Thursday, July 12, 2007

Thursday Update...

Well, it's Thursday and, in a rare display of clemency, AUC decided that there are no classes tomorrow. YAY!

It has been a rather busy week for yours truly, I had a test Tues, Wed, and today. I did very well on both my Ethics quiz as well as my Med Psych exam (despite my personal feelings on the subject matter) and expect to have done well on my Medical Ethics final which was this afternoon. I shall take advantage of this long weekend to regroup and catch up on some pathology and pharmacology that I have woefully neglected this week.

On the home front, Rileigh is doing well, and by well - I mean sleeping through most of the night. She is usually up only once during "daddy's sleepy time". Even so, it doesn't impact on me so much (since she is breast feeding; and despite any perceived anatomical similarities to the contrary, I am ill suited for such a task).

My oldest daughter, Meagan begins her trip to Italy this afternoon leaving from Philadelphia she will stop in Boston, and then Munich before touching down in Rome at obscene:thirty o'clock tomorrow morning. We are excited for her and know she will have a blast while there.

Kathy's sister Beth is on-island with her husband and 2 year old daughter to visit and we will be heading out to what will be Rileigh's first dinner out; we will see what level of cooperation there is.

I look forward to a relaxing weekend. But given how things go, I don't rule out the possibility of a category 4 hurricane hitting the island.

Monday, July 9, 2007

Hoop Jumping 470 (Medical Psychology)

Today is Monday and I find myself holed-up reading about the the mind numbing rules for diagnosis as laid out in the DSM-IV (The Diagnostic and Statistical Manual of Psychiatric Diseases, 4th Edition).

Frequent readers of this blog will recall that I have previously accused my Medical Psychology class as being the equivalent of academic masturbation. (You can read it here if you missed it the first time.) Perhaps I was too kind. Masturbation at least feels good. This class has become the absolute bane of my existence. Allow me to (rant) explain.

While I am not ready to join Tom Cruise, John Travolta, Kirsty Ally or any other delusional religious moron in calling for the boycott of the entire psychiatric branch of medicine, I do loathe the course work that we are forced to undertake in its name. If we were simply learning about the various afflictions of the mind, recognizing them, and theories on their respective treatments it would not be too bad. This is not the case. We are forced to undergo what equates to an exercise in taxonomy. The rules to "label" a patient with a particular numbered diagnosis read like corporate tax code:

"In order to meet the criteria for the diagnosis of blah blah blah, the patient must have had 4 of the following 9 symptoms from column A, and at least 2 of the 5 from column B. Furthermore, must never had had any previous diagnosis of any overriding disorder which preempts this diagnosis. Oh yeah, by the way, the symptoms must be present for at least xxx but no longer than xxx. If ,and only if, the aforementioned criteria are met then hop on one foot, point a thumb east and enter this number on your diagnosis sheet."

Sweet mother of tap-dancing Christ! This would be an almost noble (albeit tedious) pursuit were it not for the intentional ambiguity and rampant overlap. I asked the professor in class what, other than a curious taxonomic diversion, was the point in all this hair-splitting. The answer I received, suffice it to say was less than satisfactory, although, in her defense I suppose the question could have been interpreted as rude and an insult to her life's work.(my bad)

Todays particular brand of Vince tourture (oh yeah it is ALL about me, that gets me a diagnosis of 301.81 if you're playing along at home for Narcissistic Personality Disorder) involved being critiqued on how well we 'pretended' to interview a 'pretend' patient who 'acted' like she had a substance abuse problem.This was the first hour of hell, without so much as a milk and cookie break or nap time, we were forced to watch a video of a (I presume) a real psychiatrist interviewing a (again I'm guessing here) real patient with some "depression issues". We were then charged with the task of flipping around in our little DSM IV books and finding numbered diagnoses to label her with. 296.33 was her winning label: Major Depressive Disorder, Recurrent, Moderate in severity with no psychosis. Really! No shit. Thats how I spent 2 hours of my afternoon in medical school. I miss and long for the days of old when I was being bled on, puked on, and spit at. (and no I am NOT talking about the delivery room! ) I miss the ER. Even when I was having my life threatened by some of the kindly denizens of Philadelphia, or being assailed with various bodily fluids, I at least knew why I was doing whatever it was I was doing. This mindless hoop-jumping is enough to drive me to drink some scotch and forget all this! (291.1 - Alcohol-Induced Persisting Amnestic Disorder)

Whatever Psychiatrists earn in a year it's not enough! Not only do they spend all day dealing with, well let's face it, crazy people; they are forced to play this ridiculous square-peg, round-hole diagnosis game with silly little rules. If other physicians had to do this, the whole practice of medicine would grind to a halt.

Saturday, July 7, 2007

Killer Cement Trucks loose on St. Maarten!

The picture on the left was posted by Paul Kyser with the title "Insert Your Own Darwin Joke".

I thought that was pretty funny and I dug out a picture that my daughter Meagan took about 2 weeks ago. This was right before we crashed into a rogue cement truck that was for some reason driving backwards at a very high rate of speed. Also, I didn't see it coming at all; it must have been going WAY to fast!

These cement trucks are very very dangerous and should be avoided at all costs!



DISCLAIMER : Although the pictures are real, I am KIDDING about crashing. (but I still believe those cement trucks are evil incarnate)

Friday, July 6, 2007

Quiet Friday

Today was a pretty quiet day, after taking a quiz in my ethics class I came home to get in a couple hours on studying Pathology, learning about the wonderful world of Lymphomas and Leukemias. It has taken a while to beat all the variants of each into my increasingly thickening skull. With our tests being 7 weeks apart, I have to try to stay on top of things. As is my luck, I am enjoying my ethics class more than any other I have taken in medical school but alas, it is only a week long.

Maybe because it is a diversion from my usual assault by science based courses, but I enjoy the debate and discussion about issues in medicine that don't have an answer based in flow cytometry or hemoglobin values. This is the first time when we have been expected to think about not only our role as future physicians but how the patient and society for that matter fit in to this dynamic that we will be working in for the rest of out careers. Our professor is very knowledgeable and is more of a conversationalist than a pedantic. She holds a position with The Catholic University of America but has maintained a secular tone in her treatment of the topics.

On the home front, Kathy's mom, Betsy came back to our lovely little island today to visit her latest grandchild. Both she and Kathy's dad were here for the week ending June 20th but, just like Meagan and Kaitlyn, left prior to Rileigh's arrival. She is pictured to the right holding Rileigh after bath time this evening.

I would like to offer a big Thank-You to all the members of the AUC Spouses' Organization for their wonderful support this week. As is tradition now, members take turn bringing new moms and their (starving to death husbands) meals for the first week. We have eaten very well and I can say to those who have been worried about my wasting away: crisis averted!

Good Cop, Baby Cop

Thanks to Jason and Mary I found this video at www.funnyordie.com. Will Farrell proves he can be the straight guy too. Go ahead try not to laugh. I guess someone really needs a nap!

Good Cop, Baby Cop

Wednesday, July 4, 2007

The Upside of Outsourcing!

Courtesy of the Onion : Finally a fiscally responsible solution to working parents' dilemma. I love little Kimberly's comments! Hysterical.

Happy Birthday America / Medical Moos

Happy birthday America, or as some like to call it, Northern Mexico.

It is definitely an eye-opening experience living in a foreign country. If you ever have the chance, I recommend it highly. Too often we as Americans are lulled into a mindset of patriotic zeitgeist where we assume that our way of doing everything is "the best" since we are "the greatest" country on the planet. One could make the argument that this arrogance and elitism is at the root of some of our foreign policy missteps but I digress... I don't want to turn this post into a political diatribe on the 4th of July. I'm not that patriotic.

I have however, seen too may examples of American tourist living up to their "ugly American" stereotype that much of the world holds about us. One quick word of advice and then I will step down from the soap box: when visiting a foreign country, RELAX and accept that, although things are different and admittedly at times frustrating, acting like a 3 year old whose ice cream was snatched out of his hands, stomping your feet, yelling, and other obnoxious behaviors will NOT ACTUALLY HELP YOU GET ANYWHERE. In fact in most cases, people will actually treat you like you behave: an idiot. In the great globalization of the planet, ideals such as customer service and 'time is money' have not yet pervaded the culture everywhere; especially here on SXM.[PREACH OFF]

Of course living in a different culture allows one to better appreciate how good we actually do have it. Creature comforts such as dependable electricity, running water, and oh.. I don't know... let's say... PAVED roads are a distant memory that makes me long for the good old U S of A.
Not everything has been bad however.

Dozens of people have asked me how I felt having a baby in a foreign country. I admit at first I was a little anxious about having a baby here. As a paramedic and an ER nurse I have had ample opportunity to deal with my share of sick neonates. I have a keen appreciation of the importance of a certain level of expertise as well as a certain amount of necessary technology required to do it well. At my first glance of the hospital on the French side there was little to substantiate the claims by everyone I spoke with that the French hospital was more modern and better equipped than the Dutch hospital here. As we drove into the complex we passed a small herd of cattle were lazily grazing. Hmm ,I thought, "We're not in Kansas anymore." (that and the curious lack of a creationist lobby here on the island..again with the digressions....)

My anxieties were soon allayed however when, in the exam room, I noticed that these backward, heathen, socialistic, and altogether French people use the same exact equipment that was in use at most of the hospitals that I have worked in. OK, fine they have the toys but do they know how to play?

This too proved to be worry over nothing. As a matter of fact I would go out on a limb and say that for the entire experience that it was not only comparable to a US hospital, in our case* it was superior. The entire delivery was handled by a nurse-midwife and I do mean the ENTIRE delivery. She was the only staff member (besides the anesthesiologist who administered the epidural) that we dealt with. She placed the IV, drew labs, hung and titrated her own medications, during the delivery make the episiotomy incision, and sutured it herself at the end(no pun intended hahahaha). A physician was only called when the baby's head was crowning (as back-up in case of a need arose for an emergent c-section) but the baby was delivered by the time he arrived. I was invited to participate in the peri-partum care: I got to help clean, bathe, dress, measure, weigh, and hang out during the entire process. The staff was wonderful and extremely helpful. So, based on my prior experience, and my being about 40% of a doctor now(yikes!), and what I witnessed here for myself, I would whole-heartedly recommend having a baby at the French hospital if you found yourself here.

This picture was taken while I was leaving the hospital for the evening and the cows were munching right next to the hospital entrance.


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* Thankfully we had no need of a NICU nor were there any complications that needed attending to. One could argue that a routine delivery, sans problems, can be effectively handled in a barn- and you'd be right.

Monday, July 2, 2007

For Audiophiles Only...Virtual Barbershop

The following is a very cool little audio clip that MUST BE LISTENED TO WITH HEADPHONES ON!!!

Do not bother if you aren't using headphones! It will not work even close to as well!

It is a cute little skit that demonstrates how we use our ears to echo-locate where sounds are coming from. It is very well done. I recommend closing your eyes to fully appreciate the effect.

Sunday, July 1, 2007

Mugging for the camera

As Professor Jodi Parr would say, "more gratuitous baby pictures"...

Left: Rileigh's first smile(smirk) caught on film

Right: Annie Liebovitz called and she said, "Don't quit your day job, Vince!"

Lacrimal Confessions

On the way home from the hospital last night I met up with the DiCarlos and Jersey Pete. I decided to go along with them to Bali Bar in Marigot where they were meeting up with Cyrus, Dan, Grace and her friend from the states Cindy. It was a load of fun and we had some great conversations. One of which is the inspiration for today's post.

Somehow we got to talking about movies that made us cry. Any of you that know me would probably not categorize me as the touchy-feely type that gets all mushy and weepy at a movie. Now for the most part you would be right. Perhaps I am getting a bit softer in my old age but there have been a select few movies that moved me to tears. The one that pops into my mind first is, I am Sam with Sean Penn Michele Pfeiffer and Dakota Fanning. Maybe it is because I am a father, or maybe it is due to the soft spot I have for the mentally retarded, but this movie reduced me to a blubbering, sobbing idiot. I have only seen the movie once but once was enough. As a matter of fact a few months ago I was in the bedroom studying and Kathy was flipping the channels and stopped on this movie. I heard a few lines of dialog and rushed out to ask, make that, DEMAND that she turn it off, lest I cry all over my Pathology book. My Achilles heel has been uncovered.

Other films mentioned last night included:
Field of Dreams
Braveheart
Saving Private Ryan
Rudy
Life is Beautiful
The Notebook


So I'll pose the same question to you: What movies made you cry? Post your answers below (you can post anonymously, if you don't want to be embarrassed) I am curious to see what makes other people cry.

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