Useless

Now I know I really don't look forward to getting old.

Case in point, this weekend. Instead of being a good medical student and go to board review class, I decided to do a little self review, which is fine and dandy. Benefits: I could multitask and not have to worry about getting caught nodding off. So I bust out the computer. Lo and behold, the internet doesn't work. After a few hours of fiddling around with the modem and the router to no improvement, I gave up. I figured, "I'll do laundry first, get some subject reading done in the interim, and when the load is done, I'll hightail it to the nearest coffee shop fro some free internet. Just so we're clear, the internet is essential for study because I need to to access Kaplan's question bank...and not to surf or blog...but I digress.
So to the hamper I go. I bend over and pick up the colored pile and before I could straighten out, a sneeze overcame me. That's when I realized that something had gone horribly wrong...

It was over in a second and I was Done, with a capital D, down for the count, literally. That little sneeze had sent my lower back into such horrible spasm, that I actually fell to the ground in pain. Sharp, stabbing pain in my lumbar area. Tears welled up in my eyes and I began cursing up a storm, hoping that I could intimidate my sciatica away. It never abated. So for 15 minutes or so, I was on my back, like a flipped turtle, praying that it would all go away. After much deliberation I managed to crawl my way to the bathroom, to the medicine cabinet, looking for some Tylenol. I can't take anything else because I'm allergic to the other pain killers. Wouldn't you know, only 2 tabs are left. Better than nothing. I took them and began making my trip to my room, one agonizing step at a time. I positioned myself as comfortably as possible and passed out.

I woke up in darkness. I check the blackberry: 9:15. I slept the whole afternoon away. I checked my back. Pain's still there. Crap. I tried getting up. It was doable but with great difficulty. I shuffled my way to the kitchen and somehow managed to make a pb&j sammich. I ate in complete silence.

Phone calls to friends/family would have been made, but it was already night and since I'm not one to bother, wouldn't think of calling unless it's absolutely essential (the word 'cripple' came to mind and I just didn't like it at all). So it was like that the whole night. Slow shuffling to the sink, to the bathroom, to my room. I managed to get my study book out and crawled into bed where I read and crashed, till the next day, when my sister came back from her trip and was able to pick me up some extra Tylenol and Capsaicin (try it on sore muscles and joints...works like a charm!).

And there you have it, folks. Another potentially productive weekend, wasted because of a sneeze. Yet one more reason why growing old sucks.

Song of the day: When I'm 64" - The Beatles

Just remembered something

This past week, I was @ the Jersey Java and Tea and was having my afternoon coffee when an old vet sitting by the window struck a conversation with me.

It happened while I was paying for my drink. I only had the exact amount to pay the barista, but not enough to give him a tip. So I ran back to my jacket pocket and scrounged up enough coinage to give him a buck...looks cheap but it's still legal tender. So the vet says "Those coins sure are a pain in the ass to carry. I don't know why the government still keeps making them." To which I replied "Perhaps they like the sound the coins make when they jingle." And from there, a conversation was struck between us about all sorts of things. Mostly I let him talk because he seemed like he had a lot to say. He had amazing stories, from the time he was kicked out of high school for kicking a couple of racist kids' butts (they started it btw, just because our hero in question was black and was at the wrong neighborhood), to the time he joined the marines and his training days in Parris Island (to which he recounted his experience as being "a peach"), to his tour assignments throughout the Far East during Vietnam and beyond. He recounted his accession into the Navy SEALs, his many promotions and his numerous travels throughout the world in his 35 years of service. He beamed with pride when he spoke of his two sons, both in the armed forces.

He tells me that while in the during his tour in Vietnam, he was exposed to agent orange and from that, how he developed cancer. He says that he's just hanging out @ the cafe before he had to go to his doctor's appointment. To this, I said nothing. I couldn't say anything. What could I say? Somehow, "sorry" just could not encompass the gravity of it all. He spoke of his condition as if it was a random, daily thing, or rather more like an inconvenience. I suppose seeing and knowing what he'd been through all these years in the service, Cancer is just an inconvenience to him, even if it meant his mortality.

He wasn't resigned, sad, or regretful, at least not from what I can tell of how he spoke about his life. He was just an old bloke, happy to be alive, trying to tell a youngblood like me about a really good and honest story...his story; as if imparting to me his most valuable treasures, wishing that I should have such an adventurous and amazing tale to tell when my time comes.

I shook his hand and thanked him for his story and his service. He wished me luck and with a nod, he left for his appointment.

So, to Chief Warrant Officer ______, my sincerest thanks.

Song of the day: "Sawdust Saloon" - The Low Anthem

Some people are just born romantics

Check this out.
I had a 64 year-old patient today who was going for penile implant surgery. Seriously. A few minutes before we headed to the OR, I asked him the question that every guy would have asked if they were in my place...

Why?

Why would you go through such a seemingly painful (and it sure looked painful, afterwards) procedure?

He looked at me straight in the eyes and answered with a faint smile:
I love my wife...and Valentine's Day is coming up.

I just had to smile after that one.

Ah, l'amour.

Song of the day: "My Funny Valentine" - Chet Baker

Moving right along

One of the few memories I take with me (for better or worse) as my Internal med rotation comes to a close is the story of Mrs. ___.

Mrs. ___, a 68 yo F. patient of mine a few weeks ago during my inpatient IM rotation is in the hospital for worsening SOB (that's Shortness Of Breath ;-)).

She claims that she was a stripper during her heyday and insists on sleeping buck-nekked underneath her covers hoping that her other "cute" doctor would examine her thoroughly!

Sure enough, after the morning labs came out, my attending sends me and another intern to her room to do a rectal exam on her (to check for occult blood).

Needless to say, it was quite disturbing for me...and my intern.
And the kicker was, after I finished the exam, she proceeded to thank me for it...and with a smile!

Never really thought that rectal exams warranted a thank you. What disturbs me is that I don't know if Mrs. ___ was being appreciative or inappropriate or both.

Sorry if this post sounds uncouth. Still, the humor of this situation wasn't lost to either my attending, her resident or my other fellow students. They just love bringing it up from time to time.

Hey, I didn't exactly say that this memory was all rainbows and bubblegums.

And on that note, I take my leave and wish all my colleagues taking the IM SHELF exam tomorrow the best of luck.

Song of the day: "Healing Hands" - Citizen Cope

Stating the obvious

Normally I have a very prodigious amount of patience for patients. I'll sit there and shoot the shit with them even though there are time constraints with their office visits. The stories they tell are amazing and everyone of them, priceless. The patients themselves seem to appreciate the banter and it makes their visit a little less stressful. Today, however, I could feel my blood pressure rapidly reaching critical, because of them.

How, you ask, did they manage to get under my usually tough outer shell?

4 words: "Why aren't you married?"

It's all together sad when all I can say was "I wish I knew..."

I must've been asked this at least a dozen times before quitting time today. I was clenching my teeth so much, I think I developed TMJ disease after all of that nonsense. Sometimes the questioning doesn't end there. Some patients like to probe a little more and make mindless suggestions like "maybe you should try those internet sites" or "I got a niece that would be perfect for you."

Sometimes I think that the doctors that precept my rotation judge me on my bachelorhood as well. They always seem so surprised after they ask when I tell them my age and that I'm single. It's even worse when there are other people around me who are my age or younger and they are already married and/or have kids of their own. Somehow, the comparisons are made automatically, but in the most "tactful" of senses, of course.

Then they end with, "Well, you're going to be a doctor soon. You'll find the right one, eventually."

It's quite demoralizing, really. It's gotten so bad that at one point, I was compelled to lie about my age just so I can dodge their judgmental questions. To me, it sounds as if they are implying my becoming a doctor is the only redeeming quality and selling point at this point in my life.

Can't I have at least a tiny iota of slack on this subject? Yes, I am getting older, but the church ain't goin' nowhere, either. And if I knew why I'm still single, we wouldn't be having this conversation in the first place anyways. I'm not that lucky like the rest of America's wedded sons and daughters are, but that doesn't mean that I'm broken. I'm 29 and single...and there's nothing wrong with that.

Give it a rest. Get a life and move on.

Song of the day: "You Don't Know Me" - Ben Folds feat. Regina Spektor

Happy 4th =)

Week 1 of 3rd year clerkship in Family Medicine is officially done! Where did the time go? Why it seems only yesterday, I was spewing out information to teachers and tests. Now, I'm getting spewed on and learning how to order tests. Wow.

Saw a good deal of patients this past week and some of them were pretty interesting cases, which I dare not go on about at this point. Lets just say, I'm never bored and am seriously learning a lot. Still, I'm slowly getting the hang of writing SOAP notes and doing histories and physicals. Best time so far is 45 minutes (with another med student helping me, of course). I hope to bring that down to 10 minutes, flying solo. I certainly am feeling overwhelmed, but in a good way. So far, the outlook about this rotation is very positive. I have good doctors teaching me and they are being really good role models as far as patient care is concerned.

I've met several good people along the way too. The best ones are the vets. They always have the best stories. God bless'em. They're all fiercely proud about their close calls and battle scars and they know how to tell it like it is. And rightfully so! There was this one gentleman who wasn't even a patient, but the husband of one and he was telling me the story behind the ginormous scar on his shoulder, how he got hit by shrapnel from an exploded bomb during WWII in Austria; how he lay wounded for hours before the medics found him, barely alive; how he only received one shot of morphine to last him the 20-hr., 200+ mile back-country ride to Italy where he was to be operated on; how he was fading in and out of consciousness because of the pain; how later on, his scar resembled the emblem of his division because it looked like a red "T." Pretty kick-ass, to say the least. Then there was this other guy who told me how he survived the bombing of Pearl Harbor and how he was on 2 other ships later on in the Pacific and again, survived at sea after having his ships torpedoed. Honestly, I could've sat there and listened to them all day.

"He that shall live this day, and see old age,
Will yearly on the vigil feast his neighbours,
And say 'To-morrow is Saint Crispian:'
Then will he strip his sleeve and show his scars.
And say 'These wounds I had on Crispin's day.'"

Thank a vet for serving next time you see him or her.

Happy 4th of July.

Song of the day: "Chocolate Jesus" - Tom Waits