City of Big Shoulders

Tomorrow I'm off to Chicago for more residency interviewing. Tomorrow is also Lady M's birthday, so I'm taking her to Birthday Brunch before heading out. Happy birthday to Lady M!

Paradigm shift

I'm going to be on the road interviewing for most of the next eight weeks, so as you can imagine there are a lot of travel arrangements to make. And many of them are a bit complicated: fly into this city, take a train to that one, catch a red-eye from somewhere else in time for the next interview, all with very limited flexibility in times and dates. I've been getting quite frustrated with the interface options at a lot of the travel web sites; for example, today Hertz.com absolutely refused to let me rent a car for one day only.

So I've been doing something I haven't done for a long, long time -- picking up the phone and calling a travel agent. It started when I spent over an hour trying to book a three-leg plane flight with a limited window of takeoff times, and I just couldn't get what I needed online. So I called the local agent, and five minutes and $35 later I had my tickets! A human being and a telephone.... hmm, I wonder if this new technology has a future.

Dazed. Crazed. Fazed. Malaised.

Took the big board exam yesterday. Have to wait six weeks for results. Very, very tired of multiple choice questions.

Glazed

On my walk to the hospital today I had a chance to appreciate the effects of the latest ice storm to blow through these parts. It was pretty magical: everything, and I mean everything, is encased in a quarter inch of clear ice. Each large tree must be covered with hundreds of pounds of ice; each individual needle on the pines is locked in its own crystalline sheath; even the snow is covered with a thick layer of ice. Walking on it, the crust shatters with every step. The trees make a particularly impressive sound in the wind: a sort of crinkling groan, due to the extra weight they're bearing combined with shearing ice. Watch out for those falling branches!

However, the board exam is the day after tomorrow, so the splendor of Nature must wait while Nerdery calls. Thus, this weather-appropriate quote of the day, from the section in the book on hypothermia: "A patient is not considered dead until he or she is warm and dead; in other words, do not give up resuscitation efforts until the patient has been warmed." And on that cheerful note, it's back to the books.

Busy, busy Cushing

A trend in medical terminology is to avoid the use of eponyms, or "tombstone names" -- a particular person's name given to an entity. For example, one might come across Cushing's syndrome, Cushing's disease (which can be a cause of Cushing's syndrome), Cushing's reflex, Cushing's triad (the classic sign of Cushing's reflex), or a Cushing's ulcer.

Of course, one has to admire the guy. Somehow while doing all that medical research he still found time to play Grand Moff Tarkin in the original Star Wars.

Voluntarily snowbound

Madame L continues to taunt me (but I know she means it in a nice way) with reports of how much better the weather is in the Bay Area than in my frozen neck of the woods.

However. The other day I had parked my car on the street overnight, returning the next day to find it under several inches of snow. It was a wet snow, so all of the windows were covered, including the door windows. I got in to retrieve the scraper/sweeper, but instead, without really thinking, I just closed the door and sat there. It was quiet on the street, like it usually is during a snowfall, and inside the car the snow blocking the windows made for a sort of peaceful twilight. It was very relaxing to sit there for a while in the quiet half light.

Or maybe studying for the upcoming board exam just has me entirely too stressed out.

Snow Train

We got a bit of a snowstorm today and late this afternoon I was walking through it, heading for the library. At one point my path to the hospital complex crosses a bridge over railroad tracks, and I stopped to watch a train going by underneath. It looked quite beautiful in the snow, with a layer of white on each car covering the rust and giving off wispy streamers. The snow was heavy enough that I couldn't see more than ten or twelve cars ahead in the snowfall; the train just melted away into the whiteness car by car. Eventually the blinking red light on the last car was all that could be seen in the haze.

It all seemed sort of symbolic, but symbolic of what I don't know.

Anybody know how to get out highlighter stains?

One week to go until the boards. My fingers and clothes are starting to acquire errant highlighter marks (I never used to use a highlighter) and I'm sporting glasses (I never used to wear glasses).

Earlier this evening I was reviewing syndromes of overdose and withdrawal for various drugs of abuse. Which one presents with headaches, irritability, and fatigue? That would be caffeine withdrawal.

I'm trying not to fixate on the following from Chapter 15, Geriatrics, describing normal changes associated with aging: "...slightly decreased ability to learn new material."

Hey, does anybody remember the signs of caffeine withdrawal? And where's my highlighter?!?

Cheers to you, head-smacking-tagging-bloggers!

Just before my latest round of interviews several people tagged me to list 10 things that make me want to smack someone in the head. Of course, now it's been so long that not only am I lame for not having done it -- if I go ahead and make the list at this point I'll be even lamer, ironically enough. The sheer lameness of it makes me want to smack myself in the head. Sort of a meta-smacking, I guess.

Board Exams

In order to apply for a medical license in the U.S. you have to pass all three parts (Steps) of the United States Medical Licensing Examination (USMLE). I took Step 1 last year, a grueling, all-day testathon that Wikipedia describes as "arguably the hardest and most important examination a medical student will take during his/her career." And that's sayin' something. Made it through that one okay, and now Step 2 is coming up fast. Next week I take the written part of the test (another day-long gruel-a-thon), followed in a few weeks by a full day (in Houston, perhaps) of being observed on video camera examining a string of standardized patients.

So, as you can imagine, my days lately consist of reading Board exam review books, punctuated by sessions of doing practice exam questions, after which I go back and study some more. The big thrill for me is that I just got a new review book. (Sad, no?) Most review books consist of hundreds of pages of outlines, but I'm loving this one because it includes practical, real-world advice. For example, after an introduction to the etiologies of shock the author tells us "Your job is to figure out why the patient is in shock while keeping him or her alive. Give fluids while you're thinking." Sound advice.

Ice Storm

Can no longer see out of the windows on the north side of our place because they're covered with a sheet of ice.

UPDATE: Went to get the mail and found that the front door, which also faces north, was iced shut. Managed to push it open about a foot so that I could slip out to get the ice scraper from the car. Hmm, tonight might be a good night to stay in.

Wintry Mix

As you may recall, I'm a big fan of the nifty forecasting artwork at the National Weather Service website. Today we are anticipating the infamous "Wintry Mix" -- anticipating it, because there's a 100% chance of experiencing it!

Drive carefully.