Medical Mumblings

I got hitched!

2010-08-12T16:14:00.002-05:00

And therefore have a new blog! You know you want to follow it too! Head on over to kacieandstuart.blogspot.com

Meanwhile, I'll still be writing here. Which reminds me, I need to do a post on why I think I want to become a neurologist. More to come!

2010-07-14T17:18:00.003-05:00

I've learned a lot of things in neurology so far (and am still loving it by the way), but chief among them is the importance of taking a good patient history. You know ... that's the form you usually fill out that asks you how many cigarettes you smoke and what your great great grandparents died from. Since I am a medical student I dont get those forms. I have to find out for myself. I usually find it pretty enjoyable; its like fitting puzzle pieces together. However, there are some situations I have found in the past week that make it a bit difficult to get a history. The highlights are:

(1) A comatose patient
(2) A child with mental disability, who has his father in the room who can't remember anything, and his stepmother on the speakerphone yelling out things and yelling at the dad. I was so frustrated at the end I actually forgot to do the physical exam. Oops.
(3) A stroke patient rendered completely mute who can sign but not write clearly.
(4) A patient in a nursing home who has no idea why he's in your office. The lady who drove him there has no idea either, but needs written confirmation of all decisions made about his care that day.

Those situations have definitely been frustrating (both for me and the patient I am sure), but it definitely helps me work on the skills of flexibility and thinking outside of the box!

Week 1 review

2010-07-06T17:01:00.003-05:00

After getting over the confusion on my first day of pediatric neurology ... I ... LOVED ... IT. Here's why:

1. The physician I worked with was absolutely amazing. He was a genius and also humble. He took my advice (mine! lowly medical student!) on a few patients. I can only hope it was good advice. My last day with him we sat in an exam room with a patient who had very strange symptoms and bounced ideas off each other the whole time as to what the diagnosis could be. One of the most intellectually stimulating moments of my life.

2. Kids are more fun than I thought they would be! Normally they freak me out a little bit. I blame it on being an only child and not having much kiddo experience. But kids in the office are pretty fun. You can joke with them and compliment them on silly little things and they light up like a 100 watt bulb. Also when you make them follow your finger to test their eye movements you can come in close to their nose and flick it and they think it's the funniest thing in the world.

3. I thought a sub-specialty would consist of seeing the same thing all the time. Not true at all. While most of the kids I saw either had migraines or seizures (the two of which are actually medically related), each one of them had different symptoms and required very different treatments. And a lot of times they are very challenging to manage. Variety is the spice of life I say, and that definitely kept me on my toes.

4. Lots of interesting stuff happened. I saw things we didn't discuss much in class. Like congenital CMV, and Chiari Malformations.

The main thing I like about third year (after the first week at least) is that I am a normal person. I worked and was on my feet all day ... even had one day that was 11 hours long, but it SURE as heck beats sitting in a dark classroom for 8 hours, then coming home to study for 8 more. I'll be A-ok if I never have to do that again.

This week is still neurology, but adults. I'll keep you posted on how much I like it. Perhaps this blogger is a budding neurologist?

Day 1 of the rest of my life

2010-06-28T16:28:00.002-05:00

Today marked a big transition in my medical education: switching from the classroom to the clinics. I actually had a little trouble sleeping last night in anticipation of what would come. I knew I was starting out on Neurology, but didn't really know anything other than that!

I got up bright and early this morning in time for a little phone QT with the fiance, and then I actually studied a bit. Yes, I am a nerd, I know. I was supposed to be at clinic at 8am, and as 7:30 rolled around I was getting a bit concerned that my carpool partner had not arrived. So I called him up and it turns out he had to drive all the way across town and forgot to call! So I raced out to the car and drove away.

After meandering my way around an office park I had never seen before, I made it to my location with exactly two minutes to spare. Whew! I was handed a ginormous packet by the department secretary, was told my schedule in approximately 5 minutes, and then had to drive back across town to meet my resident at another hospital. On the way, while dodging rush hour traffic, I called my resident to find out he was actually on ... vacation. So he assigned me to another doctor that he said was "nice but really hard to find", and gave me approximately 4 locations in the hospital he could be found (by location I mean floors, not particular offices). After making my way through a few floors where people had never heard of this man, I luckily ran into a professor! He gave me the doctors office number which I called. He had to call me back and after about 10 minutes of waiting I found out he was not in the hospital at all. He was in clinic. The clinic I had JUST COME FROM.

So back I went. I was a little frustrated at first but I think it actually gave me some time to calm my nerves, which was good.

After I actually got there I started seeing patients with him. My first patient of third year was a little boy with cerebral palsy. After that came children with seizures, and even a few rare combinations such as one patient with Chiari I along with diabetes insipidus and ADHD. And I must say, before today I was not a strong believer in ADHD. That's different now!

And then, the last patient of the day. An adolescent with migraines. The doctor handed me the chart and said, "I have another patient, why don't you go see this one?" I'm sure I stood there with my mouth hanging open and asked if he meant to see the chart or the actual patient. Of course, he meant the patient. After studying the chart for a good 5 minutes I went in. Luckily, it was a really nice kid and mom and they were so kind to me. The doctor came in later and we went over things again. Of course I missed a few things - but it was still pretty exciting for my first time with a patient!

We'll see what tomorrow holds. I have to try and find the doctor at the hospital again...

How do I find myself in these situations?

2010-05-21T17:03:00.000-05:00

Stuart bought an elliptical. It is super awesome, except for the fact that it doesn’t work. After spending a few hours putting it together we spent a few more hours taking it apart to find that one teeny green wire had snapped in half. I don’t know if we did it or if it came like that, but we called the repairman nonetheless.

So, being the good fiancé that I am, I offered to study here at Stu’s house today so I could let in the repairman who was to be arriving at 8am sharp. At 9 there was a knock at the door. I answered to find a tall man in black denim jeans and a black collared shirt with rose-colored glasses on. I let him in and then he said, “Um, my wife is with me. I hope that’s ok.” As he turned to gesture towards his car I noticed the reason for the tinted glasses: two lazy eyes. I invited the wife in as I wondered how one could take apart machinery and do wiring with two lazy eyes.

A few minutes later his wife appeared at the door. She looked like she hadn’t brushed her hair in a week and introduced herself with unmistakable slurred speech. Yes friends, she was drunk. I am alone at Stu’s condo with a lazy eyed repairman and his drunken wife.

I explained the problem to the repairman and told him I was pretty sure there was a faulty wire. I even pointed out the location where the wire was to save him some time. He got to work and I came into the living room to find wifey flopped on the couch, playing with Mardi and calling her “Titty Tat”. I offered her the television or a book, which she refused. I sat away my board studying materials and we started chatting. I found out her youngest son was graduating from high school tonight. That, somehow, led to her telling me her entire life history. Sometimes it was hard to make out a few of the slurred words, and sometimes the sentences were out of order. I will abbreviate the story for you below. And no, I am not making any of this up. Names have been changed to protect the not-so-innocent.

When “Jane” was 18, she moved out of her parent’s house because she could never get along with them anyway. She moved in with two of her good friends, who just so happened to be sisters. What do you know but a few months later she was married to their father, a man who I could only imagine to be at least 20 years her elder. They were married for 12 years and “it wasn’t too bad”. They had two sons, and after a while her hubs started getting a little too friendly with a girl from work. And this wasn’t just any girl. She was ugly. And she had a glass eye too. So Jane got suspicious and drove to glass eye girl’s apartment one night to find the blinds open and her husband standing there with no shirt on and his pants unzipped. Needless to say, they got a divorce, and her ex-husband and the girl with the glass eye were married 4 days later.

Then after the divorce, Jane went out partying for a while. She had fun being single, and then married someone else for a year. That was the “worst mistake of her life”.

By this time, her two sons grew up. The oldest son, we’ll call him Jim, got a job and became friends with a “real far out girl” that he worked with. They hung out some and then one night decided to go out to a bar together. They both woke up in bed together the next morning (surprised, anyone?) and then fell in love. They bought wedding bands and called each other ‘wife and husband’ but never actually got around to getting married. Who needs papers, anyway? They had a baby soon. Jane never fully believed it was her son’s baby. Everyone knew that Jim’s wife cheated on him a lot, but strangely only with black men. The son was white but Jane was still suspicious. After the baby was born, Jim’s wife went kooky, packed up a diaper bag, and boarded a 3 day bus to Colorado with the baby. This led Jane and her new husband (lazy eyed repair man) on a wild goose chase to gain custody of their grandson. It never worked because the judge never wanted to hear their case. After a few years the wife broke off her and Jim’s fake marriage and they never heard from her again. Now Jim is married to a new lady and in the army. He and his wife have a new baby named Tobias McDonald (real name there). He is in Iraq and just got a new tattoo on his side of a naked lady. His wife drew it for him. He showed it to Jane on Skype.

Well, back to Jane now. Here’s how she wound up with husband number three (repair man). Let’s call him Jake. Jane was trying to get back on her feet after the 2nd divorce and losing her job. Jake’s mom, who she apparently knew, suggested that Jane move in with Jake. Just for a week, just to see how it worked. So she moved in. It “wasn’t too bad”, they fell in love, and 3 months later they were married and living in his trailer with their 4 dogs and 3 miniature ponies (I assume those live outside).

Now, while her husband was in the next room with our new elliptical machine, Jane proceeds to tell me about their marriage. It’s pretty good. She really wants to kill him sometimes. He makes her wash his clothes and fix his lunch. Why doesn’t he ever do anything for her? He likes her hair long, she likes it short. She doesn’t like it that he controls her life so much. Sometimes she really regrets getting married again at all. Sometimes she wants to just be free so she can move away somewhere else.

After TWO AND A HALF HOURS OF THIS (interspersed with 3 bathroom breaks, a tour of the house, comments about my tomato plant, etc), Jake comes back in the room. He has discovered that there was a faulty green wire. In the exact spot that I showed him. He’ll have to come back next Friday to fix it.

Don’t you just love learning people’s stories? =) This is why I always talk to people on planes … in the hopes that I get to hear something like this!

Your Medical Term of the Day

2010-05-11T17:30:00.002-05:00

THYROID STORM

Who knew this little cutie could cause such a problem? The thyroid makes a hormone called thyroxine. This hormone is responsible for bone growth and, more famously, increasing metabolic rates. Increasing metabolism may sound like a good thing to you, but not in the case of a THYROID STORM!!!!!

Sometimes, the thyroid can go haywire and start secreting lots of thyroxine. This can often happen associated with stressful periods in the patients life (like studying for boards). When this happens, the heart rate speeds up, the patient gets confused, may have diarrhea and fever, and begins shaking and sweating. This can cause the heart to quickly fail and lead to death.

Moral of the story? If you have hyperthyroidism, get it treated and your forecast will be sunny skies ( ... bad joke I know).

A day of leisure

2010-05-07T15:04:00.002-05:00

Yesterday was my FINAL final of 2nd year! I am officially one half of an M.D!! I plan on blogging soon about what I have learned throughout these two years ... but for today I am relaxing. This is what I have done:

9am: wake up. Whoa. That's 4 hours later than usual!

10:30am: I heard a rumor my local Barnes and Noble was closing, so I headed on over to stock up on the clearance items. After browsing around for a while, I got some good 'ol classic lit: Great Expectations, Utopia, and The Picture of Dorian Gray. Not to mention two awesome cookbooks. One is 1 stock, 100 soups, and the other is 1 dough, 100 cookies. I plan to cook through that cookie cookbook rather quickly.

11:30am: grocery shopping. This was important since I only had organic skim milk, spoiled egg beaters, and spaghetti noodles in the pantry.

2:00pm: Made a BLT for lunch, and also whipped up some avocado mayonnaise. Delish!

3:15pm: About to bake cookies with Liz.

I could get used to this.

Warning: This is disturbing

2010-04-29T19:53:00.003-05:00

I have a test tomorrow. So what did I do today? I laid out on one of the docks of the Yacht Club in Daphne, AL. Stuart is still out of town and I am still cat sitting, so I thought I would venture outside and enjoy the sun. With my notes, of course. Shannon was here studying with me too, and we were just minding our own business, studying fexofenadine and leukotriene antagonists, when all of a sudden we witnessed a cruel death right before our eyes.

All was quiet except for the seagulls, when out of the corner of our eye, a teenage boy came jauntily walking up the pier. He kept walking toward us and I began wondering if he was going to ask us to leave since we weren't members of the "club". Instead he walked past us and began forcefully yanking this rope tied to the end of the pier. He kept pulling and pulling and suddenly a big red cage appeared and he delightfully screamed, "YESSSSSS"!! Inside was a teeny fish flopping about. I asked him what kind it was and he replied that it was drum. Now Stuart and I have actually seen Drum on a menu of a fine restaurant, so I kindly told him I hoped he had a great dinner. He looked at me like I came from outer space and said, "Dinner? No! This is bait!"

He then threw the cage back in the water, threw the fish down on the pier, and walked off. Let me tell you, friends. I have seen AIDS patients and I have seen some really gross wounds. But nothing was quite so horrifying as watching this cute little fish flop about on the pier and literally gasp for air. It was like a terrible car wreck that you can't look away from. The flopping finally stopped and I thought it was over. Feeling relieved I looked over at the little fish hoping to find it in peace, but instead horrified to see it lurching to get air. AGH! I was considering sneaking over to toss it back in the water until the guy walked up again. He had a fishing pole in hand, so I expected him to put the fish on the line and cast it in. Wrong again. He whipped out a knife from his pants and STABBED THE FISH INTO THE PIER!!!! I think I gasped out loud.

He then proceeded to cut it up for bait and fish to his little murderous heart's content. I turned back to my drug studying to try and calm myself down. After a few minutes he got up to leave because his line broke and the little fish bits floated away. Shannon and I (and the fish) went through all of that for nothing!

OH! The humanity! Please tell me shrimp and scallops dont die this way. They are too delicious and I would have to feel bad for eating them.

The Domestication of Kacie

2010-04-21T19:00:00.002-05:00

This afternoon I was studying for pharmacology and all of a sudden thought: I want to make pan fried grouper crusted with Panko bread crumbs and citrus zest. And then I thought: Where in the heck did that come from?

I've never really been the domestic type. I cannot sew on a button or stitch a hem. I've only semi-successfully baked one cake in my lifetime. Maybe it's because there are 101 days before I become a wife, or maybe now that school is starting to wind down my creative juices have room to surface. Regardless, I now have the urge to be - gasp - domestic!

Stuart will be out of town for around 2 weeks for a couple different business and church trips, so I have been here house and cat-sitting. It brings a nice change of scenery and living on the Bay is pretty much like vacationing all the time. I definitely can't complain about that. I think that living here "for pretend" for the last few days has helped light my recent domestic spark. It all started when I decided to unpack some of our wedding shower stash. Stuart's office was filled to the brim with goodies to the point of not being able to open the closet or use the desk. I decided to fix that problem and gleefully set out the RED KITCHEN-AID mixer. I've been dreaming about seeing that baby out on the counter since we first got engaged.

Also, since I have been here, I have taken advantage of the cable. I don't have cable and it has been a blessing to help me study. But I didn't realize how much I have missed the Food Network. An episode of Barefoot Contessa makes me drool, followed by an episode of Chopped, where I learn proper plate presentations to impress a crowd. Maybe that is where the Panko-encrusted grouper idea came from?

Then, while unpacking presents, i sat down last night and read a whole entire cookbook. Yes, read. Of course it was a Barefoot Contessa so I was drooling the whole time. Anyway, BC is famous not only for her food, but also for the gardens at her home in the Hamptons. That got me thinking again. Those of you who know me know that I can pretty much eat a tomato like an apple, and that shopping for produce is the highlight of my week. So far this spring I have already spent about $30 on tomatoes. Perhaps it would be economical to just plant them myself? So with the first urge to play in the dirt since I was about 6, I headed off to Target's garden center. I went for tomatoes, but also wound up with green beans, cilantro, basil, flat leaf parsley, and sage.

So during my quest to become a great doctor, I have also begun a quest to become domestic. I'll let you know how the garden turns out. Maybe I'll get to serve some fresh green beans with that Panko citrus grouper!

Today was a great day

2010-04-15T14:06:00.003-05:00

Here's why:

1. I slept in. 6:00 AM. Whoa!

2. Today was "bring your own refillable cup and get free brewed coffee day" at Starbucks. I used to have a moral problem with Starbucks, mainly because when I went hiking in Peru, I saw all the little coffee farmers who were put out of business by big corporations like Starbucks and Folgers. Then I tasted it and discovered how delicious a Grande Skinny Cinnamon Dolce Latte is. I guess that means that my moral convictions are not too strong. It makes me feel a little better to know they at least appreciate my attempt to better the environment by bringing my own cup.

3. Today I ordered flowers for the wedding!!!! I wound up being $70 under my already-frugal flower budget, so that was a great success. For those of you coming to the wedding, here is a little something to whet your appetite before the big day:

Summery, simple, and friendly!!

4. I am 5 days away from being finished with Neuroscience. At the beginning of the year our professor (who is awesome) read reviews from the previous year's class about how it was their favorite class, and it's very possible to make an A, etc etc.

False.

I have never studied so hard in my life to feel like I understand something so little! I think I will rule out neurology as a residency because it just makes my brain too tired!

A lesson from a dying patient

2010-04-06T17:30:00.002-05:00

Today was my final H&P of 2nd year. H&P is short for "History and Physical". It's that thing that happens whenever you see a doctor for the first time and they ask you questions like, "how much fiber do you eat?" and "what was your mother's maiden name? What kind of diseases did she have?" Believe it or not, all those questions really are important tools used to piece together a patient's background and to better understand the diseases they may have now, or the ones they may be at risk for in the future.

So far my patients for my H&P's have been pretty cut and dry: a 40 year old women with cholycystitis (gallbladder probs), a middle aged man with a foot infection due to his diabetic peripheral neuropathy. We even had one patient who I think may have been faking. It was kind of a strange case. Nevertheless, all these patients were going to be released from the hospital soon to go on with their lives.

Today though, was a different experience. For the sake of HIPAA I'll call my patient Mr D. Mr. D had stage 4 metastatic lung cancer. He had had some treatments before and thought that the cancer was gone, but now it had come back with a vengeance in both his lungs and spine. Mr D was in so much pain from the metastases in his spine that you could see the pain in his face each time he moved, and each of the 20 times he hit the morphine pump while I was in the room. But even with all that, he was a good sport and let us ask him 5 million questions and poke and prod his every part.

After the H&P was done, we went into a conference room to discuss Mr D's case. This is one of those awesome times when you learn things you haven't learned in class yet and then integrate it with other stuff you have.

After our 'conference', I just had one of those heart tugs to go back in Mr D's room and pray for and with him. Being the first time to do that I was a bit nervous, but my other H&P partners came with me and it was SUCH a blessing!!! After we got finished with the prayer, Mr D started talking to us. He told us that he knew our careers were going to be hard but to "never let anything cut off your blessings", and to enjoy every day that we have on this Earth, because no one knows what tomorrow holds". Mr. D said he would do anything to get out of the hospital and get back on the streets to tell everyone how blessed he has been in his life and how God has taken care of him.

Mr D must have known I needed to hear those things. It's been so easy, especially this semester - the toughest for me yet - to want to just complain and give up. But I have been blessed with the opportunity to be a physician and to impact my patients lives! What a great opportunity!

And PS - maybe I'll start blogging again. I've had quite the hiatus.

Have you ever found a baby in your cake?

2010-02-08T17:37:00.000-06:00

If not, you must have never truly experienced Mardi Gras.
Sent from my Verizon Wireless BlackBerry

Things I brought with me to school today

2010-02-03T18:09:00.002-06:00

All these items are either on my library study desk, or in my shiny red pleather laptop bag:

(1) 3-ring binder for pharmacology
(1) 1/2" binder for neuroscience
(1) Neuroanatomy Through Clinical Cases textbook
(1) First Aid for the USMLE Step 1 textbook
(1) Laptop and charger
(1) coffee mug, today has been filled with coffee and water x 2
(1) pair of glasses
(2) empty Tupperware containers, previously filled with leftover panini and green beans
(2) manila envelopes from the student affairs office stuffed full of papers with my name on it. I look important.
(1) I-clicker pop quiz taking device that I keep accidentally squooshing and turning on in my bag.
(9) pens: 1 empty, 3 black, 3 pink, 1 red, 1 green
(1) hand lotion for those bitter Mobile, AL winters
(2) bags of grapes, half eaten, from the past week of school
(2) spoons, one real and one purple plastic
(1) small container of no-sugar added applesauce
(1) cell phone charger
(1) envelope from the neuro department with my lab exam grade, a 90!
(1) bag of small Doritos, eaten all except for crumbs
(1) Nivea chapstick to soothe my cracked, stress-induced fever blister

No wonder my back hurts!

Brains and Breakfast

2010-01-25T16:10:00.002-06:00

I had my first Neuroscience exam today. I studied my little butt off for this exam. For example, there was this one PowerPoint presentation that I spent around 6 hours on. I had it down pat. And were there any questions on that lecture? Maybe 1 question out of 100. Apparently what I thought was important, my professor did not. So we'll see how my grade turns out.

Anyway, this morning I decided to stock up my energy for this three hour examination. I had already brewed my strong Starbucks coffee at home, which I then proceeded to spill it on myself on the way to grab a delicious Chick-Fila biscuit. I promise I wasnt trying to drive and talk on the phone at the same time or anything while that was happening. After asking the not-a-big-morning-person window attendant for lots of napkins, I drove on to the library for some last minute studying/cramming.

I popped open my laptop and got out my grub. Turns out my weakest area was brain anatomy. Our professor gave us this really helpful video of him dissecting lots of fresh (and by fresh, I mean FRESH) brains and pointing out anatomical structures. So of course, what did I do while eating my hot chicken biscuit but watch this video of a man poking wet bloody brains with a probe.

My grossness tolerance has gone way up in 1.5 years of medical school.

In Celebration of an Old Year

2010-01-10T20:31:00.002-06:00

Yes, I am aware it is already halfway through January 2010, but I am just now getting around to writing in my blog again! It has been way too long! So to get me back into the blogging state of mind, I would like to take a short reflective look at some milestones from 2009 ...

1. I GOT ENGAGED!!!!! Yes it's true! The always suspected 'last to get married' of my friend group is going to tie the knot with the most wonderful man in the world, Stuart Saulters. If you don't know him, you should. Wedding planning is exciting and makes studying a whole lot harder.

2. I traveled to two new continents: Africa, more specifically Tanzania, and Asia, more specifically India. If you have been a faithful reader of my blog you know all about what I did in those two places. It was a long, and at times grueling trip, but I met so many beautiful people and had many experiences that I would not trade for the entire world.

3. I made the worst grade in my class. On a test for Fundamentals of Doctoring, which is supposed to be a common sense class. Oops.

4. I made the best grade in my class. On a pathology exam on the GI system. That may have been one of the proudest accomplishments of my life! Seriously.

New life goal

2009-12-10T19:00:00.002-06:00

Tomorrow I have a pathology exam on the kidney. One of the most fascinating things I have learned is this:

Some people [male smokers who have also been exposed to cadmium] are unfortunate enough to develop renal cell carcinoma [aka kidney cancer]. Now, while this is a terrible disease, it has the ability to do something really cool:

RCC can take a trip from the kidney into the renal vein. This leads back to the heart. So instead of sending little cancer cells out to cause metastases, this tumor actually just grows straight up the renal vein, like a plant of some sort. It can make a single solid column of tumor straight up the veins into the heart. I think that might be the neatest thing I have ever heard. Of course I hear a new one of those every week. It is my new life goal to see one of these in person.

Two Stories

2009-11-19T07:32:00.003-06:00

1. My raisin bran did not last long yesterday. I became ravenously hungry around 9:30am. I remembered there was a snack machine on the second floor of the building. I quickly dug through my wallet to find 80 cents worth of change, and 20 pennies. Just enough to purchase a nice, highly caloric poptart. I ran into the secretaries office and swapped my change for a dollar bill. I ran up the stairs, slowing down at the top because I was out of breath. After rounding the snack machine corner I stopped in horror. They were gone! The room was gutted and was being remodeled. I ran across the hall to a secretary's office, who then referred me to another secretary, who I asked where I could find my poptart. She said, "Go down this hall, make a right onto the breezeway. Be careful to not fall because they are retiling the floor. Then take a left and get on the elevator. Ride it to the second floor where you will turn right and then another right into a hallway. The machines are on your left approximately halfway down the hall." That was a bit confusing, but she seemed like she had traveled that path to get snacks before, so I followed the directions as best I could. I finally arrived at the snack machine. My dollar was too floppy to go in. I stood there huffing and puffing and trying to cram in my dollar. Finally it went in. I pressed 162 for the poptart [there were only 20 things in the machine ... I don't see the need for such large numbers]. I got my poptart! And then ... it was stale.

2. I came home yesterday around 5:00. When I opened the door to my apartment there was a horrendous smell coming from inside. It was a smell somewhere between dead animal and human waste. I promise I produce nothing of that caliber of odor, so I was a bit concerned. I walked around my house for a while, and eventually located the smell in my pantry area at the washer/dryer hookup. I have no washer/dryer so it is just a box with a big hole in it that connects to a mysterious tube that travels somewhere underneath my house. I remember from life experience and microbiology lectures that a dilute hypochlorite solution [watery bleach] will kill almost anything. So just to make sure, I decided to pour straight bleach down this tube. After some sizzling sounds that were a bit bothersome, I also decided to attack the house with febreeze. Problem solved. Until I sit down to study tumors of the testicle and ovary. While at my kitchen table, I am periodically overwhelmed by a burst of that smell. Almost like the washer/dryer line is burping from time to time. I call Mom. She suggests putting aluminum foil over the box. Genius! I pull out my aluminum foil, and wouldn't you know, I am out. My last square is not big enough to cover the hole. Dang it. Well, how about saran wrap, I think to myself? I have plenty of that. I pull off a huge square and tiptoe slowly over to the pantry as to not make the wrap collapse on itself and be forever wrinkled. I gingerly lay it over the hole. It doesnt stick. I run upstairs for some tape. That doesnt stick either. I am about to cry at this point because my house smells really bad and I don't know how to fix it. I decide to try a rubberband around the saran. I run back upstairs to my office for the rubber band bag. I pull out two, stretch them a bit, and decide they are too small. If I stretch them over the hole they will pop and sting me. Back downstairs. I sit back down at the table to just grin and bear it, when VIOLA! I see a stretchy headband. I run back to the pantry [doesnt take long, its like 3 steps away] and stretch the headband over the box with the wrap. Stench? Gone!

I cannot get away from medical school

2009-10-17T10:28:00.004-05:00

In a feeble attempt to gain normalcy in my life, I decided to watch an epidose of Seinfeld after my 9 hour stay at the library today. I turn on the "Yada Yada Yada" episode [if you don't know what this is about, you obviously are not a fan of Seinfeld and you cannot be my friend any longer]. And in one of the first few lines of the movie, George's girlfriend mentioned how her friend thought she got Legionnaire's Disease from a hot tub, but it turned out to be bad egg salad. I immediately think: Legionella pneumophilia. Gram negative rod. Causes Legionnaire's Disease with dry cough progressing to productive cough and intestinal distress. Also causes milder Pontiac Fever. I then consider calling the past writer of Seinfeld to let him or her know that bad egg salad would likely cause Staphylococcus aureus or Listeroisis food poisoning, which would not be confused with the Atypical Pneumonia caused by Legionnella pneumophilia.

Then, a few days ago, I found a leaf in my yogurt. Actually it looked a little more like part of a sea fan. Instead of returning my yogurt or calling Target to tell them about the incident, I remember that 'sea fans' are seen in the retina of someone that has Sickle Cell Anemia.

I also begin to think of all the food-poisoning illnesses I can get from finding a leaf in my yogurt. Such as: Listeria monocytogenes, Clostridium botulinum [a stretch], Brucella abortis if my yogurt was unpasteurized ...

I need a break.

Where have I been you may be asking?

2009-10-16T08:37:00.003-05:00

I am currently drowning under ~800 flash cards about various microorganisms and diarrheal diseases. You could say I'm drowning in diarrhea, but that sounds a little more gross.

Microbiology test is on Monday, then after that I have about a week to study for my Hematology/Oncology Pathology exam. For that I have way too many powerpoints and pdf's and flash cards to count. So for now Im drowning in diarrhea, but next week I will be drowning in blood.

One day I would like to blog about health care and tort reform. But for now I will share this: I really wish you could set up a tab at Panera, much like you would at a bar. I studied there for like 5 hours yesterday. I got a coffee first: $1.76 on my debit card. Then a couple hours later I was really hungry: $7.89 on my debit card. Before I left I really wanted a cookie to medicate the depression/frustration/anxiety I was encountering from studying, but I didn't want to use my debit card again. They would probably get a lot more business out of me if I could set up a tab.

Anyway, back to learning.

My dork factor is going to increase because of this, but ...

2009-09-14T17:00:00.002-05:00

Isn't this the cutest parasite you've ever seen? It looks like a little ghost!

Unfortunately it preys upon campers in the woods that aren't smart about cleaning water and causes terrible diarrhea.

Today ...

2009-09-11T16:47:00.003-05:00

1. My radio/cd player quit in my car. I knew it was going to happen eventually since the display hasn't been working for the past three years. I knew it was broken and still tried to turn it on about fifteen times on the drive home. I guess I won't be getting my daily dose of NPR anymore.

2. I saw a lady at a bus stop on the way home. She had her entire right arm inside her shirt through the neck hole. It looked like she was either putting on deodorant or giving herself a monthly self-breast exam. Could have gone either way.

3. We had to gram stain unknowns in microbiology lab. After suiting up in my lab coat and gloves I prepared my stain and discovered small gram negative diplococci. When one of my classmates asked me, "What unknown did you get?" I replied with, "I got Gonorrhea!" Hmmmm.

2009-09-10T12:12:00.002-05:00

Back this summer, when I actually had free time to read, I put away quite a few books. Here are my favorites to share with you:

Let me first say that I have never seen Wicked. The book was my first introduction, so other than the story of the Wizard of Oz, I had no idea what I was getting myself into. Let me also say that I am very not into the Harry Potter/magic and dragons sort of stuff, which this book is full of. However, I LOVED IT. It ranks up there in favorite books I have read. And for those of you who have seen the play, from conversations with friends, the book seems to be very very different.

Gregory Maguire, the author, is a genius. He takes the story of Oz that we all know, and then spins it around to tell it from the side of Elphaba, the Wicked Witch of the West. And by doing so he really challenges the definitions of good and evil, and what makes someone 'evil'. It is pretty thought-provoking, at times scandalous, and a few parts actually made me laugh out loud. I loved the book so much that I'm not sure I want to see the play because I know it is so different!

This should be required reading for all medical students, and perhaps the whole country. It is about a Hmong family who are refugees from Laos. They move to California where their youngest daughter is born with a seizure disorder. The Hmong see the seizure disorder as a spiritual gift, and her doctors disagree. It's all about communicating across cultural barriers and the importance of physicians knowing their patients' cultural and spiritual preferences. It also goes pretty deep into American involvement in Laos in the time of the Vietnam war. Without getting too much into politics, our involvement was kept secret, lead to pretty much the destruction of Laos, and thousands of refugees with no place to go, which were then treated quite bitterly upon immigration to the United States. Not a real quick read, but I think well worth it.

During my visit to Tanzania this summer, I became quite interested in the Masai Tribe. You can read more about them here. I became fascinated mainly with their body modifications, dress, and their insistence on paying for medical services with cows. So when I saw this book at the overpriced duty-free shop in the Dar es Salaam airport, I knew it was a must-read. It's quite a shocking book actually. A Swiss woman goes for a holiday with her boyfriend to Kenya. Upon first stepping off the plane, she sees a Masai warrior and 'falls in love'. She dumps her boyfriend a few weeks later and decides to move to Kenya, live in a mud hut, and marry this man. And its an AUTOBIOGRAPHY. I cannot understand the reasoning this woman had, but her cross-cultural experiences [including malaria and several near-death experiences] are worth reading. It's not my favorite book of all time because it has somewhat of a bummer ending, but I still enjoyed it.

Whoa. Whoa. Whoa. I cannot put into words how wonderful this book is. You can probably tell by the title it is a book about diversity and various things. Alternating chapters are written by Ron, a multi-millionaire from Texas, and Denver, a homeless modern-day slave. He was a slave in Louisiana in the 1940s [yes, the 1940's] and escaped to Texas where he became homeless. As the book continues on, Ron and Denver meet and actually form a beautiful friendship because of Ron's wife. I won't give away too many details, but it makes you think really hard about perceptions you may have of the people you pass on the street corners in your town, about other races, and about the obligations we have as Christians to serve others. I read it in about 2 days, including staying up until 2am one morning, which is unheard of for me. Stop what you're doing and go buy this now =)

Autopsy: a nice study break

2009-08-29T13:20:00.004-05:00

I woke up at 6:20 this Saturday morning [Nope, no alarm, that's just me being my jovial morning-loving self]. I make my usual cup of coffee, had my quiet time, and then set off to studying. We have our first exam on Monday: Immunology. We have covered in much more detail in 15 days what I covered in a whole semester at Auburn. I was just getting into tumor immunology when my phone rings...

"Hello?"
"Hi Kacie. This is "name here" from the the forensics department. I need you to come into the hospital to do an autopsy with our medical examiner."

What an odd call for a Saturday morning. I knew I was going to have to observe/assist an autopsy this semester but didn't expect it this soon!

I ran upstairs to put on my scrubs for their first wear in the hospital. I did a quick little glance in the mirror. I decided I looked kind of cute in my new scrubs, minus the fact that I have been in 'no shower study mode' for the past 36 hours. Oh well.

I get in my car and my adrenaline starts pumping. I had heard some pretty gross/disturbing stories from other students' autopsy experiences so I was a bit nervous, I admit. But at the same time I was hoping that early Saturday morning autopsy meant something crazy went down in the Mob-town last night and I would get to help solve a crime CSI style.

I pull into the hospital parking lot and get out of the car. I strut up to the hospital door feeling quite cool and confident. A helicopter starts coming in for a landing to deliver someone to our trauma center. I could hear the Bee Gee's singing 'Staying Alive' in my head. Just kidding. It was like a scene out of a super cool movie.

And then I realized I left my notebook in my car. I run back to get it. I get halfway to the front door again and then realize I also left my pen in my car. Dang it. Again, walking back to the hospital, I realize I am carrying my grocery list in my hand. I am not good at trying to be cool. Once I make it in the hospital I realize I have no idea where I am going. The friendly little front desk man has apparently taken a coffee break. I figure it would be bad PR to ask a patient to direct me to the morgue, so I just meander a little through the pathology department.

As I round a corner, what do I see but the large double doors opening and the aforementioned helicopter team trying to lift the trauma patient and hook them up to all kinds of things. One of the hospital workers [the front desk man perhaps?] looks at me walking up with an expectant glance. I realize I have on scrubs and probably look like I know what I'm doing. Completely false. Fortunately I came to another bend in the hallway and ducked out of sight before they asked me to do something I had no idea how to do.

Finally, I arrived at the morgue [there's a sentence you don't say everyday]. I ran up to the door because by this time I'm almost late. The door is locked. Not surprising I guess since they don't want just anyone waltzing up in there. My ID card didn't work to open the door. Dang it. I run back upstairs and eventually run into the man that was expecting me to start doing trauma surgery on that patient. I say, "ummm excuse me sir. I'm lost. I need to do an autopsy in the morgue and I can't figure out how to get there." He pointed me toward a 'duck-like' lady [his words, not mine] who then referred me to hospital security, who then drove me around back to the morgue in a golf cart. I rang the buzzer on a different door this time, and in I went.

It's not like CSI/NCIS/whatever. It was hot in there. No one was was wearing lab coats. Rather we put on plastic gowns [getting even warmer now], booties, gloves, hairnets, masks, and topped all that off with a plastic face shield. By this time I wasnt feeling too bad about not taking a shower because you could only see my eyeballs. Pretty much with my glasses on I looked like this:

Also I would like to mention that as I was putting on all this garb, I was standing next to two fresh bodies that had all their insides on the outside in little baggies. The golden oldies were playing on the nearby radio station.

On to my autopsy. For the sake of privacy I will withhold all identifying characteristics except for the fun fact that this person was a prisoner. They presented last night with chest pain and expired 20 minutes later. A heart attack was suspected, but with no prior medical history I assume based on living conditions that an autopsy was required by forensics to rule out any other possible causes.

I would like to go into a lot of gory detail here, but I realize not all my audience would appreciate that. Let me just say that there were lots of saws involved for various body parts, as well as gushing blood, and I can also tell you what this person ate for dinner last night. It was determined upon removing and dissecting the heart that the Left Anterior Descending artery was 95% occluded and Left Main, Right Main, and Left Circumflex arteries were 75% occluded. In other words, that's bad news. Pretty much the whole heart was not getting the blood that it needed. Especially the Left Ventricle which supplies the body with blood, and the Intraventricular Septum which holds the electrical conduction system that makes your heart beat. You could actually see hemorrhaging of blood into the heart muscle, and the heart was also hypertrophied [larger] probably due to years of hypertension.

Anyway, after it was all said, done and dissected, it was time to go home. Like I said, i was a bit scared at first, but I actually really enjoyed it. I would sign up to do another one actually - hopefully one where I could solve a crime =)

My new favorite diesase

2009-08-26T06:06:00.002-05:00

I love germs and disorders. I guess it's a good thing that I'm in medical school. My personal favorite diseases are those involving parasites or other infectious organisms. However, I have recently discovered a new favorite that is non-infections:

Aortic Dissection and Cardiac Tamponade

So here's what happens. Let's say that you have had chronic hypertension for 30 years. You don't like taking your medicines because they are expensive, and you don't really think you need them because you never feel bad [hypertension is often asymptomatic].

As your heart pumps out blood, a high pressure stream of blood hits the aorta, which looks like this. Well after years and years of high pressure hitting the wall of that aorta, you can actually cause a tear in it. That creates the dissection, pictured here:

This creates a false channel that the blood can flow through. Eventually the tear can extend all the way through the vessel wall. Now, surrounding the heart and part of the aorta is the pericardial sac. When the aorta ruptures all the way through, the blood will spill out into the pericardial sac. Since this is a closed off structure, the blood has no where to go. This creates something called a hemopericardium. Hemo meaning blood and pericardium meaning ... pericardium.

Obviously this would cause a problem. All that pressure builds up in the pericardial sac and can actually 'crush' the heart if you will. This is called Cardiac Tamponade. The pressure will smoosh the ventricles, keeping them from filling properly. This decreases, or can actually shut off, blood flow out of the heart and kill you in a snap.

So how do you know if a patient is having this? They will present with a 'ripping' chest pain that radiates into their back. You could mistake that for a heart attack, but that usually will radiate into the arm/jaw area. Their heart will sound very faint because the valve sounds are having to travel through all that blood.

Now, the coolest part. How do you treat this? A little something called pericardiocentesis. In other words, you stick a needle into the chest and draw the blood off the heart to reduce the pressure. Hopefully I'll never have to do that to anyone, but if the occasion presented itself, I don't think I would shy away!

Holy Cow

2009-08-20T06:15:00.003-05:00

I woke up about 45 minutes ago [and yes, it is 6:15am right now] and I decided to reward myself for getting relatively caught up with my studies in pathology by writing a blog.

And where to even start? I will just say this: MS2 is quite different from MS1. Maybe it's just still adjusting back from my summer break and not being into the studying groove yet, but it seems that the amount of material covered has grown exponentially from last year. For example, here are all my notes I have taken so far. Remember please that class has only been in session for 8 days.

Last year I used one of these notebooks per class for each test block. Well my first exam is a week and a half away and my notebook is already full!

As another example, I typed a transcript from Immunology a couple days ago. Usually I could get a transcript for a 2 hour class done in 8 or 9 pages, but this one wound up being 18 pages! My fingers actually had blisters on them when I was finished.

I have also noticed that my handwriting is getting worse. I knew this was bound to happen since all physicians have the common characteristic of writing that you can't interpret. I think its due to typing and writing so much that my hand has cramps at the end of each day. I liked my old handwriting, too. I hate to see it go.

But, with all that said, I'm enjoying this semester a bit more than first semester of last year. I know all my classmates already and we are actually in the position where we can give advice to the new first years below us. That's kind of weird. And the material covered is SO much more interesting and relative to clinical practice!

Now if I can just work on staying caught up ...

I have a new favorite professor

2009-08-11T20:13:00.002-05:00

For sake of confidentiality/professionalism, let's call him Mr. Pathology.

Mr. P is a little taller than average, with circular large glasses and a full beard and is balding on top. He has a bit of a middle age spread and wears suspenders to hold his pants up over his shirt and tie.

He's the kind of person that you can tell absolutely loves his job. He lives to teach, and I love listening to him. He gets really excited about droll things like morphology of nuclei and to keep the audience entertained he makes really cheesy jokes and then stands there until we laugh.

I knew I liked him when during our first lecture the first words out of his mouth were, "So what's the deal with cancer?!" Also today in my small group he quoted Monty Python's Holy Grail, talked about his step-cat, and told us that he is "usually here, unless I am out of town". Very deep. And finally, today Mr Pathology was illustrating something on the SmartBoard in front of class. He drew two cancer cells pretty small and then erased them saying, "This is cancer so I can draw it bigger. Two big cancer cells. ARRRGGGGGGGGGGG!!!"

In other news, today we spent our first day in the hospital. Of course, we had lectures instead of seeing patients, but it was still exciting to wear 'professional attire' with our name badges and walk around like we knew what we were doing.

First day of MS2!

2009-08-10T20:55:00.003-05:00

Dave Barnes sang to me at 7am this morning. There was excitement in the air. Today was my first day as an MS2! I got up and showered, then packed my fancy new 'work tote' from target with everything I thought I might need: laptop, board review book, planner, notebook, calculator, index cards, pens, highlighters, lotion, hair brush, ear buds, and my glasses. And of course who could forget lunch and my infamous healthy snack in a ziploc container [today was strawberries and almonds]. I headed out the door after my coffee, fresh and ready in my oxford shirt and pearls!

After arriving at school I opened the front door with a smile and was immediately blasted with humidity from inside and that odd smell of a building that has been closed up for too long. I walked upstairs to put my lunch in the refrigerator and found it already crammed to the brim. Of course who greeted me after that but the super creepy anatomy professor I had last year. Let's just say that he enjoys female anatomy a little bit too much, and we'll leave it there. As soon as I had gotten there I forgot why I was excited to come back to school.

At 9AM it was time for class to start. I am turning over a new leaf this year and sitting in the front in hopes of paying better attention during class. So far today, it worked!

The day started out with Pathology. We have Path every day from 9am-noon. On Tuesdays this three hour period is held at the hospital where we do group case studies and more lectures. In these group sessions we are expected to do outside research as well as make presentations for our class. Also the pathology students are expected to help perform at least one autopsy during the school year. For this I will be 'on call' for a week, during which I will carry a pager with me, and at a moment's notice be able to drive to the hospital to the morgue. Oh, and we also have unannounced quizzes, assigned tested book readings, and laboratory sessions. Pretty much this class will be a piece of cake. Sike.

Next up after lunch was microbiology. We first reviewed the syllabus. The professor, wearing a white lab coat as if he had just come from working with salmonella in a petri dish, repeatedly referred to the class president [me] as 'him', which was kind of hilarious. Also there was a lot of stress put on the fact that if we miss just one microbiology lab, we fail the entire course. I thought that was kind of intense, especially after he added that the only way we can miss one is with a letter from a funeral director saying a parent/grandparent had died, etc. Good times. Then the real lecture began. An introduction to immunity, by a short professor with a comb over and a mustache, wearing short pants and converse sneakers, and who spoke like he had just inhaled a large amount of helium.

Basically what I got out of today is this: I am going to be very busy this semester. Not only will I have to learn mechanisms of disease for 1400 pathogens, I will also have to learn 250 hours of pathology lectures along with a textbook that will be tested on, how to do an autopsy, and I will also be on call for the first time in my life.

Let the fun begin!

2009-08-05T19:40:00.000-05:00

Baking a cheesecake ranks right up there with applying to medical school as one of the most stressful experiences of my life. You should see the crumbs in my floor and on my face!
Sent from my Verizon Wireless BlackBerry

Kansas city day one

2009-07-30T23:28:00.000-05:00

9am. Breakfast. Yogurt and coffee for six dollars. Luckily the conference gives us twenty dollar vouchers.

10am. Dr Epperly, one of the physicians invited to the white house summit on healthcare, spoke to us about the healthcare reform bill. Pretty interesting stuff that I may have to blog on later.

11am. A session on wilderness medicine and outdoor health, where I learned to splint fractures and make a stretcher from tarp and sticks.

Noon. Lunch. Nothing to write home about.

1pm. Healthcare for the homeless seminar.

2:30. Common skin diseases and their not so common look alikes. Gross/cool pictures but some topics well above a second years head.

3:30. Choosing a contraceptive. A seminar on the limitless choices of birth control, their indications and contraindications, and how to help a patient choose the right one. Very interesting!

5pm. Fun with pharmaceutical ads. I admit I was skeptical because I strongly dislike drug reps, but this was fun! We dissected drug ads and talked about how to avoid marketing ploys of big pharma. Good times!

We had a fancy shmancy dinner tonight too that I will write about later because I am full and tired!

Sent from my Verizon Wireless BlackBerry

MEDICAL PUZZLE!

2009-07-29T08:50:00.003-05:00

Ok all my med school/nursing friends who read this blog [are there any of you or do i just write this for myself?]

Here is a puzzle I was presented with on my emergency medicine rotation in India. See if you can solve it.

You are all alone with no medicine and no cell phone. There is no way for you to contact anyone or travel to a hospital. You have severe chest pains, nausea, left arm pain, etc. You are having a Myocardial Infarction. What is the one thing you can do to lessen the MI, or to decrease your chances of death until someone can get to you?

Post your answers!

India Journals: June 17-18 ... SICK

2009-07-29T08:46:00.002-05:00

Woke up Wednesday morning with body aches and hypersensitive skin. I tried to go to Dr Joshi's for work but wound up hiring a rickshaw home. I made it even though he got a bit lost. After a while I had intense stomach pains and then the fun begin ... about 20 trips to the bathroom in a couple hours with one fainting spell. It was made better by some ocean-flavored rehydration drink and yet another round of Cipro. I thought I was better last night and went to work at Dr Gandhi's which made me weak and nauseated to the point that I couldn't eat dinner and just went to bed. This morning I feel better and was actually kind of hungry for breakfast. Apart from a concave stomach and prominent hip bones and clavicles, I think I am on the road to recovery!

India Journals: June 15th

2009-07-29T08:32:00.004-05:00

Today begins a new set of rotations. yesterday I woke up early and headed out for some quiet time by the Ganga. I journalled and then got introduced to an entire family by a sweet 17 year old girl who spoke English. She told me she had just finished her 12th level and didnt know if she would go to University or not. If she did, her parents would decide what she would study based on her talents. Interesting.

After that I came in away from the crowds to sit by the Pipal trees in the ashram for a while and people-watched, which of course turned into people curiously watching me.

One interesting sight - an older man searched both trees for money offerings and pocketed a few rupees. That's probably bad Karma!

The rest of the group woke up and we hiked to Temple Bhutnat: one of the temples Hindus are required to make a pilgrimage to once in their life. The view from the top was great!

After our hike we boarded the bus back to Dehradun. The seemingly good idea of sitting on the back bench of the bus for room turned out to be a disaster. They can fit an amazing amount of people on that bench, and Natalie and I were squashed together, sweating through our clothes. It wouldn't have been quite as bad if the [non a/c] bus didnt stop in a traffic jam for 30 minutes. I was rationing my precious half liter of hot water. We finally arrived back at the bus terminal where we hopped a crowded vickram. To get away from public transportation for a while we decided to walk the last leg of the journey, and then we got lost in our own neighborhood. It's hard when there are no street names posted and everything looks the same. We finally made it home, exhausted and dehydrated, and my lukewarm bucket bath was the best thing I have ever experienced!

India Journals: June 13

2009-07-29T08:26:00.002-05:00

Today I woke up early to the sound of prayer chanting and monkeys running across the roof. Since I was awake before the rest of the house, I decided to venture around the ashram. The place was twice as big as I had thought! We enjoyed a free breakfast downstairs later and then set off to explore the high bank. Basically we just looked around a lot. I got some sweet maroon pants, as well as an orange dot, a chicken cluck, and what I hope was a blessing from a painted up priest. We scarfed down some lunch at Green Italian Food in about 10 minutes - just in time to meet everyone for rafting. We took a 30 minute jeep ride up into the Himalayan mountains. I rode in the back of the truck with 6 friends, 15 oars, 15 helmets, and 15 life vests. Turns out that was probably the most hazardous part of the adventure. We arrived at the site and sat in the river awhile to cool off while we waited our turn: my first dip in the Holy Ganges [Gangaji]! We all piled in the raft, and i admit I was a bit nervous. Turns out it really wasnt that bad. We even got to go 'body surfing' for a while and cliff jumping - which I politely declined. So my first rafting experience was pretty sweet considering I did it in a holy river. Though from time to time I wondered if we were being a bit 'sacrilegious'?

After the adventure we headed back to the ashram to change, and took a 30 minute walk to the Little Buddha Cafe, a hangout for tourists and ex-patriots. It was a treehouse with pillows and blankets on the floor. Smooth music played and a guy in the corner was stoned out of his mind while I chowed down on my veggie fajitas and watermelon juice.

India Journals: June 13

2009-07-24T08:05:00.002-05:00

[Here I wrote in my journal the instructions to get to Rishikesh, our weekend trip, from Dehradun, our homestay for week 2]: Take Vickram #8 to Sarampur Chowk. Get out and walk right until you catch Vickram #5. Take this to the ISBT [bus station]. Get out at Rishikesh, walk 50 meters down a side road, bargain for a rickshaw to take you to the parking lot by the Ram Jula bridge. Cross the bridge and walk until find Parmarth Ashram.

After we finally found the right bus, it made for an interesting ride. No a/c, constant honking, fishtailing around mountain curves, sitting smashed against strangers ... The bus ride was probably more dangerous than I would like to think. Fortunately I was in the back and couldn't see anything that was lying ahead as we would pass other buses on the windy mountain roads.

Once in the city we bargained for a rickshaw and made it to the bridge. You could feel the swing of the bridge underfoot as hundreds of people walked across and the Ganges flowed beneath.

We turned onto one of the two main streets and immediately were greeted by vendors selling vegetables, handicrafts, chipotis, and of course there were beggars lining the streets. A giant statue of Vishnu sitting meditatively on the Ganges signaled to us that our Ashram was across the street. We signed in and headed back out to the Ganges for the evening arthi [prayer] ceremony.

I didnt understand the prayers sung in Sanskrit, or why ash was spread on foreheads, but it was still a great spectacle of faith and devotion. Natalie and I accidentally interrupted because apparently our presence was so shocking that everyone wanted to take photos with us. families, with babies, photos kissing babies on the cheek - I felt like the president!

The evening was ended at Chotiwala Restaurant. Delish!

India Journals: June 12

2009-07-24T07:50:00.002-05:00

Today is out last day in Than Gaon. I'm a little bummed I guess. I have gotten used to it here and love the peaceful atmosphere and simplicity.

The clinic has been slow, but interesting. It is definitely an odd healthcare setting in that no diagnostic tests can be done except for an hCG titer. All diagnoses are solely on a clinical level. I would be very wary of doing a diagnosis and treatment here without evidence, but I guess you get used to it? Perhaps we should all be such good diagnosticians that we would feel comfortable treating without proof?

Yesterday we hiked down to the Swarna River, which is down in a valley behind the Nature Quest campus where I am staying. It was an easy, although slippery, hike down. Going back up again was another story! On the way down we stopped at a 'water grinder' where a couple of men live and have harnessed the power of the river to grind wheat into flour. It was pretty amazing! The best part though was the end of the hike. At the top of the hill, the wind funnels through the valley and blows at what feels like 50 mph! We all stood at the top and 'wind surfed' for a while. A few of the village kids came up and joined us. It made the rough hike well worth it!

This is us at the top of the valley with the wind. We tried to explain a 'jump shot' to these kids but they did not understand. When you jumped you would move back like 4 feet because of the wind.

An Open Letter to my favorite Mexican Restaurant

2009-07-22T10:02:00.003-05:00

Dear Casa Grande,

RIP. I drove by your building the other day while meeting my friend Tricia for lunch. What used to be your creamy yellow exterior and manicured lawn was looking kind of unmaintained with weeds. I was a bit concerned and then noticed the small, sad looking "For Lease" sign out front. I gasped in horror and then shook my fist and actually yelled, "Daggum economy"!! Outbursts are not usually in my character, but I was upset!

What happened to you in the month and a half that I was away?! I know that when I would bring my friends to your place to eat we were often the only patrons there. I feel that I somehow failed you because I was gone for so long. Maybe if I had only purchased one more round of grilled grouper tacos the last time I was there your business could have stayed afloat.

I remember the first time I entered your doors. I immediately fell in love with the hospitality, and the dingy posters of Marc Anthony and Jennifer Lopez on the wall. And of course then there was the menu. You had the only Peruvian food in town that I know of. Now I will be forced to learn how to make Lomo Saltado on my own. And you should know that that is one of the only beef dishes I even eat!

You will be dearly missed.

India Journals: June 10

2009-07-18T08:02:00.002-05:00

I am glad I'm going to be a doctor. And all because I gave an enema!!

This poor lady came in the clinic today, not having had a 'movement' for about a week. She was miserable. I gave her an enema [for the first time!], she 'moved', and left happy.

On some strange level I realized that's what being a doctor is all about: relieving suffering, in whatever form it takes.

India Journals: June 8

2009-07-18T07:58:00.002-05:00

Bugs, bugs are everywhere! I opened the door to one of the bathrooms today and there was a huge spider on the wall. Tarantula sized, but not hairy. Beetles and silverfish crawl up from the drains. A beetle somehow got into my shirt while I was using the bathroom last night. And of course flies and gnats are everywhere!

Yesterday Mayank [program coordinator] talked with us about culture shock. He said that India is often hard to handle because it attacks all your 'six' senses:
- sight: new and sad sights
- sound: nothing is ever quiet
- taste: new spicy foods
- touch: overcrowded, lack of personal space
- smell: stinky
- temperature: HOT

India Journals: June 7

2009-07-16T07:31:00.001-05:00

On the train from Delhi to Dehradun. There is a soldier on board with a machine gun. He has paced from car to car the whole trip and is now taking a nap on the front seat of my car. I haven't decided yet if this makes me feel safe or unsafe.

Africa Journals: June 5

2009-07-14T10:36:00.002-05:00

I'm now on Qatar Airlines headed to Doha, Qatar. I wound up having to check my backpack which I worked so hard to pack because I only wanted to carry on. On well! The airport in Dar was a little confusing because there are no terminals - just one big waiting area. They call the flights in Swahili followed by unintelligible English. Once I figured out it was my turn to go through security I sat down in another waiting area. Just to double check for my nerves' sake, I asked the man behind me if this was for flight QR545. He confirmed and we struck up a friendly convo. Turns out he is the national coordinator of the Tanzania Early Childhood Development Network. I am thankful for sitting down next to him! He was a great encouragement. I told him this was my first solo international flight and that I was nervous. He grinned and said that was good because now I was officially an adult and proving that I didnt need anyone by my side.

In talking about his job and the things I did in Tanzania, he said he thought the only two really important careers were that of physicians and teachers. He said that physicians save lives everyday and even Bank of America does not have as much money as the value of a life [that's pretty much a direct quote]. And teachers help people to grow up and reach their potentials. He said without these two, the world would have a very small population, especially in Africa where education is crucial to survival.

He also told me that he knew I learned a lot in Tanzania and that I was also able to teach. But now, he said, it was my job to go back and to tell America the truth about Africa: why men and women have to beg for bread, and why survival is only by chance.

Africa Journals: June 5

2009-07-14T10:23:00.002-05:00

Leaving...

Yesterday morning we headed out at 6am to arrive in Dar Es Salaam at 6:30pm. Everyone in the house woke up early to send us off. really sweet considering most of them are not early risers. It's awesome who God places in your path. I was very blessed to meet and become friends with everyone in that house, and I will miss them on this new part of my 'safari'.

The trip was enjoyable enough with all the twists and turns, near death encounters with fishtailing buses, and rain! Made completely with a few squatty potties. One bathroom break was especially interesting. I stood 'in line' with about 30 African women waiting on a vacant porcelain hole. At another pit stop I got a 'Jambo!' going in from a man on an adjacent roof, had an encounter with a millipede, and then got a thumbs up from a different man on the way out. Good times.

After getting to Dar we headed to the White Sands Resort. Service was lazily good and I listened to an African band play while eating grilled tuna under an almost full Indian Ocean moon. A good night's sleep and a cold shower in the mission where we stayed, and I was ready for the rest of my journey!

Driving around Dar was interesting to say the least. There are tons of street vendors selling everything from pirated movies, to peanuts, to puppies. All of the beggars broke my heart. A lot of them seemed healthy and able to work, but there were some children, polio victims, and amputees. In Tanzania, disabled people are ostracized from the community and not allowed to work anywhere. I think one of my proudest moments from this trip may have been giving my last two slices of banana bread to a man with only one leg. He said "Asante" which means thank you, and hobbled to the median on his crutches where he crammed the whole slices into his mouth. While chewing he glanced back at me through the windows of a car that separated us and flashed me a snaggle-toothed grin. I smiled and gave him a thumbs-up in return.

Someone needs to teach me how to pick good cantaloupe.

2009-07-13T09:03:00.000-05:00

I noticed there was a worm hole in the side when I got home. So whatever that is I think its alive and in a cocoon or something. Guess I need to make another grocery store run before making my cantaloupe soup.
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Things I brought home with me

2009-07-08T15:37:00.003-05:00

1. Flea bites

2. A frame that is 10 pounds lighter. Clavicles, a spine, and ribs 1-4 that are a bit more prominent.

3. Jet lag

4. An intolerance to hot water. My showers must be lukewarm or else I want to cry.

5. A desire for American food, but a stomach that doesn't like it anymore. Chick-fil-a sandwiches, milkshakes, a cookie dough taste really good, but make me feel like I'm going to barf. Maybe that's a good thing.

6. Some pretty cool souvenirs including, but not limited to, some super cool Indian clothes and a cookbook that Stuart will be the guinea pig for.

7. 7,500 shillings [Tanzania], 202 Rupees [India], and 3.15 Euros [Amsterdam Airport]. I may sound rich, but that rounds out to around $15. Not really enough to justify the fee I would pay to exchange them back. I guess I will just store them in a box along with my Panamanian Balboas and Peruvian Soles until some later undetermined time.

Africa Journals: June 30th

2009-07-08T12:13:00.002-05:00

Today was one of the most exciting days I think I have ever had! At about 9am we all hopped in Land Rovers and headed a few kilometers down a paved road, followed by many kilometers down a dirt 'road' to Kimani Falls. And I use the term road loosely. The car climbed over pipes and rocks, passed washed out spots and acres of burned grasses where people illegally hunt wildlife. And we passed a few baboons along the way.

After getting knocked around quite a bit we finally arrived. We saw the bottom part of the falls which were huge just by themselves. We then started a 1.5 mile hike to the top, made complete with lots of thorns, spiderwebs, and even a washed-out bridge of sticks where we all got a little muddy! We also got to stop at a few spots along the way at different heights along the falls. Finally we arrived at the top and chowed down on our chicken salad sandwiches. I figured we would just hike back down, but then Tizo and the boys started going in the water. Hindsight being 20/20, this was probably pretty dumb since the current was strong, but how often are you at a beautiful waterfall in Africa?! We hiked all the way down almost to the part that we could see at the beginning of the hike, and our parked Land Rovers were just white dots among the Acacia trees. The BEST part was actually crossing under part of the waterfall. The ice-cold water pounding on me took my breath away and unfortunately stretched my shirt so that everyone could see my unmentionables [I'm in the pink in the picture, by the way]. Tizo helped us across and actually slipped once which was pretty scary. We all made it back up a little scratched and muddy but relatively unscathed!

Africa Journals: June 29

2009-07-08T12:06:00.002-05:00

Today I rounded with Dr. Mahengi in the womens' ward. We started out and Dr. M immediately asked me to remove an IV. I've never done that before but went right to it and had success! This particular patient had meningitis and was getting to go home. We rounded past an HIV/shingles patient, HIV/pneumonia, and several ladies who had had miscarriages. While all of those were sad, I didnt really get upset until one of the last patients. She had AIDS with a CD4+ count of 3 [normal is 700-1000 I believe]. She was literally on her death bed and was so emaciated that I could hardly tell where her body outline was under the sheet. And she was so weak that she could not lift her head and could barely speak. We asked if she had any family and she said that she had one child that she had to leave behind in Zambia to come to this hospital. Seeing her really made me upset and made me realize the helplessness of AIDS. There was really nothing that could be done for her, even though she was on anti-retrovirals. And I suddenly felt very small there in that hospital, not knowing her language to comfort her, and not being able to do anything to help.

Home!

2009-07-05T20:25:00.002-05:00

I made it home safely after a twenty four hour-ish journey. I left at 1am July 4th Delhi time and then arrived at 1:30pm July 4th Alabama time. Or in other words, my July 4th lasted about 36 hours. And because of that I ate about 8 meals in that one day.

Mom, Dad and Stuart were there to pick me up at the airport and it was quite a joyous occasion. I can truly say that I was ready to come home. I think this was the first trip I've taken where I could say that.

We made an emergency trip to Chick-fil-a afterward where I consumed a small chocolate milkshake and half a chicken sandwich. It was well worth the stomach pains it caused.

My bronchitis/Upper respiratory infection is better, and I am still exhausted. In the next few days since I have nothing to do, I think I may type up some of my journal entries from the trip and post them on here.

Thanks for reading while I was gone, and thanks for all your prayers!

Halfway home!

2009-07-04T01:29:00.000-05:00

My flight left delhi at 1am Saturday morning delhi time. My seat did not recline and there were several screaming babies, so I didn't sleep too much. That actually may be a good thing so I can sleep on the next plane and catch back up a little with Alabama time. So now I'm In Amsterdam. I brushed my teeth with tap water and had a cafe latte which were both thrilling. Now I'm at my gate for Atlanta and am hearing southern accents again! I'm getting excited!
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Delhi Disenchantment

2009-07-04T00:58:00.000-05:00

This morning we all said goodbye to ms Sethi, or auntie, and boarded our 5am train to delhi. Once we arrived and stepped off the train the heat struck me like a slap in the face. But I didn't sweat too much. I think I am on my way to adapting to the climate. Unfortunately I leave today.

We hired a taxi to take us to lunch and around town. We had a very idealistic list of about eight places we wanted to see in eight hours for eight hundred rupees. That's about fifteen dollars. The driver said the hindi equivalent of no problem and we headed out. Of course, nothing here in India is as it seems.

First stop was to be the city center where there are a lot of good restaurants and good shopping. We got there pretty quick and were confused when we just sped right past. Turns out the non English speaking driver had other plans and took us to a restaurant that caters to tourists. Apparently taxi drivers have deals with certain establishments where they get commission off tourists they bring. We somewhat politely refused and watched forty five minutes drain away from our time. Eventually we wound up at united coffee house which serves the best veggie burger and Darjeeling tea I have ever tasted. And the bathroom, friends, was well worth the inflated food prices. It was the nicest bathroom I had seen in one and a half months. It had a toilet you could actually sit on, and it smelled good! I took two trips just because I could.

After lunch, Mindy and Neeraj continued on to agra and Natalie and I did a bit of shopping. I finished off my purchases for everyone on my souvenir list! By this time it was already 2PM. We decided to head to Gandhi Smriti, which is the site of Gandhis assassination. We conveyed our desire to the driver. Obviously this was his first day as a taxi driver because he had to stop and ask for directions three times before finally taking us to Rajghat, the place where Gandhi was cremated, instead. That was neat, but all the way across town. Cross another hour off of our plans. After finding a policeman with enough broken English to translate for our driver, we finally made it to where we wanted to go. The memorial and museum were really moving, and I bought a thick biography of his life which I plan on starting on the plane.

Time check. Only an hour and a half left. We gloomily toss aside the hopes of seeing the largest mosque in India and touring old delhi on a bicycle rickshaw. Instead we head for the eco-friendly markets which are the only thing open this late in the day.

After that its time to head back to the hotel. Though no one is sleeping there, the four of us will be in delhi at different times and desperately wanted showers before boarding our flights. The taxi driver informed us upon arrival that we went over our kilometer limit and our balance was 1300 rupees, or about 25 dollars. First of all I didn't believe him, but had forgotten to note his odometer before starting and couldn't prove him wrong. Second, if we were over our limit it was his fault for trying to swindle us at the restaurant and then getting lost afterwards. Unfortunately there was nothing we could do and we had to pay the bill anyway.

At least we got a nice shower afterwards, even if cost me ten dollars for the hotel room.
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Whoa!

2009-07-01T23:14:00.000-05:00

Today is the last day of my program! I am visiting a slum today and going to a traditional Indian concert tonight. Tomorrow I board a 5am train and will tour delhi for a few hours before my flight leaves at 1am Saturday. Ill be in Atlanta at 1;40pm the same day, though my total travel time is around twenty four hours. Pray for safety!
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I'm allergic to the entire Indian subcontinent.

2009-07-01T10:23:00.000-05:00

Week 1: the rural village of Than Gaon. No pollution. Perfect weather. I have nosebleeds every morning.

Week 2: dehradun. Polluted suburbia with dust tickling your lungs in every breath, stifling heat, and human waste running in the ditches. I have a very Cipro worthy case of the 'Delhi dash'.

Week 3: mussoorie. Lovely hill station at six thousand feet elevation. I have asthma all week.

Week 4: dehradun. I now have runny nose, sneezing, coughing fits, and an impressive very manly voice. I suspect an upper respiratory tract infection and am self medicating with expectorant from my friendly neighborhood pharmacist and Zithromax borrowed from a friend.

I just hope the crazy Delhi airport workers don't think I have swine flu.
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The odd couple

2009-06-30T11:34:00.000-05:00

For some reason I really like Sikhs. They have a very violent religious history, but something about their turbans and uncut beards just make me feel like they're all really friendly. Anyway I went to church on Sunday. I was meeting some new friends there and had to hire a rickshaw for myself. The first one I saw at the end of my lane was owned by who other than a friendly looking Sikh. He appeared about sixty, with a nice plaid shirt and curly moustache. He gave me a good price for the distance I had to go, so I hopped in.

Let me pause for a second to say on that trip I realized how much the success of this trip/getting around town/my life in general depends on the kindness of strangers and the hope they don't take advantage of me.

Back to the story. The driver was nice and got me to my location successfully. Later that night my whol group decided to meet the same friends for coffee. Again at the end of the lane was the same driver, but this time with a friend. Another aside. It seems rickshaws are often owned by a pair of friends. Usually the same age and they seem like they would be BFF otherwise. But this guys' friend didn't necessarily match him. Instead of a nice looking obviously religious man he was very disheveled with greasy hair. When we got in the car he tossed his empty liquor bottle into the street and started up the car. After some interesting driving and incessant honking, even at speed bumps, we arrived.

Now today we had a couple hours between rotations so we decided to take a trip to a nearby temple that was built into a cave. And of course who do we find but the odd couple waiting on us. One as cute and the other as drunk as can be. The four of us and the two of them hopped in the scooter made for three and headed on down the road. When we got there the drunk one of the two came in too and I think was trying to explan things to us in Hindi to no avail. He also pointed out good photo ops to us throughout the trip.

Once done, we got back in and they drove us back with curbside service to our door! Again we got a good rate and since the odd couple was fascinated by our camera, we took a couple of pictures of them in their rickshaw. Pretty priceless. Ill post them later so you can appreciate the hilarity.
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Cooool

2009-06-30T06:08:00.000-05:00

A man came to Dr Gandhi's today and looked like he was about fifteen months pregnant. His belly was so big that he waddled and was short of breath from the pressure. Also I thought he had a Colostomy until he lifted his shirt and it turned out to be his belly button. His cirrhotic liver had caused such a buildup of fluid that it had pushed his bellybutton out like a grapefruit. Anyway Dr Gandhi stuck the hugest needle I have ever seen straight into his stomach to drain the yellowish clear fluid. He has to do that every three weeks. Guess that's what too much alcohol will do to you after a while. Anyway it was a pretty cool procedure. Wish I could have done it!
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New-ish rotations

2009-06-29T10:45:00.000-05:00

Natalie and I were supposed to start rotating with a pediatrician in the mornings this week. Apparently the programs pediatrician is kind of a bummer and never translates or explains anything. So instead this morning we were told to go back to Dr Gandhi, the emergency medicine doctor. And that is fine with me because he is a great teacher! Today was a bit slow but I think tomorrow were reviewing lung sounds which I really need to work on.

Second rotation: ob/gyn. I started this summer thinking I might want to pursue that as a specialty. I have since changed my mind. Birth is wonderful and its great seeing a new life come into the world, but it is also the most disgusting thing I have ever witnessed. Anyway tonight I saw a vaginal birth. It was a very quick delivery which I handled fine, but watching the suturing of the episiotomy was a different story. Can I adopt, please?

Anyway, here's tonights story. A lady came in seeking an abortion. She and her husband refuse to use contraception. They just abort whatever babies they conceive because that's 'easier,' for them. That made me a bit upset to hear and it may be best for tha lady tha I don't speak Hindi. Anyway, no less than ten minutes later another lady came in beaming. She got on the table for an ultrasound. She was eleven weeks pregnant, which is within the window when most abortions occur at home. As the nurse out the jelly on her belly, she asked us to come watch. Instead of saying come see the ultrasound or the fetus she said 'come see the life'. I thought that was pretty awesome.
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Things I have learned to do without

2009-06-29T10:10:00.000-05:00

1. Meat. Who am I kidding. That wasn't too hard for me to give up. I do miss chik fil a though.

2. Makeup. Haven't worn it in a month and a half and that has been a very liberating experience! No woman should need makeup to be/feel beautiful. I would say ill never wear it again, but I do enjoy mascara I must admit.

3. Caffeine. I had coffee some in africa and then for the first time here last night. And then I couldn't sleep. That's a big change for me from one to two cups a day and diet cokes!

4. Air conditioning/electricity. I am almost used to constantly sweating profusely.

5. Razors. My legs have been shaved about four times since I've been gone. And above the knee hasn't been touched since May 18th. I need to do that soon because its getting a little scary. Hope that isn't too much information!

6. Washing machine. My hands are red and raw but my clothes are (sort of) clean!

7. A variety of clothing. If you have been a faithful reader you will know that I was determined to just carry on for a month and a half. And I have had more than plenty of clothes to get by on. Makes me think I may need to clean out my closet when I get home.

8. Shoes. Again not too hard for me. I hate wearing shoes. Here you take off your shoes upon entering a home, any important building, and even certain parts of hospitals. My feet are always dirty but my toes are enjoying being free.
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Things that I couldn't have made it without on this trip:

2009-06-29T10:03:00.000-05:00

1. My blackberry. Blogging has been therapeutic, and for those of you who have emailed you have no idea how encouraging it is for my phone to show I have an email from someone I love!

2. Ipod. This gives me a little taste of America. It has also helped me survive several non air conditioned bus trips without wanting to jump out the window.
3. Cipro. Two rounds of this are done with. If I didn't have this with me I might still be in the bathroom instead of typing right now.

4. Face wash wipes. See previous post. These make a nice shower in dire circumstances.

5. Deodorant. I have experienced 116 degree heat. My program partners would not be my friends if it weren't for my deodorant.
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New definitions

2009-06-28T12:37:00.000-05:00

Since I have been in India I am amazed at how my standards for things have lowered. As an example, here are some common phrases and terms and how I now define them.

Taking a shower: splashing myself with soapy water from a bucket. If I'm lucky, there's not a water shortage and I can stick my head under the tap. When I'm not lucky, a shower consists of wiping down with wet wipes.

Feeling clean and smelling nice: not applicable.

Being healthy: having constant dehydration, a spider bite on my face, and sometimes and emergency bathroom run. Also having lost seven pounds since being home last.

Roadside debris: back home this would consist of the occasional can or fast food bag. Here it is all forms of household waste, human waste, cows, pigs, and the occasional monkey.

Personal space: not applicable

Washing my face: again with the wet wipes.

A good nights sleep: tonight that would be defined as sweating on a bed made of wood with a 'mattress' of blankets. Other definitions would be in a patient bed as a hospital worker, and sitting straight up on a bus for eleven hours.
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A wonder of the world!

2009-06-27T09:41:00.000-05:00

I'm two down five to go! I think I got heat stroke from the 116 degree temperatures, but it was well worth it! Now on another sleeper bus back to dehradun.
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Weekend 3

2009-06-26T08:10:00.000-05:00

Of all the things I have experienced here in India - rafting the ganges, narrowly escaping mobs at the Pakistan border- you might be surprised at what I think has been the most dangerous part: transportation. I have ridden in the back of a truck with rafts on winding mountain roads, walked in narrow streets with cars coming within inches of my flip-flop clad feet, ridden in vikrams and rickshaws without doors, and ridden on the back of a motorcycle with two others in city traffic with no helmet. You might ask why. Its not because of my adventurous spirit. I basically had no choice.

Today ended my rotation in Mussoorie. It was a very enjoyable week perched at 6500 feet and not a sweat droplet to be seen. Natalie and I are going to see the Taj Mahal tomorrow. To do so we had to take a bus down the mountain back to dehradun. This bus was again streaked with vomit both inside and out. The body of the bus groaned, the shocks squeaked, and the brakes screamed at every turn. A few fellow bus riders contributed their own stains and streaks during the trip. As we lurched around each curve my life flashed before my eyes. Thankfully we made it and we are now ejoying a melted ice cream waiting on our air conditioned bus to take us to Agra!
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2009-06-23T20:48:00.000-05:00

I witnessed death for the first time yesterday. There was a one year old girl who was having a fever and stomach virus. Apparently yesterday morning she was at home and vomited, and then aspirated some of that into her lungs. She then quit breathing. Her family doesn't live too far from the hospital, but because of the condition of the roads causing traffic jams they could not make it here quickly. By the time they arrived the baby had blue lips and was not responsive.

I was working with an anesthesiologist yesterday. He intubated her and someone breathed for her while he did chest compressions. This went on for at least thirty minutes all the while giving her drugs to try and stimulate her heart. However there was never a response and so about forty minutes in they called her death.

It was a really weird moment to go from a team of five working on her to everyone just stopping and standing back. They cleaned her up and wrapped her into a little bundle and then called the family in. First were two men. One was very upset and I did my best to console him without knowing his language. Then came the mother. When she saw her child she threw herself down screaming and crying and had to be carried out. It was one of the hardest things I have seen.

And I can't help but be a little irritated about it. Why was the girl sick in the first place? Probably because of bad water. And she probaby would have lived if the road conditions here weren't so bad. Very frustrating. But I guess such is life, and death, in the third world.
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Home #3

2009-06-22T11:06:00.000-05:00

I love this place!
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Weekend

2009-06-22T11:02:00.000-05:00

This weekend I spent twenty six hours in the city of Amritsar and twenty three hours on a bus. Here's the scoop:

We got done with our rotations on Friday around two. I got to see a little boy with Tetralogy of Fallot, complete with fingernail clubbing, and learned how to read echocardiographs. That may not be as exciting for you as it was for me, so ill move on. We had a quick lunch when we got home and then headed out to the bus station.

To get to the station we have to take a vickram. Once arriving we head to the information desk. We had planned on taking an air conditioned bus for half the trip and non ac for the other half. Turns out our Lonely Planet guidebook got this one wrong as there are no ac buses to this place. Also it turned out that instead of a five and six hour ride, we had to take a nine our bus, followed by a two hour bus.

So without a choice, we boarded our rickety bus that was streaked on the outside with vomit stains, showing the history of warp speeds on curvy roads. I kept up a good attitude at first, admiring the scenery and the busy roadside markets. But then I started to sweat and my one square foot of personal space became really small. We finally stopped for dinner and a bathroom break after about five hours. Once we arrived in amritsar it was about 4am. We headed over to our hotel and passed out for a few hours in the glorious air conditioning.

We got up and had a quick breakfast and then headed out t the golden temple. I sent a pictur of that the other day. It is a holy shrine for Sikh's, I guess somewhat like vatican city for Catholics. Anyway the architecture was amazing and the air was filled with chanting from their holy book. We waited in line for about half an hour in the sweltering heat to go inside the temple. Once inside I had chill bumps. Hundreds of peopl we're bowing in prayer and chanting and priests were reading from the holy book and devotees were offering sacrifices. Even though I didn't understand it, it was a beautiful sight. We wndered around a while and a friendly worshipper offered to take us through the museum and explain the religious history. It was great!

After that we did some shopping and eating and hopped on a jeep bound for the Indian-pakistan border. Each night the close the border which is the only point of cross between the two countries, and thousands come every night to watch. For the sake of my mothers nerves I will not explain the process of getting in. Suffice it to say that I have a cool story of almost being crushed in a mob at the Pakistan border. Anyway the ceremony was really enteettaining. The two cubtries hate each other and so while the soldiers have to do their duties, they do it with a lot of pomp and insults to the other side. And every moment the crowds are chanting and cheering with excitement and unbridled nationalism. Awesome. Ill try and post a video later.

That was pretty much the weekend. There was another long sweatty bus ride back, and I also found an amazing pair of shoes. A success!
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The Golden Temple

2009-06-20T00:48:00.000-05:00

Birthplace of Sikhism.
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Amritsar!

2009-06-19T22:07:00.000-05:00

After a horrendous ten+ hour bus trip, we finally arrived! I cannot begin to explain how sketchy it was to arrive at a new Indian city at 3am and try to get a rickshaw driver to take us to our hotel in the dimly lit streets. But god was with us and we made it safely! Now after about four hours sleep we are off to get some breakfast and explore the golden temple!
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Weekend travels take two

2009-06-19T05:46:00.000-05:00

Thank goodness my stomach is better. I have just settled in for a nine hour trip on a non air conditioned school bus. Let the sweating begin!
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Reading EKG's is like milking a cow?

2009-06-18T00:44:00.000-05:00

I Think most of you are familiar with my love/hate/mostly hate relationship with EKG's. I think I have blogged about them in the past. When in physiology last semester I knew didn't understand them too well but didn't worry much because I knew cardiology wasn't for me. Well it turns out that they're important for all doctors t be able to read. Since being here in dehradun for two days with the areas best cardiologist and emergency medicine doctor, I have been presented with at least twenty printouts to read and I have maybe done two successfully.

I get upset because I don't like being wrong, especially when I should know something. I think Dr joshi could sense my irritation yesterday because he told me, "don't worry, reading an EKG is like milking a cow. You have to feed it and give it affection, and then do it step by step." I don't really understand that analogy, but tonight if I feel up to it Dr ghandi is going to give me ekg lessons. Hopefully I will be a master reader by the time I get home.

This weekend is free and we are going close to the Pakistan border to see the golden temple and the daily border closing ceremony. Next wek I will be in the mountain town of mossourie and living in a hospital!
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Sick

2009-06-17T23:57:00.000-05:00

While rafting last weekend Mindy and I got a pretty big gulp of the river. She was sick starting Monday and now I have it. Yesterday I woke up with horrible body pains. It felt like someone had beaten me with a stick. I decided to go on to my rotation anyway but once I got there I started feeling worse. I hired a rickshaw to take me back home. Probably not the safest thing to do but at that point I didn't really care. I made it back home and slept a few hours until I awoke with intense stomach cramps. You can probably figure out what happened next! Within about two hours I made about twenty trips to the bathroom. One of the last times I had a fainting spell, or a date with the bathroom floor as I like to call it. Mix that with having a high fever in a non air conditioned house and you've got a recipe for a good time!

One of my group members, neeraj, is the nicest guy ever and took a trip down the street in the dark to get me electrolyte replacement powder. Mixed with water it tastes like the ocean but it works well!

I slept pretty solid last night and my fever feels a lot lower today. I'm resting up because I have an eleven hour bus trip ahead of me tomorrow. Say a prayer for me if you don't mind!
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New week!

2009-06-15T12:07:00.000-05:00

I am staying in dehradun with a little lady that calls me her daughter and feeds me like I won't be eating for another month. The power turns on and off ad there is only running water for two hours each day, but her house is super nice! Also with that running water today I washed all my clothes by hand.

Here is my schedule for this week:
10-1: cardiology rotation with Dr Joshi at a government run hospital. Apparently he is very well known. He sees around two hundred patients a day. I got to practice heart and lung sounds a lot today.
5:45-until: emergency medicine with Dr Ghandi. Tonight he let us be the doctor and round on patients he had already seen and made us do a diagnosis. The two patients In icu that we saw I diagnosed correctly with meningitis and a myocardial infarction. I felt like a doctor and it felt really good!
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2009-06-14T05:17:00.000-05:00

I remember this one time (yesterday) when I was rafting on the ganges. The water was so cold that my teeth were chattering. Now I am sitting on the back seat of a non air conditioned bus. It seats 23 but there are 29 riding. I am crammed between the gray smudgy glass window and my friend Natalie. I am holding my thirty pound backback in my lap and both of us sweatted through our clothes about an hour ago. And at any given time there are at least threes flies on me. My, what a turn of events.
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Holy tree?

2009-06-13T21:38:00.000-05:00

People walk up to these trees, tie string around them, circle them, pray, and or make offerings to them.
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Lord Vishnu and people bathing in the Ganges/Gangaji

2009-06-13T20:46:00.000-05:00

Not the best picture in the world. I had to do it fast because people were starting to notice my whiteness and come up and ask me questions and want to take pictures with me.
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View from my room in the ashram

2009-06-12T20:44:00.000-05:00

I woke up this morning to the sound of monkeys running on the roof and Hindu prayees being chanted.
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Free weekend!

2009-06-12T11:24:00.000-05:00

After working in the clinic all week, we are given our weekends off. Today, we said goodbye to our new friends at than gaon and headed out for Rishikesh.

Rishikesh is a holy city, often known as the city of yoga. The holy river Gangaji (Ganges) flows through the middle of the city, and two hanging footbridges cross it. Each night a Hindu prayer, the arthi, is sung and flowers and candles are released into the river.

We arrived just in time to check into the Parmarth ashram and head down to see the prayer at the river. An ashram, from what I can understand, is a place where you can come to learn yoga and meditation, or just escape for a while. According to my guru (yoga teacher) Dharindra, ashrams were known for accepting anyone as a tennant, regardless of caste. Now they charge. Inflation I guess. Anyway, the four of us have the 'penthouse' of the ashram I must say. We can look out our balcony and see the monkeys playing in the courtyard and everyone paying tribute to the various statues of the gods. And all for $12.

The ride here was very interesting. Ill have to blog it later because right now my thumbs are hurting. Tomorrow: rafting the ganges! I'm nervous! Say a prayer!
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Food

2009-06-10T11:15:00.000-05:00

As I lay in bed sweating, I thought it might be a nice time to blog about indian food.

Here in this village, as with all the places I will be staying, three meals a day are prepared for me. Myself, the other students, our yoga teachers and Dr Paul all eat together under a little awning outside. We have no tables but do have the most comfortable wooden chairs ever.

Most Indians do not eat meat, so while we are here we don't either. Of course I don't object too much. Meals usually go something like this:

Breakfast: porridge, fruit (papaya, mango, etc) and chapatis (cha-pa-tees). Chapatis are a traditional indian bread, kind of like tortillas but better. The are usually served with a vegetable mixture (yes mom, veggies far breakfast!) or with veggies cooked within the bread. To eat one you just tear it with your hand.

Lunch : rice, with some kind of lentil stew to put on top, another veggie mixture, and more chapotis.

Dinner: same as above, with different veggies each time.

Of course all meals are cooked with spicy green chilis, even breakfast.

And, if you are talented enough, you can get through a whole meal without ever using a utensil. That is what the chapoti is for! I am getting much better, but still have a problem with those last few grains of rice.
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Look what I found while brushing my teeth!

2009-06-10T10:43:00.000-05:00

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So far today I have...

2009-06-10T05:23:00.000-05:00

Had a yoga lesson from my guru.

Given an antibiotic injection to treat a throat infection

Given an enema. Weird!

Played catch with a cricket ball in sweltering heat
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Things I take for granted ...

2009-06-09T11:23:00.000-05:00

1. Electricity
2. Not having to have a bed net and not having to wonder if a scorpion will sneak attack me in the night
3. Clean water coming out of a faucet and not having to boil and filter and or bleach it.
4. Washing machines
5. Sleeping free of sweat.
6. Clean bathrooms
7. Bathrooms with toilets in them and not holes in the ground.
8. Bathrooms free of frogs, lizards, giant beetles, sleeping dogs, and spiders.
9. Having a shower head and not a bucket
10. Good health
11. Being female and also having a good education.
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I'm proud of myself!

2009-06-09T09:27:00.000-05:00

First of all let me say that I spoke too soon about my stomach. I started a round of cipro today. If you don't know what that means, ask someone else.

I did the four hour hike to the village and back anyway. I got pretty dehydrated I think but it was worth it. The hike was beautiful and the village had a lot of cute kids. And I got to check a lady for hemerrhoids. And that is probably spelled horribly. Anyway I thought the doctor was joking at first when he told me to do it. He was not so I put on gloves and went to town! Got to check an ear and some lungs but that is not nearly as exciting. One cool thing is that Dr Paul tells me to check something and then trusts my word without checking himself. Unless I have doubts about something. So I feel like I'm really doing patient assessments!

After getting back I took a glorious cold bucket bath. I scrubbed and feel really clean for the first time in a while. Afterwards I decided to be industrious and wash my clothes in a bucket! My back feels like its going to break but I was successful. Minus the fact that I don't think I rinsed all the soap out. Oh well.

Just finished yoga class. Yoga will gave to be a whole other blog. Dinner time now!
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First day in clinic

2009-06-08T11:03:00.000-05:00

Surprise my email works! I don't know how considering I am in a place that only has power sometimes. We went to clinic from nine to one, then four to six. During those hours we only saw ten patients, so it was a little slow. This is a primary care clinic that treats a village of fourty two families.

Tomorrow we will go one a two hour hike one way to a village to do a clinic there. I'm pretty excited about that.

I am in the village of than gaon which is about fourty five minutes away from the major city of dehradun. It is perched on the side of a mountain about four thousand feet up. It is one of the most peaceful places I have ever been. In the morning all you hear are the birds chirping and children laughing and playing in the village. There are only maybe three cars that pass per day and everyone leaves their doors unlocked because there is no crime here.

We have tadutionsl Indian meals three times a day, which means even breakfast is spicy! So far no stomach complaints! I have to learn some of these recipes!

We also have yoga class twice a day. The morning class focuses on poses, or asanas. The evening class focuses on chanting and meditation.

I'm off for dinner now!
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on the road again ...

2009-06-07T04:59:00.001-05:00

I arrived safely in Dehradun and got my first week's assignment, which is a week in the rural village of Than Gaon with three other students. I have no internet service there so will not be able to blog.

This next weekend will probably involve some white water rafting, so pray for safety!

-----
kacie e jackson
com 2012, president

some live by 'love thy neighbor as thy self'. others by 'first do no harm', or 'take no more than you need'. what if the mightiest word is love?

On the train to dehradun!

2009-06-06T19:50:00.000-05:00

I felt like singing the SLUMDOG MILLIONAIRE theme, but decided not to.
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Food

2009-06-06T09:36:00.000-05:00

I woke up around eight this morning and decided to skip breakfast. I wasn't too hungry and I want to conserve my rupees. I got hungry around noon after a morning of catching up on my blog and my reading. I headed downstairs to the hotel restaurant bawarchi. I ordered black tea, vegetable soup and naan. The black tea turned out to be chai and I was thrilled. That is black tea boiled in milk with added spices and is the most delicious drink I have ever consumed. The vegetable soup turned out to be just tomato soup with three hunks of mysterious meat floating in it. I had a flashback to earlier that morning. I was walking past the kitchen on the way to find some bottled water when I saw some sort of skinned animal being butchered in the kitchen. It looked similar to goat, though I can't be too sure. Anyway, I think whatever it was made it into my soup. It was so tough that I couldn't bite it in half, so I just let it float. The soup was great though. Now, naan is the traditional Indian bread. Itis flat and reminds me of a mix between communion bread and pizza crust. It is also quite delicious.

Dinner came around six. Since I could not understand what anything on the menu said and my waiters English is about as good as my Hindi, I decided to stick with what I know for my stomachs sake and get black tea again with chicken fried rice. I figure I am pretty close to China here so it can't be too bad. The tea gets delivered and though I ordered the same thing, I receive something different. It's still great though. I may have to bring some of this stuff home. The rice is good too and I walk away paying the equivalent of a little over four dollars for two meals!

In other news, I don't know how long my internet will last. I learned not to depend on it in africa. Hopefully at least for the next two weeks I will have it because I will be in the fairly large city of Dehradun. If not though, I am also keeping a journal and will just write my blogs from that after I get home.

I appreciate your continued thoughts/prayers for me. I am a bit lonely here today and am missing the hustle and bustle of my house in Africa and of course my family and friends back home. I would appreciate any email encouragement you would like to send my way!
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Adjustment #1: bathrooms

2009-06-06T07:24:00.000-05:00

Here is my bathroom in the Hotel Star in downtown Delhi. The toilet is like a throne! Note the bucket and small stool in the tub. The ' bucket bath ' is the common way of bathing here. Bath plus hair washing plus leg shaving took approximately thirty minutes to accomplish, but was surprisingly refreshing! Tomorrow I am off to a homestay and am a bit curious as to what the bathroom will be like. Oftentime toilets are holes in thw ground with porcelain footprints. I took a shot at a few of those in africa (no pun intended) but wasn't overly successful. Ill keep you posted
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The men of India have welcomed me.

2009-06-06T07:11:00.000-05:00

I arrived in the qatar airport and found the gate to my connecting flight to Delhi. Immediately I noticed that not only was I the only white person in sight, I was also the only woman. Perhaps I shouldn't have worn my bright orange coat.

Many men were in traditional Muslim attire since Friday is their holy day. My favorite man was wearing a long white 'dress' with pants underneath. He had one of those coverings on his head that looked like a pillowcase held on the head by a band around the forehead. He not only was jamming out on his ipod, but also was using his red dell laptop and balancing a cup of coffee on his Louis Vouiton rolly luggage.

When I walked up everyone proceeded to stare at me, but none so much as the man sitting across from me. I avoided his gaze until I saw him holding his cell phone up and heard the camera click. I looked up at him and he was embarrased to be caught.

Although there was no announcement made, everyone got up all at once to line up at the gate. I followed suit and after greeting me the passport checker said, "here you are beautiful". I thought that was sweet rather than creepy and so smiled and said thanks.

All passengers then boarded a bus to take us to the moveable stairs to get on the plane. I noticed a young Indian man with slicked back hair and a black and white silk shirt. He was looking at me so I politely smiled and looked away. During the course of the bus ride I could feel his eyes on me in a creepy sort of way. After we stopped he had somehow scooted from across the bus to six inches away from me! We were allowed to board and I was glad to be rid of him.

I walked down to find seat 11f. When I got there who did I find in the seat next to me but silk shirt guy. What are the odds!? He flashed a huge grin and raised his eyebrows. I grudgingly got situated, all the while with him watching and smiling. He asked my name and told me he was Sakham. Then came more questions: where are you from, why are you traveling alone, how many brothers do you have, where are you staying in India? All of which were answered vaguely or untruthfully by saying I didn't understand him.

I thought sleep might solve this problem but actually made me feel more awkward because every time I opened my eyes he was looking at me. The othher men on the plane would talk to him in Hindi and they would laugh, who knows what about. He then tells me he is a lucky man and that I am a lucky woman because of our seating arrangement, and he also adds that my sunglasses are beautiful (walmart $6). My second walmart special is a fake silver wedding band to try and detract such advances. He points to it and asks if I am married. I don't thing the ring worked because later he asked me to give it to him as a gift.

Later he needed to borrow my ink pen to fill out the immigration form. He finished and then asked for my pen as a gift. I gave in. Mainly because I don't like that pen too much. He was elated and lovingly held it in his hands while alternating his gaze from the pen to me.

The plane finally landed and when the seatbelt sign went off I literally speedwalked to customs. Thankfully that flight was only three hours!
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The people God places in your path

2009-06-06T04:42:00.000-05:00

I could write a whole book about the nine people I shared a home with in Tanzania. I had originally been told I would have my own house on the mission and was excited to find out instead that I would be staying with seven nursing students, an ob/gyn, and a nurse practitioner. I was a bit nervous too because they all knew each other before hand and I didn't want to be the odd man out. I wound up rooming with two girls named Birdie and Whitney. They were huge blessings to me and we shared many late night chats about lots of different topics. The other three girls and two guys(bless their hearts) were great too. I learned a lot from them and was greatly encouraged by them too. And Dr paulsen and ms bingham were also wonderful to work with and get to know and I learned so much from them as well.

Another fun story is from yesterday in the dar es salaam airport. I was nervous because the airport was a little confusing and I couldn't understand the speaker announcing the flights. Well I sat next to a nice tanzanian man and decided to strike up a conversation. I told him once he asked about the work I did in tanzania. He then informed me that he is the national coordinator of the tanzania early childhood development network, an organization that provides prenatal and postnatal nutrition and education. We both shared our thoughts on the tanzanian healthcare system and swapped business cards. Meaning he gave me a card and I wrote my name on a piece of paper. It was as if he knew exactly what I needed to hear because afterward he told me I was proving myself ad an adult by flying alone internationally. He also spoke a few minutes about the importance and honor of being a physician. By the time we boarded the plane I was ready to give him a hug!
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A true african safari

2009-06-05T17:55:00.001-05:00

In Swahili the word safari means trip or journey. Yesterday I had a ten hour safari in a car with an archaeologist, an ob/gyn, and a racecar driver turned missionary. If someone were to ask me how my trip was they would say , "habari za safari?". And I would answer, "nzuri". That means good. The trip went well mainly because there was beautiful scenery and I didn't die.

We left out at six am with the race car driver behind the wheel, which is on the right side of the car. It was still dark with the red sun peeking up over the David livingstone mountains. Many people we're riding their bikes and walking in the road. Since there are no street lights we narrowly missed them.

The road continued, filled with pothole a foot deep and speeding buses fishtailing around the tight turns. Occasionally there was a baboon and even once a giraffe crossing sign. Don't get that much in Alabama.

We made it safe from chimala to Dar Es Salaam. We we're hungry by that time and the racecar driver knew of a resort with good food so we stopped there. The night was made complete with grilled tuna and an African band playing while I overlooked the Indian ocean.
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May be last blog for a while ... email is very sketchy here!

2009-05-24T06:35:00.001-05:00

I was introduced to a sweet little baby yesterday. He was about one and a half and was wearing a little hat and an olive green shirt. He was an ashy gray color and his breaths were labored and only came out in little gasps. He was awake and looking around, but lying completely still on his little cot. His mother sat beside him watching, wearing her brightly colored dress and head turban.

An –ray was taken and showed four of the five lobes of the little boy's lungs were consolidated with fluid. Tuberculosis or pneumonia was suspected. But there was something else. He was HIV+. It then had to be explained to the mother in seemingly perfect health that her baby has this horrible disease, and that he received it from her meaning that she too was HIV+. I saw the mom after this and she was just sitting quietly with her baby.

Late last night he passed away and his mom put him in the handmade sling on her back to make the long walk home to bury him.

At the same time yesterday afternoon there was a woman in labor. She was fully dilated but the baby was a bit stubborn. We took her to the semi-sterile operating room and I got to see part of her C-section. A healthy 9 lb. 9 oz. baby was born.

I couldn't help thinking of the song, "He gives and takes away … Blessed be the name of the Lord!"

-----
kacie e jackson
com 2012, president

some live by 'love thy neighbor as thy self'. others by 'first do no harm', or 'take no more than you need'. what if the mightiest word is love?

The good, the bad, and the bloody

2009-05-21T23:03:00.000-05:00

Yesterday morning and the afternoon before I went on an African safari! Myself and three others hopped in a 4wd and headed through the plains. It was quite and experience and believe me it was well documented with pictures!

For sake of time I will describe the good and bad of the trip.

My favorite animal was the hippo! They pretty much just lay in their pool and float around all day. They are big and day and kind of ugly with bad teeth and they don't really care. They also just kind of roll around in the water and whenever they come up for air they grunt really loud and make tooting noises. It was a good time!

Least favorite was the tse tse fly. We were cruising along with the windows down when all of a sudden we heard buzzing. These little suckers that look like horseflies were buzzing around everywhere! They bite and carry African sleeping sickness so we were a bit concerned. We sped up and tried to shoo them out, all the while smacking those suckers and probably zooming past all the wildlife. When we would squash them, blood would squirt out all over the place. Who's it was we don't know. I don't think it was mine. If anything I have jet lag and can't sleep past 330 am.
I am attaching a picture for your general enjoyment.
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indian ocean.jpg

2009-05-19T23:10:00.000-05:00

This is what I woke up to this morning! Thank you God! Also there was a HUGE spider that I took a picture of with my other camera. I'm now eating a hardboiled egg with Jam and tea and about to head out!
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Tanzania!

2009-05-19T15:45:00.000-05:00

I'm here! I am currently laying in the tan-swiss mission in tanzania under my bug net pictured here! The flight was good but long! I am about to go to sleep to try and recover from my jet lag and then tomorrow I'm going on a safari!
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In Amsterdam!

2009-05-19T00:45:00.000-05:00

You will see my post time as approximately 1am. But here in Amsterdam it is a bright and sunny 7:30am. Hello, jet lag! I managed to sleep about two of the eight hours I was on the plane and now have a three hour layover before doing it again.

Fun facts:
1. Amsterdam is a lot more farmy and a lot less party than I expected. From the view from the plane window at least.
2. Sitting in the middle seat of a row for eight hours is not a good time.
3. Everyone native to Amsterdam could pass as my immediate relative.

On to africa!
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I'm on the plane!

2009-05-18T15:17:00.000-05:00

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I did it!

2009-05-18T10:50:00.000-05:00

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Poll

2009-05-15T18:55:00.000-05:00

Will all of this fit in my carry on bag?
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SWARMING TERMITES!

2009-05-13T16:34:00.003-05:00

Soooo a lot has gone on since I last blogged:

1. I AM FINISHED WITH MY FIRST YEAR OF MEDICAL SCHOOL! I could do a whole blog about that, but I decided not to. Mainly because I'm leaving the country soon and I have a whole lot of stuff to take care of! Basically, I'm 25% of the way done and I've learned a lot of stuff! haha. Next year I'm going to have to work a LOT harder if I want to keep my grades up.

2. I am leaving the country on Monday for 2 weeks in Tanzania followed by 4 weeks in Dehradun, India. I will still be blogging via my BlackBerry, so stay tuned!

3. I have swarming termites in my house. What is that like, you may be asking? I had noticed a few weeks ago that I had these small wormy looking things that would crawl on my walls at night [gross, I know]. Anyway they looked pretty harmless and I wasn't too worried about it because I had been leaving my windows open during the day so I can save money on a/c. I figured they had just crawled in. Well after a few nights of this I began to get concerned. On Friday night I decided I would go to the office on Monday and tell the landlord I wanted to be fumigated. My fam came that weekend and all the bugs were gone! So I was really excited and thought maybe they had sprayed serendipitously sometime while I had been gone and the problem was solved.

Fast forward to three nights later. I am sitting at my desk in my office trying to organize all of my notes from my first year of med school. Out of the corner of my eye I saw something move, but when I turned to look it was gone. My phone rings. It's Stuart. We start talking about Mississippi State football games this fall and I was very engrossed in the conversation when all of a sudden, five bugs fly out of my air conditioning vent and start swarming me!!! Stuart hadn't really been exposed to my girly fear of bugs yet and so I tried to keep relatively quiet while swatting them down and running around the room out of fright. I then ran out into the hallway where there were at LEAST 10 of the same bugs flying around! At this point I get a little more vocal. Stuart encouraged me to spray the bugs instead of just yelling at them and running around, which turned out to be a better idea. I got off the phone and all the bugs died what I hoped to be a slow and agonizing death. I then turned on my bedroom light to go to the bathroom to wash my hands when FIVE MORE bugs flew out of my a/c vent there and landed IN MY BED!!!!!!!! AAAUGHHHH!

After I killed all the bugs, a few more would fly out of the vent and I would scream and then kill those with my trusty Raid spray. This went on for about half an hour. I worked up a sweat comparable to running a race, and I almost fell down my stairs twice trying to swat all those suckers down.

Fast forward again to the next morning. I call the office ASAP. I told her about the horrible story and that after researching I thought I had swarming termites. To corroborate my story I had a little plastic baggy that I had filled with samples. She started laughing. Bad sign. She told me that in our neighborhood, there are about 10 blocks or so that get infested with these little boogers for a few weeks every year. They enter the duct work and then at dusk they swarm to lights inside the house in order to establish new colonies. They cant find them and then immediately die. I was not comforted by any of this. I realize that I am not made of wood and termites won't bite me, but nevertheless I don't want them swarming around me every night. I asked what I could do to avoid it and the answer was to not turn on my lights at night. At least I am going out of town this summer! =)

4. Yesterday I drove from Mobile to Auburn to Birmingham to Gadsden. It was so so good to go back to Auburn even though it was just for a few hours!! I had a lunch meeting with some nice ladies from the Women's Leadership Institute. That is a super program that I got to be a part of in 2006, and they want me to be involved in the future which I am super excited about! I also got to visit with some of my favorite ladies from the COSAM office! Of course I am prejudiced, but I don't think there is any other collegiate department in the world that can rival the friendliness, helpfulness and awesomeness that is COSAM! Ask me about it in person some time and I will tell you more =) Then I traveled to B'ham to visit Mr and Mrs Alan Baggett! I havent seen them since their wedding in December so it was really great to catch up!

5. I'm in Gadsden now and getting ready to have some family + Stuart time tomorrow and then getting ready to leave for this summer. I'm starting to get nervous/excited. Like I mentioned earlier, I will be blogging as much as possible while I'm gone, so stay tuned!

Uh Oh. I knew this was coming.

2009-05-07T10:16:00.003-05:00

I have:
Headache
Post nasal drip
Sore throat
Fatigue
Swollen submandibular glands
Nausea [last night, possibly from consuming an entire milkshake]
Decreased energy
Slight nasal congestion
cold sore

My differential diagnosis would be:
Pharyngitis
Chronic fatigue syndrome
Tension headache
Peritonsillar abcess
Strep throat

However, I think the most likely diagnosis is, you guessed it: SWINE FLU.

This means I get out of my physiology final, right?

2009-05-06T14:55:00.002-05:00

My first physical exam? It was a bit anticlimactic. Three of my classmates and I gathered in the smallest exam room possible with a resident and took turns doing partial exams on each other under their watch. I got assigned an ear, heart, upper extremity neurological, and sensory exam. We fortunately were with a resident who was not too excited about her job it seemed and therefore we didn't have to try too hard. I'm sure that Sarah Beth was thankful for this. She was my exam partner and that meant I didn't have to lift her boob out of the way to listen to her mitral valve and feel her Point of Maximal Impulse. Whew!

The exam went as follows: the resident said, "Kacie, please do an upper extremity neurological exam on your partner." I rose from my swively doctor's stool and walked to the exam table. Here was my shpiel: "Ok please hold your arms out to your side and push up against my resistance. I'm testing the deltoid muscle, innervated by C5 and C6. Hold your arms like this and flex then extend against my resistance. Biceps. C5 and 6. Triceps. C6, 7, and 8." That went on for about 5 minutes and then the resident asked questions that I had not studied for such as: what symptoms would she have with an upper motor neuron lesion? And what is an example of that? Some I guessed well, others not so much. Once during my ear exam I forgot to check the periauricular lymph nodes. The resident then said, "Kacie, would you like to palpate something?" I almost made a joke, and then decided that would be inappropriate. So I just palpated them instead.

Though the exam was less than exciting, I did learn some interesting things about myself during the studying process. For instance, my nasal turbinates are purple instead of pale meaning that I have allergies. I have long been suspicious of this despite the fact that no doctor has ever told me I have allergies. Also I have easily documentable orthostatic hypotension, meaning that from laying down to standing up or sitting my blood pressure drops 20 points on top and 10+ points on bottom. Finally, I have readily palpable scoliosis. Remember when all the moms would come to your third grade class and make everyone bend over and feel your back for scoliosis? Well apparently they missed me or just had no idea what they were doing.

Now moving on to what youre probably most interested in... my double date with a professor. One of my histology professors is Dr Bhatnagar. He is from India. I believe he has been mentioned in a blog before. Anyway, he and I have chatted quite a bit and when he found out I was going to his homeland this summer, he said he and his wife would like to have me over for dinner to tell me about India. I said, "Of course!" because would you really refuse dinner from a professor that wanted to cook it for you? After I accepted I realized it would be awkward for me to go to a professors house by myself, so I asked Dr. B if Stuart could come. He answered in the affirmative.

So immediately after my practical yesterday I sped home to find Stuart waiting on me. I begin to have a horrible feeling in my stomach. As in "Holy cow I'm about to have dinner with a professor and this is going to be really awkward and we arent going to have anything to talk about." And let me please interject that I have the best boyfriend in the world. Not only did he go to Skit Night with me where he understood none of the jokes that we all laughed at uncontrollably, but he also gladly accompanied me to a histology professor's house after a hard day at work. I digress. We mosied on down the road and finally arrived. I noticed a van in the driveway but didn't think too much about it.

I rang the doorbell. Dr B, who normally dresses in a suit and tie every day for work, answered the door in jeans and a fly-fishing shirt. I walked into the house and out of the corner of my eye spotted someone else in the kitchen. Lo and behold, it was DR KAYES. Let me interject again. I'm not quite as BFF with Dr K as I am with Dr B. I always considered him a bit grumpy because every day that I would walk by him I would say, "Good morning Dr K!" and he would respond with, "I sure hope so" or "I guess we'll see". Debby Downer. It had actually been my goal all semester to get him to say good morning back. I only succeeded once, but it was a sweet victory indeed.

So needless to say I was a bit shocked to see him [and his wife, Harriet, wearing a Hawaiian shirt and stretchy pants] in attendance. I suddenly started to feel a bit more awkward until I realized they had already had some wine and were probably relaxed. Surprisingly though the evening went smoothly. We had somewhat normal conversations including but not limited to: Swine Flu, designing a hurricane-proof house, debilitating diseases I will be at risk for in India, and Wisconsin.

The only hitch in the evening was ... Harriet. She managed to offend both Stuart and I unknowingly by mentioning that Focus on the Family would warp your brain [Stu did an internship there] and that medical students were whiny babies that got too much respect and professors wiped our butts for us. That was fun. I wanted to ask her if she had ever met Dr Cohen [The Sweater], but refrained.

Anyway, all in all the evening was a success. I had as much fun as can possibly be had at a dinner party with professors. And Stuart had a good time too! I wonder what other awkward situations I can get myself into next semester?

Stay tuned ...

2009-05-05T14:38:00.001-05:00

updates on giving my first physical exam and a double date with a professor coming soon!

Anxiously awaiting ...

2009-04-28T08:32:00.002-05:00

GRADES! I'm done with three classes this semester and grades are yet to be posted. I think this is some kind of cruel experiment to track how many times I log on to USA's website to see if my grades are there. I am most interested/nervous about my histology grade, because I have a borderline B in that class. I remember a time when I used to get really mad if my grades were below 95's. Now I hope for B's in some classes. Is that bad?

Also, my grade for Fundamentals of Doctoring is a little troubling. Here are my grades so far this semester:

C [mid term exam. Let's not go there...]
B [final exam. Again, I don't want to talk about it.]
P [stellar paper about sexual deviance, if I do say so myself]
8 [community service points]

These all average out to ... drumroll please ... an 8. I'm not exactly sure how that works. Hopefully the other paper I wrote will get posted soon and bring me up at least 82 points. Hmm.

FoD Propaganda?

2009-04-21T09:43:00.003-05:00

This weekend I took a trip to the lovely town of Starkville, MS, home of Mississippi State University. I experienced the campus for the first time and got to meet a lot of Stuart, Caleb, and Tricia's friends - it was a good time!

Unfortunately I had to study some while I was there too because we had a final in Fundamentals of Doctoring on Monday. We only have two exams in that class, and the first exam did not go over too well for a majority of the class. Thankfully, the faculty was kind enough to let us have a 'bonus' paper assignment to make up for it. This paper required us to come up with two examples of misbehaving children, and how to fix it using operant and classical conditioning. For the sake of time I will not comment on the fact of how classical conditioning is only used in animals.

There were examples of these things in our textbook. Unfortunately I bought my textbook from a second year who sold me the wrong book. I don't know if he was trying to be sneaky and make a buck, or if he accidentally used the wrong book all year and just had no idea. I wonder what his grade was like.

Anyway, Caleb and some other people in my class had come across this textbook online. Caleb put it on my computer and warned me that it contained communist propaganda. I thought he was joking because he is very conservative and FoD teaches us some not-so-conservative stuff. Well actually it turns out that this online textbook was scanned online by the Chinese who have no copyright laws. Since they made it free to everyone, they put some of their 'memos' in it. As I was scanning along reading about child behavioral theories, this scary image popped up on my screen:

I think he's telling me that I should scan books to make sure they don't say anything against the government. I hope the Chinese government doesn't get me for writing this ...

Mishaps at Wallgreens

2009-04-16T16:08:00.002-05:00

Well folks it's time of year again where I start preparing for my summer adventures. Today's assignment: send off the application for my Indian Visa.

This requires mailing my passport to Texas, which is something I dont like the idea of very much, so I wanted to make sure I did it right. I went to Rhonda's office and she told me how to go online and print off a FedEx form. I spent approximately 10 minutes doing that and then it informed me that it did not want to accept my credit card. No problem. I still had to go get my passport-sized ID photos made so I figured I would just swing by the FedEx store after that.

I head to Walgreens for the photo-op. I must admit that even though I did not shower this morning I was pretty excited about getting these pictures made. I felt the need to make up for my real passport photo, which is a complete disaster. I was 18 when I had it made. The lady at the post office was ever so charming and barked at me that I was not allowed to smile. This of course made me start laughing. If that were not enough, she didn't tell me when she was going to snap the camera, so when my picture finally came back I had a crooked grin and one eye half closed. I have actually had workers at the airport laugh at me for it. I look high.

Anyway, once at Walgreens I smiled extra pretty for the camera and sat down to wait. The lady told me 5 minutes tops. I people-watched for a while until alarms started ringing from the photo printing machine. Out of paper. I walked around the store a bit while the technician decided to train the new hire on how to load paper. 10 more minutes. I'm still bursting with excitement on the inside to see my pretty Visa picture. Then ... another alarm goes off. Apparently when you change the paper it's easy to mess up everything else. My picture comes out pink. 10 more minutes go by. I tell the lady I'll just go work out and come back to pick it up.

Hello Planet Fitness. I do elliptical for 20 minutes and then run at a pretty quick pace for 10. I had a protein shake for lunch and I think it had given me a little extra boost. So of course I leave the gym nice and red and sweaty.

Back to Walgreens. The lady greets me by saying their machine is destroyed and I will have to go to the other Walgreens and repeat the process over again. This means taking a new picture now that I am completely sweaty and disgusting. Cool.

Now off to the new Walgreens. Vickie the photo tech escorts me to the background screen. It is conveniently inside the refrigerated compartment where they keep the drinks. It was nice and cooling. She takes the first picture. Not good. There's a shadow on my face. She takes another, another, and another. As I stare across the isle at the Jack Link's beef steak nuggets bags, I wonder if perhaps my nose is causing the shadow. NINE pictures later, she is done.

I finally got my picture, and while I don't look worse than my passport picture, I definitely don't look much better. Oh well.