My Europe Trip- Hallstatt

After navigating the Austrian railroad systems, we arrived in the tiny alpine town of Hallstatt. In making our Europe bucket list, one of the things we both wanted was to hike in the Alps. I added a stroll through a quintessential alpine village, and Hallstatt gave us both.

Hallstatt is this tiny little town, which happens to be one of, if not the, oldest continually inhabited locations in human history. The reason for this is a rich salt mine in the mountain above the village. They have found remains from thousand of years ago there. Since these stone age folk, the place has been used by Rome, various small kingdoms, and the Hapsbergs. They still mine the salt (which comes out pink) today, and Laura and picked up a few bottles.

Anyway, here's the town:

And here's a few pics from our stroll through the Alps:

After a few days, several bottles of great Riesling, and witnessing a genuine May Pole, we caught a bus through the Julian Alps and straight to Venice...

My Europe Trip- Vienna

Now I can't really remember why we started with Vienna. I guess it seemed like a good idea at the time.

Anyway, whatever the reason, we embarked from Portland, Oregon (Where had just moved all our belongings 4days prior), and flew almost halfway around the world to Austria with only a backpack each. We only spent a couple of days in Vienna, but it was great. Amidst wienerschitzel, extravagant cafes, various kinds of wursts, and a sea of Arians, we took in the higher points of the city.

The first stop was the Belvedere, where we got to bum around and old Hapsburg-era mansion and check out Monets.

From there we meandered over to St. Michael's church, which was built in 1147. It has since been added on to several times, though not since the mid 1400's. There I lit the first of many candles across southern Europe, and we climbed the 350 steps up one of the towers, and got a bird's eye view of Vienna.

Before we left, we went to the Haus Der Musik. It's basically the OMSI of music museums, which means it had endless rooms of crazy hands-on music sound exhibits with a Euro-punk vibe throughout. The grand finale of the museum, though, was Laura getting to conduct the Vienna Orchestra through a full piece. The orchestra was a recording on a huge projector, but it went faster or slower and got louder or softer depending on your conducting.

The next morning we hopped on a train straight into the Alps...

My Match

So, it's been a while since I've blogged, and a lot has happened.

I'll try to tell things in chronological order.

First, I matched in Oregon.

As an aside, this upcoming thursday is the 2011 match. It's so weird to be on the other end of things now. I would have been way way more nervous if I'd known just how arbitrary the whole decision making process is.

But, as fate would have it, I matched in Oregon.

Here are some pics from the celebration, which was on the top floor of the Mayo hotel in downtown Tulsa:

Here's the view from the rooftop, just outside the penthouse:

These are the other Tulsa folk who God smiled upon and matched in Portland:

Another shot of the Match Day festivities

Immediately after this party, Laura and I changed, jumped in the already packed truck, and took of for a cabin in the Ozarks. We hid out there without cell phones or indoor heating (Just a sweet fireplace) and planned our move to Portland and now possible trip to Europe.

My Tradition

First off, let me announce that Laura and I sold our Ram. Though we had our ups and downs, it was a great truck to drive, and in the end we sold it for more than we bought it. And, it was of course way better than Zach's.

So in keeping with our tradition of only owning blue vehicles, Laura and I went on an expedition to Topeka, Kansas, and came back with this:
our new old Jeep CJ7! It's rough and bare, but it's ridiculously fun to drive.
Now we have to think of a name for her...

My Family Heirloom

Tonight I was over at my parents' house, and my dad handed me this family heirloom:
This was my great grandmother's. Her name was Beatrice, she kept a spittoon under rocking chair, and she used to take me to the local grocery store to get Moon Pies.
Now, you may be wondering what in the world this is. Well, it is a printed extra long revival sermon explaining very clearly that alcohol is the tool of the devil.
Here are some excerpts I have stumbled across in my first five minutes of reading:

"The booze business is the best friend the devil has, and it is the greatest enemy the Lord has. A booze seller has locked arms with the devil... booze lies in wait for the unborn. Booze is a killer and a liar.
Yes, BOOZE IS THE BEST FRIEND THE DEVIL HAS ON EARTH."

[In response to a Pub owner saying that he sells alcohol legally and does not tolerate drunkenness in his establishment. He sells only to "decent people."]
"'Friend,' replied a Quaker, 'that is the most damnable part of thy business. If thee would sell to drunkards and loafers, thee would help to kill off that race and society would be rid of them.'"

"The booze crowd lives in the most fashionable houses in town.
The booze crowd rides in the finest cars in town.
The booze crowd sits back in their easy chairs while their patrons sweat.
The booze crowd wears the finest clothes in town.
The booze crowd eats the finest steaks.
The booze crowd's little children wear nice little warm sweaters and shoes.
...I MUST SAY JUST ONE MORE TIME- WINE IS A MOCKER!"

You can't make this stuff up.

My dream car

This was parked next to the hospital yesterday.

My Poor Patients

What not to say to the new mom who brought her 2 month old in for a checkup:

"Her name's Adelaide? That's a great name. It's what I named my dog."

My Clinical Example

I've been studying for taking test #2 of 4 for my medical license. I'm pretty sure it's like 10 times harder than taking the Bar exam.
Anyway, this is an excerpt from a clinical example they gave for a lung abscess:
In fact, the most striking feature of his presentation is not his physical exam, but the fact that as soon as you enter the room, there is such a powerful, bad odor that you look under the bed in the drawers to see if a decomposing, dead animal can be found when suddenly you realize it's your patient's breath. No dead animals are found.

My New Chart

For Zach.

This is posted on the wall of the residents' station in the hospital.
No joke.

My Garden

Here's a few pics of my garden these days.

My Lunch Lady

The lunch lady at the hospital had this nametag:

"Patricia Titsworth"

My amazing niece

Yesterday we hung out at my brother's house for a Terminator marathon. When we got there, my adorable niece

asks if "Keesh" is coming. By "Keesh" she meant "Keith." She had met Keith the week before when we babysat her for a while. Anyway, we told her that he wasn't coming, and she goes, "Okay good, 'cause he was scary."
After we stopped laughing, Laura tried to explain that Keith wasn't scary. It went something like, "Keith isn't scary. He's just tall and really skinny. Kind of like a bean."
To which my niece replies, "Like a scary bean!"

Also, this is her making her Zoolander face:

My provost

So the OUHSC provost, while in the process of developing a swine influenza task force for the zero swine influenza in Oklahoma, sent out an email to the entire OUHSC community which included the following list "basic personal steps" to stop flu transmission:
1. Wash your hands thoroughly and often with soap and warm water for 15 to 20 seconds, especially after you cough or sneeze.
2. When soap and water are not available, alcohol-based hand gels are effective.
3. Cover your nose and mouth with a tissue when you cough or sneeze, and throw the used tissue in the trash. If you don’t have a tissue, cover your cough or sneeze with your shirt sleeve.
4. Suspend courtesy hand-shakes and kisses for the time being.
5. Avoid touching you eyes, nose or mouth. Try not to touch surfaces that may be contaminated with the virus.
6. Avoid close contact with people who are sick.
7. If you get sick with flu, stay home from work or school and limit contact with others

So now I can no longer give my patients courtesy kisses, nor can I touch my eyes, nose, or mouth. I must also be careful not to touch any surfaces that could have the virus on it- not a problem in a hospital. And my personal favorite, I, as a consciousness medical professional, need to avoid close contact with sick people.

Did I mention there are no documented cases of the swine flu in Oklahoma?

My Train Wreck

When I got into the ED yesterday, they tell me that the Electronic Medical Records system is down. Since the health care field is moving toward using this, there are whole sections of the hospital that use only electronic records. The ED is one of those. So when they say that the computers are down, what they're really saying is that we have to write all our lab/x-ray/CT/consult orders by hand, and have couriers deliver them where they're supposed to go. And we have no way of knowing what the results are unless a courier brings them back. Take x-rays for example. The image is taken digitally, read on the computer, and the report is sent back to the ED in an e-mail-like fashion. When the system crashes, they have to find x-ray film, the radiologist has to do the old fashioned holding up to to a big light thing to read it, and then they have to send a hand written report back to us. The result of all this is chaos and everything taking hours instead of minutes.
On top of this, one of our three CT scanners broke earlier this week, and has not yet been repaired. Since three is barely more than enough, we've been making do with just the two, it's just slowing us down a little.
A few hours into the shift, the computers finally come back online. We all rejoice, and everyone goes into overdrive trying to re-enter everything in the computer systems. We're doing alright when, twenty minuted after the computers come back, the power goes out. Yes, we were sitting in pitch black in the hospital for a little bit. Of course, the hospital has generators that come online quickly, so people didn't die.
Now, this power outage did two things. First, it took the computers back offline. Not only did this mean we were back in our previous predicament, it meant that all those bajillion orders we were frantically entering just disappeared. The best part is, we weren't sure what made it through and what didn't. So for the rest of the shift we were getting half our labs back, or discovering that no labs had been done at all. Second, when the power went out, it scrambled one of the two remaining CT scanners. When I left, there was a 5-6 hour delay for anyone needing a CT, and the low-priority section of the ED had discharged only one patient in the last four hours because they couldn't get CTs.
The ED was a disaster. Since everything was going so slowly, our patient load backed up out of control. There were people laying and sitting wherever there was an empty space in the hallways. People were being treated wherever they were. It was like a war movie or something.
Hopefully today will be better.

My procrastination

I realized yesterday that I haven't really done any of the extra work for ER. So, now I'm doing doing a month's worth of reading, quizzes, and case presentations in the next three days.

And I just spilled coffee on my crotch.

This is going to be great.

My time in the ER

or "ED" if you keep up with fashionable new medical terminology.

Anyway, I haven't blogged in a while, so I'm combingin all my recent happenings in one convenient post.

Why I Love America
Guy has average/mediocre job in America.
Guy can't afford good health insurance in America.
Guy develops Schizophrenia.
Guy can't get adequate medical treatment in America.
Guy loses job.
Guy still can't get adequate medical treatment in America.
Guy becomes an alcoholic because the voices in his head aren't as loud when he's drunk.
Guy becomes homeless.
Guy gets jumped under a bridge.
Guy comes to the ER, gets stitched up, and still can't get adequate medical treatment because there's no one to pay for psychiatric therapy.
Guy gets kicked out of ER two hours later.

I love it.

ER Quote of the Day (For Jen)
"There's not that much that Percocet and Valium can't fix."
-my attending physician

I'm not going into ER
When I came to medical school I figured I'd go into ER. I thought I'd love the shift work, and love never being on call. I remember thinking the last thing on earth I'd want to go into was Family Medicine. I thought it'd be the crappiest, most boring field in medicine. Well, once I actually did Family Medicine, I freaking loved it. I loved being in the clinic, I loved keeping up with patients that I was treating, and I loved having a regular schedule. Still, though, I hadn't given up on ER.
All that changed on Tuesday. I was presenting a patient to my attending, and this guy was on insulin and four different diabetes medications. That's absolutely ridiculous. So, I bring this up to my attending, and he just looks at me for a little bit, and then says, "Oh, I was waiting for you to get to the part that I'm supposed to care about." Now, to be fair, he wasn't being a jerk, he was just pointing out that in the ED, we can't manage every aspect of a patient's health care because we don't have the time or the resources. That's just not what the ED is for. Anyway, right then it hit me- I want to manage this guy's medications. I cared about what would happen to him after I left, and the next day, and a year from now. I liked talking to my patients, and I liked looking at the big picture of their care. And I really don't care about doing some awesome procedure or managing a trauma patient.
Also, I really hate being in hospitals.
So all this to say that at that moment I realized that I am going into Family Practice, and I'll be probably be poor, and I'll probably take it up the butt from Medicare, but I will be happy.

My Life Really is Like the TV Shows
Keith came to town today. He starts his ER rotation tomorrow. Being the kind, even saint-like, friend that I am, I told him to come up while I was working tonight and I'd show him around. Right, so I do, and Keith leaves to go home and I walk back into the ED. As I walk in the door, paramedics blow through the outside doors with a guy on a stretcher getting CPR. The attending looks at me and goes, "Josh! Get some gloves on take over. Now." and so I rip off my white coat, grab some gloves, jump on this guy's chest, and start doing compressions. Unfortunately, the guy dies in the middle of this. So then we're backed up, and I turn right around and start seeing a new patient while my attending goes to break the news to the family. All in a day's work, I guess.

ER quote of the day

Guy rushes into our section-
"Hey, is this the place with the ruptured orb? No? Oh, okay."
-rushes back out.

["orb" is in reference to someone's eyeball]

My first night in the ER

Within the first hour I'm there, two people come come in with heart attacks.
A while later, this tiny Vietnamese lady comes in who speaks no English and hates doctors. She has this huge bleeding lump on her head that the family says has been there all day. The family swears she didn't fall, but as I'm sewing up wound, the CT comes back showing a significant subdural hematoma.
At the same time, this huge guy is brought in because he was found lying in the street, unresponsive, with white powder all around his nose. The rest of the shift was spent making sure this guy stayed very "relaxed" in a quiet room. With two police officers outside just in case we failed at relaxing him.
The rest of the shift was pretty laid back, until the end, when a really nice old lady comes in with all these crazy wounds. What happened? She was out with her tiny little old lady (or Zach Herbert) dog, and these two Great Dane mutts run and go after her little dog. What does this lady do? She grabs her dog and holds it above her head while these two dogs maul her. She had bites that seriously went to the bone. When neighbors came out and chased the dogs off, she was still holding her dog up. That's legit.

Quote of the day

"Have you ever known a fat person who didn't like yellow?"
-Laura Reese

And so it begins...

Sunday was a very busy day for me. First, I moved my home-brewed beer over to a secondary fermenter. I had this idea of brewing beer a couple of months ago, and it went something like this: "Well, I've made wine and I'm aging some whiskey, what other alcohol can I make?" and of course beer was next on the list. Since I've never brewed beer before, and it seemed like a fairly complicated process (which equals a high likelihood I'll screw it up), I decided to scale down the operation. A typical recipe makes 6 gallons of beer. That's a heck of a lot of beer, especially if it's messed up and makes you go blind. So I decided to scale it down to a single gallon and test it out. There are two problems already with this idea- first, it reduces the ingredients to an obscenely small scale, and second, I didn't have Laura double check my math. Nevertheless, I persevered and will have about ten bottles of beer just in time for the Crawfish Boil.

Second, and more the reason for the title, I also started a new batch of wine. This current batch is Pinot Noir. I'm excited, because this is our favorite wine, and it's normally pretty expensive in the stores. My fermenting it myself, it comes out to about 3 bucks a bottle. I'm also excited because I got to use smoked oak chips in the fermentation, which should be mind-blowing. Anyway, the thing about making your own wine is that it gets better with age. With our Reisling that we made before, it had to age at least three months. With a red like this Pinot, it has to age a minimum of six months, and should be aged about nine months. So, we'll probably break out our first bottle around Christmas. Be there. It'll be awesome.