Fuck Kouzmanoff

• Which one was Prometheus, and which one was Bob? I think the alien is Prometheus, but I'm not sure. [EDIT: I looked into it. They put the names in the intro. Prometheus is labeled under the alien, and Bob is labeled above the caveman. Or, alternatively, Prometheus is labeled to the left of the caveman, and Bob is labeled to the right of the alien. That didn't really clear it up.] [EDIT: If you don't know what I'm talking about, don't worry about it.]
• Microsoft Word spellcheck recognizes "podcast," but not "audiobook." It also recognizes "spellchecker," but not "spellcheck." Blogger spellcheck doesn't recognize any of those. It doesn't even recognize "Blogger." It does recognize "Microsoft," though. Okay, I'm done.
• Headline of the week: "Georgia Man Wins Lottery Twice In One Week" If you won the lottery, why the hell would you keep playing the lottery?
• It's amazing how good I've gotten at pen-twirling during the past few months of medicine.
• If I unplug my alarm clock, I have to reset the time. If I unplug my laptop, shut off my cell phone, or take the batteries out of my pager, I don't have to reset the time. I don't know what new piece of technology these all share, nor do I know why alarm clocks have been unable to adopt this technology.
• Pet Peeve: When people add extra letters to a typed comment with intended to be read as long and drawn out. I can tolerate it when it makes phonetical sense (as in "Nooooooo!"). It bugs me when they do it to hard consonants (as in "I need a napppppp"). But it drives me FUCKING nuts when they do it to silent letters (as in "I want to go homeeeeeeee").
  

• It always makes me smile knowing that somewhere in my subconscience, amidst all the medical knowledge I've gained over the past three years, there still lurks an absolutely categorical knowledge of all 151 original Pokemon. I like to picture it there in my mind, hanging out with Ranson's criteria for acute pancreatitis and the differential diagnosis for bilateral lower extremity swelling, as if to say "Screw you guys, I was here first."


• There are two sources for confidence during morning rounds. One comes from knowing every little detail about your patients' histories, thoroughly understanding the pathogenesis and etiology of their diseases, and having recited the differential and treatment plan over and over in your head in preparation. The other comes from completely giving up in trying to impress the attending, knowing that their evaluation ultimately amounts to only 10% of your final grade. Guess which one I've learned to embrace?


• Oreos dunked in coffee. Try it. Your head will explode.


• I had a fortune cookie today that said "Remember three months from this date. Good things always happen on that day." Today was June 11th...


• I am never able to spell "restraraunt" right on the first try. Restraunt? Restraurant? Restaurant? Restaraunt?


• (Patient with severe hypotension in the ICU) "I don't know why you've got me locked up in this hospital. I'm an herbalist, and I know exactly what I need right now. I need some garlic and some saw palmetto. That stuff you're injecting into me is POISON! The drug companies paid the FDA $50 million so they could pass it through trials. It's all a damn conspiracy! You know why this is happening to me? I know. I know because I'm training to be an astrologer, and I saw it in the stars. I'm going to be a millionaire! I'm not just saying that, you know. I'm training with five other millionaires and they're teaching me how to be a millionaire astrologer. So don't think you can keep me locked in this prison forever."
  
  People have asked me why I want to go into Pathology. I don't think I can make it any clearer than that...
  
  
• There's currently a video poll on Yahoo!: "You decide! Is this goat waving?" I haven't watched the video, but I'm pretty sure this isn't the democracy the founding fathers had in mind.
  

Long Overdue

• From now on, for every goddamn news story I see about someone returning a library book 20 years overdue, I'm going to shoot an innocent civilian. JUST KEEP THE DAMN BOOK!
• Patient (a 90-year-old woman)"Because of my reflux, I can't sleep flat anymore. I have to prop myself up with pillows."
  Dr. F "That's bad for your back. What you need to do is pile bricks or cinder blocks under the head of your mattress, that way it's a more even slope."
  Patient [looking at me] "Doctor, is your nurse serious?"
• Another entry in the Meaningless Statements Found in Textbooks series: "Almost more than 90-95% of streptococcus is sensitive to these drugs." What?
• I never know what to say when a cashier says "Thank you." "You're welcome" doesn't seem appropriate.
• Another phrase I don't get: "They're as different as apples and oranges." Come on...they're both fruit! In the grand scheme of things, they're fairly similar. It should be something like "...as different as apples and gazebos."
• Did I pluralize gazebos correctly? Gazeboes? Neither one looks right.
  
• Any sentence beginning with "Avast" must be taken seriously.
• It's official: I'm sick of DevilDriver.

On a Serious Note

It's been a while since I wrote a serious post, so I decided to take a break from humor (I haven't updated in a month anyways). Today, as part of my Internal Medicine rotation, I shadowed a Palliative Care doctor for a day. Palliative Care is a division of medicine which deals with actively dying patients. The goal of PC is to find the balance between ending suffering and providing comfort, while still working towards prolonging life.

As part of the experience, I had to work through some online modules to teach me about the different aspects of PC. One of these modules dealt with "spiritual concerns," a common concern among dying patients. A section of the module had a list of Universal Spiritual Questions:

"When faced with a life-limiting illness, there are common questions/concerns of patients that transcend all religions, and cultures:

What is my purpose?
Does life have any meaning?
Why do people suffer?
Is suffering a punishment?
What is the meaning of death?
What happens after death?"

The last question made me pause. It used to keep me up at night. The thought of death didn't scare me half as much as that of an afterlife. I don't care how good an afterlife it is, I don't want eternity. But is nothingness a better alternative?

This is one of the comforts atheism has given me. That question no longer scares me. In fact, it doesn't even make logical sense to me anymore. What happens after death? That's like asking What color is honesty? Honesty doesn't have a color, and death doesn't have an after. Sure, time doesn't stop when I die. My friends and family go on living. But from my perspective, death is the end. The year 2200 will be the same to me as the year 1200. To quote Jim Jefferies, "I won't even know I'm dead. You wanna know why? 'Cause I'll be fucking dead!"

The sad thing about all this is how many people believe in an afterlife. I had a patient this morning, dying from metastatic prostate cancer, who is looking forward to reuniting with his father. I don't believe he will. The disappointment that he (won't) feel after he dies is utterly depressing to me. So depressing that I'm glad there won't be a moment of realization. But one thing I learned this morning is the importance of dying comfortably. And if that makes you comfortable, go ahead and believe it. Even if it is just a form of Pascal's Wager. Nothingness is much more comfortable for me.

"Although the time of death is approaching me, I am not afraid of dying and going to Hell or (what would be considerably worse) going to the popularized version of Heaven. I expect death to be nothingness and, for removing me from all possible fears of death, I am thankful to atheism." -Isaac Asimov

No God. Truth? Sham.

• I wonder how many crossbow deaths there were in Wisconsin last year?
• The most depressing thing I've seen this year in medicine: A 27-year-old grandmother.
  
• I wrote "radio beef" in my note pad. I have no idea what that was supposed to mean. If I remember, I'll update.
  
• Best bumper sticker I've ever seen: "Your child may be an honor student, but mine has more chromosomes!"
• In a couple months, swine flu will go the way of El Nino and SARS.
• Me "Mrs. P, even after your gastric bypass, you're still gaining weight. You still need to cut back on the snacks, and you should be drinking at least 60 oz. of water every day."
  Mrs. P "60 ounces?! Really? If I drink that much, I won't even be hungry!"
  Me "...yeah, that's kinda how it works."
  
• I had a patient named Jorge this morning. The resident pronounced it "Whore-gay." Good try...
• Later that day, the same resident asked a female patient her name. She said "Yvonne." The resident wrote "Ivan." Seriously, this person is a doctor.
  

Math Hotdogs Run

• Dr. P "Brandon, why don't you present your patient quickly, we only have a few minutes left."
  Me "Okay, this patient is a-"
  Dr. P "We'll try not to interrupt you."
  Me "...this patient is a five-year-old male-"
  Dr. P "Unless we have questions."
  Me "...who presented with a three-day history of-"
  Dr. P "Got that? No one interrupt him."
• Drug names that would make good villains in a sci-fi movie: Lopressor, Tordol, Zofran
• I hit my forehead on the open window in our shower hard enough to draw blood, but not hard enough to realize I had drawn blood. I had about a 1-inch gash trickling blood down my forehead without realizing it. The weird thing was, no one told me about it until I was at the mall three hours later. I had even gone to the supermarket to buy a bottle of bourbon for my bar. I had an open wound and dried blood on my forehead, and all I'm buying is a bottle of liquor. No wonder the cashier was avoiding eye contact...
• Nick "How's that coffee cake?"
  Me "Great, it's like a muffin in loaf form."
  Nick "They should call it 'muffinloaf.'"
  Me "...good one."
• I don't think I've ever chosen to "Move Single Card" in FreeCell.
• Line in a medical textbook: "Usually, ependymomas tend to recur in some cases after surgical resection." That sentence has so many modifiers, it has become meaningless.
• Four. Fourteen. One-fourth. Forty. WTF?
• I don't know what species of fish is in a fishstick. Flounder? Goldfish? Seahorse? I hope it's seahorse.
• Today, a cashier told me to "Have a good night" as I was buying lunch at 11:30 am. That's at least five hours before acceptable.
• Snow? Snow? SNOW?! It's April 21st! That's it, Al Gore. Game over. I officially call bullshit.
  

Romeo Alpha November Delta Oscar Mike Tango Hotel Oscar Uniform Golf Hotel Tango Sierra

• It's been a while since I've laughed at Cyanide&Happiness. Disappointing...
• If you heat up something solid, it will melt into a liquid. Ice, glass, metal, plastic, almost everything. Except eggs. Heat up a liquid egg and it becomes solid. I think this is a phenomenon that is largely unrecognized by the world.
• This news story made my day/week/month/year.
• Do midgets have to ride in car seats? Seriously. The American Association of Pediatrics recommends that children should be riding in a car seat until they are 4'9'' tall. No age restrictions. So if someone never reaches that height, shouldn't they have to ride in a car seat?
• Sharon got onto my computer while this post was being edited and tried to insert the phrase "Brandon is a jerk face..." in this spot without me realizing it. Nice try, Sharon.
• Just for that, here's another "Crazy Sharon" moment:
  Sharon "What time do you have to get up?"
  Brandon "Quarter to seven."
  Sharon "Okay, my alarm is set for 6:46."
  Brandon "...why 6:46?"
  Sharon "Because it's a palindrome. What? Stop laughing at me!"
  
• I don't get this commercial. I know they're trying to say "Windows is so easy a three-year-old can use it," but come on... the kid's Asian. She probably wrote the damn computer program.
• I want to meet the advertising executive who first went to Vlassic and said "You know what would really help sell these pickles? A stork who impersonates Groucho Marx."
• Let it be known that I coined the phrase "guano crazy," the censored form of "bat-shit crazy." If you ever hear this, make sure people know I started it.
• If my last name were cooler, I'd totally name my son Remington.
• Poll: Who had the bigger rise and fall?
  "Who Let the Dogs Out" or "The Macarena?"
  Hanson or Smash Mouth?
  Pogs or Magic: The Gathering?