Brigadoon

Posts dated February 29 appear but rarely and then disappear back into the mists of the internet....

It looks like one of the fellow physicians in the clinic will become a father today. He's a bit worried that his child will be plagued with lifelong computerized record-keeping errors. But we're happy for him anyway.

Sticky fingers

And another thing. Public computer keyboards -- say, that you use in the library when you're on call and don't have any other options -- with sticky keys? Ewwww! Seriously, I see (and touch!) a lot of gross things in the hospital, but these snot-covered keyboards are the worst. Still handling that mouse without a second thought? Check this out (if you can manage to click the link using your elbow).

Okay, that's probably enough. I need to go wash my hands now. With soap. Obsessively.

Prisoner's dilemma

After a long hiatus, On-call Liveblogging returns! Yes, tonight I'm on call with the Ophthalmology service. But the stakes are high, because tomorrow is the ophthalmology exam. Med school exams are generally no fun, and this one carries a particularly brutish reputation.

Hence, my dilemma. On the one hand, as a budding emergency medicine doc I would relish a night of being called to the ER for burst and bloody eyeballs, horrific pus-dripping ocular infections, and mysterious cringe-inducing presentations of disease in that most squeamish-making of organs, the eye. On the other hand (and if there's one thing I've learned in medical school it's that there's usually another hand), the big test is tomorrow and I really do need to hit the books. As always, failing one of these tests is easy to do and has dire consequences.

Of course, there's actually very little that I can do to influence the outcome. (Powerlessness, thy name is Medical Student.) But deep in my heart of hearts, what do I root for -- the ER or the library?

And in any case, thus far I seem to be opting for choice number three -- blogging.

Rolling the dice

Today is a big day for folks who hope to start a residency this summer: it's the deadline to finalize the "Certified Rank Order List." Every applicant submits a list of desired residency programs in order from most to least desirable, and every program does the same with all of their candidates. Later tonight, in a secret Dobermann-guarded laboratory under a mountain somewhere, a computer will begin running, assigning applicants to programs. March 20 is Match Day, when we all find out where we'll be going.

Walt, meet Richard

Hmm, seems like watching the Oscars has unleashed my inner film critic.

Several weekends ago the cinematic fare here at the old homestead was Pirates of the Caribbean: At World's End. Talk about glorious, epic messes. It had not one but two beginnings. (The first of which depicts one of the most brutal events I've seen onscreen in a long time -- did they really mean that!?) Within the first 30 minutes not one but two melancholy, evocative musical leitmotifs have been established. And what really got my smarty-pants attention was a sequence where Jack Sparrow is marooned in Davy Jones' locker -- there's as much surrealism and symbolism in that scene as you're ever likely to see in a mainstream blockbuster. The scene's script could have been by Beckett with production design by Magritte.

Then I got to thinking: all of the musical clues to characters' feelings and motivations; the themes of nautical redemption; the stylistic pastiche; the Flying Dutchman -- this reminds me of something. Why, Wagner, that's what! He even based one of his operas on the same seagoing legend. And if Wagner is anything, it's a glorious, epic mess. Maybe it's a stretch, but I was struck by the parallels. And the high-end CG in Pirates of the Caribbean certainly reminds me of Wagner's notorious tendency to come up with stage directions that were nearly technically impossible in his day. As I recall, the libretto of Der Fliegende Holländer ends with the direction that the ship break into pieces, swallowed by the sea, while a couple of characters are borne skyward above it in an embrace of redemption. That sequence would have fit into the Disney movie just fine.

Logically, the next step is Mickey Mouse as Siegfried in the Ring.

Julius Higgins Caesar

Lady M and I recently finished watching all four hours of the 1963 epic Cleopatra, which neither of us had seen all the way through before. Whew! It was a glorious, epic mess. In fact, it very nearly sank 20th Century Fox.

We came away feeling that it suffered a bit in comparison to more recent, more vérité screen portrayals of the story. But we were most unconvinced about the casting of Rex Harrison as Julius Caesar. Of course, this was an age when stars were stars, and were expected to be themselves on screen as much as their characters. Still, it was hard not to imagine him asking "why can't an Egyptian be more like a man?"

(Okay, okay, My Fair Lady came out the year after Cleopatra, so it's not really a fair criticism. But still.)

I'd travel around the world for a residency

Turns out that this is almost literally true. In an idle moment I looked at how many miles I racked up going to residency interviews and came up with the following interesting statistics:

Circumference of the Earth: 24,900 miles
Total miles traveled for residency interviews: 23,089
Ratio of miles traveled to circumference of the Earth: 0.927

In other words, looking for a medical training position I traveled the equivalent of over 90% of the distance around the Earth at the equator. For the truly detail-obsessed, here's the breakdown by mode of transport:

Miles by air: 20,648
Miles by car: 2,052
Miles by rail: 389

And the total costs of all of this? I'm trying not to think about it.

Eye-mergency!

Things were eventful yesterday in eye clinic. Upon hearing the description of a patient's upcoming eye surgery, the patient's spouse collapsed. It caused quite a commotion -- we don't run many codes in Ophthalmology. We got this person revived and up in a chair, when my staff told me that another patient was having chest pain and could I transport to the ER? I stole the wheelchair from the first room and made the delivery. Upon arriving in the ER I found that none other than the director of our EM residency program was staffing -- so I had a chance to chat about the upcoming residency match in the context of some actual on-the-fly emergency medicine. Fortunately all patients' eye problems, loss of consciousness, and chest pain were under control by the end of the afternoon. Today we stuck strictly to eye issues.

Eclipsed

Having carefully considered my dilemma, I opted to face the deep freeze and go outside to see the lunar eclipse. I watched until just before it was full, and it was an astronomical spectacle well worth braving the cold for. Sadly, however, I was robbed of any claim of toughness. As I stood there in my sweater and fleece and heavy coat and long underwear and three hats and two pairs of gloves, a guy came out of the building carrying a tripod and wearing only a fleece -- and no hat! "Watching the moon?" he asked. I was too humbled to reply with more than a mutter.

As fate would have it, cloud cover soon blew in, sparing me any further frostbitten embarrassment.

Colder than an obscene metaphor

Oh, man, it's been cold in the Midwest lately. So cold that I find myself pondering something that's ordinarily a no-brainer for me -- do I go outside to gawk at tonight's lunar eclipse? My friends at the National Weather Service tell me that the temps are heading down below zero Fahrenheit with wind chills around -15 F. Brrrr. On the other hand, it's the last one I'll be able to see until 2010.

What to do, what to do?

Up to my eyeballs...in eyeballs!

Today I went back to a clinical clerkship in the hospital for the first time in two months. Although the last eight weeks of traveling and interviews and board exams haven't exactly been a vacation, it kind of feels like I'm coming back from one. So I started ophthalmology today. I should learn some useful stuff and if nothing else there are only 12 weeks until graduation! I may be a student ophthalmologist now, but I won't be a pupil for long....

Deep in the heart

The last stop on my two-month odyssey was Houston, a city I had never visited before. I went for a board exam that consists of an entire day of encounters with simulated patients, all for the low, low fee of $1000 to take the test, plus airfare and accommodation. Not a very rewarding experience, I thought, but with luck I will be pronounced competent and pass the test (a requirement for various details that are coming up, such as getting a medical license).

However, I did have some time to take a quick look around Houston. And it was a very pleasant surprise! Everybody I met was unfailingly friendly and helpful. Although I didn't find too much in the way of distinguished architecture (admittedly I didn't have much time to look) I thought the city still has a distinctive character. On my night off I found a Mexican restaurant where I sat on the patio enjoying the tamales compuestos, watching a lightning storm while sprays of warm mist blew under the awning, and drinking bottles of beer that came wrapped in napkins -- it had a satisfying Gulf Coast feel, especially considering the blizzard conditions waiting for me back home. And on my way to the airport the next morning (Hobby Airport, with its charming 1930s-era control tower, not the grandiosely-named George Bush Intercontinental Airport) I even found time to stop off at the Johnson Space Center for some nerd tourism.

Back on the blog

I'm back from my last trip of the residency interviewing season! No more canceled flights, waiting in airports, random-model rental cars, or worrying about arriving at my destination with a wrinkled suit.

Of course, after nearly a week in southern California and Texas (where I took another board exam, of which more later), I had to deal with the seventy-degree temperature drop of returning to my icy midwestern home. I try not to be that blogger, the one whose posts consist largely of quoting other folk's online musings, but I came across the following and it struck home. (And to my Minnesotan and Canadian readers: yes, I know you have it even worse.)

Cold Enough For Ya?

60 above zero:
Floridians turn on the heat.
People in IOWA plant gardens.

50 above zero:
Californians shiver uncontrollably.
People in Iowa City sunbathe.

40 above zero:
Italian and English cars won't start.
People in IOWA drive with the windows down.

32 above zero:
Distilled water freezes.
The water in CEDAR RAPIDS gets thicker.

20 above zero:
Floridians don coats, thermal underwear, gloves, wool hats.
People in IOWA throw on a flannel shirt.

15 above zero:
New York landlords finally turn up the heat.
People in IOWA have the last cookout before it gets cold.

Zero:
People in Miami all die.
IOWANS close the windows.

10 below zero:
Californians fly away to Mexico.
People in IOWA get out their winter coats.

25 below zero:
Hollywood disintegrates.
The Girl Scouts in IOWA are selling cookies door to door.

40 below zero:
Washington DC runs out of hot air.
People in IOWA let the dogs sleep indoors.

100 below zero:
Santa Claus abandons the North Pole.
IOWANS get upset because they can't start the Mini-Van.

460 below zero:
All atomic motion stops.
People in IOWA start saying..."Cold 'nuff fer ya?"

500 below zero:
Hell freezes over.
IOWA CITY public schools will open 2 hours late.

Watching the skies

I was due to fly out this morning for one last interview tomorrow, but it's snowing, snowing, snowing and two of my flights have already been canceled. Let's see what my good buds at the National Weather Service have to say about local conditions at the airport:

"Hazardous Weather Outlook
Winter Storm Warning
This Afternoon: Periods of snow with areas of blowing snow...Blustery, with a north wind between 17 and 20 mph, with gusts as high as 28 mph...Total daytime snow accumulation of around 4 inches."

Hmm, that doesn't sound promising. Oh, and my airline's online reservation system has, unsurprisingly, crashed. So far today I've been routed through Chicago, Dallas/Ft. Worth, and St. Louis. I wonder what city I'll be in tonight?

Carnival!

Carnival just started in Rio and the samba schools have been marching. And where do they march? In the Sambadrome, that's where! What other venue has a name as cool -- and apt -- as the Sambadrome? (Or, if you prefer, the Sambódromo.) And designed by monster centenarian of Brazilian architecture Oscar Niemeyer, natch.

Four things, eight times

Since I failed so miserably last time, this time I'm living up to my Melinda June-inspired tag obligations:

Various sets of four things about me that you may or may not know in no particular order

Four jobs I have had in my life:
1. house painter
2. taco slinger (Taco Bill's, anyone?)
3. music copyist
4. laboratory research assistant

Four movies I would watch over and over:
1. 32 Short Films About Glenn Gould
2. Spirited Away
3. South Park: Bigger, Longer and Uncut
4. Tremors

Four places I have lived:
1. Decorah, IA
2. Boston
3. Seattle
4. Asmara, Eritrea

Four TV shows that I watch:
1. The Sopranos
2. Breaking Bad
3. The Office (UK version)
4. The Office (US version)

Four places I have been:
1. Churchill, Manitoba
2. Qing Dao, China
3. Cromer, Norfolk (UK)
4. Agordat, Eritrea

Four of my favorite foods:
1. Pella bologna
2. injera
3. rice pilaf
4. Tombstone Supreme frozen pizza

Four places I would rather be right now:
1. Where the grass is greener.
2. Close to you.
3. Under the sea in an octopus's garden in the shade.
4. Philadelphia, on the whole.

Four things I am looking forward to this year:
1. April in Veracruz.
2. Finishing med school.
3. Starting residency.
4. Finally having an income again! (see #2 and #3)

Mush!

Just back from an interview in Chicago. On Thursday the trip, usually four hours, took eight hours because of heavy snow. Saw many potentially nasty accidents; at one point I thought I saw an oncoming car that turned out to be the headlights of someone who had done a 180 and was stuck half in the fast lane, facing oncoming traffic. Made it to Chicago in one piece but it was snowing again in the morning, so hard that I was half an hour late to my interview. (The program people were very understanding.)

In general Chicagoans drive well in the snow, but at one point I wound up behind a dude in a Lexus with vanity plate Big Gear. Sadly, Mr. Gear's only snow driving strategy seemed to be to step on the gas. I watched him spin out and careen all over the expressway, at one point fishtailing into a line of oncoming snowplows. Fortunately he regained control just in time and my nascent trauma management skills were not put to the test. I have to admit, it's the most exciting trip to an interview I've had yet.

(Many thanks to B and Cali for their hospitality.)