Monday, January 31, 2011
Well, folks.  The deed is done.  Granted, it can be changed an unlimited number of times until 9pm on February 23rd.  But there's still a sense of finality.  I've ranked 8 programs, but will hopefully end up at my number 1!  I'd be happy at any of my top 3, though!  I thought now would be a good time to explain the whole Match process.  It's a foreign concept to most of the world.  Here's how it works:

First of all, the Match is the process by which 4th year medical students apply for and are placed into residency programs in their desired specialty.

During the third and beginning of fourth year of medical school, you decide what you want to do with the rest of your life.  Sounds easy, right?  Right... I talked about how I ended up deciding to go into Family Medicine in the post, "Battle Royale: Ortho v. Family".  Once you decide what specialty you're going to apply to, you start collecting necessary information for the online application (called ERAS).  This involved collecting licensing test scores (Step 1, Step 2 CK, and Step 2 CS), three letters of recommendation, a personal statement, transcript, and deans letter.  This mostly happens during the summer of your 4th years.

On September 1st, ERAS opens to programs, and students can send their application information to the programs they wish to apply to.  The number of programs people apply to varies greatly depending on specialty, location, future plans for fellowship, and whether or not you are "couples matching" (trying to end up the same place as a spouse).  I applied to 10 programs. 

In general, your applications should be sent to all desired programs by November 1st, which is when Dean's Letters are released from your school to the programs you applied to.  The dean's letter comes from the dean's office, and basically highlights everything in the rest of your application. 

Once the applications are sent to programs, you will (ideally) start to get interview invitations.  There can come in anywhere from September through November, and into December for some specialities (not family though).  Then you spend a lot of time trying to figure out how to fit in all the interviews in different places.  It's good fun.

November - January is spent interviewing.  Interview days generally consist of dinner with residency the night before, a couple interviews with faculty members and residents, a tour of the clinic and hospital, explanation of the program and it's benefits, and lunch with residents and faculty.  Most of mine lasted from about 7:30-2:30. 

Once interviews are done, you decide how you want to rank programs.  Here's the tricky part.  The Match.  Why is it called The Match?  Well, because some computer somewhere MATCHES you and a program.  Basically, you rank the programs in the order of where you'd like to be.  Programs do the same with applicants they've interviewed.  A computer goes through the applicants list, and puts them into the program they rank #1.  This applicant is only bumped out of that program when there are enough people the program ranked higher than them to bump them out.  Confused yet?  I thought so.

Basically, it's an applicant system.  There is NO benefit to ranking in any order other than where you want to be.  Just because you think you have a higher chance of getting in somewhere doesn't mean you should rank it higher.  If you do, you may never get the chance to be put in the program you REALLY want to go to.

So, we have until February 23rd to submit a finalized rank list (officially, "Rank Order List").  After that date, computer magic happens.  On March 14th (Monday), everyone finds out IF they matched.  Yes, it's possible not to match.  This happens at noon.  At my school, if you didn't match, you receive a page at noon asking you to come to Student Services.  God forbid this happen to anyone, you enter something called the Scramble.  This involves calling all the programs who didn't fill their spots and begging to be let it.  It's stressful and anxiety provoking and terrifying.  I'm getting anxious just talking about it.  Shutter.  Given that DOESN"T happen, Monday at noon you are relieved to know you will be going to residency SOMEWHERE on July 1st.  Then, you wait until Thursday.  Thursday, March 17th is Match Day.  At noon, everyone finds out where they matched.  At my school, everyone gathers in one room, and then we countdown to noon, and then everyone goes to a table and gets their envelope and opens it.  Some families come.  Some people hide in the corner.  The is much joy and many tears. 

And that, my friends, is how the Match works. 

I hope that clarified the system for you...

Sunday, January 30, 2011
The newest thing in running is the "barefoot" running tread, aided by Vibram Five Fingers shoes so people don't end up with shards of glass and old bubble gum in their feet.  I think there is probably some value in running without traditional shoes, but I have no plans of trying it out.  Why?  Well, there are a couple reasons.

1)  The feeling of fabric rubbing together between my toes makes me cringe.  As does the feeling of cotton balls being pulled apart, but that doesn't seem relevant here.  And this isn't just an "I don't like it", it's a "makes the base of my neck spasm and I get a little nauseous".  Why?  I don't know.  Seems a little irrational to me.  But when tall toe socks were the trend back in middle school, I had to forgo the fad because the thought of cotton between my toes made me cringe.  And since, to wear Vibram Five Fingers, I would also have to wear socks with little toes, I just can't do it. 

2)  I have abnormally long toes.  The short little stubby spaces allotted for toes in the Vibram Five Fingers would only accommodate about half my toe, meaning that the shoe wouldn't bend in the right spot, and the whole fit would be off.  I have this problem with anything that relies on having normal sized toes.  Like flip flops.  The little toe thing is too far forward and my toes hand off the front.  Obnoxious.  Anyway, this would be a deal breaker.  Shoes bending at places they weren't meant to bend never ends well.  Creates foot issues.  I don't want foot issues.

Sadly, I will never know what it's like to run barefoot, with something on my feet.  I have run actually barefoot on the beach.  That is nice.  But other than that, I'll just stick to my regular running shoes.  They work fine.
Saturday, January 29, 2011
It was BEAUTIFUL outside today (for January...), and I decided to take the new Blue out for it's inaugural ride.  When I pulled up to the parking lot at the lake, I thought to myself, "hmmm, I thought there would be more people here, it being Saturday and nice outside..."  I should have realized that meant something...

The trails was a wet mudpit.  Some areas were easy to get through, but others were deep and slippery.  I almost bit it a couple times, but managed to avoid faceplanting!  The backside of the lake was not as bad, but the damage was done in the first 4 miles... 

Blue will never look the same again.

Neither will my knee warmers...

My legs were a lot muddier until I went over a flooded bridge and got soaked.  Brrrrr.

Don't worry too much though!  Blue got hosed off at the car wash, and then wiped down inside.  ALMOST good as new.  But not quite...
I got home from a bike ride (which I will tell you about later), and was famished.  I made my own version of chicken tikka masala, which involved simmering.  In the simmering process, I created a large yellow splattery mess all over my stove.  No worries, I have 409.  Remember how 409 is one of the things that makes me happy?  Well, now it makes me even happier! 

First, lets review what 409 looks like when you spray it on the counter.
It looks like spray on a counter.
And now, lets looks at my yellow splatter mess.

So, when I sprayed 409 on the yellow splatter mess, I figured it would look like yellow splatter mess with spray.

Oh no, no no.  It was magic!  409 MAGIC!!!!!

It turned RED!!!!! 

What kind of chemical craziness was going on in the tikka masala?  Should I be afraid that I ate something that changes color?  Bind boggling.

I hope you all found that as exciting as I did....

Friday, January 28, 2011
This house in Winston-Salem (in cash)...

Eight brand new Subaru Outbacks

32 Trek Madone 6.9 bikes

875 KitchenAid mixers... about 75 of each color...

3840 Le Creuset Ogive teakettles

48,000 Chipotle burritos

or 576,000 Krispy Kreme donuts

Wednesday, January 26, 2011
I thought we'd have some good ole' fashion ethical fun tonight.  In class today, as a launching point for conversation about the purpose of punishment, we read the case below.  It's a true story, but don't ruin the fun by googling it and spoiling the ending.  I've paraphrased a bit to shorten the story, but haven't changed any details.


In 1985, Roswell Gilbert, a former electrical engineer, killed his 73-year-old wife to end her long suffering from Alzheimer's disease and osteoporosis, a degenerative bone disease.
It was on March 4, 1985 that Gilbert loaded a 9-mm Luger, part of his extensive gun collection, entered the living room of his Fort Lauderdale condo and quietly walked up behind his wife, Emily. He shot her in the temple, then, after feeling her pulse, reloaded the gun and fired again.
"I just could not allow my lovely lady of 51 years to descend into a hell of suffering and degradation," he wrote in a note he pinned to the bulletin board before he summoned the police.
Everyone who knew the couple, including their daughter, insists that Roswell was a devoted husband. During their first decades together he happily spent the bulk of his comfortable income to indulge Emily's taste for the good life. Later, as she steadily deteriorated, he went to extraordinary lengths to maintain a semblance of normal life for her. "Daddy used to put on her makeup," said Moran.
Emily and I were madly in love for 51 years. We had a nice life, a big house in Montclair, N.J. Emily didn't like to cook and I didn't care. We ate in restaurants and had a housekeeper who helped raise Skipper [daughter Martha's nickname] before she went to Vassar. We belonged to country clubs, traveled extensively.
It was in the early '60s, shortly after we'd bought a condo in Manhattan, that Emily demonstrated the first sign of Alzheimer's -- though no one knew it at the time.  Time passed, and in we wanted to live abroad, and in 1972 we moved to a waterfront condo in Majorca, Spain. In the five and half years we were there I had to fly back to America 27 times to be an expert witness in electrical engineering lawsuits. Fortunately I was back when Emily suffered her first fracture. She fell down in my lab, screaming in pain. We found out it was osteoporosis, which eventually led to multiple fractures of the spine. Soon we decided to move back to the States, and I suggested Fort Lauderdale.
We loved our Florida condo from the day we bought it in 1978. Emily was gregarious and made friends in the building, but her memory was starting to fail. She had a hard time remembering simple things like where she was going or what happened yesterday, and after tests, they diagnosed Alzheimer's.

I kept all this quiet. Didn't even discuss it with Skipper or my friends. It's not my way. I kept it all inside.

I set up a shop in the apartment and consulted to companies up North, but Emily became more and more dependent. If she saw me leave on a business trip, she'd throw a tantrum. I tried to make day trips or leave at 2 or 3 a.m. so it wouldn't seem as if I was gone overnight. That went on for a couple of years. But her fear complex grew worse by the day. Friends tried to help out, but she only wanted me. In 1984 Emily woke up and had a fit because I was gone. She remembered nothing. She ran to the neighbors demanding to know where I was. "Did he leave me? I can't make it without him. Find my husband." When neighbors reached me by phone and she heard my voice, she calmed down. But I came home at once.

For months leading up to the end, our living ritual was virtually the same. I would get up at dawn and get us two glasses of orange juice. She slept on the couch because it was more comfortable for her back. I'd sit down in front of her, sip my juice and wait for her eyes to open. Usually she didn't know me. She would ask, "Where are we? Are we in Spain?" It was pathetic. I'd talk to her and try to bring her around.

I'd pick her up and carry her into the bathroom. I'd bathe her, brush her teeth, perform her feminine hygiene for her. We would go out for lunch and she would pick at her food. She had no appetite. She weighed less than 80 pounds. There wasn't much I could do except make sure she took her daily medication. I asked the doctors for help, but they had little experience with this condition.

The weekend before the end was awful. She was in such pain from new fractures I took her to the hospital; the doctor said she needed to be x-rayed. But she got recalcitrant and carried on like a sick baby. She refused to take her clothes off for the x-ray, and when they tried to take a blood test, she yanked the needle out of her vein. Blood flowed all over the bedclothes and her already soiled dress.

I stayed in the hospital all night with her, but she refused to stay in bed. The pain was so bad she screamed and cried. She went out in the hall looking for elevators and pushed all the buttons, which caused an uproar. The nurse said, "We can't handle her; we're not used to this disease." She echoed the words of three nursing homes in the area, which said they were not equipped to take her in.

So we left on Sunday. I put her back on the couch, and she hadn't eaten for 36 hours. I gave her Percodan. What else could I do?

The next day I had to go down to the manager's office and sign some checks for the condo association. After a few minutes she must have noticed I was gone. She hobbled onto the elevator and came down into the lobby. She was dressed in the same bloody dress that she'd worn in the hospital. She looked a mess. She was crying. She brightened up when she saw me, but then I started crying. And the office secretary started crying.

I took her back to the couch. I just looked at her and cried and asked myself over and over, "What the hell can I do?" She said, "Ros, I love you dearly. God, I want to die." It wasn't the first time she had said this. I even thought about killing her a year before. Had she not asked me in those last few hours, I wouldn't have gone through with it.

I walked into my lab and fetched the Luger. I shot her on the side of the head. Then I did something foolish. I felt the arteries in her neck. I realized she was still alive. So I reloaded the gun. I was shaking like I'd never shaken. I shot her again. Her chin dropped. Her mouth just opened. Her right hand shook. No other movement. She was dead.
I felt grief. Not regret. I stood there and cried thinking my wife was dead. But the fact that she was no longer suffering gave me relief.

In Florida, the sentence for murder is life in prison without the possibility of parole for 25 years.
Knowing this, should the prosecutor try Mr. Gilbert for murder?  Why or why not?
Should he be charged with something other than murder?
Should he be punished at all?
I've mentioned this one before, but I recently discovered a blog called "1000 Awesome Things".  Every day, there is a new awesome thing.  They are hysterical. 

Today's awesome thing is Atoms. 

Speaking of atoms?  Were you as excited as me in high school when you learned that there is always space between atoms, and therefore you can legitimately yell, "I'm not touching you!" to your siblings, even if you were sticking your finger in their ear?

Atoms are awesome.

Tuesday, January 25, 2011
You may have noticed that my "medical fact of the day" never ever changed daily.  I think I've successfully posted about 5 medical facts.  It's not that there aren't a gazillion interesting medical facts that I COULD list... it's just that I don't know which ones would actually be interesting to you.  So I've decided to abandon the medical fact of the day idea, and replace it with "101 things to do with a mini spoonula".  There are a couple reasons I like this idea.

1)  It's not time sensitive.  I don't make any promises about how long it will take me to post 101 things to do with a mini spoonula.  I just promise that some day, I'll have given you all 101.  Maybe even more.

2)  I love the mini spoonula.  Check out this post for the introduction to the mini spoonula. 

There are regular-sized spoonulas also.  But the mini ones are cuter.  It's basically like "101 things to do with a cute puppy", only you don't have to take care of it. 

We'll start out with the reason (or excuse) I got the mini spoonulas in the first place...  To get the peanut butter out of the bottom of the jar!  All of it.  Way more then you knew was in there.  At least enough for another piece of toast, or a couple ants on a log.

Go ahead, try it.  You never knew there was so much PB left in that jar.

Stay tuned for reason #2!!!
Monday, January 24, 2011
Hello, world.  It's been a few days.  Sorry about that.

Yesterday was a busy day!  And like all the best made plans, it got shot to ___ shortly after I made it!  I headed over to Starbucks at about 9AM.  It would have been 15 minutes earlier, but some raccoon decided it would be good fun to totally destroy the garbage bag I'd put out by my door.  So I spent some time picking up garbage strewn about, and then some more time thawing/scrubbing my hand of garbage/raccoon germs.

After I spent some time reading at Starbucks, I headed over to the Y to work out a bit, then went over to the undergrad campus to play basketball.  As I was driving onto campus, I noticed by vision was getting a little... blurry.  And I couldn't really see much to my right.  That's pretty much universally a sign of an impending migraine for me.  But I decided to go play basketball anyway.  So I did that for about 45 minutes until I had to go to the law library for a group meeting.  It was all downhill from there.  About 30 minutes into the meeting, I realized I was not going to evade a migraine, and decided to leave for darker lands.  But I couldn't drive home because I couldn't really see... or look up.  So I went over to student health, who isn't really allowed to treat medical students.  But I knew some of the nurses working there, and asked if I could just lay down for a bit in an exam room since driving wasn't really safe, and I had nowhere else to go.  They kindly let me, and gave me lots of ibuprofen.  By that point, I felt like this.
For those of you who have never had a migraine, let me give you a description.  Half your head feels like it might blow up.  It hurts to lay on that side, or the other side.  And you'd really like to fall asleep, in the dark.  But you're too nauseous to be comfortable enough to fall asleep.  And you can't move, really at all, or you will be more nauseous.  And I can't really see when I get mine.  And the only way to make it go away is to sleep... for hours.  And then you feel hungover for about 24 hours.  And it's crappy.

I used to only get them about twice a year, when I got really overtired.  But lately, I've been getting them about monthly.  And that's just not okay.  So it's time I get my butt to the doctors and get some abortive meds (that you take at the start and prevent it from becoming a migraine).  I really should do that...

So, to continue my saga, I slept in student health for a few hours, and then I went home to get ready for my interview dinner.  I really debated going, but decided to give it a whirl (I was only 2 minutes from home, so I could always leave...).  I think eating something did me good (I hadn't eaten anything except a couple saltines since breakfast), and I started to feel better as dinner went on.

After dinner, I went to bed.  Yes, it was 9PM.  I don't care.  That's the other thing I do after migraines.  Sleep.  Once I came home, slept from 10AM until 5PM, woke up, ate some soup, and slept until the next morning.  Blah.  So, I went to bed and decided I would wake up earlier to get ready for my interview today.

Luckily, I actually woke up in time to get my suit out and put it on.  Then I got my interview on, and now I'm DONE!!!!! 

All that's left is to decide where I want to go.  Gulp.

I still don't feel normal, so I think I'm going to have a lazy night at home, and then go to bed early.  Hopefully tomorrow I'll be back to normal!

Saturday, January 22, 2011
I don't normally post recipes on here.  It may be because I'm too busy writing about other random stuff, or because I eat strange and uninteresting things, or because I don't pay enough attention while I'm cooking to document the process.

But tonight, I made beef stew, and it was so delicious I feel like I must share.  The recipe I used can be found here, but I made some adjustments to the original, so I'll detail it below. 

Deliciously Delicious Beef Stew

1.5lb stew beef
1/2-1 tbsp butter
1 tbsp olive oil
2 cups water
1 tbsp worcestershire sauce
1 tsp salt
1 tsp sugar
1/2 tsp paprika
1/4 tsp black pepper
1/4 tsp white pepper
2 bay leaves
2-3 cloves garlic, peeled
Dash of ground cloves
3 carrots, sliced
3 celery stalks, chopped
2 potatoes, diced
2 tbsp cornstarch

In pot, heat oil and butter.  Brown outside of meat in hot oil.  Add water, worcestershire, bay leaves, garlic, sugar, salt, paprika, pepper, and cloves (and one onion, sliced if you want.  I was out).  Bring to a simmer, cover, and cook for 1 1/2 hr.  Remove garlic and bay leaves, and add carrots, celery, and potato.  Cook an additional 30 minutes.  Throughout cooking process, add water as necessary to ensure enough cooking liquid (keep it about where it was at start of meat cooking process).  To thicken gravy, stir cornstarch with 1/4 cup water.  Stir until smooth.  Ladle some cooking liquid into cornstarch and stir.  Add to pot, stir, and cook until thickened and bubbly.  Enjoy!

I imagine you could also use some red wine as cooking liquid in addition to water... but it's delicious as is!
I'm making beef stew for dinner.  I predict it will be delicious.

In the midst of prepping all the spices and such that needed to go into the pot with the beef, I pulled this from the pantry:
If you can't read the bottle, it says "bay leaves".  Aside from the fact that I really don't know what flavor bay leaves impart on a dish, there is a serious design flaw here.

If you have ever cooked with bay leaves before, you know they are leaves.  Hard, chewy, inedible leaves that are meant to impart their critical tastiness on a dish, and then be removed (or left in the pot to be found during dinner by someone who then wins a prize...).  They are big.  Bigger, in fact, than the little shaker holes at the top of this jar. 

Someone didn't think that through.  Hellooooo, people.  Have you ever tried to shake a bay leaf out of little holes in the top of a jar?  No?  I think you should give a whirl.  Just to see what happens! 

And then, consider giving us a jar that doesn't have holes in the top.  There are about 2 square centimeters of blue plastic there that could have been saved. 

Environment killers.
This morning, I am full of questions.  Very important ones.  I thought I would share them with you.  I tried to look up answers (on Google, duhhh), but it seems that people don't have the same questions as me.  Before I ask mine, I will share what people who search google want to know...

Ohh, the things people wonder about.  My questions are far more profound.

1.  Why is greek yogurt whiter than regular yogurt?

2.  Why don't they make more bib shorts for women?

3.  Why does Wyatt let me pet him, even though every time I do, he gets shocked?

4.  What happened to the Saturday morning cartoons of my childhood?

5.  Why isn't there a grocery store closer to my apartment?

6.  How much coffee is too much?

7.  Why are legal pads yellow?

8.  How do you get bike grease out of carpet?

9.  Should I make beef stew or chicken tikka masala for dinner?

10.  What brand of peanut butter do you eat?

Ready, answer.
Friday, January 21, 2011
Alternatively titled "The New Blue is Black (and White)"

But that's just not as catchy.  And everyone knows you need a catchy title! 

Good news!  My new bike has arrived, been sized, assembled, given pedals and a water bottle cage, and been safely placed in my living room.  You wanna see it?  It looks way cooler in real life than it did in the pictures... and it looked pretty durn nifty in the pictures. 

Yeah, not the greatest picture, I know.  But there aren't lots of places to put a bike that will have a nice backdrop.  Sorry.  Want some niftier pictures?  Yes?  Okay, here you go!

The frame is much more geometric than traditional aluminum round frames. The top tube is oval for shoulder carrying comfort, and the frame overall is a little more substantial (although not heavier) than my old one. That was hard to appreciate from the pictures. The components have a sharp black finish which looks great with the frame colors. I'm definitely going to have to get used to the double tap system of the SRAM Apex components though.

I must admit, I haven't taken it out for a test ride yet.  But in my defense, I only brought it home 24 hours ago.  This weekend is looking promising, though!  And, thanks to the good deal I found online and the fantastic support of our killer bike shop, Ken's Bike Shop, I made out under budget for the replacement... now that's a good day's work. 
Okay, enough chit chat about the new toy... I must get back to reading about medical malpractice. 
Peace out,
The story of how I ended up with this camera is kind of entertaining...

It was a cold and dreary day, long long ago when I was a third year.  Betsy and I decided to drive to the mountains to frolick in the snow.  Why did we want to frolick in the snow?  Fair question.  Because snow is cool?  Or because we were bored?  Or because we like the mountains?  Or because being in the cold is no fun when you can't do anything in it?  Who knows, really.  We once drove an hour just to get donuts from an amish bakery.  There's no telling why we do the things we do. 

So, we're on the way to Boone, and I asked Betsy if she brought her camera.  Negative.  She rarely does, because I always bring my camera, which is just a small step below a dSLR and takes excellent pictures.  BUT, I didn't bring my camera because the battery was dead and I couldn't find the charger.  Bummer.  So we decided to stop at Walmart on the way to Boone so I could get a disposable camera just for the day.  Gotta have a camera... you never know what might require picture taking! 

Well, it turns out they were having a big pre-Christmas sale on cameras.  After reading up on all the ones that were a decent price, I decided to get a small point and shoot camera instead of a disposable one.  There are some times where lugging a big camera around just isn't practical or necessary.  Extreme weather conditions, nights out, technical hikes... it's just not conveneient to have a big camera.  So a small point and shoot seemed like a reasonable alternative! 

I decided to go with the Nikon S220, a 10Mp, 3x optical zoom compact PhD (abbreviation from back in the day meaning "push here, dummy") camera. 
I went with the Nikon because of the price (I think it was about $120 when I grabbed it), the size, and Nikon's history of making good quality products.  At that price point, there isn't a huge amount of variety in the features you get...

After spending a lot more time in Walmart than we intended, and snagging the camera and a matching memory card, we hopped back in the car, used my sweet car power converter to charge the battery, and snapped some pictures driving through Christmas tree farm land!  Here's an example:

Have I discussed my intentions to marry a Christmas tree farmer?  No?  I should do that some day... it's a well thought out plan...

Now, after months and months of use, I can tell you that I think this camera was a good purchase.  Had I had more time to research the cameras in this price range, I maybe would have made a different choice, but this one definitely serves the purpose.  It's small, light, easy to use, and easy to stick in my pocket.  The picture quality is okay, definitely far below my other camera (which is expected).  It's used for proving that I was, in fact, on the top of that mountain... not to show you how beautiful the view was or how cool the leaves on a tree are.  You've got to know your lot in life, right?

It also conveniently sits on top of my GorillaPod, making it exceptional at taking self portraits from pretty much anywhere.  Like the fireplace....

Overall, if you're looking for a performance camera, this isn't it.  If you're looking for something to stick on your pocket or backpack and snap pictures of cool situations you find youself in, this will do the trick very nicely!  And, bonus, it comes in 6 different color options!  Everyone loves color options...

Adventure on,
Thursday, January 20, 2011
There are a lot of things that scare me about my future practice of medicine.  Of these, the general idea of making a mistake is the most terrifying.  I wrote about this in my first post ever, "Getting Used To Failure", where I talked about the difference between bad outcomes and true mistakes.  Part of this fear is linked to the fear that someone will sue us.  This fear, probably more significantly than it should, drives part of what we choose to do in medicine, part of how we treat our patients.
Truely eggregious, intentional, or illegal incidents aside, many many medical malpractice suits are brought because a patient, or a patient's family, are upset with the outcome of a particular course of treatment.  There are five things that must be proven in order for a doctor to be found guilty of medical malpractice: duty, breach of duty, causation, proximate cause, injury.  Basically, they have to prove that the doctor's actions were outside the standard of care for physicians in his field in that instance, and that action resulted in injury that otherwise would NOT have resulted if standard care had been given. 

I could go talk about the way litigation against doctors changes the common practive of medicine from an evidence based one to a defensive one.  Or how devestating it is to be sued when you truly think you did the best you could (I don't know that from first hand experience...).  Or how most suits are brought against a small percentage of physicians.  Medical malpractice is a complicated beast.  And three days of class within the walls of a law school certainly don't qualify me to talk about it.

What I do want to talk about is compensation.  Specifically, the money.  There are two types of compensation that can be given to a plaintiff that wins their case (the following is not official legal lingo.  It's my lingo).  First, there's compensation for economic loss.  This may include lost wages, loss of future earning potential, medical bills, future health care, etc.  If medical malpractice is found, this seems to be reasonable.  For instance, if a surgeon is drunk while performing an appendectomy, and accidentally removes someone's kidneys instead (I really hope this has never happened....), it would be reasonable for the patient to receive money to compensate them for the cost of being on dialysis, the lost wages for spending extra time in the hospital, and even the lost earning potential because they now must got to dialysis three times a week.  Were it not for the neglegence of the doctor, this person would not be on dialysis. 

But then there is the less clearly defined catagory of "pain and suffering".  There has been much debate about whether or not there should be a cap on the awards for pain and suffering.  While the majority of awards are not outlandishly high, some are.  I have reservations about any awards for pain and suffering.  I understand that I've never been in a situation where this would apply to me.  But still, I have an opinion about it. 

The assignment of money for pain and suffering implies that in some way, this money will make up for the pain and suffering of the patient or their family.  It also suggests that the pain and suffering caused by this negligence on the part of the physician is somehow more valuable, or worse, than the pain and suffering experienced by everyone else in the world who experiences pain and suffering.  I don't know that I think money should be paid at all for pain and suffering.  I don't understand what it compensates for.  I am certain that in many instances, the patient experiences pain that they otherwise would not have.  They may have pain for the rest of their life.  But money doesn't fix that, in any way.  The costs associated with medical treatment due to the pain should be covered under economic loss.  But for this person, to gain money due to pain?

I guess I feel like they are looking in the wrong place for resolution of this permanent change in their life.  But no amount of money will make things like they were before.  And that is tragic.  Tragedy happens every day.  A child gets shot in the crossfire of a gang war, and is paralyzed.  The people responsible are held accountable for their actions, sent to jail.  But the kid is still paralyzed.  And that becomes his life.  What is that worth?  And who pays it?  Is it worth less if the kid becomes a world class paraolympian?  Worth more if he wanted to be a basketball player, and now his dreams have to change? 

At the hands of us, or someone else, our life becomes what it is.  And we live it, with the pain and suffering, joy and happiness, and mundane days.  We don't earn for pain and suffering any more than we pay for joy and happiness. 

In these cases, I think that, as society, we recognize someones pain and suffering.  We valiadate it, give them as much support as possible, and recognize that their life will be different.  We understand that we don't understand. 

But I don't think that compensation should be an option.  I don't think we assign a value to the loss of someone's leg, or the value of chronic pain.  The pain and suffering is no different in someone who lost their leg in a car accident caused by snow as in someone who lost in an accident caused by a drunk driver.  Certainly, the punishment for the cause should be different, but should the compensation to the injured? 

I don't think it should.

But that's just me.

What do you think?
Tuesday, January 18, 2011
Alternatively titled, "Is There An Elephant In The Room?"

Were one to have taken, oh, say, a year off from speed training and circuit work, one should seriously consider NOT doing BOTH on the same day...

Or one might end the day in a considerable amount of discomfort.  Hypothetically speaking, of course.

I seem to be speaking hypothetically a lot recently.

I had a pretty standard circuit workout I did before the ankle disaster of 2010, and since then, I haven't done it once.  The result?  A weak core, arms without much strength, and no speed in running.  Blah.  So I decided to return to the circuit today (it was dark and raining, so no running outside).  It doesn't SEEM like it should be that hard.  Really, it's pretty simple.  But for whatever reason, it always kicks my booty.  Here's the workout (which happens on a 0.1 mile indoor track with 4 corner workout areas):
  • Step 1: Stretch
  • Step 2: Warm up lap, jog.
  • Step 3:Fast mile: Can't fall over at the end, but should be close.  I don't mean speedy, I mean almost your fastest mile possible. 
  • Step 4: Cool down lap, slow jog
  • Step 5: Corner 1: 2 chin ups
  • Step 6: Run 3/4 lap
  • Step 7: Corner 4: 25 crunches
  • Step 8: Run 1/4 lap
  • Step 9: Corner 1: 5 pushups
  • Step 10: Run 3/4 lap
  • Step 11: Corner 4: 10 shifty leg things... I'll get back to you with a real name for them.
  • Step 12: Run 1/4 lap
  • Step 13: Repeat steps 5-12 x4 for a total of 5 times through the whole circuit.
  • Step 14: Cool down lap (and I usually do a slow cool down 30 minutes on the bike afterwards)
At the end, you've run 2 miles, done 10 chin ups, 25 push ups, 125 crunches, and 50 shifty leg things.

I judge improvement by speed... Today I clocked in at 23:49 from the start of the fast mile to the end of the last 1/4 lap (the warm up and cool down laps don't count).  For my time to count, I have to get in good chin ups and real pushups before I can move on... no cheating.  I'm pretty sure I've clocked in as fast as 19ish minutes, but I have mixed the exercises up a bit so I don't remember if that was exactly the same circuit...

Anyway, it's a buttkicker, and now my arms hurt... a lot. 

Aside from that, check out what was at my door when I came home today!

Does someone sense something large in the middle of the room?  Oh, right, it's my new cyclocross bike!!!  Just as a reminder, this is what it will look like when it's put together...

I'm going to take it to my bike shop tomorrow to do a pseudo-assembly and make sure the frame is the right size.  If it is, they'll go ahead and build it, and I'll be on the trails by this weekend!  Bliss.

On that note, I'm off to supervise the baking of chex mix while watching The Biggest Loser and reading a lawsuit about Seinfeld.

Peace out,
Monday, January 17, 2011
It may seem strange to have a scheduled date with your roommate... but we are both very busy young women!  So, today, we scheduled ourselves a nice little baking date.

New mixer + cookies + chick flick = a good day.

We busted out the always-reliable cookie bible and chose a new recipe: cappuccino swirls.  Who doesn't love a little bit of chocolate and a little bit of coffee in their cookies? 

The fact is, I am not a food blogger.  I don't ever remember to take pictures of food while I'm making it, and I rarely make things worth talking about.  So I only have the after pictures.  But I'll give you some factoids about the process, and you can imagine what might have been happening in our kitchen. 
  1. Butter takes too long to come to room temperature when you don't think ahead.  Microwaving butter NEVER ends well, so we just went ahead with cold.  It worked out fine, with a little extra mixing.
  2. CVS doesn't sell corn starch.  And we need a grocery store closer to our apartment.
  3. The swirl part of "cappuccino swirl" requires piping.  Our batter/dough was a bit thick for our piping liking (probably due to the cold butter...).  So we went with the "ball and flatten" method.  Seemed to work fine.
  4. Flicking chocolate only works if you have thin chocolate.  White chocolate doesn't melt as well as high quality dark chocolate.  One might resort to piping the white chocolate in this instance.  One might also cut too small a hole in the piping bag, and have it blow up on top of a cookie, drowning it in semi-solid white chocolate.  All hypothetical, of course...
  5. Flicking thin high quality melted dark chocolate may result in finding chocolate all over your kitchen...
Okay, so now for the final results!

Giant pile'o cookies.  With oodles of chocolate.

They turned out tasty.  They're a bit dry... kind of crumbly, not crunchy like biscotti.  With milk or coffee they are DELISH.  Without, it's kind of like eating 15 tremendously delicious saltines and trying to whistle.  But you don't want to whistle, because you don't want to lose those few tasty crumbs...

And we watched Leap Year.  And Jen did her nails.  Roomie date day: Success.

Tomorrow, class starts.  And my new bike comes.  Should be a good day!

Sunday, January 16, 2011
It's time to start gearing up for the road season (hehe, pun intended..).  The first race isn't for another month or so (it's still gonna be FREEEZING), but we took a team photo this morning, which means I officially feel like I should haul my lazy butt outside into the cold and put some miles in on the road.  To motivate myself, I put some new tires on my bike, which don't hold up well to the trainer.  Which means I actually HAVE to go outside.  Even if it's cold.  Brrrr.  Say hi to the team! 

To get ready for the season, I decided to give my bike a nice bath today.  While it wasn't too dirty since it hasn't been outside much, it was definitely a little dusty from sitting inside all winter.  I tried to snag some nifty pictures, but there is basically no natural light in my apartment, which makes it tricky.  I got a couple I was decently happy with, although they weren't what I envisioned.  I needed light!!

Still kinda nifty.  Now, my bike is clean and my hands are covered in grease... whoops!

I'm off to eat Thai food with a friend! 
Saturday, January 15, 2011
I really should have learned this by now, but football time is in no way related to real time.  Not even close.  There are 60 "minutes" of game time in football, four 15-minute quarters.  So how is it that football games last 4 hours???  I just do not understand.

Being a person who played sports that had running clocks (soccer, rugby), I just don't understand how you can get so many breaks in a game with a clock!  I mean, seriously.  There is no way that during a bike race, we would get to the top of a big hill and say, "Phew.  That was tough.  Why don't we all just pull over here, have a rest, maybe warm our feet by the fire..."

So, why did this matter tonight?  Well, I went over to the gym towards the beginning of the Ravens/Steelers game and decided I'd hop on the treadmill and run until the end of the first half.  There were 5 minutes left in the 1st quarter, so there were 20 minutes left of game time in the first half.  With commercials, time outs, etc, I figured I'd get a nice little run in.  Well, an hour and over 6 miles later, the half was over...  Not QUITE what I had bargained for.  And that was just the first half, where they don't go unimaginably slow during the last 2 minutes like they do at the end of the game.

So, I came home at half time, ate some yogurt, stretched, paid some bills, took a shower, got dressed, made dinner, made and drank a giant glass of blue gatorade, ate my dinner (giant mound of roasted broccoli, less giant mound of mac and cheese), answered some emails, and they game just ended.

I think they should have a running clock with the exception of time outs. 

Good thing the NFL cares about my opinion...
I'm watching Property Ladder, and the girl who is tackling her first flip is definitely falling face first OFF the ladder.  First of all, she bought a house without looking at it first.  And planned to spend $10,000 in remodeling before selling it for a $40,000 profit.  Shockingly, the house was a disaster, and her budget ended up being closer to $25,000.  She didn't show up most days, her contractor couldn't get a hold of her, and she refused to lower her asking price when the place wasn't selling.  She tried to cut corners to save money on her budget... and yet she drives a gold $80,000 Lexus convertible.  Maybe we need to help her find some reality...

Okay, so that all aside, I've been house hunting too!  Not REAL house hunting.  Just pretend.  I don't even know where I'm going to be living.  But the fact that I will be moving at all means I get to pretend house hunt.  The whole "I need a garage or basement so that no one steals my bike again" gave me reason to peruse the for sale options in some of my top choice residency locations.  I wasn't looking at totally unreasonable options though.  The search criteria?
  • $90,000-$140,000
  • At least 2 bedrooms
  • Basement or garage
  • Not cavelike (that's just an instinct sort of thing...)
  • No more than 1 room of wallpaper. 
That's about it.  Not demanding :)  So, let me show you some of the houses I came up with!  (Remember, this is pretend.  But oodles of fun).

House #1:  The people who love color.

House #2:  The people who don't love color.

House #3:  The most adorable little cottage EVER.

House #4:  The one with something secretly wrong... we just don't know what it is.

So, there you have it folks.  The best of the "house" options.  Any favs?  And no, I didn't tell you where these houses are located.  That was intentional.  Remember, I'm being verrrry secretive about my potential residency choices in blog world... until I make a decision!  Sorry :)

Fake house hunting is so much fun.


About Me

I am a Family Medicine intern at a community hospital in Indiana, navigating the new world of being a physician. I am privileged to work in a field I love, where every day is a new and unpredictable challenge.
I am not only a doctor, but also a cyclist, runner, DIYer in the making, lover of the outdoors, traveler, and human.
Human, MD is a glimpse into the world of a young doctor who is just trying to stay true to herself through the grueling whirlwind of residency.


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