My Journey Towards Becoming a Doctor

Hello All

2011-05-29T10:13:00.000-07:00

First off, the rumors of my demise were greatly exaggerated. I did not die, become a Tibetan monk, or join a cult. I was simply lost in the jungle of studying for the MCAT (there's a summer goooooooone) and applying to medical school.

The long and the short of it: after 38 essays and 400+ hours of studying for the MCAT I was accepted into medical school. I'll be attending the Kirksville College of Osteopathic Medicine in my home state of Missouri beginning Fall 2012. (Ironic that my username used to me "WanabeMD" and I'm going to a DO school ay? More about that later)

Yep, 2012... I deferred for a year (and my parents ARE talking to me again finally). Why? I wanted to continue working for the Search and Rescue team- especially as short staffed as we are. I wanted to finish my research at the Neuromuscular Function Laboratory and I wanted to explore the mountain west for one more year before I bear down on the next umpteen million years of studying, boards, clerkships, interships, residencies, etc.

You can follow the adventures of my girlfriend and I here. Our goal is to hike, bike, run, and climb to at least one summit a week until we move back to Missouri.

I'm not sure if I'll post more SAR mission stories on here. I got in a bit of trouble despite my complete fabrication of hybrid patients. We'll see....

Buried Alive, part 2

2010-03-02T20:13:00.000-08:00

Wow.... this took a while to finish. Trying to get a paper written and its A LOT more work than I expected. First author though!!!!

So what was being buried alive like?

It was warm, honest to god- under the snow I was never really cold. I had some intermittent shivering but that's it. My core temp (which is usually a little high) never dropped below 37. Begin the alpine fat jokes now... I was only in a mid weight capilene and gore tex suit.
NG tubes SUCK. I gagged, and gagged, and gagged even with the nasal lidocaine, spray lidocaine, and lidocaine gel. I wish that upon no patient, ever. This reaffirms by belief about performing procedures on professionals before they'll do them on patients. I've been strapped to a backboard for 3 hours, had an NG tube dropped on me, had an epidural, and had venous and arterial catheters put in. I can for sure relate to patients a lot more.
Even sitting upright (think a snow recliner) in the snow, I still got vertigo. There were moments of confusion. I'm confident that if ever buried for real I'll have no idea which way is up
I couldn't move one inch and the snow was just boot packed around me. The avy debris I've dug through was much, much, much harder. SCARY.
I was under the snow for an hour but it went by really quick. I was bored, but I meditated and got through it. One guy pissed himself.... I was really happy I just didn't eat or drink that morning.
Once they dug me out I got really, really cold. As per protocol, I was placed in a hypothermia wrap for an hour while they continued to measure my vitals, etc. Once I hit the air (even in a sleeping bag, tarp, and sleeping pad), I started shivering violently. So violently that my whole body was sore the next day. The rewarming was the most miserable part.
It couldn't have been that bad... I went back and did it the next day =)

Buried Alive?

2010-01-08T17:42:00.000-08:00

Not many words for now, just pics. But being buried was quite interesting.

Getting ready to be put under sans helmet. The wires you see are finger pulse oximeters, forehead skin temp probe, EKG probe, rectal temp probe, and O2/CO2 monitors.

Begining the burial.

Halfway under, the snow was packed hard around me so I couldn't move more than a cm. The heavy wire you see was my radio to the surface.

All the way under. Only 60min to go at this point...

They look nice and warm don't they?

Headlights... no, not THOSE headlights

2009-12-31T09:02:00.000-08:00

This callout still sticks in my head for a few reasons.

First, it was the first time a dead body bothered me. It was the first time I really thought about it once I was done, the first time I shed a tear about it, and the first time I dreamed about it. I still don't know why.

Second, the night was absolutely gorgeous. The kind of night that brings you back to alpine climbing again and again. This contrasted sharply with our mission.

Third, I LOVE my petzyl head lamp- but it is not enough light to ski by and is makes a true search in the trees difficult. Being a self confessed gear whore, I wondered what I could do about this.

When doing 24 hour mountain bike races, I have a really nice, light, bright light set up made by NiteRider. Two on my handle bars, one on my helmet and I usually run faster laps at night than I do during the day. I would love a similar headlamp possibility on my ski helmet.

There is a helmet mount already made:but it is intended for mountain biking helmets with ample open vents for the velcro straps. I'm planning to try epoxying it onto my Giro G9 ski helmet to see if it may be a viable option for holding a light. The battery pack would either go in my backpack or jacket. Anythoughts?

Mountains Are My Home

2009-12-30T08:53:00.000-08:00

First, check out my good friend and former roommate's blog:
Mountains Are My Home

He's a super talented rando racer, mountain bike racer, and all around good guy!
He was with me on one of my worst back country touring days ever (Tele, SURE I remember how to tele!), some loooooooong ass mountain bike rides (7 hours? no prob), and introduced me to Mate tea (for which I will always be thank full).

Torture Test 2010

2009-12-27T07:26:00.001-08:00

No callouts
More gear
Yay Christmas!
Home for Christmas and Santa was nice enough to bring me a few really nice pieces of gear that I will be beating the shit out of as soon as I get home:

Rab Mountainering Neutrino Endurance Jacket

750 fill down
A giant freaking hood (I have it over my Giro G9 size XL ski helmet in this pic!)
638g (on my postal scale)

Mountain Hardware HeavyWeight Gloves

Full leather palm... ohhhh yeahhhhh
Longer cuff than most "liner" gloves

REI Performance Headliner

Neck Gator
Full Balaclava
Pretty lightweight

All of which should come in handy during the upcoming cold days and nights on the snowmobiles and skis during back country rescues. Last year I didn't have a puffy with a hood, that made belay stations very chilly. I know some people aren't a fan of the hood, but I've wanted one for a while. Rab has started to become popular in the US with excellent recommendations on their gear from a few of my friends.

The helmet liner should be excelent as well. Considering the size of my head it seems like it'll fit under my climbing, skiing, ans snowmobile helm

Gear You Can't Live Without

2009-12-17T22:47:00.000-08:00

I'll admit it, I'm a gear whore... unabashedly a gear whore. Luckily, I live in a house I work on rather than pay rent for so I have some extra money to buy gear. The whole being single with no kids thing helps too.

While I own a fair bit of gear (like a lot of us it takes up an extra bedroom), I'd like to think its because I'm picky with what I use. Hence, I'd like to begin a series about "Gear I Can't Live Without" based on my favorite packs, boots, ice tools, and other expensive shiny things I've tried to kill without success. Gear Like:

My Cold Cold World Chaos Pack

The La Sportiva Nepal Extreme Boots

and

Petzyl Gloves and Headlamp

That are always in my car ready to go.

Before I tear stuff apart one at a time, what have been some of your favorite pieces of gear? Anything you can't live without?

A Lesson in Redundancy?

2009-12-02T19:18:00.000-08:00

http://www.sltrib.com/ci_13873501?source=most_viewed

I think there are a lot of people in the high angle rescue community who would like to more specifics about this. I hope they surface soon so that we can all learn something.

First off, I realize that any enclosed space rescue is difficult. If you add a high angle component it increases the complexity by quite a bit. Combined with a patient that is circling the drain fast and you have a rescue situation I hope I'm never placed in.

That being said, most rescues should be a "back to the basics" affair. I think it's unfair to say that "the equipment didn't fail, the rock did". The most basic part of your system is your anchor- it IS a part of your equipment in my eyes. If there are doubts you need to increase the redundancy until your safety factor (our team uses 10:1) is reached. If using man made anchors (bolts, cams, nuts, hexes, etc) then your suspicion should increase and so should the redundancy of your system. This often entails using many more anchor points than you would have otherwise to avoid a system failure. Why would you build a system that would put your patient's life in danger if one component failed?

My condolences to the patient's family and friends, along with the rescuers involved. Here's hoping we can all learn something...

Get Back on That Horse

2009-11-19T15:27:00.000-08:00

I never was very good at horsemanship....

Physics over the summer, an ass ton of callouts (four, FOUR on one day) and my research have taken priority over this blog. I missed it though, so I'm back (thanks, AlbinoBlackBear for awakening me from my slumber).
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I've decided to apply for MD/PhD programs. That's how much I've been liking my research as of lately. The key will be finding a program where I can keep doing what I love and still fund me. Its an interesting mix of exercise science and medicine. Really, its exercise as a specific treatment for chronic pain. I think I'm going to get a masters first, especially if I get the big mutha' of a grant I just applied for.
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Rescues have been lacking as of late now that there's just a little bit of snow on the ground. Not enough white stuff to play in or slide, just enough to make it muddy. The few rescues we have had we're impressively fun.

This weekend entailed a full on alpine rescue. First, in the dark then into the next morning and afternoon. Granite covered in Rhine ice, a little snow, some really stuck kids, it made for a challenging rescue.

Highlights: A helicopter offload at 8,000 feet with one skid on a wee small granite fin, stepping out onto snow and with full packs on; beautiful alpine rock and ice; everyone surviving (I didn't think we were going to make it there in time); getting to watch my good friend and roomate lead his first rescue team in to support our helo team; getting hoisted off the mountain- I always feel like I'm flying hanging beneath the rotors of that beautiful bird.

It cannot be stressed enough: no matter how many times I get to play with the helicopters they still give me a giant woodie.

Lowlights: Getting hit in the chin as the helicopter peeled off the mountain in a wind gust; wondering all night if these kids were going to die because I couldn't get to them till the morning (and not sleeping one wink because of it); having to tell a patient that they were "just going to have to hold on till daylight" for the first time because my team couldn't climb to them in the dark; having to tell a new team member to take his comments off facebook because of the poor things they said about our patients- and the attitude I got back from it.

I'll try to upload some video we shot during the rescue but until then enjoy the poor quality pics I grabbed off the news:

Sorry

2009-07-06T21:42:00.000-07:00

I can't finish the last series of posts... its just not going to happen. Hopefully I'll have something else to write about soon.

Two Rules

2009-06-17T19:07:00.000-07:00

1.) Its no fun to climb and die

2.) Learn to down climb, it will save your life

that is all, back to physics

ThreeFive Days in the Water Part Two

2009-06-17T16:15:00.000-07:00

Did I say three days in the water? How silly of me; I meant Five. Allow me to ruin the end of the story for you. We didn't find the body, rarely do we ever find the body. But, we sure as hell tried.

Like any story worth reading; this epic has a girl involved. Actually, a really hot girl, some damn good ice cream, a $50 bottle of port, and my hot tub. Then my fucking pager went off (to which the first words out of my mouth are always "oh shit") and that will be the last we ever hear of that girl.

The page was its usual cryptic self:
"S&R CALLOUT SEARCH OF 10YOF RESPOND TO (GETTO) BRING DIVE EQUIPMENT"

Translation: the kid is dead, he's been in the water for an hour before fire called us to find the body. Never mind that we have an actual fast response rescue team. I guess someone at the station forgot to set the TIVO and they had to head back home to catch House.

I changed into my wetsuit at my house (in front of a very perplexed female, I guess I didn't explain what I do very well) and high tailed it to the scene. By the time I got there it was the normal multiple agency cluster fuck. I was assigned to build the grid- a giant man made strainer down stream- but got pulled into a zodiac for a bank search. Of course, I didn't clear that with my commanding officer and got an ass reaming for it that night.

A lot of people on our team readily assume that every water call out is a body recovery. They're right 98% of the time; but that's not good enough for me. I grabbed (stole...) a jump bag from the ambulance on scene just in case. I can't image how stupid I would feel if I found an *almost* dead patient and didn't have shit on me to help.

Of course, the bank search was uneventful and we went back to probing. A lot of people ask how we find bodies in the water. We pick the most likely spot they could be and see if we can snag anything with a giant metal pole with two or so hooks on the end. That is when most of my friends stop asking what I do... gruesome indeed.

Darkness fell, the rain started, and the fishing continued. We had three people in the zodiac- one running the outboard, one probing, and the other holding onto the bottom of the bridge so we'd stay in one place. We found a lot of shit- blankets, pillows, signs, shopping carts- all of which feel A LOT like a body. Each time we'd get our hopes up, only to have them be killed. It could be worse, we've found bodies in this river in past searches... that weren't the body we were looking for.

Midnight came and command sent us home with the promise that we'd be there the next day bright and early. My dreams were short (as was my sleep) and weird; it wasn't until I got home that I realized EXACTLY what we were looking for:

someone's daughter
someone's sister
someone's niece
some little kid's best friend
some little boy's first crush

Dammit...

Three Days in the Water, Part One.

2009-06-14T18:32:00.000-07:00

Its been a while since I've had anything to post on here. Its been

QUIET

DEAD QUIET

(may the ems god smite me... fuck them)

Until this weekend any way. Friday we were called out to a 3 year old who fell in a creek while chasing her dog. I had just began an exam when the page went out. I glanced at it and all I had to see was "3 year old" and "swift water" and I was out of my seat and heading towards the door. The TA confronted me, I explained the situation (swift water rescues are one of the few times where our response time means life and death) and continued out the door.

"I'm going to fail you" was the last thing I heard. I couldn't care less- I don't think I could ever forgive myself if a kid died because I wouldn't leave some pointless piece of shit exam. I hauled ass to my partners house. He was waiting, wetsuit on, so I let him drive while I tossed mine on in the car (I'm sorry to everyone on Main street i flashed).

As we drove we checked in on the radio reports; witnesses were reporting seeing her, still alive, further and further downstream. We adjusted our course accordingly (wishing our friggin department would give us blue lights the whole time) and finally hit a part of the steam accessible to the road downstream from her position.

We readied for a "live bait" rescue. In escence, something like this:
One team member has a rope attached to his rescue PFD and stands poised at the waters edge or on a rock while the other team member gets ready to belay him from shore with the rope. When the "swimmer" (patient, victim, w/e) is in sight and slightly past the rescuer in the water he makes an elegant swift water entry (belly flop), grabs the swimmer, and is then pedulumed to shore by his team mate who hope fully still has hold of the rope. The difficulty of this maneuver is compounded by a struggling patient (yes, I hit them if need be), and the shear idiocy of jumping into the very situation killing your patient.

I couldn't have been more surprised when we hit the shore and there was our little girl, laying in the shallows... face up. My partner gave two quick rescue breaths (without a barrier... oops) and just like that the girl coughed up a little water, gave a wail, and pinked up. The ambulance was right on our ass so we handed her off to the medic and that was the last we saw of her.

I got to finish my exam... and I got the high score in the class... eat that Mr. TA!

New Packing List

2009-05-16T14:44:00.000-07:00

They say that you can tell an EMTs experience by the amount of shit on his belt. The more shit there is, the less experience he/she has. I think the same can be said for SAR; except I carry everything in the back of my car. Now that its summer I can get rid of most of my winter gear (skis, avy gear, etc) and I took hard look at what I was carrying.

My goal was to have a pack that was ready for 90% of our missions pre-packed in my car. This includes food, water, etc. I use a Lowe Alpine Alpine Attack 50 for my SAR pack because it *can* be a load hauler when I end up with the 600 foot static line or I can compress it down if I'm in the HASTE team.

I was always amazed at the small size of the packs carried by experienced members on our team. Especially considering they ALWAYS had what they needed. Now, I understand why. Speed= safety (as long as you have the crapola you need). Here's what I'm keeping pre-packed:

Lowe Pack

Top Pouch

i. Map

ii. Compass/ Whistle

iii. Pro Bars (2)

iv. Pair of socks

v. Laser Pointer

vi. Safety glasses

vii. Headlamp

viii. Fire starter + matches

ix. Sunglasses

Main pouch

i. Team shell

ii. Team fleece jacket

iii. Team fleece vest

iv. Team fleece hat

v. OR waterproof gloves

vi. MH fleece gloves

vii. Helmet

1. headlamp attached

viii. Climbing bundle

1. 3 Omega Team Carabineers

2. 15’ webbing

3. 20’ webbing

4. Personal prussic cords (2)

5. Black Diamond Alpine Bod harness

6. Petzyl gloves + keeper carabineer

ix. Climbing harness

1. ATC + belay carabineer

2. Personal Purcell

x. One Nalgene (water)

xi. One Nalgene (gatorade)

Outside pocket (crampon pouch)

i. Team first aid kit

1. Trauma sheers

2. BVM

3. Gloves (Large)

4. Bio Bag

5. Kerlix Roll

6. 4 X 4 gauze (4)

7. 8X 10 Combine dressing

8. Cavet bandages (2)

9. Mole Skin

10. Triple antibiotic packages (2)

11. Antimicrobacterial wipes (3)

12. Ibuprophen (2)

13. Diphen (2)

14. Bandaids

15. Bug X towelette

16. Sunscreen

17. Sting relief

ii. Sam Splint

So that's about 1000 calories plus a combination of clothes that will keep me comforatable in a range of conditions. I'll drop my primary climbing harness before we set out if it doesn't look like we'll need it- its a super heavy (comfy) big wall harness but I'll keep my main climbing kit because a simple carryout can require belays very quickly.

Also, in the back of my car ready to go is my radio chest harness. Now, I'm not a huge fan of this thing. Its hot, heavy, and seems to get in the way. I'd rather toss my radio in my crampon pouch on my pack and run the lapel mic up to my shoulder strap. I'm still afraid to not have somethings attached to my body (space blanket, radio) so
for now it stays:

Radio Pack

4 X 4 bandages (2)
Space Blanket
Sharpie
Pen
Notepad
Small flashlight
Team medical form
Two pair large medical gloves
One pair each: small and medium gloves
Medical reference card
Small gerber
800 mHz Radio + Lapel mic
Medical tape
Ear plugs (helicopters)
AA/AAA batteries (3 each)

Finally, I have two small duffels I keep in the back of my trusty subaru. One is specifically for swift water rescues and the other has some snow/ice gear (there's still a lot at high altitudes) and my normal clothes/boots I wear on callouts.

Duffel

Tall leather boots (socks + gaitors inside)
Mountaineering boots
Crampons
Ice Screws (6)

i. 10cm (2)

ii. 15cm (2)

iii. 17cm (2)

DMM ice tools (2)
BD Ice Ax
MH winter gloves
MH prima loft jacket
Green team pants
Team short sleeve t-shirt
Synthetic boxers
Long sleeve synthetic shirt
AA/AAA extra batteries (10 each)

Swift water duffel

Swift water PFD

i. Whistle

ii. Knife

iii. Attendant line + locking carabineer (LOCKED)

Helmet
Neoprene gloves
Neoprene socks
Wetsuit
Old tennis shoes
Throw rope

That's still a ton of stuff, but I'm open to ideas of what I can get rid of....

Quite Possibly the Finest Prank Ever

2009-05-15T11:00:00.000-07:00

I credit myself for being a little bit of a prankster... Its a defense mechanism and a way of reminding my self that none of us are really all that important. Usually, its little stuff. Like sneaking into one of our deputies cars and turning up the radio so that when he turns it on in the morning he'll be bombarded with Mexican polka (bonus points for taking the radio control knobs off or covering them in KY) or tying my team leader's boots to the litter as we're practicing carries.

One deputy I work with took the cake though. We were doing a body recovery. A really, really bad body recovery. The kind where you bring the pieces out in small trash bags as you find them and hope the patient had good dental records.

Well, for some reason, the patient's ear was found far, far away from the rest of the pieces of the body. The ear was placed in its own bag and because of that forgotten about when the rest of the pieces were handed over to the coroner.

This deputy realized his mistake about an hour later, and sheepishly told our commanding officer. Our CO's reply:

"Fuck, well just throw the damn thing away, none of us ever saw it..."

Ay, ay captain, and so it was done, or we thought.

Not long after the call out the afore mentioned deputy and went to grab us sandwiches after the call out. Our CO had been bitching all day about how hungry he was and how long the recovery was taking, etc, etc, etc.

The Deputy returned from his food run, handed out all the boxes of food, and (quickly) walked away. Our CO opened his sandwich box, opened his hoagie to pile on the mayo and letuce and there, smack dab in the middle of his ham was the ear that had been "thrown away".

Our CO immediately recoiled, and chucked the sandwhich at the (now running) deputy. After a brief pursuit the deputy handed out CO his real sandwhich, the ear was finally thrown away, and one of the better pranks in our department went down in infamy.

Happiness

2009-05-14T12:24:00.000-07:00

Happiness comes in many forms. Today it was:
200 rounds through this:

And 49 rounds through this:
And 3 seconds between shots rule at civilian ranges? WTF?

Still haven't decided what I'm getting when I get my concealed carry permit.... probably neither one of those. Leaning towards a SIG.

To ALS or BLS, that is the question

2009-05-13T19:24:00.000-07:00

I loved Kelly's new writings on EMS1:
http://www.ems1.com/medical-clinical/articles/492833-Too-Much-of-a-Good-Thing

But I'm curious, if EMS is the spinal tap what is SAR? The bastard, kinda dumb, jockish guys? I think so...

But the question remains, is there a place for Advanced Life Support capabilities on a mountain search and rescue team? Many argue yes because of the long transports of critically injured patients.

However, I argue no for a few reasons:

Most patients, by the time we get to them are either dead or stable. I have to leave work, change clothes, get to my car, drive to the callout (without being able to go Code 3...), hike/fly/ride into the patient and then transport them out. We're talking hours here.
It is damn near impossible to get an IV to stay in and active while moving a patient through the terrain we deal with. (If anyone has any ideas let them rip). Cold skin just aggravates the problem.
ALS would mean more shit I'd have to carry in, and I already have a lot. Plus, meds would have to be kept controlled and current. That would be impossible in the back of a civilian car and hard in a non medical (Sheriff's) truck.
In my opinion, and this has always been my opinion with EMS, the fastest way to the hospital is the best way. Get in, get the patient, get them the fuck out....

Will I still go to paramedic school if the department pays for it? Hell yes I will.

Guilty As Charged

2009-05-09T20:18:00.000-07:00

I leave town for a week and miss TWO, TWO friggin rescues. Seriously, I'm thinking the worst thing for the welfare of mountain going folks in my county is for me to leave town (this has happened quite a few times).

I feel guilty. I should be there helping our relatively small rescue team out with these (especially when there's two in one day). Instead I'm sitting on my ass in my parents house, where I'll be for the next week. If there's more rescues I'm tempted to fly home NOW.

Should I feel guilty? We're a volunteer team- I don't get paid a dime to go on rescues that will occupy 500+ hours or so of my year. In fact, I buy most of my own gear for those rescues. So who cares that I'm home and enjoying time with my family? I do... I love going on call outs, I love the challenge, I love the rush, I love talking to the patients on the way home, I love it all and get pissed when I miss out- end of story.

I'm going to get so much shit at the next meeting....

My fake craigslist personals

2009-05-05T21:14:00.001-07:00

What do I do in my spare time? Post shit like this to craigs list:

Geek seeks an MHC with the right antigen shape to bind to his Tcell. I keep trying to find the right one but they seem to be MHC-1 and I need an MHC-2. Can you be the second signal to my receptor site?

How do you know when you've been teaching too much?

2009-05-05T14:37:00.000-07:00

11 lectures a week for three weeks....

According to my girlfriend, I've been lecturing in my sleep. As in reciting my power point slides, talking about shock, and walking through the primary and secondary assessments. This is nothing new. I've always been quite the sleep talker. Even going as far as too carry on conversations (that I have NO recollection of). I'm also known on our SAR team for being able to fall asleep when ever, where ever and be up and awake when I need to be just as fast.

The icing on the cake was when she woke up to me doing a full head to toe patient exam on her. An exam:

I don't remember one bit of
In which I was asking her the SAMPLE questions
I even kept my hands together when I palpated the sternum (so I didnt "cup" her... not that I haven't used that excuse on dates before...hehe)

Seriously, WTF?
Just say no folks:

I want...

2009-05-03T17:12:00.000-07:00

I want....

A teacher that won't mark a question wrong because I didn't regurgitate what he said in class word for word; but rather integrated my knowledge of outside sources and answers into a comprehensive answer that actually showed thought and/or knowledge of a subject that the professor is woefully behind in.
Grades to actually show how much I've learned, not the random shit I memorized before an exam
Classes that integrate with each other... or at least agree
It not to count against me if all of my classes but one have presented a fact in one way and hence I write down that fact when my current professor is stuck back 20 years ago.
It to count that I'm a better clinician than the medical school students I work with in the homeless clinic. They are, without a doubt, clueless and inept. Oh, sorry, they got an A in Ochem of course they'll be good doctors.
The fact that I know exactly what I'm getting myself into to help me, not hurt me. Just because I don't have the same starry eyed enthusiasm to save the world and work with the undeserved like all the other douche bag, clueless pre-med students doesn't mean I do not care. It just means I'm realistic. Sorry, I know medical schools love to beat that kinda thing out of their students.
To be a doctor, because right now I'm watching patients die because I can't do anything to save them, because I don't have the training, or the knowledge, or the experience.

I know I'll be a good physician... someone just has to give me a chance.

Another Short Haul Picture

2009-05-03T17:07:00.000-07:00

Why can't I make a living doing this again?

This just in; swine flu

2009-04-29T11:43:00.000-07:00

I'm considering applying for a MD/MSPH combined program. That is, ONLY to be more able to do research as part of my practice. Any part of me that actually wanted to work in public health has been finally scared away by the mass hysteria over the "swine flu". Seriously, I couldn't deal with this stupid of people all day...

Pissing off the FAA

2009-04-26T12:12:00.000-07:00

(Image "Dope on a Rope" from www.tetonat.com )

That's a picture of a "short haul" technique used to insert rescuers and evacuate patients from highly technical terrain. Its certainly one of the perks of SAR because its a ton of fun and certainly something different from the normal EMS routine (which is "treating" patients who don't really need your help).

Advantages include decreasing the hover time (which is the most dangerous time period of any helicopter operation) and staying away from the more complicated winch in/winch out mechanics.

Disadvantages include no visual communication with the pilot (radio only) and it requires a tremendous amount of skill on the pilot's part to avoid flying the rescuer and patient into trees, buildings, rock walls, etc. Sadly, such an event happened recently with one of the most accomplished mountain rescue teams in the country. The patient was killed and the rescuer critically injured.

Usually, our team is inserted via helicopter on a ridge and then we descend to the patient. In this manor, the ship is usually on the ground (or has one skid down) and we exit out the doors onto non technical terrain. Per FAA regulations, short hauling, winching, and rappelling out of civilian helicopters is strictly prohibited except by a very select few trained individuals who work for the helicopter companies. For example, there is only one civilian air ambulance company who is allowed to winch patients and their medics in and out.

That's great... but I really don't give a shit. If inserting via technical means (mentioned above) is the safest way I can get to my patient I'm going to do it and ask for forgiveness if necessary. I've always followed the motto that "The fastest way to the hospital is the best". We're lucky that we have a helicopter crew that is willing to support these transgressions.

Case in point; a few days ago we had a MCI on a large rock face. Multiple patients took extended (500-1000 ft) falls or slides. We had a few fatalities and a lot of patients circling the drain- including pediatric patients. We had two options- climbing in from the top or bottom or short hauling in.

Hiking in would have exposed our rescuers to an extreme avalanche danger, rock fall, and a slope that was melting out. It also would have meant the death of many patients because it would have taken us an hour to reach them.

We choose to short haul two of our rescuers in and extricate the patients as soon as possible. No worries, it has become standards operating procedure. We did, and not one patient died who wasn't already dead when we arrived on scene. Considering the nature of their injuries, that is a huge accomplishment and uncommon in SAR.

In typical fashion, the news crews (who could ruin a wet dream) published the footage despite us asking them not too. The FAA saw it. We're in deep shit. But, ya know what? I'd do it again, and again, and again without a thought otherwise.

Get the patient out as fast as possible and they live... all I give a damn about.

Prostate Watch 2009 (Last One, I Promise!)

2009-04-16T08:54:00.001-07:00

Final pathology came back for the lymph nodes sampled during my dad's surgery. The cancer was contained to the prostate, Gleason remained at 6, and there were no other indications of a spread. Hooray! The tough old hoot went for a hike today, I'm proud of him!

The lesson in all of this is to get checked out early and often. His PSA never rose past about 2 and had been consistent there for a few years (with negative biopsies). But that, combined with a strong family history, kept him going in for biyearly exams. The list of people whom have died from prostate cancer they ignored is long and distinguished and thank god my dad isn't one of them.

Peace

Have you farted yet?

2009-04-15T12:55:00.000-07:00

If you're asking my dad then the answer is yes!

His robotic prostectomy went well. The procedure as a whole took 3 hours from pre-op room to post-op room and bleeding was contained at 500mL (slightly more than usual because some of the bleeders were near nerve plexi that the surgeon wasn't going anywhere near with a cauterizer). The surgeon caught the tough old stuborn man walking around the ward about 12 hours after surgery and promptly told him to get back to bed. Doctors truely are the worst patients.

30 hours post-op he was back home and eating solid food AND refusing pain meds. I love my dad, one day I hope I'm as stuborn and tough as he is.

Oh, FSM, why do you hate us

2009-04-12T17:43:00.000-07:00

My little brother broke his nose. He broke it really, really badly. Hence, he will be going into surgery the same day as my dad to have it repaired. They'll have to put him under general anesthetic and it'll take about 2 hours. My poor mom will have to deal with it all because my asshole Ochem professor won't let me out of my exam that day. I hope his rotting carcass burns in whatever hell he believes in.

I am the only one in my family who won't have had surgery this year. I guess we used our deductible. Maybe I should get my tonsils taken out (they're friggin huge).

I'm a dumbass....

2009-04-10T13:57:00.000-07:00

I got my father (a classical rock aficionado) a mint, two sided, Frank Zappa LP (The front and back are below) and original concert poster from the mid 1970s for his birthday.

His birthday is the day before he goes into surgery to remove his cancerous prostate

Frank Zappa died of prostate cancer...

Dammit.

Lights Flashing and Bodies Stiffening

2009-04-07T17:55:00.000-07:00

It was a bizarre scene, lights flashing through pine trees weighed down with powder alternated breaking my view of a perfectly clear night. The stars were so beautiful against the high alpine background that it would distract me for minutes until the reality of what we were doing came inching back to me, dripping down my neck and reminding me of our situation.

A kid, 16, had been missing since about 2pm. It was now 8pm. Six hours at 10,000 feet in rapidly cooling conditions and with feet of new, light snow on the ground decreases your survival time significantly. She was without any survival gear, without an avalanche beacon, and had been in a resort skiing with her family. High winds turned around our helicopter so we were alone and searching a mountain on skis.

The beams from our headlamps are really what sticks in my mind. I'd be alone, or I'd feel alone, then one of my teammate's lights would splash across me and be gone as they turned to complete another traverse. The reality of the situation was that we were searching for a body. All of us would like to think she was still alive but I doubted it. In an area with excellent cell phone coverage we would have heard from her by now.

When one of us skied across her skis... literally skied across them, their edges stopping my teammate, our suspicions were confirmed. Her skis didn't move, they were firmly attached to her boots and thus to her. She was upside down, headfirst in the soft snow of a tree well.

People have warned me of the gruesomeness of Search and Rescue... or Search and Recovery... but I hadn't experienced it yet. All of the dead bodies I'd seen were fairly benign before this. She had obviously struggled, attempted to free herself, then passed out from the lack of oxygen.

I wondered if the light filtered down to her like the lights from the snow cat above us randomly filtered down to her. Five feet of snow was probably too much though; and her last images were almost surely dark. She was within sight of a groomed ski run.

Cold bodies with rigor don't fit well in body bags and fit even more poorly into ski toboggans but we did what we could. We skied her awkwardly to an ambulance. It was clear that she was dead but there are less questions if they declare her than if we do.

No one really talked, even at the debrief. Some team mates made mistakes traveling in but no one was in the mood to criticize. I answered some of the medical school student's questions and thought about my little brother, 16, loves to ski, loves to ski through the trees. Then I went home to a warm bed, a cuddly girl, and promised to not dwell.

I lied to myself and said it didn't bother me, it did.

Bad Weekend

2009-04-05T15:37:00.000-07:00

Two rescues. A lot of time on skis, with avy probes and shovels out. One fatality- he didn't see anything coming and did nothing wrong. One survivor- a knowledgeable skier in a spot no knowledgeable person should have been.

Maybe I'll write about it later...

The medical school students I'm teaching sure saw what a lot of SAR is about this weekend.

New Blog and Some Motivated Students

2009-04-02T21:11:00.000-07:00

EE pointed me towards a blog co-written by a psych resident and an ER resident. It *almost* makes me want to go back to working in an ER. But then I think about playing with helicopters and all those silly feeling go away. Anyway, check it out: http://serenitynowhospital.blogspot.com/

I started teaching our annual Wilderness Medical rotation for the 4th year medical school students today. Needless to say it'll probably be their easiest rotation, but I'm hoping we can make it a lot of fun. I did get a call from the Dean of their medical school this morning:

Dean: "I'm a little nervous about a lowly EMT teaching a med school class, what makes you certified"
Me: "(All of the BS letters behind my name, blah, blah, blah) and I think I have enough experience to be able to introduce them to real life wilderness medicine.
Dean: "Oh, well, ok. They'll be writing evaluations on you though. So be warned. I don't want this to be a 2 week vacation for them. Med school can't be fun..."
**paraphrased slightly... and over exagerated

To be honest, I'm really excited. All of the students are motivated and learn quickly. Traits lacking from 99% of my undergraduate students. I guess that's why they're in medical school.

If you're a medical school student interested in a fun rotation leave me a message on here and I'll get in touch with you. Topics we're covering:
-Search and Rescue basics
-Patient Packaging
-Patient transport decisions
-WMS approved wilderness medicine curriculum (same stuff we teach the docs)
-Basic Rope skills (raising, lowering, low angle evacuations)
-Helicopter operations
-A few practice rescues

Plus, you'll get too do some rotations with the docs on ski patrol (assuming you can ski or board) and any call out I go on while you're in my class you get to tag along on.

Enough shameless plugging. Back to writing lectures on acute abdomens:

Its the little things

2009-04-01T05:29:00.000-07:00

I have the best girlfriend known... I swear. Why? Because this is what I woke up too: Click Me

Except in a tuperware and in my back pack. What'd you think I was going to link you too?
On the morning before a big mutha of an OChem exam it really is the small things in life. And a lot of Red Bull. And some trashy pop to keep me awake.

Ouck FChem

2009-03-31T19:30:00.000-07:00

I have yet to hear a logical argument as too why I have to take organic chemistry to be a good physician. The pre-med requirements don't even require anatomy...which is something that I would actually use on a daily basis.

Case in point. My mentor has a graduate degree in organic chemistry. He says it was the most pointless piece of bullshit he's ever undertaken. No medical school student I've meet (and I teach them, I've meet quite a few) has claimed that Organic Chemistry has helped them at all in any class.

As a final piece of argument I cut and pasted multiple questions from my honors physiology, honors anatomy (two classes... our college doesn't do the BS combined crap), general chemistry, organic chemistry, and physics classes into an exam and had 20 medical school students, residents, and attendings I know take it for fun. These are folks who are in the top of their class, chief residents in internal medicine, and residency directors in multiple fields (oncology, radiology, surgery) respectively.

The questions they got right were all from the Physiology and Anatomy sections.
Not a single person answered a general chemistry, organic chemistry, or physics question right.

Hence, it is proven that you need none of this bull shit to practice medicine. Want us to prove* we're intelligent? Have us take something that matters.

*Intelligence is not an A in Ochem.... which is no way proves you will be a good doctor.

Power Point Hell...

2009-03-27T10:58:00.000-07:00

I teach A LOT of classes. From advanced first aid to Basic and Advanced Wilderness Life Support to a 4th year medical school student rotation.

While I like to spend as little time in a classroom and as much time outdoors as possible (that's where you learn it all anyway) some lecture time is a necessity. This often means power point and
I
Hate
Powerpoint

At least most of the ones I have to sit through as a student. The slides have too much info on them, they're boring and when the professor just reads off them I wonder why I even came to class.

I'd rather make mine, simple, to the point and interesting. This may be my favorite site to help with the last aspect:
Free Medicine PowerPoint Templates

I'm teaching a diabetes lecture tomorrow, I think I'll use this one:

Struggling

2009-03-26T20:30:00.000-07:00

I've been struggling with what I want to write on here.

I'd love to recount stories of SAR callouts, and I have for some one the more interesting ones, but I've found that for the most part 90% of them follow the same basic outline:

-Hiker/Skier/Snowmobiler is TLS (Tired/Lonely (or lost)/Scared) and calls us
-We usually have a good idea where he/she is
-We hike in
-We hike them out (yes, if they can hike out they weren't that hurt in the first place...)

There have been some interesting ones but they've been few and far between (and I've written about most of them).

So, what should I write about? I'd love to talk some about how I see technology helping and hurting our search and rescue team. Or, even the general attitudes in EMS and medicine. Any other ideas?

Fuck it all

2009-03-15T19:13:00.001-07:00

My parents are some of the healthiest people in their mid fifties I've ever meet. Between the two of them they've:

Ridden bikes from one side of our home state to the other
Kayaked the ENTIRE Missouri river from Montana to St. Louis
Hiked the entire Ozark Trail
Spent weeks in Banff, Yellowstone, Glacier, Zion, Arches, Colorado, and god knows how many other places backpacking

They eat right, sleep lots, exercise a ton (in a healthy, no obsessive way), and live outside the city.

And in the past six months they've both been diagnosed with cancer.

What
The
Fuck

Search and Rescue/Helicopter Demonstration at WMS Conference

2009-02-23T20:00:00.000-08:00

Improv

2009-02-13T21:06:00.000-08:00

Scenario: Broken femur, three pitches up an ice climb. You can't reach the patient from the top. Hence, you can only bring in whatever gear you can put in your pack. No littler, no sled. 600 feet of rope and an air splint. How are you going to bring him down?

Fuck it, assess it, splint it, toss him on your shoulders, and go...

Please Thank a Military Family This Christmas

2008-12-25T08:46:00.000-08:00

Thank The Troops...

But Thank Their Families Too

My parents have always encouraged my brother and myself to give generously to charity growing up- especially around the holidays. I've always felt lucky and a little guilty to be from a family that (through no help of my own) has always been comfortable financially.

This year, we decided to help Military families. Despite giving up years of their lives for our country our soldiers are not paid very well and many of their families are hurting. There's a great website based out of my home state which has dedicated itself to helping these families:

http://www.thankmilitaryfamilies.com/

It may be a little late for this holiday season (contact them if you're interested) but please keep this in mind for the future.

Happy Holidays!

What will save your life?

2008-12-14T15:58:00.001-08:00

Will this save your life?
Not without this:

Or This:

If you play in the woods in the winter there is absolutely no excuse for you not to have the proper gear. In the mountains, that means an avalanche beacon, AND and probe, AND a shovel. We just pulled our first two avalanche victims of the year out. One was air flighted out, the other wasn't. Why? They don't fly dead bodies. Guess which one we got to first? Guess which one had a beacon on?

Snowshoeing
Hiking
Skiing
Snow Boarding
Snowmobiling

If there is any white stuff on the ground you need to plan accordingly:

First and foremost get trained. Take at least a basic avalanche course or better yet a level one certification. You can find a list of providers in your area here
Second, make sure you have the right equipment. This means a beacon, probe, shovel, and extra batteries. EVERYONE in your party should have the same. Anything else is sure idiocy
Finally, use your head. Be "that guy". The one who says the conditions are too dangerous and makes everyone turn around. Testosterone is a neurotoxin- most avalanche victims claim to have had a poor impression of the conditions, but pushed ahead anyway for reasons of pride or ego. Neither one of those do you much good if you're dead.

Be safe, be smart, come home alive!

Dear Mr. Flight Nurse

2008-12-07T17:46:00.000-08:00

Dear Mr. Flight Nurse,
I'm sorry we weren't able to hand you our last patient with an IV ready to go. I know it must have been incredibly frustrating for you too have to do it yourself in the warmth of your helicopter. You see, for some reason I didn't quite have the sensitivity in my fingers to get it right. Oh yeah, that's right, because it was 25 degrees. That's maybe why the patient's skin was f-ing freezing, complicating matters.
We had the patient packaged well and he was alive, give us some credit. Yes, you got a helicopter ride to the top, I busted my ass for 2000 vertical feet. I'm sure all that turbulence was rough- I hope the barf bag treated you well.

Your's in this fine world of medicine,
Me

Link Love

2008-11-25T10:16:00.000-08:00

How about a pre-Thanksgiving post for some of the blogs I enjoy:

Congrats to EE on a new kid! I hope he's as stubborn, hard headed, and smart as you are!
Sam moved her blog to wordpress, if you haven't read her writings before they're well worth it.
Receiving is one of my favorite blogs, they're Quizzes give me some hope for the future (I'm soooo much better at them than Ochem- but hey, an A in Ochem means you'll be a good doctor right?)
Does anyone know what happened to PJ country?
OMG doesn't seem to be looking forward to trauma surg... I hope it goes well. My experiences with the trauma surgeons has been a total dicotomy. They're either going for motorcycle rides with me and super nice, or complete pricks who need a cranial-anal disimpaction.

A Probie's First Callout- Part 3

2008-11-14T09:21:00.000-08:00

"Hi, my name is Jason, I'm an EMT with ________ county search and rescue, what hurts?"

"My leg.... where's the helicopter?"

"Dude (yes, I called a patient dude...oops), there's no helicopter tonight, we're carrying you out."

"Oh shit"

I've certainly done better assessments in the past than I did that night. With my right foot and ass hanging off a 15 foot drop, the wind kicking up, and the excitement of my first night on the mountain I was scattered during my initial assessment.

'Shit, do I check his leg out first or give him a head to toe, what about vitals, god damnit- stop moving your head, how am I going to do all of this without exposing him to the elements?'

Kenny damn near smacked me up the head and I got my shit together in about 20 seconds. Talking= ABCs, a quick head to toe revealed no abnormalities except his ankle, and Kenny started on some vitals.

The kid's ankle was bad. Not quite bone sticking out of the skin bad, but bad enough that I lost a pedal pulse in his foot as it swelled to the size of a nalgene bottle. We splinted it and hoped for the best. I know EE hates them, but I love SAM splints, especially in situations like this. One posterior and plantar on the foot, the other medial and lateral under the heel and both shaped as best as possible around the foot/crus made for a fine splint with the requisite duct tape. I put my spare socks on the patient (they are XXL just to fit over a splint) and we wrapped him back up in the survival sack.

At this point, we had a dilema. Everything was in place for a potential spine injury that couldn't be cleared via the NEXUS criteria- MOI, intoxication, and a distracting injury. But, we had no C-collars, no KED, and no Bean Bag. We packed the patient's head into the litter with his boots, our first aid kits and a jacket, put a helmet on him, and I taped it all in. Was it perfect? No... but it worked. I've already placed both an adult and peds C-Collar in my pack...

Skip forward 10 hours and 25 assisted belays later. The eight of us were black and blue from tripping down scree and being torn off the litter team by scrub. Backs were strained, eyes were scratched, hands were bleeding, and everyone was hungry. I have no doubt that this is what 90% of resuces are all about- and I loved it.

I had taken to 5min catnaps while the next belay was being set up. I have a wonderfull talent (wonderfull for EMS at least) in which I can fall asleep anywhere, anytime. The patient was quiet, cooperative, and docile even as we were cussing at the trail and struggling to lift him over downed trees and stumps.

We loaded him into the ambulance at 7:30am the next morning as the sun was coming over the peaks behind us. I gave the bullet to the medic (who looked far to warm, comforatable, and well rested having slept in our command post all night) and we all hid from the TV cameras.

After the debriefing I ate $16.32 worth of food at a breakfast diner and collapsed onto my girlfriend's couch (which may still stink because of it). It was, without a doubt, everything I had expected a mountain rescue to be, and I loved it.

I don't want anyone to get hurt in the hills... but I like knowing that if they do we'll be there, again, to get them out.

A Probie's First Callout- Part 2

2008-11-13T18:41:00.000-08:00

"Jason, you have your pack ready?"
"Yes maam"
"Good, follow Kenny, you're chief medical, don't fuck up"

You
Have
Got
to be
Kidding
Me

That was, word for word, what went through my head. I shoved the trauma kit and an extra pig rig into my pack as it was thrown at me (memo to self, bring a bigger pack next time), an extra liter of water, and resisted the urge to piss and vomit.

We started up the "trail" in two teams that quickly caught each other. Trail is really a loose term for a deer path up some quasi scree. After a wrong turn, Kenny and I found ourselves at the front of the group and were able to stretch our legs out a little.

I would like to digress for a second into one of the reasons I really liked this rescue (and hopefully rescues in the future). I've always had an aptitude for endurance sports. I was an elite cyclist, I ran in high school, I've always been able to hump the heavy pack really fast for a long time. This was, however, the first time that it actually meant something. Whatever genetics I was born with or hard work I've put into my heart, legs, and lungs finally was able to do something other than just cross a white line in the middle of nowhere....

Because there was no helicopter in the air it was hard for us to know exactly where our patient (victim?) was. We had a general idea from the team members in the helicopter who had dropped a survival bag to him but the perspective from the air and from the ground are vastly different. The survival bag contained glow sticks but they were all but worthless in the deep scrub oak we were fighting.

Kenny and I found ourselves in deeper vegetation and on a steep side hill fighting the branches that obstructed our way, and periodically yelling but never getting a response. In the 45min it took us to hike the 1800 vertical feet in there were a lot of thoughts in my head. Was our patient still conscious? Still alive? Are we in the right draw? Did we pass him? I had no frame of reference with which to base anything on and we kept pushing.

Bright yellow green is not a color that belongs in the woods, but visualizing the glow sticks from the survival bag made my bag feel lighter and upped our pace. Kenny had not been able to find them but trusted me and we plowed oh so ungracefully through the woods towards it, cliffing ourselves out twice, and finally descending to the patient.

I approached from the uphill side and the patient's head- usually not a good idea (I don't want to startle him nor make him crane his neck) but dictated by the terrain. He looked good, in the survival bag and yelling at us. I could see about 25feet of scree that had been disrupted when he fell- the MOI for a spinal compromise was certainly there.

"Hi, my name is Jason, I'm an EMT with ________ county search and rescue, what hurts?"

"My leg.... where's the helicopter?"

"Dude (yes, I called a patient dude...oops), there's no helicopter tonight, we're carrying you out."

"Oh shit"

Oh shit is right....

Ahhhh, I'm an idiot

2008-11-13T18:06:00.000-08:00

There will be a few posts popping up in a second. I had been saving them as drafts and not posting them. Please, no one tell the admissions committees that I'm an idiot.

A Probie's First Callout- Part 1

2008-11-08T14:07:00.000-08:00

We had just finished a ropes rescue training session, it was 9 O'clock, dark, and slightly drizzling. There had been the usual SAR team bullshit arguing about our team standards, whether or not we should have attendance requirements, what our medical certification level should be, etc. Not surprisingly that all disappeared as everyone unconciously reached for their hip as the multitude of beeper tones and vibrations began.

The five probationary officers of my incoming class looked at each other. I'm sure it was a look akin to a combination of a deer in the headlights and a kid caught with his hand in the cookie jar. We'd been on the team for two weeks, had three training sessions of training under our belt and were very, very green. Hell, we barely knew how to call in 10-8 (on duty) to the dispatcher, all of just listened to radio traffic for a few minutes once we were in our cars.

The trailhead was only 15minutes away, it probably should have been twenty but most of us drove a little to fast. Of course, it didn't matter. In typical SAR fashion we stood around in the parking lot for 30min just waiting. One of the more experiences members of the team knowingly stopped and grabbed a burrito on the way over- I envied him for most of the next 10 hours.

Not much longer we had a National Parks Service helo on scene and the old, ex vietnam era military era, pilot to go with it (I say this with all due respect, it was the only helicopter we could get at night, in a slight rain). We also had the patient on a dieing cell phone but he didn't know where he was. The bird went up, the Haste team went up the trail and the search began in earest. All while the newbies sat on the bumpers of their cars.

I packed, repacked, and packed again my backpack. Then I drank a liter of gatorade, a liter of water, pissed a lot, and waited. All the while I wished I had packed more food than the package of oreos I scavenged from the floor of my car (the proverbial shit show that it is) and a cliff bar from a cycling jersey on said shit show. It didn't matter, I reasoned, there was no way I was going to be put "on the hill".

Word came back that they found the hiker and he was much farther south of where we were at. The whole shebang of private SAR cars, our mobile incident command center (a large motorhome), fire trucks, ambulances, and the rest picked up shop and moved to a closer location. I hesitate to call it a trailhead because, well, there was no trail. Again, everyone who knew how to do something did it and the probies waited. I made sure I had my pack on and clothes ready to go so I wouldn't have to strip off any layers if I got to go up...

"What about Jason, he teaches Wilderness EMT classes, let him go up" I have good ears and a curious mind and I couldn't help but overhear one of the training officers talking to a COG (crusty old guy- again, a term of incredible indeerment).
"Nah" A simple anwer accompanied by a head shake that seemed final. My hopes, what little were there, were killed.
Yet, another training officer began speaking to the COG and after 5min he nodded, very subtley, and walked away. I wouldn't let myself believe it, I had to be making things up.
"Jason, you have your pack ready?"
"Yes maam"
"Good, follow Kenny, you're chief medical, don't fuck up"

To be continued.....

And So It Begins...

2008-10-21T15:46:00.000-07:00

Alright, as of 5:00pm yesterday I'm part of the Search and Rescue team and officially on call.

Pager? Check

Radio? Check

Radio chest harness? Check

Backpack dutifully packed, in my car, and ready to go? Check?

New Box of climbing goodies? Check

Training? Ummmm, we're working on that.

Each new member received our basic first aid kits and a small amount of high angle rescue gear, plus our electronic leashes (pagers) that will define our lives for a while to come. I'm kind of a geek so I ripped into the first aid kit right away. We were told that we can add whatever we want, but we have to have at least this as a minimum:

-Trauma sheers

-BVM

-Sam Splint X1

-NiTride gloves

-Small bio bag

-1 large roll Kerlix

-4 4X4 Gauze

-1 Combine dressing 8X 10

-2 triangle bandages

-Tape

-Emergency blanket

-Mole Skin 4X3”

-3 antimicrobacterial wipes

-2 triple antibiotic

-2 Ibu (Cedaprin)

-2 Diphen

-Bandaids

-1 Bug X towelette

-1 Sunscreen

-1 sting relief

I added:

Two more SAM splints
Acetaminophen (in case someone is allergic to both aspirin and Ibuprofen)
Small mag light
Maxi pads (don't laugh, they're the best wound control I can find other than a quick clot bandage)
Tongue depressors (I'm super nervous about putting my fingers in patient's mouths)
Smaller gloves for bystanders, bigger gloves to fit over my thin pair of liners.

I'll be in a probationary period for the next 9 months. That means I have to be at all the training sessions an 67% of the call outs. The probability of me getting called out before all of my basic training is complete is pretty high because of our call volume (2-3 per week on avg.). I just hope that they'll use me as a pack mule and not much else. Its not that I'm not comfortable with my high angle rescue skills or my medical knowledge (I teach that stuff...) its that having never worked with anyone on this team before I have no idea what to expect, I have no idea how THEY do things, and I sure as hell don't want to piss anyone else off.

One....More....Month

2008-08-26T18:18:00.000-07:00

Looks like in a month I'll begin training with the Search and Rescue team. I wish I had something more exciting to report. A Sheriff's Deputy dropped by my house to look around today and talk with me, then interviewed my neighbors, and yesterday called all of my former bosses and everyone I've ever lived with. They're taking this rather seriously I guess.

I'm excited...
I'm excited to be on call
I'm excited to hump it up a trail and help someone (i.e. 90% of rescues...)
I'm excited to pull people off rocks
I'm excited to learn how to pull people our of rivers
I'm excited to challenge myself and to be a part of the team

I don't know where I'm going from here, but I promise that it won't be boring!

Pre-Employment Physical

2008-08-15T08:03:00.000-07:00

After being poked, prodded, tested, and felt up I'm one step closer to actually starting on the Search and Rescue team. All that stands in my way now is my yet-to-be-completed FBI background check (because our SAR team is Law Enforcement based its required, we also assist in fugitive recovery and child abduction response).

Surprise, I passed my physical. I guess devoting the last ten years of my life to attempting to become a professional cyclist has some perks. My 12 lead EKG actually came back as Sinus Bradycardia... my resting heart rate was about 39. The rest of the physical was unremarkable. Except that I HATE FRIGGIN NEEDLES. I'm terrified of them. Hence, the blood draw was not fun, nor were the immunizations, nor was the TB test. All I have to do now is get XRayed and hope my background check passes!

The Basic Amentities...

2008-07-17T22:03:00.000-07:00

Sorry its been a while. I've been working... a lot... between 4 jobs and about 83 hours a week average. The funny thing is that I enjoy all of my jobs enough that it doesn't seem to bad. Sure, not hanging out with the girl of the moment and driving all the time sucks. But, what can ya do?

Interestingly enough we've had some issues at our house too. I say house, but in reality its a cabin... in the woods...at 6500 feet or so. For instance, our septic tank overflowed. So, no toilets for a while until that got fixed (the work bathroom sure saw a lot of use). Now, our well is having issues and hence no water. Its actually quite a challenge to live without running water. We cart up 25 gallon jugs of water from the valley but still no *running* water. No showers, no toilets, and its hard to wash the dishes. Forget laundry or washing the bikes!

In the back country there isn't indoor plumbing either, obviously, but I'm also not having to show up for work, be close to customers, and teach classes. Its not good for me to stink! So, I'm at a loss for what to do until all of this is taken care of.

Also, I've been debating which direction I want this blog to go. It began as a semi-anonymous chronicle of my journey to get into medical school and then hopefully points beyond through the medical education system. But, during the summer there isn't much of that going on. Sure, I think everything I do helps me in one way or another but not really directly. Plus, if I begin to get to specific I loose what little anonymity I have (example: I teach wilderness medicine classes... but if I said any more than that a lot of people would know exactly who I work for). We'll see in the future where it goes. I like writing though, when I have the time. Its calming and allows me to organize my thoughts.

Until then, cheers! And thanks for reading!

CV

2008-06-21T10:05:00.000-07:00

I had to rewrite my CV for a new wilderness medicine instructor position I was offered and I thought the cover letter described my "I DONT WANT TO BE ANOTHER PREMED" mentality pretty well. I'm still editing it, but for shits and grins here we go:

Since graduating high school in May of 2004 my goal has been acceptance into medical school. My path towards that goal has changed and evolved as I have continued my education, both within and outside of academia, but the goal has remained the same. Rather than assuming the same path as many of my peers with the same goal I wanted to branch out into other fields of study, gain experience, and prove to myself that a career in medicine was my calling in life.

My first two years of college I balanced my academic career with an elite level athletic career in cycling. In 2006 I decided to take a hiatus from school in order to pursue my other dream of becoming a professional cyclist. I moved to Herstberge, Belgium to race for an amateur Elite team against some of the finest cyclist’s in the world. Racing and living in such a professionally oriented environment taught me many things. I learned discipline throughout my lifestyle, I learned to love a routine, and most importantly I learned how to struggle and be successful.

Upon my return to the United States I was set to return to Europe and race the next season. Fate had other plans and in the spring of 2007 I found myself injured and unable to ride my bike. This blow to my racing career brought me back into academia as I threw all of my energy previously reserved for athletics into my school work. It was at this time that I began working in the Vascular Biology Lab at Big Mountain University and found my passion for research. This new found passion changed my academic plans and I began to explore careers that would allow me to combine medicine and research. The natural path was a combined MD/PhD program.

Athletics had instilled into me a work ethic and my research experience has shown me a new path I wished to take. However, the true turning point after which I allowed myself to completely dedicate myself to a career in medicine came when I earned my Emergency Medical Technician (EMT-B) license. I loved interacting with patients and hearing their stories. I loved having the knowledge to help them and most importantly I was driven to gain more knowledge and more experience in order to help those patients more. I finally saw medical school as a means to an end rather than the goal itself. Now, I wish to go to medical school not to become a physician but so that I can gain the knowledge and experience necessary to help the patients that I cannot help now.

I have many opportunities now that I believe will help me become a better physician in the future. I would like to teach Advanced Wilderness Life Support courses because it is a combination of my passions for the outdoors and for medicine. I would like to work for the County Search and Rescue team because of the challenging and rewarding nature of such work. Finally, I would like to continue my training as an EMT because in the end I believe it is those experiences with patients that have driven me this far and will help me the most over the course of my life.

Reflection of a Mechanic (i.e. sleeping on the ground and wanting a motorcycle)

2008-06-16T19:20:00.000-07:00

As part of my job at the bike shop I'm the "Special events and promotions manager" (yes, that's a self appointed title) I get to work at a lot of events, races, clinics, and the such. These events are fun but a ton of work and often the people I deal with are trying to say the least. I figure that's good practice for the future... especially the second part. Plus, clocking in 56 hours in a weekend does not hurt the dwindling checking account.

First, my nomadic sleeping arrangements for the weekend:Please notice the ten grand worth of bike frames in the passenger seat, the awesome lesbian seagull (my car) and my bivy sack which has taken me many, many places. I've said it before, but I feel lucky that my parents raised me in the outdoors, living out of our minivan on vacations. Because of them I'm comfortable living out of my car for days and NOT living like a hobo.

Second, my friend's new KTM 450 dual sport moto:The problem is that he let me ride it when we had two hours of downtime. Now, I was an idiot and didn't have a helmet on or anything but my mechanic's T-shirt. This kept me from going really, really fast. I just went really fast. That bike was like an orgasm on wheels. I couldn't believe it. I want one now, very very badly. Insurance on a motorcycle for a 21 year old male? Ouch.....

What else have I learned?

2008-06-09T06:29:00.000-07:00

That simply waking up in the morning means there is something to be thankful for.

Rest In Peace...

Things I've learned this past week

2008-06-09T06:20:00.000-07:00

1.) When someone asks you when you can work, tell them to send you the schedule and you'll see what you can squeeze in. Instead, I sent my internship director my schedule and he signed me up for every available shift he could squeeze me into. He even made up some shifts just for me! I guess its nice to be loved, but not when I have to pull a 100 hour week.

2.) Never, ever, schedule a drug test over the phone. That's not something that you want a miscommunication about. Case in point- I'm being threatened with a 12 month suspension even though I pissed perfectly clean....just 12 hours after I was supposed to. I'm in the appeals process now....

3.) I hate to say it, but I wouldn't be anywhere if it weren't for the people I know and my charm.

4.) When I work a lot, I really miss riding my bike/climbing/playing in the mountains. This is the primary thing that gives me pause about a career in medicine.

Pictures from Moab

2008-05-30T10:22:00.001-07:00

Where the Colorado and Green rivers meet

Reptilian paparazzi (I have about 50 pics of this little guy, oops)

Sitting on the edge of Dead Horse Point

Out of their element

2008-05-28T20:57:00.001-07:00

I have no pictures as promised because I can't download my camera =(. But, have no fear, because stories abound!

We had lecture all morning and covered:

Scene size up and patient assesment
Wound management
Cold injuries
Heat injuries
Lighting
Water purification
High velocity injuries
Water disinfection

I'll admit, I actually skipped the water disinfection lecture... but I'm pretty comfy with that. The acronyms they teach us are similar to what I learned in my basic class (SAMPLE, AEIOUTIPS) but some are different (COLDERR instead of OPQRST). All in all, I've been really comforatable with the material presented.

We went outside for the afternoon and practiced some patient scenarios (which are always total bull shit, but I guess they serve a purpose). This, I might add is where the EMTs and Paramedics shined. The MDs were a little out of their element. Scene size up what!? Obviously, to graduate from medical school and complete a residency you have to have an incredible depth of knowledge. However, when it came to extricating 'patients', carrying, or log rolling things didn't go do well. I learned from them, they learned from me, we're all friends!

As I sign off, I'd like to leave you with some interesting lightning facts (THE most interesting lecture of the day):

The most likely time for a severe lighting strike is before the storm appears and after the storm has passed
Rubber boots, rubber tires... they don't mean shit when faced with a unidirectional massive current impulse of 30 million volts. If it traveled 10 miles through the air it'll blow through rubber like nothing
For those of us in EMS...A mass casualty incident (MCI) involving a lighting strike should be reverse triaged. Patients may appear dead because the heart initially becomes asystolic after the strike. It will, however begin beating again. There will often be a concomitant respiratory arrest that occurs and the heart may deteriorate back into asystole secondary to the respiratory arrest. This respiratory arrest may last 5-8min (during with the patients is asystolic and apnetic) because of a temporary paralysis of the medullary center. -Long story short, keep them alive and they'll be fine (even if they look dead). If the patient looks ok and is at least semi alert and oriented they'll be fine- take care of the serious patients first.

Finally, the feathering pattern from a lightning "side splash" is amazing looking:
I would totally get one as a tatoo if I ever got hit (as opposed to that OTHER tatoo I was thinking of getting, more of that later).

Cheers!

I might be the one who needs rescueing...

2008-05-27T23:08:00.000-07:00

I interviewed with the search and rescue team today. It was me, at the head of a conference room table, being interviewed by three sheriff's deputies and three civilians, for an hour. Easily the most nerve wracking interview I've ever gone through. And, yes, this is a volunteer organization! I'm happy that they take things so seriously.

A lot of the questions I felt easy answering. Rock climbing experience? Check. Ice climbing? Check. Hiking, camping, navigating, scrambling? Check, check, and check. And yes, I know what declination is.

Other questions I wasn't so strong on. Name 10 trails in Area X.... um, I know where the trails go. Hand me a map and I can find where I am, where you are, and get there... but the names of the trails? Damnit! I'm also weak on swift water rescue techniques, and anything that involves me driving a snowmobile or ATV (wait, something that doesn't require me to bust my ass to get somewhere? what's the fun in that!?).

Overall, I tried to convey that if I didn't know something they asked that I'd love to learn. That, and I'll do things their way, I don't mind humping a big ass pack up a mountain, and I learn fast. Luckily, I have about four times the medical requirements (50 hours of class time) required- that was a major plus.

I really, really, really, really hope I get on the team. It would be a huge commitment, but it has also been a dream of mine to work SAR since I was about 10 and meet some members of the Ouray Mountain Rescue team in Colorado. I bought one of their hats:
and wore it FOREVER, no one could pry that sucker off my head. I guess if its to be, it'll be. And if its not to be, then I'll work on my weaknesses and reapply.

J

P.S. In moab now... will post pics from the WALS classes as soon as I have them!

Search and Rescue

2008-05-25T18:56:00.000-07:00

I got a call from our local search and rescue team today. They want to interview me for an open position on the team. Excited does not do justice to how I feel. I love the mountains, I love EMS, this is a great combination. I realize that I won't be able to do operations like the picture above for a long time, and that most of the time there isn't much medicine involved (one member of the team impressed me with the quote "by the time we get to them they're usually either stable or they're dead) but I honestly cannot think of anything I'd rather be doing.

If I get on the team it is a huge time commitment though. I would be expected to respond to 66% of all call outs for the first 9 months and 50% of all call outs from there on out. I would also be on call 24/7/365.

My mom (a nurse practitioner) thinks this that if I get on the team it will change everything- that I won't want to go to med school, that I'll be a flight nurse or medic, etc, etc, etc. We'll see about that....

Wilderness Advenced Life Support

2008-05-23T07:32:00.000-07:00

Next week I'll be headed down to Moab for a Wilderness Advanced Life Support class. I'm excited for a number of reasons not the least of which is that my whole family will be meeting me there and my dad and I are taking the course together. My dad is one hell of a surly, and excellent, ER doc (formerly family practice) and one of the original members of the Wilderness Medical Society. I've been going to their conferences with him since I was pretty young and I've had the opportunity to meet some cool people (Like Dr. Auerbach, and Alex Lowe among others) and learn a lot about 'improv' medicine- which seems to fit well with EMS.

You see, the people I meet at these conferences give me hope that I won't be miserable if I become a doctor. To often I'm around docs who are workaholics and have completely martyred themselves for the cause. But, at the WMS meetings I've meet doctors (and nurses, and PAs) who have been able to combine their passions of medicine and the outdoors. They are all very much more happy than your average doctor. Most of them use their high level of income to work less (and, gasp, make less money) and play more. They are the doctors I look up to, not the overworks asshole attendings I am usually around.

I'm not opposed to working hard but in the end it has to be worth it. 80 hours a week once your outside of a residency isn't worth it to me. Combining my passions is.

NREMT

2008-05-22T07:47:00.000-07:00

This just in, I passed my NREMT-B exam.

Not that I'm surprised, I would have felt pretty bad if I hadn't. Its a relief none the less.

First Busy Week of Summer

2008-05-21T07:17:00.000-07:00

My first 'real' busy week of the summer is almost over. I'm thinking I may have bitten off more than I can chew with coaching two evenings a week (plus races on saturday), working in the shop 3 afternoons a week, a summer internship in the mornings, plus two night shifts a week in NICU research lab. All that plus training for some sport aspirations that I thoughts were long gone but seem to have been dredged back up by coaching.

Why do I do it all when most of my friends are content with the easy summer research job? Maybe some summer shadowing? You see, I have a confession. My first year of college, my grades were pretty good. I had a 3.7 or so (although I did withdraw from a calculus class that I retook later and got an A) and was well on my way to an honors degree. Then, I got this hairbrained idea to be a professional cyclist. I'd raced bikes since I was 14 and had some regional success but nothing major.

I applied, and was accepted, onto a European semi-professional team. Classes took a backseat to training and I was on my bike or in the gym 5-6 hours a day. My grades plummeted- at one point I was on academic probation (i.e. below a 2.0 GPA). Far, far from the grades one would need to get into medical school. I up and moved to Europe and said the hell with it all.

This went on for about two years; I was invited back to Europe for a second season and started training hard again over the winter. Then, disaster struck. My hip started to hurt, I assumed it was part of nagging back problems I'd had since I broke 4 vertebrae in a crash years ago, but it got progressively worse. Soon, walking hurt, at times I couldn't even get out of my bed. My dream of becoming a professional cyclist was quickly vanishing.

I also had a lot of free time on my hands because I wasn't able to train so I threw myself into school. The grades went back up, I began doing research, received research grants, and decided I had to make up for lost time. As such, that's how I'm here now. Making up for mistakes on my youth (haha, a whole 2 years ago), retaking almost every class, and hoping somehow it'll work out.

Call Me Theodore

2008-05-06T21:00:00.001-07:00

If anyone is curious why I there hasn't been any new posts lately its mainly because I'm now living in the mountains. Far, far in the mountains....at almost 7,000 feet...surrounded by snow and trees.

I

Freaking

Love It

Seriously, I was so happy to be out of the city a girl I was hiking with the other day said I was giggling the whole time we were driving back to my house. However, living in a cabin is not very conducive to communication. The BlackBerry's service is spotty and we have one ethernet cable. Not to mention that after school I'm not all that motivated to talk to people at all!

Good things have been happening though. I'm back on the bike again and training reasonably hard. 3 hour rides the last five days are so. Most of those have been with the Junior's (under 18) team I coach. I discovered that I LOVE coaching. Its really a lot of fun, and we have a great group of kids to work with. That, and they've been working me over on training rides. Damn whipper snappers.

Hopefully... more soon.

J

I just assumed....

2008-05-02T10:13:00.000-07:00

What is a college student with no finals left to do? Read blogs, of course...

Moving Meat if one of my favorite ER doc blogs. It has come very close to making me very interested in administration (oh god, my dad will kill me now). I found This Post and Dr. Gawande's Writings particularly interesting (although they are just an aside on the topic of the post).

You see, I always assumed that there were checklists like that in place. For instance, when I do a Western Blot in the lab I have a checklist that I've written that I go through. Before I started doing that, our results were sporadic. Afterwards, they became much more consistent. Hell, in almost everything I do I have checklists. Studying, yep. Training sessions, yep. Girls, ok- maybe not everywhere. Why would medicine be any different?

But, do have I used checklists per say on the few EMS runs that I've done? Nope.
Sure, we have run forms, I have my SAMPLE and OPQRST questions that I run through in my head, but that's the extent of it. In fact, a checklist sounds like it would be a pain in the ass. But, if it would be worth it I'd do it in a heartbeat.

Random Pictures from Our PreFinals BBQ

2008-04-30T14:43:00.000-07:00

Steak, Bratwurst, Swordfish
Peppers, Asparagus, and Pineapple
Who says I don't have taste? (ok, a lot of people do, but I try!)

Random people who shall not be named, but rock. One pre-med, one future biology professor, and one engineer, can you figure out who is who?

Oh god, that's a cheese ball picture of me. But lets focus on what's important... the swordfish was excellent. Props to the people who brought it over (who may or may not read this blog).

Finals!

2008-04-27T21:20:00.000-07:00

I'm curled up in my Study Area preparing for my chemistry final tomorrow. Amazingly, I have an A- right now in the class (I got a C+ in my previous chem class, not exactly a 'get into med skool grade') so I'd rather not blow that. I've also begun my redbull regiment- one sip every 5min. I've progressed to the 20 oz Red Bull, AKA- Status Epilepticus. Yes, it helps me stay awake, yes it gives me localized facial seizures and a minor eye twitch... oh well. No one every said this was easy, or healthy.

I take an interesting approach to finals, and exams in general. I work really, really well under pressure. I don't procrastinate and cram for exams (no, I study all the time) but I do put a lot of pressure on myself and I increase that pressure as the exam gets closer. Thoughts like "if I fail this exam I might as well just be a firefighter" go through my head all the time. I have a lot of friends that gasp in horror when they find this out. But, it helps me, a lot. To each their own. I like being in the zone and fighting hard.

If you're not afraid about what you're about to try then you're not pushing yourself hard enough.

Cheers!

No Surprises Here

2008-04-24T22:36:00.001-07:00

Created by OnePlusYou

Thanks DocSurg

Screw you: World Laboratory Animal Liberation Week

2008-04-24T14:06:00.000-07:00

Great, I just got an email from my PI informing us of "World Laboratory Animal Liberation Week" (this week) and a march on our campus to MY building tomorrow. This means that I can't get into said building to get my research done without fearing for my own personal safety. For the record, some of the research I do includes animals, mainly mice, but sometimes rats, rabbits, or sheep. Guess what? I'm perfectly fine with using them and I do everything I can to make sure the animals are treated with respect and are never in any pain. So does every other researcher I know; animal research is strictly governed by every University.

I wonder.....
I assume the people who are protesting the use of animals in research are vegetarians, most of them probably vegans (if not then the hypocrisies have already begun). But:

Do they ever visit the doctor?
Do they ever use ANY medication, even Tylenol or Advil?
Have they ever undergone any medical treatments?

If so, (begin sarcasm) SHAME ON THEM FOR CAPITALIZING ON THESE POOR DEFENSELESS ANIMAL'S LIVES FOR THEIR OWN GOOD (end sarcasm). In reality, if they have then they are hypocrites and should crawl back into whatever hole they came from (or house they're squatting in).

I ask them this: If a loved one was lying on the OR table, rapidly de-sating and facing death, would authorize a procedure that had been tested on animals (virtually ALL medical procedures)? Or, would you value the life of an animal that was bred only for research purposes over the life of someone you love?

Sure, we all want free healthcare (cough), but please god, don't hurt the cute little mice.....

I think we're going to need more of these...

2008-04-23T21:05:00.000-07:00

if EE could "pimp her ride" I'm sure it would look something like this:
I'm not sure if you can tell from the photo I blatantly stole off the Southwest Ambulance Site
but that's a Bariatric Ambulance.... yes- its for fat people (sorry, obese). Really, really fat people. From the SW ambulance site:

"Its main purpose is to create a safe environment that allows obese patients to preserve their dignity during transport."

Ummmm, yeah. Or so that your employees don't kill themselves and their backs trying to life a beluga whale into the back of an ambulance. Some key features:

specialized air shock/ lifts and heavy-duty suspension to lower the entire ambulance for a safer loading and unloading angle. (think you can make it bounce? We'd get a little more street cred that way)
A new loading ramp which extends for safer loading and unloading of patients with a motorized pulley system that attaches to the gurney, and a strengthened, lowered and widened patient area.

I'm all for this, hell- can we get a ramp and a winch standard on all the rigs?

(oh, and NO, I do not work for Southwest Ambulance, nor am I affiliated with them in any way. Any rumor you may have heard about me and a female EMT in the back of an ambulance is just that- a rumor. For further comments please speak to my legal council)

Why I Love Anatomy

2008-04-23T13:51:00.000-07:00

Today was the last day of my anatomy course- and I'm actually pretty bummed out about it. Its been a hard course, I've been told its almost medical school level but with an easier curve for those who just need to pass. I don't 'just' need to pass... I need to get an A, I want to be a TA. I LOVE ANATOMY, here's why:

-The professor.... the best at our school. He does crunches to show us the rectus abdominus, makes kids flex their biceps brachii, and runs around to show us what each of the three gluteal muscles do. He's a professor that you want to do well for because you love him so much

-The exams. They're hard, really hard. I've never, ever used the whole 2 hours to take an exam before this class. His exams make you think and analyze rather than just memorize. I've never been more proud of an A on an exam.

-The lab. We have a cadaver lab for undergrads. 6 people to a cadaver for the whole semester. Its amazing to put your hands inside of a body... simply put- everything makes sense. Curious to what that muscle does? Pull the tendon. What does that nerve inervate? Trace it out. All the TAs are undergrads too and they have an amazing enthusiasm for teaching.

-The usefulness. Will I ever need to write out a half cell equation and balance the electrons in an ambulance, ER, operating room, etc? Not likely.... Will I need to know the collateral circuitry of the Celiac trunk arteries? Probably... The Brachial Plexus? I bet I will... The funny thing is, anatomy isn't a pre-req for medical school. That's ridiculous! I can't think of any other one class (ok, physiology) that I will use throughout the rest of my education and medical career. Such is the life of living under Ivory Towers.

I'll miss this class a lot, but such is life. Here's hoping I'll be a TA next semester!

NCUR- A Complete Success!

2008-04-12T19:30:00.000-07:00

I just got back to my house from NCUR in Maryland. It was a great time, in fact it may have been even more than great. Stupendous? Excellent? Phenomenal? No pictures yet because I forgot my camera; but as soon as I get my grubby little hands on the pictures other people took I'll post some of the best (like me assaulting Sammy the Seagull ).

What did I do?
-Learned lots of Science, of course. Go Science...
-Partied till 5am
-Made an excellent wingman... and took one for the team
-Made the 8am shuttle, because Science is a cruel mistress
-Meet a ton of cool people from my school that I didn't know existed
-Realized exactly how freaking cool my adviser is
-Watched a lacrosse game
-Partied with the Wisconsins
-Found a new lab to work in!!!!!!!

Some of the research was impressive. Genetics and Cardio are way sexy right now and that's where a lot of the focus was. A lot of the research was pathetic- bad, non-random surveys. In college research!? The stuff I did my senior year was better than most of this crap! Oh well, it bodes well for next year in LaCrosse Wisconsin.

Cheers!

NCUR 2008

2008-04-04T20:50:00.000-07:00

Back in February a paper from my lab got accepted to the National Conference on Undergraduate Research. I won't tell you what the paper is called because that would shred the (very) thin vail of anonymity I have going on this blog. But, trust me, it was cool.... if you're into that sort of thing.

Two of my colleagues from the lab will be giving talks and I will be doing a whole lot of nothing. I'm hoping to see an old friend that goes to Georgetown and maybe go out and party sometime if it can be arranged. Because, lets be honest here- if I end up stuck with a couple hundred other type A pre-med gunners for 3 days I'm going to have to drink, a lot.

Wish me luck!

J

Exams are Over!

2008-04-03T16:13:00.000-07:00

The Brachial Plexus can suck it! The Anatomy exam was challenging. It took me 1.5 hours and I'm a very, very fast test taker. Case in point- I was done with each section on the ACT in less than half the alloted time and still almost got a perfect score. Usually, I either know it or I don't but this time I made myself slow down and really think about each problem. The good thing is that there were no collateral circuitry questions with the blood traces. The bad thing is that I messed up one of the posterior cords of my Brachial Plexus sketch and that really screwed over my answer. The question:

"The Medial Cord of Bob's Brachial Plexus is cut, the Lateral Cord of Jill's Brachial Plexus is cut. List all of the muscles (and muscles only) that are paralyzed for each person. Also, list the common muscles that are weakened."

Straight forward, easy points... damnit!

Oh, well, I guess I'll just keep studying a little harder each time...

J

P.S. There is nothing quite as cruel as having to sit through 4 hours of research symposiums when you haven't slept in 36 hours. Especially if your PI is on one side and the Dean of the Medical School is behind you. Must... Not... Yawn...

My Little Home

2008-04-02T13:12:00.000-07:00

oh, and my study place... been living here a lot lately.

All the essentials:
-Blackberry
-Pudding cup
-EMT badge and ID that the state has FINALLY gotten around to sending me 3 months after the fact.
-Desperately highlighted syllabus

One Down, One to Go and Mnemonics

2008-04-02T12:53:00.000-07:00

...midterms that is. Chem 2 this morning, Anatomy tomorrow morning.

Chemistry wasn't to bad which scares me because now I'm afraid I missed something. Whatever... to late now!

In case you didn't know, Chemistry saves lives.... it keeps stupid people out of medical school!
har de har har, except I may be one of those people.

Anatomy tomorrow will be difficult. Pelvis/Perineum, Scapular sling, Rotator Cuff, Brachium, Antebrachium, Hand muscles, and the vasculature and nerves to go with. Our anatomy program is one of the best undergraduate programs in the nation and far beyond the typical anatomy/physiology in a semester deal. I'll post some exam questions after the fact.

Anatomy Mnemonics really save my ass. A few of my favorites:

Anterior Antebrachium Muscles:
Pronator Teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Pronator longus

Pimps F*ck Prostitutes For Fun From Franks Place
-----------------------------------------------------------
The Branches of the Axillary Artery:

Superior Thoracic
Thoracocromial
Lateral Thoracic
Subscapular
Anterior Circumflex humoral
Posterior Circumflex humoral
Profunda Brachii

Sally Thompson Loves Sex and Pot

and:
the first section of the axillary artery (first rib to pertoralis minor) has one branch
the second section (medial to lateral borders of pectoralis minor) has two branches
the third section (lateral border of pectoralis minor to distal border of teres minor tendon) has three branches
------------------------------------------------------------

Yep, its not hard to tell where my mind is based on those... but alas what is a 21 year old guy to do?

Who am I?

2008-03-30T19:14:00.000-07:00

Hey there, first post here and one that I'm sure nobody will read for quite sometime.

Hi, I'm J. Yeah, for those of you who actually know me that's not exactly anonymous but I'm not sure how anonymous this blog will stay. Probably just enough so that I don't get fired ;)

Who am I?
-I'm a student at a big University in the Western United States. I'm hoping to go into medicine and I'll be applying for medical school in 2 years or so. Lately I've been having my doubts about this career path though. My father is a physician and I've watched him work himself to death- he claims its not worth it but I've always been stubborn.

I play the game well, I've been published and I still do research. When I focus on school it gets done and I get good grades. This is my fourth year of undergrad but I really took two years off, which leads me to:

-I was a semi professional athlete. I wasn't really all that talented but I worked my ass off and it let me travel the US and Europe. I loved the lifestyle but hated the day to day work and starving myself. Eventually, I took a sport that I loved and made it into a job- I still don't regret it though. In a lot of ways attempting to be a professional athlete is a lot like going into medicine. I'll talk about that more later on.

-I'm an EMT-B, and a very new wet behind the ears one at that. So far, I love it. I'm sure I'll have some (HIPPA approved) stories to post this summer.

-I've played the cello for 12 years (random instrument ay). Another thing that I'm not very talented at but I make it work. I'd like to learn the guitar this summer.

What do I want this blog to be?

An outlet. I often need to vent, I'm hoping this will help more than anger management classes
A resource for other aspiring pre-med students. Please, someone learn from my mistakes!
A small bit of daylight and happyness, bunnies and all that stuff, in your big world of darkness. Perhaps a bit of entertainment if you will.

Cheers all.