Isiah Washington is no plantation slave

In this ridiculous CNN report, Isiah Washington, the former Dr. Burke on ABC’s Grey’s Anatomy, shows he’s quite the victim:

“Well, it didn’t help me on the set that I was a black man who wasn’t a mush-mouth Negro walking around with his head in his hands all the time. I didn’t speak like I’d just left the plantation and that can be a problem for people sometime, [sic]” he said.

“I had a person in human resources tell me after this thing played out that ’some people’ were afraid of me around the studio. I asked her why, because I’m a 6-foot-1, black man with dark skin and who doesn’t go around saying ‘Yessah, massa sir’ and ‘No sir, massa’ to everyone?

Hmm, I guess simply being an asshole never factored into it. Calling a co-worker a ‘faggot’ more than once could be grounds for dismissal in any job, depending on the circumstances. This is show business, though, and the opinions of fickle fans (and sponsors) matter more than Washington’s sense of justice (and it’s not like he’s an A-list superstar, or anything to begin with). Maybe there was racism on the set, and this is all that was needed for ABC to axe (as in the cutting implement, not the verb, ‘to ask’) Washington, their “dilemma” solved. Chandra Wilson, the other Black cast member doesn’t seem to be saying there’s a racist element on the set. But she keeps her mouth shut and doesn’t get “uppity,” I’m sure Washington would say.

It just astonishes me (well, maybe not) that certain obviously talented and educated people in the Black community resort to slavery allusions in the unfairness of how they are treated today. Not even Jim Crowe–slavery.

This isn’t Roots, this is 2007. Grow the fuck up.

Multi-Update I: Working, not studying

This is the first in a series that will let everyone know what’s going on with me, at least as much as I’ll let on publicly. I’ve been posting here and there, yes, letting people know I’m still alive and kicking (not necessarily a given, as I’ll go into later), but not really writing with any gravitas, any real soul about what’s going on. Part of that is that things are so totally difficult for me, I felt that if I really wrote what was really going on, I’d depress the shit out of everyone at best, lose all my readers at worst. But as much as I love communicating with all of you out there, I have to remind myself this blog has always been and will always be primarily for me–whoever wants to follow along is welcome; whoever wants to actually comment or write is warmly appreciated. I’ll warn everyone straight away that the posts that follow are going to be raw, mostly unedited, and like the little “film rating” meme that’s going around, “NC-17.” Some of the posts might be long, as in Merchant-and-Ivory long. That’s part of the price that goes with lack of editing, but that kind of raw writing is what I need now. You’ve been warned.

So I’ll start this series with a topic that everyone can relate to: financial difficulties. Ever since May, I’ve not been spending 100% of my time studying and living, as would be expected in someone of my position, weeks away from boards. I’ve been separated from family and have been rather “in the dumps,” so to speak, in general since that break, but I’d be lying if I didn’t say that part of me didn’t appreciate the silence, the freedom to make my own schedule that it brought. I’d also be stupid not to have taken advantage of it, which I did as best I could, but unfortunately, “life got in the way.” (I don’t know if that’s a quote or a lyric, but it should be) It was clear that around my daughter’s birthday that our finances were dwindling to zero. We get our fin.aid/loan checks at the end of August to last all year, and with all that’s happened, plus the incalculable/unplannable first year of parenting, we were gonna be dead broke fast. We’ve been blessed with family that’s been a great help with the “first grandchild” on my small-family side, help in numbers with many aunties on my wife’s side. Still, it wasn’t enough.

My relationship with my previous employer has gone back off and on since 1995 while still and undergrad. Even through breaks from school, research, jobs in other states, to working with them full-time just before our wedding (something had to pay for it!), I’ve never burned that work bridge. They are always in need of my help to some degree, and they know I’m good for it, talent-wise and if nothing else, expansive legacy knowledge. This, added to a wage that is commensurate with my experience (I don’t work for cheap!), means that time spent working is at least worth something, not like flipping burgers for $4/hr. In addition, my particular line of computing work means that I can work from here, via the use of VPNs and other network resources. (not that it would be useful financially since pay is so low here, but on a student visa, I am prohibited from employment here anyway) However, nothing could be more detrimental to Step 1 studying than having to work. It saps precious time and energy–even when not working–having to think about work-related activities. Add that to the monumental burden of wondering how the light bill will get paid (because I’m sort-of just “ignoring” that part in this post), and staring at a table of which bacteria are fucking optochin sensitive but ferment lactose (I’m totally making this combo up–which should show you how behind I am), and you just zone out, not learning anything. To fire up QBank or the like seems like worse idea, wasting questions in a limited bank like that, so you just sort of curl up in a fetal ball with a book and hope some of it sinks in via osmosis. You also wish you’d done more/better studying earlier, to carry you through times like this, ie, “If only I’d not have slacked off for x weeks, I’d not feel so desperate right now.” Woulda, coulda, shoulda.

Some of you might think, “What a whiny little bitch. People have to go to work all the time. You have a wife, a daughter, that’s what you’re supposed to do.” And you know what? You’d be right–that’s why I did it and didn’t stay in that fetal position crying “Woe is me.” But there’s a limit to the amount of external stresses one can endure–even the strongest metal has definite, innate tensile properties and can be bent, eventually broken–and last I checked, medical school itself was somewhat of a stressor. So was being a new parent. So was living in another country. So was separation from family. So was financial ruin. Think Maslow: I can only assume that excelling in medical school as a personally-defined goal is somewhere at the tip-tippy-top of the pyramid in the “self-actualization” area, but right now I’m wondering how the rent and light will get paid. Working certainly puts a damper on studying, but so does being evicted or being in the dark. Sometimes I think I’ve already passed my breaking point, but I’m still here, trying to scrap it out, like Rocky when he said, “I got nowhere else to go!” I don’t, at least not as a whole, complete person not defined by defeat. I can’t quit now, based on temporary shortcomings, no matter how severe. But I didn’t make the system, and the system says that I need to not only pass but if I want to have any say in the matter where/in what I do my residency, especially as an IMG, I better kick some ass on Step1. I’m barely trying to keep things together, much less excel.

So you’d think when I go to my school with this, that they’d do what at least was within their control to make things better for me, one of their top students (or at least “towards the top”) by their measure. Right. That’s for Part II.

The Assimilation of YouTube

I am shocked and appalled, I tell you, that my account was cancelled due to DMCA copyright violations. FOR CLASSICAL MUSIC VIDEOS. In every case, I was just posting what was publicly broadcast on TV at some point, not “bootleg” or other content that would understandably cause a problem since those watching didn’t pay something. Mind you, YouTube never said, “Ok, you better stop this or we’ll permanently disable your account,” which I would have taken seriously, but instead, on two and only two separate occasions, I received email letters such as the following:

Dear Member:

This is to notify you that we have removed or disabled access to the following material as a result of a third-party notification by HOGAN & HARTSON RAUE LLP claiming that this material is infringing:

Beethoven Triple Concerto – 1st mvmt, Part 1: http://www.youtube.com/watch?v=e01FtIEeXEU

Please Note: Repeat incidents of copyright infringement will result in the deletion of your account and all videos uploaded to that account. In order to avoid future strikes against your account, please delete any videos to which you do not own the rights, and refrain from uploading additional videos that infringe on the copyrights of others. For more information about YouTube’s copyright policy, please read the Copyright Tips guide.

If you elect to send us a counter notice, please go to our Help Center to access the instructions.

Please note that under Section 512(f) of the Copyright Act, any person who knowingly materially misrepresents that material or activity was removed or disabled by mistake or misidentification may be subject to liability.

Sincerely,
YouTube, Inc.

I received three (3) emails just like this one, two for the 1st movmenent of the Beethoven “Triple” Concerto for Violin, Cello and Piano, Op. 56, and one for the third movement. Apparently the 2nd movement didn’t violate anything. The artists were Yo-Yo Ma, cello; Itzhak Perlman, violin; Daniel Barenboim, piano/conductor (w/Berlin Philharmonic). All “A-list” performers–luminaries–in the classical world. The $300/hr-paid-lawyers above could be representing ANY of the previous artists, but in every case, I had videos from each of them separately, so why not have flagged them, too?

I also got an exactly similar boilerplate letter from Dewey, Cheatham, and Howe, LLC, about 6 Hilary Hahn videos I had. I got 6 emails, six removals, and I’m sure 6 “demerits” on my YouTube account before I even woke up in the morning that day. (Which, for HH I understand: she is a current “superstar” in the classical music world right now, but this was a TV performance on A&E) This is the problem: before I have a chance to act on anything, YouTube has mathematically decided that I ignored them not once, but 6 times; added to the previous infraction must mean that I don’t care. Action: Account Disable. My chance to do anything about either case after-the-fact? Zero.

What sucks, beyond all the lost uploading time, is by losing the account, I lost all the comments, the reputation and persona I’d established in that community on YouTube, and especially, a loss of great performances that, unless one was there to see the PBS concert that night in 1995, you’d never, ever have the chance to see again because you can’t even order it. If I’m taking money out of someone else’s pocket for broadcasting videos that I lovingly recorded to VHS 15+ years ago as a giddy teenager, then I understand. If not, then I’m just sharing with a musical community out of love; no harm, no foul.

Again, I repeat: this is classical music we’re talking about. I still can’t wrap my head around this one. I knew the day YouTube was aquired by Google that things would go south. I am sorry to say that my prediction was proven true, so close to my heart.

Grand Rounds 3:39

Grand Rounds 3:39 are up at Code Blog: Tales of a Nurse. Geena is, amazingly, a 4-time hostess! Enjoy a refreshingly creative edition in a unique Q&A format.

I’ve been tagged!

No, I don’t get a new Tag Heuer watch (I am partial to Movados, myself), but I have been tagged by Dr. Rob over at Musings of a Distractable Mind. So the meme is “8 Random Things” whereby I list 8 random things about me and tag 8 more people in chain-letter fashion.

So, in random order, here they be:

1. This is the first official “tag”/meme I’ve actually been asked to participate in. I feel like one of the “popular people” now. Watch as I wave with my rotating wrist (that’s pronation and supination for you smarty-pant-types), fingers fixed and extended…
2. My first computer was a Commodore VIC-20 in 5th grade (the “monitor” was a 13″ color TV). I had mononucleosis at the time and was home for two weeks as I devoured the manual. My life has never been the same. (and I’m not referring to why I got mono…)
3. My #1 choice of profession outside medicine/science would be an orchestral conductor. I have had some experience in the past, so this said with serious familiarity. I have a stack of orchestral scores and collect more all the time. To actually conduct any of Tchaikovsky’s last three symphonies would be a dream come true (I dream little things, don’t I? ;P)
4. I hate dust and am always doing battle with the miniscule beasties.
5. Pertinent to the above, I have a vacuum cleaner fetish. For the dust.
6. I have the time management skills of an amoeba. How I’ve gotten this far is beyond me.
7. In high school, I’d call from the pay phone next to the attendance office pretending to be my dad (in proper, business-like, attorney voice and all) informing the school that “my son” will not be able to attend school because of blah blah reason, then take off. Why was I at school in the first place, then? Duh, to see my friends! I’d also steal hall passes, write passes for friends, so I’d have someone to hang out with when I wasn’t attending classes. And yes, I was in the top of my class, with honors…just bored.
8. I am working on the future-cover-of-Nature and Nobel-winning article whereby I prove that in spite of years of being told I am overweight, I am in fact, undertall. The data are irrefutable.

Well, there you have it! No doubt, the world is no different with this information (save the article, once the editors stop throwing it away), but it’s there nonetheless. I now tag the following: Dr. Schwab, Fat Doctor, Dr. Charles, Punchberry, Keagirl, Dr. Iñarritú, TinySurgeon, and Colin. No offense if you don’t want to participate.

2nd year is OVER!!

WOOHOO! I am finally free of the shackles of the slow torture called “the basic science curriculum,” AKA “Pre-Clinical Years.” I now move on to the hospital, but down here, unfortunately, it’s not quite like it is the States with that. We still have quite a bit of classroom/didactic learning. Too much, in my opinion. We are only let loose on the wards, totally, for a precious few weeks out of the semester, at least at first. The rest of the time isn’t all lecture hall like the first two years, but rather small problem-based learning groups (you know, the progressive learning that many US schools have been doing for a long time, in the first two years, but I’m not bitter…) that do revolve around actual, current patient cases. I can only surmise that this spoon-feeding of procedures, techniques, diagnostic analysis, is to ensure we get the proper clinical training by design, rather than hope it gets through in “on the job” training. I wish we’d be given more credit, but that’s the way it’s done. Many people have told me that just the fact that you are doing relevant clinical learning by knowledgeable professors (as opposed to those lecturing from 10-year-old yellowed transparencies) more than makes up for whatever shortcomings exist.

If all goes the way I plan [insert raucous laughter here], I would have taken Step 1 by the time July 16th rolls around. Yes, I only have 6 weeks of vacation (if you can call it that this time), and yes, we start insanely early, and no, taking/passing Step 1 is not mandatory for int’l students to progress to 3rd year, since we aren’t in the US. However, you’d have to have a serious screw loose not to take it ASAP, and I really don’t relish having to take the exam while actually enrolled in classes. If, due to scheduling conflicts or something coming up life-wise at the last minute I must postpone into late July/early August, then that’s the way the cookie crumbles; I’ll deal.

The only downside I can see from here–and this is somewhat petty, but it is a real issue–is that for the next two years, we have to wear our “whites” every day to class. No exceptions, even if we aren’t doing rotations. I’ve written about this before, but the reality of all white–while serving the logistical purpose of showing you aren’t going around with others’ bodily fluids while you see a patient–is just beyond impractical. More to my personal point, NOBODY I know looks better in all white. I’m not fashion-conscious at all, but c’mon–white isn’t flattering, except for the lucky few. I makes you look bigger, it’s semi-tranlucent, underclothes-wise, impossible to keep clean, etc. It wouldn’t be so bad if I looked like this, but unfortunately, it’s more like this. Oh well. I better get over it, fast.

So Claudia and baby are coming tomorrow for a week-long visit. Yay! Basically, this is a final family hurrah before I take my exam–from here on out, I’m electively staying here alone so I can maximize studying. Also, Claudia wants to take inventory of things, organize, plan, etc. regarding household/baby times for when they come back for good in July having finished her PT later this month. But for now, I must de-bachelorize the house, do 6 loads of piled up laundry, remove traces of weeks of single-living debauchery (I’m *SO* kidding–I have no life, really), and just in general, relax knowing that although I’m busy as ever, at least it will NOT extend to have to sit in a lecture hall anymore for hours on end. It’s about damn time!

Placeholder

I’m exhausted. I had an 8-hour simulation Step 1 Exam today, my last hurrah with Kaplan. (well, I was really done in less time than that, but that’s because there was a little too much “hell if I know”-type responses.)

So, I have LOTS to say, and a little breathing room in which to say it, but first I must sleep. Precious sleep. More tomorrow after a REM recharge.

Grand Rounds 3:37

…is up at Inside Surgery. Succinct and to the point.

Arrakis

I noticed outside today as the sun was starting to go down that the sky was an unnatural orange-yellow color. Sometimes with cloud formations, the reflecting setting sun can produce some striking hues this high up with the dry air, but as I peeked out the window, it was a normal, partly (barely) cloudy sky–certainly nothing that I could see that explained the alien color. However, I don’t have a good westwardly view because of the connected houses, so rather than go outside (heaven forbid I might be irradiated with whatever is causing this), I went online to see if there was some ominous storm approaching. I found this:

Lovely. COPD: yet another souvenir from down here.

P.S. Title reference is here.

Certifiable

This post has been a draft for weeks, but I thought I’d finally get it out there. A few weeks ago, I finally had my certification exam. This exam is a 2 hour exam with a real patient which includes a hand-written write-up (in Spanish, of course) on the spot without reference materials or other aids. Think USMLE Step 2 CS, but on a far more basic level. The main point is to simply show that you are ready to start your clinical years and transition to the hospital setting. In other words, you’re not a danger to yourself or others; it’s not about whether you can diagnose small cell lung cancer with your palpation, percussion and auscultation skills.

There are two variables at play here: 1) our school never uses standardized patients, so the overseeing doctor at your clinic (randomly assigned) decides based on who comes in who is a good candidate for the exam, and 2) the variation in overseeing physicians at various clinics to which they send us and what they are looking for. We have a sheet of things we’re “supposed” to say and do, but it’s not only ridiculous (as you’ll see in a moment), but it is far and away different from what we’d been taught up to that point in many cases. For example, it’s totally understandable and relevant to ask during the clinical history if they live with any pets, but a rundown of the pets’ vaccinations, chronic diseases, and pet family history (”Did your dog’s mother suffer from hip dysplasia?”) OK, so I exaggerate, but that’s how it feels.

So you know exactly what I mean, here are some of the more, um, “questionable” questions:

GI:
Have you seen worms or other parasites in your stool?
Does your anus itch?

“Gee doc, I came in because of a sore throat, but now that you mention it…yeah, I did notice a bunch of worms running around, and wouldn’t you know it–they itch! I wasn’t going to mention it because I didn’t think it was important, but…HOW DID YOU KNOW?! You’re a genius, doc…A GENIUS!”

Neuro:
1) Do you learn quickly or are you slow? [I promise this is a word-for-word translation]
2) Do you hallucinate or hear voices/noises that don’t exist?

#1: I guess if you got somebody who actually replied, “Yeah, I’m kinda slow..*drool*,” that’d be enough data in and of itself. Note that there is no option for, “Well, I think I learn average/normal/like everyone else.” It’s the Corvette or the “short bus”–you choose.

#2: Now this is one that I couldn’t help but think, “What if the patient thinks they’re real?” The patient could have daily conversations with Abraham Lincoln and not hesitate in answering the question, “No, of course not–do I look crazy?”

OK, you get the drift. It’s so unlike a “real” patient encounter where time and substance can’t be set aside in the name of academic thoroughness, but I understand that at SOME point they have to make sure we understand the value of a complete history to get not only the details of the primary problem but hidden clues and details that would not be known if not asked. Of course, we understood this our first year, too, but they never stop trying to imprint this every chance they get.

So, in a hat tip to Punchberry who wrote a hilarious post about being clueless trying to figure out patients’ problems, I have to say during my certification exam, I had a major “duh” moment as well. My patient was a mid-20s, obese man with a history of significant hypertension but no diabetes. Chief complaint was epigastric pain and a headache, which were unrelated, but it was an overall “uncomplicated” case, for which I was grateful. When it came time to do the physical exam, I started with the abdomen. I was prepping the drape along his pants when I noticed what looked exactly like a C-section scar. “OK, this is obviously a male,” I told myself (you can never be too sure ), but what kind of surgery would leave a scar there? From the umbilicus, it went about 8-9cm downwards. Ventral hernia? Unlikely, especially at this (pelvic) level–perhaps if it was above the umbilicus. Bladder surgery? Perhaps.

He denied surgeries on the history, so I asked again, “Are you sure you haven’t had any surgeries?”
“Yes, I haven’t had any.” he replied.
“Then how did you get this scar?” I asked, pointing.
He looked at the scar, then me, furrowed his brow, and said banally, “That’s from my pants. They’re a bit tight.”

It’s one thing to be embarrassed. It’s another when you’re embarrassed because you made a patient potentially feel embarrassed. It’s quite yet another when you’ve accomplished the latter while being supervised, look up, and see the proctoring doctor scribble in a clipboard with an disapproving look on his face.

In spite of the gaff, I actually scored quite well. I’m now certifiable certified!!