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.

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.

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!"

A Teeny Tiny Place Called Home

Photo Safari!

This is a picture tour of my new apartment at The Vistana. It's located immediately adjacent to Christus Santa Rosa and El Mercado downtown, and is currently home to about 32 other tenants and 13 hobos. The objective of the tour is to catch all the Pokemon.

(click on the photos for extra super huge mode.)




So... say you were to walk through the front door of my apartment. It might look something like this.


Excited yet?

If you were to immediately turn around you'd probably then see this.



Nice.

Now supposing, just supposing, you had turned around on a slightly different axis you would have seen this.



My that chair looks pretty relaxing. And a coat rack slash hat holder? Brilliant.

Here's my kitchen. Or at least the part of it I could merge into one photo without it getting all wonky.




That white box has been there for about 2 weeks now. I have absolutely no idea why I have not moved it especially seeing as how it annoys the crap out of me every time I go into the kitchen. The box aside, though, as you can see I have some lovely black appliances to distract from the fact that I don't have a single drawer wide enough to stash my silverware.

Now if you were to keep moving by, say, oh six or eight inches you would now see this.



My kitchen table now sits three, but seeing as that is two more than it typically ever needs to sit that's just fine. Plus one chair has ready access to the dishwasher. Convenience is a must!

Turning 90 degrees to the right and...



My bathroom. With a hangboard on top of it. Does it go there? Probably not. Was there any other place for it? Certainly not.

Inching into the bathroom you see the antrum of the washroom itself.



Phenomenal. The laundry basket may or may not end up being a permanent fixture there depending on whether I can find somewhere else to squeeze a big yellow laundry basket.

A little wider angle now.




So we got some teals, we got some green, some cherry, some tan. Does it work? Maybe a little bit. This is as good as it gets people.

And at the distal end of my washatorium is the toilet.



What a lovely toilet. Unfortunately there was no room for a bidet.

And of course the shower itself.




The pressure is terrible, but I like my new shower mats. I wish more things were made of wood. This apartment would go from "pretty good" status to "pretty great" status pretty easily if there was just more wood. (that's what she said.)

Having completed the bathroom subtour we head back out.



Goodbye bathroom.

Skipping the kitchen we get to the living room/bedroom/office.




Much like the big white box and yellow laundry basket I really do not have the slightest clue as to what to do with the giant fish. As such its place of rest generally rotates between the bed or the couch depending on which I want to use at the time. In other words, its sole purpose at this point is to inconvenience me. I am taking suggestions though.

Now here's the bed/office from a slightly different angle.




You cannot appreciate it, but the bed, desk, and book shelf are pretty much all wedged together. I think it's a masterful use of space. And possibly a fire hazard.

Here's the window.



I am contemplating adding my hanging garden baskets to either end of the window and possibly even screwing in the window baskets below the window itself. Perhaps that will be plant overload, though.

Here's a Psyduck.



And the living room all altogether now.




Breathtaking. Simply breathtaking. The little picture gallery isn't completely done, and, yes, one of the pictures is upside down, but it's pretty spectacular nonetheless. Even from a distance. Note now the hand crafted coffee table constructed from American pine, refurbished couch with throw pillows imported from India, individually blown glass candle holders created in Greece, and a state of the art 19-inch television entertainment center with DVR. Truly this is lofty living indeed.

Quick look back at the kitchen!



Yeah the kitchen light is partially obstructed by the huge metal air conditioning duct -- yet another way in which this place was not designed terribly intelligently -- but too much light just makes bananas go brown anyway.

Here's the kitchen with the lights off!



The picture sucks, but I threw some Christmas lights atop the cabinets seeing as how there's enough space to support a small family of five up there and this is what it looks like. Amazing -- take my word for it.

And done. Didn't think the tour would ever end? I didn't either. There was just so much to see. Man what a blast.

So who got the Jigglypuff? and the Wigglytuff? and the Kookookachu?

Let Them Use Change

Something interesting. Perhaps.

I heard recently on the old radio that new studies in economics could suggest alternative ways to tackle the recession. Briefly detailed, the first study consisted of paying gas station customers $5 for filling out a brief survey before they went in to pay for their gas. Depending on how they were given those $5 determined how they spent it. More specifically, those given the cash in the form of a five dollar bill typically ended up placing the cash in their wallet and moved on with their lives; while those given five individual one dollar bills typically spent a small portion on drinks, candy, and corn nuts; while those given five one dollar coins typically spent the most leaving the store with nothing but Big Gulps, a handful of lotto tickets, and a receipt for their short sightedness. The lesson: either people just really hate one dollar coins and strive to relieve themselves of them as quickly as possible, or smaller denominations of currency leads to increased spending.

To further push this point home a second study was cited. In this study, women house cleaners in China were given a week’s worth of their salary in varying denominations. Those given larger bills tended to save while those given a giant wad of small bills tends to splurge frivolously.

So the practical recommendation? If Obama wants to stimulate the economy, or if Bush wanted to back in the day with his tax rebates, he should refrain from sending out bulk sum checks. Instead give everyone change. Flood the nation with Sacajawea dollars and people will be consuming again in no time.

And I agree. Although likely not terribly practical to dispense sackfuls of coinage, it does make sense that if people feel that they have a lot of something of little value, say a handful of small bills, they will spend it more freely than if they feel they have a few of something of great value, say one or two Grover Clevelands. I can even say I have consciously experienced this effect myself, which is why I propose we go one step further. Let’s join with our transatlantic, Western brethren and adopt the euro! If economists thought people spent one dollar coins fast, they haven’t seen tourists go through shiny silver and gold two euro coins. Not only do they pack greater value into a single coin, but with exchange rates as they are we get even more bang for our buck. Hand a man a handful of euro change, and he will be poor and penniless again in no time. That, my friends, is some serious stimulus spending.

A Series of Poor Decisions

I have made... a series of poor decisions.

I could of had a V-8! *Bonk!*

Anyway.

I decided to pursue some research. Expand some horizons. Advance our collective knowledge. Enter endless amounts of data into an unwieldly sized Excel spreadsheet. It has, unfortunately, like the velociraptors of Jurassic Park, now escaped my control and started opening doors with its razor clawed hands. My research block ended a week ago, and yet I still find myself researching. I will still be researching next block no doubt, and likely researching to my grave. I did not imagine that I would like the whole empirical approach to problem solving -- much preferring the impulsive assertion approach instead -- and the rigorous testing of hypotheses never sounded like much fun to me, but I was curious and so I did it anyway. Mistake! Hours and hours and hours later, and I still have not effectively answered what the risk factors for Clostridium difficile infections in thermal burn patients are. In fact, now knowing how arbitrary the research process is, I am inclined to believe we will never find out. I will have an answer certainly, but that answer will mean beans to me. Plenty to the people who read the research perhaps -- ooh flouroquinolones do lead to C. diff! -- but I will know the secret. Research is madness. Truly it hasn't been that bad, I did get great delight from learning computer shortcuts that made my data gathering more efficient. I like to think I have made "data monkey" into a respectable vocation.

I also decided to assemble my IKEA bed frame a few nights back. At about 2200 hours. Unfortunately it took much longer than the anticipated two and a half hours I expected, and so two days later and some sleeping on the couch I was still assembling the dang thing. I would like to say once assembled, seven or eight hours in total, I had accidentally assembled a magnificent gazebo a la the Simpsons where Homer builds a barn instead of a pool, but all I had in the end was a simple wooden bed frame. With drawers. A simple wooden bed frame with drawers that I now had curiously hostile feelings towards.

And then I decided to use the restroom at work. Upon doing so my pager dumped off my belt and into the toilet. I will leave it up to the imagination what was in said toilet.

Good night ladies and gentleman, you've all been great!

And Now For Something Completely Different

The car! The car! It is here! And it...

is...

beautiful.

After a prolonged stay at the port where it took two weeks to change out four tires -- and likely retrieve 40 lbs of hashish from the wheel wells who knows -- my car has finally arrived. Without a bike rack -- the one extra aside from the "hot chocolate" paint job that I paid for -- but it has arrived nevertheless. And let me tell you, friends, it's pretty great. Driving out in the open air is the only way to drive. It's the way God intended it. Now it's the way it will always be. At least until the day the complicated, convoluted electrical wiring keeping the whole thing together goes haywire as all expensive technology is destined to do. Till that day, however, I will drive a little happier and a little sweatier. Sweet.

The coolest feature, though, was one I was entirely unaware of: the colored light palate. With the flick of a switch the in-cab lights rotate through an array of assorted colors from orange to red to purple to blue to green. The lights are all fairly small, mind you, and you can only really appreciate it at night in the country with a new moon, but I will still say it is rad. Radical even.

I will miss truck, though. Truck's been good to me, and aside from the jettisoning of it's passenger side mirror a while back it has held strong. Truck, if you're out there, reading this, I miss you man. You stay safe now you hear.