Urgent - Delete My Mailing Address

The time has come - I am moving out of my apartment in Queens to a friend's apartment in Staten Island. Therefore, please remember to delete my current address in Queens out of your address book.

Go ahead. Do it now.

NOW!

And no, I will not give you my "new" address in Staten Island - I will only be there for three months. Send stuff to my California address and I will get it in a few months or if it is urgent, my mother will forward it to me.

HEY YOU! I said DELETE!!!!
Thank you.

Chocolate - Oh, So Much Chocolate!!!!

Last week I got a pretty big taste of what heaven will be like, God willing I make it!

My good friend S.A. invited me to a "great place for dessert in Brooklyn." Really, she could have brought together any number of words in a sentence - the mere fact that "dessert" was included as one of the words perked my ears. "Hovig, the world is coming to an end after dessert" suggests to me that I still get to enjoy dessert first!

Anyway, SA took me to a place called The Chocolate Room. That's right - the place is EVERYTHING CHOCOLATE and is absolutely divine. Divine I say!!!

We enjoyed hot chocolate; literally melted chocolate in a glass served warm with a homemade marshmallow! We split a Chocolate Layer cake (pictured) that was quite possibly the most tantalicious and moist and gooey and FRIGGIN' AWESOME chocolate cake I've ever had (disclaimer: I may have made similar statements to some of you when you have baked me a cake - those statements still hold true). We also split a Chocolate mousse with homemade whip cream on top that literally melted in your mouth. We did indeed OD on chocolate.

Truly, truly I say to you - if this is heaven, PLEASE count me in!!!!!!

Quickies: Quick Updates On What's Going On

Twitter seems to growing in ubiquity - the web service, which allows users to keep the world updated on what they are doing every minute, seems to be all the rage right now. Even my friend NK over at his blog is using the service now. At some point, I may take the bait - but for now, I'm introducing this new blog feature - "Quickies" - where I will give short update blasts on various events going on. Things that wouldn't necessarily get a full blog post in the past, will get their little space and 15 seconds of fame here.

1. Day Off
Since my hospital is now totally and completely closed down, without any patients, sans doctors, and lacking supplies, I was given today off. Starting tomorrow, I am being moved to Wykoff Medical Center in Brooklyn, which is about a 45 minute commute from my house by subway. I will be there until my current rotation (Internal Medicine) finishes on March 13. I then have a two week hiatus before starting Surgery at Staten Island University Hospital. From my house, that would be about a 2 hour commute - so that's NOT happening...I will be moving to Staten Island and staying with a dear friend who is also doing her rotations at SIUH.

2. Amazing Mac and Cheese
I just had the most amazing - AAAAMMMAAAZING!!!!! - mac 'n cheese EVER last night. A friend made it and I melted right along with the cheese. Just boil some pasta (we used the small shells which were perfect), drain, then add milk and velveeta cheese and let it melt together and let the milk dissolve into the dish. My friend claims the true southern style would also include eggs and some baking of the pasta - but whatever man, it was AMAZING as is! I can't wait to make it for myself...though it should be noted that this is NOT a health food!

3. Biggest Loser
I have been stuck at my weight for the last few weeks. I made it to 224 and I have another weigh-in sometime this week. But it has been frustrating not being able to lose weight as fast as I lost it the first few weeks. But alas, this is to be expected, so if you find yourself in a similar frustrating situation, don't give up!

4. Renaming the No Child Left Behind Act
Congress, rather than making meaningful changes to a law that requires much improvement, is focusing instead on renaming the thing. Great use of time and effort guys - way to go! So here is my contribution: "Don't You Dare Hold Parents Accountable in a Child's Life, Only Blame the Teachers Act". Other ideas?

5. Pondering First Class Flying?
I found this great picture about the recent US Airways Flight 1549 that landed in the Hudson. The flight crew were amazing and deserve all the credit for landing safely and getting the passengers out. But this picture DOES give you another pretty darn good reason to fly first class! (And people who know me, know that I'm always looking for any reason to fly first class!)

Why Mr. Rogers Was The Best Neighbor Ever!!

This has been a tough week for me - not because I have been working hard, but because I have been hardly working due to the imminent closure of my hospital. The transfer of patients has been moving ahead of schedule and the last of the patients are expected to be transferred out by today, rather than next week. Thursday afternoon, the hospital was like a high school at the end of the year - all the employees were in the halls, clearing personal effects and hugging each other and taking pictures and just soaking it all in before the hospital is closed forever.

Rather than dwell, however, I want to enjoy an article written by Mangesh Hattikudur that I found online. He describes the top 15 reasons why Mr. Rogers was the best neighbor ever. Hope it brings a smile to your face the same way it did for me; and I hope you have a wonderful weekend, neighbors! :)

1. Even Koko the Gorilla loved him
Most people have heard of Koko, the Stanford-educated gorilla who could speak about 1000 words in American Sign Language, and understand about 2000 in English. What most people don’t know, however, is that Koko was an avid Mister Rogers’ Neighborhood fan. As Esquire reported, when Fred Rogers took a trip out to meet Koko for his show, not only did she immediately wrap her arms around him and embrace him, she did what she’d always seen him do onscreen: she proceeded to take his shoes off!

2. He Made Thieves Think Twice
According to a TV Guide piece on him, Fred Rogers drove a plain old Impala for years. One day, however, the car was stolen from the street near the TV Station. When Rogers filed a police report, the story was picked up by every newspaper, radio and media outlet around town. Amazingly, within 48 hours the car was left in the exact spot where it was taken from, with an apology on the dashboard. It read, “If we’d known it was yours, we never would have taken it.”

3. He Watched His Figure to the Pound!
In covering Rogers’ daily routine (waking up at 5; praying for a few hours for all of his friends and family; studying; writing, making calls and reaching out to every fan who took the time to write him; going for a morning swim; getting on a scale; then really starting his day), writer Tom Junod explained that Mr. Rogers weighed in at exactly 143 pounds every day for the last 30 years of his life. He didn’t smoke, didn’t drink, didn’t eat the flesh of any animals, and was extremely disciplined in his daily routine. And while I’m not sure if any of that was because he’d mostly grown up a chubby, single child, Junod points out that Rogers found beauty in the number 143. According to the piece, Rogers came “to see that number as a gift… because, as he says, “the number 143 means ‘I love you.’ It takes one letter to say ‘I’ and four letters to say ‘love’ and three letters to say ‘you.’ One hundred and forty-three.”

4. He Saved Both Public Television and the VCR
Strange but true. When the government wanted to cut Public Television funds in 1969, the relatively unknown Mister Rogers went to Washington. Almost straight out of a Capra film, his 5-6 minute testimony on how TV had the potential to give kids hope and create more productive citizens was so simple but passionate that even the most gruff politicians were charmed. While the budget should have been cut, the funding instead jumped from $9 to $22 million. Rogers also spoke to Congress, and swayed senators into voting to allow VCR’s to record television shows from the home. It was a cantankerous debate at the time, but his argument was that recording a program like his allowed working parents to sit down with their children and watch shows as a family.

Heart Attack? Don't Come Here - We're Closed

After serving their respective communities in Queens for over a collective 150 years, Mary Immaculate and St. John Hospitals will be shut down as of next week, victims of decades of mismanagement and a very hostile economic climate. All efforts for a government bailout or loan have been exhausted. As of last Saturday at midnight, the ER at St. John where I am doing my Internal Medicine rotation has been shut down. All is quiet on the western front. In fact, it is downright eery in the ER.

The hospital, which was full the whole time I have been there up to last week, and has a capacity of around 240 beds, is currently holding about 40 patients in the remaining two wings that are still operational. As soon as those patients are either discharged home or transferred to another facility, the padlocks will be placed securely on the doors and only auctioneers will be allowed inside to inventory and sell the stock.

I wonder what hospital beds sell for these days.

NOTE: The two pictures of the ER above, although from a slightly different angle, are of the same side of the ER. You can see beds were empty before we officially closed down. After our official shut down of the ER, you can see that the once organized and well-kept area is already in disarray. Very, very sad.

Quotables: Regarding Baltimore City School's New CEO

"I have a feeling if Jesus brought him the Lord's Prayer, he would've had edits."
-Benjamin Feldman, Research and Testing Director in Baltimore City Public Schools

A year after I left the Baltimore City Public School System (BCPSS), a new CEO (our version of Superintendent) was brought in named Andre Alonso. From all accounts I have read at the Baltimore Sun newspaper online, the man is committed and passionate, if not a bit of a firecracker. He is driven and wants nothing more than to see the children of BCPSS succeed. I must admit, had somebody of his caliber and zeal and ingenuity been running the school system during my tenure, I may well have stayed longer.

Mr. Feldman, a 33-year veteran at BCPSS, goes on to say this about Dr. Alonso:
"You know what would be really heartbreaking? If he [Alonso] failed. If he can't do it, no one will ever do it. We will never have a superintendent of this caliber again."

Watch What You Say

Sometimes it is very difficult to "nail a stick" - medical street slang for being able to draw blood for various exams. On one particularly challenging patient, I was getting very frustrated because I couldn't find any veins. I should have suspected as much, since I was sent in after a nurse was unable to nail the stick. Let me learn you something: if the nurse can't do it, it most likely can't be done!!

Well, I kept trying to locate a vein and hopefully "see the flash" - meaning blood fills the butterfly tube indicating you have hit the vein, so go ahead and push in your test tubes in the other end to draw the blood. Anyway, I kept getting nothing and at one point I got so frustrated that I used my Arabic language skills (very minimal - I just know the cuss words) and said "yeelan abook" under my breath. I'm not exactly sure what this means, but I think it loosely translates into something like $#*t.

My comment caused the patient to suddenly look at me with wide eyes and a quick "oolek!" Yes, that's right - turns out my patient with a very NON-Arabic sounding name was indeed of Egyptian background and understood what I said!

Luckily, the patient was quite understanding and we both got a great laugh out of it. And in fact, as a result, the patient who was quite on the verge of refusing any further needle sticks allowed us to keep trying. Eventually, another nurse was able to nail the stick.

And I learned to keep my comments...ALL my comments, to myself :)

HAPPY BIRTHDAY!!!!

There is a very special person out there who reads this blog. She goes by "Mom #2" and it is her birthday today!!!!

Here is wishing another 28 wonderful years in addition to the one we celebrated today!!!! ;)

Love ya!

Did You Know: I Love Sesame Street!

I found this awesome article on CNN written by Stacy Conradt. It is the story behind some of my favorite characters from Sesame Street and the Muppet Show and all the favorite little monsters that Jim Henson created. What a great imagination!

Enjoy the read! I know I loved it! And be prepared for a little nostalgia, and I hope I didn't leave out your favorite -- not all of the characters have interesting background stories (sorry, Big Bird).

1. Cookie Monster: Jim Henson drew some monsters eating various snacks for a General Foods commercial in 1966. The commercial was never used, but Henson recycled one of the monsters (the "Wheel-Stealer") for an IBM training video in 1967 and again for a Fritos commercial in 1969. By that time, he had started working on Sesame Street and decided this monster would have a home there.

2. Elmo: The way it's described by a Sesame Street writer, apparently this extra red puppet was just lying around. People would try to do something with him, but nothing really panned out. In 1984, puppeteer Kevin Clash picked up the red puppet and started doing the voice and the personality and it clicked -- thus, Elmo was born.

3. Telly Monster was originally the Television Monster when he debuted in 1979. He was obsessed with TV and his eves would whirl around as if hypnotized whenever he was in front of a set. After a while, producers started worrying about his influence on youngsters, so they changed him to make him the chronic worrier he is now.

4. Count von Count made his first appearance in 1972 and was made out of an Anything Muppet pattern -- a blank Muppet head that could have features added to it to make various characters. He used to be more sinister -- he was able to hypnotize and stun people and he laughed in typical scary-villain-type fashion after completing a count of something and thunder and lightning would occur.

He was quickly made more appealing to little kids, though. He is apparently quite the ladies' man -- he has been linked to Countess von Backward, who loves to count backward; Countess Dahling von Dahling and Lady Two.

5. Kermit was "born" in 1955 and first showed up on "Sam and Friends," a five-minute puppet show by Jim Henson. The first Kermit was made out of Henson's mom's coat and some ping pong balls. At the time, he was more lizard-like than frog-like. By the time he showed up on Sesame Street in 1969, though, he had made the transition to frog. There are rumors that he got the name Kermit from a childhood friend of Henson's or a puppeteer from the early days of the Muppets, but Henson always refuted both of those rumors.

6. Animal: The Who's Keith Moon may have inspired everyone's favorite member of Dr. Teeth and the Electric Mayhem. This is speculation, but people who support the theory will point out that Jim Henson named one of the Fraggle Rock characters "Wembley," which is the town where Moon was born.

7. Miss Piggy is apparently from Iowa. She started as a minor character on "The Muppet Show," but anyone who knows Miss Piggy can see that she wouldn't settle for anything "minor." Her first TV appearance was actually on an Herb Alpert special. It wasn't until 1976, when "The Muppet Show" premiered, that she became the glamorous blonde with a penchant for frog that we know and love today. Frank Oz once said that Miss Piggy grew up in Iowa; her dad died when she was young and her mother was mean. She had to enter beauty contests to make money.

8. Oscar the Grouch is performed by the same guy who does Big Bird, Carroll Spinney. Spinney said he based Oscar's cranky voice on a particular New York cab driver he once had the pleasure of riding with. He was originally an alarming shade of orange.

9. Gonzo: What exactly is Gonzo? Nobody knows. Even Jim Henson had no particular species in mind. Over the course of "The Muppet Show," "Muppet Babies" and various Muppet movies, Gonzo has been referred to as a "Whatever", a "Weirdo" and an alien. Whatever he is, he first appeared on the scene in 1970's The Great Santa Claus Switch. His name was Snarl the Cigar Box Frackle. In 1974, he showed up on a TV special for Herb Alpert & the Tijuana Brass. He became Gonzo the Great by the first season of The Muppet Show and developed his thing for Camilla the Chicken almost accidentally: During one episode where chickens were auditioning for the show, puppeteer Dave Goelz ad-libbed, "Don't call us, we'll call you... nice legs, though!" It was decided then and there that Gonzo would have a bizarre romantic interest in chickens.

10. You have to love Statler and Waldorf. I couldn't find much on their particular inspiration, but I can tell you that they've been around since the 1975 "Muppet Show" pilot. They are named after popular New York City hotels (the Statler Hotel was renamed the Hotel Pennsylvania in 1992.) Guess what Waldorf's wife name is? Yep... Astoria (she looks startlingly like Statler.) FYI, Waldorf is the one with the mustache and white hair. Statler has the grey hair. Apparently Waldorf has had a pacemaker for more than 30 years.

11. Beaker: I always thought of Beaker and his buddy Bunsen Honeydew as characters that came along later in the Muppet timeline, but they have been around since the "The Muppet Show." Although Beaker usually says things along the lines of, "Mee-mee-mee-mee!", he has had a few actual lines: "Sadly temporary," "Bye-Bye" and "Make-up ready!" Despite being word-challenged, he manages to do a pretty convincing Little Richard impression and, surprisingly, had mad beatbox skills. Beaker is one of the only Muppets that was never recycled from some other purpose -- he was created solely for "The Muppet Show."

12. Fozzie Bear. Poor Fozzie. He's the perpetual target of Statler and Waldorf because of his horrible jokes and puns. It actually created a bit of a problem during the first season of The Muppet Show, because when Fozzie got heckled, he got very upset and sometimes cried. Viewers didn't feel sympathy; they felt embarrassed. The problem was solved by making Fozzie an optimist so that even when he got heckled he was good-natured about it. It's often thought that he was named after Frank Oz, who was his puppeteer, but Frank said it's just a variant of "fuzzy bear." Yet another story says he was named for his builder, Faz Fazakas. Wocka wocka!!

13. Bert and Ernie are the Muppet version of Felix and Oscar ("The Odd Couple," for you young'uns). Lots of people think Bert and Ernie were named for some minor characters in It's A Wonderful Life, but according to the Henson company, that's just a rumor. Jim Henson always maintained that it was just a coincidence -- the names just went well together and seemed to fit the characters. Jerry Juhl, one of the head writers, corroborated this and said that Jim Henson had no memory for details like that and would have never remembered the name of the cop and the taxi cab driver in the old Jimmy Stewart movie.

Other rumors to clear up: Bert and Ernie aren't gay and neither one of them are dead. Now that we've got that straightened out, here are a few more tidbits: the original Ernie used to have a gravelly voice similar to Rowlf the Dog's. Frank Oz was Bert's puppeteer and hated him at the beginning. He thought Bert was ridiculously boring, but then realized that he could have a lot of fun with being boring. Jim Henson once said, "I remember trying Bert and Frank tried Ernie for a while. I can't imagine doing Bert now, because Bert has become so much of a part of Frank."

14. Grover: Everyone's favorite "cute, furry little monster" made his TV debut on the "Ed Sullivan Show" in 1967. At the time, he was known as "Gleep" and was a monster in Santa's Workshop. He then appeared on the first season of Sesame Street, but sported green fur and a reddish-orange nose. He didn't have a name then, but by the second season he transformed into the Grover we know today, more or less -- electric blue fur and a pink nose. The original green Grover was reincarnated as Grover's Mommy for a few episodes. In Latin America and Puerto Rico Grover is known as Archibaldo, in Spain he is Coco, in Portugal he is Gualter and in Norway he is Gunnar.

NOW YOU KNOW!

Akbar! Akbar! It Is 45 Degrees Outside!

In California, 45 degrees translates to the following: "E-gad, it is friggin' freezin'!!!! Get the winter clothes out!"

However, I am not in California. I am in New York - where I have suffered through days when the temperature was a frosty 7 degrees.

Therefore, in NYC, 45 degrees translates to: "PHEW, MAN, it is so stinkin' HOT! Take the coat off, take the sweater off!!!" It is balmy! I really could jump in a pool right now. I've even turned the heater off in my house.

And tomorrow will be 50 degrees. Time to start studying in the park.

My Hospital is Closing

Lately, I have adopted the two following statements:

C'est la vie

and

Que Sera Sera

On Friday, the rumors finally became official as the Caritas Health System, which includes Mary Immaculate Hospital in Jamaica (where my father was the pharmacist) and St. John's Queens Hospital in Elmhurst, filed for bankruptcy. The history of these two hospitals is amazing and both have served a pretty integral role in the history of this community. C'est la vie.

Despite the rallies that we held and press conference at City Hall (where I saw Mayor Bloomberg), the Governor notified the system yesterday that no more bailout money would be forthcoming. Therefore, the hospital officially filed for bankruptcy yesterday and unless another hospital does come in with a last minute reprieve (unlikely), the hospitals will stop accepting new patients starting February 14. Happy Birthday to me - what a great gift. C'est la vie.

As a result of this closure, 1000s of nurses, clerks, cafeteria workers, security guards, social workers, etc will lose their jobs. Some have worked at the hospitals for over 30 years. Some were just another year or two from earning their full retirement benefits. C'est la vie.

This also has thrown my own rotation schedule into a tailspin. I now will have to move to Staten Island University Hospital for Surgery until June, then move to California for psych, then have off a few months to study for my Step 2 board exam. Then I have to come back to NYC in November for OB/GYN and Peds at Flushing Hospital. Originally, I was going to be able to do all my cores at Caritas and be done by July. C'est la vie - besides, I like traveling.

Really, this is a very sad story for the employees and families of these hospitals and community. As it stands, there are something like 7 or 8 beds per 1,000 population in Manhattan, but only 1 or 2 beds per 1,000 population in Queens. This closure will further deplete an already underserved area. Indeed, our hospital was filled to capacity every single day of my rotation so far. There has never been a day where an empty bed could be found on the floor of the hospital. But, if there's no money, there is no money. What can you do? C'est la vie.

Que sera sera.

Future Pediatrician

I love working with kids, therefore my medical career goal is to become a Pediatrician. However, here's hoping that my office stays a bit more organized and sane than the poor traveler depicted in this hilarious Delta Airlines marketing video from their blog.

Regardless, I think we can all identify with the dude in the video. We have all experienced having our seat kicked or a child in front of us doing their darndest to capture out attention. They are adorable, aren't they??

Exodus of ER Doctors in California

My goal when I started medical school was to get my degree then return to California to start my practice. Returning to California is still the end goal, but click right here for an article pointing out that we are losing many great Doctors in our Great State due to the low rate of reimbursement for patients on MediCare or lacking insurance altogether.

At what point, as a society, do we say that healthcare should be ensured for all humans AND that those who provide the services should be reimbursed fairly? I even find myself at a hospital in NYC right now that is in danger of closing due to bankruptcy in the next couple weeks. Why? Well, there are many reasons, but one of the main reasons is that the hospitals operate in areas where the population is mostly poor and can't afford insurance. Rather than turn them away, as most private hospitals have the right to do in NYC, we accept them and care for them...apparently to our detriment.

Regardless of your views on universal healthcare, I think we can all agree that the current system is broken. And ultimately, it will lead to problems for all of us as more hospitals shut down or more Doctors leave areas where they are not profitable.

In case the link above didn't work, here is the web address for the article (copy/paste):
http://latimesblogs.latimes.com/lanow/2009/01/emergency-room.html