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)!

Worst First Movie Dates

For some reason, in every relationship I have ever been in, there has been one date involving a really bad movie early on. Some movies were so horrible, it was a great prelude to the shit-ass dating to follow (or in some cases, no following at all). Unfortunately, due to my memory for really bad pop culture, I can remember almost all of them. There were so many classic movies that came out at this time, Schindler's List, Pulp Fiction, Shawshank Redemption, LA Confidential, even the classic Happy Gilmore. I watched none of these while on a date. It was like my dates and I decided to see if the relationship could handle 2 hours of hell and come out unscathed.
Now, I've been with my husband for over a decade now, so most of these movies have been rightfully placed in the $1 VHS bin of movie history. I'm dragging them back out.
The top 5:
No5 - Victim: my own dear husband, Darren.
Movie: Fear and Loathing in Las Vegas.
This movie had everything going for it. Hunter S. Thompson story. Johnny Depp. Benecio Del Toro. What it lacked was coherent plot and flow (which is probably the point). However, my brain couldn't take it, and to this day I have blocked out the majority of what actually happened in the movie.

No4 - Victim: Dan?, Dave?, Mike? - you can tell this was a meaningful relationship
Movie: The People Versus Larry Flynt
I should have run away as soon as the words "with Courtney Love" flashed on the screen. It was painful, and I never went on another date with whoever that was.

No3 - Victim: Josh
Movie: To Wong Foo, Thanks for Everything, Julie Newmar
Good Lord! What a premise! Patrick Swayze, Wesley Snipes, and John Leguizamo in an awesome 50's convertible looking for adventure across the country...Did I mention they were in drag? While at sometimes fairly funny, it was overall completely stupid. I mean, Wesley Snipes' stage name(?!) - Noxeema Jackson. Patrick Swayze - Vida Boheme. The basic plot had our three intrepid ladies stranded in a small hick-town in the middle of nowhere, and they had to teach the townspeople valuable lessons about acceptance and moisturizers. At the end, everyone learned that everyone is wonderful and the world will be perfect if we can all just express ourselves. I express myself by firebombing theaters that show crappy movies. The End.


No2 - Victim: Rob
Movie: Made in America
My first date of all time. I had to be set up on a blind date by my best friend because I could not have gotten a guy to look at me without having my hot friend around. Usually the guy I was checking out would eventually walk over and say, "Hey, does your friend have a boyfriend?" It was awesome. Back to my story, so here I am, 15 years old, never been kissed, bad hair, braces with a huge gap in my front teeth, and in general, really awkward and nerdy. We went out on a double date, and this is the stinker that young love was supposed to blossom to. The plot of the movie (if you can call it that), was that Whoopie Goldberg had a daughter by artificial insemination, and the donor daddy was a used-car salesman played by Ted Dansen. The daughter wanted to find her dad before leaving for college, and she finds out it's him. Whoopie and Ted eventually fall in love and make the girl's childhood dreams come true. It is actually even worse than it sounds. I vaguely remember something about a rampaging elephant, which could have been the best part of the movie had Ted or Whoopie gotten smushed.

No1 - Victim: Kyle
Movie: ConAir
This is the #1 worst movie ever made of all time (I consider Ed Woods' movies to be works of genius in comparison). The first problem is that Nicholas Cage is the worst actor in the history of time (just ahead of Bill Paxton (have you seen True Lies? Seriously)). He can do okay in comedy, but as a mulleted, wrongly-convicted, ass-kicking, righteous badass? No chance in all of hell. The producers somehow slipped rufees to John Cusack and John Malkovich into joining this piece of rhinoceros poo as well. I really can't say anymore. It is in fact the essence of suck.

Honorable Mention: Johnny Mnemonic. I actually saw this movie towards the end of a relationship, and I blame Keanu Reeves for the breakup. My brain still hurts from the implausibility of the whole thing. Keanu can't hold one coherent thought in his head, much less the super-secret data plans for something or other.

Thanksgiving and IPOS

Sorry it's been so long since my last post, but between work and travel I've been pretty wiped lately. Here's a small sample of what's been going on:

1. Went home for Thanksgiving for a great weekend with the family. My parents usually go to my in-laws for Thanksgiving dinner since we don't have much family in town, so Darren and I don't have to run between houses all day. We played the first annual game of Brey family flag football; hopefully it will get better when the boys get a little older. Laura also had her baby shower on Sunday. I cannot believe that my little baby sister is about to be a baby mama (can't wait!). We also caught up with old friends that we haven't seen in a while. By the way, $10 redbull and vodkas are a fraud.

2. After being back in Philly for about all of 18 hours, I flew out again, this time to the International Pediatric Orthopaedic Symposium in Orlando, FL. I had won a scholarship to attend the conference along with two of my ortho friends from other residency programs. I also got to know a third resident who has so much in common with me it's scary. She's another resident in town and one of my newest facebook friends!

As for the conference, it was a great opportunity to learn more about Peds Ortho and get to know some of the big names in the field. It's actually one of the smallest branches of orthopaedics, so most people know each other pretty well. Here's an example of one of my encounters. Do demonstrate how big the names of the guys involved are, I'll use NBA references. To set the scene, I had arrived in Orlando fairly early on Tuesday, and most of my friends were supposed to arrive fairly late that night. So, I sat at the hotel bar to watch some basketball, drink a beer, and eat some nachos. As I am eating said nachos, Dwyane Wade walks by. I call out and say, "Hey Mr. Wade, I met you a couple of weeks ago when I interviewed to join the Heat organization. Want some nachos?" So Dwyane sits down and starts eating nachos. A few minutes later, Kobe Bryant walks by and starts eating nachos as well. Finally, LeBron James comes and joins the pary as well. Weird.

AM, M, and I also snuck out of conference a little early one day to visit Disney World. I have never been during Christmas season, and I must say that the parks were actually very pretty. We got to do a few of the rides and watch the fireworks just before closing. The rest of the week we hung around with some of the residents from different programs around the country. Again, peds ortho is a small community, so I will probably work with these guys for many decades to come. It's good to know that there are really good people going into this field.

3. A lot is going on at home as well. I've hardly been home the past few weeks, and then as soon as I got home I was on call the next day. I'm so ready for a change of location at work. It seems that all I do is read and make presentations and I really feel the need to get some of my personal life back. My dog barely recognizes me anymore.

4. Happy 1st anniversary to Washed Up!

random nostalgia

Believe it or not, beneath my tough-as-nails exterior beats the heart of a severely nostalgic person (really, I cry at all movies, including Return of the Jedi). Despite the fact that I pretty much hated most of high school (with the exception of the people I hung out with), I sometimes think it would be neat to go back and live the moment again. Would I be much different this time around, knowing what I know now? I bring this up because I started laughing at my oldness today. My senior year in high school, all of us had to do a presentation on some topic of our choosing. The topic my partner Clint and I chose? The internet. Seriously, the whole thing. Can you imagine trying to sum up the internet in a 30 minute presentation today? This was, of course, back in 1996 when only about 5% of people had AOL with their 14.4 kbps dial-up modems. Scary. We made up the majority of the entire thing, and I swear there were portions that we cut and pasted right out of the internet explorer help page. We got an "A".
Another goofy thing about these presentations? There was no power point. The only person that used power point was a girl (that we (semi-) affectionately called Elmo) for her presentation on cowboys. We were blown away by the sophistication.
Some of the other topics I remember people doing were H's talk on "A Day in the Life" by the Beatles, L's talk on chinchillas, and A's talk on ebonics. J did a talk on magic that included real tricks!
How in the world do I remember crap like this?