Paperwork on the Road

For all the papers I have to fill out and send in for rotations and residency lately, it would have been nice to have a portable printer/scanner that I can use while away from home. I have to print things off, sign them, and fax or email them in. I'm looking into getting a small printer/scanner so I can fill out and sign a hard copy, scan it back in and either send it as an email attachment or fax it via an online fax service. There's at least one website that rents you an individualized fax number and you can email in a document to be sent out via that fax number and receive electronic versions of documents faxed to the number.

These are ideas I've toyed with in the past, and now I wish I had devoted some funds to them in the past so I wouldn't have to shell out so much money right now when I've got travel and other big expenses fourth year.

Scott

Late-night, End of Rotation Studying

I am up late reading about metacarpal fractures. I was worried that I would have trouble studying in sleep-deprived mode during residency, but I think I can hack it if it's ortho related. This stuff just clicks in my mind. It's so much more concrete than the rest of medicine, and holds my attention better. I'm nearing the end of this month, and it looks like I won't get the time I had hoped to recover from the drive back home. I'll be starting an emergency medicine rotation two days after I get home, and the kicker is it'll be 50 miles away from home. Thankfully, I was able to set up free housing in the area so I won't have to commute the full distance.

I've seen some interesting knees lately. If you don't know what the typical radiographic signs of arthritic change are, you should look them up. Osteophytosis, sclerosis, subarticular cysts, and joint space narrowing are the four big ones, and I've seen these pretty bad of late as my attending is a big knee and shoulder guy. One young adult patient in particular had a nasty case of bilateral arthritis, the severity of which normally wouldn't set in for another 30-40 years. Another doctor had recommended moving straight to knee replacement, but the patient didn't want to use that drastic of treatment right away. This patient came to clinic for a second opinion and my attending explained that usually there is a progression in treatment from conservative measures like steroid injection, physical therapy, viscosupplementation, and bracing, to more intermediate treatment with arthroscopic surgury and "cleaning out" the joint, to more radical treatment like knee replacement. The pateint appreciated this approach a lot more and understood that conservative measures may fail, but we could cross that bridge when we come to it. My attending said some patients come in and can't be talked out of knee replacement, so he's willing to do that, too if it's indicated. You can't force a patient to adhere to a certain treatment regime, so matching the proper management with each patient is part of the art of medicine. That sounded less cheesey in my head.

I was thinking a bit ago that as I progress in my medical career, anything I distribute publicly can be taken as medical gospel and cause liability for me,which I would like to reduce when possible. Hence the ugly disclaimer at the top of the page.

Hopefully I'll have some more ortho cases to post about and maybe some ER cases before my next newsletter.

Scott

July Newsletter

I know, I'm late. No excuse. July was designated by my school as a study month to prepare for our next round of boards, which I thought was a universal concept. Apparently*, other schools don't waste... I mean, utilize the month in this way. I'm over the bitterness; it's not like I was chomping at the bit to go straight through the year on a rigid schedule anyway. In any case, since July was just a study month, I don't have any exciting clinical stories to share, but there was some excitement in the form of getting my motorcycle license and buying a motorcycle. The following conversation always ensues when I tell people I bought one: What did you get? It's a Kawasaki KZ750 LTD. Oh, so it's a crotch rocket? No, it's not a crotch rocket. So, what kind of motorcycle is it? A cruiser. Which is what exactly? The stereotypical around-town and cross-country bike.

If you have further questions, the internet is infinitely more knowledgeable than I and your favorite internet browser would love to guide you to the answers. More details of my entrance into the world of motorized bicycle riding are here.

In more academic/medical news, I'm getting a crash course (no intended reference to the afore-mentioned motorcycle riding) in applying to residencies. Becoming a doctor is a long, arduous process of gracefully navigating a series of applications. I'm pretty sure the rest is just details. The latest installment will decide where I will spend what are purported to be the most difficult consecutive five years of my life. No biggie. Here are more details on applications.

Right now, I am halfway through the second week of my first audition rotation, which happens to be in Las Vegas (WHOO VEGAS!!). The "audition" modifier refers to the fact that I'm trying to impress the director and anyone else involved with deciding who gets into the ortho program here. So far, I have no idea how I'm doing. Again, no biggie. It's just the rest of my life. Speaking of the rest of my life, I learned a valuable lesson on the Vegas (WHOO VEGAS!!) strip. I lost what I consider a profane amount of money in a casino after initially doubling my starting amount of $20. My compulsive side kicked in and I kept thinking I just needed to hold out for the big win and I could get back the increasingly large amount I had lost. Thankfully, I finally snapped out of it and left, my deflated ego and the damning atm receipts trailing behind me (yes, Sister, I kept the receipts). I was just talking with a friend who pointed out that I could think of my losses as having sacrificed a vacation to, say, Arkansas. Not a devastating loss, but if I keep it up, I'll lose Hawaii, then Europe, etc. Actually, I need to save up so I can make a trip to Scotland with my mom and sister next year. Ramen noodles for me, I guess.

Back to studying.

Scott

*My little cousin (cousin's daughter) didn't know what "apparently" means, so my Granddad and I explained it to her and I now think of her every time I use this word. She and her siblings are cuties; I thought only women were supposed to have biological clocks.