dear God, please don't let me become an asshole.

i'm afraid.

i'm afraid of when i graduate medical school and perhaps purchase a car that i will magically become an asshole. there seems to be a rather disproportionate number of Doctors Who Drive Fancy Cars and Are Miserable Ill-Willed Individuals.

let's hope i am spared such a fate.


::hops on bike::

the beginning of inadequacy.

today i took my first complete history on a real live patient who actually had problems.

...lots of problems.

congestive heart failure. renal failure. high blood pressure. osteoarthritis. fibromyalgia. hepatitis. seven different surgeries. ten medications. life in america. church. grandkids. everything, including the kitchen sink.

to give you an idea, the following is a short excerpt taken from the interview not long after i'd listened to the details of all her surgeries with no mention of any transplants....

me: 'yes, well i'm originally from pittsburgh...'

patient: 'oh, really? that's where my kidney's from!'

me: '.....................okay! let's talk about that!'


this was definitely unlike anything we'd rehearsed last year: "chest pain", "back pain", "headache".

and trying to present my chaotic plethora of notes to the preceptor was pretty much....a disaster.

hi, i feel dumb.

:::sigh:::

shoot the moon.

everyone remembers their first true romance, followed--in most cases--by their first heinous break-up.

you really, really liked them. they really, really liked you.

for about a month.

i was a freshman in college. he was a sophomore.

he liked dave matthews and john mayer and norah jones. i liked dave matthews and john mayer and norah jones.

he was italian catholic. i was italian catholic.

he coached our intramural flag football team. i was the runningback.

he bought me roses and a poster of dave and told me i was beautiful.

we took walks around the city at night and talked about Important Things.

he was spontaneous. and funny. and sweet.

and he was cute.

really. really. cute.

i was smitten.

this. this was it. we were perfect. people wanted to be us. life couldn't possibly get any better.

and suddenly, it was over.

he called me naive before ceasing to speak to me and began dating...a sophomore.

enter the chocolate, the hugs, the kleenex, and the 'he didn't deserve you's.

over time, we learn that the break-up recovery period is directly proportional to twice the length of the relationship and some mysterious algorithmic factor designed to take into account things such as roses, number of songs ruined, etc.

yep. it took me about two months to move on.

from this, it would be logical to assume that i'm still bitter about what happened.

wrong.

there have been several more relationships since, yet each time i hear norah's 'shoot the moon' or john mayer's 'city love' i cannot help but smile and think of my first perfect tragedy.

yeah, it hurt.

but for that month.....

yeah, life was good.

let's write in the blog instead of going to bed.

a few words on studying to music--

i-really-just-want-background-noise = solo piano or wduq pittsburgh

i-hate-studying-useless-information-that-will-never-appear-on-the-boards = supply and demand by amos lee

i-understood-nothing-of-what-i-just-read-and-oh-shit-the-exam-is-tomorrow = braveheart soundtrack

this-is-so-boring-i'd-rather-be-having-a-dance-party-in-my-pajamas = hey ya by outkast, anything with a fiddle, or released prior to 1990

let's-see-how-much-i-can-memorize-in-the-car-on-the-way-to-the-test = going the distance by cake

yeah-i'm-screwed-so-might-as-well-enjoy-myself-a-bit = preservation hall jazz band

satisfying-the-need-to-burst-into-song = bohemian rhapsody by queen

wouldn't-it-be-neat-if-i-could-fly-instead-of-learning-about-chemokines: the prologue to hook

spacing-out-and-wondering-what-life-will-be-like-when-i-actually-get-to-have-one = the opening theme to the boondock saints

let's-write-in-the-blog-instead-of-going-to-bed: you're nobody till somebody loves you by dean martin off the swingers soundtrack


among others. :)

welcome to second year.

Staphylococcus aureus
Staphylococcus epidermis
Staphylococcus saprophyticus
Streptococcus pyogenes (Group A)
Streptococcus agalactiae (Group B)
Enterococcus faecalis (Group D)
Streptococcus bovis (Non-Enterococcal Group D)
Streptococcus pneumoniae
Viridans streptococcus (S. mutans, S. intermedius)
Corynebacterium diphtheriae
Corynebacterium jeikeium
Listeria monocytogenes
Erysipelothrix rhusiopathiae
Shigella dysenteriae
Shigella boydii
Shigella flexneri
Shigella sonnei
Salmonella typhi
Salmonella cholerasuis
Salmonella typhimurium
Salmonella enteritica
Yersinia entercolitica
Enterotoxigenic Escherichia coli
Enteropathogenic Escherichia coli
Enterohemorrhagic Escherichia coli
Enteroinvasive Escherichia coli
Enteroaggregative Escherischia coli
Vibrio cholera
Vibrio parahemolyticus
Vibrio vulnificans
Campylobacter jejuni
Helicobacter pylori
Neisseria gonorrheae
Neisseria meningitidis
Branhamella catarrhalis
Haemophilus influenzae
Haemophilus ducreyi
Bordetella pertussis
Bordetella parapertussis
Pseudomonas aeruginosa
Burkholderia cepacia
Burkholderia pseudomallei
Stenotrophomonas maltophila
Mycoplasma pneumoniae
Mycoplasma hominis
Ureaplasma urealyticum
Microsporum
Epidermophyton
Trichophyton
Tricophyton rubrum
Mucor
Rhizopus
Sporothrix schenkii
Histoplasma capsulatum
Blastomyces dermatiditis
Coccidioides immitus
Paracoccidioides brasiliensis
Malassezia furfur
Phialophora/Cladosporium/Fonsecaea
Penicillium marneffei
Candida albicans
Non-albicans Candida
Candida glabrata
Candida tropicalis
Candida parapsilosis
Candida krusei
Cryptococcus neoformans
Pneumocystis jiroveci
Aspergillus fumigatus
Aspergillus flavus
Zygomycetes
Mycobacterium tuberculosis
Mycobacterium leprae
Mycobacterium avium-intracellulare
Chlamydia trachomatis
Chlamydia psittaci
Chlamydia pneumoniae
Rickettsia rickettsii
Rickettsia prowazekii
Rickettsia typhi
Coxiella burnetti
Bartonella henselae
Ehrlichia chaffeensis
Anaplasma phagocytophilum
Entameba histolytica
Giardia lamblia
Trichomonas vaginalis
Trypanosoma brucei
Trypanosoma cruzi
Cryptococcus neoformans
Toxoplasma gondii
Cryptosporidium parvum
Trichuris trichuria
Necator americanis
Ancylostoma duodenale
Ascaris lumbricoides
Toxocara cani
Enterobius vermicularis
Taenia saginata
Taenia solium
Diphyllobothrium latum
Hymenolepsis nana
Echinococcus granulosus
Strongyloides stercoralis
Plasmodium falciparium
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium


this is just a sampling of material from our first microbiology exam. we were to learn the diagnostic profile of each bug (read: all their bells and whistles), how someone would look if they were infected with the bug, and the plethora of meds used to kill each bug.

all in three weeks.

and i cry and i whine and i pull my hair and wish i was anywhere in the world doing anything else then ask myself if it's really even worth all the chronic misery.

and then my five-year-old patient hugs me before running out the clinic door.

yes. it is.