The Hippocampus

Thanksgiving on the Beach

2006-11-27T20:37:00.000-08:00

This year we had Thanksgiving a little differently than in the past. The McMillans, who are really good friends of our family, invited us down to have dinner with them in Houston and then to come with them to their new beach house in Matagorda Bay for the weekend. My parents took this opportunity to drive down from St. Louis.

Dinner of course was wonderful at their house. Their two girls, Amie and Carrie, did all of the work cooking and preparing the meal for us to enjoy which included all the fixings. Turkey, mashed potatoes, rolls, an outstanding pecan stuffing, and an authentic Hungarian macaroni and cheese were all present. Kristi and I also made a pumpkin cheesecake the night before to bring as well which turned out to be a very successful hit for all present. The dinner was very delicious and before too long we were all happily stuffed. It was just in time to watch the Cowboys play too! We left for the beach house before the game was over, but we listened to it on the radio to hear that they beat the undefeated Indianapolis Colts in a really well played game by them! It was exciting to hear them playing so well again, with a new quarterback that is receiving lots of attention as well. It took us about 2 hours to get to the beach house, which is really nice and very well decorated by Carol already (which of course was no surprise to any of us). We drove out to the beach that night and walked down the jetty. The weather was amazing and the skies were crystal clear, perfect for star gazing. I was able to give K some lessons about the constellations as well.

The next day brought breakfast and the annual big football game with the Aggies against the Longhorns, for which we all gathered anxiously around the TV to watch. This football season has been filled with so many heartbreaking losses already, that I think none of us were expecting much of anything. However, the Ags proved us wrong and took down the Longhorns for the first time in Austin in 1994 with a score of 12-7. We were all screaming and really excited we couldn't really believe it.

Les has a boat attached to his pier and after the game we all took a ride down the Colorado river to the beach. On the way we even saw a friendly dolphin in the river as well who came up several times near out boat. They let us out on a beach that doesn't allow road traffic and we walked up and down for about 2 hours. The girls were mainly interested in the many many seashells that littered the beach, I saw a good opportunity to take some photos.

Matagorda 2006

After sunset, wet got cleaned up and had some outstanding seafood at a local restaurant before heading back to the beach again for a nice campfire, hot chocolate and s'mores. It was really nice with the fire crackling, and the shooting stars coming down from up above. Made it really easy to forget the wards on Ob-Gyn. It made for a really nice holiday as well. We all had to pack up and leave on Saturday morning. It was goodbye to the McMillans and my parents as well. It was a really nice excursion, but also a very fast one, and before we knew it, it was back to the busy work week at hand.

On the Interview Trail once again...

2006-11-27T20:05:00.000-08:00

Part of being a 4th Year Medical student includes the inevitable transition from being a student, to being a doctor. A big step in this process is choosing a specialty in which you want to practice in, and where you would like to learn this trade. For medicine, this process is called the residency. After graduating from medical school, the new doctors enter into a residency where they continue their training specific to their career goals, such as in orthopedic surgery, or cardiology. Most of the time as a 4th year medical student is spent in applications and interviewing for the different residency programs that are available.

My application for a residency in Emergency Medicine is now complete and I have started on the interview trail. I'm already lucky enough to have one interview behind me. When I did my away rotation at UT Houston (which is practically right across the street) they went ahead and interviewed us there on the spot to save us from having to travel back once again--again not much of a deal for those of us that already live in Houston, but a great deal for those who do not. So for me, my first real "away" interview was a week ago at Scott and White Memorial Hospital in Temple, Texas. Again, not very far away, but it did involve some traveling. Scott and White was the program that I spent a month at in August and was really impressed with on many levels. I loved the small town nature of the area, yet the business of their emergency center and the quality of the training available. The staff and residents were extraordinarily friendly and easy to get along with. In January, they also have a brand new, very large emergency center opening to brag about as well. Temple is also where Kristi will be doing her clinical years for her medical school as well. So I definitely have a lot of reasons to have S&W as my first choice.

The night before the interview, the residents hosted us for dinner at a local restaurant as kind of a meet and greet ordeal. Kristi was able to make it and I think we all enjoyed ourselves. I was familiar with all the residents who were there that night, so it was more of just catching up than meeting. There was one other student from Baylor there that night, but I've never shared any activities with him, so I really didn't know him that well. This was our opportunity to "get the dirt" on the program, or in other words, the information that we wouldn't really feel comfortable getting from people at the hospital on the day of our interview. It was very comfortable and laid back, and I think everyone enjoyed it.

Kristi's parents were gracious enough to let me stay at their house again overnight for this weekend stay, even though S&W offered to pay for an overnight stay in one of the local hotels. It was really nice of them considering most programs do not offer as much. The interview day started bright and early with a tour of their brand new Emergency Department. It's so new that it's not even open yet. We had to wear hard hats and safety goggles and dodge the construction crews. It was very impressive however, and much larger than their current space. If I did happen to come to Temple, it would be a very nice place to work and learn, state of the art as well. Dr. Stallard then gave a presentation of the program which was very thorough and informative and interviews quickly followed. I interviewed with Drs. Stallard, Stone, Greenberg, and Tobleman, all of which I knew, and were familiar with me from my stay in August. I definitely learned of the importance of visiting a program you were interested in and getting to know people beforehand. All of the interviews were very laid back and comfortable. Most simply wanted to know what I had been up to since my visit. They also all gave me a very good impression that I would very likely have my first choice in a spot for residency. That much was very encouraging.

After the interviews, they took us out to eat in downtown Temple at a very nice restaurant called Cheeve's, which they provided for again. Overall, it was a very positive and laid back experience which only solidified my reasons for wanting to go there. Now I just have to wait for March for match day to see if that's where I will be going come summer.

The rest of the weekend was filled with helping the Kreneks at the lake and enjoying a Sunday early Thanksgiving dinner with them at their house. It was the perfect way to end the weekend.

Catchin' babies..

2006-10-30T18:01:00.000-08:00

Well, my month of surgery is finally over, and I move into two months of Obstetrics and Gynecology. It officially wraps up my last clinical core rotation for my graduation requirements. I guess it would have been nice to finish up with something easy, but it'll all be over with soon enough. I've started out the two months on Labor and Delivery, at Ben Taub Hospital which delivers over 70,000 babies a year. Yeah.. that number I just quoted was correct. That's a lot of babies ladies and gentlemen. Hopefully, I'll be able to deliver a handful of those that come my way. It's a pretty amazing experience, bringing a new life into the world. A birthday is something that most people celebrate across the world, it kind of means something to be there at the time that will be so important to that person for the rest of their life. Also, what would a post about labor and delivery be about without pictures?

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The Real Grey's Anatomy...

2006-10-16T21:42:00.000-07:00

I don't know how many of you out there watch the show. I attempted to watch it for about all of two episodes, and it just so happens that the first two episodes coicided with my first month of General Surgery, as a 3rd year medical student. For those of you who watch it, you might have an inkling to how a surgery service is run in a academic hospital. At the top of the ladder, you have the Attending surgeons. These are they guys who are finished with their education, and this is now their full time job. Below them are the residents, or the surgeons in training. It's about a 5 year long residency of training, with the chiefs being the 5th years, and the lowly interns at the bottom in their 1st year. But yet, even below them reside us, the always enthusiastic med students who unlike those mentioned above, pay to be there. The 4th and 5th year residents pretty much run the show, with the interns doing all the dirty work, all the attendings really ever do is stick their heads in from time to time. And unlike the television show Grey's Anatomy... no one is sleeping with eachother. In fact, the bantering and ridiculousness of it all made the show pretty much unwatchable after only 2 episodes for me. It's by far the least realistic medical show on TV currently.

Which brings me to the topic of this posting. This was all about a year and a half ago, and although I would have been perfectly happy only having 1 month of General Surgery, I now find myself going through it all over again as a part of my required Sub Internship for graduation. Granted, we did have a choice between Surgery, Medicine, and Pediatrics, however, everything I heard from those that matched into Emergency Medicine said that I should do my Sub-I in surgery. So here I am...again...getting Tmaxs and running around in a hospital at 5am everymorning until about 8 at night.

However, today was an interesting day. A day we probably couldn't have scripted even if we were working for a major television network and had even tried to burn it onto celluloid. You see, in medicine, and in a hospital more specifically, we have a term called a "rock". The general idea is that patients come into the hospital with a problem, we help them with that problem, they move on and go home. This is not true for a "rock". "Rocks" are patients who come into the hospital, wind up on your service, and end up staying there. They stay...and stay... and stay, and they never leave, and there's very little you can do about it. The largest "rocks" can stay on your hospital service for months until what usually happens is they die. Even though there's nothing much you can do for them day by day, they still eat up a considerable amount of your time because it is required that you see each and everyone of your patients everyday. This is the bane and the anguish of the "rocks".

We've had a "rock" on our service for the past 2 months now, one that deserves special mention. You see, he came to us with a very interesting background. From what we were able to gather, he grew very sick suddenly in a hospital in Arizona, where he underwent a "unknown pancreatic surgery." His recovery didn't go very well and he sought out an alternative therapy or something in Mexico. In Mexico he underweant another surgery that ended up giving him a massive raging infection that nearly killed him. Instead he languished in this Mexican hospital with his insides open to the world for about a month. Unable to take it anymore, he actually taped up his stomach by himself, caught a bus to the border and went to the emergency center in a Brownsville hospital. His abdominal wound was so severe that they wouldn't even touch him, they sent him direct to Houston via an ambulance transport.

He pretty walked into our emergency center with his abdominal tape falling off and his insides hanging out of his belly. You can imagine what the interns down there thought when they first saw him. During his two month stay with us, he went to the OR repeatedly to get his abdomen pretty much sprayed out with a water hose the way you power wash two story windows. On one occasion, they put a scope down his esophagus and into his stomach to get an inside view, but once they passed the scope into the intestines, the first thing they saw was not tissue of bowel, it was the ceiling of the OR with the surgeons looking right down into the camera. He had a massive hole (fistula) going from his bowels straight through his abdominal hole and to the outside world.

You can't imagine the pain this guy is in. Our everyday visits with him were always secondary to his pain control. He was always on massive amounts of pain medicine and none of them every really scratched the surface. We had every assurance that this man would unfortunately die on our service. His insides were pretty much mush at this point.

However... we had a plan: Operation Flying Rock was conceived. The patient had often expressed a wish to go back to Arizona, where he still had family, and a hospital that had his records and was familiar with him. The thing though is, you just can't put a person who is one breath away from the SICU on a bus or a plane and ship them to another hospital, or can you? Technically, you're supposed to treat or cure a person before you discharge them from a hospital, sometimes though you just can't follow the rules. The plan was to get this pt. back to looking like a normal human being as much as possible. He was given a good shower, new hair cut and a shave and new clothes that a nurse picked up from Target the day before. The hospital provided for a one way ticket on Southwestern Airlines to Phoenix, AZ. (A plane ticket is much cheaper than one night's stay in a hospital). Up until this point, the patient was getting all of his nutrution through an IV and was getting a constant morphine drip for pain. Overnight, he was loaded up with a IV solution with a very high concentration of sugars. His open abdomen was packed completely full with gauze and four layers of plastic wrap was adhered to his belly to prevent any openings. A taxi was then called this morning with specific instructions (including a big hefty tip) to pick him up at the hospital, take him to the airport, and get him in a wheelchair with a personal escort upon arrival to the terminal. Before the taxi arrived, he got shot up with IM morphine, and was given several tabs of darvocet for him to keep in his pockets. His part was to act as much like a normal healthy person on the airplane just long enough for them to get him to Arizona. Once in AZ, his mom would pick him up and drive him directly to the general hospital there. All this happened at lightning fast speed this morning to make sure above all else he made it there.

Just so you know, this isn't how things usually happen, but stranger things have been scripted, that's for sure.

Pass the scalpel.

2006-10-02T19:19:00.000-07:00

Well Vacation certainly ended very quickly and now it's back to the daily grind. I certainly didn't pick an easy rotation to get back to either. We're all required a "sub-internship" here at Baylor before we graduate. It's basically a rotation in a major area of medicine such as surgery, internal medicine, pediatrics, or family medicine, in which we're given more responsibility and pretty much act like interns. We're allowed to pick one in any of the areas I mentioned above, just as long as we do one before we graduate. I picked surgery--not because I'm going into surgery--but because people I know who have gone into Emergency Medicine have all recommended it very highly as far as helping me get the residency I would like.

For anyone who doesn't know, surgery hours are long hours. I usually get to the hospital at 5 in the morning and frequently don't leave until after 7pm in the evening, which doesn't include call nights when I have to stay all night. I often also have to work 6 days a week. It's all a part of being a medical student though, and usually the days are pretty fun and go by quickly. Some of it is a lot of paperwork, but as a sub-I, I actually get to scrub in and help out with a lot of the surgical cases as well. So despite the long hours, the month should go by pretty quickly, and maybe actually be a little fun as well.

Off to St. Louis.

2006-09-24T12:23:00.000-07:00

St. Louis 2006

Sep. 24, 2006 - 53 Photos

200 years ago, the great explorers Louis and Clark set out from the Mississippi river on a 3 year expedition to explore the Western territories in President Jefferson's great plan for westward expansion. In the past couple of days, I traveled to within 100 yards of their exact step off point on their great journey. Coincidentally, this weekend also marks the 200th anniversary of their safe return back to the St. Louis area.

For those of you who may not know. My dad recently took a job promotion with ConocoPhillips which has moved my parents from Houston to the St. Louis area. They are enjoying the change in scenery and the new job. It is a job that keeps my dad from flying all over the place which is much to his liking. They're also enjoying a new home in the country compared to the hectic day to day life in a city of 6 million people. This past week offered me the opportunity to fly to St. Louis and spend a good 4-5 days with them and experience the life and times of St. Louis and the surrounding areas as it is a part of the country I have not traveled to yet. I flew to St. Louis this past Tuesday with my parents picking me up at Lambert International airport. They don't actually live in St. Louis, they live in the outskirts of the Mississippi river town of Alton, Illinois. Incidentally, Alton has often been cited as being one of the most haunted small towns in America. Pretty interesting especially approaching Fall and Halloween. Over the course of the week, I was shown around the new house, and met some of the neighboors who all seem really nice. The property that my parents bought is surrounded by woods on all sides of the house except for the back, where the backyard gently slopes down into a private pond. There's a small pier out there with two row boats for anyone to use at all times as well. You can tell fall is in the air as well, as many of the trees are starting to change in color already. It's a very secluded area, and I can tell that it's much better for my mom than being in the city. She's a very earthy, woodsy, type person and I can tell she's really enjoying it. I also really like their house. It's a two story building with lots of windows facing the backyard and the lake. Mom is currently busy texturing the walls and trying to figure out which colors to paint it. There's all kinds of little projects in it to keep them both busy for quite some time.

On Wednesday, we ventured up the Mississippi river to a ferryboat town called Grafton. The town is surrounded by very high sandstone bluffs that the American bald Eagles will soon be migrating to to roost in winter. It's a prime eagle viewing location as well as other river sports and sightseeing. We ate some really good Mississippi catfish in a 100 year old Victorian Home that used to be the home of a Civil War colonel.

It wouldn't be a trip to St. Louis without a trek downtown to see the Arch. There were all sorts of festivities going on in the Gateway Arch celebrating the 200th anniversary of Louis and Clark's return as previously mentioned. Everywhere you looked was Louis and Clark stuff. Unfortunately we were also dodging bad weather as storms and tornado warning were in the area. However, we did get to spend around an hour in near the arch taking pictures and seeing the sights. Hopefully, on my next trip we'll actually be able to take the tram up inside to the very top of the arch for the great view. I wasn't able to do that on this trip, but there will be others.

And of course that wasn't the last I heard of the inclement weather either. Traveling back to Houston, I ran into a detour in Dallas as all incoming flights into Houston Hobby airport were cancelled. Not wanting to spend a night in the airport or a local hotel, I just decided to rent a car and drive the distance from Dallas to Houston. It's only a 4 hour drive and I much preferred the idea of sleeping in my own bed. The drive went without problems and I made it back into Houston and my apartment at 2am last night. I have also since gone to the Houston airport to get my checked luggage from the flight that finally made it in as well as get my car. It was a rough ending to an otherwise great trip. I'm sure Louis and Clark had many detours along their journey as well.

Back in Houston.

2006-09-13T12:26:00.000-07:00

So I finished up my two months of away rotations in Emergency Medicine and now am back In Houston once more. The weather is turning more towards Fall everyday so it's not nearly as bad as it has been this past summer. My big thing to do was schedule my sub internship which is required for all graduates from Baylor. It turned out to be not so troublesome as I got the rotation that I wanted. Now I'm just kind of kicking back on a mini vacation waiting for that to begin. It's given me some time to get some things done around here at my apartment. I've also been able to attend the first two Aggie Football games, against the Citadel and Univ. of LA Lafayette. Next week, since I have the time, I'm going to fly up to St. Louis to spend 5 days with my parents and see their new place. Should be fun, as I've never been up there before. We also have the big football game against Texas Tech coming up soon again. That's always at least a little interesting.

In Temple

2006-08-07T15:43:00.000-07:00

Things are going well in Temple, I've been away for about 8 days now and have worked 5 shifts in the emergency center. It's a very different experience so far from Houston, but I would say that I'm still enjoying it alot. It's much busier than I thought it would be, and in some circumstances I'm having busier shifts than I ever had at Hermann. Part of the reason is the e.d. here at Scott and White isn't separated into different areas like the center at Hermann. There they had a pediatric section, a medicine section, and a trauma section. At S&W, they all go to one central emergency center with 25 exam beds. I was also slightly worried about the variety or lack of that I might experience here, but that hasn't been a problem at all either. I'm also enjoying working with many of the residents as well. I haven't had a lot of time with the attendings just yet, but I'm hoping to work on that in the coming days.

Living with the Kreneks is also going well. I don't see much of them during the days as I'm either on a shift or they're at work, but I usually help out around the house in the evenings with the many chores, and it's also fun to have a dog around for a change. It's been so dry up here and it was finally nice to get some rain last night, hopefully the storms will continue tonight as well as the area really needs it. My internet connectivity is somewhat limited up here, but I get access everyonce in awhile when my hours at the education center overlap with some business hours, so I can generally read my email every other day or so.

I'm also starting to work on my actual residency application up here as well. Hopefully I can knock some of that out while I have the extra free time before coming back to Houston for my sub-internship.

Off to Scott and White

2006-07-28T15:12:00.000-07:00

Last night I finished my final shift in the Emergency Center at Memorial Hermann hospital in Houston and now I'm off to my second month of away electives at Scott and White Memorial Hospital in Temple, Texas. I'm especially looking forward to the comparison between the two hospitals and their two likely different programs in Emergency Medicine. It should be a fun month and I'm looking forward to it. Leaving Houston for a month will probably be kind of mixed. I certainly won't miss the traffic, the constant noise outside my window and some of the other problems with living in a major city, but being home is always kind of nice and leaving it for a long time gets a little hard. We'll see how it goes though! I will still have my cell phone and hopefully reliable access to my email and stuff while there. So I shouldn't be that hard to get a hold of if needed. I'll be back in Houston at the end of August.

The comings and goings of Emergency Med.

2006-07-23T22:56:00.000-07:00

Wow, it doesn't seem like three weeks have already passed in this EM rotation at Hermann. I've really been enjoying this month so far, and they've definitely been keeping me busy. The last couple of days I've been spending nights in the trauma section. We've been receiving lots of car accident victims, assault victims including a stabbing where Dr. Duke ran the code amidst lots of excitement and activity, and I've been getting some very good practice on my suturing abilities. The residents and staff are all very cool and I've been learning some very helpful tricks of the trade from them which have really made some things very easy. I just can't believe the month is almost over already.

I had today off, which I used to polish my personal statement and Curriculum Vitae because I actually have my first residency interview in the morning. UT Houston grants a personal courtesy to their visiting students by letting them interview while on their away rotation. Although this really doesn't make a difference to me since I live in the same city, it's a great opportunity to get one interview out of the way already. It should also be great practice for when the real interview trail starts up this fall. I'm not planning on travelling too far though, alot of medical students interview and thus travel all over the country. I really just have the intention of staying in Texas, so I'm limiting my traveling to mostly inside the state. Once I get the interviews over with tomorrow, I work only three more shifts at Hermann, and then it's time to get ready for Scott and White in Temple.

Emergency Medicine at MHH.

2006-07-03T14:32:00.000-07:00

Memorial Hermann Hospital

Today I officially began my emergency medicine rotation with UT Houston at their central facility, Memorial Hermann Hospital which also happens to reside in the Texas Medical Center. This is no change in scenery for me, as most of my schooling and work with Baylor just takes place right across the street, mostly. Still, it marks the first time I've ventured outside of the Baylor system, and also my first month of two of elective rotations in emergency medicine.
Mermorial Hermann is also home to world renowned trauma surgeon Dr. Red Duke who is well known for both the devlopment of helicopter assisted emergency rescue and transport, as well as his nationally syndicated nightly news health segments.

This morning in particular, I started off in a day shift in the pediatric emergency center, which was nice just coming off of pediatrics and spending some time in the Pedi EC at Ben Taub. The morning was slow--which they usually are--but things picked up around 10 o'clock and we started having patients. Overall, I really enjoyed it and I'm now really looking forward to what this next month brings.

Eventful day on I-10

2006-06-30T09:58:00.000-07:00

Well, yesterday was a day unlike I've had in awhile, or maybe ever. Kristi was in town to spend a few days before I started two months of Emergency Medicine, as well as before she moves back to College Station to start her first year of Medical School there. The intention was for yesterday to be a lazy day, maybe go to a mall, maybe get her haircut, and just take it from there. We had plans to meet our good Houston friends Susie and Paul for dinner and a movie later that night.

So to pass the time, we decide to go to a local mall here in Houston which is located on Interstate 10, or the Katy Freeway for locals. It's a nice mall, and we've been there several times together, especially when she's been wanting to get her haircut. Traffic was moving fine until we were about 2 miles away from the mall on I-10, when we notice this big cloud of black smoke looming in front of us on the highway, still about 2 miles away. When traffic starts slowing down, we start getting kind of worried, and then without much warning, it grinds to an absolute halt. The HOV lane also comes to a complete stop as well. At this point, we can see the black smoke getting worse and worse and nothing continues to move. It isn't much longer before we hear the screeching sirens of multiple fire trucks, ambulances, and police cars/motorcycles, as well as multiple helicopters arriving overhead. After not moving an inch for half an hour people in their cars all around are getting very antsy and frustrated. Some left their cars, some were walking their dogs, some were just sitting or standing on the freeway barricades. By the time some of the lanes started moving a little forwards, one guy in his car had completely passed out. His lane cleared in front of him and people were going crazy honking their horns and even running out to bang on his window to get him to move.

In another instance, a car had apparently stalled in the HOV lane while idling and there was a group of people surrounding it apparently trying to lift it up to move it as close to the side as they could to allow other people around. At first I didn't know what they were trying to do as it appeared to have 2 people standing and jumping on the hood and if it wasn't for the presence of a police officer looking on I would have thought it was road rage vandalism.

Eventually, the lanes started creeping forwards as they police had shut off the freeway before the accident and were bottlenecking everyone off that last exit ramp. When we made it to the very front of the bottleneck we could clearly see that the accident involved a single 18 wheeler which had gone out of his main lane and slammed into an HOV exit barrier with the damage causing the truck to catch fire and become completely engulfed in flames. It was a completely smoldering ruin by the time we made it up to the detour.

However, the excitement wasn't even done. There was a white Cadillac in the lane next to us waiting their turn to go on the exit ramp which suddenly started to emit white smoke from under the hood, as well as some awful grinding noise from the engine. There was an elderly couple driving who were both terrified and confused and had no idea what to do. The car started smoking even more and then developed an oil drip which was catching fire. At this point, another driver got out of his car, ran up, and yelled for them to get the car over to the closed off part of the freeway and get out of it. They managed to get the car over to where no other cars were and get out of it safely. About a minute later, the oil drip which was catching fire caused the entire car to suddenly become engulfed in flames. This caused the exit ramp to come to a halt for fear of a suddenly exploding car. One of the firetrucks at the main accident site finally came back and started to put the new fire out right in front of us. We were so close I felt almost certain the news helicopters overhead had shots of us on the nightly news as well. They eventually put the Cadillac out, and about that time the exit ramped cleared and we were finally able to make it off the freeway.

I-10 stayed closed until late that evening for the cleanup to be finished. We finally made it to the mall, Kristi got her haircut, which I think turned out really cute, and we had a great dinner that night with Susie and Paul at Buca di Beppo. The food was really great, and the girls probably had a little too much vino to drink, but it was all great fun, and a much better close to the day that what it had started out as.

Trip to Amarillo and Palo Duro Canyon.

2006-06-30T09:37:00.000-07:00

My pediatrics rotation has recently come to an end and with summer starting, that means vacation! At Baylor we usually get the last two weeks of June off for vacation before we start back after the 4th of July. This year, Kristi and I took a week to hit the road to go back to Borger and Amarillo to see some old friends and family. We managed to find a place to stay with the newly graduated Dr. Wesley Nickens, lol, still getting used to that. The trip up wasn't bad, and we decided to spend a night in Dallas on the way up to see Lucy Rochetti, a good friend of mine from A&M. We hit the town on the night and made church on Sunday morning before finishing the trip to Amarillo.

One of the big things was to see Dustin and Lindsey in Borger as they were currently in from North Dakota for a month. Dustin had his Step 1 exam to take later that week and of course Lindsey is currently expecting a baby girl come late September, so that was exciting to get to see them. Also, Kristi had been working on a really sweet baby blanket that was hand knitted, so it was fun to be able to give that to them in person. We also got to have some good ol' Lorene's Mexican food, although I'm not too sure what K thought about it.

The next day, we made plans to hit up Palo Duro canyon with a day of hiking and a night of Texas the musical drama. The famous landmark of Palo Duro is the well known and widely photographed "Lighthouse" landform which involves a 6 mile round trip hike to get to. Both Wes and I have been out to it before as well as the play, but I thought it would be great if Kristi could experience it too while we were in Amarillo. We started the hike early in the morning and were able to take quite a few pictures while out there.

This was fairly close to the start of the hike, a part of what's named Capitol Peak.

This was also pretty early on in the hike, you can see how dry the area is as there has been very little rain for a long time.

Really interesting sandstone embankment, filled with little holes and caves on the side.

You can really see the canyon's famous "Spanish Skirts" on the side of this embankments from all the different sedimentary layers in the canyon's walls.

Eventually along the hike you can see the lighthouse jutting up in the distance.

We had just finished a pretty demanding climb up the canyon wall after reaching this point, thankfully some rudimentary steps had been made to help hikers out along this part of the trail.

We finally make it to the lighthouse and took a little break on the "tabletop" plateau that bridged it's main promontory to the clifface on the opposite side. From here it had a good ranged view to a lot of the canyon we just hiked through.

Also nearby was a little overhanging stone which gave a good vantage point for pictures.

And of course some people wanted to clown around with some pictures as well. ;-)

Overall it was a fun hike and good to see the canyon again, although by midday it was extremely hot and the three of us was exhausted and probably borderline dehydrated despite bringing plenty of water out there. After getting cleaned up, we went back for the musical which had added a few things since the previous times I've seen it, but overall was kind of disappointing since they cancelled the big closing fireworks show due to the extreme drought conditions and the burn ban, but overall it was still worth it. After a few more days of rest and relaxation we eventually made our way back to Lorena and Houston respectively, but it was a good getaway, and fun as always to see old friends.

No more Tag-board.

2006-06-22T18:43:00.000-07:00

I'm sorry to say for those who have posted in the past, but I've had to remove my tag-board (message board) from my site due to the increased amount of obscene spam that has been written on it. I had initially just kept deleting the posts as they were put on my board by various automatic sites, but I can't really keep up with it anymore and I don't want visitors to this site to see something objectionable.

Pediatrics at Texas Childrens Hospital

2006-05-23T13:23:00.000-07:00

Today I began the 2nd month of my pediatrics rotation at Texas Childrens Hospital here in Houston. I had spent the last month doing neonatology and clinic pediatrics at Ben Taub, the local county hospital. First days are always hard, especially when you're orienting to a hospital that you've never previously done any work in. Up until now, I have done most of my work in either the VA Medical Center here, or in Ben Taub County, with brief stints in both The Methodist Hospitals and the MD Anderson Cancer Center. The morning didn't exactly go perfectly, I wasn't on Security's list for a namebadge and passcodes, so I wasn't able to get either of those. Also, the other med student on my team for this month was the one who dropped out a month ago from the rotation, so I'm currently the only student assigned to a very busy team. That team being 9th floor Hematology/Oncology, or in other words the cancer floor. It should be a rewarding experience, but will probably be a lot of work as well. I wish there was another student to help with call schedules and such, but it should still be ok.

In other news, I got a confirmation from my away rotation at Scott and White hospital in Temple, Texas for Emergency Medicine. I am scheduled to start there on July 31st, and return August 25th, barring any complications with my UT Houston rotation which is supposed to end on the 31st. I'm still working out the issues with the overlap on the schedule.

New Furniture

2006-05-06T20:07:00.000-07:00

With my parents moving to St. Louis within the next couple of months, they've been needing to get rid of a little extra stuff they no longer have room for. This of course only means good news for me. I got to "inherit" a really nice sofa and love seat from them, as well as the table and chairs that we've had as our dinner table for the last 15 years or so. They came this morning and dropped everything off in exchange for my futon, rocker, and table and chairs, most of which will go to Kristi's new apartment. Upgrades are always nice. :-)

2006-05-02T15:10:00.000-07:00

One of the last big events each year at Texas A&M is the Senior's annual "Ring Dance". It's a formal occasion to celebrate all of the accomplishments of college, and especially of getting your class ring. Of course my class's was several years ago, but this past Saturday was the Ring Dance for the Class of 2006, Kristi's class. So it had been something that we had been looking forward to for a long time, getting dressed up, eating at a nice restaurant, dancing, the works!

Kristi got a really beautiful cream white gown to wear, and while I had a suit and everything to wear, she suggested that I go with a solid white tie to match her dress. I didn't really know what to think about it at first, but all in all I think it turned out really well and I ended up liking it afterall. We had made plans to go along with Chad and Allison, two really good friends of ours who are also getting married this summer. So in the early afternoon, we met up and took lots of pictures on campus. The weather worked out in our favor, it was sunny but not as hot as it could have been. There were lots of other people around all dressed up doing the same thing. We took more pictures than I could possible put on here, but i put them up on snapfish if anyone else wants to see them all. Here's a few of the ones we took....

(this is apparently my "tux rental ad" pic)

(I like these past three, they kind of tell a story)

We then met up with Ryan Reddy and Christina Wallace for dinner at Christopher's World Grill inBryan, which is an amazing place to go if you ever get the chance, and of course the dinner and lagniappe was unbelievable. We all left absolutely stuffed and miserable, but it was well worth it.

After that, we went on to the dance at the Memorial Student Center which lasted until midnight. They usually have several different theme rooms with various styles of music. This year they had a "kind of" classic rock room, but that's not all that they played, a Country and Western room, a Latin salsa dancing room, and a Hip-Hop room. They also had a casino to win raffle tickets and a room where Freudian Slip (a local comedy improv group) was performing. All in all, we had a really good time, but it was definitely time for a good night's sleep afterwards...

Celebrating a 50th Wedding Anniversary

2006-04-27T16:20:00.000-07:00

This past weekend I went to East Bernard, Tx to celebrate a wonderful occasion with Kristi's family and her grandparents. They celebrated their 50th wedding annivesary this past Sunday. I was able to make it down for a special Mass in their honor as well as brunch/luncheon for them and their family. The weather was really nice and it turned out to be a really nice day for a big family gathering to honor a worthy occasion. I didn't get to stay very long because of having to be back in the hospital the very next day, but I did get to see everyone again as well as play with Klay and Luker a little, and that's always fun. And of course there were lots of pictures taken too. Way too many to put on here, but here's a couple.

Tommy and Yvonne Krenek

The Krenek Family (plus guests)

Start of Pediatrics

2006-04-24T16:36:00.000-07:00

Today was orientation day for my Pediatrics rotation. It was mostly filled with lectures and seminar series but I did get to find out my schedule for the next two months. I will be doing Neonatology with the babies at Ben Taub Hospital for the next two weeks, then will switch over to Ambulatory Medicine also at Ben Taub for two weeks. A.M. consists of normal clinic visits and stuff, for immunizations, colds, ear aches, that sort of thing. I then finish out my last month at Texas Childrens' Hospital on the wards with pediatric internal medicine. I'm looking forward to it, and I like the schedule that I ended up with, so here's to hoping it all turns out well.

Parents to St. Louis

2006-04-17T20:44:00.000-07:00

St. Louis Arch

It's official now, Conoco Phillips is transferring Jay to their St. Louis division to be a director of Human Resources starting as soon as July 1st. We've known about the possibility for a little while now, but only recently has it been made a sure deal. Of course this makes things kind of crazy around my parents' house now. Mom's in a flurry trying to get the house on the market (as if she really needs to work at it, it looks amazing as ever). Jay's having to make lots of plane trips now. He's currently in Denver, but he'll be flying very frequently back and forth to St. Louis to get everything ready for the transfer. Part of this is also so he can check out some neighboorhoods and possible houses to buy. Speaking of that, mom has made very clear that she wants a "real fireplace" this time, not some imitation that you flip a switch on the wall and fire magically appears, lol. I'm pretty sure she'll get what she wants this time around. It sounds like they may be there until he retires. This move won't affect what I'm doing much, I'll still be here in Houston going to school until I graduate next summer. Residency is still up in the air, but I'm hoping to stay around here and close to Kristi. This does mean that I get to see some new cities on occasion, holidays in St. Louis, maybe some road trips to Chicago where I've been before. That sort of thing should be fun. It's kind of exciting, I'm happy for them to get out of Houston and on to something different, and it is a rather nice promotion for Jay as well. We're hoping that with this new job he won't have to fly nearly as much if at all. That would be great if that's the case. We'll see, i'll keep everyone updated.

In Bluebonnet Country...

2006-04-04T13:18:00.000-07:00

For the past several years, Kristi and I have tried to take advantage of Springtime here in Texas by going to see the different wildflowers that bloom and come to life this time of year. In particular, this part of Texas is famous for the Texas Bluebonnet, which is the official state flower. Bluebonnets are commonly seen on the sides of the country roads and in random fields across the area, some like Washington on the Brazos make for popular roadside destinations for many seeking picnic areas and wildflower viewings. This year, two of our good friends, Susie and Paul, came along with us and we made a roadtrip out of it to go to another popular wildflower town, Brenham. It's also the home to the Blue Bell Ice Cream Creamery (which was closed on this day, so no tours). But we did find a good spot with lots of flowers and took some nice pictures for eveyone to enjoy.

Kristi and Me

Paul and Susie

The girls...

Unposed pic of K

Hmm. . she looks contemplative

Roadside field we found

More bluebonnets

A little closer..

Opposite view

Ok, playing around a little here

Kristi looking sad because she just smushed some bluebonnets

Susie and Paul playing with some flowers

After Brenham, we also went back to Washington on the Brazos state park to see if they had many flowers like the years before, but it was rather disappointing and we ended up not staying very long at all. We also didn't get many pictures from that trip either, just a few. It was a fun trip though, and good to get out and enjoy some nice spring weather.

Two down, one to go...

2006-03-23T16:06:00.000-08:00

This week is my final week on my Family Medicine rotation. This past month has seemed to just fly right by and I have no idea where the time went. I was assigned to a very busy group practice of seven physicians, my doctor was Dr. Dwane Broussard. I enjoyed my time with them, and learned a lot as well. We had some patients that I'll probably remember for a long time, even though I only got to know them for a short amount of time. This week caps off my month with 3 days of exams, two of which I just completed. Yesterday we had to see three standardized patients with various complaints that are commonly seen in a family practice clinic, and were graded on our performance of our history and physical exam. Today was a computerized clinical case exam with videos and such, with short answers, and tomorrow is a typical national board exam, which thankfully is just pass/fail for this clerkship. After this week is through, I plan to spend some time gathering some residency information together and hopefully finish most of my work on that before pediatrics begins.

I've also found myself going to the doctor myself pretty often this past month, the eye doctor. Most of you all know that I've worn contacts for the past 10 years, and for some reason or another my eyes stopped tolerating them last fall. I've been through an optometrist and two ophthalmologists and we think we finally understand what might be happening. Some freakish kind of immune mediated allergic response to the preservatives in my contact solution seems to be the issue. So I'm currently on 4 different types of eye drops (a major pain in the butt) and have another appointment scheduled soon. Hopefully I can get this sorted out and be back to normal before too long. They're going to run some more tests on my eyes my next visit to see if this is helping and if I can get back in my contacts (preservative free stuff this time).

Weekend at Lindy Fest

2006-03-23T15:50:00.000-08:00

This past weekend was Houston's annual Greater Southwest Lindy Fest. It's a four day extravaganza full of lessons, classes and all the Lindy hopping you could imagine. Kristi and her friends have been going every year for the past several years, and this year they finally managed to get me to sign up and go, haha. This year though, my schedule with med school was pretty lenient and actually allowed me time to go as well, so that definitely helped. The event has brought in some world class instructors and participants for the past several years in a row, and this was no exception. There were certainly a lot of people there who know a whole lot more what they were doing that I did, or probably ever will, and that certainly got intimidating at times. It was also really crowded, showing the popularity that Lindy Fest has been gaining. However, by the end of it all, I had really learned a lot, and had gotten a lot more confidence in this style of dancing, and of course I was having a lot of fun as well. I managed to get a lot of help on my lindy help and also picked up the Shim Sham along the way, or least tried to, still working on that one. I also met some really fun people along the way. Kristi and her friends had just made it back from a week long "Tour de Tejas" spring break of dancing across the state, I have no idea how any of them had any energy left for the weekend, but they all seemed to have enough to have a blast, and I'm sure they're all ready for next year again.

Two of this year's special guests are two living legends in the world of swing and dance, Frankie Manning and Dawn Hampton. Frankie Manning is currently one of the most famous swing dancers and lindy hoppers alive. He's personally responsible for developing the fast paced and high flying aerials that most people think of when they imagine Lindy Hop, and he's also been dancing since the 1920s! He's also been in numerous movies both as an actor, dancer, and choreographer, his last being Malcolm X. This year he turns 92 and still going full steam.
Dawn Hampton grew up in a family of musical performers playing the Saxophone and singing as well. She made herself famous in caberets across the world and then later turned to dancing when she lost her voice due to medical reasons. She has also been in numerous movies including Malcolm X with Frankie Manning. She's about to turn 78 years old and still travels the world teaching music and dance. Both are very friendly down to earth people and it was really nice meeting both this past weekend.

Me with Frankie and Dawn

Kristi with Frankie and Dawn.

So the weekend came and went, and I sure need a new vacation from this weekend. But I did have a really good time, and learned an awful lot, and I can't wait to try some of it out again at the next dance. But now it's back to Family Medicine and a week of exams coming up.. Wish me luck!

Test is over with...

2006-03-07T16:32:00.000-08:00

Step 1 of the USMLE that is.... In order to get a medical license in the U.S. you have to pass 3 steps of what's called the United States Medical Licensing Exam, and none of them are much fun at all. They pretty much exist in order to determine what kind of residency you can get as well as just making sure you know what you're doing in order to become a doctor. The first step of it pretty much covers everything that is taught in the first two years of medical school and then some, which is an enormous amount of material. People usually take two months off from whatever they're doing just to study for this test. It's over with now. I can go back to normal business as usual, and also have a little bit more fun occasionally now too. I'm still on Family Practice and will be for another 3 weeks.. More on that later.

Back to Clinics!

2006-02-28T17:00:00.000-08:00

Now on Family Practice

Now that study time is over, and a new month has begun, that means that it's off to clinics again. Today I started my 5th of 7 core rotations before I can graduate, Family Practice. This rotation is going to be pretty different from the other ones that I've has so far. For the past year, I've pretty much been seeing patients in the hospital setting, now I'm in a private practice clinic seeing patients who for the most part are pretty healthy. It's a differnet environment and a completely different way of assessing and treating people. I think I'm going to like the change overall, it's just going to take some getting used to at first, especially with the time that I've had off.

For the next month I'll be at a Group practice clinic in Family Medicine on I-10 (Katy Freeway), which is about a 30 minute drive for me but I think overall it will end up working out pretty well.

Time off to study..

2006-01-22T14:14:00.000-08:00

In other news, when I haven't been helping to build a house, I've been having to study a lot lately as well. I've taken the months of January and February off to study for one of the major tests that we have to take in medical school, the United States Medical Licensing Exam (USMLE). Your score on it pretty much decides where you go to do your residency, or specialty training. For example if you wanted to be a dermatologist or ophthalmologist, you would have to score very very high since those two specialties are in very high demand and now very hard to get into. Due to this fact, most Baylor students schedule into their 3rd year two months to study for this test. That's what I'm currently doing until I take the exam in late Februrary, and afterwards I'll go on to do a month of Family Medicine and then two months of Pediatrics. So if you don't hear from me in awhle, that's what will be up.

A new year and a new house...

2006-01-22T13:51:00.000-08:00

An ABC Extreme Makeover: Home Edition house that is! This past week, ABC's home remodeling show for charity featuring Ty Pennington has set up shop in East Bernard, Texas (home to most of Kristi's extended family) helping out a local family that really couldn't be more deserving. The Kubena family has twin daughters, both of whom battled leukemia when they were 3 years old, one of which is currently in remission, another has relapsed and receiving therapy at Houston's famed Texas Children's Hospital. With massive medical bills and debt, they were living in a small trailer home, but last week were surprised when the ABC production crew showed up at their doorstep and told everyone that they were getting a completely brand new house, made litterally from the ground up. They then had to load everyone up in the bus to go to the hospital to tell young Kara who cannot leave the hospital due to her weakened immune system. As you can imagine, building an "extreme" home from scratch is an impressive undertaking, especially since everything has to be completed in one week's time. So as should have been expected, the town has really opened their arms and helped with hundreds of volunteers to get the house raised. Royce Builders is providing the construction crews around the clock, and Gallery furniture is providing the interiors.

Since a lot of Kristi's family is from East Bernard, including both sets of grandparents, and numerous aunts, uncles, cousins and so on. Several of us, myself included, were granted spots on the volunteer roster to help out with this project. We were assigned to the 3am to 7am time slot on Saturday morning. It was in the middle of the night, so that meant that there were no cameras, production staff, or famous people around (for those of you wanting to see me on TV or something, I'm sorry!). A cold front had also just blown in so it was a little chilly, but that didn't keep everything from going on as scheduled and people being busy busy. Construction began Thursday morning, and as this was Saturday night, they had already gotten a very impressive amount done. The foundation was poured and set, all of the wooden frames including roofing was up and in place, the tarps on the roof were up and ready for the roofers to begin shingling. Inside, all of the piping, wiring, and duct systems were already installed. Fiberglass insulation was currently being placed as well as the drywall and sheetrock. Oh did I mention that this was going to be a 5000 square foot two story house? Since the actual construction is done by professional volunteer contractors, we mainly helped out around the site to make things go smoothly and more efficiently. We moved wood and supplies to where they were needed, transported the ever building piles of construction trash to the dumpsters and also cleaned and sweeped the inside inbetween different job crews to keep the workspaces clean. After our four hour shift, the house had litterally gone from mostly just wood frames on the inside to being covered with sheetrock. On the outside, half of the house had already had siding placed, while stone masory was halfway done on the front of the house. In just 4 short hours that we were there helping, an enormous amount of work had already taken place.

We were a little disappointed that we didn't get to see any of the television production take place, nor any of the stars or people behind the show, but it was still a very rewarding experience and it was fun to see how everything happens behind the scenes of the construction process. It's also a good project to give a deserving family a little help when they need it most. If you're interested in watching the show when it premiers, I believe the episode date is scheduled for Februrary 19th, or sometime around then.

For a news article on this, try http://www.herald-coaster.com/articles/2006/01/17/news/news02.txt

PS. Sorry there aren't any pictures on here. Security on site was pretty particular about there being no cameras or photographs being taken while helping volunteer.

Christmas with the Kreneks..

2005-12-26T17:37:00.000-08:00

This year, I spent Christmas with both sides of Kristi's family, the Krenek's and the Jasek's. I wasn't able to spend it with my own family on the holidays due to both my mom and dad being very sick with the flu and warning me against coming anywhere near the house.

Everything turned out ok though, and there certainly was a lot more activity than what my family has had in the past. As food is concerned, we had everything from home caught fried fish with shrimp etouffee to large helpings of turkey, ham, and deer sausage. Everything was really delicious and it was good to spend the holidays with a large family gathering again (twice!). It was also good to spend some time getting to see everyone again, some I've only met on one or another occasion. I think several of them are worried that they scared me off or something! haha.

I hope everyone else has had a wonderful Christmas or holidays of your choosing and here's wishing for a very Happy New Year.

Goin' Skiing...

2005-12-26T17:22:00.000-08:00

After exams and school was pretty much over for another year, we managed to hit the slopes again for a well needed break. This time, four of us were able to make it up to Wolf Creek, Colorado, one of our favorite places to go. On the last occasion, the weather was very cold with blizzard like conditions for most of the skiing time, however, the weather cooperated very well with amazing sunny and warm condtions. There wasn't much snow, but it was still early into the season so that was expected, but we still managed to have lots of fun in the mean time.

We stayed at one of the closest places you can stay to the ski mountain. The Wolf Creek Ranch Ski Lodge which we have stayed at several times in the past. It has both cabins and a streetside motel, this was the first year that we weren't able to secure a cabin, but the motel worked out just fine as well, and was probably best since we just stayed 3 nights.

At Wolf Creek Ranch Ski Lodge

The lodge is situated right in the middle of Wolf Creek Pass, with mountains on both sides and the Rio Grande river right behind the property. It's really a pretty scenic area.

Mountains and Pallisades outside

More mountains on the way to Wolf Creek Ski Resort

Kristi got a new green ski coat for Christmas.

Here's the two of us going up the ski lift to the top of the mountain.

Kristi and Wes

The View from the top really is quite amazing, I wish I would have taken the time to get some more pictures, but here's one of the four of us. Sam, Wes, me and Kristi.

One of the things that I like so much about Wolf Creek is how varied the terrain is. There are your usual runs that are trails bordered by trees on both sides, but then there's also alot of really open terrain with no trails that you can pretty much choose where and how you want to ski it. You can ski down the same area 10 different times and get something new out of it, especially if you're into skiing trees and through non groomed terrain.

One Run in particular gave us a good challenge, "Windjammer", starts out with a very steep grade with moguls, some 3 feet high. It then levels out and ends with several jumps, hills and a gully that can catch you off guard if you're not in control. Below, Kristi found the gully by accident. You can also see Wes up in the top right trying to avoid it.

On the way back up to Alberta Peak... It's not a very tall mountain--elevation wise, but it is spread out quite a bit with also an extensive backside area. So there's still plenty to see and ski.

Flags flying at the base area representing the states they get the most skiiers from. Good to see Texas strongly represented.

We only had 2 days of skiing, but I think it's safe to say that we made the most of it. Everyone had fun and stayed safe, and of course looking forward to next year already!

Done!

2005-12-16T13:13:00.000-08:00

Just got out of my Psych final and I'm officially on Vacation! At least until the middle of January when I actually have to bunker down and start studying very hard for the next most important test in my life (the one that determines where I go after I graduate), but until then I can have some fun. Mountains and snow skiing here I come!

The joys of being 26....

2005-12-14T10:36:00.000-08:00

Are there any joys of being 26? Hmm, good question, I'm not really aware of too many from this point on. Lol, birthdays kind of eventually lose their fun I guess after awhile. The day was pretty gloomy as it was raining pretty heavily in Houston, but it was also my last day on clinicals for the year, so that just means that once I get my tests out of the way tomorrow and Friday I'm on vacation! That means skiing and Christmas and just enjoying not doing a whole lot of anything for a little while at least.

Kristi made me a cake for my birthday, which she actually gave to me last weekend. It's very yummy with devil food cake and white icing, and she even put planets and stars on it for me too, haha. It's already almost gone though. :-( I'm eating out with Classmates tonight and will most likely have birthday with my parents on Saturday night. We may also go see King Kong then too if we have time. I'm really looking forward to seeing what Peter Jackson did to the great gorilla. Other than that, good luck to everyone taking final exams or other types of end of year activities/things!

Celebrating 2 years at the Aquarium

2005-12-10T12:36:00.000-08:00

Kristi came down to Houston this past weekend, and with so many things to do and occasions going on, we kind of had to cram a lot into this one weekend. For one, this past Friday was her medical school interview at Baylor (my school), so that was kind of an exciting affair. We also were celebrating our 2 year anniversary since we started dating, and I also have a birthday (my 26th) coming up as well, so we tried our best to get as much in as we could. And in the middle of all that, I had an overnight call that I had to spend in the Psych ER too! So yeah, this was a pretty hectic and crazy weekend, but overall I think it went very well.

As I mentioned, I had to spend all Thursday night in Ben Taub Hospital for an overnight psych ER call. It went ok, tended to two patients all night as it was really slow due to the cold winter weather that Houston got that night. I did manage to make it home in time for K to get off to her interview, after which I slept pretty much the rest of the day. After picking her back up, I had made plans to go to the Downtown Houston Aquarium (restaurant and theme park type place) all dressed up and have a fun night there for a our 2 years. K wore a dress I had recently gotten her and I wore a new suit I had gotten recently.

Ready to go

It's a really cool place. The restaurant itself is three stories with a bar/lounge on the first floor, and you walk up a spiral staircase around a 3 story cylindrical aquarium to go up to the main dining floor around an even larger tank filled with all types of fish, sharks, and coral reefs. We both had fish and then just walked around and enjoyed the sites.

Inside the Restaurant

There was a large decorated Christmas tree outside within view of the skyscrapers as well as the landmark neon Ferris wheel. K also posed outside one of the many water fountains as well.

Christmas Tree and Downtown

Talking with Santa

Neon Ferris Wheel

Marlin Water Fountain

We then made our way through the large aquarium exhibit that had many many different kinds of fish, as well as the white tigers from Asia. We had a really fun time and said that we'd have to go back again when it wasn't so cool outside and we could do more of the attractions.

Home after a night out.

After making it back, we had birthday cake and all that fun stuff as well. She got me Scrubs season 2, yay!

From the City to the Fields

2005-12-06T13:51:00.000-08:00

This past weekend was spent in Dallas while K was still hot on the interview trail for medical school. This Saturday was her day at UT Southwestern Medical School which is very close to Downtown Dallas. My friend, Lucy, who is currently a Physician Assitant there was very gracious to offer us a place to stay for the weekend. We had a good time, with way too much good food to eat, and K said that her interview went very well with no major surprises or hiccups along the way. Also got some Christmas shopping out of the way as well. Wasn't able to totally get away from medicine myself, I actually had to help answer a page or two while Lucy was driving, haha. One of the place that we had dinner at was a Latin restaurant named Laduni. It was really really good, I had some pork tenderloin tacos and we all split an amazing dessert. I highly recommend it to any in the Dallas/Highland Park area.

On the way back, we stopped in Lorena to see K's parent's again, and got recruited into picking pecans in the countryside as well as scouting out potential Christmas trees on their private land. We came up empty handed as far as the trees go, but managed to pull in about 20 lbs of pecans. A pretty nice haul. Finally made it back into Houston late Sunday night, with the workings of an eye infection in progress too, oh well.

Attached at the hip...

2005-11-29T14:21:00.000-08:00

to my pager that is. Ah the joy of sitting here at work doing not much of anything except wondering if I'm going to be able to go home soon, or if my evil pager is going to go off any second meaning that I have to stay late tonight. Here at MD Anderson, I'm on a consult and liason service in the branch of Psychiatry. That pretty much means that other doctors, services, or whatever call on us when they have a patient that they think might need psych. And when that happens, our little pagers go off alerting us that we have a new patient that needs to be seen somewhere in the hospital. Usually this is all fine and very educational, but not all that welcome when the pager goes off at say.. 4:45 when we're almost about to close the office. That usually means staying til 7 or so at night until all the paperwork and dictations are done.
I'm not really all that bothered by it in the end, it just makes everyone really anxious during the 4 o'clock hour because we're doing everything we can to hope that that stupid pager doesn't go off. Thankfully, a lot of the time it doesn't. Which is ultimately great since that means that someone doesn't need us. Usually in this hospital it's a bad thing when they get to the point that they do.

Now at M.D. Anderson

2005-11-22T16:28:00.000-08:00

Last month, I spent my time on Psychiatry at the Ben Taub Inpatient ward, where the daily business is schizophrenia, bipolar disorder, and just plain everything under the sun. Lots of people having bizarre behavior and hallucinations, or if you're anything my most of my patients were, you had a whole lot of things to talk about, but very little of it made any sense. It was a very interesting month.

Now I've been reassigned to do a month of consult and liason Psychiatry at M.D. Anderson, the country's (and some say the world's) largest and most prestiegous cancer center. It's definitely large! I spent a lot of my dad walking across skybridges connecting all the different buildings, centers, and towers of the place, and that was after I had to initially find out where I had to go. It is a pretty confusing place, but I will say that it's a very beautiful hospital. They've gone out of their way to make it as comfortable and "resort" like as possible. They want to take the cancer hospital feel out of it as much as possible and they've done a pretty good job. The hospital lobby feels more like a hotel lobby, with large water fountain, musicians playing a piano or violin, lots of windows and sunlight. There's also an indoor forum with shops, that resembles a small mall for patients and families to shop, art galleries, garden areas and lots more. It's pretty impressive when you take it in for the first time. But it also never escapes you that as nice as it is, it's also a place that you hope you never have to spend time in other than working.

Today was my first real day there, as yesterday was mainly doing paperwork and getting badges. Since it's a consult service, people refer their patients to us for whatever needs they might have. So actually a lot of the day was spent waiting for my pager to go off. We did see 3 patients today though, with various needs, so all in all it turned out to be a pretty good day.
The different setting will probably take some getting used to (MD Anderson is a University of Texas Houston Hospital, not a Baylor hospital), but I think it will turn out to be a pretty good month, and I'm looking forward to getting to know this new team and the patients I'll have.

Off to the Faire

2005-11-15T18:26:00.000-08:00

One of the large Fall attractions for South Central Texas is the annual Texas Renaissance Festival held two months out of the year near Plantersville, Texas. It's one of the largest of it's kind and is always a fun place to go for period shows, atmosphere and to just plain see people in some very crazy costumes. Some very nice and classical, others just down right creepy and scandalous, haha (chain mail bikini's by people who should not be wearing them). I've been several times before, but never before in costume. This year, Kristi and her roommate Suzie really wanted to go dressed up with a group, which of course meant me and Suzie's boyfriend Paul in costume as well. I was just hoping she didn't want me in tights! It turned out to be pretty fun. We picked out the patterns and the fabric and K used her great sewing skills to whip up some pretty nice looking outfits, and all in all it turned out to be a really fun day, and it was different than just going in street clothes.

Of course we ended up doing a lot of walking as usual (the place is like a Disneyland in the woods, pretty big!). We took in a lot of the sights and shops, saw the Ded Bob Sho again which is always hilarious, and caught the joust too. Our knight was of course the first to die. At least the French guy didn't win. We filled ourselves with turkey legs and beer of course too. You can't go to the faire without partaking in those. And we also managed to take a lot of pictures too, most of which there's no way I could post on here, but I'll probably manage to get up somewhere.

Me and Kristi in our costumes.

Suzie and her Monk (Paul), with K and me

This Pirate tried very hard to get me to buy this hat and sword, ahem, or rather trying to take my money like any good pirate would do.

I came pretty close to buying them too, especially after all the compliments the Kristi and Suzie gave me with my new additions.

One of K's favorites

Paul and Suzie

The girls being silly in front of a statue

The friar does love his brew.

The knights of the Joust

Some more of Me and Kristi

Weekend in Lubbock

2005-11-07T19:31:00.000-08:00

So it was that time of year again... and no I don't mean the annual roasting of Rob Schneider for his career dropping performance as a stapler (inside joke, ask sometime, or watch Southpark). It was the time of the annual college football game of Texas A&M and Texas Tech, which several of my best friends and I from High School have attended religiously since 1998. This year, it was my turn again to travel up to the Llano Estacado--or to Lubbock--to see the game. Not very fond memories have been had up there. I've almost been crushed by a torn down goal post as it was being carried out of the stands by a crazed mob, I was sprayed with beer, and many other rather things that I wouldn't mind forgetting about. Nevermind the fact that I've never seen the Aggies win in Lubbock, but despite that, the A&M/Tech weekends are always fun and this was no exception.

I wasn't driving this weekend and out of cheapness I flew into Amarillo rather than Lubbock. Wes picked me up and then we headed on down and met up with Sam. We had some fun out on the town, had a horrible dinner at Denny's after the game, and enjoyed our usual highjinks. It made for another memorable weekend. It's just sad that more people aren't able to make them anymore. We did see Saul so that was good. It was over all too quickly and back to Psychiatry but such is life.

Me, Wes, and Sam taken from a friends wedding over a year ago.

Physics and Stupidity can sometimes be bad....

2005-10-30T07:37:00.000-08:00

This Halloween weekend, or time change weekend, whichever you prefer actually started off pretty eventfully. I had to go into the hospital this morning to check on my psych patients as well as two others I was covering for. Afterwards, I had made plans to go to College Station to hopefully finish my costume seeing as this was my last weekend to do so (next I shall be in Lubbock for a rather horrific massacre I presume). On my way to my parent's house to check on my dad and drop off some stuff, I suddenly forget that I left something at my apartment that I really kind of needed to finish stuff with. On my way back to my apartment, I then found myself directly behind a motor vehicle accident immediately after it happened, so I then had to pull over to the side of the road, make sure everyone was alright and stay to give statements to the police and paramedics who arrived on scene. In all simplicity, there was a tan car who sped through a red light intersection which caused a white car travelling in the green light lane to broadside him directly in the passenger's side, this pushed the tan car over into opposing traffic to hit a green mini van. The driver of the white car was a 74 year old man who had some scrapes and bruises, and the driver of the green mini van was an elderly grandmother driving her family somewhere, she had back problems and was the only one taken by ambulance. No one else was seriously hurt. We stayed by as witnesses for the 74 year old gentlemen in the white car who had just bought a new car and there was really little he could have done to prevent the accident.

After that whole mess was sorted out, I finally made it back to get what I had forgotten and made it to my parents place to find the Aggies playing miserably on TV to Iowa State. I stopped watching that to play surgeon on my dad to inspect and change his dressings, and in College Station, we made Jack 0' Lanterns! So yeah, a pretty eventful weekend so far. I'll be sure to update more if anything else exciting happens.

Making Jack O' Lanterns

Getting a little messy

Susie and Paul

The Finished Work
(my Haunted house on the left, Suzie's Monkey (with banana in mouth), Paul's Spider, and Kristi's Bat that says "Boo". )

Yeah, I know it's been awhile

2005-10-29T18:32:00.000-07:00

Things have been a little crazy around here lately, with the conclusion of my three months of Internal Medicine around the time of the multiple hurricane dramas and the rescheduling of all my exams, I seem to have forgotten to update this in quite awhile. Everything eventually turned out ok though. I have since completed two weeks of Dermatology, and two weeks of Anesthesiology as part of a month of medical selectives.

Derm was fun, we got to cut a lot of things off of people, and I even had a patient who gave me his book afterwards. It's an autobiography of his life after being born in France, growing up off the coast of India and then going to work for the American Intelligence agencies. Pretty cool guy. Anesthesiology was also fun, got lots of good experience placing IV's and a couple of good attempts at intubating people.

I'm now on my first week of two months of Psychiatry. I'm in an inpatient psych ward with some really sick people, it's really sad mostly. Some of them we're able to help, most of them not. I'm learning some interesting cases though, so it should be very worthwhile. Naturally, I'm not really allowed to discuss much on a public site though.

Jay also just had surgery again last week. He had to have a left hip replacement, acetabular arthroplasty in medical jargon. That pretty much just means that the ball and socket part of his upper leg and hip needed to be replaced by metal and synthetic parts. Overall, his surgery at the Methodist Hospital here in Houston went very well according to his doctors and his recovery should go very well and uneventfully. He just hated having to have another surgery.

Also, I've been in the process of making a Renaissance costume with Kristi. We've made plans to go to the annual Renaissance Festival near Plantersville with her roommate and her roommate's boyfriend, and apparently everyone has to go in costume or not at all. So we spent some time actually making hommade costumes from patterns and fabric and a few personal adjustments here and there. They're still not finished, but may be by Halloween. We'll have to see.

In other news, two of my best friends, Dustin and Lindsey, are expecting a new baby come mid next year. I hope he gets a girl... ;-) lol.

Lost post I know, hopefully it won't take me this long again to make postings here, if it does, just slap me upside my head and yell for an update and I'll get one rolling. :-)

These ladies aren't too kind...

2005-09-21T18:26:00.000-07:00

For the past several weeks, Houston has also been dealing with the aftermath of Hurricane Katrina, we've welcomed our doors and our homes to all those who fled and left the path of destruction that was Hurricane Katrina, and now it appears it's our turn. I'm in preps right now to pack up stuff and head out of town myself now. Hurricane Rita is appearing to be a real... well I don't think I need to elaborate. I'm aware that my apartment is in one of Houston's 100 year flood plains and so there's a good chance I could be dealing with a lot of damage when I return. I hope everything turns out ok, but you just can't tell with these storms that are this powerful. Please offer your prayers and support for all those who might be affected by this monster hurricane. My plans are to be up in College Station for the weekend, which still could very well be in the path of the storm, but it should just be heavy rains and thunderstorms, not the flooding who knows what this area is expecting...

Amongst the butterflies...

2005-09-15T20:08:00.000-07:00

A couple of weekends ago, Kristi and I went along with Ali and Zahra to the Butterfly exhibit at the Houston Museum of Natural Science, just to kind of get out for a day excursion. It was a fun thing to do and we all enjoyed it as we had never been before. It's in a glass greenhouse/pyramid enclosure on the side of the museum, complete with rainforest jungle ambience. It even has its own waterfall and pool with multileveled areas to explore. So we tooks lots of pictures of course and ended up going ot eat afterwards. Below are a few that I wanted to share.

Kristi doing some butterfly hunting.

The Waterfall Pool.

Sneaky little guy.

A Great Owl Butterfly.

More Random Butterflies.

Sharing a landing spot.

Ali and Zahra.

Me and Kristi.

In the Exhibit Hall.

Colorful display.

Me? on a Rollercoaster?

2005-08-29T19:27:00.000-07:00

Last Friday, Kristi came in for her medical school interview at UT Houston and I'm sure it went great. So the next day she decided to call in a debt which had been building for quite some time apparently. Over a year ago I made a deal with her that I would ride a rollercoaster with her if she would come snow skiing with us over winter. Those of you who me pretty well, know about how much I despise, or rather flat out hate rollercoasters. Ever since I was little when my parents put me on the Excalibur at Astroworld when I was 7 or 8, I've had this horrible aversion to getting on them. I pretty much had the crap scared out of me by that experience, and I pretty much made sure my parents were aware of how I felt. They never made me get on another ride like that since. Since then I've done a pretty good job of avoiding thrill rides altogether, which of course made school trips to Amusement park rides not so much fun, since everyone wanted to ride rollercoasters and thrill rides, and I never could bring myself to want to. It was always the g-force, or drop sensation that I hated and could never understand what people thought was so fun about it. Well in later years, I had begun to believe that it was more of a psychological phenomenon and that I really needed to branch out and try them again, but I wasn't about to just go out and test this new theory. Which brings us to this Saturday, and repaying this debt. This past Saturday we decided to go to Astroworld since we had the day to mess around with, I didn't really go willingly either cause I didn't quite have the nerve built up, but the tickets were bought and off we went. She didn't start me out with baby steps either. The first coaster she took me down was the new blue and green Ultra twister that has a very steep initial drop off then hurls you through barrel turns..... I was not very happy with her after this first experience and part of me actually wanted to leave and go home right then! haha. But I stayed, and we ended up going down almost all of the coasters in the park, and by midday I was having fun and enjoying myself. Two of them, the Batman and the Cyclone gave me headaches though from all the shaking around. I have to say that overall it turned out to be a pretty fun day, and I think my fear of rollercoasters is in the past.

It was a very fast weekend, and a very fun one at that! Now I'm back to the hospitals for my final month of Internal Medicine, this time back at the VA. I think it will be a good month though and I'm excited to move on to another team and see what follows.
.

Last Week at the Taub

2005-08-22T18:27:00.000-07:00

So this is my last week on internal medicine at Ben Taub, the county's hospital. It's been an interesting experience, and I'm sure I'll miss some of the craziness when I move back to the VA. I certainly won't miss the 6-10 page handwritten H&P's. Or the nice whiffs of who know's what as you're walking down the halls. Overall, I've had a good experience with it though. Good teams, interesting patients, and people who are mostly grateful for the help that you're able to give them. It wasn't nearly as bad as I was expecting it to be coming in 2 months ago. It'll be interesting to see how it compares to the VA system of doing things. I'm certainly looking forward to being back on their computer systems and all. The daily parking will also be pretty nice again.

Halfway through Internal Medicine

2005-08-16T16:45:00.000-07:00

"My God man. Do you want an acute case on your hands? This woman has immediate post-parandial, upper-abdominal distention." (or in other words, cramps) Bones Mccoy

So yeah, it's been awhile since I last posted, but Medicine has been keeping me pretty busy as of late. I'm on my 2nd month of Internal Medicine and still living it up at the Taub, as much as that's possible. Things are going well though, I have a good team and it hasn't been nearly as crazy as I was led to expect. This has actually been a fairly slow month in general at the county hospital. Lots of beds on differently floors are actually vacant. It's pretty strange. Sadly, it seems that the patients that we do have all have one form of cancer or another. One of my patients has a type of bone marrow cancer called myeloma, another has severe throat cancer, and we admitted a patient today with leukemia. It's been kind of depressing. Why can't it be more run of the mill stuff that you treat and send home? I guess it's good experience though. Two more weeks here and I'll finally be changing hospitals and going back to the VA. I'm ready to be writing notes on computers again finally. My life has pretty much been hospital work lately so that pretty much covers it as far as updates go. I did manage to get away and see the Lord of the Rings movie exhibit this weekend at the Houston Museum of Natural Sciences. It was cool to see all the movie props, buildings and costumes that they used in the filming of the trilogy. Other than that, yeah, I guess my life has been pretty boring lately. ..

In CS for Kristi's 21st B-Day

2005-07-21T16:41:00.000-07:00

This past 15th was Kristi's 21st birthday, so of course I made sure to have the day off from the hospital to make it up for the occasion. I was actually able to make it up a day earlier than I was expecting just the way things happened to work out. Since Kristi is back with her parents for the summer we stayed at her cousin Jenny's place. We went ice skating on the day of her birthday since that's something that we both have been wanting to do for awhile. CS actually has a brand new ice rink, so trying it out was pretty convenient for the occasion. Afterwards we made dinner at Johnny Carino's because she had mentioned for a long time that she wanted to try the Bellini there (mostly cause she likes pretty drinks, ;-) ) We all ate waaay to much including the free birthday dessert. We had to let the food settle for awhile before heading to Northgate for the obligatory 21st birthday drinking fest. All in all, I'm quite proud of my lady. She handled it all pretty well, and kept managing to pass the "finger" test long after I thought she'd fail it. Lets see if I can remember: 1 long island iced tea, 3 shots including a tequila, a pineapple shooter she really liked, an amaretto sour, cherry vodka sour, and crown and coke. And she definitely took it all in stride, without much of a hiccup at all. I think I'm going to have to look pretty hard into exactly what goes on in all those Lechner parties.......

Getting ready for a night out on the town...

Me and Kristi at Johnny Carinos

K and her first drink of the night (a pretty drink as she calls it)

Matt and Gracie

Busy, Busy, Busy

2005-07-21T16:24:00.000-07:00

So my first day on Medicine gave me a pretty complicated patient, that two and a half weeks later I'm still taking care of. She's what we usually refer to as a "rock". That's someone who comes onto your service and just stays there. Not sick enough to go to a intensive care service, and not well enough to leave. We've been finalizing a lot more of the aspects of her care that were on hold for awhile, so hopefully we're making progress on getting her sent to a more long term facility. My patients keep coming in pretty complicated though. I had a patient who came in with some fatigue and cramps, and it turned out to be Malaria! Then I had a guy come in to have some fluid drained from his belly and it turned out to be from liver cancer.... I guess it's good in that it's giving me some experience with that kind of thing. I just have a way of attracting the heavy stuff I guess. Oh well, Ben Taub hasn't nearly been the nightmare I was expecting and I did end up with a good team afterall and that makes all the difference.

Thrown into the Fire..

2005-07-07T17:16:00.000-07:00

So I finished my third day of my three month Internal Medicine rotation this afternoon. It pretty much started off with baptism by fire as they say. We went through orientation and team meetings on Tuesday and found out who we're working with for the next month. I'm back at Ben Taub County General (sigh), but I think I'm going to have a good team. I'm with Vicki Feng again who was my partner on Vascular Surgery, so I already know that's going to work out fine. Our residents are pretty cool too so I think that aspect is going to be fine as well.

First Day: Our team was on call.. (double sigh). Ben Taub rotates 8 different medical teams on call on different days. Usually it's an every four day schedule with one team taking a long call, another taking a short call, and another taking a night call. Our team was up for long call, meaning that we had to admit the brunt of the day's medical patients and stay later than everyone else, well except for those that were coming on to be night call. I just admitted one patient, but of course it had to be the day's most difficult patient. I'm not really complaining. So far it's been a very interesting case and I've already learned an enormous amount about how to approach the care of a "medical" patient, as opposed to a surgery or specialty patient which is just about all I've seen up to this point. The past two days have pretty much just involved taking care of this one patient. So I think this rotation will work out just fine, it'll be a lot of work for sure, but I think it won't be as bad as everyone said it was.

Vacation over.

2005-07-04T20:05:00.000-07:00

So here I am, last day of vacation is finally here. Tomorrow I start back in my clinicals with Internal Medicine. After getting back from Mexico, I didn't really do a whole lot until my 2nd weekend off. Jay finally got the call for his surgery on his knee, so that was performed on Friday. I was in College Station at the time on a day with Kristi that we had been planning for awhile, but I went home to help take care of him that night and next day. His surgery went very well, all except the post-op mess that happened because someone didn't get the discharge orders. But other than that it went well.

I did manage to have fun in CS though, we saw Bewitched, which is actually a pretty fun date movie. Even more so if you're slightly familiar with the old TV sitcom. We did some other random stuff as well, but it was a good day, especially since I hadn't seen her in about a month.

On Sunday, I left on my weeklong trip up to Amarillo to see my good friends, Wes, Sam, and Kelly from high school again. In order to make the trip more manageable, I stopped and stayed over in Waco with Kristi's family on my way up. Amarillo was fun, and I did a lot of just what I was hoping to do. Which was a lot of nothing. We went out a couple of times, managed to get a round of golf in at the local Par 3 course, as well as a game of bowling. We also played a lot of Halo since Wes and Kelly are into that now. I also managed to successfully infect them with the insane hilarity that is the Numanuma kid. It was really good just to see everyone again as well as get out of Houston in general.

On the way back, I spent the weekend in Waco again. Sam and Vicki had the kids up from Houston again and it's always fun to play with them. I got to see the new progress on the house and also have the kids play with fireworks out at the lake. The next day, we drove to Conroe to Kristi's dad's cousin's house. Dr. Gregg who is a local dermatologist has a nice country estate and was throwing a fourth of July barbeque for the Krenek family as a gettogether. The house was beautiful and everything was really nice. I got to meet more of her family and hear some more crazy Krenek stories. Food was good as well. All and all it was an interesting experience. I was really tired at this point and was just kind of ready to get back home and situated again. I had been away for a week and was really ready just to get settled down again. Which is good in it's own right as well.

So here I am, most of the stuff I needed to work on is done and I'm ready for tomorrow I guess. Orientation is at 8 which is where I'll find out which hospital I'll be in along with my teams. It will be interesting working with some brand new interns, so I'll have to keep writing with my experiences there for sure. So vacation is finally over... back to clinics!

Off to Mexico!

2005-07-04T19:20:00.000-07:00

I realize that this is a looooong time in coming, but I'm finally getting around to write an entry after all this vacation time that I've been having since coming off of Neurology. So I think my test and everything went fine and it was litterally the very next day that several of us packed up and flew to Mexico to enjoy some fun in the sun. We flew down to Puerto Vallarta, which made the 2nd trip there for me. First time for everyone else, so I kind of had the advantage of knowing my way around, and where the cool things were. It was a fun trip, a very short one at that, but it was just good in general to get away. We did the whole walking around downtown thing on the Malecon (boardwalk), as well as eating in some of the local beachside eateries. We also spent plenty of time on the beach by the resort just relaxing and taking in the sights and sounds of the bay. I also parasailed! THAT was quite an experience, and definitely something to bring home and talk about. The view from high up in a parachute is just amazing! I didn't post all of the pictures I took, if you want to see them all just shoot me an email and I'll send you the link to snapfish, but the following are some of the notables.

This is a picture of our resort that we stayed at from the beach. It wasn't nearly as nice as the one we stayed in 2 years ago (which was just down the beach) but it was still nice and they treated us well. It was all inclusive and the buffet style food was decent. Drinks could have been a little better though but were still ok.

This is a photoshopped panorama of the resort. You can see a little bit more of it from here, not to mention that I just like to play with photoshop.

Some tropical plants and scenery around the resort.

Los Arcos (the arches) are a natural rock formation off the coast of the Bay of Los Banderos, where PV is located. They're a popular local attraction and scuba/snorkeling spot, and as such arches are a pretty common theme around PV. Our resort carried some replicas of some sculptures and arches found throughout the city and this is one of the such replicas on the resort grounds.

This is another angle of the arches, apparently this photo is a particular favorite amongst some of my friends as it's gotten some good remarks.

The beach was really nice and clean with lots of sand. You can't really see much of the surf in this picture but in some days the crests were really getting high.

This is a picture of the local landmark, The Lady of Guadalupe Cathedral in downtown Puerto Vallarta. It's a really beautiful church, and I would have taken pictures inside as well except that they were celebrating Mass at the time, and of course I didn't take any out of respect.

Simple picture of me in front of the church. We did so much walking around the city proper that day that most of my pictures were snaps on the go. Didn't really take a lot of me or any of the other people who went along.

This was one of the many sculptures and art pieces set alongside the Malecon. This piece was also replicated at our resort along with the arches from above. There was also a cool one of a tall ladder with children climbing up it and reaching for the stars. It's a popular one for people to have their pictures taken on while climbing it. I would have gotten a picture of it too, except I already had several from my last trip.

This is a view of the PV main beach right off the Malecon, the downtown district. You can see it's a much rockier beach than those by the resort. A lot of the rocks are actually popular for beachside vendors who make money by actually balancing rocks on top of eachother as "art displays". Some of the sand they also make into sandsculptures as shown below.

This was the main sand sculpture out on the beach while we were there. On the far left is an iguana with the caption, "Night of the Iguana" because that was the movie with Richard Burton directed by John Huston that made Puerto Vallarta famous and the tourist attraction that it is today. It was also the movie with the famous affair between Burton and Liz Taylor. You can still see and tour her house in the Downtown district. We tried but it was closed on the day we were there. There's also a very nicely done image of the Virgin of Guadalupe on the right as well.

So that was pretty much my trip to Mexico in a nutshell. It was short and quick, but it was a good get away and much needed after Surgery and Neurology. I'll have a little bit of vacation left before Internal Medicine starts now.

Yay, off to Mexico!

2005-06-17T19:12:00.000-07:00

Today was my last day on Neurology, and we had our departmental exam. It wasn't that bad, kind of easy actually compared to the other exams that are out there. So the end of another rotation already, and another year too! I'm officially a 3rd year. Doesn't seem possible. But what better way to celebrate than to go off to Mexico? We're flying to a quick little getaway weekend in Puerto Vallarta, Mexico tomorrow and will be back Tuesday. Quick, but I'm sure it'll be lots of fun. Just what I'm needing before internal medicine starts. So, I'll be sure to bring back lots of pictures!

2005-06-06T18:43:00.000-07:00

It almost seems like yesterday when I was filling out applications for medical school, now my girlfriend Kristi is going through that all right now too. Last week she took some pictures of herself for her application file and sent me some of them to pick the best from. I saw the following picture and the first thing that immediately came to my mind was some cover shot that nightly news programs use to advertise their news anchors. I had, "and tonight on News 13 at 9, with Kristi K. reporting live"... running through my head and just thought it was the funniest thing. We laughed about it for a good while. I showed it to a friend and he thought the exact same thing, anchorwoman shot. I know she's going to do great in med school, but you never know.......

"And now for tonight's breaking stories....."

Weekend at the Zoo

2005-06-06T18:15:00.000-07:00

I had the weekend off from normal hospital activities, so I headed up to Waco to spend some time with Kristi and her family. It was also really good just to get away from Houston and the normal grind of the city for awhile too. At first I wasn't really sure how I was going to pull the weekend thing off since I was on call at the hospital on Friday, but I got off early and was able to make the drive up without any problems. We spent Saturday at the Cameron Park Zoo in Waco, it was Providence Hospital's company picnic day and since Kristi is an employee there now, we were able to get tickets in. The day included free barbeque, drinks, ice cream and attractions. It was pretty fun once we found the place. We saw all the animals, had food and drinks and even played some bingo too, although our luck wasn't very good. Afterwards, we got some Red Lobster thanks to a gift card that hadn't been used yet and watched a movie.

The next day, Kristi's dad actually put us to work on his land taking care of some of his pecan trees and some fire ants. It was kind of fun though. I had to come back it seems like just after I got there and now it's time for another week... I have some tests coming up too, so I guess I should get to work on those pretty quickly.

Memorial Day Weekend, and back to the brain.

2005-05-31T16:56:00.000-07:00

I had an enjoyable weekend with some much needed time off from things around here. Much of it was just sitting around not doing a whole lot of anything, which is good in it's own right, but I also got to go down to East Bernard to party with the Kreneks and Jaseks (my girlfriend's family). They were celebrating two 40th birthdays at once and had quite the affair with barbeque, beer, and country music and dancing. It was quite an "interesting" experience.

I also had dinner and such with my folks yesterday including steaks and twice baked potatoes. We also made some chocolate chip cookies. It was all very very yummy and I'm about to go have warmed up left overs.

Back in the hospital today, it was our residents' last day before switching over to a new hospital. We'll have a new team to work with tomorrow so that should be interesting. One of my patients today has ALS which is pretty sad. For those of you not that familiar with Amyotropic Lateral Sclerosis, it's also known as Lou Gehrig's disease, and it's a devestating degenerative nerve disorder that destroys your voluntary movements eventually leaving you paralyzed and unable to breath, or move anything. My patient today just had some weakness, but was otherwise ok. He's still in amazingly strong spirits and is keeping a great attitude about the whole thing. Much better than I think I ever could in his situation.

Where was the hippocampus again?

2005-05-26T20:37:00.000-07:00

I feel like I'm in a different world now. Spending three months in surgery is completely opposite from the "medical" world, which I got thrown into this week on Neurology. I'm back at the VA hospital and it's been going ok so far. I've just had to shift gears and ways of thinking of things. On surgery, you concentrate on the most obvious problem, do things only related to that problem and then move on quickly. On a medicine rotation like Neurology, you pretty much have to concern yourself with every little thing going on in the patient, which gets complicated. Thankfully, most of our patients have neuro complaints (obviously) so even then we're still narrowed down to a fairly small area. It's fun though. I really like the neuro exam. It's fun to do and think about. I don't like how most of the therapy and treatment that is involved in neurology is mostly palliative though. Meaning you can't really do much to cure your patients, you just do your best to help them understand what's wrong with them. I'm pretty sure I couldn't do that kind of work for a living, but I'm certainly glad there are people out there who can.

Surgery Core Rotation completed

2005-05-20T14:13:00.000-07:00

Whew! What a load off. This past week hasn't been much fun at all trying to get my studying and reviewing done for this monster test we had today. Today was our Surgery Core Rotation Shelf Examination. Meh, I think it went ok. I was just hoping for a pass in this course anyways. I don't really have any intentions of going into surgery so doing exceptional on this test wasn't really a goal for me. I think I did ok though. We'll see when grades get back. I check on some of my evaluations that already have though and for the most part they're really positive. That's good then.

Up next... Neuology..

I can breathe again

2005-05-12T20:35:00.000-07:00

Well I'm finally beginning to feel like myself again since being sick for most of this week. It wasn't a very fun week and having it be my first week at Ben Taub certainly didn't help much either. However the past two days have been considerably better. Yesterday we did two "prostatectomies", which are complete removals of the prostate gland, usually from prostate cancer. The surgeries were fast paced and fun to help with, especially since I got to really help the scrub nurse with passing instruments back and forth. It doesn't sound like much fun, but with things flying back and forth and the two surgeons litterally yelling for things faster than you know what's going on, it was really fun and exciting. (medical nerd speaking I know). The surgeries were long, but the time flew by and the day was over before I knew it. It also meant we spent minimal time in the clinics which so far I can't stand here at the Taub. It's not so much the clinic aspect, but the administration which is horrible. Nothing is where you need it when you need it, and it's that way all day long. So I was happy I didn't have to deal with that.

Today was Thursday so a half clinic day/half afternoon lecture day. But it got started off with a 7 am comedy session almost. Every morning at 7 we have our subspecialty lectures, and this week has been all ophthalmology. This morning was ophthalmic trauma and emergencies and the professor was hilarious, sometimes at our expense but we were all still laughing our heads off, and at 7 in the morning that's quite the accomplishment. We were talking about injuries that can happen around car batteries and Drano, specifically alkali chemical burns, and he was just having a ball with the people who didn't know how to jump start a car, or even how Drano works. So then we got to talking about a patient who claimed to be whacked upside the head with a 2 by 4, he had several gashes across his face and a place where the hair was taken off his eyebrow. He was trying to get us to come up with a way that a 2 by 4 can "shave" the eyebrow off of someone, since being beaten that way usually doesn't leave injuries such as that. Well once clueless classmate answered rather reluctantly that maybe he was using a 2 by 4 that was somehow dripped in Drano, and of course this brought out instant hilarity from everyone in the crowd. After the lecturer himself stopped laughing he then claimed "Why stop there, why not have a 2 by 4 dipped in Drano, set on fire and soon you could have plague, death, famine and pestilence and the rest of the Four Horsemen come and take the other eyebrow." It's probably one of those things where you had to be there, and it being 7 o'clock in the morning, none of us were really in our right minds, but we just nearly about died with laughter. It was at least a good way to start off the day. Clinic went much better too. Still had some problems communicating with the patients, but it was pedi urology day so it was at least fun. And of course we got out at a predictable time too which is always nice.

A tissue?... anyone?

2005-05-09T19:34:00.000-07:00

There's nothing like getting pimped for two straight hours while you're nursing the full onset of a cold.

Today I started my last service in my 3 month block of core surgery. After our usual 7 am lecture, this time by none other than classroom favorite Dr. Frank Kretzer, I got my first real introduction to Ben Taub County General via the Urology clinic. Granted, it wasn't General Surgery or Emergency Center at the Ben Taub, but it was still a good indiction of how different things are from a county hospital perspective, compared to a state of the art computerized facility with automated robots going from place to place.

Everything is done by paper charts. You have to seek and find if you want to know any lab values, or even if the patient had labs. Most of the time you can't even read what's in the charts, or even understand the patient. And none of this helps when you start off the new week and a new team, and a new location with a new cold. I felt it coming on last night and knew what I was in for. I was just still in denial that I could hold it back. Well now I'm on Nyquil and Dayquil and hoping I can just make it through the days. So oh well, I'm hoping tomorrow goes a little smoother since I know more of what to expect, and I'm going to try to get some more rest tonight to help with the cold. I need more sleep than I got last night, that's for sure.....

ENT done

2005-05-06T15:14:00.000-07:00

Today was my last day on the Ear Nose and Throat service at the VA. I actually wish I could spend more time on it as I really enjoyed it, and a lot of the stuff I learned is really practical if I do end up going into something like Family Practice, or a Rural clinic setting in general. Plus the residents were really fun to work with. It helps when they lavish all us students with high praise too :-)

Today was really busy though. I think we ran through 50 clinic patients in our normal hours. Two of our residents were involved in surgery, leaving just one for the clinic. But it all worked out extremely well. We had three of us students helping out and we were able to work through the patients pretty well to help her out. So all in all, I really enjoyed these past weeks, and I may actually consider coming back to help out again as a SubI for fourth year or something. We'll see. Now I just have the weekend to look forward to before I start Urology on Monday at Ben Taub.

Birthday Dinner with Friends

2005-05-04T21:02:00.000-07:00

A good friend and classmate celebrated his 24th birthday tonight so we threw a little bbq dinner at his place for him. I knew ahead of time that we would have plenty of chicken to work with so I decided to try some new things. We were going to do half in bbq sauce and half in teriaki and I wanted to come up with some kind of funky garnish or salsa to use as well. Kristi came in for the occasion too, so we had some fun grocery shopping. We picked up a pineapple, some mangos, red onions, honey, guava nectar and some cilantro and used all those ingredients to make this tropical salsa which actually turned out pretty well in my opinion, especially on the Teriaki chicken. We also had corn, and a banana split cassarole dessert and overall the evening was quite a success, and a lot of fun to be had as well.

Friday Friday...

2005-04-29T17:08:00.000-07:00

I'm getting very spoiled by being able to drive to school everymorning. Normally, it's impossible to drive and park anywhere in the Texas Medical Center, and if you choose to park in a parking garage, the rate is already $10.00 after just 2 hours. It's ridiculous. However, we have morning lectures at the school at 7 in the morning, and there's a small little open parking lot in front of the main building that doesn't fill up until closer to 8. Students aren't normally allowed to park there, but there are exceptions for special seminars, lectures, or classes for clinical students who are off site. So needless to say, since I apply I've been making use of it. Very nice, much better than riding the ol' train everyday.

So ENT is still going quite well. I helped in "tympanoplasty" today, which is reconstructive surgery on the ear drum. Pretty cool to operate with microscopes in such a small little space.
I also saw a patient today who shares the same name as a rather famous horror story villain. Of course I can't say the name here or anywhere due to privacy issues, but it was kind of cool nonetheless. Now it's just time for a fun weekend! :-)

Another week moving along quickly

2005-04-27T18:10:00.000-07:00

Ear Nose and Throat is moving along fairly quickly. Week 1 of 2 is already almost over. The hours and workload are certainly much nicer than what general surgery threw in my direction everyday. I like the team much better as well. I spent today in the OR again, we took out a salivary gland and a thyroid. Got home at a decent time too. All in all, can't complain too much. Jay's birthday is coming up so I guess I need to do some shopping for that.

Don't Smoke!

2005-04-25T21:22:00.000-07:00

Today I started my small little selective in Otorhinolaryngology, or people who don't have a clue how to say that or even what it means... Ear, Nose, and Throat surgery. This 2 week rotation is going to be much more relaxed than general surgery. Today we pretty much just followed the residents as they saw patients, and then I got to do an impromptu abscess incision that was brought up from the OR. Then, we got to go home. :-) At 1:30 amazingly enough. It gave me time to do some grocery shopping and cook up a new batch of my Mom's spaghetti. Didn't get a chance to eat it tonight, but I should be able to fix that tomorrow.

In and Out of General

2005-04-22T21:20:00.000-07:00

Ok so I finished up my rotation in general surgery, or survived may perhaps be the better term. I won't miss the twice a day dressing changes on smelly wounds infected with pus or what not. I also won't miss the bickering amongst the team members and the yelling that goes on to the interns either. It's said and done and I'm finally moving on to something new. We did have our evaluation session today which was quite therapeutic in rating what I thought of the clerkship as a whole. I guess we get to see if it turns out to be reciprocal when my evals come in later on...

Last week on general

2005-04-18T19:43:00.000-07:00

After a nice relaxing weekend, I had to come back to more general surgery. Mondays as usual, are clinic days, which I normally enjoy. However, today was just worse than usual. Clinic days are usually chaotic and completely unstructured, or absolute lessons in total inefficiency, but today managed to top that. Clinics should in theory run something like this: the rooms are filled with patients, us med students see the patients first and take histories to find out why they've come to see us, and then we present the patients to either the residents or the attendings who then see the patient with us to decide a plan or what should be done. Then the plan is carried out and things keep moving. This has yet to happen. Usually, we see the patients and then end up waiting around for someone to have a break in paperwork or whatever to see a patient for 30 seconds before going back to paperwork. I understand this is the system of medicine that we live in, especially at the VA, but what makes me upset is that even under this system they could handle the chaos so much better. They could easily work out a system to that at least one resident is always getting the patient work done while another is doing the computer and ordering work. And this would be on a normal day. Today, we only had one "physician" in the entire clinic, and most of the time he was doing something on the computer that had nothing to do with clinic work! We had all these patients to present and he wasn't seeing any of them. It forced us to get very very behind. Finally one of our attendings came and tried to fix the situation, but it just ended up in him getting very pissed off and flying off the handle yelling at people. It was not a good situation. He remained very cool at the med students though and we continued to try our best just to help out with what we could. It was just a very frustrating day. I'm glad it's my last week on this service. It's clear that surgeons know what to do in the operating rooms, but don't have a clue about how to run a clinic.

This week in review...

2005-04-16T12:18:00.000-07:00

Blogger has been down a little lately, or perhaps just when I've tried to write to it, hence why the late update. Things were kind of up and down this past week. It didn't exactly get started off very well with some confrontations with people on my team. It was pretty much just differences in opinion, at a time when differences were not good to have. Particularly at 6 in the morning when some people had rather bad weekends. However, things have been worked out and the week got progressively better. I saw and took care of some very cool patients, did some more procedures and spent some more time in the OR. So all in all, it turned out ok despite a rocky start.

Tonight I hope to go out and have a little fun with my Saturday night off, we shall see how that turns out.

Washington on the Brazos

2005-04-10T15:06:00.000-07:00

Kristi and I made it out to WotB again this past weekend to enjoy the amazing weather and check out the yearly wildflowers, as we did for the first time last year. I had heard they had been pretty scarce up to this point, but we managed to find some patches of really nice Texas Bluebonnets and Paintbrushes, as well as a few others spread out here and there. We took lots of pictures, and I put some of the best below. I'll probably put the rest up on a photo site like webshots or snapfish, so if you want to see the others just let me know and I'll send you the address.

Washington on the Brazos 2005

Me

Kristi

Feet

Flowers

A large Texas Paintbrush

Bluebonnets and Purple flowers

Close up on Pink and Purple Flowers

Field of Flowers

MSC Variety Show at Texas A&M

2005-04-10T14:55:00.000-07:00

This weekend, I made it back to College Station just in time to see Kristi and her Swing Dancing performance team perform at the annual Memorial Student Center Variety Show and contest. The acts are usually always top notch as the groups usually spend months and months preparing their shows/routines, and this year was no exception. The performances were truly amazing, and of course naturally I was quite biased towards the the Swing Cats' performance. Some of the other notables included A&M's Percussion Studio, an elite group of about 30 percussionists who always are spectacular. This year they played a percussion arrangement to the hit song Clocks, by Coldplay. There was also hip-hop and tap dancing acts, and a solo pianist who will be going to Juliard soon. A mariachi group played, as well as the group that won from last year which was a band of students that play traditional folk instruments. The night was MC'd by Freudian Slip, A&M's band of improvisational comics that have made quite a name for themselves. A&M's Aggie Wranglers also performed which are known for Country and Western dancing and their high flying aerials which were showcased during the Austrailian Olympic Games. As I said earlier, all of the acts were very very good and when it came down to the judging I was worried that the Swing Cats might not place. When the awards were announced it was...

3rd: Aggie Wranglers

2nd: Percussion Studio

1st: Texas Aggie Swing Cats!

They won! We were all so excited and proud of them, me especially knowing how much hard work they put into their routine this year. It was really exciting.

The next day, they had a booth at Whoopstock where they got to show off their trophy and advertise for lessons. I got to go and help out, and got in a little of the craziness as well. Below are some of the pics.

5 of the Texas Aggie Swing Cats who won 1st Place Friday night at A&M's Variety Show Contest! Kelly, Ashley, Kristi, Byron, and Heather.

Kristi and Me goofing around at Whoopstock

Kristi, and yes she is taping up her well worn out dancing shoes. The hole went all the way through her socks as well!

So you want me to cut what?

2005-04-05T16:55:00.000-07:00

So it's back to another week of General surgery, hard to come back after such a fun weekend. Monday was clinic day again so that's always busy, but this day I got called into the OR for a couple of cases as well. One case was incising and draining a rather large abdominal abscess, and they let me use the scalpel to make a rather large incision from which to work with. That was pretty cool. I also helped a lot with the rest of it as well. Pretty funny when you compare it to that new medical show on Sundays, Grey's Anatomy, where the new surgical interns (3 years ahead of me) are jumping with excitement just to hold a retractor. It's not exactly very accurate. Or at least the surgical interns here in Houston know what they're doing.

Today I did mainly floor work, but it was really really....... Really slow. There was nothing to do for much of the day at all. But they still didn't send us home until just recently... Oh well, food time... must eat and sleep as usual....

Saturday at the Beach...

2005-04-03T21:51:00.000-07:00

I had this entire weekend off, so we decided to take good advantage of it. Kristi came down from College Station and we took off to go to the Beach at Galveston. Granted, it's not even close to being the best beach in Texas, but we couldn't afford much more than just a Satuday day trip to someplace closeby. However, it turned out really well. The two beaches we went to were pretty clean and sparsely populated. We got exactly what we both were needing. Some time away from the city, some fun in the sun, and a really relaxing afternoon.

We packed a picnic basket and took along Scout (the stuffed puppy Kristi gave me for Valentine's Day until I can get a dog of my own) and just made of day of it. The weather was amazing. Not too hot, with a nice breeze. We made our way out to East Beach first, which was actually a lot better than we were expecting any of the beaches in Galveston to be. Whenever we go back, I think we're just planning on staying out there the whole time. But on this occasiona, we wanted to see what some of the places south of the city looked like, and ended up spending 2 hours at such a location. It was nice there too, not crowded at all, but the sand wasn't as soft as it was on E. beach. We got some great seafood before heading back, a little tired and sunburnt. We also took some fun pictures to bring back as well. Some of which are below.

Putting a picnic basket together for the beach. Lets see, sandwiches... check, cheetos... check....

It didn't take long to get someone's shoes off...

Not bad for a Satuday morning/afternoon in Galveston..

Just the two of us..

Gathering seashells..

We weren't the only ones enjoying the sand that day...

Watching the surf...

One for Texas A&M...

A little burnt but still having fun..

Smiling for the camera..

Last stroll before going back to the city..

Long day...

2005-03-30T19:07:00.000-08:00

Today was pretty long.... Wednesday's are usually education and conference days. Meaning after we round on patients at 6 in the morning, we have to go back to Baylor's campus for Surgery Grand Rounds, which is pretty much a speaker giving a presentation on a particular topic for everyone in the department of Surgery. Then at 8 we have a lecture just for the medical students in their surgery clerkship. Today's was really interesting by the way, especially with my background as an EMT. It was about the changing standards of care in regards to emergency trauma patients in whether or not to give them large amounts of fluid to raise their blood pressure before any treatment begins. Say if a person has been in a bad car wreck and has lost a lot of blood, usually the first thing the paramedic on the scene would do is to put two huge IV tubes in them and pump them with as much fluids as possible, thinking you had to keep the blood pressure up. Trauma people are starting to change their attitudes on this because of a lot of very new research saying that people who are just left hypotensive until surgery do much much better. So it was actually a very informative lecture.

Back at the hospital around 9 or so, I was planning on a day of just more floor work since I wasn't expecting to go to the OR today, however, Cardiovascular surgery called saying their students were gone for computer training and they needed some from general to help out with two Coronary bypass surgeries. So I got drafted to help out with an open heart surgery case. It was my first triple bypas to help out with, and in that aspect it was really good to be in on. I got to help harvest and strip a vein, and then hold the heart for the surgeons to get a good position for the bypass. Again, it's hard to stand in one position--horribly off balance--and trying to hold something up for a given amount of time, but the surgery went very well and the patient was sent to the recovery room after 6 and half hours.

After that, there was considerable confusion amongst the rest of us as what to do next. Apparently someone had heard that our chief wanted to talk to us, but none of us knew about what. So we hung around, and hung around and basically didn't have a clue what to do about anything. The interns were all either just sitting around doing notes or nowhere to be found. It took us til 7 to meet back up with our teams and even then there was nothing to discuss. It was just a bunch of wasted time when we could have been doing something far more productive than waiting for a team meeting that never happened. Oh well, such things happen.

So is that a scalpel or a Metzenbaum?

2005-03-28T16:25:00.000-08:00

Today I began my month of General Surgery. I'm once again back at the Veterans Affairs hospital in the same general area as I was in for Vascular, but with a whole new team. The fact that I'm on familiar territory is comforting, in as much as it won't be the headache of confusion The Methodist was on my first day. I'm already familiar with some of our residents as well from seeing them rounding with last month's group. There are four of us students from Baylor on the Team along with an international student from Italy, and I think we're going to be able to get along just fine and learn a lot along the way.

I definitely like the fact that we're going to have more involvement with the patients' care outside of the operating room. I missed that about the Vascular service. In CT surgery, pretty much my only involvement with patients was while they were asleep and sterile, and then I never saw them again. I never got to know them as people and individuals, rather than just the anatomy before me. So in that aspect I'm looking forward to the month to come. It won't be easy though. We have a lot of work in front of us, and I'm sure the team will be somewhat demanding. But it will be challenging and rewarding, and hopefully a lot of fun.

Easter Sunday

2005-03-27T16:18:00.000-08:00

My weekend was fairly uneventful as I pretty much just took it off. However, I met my parents for Easter Mass on Sunday at the church they've been going to lately. It's a short drive away and it looks like an old Spanish mission you might find in New Mexico, complete with a very nicely landscaped courtyard. The priest was Polish, and a little hard to understand occasionally, but other than that it was a very nice service. There were 6 baptisms and plenty of babies all around. We went out to eat afterwards as my parents didn't feel like cooking after the weekend they had had. We managed to snap a few Easter pictures as well.

Me and my Mom on Easter Sunday 2005

Jay and me, Easter 2005

Last Day on Cardiovascular

2005-03-25T13:38:00.000-08:00

Today was my last day on CV surgery with Dr. Noon, and with it being a holiday it was actually pretty short. They don't schedule surgeries on most religious holidays (since it's the Methodist Hospital), so I just met with my intern and went over last minute stuff. I wasn't able to tell Dr. Noon goodbye because he was in on a heart transplant surgery which can happen at anytime unscheduled to due the donated organs.

I enjoyed the experience, and I learned an awful lot. I feel a lot more comfortable doing sutures, so I think I feel pretty prepared going into my full month of general surgery. At least I get to take my car and park there for the whole month. That's always nice.

Last night, I made a quick trip to and from College Station to give Kristi her Easter basket. It had a lot of little knick knacks and other things in it that I think she liked quite a bit. We also went and swing danced for awhile too at their Thursday night sessions. It was fun, but just a very quick trip there and back. I didn't get much sleep last night before having to get up early and all. Hence why I just woke up from a very nice nap. ;-)

Start of a new week.

2005-03-21T19:13:00.000-08:00

Ok, so it's been going a little better lately from the "chicken with it's head cut off" stage of last week. I still haven't been given a lot of duties other than just be present and watch, but I guess that's ok. There's really not that much that I can truly contribute to heart surgery, which brings up an interesting point that I'll mention later. I pretty much spend my days bouncing from OR to OR at the Methodist observing, and when necessary, holding a plethora of surgical instruments that have names where I have no idea where they got them from. I watched a thyroid lobectomy today, and afterwards the surgeon reimplanted one of the parathyroids back in. I didn't know you could do that. Pretty cool stuff. I really like Dr. Noon and the team I'm on. Everyone is really nice and helpful, although one of the PA's is almost constantly in a bad mood and appears to be annoyed that I have to be with him half the time. Dr. Noon is amazing as well. For one, he's one of the top Cardiothoracic surgeons in the country, has worked with Dr. Debakey for many years including in top research projects including a heart bypass device that is still being used widespread, has travelled extensively around the world operating on high profile cases, and loves to heliski! Since he has his pilot's license, he'll just fly up to Canada or someplace and rent a helicopter to take him to the top of the mountains to go skiing. He also likes astronomy and telescope viewing, so we actually have quite a bit in common. Still, I don't think I'll be taking the surgery route though.

Which brings up what I mentioned earlier. Sam and his brother Mickey were in Houston yesterday on a layover from coming back from a cruise with their parents. They went off on a 7 day cruise to Cozumel and back. I met with them for dinner and some hanging out. In catching up with all the gossip from back in Borger, apparently there are rumors spreading around that not only did I go to medical school but I'm also some fancy schmancy heart surgeon already. I know people always told me I should be one just from my name and all, but it's funny how quickly things have spread. This was all before I started this blog or anything. Funny times.

This weekend also marked the Great American Southwest Lindy Fest, which is always a annual favorite for Kristi and her Swing Cat friends. So I got to see most of them again and have dinner with them once. Having K for the weekend is always a great thing as well. She was gone in lessons and dancing most of the time, but I managed to find a time when she was off to cook her dinner and such. Palm Sunday was nice as well. Can't believe it's time for Easter already.

Easy as heart surgery?

2005-03-15T18:11:00.000-08:00

So yesterday, in a new hospital and rotation I was definitely running around like a chicken with my head cut off. I wasn't given a clear indication of where to go, what to do, who to do it with, etc. I haven't really been given any clear duties, just to follow around a person on the team, and be present in the OR as much as possible. Something I think I definitely managed quite well today. I got good practice at standing in one spot, without moving, and staying sterile for 7 straight hours. That's right, I did not move an inch for over 7 freaking hours. I'm still working out the cramps and knots in my calves.

Of course it wasn't supposed to have gone that way. I scrubbed in on an aortic valve replacement which is open heart surgery. They crack the chest and split everything open wide as you would imagine. The actual procedure of putting in the new valve went quite well, afterwards however, the patient wouldn't stop bleeding, and it nearly took us an hour just to find where the bleed was from. We had three suction units going and could barely keep up with all the blood loss. Now this may sound bad to most of you all recalling patients bleeding out in movies and then dying once the blood bank can no longer keep up with the supply of donated blood, however, this is Methodist Hospital, and the Debakey Heart Center of all places so they can afford handy dandy nifty little devices that take all the blood suctioned out, filter it to save all the cells and plasma, and then pump it right back into the patient. All in all, he bled almost constantly from his heart for over 2 hours and after it was all said and done barely lost more than 100 mL's of blood, which is pretty good for a surgical patient. Pretty amazing technology.
We ended up having to give him factor VII which is a very very expensive blood component that helps with clotting to get him to stop, which he did almost immediately after transfusion. Then, everything was great and we were able to close up, after about 7 hours after initial incision in the OR. I guess you could call it a pretty good learning experience into what life as a surgeon is like.

Two weeks down...

2005-03-13T20:50:00.000-08:00

I finished my first two weeks in Vascular surgery today. Tomorrow I go into a new hospital, with a new team, and a new rotation in cardiothoracic. I'm probably going to miss my old team, I had gotten to know them really well, and especially enjoyed taking care of our patients. I'm sad to say that we lost one of them this past weekend. He developed a perforated colon due to a CMV virus invection, and despite surgery wasn't able to pull through. I wasn't there when he passed, and he will be missed I'm sure. It's a natural part of medicine I suppose. Taking care of people when you can, and helping out even when you can't. Such is life.

I get to start the new week with a full belly though. My parents took me out to dinner tonight with some good friends of ours, the McMillans. We went to a little steakhouse here in Houston that's been open since the 1930s. Very cozy place with a very well landscaped outdoors area. If it wasn't so expensive I'd like to go back again sometime. It was pricey, but the food and everything was amazing, and I guess that's what parents are good for!

As usual, the morning will come calling awfully early, so it's time for sleep for me.

Clinic day

2005-03-10T14:54:00.000-08:00

Thursdays are always a little different on the Vascular service. We round in the mornings as usual, but then we are in clinic for the rest of the day seeing outpatients who get referred to us. It's a nice change of pace and we're interviewing patients more in the sense to what I'm used to. I'm also learning a lot about how you evaluate patients for candidates for surgery or what not. Most of my patients that I saw today ended up not needing surgery, although it's likely they will in the future. It was actually a short day as we had to get back to school early for some tests in Radiology and Pathology. Now I just have some errands to do before cooking some dinner and catching up on some reading tonight. Carotid Endarterectomy studies from the New England Journal of Medicine will probably be some highly entertaining bedtime reading let me tell ya!

The Sun?

2005-03-08T14:22:00.000-08:00

Wow, this is unusual. I've gotten used to being at the hospital and coming home all in the dark. Not used to leaving and still having the sun be up. Our team got done really early today. I mainly completed some paperwork projects and got some work done. Everyone got done really early today and got to go home early. Now that I'm actually home during normal business hours I need to run errands!

Such a little thing...

2005-03-07T20:12:00.000-08:00

It really is quite amazing the ways in which our bodies are put together. Much of our legs are actually supported and kept alived by tiny little "thread-like" arteries not much larger than a string of yarn. We fought for much of this weekend to save a patient's leg, but in the end we had to take the limb this afternoon because all of our attempts had failed. It was frustrating, but in the end we still did what we had to do for the best of our patient, and what ultimately would prolong his life. We all ended up putting in long hours this weekend, a weekend that we weren't really supposed to have to go in for until this transfer came in. But regardless of the outcome, I think we helped make a difference and that's all that matters sometimes.

On another note, my attending took me and the rest of the team out for dinner and such tonight. It was a nice change of pace and was fun to get to know them all in a different light. It was really nice of her as well.

In's and Out's.....

2005-03-04T15:54:00.000-08:00

I find that there is a lot of running around to be had inside a major metropolitan hospital, especially one that typically treats about 750,000 patients a year. In one door, out another, over and again. At what point does it become a blur, just spinning around and around in the revolving door of life? This first week in clinics has gone by very fast, definitely like a blur. I wish that I was on this service longer than the two weeks that I am. I'm really enjoying my team and they're very helpful in transitioning over to clinics. The veterans are also really cool patients, I really enjoy working with them, and also joking around with their unique senses of humor. Today we kind of had some down time. We discharged several of our patients so I was kind of free to do things on my leisure. So I walked in on a varicose vein oblation, and also helped some of my other classmates with an abcess drainage who were on a different service. I'm trying not to let the "medical" aspects of the patients overwhelm me and just concentrate on the simple things that I'm supposed to be doing and learning. These surgical patients are dealing with problems above and beyond what I'm supposed to be doing, and hence learning and realizing that has definitely helped a little. I can worry about that kind of stuff a few more years down the road, and just keep concentrating on the basics for now. I think I'm finally getting the hang of navigating the "Titanic" size hallways of the VA, since apparently the main hallway is longer than the Titanic as some have said. It's not so bad once you get used to it. I have some time off this weekend as well. I don't have to go in at all tomorrow, and just for morning rounds on Sunday which should take at most an hour and a half, the rest of the time I can just relax, have some fun, and do some reading etc. I'm sure I'll take advantage of it. :-)

Fresh blood..

2005-03-02T19:32:00.000-08:00

I definitely feel like fresh blood in the hospital. For one, the place is huge and hallways are always twisting and turning on themselves and you're almost always lost and disoriented in there. Not to mention constantly being reminded of just how little you know compared to most everyone else there. I'm catching on though. It seems like mostly lectures and conferences still, we actually spend much much less time with patients on the wards than I was expecting. But I did manage to make it in on my first surgery today. It was what's called a carotid endarterectomy. It's a procedure where you go into the neck to uncover and open one of the carotid arteries in order to remove all of the fatty plaque that builds up in there with age. It's to increase the flow of blood to the brain and "hopefully" prevent a stroke. It was impressive to see them working around such a delicate artery and all the while having the patient be totally awake during the entire procedure.

Tomorrow, everyone is on vascular clinic, but I think we have lectures all day back at the school.
Honestly, one of my main complaints about this service is that we always seem to have lectures or conferences to attend, and no one bothers to tell us what time or where they are. We always just have to find out second hand. We think we have lectures tomorrow, but no one is even sure how many or where. I'm sure we'll find out though, things have seemed to work out so far.

Another Beautiful day in the City....

2005-03-01T15:10:00.000-08:00

and more orientations for me in the hospitals. We were able to take advantage of the amazing weather yet again by enjoying a brief lunch outside in the sunshine. It's going to be short lived I think though. It's supposed to storm like crazy tomorrow, or at least that's what it looks like. Today we took tours of the O.R. and got acquainted with our teams. Still don't have access to the computer system though, which is pretty much vital at the VA as that's where everything is done. The VA is a completely paperless hospital here in Houston. Great in theory... Today was somewhat short as there was more getting to our way around and the people we were with. Tomorrow will be more like a real day I'm sure. I'm excited about our residents, they appear to be a pretty cool bunch. I think overall I'm going to end up enjoying this rotation, lets see if hindsight plays itself out as well...

First day down...

2005-02-28T20:29:00.000-08:00

Well, day one is down. It was mostly orientation and beginning lecture stuff. Not all that interesting really, but it was a really nice day outside and actually had to do quite a bit of walking. It was nice to see the sun outside again and actually be out in it for awhile. I'm going to be spending most of my time in the Veteran Affairs hospital here in Houston for the next 2 months it looks like. I'm starting off with two weeks of Vascular surgery, then 2 weeks of Cardiothoracic surgery, and then a full month of general surgery. I'm excited about it, just wondering how my attendings are going to turn out. I'll find out more tomorrow from the looks of it.

I also learned today that you can become practically impervious to almost any kind of blunt or penetrating trauma if you're doped out on PCP. Good to know if you ever decide to steal a cop car, smash into almost any and every obstacle before flipping your car and getting ejected, then jumping off a bridge falling almost 100 feet before instigating yet another fight with the police, to then get shot three times injurying your aorta, having surgery and walking out the hospital a short time later. (true story)

Tomorrow... Off to Surgery!

2005-02-27T16:10:00.000-08:00

Well, the last day of my little break from school has arrived and I venture off into the world of clinics starting tomorrow morning. I spent much of this day getting ready for things, doing laundry, running errands around town. I came to the realization that I was really short on undershirts, so I had to run to Target to get more of those on short notice. Also made some last minute charting notes, and read my new emails regarding what's going to take place tomorrow.

All in all, it's pretty exciting, although a little nerve racking as well. I'm not sure yet which of the three hospitals Baylor uses for Surgery I'll be in. We'll find out in our day long orientation tomorrow. I'll also find out who will be on my team, which could be good or bad considering some of my classmates. So I guess we'll see what tomorrow brings.

As for the rest of tonight? I got some stuff to make cheeseburgers and I'm going to relax for much the rest of it, maybe watch a little of the Oscars, but not the whole thing. Watching Hollywood in their usual congratulatory narcissim has grown old on me, but it should be interesting to see what Chris Rock will do.

The Baylor/Methodist Saga, Part 3 of 3 - Uncertainty, hope as giants part ways

2005-02-23T08:19:00.000-08:00

HoustonChronicle.com - Uncertainty, hope as giants part ways

HoustonChronicle.com

Feb. 22, 2005, 12:31PM

Uncertainty, hope as giants part ways
Baylor's choice for a new partner put plenty at stake
Editor's note: With new partners and new ambitions, Baylor College of Medicine and The Methodist Hospital all but part company. The split has generated sorrow and hope. The question, though, remains: Can the storied institutions be as formidable, apart, a
By TODD ACKERMAN
Copyright 2005 Houston Chronicle

In the end, the conflict between Baylor College of Medicine and The Methodist Hospital came down to control.

Both wanted more. Neither would budge.

On April 21, 2004, as rumors swirled around the Texas Medical Center about who'd become Baylor's teaching hospital, the college's board met to choose between longtime partner Methodist or new dalliance with St. Luke's Episcopal Hospital. Baylor President Dr. Peter Traber presented the two options, which boiled down to Methodist's better resources or St. Luke's philosophical compatibility.

"I, Peter Traber," he said, "am willing to work hard to implement either of these."

The board went for St. Luke's, infatuation over money. Many found it strange — though the two institutions already had a limited relationship, St. Luke's had long billed itself as the Medical Center hospital for doctors who didn't like the dominant presence of a medical school. A 1994 plan to merge with Methodist fell through, for instance, because its doctors didn't want to be under Baylor's control.

The announcement didn't go over well at Methodist, which was previously upset with Baylor for publicly announcing its clinic plans and what they suspected amounted to secret negotiations with St. Luke's. Now, officials said, they had to hear of Baylor's rejection from the media.

But Methodist didn't waste much time moping. Two months later, it announced it had its new partner — Cornell University's medical school in New York City, nearly 1,500 miles away, an unrivaled distance between a teaching hospital and its medical college. Skeptics viewed it as buying a brand name — the school already has a teaching hospital in Manhattan, as well as eight other hospital partnerships in greater New York — but Methodist was unwavering in promising the idea will work.

Fighting a 'custody' battle
The relationship cost Methodist $100 million. Cornell gets $10 million a year for five years, and New York-Presbyterian Hospital — with whom Cornell is contractually bound by a 76-year-old affiliation — gets the other five-year allotment of $50 million.

The new deals only exacerbated the fighting, most of which involved who would get "custody" of shared staff. Methodist accused Baylor of using residents as "pawns" when the college began moving some to St. Luke's; Traber responded that Methodist was just unhappy it was losing "cheap labor."

At another point, Baylor threatened Methodist with legal action if it didn't stop its "aggressive recruiting" of college faculty-physicians. Behind the scenes, Baylor was getting help from a formidable figure — Joe Jamail, dubbed the "King of the Torts" for his multimillion dollar court victories involving contract interference.

It got so bad that Mayor Bill White intervened, calling on Methodist to accept Baylor's long-standing suggestion that the two institutions try mediation. Methodist finally acquiesced, but after three months the mediators withdrew. Traber said Methodist handled the mediation "like your child would when told to do something." Methodist Chairman John Bookout expressed vindication for Methodist's initial resistance.

White got involved, he said, partly because the two nonprofits were "built with Houston philanthropy and public assistance" and partly because he'd been contacted by doctors, who believed a great community resource was being ruined by board politics — specifically, by a personality conflict involving Baylor Chairman Corbin Robertson Jr. and Bookout.

Pain felt on both sides
Both Bookout and Robertson call the theory nonsense — they say they have long histories of conducting business professionally and strong boards to whom they answer. But Robertson acknowledges that at one point during negotiations he suggested he and Bookout step down as chairmen if that would help discussions.

Others blame Traber, Baylor's first president to come from outside. Noting his experience at Pennsylvania, where he resigned rather than go along with the board's plan to sell the school's hospital, they think he is committed to school-owned hospitals and was recruited to divorce Methodist. Traber dismisses the suggestion.

Whatever the cause, no one disputes the pain the divorce has caused.

Dr. Stanley Appel, the 73-year-old neurology department chairman who chose to stay with Methodist, talks sadly about the freeze he feels from former colleagues at Baylor. Dr. Dale Hamilton, a Baylor endocrinologist whose diabetes program is being moved to St. Luke's, laments that he'll no longer be able to trade insights with some Methodist staff who'll now be working at a diabetes center the hospital plans to launch. Robertson, who served on both boards before Methodist voted him off last year, says simply, "I've got a hole in my heart."

Perhaps no one feels the loss more than famed heart surgeon Michael DeBakey, who spent decades building up Baylor's association with Methodist and who warned of the crisis in a 2002 letter to trustees, more than a year before matters came to a head. Friends describe him as "heartbroken" about the split, but he stops short of the word.

"It certainly saddens me," says the 96-year-old DeBakey, after a moment of reflection. "I don't understand it. I don't think it's in the best interests of either institution."

The key question now involves what will to happen at St. Luke's, where many private doctors are said to be nervous about Baylor's new presence. The contract with the college calls for hospital service chiefs to be selected collaboratively, not just granted to Baylor, but skeptics suspect that in time the college will take over.

A January Standard & Poor's analysis predicted some doctors will leave St. Luke's for Methodist. Noting his hospital has lost no doctors so far, St. Luke System CEO David Fine calls the suggestion "wishful thinking" by Methodist.

But clearly St. Luke's, whose officials were astounded Methodist let Baylor get away, faces significant risk as a result of the new partnership. Smaller and less affluent than its longtime rival, it must manage increased volume, potentially alienated existing medical staff and expansion. It is paying Baylor $20 million and has budgeted $20 million more for related expenses.

Baylor, too, faces risk. Never known for its business acumen, now without Methodist's deep pockets to back it up, it must show it can profitably run a clinic in an environment glutted with such outpatient centers. It also must withstand the loss of key people to Methodist and other institutions, and a possible hit, at least in the short term, to its national rankings.

New opportunities seen
Methodist's risks are nothing about money and all about its reputation. In short, can it survive the loss of star doctors who helped make its name and remake itself as an academic institution, with its own newly started research institution and residency program? Experts say such enterprises of quality usually take decades to build.

"It's going to take a certain amount of time, probably two to three years, for this to sort itself out," said Martin Arrick, a Standard & Poor's analyst who wrote the January Methodist report. "Until then, there's going to be a lot of nervous people in the Texas Medical Center."

Much of the nervousness will center on money. A few Medical Center officials worry the conflict could cause some patients to head to a community hospital. Some are convinced that continued Baylor-Methodist discord will turn off philanthropists.

But a few see hope in the divorce, great opportunities from great upheaval, the chance for new kinds of collaboration. One such was the rapprochement last year between Baylor and the Texas Heart Institute, estranged the last 35 years because of the rivalry between DeBakey and Dr. Denton Cooley. And what else would have caused Methodist, sued by Texas Attorney General Jim Mattox in 1990 for shirking its duties to charity care, to even suggest it's interested in helping staff public hospitals for the indigent through its new partnership with Cornell?

Still, as the squabbling between Baylor and Methodist shows no signs of abating, the best view might be the last line in a thank you note received by Dr. Richard Stasney, a Methodist ear, nose and throat specialist. It said, "Let's pray for peace in the Middle East — and the Texas Medical Center."

The Baylor/Methodist Saga, Part 2 of 3 - The real heartbreaker: money

2005-02-23T08:18:00.000-08:00

Part 2/3

HoustonChronicle.com - The real heartbreaker: money

HoustonChronicle.com

Feb. 21, 2005, 10:59AM

The real heartbreaker: money
Ambitions drove a wedge between Baylor, Methodist
Editor's note: The demands of managed care in the '80s and '90s wrought fissures in the historic relationship between Baylor College of Medicine and The Methodist Hospital. Strong leaders and divergent visions left little room for compromise.
By TODD ACKERMAN
Copyright 2005 Houston Chronicle

The rift that would tear apart Baylor College of Medicine and The Methodist Hospital began with differing visions and soon became all but visible.

As Baylor's commitment to basic research exploded, Methodist went outside academia to purchase new private practices and opened a main facility with a lobby featuring soaring palm trees and a vaulted skylight.

The situation, one doctor said, was analogous to a long-married husband or wife getting a tummy tuck and face-lift, then seeking new suitors.

"The spouse asks, 'What happened to our love affair?' " said Dr. Kenneth Maddox, Chief of Staff at Ben Taub Hospital and a full-time Baylor faculty member. "The other responds, 'It's still on. You can have Thursday afternoon.' "

What happened to the Baylor-Methodist love affair was managed care. It arrived in the mid-'80s, hitting teaching hospitals the hardest because their expenses are 25 percent to 30 percent greater than community hospitals.

Reimbursed less by government or private insurers, most cut back on what wasn't cost-effective. Not atypically, that involved their medical school.

"Doing well rather than doing good became the end in itself," writes Kenneth Ludmerer in Time to Heal: American Medical from the Turn of the Century to the Era of Managed Care. "Even leading teaching hospitals often seemed preoccuppied with market domination and profitability rather than academic work and the quality of patient care."

The way Baylor saw it, Methodist was becoming less an academic hospital and more a swank community hospital, focused on the bottom line, only interested in research if it meant a quick return.

If so, the strategy worked for Methodist. While hospitals in the Eastern United States foundered, Methodist built a war chest, thanks to extraordinary business prowess and investment decisions. In the '90s, it became one of the richest hospitals in the country. Today, its reserves top $2 billion.

Meanwhile, Baylor was still dependent on private donations or, as one observer put it, the kindness of strangers. Methodist's reputation was built on Baylor doctors, but the college was seeing little of the profits, which became all the more grating to faculty in 1989, when the hospital opened the John S. Dunn Tower, the building with the opulent lobby.

Methodist's private doctors, accounting for three-quarters of the hospital's revenue, said Baylor should be more grateful. Without Methodist's support — about $50 million a year, according to the hospital — the school might have gone bankrupt, they said.

The love affair had become a marriage of convenience.

But Methodist's charms were seductive to many Baylor doctors. Between 1995 and 2003, 134 Baylor faculty members left the college's employ for private practice, most at Methodist, where they could make significantly more money. Baylor's adult clinical programs deteriorated.

In 2002, when Baylor began searching for a president to succeed Dr. Ralph Feigin, its priority was finding someone who could build up the college's adult clinical programs. An analysis showed Baylor research and education ranked in the top tier of medical schools, but the revenue it generated from adult clinical practices was 50 percent less than its peers.

In 2003, Baylor settled on Dr. Peter Traber, an outsider and drug company executive who before that was briefly CEO of the University of Pennsylvania Health System. Baylor wanted him so badly it gave him a $1 million signing bonus.

Traber, 48, brought a different style to Baylor.

Whereas his two predecessors were quiet and circumspect, he is expansive, brash, happy to butt heads. The style has endeared him to some, alienated him from others.

"There are a number of ways to do things," Traber told the Chronicle in 2003. "One is to know what to do and never do it. I'm the other kind: knows what to do and can't resist doing it. I have no problems shaking things up."

Four months after arriving in Houston, Traber did just that, announcing that Baylor wanted to build its own one-stop outpatient clinic, which would offer the full spectrum of adult care except hospitalization. The clinic would give Baylor what it never had — profits from diagnostic and other tests that make hospitals their big money.

Methodist hated the idea. Happy with the arrangement the way it was, its officials argued that such a clinic would duplicate what it did better and put the hospital in competition with its affiliate. They also argued it would strain relations with private doctors, who historically traded patient referrals with Baylor faculty.

The disagreement came at a crucial time. The partnership's contract was scheduled to expire in the spring of 2004. If they wanted an extension, the two institutions were going to have to resolve their differences.

Negotiations extended over the next eight months, halting first while Methodist studied the idea and later while Baylor entered into talks with St. Luke's Episcopal Hospital, with which the college already had a limited partnership. People close to the negotiations said it was a different Baylor in the negotiations, no longer the submissive partner it had been historically, no longer intimidated by Methodist's cash flow.

Some attributed the Baylor swagger to its new leadership, Traber and Corbin "Corby" Robertson Jr., now the board chairman. Both are former football stars — Traber was an all-state high school tight end who played at the University of Michigan until a neck injury ended his career; Robertson was an All-America linebacker for Darrell Royal's University of Texas Longhorns.

Actually, a group of 150 Baylor faculty, administrative and trustee leaders agreed on the clinic plan before Traber's announcement.

Baylor's problem was the negotiator at the other end of the table: John Bookout, now the Methodist board chairman. Bookout had piloted a B-17 bomber over wartime Europe, so he wasn't about to be intimidated by a couple of former football players a generation younger than he. He told Robertson and Traber that Methodist would build Baylor a clinic but the hospital would run it.

That wasn't what Baylor wanted to hear. It negotiated a deal with St. Luke's — one that included its own clinic — then resumed talks with Methodist.

Methodist proposed more financial support, including a bonus of up to $7 million if Baylor improved the hospital's U.S. News & World Report rankings. But Baylor thought the offer was mostly smoke and mirrors, and the philosophical differences remained.

Still, in the final weeks, the scuttlebutt was that Baylor and Methodist had worked it out. Bookout called colleagues and told them he thought they had a deal. Baylor-Methodist loyalists celebrated.

But no one knew of any deal at Baylor. On April 21, 2004, the day the college's board met to vote on the competing proposals from Methodist and St. Luke's, the college's public affairs office had two news releases ready — one that Baylor would affiliate with Methodist, the other that it would affiliate with St. Luke's.

The Baylor/Methodist Saga, Part 1 of 3 - BEHIND THE SPLIT

2005-02-23T08:14:00.000-08:00

(note: I have decided to use this blog for all things Medically related and my other blogs for everything else. As such, this series of postings will be most fitting.)

Part 1 of 3

HoustonChronicle.com - BEHIND THE SPLIT

HoustonChronicle.com

Feb. 20, 2005, 1:26PM

BEHIND THE SPLIT
Divorce in the heart of Texas
How the great Baylor-Methodist love affair failed
Editor's note: For 50 years, it was a marriage of power and prestige, a relationship that nurtured superstar surgeons and groundbreaking research. Then it all fell apart. The Chronicle examines the disintegration of one of Houston's most storied relations
By TODD ACKERMAN
Copyright 2005 Houston Chronicle

GRAPHIC
• Baylor Clinic's revenue lags behind

One night last spring, Houston elite from Michael DeBakey to Jack Blanton to Paul Hobby sat down for dinner at the River Oaks home of Dr. Joseph Coselli.

Next to each attendee's plate of chicken piccata stood a table favor — a handpainted miniature ceramic lighthouse — whose symbolism was lost on no one. It would serve as a beacon of hope to guide Baylor College of Medicine and The Methodist Hospital through the turbulent waters swirling around them.

One by one, the roughly 25 people there stood and spoke about the looming crisis, the institutions' shared history and the heartfelt plea they should send to governing board members to not let it end.

"Baylor and Methodist are stronger together than they are apart," said Blanton, a Houston civic leader and oilman who is on Methodist's board. "The sum of the parts is greater than the individual pieces."

Nine days later, on April 21, 2004, the individual pieces fell apart. After 54 years together — some the stuff of legend — the two venerable nonprofits parted ways, squabbling, suspicious and, finally, unable to reach an agreement to extend the partnership in which Methodist served as one of Baylor's primary teaching hospitals. In the history of U.S. academic medicine, say historians, such a split has never occurred.

A bitter battle
On the surface, the split has been nothing so much as a mud bath, made particularly incongruous because it's happening in the Texas Medical Center, which prides itself on keeping dirty linen private. Suddenly, the center looks more like the scene of a nasty Texas divorce, replete with bitter custody battles, eyebrow-raising new mates, unsuccessful mediators, accusations of betrayal and longtime friends trying to stay neutral.

Beneath the surface, the breakup is just as compelling. At heart a tale of changing health care economics and contrasting strategic visions, it is also the story of personality conflicts, big money, 11th-hour intrigue, high risk and innocents caught in the middle.

What happened before the split, what's happened since and what might happen have shaken the Medical Center like no previous event. Even as Baylor and Methodist claim they've moved on, people around town still shake their heads, still questioning the split's wisdom.

"I don't know who is to blame or how it happened," said Larry Mathis, Methodist's president and CEO from 1983 to 1997. "But the divorce is a tragedy nonetheless. It benefits no one — not patients, not physicians, not the Houston community and certainly not Baylor or Methodist, who'll spend all that money on lawsuits, consultants and mediators and all that executive energy and focus on dissolution instead of patient care, teaching, research and community benefit. To what end? To duplicate a fine system that already exists."

'The new Lourdes'
The deep feelings about the Baylor-Methodist partnership can be traced to the Medical Center's rise to greatness in the 1960s and 1970s, a time when it became, in the words of late author Thomas Thompson, "the new Lourdes."

At first glance, the partnership's role in that rise may seem overblown. Methodist, after all, is one of five major Baylor teaching hospitals, and even in the institutions' heyday, more residents rotated through Ben Taub and Texas Children's hospitals.

Through their history together, Methodist employed about a sixth of Baylor's total residents, who now number about 1,200.

But Methodist was always the most glamorous, the place that provided treatment to celebrity patients from the shah of Iran to Mafia boss Sam Giancana to movie actress Marlene Dietrich to shipping magnate Aristotle Onassis.

The rise of DeBakey
The celebrity patients were usually there to see DeBakey, of course. Based on research conducted in his Baylor lab, DeBakey pioneered numerous cardiovascular firsts at Methodist — techniques for the repair of deteriorating arteries and heart valves, the coronary artery bypass and the surgical clearing of arteries leading to the brain.

It all made DeBakey the world's most famous surgeon — and Methodist the place to receive his treatment. In 1963, 200 million people watched on the first live worldwide satellite broadcast as he performed a heart-valve operation. In 1965, Time put him on the cover and the Duke of Windsor called him "the maestro." From the early '60s through the '70s, his rivalry with Texas Heart Institute surgeon Denton Cooley brought patients to the Medical Center from near and far.

"DeBakey built a department of surgery at Baylor and at the Methodist Hospital, which was to become one of the most celebrated in the world, a galaxy of young stars," Thompson wrote in 1970 in Hearts: Of Surgeons and Transplants, Miracles and Disasters Along the Cardiac Frontier. "In a city where 25 years ago there was practiced medicine of the most mediocre sort, there sprung up in a swampy area six miles south of downtown, a collection of medical facilities, which, by 1970, had become one of the handful of distinguished medical centers in the world."

If the Baylor-Methodist story is one of an ultimately failed marriage, the '60s and '70s were the years of its great love affair. DeBakey became president of Baylor in 1968 and he and Methodist President Ted Bowen got along famously.

When DeBakey went to the Soviet Union to operate on a nuclear scientist, Bowen went along, making sure the surgeon's team was well-managed, taking care of hotels and meals. Earlier, the two conceived the first cardiovascular intensive-care center.

Working in harmony
It wasn't just DeBakey and Bowen. Bowen also teamed up with Dr. Antonio Gotto, then Baylor's chairman of internal medicine, to launch a restaurant — Chez Eddie — that combined healthy cuisine and creative cooking. Ahead of its time, it would eventually become quasi-trendy despite its Medical Center location.

The harmony was great for philanthropy. About $10 million in the red when DeBakey became president, Baylor subsequently cut ties with its Waco university parent and began fund raising aggressively in Houston. Its first campaign, for $30 million, put it in the black and in less than 30 years it would grow to $1 billion. Among the early campaigns was a $35 million joint effort with Methodist for a then-groundbreaking neurosensory building.

The neurosensory building campaign was chaired by a new Baylor trustee, Corbin "Corby" Robertson Jr., a grandson of Hugh Cullen, the "King of the Wildcatters" and Humble oilman whose philanthropic foundation has endowed education and medical research in Houston since the '40s. Later, in the '70s, former Shell Oil CEO John Bookout joined the Methodist board. A quarter century later, the two would figure prominently in the split.

But problems would surface long before then.

2005-02-20T17:30:00.000-08:00

We decided to take advantage of the amazing weather lately and do some studying in the park behind the Bush school in College Station, here's some of the pics we took.

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First Post

2005-02-20T00:43:00.000-08:00

I decided that I would start a blog to kind of chronical my clinical years through the last part of medical school. I thought it would help putting my experiences down somewhere, and keeping track of how things also go in my daily life. I hear it's good for venting and I'm looking forward to something new... plus anything by Google is great anyways.

Anyways... the night is getting on and I've got a case of the midnight munchies...