Med II, My Last Rotation!

Whoo hoo!! I am done with medical school! It has been a long haul, occasionally rough but mostly pretty fun. Inventing the exclamation point t-shirt, though, might have been an easier way to make money and make people feel better. My last rotation was half ICU, which was fun because to try to manage the Uncle George's that come in and still kind of overwhelm me when I see them in the ER. I got to practice breaking down their problems into manageable problems. Working in the ICU makes you REALLY not want to be full code, after seeing so much money and resources be spent on patients with a maximum of 6 months left to live. The thing is, it is great to be able to prolong life. But medicine can't fix everything and ultimately, you have to accept death. And I don't want a tube down my throat so I can stay in the ICU for thousands of dollars a day too doped up to be conscious of my last 6 months of life. I'd rather accept death. I know I can't make that decision for everyone, but I do know that its frustrating when you try to ask patients' families if they are full code and they get all offended, like you are telling them that their grandmother's life isn't worth saving. I want very much for their grandmother to live, but the fact is she's going to die soon. I may be able to give her a short artificially prolonged indian summer of life before death, but . . .

Fall Climbing

Newly legal, Sandstone is some of the best bouldering in MN. Some of the boulders are located on private land and access is a bit tenuous, but how can you help but get obsessed with these sweet lines? Here is Lynn on a cool V5ish problem.

Me on the same problem, I don't know the name. The area can be kind of wet and mossy, but its really beautiful.



Here's Joel on the 30 degree wall. The wall itself isn't especially photogenic, but look at the gorgeous forest you are climbing in!!











Here's Lynn on our favorite proj, Pocket Hercules, V8. So good.















Brotherman at Taylor's Falls, tearing it up.



















He's more powerful than I am at bouldering for sure. If he worked on a little finger strength, he'd outclimb me one of these days ;)













Rocco at Willow River State Park, one of his favorite places second only to Hueco Tanks and Petie's house. He can smell when we're getting there, he huffs his little nose in the vent and when he figures out where we're going, he stands up and gets all psyched.






Jess at Sandstone on the warm up boulder.

















Lynn and Jess hiking in on the beautiful banks of the kettle river.

Psychiatry Madness

So, I can't really put up a picture of the awesome psychiatrist that I worked with because of HIPPAA and privacy and laws and such. So, let it be known that all names and details have been changed and modified to protect the identities of my fair colleagues and patients. But, I thought the comic was pretty good.
"They'll never find me, I'll just tell them you're Dr. Martin and I'm Dr. Chang," Dr. Martin joked, pitting me against a patient's pugnacious family. Their son was in here against his will, it was illegal, this place was a crap-hole, he didn't do anything wrong . . . of course, I think by now in his career, there is absolutely nothing that Dr. Martin has not heard. And he maintains the same acidly unaffected sarcasm throughout. His patients seem to be unable to affect him, yet he is somehow able to change his patients in the course of 15 minutes. He is of the school of dialectical behavioral therapy, wherein he gives his patients back exactly what they give to him and teaches them to modify the way that they interact in order to have more interpersonal success. So, he is bold and sassy. He will swear back at patients. And by the end, the belligerent youth with an attitude problem who made the ER doc cry and was yelling at half the nursing staff was repeating the words, "Keep my words sweet like sugar in case I have to eat them" and writing an apology letter to the ER doc. Talk about an abrupt change. I think Dr. Martin is amazing.
And he deals with some amazing and amazingly difficult individuals. He wanted us to really just "marinate in the craziness" of the psych ward. And that we did. Sheila had pickled her brain with alcohol and couldn't walk without her walker, but was so excited that she was going to join a basketball team. And there was Peter, who had his first schizophrenic break and was a cybertronic robot with metal for bones who you might catch near the wall "recharging." And Sally's make-up and outfits typically got darker and more flamboyant as the day went on--in parallel with her emotions. And Kara's hypersexuality, where you might find her naked on the bed screaming at the demons to "get off her." There is never a dull moment in the Regions psych ward. I learned a ton and I definitely have a lot of respect for both the people who struggle with mental illness and the doctors, nurses and support staff who help them in their struggle. My favorite image, of course given to me by Dr. Martin, is that of dreams invading your reality. And how sometimes you need drugs to help keep those thoughts in your dreams where they belong. Or you can write a book about it.