vacation has been a little bittersweet, as it is probably the last Christmas vacation I will have, at least for the foreseeable future. I have come to realize that normal people leave early on Christmas Eve, get Christmas off, and then go back to work. Being as I've been a student for over 20 years, I've had at least 2 weeks off for Christmas every year. Usually those 2 weeks are at the end of a semester, so there's no work, just relaxation. I'm really going to miss it, but I guess at the age of 25, it's time to join the adult world.

The interviews have been going well. They're all pretty much the same thing; interviews, tour of the hospital, breakfast/lunch/dinner with the residents to get to know them better. A couple places have had a cocktail hour with an open bar. They're fun to go on. I like traveling, seeing new places, seeing new people. Orthopaedic programs are all similar. People who go into it are sterotypically weight-lifting, frat-boy jocks. While that doesn't exactly describe me, being a sports fan is pretty much all I have time for, so it's nice to know that there are going to be people like that wherever I go. And even though I wasn't in a frat, I can relate to that mentality. As an example, at one place, the residents were talking about playing beer pong and having one of their girlfriends get mad that one of them wasn't paying enough attention to her. And the resident said, "I mean, does she want a boyfriend, or does she want a champion?" And I was like, yes, I can see myself here, with these guys for the next 5 years. This was also the place where we discussed the hot/crazy scale for girls.

There's so much more to say about interviews, but I don't want to talk about it until it's over and done with, because I don't want to jinx myself by saying the wrong thing. The next two months are going to be relaxing but at the same time nerve-wracking, as I wait to find out where I will end up for the next 5 years. And I'll just leave it at that.

12 more weeks of school, forever.

Medicine is an art, not a science

2008-12-01T18:52:00.000-08:00

I remember being in 6th grade, and reading in our history book about the Roman Empire. One of the questions at the end of the chapter which we were supposed to answer struck me, although I can't recall it word for word. The essence of the question was that the people who lived in the Roman Empire made a point of calling themselves "modern" in comparison to an older Roman Empire, which they called "ancient." But obvious to any 6th grader, no one who lived at any point in the Roman Empire was "modern"; they were centuries behind and weren't up to date about anything. The idea that the question was trying to get at was that everyone thinks they live in modern times, but modern is a relative term. So what makes us think that anything we learn is right, when 20, 50, 100 years from now we're going to look back and wonder how anyone could possibly think they had any idea what was really going on?

The history of medicine is full of stories of things we thought were true or right at one time, which is no longer the case. They used to call AIDS GRID (gay related immunodeficiency) because they thought only gay people could get it. They used to give thalidomide to help people sleep, and then they found out that it caused birth defects (and if you have a strong stomach feel free to do a google search on it). They used to do lobotomies to cure psychiatric disorders, when all it was doing was turning the patient into a zombie. I'm sure there are countless more examples of things people used to think were right and now are just populating the pages of a dusty old medical text that will never be opened again.

What I don't like is that they teach us things in medical school like they are gospel. Every question has one right answer. We read hundreds and hundreds of pages of text describing physiology and biochemistry and pathology. One guy's theory about a disease process, which will be replaced by a different guy's theory once the new edition of the text comes out in a few years. How many things that I "learned" in med school, that I've lost points over for giving an "incorrect" answer, are going to be shown to be completely wrong in 20 years?

The first two years in medical school are nothing like the real world. Everything in med school has a right answer. Bloody sputum in a prisoner? TB. Kid collapses while playing basketball? Cardiomyopathy. We're programmed to look for key words and find the diagnosis. Anyone who graduates med school knows the same tricks. It makes you think you're so smart, that you can diagnose anything, but that's not real medicine.

Real medicine is a big enigma. I'm on a neurology rotation right now, and I'd say at least 33% of people that come in to the office have something that we don't understand. There are so many vague complaints of burning pains, shooting pains, numbness, tingling, weakness, headaches, etc. where the doctor doesn't know what's going on. If it isn't something that can be found in a text book, they don't want to hear about it. This isn't something exclusive to neurologists; I've seen it on every other rotation, and I'm starting to develop that mentality myself.

We are taught a framework for looking at any medical problem. As an example, I'll use orthopaedics. There are things we understand. If you break a bone, we understand that. We know how to fix it. We have some idea of how it actually gets fixed at the cellular level, although my confidence in how accurate any of the cellular stuff is is dwindling. Anyway, there are things we don't understand. Fibromyalgia is a term given to someone who has multiple somatic complaints - multiple pains in different parts of the body with no recognizable cause. It's a term given to someone who comes in with pain when we can't find the reason. Maybe there is no pain. Maybe there is. Maybe the person is more sensitive to minor aches and pains that we all experience. Who knows. No one. Doctors don't like treating people like that because it isn't a tangible diagnosis, with a tangible cure. I've seen a lot of people with the diagnosis, it's not rare. It's just one example of many where a patient comes in with something we don't understand and we don't want to deal with it.

This is one reason why I like orthopaedics. You can treat a lot of things and see them get better. If you treat high blood pressure, you don't know what's going to happen. Maybe you give a patient a drug and his pressure goes down. Maybe it goes up. Maybe it goes down, and then 2 years from now it goes back up. Why should two people with the same diagnosis have completely different reactions to the same medication? No one knows. It will be years, decades, before anyone knows. Until they know, medicine is going to be an art, not a science. But in orthopaedics, even if I can't tell you how your bone heals, I can still fix it. I can fix your meniscus, or your rotator cuff. It's not 100%, it never will be, but I can see that I did something and watch it get better.

Yes, medicine is an art. It can't be a science, because there is too much we don't know. I used to want it to be; I studied so much because I thought I was learning facts, becoming smarter, gaining a better understanding of the human body and disease. But I've come to realize I was wrong to put so much faith in it. It doesn't mean that there is an inherent flaw in Western medicine, or that we've wasted the last 4 years of our lives. It just means, and this is only my opinion, we need to change the way we look at patients and disease, and allow for the fact that we don't know everything, and never will. But that's ok. There isn't one way to paint a picture. Walk through any museum and it's obvious. You can treat back pain with surgery, medication, therapy, accupuncture, exercise, and who knows what else. There is not one right answer to every question. There are many ways to make art, and one way isn't better than any other.

Not a creature was lurking

2008-11-04T18:14:00.000-08:00

I took Step 2 on Monday. As the name may or may not imply, this is the 2nd part of the licensing exam to become a physician. I studied for about a month for it, doing some reading and a lot of questions. I did well enough on Step 1 that my actual grade on this exam isn't that important, as long as I pass, which is not really a concern for me. Now that I'm done with it I can pretty much take the rest of the year off, as nothing really matters as long as I pass the rest of my rotations.

But back to Step 2. I was planning on going to bed around 11, so I could wake up at 6 and have a good nights sleep. I was watching videos on Youtube right before I was planning on going to bed, when I saw something out of the corner of my eye run across the kitcehn floor. Let me backtrack and mention that I'm subletting an apartment for the month for this rotation, since is the last time I'll be in Philly this year. So I've only been here for a week.

I often see things out of the corner of my eye. I like to chalk this up to having excellent peripheral vision. It also may be partly due to living in the middle of Philadelphia for 4 years where seeing a roach run across the floor was common practice. Anyway, what I may or may not have seen was bigger than any roach I have ever seen, even the radioactive ones at 2100 Walnut Street. It ran behind the refridgerator.

Now, at this point, I have no idea what to do. I'm assuming it was a mouse, although I guess it could have been some kind of opposum or racoon or even a small dark person. But realistically, let's say it was a mouse. I have never seen a mouse before, except for the white ones on TV that are used to feed snakes, or the ones that run across the subway tracks on the 6 line at 91st street. I have never been in the same establishment as one. Well, except that time Minnie Mouse came over and insisted on spending the night.

What are you supposed to do? I really had no idea. I've never experienced it for myself, all I knew is what I've seen on TV and movies, which is pretty much where I learn what to do in every other situation. So basically I had the option of standing on the table and screaming for Jeffrey the butler to do something, or improvising.

I don't know anything about mice. Are they aggressive? If I went into the kitchen, would the mouse stay hidden under the refridgerator, or would it get threatened and try to attack me? That's a serious question that I don't know the answer to. Can mice have rabies? I don't see why not. Maybe normally they're docile, but if it has rabies it might try to bite you. Are they fast? Could I kill it with a broom if I tried? If threatened, can it send out some kind of signal to call for back-up mice to come and help? Ok, the last one wasn't an actual concern, but the rest of them were.

I called the person who I was subletting from to see if they had any advice. He mentioned they did have a mouse once before. Great. That makes it more likely that I actually saw a mouse and it wasn't my imagination. He also mentioned he had same left over traps. In the kitchen. Awesome. I managed to open the cabinet without actually entering the kitchen using the broom handle, and after a lot of hang-wringing and pep-talking, I made it into the kitchen and got the traps.

Setting the traps was another issue. I managed to figure out how to use them after a few minutes, but I'm pretty sure they're not set the way they were originally designed to be. They'll go off if something steps on them, but they just look awkward in the way they're set-up. Another problem was that I didn't have any food to put on the traps. I know they always use cheese in cartoons, but do real mice actually eat cheese? I remember once when I was very young and we thought we had a mouse in our old house, I took a slice of American cheese and put it out on one of the steps, thinking the mouse would come out and start eating it. My grandfather had a good laugh at that one. Either way, I had no cheese in the apartment, or anything else I could use in a trap, so I left them empty, in the only path that a mouse could travel if it was to maneuver around the kitchen.

By this time, it was past midnight, the night before Step 2. I still hadn't actually seen the mouse, and I was starting to wonder if this was all just my mind playing tricks on me. Life is funny sometimes, or all the time if you're me. The night before this important exam, when I wanted to be sleeping or possibly reviewing some last minute things, I was battling wits with a mouse. Of all the days for me to schedule it, of all the places I could have subletted, of all the days the mouse could have ran from the stove to the refridgerator, it happened like this.

I was debating whether I should sleep on the futon in the living room, which is 5 feet from the kitcehn and where I usually sleep, when I heard it scratching. Somehow, I think it got into a vent in one of the kitchen walls, although I haven't yet found a way it could have done that. But I definitely heard it scratching. I wasn't sure if it was scratching to try and break through the vent, or scratching a hole, or an itch, but it was there and it was moving. And I was freaked out. Again, not knowing anything about mice and what it might do or not do if it came out in the middle of the night. And so, I slept in my car.

In retrospect, yeah, maybe it was a stupid idea. I've pretty much been told by everyone I've talked to that it was stupid. But in my defense, I've already explained how little I know about mice. I didn't want to be in an enclosed area with one. Also, the futon is close to the ground, and what if my foot dangled off the bed in the middle of the night? there's also the possibility that the mouse could jump onto the bed, because I don't know if mice jump or not. But the biggest deciding factor was the scratching. I knew I would never fall asleep hearing that all night. And wondering if that scratch was the last one before it broke through the vent. You can't put a price on peace of mind. So I got 3 hours of frequently interrupted sleep in my car. And then went to take my test.

To wrap the story up, I called the property management office and they sent someone over yesterday. they put out some more traps. The food they used? Peanut butter. I guess it makes sense. If the mouse was quick enough, he could grab the cheese and run before the trap hit. But peanut butter is stuck to the trap so it has to stay there to enjoy it. I guess that's why they're the professionals. Anyway, now I guess I just wait and see what happens. I haven't heard any more scratching. I think it's gone, but I don't know where. It never came out again. I can't generalize about all mice, but this one wasn't agressive and never came out. If it comes back, I just have to check all the traps and hope he's in one of them, alive or dead or paralyzed or I don't know what. How to get rid of it is going to be a whole new problem.

It's Been a While

2008-10-18T19:05:00.000-07:00

Yeah, I know, it's been a long time. Lay off me, I've been busy.

I was legitimately busy until October. For the past 3 weeks I've been busy doing nothing. As a quick recap, I did three months of orthopaedics, now I'm doing a month fo radiology. It was supposed to be an easy rotation, and I was going to use my team to study for Step 2 and get that over with. The rotation itself has been easy, but the hours are long. I'm there from 7:30 to 4 or 5 every day. I have a book that I bring to study, but I was hoping to get home earlier to I could do practice questions. Also so I could watch youtube and The Office and listen to music.

At this point I'm about 40% done with the year. By Christmas break I'll be more than halfway done. My application is out, so for the next month or so I'm going to be waiting for interviews. Then I will go on said interviews, and hopefully find the place where I will work for the next 5 years.

It is a time of transition. I'm close to being done with my 21st year of school. That's crazy. I'm 25, and I've been in school for 21 years. I've identified myself as a kid for that long period of time, because kids go to school and adults work. Now I'm going to be an adult (as I sit here in my Simpsons pajama pants and dog slippers). At this time next year, if you come into the hopsital, I could be the one that treats you. People will be lined up around the block.

Lying in bed this past week I came up with 100 things I wanted to write about. But now as I'm sitting here I can't remember a single one. I need to post more often so I can just write about whatever's on my mind at the time, instead of waiting 3 months and having to recap everything. I will try.

Memories

2008-08-25T17:04:00.000-07:00

Many times during the day I think of things that would be interesting to post. By the time I actually get around to posting, I usually forget all of them, as is the case tonight.

On a separate topic, I have a really good memory. I remember things from a long time ago, and I remember inane events that most people wouldn't think important. It's helped me do well so far in med school. I'm also good at remembering the things I dream about. The two things may be related, since I find that a lot of times when I wake up, I find that the things I dream about have something to do with a person, or a place, or a thought I experienced the day before.

Sometimes during the day I'll see something that sparks a glimmer of familiarity in me. But a lot of times I can't remember whether the thing I'm reminded of is something that really happened, possibly a long time ago, or just something I dreamed about. Sometimes if I think long and hard enough I'll remember exactly what it was, and sometimes I won't. It hasn't happened to me recently or I would give an example.

I wonder if this has something to do with me tending to be an introverted person. I have so many things, thoughts, memories, running around in my head that I can keep myself occupied for long periods of time. For example, I can be sitting in a car driving someone somewhere, and I won't say anything, sometimes for the entire ride. If the radio is on, I listen to the music, and my mind starts running with it. I picture the music video in my head if I've seen. Most of the time I think of some time when I can remember hearing the same song. It could have been on the bus riding to Hunter when I was 13, or at Yankee Stadium as someone's intro music, or at a roller skating rink in the 1980's when I heard the first song I can actually remember hearing, Aerosmith's "Walk This Way," back when people went to roller skating rinks for parties.

And that event will lead me to someone I saw at that event, which will lead me to all the things I can remember about that person, which will lead me to some place where me and that person spent some period of time, and so on. I can keep myself occupied forever. I have no idea if this is normal or not. I know that I always see people on the train or subway or just walking in the street on cell phones, and I always, or usually, think that they call someone because they don't have the attention span to spend some time alone with themselves, just thinking and reflecting on their day, or their week, or their life.

I don't think it's normal. People always tell me that I'm quiet, or ask why I'm so quiet. I can't tell you how many times I've heard that this year, on different rotations meeting different residents and attendings. It seems perfectly normal to me to sit quietly, and take things in around me and understand them. But everyone else seems to think that if you aren't talking, you aren't interacting. I like just being alone with my thoughts. People should get to know themselves. If people were in touch with themselves a little more I believe we would have more deep, meaningful interactions. Don't get me wrong, I'm still totally nuts on the inside, but at least I'm aware of it.

This post started out as just an observation and I wrote and I like how it came out.

Fourth Year Begins

2008-07-21T17:20:00.000-07:00

It's July 21st, and that can only mean one thing: the new school year is entering its third week.

I am in the middle of the first of what will be approximately 9 1-month long rotations this year. My first three months will be all orthopaedic surgery. Historically, the three orthopaedic surgery rotations of your senior year have been the toughest three months of med school, and the rest of the year is cake. It's been that way since the early days of med school in Greece, where medicine was most likely invented.

On your orthopaedic surgery rotations, or sub-i's as they're called, your three goals are to do well on the rotation (honor it), make an impression on the residents so you increase your chance of getting accepted into the program when you graduate, and earn strong letters of recommendation to make your application look better. The way to accomplish these goals is to show up before your residents do in the morning, see your patients and write notes so the residents don't have to, work hard and stay late, and don't act like a tool. You can expect to put in over 80 hours a week during these rotations, as that is what you'll be doing once you graduate.

The only issue is that on this rotation they told us specifically not to come in early, write notes, or stay late. So I'm a little confused about what exactly they want us to do. I'm still working hard, and not being a tool. I stayed in the OR until 2 AM the other night, and 10 PM a couple nights before, even though they told me I could leave early. I'm just trying not to piss anyone off and help out in an opportunities I get.

I have a strong feeling my next two ortho rotations will not be this easy on me, and will require more hours and more work. So right now I'm kind of enjoying this relative break in my ortho schedule. I'm staying in a big three bedroom , two-level apartment in Center City, with two other 4th year students. One of the attendings here, who is awesome, takes the residents and students on her service out for lunch once or twice a week. She also took all the residetns and students out a couple Thursdays ago to a hotel bar and treated everyone on her tab. The comraderie among the residents here is great. Everyone....well almost everyone gets along incredibly well, eats meals together, hangs out together on weekends, and has fun during the day. It has been enjoyable getting up and coming to work every day.

We got Direct TV back in New York. Movie channels, baseball channels, football channels, XM satellite radio. Perfect timing considering I'll be back in New York starting August.....and working 80 hours a week.

Surgery

2008-05-25T19:12:00.001-07:00

It's appropriate that I haven't posted in 9 weeks because I've had no free time. On a typical day, I set my alarm for 4:30AM, and get home anywhere between 6 and 8 PM. Crazy hours, the worst hours I've worked all year, but it hasn't been that rough on me. I've found that I don't mind waking up early or being at the hospital all day. The only thing that bothers me is that in order to make it all work for me, I have to get to bed by 10PM, and that leaves very little time to do anything when I get home. That lack of free time is the worst part of it all.

I've definitely having second thoughts about whether this is what I want to do for the rest of my life. These hours are rough, and it's going to be hard to have a life outside of the hopsital once I start residency, if I get into orthopaedics. The thing is, I haven't really found anything else I would rather do. I'm definitely into surgery, and being in the OR is the most interesting thing I've done this year. I can't really see myself doing anything else. Emergency medicine sounds good because you work 12 hour shifts, 3 days a week, which leaves plenty of free time. But what you ER doctors actually do doesn't interest me, because it seems like it's a lot of people with chest pain or someone coming in drunk or on some drug trip.

I guess you have to decide what's really important to you. I can do something I like, and give up a couple more years of my life to working like a dog. Or I could do something I don't really like, but have it pretty easy. I think you have to go with what you like and just trust that everything will work out for you. The fact that I like what I do helps me through the long days. I'm around people I like, doing things I like to do, and the hours go by super fast.

That's another thing, right now I think the most important thing that will determine where I want to end up after I graduate are the people in the program I join. If I'm working with people I like it won't be that bad, and on the flip side, if I'm surrounded by tools, I'll want to kill myself. One of the best orthopaedic surgery programs in the country, which is in NYC, is rumored to be a malignant program because there are a bunch of gunners there who will cut your throat to get ahead and make a name for themselves. Theoretically, if they were to offer me a spot there and I found the rumors to be true, I can honestly say I would lean towards saying no because I care about my own happiness and sanity more than the name that will be on my diploma.

So it's been an exhausting 9 weeks but its been rewarding at the same time. I've gotten to do some cool things. Some attendings let me suture the skin closed at the end of the surgery, which I really like. It's just cool to be able to do something with your own two hands, to have the ability to be able to fix something, even if it's just closing skin. I've gotten to help with knee and hip replacements. One of the ortho attendings let me put screws into a guys broken leg to fix it. It's a little weird because it's exactly the same as putting a screw into a desk or a table, and it takes no special skill, but it still felt awesome. I guess that's why many people refer to orthopaedic surgeons as glorified carpenters, and I have no problem with that.

I've seen a lot of sad things too, I should save them for another post, if I ever get the time. The stories aren't as important as the fact that I've kind of become numb to them, and it's not something I'm proud of. But if you get affected by every person that comes into the hospital, you would never survive. You have to dehumanize yourself a little otherwise you would go home and cry every night. It's complicated, maybe I'll get into it at another time.

Surgery Begins

2008-03-30T13:39:00.001-07:00

There's not going to be a lot of free time for the next 12 weeks. I started my surgery rotation, and I'm getting up at 4:15 AM eveyr morning, which is requiring me to be asleep by 9:00PM every night. The biggest downside of this is that I'm not going to be able to watch baseball, the only joy I have left outside of school. On the bright side, my weekends should be free, and after I finish this rotation I'm done with third year, and I get three weeks off.

They don't always have happy endings

2008-03-15T20:42:00.000-07:00

21 year old kid, Drexel student, majoring in Music. Starts using IV drugs in November with his girlfriend on a trip to New York. Either he got a dirty needle, or he used the same needle twice, or something else, but he ends up giving himself an infection. The bacteria travel through his body and set up shop in his heart. They hang out for a couple months and eventually take over.

By the time he comes to the hospital, he's got bacterial vegetations on the right side of his heart, and an abscess on the left. His mitral and tricuspid valves are destroyed. He's shooting off bacterial emboli to his lungs, he's got them in at least 10 different places. He also has an infection in his hip that requires surgery to clean out. Last week an MRI of his brian shows his heart has been sending off bacteria that have ended up in his brain.

The attending doctor says it's one of the worst cases of bacterial endocarditis he's seen in his career. If the kid is going to live, he's going to require surgery to open his chest, then open his heart to go in and clean it out. Even is he survives that, a procedure to open his heart, he's still got infection all over the rest of his body that could come back and reinfect his heart. It is not good.

Hey mom, you know that son you have in college? The one who's going to graduate and get his degree and make the whole family proud? Yeah, there's been a change in plans. We're going to have to put that college thing on hold because he's dying. He's in the hospital and he might not get out alive. Not exactly the kind of thing you were expecting him to accomplish when you sent him off on his own now is it?

Everyone makes mistakes. Not everyone gets a second chance like on TV or in the movies. There isn't always a happily ever after. This kid did what everyone does, goes to college and has a good time for 4 years before having to go to the real world. That's what's so great about college right? It's a shame because now this kid learned his lesson. Anyone who walks into his hospital room and takes one look at him learns their lesson too. If everyone could spend a day in the hospital and see the end result of the decisions you're making now, we would be living in a different world.

The Burgh

2008-03-02T13:31:00.000-08:00

Interesting things about Pittsburgh:

1) They put french fries in their salads. Outstanding. You can find normal salads here, but it's common practice to order a salad and get french fries in it. Sometimes the cafeteria, in addition to french fries, will add chicken, or even steak. I refer to these days as "the greatest day of my life." It gets more people eating salad than normally would, myself include. It's brilliant.

2) They call soda, " pop." "Yeah, I'm going down to the cafeteria to get some pop. Do you want some?" I thought that term was reserved for 1950's drugstore/diners, along with "malts" and terms like "golly" and "swell".

3) I know it's late to mention this, but the city is a huge football city. Maybe that is obvious, given the alternative of being a Pirates city or a hockey city in the United States. When the Steelers were in the playoffs, I would see people in Steelers jerseys all along the streets, and even in the hospital. They brought out two big TVs into the cafeteria to watch the game, and the gave free lunch to everyone in the hospital, patients included, the day before the game. It was very impressive.

4) I heard that there is a law that says if you play beer pong you have to use water instead of beer. I haven't been to a place that has beer pong yet, and I don't plan on it.

I have a Dream

2008-02-14T17:26:00.000-08:00

An example of how my world works.

I needed a physical exam to say that I was healthy and could apply for away rotations next year. I have no doctor here in Pittsburgh, my doctor is in Flushing. So I asked the doctor who I've been working with for my outpatient service if he could do it for me. Bada bing, bada boom, I get seen that day, get everything signed off, and don't even have to pay. It's not that great of an accomplishment, but sometimes it's hard to get an appointment with a doctor, especially certain fields. Dermatology, orthopaedics, ob-gyn, you might end up having to wait a couple weeks before you're in the office. If I need to see an orthopaedic surgeon, I'm in whenever I'm free. two years ago when I broke my wrist the day after Thanksgiving, I was in there on Monday.

I'm not saying this to brag, but this is how I want my life to be. When I need something, I want to know someone I can call who will take care of it. Like, my father knows a mechanic, a Greek guy, who's honest and has taken care of his cars for a long time. Since I've been driving, he's become my mechanic, and when I have something wrong, I take my care to him, get seen that day, get it fixed, and don't get overcharged, sometimes not even charged at all. Life is about who you know. I'm not at the point yet where I can call someone and say "I want Yankee tickets, can you get me some?" but there are people who have tickets who will offer them to me, usually through the office where my mother works. I sat behind home plate with Kevin a couple years ago, I've had box seats at Shea a couple times. It will probably get better, especially if I get into orthopaedics and sports medicine, for sure if I end up working as a team physician somewhere which is what I want to do.

I know it's a two way street. I'm doing what limitied things I can do at this point in my career. There have been people who have needed appointments with an orthopaedist and I've gotten it for them through my mom. Plenty of people tell me what's wrong with them and ask me to diagnose them, more and more people actually as time goes on. Usually I can give them an idea of what's going on and what to be worried about. I actually diagnosed a guy with biceps tendonitis which I was really proud of and which still gets mentioned when I see him. I never got paid for that consult, but whatever.

It will get better as time goes on. When I graduate, and I can see people in my office and treat them, do surgery, send them to therapy, write for medications, I'll be able to do more. Just like Santa Claus, I know who's been good, who's loyal, who has my back. Whenever they need something from me, I will take care of them. I will use my powers for good. I think this one fun part of growing up, seeing what your friends end up doing. I know a guy who does this, I have a friend in this business, etc. Like if I want a good deal on a new car, a place to stay when I go skiing in Colorado, a reservation at a busy restaurant, I want to be able to call up someone and make it happen.

Some of you may say I'm getting carried away with this, but I assure you I'm not. I've been lucky to meet some people as I've gone along, through my family and through school. I hope to continue as I move on. This is my dream, a life where people do things for each other, help them out. You scratch my back and I scratch yours, and we're both better off. It really is all about who you know. It's unfortunate that everyone doesn't have equal opportunities in this country. But I'm not a philosphizer, this is the way it is, and I'm doing what I can to play by the rules. The game of life, I guess.

Super Bowl XLII

2008-02-03T20:05:00.000-08:00

How awesome was that game? Let me count the ways:

1) We stopped the Patriots from going undefeated.

2) Biggest upset in Super Bwol history? I wasn't around for Super Bowl 3 but you have to think a number 5 seed beating an undefeated team gives that game a run for its money, even if the point spread was bigger.

3) No one gave us a chance. No one. The only person on the Fox pregame show who picked the Giants in any game this postseason was Terry Bradshaw against the Packers. That's 15 out of 16 picks against the Giants. My godfather bet on the Giants straight up and won $1,200.

4) The Giants won as a team. A bunch of average players coming together, shocking the world when no one believed in them but themselves and their fans. The Yankees have a bunch of superstars and are expected to win. When they do, it feels great, but this is different. I can't explain it. Being part of the underdog, it just feels awesome.

5) Cheaters never prosper. Two days after we find out about the Patriots long history of cheating, we find out how good they are when they don't have videotape of the other teams walkthrough. Thank you Tom Coughlin for holding your practices in a secure area.

6) Bill Belichick, what a genius. Even I knew the Giants game plan was going to be runs and short passes on offense, and blitzes on defense. I guess the genius isn't so smart when he doesn't get the answers to the test ahead of team. And walking off the field before the game was over, not stopping to congratulate the other team. Thank you for showing how much class you have. Go get started on making some new cut-off hoodies for next season.

7) Tom Brady, well I can't say much because he still goes home with Gisele after the game. Actually, I think that makes him a winner at the end.

8) And best of all, the reason why this game meant more to me than a Super Bowl against any other team, all the tears being cried in Boston right now. All the people who bombard ESPN and the Daily News message boards with all their trash talk and how the Giants had no chance, I hope this game stays with you for the rest of your lives.

I'm sure I missed something, but I like that list. I'm walking on air. This is awesome. That play where Manning spun away from the sack and heaved it up, that is going to go down as one of the most famous plays in Super Bowl history.

I also want to say, because Roger refuses to put it on his blog, that I went 8-3 with my picks this postseason. That puts me up there with the experts on any website, and I want you to know that because I'm proud that I'm good at that. I've been doing it for a long time and I am good at it and that's all I have to say about that.

We are the champions of the world. We were the best team in the NFL in the 2007-2008 season. No one will ever take that away from us. As a sports fan, you live for the moments, and I will take this one and put it in my trophy case, second only to Aaron Boones homerun in 2004.

Internal Medicine

2008-01-27T17:52:00.000-08:00

I think this has been my favorite rotation so far. Other rotations have had their moments. Pediatrics was my first, so it will always have a special place in my heart. I had a patient on Psych who was so psychotic he thought he was God, he thought he could turn himself invisible, he thought he could travel through time, and he thought the Mets were going to hold off the Phillies for the division. Ok, the last part was made up, but the rest is true. When he would pretend to be invisible, I would be like "Carl, where did you go? Carl? CARL?" a la Adam Sandler in Big Daddy. Good times. I delivered a baby on OB/GYN. But all in all I think this has been my favorite rotation so far.

It's late enough in the year that I actually know enough to not be a waste of space. Like, I can answer patient's questions and not have to say "I don't know, I'll ask the attending and get back to you." I have a reasonable idea of the things that need to be done to treat people who come in and are sick. So even though I'm not actually in charge of anything and very little I do will make a difference in a patient's care, I feel like I'm getting close to being a doctor and knowing how to manage a patient. In a little over a year, that's what I'm going to be doing, which is pretty crazy.

I think what I enjoy most about this is that every patient is a new story. They're like books. Some of them are interesting, some of them are boring. Some of them have surprise twists. Sometimes you think you know what's going to happen and you're way off. Sometimes the butler did it. But every story is different, and every day you wake up, every new patient you see, has their own story.

The last patient I saw was a 62 year old guy who was in a car accident and almost had his arm cut off. His wife was driving, and tore her rotator cuff. He became delirious and didn't know where he was and couldn't make decisions for himself. When I saw him, it was resolved. He was a contractor and he thought he was going to lose his job because he wouldn't get full function back in his arm. He told me that a lot of girls have nice bottoms, but I need to find one that can pay her own bills, because a lot of them are just looking for money. Then his daughter came in and he told me she was single and she could pay her own bills. I told him if she could pay my bills then we could talk.

I saw someone who had a pheochromocytoma, a tumor that secretes adrenaline and gives you a rush 2 or 3 times a day. A lady with diarrhea for 3 months. A 19 year old kid whose kidneys had failed. A guy who wanted STD testing because he had slept with someone during a vacation in Thailand. A different story every day. Some of them have happy endings, some of them don't, some of them don't even have endings because we never figure out what was wrong with them. But I am lucky because I love talking to patients, and I love trying to figure out the mystery of what's wrong with them, and I love being able to fix them. I say I'm lucky because I naturally enjoy this, and I'm going to enjoy my job and look forward to coming to work, even if I dread waking up at 6 AM. So I've found something that I like doing, and I'm not going to have to worry about hating my job like so many people do.

Pittsburgh

2008-01-13T09:50:00.000-08:00

Greeting from the other side of the world, beautiful Pittsburgh, PA!

To begin, I'll start with the ride out here. Six hours wasn't that bad. I would have made much better time if it hadn't started snowing when I was about an hour away. I thought that was going to be the norm here but it's only snowed one time since then, and very lightly. One other thing is that my GPS doesn't work here. On Toyata's GPS DVDs Pittsburgh is considered part of the Midwest and not the Northeast. So even though I have a map on the screen that shows the entire area, I can't put in an address and get the directions. I'm going to have to go back to the Stone Age and use mapquest to find my way around.

I'm not going to lie, I really lucked out with the housing. I was expecting a 2 bedroom apartment with 4 people in it. It's me and 2 others, both fourth-year students. One of them has the small room to himself, and I had to move in to the bigger bedroom with the other one. But the guy I moved in with has a girlfriend at our school who is living in the same complex, and he decided to spend most of his time there. So I basically have the room to myself. And the other guy has a fiance here and he's rarely around, so I actually almost have the entire apartment to myself.

And the apartment is huge. The living room is the size of my living room back in New York, probably a little bigger. There's also a balcony. I'm not planning on getting a lot of use out of it in the middle of winter, but it's one of those things that's nice to know you have even if you never use it, like something that would fit that description which I can't think of right now. There's shuttle service back and forth to the hospital every day so I don't need to drive and park like I did last block. The only negative is that they only give you $70 for food for 3 months, but it's a small negative in the face of having this huge, awesome apartment.

The hours are also awesome. I had to go in for work the first 10 days I was here because I was on call the first weekend. I thought it would be torture waking up early every day, but it hasn't been bad at all. I guess I've been going to bed earlier and earlier over the years, and I'm getting to the point where I know how much sleep I need to get to not have a problem getting out of bed in the morning. Like in college I would stay up foever, in med school I started trying to get to bed before 1 AM, these past 2 weeks I've been going to bed before 11. I wake up at 7 and am functional throughout the entire day, and I don't need to take naps like I've done for the past 3 years. If it's a sign that I'm maturing, it's the first of its kind.

Even though I get to the hospital early, I 'm out early most of the time, usually around 2-3PM. So, awesome housing, awesome hours, good tunes, good brew, good buddies. I feel great man! I'm relaxed and I feel good. Especially compared to the living situation last block, coming out here for 3 months could have been a nightmare. I feel really lucky to have it sort itself out like it has. Also, all the med students are in the same complex, so there's always something to do. It's like being back at college only instead of going to class during the day we save lives.

2007-12-18T10:50:00.000-08:00

I am currently enjoying the beginning of my well-deserved break. A quick recap of my last rotation; it went well. My preceptor was half Greek, so I was in a good spot from day one. Did I learn a lot? Probably not as much as I could have. I did a lot of physical exams, and since it's that time of the year, I think I'm good at picking up bronchitis, strep, sinusitis, things like that. I got a good idea of how primary practice works, screening for cholesterol, diabetes, heart disease, giving flu and pneumonia vaccines and the like. I'm not so cocky that I'm going to say I'll never use this again, but if I end up in orthopedics I think I've learned as much as I needed.

One thing that you'll find if you talk to any third year med student is that grades are incredibly subjective. The formulas are different at ever school; for us they even vary from rotation to rotation. On this last rotation, it was 80% clinical evaluations and 20% exam score. the clinical evaluation is something you have little control over. If the greatest student in the country worked there the week before you got there, you're going to look bad by comparison, no matter how deserving you may be of a good grade. The grading is 1-5 on several areas. Personally, when I fill out surveys like that, I rarely use 1's or 5's, or things like "Always" or "Never" because I always think there can always been something more extreme than what they're asking. This is kind of abstract, but I think you can understand what I'm saying.

My point is it's very hard to get a 4.5 average, which is what you need for Honors, and it's very dependent on who your evaluator is. For comparison, in Pediatrics I had a 3.86 and in Psychiatry I had a 4.11. The Psych grade was helped by the fact that I made friends with the residents and they gave me good evaluations. Which brings me to my next point, that third year is much like the rest of your life, where it's all about who you know. The people who do well are the people who make friends with the evaluators, not necessarily the people who know the most or work the hardest, although the two categories are not mutually exclsuive. Likewise, one bad evalution because you pissed off the wrong person will kill your average and any shot of honoring the rotation.

This wouldn't be so bad if third year grades didn't count for so much of your med school performance. Some people will say it ranks second to your Step 1 score, others will say it's more important. I'm not coplaining, because I've been lucky enough to figure out how to do well early on. But you shouldn't have to "figure out how to do well." The people who do well should be the people who work the hardest to learn the most and be the best doctors. That's the way it was first and second years, and I absolutely loved third year because I worked not-stop and dominated. It's not fair, but that's how life is. If you know the right people, you get ahead. \

Now I'm off for 2 weeks before I move to Pittsburgh for 3 months. It will be a big change, but I think I'll enjoy myself. It will mostly depend on the housing. As I've already mentioned, the housing the last 6 weeks was horrible. No TV, bad internet, no chair or couch. The food was pretty good. But if I had been there for 3 months it would have sucked. Also, I won't be able to go home on the weekends, so it's more important that the living situation is comfortable. I know a few people who are going to be out there the same time as I am so I'll have some things to do. Right now I'm just going to enjoy my two week vacation and enjoying being halfway finished with third year.

Music's my imaginary friend

2007-11-18T15:57:00.000-08:00

Ok, I lied. The internet actually comes in and out, so I can be online for like 20 minutes at a time. What makes it better is that there are computers in every patient room in the office I'm working in, so I have no trouble getting e-mails or checking grades. I've been able to keep up with the a-rod situation minute by minute. But there's still no light in the room (I use a lamp), no chair, no desk. When I'm home, I usually lie in my bed and read or use my laptop. My lumpy bed, which is terrible on my back. I'm not very high maintenance, so I'm surviving well.

What also helps is that this is the easiest rotation I've had so far. I work 8:30 to 4:30, with at least an hour and a half for lunch. Waking up at 7:45 is made to look much better since a few weeks ago I was waking up at 5:30 for ob/gyn. And for the first time probably since elemantary school, I feel rested when I wake up. My roomate is on ob/gyn, and he usually goes to bed around 9. To be polite, I go to bed around the same time, so I'm not up typing or listening to music while he's trying to sleep. So I get about 10 hours of sleep a night, with an interruption around 6 am when he wakes up.It's pretty sweet to have no trouble getting out of bed, and not be yawning all morning. It's not a luxury I'm planning on getting used to.

I don't know if I mentioned it before, but I'm doing family medicine right now. It's pretty much run of the mill things, like bronchitis, sore throats, people with high blood pressure, things like that. Every now and then we'll see an interesting case, like this lady who's being worked up right now for what might be a tumor of the auditory nerve, which is very rare. The work is adequate, but nothing too stressful. It's a good rotation to be doing during the holidays, as I have plenty of time to go home and relax.

The holidays. The most wonderful time of the year. I understand that suicide rates are higher around these times, but I love getting to see my family, plus my extended family, and celebrating. I love having nothing to do except eat for extended periods of time. I also love going shopping without having anything specific to buy, walking around the mall and buying whatever looks good to me. I buy the best things, especially for myself.

Update

2007-11-11T16:16:00.001-08:00

I've got no internet in my new place....in addition to no TV, no computer desk, and no chair in my room. When I'm home, I just lie in my bed and read or play on my laptop. I'm also sharing the room with another person for at least the end of this week. If I'm lucky, we'll shift rooms by next week so I can at least have some privacy. Either way, this is going to be a long rotation, and the weekdays are going to go be very slowly.

Ob/Gyn

2007-10-11T16:26:00.000-07:00

I've been on ob/gyn for almost 3 weeks now, and I've seen:

5 deliveries
2 C-sections
a bunch of scopes of the uterus
a couple of hysterectomies
a couple of women have their abdomen explored to see how far cancer had spread
one time where they took a set of twins and separated them at birth and made one evil and one normal so they could set up for a really cool plot twist when they eventually cross paths.

I am enjoying this rotation much more than I thought I would. Previously, I had said I would rather drop out of school than work in this field for a living. That was me being uninformed. While it isn't one of my top choices, I could see myself doing some of these things, but I am pretty sure I won't end up here. It is very interesting because it is a mix of surgical and medical treatment of patients, which I don't think you get in any other field. So you have to be like a five tool player to be good. There is also a potential to make a lot of money if you end up in the right specialty, which is the in vitro fertilization area, where you can make some sweet moolah without working long hours. But this hasn't tickled my fancy so far.

One problem is that there are too many women in this field. I mean the doctors, not the patients. While they are an important part of society, I think that too many of them spoil the pot. The atmosphere in this part of the hospital doesn't suit me. For one thing, their sense of humor is way off. Today there was a patient who didn't want to give urine for a drug screen, even though she was pregnant and we needed to know. They were talking about what their options were, and I said "Why don't you give her a catheter?" which I meant half seriously, even though it would have solved the problem. The first thing the nurse said to me was "That would be assault" and she stared at me with her cold, dead eyes (she was a zombie nurse). While I should have been commended for my incredibly creative solution to the problem, or at least I should have gotten a laugh at my unique approach, I got nothing. Not only that, but she took it way too seriously, the way women always seem to take certain topics. I couldn't work in a field where my incredible humor goes unappreciated.

The birth process is not as amazing as it was made out to be. Everyone talks about how amazing the miracle of birth is, and I was really jacked up to see it. I wouldn't say it was a dissapointment, but I don't think it was all that it was made out to be. It's not that I've been disgusted by it, just kind of unimpressed. I hope that when it's actually my kid that's being born I'm a little more excited. I've actually been more interested in watching the kid in the first few minutes after it's born than I've been in thhe actually process. C-sections have been cooler, because they just reach in and pull out the baby. It's very much like pulling a rabbit out of a hat.

The hours haven't been as bad as I expected them to be. The first two weeks I went home between surgeries and slept for about an hour, which made the entire day perfect. I wasn't tired or anything, which gives me hope for the next few years. If I can just find about an hour each day where I can take a nap, I think I'll be able to manage the 80 hour work week. I'm sure there's no way that's possible though. The best I can hope for is dozing off for 10 minutes in the library and hoping that sustains me for the rest of the week.

The Goal Line is in Sight

2007-09-17T17:29:00.000-07:00

With only one week left in my psychiatry rotation, I guess it's time to give an update.

Psychiatry is pretty easy, in terms of hours and workload. Everyone at med school already knows this is the easiest rotation. I feel like I started with the two easiest rotations first, pediatrics and psychiatry, which is not what I would have preferred. I would rather have done the hard ones first and then relaxed att he end of the year. I don't really know how easy these rotations were because I have nothign to compare them too. But I have a feeling in about a month I'm going to be saying "wow, psychiatry was a piece of cake compared to this." The "this" I will be referring to will be ob/gyn.

As for psychiatry itself, we spent 3 weeks seeing inpatients and 3 weeks walking around the hospital evaluating "normal" patients who may have had something psychiatric wrong with them. Three days a week we started at 9:30, the other two days we started at 8. We usually had an hour and a half for lunch, and we finished around 4:30. Pretty sweet.

There weren't a lot of "crazy" people. Most of them were susbtance abusers who said they heard voices. They may or may not have been lying and just looking for a place to stay and something to eat for a few days. Even the doctors will admit that people lie about symptoms just to get into the hospital, but it's hard to judge who's telling the truth, so most of them get admitted. In my opinion it's a huge problem that costs the hospital, and the country, a lot of money. But it's one of those things that is so big no one really knows where to start in terms of fixing it, so people just get admitted, stay for a few days, and then leave to go try the same thing at another hospital. Or they'll lie and say they want to kick their cocaine habit, but never go to the rehab place we refer them too.

As I finish my second rotation on Friday, I will be 1/4 done with this year. 2 1/4 years done with med school. And for all intents and purposes, in about a year and a half, I will know what I'll be doing for the rest of my life, even though I won't know where I'll be doing it, which I find out in May 2009. The one exception to this will be if I decide to take a year off to do research to strenghten my application. Basically, orthopaedics is really hard to get into, but my grades are good enough that I'm confident I'll be accepted, as long as I don't screw up this year. But there are some places, like California and New York, where everyone wants to go, so they're even more competetive, in all fields. I think very few people are confident that they can get into the specialty of their choice as well as the area of their choice. I'm confident, but realistic. Taking a year off would help my application, plus it would be even better if I work at a hospital in New York, meet some people, and get good recommendations from there.

I talked to our Dean and I don't have to decide until the end of the year. I thought it was much earlier. My Step 1 score is great, my grades this year will determine whether I take a year off or not. I knew I had to do well in my surgery rotation, but he told me that I should probably do well in all my rotations this year. Ok, no problem, except I've already finished pediatrics (I'm still waiting for my grade) and am halfway done with psych. There's only 4 left. So I have my work cut out for me the rest of this year. This continues to be the story of my life, at least for the past 6 years. But, as the black guy recruit in the GI JOE movie says during his training while he's swimming underwater, "The goal line is in sight."

I'm super excited about the premier of Beauty and the Geek tomorrow. I know it gives beauties like me a bad name, but it is so entertaining. I'm also kinf of excited that my voyage across the Northeast begins next week, from St. Peter's to Monmouth to Pittsburgh, and back to Philadelphia. I'm less excited about being in Pittsburgh in the middle of winter, but the chance of school being cancelled for snow is enticing. Yes I realize hospitals don't close.

Stamatakis

2007-08-16T19:17:00.000-07:00

This is the essay I wrote for the scholarship I won:

I decided that I wanted to pursue a medical degree at the end of my first year of college. I was living with my older brother, who was enrolled in a graduate program at Hahnemann University, and I got a first hand look at all the things that were being taught at a medical school. It interested me much more than anything I had learned in the psychology classes I had taken for my major, and so I decided to change my focus from psychology to medicine. My decision was finalized the next summer when I worked as a medical assistant in an orthopaedic surgeon’s office. I saw how much I enjoyed being part of a team that helped to take care of patients with broken bones and torn ligaments, and knew that it was what I wanted to do with my life. It is that ability to be able to fix people who are hurt that most appeals to me about a career in medicine, and more specifically, in orthopaedics.

The late decision to change my concentration was the most difficult obstacle I had to overcome to get into medical school. I still needed to take all the classes required to get my psychology degree, and there wasn’t a lot of extra time to schedule classes to prepare me for the MCATs and medical school. During some semesters I was taking the maximum number of credits allowed. I was only able to take two courses beyond the bare minimum of requirements for applying to medical school, and I was concerned that it would put me behind most of the other students applying to medical school, as well as during the first two years of med school. My sophomore and junior years were very hectic, with a lot of psychology courses, medical school prerequisites, and MCAT preparation in addition to traveling home every weekend to work in my family’s restaurant to pay for school and living expenses. It was difficult, but I’m happy to have gone through it and come out successful. I feel that it built a lot of character in me, and it was good preparation for the workload that I ended up seeing once I came to medical school.

The two most influential people in my life are definitely my parents. My father was born on a small island in Greece and came to the United States when he was 17, by himself. My mother was born in Africa and came here when she was a teenager. Neither of them spoke English when they arrived, and neither had much money to their name. They’ve both been working almost from the moment they first stepped foot here. My father still wakes up at 5:45 six days a week, and he just turned 61. The fact that they have both worked so hard to support their three kids is something that I am incredibly proud of, and have always kept in mind when making decisions about my own life. They have always put the wants and needs of my siblings and me before their own. It’s more amazing to me when I see all of my friends with divorced parents who grew up not knowing one or even both of their parents. I chose to travel back and forth to New York every weekend to work and support myself as much as I could in order to take some of the responsibility off of them. I know that once I graduate, as much of my paycheck as possible will be going toward helping them finally retire. It’s the most I can do to pay them back for everything they’ve done to raise me the right way and give me all the opportunities I’ve had that they were never offered.

I would like to enter the field of orthopaedics once I graduate. Most of my pre-med experience came at the orthopaedic surgeon’s office where my mother works. I worked as a medical assistant, and later shadowed two of the surgeons during their outpatient hours. Aside from that, the only interests I have time to follow outside of medical school are sports related, so it has always been my plan to do something related to orthopaedics or sports medicine. I would like to end up practicing in New York because that is where most of my family and friends reside. However, at lot of things can change by the time I am finished with my residency, so I am flexible in my thinking of where I want to end up living. I’ve been living in Philadelphia for the past 6 years and I am comfortable here, so that will also be a strong possibility.

I ended up winning because of the hard sacrfice I made, going back to New York on the weekends and working trhough college. It worked out pretty nicely, because I had no idea what I was supposed to be writing about, and I was just being honest. It turns out they were looking for students who had difficult roads on the way to med school.

I started my Psychiatry rotation this week. From what I've heard, I expect to befriend a criminal mastermind who is in isolation and then use him to catch a serial killer. Pretty standard stuff. I also expect to see a lot of people who are in the hospital even though they are clearly less crazy than I am.

How many times can I use the word anyway

2007-07-31T19:15:00.000-07:00

My pediatrics rotation is over next week. My, how time flies! Yeah that didn't really need an exclamation point.

One of my concerns going in was how I would manage staying awake from 7 Am - 5 PM, something I haven't done in years. The 6 weeks I spent studying for the boards, I was waking up at 2 in the afternoon and going to bed at 3 or 4 in the morning, just because that was my body's natrual way of doing things. Even when I was waking up at 8 for class, I would usually take a nap when I got home, or something during class, because I'm always tired. But anyway, I've managed it well so far. I've come home for lunch a couple of days to sleep, and I have drifted off momentarily during a couple of lectures, but I don't think anyone noticed. I'm still able to think and answer questions even when I'm half asleep, which I guess is the most important thing.

Some days have been really interesting, and some days are really boring. The two days I got to work with the pediatric surgeon were cool because I got to see cool things and I had more responsibility. Or, I may just think it was cool because that's what I'm interested in. The past two weeks I've just been spending most of the time seeing 1 or 2 patients, writing a note about how they were doing, and then going to meetings or discussing patients with the residents and attendings. Sometimes it's cool, like when an interesting patient comes in and we're not sure what's wrong so we talk about different options. This reminds me of "House," and that's probably the most interesting thing we do, plus I get to show what I know, which isn't a lot but I've had my moments.

One thing I've been thinking about is that we've had a few kids come in who were, let's say mentally challenged because I don't know what the politicaly correct way to say it is. I think three kids with autism, one with FG syndrome which no one had heard of, and another who has something that they don't know what it is....if that explanation was in correct English. Anyway, it definitely breaks my heart to see kids like that, who won't grow up to have normal lives and experience all of the things we take for granted. I also feel bad for their parents, all of which have been really loving towards their kids. I can't say for sure what I would feel if I was in their shoes, but I don't know how I would react to finding out my child had some kind of serious mental problem.

I'm definitely thinking about what it's going to be like having my own kids. Well, having a kid that I get to see and who doesn't live in China with his mom and who never even calls to say Happy Birthday or Merry Christmas. I've already got big plans for the future first ever US President/Baseball Player/Ninja/Hitman before he retires at the age of 40 to the underwater lair he built with his own two hands. Don't you think it would suck to look your kid in the eyes and not even know if he understand you when you say you love him? I think it takes a special person to have the patience and understanding to be a good parent in this situation, and I don't know if I could do it. Basically I'm saying that in this respect, I'm a terrible person.

But I am enjoying myself. It's a lot different being in the real world compared to being in class. I look like more of an adult on the outside, even though I'm still like 14 or 15 on the inside. But I'm an adult in all the right places, specifically the biceps and chest hair areas. I think the reason I like kids more than adults is because I can relate to them better, being as I'm nowhere near to being an actual adult. Anyway, time for some milk and cookies.

First Day of School/CompUSA Sucks

2007-07-02T20:12:00.000-07:00

Cyprus was fun. Seven days is too short for a good vacation, but it was the only time I had available, with school starting on June 25th. It was either 7 days or no days. It also wasn't smart to come back the day before orientation started when we had homework assignments due the next day. But what can I say, I fly by the seat of my pants a lot. I've been running around all week trying to get everything ready for school. I finally got my PDA to work the right way after a week of struggles. Which leads me to my next point.

CompUSA is terrible. Just terrible. I bought a laptop from them 2 years ago, right before med school, and got a 3 year warranty. Recently, the sound stopped working. I brought it to them to fix the sound, which was the result of a broken external jack. External, as in having nothing to do with the actual computer part. The asked me if I wanted to backup my data, for $100, which is a rip off. I declined, because I knew they didn't even need to turn the computer on to fix it and wouldn't need to mess with the hard drive. So of course 2 weeks later it comes back with the sound working and all my stuff gone. I'm pretty sure the only reason they did it was because I didn't pay the stupid fee. But whatever, I could live with losing all my notes and pictures and stuff. The problem is, in replacing whatever internal parts they replaced, they messed up the computer. Error messages kept popping up, explorer wouldn't work, and eventually the screen just went blue when I turned it on one day and stayed like that.

So the computer was working fine when I gave it to them, and then they gave me back a broken computer. I took it back to them to fix the problem they created. Two weeks later I pick it up, and the same thing is wrong with it. Oh yeah, and when you pick it up the battery is completely gone, which I'm sure is so that you can't check it in the store to make sure it's working before to go back to Queens (the store is in Manhattan) and find out its broken. They kept it for 2 weeks and did nothing. Unbelievable. I paid $300 for a warranty, and all they've done so far is mess up a computer that was working fine, and then not repair the problem they created. They keep iit for 2 weeks, so I have been without my computer for a month. There's also no parking near the store unless you put it in a garage for $12 per 1/2 hour. Two round trips, a month without a computer, 2 years worth of data lost, and no end in sight.

I just went and bought a new laptop. I was forced to, because without a computer I would fail my first rotation. $1200, from Best Buy, my new favorite store. I will never again buy from CompUSA, my kids will never buy from CompUSA, my future office will not buy from CompUSA. On the other hand, I will invest in Best Buy stocks and do free surgery for the CEO. A $300 warranty that's good for nothing, and a company that can't fix a problem that they created. Unbelievable. I can't wait to see how this works out on Wednesday when I'm back there again. In all seriousness, I'm going to ask for a new computer. I don't see why I should let them repair the blue screen problem that they are obviously incapable of fixing. At the very least, I'm walking out with $300 from the warranty that they can't provide.

Anyway, today was my first day in the hospital. I got to examine a baby that was 3 days old. It was pretty freaking cool. More fun to follow I supposed, even though we have homework that I didn't do. I think this year is going to be a lot of fun. I will try to write about the things I get to do without violating and privacy laws and getting myself kicked out of school.

Update

2007-06-02T23:01:00.000-07:00

Just studying, all the time. This test is going to determine what I can do for the rest of my life. No pressure. You feel guilty when you do anything besides study. And I've been feeling guilty a lot. Even though all the practice questions and exams are telling me I'm going to be fine, there's no reassurance. The most depressing part is that if I don't get what I want to get, I have only myself to blame. I don't even want to think about what's would happen after that. Yeah this is pointless. I'll have more to say after I get my score back, but that won't be for a while.

I coulda been a contender. I coulda been somebody, instead of a bum, which is what I am

2007-05-03T13:08:00.000-07:00

Finally done.

For the last 2 weeks, aside from playing a game of softball, I've been studying about 10 hours a day for finals. Four finals, encompassing about 90% of what we learned all year, all of them must-pass. We heard rumors that last year 40 people failed the Pharmacology final, and that 6 or 7 people failed the entire ICM course.

On top of that, I went into the last 2 finals with grades above 90. If I had ended up working hard all year in Pharmacology and Microbiology and then not honoring them because I screwed up the finals, it would have been the most depressing thing in the world. Also, not passing one of the finals would be a huge blow to my already huge ego. I don't think it would be a huge deal to everyone, because they offer a make-up exam afterwards, but just having to sit for that exam would mean I'm not the man. So I ended up sleeping only 1 hour the night before. I can't go to sleep knowing that there are things that I still don't know 100%.

And since you're all curious:

ICM - 101/114 - 88.6%
Pathology - 84/95 - 88.4%
Microbiology - 80/88 - 90.9%
Pharmacology - 86/94 - 91.5%

Put that all together, and my performance this year, very broadly speaking, was 90%. I know there are people better than that, but I am incredibly proud of how well I did this year. I honored 4 out of our 8 classes, I passed the NBME practice exam on the first try, and I feel great about where I'm at right now. First year was tough, with a lot of family health problems on top of the huge transition from college to med school, but I survived that. I was a lot better prepared for second year, I knew what I had to do, I put the work in, and I shined. It wasn't without its distractions though. It got so bad at one point that I thought about taking time off or maybe even coming back next year to finish second year because I couldn't concentrate on anything and I thought the grades I worked so hard for were going to go down the drain. But I told myself to be a man, plowed through it, and came out a champ. I know I've said it on here before, that it is just the best feeling in the world, to get hit with something, take it head on, and survive, without asking for help, just being a man and doing it yourself. Like Robert de Niro said in Raging Bull "You never got me down, Ray."

So what now? I don't really know. I kind of got a preview from Scott because he finished about a week before us. I'm not sure where to start studying for the Boards. At this point, it just feels awesome to be done with 2 years of school, to be done with finals, to just be free, at least for a couple days. Everyone at school says the same thing. It's like walking 2 feet above ground. I'm halfway done with med school, it's amazing.

One thing that is weird is that I don't know when I'm going to see people again. I play softball with a couple of my friends, I know some people who are going to be in Pittsburgh when I'll be, but everyone is going to be so scattered, for the Boards and then for 3rd and 4th years, when we're all in different places. No more seeing 100 people in lecture every day. I suck at keeping in touch with people because I feel gay calling someone up without a specific reason, just to see how they're doing. Like when Peter called Quagmire after he got in touch with his feelings, and you know the rest. Anyway, I guess I'll have to be better at that.

Final thoughts: I'm the man. No matter what happens from here on, I dominated this year, and no one can take that away from me. Life is about moments, graduations, weddings, births, Aaron Boone home runs, and the moment I got my last 2 grades and put the seal on the end of this year will always be mine.

I don't know if we each have a destiny, or if we're all just floatin' around accidental-like on a breeze. But I, I think maybe it's both

2007-04-01T21:19:00.000-07:00

Nice guys seem to finish last. In everything. This isn't something that has come up recently, but just something that seems to prove itself true time and time again.

Seriously, when does doing the right thing get you ahead in life? Who does better on a test, the guy who studies and learns everything on his own, or the guy who gets a copy of the old exam? Who's the better baseball player, the guy who wakes up early to take batting practice and works out all winter to stay in shape, or Barry Bonds? The shortcut, the easy way out, is the ticket to the fast lane. Even in the real world, look at all the CEOs who are embezzling, all the shady stuff going on in the government. I'm guessing there are certain cases when someone who has done things the right way has really made it in life, but for the most part, the nice guys get passed by the guys who figure out the easy way to do things.

I wonder why they have children's cartoons that have the good guys beating the bad guys. Good guys always win right? Well, except for Chuckie, that's supposed to be true, but little kids shouldn't be watching Child's Play anyway. They should make cartoons where the bad guys win, so that kids can learn the way the real world works and be prepared. Kind of like how they have shows where they show you that drugs are bad, like the episode of Saved by the Bell, but you know all of those guys were probably on one thing or another. They teach us the way we're supposed to do things, but it's not the way anything actually gets done.

Why am I writing this? I don't know. It's a sad realization when I realize that the rules I try to live my life by are different than the ones that everyone else lives by. When someone asks me for something, a favor or help or something, I didn't know I had the option of saying no. The first thing I ask myself isn't whether or not I should do it, or what's in it for me, but rather how can I find a way to do what they need. Apparently this makes me different than everyone else in the world.

Why the realization now? I guess two things. One, I'm starting to realize that some people only talk to me when they need something. No one ever asks if I need anything, if there's anything they can do for me. But when there's something they need, and they think that Christos can help with that, they don't hesitate.

The second thing is that I'm going to be spending 3 months in Pittsburgh next year to help someone out. It may not sound like much, but it's 3 months in a new place, where I don't know anyone, and it's in the middle of the year. I don't mind doing it, I did it because he wanted to be closer to his wife, so I switched my Philadelphia hospital for his Pittsburgh one. What surprised me was that he was surpsied I agreed to switch, and asked why. I didn't really know what to say. All I said was that I didn't think I had a choice. I guess I did, since the other 40 people he asked said no. But seriously, was I going to stay here because it was more convenient for me when I could have helped him out? At least I'll be able to see some Penguins games.

Also, I just saw Forrest Gump, one of my favorite movies, and possibly the movie character I identify with the most, although I might just be saying that because I just saw it. Oh yeah, also Tony Montana. Anyway, Forrest Gump, the guy did everything for everyone. He helped out Lt. Dan, Bubba's family, his mother, and he always helped Jenny when she came back to him. Never took advantage of anyone, lived life the right way. Integrity and good morals. Almost brings a tear to my eye, that he was so nice, and almost never got the one thing he wanted in life.

What's the moral? I don't know. I don't expect anyone to change. Simply put, I think most people are selfish. Obviously the world would be a better place if everyone looked out for other people and always tried to help. Actually, maybe being selfish has evolved to help people survive. I guess the caveman who didn't share his wooly mammoth meat with the caveman who didn't have any got to survive and reproduce while the other one didn't. Damn, I wrote this whole thing and maybe there's a scientific reason behind it all.

Well I guess the point is to think about how you treat other people, who you're friends with only because of what they can do for you, and what you do when someone asks you for something. Why not make life easier for someone if it's in my power? The sad thing is that even though I know when people want something from me, I still can't say no. Ever. Isn't there some saying like that, if you ask me for a shirt I'll give you a suit, ask me for a room and I'll give you my house, etc etc? If you know it, let me know.

Haircuts

2007-03-14T21:42:00.000-07:00

Have you ever gone to get a haircut and you were sure that you needed one and your hair was way too long? And then when you got there and sat in the chair, and looked in the mirror, you were amazed at how good your hair looked, and thought you could probably go another week without one? That happens to me all the time. You know why? Secret, good looking mirrors. They put them in so at the end of the haircut, you're like "wow, i look freaking awesome." Even though you probably don't. But you can catch them if you look closely when you sit down. Most people don't pick up on it because they're making chit chat with the barber as he's getting started. That's why they start talking to you as soon as you sit down, to distract you so you don't catch on to their ploy. But next time you go, before he gets started, see if you don't look a little better than you did a few minutes earlier when you were looking at yourself in your own mirror. And then get freaked out, because I blew your mind. And I invaded your thoughts.

Update

2007-02-24T21:32:00.000-08:00

She didn't sell my clothes, but I now have a white thermal top that does not belong to me. I really wish I had kept track of what was in that bag when I dropped it off.

But the shopkeeper and his son... that's a different story altogether. I had to beat them to death with their own shoes

2007-02-17T15:21:00.000-08:00

Disclaimer: if you don't want to hear about my grades and think I talk about them too much, or if you're jealous that I'm better looking and more athletic than you, then stop reading now Tom.

I dominated another set of exams. Four grades above a 90, and one 81 in the class I decided to sacrifice in order to concentrate on the others. I'm comfortable saying that this is not a fluke, and this year I finally learned how to study for med school exams. It's just a shame that I only have 3 more months of this before I have to learn a whole new way to get good grades when I start working in a hospital.

I never thought I was that much better than the other people here. There are about 170 people in my class, and the grades are distributed along a normal Bell Curve, probably. It just worked out that some of the people I made friends with first year were the smartest ones in the class. I know 3 people who honored every class last year. So being around them made me figure I was in the middle of the distribution. This year, in addition to doing much better, somehow the word is getting around that I'm one of the geniuses in the class, which I don't agree with. But during this last set of exams, people were asking me to study with them so that I could help them. One guy wanted to copy my notes, and another asked me to make a study plan for him and tell him what was important in Pharmacology. Of course I helped both of them because I'm a nice guy and I'm not a gunner, but I'm not even sure why they thought I was the person to help. A first year student came up to my group and asked for help with what he was studying, and the other people pointed him at me, saying I was the one who would remember the first year stuff the best. I'm actually really surprised that I did remember and could answer his question. But I don't know why people thought I would remember a random thing from first year. It does make me feel good though.

Even though I brag about my grades and I'm really proud of them, I'll be the first to admit that they don't really mean anything. Just because I'm able to memorize things and reason through problems, doesn't mean that I really know anything about it. If I get a 100 on a Pharmacology exam, does that mean I know everything about the drugs that are used in kidney problems? Obviously not. It's not like I remember everything from old exams either. If somebody can remember the things they learned back in October even if they didn't do well on the exam, I think it's more impressive that someone getting 100 and then forgetting half the stuff after walking out of the exam. But studying and test taking are skills, and I'm not picky about the things I'm good at it. I do well, and that's important and plenty of people would like to do as well as I do, but I don't think it says anything about how much I've learned. I'm not really comfortable being labeled one of the smartest people, because there's so much more I could know, or do, and I'm not complacent with where I'm at. It's like, does Jose Reyes think he's great? Obviously not, because he looks across the river and sees the gold standard of shortstops, and he knows how much more he has to improve before he's at the elite level of baseball.

On another note, my personal life is awesome at the moment. I purposely don't talk about it, and I'm not going to do it now. Last year was rough, and I don't think anyone outside of my family knows everything that went on, which was a lot. I don't know what the point of talking about your problems is. Firstly, I don't think anyone really cares, and secondly, if they can't do anything to help you, it seems awkward, like "yeah, that's rough, well good luck with that." If you're world famous doctor or you're best friends with one, I'll let you know and see if you could help me. And when it's going good, I don't want to jinx myself. I suppose if anyone really wanted to know they could find out, but I don't get the feeling people are really interested. It's mostly my own fault, for being very private and never offering anything. But I think I've said before, I believe that when you take something head on and handle out on your own without any help, it makes you into a man. Which is obviously how I have become the manliest person I know.

I dropped off my laundry to be washed and folded today, because I have never done my own laundry and never will (most likely), and the woman made me pay when I dropped it off. This has never happened before, usually I pay when I pick it up, and I don't see what's stopping her from washing them and then selling them, and making a sweet profit. I just wanted to document it so when it happens I can say I told....me so.

You got a banana, you don't need no snack pack

2007-01-29T18:25:00.000-08:00

There are a lot of things I thought about posting but never got around to. There were all very important. So now instead I'm going to post about a very important topic that I've been going over in my head since I started med school. The things that med students do that annoys my to no end.

People who come to class late.....every day - ok, sometimes people run late, car problems, parking problems whatever. There's nothing wrong with coming to class 2 or 3 minutes late. But why do people come 25 minutes late to lecture? Our lectures are available online. You're going to have to watch the first 25 minutes anyway. What's the point of picking up in the middle when you have no idea what happened before? It's like starting a book in the middle. Not only that, but they come in with coffee and a newspaper. I guess once you're 20 minutes late you might as well take the time to make sure you can enjoy the op-ed page with a hot cappucino. And make sure you walk all the way to the front and cross in front of everyone so we can all see how late and careless you are. Oh yeah, and it's distracting to the lecturer and the 100 other people who know how to set an alarm clock.

People who take notes in different colored highlighters - come on now, is this kindergarten? It's not coloring time. Your attention span should be long enough that you can read 5 pages of notes without needing rainbow words to keep your mind from drifting off. Also, I haven't actually performed a surgery, but I don't think the human body is color coded.

People who bring laptops to play games in class - ok, the other 2 can be defended. This just drives me insane. First of all, everyone who's sitting behind you can see what you're doing. It doesn't reflect nicely on your character when you break into the youtube cartoons after 5 minutes of lecturing. Why are you even in class if you don't want to pay attention? Do you think that you're going to learn things by having them diffuse into your brain? You can stay home and do the same thing from the comfort of your home with whatever food, drink, whatever will please you. At least have the decency to sit in the back row so you don't distract people. Yes, I don't have to watch what you're doing. But flashing lights and tapping keys are hard to ignore, especially when you're trying to learn something. Last year, there was a kid during first year who used to watch Ultimate Fighting Championship videos in the front row, in the middle of class. You know where he is now? Still in first year. Honestly, if I ever decide that I don't want to be a doctor and wouldn't mind being expelled, I promise to take one of those laptops and fling it across the room so that it smashes into a million pieces. Then I'm going to sit back down and say to the lecturer "I'm here to learn people. Go on with the chlorophyll" as I wait to be carried out of class by security.

Other things that bother me include people who continue their conversations, loudly, after a lecturer tries to start class; people who ask stupid questions that prolong lecture and get the lecturer off track when no one else in their right mind cares about the answer and it could have just as easily been asked after class when you would have gotten a better answer and not looked like a doofus to everyone else in class; and Turkish people.

Anyway, the main point is that so many people are inconsiderate of other people. Don't come in late and make noise; it's distracting to people who are trying to learn. Don't watch the top 10 fireworks displays of all time on your laptop; it's distracting, and who in the world likes fireworks that much. The highlighter thing, well I guess there's nothing wrong with that actually. But definitely don't be Turkish. And most of all, don't get mad if you fall into one of these categories. Unless you play on your laptop in class. Then watch out.

Besides, we both know I'm training to be a cage fighter

2007-01-14T20:02:00.000-08:00

School has started again. The next 6 months are the most important 6 months of my life. Seriously, like half of med students don't even survive to the end of second year. They die. Fifty percent of med students die because this semester is so important. Those aren't good odds for me.

But seriously folks, the next 6 months are important because they will have a big effect on what field I go into, and therefore on the rest of my life. The second half of second year, culminating in finals and then the Boards, the exam that pretty much determines what field you even get a chance to go into. If you want something good, like surgery, you better do well. We just started getting e-mails about preparing and scheduling the exam, so there is a bit of palpable anxiety at the school that is only going to get worse as the months go on. Personally, I feel no anxiety at the moment. I just started reviewing with a couple other guys, and I'm pleasantly surprised by how much of the first year material I still remember, and how much time it's taking to review. Different people have different things that they're good at. Some people can sit in front of a textbook for 12 hours and learn everything in it. Some people can memorize things easily. I guess the thing I'm good at is learning things and remembering them. Sometimes you take a test and as youre taking it, you start forgeting things that you learned. It's like the material leaks out of your head, and once you're done, you don't remember anything. I hope that my strong memory holds up and helps me for the Boards.

It's also the last 4 or so months of proper schooling for me. The next two years are spent in the hospitals, not in lecture halls. So this is like my senior year of college. I've been in school for like 19 years. I like school. I like getting a binder full of notes and being told to learn them. I'm good at it. I don't know what to expect next year. It's going to be cool to be out in the field doing real things, but it's also going to be a big adjustment. You get graded more subjectively, based on how you think on your feet, or whether or not the doctor likes you. Finally, one time when it will pay off to have female doctors. For sure my charm will make the difference between me and the other dork who knows the same things I do. Looks like everything is coming up Milhouse.

I hope this makes sense

2006-12-20T21:56:00.000-08:00

Don't judge a man until you've walked a mile in his shoes. I make fun of a lot of people, in person and privately, but I shouldn't. Until you've been through what they've been through, you shouldn't act like you know anything about them, and you definitely shouldn't look down on them. I guess I'm guilty of doing that. But sometimes you go through things that make you feel the worst feelings in the world, and I can't imagine doing or saying something to someone to make them feel bad, when you've been to the depths of the deep. I don't really think that makes sense as it's written, but I hope I remember where it comes from when I reread it later on. No, I wasn't made fun of earlier today. This isn't high school stupid.

I try to do the right things for people. I try to be nice, and whenever someone asks me for help or for a favor, I try to help them. Whenever someone needs something, I try to do it for them, and I try to get a feeling for when someone needs something and won't say it, so I can go out of my way to help them. I've always been like that. I try to help other people, and make them happy. Maybe I'm not so great at it, but I try. I've been like that for a long time. I think it's because there have been some times when I've felt miserable, and I don't want anyone else to feel like that. I wouldn't wish those things on my worst enemies. Maybe that's why I want to be a doctor, just so I can help people to feel better from whatevers bothering them. I don't know, 12:30 at night probably isn't the best time to contemplate my future.

I wish other people would consider other people's feelings before they act. I think the world would be a better place. Just think about what you're doing to someone, and why you're doing it. Is making someone feel bad going to accomplish something, besides making you feel like a winner for the time being? Is it worth it to make them feel like dirt? I don't know, maybe for some people it is. I don't think so, and I feel that way more and more as life goes on.

I hate when people say they don't know what they're posting and I don't know if it makes sense and all of that. But whatever, I felt the need to write this down because it's been rolling aorund in my head. I do hope it makes sense to me later on, because it makes good sense now. Think about other people's feelings. Sometimes, you have the power to control to them, so do the right thing.

Long Overdo

2006-12-02T22:19:00.000-08:00

I was going to post, really. But I wanted to keep everything in order, so I was waiting for Halloween pictures so I could post about that.

As many of you now know, I went as Borat, and it was great success. My biggest concern was that someone else would have the same costume, so I purposely didn't tell anyone beforehand. No one else ended up with the same costume. My second biggest concern was that I wouldn't look like him. I bought the wig, which was like Sideshow Bob-like before I trimmed it. Yeah, I stood in front of the mirror trying to give a wig a Borat-like haircut, including the widow peak. I made the moustache with some of the hair that I cut off, and attached it with double-sided tape. That was ok, except I had to bring the tape with me and replace it like 5 times during the night because it was hot. And finally, I went out and bought the suit. That's commitment to my craft.

It went over very well. People were like really excited about it. Some of them mentioned that I should win best costume, not to brag. I didn't win, as you'll see later. But the night was cool, I enjoyed myself, as did other people. Also, I should mention that driving there, and then walking there was fun because it was Nov 3 and I was driving/walking around in a big wig and moustache. It was also the night of the premier of Borat, so I think people who saw me thought I was going to see the movie, and I was some huge dork who dressed up like him to show support. Like one of the Star Wars people that dresses up and waits in line. So that was cool. Anyway, it was great, and I'm happy I put the effort into it.

I have a bunch of other things to post about, exams and such, so I'll keep it in order and pick up where I'm leaving off.

2006-12-02T22:17:00.000-08:00

The man.

2006-12-02T22:15:00.000-08:00

Me and Eric, who ironically enough worked in the same office that I did like 2 years before me.

2006-12-02T22:12:00.000-08:00

Brent, aka Sonic, won best costume. He made it all himself, including the rings, and the big, red, cardboard shoes that you can't see in this picture. If I had a vote, it would have gone to him. Next to him is Konrad, who is dressed as Dr. Parrish, our Dean of Student affairs. If you don't know him, you won't appreciate it, but if you do, it was a good costume. Next to him is Lance, a first year, who's an American gladiator. I'm not exactly sure, but I think they're standing in the order that they finished, from first to third.

2006-12-02T22:11:00.000-08:00

I think there are people who will really appreciate this picture.

2006-12-02T22:07:00.000-08:00

I think it's self-explanatory.

Med School Gangsta's Paradise

2006-10-31T20:45:00.000-08:00

Microbiology - 34/36, 94%
Pharmacology - 44/48, 91%

I've seen the light. I never thought it was possible to get 90s on 2 exams in the same day. As an undergrad, every grade I got was in the 90s. But when you think about it, 90% is very hard to acheive. I mean, you would have to get like 8 out of every 10 questions right. But this isn't 10 questions taken from a chapter in a text book. It's 10 questions taken from a sample of everything there is to know about the heart and lungs. So you need to have studied the right things, understood them, be able to recall them on very little sleep, not make any careless errors, and finally fill in the same letter on the bubble sheet that you circled on the exam. There's a lot of things that can go wrong, mostly in the "study the right things" category, so answering 9 out of each sample of 10 questions is quite difficult. On top of that, you have to do it in 2 different subjects. You can study one subject over and over again and be an expert on it, but to know everything in multiple subject is a feat.

I know people here who honor every class. I had no idea how. I knew they studied more than me, but even when I studied, I still missed something in the notes, or made a careless error on the exam, and my average was consistently in the mid to upper 80s. I thought maybe there was a copy of an old exam circulating around that helped them, but now I know better. I studied for these exams a lot. I still didn't study as much as some people, but I read the notes over and over again, went over them in my head, read textbooks, and dreamed about bacteria and asthma medications. I went into the exam, and owned it. I knew the answers to questions before I even got up to the answer choices. I was writing things in the margin that weren't even related to the question, just because I knew extra things. When I walked out, I thought it was one of the easier exams I've taken here. But it wasn't easy; the averages were 80 and 81.4. It was just easy to me because I knew everything on it.

If I never do it again this year, this will still be an accomplishment, to own a set of exams like I did. But since we're 30% of the way through both courses and my average is above a 90 in both of them, I have extra incentive to do the same thing on every exam for the rest of the year. It's like Michelle Pfeiffer said in "Dangerous Minds", that anyone can get an A once, but to keep an A is much harder. If it's more difficult, then count me in. And as Coolio said in the same movie (soundtrack), "death aint nothing but a heartbeat away, I'm living life do or die, what can I say? I'm 23 never will I live to see 24 the way things is going I don't know." So so true.

I won't pretend to be a politician and only give one side of the story. We had 3 other exams that week, 2 of them serious classes and one of them not so much, and I didn't do as well. Micro and pharm came first, and after all the effort I put into those 2, I couldn't bring myself to keep the same pace for the rest of the week. But I passed, and I'm not in danger of failing. Basically it's honor or pass, so instead of just trying to do equally "well" in every class, I'd rather honor some and just get by in the others. I tried the first approach last year and ended up with 1 honors, and 5 highly satisfactories (generally 87-90), which I think is cool, but I think the alternative is better. Anyway, I hope I don't jinx myself with all this talk about killing those exams. Seacrest out.

You down with PPD?

2006-10-13T18:34:00.000-07:00

We gave each other Tuberculin PPD shots this Tuesday. If you don't know, the tuberculosis shot is an injection of a small amount of tuberculosis protein into your skin. If you have tuberculosis, your body will attack the protein because it recognizes it, and your skin will turn red and bumpy. If you don't have tuberculosis, your body doesn't recognize it, and nothing happens. You may be familiar with it as the shot you get at the doctor's office, usually in your forearm, and then have to come back in 2 days later so he can look at your skin.

I've gotten them before, and I've never been positive. We need to start having them done every year because they need to know if someone who's going to be in a hospital has TB. I don't know what they would do if you tested positive, maybe you would have to wear a radiation suit or something when you interact with patients. What made this experience interesting was that we gave the shots to each other. Some people have probably had experience with this before, although I'm not sure how legal it is for someone who hasn't finished med school to be giving shots. Other people may have other experience with needles. Diabetics - I'm talking about diabetics who have to give themeselves insulin shots.

I have never given a shot to anyone, including myself. I thought it was very cool. The injection goes into the skin, not the blood, so it wasn't very dangerous. I don't think they would have let us do them if we were injecting veins. I tapped the needle to get the air out, I went in, did my business, and got out. When I think of doctors, I think of stethescopes and needles. I've used my stethescope before but not in a real situation, so this was my first "real" experience with either of those things. That's it, there's no joke here.

Next week is exam week. Last exam week I didn't leave my apartment for 4 days. This weekend I only expect to leave once, because I need milk for my Corn Pops. See you all on the other side.

2006-09-29T18:50:00.000-07:00

I got a spot doing research at our hospital. I wish I could tell you what we're doing, but I know half of you have been looking for a research proposal for some time now and would just love to steal our awesome plan. It involves magnets and rabbits, and......no, you must go. I've already said too much.

It's going to be a pretty interesting last weekend of the baseball season. It looks like the Phillies are going to fade during the last series of the year again, but most of the city is already in football mode. I would like to experience the playoffs from a different side, but that will have to wait. I have a friend at school who's a big Dodgers fan, so that's been cool. I don't know if I know any serious baseball fans outside of the New York area, so it actually is cool to get a different perspective on the sport.

I got my playoff tickets, even though no one believes me. I don't think I'm going to be able to make it to any games because I think they're all during the week. I'm going to have to find someone who wants to go, which I don't think will be a problem. Also, for the first time in my life I believe, I'll be rooting for the Mets, because a Subway Series would be very good for someone with World Series tickets, and who can't make the game, if you catch my drift. This will probably last right up until El Duque's first pitch to Furcal next week, but we'll see.

Speaking of the Mets, I must point out how right I was about how frail Pedro is. I said it was too much money, I said it was too many years, but no one wanted to listen. I've won bets each of the last two years because I knew he wouldn't make a normal amount of starts. Now you guys paid him 54 million for basically a year and a half, and you have no idea what you're getting next year or the year after. If this wasn't Pedro Martinez, the most obnoxious player I've ever seen, and the player who has beaten the Yankees one time in the seven years he was worshipped in Boston, I wouldn't be making such a big deal. But on top of winning the bets, seeing him cry in the dugout was extra sweet. Good luck my friend. Maybe next year you'll win a big game. Or at least survive to pitch in one.

(yes I know he won a world series game against the cardinals. it doesnt count)

2006-09-12T16:52:00.000-07:00

There are a few things I want to write about, but I guess I'll stick to my grades in this post. Our first set of exams was last week. From Friday afternoon to Wednesday morning, when our first 2 exams took place, I didn't leave my apartment. Ok, I didn't study nonstop for 4 days, but it was close to it. It's been over a year, but I'm still refining my study techniques. I used a combination of re-watching lectures, reading textbooks, reading notes, and looking at practice questions. At the end of the day, I still felt like there was more studying I could do. Crazy. I ended up with an 89 and an 87, both respectable considering they were the first exams of the year and I had no idea what to expect. Now at least I'm in striking distance of honors or highly satisfactory. Plus I know what to expect in the future, so I think this was a good way to start the year.

After that monstrosity I had to pick myself up and study for Pharmacology on Friday. It's supposed to be the hardest of the three. A lot of people had trouble finishing the exam on time. I was lucky because I had no idea how long we had for the exam (1 hour and 20 minutes for 58 questions) but I looked up with half an hour left and saw how much time I had left, and was able to adjust accordingly. Some people were not as lucky, as is evidenced by the class-wide 78.5 average. All that means for me is that my 90 put me in the top 15%.

So I did the best on the hardest exam, which means I'm going to want to put in the most work in the hardest class to keep my grade high. Which means I'm going to be sitting here memorizing hundreds of drugs for the rest of the year. It isn't so bad because I've been gradually becoming more driven to learn everything and do well in every class. Last year I took it easy in easy classes, but over time I decided to just do well in everything. I know people who gets 100s on many exams, so if it's possible to do it, why shouldn't I aim for it? My only concern is that I may burn out over time, but right now I'm not too worried about it.

2006-08-24T19:02:00.000-07:00

I just got internet access at my apartment. I remember having a lot of things to write about, but now they're all gone.

The school year has started. It's already killing me. All we have right now are three classes, but they're just piling on top of each other. Sometimes I feel like I'm caught up, and sometimes I feel like I'm so far behind I can't even comprehend. Part of it is that I'm not sure what to expect on the tests. The tests this year are supposed to be similar to the USMLE Step 1 exam that all students take at the end of their second year. So I'm studying what they're teaching us in class, but I'm also looking at what we need to know for that exam, and sometimes the two aren't exactly the same. So should I study to do well in the class, or study to do well on the most important test of my life? Ideally I would be studying for both at the same time, but I don't know if that's how it's going to work out.

I don't think it's as bad as I'm making it out to be. It's a little frustrating to study so much and not be sure if you're doing the right thing. I guess we'll find out when I get my score back. If they just gave me a book and told me to learn it, I would. I guess that's the funny thing about this thing we call life. Nothing is ever as easy as it should be, or could be. Actually, that isn't funny at all. That's the tragedy of my next 10 months.

All we've had so far is classes and a few labs. We're supposed to have some trips to the hospital to see some real patients, so that should make for some good fodder. Today I grew some bacteria that I took from my cheek and then looked at it under a microscope. My very own bacteria. I saw a little purple one that had my eyes.

2006-08-06T19:08:00.000-07:00

Here are pictures from the Yankees-Blue Jays game on August 1st, 2006. One of the doctors that I worked for got the tickets from a physical therapy office, gave them to my mom, who then gave them to me. They were box seats behind home plate. Very good seats, although it was very hot. Also, I didn't like sitting behind the net, because I wanted to get a foul ball, which I could have done if I was farther down the line. Also, the people in front of us (Kevin and I), were kind of annoying, being rich teenagers who probably got the tickets because their daddy was rich and they never had to do a hard days work in their life and think everything is going to come easy to them and the world is theirs. One of the parents who was with them, who mentioned to me twice that he wasn't gay, got up to laugh at someone who was sitting in the level above us and missed catching a foul ball with a fishing net. He actually got up, ran down the aisle, turned around and screamed "You suck!" at what I am assuming was a kid. What kind of a tool does that? Seriously. Anyway, they were good seats, but I don't think they were that much better than my usual seats, which are behind home plate but in the upper deck. It was nice to see a new angle, but if you can't catch a foul ball, or be in range for a player to toss you a ball or something, I think all seats are the same, as long as you can see the entire field.

Bobby Abreu's first game, Yankees end up in first place for the first time since June 18th, Bernie Williams tied Don Mattingly with his 442nd career double., and the AP recap says the temeprate was 96.

2006-08-06T19:05:00.000-07:00

Jared Wright started for the Yankees. He went 5 innings,,5 hits, 1 run, 5 K's and got the win.

2006-08-06T19:01:00.000-07:00

AJ Burnett started for the Blue Jays. He went 4 innings, gave up 4 hits and 4 runs, and struck out 3. And got the loss.

2006-08-06T18:58:00.000-07:00

Bobby Abreu's first at-bat with the Yankees. He grounded out to Aaron Hill, and yes he hustled to first.

2006-08-06T18:55:00.000-07:00

Miguel Cairo settles under Vernon Wells' pop up in the third inning.

2006-08-06T18:51:00.000-07:00

Standing ovation for Bernie Williams' first at-bat, when he lined out to Vernon Wells. In his second at bat he doubled with the bases loaded to score 3. I mention this because I wore my Bernie Williams jersey and he had another good game.

2006-08-06T18:48:00.000-07:00

Derek Jeter talking to a couple fans.

2006-08-06T18:45:00.000-07:00

Jeter making a throw to first to end the 4th.

2006-08-06T18:41:00.000-07:00

Jeter stealing one of this two bases on the night.

2006-08-06T18:38:00.000-07:00

Jason Giambi singling through the shift.

2006-08-06T18:35:00.000-07:00

Here's visual proof of A-rod getting an important hit, doubling in Jeter in the bottom of the fourth inning to tie the game.

2006-08-06T18:31:00.000-07:00

Miguel Cairo turning one of two double plays.

2006-08-06T18:27:00.000-07:00

Scott Proctor pitching to Vernon Wells.

2006-08-06T18:23:00.000-07:00

Picture of Kyle Farnsworth warming up in the 8th inning right before my battery died.

2006-07-18T20:04:00.000-07:00

My dad went grocery shopping while my mom was away and bought 2 boxes of Oreos, 2 cartons of ice cream, a carton of milk, and two boxes of Fruit Loops.

I saw Martina Hingis at the airport today. Actually, my dad saw her and pointed her out to me. No bodyguards or entourage or anything. I would have asked for her autograph if we had a pen.

One downside to being one of the only guys at the office where I work is that everytime I go to the bathroom, which is usually just to wash my hands, I have to check the toilet seat to make sure it's clean. Because if I leave it messy or wet, the next person to use it might see me and think I left it like that, and that would be disastrous. I can't explain it any better than that, either you get it or you don't.

The summer is slow.

2006-07-03T18:25:00.000-07:00

Yesterday was a very eventful day. I went to Long Island with my dad to play softball and hang out at my godfather's house with a bunch of family and friends. They play softball every 4th of July and Labor day weekends against the same team. I don't know how the other team knows each other, but whatever characteristic binds them, be it a job or a company or a high school or college, is a clear characteristic for being a tool. More on that later, maybe. I played third for both games, all 14 innings, and boy am I feeling it today. I'm getting too old for this.

My first 6 at-bats, spanning both games, I was 6 for 6. There's a running joke in my family about how my dad always talks about the doubleheader he played in where he was 7 for 8, back when the Jackson Hole team played in Central Park and was part of an official league. Everyone was asking me about it after my 6th at-bat, whether I would break the 25 year old record, and how nervous my dad was getting. I told them if I was 7 for 7 I would strikeout in my last at-bat to keep from breaking the record. Of course, after starting 6 for 6, I went 0 for 2 in my last two at-bats, and the record still stands. My uncle said I was the best kid in the world because I purposely got out to make my dad happy, which definitely wasn't the case. I made some nice plays at third, but I also made some bad ones which always stays with you more than the good things you do. But hopefully I made enough of an impression on them that I don't get made fun of for being one of the rookies who can't hang with the veterans.

The second part of the day happened after we went back to the house. People were just hangining out, eating hors d'evours or howver it's spelled, and someone called out someone's name who was sitting behind me. I'm not going to use names because I don't think anyone needs to know who it was and no one who reads this knows anyone there except me, and to respect privacy. I turned around, and saw the guy slumped over on a bench with his eyes closed and some vomit coming out of his mouth. Now you can be scared when you're alone late at night in the street, or if you're in a fistfight with someone, but being scared because you have no idea what's going on, or what to do is a whole different fear that I've never experienced before. On top of that, no one else knew what to do, and I guess because I'm in med school now I'm the medical expert and people were looking at me to do something. The only thing I knew to do was lay them on their side so they wouldn't choke on the vomit, and try to open their mouth so they wouldn't swallow their tongue. So I did that, while they were throwing up and their eyes were rolled back in their heads, but it felt surreal, like I wasn't even there. In retrospect, I should have been thinking about checking their pulse and their chest to see if they were breathing, and then maybe CPR, but I don't know if I would have thought about doing that if it ended up reaching that point. As it was, he came out of it after 30 seconds and didn't know that anything had happened. I forgot to mention that the one thing I did remember from CPR class was to tell someone to call 911 as soon as it happened, which is weird because I can specifically remember that step of CPR and Ms. Pashkin empahasizing it. So I guess I actually did learn something in high school.

An ambulance came and we ended up going to the hospital, and everything ended up alright. I still don't know what happened. I looked up some things online, and I think it could have been a heatstroke, because we were playing softball for like 4 hours, but I didn't see much about vomiting with heatstroke. The person who it happened to thought it was food poisoning, because they had just eaten some sausage, which is possible but I don't think you would pass out while you were vomiting. I asked my older brother and he said it's possible to have seizures when you're dehydrated, which is also a possibility. The good thing is that all three of those are not chronic issues and he was normal at the hospital. If it was heatstroke like I think, the literature says it's really dangerous and can be fatal if it isn't treated immediately, none of which I knew at the time, so I think we were lucky in a lot of ways.

I don't think I saved this person's life because a) there's no guarantee that he would have choked if he wasn't moved and b) someone else may have known what to do. But I do think that I acted quickly and calmly, and aside from how scared I was about being in the dark about what was going I'm proud of what I did. At the end of the night a couple people commented about how cool I stayed during the whole thing, which sounds good except that's not how I felt at all. The other thing is how quickly it happened. It turned out ok, but it could have been a heart attack or a stroke, and the guy could have died in my hands, just like that. This may not be novel to some people, but I've never had a close friend or family member die, never been to a funeral or a wake, and haven't had much experience with death. While the EMT people were checking him over, I felt like crying because of how close I came to seeing someone die. Of course I didn't because I'm a man and men don't cry, but if you know me you already know that.

I don't know if there's a moral or a lesson to be learned. I did reflect back on how mad I got whenever I missed a play in the field or didn't get a hit, and how stupid it seemed to get mad over something like that after seeing what happened later on. It also goes to show how fragile life can be and how everything can change in a second. This is another thing that other people may have already learned but I haven't experienced much in my life. I haven't changed into one of those hippie people who always "live life to the fullest" and "dance like no one is watching" and "live every day like it's your last." I do think that you should make sure people know how you really feel and not hold gruges, because you may not get a chance to fix the problem. Roger, this is not an invitation for you to tell me that you love me.

And as for the opposing softball team, they're a bunch of tools. I think I've played in 2 or 3 other games, and these guy argue about every call. Plus they're always "accidentally" giving themselves more runs than they actually have. There's nothing sadder than watching a 30 year old grown man throwing a temper tantrum about how they slide in under the tag and they're not going back to the dugout. Oh, and one guy on the other team kept crying because our pitched, my godfather, wasn't putting enough arc on his pitches. He kept saying" it's supposed to be a 12 o clock to 6 o clock drop," then acting like it was a big joke. except he said it like 50 times, and it wasn't funny the first time. Like it's so important to them that they sweep the doubleheader against a team of 4 20 year olds and 9 50 year olds. Dude, there aren't any scouts from the World Softball Team watching our Sunday afternoon game at Mattituck high school.

2006-06-18T20:38:00.000-07:00

These pictures are kind of lame because I only had the camera out for 1 inning. But it's important because we captured Roger's 100th strikeout on film, something he seems strangely proud of. Before we get to that, our team (drafted by Frank), Team Tom, beat Team Hungover, 16-10. I went 3-6 with a couple RBI. I didn't pitch well at all, but the game was close until we took the lead and CJ shut them down the rest of the way. There weren't too many memorable moments aside from Roger's strikeout. I caught 3 innings, the first time I've caught since Little League, and my legs are killing me today. It's hard to get up from a sitting position today. But we won, so I don't care how I fell. Anyway, without further ado.....

2006-06-18T20:33:00.000-07:00

Here's strike 3. No just kidding, I don't know what this was. But you got excited for a moment there, didn't you? Look how great I look behind the plate.

2006-06-18T20:23:00.000-07:00

Here's the momentous occasion, captured beautifully by photographer Brian Jackson. I'm just honored to have had a hand in calling the pitch (fastball), and then framing it beautifully. Yes, it was a swinging third strike.

2006-06-18T20:18:00.000-07:00

The game was delayed for 15 minutes while the league celebrated Roger's milestone, with Roger celebrating the hardest.

2006-06-18T20:14:00.000-07:00

Continuing the celebration.

2006-06-18T20:10:00.000-07:00

Roger demonstrating the form that helped him acheive his milestone. Brian, Kevin and myself demonstrating that we know our numbers.

2006-06-18T20:05:00.000-07:00

Kevin warming up before his inning of work.

2006-06-18T20:00:00.000-07:00

Tom getting a single into right field.

2006-06-18T19:56:00.000-07:00

Leo getting ready to do his Super Macho Man swing. You know what I'm talking about.

2006-06-18T19:51:00.000-07:00

Tommy getting ready to take a cut.

2006-06-18T19:47:00.000-07:00

Tuesday, June 6th, 2006. Yankees take the field against the Red Sox in what will be known for years to come as the game where Melky Cabrera made "that catch" to take away a game tying home run from Manny Ramirez in the 8th inning.

2006-06-18T19:43:00.000-07:00

Bernie Williams hit a solo home run in the bottom of the fifth to tie the game...and I was wearing my Bernie Williams jersey. I'll let you draw your own conclusions.

2006-06-18T19:39:00.000-07:00

Bernie gives a curtain call.

2006-06-18T19:36:00.000-07:00

Drunk fan runs across the outfield.

2006-06-18T19:30:00.000-07:00

Drunk fan gets speared by security.

2006-06-18T19:26:00.000-07:00

This may or may not be the game winning, bases loaded walk to Giambi.

2006-06-18T19:23:00.000-07:00

Rivera came in to close the game out in the ninth.

2006-06-18T19:18:00.000-07:00

Varitek grounded out to first on this pitch.

2006-06-18T19:14:00.000-07:00

Mike Lowell grounds out to end the game.

2006-06-18T19:09:00.000-07:00

Yankees celebrate another win,

2006-06-08T22:38:00.000-07:00

Ok now school is over. I got my final 2 grades, and I managed to not fail Behavioral Science, the only class I goofed off in and almost had a heart attach when I thought there was a chance I would have to remediate. going into the last exam I had 85 points out of 123, which is a 69, and the instructor sent out an e-mail saying people below 92 points were in danger of remediating. So that got me a little worried. I got a 35 out of 40 on the final to finish with a 120/163, and then found out that the cutoff for passing was 107 points, so I was in no danger of failing at all. But he put enough of a scare into me to form a pimple on the corner of my forehead that I affectionately referred to as "Behavioral Science." Until I squeezed the life out of it like I squeezed the life out of that final exam.

The last class of the year was Neuroscience. We went through the entire course, which is pretty big, in like 2 fast paced months. I ended up with a highly satisfactory, which is great because I put a lot of effort into that class, reading the text book and studying some every day, rewatching lectures and making sure I understodd everything. A couple of screw ups kept me from honors, but I'm happy because I decided to try studying hardcore for this and i was rewarded. It's the amount of effort I plan on putting into my courses next year, so I think the results bode well. And oddly enough, Scott and I both ended up getting highly satisfactory in the last coruse of the year.

So I finished with 1 honors, 3 highly satisfactories, and the rest of the classes were just passes. I missed the coutoff for highly satisfactory by less than 1 point in 3 classes, which really annoyed me, but there was nothing to be done. I'm happy with how I did, because I came into med school with very little of this stuff under my belt, and I did better than some people who had taken some of the courses before. I feel good. I'm ready to do better next year, and I'm already starting to review for the Boards, and get ahead in some of my classes next year.

I was working today, at an orthopaedic surgery office, and my first grade teacher came in. I didn't really recognize her , though I thought she looked familiar. When I went to write her a note saying she could return to work at school (she broke her wrist) I saw her name and put 2 and 2 together. I'm sorry, I can't reveal her name due to privacy laws. But I asked her where she worked, and if it was at PS 107, and then told her she used to be my teacher. I said she might remember me because I was probably the kid she remembered as always talking during class and being disruptive. Then I surprised myself by remembering some of the kids that were in my fist grade class. I know I had a good memory, but pulling out kids names that I haven't seen in 15 years was amazing. I even remembered where the classroom was in relation to the school layout. She said she would go look up the picture to see if she would remember. I told her I had a big afro back then, so she shouldn't have much of a problem finding me. Before she left, she did say that she though she remembered my as being very chatty, which I was. All my report cards back then were all excellents in math and reading, and always a "needs improvement" in 2 things; shows self-control and obeys rules and regulations. I would just skip right to those two things on every card to see if I did well, and I would always get into trouble when I saw that I was still a bad kid. And all the teacher comments on the back of the report card were the same every year; something like "Christos is so bright and creative. He always finishes his work early. But he has a problem disrupting other kids and he needs to learn to work quietly." Same thing every year. Which is why I like the name of this blog. I was always smart, really smart, but I was always eccentric and I liked to color outside the lines. There are a lot of things you wouldn't understand about me. Things you couldn't understand. Things you shouldn;t understand. I'm a loner. A rebel. Also, my kindergarten and second grade teachers are both still teaching.

Baseball pictures and subway stories from this Tuesday's Yankees game to come.

2006-05-22T21:58:00.000-07:00

Why I haven't been posting:

Feb 3 - 3 exams, 2 finals
Feb 7 - 2 exams, 1 final
Feb 10 - 3 exams
Feb 20 - 1 final
Feb 28 - 1 exam
March 10 - 2 exams
March 13 - 3 exams
March 20 - 1 exam
March 24 - 1 exam
April 10 - 1 final
April 12 - 1 exam
April 14 - 2 quizzes
April 18 - 1 exam
April 21 - 2 exams
April 24 - 2 exams
April 26 - 1 exam
May 8 - 1 exam
May 15 - 2 exams
May 17 - 1 exam
May 22 - 1 final
May 31 - 3 exams
June 2 - 1 final

Exams every week. Not one of these exams was easy. Ok, maybe 1 or two was easy, but the majority were really difficult. Since February we've been getting killed. But it makes you a man.

I'll be posting more as school finishes. One thing I wanted to mention was something we saw in one of our neuroscience lecteures the other day. We saw part of a video from some robotics company where they had a guy who was paralyzed from his neck down who was moving a cursor on the television screen just by thinking about it. I think it was the most incredible thing I've ever seen, right next to the mice who had their spinal cords cut and then had them healed using stem cells. This guy, who had no control over anything up to that point, was using his head to use a computer, which was controlling like his TV and radio and stuff. They were able to do it by implanting an electrode-type thing into his brain into the area of the brain that is active when you think about doing a movement. So using their research, they hooked up this contraption that would move the cursor on the screen to the right whenever the guy thought about.... well I guess it was when he thought about how he would use his hand to control a mouse to move the cursor. The movement of the arrow on the screen wasn't perfectly smooth, but it was definitely accurate enough to allow the guy to use the computer for whatever it was designed to do. It was really incredible. I noticed that the auditorium was silent, but I don't know if everyone was as amazed as I was.

Think about what you would feel like if you were a paraplegic. Not able to do anything on your own, totally dependent on someone else for all of your daily functions. Not only would you be depressed for yourself, you might feel bad about whoever it was that was helping you survive, and how they had to give up so much just to tend to you. But because of this new technology, people can be able to have so much more control over things that were previously unavailable to them. Whatever you can think of can be applied to this technology. You can use it to move a wheelchair, control the TV, radio, use a telephone....the sky is really the limit. At the very end, they showed how they were using the same thing to move a prostetic hand, specifically using it to make the thumb and pointer finger touch each other, like if you were picking up a pencil or something. That probably needs more time to become useful, but it could eventually lead to prostetic limbs being controled by paralyzed people just by thinking about it. They could feed themselves, read books, and do a whole lot of other things that 10 years ago would have been an impossible dream. It's amazing. At the same time, it's a little freaky, because it's kind of like a step towards making cyborgs or some kind of human/robot hybrid. Anyway, what really got to me was how you can move something just by thinking about it. It was crazy to see.

I'm not even that interested in spinal cord injuries and paralysis, and I don't know anyone who has that problem. It just seems like that's one of the hot things right now in medical research. They showed a lab on 60 Minutes that used stem cells to repair spinal cords that were cut in mice earlier this year, so I think that area is about to explode. Of course it will take time, but within our lifetimes there are going to be incredible options for people with spinal cord injuries, and there might even be a cure one day.

I don't know, it just inspired me to write about it. I was also inspired to take a picture of this huge rainbow I saw on City Avenue later that day, which I'll be posting when I get home.

2006-04-29T19:31:00.000-07:00

Baseball pictures from the last 2 games. I'm not 100% sure where the division between the two games was. I think the first was April 1st and the second was April 15th. I'm sure someone will correct me if I'm wrong.

2006-04-29T19:20:00.000-07:00

Ok so this picture is from April 15th, not April 1st, but it didn't get posted when I originally tried to. So now it's out of order. Anyway, Tom is trying to look candid as he warms up before the game. After Jimmy took the picture and walked away, he kept swinging the bat for like 20 minutes because he thought he was still posing candidly.

2006-04-28T23:21:00.000-07:00

The day and the season started with the first Mark Rubin sighting in many months. April Fools joke? Fortunately for us, no.

2006-04-28T23:20:00.000-07:00

Japan vs. China? Godzilla vs. Mothra? Marvel vs. Capcom? I can't help but think I could come up with something funnier if I took the time.

2006-04-28T23:18:00.000-07:00

I think this was the winning team. I don't know what else. Man it's late.

2006-04-28T23:15:00.000-07:00

Team Big Buckin Chicken. The ball is a cool effect. And I look really fruity.

2006-04-28T23:12:00.000-07:00

Mark being hasseled by the media. His official statement on his past steroid use is "No comment."

2006-04-28T23:05:00.000-07:00

This is Jackson's reaction to Laura's apple and oranges joke, and some kind of odd look on Roger's face. I had posted a picture of Laura telling the joke but for some reason it's gone and I don't know how to go back and insert it.

2006-04-28T23:02:00.000-07:00

More pregame warmups. Here's Jose Lopez in his red aqua dynamic shorts.

2006-04-28T22:58:00.000-07:00

Live action shot. You know what always bothered me? After Lisa left Will at the alter on Fresh Prince of Bel-Air, how come she was never in another episode? It's not like she said she never wanted to see him again. They should have tried to reconcile. She just disappeared, sort of like Aunt Rachel and Judy on Family Matters.

2006-04-28T22:55:00.000-07:00

Tom isn't only a member of the Jason Flynn wooden bat club, he's also the current president.

2006-04-28T22:52:00.000-07:00

Tony Meola made an appearance at the game.