I'm not a med student, not yet a physician...

My last core rotation is over, and my two week Christmas vacation has begun. And there are lots of interesting events that are coming my way such as...

1. Five interviews in January
2. Step 2 in February
3. Match Day in March - hopefully a glorious day for me!
4. My brother's wedding in March - very exciting! I get to sport some new duds for the event...
5. Trip to India in April
6. Graduation in May!

These are the thoughts I've been having since finishing my OB-Gyn rotation, which has thus led me to feel that I'm truly in this interesting interim period, where I'm still enrolled in medical school, but have finished all of my requirements, expect for a 2 weeker in derm in Feb, but does that really count? Even though I'm done with my requirements, it is quite clear: I'm truly not yet a physician! I felt this quite strongly on the way home from my interview @ Emory a couple of weeks ago.

As I entered the plane, searching for the middle seat that was to be the bane of my existence for the duration of the flight, I noticed the woman sitting in the window seat next to my assigned seat was facing away from the window, flickering her eyes here and there. I could tell she was nervous about something... I greeted her with a smile (I usually like to strike up random conversations with my fellow passengers, unless they're some weird looking man exuding strange vibes), and I asked her if she was ok.

"Yeah, I just hate looking out the window."

This comment surprised me, since most people like window seats, when they have one, all they do is look out the window, or they use the wall of the plane as an opportunity to rest their heads and catch some zzz's.

"I'm terrified of heights," she told me.

"Well, you can switch seats with me if you want," I said, only eager to abandon my claustrophobic seat assignment.

"Oh, thank you!" she said, and we some how juggled past each other and exchanged seats.

As we both settled, she told me that she fell a distance of two-stories from a balcony not too long ago, and even since then, she has had this particular phobia.

"I have Meniere's disease," she said, which caused her to have frequent episodes of dizziness.

And then, without warning, an image entered my vision. I saw a grey-haired, chubby, jeans clad, ruddy-complexioned Dr. Kretzer pointing to a diagram of semicircular canals, explaining how the frequency of sound is picked up by different hair cells. Kinda neat, said Dr. Kretzer.

Although Dr. Kretzer was kind enough to pay a brief visit to my thoughts, I definitely couldn't remember exactly what Meniere's disease was. Other than Steve what's-his-name-of-a-former-Rocket-player had it. I think.

"Oh," was all I said to my fellow passenger, nodding my head, acknowledging that this disease was a part of her life. Just like they taught us in PPS...

Now, I must have nodded my head rather profusely or with a knowing smile or something like that. Or she saw and heard Dr. Kretzer with me. Honestly, I have NO IDEA what caused her to ask me, "Oh, are you a physician?"

I wanted to reply "Hell, no!" But I managed, "No, I'm a medical student."

And then, for a moment, I panicked. I was on a plane going on a 2-hour-plus journey to Houston, packed with passengers, many of whom probably had serious medical conditions that had a decent chance of spiraling completely out of control right before my eyes and requiring immediate medical assistance in a plane on which the most qualified medical personnel was a 4th year medical student!! And, I had revealed my identity as a medical student to this woman sitting next to me, whom, I feared, would reveal my identity to the world without knowing that all I would be able to do if, by chance, one of our fellow passengers decided to suffer from an acute event, is to do a pretty darn good H&P (history and physical). I'd probably also be able to find a decent radial pulse. And, a good pedal pulse. If I was lucky...

"Oh, that's fantastic," the woman said, "good for you!"

"Good for me... as long as no one falls ill on this plane!!" I thought.

Well, everything ended up being ok on the flight. No one had an acute event. The woman didn't freak out during the plane ride. We had some interesting conversation. I got myself a pretty decent window seat.

But, I couldn't but help look forward to the time when I wouldn't be too panicked to reveal my identity on a plane. Hopefully that day will come...

You know you're being a 3rd year med student ass when...

You know you're a really really really mean 3rd year med student when you and the other 3rd year on the team gang up on the poor, lonely 4th year and say to her (regarding rounding on patients on the weekend), "Actually, since they only need one student this weekend, we were thinking that you could come in tommorow and see the patients." Enough said. This blog entry is over, but not forgotten!!!!!

Baila conmigo, yaar?

I signed up for Intermediate Salsa 4 tonight at SSQQ on Bissonet and 610 - it's my second salsa class, and I was suprised to see several Indian guys there! Not only were they Indian, but they were FOBs! The best part of tonight was seeing all the FOB's in their "salsa element," if you will. I will attempt to describe their dancing styles here in the unlimited space provided below.

• FOB #1 - The Nimble with Numbers FOB

This is a salsa style that incorporates years of mathematics training culminating most likely in a engineering degree at an American institution of higher learning (which led to his arrival in the U.S.). The style goes a 'lil something like this. You chant all the counts of the beats as they are performed, of course, while maintaining an Indian accent. With each count of the beat, you give your partner a little nod of the head., "one... two... three... four... five... six... seven... eight... and one, and two, and three, and four, and five, and six, and seven, and eight." How could this not make one smile, even a little?

• FOB #2 - Bollywood FOB (see picture)

This style is not so much what you do during the dancing, but what you do in between numbers. It involves tilting the head to one side with arms crossed and then running your hand through your hair. It also involves tugging upwards on your pants and then making your shirt is tucked in properly in all areas. And here's the clincher, which need a bit of explaining before understanding it completely: At our dance class, we rotate partners... if it's a big class, sometimes the guy will have to literally run across the entire dance room floor to dance with his next partner. Most people jog in order to accomplish this formidable task. Our Bollywood FOB hero begins to sprint across the room and covers the last 10 feet by sliding across the floor on his shiny black loafers to his awaiting lover, all with a large smile on his face. He pauses, to make sure everyone in the room has seen his daredevil stunt, and again runs his hand through his hair. I half expected Bollywood FOB to end up on one knee and seranade his partner in song with a violin that he somehow acquired on his journey across the room. Bollywood FOB is my favorite, needless to say. Thank god Bollywood FOB I saw tonight wasn't sporting the same kind of shirt Shah Rukh Khan is wearing above.

• FOB #3 - Clueless FOB A.K.A "How do they do these things in this country" FOB

This is the FOB that you simply feel sorry for. He's decked out in jeans and a kurta, and he can't quite seem to get the rhythm required to lead properly. He's always saying things like, "This appears to be quite complicated" and "These turns are simply spinning, spinning me to India." Clueless FOB wears chappals (Indian flip flops) to class, which salsa even more difficult.


So I told y'all which one was my favorite. Tell me, which one is your favorite, yaar??!!

*****
Note: Yaar = some sort of Indian expression, but i'm not sure how to explain it exactly. oooh i got it!!! It's the Indian quivalent of "y'all"!!! (I think... someone help me here...)

Gynecologically Disturbing...

Some things that I heard today during my OB-Gyn lecture on "Dysfunctional Bleeding" this afternoon:

• "Yeah those ballerinas are dancing their ovaries into oblivion."
• Something heard from the lips of DeBakey in the good ole days when he still performed surgeries: "What's the difference this hand and your hand? This hand (pointing to his own hand) is connected to this brain (pointing to his own head)."
• "Guys, don't get a cremasteric reflex when I tell you this..." ((You may access this website if you're not familiar with a cremasteric reflex. I refrain from explaining it here. http://www.gpnotebook.co.uk/cache/228196357.htm))
  
• "Dysfunctional bleeding is a physiological event in early puberty, and after your first few periods, you then take off the runway and you'll just fly away..."

Stay tuned for some stories from my interview in Pittsburgh...

On Top of Herman Hill

My torn sandals crackle the aged grass
with unfamiliar steep strides
sore from a lost love
now fading down Herman Hill

the sun drops baubles of sweat
on my breath, alone and alive,
as wind-blown strands caress my chin,
i finally feel beautiful again.

You know you're a 4th year medical student when... - Part 2

You know you're a 4th year medical student when you're having internal dialogue with yourself with the goal of trying to leave as soon as possible. Here's the scenario:

It's close to 7 am on 3A @ Ben Taub, Gold Postpartum OB-Gyn team. My team and I - including myself, two other 3rd years, and an intern- are about to round with the upper level. I'm post-call.

During my 24 hours on Labor & Delivery, I've:
- assisted with three deliveries
- delivered my first baby! what a cutie he was!
- got scutted by a fellow 4th year!!@@##$%#$#
- slept for 2 hours in the med student call room, minus the time when I awoke to the sounds of doors banging shut I'm tired.

We only have 5 patients to round on, so I expect to be outta here by 7:15 or so. We round on the patients, and I step forward, ready to put the charts back, ready to head out the door and go home when all of a sudden...

"Why don't we talk a little bit about prenatal care since there's time?" the upper level suggests.

Is this a sick joke? I'm post call! Can't you see?

And then maybe I think I look too cheery, and don't look like i'm post call, so I try and put on my best "haggard" face possible and decide not to suppress any yawns.

No, that's not going to work, I hear myself thinking, you need a way out. Tell her you're post call!

No, i can't do that, cuz then they'll think I'm lazy. But you ARE lazy. Ok, I'm not getting into this discussion with you right now!

Then, I develop a brilliant idea. "Isn't grand rounds today?" I ask the upper level.

"Ohhhh damn. I forgot." says the upper level.

SCORE!!!!!

"Well, we'll just get through what I wanted to talk about in five minutes, and then you guys can go to grand rounds." Sigh.

Somehow I doubted that this was going to take "five minutes." But I decided to keep the hope alive.

"So, when a woman comes in, say she's 8 weeks pregnant, what are some of the things you want to check?" the talk begins.

Silence fills the hallways of Ben Taub 3A, minus the endless gossipping of the Malyali nurses.

I look to my fellow third years. One of them is looking at the ceiling trying to figure out the answer. The other is biting her lip, thinking. I know they both know the answer - i've seen them reading books, but they're 3rd years... they might be afraid to give the wrong answer. How not cute.

Well say something why don't you??!! I hear myself say to myself.
Ok, ok!

"You wanna check some labs like HIV, Rubella..." I say, hoping the third years will fill in the rest.

"Yes, and?" the upper levels says, looking straight at me.

Malyali chatter in the background ensues.

"And Hep B, CBC..." I spatter off the names of other "really bad diseases."

"Ok, very good, and what do you want to check in a mother who's at 24 weeks?" she asks.

Damn, you don't know this one.

Silence again allows us to make out the linguisitc nuances of South Indian chatter.

Then, I telepathically transmit a message to my fellow third years. Say the answer! Say the answer! Say it now otherwise we'll be here forever...

"Is that when you want to check a Glucola test?" asks one of the third years. Now, I was happy to hear this answer, but also afraid that since the third year framed the answer in the form of a question, that the upper level would ask, "I dunno, is it?"

Thankfully, she didn't and we ended our little talk with a discussion on the glucola test. Finally, at 7:15... "Ok, you guys need to go to grand rounds... it's 7:15. Any other questions?"

I telepathically again transmit a message: Don't ask questions... Don't ask questions.... Don't ask questions.

"No questions? Ok then, see you in the morning!"

I headed home. I was one 24 hour OB-Gyn call closer to graduation.

You Know You're a 4th Year Medical Student When...

You know you're a 4th year when you decide that you're cool enough to pimp your resident. And yes, folks, that's precisely what I did on my 1st day of OB-Gyn, while on the intake service. There were two residents in that particular area, that serves as a sort of OB emergency room. One was an OB-Gyn intern, the other a family practice resident. The family practice resident was very impressive to me. He was doing a lot of teaching and explaining, which is always well appreciated. And then... he started pimping me.

For those of you who are non-medical people, "pimping" refers to when someone above your level tests your fund of knowledge by asking you questions. This can range from "draw me the carbon skeleton of the neuromuscular blocker, succinylcholine" (this happened to me on anesthesia... i'm not kidding) to "which side of the heart is the right atrium on?" (this did not happen to me, but i think it would be amusing if it did... especially if i got it wrong).

Anyways, he was pimping me on UTI's - urinary tract infections. What do you see on the urine dipstick, what would you look for on the urine culture. Then, he started asking me about vaginosis... what's the treatment?

Metronidazole I say.

Why wouldn't you give this medication to an alcoholic? he asks.

Cuz it causes a disulfiram reaction, I say.

Then, I start to get irritated, for no particular reason. I began to develop an unnecessary mentality that kind of went like this: How dare you ask such menial questions to a fourth year medical student? Don't you know who I am, and how superior I am? Leave me alone!!

And then, it happened, before I figured out that it was coming.

Do you know the mechanism of action of metronidazole? I ask.

He pauses for a minute. Leans his elbow on the counter. Ummmmmmm... lemme see. Does it work on a protein?

Nope, try again, I say.

I dunno. What is it? he asks me.

Forms toxic metabolites in the bacteria, I say, withdrawing this very miniscule piece of information that was somehow acquired during the process of studying for the Step One.

Ohhh! That's really good! Thanks for letting me know, He says.

Dammit. He actually was happy to learn. He had a much better attitude at getting pimped by a medical student, than I would have. In retrospect, I think this may have been a dangerous thing to do, to pimp my resident, especially since I was asking him a question that I was almost 100% sure that he wouldn't get correct, but I really do feel it was an accident. Maybe...

Sutures and Shoes

The first day of my OB-Gyn rotation was precious, not because I delivered my first baby, not because I found myself in a position where I was the most qualified medical personnel to perform an emergency C-section, but because I taught Anu how to tie his shoelaces.

We formed our teacher-student bond during the "suture workshop" portion of our OB-Gyn orientation day. I was first showing Anu how to tie the one-handed and two-handed surgical knot.

"Yeah if they want me to tie in the OR," Anu said to me, "I'll just do it like I was gonna tie my shoelaces." I laughed.

He then demonstrated on the practice suture model, making two loops with the two sides of the string, and tying them together. And that's when I realized... Anu ties his shoelaces like a FOB.

"What do you expect? My parents taught me how to tie my shoelaces," Anu said, when I told him that he was a FOB, "and I never learned the whole 'round the tree trunk' thing."

I told him that I would teach him. First, we needed some shoelaces! I looked at Anu's shiny black Kenneth Coles, and I reached down to untie his shoelaces.

"It's quite simple Anu," I began, "You make a loop with one side of the string, bring the other strand around, and pull it through the little loop, and tighten."

"Like this?" Anu.

"No, no... like this..."

He got it after two tries. I guess the first day of orientation of OB-Gyn is useful after all:)

Versed for laughs


I got to place an IV in a real live comic today - a comic who travels the country touring and putting on shows.

I had a lot of questions for him such as, "Can you tell me a funny joke?"

He told me he gets that question a lot and says it's hard to deliver on the spot. How bout that for a comic? Maybe it's similar to when you pimp a brilliant medical student, "How many chambers in the heart?" and you only get a blank stare...

He did say that because he was getting his toe amputated, he considered himself a "toe-away zone." Ba-doom ching!

I was putting an IV in him. He had this gorgeous vein popping out above his wrist that was the size of a tree trunk, and the resident said, "We're gonna put in a 16 gauge in this baby! I'll have my star medical student put in the IV." Now, this is one reason why I'm actually looking forward to intern year, so that patients won't actually fear getting treatment from you, and because residents don't have to treat you like a two year-old. I only worked with this particular resident one day... star med student? Gimme a break...

It's not like I wasn't capable of putting in the IV or something like that - by now I had gotten real comfortable with this minor procedure, having had two weeks of experience. Place the tourniquet, patient pumps their wrist, swab area with alcohol, then inject some lidocaine, swab area with more alcohol, then place the IV catheder, advance the catheder, connect to the tubing, let the IV run... But I think the combination of the patient'thick skin, and an annoying resident looking over my shoulder led to me blowing his vein. I had failed to put place an IV in a tree trunk.

I tried again... this time in his hand, and I got it very easily. I think maybe cuz the resident wasn't hovering over me as I did it. Then, I saw someone in scrubs pumping his fists in a very Home Alone sort-of-way out of the corner of my eye. It was the resident. It's almost like he wouldn't have been happier if the Astros made the World Series or something...

Anyhoo, it was at this point that I began to talk to the patient more, while I was securing the IV in place with tape.

"I want to look at my hand. Feels like a mummy down there." he said. I smiled.

"Just trying to tape it up real good," I said.

He held up his hand. "What's that?" he said, referring to a blood stain on his index finger.

"Ahhh... that's just... uhhh" I said, trying to think of something to make the comic laugh. Something witty, on the spot, something that would reveal that this medical student had hidden stand-up comedy talent. But all I could think of was the word "lipstick." Lipstick???!!!#@$

"You hesitated too long there," he said, interrupting my stuttering, "You're about to lie. I know... I play poker."

Of course he knows, he's a comic! "What would you have said?" I asked.

"Iodine," he replied, "It's just some iodine there..." He was trying to sound like a doctor.

"Iodine? ! But iodine doesn't even look like that!" I said, appealing to my logical medical knowledge, "It's more orange in color!"

"Most of us don't know that. We're stupid."

"I guess." He got me there.

We talked some more. He told me about various jobs he had and told me about some of the other comics that were his friends. He said he knew some Indian comics.

Then I noticed some blood trickling from his IV. Crap. It was leaking. I tightened the tubing on the IV a bit tighter and the leaking resolved, but there was another, much larger blood stain on his hand. He held up his hand to see how bad it looked.

"Nothing but some iodine there," I said, "The alcohol swab'll do that to ya too."

He laughed. "You learn fast."

I accepted the compliment.

And I decided not to tell him that I had what I considered to be a "stupid med student morning." I had to transfer some Vanc from a bottle to a bag of normal saline for a patient's IV using a 10 cc syringe, and while doing so, I punctured the bag of normal saline, leaking the liquid onto the floor of the OR. The resident (different from the one earlier in the story) looked at me like I was a moron. And I agreed with him. I thought about apologizing, but decided against it, based on principle. Why should I have to apologize for being a moron? I'm sure back in the day, that resident had many moronic moments. I hope...

The point is, that I had a great conversation with this particular patient. I didn't really have any life-altering epiphonies, or signficantly impact the rest of this patient's life, but I got to learn about a lifestyle I knew nothing about, and did counsel him a bit on how to take care of himself better. Despite my moronic moments, it was a morning that made me glad I was going into medicine, glad that I was going to be able to touch many lives in ways that are more meaningful than they may seem.

*********
Note: Versed, pronounced "Ver-SAID", is a drug (benzodiazapine) used for pre-operative sedation. Anesthesiologists refer to Versed as their margherita, their cocktail. When you give it to kids, it can make them pretty giggly.

The 6 A.M. Wire

The darkness envelops my sense of urgency to arrive promptly at the Ben Taub OR at 6:30 A.M so I can have the best pick among the patients needing intubation. My steps are soft on the concrete, but the synthetic fibers of my scrubs swooshing and my ID badge colliding with the head of my stethoscope serve as familiar music on the short journey from my car on "Lanesborough Street" to the Smithlands Metrorail station.

I check for cars twice before making a potentially fatal crossing that would otherwise be safe if only a luminous walking man signal were present. I'm well aware that I awakened from my dreams only thirty minutes earlier. I arrive at the rail stop and fill an empty seat that lies between an African American lady and a balding Asian man engaged in conversation. I lean back against the glass, trying to give them space to communicate. The lady is showing many of her teeth in her laughter, and she seems to be saying to the other man, "... much better job. You just don't work as much." It doesn't make sense, but I admire that she is animated while knowing that a med student sits beside her in that pre-dawn state in between slumber and wakefulness. It's similar to the "in-between" state in anesthesiology where it's dangerous to extubate patients: you want to make sure the patient has regained all their airway reflexes before you take the endotracheal tube out.

The conversation continues, and the lady's voice is the only one I can hear on the metrorail station. It's an anomaly, and I enjoy that at least two people around me know eachother. Suddenly the man turns away, the lady still speaking, now looking in another direction, "I don't know what he wants. But this is what he should have done..." What's going on? Who is she talking to ? Is the man mad at her? Or does she have schizophrenia? I want to know more, I want to ask her, but I've learnt that people don't always like that. Just like in the 2nd grade one time when I saw Casey and Shannon sitting on the monkey bars talking to each other about something that I wanted to know about. I yell out from down below,"Who are you talking about?" "Mind your own beeswax!" Casey yells back. I walk away thinking "Yeah, well I'm never gonna tell you anything again." Not that I had ever told her any of my juicy secrets prior to that moment... Not that I had any juicy secrets. I was eight.

The lady was still talking, still laughing, and the Asian man was now looking in the opposite distance, presumably for the train to arrive. And then, I see the wire, highlighted by the red background of her blouse. A wire that connects a cell phone I can't see to a small silver earpiece. Ahh, I should have known. It was the all-pervasive cell-phone conversation, with an apparently crazy woman and a wire as clues. Now I'm sad - no one on the rail station knows eachother, and maybe the lady and the balding man would have begun conversing, maybe about the Astros losing last night, if she hadn't had her cell phone. Or maybe she and I would have talked. Or maybe I would have talked to the Asian man. I still could say hi... but I decide I'm too sleepy, too tired, not interesting enough. I sigh, wondering how long it'll take for me to awaken, just as the train arrives and opens its doors, allowing me to enter.

Ode to Intubation


I started a two week anesthesia selective this past Monday, and I felt the urge to dedicate a poem to the intubation:

Ode to the Intubation

I was hangin’ in the pre-op area one day
And a surgery patient came my way
My resident says, “It’s a thyroidectomy!
She’ll need to be intubated, so follow me!”

We wheel the patient into OR number five
Where blue sterile towels are happy and alive
And on a tray right next to me
A gleaming Mac blade is what I see

We put the patient to sleep, she never fought us
I then insert the Mac blade to see the epiglottis
The plastic tube went through the vocal cords
A job I felt deserved accolades and awards

I listened to her lungs for equal breath sounds
Alas! For a minute I began to frown
What if I intubated the right main stem bronchus?
And the tube went way past the glottis?

But as I listened more clearly to her lungs
They were equal, and my heart gleefully rung
with joy at completing my intubation well
To you, dear reader, this tale I wish to tell.

Vera and her fibrous pineapple


My friend who is also in medical school - we'll call her Vera - attended what she called a very engaging Psychiatry lecture given by the queen of psychiatry(and of the Step 1 apparently), Dr. Kristin Kassaw. Dr. Kassaw covered many topics regarding physician burnout, one of which involved the tendency of many physicians to be "perfectionists." Now, I know that I definitely have this trait as a part of my personality, and I felt that this term nicely describes Vera. Vera, however, profusely denied this particular label.

She then told me an unrelated story, which I will attempt to recreate here, and you'll see my point when I'm done:

"So I had a really funny morning. You're gonna think I'm crazy when I tell you this. This morning, I decided to go to *Anonymous medical specialty* Grand Rounds because I had to talk to *insert famous faculty name here*. So I get there, and walk in to the room with my little plate of food and coffee and sit down. And as soon as I set my coffee down, I tell myself, Vera, don't spill your coffee! *laugh* So right after this, a grape rolls right off my plate onto the floor. I check to see if anyone's looking at me, and then I pick up the grape and I tried to throw it into the garbage, but I missed and it ricocheted off the side of the garbage can and landed behind the damn garbage can. I panicked. I looked to see if anyone was watching - thankfully no one was! Then, another grape rollls off the other side of the plate! And my coffee spills! But I tried to keep my cool, so I picked up the cup and started drinking the rest of my coffee like nothing happened. I didn't even clean up the coffee that had spilled! *laugh* So then I was eating my pineapple, cutting it with my fork. The chief resident was sitting right next to me, and so I trying to do my best in cutting my pineapple, so he wouldn't think that my surgical skills were terrible. *pause due to outburst of laughter from Devi* And then I realized that it's poor etiquette to cut your food with a fork, but I didn't have a knife. I was doing a good job cutting my pineapple, but there was this little strand of pineapple that I couldn't cut! I was getting nervous that the chief resident was watching me, and finally I managed to cut the strand. I didn't even bother with the rest of the pineapple on my plate."

Hmmmm Vera... ya think you're NOT a perfectionist?

Conversations with a Guatemalan


Orlando, the condo maintenance guy came to my apartment yesterday afternoon to repair the hole in my ceiling. Whenever some "guy" comes over to fix any non-specific appliance or non-specific home issue, you never know what kind of dude you're gonna get. Is he gonna be scary looking? Resemble a thug you saw on TV or on a scary MTV music video? Is he going to look like Brad Pitt or Gumby? Not that I have actually had this last thought... but you know what I'm saying.... maybe...

So, when I heard a knock on my door this afternoon around 2 pm, I was wondering... what is this guy going to look like, and how much should I trust him? And then, of course, you don't want to seem like you're adopting some sort of stereotype by acting like every maintenance guy is going to like jump you or something. However, I'm a small female, and I'm innately paranoid about any strange fellow, so I proceeded to open the door with extra caution.

Turns out Orlando was really nice and friendly. He was talkative too, which made me kind of suspicious, but he told me he had a wife and two kids, so I felt better. Orlando is from Guatemala, and his mom brought him to the U.S. at age 7 to get away from his father and from the political unrest in the country. She wanted to get away from my dad, he said, and i didn't probe further. He did say that he would never want to live in Guatemala, because anyone can kill you for free there. yikes, I thought.

I didn't know anything about Guatemala, so I did a search on the country, and here's what I found on wikipedia.com:

1. Mayans flourished in Guatemala from 3rd century BC to the 11th century
2. The country was conquered by the Spanish in 1523
3. Independent from Spain in 1821
4. CIA (that's us!) overthrew Guatemalan gov't in 1954, which led to a war that lasted 3 decades in which 300K Guatemalans were killed. (yay for the americans)
5. Belize used to be part of Guatemala, and there are still disputes as to where the border lies between these two countries.
6. Currency is called quetzal!! i love it!!!
7. 1% of the population practices Mayan religion
8. official language is Spanish, with an additional 23 indigenous languages

I thought that was interesting.

But anyways, my ceiling is fixed. And Orlando wasn't scary. So I'm quite pleased.

There's a hole in my bucket, dear Liza...

My family and I returned from fleeing Rita last Saturday to Clear Lake, where we found no flooding, no damage, and no tree sitting in the middle of my living room. We even had power! I was amazed, and I felt blessed.

My father wanted us to check on my condo, but I figured that could wait till later in the week. I finally made it over to good 'ole BriarGreen yesterday, and found everything in order except for some weird lookin' stuff on my kitchen floor. I figured it just fell of of my trash can when I emptied the trash before I left my apartment. Oh boy was I wrong.

Later on Tuesday night, I opened my pantry door and I realized that the "stuff" was insulation. There was a hole in my ceiling in the pantry closet, and insulation had spilled out onto some cracker and cereal boxes inside the pantry. It almost looked like someone had punched a hole in my ceiling!! It was kinda freaky.

So then i did what I usually do when I didn't know what to do. I called Ahila. The conversation initially went something like this:

"Ahila, there's a hole in my ceiling." Laughter on the other line. "Ahila? Did you hear me? There's a BEEP hole in my ceiling!" More laughter.

I'm not quite sure why she found this so funny, but somehow she managed to get over her laughter, and she came over to help me repair the hole until I could call someone in the morning. She brought her flashlight, and I decided that the hole was "non-communicating" with the outdoors. Ahila said I was a nerd for using that term, but I was kind of proud of myself. I also told her that the hole was approximately 8x3 inches, which I was proud of also because I had measured it. I mean, I knew a lot about my hole in my ceiling.

Well, everything except where it came from. I also happily realized that nothing had fallen through the hole, such as a racoon or a skunk or something. I told this to Suneal on the phone, that I was happy that a racoon hadn't come in my house to give me rabies. He pointed out that rabies was most commonly found in bats. Damn my microbio memory.

Anyways, we fixed the hole with duct tape and some plastic. I was pretty proud of what it looked like, and I hoped nothing would crawl through.

This morning, I got "Shawn," one of the "condo guys," to look at the hole. He decided that he looked like someone had stepped through the ceiling. He said, "Yep, looked like someone just stepped right through. That hole is the size of my foot." He said someone musta been up there in the attic doing some work and created the hole.

The condo guy made the diagnosis and I had failed. Maybe this reveals my insecurities, but I felt kinda dumb at this point, like I have many times in clinics when I present a case to my upper level or attending, and they make the diagnosis in a snap. I mean, damn, I should have deduced that the hole was in the shape of a foot. See! This is what med school has done to me. A hole in my ceiling turns into a competition with Shawn the condo guy to see which one of us can figure out how the hole got there first. Ahhh well. I've talked to the condo property management since then, and they've agreed to fix my hole. So I'm happy. As long as nothing crawls through ...