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

Book #4: Prince Caspian  0

Posted on January 19th, 2006. About Books.

Book #4: Prince Caspian by: C.S. Lewis, the fourth in the Chronicles of Narnia series; pages: 101.

This was my favorite of the first four Narnia books. The four children reappear on a deserted island and stumble across ruins that stimulate sad, nostalgic discussions of their days as kings and queens of Narnia. They venture out to assist the rightful heir King Caspian in his claim for the throne. The transition at the end for the older children into young adulthood is smooth and believeable.


  • 19/365 – 5.20% of 2006 complete
  • Books Read – 4/50 – 8.0%
  • Pages Read – 398/15000 – 2.65%

Book #3: The Horse and His Boy  1

Posted on January 17th, 2006. About Books.

Yet, another book in the Chronicles of Narnia is complete (or has been for decades, but now *I* have completed my read of it). The Horse and His Boy by: C.S. Lewis was a decent read, but at times it seemed a bit silly and unrealistic. Yes, I am aware that it is fantasy and that talking horses may seem that way, but I have read fantasy before where I was able to successful undergo “the suspension of disbelief.” In any case, I did like one particular scene where Aslan reappears and explains his omnipresent existence throughout the book. I got sick of the scenes in Tashbaan. I much preferred The Lion, the Witch, and the Wardrobe.

Anyway, another brief read finished, and still I am ahead with total books but behind in number of pages read. Once I am through with the Narnia books I will embark on lengthier reads – my plan is to go next to Team of Rivals by: Doris Kearns Goodwin, a book I received for Christmas about Abraham Lincoln.

Progress toward goals:

17/365 = 4.66% days of the year completed

3/50 = 6.0% number of books completed
297/15000 = 1.98% number of pages read

Book #2: The Lion, the Witch, and the Wardrobe  1

Posted on January 8th, 2006. About Books.

Book #2 – The Lion, the Witch, and the Wardrobe by: C.S. Lewis, the second in the Chronicles of Narnia series. Pages – 86 (again, in the anthology of all seven).

This was a quick, fun read, especially after having recently seen the film.

Jenna is off to a roaring start with her new year of 50 books/15000 pages for 2006. She has completed three books totaling 851 pages. Wow!

I will follow her in tracking stats because, well, numbers are fun.

Progress toward goals:

8/365 = 2.19% – days of the year completed (2006 is already over 2% finished; unbelieveable!)
2/50 = 4.0% (doing okay as far as number of books goes)
192/15000 = 1.28% (Yikes! Once the Narnia series is complete, I need to get started on some lengthier books to keep up here)

Book #1 – The Magician’s Nephew  0

Posted on January 6th, 2006. About Books.

Book #1 – The Magician’s Nephew by: C.S. Lewis, the first in the Chronicles of Narnia series. Pages – 105 (at least in the edition I am using – a large volume containing all seven books).

This is the first book completed in my attempt to read fifty books in 2006. It has established what is to come – how the famous wardrobe came to function as a doorway to another land, how the White Witch entered the land, and, of course, presents an allegory for the Creation. It’s good to finally be reading something I should have completed by junior high school. 🙂 Where have I been all these years?

Overly ambitious, perhaps?  0

Posted on December 26th, 2005. About Books.

Previously posted on December 26, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!146.entry

I have decided that I *am* going to attempt to read 50 books in 2006. Now, those who know me best probably find this hilarious given that I seldom make it through five books in a given year, but I am determined to read more. I believe the way Jenna’s goal went was 50 books or 15,000 pages, and not all 50 books had to be the length of Atlas Shrugged. I may even begin posting reviews on my website – – which is actually a website documented my running experiences, but I can create a sub-directory and go for it. I actually know exactly where to start with my reading too – Mom, Evan, and I saw the new cinematic version of C.S. Lewis’ The Lion, the Witch, and the Wardrobe, and I was pleasantly surprised by how much I enjoyed it! This is the only book of the Chronicles of Narnia series I have read, and it was when I was in fourth grade – so I think it’s time to read the series (See? Seven books, right there…). I also received Doris Kearns Goodwin’s new Abraham Lincoln biography, Team of Rivals, for Christmas, so that will be on there as well (significantly longer than any of the Narnia books). I will put together my reading list and post it soon.

“Head and Shoulders” by: F. Scott Fitzgerald  0

Posted on December 9th, 2005. About Books.

Previously posted on December 9, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!142.entry

Anyone who knows me is aware of the fact that I became an F. Scott Fitzgerald fan after taking a marvelous course on Fitzgerald and Hemingway during my college days. Not only was I enrolled in a fascinating course, but it was taught by Matthew Bruccoli, well-recognized as the world’s leading Fitzgerald scholar. He has amassed the most sizeable and important Fitzgerald collection in the world over his 50+ years of scholarship, and on the centennial of Fitzgerald’s birth (1996 was the 100th anniversary), Bruccoli donated his collection to the University of South Carolina’s Thomas Cooper Library. Throughout the course, we held first editions belonging to Fitzgerald, inscribed to him by greats such as Hemingway and Joyce. It was among the more remarkable academic experiences I can boast.
I would like to comment here on a Fitzgerald short story unfamiliar to me until this afternoon, Head and Shoulders, from The Short Stories of F. Scott Fitzgerald, edited by Bruccoli. Bruccoli notes that this was Fitzgerald’s first short story to appear in the Saturday Evening Post (1920), and indeed it does seem somewhat juvenile compared to the author’s later writings. However, it is very amusing and whimsical – typical Fitzgerald, admiring a woman and yet blaming her for a man’s poor decisions that have led him into a less-than-stellar existence. In brief, Horace Tarbox is a seventeen year old boy, full of scholastic promise as he pursues his Master of Arts degree at Yale, until the beautiful and interesting vaudeville actress, Marcia Meadow, appears at his doorway. From this point, he falls for her and sacrifices his entire future in academia to marry her. They call themselves “Head and Shoulders” – she earns money dancing (shoulders) until his intellectualism begins to gain recognition and earn money (head). (Warning: spoiler alert!) She becomes pregnant and is forced to stop dancing and acting. He, therefore, must use his skills in gymnastics to earn money for his new family; later, he finds that while he has been performing each night, she has been writing a book. Her book is published, she becomes a famous author while he performs, and a newspaper article at the end of the story paints her as the head and him as the shoulders in the relationship.
It is a real killer- throughout the narrative, the contrast in the two people’s cognitive ablities is quite evident – Marcia cannot comprehend the basics of philosophy or economics (she even comments on her husband’s endless reading on the subject of “economy,” when she means “economics”), while Horace enters Princeton at 13 and debates whether he should wait until he is 17 to compose a series of essays, while he will title “The Pragmatic Bias of the New Realists.” The reader cannot help but cringe when the newspaper at the story’s conclusion refers to Marcia as the “head” in their marriage.
Dr. Bruccoli used to tell me that he believed Fitzgerald painted women in a positive way compared to his contemporaries of the time. It is true that he describes their beauty and their importance to men, but I find a pattern emerging in which the male protagonist blames a woman for his lack of success. Head and Shoulders fits perfectly within this description. In any case it is a fun and interesting read, especially after having read Fitzgerald’s darker, more complex writing from later in his life (Tender is the Night is the piece that springs to mind here).
Of note, it was Dr. Bruccoli who encouraged me to evolve into a rare book collector. My Iris Murdoch collection exists because of my experience with this remarkable English professor.

Inspiration!  0

Posted on December 8th, 2005. About Books.

Previously posted on December 8, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!141.entry

I have recently found the inspiration required in order to write a good, complete story. I would claim to be writing a book, but A) I don’t know how long it will be, and B) I may get sick of writing it at page 40 (which has happened twice before). I have a day off tomorrow and look forward to working on an outline and character summaries.
On that same note, my friend, Jenna, spent 2005 attempting to read 50 books and/or 15,000 pages within the year. I think she’s on ~ book 39, but knowing her, she will not sleep the final two weeks of December in order to achieve her goal. I seriously doubt I could read that many books in 2006, but I am playing with the idea. I have reached a point where I watch too much television and could use a good dose of intellectualism again, especially given how nostalgic I have grown recently over my college days. I will put together my ideal list of the 50 books I would like to finish – some will be new for me, and others re-reads of what I used to enjoy but have not touched in nearly a decade – and I’ll post it. Keep in mind that whenever the final Harry Potter book is published, whatever I am reading at that time will be dropped in order to learn whether Harry or Voldemort ultimately survives. The same goes with anything new that Jonathan Safran Foer may complete – all else gets tossed aside to indulge myself with his next novel/essay/anthology.

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.

My Introduction to Jonathan Safran Foer  0

Posted on September 25th, 2005. About Books.

Previously posted on Sep 25, 2005 at:!1p1a54g1PSNkhyBLLbfi4i8A!106.entry

During the summer of 2001 The New Yorker magazine published several stories (I think there were four) by new, young, up-and-coming authors. I had begun reading the publication a year earlier, when a biology professor informed me that reading New Yorker-quality articles would aid me in preparing for the verbal reasoning portion of the MCAT (Medical College Admissions Test). Yes, he admitted, this was South Carolina, and the locals were not prone to reading periodicals with Yankee state names in the title <g>, but this was worth the read. I quickly became hooked on the weekly short fiction. In any case, I distinctly remember several things about the up-and-coming fiction writers issue of The New Yorker from 2001 – the first story was about a young girl who falls in love with a much older man in India, but I don’t recall the author’s name. There was a story by Gabe Hudson about a soldier who returns from the Persian Gulf with Gulf War Syndrome – an intriguing, tongue-in-cheek piece outlined in the form of a letter to President Bush (41). Most remarkably, though, was an excerpt from a novel by Jonathan Safran Foer. I won’t elaborate on details, but the style of the piece took me by surprise – Foer possessed a mastery of language, of delineating the barriers of languages in communicating sentiments and emotions. His writing was hysterically funny, too. I placed the magazine onto my bookshelf, deciding that I would watch Foer’s career and see where it took him.

Summer of 2002: Again, I’m reading The New Yorker, although I haven’t been as diligent about reading it cover-to-cover over the past year as I have been surviving my first year of medical school in Charleston, SC, and I must admit that I had forgotten that Jonathan Safran Foer existed a year ago for me. One of the most phenomenal pieces of short fiction I had read to that point (and have still read to this day) was hidden, awaiting me as its audience. “A Primer for the Punctuation of Heart Disease” utilizes typeface symbols to represent expressions. Foer introduces the symbol, then gives an example of how the symbol would be properly used, and then throughout his story he incorporates these symbols as a substitution for the English language, but still perfectly conveying his intentions, the meaning behind the passage very clear. I loved it.

In the interest of keeping this entry brief, I will outline some of Foer’s writings I have enjoyed since my introduction to him:

Everything is Illuminated – Foer’s first novel, and an excellently crafted montage of tales featuring the history of Trachimbrod, a town obliterated during the World War II. Paralleling these mythical accounts is the story of Jonathan and Alex (Jonathan’s Ukranian translater) journeying through the Ukraine in search of information about Jonathan’s family history.

“Cravings” – short story, kind of bizarre, but a fun, interesting read

“About The Typefaces Not Used in This Edition” – short story in The Paris Review, where Foer further explores the use of symbols to convey tone/emotion

The Future Dictionary of America – edited by Foer, this is a compilation of satirical definitions, most of which possess political overtones. It was published before the 2004 presidential election, and proceeds were advertised as going to liberal groups. It is one of the most clever concoctions so far this century.

Extremely Loud and Incredibly Close – Foer’s brilliant 9/11 novel about Oskar, an extremely gifted and eccentric young boy who loses his father in the World Trade Center catastrophe; again, Foer manipulates language, this time between a man who has gradually made himself mute, but who uses “yes” and “no” tattoos on his hands and points to phrases on a pad of paper that mean almost what he is trying to express. One of the best novels I have had the pleasure of reading – I highly recommend it to all (anyone who does not mind putting energy into a rewarding reading experience, anyway).

So this is my official introduction on Jonathan Safran Foer. More to come later

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