Wandering Spirit

I'm a wandering spirit, yes I am a restless soul
I'm a wandering spirit, there's no place that I can call my own



I've decided to move again for my clinical year -- it has been nice living 5 minutes from campus during my didactic year, but since I only need to be at the school maybe 10 times during my clinical year, I've decided to move back to the side of town I'm more familiar with and comfortable in. Which got me thinking ... this will be my 7th move in just less than 4 years. As you can imagine, you learn to travel pretty light when you don't let the grass grow under your feet. And for about 2 of the last 4 years, I lived with basically whatever I could pack into my car (the bulk of my belongings spent time in storage sheds in Michigan and Texas, as well as in my brother's garage -- even my "stuff" can't seem to stay in the same place for very long). Those of you who know me well would probably attest to the fact that I'm a sleepless nomad, so it's not so surprising, but the number of moves lately even leaves me a little stupefied when I sit down and do the math. Had to include my favorite solo Jagger tune (with rot-rod guitar by the groovy Jimmy Rip) as I've been on a rockabilly kick lately (my musical appetites shift like the winds too...) Mick name-drops so many exotic locales in this tune that I almost feel like I'm listening to Warren Zevon's Excitable Boy album.

So what's been going on in school, you wonder?

Well, after enjoying the usual test-free 2 weeks of the new quarter, I had 2 exams this week -- the honeymoon is officially over and it's all downhill from here.

In Emergency/Surgery this week, we covered the various forms of shock (hypovolemic, cardiogenic, septic, and neurogenic.)



In Clincal Medicine, we are starting the GI unit. So far we've covered Alcoholic Liver Disease, bowel obstruction, peptic ulcers, GERD, diarrhea/constipation, Hepatitis, and Irritable Bowel Syndrome, which is not to be confused with the benign condition known as "guitar face", illustrated below by Gary Moore, one of my favorite Irish guitarists :



To the non-guitarist readers, I know what you may be thinking, and let me just say that no, "guitar face" and passing a kidney stone are not related either. It has more to do with a hyperemotive personality state or a manic phase -- a sublime channeling of one's emotional essence that makes its way from the soul and into the fingers and then is transformed into electrical and sonic energy. Someday I'd love to study the physiologic effects that music has on the body...

And with that, I'm off to sequester myself to study for my Pharmacology exam on Monday.

It's Not Easy Bein' Green

Happy St. Patrick's Day everybody! Hopefully you are all celebrating for me tonight. I am spending the night in, studying for a few tests coming up. It is soooo tempting to just walk down to the local dive and have a green beer or two (though I would be having a Guinness with a shot of Jameson's, followed by a Black and Tan), but I find it easier to be a teetotaler when classes are in session, and saving up for the breaks to cut loose a bit. I guess I don't trust myself to have only 1 or 2 drinks -- once you're bellied up to the bar, it's too tempting to have that 3rd, and then a 4th, and so on...

Even though I just had a Van Morrison tune on my last post, I wanted to post "Bein' Green" for today and his is by far my favorite version (no offense Kermit), plus he is a Belfast boy after all, so all the more appropriate for today.




None of these folks got pinched today, like I did -- I had it coming though for not donning the emerald...













Well that felt good to bask in my sci-fi/fantasty/comic book fanboy geekdom a bit.

Not too much else new to report here -- just easing into my 4th quarter and starting to get a good feel for the new classes. This semester has some classes which only have a midterm and a final -- I'm used to all of my classes having 4 or at least 3 tests per quarter. So it looks like there will be some short bursts and flurries this quarter, followed by periods of relatively laid-back weeks. Granted, there will still be plenty to keep me busy, but it's nice to know it won't be another all-out blitzkrieg like last quarter.

Going to the state PA conference later this week, which should be interesting. I've done OT conferences in the past, but this will be the 1st big gathering of PA's I've attended. Our school is having an alumni get-together, so it will be nice to see exactly what/how past graduates are doing out in the "real world" aka the work force. I have to say that as much I gripe and moan about how rough this program is, and as eager as I am to get back into working myself, I think a part of me is going to miss living in the relatively safe & sheltered cocoon of academia.

Today's Tomfoolery: today's image is an inside joke of sorts for my brother Aaron -- I refuse to let this die just yet!

And The Healing Has Begun

(Camera is static & far away with no zooms ... but the performance itself transcends)

Well, things are slowly going back to the way they were. I had to channel some Van Morrison as I've been listening to him quite a bit lately -- something about his music does seem to bring comfort in times of distress and melancholy. He's a poet with prodigious pipes. This song is from his 1979 album Into the Music, and the title says is all. It's amazing how good Van the Man sounds 30 years later...

I just want to take a quick minute to thank all my friends and family for their support and condolences in the last week. It was amazing to see everyone rally to offer their assistance in a very somber time for me and my family, when we needed it most. You all are amazing, and I'm lucky to have you in my life...

Now it's time to take a deep breath, regroup, and get busy living. Gramps would surely have wanted it that way.

I have just completed my 1st week of my last didactic quarter. I suppose a description of my load this quarter is in order...

First, a couple of continuing classes:

Clinical Medicine III: Part 3 of our "bread-and-butter" class. This go-round, we are covering endocrine disorders, infectious diseases, GI problems, seizures/strokes, and many other various and sundry disorders, afflictions, maladies, endemics, and sicknesses. We have the small group case studies once a week as well, where we are presented with a new patient each time and work collaboratively to do the history and physical exam, formulate a diagnosis and plan, and then write up the SOAP note, complete with prescriptions.

Lab Medicine II: Part 2 of our lab class. This quarter we are covering thyroid tests, liver function tests, tests for infectious diseases & rheumatologic disorders, blood cultures, radiology, diabetes, arterial blood gases, heart sounds, and pulmonary function tests.

Pharmocology II: This quarter we are covering CNS drugs (sedatives, hypnotics, antianxiety, antidepressants, antipsychotics, opiods, Alzheimer's/Parkinson's drugs), antibiotics, chemotherapy, antiepileptic, corticosteroids, contraceptives, GI drugs, asthma/allergies, migraine/gout, & analgesics.

And now for the new classes:

Emergency Medicine/Surgical Procedures: This class is going to cover all kinds of procedures that you would come across in the ER & surgery. Some of the topics include: airway emergencies, trauma, shock, altered mental status/drug intoxications, wound healing, chest pain, neurologic emergencies, metabolic emergencies, orthopedic procedures, and burns.

Psychiatric Principles: This is going to cover all of the major DSM IV diagnoses like psychotic, cognitive, personality, depressive, anxiety, somatofrom, eating, sexual, and bipolar disorders.

Pediatrics: You know, for kids.

ACLS: This class will get us certified in our cardiovascular life support skills. One of the new techniques coming into favor is CCC or continuous chest compressions, as opposed to the traditional CPR.

Medical Spanish: This is an elective but I figured it would come in quite useful. I have picked up quite a bit of colloquial Spanish over the years just from living in Arizona, but this class is more focused on terms/phrases I'll use in practice. I have a cousin who teaches Spanish as well as an aunt from Venezuela who works as a Spanish courtroom translator, both of who have been encouraging me for years now to brush up on my linguistics. I've considered trying the Rosetta Stone software as well and never got around to it. Maybe at the end of the quarter, I can try making a blog entry en Espanol.

I also have some other infrequent or independent study classes this quarter as well, such as my Clinical Master's Track course (going to focus on my clinical specialty and start building my portfolio this quarter), Interdisciplinary Core class, and the PCP or Preparation for Clinical Phase classes. I do think it will be somewhat easier than last quarter, as there is only 1 hardcore science class and more practical medicine courses. That being said, it's still going to be a breakneck free-fall to finals.

Today's Tomfoolery:

Cheers to a new quarter!

I Still Can't Say Goodbye

I lost my grandfather Ruben yesterday afternoon. He truly was my hero, and taught me everything there was to know about being a good person -- working hard and diligently, being a devoted husband, keeping the faith, getting involved in the community and neighborhood, spending money wisely, developing a keen sense of humor, becoming a shrewd Euchre player, and so much more. He was the pillar of the family, the toughest man I've ever known yet gentle and kind, and had many nicknames over the years -- Mitz, Kenobi, and Redwood just to name a few. He also was responsible for the nickname of myself and my 2 brothers -- aka "The Hoy Boys." This came about because when we would visit my grandparents (who we lived next door to growing up and saw nearly every day), my grandpa Ruben would greet us with "Hoy!" rather than "Hello." Somewhere along the line, the family came to know the 3 of us as the "Hoy Boys" and the rest is history ...

Here is a picture of my brother Peter's license plate, in honor of that nickname that has stuck for over 30 years now:



My grandfather was also a carpenter by trade and kept quite busy after retirement, working in his workshop in the back of his garage, creating all kinds of projects for friends and family. He had a remarkable knack of looking at something and figuring out how to make it in his head -- it always amazed me how talented he was at that. One summer my grandpa, my dad, my 2 brothers, my Uncle Dave, and myself built a 2 car garage with attic and workshop in our backyard, basically from the foundation up. Grandpa and the rest of us even built the trusses for the roof -- although I'm not nearly as handy as my dad or my grandpa was, I will say that I learned a lot about blood, sweat, and tears on that summer-long project. I also remember one school project I had asked grandpa to help me on -- we had discussed it the day before, and the morning he was going to help me, I woke up and walked over to his workshop around 6:30 a.m., figuring he would be getting the wood together and waiting for me. To my surprise, he had been up early and finished the project all by himself while I was still sleeping!

He made many varieties of birdhouses, and the one that my parents mounted on their back deck was a famous haven for all of the many cats we had over the years. Here is a good example of that birdhouse in full use:






I think the hardest part of the last week has been the fact that I wasn't able to go back to Michigan to say goodbye to my Grandpa. When I got the news that he was sick and had inoperable cancer, I was just preparing for my 2 weeks of finals. By the time finals were over, he was very close to the end. I am grateful that I spent almost all of my 2 week Christmas break back home and had many great visits to him. And over the last week, I was able to talk to him on the phone and let him know how much I loved him. I'll never forget the last words he spoke to me -- he told me he was proud of what I was doing in college and wanted me to keep working hard.

There is so much more I could say and yet it's hard to find the words right now too. He was a role model for myself and my brothers and I really miss him. Somehow I think he is still watching over his family...

They say a picture is worth a thousand words, and so I'll end with this video I made tonight with some of my favorite pictures of my grandpa. I want to thank all of my friends and family who called and contacted me after getting the news to offer words of comfort and support -- it really means a lot to me.

I'm Good Now

Well, the dust has finally settled and I find myself surviving the toughest quarter yet. The last week of finals was a endless parade of semi-consciousness and went by like a blur. One of my professors even commented that I looked like I was sleepwalking. I think I slept for almost 14 hours straight following my last final. It feels extremely odd to wake up in the morning and not head immediately for the book bag. I find that I almost don't know what to do with the free time.

For the meantime, I suppose I will just be thankful for making it through another quarter. Performance-wise, it was a bit of a mixed bag; I didn't get as many A's this go-round, but on the other hand I passed all of the 20+ tests and don't have any C's either. In other words, I'll take it! Success these days is measured by being able to move on to the next semester rather than letter grades.



Doubt I'll be getting into too much trouble this week -- have a lot of odds and ends to catch up on and need to go look at some apartments for my upcoming clinical year. It's starting to really warm up already -- high of 89 tomorrow so perhaps a little pool time is in order.



I've had Curb Your Enthusiasm in heavy rotation lately -- here is one of my all-time favorite LD moments, where he does what he does best -- beating a dead horse and prolonging an argument by repeatedly insisting his point of view and refusing to "let it go" in the infamous "Doctor's Phone" segment:



Well, I'm off to enjoy my brief down time and recharge for my *last* didactic quarter, which hasn't really sunk in yet and doesn't seem possible.

"Life is never made unbearable by circumstances, but only by lack of meaning and purpose" -- Victor Frankl