I recently heard a song that really struck me. The tune was the first thing that really hooked me, but as I listened to the words it dug at me more and more. I suppose in that form it is good art, because that is the core of art. Normally not a huge Puscifer fan, I will grant them this victory over me.

"Nature, nurture, heaven and home
Sum of all and by them driven
To conquer every mountain shown
But have never crossed the river
Braved the forest braved the stone
Braved the icy winds and fire
Braved and beat them on my own
Yet I'm helpless by the river

Angel, angel what have I done?
I've faced the quakes the wind, the fire
I've conquered country, crown, and throne
Why can't I cross this river?

Pay no mind to the battles you've won
It'll take a lot more than rage and muscle
Open your heart and hands my son
Or you'll never make it over the river
It'll take a lot more that words and guns
A whole lot more than riches and muscle
The hands of the many must join as one
And together we'll cross the river"

In particular the opening lines, Nature, Nurture, Heaven and Home. Sum of all, and by them driven.

I can apply these words to myself because I think in some ways I have felt that I have always treaded water. Even as I have moved ever forward through life, towards my goal to be a doctor, a man, a friend, a husband and a father I have always had trouble crossing the river. Facing oneself and coming to terms with the weakest part of oneself is often a river we fail to cross. Puscifer front man Maynard James Keegan has often flirted with religious themes. And while that might not have been his intention in this song, I certainly took it that way. Because while I may not be able to cross that river, I certainly believe that hand in hand with my creator it is something I fill be able to face.

Pretty awesome song. Worth a listen.

Humbling River

Stay healthy.

Winter is here.

Our first real snow of the year was yesterday, and it is still blowing around today. In all honesty it was somewhat refreshing. Please, don't be mistaken. Snow sucks. And seeing all of this white stuff was enough to make me seriously consider south Texas. But the change of seasons can be nice. And in an effort not to break the 11th commandment I am trying to look on the bright side. This cold will only make the summer seem that much nicer. So there is that.

I have finished up Dermatology today. It was a great month long rotation. Gave me some serious procedure time. Resections, freezes, etc. I am much more comfortable with these things than I had been before the rotation. And since this is bread and butter kind of stuff, I am pumped to have that learning behind me as I move forward towards Monticello. Now on to Urology. I will be working with one of the local Uro's here in Peoria. I am pumped about the possibility of learning how to perform vasectomies. That skill would be something I could carry forward to provide a local service to my patient's in Monticello, as well as make some extra money. And they don't take that long at all! I am pretty sure I would have to attend a certification conference to actually get cleared for it, but learning the procedure is the first step. Should be a good time. Two weeks of Uro and then off to another 2 weeks of Ortho. Those two weeks will hopefully help me shore up my injection procedures. All very exciting!

More fun to come, and only one more FMS block to go.

Stay Healthy!

2012 has arrived.

The Holidays are over. 2012 is here. It has been a whirlwind of a few weeks. I went from FMS, to Vacation, from an empty house to a full house, and then back to an empty house again. An old year is gone, and a new year has come.

Mandi and I rang in the new year at my friend Matt's place in Bloomington. It was nice to see some of the MSHS gents again. It had been a while. I gave my beautiful wife the appropriate new-years smooch and called it good to go. We slept in today, rested on the couch, watched the Bears win (BEAR DOWN!) and are going to have some Lasagna for dinner. If the rest of the year follows in the fashion of today, it should be good.

Oh, and also. Its MY year. Booyah. For those of you who don't know Mandi and I have devised a system for deciding the age old Husband/Wife quandry of "who gets the last bite of dessert?". Like many couples, we often split a dessert. But when a treat is split, there comes a point where there is always a last bite to be had. In an effort to avoid nasty competition over this bite, or bitterness over someone getting it more often, Mandi and I decided that the fairest way to do it was to alternate years. She was born on an odd numbered year, myself on an even numbered year. As such on the odd numbered years SHE will get the last bite. And on the even numbered years I will get the last bite. Well suckers, its 2012. And that makes it my year! WHOO HOO!

2012 offers the promise of much more than last bites. 2012 is a big year. A huge year really. This is the year that I finish residency. This is the year I become board certified. This is the year where I realize a dream that is 20 years in the making. I start medical practice in Monticello in June. This is the year in which my oldest, and most favorite RP group is to be given new life. This is the year Mandi and I's marriage turns 5 years old. This is a year of new beginnings. For the first time since High School I will live within 50 minutes of all of my close High School Friends. For the first time in my life I will be in a place of financial stability and true independence. For the very first time in my life I will have no "next step" professionally looming at me around the corner.

And that is only that which I am aware of. Life has a habit of throwing curve balls, fast balls, and knuckle balls. Life as the QB rarely connects with the receiver you called the play for. Life can sometimes check you right up against the glass. It should be interesting to see what else comes at Mandi and I. Needless to say, updates will be forthcoming as events unfold.

Stay Healthy!

FMS ending.

Its almost over. I have really liked this rotation for a lot of reasons. Tons of learning, both systems learning and professionalism learning, but also (more fun) academic learning. Its amazing how fast one can process new information with the incentive of patient health and wellness. That said, I have really disliked this rotation because I have had 24/28 days getting up at 0530, and not getting home until an average time of 1820. Thats a LONG time away from home everyday. And it gets old. It gets old really really fast.

Its still a great job though, with a great opportunity to learn. I may have to force myself to say that through gritted teeth, but that doesn't make it any less true. And its during rotations like this that I feel the march towards residency completion all the more. To think that I have three days left of my first FMS rotation... after this I only have one more rounding rotation... ever. Thats astounding to me.

And I learned something really fun today. One of my attendings was telling a story about a tradition in his family of the 11th commandment. Everyone knows about the 10 commandments, even if they can't list them everyone gets the idea. Don't steal, don't bear false witness (different than lying btw), don't worship false gods, don't murder, etc... But what this attending has proposed is an 11th commandment that I can really get behind.

So what is the 11th commandment? Thou Shalt not Whine.

Now, first let me say I mean this with no blasphemy intended. Of course this commandment isn't something that we should consider holy. I am not comparing my attending or myself to Moses or anything like that. This is meant as a play on words, and a quirk on a theme. Some of you might be surprised at such an honest disclaimer from me. Usually I just bull through this kind of stuff and damn anyone who doesn't like it. But I take blasphemy seriously, and I hope everyone knows that I mean this in a different way.

That said, I think its a great rule to live by. Especially here in the US. Whining, I think is a function of a sense of entitlement. After all, one cannot complain unless one feels that he/she is entitled to something better. And really, I live a pretty good life. 0530 mornings and everything included, it ain't a bad gig. And whining only belittles myself.

So no more whining! Or less anyway ;)

Stay healthy! And a happy end to FMS to you as well!

FMS

The temperature has dropped, Jay Cutler has a broken thumb, and I am on FMS. And still its better than MNPS! Woo hoo! So Family Medicine Service has begun. I am actually already a week down. 25% through with it. 28 day rotations tend to fly by. The Thanksgiving holiday was a large part of that. Left us with four straight days of half days. Nothing to complain about there for sure. This coming week is likely to be a different story.

Have already learned much though. All of the time is time well spent. And while 12 hour days wear at you after a while, its bearable when the rewards are so clear. Reviewing the Duke Criteria for bacterial endocarditis, or reviewing the empiric coverage on a patient with possible meningitis who we can't get an LP on. All very good stuff, stuff I could easily see myself using someday.

Thanksgiving was very nice. Mandi and I hosted a small event here with some of the other Residents/Spouses who were stuck in Peoria as we were. Nothing fancy, no turkey. But it was a good time. We ate a lot, drank a little, and played some board games. All fun.

And now we are gearing up for Christmas. As I speak Mandi and Shaun are decorating the tree. Had to get store bought this year as time was at a premium, sorry Warren Tree Farm. Having our tree up definitely makes the season feeling come alive. I will admit that the tree is pretty even if I don't like it. I just can't make it square that we celebrate Jesus' Birthday (at a very wrong time of year) during a pagan festival time, with a symbol of a burning tree. Not my style. A very simple cross, or even a nativity would be fine. But Mandi likes it, and she does put up a Nativity every year which is very nice. I would never want to put a damper on her Christmas joy.

Thats all for now, more to come as the season progresses I am sure. Gearing up for the holidays and seeing friends always leaves much to blog about.

Stay Healthy

MOHS and the Holiday Season

I love outpatient rotations. And among outpatient rotations, MOHS is especially good. Its essentially the rotation in which Residents learn the business of being a Doc. So rather than focusing on how best to treat patients, we learn about how best to charge for our services within the convoluted government/private insurance world. We do this so that we can stay in business, and continue to help more people.

Because while most people like to believe that I should work for nothing or next to nothing, I have no intentions of doing that. Don't get me wrong, I didn't get into this job for the money. I could have made a lot better money elsewhere. But at the same time, I wouldn't have done this if I didn't know that it could provide a comfortable lifestyle for my family. I don't ask to be rolling on piles of cash or driving a Porsche, but I want to make sure I have a retirement, I want to have a few nice things, and I want to to be comfortable. And if I can't do that being a Doc, I will take my considerable amount of effort elsewhere into a field that will.

And if I am going to make any money, I have to learn to navigate an overly-complicated financial system that is set up to make sure I provide as much care as possible for the least amount of money. If you can't tell, MOHS has made me a little bitter about this. That said, its been a fun rotation, and I can't believe I only have a few more days left of it before FMS starts again. FLEW by.

And now its the Holiday Season. Which means Holiday shopping. Not only is that usually completely brutal, but I get to do the bulk of it while on service. Talk about rrrrough. 1st world problems right? It shouldn't be too bad though. This is the part of my job I like because I can learn from it. Even with 12 hours a day, 12 days in a row, with 4 days off in a month, I think I will have a good time, and I imagine I am going to be looking back 28 days from now unable to believe that I am almost done with FMS. The only difference between now and then will be a few inches of snow on the ground, and Christmas immediately ahead.

I also drew short straw on Thanksgiving this year. Again, not complaining. If one is going to work a holiday, Tgiving is the one to work. It means a few days that would have been full become half, and I get to round when there is a ton of Pumpkin Pie to be had at the various nurses stations. Jaaaam! I also have a real heart for those patients stuck in house over a holiday. Talk about a bummer. Its a lot easier to remember an adage one of my attendings uses when one is rounding during the holidays: It may be difficult to deal with some patients, but 99/100 times its even more difficult BEING those patients. That goes double on the Holidays. As much as working sucks, being sick is worse. And so I pray for the health of the patients. May there be very few to none in the hospital this year over the holidays. And I pray for my own health (and sanity) for another rounder. It will be a whirlwind of a month I am sure. Or worse, a blizzard ;)

Stay Healthy!

Done with BestBuy

So for those of you who know me you know that I used to love BestBuy. As someone who enjoys a good movie, video game, computer and large TV that should come as no surprise. BestBuy has all of those things, in spades. I even have a BB mastercard that earns me "reward zone" points as I buy other things. I have shopped there for... for as long as I have been shopping. I probably visited over 20 BestBuy's across 4 states. Not because I was ever a fan of the store, but because I enjoy movies, video games, and electronics that much. They typically have some of the best prices, and the best selection.

Well thats over with.

Those of you who know me also know that I have a very low threshold for dissatisfaction with poor customer service. It really takes so little to meet my criteria for what is acceptable. 1) Value the customer. 2) Meet the terms of the contract.

Its that simple. I ask them to not be rude, and to simply do what they say that they will do for the money I will give them.

BestBuy has now failed in this regard... twice. Twice in less than two weeks. I pre-ordered three games over the past several months. Gears of War 3, Battlefield 3, and Uncharted 3. Its the year of 3's. GoW3 arrives on time, like it should. But Battlefield 3 arrives two days late. So I call BB and ask them why I should use their service which supposedly gets me a game the day it comes out (you know, the point of pre-ordering it) and fails to perform. BB has no good explanation, but they apologize and I get over it. No fast forward to today, I come home from work excited to try out Uncharted 3 to once again find that the terms of the contract between BB and myself violated. No game. I check the shipping status online, sure enough, it may not be here until the 7th. It would appear that BB.com has absolutely ZERO idea why someone pre-orders a game. And while I don't claim to be an expert, I can tell you for sure its not for the purpose of waiting to get said game 3 days later than it could have been had at a store.

Once again I call BB.com. This time the representative lies to me. She states that the games ship on the day they are released. I call that garbage for what it is and then ask to speak to a supervisor. Word of advice to anyone in customer service. Don't lie. And especially don't lie when your customer has a legitimate reason to complain. Just say you don't know, you're sorry and fix it. I know taking crap sucks, I take crap from my customers all the time. But thats service. That's the economy. That's how it works.

So now enter Tony the Supervisor. Tony talks to me in that deep, authoritative supervisor voice, trying to convince me he knows what he is talking about. And maybe he does. But much like representative #1, he fails to offer me any new information and his apology sounds less real than hers. I am done. By this point the rage is rising, and I know if I don't disengage soon I will start letting it out. I tell Tony to forget it, I don't want his 10% off, I am done with BestBuy. Forever. I am answered by silence on the other end. I've been hung up on.

Keep in mind, I never yelled, I never asked for anything, I never demanded something in return. All I wanted was to know why the contract hadn't been fulfilled for the last two orders. I wanted to understand what had happened. I was given, in the following order: lies, and rudeness. This from the people who screwed up. Wow, if I pulled that kind of garbage I get sued.

Long story short. No more BestBuy. Amazon offers better prices, better service, and a faster loading website with a greater range of products. Never has Amazon failed me, or anyone else I know. Heck, if I want an in-store experience I will go to GameStop or Wal-Mart, both still have better customer service (which ain't saying much) and more or less the same prices/selection.

And let me tell you, I spent a lot of money at BestBuy. Are they going to go broke because they lost me? Probably not. But if they treat all of their customers this way I can't imagine they won't go broke eventually.

Do what you say you will do. If you don't, make it right. And do it with a smile. Its that simple.

Stay Healthy