What?

From an article in the NY Times titled

Bush Takes a Step Away From Maliki :

"Mr. Bush also links withdrawal from Vietnam to the rise of the murderous Khmer Rouge regime in Cambodia, and asserts that the American pullout caused pain and suffering for millions, saying, “Whatever your position in that debate, one unmistakable legacy of Vietnam is that the price of America’s withdrawal was paid by millions of innocent citizens whose agonies would add to our vocabulary new terms like ‘boat people,’ ‘re-education camps,’ and ‘killing fields.’ ”

Those assertions are already being criticized by Democrats, including the Senate majority leader, Harry Reid, and at least one historian, Robert Dallek, a biographer of presidents Kennedy, Johnson and Nixon. Both said Mr. Bush was ignoring fundamental differences between the conflicts. Citing Cambodia in particular, Mr. Dallek said in an interview that the mayhem under the Khmer Rouge “was a consequence of our having gone into Cambodia and destabilized that country.” (Italics added)   "

Good thing we didn't go into Iraq and destabilize that country. I don't know who to listen to now. The academic who doesn't seem to see the parallel between the two situations (I know Iraq is not Vietnam/Cambodia. South East Asia is a jungle, and the Middle East is not) or the President whose administration got us into this situation.

Where does the time go?

Wow, May 27th eh? Since then, a whole lot has happened. I finished up 3rd year, started and finished the supposedly academically hardest part of 4th year, have picked a future career, and have taken an 8 hour test. I've gone to a (thanks Heyzeus, excellent point that I didn't have a) bachelor party, a wedding, a whole lot of partying with friends. So now what do I do with my time?

I do still have applications for residency to complete, and some meetings to have with attending doctors to get letters of recommendation, but it's really coming down to just getting it all in and waiting for the inevitable hundreds of interview invites as everyone looks at my application and says "we gotta meet this guy"... or not.

I'll be doing Anesthesia. I kinda knew it was the answer to my question before I had officially decided, but I had to rule out Emergency Medicine after going through it. Turns out, it was a good call on my part to give significant weight to Anesthesia, and not EM, because I'm really not all that excited to go in every day I have to work. The good news is, I only have 7 more shifts in the Emergency Department. The bad news is, I have 7 more shifts in the ED.

I came to the realization that I didn't want to do EM pretty quickly. The attendings made it sound like it was "just another job" and most did not express a whole lot of satisfaction. I know that's present elsewhere, but it was discouraging. I figured if I was going into it with a relatively low likelihood of saying "this is it, I have found my niche" then what would happen to me after 3 years of residency, let alone 20 years of practicing in the field.

Not only did the practitioners not seem excited, but I just found the experience to be frustrating. There is always a degree of uncertainty in medicine, but not like in the ED. I left shifts without diagnoses for my patients, and that was considered OK because it would be someone else's job. I don't need a whole lot of long term followup with people, but it was pretty unsatisfying to start the workup of a patient and not see any real results.

There have been some good moments though.

I have gained some procedural skills and found out that I'm pretty good a suturing. Not plastic surgery good. And I'm still slow when it comes to doing the suturing, but it ends up looking pretty good.

I have become a hell of a lot more comfortable with chaotic situations. I think I can stay calmer now than 2 weeks ago. Two thursdays ago I walked into the trauma bay and it was me, the nurse, and an attending, who wasn't really even in the room, as he had to deal with patients in the regular part of the ED. No resident. I was the eyes and ears. And the shit hit the fan. Two people had major problems. One woman's heart stopped. Just... stopped. And it happened right in front of me. A few minutes of CPR and she was up and running, although not doing so hot. But everyone congratulated me on my chest compressing abilities. That felt pretty awesome. And a second woman who was incredibly sick with an infection in her blood ended up having something bad happen to her. I'm still not sure what it was, but it involved a room full of doctors, a tube down her throat to help her breathe, and a trip to the intensive care unit. Sadly, the first woman went up to the floor, had big time problems again, and died about 3 hours after I had seen her. As far as I know, the second woman made it and was alright.

Which gets me thinking of the first big time code that I saw. It was a guy who was sick, incredibly sick, in the ICU with a bad case of rhabdomyolysis, where your muscle breaks down. In case you had any question, that's a bad thing. His family had been with him, and they said they wanted everything done for him in case his heart were to stop. Chest compressions, shocks, the whole deal. When he coded, it was bad. He just kept going into an irregular heart rhythm, having no blood pressure. After multiple rounds of CPR and shocks, his sons (who had been standing in the room watching the whole code) told us to stop. They signaled to the rest of the family (who had been waiting out in the hall) that they were not going to proceed, and the only thing I could hear was one woman who started balling. Even now, 2 months after the fact it's an intense experience to recall. That was one of the first times I saw someone die in front of me, and sadly it won't be one of the last. But I think about all the good times I've had and realize it's not all so bad.

And now that that's all done, I think it's time to move on.

That was awesome...

 I got back from Poland yesterday. That was 3 weeks of great times in a beautiful (the old parts, not the communist bloc parts) city. I was pleasantly surprised by Poland. Part of me wishes I could stay there. But of course, it's not all bad getting back to Rochester (I think this thought is a sort of defense mechanism).

But before I say anything about Poland, I can't forget about Greece. 1 week of the Greek Isles. Absolutely fantastic. I went to Santorini and Mykonos with two of my good friends, playing the 3rd wheel. But it wasn't so bad. A few highlights of the trip include: sunsets with bottles of wine, ATVing across Santorini, beautiful beaches, excellent food (including awesome Greek salads; there's just something about the vegetables there, they were so fresh and full of flavor). At the end of the week I felt refreshed from the chaos of medical school.

And now, some beautiful eye candy from Greece:

We'll start with the first sunset. After a night in Athens, we hopped on a fast-ferry clone (for those not in Rochester, that doesn't mean much). We had a beautiful trip to the island, and were stunned by the landscape. It's basically a volcanic island with the middle that exploded (some people think it's what inspired Atlantis). So now there's a rim of a caldera which has a few towns on it. We got to our hotel, went out to explore the local area and pick up some wine, and settled down on the balcony of our hotel to observe the following scence:

Later that night I was up on the terrace of the hotel and watched the sun go down over Fira town. The town is beautiful, with buildings that tumble down the cliff-side. It's probably one of the most perfect combinations of human settlement and nature that I have ever seen, aside from the Ewok village. Here's a picture of Fira at night:

The reason there are no lights on the right side of the picture is because those buildings would fall into the ocean, and that would obviously be not desireable.

Up next was a trip to Oia (on the northern tip of Santorini). The place is known for its sunsets, and after seeing this one, it's understandable. I mean, the first one was also fantastic, so it's not like Oia is the only place to see a great sunset. And it's really not clear how one can say that the sunset is the best on a certain part of the island. But anyway. We got to Oia just in time for the sunset. After a long day of ATVing around, we all passed out in the hotel room, and got up about 40 minutes before sunset. So we hopped on the 4-wheelers and hauled ass to the northern end of the island. We found a nice spot to watch the sunset and we were treated to this:

In this picture you can see two things that are omnipresent on the Greek Islands - churches and windmills. Another cool part of Santorini is the black sand beaches. We discovered this place somewhat by accident. My friend wanted to drive our ATVs on the sand, which would have been fun, unless we got stuck, which would then be the opposite of fun. This beach stretched for probably a good mile and a half:

As we walked along it seemed like a cool place, until we found the naked people. And by people, I mean fat hairy old men. Fortunately, their business was hidden by other parts of their bodies. Sadly, no beautiful women here.

On to Mykonos... this is a party town, with clubs that are open all hours of the night. Sadly, in the middle of the week it's not all that crazy. Also, not quite as crazy during the low season, but it was still a blast. This shot was from our first night, wandering around the harbor after having shared a few small bottles of ouzo. The waterfront is a pretty happening place, and the town stretches out like a maze back behind.

Finally, I was in Athens, so naturally I went to the Acropolis. For my last picture of the night I've chosen one of me in front of the Erecthion. It's a temple with half dedicated to Poseidon, and half dedicated to Athena. It's also the sight of the legendary contest between Poseidon and Athena where Athena won and had the city named after her. Sorry Poseidon, olive tree > river. It's a beautiful temple, and a great example of classic architecture. But primarily I included it because the word Erecthion is funny.

Enjoy your Memorial Day.

The adventure begins...

Today was my last day of the first half of my Medicine clerkship. It was a great feeling to be done with that first 4 weeks. Especially since I now go on electives for the next 4 weeks. It's odd to finish on a Thursday. But that's because my elective time will be awesome. I'm leaving for Greece in about 12 hours. I will spend 1 week as the third wheel with two of my friends as we explore Santorini, Mykonos, and Athens. From there, I fly to Warsaw and then take a train to Poland with my two co-adventurers where we'll meet up with 7 other medical students for 3 weeks of a teaching elective.

I'll be teaching Polish medical students (English speaking, mostly from the US or Canada but didn't go to a US school for whatever reason) to interview and do presentations and writeups. The comedy is that all of the interviews will be in Polish. and how much Polish do I know? Kielbasa. That's about it. So unless they're talking about sausage, I'll have no clue what they're talking about. But I think it will be an absolutely incredible experience. According to the medical students who went last year, there's a ton of time to explore Krakow, and on the weekends we can go on a few trips to places like Prague or Budapest. Hopefully I'll get some great pictures to share.

That's all for now. Maybe I'll have updates from the road, but I don't know what sort of internet access we'll have, how often I'll get on and whatnot. And obviously I've been updating constantly, so that trend is likely to continue.

This is awesome

This is one of the more awesome things from Saturday Night Live in quite some time.

This is one of the others.