Road Trippin'

As I write this entry I am high.

So high.

34,000 feet to be exact. I gotta make one quick stop in Houston and then my time on the road is over. Before the sun sets I’ll be back home. This beat down started back in July, ironically, in Houston. Then Further south for August. Home for a few months, then back on the road for two months. All the while, making trips within trips to various cities for interviews. But finally, no more.

Add onto the general stress of traveling—airport security, delayed flights, catching cabs, trains, shuttles, and renting cars, sleeping in a bed not your own on a pillow not your own, getting lost in foreign cities, eating every meal "out"—the stress of having to switch from sleeping nights to days and back to nights. Plus jet lag. My circadian rhythm is shattered. Last night, I tossed and turned in my hotel room well past 1 A.M. despite having to wake up for a 6:45 A.M. shuttle to the airport. And despite the 3 beers I consumed between 10 P.M. and 11 P.M.

All this would be more tolerable if my wife were able to come with me. Ok, and the cat too. I miss them both tremendously. I can’t imagine what it would be like if I had a kid. I don’t understand why, but people seem to be pretty attached to them.

So kids and travel. Funny story. First, anyone that thinks traveling with an infant is a good idea is clearly fucking retarded. As I’m sitting in the airport I notice just such a retard. He’s dressed in his Dockers and denim button up shirt (I thought that went out of style in 1994) with his corporate man hair cut and “I’m important” PDA contraption strapped to his woven belt (once again, thought these went out about the time denim shirts did).

Well, guess who sits down on me behind the plane. Mr. and Mrs. Important Retard. And little Baby Retard. No big deal, I put the head phones on, put on my sunglasses and lean back for desperately needed nap. Just as I’m dozing off I’m snatched into the realm of wakefulness as my chair and body lurch forward. I look around and see Mr. Retard cruising down the isle. Whatever, accidents happen.

Back to napping. Then, he sits down and I feel something jamming into my seat back. Then out. Then back in. Then out. By this point I’m getting a little frustrated. I figure he’s trying to get something going to placate his kid and decide to let it slide—when the fucker, with his hands, pushes my seat into the upright and locked position. I turn around, give a dirty look and put my seat back.

At this point, Mr. Retard stands up and begins talking at me. I say at me because I have my headphones on and eyes closed so I don’t realize it. The gentleman next to me gets my attention and points to Mr. Retard who is now standing in the isle scowling at me. I take out an ear phone. “Can you give us a little space here?”

Oh. Dear. Lord. I tell him, “When you are asking people to inconvenience themselves for your convenience you should learn to be a little diplomatic about it.” I guess his ticket on the budget airline we were flying entitled him to more space than mine. At this point I decide rather than getting arrested and then miss an exam vital to fulfilling graduation requirements, I’ll just be the adult and concede half the distance of my chair’s recumbent abilities. Fortunately, the flight attendant intervened before I had a chance to run my mouth again and the douche returned to his seat in dejection. As he sat I reclaimed the other half of my lean. I guess they didn’t notice the PDA attached to his belt indicating he was an upper level sales guy, not entry!

Anyway, just one of the examples that has completely convinced me socialized medicine, or socialized anything, is not something I’m willing to pay for. I just don’t think the majority of my fellow humans are deserving of suckling at my motivated teat.

You never know when the guy in the seat you’re jacking with is teetering on the edge of a total freak-out.

Pain

The way people handle pain is awesome. Medicine as a field pretty much hates pain. Its too subjective. Consequentially, we had to try and make it more objective and the visual analogue pain scale was created. No one uses this, they just use the 1-10 scale. It doesn't work.

I think a lot of pain is actually cultural. Young Hispanic males and black females tend to vocalize and externalize their expressions of pain. Old white ladies tend to be exceedingly stoic. There are always exceptions of course.

My favorite is when I walk in a room and someone is sitting there, quiet, reading a magazine. Their problem--pain. Vital signs are all normal, not tachycardic, not hypertensive. So I start talking to them and they are telling me about how terrible their pain is. So I get ready to pop the question. "On a scale from 1-10 where 1 is pain that is barely noticeable and 10 is the worst pain you could ever imagine. As bad as you might imagine having an arm slowly torn from your body would feel." I literally describe the scale with those terms.

So this same person, then looks me straight in the eyes and calmly says, "my pain is a 10." Holy hell. My brief experience has led me to a couple realizations about the 1-10 scale.

1) If someone says their pain is 10 out of 10, its probably closer to 6 out of 10 at most.
2) If someone says their pain is 6 or 7 out of 10 its probably actually a 9 or 10.
3) Anything 5 or less is probably accurate.

As far as treating pain, this is what I've learned.

1) Vicodin is the most potent pain reliever known to man. More people with 10/10 pain say its cured by vicodin than any other substance. It does for pain what the "Z-pack" does for URI's.
2) If Vicodin doesn't work, Dilaudid and Phenergan will.

Ah, the drug seekers. I love them. My favorites are the ones that make God awful retching noises that everyone in the ER can hear but never actually bring anything up. The good ones will keep this up for hours, even after getting Zophran, arguably the most effective drug ever conceived to treat nausea. For a drug seeker, having a kidney stone is like winning the lottery. They come in writhing in pain, making the retching noise, and sure as shit have a stone that shows up every time on CT. How can anyone argue against treating that--especially when they tell you they are "allergic" to all NSAIDs. Brilliant.

Armageddon

How much would you pay to sleep in a motel, taken over by a hospital as its campus expanded? Its amenities include those rock hard, pokey, vinyl hospital pillows which are too thing to adequately support your head but if you try stacking two of them they are then too thick, a 13" TV with cable, and regular "Armageddon" like events.

Let me explain.

My first day I got up at 4 A.M. and drove into the town where I'm currently working. Checked in at the hospital at 8 A.M. with the program coordinator, and discovered I was scheduled to work that very day! No big deal. Worked my shift, tried to figure out the flow of the department where things were located, etc., then headed to the satellite campus where my living quarters are located. I found my way there purely by accident as I didn't have a map. I took a winding course, only later to realize both hospitals are located on the same main street about a mile apart.

After I put my stuff down I grabbed my laptop. You can imagine my horror upon finding there was no wireless internet access. Why the hell would you design living quarters for senior medical students that didn't have net access? See, in your fourth year of medical school you spend the majority of the first half out of town rotating at places where you might want to go to residency. At the same time, you're also traveling to cities to interview with programs. This requires lots of schedule tweaking, most of which is done through careful email communications. So, again, why the hell would you design living quarters for senior medical students that didn't have internet access.

Anyway, Armageddon. I step outside and look down the street and see a Whataburger. I guess thats a plus. So I was full of fast food and exhausted. The perfect recipe for a good night of sleeping. I went to bed at about 11 and quickly fell asleep despite my pillow situation. Minutes later I sat straight up in bed...confused...disoriented...looking for the horsemen. The room shook. I heard the rumble of ghastly hooves.

Then I heard it. A train whistle. I was certain it had derailed and was probably crashing through the rooms at the opposite end of the building headed towards me. Death would come quickly. My funeral pyre would be of concrete and steel fueled by diesel fuel and whatever other hazardous materials the train brought.

I decided to look my death in the face. I flung the door open. To my surprise, there was no train headed for me. It was still on the track--which was located 50 feet behind the building.

These trains comes about every 50 minutes on average starting at about 10:30 P.M. Each time I am wrested from sleep certain Armageddon approaches. I get stressed out because I can't remember all the things I've meant to repent for but procrastinated on.

So anyway, how much would you pay? I paid 300 bucks.

Reasons I know I'm more committed to my marriage than my wife.

There are many reasons, but here are a few.

1) Wedding cake. Tradition mandates that you eat a piece of frozen wedding cake on your 1 year anniversary. My wife had one piece. I ate an entire top from a frozen wedding cake.

2) The other day my wife asked me what time I was getting up to catch my flight. I said, "4:00 in the A.M." She replied, "Holy Hell! Thats early!! DON'T WAKE ME UP!"

Thats about all I've got for now. Please accept my apologies for the paucity of entries lately. I'm out of town, and the place I'm staying doesn't have internet access. More about this later.