Last one...

No, not my last post.

Today is the last day of my Sugery rotation. It has been trying to say the least. I love the work, but hate the lifestyle. Its tough, so I'm perhaps in a bit of a conundrum. If I choose surgery, my life will be brutal for a long time. Emergency medicine won't get me into the OR as much but there is always the rush involved, and the lifestyle is great...

Off to take a brutal final exam, then I'm departing this eternally gray and dreary state known as Maine. Hopefully to greener pastures.

Call

Why call can suck:

You can lose your first patient.
The sound of your pager the moment you drift off to sleep.
You round for 4 hours at the end of a 30 hour shift.
You have your other patient be transfered to the ICU.
You post ~1.5 hours of sleep from 5am until 10am the next morning.
Lawnmowers (and trucks that beep in reverse) right outside when you finally make it home.
Waking up to some maintenance worker at the foot of your bed in your room.
Walking home in yesterday morning's clothes (not your typical walk-of-shame)

Why call is pretty cool:
Open thoracotomies (chests)
Traumas on the Saturday of Memorial Day weekend.
Kidney transplants
One-on-one time with attending physicians who make sure you understand everything.
Finishing call for the surgical rotation.

Uncle Stan

My hope is that Stan has found peace, comfort and harmony with his world.

My thoughts are with his family. May we all remember those close to us and again tell them we love them. Life is far too short and we are reminded again that life is a fragile balance.

Please enjoy it.

Cheers Uncle Stan! I'll raise a glass in your honor (probably Lite Beer from Miller, right?).

2 Shrinks

I've got two outlets in this world. This online source and one hand written. Of course I get by with a little help from my friends.

Last night I needed an outlet. The entire idea of committing to something this big is a bit overwhelming at times.

I found one of the sources of my struggle. I've been lucky in life in that I can typically do something fairly well with some time put in (and it upsets J-Rad lots). I made the Cat 5 to Cat 1 progression in something like 18 months in New England, not Utah (yup, tooting my own horn here). I've succeeded at academics when I really apply myself (and sucked when I didn't). I like to see results (hence my desire for surgery). The difficulty with my current state, or at least my source of struggle stems from the fact that this is not a "quick and dirty" process. First off, it should not be. But I hate sucking at things and medicine requires sucking in order to get good. Sure other things do too: ski racing, freshman chemistry, tennis, retail sales...cycling. The learning curve is MUCH longer now. I hate to suck at something. It's just not in my nature.

Ok, change of pace.

Regrets. Have any in life? I do, but only a select few. I think one of my biggest is sometimes taking life for granted. Not my life, in particular, but life in general. We all just expect to see someone again. When they are gone, that's it.

5 North. I really need to write a screen play for this crew's story. It would be the funniest, most tragic story ever. These 5 guys are not only some of my earliest role models (everyone should aspire to make a pool volleyball net out of 6-pack rings), but also my dearest family. I don't see them as much anymore as I used to. Life grows up, moves fast. Anyway, these 5 deserve my thoughts as they come together under some difficult times. One of them is fighting hard right now. May we all be as lucky to have friends like these 5 guys (missing Buddy-Wuddy below)

Give 'em hell Uncle Stan.

Like that fun mud puddle in February.

You know those puddles that freeze completely and then are totally crushable? We've all encountered them. You walk toward it and plan on maximum damage with one large stomp. What happens? Crack!

So satisfying right? Thin crunchable ice!

I'm slowly getting the feeling that my enjoyment of the surgical persuasion is kinda like the ice on the puddle. It is very close to being completely cracked. I spent many days in a Cardio-thoracic OR for work before med skule. I've spent many days in the OR over the past 10 weeks. I've seen everything from a hysterectomy to a complete bowel resection to a urethral taping for incontinence. Some stuff was pretty sweet. Somehow the current service I'm on is less than appealing. GI and Bariatric. Gastric bypass, colon removals...not my cup of tea, yet. On top of this ice which is close to being satisfyingly crunched stands the residents and attending physicians of the surgery dept. Many of them just don't seem happy. Those that do rarely show it. They all look tired. I've joined them. I was told by one of those highest up, that in order to read and study more, I need to get by on less sleep.

Wait a minute. I've also been told that in order to retain what we are exposed to during the day (which is more like a fire hose now than ever before) we need 7-8 hours of sleep. I function poorly on less than 6 hours. By three days of that I'm useless. Who does that help? Not the patients. I'm okay with the process of call and night float. Those really ARE amazing learning experiences, and I actually like them. One sees a wide variety and has the opportunity to learn much more.

Tack on 5 years of this (surgical residency) and I can see how those in the surgical field are irritable, grumpy, less than friendly people. It's scary to think that I might have once wanted this to be my chosen career. Perhaps that will change with exposure to different surgeries, different residents or different attendings. Otherwise, listen closely....

that puddle could be cracking, and it might feel pretty good.

First 100 days

Well, we have all heard about Obama's first 100 days. Some are happy others are not. Can't please everyone, right?

In that time I've:

1. Journeyed to AZ
2. Seen Deb and Stu
3. Moved to Maine
4. Spent 4 weeks on Gynecology.
5. Spent 4 weeks on Obstetrics
6. Delivered my first baby.
7. Really enjoyed my OB/Gyn rotation
8. Started my surgical rotation.
9. Watched a 5 hour Roue-en-y gastric bypass
10. Spent an afternoon at the beach

Yup, life moves pretty fast. As Ferris said, if you don't stop to look around once in a while, you just might miss it. He's dead on. Somehow it became May. Probably the best month of the year. Temps warm up, leaves come out, everything turns green, days get really long, BBQ season hits full swing. I'm spending mine in Maine. I will be on Surgery for the next 7 weeks, which means little sleep, long hours and some pimping (questions on the spot in the OR - part of the medical hierarchy). No worries, as I like surgery. I just need thicker skin for when I mess up.

My goals for the next 7 weeks include eating better, working out, not fall off the face of the earth with respect to family, friends, news and society. I'm on call Q6 (every sixth day) so if I don't get to your missed call right away, I apologize, it might have to wait until a free weekend.

Those of you playing bikes, realize how good you have it and enjoy it without getting caught up in the regular crap that can consume a bike racer.

Those of you playing golf, realize how good you have it and don't worry about missing that put.

Those of you doing the tri-geek stuff, realize how good you have it and forget about transition time.

Those of you in medical school, realize how good you have it and go get some sleep.

cheers.

Night Float

Ever try turning you clock 180 degrees? Kinda funky. I get up at 4pm, work 5pm to 6-8am, then to bed STAT (ok...story about that word to follow). sleep during the day, work all night. Two more days. See absolutely NONE of the world. If you think med school takes away your life, try night float.

I share an apartment with Melissa. I've not seen her since Sunday. We are on exactly opposite schedules. Imagine what this does for trying to run errands. Mail? Bank? Groceries? Impossible. Actually, not impossible but it severely eats into sleep. Adding a workout? Not a chance.

But, spring is springing. The Sox started with a win, and I'll have something to watch on TV as basketball just ain't my thing. UVM plays in the Frozen Four tomorrow night on ESPN2 - the Deuce at 8pm eastern. I hope to catch some of it at the hospital.

I'm finished this opposite schedule in two more days. I've been able to help with an emergency case of Ovarian torsion, multiple C-Sections and a couple of baby deliveries the old fashioned way.

STAT. I've never looked up the origin of that word. It's like CODE. These are two words med school expects you to know. Get me that STAT. Sure I know it means "right f#$%ing NOW", but why does it mean that? STAT comes from...? I can't find a correlation. If anyone knows the historical context/root of the term, I'd love to learn.

CODE? Sure it is a general description of an operation. In the military it means one thing. In the hospital it means something completely different, fire or something emergent. So, people have shortened the Code Blue or Code Red or Code Green... IF someone is requiring resuscitation, the Code Red or Blue or Black is shortened to CODE. As in he/she CODED. It's a verb. To Code means to need some major medical intervention with impending doom.

Two of the most basic things that are fairly common knowledge but never taught in med school. Go figure.

Nighty night...well, after breakfast.

Chips, Dips, Chains, Whips...

In conversation earlier tonight with one of my favorite former Utah bloggers, the topic of racing in Utah came up. I've left, I'm in New England where the riding is decent, but the amount of time to do so sucks. He's left, he's in another state altogether and doesn't race in Utah much any more.

After listening for a bit, my move is probably for the better too. I recall being a member of the original UCA "board" in 2002. We were a loose bunch. Dirk, myself, T$, and a few others. We hardly wrote bylaws, but we tried to watch the budding business of SBO closely as the potential for conflicts of interest became quickly evident. The UCA has evolved greatly from there.

So now, after watching that relationship closely, Utah racing is getting timing chips. Out of state racers like me will need to "rent" chips. I'm the guy that never bought the RMR plate because it was a waste of money. I actually sat down and did the math and unless I raced something like 8-9 days, the $7 entry and $3 savings just could not convince me to spend $50. Something was a little washy. I still struggle to figure out how those plastic plates cost $50. That's not much less than a jersey. Was someone making a little extra? Folks claim that RMR was hardly a break even deal, and yet, those little cheap plastic plates somehow cost $50. It didn't/doesn't add up.

Now we're onto timing chips. Get one or else. No scoring? Really? $10 rental? $40 fee? C'mon. I'll try to put the math together if someone would send me the facts, but I'm having a hard time with this. Why? The UCA requires it. They've never needed it before. Not in Utah per se, but in other HUGE races around the country/world, chips have basically been avoided. Perhaps they are the wave of the future, and USAC wants to make more money. If officials and a camera are still the prime means of judging and scoring an event, why the chips?

Simple: $$$$$ Yep, money for everyone but the promoters and racers. Promoters need to pay someone (guess who...SBO!!) to employ the chip timing and scoring system. Racers pay the entry fee and cost of the chip. The people who provide the timing and scoring system are in it FOR PROFIT! USAC signs with a chip company due to financial incentives. Who's losing out on all of this? You are: the cyclist. It is coming out of your entry fee. It is otherwise money that could be spent on promoting grass root cycling as profit for the promoting club (equipment for juniors, entry fee reimbursement...)

Need an example? Tax Day Circuit Race. Now I might be wrong here, but not holding an event due to margins being too narrow thanks to the need to employ chip timing (on a mountain top finish??!!!) and the associated costs, seems very unfortunate. Actually pathetic. Shame on the UCA.

Too bad. Perhaps I did leave Utah in the nick of time (pun intended).

For all of the promoters out there who actually DID support (all but 1 of 60 or so?) use of the chip: please rethink your decision. It will effect the course of YOUR races and only makes it more expensive for riders while putting more money into the pockets of...well, not you or the riders. That just doesn't sound right...does it?

ps: here's to working in the outpatient clinic with decent hours (only 6:15am-5pm). It allows me to rant like this.