Yesterday was an interesting day. After rounds we went downstairs to work on a guy who's having some problems. He had a NAIS procedure two weeks ago (Neoaortoiliac System, which is basically a procedure that bypasses an infected graft of the iliac arteries.) What are the iliac arteries? Well, your aorta is the big artery that leaves the heart and supplies blood to the rest of the body. (My research is looking at complications that affect the surgery to repair aortic aneurysms.)

**It seems this image is quite popular across the internets, especially when you search for "aorta" on google images. Hurray for that!**

Well, eventually the aorta branches into two different arteries called the iliac arteries which supply each leg with blood. Often the iliacs can become blocked with plaque (similar as to what happens to the coronary arteries in a heart attack or the carotid arteries in a stroke) and will require a bypass or actual removal of the blocked part and replacement with a synthetic graft. In this patient's case, the graft became infected, which is bad. You can't cut the graft out and put a new one in, because it will probably get infected again. So, a vascular surgeon does what's called a NAIS procedure to bypass the infected graft. Anyway, this guy isn't doing too well, and apparently some of the infection has spread to his right foot. It's not good if the infection gets worse (gangrene) or continues to spread up the leg. So in this patient's case, we had to amputate his foot to hopefully save the leg. I actually had never seen or performed an amputation, so it was kind of weird to take part. (stop reading if you're weak of heart) What basically happens is you draw a circle around the leg where you're going to amputate. Then you take a knife and cut around the circle, making sure you go to the bone. Then you take this chain-like thing and hold the two ends and saw the rest of the foot off. Then you tie the three major arteries that supply the foot, and it's all done. Before that we did a tracheostomy, which is cutting a hole in the trachea (wind pipe) and putting a tube in there so the patient can breathe. This is better (less chance for infection) than being intubated, which is having a tube placed through the mouth into the trachea. Anyway, it was interesting to partake in both procedures, although I felt weird that the patient would wake up without his right foot.

The research stuff is going wonderfully. I think tomorrow or maybe today if I have time, I'll talk about aneurysms and pseudoaneurysms (complete with illustrations).

I picked up my digital camera from the repair shop here in Houston. Apparently it is so damaged, they can't fix it. So I'll be sending it to the Kodak factory for repairs. I'm sort of pissed at the repair shop, because their website says free estimates. Of course, the estimate actually costs $15, even if they can't perform the repair, which is complete bullshit. I'd understand if they quoted a price which was too high and the customer walked away. But if they can't fix the camera, they should refund the estimate fee. So don't take your camera to Houston Camera, cause they suck.

I also had a big meeting today with the surgery clerkship director, Kim Anderson. Dr. Anderson is probably one of the nicest, coolest faculty members at UT-Houston. She's very, very sarcastic and jovial and really looks out for her students. So of course, her personality meshes with mine perfectly. Anyway, today we discussed residency programs and decided on 30 or so that I will apply to in a few weeks. It also turns out that she is the President of the Association of Surgical Education, which is a national committee that helps to decide how surgery is taught to residents. Plus, she knows tons of people around the country who help decide who will be training at their institution each year. So I'm really grateful to have her on my side. Plus, we decided on some really nice programs around the country which is also a relief, cause I really had no idea where I wanted to go or which were good programs.

I think over the next few days I will showcase various friends I have around the country. I have all these random images that I need to put into the blog, so I have decided to start posting them so my friends can have stalkers too. Please note: I'm listening to Dallas/Ft. Worth's Sportsradio 1310 The Ticket on your AM dial or over the Internet at www.theticket.com, so forgive me if some of this doesn't make sense. Everyone knows that males can't multitask, and women just shouldn't even if they can (i.e. when they're driving).

Travis Fluitt

Travis hails from the armpit of Texas called Houston. He grew up in Dallas, Texas attending Parkhill Junior High and graduating from J.J. Pearce High School in 1996. After graduating he headed to The University of Texas at Austin to learn about physics and liberal arts. Upon graduating in 2000 he moved back to Dallas to earn some spending cash then went back to The University of Texas to obtain a masters degree in traffic engineering or whatever. Now he lives in Raleigh, N.C. and is dating a girl named Alison. He's a very serious guy who almost never laughs. Everything is do or die with him. He also has a bit of a weight problem. So here's Travis!

Today the data collection part of my aneurysm research officially started. I look forward to completing the work and analyzing the data. I'd be thrilled if we actually found something interesting. Soon I will show you what an aneurysm looks like on a CT scan. Well, I actually have a picture of a pseudoaneurysm which is almost as cool.

Another nice Dallas weekend is in the books. Save the unpleasantness of taking Step 2, I enjoyed being back in Dallas to relax over the weekend. Here is the recap:

Friday Night

After the exam, we decided to go to Houston's for dinner. Houston's is a mini-chain but serves excellent, excellent food. I've never had something bad there, and last Friday was no different. We started with the traditional spinach dip and also had the salmon appetizers. Then we split a Cesar salad. Finally the main courses were delivered. Grandmother had some tasty grilled chicken, mom had the halibut, David Schultz (or "Tiger" as my roommate Ryan calls him) had a rib eye, and Dad & I had the special Worchester marinated prime New York strip. Everything was quite good, down to the three Grey Goose and tonics I had. The dinner was comparable to dinner on Wednesday night, when we all ate at Javier's gourmet Mexican cuisine at Knox and Harvard in the uptown area. This is not the dreaded "Tex-Mex" that litters the restaurant landscape of the South. This is authentic Mexico City cuisine, which is far, far better than the crap you get at places like On the Boarder or even a nicer place like Lupe's in Houston. (Lupe's isn't crap, that's for sure. But if you get something besides their signature fajitas, you aren't going to be all that impressed in my opinion.) Should you have $50 or so to spend per person, I highly recommend Javier's or Houston's.

After dinner, Julie Hirsh and her teaching friend Erin picked me up. We proceeded to Cape Buffalo, which is half pool hall and half live music/dance place. It's very similar to a Fox and Hound, but higher class and more expensive. The evening was very enjoyable. We were joined by Dave Dierkes a long time Aggie softball friend of mine and then eventually by Tony Rucker, Stephen Wu, and another of Julie's friends. The drinks were flowing, and we had a very nice waitress named Lisa who I will look for whenever I go back there. She was having a rough night, but I thought she did very well. Plus she was cool as shit which always makes the evening nicer when you have fun waitresses. The only event of note was the spilling of 12 ounces of beer on my lap. Dave reached across the table to shake hands with one of the arriving guests and shortly after I felt this very cold liquid on my crotch. Being the astute medical man that I am, I knew it couldn't be urine, as that liquid comes out hot. The only remaining option was the ice cold, brand new beer Dave had just received. So my wetness wasn't very appealing, and I borrowed Julie's car to go home and change. The rest of the night was good times and culminated with Kenny Rogers snapping Mark Mulder's 11-game win streak, which I really enjoyed. Can we say +1.45?

Saturday's Bar-B-Que

Saturday was very lazy. The roofing guys were at the house finishing off day 10 of new roof installation. Apparently they stapled some electrical wires, and the west wing of the house was having power problems all afternoon. I floated in the pool for a while then headed down to White Rock Lake for an evening with the A&M softball people. I do say, the evening was a success for the most part. Let me rephrase...it was an expensive success for some of the invited guests.

We started with some horseshoe throwing, beer drinking, and burger grilling. James Banze and Brendan Grych were the excellent hosts and food makers. I met these dudes through the Dallas A&M Club and softball ties about 4 years ago. The whole group is very cool and always a good time. Dave Dierkes was there with his new girlfriend Nicole, also Chinh Vu, a dude named Neil, and two very attractive girls called Julie and Selena. Julie was sort of confusing, because apparently she was often confused with a girl named Shelby, so I was told to call her "not Shelby". She hails from Atlanta, Georgia. I didn't get to talk with the other girl Selena as much, but she likes to participate in marathons and triathlons from what I gathered. She wasn't drinking as much, because she had to ride 60 miles on her bike today. There were other various people in attendance, but you've now met the principal players. So the partying continued until someone had the bright idea to play "quarters" which is a drinking game. Basically, one tries to bounce a quarter off the table into a shot glass filled with a booze beverage. If the quarter goes in, you designate one of the other players to consume said beverage. If you miss, you get another chance to make the quarter at your option. If you miss the second one, you are required to drink said beverage. Let's just say things got interesting after that. I will fast-forward 2 hours now in the interest of time, but in summary:

1. a bottle of Jose Cuervo was demolished (consumed)
2. a bottle of Jim Beam was demolished (consumed)
3. lots and lots of pictures were taken by Dave
4. my digital camera was demolished
5. several (and I mean several) beer beverages were demolished (consumed)
6. the speaking volume by all parties became increased
7. it seemed much more flirting was taking place among the guests

So now I'm taking a break from quarters, and I don't have a camera anymore cause Dave dropped it (although he did make a valiant effort to save the camera with his foot on the way down...except the lens was facing his save foot which bent the lens out of place thus jamming the mechanism). He of course offered to repair the damage which will cost him in the area of $150 according to the quote I have from kodak.com. Then a bunch more people arrived including my favorite lady friends from softball, Gretchen Feinhals and Connie Hartmann. They brought with them two girls who seemed very nice, but I can't for the life of me remember their names. I walked in on a political discussion in the kitchen, which forced me to promptly run outside. However, I think the mere thought of political discussion planted a seed for what was to come. Somehow I ended up sitting in a circle of chairs outside on the deck. And somehow I became engaged with Dave's girlfriend Nicole and another dude regarding the recent film Fahrenheit 9/11. You know my feelings on this movie, which I expressed to them. I basically said I liked it but thought it was the worst of Moore's three movies, because it wasn't nearly as entertaining and Moore didn't present any new, exciting information like he did in his other films. Then we discussed the movie further, which started a side discussion of the 2000 election in Florida. Ugh, what a huge cluster fuck that was. These two people with whom I was talking decided I was a right-wing republican (which is very far from the truth), so it was difficult to have a good conversation. However, the amusing part was that Nicole was very, very intoxicated. She had this problem of repeating one phrase literally 8 times to try and get her point across. I tried very hard to keep from laughing (which was difficult already because I had the giggles due to my disinhibition). So the political conversation continued at which point Nicole started raising her voice a bit, which was my queue to leave the discussion. So I went over and chatted with Gretch and her friend, who dogged me about being 26. Speaking of being 26...earlier in the evening I made some comment about how OLD 30 year olds were. Oops, not a good idea. I forgot everyone there was over thirty (because I normally hang out with people my age in Houston, and I forgot to make the transition in Dallas), and hellfire rained upon me after that. So the rest of the night it seemed people were dogging me for being such a youngin, when in reality they dearly wished they were a 26-year old sprite lad with the fun and mature personality that I have. Anyway, I think I promised Gretchen to take her on a date when I'm back in Dallas next week...which would really kick ass if I had the balls to do that. I will confirm this with her via the "Internet" tomorrow. So the evening winded down, and I drove home. Just as I finished brushing my teeth, Dave called. He wanted me to have some beer with him at his place, because he had just broken up with his girlfriend. Holy crap, I hope I don't have anything to do with that...but it is quite possible from the description of their conversation in the ride back from Banze and Bendan's place. I don't know how Dave feels about this, and I really don't know how I feel either. Nicole seemed like a very cool girl during the sober part of the evening, but then she started getting annoying during the drinking part of the evening. However, I attribute the annoying part of her to the EXCESSIVE amount of alcohol she consumed during quarters, and I actually give her credit for partying so hard. But from what Dave said last night about their conversation driving home, he apparently wasn't "husband material". YIKES! That's a low blow dude and probably a breakupable comment. I will get more information as to their status shortly.

>>View the PICTURES<<

The plane ride home was interesting. While I was in line to be screened, a random girl behind me asked if I was going to Houston. We started chatting, and it turns out she's pretty cool. Margarite (like margarita without the "uh" at the end) is 21 from Lake Jackson which is 45 minutes south of Houston. She has this really cool sarcastic personality, which of course was perfect for Ryan and me. It was kind of instant chemistry. So the three of us sat together on the plane and shot the shit. She sort of lives far away, so I don't know how much I'll be seeing her. However, she's a pool player and a fun girl, so we'll see what happens. It's always nice to meet cool people in the airport.

And that was my Step 2 weekend. Next weekend, we're going toobing in New Braunfels. Get ready for some fun blogging then...

It is now the eve before I take the final big test of my medical school career. Tomorrow is the United States Medical Licensing Exam's Step 2, which tests us over the clinical skills learned during the 3rd and 4th year. I finished my 3rd year on the internal medicine rotation which is a substantial portion of the exam, so it makes sense for me to take it early before I forget the nit picky details (you know, like what the heart does, and why we have lungs). So I'm winding today's review session down so that I can relax tonight. I'm so sick of studying for tests. Seriously, I've been studying for tests since I was 6 years old. I think it's time to do something else with my life.

In other news, the big 9/11 Commission's final report was released today. Basically, they said government screwed up (not blaming anyone in particular) and we URGENTLY need to have better security for the future. Thanks guys. How much money did it cost us to fund that report? The government screwed up and we URGENTLY need better protection before something else bad happens. It's almost as obvious as Fahrenheit 9/11, which a 1st grader had the knowledge to write and produce. The commission also URGENTLY wants to create a cabinet-level position that would oversee all the intelligence-gathering organizations. They also URGENTLY suggested that instead of the FBI and CIA directors reporting to 18 separate congressional committees, they be consolidated to three or so. On World News Tonight with Peter Jennings, the Capitol Hill reporter said that was not likely to happen, because many of the senators and congresspeople on these committees would be required to give up power, which rarely happens in Washington. Plus, it was also mentioned that many of the politicians are now busy with re-election campaigns for the rest of the year and don't have time to tend to such matters as national defense. Man, you gotta love politics.

In local news (directly before the national news), the only stories on CBS 11 here in Dallas were about a female missing jogger presumed kidnapped, a murder in Mansfield (suburb of Ft. Worth), a lawsuit concerning the woman in Houston who ran over her husband with her car, a veterinarian who killed a neighbor's dog, and a new home menopause test that tells you you're having hot flashes and insomnia. Why did I mention this? Watch Bowling for Columbine to find out. I hate the media so much it makes me want to puke. However, it makes sense. They are here to make money (Edward Murrow is rolling over in his grave), not report the news. In order to make money, the television stations need to talk about murder, rape, kidnapping, murder, politics, and death. Regular news about the city council or mass transportation just isn't interesting. People might actually change the channel if that were the only news. My God, people might even watch ESPN or the Outdoor Life Network to see stories about achievement and triumph. We don't want that now do we? Speaking of triumph, let's talk about Lance Armstrong.

Since I'm totally apathetic about everything (except medicine ironically), it may turn out that Lance has cheated during his amazing sting of 5 (now almost 6) straight Tours de France (did anyone ever look up the plural like I asked?). But he's always tested negative, and he says he doesn't cheat. So what I'm going to do is take him for his word and trust his integrity that he's being truthful. And if that's the case, he is one of the greatest athletes to walk this planet. He has now won the last three stages in a row of the 2004 Tour to increase his lead to over 3 minutes. The guy just isn't human. He symbolizes the greatness the human body can achieve not only physically but also mentally. Really, all the news stories should be about this guy...not some fucking horrible murder in Mansfield, Texas. So congrats Lance, you are an amazing human being, even if you were a drunken idiot throwing ice cubes at Ryan and Janelle at some bar in Austin a few years back.

I e-mailed California state representative Sheila Kuehl today.  I read a story >>click HERE<< which said many of the California democrats were "outraged" when Arnold Schwarzenegger called them "girlie men" for not reviewing the state budget or something like that.  Ms. Kuehl said Schwarzenegger resorted to "blatant homophobia" by using the term to insult the budget stallers.  Incidentially, Ms. Kuehl is a member of the California State Lesbian, Gay, Bisexual and Transgender Caucus.  So I e-mailed her very politely and told her she's basically full of shit and to get back to the business of running California instead of trying to associate the term "girlie men" with gay bashing.  Come on Sheila, you're off your rocker if you think calling the puny little democrats with their girlie arms and girlie brains is homophobic.  I agree we should foster tolerance and acceptance in our society for all people however gay they may be.  But I've had enough of this going overboard on being PC.  Wake up and smell the coffee Ms. Kuehl...It's a fool's paradise.  He's just leeeeeeading you down the primrose path. 
 
Here is her website >>click HERE<< should you be interested in reading about her. Ahhhhh, it's so refreshing to be a part of the political process.

There was some golfing drama at today's final round of the British Open.  Phil gave it a valiant effort but came up short by a stroke.  He'll end up in third place, because the top two finishers in regulation had to go to a four hole playoff.  Ernie Els and Todd Hamilton (living in McKinney, Texas just north of Dallas) finished at -10 for the tournament.  Todd Hamilton, the 17-year professional, is spending his first full year on the PGA.  Previously he played in other countries including Japan.  The two were deadlocked through the first two playoff holes, but Hamilton birdied the 3rd and pared the 4th to win the British Open by one stroke.  This is yet another Cinderella story in one of golf's major championships.  Ben Curtis, the rookie, won last year, Phil finally won his major this year, and now the unknown Todd Hamilton has won the 2004 British Open.  Mike Tirico made an interesting comment during the broadcast, of the 6,000,000 pounds wagered on the tournament, not one pound was wagered on Todd Hamilton.  And he is your winner.
 
In other sports news, the Rangers pulled out an unlikely victory over the Blue Jays (to sweep the 3-game series) by scoring 6 runs in the bottom of the 8th inning to pull out the 7-5 win.  It's good when the Rangers win.
 
Studying is killing me.  I think I'm delirious.  However, I took a break and watched the first half of the Martin Scorsese film Casino.  It looks like a pretty cool movie.  I wasn't gasping in my chair for breath due to its greatness, but it looked like a nice picture. 

The new template is up, which I think looks more like a diary of sorts.  I think it's funny that I want to use advanced technology to record a blog that looks like I'm using pen and paper.  Whatever.  A new feature is the "comment" section after every post.  If you'd like to make a comment about something I write (maybe I posted something incorrectly or maybe you just feel like commenting), then just click on the comment section and the computer will tell you what to do.  Phun!  
 
I've been studing for my boards all day.  Now I'm exhausted.  I made some dinner, and now I'll probably go to bed.  I think it's pretty lame that I'm going to bed this early on a Saturday.  However, Nick and Ryan are both out of town, and on top of that I'm sort of tired.  That's a formula for success if you ask me.  
 
Lance Armstrong won today's mountain stage and is now only 22 seconds behind the leader, a Frenchman.  Armstrong was over 9 minutes behind at the close of business on Thursday, but the race is usually won in the mountains, and Lance made up most of the deficit yesterday and today.  He won his 17th stage in 10 tours and is now one step closer to becomming the first person in history to win 6 Tours in a row.  What is the plural of Tour de France?  Is it Tours de France or Tour de Frances or maybe Tours des Frances?  If you speak or write French and know the answer, feel free to not waste your time by giving me the answer.  (You can try the new "comment" feature.  How convenient!)

Ryan and I just returned from the Astros game.  It was very nice of Stephanie to give us the tickets.  But let me just say that the Astros suck.  Allow me to repeat myself.  THE ASTROS SUCK!  I'm so not impressed with their lack of enthusiasm and teamwork.  I'm disgusted with them.  On the other hand, the Texas Rangers won 11-2 tonight over the Blue Jays.  This is yet another reason why Dallas is better than Houston.   I also need to shout out to Pedro Martinez and the Boston Red Sox for winning their game over the Angels.  It was Pedro's 5th straight descision, and the win helps out the Rangers in the standings.  
 
Today at work was interesting.  Grand Rounds was 0700 followed by regular rounding and shooting the shit with Drs. Estrera and Safi.  I really can't express how much I respect and admire these two guys.  They really are two of the best surgeons I've ever met, and I couldn't be more happy to be rotating with them this month.  Also, I must admit I have an "academic crush" on Dr. Tam Huynh, the vascular surgery attending at UT, for quite a while now.  What is an "academic crush"?  I don't know, I think I just made it up.  But I digress....  Dr. Huynh is the smartest and one of the nicest women alive.  Seriously.  If I ever need to learn something, I'll scrub in with her and I'm golden.  Awesome lady.  She just finished her maternity leave after having her baby without complications.  Anyway, the big case today was the repair of a descending aortic pseudoaneurysm.  It turns out that I actually found the aneurysm on the patient's CT scan, which I will include shortly.  I will also describe what this type of injury is and why it can be deadly.  In the meantime, use your imagination.

Shortly the blog will be transformed into a new format.  I've found a better template, and I will be making the switch in the near future.  Keep your eye out for it.

I keep meaning to write something on this here blogger thing, but my duties of self-preservation preclude such things. The last time I was going to write was on Tuesday while watching the Rocket get his ass kicked by the American League. The game was held here in Houston at the lovely Minute Maid Park, which I tend to frequent when I have the time. The American League ended up beating the National League by a nice margin, which means the American League Champion gets home field advantage in the world series. The Texas Rangers sent 5 representatives to the game, which was the most they've ever had. It's good to see the Rangers playing so well sans A-Rod who is a whiny baby. I think it's funny that whenever he leaves a team, that team inevitably does very well. Reference the Mariners who won the division several times after he came to the Rangers. And now it appears that the Rangers are following in the Mariners' footsteps. Don't get me wrong, A-Rod is one of the best shortstops to play the game, but he's still a whiny baby and proof that one man cannot carry a team (unless it's Michael Jordan).

I visited with Nathan Beach yesterday regarding my website statistics. He sent me a document which shows every individual person who has viewed one of my websites. It was way too big and technical for me to digest, but I did learn that 152 unique users have visited tommyroshek.com since its inception. I don't know if this is good or bad, but it's something. I'm kind of embarrassed actually, because all I have is this blog. I promise other things will follow such as my photography gallery and my stick figure book for children, conceived by Ryan Ricks (one of my roommates). Until then, I guess you'll just have to be satisfied with this silly thing which is unfortunate for you.

In other news, my grades from internal medicine are back and turned out to be very good. I am pleased to end the 3rd year on a good note academically. Grades really don't matter in the 4th year which makes me very happy. However, I'm currently a bit stressed, because I'm studying for the United States Medical Licensing Exam Step 2, which I take a week from tomorrow in Dallas. I need to do well so that residency program directors will like me. I am also busy with cardiothoracic research (as mentioned previously) and preparations for residency applications which include writing a resume and the dreaded personal statement. I somehow must brag about myself without actually bragging about myself. Nathan has a similar problem in writing his artist's statement for his future gallery at Master Baquero's place. Remember that you can always view Nathan's paintings (available for purchase) at www.nathanbeach.com. My other painter friend, Kristen Ohlenforst has started painting things without looking at the canvas. Weird? Yes, but I've seen advance copies of the work which looks very impressive. Her website is www.ohlenforst.net for your edification. She is having a showing of her paintings at a place called Kathleen's on Lovers and the Tollway in Dallas. Be sure to show up and purchase some of her work.

Finally, I have two images I need to post on this here website. My "friend" Priscilla Saldivar has been giving me shit about this blog, because apparently she thinks it's kinda "gay" as she puts it. However, I also have noticed that she's visited several times, which means she must like things that are "gay". Funny how that works is it not? I happened to have stumbled across a billboard in the Montrose area (the gay part of Houston) while driving to Niko Niko's to get some Greek food. I'm sure many of you in the Houston area are well aware of this monstrosity (the billboard). So in honor of my "friend" who has a child and seems to like gay things, I present the following image obtained from the gayest part of Houston. Notice the Mexican restaurant is right beneath the billboard, which is think is priceless. (By the way, I think this is highly amusing, and I'm sure most of my friends will too...but it just kills me to pull pranks like this especially with the knowledge that my parents and other adults read this thing.)

Also, I think it's necessary to divulge a trade secret of Nathan's. I am going to post a conversation the two of us had using Microsoft's Windows Messenger on Monday. We were discussing one of his upcoming paintings for the Baquero Gallery tentatively called "Moth and Moon" (which is really cool). I think I've made it my mission to create as much controversy as possible for Nathan's art career before he actually becomes famous. My goal is to create strategic confusion so when the scholars look back on his career of greatness, there will be doubts and speculation (as there are with all famous painters). Thank God for the Internet, or none of the scholars would know THE TRUTH ABOUT NATHAN BEACH. (I think this could be the making of a television documentary.)

Gosh, it appears I need to talk about the whole weekend. Fortunately it has been relatively quiet, so it shouldn't be a big deal. School was quiet on Friday, except for two things: 1) Dr. Safi gave me two books to read at me leisure. The first one is called Wealth and Democracy by Kevin Phillips which looks at the concentration of wealth in the richest families in America since independence. I always get skeptical about this sort of thing, but The Economist gave it a good review, so I'll give it a read. Dr. Safi also gave me a book called Nickel and Dimed which looks at how a woman works her way up from nothing to become a writer for The New York Times. It also looks very interesting. Both of these books are best sellers and both appear to be very interesting reads. Unfortunately I can't spend too much time on them right now, with the whole Step 2 thing coming up. Dr. Safi is such a cool guy. Not only is he one of the top aortic aneurysm repair guys in the world, he's also a virtual encyclopedia of the social world. Granted he might be a little liberal for my tastes, but I'm actually beginning to question that. He's just so well informed, which is the most important thing one can be in this world. In addition, he always takes such good care of the students on his service, especially the ones that show interest. This sort of thing is sort of rare...it's like the CEO of the company taking time out to drink coffee and chat with the guy in the mail room. Pretty cool 2) The research stuff is coming along nicely. I had a mini-assignment which I completed Friday. So this week we can begin to collect data in earnest, which really should only take a week or so if we get moving.

Friday night Ryan and I went to Baker's Street Pub for a drinky then to Azteca for a bite to eat. Earlier that day, the name Roscoe came up (I forget why...maybe it was an athlete or something on the news), and Ryan decided that he would name his first child Roscoe Ricks. I thought that was the coolest name ever, so henceforth we shall all refer to Ryan as Roscoe. There we met up with a bunch of other medical school people including Priscilla, Lily, and Mike along with my friends Chris, Katie Taylor (from high school), Jenn, and Jenn's friend Ruth. A good time was had by all. Priscilla, Chris, Ryan and I ended up back at Club 1948 for some more drinking and partying, before we fell asleep watching Super Troopers.

Saturday was rather unremarkable. I basically studied all day until 9 when Seema picked me up to go see Fahrenheit 9/11. Of Michael Moore's three movies, this was by far the worst of the three. It was very little documentary and very much two hours of soap box. I really like Michael Moore for his filmmaking ability, but I don't really care for his political agenda. Actually I don't care about anyone's political agenda, especially politicians and entertainers, because they're all god damn liars and cheats. However, Moore is probably a Marxist, which is a little lefty if you know what I mean (and by "a little lefty" I, of course, mean A LOT LEFTY). So I was disappointed with the actual film, which didn't really present information I didn't already know and was far less entertaining than Moore's first two films. Then Seema and I went to a Cafe called Brazil on Westheimer and had French Roast coffee and German Chocolate cake which was quite good. We sat and talked for about two hours until 1 AM when it was time for me to fall asleep.

Finally, I need to clarify an earlier entry in my blog describing the trip to Kansas. There I discuss the "pickle" plants that dot the landscape. My Aunt Mary happened to read the blog and gave me the scoop on this particular plant, which is actually called the Yucca Plant. Here is what she wrote:

"BY THE WAY, THOSE "PICKLES" ARE YUCCA PLANTS. THEY JUST FINISHED BLOOMING, BIG WHITE BLOOMS AND THOSE ARE THE SEED PODS. MAYBE YOU ALREADY KNEW, BUT THOUGHT I WOULD LET YOU KNOW IN CASE NOT! THEY OFTEN RIM THE SAND TRAP AND MANY A BALL HAS LANDED IN THE MIDDLE OF THEIR VERY PRICKLY CENTERS - IMPOSSIBLE."

Some bad news today, my next door neighbor growing up and throughout high school and college died a few days ago. Cause of death was not disclosed, but it has been speculated to be suicide. Unfortunately, now both of my next door neighbors and childhood friends have ended their lives in this manner. Ugh, was a shit deal.

I'm pretty sure James was the first person I met when I moved to Dallas in May of 1984. The Burke family was pretty big and had moved from New York a few years prior to our arrival. We sort of hung out together; I could be found playing video games at his house or wandering around the neighborhood doing nothing. The two things I remember most about James was his love for comics and professional boxing. When we were little, he would annually dress up at Halloween as superman, complete with tights, cape, and trademark curl of hair on the forehead. As I recall, he may have even dressed up a few other times besides Halloween. In addition to Superman, he was a big fan of comics, most notably comics of the Marvel® variety. I think he taught me about the "rivalry" between D.C comics (who made Batman) and Marvel comics (who made Superman). For all you dorks out there, if I butchered that, I don't care to know about it. Bitch to someone else at your next Star Trek convention. Anyway, James' other fascination was professional boxing. I think he learned that from his brother Paul, but nonetheless he knew every boxer, what class they were in, and what their records were. This was very impressive for an 8 year old. Over the years we sort of grew apart for two reasons 1) He was always kinda unstable growing up. Some of the time, I felt sort of uncomfortable around him. I never figured out if it was ADD or maybe even bipolar disorder, which may have developed in the later years. 2) We were separated by geography once we approached the junior high and high school years. I continued along my path in public school, while James was enrolled at a private school called Winston for kids who had symptoms/disorders I just described. So I really didn't see much of him the latter part of my life but would occasionally say hello and catch up if I saw him in the yard or somesuch. This sort of thing really gets to me. I enviably feel guilty that I don't have some of the problems other people have. Don't get me wrong, I have my fair share of problems, and maybe I just cope with some of these issues better than other people. Either way, I just wish there were ways we could deal with mental conditions better than current medical therapy allows. I've seen a lot of this stuff first hand in medical school, and these conditions are very real and very problematic. The other unfortunate thing is how wonderful James' mother is. She is probably one of the first people my mother met when we moved to Dallas. She used to be rather involved at our church and just a wonderful all-around lady. I hope my mom will get to have lunch with her soon to see how things are going. It's a shame when such good people have such misfortune. Rest in peace James.

Speaking of my church, at James' funeral my mom found out that our music director (and a million other "directorships" he currently holds) quit smoking 2 years ago. This sort of shocked me and reminded me how long I've been away and how disconnected I am from Dallas. I've known Don since my sophomore year of high school. I don't really remember how I got involved with the music ministry at my church, but I think I decided that I would approach him to see if he needed another trumpet player. I remember starting as the low guy on the totem pole, playing the Sunday evening mass with a flute player and usually another trumpet player which would switch every month it seemed. I think after a year or so (my sight-reading was dreadful at the time, which really limited how much I could do at church, because most of the music performed is handed to you 30 minutes before you actually perform it) I was promoted to the 11:00 mass where the choir sang and the full brass ensemble would perform. Ever since then, I try to get back with the group to perform as I love the music and people. Plus it actually gives me an excuse to go to church which can't help my afterlife chances. Anyway, Don has been an influential figure in my life, especially in high school. At that time in a person's life, there is so much bullshit to sort through, and it was almost comforting to have Don around as he often would help me sort through a lot of those issues. I'm sure I could write a movie about it or something. Anyway, it was good to hear that he quit, and hopefully I can hear more about it this Christmas when I'm back in the band for the holidays.

Also, the cat broke my picture frame with Bentley in it; I may have to sell him to the Chinese restaurant. Damn cats.

Dad is smoke-free 6 weeks now. It's kinda like the Energizer Bunny...just keeps going. Sort of goes to show that once you get over the withdrawal period, anything is possible.

My cardiothoracic and vascular surgery rotation started yesterday. I'm thrilled to be back in surgery. Yesterday I scrubbed in on an aorto bifemoral graft procedure. Someday I might explain what that means. Today I had a meeting with Dr. Villa and the anesthesiologist to discuss how to approach the thoracic aortic aneurysm repair study we will be designing. The aorta is the huge artery that leaves the left ventricle of the heart and goes on to supply blood to the rest of the body. Basically, when someone's aorta gets dilated, it can cause problems. When the aorta dilates to over 5 cm (called an aneurysm), there is increased risk that the aorta will rupture and the person can bleed to death. Dr. Safi's group at UT-Houston is one of the world leaders performing the operation to correct this condition, and it seems I will be helping them on their next big aneurysm repair study. Anyway, the biggest complication of this surgery is paralysis that can occur during the procedure, develop shortly after, or a few days post-op. No one is completely sure why these patients develop paraplegia, but there are several theories. Dr. Safi's group has made several innovations to try and reduce this morbidity including draining cerebral spinal fluid (CSF) to lower the pressure. CSF is fluid that bathes the spinal cord providing nutrition and a mechanical cushion from vibration and outside forces. It is postulated that high CSF pressure during the operation might block the blood flow to the spinal cord causing ischemia (or lack of nutrition and oxygen) which causes damage. There are several other possibilities which we will attempt to study. I'm really excited about this project. Hopefully I'll learn a lot and actually contribute something to the group.

Other than that, I hear Nick speaking forcefully to Seema on the phone. I'm glad I'm not involved. Nick is heading to Austin tomorrow for Lonnie Mark's wedding (a classmate of ours) and then on to Pittsburgh, PA to do a rotation in transplant surgery. The chairman of the center where he is rotating invented several of the techniques in transplant, so he's a bit excited about going. Also, I beat Ryan in X-Box soccer today in overtime, scoring on a pretty sweet free kick just outside the penalty box. Hurray for video games.

At this point, it's my duty to discuss this weekend's festivities. But before all that happens, I am sitting here watching Kevin Smith's great Jay and Silent Bob Strike Back on Comedy Central. There was just a commercial for a talk show on TV Land starring Alf. Yeah, a fictional character is having his own talk show on TV Land. I suppose it will be similar to Martin Short as Jiminy Glick (Primetime Glick), so maybe I just might try and see it. Or better yet, I won't.

So, Nikolas and Lacy were married this weekend. I shall attempt to describe how things went day-by-day.

The Continental Flight/Wedding Rehearsal/Rehearsal Dinner

Nick and I drove to Meaghan's house up in the Heights to pick her up. We proceeded to Houston's Bush Intercontinental Airport and hopped on the flight to Washington DC's Reagan National Airport. Remarkably we arrived 25 minutes ahead of schedule, which was perfect timing. We left the airport and hopped on the Metro (DC's subway system) which took us directly to the Hilton Hotel in Alexandria, Virginia (south of DC). We quickly put our stuff in the rooms and headed to the lobby where everyone was waiting. We traveled en masse to one of Robert E. Lee's old houses to have the wedding rehearsal. The little house was very beautiful and the wedding was scheduled to take place in the back yard. We were instructed as to how the wedding would take place, where people should stand, who walks where, how fast you breathe, the extension of pi to 600 digits, and how many licks it takes to get to the center of a tootsie roll pop. After the rehearsal, we went to the rehearsal dinner at a wonderful Tappas restaurant. I have forgotten the name of the place, but if you don't know what tappas means then go look it up. Just kidding. It basically means that all of the meal is brought out in appetizer sizes, and everyone gets to sample a bit of everything. On top of that, they brought out pitchers of sangria. Yeah, we drank pitchers of sangria. It's probably not appropriate to discuss how many glasses I put down, but I suppose it wouldn't be a stretch to say I may have needed more than one pitcher. The dinner was absolutely wonderful as well as the atmosphere. I sat at a table with Jeff, Adam, and made two new friends Caroline and John. Caroline is currently getting her masters in public health in the same program as Lacy. John is the cool boyfriend who used to wrestle and now works with wireless telephone technologies. I must say our table was very social and very enjoyable. Nick and Lacy gave the wedding party presents which consisted of martini utensils and a lovely ice bowl from Crate and Barrel. I have placed these items with my current martini materials and now have a complete set. I can't wait to have a wet bar at my condo for residency. It probably will be a very nice little place. So the first leg of the weekend was a complete success. Would it be hard to get any better? Oh yes it would.

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Adam's Morgan Night of Drinking

After we finished the dinner, we all went back to the hotel to prepare for that evening's festivities. The best man, Sean Glass, apparently treated Nick to a bachelor party the weekend before, but no one else was there so we decided to attempt and have our own mini bachelor party. The whole Texas Group accompanied Nick to an area of Washington DC called Adam's Morgan, which is like an Addison (near Dallas) or maybe something like the Galleria area of Houston. The centerpiece is the street we were on similar to 6th street in Austin. The first place we attended was called Madam's Organ (notice the pun on Adam's Morgan). We went directly upstairs and proceeded to sweat our fat asses off. Literally. It was an absolute sauna up there. So we got our drinks and went downstairs to continue the drinking. Downstairs was much better so we stayed for a bit and enjoyed some good conversation and discussion. I probably should introduce you to "The Texas Group" and how everyone knows everyone. We consisted of former Aggies and former Longhorns. Meaghan (lawyer) and I (doctor) now live in Houston; Jeff (park ranger) in New Mexico; Adam (chef/waiter), Margaret (engineer), and Chris in Dallas, and Nick (groom) in Virginia. I obviously know Adam, Jeff, and Nick from Texas A&M. I met Lacy through a friend in Fish Club, who introduced me to Meaghan and Margaret at the University of Texas my sophomore year. Lacy, Meaghan, and Margaret are from Huntsville. After meeting them I introduced Lacy to Nikolas (my roommate at the time), several years passed, and now we can continue with this wedding recap. After Madam's Organ, we went to a place called Heaven and Hell. The upstairs part (Heaven) was decorated with black lights and neon, and the music was sort of yuppie techno dance stuff. The downstairs part (Hell) was decorated with red lights, and the music was bump and grind rap. Ironically, not only was the decor and music separated but also the races. It seemed a lot of the White folks were upstairs dancing in Heaven and a lot of the Black folks were downstairs movin' in Hell. Of course this was totally due to the music being played in each venue, but it was interesting observation none the less. Oh, also of note was the middle floor, a bar called Purgatory. So we went to all three places, drank some more, and then it was 0300 and last call. We left the bar and navigated the immense crowds of people along the street. We stopped at a fine eatery called "The Diner" where the line went out the door into the street. We waited 30 minutes to get in, but the food was good, and again good conversation was had by all. After dinner, it was time for a cab ride back to Alexandria, because the subway stopped running at 0300. Ironically Crazy Chris suggested that the seven of us pile into one cab, which we then did. Funny thing about the cab ride is that in Washington DC, the drivers don't have meters...they have zones. Of course we were all drunk and didn't have a clue, so halfway home we asked how much the ride would run us. The driver said about $90. To this we gulped and went back to our previous mindless conversation. About 3/4 of the way home we told the driver not to expect his $90, so he suggested $40 which we accepted. I think we ended up giving him $55, which was very reasonable for 7 people driving illegally in one cab. After that we pretty much stayed up until 0630 or so. I do recall the sun was already up when I finally fell asleep. There are all sort of other indiscretions to discuss, but I can only tell you about it if you e-mail me. Later that day would be a trip into town, the wedding, and the reception.

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Enjoying Our Nation's Capitol

With grand expectations of going into town and seeing every sight possible, the day started around 11:30 AM. Thankfully I was not hung over in any way, so getting up was only difficult due to sleep deprivation. We got things rolling by noon by eating at Joe Theisman's restaurant directly across the street from the hotel. I had a Swiss mushroom burger and tea, recommended by the waiter. Adam had a chicken salad and tea. We finished quickly and headed back to the hotel to meet Nick to go pick up my tux from Men's Warehouse. We drove to the store, and I tried the tux on only to discover that the vest was too small. So, yet another wedding was screwed up by a wardrobe malfunction (at Cory's wedding, my tux had four buttons and everyone else's had two...but at least I got the rental free). So I mentally prepared myself to suck it in for a few hours, put the tux into the car, and headed to the Capitol. Nick dropped Margaret, Meaghan, and I off at the Washington Monument, which is absolutely breathtaking. It's such a great symbol of power, reaching up to touch the heavens. It reminds me of the Williams Building in the Galleria area of Houston. Maybe I could find a picture of it. Apparently, people still can't go into the tower since 9/11, so we just sort of looked at the thing and took pictures. Anyway, the area surrounding the monument is under construction, so we walked all the way around it to arrive at the World War II Memorial, just recently completed. The WWII Memorial is beautiful. It has two big fountains inside a big pool. Each state has an arch which surrounds the pool. The Washington Monument is in the background, making for a wonderful display. I was very impressed. I took pictures of Iowa and Minnesota, but people were surrounding Texas, so I missed that one. Then we walked near a nice little park/pond area on the way to the Vietnam Memorial, which was under construction. It is a very somber place, but beautiful. The geometrically right triangular wall just stands there in tribute as it gets taller and taller, with the thousands of names inscribed. It is very sad and makes one wonder if our presence in Vietnam truly helped stop the spread of communism throughout the world. Even if it didn't, I continuously respect and admire all who have died in wars defending the American way of life. The experience really moved me. Then we headed over to the Lincoln Memorial, with the big statue and the huge pool with the Washington Monument in the background. The Lincoln Statue reminds me of an episode of The Simpson’s where Lisa wins an essay contest about America but is tarnished by the corrupt congressman she overhears accepting bribes from lobbyists. But everything turns out ok in the cartoon; however, I wonder if that's accurate in real life. So then after you look at President Lincoln, you turn around and there is the big pool where Dr. King made his big speech and also where Forrest Gump makes his speech. It's quite breathtaking actually. I took a picture of it which is among my very favorite photos. So we finished all that, hopped in a cab, and went back to the hotel to prepare for the wedding.

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The Wedding

The groomsmen arrived at the wedding site around 4:20 to set the thing up. We did all the chairs (pictures included), tables, and set out bottles of water in tubs of ice for the guests. Then we headed up to Robert E. Lee's house to change and cool off. I wasn't quite soaked before the wedding, which was nice. But about 15 minutes into it, I was certainly feeling some intense moisture. The ceremony was very nice. The yard was pretty, the guests seemed very happy and interested, and I pretty much made jokes with Jeff the entire ceremony. However, let's preface that by saying I didn't miss any of the speaking, vows, important stuff, et cetera...but I did have my usual fun time making silly comments and the occasional stupid face at Adam in the second row. Plus it seemed as if World War III was happening on the street next to the wedding: two fire trucks screamed by, some Harleys roared by, and there was a lot of general commotion on the street. That in addition to the preacher's soft voice made it difficult to hear the ceremony. But it was very nice, with a lovely string duo, and a singer who is Lacy's work-out partner. The vows were spectacular, and Jeff even said he got teary-eyed when Lacy gave hers to Nick, which she had completely memorized. So, it was an A+ wedding through and through. After that we took some more pictures and went back to the hotel ready for some serious drinking and dancing.

The Reception

The Reception was held at the Hilton's huge conference room. Before that, the wedding party and family had a brief cocktail and hors d'oeuvres in a private room. There were crab cakes (no not lump crab), champagne, beer, and wine for all. After we did that, the reception began. The wedding party got a nice introduction, and then Sean (the best man) kicked things off with a nice story about Nick that even made everyone laugh. Jeff and I didn't speak about Nick, which I sort of regret now. But I think Sean did a sufficient job, and really all I would have done is make fun of Nick, and then add the whole "but he's a wonderful person and the best roommate I could have ever during my four years of college" sappy bullshit. Actually, none of it would have been bullshit, as I really consider Nick a great friend of mine. We spent our entire college careers together, the good, the bad, and everything in between. Yette mentioned how similar her family was with mine, which is entirely true. Nick and I are the same age, Carolyn and Kristine are the same age, and both our sets of parents are happily married with wonderful families. What a blessing to end up with Nick, totally by chance, by the way. I also have very strong feelings for Lacy, who was one of the first people I met my sophomore year. She always impressed me with her intelligence, charm, and beauty, and it turns out that her roommate (who was my little sis in Aggie Fish Club) really only remained my friend about a year while Lacy continues to be my buddy today. So let's end this mush-session by saying that I really love these two people, and I can't be happier that they are married and will spend many, many wonderful and successful years together. (There, that would have been my wedding speech. Maybe I should e-mail this to the wedding guests to make up for it.) So the reception went according to plan, with LOTS of drinking and even some dancing on my part. Actually, I hardly danced at Cory's wedding, while at Nick's I went ape-shit out there. I was absolutely drenched by the end of the night, which means I got my money's worth. Of note, I remember Adam singing "Sweet Caroline" with Neil Diamond; Lacy's singer friend was the best dancer on the floor; the food was good; the beer was free (for me); I danced with Yette but not Hans, Nick, Adam, or Jeff (thank God); the music was very generational and appropriate for a wedding; and a great time was had by all. Hurray!

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After the Reception

So after the reception, everyone basically headed back to our room (apparently the official meeting room of the group) to decide what was next. I was invited to and Irish bar called Murphy’s with some of the local DC guests, but no one was interested in joining me. So Crazy Chris and I took a cab to the bar and drank for the 35 minutes until it closed. I remember drinking Black and Tan's and singing "One" by U2 with the live one-man band. Afterwards, Crazy Chris, myself, and a guy named Ross? drove into Georgetown, which is a yuppie part of DC to have a bite to eat. I haven't told you about Chris. Basically this guy is a high school friend of Nick's who came up to PARTY. Every wedding has a guy like this; he was totally out of control. But I must say he did have a great time and made the trip more lively. Plus, we were the only two to go out after the reception, so I have to respect that. Sober he was pretty cool, but drunk he was just kind of overboard...which I actually think every wedding requires. So cheers to Chris. The drive up was great, because we passed by the Iwo Jima memorial (you know the statue of soldiers putting up the American flag...which was inadvertently reproduced by the 9/11 New York City firemen). There was this great punk rock song CD we listened to which I can't recall now. I remember it was cranked up pretty loud, and we were jamming for sure. I'll e-mail the guy and find out what it was...stay tuned. We went to a nice 24-hour diner and sat next to 4 recent Georgetown Law grads getting ready for the Bar, and one Capitol Hill staffer. I just sat there and thought, there are the people that basically write our country's laws. They sort of reminded me of Janelle, who does that very thing for the State of Texas. We had some very good business and philosophy conversation, and finished with a cup of coffee. After that, we went back to the hotel and went to sleep. It was a perfect end to a perfect weekend.

Sunday, July 4th

We all got up early, because Jeff had a 10:00 AM flight. We sent him off, then got packed up to leave. Adam's flight was at 12:50, so we got brunch at the hotel (which wasn't all that bad for the price), and proceeded to say our good bye's. Everything was wrapped up nicely, and it was sort of sad to see everyone go their separate ways. The wedding was a complete success--one of the best I've ever been to. Meaghan and I hopped on the Metro and flew home, which arrived only 5 minutes late. Ryan was there to pick us up, and that ended the weekend. I went home and grilled a few burgers and sausage with Ryan, had a few beerskies, and drove to school to watch fireworks from the top of the Hermann Professional Building garage. Ryan and I were joined by Melissa, Nick, and Katie (Melissa's sister) and then also by a bunch of medical school friends including Erik Graham and Priscilla Saldivar with her daughter Natalie. From there you can see about 6 or 7 shows throughout the Houston area, but the best was at Memorial Park which was rather far away. The Hermann Park show was less than impressive and afterwards we all went home and called it a night.

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