Good morning, or whatever time it is while you read this. I've been home from Ireland for less than a week. The last month has been a whirlwind of exams, details of a new home and newer floors, packing, escaping from Ireland before the volcano could cause me any trouble... Once landed I've gotten various forms of insurance, registered my car, and done all of the other things necessary for a new house and life. The next week will be all about packing and moving to Northampton with Kate. We'll have a few weeks to paint and move in before I start the doctoring at Baystate. An exciting time to be sure.

It was strange to leave Ireland. My last exam was enormously exciting and relieving. I had the exam in Tralee, so we had a 2 hour drive back once the day was over. We had champagne and beer for the trip back, and the mood was quite different than on the way over that morning, as you can imagine. The following several days involved recovering from the night before, packing, seeing friends, and taking in my last days in the city where I spent the last 5 years.

I'm picking up this paragraph some weeks after writing the first two. Life has been good, and busy. More painting has been done (with more yet to do, probably today!) some artwork has been hung. We've had some people over so the house feels more alive. New cichlids have been added to the tank. And I started at the hospital. I have to say everyone at Baystate has been great. The other interns are an interesting, friendly bunch that I'm looking forward to working with for 3 years. Talk about a diverse group. Different ages, family status, countries of origin, countries of education... Fascinating. Plenty to learn both in and out of the hospital! After a week of various training and orientation we had our first few days in the hospital. They are taking it very easy on us to make the transition smoother. Four of us to one patient, no real responsibilities except learning the electronic charting and figuring out how to report back to the attending. I will be starting in outpatients tomorrow, where we will continue to have a day or two of orientation and shadowing, and then start getting our own patients. It's all very exciting, and still only mildly nerve-wracking. I hope the balance stays that way!

I'm not sure how this blog will continue. I know I don't want to be worrying about patient confidentiality issues, so I will stay far away from that. Hopefully I will have the time and energy to continue to write about my experience as a resident, and thoughts about medicine and life. Stay tuned. The blog title no longer makes much sense so don't be surprised if that is different soon too!

Thanks for reading these 5 years. Talk to you soon.

Eli

You can tell it's exam time because the days are getting longer, warmer, and sunnier. How's that for a mixed blessing?!?!

Hi all. I know I haven't posted in a while. Have been having trouble keeping up with my email as well. I wonder if the moods that allow both to happen are related. Anyway, where am I at? At where am I? That's the ticket. For the last two weeks, and for the next two, I'm in Limerick in the pediatric department. I'm learning a lot there. Lots of kids with CF, and a wide assortment of other problems. There's an outbreak of measles currently, due largely to the bozo Wakefield in England claiming the MMR vaccine causes autism. Another out break is in the Traveling community here; they're a group of gypsies, basically, though racially they're Irish. Because they move around so much it's hard to make sure they get all of their immunizations. This year has been bad for measles in Ireland. Luckily the vaccination rates are back up to nearly what they were before all the damage was done.

I suspect most of my readers (are there any any more?) know, but I do have exciting news. I will be starting as an intern at Baystate Medical Center in Springfield, being trained in internal medicine. This is great for a number of reasons. Being close to my family and being at a great hospital being two of the most important. Only 6 weeks left in the hospital here! Then 2 weeks of study time (or perhaps 1 week to travel in Italy and 1 to study) then a month of exams, then I'm done!! Hard to believe. This time feels to have gone both quickly and slowly here. I suspect I will have a more reflective blog entry in a few months once I've finished here.

That's it for now. I've got to apply for a Massachusetts medical license!

I suppose I've not been great at sharing my experiences this year. Haven't felt particularly motivated for whatever reason. Trust that I've been keeping busy! I'm now only about 4 months from finishing my degree. Wowsers. That's mostly what's in my head these days. Perhaps once some of my school work and residency stuff slows down I'll find the muse to write some more. Until then, here a few pictures of the "extreme weather" we've been having in Cork. The flood picture is really quite mild compared to the destruction in caused the the center of town (though the stairs to a rehabilitation hospital is not really an ideal spot for a waterfall), and the winter shots are what happens when you get a hard frost in a country as humid as Ireland. It's snowing as I type, so perhaps I'll include some pictures from that soon.

Oh yeah, some of you probably want to know what happens at the end of this year. I've applied for emergency medicine programs. Many of them. All over the country, pretty much all 4 corners. It's really a waiting game at this point. Perhaps I'll see some of you when I go for interviews (keep your fingers crossed). More news as event warrant.

I still haven't taken pictures of my new place yet. A thousand pardons.

After a week of lectures, some of which were great, I started in the hospital. My first rotation is surgery, and the first 2 weeks were with a colorectal team. Interesting medicine, and interesting doctors. One an older, revered Professor of surgery, who has a very old-fashioned, and enormously educational teaching style. He really believes that teaching is as big a part of his job as practicing medicine. The other man has only been in Cork a couple of years, but is also a great teacher, and his patients love him. For the next 2 weeks (one past, one coming up) I'm in Mallow, apparently the ancestral homeland of Tip O'Neill. Things are a little quieter up there, so I'm getting to admit patients, take bloods, ECGs, etc. It's great, and reminds me that I learn much better from doing than reading or watching. Though it feels all too familiar from other times when I've been stationed out of the city, I'll include some pictures here for your enjoyment or what have you.


The top one is the view from the res. Pastoral, no? The other three are my room. It's en suite and everything. Not to shabby. Its only draw back is the view:

Not that it's an ugly hospital, but I generally don't like to live in sight of my work. Here's a picture of the hospital from the front:


One evening I took a walk into town looking for a cyber cafe. Though we have internet access, email is blocked.



The top picture is this old building with a forest inside. I thought it was cool the way the trees were coming out the roof, door and windows. The next is a restaurant I passed on my walk. Perhaps Kentucky has a meaning I'm unaware of? The last is just some pretty berries I saw. I didn't eat any of those, though I did stop to munch some blackberries growing beside the road.

That's enough for one evening. Thanks for stopping by.

Well, here we are again. I'm a little later than usual with a summer update, but things have been busy since I got home in late May. To start with, I went to a reunion at Macalester with the Traditions, the men's a capella group I was in there. It was a blast. Josh and I stayed in a dorm room together, surrounded by other Traditions and reunionites.



It felt a lot like being in college again. It even smelled the same. Though now this dorm has an elevator, which would have made getting to and from storage in the attic a lot easier. Oh well. There was much frivolity, usually involving singing, liquor, or in true Trads fashion, the combination of the two.




It also proved to be a great time to catch up with many of my other friends who were in town for their 10th reunion. Hold on to your hats/seats, but my 10th is coming up. It's unlikely that I'll get to attend, but it's amazing to think about. By that time I will have lived in Cork for as long as I lived in Boston. And who knows what's next?!

That weekend was also host to a local street fair, Grand Old Day or something like that (it happens on Grand Ave.) I got to eat cheese curds, talk with an old friend, and see my friend Casey perform in his hip hop role, rather than as a goofy a capella singer. An excellent weekend all around.

The day after I returned from there I started at Baystate Hospital for my month-long elective in emergency medicine. If I was a better person I would have done more writing as I went through that experience, but I'm not, so I didn't. It was a great month though. From the staff at the parking lot through to the Chief of the department, everyone was friendly, helpful, and seemed happy to be doing what they were doing. It was eye opening, considering how cranky the nurses and porters tend to be in the Boston area. I got to examine and take histories from patients, help form treatment plans, learn (and utilize) new suturing skills, spend time in the sim lab, have tutorials, drink bad coffee, and spend an evening with some paramedics. I loved it. So many patients, so much pathology. My first shift epitomized what I love about emergency medicine. As I walked in, there was a patient crashing after a crack binge, someone who had had a stroke, and a child having an asthma attack. There are few, if any, situations outside of an emergency department where all of those people present at once.

A couple of patients stick in my mind. One was a 100 year old man from Kerry. He didn't seem at all surprised or interested that I greeted him in Irish, but his children were delighted. He was fine. 100 years old and didn't need a single pill. Another woman came in with benign positional vertigo, which anyone who has had it will tell you is far from benign. Anyway, in the course of investigating her illness we ran some bloods and it turned out she had a million platelets. The normal number would be somewhere between 150-400. I never did find out what that was all about.

As soon as that month ended, I was straight into studying for the USMLE Step 2, a continuation of the licensing exam I took last summer. Lots of studying. I did much better this year than last, which is a relief. The scores are an important part of my application for residency, especially coming from a school abroad. One of the exams (it was a 2-parter) brought me to Philadelphia where I got to catch up with some more old friends.

It wasn't all work, though. I had 2 wonderful weekends in Maine with Kate, and lots of visits in between, since it turns out Middle St. is closer to her job than her own apartment. She was also able to join us on the Cape for a few days which was excellent.

All in all it was an excellent summer. The work was rewarding, and my time with Kate and my family was marvelous. Or "grand, like" in the local vernacular. This brings us to the start of the school year, which we're all expecting to be my last. But that's for a different post.

So long, and thanks for all the fish.

I was kind of dumbstruck when I saw this advertisement. I'd be interested to hear your reactions!

I realize it's been a while since I've written, and between exams coming up and the busy June I've got lined up I don't know when I'll write again. I may as well put my early mornings to good use.

I spent the last month on the psychiatric inpatient ward, which also included some time in the outpatient department. Because of limited resources, the people who arrange to get themselves admitted in the unit are really quite ill. Schizophrenia that's not responding to treatment, bi-polar disorder that becomes destabilized... I'd say 80% of the inpatients I saw fit into one of those two categories. It was an interesting month, to say the least. Besides learning about the pharmaceutical options of treatment, which are mainstays here but a relatively small part of the job, I also got a peek into the multidisciplinary approach they take here to mental health. Again, only with the sickest of the sick. The MDT meeting I went to consisted of a few psychiatrists (one consultant, 2 trainees) a couple of community nurses, a social worker, an art therapist, and maybe a couple of others. They talked about all of their cases, and made sure that living arrangements, medications, home visits, and social/activity lives were all maximized.

Now that that's over I'm headed into 3 weeks of exams. 2 next week, 3 the following week, then one more right before I come home. I land in Boston on the 1st, and then head out to a Trads reunion in St. Paul for the weekend, before I start my month in the Baystate emergency department. Hopefully I won't see any of you there!

Not much of an update, I understand. Such is life.