Graduation

Say hello to Dr. Axis Deviation!

That's right ... I am now done with medical school. The feeling has not quite set in yet, and it probably won't for some time -- I am guessing it will be around the time internship begins -- but it fun to think of myself as a "doctor". Fun and weird, especially since I still consider myself the same goofy kid as before.

With graduation this past weekend, I have also now advanced past the ranks of medical student to doctor. "Doctor". In the morning I was a lowly student, and then all of a sudden I became a doctor, one of the most prestigious professions in the world. Quite a big jump in social status for one day. Let's see if I can handle it!

Back From Traveling

Yes, it's true. My two months of international travel, sadly, is over. I got a great glimpse of South America (hot beaches and arctic weather) and central Europe (lots of beer and great food), and I hope to return to both places in the future. And unfortunately, no more extensive vacations ... well, ever, probably.

I now have to transition quickly from travel mode to graduation mode, as the next few days will be a whirlwind of graduation related activities, from a pre-graduation banquest and award ceremony to graduation rehearsals and finally the ceremony itself.

Stay tuned for some possibly interesting entries about graduation.

Hello from Central Europe

(I'd translate "hello" to the local language, but it's way too difficult!)

The travelling continues. I am now -- and have been for the past two weeks -- in Central Europe (Middle Europe? Eastern Europe?) visiting several countries. All these countries are post-Communt, so it is interesting to see how they are trying to reshape their image to more, Western ways. Luckily one is famous for its beer and one for its wine, so already they're fine in my book.

I will soon be returning back home to the states, only to deal with med school graduation and all that is necessary for my relocation for residency. Till then, ahoj!

So What Do You Do?

I have just returned from nearly three weeks of travel, touring several countries in South America. It was a great trip and I regret not being able to travel longer.

While I still have no medical anecdotes to report, some interesting moments did occur during my trip as a result of me being in medical school. Because I am essentially done with medical school -- graduation is next month, but my classes/clerkships ended last month -- when people asked me what I did, I simply told people I was a doctor. My responses weren't far from the truth at all ... I said I had just finished with medical school and I would be starting internship very soon.

(Interestingly, Americans were intrigued by newly-minted doctors, while foreigners were not.)

Inevitably they would start asking follow-up questions such as what specialty I had chosen, why I went into medicine, and other related topics. These conversations were amusing and enjoyable at first, however, I quickly grew tired of them. After the first few of these conversations I knew exactly what question(s) people would ask next, and all my answers were canned.

I therefore came up with an alternative response to the question "What do you do?" I just told people I was in "healthcare". That usually elicited a response similar to "Oh that's a good field" ... and then the conversation usually ended.

It was great. With this wise choice of words, I evaded that repetitive conversation. It worked great the rest of the trip ... although one woman pried a little by asking "What do you do in healthcare?" to which I responded "I work in a hospital."

It is funny how certain things in medicine are so exciting initially, but whose novelty wears off quickly. Other examples include wearing my white coat (I was so excited the first time I wore it but now I can't stand wearing that short white coat) and having a pager (my first page was exciting, while every single one thereafter was annoying). I can only assume more of these situations will arise in the future, and so I should just accept them now.

Hello from Argentina

Hola again!

 

I am writing you all from near the bottom of the earth. While I entered Argentina through Buenos Aires -- which is a great and lively city -- we then flew further down south, to the Patagonia region of this country ... which, if you refer to a map, approaches the bottom of the globe. I am probably upside down compared to most of you (at least those in the US)!

 

Patagonia offers LOTS of amazing scenery and some of the planet´s greatest outdoor sites. Mountains, glaciers, towers of granite, fjords, it has it all. It is also quite cold here, which is unfortunate since I wasn´t expecting to take this excursion and thus only packed beach clothing. Not wise, but a little 0.4 degree Celsius never killed anyone, right? (OK, it probably does.)

 

Until next time, chau!

 

Greetings from South America

Buenos dias!

 

I am writing from the nice beaches of Uruguay. This particular city is where many people in South America -- as well as some Americans -- flock to when it gets hot. It is actually fall here (we are in the southern hemisphere) so the masses of people are no longer here, but with Easter weekend approaching there should be a ton of people visiting for the next few days.

 

Uruguay is an impressively modern country, with great internet connections, fancy stores, and drinkable water. If it weren´t so far from America, I might consider buying a second home here ... and with prices starting in the $80s for a small apartment, you gotta consider it!

 

Anyway, we´ll be here for a few more days and then move on to another country. Till then, adios!

 

P.S. I wish I had taken Spanish in high school. French, unfortunately, is a totally useless language for journeys such as this (as well as practicing medicine in California!)

No More Medical School

My rotations finished two weeks ago, meaning I am done with medical school. Since graduation is still months away (end of May) that also means I have nothing to do until then. Unfortunately, this weblog will probably suffer temporarily as I have nothing medically-related to report. Fortunately for me, though, this means I have almost three months to play around.

Which reminds me ... I should start packing soon for my trip to South America tomorrow.

Post-Match Day Thoughts

Now that Match Day is well in the past, I thought I would share some thoughts regarding that entire experience.

When I think about it, that was truly the worst experience I have ever experienced -- at least the worse experience I have participated in voluntarily. Not the overall residency application process, but just Match Day itself.

There is something unusually stressful about this day ... whether it is knowing about Match Day from the very day you enter medical school, or realizing that Match Day is a more significant event than graduation, or just realizing that the envelope you are holding in your hand, once opened, will declare where you will be forced to stay for the next several years of your life (for better or worse) ... whatever the reason, it is enough to turn the sane insane.

What the contents of the envelope reveal is an entirely different story. It is difficult enough waiting for Match Day to arrive, but finding out where on your rank list you were assigned is potentially much more difficult. Unfortunately I tend to set my heart things, and when they don't happen I get demoralized. The same thing occured here -- I was set on my #1 choice and had been planning my short-term future around it; and so when I opened the envelope and saw I was off to #2, I was devastated. It made that day pretty tough when responding to all the people who asked me "Are you happy?"

Anyway, there is a first time for everything ... and luckily this will be its last time too.

Today

So, 15,252,514 minutes ago ...

or, 10,592 days ago ...

or, 1508 weeks ago ...

or, 29 years ago ...

I guess I was born.

Damn.

This is the last year of my 20s. Next year I will be 30, and next thing I know I'll have osteoporosis and be going to sleep at 5pm.

Match Day

Matched to my #2 ... not bad, not bad.

Still in southern California (new city, however).

More to come, most likely.

Seattle Grace Hospital

So I found myself in Seattle Grace Hospital today. For those who aren't in the know, this hospital is the setting of my favorite TV show Grey's Anatomy.

I was invited to give a talk at a VA hospital in the valley ("the valley" is an area about 30 minutes north of LA), and when I arrived I immediately noticed a motorized golf cart labeled with "Grey's Anatomy" driving around the lot. Once I was inside the hospital, there was one section of the top floor filled with camera crews, lighting, screens, and other filming gear. After looking around a bit, I saw that well-known breezeway seen in almost every episode, the concrete pathway leading up to the hospital, and a lot of SGH signs on windows and floormats! I love getting behind-the-scenes and seeing film sets, so I was pretty excited.

(Hm, considering how much I hate this show, I sure talk about it a lot.)

Unmatch Day

Today is a moderately important day. It is known as "Unmatch Day", the day when all applicants find out if -- but not where -- they have matched to a residency program. It is particularly important for people applying to competitive residencies since there is a good chance they might go unmatched.

For someone like me, however, who is applying to internal medicine, which isn't as competitive (except at top-ranked institutions), it isn't as much of a big deal. Having said that, I was up all night tossing and turning, having nightmares about the worst-case scenario of not matching and getting the dreaded email in the morning.

Lucky for me I received this lonely little one-liner in my inbox this morning:

Congratulations! You have matched.

It was a nice relief. It is also kind of strange when I think about it actually, because this email essentially indicates a job offer. It confirms that I have a job awaiting me in July ... salary and all, as a doctor, no less! That's a little frightening and intimidating.

Now all I have to do it last until Thursday ... which is easier said than done.

Less than One Week Until Match Day

The big day is quickly approaching. It wasn't until last Thursday -- exactly one week before Match Day -- that I began getting anxious just thinking about the match. I am fine as long as I don't think about it (which is most of the day), however if I think about it my mind quickly works itself up into a state of mild anxiety and stress ... not very pleasant.

I just want Match Day to come and go without having to actually go through it ... in other words, I want to know where I match without having to experience the actual moment where I open the envelope and face what's written inside.

Grand Rounds 3:24 is Up

I don't like tooting my own horn (or, for that matter, using that phrase), but that latest Grand Rounds is up at GruntDoc. I mention this because one of my posts is included ... so go check it out!

Scrubs vs. Grey's Anatomy

Abortion. Euthanasia. Stem cells.

These are famous examples of some of medicine's oldest and greatest debates. There is no shortage of passionate people on each side arguing their position, and unfortunately there will likely never be a solution that satisfies both sides.

The times are changing, however, and a new debate is emerging, one that involves medical TV shows. Yes I'm speaking of Scrubs and Grey's Anatomy, both of which have huge and loyal followings. Is it Scrubs, the quirky single-camera show about the life of three residents and a nurse, or is it Grey's Anatomy, the new medical drama about a group of surgical interns?

Never fear, Axis is here to help settle this debate. I will attempt to evaluate this dilemma by using several objective criteria to answer modern medicine's ultimate question once and for all.

Medical Accuracy
Let's start with the easy one. The medicine that takes place on Scrubs is nearly dead-on. Internists diagnose and surgeons operate. Classic stereotypes are explained (e.g. surgeons as knife-wielding morons, ob/gyn's as sorority girls, etc.), inside secrets about medicine are revealed, and the emotional aspects of medicine are well conveyed . On the other hand, in Grey's Anatomy surgeons deliver babies and neurosurgeons do abdominal procedures. Most interestingly, the interns have hours of free time on their hands. Point goes to: Scrubs

The Girls
Elliot and Carla on Scrubs are both fairly attractive and well-fed. On Grey's, while Katherine Heigl is hot (albeit whiny), Ellen Pompeo is so skinny she looks like an ashen grey skeleton ... and Sandra Oh looks like a catcher's mitt with eyes. Point: Scrubs

Attendings
You can't beat Dr. Cox: who else can turn a word with two syllables into six? Who can come up with a new girls name every 10 minutes? In fairness, Dr. McDreamy is unusually popular, both on- and off-screen. Point: tie

Chiefs of Service
This is a tough one. On Scrubs, Dr. Kelso is a scowling money-driven Chief of Medicine who makes everyone's life miserable (especially for Ted, that poor attorney). On Grey's, the chief is Dr. Webber, a big guy who simply plays a generic "stern black man". Point: tie

Humor
Scrubs is overflowing with quirky humor (my personal favorite) while Grey's has none (quirky or otherwise). Point: Scrubs

Drama
But what Grey's lacks in humor, it more than makes up in drama. Grey's Anatomy is not so much a medical TV show but rather a soap opera that happens to take place in a hospital. Medicine is occasionally practiced, but only if an intern can hook up with an attending in the process. The winner here is clear-cut. Point: Grey's Anatomy.

Timeline
Characters in Scrubs progress nicely each year, from intern to junior resident to senior resident, etc. In Grey's, the characters apparently are so dumb that they are still interns after three years. Point: Scrubs

And the winner is: Scrubs.

There you have it peoples, objective proof that you may safely avoid watching TV on Wednesday nights. Anyway, it's time to watch Scrubs ... seeing how it's the better show.

The Flu

I think I have the flu. I woke up three days ago unable to move a muscle and have since been clinging on to life by a delicate thread. I wish it was just a severe cold, but I guess I have the classic flu symptoms: fever, chills, muscle aches, cough, headache, and fatigue. I'm a mess. I also don't think I've ever slept as much as I have in the past few days, with that first day setting the record: only 3 hours of the day when I wasn't asleep!

I should just be thankful that I'm on a rotation where I can afford to take a few days off without serious repercussion. Speaking of this ID rotation, I should also be thankful that I only have the flu, and not one of the many nasty infections I've encountered the past few weeks. Would much rather have influenza than salmonella or cryptococcal meningitis. (But then again, with the way I easily scare, I keep fearing that I have the bird flu).

Anyway, back to the grind (meaning get out of bed, drink juice, take temperature, get back into bed.)

1 Month Until Match Day

Title says it all. One month -- exactly 4 weeks -- till we find out where we go for residency. I am really looking forward to Match Day ... except that once the day arrives and it's time to open the envelope, I know that anxiety will overpower me, and I won't be able to do it.

Apparently there is also a big breakfast for us that morning (this is probably common to all schools). I don't know about other people, but I will likely be a little too nervous to keep any food down. We shall see.

Rank List

It's in. Today I submitted my rank order list, which is the next step of this residency application process. Even though the deadline to submit our finalized rank order list is February 21, it was recommended that we submit approximately one week early to avoid overloading the apparently frail servers that become unresponsive the night of the deadline.

My rank list consisted of very few programs and thus was fairly easy for me to create, in that it was easy for me to determine which program I liked best, second best, and so on. It did, however, get me thinking about the programs' end and how they need to rank a large number of applicants. The average internal medicine program interviews 200-300 applicants for about 30 available spots. Assuming they rank most of those applicants -- or even if you don't make that assumption -- that is a lot of people to rank.

Furthermore I cannot imagine how they differentiate their applicants, in particular the ones that are similar. I had minor difficulty deciding my #3 and #4 spots; now imagine a program trying to decide which of their 200 applicants gets what rank. Can they fairly or accurately tell the difference between their #56 applicant and their #57? Differentiating that many applicants seems nearly impossible. I haven't a clue how they do it, especially in internal medicine where the interview -- a seemingly important component of their evaluation of us -- is useless. No hard-hitting questions, no difficult questions, no nothing; just casual chatting. (I suppose this weeds out the social idiots, but really, how many people does that eliminate?)

Anyway, the process is now completely out of my hands and controlled only by the magic that is the matching algorithm. Nothing to do but wait.

For a reminder of how the residency application process works, re-read this post.

Happy Valentine's Day (every day is the 14th)!

First Time With a Foley

Read this post by keagirl on her blog, UroStream. It is a great and entertaining description of her first time placing a Foley catheter in a patient. The reason I link to it is because this was exactly what happened to me too the first time I tried placing a Foley. I was obviously very embarassed, and my resident who was with me at the time instructing me, was thankfully being very patient ... although I could tell she was feeling slightly sorry for my girlfriend.

Anyway, I was going to write about this experience myself at one point, but I procrastinated and keagirl unknowingly beat me to it. Maybe it's for the better, as she probably describes it better than I could.

Ensuring Professional Behavior

It's late at night right now, and I just got home from hanging out all night with people from school. We were at a bar, and something on everyone's mind was DUI ... or more precisely how to avoid getting one.

See, today we had a (outrageously long and boring) session on medical licensure, and to make sure this topic was properly shoved down our throats, three middlemen representatives from the Medical Board of California made an appearance to talk to us. In addition to describing their mundane job in great detail (i.e. sifting through thousands of applications a year), they spent lots of explaining how we had to make absolutely sure we were being truthful when reporting any prior offenses ... including but not limited to reckless driving, DUI, and running red lights.

Needless to say many students were a little shocked that these offenses, no matter how distant, would have to be reported, lest their application for a license be denied.

So whereas before, people were not overly scared to get a DUI (they were, but everyone has had a friend at one point who got one), now everyone was just a little more careful with their drinking and driving ... to make sure their behavior now doesn't jeopardize their future career.

That was a lot of words. To sum up: now we're really afraid to get a DUI.