Without pain, without sacrifice, we would have nothing. Like the first monkey shot into space.

-Tyler Durden from the movie Fight Club

Well, I am sure most of you have given up hope I was going to write anymore...but here it is. As a testament to my difficult month, I haven't had much of a chance to write. I have written small notes in my mini-notebook of topics to address....but it has been so long, half my notes don't even make sense to me anymore.

I started my 3 year journey on wards, which is the equivalent of being a hospitalist for those of you not versed in the lingo. Despite having a simply phenomenal team, it has been rough. To begin, the admit caps for the team were 'magically' raised between my interview and start date. They actually blamed the med students for this ( "they didn't have enough to do") but in reality, seems money driven.

Second, most ward teams, especially in the first few months, are supposed to have three interns. But due to some MDs (not foreign grads, surprisingly) having license issues, we were short an intern. Basically, created 50% more work per intern.

And last, but certainly NOT least, my team (Team 1) had one of those infamous black clouds. Simple cases turned into 2 week stays. Bounce backs (previously discharged patients from our service returning within the same calendar month) weekly. Always maxing our admit caps. Team 1 became famous for our work load.

So my new year enthusiasm lasted all of 3 days, and the real work began. I admit, in line with the quote above, I now feel more confident to handle a large patient load in an efficient manner, much like the confidence I gained from a rugged med school curriculum. While some interns came in some days with 1-2 patients, I became accustomed to seeing anywhere from 6-10 on a regular basis.

But it is not without its downside: time for reading and learning has been nil. Being proficient at the bread and butter of Internal Medicine is important, but being mindful of the rarer findings is essential as well. Thankfully, a lighter schedule the next two months should allow for this.

No tragedies so far, either my fault or otherwise. A few young patients with disabling diseases, but none that weren't mostly self inflicted. I do still feel for them though; their "wake-up call" will not ever become a clean slate. I think everyone should be allowed a second chance.

Off topic: Anybody else rolling their eyes at companies "Going Green"? Not a global warming debate, but I am almost offended by companies (including my hospital) cutting services or charging more and labeling it "Going Green". It is just a cop-out to raise revenues. I will only be impressed when a company does something Green that is more expensive for them (and NOT the consumer) and is beneficial to the planet. Until then...

I don't want to be in a battle, but waiting on the edge of one I can't escape is even worse
-Pippin, Lord of the Rings: Return of the King

Orientation began on Monday, which I should be thankful for; many of my former classmates (former? that is sad to type) began much sooner. Many who know me well know I have become quite the nervous ninny over the last few years, and this has not waned. Heading into orientation, I was so nervous I could hardly sleep.

It's hard to say why. Beginning a new year, maybe I expected a speech like those Dr. Bruce D. gave us every year: "This next year will be 4 times as hard as last, you will need to study all the time, and for most of you it still won't be enough, and you will probably all fail out". Fortunately this has not occurred, but I am still not at ease. Partially because I am incredibly homesick. Not only are Susan and Anara not here yet, I am actually living in a motel til I close on my house on Friday. But also because I miss Fort Worth and all my family, and it has really sunk in: I am going to be away for atleast 3 years.

The other part has to do with the quote at the top: Intern year will suck, but twiddling my thumbs waiting for it to be here is almost worse. I am motivated to study by fear at the moment, but all my books are packed away in Fort Worth. I know this all seems to be fairly normal, but that isn't helping me much.

Two side notes: One, I will try to post more often, because this post had about 17 points that I seemed to only lightly touch on. Two, I have been disappointed in one thing about the program: They seem to have magically changed up a few of the things that made me rank them higher in the first place.

Which is in contrast to.....

The Express, a movie about the first black Heisman trophy winner (Ernie Davis), has almost nothing in common with the aforementioned tv show The Wire. Now admittedly, my review is only based on the first half of the movie, as I simply had no interest in completing the rest.

While the Wire was real and gritty, The Express shocked me only in that it wasn't produced by Disney or as a Lifetime tv special. The actors are all very pretty, with overly eloquent and clean speech that hardly seems believable. The so called racial tension seem to lack any real tension at all, and the acting is mostly sub-par (I did like Dennis Quaid, and the actor who played Ernie's father).

As a side note, it was my first Blu-Ray movie, and the clarity was amazing. It almost threw me off, and I will have to figure out if it was just the video style of this particular movie, or if I am just not used to the definition.

Also, an update on my grandfather. He does have several Multiple Myeloma hot spots, and will start chemo tomorrow. Not too much other word.

The Wire

Friends of mine turned me onto an HBO series The Wire, a realistic portrayal of the seedier sides of Baltimore, Maryland. Far from the cookie-cutter network television dramas, this show (much like another HBO series, The Sopranos) demands a lot of time investment in order to reach a 'pay-off', whereby conclusions are reached and storylines completed.

Check it out.

The PS3

As graduation started rolling around, I was treated with a surprising revelation: graduation gifts. Honestly, the thought hadn't even entered my mind, which made the gifts twice as nice. A new smartphone, a new laptop (sorely needed) were among the awesome toys I received.....and then there was my gift from Susan......

Susan is not a fan of video games, as they have traditionally been a guys get together or a ben-solo affair; neither scenario involving Susan. This information may help explain why Susan absolutely refused to ever buy me anything video game related, and she certainly seemed to be sticking to her guns. I had been touting a PS3 for 2 years now, without a budge from her. (I admit, spending $400 outside of a graduation gift would not be prudent). Amazingly, she even stood strong as she agonized over a graduation gift for me. I was confounded; why struggle so mightily for an idea when I had (pun intended) gift wrapped this for her? Go buy the PS3, and you're done. Best of all: IT IS WHAT I WANT.

But alas, she would not give in, and instead she booked us a room at our favorite Bed and Breakfast outside of College Station with a massage to boot (married friends or future to be marrieds, take note: Susan is the master at giving gifts that are great for her as well). While not a PS3, it was nice, and I was appreciative. Unfortunately, things didn't turn out the way she planned, as the night in question was the day after my grandmother passed; wouldn't have been a very fun evening, and thus we had to cancel. Even worse, the calendar didn't suggest any alternative dates, and we're moving an additional 4 hours north from College Station very soon.

Committed to not giving in, Susan in turn gave me.......nothing. Absolutely nothing. My new PS3 that just showed up in the living room? That's from Anara she said. Certainly not her. =)

The original idea for this post was to explain why I chose the PS3 over the XBOX360, but that seems to have gotten lost in the shuffle. In short: the added Blu-Ray capability. I could have done Blu-Ray in my Home Theater PC, but reviews for Blu-Ray software seem woeful, especially when the PS3 is also one of the best Blu-Ray players. I also like idea of one box for the games and the movies: having the XBOX plus a Blu-Ray player seems like a messier solution better left to my bachelor days. Now my only problem is games: I am used to hitting up gamestop specials of $8-12 for used games, where I am looking at atleast $20 per used game.

Ah well, internship starts in one week, who has time for games?

Quick "what the hell have I been doing lately update":

Agonizingly enough, not much. The cool "right across the street from the hospital house" deal fell through, so I am all packed up with nowhere to go. We have a new deal going on another house, but the closing will not be in time for orientation. I am currently researching temporary housing, and have decided to shell out the big bucks and pay $210 a week for a hotel room. Should only be for a couple of weeks.

In the mean time, I have been playing my new PS3 (more on this in the next post) and checking in on my grandfather. Y'all may or may not know, but my grandmother passed away from multiple myeloma about 2 weeks ago. In fact, she entered the hospital on the day I graduated from TCOM, and she never recovered enough for me to talk to her before she passed away. So....my grandfather, who is not a beacon of health himself, is now home by himself during the daytime. Diabetic, some collapsing vertebrae and a new, shocking diagnosis of multiple myeloma (not a typo) on top of some emphysema add up to a tough time being by oneself. Even more than that, he just lost his wife of 60 years....

So my sister and I have been taking turns fixing/taking him lunch. Amazingly my grandmother continued to feed him up until the very end, so it is just not something he is used to doing.

Orientation starts next Monday....and I think all this house and family hub-bub has been good to keep my mind of my impending doom.