My friend and fellow surgery resident, Trung

My first Christmas Tree, but I succumbed to a faux tree. Who would of thought a northwesterner would have a fake tree?

Thanksgiving dinner at Dean and Rhonda's house

I am over half way through my month of working nights in the hospital. I can't wait to be done and feel human again! When I get some time I will have to post a couple of the highlights of my month. A hospital at night can occassionally be a quiet place, but it more often than not becomes a bit of a psych ward. :o)

A month of nights has definitely matured me as a physician though. You grow up fast when you are it!

For those of you with blogs out there, I love staying up on your lives via them, so thanks for posting often.

General Motors Building

A classic view of Detroit landscape when looking in the opposite direction of the GM building and waterfront. The city is being revitalized but there are many reminders of the Detroit Riots and the mass exodus to the "burbs."

Burning Bush in Front Yard

 

Bonzai in Autumn

 

My Walk in Elizabeth Park Today...

"Still Life"

Swamp Grass --Gone to seed & basking in the autumn sun

Symbiosis or Parasitosis? Who is benefitting? The tree is made beautiful by the vine, but the vine is given its life by the tree

Autumn's "Chili Pepper"

Winter creeping in

The typical "Monet" shot

"Aged Beauty"

cold weather breaks up cement, much like all the local roads in the area

The end of the thissle's life cycle: Full of character despite it's nasty reputation

 

Want to be inspired...Checkout this blog. Part of this group of people are former Trout Lake residents, now Portlanders.

http://lahash.blogspot.com/

PATHOLOGY of DETROIT
I am sure many of you have heard me say that Detroit is not the most desirable location to live, but one of the best places to see pathology and learn medicine. This past week has confirmed that for me once again. Surgery was consulted to see a head and neck cancer patient, concerning the placement of a feeding tube into the pt's belly, so I went to the floor between surgery cases to meet the pt. What I found was truly a "Phantom of the Opera" picture. This pt has had face cancer for over a year, and has never been to an MD/DO for care. He is barely able to speak anymore as the tumor has completely overtaken the right side of his face from his eye ball to his jaw. This patient's tumor is equal to the worst cancers I have seen in Africa. This patient is a real lesson in the importance of building rapport and trust with your patient. He has a complete distrust of physicians, and believes that we are not there to serve his best interests. This patient has been cared for solely by a naturopathic physician, who unfortunately has done a disservice to this patient. I don't want to harp on alternative medicine, for I will be the first to say that it has its place in medicine, but when distrust of western medicine leads to the neglect of a patient's care something is clearly wrong. Not only is this patient in complete denial of the extent of his disease, but he was even slow to sign a consent form for the placement of the feeding tube because he thought we might harvest his organs. Everyday is a complete education for me!

Good news for PIH!

Click on this photo

If humanitarian projects inspire you, I highly recommend you read the book about this organization called, "Mountain Beyond Mountains." For more information go to "links" and click on "Partners In Health-Paul Farmer"

"Hint of Autumn"
PJ Hoffmaster State Park

Me at Lake Michigan shoreline in PJ Hoffmaster State Park, 9/25/05

Eastern Shore of Lake Michigan

My campsite this past weekend at PJ Hoffmaster State Park just ouside of Grand Haven, MI (30 mintues west of Grand Rapids) First time to use my REI "MORPH" tent. I loved it!!! Can't wait to use it again.

BIG week for the intern

I am doing my ICU rotation, and as a surgery bound intern I have jumped at every opportunity to put in a central line or any other procedure that is needed, so as a result I have done 7 lines this week. In addition, I was on surgery call for the weekend and had the fun experience of caring for a patient who was panic stricken by the sight of her own blood shooting across the room from her leg after a central line was pulled and the nurses were unable to stop the bleeding. As all call weekends are destined to go, I was on my way out the door when the pager "beep" goes off requesting I come see this patient, which then inevitably led to more pages and me spending an extra 6 hours in the hospital. I am learning that part of being a physician is being the calm in a storm. It is very therapeutic for a patient to see that the doctor is calm and collected in the face of what appears to be dire straits to the patient. I guess my calming presence was helpful, because as I held pressure over the bleeding site, the patient went on to tell me her rather horrific life story. Basically a "Jerry Springer" type life. Good times. ;o)

In other news... I bought two trees last week, but have yet to plant them in my yard, but when I do I will take their picture (of course) and post it on the blog :o)

Later-

Me, doing what I love. Photo by Audrie Lambert

A lesson in sharing...

...Or maybe just bonding

The crew on White Salmon River Rafting Trip. Everyone enjoyed Husum Falls this day! September 3, 2005

My incredible aunt and uncle

Sister with 2nd cousin

Never shy of the camera

Not shy of the camera

Yummy!

My Niece -Beautiful eyes!

GABE enjoying rib dinner

"Copper" Sunrise at Brightland Kerr Farm

Beautiful Redhead!!

Sleeping Beauty at Sunset from Witch's Wart

Mt. Adams from Sleeping Beauty

Mt Adams Sunset from Ekhert Point

September 7, 2005

I returned yesterday from amazing weekend in Trout Lake, Washington. We had a family reunion that reunited all siblings for the first time in two years, as well as my uncle, aunt, and cousins from Sonoma, California in 5-10 years. I got to guide my relatives down the White Salmon River, hike sleeping beauty, eat like a king, and socialize to my heart's content.

Caleb and Katie (Newly Engaged)

Beloved Mt. Adams from the rock face of"Sleeping Beauty"

On the patio at my parent's this past weekend.

Cardiology 8/1-8/31

Recap of first day.
First consult: Feel like I'm back to being a medical student as I try to recall the relevant questions pertaining to one's cardiovascular system.

Second Consult: Much improved from the first

Third consult: Pt needs to be seen for pre-operative cardiac evaluation. While talking with the pt, I learn that he has very severe heart disease and has been denied coronary bypass surgery on the basis that risk of surgery outweighs the potential benefits. While talking with the patient he goes in to respiratory distress. I call a "code blue." Pt is intubated and CPR with advanced life support protocol is performed for 25 minutes. Pt dies.
Not the best first day! Consultation recommendation: Not a surgical candidate...

Since that day, I have been involved in 5 more code blues. All the nurses recognize me as the doc with the "black cloud." I am beginning to believe them.

I am convinced that cardiology and I don't get along too well. I am glad that I have chosen to study surgery instead. It is really nice to diagnose and treat patients that have a fixable problem and greater likelihood of recovery.

Below are my recent decoration additions and two collages:

Collage #1: My new "PET"

Collage #2: Detroit Tigers Game

Copacabana Beach, Rio De Janerio. Photo by me 2/05
Photo in Livingroom

Angra Des Reis, Brazil. Photo by me 2/05
Photo in Kitchen

My new "pet". I bought a 25 year old Japanese Maple Bonzai tree. I call it my pet because it requires daily care and has to be taken outside 3-4 days per week. It rocks though, because it does not shed, releases no allergens, and does nothing but look beautiful. Awe, the ideal pet in my book.

Last weekend at Comerica Park: Detroit Tigers Game

I am already in my finally week of my first rotation. Life is a whirlwind, and I am enjoying every moment. My first weekend was quite memorable, as the attending and I stayed busy covering for three other surgeons. On Saturday I was in on a good case, where a gentlemen came into the E.R. with acute abdominal pain. After a thorough work up and reviewing of films it was decided that the patient needed to be taken to the O.R. for an exploratory surgery to rule out necrotic (dead) bowel secondary to ischemia (lack of blood supply), and/or small bowel obstruction. We found that the patient had an internal hernia, which in this case meant his bowel had slipped through a hole in his omentum (fat apron over bowels), causing the bowel to be strangulated and on its way to dying. We were able to free up the bowel, and it was early enough that the bowel regained its blood supply and recovered. This was one of those cases that causes you to go home feeling that you have made a good decision about being in medicine. It is a great feeling to know that the procedure performed saved a life. The patient returned home 6 days later, with a fully functioning bowel, and a 8 inch scar down his belly.

Other than medicine....
I had this past weekend off, so I got up early on Saturday and washed all the windows to my house, then cleaned my garage out, before attending a pig roast that afternoon. I got selected to be the carver of the full size pig that was roasted on a spicket. I figured it was a good opportunity to pick up a useful "life-skill" of carving the meat for the feast. That evening I went to the Detroit Tigers game and watched the Minnesota Twins beat us. I have hardly been to a pro-baseball game since high school, so it was fun to be back in a park. However, I was surprised at how boring a game is when you don't know any of the players. Back in high school there was hardly a player I didn't know, now I don't know anyone on the field. It was quick reminder that 10 years have gone by.

This is my home in Michigan. I am saving the landscaping for the fall or next spring, so all the work thus far has been done on the inside. Below are photos showing the results of my past month of painting, laying flooring, decorating, and building IKEA furniture. The home has an In-law suite in it, so there are two kitchens, two baths, two livingrooms, and three bed rooms. The in-law suite is fully attached, but has a private entrance, and can be closed off from the rest of the house, therefore I intend to rent out that portion as an apartment.

Kitchen with IKEA table and chairs. Painted it yellow, otherwise unchanged from when purchased.

Living room and entrance to kitchen. Painted the one wall orange and framed it in with white molding. Bookshelves from IKEA.

Kitchen and part of living room in rental portion of house with new maple wood laminate flooring from Costco

Living room with sofas from garage sale and shelving from IKEA