What My Med School Aceptance Leter SHOULD Have Said

Congratulations! You've made it to medical school. All of your hard work, community service, over-involvement in extra-curricular activities, long nights spent studying while your English major roommate goes out and enjoys the college experience, and never, ever getting to schedule all your classes on only Tuesdays and Thursdays (so the better to enjoy a 4 day weekend) has finally paid off. Well, sort of. We'll get to that "payment" issue in a minute.


Right now you are, no doubt, a very big fish in a little pond. You are probably known as the smartest, most ambitious, and most masochistic of all your friends. In medical school, you'll be surrounded by 160 people just as smart, ambitious, and masochistic (if not more so) than you. You will probably be, maybe for the very first time in your life, average. And as much as that may give you angina right now, you need to know that "average" is actually ok!  Really!

You thought you studied hard in college, but you are in for a surprise. You did study harder, relatively, than anyone else you knew. You also were routinely rewarded with straight As. In medical school, you will sit in the same position for 8-9 hours a day, pausing only for bathroom breaks and food, reading, re-writing notes, and reading again, only to score an 80% on your exam.
The first two years of medical school, you will work, and study, and take tests, and wonder why in the world you ever wanted to go to medical school. Keep the faith.

Your gross anatomy lab group will likely form the core of your best friends throughout your four years together, even though at times you want to throttle all of them. Familiarity breeds contempt, but you are all going through the same hellacious experience. You will value these memories, even if you don't believe it now.

You will develop a jaded, sick sense of humor that would shock you now. But no worries. All of you will end up with the same sense of humor, so you wil be understood and won't feel alone.

Everything, including the food you eat, will smell like your cadaver for an entire year.  Until you are finally done with the poor shredded thing and it mercifully gets incinerated.

You will make mistakes. You will fail (yes, I said FAIL) a test. You will cry, a lot. You will feel like everyone else smarter than you. You will wonder, more than once, if you have chosen the wrong path. You haven't. You will eat too much and exercise too little. Try to take better care of yourself, that extra hour of studying probably won't make a difference, but that hour of exercise could mean a healthier you four years from now. Don't forget about your family and friends. Try to stay in touch with the people that mean the most to you. Their support is important. Life is going on outside your little microcosm, and you'll be sorry that you lost touch with the friends that knew you before you became a med bot.

Once you start clerkships, you will remember why you started doing all of this in the first place. Taking care of patients! You will like what you are doing again, and, all of the sudden, some of the lectures that seemed like absolute nonsense will actually begin to become more clear. No matter what you think you may want to do, clerkships will change your perspective on everything.

Be a good student. Know your patients. Have the patient seen and the notes written before your (overworked) intern hits the floor. Keep a running list of scut that needs to be done on all patients on your service (not just your patients, remember, you are working as a team) and be sure it is done before you leave the hospital. Check in with your resident/intern often, they are too busy to page you, but you may get to see (and do) some cool stuff if you stay visible. Learn how to write orders and practice whenever you can. Do everything you can to make your resident's life easier. Write prescriptions, skeletonize discharge orders ahead of time, and offer to get them food if you notice they haven't eaten. Stick close to your resident on call, but go to bed if they tell you to go!  Don't try to show off how much you know, it is obnoxious and will likely come back to bite you. One of your patients will likely die, and you will never forget it.

Once you find out what it is that you want to do when you "grow up," be sure to make yourself known to the residents and attendings in that specialty. Ask lots of questions. Find a resident that needs help with research and offer your data gathering skills. If it is a surgical specialty, make an effort to scrub in on as many cases as you possibly can. Center your fourth year electives around the specialty early in the year, so you can make the proper connections for letters of recommendation.
Even if you have met the love your your life, don't think it is going to be easy to plan a wedding during medical school. Give your mother the reigns and let her run.  The good news is that is quite possible to nurture a fledgling relationship through the stresses of medical school (and it will prepare your spouse to be twice as awesome as he supports you through the worse stresses of residency!)

When you finally finish medical school (it is a marathon, not a sprint!), you will not be the same person that you were. You will be in debt up to your eyeballs, literally. It will take you years (some as an indentured servant) to pay off tens to hundreds of thousands of dollars just for the privilege of being tortured, ahem, learning for these last four years. You will realize that you will never be "rich," like your classmate that quit second year because he was making more money day trading stocks than the average family medicine attending. However, you will be a physician...fallible, over-educated, and under socialized, and you are going to help people in ways you never even considered when you first sent in your application.

Eggs in Purgatory

I picked up this month's copy of Bon Appetit while at Fresh Market recently.  There are so many recipes in this issue that I want to try.  Which is sort of funny, because I am more of a Southern Living/Cooking Light type cook.  Bon Appetit's recipes are usually way too fancy and labor intensive for my tastes.  But the "One Dish Dinners" headline really grabbed me.  That and the Irish Soda bread recipe.  And the fact that I was really hungry that day and thus had very little restraint for what was going in the cart.

So last night I tried my first recipe from the magazine:  Eggs in Purgatory.  A nod to both the picky gourmet vegetarian I am raising and my partial Catholic upbringing.

It was really delicious.  So I thought I'd share.


Eggs in Purgatory with Artichoke Hearts, Potatoes and Capers
   (yields 4 servings) 


3 T. EVOO
1.5 c. chopped onions
2 t. chopped fresh thyme
0.5 t. dried crushed red pepper
coarse kosher salt
1 8-10 oz. package frozen artichoke hearts, thawed and drained
2 garlic cloves, minced
1 28 oz. can diced tomatoes in juice (preferably fire-roasted)
8 oz. red-skinned or white-skinned potatoes, cut into 1/2 inch cubes
2 T. drained capers
8 large eggs
1/3 c. freshly grated Parmesan cheese


Heat EVOO in heavy large skillet over meduim heat.  Add onions, thyme and red pepper.  Sprinkle lightly with salt and saute until onion is tender and golden brown (about 10 minutes).  Add artichokes and garlic; stir one minute.  Stir in diced tomatoes with juice and bring to a boil.  Reduce heat, cover and simmer for 15 minutes to allow flavors to blend.


Meanwhile, cook potatoes in small saucepan of boiling water until just tender (about 8 minutes).  Drain.  Add potatoes and capers to tomato-artichoke sauce.  Cover and simmer 5 minutes.  Season to taste with coarse salt and pepper.


Preheat oven to 375 degrees F.  Pour mixture into 13x9x2 inch glass or ceramic baking dish.  Using back of spoon, make 8 evenly spaced indentations in sauce for holding eggs.  Crack 1 egg into each indentation in sauce (some eggs may run together slightly in spots).  Bake until egg whites and yolks are softly set, 12-16 minutes.


Carefully remove baking dish from oven.  Sprinkle Parmesan cheese over and serve.

Before baking

After baking.  Now, let me be clear.  Those eggs are completly cooked with hard centers.  Additionally, this photo was taken before the cheese was sprinkled on the top.

I served this dish with a big bowl of lighly boiled and salted edamame beans.  And it was a really great dinner...for Andrew and I.

For the children, notsomuch...  Alice ate it well but she'll eat anything for a brownie sundae.  The other two bellyached and gagged and cried (yes, both of them).  But we did not give in.  No dinner = no dessert.  And Clara and Jack went to bed hungry. 

Andrew and I are dilligently trying to combat the rampant pickiness that has overtaken our children.  They eat what's for dinner and that's all they're offered.  They all have enough meat on their bones to survive occasional dinner-less nights.  And hopefully, in the end, their pickiness will go away, or at the very least be diminished.

Now, I did draw the line at packing the leftover Eggs in Purgatory into their lunch boxes today, as Andrew wanted to do.  He was not pleased with the show they made at the dinner table.

Because while they have meat, its not all that much.  And I'm a mother.  Watching my children go hungry causes me exquisite suffering.  I just hope Andrew does not find out about the sandwiches I snuck into their bedrooms after lights-out last night.  ;-)

Spring Break!!

It's almost here!  A week from Friday, the kidlets and I have off for nine days.  We five are going to Chapel Hill for the weekend, as that will be Easter and my dad will be postop from a big operation and hopefully up for some wild-child visitors.  Then it's on to Topsail for rest of the break.

With Beach Season quickly approaching, the children are almost in a frenzy.  Especially Alice, who declared going to the beach more fun than going to Disney World.  Now that's saying something.

And unlike our long August sojourn where we have lots of visitors (basically all of our immediate relatives are in and out - aside from Andrew's parents who long ago declared themselves "mountain people") including my parents, Ashley, Allison and her family, Meg and her family, and sometimes friends...Spring Break at the beach is just us five and Goose.  And it's heavenly. 

It's not too hot.  The weather is gorgeous.  The fishing is prime.  We kayak, the children swim (notice I say the children...Andrew and I are not that crazy), we do puzzles, take boat rides, watch movies, eat out.  It's just good, fun family time.

In thinking about the beach, I decided to do some editing of photos from last year.  I've recently discovered the lomo effect and I love what it does to pictures!  I had to look this up, but lomography is a type of photography taken with specialized cameras that creates beautiful photos.  Wikipedia describes lomography in this way:

Lomography emphasizes casual, snapshot photography.  Characteristics such as over-saturated colors, off-kilter exposure, blurring, "happy accidents," and alternative film processing are often considered part of the "Lomographic Technique."

Below are some photos I took last year with my run-of-the-mill Canon SLR and lomo'ed up in post-processing. (Don't tell the lomo-purists, who vehemently insist that the only way to really lomo is with lomo-specific cameras.)  Mine are not the artsy square prints as valued in the medium format film world, but some judicious cropping is simple enough. I love the fading-to-black around the photo edges in addition to the slight saturation the photo's colors receive.

You can use Photoshop, of course, or this new service I recently discovered called Picnik, which is like Photoshop for people who don't know how to use Photoshop, or would rather not deal with all those layers and masks and stuff. Check it out, it is rather pleasing, and free as well.

(my absolute favorite, above)

The Dentist-Shopping Connection. AKA: Andrew's Bane

After a lifetime of completely healthy teeth, I mean really, no cavities, nothing...I developed a crack in a molar almost two years ago. Which required a crown. 

Until then, trips to the dentist were actually fun. I could not understand why people had dentist-dread. I mean really. I went in, got cleaned, chatted up my hygenist. Got complemented on my "excellent oral hygeine," went home with a new toothbrush. What are these dramatists complaining about, anyway?!

Then, about a month after my crown went on (which was not too bad of an experience), it fell off! What? I was told it would last 20-25 years! So I switched dentists, had a new one put on. That one fell off too! Yesterday's crown was my fourth. The tooth now is extremely sensitive, even with the crown on. ( I am contemplating a root canal just to be done with all sensation in the tooth.) And to top it all off, apparently I have an "abberant" nerve and it is very difficult to numb me up. Like, five shots difficult. So much epi that my heart begins to feel like it's going to beat out of my chest.

I no longer like going to the dentist. I think it is this reason that I've developed my dental shopping habit. I guess spending money helps me deal with the stress of being there. Now every time I go, while my new crown is in the oven, I shop.

So yesterday, when I walked into my procedure room and saw this:

...my hand gripped my laptop and VISA card.  I signed onto Williams Sonoma, and I felt instantly better.

So these are the damages:

The Handblown Nest Bell Jar.  I think this will look so nice on our new dining room table.  It comes with the pretty butterfly/nest/egg arrangement which I'm certain will captivate the children.  And I also know the arrangement will not last forever, but it will be fun finding or making a replacement in a couple of years.  I ordered the jar and arrangement closest to the front and plan on displaying it all Spring.

Next up:

The Calzone Maker.  Oh, this will be a hit.  Homemade pizza dough, a variety of cheese and vegetable fillings, my pizza stone and VOILA!  Dinner in a pocket.  Dinner that will please even the picky gourmet vegetarian in my house.

Then I happened upon this little beauty:

The Babea Babycook Baby Food Maker.  Man, I wish I had had this.  I ordered this for Allison.  It steams and processes any meat, fruit or vegetable to desired consistencey.  Hailing from France (leave it to the French to make sure even their babies eat right!) it is one of the coolest devices I've seen. I mean really, who isn't grossed out by jarred baby food?  And after I ordered it, the saleswoman informed me it was $50 off that day.  Woot!

So then I started thinking about another sister, really sister-in-law, but what's the difference?  I know she'd like a little treat, too.  So I ordered her this tasty trio for her:

I think she'll love this Zoku Quick Pop Maker!  You freeze the device.  Then use the flexible measuring cups to fill the slots with all sorts or fruity, creamy and chocolatey concoctions that are described in the coobook shown above.  Insert the popsicle handles.  Pop it back in the freezer.  And then soon you can indulge in healthy, or not-so-healthy treats.  The whole set up looked so enticing to me that I ordered the three items for Meg....and also for me.  

So...I got home, walked in the door, and what did Andrew say?  Not "how was it?" or  "did it hurt?" or "how about a hug?"  Nope, he just said, "how much did you spend?" 

I think he's sort of hoping I go the root-canal direction, too.

Men: Have You Ever Felt Like Cutting Off Your Balls?

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My New Favorite

Spent a couple of middle-of-the-night hours with two young, hip ER nurses and they told me about their favorite website. They say that they literally spend hours each night on it in the ER. Which may explain the never-wait-less-that-three-hours-to-be-seen-in-the-ER dilemna...

Anyway, it IS a hilarious time kill if you're in the need.

http://www.textsfromlastnight.com/

Alice Rocks a Jam

Alice. Oh the words to describe her...athletic, competitive, intellectually curious, mischevious. And does she march to the beat of her own drummer...

Apparently, she also writes music. She got a mini-electric guitar for Christmas this year and spent long hours in her room rehearsing this song. I can't quite understand the words, but the chords, beat and utterances are the same every time she sings it.

She came into my bathroom just the other night to entertain me, and I found myself groovin' and singing along with her.

It's sort of catchy, don't you think? But no worries, we continue to cultivate her academic talents. No child of mine has a snowball's chance in hell to make it as a musician. Genes, you see.

The Anesthetist's Hymn

A couple of weeks ago, I was pre-opping a patient and she asked me if I'd ever heard "The Anesthetists Hymn." This is a song written and performed by a couple of British anesthesiologists (or "anesthetists" as they call them in the U.K.) It has been around for many years and we anesthesiologists, surgeons and OR nurses periodically put it on YouTube and LOAsO. It is a real hoot and is just as funny each time I watch it.

So, of course, I was delighted that my patient was familiar with it. And to top it all off, she asked if we could play it in the OR when she was falling asleep! Really?? Of course!

So we went back to the OR. I got her all high on Versed and fentanyl and we got on YouTube and looked up the video. She was healthy and had a great airway so I didn't bother with any pre-oxygenation. And would you believe...she sang along with the anesthetists. I mean, really belted it out. So the rest of us started to sing too. And before you know it, people passing by the room that could hear the commotion started coming in and joining us!

As the last notes played, I began to push the "white stuff" and she drifted off to sleep with a big, goofy grin on her face. Everyone else went back to work with smiles on their faces, a little happier.

I really do love my job. And some days I love it even more.

Un-be-livable

Check out this current food pyramid subsidy model. The daily recommended servings for each category of food is compared with how much federal farm subsidy the category receives.


Dairy and meat farmers get 50 billion dollars in farm subsidies while vegetables, one of the most healthy things we can put in our mouths, are getting slaughtered at the table of entitlement handouts.

Why??

It's because of money in Washington, that's why. Health care decisions are being determined by lawyers (sorry Matt) who are getting money from every which direction to stay in office. And then look at where our government spends our money.

Before we spend 3 trillion dollars (nope, that figure is not a typo) on a new health care entitlement program, how about we first stop spending $50 billion dollars on porterhouse steaks. If we want real change and a different arc in our health care inflation curve, the solutions exist not within the health care finance system, but on its periphery. In our grocery stores and in our kitchens. If we want a nation to eat from the current food pyramid, then we have to talk the talk . Unfortunately, the money is too powerful . Government subsidies are directly to blame, I suspect, for the fattening of our nation. This is the result of money and power driving policy.


This current food subsidies pyramid says it all. $50 billion dollars to eat meat. What a waste. Health care won't make you healthy. Vegetables will. Unfortunately, as the title of this picture says, a Big Mac costs less than a salad because our government makes it so. Unless we can get our population to start eating more salads and less Big Macs, we are all heading for the slaughterhouse along with the zucchinis and tomatoes.

But who asked me? I'm just a doctor. It's the lawyers who are determining how healthy we all get to be.

Jack is Ten

My sweet firstborn, apple of my eye, turned ten yesterday.

He had six boys over for his first sleepover (of considerable size, that is). It was such a fun party. They played backyard basketball, ran around with guns, silly stringed a fourth grade "hottie's" house, ate yummy food, played Wii, watched movies, and yes, somewhere around 2 AM, they actually fell asleep.

Jack's sisters had two different takes on the party.

Clara, my princess, spent an hour in her room beforehand getting ready. She emerged in time for the first guest's arrival in a pink tutu, makeup carefully applied and pigtails pulled tight.

Alice, on the other hand, prepared by layering her University of Pittsburgh basketball jersey (a hand-me-down from Jack) over her clothes, lacing up her Chuck Taylor high-tops and taking some practice shots at the driveway basketball hoop.

It was a fun party. Boys from both Jack's old and Jack's new school, who had never met each other, got along famously. Jack was thrilled with his party and the other boys had fun. Success all around.

The only problem with the whole birthday was that several people who really shouldn't have forgotten Jack's birthday did just that. And I wouldn't really care if it weren't for the fact that Jack noticed. And although he said it didn't bother him, I know it did. Grrrr... I hate it when my kids get their feelings hurt.

99 Things To Do In This LIfetime

I found this on another mother's blog and thought I'd give it a try...

Instructions:
Copy the list, bold the ones you've done (with explanations if needed), share with friends.

1. Started your own blog
2. Slept under the stars
3. Played in a band
4. Visited Hawaii (twice!)
5. Watched a meteor shower
6. Given more than you can afford to charity
7. Been to Disneyland (and World nearly a dozen times- love it!)
8. Climbed a mountain (have lived in them most of my life)
9. Held a praying mantis (not a goal of mine)
10. Sang a solo
11. Bungee jumped (definitely not a goal)
12. Visited Paris (prefer the French countryside)
13. Watched a thunder and lightning storm (from the Topsail Sound- stunning)
14. Taught yourself an art from scratch (if baking bread counts)
15. Adopted a child (my parents did though!)
16. Had food poisoning
17. Walked to the top of the Statue of Liberty (walked around it though)
18. Grown your own vegetables
19. Seen the Mona Lisa in France
20. Slept on an overnight train
21. Had a pillow fight
22. Hitch hiked
23. Taken a sick day when you’re not ill
24. Built a snow fort
25. Held a lamb
26. Gone skinny dipping
27. Run a Marathon
28. Ridden in a gondola in Venice
29. Seen a total eclipse
30. Watched a sunrise or sunset
31. Hit a home run
32. Been on a cruise (four)
33. Seen Niagara Falls in person
34. Visited the birthplace of your ancestors
35. Seen an Amish community
36. Taught yourself a new language
37. Had enough money to be truly satisfied
38. Seen the Leaning Tower of Pisa in person
39. Gone rock climbing
40. Seen Michelangelo’s David
41. Sung karaoke
42. Seen Old Faithful geyser erupt
43. Bought a stranger a meal at a restaurant
44. Visited Africa
45. Walked on a beach by moonlight
46. Been transported in an ambulance
47. Had your portrait painted (if those caricatures count)
48. Gone deep sea fishing
49. Seen the Sistine Chapel in person (spent all my time in St. Peter's)
50. Been to the top of the Eiffel Tower in Paris
51. Gone scuba diving or snorkeling (three weeks in the Galapagos)
52. Kissed in the rain
53. Played in the mud
54. Gone to a drive-in theater
55. Been in a movie
56. Visited the Great Wall of China
57. Started a business
58. Taken a martial arts class
59. Visited Russia
60. Served at a soup kitchen
61. Sold Girl Scout Cookies
62. Gone whale watching (on our fabulous '07 Alaska trip)
63. Got flowers for no reason (have a fabulous husband!!!)
64. Donated blood, platelets or plasma (many, many times)
65. Gone sky diving
66. Visited a Nazi Concentration Camp
67. Bounced a check
68. Flown in a helicopter (over Alaska - gorgeous)
69. Saved a favorite childhood toy (if all those books count)
70. Visited the Lincoln Memorial
71. Eaten caviar
72. Pieced a quilt
73. Stood in Times Square (most recently with my two boys)
74. Toured the Everglades
75. Been fired from a job (the Welsh Dragon - boss and I laughed together because I was so bored. Joined an ambulance crew after that.)
76. Seen the Changing of the Guards in London
77. Broken a bone (although I suspect I've broken my little toes many times)
78. Been a passenger on a motorcycle (rode with Andrew many times)
79. Seen the Grand Canyon in person
80. Published a book (my college honor's theses is published and in the Library of Congress with it's own ISBN)
81. Visited the Vatican (went into the ruins under it, too)
82. Bought a brand new car (my lovely 3 series. Had to sell it four years later in favor of a sensible station wagon. But have to park next to it in the doctor's parking lot. A daily torture.)
83. Walked in Jerusalem
84. Had your picture in the newspaper (many times for sports)
85. Kissed a stranger at midnight on New Year’s Eve (ewww)
86. Visited the White House (did visit the Capital Building)
87. Killed and prepared an animal for eating
88. had chickenpox
89. Saved someone’s life (many times, and once in a restaurant)
90. Sat on a jury
91. Met someone famous
92. Joined a book club (would love too)
93. Got a tattoo (nope and won't)
94. Had a baby (three in two attempts!)
95. Seen the Alamo in person
96. Swam in the Great Salt Lake
97. Been involved in a law suit (occupational hazard)
98. Owned a cell phone
99. Been stung by a bee (spent a lot of summertimes barefoot in the south)

Looks like I still have a lot to do.