2005-2006 Duluth Curling Club

Believe it or not, "Duluth Curling Club" is the name of this year's Fantasy Basketball Team. I'm co-owners with Steve Hauck AKA Da Professa of Cool. We managed to snare two of the game's big men in this year's draft, Tim Duncan and Shaquille O'Neal (who has his own lego figurine, shown on the left, although admittedly out-of-date in the Lakers uniform), so I'm excited about our chances.

The full line-up:
PG Baron Davis, GS Warriors--could be a steal in 3rd round, if he fully recovers from knee injury.
SG Quentin Richardson, NY Knicks--hoping that his 3-point production doesn't fall off too much with a change of teams.
SF Pau Gasol, Memphis Grizzlies--feisty Spaniard is team's best all-around player.
PF Tim Duncan, SA Spurs--our 1st round pick and Mr. Dependable.
C Shaquille O'Neal, Miami Heat--still the most dominant player in the game, in my opinion.

Bench:
C Carlos Boozer, Utah Jazz--another solid big man.
PG Chris Paul, New Orleans Hornets--first rookie chosen in draft, my pick for ROY.
SG Larry Hughes, Cleveland Cavs--may be a little optimistic, but some are saying could be Pippen to LeBron's Jordan this year...
SF Josh Howard, Dallas Mavs--a little raw, but came on strong towards end of last year.
PG Jason Williams, Miami Heat--just have a gut feeling that "White Chocolate" will thrive playing with Shaq & Wade.
SG Eddie Jones, Memphis Grizzlies--a veteran presence who hopefully still has something left in the tank.
SF Mike Miller, Memphis Grizzlies--how'd I end up 3 Memphis Grizzlies on my team? Always good for a couple of treys.

I'm Back

Unfortunately the Sleazy E persona didn't quite work out...the police confiscated my collection of illegal weapons and made fun of my homemade ninja stars. Besides, I wasn't really pulling in the serious bling as I had hoped. So I'm back to being mild-mannered Nate Hellman (picture on right) as usual.

I got some good news on my RT-PCR reaction last Friday...was able to convincingly show that fibronectin was upregulated and claudin-2 was downregulated in response to HGF-induced tubulogenesis, which helps validate my samples that I intend to use for my chip experiment. To make a long story short: I got some good data...

I did attend a Halloween party last night which was pretty fun...my costume was fairly lame...I just wore the silly glasses that are shown on the picture to the left. No fangs or blood though.

On the agenda for today: more grant writing (ugh!) but also plan on drafting my Fantasy Basketball team on espn.com. Results to follow!

Sleazy E's Halloween Costume Contest

Yo bruthaz,

I'm rakin' in the bling ever since I changed my life philosophee! This has allowed me to buy some sweet new nunchucks and ninja stars. Ain't nobody that's gonna mess with Sleazy E now.

I've also decided to conduct my very own Internet Halloween Costume Contest. The winner gets $1 million cash. The runners-up get $250,000 each and an autographed photograph of the king of sleaze, Sleazy E hisself. After hours of exhaustive research, the results are as follows:

Winner:






Dogs dressed as fast food items. Yo, I never said anything about the contest being restricted to humans. These dogs can split the $1 million and buy a bunch of chew toys or bones or shit, I don't care.





Runners Up:








Han Solo encased in carbonite.












I don't know who this dude is, but he's brilliant.








Most Disturbing Costume:






If this guy showed up at my door, I'd kick him in the nuts first and ask questions later.







Peace out, Sleazy E

The New Me

I've decided to take a departure from my career path as a physician-scientist.

Instead, I've decided that I'm all about the bling-bling and gold chains. My new hobbies are collecting nunchucks and illegal weapons. And my new favorite team is the NY Yankees.

For those of you who know me well, I know this may come as a bit of a shock to you. But deep down in my heart, it's what I've always wanted.

From now on instead of calling me Dr. Hellman, I will now be going by the name of "Sleazy E".

Catch you on the flip side!

Line Dance

Since I haven't put up too many pics of my lovely wife Claire Hellman nee Pecqueur I thought I'd throw in this lovely shot of Claire waiting in the unemployment line for a handout...

Actually, this is one of the many statues at the Franklin Delano Roosevelt Memorial in Washington, D.C. (which is actually quite nice) commemorating the Great Depression era. Claire's the one at the front of the line.

How 'bout them White Sox? Maybe we'll continue the trend of Teams That Haven't Won the World Series Since World War I Finally Getting One and the Cubbies can bring home the goods next year?

Star Wars Figure Convention

There's really no reason for the image of Star Wars figures except that I thought it was a funny that somebody lined them all up to be photographed.

I was a big fan of Star Wars figures when I was younger & I think I had pretty much all of the ones shown here at some point. Unfortunately, my own Star Wars figures took quite a beating over the years (I seem to remember playing a type of "hide and seek" game when we were younger which consisted of divvying up the Star Wars figures into two different teams, then hiding them in various nooks and crannies of our yard for the other team to find, and this sometimes included burying them in my mom's garden) and therefore are probably not worth anything anymore.

The crown jewel of my collection was the Rancor:



Not much else going on today.

I'm working on a kick-ass RT-PCR reaction in lab (although whether or not it deserves the label "kick-ass" remains to be seen).

I've also been tinkering around on my crap-pile excuse for a homepage a little bit, having updated some of the information & also included a new resume. You know, in case there are any job openings out there with my unique qualifications (namely, reading comic books and testing out new ideas for breakfast cereals).

Watta game!

What a great game to get to see in person! Yesterday's 20-17 Eagles' victory over the San Diego Chargers will certainly be memorable for me. I will admit that Philly kinda lucked out--don't get me wrong, the blocked field goal was inspired--but the ball bouncing up conveniently into the waiting arms of special teamer Matt Ware was pretty damn fortuitous.

And to top things off I even got to witness firsthand the latest of Terrell Owens' notorious end-zone celebrations after he scored the Eagles' lone offensive TD of the day. I could only find one AP photo of the celebration, which is shown on the right. After scoring, T.O. untucked his little towel and then draped it across his left forearm. He then carried the ball with his opposite hand, as if he is impersonating a waiter, as shown below in the cartoon:

I'm not sure why he decided on this for his celebration...perhaps symbolic of his "serving up" one of his patented touchdown celebrations? I certainly don't rank it up there with his Sharpie football signing TD celebration, or the cheerleader with pom-poms celebration, both of which were brilliant. However you have to admit that it's original...

Guess what just fell into my lap?

A Halloween costume of the little-publicized Crest toothpaste mascot?

An autograph from J. Edgar Hoover?

Perhaps a giant watermelon shaped liked a Viking explorer?

Hell, no! A ticket to see the Philadelphia Eagles-San Diego Chargers!

It's true...may main man Mike Shashaty hooked me up with an extra ticket that came into his possession. I shall not ask if he acquired it through legal means, such is my desire to watch this game today...

I've been to see games of the Philadelphia Phillies (baseball) several times, 3 different Sixers games (basketball), and even once to the Flyers (hockey). This will be my first Eagles game, and the first professional football regular season game I've been to since Bryan Johnson's dad brought me (and Bryan Johnson too, of course) to watch the Minnesota Vikings play the then-Houston Oilers & Warren Moon.

By the way, our raclette party was a definite success, and we managed to polish off over $20 in cheese. Mmmmm, cheesy goodness!

I'm crackers about cheese!

It's been a busy coupla days...would you believe that I was workin' in the lab 'til 2 in the friggin' am last Thursday night? Fortunately I have the rest of the weekend to relax.

And on the agenda for Saturday night is our first raclette party! Our friend Gael bought us a raclette maker for our wedding present & we're going to try it out for the first time tonight. For those of you who are not familiar with raclette, it's a meal (most websites report it to be off Swiss origin, although my wife assures me that it is also considered a major part of French culture as well) prepared by placing sheets of raclette cheese on a little pan and inserting them into a specialized oven (as shown in the picture). Once it has melted, you pour the cheesy goodness over potatoes and different types of yummy ham.

By the way, it was a tough call deciding what the link for "cheesy goodness" was going to be. I almost had to go with this.

Finally, for our news item of the day, check out this piece from cnn.com entitled, "Cunning Rat Outsmarts Scientists". If this research can get funded...

The Greatest Thing Since Sliced Bread

Ever wondere'd where the expression, "greatest thing since sliced bread" came from? Me neither. But I met somebody from a small town called Chillicothe, Missouri, which claims to be the home of sliced bread. I looked it up on the web and it seems hold water. What does this expression mean, exactly, though? I ve heard it used with both sarcasm as well as with a genuine sense of wonderment. It's put very succinctly in the following passage I swiped from some other dude's blog:

"I'm really hoping somebody can clear up some confusion I'm having. We've all heard the expression, "The best thing since sliced bread." For example, "This new inside the egg scrambler is so convenient... why, it's the best thing since sliced bread!" It's usually used to express something's greatness, the potential impact it will have in our lives and so on.But does the expression mean that:

1) the creation of sliced bread marks a point in time, and this is the best thing to come along in the time since bread was first sliced? Bread has been sliced for a long time, I think, so the expression essentially says, "This inside the egg scrambler is the best invention since the dawn of man." OR
2) the new invention has utility which is greater than that of sliced bread, that is to say, it's more useful than sliced bread.

The more I consider it, though, I'm inclined to think that the invention of sliced bread was not a good development: has anybody ever really thought about the value of low quality bread that comes already sliced versus the value of high quality bread that you have to cut yourself?I'll take the high quality bread any day. And I'll never use that expression again. It is either a gross exaggeration or an endorsement of low quality bread."

More information about sliced bread can also be found here. Just goes to show ya...keep your ears open, and you can learn something new every day.

Not much goin' on today...I actually slipped home from the lab this afternoon in order to eat lunch, read comics, and generally chill out before going back in...I am scheduled to put in a very late night in the laboratory, but because the experiment is a timed one I can't really start working until about 5pm or so...I'll probably be there 'til the wee hours of the morn, but fortunately I have the weekend off to catch up on sleep...



In other news, I've always been a bit of a sports fan...but this is friggin' ridiculous!

NBA 2005-2006 Predictions

There's an autumn chill in the air, NBA commish David Stern has already been accused of racism (for his travesty of a dress code), and there is hope anew from the defending champ Spurs all the way down to the perennial doormat Clippers...is there any doubt that the NBA season is just around the corner??

I present here my picks for the upcoming NBA 2005-2006 season, which I can guarantee are of Nostradamean accuracy. The NBA is generally somewhat more predictable than baseball or football in that the great teams tend to stay the same from year to year, though there are always a couple of nice suprises every season (e.g. last year's Phoenix Suns, Washington Wizards, Seattle Sonics, and MVP Steve Nash, to be sure).

This year look for the Houston Rockets, Sacramento Kings, and Indiana Pacers to make significant improvements over last year. It's also time for LeBron to have a bust-out season and win the first of potentially several MVP awards. Rookie of the Year will go to Chris Paul of the New Orleans Hornets--they don't have too many other options so he will be showcased in their offense. Miami will of course be impressive with their many off-season pickups, but I foresee the team effort in Indianapolis & the return of lunatic Ron Artest (who my Dad assures me seems like a nice enough guy, as he works out at the same Jewish community center gym as him) the triumph in the playoffs. In the end, however, it's hard to argue against the SA Spurs, as they have even improved their lineup from last year's championship effort...

Here's the predictions in fuller detail, with the help of an Afro'ed Allen Iverson (overall conference finish in parentheses; * indicates playoff team):
Atlantic:
NJ Nets (5)*
Philadelphia 76ers (6)*
NY Knicks (7)*
Boston Celtics
Toronto Raptors

Central:
Indiana Pacers (2)*
Detroit Pistons (3)*
Cleveland Cavs (4)*
Milwaukee Bucks (8)
Chicago Bulls

Southeast
Miami Heat (1)*
Orlando Magic
Washington Wizards
Charlotte Bobcats
Atlanta Hawks

WEST
Southwest:
San Antonio Spurs (1)*
Houston Rockets (2) *
Dallas Mavs (5)*
Memphis Grizzlies
New Orleans Hornets

Northwest:
Denver Nuggets (3)*
Seattle Sonics (8)*
Minnesota Timberwolves
Portland Trailblazers
Utah Jazz

Pacific:
Sacramento Kings (4)*
Phoenix Suns (6)*
LA Lakers (7)*
GS Warriors
LA Clippers

PLAYOFFS
East
Round 1
Miami Heat (1) def Milwaukee Bucks (8) 4-0
Indiana Pacers (2) def NY Knicks (7) 4-1
Detroit Pistons (3) def Philadelphia 76ers (6) 4-2
Cleveland Cavs (4) def NJ Nets (5) 4-2

Round 2
Miami Heat (1) def Cleveland Cavs (4) 4-3
Indiana Pacers (2) def Detroit Pistons (3) 4-3
Round 3
Indiana Pacers (2) def Miami Heat (1) 4-2

West
Round 1
SA Spurs (1) def Seattle Sonics (8) 4-0
Houston Rockets (2) def LA Lakers (7) 4-1
Denver Nuggets (3) def Phoenix Suns (6) 4-2
Dallas Mavs (5) def Sacramento Kings (4) 4-3

Round 2
SA Spurs (1) def Dallas Mavs (4) 4-1
Houston Rockets (2) def Denver Nuggets (3) 4-3

Round 3
SA Spurs (1) def Houston Rockets (2) 4-2

NBA FINALS
SA Spurs (1) def Indiana Pacers (2) 4-3

ALL NBA 1st TEAM:
G LeBron James
G Kobe Bryant
F Kevin Garnett
F Tim Duncan
C Shaquille O’Neil

ALL NBA 2nd TEAM:
G Tracy McGrady
G Allen Iverson
F Dwyane Wade
F Dirk Nowitzki
C Yao Ming

funny

Just got back from seeing the new Wallace & Gromit movie...

In short....hilarious! Go see this "veritable vegetable paradise." I challenge you to tell me that it's not funny. It was the perfect pick-me-up after a crappy day in lab which mostly consisted of me failing to isolate RNA.

We'll try the RNA thing again tomorrow...

Back to the Lab

Hey, it's a pretty sweet deal, but for about a few weeks every year they unshackle me from the hospital and let me screw around in the lab for a bit. Since I have a PhD as well as an MD, I know my way around the lab and have made some reasonable progress over the past 2 years. Anyways, I just started working in the lab again and will be happily pipetting for the next 2-3 weeks. I'm working in the lab of Josh Lipschutz and my research involves (in a very broad sense) how kidneys develop.

Specifically, my project is using kidney cells (MDCK cells) which when grown in a dish full of collagen they form these cool spherical cysts which are hollow. When you stimulate the cells with a growth factor (HGF), they start shooting out all these tubules--extensions made up of multiple cells. It's thought that this process is analagous to the way in which kidney development occurs in real life.

Our goal is to understand which molecules are responsible for the tubules forming. To this end, I'm going to use gene chip technology. This is pretty cool--companies have developed a small chip upon which tens of thousands of cDNAs are attached. There's a picture of how small this thingamajig is. The powerful thing about the technology is that you can look at a HUGE number of genes all at the same time.

Should be fun! The experiment is scheduled for this Thursday...

A salute to the Cap'n

First off, thanks for the comments on my recent cereal posting, including an astute question from Steve "Rock Hound" Hauck regarding any specific mental issues that might be possessed by Cap'n Crunch (which happens to be my favorite cereal of all time, even despite the fact that it makes your mouth raw due to the extremely abrasive physical properties the cereal has).

Apart from perhaps having a touch of senile dementia, the Cap'n seems like a pretty healthy guy overall.

The history of the Cap'n (whose full name is Horatio Magellan Crunch, jr.) is nicely detailed in this piece I found recently...

To summarize: Cap'n Crunch cereal was invented in 1962 by Quaker Oats in response to marketing data which indicated that children specifically wanted a sweet cereal that would stay crunchy in milk. The character of the Cap'n was actually created by some of the same folks who did the "Rocky and Bullwinkle" show. The website describes in detail the excellent adventures experienced by the Cap'n and his crew (which includes his dog, 4 kids, and various mythological animals including the Crunchbery Beast) as they sailed the seas in their great vessell, the SS Guppy, transporting cereal. I can't really assign any specific mental illness to the Cap'n but it's certainly true that his adventures are sufficially bizarre and zany that the entire marketing campaign may well be one freaky LSD trip...

My theory on cereal mascots

My theory on cereal mascots: they're friggin' NUTS! Psycho! Insane in the membrane, so to speak...

Although there are certain some wholesome, upstanding citizens out there (e.g. Tony the Tiger), the vast majority of birds, leprechauns, rodents, and other members of the animal kingdom who have become cereal spokesman have some serious psychopathology going on. In most cases, their various illnesses have mellowed to some degree since the late 70s/early80s (my childhood), which I suppose we can attribute to the dramatic strides we have made in the development of antidepressants (e.g. Prozac) over the past few years.

Examples, you say? Let's start with the obvious, that bird who hawks Cocoa Puffs. For whatever reason it seems like he's been banned from eating Cocoa Puffs...so he must spend his life in a desparate search for a Cocoa Puffs fix. When a spoonful of the Cocoa Puffs finally enters his mouth, the dude just FREAKS OUT. It appears as if he's having some serious hard-core hallucinations. He's clearly a drug addict, and it's clear why he's been banned in the first place.

The Trix Rabbit is somewhat similar to the Cocoa Puffs bird in that he is restricted to the cereal of his dreams, yet he still spends most of his life hoping to pilfer some Trix. The key difference is that "Trix is for kids"--why General Mills felt it appropriate to make the cereal expressly forbidden to adults is not entirely clear--and the Trix Rabbit (who is presumably an adult rabbit) is constantly foiled by a band of children seeking to protect their Trix. The rabbit is a tragic figure--he yearns to have his youth back (which was likely scarring and inadequate due to being denied Trix as a child) and yet his attempts to get it back inevitably end in failure (unike the Cocoa Puffs bird, the Trix Rabbit is never allowed to actually eat the cereal). At the end of each commericial, the rabbit slips into a deep depression.

And how about that Lucky the Leprechaun, who labors under the unhealthy delusion that people are always after his Lucky Charms? If that's not a clear indication of paranod schizophrenia, I don't know what is.

Even some of the cereals which don't have mascots will occasionally have evidence of psychopathology. Take for instance the "Gotta Have My Pops" campaign for Kellogg's Corn Pops several years ago...the show depicts young men and women who look like they're about to strangle their parents with piano wire when they are led to believe that the last Corn Pop has been eaten by somebody else...fortunately a bloody catastrophe is averted when somebody whips out an extra box and the spectre of a violent crime of passion is averted. And they say that marijuana is a "gateway drug"....according to their commercial, it's CORN POPS!

So there it is. My theory on cereal mascots.

During my "research" for this article (which took a good 5-10 minutes, I can assure you) I came across this excellent study of the history of cereal mascots focusing on the so-called "Monster Cereals" (e.g., Count Chocula). That's it for tody, folks!

I Tunes

So I discovered the "I-Tunes" online store today...potentially very dangerous! I spent the better part of this evening browsing through the "Billboard Top 100" over the past 15-20 years and reminiscing about the great songs of yesteryear...

Here's the songs I downloaded today:
Starship Trooper (Yes)
Train In The Distance (Paul Simon)
Ballad of Dorothy Parker (Prince)
Lovely Day (Bill Withers)
You Keep Me Hangin' On (Kim Wilde)

Make fun of me if you wish for my musical tastes...at least I haven't posted stupid photos of myself with nothing but a small blue towel and a bottle of "Yes" shaving cream like this poor schmuck.

Help! The wedding cake is on fire!

A cool photo of our flaming wedding cake (called the "piece montee" in French, which I guess is their traditional wedding cake). The sparklers are certainly good for a dramatic entrance. One of my goals for the weekend is to scan in some of the wedding photos and get started on putting these photos up online.

So I finally gave my presentation on Jehova's Witnesses & bloodless surgery...so no more comments on the history of this fascinating religion and their interesting system of beliefs, I promise...

A good week for comics this week (a new batch hits the stands each Wednesday...when I was a kid it was every Thursday, and for whatever reason with the change of days I always feel a little giddy when I get a chance to pick out my comics "one day early"!) This ish of "Y the Last Man" is particularly good...I think this would actually make a pretty good movie or TV show someday, if they did a good job of selecting out the good parts..

Bloodless Part II

So I was up 'til the wee hours of the morning preparing my talk on Bloodless Medicine & Surgery and the Perioperative Care of Jehovah's Witnesses. I couldn't help but feel astounded by the interesting history of this religious organization. Here's some "did-you-know?" factoids on JW's...keep in mind that this is simply based on a night's worth of Internet-based research by a non-expert, so hopefully I'm not oversimplifying or getting anything terribly wrong...

DID YOU KNOW...

...that Jehovah's Witnesses will not vote, pledge allegiance to any nation's flag, or serve in any nation's military? They view their allegiance to Jehovah, rather than to any nation.

...many Jehovah's Witnesses believe that Jesus returned in a spiritual form which we cannot recognize sometime around 1914, although this date nonetheless remains a controversial one.

...although most Jehovah's Witnesses will reject transfusions of whole blood, packed red blood cells, platelets, or FFP, many experts consider bone marrow transplant (often the only cure for some forms of leukemia) acceptable?

...an anonymous organization within the Jehovah's Witnesses religion entitled AJWRB (Associated Jehovah’s Witnesses for Reform on Blood) was formed in 1996 in which members are attempting to change the religion's official stance on making blood transfusions forbidden? The reason it's anonymous is presumably because members fear ostracization or excommunication from their religion should they make these opinions more publicly known.

Bloodless

Since I am on the Med Consult service, I have to give resident report this upcoming Wednesday (in two days...yikes! Better get workin'!)

I've decided to do a case report/presentation on a patient who was a 37 year-old female Jehova's Witness who needed to have a total knee replacement performed due to severe pain from osteoarthritis in her right knee. The care of such patients brings up some interesting medical & ethical issues since one of the core teachings of this religion is the refusal of transfused blood products. Previously, a lot of surgeons would refuse to perform procedures on such patients due to the lack of an ability to transfuse patients packed red blood cells should the procedure go awry. Now there is a movement towards offering surgery to Jehova's Witnesses--most physicians have come to realize that they cannot ethically withhold a treatment which could be beneficial for a patient, and furthermore there have been several advances in the field of "Bloodless Medicine", which is what I intend to explore in my presenation.

There are lots of options, including the injection of erythropoietin (a substance which can stimulate the body to produce more red blood cells), the use of intra-operative technologies such as cell savers (machines which "save" an individual's red blood cells as they are shed during surgery), and even specialized centers around the country which are devoted to the idea of bloodless medicine--we have one in the Hospital of University of Pennyslvania System...

Regarding the theories of Jehova's Witnesses...why do they refuse blood? I can't pretend to be an expert by any stretch of the imagination, but there is a pretty useful explanation that can be found via the Jehova's Witnesses official web site.

BTW...my own personal opinion is that there is no rational reason to refuse blood transfusions, particularly in life-threatening situations in which blood transfusion may make the difference between life & death...however we're all adults here and if somebody's religious beliefs are that strong, who am I to force a treatment on them?

Enough procrastinatin'...time to start preparing for this talk! PEACE OUT.

The Hunchbacks of Notre Dame

That's right, hunchbacks (PLURAL).

My buddy Jason Medeiros just sent me these photo gems from his recent trip to Paris (en route to my wedding, of course). Jason, my best man Nir Modiano, and my sister Susie Hellman were visiting Notre Dame and got a little carried away with their Quasimodo impressions.

As if the French didn't have a low enough opinion of Americans as it is...

The Brain That Wouldn't Die

Fun with Photoshop a la last year's XMas card, which I'm already starting to think about.

Maybe a French theme since I will be moving there soon? Or perhaps save that for next year? Perhaps a wedding theme? Or maybe I will forget the XMas card and simply send out gift certificates for E-Harmony.com.

Last weekend I bought a shitload of wood and spent a good portion of the morning hauling it up several flights of stairs. I'm hoping that using our fireplace frequently will cut down on our horrific gas bill from last winter and also create a delightful ambience in our little Philadelphia apartment.

I'm off to Washington DC this morning for my sister's baby shower, which I'm certain is going to kick ass!

My parents' dog ZEUS (king of the Samoyeds) is also scheduled to make an appearance, and I will be certain to take pictures and post them on the blog soon!

My 2 Cents (on the AL MVP race)

By the way, my opinion on who should win the AL MVP is strong:

A-Rod over Big Papi all the way.




Should it even *be* a consideration to give the MVP to a DH?

I don't have anything else interesting to say for today.

The mysteries of chest pain

So I'm having a busy and I'm *literally* in the process of walking out the door at about 9:30 am--I have to travel to a different hospital in order to run a teaching conference--when my Med Consult pager goes off. Nuts!

It's the Detox floor (where patients who want to stop taking cocaine, alcohol, etc. go for a spell in an attempt to stop using) calling, they want to me to see a woman there who just started having excruciating chest pain about 10 minutes ago. Crap. There goes the teaching conference. I page my chief & update him on the situation. He'll run it in my place.

I hurry up there, they're already giving her some nitroglycerin tablets, she's pretty agitated and crying out in pain--we slap some electrodes on her--all of this is pretty routine stuff. The EKG comes back: she has ST-elevations in her inferior leads. Holy magnarolie! This could be serious...that's a baaaaad sign for the EKG. At this point I don't have access to her old records yet for reasons I won't get into. I call the cardiologist on call and give him the scoop. "Sounds like she needs to go to the CCU right away!" he said, "I'll activate the cath lab!"

"Okie dokie," says me, "her name is XXX XXXX" (obviously I can't give the real name out).

"XXX XXXX?!?" says the Cardiologist, "Forget everything I just said...she's come in to our hospital a million times with bogus chest pain...I can give you a 100% guarantee that she isn't having a heart attack...don't send her to the CCU, she'll just be wasting a bed for somebody who needs it."

Point of the story? There are two, I guess: (1) the interpersonal relationships (e.g. between the cardiologist and the patient) are so key in determining the patient's plan of care...if she had happened to be at another hospital for Detox, she could very well have ended up having some invasive procedure done to her...which according to the data we have now probably would have been an unnessary risk to her health (once I had full access to her files, I found an old EKG which demonstrated the exact same ST elevations--suggesting that nothing NEW was going on in her heart).

And (2), why are all these people out there having chest pain? It's *very* often not related whatsoever to heart problems (although it certainly can be a warning sign of a very serious heart problem if the story fits). We have some alternative explanations in medicine (e.g. gastroesophageal reflux, panic attacks, costochondritis, etc)...but also in my experience thus far I am left without a real convincing explanation for their chest pain. I guess since I've never had any kind of chest pain myself, I find it a little odd that there are all these people out there walking around with chest pain...

General weirdness

One of the truly surreal moments on our honeymoon was visiting the modern exhibit at the chateau at Chambord--easily the most impressive of the chateaus we visited on our trip (there is a small picture below). The chateau itself was a little different than the others in that it was built from scratch to be simply a sumptuous palace--that is, it wasn't built to be the center of a city, it was never a fortress--it's really in the middle of nowhere. The King (Francois I) wanted to create the most impressive chateau as a monument to his reign.

Anyway, it's huge, and dramatic...and there are more rooms than they know what to do with. There's a huge portion of the castle that is in fact blocked off--I'm not sure what's in there. But there is also a section which uses the great open space of the castle as a showcase for modern art. A lot of it (like the piece of bizarro art shown on the left) deals with hunting and nature, as one of the reasons this site was chosen for Chambord is its proximity to good hunting areas, for which Francois had a great passion. It's pretty strange to see some of this very modern art in the context of a very old castle (much older than anything in the U.S., anyways).

I posted more pictures of our honeymoon on Snapfish.com. Contact me at nathanhellman@yahoo.com if you would like to see them but can't figure out how...

Although it's a bummer to back at work after essentially one month of vacation/elective, I'm enjoying the start of my current rotation. I'm the "Medicine Consult" resident for two weeks--basically, when patients are on a different service (e.g., Surgery, Orthopedics, Podiatry, etc.) and they need to have the opinion of somebody from Internal Medicine they call on me. Should be fun!

I have returned!

In the immortal words of General Douglas MacArthur: I have returned.

My computer viruses have been vanquished and I stand triumphant after what was once a seemingly hopeless situation.

I shall begin posting my wedding/honeymoon photos shortly.

Great Eagles game today! I was watching it while simultaneously doing my thank you notes (actually, "merci beaucoup" notes) earlier this afternoon.