Quilts by Ramona(tm)

Anybody who’s anybody in the medical blogosphere knows that Dr. Ramona Bates, besides being a plastic surgeon, is a master quilter of the first order. It’s also no secret that she’s a great person and supports so many bloggers with kind words and commentary.  However, her kindness totally went to the next level when she offered to make my daughter a “crazy quilt” from leftover fabric that had fun animals, bright colors, etc. that would be great for kids to relate.  

Here is the gallery where the quilt pictures are (plus some more from the same few days). I got an account on SmugMug a couple of months back because that’s where I really felt my “good” photos should live because I’d have control over the design, layout, etc. unlike Flickr. That said, I’m still moving stuff over slowly (read: barely) but feel free to bookmark the main gallery and check back as photos will be populating regularly. 

Ramona sent a nice card with the package, but one thing that stuck out was that she wanted the quilt to actually be used, not (I assume) tacked on a wall–or worse yet, left in a drawer. To that end I made a small video of my daughter with the new quilt that very evening. It’s nothing fancy, the lighting was off (it was almost bedtime, so only indoor light) and I overlooked correcting for WB or gain in the camera, but that’s not the point–the point was to show Ramona that her gift was received with the same care and affection with which it was sent, used immediately and often, and treasured forever.

Thanks Ramona!

 

And now, back to our regularly scheduled program

I’m back!! I missed blogging tremendously with so many times thinking in my head, “Oh, I gotta write/share that!” but I made a commitment to let things settle down to a dull roar before I started posting again, not wanting to have this start/stop bad mojo on the blog. Thankfully, I think I’m finally at the point where I can say things are calm enough and look like they’ll remain so, at least as much as I can expect. So much to tell, so much I’m glad is in the past, so much to look forward to–all in good time.

For now, here’s a small list of some general comments to catch you up, in no special order (some of which will be expanded on later):

• I got some email wondering if my “Hiatus” post indicated I was going to seek psychiatric care or the like. Funny that, because I did actually call around to see what was available. Unfortunately, there isn’t anything available for “crisis counseling” on an outpatient basis for people who need short-term, more focused help but are functional otherwise. Therapists and psychiatrists are backlogged for weeks or months, so “emergencies” here are handled by inpatient programs akin to the state ward where you get to use crayons and clay for art therapy and ice cream snacks are used as rewards for good behavior. Um, no thanks.
• Instead of mental health care, I got treated to some hard-core health care: 2 hospitalizations with a sum total of 15 days inpatient stay involving multiple scopes, surgery and blood transfusions–oh my! (definitely much more on this later) I’m still on pain meds as I heal, so pardon the grammer and mispellingses for now.
• Shortly after I arrived in TX, I treated myself to a Blackberry Curve 8320 now that I was stateside and my cell contract had long expired, ripe for cheap equipment renewal. No more living in the Mexican data desert! (Actually GDL is totally wired for 3G–it’s just that there, the “3″ means you have to pay 3x as much!) Having mobile email and browser is schweeeeeet.
• In just the span of a couple of months, my daughter seems to have grown up so much, yet she’ll barely be two next month. It’s awesome seeing her slowly develop every day into her own person. It’s also clear to me that all the trauma we’ve gone through seems totally lost on her–as it should be–as I watch her happy as can be with the simplest of things. I’d go through 100x more just to make sure it stays that way.
• I still haven’t decided what do call my new domain (since Mexico Medical Student is obviously not applicable anymore). I am tending to pick a generic title that has nothing to do with medical school, just because I want to be prepared for anything, and more to the point, keep using it after medical school. I want to be happy with something long-term and not have yet another migration later.
• It’s nice to have TiVo actually doing what it’s supposed to do now that it can actually use US programming data. I watch so little TV anyway, but what I do watch, I’m fiercely addicted to. Right now that means Top Chef and Battlestar Galactica, both new seasons recently started. In Mexico, I used to always download and watch episodes in large chunks after-the-fact; now it’s almost torture waiting week by week like everyone else for what’s next.

Well, that’s pretty much enough to get an idea of what’s going on. Other than the medical stuff that will follow, there’s not been much. I do have to make one very important point to close this post, however. A few friends have asked how school search/applications are going, completely because they cared and wanted to know. On the blog, however, I will not be posting anything about any facet of any applications, status updates, prospects, etc. Medical school application is a rigorous and, frankly, competitive endeavor. There are enough lookie-loos from my school who (for reasons also to be written about) are in the same application pool as I, trying to transfer to other programs. I don’t need to divulge what I’m doing for obvious reasons. If anything is shared, it’s pretty much because something is a done deal well after-the-fact. Since my target is August, that means mum’s the word for a good while. I hope this is easily understood. Thanks.

Last night’s show/What’s next with school

Thanks to all who showed up last night for the live broadcast! Dr.A. would have to confirm this for sure, but I think that the chatroom peaked to its highest number so far for the show…that’s awesome! For those that didn’t get to tune in, the archive is #18 and is available at Dr.A.’s BTR site (until the next show, this episode starts playing automatically from a widget on the right, but you can always download the .mp3 file to listen offline as well).

I listened to most of the show already, and I’m slightly embarrassed of the times that it seems that I’m ignoring Dr.A’s quick questions. As was brought up in the chat room after the show, Dr.A was using a new headset, and apparently the mic volume wasn’t turned up enough. (This can be heard in the difference between our respective volumes on the archive.) However, when I was talking in real-time on the call, I swear I couldn’t hear most of the attempts when Dr. A. would make a quick 1-second question. On the archive, one can hear it objectively (ie, not talking at the time), and it sounds like I’m bulldozing over what he was saying. I promise that wasn’t the case. :/ I hope Dr. A. understands.

The universal advice I’ve received before, during, and after regarding my situation is, to be polite, “Do whatever it takes to get things fixed.” I agree, and I never intended to do otherwise. It’s also why I never complained online until the other day even though I’ve been going through this for 6 weeks now. I don’t want to get into specifics, but there is a very real chance that this will not be resolved to my benefit, and I have to start down the road of a “Plan B,” even though I can’t say for sure what that is yet.

Even though absolutely nothing has changed with school, I already feel SO much better having put all of this out there. The consequences/implications/etc. have been shouldered in private for too long and have gotten me absolutely nowhere. Things can’t get worse with school–they simply could say that all of this online shenanigans “prevented” them from giving me their Holy Dispensation, but that’s yet another abusive tactic because one can never know if that were true. The intended effect is drive a student into despair over “what could have been;” in my case, I simply go on the alternative course I’m already pursuing. The default answers have never changed from “no,” and “no.”

I’m not above groveling, but how can I grovel to a person that refuses to meet with me, that tells a “superior” at the hospital that I’ll be seen, then 10 minutes later tell me (through the inept secretary) that there’s no point in seeing me? I’ve never been able to break through this, so what do I do, kneel in supplication from the hallway and hope they see me on the way to a bathroom break? Video myself begging and send a YouTube clip to their email address? If this turns out to be about “Well, we’re offended that you didn’t do XYZ in person,” then their hypocrisy is one for the record books.

I have to work, and time spent sitting in a hallway on the off-chance said dictator may/may not be coming to the office that afternoon, combined with may/may not be willing to see me is time I’m not billing, money I’m not making to support my family in the absence of loans to fall back on. Every dollar in my bank account is because I worked for it this semester. Talk about responsibility–what respect is there for that? They seem to think I’m at their complete convenience (and sport), and as a lowly student, that’s true–to a point. They know I’m working, they know I have a family to support, they just “forget” (or don’t care) that it’s not all about me. If they’re going to be insulted because I make a phone call to check if they’ll be in before I waste hours (read: earned money) going to and from, waiting, etc. and make that a daily habit, they can do something “creatively promiscuous” with their expectations.

UAG may be trying to teach me a lesson, beat me down, whatever, but to what end? I’m playing for keeps, and here’s why:

I don’t have the luxury of wasting time. I am willing to sacrifice whatever of myself, but there’s a limit to what I’m willing to put them through. This isn’t about principle vs. pride. Steeped in old Mexican medical school traditions at the core (primarily dealing with 18-year-olds), UAG feels it’s their job to “teach” me humility, maturity and responsibility with their tactics.

Those two above teach me more about those in one day than any amount of passive-agressive bullshit by administration. The two above is where my faith, my hope, and my pride lie, not my school. If I’m going to sacrifice any part of myself further, it’s for them, not for the whims of UAG. My school is a replaceable commodity; they are not. If this constitutes my “bad attitude,” then so be it. Regardless of my financial debt, I will always remain far richer than UAG could ever be.

Dosing OTC Pediatric Meds

It’s been about a month or so that various OTC infant cold-allergy manufacturers [semi-]voluntarily recalled their products in light of dosing mismanagment. Our little one has never had any OTC medication from these recalled “infant” products, so I don’t have any experience with them. In addition, I can’t get my hands on any of the products now that they’ve been recalled to see what could have caused such problems. I mean, how hard can it be?

Obviously, as a med student with a research science background, I am not the “typical” parent one would use as a case study for following directions, but having used various brands of Tylenol (acetaminophen or paracetamol, if you prefer) for our daughter, significant directions and delivery variations DO exist. In the US, every brand of infant Tyelenol was in a concentration of 80 mg/0.8 ml. Look at that fraction. Some leftover from 5th grade fractions should be ringing about now regarding “same numbers on top and bottom.” (We’ll come back to this in a minute) The same 5th grade education should be telling you that mixing decimals and fractions, while not incorrect, is a no-no–much like leaving a fraction unreduced. Points off, no gold star. Mistake #1: When you’re dealing with…oh, I don’t know…the “lowest common denominator (LCD)” (har har) of society that’s going to read your directions, you might want to clean things up a bit.

“But Rico, nobody but math and science geeks are going to read the concentration.” Well, you got me there, but it’s still odd. Upon opening the box, you’ll find, depending on the brand, either a bottle with a dropper already built into the cap, or a separate lidded bottle (why?) and a separate dropper that you then put together, throwing the perfectly good original lid in the trash. Mistake #2: There are plenty of people who might just keep the two separate, and if they’re do that, they probably aren’t keeping the dropper sealed, away from dust, etc.

If you look at the dropper, you’ll find two markings: 0.4 and 0.8, or just one: 0.8. The dose for 24lbs or 2 years is given on the directions as 1.6 ml. Mistake #3: You’ve assumed that the LCD of the general public can add fractions, much less without a calculator while a feverish, screaming infant is in the background. In my opinion, worse still are the “Only use this dropper with [product]” so that the directions are foolproof, like “Fill dropper to the white line.” Yeah, but what if I have a Robitussin product, a Benadryl product, and a Dimetapp product that all use “special” droppers and all have no other concentration/volume information for dosing purposes on the bottle, not the long-thrown-away box? True, few people outside those in the “import/export” business have graduated cylinders or pipettes at home, but SOME information should be given plainly should that “special” dropper be lost.

We usually have things decently stocked from the US side for basic things since we travel back and forth often (especially my wife). However, we ran out of infant acetaminophen a while ago, and since Claudia was doing the shopping, she didn’t want to have to decide among all the various brands here in Mexico and bought name-brand Tylenol. At first I was shaking my head because she didn’t get a super-easy-to-find generic product, but then I saw the exquisite delivery mechanism.

Behold, friends: pediatric liquid oral dosing perfection:

The plunger is marked on both sides, one being volume and the other weight, for which the volume on the other side corresponds. Also notice the ultra-precise measurement graduations. It certainly doesn’t mean the plastic plunger is that accurate, but it’s nice to look at. Looking at the info, one finds the following concentration: 100 mg/1 ml. Look at the fraction on the US bottle: they’re the same! Except now that we’ve reduced the fraction like good 5th graders, we can make sense of this from any angle without having to multiply and divide decimal fractions. And as a bonus, since this long quasi-syringe and the bottle clearly don’t physically go together, there is a plastic housing for the setup to keep it clean in between uses. Even if I had several products from different brands, if they all had this, it would be trivial to know which ml/kg measured syringe belonged to which because there’s a clearly visible “Tylenol” on the plunger! Score 1 for Mexico. (God knows the way things have been here lately, Mexico could use some bonus points…)

Seriously people, this foolproof delivery system is where it’s at. In the US, pounds would be the unit for the general public, obviously, since asking people to do MORE math–and to use the eeevil metric system–would surely not be good for little livers everywhere. If all the pediatric OTC medicines in the US were to have had something as universal and consistent as this, one wonders if there would have ever been a recall.

---

P.S. Come to think of it, we’ve never bought name-brand Tylenol in the US either, so I can’t say this isn’t stateside for sure. I tend to think not, since there was probably some focus group where parents said, “Ew, I don’t like this long plunger…why can’t you make the bottle in the dropper like everyone else?” I’d love to know if I’m wrong.

Musical blasphemy, for a good cause

One of my recent projects was coming up with some audio/music to use for my daughter’s sleep. White noise is ideal to block out unwanted din, especially living here in Mexico in a closed off gated community (coto) where everybody insists on living their lives outside. You can’t really tell the neighborhood to “shut up,” when it’s 8:00pm. In addition, most houses have no insulation of any kind, so just general noise from the outside such as cars driving by, a short honk, a delivery truck, etc. all have the potential to rouse our little Energizer bunny from the sleep that she naturally fights.

“No problem,” I thought to myself. I just needed a tool to “normalize” the audio so that the mostly classical music doesn’t have the all the dynamic range of the natural louds and softs. Right now, a median volume would mean that soft passages would be unhearable and louder passages (though musically appropriate) would potentially wake her up. Then, I thought, “Wait–I can’t be the only person to have needed this. Let me Google this…”

I could have sworn what I was going to use was a tool/plugin that does “normalization.” After beating my head against that wall for a few days with no good results, I found that what I was looking for is what’s called dynamic compression. “Compression” seemed totally the wrong word to me, because to compress is to remove redundant data to fit a smaller space (and “decompression” would fill it back in). But NOOOO–some crazy group of audio engineers decided to call a limiting of dynamic range–that narrowing the gap between the difference of louds and the softs–”compression.” That’s what radio stations have been doing for years so you can hear everything in car w/o having to ride the volume control, as well as giving extra “punch” to certain audio frequencies so you think one station sounds better even though they play the same recordings.

Jacking with the dynamic range of the latest “Arcade Fire” track is one thing, doing it to a symphony or a string quartet is something different. Classical music is the domain of serious audiophile engineers analyzing acoustics in concert halls, obsessing over the minutiae of different polymer tiles, their placement, etc. all to provide the best aural experience for a live performance. When recording, mics are placed strategically to capture the ambience of the hall, but also throughout the stage. You want to hear the crispness of a freshly rosined bow on a string, the collective breath before a horn section’s opening, the higher frequencies in the “blat” of a low-brass instrument. Trying to dampen these subtleties is blasphemy.

“Baby Einstien” sells 22 minutes of toybox-synthesized classical lullaby crap for $10 on iTunes Music Store. That’s a serious cash-cow; even pop CDs are at least 50 minutes or so. Even if I bought both volumes, that’s not even 45 minutes of non-repetitive music. It is, however, homogenous in terms of timbre and volume, which, along with clever marketing, is why it sells. I’d rather have my daughter listen to the real thing, but I also have a practical need here as well. So imagine my own self-loathing when I subjected many wonderful pieces to a transmogrifying audio laboratory like a Maestro Mengele, removing the artistry, audio quality, and individuality to make a homogenous, similar, and ultimately inferior final product.

I’ll give an example: the “Adagietto” movement from Gustav Mahler’s Fifth Symphony. People in the know will gasp, “You’re putting her to sleep with Mahler!??” because Mahler is known for wide variations in dynamic expression, extremely long symphonies (>100 minutes), very busy and thick scoring (over 120 members in the orchestra, plus a choir at times), and did I mention long symphonies? Relax–this is a slow movement that is scored simply for strings and harp. I even have the relevant excerpt from the score here to follow along for those that want to for the musical sections below:

Note all the instructions Gus has provided above; the score is full of details, all about to be lost. This is the final 18 or so measures of the movement before heading into the buckle-your-seatbelts finale that comes immediately after. In this excerpt, 8 minutes into the movement, we go from quiet yearning to a final gushing emotional outpouring, to a complete fade to nothing. Gorgeous, heart-tugging, and although sublime, completely unworkable to put a child to sleep. Here is a picture of the original waveform in the audio editor (Apple Soundtrack Pro) and the playable excerpt below it:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Now, the bastardized, compressed audio. Note that there is a lot of artifact bringing up the volume from the low-amplitude sections, which you can visually see in the following graphic. This is the price one pays:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Upon finishing compressing 2h of music selections, they were transferred to a minidisc set on “Repeat,” and applied that night. I happy to report it was an unqualified success. I met the dual objective of both blocking out more external noise and giving daughter something to listen to that she can carry with her, even if only subconsciously, as she grows older to appreciate it more. Part of me feels bad for blasphemy I’ve wrought (ok, I’m being a bit facetious here), but Claudia and I certainly get more quality time as daughter gets more sleep, so too bad.

---

P.S. Once unleashed, the compression monster can level anything in its path, rendering even unthinkably inappropriate selections even and unwavering. I’ve always joked to everyone I was going to inflict Soviet composers, such as Shostakovich, on her as soon as possible. I may do some personality damage if I start too early with things like this. LOL!

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

My new avatar

Who said I can’t have fun with my daughter’s things?

Teething: worse for the baby or the parent?

OK, so I’ve about had it with this teething crap. We already have a high-energy, go-go-go, sleep-fighting, hell-on-training-wheels toddler (16mo) as it is. The two upper canine teeth are coming in simultaneously, and it’s about all I can do to keep it together. After the Tylenol and topical Orajel have run their course and the wailing STILL doesn’t stop, I start having sick fantasies of injecting *caine right onto her superior alveolar nerve for certain relief; if I’m a little too trigger-happy on the plunger and she doesn’t wind up feeling half her nose/cheek, well, it will wear off eventually.

Of course, in terms of development, this is also the period where screaming is a “normal” part of starting to assert themselves–aka, the “temper tantrum.” This is often accompanied by a complete loss of skeletal muscle tone as the child goes completely limp. If she were an adult, I’d be calling the neurologist. With wall-to-wall tile floors, this a great way to hit her head–making me not lose that neurologist’s phone number after all.

All in all, it’s been rough. I work from home now, so I’m around baby noise ALL. THE. TIME. All my noise-cutting tricks for studying are still being employed. I think I’m the only med student in the western hemisphere that actually uses ballistics/gun earmuffs as part of their study arsenal…and I’ve never owned a gun! But there’s my ace-in-the-hole secret weapon, fellow med students. If you can tolerate looking like a total dork (and at my age/status, it’s not like I’m trying to score), putting on what looks like headphones from 1975 combined with inserting foam earplugs first, will give you (theoretically) over -60dB noise reduction. Some people get freaked out with near-silence; they always need some ambient noise (other than the blood rushing in their ears). I am not one of them. There are only a few select genres of music I can listen to (and classical is certainly not one of them) that won’t have me audibly distracted, involuntarily processing the music instead of processing what’s on the page.

When I was a kid, it was determined that my auditory processing was not up to snuff. In the classroom, I often didn’t do what I was instructed partly because I just didn’t assimilate what was told to me. As an adult, this has not changed. Everything has to be written down. Thankfully, it’s limited to verbal auditory processing. As a musician with a super-finely tuned ear, one would be surprised that I have to think about what’s told to me a lot harder than most. I can musically process a song instantly, but I can hear the same song 10 times and probably recite one line of lyrics. If you give me the lyrics written out, such as on liner notes, I’ll remember most of them at first glance, because I processed the information visually. At work, people would tell me any number of things, and I’d famously say, “Send me an email so I’ll remember.”

I should clarify that this is a problem only if I’m not 100% “on task” with listening (which, for most people in busy situations, is almost 100% of the time). But I can’t audibly multitask. If I’m talking to you on the phone, you have my complete, undivided attention–not because I care so much about you (but of course, I actually do), but because I really have no other choice! You’d know if I started trying to investigate something around me if we were on the phone, because suddenly you’d hear, “uh huh…*silence*….what was that again?”

It’s this same “odd” auditory sensitivity that makes living with a loud, active, fussy (but thankfully healthy-as-a-horse) toddler a mental drain. The distracting auditory input that would be annoying to anyone is crippling for me (as far as high-level mental processing goes). The same goes with many different types of “noise pollution” around me. Am I making a problem worse by finding new and better ways to give myself quiet? Should I be going the other direction, slowly desensitizing myself so that I can cope better in the “real world?” I haven’t figured out how to accomplish the latter yet, but something’s gotta give. I can’t have complete quiet and no interruptions doing an H&P like we’ve done as students in the real world. One often doesn’t have the ability to scribble anything until, say, outside the hospital room.

This is one of those unforeseeable things I didn’t know I’d have as rough a time with. The other is social isolation from working at home/not seeing classmates, but that’s for another post.

Belated update: No longer a med student

A thousand-mile journey begins with that first step, and so too does a long-overdue blog post also begin with the first words. You just have to start or it’ll never happen. That first step of a journey is pretty much the only one guaranteed to be 100% directly towards one’s goal. I mean, you don’t take the first step of a trip to the North Pole going south. You try for all the other steps on your journey to be equally directionally efficient, but detours happen, large and small.

I am on one such detour right now. The title is true, but I admit it is a bit “sensational” to get you to read further. The unvarnished truth is that I am not in school this semester by choice. I completed my 2nd year. Done. No doubt about it, grades official. Instead of plowing ahead and making the academic, clinical, and physical leap to the hospital setting, I decided instead to take a breath after having the wind knocked out of me so many times recently. What more natural academic break would med school give than the traditional space between 2nd and 3rd year? So to put the title in perspective, no, I’m not currently a med student, but I am not quitting. I will be resuming exactly where I left off in January, thanks to my school having rolling semesters. So in essence, I am giving myself a 5-6 month break.

Why am I doing this? Simple: “Physician, heal thyself.” My life was no longer in control, at least not to a standard needed to excel in school nor to be happy with life. Several pending health issues, a marriage going through some serious valleys, numerous separations from daughter, being shafted by my school regarding my USMLE timing for petty bullshit reasons, and certainly not least, crippling financial hardship (my loan year was months away from cycling yet I was approaching zero in the bank with a wife and child to consider) were the main factors pushing this decision. I could have been stubborn and said, “Fuck it–I’m no quitter; I’m going ahead anyway,” and people could have even applauded my determination. But I’d be a ticking time bomb, literally ready to psychologically detonate at any moment with the increasing pressure. Practically speaking, it seemed wiser to handle this on my terms in a “controlled” fashion than push ahead and wait for said meltdown in the middle of a semester where it would have academic impact as well. Speaking from the heart, though, there are certain decisions just feel right independently of all the mental masturbation of pros and cons, to-do lists, spreadsheet forecasts of finances, etc. One can’t ignore such realities completely, but some decisions in life live “in the gut”–in this case, borne out of some archetypal survival instinct–and I had to concede the silently obvious. The final thing I needed to do to seal the deal was work it out with my job to ensure I had the funding to work these months since not going to school meant no student loan money. Once that was settled–literally days before classes resumed–it was like a huge weight was lifted from my shoulders. I was sad that first Monday and Tuesday when I knew all my classmates were starting without me, seeing the emails fly back and forth about all the scuttle I was not there to experience, but in my heart I knew it was not yet my time–there were more pressing matters at hand.

In spite of my waxing philosophical above, don’t think this is all touchy-feely goodness. I still have the issue of what the hell to do with my USMLE Step 1, for example. There are no good solutions, but the “proper” decision, not taking any risks with the ECFMG, is to take it upon returning to school. That’s 6 months away and feels like board suicide for someone who had geared up prep to take it yesterday. I am constantly reminded that details of various fungi, adrenal gland enzyme deficiencies, and properties of Class Ia anti-arrythmics are certainly draining out of my recall at a nice flow rate every time I even attempt to pick up a study book. However, I have to trust myself–I am certainly no dummy–and that I can figure out a plan to minimize the leakage in the interim and re-prep (which for a 2nd go-round should be faster/easier) over the holidays and still have the confidence I’ll get the score I’m capable of. It’s hard, though, to have that self-discipline for something so specific when your life is not currently revolving around it.

In the end, this, like all the other things on my plate, are challenges I have to rise to meet. I’m not handling everything as neatly as the words on this post, I promise you, but I hope to get there. Claudia is on board with me, my daughter’s back, and we can finally be a family again, settled in here in Mexico for good. 3 months of Claudia living out of suitcases and various family members’ houses as she did her surgery, therapy, and other things back home reminded her that home is, as we say in Texas, “where you hang your hat.” Our home, the place we as a family call our own as long as I continue my studies, is here in Guadalajara.

Hopefully, my temporary status as med-student-in-limbo doesn’t affect whatever readership I have. I know I’ll always have my true blog friends, but I promise that in spite of not having personal medschool stories to share for a while, I still have lots to say. My stories of the next few months may not be sexy material for Grand Rounds, but they will as always be honest, unique, and hopefully interesting, too. I hope you are here to read them.

Happy 4th!

Of course, here in Mexico, it’s non-existent. I spent the whole day yesterday forgetting today was a holiday. There are no “4th of July Sales” advertised on TV/newspaper, no ads for barbeques, and no brilliant fireworks tonight. There are, however, fireworks on any random night that one of the local soccer teams wins a game, so I hear (not see, because they’re mostly just noisemakers) them all the time.

Last year, I was in my hometown, and my grandmother’s house is very close to the stadium where they do the fireworks/music-on-the-radio thing. Our daughter was a little peanut, less than 2 months old. I thought bright lights could attract her attention a little bit. She didn’t show much reaction at that age of course, but when some of the louder “booms” started happening mid-way through, she was NOT happy (understandably, as even I could feel the reverberation in my gut), so we just went home.

I mentioned all of that only to say this year, I know she’s going to go nuts with excitement. At 13-14 months, the louder, the brighter, the better. And this time, it’ll be with vocal approval, clapping, pointing, and general happiness. I wish I were there to see it. I thought about grillin’ and chillin’ here, but I really had nothing to grill. I’m low on money and am by myself, so I don’t want to buy a big slab of meat. I thought about hot dogs as at least an American substitute, but the best Mexican hot dogs are like the no-name not-sure-if-you-want-to-chance-it generic brands in the States. The “cheap” variety here are these disgusting, gray-pink Vienna-sausage-looking things, and Oscar Meyer brand dogs here will set you back almost $4/pack. Wrap your head around that one–Oscar Meyer, probably at $0.99/pack on sale in the US this time of year, is the “fancy import” brand. LOL!!

I think I’ll just open a bottle of wine later tonight, watch a movie, and relax. I’ll need some calm-before-the-storm given tomorrow’s meeting. I don’t think Thomas Jefferson ever said, “¡Viva la independencia!,” but it’s all I got right now. As an aside, I don’t think any of the founding fathers would have condoned this disgrace, either, but I don’t want to ruin my day thinking about it any more.

Recharged

I finally came back Wednesday night, and what an great trip it was. I am still adjusting with a tinge of post-travel fatigue and dealing with being alone again needing to study like there’s no tomorrow, but everything went really well with my family on all fronts. I spent much-needed time w/my daughter and we had a great 1st birthday party. Not a lot of people were there as I mentioned, since it was mostly family, but it was an all-out affair for a 1-year-old, let me tell you. The only thing missing was other kids. This is due in part because Claudia is the youngest in her much older family, and I’m the oldest in mine with only one brother (no kids). There was more than enough love and fun, however, and we all had a good time.

Thanks to all the commenters who wished me (us) well; it means a lot to know that in spite of my more sparse posts as of late, that people still read, care, even have me on their radar. There’s a lot more I want to post about–and will–but before I get to some other things, I definitely wanted to give a quick update that all is well for now, and hopefully, for good (as much as can be). I definitely needed that to be the case if I am to focus without unnecessary distractions on the task at hand for the next 6-8 weeks until test day. As long as school leaves me alone and doesn’t get unreasonable about missed days or similar BS reasons (esp. with other students having rules bent all the time), I should be just fine.

Starting up the grindstone…