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.

Communication

I wonder what my baby would say to me if he could talk. Yesterday, Spiff and I were running an errand, and Gunner had a meltdown in his car seat. There was no apparent reason for it. He wasn't tired or hungry, and Spiff was in the back seat with him. Yet Gunner cried inconsolably for about fifteen minutes. Once we reached our destination, he was fine.

It makes me wonder what babies think when weird things bother them. I wonder if his foot fell asleep, or if he was being pinched by something in the car seat, or if he was too hot. I also wonder what he thinks when he gets a sore throat. I have also wondered how it is for him when he wakes up hungry in the middle of the night, and it's dark and he has no way of getting food for himself. He can only cry and hope that those big friendly people who take care of him will eventually come and help him.

Even though he doesn't talk, Gunner is pretty good at communicating to us. He cries when he's hungry, and he squawks when he's tired. He fusses when he has the hiccups. It still makes me wish he would say, "Momma, my foot has gone to sleep and I'm stuck in this uncomfortable car seat. Would you please pull the car over and get me out?"

But then again, even if he could say this, I have to wonder if I would listen. I would probably just say, "Just a few minutes. We're almost there." And I would keep on driving because the errand has to be run...Doesn't it?

Lies People Tell

People tell lies sometimes. I'm not talking about deliberate lies people use to cover up something bad they have done. I'm talking about the lies they tell to make you feel better about a situation. When I had my baby, I was told that babies sleep so much when they're newborns that I really wouldn't be that sleep-deprived. Simply sleep when the baby sleeps, and I wouldn't get that sleep-deprived. They said that this is especially true since this is my first baby, and I don't have to chase after a toddler. I believed that one until we had a newborn who wouldn't sleep longer than 30 minutes at a time. I have never been so sleep-deprived in my life.

The most recent lie I'd like to discuss is one I have heard many times at the doctor's office, at the lactation consultant's office, and from many friends. They say that breast fed babies don't get sick. There is something about the mother's antibodies that get passed through the milk to the baby, and the baby isn't supposed to get sick because he has "breastmilk antibody power" to fight off whatever hits him. This is such a lie! My baby now has his third cold in three months.

Here is my theory: I haven't gotten sick. Maybe it's backfiring and I'm getting double antibodies from the milk. Maybe it's helping me instead of the baby. So, student doctors, go on and tell me what a bunch of poo this theory is. I don't mind. I'm just trying to make myself feel better about my baby being sick again.

Going public

On my mission, my mission president taught me a few valuable principles regarding goal setting. First, the goal must be quantifiable, i.e. you can measure it numerically somehow, or have some other definitive way of defining accomplishment. So, it would not be a good goal to say to myself "get in shape". What does that mean? Unless I assign some quantifier, then the goal become mutable and therefore useless. Secondly, it is beneficial to go public with your goals so that you become accountable for their accomplishment. So, here goes:

We joined the YMCA several months ago, but until now I haven't used my membership. Here then, are my fitness goals for 2009, and you, the readers will hold me accountable (if you care to) for their accomplishment. If nothing else, I will have to hang my head in shame and tell you why I did not follow through. I am doing this in order to avoid the stereotypical new-year's-resolution-fitness-bandwagon-jumping that peters out by mid february.

Since I can only control my schedule through the end of June, these goals are only to be accomplished or worked on until June 30.

Row 15K in 60 minutes on the erg.
Run 10k in <45 minutes.

To accomplish:
at least 3 days/wk rowing and lifting or running.

We'll see how these pan out. I'll post them on the sidebar to keep them fresh.
-SS.

Coulda, but not Woulda, and not Shoulda.

We have several friends here who aren't in medical school, but are rather pursuing degrees in history, or law, or other paths not connected with the diseased human form. In speaking with them, I can sometimes glimpse the world of what might have been. I studied history and french literature as an undergrad, before turning my sights on medical school. I thoroughly enjoyed history, and have since I first read Winston Churchill's "Memoirs of the Second World War" as a 4th grader in france starved for english reading material. My sister is also studying history, in fact in a domain that I find fascinating, the Great War. When listening to their stories of school and the esoterica of their respective fields of interest, I feel a sense of loss for the intellectual discourse and discovery that the pursuit of historical research provided me as an undergradate, and which I no longer have as a medical student. In many ways the first two years of medical school are not very challenging from an intellectual standpoint. School is not easy, it requires lots of work and time, but the material itself is, with the exception of renal physiology, not too challenging. The challenge of these first two years is not in articulating and researching new interpretations of bygone machinations of the Hapsburg empire, but rather in simply force feeding my brain a large volume of material in a small amount of time.
When I consider the alternative, which I did 3 years ago when I applied to medical school, I would not choose to study history or French literature, however. As I wrote my senior thesis, such as it was, I was more depressed than I had been since my mission. I didn't realize it then, but that pushed me more firmly away from history and towards medicine. I enjoy medical school and the material I'm learning, even at the expense of having the joy of intellectual discovery a graduate history degree might have afforded me.

Piano Teacher's Musings

I visited some of my former piano students and their parents while we were in Oregon over Christmas vacation. My students were so adorable, and so much taller than they were when I left them 18 months ago. One student got all dressed up to perform for me in her nicest dress, necklace and shoes. Some other families had a little recital for me, each of the kids taking turns to play their most recent recital pieces. Some other students I met with played their Christmas songs for me because none of them could remember their most recent recital pieces! They have all improved with their new teachers, and it was a lot fun to hear them play. I realized as I listened to them that I miss being a part of the process. I love that part of teaching...helping them figure out the technical challenges, guiding them through the form, finding the details that make it extra special, and watching as they feel the satisfaction of finishing and performing a challenging piece.

I have a new piano student. She is my neighbor girl and will be taking lessons from me temporarily until she moved to CA in June. She is 13, a transfer student, and a beginner with three months of experience. I taught her first lesson today. It was my first lesson in a year and half, and I can tell that I'm rusty. She is very bright and talented, and I am excited to work with her.

I was so spoiled in Oregon, and I have a feeling that I will always remember my time there as the Glory Years. I had the very best type of students and families to work with: talented, hard-working, smart, fun kids with dedicated parents. I left Oregon with extremely high expectations, and I am afraid that I will never find such good families to work with ever again. I am also afraid that I won't want to teach because any new family just won't be as good as my Glory Years families. I think this new student is a good one. I'm hoping that she will help me get over my irrational fears, and I will find the courage to build a studio again some day.

He exceeds even himself

No, the title is not some immodest boasting about my academic performance. Instead this is another episode in the continuing saga of foolish classmates in medical school. Faithful readers will no doubt recall a certain individual who, when questioned about diarrhea caused by food poisoning, confidently asserted the diarrhea was indubitably due to duodenal atresia (a congenitally non-patent gut tube). This same individual surpassed that poor showing yesterday.

The picture above is of a Littmann Cardiology III stethoscope. What you can see is one side of the stethoscope that is configured to be a pediatric diaphragm. The opposite side looks exactly the same, only larger as it is an adult diaphragm. Just for absolute clarity, this stethoscope, configured as shown, has two diaphragms.

In our physical diagnosis class, we have been learning to do an abdominal exam. Part of the exam requires that the medical student auscultate the abdomen to hear bowel sounds. In order to do so, we are to use the diaphragm of the stethoscope. The protagonist of our tale (not me, but duodenal atresia boy), took his turn to auscultate the standardized patient. With his Littmann Cardio III, configured exactly as the image above shows, he sheepishly asked to borrow one of the other medical student's stethoscopes since his lacked a diaphragm. This confounded everyone in the room, including the standardized patient who asked him "how does your stethoscope not have a diaphragm?", to which he replied "this is a pediatric stethoscope, it doesn't have a diaphragm."

Now, to be fair, this could be an honest mistake for a medical student to make. The only problem is, we're not first years anymore who only have stethoscopes we've received as gifts and no formal instruction in their use. Dr. M has lectured twice on medical equipment, there have been presentations by 3M, makers of littmann products, as well as by Welch Allyn and other equipment manufacturers. Scariest of all though, is that we've been instructed and tested on the cardiac exam, which requires knowledge of where and what sides of a stethoscope to use, as well as the respiratory exam which requires the use of the diaphragm on a stethoscope. So, barring attendance-optional corporate presentations, there have been 3 physical exam lectures, 3 reviews, and 2 equipment lectures that should have clued our protagonist in regarding the parts of his stethosope. Even more shocking, is that, regardless of how he would have put the stethoscope on the patient, assuming of course that he wasn't using the earpieces or the tubing, he would have put a diaphragm on their abdomen, yet he didn't have the sense to realize this. Wow. Strong work lad.

A Visit to the Doctor

I took Gunner to his two-month check-up yesterday. Apparently going to the doctor's office is a stressful experience for me. I was terrified the first time I took him, and I shook the whole time. I was still shaking this time, and especially nervous because it was time for his first round of shots. He did amazingly well throughout the appointment. He was a happy baby while being stripped down, weighed, and measured. I fed him while waiting for the doctor, and he promptly fell asleep. He slept through the medical student's exam, and when the doctor woke him up during her exam, he just smiled at us. The doctor kept commenting on how amazing it was that he wasn't cranky from being awoken during he exam.

That is another reason that the shots were so awful. He was in such a pleasant mood that when the nurse stuck him, the look of betrayal on his face was heart-breaking! He screamed, and I cried, too. He got three shots in his legs, and with each one, there was a new scream. Poor little guy! It was my first lesson in teaching "That Lesson" to my child. You know the one..."I know this hurts, but it's good for you." I'm hoping it will be easier to teach those lessons to a kid who can reason and make his own decisions. Hurting my completely innocent and dependent baby was very difficult for me to do. But I'm a believer in immunizations, and I know it's necessary.

He only cried for a couple minutes, and he has been mainly pleasant ever since. He has been sleeping a lot today, and I'm grateful for that. For anyone who is curious, here are Gunner's new stats at 2 1/2 months:
Weight: 13 lbs. 14 oz. (birth weight: 7 lbs. 1 oz.)
Length: 24 1/4 in. (birth height: 20 inches)
He was in the 75th percentile in weight, height, and head circumference.
He's growing perfectly! He's getting so big and tall, and I love his chubby little body.

Aye-aye-aye!

This is what happened between 8:20 and 8:45 this morning:
I was up quite a bit with the baby last night, so I slept in this morning while Spiff got ready for school. I woke up when I heard something clank to the ground and him holler out in pain. Turns out that he had sliced his finger with a knife while preparing his lunch. It's a pretty deep cut, and I'm grateful that we invested in first aid supplies a few months ago. He tended to his finger while I groggily bustled around and finished packing his lunch.

Since his finger was still bleeding, Spiff asked me to take him to school. Thankfully, the baby woke up in a good mood, so we packed him up in the car seat, and I threw on some jeans and my Keen clogs. Spiff commented on the icy conditions caused by last night's freezing rain while he took the baby out to the iced-over car. I locked the door behind me and then preceded to slip down the icy concrete front steps, falling on my back and head. It knocked the wind out of me, but other than a sore neck, no damage was done. I didn't realize that my Keens don't have the greatest traction for this kind of weather. I'm also incredibly grateful that I wasn't holding the baby when I fell. Spiff helped me back up the stairs, and I left him to scrape the ice from the car and to try to get to school on time.

I went running yesterday for the first time since having the baby. My faithful running partner and I ran a measly two miles, with walking breaks. It was cold, and my lungs felt out of shape. And now my legs are terribly sore, and I feel like a weakling for getting sore after a two mile jog. Add that to my newly sore neck, and I feel like a Moaning Myrtle every time I move.

I'm proud of Spiff for going to school today. After his cut, the icy car, and my fall, I wanted to give up and spend the rest of the day in bed.

You're a sick man, charlie brown

So, I guess I really belong in medical school. A good friend of ours recently had hand surgery to remedy a mass that had been there for years. On his facebook page, there were 25 comments expressing sympathy and encouragement. And then there was my comment which was essentially, "what's going on with the lesion? what was it?" Sadly I was more curious to know all about the pathology and the surgical management than how our friend was coping post operatively. I can't help it, can I? I really want to see a cross section of that thing histologically, and see the gross specimen. So, that's how it happens folks; those callous doctors start in medical school. No soft Florence Nightingale here, just someone with clinical curiosity that surpasses his empathy.

School starts tomorrow and I'm really going to miss hanging out with my little boy all day.

The value of study

So little G.A. has been sick this week. I got a little tickle in my throat sitting in the airport waiting room on our way out here, and 24 hours later it was yet another cold. That makes 3 in 8 weeks. I hate colds, when the prodrome hits, I think "ok, i've done this, I know what this feels like, let's just fast forward 7 days and I'll be well again. I've been recovering, and now GA is sick. That makes you feel pretty terrible as a parent, knowing that you, and only you, are resposible for your little one's misery. He's a good little trooper though, and he smiles at me between his periodic bouts of coughing and congestion, which makes the smiling a little sad.

The midnight thought of a semi-awake medical student with a sick child make me realize that I know nothing about medicine. I study about 40-55 hours a week, and finished a unit on the respiratory system not quite 1 week ago. For all that work, however, I realized as I listened to my little boy's cough, that I didn't actually learn anything while studying respiratory viruses. The first clue of course was the fact that my second respiratory exam was the worst one I've had since anatomy a year and a half ago. It became obvious of course, as well, when I could not recall which viruses caused RSV, Croup, pertussis etc, nor which ones were associated with wheezing v. stridor v. cough v. rhinorrhea. Fortunately, it seems that GA has only a garden variety cold, but seeing costal retractions and hearing his cough made my mind whirl away to unpleasant places.

I imagine then, that the main purpose of 3rd year will be to actually acquaint me with the real presentation of these and other illnesses. What does a child with stridor actually present like? I know theoretically what to look for, but I'm a pretty visual learner, so I need to actually see something before I can really recall it in a useful way. It was pretty disheartening to realize that all my work is not as productive as I had imagined.

Things that make it feel like Christmas (to Mindy):

Shopping: I have done most of our Christmas shopping online this year. It has been cold, and I didn't want to take the baby out. Besides the fact that all of our gifts have to go to our families in Idaho, Utah, and Oregon. So, if we have to ship them anyway, we may as well let the company we buy from ship the stuff for us. I did send a couple packages yesterday via the US Postal Service. It cost $10 per package. Therefore, I am a huge fan of Amazon.com's super-save shipping and other companies' free shipping offers. I think online shopping will become a Christmas tradition.

Christmas Cards: I need to keep the promise I made to myself last year to sent my Christmas cards before December starts. They are so much work! At least I don't make my own cards, although I admire my sisters' beautiful home-made cards every year.

The Christmas Photo: I like getting photos in Christmas cards I receive, so I like to send photos in our cards. We didn't get a professional portrait taken this year. In fact, the only family picture we had was a snapshot a neighbor took of us when we happened to be out on a walk with her on a nice Fall day. So, that's what made it into our cards.

Music:
The Messiah
Nat King Cole (I love his rendition of "Sing Sweet and Low". So beautiful!)
The Manhatten Transfer
My family's old Christmas mix my dad made years & years ago (before I was born?). I couldn't tell you who the artists are, so don't bother asking.

I also don't think it would feel like Christmas without at least one summer sausage. We have experienced these things, and we're fully in the Christmas spirit. It's the end of Spiff's block of Pulm, and it's off to Oregon for family, fun, and a two-week vacation!
Merry Christmas!

Great Words Part II

Last year I had a post about great words in medicine. This is a follow up post to that one, demonstrating a few of the new words I have learned in the respiratory module.

Ferruginous: Having the color of iron rust; reddish-brown.
Choryza: sticky nasal secretions, seen in RSV
Recrudescence: To break out anew or come into renewed activity, as after a period of quiescence.
Birefringence: Double refraction. This is seen in microscopy with certain compounds in the body, namely talc and amyloid stained with Congo Red.
Atalectasis: Collapsed alveoli in the lung.

America the strange

So this is a picture of what I want for Christmas. This is the perfect gift. It combines NASCAR with Thomas Kinkade. Yes folks, for a limited time, two of the classiest things in America are united in one perfect painting. Look at the jets, and the little boy perched on his daddy's shoulders, just waiting for some fiery mayhem to entertain his drab little Dickensian life. It's almost Norman Rockwell-esque, only this is Art, whereas Norman Rockwell was just some paint-by-numbers hack. Perhaps I have those reversed. No matter, Thomas Kinkade has finally engraved the Sport of Kings with his enchanted brush.


Additionally, I have decided to use my car as a tombstone. There seems to be a trend in our fair city of putting up a sticker in the back window of the car saying "In Loving Memory of Wallace "Buck" Servohammer, 1981-2004." Granted, there are probably a disproportionate amount of untimely deaths, especially in the north. Why the automobile, however? What can a rolling epitaph acomplish that a stone monument cannot? I can only assume that the car itself is "in loving memory". That, to preserve the untainted memory of their loved one, the driver purchased this automobile. Thus, quite literally, the car is "in loving memory of Joe "pink-eye" Jones". Perhaps the phenomenon is even more macabre. The family, unable to afford a traditional burial plot, elected instead for a motorized one. The car, then, is a mausoleum with the remains inside, and the sticker is an affordable epitaph.

This brings me to another point. There is a local cemetery with an associated vault that claims on the entry sign to be "A Library of Lives". Implicit in the use of the term library, is the notion that items may be borrowed and returned. Presumably then, one can, as a member of the library, check out some remains, which are due back within a specified time period. I don't even want to contemplate what people do with the cadaver during their loan period. I wonder if there are very popular corpses which you can only check out on reserve? Also, if it truly is a library, doubtless one does not check out the same 'volume' every time. What do people look for as they comb the shelves? "Oh, this one looks good, he was around in the 1790's." They might say to themselves, hoping to check out a piece of history.

Well, these are the ghoulish thoughts that my have occupied my mind of late.
-SS

Respiratory

So we've been studying the respiratory system in school. Unlike the majority of my classmates, I have enjoyed the last two units immensly, namely cardio and pulmonary. Learning things in these last units has been different than anything else in medical school so far. It's all physiology, which is great because it's not memorizing meaningless details about the histology of ADEM TS-13 deficiency or which type of tick carries Lyme disease. This is medicine that will be relevant every day of my professional career, if in fact I decide to pursue anesthesiology. The other stuff is useful mainly as context for me, so that I can read an article and know all of the vocabulary. I realize that 'everything is important' but lets face it, sometimes a PhD will preach about his pet project and it's not important.

I really enjoy the respiratory syllabus, it's extremely well organized and full of cross references that I would otherwise have to make myself. Cardio as a subject was good, but it was really hit or miss with the instructors. The first half of pulm, has, so far, been well taught.

In other news, I have been nursing a rather intense cold for the last week , which has been pretty upleasant. It's really hard to study all day and evening when your head is leaking and your lungs are full and your eyes are watering and you feel miserable. Nevertheless and notwithstanding the greatness of my misery, I think I did pretty well on the pulm exam . We'll see next Monday.