Ice for my island princess
Some lifetimes happen to hinge on a single day and for Island Princess last sunday was such a day. Our peer's had known for a while that we had seriously talked about getting married. My IP was expecting a ring but at an undetermined date. I had asked for the help of the frog prince to help me acquire an engagement ring. I had lead her to believe that she would recieve her ring before the period of fall and winter festivals. The frog prince and I searched for 2 lunar cycles and with his guidance I was able to secure a gem worthy of my princess. We had traveled to the land of good grass to pick up the ring. The diamond was a square, near colorless, nearly flawless stone certified by the GIA (gnomish institute of the arcane). Set in a rare band of platinum is seemed almost enchanted as it lay centered in an ornate crimson box. Ah now the quandry of how to propose. Months prior to purchase I consulted several of my healer friends as we proposed different scenarios. I decided to simply suprise her.
This past sunday was just like any other sunday we had finished going to church and we were on our way to a Bridal Convention. We went home to pick up directions and as usual we were in a hurry. As we were about to leave I asked her if she had forgotten anything? She didn't know was her reply. It was then I got down on one knee and out of my pocket I produced the gem box. The last thing I heard her say was that she was nervous. I proceeded to tell her if she were to join other expecting brides she should have her own ring. As I opened the box to reveal its treasure I told her that I loved her, thru the years she had always been there for me and that I couldn't think of any more deserving woman than her to spend the rest of my days with, on this blue rock. It was then I asked for her hand in marriage. The light from the diamond reflected from the ring mezmerized her that to this day I'm not sure she was aware with what I had just said. Of course she said yes. I certainly surprised her that day.

Broken Hearts,The Da Vinci Code, and Vegas Baby Vegas
Once again I'm off the inpatient hospital service and back on outpatient medicine. So now I get more time to muse about the world around me outside of medicine.

In medical school they forget to tell you that when you graduate you become your own family's unoffical primary care physican. My gf's dad recently underwent major heart surgery and of course they mention I'm a physician too so the surgeon emails me and I'm now the health advocate for my gf's dad. At the beginning of July my own uncle who had end stage renal disease, heart disease, and diabetes passed away from a massive heart attack. My cousins were in shock and I had to make a couple of phone calls and of course explain everything. It's tough sometimes when you're both the family member and a health care provider. You don't want to be the ass-hat micromanger of your family members health because you respect other physicans clinical judgement.

I've also been reading more non-medical books lately. The last novel I read was Dan Brown's Da Vinci Code. The book is a very absorbing thriller. I heard his earlier book Demons and Angels is just as acclaimed. This sure beats reading articles from JAMA .

I'm still trying to recover from the weekend at Vegas. . . I hung out with my highschool buddy maverick and co. at his bachleor party. I only got 6 hrs sleep total and had a blast. However, getting older I do realise you can have too much "fun". I also had a chance to hang out with my kuya and his family. The poor bastage has 4 mestiza daughters. He got hit hard with the players curse. To make him feel better I got him a Dave Chapple stand-up DVD and some baby back ribs. "All daddy ever wanted was the big piece of chicken"-Chris Rock. In this case some ribs.

On Call-Last week as a second year
Out with the old in with the new
Sorry I haven't posted in the last 6 months been kinda busy. The new interns start on Thur 23. Try not to get sick or go to any teaching hospital in the next 3 months. lol. It's been an amazing ride so far.

Senior Resident
I can't believe that exactly one year ago i was an intern thinking about quitting medicine b/c an attending made my life hell for me for one week. Now for the last 3 weeks I'm suddenly "the senior" resident with two interns and +/- sub-intern to manage. Damn they never had a course in med-school or internship on how to be a leader. Having subordinates to manage is tough; you have this feeling they're tryin to jack you or pull a fast one. Life is certainly differnet on the other side. I used to complain to my other fellow interns that the seniors didn't teach me squat and I realize that when one goes from managing 10 patients to 20; finding time to teach is a challenge. I saw one of my buddies who was my second year senior when I was an intern and thanked him for his patience and I was sorry for not being a better intern. He just laughed and told me to stop being so damn sentimental and admit some patients.

Now this doesn't happen everyday

I'm finishing up my intern year in the ICU. I had this one pt where I was the cross-covering intern, the nurse was Filipino(a given) but suprisingly the surgical staff was all Filipino the attending the only Filipino surgeon at the hospital and so was the resident assisting. Cool!

25%
The chances of anyone surviving a cardiac arrest outside/inside a hospital are 25%. If you have any co-morbidities like prior heart attack, stroke, cancer then your odds go way down. Your odds of coming out of the ICU are about the same. I just spent the last month in the ICU. I've help bring people back from death and I've also watched rational people tell me to take them off the breathing machine because they've suffered enough and let them die. I 've told spouses, grandchildren, and kids that their loved one has passed. Up front I'm very frank and I don't tell them if I know for sure if they can go off the breathing machine or if they're going to have the same quality of life before they were in the hospital. I learned that there isn't much you have control over in the ICU where the patients get 1 on 1 care. Their number's can look great but they die so fast or their numbers appear to look like they're going to go that same night but I come back to them the next moring and they still holding on. The only control we have is to think ahead and really wonder if I ever want to be on a ventilator or be kept alive with drugs although our brain function is nil. It sounds morbid but it saves the people around you as well as the dedicated nurses and doctors alot of grief if something catastrophic were to happen to you and those tough decisions have to be made. So what's your Code status . . .you know the odds.

Elective/Clinic. . .
This past month was pretty sweet. I spent the time on my elective that consisted of Dermatology and Endocrine. Samples galore! Lot's of half-days and "read" time or should I say quality x-box time. Next weekI hit the ICU unit where the sickest of the sick are treated. Opps here's my next patient. . .