Thirsty? Why Wait?

For the second time in as many weeks, I bought one of these guys. Insanely good stuff. Not your cheapest drink ever at $1.59, but it is cheaper than an ice bomb or a Jager bomb, sans blue coloring and heart effects respectively. This is probably the fastest I've ever downed 14 ounces of anything, it's that good. On a side note, they also make cookies and cream Pop Tarts. I've yet to try them, but a box of them still awaits me from my Chicago trip.

Also, if you're ever around the Illini Union, stop by Serendipity. Apparently they serve ice cream among other things, who knew? In passing a friend's recommendation on, I'll vouch for the green tea ice cream. Yeah, I questioned the deliciousness factor of a tea flavored ice cream also. But as someone who doesn't drink or like tea, I liked it quite a bit. Whether or not that's a good thing, I'll leave that up to you.

Scratch One Off

I don't have one of those lists of things to do before I die. But if I did, finishing a crossword would be on such a list. A couple of times I've come close, but I've always needed the puzzle's help to tell me what letters were wrong. Not this kid, not today.



Ordinarily I'd down a beer in pseudo-celebration. But society tells me that something's wrong about doing this at 10 AM and before breakfast.

Progress Note: Mr. Illinaisa (4/26/07)

Subjective
21 year old male presents with symptoms of not wanting to do anything. Pt reports sx starting after first med school acceptance. Condition initially described as chronically occuring, without trigger or aggravating factors. Sx relieved only by occasional interest in class topics and thinking of getting into (a) certain med school(s). Pt c/o sx recently worsening with "end in sight and last summer before med school looming." Increasing amount of time with neuro research not helping sx. Pt reports jackassing, lounging, and drinking help condition. No other complaints.

Objective
Labs, vitals, physical exam within normal limits.

Assessment
Senioritis

Plan
Continue jackassing, lounging, drinking. Partake in neuro barcrawl, barbecue. Enjoy light finals week. Followup in four weeks. Advised to call office if symptoms continue to worsen.

CPT Code: No Charge
SSN: ***-**-****

Signed: Illinaisa's PCP, M.D.
(04/26/2007, 12:39)

On the Road Again, Part Deux

Got back from Chicago last night and in the words of Laverne Roberts, all I have have to say is mmhmm. The combination of UIC's second look and having easy access to the city was just amazing. Second look did its job. The program had faculty and a student panel talk to us and they seemed genuinely happy to be at UIC. I like the way the curriculum is set up, they have an insane number of clinical rotation sites throughout Chicagoland, and I like how much M1/M2 clinical exposure their kids get. Also, the atmosphere and camaraderie they demonstrated were clinchers for me. On my interview day, these were things that I found lacking. Rush was a place where the atmosphere and general vibe were just there; it made me want to be a part of that. UIC's second look showed me that they too have that, and completely changed my opinion about the school. This, in combination with being in Chicago and UIC being one of my cheaper options, (around $40000 cheaper vs Rush) makes me pretty sure that I'll be at UIC next year.

I mentioned having easy access to the city as something that I liked. The Eisenhower runs right by the Medical District area, as does the CTA's blue line. With these two, you can go a lot of places. The picture below shows the Eisenhower meeting the Dan Ryan and Kennedy, while going off into the Loop. Also, to the left is a Blue Line station. On a side note, I think the Camry in front of me was trying to get into a wreck.

Why does all this matter? Because Chicago is a pretty big city with lots of unique neighborhoods. It took me a day and a half to explore most of the UIC area on foot, and I found some interesting places with the area definitely having its own feel. I can only imagine that there are a lot of other neighborhoods that I'm unaware of that I'd also like. UIC gives med students a card that allows free, unlimited access to the CTA system. That card and being so close to a few major highways would make it pretty easy to get around the city.

A few more random things. I ate at White Castle for the first time in ten years or so, and it's good stuff. I can see why Harold and Kumar would want some of that so badly. Also, since their burgers are so small, you can have quite a few before getting filled up. Still, it's still weird to hear phrases like "I need 20 white castles" being thrown around.


I mentioned the Eisenhower as one of a couple major highways in Chicago. Out in the near west suburbs, it's pretty much a guaranteed traffic jam. This is thanks to the design of this area of the highway: way too much merging from too many major roads in a distance that's too short to accommodate this. This guy below is a picture from a Saturday afternoon around thirteen miles outside of downtown. Rush hour's gotta be pretty shitty.


During my downtime in Chicago, I figured out how to use Photoshop to combine pics together.This one's kinda blurry, but there's only so much I do with a night shot and no tripod.


And a twilight view of downtown.

On the Road Again

I'm back in Chicago, again at the Marriott Medical District. Nice hotel: sweet king bed, nice rolly leather chair and desk, even a wet bar. I'm up here for UIC's second look, a program where the school highlights itself without the pressures of interviewing. It's a chance to check out UIC and possible future classmates before the May 15 deadline of picking what school you want to attend. Other schools make second look into a weekend affair, usually involving some sort of social outing. For some reason UIC does neither: it's a one day thing without any kind of bar outing. I'm hoping there's an informal get-together tomorrow night.

While I'm here, I figured I'd check out the area and get a look at some apartments. Since UIC is divided into an East (undergrad) and West (med) campus, the area in between has parts with a collegetown feel. I've found some local ethnic restaurants and a couple of decent looking bars, without even venturing over to the East campus yet. I've also found an apartment that's definitely the front runner. Two bed, two bath townhome for $925 with secure parking included. The free parking's a big deal. Another place I looked at charged $185 per month for parking. And that's on top of the $1000/month for a studio. Hopefully the place will check out when I ask about it tomorrow, because it seems like too good of a deal.

A couple of random observations from the day. I have got to start making my own mochas: damn you Espresso Royale. Mochas are good stuff, but $3+ a pop adds up over time. My car has shitty luck with bumps and bruises; today I found that someone had keyed my driver side door. Asshole. Left lane drivers suck. I don't care if you're doing 65 or 85. If there's a line of cars behind you, move your ass over or speed up. With all the construction going on on the Dan Ryan and southern Tristate, I don't know if there's ever a period of time when you drive faster than 50. I've also come to the conclusion that the Eisenhower just east of the Tristate is in a perpetual traffic jam. Every time I drive through a certain one mile stretch, it takes way too long. While trying to find a spot at Rush's parking garage, there were probably 5-8 spaces that would have been available on the lower levels. But apparently not everyone can park between lines. Hell, someone even parked directly on a line and was taking up exactly half of two spaces. Come on people.

Driving, keying, construction, and parking aside, I'm pretty excited about the area and moving. After walking around for a few hours, I'm almost positive that this is where I'm gonna end up. Oh yeah, and there are some sweet views of the city. Both of the pics in this post were taken from atop a parking garage, and there are views like this all around Rush and UIC.

It's All About the Benjamins, Part III

I've had this post brewing for a few days, so I'm going to open on a note unrelated to this post. My thoughts and condolences go out to all who have been affected by the tragedy at Virginia Tech. My friends share these feelings and add some interesting commentary about the situation here.

If you want, check out these two articles for what I'm going to be talking about. Otherwise, I'll give a quick summary.

War on Terror
Odds are you've heard what's going on with Bush and the war on terror. That and Bush is wanting $1.6 billion for an imminent shortfall in Iraqi operation funding. In the long run, GW is wanting $100 billion for the Iraqi and Afghani "wars."

Residency Funding
Quick background on residencies. After your four years of med school, you enter a residency program. It's through these programs that graduated med students receive training in their specialties, be it family practice or neurosurgery. Hence, graduate medical education as a synonym for residency. You've pretty much gotta get through residency to be eligible for the board certifying, state licensing, and practicing of your specialty. Relevance? GW is proposing cutting funding Medicaid contributions towards residency training. It's through Medicaid and Medicare that residencies receive most of their funding.

Why does this matter? Well, it costs money to train residents. Without money, this doesn't happen. In light of a looming physician shortage, this would not be good. A couple of solutions are in the works: expanding the number of med schools and increasing class sizes. Shocker, if you increase the number of med students, you've gotta have more residencies available when these same kids graduate in four years. Less money for current residencies, bad. Less money for even more residencies, badder.

Another negative of cutting residency funding is the fact that residents perform a lot of the MD level (and scut) work in academic hospitals. Without residents working their 80+ hour weeks, you've got a pretty significant loss of highly-trained manpower. Also, since residents aren't paid at the level of full attendings or that of mid-level providers (PAs, NPs), these same hospitals are able to have two residents working for the price of one mid-level. Oh yeah, and these two residents can each work over twice the number of hours as midlevels without having to be paid overtime.

So yeah, let's keep waging that "pre-emptive war" so that WMDs which may or may not exist don't get used. Need more money for said operations? Why not. Oh, what? Domestic issues? Yessir, we've got us some of those, one of which includes the medical system. Instead of helping the field out, let's cut money out of it. After all, since our "mission is accomplished" in Iraq, we've gotta make sure things stay that way. I'm not saying that Bush is cutting Medicaid funding in the interests of funding his wars. Hell, I have no idea how that type of money gets distributed and/or reallocated. But the timing of the two statements is pretty convenient.

Here's to hoping there are still enough residency spots for me and my classmates when 2011 rolls around.

CCNH

Yesterday I picked up something I had done throughout junior year: playing bingo at the Champaign County Nursing Home. A group of about ten premeds sits down with thirty or so residents, and we do just what it sounds like: play bingo. We can just give them someone to talk to or play bingo for/with them. There is a continuum in terms of how the residents are doing: ridiculously well to barely there. After visiting CCNH a few times, I've found that I always leave feeling good, but also saddened. This time, I left feeling a little guilty though.

I feel pretty good when I hear some of the residents' ages and see how well they are doing. These residents make me wonder why they're in a nursing home to begin with. Another good feeling comes about as a result of providing company for the residents. This isn't to say that the nursing staff ignores or hates them. But the times I've come in, most of the residents seem genuinely happy to have visitors who are semi-interested in them and engage them in conversation.

It's partly because of these residents' excitement that I'm saddened when I leave. Because when it comes down to it, we're just a random group of college kids with no real connection to the residents. What's there to get excited about? Another thing that saddens me is hearing the things some of these people have done and contrasting those people to who they are today. One resident (I'll call her Anita) finished college in three years and got her RN. All her kids have some sort of advanced degree, be it MS or PhD. And now Anita struggles to remember my name. Sad thing is I can tell she's trying. She repeatedly asks me when I'm getting my masters and keeps telling me that her birthday was on Thursday. She talks about how her son was supposed to come visit and how he hasn't shown up. I don't know if her son actually didn't show up or if she just forgot. There are also those who just can't physically play bingo, due to poor eyesight, ataxia, or inability to keep up with the numbers being called.

Anita asked me if I wanted to live to be 91, like she was. I reflexively said yes in the interests of being polite. Really though, my answer is "it depends." Will I be 91 as a result of medicine keeping me past my time, aka barely mentally or physically functioning? Or will I be a (relatively) healthy 91 year old who can do most of the things I want to? Hell if I know. But in reality, if I had to lose my faculties to live to that age, I would say no. Damn. Sorry Anita.

Lent and Such

As a Catholic, one of the traditions I observe is giving something up for Lent. Things I've given up in the past include soda and using elevators. Regarding the latter, I was living on the sixth floor of a dorm at the time. Heading in and out of the building over the course of a day adds up. Hell, it adds up when you've gotta go down for lunch and dinner. It also wasn't the funnest carrying all my stuff for spring break up and down those stairs either. Every time I forgot and took the elevator, I gave x amount of dollars to a charity. This year instead of giving up something, I decided to eat (somewhat) healthier. That is, I made myself eat at least one fruit or vegetable each day, and kept the clause of giving money to charity for each day I forgot.

After these different Lenten seasons, I hardly ever drink soda anymore. I also find that I take the stairs more often than I used to (never). Being only a few days removed from Easter, I'm still trying to eat some fruit or vegetable each day. This would be an improvement over my never eating fruits or vegetables. Maybe this fruit/vegetable thing will stick. Regardless, it's kinda cool how just forty days can lead to rehabituation that actually persists. Hooray for eating healthy!

Saturday! In the Park...

I'd have to disagree with Chicago in thinking it's the Fourth of July. Mainly because 1.) it's April and 2.) its 30 degrees out. But I have spent a decent amount of my Saturday on YouTube looking for talk show segments I'm fans of. On a side note, Jawed Karim the founder of YouTube, is supposed to be speaking at U of I's commencement this year.

Jimmy Kimmel's "Unnecessary Censorship"


Jay Leno's "Headlines"




Random Conan O'Brien Bit


Peyton and the United Way

It's All About the Benjamins, Part II

The counterpart to this post dealt mostly with the funding aspect of medical school. Mainly, coming up with around $200k for school.

Once the loan business is figured out and you get to fourth year though, you should probably know what specialty you want to practice. Depending on your M3 letters of recommendation, med school ECs, and USMLE Step I score, various specialties might be opened up or closed off. Obviously, each specialty differs in its lifestyle, hours, and pay. And in reading through SDN, I've gotten the impression that there are a few people who are going into medicine purely for the money. You would think that interviews would weed these people out, but some people are just good at playing nice for a few hours. These are the people who make it hard to mention money and medicine in the same sentence. But having said that, I highly doubt that there's any med student who doesn't think about money a little bit, myself included. The following are all based on a premed's somewhat idealistic notions of medicine and the educational process. We'll see if this changes over the next few years.

For the most part, people go into medicine for the cliche reasons: helping people and liking science. Where things differ is how people get to the point of deciding on medicine and how sure they are of this decision. Similar situations abound in how people come to deciding on a career. Either way, money is (usually) a secondary player in the decision. Come time to really pick a specialty and all things equal, most people, like anyone else, will choose money. All things equal = same interest in the fields, hours, call, lifestyle. Of course, things are never equal. Some people value personal interest over hours and vice versa. At this point, I'd personally go into a field that interests me and hopefully all the other stuff falls into place nicely. Others may want fields with the least call and least hours: to each his own. Either way, I'll probably have no idea of what field interests me until I get to M3 rotations. If this happens to be derm, then so be it; if it happens to be family practice, so be it. If I've ruled out everything else and it's a dead heat between derm and FP, then derm it'll be. But if I had to choose now, it'd be between emergency medicine or a surgical field.

I guess the point of this is to put my thoughts on money and medicine out there. More so for myself to see if and/or how things change. But also for any reader(s) out there. Yeah, I think about the money aspects of everything: both loans and what I might be making. But both of these are secondary considerations in comparison to the reasons I'm going into medicine and eventually finding the specialty that I want to practice (USMLE scores willing).

Einstein Was on to Something

According to Einstein, time is not a constant, the speed of light is. Enter my contribution to his theory: damn, time flies.

I was wasting some time on SDN and I found some threads talking about the MCAT and letters of rec. I kind of laughed to myself and realized that that was me a year ago. This time last year, crunch time for the MCAT was coming up. I can still remember taking practice tests. I remember seeing Silent Hill the night before the MCAT and wanting my money back. I remember the kid who inexplicably voided his test after the last section and left. I remember asking profs for letters of rec and hoping they'd get them in on time. It seems like not too long ago that I was working in the clinic and pumping out secondaries. Interviews seem like they just happened. This semester is going by fast: a little over five weeks until commencement. And in about four months I'll be moving into an apartment I've yet to see.

It's weird thinking of how in such a short time so much stuff is going to change. While I like it here in Collegetown, IL, I'm pretty excited about moving up to Chicago, checking out the city, meeting new people, and all that jazz. Hell, these are the reasons I'm heading up to UIC's second look in a few weeks.

But until all this change happens, I'm enjoying where I'm at now. And it's flying by.

Multiple Choice Patients

In taking an endocrinology exam the other day, I realized how much more I like multiple choice exams over any other format. Recognition trumps recall any day. On a side note, good exam formats trump horrible exam formats also. But I digress. Never fear, I'm pretty sure that the vast majority of med school exams are multiple choice. Actually, as a premed one of your bigger tests in the MCAT is multiple choice. And as a med student, the various steps of USMLE are multiple choice. With all this learning and testing happening mostly through MC, it'd be nice if patients presented clinically in a multiple choice format. Here are two patients I made up.

Patient A
"Hi doctor. From what I can tell, I've got normal TRH regulation, with elevated TSH production and increased T3/T4. If your really want my symptoms I'll tell you. Otherwise, I think I've got a.) primary hypothyroidism b.) primary hyperthyroidism c.) secondary hypothyroidism d.) secondary hyperthyroidism."

Patient B
"Hey doc. I'm pretty sure I've got some decreased calcium levels, increased phosphate, increased PTH, along with some muscle fatigue. Do I have a.) primary hypothyroidism b.) primary hyperparathyroidism c.) secondary hypothyroidism d.) secondary hyperparathyroidism?"

The answers, which I'm sure I'll slowly forget, are d and b. At least, I think those are the answers.

Sure these "patients" are exceedingly simple and there are probably numerous differentials that I'm unaware of. At this point, it'd take me a bit to figure out which of the choices is right, and that's including knowing the proper context to look in. It'd take even longer if I had to pull stuff like this out of my ass. Ah well, I guess that's what med schools are there for: sciences and clinical applications of science.

Either way, as long as multiple choice patients don't bring in the answer choices "none of the above" or "all of the above," MC patients would be sweet.