Behind the White Coat

The Shaadi

So finally my cousin is married.  It was an epic wedding, as there were functions up in Buffalo the week before, and more functions in New York this past weekend. Though I am sad it's all over!  When you get into the shaadi mode, it's hard to get out of it.... Anyway, like I mentioned, it was a Muslim-Christian wedding, so it was somewhat of a fusion wedding.  Buffalo was the Church function, which didn't turn out to be any sort of pure Catholic ceremony, but instead more of a multifaith, integrated ceremony, where they read from the Bible, the Quran, and, even the Tora.  They also left out the "you may kiss the bride" portion, I suppose that was a wise compromise....  It turned out to be a good time since all our cousins were there to hang out.  We also got to sneak a peak at Niagra falls, and eat buffalo wings at Anchorbar, the home of the original Buffalo wings.  The nightlife was, well, ghetto.  But we found salvage at a bar called Soho lounge for drinks amongst frat boys and white trash.  At least the beers were dirt cheap!

One of the crazy stories of the Buffalo trip though was the airport incident.  So get this, I check into the airport, get my boarding pass, and am waiting at the gate. Of course half the 20 row plane we are taking back to New York is our family, so a short while later, the rest of the brigade arrives.  As they check in, my aunt, who has my last name as wel, got her ticket at the counter, checked in, walks through security, and has her ID checked and everything.  Security was standard, slow, checking all bags, making you take off shoes and belts, and takin away any lotions or liquids over a certain size.  When she gets to the gate she sees her boarding card, and it is the exact same as mine.  That's right, she has "Ali Haider seat 1A" on her card, just as I do....  Are you kidding me? I was shocked! It was issued to her, AND she passed through the ID check with the WRONG fuckin name on the boarding card.  How can you even issue two of the same boarding cards and not know? What the hell kind of security is this?  So many millions of dollars and anally retentive checks, and even making walk through some weird ass machine that blows air up your clothes, and you issue a second boarding card for a Paki dude named Ali to an auntie.  I just couldn't believe it.  It coulda been some sleeper cell terrorist taking my name, shooting me in the bathroom, and then hijacking the plane, all the while I would be the one blamed for it all!!    Unbelievable.  The airport personnel didn't even make a big deal out of it, and ironically I wanted to bitch them out, and ask them what kind of freakin system are they running here? But decided not to push my luck..  But just goes to show, are we really safe when we fly??  I don't know.....

Well we did make it back in once piece.  And the whole week was filled with dinners and dholki's my cousin's house, which was essentially the Shaadi House, as the Mehndi and Nikka, and Valeema were all there.. Friday and Saturday was the Mehndi and Valeema, and it was nothing but fun.  Great set up, great food, drinks, and a lot of dancing. We even did a choreographed dance, which will never make it to youtube contrary to popular opinion.  Oh there were problems sure, like the power kept going out because the lights and DJ equipment kept competing... Of course I somehow was appointed the electrician, and was dancing banghra to Daler Mehndi one second, and running into the basement to flip the circuit breaker the next.  Food catered by Diwan grill, you can't go wrong with that! The DJ was great, I'll throw him a plug in case you ever need a good DJ for a desi event - DJ Gudah.  I forgot how much I loved Pakistani weddings, as it has been a while since I went to one, and it was a great time, mostly thanks to our great family and friends.  I have tons of pictures that I've launched onto facebook, so feel free to check them out, as they tell the story better than words.  And of course, Good luck to Umar and Judith!

The Match

I've been a little busy lately.  It is my vacation, and also my cousin's wedding as some of you may know.  Buffalo last week, and this weekend here in New York up in Westchester.  The Mehndi was last night, and the Valima tonight, and I have to say it was loads of fun!  But of course the other big story is the match...

Yes my friends I did indeed match!  I will be doing my cardiology fellowship at North Shore & Long Island Jewish (it's a combined program of the two hospitals).  I will be starting in July of 2008, as I have my final year of residency starting in one week (we apply a year early, it's weird). I will say yes I am happy.  It is somewhat bittersweet, since it was my fifth pick, and not one of my top 4 as I was hoping for, but North Shore is a great place, highly regarded, and I will have great training.  I will definitely be getting my ass worked there, as it is known to be a very busy program, but I must say I am greatful to go there, and so relieved the match is over! It was like biting nails until I logged on to check the result! Oof!  I will be going with another friend from Montefiore as well, so that is definitely a great plus, and will make it much more fun.  Some of the applicants from my program got their 10th or 11th pick, and two of the 14 who applied from my program didn't match at all, so I should be very happy indeed!  It was a rough year for cardiology, super competitive, more than it usually is! The funny thing is, my dad actually did his internship there bacdk in the late 60's!  Who would of thought, inadvertanly really following in daddy's footsteps.. Array!

Anyway, it's 230am, im a little tipsy after the super fun Valima, and time to sleep.  Tomorrow I'll start feeding y'all stories of the wedding, which really made me remember how much freakin fun Pakistani weddings are!  Until then....

D-Day

Vacation is a great thing.  I usually go away, but because of the wedding this past weekend, and this coming weekend, I decided to hang around NYC and roam, relax, shop, eat, and play.  I have some stories to recount from this past weekend in Buffalo, but right now my stomach is twisting, hairs are standing, and I have been having intermittent palpitations, as I await tomorrow: D-Day.  I guess it should be M-Day, because it is the Match of course.  Tomorrow at noon I will find out where I match for Cardiology.  I know I'll match somewhere, but the question is where?  I was totally fine through interview season, as well as the last few months, until today it hit me.  I kept myself busy today by doing a moonilghting shift from 8 to 8, I am still here, and still shitting a brick, sweatin a storm.  I'll have to go home and have a stiff drink or two, and face the day tomorrow....  Anyhows, here we go.....

Shaadi Time

So heading to Buffalo today for my little cousin's wedding (well he's 27, so I only got 2 years on him. But damn, I definitely feelin the age now). Gotta love the shaadis!  He happens to be marrying a white Catholic girl, so needless to say drama has been cooking for quite some time.  I am excited, both for the wedding, and any drama that may simmer, brew, or explode.  Is that a twisted way of looking at it? I don't think so.  A wedding is a great occasion, and I say welcome to all things that make it all the more memorable! Besides, what wedding lacks drama? This just happens to be kicking it up a notch.  Or this could be just another step in counteracting the negative East-West sentiment in the post 9/11 era, working towards a union of people, culture, and ideals.  Or, as our elders seem to think, it could be a disaster.  But alas, only time will tell! Though it's not like inter-religion (particularly Muslim-Christian) is not that uncommon as it used to be in our generation...  I'm no super religious person, so I say do what makes you happy.  Besides, given the stats, it's gonna happen to someone in your family (inter-religous marriage) if you're Muslims residing in the U.S.!

The Buffao portion is the bride's portion of the wedding, which happens to be taking place in a Church.  The fam wasn't too happy with that, and as of now, my Cha-cha (Uncle, father of the groom), has refused to attend the Church portion of the wedding! And neither is my father because he has to back up his lil bro. I think aside from being upset about my cousin marrying a white Christian to begin with, he was upset that they opted not to choose "neutral ground", given that the religion was the biggest ordeal in this forbidden union.  The "Paki portions" of the wedding will be the following week, with all the events being in people's houses.  I suppose I see his point of view in the whole thing.  Though I wonder if he will eventually break down and just go.  They will all be in Buffalo, and are planning only to attend the reception, not step into the Church.  But will they give in at the last minute?  I'm curious to see...  And on a side note, I thought the Catholic church could only marry 2 Catholic, am I mistaken?  I wonder if the Priest knows this.  This should be interesting indeed!  Regardless, lets hope there is tasty food, free flowin champagne, and of course, hot bridesmades. 

I leave with the latest song stuck in my head....

Mylo - Otto's Journey

Bathroom Codes

I was the "day float" on this past Sunday, which is basically me covering the patients of all the interns who have that day off.  It's a grueling day because there is a shit load of patients, and often a lot of stuff happening at once.  So there is this one guy who was quite sick.  Just came out of the MICU, he was 50, and had metastatic pancreatic cancer, far beyond any sort of chemotherapy.  There were metastases in his liver, lung, bowel, everywhere.  He was basically on the road to death, and probably had not even a week left.  I saw him in the morning, and he didn't look too hot.  Quite lethargic, breathing heavy, and just looked sick.  His pain was adequately controlled at least.  I looked at his blood tests, and things did not look good.  I discussed with him the issue of DNR, which was addressed several times over the past few weeks.  He insisted that his decision was to be resuscitated in case the worst were to occur, despite understanding the chances of him being revived were slim to none.  His family wanted him to be DNR, but he was quite with it despite being so ill, and it was his decision.  I spoke with the oncologist, and we both agreed that he probably wouldn't last the next 48 hours.  I ordered a few more tests, and went on my way to see some other patients...

Ten minutes later, I hear a code called on the overhead speaker, on that same floor.  I knew it would be him.  I made a run for the stairs, intercepting the other residents heading in the same direction.  When we got there, he was found unresponsive in the bathroom, and the nurses could only pull him halfway out the bathroom door.  He was a big guy, maybe 6'3", 230 lbs, and dead weight on the floor. Forget about getting him up into the bed, we were goin to code him right there.  From the waist down he was still in the bathroom, partly sitting in urine and feces, and his upper half stuck out the door, with the wall only a couple of feet from his head.  The whole team was there by then, and there was no pulse.  I got on my knees and started chest compressions as we got the cardiac monitor on him.  The rhythm showed asystole. Flatline. No shockable rhythm. Resume CPR and get him the meds! To make it worse, he had no IV access, so my co-resident jumped over him into the bathroom to try and put in a femoral central line.  Respiratory team arrives, as he is being bagged for breathing.  How the hell would they intubate this guy while he's lying on the floor, 2 feet from the wall?  I don't know how they did it, but somehow they tubed him.  Still no access, so we gave him the epinephrine and atropine through the endotracheal tube.  Now 8 minutes into CPR, my herniated disc was about to pop, so I gave the job to an intern as I leaped into the bathroom side to try and help my colleague with the femoral line.  I had to kneel inside the shower, with barely any room to work with!  Bad day to wear my jeans and nice sneakers I thought briefly as I felt the sweat sticking to my clothes.  After a few sticks I got the access, but the line kinked on the way in. Fuck!  We managed to get one round of meds in, but then lost the line. Luckily the critical care fellow was able to get one in on the opposite groin. More meds given, and by then it was 17 minutes into it.  Even if we were successful at this point, he'd be brain dead.  We called the time of death 23 minutes into the code.  I was not surprised, but somewhat shocked how fast it happened, especially after having discussed the issue not 15 minutes ago....

Aasif Mandvi on illegal immigrants

This one is too funny

The Day of Submission

Today was one of the more stressful days I've had in months.  Forget about the fact that I was on my fourth 12 hour ER shift in a row, on the "West" side of the ER--which is where all the really sick people are--but add to that the fact that today was the day my rank list for fellowship was due for submission.  Shit!  I tell you, I have a knack for procrastinating, but I had a huge element of indecisiveness that came into play on this one, and last minute panic for that matter, all of which made me go somewhat crazy.....

So my day in the ER started off OK.  I picked up maybe one patient every 2 hours at first, a pretty chill day.  It was the day of GI bleeds today. One dude showed up vomiting liters of blood, the last one right in front of us, bright red with clots and all.  Hepatitis C cirrhosis on the transplant list.  We gave him some blood, got him an endoscopy, and he was doing pretty well. My second guy was a guy with alcoholic cirrhosis who was found in a pool of blood.  That blood came from his ass, oh yes indeed.  Probably a liter or so of blood poured out.  By the time he came to the ER and got cleaned up, he was stable and not bleeding.  That is of course until we did a rectal exam on him, probably disrupting some clot, and out came pouring blood, and I mean it just kept coming!  We finally got him a colonscopy, finding the oozing internal hemorrhoids and rectal varices from his cirrhosis.  His blood alcohol was also at a level that could kill a horse.  Finally the sad case of the 44 year old lady with ALS.  It had progressed to involve everything, including her lungs and mouth. She was trach'd on a vent, with a PEG tube, and could only move a few fingers in her right hand, couldnt speak, but could understand everything you say.  So sad.  If it were me, I would want it all to end.  That subject, which may remind you of Jack Kevorkian who was recently released from prison, is a subject for another day....

So my ER shift ended at about 7:15pm, and my rank list was due at 9pm.  I got home at 8pm, and kept pondering!  I just could not make the final decision.  I ranked 12 programs, and it was numbers 5 through 8 that I just did not know what to do with.  I changed it so many times, and got so damned confused by then!  I hope it doesn't have to go down that low, but shit, it is so competitive this year, you just never know.  I am already having second thoughts about my final list, but just gotta let it go, and go with it, and just prey.  I know I will match somewhere, so that's all that matters I suppose. Even if I go to a place that gets my ass whooped, and I have no life, I'll be a cardiologist in the end....  June 20th is the magic day, so just gotta keep the fingers crossed....

Bollywood Star?

So I am working in the ER these days.  As I am walking around doing some busy work, I see this desi patient and some family member in the ER, who kept glancing over towards me.  Eventually the man who was with his sick wife flagged me down.  I assumed it was a medical question or to translate something vital to the wife's illness.  Instead, he asks me where am I from.  I told him I am Pakistani.  "Ahhhh", he says.  "You look just like Abhishek Bachan!"  And they gave me this smile and the head nod, and that was it.   Great.... Is it because I regrew the beard? Frankly I don't see the resemblence... Though I don't blame them for confusing me with a movie star.  Aha, aha! Balle Balle!