Friday, March 27, 2009

Back to work program, part two

Yesterday I dragged my jet-lagged ass back to work, after two glorious weeks on the soft underbelly of the planet.

Service isn't too bad right now, only 16 on the board and we actually shrank despite 6 admits overnight, but it still is work. I have 73 more days (10 weeks of work + 3 days of clinic at the end) to knock back, actually now 71 since I have worked 2 days. Not that anybody is counting. In some sense I don't know what I'm looking forward to, because it's just more work after the Big Move. Just different work, in a different place, without fewer shooting galleries and vacants and pit beef sandwiches.

Tuesday, March 10, 2009


Me and my superhero-movie watching buddy went last night to see Watchmen. I own the book and enjoyed it, although not in the life-changing way that it has affected others who belong to the Church of High Geekery. Like most fluff that I have processed, I remembered parts of it but forgot most of it, to which my friend (who has a better memory than I for most things including this) filled me in on the way to the theater.

It has been getting pretty mixed reviews. All in all, I found it very watchable -- it held my attention for the two and a half hours without any problems. It was a superhero movie, and was about as true to the story as could be expected (while fixing the original awful ending). There were some very, very noticeable fatal flaws though:

1) The violence in it was not only over-the-top, it was unnecessarily graphic and gory. Slow motion leg breaks, cutting the arms off of people, etc. I'm not normally bothered by cartoony violence (i.e. Kill Bill or a slasher movie), but this was so gratuitous that it made both of us turn our head. And I debride abscesses for a living, and my friend slices up eyeballs (oh oh oh oh - 5 points to name the song).

2) The acting, and especially the sex scene, of the girl was just terrible.

most of all, though

3) The music selection was unbelievably awful. We both commented on this as soon as the final credits began to roll over a My Chemical Romance (ugh!) heavy metal (ugh!) cover of "Desolation Row." Vietnam war footage to "Ride of the Valkyries"? How cliched is that? A funeral for a right-wing nearly fascistic superhero set to "Sounds of Silence"? "99 Luftballoons" just thrown randomly in some scene? A fight scene to "All Along the Watchtower"? A flashback to "The Times They Are A-Changin'"? Cliched at best, totally inappropriate at worst. The low point was the aforementioned terrible sex scene set to the original Leonard Cohen version of "Hallelujah." It was almost laughably bad.

Saturday, March 7, 2009

Lighten the mood

The most ridiculous thing I have seen for a while.

18 large hot dogs!


Priya died one year ago today. She was 29.

In Memory of Priya

Our program is kind of odd that we grow very close with the people in alternating years -- 1st year interns are mostly supervised by 3rd year residents, who are mostly supervised by a chief who was a 3rd year when the 3rd years were interns. There are only a few opportunities to work directly with the 2nd years, who are off at Bayview or elsewhere. Priya was a year ahead of me, so our direct interaction was limited to time we had together in the CCU.

Priya was my CCU resident when I was an intern for just one night of call, and also on my CCU team for another 2 weeks. She was also in my firm, so I knew her pretty well through that. But it was clear from that short time that she was spectacular. When she was a senior resident, she was one of the strongest and the most respected in our programs. Indeed, we learned at her funeral that she was offered one of the 4 chief spots.

It was obviously incredibly painful to have someone so young and promising die. Nothing good can be said of the whole thing. But there were a few points to take away from the whole thing. When Priya got sick, she was choppered in to our hospital from the community hospital to which she had been admitted. She had the heads of many departments at this hospitals pore over her case. Her case was discussed by world experts in neurology, infectious diseases, rheumatology, pathology, and of course internal medicine. Everything that could be done was done. Every stone that could be turned was turned. Not only did she pass, but even after an extensive autopsy, we never arrived at a diagnosis. She will never let us forget that we are always limited in our practice of medicine.

The other thing that can be said is that this program is much more like a big extended family than it is like a regular job. First, obviously, the pain of the loss that we all felt was more akin to a family member than it was for a co-worker. Second, the whole program pulled together, coverage for people who needed to attend the funeral and the other events was arranged without an eyeblink, and support was put into place. I try not to drink the whole "#1 hospital/#1 program" Kool-Aid, but I think it is a huge testament to our program.

Priya will be missed. There will be a dinner for her tonight which I will try to attend despite pulling this 18 hour overnight->day shift.

Wednesday, March 4, 2009

Wednesday morning, 3:40 AM

So far, the night has been silent. No admissions for either me or mi compadre, the other resident admitting from 1 AM to 7 AM. That either means that it will stay silent (note how I avoid the "q" word) or that all the admissions will be backlogged right to the time that I start getting groggy at about 5 AM. Since mi compadre has an interview this morning across town, I'm taking all of the late admits. Which of course means that we are talking backlog. I could lay down and sleep now, but my schedule is messed up enough that I'm not at all tired. It's gonna be great when I go to day shift in a few days.

Just catching up on reading, which means instead of this week's NEJM, I just read a fantastic article on a systematic analysis of why Billy Joel is so awful.

I should really go read this week's NEJM...

Sunday, March 1, 2009

It's March!

It's March!

4 months until the Big Move!