Here I am, in the momentary lull between exams, a hectic day of travel, and Christmas. Various relatives have been coming, going, and returning, with more to come and go today. How wonderful to have a family that's willing and eager to travel great distances to be together. There's a beautiful lazy snow falling now, which I predict will make those of us traveling today less than thrilled.

It's been longer than I wanted it to be between posts; I'm afraid by now I won't be able to capture some of the excitement and import of the latter half of my term at school. Probably the most interesting was the two weeks I spent with the anaesthetists in the operating theaters of Cork University Hospital. I got to see a laparoscopic bowel surgery, some neurosurgery (where I got to see how the brain pulses!) and watch an anaesthetist put lidocaine underneath the sclera in preparation for cataract surgery. Wicked. Though I don't expect to go into anaesthetics, it was cool to see, and got me excited to continue to learn about surgery. I got to start some IVs, put in some airways, and learn about various anaesthetic agents. So all in all, a very educational couple of weeks. I finished off with a few weeks with some respiratory and cardiac patients. That included a few good tutorials, and I got to hear some heart murmurs and the like. The two or so weeks after that were devoted to exams. Few classes, too much studying.

The next term, starting in January, should be quite exciting. With the exception of 2 weeks spent learning more about epidemiology we won't have any classes whatsoever; all of our time will be in hospitals and clinics around Ireland. For the first 3 weeks I will be with a GP in Clonmel, the county seat of Tipperary. It turns out that it's not as far as the song would have you believe. I'll get a week of vacation, or I think they're actually calling it private study time. Then I'll be back in Clonmel for a month in the hospital there. It should be really interesting to get to see medicine in a more rural setting than Cork, since most of Ireland doesn't have all of the resources of the city. The doctor who organized this term is also hoping that there will be some continuity between the GP and the hospital so that I might be able to see the full course of some of my patients' care. The town is about and hour and a half north of Cork, and I don't really know what my living situation will be. The school will put me up somewhere, likely a bed and breakfast, but I probably won't know until I go back. Most of my friends will be in Cork the whole time, so it will be strange to be away from them for so long. I imagine I'll be back at my own place for the weekends. I'll probably have little to do but write while I'm up there, so hopefully I will be posting frequently.

I think that's it for now. Mom's up, and the heat's on in the other room. Later.

Here's just a quick one. I took these pictures with my cell phone, and one of them was in the mirror. It felt much like that old riddle. What's the one part of your body you can't touch with your right hand? Do we have any suggestions for names for those guys?

I have now spent two months in the hospitals. My first month I was on the team, or more accurately, loosely affiliated with a team that was lead by two gastroenterologists. One of them was a hepatic specialist, or which there are surprisingly few of in a country so full of alcohol. It definitely wouldn't count as efficient education, but I did get to see a fair amount. I took lots of histories of patents with conditions related to liver failure, anaemia, and Crohn's Disease. One man who was having mild anaemia and liver trouble talked to us for a while about addiction and told us where to find an open AA meeting to go to to learn more about what it's like to live with an addiction. He is underwhelmed by physicians' understanding of the psychological and social aspects of addiction. We also examined these patients, and got to see and feel on live people many of the signs and symptoms we've read about in our pathology and physiology texts. For the last three weeks I've been with a urologist at one of the private hospitals in the city. It has been a wonderful experience so far. We have spent several days in the operating theater with him, and he has been a really supportive and proactive tutor. Urology isn't necessarily a branch of medicine I'm expecting to go into, but it has gotten me excited to learn more about surgery. Another great aspect of this rotation has been an hour long tutorial given to our group every morning we're there. It's generally about how to conduct a focused history/exam on patients in different wards (cardiac, respiratory, endocrine...) On Tuesday I start my next rotation, which will be 2 weeks of anaesthesia and 2 weeks of cardio/respiratory medicine. A lot of people have really been enjoying this rotation because you get to see surgery, and generally practice a few procedures. In the mean time we're studying furiously for a pathology exam to take place next week.

In completely unrelated news, I finally got a tattoo at the beginning of the year. I've been percolating the idea around in my head for several years, and finally I got the inspiration to do it. I've included several photos of the scene. To help explain one of the pictures, you should know that the place I got it done (by a German man named Stefan) among other things bills itself as the only place to get pole dancing lessons in Cork city. Needless to say it was an interesting afternoon. I though I had a close-up of the tattoo itself, so check back here for more pictures.

After some "gentle" urging from my Aunt Megan, here goes the first blog entry of my third medical year. The summer had a lot going for it. I got to spend a lot of time with my family, which is great considering how much those little nephews change in short periods of time. My work at the clinic was fun, educational, and I got to continue to develop some friendships and professional contacts there. There was some weird interpersonal stuff at one of the clinics, where a couple of the LPNs decided they didn't want me helping them. The other clinic, however, had plenty to keep me busy and were quite happy to have me. I also go mini tutorials from Dr. Sondhi throughout the summer, about some kind of medical condition that was relevant at the time. I also got to see a lot of my friends Carrie and Gabriel, and their spouses, which was really fantastic. I've been friends with Carrie since we were about 5 years old, and it's kind of amazing to have that kind of longevity to a friendship. Gabriel I met later, but it is great to renew that friendship after several years apart. I got to spend a full week on the Cape for the off-site session of Camp Tofu, which was too much fun. I don't have any of those pictures, so you'll have to harass my family for those. Because school started a month earlier than it has in the past I only got to spend a few days at family camp, but it was a great way to prepare myself for the coming year.

After getting an interview at Drexel over the summer, I was once again rejected. I was having a really hard time getting excited about coming back here. But, with the help of various professionals (including the McKenna/Crawford/Smith family doctor, Julian Jonas) I find myself quite happy. My mood is generally much higher than it has been in years, I'm feeling confident, more or less relaxed (how relaxed should I really be in medical school, you're wondering). I'm also noticing that I'm able to feel more at home and content here, and less like I'm divided across two continents. A whole bunch of us seem to be happier, so there could be some kind of adjustment period in effect as well. Something else that helps is that the school is much better organized this year than it has in the past, so with a few exceptions, things have been running quite smoothly. It's also the first semester I truly feel like I'm in medical school. We're finishing all of our class work (at least for this year) by Christmas, so it's going to make for a very busy fall. Or autumn as they insist on calling it here. Pathology is the biggest single class, and that's moving along at quite a clip. Who needs more than 3 hours to talk about disease processes of the lungs, anyway? Pharmacology, epidemiology, clinical practice, and an elective (I'm hoping mine is going to be a moot court with a lawyer who's on staff here). One of the other exciting things is that 3 mornings a week we're in the hospital. Our role is minimal, by which I actually mean non-existent. We're there to take histories and examine patients, since those are the skills that will provide about 90% of our diagnoses in the future. In the spring we will be full time in the hospital, I believe with a little more explicit teaching going on. In the mean time, I'm with a gastroenterologist who specializes in liver disease. Let me assure you there is no shortage of that in this country, naturally mostly due to alcohol. These patients make for interesting examinations and histories, which is great. Also learning some about ulcerative colitis and Crohn's disease. Lots to do!

The pictures in this post are a random sampling of recent months. The top is a picture from our tutorial on how to scrub in for theater. At the bottom is a picture of Camp Dad took from the ridge, and a picture of me and my cousin Molly from a hike we went on with Pam, Megan, and Mom. Fun times!

I suppose that's enough for now. Hopefully I'll post some fun/exciting/interesting stories from life in the hospital!

All my love,

Eli