Scavenger Dash

The weekend before last - my co-resident, Sarah, and I entered a Scavenger Dash.  It's approximately a 5 mile, run/walk/ride public transportation race around the city - following clues, completing tasks, and gathering items.

Here we are prepping for the race - both packing our bags.  2nd use for my camelbak and still I didn't drink enough water during the day.  I guess I forgot that I was in the desert.

"Two White Chicks"

That's our team name.  It's from an inside joke, that one of our other co-residents honestly believed that we both are through and through white.  According to her, neither of us appear to have any different ethnicity in our blood.  hmm....???

The rest of our team uniform - tail feathers and all!  MoJo is our favorite type of granola bar.  My favorite MoJo flavor is mountain mix - Trader Joes sells them for $0.99 each.  (like that plug)  Maybe next time we should contact the Clif Bar company to see if they will sponsor us!

The starting point - "The Hut" in Tucson.  We ran to get our envelope of clues and then immediately started trying to figure out the answer.  They give you all of the clues at once, so if you figure out all the places you need to go then you can map out your route accordingly with the least amount of back tracking.  You're allowed to use cell phones and have a "pit crew" who is at home and can look up stuff.  I immediately called Waseem (my old roommate from last year who was in town visiting) and Sarah started searching on her phone.  After a few minutes we decided to start and have Waseem figure out the clues as we headed for one of our first destinations.  (I eventually ended up emailing Waseem a picture of the clue sheet)

1st photo clue done - Picture with a Mannequin.

1st challenge - we met a representative for YELP and had a challenge that involved searching their website for clues and reviews.  This took us longer than it should have, because we were trying to use our iphone apps rather than use the actual YELP website.  Eventually, I got fed up trying to find it on my phone and called Waseem.  This ends with me yelling "SPLOOGE" - S-P-L-O-O-G-E - into the phone in the middle of a cafe.  Waseem couldn't hear me for some reason and wasn't getting "splooge."

2nd challenge - (sorry no picture) involved Sarah blindfolded in a park standing in a maze of cones.  It was my job, using only my voice to guide her through the maze without touching a cone or else we would have to start over.  1st try was a success!!!  I guess all that talking I do paid off and Sarah's a good listener.

Next photo clue - picture of the team in an elevator.  This is a random elevator at a parking garage on the U of A campus.  

Next up - put a dollar in the donation safe at a museum (can't remember the name of the museum now)

While on the U of A campus - we made a quick run into a Jimmy Johns and grabbed a "WIPE" - which apparently is just a Jimmy Johns napkin with the word WIPE on it.

A picture of border issues.  Who is who?

NCAA Softball Champions for a certain year - we found the plaque.  woo woo

Time to do some planning.  Where are we headed next?  Can we catch a bus back part of the way?  Let me tell you - reading the bus map/schedule is more complicated than you would think.  And....if you know me - you know that I'm not the best when it comes to directions.

YAY!  Having fun.

Oops....something went awry.  One of our clues was GPS coordinates that needed to be converted into an address.  Waseem sent us an address and well....it stuck us in an alleyway.  We actually caught a bus by chance, rode it for one stop - jumped off, only to find we were not in the right spot.  Sarah called another friend to try and see if she could help us with the coordinates after we both attempted searching on our iphones.  A new $1.06 iphone app later and we had found the address.  Waaaayyyyy down the street from where we were - many more bus stops.  Now that we knew where we were headed, guess what  - no bus.  So we walked and eventually made it to Rocks and Ropes to pick up a sticker.

Last stop/worst stop - at least for Sarah anyways.  Time to eat something nasty.  A pickled egg.  No bugs though.  Sarah reported the egg as being disgusting, all the wrong texture - apparently it was chalky and not easy to swallow.  A small 5 ounce beer helped wash it down, but probably a whole gallon of beer wouldn't have been enough.  We were both glad that was our last stop & not our first.

WE MADE IT!!!  Woo hoo.  Drinks in hand.  We didn't finish so hot in terms of ranking, but we had FUN!!! 

Goooooo GIANTS!!!

Last night - game #4 - I was THERE!!!!  Wooooo!!!!!  It was a great game.  I can't say the same for tonights game.  Lucky for us we were there for a GREAT game, giants win 6-5, and beautiful weather.

A drink before the game with cousin Liz.  Yummy, margarita.  Thanks Liz.

Entering the park - surrounded by tons of people wearing orange, black, beards, jerseys, hats with fake Lincecum hair, not a smidgen of red in sight.  (Phillys are red & white - and I will admit in the fear of being cold almost packed a red & white ski jacket, but mom stopped me.)

Gorgeous stadium.  We sat behind right field.    

Let's Go Giants!  Let's Go!

Behind us sat one of those "fans." One that yells at the players and the entire team.  I learned lots of new info about the right fielder, Werth.  "You sucked as a Dodger and you suck as a Philly."  or "You're Werthless."  "Werth nice mullet."  There were many more, but I can't remember them all.  My favorite though was when Panda from the Giants was up and "Fear the Fat" was echoed from behind me - a play on Fear the Beard. :)

Excited!

Uncle Kevin, Dad, and Uncle John.

Time to close...it's Wilson on the mound - FEAR THE BEARD!  This is Sief's current man-crush.  He is growing a beard himself to show his support.  

And..... a trip to San Fran would be incomplete without dim sum!

Good Night or Should I Say Good Morning?

I just came off of my night float rotation.  What is night float you ask?  Well I worked approximately 2 weeks as the night shift - coming in at 5pm and leaving around 6:30 am.  Admitting patients overnight and taking care of all the other patients on the floor - when they needed more pain meds, blood pressures dropped, hearts went into funky rhythms, or heart's not receiving enough oxygen.  Well at least my attending took care of a lot of patients and I stood faithfully by her side trying to learn.

Things I learned:  That it's better to stay up all night than try to get a nap.  That the ring of that phone we carry in which we get all the calls about our patients and admits is the worst, most dreaded noise in the world - especially while asleep and that my body has a physiologic response to that ring -my heart beats faster, my blood pressure goes up, and I hope I'm smart enough to answer the question that comes from the other end of the line.  That my stomach doesn't handle blood, guts, and puss quite as well when it has been up all night and is tired.  That my body was confused for 2 weeks as to when it was appropriate to eat and when it was appropriate to sleep.  That next time I'm on night float Penny is going to live at my friend Sarah's house, so she won't wake me up, by shoving her cold wet nose in my eye, 1 hour after I've fallen asleep when I get home.  That dusk and dawn can look very much the same.

I'm in the Tucson airport now, on my way home for my 1 week vacation.  I have an exciting day to tell you about, but am waiting to upload all of my pics before I share.

Decisions, decisions, decisions

I make probably hundreds of decisions a day.  We all do, some bigger and some smaller than others.  The last 2 weeks I have spent my days in the hospital and for the next 2 weeks will spend my nights in the hospital - learning to be a doctor.

My attending doctors slowly giving us more autonomy to make our own decisions, to figure out how to practice medicine and feel that we are managing our patient's care.  It started out small last week, with how to make my patient's poop.  "What's your favorite treatment for constipation?"  Options include - Milk of Magnesia, Colace, senna, Magnesium Citrate, lactulose, and a variety of suppositories.  So I picked one, no poop, next day try a different one.  There you go that's what I'm learning :)  Hey, all decisions matter the faster I can get my patients to poop, the happier they'll be?!
My little decisions and slowly advancing to other parts of patient care.  Learning from watching the decisions my attendings make in their choice of bedside manner - when to play tough and try to scare the patient and when to sit down and really talk out the situation.  As doctors, I am still learning much like a 2 year old, through mimicking.  I watch and then I do - picking and choosing which pieces of my attendings I want to mimic.  Taking those little pieces to make me into a doctor.

I am able to see the consequences of many of my patient's decisions.  Deciding to be an IV drug user and blowing out all of your veins may buy you a central line in order to be able to draw blood or give you fluids.  You also will likely get stuck umpteen times in an attempt to get a peripheral line before heading for the big guns.
Shooting up into your external jugular vein may cause a life threatening abscess in your neck that may actually scare you enough to come clean.  Or perhaps you'll be admitted to the hospital with what I learned is called "cotton fever."  Apparently when shooting up heroin or crushing up pills, then dissolving it in a liquid in order to shoot up - during this process at some point they filter it through cotton, but oftentimes it is a cigarette filter - well sometimes microfibers from the filter get into the bloodstream when shooting up and the body has an inflammatory response which causes high fevers.  Apparently if you go to the needle exchange program in town you can also get clean cotton which will prevent the likelihood of cotton fever.

And working in a hospital makes it inevitable that end of life decisions will be made.  When is the proper time to send your mentally handicapped brother to hospice rather than try to prolong his life with feeding tubes?  Rather to let him enjoy eating whatever he likes, but knowing ultimately he will likely die from aspiration pneumonia.  Apparently, I have learned that pneumonia is not such a bad way to go, because the brain becomes hypoxic and there is not much pain.  They know this from patients who were nearly there and came back from the edge.
What decision would you make if you were able to choose your death.  I watched from the sidelines, as she was not my patient, a late 90 year old lady make the decision on whether or not she wanted to go to surgery for an incarcerated hernia.  Take a chance to die on the operating table from a MI or other complication versus dying from your bowel dying inside of you, a likely very painful death.  Hospice is a wonderful service and provides great care to those in their last moments for both themselves and their families.  I cannot imagine making that last decision - being rolled into the OR knowing there is a good chance that I would not come out of those doors, that this was it.  Or if I do make it out who knows how long or horrific the recovery would be.  It was a decision I could see going either way - both sides equally difficult to choose between.

Decisions, decisions, decisions - all day everyday we face 100s of them.  Many are decided without even realizing we've made a choice.  I guess just keep practicing, find out what works or makes poop and hopefully when those big time decisions roll around we'll be prepared.

A little medical humor

I'm not sure if you will all find this funny, but I find it pretty hysterical.  It's a play on the stereotypes on the different specialties :)  There are more on youtube, but these are my favorites

1/4 of the way done

It's crazy, I'm already 1/4 of the way done with my intern year.  3 months have already passed out of 12.  Wow - time really does fly.  And I know with residency it's only going to get faster.
I spent the last month on my surgery rotation.  I actually took call from home, which meant I carried a pager with me at night and had to answer calls from the nurses about our patient's on the floor or occasionally go into the Emergency Department to see patient's who may need surgery.  It pushed me and made me think, because even though back up from a more senior resident or attending was only a call away - I was still the first line and didn't want to bother them with stupid stuff.

Shh...now don't tell patient's in the hospital this, but just picture.... me asleep in bed (got to go to bed early when you have to rise before the sun), sound asleep.  Then at 10:45 pm my pager goes off.  I wake up and dial back the digits that show up on my pager.  "Hello, this is Dr. Chun with surgery, I was paged."   The nurse comes on the line - informing me that my patient's pain was not being controlled and if I could give her a telephone order for something stronger.  I suspected this might be an issue earlier in the day, but had never heard anything.  My senior resident told me if necessary I could order a PCA (patient controlled analgesia) - so the patient can give themselves pain medications, obviously there are parameters and it locks out after a certain amount.  So there I am sitting in bed, opening up my newly purchased ICU book ready to read off what it tells me on how to order a PCA.  I have no idea how to order a PCA.

I don't think that's what patient's picture when going into the hospital - there's my doctor sitting in bed, glasses falling off their face as they try to read what the book says to do.  It's crazy and yet - that's one way in which we as physicians learn.  Ultimately I did not end up ordering a PCA but rather increased the strength of the medicine the patient was already receiving.  There is still so very much to learn.

3 months in and I can say that my clinic population is building.  It's fun to see the same patients back for follow up - to learn what their test results show and to be able to see them get better with treatment.  This continuity was something you don't often get in medical school.  There are those patient's you don't want to come back and then their are those patient's who you really want to take under your wing.  I guess it's like teacher's playing favorites.  At least no one has to know about mine.  ;)

I wish I had more exciting things to share, but not too much has been happening - work, work, work.  Well, I guess the other weekend I did go to a UA game.  Ok, that was fun.  College football and I don't seem to mix though.  For whatever reason, I never seem to watch the game.  I'm too busy having too much fun.  I only went to part of one Trinity game and that was while rushing a sorority and well...here are some pics from last week's game and as you can see that's not much game watching going on.

Outside the stadium!

My co-residents Vidhi and Sarah!  You can see the field behind us!

The field!  woo woo

And....just because the game is over doesn't mean the tailgating has to stop! :)

For Fun!

My dad sent me this link today and it just makes me laugh.  I've been taking Penny to behavioral training class....let's just say she can't do what this dog can do.  Heck, this dog dances better than me!  :)