Minh Ba, medicine and the midwest

New home

2007-04-14T10:25:00.000-05:00

Since I've posted the blog of that last home that I wanted, that deal fell through, and I've been scrambling with trying to find a new home and getting all the mortgage paperwork approved. Actually, the deal never really happened, I offered, he countered by saying he's not budging from his price and was unwilling to pay any closing costs, so I had to back out. It wasn't a bad price for the house, but for what the property was valued at, I would have lost money on the resale. Unfortunately the guy who flipped the house got bad advice, bought a cheap property in a not so valuable neghborhood, and then put in too much money into it. If I had purchased the home, it would've been the 2nd highest home in the neighborhood at $120,000 the 3rd highest was at $75,000...too much of a difference. So I went back to Tulsa two more times by myself to lookfor homes, and had everything narrowed down to four. Salwa drove down with me on her way home to Arkansas last weekend to look at the houses and give me a second opinion. We stopped by the home I offered on earlier anyways, because she wanted a look at it, and on the way out there were several people staring at us strangely. Apparently it was the new "owner," he said that they hadn't put up a sign yet, but he had purchased it. I found out yesterday that the home offer fell through for him also, because the realtor called mine to see if I was still interested. My answer..."too late."

I put down on a contract last weekend, and was up there yesterday for inspections. Just a few minor things to get taken care of my the seller, but overall, the inspectors were really impressed with the condition of the home. The closing date is May 8th, and I'm stoked that this home hunting is almost over, it has been quite stressful. The house is bigger than the last one and has an attached garage, which is a plus. It has 2 bedrooms with an office (can count as another bedroom to make it 3 because it has a closet), and one bathroom. The house is in a decent neghborhood, it was also flipped by the seller, but the neighborhood value is much better and will be good for resale. It is only two blocks away from Driller's stadium (minor league team for the rangers) so that's kind of nice. I tried taking some pictures, but for some reason I was a little retarded with the camera, and they don't do the home much justice, so I combined the pics with some of the listing realtors.'

Front of the house

View of front door entrance into the kitchen

View of front door entrance into living room

Living room with faux designer fireplace
(Kinda gay... but what can you do?)

Close up

Dining room

Kitchen

Kitchen view 2

Bathroom sink

Bathtub/shower

Master Bedroom with entrance into office/sun room

Office/sun room

Backyard

Backyard/toolshed

Backyard/firepit

Back of the house

Back of the house facing the office/sun room

Grady's Anatomy

2007-03-24T21:41:00.000-05:00

If you get a chance to watch an hr long special on CNN called Grady's Anatomy, you should give it a shot. It will be on tommorrow night (Sunday) at 8ET. It covers the lives of four real medical residents, one of them graduation from my school last year and is now starting his surgery residency at Grady Hospital in Atlanta. Not quite as drama filled as Gray's Anatomy, but definitely a good 1hr schpiel to check out.

Europe advice

2007-03-22T13:32:00.000-05:00

I will be heading to Europe, specifically Italy, Switzerland, Prague and Southern Germany for a month after graduation. I am in charge specifically of looking up stuff for Southern Germany, but any advice on places to go, things to see or where to stay, or travel advice in general would be nice. Since every one of you guys seem to have traveled the globe after graduation, I thought I could elicit some help.

House hunting and mortgage woes

2007-03-21T14:24:00.000-05:00

So I spent the last weekend over St. Patty's day looking for homes in Tulsa. After burning through nearly 30 homes, I'm spent. I narrowed it down to about 3 or 4 homes, with 1 that I thought was promising and 2 that are real nice, but maybe a little too far away from work.

The house I found is a small bungalow that is 5 minutes from the hospital, 1200Sq ft or so, with 2 bedrooms and 2 baths. Here is my dilemma: the seller is asking $120,000, which is definitely not bad, but I called the county assessor to verify a few things, and they told me that the house was purchased a year ago at $34,000 and now has been valued at $60,000. The owner claims that he did $50,000 in renovations, and it definitely looks nice, but I don't want to pay too much if I can't unload it in 5 years when I leave. On top of that, the bank won't lend me more than the appraisal value. It is also on the high end for houses in the neighborhood, with the majority selling from $60-$75,000.

Here are a few pics of the house:

The next step I guess is to make an offer, but I have to figure out the whole mortgage thing. I'm trying to apply for physician loans, because I don't have any income, these loans are the only ones that will allow me to have no down payment, and will let me close up to 60 days before I even receive a paycheck. Problem with this is that most of them require some combination of a credit score of 700. Some will take the middle number out of the three credit bureas, an average of the three, or just use the FICO score. My FICO score when I check a month ago was a 683, with various discrepancies on my credit report. I have fixed it with transunion and experian, but equifax is really starting to piss me off. Both the Transunion and Experian scores are above 700 but my Equifax score is at 640, and is what is killing me. For some reason, my credit report from them has no activity on all my accounts, it was like they are too lazy to gather any of the information. It is impossible to find a number or way to talk to someone from Equifax, so I have placed disputes online, and now I'm just crossing my fingers and seeing what happens. Has anyone else had problems like this or any idea of what I can do?

My timeline is closing in. I need to be moved by the first weekend of May, so that leaves me about 2 weeks or less to find a place and get things rolling.

I can't wait till this crap is over with and I'm hanging out in CA with everyone. This blows.

March Madness

2007-03-14T20:14:00.001-05:00

It's that time of the year again, when the brunt of my spare time from Thursday to Sunday will be spent glued to the tube. I am taking part in 4 different brackets this year, one that I'm doing just for fun, and the other three in hopes that I might actually make some money this year. One bracket is with Schaefer and peeps from back home, which he e-mailed a few days ago about splitting the winnings and making 50% go to a charity, specifically the Leukemia and Lymphoma society. I think this is a great idea, and with so many people running office pools, we could fundraise so much money for charity if everyone donated a portion of the tournament pool money. The other two brackets are with the orthopedic clinic and the anesthesiologists at the hospital. An interesting stastic that I heard on the news is that American companies are projected to lose nearly $4billion in wages and productivity from distractions caused by the NCAA tournament. I know that the next following weeks, in clinic and in the OR, we will definitely be slowed down. My attending joked today that turnover time is going to be ridiculous for our Thursday and Friday surgeries.

This year I had intended to go to the final four, when I won tickets through the NCAA lottery, but with all the expenses I've accrued this year with traveling and the upcoming Europe trip, I had to pass, and instead had to sell my tickets. My $200 investment turned into a $1000 profit, so I'm not too terribly disturbed.

On other news, I ran a 4 mile early St. Patty's day race last weekend and finished at around 45 minutes. Pretty piss poor for most people, but damn good for me.

This weekend is the start of house hunting. I'm going to head down to Tulsa on friday to start the search, hopefully I'll have a good idea by the time I leave on Sunday, by miracle maybe I'll find a home before I leave.

Hope everyone is doing well. Have a fun and safe St. Patty's day, and hopefully I'll see most of you guys in a month for Meathead's wedding.

Happy New Year

2007-02-18T19:19:00.000-06:00

Chuc mung nam moi! To all that may not know, today marks the beginning of the year of the pig. I hope Shaefer and Davis are having a good time celebrating the new year in the homeland, it should be a blast. There is really not much to do out here in North Carolina for Vietnamese/Chinese new year (They should just lump it together as Asian New Year), so I decided that I would go to the Duke vs. GTech game instead. Obviously since my prior prediction of the Husky's game was erroneus, I decided that I would just keep my mouth shut in deciding beforehand who might win this game. It was somewhat of an interesting game to attend. It was one of the few games in the last 11 years that the Bluedevils weren't ranked in the top 25. The other game was earlier on this week against Boston College. Go figure...I arrive at Duke and they lose four games in a row to get dropped out of the top 25. More importantly though, was that it was Coach K's 700th win. He has been at Duke for 27 years! Longer than I have been alive. Most people didn't realize it until the end of the game, amidst the mad rush to get out, the announcer halted everyone for an important message, to present coach K with the game ball for his 700th win.

The game itself was a great experience to have. I went with McCarthy since Uhlman and Devo were too busy studying for their test on Monday. We crowded into the grad student section about 8 rows back from the basket. The entire game consisted of nonstop cheers. A few consisting of, or ending with, "eat shit," but most of those were directed at North Carolina...even though we weren't playing them?!?! Who knows...probably for the same reason that most of our cheers involve a "fuck wazzu." The atmosphere was great to be a part of. Cameron indoor isn't that big, and when all the ticket holders are seated, they let in all the standby fans in for free to completely fill the house.

Game time

2007-02-17T12:46:00.000-06:00

I am going to call it now before the game starts: UW 76 - Pitt 72. The loss to Washington St. still pisses me off, I think we could have won the game if it wasn't for Dentmon. We should be able to pull this one off if Dentmon and Appleby can play with out sucking. Anyways, I'm headed to watch the game with Uhlman and McCarthy at a friend's house, so I thought I would just throw out the wild prediction.

The education that we receive

2007-02-15T17:39:00.000-06:00

Today I got a chance to talk with Victor, a radiology resident from Madrid, Spain. He is spending the last three months of his medical education over here in the states learning radiology from the physicians at Duke. We had some down time today so I talked to him about several things, including trying to get some advice for my Europe trip after graduation. I figured that because he's from Spain, he has probably traveled to Italy, Switzerland and Germany....the places I plan on going. Unfortunately, it appears he mainly stays within the confines of Spain. Strangely enough, when I asked Gauthier about Europe, for someone that grew up in Madrid, he said the exact same thing. You would think living that close to each other you would spend time exploring...but maybe that's just an American thing. Luckily when I mentioned the possibility of going to Ibiza (with little Shader) his eyes lit up, and he insisted that he get a chance to write up some great clubs and beaches to go to while I am there. Of course I couldn't refuse. I tried throwing around Schaefer's name too, since it's a household European name by now, but Victor doesn't pay much attention to poker, so it was useless.

After I tried to get some traveling tips and ideas from him, I decided to ask about the medical education process in Spain. It is very different from how things are set up here. In Spain, right after highschool, you take a standardized test to get into medical school, this counts for 50% of your acceptance criteria, the other 50% coming from your grades. The medical schools as well as law schools all function like this, with no intervening "undergraduate" requirements inbetween. These grad level courses are also public institutions, with the tuition being roughly about $500 a credit, which is basically nothing in comparison to what we pay in the US. After 6 years of medical school, you take another standardized test, this time it counts for 75% of your acceptence criteria to get into a residency program, the other 25% again from your grades. With these results, they rank you in order (all the medical students in the country) and you take turns choosing what specialty and where you want to go. Once the specialty or residency position fills up, you are out of luck.

I wonder if that system is any better than the one we have in the US. We also take standardized tests, and our grades are utilized, to get us into college, but this is just to get into an undergraduate college. Again you take more tests, the MCATs or the LSATs, count the grades, and throw in the interview and essay, and you have the graduate level entrance. Is that really necessary. It seems like in other countries, people know what they want at an earlier age. They decide their careers by the time they are done with highschool. In the US, we have 5th year seniors in college still "undecided" of their majors. Why is this so different? Is it the quality? India is very similar in having highschool graduates take exams and go straight into medical school. They have some of the best physicians and engineers in the world.

Is it then our culture? I say all the time, that I wouldn't give up college and that it is where I have grown up the most. It also wasn't until college that I decided on what I wanted to do. But would that change, if there were greater pressure to decide earlier?

In these other countries they are often into the working world helping, treating, serving before they are 30. Here in the US we seem to place an added emphasis on more and more education. At first all you needed was a highschool diploma, then you needed a college degree and then a masters. Even with orthopedic surgery, you need to specialize now in order to differentiate yourself from the rest. Why have we placed such an emphasis on spending so much time to receive what people consider "a better education?"

It's official!

2007-02-12T11:56:00.000-06:00

Today my future became clearer, at least for the next 5 years. Today was the osteopathic match for intern/residency programs. I opened my e-mail today to this:

"To: JIMMY B. DANG -
This message provides you with your Match result for the AOA Intern/Resident Registration Program for positions beginning in 2007.
Congratulations!
You have been matched to:
Institution: OKLAHOMA STATE UNIVERSITY MED CTR
Program: CMB:T/ORTHOPEDIC SURGERY""

So it looks like I'll be staying out in the midwest for 5 more years, but you can count on me coming back to the NW as soon as I'm finished. Now it's on to house/condo searching...anyone have $125,000 to loan me?!?

North Carolina

2007-02-05T19:49:00.000-06:00

So I lied about blogging about NY last week. I was lazy. I will do it sometime soon, but I just started my rotation today at Duke. I am doing a month in Musculoskeletal Radiology to hone my skills of reading plain films and MRIs. So far it has been really good, there is lots to see and many good lectures to take part in. I lucked out and arrived the same week they have a week long lecture series on Musculoskeletal MRI put on as continuning medical education (CME) credits for local physicians. Being a student, I pay nothing for the lectures, I just get to sit and absorb. I am very impressed so far; Duke has an amazing medical centerwith over 800 beds.
It is definitely nice to be out here with some familiar faces. I'm staying with Devo at his place this month. Last night when I got in, we went to Uhlman and McCarthy's place to watch the superbowl. It was great to see them, and I'm sure I'll be spending much more time with them soon. Not too many plans so far but to attend as many bball games as possible and explore North Carolina. I've got one game lined up, since Devo managed to round up two tickets to the Duke/Wake game. We have other plans to go to Raleigh and see a NCState game and maybe a UNC game in Chapel Hill. Just the kind of things I need to do to prepare for March Madness. We might even throw in a trip to D.C. one of these weekends and maybe even the Kritsonis can come down from his lair in Virginia Beach. That's all for now, another update soon. I promise...really....I do.

I'm back...sort of

2007-01-25T14:55:00.000-06:00

Allright....since everyone else seems to be blogging more frequently than me, I promise to update everything soon. I am on my way out of NY either tommorrow night or Saturday early morning I will start the long drive back to Missouri. I have a week in-between my next rotation out at Duke, so I will use that week to prepare for my next rotation and recap my month in NY with plenty of blogs. I've got lots of pics and stories to recap so I'll break the month up "Boyd" style, so it'll be easier to digest. Hope things are going well for everyone, and I apologize to anyone that I mentioned possibly coming back in March to rotate in Seattle. Unfortunately, the physician I was trying to set things up with informed me recently that he won't be able to accomodate me. He has other committments that month (mainly traveling with the Mariners for Spring Training). At the same time that news hit, and I started to worry about not having a rotation in March, I received notification today that I have one set-up with a local orthopedic group within walking distance of the apartment that I'll be staying at. So it looks like after North Carolina, I'll be finishing up my year in KC for three months until I graduate in May. In between I have a few trips planned...mainly weddings and then post grad --> Europe --> the real world.

What in the hell with all these ads?

2006-12-28T11:14:00.000-06:00

It's called I'm broke...so now I'm shamelessly advertising. So click on the links at the top and right hand side of my page and pay for my education.

Random pics

2006-12-27T20:00:00.000-06:00

I picked up a few old pics of my family and I, scanned electronically when I was back in Vancouver, so here they be along with some recent ones from last weekend:

Little Jimmy and Julie

All grown up

Pops handling my weight

A little harder to handle now

The family in the early 80s

The family now

Group of cousins picking on me and my pimp Eskimo outfit

A little older

Most recent photo of the group (4years ago)Family

The clan back in the day

A decade later (Check out my dad, Mau, the prankster taking center stage of the photo)

The Longest BLog Ever Written

2006-12-27T19:39:00.000-06:00

This may be the longest blog ever written (at least for me it will be), but my flight to Minneapolis from Portland is 3½ hours long and I forgot to bring any movies, so I’ll just draft this blog up while I have the spare time. I apologize in advance for the length, but if you are bored at work, it will give you something to do, maybe something to learn, and maybe something to reflect on.

First off, I hope everyone had a good holiday with their family, and are getting pumped for the New Year. I’m usually pretty indifferent to New Years Eve and all the random festivities that accompany it. I feel like at this point in my life I would rather be spending it at home with close friends (damn this getting old and getting lame). A few days ago I thought about the most memorable New Year’s Eve that I had. It was probably the New Year that was spent down in Pasadena for the UW vs. Purdue Rosebowl game in preparation for the year 2001. I remember the details vividly, everything from spending the evening with Inoue and Blum at the LA Sports Arena and Coliseum where we rung in the New Year, “raving” to our hearts content; the next morning as we wandered back to the hotel to hear the stories of drunkenness (mainly Shaefer) that ensued during the night; and of course the game, which we were able to enjoy watching UW run all over Purdue. Curious to see what New Year’s Eve memories you guys have that you would consider the most memorable. This year will likely be another one for the books. I will be in Times Square celebrating it with a few friends and thousands and thousand of strangers corralled between the busy streets of NY. Not sure what to expect, I’ve heard from many of the NY locals that it sucks à you’re stuck in one place for 7-8hrs, with no food/drink/place to pee; but hell you have to try it once in your lifetime, right?!? I’ll be sure to post many pictures of the evening, and my month in NY. I leave tomorrow for St. Louis and then Friday I will start the drive with Jill to NY. Although everyone thinks it’s crazy that we’re driving, it’s only about a 14hr. drive per Mapquest.

I don’t have any pictures electronically on file so here are a few favorite pics/memories from New Years in 2004 and 2005:

Inoue’s place to ring in the 2004 New Year

Me, Green and Mike (2004)

Mike, Me and Inoue (2004)

Still one of my favorite pics from the 2005 New Year

Now to backtrack, my blog flow sucks, but I’ll quickly recap my “winter vacation” home and the horrors of flying during the holidays. Originally, I was supposed to fly home to Vancouver last Friday on the “GREATEST” airline ever…that would be Northwest Airlines. I’m sure you have heard me bitch about it before, and how I’ve sworn off flying this horrendous airline, but again low fares and a nearly empty pocketbook, keeps me coming back. Anyways, the original flight was to go from KCà Minneapolis (Northwest’s main hub) à Portland. Unfortunately, the whole Denver fiasco sent a ripple through the rest of the flight world, delaying the transport of planes and/or crews to their desired destinations. So with my wonderous luck, I decide to check my flight status before leaving the airport, relieved to see that it was “on-time.” The minute I arrive to the airport, the flight is listed as delayed for two hours for a minor technicality: lack of an aircraft. The two hours left me with a whole 1 minute window to catch my connecting flight to Portland. I am a quick…but not that quick. As I waited to see if the Minneapolisà Portland leg might be delayed, the KCà Minneapolis leg kept getting delayed further. It got delayed so long, that the incoming flight crew would not be able to fly out at all that night due to a mandatory rest period. This left me with no option but to reschedule to see if I could get out the next day, one of the busiest flight days: two days before Christmas. I was able to sequester a flight the next day through Midwest to San Antonio for the first leg and then from San Antonioà Denver à Portland on United. At this point I didn’t care about all the connections, I just wanted to get home. Since we are discussing flights, I do have to give props to Midwest. It is probably one of the best airlines that I have ever flown. The airplanes are very roomy and the service is very excellent. That leg was no problem. The newest problem arose in San Antonio, as I was to board the United flight. Apparently, the Northwest ticket agent screwed up the reservation for me and when I reached the ticket counter 5 minutes before the flight was to take off, they did not have a seat for me. So my luggage thus was headed to Portland, and I was to be stranded in San Antonio for the night. Luckily they provided me with a hotel room and some cash for food, but it still was a pain in the ass. Two days down, and still not home yet. The next day (third times a charm) I finally made it home.

One more gripe about Northwest Airlines, on the flights back to KC, I was reminded again of their stupidity. Both flights were with rather large aircrafts and for the most part were entirely booked. Who then was the smart one on both flights that decided that the best way to board the plane was to say, “Now boarding all rows.” Genius. Pure genius. It took at least ½ an hour each time to load the plane.

It was good to see my parents and my sister and her fiancee. It has been a long time since we have all been home at the same time. I was pleasantly surprised to see everyone get along real well. I think my mom is warming up to him, over dinner I even heard her teaching him some Vietnamese sayings.

The new family addition

I missed our annual family get together, due to the flying fiasco, to remember the passing of my grandparents; that was on Saturday night. But on Sunday was a gathering at my aunt’s house to introduce my cousin’s new fiancée, so I was able to catch up with most of my family members then. It was good to see everyone, but I feel so much like an outsider now at these functions. It’s hard to explain, but I don’t really feel like I belong there. A. I don’t really know any of the little rugrats that are running around; what their names are or even who they belong to. B. My Vietnamese sucks, and although I understand it pretty well, speaking it is a whole other thing. With my older relatives, they always give me a disappointed look when they speak to me and I can only reply back in really broken Vietnamese or in straight English.

Pictures from the shindig:

My mom and her little brother

My aunt Binh and my cousins Richard (engagement party and father to be) and Caroline

Me and my aunt

Monday morning we exchanged gifts…or more like I accepted gifts (It doesn’t count for an exchange if you don’t provide any gifts yourself). I got the usual cash for a Christmas present from my family (this year they finally stopped writing “from Santa Claus;” funny how Santa has always shared a checking account with my parents), something I can definitely use at this time. My sister gave me a bunch of random things, but my favorite gift was the little Vietnamese coffee maker ½ pound of Vietnamese coffee from my uncle’s coffee company that she brought back from her trip last year to Vietnam.

Another highlight of the trip was getting to see my parents’ new computer shop. They had converted one of our rental homes into a little workshop. Things have been going real slow for them in the first three months. I keep trying to figure out a way to make them more marketable or help them advertise, but I’ve been drawing a blank as to what do to help out. They’re goal is to see how things go at least for a year, and if things don’t start to pick up, they’ll probably just rent out the business property to a real estate or insurance group. I think the new business venture is good for them. Although it is not very profitable, with their “retirement” it keeps them busy and they have fun doing it.

Computer shop from the outside

Mom at her desk

Dad doing his thing

Overall it was a good trip, nice to see the family, and nice to get some time to relax in a familiar setting.

Last, but not least, I wanted to reflect on a death that occurred yesterday, a day after Christmas, that of President Gerald Ford. I wanted to take a moment to contemplate on his life and noteworthy events , not only because I have been on a recent history binge, but also because I had the pleasure of meeting him a few summers ago, when I participated in a medical student program at the Betty Ford Center in Rancho Mirage, CA. They hold an annual picnic at the Betty Ford Center and I met him and his wife there as they were serving food in the buffet line. Flanked by two secret service bodyguards on each side, President Ford and Betty were more social and energetic than adults half their age. I remember him joking with each person as they passed through line, and taking a concentrated effort to make each interaction unique.

If you could care less about history, then you can probably just skip the next few paragraphs and jump to the end. What we are taught in our clinical years through medical school, is to look up the information on the interesting cases/patients that you are presented with or are responsible for, that way the information will stick. Along the same lines with history, I feel that is important to know about significant events and people in history that have worked to mold the place in which we live today. Taking that medical school approach, I have decided with major events, I will research them as they are presented, to ensure that I can grasp a better understanding of the issues and become a well-rounded person when it comes to national and worldly topics. Hopefully it won’t sound too much like a 5^th grade autobiography report, but no guarantees. I have to give credit where credit is due; most of the information comes from Wikipedia. I condensed the 22 pages of information on the site to make it more manageable. What amazes me the most about Wikipedia, which relies on its own readers to provide, update and correct the information, is that although President Ford passed yesterday, there is already a few paragraphs written about his passing.

Some quick background information:

Gerald Ford was the 38^th president of the United States. He was in office for one term from 1974-1977. Succeeding President Nixon and was then followed by the president I was named after, Jimmy Carter. He was the only president in U.S. history to not achieve the position of President or Vice-president through an election. He was appointed to the vice-presidency in 1973 under the 25^th amendment when Vice-president Spiro Agnew resigned and President Nixon nominated Ford to take his place. Only a short time later, President Nixon resigned amidst the Watergate scandal allegations, and Ford was sworn in as President.

Significant events during his presidency:

· Withdrawal of U.S. troops from Vietnam in Operation Frequent Wind

· Pre-emptive pardon to President Nixon for his role in the Watergate Scandal, which many believe was the driving factor to why he lost his re-election bid to Jimmy Carter

Relationships to current political figures:

· Selected George H.W. Bush to director of the CIA

· Named Donald Rumsfeld as 1st Chief of Staff and then youngest Secretary of Defense

· Dick Cheney was chosen to follow Rumsfeld as new Chief of Staff, and was also the campaign manager for Ford’s attempt at re-election

· In seeking re-election, Ford dropped his former Vice-President Nelson Rockefeller for Kansas Senator Bob Dole

And some other notable or just random points:

· The longest-lived U.S. president, passing Ronald Reagan’s record just over a month ago on November 12th (93yo).

· Gerald and Betty hold the record as the longest-lived first couple at 93yo and 88yo

· Only president whose parents have been divorced

· Played as a center for the University of Michigan football team during their undefeated seasons in 1932 and 1933

· Had offers from the NFL (Lions and Packers) but turned it down to go to law school at Yale.

· Washed dishes in his fraternity (DKE) during college: Joe Hoover as the next president?

· Joined the navy after law school in response to the attack on Pearl Harbor

· Mrs. Ford battled breast cancer, alcoholism and addiction during Gerald’s presidency

· Appointed to the Warren Commission to investigate the assassination of JFK

· Covered up the assassination details to support the single bullet theory by altering the location of where the bullet had entered as it struck President Kennedy

· Vaccination program was instituted in an attempt to prevent a suspected swine flu plague in the 1970s. 25% of the United States population was vaccinated before the program was cancelled. The vaccine was blamed for 25 deaths; more people died from the shots than from the swine flu.

· Ford faced two assassination attempts during his presidency (within three weeks)

· Ford passed on the 34^th anniversary of the death of President Harry S. Truman

Feel free to pass along any other facts or events that you found significant in President Ford’s lifetime. I am always open to learn new things or clear up any misinformation I might have.

Alas, although yesterday marked a day of loss, it also marks a day 26 years ago, in which a large Puerto Rican meathead and his brother were removed from their mother’s womb and were brought into this world. With that I want to wish Mike G. a happy 26^th birthday and everyone else a wonderful New Year!

Tis the season

2006-12-17T16:53:00.000-06:00

I'm usually in a better mood over the holidays, but for some reason this year feels a little different. I don't know if it's because I'm still not sure of where I'll be next year, where I want to go or if I really have a choice to make. Nothing really jumps out at me as the definitive place where I should spend the next 5 years of my life --> which will take me through to the ripe age of 32. Kind of depressing that I'll be in my mid-30s before I really get into the real world and "start" my life.

I finished my last interview this week, and although I felt real confident (statistically I have a 4 out of 33 chance/300+ applicants but only 33 are interviewed) the whole "match" does not work in my favor. The whole premise is that the last interview, although it is probably one of the better programs, can only be utilized as a "back-up" for me if all my other options fall through. I could chance it and try to rank it, but then I'd lose out on all the other spots, and if I don't get it, I'll be left with nothing. It is a little complicated, and would be too long and boring to explain, so I'll skip the whole thing. Basically this entire process blows.

This month has been pretty laid back with my physical medicine and rehab rotation (PM&R). PM&R encompasses many different areas including inpatient patient rehabilitation for orthopedic procedure/problems, traumatic brain injuries, etc., electromyography(EMG)/nerve conduction and pain management. The clinic I am at does mainly pain management, my physician specifically does the EMGs and nerve conduction studies as well as various injections. The plus side is that I am not there for that many hours in the day, but the days drag on forever, and can be quite frustrating dealing with these patients. Maybe I have a low tolerance for people that complain about back pain and knee pain and they weigh 400lbs; instead of exercising they would rather the doctor "fix" them with narcotics. It blows me away. Half the time I just wanat to yell at them to suck it up and quit bitching, but that's not really kosher for the medical student to say to the patient.

The physician I am with is a very knowledgeable doctor, not only about medicine, but also business and worldly affairs. So on our down time, it's not so bad when we can just kick back and talk about non-medicine things. Which brings me to my latest focus with all the time that I've had recently--> history. It's amazing how much I have forgotten about the world around me and how it has come to the state of affairs that it is today. What sparked the interest was going to the Harry Truman museum/library here in KC with my little brother (Kendale - not sure if I've ever mentioned him before, but he's my "little brother" for the KC big brother program, kind of like what Rau did in college; some people say we are related, with his dark skin and afro puff).

Kendale w/cornrows

Kendale w/o cornrows

Anyways, the museum was a reminder of many important points in american history. Truman served in World War I, was president during World War II (including placing the order to drop the atom bomb), and set precedence for the events of the Cold War. He grew up just outside of Kansas City, and returned there after his presidency where he is now buried. After I left the museum, I realized that aside from American Histroy, I know very little about my own family history and that of the Vietnam War. Over the last couple days, that is all I've been reading and somewhat "preparing" so when I go home to the Couv on Friday, I can clear up "american accounts" of the Vietnam War, with that of those that lived and breathed it...my mom/dad/etc. The more I read about it, the more fired up I get, and part of me even becomes angry. It's hard to explain, but has so much similarities now with the war that is going on in Iraq.

Speaking of going home, I'm excited, and wish I had more time. It's been over a year since I've been back. It means a lot that Dook brought up the idea of possibly coming down to the Couv and visiting for a few hours. Last year Dook and Schaefer came down for a few hours around the same time before I went to my yearly family gathering. Wether he and others make it or not, it doesn't matter, the thought itself means a lot.

I'll be home this friday night until tuesday early morning...and I mean EARLY morning (1:00am is the flight out of PDX). I'll be in KC for two days and then I'll drive to St. Louis, where I'll leave my car and exchange my gear into another vehicle and drive to NYC with Jill to prepare for the New Year and my month in NY.

Well...enough of my babble for now; if by chance I don't get to post another blog soon because I'm just plain lazy....Happy Holidays.

Happy holidays

2006-11-28T10:58:00.000-06:00

I hope everyone enjoyed their time over Thanksgiving, with family or where ever you were. I was lucky enough to spend time in North Dakota with my "second family," which gave me a good few days to relax, which I haven't seen in months. Since I last blogged I was on the interview trail. I finished my rotation up in Michigan and started another orthopedic surgery rotation down in Oklahoma. In the meantime, i had a few more interviews, one in Riverside, CA where I had a short chance to visit with Bellomy and one in Oklahoma where I was at. I finished that up a week ago, drove back to KC and flew out for the holidays. Now I am in New Jersey for an interview that I have tommorrow. I got into Philadelphia last night and drove to a high school buddy's house in central jersey, whom I haven't seen in probably 6 years. He moved out to Jersey from WA a year and a half ago to help his dad open up and run some Jewelry stores. Look for their stores to dominate the NJ/NY area in the next couple years (Ashton & Grace). It was definitely good to see him and catch up with old memories. Tonight I will drive back to the Phily area and stay with some friends from medical shool, whom have a place closer to my interview site tommorrow.

I could really care less about this interview tommorrow, which will probably be good, cause I'll be more relaxed. I booked the flight and interview over a month ago, and my interest level has decreased greatly since then. The most likely places I will end up for residency will be either in KC or in Oklahoma. That will be at least another 5 years in the midwest, most likely 6 if I decide on a fellowship. So sadly, I won't be headed back to the sunny NW anytime soon, but my plans have not changed as far as future goals to end up back in WA.

At the end of the week, I'll fly back to KC and start a physical medicine and rehabilitation rotation, which will be beneficial for me if the physician does orthopedic rehab. I'm not really sure what type of rehab he does, but I chose it cause it's near the holdays and a block from the apartment I'll be staying at. Most importantly with all of this is that I'm done with all my months of ass kissing and scut work. The remainder of the year I can relax, and learn what I want to learn only for the sake of learning.

Lastly, I have some short future plans if anyone else is interested in joining me and some other peeps:

1) New Years in Times Square - I'll be in NY for January doing a rotation
2) A Duke basketball game in February - I'm trying to set up a rotation at Duke so I can kick it with Devo and Co. (I know you want to go Mike)
4) Back in Seattle!!! (most likely) --> I need a home for the month
3) Europe - specifically: Italy (rome--> cinque terre --> venice) --> Switzerland --> Austria --> Czech Republic (prague) --> Germany (munich and southern germany) . The dates will be May 21st --> June 16th; I am traveling with two other friends from medical school, and they will be leaving the 11th, so I'll be traveling by myself for the last few days or so. I might go to Weisbaden and visit Brando's adopted brother Cliff

That's all for now.

One down...two to go

2006-10-19T14:56:00.000-05:00

I just got done with one interview for an internship/residency slot just outside of Cleveland and I'm camped out at a Panera south of Clevelend in a town called Masillon, just two exits off where the NFL hall of fame is located. It was suprisingly a very relaxing interview, but getting to the place was a whole different story. My goal was to leave yesterday and cut out of surgery around noon, unfortunately that ended up not being until 4:30 before I could take off. The time wasn't too bad, because from Grand Blanc it's only 3 and a half hours to Clevelend. But with my luck and traveling, something always has to go wrong. 45 minutes out of town and I get stuck on a two-lane freeway, moving a whole 100ft in over an hour. There was no where to pull off, and everyone around had no clue as to what was going on except they were all just pissed. I called up Jeremy, my old roomate who's also out in MI, and he passed on the news that a semi had overturned on that freeway spilling gravel everywhere. After 2 hrs and the tow-truck came as well as the clean up crew, I was finally on my way. Total time: 6hrs to destination. Horrendous.

Bastard Driver

When I finally got into town and checked into the good ole Comfort Inn, I couldn't stop laughing at the room that i got. The room had a king sized bed, a small couch, and really old appliances everywhere, but the kicker is how it was arranged. I have never seen anything like this, but from the bathroom you could walk through the tiny bath tub (or "jacuzzi") through a octagonal window into the living room. It's hard to explain, so below are some pictures (maybe someday I'll get a condo like this....what a great idea):

The Octagonal window can be accessed either from the bathroom or the living room (basically, I brushed my teeth in the bathroom--> rolled into the shower to bathe myself--> rolled myself out the other window onto the couch to dry myself off--> and then rolled over the nightstand onto the bed never once touching the floor)

This tub was made for midgets

Midgets with style, but midgets nonetheless

I felt like I should've put on some disco music, got into my bath robe, broken out some champagne and invited hookers over for a shin-digg...I dunno, maybe that's just me.

So for the whole interview process, I arrived there at 7:00 for the morning fracture conference (presentations were done by the students and the attendings discussed some x-rays from the past week), we ate some breakfast, got a tour of the hospital and then had our interviews. We got interviewed by the program director who was an orthopedic surgeon and the medical education department head at the same time and then after we had to decipher a case presentation that the chief resident presented. The case wasn't too difficult, and my thought process was correct, but I still managed to screw up part of the analysis...but I think he got a good sense of how I think, which was basically the purpose of the case.

There were three other students that interviewed today; they are doing a large first round of interviews of 30+ students, and then narrowing it down to 8 for the second round which they will then axe the rest down to the two available spots. An aside random note...I asked one of the other students about what he did inbetween college and medical school because he told me that he had taken 7 yrs "off." Oh...nothing big...just a little MLB baseball...well sorta, he was drafted by the Yankees in the 3rd round in 1995 and played a lot of minor league ball for several years, not quite sure if he ever played much in the majors. Anyways, I got bored and looked him up...here's the only baseball card I could find of him:

So now I'm waiting to check into my "apartment" they gave me for the night for my interview tommorrow morning. After that, depending on what time it gets done tommorrow, I might go check out the Hall of Fame and then drive back to the Detroit area. I have one interview around those parts Saturday morning, and after I should be completely burned out of interviewing....so the next logical step is...to drink. If it finishes early, I'm going to head down to Ann Arbor to watch the Michigan vs. Iowa game, Debbie is from Iowa and I had promised her a few months back that I would go down there to try to get tickets with her. Hopefully I won't get beat up in the process at "the Big House" since she'll be wearing all Iowa gear and rooting for her team. On Sunday the goal is to go down to Comerica and try to scalp tickets...although I might have to sell my kidney for one. If we can't get tickets, we're just going to go watch the game at a nearby bar. I got one week left in MI, and then back to KC for the weekend, where I"ll be watching the Chiefs and Seahawks with Shader, Kenny and his dad.

Sports and the Humor in names

2006-10-14T16:02:00.000-05:00

I love the weekend...nothing like sitting in front of the TV and watching football and some baseball. I've been toggling around channels to watch the Iowa and Georgia upset. Now I'm tuning in to the Tigers and A's game, hoping, yes I'm actually hoping for them to lose. Don't get me wrong, I want them to make it to the World Series, but if they lose tonight, they'll be playing at Comerica tommorrow afternoon, which will give me time to venture to downtown Detroit. I would've tried to go to the game today, but I'm on call for any cases that might come up in the hospital today. Sure I don't do much in the cases, but when you're trying to impress people in the program, you have to sacrifice your weekends (at least that's what I've been told by some residents, so I guess I won't try to look like the slacker). I already went in this morning for a hip fracture that was relatively easy to fix. It was broken near the neck of the femur (an intertrochanteric fracture), so to fix it we simply placed a rod down the shaft of the femur (called a gamma nail) and put a screw across the femoral neck to the femoral head to compact the fracture site. All in all, the procedure takes about 20-30minutes. Here is a picture of what the final outcome looks like:

Illustrative view of the gamma nail

Radiograph of the Gamma nail implanted

For the rest of the day I'll be stuck in front of the tube, and doing some preparation for my interviews next week, creating a presentation on ankle fractures, as well as some studying for cases next week. Thank god, there are games on all day.

As for the title of my blog...I was checking the score to the Arkansas game and noticed that they were destroying Southeast Missouri State. Since they were dominating so much, the backup quarterback to Mitch Mustain was in for a few plays, and his name is Casey Dick. Too bad that he wasn't playing when they were up against USC earlier this year...cause then it would be Dick vs. Booty. Get it...ha...get it...funny...i know. The other good matchup I remember was when the Yankees earlier this year were playing against the Blue Jays and it was Wang vs. Bush. Damn...just hilarious...there are your random thoughts for the day...out do that $#!t.

One more thing...do all asians look alike?

2006-10-12T14:34:00.000-05:00

Forgot to ask a question...one of the residents last month said that I look like BD Wong; the guy that plays a psychiatrist on Law and Order: Special Victims Unit and I a preacher on Oz.
See for yourself, I see no resemblance:

Good lord it is cold....

2006-10-12T14:04:00.000-05:00

I've decided it's about time to do a quick update of what I've been up to. Since my last blog at the end of August, I started my chain of orthopedic surgery rotations. Last month I finished off in Kansas City; which I really enjoyed my time there and would be happy if I got chosen to stay there for the next few years. I interviewed on the last week that I was there, and could say that I was pleased with how it went. It was a little wierd packing up what little I owned, and start driving to Michigan. But alas, now I am currently in Grand Blanc, MI (20 minutes NW of Detroit), and I have been here for two weeks. The hospital that I am at is very nice, the first day that I walked into the hospital I thought I was at a large hotel; there is nice grand piano that greets you as you enter the foyer. It is a relatively new hospital and houses 350+ beds. It also has two seperate surgery floors, the top surgery level is the orthopedic and cardiovascular surgery floor, and the floor below it is for the general surgeons.

This is a picture of the hospital that I took off their website, I will try and take some pictures of it on my camera soon, so you can get a better idea of how nice it looks on the inside

Overall, the program here is excellent, especially with didactics. It is associated with Michigan State, and they are pretty involved with many of the other programs across the state. Similar to the Kansas City program, they take 3 new residents a year, which makes it a little stressful in applying to these places. The only real downside I've figured out so far, is the weather. It just started snowing today, and it's cold as b@lls in the middle of October.

In other school related news, I went to Philly in the middle of September to take my physical exam boards, which was definitely a waste of money. We had to fly all the way out there, spend $1000 to interview 12 "patients." Hopefully I passed; it was definitely one of those tests where you leave feeling one way or the other: either I did really well, or I completely bombed it. Although, the weekend itself was definitely nice to hang around Philly and see some of the sites with some friends.

These two weeks here in MI, have been busy with getting used to the hospital, studying for my written board exams that I took yesterday, and preparing for interview season. Aside from the KC interview, I have two near Clevelend, OH next week (Thu and Fri), one in Morena Valley, CA in the beginning of November, one in Tulsa, OK while I'm there and one in Stratford, NJ at the end of November.

No big plans for this weekend, but to work on some homework and presentations; I might also take some call for the weekend and volunteer to scrub some surgeries. I was going to try and go to the Tigers game, since they'll be playing on Fri/Sat/Sunday (possibly), but I think I'm going to save my money and try to hit up the World Series instead next week.

Next stop in two weeks is to Tulsa, OK for a month and then back to KC. I'm going to stop on my way down to Tulsa in KC, to try and catch the KC and Seahawks game with Shader and some of his friends.

Sorry for the random brain dump of things, I'll try and update my blogs more often, but make them shorter...so that's the plan for now...I'll try not to slack off.

Fun day in the OR

2006-08-31T18:25:00.000-05:00

I "saved" this post from last Thurdsday, my last day of OB, and I was going to elaborate on the interesting stuff I saw and participated in on my last day...but unfortunately I'm stacked on time, so instead you get some pics below...and explanations of the cases/surgeries to come later.

Monochorionic (one placenta) diamniotic (two amniotic sacs) twins with twin-to-twin transfer syndrome delivered by C-section:
basically the one baby is hogging all the blood and nutrients from the other, so to ensure that both their survival they were delivered earlier

Cervical spine; not apparent from this picture representation, but our patient had two herniated intervertebral discs (the light blue between the vertebrae above) C5-6 and C6-7 levels leading to compression of some of his nerves

To relieve the pressure on the nerves from intervertebral disc compression, the intervertebral disc is removed the space is filled in with an allograft (bone from a cadavar; usually bone from the hip bone)

Finally it is stabilized with a metal plate anteriorly

Here is what it can look like on MRI; the arrow is pointed at the herniated disc. The "gray" between the two "white" lines is the spinal cord; the "white" lines on each side represents the spinal fluid and should be continuous, but you can see above that the disc bulges into the fluid and impinges on the cord

Pictorial example of what a herniated disc can look like

The last case I scrubbed on was a laminectomy of two lumbar levels. In this case, the neuropathy (nerve problem) was due to a narrowing spinal canal (where the spinal cord runs). To relieve the pressure off the spinal cord, a decompression is done through a laminectomy; basically, a window is cut from the back of the vertebrae to air out the cord and give it room

That's all I have for now. I started my orthopedic surgery rotation on Friday, and I've been pretty busy since. The hours suck....not used to getting up at 4:00, but luckily my roomate has to get up the same time, and he doesn't get home until 8:00 or 9:00 at night. The remainder of my immediate schedule consists of being on call this weekend, flying to Philadelphia for a test next Wed through Sunday, and starting up my 2nd from last MBA class.

C-Sections....and Slooooooooooooooowness

2006-08-30T18:13:00.000-05:00

Holy crap...I'm dyin here...miraculously, somehow my blog and even myspace for some reason today got through the hospital computer internet block, don't know how, but works for me cause I am bored. First the good news, sort of...I got an interview invitation at an Orthopedic Program in OH. It's in a city called Massilon, which is between Columbus and Clevelend. I haven't set up a date yet, but the crummy part is that I just came from OH last week, so now I have to fly back out and spend some more money I don't have. Oh well...I'm hoping to put the interview off for a little bit if possible, in case I get another one out there in OH, so I don't have to make several trips. But overall, I'm stoked, cause it means at least I have a chance somewhere.

In other news...last night before I left we had a C-section delivery for a breech presentation. I was waiting on her all day to deliver...but the baby just would not progress any further, so the physician grabbed me to help him for a C-section. A good thing about not having this be a planned C-section...well not for the patient...but for me...was that I got to be first-assist. Normally all of the OB/GYN physicians work in tandem, leaving the student...that would be me...doing little but retracting the bladder...and staying out of the way. With such short notice, the physicians aren't able to have their partners come and help, so they are left with the low man on the totem pole...the lowly student. The C-section went successfully, I was a little worried at first, because it took some time for the baby to move around and cry, and actually looked a little lifeless for several seconds after the delivery, but it wasn't too long, before it started flopping around and crying. Strange enough...this morning we had only onoe delivery scheduled. The patient was to come in the morning and we were to give her some Pitocin to induce labor. Unfortunately, this baby was in breech presentation also, so again, she was brought to the OR for a C-section, and again...I got first dibbs to assist. But since that C-section...ohhh...at 8:00 this morning, I've done nothing but study ortho stuff. I've been confined to my "office" trying to study, and now I just want to peel out my eyeballs. Some genius thought that for this rotation the students should stay until 7 every day, even if nothing is going on, just in case, something miraculously shows up.

Anyways, I guess I should explain a little aobut breech presentation. Presentation for labor simply specifies what part of the baby is headed out first. Normal presentation is with the head presenting first, also known as vertex presentation. In addition normal is also with the occiput (back of the head) facing anterior.

When the baby presents butt first, it is considered a breech presentation, making it much more difficult to be delivered vaginally. Breech presentations occur in 2-4% of pregnancies. There are variations to the breech presentation, but the baby we had yesterday was a complete breech, and the one this morning a frank breech, with its feet up by its ears.

There's your damn education for the day.

Almost game time

2006-08-29T19:41:00.000-05:00

So I made it back from Ohio in one piece...it was definitely not a vacation... in an effort to impress or be seen as much as I could, I had to sacrifice any sleep or opportunity to explore the city and surrounding areas. I did get a good glimpse of the program, and I can tell that they are very strong didactically and they see a ton of cases. The first full day I spent, was in the OR from 7am until 9pm, watching 12 or so cases. The second day was pretty much the same in terms of how busy they were. The last day I was there was spent in clinic to see the other aspect of the program. I was amazed at the efficiency of the physician and his staff. In 8hrs, he saw a little over 70 patients, but none of his exams seemed rushed. He was a very good physician, had good repor, explained everything to his patients, including x-rays and the results of their operations and was able to do an inclusive musculoskeletal exam all within several minutes. At the same time he was able to ask me questions and do some teaching along the way. Overall it was a good trip, as far as really getting a chance to know people, it was difficult. With 15residents and 7 orthopedic surgeons, and only three days, I did my best to meet them all, and then I concentrated on just a handful to spend more time with and hopefully they will remember me. The bad news is, that statistically, the chances aren't that great. Last year they had 75 applications...12 interviews...all for 3 slots. So...I'm hopeful, but as always, I'm going to spread my seed everywhere (that wasn't meant to sound bad...but it just does) and apply to 20+ programs. An alternative if I don't get in this year, is to do a rotating internship year and then apply to the 7 orthopedic programs that only take intern applications.

Thursday, I had to get back into the grind of things with OB. Of course, the first day back was extremely busy. I assisted with a C-section and 3 vaginal deliveries. Friday was much slower with only a few GYN surgeries, and Labor and Delivery was slow upstairs in the hospital, so I decided to lounge around the OR, and try to see some other cases. Luckily, I was able to scrub in on an odontoid fracture (part of the C2 vertebrae of the spine, shown below) with a neurosurgeon. He was very good at teaching me stuff and letting me do a lot also. Having met me only once, he still let me do some cutting, cauterizing, and then left me to close up the incision. The case was interesting and rather rare. He stated that he gets one of these cases maybe in a year or two. Most of these cases happen in situations with great trauma...in this case it was a very elderly man, that slipped and fell in church.

The fracture that the patient had was the type II fracture, which is the most common. This is a view of the anterior surface of the C2 vertebrae as if you are looking straight at someone who is facing you. The C1 vertebrae sits on top of the C2, and because it is shaped as a ring, it pivots on the odontoid of C2 (the pointy thing that looks like a head and neck). With a fracture through the base of the odontoid, there will be a lot of instability between the two vertebrae. To fix the problem, a screw was drilled from the left base of the C2 body through the head of the odontoid that had fractured off. It was a neat case to see, and since I have two days left and he has surgeries on Wed-Fri, I'm hoping to scrub a few more spine surgeries.

The weekend was pretty lame, I mainly studied. I start my string of orthopedic surgery rotations on Friday for the next three months, so I've been trying to review a lot of stuff, so I can look somewhat smart. I'm a little nervous...but I know it's game time...and if I want to get into any of these programs...I'm going to need to work my @$$ off.

I do have a roomate now for the remainder of the month, which is kind of nice. Dan, one of my classmates (who went to school at West Valley with Uhlman/Peaches/Steele/etc) is doing urology here in town, so he moved in with me to Salwa's apartment...so it was good to have someone to rattle of the days details with.

That is all for now...I will try for one blog a week...mainly on weekends...that is my new goal...

Destination unknown.....ruby ruby ruby soho.....

2006-08-18T22:14:00.000-05:00

Yeahhhhhhhhh....I made it to Ohio... so far another state uncharted by the Dang. These next couple days should be interesting, hopefully I'll have time to explore the best of what Ohio has to offer. Well...I Just got in, picked up my pimp @$$ rental car the Chevy Cobalt (Sure as hell doesn't beat the El Camino that Sarah took me to the airport in today)...and now i've sorta settled into Jake and Kirin's condo in Columbus. I will have more details on this "trip" later when I get back to Kansas City on Wednesday (Maybe earlier if I get some extra time this week), but it's getting late and I have to be at the hospital in Dayton by 6:00 tommorrow...so I think this calls for bedtime.

Enough already

2006-08-10T22:27:00.000-05:00

Well, it's been two weeks...and I'm pretty much tired of the whole baby/vagina/uterus stuff. Sorry...after a few vaginal deliveries/C-sections/hysterectomies...I'm pretty much done. The actual procedures itself aren't that bad. In fact, the days down in the operating room (OR) go by quite fast, it does get old...but it's the closest I've been to an OR in a few months, and it can be quite refreshing. The deliveries on the other hand suck, because there is so much sitting around and waiting. I've tried to master the art of predicting the time in which the babies will deliver...but that doesn't always work as planned. The things I look at on the monitors, is how much the cervix has dilated (full dilation is at 10cm) and the station; station refers to the position of the presenting part of the baby (head/arm/etc, whatever is coming out first) in relation to an anatomical imaginary line in the female pelvis. The OB nurses usually go in every hour or so to check these two parameters by doing a manual exam and then they document it in the computer. Supposedly, the approximate rate is 1cm of dilation per hour, but that never really happens. For instance, two days ago, I sat in my "office" and was lounging around, because the patient was only dilated to 4cm; 20minutes later, the little bastard popped out, and I missed it all....I probably should have gotten an idea that something was happening when the stampeding herd of nurses ran by...but I thought...nah...couldn't be...she couldn't have dilated that quickly....boy was I wrong. To contrast that, on the same day, I went into the delivery suite when a patient was dilated to 10cm and ended up standing there for over an hour before the baby finally came out. It took forever because the woman had a small vagina and the baby's head was huge...it rivals Shaefer's dome. Then for one last example, today when I got to the hospital at 6am, one patient was dilated to 2cm, by the time I left at 7pm she was only up to 6cm....so you just never know.

I did come up with a small theory I've been discussing with the other student that is with me. He was commenting on several of the nurses and how, outside the hospital we would never really find them attractive, but somehow on the "inside" we do. Strange?!?! Well, my theory is that we develop "hospital goggles," similar to the familiar "beer goggles" that everyone is aware of, but instead of the opposite sex looking better with an increasing number of alcoholic goodness, the level of attractiveness is instead directly proportional to the number of hours stuck in the hospital...ie. 13hr work days...makes the 34wk pregnant nurse...slightly appealing....I know, I know....just ridiculous...and the 6-8cups of coffee really doesn't help either. Anyways...enough of that.

Lastly, I just wanted to make a comment about all the stuff happening about the terrorists and their plots that has been all over the news today. I am amazed at how long it has taken people to start accepting the reality of our times and how many more acts like these or attempts that we will probably see in our lifetime. Sadly, this is the fear that many overseas have lived with daily for decades...it just that we have been blinded to it all. As successful as today was in thwarting the plot...it still doesn't make me feel safe. It won't take long, before the security gets lax again...and people start to forget. I'm not sure if the purpose today was at all to simply cause mass destruction...or if it was just to continue causing disorder in all our lives...if that is the case, then they have surely succeeded.

Oww

2006-08-01T21:48:00.000-05:00

My arm hurts...I forgot to mention yesterday that I got a tetanus shot too for the hell of it. You should get one every 10 years and most people were required to get it at the age of 15 during HS. I wasn't sure when I received the shot last, so I got it anyways. If any of you remember what the shot feels like afterwords...you'll probably remember that it is like a charliehorse that never goes away. I am annoyed...my L shoulder is throbbing.

So...aside from that, I started my first day of OB/GYN today. It wasn't too bad, today was mostly an introduction day, and things were really slow in Labor and Delivery. I will be in Labor and Delivery again tommorrow and then after that, me and the other student will alternate between that and GYN surgeries in the operating room. We had one whole delivery today, and it happened really quickly. During our orientation, we heard someone yelling about a delivery. I ran into the delivery suite looked at the woman on the table, and saw her pushing and screaming. Not much of the baby could be seen at this point, and the nurse told me to glove and gown up. It probably was less than another minute for me to gown up and then glove up, but when I looked up, the baby was already in the doctors hand's. Normally for first pregnancies, moms will push for at least 1 to 2 hours, somehow, this woman did it in less than a few minutes. Aside from being suprisingly quick, it was also suprisingly clean. I have heard so many horror stories about deliveries with amniotic fluid, blood and feces flowing everywhere...luckily my first experience was not that. It's amazing to see the process of bringing the baby into this world, and I can see how people would enjoy this as a profession. Unfortunately...I could never see myself doing this.

The hospital and rooms themselves are very impressive. The suites are basically modeled after hotel rooms, and creates a very relaxing atmosphere for the patients.

Besides the delivery for the day, the rest of the day was spent studying. We are required to be at the hospital every day (minus weekends...thank god) from 6am to 7pm. If there is nothing going on, we have to be studying, or at least appear to be, because the doctor comes by to make sure we are doing something and not skipping out early. Hopefully the rotation will pick up, because busy rotations go by much quicker.

Now I have a whole two hours to finish my paper on Germany's healthcare system. But before then...I have to get on a little soapbox about the paper. Many of you already known how our healthcare system is composed and how we pay for our care; we basically purchase insurance to cover the majority of costs, and for those that can't afford it, the elderly and/or the disabled, are covered by medicaid and medicare. In Germany, the government requires every employed individual under a certain threshold ($40,000) to enroll in their health insurance program. Over 90% of the country is enrolled in these programs. The pool of funds that runs this program is attained through 50% contributions from employee paychecks and the other 50% from their employers. In the past it has been touted to be one of the better healthcare systems in the world. The United States has always been ranked lower and is consistently being compared to Germany as well as other countries' health care systems. The problem is, these other systems don't work either. Countries like Canada and the UK have a lack of access due to socialized medicine; sure everyone receives care, but can the provider system really handle it off of what they get reimbursed for? In Germany, they're system is actually heading towards one similar to ours. Years of neglecting cost containment have led them to have the same problems we face.

What is the underlying problem leading to these costs? Is there a solution? I think that the problem of increasing health costs is a product of our own doing. Major factors of rising healthcare costs are increased utilization of services and the advent of new technologies and pharmaceuticals. Here is the problem: these new technologies and pharmaceuticals have worked to prolong our lives; prolonged lives leads to more people with inevitable chronic conditions, thus they need to use more services. It is a vicous circle...we work to increase quality...but the increased quality leads to increased costs...where does it end?

Any ideas for heathcare improvement in the US?

Holy hell...hope that rambling made any sense.

*3 in a row....get some

Screw genetics

2006-07-31T21:35:00.000-05:00

So I had my annual physical today...well sort of annual since it's been three years since i've gone in to the doctor's office. Not necessarily because I neglect my health, but because of this whole moving around thing and being on my parent's insurance plan. Good ole Kaiser doesn't quite have as much pull out here as it does on the west coast. So anyways, after I turned 26 this year, I got booted off the plan and had to find my own insurance. Not so bad, since I'm relatively healthy and I really only have to get the heatlh insurance for a year until I get into my internship/residency where that should be covered for me.

That's where the problem comes in. I got a cheap health insurance plan, cause I figure just that, I'm a physical specimen with no health problems. Enter: a few things I've neglected over the last couple years --> 1) My BP and possible my cholesterol 2) My inadequate sleep

Lets examine first my BP and my cholesterol. Over the last couple of years, my BP readings have been relatively high whenever I take them, either at school or in the clinic. My cholesterol too has been borderline...not quite high...just getting real close. I usually just attributed it to the ridiculously unhealthy food that I ate in the fraternity...cause we all know...Twig could cook...but he sure as hell could care less about cooking healthy...need I say Meatloaf grease...mmmmm. Well today, I was a little shocked, my BP was 154/110 at first try and 145/94 at the second try. That is horrible...that is something you might expect for a 45 yr old...not me. Enter...genetics. My dad has always been a healthy person, he works physical jobs, exercises and eats healthy...crap the man eats rice for almost every meal. Then again he has had angioplasty on his coronaries at the age of 50 and his blood pressure and cholesterol always run high. So what now for me? Well I have a few options...one ties into the second thing I've neglected which I will discuss below. In the meantime, I have to check my bloodpressure and record it several times a week and then follow up in a few months. If nothing changes...it looks like this bad boy will be starting -thiazides for blood pressure and -statins for cholesterol at an early age. You can't really fight genetics, but you might as well try to slow it down.

The second thing I've neglected has been my lack of sleep for various reasons. I'm always tired no matter how much sleep I get, for the most part I've always attributed it to school and the inconsistent sleep schedule. Next is my snoring...supposedly I snore a lot...i dunno....people tell me this...I think they are just sensitive sleepers. Hell, if they want to hear snoring, they need to spend a night with Brandon, they'll have better luck trying to sleep during an air raid. ANyways, on top if it all, I've noticed that when I wake up in the mornings coughing and hacking up a lung, my throat is usually sore, either from some reflux or because my nose is so stuffed up I do so much mouth breathing when I sleep. That would all sort of make sense then if I have some type of sleep apnea that can be explained with something being wrong with my nasal pasages. To top it off, in a sleep study last year, I was kicked out of the overnight study, when they informed me that my oxygen saturation levels dropped 10 times during the night to 85-89%...which definitely should not happen. Again...this defies all conventional medical stereotypes. Normally a person with sleep apnea will be overweight or a chronic alcoholic...obviously i'm neither. So what am I doing for this...I'm gonna try self medicating myself first with Nasocort which I received from Salwa, which is a decongestant. In addition to see if reflux is the cause of the coughing fits I started Prevacid which I received from my attending last month. On top of it all, I have a referral to see an ENT doctor sometime this month for a real sleep study evaluation. Pending the evaluation, if I do have sleep apnea, the treatments pretty much suck. I can lose weight...if i'm fat, I can stop drinking...if I really drink; since those two are out the door, i'm stuck with CPAP and surgery, if surgical intervention is what can fix things. CPAP is basically a mask that I would have to sleep with every night that would create positive pressure and a larger gradient so air will flow easier into my lungs. Surgery may be an option if I have some type of septal deviation in my nose or anything else that is obstructing the airflow, problem is, that will knock me out for a long period of time...that I just don't have to give up right now.

Well..that was my day. Now I sit and write my paper on Germany's healthcare system...fun stuff. Somehow, this assignment was given two months ago, and I thought it was smart to start it tonight....at least I have a full 24hrs to turn it in....ha....i'm a moron.

Whoa...two updates in two days...i've gone crazy. Maybe there will be another one tomomorrow....after I bring life into this world...boyaaah...deliverin babies...

Can it get any hotter

2006-07-19T17:39:00.000-05:00

Sunny

98°F
Feels Like
111°F

Updated Jul 19 05:25 p.m. CT

UV Index:		3 Moderate
Wind:		From SSW at 8 mph
Humidity:		47%
Pressure:		29.91 in.
Dew Point:		75°F
Visibility:		8.0 miles

That "feels like" 111 degrees farenheit is no joke. Holy hell, could it get any hotter here. I was going to try to drive to Tightwad today to take pictures of the town, but I didn't want to die of heatstroke in Tightwad...although it would make a nice epitaph...

I don't know how people could survive like this without a/c...i'm getting kind of nervous about my car, because the a/c hasn't been checked in a long time, and it has been taking a much longer time to cool the car, and even then, it's still not that cool.

Oh hell...i'm going to sit here in a pile of my sweat and just enjoy the sheer stupidity of this heat.
-Dang

Holy hotness

2006-07-17T19:26:00.000-05:00

Today the temperature in good 'ole Clinton, MO hit about 100degrees, with the heat index it got almost up to 110. It supposed to be this way for the next three to four days. All I can say, is thank God for air conditioning, and not having to pay for the bill. For those that don't know, I'm out in Clinton for my rural family practice rotation and they are kind enough to put me and another student up in an apartment for the month. It is actually a pretty decent apartment and it is well furnished, the area is also decently nice with plenty of stores and restaurants, something I didn't expect for this town. It has about 9,000 people in this town, and the town I drive to on Mondays and Wednesdays (Windsor, MO) has a total of 3,000 people. In between Clinton and Windsor is a town called Calhoun, with a whole 430 people; that's smaller than my HS graduating class. Also along the way to Windsor is a sign pointing to a town 15 miles out called Tightwad...that's right....Tightwad. I'm going to go explore it next week if I get out of clinic early.

Anyways, that's all I got time for right now, hope all is well with everyone, I will try as I always say I do to update this more...but I guess you'll just have to wait and see if I'll actually do it.

-Dang

Happy early 4th

2006-07-03T11:43:00.000-05:00

Thought I would say happy fourth of July to everyone a day early. I just got back from Spokane yesterday for a good HS buddy's, Matt Elliotts, wedding. It sucks that I missed out on Marlow's wedding, and soon I too will miss out on Bloover's. Seems like everyone is getting hitched nowadays....yesterday I even learned that meathead just got engaged. Holy hell. Anyways, enjoy the holidays, I am currently working on my residency applications, personal statements (looking for any volunteers who wouldn't mind reading it over to proofread and critique), etc. and getting ready to go to start my rural family practice rotation in Clinton, MO on Wednesday (that is the same town where the Elks Lodge building collapsed last week). PEace out...here are some pics from the weekend to tide everyone over:

My 5:00am alarm clock

Rusty was kind enough to puke on the couch and then lick my phone

The setting Part 1

The setting part 2

My second family

Oh so confused...

Mama Elliot getting some love from her men

We're so cool...

Hear no evil....Speak no evil...
What is on my hands (aka..on my way to see no evil)

Sealing the deal...(signing his life away)

How come every one else looks normal in these tuxes...
I look like I should be serving Dim Sum at a Chinese restaurant

Me Like Picture...

2006-06-17T12:33:00.001-05:00

Ummmmmmmmm.....i'm a lazy fuck...so instead of writing about stuff that has happened in the last month...which maybe I'll do someday...I decide to just vomit out pictures. So enjoy.
-Dang

Wrigley

2006-05-25T22:36:00.000-05:00

Sorry, I'm lazy like Shaefer and don't feel like writing anything right now, so here are some pics from the weekend in Chicago and Milwaukee with Shaef and Dook:

Shaef in fron of Wrigley before the Cubs/Nats game

Heading towards our bleacher seat entrance

Me, Jerry the peanut guy and his VW bus

Shaefer's head is sooo big it's blocking the entire L field

Drenched from the onslaught of rain, but we weren't about to give up our prime seats

A different view of Wrigley

Shaef's glove against the bleacher wall at Wrigley
(I love my camera)

Sear's Tower

2006-05-25T22:35:00.000-05:00

U.S.Cellular

2006-05-25T22:33:00.000-05:00

Maddux

The clusterfuck of trying to leave

Milwaukee/Miller Brewery/Miller Park

2006-05-25T22:11:00.000-05:00

Miller High Life Cruiser

Miller Brewery

The Lauter Tuns

Miniture "Miller Park"

Miller Park close-up

Miller Park from afar

Random Pic of Marines from Above

The slide in L field that Bernie the Brewer goes down after every HR

Our view
(Not bad for standing room only)

The Hot dog/Italian Sausage/Polish dog race
The fans were more excited about this 7th inning event than they were of the game
(Especially the handicap row in front of me, the ladies actually got up out of their whe

#$@(&#$ me for being a complete moron

2006-05-09T23:04:00.000-05:00

It strange how you can seriously jinx yourself. Today has been slow at the hospital and around 8:30 tonight, I walked by the ER and noticed it was pretty empty, so I mentioned it to my resident...who proceeded to scream profanities, because he knew just as well as I had when I muttered those words, "it looks like tonight's gonna be slow," that I had just screwed us over. One hospital admit shortly after that comment, and my pager just went off to the tune of two more. I love medicine...and it loves me.

Happy Cinco de Mayo

2006-05-05T16:08:00.000-05:00

Cinco de Mayo is not Mexican Independence Day, as some may think, and it isn't just another day to get drunk, as some may do. This day marks Mexico's victory at the Battle of Puebla, when the Mexican forces where able to defeat the French and Emperor Napolean III. Spain, Britain and France had all previously gathered in Mexico to reclaim debts owed by Mexico, and although Spain and Britain made agreements with the Mexican government to return home, the French stayed, confident that they could so easily seize Mexico City. In actuality, they ended up getting their @$$es beat by the local militia, peasants and a plethora of cattle at the aforementioned Battle of Puebla. In celebration of that fated day we have Cinco de Mayo. Now we drink, and we act merry, but we sure as hell don't want to legalize those immigrants...but honestly now, we can celebrate something great...today we celebrate Eriberto, probably the only true Mexican any of us really know. So as a tribute to our brother "Burrito:"

Happy Cinco de Mayo

I must also leave you with one last thought....How come we don't celebrate the 17th of May? This was the day, a year later, when the French came back to stomp on the Mexicans, overtake Puebla and destroy their army and eventually take over. We could all spend May 17 in our berets, sipping wine, smoking cigarettes out of long cigarette holders and talking about how much work we have to do or how much vacation time we really need...think about it...with one Great Franco-Mexican war, why not have two holidays to celebrate?!?!

Super Update....Vegas....Seattle...B-day

2006-05-02T21:26:00.000-05:00

OOps, by my "tommorrow" from my previous post...i meant 2 weeks later, but alas here she be, a monstrous update of these past few weeks (It is broken up into three parts, with the other parts to follow this post --> ie. scroll down):

Since this is technically a new month, I normally would be starting a new rotation, but with internal medicine at the VA, they require back-to-back months, so I'll be out here until the end of May. I don't really mind so much, because I hate the transitions every month, getting use to a whole new hospital, system and staff. I'm usually slow to get comfortable with things, and by the third week or so, when I feel proficient, usually it's just about time to go. So I think I'm going to enjoy this month a lot more, now that I've gotten the hang of things around the hospital. The majority of the residents have also switched elsewhere for the month, but I lucked out and got to keep the same crazy "terrorist" resident that I had last month. He's not really a terrorist like Safavi, but he was born in Baghdad, so I still get to give him shit. My attending frequently asks him if he's part of a sleeper cell and one day will come back to hurt us, needless to say, I try to act nice...just in case. Maybe he would get along with Safavi though...i dunno, do Iranians and Iraqis get along?!?!

Anyways, I guess I'll start off with my new happenings for the day; as typical of these last few posts, I'm on overnight call again at the hospital and as of recent, I was deemed the black cloud by my resident because when I was in Seattle last weekend and he was on call by himself, he had only one pt. When I'm around we get at least 5 new admits a night and today didn't appear to be any different. To start off the wonderous day, I noticed "bounce-back," a pt. that was recently discharged, and now for some unfortunate reason is back in the hospital. He was assigned to another resident, and it appeared that he was going to be discharged, ready to go home again for a second time. I remember seing him go down the elevator with his wheelchair, and then several minutes later...I hear a "code" paged overhead. Of course, it was this pt., and by the time I got there, there was already too many people around trying to rescuscitate him. I have never been that close to a code before, but it gets your heart thumping and your mind racing. It gives me a lot of anxiety, knowing that someday, I'll have to run a code. It's amazing to see the organized chaos that ensues between the attendings/residents/nurses that arrived first at the scene. Luckily, the pt. came out of it, and is currently in recovery in the ICU.
My resident finished helping with the code and looked at me to say, "great start to the day...we're fucked tonight." But, thankfully he was wrong, or at least so far he is. We've had two admits today, and they came relatively at the same time, so he worked up one, and I did the other. Both are ICU pts, mainly there to rule out an MI (myocardial infart = heart attack). Plus side to being in the ICU today was watching "The Amazing Race" with some old nurses...that sounds kinda gay... but that's what keeps me entertained. If you watch the show...I'm rooting for the hippies.

After the ICU I stopped by another "bounce-back" who will have his infected foot drained tommorrow. I kept passing by his room all day, and he hadn't had any visitors and was looking quite bored, so I made a social visit. We chatted about his work/travel/previous military service, then watched some of the Wizards/Cavs playoff game. It felt good when I finally left the room, and I realized that overall today, I've been in a different mood. Not that I'm not normally the most pleasant person in the world, but today, when I look back, I've just been going out of my way to talk to people and being jovial. I think a lot of is had to do with going to church yesterday during worship and just getting time to reflect and think about many different things. One of the last things the speaker said before the night was over, was to make it a point to do something this week to make a difference in another person; ie. use what you know, and do what you can to impact someone else. Although it wasn't much, just spending those few minutes to chat with the pt. made me feel like I belonged working in a hospital and that I am on the right path that I was chosen to be on.

Alright enough of the moooshyness...my highlight of the day: plane tickets to Chicago!!!! I cleared the days off with my resident, so I will be joining Dookie and Shader in Chi-town from May 17-->21 for hopefully at least 1 Cubs game, 1 Sox game and maybe even a Brewers game. I'm hoping that James, one of my classmates that is doing his rotations at home in Chicago, and Tricia, will get a chance to come hang out and even go to a game or two.

For anyone out there that may pass by this blog and has tickets or knows of people in Chicago that might have tickets to the Sox-Cubs game...let me know. We do not have tickets for that weekend game yet and if we can't find any, it'll be up to Shafer's scalping abilities.

Speaking of baseball this week:
Fantasy baseball lowlight: F#$K Eddie Guardado... blown save #3!!!!!.
One out from getting right back on track, and ?!?!?!? Pablo Ozuna...you give up Pablo's first career HR!?!?!?!?!? Crap...of course it has to happen on the week that my team is up against another team that has monsters of closers. Holy bunghole.

Fantasy basball highlight: Scott Podsednik --> 4 stolen bases...1 game, 'nuff said

Allright, that's all I really have for now, the following three blogs to follow directly under this one will recap Vegas, Seattle, and my b-day on monday. Since my pics are on my laptop at home, if you are reading this early...the rest of the blogs won't be done until tommorrow night (Thu)

If you guys are still reading this and checking up on this blog even though I don't regularly update it, thank you for taking the time to read it

"My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba, My name is Minh Ba"

-The end...for now

Seattle

2006-05-02T21:25:00.000-05:00

I'm tired...here are some pics...I"ll write about this tommorrow...or next time I'm on call...

Dook and Davis tryin hard to flex for the camera...Mike is already naturally flexed

Screwin with my new camera, this pic reminds me of an old 80's video

What's a wedding without some alcohol?
Kickin back some Jaeger bombs in chowder bowls with the boys

Dook and Davis well protected from spillage

Mike sealing his fate

B of A crew
(L-->R, Mrs and Mr. Bossman, don't know, Becca, Hyo, don't know, don't know and Merchado)

Good friends = good times
(L-->R, Julie, Stiffy, Dookie, Tasha, Bunghole pirate, Davis and me)

Clusterfuck of Psi-U's causing trouble
(Who the fuck is the old guy with the glasses right behind me, why does there always have to be "that guy" in every picture, that just pops their damn head in....Holy hell...)

Sleep deprivation is my friend

2006-04-25T01:37:00.000-05:00

I was going to write a blog...but i'm on call and I just finished my history and physicals (H&P's) for the night, so I'm going to try and get some sleep. Still recovering from Vegas and my stupidity for staying up all night Saturday night to play 1/3 NL hold'em. Fuck...wish sleep wasn't necessary, there's never enough time, it's really just a waste, if only I could survive of cofee and crack, too bad it can't be done...?!? Even though I am tired, I'm wasting time about typing about being tired and not spending it sleeping like I should. I could start a blog, but thus it would not get done, I would probably get halfway through and fall asleep, so I'll wait until tomorrow. Sorry Ash...thought I'd have time for some delirious rambling about the weekend and such...maybe tommorrow.
-Dingo

Finally...some down time

2006-04-14T01:36:00.001-05:00

I don't know how many times I start off my blogs by apologizing for not writing these on a more regular schedule, but I'm sorry. I'm busy, i'm lazy, and I just simply forget to do it. I think my last blog was back on St. Patty's Day weekend, since then I finished up Orthopedic Surgery and I have decided that I'm going to pursue that path for a career. It's funny that leading up to that rotation, I tried to get rid of it, and for the first week or so, I complained a lot about it. Now, I can't picture myself doing anything else when I finally finish school than Ortho. Getting in will be difficult, because it is highly competitive, but I figure if I apply to a $#!tload of programs, eventually one will have to let me in, right?!? Only problem with that is that it kind of negates my chances of returning home to Seattle or even WA for the next couple of years. The internship and residency programs run 5 yrs total, so I'll be a nice ripe 32 when I'm finished, and if I choose to do a fellowship, you can tack on another year. I guess Marcus was right when he tagged me with the "professional student" label.

I am currently doing IM at a VA hospital, and I will be out here until the end of May. The hours are much better, but I have to drive 35-45min each way, and the way gas prices are going, these two months will destroy the pocketbook. Luckily I've been eating lunch at the domicillary with the patients/residents of the compound, and although the food isn't the most appetizing (picture elementary school lunches...minus the tator tots, ham torpedos, and good stuff in general), but I can't argue, because it's free. The patient population here is very interesting, and while I do enjoy talking to the patients about war stories and shooting the $#!t in general, after these two weeks, I know that internal medicine is something that I could never do, especially at a VA. Every patient has at least 10 chronic problems and are on 20+ meds, it takes forever to deal with the patients and 1/2 the time they aren't even compliant, so after they are discharged, they come back in a few weeks. I know I will enjoy Ortho, because although it has the same patient population of old folks, who I found are my favorite group of people to chat with, you can fix a concrete problem for the pt. and they can see the results. Ie. severe arthritis of the knee causes pain --> knee replacement --> pain gone. With IM, the patients don't see or appreciate the changes that you are trying to accomplish. Ie. lower BP, lower cholesterol level --> they don't know the difference until they have a heart attack, meanwhile, if they don't see changes they start to slack on their daily medication regimen. The end result is a sick patient, and a frustrated health care provider.

A plus side to this rotation is that I have internet access that blocks out all games and myspace...i guess that's not really a plus side, but...it doesn't block out this blog site, so, at least in the next two months, I should update this more regularly, really, I'll do it this time.

Outside of the whole school and work thing, most of my friends here are doing "outward" type rotations in other cities for the month, so I've been hanging out mostly with Debbie and exploring what KC has to offer. We checked out some fun restaurants, bars and sites in KC, and although I've managed to be stingy with lunches while at the VA, I've managed to amass quite a hefty credit card bill from these two weeks of going out. More details on that at a later date...i'm starting to gt piss @$$ tired and I wanted to briefly mention a few more things in this blog before I forget, tonight is technically my "first" night being on call at the hospital, last time was over the weekend, and the resident sent me home after morning rounds. This night has been quite interesting; for the majority of the week we have been slow, and I've only been responsible for 2-3 pts. Leave it to me to be on call when things get recockulously busy. We had 4 new admits tonight, and by the time I finished my H & Ps, updated the list and read up on what I need for tommorrow, the night was well over. So...after pounding a few 20oz of soda, I got the urge to type this blog. I would go to sleep, but my "room" is on the 6th floor of the hospital, the only room that is being occupied on that entire floor. It's not a small floor either, it's a big, long, dark hallway, and the room is at the very end. It kind of reminds me of "the Shining." So, being the pussy that I am, I'll probably just pass out in this cubicle of an office, that currently feels like a sauna. Today was about 90 degrees and the sun has beat down in this little room all day, I would sleep in this room in my boxers, but might create a rude good morning to those who woke me up, come sunrise.

Shit...where was I. Uhhh....last thing to mention, I'm excited to go home in two weeks for Mike. G's wedding. I haven't been home in a long time, and I'm looking forward to seeing everybody. It is alsokind of weird that, his "wedding" will be the first time that I'll actually meet his wife. Strange....indeeed.

That's all for now.

Happy St. Patty's Day

2006-03-17T19:42:00.000-06:00

Just wanted to say a quick happy St. Patrick's Day to everyone, and I hope everyone is enjoying the NCAA tournament. I'm hangin out in Memphis, TN for the weekend with some friends, and going to go down to Beale st. tonight to enjoy the nightlife. Tommorrow, going to check out Graceland and the hotel where MLK Jr. was assassinated, which has been converted to a museum. This trip has been a good midpoint break from my rotation, and has been lots of fun so far. Anyways, sorry this blog is so short, but I will sit down when I get back Sunday, and make a update on stuff in general and maybe figure out how to throw pictures up on this thing. Enjoy this drunken holiday, and "Go Albany Great Danes!!"...this is gonna fu_k s#!t up for everyones' brackets.

Estrogen-->Testosterone

2006-03-04T20:37:00.000-06:00

So I finished up with peds last month at the hospital which was a good experience, but it has been a crazy transition from being around predominantly women physicians and residents at the Children's hospital to now working in a specialty dominated by testosterone. This month I have orthopedic surgery, and its basically filled with lots of blood, broken bones, metal prosthesis and powertools. The speciatly itself, is pretty remarkable, and while it still may be an option, its not at the top of my list. I big problem about this whole month, is the rotation itself. The orthopedics group is a great group, but there are so many residents and three other students, that I get limited to being 3rd assist during the surgery, or only watching. This rotation is more of "face time" if I want to do my residency with this group, unfortunately if I don't, this rotation may be pretty worthless because I don't get much hands on experience, compared to my last couple rotations. I'm really limited to doing scutwork when it is available, but besides writing a few prescriptions, changing dressings, and occasionally scrubbing into some cases, this month is not looking too exciting. The worse part of it all is the long hours, which drag like none other when you are standing around. So far this week, I've only scrubbed one case to hold up a leg, cut a few sutures and throw in some staples. It was a pretty cool surgery to see though. The patient had shattered his tibia and fibula about midshaft, and the surgery consisted of placing a rod straight through the tibia. The surgery before that I watched was similar, but I only got to watch that from a distance, which was probably ok because the repetitive x-rays to confirm placement of the rod was probably good enough to destroy any chance of me having kids, which is why I made sure that on the surgery I scrubbed in on next to wear a lead vest. Since there are four students, we each only have to take a weekend of call, mine is this weekend of course. I feel like I haven't had a weekend off now without having to come into the hospital for over a month now, who knew this would be so painful. Anyways, enough of my bitching. My excitement for today after rounding/shadowing was playing a 2-on-2 game with Dustin against two high-school kids at the gym. Holy s#!t, I'm old and out of shape. Of course they beat us, but we have about 10yrs on them, that's 10 more years to f_ck up your body. So my whole goal of getting back into the gym, keeps biting me in the @$$. I can't get healthy eating the crap I eat at the hospital, and I'm too piss @$$ tired when I get home to lift, not to mention I have to look up stuff for the following days' surgeries. $#!t, more bitching. When did I get to become such a negative @$$ person?!? Oh well. That's all I got for now.

I think a broke my back

2006-02-16T19:29:00.000-06:00

Just when I started to get back into the swing of lifting again I jack my $#!t up. I know I mentioned back in November that I would go hardcore on the weights once again, but I lied. Yesterday, I had completed about a full week in the gym, getting all the aches and pains out that you get if you haven't lifted awhile, and next thing I know, wonderous crippling pain. In the middle of a deadlift, I felt a tweak in my back and shooting pain up my neck and down my back on the right side. Not a fun feeling, it hurts now when I cough, burp and even when I rip @$$. And this is after I finally figured out how to breathe right with deadlifts so I won't create too much intra-abdominal pressure and get the herniating feeling of my intestines dropping into my nuts. Anyways, it is now one of my favorite new superset lifts, you all should try it, the deadlift/shrug combo. Do 8 deadlifts followed by 8 shrugs, followed by 6 deadlifts, 6 shrugs...etc, etc*, down to 1 of each without a break between any *8/6/4/2/1. Stop at any sign of pain, back pain or herniating pain. The key is in the breathing, trust me, the last thing you want is to give yourself a hernia while lifting in front of attractive women in a packed gym. As you perform the main motion of the deadlift, pulling the bar up and extending your back, breathe out. It won't look good if you are rolling around on the mats grabbing your balls and crying like a little baby. In addition the surgery for an inguinal hernia repair, is not that fun, at least for me, that was the surgery in which I had to hold the ole scrotum of the patient while he was being sewn back up.

I'm gonna keep this short an sweet, that way I can try to make these more routine...not the self pain infliction, but the blogging

Blogging again?!?

2006-02-12T19:09:00.000-06:00

Since Shaefer hopped back on the blogging bandwagon, I thought I might also. It has been a busy couple of weeks, and things don't look like they will slow down anytime soon. I finished surgery last month, and I really enjoyed the experience. There is no way in hell that I would ever choose that as a career, but I will definitely take with me the things I learned last month. I am currently at a Children's Hospital on the GI team. We are assigned 4-5 kids everyday to see and write up progress notes on. We get an even amount of kids with GI problems as well as those with general problems. Although it is intimidating after you present your kid to the group and the physician asks what you want to have done next, it is helping me with thinking through situations. Most of the docs and residents will gladly help you out and tell you if your decision is right or wrong and why it is that way. The hospital reminds me a lot of the Children's Hospital in Seattle. There are many interesting cases, and I'm trying to mix it up so I get a variety of cases to learn from. This rotation had definitely not helped me with deciding on what I want to do with my future. The last blog or two, I have mentioned interventional radiology, which is still at the top of the list, but now I can't rule out pediatrics once again. These kids are awesome and help me forget about all the crap I've been sulking about lately. Aside a few instances with unreasonable parents, I could see myself working at a hospital like Childrens. Also added to the list is gastroenterology, a combination of seeing a few scoping procedures last month during surgery and dealing with GI cases last month and this month.

I've had lots on my mind in these last couple months, and I have felt like this blog is one way to get it out. Lately I've been fluctuating between good days and bad, and I've learned to keep myself busy so I don't have to think about things at all. It has been a combination of being unsure of what I want to do for the rest of my life, where I want to go and a few problems with just being confused on some issues.

As far as KC is concerned in general, I think this place is starting to grow on me. I've finally hit my comfort zone with this area and I'm just starting to figure stuff out. The weather this year has been great, my main concern has been the snow and ice the last few years, but this year it hasn't really been to big of a problem. We got a day of snow yesterday, but other than it being balls ass cold, it was drivable and didn't mess with my day too much. It will kind of suck to live out of a suitcase next year, but I guess it must be done. So if for any inspired reason, any of you want to come visit me out here in KC before I move, now's your chance.

Although my plans aren't as exciting as Schaefers, in case I don't blog for awhile, my immediate future plans include:
1) Orthopedic surgery in March
2) Internal Medicine in April and May at the VA
3) Vegas in April with Salwa/Tricia and family
4) Seattle in April for Mike G wedding
5) Possibly Vegas again in May with Dave/Schaefer/Davis/and crew
6) Baseball journey either to Chicago/St. Louis/or Denver to meet Shaefer on baseball tour
7) Psychology in June
8) Deanna coming up to visit in June
9) Family Practice in July in Clinton, MO
10) Matt E. wedding in July in WA (Spokane)
11) OB/GYN in August
12) COMLEX Step II and USMLE Step II in August
13) Philadelphia for clinical skills exam in August or September

Well...that is all, sorry my short return to blogging isn't very exciting, I will do my best to get back in the swing of things, but no guarantees.

Booyahkashah

2006-01-10T18:29:00.000-06:00

Oops. It has been quite awhile since I have written anything, I hope people still check this blog. The last week or so has been busy to say the least. My days go something like this:
4:30 wake up
5:00 - 5:15 leave the house
5:30-6:00 arrive at the hospital and start pre-rounding on my patients on the surgery service
*basically pre-rounding consists of waking up the patient (which they love), asking them about their night, and then doing a quick, history and physical pertaining to why they are being seen by the surgery service. Then I have to fill out a progress note of my findings, any pertinent lab values/radiology reports, etc., and create a assessment and plan for the patient for the day (usually the assessment and plan is the same as the day before, unless something major has changed)
6:30-7:00 round with the attending surgeon
7:00-8:00 some days go to didactics (lectures) other days:
7:00-1:00 any surgeries scheduled I scrub in for if my attending has any at the hospital, sometimes the surgeries are at two other hospitals, if he has no surgeries, I hang out with the intern, who is a pretty crazy ass chick from Texas. She is doing her internship/residency in orthopedic surgery.
1:00-5:00 clinic, this is where we can evaluate patients for surgery or follow-up post op
Usually I am home by 6:00, I eat dinner and then go to the bookstore to study untill about 10:00
Then after I get my dose of TV, I go straight to bed by midnight.

I haven't been called in from home yet on my call nights, but last wednesday-->thursday, the night I had overnight call at the hospital, I was there for 36 hrs and slept for a total of 3. We had a kid come in late wednesday night with acute appendicitis, so we had to operate at midnight, I got to bed around 2:00 and the fire alarm went off at 5:00 in the morning.

Most of the cases I scrub in for are laproscopic cholecystectomies, herniarrhaphy, colectomies and appendectomies. My main tasks thus far are cutting the end of sutures when they tell me to, suctioning and retracting back skin/muscle/tissue (my favorite). Today was the highlight of it all, i had to retract back tissue with my left hand and in my right hand I had to hold a nutsack for about an hour. Good shit huh. It was for a repair of a bilateral inguinal hernia. Basically, this guy had a crap load of abdominal tissue hanging out in his balls for over 5 months. Hopefully by the end of the week, I will get a chance to suture and do some ties as well as put in IV lines and NG tubes. That is the goal for the week.

Right now, is the start of my MBA classes, which will occur every Tuesday night for the next two months. So...I will do my best to update, but I can't guarantee. I was at the hospital for over 85 hours last week, and I expect more of the same this week, so who knows how much time I will have to blog, besides Tuesday nights before class. The best part of it all is that for all this work...I am paying them to be their bitch. I'm glad all those years in the fraternity have prepared me for the professional world of hazing.

Hope everything is going well with all of you guys, wherever you are.
-Minh ba

I need some help

2005-12-30T19:11:00.000-06:00

Well, actualy my parents do. My mom has finally succumbed to the fact that she will probably not get another permanent full time job. She got laid off from a company she worked for over 15 years about 2 years ago, and has been working part time at the school district. After they kept promising to hire her full time and give her benifits, time and time again, she has finally dropped it. I want nothing more than for my mom and dad to be retired and enjoy life, but what brings them joy is work. They are the hardest working people I know, and I don't think they know anything else but work.

My dad has decided to open up a company fixing computers and their components for my mom, and they asked me to come up with a name for it. This is where you guys come in, because you fu*ks (that would be all of you guys reading this) are the most creative people I know. My only suggestion, as gay as it sounds, is MTD (For Mau/Tuy/Dang) Computer Solutions...pretty plain, and pretty lame. The gimic could be: "Pissed off at those Dang computers, let Mau and Tuy Dang fix those problems," Yeah...I dunno, my creative juices are null right now. So, please post some ideas, serious ones, stupid ones, funny ones or profane ones, I don't care...any help would be greatly appreciated and would be rewarded with Pho the next time you are in the Couv. So name suggestions, poster/gimmic suggestions (ie. pics/slogan) would be awesome.

Shaniqua tried to eat me

2005-12-02T17:48:00.000-06:00

So I've started radiology this week and it has been quite interesting. Yesterday my attending physician was not working, so my assignment was to go to the hospital's radiology viewing room and make friends with the radiologists and residents on staff that day. It didn't turn out too bad. I got there at 7:15am, about the time that the on call resident and radiologist go over plain films from the ER the night before. First off I was told not to be a douchebag next time and wear my tie and white coat; then I got to join in while they examined the films.

Two plain films I looked at were quite amusing. The first one was easy enough for me to identify. In looking at plain films and CTs you work with differentiating out five different types of densities: (From darkest/black--> to brightest/white) 1) air 2) fat 3) water/soft tissue 4) bone 5) metal. Because metal is the brightest/whitest I could tell that the patient had a bullet lodged in his head. The next patient had plain films of his leg, the area around his knee and his ankle. Around the knee were 21 little round balls also of a metallic density and 7 more around his ankle. Apparently, the patient had accidently fired off his shotgun and scattered the ball bearings into his leg. Miraculously, all of the bearings were lodged in his muscle and fat and none reached the bones to cause any damage.

The rest of the plain films were not that exciting, so I will spare the details. Around 8:00 more medical students and residents from other specialties arrived, packing the viewing room, and at 9:00 the radiology residents arrived. From here on out it was a clusterfuck, but I did manage to learn a little on vieweing MRIs from a 4th year resident.

Around noon I had to take off for didactics (which is a fancy name for lecture) at school. On my way out of the hospital I took the elevator and ran into a large ebony princess, hence the name for my blog. She was already pretty obese, but she also had a couple pounds of layers on to battle the cold weather outside. It happened to also accentuate her gargantuan form. Anyways, as she got on and the door closed she asked me, "Are you a doctor?" And I replied ever so gentlemanly like,"No I'm a medical student." She gave a funny twitch and said, "You better answer my fucking question or you're going to need to see a doctor!" At first I thought she was joking, and then I realized she had the look on her face like I was a 5-piece fried chicken meal from Church's Chicken. I was quite intimidated, any hesitation on my part to answer, and she could have easily, stopped, dropped and rolled over my small frame and crushed the life out of me. Luckily the door opened and she stumbled out before I could karate chop her to the elevator floor. I escaped unscathed and continued on my way to school.

Lecture was an immense waste of 2-hours of my life, it was about professionalism in medicine. Just look at me and this blog I write of, how much more professional can you get? For the rest of the night, I went over to Salwa's place and watched some shows with her and Dustin.

That ended day one. Day two was much better, because I was one-on-one with my attending physician at their radiologist clinic. I learned a great deal today, but after 4.5 hours in a dark room I couldn't take it anymore. I got more proficient at reading CTs and MRIs but on boobie imaging and ultrasound I still suck at it. Dookie may be out of luck, because the system they have is all digital alrady and pretty pimptastic. I'm glad I only have to work from 8-12:30 (not horrendous hours, but try staring at multiple computer screens in the dark for hours on end, I know of only one man that can really do that and his name rhymes with Gayfer). I am completely drained now and would write more but, I'm tired and hungry, besides todays cases were pretty basic and not too fantastic.

I will leave you with a metaphor for how it feels to work in radiology thus far. I'm drawing a blank for the name of that football movie...but maybe someone can figure it out. There is a scene where some football players spend all night in a strip club and when they leave the next morning, as they exit the sunlight catches them by surprise and they are a little disoriented. Radiology is kinda like that, well sort of, you are in a dark room all day examining the finer details of life and eventually when you leave the "viewing room" you get totally bewildered by the daylight. It is if you are shut off from the living world. Strange. I may just be rambling because I am delirious.

Hope all is well. Jimmy "aka" 5-piece fried chicken meal

Here goes...

2005-11-23T16:31:00.000-06:00

Reading through Schaefer’s, Farris’s and Boyd’s blogs have inspired me to put my own life and experiences in medical school out onto the internet. I have decided to do this so you all can get a glimpse of my path through medical school and everything that goes along with it and so I can look back on this stuff further down the road. Hopefully this will be somewhat entertaining and slightly educational, but most importantly I want it to answer the questions everyone asks me when I’m home, “How’s it going in medical school?” and “Do you know what you want to go into?” My usual answers are “Good” and “I dunno yet.” I never know what else to say, there is always so much but I just cant spontaneously put it into words and I’ll be honest, for the most part I don’t have the time and when I do I tend to forget and leave a lot of things out. So here it will all be, my life, tracked from here on out: externship/rotations to my internship year through residency and finally becomming doctor.

Right now though, I'm in Flint, MI about 40 minutes northwest of Detroit. I'm spending Thanksgiving here with Tricia, a friend from school. She is out here doing her rotations for her third year and is doing surgery right now. I'm glad my schedule isn't quite this bad yet, I had to get up this morning at 4:00 to drive her to the hospital so I could borrow her car for the day. Not like it mattered much, I went back to the apartment and slept until 12:30.

I finally did get up and was in charge of the thanksgiving grocery shopping. Note to self...never go to a grocery store the day before thanksgiving to buy what you need for dinner. I was there for over an hour dodging full shopping carts driven by blind old ladies. How is it that when they hit you with a grocery cart, they look at you like it was your fault? I'm sorry, I'm not the one with the cataracts. Also, bad idea to buy a meat thermometer the day before thanksgiving; three stores, and a no go. So it looks like I will have to guestimate the temperature of the turkey. It will be my first attempt at preparing my own thanksgiving dinner, so if I can survive not burning down her apartment or giving ourselves food poisoning, it will be an accomplishment. First medical tip of the blog: if after thanksgiving you are puking or shitting out green clumps of doo...chances are you have food poisoning.

I hope you all have a good thanksgiving, I know at this point in my life I have lots to be thankful for. For everyone one I saw when I was back home in Seattle, It was great to hang out and be somewhat normal again.

Minh Ba, medicine and the midwest

New home

Grady's Anatomy

Europe advice

House hunting and mortgage woes

March Madness

Happy New Year

Game time

The education that we receive

It's official!

North Carolina

I'm back...sort of

What in the hell with all these ads?

Random pics

The Longest BLog Ever Written

Tis the season

Happy holidays

One down...two to go

Sports and the Humor in names

One more thing...do all asians look alike?

Good lord it is cold....

Fun day in the OR

C-Sections....and Slooooooooooooooowness

Almost game time

Destination unknown.....ruby ruby ruby soho.....

Enough already

Oww

Screw genetics

Can it get any hotter

Holy hotness

Happy early 4th

Me Like Picture...

Wrigley

Sear's Tower

U.S.Cellular

Milwaukee/Miller Brewery/Miller Park

#*$@(*&#$ me for being a complete moron

Happy Cinco de Mayo

Super Update....Vegas....Seattle...B-day

Seattle

Sleep deprivation is my friend

Finally...some down time

Happy St. Patty's Day

Estrogen-->Testosterone

I think a broke my back

Blogging again?!?

Booyahkashah

I need some help

Shaniqua tried to eat me

Here goes...

#$@(&#$ me for being a complete moron