Hospital on a Hill

There are many reasons that I think a hospital on a hill is a bad idea. Here are my top 5:

1) Sick people don't have the strength to climb hills

2) Parking

3) Ambulances are not the best vehicles to speed up winding steep roads

4) Earthquakes + Gravity

5) When the fog settles around the hill, and a patient unfortunately has end-stage disease, they may look out their window and have a terrible existential moment. Am I already in Heaven? Is Hell this hospital room where I have to see the same residents everyday, much like Sartre's play No Exit? No joke, the following is a picture from the hospital on a hill.

--By Farrah, who is now giving bonus points to non-hill hospitals when comparing her residency choices

Well Portland Oregon and sloe gin fizz, if that ain't love then tell me what is

I am currently doing my fourth month-long away elective in Portland. I now realize that while I know I don't want to stay in Ohio for residency, getting out of Ohio for 4 whole months probably wasn't the best plan. I was exposed to H1N1 in multiple hospitals. I lived in environments that involved sharing bathrooms down the hall with french scientists, hippie medical students, and occasionally a lizard. I had to buy both warmer and cooler clothing depending on my location and inappropriate packing (how could I predict what I would need for the next 4 months when I left Toledo?). I had to shop in weird unfamiliar grocery store chains. Today, I felt homesick and trekked down a steep hill to get some Chipotle like they have back in good old Colorado. I got back to the co-op where I am currently staying and settled down to watch yesterday's episode of 30 Rock. As I watched Liz Lemon substitute a scented candle for deodorant, I saw myself in her character.

(There was a video here before the NBC nazis took it down: it was Liz Lemon smelling her armpit and then rubbing a scented candle on it)

Later when she went to Georgia, I was reminded of how uncomfortable I am in the unfamiliarity of each new location I visit.

(There was also a video here: it had Liz Lemon sick with Jack handing her a bottle of medicine. She then says, "What is this? Peppy Bismilk? Why is everything a little different here? I HATE IT!")

I feel unkempt, and less organized in general in all these new locations. While I really enjoy visiting lots of new locations, I am afraid I may have tired myself out too much before interview season. Here are a few things I learned about each of the cities I visited. This information does not include any opinions about any of the residency programs because it's interview season and I'm not stupid.

San Francisco: Expensive city. Don't go into the woods in golden gate park after dark, and also before dark. I don't like Ethiopian food. I really like "hot chocolate" brownie desserts.

Tucson: Really hot. Lot's of different desert wildlife: snakes, lizards, scorpions, coyotes. The desert museum is not actually a museum - it's a zoo. A cactus can be pretty. Also, when I said there were scorpions, I want to emphasize that they were IN the house, yuck.

Denver: Best city ever. I love being home.

Portland: I've only been here for a week. I live right next door to the hospital so I don't really get a chance to explore. I am excited to see what the city is like this weekend. So far I only know that it is wet, the fall trees are really pretty, and there is a pretty high chance that there are bed bugs based on the bites on my legs and arms. :( Also, there are a LOT of hippies here, and that's saying something from a girl who went to college in Boulder.

--By Farrah, who never thought she would admit that she misses Toledo. Also, bonus points to anybody who recognizes the lyrics in the title.

Singles Vs. Marrieds: A Comparison Study

In the Sex and the City episode "A Woman's Right to Shoes," Carrie attends her married friend's baby shower. The host insists she take off her Manolo Blahniks upon entering her penthouse apartment. But when Carrie leaves, the Manolos have been stolen, and the hostess refuses to pay the exorbitant $485 to replace them. At the end of the episode, Carrie registers herself for the same shoes she lost at the Manolo Blahnik store and announces her marriage to herself. After all, she reasons, "Think about it. If you are single, after graduation, there isn't one occasion where people celebrate you. ... Hallmark doesn't make a "congratulations, you didn't marry the wrong guy" card. And where's the flatware for going on vacation alone?"

I never really thought there was much of a difference between married and single people. Weren't we still a part of the human race? Recently though, after spending quality time with married people and observing them in their natural habitats - one-dish dinner parties and Ikea - I have realized that singletons and marrieds have diverged into two different species - call it homo marritus vs. homo singletus. The question remains - can we still co-habitate?

Recently, I was sitting at a table with married people who were slightly older than me, but not so old that they wouldn't get the Jesse Spano, "I'm so excited!" reference. As I sat there, attempting to make conversation, I realized that for the first time I was at a loss for words. One girl discussed the difficulties of building a home - picking out the tiles, the sinks, the appliances etc. I had been renting since I was 18 and would probably continue to do so until the age of 31 when I finished residency (i.e. when I could finally afford anything that didn't have linoleum floors and a shared wall), so I merely said, "Yeah...Home Depot is a confusing place" awkwardly.

Another girl discussed how her son had just gone for his first soccer practice and how confused he had been by the concept of kicking the ball into a large net and had merely wandered off to pick daisies instead. I didn't have a 4 year-old son or ever play soccer, so I merely "awwww'ed" accordingly as is customary to do so when someone tells you an incident about their under the age of 10 child.

Another day at a post-Ramadaan brunch, I once again found myself at a table full of married folks. The restaurant was taking a long time to fulfill everyone's orders, and one girl's husband rushed to her side and gave her a Danish pastry he had ordered so that she wouldn't get hungry. "Awwww!" the other marrieds cooed, "My husband doesn't do that ever!" they said with mock-jealously. There was congenial laughter about how sweet this said husband was and how their own spouses were too busy watching football to care that much. I was the only single girl at the table and by this point, I had learned the value of silence.

During my one-month stay amongst the Marrieds, I felt less like the independent Miss Mary Tyler Moore with her "you're gonna make it after all" attitude and more like an old unmarried lady with other unmarried lady doctor friends who only had a wealth of arcane medical knowledge and a litter of cats for company. Even Carrie who felt inferior to the smug married people got her Manolos at the end of the episode and could drown her sorrows in her fabulous wardrobe. But where are real single people supposed to find solace? In their crappy H&M and Banana Republic-on-sale button downs and poly-blend work pants (which is all one can really afford on a resident salary)? Or perhaps we can find silver lining in that our conversations haven't solely degenerated into the chemical composition of baby vomit and home moldings. Yet.

--By Mariam, who feels bad because she hasn't blogged in so long.

Critical Analysis of Drawings on Tile: Part IV of a Series

While we are studying for the USMLE and learning about child psychiatry, we don't want to leave our dear blog readers without art to critically analyze. Here is part IV of the series:
Farrah: The degree of jaundice here implies pancreatic cancer. Very hard to cure. This child is very ambitious, very ambitious indeed. Also that shot looks like a pen.

Mariam: You totally couldn't cure cancer with a simple "shot" to the hand. You'd need central line access shit to "cure" cancer AT THE VERY LEAST.

--by Farrah and Mariam, one of us saw Julie and Julia, and it reminded her of us, in our infinite narcissism

Meet Farrah

Several people commented that it may not be politically correct to critically analyze the drawings of children, so in an effort to make things fair, I present a series of my own drawings. I am doing an independent study in pathology, studying for the USMLE in the library of my childhood home, surrounded by many hardcover books. In a cabinet underneath one of the many shelves, you will find some soft cover books written by and pictures drawn by me and my little sister. Since any distraction from Crush Step 2 is welcome, I browsed through this cabinet and found out a few things about myself. This project was a self portrait with a short biography at the bottom. It hung on the wall of my elementary school in September 1992.

"September 15, 1992

My Best friend is Victoria. My favorite book is Little me mo's Pizzra. When I grow up I want to be a doctor. I'll never forget when I went to Iran for the first time. The hardest thing to do for me is math. I feel happy when I am at home. If I could go anywhere in the world I'd go to Orlando, Florida. I like to read."

This biography is somewhat accurate. The thing that surprised me the most is that I said I wanted to be a doctor when I grow up. I was almost positive that I made that choice my sophomore year of college. I guess I have always wanted to be a doctor. I really wish I could use this stuff for my personal statement. In terms of the artwork, my critical analysis found that the nose holes look extra weird, and there is some sort of hemifacial hypertrophy. Anyway, if I wrote the same type of biography today, it would look like this:

"August 10, 2009

I have a super awesome friend named Tor. The Harry Potter books are some of my favorites. When I grow up, I want to be a pediatrician. I forgot most of what happened when I went to Iran for the first time. The hardest thing for me to do is statistics, but I used to be really good at calculus. I feel happy when I am at home. If I could go anywhere in the world, I'd go to Venezuela and see Victoria falls. I like to read."

Hmm... not much has changed.

--By Farrah, who's got more childhood drawing and hospital tiles to critically analyze!

A Complex Person

This week, I discovered new medical school blogs from strangers by typing in "Medical school" into the magic Google machine. I found entertaining blogs about medical school and the standard woe-is-me entries about how tiring, entertaining, pointless it is to be a medical student, even though we will go on and become the top earners in American society. The backrow blog has had its fare share of bitch sessions about medical school, and I realize now that these stories aren't universally entertaining. They are only amusing to our small, select audience of secret medical student readers, Jack's dad and sister Eileen, and Lindsay, our friend from the Detroit suburbs. What this blog needed was wider appeal like my hero David Sedaris.

And what I want to say is: yes, I'm in medical school, and it consumes a lot of time, but I am still an interesting person, regardless. In essence, I want to reclaim my identity from medical school, and I want to say to UTCOM, you have not destroyed me - I am still desperately clinging to the last shards of my personality. For instance, I do a funny white person voice with Farrah**, I really like zombie movies, and I love Sephora. In other words, I am a person without you, medical school. I am a person of varied interests, and I will now have to end my affair with you. We are officially on a break until I reclaim myself from your tyrannical clutches (really, medical school, you are as possessive as a jealous mistress). No more, I say! Down with medical school entries about butt abscesses and patient care! Viva non-medical school-related blogs!

**Really, it's very humorous. I wish blogs had audio capabilities.

--By Mariam, who can talk about things other than rotations and medical school. Just ask her about the Nazi plundering of art treasures during WWII.

Crtical Analysis of Drawings on a Tile: Part III of a Series

To help you dear blog readers pass the monotony of summer nights, here is another critical analysis of a child's drawing. Warning: it's one of the most challenging drawings to date.



Farrah: This drawing captures the very terrible nature of illness. Especially illness next to triangle shaped gravity-defying houses.

Mariam: ?!!???

--By Farrah and Mariam, who are now MS4s at UTCOM.

Critical Analysis of Drawings on Tile: Bonus Link and Video!

Sadly, there is no tile in this post, though we do have more tiles to offer at a later date. I was talking to one of my friends who reminded me of a website from my undergrad days that abrasively made fun of kids rather than critically analyzed their work in order to improve their art skills. Anyway, it reminded me of us, and it's from the humble guy who runs thebestpageintheuniverse.net.

When I was searching for the site, I was brought to another favorite undergrad website - Homestar runner. This clip is way more awesome than the link above, and it's highly recommended from this backrow baller. Enjoy!

--By Farrah, who just moved back to her sister's house where her 2 year old nephew now knows enough words to say "Teddy pooped" when the dog farts, aww!

Garage Sales

My husband and I recently had a baby girl, and let me say, clothing these little monkeys is a ridiculous venture. You pay $10 for what can’t be more than a yard of fabric which they will outgrow in a month or so anyway. Honestly, though, a month is about the longest these clothes would make it because the instant you put a clean outfit on your child, he/she will vomit/poop/pee on it. You can tell a baby's age by how much stuff their parents will allow to be on their clothes before changing them. Generally it goes from a small amount of spit up to a onsie so crusty it maintains the babies shape after you take it off.
So the best solution I have found to the huge cash sink that is infant clothing is attending garage sales. In the interest of public service and contributing to the blog, I want to share the many awesome things I have learned about garage sales.

1. The best prices can be found in lower middle class and upper class neighborhoods. Lower middle class members realize the value of dollar, and let's be honest, they probably bought the clothes at a garage sale too. The upper middle class was probably going to throw the stuff out anyway, so why charge more than a dollar for anything? The middle middle class is under the delusion that because they value their stuff, so do other people. But truthfully, no one cares that your little girl ate her first carrots in that chair, I am still not going to pay $50 for it.

2. Bring quarters. There will be adorable little children at most garage sales selling lemonade. And you may not care about supporting their first venture into a capitalist society, or hell, lemonade may give you a severe case of GERD, but I promise you, a cute little girl in pigtails + minute maid = you giving up those quarters.

3. Sometimes Googlemaps likes to mess with you. Bring a backup map just in case someone out there in internet land thought it would be funny to send you into the shady east side of Toledo near dusk.

4. Estate sales sound like the weirdest thing on earth, but actually it is an opportunity to spy on people in their (once) natural habitat. The only other way you will get to know people this well is by risking a breaking and entering charge.

--By Sarah, who is contemplating not letting her daughter watch Disney movies.

Critical Analysis of Drawings on Tile: Part II of a Series

We are well aware of the popularity of this series, and so, we present to you Part II of the series. Please comment below on what your analysis of the art is. After all, we bring a huge part of ourselves as observers when we examine art or in this case the confusing nature of child drawings. For more see: Part I of the Series.

Farrah: This picture was clearly drawn by an adult! CHEATING! Nice representation of sterile technique though, except for the LACK OF EYE PROTECTION.  Shit in the eyes is a very likely complication of said "miracle of birth." 

Mariam: Your cynicism about this tile is so ugly and disheartening. This kid could be the next Michelangelo for all you know. However, I'm not sure what is going on with these proportions - the torso of this butch-looking lady is way too short to give birth to anything remotely human. The "miracle of Rosemary's baby" perhaps?

--By Mariam and Farrah, who should be studying for their surgery shelf so they will never have to endure this horrific rotation again.

Critical Analysis of Drawings on Tile: Part I of a Series

The walls of the pediatric ward at our local hospital are decorated with touching tiles made by children about illness, recovery, or any of the other fascinating things that can occupy the mind of a child about weighty topics such as death, dying, and cancer. Though they could only work in blue, yellow, green, and maroon, since these were the only colors given to them by the Color Nazi hospital admins, the tiles add an artistic flair to the dull walls of the hospital. They were drawn by children who are now grown adults. Maybe they can look back at these tiles of yore make some objective observations about their art. And since we can't possibly track down those folks, we will offer our own critical analysis of the tiles in Part I of the series.

Farrah: This picture doesn't really differentiate between hurt and better. The sun is shining in both sections which doesn't really leave kids with a motivation to move towards better. A+ for spelling. B- for leaves on trees.

Mariam: I completely concur with your analysis. I really don't see much difference except that the tree is closer to the so-called "patients" in the "better" picture. I am truly not getting a sense as to what the hospital did for this child except plant some trees. Def a C- effort and that is only because I'm feeling generous.

--By Farrah and Mariam, who are not this critical of people who are still children, and who actually want to heal kids when they grow up (which probably won't happen anytime soon)

"It's all fun and games until someone gets shit in their eyes."

Although I blogged on this topic not too long ago, I firmly believe in knocking down the facade of the seemingly glamorous lives of doctors. Everyone sees the fancy cars, the long white coat, and the self-assured and cocky attitude of doctors, but rarely does anyone realize what this job actually entails.

My mom was always enamored by doctors. She didn't get to go to medical school and always regretted that decision. She said things that were classic of a non-doctor like, "Wow, you get to be economically self-sufficient" or "Doctors get so much respect," or "You help people!" In short, the classic immigrant lines about the American Dream. She, of course, had me at "economically self-sufficient."

I find that it is my duty as the resident blogger/muckraker to dismantle the myths about this seemingly dignified, respectable profession of the bourgeois class. I realized this year that being a doctor involves doing a lot of shit, literally.

For instance, last week, I scrubbed into a procedure that I thought would be simple - a mere colostomy and central line placement. But then, suddenly things took a dark and sinister turn as the patient was placed in the lithotomy position. The surgeon started to explore this lady's anal cancer as if he were the Vasco da Gama of the anorectal canal, and I was his humble skipper there to help with whatever was needed.

The scrub nurse (who had the attitude of a cab driver in rush hour in NYC) aggressively forced a small yellow bowl and suction into my hand and told me place it under the butt hole (for a lack of a better word) as the surgeon irrigated the fistula that had developed there. As he cleaned out the fecal matter from the vagina, I got to suction the lovely contents up like a dutiful Vanna White that I was. It was at this point that I thought, I went through 8 years of extra schooling to do this? To have the dubious honor of suctioning up shit?

My internal diatribe was interrupted suddenly with a huge splash. The saline and fecal solution that the surgeon had been irrigating splashed on my face and eyes. The moment was very surreal - did this really just happen? I didn't say anything at first until I heard the scrub nurse making a huge commotion about how it got into her eye.

"Uh, can I, uh, please get a towel?" I asked timidly still thinking that my job of holding the feces bowl was still relevant despite actual contact with someone else's bodily fluids.

"WHY?? DID IT GET IN YOUR FACE?" the nurse said in a panicked voice.

"Yeah, um just in my eye and face," I said. I was then forced to de-scrub and promptly head to the eye wash to irrigate my eye.

The doctor looked at me with bemusement and said, "It's all fun and games until someone gets shit in their eyes." Ah, a surgeon's sensitivity.

When I told my friends about this incident, they couldn't stop laughing. "This happend to YOU? YOU?" they said with incredulity as they pictured their prissy blogger friend in such a horrendous, disgusting situation. And then I had an epiphany as I filled out an incident report at the nurse's station that day: that being a doctor doesn't require the intellectual mind of a great thinker. Because when all of that prestige and respectability and glamor is stripped away, all you're left with is someone who is willing to get down and dirty and deal with all the literal and metaphorical shit of people's lives.

--By Mariam, who loves the "Wedding & Celebrations" sections of the New York Times, just like Katherine Heigl in that crap movie 27 Dresses.

The Death of Blogging

We rarely update this blog anymore with an average of 2 blog posts per month, a far cry from the BackRowBallers' heydey when we posted at least 3 times a week. Of course, this is a sad turn of events, but the daily grind of life prevents us from having the time to be witty and engrossing. Or it could be that I have simply run out of material - there are only so many funny, foreign stories from childhood one can share. Or perhaps, on a larger scale, blogging is no longer the "rage" anymore with short twitter posts by Ashton Kutcher (which are a disgrace to the craft of writing but whatever) becoming the new style of self-expression. And so, my suspicions about the End of Blogging as We Know It were confirmed with this recent New York Times article with a quote from a former blogger that I can especially relate to:
“I just wanted to post something interesting and get people talking, but mostly it was just my sister commenting.”

I sometimes feel like Paula Cole, singing "Where have all the blog commentators gone?"

--By Mariam, who hates surgery with a fiery, burning passion. June 26th will be a magical date.

Surgery Grand Rounds

 

General surgery M&M and grand rounds conference has been more formulaic than the average medical service grand rounds.  It always starts in the same way.  A resident goes forward to present on a patient who was very sick or died that month (morbidity and mortality for those of you not in the medical field, an M&M unfortunately completely unrelated to chocolate), and the attendings decide to talk about everything that is wrong in medicine in the seemingly impossible aspiration that it will lead to "quality improvement."  But since medicine tends to be practiced in the same way week after week, the conference tends to become repetitive.  Here are ten gems to bring up if you ever happen to be an attending at a surgery "quality improvement conference."

1. Excuse me resident, did you happen to do a (insert atypical diagnostic test) before you did (insert standard diagnostic test)?
   
2. Did you do a rectal exam?
   
3. Wait go back (insists on going back to first slide that states only age, gender, and chief complaint), what is the prognosis?
   
4. Did you do a rectal exam?  I don't think our residents are giving everybody rectal exams.
   
5. Resident, have you read any studies during your research that explored (insert any question, related or unrelated to case)?
6. Did you do a pelvic exam?
7. Wait, could you go back and explain (insert exceedingly basic medical knowledge) for the medical students?
8. Did you do a rectal exam?  I would like to emphasize the importance of rectal exams.
9. (Question resident in audience) Let's make sure we're paying attention and learning, what are the approaches for the procedure? (word this question as bizarre as you can so that you can correct the resident when they are done speaking)
10. I would just like to comment that the rectal exam is very important.  

--By Farrah, who would like the reiterate the importance of rectal exams.  Oh yeah, and shout out to Amar who was sitting next to me in grand rounds while I was drawing the picture.  

Musings while on Surgery Call

I imagine that when you used to tell people you were in medical school in the olden days (i.e. the 90s), they would think "NERD" or "GEEK" or something decidedly low on the social ladder. In the'00s because of popular primetime dramas like Grey's Anatomy, medical school is one's path to a life of nonstop glamor and sexual hijinks with fellow residents. For instance, the "on-call

My On-call room. Notice the Coke. A call must!

room" has a whole new connotation since the crazy cast of Grey's has popularized it with extra-curricular activities other than sleeping.

But here I am, nearing the end of my third year of medical school, and I can definitively say that while there may be some eye flirting between MS3s (the equivalent of "fresh-meat" in college) and the tired residents, life as a student is just one large charade of pretending to be a doctor. Here are some examples:

Seemingly Glamorous Activity: I'm on 24-hour call tonight, and when I tell non-doctors this fact, they are probably thinking, "Wow impressive! Saturday call - you must be really committed to be a doctor to sacrifice weekends." People might wonder what kinds of fun things I do when there is a trauma emergency - as I run in scrubs that fit me perfectly to the ER.
Reality: I've been sitting in a windowless call room with no cell phone reception for over 12 hours. No one has paged me to do anything, and my afternoon has been spent studying and watching a documentary on Roman Polanski (he was unfairly convicted!) and Little Mosque on the Prairie episodes. If there is a trauma, I'll most likely walk at a brisk pace to the ER and then act as an extra as real doctors run the show.

Seemingly Glamorous Activity: Pre-rounding on patients at 6 AM and writing notes about their progress overnight. Improving patient care, saving lives, and taking names.
Reality: I write progress notes that I can't put in the medical chart or the attending physician will get sued. No one ever reads them so my elaborate works of progress note art are relegated to my pocket. The question remains: if a SOAP note is written in the forest, and no one reads it or acknowledges it, does it even exist?

Seemingly Glamorous Activity: Scrubbing into a radical neck dissection surgery in the OR. This is preceded by going through the entire procedure of scrubbing and possibly flirting with cute resident/student by the metal sinks while soaping up one's arms into a heavy lather.
Reality: Scrubbing in for a student means holding a retractor at an awkward position for hours on end. The uncomfortable angle makes me wish that I could cut my arm off just to end the misery. And unless I want to stare longingly into the eyes of the middle-aged scrub nurse, mother of 5, then it's best to look straight ahead into the sterile field.

And so, while rotations are a necessary part of preparing us for the responsibilities and hardship of residency, the tediousness sometimes makes me wish I were an intern already, despite the low pay and lengthy hours. After one year of this, I'm ready to stop playing doctor, and actually, you know, be one.

--By Mariam, who hopes that no one gets drunk and hits their head or gets run over by a car tonight (i.e. the bulk of traumas at the UT ER).

UNC: 2009 NCAA Champions

Naadia and I ventured off to Motown City to attend the Final Four last week. Sure, it cost us an arm and a leg for tickets. Sure, we were in virtual nosebleed territory despite sacrificing aforementioned arm and leg because of the shitty seating system at Ford Field. Sure, half of the crowd cleared out 1/4 of the way through the Villanova-NC Final Four game. And sure, we were surrounded by a literal sea of Spartan forest green. And no problem, that we were late to both games due to technical difficulties beyond our control. And, sure we got lost both days because I-75 S to Toledo was closed and we had to take a scary detour for almost 30 miles before we got on the right track. And finally, no problem that when NC won rather anti-climactically in the final game Monday night, the Michigan State fans cleared out like someone had yelled "fire" in a crowded theater, and no matter that there were about 200 people left to celebrate the glorious Tarheel victory. And also no big deal that the next day during surgery lecture I was so tired that I hallucinated that the professor was talking about going to Costco to buy normal saline when in fact, he was talking about cholecystectomies.

In the end, despite all of these factors and the subzero Detroit tempeartures in APRIL (April is the cruelest month when you live in the Siberain terrain of the mid-West), it was still worth it to see Tyler Hansborough and friends single-handedly crush the dreams of an entire city on its last legs as it is mired in an economic depression and soaring unemployment rates. It was still nice to see Goliath take home the glory for my home state of North Carolina. Because even though we always love an underdog to come home with the prize - a la Ralph Macchio at the end of The Karate Kid - it so rarely happens in real life. Because hell, Goliath is an unstoppable machine with at least 6 future NBA players. Eat it, Detroit.

--By Mariam, who thinks that she should have gotten AP credit for the surgery rotation since it literally has taken the life force out of her.

Cosmo confession: I was a TV Extra

We all do embarrassing shit when we're younger. We wear hideous clothes like tie-dyed T-shirts or Hard Rock Orlando sweatshirts. We may get high on caffeine pills and accost our Upper School director. Or we may have had a profound love of Boys II Men. But there comes an age when your misguided thoughts on what seemed like a good idea are actually just unforgivable.

For instance, when I was a junior in college, my friend Bushra and I decided to be extras on the teen drama One Tree Hill. We got the call from a casting company asking us if we'd like to be extras, and I thought, "OMG OMG OMG CHAD MICHAEL MURRAY IS A HOTTIE!!!EEEEEEEEEEEEKKKKKKK. THE SHOW IS SOOOOOO AWESOME.!?!" in the manner of a teen girl with the latest copy of Tiger Beat. And so, we took the day off from our classes and drove down to Wilmington, NC (known as Wilmywood by locals) to participate as glorious extras and get paid a tremendous sum of $60 for 14 hours.

I am not sure how I imagined my stint in show business - maybe some glamour and fraternization with the talent. I rehearsed what I'd say to Chad, "Hey, I think you were so great on Gilmore Girls! Want to chillax later?" Maybe one of the actresses would like my top and ask me where I got it, and I'd tell her with an air of sophisticated casualness.

What I imagined in my mind's eye was far from reality. When we got to the designated meeting spot, the extras from all walks of life (mainly unemployed townies and trashy bottled blonds from the local high school) were ushered into yellow school buses like cattle. Inside makeshift tents, the production assistants told us to keep quiet and not to ever talk to the talent. We were lowly human beings or "background artists," not worthy to be spoken to by superior Hollywood folk. If we did dare talk to the actors, then we'd be banished from the set, never to work in the "biz" as background artists again.

Our assignment was simple. Walk back and forth in a club scene. Bushra, sensing her inner hotness, whispered urgently to me, "Mariam, they are picking cute girls to dance in this 'club' scene, and that's haram, let's move to the back so we can lay low."
Never one to rock the Islamic boat, I hid behind some tall African American guys. And so, we merely walked back and forth, mouthing to each other, even though we were not in the shot. I stared at Chad Michael and all of the other D-list actors with great awe, and I thought, someday I'll be back, but I'll be a part of the crew! And as you blog readers can see, that wish certainly didn't come true, because here I am, in medical school and not in Hollywood (or even Wilmywood).

Anyway, Bushra started to sense the low-class nature of extra work and started to get agitated.
"Let's go! This is so lame!" she whispered.
"We can't! We'll ruin the continuity of the episode!" I said, ever the ye old faithful to Hollywood magic.
"This whole scene is so trashy" Bushra countered. She was my means of transportation so I finally acquiesced begrudgingly. I had realized early on the trailer-trash nature of the whole activity, but I didn't care - so caught up was I in learning the anatomy of making a TV show. We grabbed our stuff and I sadly made a run for the parking lot, fearing that the One Tree Hill crew would hunt us down and make us return to the "club."

And that was the day I gave up hope of working in Hollywood. I should probably thank Bushra for crushing my dreams like a cockroach on the wall, but I realize what could have been: I may have ended up a washed-up, 40 year-old extra in Wilmington, hanging out at the local casting office, begging to be cast in a high school classroom scene or the big prom episode. Instead, I sit back hundreds of miles away from Wilmywood and watch Chad Michael Murray's shitty acting chops on my 42" TV. Ah, the life.

--By Mariam, who is loving OB/GYN!

Specialty Scoreboard

I'm done with almost 75% of my medical school education now.  It's hard to believe, and I hope that somewhere in this chaos I learned something.  I don't know if I'm wiser, but I really do feel older, like George W. after 4 years in the white house, extreme stress brings out your mature look.  I went into medical school with an optimistic vision of me as an OB/GYN, maybe coming to the aid of the lady who went into labor at grocery store, or TJ Maxx.  I'm not so sure OB/GYN is my first choice after three years of school, but here's the current scoreboard of specialties I've already done with arbitrary numbers assigned to each specialty.  

Internal Medicine: 57.43 points

Hospital: Can you say diabetes medicine management? Most interesting things were consulted out to infectious disease, cardiology, nephrology, pulmonolgy, etc. and all that was left for the primary, trampled on internal medicine team was making sure Mr. Jones didn't go hypoglycemic in the middle of the night.  To be fair, this was probably where I learned the most about the kind of medicine you see on the average medical board exam.

BONUS! Internal Medicine Outpatient: negative 1,000,000 points

Seriously one of the most boring times of my entire life.  And the patients were mean, and angry, and yelled at me, and stupid, and ugly.  Learned an awful lot about how NOT to do a physical exam properly.

Nephrology: 77.777777 points

Nephrology gets more points because it was slightly more interesting than internal. When you can focus more on a single subject, you can really start to understand it.  Still there is a lot of poorly managed diabetes around, and the strain dialysis takes on the patient's life is hard to watch.  The thought of having to endure an internal medicine residency to get to the nephrology fellowship is too much to bear. 

Family Medicine: negative 3,234,782 points

I am NEVER NEVER NEVER NEVER NEVER going to do Family Medicine.  There are a lot of people who feel comfortable tackling a little bit of every specialty.  I am not one of them.  I encountered a few family doctors who were really good at combining everything, but I also saw quite a few bad docs.  I encountered a doctor tell a patient that she should absolutely not get Gardasil - that's not informing the patient, it's forcing your opinion on the patient.  

Pediatrics: 53,234,598,371 points

I loved pediatrics.  It's lighthearted and fun because it has to be for all the kids right before you shoot them with a vaccine!  Most people who don't like peds cite dealing with the parents as the biggest deterrent, but I love that parents bring their kids to the pediatrician - when else will you get patients who so actively seek health care and follow up.  Even the parents that don't take good care of their kids, I would love to be the doctor that is the advocate for those children.  Plus I dearly love to laugh, and 3 year olds are hilarious.  Just note the following conversations:

Me: What do you want for Christmas?

Kid: um... A SHARK!

Me: What do you want for Christmas?

Kid: well... um... PINK!

Me: Are you sure? Just pink?

Kid: I guess... purple?

*Kid who has recently eaten blue popsicle*

Me: Oh my, your tongue looks like a smurf!

Kid: uh...

Me: Do you know what a smurf is?

Kid: nope

 

Psychiatry: 15.005 points

Psychiatry gets a lot of lifestyle points - the hours are truly awesome.  Short days, home calls, and no blood.  However, I really dislike working with the angriest people in society.  After a patient told my fellow med student Steve that he could stab Steve in the neck with a ball point pen if he felt like it, and that he could slap the hell out of me, I wanted OUT of psych.  6 weeks was plenty for my lifetime, maybe I'll do a child psych rotation, but that's it.  

OB/GYN: 799.99 points

I got really lucky with my OB/GYN rotation to get the private practice office with basically the best hours an OB/GYN could hope for with only 4 calls per month, and normal office hours otherwise with no weekends.  I really like my attending, and I don't think childbirth is as gross as others had described.  I also really like the patients, and interacting with them.  However, the estrogen impact is overwhelming at times.  There are only women in the office, and women in the patient rooms, and no doubt more women floating in-utero waiting to be born.  It's a lot like that movie The Women starring all women, that I do not recommend unless you are really in touch with your feminist side. All that estrogen left me with chocolate cravings and spontaneous crying for the first 2 weeks of the rotation.  I also had the inclination that I should start moving more aggressively towards having a baby of my own.  Woman were coming in at my age, well off and happily married for several years, having their second child - people with family first, career second - it's practically unheard of among the female medical student!  Things have eased up a bit now that I'm on week 4, but I'm still a little wary of the specialty when I see signs in the office that say things like "If you have melted chocolate on your hands, you are eating it too slowly!" or "OB doctors help to bring a little more sunshine into this world."  It's okay to cringe, I did.

Surgery: ??? points

Surgery is my next rotation, so we'll see.  My tallest friend asked me, "Will surgery be like baseball?  Fun to play, but really boring to watch?"  I think he's probably right, and I'm in for a boring few months.  Hopefully I'll get to do a few things and find out if I actually like it.  I like watching baseball at the stadium, so maybe surgery will be more exciting live.  

--By Farrah, who wonders if she should be studying right now at this very moment

Those Cute Slumdog Kids

I will wholeheartedly admit that I loved a mainstream movie - a film for the whole family, one even my 12 year-old cousin in Pakistan loved - Slumdog Millionaire. The kids in the movie were adorable - with their wide, sad eyes and grubby faces and their precocious acting. The movie had a real-life dimension, too, as the child actors, who lived in Garib Nagir in Mumbai (which literally means Poor Corner), got to attend the Oscars a few weeks ago. The two youngest kids looked so excited even though they probably had no idea who Kate Winslet or Mickey Rourke were. In one interview with the E! Channel, Ryan Seacrest asked one of the little kids how he liked working on the film. He looked at him in a puzzled manner the way my grandma used to look when a white person spoke to her. Then the other kids piped up excitedly, "He doesn't speak English." Watch the video of crazy Oscar hijinks below:



This moment reminded me of my own childhood because for the first few years of my life I only knew how to speak Urdu. Here I was, a little foreign FOB preschooler despite having been born in the whitest area of America - the Midwest.

When I got to preschool, my parents did not seem to be concerned that they were sending their FOB-ish 4-year old, who did not have a basic grasp of the English language, into the proverbial lion's den of little white kids, who could attack the foreigner in their midst at any time (this was the South after all, with its dark history of the KKK and lynching mobs). However, once I got to preschool, there were only minor kerfuffles with the whole language barrier thing. I remember getting Urdu and English words confused a lot, and I would tell my teacher about "anecks" (eyeglasses in Urdu). She would look at me in confusion and probably thought I was a kid with neologia.

Now, since I lived in the country with no siblings, I also developed a selective FOB accent. Once in kindergarten, I told Mrs. Caldwell about how my dad went to the "e-mur-gen-cy room" for his job, and I ate "veg-e-tables" at home. She looked at me with a casual disdain and said haughtily, "It's ee-mur-gency and -veg-table!" That day I promptly went home and told my parents that they pronounced these words incorrectly. And so, we sat in the car together and worked on our pronunciation chanting, "ee-mur-gency" and "veg-table" over and over as if we had just invested in Rosetta Stone: English edition.

--By Mariam, who has returned from blogging hiatus.

The Curious Case of Benjamin *snore*

I'm so sorry to have taken so long to return to blogging, but there was no way to wake up and motivate myself after seeing The Curious Case of Benjamin Button back in January with Mariam.  Mariam convinced me to see this movie, citing it's numerous oscar nominations.  I wanted to see the seemingly endearing old people romance Last Chance Harvey, but Mariam told me that movie was just for old people.  The problems with the Benjamin Button movie were obvious to me upon hearing the concept of the film - there is only one point in the movie where pedophilia isn't an issue.  Yeah, I know the mind of old Benji isn't the same age as his appearance, but while it might be appealing in the short story by F. Scott Fitzgerald, it's extra creepy on film.  The beginning involves a deformed old man baby hanging out at an old folks home chilling with other people's grandkids, and the end involves Cate Blanchett holding her old man baby lover at the same old folks home.  You may go into the film thinking that at least I get to look at Brad Pitt for 3 hours, but you have to endure the first two hours waiting for the guy you swooned over in Fight Club and Meet Joe Black to emerge.  You are staring at a scientifically impossible ugly old man baby for far too long, and I don't know how this film could have been inspired by a SHORT story.  I simply have to agree with Jon Stewart's assessment of the insomnia curing film, "It's Forrest Gump meets (snore)." Now that I've finally emerged from the coma this movie induced, I hope to return to telling humorous tales of the adventures of a 3rd year medical student.

--by Farrah, who recently got to watch the extremely messy, sloppy, and bloody miracle of childbirth

"Mary" @ Tech Support

My dad calls me daily with a different question, but the conversational theme is always the same: electronics.
"Mariam, my iPod isn't turning on. What do I do?"
or
"Mariam, how do I raise the volume of my phone?"
"How do I listen to my voice mail?"
And my personal favorite: "Mariam, how do I email?"

Everyday, it's either some vaguely described technical issue with an electronic or it's a huge, broad question about the modern technology as a whole (for example, how to email). Now, since I have no brothers, I always had to play the role of a dutiful son within our family unit; for instance, I had to help my dad carry the heavy TVs up a flight of stairs or movefurniture (I can almost picture the naysayers, reading this in disbelief, and thinking Yeah right, like she ever did that! But full disclosure: this is true). I also became really interested in electronics so my dad could have someone to bond with when we went to Best Buy or the now-defunct Circuit City. We would read Consumer Reports (one of my favorite magazines until age 12) and read online reviews on CNET of various electronics from TVs to cell phones to blenders together. These were truly moments worthy of a Norman Rockwell painting.

When I moved away for medical school, though, these moments came to an abrupt end, and I think my dad is still dealing with the after effects. And hence, the daily phone calls to technical support: me. As a busy medical student, I really can't help him trouble shoot over the phone, nor am I exactly trained in dealing with issues such as, "My computer has been running slowly. How do I make it faster, Mariam?" Usually, if it's an easy question, I'll break it down in layman's terms: "You see that circle white thingy on the iPod? Make circles with your finger and that will increase the volume!"

At other times, I admit, my patience wears thin, and I say, "Dad, why am I in to school?"
My dad will say, "So you can be a doctor!"
And then I'll respond with: "I'm not going to school for computer engineering! I'm not Mary, technical support from India, am I?"
My dad, unfazed by my catty sarcasm, will merely say, "I know, Mariam! But I expect you and your generation to know everything about technology!" And with logic like that about Gen Y, how can you argue?

And then I realize that there is a beautiful analogy hidden amongst this daily back and forth. Doctors go to school for years to fix people; people come in with a vague constellation of symptoms, and the physician basically figures out what went wrong with the intricate machinery of the human body. And in theory, how is this cognitive process any different than technical support at those call centers in India?

--By Mariam, who is so excited for the Jon Hamm-Tina Fey event on 30 Rock!!

I, Robot

In many Hollywood films of the action/sci-fi genre, the plot starts with strange, unexplained happenings such as street lights changing unexpectedly, computer screens blinking randomly, and then, people start dying in strange and unseemly ways. Who is this terrorist that lurks within, the audience wonders. And then, all is revealed - the enemy is really a huge supercomputer housed somewhere in the D.C./Virginia area. The supercomputer has taken on a life of its own and has started to destroy the life that it helped make easier. The metaphor is this: society is too technology dependent, and if we do not rectify this immediately, BAD THINGS will happen, like the deterioration of human relationships or even, DEATH.

When I was in grade school, computers were just starting to gain popularity in the average home. My dad brought home a computer when I was 7 - we were the first people to have one on our block, probably in the entire county, because I live in the literal backwoods of North Carolina, where running water and grocery stores are novelties. Anyway, our computer had a tiny screen with literally 10 color graphics and was very, very thick (about a foot in diameter). I played Wheel of Fortune on it and different addition/subtraction games ("educational" CD-ROMs were the only computer programs my dad approved). To play these games (that seemed wondrous at the time, but now in retrospect I realize were really ghetto), I had to navigate complicated command lines in MS-DOS like "C://execute: game.exe."

One day, I remember my 3rd grade teacher Mrs. Billera made a general, sweeping statement that many grade school teachers are prone to: "Computers are going to change the way we live. We may not even need certain jobs anymore because computers will be doing stuff for us instead of real people!" Now, I'm not sure if Mrs. Billera had read the completely wrong predictions of Orwell in 1984 one too many times, but I do think this was a tremendous overstatement.

Anyway, I took her very literally. Suddenly I imagined a world where my dad's job was replaced by a cold, steely robot. I imagined this robot examining and diagnosing sick patients quickly and efficiently, and my dad pathetically begging the robot for his job back. The robot would ignore my dad, since human physicians were now as irrelevant as VCRs or record players and continue coldly and methodically about his day.

I immediately went home and asked my dad in a panic: "Can a robot do your job, Dad? Can you be replaced by a robot?" My dad was foreign, so he didn't understand the concerns of children who lived within the cushiony comforts of America. He was used to children wondering whether they'd get dinner that night because there were 10 other siblings to feed that night and only so much chicken, and so my dad merely stared at me in confusion, as if to say, "WTF?"

Needless to say, I never got a satisfactory answer to my pressing paranoia as Michelle or Stephanie would have gotten at the end of a 30-minute episode of Full House, like "No, daughter, we're going to be okay. Computers will make our life easier, but your dad won't be jobless, on the street, asking for money because of technology. Rest easy, little one." Instead, I was left with my stream of paranoid, OCD-like thoughts, thinking that one day welfare and a soup kitchen were in our imminent future as technology advanced (i.e. humans pushed towards their own self-destruction, just like in the movies).

It is 2009, and we now have the iPhone, robotic surgeries, and a robot vacuum cleaner, and my dad luckly still practices medicine. No sirree, no robots doing his job as of yet. But I guess the ultimate point was this: children have the darndest imaginations.

--By Mariam, who realizes the substandard nature of this blog, but feels the need to keep the BackRowBallers blog alive.