This thing I refer to as My Life

The break draws to a close. It was a nice several months filled with family, graduation and resting. Lots of resting! Alas, the sleeping is going to come to a quick close with the start of intern-year this week. It will start pretty easily with Basic Life Support on Wednesday, Orientation on Friday, and Advanced Cardiac Life Support on Saturday and (I think) on Sunday. Monday (if I understand the schedule correctly) will be a BIG day. I will start with my first rotation on the Medical Intensive Care Unit. I think what worries me most is the fact that I don't know anything about the new hospital. I don't know where anything is kept or how any of their paperwork is done. It will be something of a trial-by-fire. Probably, there will be lost of great stories to tell, however, I doubt I'm going to have time to tell them because if I have time to write, I should probably be reading or sleeping. But, we'll see. I may need some time for catharsis. We'll have to see how peds goes as far as "extra curricular time" goes.

Last week I had my pre-employment physical, which is pretty much an excuse to get me to pee in a cup to be tested for drugs. I tried to stay away from foods with poppy seed! It took me a solid 50min to drive there at 1p. I lost track on the way home because I got off of the highway to get gas and kinda' got lost. That turns out to be something of a mistake in down-town Detroit. I suppose the Caucasian-old-man in the green convertible with the top down sorta' stood out. There were a lot of people watching drive down the road. Oh well!

People are still making fun of me for not driving the WRX very much. They're just crazy! The weather has been great here! Perfect for the rag-top! The WRX will get its chance soon enough.

In fact, I went through a special experience with the WRX last week. I installed new spark plugs. In more cars, you would not think of this as a challenging job. Well, maybe that's not so true with the newer cars. In fact, three of the six plugs in the Sebring are completely hidden by the intake manifold.

When we first got the WRX, I was checking the fluid levels and I started looking around for the distributor cap: which I could not find! Then I realized I did not see a coil and there was nothing on the engine that even approximated plug wires or spark plugs! That prompted an internet search and education session. It turns out that there is no distributor cap and there is not one coil, but rather, there are four at each of the spark plugs! Since the pistons are horizontally opposed, the plugs and coils are rather low on the engine so to change them; you have to take out the battery and washer fluid reservoir on the driver's side. Neither of which is difficult save the fact that my washer fluid was full so I had to plug the rear wash outlet to keep it from free-flowing. On the passenger's side, I had to remove the air intake and air filter assembly--all plastic pieces but bolted into place. The new plugs were $10/each for the stock plugs. All of the information on the web suggested sticking with the original plugs or going one-step-cooler if you run the engine hard, which I don't. The one-step-cooler plugs were even more expensive. But, with that said, the car runs MUCH better now, at least from a standing start. Before, I had a great deal of difficulty getting the car going without bucking a little in first gear. I could rev the engine a little more, but I don't want to be that hard on the clutch. Much to my surprise, the new plugs resolved this and I can work the clutch they way it is supposed to be worked.

I'm having some warranty work done on the AC on the Subaru and I am, so far, unimpressed with my local Subaru dealer. My neighbors have had similar experience with some clutch-work. I figured they could not screw up the AC, which they have not yet, but they are slow to get parts for the car. I think this will be the last trip to this dealer and I'm going to start going to a dealer closer to work for future warranty repair. Hopefully they'll be better able to work on the car.

Remember to change your URL on your bookmark to ~mschin!

First order of business.....
Now that I am a distinguish alumnus of MI medical school, they are going to close my account down. Thus, I have moved the web page over to ML's account. That at least buys me another year! So, you need to change the URL with the part of my name with ~egozansk to be ~mschin. The rest of the URL is the same. Those of you who just view the blog without any of the frame around (like my mom on her computer at home), you don't need to do anything!

Second order of business...It looks like my schedule has been set. It started off VERY badly but I was able to swap one of my blocks with one of my classmates and that helped a lot! As it stands right now, here's the plan
July: Medical ICU with in-house call every 4th night (q4)
Aug: Pediatrics - q4 (in-patient...hopefully it will be better than the U)
Sept: Radiology - no call
Oct: Medicine In-Patient - q4
Nov: ER - about 20 12 hr shifts
Dec: Medicine In-Patient - q4 (Very busy month! I will be hating life!)
Jan: Pathology - no call, planning to take Step 3 (the last of my non-radiology boards) and house shop during my one week vacation
Feb: Interventional Radiology - no call
March: Ambulatory Medicine (Out-Patient) - no call
April: ER - about 20 12 hr shifts
May: Allergy and Immunology - no call
June: Nuclear Radiology - no call, 2 week vacation at the end to move

As you can see, all of my call months will be over in the first half of the internship. It's not quite as good (with respect to order) as I had originally wanted, but it will suffice. Later this week, ML and I are going to Baltimore to look/familiarize ourselves with some more neighborhoods in anticipation of "the move" next year. Shortly after we return, I will start some training courses for work (basic and advanced cardiovascular life support) and then right into the frying pan of ICU! We'll see if I have time to post. Probably, if I have time to write something I should probably be sleeping. ;-)

Today, tragedy has struck my medical family. Those of you who know me best know that I entertained the thought of becoming a transplant surgeon. ML made the observation that my transplant month was my happiest month of all of M3 year and I enjoyed it so much that I did a second month of it during my M4 year. Today, the jet that is used by Survival Flight for organ procurement that is out-of-range of the helicopters crashed 5 minutes after takeoff after leaving Milwaukee. You can read about it here and check CNN for updates.

The news that has been officially released by UofM to the staff is identical to what the news reports are saying and, although no survivors have been found yet, the coast guard is planning on working through the night.

I did not know any of the staff or crew that was on board but, since I have a strong relationship with the liver/kidney transplant team, the cardio-thoracic team were our brothers.

To the best of my knowledge, this is the first crash of any survival flight and I have been told by survival flight that (at least with respect to the helicopters) one is more likely to survive a survival flight trip than a trip to the same location by automobile.

Although I never flew on the jet or the helicopter as part of my transplant service (I flew on the helicopter during my ER rotation), I always met the opportunity with great enthusiasm and I get a rush of that enthusiasm when I hear the helicopter flying overhead. (Our apartment is frequently under the flight-path.) Now that naive enthusiasm will be tempered with wishes for a safe flight for those aboard and a touch of fear for what will hopefully never happen again.

My heart goes out to the families, friends, patients and coworkers who have and will feel the impact of this tragedy.

It is a sobering thought to consider that I used to hope that I would get to go on such a mission. And, although I could say that I knew it could be dangerous, I think a part of me did not really believe, or rather appreciate, that it actually was that dangerous. I suppose it is easier to fool one's self in the presence of a perfect safety record: less so, now.

I would like to think that if I had chosen that career path that I would still be willing to go on such missions. I like to think that I have such resolve and dedication. I know that the impact a transplant surgeon makes on a patient's life can be unlike any other form of medicine I've experienced, but, is that enough?

Not uncommonly, many doctors (and especially transplant surgeons) give up their social (and family) lives for their career. But it takes a different level of dedication to put one's own life on the line and to continue to do so when confronted with such an event.

Some might find it interesting to know that I was seriously considering liver and kidney transplant surgery as a career. It was only after several hours counsel with my "transplant" mentor, that we came to the conclusion that my age was too limiting and that I was fortunate to be able to find happiness in another career path. I still think about transplant occasionally (usually when I hear the helicopter), but I worked it out something like this: I find transplant surgery a *great* place to "vacation," but, ultimately, I don't want to live there.

Peace and Love to my transplant family.