Mud on the tires (South Africa, Day 5)

And then there was light!!
[Cue 2001: A Space Odyssey theme song]

The Australians call it a barbie, we Americans call it grilling, and apparently the South Africans call it a braai.

Every Wednesday, the International Students Lodge gets together and has one giant cookout. Everyone brings their own meat and there’s lots of beer and wine, leading to general debauchery.

Being the new kids on the block, the Canadians boys, Gelia, Jean, and I were all super excited for the weekly “meat and greet.” I bought wine specifically for the occasion, because hey, the one ingredient to having a good time is alcohol, right? And by good, I mean, less awkward. Because you hope to get everyone liquored up enough that your awkwardness is just masked by all their drunkenness. Or at the very least, you can pass off your own awkwardness as drunkenness.

However, a couple hours before the party was supposed to start, the floodgates from heaven opened up, and it started pouring rain.  Pouring by South African standards, since it was more of a drizzle than a downpour. Man, if they were to experience a Chicago thunderstorm, they might think the apocalypse was upon us.

But we had meat to grill, and the Canadians are used to even more severe weather conditions than us, so we decided that rain or not, this barbeque was going to happen, one way or another. So the boys fired up the grill, even amidst cries of “no braai today!” coming from the windows, and we cooked up our ostrich steaks and lamb chops to medium rare perfection.

And with damp charcoal at that!  

Livin' in paradise (South Africa, Day 4)

Dinner at Mama Africa! Recommended by our friend Gelia - who is from Germany, and also arrived just this week. Apparently the shunning extends to all of the new kids, but we're forming our own pack. And Gelia is great, totally in the know about what to do and where to go. I kinda adore her.

So for dinner I got the mixed grill plate, which consisted of: venison sausage, kudo, springbok, ostrich, and crocodile. Who knew I'd be so adventurous, ey?

Crocodile - apparently it's not just a phrase, because it honest to goodness does taste like chicken.

Ostrich is delicious! And not at all like chicken, which is what I was expecting, since it's just a giant bird right? But no, it's like filet mignon, but even more tender and delicious, if you can believe it.

I had no idea what kudu or springbok was, except that I had seen them on safaris, but are apparently not so wild that they're not raised for their meat. Unless someone actually went and hunted these. Anyhow, wild or not, they were both delicious as well.

And well, venison is venison, and even in sausage form (or perhaps because it was in sausage form), it was quite game-y and I couldn't really stomach it.

From left: vegetables, venison sausage, kudu, springbok, ostrich, crocodile

Must get out (South Africa, Day 3)

ME

Jean! I heard two guys with American accents!

JEAN

What? Really?? YES! Friends!!

ME

Wheeeeee!!!!

They weren't really American. And as soon as we heard the 'ey's and 'out's and 'about's out of their mouths, we knew they were Canadian. But also maybe because they told us they were from Toronto. Deductive reasoning, it's my strong suit.

But regardless, we were glad to know people from our same continent. Because the other international students are all from Germany or Belgium, and with their secret languages, they've kinda bonded together, and it's quite hard to break into cliques and BFF circles without a good grasp on German. And by good, I mean, any grasp whatsoever. My German abilities only extend as far as frankfurt and dankeschon, and I don't think hot dog and thank you can get you all that far in a conversation. 

All this exposition just to tell you that we were glad to meet other people who were kinda forced into a friendship with us, just because we were being shunned a bit from the others.

So as soon as we got our mini cars from the rental company (seriously, so tiny! Think golf carts and then make them squatter), the Canadian boys gave Jean a quick crash course in gear shifting and clutch pressing. And just five stalls later, we were on our way out of campus, onto the streets, and to the closest shopping mall district.

Our new friends! Oh Canada!

Freedom baby! Or rather, freedom from the student cafeteria. And I gotta tell you, that dinner was quite a delicious change from the grilled cheese and cereal diet that had been forced upon us for the last three days or so.

Sparks fly (South Africa, Day 2)

Still suffering from jet lag, but must make friends. Today, we also realized that we must rent a car. Unfortunately, I still don't have a driver's license, so Jean is our de facto driver. So I did all the calling to reserve the car -- and not only do South Africans drive on the RIGHT side of the road, they also laugh at you when you ask for an automatic instead of a manual.

ME

Is this car stick shift? Because we want an automatic with power steering.

CAR RENTER

Stick shift? What's that?? Is that manual??

ME

Oh yeah. That's the term.

CAR RENTER

[audible laughter, and then to his buddy in the next cubicle] 

Hey, this American wants an automatic car! 

[more audible laughter from both of them]

ME

...So is that a no?

CAR RENTER

Darling, we can get you an automatic car, but it's three times the price.

ME

Oh. Never mind, we'll take the manual. We'll figure it out.

CAR RENTER

You guys are gonna burn through my clutch, yeah?

ME

Maybe, but that's why we're getting full insurance!!

CAR RENTER
Oy.

Wild at heart (South Africa, Day 1)

Haven't showered for 33 hours,
but we still look good, yeah?

We arrived! And the taxi driver actually took us to the proper location (albeit after driving in circles to run up the meter). But we're here, and we're safe, and we have lodging, so there's not much to complain about.

...except for all the mosquitos and spiders and bugs that are eating me alive. I swear I have target lesions developing into cellulitis, all over my arms and legs.

London Calling (South Africa, Day 0)

Had a nine hour layover in London, so after successfully finding Jean in a different terminal after a different flight on a different airline, without any means of communication, we hopped aboard the Heathrow Express and made our way to London (which was in the midst of government protests which we happily took part in, because hey, there were guys in kilts playing bagpipes and unions singing songs in three-part harmony and lots of funny signs, so how dangerous could it be, really?).

The best part was when we went to eat lunch (in which we ordered English staples -- fish and chips! bangers and mash!). Then halfway through our meal, we noticed squadrons of riot police teams teaming outside the pub. Turns out that the McDonald's right next door was attacked with graffiti and rocks. Maybe it wasn't such a peaceful protest after all.

But undeterred, Jean and I continued on our tour of London, and walked across a gorgeous bridge that thankfully wasn't falling down, falling down.

Off to South Africa! See you all in a month!

[not sure how much internet we'll have, but will be saving up blogs to post once I return.]

I need a doctor

Not quite sure which category I fit into.

(click to enlarge)

Raise your glass!

Holy cow, Loyola. Major props to you and your fourth year med students. I can't believe they were able to pull this off on the most stressful day of the year!



Seriously, I'm so impressed. I know I personally wasn't able to do anything but clutch my envelope anxiously while I waited for the countdown. To do choreographed steps too? Man. I was barely able to put one foot in front of the other and not fall over.

Hey Loyola - I'm raising my glass to you.

Don't stop believing

The letter - unopened.

You know that cliche - looks are deceiving? It's totally true. Because to anyone not in medicine or related to anyone in medicine, it's just a simple white standard letter-holding envelope. No special emblem. No fancy wax seal. Nothing. Not even a sticker.

Yet, there I was. Trembling and shaking and unable to form words. All because that simple-appearing envelope held the culmination of everything I have worked for in the last ten years.

Where was I going to end up for residency? That envelope held the answer. My future, quite literally, was in my hands.

I had nightmared about this moment. Had night terrors about opening that envelope and seeing my last choice, or worse yet, scrambling into a program in the middle of nowhere. Despaired that I was going to have to start this brand new chapter of my life without friends and family to guide me along. Worried that I had put non-California programs too high up on my rank list. After all, what's prestige when you're all alone, with nothing but snow to comfort you?

ME

No matter what it says, I need you to be really excited for me.

MARTIN

Of course! 

ME

No seriously. Even if it doesn't say USC, I still need you to be super enthusiastic. And that whatever program I end up at was my number one choice.

MARTIN

I'm gonna start yelling that you got your first choice as soon as you start opening your envelope. Loma Linda? Yayayayayayayayayayayayayaya - you got your number one spot! Arizona? Wooooooo!!! TOP CHOICE!!

ME

Actually, don't say that if it says Arizona or Mayo or Lutheran...........because let's face it. If I end up there, I'm going to be really disappointed.

MARTIN

In that case, I will yell out instead -- Mayo Clinic! YEAH you're gonna be a psychiatrist!!

The truth of the matter is, I wanted my first choice so badly. So badly I had refused to let myself even entertain it as a possibility. And now, here we were. Minutes away from finding out. Seconds away from knowing where I would be training.

I held that envelope in my hands, fingers shaking visibly. The deans started saying something over the loudspeaker, and even though others around me were laughing at their jokes and pranks, I didn't hear a word they said. I was so nervous. And then, the countdown started.

Five.

I thought my heart was already beating quickly, but now it started pounding.

Four.

I felt Martin rub my back.

Three.

This is it. 

Two.

Oh my god, this is really it.

One. 

Go.

My fingers started ripping through the envelope, fumbling with the seal. I had opened a million letters, yet for some odd reason, I could not open this one for the life of me. People around me started yelling and screaming and jumping up and down. And there I was, trying desperately to get to the letter. Panicking, I tore it open.

I opened the first flap. All my identifying information. Name. School. AAMC ID. USMLE ID. And then, more white space.

The answer was just a page flip away.

I looked at Martin, who was gripping my side so hard, I woke up the next day with a possible rib fracture. Ready? I asked as our eyes met. He nodded.

Taking a deep breath, and telling myself that I would be happy no matter where I ended up, I opened up my letter. And there it was.

I started shaking uncontrollably, speechless and totally shocked. And before I could react, I was up in the air -- Martin had picked me up and was swinging me around the room, yelling at the top of his lungs. I started shouting too, as my eyes filled with happy tears.

I did it. Holy cow.

I'm coming home.

And I haven't been able to wipe this silly smile off my face since Thursday.

Spitting fire

A personal story from the emergency department, in which I am very thankful for face masks. Very very thankful.

My resident injected the lidocaine into and around the peri-rectal abscess.  "Do you feel the burn?" she asked our patient, somewhat redundantly, as he yelped and writhed and tried to escape from the needle. He answered in the affirmative with a couple of choice - and quite colorful - words, and she nodded at me, handing over the scalpel. I felt the abscess again, feeling where it was fluctuant and spongy, and then, after testing to make sure the lidocaine was working, I stabbed the exact center of the abscess.

And I immediately cried out in surprise.

Because, see, the moment the scalpel touched the abscess, pus shot out, like good Ol' Faithful. My eyes closed instinctively, and when I finally opened them again, seemingly hours later but really probably no more than a few milliseconds, I was more than aware that the pus previously inside the abscess was now outside, sprayed across my thankfully mask-covered face. I started dry heaving and gagging. I looked furtively at my resident, hoping my mask was effectively shielding all of my grossed out facial expressions. She merely raised her eyebrows, waiting for me to complete the procedure, even though I wanted to dash from the room and into the closest shower. But my feet stayed firmly planted to the ground, as my fingers continued to coax more fluid from the abscess.

I kept my mouth pursed tightly shut, hoping that my mask was strong enough and pus-proof enough that none of it would seep through the paper-like material and onto my lips.

After packing the cavity, we let our patient know that the procedure was finished, washed our hands, and stepped out of the room. Where I promptly tore off my mask and rinsed out my mouth.

Moral of the story: wear a face mask, kids, for even the simplest of procedures. And don't be ashamed to wear those nerdy lab goggles. Masks and glasses are infinitely better than pus in the eye/mouth. Infinitely, exponentially, eons better.

Dress and tie

Love the song. And I love her voice! There are very few people who can show up Darren Criss, but Charlene Kaye does. Also, love that Darren Criss isn't such a huge Glee star now, that he forgets about his friends from college. True friendship.

Late nights and early mornings

I haven't had to talk to a patient in four months.

Four months ago, I finished my sub-i. And then I started working in the surgical ICU, where patients were on ventilators or recovering from anesthesia and complications, and generally just not really up for having deep long conversations about family history and are you still sexually active type of questions. After that, I went on vacation to do interviews, where I talked a whole bunch about my favorite patients, but again, didn't really see any, except when we peeked in on hospital tours to ooooh and aaaaah over EMRs and private patient rooms. And then I came back and did radiology, where you definitely don't see any patients or have any sort of patient contact.

Aside: true story, there were a couple of times when I presented patient findings to the radiology attending without knowing whether the patient was male or female. Even when the images clearly had the answer. This might be why I didn't go into radiology. That and I think my eyesight got so much worse after all the in-the-dark reading we had to do. And my grades and scores really aren't up to par. End aside.

After radiology, I did physiatry, but I was on the stroke service, and the patients who come to rehab hospitals after strokes, well, they aren't really the type of patients whom you can have understandable conversations with. At least not when they first get there.

Now I'm starting emergency medicine. And I'm a little worried that I've forgotten how to take a history or even what the OLDCARTS mnemonic stands for. I'm a little anxious that I no longer know how to distinguish heart sounds from benign whatevers to holy-crap-get-this-person-to-the-cath-lab-now! And if I can only fudge my way through interpreting EKGs, how am I supposed to read stat CTs and chest xrays?

So I'm a little bit anxious. A little bit apprehensive. And a little bit terrified. But you know what else? I'm kinda excited too. Because it's the emergency department. And if there's one thing I learned from all those years of watching ER - besides that George Clooney and Noah Wyle make for very good-looking doctors - it's that anything that can happen, will.