A Comedy of Errors

One of the greatest things about Philadelphia is that is really close to much better cities. The crown jewel of these is, of course, New York, especially during conference tournament time. For the past three years, I took a week off during the Big East tourney in order to travel up to Madison Square Garden. Usually, Darren and I stay at Casey's place in SoHo. This year, however, I took my vacation in February to go to Jamaica, so I was only able to travel on the weekend. Luckily, Louisville managed to get into the finals on Saturday night. Since Casey is in China, he kindly mailed us his house keys so we could still crash at his place (and watch his cat). Darren found some tickets on Craigslist Saturday morning, and the day was set! That's about the last thing that went right....

Problem 1: I blame Tim Burton. If Big Fish wasn't such a darn entertaining movie, I would have put more thought into the packing process. As it was, Darren and I got stuck watching it until 11:30 or so when our bus to NY was supposed to leave at 12:30. After the scramble to get out the door, we started our trek to 30th street station to catch the bus. About 2 blocks from our house, Darren remembered that we forgot to put Max up. So he ran back to do that while I kept walking. When we reached the bus stop at 12:15, our ticket was nowhere to be found. We still haven't found it. Perhaps Darren dropped it while trying to catch up? The bus pulled away while we stood there frantically searching our bags.

Problem 2: Well, the bus problem was easily solved as we were already at the train station and the R7 Septa line goes to Trenton, where we can switch over to New Jersey transit trains. We were out $24 bucks, but at least we would still get to NY in plenty of time for the 9pm game. We waited in yet another line for Septa tickets and caught the train with a few minutes to spare. (side note: Septa machines spit out $1 coins for change, but yet don't accept the same coins. Go figure). As our train pulled up to Trenton Transit center at 1:48, Darren leaned over and asked, "did you grab Casey's keys?". Uh, no. I felt like the fat kid in Stand by Me that only remembered to bring a comb (I brought two of those). After a quick discussion before the 1:59 NY bound train left, we agreed that Darren would return to Philly for the keys, and I would continue on to Penn Station in order to meet with the lady we were buying tickets from. Darren would drive up in our car.

Problem 3: I've had my phone for a couple years now, and as it has aged, the battery has lost the ability to hold charge. When we left the house, I had 3 bars. By the time I reached Penn Station at 3:15, I was down to 1. I called Darren on his train and asked him to grab my charger. The problem arose when I had to meet the ticket person. As my phone kept blinking stupidly at me that my battery was dead (side note, if you are dying, stop doing the equivalent of jumping jacks. save your damned energy), I was able to get the tickets at 4:55. With my phone now completely dead, I waited outside Casey's apartment hoping that Darren wouldn't break down on the way there (my car is ancient).


After all that happened, we were finally together by 6pm in order to enjoy the day that we wanted to. The NY alumni associated hosted their annual pre-game party at Stouts Bar on West 33rd, and we got to talk to Denny Crum and Darrell Griffith while listening to the pep band. Much more fun than missing buses and forgetting keys. The game itself was awesome, and congratulations to UofL for not only winning the Big East (twice), but doing it with a crowd that was 70% Syracuse fans. Darren and I went down to the lower levels for the trophy presentation and cutting of the nets, and it made the whole day of adventure well worth it.


Last story: we went to a diner accross the street from MSG after the game for some (veggie) burgers and fries (I also wanted a milkshake but their machine was broken. Bastards!). We talked to our waiter who had worked Thursday night during the 6 OT SU-UConn game. He said the manager had let all the waiters but one leave at midnight or so. Then they got swamped with post-game fans at 1:30 when the game let out. I guess they should have turned on the radio or something.

Catching up on things

1. I would like to start an awareness campaign for the entertainment industry. Please know that for a very long time now, doctors are not filthy rich. They do well as a group, but very very few are millionaires. I bring this up because on Law and Order the other night, the DA was arguing that a pediatrician shouldn't be allowed to post bail because he was worth 9 million dollars. Uh, no. The average pediatrician makes $90,000 a year. That's it. 20 years of school and three or more years of residency. Wow.
To be fair, surgeons make more, but most of that is because we do procedures, which are compensated by insurance companies at higher rates than office visits. Even that has decreased significantly in that past 20 years, as a joint replacement surgeon makes about half of what they did then.
I almost still wonder why college kids go to med school. Again I think it's the media portrayal. Here's the reality: go to med school, bust your ass for 3-7 years of residency making $12 an hour, graduate, and then pay half your income in malpractice insurance. Have fun kids!
(disclaimer: I don't care how much I make, I like my job just because it's fun)

2. Late in high school and early college, Street Fighter II was a great way to spend an evening. The new SF IV makes me laugh because it looks exactly the same. Same jerky graphics and all.


3. MarioKart for Wii is fun.

4. I'm ready for spring. The Chuddley Cannondale is ready to go (once she gets new tires and a tune up).

5. We're considering getting a new car, but we're concerned that the car we want is made in Mexico by non-union labor. Seems kinda silly trying to stimulate the economy by buying an American car when the workers aren't American.

Jamaica recap

To be honest, there's not really a lot to say that wasn't said in Darren's blog. We had a great time, enjoyed the weather, and ate more then is ever recommended (I had a bowl of ice cream at every meal). We got back a week ago, and the Philly weather has welcomed us home to light snow, cloudy skies, and below average temps. I actually got out on my bike this week, but that was only because I had to take the car to get new brakes and it was the only way home. It was nice to get out on the old girl again...
Here are some pics, enjoy!

Hasta luego!

For the first time in seven years, Darren and I are off for a one week vacation. No cell phones, no internet, no work, all the sleep I want. We're headed to Runaway Bay, Jamaica, for one whole week of nothingness. My perfect day would look something like this:
9am: wake up, breakfast
10am: morning nap
11am: sit by pool or on beach for 2-3 hours (yeah, it's the worst time of day for skin cancer, but I am young and invincible)
3pm: lunch, afternoon nap
4pm: go for hike, scuba dive, snorkel, or nap
8pm: eat
10pm: sleep

That's 11 hours of sleep a day!

Moving Buddy

Darren decided to make a cake today, and he thought he would use the white cake box we've had for a while. By "for a while", I mean about 5 or 6 years. It expired in February of 2004, nearly 5 years ago. We estimate that we bought this box sometime in 2003, meaning that this box has lived in four different houses in three states. We can't even cut out the box top for education; that expired in 2005.
We apparently need to make more cakes.

Blink

I've been reading Malcolm Gladwell's books since Darren received them for Christmas, and I'm not quite sure what to take from them yet. Blink discusses how humans have developed the ability to make very good decisions at a glance, but how these decisions can be horribly wrong if we don't have the correct background of information. A great story that leads off the book is about a good number of art historians who knew that a piece was a forgery, but couldn't quite put their finger on why. The other book of his that I read was The Tipping Point, which discussed how some events, such as disease epidemics and fashion trends, begin because of a few specially connected people. I am currently in the middle of his latest book, Outliers. I mention these because Blink has really gotten me thinking, and I wonder if I can apply any of the lessons of the book to my daily interactions with patients. While running today, I realized I already have on several occasions.
As an intern in orthopaedics, most of my struggles came while trying to build up my background of information. Orthopaedists read their own x-rays (while ignoring radiologists), but this is a skill that took me several months of practice to pick up. The advantage we have over radiologists (and why we ignore them) is because we have physical exam findings to correlate with the radiographs. For instance, I often pick up subtle findings on xray that radiologists don't simply because I know that the patient hurts at a certain location. By the same token, I have had to see patients with no injury because a radiologist thought they saw something that simply wasn't there.
Another example of knowing something without knowing why happened to me a few months ago at work. My intern called me about 2am about an inebriated young woman who had been struck by a car and was complaining of severe leg pain. Xrays were negative for fracture and the patient constantly screamed how she was going to sue the driver. She was also screaming in pain at the most minor of movements to her leg (these are all strong predictors for not really having an injury). When I examined her, her leg muscles were all soft (this essentially rules out compartment syndrome), there were no gross deformities, and her nerve function seemed to be intact. She was also not cooperating with any exam, so I couldn't do as much as I would have liked. It was also 2am, and I was cranky having to deal with a histrionic, drunk, annoying patient. But something was wrong, and I could not figure out what. I remember calling my attending and telling her that my spidey sense was tingling (really, I used those words). As the patient's pain continued unabated the next day, we did an MRI just to prove that she was crazy. And of course, she wasn't. She had an Achilles tendon rupture, which I completely missed due to such a limited exam (and xrays can't pick that up). Now in truth, Achilles ruptures generally don't hurt that much (it's like a really, really bad sprain), but at least something in me knew her exam didn't make sense. She had surgery to repair it a few days later.
So have my skills increased over the past four years? Undoubtedly. Do I still make mistakes? All the time, but now I have the background of experience and education to make a whole lot less.

New babies everywhere!

In my residency program, we usually divide the last several days of December into two 6 day blocks: those encompassing Christmas and the ones for New Year's. Half of the residents work one, while the other half work the other (there are many fewer elective surgeries to staff). I traditionally try to work the New Year's half, because I couldn't care less about that holiday (I went to bed at 10 this year, but I was also sick). I also really wanted to be home when my sister delivered her baby. Alas, I was destined to work the Christmas half. It turned out to be a blessing in disguise, however, since Laura's baby came late. Darren and I packed up the car and left town Friday afternoon (after I had a very difficult pelvis fracture to fix). We stopped just outside of PA that night, and then raced home Saturday morning when my mom called to say she had been admitted. Unfortunately, we missed Isaiah's birth by about 1 hour. We went straight to Baptist East to meet our little nephew!

Isaiah James, 9lb, 3oz, 21.5 in, December 27, 2008

My roommate from college, JP, was also expecting the birth of his daughter Emerson around the same time, and wouldn't you know it, she was born 7 hours after Isaiah! It was a wonderful day for everyone.



Other highlights:
We had dinner with Darren's high school friends Keith and Amanda (the couple we double-wedding'ed with) and their 6mo old Macy. So cute!


Got to know Julia's fiance Gram a little better. I have a sneaking suspicion we may end up getting along really well because he is a funny son of a gun (although, he does make a lot of bizarre comments about cannibalizing my sister).

Happy Holidays from the Bergants, Breys, Cornwells, and Gibsons (and Max's butt)!