Alpha Omega Alpha

Alpha Omega Alpha (AOA) is the only national honor medical society in the world.  Its raison d’etre can be expressed in a phrase: to recognize and perpetuate excellence in the medical profession.  As stated in the society’s constitution, "Alpha Omega Alpha is organized for educational purposes exclusively and not for profit, and its aims shall be the promotion of scholarship and research in medical schools, the encouragement of a high standard of character and conduct among medical students and graduates, and the recognition of high attainment in medical science, practice, and related fields."

Election to AOA is a distinction that accompanies a physician throughout his or her career.  Especially for the younger physician, the society provides a forum for the exchange of ideas as well as a source of valuable contacts.  Members can be elected as students, house officers, alumni, or faculty of an affiliated institution, or by virtue of distinguished achievement in any field related to medicine, on an honorary basis.  Students are elected into membership based on scholastic achievement, personal integrity, ability to work well with their peers, and promise for significant contributions to the medical profession.  No more than 15% of each class can be chosen for membership.

I just got word yesterday that I am part of that "no more than 15%" of my class.  Apparently this is a big deal to residency programs and is looked upon very favorably.  🙂

Still Alive :-)

In case anyone was wondering… I am still alive and kicking.

I have been back in St. Louis now for about a week and a half and I have been nonstop busy the whole time.  I started my sub-I (sub-internship: a way to test the waters and let me see what things will be like when I am a doctor next year, and I get evaluated to make sure I am up to par) and it is going fantastically well.  Though it started out kind of crappy with a disorienting first day (new people to meet, given a patient load right away without good instructions, I was also on call…) but it just got better from there and I am all settled in now and loving it.  I am on call again right now, I’m on call Q4 (which means every fourth night) but sometimes it feels like I haven’t had a break for a long time.  I really like the independent feeling of working as a sub-I, and it will be even better next year when I don’t have to get anyone to co-sign my orders. 🙂

I have been seeing kids with asthma, diarrhea, pneumonia, cellulitis, acid reflux, diabetes, cat scratch disease (we think), osteomyelitis… lots of different things.  All very interesting, all things I am trying to read more about so I can better understand the management end of things.  Last year I spent so much time learning about the conditions, what causes them, how to diagnose them… but I didn’t learn a whole lot about how to treat thing so that’s what this year is for.

Outside the hospital things are good too.  I saw "Serenity" and totally loved it – though I was disappointed by the small turnout at the theatre.  Too bad that people are missing out on a great movie (and that they missed out on a great tv show when it was on).  I don’t have any brilliant solutions or suggestions.  I just wanted to say I loved it, it was full of Joss Whedon, which was fantastic.  You could totally tell that this was his movie from the characters to the plot to the witty dialogue and subtle treasures included in every scene.  Joss is brilliant and I want more of him.  I am not so sure about this new Wonderwoman thing he’s got going on – I fear he will be a collaborator and not the driving force so his stuff may get lost in the crowd. But I will see it – I will support Joss – and hopefully he will continue creating great entertainment.

I also saw "The Corpse Bride" – because it was at the Moolah and I like going to that theatre. 🙂  If anyone visits out here, you will definitely see a movie there – no matter what’s showing, you just have to go.  It’s worth the experience.

Hmm, guess it’s back to work.  I have to call some primary care doctors and let them know their patients are in the hospital, and go dictate a few "clinical summaries" for kids I discharged over the past few days… and maybe go watch an upper endoscopy if there’s time.  Hopefully I can find some time this weekend to get some more pictures up on here.  I’ve taken a lot over the past week since I’ve been back, but they’re all on my computer at home so no love right now.

Week At A Glance

This was going to be a prospective Week-At-A-Glance, but then I kept putting off the writing part and just made little notes of what I did.  So I went back and filled out the details and now it’s a long retrospective look at what I did last week.

Monday – A.J.’s last day here over this long Labor Day weekend.  We got up and took a walk around the part of the Interurban trail that runs by the office.  It is lined with blackberry bushes on both sides, so we often bring containers when we walk and pick the berries.  There are 2 or 3 different kinds of blackberry bushes along the trail so there are always some that are perfectly ripe.  A.J. has been bringing bags of frozen berries back to St. Louis with him and we’re going to have little blackberry pies when I get back.  He made some for Jill2 for a Star Trek night and she said it was the best blackberry pie she had ever had.  Today we also had lunch over at the Lynnwood Claim Jumper with Sandi and the visiting South Dakota relatives.  This was a first time experience for the out-of-towners, so we got one of the big desserts (an "I Declare") to wow them with.  I’ve found that ordering a black decaf coffee and then just using the whipped cream off the dessert works wonderfully.  No messing with cream and sugar, just a mouthful of whipped cream and a slug of coffee – heaven in my mouth. 🙂  After lunch we had just a little bit of time before we had to head to the airport, so A.J. and I got out our Beamo and tossed it around in the driveway.  This frisbee-like thing has got to be the most fun park toy I have ever played with.  I like to play ring toss with it, where A.J. is the thrower, and I am the thing that the ring has to land over – I can catch it by putting my up-stretched through the hole in the middle, then the beamo just falls down around my waist to my feet.  It is so much fun – sometime I’ll get a video or picture or something so you can all see what I’m talking about.  Well – then it was time to drop A.J. at the airport – which was a funny goodbye since he would be back on Thursday night (a little mix-up when buying the tickets led to visits 2 weekends ina row instead of more spaced out – but it still worked out well so no worries).  After that I got some laundry and visiting done over at mom and dad’s and then I headed out for an evening of socializing and reminiscing with Arielle – my best friend from high school.  I hadn’t seen her for a long time – we usually end up talking on the phone once or twice a year and seeing each other maybe once a year – but I love how we can just pick right up like no time has passed.  We went down to Alki and ate at the Bamboo Grill followed by coffee at Starbucks.  I love how we can talk about everything from school/work to relationships to current events and life in general and there’s no awkward pauses. no worries of "should I be saying this?" or wondering how she’s taking the things I’m saying.

Tuesday – After the long holiday weekend, I went back to work at the NICU today.  I met up with Heather and we bussed back to West Seattle together.  After some dinner down at Puerto Vallerta (in the West Seattle junction) with Heather and Justin, the three of us went to The Garage (on Broadway by Seattle U) for some bowling and pool.  I slept over in West Seattle and got to experience the bus ride to the U by myself the next morning…

Wednesday – Yes, so the bus ride… funny how it costs half as much to get to the UW from West Seattle ($1.50 compared to $3.00) but it takes twice as long as when I leave from Lynnwood.  I was on call today and we had a lot of 31-week babies threatening to deliver, but in the end only 2 (a set of twins) actually showed up.  I get to follow them now for as long as they are here… well, catually for as long as I’m here, because they’ll likely be here longer than the two weeks I have left here.  Surprisingly enough, after those two little guys showed up around midnight, I got to go to bed and didn’t get woken all night. 🙂  Oh, and A.J. e-mail my Step 2 CS score sheet to me today, and surprise – I passed!  And the score sheet was really lame without any explanations or anything – but the main gist is that I passed so I suppose nothing else really matters anymore.

Thursday – So after being on call, I got out of the hospital early and bussed home to Lynnwood where I showered and ate lunch and watched a little sci-fi before falling asleep.  I slept for three or four hours and then still had time to watch some more sci-fi and an episode of House (great GREAT show – very funny!!) and work on the Camp Casey newspaper before leaving to go pick up A.J. at the airport.  We had a late dinner (and A.J. spent an hour on the phonewith T-Mobile debating a charge on the monthly bill) and then went to bed.

Friday – Last day at work this week!  It was a short day, I was done by noon or so and then had lunch with Heather.  A.J. came to pick us up from the U and we dropped Heather off at a bus stop downtown so she could get home to West Seattle.  Then A.J. and I went down to Pike Place Market and had the chowder sampler for lunch.  It’s from a little chowder shop in Post Alley – but I forget the name.  It’s really yummy – I especially like the seafood bisque!  We also got some fresh peaches and a maple doughnut!  We walked around downtown a little bit, and then headed up to Queen Anne.  We sat in Starbucks and reminisced about our years at SPU – and both agreed that we would take much more advangtage of the area (Queen Anne) if we were at SPU now.  Funny how hindsight works, huh?  But I think we took good advantage of other areas during those years – I just miss being in Seattle and being able to hang out in places like that.  As we sat in Starbucks, I had the great idea of visiting the SPU campus to go see if our University Scholars Honors Projects were really in the library like we were told they would be.  I wasn’t sure what I expected to find there, but I was really excited to see that I could search the database by my name and my project would show up.  It was catalogued and numbered and everything.  It was very cool. 🙂  I felt very special.  After that ego boost and reminder of how I used to understand very technical science-y things, we wandered around the rest of campus.  We explored the new science building, and then the old Slick (Miller Science Learning Center = SLC = Slick) which is now called Otto Miller hall – which I don’t appreciate at all.  I like the old name better, it had more character.  Anyway – that building is all remodeled too, and we ran into a couple of A.J.’s old professors who showed us around and chatted.
     Wow, this is a long day – I’ll start a new paragraph. 🙂  So after the SPU fun, A.J. and I headed back up to Lynnwood for some racquetball with Brasten and Chris.  It was a great night and we all played well – I had so much fun.  I am going to miss playing racquetball when I go back to St. Louis.  A.J. plays on Wednesdays there with his law school friend(s), but I will only sometimes be available for that.  After the exercise, we all went to the Claim Jumper for appetizers and dessert – and we celebrated Rainbow Bear’s 6th birthday.  You should go to his website and check out the picutres.

Saturday – After a little sleeping in, A.J. and I got up and headed out for the Puyallup Fair.  Fun, fun, fun times. 🙂  I went down the Giant Slide 5 times in a row and it was awesome! We had yummy fair food (sliced caramel apple, spud’s fish and chips, strawberry milkshake, scone) and browsed through all the vendor displays.  A.J. took lots of pictures of the info-mercial people, and I think he’s going to put together a little photo album of them.  I love going to the Puyallup Fair and just wandering around.  Did you know that people enter their collections of things to be showcased?  I could enter my vast array of koalas for people to ooh and ahh over.  I might just do that one day.  People had Lion King and Dolphin and Spice Girls collections… so why not koalas? 

Well – this entry has gotten very long.  Hopefully it was a not too uninteresting read for all of you, and hopefully it has captured my memories well enough for it to mean something to me when I read it again later on.

The things I see

I see the strangest and most interesting things at work.  I also see the happiest and saddest things.

Tuesday morning I was at the birth of a very tiny little baby.  He was only 25 weeks gestation (full term would be 40 weeks) and his story is heartwrenching.  His 18-year-old mom had at one point made the decision that she was not going to carry this baby anymore and went in to have an abortion.  However, something changed her mind once the procedure was set in motion, and she ended up not going through with it.  However, her membranes had already been ruptured and she had lost a lot of the amniotic fluid.  This was not a great thing for the little one inside, and sure enough mom and baby both ended up getting an infection because the protection of the membranes was no longer intact.  This necessitated induction of delivery since it was going to be much less healthy for the baby inside than out here, where we can give him medicines and help him get better.  So mom had the baby at 25 weeks.  Now she’s going home (to far to commute to visit) and is planning to come back and rent an apartment closer to here so she can visit her baby.  Her baby who will be hospitalized for months because of his age.  Her baby who will endure the hardships of prematurity and all that it brings – infections, lung disease, feeding difficulties, risk of blindness, bleeding in the brain…  and very likely a less than ideal outcome as far as disabilities go.  I wonder what this girl had planned for her life and how things will work out for her now – so different than what she expected I’m sure.

On Wednesday we anticipated the arrival of a new baby with a sacrococcygeal teratoma.  Whoa, big word!  It’s basically a really big growth near the tailbone.  It makes it nearly impossible to have a vaginal delivery (it would be like trying to get 2 heads out – and just 1 is work enough, ask any mother!).  Usually they are benign growths, but 10% can be mailgnant so it’s important to have the surgeons go in and remove all of it.  So I was there in the operating room when this little guy was born, and I watched as he was stabilized and then put into a sterile plastic bag to protect the growth from rupture/infection until he could be transferred to the operating room.  Don’t worry, the plastic only covered from his feet up to his chest, his head was open and free to breathe. 🙂  It was pretty amazing to be able to see this kind of birth defect in person – one of those "I hope it never happens to anyone again, but if it has to, then I would appreciate the opportunity to see and learn from it" kind of things.  It’s considered the most common tumor of newborns with an incidence of 1 in every ~40,000 births (which still doesn’t make it that common).  My attending said that maybe there are one or two born here every year, so it’s not often that one gets a chance to see it.  I’ve seen lots of textbook pictures of these tumors, but this was my first "in person" experience and it will definitely stay with me.  The tumor was at least 1/3 of the baby’s weight!  Anyway, here’s a drawing of what one looks like:

This morning there was another baby born with an abnormality – he had some blockage of the urinary tract and his bladder was really distended.  While he was still in utero, a surgeon put a little tube in so the bladder could drain (into the amniotic fluid – where it would go anyway, people, so don’t be grossed out by that!).  It looks like he might have "prune belly syndrome" where the abdominal muscles don’t form well and the urinary tract may have malformations.  He was a twin, and his brother is totally fine.  Actually, he was totally fine too.  Breathing well, heart beating fine, good muscle tone – all the good stuff.

And finally, this afternoon a little boy was born (all these boys, oh my) by C-section because his mom was getting sick from being pregnant.  She had HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), which is something moms can get for unknown reasons and it can be fatal – the treatment is delivery of the baby as soon as possible.  Luckily, this guy was almost 35 weeks, so he was barely premature.  He came out a little dazed and confused since his mom had gotten general anesthesia and it affected him as well.  But soon he was kicking and breathing well.  And his dad was just so happy and excited.  He teared up and held the little guy’s fingers and was positively giddy.  It makes me smile just thinking about it. 🙂

There are lots more happy stories too – but of course not all of those stick around in my head as much as some of the "interesting cases" do.  Kind of like on the evening news – we hear lots about the crazy and bad things that happen, but not too much that warms the heart.  I’m trying to make sure I remember the good experiences with as much clarity as the not-so-good.  It helps to remember that more than 90% of babies don’t need any help from us doctors when they are born.  That’s a big number.  And it’s just fine with me. 🙂

Commuting By Bus

So this morning I took the bus as a commuter for the first time ever – and it went pretty well.  I found that the Community Transit 855 runs from the Lynnwood Park and Ride right down to the University of Washington Medical Center.  It takes half and hour and costs $3 (though I’ve heard it’s only $2.25 if you’re a student, which I am, so maybe I’ll try that out tomorrow).  This is espcially nice for when I’m on call so I don’t have to find a place to park my car overnight (virtually impossible down at the U).

So all in all I liked doing the bus thing.  I can read a bit during the drive, I don’t have to deal with traffic, and it’s fairly convenient.

Just for fun, here are some pictures from this morning:

Ch-ch-ch-ch-changes

This weekend marks another change in cities for me – I’m now done with my Peds Neuro rotation in Portland and I’m getting ready for my Neonatal rotation in Seattle.

The past month went by so fast!  It seems like just a few days ago I was moving all of my things into Paul and Theresa’s place, and then yesterday I moved everything back out.  I still can’t believe they were so generous as to offer their house up to me for the whole month.  And I felt so at home there – much of that due to Paul showing me around, teaching me about the tv, and including me in family dinners.  And their two kids, Alex and Lauren, provided much needed study breaks when I would leave my bedroom door open – compliments on my clothes and inquries as to how I was doing and if I was learning anything good that day. 🙂  I’m looking forward to staying there again when I head back to Portland for my residency interview in a few months.

My rotation went really well and I enjoyed myself quite a bit.  I could really see myself at that residency program, I think I would fit in quite nicely.  As I was telling some people, I sure hope I like the program in Seattle as much (or more) since overall I would rather be in Seattle than Portland – but really, either would work nicely.  I had a very nice meeting on Friday with the head of the Peds Neuro department at Dornbecher (the children’s hospital in Portland I was working at).  We discussed career options in Peds Neuro and how to go anout getting there.  I also was on the receiving end of quite a few compliments regarding my clinical skills, my intelligence, my personality, my overall performance there during the month… it was very much an ego boosting afternoon – something I highly encourage all of you to participate in whenever you get the chance. 🙂

So now I am preparing to start with the little, little babies tomorrow – a little anxiety inducing, but also somewhat exciting as well.  I got back up to Lynnwood late last night (after stopping to drop my mom off in West Seattle and getting sucked into watching a "Trading Spaces: Home Improv" with her, Heather, Justin, and Ruby).  I’ve spent the day so far unpacking, settling in, organizing, and catching up on my Sci-Fi Fridays that I’ve been missing by going to sleep too early for the past few weeks.  I also watered our rooftop pea plants and made some Winner-the-Pooh toast.  And hopefully I’ll get some of my residency application info entered into the online application service, go out and get some groceries, and maybe check A.J.’s PO Box before I head out for my soccer game this evening.  And here I thought I was having a relaxing lazy day, but look at all the things on my list.

Graduation – New Info!

So my medical school graduation has been changed slightly – it will now take place on Thursday May 18th 2006 at 1pm (still in St. Louis :-))  Although I think this is the final arrangement, I wouldn’t be overly surprised if the plans changed again.  If anything else changes I’ll be sure to let everyone know.  A.J. still graduates that same day starting at 7pm.  So this will be the marathon of graduation days.

Superstar

I just got my Step 2 CK score in the mail.    I got a 242 – which is really good!  It’s even better than my Step 1 score was (231).  This is wonderful and awesome and I am so excited!!  Of course, it was sent to St. Louis, so A.J. opened it and read it to me… it was so suspenseful as he read through all the mish-mash, blah blah, blah at the top of the score sheet… I almost couldn’t stand it!  Anyway, to put it in a little bit of perspective, the mean and standard deviation for recent first time test takers in the US/Canada is 218 +/- 23.  So I’m above average.

If you want to see what a USMLE Step 2 CK score sheet looks like, click here.

OHSU

Some representative pictures around the OHSU campus.

A pretty cool fountain up near the medical school building.  It was cool to find this because I love fountains (and waterfalls, and rivers, and oceans, and showers… pretty much I love anything featuring water).
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These are a couple of views of Dornbecher Children’s Hospital – see how it looks like a bridge?  It goes across a canyon.  Very odd construction up here on this hill, but somewhat cool as well.  The hospital has ground floor entrances on the 1st and 10th floors. 🙂
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Anyone with half a brain can work here… no just kidding.  This is a sculpture outside one of the research buildings.  It’s pretty big (about 6 feet tall).
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Migraine Dinner

I went to a dinner lecture last night at the Riverplace Hotel down by the waterfront here in Portland.  Very nice hotel with a beautiful conference room.  The lecture was on migraine headaches and the newer research that shows that it’s not entirely a vascular phnomenon as was previously thought (and as was taught to me in medical school).  It used to be thought that the blood vessels in the brain would go through a spasming period (which could produce an aura) and then would dilate and become engorged and congested (producing the migraine).  But new studies show that the headache actually begins before the engorgement of the vessels, and maybe that is actually a response to the headache and not the cause.  All very interesting… and offers some insight as to why neurotransmitter modulating drugs have helped prevent migraines for a lot of people (things like the SSRI anti-depressants and some anti-epileptics like Topamax and Depakote).

Anyway – the talk was interesting and I got to enjoy a very good dinner, starting off with some great appetizers!  I love appetizers.  They make me smile.  They are definitely on my list of "Happy Things".  🙂

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