Back from the Bay

Back home after a delightful few days enjoying the boundless hospitality (and patience) of Madame L's household. Her effervescent charm, excellent cooking, and generosity with early-morning rides to interviews were hugely appreciated. And as a special bonus, she let me take a turn at the spinning wheel, giving me a chance to produce my very first skein! Well, skeinlet, anyway.

On the run

Had a pleasant couple of days with friends and family after getting home from a very encouraging interview in Chicago. Later today I'm off to the west coast for another interview, where I will be enjoying the hospitality of none other than the delightful and talented Madame L. For added fun, I'll be taking a carry-on-sized board exam review book.

Not sure how much posting I'll be doing from out west, so I'll leave y'all with this. Lady M and I saw 28 Weeks Later the other evening. Now, I was a huge fan of 28 Days Later, and I have to admit that I had low expectations for the sequel. Fortunately I was proved wrong -- I thought it was every bit the worthy successor. (On the other hand, I've been known to show more than average enthusiasm for sequels -- long-time pals will remember scuffling with me over Godfather 3.) In any case, this provides me with an excuse to share my all-time favorite Straight Dope article: When the zombies take over, how long till the electricity fails?

Finally, a big ol' mea culpa in the blogging department. I have been failing to link back to folks who have linked to me (rude!), answer tags (lame!), etc. (etc!). But I'll get my act together and make amends when I'm back home next week.

Hitting that dusty trail

Off to Chicago today for a residency interview. Had my first interview about a month ago here at the home base, but this is the start of a couple of months of traveling for interviews and board exams (of which more later). I wonder if I can apply the frequent flier miles to my tuition bill?

Past lives

Swept away by a wave of nostalgia this weekend. First of all, a confession: I had never seen Singles. I finally saw it last night, and when I realized the venue in many of the scenes was Seattle's late, lamented OK Hotel, well, I have to admit that I got a little sentimental. It was filmed shortly before our motley crew moved to and met in Seattle. The whole film was full of bits of Seattle that I remember fondly from those early 90s days, and it really took me back to the feeling of being a twentysomething newly arrived in the city that was the next big thing.

Then at a dinner party tonight I met a guy who was recently returned from years of studying piano at the New England Conservatory. It took me back to my own (much longer ago) days of studying music in Boston, and many reminiscences were reminisced.

After these pleasant memories of the past, however, it's time to look to the future. Which happens tomorrow when interview season begins for real. Stay tuned....

Life imitates blog

Last night Lady M and I went to a party. As we walked in, someone shouted "it's Lady M!" Now the thing is, the only place she's ever been called that is in this humble blog. Which means this online ephemera is having a bit of influence on the real world. I guess I'd better be careful what I call people.

Paging Dr. Gray

Today I got my senior picture taken. (Ahem, that's "senior" as in senior year of medical school, natch....) I got all dressed up in a coat and tie and figured the camera would be loving me. Not so much, as it turned out -- those were some pretty serious bags under my eyes. (Although perhaps someone will work some Photoshop magic on my behalf.) Med school really takes a toll in the appearance department.

But then I thought, maybe this will be a Dorian Gray kind of portrait. As I slog through the stress and sleeplessness of my residency the senior portrait will acquire dark circles under the eyes and a cynical squint, will lose any traces of empathy or exposure to natural light, and perhaps even develop the stooped back of too many 3:00 AM catnaps on a call room sofa. Meanwhile, I will remain perpetually a fresh-faced, well-tanned, idealistic-looking beacon of compassion, while envious fellow residents and admiring attending physicians wonder how I manage to keep that just-out-of-med-school look.

But who am I kidding? My fresh-faced idealistic look was long gone before I even got to medical school. I think my best bet at this point is to try to project a wisdom and maturity gained through hard experience. Or, failing that, try to project a minimal level of wakefulness.

Leaving the 'Lawns

Just finished my last shift in the ER at Broadlawns Medical Center in Des Moines. It's been a great month -- I haven't been able to convey, in my humble blog posts, even a fraction of all the fascinating cases I've been seeing. And the staff here have been friendly, supportive, and dedicated teachers. It's bittersweet to be leaving. On my way out of the Emergency Department a patient stopped me in the hall. I had seen her when she came to the ER, and she was admitted to the hospital. She wanted to let me know how her tests came out, that she was doing much better, and thanked me for taking care of her. I can't think of a more poetic conclusion to my ER rotation.

And now, back to the student apartment to pack and hit the road back home.

Buzkashi!

Hey sports fans! Tom "Danger" Haythornthwaite recently attended a Buzkashi game in the suburbs of Kabul and came away with a spectacular collection of photos (link at the end of his blog post). He's being coy about whether he or someone else ended up with the goat carcass.

Pulling nails

I was an hour late getting off my shift tonight because I was busy pulling out this guy's fingernail. (He had crushed his fingertip and the nail had to go.) Usually when I'm part of the way through a procedure for which the patient has received local anesthetic I make sure that they still can't feel anything. But considering that this guy was sitting and smiling pleasantly at me, I was entirely confident that the anesthetic was working -- even without asking. His daughter, meanwhile, was looking on saying "oooh, this is so cool!"

Bouncing around in my head

A few nights ago I got to do a chest tube, which inspired me to read about penetrating trauma, which led to reading about gunshot wounds. Along the way I found some information about a particular mechanism of injury in gunshot wounds to the head: intracranial ricochet. This phenomenon can explain a discrepancy between the presumed path of the bullet and the patient's actual neurological findings.

I tell ya, emergency medicine never ceases to fascinate. Me, anyway. Other people may have less morbid fascinations.

I just want my Haldol

In the middle of the night a patient comes in to the E.R. requesting a refill of his antipsychotic medication. He's a large man with an angry demeanor and piercing eyes. He says that he ran out of his medication and just needs a small supply for the next few days. He leans over me with a clenched jaw and explains, setting his large bottle of Diet Mountain Dew on the floor, that he gets jittery when he drinks caffeine without his Haldol. At that point I realize I've made a rookie mistake: he's between me and the exam room door. And, of course, we're in the very last room down the hall farthest from the nurses' station. However, we complete the encounter without incident.

Let's get this gentleman some Haldol.