Tuesday, June 30, 2009

Baffled

I finally got my MCAT scores. I got a 33. If you would've asked me a year ago if I expected to get a 33 I would've laughed at you nervously. I wasn't even sure I could swing a 30 back then. After taking lots of practice tests, however, I feel that 33 is at the lower limit of acceptable. That being said, I accept a 33 gladly. It doesn't guarantee me a spot in a medical school, but it's not too shabby. I got a 10 in Physical Sciences, an 11 in Verbal Reasoning, and a 12 in Biology.

What I found baffling was my writing sample score: M. For whatever reason, AMCAS grades your writing on a scale of J to T, J being an illiterate foreigner and T being a Pulitzer Prize winner. I can't figure out how in heck I got an M. That's like 35th percentile. NOT GOOD! I might not be the best writer who ever lived, but I certainly feel capable of expressing myself in English. I was expecting something closer to a P or Q. An M is like a piece of poo in an otherwise scrumptious chocolate pie. Supposedly the writing sample doesn't really matter when schools evaluate your score, unless it comes down to a tie breaker. Let's hope and pray it doesn't come to that.

Monday, June 29, 2009

Idiot

I'm pretty furious. After centrifuging a test tube filled with bleach, sodium hydroxide and nematode eggs, I was sucking the liquid out of the tube and squirting it into the sink (a procedure I've done a million times) and the pipette tip fell off as I depressed the plunger, splashing bleach all over my favorite shirt. My FAVORITE shirt. The most beautiful shirt I have ever purchased -- a light-blue short-sleeve button-down that makes me feel like a billion bucks every time I wear it. Andrew and I bought them at H&M the day we saw Beirut last summer in Los Angeles. I watched in terror as the water marks slowly turned from light blue to purple to pernicious white. Out, out damned spot! You can't wash bleach out. I guess that's why people wear lab coats. Idiot!

Sunday, June 28, 2009

Reform

The last week was nice. Busy, but nice. I started up classes for summer semester and I picked up extra hours at work. Waking up at 6:00 every morning is exhausting, but I need to become a grownup sooner or later.

Working at the library has afforded me a lot of reading time. Last week I picked up Hot, Flat and Crowded by Thomas Friedman. He's a journalist and a little full of himself, and his writing is really really repetitive, but he has a lot of interesting things to say. He preaches the Code Green doctrine, and expounds on the many benefits that will come if we can find alternative energy sources. He argues that with the limited amount of resources in the world, not everyone can live like a middle-class American. But with the globalized economy, it's getting pretty crowded. Going green will help us avoid energy shortages, liberate us from our dependence on petrodictators (and thus improve our national security situation), ameliorate the affects of climate change, and stop the Holocene mass extinction of our biodiversity. Despite his obnoxious writing style, I'm definitely converted to the green religion.

I've also been reading a lot about health care reform and world events, as I try to prepare for upcoming medical school interviews. I've read a lot of opinions on how we can fix health care, and I haven't come to my own concensus yet. There's a lot of information to process. What I do know is that we have the greatest potential to do amazing medicine, but our country finishes last among all the industrialized countries in executing it.

I like the idea of passing a law that requires health insurance companies to accept anyone, regardless of pre-exiting conditions, but I'm not too keen on the idea of having a law that requires everyone to have insurance. And I'm also not sure I'm down with a public health care plan. Even if it can drive down insurance premiums by competing with other insurance companies, it would give the government too much power. I do like the idea of evidence-based medicine and patient-centered homes, but we've got to find a way to pay for them, preferably without bumping taxes any higher.

I'm excited about the discourse on preventive health care, where the emphasis is on keeping people healthy instead of treating sick people. If we could halt the heart disease, obesity and diabetes epidemics, we could save a lot of money, since that's sucking up about 75% of all medical expenses. Of course, Americans don't want to change their lifestyles, and not even a 3 cent "sin" tax on soda will do much to curb the Western diet.

Yesterday we went up to Bountiful for Seth's nineteenth birthday celebration. We ate massive burgers and then put on special-made T-shirts for a family basketball tournament. I couldn't hit the broad side of a barn, and my team narrowly lost the first game. The second game ended abruptly when I rolled my ankle. I felt like an invalid hopping over to the stage, but I was proud of myself for not cursing. Vitamin I made the pain go away, along with Brian Regan's ER sketch, and we finished the night with some more star gazing.

Sunday, June 21, 2009

Father's Day

Last night we went up to Bountiful to celebrate Father's Day. I went up with a pretty loaded agenda. Right when we rolled in we headed down to the church for some basketball. Seth and I played Jesse and my dad. I have very few basketball skills, but I am tall, so I just lurped out with a pseudo-hook shot that magically went in two thirds of the time. I also had about a million rebounds. After Seth and I won by two, we had a stellar Father's Day feast, with salmon, steak, pilaf and a wonderful salad. After dinner Ashton helped me clean out a bunch of junk in my old bedroom, where Lauren and Jesse are currently staying. We probably saved more of it than we should have. Everyone protested when I tried to toss a junior high yearbook (I wasn't overly fond of junior high). Sheesh. It was fun though to reminisce and try to figure out why there were so many lanyards in the top drawer. By eleven o'clock the stormy skies had cleared up (quite miraculously) and we took out Big Bertha (a nickname I just coined for my dad's midlife crisis -- an enormous telescope) for some stargazing. We had a little dance party to a Canadian band called Metric while my dad got the laser scope working, and then we practiced sighting stars and finding them in the scope. Did you know that the second star in the handle of the Big Dipper is actually two stars? We also had a good time spotting airplanes and watching them fly by upside down.

Today we visited Grandpa Jenkins on our way back from Bountiful. He's such a great guy. Every time I visit him I wish I had a tape recorder for some of the stuff he says. He always tells at least twenty stories and swears at least four times. He's 87 years old, almost 88, and he recently went to the doctor for a checkup. The doctor asked what was wrong with him, and my grandpa replied that he had come to the doctor to find out just that. The doctor looked at him and said, "Lars, you got out of the car by yourself, you walked into the office by yourself, and you still knew who you were when you got here. I'd say, for your age, that's pretty good!"

My grandpa showed us some navy pictures and shared some stories from his youth. He told a funny story about working the night shift as a radar repairman on the U.S.S. Independence in World War II. All the men had to shower in salt water, to preserve the fresh water for drinking, but after they showered they were covered in salt, which "just about killed you because you'd itch so bad." Since it was two in the morning and no one else was around, my grandpa grabbed some pliers from his tools and switched the valve so that freshwater came out of the shower. He said he was taking a shower, having a great time, when he was busted by "one of those ninety-day wonders" (a derogatory term for dumb officers). He was informed that he would have to meet with the ship's captain and marshal, and that he would likely be demoted. He replied that he would love a demotion, because then he wouldn't have to work the night shift anymore. I guess there weren't any other first class repairman that could work the shift. Needless to say, he never got demoted.

Grandpa took us downstairs to get me a copy of the short histories he'd written for his parents. While he was digging around in the cabinets he found a copy of a short document entitled "Memories of Larry." Here are some excerpts:

"To record my memories of Larry, [in] whom I am well pleased, would take a volume or more. The times since he was five years old and could beat me hands down with concessions in the concentration game. The thousands of knocks on the bedroom wall when he needed help and the hundreds of nights we looked at the stars through the upstairs bathroom.

"I have chosen to tell of his work that few know of. When he graduated from high school and was looking for a job, I was considering building some sort of garage and at the time there was a building boom so no one was interested in a small job. So I asked Larry if I paid him the minimum wage would he build a garage.

"Larry took to learning and planning what he would build. I obtained a building loan from the bank so he could buy what he needed. No one could have worked harder and longer than Larry did as he broke up the two small concrete strips that had been the driveway for many years . . . Each strip was over 40 feet long so there was a lot of concrete to haul away. When we loaded the blocks I was amazed at how even they were. Larry had hit each square in the center and broken them into almost the same size . . . He built the frames for the driveway and we poured 28 yards of cement before we were done.

"Larry's skills of planning became obvious when he designed the position of the garage. Larry planned the garage so that we could have the breeze way covered and tie the old carport onto the back side of the garage. When we got the rafters I marveled at how accurate he had them measure so the roof of the garage and the breeze way and the roof of the old carport came together in a flowing manner and they became one roof.

"When we finished the cost of the garage was only two thirds of what a smaller garage would have been. . . I seldom spend time in the garage without thinking of the summer Larry built the garage. We did have fun and enjoyed doing something that neither had done before. The memory of his love for the gospel and for our family is always a constant as we think of the past."

As Ashton gets closer and closer to having our first baby, I think of my grandpa and dad, and hope I can be the kind of father they've been to their kids. They're both solid, faithful and selfless men, and I am proud to carry on their legacy.

Thursday, June 18, 2009

Fuji

I just submitted my primary application for medical school. That's a nice burden to have lifted from the tired shoulders. I don't think I've ever been so meticulous or anal about anything in my life. I went through each piece of the application over and over, making sure everything was in order and entered in correctly. The worst part was punching in information from my transcript. All my AP, CE, and Foreign Language credits really made it painful. But it's done!

In other news, I got a road bike. That was technically last Wednesday, the 10th. It was a day of guilty pleasure. I ditched a training meeting at work to go up to Bountiful to celebrate the end of the MCAT with Andrew and Drew, and get a bunch of new music. We stopped at Pedersen's to see how much their bikes were. I'd been shopping for a bike for months, checking KSL and craigslist everyday, and I was tired of not finding what I wanted. Pedersens was selling the Fuji model I'd looked at for 120 bucks cheaper than anywhere else. Ashton gave me the go ahead, and I became the proud owner of a brand spankin' new Fuji road bike.

Tuesday was the first day I was able go out for a ride. Quinn, my cycling fanatic friend, had been wanting to go for a ride for the last week. I was a little hesitant to go with him, since he's a seasoned cyclist and I'm a wuss, but I really didn't have an excuse better than that. He rode down to my house, decked out in a Lance Armstrong racing suit that made my t-shirt and gym shorts getup look totally homemade. We headed up Canyon Road, and it wasn't long before Quinn and his grapefruit-sized gastrocnemii were leaving me in the dust.

Thanks to a couple red lights I caught up to Quinn, but the emasculation wasn't over. Quinn decided it would be fun to ride up Foothill Drive, an insanely steep road that wraps around to where Ashton's mom lives. After about a third the way up my legs turned to goo and I pulled into a random driveway in shame. Quinn raced up the hill at a solid pace, not even realizing I was still at the bottom. Following that thorough castration, Quinn had to head home, and I decided to go to Ashton's mom's a different way, since Ashton was waiting there. I road back down Canyon Road until I hit Quail and started heading east up the mountain. It turned out Quail was worse than Foothill, but I just had to make it to the top. Somehow I made it to the top, but I think I burned my entire glycogen storage getting there.

The following day I decided to take a shorter, less strenuous ride. I headed down the Provo River Parkway toward Utah Lake. Things were going great until I cruised through a swarm of swamp flies and took one in the eye. I thought I got it out, but two hours later I was enjoying "Obama's Rescue Plan,"an exceptionally delicious and cheap Mexican plate, and as I rubbed my irritated eye, the bug finally came out on the tip of my finger. No one else seemed as impressed as I was.

Thursday, June 11, 2009

Lazarus

I know you're probably tired of reading about miraculous fish survivals, but when I find myself telling the same story to multiple people, I realize it's probably blog worthy.

A couple of weeks ago we had a barbecue at my biology professor's place. As part of the evening we were asked to share talents, for which we were awarded a betta fish. Byron had been keeping 38 bettas in his laboratory for his evolutionary biology class for some experiment with male dominance. I personally think they were having cock fights on the weekends. With the experiment completed, Byron had a lot of fish to dispose of, and one by one guests at the barbecue got up and performed lame-o talents to receive their gilled prize. I played an Avril Lavigne pop song on Byron's guitar and picked out a nice purple fish. As the guests dwindled and the box of fish remained relatively full, I felt it my duty to pick out a couple more fish, to ensure that they made it to a good home. I chose a healthy red looking fish and a feisty little guy named Franky Valentino, who apparently had proved his fighting skills earlier.

The fish sat in our kitchen for about a week before we had time to set up new homes for them. Each fish needs its own container, and we didn't have enough fish bowls for all of them. We went to DI and I picked out some plain looking vases, despite Ashton's protests (they weren't aesthetically pleasing). We only got two vases, so the red fish remained in the Petsco cup he was purchased in.

During our awesome baby shower on Saturday, Ashton arranged the vases and cup on the window sill above the sink, and she left the lid off the red fish's cup. A couple hours later we were scurrying around getting ready to attend a cousin's baptism, and we noticed that the cup above the sink had only water in it. We were very perplexed, and we looked all around the window sill and sink to see where the red fish might've plunged to. I sniffed around the drain and detected a definite fishy smell. I shined a flash light down the drain, and saw the unlucky pet, obviously dead. We have no idea how long he'd been there, but the aroma indicated it might've been a while. I sprayed water down the drain to dislodge his body and reached down with a glove to retrieve him. I dropped him in the sink and confirmed that he was dead. Not knowing what to do with him, I threw him back in the cup of water so we could take off for the baptism. As I washed the gloves off in the sink, Ashton noticed that the fish's gills were starting to move. The fish gradually began moving its fins, but it was tipped on its side. We left for the baptism, and when we got back, the fish was still alive, and looking pretty normal and healthy. We were completely amazed at his recovery, and I named him Lazarus. Those bettas are invincible.

Unfortunately Lazarus's tail fin has slowly deteriorated and fallen off in chunks. I think that while he lay in the disposal his circulatory system pumped all the blood to the core, keeping all his vitals okay but causing his extremities to die. It's definitely affected his ability to swim. He kind of looks like he's nodding.

Tuesday, June 2, 2009

Shadowing

In the last week I've had two opportunities to shadow physicians, and I've seen two very different ends of the spectrum. The first physician is a family physician down in Hurricane, UT. I've shadowed him before, and I always enjoyed the variety of patients he saw. In any given day you see everything from shingles to sunspots. True, many of the patients were on the crazy side or looking for handouts, but in general they were just nice people who obviously had a lot of respect for this doctor. I was impressed by his dedication to his patients, and how he always took as much time as each case required, until every question was resolved or a plan was set to resolve it. Ashton and I have been less than satisfied with the OB doctors she's been visiting. They're in and out before you can ask any questions, and often shut the door on you when you're mid-sentence, so it was refreshing to see a physician who cares about his patients and physicians who trust and love their physician. It's that kind of doctor/patient relationship that's making me gravitate to family practice.

On Friday morning we started the day a little unusually. Ashton and I were driving up from Vegas, planning to meet Danny before he left for the clinic. As we approached the city limits I gave him a call to confirm the time we were leaving, and he informed me that he was in St. George at Dixie Regional because one of his patients was in labor. "Do you want to come watch?" he asked. "If that lady's down!" I replied with excitement.

After dropping Ashton off I was speeding back down South I-15, not wanting to miss a minute of the action. I got there just in time, and Danny showed me all the monitors and graphs he was watching to make sure the baby was doing okay. Just twenty minute after my arrival Danny announced it was go time, and we went into the woman's room.

She's had an epidural, so she wasn't in any pain, but you could tell she was exhausted from all the contractions and pushing. This didn't stop the nurses from screaming like taskmasters, demanding that she push and push, "just one more time." Finally the baby's crown emerged from the (for lack of a better word) orifice, and I was surprised at how small it looked. I thought the head was a lot bigger than that, I said to myself, remembering a movie I'd seen in Biology class. Danny had to use the forceps to rotate the baby's head a little, and as he braced himself and started tugging, the baby's head stretched into a cone shape, until its little nose popped out over the lip. Danny quickly suctioned goo out of the baby's nostrils. Another push and the baby's entire head popped out. Whoa! There's the big head! The infant's head hardly looked human, and I fully understood Bill Cosby's comparison of a newborn to a lizard. She pushed again and the whole baby seemed to slide out of her. This was the most shocking moment of all. Like Mary Poppins pulling a lamp out of her purse, Danny carefully extracted the 5 foot long baby and presented it to a nurse with a towel. It looked like an inflatable blow up toy, and its chalk white rubbery skin looked like something from a Sam Raimi horror flick. Apparently while the baby is squished in the birth canal all the blood is forced to the core, like when you pinch your finger and it turns white. It also had a hint of blue in its skin from minor hypoxia. It didn't even look to me like the baby was alive, but a few squeezes from a suction bulb brought the monster to life. The transformation that happened next was truly incredible. As the nurses toweled off the placental goo, the blood returned to the periphery and the limbs took shape. Soon the baby looked perfectly normal, like any other newborn. What a bizarre first five minutes of life.

While the nurses were tending to the infant, Danny was holding onto the umbilical cord, waiting for the last push and the placenta. The woman summoned all her strength for the last heave ho and out came the large sack of blood soaked tissue. I was startled by how closely it resembled all the drawings I'd seen in my physiology textbooks. What a remarkable organ. I decided that this was the perfect primer for me, with just a couple months away from Ashton having our baby. The rest of the day I was pretty tired from waking up so early two consecutive days, and I followed Danny like a zombie from room to room.

Yesterday was also an awesome shadowing experience. I arrived at TOSH in Murray at 7:15 and changed into scrubs in the locker room. The OR was buzzing like a beehive, with techs and nurses and physicians running from room to room like everything was a race. I followed Kevin, an anesthesiologist, around, and he is at the top of his game.

In all I sat in on two total knee replacements and a couple of knee scopes. I was shocked at how brutal surgery can be. The surgeon was hacking off pieces of bone, pounding in pins and drilling holes in almost a frenzy. Most of the instruments he was using looked like any power tool you'd find in a garage. Everyone participating in the operation was wearing a sweet helmet getup with a special oxygen tank that made them look like something between a HAZMAT worker and a storm trooper. Blood periodically sprayed on their hands and face guards, and chunks of fat and flesh seemed to spill everywhere. Each knee replacement took all of 35 minutes to perform, and the patient was shipped out to the recovery room while the assembly line brought in the next lucky winner. I was amazed at how quick and efficient everything was, like an orthopedic factory.

Shadowing Kevin is always fun because he makes it a stimulating learning experience. Throughout the operations he would pose hypothetical threats to the patients and ask me how I would solve them. He was constantly drawing diagrams and explaining complex principles of physiology, or teaching me what all the different drugs did. Each patient became a case study as we monitored their vitals and periodically infused them with this or that to counteract any negative responses. He even let me insert the LMA into the last patient. I was a little nervous as I tried to open her clenched teeth and feed the tube down into her larynx. He then had me set up the IV drip with antibiotic, which was even more nerve-wrecking than the intubation.

I was surprised at how different my two shadowing experiences could be, and at the wide range of possibilities in medicine. Anesthesiology involves the thrill of the operating room, has great hours and pays exceptionally well. Family practice sees a lot more patients daily, requires constant problem solving and allows for lasting relationships with patients. I'm glad I have a few more years to decide what I want to do.