"I don't know about you, but my mouth gets really dirty"

The quote is from my anatomy professor. He was talking about how to equalize the pressure in (i.e. "pop") your ears, like during airplane take off or landing. Apparently you should yawn or swallow, not plug your nose and blow. Someone asked why it was a bad idea to plug and blow. I guess bacteria from a dirty mouth can get pushed up into your middle ear and cause an infection. At least I hope he was talking about bacteria.

Not the best day today. I had to interview a "patient" (an actor) in front of a large discussion group. It did not go well. She was a good actor though. I think she's up for an Oscar the the category "best performance in a bitchy role."

I've picked up racquetball again here in med school. I played a lot growing up at the YMCA in good ol' Beaver Dam. I also played a lot in college and grad school. There is a group of about 8 of us that play almost every day. These are all classmates of mine. Then I met some guys who work at my school who are older than me, and I play with them about once during the week and on every Sunday. It's funny, the young guys I play against I can pretty much beat every time, though they are getting better quickly. The old guys on the other hand - and one guy is in his mid-50s - beat me like a rented Dodge Neon. I haven't taken a single regulation game off of any of them yet. I got into a tournament here and drew one of the old guys for the first round. It's a best of 5 games to 15. We played three games and if you add up all my points from the three games, I doubt I broke 15. I was trying to play today and when I finally got onto the court, I played two points against a friend of mine before we got kicked off for a yoga class. Another crappy part of the day.

On an up note, this weekend is my school's annual ski trip to Tremblant, a resort just north of Montreal. Between medical school applications and interviews last year, I didn't get in a single day of boarding. So this ski trip has been a long time coming. From what I hear though, east side skiing is not the best. Word has it that it will be icy and not very steep. I don't mind the non-steep, but the icy part will suck if true. But then again, boarding is like sex. When it's good, it's great. When it's bad, it's usually my fault. I will have to brush up on mon Français as we will be deep in the heart of French Canada, eh. As you can see, I have begun my cultural warm-ups already:



I promise ski pics upon my return.

"Well, this really doesn't look good"

Saturday I worked at my school's student run free clinic. It's located in the very poor inner-city Bronx. Thus, most of the patients have no health insurance and in fact, very limited access to any kind of routine health care. This is my third time working there. The first two times I did important, but not the most exciting jobs. I took vitals and processed specialist referrals. Yesterday I was a clinical shadow, so the day was a little more exciting. When you shadow, you basically tag along with one of the 3rd or 4th year students who are acting as physicians at the clinic. They see patients, take the history, do any physical exams, make a diagnosis and plan treatment. They then run all the information through a "real" MD who is the attending doctor for the day. The attending then makes sure the plan is sound or adjusts it as needed.

My day was pretty uneventful. The patients we saw had problems like strep throat, or needed a gynecological exam or a refill of some prescription. During one of the waits for our turn with the attending, a 4th yr student asked me if I wanted to do an EKG. An EKG is one of those electrical traces of your heart:

I said sure, I'd like to learn how to run one. So we went in and popped the little stickers onto the guy's chest and started up the machine and got the trace. The 4th yr looked at the results and I could tell that something was wrong. Her eyes got just a little bit wider when she first looked at them. So she said that she had to go talk to the attending to confirm what she thinks this is showing. When we left the room she said that she thought the guy needed to go to the ER because she thought the EKG indicated a heart attack. I asked how long ago she thought he had the heart attack. She said "No, he's having the heart attack right now."

So we showed the attending the EKG and she said "Well, this really doesn't look good." The 4th year went outside, hailed a cab and took the guy to the ER. I have no idea if he's OK nor not.