Julie: A post from my friend Rick on his blog.

I went to my very first skeet shooting and wine tasting party at Julie’s farm last week. You never know when your first skeet shooting and wine tasting party is also going to be your last. I wasn’t listening that closely when I was invited and heard something about shot this or shot that, and I thought it involved Alabama slammers, kamikazes, or maybe, sex-on-the-beach with an orgasm chaser. But this thing actually involved a fairly large arsenal of handguns, shotguns, rifles and of course a pink BB gun. It seemed like everybody in the place was packing. Mike had a .357, a police special .38 and what looked like a Kevlar vest just in case someone else had outgunned him. I thought I saw him pull a taser when I was reaching for the last chicken skewer.

I brought an appetizer, my shotgun and a couple of bandolero bullet belts. I was wearing a duster to affect a slightly menacing look, and also in case the place was dusty. It looked like we had barged in on a gun amnesty program. I thought I saw a hand grenade on the buffet table but it turned out to be a pineapple.

Lew and Rob ran the target shooting areas with safety in mind, and no one was killed or seriously hurt. Or even humorously hurt. I shouldn’t say no one, since I tripped up the stairs twice at the barn. Everyone had earplugs to use against the noise, and I noticed several people even wore them later on as I was talking to them, I’m not sure why.

Many guests had never fired a live weapon, and seeing so many women with guns was both exciting and unnerving. I myself had never shot a handgun, so I stepped up to the target area. I waved off the instruction, since I had watched the beginning of every James Bond movie at least 50 times. The target said to me, “So, Mr. Bond, we meet again- and this time, the cards are in MY favor. HA HA HA HA HA!” I wryly responded, “You had better check your hand once more, my friend… perhaps you hadn’t counted on THIS!” I spread my feet, lifted my sidearm using both hands, and emptied the clip. The target did not go down, so I threw the gun at it, momentarily confusing James Bond with Superman. Lew pried the gun out of my hand, saying something about having to re-sod the lawn now.

I fared a little better with the shotgun, since I have shot skeet before. Luckily, most of the clay pigeons broke coming out of the thrower, and if I shot quickly and winked I could create the illusion of success. Most of the birds fell harmlessly into the lake, and when I say harmlessly, I’m not counting all the fish who were beaned in the head. I asked Julie if she could put some of the fish into a barrel so we could shoot them and see if it was as easy as people say.

The estate was spectacular and beautiful. The grounds so big they could only be navigated by Segways with knobby tires. If you have never ridden a Segway, it’s quite a treat: you simply get on, and after you chase it about 20 feet trying to get on, you just lean in one direction or the other to turn or go forward or backward. The property slopes to the west, so several Republicans fell off the thing trying to turn left.

The wine tasting was also lovely, except for a tense moment when somebody popped a champagne cork and everybody hit the deck, still a little gun-shy. The venison was quite tasty, and it turned out that the boys had killed it themselves. No one would actually admit that they ran into it with their car, but I did see an antler-sized dent in the fender. There was a beautiful duck on the table that the menfolk had shot and stuffed. They said it was a hooded merganser, but I couldn’t tell one way or the other with the hood on.

Everyone brought an appetizer, and my wife made a delicious chicken and ginger offering. I kind of wished we had shot the chicken ourselves, but it was already dead so it seemed pointless. I did however empty some lead into the ginger.

I hope Julie doesn’t mind, but on my way to the party I took the liberty of stopping by the neighbor’s house to feign asking directions, and I let them know our two families were having a nasty blood feud and we were still pretty pissed off that the North won the war. When the gunfire started I pictured them shivering under the bed pretending to be dead.


Incidentally, the Puckle gun was unveiled in 1718 by James Puckle. Some say that “necessity is the mother of invention,” but it’s possible that having a name like Puckle is, instead. It fired square bullets, an upgrade over his previous design, which fired bullets in the shape of a parallelogram. Samuel Colt was the first to apply modern machining and mass production to the manufacture of firearms, his patent for the Colt revolver issued in 1836. Muzzle-loaders went out with the Crimean War in 1856, with the exception of my dog.

Methodist

On Tuesday I started my fourth clinical rotation at New York Methodist Hospital. (recap: one, two, three) I will be spending my first month here doing a general rotation (meaning that I am in an operating room doing general-type cases, as opposed to a specialty, like trauma). The second month I am going to be doing OB! I am really excited for this rotation, the only downside is this:

Methodist (point B on the map) is in Brooklyn, about an hour away from my apartment (point A on the map) by subway. This isn't ideal but it is doable, especially if I only need to take one train (the first option) but for the next three weeks the 3 train is not running due to construction (this is the busiest time for construction on the subway because the summer tourists have left and the holiday Thanksgiving/Christmas tourists have yet to arrive) which means I need to take three separate trains to get there. The unfortunate part about that is that if any of the trains is late, I will miss my connection... and when you are riding the subway that early in the morning the trains only come every 20 minutes or so. To give myself a cushion, I have been trying to catch the trains in that third option (the one that gets me there at 5:34) but I have yet to make them all so I keep ending up getting there around 6... so by the time I get in and get changed, it is 6:15 and I have already been up for two hours before the day has really even begun! Enough whining. I have a cool video for you from the OR yesterday. I spent the day giving anesthesia for robotic procedures - the way the robot works is that the surgeon sits at a console (picture a video game in an arcade) where she controls the instruments connected to the ends of the robot's arms. The instruments are inserted into the patient's belly through tiny little incisions, the idea being that this type of surgery is much less invasive than having your whole belly cut open. In theory this will make for faster recovery times for patients (since they have less healing to do) which will translate to lower costs to the hospital (because you won't have to stay as long). Since the robotic procedures are still so new, the surgeons are still getting used to using the robots. This means that they are much slower at doing the surgery (than they would be if they just cut the belly open) and, since OR time is so expensive, that is negating any money the hospital saves by getting the patient home sooner. First take a look at this picture so you can get a lay of the land:

You can see my anesthesia machine on the right, then there is the patient's head right in the middle (I am at the head of the bed, so picture the patient laying with his feet away from me, towards the back wall), there is the drape separating my area from the surgical field and then you can see the robot arms - they kind of look like big spider legs - covered in plastic to keep them sterile. I took the video looking over that drape towards the patient's belly. You may notice that his belly is blown up like a balloon, the surgeon injects gas into the belly to open up the space so that she can see what she is doing. The sound you hear is the sound the cutting instrument makes. One of the robot arms is holding a camera, I pan up at the end of the video so you can see the camera feed, this is what the surgeon is looking at in the console (only in much higher definition, and in 3D). They cut using electrocautery (heat conducted by electric current) so that is why you see bubbling/smoke when the noise is happening.

Halloween Snow Storm

You may recall that Chuck's birthday is at the end of October so Happy 27th Birthday Chuck! I came up to CT for a weekend of pumpkin-flavored beer drinking between clinical rotations (I finished at STC on a Friday and started my next rotation the following Tuesday). Chuck brought some pumpkins home from work and we had an evening of carving while watching Hocus Pocus (on my laptop which is set up in front of the TV because Hocus Pocus wasn't available for streaming on Netflix but I insisted that we watch it). Here is the scene:

Now, while I am a fan of pumpkin carving I don't go all out. I am happy with a simple face. Chuck decided that, if we were going to be carving pumpkins as 27 year olds, we could set the bar a bit higher - so we went to work:

Chuck settled on a Boston College mascot theme (they are the BC Eagles):

I went with a ShopRite theme in the hopes that Chuck's parents would put it at their front door for all of the trick-or-treaters to see:

Pretty good eh? I'm sure my plan for pumpkin displaying would have worked out but then this happened:      

Alas, since it is still supposed to be fall all of the trees still have leaves on them so when the snow storm hit the trees couldn't take the weight that built up on their branches so they started toppling left and right. Here is a picture of Chuck and his dad on his dad's street:

They are standing at the top of his dad's street (the plow couldn't get through during the night for obvious reasons). Aside from it being sad/scary to have trees falling down all over town, it was crippling because they were falling on phone and power lines. The storm happened Saturday evening/night. I was supposed to take a train back to the city on Sunday (I had class and a test on Monday morning) but all of Amtrak was shut down in the state of Connecticut because they were without power. Instead, I went to ShopRite with Chuck (we picked his dad up on our way, that is when I took the picture!) where we tried to salvage their perishable goods by moving them into refridgerated trucks. It was quite a disaster. As I write this (a week later) one of their stores still doesn't have power so it is running off of a giant generator and Chucks apartment (along with 75% of homes in Connecticut) still doesn't have electricity - remind me again why we left California?

Flexible Fiberoptic Bronchoscope

This past Monday we had a difficult airway lab where we practiced anesthetic scenarios with patients who have difficult airways. This means that for some reason it is hard to get the breathing tube in - maybe the patient has a really tiny mouth or a fat tongue or a tumor (or a knife!) in their throat. In this situation we can use a fiberoptic bronchoscope which has a camera on the end that allows us to see into the mouth/throat/trachea and then, once we are sure we are in the right place, we can slide the endotracheal (breathing) tube over the scope into the trachea. Unfortunately, this is easier said than done! The camera lens can get blocked by spit or blood and it requires a good bit of hand-eye coordination to maneuver it where you want it to go. The best way for us to get good at using it is to practice in non-emergency scenarios (like, before you realize that you just put someone to sleep and now you can't pass the tube into their trachea). In that first picture you can see me putting the scope in - I am passing it through the mannequin's nose (because sometimes putting it through a patient's mouth is not an option - what if their jaw is wired shut?) and if you look closely you can see the endotracheal tube loaded onto the scope. In the picture below you can see the screen where the view from the camera on the end of the bronchoscope is projected (don't worry, the picture is MUCH clearer in real life). I have gotten the scope where I want it and I am sliding the tube in over it.

Fall Party at the lake

We decided to have a little "welcome to fall" party at the lake. We provided the ammo, guns and champagne. Everyone else provided the food. Great day!

Shock Trauma Center

On October 1st I started my third clinical rotation! (recap: one, two) This month I am down in Baltimore at the Shock Trauma Center (STC) which is part of the University of Maryland Medical System.  This is a specialty rotation which I signed up for - we had to request this rotation because it is so far away, if I hadn't been selected I just wouldn't have gotten a trauma rotation.  To get there I take an Amtrak train from NYC to Baltimore and then I take a bus to the University of Maryland where I am staying in a dorm room that is within walking distance from the hospital.  The trip takes about 4 hours door-to-door which would be fine except for the fact that we are still expected to show up for class every Monday morning in NY - boo!  There are three other students at this clinical site with me, but none of them are from Columbia:

We work 12 hour shifts from 6:45-6:45.  This first two weeks I was on night shift and the next two weeks I will be on day shift (my body hates me right now).  STC is a free-standing hospital but we are connected to the University of Maryland Medical Center (UMMC) so, to differentiate STC staff from UMMC staff (and to discourage stealing of scrubs), the STC gives us pink scrubs to wear:

So far I've seen gun shot wounds, stabbings, car crashes, falls, sports injuries and patients who are already inpatients somewhere but then they have a medical emergency and need surgery immediately (like 2am on Saturday).  All in all it has made me very anxious about all of the ways that I can get hurt!  I don't have any cool work photos but I do have this photo of Eric and I at school last Monday learning how to do cricothyrotomies on pig tracheas:

A cricothyrotomy is a way we would secure an airway in an emergency when, for whatever reason, we are unable to intubate our patient.  Here is a picture of where you would do it on a real person:

This is what they are doing on TV shows when someone shoves a ballpoint pen in a choking person's neck - lets keep our fingers crossed that I never need to do one :)

27th Birthday

It officially happened last Monday!  I spent the weekend before visiting Chuck.  I took a bus up after clinical on Friday.  We spent Saturday tasting our way through a couple vineyards on the Connecticut Wine Trail - it was a fun way to spend the afternoon enjoying fall in CT but it was hard not to compare it to our vineyard trips out in CA (we were enjoying ourselves enough that I forgot to take a pic though)!  Sunday night Chuck drove me back to the city and we had a tasty dinner at a French restaurant in the East Village called Antibes.  On Monday I had class and I walked in to find that some of the other students had done a bit of decorating:

We get out of class around 2pm this semester so we headed out to a wine bar and then spent the afternoon geocaching in Central Park (previously explained in this post; I am now 100% addicted and I am enjoying addicting as many others along the way as possible).  Here is a pic of us after our last find (Eric found it!):

L to R: Adeel, Paige, Emily, Eric

This past Friday was my last day of clinicals at Cornell.  After I got out I met up with Kim who was one of my roommates out in LA., she was in town for a wedding this weekend.  After a few drinks with Kim I went over to Katherine and Sheldon's apartment for dinner.  In honor of my birthday they made spaghetti (the literally made it, they got a pasta maker as a wedding present) and a cake!

You will note that Katherine and Sheldon are wearing scrub pants that I brought them and you will also note that the birthday candle pickings were slim at Duane Reade and thus I have a 3 on the top of my cake - it still tasted amazing ;)