On the other side

I’m back! Before I say anything, I definitely wanted to say thanks to all those who wrote privately to wish us and baby well. I’m happy to say that our daughter was born perfectly healthy and is an absolutely heavenly gift. Mommy is doing well, recovering from her C-section a little slower than expected, but definitely on the mend. I will be posting a couple of pictures soon, as well as a Readers Digest^tm account of the week+ I was there. I came back to GDL 6 days after birth and returned to classes this last Thursday, just in time to catch our final, wrap-up lecture on renal physiology. I missed the entire block (for such a complex system 2 weeks was too short by comparison on how much time was spent on other systems, but that’s just my opinion) and the test was today, Monday. I did get some reading done while at home, but no serious studying. As any medical person knows, “the beans” are hard, so I basically hit the ground running and haven’t stopped, which is why I haven’t posted. (not to mention the trivial little detail of dealing with a newborn at home before I left)

In spite of all the school pressure, I am elated with baby. She is just a doll. I can just look at her for hours, imagining everything she might become, just amazed at the beauty in my arms being half my genes (Mommy has the better half in the looks department) and a whole new person. Unfortunately, school doesn’t stop, so we’re separated temporarily before I go back for our mini break. I did get everything set up with videoconferencing though, and we’ve already had a couple of webchats in spite of the special-ed network infrastructure here (bandwidth is OK, latency stinks; packets negotiate when they want to), so I still get to see her “live” for a little bit here and there.

Before posting this, I looked at my site and saw it has been 11 days since my last post, yet it feels like months, even a different life. While that sounds rather melodramatic to say, it is rather accurate, because parenthood does change one’s life. I had a friend tell me that the moment our daughter would be born, my life would change in an instant, that suddenly I’d see everything differently and that it just has to be experienced to be understood. I don’t disagree, but honestly, the event was more of a dissociated experience, more shock and disbelief that this child we had tried so hard for was finally here. It took a little while longer, but it was more of a door opening inside, allowing access to feelings and perspectives that had always been there dormant, such that it felt natural, “right,” rather than a divine finger-snap of change.

I didn’t mean to get so philosophical, and I get that way anyway so I can’t blame fatherhood, but it does make it moreso. The fact that I’m not with “my girls” kinda leaves me feeling blue, but in the grand scheme of things, it’s a small sacrifice to be apart for 3.5 weeks, especially for something like finishing classes and finals, putting one more semester behind me towards a goal that will make things better for all of us.

More soon with pictures and stories…it’s post-test night and I’m exhausted.

Daddy day is here

We’re leaving to the hospital shortly, and so begins the official day in which we welcome our daughter into this world. The time they want us there is ungodly, but it will almost assure us a private room, which apparently are in short supply. I’ve never heard of ppl reporting at 2AM for a procedure at around 9AM, but I’m too tired to argue, especially if we get the room we want.

I’ve spent the last 2-3 days putting strollers, car seats, etc. together, bought the first few outfits for her (even though she has a ton now thanks to the shower), spending whatever quiet time I could with Claudia when she wasn’t napping (which is understandably a lot these last few weeks), and it’s been kinda surreal… I knew I’d be doing all these things, such as installing the car seat and last-minute baby shopping, but I had no idea what I’d be feeling. I’d be walking through aisles and aisles of baby dresses and onesies, and it was like watching myself in 3rd person at times. I can’t imagine what it’s going to be like later today.

Unfortunately, there is no public wireless LAN in the hospital, so I’ll be offline when I’m there, but I do plan to spend at least part of that time [while awake, that is] writing, so I’ll probably be posting queued snippets when I come home for breaks. I can definitely say that such times will not be often, as the little time I’m not tending to delivery, etc. I am spending trying to learn about renal physiology and the sadistic world of the nephron as I am missing classes to be here. I am usually really bad about studying under less than “ideal” circumstances, but obviously now that has to change anyway, so I better get used to it.

I apologize for anyone who has sent me personal email to whom I’ve not replied. I’ve obviously been insanely busy and preoccupied, but I promise to reply to everyone as soon we’ve cleared this major milestone. Until then, thanks for checking in, and I’ll post as soon as time allows. Wish us luck!

Positive, Happy, Baby Shopping

I promised my next post would be positive, and I aim to please. I am back in Texas, having flown from GDL on Sunday. I hadn’t posted yet because when I came in, 1) I was way low on sleep, 2) the trip from across the border was horrendous–a used car that we were thinking of buying died oh, I don’t know, like 15 times in 102 degree weather (no A/C when it was running to keep it from dying), and 3) BABY SHOPPING! Oh my gosh, there is this like, whole underground subculture of baby accessories that no one would otherwise know about. Claudia had her baby shower last Friday and we got TONS of stuff for baby; we really are blessed to have family and friends that are so generous, especially w/our starving student status (SSS). Seriously, we really got a major amount of clothes and even some real gear, such as “kangaroo carrier” (mainly for me), bassinets, bathing basins, etc. We definitely wanted to do the shopping ourselves for the carrier/stroller and other “major” purchases, but every bit helps.

As for school, after making a meeting w/the assoc. dean, I finally got them to approve (with much “yes sirs” and “of course, sirs”) today through next Monday, given the C-section situation. The guy that gave me all kinds of resistance last time was very accommodating and “You misunderstood me,” when called into the dean’s office to confirm. Afterwards, I thought about it and realized I’d basically be staying in town just to go to class for one day after the weekend which would be stupid; I do have a few absences to burn, so I changed the flight last minute and left Sunday. Thank God, because it’s been non-stop over here (after I got in some sleep) with car repair, baby shopping, visiting family, etc. but it’s all good.

This is mainly for my peeps in Mexico, but just in case, if any of you are able to fly Interjet, do so. This airline is tops. Claudia flew it when she went back to Texas and said it was great. I have to agree 110%. They are brand new, the seats are roomy (it’s a rare thing when my knees aren’t bumping the seat in front of me and not be right up against the armrests outside of first-class), and LCD panels literally swing down from the ceiling to give you all the safety information, geographic/flight status, etc. I am actually looking forward to flying again. The best part: CHEAP!! I paid less than $160 USD for a round trip ticket from GDL to Monterrey (about 1.5h each way) with just days notice. Incredible.

So here I am, daddy to be, and I just wanted for symbolic purposes to buy the first set of diapers. I don’t know why; it just meant something to me. So while at Target, I went to that aisle and was immediately humbled by the choices for something so simple as buying diapers for the first time. First of all, there are at least 3 major brands, each with their own “system” of sizing. Once you figured that out, then it was how many to get, etc. I just got a large pack for starters. (Pictures of this and other things to come soon)

Right now I have to go downstairs and start putting strollers, carriers, and car seats together, getting them fitted in the car, etc. Busy busy busy. The day of least work will probably actually be the birth day itself, since family will be there to help w/whatever we need and I wouldn’t want to leave Claudia’s side. It’s all kind of a fog still, moving too fast for me to sit and really contemplate impending fatherhood, but the feelings are there. It’s going to be a wild ride the next few days, and I’m both excited and scared. Most of all, however, I’m just glad to finally be here with enough time to actually savor the moments. More soon.

Trolls

Hello there my small but loyal readers…you came back! Actually, there has been major crap going down over here that has been distracting me in the worst way. I really vented in the last post, and while things aren’t 100% settled, the outlook is at least more positive, even if I don’t have everything go my way. I have at least gotten confirmation from the associate dean that he honestly supports everything in spirit and will do what he can. In the end, that goes a long way, so I’m better off now, but I had to work for it.

Unfortunately, others don’t see it the same way. I really don’t want to post another negatively-themed topic because I do have positive things to share, but I have to get this off my chest first. Feel free to skip if you don’t want to be shown the underbelly of dealing with medical student immaturity, particularly those from a foreign med school where, let’s face it, fair or unfair, they don’t always have the cream of the crop.

One of the meeting places for a lot of foreign medical schools is ValueMD. UAG has a forum there, but it’s pretty uninformative; the Carribean schools dominate this site. Last weekend I literally got a call from my wife saying, “They’re talking about us on ValueMD.” “What?!” I asked incredulously. “That’s impossible, I don’t post there.” Well, sure enough, there was a thread surrouding yours truly and calls attention to what I basically wrote here. It was started by a classmate who might be going through similar issues and has tried before to get absences excused to no avail, so it was more than just fear-mongering on his part. I don’t share the same opinions about everything that he wrote, but the sentiment and facts are true.

Well, imagine my surprise when I read replies such as the following:

First, no one told anyone to get his wife, girlfriend, etc pregnant. Adding one more [avoidable] expense while in medical school is, in my opinion, just plain stupid. I have no sympathy.
[Ok, no problem yet. Misinformed, but easy to ignore --enrico]

make a choice, be a man, face the consequences and stop complaining for your lack of family planning skills while in med school. condoms are very important during med school

…planning your life is maturity. Knocking up some chick while in medical school is not. Furthermore, why is UAG “good enough” to attend to get your medical education, but suddenly inferior to the point one would want to leave the entire country of Mexico because only the USA is good enough for a baby delivery? I have no sympathy for stupidity. I am sorry.

Well, I had it at that point. I created an account, (‘hexokinase’ for those that go read that ugly thread) and posted, trying to dispell what obviously has been a runaway train of misinformation and negativity, as you can see from the progression of venom above. I even referenced the original post where it said about “my wife” and “first baby,” and leave my wife out of this, this isn’t “some chick I knocked up,” and don’t even get me started on these trolls’ assumptions of what our family planning should consist of.

So, other than point out people’s lack of reading comprehension skills, I basically said back off–that’s it–but the chum was in the water, and the sharks came to feed. “Well, just pray that the kid is noting [sic] like its father. If you hate all my posts based on one in which you do not agree, I would have to say that your spawn has more maturity than you.” Ummm…I made one post, and the word “hate” or anything hateful wasn’t in it. But now you’ve already taken to calling my unborn daughter “spawn?” It’s on now, fucker.

Which was obviously a mistake, because bottom-feeders like this thrive on exactly that kind of attention. I seriously chalk it up to being alone, out of sorts, still adjusting to things w/o Claudia, which gave me more time to focus on things I shouldn’t. But the fun didn’t just stop there. At the same time, due to an email thread about a certain “political” issue at our school regarding test review, I sent a message that was both as a role as an elected class officer (I’m an AMSA rep) and some of my personal opinion. I think the vast majority of the recipients were in total agreement with me, at least one in particular went way further than I did in terms of ruffling a certain person’s feathers.

Imagine my surprise when I came home to this sent “anonymously” the next day:

Did you see the question on how obesity causes hypertension, heart problems and many things. Its very important that a physician not be obese I think. How about you? Tell me your thoughts? Isn’t it an oxymoron. I often have even heard that obese people have a problem getting residencies. It is really sad, but does our image reflect how we are as physicians. Perhaps. Because we have to practice what we preach. Do you?

I had to say I was shocked, not because this actually hurts me, but because the level of childishness and cowardice (not to mention atrocious grammar) to send pot shots like this on such an “easy” target. My weight? PLEASE! Do you think an “anonymous” email is actually going to hurt my feelings, that saying in other words, “You might want to reconsider medicine if you’re fat,” will actually sway me in the least? I’m fat, rememeber? It takes more than some schoolyard “nya nya” to move me. I will not go into my past on this at this time, but trust me when I say I’ve overcome many obstacles to achieved what I’ve achieved in my life. This immature pissant is nothing in terms of meaning, but to be embarassingly honest, with everything else going on, with everything else on my mind about the baby, other classmates, legitimate problems at school with administration, etc. etc. to get several anonymous emails about a myriad of things (not all from the same people, but all with the common purpose of attracting attention to themselves) just wore me out. I didn’t blog, I studied little, and I generally just passed the days for a while.

Now I have my respiratory physiology exam in literally under 1.5 hours, and I’m blogging this. I’m telling you, I’m in la la land, but that’s for the next post, which I promise is positive, because the biggest reason I’m in la la land is because I’m gonna be a daddy next week and the plane ticket is in hand!! More (and better) later, I promise.

Trying to forget this last week

Last week was bad on all levels. Claudia left back the states on the weekend in a very stressful trip insofar as getting her home from Monterrey to Texas and how that all panned out, so Sunday I was out of it. Monday was a holiday, but honestly I was really recovering from the last day and a half, not really resting or catching up on studying.

The the real hell began. Claudia called me from a doctor’s appointment that they needed to move up the delivery a week, which threw everything I had planned out regarding school out the window. I would not miss my renal physiology partial exam, but I’d be here just in the nick of time not having been here for more than 75% of the lectures. Wonderful. Also, my clinical classes and community medicine would now be affected and I’d need to schedule those makeups. But most of all, I would be gone from my pathology midterm…more on that later.

I tried working with my school about absences and their answer was basically that they couldn’t approve or assure anything before the fact, that a committee has to justify the absences, take into consideration x number of things, etc. but no special considerations were to be given under any circumstances: if I went over the allotted absences for any class or missed an exam, I’d have to stay a week after the semester is over for segundos which is usually reserved for people who fail. AT our school, attendance is taken like little high schoolers and if you go over 15% absences for a class, you lose the right to take your “ordinary” final. The problem with segundos that the entire grade for a class is determined by that one exam; it’s meant to be a punishment even though they bill it as a “second chance.” I don’t need a second chance, I need to not be denied my first chance.

As much as I want to bitch and complain about the inconsistency/corruption here (which unfortunately is a mirror of the whole country), the reality is that they haven’t decided anything yet. I’m just not the kind of person that can compartmentalize everything into neat packages and not worry about things smaller than this, much less for major things like this. I would have liked to believe I attended a school that said, “Don’t worry; go home and be with your family, congratulations and we’ll work everything out when you get back.” I’m not asking for special treatment academically or to be relieved of any scholastic responsibility, just don’t make me stay here another week which is one week less out of only 4 with my family, just because of your bullshit “rules” which have no basis in reality whatsoever. (and that get broken by them all the time, such as many days going by where no attendance is taken, which I thought was soooo important….)

Anyway, I’m getting mad again, so I have to stop, because I’m not done with UAG. We had our pathology midterm cancelled because administration caught wind that the exact same test we got was in circulation beforehand. There was no cheating, no foul play, just a mistake on the part of the path department releasing it before it was “decomissioned.” Someone complained–we’ll never know for sure who–and administration’s decision was to cancel the exam and give it to us again. I won’t get started on how they do test banks and other idiocies here, because I’ll take all day. Rather than decide to retake the exam in short order while the information was still fresh even though that might mean having it within a few days of another exam (the horror!!) our idiot, lemming class who feels like the more time they have to study it’s somehow going to help them (when in reality they just won’t study that much longer until the last minute) voted to have the midterm AFTER the final, two weeks after the class was done, because there was no other test at that time. Let that sink in for a while…. No, I’m not kidding. All the above happened before Easter. We were just told of the exact date of the 19th after our Easter break two weeks ago, so by the time I’m scheduling this absence stuff, the artificial date imposed on us was only one week old, yet administration is acting like I should have planned better.

This is country where abortion is illegal, where doctors actually try to coerce women away from allowed medically indicated pregnancy terminations (medically allowed when indicated only in 1st trimester, before you can get a CVS much less an amnio–let that one sink in too), but the attitude for my child’s birth is like it’s being treated as an academic impediment that I should have planned better. Students from later semesters have confirmed heavily that the “committee” is very subjective and makes their own decisions about what constitutes “deserved” in spite of any official documentation. Just so you get an idea, I asked the main guy in charge what he thinks would be excused given a C-section out of the country and he said “3 days, certainly not more than 4.” My jaw dropped — two days is travel/flight, so that leaves one MAYBE 2 for a C-section/delivery? Claudia might not even be out of the hospital, but I say, “nope, gotta go honey, I can’t miss nutrition and physiology?” I’d laugh if it wasn’t so pathetic.

My general pathology final was Friday, and I might have well bubbled pretty patterns on the scantron because it’s not going to count for anything — the only reason I showed up was to get a feel for the kind of questions they’d ask. So that makes TWO tests that gets cancelled on my for no fault of my own. Thanks UAG — you suck. But don’t worry–I’ll take the test and knock it out just like I have done on my cancelled tests and all will be the same in the end, gradewise.

But I will never get that time back, and I will never forget.

Cinco de Mayo

Well, for the first time ever, I’m actually in Mexico for Cinco de Mayo. Do you know what that means? You know what is going on here?

Nothing.

Cinco de Mayo celebrates a small, victorious event that didn’t change the final outcome at all: the French defeated the Mexican army and took control of Mexico City. Yes, yes, it’s a good story about a people’s rightful rebellion, but it reminds me of the Alamo where it’s memorialized and all that, but it was a grisly defeat. Texas’ independence was won at San Jacinto later, but not too many non-Texans know that. Actually, these days, probably most Texans don’t either. But anyway, everybody remembers the Alamo, even before it was an ugly-ass domed stadium and a crappy movie.

It would be like Americans celebrating one of the acts of rebellion in the 1770s leading up to the Revolution, knowing that days later they got slaughtered anyway. In the end, it doesn’t matter; it’s all about selling more booze.

Good ol’ days of fartin’ med humor

I was looking up something regarding ulcerative colitis and treatment in the Merck Manual while studying pathology (was convinced it was caused by C. difficile; I was quickly corrected as C. diff causes pseudomembranous colitis) and poking around, I found this link on intestinal gas. I admit; I clicked with a twinge of juvenile expecation. I was skimming through when I saw this at the bottom of the page (emphases mine):

The following piece appeared in the Gastrointestinal section of past editions of The Merck Manual, and is being reprinted here because of reader demand.

Flatulence, which can cause great psychosocial distress, is unofficially described according to its salient characteristics: (1) the “slider” (crowded elevator type), which is released slowly and noiselessly, sometimes with devastating effect; (2) the open sphincter, or “pooh” type, which is said to be of higher temperature and more aromatic; (3) the staccato or drumbeat type, pleasantly passed in privacy; and (4) the “bark” type (described in a personal communication) is characterized by a sharp exclamatory eruption that effectively interrupts (and often concludes) conversation. Aromaticity is not a prominent feature. Rarely, this usually distressing symptom has been turned to advantage, as with a Frenchman referred to as “Le Petomane,” who became affluent as an effluent performer who played tunes with the gas from his rectum on the Moulin Rouge stage.

Really, there’s no need for this. I can see where this was taken out (hopefully many editions ago) but the fact that it was brought back by reader demand is, uh, scary. “Affluent/effluent” — how clever this author thought he was. “Personal communication?” That was the bar I guess back then for standards of systematic classification. Then again, at least it’s not DSM-style, or else there would be exhaustive (pun!) criteria pages long to determine exactly how each can be labeled. No thanks.

Ok, that’s your time wastage for the day. Happy to have provided a mindless diversion or sorry to have totally ruined your snack-while-blog-reading, whichever is the case.

Analyze this

On my TabletPC, I downloaded a little “powertoy” that does a handwriting analysis based on a penned phrase. I was honest; I did not change my writing at all, but I did have to rewrite the sentence twice because my writing was so bad it couldn’t “find” a particular word.

I know my handwriting is not the best and I know that doctors get all sorts of [deserved] holy hell for their writing, but I think I can help assure some of the non-medical readers that, at least in my case, medical school didn’t ruin my writing–it was already that way.

That said, I kind of like my handwriting, when it’s as legible as you see here. Most of the time, unfortunately, I have to go “huh?” when looking at my own paper notes. My biggest, #1 problem is that I have a tendency to write smaller and smaller to (I suppose) economize time. The TabletPC forces you to write larger, since miniscule wiggles of the stylus pen won’t exactly cut it on the screen, so while Niels and others feel strongly that TabletPCs are bad for medical education, more many, many reasons, I like having mine.

So here is the report [with my comments]:

Handwriting Analysis Tool for Tablet PC Results

Attitude
You have a neutral attitude about your future. You neither procrastinate nor hurry. You enjoy physical and hands-on activities.

Mental Abilty
You learn slowly, by repetition. You begin with the most fundamental parts, skip nothing, and do not jump around. [This is so wrong it's laughable. I think everyone learns best by repetition, but I most often learn on the run, am a quick learner, and usually am way ahead of the curve at understanding new concepts. My problem lies with the lack of focused discipline to cement it into place upstairs rather than simply understand it for the moment.] You make decisions very carefully. [True dat]

Communication
You keep your inner-most thoughts to yourself. However, you enjoy discussions and are receptive to other opinions. You can be deceitful to yourself. [I keep secrets from myself? Do I have MPD? Of course not. Yes, you do, shut up. No, you shut up...]

Goals
You set ambitious, long term goals, though sometimes vague. Fortunately, you have strong will-power, enthusiasm, endurance, and self-confidence, helping you to achieve those goals. [I'm in Mexico trying to be a doctor in my 30s while married and now having a kid...I think at least part of this is correct, except I definitely need more will-power.]

Self Image
You are confident and self-assured, and resultantly set ambitious, long-term goals. However, you are also sensitive to criticism and need approval.

Emotional
You are a cautious person who thinks carefully before acting. You keep feelings inside and do not express them openly, in order to protect yourself. However, you can be empathetic and sympathetic, and forgive and forget quickly. [I think anyone in class can tell you that I have no problem expressing myself. However, I am definitely sensitive to others' feelings, wondering if I upset someone, etc. by perhaps saying too much.]

Social Skills
You are a solitary person, and desire to work alone, and be alone most of the time. However, you do feel isolated sometimes. [Dead on. See my previous post about groups.]

Anyway, not bad for a little toy program. After seeing my scrawl, what comes to your mind (other than institutionalization )?

Britney’s Pregnant Again!

Break out the potted meat and Boone’s–it’s a celebration, and nothing but the good stuff! Actually, I knew this last week, but didn’t pay much attention because I was too busy and somehow it didn’t surprise me. Except today I found out that the new spawn is 5 months along. Damien Sean Preston is 7 months. TWO FRICKIN’ MONTHS AT BEST (assuming her cycle restarted regularly immediately after delivery, which is unlikely) and she gets knocked up again! Jesus, Mary and Joseph…this chick is born to reproduce. Too bad she chose the guy on the corner that washes windshields.

Weaving this back to med school, I can say without having done a day of ob/gyn rotation that I know I’d never want to be an ob/gyn (OBG). No, it’s not the hours, the 14251:1 female:male ratio these days, or even dealing with the, shall we say, “messier” parts and functions (not the least of which is childbirth itself). No, I’d never be an OBG because I’d probably lose my license in the first few years of practice. I come from an area of high welfare mother prevalence, where having another child is a financial advantage to a degree (in spite of no job) because then you get more as a household, and one more mouth to feed isn’t that much more. I’m not kidding.

At some point I’d just snap, fake/forge a consent form, and I’d tie their frickin’ tubes under the pretense of some other pelvic procedure. I’d be doing society a favor. I’d eventually get caught, then not pay off my $500k student loan debt, be forced to declare bankruptcy, lose my wife and kids, yatta yatta. It wouldn’t be a good scene. Why put myself through all that? Better to stick a “safe” residency, like medical transcription or clinical transportation. heh.

I know Brit/KFed’s new bundle of trailerpark joy is not being funded on a dole, but I can’t help but draw parallels here. I know it’s insensitive, unethical and all that to say that some people shouldn’t [further] reproduce, but damn!