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Current Music:IASIP Season 1
Subject:My new television addiction.
Time:11:08 am
Current Mood:[mood icon] giggly
Hey, newsflash: I LOVE DYSFUNCTION. It underlies most of the TV shows that I watch compulsively - Arrested Development, Home Movies, Reno 911. (However, I have my limits. Curb Your Enthusiasm is just TOO painful.)

And now I've discovered It's Always Sunny in Philadelphia. And it's wonderful. These people are so messed up.

After watching S01E03 - "Underage Drinking: A National Concern," I now know, deep in my heart, that I <3 Charlie.


gimme some eyes! now cool your jets!!
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Current Music:Never Young Again - Mirwais
Subject:Neurosurgery
Time:02:48 pm
Current Mood:[mood icon] restless
I did a rotation in pediatric neurology after coming off 2 months of neurosurgery, and it was a major struggle switching gears.

Rounds seemed interminable, because neurologists like to know more than “Is the patient breathing independently? Is he moving all four limbs? Does he open his eyes?” (This is literally what neurosurgeons consider a sufficient physical exam.)

The neurologists were so laid-back – they got to work around 8:15, sat around the office chatting for a while, and considered it a busy day if 3 new consults came in. Compare this to the 10 consults seen by the neurosurgeons on a light day. I think I weirded my resident out because I was constantly saying, “Hey, I can start seeing that new patient in the ER while you’re working on this one,” and she kept telling me that we could go together after we took a break.

And one afternoon, when I was down in the ER, I found myself in the supply room, touching the different packets of sutures with longing while muttering to myself, “2-0 Vicryl interrupted sutures on the galea, 3-0 nylon unlocked running suture on the skin closure.”

I suppose that was the final confirmation I needed to give up on neurology altogether and commit to neurosurgery.


i had a taste, and there’s no going back
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Current Music:Tessellate - Tokyo Police Club
Subject:Everything I needed to know I learned in New York.
Time:10:02 pm
Current Mood:[mood icon] contemplative
1. While I was out with 3 neurosurgery residents, an internal medicine resident, and a urology resident (which added up to me + 5 guys), I picked up two synonyms for butterface:

shrimp – “Throw away the head, eat the tail”
bengal – “Nice uniform, fucked-up helmet”; a reference to the Cincinnati Bengals football uniform

2. Obnoxious people are WAY more obnoxious when they speak with a Jersey accent.

3. Before opening the dura, the membrane immediately under the skull covering the brain, you want to ask yourself 3 questions:
a. What is the PCO2?
b. What is the systolic blood pressure?
c. What is the urine output following administration of mannitol?

all else is dust and air
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Current Music:Girl in the War - Josh Ritter
Subject:What a weight off of my mind.
Time:07:14 pm
Current Mood:[mood icon] aggravated
 Hey kids, guess what? I just passed my Step 2 Clinical Skills exam!

What does this mean? It means that I can speak English (goodly, of course), and that I'm NOT in the bottom 4% of US-trained senior medical students.

And it only cost me $1500 to discover all of this! What a steal!!


excessive exclamation points  = irony 
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Current Music:Swollen Summer - The Bravery
Subject:It's too hot to think.
Time:11:24 pm
Current Mood:[mood icon] WTF Seattle?
But not too hot to perform a lumbar puncture, apparently. 

That's right, I performed a successful LP on a conscious person my first time out. Go me!

I will admit, however, that at least 3
Spinal Tap jokes ran through my mind before I managed to quash them and remind myself that I'm a professional.

gotta keep it together...

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Subject:Crank - an adventure in aneurysms.
Time:04:19 pm
Current Mood:[mood icon] angry
I did not go into this viewing expecting The Shawshank Redemption. What I WAS expecting was something quick, entertaining, and filled with Jason Statham’s unique brand of tough-guy charisma.

Instead, I got 87 minutes of rage-inducing inaccuracies about the human body. Let me enumerate the top 5 biological fallacies of this movie. I will refrain from commenting further on the nearly-nude women in egg-shaped glass cages – they defy explanation.

Rage + biology + spoilers behind the cut... )

The remarkable thing is that the writers went to extra effort to include all this wrongness, instead of just glossing over it like any reasonable action movie would have. C'mon guys, just take the path of least resistance.

sharpening my knife for the sequel

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Current Music:Damnkid - DJ Boborobo
Subject:A largely pointless update!
Time:05:26 pm
Current Mood:[mood icon] happy
It's been a while since I last posted, and I figured now was a good time - NOT because anything interesting has happened to me, but because I had some amusing Wikipedia links to share!

Some of you may already be familiar with the concept of a 'gay bomb,' but this was the first that I had ever heard of these US Air Force research reports.

My favorite sentence:
"The reports also include many other off-beat ideas, such as spraying enemy troops with bee pheromones and then hiding numerous beehives in the combat area...."

OMG you guys, can you imagine being the guy in charge of stashing beehives in the combat area? Running from hill to hill, seeding them with nests of buzzing, confused and easily enraged bees while not getting shot or blown up? Where do I sign up??

Also, I ran across the Bookseller/Diagram Prize for Oddest Title of the Year while searching for an awesome Darwin Award winner I read years ago (located here). I had no idea this existed, but now I want all of these books proudly displayed on my shelf. 

My top three picks: Bombproof Your Horse, How to Avoid Huge Ships, and 
The Stray Shopping Carts of Eastern North America: A Guide to Field Identification.


also: totally passed internal medicine  - hellz yeah, bitches!
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Current Music:Hello Again - Neil Diamond
Subject:Spring break woo!
Time:10:09 pm
Current Mood:[mood icon] sleepy
Went to the Oregon coast last week, and discovered that the weather was nice. This saddened me at first, since more people were wandering around, crapping up my beach with their crappiness.

(It should be noted that I didn't see anyone actually crapping on the beach. It's just a wonderful turn of phrase.)

I got over it quickly, since the good weather meant that I could take long walks on the beach in my flip-flops, which was awesome. The majority of my time there can be summed up with the following image:


you kids wait here on the shore 

tee hee, ocean pr0n!
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Current Music:Planet Earth in the background
Subject:LiveJournal: the awkwardly sexy edition!
Time:10:24 am
Current Mood:[mood icon] curious
1) I'm reposting this, so I apologize for the repetition, but OMG where was I when this first came out?

Green Porno - thanks [info]lisaofdoom. I think my favorite is the Bee.

2) Ah, the 80s. It was a decade of self-parody happening in real time.


3) Finally, I just wanted to say, in regards to Eyes Wide Shut: Thank you, Stanley Kubrick. Thank you for making sex appear as unnatural and disturbing as possible. I mean, how do you make an orgy seem completely unappealing? Jesus.
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Current Music:Gimme Shelter - The Rolling Stones
Subject:More of my weird fetishes.
Time:09:27 am
Current Mood:[mood icon] awake
 Um, am I the only one who's horribly, horribly aroused by this idea?

GMail Autopilot


minimal brevity, maximal emoticons!
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Current Music:um, Slavic folk songs?
Subject:Book review – lightning-fast edition!
Time:04:07 pm
Current Mood:[mood icon] aggravated
 So I’m sitting in Barnes & Noble, waiting for my Mac Genius appointment, and I just did a speed-read of a fairly standard, fairly AWFUL chick lit book based on – you guessed it – Pride and Prejudice. I think my personal hell would be filled with shelves upon shelves of terrible modern ‘reinterpretations’ of this novel.

 And vinegar. Vinegar makes me gag.

This is at least the second book I’ve seen where the author, for lack of an original idea, has her heroine re-reading P&P, and having real-life events mimic exactly what is happening in the book. She pulls actual text from the novel, then immediately re-states it in modern lingo. And WOW, it's done so unskillfully.

Within the first 50 pages, the protagonist had broken 3 of my cardinal rules for being a good person:

  • Speaking of Abercrombie and Fitch with anything other than scorn and derision.
  •  Wearing Uggs – and mentioning it proudly to the reader.
  • Talking on the phone while on the toilet. This is absolutely unforgivable. If you do this, DO NOT TELL ME. 
I could offer actual critique of the clunky writing and inconsistent character development, but that would be like criticizing the paint job on the Titanic.  Authors, I implore you: stop re-writing Pride and Prejudice. It’s not that I’m putting it on a pedestal, demanding that it remain untouched. I'm willing to give Pride, Prejudice and Zombies a chance, because it might have something NEW to say. I’m just on a quest to stop bad writing from being printed on paper made from trees that were doing a much more useful service to mankind.

and really, i’m just embarrassed for you

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Current Music:Windowsill - Arcade Fire
Subject:Making too many decisions can induce catatonia.
Time:04:21 pm
Current Mood:[mood icon] blank
I just had my 4th year scheduling appointment with the registrar, a lovely and helpful woman who basically spent 45 minutes asking me what I want to do with my life without even realizing she was doing it.

I feel like I just signed away a major part of my life and committed myself to things I'm not sure I'm ready to handle. This is utterly ridiculous, because I'm sure that I'll look back at this meeting 20 years from now and laugh at how little it mattered.

On the other hand, when she asked, "When are you planning to do interviews? You probably want to leave a few weeks open for that," and I had no answer for her, it forced me to accept that I will have to decide my calling within the next 9 months.

After the meeting, I had to sit in my parked car for 20 minutes, staring out the window, because I couldn't make the decision to get out.


my career is gestating before it explodes out of me and takes my innards with it, Alien-style
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Current Music:Traffic in the background
Subject:Life at the VA
Time:07:30 pm
Current Mood:[mood icon] tired
What’s wrong with this nursing report delivered over the phone?
"I can’t give Mr. L his antiviral medication. By the way, the patient is unresponsive."

Me: How many drinks a week would you say you have?
Patient: Oh, 'bout 2 or 3.
Me: Okay. Was your alcohol use heavier in the past?
Patient: [just laughs]
          
This is basically every patient I have.

Lecturer Nowadays, on those medical TV shows full of beautiful people, they’re doing lung exams with the shirts on. This is dangerous  propaganda, because it’s amazing what you can hear when there’s no clothing in the way. So, when you’re all beautiful people taking care of patients on TV, let’s get those shirts OFF.

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Current Music:Arrested Development in the background
Subject:Thanks a LOT, MST3K.
Time:08:11 pm
Current Mood:[mood icon] crazy
 It is unfortunate that so many of my patients have required consultations with the inpatient psychiatrist.

It is far more unfortunate that his name is Dr. Manos, and I feel like shouting, "MANOS! THE HANDS OF FATE!!" every time someone mentions him.

And then launching into a crappy monologue:


um, i probably need a consult too
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Current Music:All the Young Dudes - Mott the Hoople
Subject:ER Case Study
Time:08:34 pm
Current Mood:[mood icon] nerdy
My professor referred to this picture as “Bad Karma,” and I tend to agree with him.



What is remarkable about this picture

This unfortunate patient displays 4 major types of intracranial bleeding.
  1. The large, lens-shaped high-intensity area on the patient’s left (white arrow) is an epidural bleed; the shape is distinct because the dura is peeling away from the skull.
  2. The area on the patient’s right (black arrow) is a subdural hematoma: less lens-shaped but still on the periphery.
  3. The area on the right anterior brain (black arrow) is a subarachnoid bleed: note that the blood follows the contours of the brain, meaning that there is no membrane between the hematoma and the tissue.
  4. The white mass in the brain itself (white arrow) is an intraparenchymal bleed: it has a sort of blobby shape.
Note the gross distortion of the ventricles (the black areas in the middle of the brain that should be larger and symmetrical around the midline).
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Current Music:Dress to Kill in the background
Subject:Third world medicine. With alcohol.
Time:07:44 pm
Current Mood:[mood icon] amused
One slow morning, my attending was telling me about his adventures abroad. Several years ago, he was serving in Honduras during an episode of methanol poisoning in the community. At the time, there was very little medical infrastructure in that area, and no fancy drugs to reverse methanol intake.

The cure? Overwhelm the patient’s system with ethanol, in order to prevent conversion of the methanol to formaldehyde, which is what blinds and kills you.

Therefore, the doctors were armed only with rum and breathalyzers. Their mission was to ensure that anyone who had ingested the contaminated batch of booze maintain a blood alcohol level of .11 by administering untainted ethanol.

Statements I like to imagine being made:

Aw man, you’re barely blowing a 0.08. Are you even trying?

Someone get that woman a giant pina colada - STAT!

If you stop drinking this delicious rum, made from the finest dark molasses, it will be against medical advice!

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Current Music:"Aw come on, ref!!" in the background
Time:12:07 pm
Current Mood:[mood icon] content
This week,  I experienced the power of perceived wealth in human mating behaviors, i.e. someone hit on me because I looked like a doctor.

 I was standing in line at the IT help desk, listening to a conversation about money, happiness, and the relationship between the two.

"I'm not saying you need money to be happy," one guy said.

I smiled, and he noticed. "You know what I'm talking about, right doc?"

"I agree with you," I responded, “but money doesn't hurt."

He and his companions laughed. "I hear that. So, you on the market, doc?"

"Oh, I'm still in training," I cautioned him. "All I can bring to the table is debt."

"Well, we'll just set the wedding for 2013 then."

I laughed. "I'm a patient man," he said comfortably. "I think of it as an investment."

an investment in awesome

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Current Music:Sæglópur - Sigur Rós
Subject:Manswers!
Time:04:42 pm
Current Mood:[mood icon] quizzical
Billed as the show that answers the questions real guys ask, Manswers was to be my window into the male psyche. Here are my findings.

There is a disembodied voice constantly shouting bad puns and catch phrases at the viewer.

Conclusion: real men are deaf.

 Manswers provides mini-summaries for 3 minute segments, and then recaps every segment at the end of the show.

Conclusion: real men have dementia.

During each segment, the viewer is constantly bombarded by explosions and women dressed as ‘sexy nurses,’ ‘sexy professors,’ and ‘sexy person pointing at a globe.’

Conclusion: real men have ADHD.

Number of times I heard “Screw you, France!” + number of times I saw a large pile of poop crushing the Eiffel Tower > 0

Conclusion: real men are xenophobic.

On a personal note, I am concerned that I am quantifiably stupider after watching that show.

Conclusion: mission accomplished.

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Current Music:House in the background
Subject:I should go swimming more often.
Time:08:45 pm
Current Mood:[mood icon] chlorinated
 Why Float On is an awesome song to hear while you're in the pool:

1) You can hear the drums and the bass even when you're underwater.

2) The chorus line is thematically appropriate.

3) It momentarily blocks out the memory of Hotel California playing a few minutes ago. 

grrrr


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Current Music:the hum of the refrigerator
Subject: The state of neurology in the year of my birth.
Time:09:33 am

I'm reading this book called Neurology for the House Officer (1983). Things of note:

1) It is published and distributed by a pharmaceutical company, similar to The Merck Manual. So far I haven’t found any biased research studies or subliminal messages cajoling me to use their product.

2) At this time, they had determined that Crutzfeld-Jakob disease was transmissible, but had not identified the causative agent.

3) This book deems it important to inform me that Parkinson's tremor is NOT helped by alcohol. To be fair, essential and physiologic tremor are both helped temporarily by alcohol. I just like to imagine that many physicians at the time were frustrated that they couldn't tell their Parkinson's patients to just go get hammered.

there goes my primary treatment plan

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