Monday was an ok day. We had an excellent orientation of the ED software programs and the facility itself. However, I was the only student in scrubs. It made the program feel stuffy, especially when one of the Attendings pointed out that ties highly encouraged by the program's directors. First, who where's a tie in the ED!?! Kinda hard to jump in on a trauma in a friggin' suit! Second, I only brought my interview suit with two shirts!
After the students made our schedule for the first week, I decided to wear my new suit slacks and dress shirts only when I working with one of the PDs. I ended up getting the more conservative PD's only two shifts of the month, Monday and Friday. So I headed home after orientation and changed into my $1000 suit slacks vowing to send UMass a bill if I got blood and guts on them.
The facility is less than a year old. The $120M hospital included a new $50M ED and new offices for the ED department, some of which don't even have furniture yet. They did a nice job with the design. It's attractive and functional. The only problem I've seen so far is that the hospital beds are so full, the ED is becoming an Observation Unit.
The software is a little nicer than MUSC's, but has plenty of usability issues and glitches in its second version. Bottom line, they are still using paper charts for the foreseeable future. Unlike, MUSC however, the paper chart system is horrendous. It's a pain to find charts and make sure orders or being seen and acted on.
The residents are very nice. I've only met a handful of the 36, but they are helpful both on the job and in answering questions about UMass and EM. They seem very happy with the program. And they never wear ties in the ED! In fact, most of the attendings wear traditional "in the trenches" scrubs and casual clothes. I guess it's just the PDs and attendings involved in running the program that are stuffy.
Didactics have been pretty good. Wednesday conference involved five hours of lectures, case studies (M&M lectures), going over EM Board prep questions and small group break-outs sessions to work through case management together. Journal club Thursday night was well attended by residents and attendings, included dinner and had some great content on Pediatric Lumbar Puncture procedures. Today was my first morning shift, so I got to experience teaching rounds by one of the PDs on overdoses and found it very good.
The shifts have been very tiring. This is a very busy ED and I rarely get a chance to eat and take bathroom breaks. So far it's been a little too busy for optimal learning. The cool cases get snatched up and I never have time to peak in on them or procedures. My patients are either run-of-the-mill or very complicated. The former mean I don't get much attending attention and therefore don't learn much. The latter mean I have the patients all day and do a lot of babysitting between specialty consults and extensive tests. I'm hoping that as I take more morning and overnight shifts things will settle down a bit. I also think the 8 hour shifts make things more chaotic with a lot more turnovers and long stay after shifts to finish discharges. I usually stay 30-60 minutes after my shift tidying up paperwork.
Hopefully, when we finalize the schedule for the rest of the month on Tuesday, I can get some easier shifts.
As for cases, my luck seems to be hanging with me. I was able to help out on a paraplegic guy, probably homeless, who had his foot mangled by his girlfriend's chihuahua. They are both in wheelchairs, and probably sleeping on the street by their smell. He states that while sleeping their new puppy had a free meal of his left fore foot! The big toe was gone as was most of the next one and the flesh where bunions occur. I didn't stick around to see who won the debate about whether the patient should be admitted to Ortho or Plastics.
The other cases have been pretty standard. And while I'm out of practice working on adults, it coming back pretty quickly. Exhausted as I am, I'm enjoying the job which is very comforting this close to the Match.
Probably the highlight of the week had nothing to do with UMass. I received both my SLORs in the mail from the PDs at Arrowhead and MUSC. That was a relief. I immediately updated my ERAS applications to include them. A close second was winning an auction on Ebay for a new Phone/PDA since mine broke. Hate spending the money, but at least it's an upgraded model and I can have access to all my medical programs while on shifts.
Finally, the house I'm staying at is a nice old Victorian three story being remodeled by another 6th year student (MD, PhD). He and his wife, along with the two other renters are nice. It's a comfortable place with lots of room to study, store food, etc. My favorite thing is having a big room with a desk and wireless Internet access.
One week until I fly to Seattle to see the family and attend the ACEP Scientific Assembly Residency Fair!
Friday, September 28, 2007
Sunday, September 23, 2007
Election Year Politics
Everyone talks about how healthcare reform is the issue in the upcoming Presidential election. However, the candidates and, especially, the media treat it like a distraction. A good editorial from the NYT today reminded me of where we're at in this mess.
While the Democrats are least talking about the issue, they seem to be taking the easy road as much as the Republicans. No on either side mentions how generate competition between insurance companies, pharmaceutical companies (or at access their offshore pricing) and other Biotech companies. Equally detrimental to the country is that neither side mentions how we are going to cover health costs as a nation so that our biggest employers and exporters aren't burdened with costs that hurt their competitiveness internationally.
Recent articles and TV reports portrayed CEOs of multi-nationals as very interested in reform foremost because of the competitiveness issue internationally, but also because the liability of retirees is hurting stock prices and company values.
So why aren't there more substantial discussion going on? Are we Americans so naive that we can't face the truth - any solution with hit all of us in the pocketbook? Are we going to wait until this is a crisis and the babyboomers bankrupt the country between Social Security and Medicare?
It's very frustrating that elections now seem to direct their campaigns (and their terms in office in large part) towards the lowest common denominator of society: the uneducated or uninformed, those who vote on one emotional issue (gun rights, abortion, etc.) and the those naively think they can escape any pain or consequence of costly decisions.
How long can a Democracy last catering to clicks and Junior High mentalities?
The Battle Over Health Care
While the Democrats are least talking about the issue, they seem to be taking the easy road as much as the Republicans. No on either side mentions how generate competition between insurance companies, pharmaceutical companies (or at access their offshore pricing) and other Biotech companies. Equally detrimental to the country is that neither side mentions how we are going to cover health costs as a nation so that our biggest employers and exporters aren't burdened with costs that hurt their competitiveness internationally.
Recent articles and TV reports portrayed CEOs of multi-nationals as very interested in reform foremost because of the competitiveness issue internationally, but also because the liability of retirees is hurting stock prices and company values.
So why aren't there more substantial discussion going on? Are we Americans so naive that we can't face the truth - any solution with hit all of us in the pocketbook? Are we going to wait until this is a crisis and the babyboomers bankrupt the country between Social Security and Medicare?
It's very frustrating that elections now seem to direct their campaigns (and their terms in office in large part) towards the lowest common denominator of society: the uneducated or uninformed, those who vote on one emotional issue (gun rights, abortion, etc.) and the those naively think they can escape any pain or consequence of costly decisions.
How long can a Democracy last catering to clicks and Junior High mentalities?
Saturday, September 22, 2007
Trip to Worcester
It's been a long day. One that reminds me travel isn't all bells and whistles.
First, Microsoft Outlook again messed me up, almost causing me to miss my flight. Because I entered the flights while on the West Coast, my 11:50am flight became 2:50pm. Luckily I remembered this issue around 10am and called Continental to check. Charleston is a small airport, so I was still able to make it to the gate in time.
However, the plane was late arriving. Then it had mechanical problems, and being such a small airport Continental couldn't be sure when the next flight would leave or how we could catch connecting flights. I got lucky and made it back to the ticket counter #2 in line since most people lined up back at the gate. They switched to US Airways, which gave me 40 minutes to fly out. Somehow my baggage made the switch as did I.
I arrived in Boston later than expected, and it was a long limo ride out to Worcester. But it could have been much worse. The house is pretty nice and walking distance to one of the hospitals I will be working at. It doesn't look like this is as nice an area as Charleston, but it's hard to tell at night.
I'm exhausted, but I got in some pleasure reading and am enjoying staying at a place wireless access so I check e-mail while watching Saturday Night Live.
First, Microsoft Outlook again messed me up, almost causing me to miss my flight. Because I entered the flights while on the West Coast, my 11:50am flight became 2:50pm. Luckily I remembered this issue around 10am and called Continental to check. Charleston is a small airport, so I was still able to make it to the gate in time.
However, the plane was late arriving. Then it had mechanical problems, and being such a small airport Continental couldn't be sure when the next flight would leave or how we could catch connecting flights. I got lucky and made it back to the ticket counter #2 in line since most people lined up back at the gate. They switched to US Airways, which gave me 40 minutes to fly out. Somehow my baggage made the switch as did I.
I arrived in Boston later than expected, and it was a long limo ride out to Worcester. But it could have been much worse. The house is pretty nice and walking distance to one of the hospitals I will be working at. It doesn't look like this is as nice an area as Charleston, but it's hard to tell at night.
I'm exhausted, but I got in some pleasure reading and am enjoying staying at a place wireless access so I check e-mail while watching Saturday Night Live.
EM for Immigrants?
The immigrant debate seems to have crashed into Emergency Medicine coverage for the uninsured. This NYT article got me thinking:
Equally troubling is what coverage we as taxpayers should shoulder for children born here from illegal immigrants. Tetralogy of Fallot is a life long condition that typically several heart surgeries. As a chronic condition, I don't think treatment should be automatically provided. However, withholding ongoing treatment can lead to more expensive and traumatic treatment for acute emergencies.
No easy answers, but heart chemotherapy for illegal alien may mean dozens of poor kids don't get regular care, including immunizations and other preventative measures.
U.S. Rule Limits Emergency Care for Immigrants
With healthcare costs skyrocketing, why should we provide chemotherapy, expensive experimental medications, transplants, etc. that definitely aren't critical emergencies to foreigners without insurance? I think that it is a lot to ask Americans that are going broke trying pay for healthcare costs and medical insurance.Equally troubling is what coverage we as taxpayers should shoulder for children born here from illegal immigrants. Tetralogy of Fallot is a life long condition that typically several heart surgeries. As a chronic condition, I don't think treatment should be automatically provided. However, withholding ongoing treatment can lead to more expensive and traumatic treatment for acute emergencies.
No easy answers, but heart chemotherapy for illegal alien may mean dozens of poor kids don't get regular care, including immunizations and other preventative measures.
Friday, September 21, 2007
Break Time: Onion Medical Humor
These have had me rolling with laughter. Great way to relax.
In The Know: Should We Be Shaming Obese Children More?
In The Know: Should We Be Shaming Obese Children More?
MUSC Rotation Ends
Finished my last shift at 8am this morning. Slept for a few hours and now am relaxing contemplating whether to catch a movie or now. Flight to UMass takes off tomorrow afternoon, so I don't have to pack quite yet.
The rotation ended well. I managed to meet up with Dr. Kini and get my SLOR completed by him, signed and deposited at the MUSC offices. I also met with one of the assistant program directors for coffee and had a nice conversation. Probably the best was the compliments I received from the Attendings and Residents over the last day or two. You know you're doing ok when the residents say that they keep forgetting you're only a student and not one of them. And when a first year EM resident hugs you goodbye, I think it's a good indication you have their confidence and trust.
The last two shifts were 12-hour night shifts in Peds. Nothing too wild, but I did get to see some interesting cases. A depressed young girl with ALL and a rash that turned about to be a bad case of mucositis from her chemo. At least it wasn't a fungal infection like we initially believed. Another girl had a simple UTI, but the parents were petrified about rhabdomyolysis since one of siblings died from it and all the children have a muscle enzyme deficiency making them susceptible to malignant hyperthermia and rhabdo.
I would be extremely surprised if I don't get invited back for an interview, D.O. package notwithstanding. Now it's time to get mentally prepared for UMass and a month of adult EM.
Two more weeks until I get to see Becky and the kids in Seattle!
The rotation ended well. I managed to meet up with Dr. Kini and get my SLOR completed by him, signed and deposited at the MUSC offices. I also met with one of the assistant program directors for coffee and had a nice conversation. Probably the best was the compliments I received from the Attendings and Residents over the last day or two. You know you're doing ok when the residents say that they keep forgetting you're only a student and not one of them. And when a first year EM resident hugs you goodbye, I think it's a good indication you have their confidence and trust.
The last two shifts were 12-hour night shifts in Peds. Nothing too wild, but I did get to see some interesting cases. A depressed young girl with ALL and a rash that turned about to be a bad case of mucositis from her chemo. At least it wasn't a fungal infection like we initially believed. Another girl had a simple UTI, but the parents were petrified about rhabdomyolysis since one of siblings died from it and all the children have a muscle enzyme deficiency making them susceptible to malignant hyperthermia and rhabdo.
I would be extremely surprised if I don't get invited back for an interview, D.O. package notwithstanding. Now it's time to get mentally prepared for UMass and a month of adult EM.
Two more weeks until I get to see Becky and the kids in Seattle!
Monday, September 17, 2007
Lakes aren't safe anymore either!
It was a tiring but very interesting weekend in the adult ED with the MUSC Program Director, Dr. Kini. I really like his teaching style. It's obvious he loves to teach students and that is what keeps him going at this point in his career. His 3-minute lectures are pretty classic and entertaining.
I believe I did a good job being thorough and efficient, his big concerns. So I hope he'll write a standardized letter of recommendation (SLOR) for me. I didn't get a chance to ask him at the end of my shift on Sunday because we had a couple very interesting cases come in.
First, a young mom got herself and her daughter into an accident. She couldn't remember how, but she drove her car into a tree resulting in a small transverse process fracture to her T-1 vertebrae (upper back) and pretty bad laceration on her lower lip. The EM resident wanted to repair it, but a Plastics Fellow finally showed up to do the job since it went all the way through to her mouth and had big cosmetic implications for a 20 year old. Everything went smoothly until we neared the end when we learned the next trauma case coming in was a 59 year old man that had his arm bitten off by an alligator! (Her daughter was fine, just a couple of scrapes and bruises.)
As you can imagine, there was a crowd waiting to see the guy arrive. I managed to get a good view since I working the ED and helping the young mom in an adjacent trauma bay. So the guy finally arrives conscious and in pretty good condition with the help of pain medication and tight bandages over the stump of his left shoulder. The EMS personnel told us that he was swimming in a local lake frequented by several of the ED staff. He was returning from a work-out when something tugged on his arm and presumably spun around to twist off his arm. He walked out of the water clutching his stump with his one arm. He was then airlifted to us while a large posse of active, retired and volunteer police officers went on a hunt for an alligator with a human arm in its mouth!
The alligator had to be killed and then cut open to retrieve the arm, which arrived on ice about a half hour after the patient. He was rushed up to surgery for an attempt to reattach his arm. Remarkably there wasn't much bleeding. Nurses that saw him walk out of the water probably saved his life by putting pressure and ice on the wound until EMS arrived. Even so, it was a pretty gruesome sight as the surgeon felt around for the brachial artery, clavicle and scapula/glenoid fossa. In typically clinical medical terminology, it was called a 'disarticulated' shoulder.
The story made front page news in town today. The article mentioned it was a 12 foot 550 pound alligator. I headed home a half hour later as he headed up to the OR for the attempt to reattach his arm. I kept thinking how weird it has been that I experienced shark and alligator bites on this rotation in little old Charleston.
Today Peds ER shift was pretty routine. I enjoyed working with the kids again though. Now it's time to finish my presentation for Dr. Upshaw on - treating shark bites of course!
I believe I did a good job being thorough and efficient, his big concerns. So I hope he'll write a standardized letter of recommendation (SLOR) for me. I didn't get a chance to ask him at the end of my shift on Sunday because we had a couple very interesting cases come in.
First, a young mom got herself and her daughter into an accident. She couldn't remember how, but she drove her car into a tree resulting in a small transverse process fracture to her T-1 vertebrae (upper back) and pretty bad laceration on her lower lip. The EM resident wanted to repair it, but a Plastics Fellow finally showed up to do the job since it went all the way through to her mouth and had big cosmetic implications for a 20 year old. Everything went smoothly until we neared the end when we learned the next trauma case coming in was a 59 year old man that had his arm bitten off by an alligator! (Her daughter was fine, just a couple of scrapes and bruises.)
As you can imagine, there was a crowd waiting to see the guy arrive. I managed to get a good view since I working the ED and helping the young mom in an adjacent trauma bay. So the guy finally arrives conscious and in pretty good condition with the help of pain medication and tight bandages over the stump of his left shoulder. The EMS personnel told us that he was swimming in a local lake frequented by several of the ED staff. He was returning from a work-out when something tugged on his arm and presumably spun around to twist off his arm. He walked out of the water clutching his stump with his one arm. He was then airlifted to us while a large posse of active, retired and volunteer police officers went on a hunt for an alligator with a human arm in its mouth!
The alligator had to be killed and then cut open to retrieve the arm, which arrived on ice about a half hour after the patient. He was rushed up to surgery for an attempt to reattach his arm. Remarkably there wasn't much bleeding. Nurses that saw him walk out of the water probably saved his life by putting pressure and ice on the wound until EMS arrived. Even so, it was a pretty gruesome sight as the surgeon felt around for the brachial artery, clavicle and scapula/glenoid fossa. In typically clinical medical terminology, it was called a 'disarticulated' shoulder.
The story made front page news in town today. The article mentioned it was a 12 foot 550 pound alligator. I headed home a half hour later as he headed up to the OR for the attempt to reattach his arm. I kept thinking how weird it has been that I experienced shark and alligator bites on this rotation in little old Charleston.
Today Peds ER shift was pretty routine. I enjoyed working with the kids again though. Now it's time to finish my presentation for Dr. Upshaw on - treating shark bites of course!
Thursday, September 13, 2007
Hassles and 12-shifts
It's been a long four days since my last post and the beaches. I normally don't mind 12-hour shifts, but this week has been exhausting. My allheart scrubs are falling apart; three out of four pants arrived with defects. Worse, my cell phone/PDA broke so I can't make or receive calls.
I tried to solve the problem by driving to the nearest T-mobile store (hoping it was just SIM card problem) on the first day I had a few hour break. So after two days of 12-hour shifts, I worked 8 to noon in the Peds ER then headed 2.5 hours to Hilton Head! The Walmart folks couldn't help, the they got T-Mobile customer service on the phone and we determined it was the phone. They got the HTC repair dept. on the see about warranties and it came to having no phone or PDA for a couple of weeks and hopefully having defect covered by the warranty ($20 vs. $280) or buying new one ($380). While considering the options I drove the 2.5 hours back to Charleston just in time to start my first shift in the adult ED from 6 to 11.
The shift went well I think, but I would have liked to have more opportunities to impress the attending, one of the assistant program directors. I did get a chance to talk Becky and we agreed she'd ship her PDA/phone to me now that my primary medical software, Epocrates, works on Smart Phones.
Early the WWednesday morning we had 8 to noon conference with some good classes on chest pain and syncope. I got some e-mail done then at 3p three other students and I met with a couple of the residents to discuss the residency program. Nothing earth shattering came from it, but the meeting reinforced my thoughts on the program.
Finally I worked a low key shift in the Peds ER from about 4:30 to 11. I enjoy the Peds ER and the autonomy I get here. I still to work more on clearly communicating my differential diagnoses, but at least I can now get into the online medical records to see lab values, etc. It has only taken 2.5 weeks for my ID card to work and my log-in and password to be functional!
Upon arriving phone I was able to use Becky's Dash phone to call home and talk to the boys for the first time in a few days. Better yet, we're going to meet in Seattle in a couple weeks so I can see them, wish Becky's brother & his family farewell as the expat it with Microsoft to Italy and, finally, I get to attend the ACEP residency fair in downtown Seattle.
I tried to solve the problem by driving to the nearest T-mobile store (hoping it was just SIM card problem) on the first day I had a few hour break. So after two days of 12-hour shifts, I worked 8 to noon in the Peds ER then headed 2.5 hours to Hilton Head! The Walmart folks couldn't help, the they got T-Mobile customer service on the phone and we determined it was the phone. They got the HTC repair dept. on the see about warranties and it came to having no phone or PDA for a couple of weeks and hopefully having defect covered by the warranty ($20 vs. $280) or buying new one ($380). While considering the options I drove the 2.5 hours back to Charleston just in time to start my first shift in the adult ED from 6 to 11.
The shift went well I think, but I would have liked to have more opportunities to impress the attending, one of the assistant program directors. I did get a chance to talk Becky and we agreed she'd ship her PDA/phone to me now that my primary medical software, Epocrates, works on Smart Phones.
Early the WWednesday morning we had 8 to noon conference with some good classes on chest pain and syncope. I got some e-mail done then at 3p three other students and I met with a couple of the residents to discuss the residency program. Nothing earth shattering came from it, but the meeting reinforced my thoughts on the program.
Finally I worked a low key shift in the Peds ER from about 4:30 to 11. I enjoy the Peds ER and the autonomy I get here. I still to work more on clearly communicating my differential diagnoses, but at least I can now get into the online medical records to see lab values, etc. It has only taken 2.5 weeks for my ID card to work and my log-in and password to be functional!
Upon arriving phone I was able to use Becky's Dash phone to call home and talk to the boys for the first time in a few days. Better yet, we're going to meet in Seattle in a couple weeks so I can see them, wish Becky's brother & his family farewell as the expat it with Microsoft to Italy and, finally, I get to attend the ACEP residency fair in downtown Seattle.
Day at the beaches
Last Saturday (Sept 8th) I had recovered from a viral infection and decided to tour the area. It was a beautiful 85 degree day. I started by heading to Isle of Palms (IOP), a very ritzy $1+ million area with a nice beach frequented by families, tourists and locals. On the way I drove over the largest cable-suspension bridge in the US and the high point in the area, so the joggers and bicyclists were out in large numbers. The mansions on the beach were right out of postcards photos. My cell phone doesn't do them justice, but the photos below give you an idea of Charleston's version of "southern charm".
Then I headed to the nearby Sullivan Island. This is the beach were one of my patients was recently bitten by a shark, so I had to check it out. It was more residential than IOP and full of locals taking advantage of the local winds. There were so many kite surfers it looked they should be getting tangled up. My photos don't do it justice. I kept envisioning the family and I out there learning to kite surf. It looked more fun and easier to learn than sailboarding.
After snacking on a couple delicious fish tacos, I headed back to Folly Beach near my rental room. It was busy, not nearly as crowded as you'd expect a popular local beach to be on a spectacular day. After a long walk I went for an ocean swim. It was getting out past the breakers, but I tried to stay near kayakers and surfers. The memory of the shark bite kid was too fresh and I found myself looking at all the waves for dorsal fins.
It also was getting lonely by this time. Seeing all the families playing on the sand and in the water reminded me how far away my family was. Then it was time to head home and rest for four 12-hour days.
Then I headed to the nearby Sullivan Island. This is the beach were one of my patients was recently bitten by a shark, so I had to check it out. It was more residential than IOP and full of locals taking advantage of the local winds. There were so many kite surfers it looked they should be getting tangled up. My photos don't do it justice. I kept envisioning the family and I out there learning to kite surf. It looked more fun and easier to learn than sailboarding.
After snacking on a couple delicious fish tacos, I headed back to Folly Beach near my rental room. It was busy, not nearly as crowded as you'd expect a popular local beach to be on a spectacular day. After a long walk I went for an ocean swim. It was getting out past the breakers, but I tried to stay near kayakers and surfers. The memory of the shark bite kid was too fresh and I found myself looking at all the waves for dorsal fins.It also was getting lonely by this time. Seeing all the families playing on the sand and in the water reminded me how far away my family was. Then it was time to head home and rest for four 12-hour days.
Friday, September 07, 2007
Where should I live?
Interesting site with a checklist of factors you consider important for lifestyle. After taking the "quiz" I think the site is pretty accurate. We moved from Portland to go to medical school in Phoenix. Unfortunately, Portland is the only I have a chance of going to for an Emergency Medicine residency and I'm not sure how good a chance it is.
| American Cities That Best Fit You: |
 80% Portland 70% Honolulu 65% Denver 65% Seattle 60% Las Vegas |
Updated ERAS Map
A link to my Google Map of programs I'm applying to, excluding Oregon (OHSU) and Phoenix (Maricopa).
View Larger Map
View Larger Map
What weekend?
I must have caught a virus from one of my pediatric patients: dry, scratchy cough and general malaise. I'm trying to get extra sleep and still do some studying. Exploring the area has been the activity to suffer. Kind of feels like I'm wasting my three day weekend, but I know I need to rest up and be ready to work come Sunday.
I met with one of the Attendings yesterday. He gave me some good information on where I stand and the process of selecting interviewees at MUSC. No big surprises, but I sent a few e-mails today trying to set up shifts, or at least partial shifts, with the three assistant program directors. I want them to at least remember me as a good worker and someone they want to have back for an interview.
I think I'll go catch a movie tonight and get in some more reading. Tomorrow hopefully I'll get over to Mount Pleasant to check that area out. I would love to hit the beach as well.
I met with one of the Attendings yesterday. He gave me some good information on where I stand and the process of selecting interviewees at MUSC. No big surprises, but I sent a few e-mails today trying to set up shifts, or at least partial shifts, with the three assistant program directors. I want them to at least remember me as a good worker and someone they want to have back for an interview.
I think I'll go catch a movie tonight and get in some more reading. Tomorrow hopefully I'll get over to Mount Pleasant to check that area out. I would love to hit the beach as well.
ERAS and Shark Boy
Labor Day weekend was supposed to be my weekend to play and maybe explore the area. But September 1st was also the first day the ERAS applications opened up. Naturally I agonized about selecting programs and even specialties. So it was a good thing that that it rained until Monday the 3rd, Labor Day.
I spent a good part of the weekend at the rental house, holed up in the one corner where I can get wireless Internet access from a neighbor’s router. I messed around with my ERAS application until I was sick of reading my own resume. Then I worked on program selection with web sites, my anal retentive spreadsheet and the ERAS selection process. Becky and the kids went to visit my father in
In the end I picked 29 programs that broke up as follows. 19 are on the East Coast, 8 are in the Midwest and two (
I still have one more to add. And I am thinking of either
I was going to work on Monday evening, but the stress tired me out, even with 9 hours of sleep every night. So I enjoyed Monday’s sunshine by heading to the beach after I hit SEND on ERAS and paid my $375. The nearest beach, Folly, is pretty nice and seen from the pictures I got on my cell phone. The water is warmer than the West Coast, and even though it was windy and choppy I had a very nice walk. One of these days I want to go for a long ocean swim. I have to build up my confidence that one of tonight’s cases wasn’t an omen first though.
We had a 15 year old surfer come in with shark bites! Luckily they weren’t too bad as you can see from the picture. The other leg had similar small bites marks with a couple of deep heal lacerations and a little toe with a large triangular flap of tissue attached on one side. I would have liked to suture the wounds, but I was allowed (told) to leave early since I had conference in the morning. Some of the lacerations were good sized, but none were too deep. The weird part was how you see the crescent bite pattern from the mouth. Reminded me how the beach isn’t perfectly safe, especially at dusk.
Colton seems to be having a tougher time with my absence than his brother on this trip. He was always the child who got upset when having to say goodbye to relatives, so I guess it isn't too much of a surprise. But he's a happy outgoing soul you'd think introspective Connor might have a tougher time, especially stating Junior High. It was fun to share the shark case with Colton and cheer him up a bit. He always asks me if I have had any interesting cases. And just as he likes to share stories in intimate detail, he wants to hear every detail fully described regarding my medical cases. It will be interesting to see what careers the boys decide on given their greater exposure to the professions than I had. I like to think that Becky and I are also more savvy and street smart as parents than either of us had growing up.
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