Germy

For the past three or four weeks I've been reading  a treasure trove of 90's skateboarding lore and 'where are they now?' type of things called the 'chrome ball incident.'  Over the years I've perused this blog once in awhile over the years but I got caught up in it and have been working my way backwards. I'm reading interviews from 2011 right now. I've become fascinated by these interviews of people who were heavily involved in skateboarding during the same time periods I was.  Bryce Kanights at the China Banks in 1986. Photo: Grant Brittain In 1986 I had a passing fancy in skateboarding. Some kids at school were skateboarding, and they wore Vision Street Wear shoes, which I must admit I coveted with the desperation of a fourth grader who wanted to be cool, and liked.  I wanted these shoes for so long, well, 2 years seems like a really long time in grade school.  The kid also wore this Def Leppard shirt that I thought was the co...

ACGME and people in graduate medical education send a lot of mixed signals when it comes to physician wellness for residents. Much of it is program and facility specific. Some places do better than others, but at some point during this year I've had this growing awareness of larger forces at play. Retreats and local, ground level provisions are necessary and appreciated; but our day to day experiences expose us to the worst that humanity has to offer, contrasted, with varying frequency, the best humanity can impart. A strategy has to be built to deal with the desperation and apathy we are faced with. Frustration levels are high with everyone, most of us, and I mean everyone in the hospital -- from the patients, patient's loved ones to all that participate in the success of a hospital as workers; clinical and nonclinical. Every single one of us has a valid reason for our frustration. We fight for people in an inhumane, rigid yet whirling machine that forces us to feel like com...

Went home for Thanksgiving. First time travelling away from the LA since residency started this summer. It was nice seeing family and friends. My mother had a birthday recently, so the idea was to take her to Powell's   bookstore with a mandate to find books we would then buy for her. Of course, it had been a long time since I had wandered around the store, too. I found a handful of books related to the book I'm writing, and also this one: Golden: The Miraculous Rise of Steph Curry by Marcus Thomson II had been a book I've been meaning to read. I was in the Bay Area for six years. When I arrived the Warriors were not good, at all. And other than the 'We-Believe' team with the Baron Davis dunk and dismantling of the number one seed Mavericks, had last had real success around when last the Trail Blazers won a title -- the late 70's. Keith Smart was the coach, with Mark Jackson soon to come. Andris Biedrens was still on the roster. Sniffing the playoffs would ...

Lynch Park was an elementary school in South East Portland, on 148th right between SE Division and SE Powell, otherwise known as State Highway 26. I am an alum of Lynch Park, (a Jaguar for life) having spent my years of kindergarten through third grade learning how to be the best Jaguar I could be. Our gym did multiple duties; cafeteria, assemblies, whatever. But I remember Terry Porter, #30 of the Portland Trail Blazers, who grew up in Milwaukee Wisconsin, and had an impressive NBA career by way of University of Wisconsin Stevens Point, standing on what was our half court line and draining jump shots as he chatted with our principal, or someone. That memory stuck with me, thinking that he was launching them from half court with ease, draining them. Some years later I happened to be in that building, but it was now a Montessori school but that half gym half cafeteria still had the hoops on either end and the mid court line. The line was closer to the rim than an NBA three point shot on...

I've never been mistaken for a nurse. Even when I was in undergrad, working weekends in the emergency department, in a non-clinical capacity (granted, I did wear scrubs and carry a computer or clipboard) I was mistaken for a doctor more times than I can count. Not once did I enter the room and have a patient tell the other end of a telephone conversation that 'the nurse is here, I gotta go." But dozens of times in the span of a year or so, I had them say 'the doctor is here, I gotta go." These days i walk into a room, and they correctly assume I am a doctor.  When I have patients refer to my colleagues, including medical students, as nurses -- it is always based on their gender. I've seen responses that are highly varied, and I respect them all. But now, I can't help but step in and politely point out the fact that this is actually doctor so and so, or medical student blah blah blah. If nothing else, the patient should be aware of who and in what capaci...

For the past few weeks I've been on a laborist service -- meaning I try to catch as many babies as I can. Here and there I see gynecological patients, as well. Saturdays I cross cover for general surgery, too. So far I've been in more cesarean section procedures than vaginal births. I enjoy C-sections; fast and horrific. It is one thing to remove an infected gallbladder or appendix, it is quite another to cut open a belly and pull a live, squirming person out. Some people choose family medicine as it gives them opportunities with women's health and obstetrics in a way that no other specialty does. This is not me; and these components of medicine will most likely not play a large part in my eventual practice but nevertheless, it is important to consciously expend energy in areas where we feel less naturally motivated or competent. This idea of focusing on weakness, as unpleasant as it can be, has been on my mind recently. Kind of one of those things where personal experi...

I pay very little attention to celebrity and the going-ons thereof -- I don't really understand the obsession. When a celebrity dies, and people have dramatic emotional reactions, I just don't identify in that they've not played a role in my life, with some exceptions, of course. A week ago Tom Petty died; that day was also the day after the terrorist attack in Las Vegas. I work in LA and many people here have connections to Las Vegas. Numerous people at the hospital had loved ones or friends at the event. Perhaps that is why when I heard the news on Monday afternoon I felt like it was a bigger blow than it might have been otherwise. Today, while driving around completing errands, I had the Tom Petty channel on Spotify playing. It got me thinking, Tom Petty has been a part of many different memories and pivotal points in my life. I'm sure you want to hear about some of them. Here we go. I kinda think of Tom Petty, Rush and U2 as occupying the same area in my musical c...

I didn't watch Twin Peaks when it was initially on broadcast television. But for the last, oh, maybe 20 years I've been waiting to see Laura Palmer again. And true to her, and by extension, David Lynch's word, she came back. As did Agent Cooper with many of the old characters and plenty of enjoyable new ones. Plenty has been written about Twin Peaks and never so much as now, with (what seems like) the conclusion to the series finished and available for consumption.  And I stand not as a Twin Peaks authority; I am relatively a neophyte compared to many of those who count themselves as David Lynch aficionados. Similarly to how I feel about music, in that I've never tried to make it, is cinematography and filmmaking. Skateboarding inherently has video cameras involved, but a Sony DCR-VX1000 and some skater friends do not a cinematographer make. So, there is one small aspect I wish to focus on. The scene which takes us into the heart of the first nuclear detonation ...

A lot of emphasis is put on the team aspects of modern medicine and in some circles, this is viewed as a negative aspect, or more precisely, an encroachment on the (often) paternal and blanket authoritarian rule of law. Different environments have varying degrees of teamwork and each individual physician, in any given clinical scenario has a sizeable impact on the "temperature" of the room. Over time, with relationships built, and with a trust between people, people who work well with people will enjoy a healthy workplace community, in general. As a medical student, there is not enough time to let time naturally build relationships and trust, and the astute and emotionally competent ones set out to get to know the people they will rely on to do their 'job' which is being a physician-in-training. Of course, by the time the support staff knows your name, it is time to go to the next rotation. In politics, and popular culture at large one often hears about 'the m...

A patient the other day asked me at the end of her visit what I liked best about being a doctor. The question caught me off guard, mostly because we were talking about mother-in-law dynamics and how she was glad to have a good relationship with her daughter's husband. I said something about a mandate for life-long learning and building relationships, whatever. Yeah, that is all true. But I've been slowly grinding on that question for a few days and on a day off may have identified, specifically what I like best. Last week I went to a drug rep dinner (maybe the best one I've been to, with a charismatic speaker and valuable information no less) but, no, while as a resident these dinners are appreciated, they are not my favorite aspect of being a doctor. The trust that people have in me, is something that I never take lightly and while I couldn't be a physician without this dynamic I couldn't do that as well without the doing this -- Active Self-Criticism. I'...