An Exercise in Futility

I'm going to gripe, so just bear with me here.

It rained 1.5 inches last night.  I didn't even know that precipitation was in the forecast until I woke up in the middle of the night with water dripping from the ceiling onto my face.

Students on Internal Medicine don't get parking spots, so I had to walk to work this morning.  My shoes were so soaked that they didn't dry out by noontime, and they were beginning to smell like rainwater.  I had to ask permission to go home and change after lunch.

My team was on call today, but we didn't admit any patients this afternoon.  Just before we were to get off at 7pm, Tri paged us with an admission from the Emergency Department (thanks a lot, "friend").  We didn't finish working him up until 9:30pm.

As we were leaving the hospital, my resident informed me that since our patient was here for a cystic fibrosis exacerbation, we would be presenting him to the Pulmonary Medicine attending instead of Dr. Powers, our General Medicine attending.  Which means that two weeks into our rotation, and I still haven't presented a full history, physical, assessment, and plan of a patient that I worked up to the attending that will be determining my Internal Medicine rotation grade.  Great, I'm glad that my plan to appear as mediocre as possible is meeting with no resistance.

I got home at 10:30pm only to discover that my landlord hadn't fixed the leak in my bedroom ceiling, and it's actually worse than it was last night.

Can we just go ahead and transfer me to hospice with comfort care measures only?

Stress-Induced Delirium

I don't like to think of myself as spoiled, but when it comes to food, I have to face the facts.  The bounty of free nomz in the healthcare profession has trained me to no longer consider it a privilege, but a right.  So when the Internal Medicine chiefs informed Amit that we were not allowed to partake in their free lunch today, I didn't just get upset, I became outright delirious.

And it wasn't just me, it was everyone in my block.  We were so infuriated that we were being denied the free lunch laid out before our eyes that we stormed to the Wahoo West Cafe, where we... I hesitate to even say the word... paid for our own meals.  Somehow, we all temporarily forgot that there was an Internal Medicine Interest Group lunch talk today with free Papa John's Pizza.  Can you believe it!?  Our delirium actually prevented us from thinking straight.  In our right minds, we would have asked each other, "Well, if we can't have this free food, where else can we get free food?"  Instead, we skipped straight to buying lunch at the cafeteria.  So irrational!!

Happy Belated Birthday!

Last month, Qdoba sent me a buy-one-get-one-free coupon for my birthday to enjoy with a friend.  Nice try, Qdoba.  You didn't take into account the possibility that I have no friends.  WHO'S THE SUCKER NOW??

Actually, that may not be far from the truth.  The coupon expired today, so I tried futilely to get a bunch of people to have dinner with me.  Of all my conversations, though, this one was my favorite:

Sam: You eaten yet?
John: Yeah man, whats up?
Sam: got a buy one get one free coupon to qdoba, didnt know if you wanted to join
John: Aw thanks for asking, you should just eat two all by yourself
Sam: ... I guess ill have to have to (have TWO) ba dum chi!
John: Lolocaust

In the end, I was able to convince Richie to come with me, even though he had already eaten dinner.  Which meant that I got to have company AND take a second entree home to enjoy tomorrow.  Two Qdoba dinners in a row?  Now that's a real birthday present!

Work Sucks!

I know
She left me roses by the stairs
Surprises let me know she cares

Err... anyway, I worked from 7am until 8pm today and somehow only picked up two patients.  It made me want to kill myself.  Plus, since I had to work all day, I didn't even get to hang out with Catmo while she was in town.  Internal Medicine, you are a cruel mistress!

I guess I can't really complain, though, since I had an otherwise amazing weekend.  I caught the Punch Brothers concert at Lime Kiln Theater in Lexington on Friday night.  Despite Chris Thile's hoarse voice, it was still an amazing show.  There was an open seat in the front row, so I even snuck up during the second set to take some close-up shots of the band.

Sitting up at the front has its drawbacks, though, like when Chris Thile stares at you while he sings.  I couldn't avert my eyes when he did it to me, so I just sat there while he pierced my soul with his gaze for fiften seconds.  Awkward!!

I'll spare you the rant I delivered after the last time I went to see the Punch Brothers perform, but I'll still leave you with a video of them live (at WNRN in Charlottesville, no less!).

You'll Always Remember Your First

I went to work this morning, eager to check in on my one and only patient, Mrs. G.  I logged into the MIS system to see if any medications had been administered overnight, but I couldn't find her on the patient census.  Suspecting the worst, I went up to her room, only to find her bed empty.  And that's when I knew for sure.

Mrs. G passed away in her sleep last night.  It was, as they say, expected, but it was still unexpected for me.  She was at the end of her nearly three-year battle with amyotrophic lateral sclerosis, and we all knew that this would be her last hospitalization.  Even so, I believed that she would make it at least through the weekend.  But if anything good came out of her stay, it was that we were able to hold a family meeting yesterday to help her loved ones prepare for the inevitable.  We scaled back on our interventions to do only what would make her more comfortable.  Mrs. G died a dignified and peaceful death, something everybody wishes for, but few actually get to have.

I'm glad to have gotten to meet Mrs. G.  I feel like during the two days that I knew her, I learned more than I possibly could have imagined about what it's like to face the certainty of death.  I also saw an entire spectrum of how people can react to seeing a beloved family member pass away, ranging from acceptance to relief to hyperintellectualization.

Thank you, Mrs. G, for being part of my life.  I am proud to have been a member of the team that took care of you in your final days.

The Lord bless you and keep you, the Lord make his face shine upon you and be gracious to you; the Lord turn his face toward you and give you peace.

True Love

Now that the first season of Catmo's show The Gates has ended, I have no choice but to fill the void with True Blood, my favorite TV show of all time (well, except perhaps second to Lost).  I watched the first episode of the third season tonight, which reminded me of how much I love the storyline but also how much I hate every character on the show.  Especially Sookie Stackhouse.  Gah, why is she so freaking annoying??

Okay, actually, I take that back.  I hate every character on the show except for Sam Merlotte.  Is it just because his name is Sam?  Possibly.  You really can't go wrong with a name so distinguished and honorable.

I leave you with the following graphic that I stole from Garrett's Facebook page.  You'll have to click on it to read it, though:

ZOMG, a mini-projector that shows a 50" picture??  I wonder how the 33 of them decide what show to watch.

Easing In... Still

You know, I was all about taking it slow on my first day of Internal Medicine, but I was kind of ready to have a little more on my plate on the second day.  My team was on call from 7am till 7pm, yet somehow we only picked up one patient.  ONE PATIENT!!  Which brings our entire census to a whopping... two patients.  Why, why did everyone decide to stay healthy when I started my inpatient rotation??

I managed to entertain myself this afternoon by reading the giant poster in the Internal Medicine library titled "2010-2011 Intern Text Pages."  Here are a few of the best:

Mr. _____ is upset b/c he "asked to be put to death a couple of hours ago."

Mr. _____ has complaint of "crawling things down there."  Please come asses.

Ms. _____: changes in rhythm missing QRS on monitor.  FYI.

And, my favorite:

Mrs. _____ stating she is going to end it all - end it all.  Also large volume of stool.

Easing In

I am quite terrified of the Internal Medicine rotation.  It's notoriously the hardest clerkship with the most difficult Shelf exam.  I caught a lucky break today by being assigned to a resident who only had two patients, both of whom were scheduled to be discharged.  He had to work in clinic this afternoon, so there was literally nothing for me to do this afternoon, and I got sent home (literally, he told me to "get out of here") after noon didactic lecture.  Plus, since our team currently doesn't have any patients, I don't need to preround on anybody tomorrow, and I actually get to sleep in.

Oh, did I mention that our noon didactic lectures come with a free lunch?  ZOMG, they sure know how to woo me!

The only thing that gets me more excited than a good start to a new rotation is Pokemon, so enjoy this fan-made Pokemon movie trailer.  The premise is pretty FARFETCH'D, but it would be TentaCOOL to watch if you ask me!

Disaster Medicine

Instead of starting my Internal Medicine rotation today (eek!), I had to attend the class-wide Clinical Connections session on Disaster Medicine.  The timing was perfect; if you had seen me trying to operate on the wards today, you would have thought you were looking at a zombie.  Who knew that whitewater rafting could take so much out of you?

Luckily, the lecture format of our Disaster Medicine day made it easy for me to nap all morning.  The afternoon was slightly more participatory, though.  The instructors used Nosheen to show us how to stabilize a patient with a possible spine injury.

Then, Randy and I donned Hazmat suits to show how to properly prepare a contaminated patient for a physical exam.

None of that, however, compares to how much fun we had in the back row taking pictures of ourselves and making ourselves look obese using the FatBooth app on Cameron's iPhone.  Let's just hope my metabolism never slows down, because I do NOT look good like this...

General Zhao's Chicken vs. Chow Mein

My new purpose in life is to go whitewater rafting as often as possible.  I've been looking forward to this past weekend ever since last year's trip down the New River.  We returned to West Virginia on Friday, eager to conquer our next challenge, the Gauley River.

Saturday was spent on the Lower Gauley.  The weather was a perfect 85 degrees and sunny, we had a very cute (albeit somewhat inexperienced) raft guide, and our trip was just harrowing enough without putting our lives in actual danger.  Well, Chrissy may disagree with that last point.  The only downer of the day was that not only was there a Zhao party, but there was also a Chow party.  Ultimately there must be a battle between the two, because There Can Be Only One.  Also, both of our groups showed up late.  Ugh, way to feed into the chronically tardy Asian stereotype!

Unfortunately, this weekend's excitement is punctuated with sadness.  Our trip on the Upper Gauley today was canceled because the Army Corps of Engineers had to shut down the dam in order to help rescue teams search for a University of Illinois student who went missing after her raft tipped.  Her body was found pinned in the rocks over seven hours later.  I can't even begin to imagine how I would feel if this had happened to one of the members of our group.  Please keep the woman's family and friends (especially those who were on the trip with her) in your prayers.

I Miss It Already

It's hard to believe that yet another month has passed, but yesterday I completed my rotation at Waynesboro Primary Care.  I miss the doctors and nurses there already!  Of course, everything in my life has to end with a bang, and yesterday was no different.

The day was rather uneventful until I saw my last patient.  A very ill lady came in struggling with another bout of bronchitis and ear infections.  I had performed my history and physical exam, I had presented my findings to Dr. Engel, and we were just telling her what our plan would be when she suddenly started having sharp chest pains.  We helped her out of the exam bed, and while Dr. Engel called 9-1-1, Diondra and I gave her supplemental oxygen and did an EKG reading.  Hopefully it was just positional discomfort, but just to be sure that she wasn't having another heart attack, we sent her to get the full workup in the Emergency Room.

And that, my friends, is how I finished my Ambulatory Internal Medicine rotation.  Like my last patient, I will also be transitioning from the clinic to the hospital as I start my Inpatient Internal Medicine rotation next week.  Goodbye, regular office hours.  Hello, call nights!

These Streets Made Me Feel Brand New

To continue the saga known as my weekend trip to NYC:

I slept in on Sunday morning.  Can you blame me?  The festivities of the day before made it impossible for me to open my eyes before 11am.  I honestly can't remember the last time I stayed in bed that late... and it was great.  Even then, I had plenty of time to get ready to meet Erin and Will at Grand Central Station.  They took the train in from New Haven partly to hang out with me and partly because there is no Qdoba in the otherwise great state of Connecticut.  And so, we went to Qdoba in Times Square for lunch.  Is that weird??

After lunch, the impending rain thwarted our original plans to go biking in Central Park.  We decided to walk there anyway just to check it out, only to stumble across the Central Park Zoo.  Having never seen the movie Madagascar, I had no idea this place even existed.  Since all three of us are zoo enthusiasts, we absolutely had to stop and go visit.  The place was actually pretty cool, with my favorite exhibits being the polar bears and the rain forest house (not together).

We also checked out the children's zoo across the street from the main zoo, which featured my favorite thing in the world: A PETTING ZOO!  Obviously, we had to go feed the alpacas.

After taking in a few more of the sights and sounds of NYC, the rain finally became unbearable, and we settled upon a sports bar near Cal, Jim, and Kevin's apartment for dinner.  Luckily, a group of ladies was just leaving without finishing their beer tower.  We immediately jumped in on their table and cashed in on their wastefulness.  Our meal actually ended up being pretty reasonably priced, but only because we had gotten free beer and half-priced wings.

I spent the rest of the night watching football with Jim and Allie.  Although, to be honest, it was mostly with Jim, because by halftime during the Redskins vs. Cowboys game, Allie had already zonked out on the couch like she always does.

The next morning, I cleaned up the guys' apartment a little bit as a thank you gesture for letting me crash at their place for three nights in a row.  I had just enough time to head up to the Upper West Side to hang out with Christin one last time before I needed to board my return bus.  We walked around Riverside Park and checked out the Columbia University campus, which I have to admit is a beautiful place.  It's not quite as beautiful cool as the Lawn, but hey, few things in this world are.  Also, the girls at UVA are way more attractive.

And thus ends my epic three-day trip to NYC.  The one lesson I learned?  Don't wear flip flops in the city, or your feet will be black for days no matter how hard you scrub them.

A Story for the Ages

I just got back from spending the weekend in New York City, and the events of the past three days are simply too much to encapsulate in one blog post.  Tonight, I will only endeavor to tackle Day 1, which I have lovingly entitled Sorry, I Party: The True Story of the 2010 Harriman Cup.

It all began with that fateful BoltBus ride from DC to NYC.  I didn't get in to Cal, Jim, and Kevin's apartment until 2:30 in the morning.  Kevin went straight to bed, but Jim wanted to stay up and hang out.  Finally, at 4am, I realized that I needed to be up and drinking in less than five hours.  I took advantage of Cal's empty bed and slept soundly through the night.  Okay, that's a complete lie, because THE PEOPLE AND CARS IN NEW YORK CITY ARE SO FREAKING LOUD.

But nothing could put a damper on what was to be the best day of my life.  When Kevin, Teie, and I arrived at Penn Station, I wasn't exactly sure where we were supposed to go.  But then, I saw them.  The herd.  The herd of young men wearing salmon pants and pretty ladies in floppy hats.  And I knew that if I followed them, I would be safe.

If you went to UVA, I'd like for you to picture a bus full of sorority girls on their way to Foxfields.  Now, instead of a charter bus, imagine a 20-car train.  And instead of only preppy college kids, imagine that there's also a handful of adults and children trying to commute from NYC to Long Island.  The innocent bystanders have no idea what is going on around them, and their surprise and disdain are betrayed by their eyes, all of which are bugging out of their heads.

But not even my excitement from being surrounded by all that is stereotypical about UVA could prepare me for the day ahead.  When we finally arrived at the polo grounds, we were greeted by beautiful weather, lush grass, and the opportunity to do this:

I know this is hard to believe, but the Harriman Cup might actually be better than the Foxfield Races.  Why?  First of all, it features a sport that you can watch at all times instead of the slim chance of catching 5 seconds worth of horses every few hours.  Second of all, there's a giant dance party after the game's over.  Just look at all of the pink!

But the day didn't end there.  We took the shuttle--I mean, the yellow school bus--back to the Westbury train station, only to have the train pull away just as we reached the platform.  It was like a scene out of a movie, and I may have screamed and fallen to my knees.  Actually, I may have done many things at this point, none of which I can currently recall.  Anyhoo, since the next train wasn't for another hour, we were left with no choice but to wander the streets of Long Island until we found a bar.

We managed to find a place that served alcohol, but I really hesitate to call it a "bar," because it was more of a catering establishment.  It did, however, have a giant room in the back that I think is used for wedding receptions.  The owners were like, "Oh, come back here, we'll play music for you."  Meanwhile, we were all like, "WTF IS THIS PLACE??" and (re)commenced our drinking.

I don't have much to say about the ensuing train ride home, not because it wasn't eventful, but because I don't remember any of it.  Apparently, though, I spent the entire subway ride from Penn Station back to the apartment passed out on top of the cooler.  In the middle of the subway door.  So that people had to shimmy around me to get on or off of the subway.  Jen later told me that everyone was staring and/or glaring at me, yet nobody dared to disturb me as I sat hunched over on my throne.

Finally, we made it home, only to discover that Cal had arrived several minutes earlier via taxi.  Then Cal and I began verbally and physically abusing each other, as normal friends ought to do.  Upset about being left out of the fight, Kevin started taunting Cal so that Cal would direct some of his anger towards him as well.  Not wanting to leave Jim out of a good tussle, I started picking up things laying around the room and throwing them at him.  Oh, don't worry, this is typical for us.

Ah, another day that can't be remembered but won't be forgotten.  Tomorrow, I will continue recounting the stories of my travels.  There is but more to come!

I'm On a Bus

It's time for a much-belated trip to the Big Apple!  I'm on the BoltBus from DC to NYC right now, and their high-speed wireless internet is just what I needed after a long day in clinic.  I've been working on my Internal Medicine Simple Cases online while talking on Gchat... so, basically, I'm doing the same thing I'd be doing if I were in my own living room, only I'm doing it at 60 miles per hour.

I have to say, the BoltBus is much more comfortable than any of the Chinatown buses I've taken, and I've taken quite a few in my day.  Leave it to the Chinese to come up with a really cheap, get-rich-quick idea and the Americans to add a touch of customer service and make the experience more enjoyable.  Now, it's about time for me to play a few moves on Words with Friends...

Analysis of Dating Site Profiles

I received an e-mail from Cameron earlier today with a link to this article on the interests of different races.  Basically, the people who manage the free online dating site OKCupid compiled information from users based on their self-stated race and made Wordles out of them.  For example, here are the types of words found on the profiles of Asian men:

Well, I certainly do love pho, trying out new things, calvin & hobbes, surfing the net, gadgets, Asian food, Gladiator, and computer games.  Am I really that stereotypical??

Yes, yes I am.  (^_^) Y


I mowed the lawn this evening.  Well, not so much "mowed" as "trimmed."  We don't own a lawn mower, so we take care of our yard using a weed wacker.  Sure, it's not very efficient, but it's charged using a wall outlet and it's easy to use.

BACK TO MY STORY.  I weed-wacked the lawn this evening, and when I came back in side, I had 16 new mosquito bites, including five on my face.  On my face!!  Do you know how terrible that feels!?  I am currently lathered in hydrocortisone cream so I don't scratch myself.  Didn't the mosquitos realize that it's September?  I thought they would all magically disappear after Labor Day.

Star Wars: Episode 1, I'm real happy for you and I'mma let you finish, but mosquitos in September is the greatest disappointment of all time.  OF ALL TIME!

The One Meal

One Meal to rule them all, One Meal to feed them,
One Meal to bring them all and in Sammas' tummy knead them

Today was one of those rare days when I only ate one meal.  But fear not, this one meal was an epic buffet lunch at Milan that contained at least 7000 calories.  I made the amateur mistake of not pre-eating, so my stomach was contracted and unable to contain as much as I would have liked.  Sigh, not even going for a run beforehand made me hungry enough to take down more than three plates of food.  On the bright side, I got to sport this awesome t-shirt that Sunny got me for my birthday.

How appropriate!  She knows me so well.  And the Hello Kitty-looking thing on the shirt is actually a sushi roll.  If I didn't like my shirt so much, I'd probably try to eat it, too.  Mmm...

Initial Visit for Sore Throat

Sam is a 24yo gentleman who presents to clinic today with chief complaint of sore throat since this morning.  He awoke with pain in his throat which has been persistent.  He rates his pain at a 2 out of 10.  He is able to produce some phlegm, which is mostly yellow.  He denies any cough, headache, nausea, vomiting, or fever.

On physical exam today, Sam is a healthy-appearing male with blood pressure of 122/84, heart rate of 72, and weight of 122 pounds, which is stable for him.  He is afebrile with temperature of 98.2 °F.  His oropharynx is slightly erythematous with no visible exudate.  He has no nasal discharge and his nasopharynx is clear.  There is some tenderness to palpation of the trachea, which is midline and mobile.


Sam's sore throat is likely viral in nature.  I recommend that he gargle with warm salt water three times each day and suck on throat lozenges when he notices the pain.  This clinic is really just Sam's bedroom and does not carry the Rapid Strep Test, so I cannot diagnose whether or not this is strep throat.  Even if it were, I am not a real doctor, so I cannot write a penicillin prescription.  FML.

A Look Ahead

Four reasons why September is going to be the best month of 2010:

Weekend #1.  AIM workshop, aka Clerkship Group 5 Reunion.  Jubilate fall retreat.  First Cavalier football game of the season.  Cookouts.  No work on Labor Day.

Weekend #2.  New York City, aka Two Year College Reunion.  The Harriman Cup.  No work on Monday... again.

Weekend #3.  Whitewater rafting on the Lower and Upper Gauley River, aka ACE Adventure Resort Reunion.

Weekend #4.  Punch Brothers at Lime Kiln Theater, aka Bluegrass Music Lovers Reunion.

ZOMG, am I going to fail my Medicine Shelf exam?  Yes, and I'm going to spend hundreds of dollars doing it.