Oh Canada

Canada!

We have been estranged too long.

I am coming for you!

After twenty-seven long years of living in ignorance of my northern neighbor, the sum of my knowledge stemming from a few Rocky and Bullwinkle cartoons, a Five Iron Frenzy song, and some pictures of what was likely Antarctica, it is time for change. Real change. Powerful change. Barack Obama-style change -- though with less ambiguity and non-productivity. It's settled! I am going to Canada, and in the national spirit I will hug a Canadian. Which I can only assume is an eskimo.

In anticipation of this warming in relations, I have heavily studied the recent 2010 Vancouver Olympics. Although it took me two weeks of additional TiVo watching to get through it all, or most all of it save yet another women's biathalon with fatigued Norwegians drooling all over their rifles, I have learned that some Canadians are good at sports and NBC news personalities seem to enjoy mounting and riding moose. Or mooses. Or meese. I think this is sufficient information to bridge the cultural divide.

I have the USAF to thanks for my pending travels. After further consideration, and a second round of acceptance from the ACP, they have agreed to pay my way to Toronto for the the National ACP Medical Conference where I will present my research and, I guess, do some serious conferencing. Having never been to one of these events before I am not sure what to expect. Boring lectures? Boring lectures by distinguished guests? Internal medicine physician dance party?

This brings me to my last question, though, what to do in Toronto? I hear they have a tower. And.... the Blue Jays? Perhaps I will get myself some milk in a bag. Or stir up the Quebecois.

When Allergens Attack

Over the past two weeks I have learned how to be an allergist. This is about one and half weeks over the national average. If you too would like to be an allergist, just follow this simple algorithm:

Does patient have allergies?

• If yes, then prescribe Flonase, Zyrtec, and offer immunotherapy.
• If maybe, then prescribe Flonase, Zyrtec, and offer allergy testing.
• If no, refer back to primary care physician.

The differential diagnosis seems to primarily be: allergies?

The seeming simplicity of allergyology aside, there has been no shortage of rigorous academic debate. We have had no less than two extended, multi-party conversations about whether glaucoma eye drops are relative contraindications for allergy testing or not. Why are we not discussing this in internal medicine morning report? Are we afraid to confront the issues?!

Which raises the important follow up question: allergists get paid more than us why?

What is interesting in all of this is not the cytokines and chemokines and mini blinds that make up the facade of legitimate medical practice that is allergy, but how many allergists themselves have allergies. Considering that most all psychologists have some sort of personality disorder, most anesthesiologists have one or more substance abuse disorders, and most OB-GYN docs are, well, ladies, do all physicians chose specialties based on personal disease experience? Is there increased cancer incidence in hematology-oncology doctors? Does going into infectious disease require that I first acquire an infectious disease? I don't know for sure, but to be on the safe side I am going to go ahead and get myself some Cat Scratch Fever before it's too late. After all, I don't want to be left with Rat Bite Fever or Chikungunya, whatever the hell that is.

Be on guard folks: mountain cedar and elm are up today. That means goggles, people!

A Confession

I am sorry but I have been dieing to get this off my chest.

Chester Cheetah is the creepiest, sexual predator of a commercial cartoon character that has come into existence. I now feel dirty buying Cheetos.

And Jar Jar Binks? Why didn't anyone ever kill you?

The Prettiest Squirrel

That is one pretty squirrel. I went to the San Antonio Zoo recently and happened upon this guy. The Asian Tri-Colored Squirrel. Also known as Prevost's Squirrel, I didn't know these things existed. There're flying squirrels, yes, and regular squirrels, true, there're even collared squirrels that I am familiar with, but tri-colored squirrels? What was the purpose of my elementary education if not to accurately name and identify small furry animals? Oregon Trail you have let me down. I saw a lot of things at the zoo -- they even got new jaguar cubs or kittens or baby jaguar things -- but my favorite was the fancy pants squirrel.

And speaking of pretty, I've got too much bling! On my right arm at least. Whereas previously my shiny gold Aggie ring glared brilliantly in everyone's eye, now I have my shiny gold Aggie ring and a shiny new silver watch. It too is beautiful; perhaps too beautiful. Especially in relation to my completely naked left arm. I briefly tried moving my watch to my left wrist in an effort to be all right-handed like, but it felt wrong. I feel I must either alternate jewelry daily or embrace decorative excess and get myself a grill. With sapphires. There can be no room for compromise.

Lastly of note, I just got my medical license. This colored squirrel is now officially licensed to practice medicine in the great commonwealth of Virginia! Next stop, selling my credentials and credibility to late night infomercials.

Christmas In Brief

Christmas came and Christmas went. Like most holidays it was enjoyable but unremarkable. Visited with family, completed a puzzle, saw some lights on some boats in a marina. I got a lovely watch and Lucca got Horny. I tried to surf by gulping sea water. We all had some pie.

The trip ended, as all family trips are required to end, with me forgetting an article of clothing behind. In this case it was my Aggie ring; which my mom sent back to me wrapped in a sock. Wrapped in another sock. Wrapped in a package. Packed in a box. Which was then stuffed in a chicken, stuffed in a duck, stuffed in a turkey.

Anyways, here's the pictures. Not much to look at. Move along people.

Prosecutors Will Be Violated

Sometimes we need to be protected, and sometimes we need to be protected from ourselves. Thankfully that is where the Vistana apartment management comes in: to ruthlessly wield the iron club of justice on all who would perpetrate wrong doing. Wrong doing in this case defined by a monthly one page handout.

Each month like so many apartment complexes the Vistana provides us with a newsletter of sorts consisting of a few entirely uninteresting articles on entirely random subjects, a couple quotes about nonsense, a recipe for those who get their recipes from newsletters, and an empty calendar for those who need to know when Christmas and Boxing Day are since these are typically the only kind of events that makes it onto the list. Enclosed with our newsletters, however, is frequently another slip of paper. Sometimes white, sometimes pink, suggestive of something fun, fun it is not. No, it is the monthly reminder of things not to do pending criminal prosecution and summary execution. Don't throw boxes down the trash chute! Don't have too many guests over! Don't let others through the parking gate without paying the parking bridge troll! Don't smile unnecessarily or yield the right of way! Don't let your pets! The list goes on and on.

A few days ago, perhaps fearing people were just throwing their silly newsletters away without at least perusing through its pages, they decided to be more direct. I came home to find a note stuck in the corner of my door. With Christmas tree clip art affixed to the bottom corner of it I thought perhaps they were having some sort of holiday social, but no, they were putting us on notice:

Christmas celebrators beware! Security cameras and informants have reported the disposal of Christmas trees in the loading dock trash containers! This is a grievous offense. Anyone caught disposing of trees anywhere in the building will be put to death.

This is of course a rough paraphrase. The actual penalty was specified as "a removal fee" but it turns out this means be put to death.

Don't get me wrong. I have mostly enjoyed my stay at the Vistana so far, by and large, and knowing the general good nature of the office staff I am inclined to believe their threats are mostly bellicose posturing. Nevertheless I fear the clap of storm trooper boots in the hall and often lie awake at night for fear of a knock at the door. I may not live for long, but the struggle to use the pool after 10:00 pm will go on forever!

Beware Greeks Bearing Gifts

The Air Force giveth and the Air Force taketh away. All for national security reasons no doubt.

Recently I was given the “opportunity” to “be recognized” for all my “hard work” researching by working harder in order to summarize succinctly all said research on a not very conveniently sized laminated poster. This poster would then be displayed briefly in a room somewhere for people to pass by with indifference. For those not so easily persuaded, the best poster presented would earn the presenter a trip to Toronto to the national American College of Physicians (ACP) conference to take place in the spring. Being the eager, young resident that I was I presented my research like a sucker.

And I won. I won the research poster competition, and so qualified for the national ACP conference and, more importantly, a few days off work in order to attend. Or so I thought. It turns out I won nothing of the sort. Unbeknownst to the majority of us it seems there is a clause that if there are heaven forbid too many winners from our program only the power point research presenters actually really “wins.” Truly we were all winners, yes, but the winner that got the prize was not me. In all fairness I only competed against other Air Force medicine programs and so had a roughly thirty-three percent chance of winning just by showing up and affixing my name and a doodle to a 3x5 card – which in restrospect is what I should have done – but I was not too happy. As consolation prize I was given a plaque, a hardy congratulations, and an offer to return to work promptly to resume my prior duties. Those duties being on call. I would have liked going to Toronto and I would have liked not thinking maybe something nice could happen for my efforts, but Canada’s full of lumberjacks and grizzly bears I hear and nothing builds character like profound disappointment so perhaps it's all for the best.

Meanwhile the research train continues. Where else will it take me? I can only wait and dread.