Behind the White Coat

The Latest

Another new message today... A rejection from U - Chicago... Screw those guys, who wants to freeze their ass off in the windy city anyway??  I suppose I won't hear from the next one until post-Turkey day holiday weekend.

Today I was supposed to present at rounds in the CCU at Mt. Sinai for the first time.  So what do I do?  Forget to set my damn alarm.  So I woke up at 8:45am when I was supposed to be there at 8:15 with a 1 hour commute!  So what do I do? The only logical thing. I lied.  I paged my felllow and told him I drove down and my car broke down on the way, so I came back up to the Bronx to leave my car here because the bumper was hangin off, and I didn't call before because I didn't have his pager number on me.  What am I supposed to do? Tell them that I woke up late?!  You're mad. 

Thank god for the 4 day weekend.  I don't think I will ever have such a prolonged thanskgiving weekend again.  Tomorrow heading home with some family and friends for a feast.  I hope everyone else does the same.  So eat hearty, and drink up, and enjoy!  Happy Thanksgviing.

Residency Application Status

Interviews obtained: 15
Attended so far: 3
Rejections: 5
Still waiting: 8 (big ones)

Every time you log onto your page onthe ERAS website, you'll see "new messages" in a little blue link if there are new messages waiting for you.  That means an acceptance, or a rejection.  You can often tell by the subject of the message what you're in for:  "Interview Request"  of course indicates the obvious.  The rejections you'll know as well because it'll completely lack the word "interview."  They will be more like "Application Status,"  or "Internal Medicine Training Program."  And you know its a neg.  I got one from Stanford that was entitled: "REGRETS"  They spared nothing.  The messages range from extremely polite, to down right blunt.  But it's kind of interesting to see how they put it.

Well the last few days I have been fortunate enough to actually get some substantial interviews after a long streak of negs.  Yesterday was Wash U in St. Louis, and today I got Robert Wood, UC Davis, and Mt. Sinai.  I am particularly happy about Mt. Sinai, one of my higher choices, but where all these AOA chicks in my school wanna go.  It's the least they could do whilst I am there doing an elective!  The latest however was a negative from Mass General.  But that was also expected.  Only Beth Israel Deaconess remains of the big Harvard hospitals.  But who wants to be in Boston anyway? 

The ones I am still waiting on are NYU, Cornell, Columbia, U. Chicago, BI Deaconess, U. Penn, Yale.  Quite powerhouses, though i'd be extremely lucky to get even one of those!  You never know....

Stresscon 3

What could be worse than sittin around waiting for programs to either reject you or send interview requests, starting a new elective at Mt. Sinai who has yet to offer an interview and may very well likely reject you while you are still there, trying to come with terms that you will probably match in residency at Montefiore Medical Center, adding another 3 years to the 4 you have spent in medical school in the Bronx, in the midst of one of the toughest years for internal medicine applicants?  I'll tell you what.  Writing a long post only to get erased the second before you hit the goddamn button because of some random browser error.  Now that's just plain shitty.

Well in brief... I have gone on 3 interviews already.  St. Vincent's, Beth Israel, and Montefiore.  The first two are more community-based programs, and 'second tier' if you will, Montefiore being among the big University programs in the city, but the least desirable I think because of its location and facilities.  But I have to come with terms that I will probably end up there.  I got my latest rejection from Brigham and Women's hospital (part of the Harvard system) but not like I expected to get an interview there anyway. On a brighter note, today I actually got an interview request!  Washington University in St. Louis (Barnes-Jewish Hospital).  Sure in the middle of nowhere, but actually a pretty highly regarded program.  But do I really want to go spend 3 years in St. Louis?  I thin klocation is a big deal for me, but shit, maybe if they offered me one, I'll get some other offers soon too?? Or is it just wishful thinking?  Who knows.  That's why we are at Stresscon 3.

The interviews themselves arent that bad.  Most of the time is spent by the programs trying to promote themselves and sell themselves to you.  (Or probably try to sell themselves to the top candidates, people like me are the left overs who will fill in spots from the bottom of their rank list when the big guns aim higher).  So far I havent encountered any tough interview questions, and they have gone OK.   Then again they havent been glorious memorable moments either, so I don't know if they are gonna look at my app and be like, holy shit I remember this kid!

Today I started an away elective at Mount Sinai.  Damn the facilities there are nice, it's in the upper east side, and people are happy.  What a great placce to go! Too bad everyone and their mother in my school wants to go there, and most of them have a better application than me--despite my 3 honors and high board scores, and killer recommendations, my lack of honors in medicine and AOA status apparently overcomes everythign else (i will have to dedicate a whole post to that bullshit later).  Anyways, the commute sucks, I question why I am even there because I am clearly not going to match there, but I continue anyway.  My only hope is they don't reject me while I am still rotating there!  Now THAT would really suck.

Eid Mubarak

I also wanted to say Eid Mubarak to all.  It was on Sunday for most, Saturday for some (the moon calendar varies it), so hopefully all the muslims out there had a festive Eid and ate hearty after our month of fasting during Ramadan.  You can read what my cuz wrote about it here.

The Bad Week

So last week I was out and about in nyc and we were hopping from bar to lounge.  At the last place we were, at I opened a tab with my credit card, and they wanted to hold my license with the tab. Fair enough.  Later in the night, after one of our friends threw up in the bathroom before she had to be half-carried out to the cab, and after another friend stumbled and fell as we walked her to a cab (later learning she had lost her brand new digital camera), I eventually closed the tab.  Sometime between there and home in the Bronx however, as I came to realize not till two days later, both of those had vanished. Shit. The two most vital pieces of plastic that exist in this world of identity.  What to do now?

A quick call and an overnight package replaced my credit card.  The license would require a more involved proccess.  As I was heading out on fri nite to make my DJ comeback (more later), I was wondering when I'd take a day off from work, to go to NJ with my passport and get my social security card and birth certificate, and some proof of address at my NJ house (if any even exists), and go wait on line to get a new one.  Unfortunatley the next day I realized my passport was no longer in my jacket pocket!

As I left friday night to Rivington Lounge on the LES--a new, small but very sleek and chill (lounge on Rivington and Clinton)--I grabbed my passport because I had no other form of ID, just in case I was going to go out later in the night.  I was spinning with my cousn and friend.  I haven't played in almost 2 years!  I was going in nervous, out of practice with old tunes, but it ended up being a great time--and my skills were somewhat intact!  Anyway, it was a fun night, but bad next day when I realized it was gone.  On top of all that, Saturday I got the Stanford rejection, and today I was somehow rejected on the phone when I called to ask a question from UCLA, surmouning the negs to UCSF, Duke, Hopkins, and Stanford.  Though that was not surprising given their calilber, no word from NYU or Sinai concerns me more.  And despite many schools making decisions very soon, my stellar subintern evaluation would not be uploaded before December because my slow ass school and lazy ass dean wont do shit for me!  To top it off, I waited hours this morning for the goddamn cable guy to show up.  I hate those guys.

I ask you, where is the love?  Could something go my way?  Today I printed out all these damn forms and see where to go to replace my passport, realizing that it also had my multi-reenntry Pakistani visa in it.  Some random terrorist could just pose as me (and probably not with difficulty), and just flee to Pakistan. Great.  Then my sister calls me, and is like "Oh my god."  Immediately I anticipated what I wanted to hear, which was: "I found your passoprt!"   Her response was close enough, and I felt like I won the lottery.  One of our friends accidently took it because his coat was with ours, and he rolls with the 'port too, so somehow he ended up with it.  Amazing.  Euphoria is all about relative changes in mood, and man was it a good feeling to learn I had an identity again!

To keep it going, I said fuck my school and started calling the rest of the programs I wanted to go but hadn't heard from.  I told them my school didn't get my eval out and time and I wanted them to see it before making their decisions.  All of them let me fax it over and had it brought to the Program Director's attention.  Ali 1, Einstein 0.   

Finally, I got me some digital cable today, upgrading from the ghetto black-boxed OG cable.  And I just activated NBA League Pass.  Every NBA game of the year.  With 3 fantasy teams, it'll be both business and pleasure!  the passport is back, my sub-i grade is sent, and NBA league pass is a go.  If I get some interview requests from Sinai and NYU, the recent events may be but a cloud of smoke in the mirror.

Infectious Disease

So these days I am on my infectious disease elective--basically I work with the infectious disease (ID) fellow and see consults in the hospital.   Since this is Jacobi, the city hospital of da Bronx, and there are a lot of people from random countries we definitely see some interesting pathology and "third-world" diseases.  It is often kind of surprising what the diagnosis turns out to be.  For example..

We had one lady come in who came in with complaints of terrible headaches she has been having for the past 2 years, now getting worse.  She is from farm in Peru where they raised cows.  We did an MRI scan and it showed "multiple ring-enhancing lesions."  (You can see the image below).  Now for you med students, this is a classic presentation for cystercercosis; , a parasite you get from eating beef or pork in endemic areas, and it borrows through your gut, travels into your brain, and becomes a larvae in a cystic cavity. Yummy eh? But we had to biopsy it to be sure. So we had neurosurgery come in, go in there with a needle and get some tissue out. And inside the little cavities they noticed 'caseating granulomas', which is basically a graunlomatous cavity with liquid necrotic tissue--which basically occurs in tuberculosis. So thats what she had, tuberculosis of the brain! What, you thought nobody had TB anymore (let alone in the brain)? Well my friends, you are sorely mistaken. She just bought herself at leasgt 6 months -1 year of 4 drug antibiotic therapy.

 

We also had this other patient, a 50 year old laddy from the Dominican Republic.  She presented there with fevers, sweats, coughing, and lymphadenopathy.  Lo and behold she was diagnosed with TB, and started on her medication.  She was not improving on the standard 4 drug regimen, and sensitivities of the organism showed it was a highly resistant TB bug--which is very bad.  SO, she jumps on a plane (having no treatment for 1 month) and comes to the US to get treated.  In so many ways this is bad--the obvious being she, who was infective, came unprotected on a commuter plane, possibly spreading TB to everyone on that plane.  Also, she stopped therapy on a resistant TB bug for 1 months.  What does that mean??  That TB bug is going to get even more resistant!  So she has brewed a super MDR TB (Multi Drug Resistant TB) Which is never good.  Her X-ray and Chest CT scan, as you can see below, shows this giant hole in her R upper lobe--basically a cavity where the TB has eaten away at.  Now she has to be on 5 medicatoins for probably about 2 years.  If she doesnt begin to improve, which is probable, we are just going to have to resect that lobe of the lung out.  A nasty disease.

You can pretty much get TB everywhere.  Hell I'll be lucky if my PPD doesn't convert on this rotation.  I think 5 of our partients have some sort of TB.  I need to put a UV light in my apartment to make sure my clothes get sterilized before I walk in.  I probably got little AFB (acid fast bacilli--the type of bacteria TB is) crawling on my clothes and I don't even know it. Shit. I'm gotta go burn this shit now

More Bush

These are some interesting links concerning Dubya's recent farce of a re-election.  further showing how Bush misleads Americans and how the election once again was not only 'close', but was not genuinine and pure in Bush's victory.

See how Rumsfield was caught on camera lying to the American public.

This site has some interesting info on Bush's deception of Americans. Particularly take a look at the video under the story of his Osama comments.of Bush,

Bush really win Ohio? Was it so close that some sort of errors or mishaps could have swung it the other way? Read This to find out some more information.

On a more distrubing note, some guy was so upset about the re-election, he shot himself dead at Ground Zero. There is one person who would rather die than see Bush for another 4 years... Though granted he was probably off his psych meds for quite some time.

Also take a look at this map that my blogger in crime Tuan sent me. This really just about says it all.

America Has Spoken

My Ass Dubya, 48% of Americans voted to send you home, but unfortunately in the little state of Ohio, all the students and young kids and sane people failed to get to the booths or mail their absentee ballots, so you won. Well what's done is done, shit happens. Nov 2nd wasnt the Day of Celibacy, but four years of getting Fucked---Because we got four more years of Bush and Dick. So we got 4 more years of George Bush... Since moving to Canada is an unlikley option, we just have to prepare for the further evolution of this great country towards the coservative rich white republican domain it is about to become.

Now, Not only has Bush gotten re-elected, but republicans have gained stronger holds in Congress!, and don't forget impending supreme court judge appointments! What is going to happen now? Well for one, all issues will be favored to the conservatives. Roe vs. Wade will be overturned and abortion will be illegal--so the gov't will have control over the decisions of a woman's body, even if she was raped and impregnated. There will be a constiutional amendment on gay marriages banning it--for god's sake, if Michael Jackson can get married, anyone can. And we'll probably invade another small foreign country and kill innocent people so that we can say that we are fighting 'terrorism,' because of course any country of brown people in the middle east have terror camps training troops for Osama to attack America right? Please. Get a load of Rumsfield in this video. Hunting for a scapegoat aint gonna get you shit. This in turn leads to even a greater federal deficit, having already put is in the multi-trillions, and more money to put American troops in harms way, and putting even more money into "Homeland Security," where major cities have millions of cops hassling citizens and Americans in everyday life whereas the terrorists sit back and chill for another few years until the 'craze' dies down, the peak of super-security dies down to a steady-state level and they attack again. And then what? If you think Dubya has you protected from terrorism, you have no idea. Because you cannot prevent Terrorism, whcih is an art invented hundreds of thousands of years ago.

The economy. Bush thinks it will correct itself from growth? I sure the hell hope he has a better plan than that this time. We have already borrowed 147 billion in the first quarter of 2005, a new record! Spending is $400 billion higher since Bush took office, and his permanent tax cuts he plans will put our deficit to $1 trilllion by 10 year.. Good lord. To top it off, Bush has never vetoed a spendin bill, and facilitates more wealth and less taxes for the rich, and benefits for corporations. What about you 'fellow Americans' who so graciously gave your vote to this man? Our kids will be paying for this, and the economic pains of this war for years to come.

The sad truth is that Americans have been misled by the shock of 9/11, the deception of the war in Iraq, and the fear of the war on terrorism. The republicans used this to persuade and gain ground on those Americans who are just frankly uneducated and unaware of all the important issues an the impact of Dubya in the future of America.

I could go on for hours about Bush and his pathetic regime, but I won't. Im sure hundreds of blogs have posted enough about it, so lets just leave it at that and suck it up and somehow make it through these four years sane and alive and with our rights intact.

Booyakasha. Respek.

“Yo check it, dis be Ali-G in da house, chillin in the eastside of the US on a big day in American History... The Laker dyansty is over, and Shaq is now on the Eastern Conference... Some crazy shit innit? No but for realz.. Election Day 2004. It's gonna be wicked tense people. John Kerry gotta put up a fight in dem swing states, so we can lose the pathetic blokes sittin in da White House. Today is going to be National Celibacy Day.... Because it's the day we get rid of Bush and Dick!"

So my costume this Halloween was Ali-G. (If you haven't seen Da Ali-G show, you must). As you can see by the pictures, I think I did quite well compared to the real Ali-G. I almost gave up dressing up as him because I couldn't find the right gear, but then I came across the 15$ yellow jumpsuit in the fashion district, found some shades and a skullcap on St. Mark's street, some fake-bling from Ricky's, grew out my goatee, and i was good to go. There were a few Ali-G's that I saw throughout the night, and my friends saw some as well, but I gotta say, mine was the best. When I walked from my friend's house to the liquor store and to my friend's after party, people were like, "Is that Ali G...Ali G, that's awesome!!" So many people came up to me and throughout the night I just kept saying, "Respek," and occasionally I'd givem a "Booyakasha!" (You can imagine how crazy it got when we all threw back a few). For a while I really thought I was him!

We prepartied at my friend’s friends’ Chelsea apt--which was damn nice I gotta say, with a huge first floor patio in the back. The preparty itself was quite fun, with lots drinks, music, and cute girls. I realized that Halloween is pretty much an excuse for girls to dress slutty (to which they agree), but who's complaining? We then head to the Canal Room in downtown NYC. The place was fun, just damn crowded. Of course the costume was quite a hit—I even had 5 or 6 peeps take their picture with me! It was great. But the best was when I ran into a Borat or two. You can see the picture below, it was so hysterical. Our conversations consisted mostly of [said with accent], "It is niiice... “ and my favorite, “High Five!" The night was fun, and we all maintained our poise.

I am now sitting watching the election race like it's a sporting event. It is 102 - 77 Bush ahead, but Kerry just got NJ (phew!). Though none of the big "swing states" have reported, so still eyeing at PA and FL closely. (PA looks good for Kerry, but FL is lookin no good)

[click on pics to enlarge]