Dating, Relating, and Fornicating

Sometimes it's good to think of the big scheme of things.  Some good advice and interesting statistics: http://pastormark.tv/2011/10/26/dating-relating-and-fornicating

"Too many singles have a list of what they are looking for in a spouse. The problems with this are many. First, most singles don’t know what they really need for fifty years of God-glorifying marriage. Second, the list is usually just their resume and a form of idolatry, as if marrying someone just like you is necessarily a good thing. Third, the list usually does not account for the future, like the guy who told me it was very important that his future wife love rock climbing, until I explained to him that if they had as many kids as he was hoping for she would not be rock climbing much since it’s not the ideal activity for a pregnant lady. (<--haha, this thought was amusing)  Fourth, how about a list NOT FOR THE PERSON YOU WANT TO MARRY BUT RATHER A LIST FOR YOU! It seems very selfish to make a list of what someone else needs to be for you if you don’t have a detailed list for yourself and what you need to be for them..."

When Sad and Feeling Inadequate

“Those who sow in tears shall reap with joyful shouting. He who goes to and fro weeping, carrying his bag of seed, Shall indeed come again with a shout of joy, bringing his sheaves with him.” - Psalm 126:5,6


Friends.


They have not the tongue of the eloquent, but they may have the hand of the diligent. They cannot stand and preach, but they can stand and distribute here and there these silent preachers … (Charles Spurgeon)


God is good.

PATB #2 - Frustration

Parents Are The Best #2

Here's another email from my parents that made me appreciate what wonderful people I have around me, especially my parents:

That’s OK.  Sometimes frustration is a kind of blessing: It may let you to pause a little while and take a look around and you will find so many good things around you.  There are still plenty things to thank for.  We pray for your coming practice.  We always think you will be a very good doctor with a loving heart and hard working.

Love you

Mom & Dad

Real 7 Dwarfs

This is an inspirational story about real 7 dwarfs: http://www.andersoncooper.com/2011/10/21/inside-the-johnston-family-home/

Man - so strange

Haha, so true:

(nicksarnicola.com)

Fitness Class for Kids

Today I got a groupon ad for fitness classes for kids. really? has it really come down to this?

Emails from my dad

Here's an email from my dad regarding the story my brother (Bong) wrote-- makes me smile!:

Finally, Bong finished his story according to your comments(do not know yet).  Please take a look and see how it is.  He was so funny that he even laughed when he was typing on his bed this morning (looks like a real busy author.  Actually Mom and I pushed him many times and set tomorrow as dead line).  He must feel funny about his own story.

Mom and I will go to a short mission tomorrow in Washington state university.  That’s our first real mission since becoming Christians.  The fun part is that we found our Oklahoma hostess family, who led us to God, in facebook yesterday.  It has been twenty years since we left there.  Anyway praying for us that God is leading the mission.

Have a nice weekend

Love you

Dad

In This Rape Center the Patient Was 3

The following article was shocking:
"IN a rape treatment center here, I met a 3-year-old patient named Jessica, who was cuddling a teddy bear.
Jessica had seemed sick and was losing weight, but she wouldn’t say what was wrong. Her mother took her to a clinic, and a doctor ferreted out the truth. She had been raped and was infected with gonorrhea..."
In-This-Rape-Center-the-Patient-Was-3 (ED)

She is so cute, I'm gonna die!

Genius

Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They're not fond of rules, and they have no respect for the status quo. You can quote them; disagree with them; glorify or vilify them. About the only thing you can't do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world are the ones who do.
-Apple "Think Different" Campaign


This definitely reminds me of someone

Pappy's makes top 101 BBQ

http://www.bizjournals.com/stlouis/blog/2011/08/pappys-smokehouse-named-best-bbq.html
Yum!

Joplin Trip

Just came back from a trip to Joplin organized by my church.  I had no idea what to expect, but I was still surprised by all the destruction that took place and how disastrous the houses, the lands, and the buildings looked.  It was especially disturbing to see the hospital completely deserted and the high school imploded upon itself as if someone punched it from the top.  Yet, despite it all, there were bulldozers demolishing old buildings, fresh new stores that still retained the smell of a recent paint job, and volunteers standing in 100 degree weather painting colorful murals that standout against the rest of the town.

Our job was pretty simple - didn't require too much thinking, but just required a bit of physical labor and happy conversation with the other volunteers.  There were 23 of us total, ranging from business man to cupcake manager, from improv instructor to Six Flags event planner.  It was a good group of people, and we had our share of fun sharing our lives and enjoying the hot or cold weather.  We mostly cleaned up various lots that had branches, shingles, metal pieces, and whatever you can think of scattered about the land.  There was a lot of bending down and raking that resulted in some very sore backs and hamstrings.

One of the families had a house that was deemed irreparable, so the whole house was knocked over.  But there was one shack that looked like a miniature barn that remained standing and required some fixing.  However, the only person who knew how to fix it was the 80-something father who wasn't the lightest of the bunch.  He definitely knew his shed well given that he built it himself some 5 years ago, but given the 100+ degree weather, no one else thought it was wise for him to be climbing on a teetering ladder 10-20 feet above the ground.  So, we heard their story, and helped them fix up the shed with some screws, hammers, and saws.  Turns out the father had actually been a cowboy in his younger days, retired with no house or compensation, worked with habitat for humanity, and eventually obtained a shotgun house from them.  During the storm, he was away, and fortunately his daughter and her husband were safe.  The insurance, however, refused to acknowledge that house was bad enough that it needed to be rebuilt, so they have refused to pay up.  Now they have lived from hotels to trailers.

Another family we worked with needed rocks to be picked up.  Although initially sounding like a non-glamorous job, we discovered a great story.  The son had actually moved to the area a month before, and he considered it a blessing because otherwise, he would've had to drive down 15 hrs with no job, no friends, and a great amount of anxiety.  His parents, who were living in Joplin locked themselves in a closet, and fortunate for them, only the other half of the building was the most damaged.  Thankfully, they had legit insurance, and they are on their way to rebuilding their house.  However, their many acre land used to be a complete forest, and now you can see clear across it.  They needed rocks to be removed because when the trees were uprooted, they brought up with them a lot of rubble.  They still had 3 adorable goats and 9 chickens left, while the rest were lost in the tornado.  One goat, Avalon, was found wandering many blocks away.  Meanwhile, the son who worked as a top chef in the area (and worked alongside Masahuru Morimoto from Iron Chef), told us the difficulty of feeding hundreds of people without electricity and other conveniences after the storm.

We were demolishing the ruins of another house, when one member of the group found a business card with the owner's name and contact info.  She contacted them, and found that it was a reverend and his wife.  Some of their belongings were salvaged from the ruin - things that they had thought they would never see again.

Other interesting things:

• One of the volunteers is building a humongous steel archangel in Joplin.
• When asked what was the one thing people would change about Joplin, most people said to have the trees back.  (b/c Joplin used to be very heavily forested).
• 18+ people survived in a gas station beer cooler: http://www.abovetopsecret.com/forum/thread708605/pg1 It's interesting to hear one person calling "I love everyone, man" and someone else calling out "Jesus."

Pray for all those families who experienced losses!

Fun stuff on the trip:

• Waterfall in Joplin
• Visit Chicken Annie's
• Three Corners (Oklahoma, Kansas, Missouri)
• 16-hr cooked BBQ: so tender, amazing sauce.  Apparently the sauce is so secretive that it's locked away in the man's father's safe and the man who made this won't get the recipe till his father passes away.  He also has to buy the sauce from his father!

Blonde, Asian, non-smoking pharmacist named Deborah

Apparently these are the traits of high earning women:

• Named Deborah
• Asian, blond (i'm assuming it's "or" as opposed to "and", unless there are blond asians, which is just weird)
• Born in Westlake, TX
• Attractive - maybe I should start putting on those fake eyelashes
• Tall - hm...what if i'm tall in asian standards?
• Left-handed
• Non-smoker
• Single and childless
• Eldest child
• Pharmacist, more educated
• Assertive - darn, i gotta work on this one
• Drinker - really? man, this doesn't fit well with being asian.  It's like an oxymoron.
• Current residence of Washington DC
• Good credit report
• 25 lb lighter than average weight for height - Seriously? That would make me anorexic - seriously, that's just not right.

Okay, sure, certain traits are good to make more money...but at the expense of the valuable things in life is just not worth it.

Here's the full article: The Women with the Highest Earning Potential

Ob/Peds in Sierra Leone

Here's an inspirational article about improvement in ob/peds in Sierra Leone! http://www.nytimes.com/2011/07/18/world/africa/18sierra.html?pagewanted=2&_r=1 (thanks YW)

3rd year Summaries of Rotations

In general: I asked too many stupid questions - yes, there is such a thing.  If it's a question where you can just look it up - then note it and look it up later.  Better to ask questions that aren't easily looked up.  Even better to look up something, and say, "I was reading this paper...and didn't understand..."  Also figure out people's personalities.  If they don't like questions, don't ask so many questions! - i can't seem to get this right.


Psychiatry: it was a very fascinating rotation.  Got to see some things that most people would never ever see and probably never will see even if they're doing medicine just because everything's locked up.  I've definitely had a change of mind about psych.  I came in mostly skeptical about the "science behind it all" and the validity of using medication on all these seemingly personality related issues, but when you actually see these people, you know there's something else going on.  And it's AMAZING what a big change the medicine makes, sometimes just in the course of a day!  From the rambling, incoherent, suicidal lady who looks deathly distressed and disheveled to the joyful, upbeat lady who jokes with me and says I should go into psychiatry - all in 3 days.
Things that I could do: preround each morning, speak with patient's families, get previous hospital records (fax or  ask awesome social workers for help), help put in orders, help put in discharge orders, help write up discharge dictation notes.  For preround, it's good to look up labs, and flowsheet/psych notes from nurses (ask where they are under flowsheet).  Note abnormal lab results. For call, good to go down to ER to take history (b/c can take a while for them to get up to the floor).  Work with other med students on your team to present an article on certain days (maybe each week) - makes everyone happy.

Neurosurgery: Well, I had a resident who was very busy and walked really fast, so I often got lost, and didn't have much to do except listen.  I think I could've done a better job listening during rounds because I knew stuff about my patient, but I just couldn't hear their question to answer them. Sighs.  Well, know the patients, know their history, labs (results in compass and microbiology in clindesk), and imaging (ddx) in clindesk.  Also know normal values for LP pressure (5-15), and basic important things like m/c cause of strokes, etc. Chief residents know their stuff - listen/watch them well.  During operations, it's good to scrub in and watch from up close, even though you might not feel like you can do much (know how to tie knots! practice! - esp one-handed ones).  During prep/post surgery, help anesthesia and help move the patient.  Might need to watch well the first time, and then help out.  Anesthesia's always willing to teach, so it's good to ask them if you can help.  Also, you'd be surprised how much some of the tech's know - especially those monitoring that movement is still normal (Somatosensory evoked potentials).  They can teach a lot! This one guy essentially gave me a play-by-play of this one surgery + other nifty info.  Learn to speak succinctly on presentations of patients.  Very big difference from the nice/friendly atmosphere of psychiatry.  You have to be really alert/keen about what you can do.  Never ask a surgeon about bleeding (ya...my mistake).

Neurology Inpatient: Well, enjoyed it enough that I'm not crossing it off my list of potentials.  I definitely liked spending more time with patients and thinking more about each case.  I find that I really enjoy thinking about things - maybe that points me towards medicine more than surgery? Who knows.  A lot the cases were MS and seizures, but there were definitely a lot of cases where people got discharged, moved to another service, coded, or whatever...and we never really truly understood what they had.  I think that might be a plus or a minus.  The minus is that well, you don't always know what the patient has.  But the plus is that it gives some purpose to the physician aside from just treating each individual patient.  It's definitely a field that's constantly improving - kind of like psych.  There are just still so much unknowns about the brain left to be discovered.
In terms of the team, I really enjoyed working with everyone.  The attending was really friendly and greatly enjoyed teaching, and I was really fortunate to have an awesome chief resident who took the time take us aside and teach us for an hour.   Even though the junior residents were really busy, it was still a pleasure to work with them, whether it was just helping them out with the gargangium amount of stuff they had to do, learning tidbits, or receiving advice on how to improve.  It felt like me, being the slow and steady type of person, could fit in.  Although I did get the criticism that I tended to focus on the details and forget about the big picture and plans/management for the patient.  And since I'm a student, I should use the extra time I have to really work out the differential and consider all the angles/possibilities.  It's true - by the time I get down to the assessment and plan, I just want to be done with it.  One thing I regret not doing on this rotation was an LP.  It's a shame, I probably ended up watching 7 or 8, but each time when I asked if I could try the LP, it was either a bad patient (too large), there were complications, I had lecture, or the resident needed to do it because he/she hadn't done it yet.  Sighs.  Hopefully I'll get to do one in the ER next rotation.

ER: What do you know, I got to do an LP! That was really exciting.  Even more exciting was that it was successful.  ER was a load of fun.  Being able to see all these different cases, and coming up with the most dangerous ddx was fun, but also sometimes made me a big skeptical.  I mean, the lady with the fatigue and bilateral leg edema - do you really think that's a pericardial effusion when her heart/lungs sound fine?  I suppose it's better to be safe than sorry.  I also found that I LOVED seeing babies on ultrasound.  Hm...maybe this means something?  But then again, I also LOVED suturing. I could take forever.  It reminds me of sewing and knitting - but flesh. Okay, that picture's getting gruesome.  Anyhow, I can see myself doing ER.  A lot of what they do seem like protocol than actual quick decision making, but I'm sure things are different in the more traumatic areas of the ER.  We'll see, I'll probably need to do another shift next year, although I gotta say it does kind of bother me not knowing what happens to the patients (granted I could just look it up).  I think I like more continuity.  Maybe.

Pediatrics: I LOVE KIDS!  They are just so adorable! I don't see how anyone can not like kids.  Just walking through Children's Hospital gives me a warm fuzzy feeling.  Maybe a part of me is still very much a kid, so I get drawn to the bright colors and the cool contraption of the rolly balls going up and down.  Even being in heme/onc wasn't as sad as I had thought.  The kids are just so resilient, and they are so bright compared to adults.
I've been a little more concerned about interacting with teenagers, but so far, they've been okay.  They can be a little terse.  I find I go into my little kid voice and sometimes continue to talk in that voice to the parents - oops.
I thought I was going to looooove babies, and well, yes I do.  Just holding them in my arms and watching them sleep is like watching a little angel.  I just want to cuddle them all day!  But what made nursery difficult was having to work with the mothers and prepare them for motherhood - for which many were definitely NOT prepared.  It's so sad sometimes.  There are these innocent, perfect, beautiful babies, and you have to hand them over to who knows what kind of world is out there.  Well, I guess that's life.
Lessons learned:

• Don't throw/erase things unless I'm SURE they aren't needed - backup is good.
• Don't put bad things in the differential because OB is very tense about litigations
• No disclosures! - talk to residents first.
• Write a lot, talk little