tag:blogger.com,1999:blog-23867847402734158752024-03-19T01:47:29.786-07:00Type B MedicineRepresenting the non-gunners since 2007Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.comBlogger76125tag:blogger.com,1999:blog-2386784740273415875.post-13562157158208932442008-02-28T19:04:00.001-08:002008-02-28T19:05:43.228-08:00The last time I was asked what I wanted to be I was 5...and it was a horse.<div xmlns="http://www.w3.org/1999/xhtml"><p>So as I start a new rotation this week (OB/GYN) and try to get to<br />know a new preceptor, I inevitably get the question, “So…what field do<br />you want to go into?” Hey, I’m just gonna put it out there…I don’t know<br />what branch of medicine I’m going into. NO IDEA. I like doing OMM, but<br />thats not ALL I want to do. Physical Medicine & Rehab sounds<br />interesting, but I don’t have any experience in it, so who knows if I’d<br />actually like it. I like working with babies, but being a Pediatrician<br />is 90% cough & colds & paranoid parents, 10% serious and<br />heartbreaking. I sometimes think I’m the right personality to do<br />Oncology, but again, no real experience. So far, the only rotation that<br />I was excited to get up at 4am for everyday was Internal<br />Medicine-Cardiology. So, if I had to say where I am leaning, its IM.</p><br /><p>Well I can’t exactly launch into this diatribe everytime I’m asked<br />this. So I’ve had to come up with a quick answer and b/c I’m not sure<br />what I want to be, I don’t think its a lie. IT does actually interest<br />me, so maybe it could happen. I mentioned this conundrum to another<br />medstudent today…</p><br /><p>Other medstudent: “So what do you tell docs you want to be then?”<br /><br />Me: “Interventional Cardio”<br /><br />Other medstudent: “Why that?”<br /><br />Me: “Well if I say anything primary, including IM, I get the speech<br />about how I’ll never make enough money to pay off my loans. If I say<br />PM&R, they might ask me why, and all I can say is “I just think it<br />sounds neat.” If I say Oncology, they’ll ask if there is a story there<br />and then I have to launch into my mom’s story and its just such a<br />serious conversation when first meeting someone. So I say IM- Intervent<br />Cardio, b/c 1) IM is general enough to where whatever the rotation is,<br />it could apply somehow and they don’t feel like they are wasting their<br />time teaching me, 2) “Cardio” makes me sound smart, and 3)<br />“Interventional” b/c they always respect the desire to do billable<br />procedures.”</p><br />I’ll have alot of time to ponder my future, while I do this for the next month…<br /><object height="355" width="425"><param name="movie" value="http://www.youtube.com/v/SoWpyliUHn4"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/SoWpyliUHn4" type="application/x-shockwave-flash" wmode="transparent" height="355" width="425"></embed></object><br /><br /></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com23tag:blogger.com,1999:blog-2386784740273415875.post-79051205877108038972008-02-06T00:26:00.000-08:002008-02-06T00:30:02.763-08:00How to Deal with Problematic Patients<object width="425" height="355"><param name="movie" value="http://www.youtube.com/v/n5ek_mvUJBI&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/n5ek_mvUJBI&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><br /><br />Homosexuality is on the rise...except in Utah.Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-43799602189475801672008-01-14T19:06:00.000-08:002008-01-14T19:09:09.580-08:00Rotations are apparantly like preparation to be eaten aliveMy grandfather put the following entry in our family newsletter:<br /><br /><span style="font-style:italic;">Katie finishes anesthesia rotations<br />Pat also writes that Katie Jackson should have ended her anesthesiology rotation on Friday. I am always amused to hear about Katie's rotations. I know this is a serious part of her medical training, during which she gets to experience most of the aspects of the practice of medicine on a first hand basis. <br /><br />Unfortunately, whenever Katie's rotations come up for discussion, I picture my granddaughter hooked to a horizontal spit, being slowly broiled while a cannibal stands by and operates the crank.</span>Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com2tag:blogger.com,1999:blog-2386784740273415875.post-35936308442595189872007-12-27T13:48:00.001-08:002007-12-27T13:49:12.154-08:00Merry Belated Christmas from the Hills!This sums up whats been going on at our house-<br /><object width="425" height="355"><param name="movie" value="http://www.youtube.com/v/QjJCIbC9sxA&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/QjJCIbC9sxA&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object>Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-18072058922491102832007-12-16T10:39:00.000-08:002007-12-16T10:44:08.633-08:00Vote for LOLMax<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK5BBPf0TewZ0ILXdHbcQ3k7mwBVqwxhZ4Rr2IlKmS_RenF9nwU55SlDfpccsuPAAA5Y13mrA5wEYouDY6xJGevugHmTSA0lLXBQl1Dywqzra-LXwITPImbqLnuUeVmphyKSCNL1nXxOQ/s1600-h/pup+in+a+box.jpg"><img style="cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK5BBPf0TewZ0ILXdHbcQ3k7mwBVqwxhZ4Rr2IlKmS_RenF9nwU55SlDfpccsuPAAA5Y13mrA5wEYouDY6xJGevugHmTSA0lLXBQl1Dywqzra-LXwITPImbqLnuUeVmphyKSCNL1nXxOQ/s320/pup+in+a+box.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5144643090761997154" /></a><br /><br />This was submitted to <a href="http://ihasahotdog.com/">I Has a Hotdog</a>, the new doggie version of <a href="http://icanhascheezburger.com/">I Can Has Cheezburger</a>.<br /><br />Go <a href="http://mine.ihasahotdog.com/View.aspx?128423033436802500.jpg">HERE</a> to vote for it to get on the page!<br /><br />And I decided to put this on here just so Jesse would have an aneurysm from the cuteness.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1eQV7OiDtF9D66bbFBu9eiNzAGfPXxf4mbhGl2mLl6UrpMxhnK55KRBavFneLnUJVhLS5WtwMtNlA95pYtnBZVZdNMz2ijT5YvCUuiiqf7uD0ZE4V3K6ovte_OGjGPg_C3rWbZ5k-YyU/s1600-h/hed-too-heavy-cute-puppy-lo.jpg"><img style="cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1eQV7OiDtF9D66bbFBu9eiNzAGfPXxf4mbhGl2mLl6UrpMxhnK55KRBavFneLnUJVhLS5WtwMtNlA95pYtnBZVZdNMz2ijT5YvCUuiiqf7uD0ZE4V3K6ovte_OGjGPg_C3rWbZ5k-YyU/s320/hed-too-heavy-cute-puppy-lo.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5144643219611016050" /></a>Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-66380208936237812422007-12-14T21:06:00.000-08:002007-12-14T21:09:17.585-08:00Way Better than Bacon SaltThe t-shirts and magnets I received from my father and step-mom–<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtD_a71SVPr-6l07NLxfcmkLTOqLMW2y0VIHdtnZHoTTtqr-w6eeT9PxQ-udMirVuZ5rCNRWYKssQOjETXj0SOOI-sjeMENF4pWljGPVT1kSUqapyk9zkePBYa1UsPLkLfQJvd5pB0wyM/s1600-h/shiba_inu_poster.gif"><img style="cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtD_a71SVPr-6l07NLxfcmkLTOqLMW2y0VIHdtnZHoTTtqr-w6eeT9PxQ-udMirVuZ5rCNRWYKssQOjETXj0SOOI-sjeMENF4pWljGPVT1kSUqapyk9zkePBYa1UsPLkLfQJvd5pB0wyM/s320/shiba_inu_poster.gif" border="0" alt=""id="BLOGGER_PHOTO_ID_5144062020341554002" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9QG_ONMDW982Lkh7j-pYo2YJy9lw7jldm6zRrHwlFqxBNPSrEdn9rSANNOZZW-w-tH4I7elipTIS2jm5xnb84v6NGcQgyURleWwfe3xaJJ2WUahznEqFcOgwQ8HrAIqyZsBcHPgjKpe0/s1600-h/black_lab_art.gif"><img style="cursor:pointer; cursor:hand;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9QG_ONMDW982Lkh7j-pYo2YJy9lw7jldm6zRrHwlFqxBNPSrEdn9rSANNOZZW-w-tH4I7elipTIS2jm5xnb84v6NGcQgyURleWwfe3xaJJ2WUahznEqFcOgwQ8HrAIqyZsBcHPgjKpe0/s320/black_lab_art.gif" border="0" alt=""id="BLOGGER_PHOTO_ID_5144061895787502402" /></a><br /><br /><br />I don’t think we’ve mentioned it yet, but the Type B girls have a ridiculous gift exchange going. I have Jesse, Jesse has Katie, and Katie has me. I purposely didn’t get Katie b/c for her birthday, I got her <a href="http://www.baconsalt.com/">bacon salt</a>, and really, how can you top that? So anyway, when I received this in the mail, I automatically assumed it was from Katie. But no, from the dadoo. Good luck beating this Katie!Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-57943371534536527722007-12-13T17:39:00.001-08:002007-12-13T17:45:58.411-08:00"He has more active cultures than the Middle East"<div xmlns="http://www.w3.org/1999/xhtml"><div class="entry"><br /> <div class="snap_preview"><p>We’re waiting for our 10am patient in the conference room, listening to drug reps talk about insulin. They brought REALLY good coffee from the Atlanta Bread Co, so I am very happy to pretend to listen. Don’t worry, I’ve heard this spiel before. I’d be in trouble if I hadn’t b/c I’m a<br />little too distracted by my own thoughts. </p><br /><p>Rep:<br />“Lantus is meant to maintain basal insulin levels…”</p>Me:<br />(Mmm coffeeeeeeeeee)<br /><p>Rep:<br />“… an insulin drip maintained 4 days post surg decreases mortality by…”</p>Me:<br />(Oh god, so gooood. It doesn’t even need sweetener)<br /><p>Rep:<br />“…so don’t use the sliding scale protocol, you should now use the subQ…”</p>Me:<br />(num num num… pretending to listen but actually blogging… and reveling in caffeine bliss…num num num)<br /><p>Rep:<br />“…almost 66% of hyperglycemics are undiagnosed diabetics and…”</p>Me:<br />(oh thank you Jesus for caffeine, seriously why did I stay up so late watching An Inconvenient Truth? I have a 4-day weekend coming up and it was Netflix. The whole point of Netflix is there is no due date and now what will I watch this weekend? Maybe Hairspray. I should really study for the upcoming Internal Med test. I have no idea how to study for it though. I should talk to…)<br /><br />My Doc:<br />“…I didn’t go but Michelle did… what did they say Michelle?”<br /><p>Me:<br />(SHIT) “Huh? About what in particular?” </p>My Doc:<br />“Which receptor is inhibited in that niacin drug from yesterday?”<br /><p>Me:<br />"Dp1 in the Langerhaans cell”</p>My Doc:<br />“Oh ok, ya, apparently that reduces flushing…”<br /><p>Me:<br />(Smooth one, Hill)</p><br /></div> </div><br /><br /><p class="poweredbyperformancing">Powered by <a href="http://scribefire.com/">ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-698424879245625502007-12-12T16:08:00.000-08:002007-12-12T16:17:35.425-08:00The "Go On Home" TestOver lunch today, the other IM med students and I were discussing how we react when the resident tells us we can go home early. There are basically two ways to react:<br /><br />1) Exclaim "Sweet!" and bounce on out the door.<br /><br />2) Your internal monologue exclaims "Sweet!" but you just have to ask "Are you sure?" out of guilt.<br /><br />I admitted to being the second type. Not even half an hour later, our resident said "Well, you can skidaddle if you want to." I couldn't help it, I had to ask "Are you sure?" He paused for a moment and said "Well, why don't you go make sure nothing's going on in the ER and then you can go." Naturally I ended up doing a two-hour complete H&P. As I was walking to the ER, one of the other med students said "That's what you get for asking," and bounced on outta there.<br /><br />I'll probably still ask next time.Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com1tag:blogger.com,1999:blog-2386784740273415875.post-88176689995056535512007-12-09T21:59:00.000-08:002007-12-09T22:05:52.804-08:00Poor Little BunnyNo truer video has ever been made.<br /><br /><object width="425" height="355"><param name="movie" value="http://www.youtube.com/v/rXLHWmjA5IE&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/rXLHWmjA5IE&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><br /><br />P.S. Posted on <a href="http://www.dooce.com">dooce</a> as well<br /><br />P.P.S. I wrote another post: <a href="http://mvmedstudent.wordpress.com/2007/12/08/i-should-really-change-the-name-to-michelle-vs-the-scutmonkey/">Michelle vs the ScutMonkey</a>Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com1tag:blogger.com,1999:blog-2386784740273415875.post-22220154297709722007-12-08T17:51:00.000-08:002007-12-08T18:01:11.975-08:00Most physicians who go into family medicine prefer it to internal medicine because you really get to know your patients better, and you get to see what's going on with them long term and how things progress for them. It seems to me it's kind of the opposite in med school on rotations. <br />In my family practice rotations, I would meet patients once because I'm only there for a month, and I only saw a few of them a second time (usually the unfortunate ones). On my IM rotation, I see the same patients every day until they leave the hospital. With the post-op patients, that means I see them like 3-5 times. With the acute patients I see them at least twice. So I get to know people and see how their health issues get resolved. <br />That's my two cents for the day.Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-49293197183398063402007-12-05T15:08:00.001-08:002007-12-05T15:19:11.495-08:00NPO after midnight or you'll turn into a gremlin!I'm so not a morning person, however, I've gotten use to waking up super early (4ish, which is ungodly early for me). I've gotten use to having to answer questions for attendings at 6 a.m. Going to bed at 9 p.m. is fine now. But I still feel bad every time I walk into a hospital room at 5 a.m. and wake somebody up to ask them questions like "have you passed gas yet?" Maybe it will encourage people to get well quicker so they don't have to deal with med students asking questions about their bodily functions the minute they're jolted into reality.Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-80737351488678645042007-11-25T21:11:00.001-08:002007-11-26T06:22:38.291-08:00A Lazy Yet Productive Weekend aka A Type B WeekendTasks completed:<br />-Scholarship applications<br />-5 Mahalo pages<br />-Case presentation<br />-Cleaned my whole house<br />-Sold 7 items on eBay<br />-Wrote a blog entry<br />-Wrote all my notes from 3 months of rotations into my IM book<br /><br />Yet:<br />-slept in until noon every day<br />-watched 2 seasons of The Office<br />-caught up on Heroes<br />-managed to spend 9 hours in a row in front of the computer<br /><br />I am most proud of the last accomplishment :)<br /><br /><br /><br /><p class="poweredbyperformancing"><a href="http://www.afterdawn.com/news/archive/11521.cfm">Powered by </a><a href="http://scribefire.com/">ScribeFire</a>.</p>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-23059266836116297102007-11-24T14:35:00.001-08:002007-11-24T14:44:26.340-08:00A Very Medstudent Thanksgiving<div xmlns="http://www.w3.org/1999/xhtml"><div class="entry"><br /> <div class="snap_preview"><p>Or<br /></p><ul><br />“How am I ever going to decide if I can’t get past the first question?”</ul><br /><p><a title="med-student-chart.jpg" href="http://mvmedstudent.files.wordpress.com/2007/11/med-student-chart.jpg"><img alt="med-student-chart.jpg" src="http://mvmedstudent.files.wordpress.com/2007/11/med-student-chart.jpg" /></a></p><br /><p>Oy, this month has got me leaning to the left.</p><br /><p>Its funny the little rules we make in our head, or the things we keep telling ourselves and not really challenge. </p><br /><p>I’ve been putting writing off for 2 reasons. One…I’ve been too busy, to state it plainly. Well, at least by the rules in my head. I figure if I have a case presentation and scholarship forms to do, I am too busy to write. I am also too busy to call anybody or to clean.<strong> But not too busy to watch TV. Funny how that works. </strong>Two…I don’t want to be one of those people who only write when they want to whine about something. I’ve had plenty of occasion this month to do so,<br />but not much to balance it out. I mean, there has been wonderful stuff, just in small doses compared to the econo-sized crankfest thats been going on this month. </p><br /><p>Well, I overturned that rule in the last few days, starting with the cleaning. The place isn’t sparkling but hell, I vacuumed. That was like the 2nd time since we moved in. Today I’m writing b/c well, I need to. Its therapeutic for me, in that once I get out all those thoughts that<br />have just been rolling around in my head over and over again, it allows some new thoughts to finally break through. Many good thoughts, smart ones, with some wit and silliness, perhaps involving Johnny Depp or Heather Graham. Mmmm. Wait, what was I saying? Oh ya, too busy to call too. Ya, I’m going to try that this weekend, so if I owe you a call, be looking out for me. After I finish scholarships. Baby steps.</p><br /><p>You know what’s also funny? How it is humor nature to only dwell on the negative. So, bleh, I am really tired of worrying in general. The 2 hour drive to the rotation site I took every morning and the drive home every night gave me ample quiet time to dwell on things. Things like getting kicked out of my rotation housing and the subsequent ass-raping of my integrity in the eyes of the dean. Things like how I am going to be fucked when it comes to the Internal Med test b/c I spend 4 hrs of valuable studying time in the car every day. And I especially dwell on the fact that the dwindling of my bank account by Dec is not likely to match up with the replenishment of loans in January. </p><br /><p>Ok, bad things out of the way. Now, how to build up this month in my memory as something other than the month of ass-raping? Though that does have a ring to it, don’t you think? In the spirit of Thanksgiving, maybe I should focus on what I am thankful for this month:<br /><br /><strong><br /><br />1) Jesse came to visit me! </strong><br /><br />-She was here for a whole weekend and we rocked Boulder, I must say. We cruised the Pearl Street Mall, enjoying the local “color” (aka marveling at hippies & street performers), supporting the arts (aka buying hand-made greeting cards), and partaking of local fare (aka eating an orgasm roll at the BEST sushi place ever.) We finished outthe weekend rocking out to Guitar Hero III, laughing at the whitey white people dancing at the local bar, and buying Jesse a new wardrobe at Old Navy. Wow that weekend did my heart good. I am so lonely here, so the company was great, but talking to her was also an essential reminder that I am not crazy normally.<br /></p><br /><p><strong>2) I was able to spend Thanksgiving with new friends.</strong><br /> -Just when Josh & I were wondering what we were going to do on the holiday, and how we could afford all the fixings we wanted, my 4th year mentor sent us an email inviting all stragglers to a Thanksgiving dinner at her place. When we got there, they had chicken instead of<br />turkey (we hate turkey!), homemade croissant rolls (that is our holiday tradition!), and real pumpkin pie with fresh-made whip cream (ohmigod, our fave dessert ever!)…it was amazing! How did they know?? Plus I was ecstatic to be talking to someone my own age, let alone fellow medical chica. I hope we can do something together again soon <img class="wp-smiley" alt=":)" src="http://mvmedstudent.wordpress.com/wp-includes/images/smilies/icon_smile.gif" /> </p><br /><p><strong>3) Being poor brings out our creativity & makes us more thankful for what we have.</strong><br /><br />-Y’know, I talk alot of smack about how poor we are, but really, things could be so much worse, and in fact are worse for tons of people. We at least have a roof over our head, and no matter what, don’t ever have to worry about going hungry. Things are tight, but when they are, it makes a focus in on what we really need vs want. We get creative in how to stretch the most use out of something, and how to make a little extra money on the side. Most of all, it reminds me how close Josh & I are. We are both fiercely independent, and probably our biggest crime<br />is not really keeping eachother “in the loop” of what’s going on. We don’t plan dinner, we don’t call if we’re late, and we don’t go to bed at the same time. However, when things get stressful and money gets tight, we don’t argue or blame eachother. Rather, we band together and become a great team to figure out a way to survive and make our way out of it.<br /><br /><strong><br /><br />4) It was a great rotation!</strong><br /><br />-Almost worth the daily drive. I learned tons about medicine and its given me a new perspective on how to run a practice. Y’see, my doc was like an older version of the boss Michael Scott on the Office. He would waste 20min of a session just bullshitting with the patient, and make really corny and often times inappropriate jokes. His favorite was to diagnose an 80 year old woman’s problems as her being pregnant. <strong>His other one was to demand more complaints from the patient b/c he needed to make more money or else 1) he couldn’t afford the brothel he visits 3 times per week OR 2) he’d go home, beat his wife, and he can’t afford the alimony.</strong> But I did like him, and his patients LOVED him. <strong>Life Lesson #1, People like the abuse. </strong>They also were willing to wait an hour for him b/c they knew he gave them his undivided attention without any consideration of time. I also loved the staff. They said I was the first med student to treat them with any respect, so they helped me out and taught me things they flat out refused to do with other students. On the last day, they took my information and let me know that if I ever move back to the area, I’d have a whole office staff waiting for my practice. It was really sweet.<br /><br /><strong><br /><br />5) Friends, family, health, puppies, doing what I love…and all that other mushy stuff!</strong><br /><br />-I have the best friends I’ve ever had in my life, a family who loves me enough to visit me in Denver & nag me to tell them about whats going on in my life, a loving husband, 2 puppies I couldn’t imagine loving anything more until I have kids, Josh and I are both in careers we love, and we all have our health. I really don’t have the right to complain as much as I do! </p><br /></div> </div><br /><br /><p class="poweredbyperformancing">Powered by <a href="http://scribefire.com/">ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-71151614285404271742007-11-12T13:35:00.000-08:002007-11-12T13:36:46.416-08:00Medical DivorceWent to my first tumor board today. It was pretty cool, nice to finally see some real pathology from actual patients. One patient had Burkitt's Lymphoma with the classic starry sky appearance, that one was particularly interesting. They had her on some sort of a port through her head to give her intrathecal chemo, I need to look that one up and see why intrathecal rather than systemic. It was nice seeing actual doctors review cases together and ask each other questions about why they handled certain cases the way they had. Also need to look up EGFR.<br /><br />There was one patient who had had 4 stereotypic screening biopsies in two regions of her left breast, and one from each region showed pretty severe calcifications. It was documented that all physicians involved independently recommended a mastectomy, and the patient refused. A girl from my class spoke up and said she'd seen her in primary care, and she was a very difficult patient. She's a smoker with emphysema and uncontrolled diabetes, and she also has temporal arteritis but refuses to get a biopsy done. Between that and the diabetes, it's only a (probably short) amount of time until she goes blind. My classmate said her rationale for refusing the mastectomy is that she saw a program on TV where a lady had a total mastectomy and then ended up being cancer free. She firmly believed that when the biopsies were done, the cancer was now gone and she was cured.<br /><br />The oncologist in the room said that it was important for all docs involved not only to chart that she'd refused the mastectomy, but also have her sign a paper saying the same. He said that he'd divorced her. A ripple went through the crowd that each doc involved had done the same, and her primary care was getting ready to.<br /><br />Such an interesting term to use for basically kicking a patient out, divorced. I've much more commonly heard it referred to as firing a patient, but that one doesn't make a whole hell of a lot of sense either. Where does the responsibility of the doctor end and the responsibility of the patient begin? And how is it helping the whole situation if the doctors involved switch from being primarily concerned about the patient's well-being to being concerned about not getting sued? I guess it makes them more aware that the patient understand exactly what she's turning down, but I feel like the system is forcing us to compromise our ethics at times. I mean, I know the responsibility of the doc can only go so far, but it seems wrong that good doctors need to "divorce" a patient when they realize that the patient is an idiot and their risk of getting sued is too high. I wonder if the older docs, or I guess the middle aged ones who've dealt with this longer even realize how fucked up it is anymore. I hope they do.<br /><br /><span style="font-style: italic;">Addendum:<br /><br />EGFR is "</span><b style="font-style: italic;">epidermal growth factor receptor</b><span style="font-style: italic;"> (EGFR; ErbB-1; HER1 in humans) is the </span><a style="font-style: italic;" href="http://en.wikipedia.org/wiki/Cell_membrane" title="Cell membrane">cell-surface</a><span style="font-style: italic;"> </span><a style="font-style: italic;" href="http://en.wikipedia.org/wiki/Receptor_%28biochemistry%29" title="Receptor (biochemistry)">receptor</a><span style="font-style: italic;"> for members of the </span><a style="font-style: italic;" href="http://en.wikipedia.org/wiki/Epidermal_growth_factor" title="Epidermal growth factor">epidermal growth factor</a><span style="font-style: italic;"> family (EGF-family) of </span><a style="font-style: italic;" href="http://en.wikipedia.org/wiki/Extracellular" title="Extracellular">extracellular</a><span style="font-style: italic;"> protein </span><a style="font-style: italic;" href="http://en.wikipedia.org/wiki/Ligand_%28biochemistry%29" title="Ligand (biochemistry)">ligands</a><span style="font-style: italic;">." Yeah Wikipedia. I thought it was some sort of growth factor.<br /><br />And <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1800463">here </a>it talks about why to use intrathecal chemo in Burkitt's, there's a high chance of meningeal involvement.<br /><br />And bam I was right that the Burkitt's translocation is t(8;14).</span>Jessehttp://www.blogger.com/profile/07176542120287547966noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-91662739679414051042007-10-30T15:04:00.000-07:002007-10-30T15:07:37.784-07:00QuestionMe:<br />"What's a technical way to say that she feels pain whenever her buttcheek jiggles?"<br /><br />The Attending (stifles laugh):<br />"I think you just said it."Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-18530595705397613832007-10-23T22:47:00.001-07:002008-02-06T22:54:42.714-08:00What I RememberI remember the look on her face, the pain, the fear she wouldn't be able to breast feed after the surgery.<br /><br />The teenage mother with no car who walked her baby's stroller to the office for every checkup. How she would never become the inadequate mother that her mother or sister were. Knowing she meant it.<br /><br />The cries of new babies. How deliciously unfair it felt to be able to sit in the nursery and rock them while their mothers didn't even know. The realization that they might not all be perfect.<br /><br />My hand on her chest, holding the retractor. Making it through the first sight of blood, the pus and infection, but starting to pass out when I thought about her breathing beneath my hands.<br /><br />The morning I first became a doctor. Being in the room with them when she came in the day before, "dizzy," in the middle of a stroke. Watching silently, taking it all in, then going to get her son from the waiting room. That next morning in the hospital. Not even in med school yet, no clue what to say. She thanked me for taking such good care of her the day before, for being such a good doctor, and being there when she needed it. The amazement of this woman, so much older and wiser than me, looking up to me as her caretaker.<br /><br />The rush, the intoxication of the first time in an OR. Playing the passive student, but internal monologue racing, telling the surgeon why she had lost her bearings on the camera. Confidence I forgot was mine, confidence that used to define who I was. Flashing back to correcting the teacher who was incorrectly teaching the other students how to read. Knowing I could have, would have been able to do the operation better. The thrill of rediscovering what it felt like to be me.<br /><br />The fear of the first cut. The fear I wouldn't be able to handle it, that I would pass out or be sick. And once it started, never wanting it to end.<br /><br />The Amish baby boy's steadfast, determined grip on my finger during his circumcision. His strong resilient personality showing itself only two weeks after birth.<br /><br />When the pain stopped and osteopathy started.<br /><br />The girl who said nothing. The teenager, impregnated by her uncle, hoping to deliver before the beginning of her freshman year of high school. The anger that she wasn't ever allowed to make the choice, regardless of what it would have been.<br /><br />How he saw tonight. He saw right through me, grabbed the thought, and realized he was right. The split second look across the table, when everyone else disappeared, and seeing that he knew. Looking in through a window, seeing decisions I didn't know I had made. His excited smile of realization, I had already began to fall for it. Feeling that fraction of a second, shared only between us, being etched into my life.<br /><br />Constant, nagging thoughts that I will never be good enough. Always trying to suppress it. The inequality of test scores and real life interactions. Knowing that not only am I equal to them, I am better. The hope that someday someone else will also see that.Jessehttp://www.blogger.com/profile/07176542120287547966noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-79204278173701759342007-10-17T15:01:00.001-07:002007-10-17T15:01:59.464-07:00"I'm going out on an osteopathic limb here, but..."<div xmlns='http://www.w3.org/1999/xhtml'>So here’s the long-awaited recap of the FP rotation. Finally. I know.<br /><p>I really didn’t think I would love family practice as much as I did.<br />Maybe its the particular practice I was rotating in. It was just such a<br />light, fun, unhurried environment. Sure we had non-compliant patients,<br />and that is frustrating, and we saw WAY too many people for simple<br />colds. I’m sorry, I still don’t know which antibiotic I should give<br />just to get the patient to stop bitching. This was a point off on my<br />eval. Oh well. When there was an indication for antibiotics, here was<br />another problem:</p><br /><p><em>Me: “She has maxillary sinus tenderness, nasal congestion, and<br />fluid in the ear all on the left side…I believe it is classic<br />sinusitis…she does not smoke and is otherwise healthy, so I am not<br />worried about atypicals, thus I would go with the same thing we used on<br />the child with sinusitis this morning, Amoxicillin for the infection<br />and nasal steroids to open up the airway, let’s go with Nasacort.”</em></p><br /><p><em>Doc: “Go for it! Dosing?”</em></p><br /><p><em>Me: “Shit”</em></p><br /><p>I’m sorry but I don’t know dosages off the top of my head. My usual<br />resort was cussing and quickly flipping through my Tarascon<br />Pharmacopeia. This got me another point off…the having to cheat part,<br />not the cussing. They thought that was endearing <img class='wp-smiley' alt=':)' src='http://mvmedstudent.wordpress.com/wp-includes/images/smilies/icon_smile.gif'/> </p><br /><p>I was happy I got to do OMM. Actually I did lots of OMM, maybe one<br />out of every five patients. Some of the more interesting cases:</p><br /><p><em>-I did the GI release on a colicky newborn and I’ll to take her<br />word for it, but the mom said he looked like he enjoyed it. I even<br />showed the mom how to continue it at home. No word on any exploding<br />diapers, but no complaints either.</em></p><br /><p><em>-A cop came in with lower back pain she’d had for 2 years with<br />no relief. I adjusted her sacrum and cracked her lumbars. The pain was<br />down to 20% and she was ecstatic.</em></p><br /><p><em>-A woman who’d had upper thoracic pain since her car crash 1<br />year ago came in with sever upper thoracic dysfunction &<br />tenderpoints, and occiput “weirdness” that made her feel a click every<br />time she swallowed. She’d been to physical therapy, chiropractors, etc<br />who had fixed it, only to have go back to hurting the next day. I gave<br />her cranial, then kneed her in the back when I couldn’t get the worst<br />of her thoracics. They were fixed, but I told her to come back in a<br />week to make sure. She did come back, and after one more knee-ing, she<br />has been pain & weirdness free.</em></p><br /><p><em>-My first follow-up, as in someone who came back just to see me,<br />not the doc, was an older lady named Coleene. We thought she might’ve<br />broken her rib the week before, but decided to wait and see how some<br />muscle relaxants & NSAIDs made her feel. After a week of no<br />improvement, she came back specifically for OMM. I got an Xray just to<br />make sure, b/c it was so exquisitely tender. It came back clear, so I<br />spent like 45 min doing soft tissue, muscle stretching, and indirect<br />techniques to slowly loosen the area. She was so pleased with the<br />results and the fact that is was done naturally, that she gave me an<br />angel pendant b/c she wanted to BLESS ME.</em></p><br /><p><em>-A woman with long standing chest “discomfort” came in with a<br />clean Xray, EKG, and specialist referrals. Nothing got rid of this<br />“weird, fluttering discomfort.” I noticed it was over her left 5th rib<br />and that she was already on OTC heartburn meds. I approached my doc<br />with the title line, b/c this is going out on a limb, but I thought she<br />should try a more potent GERD remedy b/c the 5th rib is a neurosomatic<br />point for stomach acid. He said that nothing’s helped the chest thing<br />before, so sure why not. We gave her some samples and told her to call<br />in for a prescription if the chest pain went away or another visit if<br />it didn’t. She called in the Rx <img class='wp-smiley' alt=':)' src='http://mvmedstudent.wordpress.com/wp-includes/images/smilies/icon_smile.gif'/> </em></p><br /><p>By the end of it, they let me do a few more things than just H &<br />P and OMM. I analyzed rapid streps and urine samples; I removed skin<br />tags; I even did a digital block (before I even learned exactly what it<br />was I was doing in my anesthesia rotation). And I was officially the<br />ear lavage queen and the suture bitch. Its nice to have a title.</p><br /><p>Generally it was the same old, same old. Not to say that was boring,<br />b/c I had a great time talking with patients either way, just that<br />there were generally no big surprises in my day. Except for the whole<br />blood thing…</p><br /><p>-Chief complaint: “<strong>I ejaculated pure blood</strong>.”<br/><br />-Differential: 1) Vigorous sex, 2) Prostate cancer, 3) VD, 4) <strong>HE’S THE DEVIL!</strong></p><br /><p>And so ended my foray into primary care. I promised to return to<br />rotate 4th year (so like in 2 years!) and left them an ear to remember<br />me by. </p><br /><p>Love,<br/><br />Lavage Queen<br/><br />aka Suture Bitch<br/><br />aka the girl who knees people in the back and calls it a VERY direct technique</p><br/><br/><p class='poweredbyperformancing'>Powered by <a href='http://scribefire.com/'>ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-537937554305153112007-10-11T04:33:00.000-07:002007-10-11T04:42:36.643-07:00Michelle's Rotation JournalHey everybody, I've been posting, I'm still around!<br /><br />Ive just been doing it over at <a href="http://mvmedstudent.wordpress.com">my website</a> and have been lazy and/or too exhausted to hit ctrl-C to copy it over here, but I will from now on. <br /><br />I'm actually off to St. Louis this weekend for a wedding and to party with my fellow Type B ladies, so that gives you a minute to head over to my site to get caught up before I start back up. Plus I'm sure one of us will report on the reunion. Us ladies haven't seen eachother since beginning of rotations!<br /><br />Until then, I leave you with like 2 months of stuff to read on my site, plus this very, VERY inappropriately funny comic strip. Baby-killing is not funny, so don't laugh. <br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.jillstanek.com/archives/cartoon.gif"><img style="cursor:pointer; cursor:hand;width: 320px;" src="http://www.jillstanek.com/archives/cartoon.gif" border="0" alt="" /></a><br /><br />(HAHHAHAHAHAHAHA)<br /><br />I'm going to hell.<br /><br />~MichelleMichelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-85817667873338632812007-09-13T23:09:00.001-07:002007-09-13T23:09:51.674-07:00My top 3 moments as a D.O.<div xmlns='http://www.w3.org/1999/xhtml'><div class='entry'><br /> <div class='snap_preview'><p>#3- <strong><br /></strong></p><ul><strong>Jesse and I hiding in a corner to look at our final anatomy grades</strong></ul><br /><p><br/><br />B/c my undergrad was stupid, pre-meds didn’t take anatomy and so my<br />first semester of med school, it was brutal. I knew it was down to only<br />a couple points. So close that I could only miss like 2 questions out<br />of 40 on the final practical. Once I heard the grades were in, Jesse<br />and I went down to the mailboxes and pulled out our grade slips. <strong>I was so nervous the my reaction was to ball it up and throw it in the corner! </strong>I<br />chased after it, hid in the corner, and uncrumpled the ball slowly,<br />revealing my passing grade of 70.5%, then screamed and jumped up &<br />down with Jesse.</p><br /><p>#2- <strong><br /></strong></p><ul><strong>Dancing to “Sexy Back” with the UAAO fellows</strong></ul><br /><p><br/><br />So it was the final night at the UAAO convocation in Colorado Springs<br />last year. They had their annual Fellows Banquet where all the fellows<br />converge and induct the new president and fellows. Its a big friggin’<br />deal, in the D.O. world anyway. All the top mindsy hold a dessert and<br />dancing reception. They played the typical music you play at wedding<br />receptions so every generation can dance. So, like, no rap or anything<br />beyond the 90’s. I’m bored after awhile, so, just to see if he’ll even<br />play it, I request Justin Timberlake. I didn’t think he would, and if<br />he did, that the older docs wouldn’t dance. But the next song up, there<br />it is! I wait for the dance floor to clear, but I actually see tons<br />more older docs getting up and joining in! By the end, they were not<br />only all dancing, but singing along! D.O.’s are so cool.</p><br /><p>And tonight, I had my #1 moment…..</p><br /><p><strong><br /></strong></p><ul><strong>Getting shitfaced with my preceptors</strong></ul><br /><p><br/><br />I was invited to a dinner provided for by some drug reps, held at the<br />steakhouse up the street called Nine 75. Now, my docs are totally laid<br />back and lots of fun anyway, but over cocktails, they are a riot. I<br />walk in and one of the docs gives me a big hug, then hooks my arm to<br />head to the bar and gets me a martini. We stay hook armed, with me<br />introducing him to the 3 other med students from KCOM that showed up<br />(Yay!) and head to the room they’ve set up for the presentation. The<br />other 2 docs in the practice give me a hug and we sit down to<br />appetizers, like sushi and empenadas, and the waiter plies us with<br />wine. Our speaker is Sanjay Gupta (no, not the CNN doc, but you’d think<br />the confusion would have drawn more people in), an ENT surgeon who<br />presents on rhinitis. We get into a rousing discussion, interjected<br />with jokes and the occasional pimping. I get asked what the <a href='http://en.wikipedia.org/wiki/Kiesselbach%27s_plexus'>Kiesselbach’s plexus</a><br />is, and I have no idea, to which the doc replies “Oh man, you don’t<br />know the anatomy, your ass is grass tomorrow!” and I’m like, <strong>“I’m 3 drinks down and I got a 70.5% in anatomy, so no shit!”</strong><br />Then we learned the best way to deal with rhinitis–&gt; KY Jelly.<br />Remember, just don’t use the warming kind. We drink and eat and laugh<br />and tell stories for almost 4 hours, just enough time to sober up and<br />get back at a decent hour. God, that was fun.</p><br /></div> </div><br/><br/><p class='poweredbyperformancing'>Powered by <a href='http://scribefire.com/'>ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-64978578130615866532007-09-08T17:55:00.001-07:002007-09-08T23:19:34.251-07:00My texts & twitters<div xmlns="http://www.w3.org/1999/xhtml">Awhile ago on <a href="http://www.dooce.com">dooce</a>, she posted a link to some of her friends texts still stored on her phone, some from years back.<br /><br />This has inspired me to post some of mine that I found. Enjoy.<br /><br /><span style="font-weight: bold;">Twitters:</span><br />- Its blowing my mind that OJ Simpson and Ian McShane (Al Swearangen!) were in Roots. And no, no one said cocksucker &amp; it was the worse for it<br />- I did a name generator ie pimp name, porn name, etc...all STUPID except my punk band=CURIOUS MORMONS!<br />- Denver Culture Clash #2- Its easy to get confused about movie times when there is another movie theater ACROSS THE STREET.<br />- Denver culture clash #1- So, there are things called ghettos, &amp; I shouldn't send Josh there to get $500. He had to pull his gun on somebody.<br />- katie and I found more japanes porn, why do they like sex w monsters and underage gils? (<span style="font-style: italic;">I was drunk)</span><br />- Nope , no cat-rabbits (<i>Don't ask. I don't know either</i>)<br />- Girls, prepare to be proud of me: I went to bed at 2am last night. Its 5pm now... I JUST woke up. (<i>it was the day after boards</i>)<br />- Just a can full of Jones Cream Soda helps the neurology go down<br />- I AM alive and am looking forward to hours and hours of Kidney.<br />- From my fave Mommy blog: 6yo daughter MC (to tune of I'm A Little Teapot): When I ride my pony into town, they Fuck! me over and knock me down<br />- Owwww. Can you pull your uvula?<br />- <span class="entry-title entry-content">The flavor of the day is shittalottacrappa<br /></span><span class="entry-title entry-content">-</span><span class="entry-title entry-content"> Jesse is a big stupid head. <i>(my very first twitter!)<br /><br /></i><span style="font-weight: bold;">Texts currently on my phone:</span><br />- I have now officially seen the flattest pancake ass ever <i>-from Katie<br />- </i>I just talked to a guy from U of Utah, its not just our guys, all mormon wives are hot <i>-from Jesse<br /></i>- Honey get steaks for dinner, I can chew! -<i>to Josh<br /></i>- God or financial aid hates female doctors- <i>to Jesse<br />- </i>Denver has everything. I just passed a Casket Mart -<i>to Josh, Jesse & Katie<br /></i>- B like Bliver! -<i>to Jesse<br /></i>- Right now my fellow [McJob] employees are discussing their fave Steven Seagal movies. Aaaah! -</span><span class="entry-title entry-content"><i>to Josh, Jesse & Katie<br />- </i>The high today was 100 and now its hailing. Am I still in MO? -<i>to Katie & Jesse<br /><br /></i></span><br /><br /><p class="poweredbyperformancing">Powered by <a href="http://scribefire.com/">ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-62278609265905921212007-09-04T17:12:00.000-07:002007-09-04T17:23:07.520-07:00Oh My God! Katie's Blogging!So today was day 1 of rotations, and it was...............awesome! I wrote up my first note and prescription (granted it was only sinusitis, but I was excited! Shut up! Look it was cool I swear, get off my back!) and I had to double check with the resident like twenty times to make sure I wasn't taking over some responsibility that only the grown ups get to do while I sit in a chair that's too high off the ground for me and swing my legs. <br />It also helps that the place I'm starting off at is a family practice clinic where everyone is super laid back. Just when I thought I was getting a little tired, the cell phone of the doc I was working with went off and the ring tone was "Chip, I'm gonna come at you like a spider monkey!" Yesss! <br />That is all for now, but I will make an effort to blog more often. Have no fear, good citizens. Wait, strike that, be afraid, be very afraid.Katiehttp://www.blogger.com/profile/12651676088626337249noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-73883999594406932962007-09-02T23:07:00.000-07:002007-09-02T23:12:54.464-07:00Med school videosThe Office: Med School Edition<br /><br /><object height="350" width="425"><param name="movie" value="http://www.youtube.com/v/un4ULrgVYMY"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/un4ULrgVYMY" type="application/x-shockwave-flash" wmode="transparent" height="350" width="425"></embed></object><br /><p>Pitt Med: Above the Apathy</p><p><object height="350" width="425"><param name="movie" value="http://www.youtube.com/v/-7qTK5CXLgg"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/-7qTK5CXLgg" type="application/x-shockwave-flash" wmode="transparent" height="350" width="425"></embed></object><br /><p>Osteostache Documentary Teaser</p><object height="350" width="425"><param name="movie" value="http://www.youtube.com/v/mYVUpo9vKhE"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/mYVUpo9vKhE" type="application/x-shockwave-flash" wmode="transparent" height="350" width="425"></embed></object><br /><p>KCOM Orientation: Lawnmower Man</p><p><object height="350" width="425"><param name="movie" value="http://www.youtube.com/v/VcCEnxRAm3o"><param name="wmode" value="transparent"><embed src="http://www.youtube.com/v/VcCEnxRAm3o" type="application/x-shockwave-flash" wmode="transparent" height="350" width="425"></embed></object>Michelle, Bethany, Zach & Jameshttp://www.blogger.com/profile/05986138716214795854noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-68991790629340489982007-08-30T23:16:00.001-07:002007-08-30T23:16:59.882-07:00Jesse's advice to me tonight<div xmlns='http://www.w3.org/1999/xhtml'>"<span chatdir='1'>try to keep the dic out of your mouth tonight"<br/><br/>-dic as in D.I.C.- <a href='http://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation'>disseminated intravascular coagulation</a><br/>b/c I bled about from my wisdom teeth removal about 24 hours longer than I thought I would<br/><br/></span><br/><br/><p class='poweredbyperformancing'>Powered by <a href='http://scribefire.com/'>ScribeFire</a>.</p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-85352907323224792742007-08-29T17:14:00.000-07:002007-08-29T17:19:32.472-07:00Yay Updates!!So I decided it was time to update this page.<br /><br />I have removed all the ads, because they make the site look cheap and it's not like we've ever made any money off of them. Ever. So yeah, they're gone.<br /><br />But more excitingly (is that a word? probably not) I've added a feed of my shared Google Reader links. Basically it's a list of anything from the blogs I read every day that I think is cool enough to share. I'm going to get on Michelle and possibly Katie to do the same. I say possibly Katie because she is good and doesn't have quite the same blog addiction that Michelle and I do.<br /><br />Yay! Updates! <a href="http://www.youtube.com/watch?v=XPfKtwwUN5w">Toy Store!</a>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0tag:blogger.com,1999:blog-2386784740273415875.post-43468272592101024382007-08-25T08:37:00.001-07:002007-08-25T08:40:58.753-07:00But I don't like Spam!<div style="font-family: arial;" xmlns="http://www.w3.org/1999/xhtml"><span style="font-size:100%;">~Monty Python<br /><br />I only ever get 2 types of spam:<br /><b><br />1) Grammatically-painful personal emails concerning my penis </b><br /><br /></span><span style="font-size:100%;">"Hello mvmedstudent- </span><span style="font-size:100%;">Take a last look at your penis, it will never be that small again"<br /><br /></span><div><span style="font-size:100%;">"Hello mvmedstudent- Your penis start growing here"<br /><br />"Hello mvmedstudent- You will be able to penetrate much more deeper"<br /><br />"Hello mvmedstudent- Make your penis lllooooonnnngggggg....!!!"<br /><br /><br /></span></div><span style="font-size:100%;"><br /><br /><b>2) Abstract poems about on sale office software</b><br /></span><span style="font-size:100%;"><br /></span><span style="font-size:100%;">Yes. The obvious<br />Close at the end of distance the two Chose<br />In realms of dingy gloom and deep crevasse<br />Dreaming time has reversed, I watch drowned snow<br />Unreadable from behind—they are well down<br />Seized from creation by nonentity,<br />By the design of our own silent eyes<br />This perfection, this absence.<br />Is the moon to grow<br />demonstrating their talent for comedy—stroke<br />Merely a mockery of spring<br />Deep in the fog that quenches every ray,<br />Against which we have been projected? What . . .<br />Toward the still dab of white that oscillates<br />In dense bare branches, or the ubiquitous<br />From there. Toward . . .<br />Upon from the right by far trees, that white place<br />In Winter Haven, the ballplayers are stretching<br />I might have happily lived some other childhood.<br /><b>Adobe on sale for $89.99.<br /><br /></b><i><br /><br /></i></span><span style="font-size:100%;">Given by nature will soak into it.<br />III. Chronology of Northern Exploration<br />to restaurants for Early Bird Specials.<br />Not daring to oppose<br />That desire has ever built, have approached<br />Blurring the terrain,<br />That open before me? What I see<br />Archangel Winter, darkness on his back<br />Of meaning like these the world created by<br />Snow haze gleams like sand.<br />With my foot the supple ball, for perhaps<br />XV. The International Circumpolar Stations: The Greely Expedition<br />When Arctic winds crack down from Canada<br />Nor, indeed, the bit of paint itself can know of.<br />And off the white smoke swims<br />Summer bees were saying<br />Pierced by the mist that fades away,<br />Clear-voiced despite its years, strong, eloquent<br />I know, </span><span style="font-size:100%;"><b>US $ 269.90 Creative Suite 3<br /></b><i><br /><br /><br /></i></span><p class="poweredbyperformancing"><span style="font-size:100%;">Powered by <a href="http://scribefire.com/">ScribeFire</a>.</span></p></div>Type B medicinehttp://www.blogger.com/profile/07326826210745166007noreply@blogger.com0