Life's a Journey...

We Remember

2011-09-11T03:53:00.000-07:00

The dichotomy is odd, really. While our nation and the world mourn the senseless loss of so many innocent lives on this fateful day 10 years ago, I will be at work today being one of the first people the newest babies in our nation and world get to meet. They lay there, totally innocent and requiring our help in every way. They are the hope that anything is possible. They have not yet been tainted or ingrained with such deep hatred that our world can foster in some.

My prayers today are of course with all the families who were affected, but also, with these newest little ones. My hope is that each of them will be responsible for achieving something amazing and wonderful for our world and improve it in awesome ways.

Day in the Life of a Pediatric Intern

2011-07-28T16:25:00.000-07:00

In an effort to decrease the number of "Is it like Grey's Anatomy" questions I receive (no, we don't shack up in the call room after every patient), I will share what different days as a Pediatric intern have been like for me. I can't say there is a "typical" day because every day brings unique issues, families and new diseases. Plus, every 4 weeks we switch to a different "service" so we are always moving. So I invite you to sit back, relax, and enjoy vicariously the adventure that is Residency!

A Day in the Life...on Night Float

Arrival Time: 630pm Sign out
Departure Time: Depends on how long sign-out takes, but usually by 7 or 730am

When we first arrive, we go to "Sign-out" room and receive sign-out from day team. This is where the Docs from the day shift present every patient on the Peds service to us, the night shift team. Once a patient is signed-out to us, the day Doctor is no longer responsible for the decisions we make as the night team. During the Day shift, there is a separate Doctor who covers the Newborn service, 5-Central and ER Admits (the Peds floor at CRMC downtown; can be 2 residents if we have a guest from Family Practice), and Neonatal ICU (actually 2 residents, sometimes 3 if we have a FP guest).

At night, there are only two of us - the Senior Resident and the Intern Resident - to cover all the above areas. Since we are "only" covering and not responsible for necessarily moving care forward, it isn't as bad as it seems. However, there are times when you have two babies born simultaneously, each requiring resuscitation, an ER admit and a regular newborn who needs screening and it all happens at the same time. That can be pretty hectic.

As the night Intern, I am primarily responsible for all Newborns who join our world at night and for any ER Admits and/or Consults that occur during the night. On some nights, this can consume all 12 hours. On other nights, not a single baby will be born, in which case we either read, sleep, snack, or round with the Senior resident on NICU. It must be noted that every senior resident I have worked with so far has been incredible. Patient, guiding, kind and smart. And every single nurse is always willing to help and offer advice or just a joke to help you smile and make it through the night. The NICU nurses especially are most kind and really know their stuff.

On my busiest night so far, I received 4 pages for newborns (yes, we still use pagers), one of my mommy's needed resuscitation and I handled a consult - all within the hours of 2am and 630am. It went from being a quiet night to suddenly non-stop action. And of course, two of my babies were from mom's who either a) didn't know they were pregnant until last week or b) knew they were pregnant, had good prenatal care, but had fevers going into delivery - something called "Chorioamnionitis", which requires that I treat the baby with antibiotics after delivery and observe for at least 48 hours to ensure that baby won't become septic. The clock ticks pretty doggone fast when you have to make lots of decisions quickly.

And then, after a night of carrying 2 pagers (my own and the Newborn one) and a "Vocera" (the NICU in-house walkie-talkie-ish phone), I get to hand over all but my own pager, sign-out all the patients to Day team, and go home and rest for a bit before coming back and doing it all again.

Stay Tuned for More "Day in the Life..."

Wedding Bells Are Ringing!

2011-07-24T22:41:00.000-07:00

Since midnight last night, Eastern Standard Time, folks in New York who identify as gay and lesbian have been afforded the legal right to marriage. A union between two people who love each other. One of the first couples to marry was a lesbian couple in their upper 70s and 80s - one using a walker, one in a wheelchair, who had shared their lives together for so many years, but not been recognized as a unified couple by the law.

Congratulations to all those who have been afforded the civil right to have their love for each other formally recognized by the State!

As a Doctor, I wanted to discuss this issue from the perspective of Medicine. Although it has been less likely to occur in New York, up until today Doctors and Nurses had a legal obligation to ask the "significant other" of a gay or lesbian couple to step out of the room when discussing the health issues surrounding the patient. Regardless of how many years the couple may have been together, the patient's loved one was not considered to have the legal right to make health decisions for him/her, unless they had the foresight to make a legal document naming each other as proxy to make health decisions. In a heterosexual marriage, it is assumed and legal that the patient's spouse has full legal authority to make health decisions for the patient if they are incapacitated. Now, with couples legally marrying, the same-sex spouse of a patient will also be afforded the legal right - and human dignity - of being in the room to make health decisions for their spouse.

No human being should have to spend their last few moments on Earth alone. What a blessing that this law will ensure that doesn't happen in NYC any longer for same-sex couples.

Grade Inflation

2011-07-14T10:20:00.000-07:00

http://economix.blogs.nytimes.com/2011/07/14/the-history-of-college-grade-inflation/?hp

Go to the link above - the NY Times has some AMAZING graphs on how grades have gone up, up, up over the last 40 years. It is staggering.

ONE possible explanation, in my opinion:
1. Private schools offer more 1-on-1 instruction and greater access to the Professors, therefore allowing students more tutoring access. They also have smaller class sizes, therefore allowing more evidence-based teaching methods to flourish and allow students to understand the material better.

That's it, that's all I've got and that only explains why private schools may have higher grades than public. Why grades have shot up overall is a study in the pressures Administrators place on Faculty to keep the numbers up...and that's a whole post for another day! For now, check out the startling evidence in the graphs.

I have come to the iPhone...

2011-07-06T15:29:00.000-07:00

...and I LOVE it.

The phone is so friggin' easy to use. The designers obviously thought about the user experience and made something beautiful. I love my new phone and really am just wondering why it took me so long to purchase it!

Details:
iPhone 3GS (yup, I went with the older model because they are $49. And for me, 8 GB is more than enough memory space.

Otter Box phone cover. I really like the Otter Box because it doesn't add a ton of bulk to the phone, while still effectively protecting the phone quite well.

First App Downloaded: Epocrates. This is a medical program that helps me determine dosages for the various medications I prescribed.

Favorite App Downloaded: Words with Friends. It is addicting, although pretty frustrating that I have lost WAY more games than I have won!

Tip: If you can, but the phone somewhere OTHER than California (and I think NY) because these States apply tax on the original retail price! So tax on my $49 phone was more than the sale price of the phone. That stinks. In other states, the tax will be on the actual sale price.

Lifestyle: Eating Healthy

2011-06-04T06:50:00.000-07:00

There has been a lot of buzz lately on the government's new dietary recommendations. You probably have heard of the "food pyramid" - the confusing, practically gutted of all useful information, pyramid looking thing that you probably pretty much ignored. There were some good recommendations in there for a healthy diet (and by diet, I mean the food you would regularly eat on a daily basis, not a "diet" meant to lose weight, which often never works). But now, instead of a pyramid has been retired and the United States Department of Agriculture has introduced the "My Plate" - click here for the visual.

The new recommendations are presented as a dinner plate with sections representing the major food groups. Vegetables and grains take up over half the plate and Fruits and Protein take up the remaining sections. There is also a separate, cup-shaped section meant for dairy. You can click on each section for a listing of healthy foods that you should consume.

Some highlights to keep in mind:
1. they have fruit juices listed as an option. Don't get me wrong - I love fruit juice - but they are only slightly better for you than a can of soda. Slightly. It is MUCH better to eat the fruit whole as the added fiber and nutrients not lost to the squeezing of the fruit will help you digest it better and not turn it straight into a glucose dump on your body.
2. Whole grains are emphasized over refined/processes grains. This is critical! Whole grains maintain all the nutrients that are necessary for healthy eating AND they contain fiber, all things that are lost in refined grains (like white bread, white flour, the cheap pasta at the store, etc). Make sure to try to make almost all of your consumed grains whole.
3. Make sure to eat small, healthy snacks through out the day so you never feel super hungry. Research has shown that if you sit down to a meal when you are feeling ravenously hungry, you are going to consume way more calories than you need. You will probably also consume those calories with some of the unhealthiest food options available. To avoid this, drink lots of water and keep healthy snacks nearby through out the day.

Eating healthy CAN be difficult when you are facing a beautiful red velvet cake in the face. Being a fat kid at heart (and at the surface), I know how hard it can be. But if we make healthy choices the vast majority of the time and exercise regularly (something I have restarted doing), then it will be OK to have a red velvet as a treat on a rare occasion. The key is not to restrict what your heart desires but to make the best/healthiest choices to satisfy those desires.

Committing to Fresno with a Servant's Heart

2011-06-01T19:23:00.000-07:00

The City of Fresno is an incredible place. That's right - do your double-take and read that sentence again and let it absorb into your mind. I said it. It needed to be said. Is it a New York City? Of course not - but I wouldn't want to raise my family in NYC, either. We have an incredible community here in the Central Valley, with great schools, nice parks, good people and, pardon my bias, some incredible healthcare facilities. As I count the days left in a classroom before I retire from teaching a second time to start residency, I am made that much more excited by the prospect of serving my community here in Fresno.

In that endeavor, however, I don't have to create the wheel, so to speak. Many amazing folks with a Warrior Spirit and a Servant's Heart (to borrow the phrase from Southwest Airlines) have come before and established some amazing programs for our Valley, to help those in need.

Check out the video below on one of the way Internal Medicine residents at UCSF-Fresno are giving of themselves to help those less fortunate in our own backyard. And God-willing, with the community's support, all residents of Fresno will be able to get back on their feet shortly.

How to Become a Morning Person

2011-05-22T08:45:00.000-07:00

If you are like me, early mornings are treacherous. You are always terribly annoyed at the alarm and ultimately "in a rush" to get out the door and seemingly are always behind.

Over at the Huffington Post News, Dr. Tracey Marks wrote an excellent article on how to become a morning person. She writes,

"Are you one who rises early, but is slow to get started? Even though you may be physically awake and standing, you're not much use to anyone? You need a few hours to kick into gear and always feel like you're ten steps from diving back into bed.

The problem is, with this routine, several hours of your day have passed with little productivity. This may be fine if the only thing you have to do for the day is check your trust fund balance. But if you're like most people with an unrealistic to-do list, you have to fit the tasks in sometime. Where do you get the time? In the evening, of course...

If only you could gain a productive hour or two in the morning, you could help to put yourself on a healthier course and, ultimately, be a happier person. You can train your body to snap to attention and be ready to rock-and-roll first thing in the morning. This objective is attainable for most everyone."
Click here to link to her article and the suggestions.

Quotes o' the Journey

2011-05-15T21:04:00.000-07:00

Heard in my classroom 5/13/11:

"So, how are kids supposed to walk around the fountain? Do they suddenly become Jesus and walk on water?"

Student questioning another group on their landscaping proposal.

Teachers Should Cry, Get Mad, Resist, Do Something, ANYTHING!

2011-05-07T13:15:00.000-07:00

Go to the following link, read the article and watch the 25 minute "60 Minute" Special. You will be touched for sure. And perhaps, just perhaps, you will be moved to realize how much we have stripped from our kids in their education and want to do something about it.

http://www.huffingtonpost.com/gary-stager/teachers-cry-get-mad-do-s_b_844329.html

Political Correctness: Every Student Can Do Everything

2011-04-11T17:14:00.000-07:00

My students are currently taking the big California test, known as STAR. It tests students in Language Arts, Mathematics and Science. It is a grueling weeklong process that involves four hours of testing daily...not to mention all the exams I have given my kids to prepare them for the big day and ensure they are on track. In honor of this abuse we have institutionalized on our children, there should be some humor to get us back laughing instead of sweating with anxiety over such high-stakes testing. Enjoy!

Latest Educational Pedagogy: Blame the Teacher

2011-04-05T21:22:00.000-07:00

In less than one week, my students will take the big California test, known as STAR. It tests students in Language Arts, Mathematics and Science. It is a grueling weeklong process that involves four hours of testing daily...not to mention all the exams I have given my kids to prepare them for the big day and ensure they are on track. In honor of this abuse we have institutionalized on our children, there should be some humor to get us back laughing instead of sweating with anxiety over such high-stakes testing. Enjoy!

Testing Industrial Complex

2011-04-02T09:41:00.000-07:00

In one week, my students will take the big California test, known as STAR. It tests students in Language Arts, Mathematics and Science. It is a grueling weeklong process that involves four hours of testing daily...not to mention all the exams I have given my kids to prepare them for the big day and ensure they are on track. In honor of this abuse we have institutionalized on our children, there should be some humor to get us back laughing instead of sweating with anxiety over such high-stakes testing. Enjoy!

Quickies: 200 Posts, 27 Days, 24 Hours

2011-03-23T08:33:00.000-07:00

1. 200 Posts!
I don't know what a milestone counts as in the world of blogging, but I reached several milestones recently. On Sunday, I posted my 200th blog entry since entering the world of sharing my stories with anybody who wants to read them in the world. In the last week, I also surpassed 10,000 visitors to my website since I started. It is incredible to me that so many people are actually interested in my life...or that very few people visit my website that often! Regardless, thank you for all the support and for at least pretending that my stories are fascinating enough to earn your time and interest. I noticed that there is a new feature offered where you can take all the blog entries and turn them into a book! What a neat idea. I envision one day gifting such a thing to my children so they can see that I wasn't always boring and tired. (This is NOT a place for comment, AA - not the airline).

2. 27 Days
I don't often act spontaneously and I'm not sure I acted spontaneously in this case, either, since I have been talking about taking a trip for months. Well, with Spring Break coming up in 27 days the time has also arrived to make a decision about taking a trip. Flights are booking up, prices are high and in about 3 months when residency commences I won't have enough time to even tie my shoelaces. So, I took the plunge (corny pun intended as a hint as to what I did). One of my friends who also will be starting residency in June and I will be visiting some incredible places that I have never seen before as we set sail on the Carnival Legend for a 7 night cruise of the exotic Western Caribbean! We leave from Tampa and Port of Calls include the Cayman Islands, Cozumel, Honduras, and Belize. Add to that 2 fun-filled days at Sea on the ship and I am looking forward to one heck of a week. Now, I just need to find some airfare that is reasonably priced...

3. 24 Hours
The amazing debate and forensics teams from my high school (and through out the Central Valley) will be meeting up in Bakersfield this weekend for the National Qualifying Tournament. I am extremely excited for our kids and very much hope that many of them will earn a spot to Nationals, the most prestigious event in a debaters career. My debate partner and I from Edison qualified to Nationals our Junior year in debate and I qualified in "Congress" my senior year. As a result, I got to see Phoenix (way too hot) and Portland (amazing natural reserves!). I will be driving one of the vans full of our very talented kids and therefore will be out of town from Thursday to Saturday. Should be fun!

New Blog Design

2011-03-21T12:55:00.000-07:00

Every so often I feel it is time to mix things up here on the blog. The old design I had started feeling stuffy and heavy. While I loved the outward lines of alternating patriotic beauty, the grays in the color palette started feeling too dark and dreary for my tastes. And the smaller than normal font on that blog design was starting to exhaust my eyes.

Enter this new design. I found it as one of the options, ready-made for those of us computer half-literate folks who like things ready-made, like peanut butter, sliced fruit, and blog designs. I loved it because it feels light, airy and exciting. It evokes movement and change, similar to how my life is moving forward and change is coming. It also feels more minimalist, something I have been striving to be as a way to declutter and simplify my life.

I have also discovered that I can make the font a bigger size and I have also added space on the screen devoted to the main text, allowing it to pop to the reader more easily.

I would love your suggestions and welcome you to comment on any changes you want to see to make the blog more accessible and easier to interact with. And as always, thanks for visiting!

Flashback Friday...on Sunday

2011-03-20T09:15:00.000-07:00

While working as a Teach for America teacher in Baltimore, I kept a journal of my experiences during my first year teaching. We didn't have blogs "back then" so I used to email the journal entries to a lengthy list of folks. As a blast from the past, I will repost some of my journal entries here on this blog on Flashback Fridays. Some of you will remember some of them and I hope you enjoy it as much the second time as you did the first.

Today's Flashback is to my very first journal entry, ever. It seems so fitting as I go through similar thoughts and anxieties over what is going to be arriving very soon - the start of residency in a few short months.

"July 1, 2004:

I have been on the East Coast now for about two weeks. We were in Baltimore for our Pre-Institute Induction ceremony. There were lots of neighborhood tours and a general overview of the program. I’m filled with excitement and anticipation at the prospect of what I will be doing. The children of Baltimore need dedicated people…LOTS of us. I hope I will be able to contribute my little part to ensure that systemic inequality is combated and EVERY child has an equal opportunity at changing this world. The question that was posed to us is very profound: If not you, then who?

Well, we arrived in New York a couple days ago. We are staying at Fordham University here in the Bronx. This city is eclectic! It is alive – always awake and full of energy. This school is pretty nice, too. We are staying in the dorms, teaching during the day and attending various professional development workshops in the evenings. My dorm room is air-conditioned and has its own bathroom! WOW – we definitely didn’t have this at Whittier! However, I have a feeling they aren’t going to send housekeeping to maintain the bathroom, so maybe it was better to have shared bathrooms…

If not you, then who…"

Thank You God

2011-03-17T19:23:00.000-07:00

This has been one amazing week! It started with an awesome 4-word email (see Monday's post) and culminated today in THE most amazing news that I have prayed for, for a very long time! I found out today that I "matched" (that means was accepted by) the UCSF-Fresno Pediatrics program to start residency. This means I will be matriculating at one of the top 10 Children's Hospitals in the nation, here in Fresno! And I will be part of one of the best known names in Medicine - UC San Francisco.

When I started medical school back in 2006, I was very depressed and didn't think I could make it through. Many self-destructive thoughts went through my head, like "I'm not good enough" and "I had to go to the Caribbean so that must mean I don't belong in this profession" and "no reputable program will ever want me" and "I will never become a good doctor" and on and on. Sensing my despair, God spoke to me through one of the online "Bible Quote" programs. I offer it now to help any struggling medical student or anyone struggling in life. Always remember to...

"Rejoice in Hope, be Patient in tribulation, be Constant in Prayer."
Romans 12:12

4 Words

2011-03-14T12:03:00.000-07:00

Sometimes, the best things, including news, come in the smallest packages. Today I received an email from the National Residency Matching Program that simply stated, in 4 brief and incredible words:

"Congratulations! You have matched."

Thank God.

Quickies: Prayers for Japan, Lay Off Notices, Residency Posting

2011-03-13T12:41:00.000-07:00

Time for some quickie updates:

1. Prayers to Japan and all those affected by the devastating earthquake and subsequent tsunami on Friday. The power of Mother Nature is indeed awe-inspiring and should not be underestimated or disrespected. There are some absolutely startling before and after pictures that the NY Times posted on its website. The link is:
http://www.nytimes.com/interactive/2011/03/13/world/asia/satellite-photos-japan-before-and-after-tsunami.html

Also, there are lots of very well-written articles explaining how nuclear energy works to help understand the whole "meltdown" hoopla some in the media are trying to blow out of proportion. I highly recommend you read the article by going to my website for work then scroll down to the bottom of the screen where it says "Science Headlines".

The link to my class website is http://qp.clovisusd.k12.ca.us/cn_artinian

2. Lay Off Notices:
I have been joking about my imminent lay-off for months, but at the moment on Friday when I was actually personally handed the envelope putting me on notice of my imminent lay-off at the end of this school year, I actually got emotional! I was hired as a "Temporary" teacher on a year-long contract (as all new teachers typically are in my district) so this isn't a surprise. I absolutely knew it was coming (State Law requires notice by March 15). And unlike Baltimore where they just put a notice in our teacher mailboxes, I actually met with the Assistant Superintendent for my School area and my Principal in his office, where we discussed options. As I have been saying to anyone who will listen, this District takes care of its people and prides itself on a culture that values its employees. And I love my current job and my colleagues and the awesome environment that has been created at my school for adults and kids. It has been an absolute honor and privilege to work at my school. My lay-off notice, however, does make Quickie #3 below that much more imminent!

3. Residency Posting:
I find out about Residency very soon. I have suddenly gone from being quite content and calm to having some pretty major butterflies. "Match Day" is the culmination event of 4 years of ridiculously hard work, plus a 5th "bonus" year since I didn't graduate in time to start residency last year.

The Match email will say one of two things:
OPTION 1: Congratulations!! You have been accepted by a program for residency.
OPTION 2: We are sorry, but you have not Matched into a program for residency.

Obviously, I am hopeful for Option 1. Option 1 means I get to relax all week until they send the email a few days later letting me know at which hospital I was accepted to do my Residency. However, Option 2 means I spend the entire week in the "Scramble" - literally scrambling and calling every single program with a listed opening and begging and pleading for a residency position before the week ends.

This coming week will either be an extremely joyful and happy week (affirmative on residency), or one helluva depressing week (no residency AND laid off). Needless to say, my issue is absolutely nothing compared to what our brothers and sisters in Japan are going through right now, so please don't divert your prayers from them!

Good Teachers Being Turned Bad?

2011-03-06T18:05:00.000-08:00

I have always been passionate about the fact that as teachers, we haven't done enough to ensure that we are guiding the discourse on what we need to do to "improve education" in our country. As a result, a bunch of "Education Experts" with little to absolutely no experience in the field of education have been given almost unbridled access to the power-that-be to effect changes that are at best untested and unsupported by research, and at worst proven to be ineffective and plain out wrong!

In this article by Joel Shatzky, a retired English teacher who taught at SUNY (State University of New York), he shows how true "Good Teachers" are often rated as bad due to their willingness to actually fight for evidence-based good teaching. I am blessed to work at a District that actually does value great teaching, but even here we are faced with the testing industrial complex that has dominated all of the education field for now. Let us hope that this, too, shall pass in favor of what used to be an innovative education that placed more prowess on critical thinking rather than fact memorizing. Or at the very least, we have to start developing richer standards and evaluation tools that examine a student's true strengths and weaknesses more regularly and through more than just a paper/pencil multiple guess test once a year.

Click Here to access the article. It is a must read for any teacher and for anyone with a vested interest in their child's education. If we don't put a stop to all the crazy policies being floated around in education right now, we will be faced with an entire generation of kids who are incapable of doing basic thinking on their own.

2 Weeks and Counting

2011-02-28T08:28:00.000-08:00

March 14 is the day that many Doctors-to-be are looking forward to with a mix of excitement and anxiety. It is the day we find out about Residency - whether we Matched (and in fact, the day is called "Match Day") to a hospital program or whether we are stuck scrambling for a position (and in fact, the rest of the week is called "The Scramble"). Most of the folks waiting are 4th year medical students who will graduate in May and then a short few weeks later, start the grueling process of on the job training that is so unique to our profession.

I am a bit more unique in this respect, as I graduated last year in August - too late to start residency last year, so I have been working as a teacher in a beautiful public high school while I applied for residency this year. It has been an incredible ride and as AA (not the airline or the program) likes to say, I have been "exactly where you are meant to be."

In two weeks when I wake up, I will open up an email that doesn't change who I am as a person, but does help guide where I will be going in the near future. Will I be staying in Fresno or going to New York? If I go to New York, will I go to the city or upstate to Buffalo? There are so many questions that I have started somewhat avoiding folks so I don't have to repeat the same answer 1,352,938 times - "I don't know." Nothing is certain right now. I have no control over where I go other than a "rank list" that a computer uses in its complex algorithm to ultimately assign me a position somewhere.

So, with that in mind, I beg all of you - please stop asking. I don't know starts sounding really annoying to a person who doesn't like saying it. I promise all of you that as soon as I know, I will let you know, so that we will all be in the know. Wow, that was a lot of "know" in one sentence.

Stay tuned this week: in an upcoming blog post, I will share all the dates that important information will be arriving about this process...so that all of you will know exactly what I know, right now. Know what I mean?

Flashback Friday - The First Month of the First Year

2011-02-25T09:18:00.000-08:00

While working as a Teach for America teacher in Baltimore, I kept a journal of my experiences during my first year teaching. We didn't have blogs "back then" so I used to email the journal entries to a lengthy list of folks. As a blast from the past, I will repost some of my more humorous journal entries here on this blog on Flashback Fridays. Some of you will remember some of them and I hope you enjoy it as much the second time as you did the first. What follows is an entry from the first month of my first year teaching.

September 29, 2004:
       Today was out of control. With one section, they became so unruly that I found myself saying, in a very quiet voice, that I would teach the lesson in that voice and people who wanted to listen but couldn’t hear, were allowed to move to the front. (AUDIENCE PARTICIPATION – how many people moved?) Correct - Nobody moved. (AUDIENCE PARTICIPATION – how many people stopped talking?) Correct - Everyone kept talking with the exception of about three. I kept teaching. It took every ounce of energy I could muster not to lose my cool.
       And that was only the first period.
Today was supposed to be a wrap-up day on the “Egg-speriment” that we were conducting to explore cell membranes. We were going to organize our data in nice graphs in order to better analyze it. Quick and efficient, right? Rather, it turned into part graphing and part lets-watch-Mr.-Artinian-as-he-goes-around-the-room-shaking-his-hands-and-repeating-in-a-flight-attendant-voice-stop talking-stop talking-stop talking-stop talking-DAY.
       Icing on the cake: University supervisor observing one class and my assistant principal giving me my first official observation in another. What am I doing here? I am nothing more than a behaviorist – an underpaid, under-resourced, under-appreciated, baby-sitter who spends more time trying, fruitlessly, to get students focused instead of on the exciting exploration of science.

Get me outta here!

Good Enough

2011-02-23T08:53:00.000-08:00

I often joke that my mom has forever tainted my thinking about what is "good enough". When my students are excited about earning an A, I ask why not A+? When they earn a 44 out of 45 on a difficult exam, I ask why it wasn't a 45 out of 45. It is a disease - but one based on love and jest (well, only half jest).

But when we read about what some of our nation's children are going through in some of the most challenging situations for a child to grow up in, we can see what a lack of hope can do to a child's psyche. I was recently reading an article in the Huffington Post (click here for the article) about Chicago Public School students for whom a new school was built but then due to a change of plans, the kids at the old dilapidated building were not allowed to move into the brand new school - across the street. What was the change of plans? I'm not even quite sure myself but I think it had something to do with not wanting the "poor-performing" kids from the old school at the new building and to use the new building as some sort of magnet school.

Here is a letter one of the students wrote, asking the so poignant and heart-wrenching question: "when will we ever be good enough."

In Baltimore, I used to remind the kids that they chose to come to school. They could have been the idiots who ditch, who go sell drugs and do illegal things because it is "more fun" than school - but that whatever comes easily can go easily. And whatever is earned through difficulty can't be taken away - like a college degree. Despite the challenges they faced, they came to school. And in a final desperate plea, I used to say "so PLEASE work with me and let's get you closer to a college degree."

And don't worry - if you are accepted to Yale, I won't ask, "why not Harvard?"

Blessed...But Still Stressed?

2011-02-20T08:52:00.000-08:00

My mind has been moving a mile a minute lately, juggling between lesson planning, grading, reteaching, offering Coach Class for students who need extra help, coaching Science Olympiad, coaching Volleyball, running to meetings for special ed students, and going to games and special events for the students who tell me about their band performances, basketball games, swim meets, and debate tournaments.

My schedule is hectic, it's true, but none of it is stressful. In fact, this is all fun (well, maybe not the special education meetings, but the rest is a blast!) The best blessing of all is having students who are nice, care about the world, and mostly work hard.

But, as at every school, there are some students who seem not to care. I can't get them to do their homework. I can't get them to participate in group projects. I can't get them to break out of their shell and join in discussions, much less lead them. And some of them complain incessantly - Dr. A gives too much homework, Dr. A assigns too much classwork, Dr. A this isn't math class, Dr. A how do you expect me to do all that in 3 days (assignment: outline 6 pages from a textbook and answer the 5 questions). I stress "seem" above because deep down I know there is a way to reach even the seemingly most unreachable. I just haven't discovered it yet - but I will! I still have a couple months left to reach them!

But while trying to reach even the seemingly most unreachable, I'm frustrated by the lack of acknowledgment of how good it actually is at this school. Almost none of my students here deal with the same challenges as my students in Baltimore once did. I know "challenge" is a subjective term and we should be so thankful that not every child is going through the same struggles as the majority of my Baltimore kids went through. But when you have seen both sides of the coin - the blessed and the truly stressed - you can't help but remind the blessed that they truly are "too blessed to be stressed."

Turkey Trot 2010 - Part 3: I Heart NYC...

2011-01-09T08:00:00.000-08:00

...and NYC hearts me!

December was a challenging month, but before all the major challenges, I had the opportunity to travel to NY from November 18-25. Click to read about Part 1 and Part 2. The final part of the story, as much as I remember 2 months later, is posted below. Enjoy and Happy New Year!

NYC 11/22-11/25:
The gist of my time in NYC comes down to this: friends, friends, and friends. It was a time to reconnect with people and places. I arrived comfortably on JetBlue and took the AirTrain to the subway to the Upper East Side where my dear friend CP lives with her husband and two really fun and personable twin cats. Unlike Rochester where I had a pretty good idea of where I would be when, my time in NYC was much less structured. I sent a message to everyone saying I was in town and to book times to hang out and then just waited and explored the city. Well, not so much the city as Manhattan itself; I made appearances at all my favorite "classic" places (Times Square, Union Square, Columbus Circle, Central Park, Hell's Kitchen). And every night I had dinner with dear friends and chatted it up while gastronomically well-satisfied.

I spent the first night with CP in her living room but then got an amazing deal on Priceline to stay at the Millennium Hotel Times Square. The room was nicely appointed and had a partial view of Times Square. I say partial because, well it was partial, but it still was a great unobstructed view - and I still regret that I booked my trip back to California for the day of Thanksgiving because my hotel room would have provided an awesome view of the Thanksgiving Day Parade. Oh well, it just wasn't meant to be this time, but there will hopefully be another opportunity. I DID, however, get to see the balloons for the Parade all aired up and ready to go the night before. Funny story: I was supposed to meet friends for this amazing experience...except we got separated into the massive crowds and the NYPD is very unforgiving about even letting you cross one street to get to where you have to go. Instead, you end up going, in some cases, 10 streets and 2 avenues out of your way just to get from 76th St. to 77th St. It is definitely an opportunity to practice patience so that you don't end up arrested.

HOTEL: Millennium Broadway Hotel - Priceline Rate $99 +taxes per night

PROs: Excellent location, fast elevators, nicely appointed room with super comfortable leather chairs and plenty of space to walk around (in fact, by NYC hotel room standards, this room was palatial), and a VERY nice bathroom - well appointed, big, and luxurious feeling.
CONs: The bed was not the most comfortable AND it was sparsely appointed; the comforter was the only "blanket" on top of a single sheet - I found that downright disgusting because I wasn't sure if the comforter gets washed regularly. Expensive internet so I didn't end up using it (just go to the Starbucks located next door and use the free internet whilst enjoying hot cocoa).
OVERALL GRADE: B- (would have been an A- with better bedding).
Would I Recommend This Hotel: Yes, IF the price is right.

Other Highlights of the Trip:

Took my picture with Santa Claus at the new American Eagle in Times Square. The picture was taken in the old MTV TRL studios overlooking Times Square - an amazing spot, especially looking down from the 2nd story corner windows.
Forever 21 has a "Street Cam" that captures the street on Times Square right in front of the store. So you can stand and wave and see yourself waving back as a small dot on the big screen! I thought it was amazing. My friend NK, when we finally met up 10 minutes later, spoke scathingly about "the idiots blocking the street to wave at themselves on the screen...who would do such a stupid thing." Ahem, ya, who? And take a picture of it? I mean (insert nervous laughter) that would be so silly! I then showed him the picture of none other than ME doing what he just called stupid and a host of other synonymous adjectives. We laughed.
Two years ago I got to enjoy the Tree Lighting Ceremony at Rockefeller Plaza from the comfort of one of the brokerage firms at 30 Rock. This year, I got to see the tree in preparation for its lighting. Then, we walked into the Lego store and saw a full Lego mock-up of the Christmas scene at Rockefeller Plaza, complete with lego people ice skating. I thought it was a pretty talented work of art!
I took a bath and sipped tea. That's right. I had 2 hours to kill one evening and wanted to just relax in quiet solitude so I drew a hot bath, made some tea, then just quietly reflected and meditated. I know it sounds cheesy but those moments of quiet reflection were wonderful.

I love New York and as you can see, this whole trip did not disappoint. I will be back in NYC January 15-18, traveling with none other than AA, so look forward to some more crazy, tragic, sometimes almost magic, awful and beautiful times.

Turkey Trot 2010 - Part 2: The Turkey in Rochester

2011-01-02T08:46:00.000-08:00

December was a challenging month, but before all the major challenges, I had the opportunity to travel to NY from November 18-25. Part 1 of the series is located at this link. The rest of the story, as much as I remember 2 months later, is posted below. Enjoy and Happy New Year!

Rochester - 11/20-11/22:
My trip to Rochester can be summed up in two words: family and eating. The trip started on Amtrak. I love Amtrak. On a gloriously sunny, but wintry cold and windy day in Buffalo, I packed up my things and headed to the train station. I had just stayed two days in Buffalo (click here for the full story) and was now waiting at a pretty decrepit Amtrak station - "Buffalo Exchange St. Station" - for the train. It arrived about 30 minutes late and boarded only through two doors - one for passengers going to NYC at the front of the train and one for all the other passengers around the middle of the train. It was pretty disorganized, mostly because you couldn't hear the conductor telling you which door to go to. And especially when compared to California Amtrak, which has nice new double-decker cars and you can board at any door, the east coast Amtrak experience, while more expensive, left more to be desired, as well. But once inside the train, it was amazingly comfortable, with really kind conductors and spacious seating. And my favorite part of train travel: the soft and gentle rocking that puts me to sleep. It is unavoidable - I will be sleeping on a train.

This trip to Rochester was an incredibly special one because it meant I would get to see eight very special people, some of whom I haven't seen in a few years. My two aunts (Agnes and Maida), my two cousins (Anais and Cathy), another "like" aunt/uncle (Frida and David), and two friends from Baltimore (Alex whom I taught with and her husband Jim).

I ate way too much thanks to my Aunt Maida who cooked delicious food, my cousin Anais who cooked an amazing pre-Thanksgiving Thanksgiving dinner, my friend Alex who took me to a supermarket, and to my "aunt" Frida who took me to a really yummy Thai place.

I know, out of all the things I wrote above, you are all scratching your head about the Supermarket. Turns out that folks who live in Buffalo/Rochester area have an "absolutely amazing, super, wonderful, awesome, can't-live-without-it" supermarket called Wegman's. In fact, it was billed as a must-see place that received its own slot in my schedule for a tour. We went to their "flagship" store and yes, it is pretty amazing...BUT STILL A SUPERMARKET! What made it amazing was the fresh food they served; in fact, there is a restaurant on premises with fresh cooked everything right in front of you. The food they made was well worth the trip - especially the salad, with fresh vegetables and delicious dressing. But like I told Alex, no matter how amazing I try to make Wegman's sound back in California, all my friends will still look at me funny that we went to...a supermarket.

One must-see place that my cousin Cathy took us was the Genessee river. It is a 15 mile stretch of waterway that has boating (in more seasonable weather) and homes lining the water and a trail for walkers. The weather, while a bit nippy, was still favorable for a beautiful, fresh-air walk along the river. With the sound and sight of the water relaxing the senses and the nice crisp, fresh air to breath in against a gorgeous blue sky backdrop, it was a remarkable connection with nature and self.

My time in Rochester was way too short, but it was scheduled how I like to schedule all my trips - not necessarily overbooked, but busy and jam-packed with activities and time with the people I love. The trip did not disappoint. After having spent time with all eight of the people I love, it was time to go through security at Rochester International Airport and wait for a JetBlue flight to NYC.

Stay Tuned for the Last Installment: Turkey Trot 2010 - Part 3: I HEART NYC

1/1/11

2011-01-01T01:11:00.000-08:00

From our family to yours - HAPPY NEW YEAR!

Grandma's Eulogy

2010-12-31T08:40:00.000-08:00

At my grandmother's funeral on Thursday, December 16, we were blessed to celebrate her life with many family and friends at St. Paul Armenian Church. What follows is the sketch of my Eulogy that I had the honor of delivering to our gathered family and friends about my amazing Grandmother. Wishing everyone a very Happy New Year - may 2011 bring more joy and happiness to all.

Tribute to Grandma

There are so many lessons learned from my Medz. Most of you knew her as the sweet woman with a kind smile, a stylish hand knit hat, and a cane (honking story) who sang off key and was about 8 notes behind the choir in church. But here are some of the amazing lessons I learned from her and why I lit up with immense joy every time I was with her:

“MEDZ” didn’t talk much

my opinion: she lived in a house with me – nobody can talk much
her opinion: “my time to speak has passed”
LESSON: Talk less, listen more OR just rock in your chair and smile

Dentures aren’t necessarily a bad thing

In the time it took me to brush, floss, gargle and rinse, she had her top and bottom teeth out with the seltzer cleaner and was in bed.
LESSON: Removable teeth are cool.

Diversity is a God-given gift

5 fingers on your hand are different so why should people be the same?
LESSON: Accept every one. Don’t waste your breath gossiping or fooling yourself to think you are better than others.

It’s ok to let someone chew their food 58 times…even ice cream

I watched and helped my grandma take care of my grandpa. And even when he would chew his ice cream, she stayed calm.
LESSON: patience is a God given virtue. Don’t let anything upset you.

Red Radishes are a dangerous food. Very dangerous

Let’s just say I understood what “diffusion” meant very early in life.
LESSON: Do not eat red radishes before you go on a date.

Grandmas are the best referees ever – they always side with the grandchild

Mother’s Day Card: “Thanks for saying yes all those times mom said no”
“Asor hed mee veejapaneer. Tbrotzuh sorvazeh veejapanootyoon. Kulookh ches gurnar yelal.” Translation: Don't argue with this one (in reference to me). He did debate in school. You can't win!
2 LESSONS: 1. The “oghlum” (child) is always right. And 2. Choose your battles. You can’t win them all and there are some not worth fighting.

Be wary of anyone who says “No speak English”

Andrea was guaranteed to make Medz smile and she is CONVINCED that Medz understood every single word she heard in English. Confession: it's true - she did!
Gma spoke Spanish, too! Telenovela stories
Some phrases - explain each reference (all in two’s): “Go Astoria?” “Goot, goot.” “Open! Open!” “Cold! Cold!”

MY FAVORITE PHRASE: this one didn’t need to be said twice – once was enough:

Me: I love you!! Medz: I love you more!!
Summarize with the Bible verse above the altar: “I came that they may have life and have it abundantly.”

Grandma's ("Medz") Obituary

2010-12-27T20:48:00.000-08:00

Tarafanda Mahdissian was a wonderful wife, amazing mother, doting grandmother, loving great-grandmother and an overall awesome person. She was born in Turkey around February 10, 1918 to Toros and Ossanna Kassabian. She completed an elementary education and worked as a seamstress until marrying Ohannes Mahdissian at the age of 16 in Lebanon. Her family was blessed with three children, Margaret Thomassian, Haigouhie Artinian and Hovsep Mahdissian. Later, she was blessed with six grandchildren (one who affectionately referred to her as “Medz”=grand) and two great-grandchildren.

Tarafanda was a model to her family of how faith can guide someone through the trials and tribulations of life. Her faith in God, caring demeanor, omnipresent loving smile and infectious laugh made a deep impression on all who were blessed to know her, to hear her advice, to listen to her stories and to laugh with her. She passed away at home early in the morning on Thursday, December 16, 2010 surrounded by her family.

C'est La Vie

2010-12-17T23:36:00.000-08:00

My grandmother found eternal rest on Thursday morning, December 16, around 330am. The world and life will not be the same with out her. We are so grateful for the amazing time we had together and the lessons she taught us. We are thankful that she is no longer suffering and has rejoined her husband and parents and grandparents and all her friends who passed before her.

Funeral services to celebrate her life will be held at St. Paul Armenian Church in Fresno, CA on Tuesday, December 21 at 10:30am.

Thank you so much for all your support during this difficult time.

Thanksgiving Trip - Part 1: Buffalo

2010-12-01T17:23:00.000-08:00

I only worked one full week - 5 business days - in the month of November. The first five days of November were all work days. But, the second week of November saw Thursday and Friday off for Veteran's Day and Furlough Day, respectively. Then, the third week I left for NY on Thursday, November 18, where I stayed until Thanksgiving Day...kids now get the whole week off for Thanksgiving, so I wasn't ditching. "Not like in my day..." when only the day of Thanksgiving and Friday were given as vacation. Yes, November was great. The following series of posts over the next several days will document the awesome Thanksgiving week I had.

BUFFALO - 11/18-11/20:
I flew to Buffalo on Thursday and on Friday I met some incredible Doctors and Support Staff at the Women's and Children's Hospital of Buffalo - the only free-standing Children's Hospital in the region. It was an amazing place doing incredible work for the region's little people. I was most impressed by how kind every person was. It wasn't the fake "I'm tired but I will smile for you" kind - it was a genuine, welcoming kindness that made me feel wonderful to be there. After the interview, I was spending the night in Buffalo and had all afternoon to do something. So, with a potential future Residency colleague, we took the awesome advice of a Holiday Inn Buffalo Downtown employee to take the city bus to Niagara Falls. Forty-five minutes and $4 (the cost of an unlimited bus/rail day pass) later, we were dropped off in front of a huge Casino on the American side of the Falls. It was a pretty cold evening, so we got our obligatory Starbucks (thank God!) and walked the 10 minutes to Falls park. It would have been another 10 minute walk to the actual Falls, but we serendipitously came across a free trolley bus that made rounds around the park. It wasn't the walk we minded, it was the cold, so we got in the trolley. Three minutes later we were gazing at the top of the main falls - we couldn't really see the bottom of the falls because from our angle it was hard to see the inlet and there was a TON of mist...which at one point began blowing toward us and forced a quick retreat. But as always, the Falls are a majestic and amazing place to see - God's beautiful Hand in creation can't be denied here. We took the bus back to the hotel and about 60 minutes later, were seated at the Anchor Bar, anticipating our Buffalo Wings at the original restaurant that created the popular comfort food. It was yummy and a great way to cap an amazing time in Buffalo.

HOTEL: Holiday Inn, Downtown Buffalo. Residency Interview Rate $93.

PROs: Excellent location, awesome staff, free airport and local area shuttle.
CONs: Room decor and furniture is pretty outdated and shows wear. Housekeeping did an OK job, but there was definitely areas that hadn't been cleaned in a long time, both in the room and in public spaces.
OVERALL GRADE: B
Would I recommend this hotel to family and friends? Absolutely!

TRANSPORT: United Airlines (FAT thru SFO thru IAD to BUF)
I have to give United some MAJOR positive reviews here. I flew them to NY last week and back to FAT yesterday. I don’t know why all the United bashing goes on. I was supremely impressed! Every single employee I encountered was pleasant. Granted, every one of my flights left on time and arrived on time, if not a few to several minutes early. So I didn’t get to see them during irregular ops, but since the majority of the time they operate normal ops, they are doing a great job. The ticketing agents came up to help even at the kiosks. The gate agents did a great job of announcing up to the flights and every flight was boarded in a very orderly fashion so we didn’t have to all crowd around. And during the flight, I had some very kind, smiling, and overall pleasant and helpful flight attendants. I was blown away – United deserves some recognition for running a great operation. In fact, I am now seeking out United flights rather than trying to avoid them like the plague; they really made a great impression on me during this last trip.
Seating Tip: I got the sense that United is boarding its flights where those with window seats are in the higher boarding levels and those with aisles board toward the end, regardless of where in the plane your seat is located. So, if you want to make sure you are one of the first to board so you will have space in the bins for your luggage, choose a window seat. Otherwise, especially during the Holidays when it sounds like flights are going full, you may end up separated from any luggage that can't fit under the seat in front of you.

Stay Tuned! Coming Up in Future Installments:

Thanksgiving Trip 2010 - Part 2: Rochester
Thanksgiving Trip 2010 - Part 3: NYC

Comings and Goings

2010-11-18T07:20:00.000-08:00

I seem to find time to write on the blog when I'm sitting at airports, enjoying the people watching and ceaselessly repeating loops of the same news on CNN. Life has been pretty busy lately.

I started my new job in Fresno, teaching high school Earth Science. Well, I started it in August, but haven't really been moved to chronicle any story. Don't get me wrong, the kids are absolutely amazing. They dazzle me with their unique and fun personalities every day. I'm still trying to figure out some of my kids and what makes them tick, but the majority of them are so sweet and lovable and you can't help but want to work hard for them. Most of them. And my colleagues are a lovely bunch, too. Not as outgoing as my Baltimore colleagues and certainly not as much "hey let's go out" in the bunch, but they all are hard-working and have a great team spirit.

My school administrators know that I am technically only staying for a year. I wanted to be totally up front about that so there wouldn't be any uncomfortable questions about why I have to miss a couple days of school every so often to go on residency interviews. They hired me nonetheless and I like to think they are incredibly smart - they know a damn good thing when they see it. And, just as I suspected when I wanted to join the school where I'm at, they have provided me lots of support and encouragement, but more importantly, once they realized I knew what I was doing, they haven't smothered me with needless stuff. At many "failing" schools (I hate that label because the school/teachers ARE NOT the ones failing the kids) they require so much ridiculous paperwork and documentation. It doesn't improve teaching - the opposite, actually because it takes time away from the teacher to plan and meet with students so they can finish the paperwork that SAYS that they will meet with students and create a plan to help students succeed. Silliness really.

In news from the Doctor front, it has been OK. I have a few interviews for residency...and lots of rejection emails. They all read the same way: "You are a great candidate, blah blah blah...We had so many candidates apply, blah blah blah...We can't invite you for an interview, blah blah blah...We wish you success in your career." I feel like screaming at the computer screen sometimes as it delivers its almost daily dose of negative news. I've basically stopped hoping that I will get any more interview invitations. When I get the "noreply" emails in the subject heading, I have almost resigned myself to another rejection. It's maddening, really, the dichotomy between the education field, where I'm loved and sought by countless school leaders, and the medical field where I'm apparently a black mark that nobody wants to touch. HEY GUYS - I FAILED A TEST. ONE TEST. ONE...FRIGGIN'...TEST. Many of the folks in charge of residency programs today would have failed the exams we have to take today, too. (The exam was much easier back in the day). Not trying to make excuses, but sheesh - look past the tests every now and again and look at the person, would ya? You will find some hidden diamonds.

And in family news, my grandma fell and hit her head a few weeks ago. That means a trip to the ER and a CT head. There was nothing wrong, but her blood pressure wasn't behaving so she got admitted. That turned into a 4 day stay. Since then she has been at a rehab hospital trying to regain her strength...but in much pain and discomfort. I keep praying for God to either fix her completely or take her Home with a capital H. So far, He hasn't really listened or else He is very busy right now or else I'm not on the priority list.

At the moment I sit at gate 86, watching them board a Boeing 777 for the flight that also goes to Dulles an hour before my flight to Dulles (I connect there to get to Buffalo). The CNN buzz is acting strangely like a gentle white noise that is relaxing my senses but also putting my thoughts in overdrive. My sleepy meditation is only jarred every so often by the comparatively very loud "Now boarding Executive Platinum, Gold, Silver, Bronze, various other medals that make you important, 100,000 mile flyers, First-Class, Business Class, Priority Lane. Anyone who paid extra to board early. HEY!! YOU!!!! PEASANT WITH AN ECONOMY TICKET!!! STAND TO THE SIDE! The Red Carpet is for IMPORTANT PEOPLE ONLY!"

Some day I'll be important. Until then, I'll keep waiting in line for a seat.

ATL and Med School in my Six. MD Full Steam Ahead

2010-10-02T08:46:00.000-07:00

"This is your Captain speaking. Hope you enjoyed your time in Atlanta - our flight to Los Angeles should take approximately..." It is August 3rd and time to go back home.

During the Week...

I have had an incredible time in Atlanta. Between my own travel itinerary and Captain K and family taking me to some amazing and less-touristy places, I have seen many awesome things. I stayed at the Holiday Inn Express by the airport (which I highly recommend because it is cheap and has breakfast and really nice employees). I saw the Coca-Cola Museum, The ATL Botanical Gardens, an AMAZING Aquarium (by far the coolest one I have ever seen), the MARTA (ATL Subway system, similar in experience/design to Washington DC), Confederate Park AMAZING Laser Light Show (sponsored by Marriott), the Westin Hotel Peachtree Plaza (still undergoing renovation from the Hurricane many years ago and still smells like dampness/mildew inside - not pleasant), the CNN Center (where I met Dr. Gupta - the person who currently holds my future job!), and I even went to the Varsity (where the food leaves a lot to be desired, but it IS an experience you must have once...no really, just once). Talking about food, I experienced some delicious places in ATL. For starters, Capt K and NK took me to The Porter in an eclectic part of town. It is an old train depot and the decor still has luggage and is super cool. I had some awesome fish 'n chips there. I also went to Rays in the Town during Restaurant Week (sponsored by BofA) and had a salad the likes of which I have never experienced before. It was a Shrimp with Feta cheese and watermelon in a lemon sauce. This was the most amazing combo of flavors I have ever experienced in a salad. I loved it. And I got SUPER excited about the main dish, thinking it would be similarly awesome. Unfortunately, my Parmesan-encrusted flounder was both uninspired and unmemorable. It was actually just cafeteria quality food. Too bad, because if it was like the salad I would have come back forever. Another cool place I ate was called Tap. Billed as a "gastropub", it captured my attention with a grilled/roasted grapefruit - definitely something worth trying. Your mind can't decide whether you are eating fruit or BBQ; and that is a pretty cool combo for your mind to be confused about!

Other than the humidity, ATL was super cool and I'm so glad I got to experience it! Thank you to ASA for giving me an opportunity to interview and meet some awesome folks at their company, also. (And for those of you wondering, yes I was offered a position, but no I was unable to take the offer because of family commitments back home).

One Week Prior (July 28)...
I didn't sleep much last night. I had been anticipating this day for months - actually, a whole year, from the first time I took the exam and missed passing by a few points. A year ago, it was like my whole life was thrown upside down - again - as I sat in the Yaldizzle's home staring at a screen that showed what I had been dreading - I hadn't passed. I thought I couldn't be seeing it right - I HAD to pass! In the hospital, I knew what to do almost every time - what the hell happened? But no, the screen wasn't lying and my eyes weren't playing tricks on me. This time, however, I had a different game plan. I reviewed the material like my life depended on it and I went into the exam ready to do battle. Usually, results came out in 3 weeks - so I had my heebie-jeebies last week waiting for results. But they never came. And today, I was flying to Atlanta for a week! I was interviewing with a regional airline for a flight attendant job and was super excited about that; but also excited that I could explore Atlanta, a city I had not yet seen. But my scores just HAD to come out today and I was anticipating, finally, becoming a Doctor, officially.

The only solution was to hand over control - something I continue to work on and improve on. So, thank God for AA who graciously offered to take my password and look up my scores. Afterwards, she would describe the same pulse-racing, heart pumping out-of-your-chest, palm-sweating, head-hurting feelings I felt the week before. Surprisingly, I didn't feel that as much this time - probably because I was on an airplane at 35,000 feet when Andrea looked up the results. But until I got on the airplane, I think AA was ready to kill me because my texts to her started at 5am. AA is generally pleasant...unless you wake her up. Let's just say I'm alive today because she gave me a TON of leeway today. When we landed in SLC and I hurriedly turned on my phone, the very first text I received was from DA: "congrats Doctor" was all I saw on my preview screen and I lost it. There, in a metal tube, as we taxied to the gate in SLC, I broke down and released the tears of joy that had been suppressed for over a year. The stress of a year finally was instantly released and I felt so light. And God placed the best flight attendant on that flight that day, who gave me a reassuring look and a tissue. But interestingly, she didn't ask what is wrong - she instead asked "what happened?" A minor detail but it seemed like people knew that this was good news (perhaps the tears juxtaposed with the huge friggin' smile on my face gave it away?)

And SA was right about chocolate - eating it during the exam raised my score significantly.

Four Weeks Prior (June 30)...

Today was the big day - I was staring down 350 questions and 9 hours at a computer. I was ready. This exam was NOT going to defeat me. I would prevail. And through each block of questions, I kept thinking about what SA had told me - she raised her score about 13% by eating chocolate and she claims there is a study about this. Ya ya, we'll see. (My chocolate is ready in my locker to eat inbetween each block.)

August 4:
It has been a long week and I slept quite well last night after I got home from ATL. Today, I will celebrate with family and friends. I feel very blessed to finally be, Doctor.

Does Education Matter?

2010-08-05T10:02:00.000-07:00

In terms of dollars and cents, but more importantly, in terms of personal health and happiness, study after study has shown that getting a solid college education matters immensely. In an article in the NY Times recently, economist David Leonhardt shows just how much a completed college degree can matter.

"The median college graduate now makes about $25,000 a year more than the median worker who attended college but didn’t graduate."

It is not just about money, however. It is about personal wealth, health, happiness and achievement. Obviously, not everyone who is rich required college. Many can point to even high school dropouts who are now filthy rich as examples of why they may not need college. But this argument, in today's new global society and changing job market for US citizens, is irresponsible. It is similar to when a patient who smokes tells me she doesn't have to quit because her granddaddy smoked and he never got cancer and he lived to be 89. That is an EXCEPTION, folks. We know that the rule is much dire. The rule is that you expose yourself to ridiculously higher risk levels of cancer (lung, mouth, lip, stomach, etc), COPD, hypertension, cardiac artery disease, deep venous thrombosis, chronic/peripheral arterial disease, and even other more obscure diseases.

Every person has to make their own decisions in their life and nobody can force them to do otherwise. We can't force someone to make right decisions, we can only give them the tools and knowledge that can guide them toward success - but ultimately, we all live our own lives.

But man, this is some compelling evidence. Click here for the full article.

Quickies: Delays, Tests Results, Delays, Night in Vegas, Hope, (Updated Below!!)

2010-07-28T22:24:00.000-07:00

UPDATE ON JULY 29: I have arrived in ATL. I made the red eye flight from Vegas, had a great aisle seat next to a lovely couple, and got to the hotel without a hitch. I then promptly fell asleep which is why I didn't let you all know I had arrived sooner. But yes, I am alive and well and enjoying the lovely countryside where everyone, but EVERYONE, says hello as you pass by. I could get used to the South, yes indeedy. Except, somebody forgot to mention to God to layoff the heat/humidity at 6 in the morning! I can say that getting off the plane to that mess of weather at 6am made me realize how great we have it in Fresno - our nights are incredible.

1. Delays: Every other time I have taken the USMLE, results arrive in three weeks. Hence, last week Tuesday I was beyond nervous all afternoon and evening in anticipation of my arriving grade. I felt in my heart I had passed, but you just can never tell. I waited and my heart pounded. I awoke at 4am and started checking the computer. Every email message that would arrive in my inbox made me nervous - was it the one?! But around noon, well after results usually arrive in in-boxes, I realized there was to be no results. Another week of waiting and anticipation was the only result to be had.

2. Test Results: So, I waited another week, spending a lot of time working out and swimming in the pool to relax my mind and take it off of the test. My family and friends, God bless you all, did an amazing job keeping me distracted. But there was still no guarantee results would arrive today. The USMLE states not to bother them until it has been at least 6 weeks - they definitely under promise and over deliver, a good thing. However, if it were to arrive today, I was planning on flying to Atlanta for an interview and would not be able to retrieve the results early in the morning. Hence, God brought AA into the picture; I gave her my log-in information and this morning she checked and when I landed, my heart beating way too fast and my nerves a hot mess, there was the text: "Congratulations Doctor!!"

3. That brings us to my trying to get to Atlanta. I'm flying there for an interview with an airline and they are flying me "Non-Rev" - that means they aren't making revenue off of me and I fly stand-by. The flight from FAT to SLC, which was the one we were all worried about, went without a hitch. SLC, however, was a completely different story. Flight after flights that went to ATL was overbooked. From 830am until noon I watched flight after flight leave without me. Then, I was to be rebooked on a flight through Vegas that left SLC at 140pm. However, when I went to board that flight, there was some sort of problem with the ticket. Res Agents on the phone said they couldn't do anything to fix it because I was still listed as not having flown at all. Weird, I must have teleported from FAT to SLC. Res told me the Gate agent could handle the situation. Not true. The Gate agent said there was absolutely nothing she could do - I had been locked out of the system. Great. Stuck in SLC with a bunch of proselytizers and no way out! In the end, the AMAZING lady at the place I'm interviewing was able to intervene and get the ticket fixed. With 20 minutes before the 340pm flight to Vegas, we got my ticket fixed and I am in Vegas now, waiting for my 1130pm flight to ATL.

4. When in Vegas, rule number one is to live it up. So, I took a $6 shuttle from the airport to the Strip and walked up and down the strip. I'm exhausted quite frankly! I got to enjoy the views both in day time and night. I used $20 to gamble, which I promptly lost in about 30 minutes and that was it for the gambling. Besides, I was more interested in one thing: the Bellagio water fountains. I spent almost an hour and a half there. It was incredible. Relaxing and rejuvenating. I'm now back at the airport as I write this, using the amazing internet connection (and it's free!). FYI: on top of everything else, the Salt Lake City internet sucked!

5. Hope: Romans 12:12 says "Rejoice in Hope, be Patient in Tribulation, be Constant in Prayer." One of the most challenging periods of my LIFE has just ended. I can't say I enjoyed it and I most certainly won't say I would consider doing it again. But, now that I have arrived at the end, it feels great. I feel accomplished. The hope that I had, but more importantly, that my family and friends had for me, that never diminished and certainly never extinguished, has been amazing and carried me through. God bless you all.

Elderly and Disabled Put At Risk by DUMB Government Ideas

2010-07-20T10:10:00.000-07:00

California recently decided that one of the ways to cut its budget deficit is by slashing money to home health workers. These include nurses, health aides, meals on wheels deliveries, and other individuals that go to the homes of elderly and disabled citizens and provide them with care to ensure that they can continue living independently, in their own homes. When I first heard that California was going to reduce the wages and benefits to these home health workers, I found it to be an incredibly STUPID idea - another example of our government leaders acting EXTREMELY DUMB (something they have proven time and again that they are adept at!)

Why is this decision dumb? Because while it may cost $1500 a month to provide home health services to one person, it would cost the government nearly $6000 a month to cover the costs of a nursing home for this same individual! Some may argue we should cut that expense, too; if the elderly can't afford to pay for home health or nursing homes on their own, then they should just have to deal with it, some might say. I puke a little at the thought that people like this exist in our world. But I can show why that is an incredibly stupid argument as well. If we don't provide any care to these individuals, guess what - 911 is three numbers away and the hospital is a short, but expensive Ambulance ride away. The cost of the ambulance and even a short hospital stay can then skyrocket upwards of $50,000 for the individual - multiplied by the numerous times these folks will end up going to the hospital for falls, lack of nutrition, and other chronic diseases of the elderly. Someone on fixed Social Security benefits without savings is not going to be able to pay for these expenses and they will end up right back on the taxpayer.

There is an incredible New York Times Article on this topic that you can read and see further examples of why this is such a stupid idea. Just click on the link:

http://www.nytimes.com/2010/07/21/us/21aging.html?pagewanted=1&hp

It is very sad to me that in our rich nation, we continue to see policies that cut the nose off to spite the face. We see this in other aspects of government ideas, such as education. Rather than spend the money upfront for quality early education and K-12 programs tied together with access to housing, healthcare, jobs, nutrition, etc, we instead run a threadbare operation...and ultimately end up spending MUCH more money on prisons down the road. It costs A HECKUVA LOT MORE MONEY to house a prisoner for a year than to provide excellent opportunities early in life!!

I am really beginning to question whether dumb people outnumber smart people in our society. And if so, why haven't we smart people done something about the dumb people? We have all come to feel so powerless to stop stupid policies that, in a way, we have just come to quietly acquiesce and accept them as inevitable.

Lord help us!

Teaching for America

2010-07-15T09:53:00.000-07:00

"Just passing through."

"A threat to public education."

"Just building their resumes before moving on with their lives."

There has been a lot of debate about Teach for America, lately. The NY Times covers Teach for America quite a bit, I'm guessing because the NYC corps of Teach for America members is the largest in the nation. But, in almost every article I read, there is a general pattern that is followed, almost exactly, every time.

It goes like this:

1. Teach for America is in the news for another amazing accomplishment, like TFA teachers raising test scores in their classrooms more than other traditional teachers.

2. An explanation of what TFA is - a corps of stellar recent college graduates who work in some of the most difficult classrooms in America. Invariably, these days, there is mention of how incredible it is, in this economy, that almost 20% of the top graduates at many Ivy League schools are applying to Teach for America instead of Deloitte and Touche.

3. Of course, "there are critics" who criticize Teach for America because, as I put some of the quotes at the top of my blog post here, we are just passing through. We are not committed to the cause of teaching. We are just rookies using these hard to staff schools as a social experiment. We are not possibly as great as a veteran teacher. We should be ashamed of ourselves for just using already poor and disadvantaged students just to build our own resumes.

4. The article will usually finish by summarizing the amazing accomplishment that they originally wrote the article about in the first place.

I have never been asked to contribute to these articles, but I figure I have a blog with a readership of 6 people who I can vent my frustration to about this topic. And for full disclosure, I was a Teach for America teacher from 2004-2006 in the Baltimore City Public School System.

Here's how my article would be written:
1. Teach for America teachers THROUGH OUT AMERICA, placed in some of the hardest to staff schools, are accomplishing amazing things with their students.

2. Teach for America is a corps of recent college graduates from schools THROUGH OUT AMERICA, with diversity of ethnicity, culture, personality and opinion not seen in the traditional teaching pool. Individuals come from amazing schools, including small liberal arts schools like Whittier College (my college - nope, it's not an Ivy League, but frankly, I too am frustrated that TFA is branding itself more as a bastion of the Ivy Leagues, instead of pushing the fact that the majority of its greatest teachers come from Colleges like mine. In fact, my first year teaching, one of my housemates was from Dartmouth - he couldn't hack it. Funny, the small liberal arts school kid - me - was awarded Rookie of the Year that year by my school.)

3. There are critics - insert the oft-repeated and tired quotes that I have above. But, let's add that the very schools that they criticize Teach for America for abusing are certainly NOT being inundated with the veteran teachers these nay-sayers demand to see in those classrooms. Additionally, not even the majority of traditionally trained teachers who dedicate their lives to the profession are interested in staying at these difficult schools for their whole career. But nobody who is criticizing Teach for America - usually Professors in Colleges of traditional Teacher Preparation - is offering a better solution that is also viable (and, most ironically, most of them wouldn't dare go teach in the schools Teach for America places at, either!) Either put your money where your mouth is, or shut up and move out of the way so that those of us who would rather do instead of just say can get stuff accomplished!

4. What other articles often fail to recognize or state is that Teach for America, at the heart of its mission, includes for the very fact that not every individual attracted to the program will stay in a classroom for over two years. Solving the problems of educational inequity - the so-called "achievement gap" - won't be accomplished if we only attack the problem within the field of education. What these big-mouthed, degree-laden education professors seem to be continuously missing is that we NEED people in our nation who worked in a school for a few years to get a better grasp of the problems faced by our students, so that they can then present plausible and solid solutions in whatever field they ultimately decide to dedicate their lives. Someone who has seen the challenge first hand can then make decisions in the arenas of housing, nutrition, healthcare, transportation, etc more effectively. THIS IS THE POINT!

5. My article wouldn't end with a summary of the amazing accomplishment - most people have pretty much figured out that Teach for America is a good thing. I would end, instead, with a plea. My favorite colleagues at the school I worked at in Baltimore, were my favorite because they were supportive, provided helpful hints and feedback through those challenging first months of teaching. They neither put me on a pedestal nor disdained me merely for the fact that I was a Teach for America member. They treated me like they would any other colleague - once I earned their trust and respect, we were a solid family. If we hope to raise our profession, we can't just sit idly and wish things stayed the way they were 20 or 30 years ago. We can't propose "solutions" that sound great but are not feasible, like super monetary incentives to get veteran teachers in these difficult classrooms - especially in this current economy! We must stop blaming and putting each other down. Rather, we should be the ones dictating the discourse for the future of education! We should not be allowing people who haven't ever been close to the front lines to be dictating teacher contracts and prescribing solutions. WE should be at the forefront of the positive changes necessary for our children. Ultimately, it must stop being about the adults and start being about creating amazing, life-changing, unforgettable educational experiences for the children we serve.

And the very last sentence in my article would challenge the biggest assertion by critics. I would include this quote from Donna Foote, author of "Relentless Pursuit: A Year in the Trenches with Teach for America". She writes, "there are much easier ways to burnish a resume than a two-year commitment to hard labor in some of the crummiest classrooms in America." Indeed.

Time Softens the Heart

2010-07-05T10:34:00.000-07:00

I have taken a shower with a water bottle. I didn't go into the bathroom with the intention of doing that, but halfway through lathering up with soap, the lights went out and the water shut off. I was thrust into basically pitch blackness (there was no window in our bathroom) and the first word that came to my mind can't be published in a public forum. I found the emergency water bottles we kept by the bathtub (since this had occurred to my roommate on another occasion) and as I sparingly used them to get the soap off, I hated life. I hated my decision to go to the Caribbean for medical education. I SWORE I would never return to that retched "rock" lest hell freeze over AND pigs fly on earth.

But time has a funny way of taking memories like that and turning them into a very comic recollection in the mind. Family always used to tell me to appreciate the opportunity I was given to "live in a beautiful tropical place". Opportunity?!?! I used to think incredulously. YOU try come living in this place while simultaneously trying to cram macro amounts of information in micro amounts of time. Because while my power and water go off regularly, you are frolicking around in the resorts when you come to visit me, with their fancy schmancy generators and water tanks.

Despite this, I now find myself at the end of my medical school career. God willing on July 21 I will receive my passing score and a few short weeks after that, I will officially be Doctor A. And for those of you with the insight to have known 4 years ago where this very blog post is going - yes, I want to go back to the island. Now, I'm a practical person so I don't want to just visit St. Martin. When I spend money to travel, I like to see places I haven't yet been. So again, for those of you with insight four years ago to disagree with me when I said I not only hated St. Martin but the whole of the Caribbean, yes you were right again and I was wrong. I would love to go lay on the warm beach, frolic in the warm, calm Caribbean sea, and doze off to the sound of steel drums while sipping on a fruity Caribbean drink.

I indeed had the opportunity to live in paradise.

Video produced by AUC filmmakers recently. Some of my favorite places are shown. Enjoy!

Let Your Life Speak: The Prom

2010-07-02T10:14:00.000-07:00

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has." -Margaret Mead

I enjoy finding positive news. CNN does a great job of sharing inspirational stories of ordinary people doing extraordinary things. I wanted a way to have them all in one place, so I am going to start putting them on my blog. I hope you find some of these stories as inspiring as I do!

The first will be about a young man who organizes a free prom for adolescents with life-threatening and sometimes terminal disease. Amazing what human will can accomplish.

The video is below and you can read the rest of the story by CLICKING HERE.

Believe

2010-06-29T22:26:00.000-07:00

The "big day" starts in almost 9 hours. I'm currently going through some nerves, but luckily loved ones are helping me keep them in check and keep everything in perspective.

Believe! I can! I WILL!

There are two very special stories I will keep close to my heart tomorrow, to help me through this thing. The first comes from a movie, although I didn't know that when I first read it. I was given this quote almost a year ago, on a post-it in the bathroom mirror (next to another post-it that told me to clean my side of the mirror), when I sat for this test the first time, by CY, a dear friend.

"You can wish in one hand and crap in the other and see which one gets filled first!"

I love this quote because it forces us to recognize that ideas only work, if we do. I didn't follow its advice, however, until reality hit me - hard - with a Fail. So, I have stopped wishing. I stopped wishing I had passed. I stopped wishing I had made different decisions in life. I have stopped wishing and finally, FINALLY started acting like I want to be a Doctor. Like I really, really, truly, more than anything else in the world, want to be a Doctor. I'm not wishing anything for tomorrow - I am KNOWING that with God's help, I will be successful.

And speaking of God, in the Church bulletin this past Sunday, there was an excerpt from C.S. Lewis that spoke directly to me. God always seems to know what we need and even though we all go through moments of doubt in Him, He always fills our souls with the strength we need. I will forever in my life cite this excerpt as an example of our amazing Lord trying to help me GET IT - speaking directly to ME!

C.S. Lewis wrote - or I should say, God spoke to me through C.S. Lewis by saying:
"At the end, I know, we are told an angel appeared 'comforting' Him. But neither comforting in English nor Greek means 'consoling.' 'Strengthening' is more the word. May not the strengthening have consisted in the renewed certainty - cold comfort this - that the thing must be endured and therefore could be?"

With the Lord in the driver's seat tomorrow, I know I can make it. I know I will be wildly successful. I have studied extensively and done what I need to do to be successful. Therefore, with the peace that one can only get from trusting in the Lord, I will go to sleep now.

The Five Finger Prayer

2010-06-27T10:30:00.000-07:00

Continuing on the theme of Five, my mom #2 just sent me this email and I found it lovely and most definitely worth sharing. My test is three days away, the weather is projected to be nice (especially since Fresno is dry and not humid), and my brain is on overdrive - ready to go! God has set up a beautiful day for victory!

1. Your thumb is nearest you. So begin your prayers by praying for those closest to you. They are the easiest to remember. To pray for our loved ones is, as C. S. Lewis once said, a 'sweet duty.'
2. The next finger is the pointing finger. Pray for those who teach, instruct and heal. This includes teachers, doctors, and ministers. They need support and wisdom in pointing others in the right direction. Keep them in your prayers.

3. The

next finger is the tallest finger. It reminds us of our leaders. Pray for the president, leaders in business and industry, and administrators. These people shape our nation and guide public opinion. They need God's guidance.

4. The fourth finger is our ring finger. Surprising to many is the fact that this is our weakest finger, as any piano teacher will testify. It should remind us to pray for those who are weak, in trouble or in pain. They need your prayers day and night. You cannot pray too much for them.

5. And lastly comes our little finger - the smallest finger of all which is where we should place ourselves in relation to God and others. As the Bible says, 'The least shall be the greatest among you.' Your pinkie should remind you to pray for yourself. By the time you have prayed for the other four groups, your own needs will be put into proper perspective and you will be able to pray for yourself more effectively.

Five

2010-06-24T08:52:00.000-07:00

Five seems to be a marquee number in our lives. It is a nice, round number that we use as a benchmark to celebrate various occasions. Five year anniversary. Five year reunion. Five days in a week. Count to five in kindergarten. First Five in California to get kids prepared in their formative years. APGAR score in the first five minutes of life (if you are interested, ask and I will explain this one). There's even a really delicious Italian restaurant in Fresno, aptly named 5.

I would venture to guess that we like whole numbers - we all still remember the sing-songy way we learned 5-10-15-20-25-30-35-40-45-50 etc. in elementary school - because they give an air of finality. When we reach that milestone, we must have accomplished something.

Therefore, today I celebrate five days left until victory. Technically, as I write this I still have 5 days and 23 hours before the start of the test. But, you can't count the day of the test as a study day. So, I have less than 6 days left to study. Put another way, in the more comforting and celebratory way - 5 more days to go. The countdown is on. I have reviewed, rereviewed and rerereviewed. Pancreatitis, cholecystitis, hepatitis, and any other itis is well preserved in my brain for showdown on Wednesday, June 30.

I don't enjoy testing the Gods or inviting fate to bite me in the ass; so, with all due respect and reverence, I say BRING IT! I'm ready. Let's roll.

Quotables

2010-06-20T22:39:00.000-07:00

Every year the New York Times writes a special article that shares with the world what graduation speakers at various commencements in the United States shared with the graduates. I find many to be inspiring and a great read. Enjoy!

John McCain
United States Senator
Commencement: Ohio Wesleyan University

"You might think that I’m now going to advise you not to be afraid to fail. I’m not. Be afraid. Speaking from considerable experience, failing stinks. Just don’t be undone by it. Failure is no more a permanent condition than is success."

You can read advice from other speakers by clicking here for the article.

Inspiration

2010-06-18T00:15:00.001-07:00

Congratulations to the Los Angeles Lakers!!

My championship game will be played on June 30. It will last 9 hours, through almost 360 questions. And about 3 weeks after that, God willing, I too will raise my trophy (the coveted MD Diploma). And the award for MVP through all this? My amazing mother who has cheered me on, financed my education, and never given up on me.

Tonight we celebrate the Lakers! Their win energizes us all...especially those of us going for our own championships.

Quickies: Test Date, Party and Travel Ideas

2010-06-07T19:59:00.000-07:00

Test Update: I have scheduled THE test for June 30 here in Fresno. I'm excited because this is my time. I will be passing and I can't wait to feel the success and achievement, finally. And with passing, will come official graduation and my joining the ranks of medical doctors throughout the world.

Party Central: Many have asked about my graduation. The official graduation day for my school passed last week - CONGRATULATIONS TO NK who did participate in the day in St. Martin. I, however, never had plans to attend. Even if just my mom and I were to go, the airfare, hotel, food, and incidentals would approach $2,000. Therefore, instead I have wanted to throw a big party here in Fresno. I should find out I passed on or around July 21 so I'm thinking a big hoopla in August is in order. Let's get everyone together for some food, dancing and fellowship.

Travel Ideas: I am going to have a ton of free time after I pass my test and before residency starts. And trying to find a job right now is proving to be impossible! Research places want someone with experience. Teachers are losing jobs left and right. Airlines aren't hiring. I may be able to get a job at Starbucks, but many places like that keep saying I am "overqualified" - who knew there was such a thing. Therefore, I want to travel and explore new places. If you have any great suggestions for American or international destinations, hit the comments and share!

Back to studying for now!

Home Sweet Home

2010-05-11T06:05:00.000-07:00

Medical school is over. Four years of lots of studying and long nights; well, the lots of studying and sleepless nights aren't over, but paying tuition is over. I arrive home Wednesday night. That's right, this Wednesday night (May 12), I return to Fresno. I have checked the weather and it looks like it is in the 70s. For some reason, the weather here in NYC decided to go south the last few days of my stay and we have been in the 50s. That's not totally bad, though, since this is a walking city and I sweat like stink when the weather gets hot.

For now, I return to the land of getting in your car to go 100 feet, 108 degree weather, but most importantly, loving family and friends who I have missed over the last 4 months. What the future holds after June, however, is an open question and I'm excited about the possibilities.

Fair warning: I will be somewhat of a recluse for the next 6 weeks as I spend every moment studying in preparation for the test. Let me ask for forgiveness now if I don't really hang out or do a good job of keeping in touch for a few weeks.

Happy Mother's Day

2010-05-09T09:16:00.001-07:00

After Christmas, my favorite holiday is the one where I get to celebrate the wonderful women in my life who have helped shape who I am today.

We Will NOT Be Deterred

2010-05-02T09:45:00.000-07:00

There are those among us in this world who hate us. It is a powerful word that every religion (almost) vehemently argues against, but yet, here we are with news of another possible terrorist attack. And it is in one of my favorite spots, Times Square.

I just received a text from NK asking if I was OK. I hadn't thought about it until he texted and then I realized that I am really, ridiculously, outrageously ANGRY. How dare someone be so awfully selfish as to think it OK to attempt to kill what could have been 100s or 1000s of people. Whether this is a homegrown terrorist or one from another country, if you are so pissed off at America and what we stand for, then please do us all a favor - either take a gun to your own head, or if you are too cowardly (which I suspect you are) to finish your own damn self off, then do us all a favor and move to a faraway place and be a hermit. But LEAVE US ALONE.

I love hanging out in Times Square. I'm there often and by the Grace of God this bomb did not detonate. But the mental stress is still there for the very reason that this could happen and it is totally fathomable that I could be there. But let's be clear: you cowardly terrorists will NOT deter us. We will hunt you all down and protect the freedoms that we have successfully fought to protect for over 2 centuries. And while we hunt you down, we will continue to live our God blessed lives to the fullest possible, appreciating all the gifts that God has bestowed upon us, not least of which is the freedom to go to Times Square.

Quickies: Where, What, When, Who

2010-04-28T08:13:00.000-07:00

1. Where Have You Been?
I apologize for the lengthy wait between posts. Lately, I have just felt more enjoyment from spending all day at the hospital learning and then going to Manhattan and exploring, versus sitting inside and reading or typing up a blog. When you have no idea what the next steps in your life will be, it somehow puts all the wonderful "here and now" moments into clearer focus and you try to embrace and enjoy every moment. In other words, when you have finally stopped thinking 5-10 years into the future, what's happening now - right now - finally can fill your brain. And quite frankly, it is amazing how much of our lives we miss when we are constantly filling up our heads with what we will do next. I imagine this is what happens to a person when they receive devastating news about their health. Granted, in my case the issue is nowhere near as serious or grave, but the benefits are tangible nonetheless.

2. Where Are You Going?
OK, I suppose answering this question is fair, at least for the very short-term. I return to Fresno on May 12, arriving at 945pm on American Airlines (of course!) I become somewhat of a recluse for 6-8 weeks, retaking my USMLE Step 2 exam sometime in late June. I emerge victorious, and finally claim the title of Doctor (MD) and go celebrate somewhere. Vegas? DisneyWorld? Rome? That can be decided later by the folks who will inevitably (hopefully?) join me in my celebration. You know who you are. And then, I either, 1) find a job doing research for a year and try to Match into a residency position again, or 2) find a job doing research for half a year and enter a residency position mid-year if anything opens up, or 3) I sleep in every day for a year, get a part time job with American Airlines and travel the world in my free time. Point is, I don't know what comes after passing the exam, so please don't ask. The Armenian phrase for I don't know is "chem keeder" - embrace the phrase "I don't know" because sometimes it is truly the best answer.

3. What Have You Been Doing?
NYC is an amazing place to explore. Here are some more great places I have seen (as much as I can remember, since it HAS been awhile since my last post!)

Broadway: Been to Jersey Boys (which I felt basically took a $20 CD of music by the Four Seasons and recast it into a $60 minimum ticket "show" - in other words, didn't like it). Also been to La Cage aux Foilles (like the movie The Birdcage, this show is hilarious. It involves the audience - if you get a orchestra seat - and keeps you laughing the whole way. A must see!)
Eats: NYC is up there with the gastronomic greats of the world. And I'm quite convinced it has no parallel when it comes to the diversity of eats available. We have had brunch at a restaurant run by Tom Collichio (the dude from Top Chef), Balthazar's for Brunch is also an amazing place that must be savored (and you should TRY to RSVP for weekend's otherwise you have at least a one hour wait). Some of my other favorites include Karam (a place NK's brother, AK, also loves) - the Lebanese owners of this place make Kebab and hummus and tabouleh as close to the way my family makes it as I have found. The irony is that I love treating myself to Tabouleh ($5) every now and again - but I joke that when I get home, the QUEEN of Tabouleh (my mom) will make it everyday and I will again grow tired of it :)
Parks: What NYC lacks throughout the city (trees, greenery, open space), it makes up for in some pretty amazing parks. The most well-known and possibly largest of these is Central Park. Every time I go there I discover something new! But when the weather is nice, there is a big green lawn that many New Yorkers love to go lay out on, play some soccer or frisbee or football, and rid themselves of the NYC "tan" (that amazing whiteness that Hanes does well in t-shirts, but should not be the color of human skin!) Indeed, there was a day a couple weeks ago when the temperature hit 87 degrees. Yes, I had the unfortunate case of gastroenteritis that day and couldn't go to work. The only problem was, I didn't plan on my newly acquired tan giving me away the next day.
Subways: A whole year's salary (when I finally earn one again) says that I will get into your car in California and within the first 5-10 minutes, make one of the new automated subway announcements that you hear on the trains here. "This is a Northeast Fresno bound 1 Express train. The next stop is, my house. Stand clear of the closing doors, please. Ding-dong." Embrace it, it is one of the quirks you all love about me. (And note, this is not a real bet - no I will not give anyone a whole year's salary. Ever.)
School: Even though this blog post makes it seem like I am gallivanting around the city all the time, the truth is that the majority of my time is spent in the hospital. Actually, this should be past tense. I just finished my Neurology rotation in Staten Island - it was up there as one of the rotations I enjoyed quite a bit because the Attendings were totally focused on education and helping us learn the nuances of Neurology. Now I have two weeks of Dermatology at Brooklyn Hospital. I finish on May 7 with rotations. In other words, the only hurdle left between me and my MD is passing Step 2. And that will happen very soon.

I'm sure there are things I have forgotten, but this post should keep you all happy for a little bit. And by you all, I imagine the 4 of you who check everyday, multiple times a day - thank you :)

See you all on May 12.

What's Next? I Don't Know

2010-03-13T07:49:00.000-08:00

In medical school we are often told that it is OK, as a medical student, to say "I don't know". Follow it up with a little "I will find out" and a sprinkle of smile and you are all good. This practice works well when a patient asks you about how the moon's position around earth could affect her health and well-being. However, you can't say "I don't know" during the big bad exam and expect to be given a pass. As such, as most of you know, I missed passing Step 2, again, by about 3-4 points (I've blocked it out of my mind and can't remember whether it was 3 or 4).

While failing is a disappointment, this time, it was almost freeing. I did the best I could, the absolute best. I studied, did practice questions, and worked on trying to finish the test on time since I am a fairly slow reader. When I opened that score sheet, however, I still managed to miss passing by a hair. But, I discovered peace from it.

For the first time in my recent memory, I have no plans. Well, sort of. I DO plan on taking the test over again in June, but it is too late to make the "Match" for a residency starting this summer. In other words, I won't be starting the next phase of my "Doctor" training in lock-step with my previous "plans". I will have, essentially, nothing to do! And weirdly, rather than be terrified, I'm quite excited about it!

When I finished 8th grade, I already knew where I was going for high school. When I finished high school, I had a couple months but then it was straight to College. When I finished there, I literally had a week or two to pack up and move to NYC for the summer and from there to Baltimore. When I finished teaching, I shipped my stuff home, packed up, and moved right again to the Caribbean. Got home from there and these last two years I have been a vagabond, living in basements, other people's bedrooms (thank you Yal's), hotels, and even friends' living room pull out sofas (thank you NK). I have explored Queens, Staten Island, Fresno, Los Angeles, Grand Rapids and now back in Brooklyn.

My entire life, when people have asked me what I'm doing, I have had an answer for them. And now I won't and I feel so liberated!

I know God has a plan for me and somehow all these trials and tribulations fit into that plan. I am being made into the person He needs me to be for whatever He needs me to do to make this world, or my sphere of influence within it, a better place. And I do know that at some point, I will pass this test and the test that comes after it and I will do a residency somewhere that teaches me superbly and I will make an excellent Physician and help my patients holistically.

But in the meantime, if you want to know what's next, the answer is I don't know. I don't know! But whatever it is, I'm gonna keep enjoying this crazy and wild ride.

Grand Rapids Fun

2010-02-18T09:59:00.000-08:00

I have been working hard here in Grand Rapids. I spend close to 11-12 hours at the hospital everyday, do a 30-36 hour call every 5-6 days and see more viral bronchiolitis than you can count on two hands. But, there has been some time to explore this very fun city with a great and vibrant downtown. Here are some things I would recommend if you are planning a trip!

1. Where to Stay: Courtyard Marriott
There is a strip of Marriott properties downtown - the Courtyard, the JW Marriott, and the Amway Grand Plaza. The latter two are super expensive and other than more plushing in their mattress, won't offer you more than the Courtyard. In fact, they offer less because internet is included here at the Courtyard. Perhaps because they are all owned by the same group, the staff here at the Courtyard is better than any 5-star property I have ever seen. The front desk staff is always exceeding my expectations and doing great things for me - like the birthday surprise they put together for me (see previous blog post). Stay here - you won't regret it.

2. Where to Eat:
There are lots of great local eateries here that use only local ingredients that are fresh and delicious. One of my favorites is called Cygnus 27, a restaurant on the 27th floor of the Amway Grand Plaza Hotel. The food is not cheap, but not ridiculously expensive, either. And if you go just before sunset you can get a gorgeous 360 degree view of downtown and the Chicago River as the sun's light evolves the colors over the city. And ultimately, when the sun is set, you can enjoy the manmade lights around downtown. And the food is amazing. I had one of the most moist and delicious salmon dishes I have ever enjoyed. Ever! That said, explore all the local eateries - they each have a niche market and great service.

3. Where to Visit:
Downtown is full of fun places to spend a couple hours.

Art Museum: It is small and cozy with a pretty small collection. But, the architecture of the building is really cool and they do have some beautiful paintings. The $8 admission is pretty hard to justify, in my opinion, so I won't return - but it is cool for a one time visit.
Symphony: Hands down a beautiful concert hall and a beautiful sounding orchestra. I enjoyed tremendously their interpretation of Concerto in D Major for Violin and Orchestra, Opus 61, by Ludwig van Beethoven. And the Grand Rapids crowd is amazing - we gave an almost 10 minute standing ovation at the end of the performance, with several curtain calls. It was well-deserved and a wonderful display of appreciation for a great orchestra. If they are playing when you are in town, YOU MUST ATTEND!
Gerald Ford Presidential Museum: I haven't been yet, but plan on going.
Grand Rapids Museum: Haven't been, but plan on going.

Overall, this is a truly vibrant city and I have been having a wonderful time enjoying what it has to offer. If you are ever in Chicago or Detroit, which are 3 hours away, it would totally be worth a weekend trip, or even an overnight trip, especially if the Symphony is playing.

Unforgettable

2010-02-14T09:19:00.001-08:00

People often comment that I have the coolest birthday day since I was born today, on Valentine's Day. True, while nobody forgets my birthday day, it is difficult to get them to come out and celebrate on the actual day. Many forget that getting into a restaurant on this day is near impossible (unless you tell the Hostess that you had, in fact, made reservations for a party of 8...not that I ever did, I mean would). It is also difficult to gather your many married/relationship-tied friends to come out because they want a special evening for themselves.

The difficulties aside, however, there are many wonderful things about having a birthday on Valentine's Day. For starters, I get to share my day of birth with a Saint who made it his life's mission to bring people together in love and celebration of each other's beauties. Some call this a "Hallmark Holiday" but nothing could be further from the truth - in the ancient custom, today was a day to actually write hand-written notes of passion and love to somebody you were smitten with or just somebody you thought needed a little encouraging. The only reason Hallmark makes a pretty penny off of this holiday now is because we have lost a bit of our passionate and personal side in today's society.

On a more personal note, my mom never forgets my birthday - since 2000, I have been somewhere else on my birthday every year. For four years at Whittier College, my mom sent a cake each year (which usually got shared with my swim team friends because my birthday fell about a week before our final meet; and at our final dinner, they would always get something for me, too!) Then, for two years in Baltimore, somehow my mom, who has trouble turning on a computer and still doesn't carry a cell phone regularly on her person, would find some company to send me a cake at work. In St. Maarten, she wasn't able to find a cake delivery, but I always got a card - and don't worry mom, NK, SA, MR, GC and others made sure we went to a delicious place for dinner.

And that brings us to today - year 28 of my life is kicking off. This is the year of my life when I will pass my board exams, when I will walk into a patient's room as "Doctor" and hopefully leave as trusted friend, when I will drink a little more lemonade and not stay up so late, cry a little less and laugh [a lot] more - why wait until 30! (For those of you who didn't get this allusion, please speak with anyone who knows country music). And again, somehow my mom worked her magic this year. And with the help of a truly awesome hotel because of an awesome STAFF - they put together what you see in the picture up top. The restaurant treated me to some delicious desserts, the front staff put together a yummy goodie bag with various and sundry edibles, and they somehow found balloons from somewhere I will never know because I haven't seen any balloon shops nearby! A shout out MUST go out to somebody named Barry - an amazing, kind, make-you-feel-at-home type of person who works the front desk; he got me the good deal to stay at this hotel for a month as well as putting me in a great room and always giving me great recommendations for places to visit; indeed, if ever in Grand Rapids, do not stay anywhere else; come to the Courtyard Marriott. The service here is truly 5-star and better than you will find at places way more expensive.

Today, I like to think people are celebrating my birthday (and Valentine's day, as an aside :) Therefore, while I see great things happening in my life this year, it is my birthday wish that awesome things happen in the lives of everyone else, also. As my friend CP shared on her blog, from author Susan Ariel Rainbow Kennedy, let yourself be truly seen so you can be truly loved. I would add that I hope we all put out in the universe that which we hope to achieve, through hard work, faith in God, knowing that He wants great things for us, and a focus on improving ourselves in order to improve the world around us for everyone. I think that would make St. Valentine a very happy Saint, indeed.

Happy Valentine's Day.

Veni, Vidi, Vici

2010-01-26T10:19:00.000-08:00

In the coming weeks, there are lots of decisions to be made about my future. Many of those decisions are tied intimately with me actually passing USMLE Step 2, which I took last Thursday (1/21/10). I spent nine hours at the testing center answering 352 multiple choice questions in about a minute and twelve seconds each; and the whole time, I kept hoping my mom was continuing to recover and hoping that I could pull this off - that I could pass and bring joy and RELIEF to her and to many family and friends who have been rooting for me through this whole struggle.

The last few months have been particularly challenging, even within the scope of the last almost four years of struggle through medical school. I wouldn't want to go through all this again, but now as the light at the end of the tunnel is growing stronger and I feel more like a "Doctor" each day, I feel a renewed sense of vigor and excitement that there are so many possibilities that await in the near future. I have been humbled and have experienced failure - and yet, here I am, still standing on the other side. And I freely admit that I stand because there have been many along the way who have helped pick me up when I have fallen and felt like giving up.

Granted, I am not out of the woods yet. But I take solace in two Bible passages that I feel are worth sharing today:

"Rejoice in hope, be patient in tribulation, be constant in prayer." -Romans 12:12
"I can do all things through Christ who strengthens me." Phillippians 4:13

I am not always constant in prayer, but I continue to work on it. And I continue to hope that we will be victorious. It does take a village to raise a kid and to support him through life's trials. I truly believe we weren't meant to go through this life alone, trying to overcome challenges by ourselves. At the very least, the Lord will always be there to carry us and make us strong enough to handle the situation at hand. We should all be there for each other, also. Together, we can and will conquer all obstacles.

How's the Hotel: Comfort Suites Downtown - Buffalo, NY

2010-01-23T19:58:00.000-08:00

I recently was in Buffalo on business and had the opportunity to stay at the Comfort Suites Downtown. To sum up the experience in one word: phenomenal.

Check-In: B-
Room Functionality: A+
Bed: A+
Bathroom: A
Fitness/Pool: A for Fitness; No pool.
Location: A+
Overall: A
Recommended: YES!!

If I tried to book a room in New York City like the one at Comfort Suites in Buffalo, it would have cost me hundreds, if not thousands of dollars. This was a top-notch suite! The hotel apparently just finished renovations and they did a smashing job - I was beyond impressed. The suite was a true one-bedroom suite with a living room/work area and separate bedroom. The living room/work space was large and also included a nook with fridge, microwave, and coffee/tea maker. All the counters were marble and the room had nice earthy tones that made it feel very relaxing. There was tons of functional work space as well as relaxation space on comfortable chairs/sofas.

The bedroom was superb. It was connected to the living room via small french doors. The bed was very comfortable with a nice comforter. There was also a little sitting area that connected you to the bathroom. You could also access the bathroom from the living room via separate door.

Both rooms had TVs, which I was pretty surprised were OLD SCHOOL when I walked in. They worked, but they didn't fit with the rest of the ultra modern and chic decor. I asked about this and it turns out US Customs has held up the shipment of flat screens. Some rooms have flat screens, but the remainder were held up for lack of paperwork. That stinks because those TVs are the final link to a complete and very VERY well-done renovation that had me wishing I could stay at a Comfort Suites like the one in Buffalo everywhere I travel!

And the BEST part was that this hotel was inexpensive. It was the cheapest I found in downtown that still offered free airport shuttle and even breakfast (a delicious buffet with eggs, ham, cereal, waffles, juice).

My only recommendation for improvement is the airport shuttle. It was OK, but my main gripe is that they were not on time. They picked me up almost 20 minutes late and on the day I returned to the airport, left almost 15 minutes after the stated departure time. This is not OK; it is way too cold to be waiting outside for a shuttle at the airport for that long. And on the way back to the airport, I had left plenty of time, but if I was cutting it close, those 15 minutes make a big difference. I would recommend the hotel work on this - the shuttle should really run like clockwork.

Would I stay here again - most definitely yes!

What I Talk About

2010-01-12T15:57:00.000-08:00

A good friend from college, AS, used some fancy schmancy computer program to make a collage of terms that I often used in my recent blog postings. I say recent because the words seem to be from the main screen and not from earlier posts that talked more about education, etc. It is no surprise to me (or to anyone who knows me), that all things having to do with flight and flying feature prominently in the collage.

How's the Hotel - Four Points Sheraton Bakersfield

2010-01-11T12:41:00.000-08:00

I love to travel. In fact, I love the journey as much as the destination, so I'm always talking about flying and hotels and various details that most normal people find almost no interest in. And since, in the coming months, I'll be doing lots of traveling for school and staying in quite a few hotels, I figured I would add a feature to my blog called "How's the Hotel" since my friends always ask me that (since they know one way or the other, I'll probably work it into a conversation anyway!)

My first hotel review will be on the Four Points Sheraton, Bakersfield. It was easy to write because I already wrote a commendation and sent it to the folks at "Corporate" because I feel like hard work should be recognized. As you read it, let me know in the comments if there are other things you want to know so when you are planning your travel, you can check if I've already stayed at the place!! That's right, I'm going to turn my blog into a one-stop shop for all pieces of information that most people don't need! :)

FOUR POINTS SHERATON - BAKERSFIELD, CA
Check-In: A
Room Functionality: A
Bed: A
Bathroom: A-
Grounds/Pool: A
Overall: A
Recommended: ABSOLUTELY!!

I am a SPG (Starwood Preferred Guest) Member for a variety of reasons, not least of which is the fact that great hotels like the Four Points in Bakersfield are usually offered for around 4,000 points. I have stayed at this location 3 times now when I have business in Bakersfield - twice with points and once through Priceline for $37 (plus tax, of course). I usually like to write reviews after I have stayed at a place a few times to make sure great service is consistent - at this hotel, it truly is their modus operandi. In a word, I find this hotel STELLAR. While I can't compare it to other hotels in the region, I can compare it to other hotels worldwide and I would recommend it highly and without reservation or condition.

PROS:
1. Front desk: always efficient, courteous, and receptive to needs or wishes. Per my request, I have stayed in the main building every time, in a King room on the 2nd floor somewhere near the main entrance - every time.
2. Room: I have always had a room that smells good, looks fresh, is clean, functional, and pretty large. Nice bedding, good bath products, all the necessities for a business trip (including fridge, microwave and free internet that works well). And even a bottle of water is included.
3. Grounds/Pool: The grounds of the hotel truly are beautiful. They have a creek and waterfalls that, after a hard day, are nice to meander through and let your mind relax. The pool, although too cold to use on my January visit, is awesome in the summer. Large size and well kept, with towels readily available and plenty of places to sit/lay out.

CONS (only one minor!):
1. Desk: The desk in the room is a bit awkward to use because the chair doesn't quite fit due to the armrests and there is a bar near your feet that you will likely bang your leg on a couple times. It definitely looks like a remnant from the 80s. However, it is clean, smooth surfaced and usable.

OVERALL:
If you need a place to stay in Bakersfield, do yourself a favor and choose the Sheraton. And to top it all off, there is an In 'n Out and Starbucks (thank God!) nearby along with a variety of other shopping options.

Mid Week Laughter

2010-01-07T13:14:00.000-08:00

During my first semester studying on "The Rock" (St. Martin), NK and I used to take study breaks every so often by watching The Office. Well, I've been studying hard the last several weeks, so as a study break, I watched some clips online. I found one in particular that compiled some of my most favorite Office moments and thought I would share it so we can all have some mid-week laughter! Enjoy it! I will be in my car this evening driving to Bakersfield for my final exams in OB/GYN and Psych. I'll be back Friday.

PS: If you go to minute 7:29, you will see one of my all time favorite moments on the show!

Part 3 - A Tale of Two Airlines: Delta Airlines = Lovely

2010-01-02T12:53:00.000-08:00

This is Part 3 of my series on "A Tale of Two Airlines". In parts one and two, I chronicled the unpleasant booking experience on US Airways. In this post, I'm going to ring in the new year with a positive THANK YOU to Delta Airlines for providing their product in a clean, efficient, friendly, and pleasant manner.

Part 3: Delta Airlines - A Very Pleasant Flying Experience

For my 4th year of medical school, I have had to do quite a bit of traveling. I left NYC last June 23 for Fresno, where I spent the summer doing Pediatrics. Then, I was in LA from end of August to October 25. I flew to NYC on October 25 for 6 weeks for OB/GYN and returned to Fresno on December 4. What follows is the story of my pleasant flying experience on Delta Airlines, both to NYC from LA on October 25 and returning to Fresno from NYC on December 4.

A couple days before departure, I received an email from Delta entitled "It's Time to Check-in". That email included my flight itinerary and a link to check-in for my flight:

Sunday, October 25

Flight:	Delta 78
Departs:	7:30 am from Los Angeles, California
Arrives:	4:20 pm at New York - Kennedy, New York
Seats:	29D
Meals:	View menu options
Gate:	53A

Saturday, December 5

Flight:	Delta 703
Departs:	8:10 am from New York - Kennedy, New York
Arrives:	11:45 am at Los Angeles, California
Seats:	24D

Flight:	Delta 7446 Operated by American Eagle using their equipment
Departs:	1:30 pm from Los Angeles, California
Arrives:	2:30 pm at Fresno, California
Seats:	06A

October 25: Pre-Flight
Check-in online was a breeze and Delta gives you a $5 incentive to check-in online (they knock off $5 from the price of each checked bag if you check-in online instead of at the airport.) I arrived at LAX for my 730am flight to JFK at around 6am and the Delta counter was a zoo! In fact, this is the only part of my trip that I had a problem/minor complaint about. I had checked in online assuming this saves time, but then you have to actually physically check-in your bag and the line snaked around a few times and took a good 20 minutes. When I finally did reach the counter, my bag weighed 56 pounds and the agent said I had to remove items or pay for overprice bag. OK, I took out a couple items and put the bag on a different scale (my agent made me move to the side to help somebody else) which read 50 pounds. Awesome. My agent saw this, but still made me put my bag on her scale, which registered 52 pounds. She then insisted that I remove more weight. I declined and pointed out that the other scale said 50, which means one of the scales is wrong and I think I should get the benefit of the doubt for two pounds. She said no - take stuff out. I said no - fix your scales. We stared at each other for a second (and I felt as though we had met the alter ego of each other because neither one of us was about to back down). She again pointed out that she will have to charge since my bag is overweight. I said I wanted to speak with a supervisor. Couple more minutes passed - supervisor arrived and I pointed out the discrepancy in the scales. He apologized, put the bag tag on my bag, and sent it on down the carousel and wished me a nice flight. I thanked him, wished him a wonderful day, and proceeded to the security line, which although long, was moving pretty efficiently. Made it to my flight just as boarding was starting around 7am.

October 25 - In Flight:
This is where Delta really shined, in my opinion. A NICE, smiling, non-ice-picking flight attendant greeted every passenger as we entered the plane. Then, half way down the aisle, another kind, smiling flight attendant extended another greeting to me. I know most people don't think twice about this, but I find such greetings really set a lovely tone for the whole flight and put you in a relaxed, comfortable mood. My flight was on a Boeing 757 that Delta has updated to have leather seats with comfortable recline and TV screens! The touchscreen offers movies, games, TV shows, music and a moving map. The product is similar to Virgin America's, except you can't order food from your seat with Delta's. However, at least for now, I preferred the Delta product because it was all free! Virgin charges for movies and certain shows, but everything on the Delta screen was free. So, of course, I watched myself a couple movies and one or two TV shows. They also served a pretty yummy Almond butter and jelly sandwich ($7 - pretty steep I thought, but I hadn't had breakfast and it WAS yummy). The flight was uneventful. The flight attendants did their job extremely well and with a smile and just enough personality to make it seem like they were enjoying themselves. We landed almost 45 minutes early and I waited a total of 5 minutes before my bag arrived. Overall, everything ran like clockwork after my initial check-in and I was totally pleased with what Delta is offering its customers.

December 5 - The Return Trip
My experience in NYC is for another blog post - or actually, I can sum it up as follows: very, very long days! But fast forward 6 weeks and it was time to return to Cali. For the first time I used the JFK AirTrain service that NYC offers. You take the E train to Jamaica station and transfer to the AirTrain. The service is super efficient and pretty darn quick...and you avoid traffic! But beware: if you have a few bags, I wouldn't recommend the subways because you gotta lug that stuff up and down quite a few stairs! The Delta terminal stop on the AirTrain is a bit confusing. The signs say to go to the international terminal for check-in for LAX flights. I did go there and there was no wait - super efficient and open space (unlike LAX!!) And while those agents were kind enough to check me in, after security the "gate" is actually a bus stop that drives you over to a different terminal for your flight. I wasn't quite sure why I couldn't just check-in at the other terminal where my flight actually was, but it was fine since I didn't wait in any line!

Just like my flight 6 weeks earlier, we started boarding on time, closed the door on time, and departed (with the middle seat next to me empty this time) on time! Flight attendants were there to greet, smile, and make you feel welcome. Personal screens worked like a charm and I watched a couple movies, slept a little, snacked a little, and just enjoyed the flight overall.

I DO want to point out that American Eagle played a role in getting me home on this trip. Delta works with American Eagle for flights to Fresno and sure enough, I took a small bus from the Delta terminal to the American Eagle satellite terminal (always a fun trip because you get to drive pretty close to some amazing airplanes!) The AE flight was nothing spectacular - they did their job well - on time and efficient. What I DO want to acknowledge AE for is their incredible ground service in Fresno lately. Fresno has been notorious the last several years for ridiculously slow baggage claim times. One time I waited the same amount of time for my baggage as my flight took from LA! Unacceptable. But, this is the second time where luggage from American Eagle has ALREADY arrived on the carousel by the time you walk to baggage claim. And Fresno is NOT a big airport. I find this incredible and therefore want to commend the ground service employees at Fresno for a job very well done.

HAPPY NEW YEAR!

2010-01-01T18:46:00.000-08:00

I wish everyone a wonderful new year - hope 2010 is the awesomest ever!!

HAPPY NEW YEAR!!!

Pink Gloves Are Cool!

2009-12-15T18:05:00.000-08:00

I know I promised another part to my series about good/bad airlines, but I think a nice little reminder of the more "human" side of the medical field is in order. AA sent me this link to a YouTube video and I say HATS OFF to the organizers at Providence St. Vincent Hospital in Oregon for volunteering to do the "Pink Glove Dance". Don't know what that is? Neither did I until I watched the video, which I have included below. It is awesome to see a hospital where the staff can come together to raise awareness in a way that makes us all laugh a little bit and smile a lot. Enjoy!

A Tale of Two Airlines - Part 2

2009-12-10T22:34:00.000-08:00

This is part 2 in a series about how US Airways was not nice to me, whereas Delta Airlines was a very pleasant flying experience. Enjoy!

Part 2 - How Many US Airways Agents Does It Take...

When last we spoke, our story's hero had finally made arrangements with US Airways to book a trip with rewards points in January. Since that phone call, he went online and purchased 4,000 miles for $80 in order to have a total of 37,500 miles in his account with which to book the flight that was on hold for him until December 3, 2009. That is where we pick-up the story.

Thursday, December 3, 2009:
Assuming this would be a quick deal - just call, give the confirmation code, pay with miles, and call it a confirmed trip - I called US Airways about one and a half hours before I had to be in class. I figured the first agent wouldn't quite understand English and would be confused, but I figured all s/he had to do was finalize the booking.

Agent #1 (Agent #3 overall since I started the booking on Monday): I gave her my confirmation code and, of course, was put on hold. About 5 minutes later she returned to inform me that she could not find the booking, that it had, in fact, "expired" yesterday, and she needed my point of departure. OH NO NO NO NO - this is not happening. After some back and forth, she made it quite clear that my old confirmation code was no longer functional and that we would have to rebuild the itinerary. I grumbled, but finally gave in. I told her all the flights were the same, just use the itinerary already on your computer from the "expired" confirmation code. She assured me she could not do this. OK, FINE! I'm leaving from Fresno going to Newark through Las Vegas on Flight xxx. Hold please.
Agent: "Hmm, I can't find that flight number from Fresno to Newark."
Me: "Because the flight goes through Vegas."
Agent: "But you said you wanted to go to Newark. Now you want Vegas?"
Me: "Is this a joke? Like really, am I being recorded somewhere?"
Agent: "Mmm, pardon sir? I don't understand."
Me: "Exactly, you don't understand and I can't deal with this anymore. Please kindly transfer me to a Supervisor who does understand. Please."

Hold Please (story of my US Airways flight booking life).

Agent #2 (Agent #4 overall): Hello, how may I help you. I explain everything and tell him he should be able to find the flights from the booking code that should NOT be expired, but is. Hold Please. Oh by the way, we are now about 35 minutes into this lovely encounter. He finally returns about 10 minutes later (hence, 45 minutes into this lovely encounter) to say he has rebuilt the flights and that the total will be 50,000 miles.
Me: "Excuse me??? Umm, ya no, that is a mistake. The agent on Monday informed me the total was 37,500 - I specifically asked her to confirm that, because I went and purchased 4,000 miles for $80."
Agent: "No, she was wrong. It has to be 50,000 miles because your outbound flight ticket is 25,000 miles and since you are flying on airlines other than US Airways, even though in the same alliance, we must book the whole ticket on the higher mile round-trip; hence, 50,000 miles."
Me: Umm, no. On the Continental Airlines website I can book this exact flight for 37,500. AND, your agent told me I could book this ticket for 37,500 on Monday. Why else would I go purchase 4,000 miles?? Does it make sense that I would spend $80 for 4,000 miles if I had been told it was actually 50,000 miles total instead of 37,500??
Agent: Sorry. It is 50,000 miles.
Me: That is unacceptable.
Agent: Would you like this ticket or not?
Me: Yes I want it, for the 37,500 that was promised me on Monday!!!
Agent: That is not possible.
Me: Kindly transfer me to another agent. NOW!

Hold Please.

Agent #3 (overall, Agent #5 for those keeping a running tally): This agent actually was sans identifiable accent! Dare I say, an agent in the Americas? Could it be?? I again explained the whole situation to him. His response? A lecture on policies and how I should have learned the policy about purchasing miles before I purchased them. Umm, excuse me - please kindly stop lecturing me. I know what the policy is, but I also know what was promised to me. Why is the policy so firm, but the promises your agents make and the information they share is so wobbly and shaky and unreliable?
Agent: The policy is firm.
Me: The only policy you should follow is HONESTY - something your agents do NOT follow.
Agent: Would you like this ticket?
Me (incredulous at this point): NO, ABSOLUTELY NOT! I don't HAVE 50,000 miles. I have 37,500 miles in my account because that's what was promised to me! I'm beyond frustrated with you people at this point!!!

And here is where the story can be quickly brought to an end. Realizing I was getting no where with any of these agents, I decided to cut my losses. We were able to find another flight that was available at the 12,500 point level; the only reason I hadn't chosen this flight in the first place is that it is the last flight of the night and goes through San Francisco late at night, and I was very worried about the possibility of weather problems. But, when you have no other choice and you are trying to save money, you do what you gotta do and hope for the best.

US Airways - I know that at least ONE person who works for you has to have a conscience and will realize that I was wronged here and will AT LEAST return my $80 (you can take back the 4,000 miles - I don't need them!). Take this opportunity to do the right thing and I promise I will bring you positive publicity (believe me, all my friends - 100s of them - call me for airline advice because I'm such an airline dork!).

Well, I never like to end on a sour note, so in my next installment of "A Tale of Two Airlines" we will talk about my POSITIVE flying experience on Delta Airlines - the "New" Delta Airlines as they call themselves. I flew them from LAX to NYC in late October and returned last week from NYC to Fresno (flying Delta from JFK to LAX then American Eagle to FAT). Stay tuned!

A Tale of Two Airlines - Part 1

2009-12-06T17:17:00.001-08:00

Sit down children, this is a good one. This is a tale that involves happy journeys on one airline as well as some scary, frustrating pre-journey ticketing experiences on another. This promises to pique your interest!

Part 1 - "The Hold"

Monday, November 30, 2009:
8 or 9pm, Eastern Standard Time
'Twas the week before my departure from NYC, whilst sitting in the living room, that I realized I had some free moments to purchase my ticket for my residency interviews in January in NYC. I needed a round trip ticket from FAT to NYC, returning from BUF. I have airline miles for a free ticket so I started exploring what options were available. Continental Airlines, an airline I like very much, just joined the Star Alliance, so I looked on their website for award tickets because the US Airways website, where my points actually are, doesn't support the type of search I was trying to do. I found the perfect flights, with one exception - the trip to NYC was a 25,000 point ticket whilst the return trip was 12,500 point ticket. No big deal - I had 34,500 miles total, so I figured I could just buy the 4,000 more miles and still be cheaper than buying the whole ticket.

I called US Airways for the first time ever (the only reason I have points with them at all is because I used to have points with America West - when they joined US Airways, my points transferred, then when I have flown United I transfer the points to my US Airways account (I will give a little hint to the end of the story here: I USED to transfer my other points to the US Airways account - probably not ever again after this experience!)

The phone was answered pretty quickly and the lady sounded like she knew what she was talking about, so I got excited that this would be a good experience! Ha! I was upfront and said that what I needed to do what going to be complicated:

Build a round trip awards tickets - I already had the flight numbers I needed, since I searched and had it up on my computer screen; I would do it myself, but the US Airways website wouldn't let me.
Put the itinerary on hold so that my account had time for the purchased miles to clear.
Purchase 4000 miles to my account

I was put on hold for about 5 minutes so she could check her "resources". That should have put me on alert where this was going. But, I stayed patient. She came back on and now I picked up the accent as she asked me, AGAIN, what my Dividend Account number was. I told her. She put me on hold again. Next, she informed me, AGAIN, how many miles I had available. Thanks, can we get on with this please? HOLD. Now, what my city of origin was (again). I told her Fresno, CA. She put me on hold again. Came back to ask whether it was CHANDLER airport!! I said no, the airport code is FAT. Hold. What is the flight number? Hold. Hold. Hold. Comes back to tell me she can't find that flight number from FAT to NYC. Now, I'm slightly irritated. I point out that the flight goes through Vegas, not straight to NYC. She points out to me that I said I'm going to NYC and now I'm changing my plans. Now I'm REALLY irritated. No, I'm going to NYC, madam, but the flight goes through Vegas. HOLD.

SUCCESS - she found that flight. We are now at around 20 minutes in the conversation. I'm ready to dunk myself in cold water. Her next question - What is your return date? SERIOUSLY?! We haven't finished building the FIRST trip yet. Oh ya. Where are you going again?

NO YOU CAN'T BE SERIOUS!!! This is when I finally say "Madam, you seem very nice, but it has taken almost 25 minutes just to do my FIRST flight and there are 4 more flights. So, please transfer me to a supervisor who can do this quicker." In my opinion, they must get asked this a lot because it was the ONE function she knew how to carry out pretty darn quickly.

Around 930pm: An agent who still has an accent, but understood everything I asked gets on the phone. With her, we build my whole itinerary with the flights I need within about 10 minutes. Great. I tell her I need to purchase 4,000 miles to have the total 37,500 miles needed to complete the reservation, so please put the reservation on hold until the miles that I purchase online clear. HOLD. She comes back and says her supervisor said that is OK, so she goes ahead and holds the reservation until December 3, she says, gives me a confirmation code, wishes me a happy holiday, and we call it a day.

This pre-Christmas tale of craziness could have ended here happily with me pointing out in one line that I called on December 3 to complete the reservation and all went well. But alas, that wouldn't really be a scary Christmas tale, now would it? So, stay tuned for Part 2 where we find out what exactly happens on December 3.

DISCLAIMER 1: Dear US Airways - Part 1 is scary, but what happened next (which I will detail in Part 2) is the truly embarrassing part (for you). And while I don't have a lot of readers on this blog, I do have a thing where I will keep writing letters to whoever needs to read it for things to be made right. So, if any of you read this, please know that I informed your agent in whatever countries I spoke with them (there were a total of 5 agents I had to go through to make this reservation - but the last one will know) that I intended to even write to US Senators until I received my money back that you stole - $80 total.

DISCLAIMER 2: Dear Continental Airlines - you came out looking like a beautiful rose in all this. Your ENGLISH speaking agent was extremely kind, understood my dilemma, and did the best she could to help. I will be contacting you about transferring the balance of my miles to a OnePass membership, if anything like that is allowed (which I really, really, REALLY hope it is!) And please know that I intend to do business only with airlines who keep their reservations agents in the USA - because in frustrating moments stuck in an airport or trying to book a complicated ticket, I want to know that the first person who answers the phone will be able to help me.

Flight Itinerary

2009-12-03T08:30:00.000-08:00

It's that time again, boys and girls! Time to get back on a jetplane and leave my mark do some exploring elsewhere again. AA once wrote me a letter on pink stationary when I was leaving for med school where she pointed out how I always "sweep in" to places and fly around a lot. I still have that letter at home - it's not often AA compliments, so you gotta keep them as true honorary mementos in the same regard you would keep an Emmy!

Not flying somewhere new this time - coming home to Fresno. My next two rotations are in Fresno and are Pediatric Infectious Disease and Neonatal ICU (Intensive Care). I will in fact be in Fresno from December 5 until the end of January. I look forward to seeing those of you whom I haven't seen in a long time and hopefully meeting some new friends as well on this journey!

Hence, here is my itinerary for my flight. Oh boy, this is exciting!!!

December 5 - Saturday
Depart JFK @ 810am on Delta 33
Arrive LAX @ 1145am

Depart LAX @ 130pm on Delta 7446 (operated by American Eagle 3060)
Arrive FAT @ 230pm

Quickies: I'm Happy, Excited, and Blessed - Oh My!

2009-11-27T09:10:00.000-08:00

1. Happy Thanksgiving
I love this season from right after Halloween up through the New Year. It's just so awesome to see people decorating and warming up for the holidays. All the festive red and green and in NYC, the window displays for Christmas - it's just awesome! So I'm happy and wish you all a very happy Christmas season! (and no, I don't do PC - it's Christmas that I am celebrating. I respect if you don't celebrate it, but I will be wishing you a Merry Christmas anyway because that is what I am celebrating - you can wish me a Happy __________ (insert your holiday in blank) and I will be just as happy for you.)

2. Exciting Times
I will be flying back to Fresno on December 5 (this Saturday). Look for another post this week that details all my flight times and itinerary...of course. I know it is more information than anyone cares about when it comes to flying, but YOU all should know by now how much of an airline freak I am - so deal with it.

3. I Feel Blessed
I have to be honest - I almost titled this post as "I'm Cramped, Cranky, and Exhausted. Oh My!" I was going to write about staying in a living room the size of my bathroom back in California (with the caveat, though, that I absolutely adore my friends who I am staying with - but even they will agree that this is a typical NYC sardine can :) And I was going to write about being Cranky at the place I'm doing my rotation because of the lack of teaching, and I was going to throw in "exhausted" because I get about 4 hours of sleep and am constantly on the go. But there is power in positive thinking! I have always been a positive person and a positive thinker - medical school and this profession keep trying to break my spirit and in some ways they have changed me. But, I must fight back. Before med school, I never would have thought to do such a negative title. Therefore, since I recognize some of the ways that med school has indeed effected me, I must fight back.

Therefore, I will say (and absolutely mean) that I'm blessed. I always have been! Where others would have been defeated, I continue to persevere. And where others complain bitterly, I'm going to borrow a couple words from the famous author, William Saroyan, and smile to the infinite delight and mystery of this great world.

I LOVE Camp!!

2009-11-04T10:54:00.000-08:00

The last two years I have been able to go to Camp Hye Sierra (Hye=Armenian for the "odars" who read my blog; odar=foreigners=non-Armenians). Camp is awesome - in fact, it is more fun as a staff member than as a camper because you truly appreciate the gift that camp is - 7 days of peace and relaxation and no worrying about any of the pressures that face us "down the hill."

And now we have an awesome video made by MY, our videographer/cinematographer/writer extraordinaire! And I even get to make a cameo appearance in the video.

Enjoy!

Med School Journey Continues - Next Stop: NYC for OB/GYN

2009-10-25T06:16:00.000-07:00

I finally will see normal vagina as I do my OB/GYN rotation next, for 6 weeks in NYC. Of course, during the OB part we will most likely see happy mothers-to-be, but during the GYN part we will see all sorts of pathology. Just remember: your vagine should not have a fishy odor or a curdly cheese discharge that smells like cottage cheese - that is bad people, very bad! (But treatable!)

I digress - if any of my readers are airline dorks like me, here is my itinerary:
Delta Flight 78: Depart LAX 730am - Arrive JFK 420pm

I will add Twitter updates during my trip, so check the sidebar on this blog, to the left, for updates about flight status or any delays.

I return to Fresno on December 5. Until then, I will be spending long days delivering babies, examining cervices, and studying for my board exam (Step 2 CK).

36 Hours in Cambria

2009-10-23T06:57:00.001-07:00

Honestly, I could have spent 36 hours in one of the dusty cities along the 99 Freeway on the way home from Los Angeles and it still would have been an amazing, fun weekend due to the group of people I was with! First, AA was there - you already know a crazy good time will be had. But then add her Aunties plus their families and big P and you know there will be lots of laughing, drinking, stories, debating, and just plain old fun.

The weekend started with a blowout football game between Thousand Oaks High School and some other team not even worth mentioning because they lost HARD. We got to see our boy BH play one major crucial play, which made it all worth it! After the game, AKH drove us to Cambria where the group was already passed out, except for a couple troopers. We talked a bit, but then went to bed ourselves - big day coming up!

The big OPOLO Wine Tasting Party Day: Saturday was spent wine-tasting at a variety of wineries throughout the area. Can't remember all the names, but it was well worth the time spent. The view alone in the area was enough to help clear your mind and relax. Then, in the evening, we joined the Opolo Winery for their annual wine-tasting: all you can drink, all you can eat, all you can dance, and all you can watch AA juggle, throw paper airplanes, kiss old men, make new friends at other tables, get the owner's attention, and just generally lighten everyone's spirits and mood! And I got to do something I never have before and may never get to do again: stomp grapes. Definitely reminded me of the I love Lucy episode where she is stomping grapes and hilarity ensues. Super cool!

If you have a free weekend, definitely consider a visit to Cambria. If the scenery doesn't relax you, the wine most certainly will - just take a Designated Driver! :)

Oh, one more thing: I took three wine glasses with me back to La Habra to gift to my host family there. Of course, it is a priceless and amazing feeling when you get the wine glasses all the way to their final destination only to drop them at the last possible moment and hear them shatter in the paper bag you had carefully wrapped and placed them in. Absolutely priceless. Therefore, I award myself the biggest doof award for said accomplishment!

Whittier College 5 Year Reunion

2009-10-18T22:37:00.000-07:00

It is an exciting time for the Whittier College class of 2004 as we approach our 5 year reunion! In honor of the reunion (and because I'm on the Reunion Committee) we made a special video to commemorate the event. Hope you enjoy!!

And PS: Coming up in a couple days will be "36 hours in Cambria"! Stay tuned!

Ya Don't Say

2009-10-14T10:21:00.000-07:00

I ran across the following headline in a NY Times Article the other day:

"Study Finds High Rate of Imprisonment Among Dropouts"

Ya don't say. And all this time I figured dropouts were making our society all hunky-dory. It's a good thing lots of money was spent to research this topic.

“We’re trying to show what it means to be a dropout in the 21st century United States,” said Andrew Sum, director of the Center for Labor Market Studies at Northeastern, who headed a team of researchers that prepared the report. “It’s one of the country’s costliest problems. The unemployment, the incarceration rates — it’s scary.”

It is scary. It is even scarier that we continue to build a materialistic society that values the Kardashian's of the world to the tune of many TV shows and millions of dollars, but pays its educators an amount inadequate to live in the communities where they teach. It is even scarier that we shell out millions of dollars in salary to folks who can throw, pitch, toss, dunk, and hit a ball, but complain about $5 copay to see our Doctor.

But I digress - point is, dropouts are bad for the economy and end up in prison at a higher rate. Shocking.

8 Hours in Downtown LA

2009-10-09T15:56:00.001-07:00

The other evening I saw downtown Los Angeles in a way I have never seen it before - as a really fun, hip, lively place to have a great evening with friends! Around two in the afternoon, my friend CKH and I took Amtrak from Fullerton to Union Station in Downtown, then continued on the Red Line Metro (Subway) a couple stops to the Bank of America Building in downtown where MH works on the 53rd floor. It was a gorgeous view from every side of the building and a great start to what would turn in an amazing evening of food, drinks/cocktails, great conversation and awesome memories.

Stop 1 - McCormick and Schmit's
CKH and I went here first to wait for MH to finish his day at work. We enjoyed the $1.99 appetizers! That's right - we got hummus, fried zucchini and cheese/bacon fries for only two bucks a plate! Only catch is you have to purchase a drink - $4.50 for a beer - but still a great deal! We spent an hour soaking in the late afternoon sun next to some staircase built in the design of some staircase in Rome. Yummy food, great times and a great way to start the evening.
Drink: Draft Shock Top

Stop 2 - Library Bar
At this point MH and our friend AS joined us as we went to this well-known and famous location! The inside has super comfy sofas next to bookshelves and deep/dark wood paneling. Great place to chill after work and catch up with friends as there isn't any blaring music you have to yell over. Sophisticated and fun. And the big fat steak fries covered in bacon grease and oil help you unwind, too!
Drink: Draft Stella Artois

Stop 3 - Rooftop Bar at The Standard Hotel
This is the epitome of super chic and hip and fun. Rooftop, 16 floors up, with cushy chairs to sit around and watch the sunset, the sky turn beautiful shades of red, orange, purple, and dark blue, and the LA skyscrapers rise up and create awesome shadows around you. Not to mention a great infinity pool if you are so inclined. This was my favorite stop of the evening. The air was crisp, perfect temperature, and the atmosphere was fun! Drinks here are a bit pricey, but well worth it for the ambiance. We didn't get food at this stop, but we were eyeing the "Mac n Cheese Balls" on the menu. If you try it, let me know!
Drink: Bottled Blue Moon

Stop 4 - Casey's Irish Pub
If you want some delicious food then this is a great place to stop-in. A cozy place, not pretentious, with great service and super yummy grub. Reasonably priced!
Drink: Draft Smithwick's

Stop 5 - Seven Grand
This place was incredible. Had MH not been guiding us, I would never have known that the unassuming entrance on the street led up a staircase to a dark-paneled, sophisticated bar and pool hall. It just gave you the sense of a place where multi-million dollar deals are negotiated over some whiskey and a game of pool. None of us really drank whiskey but they had an assortment of great beers as well. We drank while playing a game of pool (where I was surprisingly playing pretty well, which is rare).
Drink: Draft Chimay

Around 930 we headed back to Union Station to grab the last Amtrak of the evening home. All of us agreed that this is THE way to spend 8 hours in Downtown Los Angeles. But, from what we hear from MH, there is still lots of great places in Downtown...so another great evening is in the works.

Why Science Rules...

2009-10-05T15:52:00.000-07:00

With science, you can explain just about anything. I found this online and thought it was great. A little bit crude, so if you are easily offended, skip this one, but if you have a good sense of humor or are trying to develop one, then this is a great read. Enjoy!

HELL EXPLAINED BY A CHEMISTRY STUDENT

The following is an actual question given on a University of Arizona chemistry mid term, and an actual answer turned in by a student.

Bonus Question: Is Hell exothermic (gives off heat) or endothermic (absorbs heat)?

Most of the students wrote proofs of their beliefs using Boyle's Law (gas cools when it expands and heats when it is compressed) or some variant.

One student, however, wrote the following:

First, we need to know how the mass of Hell is changing in time. So we need to know the rate at which souls are moving into Hell and the rate at which they are leaving, which is unlikely. I think that we can safely assume that once a soul gets to Hell, it will not leave. There fore, no souls are leaving. As for how many souls are entering Hell, let's look at the different religions that exist in the world today.

Most of these religions state that if you are not a member of their religion, you will go to Hell. Since there is more than one of these religions and since people do not belong to more than one religion, we can project that all souls go to Hell. With birth and death rates as they are, we can expect the number of souls in Hell to increase exponentially. Now, we look at the rate of change of the volume in Hell because Boyle's Law states that in order for the temperature and pressure in Hell to stay the same, the volume of Hell has to expand proportionately as souls are added.

This gives two possibilities:

1. If Hell is expanding at a slower rate than the rate at which souls enter Hell, then the temperature and pressure in Hell will increase until all Hell breaks loose.

2. If Hell is expanding at a rate faster than the increase of souls in Hell, then the temperature and pressure will drop until Hell freezes over.

So which is it?

If we accept the postulate given to me by Teresa during my Freshman year that, 'It will be a cold day in Hell before I sleep with you,' and take into account the fact that I slept with her last night, then number two must be true, and thus I am sure that Hell is exothermic and has already frozen over. The corollary of this theory is that since Hell has frozen over, it follows that it is not accepting any more souls and is therefore, extinct..... ....leaving only Heaven, thereby proving the existence of a divine being which explains why, last night, Teresa kept shouting 'Oh my God.'

THIS STUDENT RECEIVED AN A+.

Why I Flatulate

2009-09-27T08:38:00.000-07:00

Many of you have oft questioned my air passing ways. Now, thanks to my dear 2nd mom DA, you have an excellent, SCIENTIFIC explanation as to the reason. I expect that all of you will leave me alone after this. I thank you very much.

Alleluia and AMEN!

2009-09-24T06:13:00.000-07:00

I knew the day would have to arrive eventually - 9 hours at a testing center computer, walking around with my pockets turned out all day so no "banned items" were brought into the "Secure testing zone". They are hardcore about their "test security"! But, the day came (Wednesday) and here we are - it is now Thursday and I am still alive, albeit feeling much much much lighter and happier and unstressed! Alleluia and Amen!!

For those of you wondering what I'm talking about - I took the USMLE Step 2 CK yesterday. That's a mouthful and stands for United States Medical Licensing Exam Step 2 Clinical Knowledge. In July I took the USMLE Step 2 CS, which is Clinical Skills - 12 standardized patients (actors) act out symptoms and you have to demonstrate your knowledge of communication, history taking and physical exam techniques. That was about an 8 hour day as well. But yesterday's exam was my big hurdle due to my severe testing anxiety, and now it is done! Alleluia and Amen!!!

But by the grace of God, I was calm all day, even for the first block! The way the blocks are set-up are 44 questions for each one hour block - there are 8 of those. And there is a 9th one-hour block that you can split up however you want as break time. Since each block is 44 questions, in my mind I have set-up each block not to be an hour, which is totally unmanageable, but rather, as 15 minute, 11 question blocks. I can handle 15 minutes - in fact, I can manhandle it and wrestle it to the ground and stomp on it until it taps out. And that's exactly what I did yesterday. I was PUMPED. I did 2 blocks, then took a 10 minute break. Then another 2 blocks and a 20 minute break. Then another 2 blocks and a 10 minute break. By this time my brain was really showing wear and tear because when I started my 7th block, words were blurring on the screen and I was reading, but not comprehending a thing. The 7th block was a struggle and I only had about 5 minutes of break time left, but I used it all before starting the 8th and final block of the day.

Now the waiting game begins - I will HOPEFULLY find out within the next 3-4 weeks that I passed both CK and CS. That's right, even though I took CS in July, results don't come out until October for that one. For CK, results can be sent anywhere from 3-6 weeks after the test. It is a waiting game but nothing you can do about it, so no reason to stress about it, either. At least I can relax for a few weeks! And to that I say Alleluia and Amen!!!

Many thanks to my host family in La Habra!!! Auntie J packed me a HUGE lunch with all sorts of power brain food to nibble on during breaks. Got me through the day - so if you see her, give her a big hug and say thanks! And my lovely sister-like CY had decorated the bathroom mirror with all sorts of inspirational post-it notes so when I woke up before my test, my mind was set right to succeed. Give her a huge hug too!!! And thanks to any of you who have sent me encouraging texts and emails and prayers - while I won't blame anyone if I didn't pass, I DO want you to know that my success is interwoven with and dependent upon your support and love and encouragement. My success is due to the amazing family and friends I have. So, a big THANK YOU to all of you and a huge Alleluia and Amen!!!!

Camp Hye Sierra

2009-08-22T11:04:00.001-07:00

Quick Update: I finished my Pediatric rotation at Children's Hospital two weeks ago (loved it). I went to Church Camp as the Office Manager (LOVED it!). And now I'm a recluse studying for my big board exam that has like 370 questions, 9 hours in front of a computer (plan on HATING it).

Remember that even though I won't necessarily have the time for a full blog post while I'm studying, I will do my best to keep my Twitter up to date - so just look on the left sideline to see the "Dispatches 'o the Journey" for quickie updates.

And for your entertainment, one of my good friends had made this video of our camp experience. Enjoy!

Wedding Bells and Southwest Airlines

2009-08-07T18:37:00.000-07:00

Now THIS is a story of a lifetime. Check it out by CLICKING HERE or copy and paste the link below. Two of my dearest friends and one of my favorite airlines (who I almost worked for, but for being accepted into medical school...you all know the story, where my mom said, in her cute accent: "Let me get this straight...you have a MASTER'S degree and you are going to serve PEANUTS?!?!?! Are you cuuurazzzyy?????")

http://blogsouthwest.com/blog/going-chapel-luv

Thank you Southwest for bringing my friends together...and for the free peanuts :)

Quickies: Exams, In 'n Out, and Old Friends

2009-07-28T21:03:00.000-07:00

I know it has been a while since I last posted. It has been pretty darn busy round these parts lately. Here's a little update:

1. Exams:
I took two exams over the weekend. On Thursday night, after finishing work around 630pm, I drove to Bakersfield and spent the night because on Friday morning, bright and early, I had my Surgical Shelf exam. 100 questions, multiple choice, 2 hours. Not too bad. We must pass this exam in order to pass the Surgery rotation. When that exam finished, around 1030am, I went back to my hotel, packed up, got in my car, and drove to Los Angeles. I spent the weekend at the Crown Plaza Hotel (a very nice hotel, indeed - I wouldn't want to pay the rack rate for a room, but I got the room through Priceline and was extremely pleased with the comfort, friendliness of the staff, and location - my room had a view of the LAX runways so I got to watch airplanes all weekend - HEAVEN!) Well, I didn't watch airplanes ALL weekend...the majority of my time was spent studying and preparing for my exam on Monday - the USMLE Step 2 CS exam. About 8 hours, this exam has 12 standardized patients (actors) who you must act as the Doctor for and conduct a thorough history and physical exam. Lots of fun. The exam finished right around 430pm - dreaded RUSH HOUR and my only freeway was the 405. Luckily, I was able to avoid traffic until I reached the 10 freeway, where the 405 became a parking lot. Therefore I did the only logical thing: took the 10 to Santa Monica beach and chilled on the beach for a few hours until traffic went away, then I zoomed to Fresno in about 3 hours.

2. In 'n Out:
Over the weekend in LA I spent quite some time at the In 'n Out by LAX on Sepulveda Blvd. That place is ALWAYS a zoo with a bunch of people and even more cars in the drive-thru outside. But the reason I love it, besides the food, is that the airplanes are LITERALLY just over you coming in for a landing at LAX. Took my breath away time after time after time.

3. Old Friends:
Despite being holed up on the 14th floor of the Crown Plaza studying vigorously, I still did find some time to hang out with some old friends. I saw friends from Fresno and LA and spent a little time in the evenings unwinding with them, which was super nice. I even met up with a friend who I had not seen since graduating from high school in 2000. That was pretty darn cool.

Overall, Santa Monica beach and boardwalk pretty much became my new favorite place because I spent so much time there over this past weekend. It has been just a busy month. My Pediatric rotation at UCSF-Fresno is amazing, but super busy. Between long hours there, trying to studying for my exams and actually going down to SoCal for the exams, I'm exhausted.

Time to sleep.

Hilarious

2009-07-11T10:33:00.000-07:00

A lot of the people who read this blog are deep in studying for exams. Therefore, here is a bit of comic release forwarded by AA (not the drinking group). Enjoy!

Quickies: Children are Awesome, Long Hours, Going to LA

2009-07-03T11:40:00.000-07:00

This has been an amazing week! Unfortunately, part of what made it amazing also made it extremely exhausting and left no time for a blog update. Therefore, since I today off in honor of our great country's independence, here are a few quickie updates for y'all!

1. Childrens Hospital Central California (CHCC) is AWESOME!
I am one week into my Pediatric core rotation at UCSF-Fresno. The set-up is we do three weeks in-patient at Childrens Hospital and then three weeks at Community Medical Center downtown for NICU, Nursery, and outpatient clinic. I have run into absolutely AMAZING people at CHCC! The doctors are phenomenal...and ALWAYS go out of their way to teach. Truly and truly I say to you, I have found the mecca of medical education. The Attendings will SEEK YOU OUT in order to give you the opportunity to do a procedure. They will walk you through it step-by-step, staying patient and making sure you learn it.

2. Long Hours in my First "Call"
We do "Call Q4" during the Peds rotation. What does that mean? Call means we stay late - when we are residents, it will mean 24-30 hours at the hospital. As medical students, it means we stay until around 10pm (remember, we start at 630am everyday). "Q4" means the 'dosing' - if I were to prescribe you Tylenol q6hrs it would mean you take a tablet every 6 hours. Q4 for call means I am on call every fourth day. So yesterday was my first call. I have already mentioned how awesome the Attendings are, so now let me lavish some praise on the RESIDENTS at this hospital. They are top-notch. They are kind, don't even know HOW to "scut" their med students with stupid busy work, and also go out of their way to teach! Dare I say, because of the culture and example set by the Attendings, the Residents step up their game and help create an amazing learning environment for all of us. During my call, I attended to all my assigned patients, visited some of the other cute kids in the various play areas in the hospital, and took care of some patients in the ER who needed our attention - like a 2 day old infant with suspected bacteremia (bacteria in the blood, which in such a young baby is really scary because unlike an adult who has a "blood brain barrier", a newborn doesn't have a very well developed BBB and can get meningitis REAL quick).

3. Going to LA
There's a BIRTHDAY party coming up for two amazing, awesome, hilarious sisters in LA. I'll be there...but they don't know that yet. Should be fun. AA and JC and I head down there in 15 minutes. I'm just that good that I studied this morning, got ready, packed, and wrote a blog entry before I leave. Gimme some sugaaah!

Study Break

2009-06-26T11:15:00.000-07:00

I am in Fresno, I am happy, everything is going well. I don't have any exciting stories to tell other than Fresno is still humming along as usual and everyone seems to be healthy, happy, and doing their best to stay out of the heat. Indeed, the routine seems to be unchanged since I left this hallowed ground almost nine months ago.

There are only three exciting things to report:
1. There is a very special birthday coming up for HA (yes, I know those are my initials, but it is not my birthday party...the initials actually work for other people as well!) The birthday party is this Saturday and I can't wait!

2. I am finally back in town with the ONE person who absolutely loves my stories. It helps my ego tremendously.

3. On Monday I start my Pediatrics rotation at UCSF-Fresno. I am SUPER stoked about this. They have already sent confirmation emails with all the pertinent information like where to go, who to meet, when to be there, etc. Even where to park! AND, they even list the textbooks I will need for the rotation...that they PROVIDE, including one book that I am allowed to keep after the rotation! This is truly amazing - I'm getting a glimpse of what medical education for students at US schools looks like, and quite frankly, I'm a little jealous!

Flying Home

2009-06-22T19:09:00.000-07:00

I'm coming home! And while I love coming home, I have also really come to love NYC and will miss it here. C'est la vie. I'll be back here in October anyway.

Here is my flight information. Hope to see you all in California!
And remember: I will post updates about my journey on Twitter so you can follow my journey in the air and be advised of any delays.

TUESDAY, JUNE 23

American Airlines
Flight 117: Depart JFK 2pm --> Arrive LAX 5:08pm
Flight 3017: Depart LAX 6:30pm --> Arrive FAT 7:25pm

You can track the progress of my flights by CLICKING HERE

Boo to You: Salvation Army

2009-06-21T13:00:00.000-07:00

I am introducing a new Blog Award. I am calling it the "Boo To You: Big Thumbs Down" Award. I have created this award now in response to a mind-boggling refusal by the Salvation Army to accept my basically brand new full-size mattress and box spring.

Perhaps somebody who reads this blog has ties to the Salvation Army or knows why they have some of these fairly asinine policies...because the agent on the phone with me couldn't be bothered to explain.

Here's what happened: I will no longer be living in NYC, therefore had to get rid of my bed. I tried selling on Craigslist (something that I was ultimately able to do), but at first no responses to my ad got me a bit nervous. So, I called Salvation Army. I told them I had a full size mattress and box spring that I had purchased new 9 months ago and I wanted to donate it. His response: "you don't have a frame?" No, I don't. "Then we won't accept it."

EXCUSE ME?!?! Funny, my ass was able to sleep on the bed just fine for the last nine months without a frame.

Refused.

Dude, you can just go buy a $30 frame from Sears and give a family in need the opportunity to get a perfectly fine bed!!

Denied.

WHAT?! Who comes up with this stuff? This is downright STUPID!

Therefore, for refusing to accept a great, comfortable, clean, and awesome bed that a family in need could have absolutely used, the Salvation Army has earned itself a big, FAT thumbs down and BOOOO to you!!

Surgery: Complete

2009-06-20T06:07:00.000-07:00

"Want to be a surgeon?"

If you had asked me 12 weeks ago whether Surgery was something I would consider doing, the answer would have been an unequivocal NO! That answer is no longer the case. In fact, the answer is now an absolute YES!!! It is such an amazing challenge to take a patient from their point of entry into a hospital, through their work-up, and the solution. Surgeons get to practice medicine on the floor AND take patients to the OR for further treatments and procedures. It's amazing.

The bug has bit and I'm hooked.

Quotables: Life in Medicine

2009-06-18T15:43:00.000-07:00

"Over the previous months, I had thrown myself into my work and shunned everything I once enjoyed and nearly everyone I loved. I believed I needed to do so in order to become a surgeon.

But I had lost my self in the process, and the stress made me irritable. I was no longer the nonconfrontational person I once was.

I had, for example, raised my voice a couple of days earlier at a receptionist in the radiology department when she couldn’t schedule my patient for a CT scan. I had scolded a nurse who had had the misfortune of being the fifth person to page me as I scrambled to finish a procedure. And only a week prior, I had squabbled with my family after my mother innocently asked, "Why do you have to work so hard?"

According to a study from the Johns Hopkins University School of Medicine in Baltimore, I am far from the only doctor who has behaved this way. The researchers interviewed residents, or doctors in training, from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects of their lives. While the young doctors interviewed defined well-being as a balance between all those parts, many felt that their medical training was so central to their ultimate sense of fulfillment that they were willing to live with whatever personal sacrifice was required, even if it meant a temporary loss of a sense of self."

Many of you still write to me upset that I don't call or write or update you enough. AGAIN, I apologize. But, above is an excerpt from another great article from the NYTimes about some of the struggles and challenges of the process of becoming a Doctor. I hope it gives some more insight.

Click Here to read the full article.

Or copy and paste the address below:
http://www.nytimes.com/2009/06/18/health/18chen.html?pagewanted=1&_r=1&hpw

Quickies: Californians in NYC

2009-06-13T10:35:00.000-07:00

Some of my favoritest people EVER are in NYC this weekend and we have been painting the town that beautiful brownish-grayish color that is unique to our Fresno Valley. Here's an update of some of the awesome moments of the trip so far! Enjoy!

Lo's favorite experience from her first day in NYC was seeing the musical "In the Heights". Great choice, because AA and I also loved the show - every song was powerful and moving and the storyline was a lot of fun. Great show - we recommend it highly to everyone!

The Hotel: the crew is staying at the Westin Times Square. I love the Westin and this particular property is one of my favorites. I have stayed here three times before. Well, this time the room wasn't the best. There were several problems with it. No problem - we handled it. As a result, the crew was upgraded to a room on the top floor (45th floor) and we got some other minor things comped.

Singing in the Rain: the weather has been trying to cooperate with us, but the clouds are just overpowering the sun. Luckily, the rain has, for the most part, been kept at bay. But there was a small sprinkle as we walked back to the hotel after a trip down to NYU for CY. As a result, AA, LA and I decided to take a bunch of pictures whilst sitting on the new lawn chairs on Broadway and 42nd Street in the new Pedestrian walkway (which used to be an active road for cars as recent as a month ago!)

YANKEES Game! Great new stadium. Tons of fun eating, drinking (soda of course), and watching my favorite team (the Mets) play the Yankees. Icing on the cake was definitely getting my very first baseball cap that fits my head and makes me actually look cool! I'm so excited!

The View: No, not the loquacious show on ABC with "Babwa Waltwews" (Barbara Walters), but rather, the 48th floor of the Marriott Marquis Hotel in Times Square for an all you can eat dessert and cheese bar and some yummy drinks. Definitely a great way to cap the night!

Stay tuned for more Quickies from the California crew trip to NYC!
And I'll get some pictures up here at some point as well...although they are all on AA's camera.

I'm a Supa-Stahhhh (=SuperStar)

2009-06-10T15:28:00.000-07:00

I just saw the best commercial EVER! Loved it! Watch it below...and then remember that we are all superstar rockstars in somebody's world!

The Christian Spirit

2009-06-08T12:47:00.000-07:00

I am so proud of you Brian!!!!!
Here is a great story to start the week - one of my favorite people is doing amazing things for the community. This is no surprise to any of us who know him. Keep up the great work!

A Winning Combination: Brian Allbritton needed a project for his communications class at Fresno State. As luck would have it, several weeks ago Brian bumped into a friend who worked for Chick-fil-A and they began talking about Brian’s class and the restaurant’s community service programs. Chick-fil-A sponsors fundraisers within the community, donating 15% of the proceeds to a designated local charity. Brian quickly realized he had both a class project and a fundraising opportunity for his favorite charity - Habitat Fresno! Brian has been volunteering at ReStore capitalizing on his background inconstruction. He thought that Habitat Fresno would be a worthy recipient of a fundraiser and the folks at Chick-fil-A Fresno were happy to oblige. The company's official statement of corporate purpose says that the business exists "to glorify God by being a faithful steward of all that is entrusted to us and to have a positive influence on all who come in contact with Chick-fil-A."(www.chick-fil-a.com) The chain invests heavily in community services and scholarships. They also believe that everyone, employees as well as customers, deserve a day off, so all Chick-fil-A restaurants are closed on Sundays. The fundraiser for Habitat Fresno was held on Monday, May 4th at Chick-fil-A, located at 8040 N Blackstone Avenue in Fresno. This tasty event raised $137.00! Brian also set up a wheel-of-chance where diners could spin for prizes and coupons. They raised another $27 for ReStore. Our thanks to Brian Allbritton and Chick-fil-A Fresno for their service the community and the work of Habitat for Humanity Fresno County.

Feel Good Story

2009-06-03T16:43:00.000-07:00

On the NYC Subways, there was (still is?) an advertising campaign sponsored by the NYC Teaching Fellowes Program, a program that recruits career changers to teach in NYC Public Schools. The ad campaign focuses on various aspects of teaching that would make you feel great about the profession. One of the most poignant ads said the following:

"You remember your first grade teacher's name. Who will remember yours?"

Every time I see this ad I think of Ms. Giampicolo (pronounced Jam-Pick-olo), who was my first grade teacher at PS 84 in Queens, NY. She was an amazing individual who did a superb job of challenging her students to greater learning. And I think of Ms. O'Connell, my second grade teacher, and Ms. Schubert (3rd grade), Mr. Hatch (4th grade), Ms. Wells (4th grade), and Mr. Cooley (5th and 6th grade). I think about the myriad of amazing teachers I had in middle school and high school, many of which I still keep in touch with to this day. They made and continue to make a profound difference.

And so it was, that when one of my favorite people in the world sent me the following link, I was moved so much. It is a story done on the First Lady's commencement address at UC Merced. You have all heard of this, I'm sure. The more exciting part is when they interview Ms. Claudia Zepeda, one of the graduates. Ms. Zepeda was the third grade student of a dear family friend. Ms. Zepeda still keeps in contact with her dear teacher from 3rd grade, a testament to just how great this teacher is and how much of an impact a caring, passionate, positive influence can make in the life of a child.

Check out the link below to see the story. And if you get the chance, surprise an old teacher who made an impact on your life. As a former public school teacher myself, believe me when I say there is no greater reward for a teacher than to get a little update from your children.

http://www.kmph.com/global/video/flash/popupplayer.asp?clipId1=3768947&at1=News&vt1=v&h1=Students+Worked+Hard+to+Woo+First+Lady&d1=367633&redirUrl=www.kmph.com&activePane=info&LaunchPageAdTag=homepage&clipFormat=flv&rnd=36707950

Quotable: Life Goals

2009-06-01T20:06:00.000-07:00

“Dear Lord, make me the kind of person my dog thinks I am.”

My dog, Lucky (pictured), thinks I'm a God. There is no person or thing that my dog likes more than me. My goal, therefore, as a Doctor to be, and a human who gives a hoot about others, is to live up to the amazing, out of this world, king that Lucky thinks I am.

End of An Era

2009-05-31T06:20:00.000-07:00

Friday was a very giddy day for me - it was the last day I have to arrive to the hospital for 6am start time!!! Yes, that's right, starting on Monday, I don't have to be at the hospital until 8am!! Why? Because I start the Burn Unit on Monday, an experience that by all previous accounts will be both amazing, humbling and very rewarding.

And while I'm of course excited to learn a lot in the Burn Unit, it really comes down to this: 2 MORE HOURS OF SLEEP YO!!!

Everyone be aware: I will be much happier for the rest of the Surgery rotation.

Oh and one more thing: For all those who received a very holly, jolly, laugh out loud happy call from me last night in celebration of the end of 6am wake up time for at least a few weeks, please know that you likededed it.

Day in the Life: Surgery

2009-05-26T05:41:00.000-07:00

Surgery is unlike any other beast, in my admittedly limited medical school experience. You get to participate in front-line patient care on the hospital floor, just like the internal medicine doctors. But you also get to take what I call "breaks" - which are actually hours in the OR (operating room) helping a patient fix a very specific problem or issue. It is all fascinating, quite frankly! Here is a glimpse of a typical Tuesday or Thursday, which have morning lectures:

520am: My alarm clock starts singing the latest permutation of "I want to have sex with you in 18 different positions" hip-hop song on the radio. I have taken my friend NK's idea of putting my alarm just out of arm reach, so it forces me to get up at this unGodly hour!

530am: Actually get up to pee then return to bed. Yes, I know this is probably TMI for some of you, but if not for having to use the potty, I wouldn't move. I'd stay in bed for another 10 minutes. As it is, I return to bed for those precious minutes!

540-555am: Realize if I don't get up really quick, the ticker will add another tardy to my stone. Get up, shower, put some scrubs on, brush the teeth, comb the hair, grab the cell phone and start walking toward the door...turn back and grab the wallet and start walking toward the door...turn back and grab the house key and start walking toward the door...turn back and grab the car key and start walking toward the door...glance back to make sure I haven't forgotten anything else...exit and walk to car.

6-607am: Arrive to hospital, floor 4B for our AM rounds. Grab the "Lab Book" as it is my duty to rattle off the previous day's labs for each patient when prompted for them by the resident. I sure hope there is a question on the USMLE Step 2 exam about what button to click to make the computer give you the labs...because I will ACE that part of the exam! (And no, there are no questions about how to retrieve labs...please pick-up on the sarcasm here.)

7-8am: Lecture #1

8-10am: Lecture #2

10-11am: Lecture #3

7-11am on Monday, Wednesday, Friday: Go to the OR and find a surgery to scrub in and absolutely be amazed at what a human being's insides look like! It is really quite incredible to put your hand on the intestines or see the heart beating or see the lung inflating, or even to just stitch someone back together!

11am-12pm: Copy labs from computer to lab book.

12-1pm: Lunch

1-2pm: Study a bit in the library because I have a big exam coming up in about 3 months.

2-3pm: Afternoon lecture

3-?? pm: Go to another surgery, help on the floor

4-8pm: Usually somewhere in this window, head home.

Realize that this whole schedule gets turned on its head when a trauma arrives to the hospital. My location is a Level 1 Trauma, but we are in Staten Island so we're not seeing a steady influx of GSW (Gun Shot Wound) patients. Instead, we see a lot of falls or motor vehicle accidents, or once, the stab wound patient (see previous case files on the subject). As a med student, we usually are taking the History and conducting the physical exam on the patient as the surgeons/doctors are conducting the close inspection and giving the orders for what tests to do and when to do the next step in our assessment of the patient. It is always more interesting to see a surgery on a patient that you have followed from their initial arrival to the hospital, as opposed to seeing a random surgery where all you see is the small surgical window...sometimes, not even the face of the patient!

The goal after going home, of course, is to study. This is done with mixed results on most days. Sometimes I am able to accomplish my study goals for the afternoon. Most days, however, I'm just exhausted and get home in time to crash on my bed and go to sleep. The sounds of "Lets have sex in a restaurant" hip-hop song will ring in my ears before I know it.

Remembering Our Fallen Heroes

2009-05-23T06:04:00.000-07:00

God Bless America

Case Files: Stab Wound

2009-05-21T08:35:00.000-07:00

Presenting Scenario: 48 year old patient presents with a 2 inch laceration on the right lower quadrant of his abdomen. Patient reports that suspects the stabbing occurred that morning around 4am...it is now 1pm at presentation, due to "dizziness". Patient is lying comfortably on bed, seems to be in no apparent distress, but keeps asking for a telephone to call family.

Trauma Room Decisions: The patient refuses to allow the Doctors to insert their finger into the wound and explore how deep it is. Patient becomes combative any time we try. This leaves us with a difficult decision. Either we take patient to CT scan to see if there are any deep injuries to internal organs that could result in a sudden change in status, or we just rush patient up to the OR (Operating Room) and start the operation there under anesthesia. Decision was made to take patient up to the OR.

Diagnosis: Superficial wound. Yes, we rushed the patient to the OR, put patient under general anesthesia, and then were able to stick our finger in the wound...to find nothing. The wound barely even got through any fat layer.

Surgical Procedure: Stitch up the wound.

Results: Patient is fine. Was offered alcohol and drug counseling due to addictions, but otherwise, is fine.

Note: Picture is not from the actual patient's wound.

Guest Post: Explaining Derivative Markets

2009-05-20T08:23:00.000-07:00

If you are like me, the whole bank bailout business confused the dickens out of you and it doesn't seem to quite make sense why billions of tax dollars had to be spent to bailout a few banks that misbehaved and didn't follow sound banking principles. Luckily, a dear reader of my blog, DJA, sent this explanation to me regarding how it works. Enjoy!

Heidi is the proprietor of a bar in Detroit . In order to increase sales, she
decides to allow her loyal customers - most of whom are unemployed
alcoholics - to drink now but pay later. She keeps track of the drinks
consumed on a ledger (thereby granting the customers loans).

Word gets around about Heidi's drink now pay later marketing strategy
and as a result, increasing numbers of customers flood into Heidi's bar
and soon she has the largest sale volume for any bar in Detroit .

By providing her customers freedom from immediate payment demands,
Heidi gets no resistence when she substantially increases her prices for
wine and beer, the most consumed beverages. Her sales volume increases
massively.

A young and dynamic vice-president at the local bank recognizes these
customer debts as valuable future assets and increases Heidi's
borrowing limit.

He sees no reason for undue concern since he has the debts of the
alcoholics as collateral. At the bank's corporate headquarters, expert
traders transform these customer loans into DRINKBONDS, ALKIBONDS
and PUKEBONDS. These securities are then traded on security markets
worldwide. Naive investors don't really understand that the securities being sold
to them as AAA secured bonds are really the debts of unemployed alcoholics.
Nevertheless, their prices continuously climb, and the securities become
the top-selling items for some of the nation's leading brokerage houses.

One day, although the bond prices are still climbing, a risk manager at the
bank (subsequently fired due to his negativity), decides that the time has come
to demand payment on the debts incurred by the drinkers at Heidi's bar.

Heidi demands payment from her alcoholic patrons, but being unemployed
they cannot pay back their drinking debts. Therefore, Heidi cannot
fulfill her loan obligations and claims bankruptcy.

DRINKBOND and ALKIBOND drop in price by 90%. PUKEBOND performs
better, stabilizing in price after dropping by 80%. The decreased bond asset
value destroys the banks liquidity and prevents it from issuing new loans.

The suppliers of Heidi's bar, having granted her generous payment extentions
and having invested in the securities are faced with writing off her debt and
losing over 80% on her bonds. Her wine supplier claims bankruptcy, her beer
supplier is taken over by a competitor, who immediately closes the local plant
and lays off 50 workers.

The bank and brokerage houses are saved by the Government following
dramatic round-the-clock negotiations by leaders from both political parties. The
funds required for this bailout are obtained by a tax levied on employed
middle-class non-drinkers.

Finally an explanation I understand ...

TESTING New Site Design

2009-05-19T15:31:00.000-07:00

I have a new post for today, located just below this one. But I wanted to make a quick acknowledgment of the new site design! There were a few hiccups in the transition to this new design - for example, I lost all my links to other blogs I read. I was able to recover some of them, but if I lost you and can't remember your web address off the top of my head, PLEASE email me and let me know your website address again! There are a couple other problems that I'm discovering as I go, so I may very well revert back to the old site design or try a different one altogether.

As you can see, the new design captures a beautiful site off the Brooklyn Bridge...something I get to see often! It is more hip and urban. It also allows me to display my Twitter updates more prominently while also allowing easier access to the Category links so you can more easily access past posts on the blog. Yes, "easy access" was key here (and "that's what she said!")

Please hit the comments and let me know what you think! If the majority don't like it, I'll go back to the old design...or find another new one!

5 More Weeks

2009-05-19T07:11:00.000-07:00

Today marks the official start of my unofficial countdown to coming home for the summer! I leave NYC on June 23 at 2pm and arrive into FAT (Fresno Air Terminal) at 7:25pm on American Airlines Flight 3017. I love NYC, but it will be nice to be home for the summer! My tentative schedule for the summer AND the rest of my medical school career is as follows:

Pediatrics: June 29 - August 7 in Fresno
USMLE Step 2 CS: One Day Mid July in LA
Exam Prep: August 7 - September 11 in Fresno
USMLE Step 2 CK: One Day Early September in LA
Psychiatry: September 14 - October 23 in LA
OB/GYN: October 26 - December 4 in NYC
NICU: December 7 - January 1 in Fresno
Peds Infectious Dz: January 4 - Jan 29 in Fresno
Elective: Feb 1 - Feb 26 Location TBD
Elective: Mar 1 - Mar 26 Location TBD
Elective: Mar 29 - April 23 Location TBD
Elective: April 26 - May 7 Location TBD

As you can see, after this summer, I will go straight from September all the way to May without time off...but it will payoff because come May 7, I will finally be known as Docta A!

But alas, this post is about coming home in five weeks! And of course, I will be using my favorite airline...because THEY KNOW WHY I FLY! (And PS: MAJOR kudos to anybody out there who can tell me the name of the American Airlines theme song in the video below and where I can get a copy of it. I love this song! Major kudos...like a Tiffany's ring!!!!)

Case Files: Orchidopexy

2009-05-17T08:50:00.000-07:00

Presenting Scenario: A 7 year old boy presents to the outpatient surgeon due to a referral from the Primary Care Pediatrician. He has a suprapubic lump on the left side. Patient's mother denies pain, nausea, vomiting, diarrhea. On physical exam, there is a palpable lump, easily movable, located just above and lateral to the penis.

Diagnosis: Prepubic undescended testicle on the left side.

Surgical Procedure(s) Ordered: Orchidopexy; the surgeon first makes an incision near the site of the undescended testicle, similar to how he might make an incision to fix a hernia. We carefully dissect through the layers of the fascia and muscle until we reach the testicle. Next, through a series of maneuvers that see the gubernaculum (100 points to whoever defines what this is in the comments) released from the testicle and pushing back the perineum and other structures in order to free up more of the spermatic cord so we can pull the testicle down through the scrotal sac. Finally, we stitch the testicle into place and then stitch the outer skin of the scrotum over it to make it look like normal.

Results: This patient had no surgical complications and is fine post-operatively! However, it should be noted that patients with undescended testicles have an increased risk for testicular cancer - even after we fix the undescended testicle. Therefore, this patient will need to be followed closely for the rest of his life. If there are any signs of the cancer, removal of the testicle will become necessary immediately. Some signs of testicular cancer include:

A lump or mass in either testicle
Any enlargement or swelling of a testicle
A collection of fluid in the scrotum
A dull ache in the lower abdomen, back, or in the groin
A feeling of heaviness in the scrotum
Discomfort or pain in a testicle or in the scrotum
Enlargement or tenderness of the breasts

Lecture on How to Give Lectures

2009-05-14T13:57:00.000-07:00

I was invited by the Surgical Program Director at Staten Island University Hospital, an awesome man who puts student learning first, to deliver a lecture today to all the Surgical Resident. The topic? How to Lecture.

Quite the honor! I felt humbled to speak in front of all these super smart people. There were about 30 residents and a handful of Attendings were also present since our M&M Conference (Morbidity and Mortality) was right afterward. Of course, you gotta impress people with a shnazzy title, therefore I called my lecture: "Increasing the Effectiveness of the Lecture Modality of Teaching". Pretty shnazzy, eh?

The highlight of my presentation came after I was done; this room full of amazingly smart people was extremely thankful for the ideas! They thought I was offering absolutely earth-shattering suggestions that will indeed move the Earth off orbit. Little did they know that for all of us teachers out there, this is "Maintaining Sanity in a K-12 Classroom: 101".

Unfortunately, I don't know how to link the PowerPoint to this post. If you want to see the PowerPoint, let me know and I can email it to you. But really, most of what makes any presentation by me tolerable and interesting to listen to, is my goofiness whilst presenting.

Quickies: California Sunshine, Surgery Exhaustion, and Stupid Passengers

2009-05-10T14:52:00.000-07:00

1. California Lovin': I was in California from May 1 to May 3 for a dear friend's wedding in LA. It was awesome. Being back in Cali really reminded me why I love California! I had not been back since October and, although I love NYC, there is no place like home. I can't wait to come back to Fresno on June 23...just in time for the ridiculously hot summer months!

2. Surgery Exhaustion: I was hoping to get a new post out before it happened, but alas, my good friend NK called me out for taking too long to post. I gotta tell you - having to report to the hospital by 6am really knocks the wind out of me for the entire day. I am NOT a morning person. Not trying to make excuses, just telling the honest truth: by the time I reach the end of the day, around 6pm, I'm totally and completely pooped! I haven't even gone to the gym for almost three weeks now. My weight loss goals are not being reached, my nutritional goals aren't being reached, and quite frankly, I can't even study as much as I would prefer. I would much rather work from 10am to 10pm rather than 6am to 5pm.

3. Stupid Passengers: OK, I absolutely CANNOT believe this. As you may know, a Southwest Airlines flight had to conduct an emergency evacuation after its right side tire caught on fire after landing. Luckily, all passengers made it off the airplane safely and nobody was harmed. All was good, thank God. BUT, UNFORTUNATELY STUPID PASSENGERS ARE ALLOWED TO TRAVEL. Take a look at the video below - feel free to fast forward to about minute 3:45 and then watch the back slide closely. That's right, it's a suitcase floating down the slide. And yes, that's right, there is a STUPID PERSON coming down and stopping to pick up the papers!!!!!!!!!!! Are you kidding me?!?! Really and truly - the TSA needs to add CT machines at the security check point just to make sure there aren't passengers loading the plane who are completely and totally missing a brain!

Pictures Are In!!!

2009-04-30T03:00:00.000-07:00

HELLO ROOM 15!!!!!!!!!

How are my faaaaaaaaavorite 3rd and 2nd graders doing? I miss you guys! And I must ask you to forgive me for taking so long to add the promised updates - specifically, my pictures! I am currently rotating through Surgery and that means I have to be at work by 6 am and usually don't finish before five or six at night. Plus, I couldn't find the wire that connects my Blackberry phone to the computer. But, I finally found it this morning (at 545am before I leave for the airport) and wanted to post the pictures before I left! I hope you enjoy them.

Quick POINTS OPPORTUNITY: 100 points to the group who can find the answer to the following Surgery question: Where is your appendix found? What do we do if your appendix gets inflamed?

I heard one of the groups found the answer to the Empire State Building question! Congratulations!

REMEMBER: You guys are awesome and I can't wait to see all the amazing things you all will accomplish! Have a GREAT day in school!

Cheers, Hovig (Mr. A)

PICTURE LEGEND:
(Click on the pictures to enlarge them)
1 and 2: My FAVORITE toy store in America - this place is HUGE guys!
3: This is the Tiffany's store that Mrs. and Ms. A have often spoke about. Guys - stay away!
4: A huge skyscraper for you guys! There are TONS of them in NYC.
5: Me in the subway with a subway map behind me.
6: NYC skyline with big skyscrapers at night from the Staten Island ferry. (50 points: What is a ferry?)
7: Famous NYC Hot Dog Vendor.
8: Me at Bryant Park on a beautiful day with a skyscraper behind me.
9: Picture of a bridge and skyline while I was on a subway on another bridge.
10: From my DC trip - the Cherry Blossom Festival. (50 points: What monument is behind me in the picture?)

UPDATE: Favorite Airline - The Answer

2009-04-27T06:38:00.000-07:00

UPDATE: Results are in! Many of you responded with some great ideas - I have now included the answers to my Favorite Airline List with some explanations - the results may surprise you!

1. American Airlines
2. Virgin America
3. Southwest
4. Air New Zealand
5. Continental
6. Delta

Surprised? If I guess correct, you are probably most surprised about my favorite airline of all - American Airlines. I must admit, it is a love/hate relationship. I hate that management at the airline has created a hostile place for its employees and that hostility sometimes seeps its way into how they treat us, the travelers. But for almost two decades, AA has reliably brought me home, sometimes even with a smile and kind, welcoming service. None of the other airlines on the list have as many convenient flights to my home airport, and for that, I am grateful to AA for never giving up on my airport. Therefore, the top spot in this list belongs to American. HOWEVER, take note Virgin America or Southwest - you start flying to my home airport and you have a great chance of taking over the top spot.

I also want to note that American's Frequest Flyer Program, "AAdvantage", is awesome! I have found it to be the most flexible with the greatest ease of reward redemption. While in St. Maarten for two years, I flew American Airlines every time, and was able to fly free with reward points almost every time...even first class once!

Most of you guessed that Delta would be last on my list. I want to point out that they are last not because I think they are bad, but because it is right next to impossible to book a reward flight with their SkyMiles Awards program.

After posting, I realized that Air New Zealand didn't really belong on the list - not because I don't like it (I LOVED it and it EASILY could be first on the list - good job 98 on your guess), but because it only offers limited service to very limited destinations that are useful to me.

Finally, many of you put SWA pretty high on the list. It is true that I'm infatuated with the airline - I almost worked for them! But I mostly love how well they treat their employees; in terms of flying them - they offer limited service to my desired airports and quite frankly, I'm not all that excited about non-assigned seating.

Thanks to all of you who participated! I am now convinced that I have at least six faithful readers every week!

The following was the first post from last week inviting you to respond: It has been a while since I have done an interactive feature on my blog. So, in order to see if ANYBODY is actually reading my blog, we are going to do something a little fun today. One of my favorite things EVER is flying. I love airplanes, airlines, airports, airplane food, airplane smell, airport lines. I love everything flying!

Therefore, I have included pictures from some of my favorite airlines above. Hit the comments and rank the airlines in the order you think I like them, from MOST favorite on top to LEAST favorite on the bottom. Have fun and I look forward to seeing what you all think! I will post answers in a few days!

PS: To leave a comment, click on "comments" at the bottom of this post. Then, choose the option that says "Name/URL" or "Anonymous", leave your comment, then click "Publish Your Comment".