Island Med Student

“Every time I drive in rush hour traffic, I lose a piece of my wings.”

- Kendra Campbell

I’ve learned two important things this week (my first week of endocrinology, and first week of driving to the hospital):

1) I really like endocrinology. It’s interesting and not too complicated and I’ve learned a lot. My attending is the bomb.

2) I will NEVER drive to work. Ever. Again.

I’m pretty sure that driving is perhaps the worst torture that exists. It beats down your very soul. Traffic can turn the very best mood into the very worst. I am no longer able to take photos and videos along my route. I have no control over how fast or slow I can go. I am at the mercy of traffic. You might think that I’m exaggerating, but I’m not. Driving to work even for one week has taken away a piece of my soul. Now I will have to regenerate that piece via walking for a year.

I have one more week of med school (endocrinology) left. I might decide to take the subway to the hospital (even though it would be a longer trip), just because I think driving is killing me.

Anyway, 5 more days of work until I am a doctor. Yes indeedy.

Photo: Taken today during endocrinology rounds. Infection control does save lives.

Today was cold. I mean seriously cold. It didn’t get above freezing and with the windchill factor, it was close to zero degrees Celsius. The wind gusts were so strong that I was literally swept off my feet. It made for an interesting walk to and from the hospital and doggy walk.

Try walking with three large (and pulling) dogs on leashes in the bitter cold while the wind blows you all over the sidewalk. T’was not easy, but I did it. And I even managed to whip out my trusty iPhone and take some photos (all the ones from this post) during the whole adventure. My poor thumb nearly froze off while navigating my iPhone’s interface.

Tomorrow is my last day of my infectious diseases rotation. I will be giving a presentation tomorrow on vasculitis and Behcet’s disease.

I’m inside my apartment now yet my fingers are still so cold from my walk that it’s difficult to type with the stiffness.

But I’m not complaining. It is fun to battle mother nature. I fought the cold today, and this time I won!

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I’ve had an absolutely fabulous two days. Yesterday, I went out in the morning and took the doggies to the park illegally, in feet of snow. Later on in the day Micah and I went into Union Square, Manhattan and watched the movie Avatar in 3D.

I have a lot I could say about that, but don’t feel like it right now. The gist is that I was not completely impressed. It was supposed to be this breakthrough movie with amazing special effects. I thought the plot was incredibly thin, the characters were too stereotypical, and the 3D made me slightly nauseated.

This morning, I walked to the hospital for my infectious diseases rotation. I had a blast making my way over a mile through the snow covered sidewalks to the hospital. At one point, I slipped on some ice and came crashing down onto my buttocks. The great thing is that I literally laughed at myself, wiped the snow off my toosh, and continued on my journey.

After I got back from the hospital, I went on my standard run into Manhattan and back WITH the dogs. It was insanely amazing! At first, I tried not to step in the slush and snow and mud, but eventually, I just gave in to the moment. I ran full speed down the sidewalks, with doggies galloping in front of me, splashing in puddles, snow flying, and mud and slush covering my body head to toe! I had this realization that this is one of the reasons being a kid so great (and why I never want to grow up). When I stopped caring if i was going to make a mess or get dirty or wet, I was suddenly completely free. Nothing mattered but laughing and smiling and splashing in the freezing cold wetness! I wouldn’t trade the experience for a million dollars.

Afterwards I came home, took a bubble bath, and am now enjoying some wine and a cheese platter that I created.

I’m terribly excited about the holidays. More greatness to come soon. In the meantime, please enjoy the photos with this post:

1) An empty bird cage in the snow I found on my walk to the hospital (does anyone out there recognize that pink tub?).
2) Me wearing my 3D glasses with 100 pounds of popcorn and Coke Zero waiting in line to see Avatar.
3) Part of my walk to the hospital, near where I fell on my butt this morning.
4) Some cool trash on top of snow.
5) My winter attire, aka “praying mantis” pose.

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I am officially halfway finished with my infectious diseases rotation. I’ve learned a lot and saw an interesting case today (but incredibly sad) of a very young man with Behcet’s Sydrome. The case reminded me again how strange it is that the most exciting cases in the hospital are usually also the most tragic.

I went on a 9-mile run today and took a bubble bath when I got home. Apparently that did me in for the day, as I haven’t had the motivation to move very much since then.

It’s calling for quite a bit of snow in NYC tomorrow, and there is a winter storm advisory for the area. My sister was supposed to visit me, but it looks like that won’t be happening, because of the predicted inclement weather.

I don’t have any truly insightful wisdom to share with the world right now, so I’ll leave you with that for now. Enjoy the photos with this post. The first one is of a flock of pigeons huddling together in a parking lot because of the intense cold and the second one is my doggy Molly eviscerating a stuffed pyramid.

That’s a mouthful.

Anyway, as promised, here are some short and sweet tidbits learned in my infectious diseases rotation (please forgive my abbreviations and lack of links, I’m not in a typing or linking mood):

1) Elderly or very young pt comes in with h/o fever, headache, nuchal rigidity. Could be n. meningitides, so give Rocephin, Listeria > give ampicillin, or s. pneumo > give vancomycin.

2) Pt comes in with sore throat, difficulty swallowing > think group a strep or anaerobes so give unasyn or PCN + clindamycin.

3) Pt bit by cat and has erythema > give clinda for anaerobes, and a PCN for staph and strep OR give unasyn or augmentin (if you add a BLI to a PCN, it covers anarobes as well).

4) Pt w/ cellulitis > think staph or strep > give vanco or bactrim if not resistant. If they have an ulcer or abscess, give vanco bc of skin breakdown.

5) All quinolones have atypical coverage (random factoid).

6) Chronic COPDer on steroids, could be pseudomonas! (or s. peumo or atypicals) so give MAXIPIME! Covers all.

7) Healthcare associated pneumonia > give carbapenem + vanco.

8 ) Community acquired pneumonia > give zithromax (covers atypicals) + ceftriaxone.

9) Febrile pt, increased WBC, RUQ tenderness > give flagyl (to cover anaerobes) + 3rd gen ceph (for gram negatives).

Sorry if that confuses anyone, but it helps me remember when I type it up as well.

Please enjoy the photos along with this random post. All taken in Bushwick over the past 2 days. I will never tire of taking photos of trash.

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I’m thoroughly enjoying my infectious diseases rotation. I feel much more confident about being able to choose the appropriate antibiotic. I am feeling totally lazy right now, but I promise to post some more “stuff learned” soon.

Last night I had a wonderful time in Bedford. My good friend Midori was in town for residency interviews so we met up for sushi, drinks, pool, and nachos. Click here to view the photo album from the night (all taken by my iPhone, of course).

In other news, it’s definitely winter! Although I haven’t seen snow yet in NYC, it has been cold enough lately to freeze water on the sidewalks. Luckily, this frigid weather has not deterred me from my intense running schedule. So far, I’m still on target to make my marathon a week running goal!

I have some ideas I’d like to share with everyone, but right now it’s time to put the clothes in the dryer. Will return again!

Here is a short list of some things learned in my infectious diseases rotation today:

1) Penicillins are good for treating most gram positives except enterococcus and listeria (ampicillin is the drug of choice).

2) Penicillin is good for staph and strep (unless resistant).

3) For Clostridia Perfringens, penicillin works well.

4) For anaerobes, use a penicilllin + beta lactamase inhibitor.

5) For bites, Unasyn is super.

6) For intra-abdominal infections, use Flagyl + a 3rd generation cephalosporin.

7) Penicillins are excreted by the kidneys, except for the semi-synthetic ones.

8 ) All 3rd generation cephalosporins cross the blood brain barrier.

9) Ceftriaxone is good for meningitis, and community acquired pneumonia, but can cause biliary sludging.

10) Cefotaxime is the drug of choice for neonatal meningitis.

11) Vancomycin is good for staph infections and c diff.

12) Polymixin B is nephrotoxic and is only good for gram negatives.

And I learned much more!

Note: Sorry for the crappy quality of the pics with this post. I was too tired to put more energy into them!

Today was my first real day of my infectious disease rotation. I’m absolutely in love with our attending who is a jovial man with a heavy Italian/Brooklyn accent. Today was a short day and we didn’t cover too much, but I thought one point was interesting. Our attending asked us “why don’t you ever need to know the dosages of antibiotics?” All the students sat around with a blank look on their faces, so I piped up, “because you can look them up?” Yes, that was the right answer! He said that he’s been an infectious disease doctor for 20 years, but he still looks up many dosages. “It’s better to look it up, and be 100% sure than to not look it up and prescribe the wrong dosage which kills a patient.” I thought that was a pretty interesting perspective.

On the way home from the hospital I couldn’t help but go into my favorite 99 cent store. I splurged and spent $17 on two pairs of gloves, wrapping paper, a small notebook, a dog squeaky toy and some awesome multi-colored singing Christmas lights. When I arrived at my apartment, I excitedly hung up the lights and gave the squeaky toy to Molly. She promptly eviscerated it in about 3 minutes.

Tomorrow I will go in for my infectious disease rotation and then I have a residency interview in the afternoon. More to come soon!

In the meantime, please enjoy these Bushwickian photos that I took yesterday on my doggy walk and photos of my 99 cent store prizes!

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I had a wonderful weekend, which including going out with Micah and my Son Tom on Saturday night. Today I started my first day of an elective rotation in infectious diseases. I’m hoping to improve my antibiotic selection skills, which could certainly use much improvement.

I now have my official schedule in place, except for my very last 4 weeks, so I thought I’d share it with everyone:

Infectious Disease: December 7 – January 1
Nephrology: January 4 – January 29
Pain Management: February 1 – February 12
Pediatrics: February 15 – March 26
Hopefully a sub-internship: April 5 – April 30

And then I will be finished! Yes, I am doing pediatrics very late in the game but that is a whole another long story.

Also, for all ye curious souls out there, here is my schedule for the residency Match and graduation:

Residency Interviews: Now – February 12
Deadline for Ranking the programs: February 24
Find out if I matched or not: March 15
Match RESULTS: March 18
Official Graduation Day: April 30
Graduation Ceremony at Madison Gardens: June 4
First day of residency: July 1

More to come about infectious diseases!