Kerouac's recovered well from his amputation. However, it's taking him some time to strengthen his other back leg, and he still has arthritis of the hips to contend with.

This weekend we got a cheapie Craigslist red wagon, put a blanket in it and dubbed it Kerouac's Chariot. He's taken to it like bacon and now is getting long "walks" around the neighborhood. Human passersby get a kick out of it too.

Ukraine artist Kseniya Simonova uses sand and light to tell the story of two lovers during the Nazi invasion of Ukraine, on Ukraine's Got Talent. The words at the end translate to I'm waiting for you.

What real doctors have to say.

Heal Health Care Now: Doctors Speak Out for Reform

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Listen up.  I am a proud aunt.  You cannot fault me for showing you photos of my adorable nephews.  I was just looking at their "just born" photos and now they are so big!  And such characters :)


Josh


Zane

-Kerouac's leg was amputated on Friday.  He is already up and learning to walk on it today, and back to being a happy pooch, if a more clumsy one. 

-The national conference in Kansas City was great.  I <3 family medicine.  It's an exciting time to be a medical student, with all the healthcare reform afoot.  It also helped me sort out what residencies I want to apply to.  Also, my family medicine subinternship rotation is going great.  

-I ordered my wedding dress last week!  I'm very excited!

-I didn't get the big scholarship I was hoping for.  Oh well!  Who needs money anyway, right?  Economy, shmonomy.  :)

-The perseid meteor shower is this week.  Go look up!

-Edit:  Another bitesize update:  Our loach killed three of our fish in the last week:  my beautiful King Guppy, Killi #5 and Killi #6.  We were suspicious but not convinced of his culpability until I watched him kill and attempt to eat Killi #6.  RIP.  Loach has gone to sleep with the fishies... (back at the pet store.)

On Friday, Kerouac had surgery for his recurred tumor in his hind leg.  He did well initially and bounced back with a lot of energy.  Unfortunately, his wound is not healing well.  Some of the tissue initially stitched together died rather than knitted, and the location of the cross-shaped wound made it easy to tear open with almost any movement.  He started bled a little bit a couple days ago and ultimately went into the vet this morning to have a dressing placed.  When I got home today he had a quarter-sized open area of muscle showing; our attempts to re-dress were to no avail.  Even carrying him out for a pee and back was enough movement to pull off his dressing and make the gash silver-dollar sized.  So off we went to the vet ER, where they put an uber-dressing on him that wraps all the way up around his back.  Looks like we will need to continue getting the dressing changed every 2-3 days (with a trip from belmont to washougal for each of those changes, thank you), and it will be touch and go for a couple weeks. 
So say a prayer, cross your fingers, send him good doggy karma, because he's got a rough patch ahead of him. 

Kerouac is king of self-pitying looks.  He got a bath tonight. This is his typical misery.


Sadly, I think his cancer is back.  He has a large marble-sized lump in his leg where it used to be, as well as a small lump on his chest.  I just noticed it today but it makes sense, as he's slowed dramatically over the past couple months; we didn't notice a visible lump the last time he got a haircut.  He's going to the vet tomorrow, but only after frolicking around my parents' backyard and an inevitable stop at the petstore for treats.  If it just looks like a local recurrence, we'll probably put him through surgery again--he bounced back like a new dog after last time.  However, if it's spread, we'll just have to take care of him as long as we have him.

On Friday I flew down to LA with inevitability  and we hung out with rasputin , gina , and alex_victory  all weekend.  You guys were awesome!

Friday: arrival, big margarita's at CozyMel's Mexican restaurant, and illusions at Magic Castle. I've never been to a magic show before and it was pretty neat watching the sleight of hand. The last performer of the night even pulled a rabbit out of his hat.  Unfortunately, no photography inside but we did take a few outside.

  

 

Saturday: We went to Disneyland! I hadn't been since I was a pre-teen, so it was interesting to go back as an adult.  We got up at 6 to "beat the crowd" and stayed for almost 11 hours.  Thanks to their "Fast Pass" system, the five of us zoomed around the park hitting all the big rides, and then went over to California Adventure for more fun.  It was an exhausting, very hot day with lots of walking.  I'm washing our clothes now and oh, the smell.  We had planned to get grub and go see alex_victory  perform in Rocky Horror but we all pooped out. 
    


Sunday: rasputin , inevitability  and I hit Raging Waters, the biggest water park in California.  It was a much more relaxed day. We didn't even do the big water slides (I was a wimp and the lines were long), just crawled around in the easier "rides" and left early because I wanted to get home and study for my test finally.  Instead we got to our hotel, showered and curled up in bed never to leave it again until 6am on Monday.
(Thankfully, no photographic evidence of our white, pasty, fleshy bodies in swimsuits exists.)


Monday:  Test day!  inevitability  walked me to my test and I sleep-walked through 8 hours of "standardized patient encounters," pretending the incredibly healthy, fit Californian actor-patients sitting across from me were ill and required medical care.  Halfway through someone clarified for me that the test is pass/fail (though we were graded on three parts on a point system, it all sums into P/F). Woohoo!  Then we got dinner, saw Harry Potter, and rasputin  drove us to the airport.  We got home somewhere after 1AM to find unhappy fish and wilted herbs.  Oh well

Tuesday:  inevitability  got up and went to work.  I slept in.  BWUAHA.



Edit: I'm sure I   blew the test out of the water. I somehow skimmed over the "this test is pass/fail" part in my preparation booklet.  I'll find out in a couple months.

I'm supposed to be studying for a stupid exam I don't want to take so I may as well post some random recent events, right?

6/7: My first trip on the Portland Spirit!  The OHSU Family Medicine Department hosted a dinner cruise for the last year's donors and invited another student and I to join them.  It was a delicious dinner, a fun time watching the shore go by.  I sat across from our Dept Chairman, trying not to be nervous while making small talk, and realized for the first time that it was THEY who were courting ME.  Oh the power of being in, rather than applying to, medical school.

6/8: Thus began my first fourth-year rotation, a month spent in the Portland Providence Intensive Care Unit.  It was an intense month, which deserves its own reminiscence elsewhere.  I enjoyed it very much--I worked with an awesome senior resident (shout out to Nicole!) and 4 fabulous interns who made all the difference.  It had highs--attending who thought I was an intern, carrying double my caseload when new interns started, voodoo donuts on saturdays, and carrying people through severe illness--but it had extreme lows...several of my patients died.  Worse, some of them landed themselves in the ICU through heartbreaking circumstances that, as their story unfolded, haunted me for days.  I don't know how intensivists do it, but I assure you no number of voodoo donuts would make it worth it for me.

6/27: My only ICU overnight call during my ICU rotation. It was exhausting and long, though I stayed remarkably well energized throughout by virtue of a steady stream of chocolate and tea. The new interns had just started so I ended up carrying 4 patients overnight while my R3 carried the other 9.  Lots of things go wrong on overnight call.  The wonderful part of my ICU rotation is that I really felt part of the team--when nurses needed something they came to me, not to my residents.  The bad part of that is being on overnight call while your R3 is sequestered in a room placing a line for over an hour, and the rest of the patients still need orders, lines, clarifications and so on.  As a student you have no power to write orders, so I felt helpless to fix simple problems (and grateful I couldn't "fix" the complicated ones).

6/28: Post-call, sleep-deprived and punchdrunk, inevitability  drove me up to Seattle to hang w/ silentclarity  on his brew day with a couple friends.  I'm not sure I was coherent, but at least inevitability picked me up a beloved chai on the way up so I was caffinating by the time we arrived.  We stayed for delish BBQ (had my first buffalo burger, yum!) and stayed overnight at a nearby hotel.  silentclarity  indulged us by driving us down to Pike market in the morning before we headed home.  PS:  The other home-brew we drank that day was AWESOME.

7/4: The fourth! We celebrated America by overheating on the pitch n putt golf course, and changing our plans to specifically avoid  fireworks and instead eat snacks at Pied Cow. I am pleased to say I was able to pitch the golfball furthest of our group in a single hole, aided by elevation and good luck.  This also marked the beginning of my much anticipated, well deserved month-long vacation.  Patriotism, what?

7/14:  Bastille day, for any francophiles.  I resumed my hunt for a wedding dress.  I have a hard time finding a wedding dress I like because I neither desire to look like a frosted cake nor do I like lace, heavy beading, or most strapless dresses.  I tracked down the Portland area stores carrying dresses from a designer I like and made an appt.  While describing my heart's desire, using foreign-sounding words like "sheath" "bias" and "no poofiness, please," the very helpful sales lady summed it up as "well if you want to wear a night gown, this one works."  She proceeded to chastise me for not wanting to wear a ballgown, to say "well perhaps this lace is too formal for you," and contradict every opinion I posited.  She finished by bringing a mermaid cut puffy monstrosity and when I tried it on, commented "well sometimes you go shopping for a volkswagon and buy a cadillac, honey."  Later, over my irritated sniveling at lunch, inevitability  recruited his mother's help, and for all my uncertainties and difficulty describing what I want to salespeople, she summed up what I described very well in about 30 seconds and sent me a photo to boot.  I essentially want Carolyn Bassette's wedding dress.

Coming up next: Going to LA for that "stupid exam" I referenced above.  It's a series of mock-patient interview to essentially prove I have human interpersonal skills, english language proficiency, and oh by the way to net the NBME my $1500 fee.  It's not really the kind of test you study for anyway, but I have my First Aid Review book cracked next to me.  However, we're making a vacation out of it so I will also get to hang out with gina , alex_victory , and rasputin  at Magic Castle, Disneyland, a water park, and my first Rocky Horror Picture Show.  Woot!

By Michael D. Shear
President Obama has chosen Regina Benjamin, a family physician from Alabama, to be the next Surgeon General, filling a key public health post ahead of an expected surge in the H1N1 flu next fall.

Benjamin gained fame through her public efforts to rebuild her rural health clinic after Hurricane Katrina devastated it. She founded the Bayou La Batre Rural Health Clinic in 1990 and rebuilt it after the hurricane.

Benjamin has also served as the first black woman to head the State of Alabama Medical Association and was associate dean for rural health at the University of South Alabama's College of Medicine.

Obama announced her his intent to nominate her at a Rose Garden event this morning in which he also spoke of the challenges and need for health care reform. "I understand people are a little nervous and a little scared about making change. You know, the muscles in this town to bring about big changes are a little atrophied, but we're whipping folks back into shape. We are going to get this done," the president said.

"And if there's anyone who understands the urgency of meeting this challenge in a personal and powerful way, it is the woman who will become our nation's next surgeon general, Dr. Regina Benjamin."

The president's first choice to be surgeon general, CNN's Sanjay Gupta, pulled out of the running several months ago, saying he wanted to be able to spend more time with his family.

Gupta had initially said he was attracted to the position because of the ability to use his high-profile reputation to increase awareness of public health and the push health care reform through the Congress.

Since then, the administration has been without a top public health official, even as the swine flu has demanded attention.

Attention, please. *clinks fork on wine glass*

I am officially a fourth-year medical student now.

Thank you,
That is all.



(phew)

I cannot wait until I am not chronically sleep deprived.

Yesterday I pulled a tube out of somebody's neck while they hummed and today I am talking soybeans with a bulemic. Last week I was investigating a potential case of measles vs dengue fever. This is the normal scutwork of my job. I realize how bizarre that is, really.

Jamie and I do not have an "Our Song." It's not because we don't like music... we do. It's not because we don't rock out in the car to said music... we do. It's not because we don't love each other... we kinda like each other after all. We just don't have any song with particular meaning attached to our coupledom to play at The Big Wedding Extravagaza Partytastic Thingie.

I open this up for voting and bribery.


Some initial suggestions:
"All I want is you" - U2
"You're my best friend" - Queen
"At last" - Etta James
"I touch myself" - Divinyls
The hokey pokey

We officially have a wedding website. Jamie picked the frilly layout, smirk. Family, take heed!

www.mywedding.com/jamieandmelissa

Well.

I've spent the last 5 weeks with my hands in people's bellies.  (You don't look at someone the same after you sweep your hand over their liver.)  I slept an average of 5 hours a night.  I got to see someone's brain, smushed as it was.  I learned a lot about human nature in sickness and death.  I saw a lot of blood, forgot to eat a few times, and almost passed out twice.  It's been an interesting trip.  But surgery is over.  Hooray!  Now I am back to a (more) normal schedule, and although I will miss the OR, could not be happier.

In other life news since my last post

Jamie and I are now beginning wedding planning in earnest.  We are going out to look at a few potential sites tomorrow.  If we're lucky, we'll like this one and book it.  That will be a big weight off our shoulders.  Then I can worry about stuff like bridesmaids, a dress, a few fun surprises.  Anybody with wisdom on these issues should share.  God and a budget?  How do *I* know how much an average wedding cake costs?  Who knows these things?

A few weekends ago, I went to the OK Go concert with a bunch of friends.  I felt very old, surrounded by short teenagers.  Also because I desperately wanted earplugs--my right ear was ringing for *three* days afterwards.  However, the weekend was awesome, and I rediscovered my love for rockband and beer.  Mmm rockbeer.   Many thanks to Charlotte, Jabby, Jeff, Gina and Alex for visiting that weekend, and to all who went to the OK Go concert!  Puppy Party!

(PS: Jeff, that time before last you were down here and we three were rocking out and then hopped in the car and belted out songs at the top of our lungs?  Good times.  Good times.)

Immediately after said fun weekend, I got sick for the first time in two years or more.  At least in the time I've known Jamie.  Despite my crazy hours, sleeplessness, and constant exposure to sick people, I remained healthy.  And when I got sick, I managed to stay up sleepless on call and still recover in only 4 days, compared to the average 1-2 weeks of people I saw in clinic.   Let this be a lesson to you, fair readers: take a vitamin every day, get your flu shot, wash your hands, and love the tylenol.  

Also, I am already looking forward to Jamie & Jeff's birthday bash this year.  Beach house, murder mystery, private mansion, hot tub & sauna & swimming pool, private beach, assasin game, s'mores, ultimate frisbee, and more.  Oh yes.  It's going to be awesome! 

Schoolwise, I'm applying for a prestigious family medicine award, the Pisacano scholarship.  I wrote myself up to sound all smart and stuff, and made it to the interview stage.  It's coming up on Tuesday.  Cross your fingers for me that I don't blurt out something dumb.

In March/April, my nephews have respectively turned 1 year and 6 months.  They are adorable.  I am eager to babysit more and live vicariously through them.

Yes, it's old news by now, but I've been too lazy to do anything but let word of mouth and facebook spread the good news for me.  However, many people have been hankering for a photo of the ring.  Fortunately, my mother snapped many such when we saw her last weekend, so I will post one she took of the ring.  More details on my extreme happiness later :)

happy valentine's day everybody.
may you eat chocolate and get lots of hugs.