Deep(ish) Thotts

Tender Mercies

2012-01-03T09:57:00.001-08:00

It's funny what will jog your memory...

I started the night shift today which means that I have weekday daytime hours open for the first time in…well…longer than I can remember. I plan to fit in my sleeping, but also run errands that I have been neglecting for a long time since many such errands require you to be free during weekday daytime hours!

One such errand is getting my car to the mechanic and worked on (bad oil leak…no bueno!) So I took my car in after getting off work this morning. This left me needing to get home, so I loaded my bike in the back seat and rode it home after dropping the car off.

Enter unexpected memory. As I was riding my bike home I passed a run-down corner market (the kind that fill many of the corners in this city. Kind of like a gas station except it does not sell gas), I had a sudden, shockingly powerful flashback to my mission days. I was on a bike, feeling rather exhausted, in moderate weather, with my right pants leg tucked into my sock to save it from the bike's sprockets and a big/cheap/bulky bike helmet on my head. Admittedly I didn't have a fellow-biker alongside to serve as a flashback-companion, but regardless it took me back. I remembered one very specific day in Wodonga. It was similar weather. A day no different than many that sandwiched it on both sides. Not really sure why this day is the one that has stuck in my head all these years versus one of the others. There was nothing to set it apart other than my companion and myself were feeling very tired that day and stopped at a small "Milk Bar" (the Australian equivalent of a corner market) and got ourselves a cheap ice cream to cool off. That was it. Nothing big. Nothing spectacular. But for some reason, almost exactly 10 years after it happened, this memory came back this morning and brought with it many of the emotions I was having at that time and with it yet another realization of what that time in my life has meant to me.

It makes me think of what Elder Bednar taught a few years back:

"This afternoon I want to describe and discuss a spiritual impression I received a few moments before I stepped to this pulpit during the Sunday morning session of general conference last October. Elder Dieter F. Uchtdorf had just finished speaking and had declared his powerful witness of the Savior. Then we all stood together to sing the intermediatehymn that previously had been announced by President Gordon B. Hinckley. The intermediate hymn that morning was “Redeemer of Israel” (Hymns, no. 6).

Now, the music for the various conference sessions had been determined many weeks before—and obviously long before my new call to serve. If, however, I had been invited to suggest an intermediate hymn for that particular session of the conference—a hymn that would have been both edifying and spiritually soothing for me and for the congregation before my first address in this Conference Center—I would have selected my favorite hymn, “Redeemer of Israel.” Tears filled my eyes as I stood with you to sing that stirring hymn of the Restoration.

Near the conclusion of the singing, to my mind came this verse from the Book of Mormon: “But behold, I, Nephi, will show unto you that the tender mercies of the Lord are over all those whom he hath chosen, because of their faith, to make them mighty even unto the power of deliverance” (1 Ne. 1:20).

My mind was drawn immediately to Nephi’s phrase “the tender mercies of the Lord,” and I knew in that very moment I was experiencing just such a tender mercy. A loving Savior was sending me a most personal and timely message of comfort and reassurance through a hymn selected weeks previously. Some may count this experience as simply a nice coincidence, but I testify that the tender mercies of the Lord are real and that they do not occur randomly or merely by coincidence. Often, the Lord’s timing of His tender mercies helps us to both discern and acknowledge them."

It is only in retrospect that I can start to see how important and influential those mission years were. Some of it certainly had to do with me learning to be out, away from my family and "being my own man". Of course it did. But it is much, much more than just that. I have many shortcomings. Many that I recognize and probably many that I don't. Regardless, I feel a desire (a desire that, hopefully on occasion at least, translates into action) to live the gospel. That desire started with righteous parents teaching me correct principals, but it solidified and has persisted largely because of what I felt and experienced as a missionary.

And it was riding my bike past an old corner market that reminded me.

I needed that….

Many...

2011-11-05T08:50:00.001-07:00

I've got that feeling. Anyone know what I'm talking about? It's that feeling of frustration at yourself -- that feeling of wondering if you'll ever shape up. The problem is not that I don't know the way out of this. The problem is actually doing it.

In the New Testament there is the story of the man who lived in the tombs, possessed of many devils. Immediately upon meeting the Savior, this man says "What have I to do with thee, Jesus, thou Son of God most high? I beseech thee, torment me not." (Luke 8:28)

Right now, that is sort of how I feel. The natural man in me is reacting just like this -- trying to push away the only true source of healing and comfort there is. In essence I'm saying to the Savior "torment me not" or in other words, "leave me alone". I hope I'm not the only one who gets like this sometimes…fortunately, there is more to the story.

Christ asks "What is thy name?" and the man answers, "My name is Legion: for we are many." (Mark 5:9)

Sometimes my shortcomings and weaknesses feel very overwhelming...like today. Their sheer number alone is very discouraging. My shortcomings and weaknesses are "legion" for they "are many". I look at almost every aspect of my life and see where I could and should be better, yet I'm far far far short of the mark.

In the Bible story, Christ casts the unclean spirits from the man who then "spoke to Jesus, and prayed him [Jesus] that he [the man] might be with him [Jesus]" (Mark 5:15). Again, this is something I can relate to. Many times in the past when I've gotten this feeling, I have been cleansed through Christ. I've felt the darkness lifted. I'm confident it can happen again. This, to me, is the spiritual message of this particular Bible story -- that Christ's atonement is able to rid us of the "legion" of weaknesses and shortcomings we have. I've felt this before and I'm sure that because Christ is patient, forgiving and merciful that I'll feel it again.

In fact…I'm already feeling a little bit better...

The Mental Shelf: "Hope", part 1

2011-09-17T07:17:00.000-07:00

This has been a long one in coming…long enough that I am going to break it into pieces given that I don’t know when I will write the next section. This might turn into a year-long seriel…who knows.

Anyway, just about a year ago circumstances I found myself in made me really start wondering about this topic. Understanding has come “line upon line” and, as with so many things, there have been periods where those lines felt like they were coming fast and furious and other long periods where my attention was elsewhere and understanding came very slowly. Certainly there are many more “lines” to come and my understanding of this (and any other topic) will be in constant evolution, but here is a snapshot of what has come thus far.

Have you ever had there experience of thinking you were ready for something – thinking you were physically, mentally and spiritually prepared – only to discover when it happened that you were woefully unprepared? Instead of feeling like you hit the ground running, it feels like the ground hit you unaware at 200mph leaving you in a dark place, void of the ability to see any light ahead? The details are not important here, but over the last year I’ve had a few such moments. It got me wondering about “hope” (perhaps because I wasn’t feeling much of it during those times)…

My entire life I've heard about the 3 connected ideas of "Faith", "Hope" and "Charity". Like the appendages of a 3-legged stool, I know all three are important. I know that they are all interconnected in some way(s) and that should one of these 3 be removed, the structure would not be able to support weight. In some basic ways at least, I feel I understand what faith and charity are (even though it remains a life-long quest to increase my understanding and application of these characteristics in the way I live my life). However, hope has always been a little less clear to me -- more vague. It is harder to define and harder to identify, I think, than faith or charity. So, what exactly is it? When the scriptures speak of "hope", what exactly do they mean? What is hope based on? Or in other words, what knowledge must be in place in our minds before we are able to have the kind of hope spoken of in the scriptures? What is the precise interaction of faith and hope; where does one begin and the other end, or is such a point impossible to identify? Does hope build faith or does faith build hope? How does hope manifest itself in my life? Does it manifest the same in other's lives, or is hope an intensely personal thing like the ways each person feels the spirit a little differently? What does the absence of hope feel like and how can I identify when that is the condition I am experiencing? How is hope an "anchor"? (Ether 12:4) What does that mean in practical terms in my life? What are the fruits of hope? Or, in other words, what can we expect to feel or experience when we have hope?

I have thought much on these questions; read, prayed, studied and asked for the thoughts and opinions of others who's opinions I highly regard. I have found answers in all of these places and expect to continue to find answers. Just as in everything in the gospel, I don't think I've come to completely understand the depths of what hope truly is, but I do feel I understand it better than I used to. I expect that what I end up writing here will be useful as a starting ground or a foundation upon which a lifetime of further learning can be added. I simply wanted to try and write some of this down in order to help what I have learned become more organized and clear in my mind.

DEFINING HOPE

To begin, I think the world and the scriptures seem to use the word "hope" a little differently. In the world's definition, "to hope" simply means "to wish" or "to want". For example, how many times have I said something like "I hope I do well on my upcoming test" or "I hope (insert anything I want at the time) happens." These statements express nothing much deeper than what I want to have happen or how I would like a particular situation to pan-out. Now, there is nothing wrong with these statements. There is nothing wrong with feeling this way or expressing these kind of things. But I don't think they convey the depths of what the scriptures express when they use the word "hope".

Having said that, what is the scriptural meaning of "hope"? I have posed this question to several people and the definition that seems most complete and concise is that hope, in a scriptural sense means to have a joyful assurance of blessings to come (see Alma 22:15-16, Ether 12:4,8-9, Moroni 7:48). This, I think is a lot more than simply wanting or wishing. I think a scriptural example that I heard years ago best shows what is meant in the scriptures by the word hope and how it may differ from simply wanting or wishing.

A quick review of the story of Abraham, Sara & Isaac:

· Abraham & Sara are OLD, but receive the promise that they will have posterity and that the blessings of the gospel would come to the earth through their posterity (see Genesis ch. 18 & Abr. ch. 2). Under normal circumstances, this would be impossible because Sara was too old to have a baby by traditional methods – the only way this blessing could be fulfilled was by divine intervention.

· Indeed, the Lord fulfilled his promise and Sara had a son, Isaac.

· The remainder of the story is well known: the Lord commands Abraham to sacrifice Isaac. Abraham, Isaac and Sara’s faithfulness were tested in what is now known as an “Abrahamic Trial” (see D&C 101:1-5)

o This story has many applications to living a faithful life, though it is not what I wish to focus on. I want to take a minute and focus on the hope Abraham & Sara needed in this situation.

With this story in mind, we turn to the quintessential scriptural chapter on faith: Hebrews ch. 11

In Hebrews 11:11, we read:

Through faith also Sara herself received strength

To conceive seed, and was delivered

of a child when she was past age,

because she judged him faithful who had promised.

(emphasis added)

Let me re-emphasize the line in this verse that says, “…she [Sara] judged him [The Lord] faithful who had promised…”

Certainly the Lord is our judge and the time will come when we will make an accounting to him for how we have lived our lives. This is what automatically jumps to my mind when I hear the word “judge” in a gospel context – but in a very different sort of way, we are to judge the lord just as Sara did. What do I mean by saying we are supposed to judge the lord? When the Lord promised Sara the blessing of having a child in her old age, Sara could have judged that promise to be absurd. She could have “judged the lord” and determined that such a blessing was impossible, or perhaps she could have believed that such a miracle was within the Lord’s power, but not something that he would ever bless her with. But this is not what Sara did. In a very real way, Sara judged the lord and found him “faithful”, meaning that she not only believed that the Lord had the power to bless her with a child, but also believed that such a blessing could be given to her. In other words, Sarah felt an assurance that what the Lord promised to her, the Lord would deliver on.

With this insight, Hebrews 11:6 gains even more meaning for me:

But without faith it is impossible

to please him: for he that cometh to God must

believe that he is, and that he is a

rewarder of them that diligently seek him.

In order to exercise faith, and indeed, in order to please God, we must do a couple of things. First, we must believe that God is – meaning we must believe that God is real, that he is there; this is a logical first step. Second (and this is where I believe most members of the church have a problem. At least I know it is where I often start having a problem) we must believe that God is a rewarder of those who seek his blessing. In other words, we must “judge the Lord faithful” of the promises He has made to us (especially that of eternal life); we must truly believe that He can & will uphold His promise and that His promises apply to us personally. We can and must have an assurance that the Lord will deliver on His promises. Without these two things, we can not please the Lord, nor can we receive the promised blessings.

Unfortunately, I think it is all too easy to judge the lord unfaithful, or in other words, to believe that either:

1. The promise that the Lord gives to us (particularly those promises pertaining to eternal life) are not really as great as the Lord says it is, and that it is a fair trade to give up eternal life for a momentary pleasure

2. Believe that eternal life is great, but that it is way too far out of reach for a normal person like me. The Lord’s promise of eternal life doesn’t apply to a rotten sinner like me and that I am too far gone to be helped.

This is essentially the same point that Stephen Robinson made in his book Believing Christ. Robinson puts it this way:

Unfortunately, there are many members of the church who simply do not believe this [that the atonement can make us clean]. Though they claim to have testimonies of Christ and of his gospel, they reject the witness of the scriptures and of the prophets about the good news of Christ’s atonement. Often these people naively hold on to mutually contradictory propositions without even realizing the nature of the contradiction. For example, they may believe that the Church is true, that Jesus is the Christ and that Joseph Smith was a prophet of God, while at the same time refusing to accept the possibility of their own complete forgiveness and eventual exaltation in the kingdom of God. They believe in Christ, but they do not believe Christ. He says, “Though your sins be as scarlet, they shall be as white as snow. I can make you pure and worthy and celestial,” and they answer back, “No, you can’t. The gospel only works for other people; it won’t work for me.”

Yet the “good news” of the gospel is good news to me not because it promises that other people who are better than I am can be saved, but because it promises that I can be saved – wretched, inadequate, and imperfect me. And until I accept that possibility, until I believe Christ when he says he can bring me into his kingdom and set me on a throne, I have not really accepted the good news of the gospel – I have only accepted the messenger while rejecting his wonderful message.

THE FOUNDATION OF HOPE

Now, going back to the story of Sarah, I think Sarah not only demonstrated great faith but I think the whole episode shows her hope in Christ. I think it also shows the foundation hope must be based on. What do I mean by this? The prophet Joseph Smith taught in the Lectures on Faith that faith must be built on a foundation. In other words, we must have a knowledge base upon which our faith rests: We must know that God lives before we can exercise faith in Him. We must have a knowledge of his character and attributes – that He is merciful and just, loving, all-knowing and all-powerful, etc. This knowledge must be in place and serve as a foundation upon which our faith is built. Similarly, I think hope must be built on a foundation. Particularly, it must be built on the foundation of an understanding of God's attributes and character.

Did Sarah understand the character of God? Did she understand God's goodness and mercy? His quickness/willingness/eagerness to bless us? Did she understand that the years and years of waiting were not a punishment but rather a part of a grander plan? Did she understand that since God has promised something that it will certainly come to pass? Did she understand His endless power, patience, justice, mercy and a million other parts and pieces that when taken collectively build a mosaic of what God is like? I think that certainly the answer to all these questions is yes! Without this knowledge of God's character, I don't think Sarah could have had the hope (substitute the word "assurance") that she did and would not have been able to receive the promised blessing. In summary, I think that the foundation upon which hope is built is an understanding of God's perfect character and nature.

I like the way S. Michael Wilcox puts it:

Our knowledge of the character and reputation of Christ allows us to “come boldly unto the throne of grace, that we may obtain mercy” (Hebrews 4:16)…We worship the Savior not only because he is a God, but because he is the kind of God he is. A principal role of the scriptures, therefore, is to give us a clear picture of the nature of the Father and his Son. Our hope rests in that nature. [S. Michael Wilcox, “Hope: An Anchor to the Soul”, Deseret Book Company, 1999, p. 10]

With all this in mind, Jacob 4:6 begins to make more sense to me.

Wherefore, we search the prophets, and we have many revelations and the spirit of prophecy; and having all these witnesses we obtain a hope, and our faith becometh unshaken…

Wisconsin, the dairy and awesomness capital of America

2011-07-31T09:16:00.001-07:00

I'm having a quiet Sunday morning here in Wisconsin. It was a little over a year ago since I had a morning like this in this place. In truth it feels a little weird. So much feels familiar. So much is unchanged. In a lot of ways it feels like I never left...but in my head I know that I live 2000 miles away and I have a years worth of memories confirming that fact as well. I know my life is now in Texas, but there is so much that feels right here. As I said, it is a little weird.

I flew in yesterday. The flight wasn't bad, though I'm pretty sure they had the rookie pilot and crew-in-training on the flight from Minneapolis to Milwaukee -- "the local time here in..." (pause...whispered conversation still audible over the PA system..."what city are we in?"...) "the local time here in Milwaukee is 12:15" (it was actually 11:15). Regardless I made it in one piece. I got picked up by a good friend and got a chance to catch up a little. We met up with some other folks, went to lunch and then met up with even more folks. Went for a swim, talked, laughed. It was good times. Then, because I am now back in a place that is not a GUZILLION degrees and that has great running trails (seriously, Milwaukee park system is the best ever) I went for a nice little run. Then dinner at a favorite Wisconsin resturant (I love you and miss you Noodles & Co), then a movie with popcorn and water (one of those Wisconsin traditions I have really really missed this last year) then talking and laughing until 2:00am. **sigh of contentment** It was a good day!

I'm excited for church today. There are a lot of people I hope to see again (most of which do not know I'm in town). Should be fun!

The Best Laid Plans...

2011-07-29T17:55:00.000-07:00

"...The best laid schemes of mice and men, Go often askew..."

Robert Burns
"To A Mouse"

Despite my best intentions it has been a week since my last blog entry. I wish I could, in all truth, say that it was because every minute has been filled with exciting stories of saving lives, uplifting stories of good deeds, heartwarming stories of personal enrichment and selfless service or even just a plain old date or two. The truth is much more mundane however. While it is true that I have been on call 4 of the last 7 nights and things have certainly kept rollin' along at a brisk pace, that still leaves time that in which I was less than productive. I watched TV. I was feeling lazy/tired...sue me.

Tomorrow I head for Wisconsin. It has been a little over a year since I moved from the frozen tundra of the north to the arid Sahara of south Texas. Trips like this seem to be cause for a little nostalgia (at least they are for me). I remember when I got accepted to medical school in Milwaukee and nowhere else, I was a little disappointed. I didn't want to live in Milwaukee. My mental image of the city was an inner-city landscape of cement, pipes and smokestacks. Kind of like if the old Geneva Steel plant had been blown up to city size.

Ahhh...the ignorance of youth...

In short, those years in Milwaukee became some of the most meaningful and defining years of my life. The causes and reasons for this are many and I can't begin to touch on all of them but regardless, I'm beside-myself-excited to get back up there and see people and yes, even the city...(turns out Milwaukee is a gorgeous city...at least it is in the spring/summer/fall. And as hard as this is for me to believe, the weather up there is better than it is down here right now, especially considering the AC in my car doesn't work). There will inevitably be more people I want to see and more things I want to do then I will have time for, but I'll take whatever I can get at this point! :)

OK, better go pack now...

The Way of the Dinosaur

2011-07-22T15:47:00.000-07:00

A friend of mine recently posted the following article on her Facebook page (http://shopping.yahoo.com/articles/yshoppingarticles/648/100-things-your-kids-may-never-know-about/).

For those who do not take the time to link to it, the article is basically a list of items or activities that folks my age (early 30's) or older are likely to have grown up with but that have gone the way of the dinosaur. Like the vinyl records and and fat polyester ties of an even earlier generation, these things are only cool or remembered as "retro" items or activities. The modern coming of age experience will most likely not incorportate the items on this list.

As I read through it, there are some that I miss and some that make me roll my eyes and mutter "good riddance". The following is a list of some of these items and why I feel that way.

Things I will NOT miss:

Old music and video techology -- I don't understand the feeling of missing cassette tapes, walkmans, VHS, and even minidiscs (a techology I invested $350 in shortly after I returned from Australia in 2001). Modern MP3, DVD, and iPod are superior in every way. Less bulky, better battery life, more versitility, faster use, better sound/picture, etc. Call me crazy, but I just don't miss fast-forwarding a cassette only to overshoot, then have to rewined only to overshoot again and then have to fast-forward again, ad infinitum. Give me easy iPod navigation and DVD menus!

Floppy disks -- USB drives are again superior in every way. They hold more data, they are faster, they are easier to transport, they fail less...and subesequently that chemistry assignment will not need to be redone last minute because the disc mysteriously erased itself (curse you 3.5 inch floppy!)

Road maps/MapQuest -- Few things worse than trying to navigate the freeway system in a large city you have never been in by simultaniously watching the road and by glancing down at a map every 3 seconds. Things got even worse when you missed an exit...nuff said...the inventor of GPS should get the Nobel Peace Prize for how much he/she has decreased my road rage.

35mm Film cameras -- I love digital photography. That is all.

Things I WILL miss:

Encyclopedia sets -- I'm one of those people who think that books look great! My dream house will have a big library with built in book cases, a fireplace and a big comfortable La-Z-Boy chair. As much as I love Wikipedia and use it ALL the time, I miss a nice, large, asthetic, formitable, encyclopedia set that sits on a bookcase and that is your "go to" reference for 4th grade state reports, etc.

8 or 16 Bit Nintendo -- Give me the 2-D Super Mario who jumped on mushrooms and Goombas any day. I get sea sick when I try to watch Halo, Modern Warfare or whatever. I'd even take a Sega Genesis over the new Xbox. Remember the old 8-bit Nintendo running pad that came with the Olympics game? Totally smokes the Dance-Dance-Revolution thing!

Playing outside -- Not only do I miss doing this myself (I feel like I'm inside all the time) but I'm not sure the last time I saw a group of kids playing a pickup game of road hockey.

Calvin & Hobbs / The Far Side -- The world changed in 1995 when both of these comic strips ended in the same year. You know a comic was good when 15+ years later you still regularly recall them and still find them hillarious.

THOR -- Our Mighty Cardboard Boat

2011-07-21T19:04:00.001-07:00

I was scanning an old hard drive of mine and found an archive of old movies I had made. It brought back a lot of good college memories. The following movie is of one event -- one of a thousand fun memories (this one just so happened to be better documented than most). YouTube will only allow movies that are 15 minutes or less, so I'll have to post more of my videos in pieces but this is a good place to start. Makes me realize I need to get in touch with these guys again...college was the best!

The Dog Days of Summer (and super powers)

2011-07-21T15:34:00.001-07:00

It is always hot these days in south Texas...always…

The heat got my brain to wondering about what the phrase "The Dog Days of Summer" means, because I'm pretty sure that is what we are experiencing down here (my perception of this is almost certainly contributed to by the fact my car's air conditioning has not worked since January). According to "The Oracle" (my name for Wikipedia) and at least one other random web site, the phrase goes back to Roman days. Apparently it means "the hottest and muggiest part of the season". It makes reference to the "dog star" Sirius which is the brightest star in the sky (excluding the Sun, of course). It is bright enough that the Romans believed that earth received heat from it.

In the summer, Sirius rises and sets with the sun. During late July Sirius is in conjunction with the sun, and the ancients believed that its heat added to the heat of the sun, creating a stretch of hot and sultry weather. They named this period of time, from 20 days before the conjunction to 20 days after, “dog days” after the dog star.

Interesting, no?

As uncomfortable as long afternoon rides in my car can be, that does not mean I do not enjoy certain parts of this heat. For example, I can air dry my clothes faster (and cheaper) than by using my clothes dryer. I can BBQ at any time of the morning, afternoon or evening and it doesn't feel weird (see my delicious lunch from the other afternoon).

I've have learned however, that it is important to do your jogging in the mornings or evenings otherwise this is what ends up happening...not pretty...

On a totally different note, sometimes I wish I had a super power (apparently I watch too many movies). If I could choose a super power it might be strength or memory...or perhaps flight. These guys are about as close having a super power as anyone I can think of...TOTALLY AWESOME!

(Singing?) In The Rain

2011-07-19T16:37:00.000-07:00

It is raining outside. Down here in San Antonio that is rare enough that I feel justified in blogging about it.

I love rain. I'm not talking about the kind of rain that washes the road dust off your car. I'm talking about the rain that puts your paint job in jeopardy. Not rain that will mess up your carefully crafted hair gel but the kind that can strip fingerprints. I've never lived in a place that really rains on a regular basis, so maybe I'd start feeling differently if I had to live with it daily, but from my perspective there are few things as theraputic for the soul as a good stiff rainstorm!

It makes me think about truly memorable storms I've experienced...

I remember a storm while on my mission. I was tracting with Elder Gough in Wagga Wagga (yes, that is really the town's name). It hit fast. We went from sunny to downpoar in probably about 45 minutes. A lady who had no interest in listening to a discussion nevertheless took pitty on us and let us stand on her porch for 30 minutes because the street, sidewalk, lawn and just about everywhere else was ankle deep. It was actually a little awkward because both of us had been missionaries for over a year and had very little to talk about besides the message and the lady stood there with us for those 30 minutes until finally Gough and I just decided it was time to move on. Our leather shoes were never quite the same afterwards, but the memory was totally worth it!

I also remember the "Great Utah Tornado" of 1999. I was groundskeeping at the golf course. I was trimming the sand traps near the green on hole 3 pretty much working on my tan when the sky darkened and then exploded. As I'm sure there would be at any golf course there were a few old stalwarts who tried to play through but for most of us the day was over. After about 45 minutes my boss gave us the rest of the day off. It wasn't until the car ride home that I heard Salt Lake had been hit by a tornado.

There was a few memorable storms the summer I was in Atlanta and one I remember in Milwaukee. Most recently I was on vacation in West Virginia with my parents and brother. We were biking a trail when a storm came up. What made this storm memorable was not so much the wet rain, but the frozen kind. At first the hail stones were small and I figured my bike helmet would protect me. After a few minutes the stones had progressed to pea-sized and then...well, they eventually got to be about ping-pong ball sized. This picture shows some of them but I think they got even slightly bigger than this.

As much as these stung my knuckles when they hit; as is so often the case it was a storm that turned this event from something fun into something legendary. And you know, maybe I shouldn't be surprised...sometimes it is the "storms" that make turn something ordinary into something just a little more memorable!

What a difference a year can make...

2011-07-18T15:45:00.000-07:00

T.S. Eliot is famous for declairing that "April is the crulest month". As a medical resident however, no one argues about the fact that July, not April, is the crulest of the months. This is because July is when new interns start. "July 1st" is often whispered around the hospital in tones that make you feel like you are in 1962 Florida during the Cuban Missile Crisis. I'm pretty sure that most seasoned hospital employees would rather have a vacation week in early July than they would over the Christmas holiday.

Just about one year ago I was among the throng of deer-in-the-headlights residents starting their new patient care responsibilities. All things considered, I actually think I had it pretty easy. I started on Neurosurgery. On the surface, this may seem like a bad way to kick things off, but the service I was on did mostly scheduled spinal surgeries. The trauma and other really really bad stuff mostly went to a different team.

I did have one bad night however. I had been a resident for 3 days and I was taking overnight call. I got paged around 1:30 in the morning from the ER, telling me that a guy who had had a spinal surgery a few days ago was now back with what looked like an infected surgical site. Surgical site infections are never a good thing, but they are particularly bad when they are that close to the spinal cord. In addition, this guy was starting to show signs of septic shock. I rushed in to see the guy. I fumbled my way through admission orders (I didn't have a very good idea of how to use the electronic medical record yet), started antibiotics, forgot to take blood and wound cultures and just prayed that he would make it until morning. Fortunaly for everyone he did great. His blood pressure stabilized on the antibiotics and we took him to the OR the next morning to clean things out. He did well after this and I am happy to say he went home in good shape. It was however, a long night...

Because of the huge volume of knowlege we are expected to know in medicine, it gets very easy sometimes to feel like you are not learning anything. Because you are perpetually feeling like you don't know enough, it is easy to overlook the things that you have learned. I think it is helpful, if nothing else, to have a yearly reminder (July 1st) of just how much I have changed. That, of course, does not excuse me from needing to learn more and there is SO MUCH that I still need to learn, but it is kind of fun to look back at July 2010 Eric and see what a differeance a year can make....

Favorite

2011-07-17T09:37:00.000-07:00

Seeing that it is Sunday, I figured I'd try to keep this more Sunday-focused.

I've found as I get older that I'm now caring about things I used to scorn. For example, I now care about decorating. When I was in high school, mission and college my idea of decorating was sweeping the floor and keeping the dirty dishes in the sink to ones dirtied within only the last week. Somewhere in medical school I started to find myself changing. My roommate hung some framed pictures on the wall and I found myself liking it. Another roommate would occasionally have flower arrangements on the entertainment center to spruce the place up (and for anyone inclined to snicker, I'll defend the manliness of flower arrangements to the bitter end).

When I moved to Texas I started a slow (budget has to be considered) process of decorating my place. Anyone who cares to visit will still be able to tell that a bachelor lives here (I'm still working on the clean dishes thing) but I do have curtains, matching couch pillows, and a few dried flower arrangements. A few months ago I sprung for the centerpiece of my collection...

I've had my eye on this painting for a long time now. I first saw it in an Ensign article published while I was on my mission (around 2000 I think it was). I've seen it a few times since. I it is, barr-none, my favorite painting. I'll delve into why I love it so much in just a minute but suffice to say, it is my favorite.

I wanted a large, custom-framed, centerpiece-worthy painting. Something that I would pack up and move with me when that time comes. Something that will hang over my mantle for years to come. For those who have priced such items, they do not come cheap. I was floored by how much the framing alone costs (PS. Michael's perpetual 50% off sale is a total sham). I finally saved enough pennies to buy the print and the frame and it now hangs above my mantle. I love it. Totally worth it.

Why do I love it so much? There are lots of good paintings which would look great above my mantle. Why this one? You may notice the small black book in the bottom left corner of the picture above (the one being propped up by the candle). I keep this book next to the painting as an explanation and a reminder to myself of why I love this paining. In it I have printed some of the quotes and talks that deal with this particular Bible story. For whatever reason, this particular story seems to hold a lot of meaning for my life. I don't know why so much of it feels personal and applicable but it does. Among the many talks that have mentioned this particular Biblical event, Elder Holland gave one of my favorites. I think I sign off today by quoting the applicable passage.

One last piece of counsel regarding coming to Christ; it comes from an unusual incident in the life of the Savior that holds a lesson for us all. It was after Jesus had performed the miracle of feeding the 5,000 from five loaves of bread and two fishes. (By the way, let me pause here to say, Don’t worry about Christ running out of ability to help you. His grace is sufficient. That is the spiritual, eternal lesson of the feeding of the 5,000.) After Jesus had fed the multitude, he sent them away and put his disciples into a fishing boat to cross over to the other side of the Sea of Galilee. He then “went up into a mountain apart to pray” (Matt. 14:23).

We aren’t told all of the circumstances of the disciples as they set out in their boat, but it was toward evening, and certainly it was a stormy night. The winds must have been ferocious from the start. Because of the winds, these men probably never even raised the sails but labored only with the oars—and labor it would have been. We know this because by the time of “the fourth watch of the night” (Matt. 14:25)—that is somewhere between three and six in the morning—they had gone only a few miles. By then the ship was caught up in a truly violent storm, a storm like those that can still sweep down on the Sea of Galilee to this day.

But, as always, Christ was watching over them. He always does, remember? Seeing their difficulty, the Savior simply took the most direct approach to their boat, striding out across the waves to help them, walking on the water as surely as he had walked upon the land. In their moment of great extremity, the disciples looked and saw in the darkness this wonder in a fluttering robe coming toward them on the ridges of the sea. They cried out in terror at the sight, thinking that it was a phantom upon the waves. Then, through the storm and darkness—when the ocean seems so great and little boats seem so small—there came the ultimate and reassuring voice of peace from their Master. “It is I,” he said; “be not afraid” (Matt. 14:27).

This scriptural account reminds us that the first step in coming to Christ, or in his coming to us, may fill us with something very much like sheer terror. It shouldn’t, but it sometimes does. One of the grand ironies of the gospel is that the very source of help and safety being offered us is the thing from which we may, in our mortal shortsightedness, flee. For whatever the reason, I have seen investigators run from baptism, I have seen elders run from a mission call, I have seen sweethearts run from marriage, and I have seen members run from challenging callings. Too often too many of us run from the very things that will bless us and save us and soothe us. Too often we see gospel commitments and commandments as something to be feared and forsaken.

Let me quote the marvelous Elder James E. Talmage of the Quorum of the Twelve Apostles on this matter: “Into every adult human life come experiences like unto the battling of the storm-tossed voyagers with contrary winds and threatening seas; ofttimes the night of struggle and danger is far advanced before succor appears; and then, too frequently the saving aid is mistaken for a greater terror. [But,] as came unto [these disciples] in the midst of the turbulent waters, so comes to all who toil in faith, the voice of the Deliverer—’It is I; be not afraid’” (Jesus the Christ [1916], 337).

Elder Talmage used the word succor. Do you know its meaning? It is used often in the scriptures to describe Christ’s care for and attention to us. It means literally “to run to.” What a magnificent way to describe the Savior’s urgent effort in our behalf! Even as he calls us to come to him and follow him, he is unfailingly running to help us.

Finally recognizing the Master that night, Peter exclaimed, “Lord, if it be thou, bid me come unto thee on the water” (Matt. 14:28).

And Christ’s answer to him was as it always is to all of us: “Come,” he said.

Instantly, as was his nature, Peter sprang over the vessel’s side and into the troubled waves. While his eyes were fixed upon the Lord, the wind could toss his hair and the spray could drench his robes, but all was well—he was coming to Christ. Only when his faith and his focus wavered, only when he removed his glance from the Master to see the furious waves and the black gulf beneath him, only then did he begin to sink. In fear he cried out, “Lord, save me” (Matt. 14:28–30).

In some disappointment the “Master of ocean and earth and skies” (“Master, the Tempest Is Raging,” Hymns, no. 105) stretched out his hand and grasped the drowning disciple with the gentle rebuke “O thou of little faith, wherefore didst thou doubt?” (Matt. 14:31; see also Frederic W. Farrar, The Life of Christ [1994], 310–13).

Jesus is the Christ, the Son of the living God. This is his true and living Church. He wishes us to come unto him, to follow him, to be comforted by him. Then he wishes us to give comfort to others. However halting our steps are toward him—though they shouldn’t be halting at all—his steps are never halting toward us. May we have enough faith to accept the goodness of God and the mercy of his Only Begotten Son. May we come unto him and his gospel and be healed. And may we do more to heal others in the process. When the storms of life make this difficult, may we still follow his bidding to “come,” keeping our eye fixed on him forever and single to his glory. In doing so we too will walk triumphantly over the swelling waves of life’s difficulties and remain unterrified amid any rising winds of despair.

Jeffrey R. Holland
"Come Unto Me"
BYU CES Fireside, 1997

All Good Things....

2011-07-16T08:29:00.000-07:00

In attempting to start blogging regularly I realize that I run the risk of becoming "that person" (described so eloquently by the hilarious comedian Mike Birbiglia...if I can get this to work anyway)

(If the fancy embeded MP3 player above fails to work, you can find the clip I'm referring to at : https://brimhall.opendrive.com/files?34560747_HvBcU)

There are books that I would pay good good money to be able to read again for the first time. The James Herriott books come to mind. So does Ender's Game and a few other super nerdy books I will not embarrass myself by naming. At the top of this list, of course, lies the Harry Potter series. Through the miracle of modern technology and the good fortune of having this weekend off from work, I used my smart-phone while at work the other day to purchase a ticket for the last Harry Potter movie. I'm having bitter-sweet feelings because I'm confident I will love this movie, but at the same time it will be over. Yes, I know how it ends. I've read the series an embarrassing number of times and this ending is less bitter sweet than the one I experienced when the last book came out, but as the movie posters keep reminding me, "It All Ends Here"...

It makes me think back on the first time I read each of the books:

Book 1-3: When I got home from Australia in 2001 the first 4 books has already been published. I had never heard of them until returning home but I'm pretty sure it was the night of my arrival back in the USA when my aunt told me about them and got my curiosity peaked. I borrowed the first 3 books and (since I had not found a job yet) I went on a reading marathon. Book 1, done in one day. Book 2, done the next day. Book 3, done sometime around 2:30 the next morning (I barely slept that night. The sure sign of a good book).

Book 4: I went and did something "responsible" at this point (some might call it foolish) - I got a job - so Book 4 took me about 4 or 5 days to get through, though I did pull more than one 2:30am nights. Totally worth it.

At this point I had to join the rest of the world and wait for each book to be published before moving on...painful...

Book 5 came out the summer I was selling pest control in Dallas. I bought the book the next day and spent the bulk of the weekend reading instead of working real hard. I'm glad I got through it quick though because until I finished it, there was no way I was going to be a good salesman and make any money.

Book 6 happened the summer I was living in Logan, working as a CNA on the graveyard shift and taking a summer course in advanced calculus during the days (not sure when I slept). I took my "lunch break" (around midnight) and drove to Walmart to buy the book. I then slept even less for the next few days and totally neglected my calculus until I had finished. So worth it.

Now of all the memories from the previous 6 books, Book 7 holds a special place in my heart as one of the truly best days I can ever remember, and I'm not ashamed to admit that. I was in medical school in Milwaukee and I joined the crowds in line at Walmart for the midnight sale. As soon as 12:01 hit we all rushed forward like a stampede of cattle to get our "cud". I got home a little after 1:00 and had to read chapter 1 before I could go to bed. I woke up at 6am to start again and thus began a day where I did nothing but eat, read, answer the call of nature and (at the end of the day when I knew I would have time to finish before going back to bed) watch an action movie with my bros. I remember one moment when I sat on the couch reading and a friend came in and was trying to convince us to go to "Irish Festival" with her (I really do miss all the ethnic festivals in Milwaukee) but I was in such a zone that I'm not sure I even looked up. I grunted something about how maybe Jonny would like to go, so ask him, and I just kept on reading. Not my finest moment ever but I can't promise I wouldn't do the same thing if Book 7 was coming out again for the first time...

That brings us to today. I guess all good things must come to an end at some point....really though, has anyone invented a machine that will help me forget the fact I've read the books 6 or 7 times and let me read them again for the first time? I'll pay good money!

Revertigo

2011-07-15T17:54:00.000-07:00

I think part of the problem I have in regularly posting a blog is that I have strayed from the original intent of blogs. I have used this as a soapbox from which to pontificate and wax lyrical. Doing so takes so much time and energy that I rarely feel like I'm up to tackling another post and the next thing I know, 7 months has passed since my last post. Recently I have found myself following a few blogs who's authors have a simplified philosophy of blogging. They post 1 or 2 thoughts on a regular basis. Perhaps it is deep, personal and thoughtful (which is great) but usually it is more "salt of the earth"… I find myself checking these blogs daily and regularly being rewarded with a paragraph or two on some event or thought that is part of that person's life right now, and I'm not ashamed to admit that I love it. So, in a similar spirit, I hope to start posting shorter, more frequent blurbs.

It was probably back in September or so last year when my grandma (who up until this moment I would not have guessed knew how to check blogs) told me that she really enjoyed reading what I wrote and would I please post more about what I fill my days with. Clearly I have not done well at this, and at this point catching up is a bigger task than I can tackle, but perhaps I can catch a few highlights through the use of captioned pictures. I figure this might be a good way to jump back into the blogging world (since pictures/videos are my favorite part of other people's blogs).

This is something I totally stumbled across on a bike ride the other day. Kind of seems like a big event I've never heard of, all of which occurred near my home in a place that is now a totally quiet non-descript little road. Kinda' cool what you will come across if you as me!

This was a photo from a little vacation I took out east with my parents and brother. This was one night after a long day of seeing sights and we were just trying to watch the NBA playoff game. Cable TV was out of order in the hotel and so we reverted to watching the game on my dad's smart phone. Yes, that is right. We were watching a major sporting event on that TINY TINY little screen you see off to the left hand side of the picture! :) Totally awesome of us despite one of the most gigantic confusion to satisfaction ratios ever!

This is me on call last night. I'm on call a lot and spend a lot of nights in the hospital. This is the 5-star accommodations I enjoy when on call (actually, in all seriousness, these are pretty good call rooms compared to some I've seen)

In an attempt to get fitter, grow my list of hobbies, save on gas, go green, see a little more of Texas, flirt with a cute girl I know who also enjoys biking and have something cooler than work to talk about with people (seriously, when all you do is work, your dinner conversation skills start to suffer); I bought a nice new road bike. I've been really enjoying it (though I'm yet to flirt more or get better at dinner conversation)! I've found a few rides around the San Antonio area that I really like. This is a picture I snapped mid-ride along my favorite trail. I'm sweaty and gross, but please notice the scenery. Definitely the best I've found in south Texas.

So, as I type all this, I'm listening to an album that my good friend introduced me to. I'm pretty sure that if I could find a girl who I loved as much as I love this album, then I'd make my mother a very proud grandmother. Here is a link to one of my favorite songs off this album (PS. This whole album is amazing. This is just one small sample).

In the spirit of sharing what has first been shared with me, here are a few more songs that others have shared with me that are pure gold!

(If I could marry her voice I would do it!)

Here is one my brother shared. Good stuff.

Christmas Eve

2010-12-24T16:48:00.000-08:00

Christmas Eve. Generally one of my favorite nights of the year. The part of the Christmas season I generally find is the easiest to focus on the real meaning of Christmas. A night of family and reflection. A night of tradition, camaraderie and inner peace. My family usually spends some time in the afternoon building a snow sculpture, the scent of potpourri permeates the house and the wassail is as fragrant as it is delicious. The extended family gathers and enjoys company and a reenactment of the nativity with cute cousins as the biblical characters being directed from just "offstage" by Grandma while my dad reads the timeless words from Luke 2.

I'm gone, away from family and home, almost year-round; making my way independently, being my own man and "living the dream"...but for this one night I always return to the familiar and heartwarming. Christmas at home is almost Norman Rockwell-ian in my mind. The last time I missed Christmas Eve was 10 years ago and I was in Australia. I was dedicated full-time to Christian service and it just felt right. This year is different and I find myself having a hard time. My family is cognizant and thoughtful and has been tireless at trying to make this Christmas as painless as possible. I received several packages in the mail which have included a mini Christmas tree (complete with lights and decorations) and beautifully wrapped packages. I have presents to open and reminders of Christmas at home. Above all I have the assurance that the meaning of Christmas, the reason to celebrate, has not and will not change…

…Still, I find myself struggling this year. I feel a dichotomy of emotions. On one end I feel loved. I know my family is there. I know they love me. I have proof and reminders all around my apartment and not more than 3 feet away at this very moment. On the other end I feel very far away from where I want to be. Instead of a snow sculpture in the front yard, I got a light sprinkling of lukewarm rain on my windshield while I drove home from work. I'm drawing to the end of a particularly unpleasant month at work, and have an even more difficult one to face in January. I'm 30 and I'm watching television reruns in an otherwise quiet apartment. I feel the weight of my countless imperfections and worst, I feel like I've been hurtful to someone I care about. It wasn't intended. It wasn't malicious. But I caused this person hurt none-the-less and I can't shake the weight of that shortcoming either…

I write all this, because for me writing is cathartic. I find it helps me direct my thoughts and focus on the larger picture. Even as I write these few short paragraphs I find my heart lifting. In the grand scheme my momentary woes are "small potatoes". I have a family who loves me and whom I love. I have a calm assurance that God and His Son love all their children -- me included…I have been trying to understand the concept of hope better, and while I am still struggling to find an adequate and concise definition of the idea, I know the feeling. I'm feeling it right now. I feel the weight of this mortal experience. I feel the loneliness and frustrations common to mankind. I've had moments where hope felt lost and those moments are dark (and in those dark moments is when I find myself manifesting my many shortcomings most prominently). However, that darkness can't stand against the light of Christ and His truth. Just like I know my family is there. Just like I know they love me. Just like I have proof and reminders all around that tell me these things are true even when I'm feeling most discouraged; I know I have a Savior who is there and who loves me. I have proofs and reminders (Elder Bednar would call them "tender mercies") all round me. My life is full of them when I take a minute and allow myself to see them. My mistakes are many and wish as I might, they have had an effect on others. However, I feel hope. Hope that not all Christmases will be this lonely. Hope that even though I've been hurtful, that someday the person involved will understand that it wasn't intended. Hope that not all moths at work will be this dreary. Hope that I'll be able to build snow sculptures again with family members, and drink wassail and watch my cute cousins put on oversize bathrobes and pretend to be wise men from the east. That, I think, is what hope means…and isn't that the real spirit of Christmas?

Ode to Intern Year

2010-11-22T15:03:00.000-08:00

My last several posts have been like deep fried Crisco -- really really heavy! But today I find myself with just a few minutes and I reckon it's high time I write something that isn't quite so dense and unreadable! For inspiration I turn to my experience working as a first year medical resident.

I find that when I meet someone new and we are trying to be polite while at the same time not really knowing what to say to each other, the small talk generally includes (but is not limited to) our names, the weather, President Obama, why Texas is the greatest nation…errr…state on earth, and what we do for work (all of this, of course, assumes that we both speak English…I really should have tried to learn Spanish before moving to south Texas!) What is interesting to me is how people react when they find out that I am a medical resident! Almost without exception, people think that residency is this glamorous thing filled with perplexing diseases, brilliant diagnosis and of course, a little lovin' in the call rooms (I blame "House" and "Grey's Anatomy")! The truth, I'm afraid to say, is a little less flashy. A much more accurate picture of what being a first year resident is often like can be gleaned from watching that scene from Forrest Gump where the Drill Sergeant is yelling at Forrest asking "what is your soul purpose in this army?" and only wants to hear Forrest say "whatever you tell me Drill Sergeant!" This of course, varies greatly depending on which attending you are working with and what rotation you are on, but there have been plenty of times when I am listening to my attending where that scene pops into my mind and for better or for worse, the best thing to do is say "yes sir, I'll get that done!" and say nothing else. Now, before people take this all wrong and start to worry that I'm unhappy with my career let me set the record straight and say that I really do enjoy my work and I look forward to many more enjoyable and fulfilling years in this profession but that does not change the fact that there is an often amusing hierarchy in teaching hospitals that looks like this (from top to bottom):

Attendings > Senior Residents > Nurses > CNA's > Janitors > Harmless Bacteria on the toilets > Disease causing bacteria > Ebola virus > first year residents.

Let me illustrate how this principle translates over to patient care in the real world (those of you who have spent time in hospitals will begin to recognize these things).

Attending: I want to start rounds at 5:00 am

Resident (in his head): That means that I have to start my pre-rounds at 3:00 am…why can't we start rounds at 9:00 am?

Resident (out loud): Yes sir! What a brilliant idea!

** at 3:00 am the next morning after the resident walks into a the patient's room and wakes him up**

Resident: How was your night's sleep?

Perhaps only those who have been woken up or who have done the waking at 3am to ask this question will see the irony here, but it kills me every time! :)

More from the Mental Shelf: The Lord's "Plan"

2010-10-17T10:35:00.000-07:00

Being on call is a bit of a surreal experience…at least it is for me. It can be feast or famine, meaning there can either be so much to get done that you seriously consider taking the batteries out of your pager, smashing the batteries and tossing them off the roof and then flushing the remaining pieces of your pager down the nearest toilet! Or it can be quiet -- really quiet…

If I was forced to choose between the two, I'd go for the quiet because at least that way, you can feel confident that none of your patients are actively trying to die on you. Quiet, however, does have its downsides. You are all alone in the hospital. All of the fellow residents who are your day-to-day social life are off enjoying their brief time away from work and you are just sitting there waiting to put out the next "fire" as we like to call the little (or not so little) emergencies that pop up throughout the day. The clock seems to enter some kind of relativistic time warp and slows down to an impossibly slow rate and the sound of yourself humming amplifies and starts to ring in your head!

Anyway, I'm on call right now and it is quiet. I should probably spend the time reading and studying, but I'm just not in the mood right now. I want a mental escape from medicine for a few minutes, so I figured I'd see how far I can get into another "installment".

As far as actual news, there is very little to report. I am on an inpatient rehab rotation. As I was telling my parents in a brief phone conversation last night (the first in almost 2 weeks…sorry!), I enjoy the content of this rotation. It is a nice mixture of basic internal medicine and rehab specific medicine, and is very applicable to my future career. But while I enjoy the content of this rotation, the execution of it can be frustrating. Medicare and to a lesser extent, private insurance companies create a LOT of busy work that gets dumped onto residents. The hours are long and largely spent documenting, documenting, documenting. A 5 minute conversation and exam with a patient takes 50 minutes of typing at a computer to document all of the bits and pieces that are required for reimbursement from the government and insurance companies…kind of silly if you ask me…Anyway, besides the copious note-writing, I really like what I'm doing and what I'm learning. I get more confident each day that I chose the right field and I'm very happy to be able to say that.

So, with that very short news update, I'll turn my attention to another "mental shelf" item that has been on my mind in recent weeks.

Not long ago, someone taught me the phrase "the doctrine of conference" which is the phenomenon that occurs when you listen to general conference, or sacrament meeting talks or whatever and the same theme seems to pop up everywhere. The talks themselves are rarely about that actual subject but somehow that is all you end up hearing…you know what I'm talking about! I'm pretty sure most of us have had something at least similar to this happen. It's always fun for me to go back and re-read the talks if possible because so rarely do they deal with the theme I got out of them originally, and it just makes me realize all the more that I must have needed to hear whatever it was that I heard!

Anyway, one of the items on my mental shelf that seemed to really pop up a lot during this most recent general conference and many other places in recent months is the idea of God having a purpose and direction -- a plan -- for my life and for the lives of each of His children.

I'm sure most people have had the experience of something occurring that was not in their own "plans" for themselves. Often, these experiences are hard to confront and leave us wondering what went "wrong". A prime example for me happened after my second year of medical school. After over 4 years of intense effort working to get into medical school (I can't possibly remember the number of late nights and early mornings, not to mention Friday and Saturday nights spent studying instead of playing) and then after 2 more years of exceptionally demanding (and exceptionally expensive) coursework in medical school I faced a test that is often considered the most important test in the career of a doctor. This test is used by residency programs to determine if they will consider you as a candidate to train at their program; and while it is not the only factor they use, it is well known that it is almost always the single most important factor. Doing well on this test is paramount. Doing poorly will alter what career options are made available. Anyway, my "plan" was to ace this test and have any career I wanted available for the asking. What happened was the opposite. I did not do nearly as well as I had planned on. In fact, after all was said and done many of the doors I had expected to be thrown open and strewn with rose pedals and red carpets were in fact closed. I remember a sense of panic and dread that after all that time, all that effort and all that money, I would end up with only a few meager options that did not appeal to me as others effortlessly eased themselves into the careers I craved and had worked so hard and so long for. To say that I was distraught would be the grossest of understatements...

I use this example because it doesn't involve anyone else. I am the only character involved in the story. However, it is my experience that usually these kind of experiences -- the ones where we deviate from our "plans" for ourselves, involve others. Whether it be a friendship, a marriage or dating relationship, or a sibling-sibling relationship that deviates from our intended course or in fact, goes horribly wrong -- our relationships with others provide prime areas of our lives for things to go differently than planned. Perhaps it is because the Lord gives His children agency and allows us to make choices that can affect ourselves and others. Statistically speaking, the more people with agency involved, the more opportunity for choices to be made that cause deviation from our planned course for ourselves. Regardless, we all experience this derailment from our plans from time to time.

What I struggled with the most after the experience with the test was trying to understand how this could possibly be in my interest. How could having more limited options be a good thing? I believed then and still do that God wants me to learn as much as I can so that I can be used in any variety of ways He needs in order to help build his kingdom and fulfill whatever work he has for me. Wasn't this a move in the opposite direction? I think many of life's setbacks leave us feeling this way. I'm just betting that after Joseph in the book of Genesis was sold into Egypt and thrown into prison he likely felt similar feelings. How could any good possibly come of this setback? And what grated all the more was hearing over and over from well-intentioned people, "God has a plan for you and everything will turn out OK". In the midst of my trial and frustration this sounded trite. I had worked and sweated and bled and prayed for this thing and it was not happening (I refer specifically to the test, but more broadly to anything that we have poured our hearts into only to have it go poorly in our estimation). I admit that it was very hard to feel like God had a plan and that everything was going to turn out OK. Under such circumstances I think it is easy to feel like you must have done something wrong or missed some important step (otherwise things would be working out the way you expected…right?)

As I've pulled this particular item off the shelf over and over and thought long and hard about it (and I can't pretend that in a few instances the Lord didn't just use a good friend being very blunt and direct to circumvent my density) what I've realized is that the Lord's plan for us -- his overarching purpose -- is our eternal life and salvation. He does have a plan for us, but the purpose of that plan is much larger in scope than our own little plans for our lives. The course of God's plan for us will likely differ from what we expect or what we think should happen. For example, if getting accepted to Harvard's MBA program is part of what is essential for us to have the opportunity to gain eternal life, it will happen…If getting called to an exotic far-away mission field is essential for our chance to gain eternal life, it will happen…If getting married before the age of 30 (or getting married at all in this life) is an essential part of the path toward eternal life, it will happen. If these things, or any infinite number of other scenarios that feel so so so important to us in the here and now are an essential part of God's plan to provide us the opportunity for eternal life, they will happen. If they are not an essential part, they may or may not happen. What we can rest assured of is that what needs to happen for us to have the opportunity for eternal life will be able to happen if we do our best and let it.

Some of the unexpected or unwanted twists of my life (which are almost without exception difficult at the time) now make sense in retrospect. I can now see why things needed to go the way they did, even though at the time it felt like an unmitigated disaster. Admittedly, other things still don't make sense -- I'm still trying to understand why my work, sweat, blood, tears and prayers did not result in what I wanted…why the Lord has lead my life in the way it has gone…(why did that relationship end? Why have my efforts gone unrecognized by the people who I've tried to love/impress/serve/work for?)…Having said that though, there are things that have become clearer with time (for example, Rehab medicine is a field I love and that will ultimately be very conducive to a good family life and life of service in the Lord's kingdom, but I never would have even thought of it as a possibility if my test score was high enough to get into that ultra-competitive surgical sub-specialty I coveted. I would have gone into that surgical field without a second thought and missed this career that I enjoy so much...)

An often quoted scripture is Romans 8:28, "All things work together for good to them that love God." As I kind of mentioned above, and to my shame, there have been times (and I still struggle with this feeling when things feel like they are spinning out of control) that this verse has felt simplistic. It is easy to feel this way when things are not going as anticipated -- you failed an important test, a person you love ends your relationship, you don't like your job (or you can't seem to find one at all), you're fighting with family or friends or you feel you have been betrayed and your trust is broken -- at these times it is hard to see how things are working out for your good. The challenge, I think, is to remember that the Lord's purpose and his plan, in other words, "His work and His glory" is the eternal life and salvation of his children (Moses 1:39). President Packer compared life to a 3 act plan. This life is the 2nd act, and the next life is the 3rd act when all things tie together and conclude in our very own "happily ever after". Parts of the 2nd act don't make any sense unless you know about the story in the 1st and 3rd acts. God is the director who knows the script from beginning to end. From His perspective the parts of the 2nd act that don't make sense to us, do make sense to Him. I think it is a knowledge of this principle that allowed Moroni (in his loneliness and solitude and after witnessing the complete destruction of his people) to write about "the grace of God" and being made "perfect in Christ" (Moroni 10:32-33).

Returning to Joseph in Egypt (or Alma and Amulek, or the sons of Mosiah, or the Anti-Nephi-Lehi's if you prefer, or any number of scriptural/church history figures), it ultimately became clear why he needed to spend those years in an Egyptian prison. Joseph received an answer in his lifetime. Sometimes that happens, and sometimes, I'm convinced, those answers do not come until the next life -- but I believe they will come eventually! A close friend shared a song with me when I was in the middle of several simultaneous deviations from the path I had planned for myself (that is another point I'm convinced of: rarely do deviations from the path we have planned for ourselves happen one at a time. Rather, several areas of our lives seem to fly apart all at once…or maybe its just me…who knows...) Anyway, I thought it was a beautiful song and sums up a lot of my thoughts (http://www.youtube.com/watch?v=MwNibdCN8sQ).

Anyway, on that note I'll finish up. I am actually now post-call (somewhere in the middle of writing all this my call night became much busier and I had to go put out a bunch of "fires" and now it is the next afternoon and I'm going to try and take a nap before church starts). For anyone crazy enough to have read to the end of this, thanks for enduring another self-therapy session! I wish you all the best!

-Eric

09/21/2010 - The "Mental Shelf"

2010-09-21T17:59:00.000-07:00

It has again been a long time and much has happened since my last installment (though I'm not sure something as infrequent as my posts can even be called "installments" which denotes some degree of regularity). Regardless, the catharsis that writing provides has prompted me to sit down and plug away at an update. I wonder sometimes if part of why writing in a "journal" (these posts are as close as I get) is so strongly encouraged is because it provides a medium for calming and healing turbulent emotions and thoughts…it's an interesting thought...

Anyway, let me first reiterate one of the big changes in my life: I am no longer a Wisconsin resident…

Part of me was ready for this change (the part of me that hates being cold all the time in particular. Also the part of me that enjoys the excitement of newness!) Having said that however, a part of me got left in that frozen northern tundra…I made some of those rare friends -- you know the type -- the ones you will still feel close to even after months/years of not seeing them. The ones who seem to glow with goodness and yet don't realize it (part of what contributes to their glowing, I'm sure). The ones who, no matter how much you try and tell them, will never really "get" how much they influenced you….those kind of friends! For four years they helped fill gaps that I am just now beginning to understand a little better. My years in Wisconsin remind me of my years as a missionary because both were far away from family and things that felt familiar. Both were times of "concentrated life and learning" (I don't know how to phrase it any better) that felt like 10 or 20 years of normal life experience crammed into 2 or 4 years respectively. And both were periods that in retrospect I can look back on and find strength in…

In late June after a wonderful visit from my parents, grandparents and Lance and after finishing a forensic pathology rotation I hit the road in my trusty Subaru -- that I have aptly named "Rocinante" after the horse in Don Quixote (I think it is a particularly fitting name since to the world's view Rocinante was a ramshackle glue-factory animal but Don Quixote saw him as a brave and valiant stallion who stalwartly took him around on his somewhat misguided quests to fight windmills and the such…I think it is just a name that fits…) Anyway, my brave little car and I hit the road for south Texas! Along the road I got to spend a night in Nauvoo, a night in Tulsa with some relatives and a night in Dallas with friends! Upon arrival I immediately set to work moving my stuff in, finding my way around and starting residency!

I began July 1st on a Neurosurgery rotation. I had a fair amount of anxiety about being so brand new and starting on something like neurosurgery but with the exception of one very long, tense night working to keep a patient alive (we were successful by the way) it was a really nice rotation and I learned a lot. August and now September have been a geriatrics rotation which have also been nice and allowed some quick weekend trips up to Utah to see and meet people. Next month will be on the acute inpatient rehab unit which will be very applicable to my future career (despite having the reputation of really long arduous hours). I look forward to things that are heading down the residency pipeline!

Now, as I mentioned above, the major reason I started writing this post after so long of a break is for the cathartic effect writing has on me. Somehow taking the time to organize my thoughts enough to write them down has a therapeutic effect on me and helps me to solidify certain concepts or ideas in my mind in a way nothing else does. With that said, I'm about to get a lot more somber, so for anyone who is not in the mood for somber feel free to stop now and watch this hilarious video of the funniest dog of all time! (http://www.youtube.com/watch?v=4LzMAXqu8qU)

Sometimes I like to picture what I call the "mental shelf". In my mind I imagine an empty room with a shelf attached to one wall. On this shelf are a variety of strange objects of different shapes, sizes, colors, ages, etc. Each of these objects represents an idea that I just don't really understand. From time to time I will go in this room and take one of the objects off the shelf, brush away the dust and examine it. This is akin to thinking about an idea or topic that I don't really understand for a while. Most commonly I am forced to place the object back on the shelf, no better understood than when I picked the item up and I leave it to be revisited at some future day. Occasionally however, when I am turning this object over and over in my hands a spark of understanding comes to me and when I put the object back on the shelf I understand it just a tiny bit better than when I started. Over the months and years these sparks accumulate and my understanding morphs over time. I'm not sure I'll ever fully understand these topics but I am confident that my understanding today is better developed than it was last week and it will be better developed next week than it is now if I keep visiting the objects on the shelf and spend time mulling them over. I do find that these "objects" (aka: thoughts or ideas) are generally among the big tough ones that don't have easy answers and if they do have answers they are probably different for every person...

Anyway, one of these "objects" that I have been visiting from time to time in my thoughts over the last year or so has been the idea of how Christ can mend that which is broken. At first I didn't even think of it in exactly those words or terms, but over time I have come to understand that the things I was thinking about could be boiled down to the idea of Christ's power to mend that which is broken. What I have come to understand is that each of us at any given moment have a part of us that feel broken. This feeling can be because of a loss we have suffered, or from loneliness, or depression, or from frustration at our circumstances or from feeling we have been betrayed or had our trust broken. It can come when we seem to fall into the same stupid sins over and over again. It can come in matters of family, friends, work (or lack thereof) and relationships. It can certainly come in matters of dating and the heart…I think we all have these parts of us that feel fractured and broken and we wonder if they will ever be able to be fixed…

Growing up and well into my adult years I would hear the phrase "Christ understands your pain and sorrows because he felt them all" or something along those lines, and for a long time I didn't fully understand how that was important. I believed it and felt that it was true. I just didn't understand how that was helpful. Frankly, it made me feel bad because I was miserable and why would I want anyone to feel the same way I did, even if it was the Son of God? It wasn't until I was well into what is generally considered "adulthood" (debatable in my case, I know) that I finally came to understand why it was important that Christ felt all the same pains I feel. What I realized is that the phrase I heard growing up is incomplete. It is the first half of an idea, but it is not the whole idea. If I were to rewrite the phrase it would go something like this: "Christ understands your pain because he felt it too, and that is important because he descended below these things and then overcame them, and now he can show you the way out!"

Elder Holland gave a talk in the April 2006 conference that has become one of my favorites. In it he said this:
"The Savior reminds us that He has “graven [us] upon the palms of [His] hands.” Considering the incomprehensible cost of the Crucifixion and Atonement, I promise you He is not going to turn His back on us now. When He says to the poor in spirit, “Come unto me,” He means He knows the way out and He knows the way up. He knows it because He has walked it. He knows the way because He is the way."

Now, I'm not saying that healing the parts of us that are broken will be a painless process, and I'm not saying it happens overnight. Just like setting and casting a broken bone is painful, and healing takes time; pulling our broken pieces together can hurt and will likely not happen on our timetable. What I believe however, is that healing can come. Whether it is my heart that is broken or my trust or my confidence, these things can be healed through the power of Christ's atonement.

The details are not important but I have had opportunity to put this mending power to the test in recent weeks probably as rigorously as I have ever had need of it. It has been hard and painful, and I'd be lying if I said that I felt completely repaired. I have some relatively good moments and I have some not as good moments. My heart and emotions often still feel like they are in shattered little pieces. But what I find comfort in is the knowledge that things can get better if I allow Christ's atonement to work in my life. Another "mental shelf" idea that relates is the idea of exactly what the atonement does for us and how to make it active in our lives. I have gone on quite long enough and I will not delve into these topics other than to say that I have learned that the atonement is not only for cleansing of sin (it is for that, certainly) but it does more. Among other things It "binds up the brokenhearted" (Isaiah 61:1) and we make it active in our life when we are obedient to commandments and when we live covenants we have made.

I think it is part of the mortal experience to always have some part of us that feels broken -- I think that is part of what "opposition in all things" means -- but I think that when we are yolked to Christ, those broken parts don't stay broken. They are repaired and made stronger than they were to begin with. I think this is part of what Christ meant when he said he would make weak things become strong unto us (Ether 12:27). The repaired/strengthened parts will always be replaced with new broken pieces but as we continue to yolk ourselves to Christ those parts will be repaired and strengthened and the whole repeating cycle results in a new and stronger and more Christ-like person! Admittedly, some breaks take longer to heal than others, but I think that is part of why the Atonement needed to be infinite! Because no matter how bad the break is, no matter how large a part of us is broken, and no matter how feeble and inadequate our best attempts may be; the atonement will fill in where we fall short, it will repair the broken piece no matter how large it is!

Anyway, I'm going to quit rambling now. I feel bad for making anyone strong enough to have read all the way to then end here be a part of my self-therapy session…sorry!

Best wishes to everyone and I hope to catch up sometime soon!
-Eric

Graduation Announcement

2010-03-28T11:20:00.001-07:00

I didn't have the money or time to pull together a real graduation announcement.
This was my compromise...

Alamo city or bust!

2010-03-20T07:01:00.001-07:00

So, the results are in and I'm thrilled! I'll be spending the next 4 years in beautiful south Texas (San Antonio)!
It's a great program and a great city, and I couldn't be happier!
I've spent an embarrasing amount of time in the last few days browsing pictures and forums about San Antonio and here are just a few of the gems I've found.

Long Overdue! (3/17/2010)

2010-03-17T16:26:00.000-07:00

Family & Friends,

So, time flies and a year has passed since my last substantive entry…I knew this would be a danger when I started this blog. Despite my best intentions I wax and wane in my journal keeping – always have. Since this blog doubles as my journal, I guess this is just me back at my old tricks!

I will inevitably miss important details pertaining to the last year, but here is a brief blow-by-blow of my last 12 months:

Our story left our “hero” (note the quotation marks) just finishing his first month of ambulatory medicine. Despite an awkward experience or two, my big take-home lesson from that month was that I enjoy outpatient medicine where your patients come and go home again after the visit (vs. inpatient, where the patients are all admitted to the hospital and stay for…well…who knows how long! Could be a day, could be until death do us part!)

I then completed a month of inpatient medicine, 2 months of surgery, and then 2 months of pediatrics polished off my 3rd year of medical school. Here is what I learned from these rotations
• I like procedures, I even like surgery, but I do NOT want to be a surgeon! Why? Because I don’t hate myself (present/future surgeons, don’t be mad at me. That was a joke…sort of…) Really, it is because I don’t want that kind of lifestyle until I’m 60+. Also, I learned that while I like procedures, I do not like procedures/surgeries that take more than 1-2 hours. I get board and my legs hurt. Also, I’m pretty sure Robert Louis Stevenson had a surgeon in mind when he wrote “Dr. Jekyll and Mr. Hyde” because surgeons become different people when they get in the OR…seriously!
• Kids are cute and fun…but not when they are sick! And what is worse/more-cranky than a sick kid? Answer: a sick kid’s parent! I defiantly learned that being a pediatrician is for other people (bless their insane hearts!)

Around this time, I started to prepare my residency application. Here are a few highlights of what this entails:
• Writing a CV (which is a type of resume that we use in medicine. CV stands for “Curriculum Vitae” which is Latin for “make the shadow-box you built in 3rd grade sound like the cure for cancer, a clean-burning eco-friendly fuel that will replace oil, and an everybody-wins solution to the health care debate”
• Getting 150 letters of recommendation (really just 5…but it felt like 150). Here is how that process usually goes:

Eric: “Would you be willing to write me a letter of recommendation about what a wonderful student and human I am? Please make sure you include how well you know me and how you deeply wish that in another life you would have had a son as brilliant, motivated and hard-working as me.”

Attending: “Who are you and why are you in my way?”

• Writing a personal statement. This is a tricky one. Somehow you are expected to write about how incredible/amazing/talented/hard-working/good-looking/charming/well-rounded/environmentally-friendly/service-oriented you are. Also, you are expected to convey why you distain the thought of being compensated (with money) for being a doctor and why you would rather get paid in “warm fuzzy feelings” than receive a paycheck. (I exaggerate…but only a little!)

Shortly after all of my application preparation, I was fortunate to be able to drive to Utah and begin a 4 month stint at home with family! Here is how each of the 4 months broke down
• Month #1: I got to study about 8-9 hours a day and then take an 8 hour board exam. I think I have expressed my feelings about board exams in the past, and I will have many opportunities to do so in the future, so I will limit myself to saying that I’m glad it is done and that I passed just fine.
• Month #2: Infectious Disease rotation at the University of Utah hospital. Overall, this was a good rotation and I learned a lot. Also, I had my first few residency interviews (more on these later).
• Month #3: Physical Medicine and Rehabilitation rotation at the University of Utah hospital. I LOVED it! Admittedly, this is my chosen field, and I may be a bit biased, but really, it was great! At the end of the month I spent a wonderful Christmas at home with my family!
• Month #4: A “vacation” month where I stacked most of my residency interviews. Really this month was spent traveling and living the life of a “road-warrior”….(if I never have to see an airport or rental car again, so help me)…on the bright side though, I did get to spend a few quality days in Virginia with Lance seeing that beautiful state and a few days in New York seeing all that is Manhattan island. At the end of the month I drove back to Wisconsin in time to start another inpatient medicine month.

Let me state right here that invariably my time in Utah went faster than I wanted or expected it to. I never get to see all the people I want to, and those I do see, I never get to see enough. Those of you I did see, I hope I’ll be seeing more of you soon (more on this later). Those of you I didn’t see, I also hope to see you sooner than later (time will tell)!

Let me take a quick tangent right here about residency interviews and what that experience was like. Imagine this: you receive an email saying something like “Congratulations, we at the University of [fill in the blank] would like to extend an offer to interview at our program”. You call them up, set a date and then hang up the phone. Suddenly you realize that you do not live in that state and that before you can interview there, you will need to get there. You jump on Travelocity.com and book some flights (the cheapest flights, of course, arrive at 1:30am and the airport is 25 miles away from the hospital). Then you realize that you do not know anyone who lives in that city, nor do you know the how to use the public transportation even if it was running at 1:30am. You get on Enterprise.com and rent a car (the cheapest car is a neon blue VW Bug that makes you feel like you are driving inside of a blueberry) and then go to Motel.com and rent the cheapest room you can find (it is at the Bates Motel and you can still see blood stains on the wall from the last unfortunate medical student who stayed there). After arriving at the city of question at 1:30am (did I mention the 7 hour layover in Harrisburg?) you and your trusty GPS navigate your way to the motel (there is, of course a blizzard going on outside), crash for a few hours and then navigate your way to the hospital where you begin the interviews.

Most interviewers are pretty cool and do not make the experience too uncomfortable, but every so often an interviewer just want to nail you to the wall with questions like “how do you think we should solve the health care crisis?” (there is NO RIGHT ANSWER to this question and no matter what you say, you are WRONG!)

After the interview you try to drive back to the airport but the battery in your GPS is dead and you forgot the charging cord. You take the “scenic route” through cities with names like “Cottonville” and “Manitowoc” until you finally must use the force (Star Wars was on the motel TV last night) to find you way back!

Finally you arrive back home just in time to wash your clothes, choose a new tie and drive to the airport again for the next interview. After a few of these little trips, another thought strikes you: I’m a poor student and don’t have any money to be doing all of this flying/car/hotels thing! You call your bank and ask for another loan….

****

After moving back to Wisconsin and reconnecting with my amazing peeps out here (love you guys!) I’ve done 2 months of inpatient medicine (again, not my favorite). Which brings me to today…the day before match day!

Match day is a time-honored tradition in medicine. Here is a simple way of visualizing it:
• I make a list of all the programs I interviewed at (#1 on my list is my favorite program, #2 was my second favorite program, etc.)
• The programs make a list of all the applicants they interviewed (#1 was their favorite interviewee, #2 is their second favorite, etc.)
• Both lists get submitted to the mysterious NRMP (National Residency Match Program) which I’m convinced is an ultra-secret organization kind of like the illuminati.
• On a given day in March, a computer somewhere in the depths of NRMP’s secret headquarters runs an algorithm trying to match both lists up as high as possible on both sides. I like to picture an evil computer kind of like the one from “2001: A Space Odyssey” (“Open the pod bay doors, HAL”)
• A few days after the evil computer has done its work, all the 4th year medical students in the country gather at their respective schools and get handed an envelope with the results of the match inside. Prior to this point we are not allowed to know the results of the match. It is kind of like receiving a mission call, except for instead of receiving a call to serve a 2 year religious mission, it is a 4 year residency position…

That brings me to tomorrow, which is match day! Yikes! Tomorrow sometime between 11am and 1pm I will find out where I will be living for the next 4 years! My first choice is to return to Utah (why I hope to be seeing all of you Utah peeps again soon). Programs in San Antonio, Dallas, Detroit, Milwaukee, Cleveland, New York, Boise, and Richmond are also possibilities. Really, every program I interviewed at was good and I’ll be happy to end up at any of them, but a part of me is really hoping for Utah…

Anyway, that is probably enough out of me. Best wishes to all of you!
-Eric

7/28/2009

2009-07-28T18:29:00.000-07:00

It's been a long time! I promise I will try and write again soon...medical school & such gets this way sometimes...

03/27/2009

2009-03-27T10:10:00.000-07:00

Family & Friends-

I find that when it has been this long since I last wrote, the best thing to do is choose the best 1 or 2 nuggets, write about those and ignore trying to "catch up" on 5 or 6 months worth of events….the only trouble now is remembering what those 1 or 2 nuggets might be!

I'm just now drawing to the end of my out-patient/ambulatory internal medicine month. Because medical school has its own lingo and the phrase "out-patient/ambulatory internal medicine" is pretty esoteric, let me rephrase by saying I'm finishing a month in a clinic much like you might think of when you say "I've got a doctor's appointment today". Out-patient means it is not in the hospital, rather it is in a clinic. Ambulatory means that the patients walk in and walk out in the same day (they "ambulate"). Internal medicine means it is simply primary care for adults -- they are the generalists who do not specialize in one organ system, rather they are trained to handle problems from almost any organ system. This month I have spent approximately 80% of my time working with patients who have common chronic problems such as high blood pressure, diabetes, high cholesterol, back pain and coronary artery disease, etc. The remaining 20% or so was spent on more acute things like gout attacks, asthma exacerbations, etc. For some reason (probably because most medical students are cowboys who like that adrenaline rush), Internal Medicine and chronic care in general gets a bad reputation. I heard over and over that I'd be board out of my mind this month, but I guess I'm just made of different stuff because I've really enjoyed things! Admittedly, it is frustrating to have to see a new patient every 15 minutes (I'm sorry, 15 minutes is simply not enough time to do anything, even in the best of circumstances!) but aside from the problems of managed care, I like the clinic life. Next month is an in-patient Internal Medicine month (meaning I'll be working with much sicker patients who have been admitted to the hospital). Traditionally this is one of the hardest rotations in medical school, so I'm trying to mentally prepare myself for the gauntlet ahead!

Well, really only a few stories are coming to my mind that might be even slightly entertaining to write about (and I'm not sure they are even all that great…we'll see I guess!) However, before I dive in, let me preface this as I have in the past: I will be using "medical words" (meaning I'll be talking about certain anatomy) and if this is likely to offend, feel free to stop now. Also, because I don't want any of the HIPAA Gestapo to come breaking down my door tonight, I will be changing certain details in order to absolutely protect the identities of individuals. Having said that though, I am not changing the major details of what actually happened, nor my thoughts & feelings (or lack thereof).

One thing that you find out as you work with different medical educators is that each person has a different level of commitment to your learning experience. On one end of the spectrum you have the doctors who really don't want you around and who only keep you there because it is part of their contract. When working with one of these doctors (let's call them the "Apathetics") you learn very little, but the ride is usually pretty smooth -- you be as inconspicuous as possible and they won't fail you out of medical school. On the other end of the spectrum you have what might be called "The Dedicated". These doctors (bless their hearts) do ANYTHING and EVERYTHING to ensure you learn something. While this is certainly the better end of the spectrum to be on, it can get a little excessive, as I learned to my dismay a week or two ago:

I was in the clinic with a doctor -- let's call him Dr A (I'd classify him as a "dedicated" but not excessively so) and our next patient happened to be another doctor who works as a specialist at one of the local hospitals -- let's call her Dr B (it is always kind of weird to be a doctor for a doctor…but anyway, that is beside the point). Dr B was in the clinic for a routine yearly physical exam. Dr A asked all the appropriate questions, did a brief yet adequate physical exam and was writing his note, when Dr B (someone I would classify as light years beyond the "dedicated" mark) turned to me and asked if I was going to be practicing my physical exam skills on her. Dr A tried to explain that when the patient was another doctor whom the student (me) may have to work with sometime in the future, he usually didn't have them do any physical exam in order to avoid any awkwardness. Dr B would have none of it! Ignoring completely the explanation of Dr A she began to grill me about how to do a proper cardiac auscultation exam…

At this point let me take a tangent and explain the full cardiac auscultation exam (auscultation means "to listen" usually with a stethoscope). Because the heart is divided into chambers and because there are multiple valves within the heart and because something may go wrong at any of these sites, a full cardiac auscultation exam involves listening to the heart at different places on the chest -- at each spot a different part of the heart can be heard better. This does not mean that at spot #1 you only hear the aortic valve, it just means that the aortic valve can be heard best at spot #1. At spot #2, the pulmonary valve is heard best, and so on.
Cardiac auscultation is fairly easy on a male because they lack certain chest anatomy that is present in female counterparts. Where things can get difficult is when listening to a couple of the spots on the female patient because breast tissue often needs to be held out of the way. Also, part of the exam involves finding the PMI (Point of Maximal Impulse). The location of the PMI gives an indication of how large the heart is (an enlarged heart can be a sign of impending heart failure). Again, finding the PMI on a male is not too hard…but in a female, it requires a lot of maneuvering of breast tissue.
Because of these complications, in a potentially sensitive situation such as examining a teacher or colegue, the cardiac exam is often superficial and unless there are symptoms or risk factors to suggest something is wrong with the heart, a superficial exam is all that is needed (Note: this may not be what the textbook tells you to do, but we live in the real world and in the real world, sometimes the cardiac exam is sacrificed in order to preserve dignity)

…okay, back to the story! There I was, getting grilled about the cardiac exam when Dr B said "show me the proper exam technique!" (and since she was the only patient in the room, it could clearly be surmised that she meant to have me perform the cardiac exam on her). I shot Dr A a quick glance as if to say "is that okay?" and Dr A gave me a look back that said "sorry pal, technically she is right and should get a full cardiac exam today…better luck next time!" With all the enthusiasm of a man walking to the gallows, I went through the motions of a cardiac exam, trying to be as quick and non-invasive as possible. Approximately 4 seconds later I had listened to all of the necessary spots, pretended I'd found the PMI and had backed up halfway across the room to give Dr B plenty of personal space. Now, because Dr B has a level-10 black belt in medical education, she knew what I was up to and was not going to have any of it! She made me repeat the full exam 3 or 4 times until she was convinced that I had learned something about how to do a proper exam. I'll not be more detailed in my explanation than that, but I don't think a world-class imagination is needed to paint a mental picture!

Let me emphasize that while this was an uncomfortable situation for me (funny in retrospect, yes, but still uncomfortable) there was no reason to think that Dr B had any motive in mind other than the proper education of a student. She works day in and day out in a field where she sees students who are not properly trained in physical exam technique because no one is willing to let the proper exam be done on them. "Dedicated" doctors have been known to go to greater extremes than that in times past to teach a student and by comparison I got off easy! (Also, Dr A was present in the room at all times, and besides she was probably twice my age or more!)

***

So this next story is probably not quite as memorable for the reader of this letter as the last story, but for me it was a real red-letter day!

There have been plenty of times in the past where I feel like I have no idea what is going on…I do take comfort in the fact that all 3rd year medical students often feel this way, but none-the-less I sometimes sit there trying to think of some distant piece of information I learned and all that comes to my brain is that the patient probably needs a tetnus shot (not that tetnus shots cure any of the patient’s problems…but sometimes that is all that comes to mind). Fortunately, things are coming together more and more every day, but regardless there have been a few times that if you could read a transcript of my thoughts, this is what it would look like:

"This patient has sarcoidosis of the lungs, how should we treat him?"
"Tetnus shot?"

"This patient has pseudomembranous colitis, what should we do next?"
"I know, give him a tetnus shot!"

"This patient has a bunion on his foot"
"Tetnus shot is just what he needs!"

"This patient has excessive earwax"
"Tetnus shot! (then a CT scan of his head!)"

But, a few weeks ago I finally, let me repeat, I finally heard something before my attending did! In listening to a patient's heart I heard a murmur, and it wasn't until I insisted that I heard something abnormal that my attending listened closer and agreed with me! We sent the patient for an echocardiogram and it turns out he had aortic stenosis (not a real good thing). While I feel bad for the patient, a part of me can't help but be excited that I finally caught something that no one else caught!

Anyway, that’s about it, so I’ll finish here.
Love you all!

-Eric

I swear I'm not dead!

2009-03-10T19:37:00.000-07:00

Despite opinions to the contrary, I still plan to write my little entries about the funny and memorable moments of medical school and life...this has just been a really bad, what, 5 months?!?! **Sigh**

11/25/2008

2008-11-25T17:04:00.000-08:00

Family & Friends,

In anticipation of Thanksgiving on Thursday, I send my love and wishes that I could make it home to see people…but alas, I am scheduled to be on call Thursday (more on this in a minute) and will be in Wisconsin until Christmas time. Hopefully I can see a lot of you during the week I have in Utah between Christmas and New Years.
It seems to me that there are a few topics that I write about that get a lot of response from people. One of those topics is Chopper the mutant man-eating Godzilla dog who lives upstairs. The other is anything regarding me and OB/GYN – I guess the image of awkward ridiculous single me trying to deal with female-issues gives people a big kick (frankly it is funny in retrospect, though usually mortifying at the time!) Having said this, I guess I’ll be batting 50% in this letter. I really don’t have much to say about Chopper – he’s as big and dumb as ever – but I am 2 weeks into my OB/GYN rotation and I’m collecting embarrassing moments at an alarming rate!
Let me attempt to set the scene a little bit and describe what rotating through OB/GYN is like. First let me state that I respect most OB/GYN doctors I’ve met. Most are nice and reasonable people. They do good things and help with issues that need to be handled. I even find that I quite enjoy most of the work that they do (delivering babies is neat, surgery is neat, the medical chart notes they are required to write are short – a BIG plus in my mind) however, they have the WORST lifestyle! Seriously, you will never meet a bigger group of work-a-holic insomniacs in your life (outside of neurosurgery, that is). Every few days they have to be “on call” which means they work a ~30 hour shift (from 5:30am to about noon the next day) and of course as students we have to pull similar hours. I’m actually post-call today, which means I haven’t slept since 5am yesterday (it is currently about 4:30pm today). I will sleep tonight, work a 12ish hour shift tomorrow, sleep again and then begin another 48 hours of wakefulness. I’m only on this rotation for 6 weeks…I can’t imagine how people do this year in and year out! They are stronger than me I guess!
Anyway, most of the time I’m on the Labor and Delivery floor working with women who are actively in labor. What I do is meet the women when they first get there. I ask a whole bunch of questions, do a brief physical exam and then leave for several hours to write up all the information I gathered from the interview and exam. Several hours later I pop my head back in and make sure everything is going okay. This continues until the woman’s cervix is dilated to somewhere around 8cm. Once this happens the doctor and I rush in, throw on sterile gown/gloves/mask and join the nurse in helping the lady have her baby. I find it funny (maybe that is not a good word-choice) that really it is the nurse who spends all the time with the woman. The doctor and I just sort of show up for the exciting part and then leave again…strange, but oh well!
I have observed that there are several types of laboring women. There are those who have been down this road before. In fact in some cases the babies practically tap-dance their way out because mom’s pelvis just doesn’t offer much resistance any more. These women have sage-like knowledge and do not get ruffled when a stuttering medical student is catching their baby because they simply know that things usually go just fine. In many ways working with these ladies is nice.
On the other hand, there are ladies who would like to kill anything with a Y chromosome – or at very least hit us in a body part of their choice with a ball-pein hammer every time they have a contraction. Not that I can really blame them…I’m not quite sure how much I’d love some stranger sitting down observing me from, shall we say, an unflattering angle while my feet are in stirrups all the while I’m trying to defy the laws of physics by squeezing a cantaloupe through a drinking straw. Frankly, I might get a little grumpy myself!
My first day of work was something of a “baptism by fire” experience. Not only was I clueless about what I was supposed to be doing, I was on call, exhausted, and not yet emotionally calibrated to the birthing process (a feeling that comes surprisingly quickly once you have delivered 7 or 8 babies at 3am). That first night we had 8 or 9 births, 2 of which were emergency C-sections. I decided after that night that there are some fundamental laws of the obstetrical universe:
1) No babies will be born during normal daytime hours
2) All babies will be born between the hours of 11pm and 5am
3) All emergency C-sections will need to happen at exactly the same time even though there is only one team to perform the operations

That first birth really was quite the experience for me. In some ways it was one of the most disconcerting things I’d ever seen. A part of me felt like I was in a real life “Aliens” movie. The other part of me was in awe of the miracle of birth. I will say that despite all the blood and gore of birth, once that wriggling little baby was out and letting the world know he was UNHAPPY my heart sort of melted and it was easy to forget that I had just seen every law of physics shatter.
Well, I’m exhausted and need to cook dinner, so I’ll finish up. Love you all!
-Eric

10/19/2008

2008-10-21T15:31:00.000-07:00

Family & Friends-

I believe last time I got a letter written, I was on Family Medicine and thinking strongly that it was going to be my future career. I guess I must be fickle or something because that is not really the plan anymore. Sadly, I left family medicine with a bitter taste in my mouth that I think I’m going to have a hard time getting over – this was largely due to one of the professors that I really didn’t have good rapport with (more on this in a minute). My current thought is a lesser-known branch of medicine called Physical Medicine and Rehabilitation (PM&R). Obviously I’m going to need to take an elective in this before I commit myself, but it really seems to be a nice synthesis of the best parts of several other fields, including primary care, neurology, physical therapy and sports medicine. Because I know that at least my grandma’s will want to know more, and because I don’t want to take too much space writing about it, anyone who is interested in what PM&R doctors do can get an idea by taking a look at this website: http://www.aapmr.org/medstu.htm

Overall I really did like family medicine and I haven’t completely excluded it from my list of possible careers, but like I said, there was one doctor who I worked with who had the uncanny Hoover-like ability to suck all the joy of medicine out of each day I worked with her leaving me feeling like I had the intelligence of table salt and wondering if the day could get much worse. She was somebody who always seemed flabbergasted that a 3rd year student – someone with a total of a few weeks clinical experience – had failed to follow a particular line of obscure questioning or who had written a progress note in a format preferred by a doctor other than herself. Essentially she was one of those narcissistic Napoleon-esque doctors who thought everybody besides herself was wrong and who was totally intolerant of a student who was still in the steep part of the learning curve (but who deluded herself into believing she was absolutely open-minded and blessed with Job-like patience).
One particularly memorable day I was working with Dr. Hoover (not her real name), and we had a patient cancel, leaving us with about 30 minutes before our next patient arrived. My plan was to use the time to do some much-needed study about some of the conditions we had seen several times about which my fund of knowledge was lacking. Just as I was sitting down with my textbook, Dr. Hoover announced that we had an add-on patient. I stated I would be happy to visit this patient like normal and report back to her with what I found. However, Dr. Hoover said she would like to accompany me into this particular exam. I figured she must want to observe me doing the history and physical so that she could evaluate me and offer some constructive feed-back. Of course I was fine with this and so we set out down the hall toward the exam room.
When we arrived in the room I looked around perplexed because there was no patient in the room – just me and Dr. Hoover. She closed the door, sat down on the exam table and announced, “I’m your patient”. Fear stuck into my heart and I knew this was not going to end well for me. The story she gave me at that point was that I needed to do a fundoscopic exam (looking at the back of her eyes through the pupil using a tool called an opthalmoscope). She stated quite matter-of-factly that if I had the IQ of soup, I would find an abnormality with her retina. Let me pause here and take a small tangent that will help clarify why this was such a dastardly thing for her to do.
In medicine we use 2 major criteria, sensitivity and specificity, to determine if a test is useful. A perfect test would be both highly sensitive and highly specific. A test that has high sensitivity but poor specificity has its uses however, as do tests that are highly specific but poorly sensitive. A test that has both poor sensitivity and poor specificity is essentially worthless. The fundoscopic exam, as preformed in a primary care setting has low sensitivity and specificity, and thus it is not emphasized heavily in medical school training. Fundoscopic exams only become really useful when using the equipment in an ophthalmologist’s office. My training in fundoscopic exam was brief, as it most people’s. Almost all medical students and plenty of residents and doctors are not comfortable with this exam because it yields such poor results. If a person has vision problems or something suspicious about their eye they get referred to an opthomologist who can do a proper exam.
To do a fundoscopic exam, the examiner must get within a few inches of the patient’s face (essentially kissing distance) and shine a light into their eye while trying not to breathe directly into the patient’s nose or mouth. This wouldn’t be a hard thing to do…if your mouth were somehow situated on the back of your head – but as this is not the case, fundoscopic exams are invariably uncomfortable for both doctor and patient. In a perfect world, you are supposed to see a the optic nerve as it exits the back of the eyeball and spreads out into the retina as well as an assortment of vessels. The optic nerve (called the optic disc) is supposed to be a shade of yellow and have crisp defined edges. Part of the reason it is hard to perform this exam in the primary care setting is because you never dilate the patient’s pupil and so you are trying to see this anatomy through a tiny pin-hole pupil.
Okay, back to my story! There I was, my stomach somewhere down near my ankles cursing Dr. Hoover in my head for choosing the fundoscopic exam, of all the possible parts of the physical exam she could have chosen, to evaluate my prowess and progress as a student! For 20 minutes…let me say that again: for 20 minutes I was inches from this lady’s face (who has halitosis by the way) trying to see what was abnormal about her eye. It was so awkward and uncomfortable in that room that I was convinced that random objects were in danger of bursting into flames. To cut the pain short I started trying to ferret clues out of her, hoping I would stumble upon something that could help me identify her retinal abnormality, but to no avail. When she had tortured me long enough, Dr. Hoover demanded I tell her what I know and she would fill in the rest. I said that the optic nerve in her left eye had looked whiter than normal (more of a guess than a confident declaration, but a good guess I was to find out later). Then in a tone that let me know in no uncertain terms that my brain must operate via parcel post instead of express overnight mail, Dr. Hoover said that what I “should have seen” if I was not such a moron, was that the optic nerve in her left eye was whiter than normal and that the edges were less distinct – more fuzzy – than normal. All this put together should have let me know that she had an extremely rare anatomical variant where the optic nerve stayed mylenated after it exited into the eyeball (myelin is a coating that surrounds some nerves and which normally stops at the point the optic nerve exits into the eyeball). This is such a rare condition that I was forced to look through 5 books before I found a picture and description that I could read about. Overall it was not an experience that endeared me to Dr. Hoover, nor was it the only craziness she put me through. However, she was only one doctor and the other doctors were much more personable and so overall I enjoyed family medicine…though I’m not so sure I want it for my career anymore.

**Next Day**

Okay, I got distracted yesterday and will try and finish the letter today.
After family medicine I spent 2 weeks on Neurology. I really hadn’t expected to like Neuro because I hadn’t liked our neuroscience class, but I was pleasantly surprised to really enjoy clinical neurology. We spent our time working with stroke patients, brain trauma patients, or patients with neuro-degenerative diseases such as multiple sclerosis, ALS (Lou Gehrig’s disease), Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, etc.
Last Thursday I started my Psychiatry rotation. I was placed at PCS (Psychiatric Crisis Service) – basically the Emergency Room for psychiatric patients. Most of our patients are brought in by the police because they are suicidal, homicidal, or in the midst of a psychotic or perhaps manic episode. In the 3 days I’ve worked there so far I have seen the craziest of the crazy (Scott, I’m sure you know what I’m talking about). One guy came in because he was picked up while running down the street naked. Another guy set his couch on fire in some ceremony because the voices had told him to do it. Most of our patients are depressed and dangerous to themselves or dealing with drug addiction problems. One lady was antisocial to the point she had to be subdued by several branches of the armed forces. Again, I didn’t think I would like psych because it was never a class I enjoyed attending lecture for, but I find myself excited to go to work everyday. Admittedly, we see a lot of the bleakest society has to offer and in order to cope we maintain a dark humor but even then it is fulfilling to be able to intervene in a person’s life when they are at their lowest. Yes, many of these people will deal with relapses for the rest of their lives. Yes, many of these people are addicted to substances with little hope of recovery, but already there have been several people who probably wouldn’t have survived themselves for more than a few more hours if we hadn’t seen them on the service. Suffice to say, I’m really looking forward to the next 4 weeks!

On a different note, my roommate got married on Saturday. He was one of the 3 or 4 guys who really took me under their wing when I first moved out here and has helped make my time here in Milwaukee such a good experience. He has been dating this girl for the last year or so and I’m really excited for him and his new wife! They are both fantastic people and I will enjoy keeping in touch as time progresses. Without a doubt, the sealing ceremony on Saturday was 15 of the most amazing minutes I’ve ever experienced. I’ve been to many sealings at this point and they are all incredible, but the teaching and council this particular sealer spent his time on really hit home with me. I curse my feeble memory and wish I had perfect recall because I couldn’t absorb all of the doctrines covered as fast as they were coming. I only hope I can remember and apply some of what I learned in my life now and in the future whenever I find that certain someone.

I find it interesting to be living in a “swing state” during a presidential election. For all the elections since I reached voting age, I have either been in Utah (not exactly a swing state!) or I’ve been overseas and thus separated from the political Gettysburg that I had only heard rumors of. I will leave my own thoughts on politics and the candidates out of my letter but I will say it has been eye-opening to witness first-hand the political WWF Monday Night Raw that exists out here.

Well, I’d best call it a night! Love you all!
-Eric

9/13/2008

2008-09-13T10:02:00.000-07:00

Family & Friends-

I find myself with a few minutes this morning and figured it would be an ideal time to try and catch up on my letter/journal. I think last time I wrote anything I was on my Anesthesiology rotation. This month I’m on Family Medicine and it is 180° change from anesthesia (a good thing in my opinion – sorry Jared!) In fact, I’m enjoying myself on Family Med so much that barring a big surprise on my remaining rotations, I think Family Med is what I’ll end up going into. I guess what remains to be seen is how I feel about the idea of going into surgery when I’m on that rotation – but for now I think Family Med is the ticket!
Part of what I’ve enjoyed this month is the increased interaction I’ve had with people and patients compared to my time in anesthesia. I find that anytime you interact regularly with people, especially as it relates to their health, you get a lot of unique and memorable experiences. Add to that, the fact that I’m still in the VERY steep part of the learning curve and there are some downright humorous moments (in retrospect of course…they didn’t feel all that funny at the time!)
Okay, before I relate any of the actual stories, let me paint a picture of what Eric Brimhall, student doctor, must look like to patients:
First, because I’ve discovered through painful experience that I can only wear my current brand of contacts for a few consecutive hours before my eyeballs want to explode, I’ve been forced to wear my glasses to work every day. Many of you know how much I loathe having to wear my glasses, because when I got them a few years ago, I made the worst purchasing decision of my life and I got transition lenses (the kind that get dark in the sun). Let me stand as a cautionary tale to anyone considering transition lenses! Personally, I would like the opportunity to meet the guy who invented transition lenses (and the lady who sold them to me) in town square at high noon for a duel! Why are they so bad? #1, They get ¾ dark – but not all the way dark – under pretty much any light source. This takes about 0.00001 nanoseconds. However (and this leads me to reason #2) they take a good 20 minutes to get back to mostly clear (notice the word “mostly” – they don’t actually ever get completely clear!). What this means is that I walk around virtually all day with partially dark glasses, and all I would need to round out the nerd outfit would be a pair of chums to keep them firmly attached to my head!
Now that you can picture my glasses, imagine them on a lanky guy with dark circles under his eyes from lack of sleep and a white coat with pockets bulging from an assortment of student-related items. At any given time (any med student/residents/doctors out there will know what I’m talking about!) I have a stethoscope, a penlight, a reflex hammer, a PDA, 3 pocket-sized reference guides, a stack of printed journal articles, some flashcards, a Powerbar, 6 pens, something like $1.28 in loose change, a Ziploc baggie with a few emergency Excedrine pills, a pocket calculator, and approximately 1 million 3x5 index cards with scribbled reminders…okay more like 20 or 30 index cards…but you get the picture! Underneath all of that is a pretty normal assortment of shoes, socks, Dockers, ID Badges, pager, shirt and tie.
Now that you have an idea of what I must look like to a patient when I walk into a room for the first time, let me share some of my more memorable moments from the month.
Due to HIPAA regulations, I have to be careful about telling this story. I’ll have to leave some details out, but I’ll do my best to convey the spirit of the moment.
The regular procedure we follow when a patient comes in is that I will go into the room, and get a History & Physical (H&P) and then come back out, present my findings to the attending, tell him what I think is going on, tell him/her what I think we should do and then we visit the patient together. The attending does his/her own H&P, makes his/her own assessment and plan and then we talk over the points on which I was right and those on which I was wrong and then I make a list of things I need to look up on my own time. Then I write a progress note on the encounter, detailing what happened and summarizing what the doctor thinks is going on with the patient and what we plan to do to help.
On my second day of the rotation I was asked by my attending to go talk to a family and get an H&P. We had just left a different room and I didn’t have time to read the patient’s chart before I walked in. Also, because it was only my second day I was still trying to get a sense of how to smoothly get the information I needed (let’s just say I hadn’t figured it out yet and I wasn’t smooth at all). Upon walking into the room I was confronted by (here is where I need to be careful about HIPAA) a particular person I recognized and that person’s spouse and daughter. They were there because the daughter had an injury that was healing very strangely. The reason this was a little disconcerting for me was because one of the parents has a lot of influence over how my dean’s letter eventually turns out (several people are involved in the dean’s letter process, and they all have considerable say over how the letter eventually turns out). Anyway, the point is that this was one of those rare moments where you NEED to shine!
After getting over my initial shock I did my best to put together a decent H&P. I asked every question I could think of…and probably asked a few of them twice in my nervousness! Then I did a focused physical exam and had to admit that I had absolutely no clue what was going on with this little girl. Like a shamed puppy with its tail between its legs, I went out and had to tell the attending that I had no idea what was going on with this girl. We went back in together and I had one of those mixed bitter-sweet moments when the doctor said he had never seen something like this before. Bitter because it meant the girl and her family didn’t get the answer they were hoping for, but sweet because even this doctor with 25 years of experience had no idea what was going on – making me look less stupid.
Anyway, we referred the girl to the plastic surgery folks, and I’m confident they’ll know what to do.

A few days later, I was with a different attending and we were running pretty far behind schedule. In order to try and catch up a bit the two of us went into a room together instead of having me go in alone first.
The lady we were there to see is in her 80’s and showing signs of advancing Alzheimer’s disease. She was there with her daughter who did most of the coherent talking. The old lady, I’ll call her Mrs. Johnson (bless her heart), took one look at skinny little me and decided that I was to be the target of her affections for the remainder of the appointment. She began by telling me what a “handsome young man” I was (which would have been slightly flattering if she had been 60 years younger and not a patient). I did my best to laugh it off, (“Oh, Mrs. Johnson, you are just trying to get me in trouble!”) but she was relentless! In the presence of her daughter and the attending physician she proceeded to tell me that we should leave right then, get in the car, go for a drive and then “park”. Not only was I a little flabbergasted and embarrassed, I was shocked that an octogenarian with advancing Alzheimer’s disease would know how to use innuendo like that! (perhaps that one has been around longer than I suspect…who knows!?!)
Anyway, for the remainder of the appointment I had to balance attempting to learn and be attentive to what the doctor was saying and appropriately deal with the flirtations of this lady! When all was said and done I think everyone except Mrs. Johnson walked out of that room feeling a little awkward and embarrassed.

My next story happened yesterday and I’m still blushing a little bit as I think back on my mortification at the time, but I think this story needs a little bit of a preface.
Let me state right now that all things OB or GYN (obstetrics or gynecology) I am stupid at! Being a single mormon male has not given me much experience in these areas, and all I can do when I encounter OB/GYN stuff at this point is to furrow my eyebrows, nod sagely and try and keep my jaw from dropping or my face from flushing! I can hardly imagine the kind of stories I’ll be able to relate come December when I’m on my OB/GYN rotation…
Anyway, yesterday my attending told me to go in and do a prenatal exam on a lady in her 3rd trimester. I have never done one of these – in fact I’ve never seen someone do one of these! My entire experience on what I’m supposed to do is based on a 1 page sheet I glance at as I walk down the hall toward the fateful exam room. I preemptively furrow my eyebrows and begin my sage-like nodding even as I walk in the room and introduce myself. I then go through a list of very personal questions and just pray that I’m not visibly blushing. My flow of speech is interrupted every 2 nanoseconds with an “umm” and it is painfully obvious that I’m green and very nervous about all of this. I get through all of the questions and now it is time for the exam. (“umm…just take a seat up here and I’ll, umm, do a quick exam”).
Fortunately for me (and the patient), my sheet doesn’t say that I need to perform a pelvic exam, and right now this sheet is scripture to me, but it does say I need to use the dopler machine to get the fetal heart rate. The device is simple enough but in my near catatonic nervousness it might as well be mission control. I put that part of the exam off until last, but it looms over me like a Sword of Damocles. Finally after stumbling through the rest of the exam I can no longer put off the dreaded dopler. Asking the patient to lie down on the exam table and expose her swollen abdomen, I grab the bottle of ultrasound gel off the counter. This bottle resembles the ketchup or mustard bottles that you would see at any roadside café. All I need to do is turn the bottle upside down, shake the gel to where the spout is and squeeze the gel out. Unfortunately, the type of plastic the bottle is made of is the kind that gets brittle with age and apparently this bottle has been sitting on the counter for a long time because as I shake the bottle and begin to squeeze the bottle explodes sending gel-shrapnel flying in all directions! I’m completely mortified! (“umm…sorry…let me get you a tissue and we can wipe up some of this gel!”)
I guess the bottle exploding did get the gel I needed onto the lady’s abdomen and I quickly get the fetal heart rate and scamper out of the room as quickly as possible to inform the nurses that we’ll be needing a new bottle of ultrasound gel in that room (they all have a good laugh when I tell them the story).

Okay, enough embarrassing stories from work! The only other news I can think of was from Labor Day. I went with a group of ward members to an old rock quarry that has filled with water to do some cliff jumping. It was fun and relatively safe! One of the coolest things we did was lunch! The quarry we went to was right next to a very small little town – kind of a quintessential small American place. They had a rag-tag parade down Main Street that was absolutely charming despite its obvious make-shift nature. My favorite “float” (actually a trailer being pulled behind a Ford F-150) had several WWII vets in uniform doing nothing but wave to the crowd (very appropriate in my opinion even though it was Labor Day and not Veteran’s Day). To me no amount of ostentatious decoration or fanfare could have better captured what I love and admire about this country and the people who have sacrificed to make it what it is. A while ago I went on a WWII reading spurt that included Tom Brokaw’s “The Greatest Generation”, James Bradley’s “Flags of Our Fathers”, and Jeff Shaara’s “The Rising Tide”…My admiration and gratitude only continues to grow.
Lunch itself was memorable in the sense that it captured small town America so well for me! The small park right off Main Street where the Rotary Club set up their grills had several rows of picnic tables crammed with locals in their cotton dresses and overalls. The biggest entertainment was a lady dressed up as a clown who was tying long skinny balloons into different animal shapes for a crowd of kids. I ate a fantastically unhealthy meal of fried chicken and $.25 chocolate ice-cream cones – and loved every bite! We all got sunburned and had to keep swiping away the ants and hornets intent on stealing as much of our meal as they could carry. As common place as this scene is, it was a charming and memorable holiday!

Love you all and hope you are doing well!
-Eric

Blogger Moron

2008-08-28T13:46:00.000-07:00

I've switched the background to this totally lame thing because I'm trying to figure out how to make my blog look as cool as all my fellow bloggers. Until I can unravel the mysteries of the blogger universe or gain the mysterious jedi blogger powers, I guess I'll just have to leave things looking like this...
If you know how to succesfully load cool looking templates, let me know!

8/17/2008

2008-08-17T05:56:00.000-07:00

Family & Friends-

Because it has been a while since I last wrote, this letter may jump around a bit as I remember what has been going on.

To begin, I took a girl from the ward out on a first date this week and had a really really good time, but the whole asking a girl on a date thing got me thinking about the dating scene in which I have become something of a permanent fixture – a kind of Rock of Gibralter, not to be moved or swayed from my station.
I am daily grateful that, as a guy, I don’t have to endure some of the things that are uniquely female (such as long lines waiting to use the restroom and a very participatory role in the miracle of birth). BUT, least anyone think that guys are completely off the hook, let me state that Fate pointed its ugly finger in the direction of guys when choosing which sex had to make the first move and be the ones who did the asking out.
Ever since the tender age of 16 years and 10 month when I finally mustered the courage to ask out a girl for the first time (she said her “dad wouldn’t let her go”), I have gone through the anxiety attack…errr…I mean process of asking a girl out time and time again. Let me illustrate how this usually goes:

Let’s say that I want to ask a girl named Sarah if she will go to dinner with me. Even getting to this point usually involves several weeks of convincing myself that this is a good idea. I usually require a minimum of 3 or 4 decent conversations in a platonic setting before I’m persuaded that asking her out will not result in undue embarrassment and deep emotional scars. Once I’ve finally made the decision to ask a girl out, I begin the process of mustering the courage – or perhaps it is stupidity – required to call her up (this usually involves several quarts of vodka…just kidding…but sometimes I wonder if that wouldn’t help a bit!) Once the courage is in place I make the call.

**ring, ring**
(Eric secretly hoping that I will get her voicemail)
Sarah (in an unsuspecting tone): “Hello”
Eric (with all the subtly and smoothness of, say, Hurricane Katrina): “uhhh… hello dinner, this is Sarah. Would you like to go to Eric with me?”

Usually when this happens the girl is bright enough to figure out what I meant to say and if she has the common sense that God gave to gravel she will hang up and move to another country…Just kidding! If I’m lucky she will realize that my awkwardness at asking her out is actually the highest form of compliment, and if I’m REALLY lucky she will realize that if I freeze mid-sentence with a panicked “deer in the headlights” expression on my face during the actual date that just means that I’m really enjoying myself and find myself facing the terrifying prospect of asking her out for a second time!!!
Oh, those fond old memories! I have them often, although I can usually control them with medication.

This leads me to another line of thought completely different from dating. The girl I went out with is a little more established than me, in the sense that she lives in a real person house with curtains on the windows and pictures on the walls. I have lived in “college houses” for so long now that it is always fun and a bit shocking for me to realize that I have friends who live in real houses, pay mortgages, paint walls and install sprinkling systems. For the last decade I have lived in a string of apartments that have no discernable yard, have Goodwill furniture the color of an improperly treated wound and are painstakingly decorated with: nothing. I do put a lot of work into stacking the empty pizza boxes nicely in the corner and for good measure I keep a sizable pile of laundry on my bedroom floor right next to an empty dresser. I realize that these are the kind of admissions that make mothers and grandmothers worry (it might also have a bit to do with why I’m still single), but don’t fret! If the aroma begins to get too pungent, I have a can of aerosol deodorant that I can spray around as a kind of poor-man’s air freshener! If anyone comes to visit, you can rest assured that you are sleeping on the finest couch Goodwill has to offer for less than $35 and that the beach towel you are using as a blanket has been washed some time in the last presidential administration.
Okay, it actually isn’t that bad (I’m exaggerating a bit for humor’s sake…but only a bit). I’m simply trying to make the point that I get a total kick out of seeing my friends living in places that I associate with “grown ups” while I am still living in the Never-Never Land of higher education.

As far as school goes, I’m halfway through my combined anesthesiology/ emergency/trauma rotation. Every time I begin a new rotation it is my goal to try and rule out or rule in if it is something I could see myself doing as a career. Sometimes it is just as helpful to rule something out as something I’m pretty sure I don’t want to do as a career as it is to rule something in as a possibility to look into further. This month has taught me that anesthesiology and emergency are probably not what I want to do with the rest of my life. These are careers for some people…just not me.
As part of the emergency portion of the rotation, we had to become ACLS (Advanced Cardiac Life Support) certified. This basically means I had to memorize a big old algorithm of what to do when a person’s heart stops beating or goes into a dangerous and irregular rhythm. Then I had to take an oral exam and explain how I would try and keep someone alive under whatever conditions the doctor threw at me. Fortunately in the oral exam you can get a couple of things wrong and still pass (in the real world, you can’t mess this stuff up) because if I had been working on a real patient I might have killed them. In one portion of the test I needed to administer a pain killer and all I could think of to give was fentanyl (a narcotic approximately 100 times stronger than morphine). Because of its potency, fentanyl is usually given in doses of micrograms. My mistake was to get all nervous and give the dose in milligrams (a much larger unit). The doctor was nice but had to inform me that if I’d given that big of a dose to a real patient they would probably stop breathing…but hey! Now I’ll remember that for the rest of my life!

Anyway, that is about it for me! Love you all and hope you are doing well!
-Eric

7/26/2008

2008-07-26T06:59:00.000-07:00

Family & Friends-

I’m amazed that July is almost behind us and August is so quickly approaching! This has been quite a month with its fair share of peaks and valleys. Here in Milwaukee I’m approaching the end of my first clinical rotation. I’ve really enjoyed my month in Urology and I’ve been able to see a lot of fascinating cases (more on this later). I hope I am able to enjoy all my rotations as much as I’ve enjoyed this one, despite the long hours I’ve had to pull. The first two weeks of the month I spent at the VA hospital, the last two weeks I’ve been at the school’s major teaching hospital and next week I’ll be at a children’s hospital. Switching between hospitals like this has its challenges. Each hospital has a different culture, a different way it runs, a new system to learn. The residents and attendings at each hospital also require some adaptation on the student’s part. I eventually learned (though I wish I’d figured it out quicker) that what worked well at the VA in terms of getting along with the residents isn’t necessarily the approach that I have needed to use at my current hospital – a good lesson to know, but kind of tough in the learning.
One of the more interesting cases I’ve been able to participate in was an all day surgery for a guy with muscle invasive bladder cancer. We first removed his bladder, prostate and some of his lymph nodes. Then we removed a section of small intestines, rejoined the ends of the remaining intestines, and then spent several hours cleaning and reshaping the piece of intestine we removed so that it became a sphere. We then attached the ureters and urethra to this spherical structure so that in essence we made a new bladder for this guy out of his intestines. It was a neat case to be in on and the guy (though in a bit of pain) is doing well.
On Wednesday and Thursday I got to spend the days with one of the urologists who specializes in male fertility. I went into this a little skeptical about how interested I would be but was pleasantly surprised to find myself fascinated by everything. On Wednesday we spent the day in clinic meeting with couples who want to have children but need some help. Thursday was spent in the operating room doing several vasectomy reversal surgeries. This is a cool procedure to watch because it has to be done under a microscope with needles so small they look like eyelashes to the naked eye. Things seemed to go smoothly though and there is a good chance these guys will be able to have kids again.
The other night I caught a few minutes of the TV show “Hopkins” while I brushed my teeth. I can’t vouch for the entire series because I’ve only seen a few minutes, but the part I saw was a very accurate portrayal of what things are like day-to-day for medical students. My roommate (also a medical student) made the comment that “it’s my life…on TV!” and I would have to agree. If I can find the time I would like to get on abc.com and watch the whole series, but for anyone curious about what life in medical school is like (Mima, I know you are always asking me), it looks like this show might give a pretty accurate portrayal.
Well, I have a lot to get done today and not a lot of other news, so I’ll quit now. Love you all and wish you the best!
-Eric

7/11/2008

2008-07-11T14:21:00.000-07:00

Family & Friends –

It has been a long time since my last letter, lots has happened and I can’t possibly remember everything to catch up on all of it. However, I have finally started clinical rotations (so much better than the book-work of 1st and 2nd year!) so I think my approach for this letter will be to recount a few choice experiences in as much detail as I can and then just give a brief overview of what the rest of my time is usually spent doing.
First, my disclaimer: I have given similar disclaimers before, but I’m about to do it again! I’ll try and euphemize things and keep terms as medical as possible, but I have spent up to 14 hours a day in a urology rotation for the last 2 weeks…I can’t exactly chronicle how I have spent my time without using some “grown up” words. Be warned!

Well, having said all that, I’m proud to announce that I am the best third year medical student rotating in urology right now in the same way Ring Starr was the best drummer on the Beatles…namely he was the only drummer on the Beatles! J
Because of a crazy lottery system used to determine which order we do our rotations in, I was one of only 3 students in my class to start the year with my elective. Among those 3 students I was the only student to choose urology as my elective, thus I am by far the best third year medical student in urology at the moment! Actually, things are going really well and I’m really enjoying the rotation! Urology is considered a surgical sub-specialty, so of the 5 days a week I’m expected to show up, 3 of those days are spent in the operating room (OR) and 2 are spent in clinic seeing patient who are awake and who can talk back! Because it is a surgical field, urology has pretty harsh hours (I wake up at 4:30am and go to bed at 11pm and usually work 12 to 14 hour shifts with no lunch breaks except to eat a PowerBar while typing my progress notes at a computer). Despite these forsaken hours, I’m learning a lot about myself which is kind of scary…I REALLY REALLY like surgery and the OR! Yikes! Clinic is fine. I think I’ll like it even better once I know more, but I can’t get enough of the OR! I’ve scrubbed in on lots of surgeries in the last two weeks including several really long cases (including a 6 hour job) and I just wish every day was an OR day!
My residents are great also…but I’ll get to that in a minute. First, let me start at my first day and try and be at least a little chronological.

I thought my first day was going to be just an orientation day, and that is all I had mentally prepared for. I hadn’t expected to mingle among real doctors, let alone real patients who have real medical issues! I was right about one thing, there was an orientation. However, it lasted for 10 minutes! At the end of that time, I was given a pager number and the name of a resident and told to present myself at the Milwaukee VA hospital and page the resident ASAP!

What Eric says: ”okay, no problem!”
What Eric thinks in his head: “uhh…how do I drive to the VA? Where do I park? Once I’m there, how do I page someone? Are they expecting me, because I sure wasn’t expecting to be sent to them today!”

Anyway, I drove in the general direction I knew the VA to be, found it, ambled around until I found what looked like a somewhat legal parking spot, walked in the first door I found and stood there…let me try and paint this scene a little better…
The Milwaukee VA hospital is a multi-building 10 story hospital with hundreds of workers and hundreds of patients all going different directions. Everyone else seems to know where they should be and what they should be doing. Also, it is a major teaching center for MCW and so there are lots of medical students that flux through, so one new medical student is not a site that will stop anyone in their tracks and cause them to ask me if they can help. So there I am, feeling like I’ve got an IQ just north of a bedroom slipper, wondering how to page this mystery doctor. I finally resolved on a fool-proof, tried and tested method that has served bewildered medical students for decades: I blindly followed the first person wearing a white coat I could see through winding hallways until I lost site of them, but by that point I had been deposited at a nurse’s station and I once again demonstrated my keen mental prowess (“uhh…how do I page somebody?”)
This began a series of “go to this place and ask for so and so” followed by “now go to this place and ask for so and so”. This human pinball game culminated in me wearing scrubs and being dressed in a full-body lead apron just before being escorted into an operating room. The last thing, almost as an afterthought, as I walked through the OR door was that a person handed me a pair of dark radiation-resistant glasses to put on. This did nothing to ease my disquiet, but I went in anyway and stood in a corner until the procedure was over and the surgeon could pay attention to stuff other than the kidney stones he was trying to break apart and remove though the patient’s urethra (the lead apron and glasses were because X-rays were being used to visualize the kidney stones and instruments during the operation).
Anyway, at this point I met the two residents I’ve been working with for the last 2 weeks. Both are super cool guys and I feel spoiled because I know that all residents aren’t this cool, and I’m just glad I got the cool guys on my first rotation while I’m still fragile. I think a few months from now I’ll be much better prepared to face less ideal residents that I may need to work with.
Back to the story however, the day’s excitement didn’t end there! With my residents I spent the day in the OR and got to see several neat operations. To add to the adrenaline of things, two of the patients tried to have bad reactions to the anesthesia and there were a few tense moments when we could easily have lost them. They were convulsing and I was trying to help hold them down so they didn’t fall off the operating table. Even the anesthesiologist attending was shocked to have 2 of these cases in the same day when usually things like this only happen once every few months (I must have bad mojo or something!). Anyway, I went from helping hold down the second convulsing guy who was turning blue and trying to die to a computer training with several of my classmates. Most of them had spent the day in dull orientations and then I run in 5 minutes late dressed in scrubs, surgical mask and cap, sweating and flushed from the adrenaline and they could immediately tell that my day had been a little bit different than theirs had been!
When I finally got home I was exhausted and didn’t really do much besides just brush my teeth and go to bed!

The days since that first one have been filled with the exciting, the mundane, the weary, the tense, the exasperating, the bewildering, the overwhelming, the thrilling! I feel I have learned a lot and yet still have so far to go just to know the rock bottom basics! I have gotten a lot of positive feedback from people so far though, so that is encouraging because I’m working my butt off! Here is a run-down of an average day in the life of Eric during a urology clerkship:

I usually have to be at the hospital by 6am, which means I have to wake up by 4:30 or 5am
I have to pre-round which means see all the patients on our service who spent the night in the hospital and see how their night went, then I have to write a progress note on how they are doing (I still suck at these notes and they are my least favorite part of what I have to do in a day)
Then I round with the resident and see all the same patients again while he teaches me about all the things I did wrong when I pre-rounded (hey, I'm still learning…everyone is expected to have no clue at my stage!)
Then I usually spend most of the day in the Operating Room. After that first day, the residents have been getting me to scrub in, which means I actually get to assist in surgery. Tuesday, for example, I got to remove a softball-sized fluid filled-sack (a hydrocele) from a guy's scrotom and then sew him back together. My resident let me do a lot of the actual sewing and cutting! He just supervised to make sure I didn't mess up! It was pretty neat. I've also helped on several other surgeries. We do a lot of prostate removal surgeries (usually a 3 or 4 hour surgery), so I spend a lot of time on my feet for these!
Like I said, lunch is usually just a quick power-bar and then back to the operating room or clinic to round again. When all is said and done I've been spending 12 -14 hours per day at the hospital only to come home and have 1-2 hours of elders quorum stuff to do and several hours of study I need to get done also! I'm not sleeping nearly enough, but oh well! It is amazing how well adrenaline keeps you going throughout the day!
Yesterday morning I had a big presentation which I had to give to the entire Urology department. A pretty intimidating thing considering most of the people there have been urologists for a minimum of 10 years, and some for much longer than that! I did my presentation on a disease called Tuberous Sclerosis and one of the tumors that is common to this disease which are called Angiomyolipomas. I got a really good response from people, so I guess that means it went good!
Today I helped surgically treat a guy with phimosis. I’m not going to describe what this condition is because that is probably a little too graphic despite my disclaimer (if you really want to know, look it up on Wikipedia). Lets just say that the treatment for the condition is circumcision, which is a whole lot more unpleasant for a 65 year old man than it is for a little baby boy…enough said! I’ve also been assisting in a lot of cystoscopies and prostate biopsies looking for bladder cancer and prostate cancer, respectively.

Well, I’m not helping my sleep right now and I need to get to bed! Love you all!
-Eric

05/25/2008

2008-05-25T08:25:00.000-07:00

Family & Friends-

I’m not sure whether to describe my mood right now as a generalized “funk” or simply contemplative. Regardless, I’ve got a lot on my mind…but those are things I don’t want to write about, so I’ll focus on the other things that are going on right now.

First things first: I PASSED MY 2ND YEAR!!! There was blood, sweat, tears and sleepless nights (okay, maybe not blood, but everything else!) involved in this. There were moments that I wasn’t sure I was actually going to advance into my 3rd year, but with nothing short of what had to be divine help I passed all my classes! Yes!!! Pharmacology was the big worry there for a while. I had to get a certain percentage on the final exam in order to pass, and practice tests weren’t doing much to boost my confidence. The morning of the final was something of a personalized hell and the test itself was what I affectionately like to call “academic Armageddon” (4.5 hours of trying to remember every side-effect/half-life/drug-interaction/metabolism/and contraindication of Chloramphenicol, Phenylzine, Carmustine and about 1000 others) but I got the mandatory score and passed! I’m glad that is done!
Unfortunately passing my classes hasn’t exactly freed me from study. I’ve got my first board exam in 2.5 weeks and in terms of tests this is not what I would call a normal test (normal in the sense that Einstein could understand it). It is a standardized 8 hour test that quizzes, in detail, everything I’ve supposedly learned over the last 2 years! Yikes! I’ve been spending somewhere between 8-14 hours a day studying and will continue to do so until June 12th, the day of my test. Let’s just say June 13th will probably be one of the best days of my life!
Along with the end of a school year comes the expected flux of people into and out of the ward. This means a lot of work trying to make sure everyone has home teachers, that new people are situated and those moving out have the help they need. On a personal note however, this has been a tough one for me. I had a roommate graduate and move as well as one of my best friends who helped take me in and who was been a big part of what has made the last 2 years out here in Milwaukee such a great experience! I’m ever grateful for the gospel ties that bind, even across distances.

As a stress reliever and a way to break up the monotony, I have been experimenting with cooking and trying several new dishes. This came about mostly because I was driving down the road the other day and on an impulse went into a small Indian supermarket. I had just left a mid-week church function (this was not on a Sunday) but I was dressed in shirt/tie/slacks/etc. I had to be the strangest customer the shop has ever seen. When I entered I was the only customer in the place and an old Indian man sat behind the counter. As I browsed over the rice section (who knew there was so much variety!) the old man came up to me and started using his Jedi mind tricks on me. Before I knew what was happening, I was picking up several bottles of paste that I assumed would taste good with rice and chicken, but that had names written in a language I couldn’t read! (I’m assuming they were variations of the word “curry”). Fortunately I kept my wits about me enough to demand “mild” and not “spicy” pastes. I left with WAY too many of these products, which I am now endeavoring to sample one-by-one.
The first such product I decided to try my hand at was some sort of cumin/cilantro curry (this one did have some English on the label) which was distinctly labeled as “mild”. I followed the directions on the bottle (clearly written in another language and then translated into English by someone who lacked a complete grasp of grammar and syntax) and procured an extremely aromatic dish. With real anticipation I sat down and sampled my “mild” curry. Now, I don’t want to come across as too wimpy, but after taking a single bite of this “mild” creation, I began to wonder if centuries of munching on red pepper plants hasn’t given the people in India a different definition of what “mild” means. This stuff was positively nuclear. I’m convinced that if I had turned off the lights, this curry would have glowed like and Exit sign! Undaunted, and with the aid of approximately 2 liters of water, I finished my meal. After being released from the hospital’s burn unit (not really) I threw out the remainder of that curry and moved onto the other bottles, which fortunately haven’t been quite as, shall we say, toxic!
Other news includes the fact that I’ve been plagued with ever increasing migraines. Fortunately Imitrex seems to do the trick. The only down side is that my insurance doesn’t cover very many pills. I’m going to need to get back into the doctor’s office and see what I can do about this.
Since it is on my mind, and since I got a really good response from people the last time I wrote on this topic, I would like to share another funny story about the monster dog who lives upstairs (his name is Chopper, by the way). For those who didn’t get these letters last time I wrote about Chopper, or by way of a general reminder, the people who live upstairs own a dog that, in terms of size, is more like a horse than a dog. Add to this the fact that on the intelligence scale, I would rank Chopper in the “mineral” category, and you have a perfect recipe for some funny stories. The most recent Chopper story I can think of happened on Friday when I was at home in the afternoon trying to study cancer pathology, or something like that. The couple who lives upstairs both work during the day and leave Chopper alone in the house in the afternoons. Chopper, using his extensive experience as a dog, keeps vigil at the front window – scanning the street like some demented sentinel. Every time a person passes on the street, Chopper reacts like the Manson gang is trying to break in. This compulsion that everything needs to be violently barked at does not stop with just people! No! Chopper’s finely tuned instincts extend to other dogs, squirrels, cars, and even litter! All of these apparently pose a serious threat to his turf and must be dealt with accordingly (namely by trying to pulverize them with bark waves). Let’s just say that there is a reason I usually don’t study at home!

A few thoughts I had the other morning while studying (which I wrote down at the time but figured I might as well copy down here):
Alma chapter 17 vs. 9 is often quoted, but for good reason. Ammon and the sons of Mosiah desire to be “instrument(s) in the hands of the Lord” so they “fasted much” and “prayed much” in order to have the spirit that they might be effective instruments. In response to this effort, the Lord “did visit them with his Spirit” (vs. 10). I find it interesting what verse 10 says this spirit did for them – the spirit “comforted them”. Now, why is this interesting to me? The spirit is the comforter, why is it significant that it comforted Ammon and the sons of Mosiah? When viewed through the lens of “how to fulfill and magnify a calling” or in other words, “how to be an effective instrument in the hands of the Lord” it gains new meaning. All of us have our own individual trials (I do at least – if you don’t then let me know what your secret is because I want it!) I think it is easy to let our own trials get in the way of our service (it is for me anyway). I tend to get bogged down in things I feel are less than perfect in my life and because I’m so focused on myself I am blind to the needs of those around me. I think that if we will work to invite the spirit into our lives (the “fasting” and “praying” part of verse 9) and then allow him to comfort us we will be better able to see the needs of others and act to help them
I also find it interesting how verse 10 phrases things, it says “the Lord did visit them with his Spirit, and said unto them: Be comforted. And they were comforted.” It almost seems to me like the Lord is commanding them to be comforted and then of course provides the way to accomplish that commandment through his comforting spirit. If that is true, it would seem to support the idea that we need comfort in our trials before we can be effective at helping others in their trials. That is part of the reason why seeking the spirit in “fasting”, “prayer”, scripture study, selfless service (and other ways we already know about) is so essential. An additional benefit of seeking the comfort of the spirit is that it brings with it “perfect love” which “casteth out all fear” (Moroni 8:17). Sometimes I know I’m a little scared or apprehensive about what my calling requires me to do. Sometimes it seems like what is required does nothing but play on my weaknesses, and I’m scared about what the Lord expects me to do. But I find that when I feel at least a little of the love God feels for his children, the fear leaves and I’m able to do the things required of me, even if they would have scared me before.
Alma 17 goes on to talk about patience, being a good example (v. 11), taking courage (v. 12), administering to and blessing people (v. 18), among other things. Chapters 18 & 19 also had many pearls that I’ll spare you having to hear from me. All of it reminded me of Jacob chapter 2 which, in my mind, is another mecca of wisdom about magnifying priesthood duties.
Okay, those are just a few thoughts I wanted to jot down. I hope they made sense. Best wishes to all of you!
-Eric

04/30/2008

2008-04-30T12:30:00.000-07:00

Family & Friends,

Looks like I’m going to have to adopt the same strategy I did last time I wrote and just piece this letter together one paragraph at a time. I really should be studying but I have a meeting (more on this in the next paragraph) in about 20 minutes so I figured I’d write until then.
I guess the big news to report in my life is that about 2 weeks ago I got called as the elder’s quorum president in my ward. Yikes! Really, I’m very excited, I just hope I figure out what I’m doing sooner than later! We are having a mid-week presidency meeting (mentioned above) to continue working on home teaching. This meeting began Sunday afternoon, but after 4 hours we still have a lot of work to do, and we figured we’d better meet to get some more done. I already love the calling, but keenly feel the responsibility of it at the same time. It’s interesting to me that church callings have a way of juxtaposing those emotions. My love for the people out here is growing in ways I never knew it could, which is neat. I love how active service in the church provides opportunities to serve and grow in love for people.
A few days after I’d been issued the call but before the ward knew about it, I had a chance to spend an evening in the Chicago temple. Descriptions of the feelings, emotions and insight gained during such times never translates well into written word (at least not for me), but it was an evening I’m very grateful for, where I learned a lot and received a lot of insight, especially into the matter of who should be called as councilors. I felt I received as clear a direction in councilor selection as I have ever received about anything in my life and the few hours we spent together on Sunday only confirmed to me that the Lord really prepared these people for their callings. All I can say is I’m glad the Lord is in charge on this whole thing because I’d never be able to pull it off alone.

Next Day…

So, the weather in Milwaukee has been steadily improving over the last few weeks until it finally now resembles habitable! There were weeks this winter when I wondered how the first person ever saw Wisconsin and said to himself, “Self, I think I’ll build a house here on the frozen tundra amidst the drifts of snow that just buried my horse, and call this place home”. But, as always happens, the weather has improved to the point where I completely understand how a person could happily live their entire lives in this state! The snow-mountains have melted, things are green, and we get an occasional rain shower (which I love!) It really is beautiful out here.

Later in the day…

I’ve got a couple of funny stories I want to share. These strike me as funny. Hopefully a few others may see some humor in them.

First, “The Story of the Fulminate Kitchenware”
For breakfast the other morning I decided I wanted to get a batch of Pillsbury caramel stick rolls cooking in the oven. I turned the oven to the prescribed temperature (375 degrees), prepared the rolls in a small Pyrex dish, put them into the oven to cook and started doing some of my other pre-lecture morning routines.
Perhaps 3 or 4 minutes before the rolls were ready to be pulled out of the oven, I was mixing up some grape juice to supplement my morning fare and my roommate was sitting at the kitchen table contentedly reading the Ensign. In the midst of these peaceful endeavors, a somewhat startling sound emanated from the oven. It sounded a little like small arms fire followed by the disheartening sound of broken glass falling onto a hard surface. My roommate, who had been absorbed in his Ensign article, assumed I had tried to pull the pan from the oven, burned myself and dropped the Pyrex, casing it to shatter. In truth I was 10 feet from the oven, and to my advantage had not burned myself at all. My first thought was, “that can’t be what I think it is”…but sure enough it was! The Pyrex pan, of its own volition, had exploded! And I mean that in all seriousness – It exploded! This pan did not crack, or delicately split down the middle, it blew up into lots and lots of tiny little pieces, spilling caramel and glass shards onto the heating element of the oven. This of course resulted in a fumigation of our apartment with carbonized caramel smoke. As this occurred minutes before I had to rush off to lecture, I had no choice but to quickly scrape the glass shards out of the oven, and turn the oven to “self clean” before running over to the school.
Approximately 9 hours later I returned to our apartment for dinner. I had kind of forgotten the incident in the rush of daily activities and only remembered upon seeing the oven still set to “self clean”. Not knowing how these things work, I assumed the self clean cycle must be done by then turned it off, then turned the oven to 400 degrees in order to do a little cooking of my dinner. While the oven heated I called someone and we started talking. Just at that moment my roommate came home and upon entering the kitchen noted a faint aroma and a small whiff of smoke rising out of the oven. He opened to oven, determined to investigate the matter for himself. Once again, we fumigated the apartment as billows of choking smoke poured from the oven. Apparently the “self clean” cycle on our oven does not work and the heating element was still covered with caramel!
Lets just say I ended up eating out that night, and had to spend over an hour the next day cleaning the oven with oven cleaner and paper towels!

Even later (I’m clearly taking too many study breaks)…

Second story: “The Story of the Rogue Elders Quorum President”
(Tell me if this doesn’t sound like just what you would expect to have happen the week you are sustained as elder’s quorum president…)
I don’t know how many of you have ever eaten at Noodles and Co. but if you haven’t, let me recommend that you do. In fact, don’t wait. Go right now. Drive to a neighboring state if you must…I love that place! They have a dish called Pesto Cavatappi that I would rank on the list of Ideals in Humanity somewhere between a cheap, inexhaustible, clean energy source and world peace.
Last week a friend and I (this friend shares my feelings about Pesto Cavatappi) decided we needed to try and duplicate this recipe. In fact, this friend is who I felt needed to be called as elder’s quorum 1st councilor. We were meeting to discuss elders quorum business and decided we wanted a meal to go along with our meeting. We did a google search and came up with a recipe that claims to be the same as what Noodles and Co. uses. This recipe, among other things, calls for the noodles to be pan fried in white wine (thus burning off the alcohol but leaving behind the taste). Anyway, it was my job to get the groceries necessary for this culinary endeavor.
I must have been the strangest customer the alcohol department at Pick n’ Save has ever seen. I was almost blushing from embarrassment at even being in the alcohol section, and I walked around reading labels just hoping to find a bottle labeled “white wine”, but apparently that is not French enough. Everything was labeled in mystic wine code (pinot noir, cabernet sauvignon, merlot, etc). Eventually I had to approach the lady behind the counter and have the following dialog:

Eric: “umm…I need help. See, I don’t drink but I need a bottle of white wine for a recipe I’m making”
Lady: “that is what all of our alcoholics say. What is it you need?”
Eric: “I just need the cheapest white wine you’ve got”
Lady: “sounds like you actually need a Sherry”
Eric: “No, I need a wine”
Lady: “A Sherry is a type of cooking wine”
Eric: “ohh…I guess I need that”

After proving that I’m a total alcohol moron (a title I’ll gladly claim) I approached the counter and asked about the procedure of buying the wine. I had it in my head that I would have to prove my age, status as an American citizen, and possibly have a criminal background check before the Sherry would be issued. In fact, the lady didn’t even ask for my driver’s license until I asked her directly if she needed to see it!
And for bonus laughs, wouldn’t you know that in the Pick n’ Save at the exact moment I was exiting the liquor section with my purchase I ran into a lady I recognize as a member of one of the married wards in the stake! I’m hoping she didn’t recognize me as a Mormon because I’m pretty sure she’d think I was AWOL in a word of wisdom sense!
By the way, the recipe turned out really quite good and if anyone is interested I’ll gladly send it along!

Okay, those are all my stories, and I’d better finish up here. The only other thing I want to leave with is an excerpt from Dave Berry that really rings true to me right now because I just bought my plane ticket home for the summer (ouch!). This excerpt is from a section titled “Answers to Common Air-Travel Questions”

Q: Airline fares are very confusing. How, exactly, does the airline determine the price of my ticket?
A: Many cost factors are involved in flying an airplane from point A to point B, including distance, passenger load, whether each pilot will get his own pilot hat or they’re going to share, and whether point B has a runway.
Q: So the airline uses these cost factors to calculate a rational price for my ticket?
A: No. That is determined by Rudy the Fare Chicken, who decides the price of each ticket individually by pecking on a computer keyboard sprinkled with corn. If an airline agent tells you that they’re having “computer problems” this means that Rudy is sick, and technicians are trying to activate the backup system, Conrad the Fare Hamster.

(I wonder if the price of medical school is determined in a similar manner???)

Love you all!
-Eric

04/18/2008-ish

2008-04-18T13:47:00.000-07:00

Family & Friends,

I’m beginning this letter with the intention of having to spend several days plugging away at it. It is a few short weeks until cumulative finals start up and then immediately following that I begin my intensive study for my Step 1 board exam. All things considered, I should probably lock myself in a study room, do nothing but read my notes and consume caffeinated beverages through an IV in order to save time, but I can’t bring myself to do that, so I’ll be using this letter as a periodic sanity break, allowing myself a paragraph or so at a time.

(Several hours after writing the above paragraph)…

I guess one of the first things I can think to write about is a cool program being offered at the school that I have applied for and hope to hear back on soon. The program is being offered through the anesthesiology department and is essentially a resident assistant program where the recipient would follow an anesthesia resident and help out, learning how to do the things they do. I hope to get this position, not necessarily because I know I want to be an anesthesiologist, but because it is probably as high on the list as anything else.
One of my only major gripes with MCW is that they do not offer enough elective credits in the 3rd year for students to explore what kind of medicine they might like. Add this to the fact that in a normal 3rd year, you only spend a couple weeks in anesthesia and you can start to see why I thought it might be a good idea to grab any opportunity available to spend some time in the anesthesiology department.

(Next day)…

I don’t know yet if I will get accepted into this anesthesia program, but I have a funny story about my application.
When the big tamale of the anesthesia department sent around the email telling students about this program, he stated that "to apply, submit a CV and a cover letter to the anesthesiology department". Now, in 7 years of higher education, I have learned what a cover letter is, but exactly what a CV might be eluded me. I thought it might mean "cardiovascular" (though I wasn’t quite sure how to submit one of those). I also considered "critical value", "capitol vote" and "crunchy vacuum" as possible candidates…though none seemed to fit the context very well. Eventually I decided I’d have to do a very un-manly thing and ask what CV might mean (in retrospect, I should have just Googled it).
Knowing that first impressions are often the most important, I thought long and hard about how to ask the head of the anesthesiology department what a CV was while still sounding intelligent. After going through several options in my mind, I finally decided upon a sure-fire, no-nonsense, to-the-point approach that would let him know that he was dealing with a first rate intellectual while still gaining me the valuable information I needed ("Uhh…what’s a CV?")
Fortunately the head of anisthesia is a nice man and let me know that CV is the top secret medical ninja code name (really, it is Latin) for "Curriculum Vitae" or in other
words, a fancy type of resume that only people in academia use. And with that vital piece of information, I was able to pull together my CV without further embarrassment! (all of you who have known what a CV is since before you were potty-trained do not get to tease me about this!)

(later)…

Another topic which comes to mind as reportable is that I have joined the ranks of family members and fellow Americans with diagnosed migraine headaches 􀀯
These headaches are not new to me, I just never thought they were migraines. For the last several years I will occasionally (perhaps once a month or so) come down with a real thumper that can make me a little sick to my stomach. These headaches can last for 2 or 3 days and really put a damper on things. I never thought they were migraines because I don’t get any sort of aura with them, but it turns out migraines don’t necessarily have to start with an aura (the things you learn in medical school!)
Anyway, 2 days before my last pharmacology test I came down with a really nasty headache. 45 Excedrin and 2 peptic ulcers later I decided to go in and see my doctor. Normally I would have just gone to bed until it went away, but that was not an option 2 days before a killer exam. My doctor heard my story and without breaking a sweat, diagnosed me and gave me a shot of something, which did the job. I was able to keep studying and I even passed my exam (not always as easy as you would hope in pharmacology)! Looks like I’ll be getting a prescription of Imitrex to have on hand when the next thumper starts!

(Next day)…

It’s hard to adequately convey exactly how much time I spend in one little study room doing nothing but reading notes and books. (Well, in all fairness sometimes I make lists on the blackboard erase them and write them again, so as to memorize the list). I can say that I spend all day every day in these activities but I think it comes across as a hyperbole more than the truth…how much I wish that was true. Really, I spend all day every day in this room engaged in these mundane activities, to the exclusion of all but the most basic bodily needs (and sometimes even those go neglected). If I’m feeling particularly crazy and reckless I might venture 2 miles down the road to the public library, spend 15 minutes browsing a book selection I’ll never have time to get to and then swing by the Walgreens on North Ave for a candy bar fix before returning to my dungeon…errr…study room!
Having said that, however, I did escape my routine one night last week and had dinner with a girl from the ward. She is from the area and has family out here. We actually went to her sister/brother-in-law’s place, had dinner and played games. Most of the games we played were board games, but we did spend a little time playing a Wii. Let the record show that for the first time since the Super Nintendo came out in 1990 I want a video game system! The Wii is AWESOME! I’d never played one before and it was a riot!
Well, this letter has spanned enough days and I should finish it up and get back to my study! I think I’ll have some fairly major news to report next time I write, but for now that is all I had better say.

Hope life is treating you all well!
-Eric