Scheduling update

So, I decided not to go for the anesthesia elective. There were too many people competing and the scheduling lady said it was pretty unlikely I would get it. I have 2 alternatives now, however, so all is not lost. I can take my schedule as it currently stands, and do an anesthesia elective right after third year. Alternatively, I can still postpone family medicine and do a "self-designed" elective, which is essentially the same thing as doing the original anesthesia elective. The advantage to not postponing family med is that I can complete my third year which frees up which electives I can do, since some of them require that the entire third year be completed.

Schedule

So, we've been scheduling our classes for third year, and yours truly got his schedule for next year. For the 48 weeks following July 6, here is what I will be doing:

8 weeks of Pediatrics
8 weeks of Neuro/Psych
8 weeks of Surgery
Christmas break
12 Weeks of internal medicine
6 Weeks of Anesthesia -assuming I get the elective, and forcing me to postpone Family Med
6 weeks of Ob/Gyn

2 weeks of freedom, then 4th year which will include Family Medicine which I postponed from third year. I was pretty fortunate in that I got my first choice in scheduling, though I still need to get my elective.
-SS

Monkeys

So I think monkeys are pretty funny. I bet even, that you don't find monkeys as funny as I do. In 2001 before I served my mission, I watched the "Grinch who stole Christmas" with Jim Carrey. There's a scene wherein a frustrated grinch is getting his head smashed by a mechanical monkey banging cymbals together. If there's a funnier motif than a mechanical monkey with cymbals, I defy you to find it. The theatrical denizens tittered politely for an apropriate amount of time. Yours truly, however, was laughing loud and long, well after the scene had changed. I would have thought that 8 years had tempered my love of the primate percussionist, but that is not the case. We were learning about adrenal disorders in class, and the teacher drew the comparison between an adrenal gland spontaneously secreting cortisol to an elephant running wild and trampling the bleachers (which ones? I don't know, he didn't say). That got me smiling. Then he compared a small cell lung cancer secreting ACTH which causes unregulated cortisol release to a runaway elephant with a monkey on it, whipping it. The class chuckled gently, and, remembering my experience in the theater 8 years ago, I fought hard to not laugh out loud. But I was grinning to myself with my head bowed so the teacher wouldn't see me as he changed topics. I'm still grinning as I write this. I guess this is why my sister has managed to find a different monkey card for my birthday for at least a decade.

The palpable border

For the last 4 weeks we have been going once a week to work with a preceptor. We are to work in two pairs in conjunction with the preceptor in order to improve our history taking and exam skills. The last weeks have seen me in a nursing home near school. The clinical encounters we have rehearsed at school with standardized patients and in the lecture hall were not sufficient preparation to seeing real people. Our standardized patients are all very stereotyped and presenting in a pseudo-outpatient setting with some well defined chief complaint. The nursing home however, provides quite a different experience. The patient only grudgingly will consent to talk with you, as there is a bingo game impending, and they don't have any 'chief complaint' as such. "I'm doing ok" is not really a chief complaint. I also realized in this setting that, in the absence of a stilted semi-scripted interview, I suck at taking a history. I also suck at performing a physical exam.

To learn PE we were first instructed by one of our professors who demonstrated on a standardized patient. In small groups on various days, we then all took turns learning the PE from the standardized patient. While admittedly this saves on manpower because you don't have to get 8 different MD's to come in to teach small groups, this strategy also leaves somthing to be desired. I would prefer to have been taught by someone who has actually done a physical, rather than by an actor who knows approximately what a particular exam should include. There were sometimes 4th years around to help, but they were usually not helpful, nor particularly trustworthy. Usually I felt like I was being instructed by someone only marginally more familiar with this than me.

Last week and this week, my group and I asked our preceptor to help us improve our techniques in the various exams. Last week we did heart, lungs, and abdomen on real patients and this week it was the neuro exam. It's nice to examine someone who has real findings as well, because you're not just going through the motions.

Today we were examining a patient with stage 4 colon cancer. They were cachexic, but their abdomen was protruding outward, despite the patient's emaciated appearance. After talking briefly about their abdominal surgical scars, I palpated, percussed, and auscultated the abdomen. It was definitely unlike any standardized patient. This individual's liver margin was palpable nearly at the level of the iliac crest. Normally the liver is found approximately at the lower edge of the ribcage. There were firm nodules scattered diffusely over it as well. Our patient had metastases that had infiltrated the liver and caused the massive hepatomegaly that we observed.

It was a long, but very informative afternoon. I realize that it must sound callous that this poor individual's plight was educational for me in a very dry, clinical way.

SS

Another unit down

Well, since I seem to post about once a month these days, I thought I'd update the world on my doings. I passed Skin, Bone, and Joint, our connective tissue module. As the name implies it is quite a wide assortment of subject material. This made finding a studying groove pretty much impossible since every week a totally new set of lecturers would speak to us. I have now safely ruled out dermatology as a specialty, (not that I think i'll have the board scores for it anyway), hematology/oncology, which is also something I think I would detest, rheumatology -hmm, chronic disease- my favorite!, and geriatrics. My school has the #3 geriatrics program in the country, but I don't find the material very engaging. I'm currently in the endocrine module which is refreshingly homogenous. My current quandary is how best to balance studying for USMLE step I and my coursework. If i study for classes, I have less time to review for the boards, but my courses are on the boards anyway, so it's still kind of a review. If, on the other hand, I devote some more time to reviewing material from last year like biochem and immunology, then I will sacrifice my performance in my current class. At least I will have 5 weeks to review in may/june which will be very helpful.
cheers
SS.

Poisson d'Avril

Spiff loves a good prank, so April Fool's Day is right up his alley. I, on the other hand, am not a prankster. Spiff usually doesn't act on his tricksy tendencies to me, it doesn't occur to me to be wary on a day like today.

This morning, I walked in on Spiff cutting out this little gem:
If you're anything like me, you would ask him, "What are you doing?" He would answer, "Just a project for school." And you'd sort of believe him, and promptly forget about it.

Then, when the mother of your only piano student pulls this off your back at 4:45 in the afternoon...
...you realize that your dear, sweet husband got you! He really got you! I didn't suspect a thing, and I had been wearing a fish on my back all day long! Also, my 14-yr-old piano student had to explain to me the French tradition of sticking a paper fish on someone's back on April Fool's Day, since she learned about it at school today, and I had no idea about the significance of the paper fish I had been donning.

So, congratulations to Spiff on a great little prank. Here is what he got for dinner (keep in mind that every time I ask him what he would like for dinner, he very helpfully answers, "Beans").:

Crying It Out

I have come to the conclusion that Crying It Out is another name for sheer emotional torture. Our sweet little baby has been having a rough time sleeping lately. He went from a tiny newborn who wouldn't sleep because he needed to eat every two hours to a heavenly 3-4 month old who slept through the night, mostly. However, he has recently decided that the only place he wants to sleep is in his mommy's arms. I do what I used to do for him. I feed him, cuddle him, and rock him until he is blissfully in dreamland. He is happy, and I am happy to cuddle with my little sweetie. I take him to his bedroom, and as gently as humanly possible, I lay him down in his crib, which has become an action that screams "Unacceptable" to him. He immediately wakes up, kicking and happy, and ready to play. As he has already shown me he is ready for bed by falling asleep in my arms, I know it's time for bed. I kiss him goodnight, and leave him...to cry...for 30 minutes (which is up from the five we started with). And then I die a little more inside, as it has been going on for several weeks.

We have decided that there is nothing more we can do for him. If I could make it better by going in to him, by giving him back his binkie, by cuddling him, by singing to him, by rocking him, I would. But nothing I do helps, so we feel like it's time that he learns how to comfort himself to sleep. It is the most horrible thing to hear him scream and I spend the designated time on edge, frustrated, and with the highest of blood pressure. We're doing something for him by not doing anything at all, and it's one of the hardest thing I've done. Meanwhile, none of us in our little family are getting much sleep, which also makes things difficult to cope with.

Incompetance- my own this time.

So it's been over a month since I last posted. Mainly that's because nothing of note has happened in the last month and I haven't really felt compelled to write. I did very well in GI which was surprising considering that I didn't think I had studied very hard. The skin, bone, and joint module (SBJ) has been underwhelming. It's a random hodgepodge of stuff, including geriatrics, and the material itself is not interesting. I have now ruled out oncology as well as dermatology as career options. Derm is ultra-competitive anyway, but I'm glad to know that I really have no desire to analyze skin lesions that all look the same. It seems that the derm faculty here recruits solely 28 year old tall thin women, since we have had 5/7 lectures from that kind of professor. Perhaps recruit is the wrong word. I think they all rush the derm department in the same way they rushed their sororities.

I have started studying for the boards, and it's not going very well. There's a lot of material that I have forgotten, or never really knew in teh first place. Biochem is the case in point. Looking at the Krebs cycle, it's as though I never knew it; likewise with the regulation of gluconeogenesis. This is particularly frustrating stuff to memorize because I know that it's just going to leave my brain again in two months anyway. I really don't enjoy cramming stuff that i'm going to forget anyway, because ultimately, I didn't really learn it, so what's the point? Well, right now, the point is that I need to do well on the boards before I can shuffle the urea cycle back to the dusty attic where I semi-remember metabolic pathways.

So I had my first patient enounter as a medical student in my capacity as a student, not a volunteer at the student clinic. I was paired with my classmate and assigned to get a history from an elderly nursing home resident. I sucked. It's pretty hard to take a history from someone whom you can't understand, and for whom life is as ok as it's going to get in a long term care facility. No chief complaint = hard to pursue line of questions. There was no logic, no flow, no sequence to my questions. My presenation of the patient to the attending also sucked. Since I've never really been taught how to verbally present a patient, this is to be expected. I also realized that I have forgotten what little I knew about physical exam. I realize that 20 minutes sessions with a standardized patient learning skills was really not enough. I would much preferred to have had a doctor there, with me and the standardized patient to show me how these things are done, rather than having a glorified layman actor teach me how to examine a patient. Where does my $44K go anyway?

Overall, it's been a pretty sucky 3 weeks in this unit so far. At least I have my back pain to keep me pre-occupied.

Seeing Double

I saw my double today. I know everyone is supposed to have one. The person who was made from the same mold as you. Well, this girl looked like me! She had the longish face, fair skin, reddish-blonde hair, glasses, pig tails, and the t-shirt. I sat in my car at the recycling center staring at her, trying to look like I wasn't staring at her, and probably succeeding in making her feel slightly uncomfortable. I wish I had had a camera with me so I could have snuck in a quick photo of her. I would have liked to compare profiles. I swear that her profile is the one I see when I look at pictures of myself. Weird.

Getting the Ball Rolling

I haven't posted for a while. It seems like whenever I post on the blog, I suddenly start seeing and thinking about tons of things to write about. But, when I don't post for a while, I lose the knack for writing, and I don't think that anything I think about is worth sharing. I do have several thoughts floating around in my head today, so let's just see what comes out, and we'll get the ball rolling on this blog thing again...

Spiff has just finished Spring Break, and he found himself doing quite a bit of service this week. He has unselfishly given up some of his precious free time working a the HRC and serving people in our ward. I am grateful to be married to the type of man who will do this. He is a good example to me. I love serving my friends, and I try to do what I can to help them when they need it. I like to think that they can ask me for help, or accept it if I offer. I, on the other hand, have a hard time serving people I don't know or love. I find myself avoiding opportunities to serve, or begrudgingly serving only because I have been asked, all the time thinking of how I am barely being able to hold myself and my own life together, much less help others with theirs. I pray for help to be more Christlike, and I know that this is one of my biggest challenges, and I am grateful that Spiff is my willing example.

On a lighter note, I am quitting the scrapbooking business. That is kind of a misleading statement, since I have never really been in the scrapbooking business to begin with. I was introduced to this past-time in college by several fanatic friends who were amazingly good at it and created beautiful memories. I decided to jump on the bandwagon and invest in supplies, and I tried several times to creatively display my memories. However, I found that I am not good at it. Not only that, I don't really enjoy it. While I admire my friends' beautiful books, I found that I couldn't organize the pictures, paper and journaling into something artistically beautiful enough to be satisfying to me. So I resorted to plain photo albums, and then most recently to the digital iphoto version of the photo album. So, yesterday, I made a big decision and decided to get out. I am purging myself of all of my scrapbooking supplies! I went through all of my crafty things and pulled out the stickers, cutters, templates, cropping tools, and 12x12 papers, put them in a box, and am getting ready to ship them to a friend who's mother is just getting into scrapbooking. I don't know why, but making this decision makes me feel slightly more confident in myself. I bought into it, tried it, disliked it, and instead of feeling guilty about it, I'm quitting it. Go me! On to some new, creative hobby! Any suggestions?

I have many other floating thoughts, but this post is getting long. I should break it up, lest my readers get bored. I think it has done the trick for me, though. I'm already thinking of more things to post. So, stay tuned for more exciting thoughts and stories from yours truly. Wahoo!

My, How He Grows!

I took Gunner to the doctor today for his four-month appointment. He did amazingly well, and he didn't even cry very much when they gave him his shots. I gave him some Tylenol before we left the house, and I think it helped a lot. So, thank you to all of my friends who gave me that great advice.

I'm happy to report that he is a super healthy and happy baby!
His new stats at 4 1/2 months:
16 lbs. 15 oz. (70th percentile)
26 inches long (60th percentile)
34 cm head circumference

To see his previous stats, look here.

Would you like a cookie?

Spiff told me tonight that I "offer ambiguous cookies". And it's true. I apparently don't know how to properly offer cookies to my guests, and it makes for awkward moments.

Spiff was over at my house one night, just after we met and started dating (five years ago!). I opened up a bag of some yummy raspberry-filled butter cookies I bought at the World Market. I offered him the opened bag while we were chatting, thinking he would take a cookie or two, and we could share the yumminess together. He thought I was offering him the entire bag, and being surprised by this, he awkwardly packed them up and took them home with him.

Just this afternoon, I was making a batch of cookies to take to some friends, and the home teacher came over while they were baking. It was a small batch (only 24 cookies), and I needed enough to take to our friends. However, I thought it might be rude not to offer freshly baked cookies to our guests, with the smell of deliciousness in the air. So, I put a few on a small, glass plate and offered them to the two guys. The first home teacher took a cookie. The second one took the plate and put it on his lap. I didn't get to offer Spiff a cookie. When the visit was over, the guy with the cookies asked for a paper plate so he could take them home. I retrieved the plate from him and divvied the cookies up into separate plastic bags before giving them back to the home teachers to take home.

I was so struck by the awkwardness of this situation that I can't stop thinking about it. I didn't think I was offering "take homes" tonight. It's fine that they had cookies, and I had plenty left over to take to our friends, but I'm baffled. Was I really that ambiguous? Is offering a plate of cookies, on a glass plate, to a group of people in a room, really that ambiguous?

What is the proper way to offer cookies to guests?
What would you have done?

Follow-up...Festival

My two weeks of part-time work are over. The kids performed at their festival today, and five out of seven of them are going to the state festival in May. It was a successful day, and the weather was beautiful, which made the festival more pleasant because the billions of high school kids could go outside, spread out, and practice their various instruments all over the campus.

The baby never did take to the bottle before the event today. So, Spiff and Gunner came to the festival with me. The boys hung out and waited for me, and I hung out with them in between students. One of the judges was way behind schedule, so we ended up coming home an hour later than we planned. But, the baby did amazingly well through this whole ordeal, and Spiff was fantastic to take the afternoon off to oblige me. Thanks, Spiff!

Working Girl/Mom

For the next two weeks, I am doing some accompanying for Mr. Smith, a local instrumental teacher. I'm playing for his high school students' solo festival this coming weekend, and I'm rehearsing with them for two weeks. I played for them last year, and I agreed to do it again this year because the kids are pretty great. I am taking the baby with me to the rehearsals at the teacher's home. Tuesday, the first rehearsal day, didn't go very well. Poor Gunner was having a bad day, and he did not appreciate being suddenly awoken from his nice carseat nap to a loud piano/clarinet duet. Turns out, he doesn't really enjoy the sound of the clarinet all that much. He couldn't sleep through it, and he was so tired that he screamed the entire hour and half I was there. We both returned home exhausted and irritable, and I was regretting my decision to do this tiny bit of work because it seemed so bad for the baby.

Mr. Smith hired a babysitter for Thursday's rehearsal, and the whole thing went much better. The baby had a better day in general, and he was very well-behaved for the sitter. Plus, since I was in the other room, I could hop on back between kids and feed him, rock him, or change him. It was so much better! The one downside was that the babysitter wasn't very interactive. When he fussed, she would just sit there, staring at the TV. I'm sure it's just because I'm his mom, but I know what he wanted when he was fussing, and she wasn't doing anything to help him solve his problems. She wouldn't rock him, or interact with him in any way. After I fed him and he took a nap, he just wanted to be played with, and she wouldn't even do that.

I am happy to help Mr. Smith out with the festival. I'm happy to see the kids again, and it is nice to be playing for something again. Accompanying these kids is fun because they work hard, they're talented, and I get to do a bit of teaching and coaching them as to how to play in an ensemble. However, I am so grateful that I am not a full-time working mom. I know people who do it, and love it, and are so good at this type of multi-tasking, and I admire them for all they do at work and for their kids. But I am grateful that Spiff makes it possible for me to stay home, even though we are living on a student's loan budget. I wouldn't make a good working mom...at least to a little baby.

This Friday is the festival, and Spiff is taking the afternoon off to stay home with Gunner. I will be gone for long enough that I will miss a feeding, and so we have been working on getting Gunner to take a bottle. He doesn't like it at all, and we can only get him to eat by feeding him out of a medicine spoon. It's actually pretty amusing to watch him as he realizes that the stuff dribbling into his mouth is actually food.

And for the record, Gunner seems to have gotten used to the piano, and I have been able to effectively practice with him by my side several times. My performance of Clair de Lune at the church function last weekend went okay, after I got over my initial nerves. He has also allowed me to do several hours of practicing. I'm sure we'll go through another entirely different phase of the baby/practicing relationship once he gets mobile.

The human face of our economic state

So, I could probably rightly be accused of being youthfully callous. I have two conflicting sets of beliefs regarding helping other people. On the one hand I subscribe to a Jeffersonian ideal wherein everyone has the means to help themselves, provided they possess the willpower and drive to accomplish a goal. On the other hand, I also believe King Benjamin's discourse in the book of Mosiah chapter 4 wherein he states :

"v. 16 And also, ye yourselves will succor those that stand in need of your succor; ye will administer of your substance unto him that standeth in need; and ye will not suffer that the beggar putteth up his petition to you in vain, and turn him out to perish.

v. 17 Perhaps thou shalt say: The man has brought upon himself his misery; therefore I will stay my hand, and will not give unto him of my food, nor impart unto him of my substance that he may not suffer, for his punishments are just—
v. 18 But I say unto you, O man, whosoever doeth this the same hath great cause to repent; and except he repenteth of that which he hath done he perisheth forever, and hath no interest in the kingdom of God."

We often hear the debate at church about whether or not the beggar is really begging and in need, or if he's just scamming you, or the fact that maybe the beggar is going to buy alcohol or drugs with your money. King Benjamin clearly states that as long as we're willing to give, then it doesn't matter if the beggar is misleading us or not.

The reason I bring up these two conflicting beliefs is because of an experience I had tonight. The doorbell rang in the middle of dinner which happens rarely, so I answered it. In front of me was a middle aged man clutching a clipboard, wearing a grimey hoody with an ID tag on it. He spoke in a way that made me wonder if maybe he wasn't perhaps less well endowed in the intellect department. He told me he was the paper deliverer, and that he was trying to boost his subscriptions. Evidently the local paper has cut a portion of its publications that made up fifty percent of our paper carrier's income. As a consequence he was trying to make up the deficit by getting the neighborhood to subscribe at a discounted rate to the Sunday paper. I felt really sorry for the guy, and his pitch was such that I was really having a hard time saying no. I don't really have the time to read the paper, despite my belief that newspapers are essential in a democracy (that's another topic for another time). As students as well, our budget is pretty tight, and the newspaper is a luxury I don't think we can afford.
I demurred to his offer, though I wished him luck in his endeavors and hoped he would find enough subscribers to make ends meet. Here I had been presented by the real face of the current economic downturn. The man had not chosen for the newspaper to stop a portion of its publications, and given his modest intellectual endowment, might only be able to be a paper deliverer. I realize that I have probably given too much weight to the "everyone can pull themselves up by their bootstraps" portion of my dichotomous beliefs, though this man epitomizes that ethos since he was actively trying legitimately increase his income.

As I closed the door, I thought of the inflated comparisons between the current recession and the Great Depression, and as the door shut it seemed to me as though I had just said "no" in response to the song of the 30's, "Brother, can you spare a dime?" In my head I justified my refusal of the subscription because we don't have a lot of money, but in reality, I could probably have found enough to help the guy out. Next time I won't say 'no', if he asks me if I can spare a dime.
-SS.

I wish I were a turtle

I'm not a declensionist, but it sure feels like I am sometimes. I currently would like to run away to some pristine island, and start over again. Wait, I think that people did that in the 19th century and the fact that none of those utopian communities are still surviving is a testament to the fact that even if I could run away, nothing would change in the long run. I get pretty discouraged by the health care system sometimes. We have been battling our insurance company for 4 months, since our son was born to get them to pay our bill. The two hospitals administered by Tenet (our Tier 1 providers) in our area do not do OB. Ergo, you have to go to another hospital. For some reason, the other hospital doesn't realize they are my tier 1 OB provider, and bills me accordingly. Now, all of the University's OB cases go here, but somehow they think that, as a medical student, I'm somehow not affiliated with the University. Fortunately, last week, I got the Dean who administers the university health plan on my side, so hopefully he'll lay the smack down on the Hospital.

I would also like to move away to avoid a government that is pissing money away so fast it's like the US Treasury is on fire. I feel like it's 1864 and Jefferson Davis is busy administering my fiscal affairs. Of course we haven't gotten to the point where we're printing worthless money, but I worry. I don't usually wax political on here, but man I am tired of these trillion dollar packages being ram-rodded down my throat. For a government that promised greater transparency, why was the full 1200 page text of the latest debt-fest not published for public viewing until 18 hours before the final vote? Thank you Jefferson and Madison, but there are a few common citizens with grey matter who would like to know just what those bozos in washington are doing now that we've elected them.

Can we please, please, stop the hemorrhaging of money into companies that aren't viable to begin with? If the American automobile industry can't be bothered to understand the market enough to make a car I want to buy, then why should my tax dollars be used to bail them out? If you won't support us by choice, then we'll make you support us by taxation! whee! The trouble is, right now I don't even get the joy of owning a Chevy that will die in 3 years, I just get to pay for them to be made. Yeah, yeah, I should be patriotic and 'Buy American'. Trouble is, american cars suck. I'd rather own a Toyota made in mexico than some crapper from Detroit. Why is the Camry the best selling sedan? hmm. I think it's because it's reliable. And let me reiterate, it's reliable.



For your information, things could be worse. The picture above is a bona fide picture of a 100 Billion zimbabwe dollar bill. That's right folks, $10^11. That currency is worth more as an eBay novelty than it is as a piece of money.


OK, I'm done. You don't have to agree with me, and I promise, it will be a while before I indulge in another street corner rant. Speaking of which, my wife and I saw a street corner prophet on our way to church today. He was wearing white leggings (or whatever you call those close fitting pants) and a matching white smock, I guess you'd call it. My question was this, where do you get those kinds of clothes? I assume you have to either be handy with a sewing machine, or know someone who is, because when I was last at Old Navy, I didn't see a "raving lunatic" section.

Ok, now I'm really done, I promise.

Attempt #1

I have been asked to play "Claire de Lune" at a church event on Saturday night. I don't have a lot of time to learn it, and I'm hoping that I'm not too out of practice to play it decently well. But I really do need to practice, seeing as how I haven't played in public for about four years. G.A. got up from his morning nap in a good mood, so I decided to pull out the piece and practice up a bit. I set him up in his bouncy chair with his toys, right next to the piano. I got through the first page before he started fussing. I checked him, and he smiled at me, so I figured that he must be fine. I turned back to the piano, and he immediately let some a string of loud, sad sobs. I picked him up, and he calmed right down.

This is what I learned from this attempt:
1. If Gunner could talk, he would say, "Momma, stop ignoring me!" But since he can't do that, he uses his very effective attention-getting sob.
2. If I'm going to play the piano more often, I'm going to have to ease the baby into it, one page at a time.
3. It turns out that he was hungry. I should try again after a he's well-fed and well-rested and see how it goes.

It makes me wonder how my former grad school colleague accomplished her last two doctoral recitals with a new baby at home. I am also glad I'm not trying to do what she did.

Retraction

So, I was a jerk. I put some rather sarcastic stuff on a post that has been removed. Thank you to those people who put up some rather undiplomatic (and thus not posted) comments. Apologies to the individual implicated in the post.

The Die is Cast

Well, I have registered for and selected the date of my Step I of the United States Medical Licensing Examination (or simply Step I). June 12 is the fateful day, when I shall dance with fate and her hideous gavotte shall spin me round and leave me no options but to become a psychiatrist. In order to mitigate the affects of said gavotte, or even fate's repulsive minuet, I have begun to study for step I. This would probably classify me as a gunner in the eyes of most of my classmates. I take exception to that, however, as a gunner is someone who subverts other's learning by providing erroneous information in order to maximize their own chances at doing well. I fail to see how my studying will in any way change the outcome of Step I for anyone else. Like a certain husband in Miss Margaret's blog, I have started reviewing micro biology and also reading through First Aid, my step I review book. My hopes are that I will do well enough to have my pick of anesthesiology residency spots, which means I will have to score in the 270's. Ok, that's totally false. Lets just hope I do better than the national average. If I surpass my personal goal, I will let you guys know, trust me.

In other news, I continue to have the persistent hip pain that has dogged me since my mission, 8 years ago. I had hoped that a month and a half of working out at the Y would at least begin to lessen the constant muscle pain, but a run on friday prove me wrong. Back to the drawring board and time to strengthen those crappy little abductors. Maybe Dan could set me up with an early arthroplasty. Of course, that would leave me lame at age 50, but, that's still 23 years away, right? If any of you have any ideas for how to treat my piriformis syndrome (self diagnosis from the internets), let me know. I'm particularly interested in colon detoxification.
ss

Car Troubles?

Spiff and I decided to treat our 13-year-old Mazda 626 to a new radiator today. We decided that it deserved one, after putting on almost 200,000 miles. That and the fact that its old radiator had a hole in it and was leaking antifreeze, an issue we discovered when our car started overheating on our way to church yesterday.

On the plus side, we found a repair shop two blocks from our house, and the guy actually seems to know what he's doing. He's close and competent. And he fixed our squealing car! The belts have been squealing off and on for a year and half. All of our neighbors know when we leave, and everyone we visit can hear us coming from two miles away. Every mechanic we have taken it to hasn't been able to fix it. They claim, "We didn't hear it squeal, so there's nothing we can do." He found a loose bolt that wasn't allowing the belts to stay tight, and he replaced it.

New radiator, new bolt, tight belts...What a good day for our car! I'm hoping that if we occasionally treat it to new parts, it will feel loved and continue to run for us for a long long time.