Wednesday, July 29, 2009

The Great Pee Pee Mystery

Today, from roughly 1100 to 1700, I waited for an old man to pee so that I may take it and look at it under a microscope. Around 1715 I was given word that the long awaited urination had taken place. Briefly taking care of other urgent matters, I attended to my wee sometime around 1745 only to find it was nowhere to be found. Some masked stranger had run off with my urine. I asked the nurse, she didn't know. I asked the patient, he said "a doc" took it. I asked my interns, they were clueless. Somebody, for whatever clearly no good reason, had absconded with my wiz. I was upset. Although few will every appreciate this, there are few things more frustrating then waiting an entire day for urine only to have it disappear. Nevertheless it seems to be the running average for Williford Hall these days. Most labs get sucked up by gremlins in the vacuum tubes, most daily radiographs become every other day radiographs by the x-ray tech fairy, and half of our electrolyte panels seem as if the masked stranger himself is urinating in them yielding the wildest most ridiculous and inaccurate of results. Wilford Hall, you're too much for me. I don't know what to do with you.

Someone will pay dearly for the pee, though. Someday I will have my revenge.

Wednesday, July 15, 2009

I Should Have Been a Christian

I love the ladies, but the ladies, well, apparently they don't love me.

Or at least so suggests the informal polls that are Match.com and E-Harmony.

After six months of the former and three of the latter, it can conclusively be said that we, myself and the ladies, can both do better. By and large the women I fancied did not fancy me back, and by and large the women who fancied me seemed to be either entirely unaware of what was written in my profile or not particularly picky in their mate. It appeared that most of my attempts failed at or shortly after introductions, and most of their attempts never made much sense. Why women who did not share my interests or goals or even any of the "what I am looking for" criteria would think we would have any significant romantic connection is admittedly a bit beyond me. Perhaps there's intimacy in having absolutely nothing to talk about.

My failed attempts at wooing aside, the greatest realization I came to amongst all of this woman hunting is that perhaps I ditched the Christian faith thing a bit too early. Although this is an entirely unsubstantiated assertion, it seemed the more a profile directly or indirectly referenced Adonai the more fetching the woman was. (Either there is a significant lack of devout Christian guys leading to a surplus of devout Christian women or religious zeal and Internet access correlate directly with attractiveness and amicable disposition.) Unfortunately, part of being pious for most involves dating only the like minded, something about 2 Corinthians and unequal yoking, so that meant no matter how fabulous and charming I was, or how much I begged and pleaded, further discourse was right out. I was left to choose from only the nonbelievers and carnal Christians. To think, if only I had not turned to empty hedonism so quickly I could right now be enjoying myself some empty hedonism. Oh, Lord, you're an ironic one if nothing else.

This is not all to say that I missed out, though. That I feel somehow as if my experience was incomplete or that I pine for an endless series of what ifs. Perhaps had I still been waving the Christian flag I would have met the love of my life -- I would have at the very least had a larger pool of possibilities -- but I don't care for such perspectives. You do the best with what you got, learn, and move on. I certainly cannot choose my faith or will myself to believe, and I definitely cannot go back in time even if I could wear religion like a hat. But dang, man, there're some cute Christian ladies out there.

So the six months went by. At first I felt uneasy about regularly judging and assessing whether I was interested in someone or not based solely on their profiles and pictures, but this gave way to acceptance, then amusement, and then finally disinterest. It seems the appraising of maidens like all things gets boring in time. I did meet a few girls throughout it all -- a young woman whose every conversation seemed to return to Friends being a lame knock off of Seinfeld and another polite lady whose conversation style consisted of an endless stream of unconnected questions, amongst others -- and I found it interesting to see how different people chose to sell themselves -- it seemed there was a pretty even balance between tomboys with a girly side, party girls with a dorky side, smart girls with a pretentious side, and characterless nitwits -- but the pickings got slim, I got self centered (or rather more so), and so the time came for my departure.

Curiously, the very last message I was to get the day my Match.com subscription expired was from a pleasant young woman from Georgia. In it she stated that she had seen that I had seen her profile (an odd feature of Match.com), and not typically catching the eye of dudes hundreds of miles away she out of curiosity clicked to view mine. After reading it she felt inclined to write a brief message stating simply that she did not see why I was on Match.com, that my profile was not typical of the profiles on the site, and although she imagined it would be a brief venture she wanted to wish the best of luck to me with my search. That was all. Very sweet. Very nice. Very random.

And I give up.

Monday, July 13, 2009

Befuddlement

It was the best of times. It was the worst of times.

Or so I am frequently told.

Frankly, I don't find the times very enjoyable. In all honesty, though, I have no idea how to interpret them. These times apparently be confusing.

Relatively speaking us Air Force residents have got it easy. Compared to the internal medicine residencies of yesterday where interns and residents were shackled to their wards, forced to work while sleeping, and generally treated like so much chattel, we live lives of luxury with slashed work hours, broken chains, and alleviated patient burdens. Everyone always says it was harder back in the day -- and I am inclined to believe them -- nevertheless I am also inclined to believe that back in the day there were infrequent CT scans, no MRIs, only a handful of blood tests, and a pharmacy consisting mostly of a few penicillins, ergotamine, and phenobarbital. Twenty patients ain't so bad when all you can do is lay on hands and hope for the best.

Beyond that we've got it easy in other ways too. Compared to many civilian programs we work less, see fewer patients, are paid better, and likely are showed more appreciation by our patients. And compared to the hobos living immediately outside my apartment at least I have more to come home to than cheap booze and some invisible pets.

In absolute terms, however, residency is so much balderdash. We still work harder, longer, and with less perks and less confidence than the vast majority of Americans. Our job is in its very design constructed to make us feel continuously ill prepared so as to constantly compel us to learn. And through a legacy of estrangement many who teach and guide us have no great sympathy for our lot.

So how am I supposed to feel? Frustrated that it's not better? Happy that it's not worse? Thankful that I get to train for the unique career of my choosing or upset that all I do is train for the unique career of my choosing? I am undoubtedly incomparably blessed, but this particular blessing comes with an odd trial before the spoils. I have no means of measure and so am constantly wavering between emotions; I find myself muttering under my breath perhaps more than is healthy, and am thinking of joining the hobos.

Perhaps they'll let me take care of the invisible cat.

Sunday, July 5, 2009

Breaking News

We interrupt the previously scheduled post-election coverage of demonstrations in Iran in order to provide you with this late breaking news:

Michael Jackson is still dead!

Initially thought to have died on June 25th, 2009, a repeat autopsy was undertaken today to confirm that the legendary singer-song writer is still in fact deceased. He is. Further memorials and tributes are likely in light of this breaking revelation. Many have called for an official day of mourning to be followed by a national day of remembrance and a week long world wide candle light vigil. A stirring audio-visual tribute is scheduled for every multimedia awards show to take place for the rest of the year.

We will return to your regularly scheduled program once we have sufficiently beaten this story into the ground.

Monday, June 29, 2009

Welcome to the Circus

For my final act of intern year, a grand menagerie! A collection of things that shouldn't be; a hospital of patients that are not sick! Gather one, gather all to the myth, the mystery, the *greatest* show in history; the last month of inpatient Internal Medicine as an intern!

The Man Without Symptoms!
Straight from Bavaria and to our show exclusively, the man without symptoms! Not a single complaint. Not a single problem. Flawless, painless, soreless and completely disease free; solely in need of a complicated CT scan available only in our very own military institution! Watch as he is not only hospitalized, anesthetized, dialyzed, and lesion localized, but also canonized, exorcised, and cannibalized all over the course of a three day hospital stay. The man has no business being here but because no expense is too small and no admission to the hospital too trivial we will admit him for your viewing satisfaction anyway!

The Respiratorical Horror That Wasn't!
Also for your exclusive entertainment a man so sick, so ill, so reportedly toxic and pernicious, you'll be surprised to hear it's *all* fictitious; the man with a COPD exacerbation so stable it's exasperating! His symptoms are at baseline. His oxygen requirement is unchanged. His breathing is unlabored. He looks altogether all too good; but for a limited time only he will be admitted directly from clinic to receive the same care he'd of received at home!

The Woman that Communes with Spirits!
Next. Born with a terrible gift. A young woman scourged by the Almighty with a supernatural talent lain dormant for centuries. Our very own telegraph to another world. The Woman that Communes with Orthopedic Surgeons! She will be brought to the hospital for reasons unworldly, her care will guided by voices emanating from the very ether, and her entire stay will be determined by a presence heard but never seen! Truly, lads, you have not lived until you have communicated with those not living! Commune with the orthopods for just one shilling! *Never* has health care been so thrilling!

The Amazing Record Player Woman!
Imagine now madams and gents: every day the same thing, every day the same thing, every day the same thing. The next poor woman is bound by an inescapable cosmic cycle to call the police weekly raving of impending robbery at the hands of her neighbors. She is captured in an unbreakable celestial loop to be brought to the hospital on a seven day circuit to be treated for the exact same dementia. She will see exactly the same physicians. Decline exactly the same tests. And be discharged to exactly the same home exactly the same way every time; just like clockwork! It's a rotation so accurate you can mark your calendar by it -- I kid you not! And you're in luck with this one, folks, because if you miss this week's show just come back next week for the encore!

The Phantom Fibrillation!
And if that wasn't enough, friends, gather closer as I speak to you of a phenomenon that some say doesn't exist. A phantasm that materializes only to vanish seconds later. A cardiac conduction abnormality that few have ever seen! The Phantom Fibrillation! The poor bearer of this accursed arrhythmic spirit -- a gentleman from our very own town -- is forced to walk the Earth waiting for his next atrial possession. Come awe at the reports from the ER of his shortness of breath. Then astonish as the same ER reports him to be symptom free! And finally astound as we admit to monitor him, test him, and pursue a workup that could just as easily be done at the cardiac clinic anyway! Now we cannot guarantee that the specters will present themselves, but we *can* guarantee that if they do it will be an event you will not want to miss!

The Golden Crap!
But that's not all. No that's not all at all, folks. Don't even think about it -- not a bit! Our very last act -- our very last sensation, the topic of tomorrow's conversation, an aberration of constipation; ladies and gentleman I present to you the Golden Crap! The man has not pooed for days, some say months, possibly even years! Many have tried to disimpact him but some say he is undisimpactable. He will come into the hospital for one day and one day only to have what many believe will be the most expensive bowel movement ever!

(And cue curtain.)

In conclusion: sometimes my life is like a circus. But with less funnel cake.

Thursday, June 25, 2009

Something's Fishy with this Fish

Fish. Some are pretty to look at, some are fun to catch, some keep the jellyfish in line, and it is said that altogether they are all an important integral part of the food chain. Not my food chain, but someone's food chain they say. That was until yesterday.*

Although sushi currently seems to hold the title of "greatest thing ever," I have always personally been under the impression that mankind did not discover flame broiling simply to have another task added to his day and in which to potentially cripple himself with, but rather because he once killed something, immediately took a bite out of it, and thought, "man, there's gotta be a better way." Persuaded at times by family and friends to occasionally question these assumptions I have always been disappointed and have always been told that that particular place either did not have very good sushi or just not very good sushi at that particular time. With odds such as these even if it turned out sushi was delicious I doubt it would be worth the culinary gamble you need to go through in order to get the good stuff.

Similarly once or twice I have deigned to try fried fish under the belief that fried batter makes everything better, and while this is still universally true, better does not necessarily translate into good. Fried catfish and fried Chinese-body-bone-and-eyeballs fish would taste better still without the catfish and bodies, bones, and eyeballs.

I have also since been fed salmon, tilapia, cod, orange roughy, and likely other tasty sounding but not terribly tasty tasting fishes only to be unimpressed every time. Canned tuna continues to be an offense to both my taste buds and my nose buds.

But I had not, until recently, tried ceviche. The thought of adding acid to fish for whatever inexplicable reason just never sounded appealing to me. It turns out, however, that a handful of hydrogen ions and a little bit of denaturing of proteins are exactly what is needed to take the fishy out of fish. I am still not entirely convinced that there was in fact fish in the dish, but I am repentant. I was wrong. I am sorry fish eating people of the world. Fish, or at least the fish served in the ceviche at Rosario's, is in fact palatable if not enjoyable to eat. What else can a little bit of acid improve? Liver? Gibblets? The global economy?



* In the interest of full disclosure. I had actually had one prior occasion where I sampled and did not die from eating fish. The butterfish in Hawaii is actually quite good if you can get all the bones and what not out of it. But come on; it's called butterfish. It's like God was demanding it be eaten.

Thursday, June 18, 2009

No Dogs Allowed

My favorite movie as a kid was a toss up between Garfield's Halloween and Snoopy, Come Home. The first was and always will be great even long after Garfield ceased to be amusing to me. The second is possibly the saddest movie I have ever seen. Or, at the very least, the saddest animated movie I have ever seen. The most glaring memory which seems to daily reinsert itself into my thoughts, however, is the line, sung slowly in a deep voice, "No dogs allowed!" sung just about whenever Snoopy tries to go anywhere or do anything in the movie. I will likely go to the grave with that as the chorus in the back of my mind.

This last weekend I felt Snoopy's pain. I was thrown from a swanky Houston club, the Drake, for no good reason at all. Officially it was because of my lack of shiny shoes, but I believe reverse racism somehow played a role. Either my awesomeness or my excellence were clearly being discriminated against here, perhaps both. Although I could not hear it over the thumping base emanating from the club, I believe a distant baritone could be heard saying, "No tennis shoes allowed!" I had even specifically put these not shiny shoes on (and a button up shirt and pants) per the request of my friend, Ro, who I thought had been properly informed specifically to avoid such discriminations from happening. After failed attempts at then going to see a movie and renting a movie -- they were both closed -- we ended up spending the night playing two man Trivia Pursuit until Ro experienced trivia fatigue and began feeding me the answers in order to bring the game to its long delayed conclusion. Clearly the people of the Drake missed out.

In other news, I finally stopped at a Buc-ee's (the Beaver) Gas Station on the drive home just to see what there was to see. It was nice and clean and full of jerky and various Texas themed knick knacks. Oh, and about 3,000 people. I have never before and likely never will again see so many people in an isolated gas station in the middle of nowhere. Although I am not sure, I think this to be a good thing.

"Arrr, I think you be havin' a bit too many peg legs there, matey!"