Fourth Rotation: Pediatrics

(1/7/08 - 2/15/08) Mary Bridge Children's Hospital ***High Pass***

I got an Honors grade on this rotation for my clinical grade, and I was super psyched about that, and I will get a great letter of recommendation for residency, and then got high pass on the test, so I got a high pass for the course. Also, this rotation was a surprise to me. I was not looking forward to peds, primarily because I've heard that everyone gets sick, and that all you see over the winter months is bronchiolitis and that it is boring. That was not at all true for me at this wonderful childrens' hospital in Tacoma. While I was on the inpatient service for the first four weeks, we always had a very interesting mix of patients (in addition to tons of bronchiolitics). I enjoyed the team very much, and the teaching by the attendings was outstanding. I feel like I learned a lot, I'm no longer afraid of the really little guys (in fact, they are my favorite patients so far), and I was pleased to discover that I look forward to kids being about 30% of my ED patient population. I was afraid of the little guys (especially neonates) because I had no experience with them, and I was always worried that I was going to hurt them -- I didn't even know how to pick them up! I love those little guys now, and I look forward to having them in my future practice.

The last two weeks of the rotation was just bouncing around from outpatient office, to outpatient office. Oddly, we were scheduled spend 2 full days (of 8 total working days) in peds dentist offices, a day in immunizations, a half day in peds neuro, a half day in peds pulmonary, and a half day in peds heme/onc, with the rest in either the peds ED or clinic. That is what was scheduled, but during the first week alone, 4/5 of the days were totally screwed up (Dr. was not scheduled there, didn't know I was coming, was out of town, or whatever). It was very poorly coordinated. But I turned that to my advantage and spent a ton of time in the ER. It was WONDERFUL. I learned a lot and had a blast.

I was really lucky, once again, to be paired with a very cool student named Judy McCarty. I felt like we were very similar in a lot of ways, and it made the clerkship more fun having her there, laughing about stuff, and working together. She is going to be a kick butt doc.

Now on to the extra-curriculars and my surfing OBSESSION...

There is nothing new about this obsession, other than a tricked out women's specific long board (8-6) by Stewart called the Mai Tai.

And a 9-6 addition to the family/quiver. Well, that's not exactly true. It's a new board for Seth's quiver. He has a similar affliction. This board is way too big for me.


New Surf Art by Drew Brophy:
A self-taught artist, Drew started painting his lively images on surfboards at a young age when he first began to surf in his native South Carolina. With his sights set on being a professional surfer, he travelled the globe doing artwork here and there to help pay for his travels and surf adventures. Eventually, Drew found himself in California and now lives with his wife Maria and their new son Dylan, close to one of his favorite surf spots in the world.
Drew's art is recognized and collected locally and internationally. Through his travels he has been able to leave a little bit of his art around the globe. Drew's original art peices have become in high demand, and his commission orders are plentiful and keep him busy. His surfboards are sold in art galleries and establishments like the Hard Rock Casino, Las Vegas, as well as to many individuals around the world. He holds several art shows a year in different locations. A prolific artist, Drew completes about 100 new pieces of art a YEAR!
These days, if the waves aren't good, you'll find Drew sitting on a beach, somewhere in the world, doing what he loves: painting magical characters and exotic places. That is, 'til the swell picks up!
Someday when we can afford it, we want to buy some of the surfboard art for our walls. Here is a sampling of what he does:

Winter Vacation and FINALLY HOME!

(12/21/07 - 1/06/08). So after the surgery rotation, my away rotations were over. That means that even though I'll be very busy, I'll at least be home every night that I don't have overnight call at the hospital for the rest of 3rd year. What a relief. I'm glad that I front loaded everything, though, because it is over now. It was a tough six months for me and Seth.

So the day I arrived, so too did the three girls. I got home from my 5.5 hour drive from the East side of Washington about an hour before Seth arrived with Bex, Rach, and Mel.

The first few days we just relaxed, and did some fun pottery down at Art and Clay Cafe in Gig Harbor.



We all made noodle bowls and plates. Here is what Seth and I made.



I also made an incense burner and two little sake cups for me and Seth that are actually used as sipping glasses for things like vanilla vodka or other spirits.

We loved it, and everything came out so cool looking. We have decided to slowly replace our flatware with what we create ourselves. It will be much more fun that way. It is a nice, relaxing, and creative outlet.

The Menu was made by Seth a few years ago, and the Penguin serving plate was made by me.

We had forgotten how much fun this stuff is!

We enjoyed Christmas dinner with Trudy, Frank, and the Girls. :)The main Christmas present for the girls was skiing or snowboarding lessons.
Unfortunately, we could only convince Bex that skiers are much higher life forms, so the younger girls stuck to snowboarding. They got three days of lift tickets and rentals, one full-day lesson, and two half-day lessons. They were totally blessed with some of the best snow I've ever seen in Washington. It was like Utah powder: deep, light, and fluffy. The first day it was there, it dumped a foot in the afternoon alone. The next day was wonderful, too.

We enjoyed apres ski snacks and beers (well, no beer for the kiddos) at the lodge. That is always a fun way to end the days.















Thank goodness we had the mornings to ourselves, because we got tons of fresh tracks, especially in the new area of the mountain that was recently opened.





It used to be the North Backcountry, but they put in a new lift. It is all black or double black, and we found some wicked trees with waist deep powder. It was AMAZING.
A-Basin also opened up some of their backcountry this season with lift service, and we are looking forward to enjoying that over spring break. We will spend ten wonderful days up in Summit County with my dad. I cannot wait to see him, and I cannot wait to be at the Basin again. It is my home away from home.
It is always sad to say goodbye to the girls, especially for me, because with my schedule, sometimes it is a YEAR before I see them again. It seems crazy, but it's almost impossible to match up schedules. Plus, I have so little vacation time myself, that I need some time for just me and Seth, so it's tough to balance it all. So the girls went back to Georgia, and we went on to Part II of our vacation...

Part II: Surfing with family in Northern California. We had a blast visiting with Seth's parents in Moraga, and we got to surf with Mike and Chuck. We surfed Bolinas ( one of the sharkiest beaches in the world, being the closest land to the Faralon Islands where Great Whites breed)
and Pleasure Point (Santa Cruz) with Mike,
and Pacifica with Chuck.
The cool thing is that we spent Seth's birthday at home with his family for the first time in decades. Chip, Chuck, Pam, Anna, Adolf, Mike, Becky, Sophie, Ellery, and Georgia were all able to enjoy a birthday dinner with us. We ate at a vegan restaurant that was FABULOUS, and Chip brought some good wines to enjoy with the meal. We finished off with a vegan chocolate mouse cake that was to die for.

It was a little bit of a bummer, because we had five days to surf, and two of them were way too stormy. When I say stormy, I mean one of the biggest storms to hit the coast in 50 years. But it gave us time to spend with family, to check out Santa Cruz, and to see something very unusual. There were TWENTY FOOT SWELLS at Fort Point just under the Golden Gate Bridge. That is unheard of. The place was packed with people watching some crazy and talented guys get out in the outrageously big waves and ripping currents. This isn't a picture of that day, but it is a good picture of the break. Imagine this wave four times bigger, and you'll get an idea of how crazy it was. It was very cool to see, and I doubt I'll ever see it again, so I'm glad I was there. :)

It made for an interesting last day, and Mike, Becky, and the girls were able to join us, as they only live about 10 minutes away from there. We also had fun checking out Fort Point, and looking at the old pictures of the bay before the Golden Gate Bridge was built. It's a very interesting museum if you ever get the chance to check it out. It's also fun to drive through the old Presidio on the way there. There is a lot of history in this place, but somehow the waves seem to transform time and space and blend it all into one, in their never ending magnificence and power.

Third Rotation: Surgery

My third rotation was Surgery in Spokane, Washington (9/12/07 - 12/21/07). I LOVED SURGERY, and I worked with some amazing surgeons who were uniformly awesome teachers. I would love to be a surgeon, but for the hours. Even with "posh" hours, these guys are in the hospital just about every day rounding on their patients, at the very least. I need time to go on my adventures, so it just wouldn't work for me. But what I learned is that I LOVE PROCEDURES, and I'll get a ton of that in the ED. Yup, Surgery is the BOMB. This is a pretty boring post, though, because I was far from home and there wasn't much going on, and there aren't many pics. Sorry...

The housing was sort o' cheesy, but it was very close to the hospitals, so I liked it for that reason. We each had a garage, which apparently was a good thing because of the many break-ins at this complex. My apartment was the one on the top right, and the other student, Jacob, was the bottom apartment.


Jacob Henderson is a really chill, cool guy who also enjoys wine excessively, is into triathlons, and lives for his patients. He wants to do Pediatric Oncology, and he will be perfect for it. Very cool guy. I was lucky to be paired with him for this rotation.

A few days before the rotation started, I was invited to the Washington Chapter of the ACEP's annual leadership conference with all of the EM directors in the State. I was invited for my legal expertise. It was a great honor and an amazing opportunity to meet some people who are very influential in the field. I was VERY LUCKY to be allowed to fly back for the day to attend this conference.

The other nice thing about Spokane was that it was close to my sister and her family, so I got to see Wendy, Phil, Tayor, and Parker several times while I was there. That was great. I also got out for a hike one day with Wendy. It was so good to just have some relaxed alone time with my sister. That hasn't happened in I don't know how long. I'll be so happy when my training is over and I can have more of those times with family and friends. I feel like a slave to this at times, even though I wouldn't change a thing.
Oh, I almost forgot!!! I got to play hockey a few times with a women's league while in Spokane. I scored a bunch of goals, and they gave me an "honorary puck" as a gift, which was cool. I had a blast out on the ice. I had forgotten how much I love it and what a great workout it is! I haven't played since Seth and I were on the league in Augusta.


I am going to have to get into another league. The first night I play on open stick time, and then in a women's league game after that. I ended up playing for like 3 hours straight, and the first two were without line changes! I was so sweaty you could wring my "super wicking" clothes out at the end. I was also very sore the next day, but decided that I was on track for getting back in shape, so I started going to the YMCA and I did a bunch of workouts with 4 miles on the treadmill, weight lifting, and then a fast half mile swim. I think I lost about six pounds of CHUNCK on this rotation. I'm slowly getting back to being me again. I'm so happy to be on clinical rotations. This is a MILLION TIMES BETTER than the pre-clinical years.

Second Rotation: Psychiatry

I did six weeks of inpatient psych at the Seattle VA (10/1/07 - 11/09/07). It was OK, and I was the only student there, but my team wasn't the best because I had a really weird R1 who was a control freak and didn't want me to do much so he could show off how good he was (NOT!!!). He was from the east coast and just had a different attitude that didn't really jive with how most people are out here. It was pretty mellow, with the exception of never being in the loop with the other students and missing minor things like, oh, say, what was going to be on the test. I started out thinking Psych wouldn't be a bad job, but ended up not liking it at all. It seemed like all that was ever done was adjustment of medications. There was no physical exam stuff, practically no medicine. I found it boring and left thinking that not too many people are really helped.

But, the six weeks had some GREAT positives, too!
This was my second rotation, and I was well on my way to a true surfing addiction. Fortunately, call was light, so I was out at Westport almost every weekend with Seth. During this time the quiver started to expand rapidly. A quiver is what surfers call their surfboard collection, because every wave type calls for a different board. This is a picture of my S-Rail Fish made by Stewart, our favorite board shaper.

Many times we would stay Saturday night at a place called the Islander.


The attached restaurant is called the half moon bay bar and grill. The waiting area has a bench made from a surfboard, and there are tons of retro boards hanging on the ceiling. The drinks have names like "Surfrider," so you know what sort of crowd they are catering to. Unfortunately, they also cater to the Deep Sea Fishing crowd. They can be sort of gross and they tend to be smokers, heavy drinkers, fat, and loud. I know that's a big generalization, but that's been my experience. Westport appeals to surfers and the charter fishers, and they are like polar opposites in terms of personality, disposition, and the like.

Another thing we got from these excursions, were lots of new martini ideas from the Half Moon Bay Bar and Grill. One is a creation called the Sethifer-Tini:

4 parts Bicardi Lemon
2 parts Coconut Rum
2 parts Hypnotix Liquor

OK, back to surfboards. I thought that I would design my own S-Rail and have Stewart make it. Unfortunately, I'm a po mo fo, and went with stock board. Still, I'm saving this design for a future board someday when I CAN afford it...in a few years.

Seth also got a cool board. He always said that he wanted a board with a Kokopelli on it. There is a surf shop that was on my way back from UWMC while I was on my medicine rotation. Seth bought a trainer kite there for our next sport, kite boarding which we will do next Summer. But we have gone back there many times. We needed to order a travel bag for our longboards, and we went there to pick it up one weekend, and actually found THIS!!!


You might not be able to see it, but there is a Kokopelli on it!!! And even better, it was the right sized shortboard for him, AND it was like half off and totally affordable. I was seriously jealous!!!!


Halloween happened to fall during this rotation, so as you guessed, there was a theme again this year, and it was a Hawaiian surf theme. We had all of our surfboards up, an inflatable palm tree, a tiki bar sign (which still hangs in the entrance to the kitchen), and a big shark hanging from the ceiling (yes, it's still there to deter non-surfers). I was in a hula outfit, mom had a traditional mumu on, and Seth had his Hawaiian shirt and board shorts. We all had to have at least one lei and more than one surfrider martini.

We had great traditional surfing music from the 60s in the background. We actually got some, "Oh, cool" comments from the local teenagers. That's two years in a row, so we will have to come up with something "cool" again next year so we don't disappoint the kiddos. :)

This was a great night out for mom, and we had a wonderful time with her, as always.

The other thing that happened during this rotation was another ACEP National Scientific Assembly, this time in Seattle. I was appointed to another year on the national medical legal committee and had a great time. Most importantly, I met up with Lee Shockley, the director of emergency medicine at Denver General. He was also the former Program Director for the EM program. He had been a student in one of the the MBA courses I teach online, and so it was fun to meet in person. He asked me to help edit and write some chapters in a new EM textbook that he is editing. It should be a fun project. But most importantly, we really clicked and I feel like I have made a new friend with whom I will likely have a very long and interesting professional relationship. I really, really like Lee. He is something else, fo sho.

First Rotation: Medicine

My first rotation was internal medicine (7/9 - 8/16; 8/20 - 9/28). This is a 12-week rotation, which for me started with 6 weeks of outpatient medicine in a little town near the Washington coast called Montessano. It was a great rotation spent primarily with Dr. Ki Shin. He was a great teacher. I also worked with his wife Clara Shin a few times. They are both great doctors and teachers



The housing was fabulous, with three bedrooms and two full baths shared between me an one other student (Bryce Inman). There was a nice yard, wireless internet, and it was a three block walk to the office.















My room was huge, and accommodated my bike, kayak, and surf board.


There is a wonderful state park literally one mile up the road, so I'd often go for a 5 mile morning run there. One morning I actually saw a beaver. There were also mountain bike trails up there, but they were a bit too gnarley for me. In fact, Dr. Shin ate it big one time over the lunch hour and had some serious soft tissue injuries in his mouth. His wife banned him from ridding up there for a while.

The best part about being out there was that it was summer, it was light until 9pm, and I was 40 minutes from Westport, which is the surfing capitol of the Northwest! So you know what they say: "When in Rome..."

Without this rotation, I'm not sure we would have gotten into surfing...at least not yet. This has now become our passion and I'm grateful that I was at Montessano for that reason.
So the first day I went out there, I took this picture. It was a beautiful day, and you can even see the Olympic Mountains in the background.

The waves were really small that day, but there were at least a hundred surfers in the water, and I had a credit card burning a whole in my pocket. I knew I had to have a board and that I had to get in the water. In Washington, that also meant that I needed a wetsuit.

So I got my wetsuit at a store called The Surf Shop, and I got the board at a place called Steepwater Sports. These are now very frequent stops for us!



SO this is what my little bug looked like sporting a brand new 7-10 fun board made by Blue. Yup, that was my first board.






Medicine was tough because it required me to be away from home and Seth for 12 weeks, but Seth was in California for two of the weeks while I was in Montesano, which made things a little bit easier for me. When he cam back, he got totally into surfing, too. In fact, he bought a board at Wise surfboards in San Francisco on his way back up. He got a 9 foot Walden long board.

The first day we went out, there was a guy from they Olympia newspaper doing a story on Westport and surfing. He took our picture as Seth was going into the water for the very first time with a surfboard. The picture was in the paper the next day. It was fun. :)

Seth also came down on Wednesday nights, because he works in Olympia on Thursdays, and it was just as close to leave from Montesano. So we'd surf weekends and Wednesday nights while I was there.


The second half of the rotation was much different. It was inpatient medicine at the University of Washington Medical Center, where call was every 4th night for 36 hours. The only days off were if you weren't on call or post-call on the weekends, so most of the time you had one day off a week (if you were lucky). It was a grind and a lot of work. But I learned a lot, especially from Dr. Moe Haggman. She was great.

The other good thing was that I was able to ride to work, so even though I was busy, I got 12 miles of riding in every day...because it never rained on me...once.
I leased out a really nice studio condo in Belltown from Nick Wysham.