So precious it must be rationed

Recently, there have been some unusual election results. Surprisingly to me, Canada went with the Conservative party. After seeing what we've done as a nation, you'd think Canada would get smart.

In a complete shock, Hamas won the majority of the new Palestinian parliament, essentially meaning that any hope of dream of Middle East peace is gone now. I'm kind of curious how this will play out, because for all the posturing Hamas has done, Israel is still the butt kicker. Considering the stuff that Israel has done recently, I'm shocked that Hamas isn't being more Israel friendly, but bad blood runs deep, I guess.

But I think the most shocking voting in the new year is the fact that Master P has managed to be on "Dancing with the Stars" for so long. This is criminal. He sucked. I mean wow, bad. I'm glad he got voted off.

I have to admit, I really like ballroom dancing, watching it at least. I haven't done any actual ballroom dancing since... well... 7th grade. But it's so marvelous to watch two people move so beautifully. I have to admit, ABC's got me by the balls on this one.

But my point originally is that democracy and liberty are things that sometimes don't yield desirable results. And quite wisely, many a government in the world does not let people vote for just such reasons. But part of democracy is people living with their choices. And after suffering another week of Master P, America wised up. Now, unfortunately Bush doesn't have to answer to the Friday night results show, but some mistakes take a little longer to fix.

Curves

There are certain things you realize about yourself while in the process of completing a residency. Mostly, it's stuff like how much sleep you require to think, or how fast you can eat dinner. Sometimes, however, it's simply understanding your own perceptions better.

The advantage of medicine is that I now have a rather thorough understanding of the human body, from a microscopic to macroscopic level. I can appreciate the knee joint with equal interest as a single hair follicle. I am not afraid to touch things, from a crusted sore to a liver.

And part of all this tactile and visual stimulation has led me to realize some things, such as [shameless male piggishness ensues] what I view as beautiful about the female form. What really catches my eye are curves, subtle curves. I like the curvature of the cervical spine, elongated in women. I like the curve of the top of the shoulder, more prominent in women because of decreased trapezius muscle bulk. I like the curve of the abdomen to the hip, made so by the female pelvis. I like the curve of the buttocks joining the lower extremities. Of course, the curves of cleavage. [shameless male piggishness ends]

And I know this sounds very crass, but I mean beauty in the way that the Venus de Milo is beautiful. It's not erotic, but rather transcendent. It's the idyllic wonder of female beauty. It's not Pam Anderson plastic boobs. It's something far more simple.

I used to do a lot of art, and at one time thought that art was my calling in life. I've got sketchbooks and books littered with drawings. And the one thing I learned in all that artwork is that straight lines are not hard to draw. There is such a thing as a perfectly straight line. A perfect curve, however, is difficult. The balance, the angle, the bend. There is something beautiful about a curve that my eye loves.

M&M

Seriously, how can a light-hearted and tasty chocolate candy that melts in your mouth and not in your hand share the same name with morbidity and mortality conference, the most malignant thing a set of residents and attendings can do to each other?

For those of you not in the medical field, M&M is when serious complications and deaths are reviewed in order to see if there was something missed or errors made, and if we can learn from these situations. There are several varieties of M&M conferences, but may be generally broken down into two categories: medicine and surgery.

Surgery M&M, bring some popcorn. I think it'd best be done in an urban movie theatre with a large black audience. I don't mean this in a racist way. My God, I love the black folk, and whenever I want to see a movie the way it should be watched, I wanna see it in the ghetto theatre. Because it's so damned entertaining that you really need a running commentary.

Surgery M&M is vicious. It's a witch hunt initially, trying to find the right person to blame. Once that person is found, he is grilled on why he was so incompetent, because regardless of the cause, it boils down to incompetence. Cause of death was MI due to stress of surgery? Why didn't you crack his chest and do intrathoracic cardiac massage? Invariably, one attending will question the skill or acumen or technique of the attending of record, and that's when the sparks start flying. Only an inane jackass would dare try to do an end to end anastomosis in a case like this. Stuff like that. It really would go better if someone in the back row yelled out, "Oh no he didn't!"

Medicine M&M, that's not nearly as fun. Medicine M&M is when every senior resident and attending chooses to second guess the responsible party. Even though your D-Dimer was negative, you still should have scanned the chest. Weren't you suspicious of the heart rate of 110? The patient's reports of a recent episode of rhinorrhea should have tipped you off to acute bacterial meningitis. The premise of Medicine M&M is that if you did some extra test, used a better medicine, paid a little more attention, the outcome would've been different.

Medicine M&M is so hell bent on teaching people something, but in the end, the only lesson you walk away with is that you're glad it wasn't you. I'm practically a veteran of M&M's at this point. I've done more than my fair share. I didn't really do anything wrong per se, but everyone feels better when they can find my flaws.

Because there's something very reassuring when you can walk out of a conference talking about the untimely death of a person and say to yourself, if it was me, I would've done this, and the patient would still be alive. That's fucking comforting. Better than a warm glass of milk.

I don't mind doing Medicine M&M's, because I know that the learning value is not for me. It's not the scolding of a Surgery M&M. There's no veiled insult. It's like a morality play. The story has a message at the end, like always remember to consider pulmonary embolism as a cause for mild elevation of troponin in a patient with chest pain. But the part of M&M I enjoy most is when my attendings ask questions, and I agree. Like one time, one of my attendings asked, "So, why did it take so long to change the code status in this patient?" Why indeed.

Not really

I was thinking about this girl, and it occurred to me that I didn't really know her at all. Of course, I knew her, but not in that meaningful way. I knew her habits and her likes and dislikes, but know? I didn't know. I didn't know her hopes and fears, her ambitions and hinderances. I didn't really know her.

But what made things so convincing was how well I knew about her. It's strange how well you can appreciate the trappings of a person, but not the inner apparatus. It's like a building you pass by every day, but never look inside. And that's what made things so... difficult in the end. I knew too much about this girl.

So well known that when she rejected me, I couldn't understand why. I mean, other girls have rejected me, and I've had varying responses, but confusion was a new sensation. Because I thought that I understood her. I thought that she made sense to me, deeply.

But did I really know her? Not really. I just knew the shell. And I'm not bitter, no sir. That's life. Sometimes it's crumbs, and I can't really complain, because I never came out of my shell either.

Vacation

I'm buying plane tickets for my V A C A T I O N ! I know, sounds so wonderful, but really, I don't have that much planned. Visiting family mostly. I have rather fond memories of going to Mexico during med school. After so much stress and panic and worry and hardship, that vacation was well-deserved. But now, vacation seems like more trouble than it's worth.

I don't have anyone to vacation with, and that's the problem these days. I mean, yeah, any time away from the hospital is good time. Fantastic. But vacation spent with family's not really vacation. It's more like filial piety, Confucius coming to kick me in the ass.

So, since I'll be in the Southwest anyway, I decided to take a couple days in Las Vegas. I'm not a big gambler or partygoer, but a couple days in a strange town with free alcohol? Sounds good to me. And it'll be warmer than the Midwest.

I just wish I had someone to vacation with, you know, to spend the time. And I think, in the back of my neurotic little brain, there are some cute girls I know who would seriously consider an offer to spend a couple days in Vegas. And wow, that would be nice. It'd be a vacation from my life.

But part of being in internal medicine is being pretty skeptical. And the skeptic in me is rather sure that the only female company I could have in Vegas would be the kind of company that I'd have to pay for by the hour.