...and in the Spring...

we got engaged...

...and married.

MATCHED!

We matched in Philadelphia, here for 3 more years! She was a little upset at our result, she was hoping to return to Chicago to be close to family, but after the initial shock she feels better and likes the fact that we don't have to move far.

Yes we are potentially moving to a new place, our very first "place." We started to look but a lot of things are still up in the air, like start date etc. We get our contracts and employment details in a couple of weeks.

Coming up is a 5 week vacation in Europe that we're looking forward to, well at least I am, she is a bit nervous. She hasn't traveled much recently but she does have travel experience. I think she's just nervous because it's new and it's not something she would have done (going away for 5 weeks). I think we can fit vacation, moving, etc before residency starts sometime in June though.

Graduation: May 17th!

I could not have done the things I did this year without God, who took my father to a better place and left me his money to fund my interviews and take this lovely vacation, who also put in place everything we needed to match well! He also allowed me to stay here to continue to volunteer at local clinic that I've worked at for the past 4 years.

The blog will continue, I'll try to remember to post. As usual, Flickr is where I keep my pictures.

update part 2...all about The Match

In the Fall of 2012, my girlfriend, who we'll call "N," and I began applying to residency programs. This meant that we needed at least 3 letters of recommendation (LOR) (some programs require 4). We get these on our clerkships in 4th year. The better we perform on these 4 week clerkships, the higher the likelihood that we would get great letters. I think in all, N and I were able to get pretty good letters. My letters were so good that my interviewers comment on them throughout the interview season (we don't get to read the letters ourselves so we don't know what's in them, it's a bit of a gamble). From what I heard from what's in my letters, I was able to learn how to properly embellish, it's an important skill, just in case I need to write letters in the future =)

In addition to letters, we need a personal statement. I think we were lucky here to have good people who read our PS and made great comments. I also had good comments from interviewers about my PS.

So far, the stars have aligned for our LOR and our PS!

Next we needed a curriculum vitae, or resume. This is a bit different than your non-academic resume, the CV highlights our academic or clinical medicine related achievements. Again I think we were pretty lucky here. My big thing on the CV were the long trend of working in underserved areas and the few projects I've done around them. Suffice it to say, I was able to make my CV look pretty impressive, even though yours truly may not be that impressive =). N on the other hand is a smart cookie in school she got elected into Alpha Omega Alpha, an honor society. The school elects the top 10% for AOA. It's something you can put on your CV and people would know how well you did in medical school. So that's pretty impressive. She also had a few other things to write about that made her CV as impressive as she is!

LOR, check, PS, check, CV, check!

Next to select programs. Here's the tricky part. Oh I forgot to mention, I'm applying for a residency spot in Family Medicine, yep primary care. And N is going for pediatrics (if you saw here you'd think peds too, not only for the fact that she's about the size of a small child, but her whole persona oozes kid love). Anyway, these aren't very competitive fields, the least competitive in fact. Then, how to choose which programs to apply to. People generally apply based on a couple strategies: location, reputation, shotgun the nation. We went with the last, although looking back on it now, we should have just applied more strategically.

As you can imagine, you apply, you get interviews (generally), you travel and go to these interviews and the costs add up. Plane tickets, rental cars, hotel in addition to the application fee! We went on about 20 interviews total. I didn't have the patience and wherewithal to go to anymore (we applied to about 30 and got offered about 30 interviews). We interviewed starting in October/November, then spent the whole month of December traveling, and January. It's always interesting to interview and talk about yourself for a day, but it's also exhausting. We probably spent about $5000-6000 between the two of us.

And there were other costly "glitches." In a laundromat in San Francisco, I forgot myself and left my nice new expensive laptop unattended for a moment and it was stolen! Did not get it back or have heard back from the cops yet and that was back in December. The second glitch was near Christmas, I was driving N to the airport early in the morning after a day of driving from San Fran to Southern California. We were talking about residencies and I wasn't paying attention, we were on a big 8 lane highway and it was empty and my speed got up there and I got a $500 speeding ticket! Yikes.

The tally so far:

• Stars aligning x3
• "Glitches" x2

Anyway, back to the topic. It's now March and we finished our rank list. Let me take a moment to explain this complex process. The Match works like this. You interview at your programs, lets say 4 programs each for me and N. If you were to do this individually, you would simply rank the programs you interviewed at in order of preference. The residency programs also have their own rank list. A ranking program then takes both list from every program and every applicant and tries to "match" everyone based on their highest preferences. So it would be to our advantage as applicants to rank the "dream" programs up high because it doesn't really hurt us. Another way of saying it is that we don't have to consider that we may not be good enough for a particular program, because the Match system takes that out of the equation and continually tries to put you, the applicant, in the highest position possible on your list. The guy who designed the algorithm won the Nobel for economics recently, he also designs the ranking system for school systems.

But N and I are couples matching, which means all of my choices are linked to her choices. Her number 1 is linked to my number 1 and so on. Both of us would have to "match" at each program to get our number 1 choice. It wouldn't make sense for me to link a Philly program and for her to link a New York program, we'd be 2 hours apart! This involves a lot of compromise as you can imaging, I won't go into that here.

What's our list like. N is from Chicago, her family is there, her adolescent siblings are there and we would love it to watch them grow up, it's a once in a lifetime thing that we won't ever get to experience again until we have our own kids. So 2 programs in Chicago, then we go to New York City. Our 4th and 5th choice is Philadelphia, we both have 2 programs here. And then the list goes on and on. But hopefully we don't have to go past Philadelphia. 

We submitted our rank list February 20th. We find out at noon EST on Monday, March 11th if we even matched. If we don't match, that means that we have to spend the week trying to find open positions in the country to get into. This may mean I may not be a family physician depending on what's available out there or that we could be far apart from each other. Obviously the competitive specialties aren't going to have open positions after the match. If we do match, then we sit back until around noon on Friday March 15th for the official envelope that contains our match location. That's it, you're all up to date! We're waiting as of this moment, nothing else to do but wait!

18 month update part 1

It's been sometime since my last update. Last time I wrote about finishing Step 1 (of 3). That was Summer of 2011. After that I went to France and Italy for 2 weeks before 3rd year, my clinical years, began. The clinical years are different from the first 2 years. Instead of being stuck in a classroom all day and learning about the foundations of medicine, medical students are thrusted into the high paced wards of hospitals, the freeze of operating rooms (temperature and temperaments), and many other environments where we have to deal with patients, nurses, and doctors.

This is where we transition from thinking like a student to thinking like a doctor, while striving for top grades in both standardized multiple choice exams and the subjective impressions of our attendings and residents. I had a tough time of it, although I was always a fast learner, there were many things to adjust to and I had trouble sorting it all out. Every rotation was different and new and something I'd never seen before. The learning curve was steep, but I eventually got over the hump.

At the end of the Spring of 2012, I went and took Step 2 of my board exam. I scored well. And I started my 4th year with much more confidence and with a renewed sense of purpose and enjoyment in finally getting the hang of medicine, at least at my level. There is still much to learn, in the words of my attending who said "after 35 years of practicing medicine, I feel like everything is finally clicking together."

I lost my father in the Spring of 2012, April 6th. He had another stroke, he bled into his brain. We withdrew his care, meaning he would only get medication for pain control. I slept and sat in his hospital room and watched him for a week. He was like in a coma, so we couldn't talk to him, though my family thought he could listen. It was hard to watch him for a week, it makes you doubt. I still think about it now. I felt empty after he passed. It's been a few months now, and I think I'm back to my normal happy self.

I also got a girlfriend in 2011. I successfully wooed a classmate, I don't think she knew what she was getting into =). We have been together now for almost 2 years. I love her very much and she says she loves me too. She helped me become well again after my father passed. It's too bad they have never met. We decided to couples match, meaning our residency ranking will be coupled so that we could stay together in the same city during residency, more later.

boards are DONE!

I took my USMLE Step 1 exam last saturday after 5 weeks of pure intense crazy studying that sometimes wasn't so intense, just crazy. I am very relieved I don't have to open my USMLE first aid anymore, hopefully. The key to the Step 1 is to not just pass, but also to pass with at least a decent score. If, for instance you get a barely passing score, you will have trouble getting residency spots because of the emphasis that residency sites place on Step 1, and to a lesser extent, Step 2 scores. Oh and if you pass, you cannot retake the exam for a higher score for 7 years! You're stuck with whatever passing score you get. This can be very traumatic to people's careers!

So what's a decent score?

The highlighted ones are the specialties I'm considering going into. You can see the average scores and the standard deviation of scores for each specialty. It would make my life easier to have a higher score because not all residency sites are created equal. Some are better than others. But I still believe it is what you make of it and for speaking for myself, I'm happy if I get an average score for those specialties I'm looking to go into.

So what was the test like? You go to a standardized testing site and sit down in a cubicle in front of a computer. You have to be checked in, finger printed, made sure that nothing is in your pockets or written on your skin somewhere every time you step away from your computer to take a break. No strip search though! You do hour long blocks of 46 questions each. You have to do 7 of these blocks and you're given 45 minutes of break time thru out the entire day and you manage it on your own.

I had enough energy to last me through the day and I didn't feel exhausted at the end. It was very nerve wracking at first to think how significant this day will be for my future. Once that passed, though, I got into the groove of working through the questions. I don't want to pretend to know how I did. I will find out in 4 weeks and for now, I'm blissfully ignorant!

What's next? I'm going to France and Italy for 2 weeks. I'll be visiting the French Riviera, Cinque Terre and Florence before heading north to Paris for a week. It's been a very strange and I guess rewarding 2 years. I think patience is the most important lesson I've learned these past 2 years. I learned how to be patient with life and with family and with myself. I learned the value of slowing down and stopping for a while just to enjoy the moment. I'm looking forward to more lessons to learn. Done with year 2. I've got 2 to go.

Gotta pack

Pictures coming!

Moved my photos....

...to flickr, see her: flickr

Months end update

My aunt may need surgery to close the PFO, she's been having chest pains and it sounds a little like unstable angina. But I don't really know her case. I'm praying for her.

My dad's endoscopy and colonoscopy is this Thursday, it's going to be a tough week of waiting.

I have an exam tomorrow so I'll keep it short. I miss my family, but I got some of them on Kik messenger so we can text chat across continents and oceans! Very happy about that!

month of months...

its been a month of months.

a couple of weeks ago, I received a call from the debt collectors. My dad has a $55000 credit card debt that went into default because the credit card company hadn't received any payments since June of last year. I can't really share any details about that since it's not resolved and the internet is like an open book. I'm dealing with debt collectors and they're really really good at making this difficult, I guess I'm not making it easy either. But I don't really know what the hell I'm doing. I just need to preserve what's left of our assets since that's what's keeping my dad in boarding care and day care.

Here's a little tutorial on how debt works. If you haven't paid your credit card bill in a while, it goes into default after which the credit card company will contract out a debt collection agency to call you and try to get as much money as they can from you. Typically, the client pays 10-30% of the total debt. If they can't get payment, the debt gets sold off to another collection agency, then another, and another. This supposedly goes on for a while. If they think they can't get money from you and also other factors I don't know of, they'll sell it to a law firm who specializes in getting money out of people. The law firm will then sue you for the debt. But, the burden of proving that you, the client actually racked up those charges is on the law firm. That means that they'll have to follow the paper trail of debt collectors back to the original bank and pull records and try to prove that every charge on there was made by you. This is a civil suit. If they win and there is a judgement against you, they can garnish your wages, confiscate your assets etc.

It's very scary. I'm still dealing with this right now, it's not over and it will take a while to resolve I think.

Additionally, my brother has an addiction problem. I've been trying to talk him into getting some help because he needs to, if not he can ruin his life and he won't be happy. I don't really know what I'm doing though. I'm talking to the school psychiatrist this week to ask for guidance. I want him to seek help and be able to stick with the program or therapy or whatever else it turns out to be.

Last week, my aunt collapsed. She has a patent foramen ovale, which means that there is a hole between her right and left hearts. Your heart is 2 pumps. The right side, pumps blood coming back from your body to be reoxygenated in your lungs. The left side, pumps blood coming back from your lungs to your body. When you're still in the womb, your lungs aren't fully developed and there is no oxygen to breathe anyway, you're bathed in amniotic fluid. So blood needs to bypass the lungs and there are two shunts; the first is within the heart itself, shunting blood from the right to the left; the second is a duct that connects the artery leading from the right heart to the lungs (pulmonary artery) and the left heart to the body (aorta). My aunt has a hole in the first shunt, the foramen ovale. This is supposed to close completely after birth, but in some cases it doesn't. People can live their entire lives without having symptoms, but I guess she was stressed enough that cardiac output decreased and she didn't get enough blood to her brain (this is my guess, I don't really know the exact details of her collapse).

She was worked up and the hole was small so the surgeons are not going to close it. The checked her out and everything seems good. A blessing in this month of months.

Last friday, my uncle died. He is the husband of my dad's sister. They live in Maryland. I don't know him very well, but I'm close with my aunt. He has diabetes, same as my dad. He suffered a stroke before same as my dad, he's the same age as my dad. The only difference is that he's in much worse health. It's been a tough weekend for me. I'm grieving much more than I expected. I'm also scared for my dad.

A few weeks ago, we found out that he had some blood in his stool, a positive fecal occult blood test. It means that there is bleeding somewhere in his GI tract, anywhere from the mouth to the anus. He was referred to the gastroenterologist for a colonoscopy. He ran some blood test to prepare for the colonoscopy. My dad has some anemia, there were abnormalities in his iron values. The doctor came up with a diagnosis of anemia of chronic disease. Chronic disease could mean a great many things. From kidney disease, colitis (inflammation of your colon), tumor, autoimmune stuff, anything that is chronic really. What happens is the chronic inflammatory process releases some molecules into your blood that makes your cells retain its iron stores so that your bone marrow can't use it to make new red blood cells. That's how you get anemia.

The anemia is an indication for an upper endoscopy, which is like sending a camera down your throat into your stomach, looking at structures along the way. The colonoscopy covers the other end. March 3rd is the big date. I don't know what to expect. I spent the day today learning about anemia of chronic disease. I still don't know what to expect. I just pray it's not bad news.

I felt like i had to document this here. I'm just not dealing with this very well. I was really feeling like I wouldn't be able to take anymore. I felt that after my aunt collapsed that there would be more to come and there was. I just don't want to make any prediction that will come true later. I'm a mess. Talking about it with friends helps, talking about it here helps more. I want to be able to remember this moment and come back here and know the details of what happened and see that this is a pretty bad time and my family and i got through it. Maybe it's a little messed up to want to remember the bad stuff, but i can't appreciate the good stuff without the bad.

Step 1 Board Exam scheduled...insert sense of impending doom

I just scheduled my step 1 date. It's going to be June 4th at 9AM. It lasts 8 hours, I'll be outta there by 5PM and asleep or drunk or comatose from food by 8PM.

I'll have exactly 5 weeks to study for it....I have no plan on how to do that yet.

Step 1 is probably the most important exam you'll ever take as a med student. For the most part, it determines the type of residency you'll get into, if you can get into something competitive like Dermatology or Radiation Oncology. Or it determines the location of your residency. It tests knowledge from the first 2 years of medical school. It's more memorization than it is thinking, or so I've heard.

So that's what's ahead of me right now

Nicaragua travel report - Day 2

The 2nd day we arranged for a guided kayak trip of the Isletas de Granada. Our tour guide was an Austrian expat who was named Fernando or Ferdinand or perhaps both, just in different countries. Anyway, we started our day with a hearty nicaraguan breakfast at a nice little cafe that would soon be our favorite breakfast place:



I picked the traditional Nicaraguan breakfast of huevos rancheros, let me tell you it was the best huevos rancheros I've ever had:


My mates picked various things, but the standout was the bacon and also this pineapple pancake with real pineapple bits built in, they were really good pancakes with a combination of a crisp surface and sweet fluffy insides:


They also had great coffee there, it was strong and was the best cup o joe I've ever had! We proceeded to the isletas, passing through the crowded beaches (it was a Sunday) of Granada. Our tour guide says the favorite past time of nicaraguense is to go to camp out at the beach over the weekend and have lots of sex, I don't doubt it!

On to the Isletas!



The isletas are basically small islands, some of them get completely submerged in the wet season while others are large enough to support houses and small communities. There was an isleta with a house built by two gay men from New York City:



We took a break on one of the isletas:


...where two of our mighty explorers professed their undying love for each other:


...over fresh coconut juice:



And our fearless misunderstood/sleazy? austrian guide:


We would save these coconut meat for some monkey feeding/drama later on:


The story is that, on a nearby isleta, many moons ago, some ingenious person took 6 or so monkeys to this isleta and let them loose. The isleta is the size of a football field, maybe smaller, surrounded by water and the monkeys can't swim. So they're pretty much trapped on the isleta. Thus is borned a tourist attraction. The monkeys survived all this time on food given by tourists who go by on tour boats. Tourists like us. Although typically they would just come on a motorized boat. Feeding the monkeys was a little complicated, we would have to paddle close and put coconut meat on the end of our paddles and reach over to the monkeys so they could pick the coconut off the paddles. We did this for quite a while and it was fun, until the monkeys got...violent. They were grabbing paddles left and right and they were charging us from land when we got too close, mind you they didn't dare get in the water. but it was scary nonetheless...I of course was not scared....although I did get yelled at by my boat mate who had extreme monkeyphobia...sorry no pictures, I was busy feeding monkeys...

So we continued on our way back home


Afterwards we had a nice lunch in town where we found another lunch time deal, tons of food for $3 or 60 cordobas:




...then we walked around the city where the girls got many catcalls for their sexy dresses....i didn't get any catcalls from the hot nicaraguan women...i guess they don't dig asian guys, they don't know what they're missing.


In the evening we had arranged to meet up with Ferdinando at a salsa place. Actually, he invited himself to our festivities, because zees is how zey do it in Austria ya!


The story is that, he was either trying to make friends (4 hot tamales in our group) or trying to get more business out of us because we said that we were interested in horseback riding the following day. He said he'd help us set something up for horseback riding before he parted earlier in the day, but later in the day we'd setup something through our hosts at the guest house, Alvaro and Meghan. So basically at the end of the night we told him we were good with our plans and he offered to drive us to the horse place for $10 each, which is highway robbery in Nicaragua. So thus ended our relationship vith zee Austrian. Misunderstood? Sleazy? You decide for yourselves, he was, however, knowledgeable about the isletas and the kayak trip was great I thought. Perhaps zees is just how zey do it in Nicaragua no?

The salsa place was great, we had some live music too:


Overall a great and memorable day that was!

Nicaragua travel report - Day 1

For Spring Break me and some friends decided to go to Nicaragua for a cheap vacation. Some background first: We were considering various other places at first, but then it was difficult to get people to commit because of cost issues. Nicaragua had become the poorest latin american country as of April 2009. Even Haiti was wealthier than Nicaragua (before earthquake, ahem)! To us that meant fun on the cheap! PERFECT! Just on that premise alone, we booked our $350 plane tickets to Managua. Later we would be freaked out by stories of kidnapping and literally highway robbery, as in they will rob you while you are driving on the highway and leave you destitute in the middle of nowhere, central america! So we were a little worried about safety, just the mere mention of Nicaragua, evokes images of revolucion and ak-47's in the hands of guerilla rebels and drug lords trafficking packets of cocaine in vagines and anuses. Seriously, this is what our families, or at least mine, said to me (maybe just a tad less dramatic). Fearful of airline cancellation fees, we set aside our panic and went ahead full steam planning our probable one way trip...

We had a couple goals in mind, we didn't want to spend our spring break week running around all over the country. We wanted rest and relaxation with a little bit of adventure. So we decided on two places, a colonial city called Granada for a few days and a volcanic island in the middle of central america's largest lake for a little middle of nowhere adventuring!

Fresh faced and naive, we boarded a train to NYC...


One thing that really sucks about Philadelphia air travel is that it's supposed to be a hub, but really it's not, it's like a large regional airport. Tickets to international destinations cost an arm, a leg and a mortgage on the house you would buy after you pay off your student debt. Traveling by bus 2 hrs north to NYC provides much cheaper access to the world!

The flight was uneventful except for the almost getting lost in Honduras because the itinerary forgot to mention that we would be randomly stopping in Honduras. Like dippy tourists, we got off and almost didn't make it back on the plane after we figured it out.

Upon arriving in Managua, we got conned into taking a $50 cab ride an hour south from Managua to Granada. Ok so we were going to take the Chicken Bus, see example below:


we were told that chicken buses are dangerous for gringos like us and that we should take the nice taxi. It was worth it I guess, we didn't start our day in Nicaragua by getting lost in Granada or Managua. It was a good warm up to Nicaragua

GRANADA, Home Away from Home!




It was warm, the city was beautiful, the guest house we stayed at was magnificent. The combination of almost 17 hrs of traveling and warmth and sun and finally being THERE made for a very happy first day in Granada. We had trouble deciding on a place to eat, thinking back now, we really should've just picked any place, you really have only one option for local food: rice, fried beans, fried meat, fresh veggies that's probably almost as dirty as a used petri dish. The food was good, not great, but it was good!

I think that first meal we gorged ourselves on the delicious local beer called Toña. They were cold and they were cheap! less than a dollar a bottle! We explored the market area a little before coming home to nap.







There was a lot of poverty there, we saw it first in the markets and also in the peripheral areas of the city. The nicer areas of Granada are in the city center around Parque Central. That is where the tourists congregate. As you go further away, you see the real granada, gone are the remodeled colonial homes around the city center, replaced with broken down colonial homes and dirty streets. There is a huge class divide according to our hosts, and there is a range of classes among the city, each class thinking they are better than the classes below them.

In the evening we wanted more comidas tipicas, which are your local Nicaraguan food. A friend and I shared the following, which costs $13 total


Note that that is a very large plate and that everything is fried. We were then treated to a show by flame twirlers



We closed out the evening with a light stroll around the city center and called it a night:


stay tuned for kayaking the mysterious isletas of granada, uncovered from its watery berth once every 12 moons

breakfast burritos

Back in late February, we had our Block 3 midblock exams. Me and a friend studied like madpeople. I made these delicious filling breakfast burritos:


They were easy to make, but I think I forgot how to so here's the recipe to the best of my memory:

* 3 eggs scrambled with a little bit of white pepper powder, the oil from chiu chow chili oil, a quarter of a red onion, pinch of salt
* 1/3 of spam can, cut into bite sized pieces and browned until crispy
* 1/2 cup of medium soft cheese (I used cheddar once and swiss another time)
* Ketchup to taste
* Sriracha to taste
* 1/2 lemon, squeezed over eggs & cheese for some "liquidity", add before adding spam to maintain crispness of spam bits
* Tortillas, toasted, browned however way you prefer.
* makes 2 burritos

Optionally, you could add a dollop of sour cream and/or guacamole for more "wetness" to the burrito.

the finished product:

Clinic update

Had clinic tonight, we set up a triage to screen for diabetes among our patient population. One of the first years, a good friend of mine tested a patient with a random non-fasting blood glucose of 135 last week. The threshold to see the diabetes nurse was 140. His gut told him to take the patient to the nurse anyway, nurse orders him to come back fasting the following week. Today, the patient came back (fasting blood glucose is diagnostic for diabetes), and the blood glucose is 300. A first year did this, he pretty much saved the patient from untold problems down the road had it not been caught.

Although it is not a place to teach students, we have setup a program that has so far been fruitful and I'm so proud of my classmates who undertook this project. We're making a difference in the lives of people!

Other updates, the clinic has gotten volunteer ophthalmologists providing services. Unfortunately, we've lost support from Drexel's affiliated hospital to do free lab work. Right now we are not doing blood testing for our patients. I'm looking into point of care devices to do blood testing and some grants to pay for it. I have the whole summer to figure it out since I'll be sticking around here to work at the clinic. It's part of a paid summer program offered by Drexel.

life update

Dear friends and family,

I apologize for not posting in the past 2 months. I have been on a soul searching journey these past 2 months. I believe I have come to a resolution that I am satisfied with.

I have been failing classes at school and I have kept this from even my closest friends at school. I will have to remediate most classes this summer. I do not think it is responsible of me to continue to waste money and time to become a mediocre physician, let alone the consequences of my actions as a physician. I have therefore decided to leave medical school to do pursue another adventure.

That adventure was a subject of much consternation. I found my answer, however, in Nicaragua. I saw farmers growing tobacco, mangoes and rice. The kind of life they led appealed to me. I had grown to love Nicaragua in the short time I was there. Therefore, I have decided to pursue my love and my passion and move to Nicaragua to become a farmer. In the past month I have begun to take agricultural courses at the local college. This is the reason I have been absent from my regular group of friends as well as my classes. I believe I am ready to go out on my own and grow fields of produce.

I have plans to grow mangoes, tobacco for cigars in the dry season and rice and beans in the wet season. I will finish out the year and I will depart immediately in June. I will of course move my father with me as I think he will like the tropical climate as it resembles the land of our birth, Indonesia. It will not be an easy life, but life is an ever changing landscape and each new turn brings different adventures and challenges. I believe we are on the cusp of something great for myself and my father and I hope you can respect and support my decision. Thank you for all of your support in this failed endeavor, I will hopefully see my aspirations bear fruit in Nicaragua.


Sincerely,

HS

Snow! lots of it!

Philadelphia doesn't really get all that much snow in a season. There's maybe one huge storm that dumps a few inches of the fluffy white stuff. But this season, we had a huge storm before winter break that dumped 22" in the course of 1 day! It was kind of insane and I drove around in it because my friends and I decided to spend the day at another friend's house in the city, we live in the burbs. That was the night my bumper fell off, yes, it fell off. I tucked it in the trunk and zip tied it back on when I got home. Anyway that's another story.

Last weekend there was another huge storm that dumped about 18" of snow! That set new records. I didn't go out driving this time, in fact people got tickets when they got caught driving out in the snow. It was nuts! Nothing was running for about a day and a half, no trains, no buses, no nothing. Clicky the pictures for more of said storm:




Devastating aftermath:


Tomorrow, is the start of another potential doozy, that would be another huge snow storm if you've zoned off the past couple paragraphs. If you doubt the seriousness of such a storm, see here. Looks like we'll have to put a hold on the snowman making!

By the way

UPDATE: 56" total so far, record=65" in 1995-96

spaghetti with meat sauce...

...is possibly my most favorite dish to eat ever! It started with my mom's spaghetti sauce and then it evolved to my own, over-seasoned sauce both of which I loved and can eat tons of in one sitting if it didn't go directly to my hips! So I'm sitting here thinking while not studying, how can I make the sauce differently, with more oomph? Well I thought of the meat, I've tried using 3 types of ground meat (beef, lamb and pork) and it tasted good. So then I moved on to another favorite, chorizo. I realized that chorizo is seasoned ground meat in pig intestines and I could use it to make spaghetti sauce that has a latin infusions! Imagine, chorizo, anato seeds, fajita seasonings, taco seasonings infused into homemade red sauce!

My next goal, stay tuned!

The Late Christmas Poem that was sent on time!

I sent this to most people on Christmas day, but I thought I'd post it here now so that Christmas may someday be extended into January................

GOOD MORNING!

I was going to do this over mass text message and single handedly max out my monthly text messaging limit in one fell swoop (that's how much I care about you guys, nevermind the impersonal nature of mass text messages!). But then i found out that you can only mass text to a maximum of 8 people. So I refused to compartmentalize my friendships into groups of 8 because, well, that's just not right, it's also a royal pain! So here's your annual Christmas Morning Greetings and I'd like to do it in song, without the song part, so just the lyrics I guess, well then that just makes it a poem doesn't it, so your Annual Christmas Morning Greetings Poem!

May your Christmas be Joyous
With lots of love and singing
Let your voices ring in chorus
And the tree lights agleamin'

May your gift-giving and present-receiving be merry
And the wrappings impressive
Most importantly, may your presents be very EXPENSIVE!
(Optionally, In $$$ or in Love)

May your wishes come true
And your bellies be full
If your family drives you up the wazoo
Just remember you'll soon be back at school


Alright yo, I'm tired of trying to rhyme, it's too early! Sorry if that wasn't relateable to some of you, but rhyming is damn hard, so deal! And to close it up, here's a picture of a Christmas Cat. Yes it's an ages old tradition that we've all somehow missed...

Merry Christmas!

Happy New Year

Sorry for the lack of updates. Not much to update really, just studying lots and other life stuff. Went back home for 2 weeks for break and got to see my pops. I hung out with him, mostly ate and saw movies. He loves the new place, although there might be some thievery problem. I can't make out if it's him losing his stuff or people stealing stuff. It'll be cleared up with time hopefully. I saw friends and it was not nearly enough time to see everyone I wanted to see.

I got a new camera so I'm posting pictures up on my web photo album. It's at: http://picasaweb.google.com/henrysiem. I update that more often than I do this because, well, pictures do speak a thousand words. Although some actual words can help too once in a while.

So I'm finishing up my second block, we've got 4 this year. Another 10 weeks and we start our primary care practicum, more on that in another post. We've got an exam next week and also our individual process assessments where we prove that we can think logically, come up with hypothesis, find data and ask questions that will lead us to supporting our hypos. We get a paper case that says person A has a problem and here are their lab values. We have to think up hypotheses and come up with issues to research. We come back 24 hrs later and present to a member of the faculty our findings and our support for the hypothesis. It's supposed to be fun and I'm a little bit excited to do it! It's the first time that we'll be independently working towards a diagnosis!

Spring break is in 6 weeks and me and 2 of my friends just bought tickets to go to Nicaragua. In case you're wondering where that is, it is in Central America just north of Costa Rica near the Central-South American border. It is a land of lakes and volcanoes and it is also the poorest country in latin america, making it one cheap travel destination. We're hoping to have a relaxing 1 week lying on the beach and swinging from the tree tops, fitting in volcano surfing in between!

I have a physical examination to do on 2 standardized patients tomorrow. It's our first time touching other people besides ourselves. It should be fun and exciting!

update

Sorry for the lack of updates. I spent Thanksgiving in Philly with a bunch of very great friends. We cooked a Thanksgiving dinner that was more delicious than any thanksgiving dinners I've had before, and I've had...15... OK not as experienced as other diners, but it was good. I made mac and cheese and we had rosemary bacon wrapped turkey, green beans, sweet potatoes, mashed potatoes and pumpkin and apple pies. It was so delicious. Then I caught up with an old friend on friday and my thanksgiving friends went to NYC Saturday and Sunday. I spent way too much money and flirted way more than is considered appropriate I guess. But it was really fun! Driving in NYC is a different experience. It's a city where turn signals are optional and you change lanes whenever there's a space and you do it with gusto or people will honk you to death. It was GREAT!

So we finished gross anatomy end of October. We ended it with a disection of the head starting with decapitation and then cutting it in half, front to back, a cut on the midsagittal plane. Gruesome to some, another day in gross lab to us. I haven't been back in gross lab, but I hear our cadavers are still there. We're supposed to give them a nice send off at the end of the year. After gross, we had neuroscience for a month and now we're on physiology for another month.

The other day we had a lumbar puncture demo and I got to do an LP on a simulator dummy. It was really fun. I use to not care about doing procedures or giving shots, but the skill required for LP made it really fun. I'll be going into the simulation lab tomorrow to try to save a patient with heart problems from dying. We'll be working with a full sized dummy. It's the first time the simulation center will be used, it's brand new, just completed last month!

Anyways, I'll hopefully be coming home later in the month, I haven't bought plane tickets yet. Still hoping they'll fall in price! I'm shorting plane tickets HA!

Chinatown clinic

So yesterday was an interesting day at clinic. The usual suspects were mostly not present because of exams and other things going on. So it was just me and another girl who were the "veterans." It was pretty hectic with a lot of people coming in for flu shots and a ton of 3rd years, very few mandarin speakers and a lot of indonesian speakers. That's usually a good thing, but there was a majority of mandarin speakers yesterday coming in for the flu shot so we were short interpreters. I took charge of the front desk and helped coordinate where everybody should be going and what they should be doing. So I was running around half the night, juggling a dozen different things and I loved it. I may be exaggerating slightly. It was exciting and the night passed quickly. I had such a good time I sort of wish every night was like that. I guess I got a taste of a little power and am loving it. But that's the nice thing with Chinatown Clinic, it's the ONLY Drexel clinic that's entirely student run. Students get the supplies, students run the clinic every Wednesday, students see patients, students draw blood, students do EVERYTHING.

There's a change in leadership at the clinic each time a 2nd year passes on to 3rd year and they're not able to maintain a regular commitment to the clinic. At that time, responsibility falls to the incoming 1st years and new 2nd years. All I know is there's a lot to learn about the clinic and we're not exactly in an open sharing environment, meaning we have to ask for the info, otherwise they're not given.

I'm pretty excited about taking on more responsibility at the clinic. Clinic's probably pretty high up on the list of things that are fun about med school, next to friends, fun and food. The 3 F's of med school.