Saturday, April 30, 2016

FrDrDr Action Figure, Conference Edition

The FrauDoktorDoctor line of action figures has expanded to five with the long-awaited addition of the Conference Goer! This doll comes with a name badge and an empty tote bag to fill with hotel pens, business cards, and flyers from publishers that you're just going to throw away once you get home. Conference bag starter kit available separately (what's in YOUR bag?).

We no longer offer paper programs; instead, we invite you to download our nifty conference app, which lets you mark the papers you want to hear, map out the closest restroom, and rate the bars/restaurants you visit with friends and colleagues.

IN ADDITION, every conference-worthy outfit needs a scarf with which you can accessorize any suit, patterned skirt, or pair of skinny jeans you want. Fringed scarf comes in paisley teal, fire-engine red, blue-green, and tie-dye red. Let us pick one for you.

Other student action figures include Biker Graduate StudentCard-Carrying Union MemberThe Dissertator, and--for a limited time only--Medical Student, which is being discontinued and replaced by Med Peds Intern (coming soon).


I recently attended a history of medicine conference in Minneapolis, Minnesota. It was great to catch up with so many friends and colleagues. After the conference ended I decided to check out the make-shift memorial to Prince at the First Avenue concert venue just a block and a half from the hotel, so I checked Google Maps on my phone and energetically set off in the wrong direction for 10 minutes. I finally figured out my mistake and retraced my steps, but by that point I didn't have time to treat myself to lunch before returning the rental car at the airport, so I just snapped a couple photos, one of the singer's star on the wall, the other of my impression of downtown Minneapolis (construction and overhead walkways for frigid Minnesota winters).

Monday, April 25, 2016

What Medical School Looks Like XXXI

Sometimes medical school looks like a surprise half-morning off from clinic to attend to teaching duties. While sitting outside on the swing in your backyard, enjoying a cold beverage. The irises have bloomed!


Sunday, April 17, 2016

Getting my Kicks in Knoxville, TN

Over the weekend I attended a college friend's wedding in Knoxville, TN. I drove halfway and spent the night with friends in Georgetown, KY, then finished the 7.5-hour drive Saturday morning. With beautiful weather and several hours before the wedding, I played tourist in downtown.

First stop was the Sunsphere in the World's Fair Park. Knoxville hosted the World's Fair in 1982, and the park is still a favorite place for joggers, dog walkers, and families with children. However, the "observation deck" on the fourth-floor of the Sunsphere was utterly underwhelming, as most of the park sits low along a creek, and the fourth floor is level with the street.

Nevertheless, from the observation deck I could see people decorating for a wedding in the amphitheater and could hear music from the other side of the tree line. So I set off to investigate. Along the way I crossed a bridge with a picturesque waterfall underneath. Dear Husband would have liked that.

Next I stumbled upon a statue of Sergei Rachmaninoff (1873-1943), who played his very last concert ever in Knoxville, TN. The next month he died of advanced melanoma.

I had to walk the long way around before I found the entrance to Earth Fest. Wandering among the booths for local recyclers and organic food growers, I decided to take the plunge: tired of using plastic "loofahs" in the shower, I invested in a couple of natural "vegetable sponges," the flexible internal skeletons of the luffa plant. I also got my photograph taken with a "tree" and a "mushroom" (above). At the National Park Service booth I petted Monty the [Ball] Python and put stickers on two of our favorite NPS sites: Muir Woods and the Grand Canyon. Then I tried to give blood, but I had left my driver's license in the car and they couldn't register me.

 View from a bridge near Blount Mansion overlooking the Tennessee River.
Next stop was Blount Mansion, home of William Blount (1749-1800), a politician and land speculator who served as, among other things, the first governor of Tennessee. I was the only visitor they had all day, as everyone else was busy at Earth Fest, the Orange and White college football game, or the big air show. After watching a pretty good video introduction, I got a personalized tour of the house and grounds. The house was built in stages as the family grew and the property changed hands. Blount signed the U.S. Constitution as well as the constitutions of North Carolina and Tennessee. Late in life he was charged with treason for trying to plot with Great Britain and Native tribes to seize Spanish Florida and Louisiana in order to retain shipping rights on the Mississippi River, where much of his property fronted. He died of an epidemic disease at 51.

The house is furnished with period pieces, including a desk with a secret compartment and a rocking bench with a removable rail so the family's slaves could tend the children as they grew from infanthood to childhood. The detached kitchen has a spice box that the matron unlocked once every morning so the cook could get what she needed. There is also a separate office with clay pipes, seals, and a traveling whiskey cabinet.

After stopping nearby for lunch, I wandered through a park (above) to Market Square (below). There were fountains, and children, and dogs, and music, and a group of people doing tai chi. Basically, a wonderful day to be out and about in downtown Knoxville, TN, where there is a surprising lot to do.

Statue to women suffragettes.

Wednesday, April 13, 2016

Available Immediately: Spacious Single Room

Enjoy the 6th-floor views from this spacious single room with 1.25 baths, available immediately and waiting for you! Comes fully furnished with an adjustable bed, tray table, corner table, wheeled sleeper recliner, and a couch that seats three and folds into a bed for one. The large vestibule is separated from the main room by a stylish privacy curtain, while the main, handicapped-accessible bathroom has a zero-entry shower, toilet, and sink. There is a cabinet with hangers for your convenience, and two kinds of black-out shades for the large picture window. Room is sequestered at the end of a hallway to give you all the peace and quiet you need. Fresh linens changed daily. Room service available for occupants and guests. It looks even better in person, so call to schedule your visit today!

In other news, I have been apartment hunting in Pittsburgh, and Dear Husband has finally been released from the hospital after 8 days of chemotherapy and/or fluids. He is tired from all the anti-nausea medications, but he is feeling better. The cards friends and family sent lined the entire windowsill! Find him on Caring Bridge. For more details about "the temerity of a tumor," click here.

Monday, April 11, 2016

When You're a Medical Student and Your Husband Has Cancer

DH drinks "berry-flavored" oral contrast
for a CT scan the first day in the hospital.
I asked him to let me taste it, so I know
what to tell my future patients. It's less
"berry" than "fake-grape" flavored.
Editor's Note: For those of you whose spam boxes ate the email I sent--we are keeping the news off Facebook--Dear Husband has been diagnosed with a large mediastinal seminoma and was admitted to the hospital last week for a work-up and to start treatment. Cross-posted on Caring Bridge. 

Now that the chemotherapy is catching up with him, Dear Husband has been either nauseous or fatigued. Our oncologist has been very understanding about keeping him in the hospital, where he can get IV fluids and anti-nausea medication even while he sleeps. Until he feels well enough to write again, I thought I would tell you a little bit about what it is like to be a medical student whose significant other is being worked up and treated for cancer.

The first thing to note is that cancer was not on the long list of differential diagnoses I had developed for DH's progressive and months-long chronic cough. We had discussed whether he should see a doctor for weeks before he finally got fed up enough to go. Could be post-viral cough, I thought--we have symptomatic treatment for that. If it were bronchitis, then he needed antibiotics. He couldn't remember whether he'd ever gotten a booster shot, so it could be pertussis, though I doubted that was treatable this late in the game. Could be allergies, I supposed--we had a freaky early spring here, and over-the-counter allergy medication seemed to help a little. Or, since he was coughing at night, his childhood asthma could be making a reappearance, although I didn't detect any wheezing with my stethoscope. A mediastinal mass compressing his trachea was not anywhere on my radar, so I was surprised when he sat me down after dinner one night to announce that he had gone to convenient care, had an abnormal chest x-ray, and the doctor thought it might be lymphoma.

Naturally the first thing I did was ask him more history questions (loss of weight or appetite, fatigue, night sweats?). Then I walked him through the print-out of laboratory values he had been given, explaining what each one measured and noting only a single, slightly elevated result, which might or might not mean anything. Lymphoma didn't seem to fit his clinical picture. So the second thing I did was consult the interwebs. Yes, medical students and doctors research things on the internet! I skipped Wikipedia and went straight for my favorite online medical encyclopedia, Medscape, where I researched the causes of antero(superior) mediastinal masses. A mnemonic holds that there are 5 Ts: thoracic aortic aneurysm, cancer of the thymus, cancer of the thyroid, teratoma, and "terrible" lymphoma. Given his symptoms (mostly just cough and inability to run anymore) and the CT scan results the next week, I decided it sounded like a thymoma and started reaching out to medical colleagues for recommendations for a chest surgeon.

Meanwhile DH was scheduled for a CT-guided biopsy at one of the hospitals at which I have rotated. We arrived early on the morning of the procedure, and since there was no volunteer at the info desk, we proceeded upstairs to the OR, where we were told we needed to register downstairs. What? I had no idea what office the woman was talking about. Medical students never see patients that early in the process. So we went back downstairs and figured out how to register for a same-day procedure with interventional radiology. They don't teach us these things in medical school.

After the biopsy came the waiting. And the speculating. And the wondering how much this was going to throw off my clinical schedule. Thankfully my attending physicians have been eminently understanding, encouraging me to focus on DH first and school second. Because I have already Matched, and class ranks and honors have already been decided, the rest is just formality. There is nothing to keep me from graduating, although we are anxious that DH feel and be well enough to attend the ceremony. As Doctor of Musical Arts and Loyal Spouse, he has the long-awaited honor of bestowing upon me my green velvet hood as Doctor of Medicine.

Once the diagnosis came, the research and anticipation changed, of course, to chemotherapy, which is better and worse than surgery to open his chest and scoop out the tumor from among so many important structures: heart, lungs, the nerves that let him breathe. Chemotherapy means months of nursing and running him back and forth across town for appointments. Thank goodness we have so many willing friends in town! I also realized is that T for "teratoma" is really shorthand for "germ-cell tumor," which includes seminomas (what DH has) and non-seminomas (which have a worse prognosis).

Being a medical student means that the doctors and nurses have talked to me with a little more medical jargon. They have let me manipulate the scans on the computer. One even let me scrub up to access the port in his chest for the first time. Dear Husband delights in the ways in which he has contributed to my medical education over the years. When I was learning how to do a physical exam as a second-year student, and my student-partner came down with mononucleosis, he graciously let me listen to his lungs, tap his reflexes, and feel the pulses in his feet, over and over again, until the routine seemed a little less foreign to me. He joked that he must have been the healthiest guy, since he'd just had ten physicals. Now I've done my first port access, and it wasn't terrible for either of us.

Although I understand the vocabulary and am familiar with many of the drugs DH is getting, I do not have any experience with oncology treatment, so this is a learning experience for both of us. Particularly with this first round of chemotherapy, we wonder what each day will be like. Today's nurse assures us that succeeding rounds will be less physically demanding, as his body accommodates to the rigors of the chemotherapy. So that's all we know for now. We will keep you updated.

Here is a follow-up post about being a resident in a new city with a husband with a cancer diagnosis.

Sunday, April 10, 2016

I've Got Something in My Pocket...

The first time stitches popped on my backpack, I was hauling it onto my shoulder in an airplane, having just landed in Germany for 10.5 months of dissertation research. It was stuffed full of laptop, camera, cords, snacks, and goodness-knows-what-else, and a few of the stitches on one shoulder strap snapped. Wow, that was fast, I thought to myself. This brand had been recommended to me because of its sturdy design.

Since then I have reinforced the straps numerous times, and for at least a year only one zipper on the main compartment still caught the teeth of the zip. My parents had offered to buy me a professional bag for my PhD graduation, but I told them I wouldn't need to haul my laptop or books around with me while on the wards as a third- and fourth-year student. Then the other zipper lost its catch last week, and I realized it was time to bid "adieu" after almost six years of companionship.

These are some of the things I found while cleaning out its many pockets: the dish towel I used as a shock absorber in the bottom of the laptop compartment. 0.7-mm pencil lead for the clicky pencils I almost never use any more. My trusty little USB key named "Handymann," with the remains of a green flower sticker I begged off my landlady's 6-year-old daughter in Dresden, to mark which way was up. The clasp back of a stick pin.

The card reads "Paradigm Pioneer ~ Shift Happens" from friend and former pastor Howard O. Nash. I think he would be pleased by some of the shifts in social attitudes that have happened the last couple of years, but he would have had a regular conniption fit at current presidential election cycle. The pink pin "I [triangle] equality" is from Lambda Legal, the country's largest and oldest legal organization working for the civil rights of lesbians, gay men, and people with HIV/AIDS.

A friend in Germany bought me the hand mirror with a peacock on the back at Schloss Moritzburg in Saxony. The collapsible hairbrush is also from Germany (no special associations there). Finally, the beautiful business-card holder with a Gustav Klimt design in mother-of-pearl is was my parents ended up getting me for my PhD graduation. I always get compliments on it when I pull it out at conferences or an interview.

That's it for this week. Nothing deep. I just wanted to share these little bits of my history that I've been literally carrying around with me. Some of them have been transferred into my new (old) backpack that I am using again, others have been tucked into my desk. I'm sure that there will be some different objects the next time I need a new bag.

Friday, April 1, 2016

Med School Bloopers 2

A year ago I risked public ridicule by sharing a top-ten list of cringe-inducing moments from the first three years of my medical school experience (Med School Bloopers 1). As predicted, a year of clinicals and traveling for residency interview yielded more than enough for another top-ten list. It doesn't even include near-misses--like the day I almost dunked my suit in a public toilet--or other people's bloopers (like applicants showing up for interviews and the program coordinators not expecting them).

10. The time as Pediatrics Teaching Assistant I called a student for a mock phone interview under the guise of being a concerned parent contacting the clinic after hours, only to have the student break the fourth wall and ask if it was really me, since I had called a day earlier than scheduled and scared the crap out of him.

9. Then there's the time I scheduled an evening teaching session at the last minute, forgot to put it on my calendar, and went to a movie instead.

8. Lost on the interview trail: Luna cup, dongle to connect digital camera to laptop, digital camera, collection of dongles to connect my headset to my laptop, jewelry case, facewash. Broken: steel water bottle. Found on the interview trail: Luna cup, digital camera, dongle collection, jewelry case, my mother's penguin t-shirt, and a black slip I had been missing for some time (it was under the bed several of the other things).

7. Once I showed up for an interview, expecting breakfast, but all they offered was bagels, cream cheese, and coffee. It was a long time until lunch. The next day I spent $12 on an omelet with hash browns at the hotel, only to arrive at the interview to a full breakfast with baked goods, quiche, fruit, coffee, and juice.

6.  Another time I turned-down a home-cooked breakfast because "they're going to feed me," but all they had was coffee, chocolate, and "pocket snacks" like granola bars and fruit snacks. The next morning I accepted the home-cooked breakfast only to arrive to 6 kinds of coffee, tea, OJ, oatmeal, yogurt, a bowl of fruit, and a pyramid of bagels.

5. The time I bought a Greyhound bus ticket, forgot to print it out, went on a wild goose chase to find a copy shop open at 8:15 on a Saturday morning, and ended up having to repurchase my seat--in cash--at a 200% markup. And the bus was an hour behind schedule, of course.

4. Q: What idiot drinks from her spouse's water when she knows he's sick and it's the middle of interview season? A: This one. The results were utterly predictable. (In addition, he caught what I had just gotten over.)

3. While visiting a program, thankfully not for an interview: Tried to take a selfie with the skeleton in the glass conference room after everyone else had left. When the elevator dinged I turned around and noticed the program director, upset the skeleton, and dropped my phone, cracking the screen some more. Instead of getting an oh-so-clever pic, I ended up hiding out in the conference room for 15 minutes, even though the PD had long since caught the elevator down.

This is the image I snapped on my camera just before the battery died. The calvarium (skull cap) is askew, so I fixed it and tried to take another with my phone, with disastrous results.

2. Being late for a morning appointment because I needed a jump after leaving my headlights on all night.

1. Twice. Three times, although I think the third time was due to the car door not shutting all the way, and I wasn't late, because Dear Husband let me use his car that day.