Residential Space A creative outlet during residency, turned ongoing virtual soap box

$690,000 for a 1975 Ford Escort  0

Posted on October 30th, 2005. About Ramblings.

Previously posted on October 30, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!136.entry

I ran across this article this morning – there are several interesting points here:
A) The 1975 Ford that was purchased for $690,000 was owned by Pope John Paul II, and
B) The man who purchased it is Baptist.
Awwww, so a religious man wanted to own the car the Pope drove. He must be a wonderful person!
Oh…but then there’s more:
C) This Baptist man, who claims he wants to own the car so he can touch it and feel the Pope’s spirit, owns 600 cars, and he became wealthy because:
D) He made his fortune in a multi-billion dollar tobacco settlement.

Censorship!  0

Posted on October 21st, 2005. About Computers and Internet.

Previously posted on October 21, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!135.entry

I am working at the VA Medical Center right now, and during my downtime I usually check email or read the news from the day on various websites. Just now, I thought – you know, I have a few minutes. I should see if Comedy Central posted footage of the Bill O’Reilly interview from his appearance on The Daily Show. Wouldn’t you know it – is blocked on all VA computers. And since routes back to I cannot access it in this manner either. My primary source for news is unobtainable while I’m at work! And yet…I don’t have any trouble accessing the Fox News website. Coincidence?
By the way, my cousin, Shannan, was on the news recently in New York City! Click HERE to go to the news affiliate’s website, and then click on the right side of the screen to view the footage.

Nice smile!  0

Posted on October 20th, 2005. About News and Politics.

Previously posted on October 20, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!133.entry

Okay, as we all know – I’m no fan of Tom DeLay. However, I just saw his booking photo (seen here) and I think he did the smart thing. He smiled big for the camera, dressed in a nice shirt with a tie. He knew the photo would be all over the media and the internet – so he posed for a nice portrait-style shot. I’ll give him this one – it was a nice move, and it made me, a “liberal” in Seattle, laugh aloud, amused. 🙂

Do not DeLay, go directly to jail, do not pass Go…  0

Posted on October 19th, 2005. About News and Politics.

Previously posted on October 19, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!131.entry

I am sure anyone actually reading my blog will know why I am posting this (click here). I am sure that Republicans will claim that an overzealous prosecutor in Texas is out to get DeLay and has a personal agenda against him, blah blah blah. Given DeLay’s multiple indictments/subjects of investigation in the past, well, I will just quote my husband on this one: “Where there’s smoke, there’s fire.”
Oh, and for those of you who think CNN carries a liberal bias and that Fox News is the only “fair and balanced” source out there, click here. Apparently he really HAS been arrested! Go figure.

Bill O’Reilly strikes again  0

Posted on October 19th, 2005. About News and Politics.

Previously posted on October 19, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!130.entry

I just watched The Daily Show from October 18th, and Bill O’Reilly really showed what a truly miserable person he is. He immediately started in on Stephen Colbert, former Daily Show correspondant and currently the anchor of his own comedy news show (satirizing The O’Reilly Factor), The Colbert Report. First he obnoxiously picked on him for being “that French guy.” When Jon Stewart pointed out that Colbert’s family was part of the South Carolina aristocracy (Colbert was a graduate of Porter Gaud, a prestigious private secondary school familiar to Charlestonians), O’Reilly’s very predictable response was that Colbert’s family must have been slave-owners. Honestly, what is with this guy?! Stewart delivered a brilliant performance, always one-upping O’Reilly with witticisms and one-liners that added the evidence of his command of debate. In short, Stewart came off looking intelligent, witty, and brutally honest, while O’Reilly had egg on his face.
Comedy Central has not yet posted an online video version of the O’Reilly interview, but I will place a link to it here once it is up and running.

I’m finally reading “The House of God”  0

Posted on October 18th, 2005. About Books.

Previously posted on October 18, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!129.entry

Yes, I know – book titles are to be either underlined (MLA) or in italics (as in, when they are informally referenced in a newspaper article), but MSN is not allowing me to use either of these features in my title. C’est la vie. In any case, Samuel Shem’s novel, The House of God, is supposedly a must-read for anyone going into medicine. Most physicians, from what I understand, read it during their third or fourth year of medical school. A PA student, Adam Gedney, gave it to me at the end of my third year, and it sat on my shelf – until many of my fellow residents started quoting it at me.
Roy Basch is the “protagonist” in the book – a 31 year old man who has graduated from BMS (“Best Medical School” which is supposed to represent Harvard) and has landed a residency at the prestigious House of God Hospital (which is supposed to represent Beth Israel Deaconess in Boston). It’s astonishing to me, because much of what Shem relays in his writing, despite having written the book in the 1970s before residency work hour restrictions, I can totally relate to. I know how it feels to be so mentally and physically exhausted that small, seemingly unimportant things make one burst into tears. I know the smell of urine in the hospital and bowel preps. Despite being a book from “the old days,” I am also surprised by how familiar much of the terminology is – to “turf” someone to another service, a “LOL in NAD” (a little old lady in no apparent distress), and I am acquainted with the concept of throwing steroids at any patient about to die to see if it makes a difference at the last minute.
The House of God also outlines a set of rules that interns still reference in 2005. Here they are: 
  • Gomers (an acronym for “Get out of my emergency room” – these are old, demented people who will sit on a resident’s service for weeks awaiting placement in another facility) don’t die.
  • Gomers go to ground.
  • At a cardiac arrest, the first procedure is to take your own pulse.
  • The patient is the one with the disease.
  • Placement comes first.
  • There is no body cavity that cannot be reached with a #14 needle and a good strong arm.
  • Age + BUN = lasix dose.
  • They can always hurt you more.
  • The only good admission is a dead admission.
  • If you don’t take a temperature, you can’t find a fever.
  • Show me a BMS (Best Medical Student) who only triples my work and I will kiss his feet.
  • If the radiology resident and the BMS both see a lesion on the chest x-ray, there can be no lesion there.
  • The delivery of medical care is to do as much nothing as possible.

I don’t particularly agree that the only good admission is a dead admission – I think he just means that, at 5AM when he is exhausted and an “interesting case” arrives in the ER, at that point there is no such thing as a good admission, because it is preventing him from sleeping.

Many of the other rules are hilarious, and shockingly, quite true. Take #2 – “gomers go to ground.” My first week on an oncology service one of my colleagues was paged because a demented patient got out of bed, fell, and broke his hip. Since that time, I have had three of my own patients fall out of bed in the middle of the night, fortunately not breaking any bones or resulting in any cerebral bleeds. BUT, I am currently on night float, and I am constantly paged because older patients try to walk around and go straight to the ground. In The House of God they lower the beds to the ground and it saves them a lot of trouble. I have started doing this, and it works beautifully.

It may seem crass to claim, as a physician, that the proper way to practice medicine is to do as much nothing as possible, but I have seen how many consequences can arise from a patient undergoing unnecessary procedures and taking unnecessary medications. Often aggressively interveing results in more (and worse) problems than what the patient was initially admitted with. I am all about doing nothing when nothing is appropriate.

Age + BUN (blood urea nitrogen content) = Lasix (a diuretic, aka “water pill”) dose is a nice one, and because it’s not scientifically proven, most of us start with a low dose of lasix and work our way up. What is scary is that once I give a dose that exceeds the sum of a patient’s BUN and age people who I thought would never pee actually surprise me with some urine.

And placement…ahhh, yes, placement is oh so important. I would say at any point 30 to 50% of the patients on my internal medicine service have no acute medical issues, but are awaiting placement either at assisted living, a skilled nursing facility, a drug and alcohol rehab program, a homeless shelter, a transitional care unit, a psychiatric hospital…the list goes on and on AND ON AND ON… When patients hang out in hospitals without medical issues, it is inevitable that they will acquire them. They are surrounded by sick people. They end up with staph infections or C. difficile diarrhea or a hospital-acquired pneumonia. Again, it may sound insensitive to focus so much on placement in this novel, but I can atest to the importance of good, early placement.

One recurring theme in the book I cannot relate to is having sex with nurses in the call rooms. I can’t exactly relate to all of the sex that goes on between residents and attendings on Grey’s Anatomy or ER or Scrubs either though. Medicine has become a profession of both men and women and the work environments are more respectful. We are constantly reminded about sexual harrassment and what it means. Plus, I see more residents in marriages and long-term relationships, and with work hour restrictions we actually have time to spend with our significant others.

Anyway, this post is growing much too long, so I will close. I am on page 209 of The House of God and expect to see a demoralized, cynical Roy Basch at its conclusion, questioning his decision to enter medicine. I am very grateful for laws that enable residents to maintain semi-decent qualities-of-life during their training (she writes, typing at her hospital computer at 8PM, three hours before her shift ends). I do not expect to complete my intern year as a demoralized, dejected person, but rather as a physician with a year of experience, prepared to move on to what comes next.

Simple Post  0

Posted on October 14th, 2005. About News and Politics.

Previously posted on October 14, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!128.entry

All I have to say is:
  • Tom Delay – indicted
  • Bill Frist – subpoenaed to testify about his suspicious stock trade
  • Karl Rove – in deep doo doo over leaking the Valerie Plame’s identity as a CIA agent
  • Tom Delay – indicted a second time for money laundering
  • Scooter Libby – may also be in deep doo doo for the same reasons as Karl Rove

The Condo is Painted!  0

Posted on October 10th, 2005. About Home.
My mother and I spent the weekend painting my living room and hallway, and what a difference a bit of color makes! We did not drip on the carpet, and the ceiling was not harmed in the process. If you glance at the photos, the “before” shots demonstrate white walls (or, rather, “bone”) and there is no furniture, so it is a bit difficult to compare. But wow – look how different everything appears with color! I just love it.
The excellent artwork was given to the Evan and Jodi Dodds Collection by the artist himself, Dr. Curt Grob. You may check out his online gallery by clicking here.

Big step towards maturity…  0

Posted on October 7th, 2005. About Home.
I have never painted walls. Ever. Up until this point, I:
  • Never had the desire to do so while living with my mother as a child/adolescent.
  • Lived in the college dormitories and was not allowed to paint the walls.
  • Rented during medical school and, again, was not allowed to paint the walls.

Evan and I bought a condo in May, and after months of tormenting myself with questions such as – “What if I screw it up?” or “What if I drip on the new carpet?” or “What if I hate the color?” I have finally worked up the courage to try it. I have lived with white walls for too long (or, as my friend, Beth, has informed me, the current color is actually “bone,” even worse than “white”). My mother is in town from South Carolina and has graciously agreed to assist me, having painted numerous times and with a knack for decorating.

So here goes – hopefully my walls will still love me, and when Evan arrives home this evening, his home will not look the same. Hopefully I will not be convincing him that paint drips on carpet are all the rage and that it was supposed to turn out that way. Heh.

Where it’s available, try public transportation! :-)  0

Posted on October 4th, 2005. About Ramblings.
It is a huge topic of conversation these days – those outrageous gas prices. The media has thrown around phrases like, “Will we see relief at the pump?” or “The price of crude oil is soaring.” I empathize with small business owners, the airlines, and a few select others who suffer when the price of oil climbs. For all of the others – I just smile, because the thought going through my mind is: my spending on gasoline has never been lower. 🙂
On September 21st my husband, Evan, and I flew to Las Vegas out of the Seattle-Tacoma International Airport. Evan told me to pack lightly, because we would be taking the bus. Now, I am a believer in public transportation – but all of the way to the airport? What if it was crowded? What if the bus broke down and we missed our flight? We used public transportation to airports quite a bit in Europe, so I decided to give it a go in my own city. Each of us boarded the #14 bus with our small rolling suitcases, exited at King Street Station, and moments later caught the #194, which took us directly to the airport. That was it. So what did this bus ride save us?
Here are the standard parking rates at the SeaTac Airport:

Length of Stay


Total Charge

5 days $85 (savings of $15) $85
6 days $85 (savings of $35) $85
7 days – one week $85 (savings of $55) $85
8 days $85 + $20 (one day at normal daily rate) $105
9 days $85 + $40 (two days at normal daily rate) $125
10 days $85 + $60 (three days at normal daily rate) $145
11 days $85 + $80 (four days at normal daily rate) $165
12 days $85 + $85 = $170 (weekly rate x 2) $170
13 days $85 + $85 = $170 (weekly rate x 2) $170
14 days – two weeks $85 + $85 = $170 (weekly rate x 2) $170
15 days $170 + $20 (one day at normal daily rate) $190
16 days $170 + $40 (two days at normal daily rate) $210
17 days $170 + $60 (three days at normal daily rate $230

 Typically $20/day is charged, but parkers start to see breaks if they have parked for 5+ days. We would have been parked for seven days, so that is $85 (at the discounted rate) we saved by taking the bus.

 You may ask – but how much does it cost to ride the bus? A trip to the airport is $1.25 one-way. Not bad! It’s a little different for us, though, as I will explain.
The company that employs Evan provides all of its employees with a FlexPass, which allows “free” rides on all of the city buses and trains (and probably more that I am leaving out). Being a University of Washington employee, I continuously purchase what is called a U-Pass. Every two weeks, $9.50 is deducted, pre-tax, from my paycheck to pay for this pass, and it is worth every penny. It’s even less than this for UW students – for more information, click on the hyperlink above.
Here is what my $19/month buys me: 
  • Peace of mind in trying to find parking – a huge plus. In addition, I don’t have to PAY for parking either – another huge plus.
  • It buys me sanity – I don’t have to silently scream at other drivers who cut me off – because I don’t have to drive.
  • Less frequent car maintenance.
  • Try this one on – my friends and family have heard it already, but it’s worth repeating: I last filled the gas tank in my car on SEPTEMBER 6, 2005. That is two days shy of a month ago – and I still have 3/8 of a tank of gas.

I will not even begin ranting and raving about all of the huge SUVs on the roads, so let’s just say – regardless of what type of vehicle you drive – try leaving it parked and jumping on a bus! For more information on the Seattle bus routes, click here, or here, or perhaps here.

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