Which brings me to my next point.... Don't smoke crack.
Now as far as abusing over the counter, natural health supplements on the other hand... feel free to experiment. Actually, that stuff's probably just sugar pills and overpriced plant refuse. Nevertheless, as benign as much as the unregulated health supplement industry probably is, some of it will affect you, and not always in the ways you intended. Case in point for myself: melatonin. Not quite the same at St. Johns Wart or hanging crystals from your door jams as it is in fact a chemical that readily, normally exists in your body; it is similar in that there haven't been too terribly many published, verifiable studies done which show any merit to ingesting it on a regular basis. At least as far as I can tell. Allegedly, however, it is supposed to aid with sleep, regularize your sleep/wake cycle, fight cancer, and generally make for a fantastic day. For me, on the other hand, it mostly just makes me crazy.
My roommate and some other friends started taking it after a medical school lecture a few years back shared with us the boons to be had. Upon discovering this I of course had to join in. I don't have terribly much to do work wise now, and so could feel free to sleep in as long as melatonin felt I needed to sleep in for. Unfortunately, that's not what melatonin had in store for me, however. Instead about an hour after I took it and was already lying in bed I started to feel jittery. The weird twitchy feeling was quickly followed by an intense tired sensation and that shortly thereafter by my first sleep for the night.
My first sleep also brought my first dream which involved a series of fire alarms with the last one leading me out into the rainy night all alone only to be robbed at knife point. My assailant tried to take me to his car for whatever nefarious reason and, as he was going to the driver's side and lighting up a cigarette, that's when I made my break for it. After a smirk and a long drag on his cigarette he gave chase and, within a few minutes, I woke up. Disturbed but still very tired I quickly feel back to sleep.
And so we come to dream two. Dream two involved an evil clone of myself who of course had to be subdued and, later, a demonic teddy bear who, though not very strong, you knew was gonna mess you up if he got the chance. Run and go get a knife to cut you with was my guess. So that dream took its course and next thing I know it's about 9:00 in the morning. Time to get up and do some work. Unfortunately melatonin was not done with me, however, as I felt all funky dream-like for the first hour or so. Within an hour after that I was asleep again in my chair at the computer instead of being productive with my studies. In light of passing out while sitting upright, I decided to concede defeat and take a nap for a few hours. The nap was thankfully a pleasant one, but after all is said and done I have to say, "what the heck melatonin? Why you gotta be like that?" If that chemical really is normally in our brains it was put there by the devil.
And as a final note, after sharing my experience with my roommate he happily informed me that both he and he girlfriend had had vivid dreams when they first started taking melatonin too. Yeah, thanks for telling me.
Wednesday, August 15, 2007
Sunday, August 12, 2007
WTF?!
I am not usually one to curse -- in fact the only ones I usually do ever use (hell, damn, bastard) are usually said in jest -- but there has come a time recently when, truly, I wanted to yell out, "what the fuck?!"
During my Infectious Disease rotation in Ohio I was given one of many brief overviews of the internal medicine programs available up in Dayton, and the physician advising me -- an otherwise normal, amicable guy -- informed me that at that program I had the wonderful option of moonlighting if I wished. For those not entirely familiar with the term (and I had to look it up to make sure I wasn't completely misunderstanding him), "moonlighting" is when you go mercenary. When you're off the clock at whatever hospital you work at you go work at another hospital for additional cash and exposure. Really a great way to earn both from what I hear, but in light of the greater things in life -- say everything not medical related -- I feel it's hardly just compensation. I wanted to respond with a loud, "why the hell would I want to do that?!" Work eighty hours a week only to do it for another 8 or 10 on my one day off?! I imagine one of my eyes momentarily deviated to the side before I paused and replied with a smile and nod. Seriously, though, I have never before in my life truly felt the urge to scream, "what the fuck!" before until then. Now I feel I can truly empathize.
During my Infectious Disease rotation in Ohio I was given one of many brief overviews of the internal medicine programs available up in Dayton, and the physician advising me -- an otherwise normal, amicable guy -- informed me that at that program I had the wonderful option of moonlighting if I wished. For those not entirely familiar with the term (and I had to look it up to make sure I wasn't completely misunderstanding him), "moonlighting" is when you go mercenary. When you're off the clock at whatever hospital you work at you go work at another hospital for additional cash and exposure. Really a great way to earn both from what I hear, but in light of the greater things in life -- say everything not medical related -- I feel it's hardly just compensation. I wanted to respond with a loud, "why the hell would I want to do that?!" Work eighty hours a week only to do it for another 8 or 10 on my one day off?! I imagine one of my eyes momentarily deviated to the side before I paused and replied with a smile and nod. Seriously, though, I have never before in my life truly felt the urge to scream, "what the fuck!" before until then. Now I feel I can truly empathize.
Friday, August 10, 2007
Fightin' Words
In 1942 the Supreme Court determined in Chaplinsky vs New Hampshire that not all speech was in fact free. In this particular case "fighting words" were determined to be words which conveyed no ideas, possessed no content, and served no purpose other than to incite and illicit violence; they were to be considered unprotected. Much has changed since then, legally and otherwise, but nevertheless I feel the initial precedent still stands. If someone tells me some fightin' words, I should be able to round house kick them in the spleen. Why do I feel this strongly about the matter you may ask? Well let me tell you....
Much of medicine involves the fine art of interpersonal communications. While giant brains are certainly part of what's required, a tongue that chooses its words wisely goes a long way as well. Unfortunately all too often some people neglect the latter, and instead feel inclined to say whatever it is that happens to pop into their head. When this occurs in isolation it is ignorable, forgivable, and forgettable. When this happens on a daily basis they become inescapable, rage- inciting obsessions. Or so it seems to go with me.
One such example is the ever popular phrase that is especially in vogue on the wards: "he knows his shit." Commonly if not always used to express the thought that such and such resident/attending/student is particularly knowledgeable in whatever field is under discussion, the random unnecessary insertion of the vulgar "shit" gives it a jaded, street-wise edge thus identifying the deliverer of the remark as someone who knows his shit about what he's talking about. Bushy-tailed young medical students still full of ethics, sugar, and a desire to please would never say such a thing to express such an idea; this phrase thus deftly lets everyone know that whoever said it is not some silly bushy-tailed young medical student. If only it wasn't used by everyone. Unfortunately the fact that people still use it only serves to identify them as (A) bushy-tailed young medical students trying to grow up too fast or (B) oblivious idiots who have been around long enough to know it is an entirely over-used and not particularly liked phrase but continue to use it anyway. In either case the person is clearly in need of a punch to the mouth.
A second example seems to exist only in the hallowed halls of surgery. Attend any Morbidity and Mortality Conference and in short time you'll hear the word "gestalt" so much you'll think it's echoing off the walls. This is a particularly interesting case for a variety of reasons. I personally think "gestalt" is a pretty great word. Succinct, intelligent, manly sounding. Unfortunately for all the same reasons it appeals to every surgeon. In what is often an ongoing battle of egos where every little point counts and so every little word counts, "gestalt" nets at least a triple word score. Nothing takes the fun out of German words, however, like a surgeon. If a good word can be so over used by obnoxious people as to inspire eye rolling instead of a smile, I think it deserves to be included as a fighting word.
Lastly, to further infuse our discussion with history, I will draw reference from the recent Hollywood action hit "300." If the story is the least bit accurate you can be rest assured that calling any half decent Spartan an Arcadian is fully asking for a powerful spear thrust to the midsection. In case you have not seen the movie and are not entirely familiar with the plot, the Spartans must defend Greece from the Persian hordes using nothing but raw machismo. I believe the movie can best be summarized with a paraphrasing of a scene involving King Leonidas and a crippled gentleman wanting to join his army.
And credits.
Hopefully all the above examples make my case for me. Some words should not be said. And if they are said whoever says them should certainly get what's coming to 'em. The Supreme Court cerca 1942 demands it!
Much of medicine involves the fine art of interpersonal communications. While giant brains are certainly part of what's required, a tongue that chooses its words wisely goes a long way as well. Unfortunately all too often some people neglect the latter, and instead feel inclined to say whatever it is that happens to pop into their head. When this occurs in isolation it is ignorable, forgivable, and forgettable. When this happens on a daily basis they become inescapable, rage- inciting obsessions. Or so it seems to go with me.
One such example is the ever popular phrase that is especially in vogue on the wards: "he knows his shit." Commonly if not always used to express the thought that such and such resident/attending/student is particularly knowledgeable in whatever field is under discussion, the random unnecessary insertion of the vulgar "shit" gives it a jaded, street-wise edge thus identifying the deliverer of the remark as someone who knows his shit about what he's talking about. Bushy-tailed young medical students still full of ethics, sugar, and a desire to please would never say such a thing to express such an idea; this phrase thus deftly lets everyone know that whoever said it is not some silly bushy-tailed young medical student. If only it wasn't used by everyone. Unfortunately the fact that people still use it only serves to identify them as (A) bushy-tailed young medical students trying to grow up too fast or (B) oblivious idiots who have been around long enough to know it is an entirely over-used and not particularly liked phrase but continue to use it anyway. In either case the person is clearly in need of a punch to the mouth.
A second example seems to exist only in the hallowed halls of surgery. Attend any Morbidity and Mortality Conference and in short time you'll hear the word "gestalt" so much you'll think it's echoing off the walls. This is a particularly interesting case for a variety of reasons. I personally think "gestalt" is a pretty great word. Succinct, intelligent, manly sounding. Unfortunately for all the same reasons it appeals to every surgeon. In what is often an ongoing battle of egos where every little point counts and so every little word counts, "gestalt" nets at least a triple word score. Nothing takes the fun out of German words, however, like a surgeon. If a good word can be so over used by obnoxious people as to inspire eye rolling instead of a smile, I think it deserves to be included as a fighting word.
Lastly, to further infuse our discussion with history, I will draw reference from the recent Hollywood action hit "300." If the story is the least bit accurate you can be rest assured that calling any half decent Spartan an Arcadian is fully asking for a powerful spear thrust to the midsection. In case you have not seen the movie and are not entirely familiar with the plot, the Spartans must defend Greece from the Persian hordes using nothing but raw machismo. I believe the movie can best be summarized with a paraphrasing of a scene involving King Leonidas and a crippled gentleman wanting to join his army.
Crippled gentleman: Blah blah blah, glory of Sparta. Can I join your army?
King Leonidas: Ha ha ha, silly Quasimodo! You cannot be a Spartan. The strength of Sparta is in the phalanx -- which conveniently we will rarely fight in during the course of the movie -- and you're entirely too disfigured to fight in such a manner. For SPARTA!!!
Spartan Chorus: Haroo! Haroo! Haroo! (Or some other unrecognizable noise.)
Persian King Xerxes to cripple: Hey, dude, bow before me and I'll make you pope!
And credits.
Hopefully all the above examples make my case for me. Some words should not be said. And if they are said whoever says them should certainly get what's coming to 'em. The Supreme Court cerca 1942 demands it!
Monday, August 6, 2007
The Gaping Chest Wound Dove
There are few reasons for which I would travel to Houston. A million dollars, my upcoming Step 2 CS exam, on my way to some greater destination, true love. Perhaps in such situations I would begin to think about it. There is one situation, however, in which I would without hesitation pack my bags, put on my drivin' cap, and head on out; and that situation is a trip to the zoo. Until this last weekend I had never been to the Houston Zoo, and now after having gone I am free from that obligation and can once again safely keep my distance. I also visited a college friend and did not visit another college friend, but it turns out people change, consequently friendships change, and well that was that. Let us not get distracted from the matter at hand: zoo.
My college friends aside, my Pediatric intern pal Ro did accompany me and in keeping with previous performance I once again failed to take any pictures of merit. Unlike last time at the USAF Museum, however, this time I didn't so much take bad pictures as fail to take any pictures what so ever. Perhaps one day I will get used to all this. At least I'm remembering to take my camera with me; that's a start. Regardless, the Houston Zoo is nice, but largely unexceptional. Probably would have been more enjoyable had it not been so hot and humid, but I'm fairly confident that's not a meteorological possibility for Houston so I won't hold it against them. There were two memorable experiences, however, which warmed my heart or at the very least amused me.
The first was small child feeding the meerkats cotton candy. His mother scolded him the first time, but once the cute, friendly little meerkats went absolutely out of their minds for the pink confection, she found it in her heart to allow her son to throw a little bit more to the one meerkat that didn't get any. I don't know if the meerkats had had experience with cotton candy or not and were thus able to recognize it for the treasure that it was, but soon as sentry meerkat saw it fall into the enclosure he was all action. Down from his upright position resting on his haunches and scrambling wildly to retrieve his prize, he was followed by another meerkat who just happened to be sticking his head out of one of the many meerkat holes. They wrestled a bit for it. Growled a bit for it. And promptly chewed and licked it all up till, a few seconds later, the sizable cotton candy chunk was gone. It was certainly not natural and certainly objectionable, but yet also oddly amusing. Kind of like tapping on the glass of an aquarium as a kid. You kind of know already that it's probably not good for the fish, but you want to see what happens anyway. Likewise, I think everyone was fully aware that the meerkat diet does not normally consist of highly refined sugar and red food coloring, but, well, we've never seen a meerkat with diabetes before and we just kind of wanted to see what would happen. And then we moved on to the next exhibit.
The other highlight of the zoo, and only one for which I have a photo, is the Bleeding Heart Dove also known as the Gaping Chest Wound Dove, Gunshot Wound Dove, and Cutaneous Fistula Dove. Of all the crazy and beautiful birds at the zoo, and they had a remarkably extensive collection to their credit, this was the coolest. The little earth-bound bird's name was true to life. I'm not sure what evolutionary purpose it serves -- perhaps predators do not want to mess with something that can take small caliber rounds to the sternum -- but whatever the cause, it was one impressive bird. And now for your viewing pleasure, my "best" photo of Gaping Chest Wound Dove:
My college friends aside, my Pediatric intern pal Ro did accompany me and in keeping with previous performance I once again failed to take any pictures of merit. Unlike last time at the USAF Museum, however, this time I didn't so much take bad pictures as fail to take any pictures what so ever. Perhaps one day I will get used to all this. At least I'm remembering to take my camera with me; that's a start. Regardless, the Houston Zoo is nice, but largely unexceptional. Probably would have been more enjoyable had it not been so hot and humid, but I'm fairly confident that's not a meteorological possibility for Houston so I won't hold it against them. There were two memorable experiences, however, which warmed my heart or at the very least amused me.
The first was small child feeding the meerkats cotton candy. His mother scolded him the first time, but once the cute, friendly little meerkats went absolutely out of their minds for the pink confection, she found it in her heart to allow her son to throw a little bit more to the one meerkat that didn't get any. I don't know if the meerkats had had experience with cotton candy or not and were thus able to recognize it for the treasure that it was, but soon as sentry meerkat saw it fall into the enclosure he was all action. Down from his upright position resting on his haunches and scrambling wildly to retrieve his prize, he was followed by another meerkat who just happened to be sticking his head out of one of the many meerkat holes. They wrestled a bit for it. Growled a bit for it. And promptly chewed and licked it all up till, a few seconds later, the sizable cotton candy chunk was gone. It was certainly not natural and certainly objectionable, but yet also oddly amusing. Kind of like tapping on the glass of an aquarium as a kid. You kind of know already that it's probably not good for the fish, but you want to see what happens anyway. Likewise, I think everyone was fully aware that the meerkat diet does not normally consist of highly refined sugar and red food coloring, but, well, we've never seen a meerkat with diabetes before and we just kind of wanted to see what would happen. And then we moved on to the next exhibit.
The other highlight of the zoo, and only one for which I have a photo, is the Bleeding Heart Dove also known as the Gaping Chest Wound Dove, Gunshot Wound Dove, and Cutaneous Fistula Dove. Of all the crazy and beautiful birds at the zoo, and they had a remarkably extensive collection to their credit, this was the coolest. The little earth-bound bird's name was true to life. I'm not sure what evolutionary purpose it serves -- perhaps predators do not want to mess with something that can take small caliber rounds to the sternum -- but whatever the cause, it was one impressive bird. And now for your viewing pleasure, my "best" photo of Gaping Chest Wound Dove:
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