Lost In Translation

One of the clinics I work at has a large Hispanic population, most of whom speak only Spanish and require a translator.  Generally speaking I am not used to working through a translator and this additional step can make things a bit difficult (as if the job of taking a history, doing a physical, coming up with a diagnosis, and then coming up with a treatment plan wasn't difficult enough).  You really need a good translator to effectively communicate.  Last time I worked at this clinic my translators were only OK.  I found people giving inconsistent histories and explaining symptom complexes that really didn't make any sense.  I truthfully wasn't sure if it was the language barrier or different cultures or if the patients weren't really all that sick.  But what can I do?  I don't speak Spanish, so I just tried my best with what I had to work with and moved on.

Speaking of moving on, the Olympics ended a few weeks ago and now Sarah and I have found another sporting event to dominate our time for the next couple of weeks: the US Open.  We're both pretty big tennis fans.  I love prime time at the Open.  Some of those matches go on way into the night.  Here's hoping for some closer matches in the upcoming days.  Sharapova has steamrolled through the first couple of rounds.

Shot Time!

Schools have started around the city and for the past couple of weeks we have been getting the typical "The school says he/she needs shots before they can start." routine.  What gets me about this is that I am sure they are notified earlier than 12 hours before school starts, and yet they wait until the day before school starts and call and expect us to drop everything we are doing to fit their kid in last minute.  We can usually do it but some of the parents are kind of pushy about it, which can be annoying.  How about some planning?

Sarah and I were in Cincinnati this past week for the Western & Southern Open.  We saw some good tennis, and most of the big stars were there, except I missed Maria and Maria (see below).  I took a pretty cool picture of the stadium with a colorful sky in the background, which I posted below.    I have a wicked raccoon-like sunburn on my face from my sunglasses, and I think the sun got to me a bit because Thursday morning I put my shoes on before my pants!  We enjoyed the tennis and got to see Sarah's uncle and cousin which was fun too.

Maria Sharapova:

Maria Kirilenko:

A Return To Normalcy

The older I get, the more I enjoy the Olympics, especially the summer Olympics.  They provide a lot of drama and you really feel for the athletes as they fight for gold on their sports biggest stage.  The fact that they only happen once every four years adds to the excitement.  Sarah and I have watched a lot of coverage the past two weeks, which basically lasts from after dinner to midnight.  While I've enjoyed these games a lot, I am ready for them to be over so I can return to my normal routine.  Below are my favorite moments from the London games.

• Michael Phelps becomes the most decorated Olympian of all time.  If I were to name the most dominant athletes that I have watched in my lifetime, Michael Jordan, Tiger Woods, and Phelps are the first three that come to mind.
• While we are on the topic of swimming, Missy Franklin's gold debut was spectacular.
• Gabby Douglas winning the individual gold, putting her in a select group of elite US Gymnasts.
• Walsh and May winning the beach volleyball gold.  They were both amazing, but May has the incredible ability to be at the right place at the right time.  Her digs were amazing.  Walsh says she wants to return in 2016 and that is something I'd love to see.
• Usain Bolt is a beast.  Enough said.
• David Boudia's stunning gold in diving.
• US Women's soccer winning gold against Japan, the team that beat them in the World Cup.  I'll cheer for this despite the controversy.

The Hardest Part

In general, my profession is pretty rewarding.  With that being said, there are some hard parts to the job.  Probably the hardest part is telling someone their family member passed away.  I had to do that last this morning.  Absolutely my least favorite part of my job.

The 30th Olympiad

Sarah and I dominate the Olympics.  The older I get the more I enjoy them, and the summer Olympics are by far my favourite.  While they have popular sports like basketball and tennis, I prefer to focus on the more rare sports that only get national attention every four years.  Below have been some of my favorite story lines thus far.  Keep in mind that this post was written a few days before it was published so a lot has happened in that time.

U.S. Swimming and the Phelps/Lochte competition.  The swim meets can be downright entertaining and who doesn't enjoy a little competition between teammates?  Personally I find Lochte a bit annoying and am hoping Phelps will shut him up in the pool.

 I am admittedly a bit of a closet women's gymnastics fan.  I don't follow the sport throughout the year but I do enjoy watching it at the Olympics.  I do think Jordyn Wieber got the shaft a bit.  I understand limiting 2 members per country so that the competition isn't dominated by a single team.  The flip side of the argument is that if you want to have a competition against the World's truly best gymnasts, you have to have the best one's there and this rule does not allow that.  Why is it her fault she has great teammates?

 Women's beach volleyball is obviously a bit of a guilty pleasure, but Misty May Treanor and Kerri Walsh dominate their sport (have never lost a set in the Olympics) and it's always fun to watch a team dominate.  Actually, the older I get the more I like volleyball.  I watch it occassionally on the Big 10 Network.

Other sports I'm watching closely are tennis and women's soccer (we actually win in the women's division).  I'm sure once track and field starts I'll be watching it closely too.  Also, London looks absolutely fascinating on TV and would love to visit there sometime.

I'm working this weekend.  Everyone else have a good weekend.  I'll be using apps on my iPhone to keep up with all of the Olympics results and news.

A Beautiful Mind

I've spent the previous month in a locked geriatric psychiatry unit at the hospital.  A few of the patients were admitted for depression and suicidal ideation, but the overwhelming majority were admitted for poor behaviour from their nursing home or assisted living facility.  Poor behaviour typically includes verbal abuse towards the staff, but can also include physical abuse towards the staff or other residents, and sometimes sexual misconduct, sometimes eloping from the building.  The patients would be admitted so that some concoction of medicines could be generated that would improve their behaviour to at least acceptable levels to return to their previous environment.

Except for the patients there for just depression, everyone was confused.  They had no idea why they were in the hospital, or even that they were in a hospital at all.  They thought it was Christmas Eve despite sitting outside in extreme Midwest heat.  Some had hallucinations and many had delusions.  One woman insisted that she was pregnant and that her kids were still in school, despite the fact that she was 85 years old herself.  Attempts to redirect the often pressured behaviour often resulted in agitation and sometimes aggression.  Reasoning was completely out of the question.  I interrupted this behaviour as ranging from amusing to downright unbearable.

Every Tuesday we would have meetings with the patient's family.  We would have to explain to them why their parent's are behaving this way and why they have a completely different personality now compared to the past.  We would have to explain the multiple side effects of the medicines being used (one of Zyprexa's side effects: death) and the unfortunate situation of not having anything better to use.  We would have to explain to them the terminal nature of the diagnosis, that eventually they would forget how to walk and even swallow which would lead to their death, and that there was nothing anyone could do about it except hang on for the ride.  Interacting with the families made a sad situation even more depressing because you realize that the patients were "normal" people at one time with real lives.  Sometimes just seeing them in their confused and crazy state makes it easy to forget this.  I learned a lot this past month, mostly on how to talk to family members with parents who are going through this terrible process.  I also learned that I do not want to get old.

Two Down, One To Go

It's hard to believe this, but tomorrow I start my first day of my third year of residency, which for me is the last year until I finally go out on my own and get a real job.  Last week the incoming first year residents had orientation and while I didn't spend much time with them during their orientation I did spend all day Thursday and Friday with them during ACLS re-certification (Advanced Cardiac Life Support).  It was interesting to talk to them and answer their questions and hear their fears about the upcoming year.  So much has happened in the past two years that I kind of forgot that I had the exact same concerns and fears when I was first starting residency too. Now I just go to work everyday and don't really think about these things much.  It just goes to show you how many things I've learned in the past two years.

I now have one more year of monthly rotations.  I spend three days per week at my rotation which changes at the beginning of the month.  I spend the other two days per week at my clinic, seeing my own patients.  It should be an exciting year.  I anticipate within the next couple of months I should have a pretty good idea on where I'll be working full time in the future.  One year from now I will finally be out on my own, which is both exciting and scary (I will likely have the same concerns when I start my real job as the new residents have about starting residency.).

They released a flier to post in various departments of the hospital with the name, picture, and pager number of all the residents.  Being a senior, I am at the top of the page along with my lone senior classmate.  The picture is symbolic of me making it to the top of residency.  I better enjoy being on top while it lasts.  Next year I start all over again at the bottom of the totem pole.