DNGILB: Trust me, I'm a doctor.

When most people ride in an ambulance, its not a pleasant experience... as they are most likely severely injured or suffering from a heart attack or some other major health event. Possibly fighting for their very lives. Fortunately for me, my ride was a pleasant one. My opportunity came as a required part of my ER rotation. Gas pedal pressed down. Way down. We just got a call over the radio. An hour of boredom now broken. Now, lights and sirens. Blazing a trail thru traffic in a top heavy truck at 60+ mph definitely has a certain excitement. The struts on ambulances were not designed for their purpose, every pot hole is it’s own adventure... and trauma. I reminisced about being a small boy and watching shows with car chase scenes and dreaming about driving like that, or being a hero racing to someone's aid. While I enjoyed it, it wasn't a big enough rush to make me want to change careers, but it still appealed to the adventure seeking boy in me. The calls we responded to ra

On the interview trail, you travel by yourself. For anyone who hasn't traveled by themselves, its a different experience. Its not like being at home alone all day. Yes, at home alone you are in a companionship vacuum, void of all interpersonal contacts, but you're not "in" the world. When you travel by yourself, you are out "in" the world. Your around thousands of people, yet no knows you, you likely won't ever see any of them again... it feels so different. Right now I'm in a coffee shop. I've spent hundreds of hours in coffee shops in Oklahoma, but never have I felt so separated from the other "strangers" in the shop. It feels different. Maybe I feel invisible, or inconsequential. I could do or say just about anything without worrying about ever seeing these people again. Another unique thing about traveling by yourself is time, quiet time, with God. I take with me a stimulating book on Christian thought. CS Lewis's "The Prob

Okay, this is wierd. We had an elderly patient in the ICU with this history. The husband who is wheelchair bound heard his wife yell from the kitchen, then he heard a loud crash... then nothing. He knew it was something bad, so he began trying to wheel himself into the kitchen... he's weak enough that this took a great deal of time, greater than 5 minutes. By the time he got there, he saw his beloved wife laying across the ground with her shirt pulled up in front... her hands and face appeared blueish, and she felt cold to his touch. Strewn about the floor were the usual things they keep on their counter. The despirate man attempted CPR for several minutes, but knew if he didn't get EMSA there it would be of no use. He called 911. By the time EMSA arrived it had been at least 15 minutes that she had been down. EMSA got her heart beat back, and intubated her and were breathing for her. She ended up spending three days in the ICU... she was brain dead. Her heart was strong and s

They say a man's body decreases in mass by 21 grams when he dies... "proof" the soul exists... "proof" it departs when he dies. Tonight, I witnessed something new. The soul leaving the body. A man coded on the floor and we were called to respond. ET tube slides down past his vocal cords. CPR resumes. Epi and atropine given, we got him back! Robbing him from the grave, but for a moment in time. Initially, he seemed to have only brainstem reflexes intact. He would not respond. Pupils fixed and dilated. Blood pressure dropped. Dopamine was started. Family, now, gathered 'round the bed. Pressures too low, dopamine was titrated hoping to sustain a pulse. As pressures improved, he began to move. Then, from nowhere... OPENED his eyes! Looking around, but agitated now! moving extremities... thrashing! Panic stricken! Fear in his eyes. He tries to get out of bed... then, suddenly... collapsing back, peace overcoming him. His heart rate dwindled, pressures dropped and

Well, its been a while since I've written... busy busy busy... but tonight's call has given me moments of free time to relax, including a trip to starbuck's across the street, and with such beautiful weather, I'm so lucky. Now I sit, under flickering flourescents, listening to the shoegaze drone of "Bethany Curve" every bit as relaxing as a nice dose of zolpidem. what shall I muse on tonight? I've been thinking alot on mid-life crises. Who has them?  I think I'm the sort that would have one. Even at 27, I still find myself wondering, "Is this what I want my life to be like?" I don't envision a life full of work, with only moments of fellowship. This will be temporary. I am applying for ophthalmology again, though with less enthusiasm. In part, because no matter how much I struggle for something, the only way it will happen is if God's will includes it. Isn't that right? I struggled hard for ophtho once, and I didn't get i

Just a little pic from on top of Mt. Evans. If you've never made the drive, its quite scary. There were spots on the road where it turned real sharp, and since there are no barriers, it looks like you're going to drive off the side of the mountain, plumiting to your death. It wasn't as scary when you have your hands on the wheel... but for the passenger, Vanessa, it wasn't a very comforting trip. It reminded me of when my family took vacations to colorado, and my dad would freak all of us out as we drove up tretcherous roads in our big van. This feeling of safety when in control, is what drives alot of us to hold back things from God. But who better to be in control of our lives than someone who is both omnipotent and omniscient and always loving. Dngilb MD

I just got back from camping on Guanella Pass in Colorado. very beautiful... but what I am writing about is my observation that while camping I felt very vulnerable... helpless... at the mercy of mother nature. The campsite that we had was completely isolated... not another person for miles. I could be mauled by a bear, and if my girlfriend was able to escape... she'd have to rescue the car keys from the jaws of the bear in order to go and get help... by then, i'm sure i'd be dead. I felt kind of guilty, like I should believe in the goodness of nature, or the protective hand of God, and that I should be able to just relax and enjoy the experience of isolation in nature. I did to some extent, but I continued to have in the back of my mind the story of my friend Eric having a bear right next to his head while sleeping, and having to just lay there, hoping the bear would leave him alone. The bear did leave him alone... and I experienced no bears, no mountain lions, not

Medical school prepares you for being a doctor by teaching you separate elements of knowledge needed to function within the medical community. Pharmacology, physiology, pathophysiology, anatomy... a language and a theoretical frame of reference to "be a doctor." The people skills needed to function as a doctor are developed during your intern year and residency. Well, my first day of actual work with an MD behind my name was a baptism by fire. The first day: Dr. Weisz was my attending and before we go into a see this patient he says, "We got a CT scan on this lady yesterday and it turns out she has cancer which has already spread to her spine. You are her doctor and you get to tell her that she has cancer." Are you kidding me??? I think. No, he wasn't kidding. We sit down for several minutes before going into the room and he kind of runs me through the technique of telling someone a grave diagnosis like this... then we head off to the room. I do it... she does

ADD and STDs So I don't really think I have ADD, but I think if you have a continuum with ADD on one side, and SuperFocus Powers on the other end, I'd end up on the ADD half somewhere, but not too close to the end. In fact, I made it through medical school with out needing medication, and made some good grades. But there are times in medical school where some inattention really hurts (and I do mean "hurts"). 1. STD clinic: Due to inattention to details, I screwed up a urethral swab on this innocent 19 year old who had sex for the first time. Since I screwed up the swab (throwing it away) I had to swab him again... AND evidently swabbing the urethra for a 2nd time in a day is much more painful than the first. But to compound the problem... I, in another fit of ADD, failed to pay attention to what culture tube I grabbed from the drawer. It was a pink tube for "women"... Now, I swear to this day that the two tubes contain the same solution... but I couldn't

Why blog? ---- Who on earth is ever going to read this? Probably nobody... possibly my girlfriend... possibly one of my guy friends? Why blog? ---- If nobody is going to read this... why am i writing? Why did I write an entire entry, only to delete it, because I was self-conscious that someone would think critically of what I had written? Maybe someone will read this one day...I actually signed up to blog because my friend Sam blogs One day I stumbled onto his site, and wondered... Why? why does he blog? He's got tons of friends... I used to think bloggers were people who only had friends online... some sad fat sap sitting at home on his/her computer because they were bullied too much in middle and high school to have real friends... maybe some agoraphobic who can't go out... maybe some neutropenic cancer patient who can't have the risk of being out among us germ laden folk... but not Sam. He doesn't need to blog. Maybe people blog, because everyone wants to be h