Thanks

Holy Moses, Abraham and all the righteous fathers. These last few weeks have been filled with too many adventures. Here is the fun.

In short, I was able to finally hike around a Corn Maze, and it was in the shape of Washington State;

Got pulled over for speeding…accidentally (well, intentionally pulled over, but speeding accidentally);

Climbed some metal cattle on the side of the freeway (Matt twisted his ankle as we trespassed the field);

Visited an unfinished nuclear plant and played in the reactor tube (another funny story where Matt got stuck on the fence as we trespassed and ripped his pants wide open);

















Visited the awesome waves of Grey’s Harbor;
And climbed a wooden statue at Grey’s Harbor College. Glorious!

Now I am back in Maryland were I finished a Surgical Intensive Care Unit rotation and getting ready to start some more didactic education at school.

Elder Russell M. Nelson also visited my school and discussed some of the history of Cardiothoracic Surgery. Afterwards, I met him with my friend Rick Burgon and Elder Nelson made sure to pull me in tight for the picture. I had just finished a thirty-hour shift, so I was a little disheveled. Thanksgiving was great as Ben came down from Boston and we ate with some wonderful ladies in Arlington, VA. Most adventurous gluttonous day.

My last few rotations were at Madigan Army Medical Center in Fort Lewis, WA. It was a blast, and I hope to do my Emergency Medicine Residency there. I have great plans for that marvelous place…like buy a beach house.

One fine sunny day, I went with Becky Konchan and Matt Minor to go bungee jumping. This was awesome. Matt jumped first like a champ and I followed. The rules were as follows: Tie yourself in with the help of a beautiful lady, climb away from the beautiful lady over the railing of the bridge, and jump on the countdown “Three…Two…One...Dive!” I first ask myself why I was jumping to my apparent death away from a sweet lovely woman. Who knows, but she had no problem sending one man after another to a gloomy plunge of exhilaration. I think we really wanted her approving glance so we quickly did anything she requested. Afterall, we were mesmerized by her angelic features.

After what seemed three lifetimes, it was finally time for my inevitable plunge of doom. I did exactly as the beauty asked me, entranced by her every word. Placing the harness was easy; it was almost like a skydiving harness. Securing myself to the elastic cord also simple with the Angel placing the carabineer around my chest and waist loops with delicate touch and guided confidence. I gingerly mounted the railing of the bridge to her praises. I stood on the edge of death and uncertainty with a glee only known to those beguiled by womanly caresses of ego and male desperation for her attention. I listened to her countdown, “Ready…Three…Two…,” momentarily in eternal bliss. Everything was perfection with her sweet whispers to my back and the beauty of Mother Earth before me.

“Three…Two…,” my heart and vessels pulsating with adrenaline and excitement. I listened intently, “…Two…One...” Suddenly I was torn as I envisioned the fate before me, yet embracing the need of my Angel’s acceptance. It was as though the Sirens seductive love songs were being sung to the ancient sailors of Greek mythology. Instead of racing towards her beauty, I was leaping away. Oh, foolish man.

Then came the command, “…Dive!” Nothing could have prepared me for the horrid experience that followed. My body ached, my soul quivered, my head exploded, and yet I could not resist her command to contract my muscles and lunge forward into sudden oblivion towards Mother Earth. Almost instantly her prior instruction took hold and I flew forward like a well trained acrobat, with the crowd’s coos of admiration echoing in the canyon. Imagine a flying squirrel midflight, except with an umbilical-like structure attached and trailing behind. Exhilarating!

Actually, I almost messed my trousers, flailed like a fish recently removed from its watery home, and screamed bloody murder. Everyone in the crowd laughed hysterically.

As though I landed in a pocket of billowy clouds, my floundering came to and end and I bounced again and again on the end of the bungee laughing mirthfully. I was then hauled back to the top of the bridge to re-experience my distress, this time backwards. Awesome!

All-in-all, the experience was exhilarating and far scarier than skydiving. I would do it again in an instant, especially if a wondrous lady was encouraging me along the way. How does a woman gain such mastery of men? That I do not know, but how mundane this existence would be without it. Blessed day.

Long Time

Well, it has been a while since I wrote last and so much excitement has passed. I’ll keep it simple. I'm in the beginning of my fourth year as a medical student, and during one of my lectures in class a crazy professor showed us a video of death and carnage of war, put on a Kevlar helmet, pulled out an M9 pistol and began shooting blanks into the crowd while yelling expletives and telling us all to “Get down all you bleep bleepers! Get down!” It was awesome, and by far the best lecture of medical school.

Next I went to Indian Town Gap, PA for Operation Bushmaster where we get to pretend to be doctors in an imaginary Middle East country of Pandakar. The first year med students get dressed up in moulage and we fix them up. It is topped off with a Mass Casualty event with gun fire, smoke and darkness where we have to find upwards of 30-40 first years strewn about in the woods. Eventually we enlist their help, but only with the use of our own expletives. We had to scare the pooh out of them in order to enlist their help because they were being stubborn. I have learned that a well-placed expletive will get you very far in the military.

Then I had my Emergency Medicine rotation at Brooke Army Medical Center in San Antonio, TX for four weeks. There were record temps set and I was able to suture the tip of a man’s thumb back on (it was bitten almost completely off by another crazed soldier in the barracks) and also reattached another man’s pinky toe which he almost ripped off in a drunken stupor. Lesson learned: Alcohol leads to many retarded encounters in the Emergency Department.

I was then off to Fort Hood in Kileen, TX for a few days of EM as well where I saw a guy with a pretty crazy dislocation of his finger, sutured a 3 year old boys tongue back together after he fell and bit it almost in half, and saw my first patient with Wolf-Parkinson-White syndrome (a heart condition where his heart rate was wicked fast and he didn’t think anything was wrong. This stuff can kill you quickly enough).

Now I am at Madigan Army Medical Center at Fort Lewis, WA. So far I have been rock climbing a bunch, ripped my toe open (DermaBond is amazing. I had to sneak into the ED and grab some, but it was worth it. I love medical privileges.), hiked part of Mount Rainier and learned Self Arrest techniques to stop me if I ever fall on a glacier and will be certified in Advanced Wilderness Life Support. Sweet! Oh yeah, while hiking Mount Rainier and performing Self Arrest while sliding upside-down and backwards on the glacier, I smacked my knee on a rock so hard I thought I broke my patella. Luckily, I only bruised my knee a bit. It hurt like crazy, though.

I’ll have to upload the pics for you as I get them. That’s my life in a nutshell over the last few months. Glorious adventures.

More Adventures In Surgery

Happy Easter on this precious morning. I could not be more grateful for my knowledge of the Savior Jesus Christ and his love for all of us on this Earth, and the great sacrifice He has made for all.

It have been quite a while since I have written last. I have passed through Transplant Surgery, Vascular Surgery, Plastic Surgery, and Anesthesia at Walter Reed Army Medical Center (AMC) and I am now at Wilford Hall Medical Center and Brooke AMC for Obstetrics and Gynecology (Ob/Gyn). Transplant was fun—kidneys are AMAZING. Vascular was a blast and I loved my team—I laughed all the time with my friend Frank Rubio; the Fellow, a Major in the Army even made the comment that in no other place in the Army do you have two Second Lieutenants laughing at a Major. He loved us, too. Plastic surgery would definitely be my dream job, but I cannot spend the time it would take to get there. There are too many other adventures to have in life than to stay in the hospital all day long for the next Forever of my life. The Plastic surgeons are the most hilarious people in the world, although I will have tell you about them off-line. Anesthesia rocked as well, and I can thankfully start IVs and intubate without too much difficulty.

Now I work with some crazy people, but I am having a great time. Ob/Gyn has the reputation for having some of the crankiest people in medicine as physicians. As such, I have dreaded this rotation. I have learned that if you treat people well, they will also treat you well. Apparently all the horror stories I have heard about this rotation have not been my experience. I have seen many child births and delivered a couple of babies myself, seen way too many exams of nether regions, been privy to one of the most hallowed events is a family’s life, and learned to enjoy the company of even the crankiest of physicians. Delivery of a neonate is amazing and I’ll have to write about the event in my next blog. It will be quite the tale—Caesarian or Natural.

Sorry for the delay, and there are more stories I wish I could write. Father Time is my bane, and I am learning to tame him. Bring it on!

Vascular Surgery

I have just finished my Vascular Surgery rotation. It was a blast, so far as the people I worked with, but the hours were very long. I usually would wake up at 4:00am and get home about 6:00pm or later. Most of the time I got to work when it was dark and got home after the sun had set. I never really got to see sunshine. Now I’m off to Plastic Surgery. It looks like it will be less hours, and I really need the study time.

The one thing about Vascular Surgery I will remember is all the spraying of blood in the operating room. Just about once per surgery there would be a gush of blood squirting about the room, and sometimes it was more like a Water Worm with red-jet sprays flying everywhere. I learned never to get atherosclerosis (hardening of the arteries) as this makes a vascular surgery much more difficult. And don’t get diabetes or smoke as they both augment the rate or atherosclerosis development.

And I was able to practice inserting Foley catheters. I think I have it right now. A little practice is always a good thing.

Transplant Surgery

I am just finishing up Transplant Surgery this weekend. I was able to see 2 kidney transplants—one from a live donor and another from a cadaveric (or deceased) donor. It was pretty cool, especially to see how well the patients recovered to pretty much normal after the surgery. Granted, the patients are not completely normal since they are also put on immunosuppressant drugs for the rest of their lives, making them more susceptible to infection, but normal all the same with 3 kidneys instead of 1 or 2 (some people are only born with 1 kidney). There was also this one guy with a hepatic (liver) abscess that ruptured at Georgetown. It was cool to see that even at renowned facilities like Georgetown, the OR is chaotic and similar to the facilities at Walter Reed. The big difference I noted—the Argon Laser cautery we used to scorch the tissues during surgery. An Argon Laser cautery is basically a mini-flame thrower. You blast the bleeding tissue with the searing flame and that pretty much ends the bleeding. It’s glorious.

The transplant surgeries were exciting but hard to watch since so many people were surrounding the patients. I was usually delegated to Observer and could not help much. Although, I was the lucky guy who got to staple all the wounds closed. Carpentry tools in the OR. Sweet!

I almost forgot how my Chief Resident got hosed the other day. I was bored and went looking for a surgery to watch. Serendipitously, I stumbled upon him helping in a vascular surgery case. I scrubbed in and began to watch the surgeons implant an artificial aterio-venous vessel graft (or fistula) into the patients forearm. The graft connects the radial artery and the cephalic vein together in one high pressure system, bypassing the capillaries, and making it an easy access point for hemodialysis since the guy’s kidneys failed him.

We connected the vein to the graft without a hitch and began on the arterial end. There was little bleeding since the blood vessels are clamped until the last minute of the surgery when all the vessels are sutured together. It was at this point of releasing the arterial side of the graft that the mishap occurred.

I remember my Biology teacher in high school telling me that if you cut the carotid artery just right, you could get the blood to spurt clear across the room. I thought that was interesting but never quite believed him. Afterall, that would have to be at least 30 feet or more.

Well, it looks like my Biology teacher was right. After releasing the clamp on the radial artery (much smaller than the carotid and under slightly less pressure), I got to see a miracle unfold. A bright, fire-engine red, pulsatile stream of arterial blood spewed forth covering the face of my Chief Resident. I laughed as I dodged the sticky human fluid and watched to what appeared to be the resident drinking from a bloody fountain, with fluid dripping down his chest under his scrubs. It still cracks me up. Sure, we eventually stopped the spray of blood, but I will never forget the look on the Chief Resident’s face when he got hosed. Adventures in surgery.

Lest I forget, I inserted my first Foley catheter the other day…on a woman. This is the catheter that is supposed to go into the urinary bladder to remove urine during surgery, or whenever needed. Until this point, I have only placed them on male manikins and assisted other surgeons or nurses during placement. Seemed pretty easy to me. Well, at least one thing is for sure—being a 3^rd year medical student is always humbling.

I had mentioned earlier that the catheter is SUPPOSED to go into the urinary bladder (not the gallbladder or some other body bladder). As best as I could, I positioned the patient and prepared the perineal area. So far, so good. As everyone in the operating room looked on (and I mean Everyone being about 8-10 people) I proceeded to place the catheter into this woman’s urethra.

I must have tried at least 2 or 3 times without success and finally in desperation exclaimed, “It won’t go in!” The jokes began, and one of the surgeons asked me if I was married or had a girlfriend. You would think by my success that the answer was obvious. Now, I have done quite a few pelvic exams without difficulty, but this simple catheterization was my bane. Familiarity with female anatomy, I guess, is not my strong point.

I am sure glad my resident has a great sense of humor. He finally chimed in, “You’re stimulating her, not catheterizing her.”

Oh!

How humiliating. We finally remedied the situation, but I will never forget my embarrassment. Humility as a student. Yep, that’s what I learn almost every day.