congrats to sarah shanks on her 2nd place age group finish at the gallop and gorge last thursday! overall results aren't back yet, so i have no idea how i did in the race.
how could i forget!? i got to use IV caffeine yesterday at work for a patient with post-lp headache.
Saturday, November 27, 2010
Friday, November 26, 2010
messy night
actually, last night was the truly messy night. wednesday, liv and i had a lovely evening with our friends erin and jeff at our house. i made a baked polenta gratin from deborah madison's greens cookbook. i love deborah madison's stuff, especially vegetarian cooking for everyone. the greens cookbook can wax a bit fancy at times, but overall, i find it extremely accessible. i consider vegetarian cooking for everyone an indispensable volume in the kitchen, alongside joy of cooking.
well, i was about to make my beautiful gratin, but i realized that the cheese that liv had picked up at the store was gone. i searched the kitchen high and low but couldn't find it. finally, i saw the leavings of a wrapper in the living room. bubba had eaten $25 worth of cheese (valle d'aosta fontina and gorgonzola) while we weren't looking.
this is not good, least of all because i had to go back to the store for the cheese which delayed dinner. the worst sequela of this incident has been the constant doggy diarrhea for the past 24 hours. liv and i were woken up several times to clean up liquid doggy stool / soiled crate or to let bubba out to relieve himself. we would have been totally hosed if it hadn't been for deb. i had to work all day and bubba would have been stuck in his crate, except that deb graciously agreed to let him out today while i was at work.
today was also messy in that i tried to pick up too many patients at work tonight. the day after a holiday is notorious for being high volume. (people don't waste their holiday in the ER; they wait until the day after) today didn't disapoint.
in the ER, the ostensible goal is to see as many patients as possible while providing good care. it can be a fine balance. today, in walking the line between attention and volume, i strayed a bit too far towards the latter. i ended up signing out a bunch of loose ends and generally putting too much on my plate. all this in the name of trying to look like a stud. needless to say, it didn't work out like that, at least in my mind.
this isn't so much a defeat as a lesson to take things a little slower next time. sometimes, i can work through a ton of patients and do a good job. this just wasn't one of those nights.
switching gears entirely, here's a nice pic that liv took in philly with her iphone:
riding my bicycle home from work this evening, i was grateful for a few moments to collect my thoughts and take a few deep breaths after my shift.
well, i was about to make my beautiful gratin, but i realized that the cheese that liv had picked up at the store was gone. i searched the kitchen high and low but couldn't find it. finally, i saw the leavings of a wrapper in the living room. bubba had eaten $25 worth of cheese (valle d'aosta fontina and gorgonzola) while we weren't looking.
this is not good, least of all because i had to go back to the store for the cheese which delayed dinner. the worst sequela of this incident has been the constant doggy diarrhea for the past 24 hours. liv and i were woken up several times to clean up liquid doggy stool / soiled crate or to let bubba out to relieve himself. we would have been totally hosed if it hadn't been for deb. i had to work all day and bubba would have been stuck in his crate, except that deb graciously agreed to let him out today while i was at work.
today was also messy in that i tried to pick up too many patients at work tonight. the day after a holiday is notorious for being high volume. (people don't waste their holiday in the ER; they wait until the day after) today didn't disapoint.
in the ER, the ostensible goal is to see as many patients as possible while providing good care. it can be a fine balance. today, in walking the line between attention and volume, i strayed a bit too far towards the latter. i ended up signing out a bunch of loose ends and generally putting too much on my plate. all this in the name of trying to look like a stud. needless to say, it didn't work out like that, at least in my mind.
this isn't so much a defeat as a lesson to take things a little slower next time. sometimes, i can work through a ton of patients and do a good job. this just wasn't one of those nights.
switching gears entirely, here's a nice pic that liv took in philly with her iphone:
riding my bicycle home from work this evening, i was grateful for a few moments to collect my thoughts and take a few deep breaths after my shift.
Thursday, November 25, 2010
gallop and gorge
today started off with the gallop and gorge, an 8k through downtown carrboro. last year, i ran it with livvie's sister, which was awesome. this year didn't disappoint either. i saw what seemed like almost everyone i know in my little town. it was great to catch up with folks that i hadn't seen in a while.
liv and i spent the afternoon watching the kids are alright. i loved it. liv not so much.
liv and i spent the afternoon watching the kids are alright. i loved it. liv not so much.
Wednesday, November 24, 2010
Monday, November 22, 2010
results
i'm a bit disappointed with my marathon results. i shaved about 30 seconds off my previous PR, so it's a new best for me. but i was so hoping to break that 3:11 to get my boston qualifying time. for this year, it won't matter anyway (since the race is closed). so there wasn't a ton of pressure here.
on the bright side, i ran a more even-paced race. i never hit any signifcant wall of tiredness, and i even had some juice left over for the last two miles.
one thing that was lacking from this training cycle and every previous one has been the speed work. each time i train for a marathon, i go out there and do some piddly runs during the week and then usually one decent long-run on the weekend. that's fine, but it's obviously not going to get me any faster at these distances.
if i don't end up making it into the ironman lottery for next summer, i'm going to really train for chicago in october 2011 to get my time below 3:10.
there were a few things that slowed me down, most notably, that i didn't make it to the start in time and the crowd i started with had to be fought through. the taxi cab we called the previous night failed to show up, and we had to walk toward the start until we could find a cab to hail. but i'm not going to make excuses here. i think if i had been sufficiently trained, i could have ran faster.
liv was, of course, awesome at supporting me. from getting up at 5 AM to get ready for the start until the finish line where she fed me and helped me pull on some warm clothes, i had the best [one woman] support crew i could have asked for. thanks, baby!
despite the semi-disapointing finish time, we did have a big fun time in philly this weekend. we got to spend an entire day with ben and dawn and their new baby, julia skyke.
julia skye was the highlight of the day, but we were also quite taken with their chocolate lab, hercules.
philly was a good race, but i don't think i'll do it again. after chicago, it seemed pretty small and low-enery. i'm also not a huge fan of the out-and-back loop type courses.
although we had a very limited time to be tourists, we did see a few of the sights. we mostly walked around downtown and the penn campus.
but the best thing we saw was the mutter museum, which houses a fascinating collection of medical oddities and history. my favorites were the x-ray shoe fitter, the iron lung, the preserved mega-colon, and the liver of the original siamese twins, chang and eng bunker. turns out, those conjoined twins who settled in mt. airy, nc were only joined by a shared lobe of liver. the entire liver of both men and the shared segment are on view in the museum, bathed in formaldehyde.
on the bright side, i ran a more even-paced race. i never hit any signifcant wall of tiredness, and i even had some juice left over for the last two miles.
one thing that was lacking from this training cycle and every previous one has been the speed work. each time i train for a marathon, i go out there and do some piddly runs during the week and then usually one decent long-run on the weekend. that's fine, but it's obviously not going to get me any faster at these distances.
if i don't end up making it into the ironman lottery for next summer, i'm going to really train for chicago in october 2011 to get my time below 3:10.
| Bib | First | Last | City | State | ChipTime | ClockTime |
| 798 | Stephen | Gamboa | Carrboro | NC | 03:12:17 | 03:13:36 |
there were a few things that slowed me down, most notably, that i didn't make it to the start in time and the crowd i started with had to be fought through. the taxi cab we called the previous night failed to show up, and we had to walk toward the start until we could find a cab to hail. but i'm not going to make excuses here. i think if i had been sufficiently trained, i could have ran faster.
liv was, of course, awesome at supporting me. from getting up at 5 AM to get ready for the start until the finish line where she fed me and helped me pull on some warm clothes, i had the best [one woman] support crew i could have asked for. thanks, baby!
despite the semi-disapointing finish time, we did have a big fun time in philly this weekend. we got to spend an entire day with ben and dawn and their new baby, julia skyke.
julia skye was the highlight of the day, but we were also quite taken with their chocolate lab, hercules.
philly was a good race, but i don't think i'll do it again. after chicago, it seemed pretty small and low-enery. i'm also not a huge fan of the out-and-back loop type courses.
although we had a very limited time to be tourists, we did see a few of the sights. we mostly walked around downtown and the penn campus.
but the best thing we saw was the mutter museum, which houses a fascinating collection of medical oddities and history. my favorites were the x-ray shoe fitter, the iron lung, the preserved mega-colon, and the liver of the original siamese twins, chang and eng bunker. turns out, those conjoined twins who settled in mt. airy, nc were only joined by a shared lobe of liver. the entire liver of both men and the shared segment are on view in the museum, bathed in formaldehyde.
Sunday, November 21, 2010
Saturday, November 20, 2010
powered by what?
Friday, November 19, 2010
back in the department
although i'm officially still on my ultrasound month, yesterday i took a shift in the emergency department for a colleague. i have to admit, it was nice being back: seeing patients, interacting with my fellow residents, learning. one of my favorite seniors was working alongside me for the afternoon, and he gave me a red trauma to run just before i had to leave.
in about two hours, liv and i are headed to philly for a weekend of city exploration and the marathon on sunday. any suggestions for what we should do while we're there? any restaurant recommnedations? we will be staying in west philly with friends (who are out of town), and the race start is in center city, i think.
my feet are ready to go. the weather looks perfect, and i'm very happy with the way my new race shoes feel.
now that this training cycle is over, i'm thinking about getting back to things like paddling (see below) and riding my bicycle. i hope that liv and i will find some time to swim together in the new year too.
i'm a bit sad that to miss the family thanksgiving celebration next week in new orleans. i had thought that i'd have the week free. now turns out that i have to work in the emergency department. i guess that's what i signed up for a year ago when i applied for this job.
on the bright side, liv is spending the actual thanksgiving day with me before she heads to ATL for thanksgiving (one day late) on friday with her folks. i already have a little turkey day menu planned for us (minus the turkey) for after the gallup and gorge 8k thursday morning.
oh, almost forgot: if you haven't seen this guy, i think he's my doppelganger. filipino, rides bikes, runs, blogs, is a hospitalist MD, and we're exactly the same age. oh, and we happen to be 3rd cousins (i think; please help me with this, aunt vicky). we've never actually met in person, but i hope we do get to hang out together sometime, perhaps when liv and i do our asia trip.
again, any suggestions for cool things to do in philly are welcome.
in about two hours, liv and i are headed to philly for a weekend of city exploration and the marathon on sunday. any suggestions for what we should do while we're there? any restaurant recommnedations? we will be staying in west philly with friends (who are out of town), and the race start is in center city, i think.
my feet are ready to go. the weather looks perfect, and i'm very happy with the way my new race shoes feel.
now that this training cycle is over, i'm thinking about getting back to things like paddling (see below) and riding my bicycle. i hope that liv and i will find some time to swim together in the new year too.
on the bright side, liv is spending the actual thanksgiving day with me before she heads to ATL for thanksgiving (one day late) on friday with her folks. i already have a little turkey day menu planned for us (minus the turkey) for after the gallup and gorge 8k thursday morning.
oh, almost forgot: if you haven't seen this guy, i think he's my doppelganger. filipino, rides bikes, runs, blogs, is a hospitalist MD, and we're exactly the same age. oh, and we happen to be 3rd cousins (i think; please help me with this, aunt vicky). we've never actually met in person, but i hope we do get to hang out together sometime, perhaps when liv and i do our asia trip.
again, any suggestions for cool things to do in philly are welcome.
Thursday, November 18, 2010
Wednesday, November 17, 2010
lazy day
mostly, i'm trying to rest before the race on sunday.
we're already starting to plan our winter vacation. we fly into san francisco and will be heading up into the sierra foothills mostly, we'll be doing a yoga retreat near grass valley. a visit to see zosia mae is also in the works.
Tuesday, November 16, 2010
looking good
looks like the weather in philly is going to cooperate this weekend. except for my first marathon (charlotte in 2001), all my races have been blessed with good weather. even in chicago last year, with a 32 degree F start, the temperature felt perfect. it's hard to imagine how bad it would suck to spend months training only to be slowed down by soggy shoes.
ran my last "real" run yesterday: 5 miles. when i headed out the door, i realized that since i'm purposefully running slow, i can take ulysses with me! he does fine at moderate speeds, but usually he slows me down (and consequently doesn't get to come running with me).
my last ultrasound shift is today. at my meeting with our u/s director, bobby, i realized that i've actually made some progress this month with my scans. i'm not a perfect sonographer, but i can do the exams that i need to get done (aortic aneurysm, pelvic, FAST, DVT, and cardiac echo are the biggies).
liv and i are going to be in CH for thanksgiving. anyone want to run gallop and gorge with us? if you haven't heard of the race, it's a fun 8k through downtown carrboro and a great way to get a little exercise before, well, gorging yourself on turkey.
Monday, November 15, 2010
Sunday, November 14, 2010
racing flats! (one week to go)
ran a very slow 7 miles yesterday in my new shoes. they feel fast and have just about the right amount of support. (ie, i don't expect my feet to be completely ravaged at mile 20)
just got back from a very short bike ride. for me, it was about an hour. liv continued on with the team for about a 45 mile, 3-hour loop. today is supposed to be a rest day, and i'm trying my hardest to not push hard AT ALL this week on my runs. i'm still pessimistic about reaching my goal of 3:10. i'll run as fast as i can, and we'll see what happens.
had the nice surprise of meeting up with officer kitty and his west-coast fiance for dinner last night. we all just happened to be at the same restaurant, one of my favorites in carrboro. they're probably the only place in town with a decent selection of wines. they even seem to have picked my 2 favorite sonoma zins: seghesio and a few of the ridge zin blends. both these wineries were a short bike ride from my house in healdsburg five years ago.
Friday, November 12, 2010
autonomy
i've spent the last two nights working 12-hour shifts at a very rural hospital in the eastern part of the state. it has been awesome: exciting but not too exciting. (read: no scary patients trying too hard to die on me) crazy how being a resident can sometime take the fun out of an otherwise satisfying job. whatever it is about working on my own in the ED and being responsible for my own decisions, it seems to suit me well.
i left my shift yesterday tired but happy. drove 30 minutes to lumberton where i had a hotel for that day to sleep between shifts. at first, i was feeling guilty about spending the money for the hotel. the hospital has a little room that i could have slept in, but there are no windows, the bed is a little cot right below a jet-blast air conditioning vent, and it is insanely noisy.
instead, i was treated with a really nice place for pretty cheap. i ate a delicious breakfast, soaked in a hot bath (very important after a night shift) and then settled into a soft, comfortable bed around 9 am. i had planned to get to sleep immediately, but invictus was on HBO, and i stayed awake to watch the whole thing. initially, i had just planned to watch a few minutes, but i couldn't turn it off. great movie, if you haven't seen it.
i can't believe i was apprehensive about coming out here! don't know when i'll have a chance to come back, but i hope it'll be soon.
looking forward to a weekend off with liv then the marathon in one week!
i left my shift yesterday tired but happy. drove 30 minutes to lumberton where i had a hotel for that day to sleep between shifts. at first, i was feeling guilty about spending the money for the hotel. the hospital has a little room that i could have slept in, but there are no windows, the bed is a little cot right below a jet-blast air conditioning vent, and it is insanely noisy.
instead, i was treated with a really nice place for pretty cheap. i ate a delicious breakfast, soaked in a hot bath (very important after a night shift) and then settled into a soft, comfortable bed around 9 am. i had planned to get to sleep immediately, but invictus was on HBO, and i stayed awake to watch the whole thing. initially, i had just planned to watch a few minutes, but i couldn't turn it off. great movie, if you haven't seen it.
i can't believe i was apprehensive about coming out here! don't know when i'll have a chance to come back, but i hope it'll be soon.
looking forward to a weekend off with liv then the marathon in one week!
Thursday, November 11, 2010
thanks, vitalink
just saw some of the great folks from costal hospital critical care transport team. there are no bougies here at this hospital, and i forgot to bring mine! one of the transport medics was nice enough to gift me a bougie from their ambulance. i used to keep one in my timbuk2 bag, but somehow it disappeared. there's no wifi here but tomorrow i'll post a pic.
Tuesday, November 9, 2010
remembering the prom
borrowing from a post from liv:
had a great time at the med school prom last year with liv. this pic brings back nice memories of a fun night out, so it seemed worth re-posting.
i have my first shift tomorrow moonlighting at an extremely rural hospital in the eastern part of the state. for the last few weeks, i've been a bit nervous about going out there. it's pretty much the opposite of university hospital. they have few resources and NO consultants. hell, they don't even have an ultrasound or an optical airway device in the emergency department.
but then tonight i realized: wait a sec, i did this for two years before i went back to residency. pretty much the same type of set-up with almost no support in an isolated setting. tonight, riding my bicycle home from the hospital, i actually started to feel excited about the chance to work by myself with a little autonomy, away from the ultra-supervised setting of the u.
so off i go tomorrow. two 12-hour shifts separated by a short hotel stay. i'll let you know how it goes.
had a great time at the med school prom last year with liv. this pic brings back nice memories of a fun night out, so it seemed worth re-posting.
i have my first shift tomorrow moonlighting at an extremely rural hospital in the eastern part of the state. for the last few weeks, i've been a bit nervous about going out there. it's pretty much the opposite of university hospital. they have few resources and NO consultants. hell, they don't even have an ultrasound or an optical airway device in the emergency department.
but then tonight i realized: wait a sec, i did this for two years before i went back to residency. pretty much the same type of set-up with almost no support in an isolated setting. tonight, riding my bicycle home from the hospital, i actually started to feel excited about the chance to work by myself with a little autonomy, away from the ultra-supervised setting of the u.
so off i go tomorrow. two 12-hour shifts separated by a short hotel stay. i'll let you know how it goes.
Monday, November 8, 2010
tapering
my 12 mile run yesterday turned into a 10-miler because i was feeling pretty ill. not terrible, just a little tiredness and malaise. (i've been battling a little cold for a few days now) when i told this to liv, she thought it was pretty funny that i would run 10 miles whilst feeling ill. i think she's right.
either way, i'm in the taper portion of my training now. fewer miles, less time, and supposedly more energy. those last few long runs took a lot out of me, so i'm glad to be decreasing the training intensity for a bit.
i'm very excited not only to run philly but also to have a chance to explore the city. liv accompanied me to chicago last year for the marathon, and we had a spectacular time wandering around chicago, based at my friend annie's house. (although she and her husband were out of town that weekend. we had the whole place to ourselves!)
again this year, we're staying my friend kristin, who i met last year at ian and rebecca's wedding. and again, kristin and her man will be out of town.
a little less than two weeks to go!
either way, i'm in the taper portion of my training now. fewer miles, less time, and supposedly more energy. those last few long runs took a lot out of me, so i'm glad to be decreasing the training intensity for a bit.
i'm very excited not only to run philly but also to have a chance to explore the city. liv accompanied me to chicago last year for the marathon, and we had a spectacular time wandering around chicago, based at my friend annie's house. (although she and her husband were out of town that weekend. we had the whole place to ourselves!)
again this year, we're staying my friend kristin, who i met last year at ian and rebecca's wedding. and again, kristin and her man will be out of town.
a little less than two weeks to go!
Sunday, November 7, 2010
12 miler and insanity. texas style.
hey partners, saddle up for a little crazy talk, texas style. texas republicans, reveling in their political gains last week, are talking about pulling out of the medicaid program to protest the patient protection and affordable care act.
in the words of my friend heidi sinclair, "how on earth do they think would SAVE them money in the long run? it's not like children and disabled poor folks are suddenly going to stop being sick or needing preventative care - they'll just end up in the emergency departments ... or really sick ... or dead."
in the words of my friend heidi sinclair, "how on earth do they think would SAVE them money in the long run? it's not like children and disabled poor folks are suddenly going to stop being sick or needing preventative care - they'll just end up in the emergency departments ... or really sick ... or dead."
it must just be blowing smoke - can they are really so short sighted? maybe. but maybe they realize how important the ACA is. this piece of legislation was probably the most significant since i was born.
had a nice visit with my folks this weekend. just said goodbye to them, and i'm heading out for a 12-miler now.
Friday, November 5, 2010
keep your government hands off my medicare!
for those of you riding the t-party tsunami, just remember that taxes pay for your roads, bridges, schools, trash collection, and yes, your medicare. so if anyone needs to stay away from medicare, it's you. also, consider that "obamacare" will result in tremendous cost-savings. if you truly believe in thriftiness, don't mess with it.
the parents are coming to town this weekend, which should be fun. dinner tonight then fences tomorrow.
got some great news today: i'll be doing OB as my off-service rotation this year with one of my fellow ER interns. this is awesome because there will be lots of people to share call, which means fewer call nights. also, i get to deliver babies again! maybe my future career won't involve OB, but i'll definitely use these skills next time i'm working abroad. having this month of high volume obstetrics will allow me to keep my skills fresh.
the parents are coming to town this weekend, which should be fun. dinner tonight then fences tomorrow.
got some great news today: i'll be doing OB as my off-service rotation this year with one of my fellow ER interns. this is awesome because there will be lots of people to share call, which means fewer call nights. also, i get to deliver babies again! maybe my future career won't involve OB, but i'll definitely use these skills next time i'm working abroad. having this month of high volume obstetrics will allow me to keep my skills fresh.
Thursday, November 4, 2010
the papoose
to a child, it's a torture device. to me, it's a godsend. it's the papoose board. basically, when you have a procedure (eg, repair of a laceration) to do on a child, you strap the kid to this device, and they can't move a muscle. the cartoon pretty much illustrates how this works.
if you don't read the comments on this blog, officer kitty dropped a fascinating story on marathons. i've come down with a cold, and my training has really suffered (ie, non existent) for the past few days. but i've also let go of qualifying for boston at this race. i would like to run boston some day, but it doesn't have to be this year. i just want to enjoy running for now.
in other news, i visited the family medicine center today to keep up some contacts there. i love family docs. i love emergency medicine and working in the ED, but i will always be a family doc at heart. hopefully, i'll find a way to stay involved in the department in the coming years.
Monday, November 1, 2010
great day
just got back from work today at capital, and MAN i am jazzed. i had a great shift with an awesome attending.
although there are certain parameters that most doctors stay within, emergency medicine is extremely variable in practice. it's probably because i trained originally in family medicine, but my practice tends to fall on the minimalist side of things.
\sometimes, this is what happens when i run a case by my attendings: i propose what i believe to be a reasonable battery of tests for patients. attending looks at me funny. attending tells me that i need to order this or that scan or test and if i don't i'll be sued so watch my backside or else.
not so today. i had the best day i've had in a long time working with dr. c, who, i felt, was just about the most reasonable attending i've worked with so far. no unnecessary blood tests, no needless irradiation (which, we recently have learned, significantly increases our patients' cancer risks). what a breath of fresh air.
not only that, i'm off "jeopardy call," which means i can't get called into the hospital this week. sweet! now off for a recovery run and a relaxing evening. oh, and i'm not even sore from yesterday, which is a double bonus.
although there are certain parameters that most doctors stay within, emergency medicine is extremely variable in practice. it's probably because i trained originally in family medicine, but my practice tends to fall on the minimalist side of things.
\sometimes, this is what happens when i run a case by my attendings: i propose what i believe to be a reasonable battery of tests for patients. attending looks at me funny. attending tells me that i need to order this or that scan or test and if i don't i'll be sued so watch my backside or else.
not so today. i had the best day i've had in a long time working with dr. c, who, i felt, was just about the most reasonable attending i've worked with so far. no unnecessary blood tests, no needless irradiation (which, we recently have learned, significantly increases our patients' cancer risks). what a breath of fresh air.
not only that, i'm off "jeopardy call," which means i can't get called into the hospital this week. sweet! now off for a recovery run and a relaxing evening. oh, and i'm not even sore from yesterday, which is a double bonus.
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