Happy 25th Birthday to my little sister, Missy!
10:07 AM

Oops! I crapped my pants.

Today is the last day I can fiddle around with my rank list. So, I think I have looked at it online three times this morning, and finally printed it so that I could stare at it intermittantly during grand rounds and M&M today. I think I'll look again, hang on...

I still think it's okay, but unfortunately, I am one of those people who is waffeling on my #1 and #2 choices. It's between Boston University and University of Chicago. The pros of Boston are that I love love love the city. It's much less overwhelming than New York (although I found plenty of reasons to love New York in general and Mount Sinai, in particular), and I love the New England flavor. I love big lobsters. I love cobbled streets. I love the harbor. It's freaking great. The program is stable, and I dug the residents. They seemed pretty cool. There are plenty of opportunities for research, if I so desire. They're getting some new faculty that sound good. The only hang up I have is that they wear short white coats for the first two years. I know this is lame, but I want to get a real coat when I'm a real doctor. University of Chicago was my dream program until about yesterday. I talked to a surgeon that I trust very much to tell me the truth about the ins and outs of program stability, and he suggested that I make Boston #1. He said that many of the well-known people who made U of C great have left, and that I would get better clinical training at Boston University. U of C is also in a perfectly misearable area of Chicago. However, I think the research opportunities are fantastic, and I don't think the clinical training is bad at all. I still think it's a fantastic program. The silly pluses of U of C are that I can drive home to my parents' house in an afternoon, and they get long white coats right away. They would both be perfectly fine for me, in terms of program personalitiy. Both are big university institutions where I could learn how to be a bit of a bad-ass (and also stay very demure and ladylike). But, somebody has to be #1. Both cities are retardedly expensive, and both are equally fun (I think). I hope that the point isn't all moot because I'll end up at my number 9 choice. That would suck a whole bunch.

I went to the Toledo Surgical Society meeting last night, which was held at the very swanky Toledo Club downtown. We had a speaker from Case Western who is doing some very interesting research on endoscopic surgery (yes, endoscopic, not laparoscopic). My immediate thoughts on this are that I would like to be able to open the abdomen once in a while. That's the fun part about surgery! You know, blood and guts! Yes! I know that this is going to be the way things are all going, but it makes me sad. My second thought was, "Why didn't I apply to Case?" That was just dumb. If I had it to do over again, I would probably have added a few programs and left a whole bunch off. That's easy to say now, though. I know who would reject me now. This speaker came again to talk at grand rounds and showed us some more cool stuff and discussed some new things in the treatment of pancreatic psuedocysts and chronic pancreatitis. This is also something I love, which is a relic of my time with Dr. Z. I heard the three rules of surgery are as follows 1. pee when you can 2. eat when you can 3. don't mess with the pancreas. I told you I want to be a bad-ass.

I'm doing critical care now, and it's pretty cool. I have had some lectures on vents and continue to be baffled by them, but I feel like I am starting to develop some form of clinical judgement. By no means am I right all of the time, but at least something comes to mind instead of the big, fat zero I would get before. It's hard to learn to trust your own common sense when the patients are this sick. I would rather have a protocol, but I suspect that later on I wouldn't like some protocol screwing with my autonomy in treating patients in what I think is the best way. I would like the protocols to be like training wheels. I have had the chance to put in some lines and I have done a couple of intubations in the OR. These are all things I will have to do sooner than I like to think about. I am reading Murino's ICU book in a vain attempt to make myself "better" before the shit hits the fan.

This is a boring post for those of you who aren't in medicine. Sorry.

In other news, my sister and Joe are coming to Michigan on March 3rd. We're going to have Missy's birthday and a very belated birthday for me. I have to work most of the weekend, as usual, but I will be able to get up there to visit for a while.

I wish I had more non-medical things to say, but I'm crapping my pants about my rank list right now. :( 11:10 AM