Weather

It's weird how single digit temperatures can make yesterday's 30° seem warm. Last week around this time it was hovering just above 0°. Today it was just short of 50°. Big temperature change yes, but it's over the course of a week. Tomorrow has a similar temperature swing - in one day. I'm not really sure what to do with myself clothing-wise. Or life-wise for that matter, it's that mind blowing.


It's a toughie...do I wanna be cold or warm? I can layer up, but then I'd be sweating for half the day. Or I can dress semi-warm and proceed to freeze over later. I'm leaning towards the former. It's not so much the cold that'll bother me - it's the wind. It can get to be painful. I even ended up wearing a scarf on some of the colder days. It actually kept me warmer than I would've expected - especially my face. Although...the ole manhood took a bit of a hit as soon as I threw the other end of the scarf around my neck. I know, I know - it's a rough life I lead :)

Ups and Downs, Part Two

I was in the VA today and got the chance to interview a patient. In our Essentials of Clinical Medicine (ECM) class, we're working specifically on the history of presenting illness (HPI). For the most part, I've been okay with ECM throughout the year - talking about culture, patient communication, teamwork and whatnot. But this semester, we're getting into more history-taking, ethical issues, and other traditional aspects of medicine. A random fact that's been thrown around in ECM a few times: upwards of 80% of diagnosis can be made from a good history. If that's true, it benefits everyone. No extra, expensive images or labs are needed - saving everyone time and money. Of course, some people probably feel like if they didn't have x-rays or blood taken, the doc wasn't really trying. And of course there are some that think that procedures are more deserving of compensation than cognition. But, I digress.

Back to the HPI. Basically it involves looking into anything related to the patient's chief complaint - duration, onset, aggravating/relieving factors, patterns, quality, patient action, etc. Having shadowed and worked with Dr. Parks a bit, I'd already picked up on a lot of this type of stuff. It's just now these different questions are grouped together and have a name. And now I'm starting to see how they relate to a complete history. It was a pretty cool feeling being able to get through this HPI in a coherent and semi-organized manner. Sure, I don't have the knowledge to focus down the HPI. Still, kinda knowing what I was doing felt pretty sweet. And actually, I've gotten some positive feedback about my HPIs this past week. Also, the patient was pretty grateful to have a listening ear, even if it was about his (substantial) medical problems. And he felt like I helped him, even though I didn't really do anything. Either way, it felt good to "help" him out - mostly since he's been through so much.

Mr. C is caucasion male in his 60s who's been in the VA for one week with congestive heart failure. Worsening lower extremity edema and breathing problems brought him to the hospital, per his physician's recommendation. This appears to be his first CHF related hospitalization. Related to the CHF, he has a substantial cardiovascular history. Mr. C had a quintuple bypass in 2001, which itself was performed a few days after a heart attack. The bypass was performed due to finding 70-90% blockage of his coronaries. Mr. C also suffered a thrombotic stroke in January 2002, in which "all of his left sided function was affected." His wife notes losses in vision, cognition, short term memory, and math." Of note are the reduced cognitive skills, since he had previously been an electrical engineer and drafter, including work on numerous downtown buildings such as the Standard Oil (now Aon) tower. On 10/10/07 Mr. C suffered a broken nose, and on 10/28/07, he sustained a fall and broke his left hip. As a result he underwent a left socket replacement in November. His wife believes both injuries are related to stroke related motor deficits. Other surgical history includes a 1989 rhinoplasty and a 1991 bilateral leg fracture (from a 3-story fall) with resultant treatment including left ankle fusion. Family history is positive for maternal diabetes mellitus and paternal prostate cancer but with both having lived into their 80s. Mr. C served in Vietnam where he was exposed to agent orange. He denies tobacco, alcohol, and illicit drug usage. Chronic problems are numerous and include a 20 year history of diabetes mellitus (II), hypertension, elevated lipids and cholesterol, congestive heart failure, and renal failure (25% function bilaterally, not yet on dialysis). Over the course of his stay, he is noted to have mild pericardial effusion and pulmonary edema. Patient is remarkably coherent, without slurred speech and is in inexplicably good spirits.

Over the past 48 hours, I've definitely been reminded of why I'm in this. I couldn't imagine how those who are in med school for the "wrong" reasons get through the down times. The studying sucks ass (and there's a lot of it) - and there are easier and more profitable ways to make money.

On a totally unrelated "ups and downs" note. Two weeks ago it was 65°. In January Chicago. Definitely a record high. Global warming anyone? Tomorrow we're in the single digits, wind chills in the negative teens to -20°. Brrr. Some of us are heading up to Wisconsin for a skiing daytrip though. Hopefully I'll fare better this time than last time.

Ups and Downs

I've been back for about two weeks now. After the first few days of class - the following were my thoughts. "Wow. This sucks. Hard. This fucking sucks." It's at this point that I first legitimately questioned why I'm in med school and if it's really worth it. After Thanksgiving, I've been caring less about all the work and grades. Then winter break rolled around and proceeded to exacerbate those feelings. Coming back from a few weeks of sloth, med school was the antithesis to winter break. And I'm not talking yin and yang in harmony. I'm talking laziness and freedom completely dominating any reason or motivation whatsoever for becoming a doctor. Also, the fact that UIC didn't ease us into the semester didn't help - had all our shit happening from the get-go.

UIC: "Hello children! Hope you enjoyed the holidays. We know we're a state school, but we got you guys a little present: anatomy (even with lab!), physiology, neuroanatomy (also with lab, you lucky kids!), molecular medicine/genetics, and clinical med. Oh, and we were considerate enough to have immunology/microbio, brain/behavior, human development, and histology waiting for you as an early Easter present."

Children: "Fuck you."

Luckily, today I was reminded of why I'm even doing this. I worked with a pediatrician this afternoon. There were no real spectacular highlights, motivational talks, or earth-shattering revelations. We didn't even see that many patients. Hell, we had time to leave the office and grab a (second) late lunch. But just being around the guy and seeing the end result of all this was enough: a simple, but pretty powerful reminder of why I'm doing this. I've worked with the doc before, but it's never been this influential for me. Seeing him do his thing let me see that I'll eventually be that guy. That there is a clinical side to medicine - a side that's free from books and allows for free time. Dr. M left clinic for dinner and trumpet practice. I left for dinner and studying. (At least we have blocks of exams instead of one a week. As of right now, I'm loving it. Come exam time, I'll be singing a different tune.)

So even though I was only in clinic for a few hours, it was enough to get me semi-motivated again. I'm probably more in the swing of things now than I was at this point last semester. And now, I'm pretty sure I will *NOT* be doing any specialty that's time consuming - surgery especially. Selfish, yes. But I like my free time. Aaand so begins the countdown until the semester's over.

Flip Side of the Coin

Having lived here for around five months now, it's fairly safe to say I'm a fan of Chicago. Although, this probably could've said before my move up north. As with anything though, there are negatives to life in Chicago - most of which are obvious.

Crime
Even though I live in a safe neighborhood, stuff does happen. We get crime alerts through UIC and while they're fairly infrequent it probably averages out to one a month. The vast majority of the alerts involve muggings. There have been two incidents worse than muggings. One included a sexual assault and another involved picking up two people, driving them around, threatening them, and then mugging them.

Personally, I've got one semi-story. I was coming back late from studying and was parallel parking. As expected, I ended up having to park next to a park since most of the good spaces were taken by the time I got back. As I'm taking one last look in my rear view mirror to check my spacing, I notice something. In the car behind me are four guys sitting in a car without the engine running. I sit in my car for a little bit waiting to see if they were dropping someone off or waiting to pick someone up - neither happens. And it's at this point that I decide to park somewhere else. Would something have happened? Don't know, didn't care to find out. To that extent, you've gotta be aware of stuff around you and not put yourself in a shitty situation. E.g.- looking down at the ground while listening to your Ipod and carrying two handfuls of groceries at 1 AM. Like I said, it's a safe neighborhood. If stuff happens it's usually "only" mugging and not the more violent crimes. In vouching for the safety of the neighborhood, I see families and baby strollers about in the neighborhood. On top of that I routinely see Chicago cops patrolling the neighborhood, along with some UIC and Rush cops now and again. Still gotta remember that you're in the third biggest city in the country and know what's going on around you though.

Cost of Living
Living about two miles west of downtown, my rent runs $1050 for a 450 square foot one bedroom apartment. Electric and gas probably average around $150 (yay for free water/sewer/trash!!). Cable, landline/internet run about $90. Gas prices right now are probably around $3.35. Luckily for me UIC gives us a pass for unlimited rides on the L and buses, otherwise that'd be $2/trip. Also luckily for me I don't have to do any real commuting, letting me save on gas and/or CTA /Metra fares. Taxes are obviously higher around here, but the only one I really have to deal with is sales. Having said that, stuff is more expensive around here. $2.59 for a can of soup and $3 for a simple air freshener - makes me keep my eyes peeled for deals.

Traffic
If it weren't for the L, I would cringe to think about getting to and around downtown during rush hour. Driving anywhere on the expressways or in Chicago during rush hour is a bad proposition and I generally avoid it. I can only claim witness to the PM rush, but the term rush "hour" is a bit of a misnomer. It most definitely takes more than an hour for traffic to get back to normal flow. Especially during the Friday PM rush. I took a friend out to O'Hare on a Friday afternoon and stopped by an outlying suburb for some gas and errands. Without any traffic and not including errands, the entire trip should take about an hour. Enter our trip out, and the round trip took three hours...making me late for the Bulls game :( Ah, well at least we didn't miss that much of the first quarter. Aside from rush hour and a few of the interchanges, getting around on the expressways usually isn't a problem. There are exceptions to this, but it's usually random timing and traffic intensity...although not as bad as rush traffic. Surface streets are hit and miss depending on where you're at and what time of day it is.

Segregation
Chicago is definitely a diverse city. Having said that, it is also definitely a segregated city. Segregated in the sense that if you were given someone's street coordinates, you could probably tell what ethnicity someone was. 7000N and 2000W: South Asian. 2400N and 1000W: most likely a white recent college grad. 2200S and 200W: Chinese (yeah, it's cheating a bit since it's Chinatown...). 105000S and 2400W: Irish. 1800S and 1600W: Hispanic. Archer Heights/Jefferson Park neighborhoods: Polish. Obviously there are exceptions where not everyone in a neighborhood is of a given ethnicity; also not every neighborhood has a majority population. Either way, I'm hoping to get the chance to check out these neighborhoods over the summer. Why summer? Mostly since I'll have some free time and a lot of neighborhoods have summer festivals...my neighborhood even has an Italian one.

So, there are some of my negatives to life in Chicago, in (my) reverse order of importance. At this point the positives far outweigh the negatives IMO, and I don't see myself leaving anytime soon.

Edit: Hm, the list is actually in order of importance. Crime ranks higher than traffic or segregation IMO.