Monday, March 31, 2008

Family Photos

Photo of my 2 favorite nephews: Henry & James O'Malley, the newest additions to the Chicago Cubs fan club.
Sophie close-up.
Playing with mom's scarf.
I switch hospitals tomorrow! I've finished up my time at the Mass General Hospital until July--for the next few months I'll be back at the Brigham & Women's Hospital. Best part of this transition is that I'm now within biking distance...

Sunday, March 30, 2008

Sunday at the Fells

Great weekend. Cold but sunny. We are continuing our exploration of the Boston area and today drove north to hike (with our friend Heidi) the Middlesex Fells. It's only about a half-hour drive from Boston and it felt reasonably secluded. Here are some pictures from today's outing.

Congrats to Rick Hellman, who is leading the annual Hellman March Madness Pool. Rick had the highly uncreative but effective strategy of picking all #1 seeds to get into the Final Four. Way to go, Rick. I think I might make a rule against this next year...

Friday, March 28, 2008

Escape from the Ether Dome

I admit to being a sucker for history and tradition. Probably one of the reasons I decided to do my renal fellowship at Massachusetts General Hospital (MGH) in the first place despite the fact that I get paid peanuts and Boston is a damned expensive city--the hospital has a long and illustrious history of important medical discoveries.

To illustrate this, there's a small museum, open to the public, in the original MGH building which is called the "Ether Dome." It was the site of the first public demonstration of ether as a successful anesthetic, in 1846. Anyways, I found a few spare moments in my day and took a stroll through the Ether Dome for the first time. A few pictures.

Painting commemorating the first use of ether. What a wonderfully sterile operating room...
Where the surgeons can enjoy the show.

The Ether Dome is also home to two Egyptian mummies. I'm off for the weekend!

Tuesday, March 25, 2008

Boston versus Philadelphia

Boston versus Philadelphia. Quakers versus Celtics. My old city versus my new city.

Such were the makings of yesterday's NBA contest between the Boston Celtics and Philadelphia 76ers, to which I had procured tickets (along with several of my friends). Though the matchup pitted the powerful Celtics (thus far the top record in the league and coming off an impressive Texas road trip) against the Philadelphia 76ers (who, despite having achieved a much better record than anybody thought possible, are nonetheless in sixth place in the lowly Eastern Conference), it was surprisingly the Philadelphia 76ers who came out on top! The game brought my attention to athletic forward Andre Iguodala, who had several spectacular steals & dunks in the 4th quarter which sealed Boston's fate.

And I think we figured out that Sophie is probably a Philadelphia 76ers fan, as she became visibly excited and happy during the Sixers 19-0 run towards the end.

Sunday, March 23, 2008

Braafladt Gifts

What a great surprise in the mail arrived yesterday: some gifts from my former high school English teacher & school newspaper adviser, Carl Braafladt! Gift #1: a vintage 1952 Citroen 2CV car, complete with a mustachioed Braafladt peeking out the window.
Gift #2 (for Sophie): a very nice & very colorful quilt which she likes to hide underneath.

video

Saturday, March 22, 2008

Funny Medical Terms

On-call this weekend. Spending altogether too much in the hospital, I am struck by some funny medical terms which are frequently bandied about and, frighteningly, have become a normal part of my vocabulary (while in the hospital, at least). Some of my favorites:

1. "bathroom privileges." Nurses will often record the volume of urine from a patient that is hospitalized and this number is recorded in a chart. It's often necessary for the kidney patients that I see. For patients who are exempt from having their urine recorded, on their charts they will get the coveted acronym "BRP" which stands for "bathroom privileges." Yes, going to the bathroom is a PRIVILEGE, not a RIGHT, when you are a patient in the hospital.

2. "foul-smelling". Often you will hear this as an adjective describing some bodily fluid...e.g., "the patient presented with a foul-smelling ulcer." In my opinion this is pretty harsh--you don't have to rub it in, we get the picture--it smells bad!

3. "bleeding like stink". When a patient is having profound blood loss--e.g., from their G.I. tract, for instance--they are often to be said to be "bleeding like stink." Why stink? This has never made sense to me, and yet I use the phrase from time to time myself.

4. "code brown." One of my personal faves. All hospitals have a system of overhead pages. At our hospital, for instance, a "Code Blue" is a medical code (e.g., somebody stops breathing) and a "Code Pink" is when there is a baby missing from the nursery. A "Code Brown" is a fictitious but universally-understood code for when a patient drops a large #2 in his or her bed.

Thursday, March 20, 2008

Fun at Daycare

Sophie enjoys her Day Care--here's some pictures taken of her group during a recent singing and dancing session. She's the youngest of the bunch!

March Madness is upon us. My Final Four picks for this year (in our family's annual pool): (1) UCLA, (1) Kansas, (3) Stanford, and (7) Butler. I admit the last one is a stretch, but I always take at least one chance (where's the fun in predicting all four #1 seeds making it?), they've got a good team this year, and it's where my mom had taught Spanish up until very recently. And UCLA trumps Kansas for the title.

Wednesday, March 19, 2008

Access Issues

The theme of my day at work was "Difficult Access." In order to get dialysis, each patient has to have a means of getting physically hooked up ("access") to the dialysis machine. This can take the form of either a fistula (somebody's artery and vein, usually in the arm, are surgically ligated together, and then needles are inserted into the vessel), a graft (a synthetic piece of material inserted between an artery and a vein), or a catheter (basically a large iv inserted into one of the large veins of the neck or groin). For patients who need dialysis to stay alive, having a functioning access is imperative for survival. Today, there was an endless stream of clotted fistulas, clotted grafts, and poorly functioning catheters. It's not a very intellectual problem to deal with on a day-to-day basis, but nonetheless an important one.

Enough shop talk: Here's a nice series of Sophie pictures playing with the remote control on our couch.


Tuesday, March 18, 2008

I've been framed!

A day at the framing shop: On Saturday Claire, Sophie and I ran a long-overdue errand: framing an oil painting we had purchased last year in France. We went to this Do-It-Yourself Framing workshop "The Framers' Workship" where you pay for the raw materials and then assemble the frame yourself with the aid of available tools and (fortunately for me) advice from the employees. We ended up spending a paltry $12 for a piece of plywood and stretched the canvass over it, without an actual frame. It took some time but overall I'm happy with the results. The painting depicts a scene of les bouquinistes (street vendors selling used books) on the banks of the Seine with Notre Dame in the background.
With regards to my recent "World Kidney Day" post, alert reader Rick Hellman, MD points out that in the country of Iran, citizens are encouraged to celebrate World Kidney Day by donating their kidneys, the proceeds of which will be altruistically donated to the cause of funding assassination attempts on top Israeli officials. I wish I were making this up but it's apparently true. Iran is one of the few countries which allows individuals to buy and sell kidneys for transplant on an open market; in the U.S. and most other countries this practice is viewed as unethical and is formally banned.

Monday, March 17, 2008

Happy Evacuation Day!

Everybody knows that March 17th is St. Patrick's Day. The day actually has double-significance in Boston, where March 17th is also known as Evacuation Day, commemorating the evacuation of British troops from the city of Boston during the Revolutionary War. Some schools and government offices are seriously closed here in memory of Evacuation Day.

Here's some pictures from the 2008 St. Patrick's Day Parade (the 2nd largest in the country--the largest one is in NYC). The parade is held in "Southie", the traditionally Irish part of town in South Boston.
This dude is totally Irish.
Green bagels for St. Patty's Day!
Inexplicably Star Wars-themed section of the St. Patrick's Day Parade (nothing says anachronism like Darth Vader riding in the back of a pickup truck while a dude in a Boston Red Sox sweatshirt walks nearby).
Sophie trying to get her paws on one of the many thousands of green lollipops hurled at the crowd.Random Bostonians celebrating in their own special way.
Very New England: The Lexington Minutemen.

Sunday, March 16, 2008

Boston Comic Con

What a great Sunday so far...it began with sleeping in (always a good start to a Sunday). I then took the "T" to the Back Bay Events Center to check out the Boston Comic Con, the first time in several years that I've made it to a comic book convention. Sure, the gathering featured your share of nut-cases and weirdos. But on the plus side, I got to meet the real-live Batman (at least he told me he was the real Batman--but why were there two of them?) Also I rummaged through the dollar boxes and came home with a big stack o' comics, including a bunch of quality "Fables" back issues I had been looking for.


After the Comic Con I met up with Claire & Sophie and we caught some of the Boston St. Patrick's Day Parade--more pictures coming up...

Link of the Day: this Onion news article describing the anonymous donation of 200 kidneys mentions my hospital, Massachusetts General Hospital, by name. Would've sucked to be the Transplant Fellow on call that night...

Saturday, March 15, 2008

More Monkey Business

As she gets older, Sophie's reach is expanding. This morning, for instance, she pulled about 15 books off the bookshelf as she walked by in her little walker. What a little monkey. Caught red-handed.
Here is a picture of the brioche Claire recently made with the aid of her new bread machine. Yum.
I have off this weekend--yay!--in preparation for a two-week stint back on the Dialysis Service at Mass General Hospital beginning on Monday. Happy weekend, all.

Thursday, March 13, 2008

Happy World Kidney Day!

Today is March 13th....otherwise known as WORLD KIDNEY DAY! I'm sure you all made plans for this year's World Kidney Day (the 3rd such day in history)...I celebrated by having a double clinic day, first at the V.A., then at Brigham & Women's Hospital. I personally treated a total of 20 kidneys today! (5 patients each x 2 clinics x 2 kidneys per patient = 20 kidneys)!

And if you didn't make big plans for World Kidney Day, you can celebrate in your own way: the next time you urinate, the next time that glorious, golden (and sterile!) stream of pee leaves your urethra containing just the right amount of electrolytes and waste products, thank your kidneys for doing such an excellent job.

Links of the Day:

The Amazing Kidnerellies perform for World Kidney Day.

Awesome theory about the Lost T.V. show I mostly agree with.

Billy Crystal strikes out as an honest-to-goodness member of the NY Yankees.

Obama Girl sings about her political crush.

Tuesday, March 11, 2008

Stump versus Quizzo

What TV sitcom detective owned two doberman pinschers?

Who was the only U.S. President to have served in a submarine while in the U.S. Navy?

What fruit-themed movie title starred Woody Allen as a Latin America dictator?

I found the answers to these questions (and more) at last night's Stump Trivia contest at a local bar in Somerville. When I was in Philly, there was this way-cool pub trivia game most local bars called "Quizzo" which I was addicted to. I found the local Beantown equivalent of this--called Stump Pub Trivia--and gathered up some of the fellow Philly-to-Boston transplant crowd and we tried it out last night. The verdict? Well, we didn't win, but it was still pretty fun. A little slower-paced than Quizzo, and it loses some points because I think all the Stump trivias in the city are run by the same corporation--but the questions were generally well-researched and reasonable. Hopefully we'll go back.

The answers, by the way, are "Magnum, P.I.", "Jimmy Carter", and "Bananas".

I'll end with a nice B&W photo of Sophie taken by our friends Audrey & Charlie during our recent trip to San Francisco.

Monday, March 10, 2008

Celtics tickets and Beatles tunes

Read 'em and weep, boys! My tickets for the Boston Celtics-Philadelphia 76ers basketball game on March 24th arrived in the mail today. They're not cheap (though the cheapest I could find), but I gotta get my NBA fix every now and then. I'm positively giddy about the remainder of this year's NBA season: there have been a host of spectacular trades (Kidd to the Mavs! Gasol to the Lakers! Shaq to the Suns! Ben Wallace et al to the Cavs!), and for the first time in a few several years I feel there's no clear favorite to win it all. I'm hoping for a Celtics-Lakers vintage rematch in the Finals (which would be Commissioner David Stern's wet dream for marketing purposes), but logic would dictate that we are more likely to see a Detroit Pistons-San Antonio Spurs matchup as these are still the teams with the most playoff experience.
In other news, I'm looking forward to rediscovering the Beatles after the recent announcement that the full Beatles catalogue will be hitting iTunes shortly. I just purchased the "Across the Universe" soundtrack and though it's pretty good, it's still a far cry from the originals.

Life is good this week. I'm on the outpatient V.A. service, meaning that I mostly see veterans in an outpatient clinic setting. And therefore have time to catch up on the important things in life, such as following NBA basketball and making mental lists of my favorite Beatles songs (Blackbird, Hey Bulldog, Dear Prudence, Rocky Raccoon).

Saturday, March 08, 2008

What A Mess

What a wacky political system we have. Primary Do-Overs. The existence of "Super-Delegates" (I didn't even realize these existed until a few weeks ago). I'm concerned that this process is not going to lead to a clear victor anytime soon and things are getting uglier by the minute. What a mess.

Here' s a suggestion, America: keep it simple! Why not everybody in every state vote on the same day throughout the country, the person with the most votes is the nominee? Would that be so difficult? Given the convoluted nature of the system (which is becoming more and more apparent in close races such as this Democratic primary, as well as the Bush-Gore fiasco of 2000), it's hard not to feel that politicians have created undue obfuscation in order to further their own political ambitions. I would think that most citizens would be in support of a more rational system of picking our political leaders.

This weekend: On-call at the V.A. Hospital.

Sophie Pics for the Day: Takin' a Bath


Thursday, March 06, 2008

Top On-Call Pranks

The other day, my friend (and co-Renal fellow) Albert and I played a prank on another Renal fellow, Hakan, by paging him with the message that there was a 103-year-old patient in the Emergency Room named Johnny Scrotum who required urgent dialysis. Where does this rank in my personal all-time list of Top On-Call-Associated Pranks?

#5: Johnny Scrotum.

#4: paging co-fellows to the 1-800-Viagra erectile dysfunction hotline (I have to admit that I borrowed this one from one of my prior senior residents, John Chang, who brilliantly carried out this very same prank on the first day of our internship at Penn).

#3: hiding a fake skeleton under the call room bed and then anonymously paging my co-resident to look under said call room bed in the middle of the night. Freaky.

#2: in an epic battle of "Your Momma" jokes with my friend Aravind, I once wrote an entire official "History and Physical" admission note with Aravind's Momma as the fictitious patient. I think her reason for hospital admission was "excessive flatulence" if I recall correctly.

#1: when I hid a remote-control fart machine under my co-resident Dave's bunk bed (with whom he was sharing with a medical student) and then made it seem as if he was letting loose some bombs all night long. Priceless.

Hey. When you're stuck in the hospital approaching 80 hours a week, you might as well have some fun while you're there, right?

Wednesday, March 05, 2008

Sophie Shows Off Her Mad Clapping Skillz

The title says it all.

video

Tuesday, March 04, 2008

Natural History II

More pictures from our Day at the Natural History Museum last Sunday. To begin with, a really ugly fish, captured for all posterity as a fossil.

"Monkeying" around with Sophie in front of the gibbon skeletons (you can see Sophie's bottom teeth coming in pretty well in this pic).
Wall o' Stuffed Hummingbirds.
A vulture and a parrot.
Whale tail.
In other news: I've earned a brief respite and I'm on a relatively light rotation over the next two weeks. I'm back at the VA Hospital (the Veteran's Hospital of Boston) which moves at a much slower pace than the other hospitals at which I work. Whereas my list of Dialysis patients at Mass General Hospital had at one point peaked at 35 individuals, my list of VA patients is currently at six, with three anticipated discharges tomorrow. I get into work around 9 or so, accomplish my work in a leisurely fashion, and usually have a bit of time to do some educational reading or catch up on random scientific projects I've put on the back-burner. I even have time to lend Claire a hand and drop off & pick up Sophie from day care!

In other words, for two weeks I get to live like a normal person!