I've never posted something at 4:30 AM before. Now that's top quality!

This is a cholangiogram. I forget if I've posted one of these on the blog in the past. A cholangiogram is an x-ray of the duct system that connects the liver, gallbladder, pancreas, and duodenum (first part of the small intestine). I will try to get some arrows and labels on the picture to show you the anatomical structures (this here is supposed to be an educational website darnit).


This is a picture of a large stool ball removed from a patient's abdomen. What's a stool ball? Well, it's a piece of pooh. Yep, that thing was sitting outside of the colon and was hanging out inside a patient's abdomen. I'll tell you why that's not so good at a later time. (I have concealed the identities of the surgeons and of the stool ball to comply with HIPAA.)

Howdy, what is this, posting number 10 since December 2005? Sweet, I'm really on the ball now. Let's chat being it's a beautiful, crisp New England Saturday in October, and I'm stuck in the hospital on-call. Please check out the entry from July which describes Nick and Melissa's wedding (recently posted finally).

There are certain things in the hospital which over time become quite repetitive. As you know, I basically live here, so routines become commonplace (and comfortable). We round (examine and discuss patients) every MWF at 6 AM and TTh at 5:30 AM. Conference is on Tuesday from 7-9 and Conferences on Thursday from 7-10. Before all of this starts, vitals must be prepared, and we obtain "signout" from the previous night's call team (they tell us what happened with the patients, if any new patients came in, and results of tests and labs). Operating starts at 7:30 AM. Afternoon rounds usually begin around 3 PM when we gather the information which occurred throughout the day and follow-up on lab tests, consultant recommendations, et cetera. If all goes well (which is a crapshoot), we are out of the hospital by 5:30 PM. So throughout the day there are routines within routines. Rounding, Operating, Reading and Studying, Lunch, Bullshitting, and so on are all relatively consistent within the overall sphere of chaos (as most things are when you deal with lots of human beings who are typically very sick). There are two little things (among many, many little things) I wanted to share with you about my day. The first is quite enjoyable for me. Whenever I'm on the 6th floor walking across a certain skybridge between buildings, I always look out the window at the beautiful rolling hills of Springfield. Because I'm on the 6th floor, and the hospital is on a hill, the view is quite spectacular. So I always stop and gaze northwest at the beautiful horizon with its lush scenery, rolling hills, and sometimes brilliant sky (when it's not overcast and gloomy). This view is representative of the 4 seasons in New England as there are many trees to see, which currently are beginning their metamorphosis of colors. In about two weeks, it will be truly spectacular and something I really enjoy about looking northwest out the window from the 6th floor. I plan on taking pictures from the same spot during each season to illustrate one of the daily occurrences of my life here in the hospital. The other little thing I don't like so much. SHOCKS! The air is getting dry and cold, and with that I noticed in the past two days, that the shocks are coming back. I don't know if it has to do with my scrub pants rubbing together or just my electric personality (yes I really actually just said that), but when it gets gold and dry outside, I get shocked on EVERYTHING! I get shocked on my car door, on every door handle in the hospital, on other patients...EVERYTHING! It goes away during the more humid spring and summer, but the fall and winter are shocktacular. (I'm even extra careful to shock myself before pumping gas, as I'm afraid of causing an explosion.) So there you go...winter is coming, because I'm getting shocked more often.

Fall in New England is quite beautiful. Please refer to last year's entry around this time for pictures. I'll try and take more this year. There is much to do as far as free-time goes (if I get any), which will include apple-picking and going to some mountain which overlooks a cute little town which is supposed to be quite pretty. The golf has been fantastic. That's another awesome thing about New England. The courses are incredibly nice, very cheap, and quite fun! This is the most fun I've had with golf, probably ever. I can't believe I've had time(usually post-call) to go play. Plus, I've totally upgraded my bag (for the first time in my life) with new irons, wedges, putter, driver, rescue club, and fairway wood. So basically I have an entirely new set of clubs thanks to David S. and eBay. I need to get out there a few more times before the season ends in a few weeks and the snow arrives (noooooooo). I also need to cover my pool for the winter and pick up leaves. The leaves won't be a big deal, as I have this really cool Black and Decker blower/sucker which I can hook up directly to the trash can! So either Kayla or I can suck up the leaves while the other pushes the trash can. That's going to be a snap. Covering the pool is a different matter, as the tarp is huge but we'll manage.

My bathroom and kitchen are slated to be repaired as soon as the tub gets here, which will be 3 weeks or so. It's going to be really incredibly nice once it's all done. However, this is going to cost a lot of money. I may require a loan of some sort, so we'll see how that goes. The bathroom will be totally redone with nice tile, some sort of new wall and paint, along with a leak-free tub. The ceiling in the kitchen will also be repaired which will be nice as well. It will be nice when completed...along with the new faux wood blinds I need to install, the new paint job on the garage floor which needs to be prepared, and a few other things. It never ends.

My 10 year high school anniversary was a few days ago from what I hear. How weird is that? How weird is it that I haven't lived in Dallas (except for the one year in between college and med school) since 1996? That's ten years ago. And, I won't be back until possibly 2010 or 2011! That's a long time. In 1996, ER was still a show, which is about the only thing still going today. In 1996, the show "Southpark" wasn't even a show yet. In 1996, gas cost $1.31 a gallon. (Remarkably, gas is only $2.13 right now in Springfield which is the lowest it's been for quite a while...it was $2.90 a month ago). Anyway, 1996 is a long time ago.

Studio 60 on the Sunset Strip is Aaron Sorkin's new behind the scenes show about a Saturday Night Live type sketch show on a made up network. This show is destined for greatness if the first few episodes are going to be representative of the rest of the series. I think this show has the potential to be better than "The West Wing" and will be hopefully comparable in quality to "Sports Night". Actually, I think this show is more like Sports Night, and is finally on the right network, NBC. This should be Aaron Sorkin's opportunity to do a show like "Sports Night" the way he intended. There is no canned laughter, he's not forced to make a sitcom out of a drama, and hopefully NBC will give him the freedom to write whatever he wants and face the tough issues (which he tried to do on "The West Wing", but what he couldn't do on "Sports Night" with ABC). Anyway, I'm really excited about this and hope the show will really be something special once all the characters are developed and Sorkin fires up his genius.

So I think that's all for now. Happy fall y'all!