Thursday, February 24, 2005

No big surprise here

I could have predicted this result:


-- Personality Disorder Test - Take It! --

But really, why am I not asleep?

Great Balls of Fungus

Following his correct replies to my literary trivia and the receipt of his Kudos, Extreme Unction requested the name of a respiratory infection that could be obtained from living in a damp Irish boarding house. As per that request:

Aspergillus fumigatus is one of the most common spores you might encounter in the environment, and the one most likely to lead to a respiratory infection. Typically it affects individuals with certain predisposing factors, such as immunosuppression, asthma, cystic fibrosis, or previous cavitary lung disease (i.e. TB). The manifestations of the disease differ depending upon the host's status. For instance, if your boarding house resident has asthma, he might become infected with Allergic Bronchopulmonary Aspergillosis (ABPA), involving high fever, cough, hemoptysis (bloody sputum), and general respiratory distress (wheezing, difficulty maintaining oxygen saturation of the blood, etc.). If, on the other hand, your character has a hole in his lung such as from a previous TB infection, he might form an aspergilloma, which is literally a ball of fungus that occupies that lung cavity; the manifestations of this sort of infection would not be as severe as ABPA because the fungus ball remains somewhat isolated in the lung tissue, but symptoms would nonetheless include fever, cough, and bloody sputum -- the latter of which can, in some cases, become massive and life threatening. Finally, if your boarding house resident has some degree of generalized immunosuppression, such as AIDS, neutropenia (reduced white blood cell counts due perhaps to cancer or its treatment), immunosuppressive therapy, or even severe alcoholism, he might suffer from either invasive aspergillosis or chronic necrotizing aspergillosis. The former is a uniformly life-threatening infection involving, as the name implies, an invasion of multiple body tissues after the aspergillus spores make their way into the bloodstream and disseminate broadly. The latter, chronic necrotizing aspergillosis, is a longer-term, less acute infection of the lungs that may mimic various other types of pneumonia and lead to multiple rounds of futile antibiotic treatment. It ultimately can lead to the death (necrosis) of large areas of lung tissue if allowed to progress unchecked.

Anyhow, this may have been more info than you desired, but I wanted to provide a thorough list of clinical scenarios in order to provide the best fodder for your story. It strikes me the aspergilloma is the most fascinating infection, as the fungus sets up shop in its own sequestered micro-environment of the lung, and can remain there for years. A character with this problem might even find himself coughing up the same stuff that's growing on the walls of the damp boarding house room. All he needs in order to be eligible for this fascinating disease is a hole in the lung; if TB isn't glamorous enough, perhaps he could have suffered a gunshot wound to the chest at some point; all of those fungi could crowd themselves around a nice .22 caliber bullet lodged in his right upper lobe. In any case, good luck with the writing.

Here's a picture of me with my girlfriend at our Senior Medical Students' Dinner, 2005.  Posted by Hello

Wednesday, February 23, 2005

As promised, I offer Kudos to pinhut at Extreme Unction for his rapid, accurate responses to the literary trivia questions in my last post. He gets Bonus Points as well, for what it's worth.  Posted by Hello

Tuesday, February 22, 2005

Well now that's done: and I'm glad it's over.

I took my Step II board exam today. Or rather, it took me. The test endured for a total of nine hours, with eight one-hour blocks of questions and an hour of break (O such overwhelming magnanimity!). During this time, I faced a continuous stream of questions designed not so much to test my knowledge as to break my will and leave me crestfallen. Despite taking four Vivarin (4*200mg of potent, alertness-inducing caffeine), my attention flagged after about two hours into the exam; in fact, to say that my attention flagged is somewhat of an understatement, as even Betsy Ross would envy what this exam created of my meager mental capacity. I struggled, battled, and sweet-talked my mind into finishing the interminable onslaught of questions, but by the end I was suffering even trying to read, much less to discern the proper management of yet another cause of second trimester bleeding (Ob-gyn, my least favorite subject, featured prominently on the exam, as it turned out). All in all, now that I have finished, my brain feels rather like a stadium urinal at the end of the seventh inning stretch: slightly stained, frothy, possessed of a singularly foul odor, and altogether used. Thankfully I have a few months to recover my wits before my surgical internship begins, and patients' lives actually depend upon my clinical acumen.

Well, since completing my exam I have ventured to the local riverboat casino and pissed away $120 into the Mississippi River, then returned home and voraciously consumed a glass of port wine and two bottles of McEwan's Scotch Ale (the best beer on the planet). Now I have about two hundred pages of reading to complete before my Health Administration class at 9:00am. So it goes.

*Kudos to the first person (amongst my substantial readership, ahem...) to recognize the source of the title of this post. No cheating with Google, though!
*Bonus points if you point out the novel in which "So it goes" was utilized as a concise means of recognizing the conclusion of a human life. (I have, of course, abused the term here).

Monday, February 21, 2005

A sad day in the literary world

Hunter S. Thompson committed suicide today at his home in Aspen, CO. The story is here:

I was a sophomore in college when I read Fear and Loathing, which still stands out as having perhaps the most vivid imagery of any book I've read. Anyhow, this is sad news for anyone familiar with Thompson's work.

Friday, February 18, 2005

The drudgery continues

Well, this is now my sixth consecutive day of 10-12 hours of studying. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy. All work and no play makes Jack a dull boy.

Anyhow, I have amused myself during my study breaks by going to You see, when I took one of those online quizzes not long ago, "Which website are you?," I learned that I most resemble, because I am flashy [sometimes] and funny [again, sometimes], I have a large following [well, not really], I talk funny [hmm...sometimes], and most people don't get me [definitely]. In any case, it turns out that the website provides just the kind of humor I like: a quirky plethora of puerility with an intellectual undertone. I highly recommend it to people who like that sort of thing.

Well, I look forward to spending more guilt-free time blogging once next Tuesday's exam has passed.

Thursday, February 17, 2005

Google ascent and a new idea

I realized recently that many people reaching my blog did so by searching for the term "orgasmic cephalgia" on Google. In fact, my blog attained the fourth rank on Google for this search term -- something I never thought possible. Then, I got to thinking... First, the post containing that search term was rather tongue-in-cheek, and lacking some of the professional detachment befitting somebody who will, in fact, be a real life doctor in a handful of months. Second, the fact that my blog shot up the ranks of Google's ponderous list of websites means that not much info is extant on the Web about orgasmic cephalgia. As a result of these revelations, I have considered starting up a separate blog containing general information about medical topics of interest to myself and anyone who might happen to surf (or search) along and find me. Once I finish my board exam next Tuesday, I'll try to create that blog and post a link to it here, for the two or three of you out there who may be interested.

Meanwhile, here is a small blurb about orgasmic cephalgia, restricted to useful info this time (the previous post has been expurgated from my blog).

Orgasmic cephalgia -- According to The Handbook of Neurosurgery, this disease consists of "a severe, throbbing, sometimes "explosive" H/A with onset just before or at the time of orgasm." Besides the obvious emotional and physical ramifications of having a pronounced headache at the time of orgasm, this disease merits consideration because it is actually relatively benign, yet closely mimics a different, life-threatening illness. Subarachnoid hemorrhage -- acute bleeding into the brain that generally occurs because of the rupture of a weakened arterial wall -- presents similarly, with a sudden-onset headache that frequently can occur during a period of intense exertion (such as during intercourse, at the time of orgasm). Subarachnoid hemorrhage is a medical emergency, and requires prompt consultation by a neurosurgeon. On the other hand, orgasmic cephalgia is transitory, not life-threatening, and essentially avoidable -- though not without significant lifestyle changes.

I'll see what I can dig up on treatment of orgasmic cephalgia, and perhaps post it on my new blog when I have time. Meanwhile, I'm back to the books...

Tuesday, February 15, 2005

Will they never stop

As it turns out, I'm a... (picture Uma Thurman as Beatrix Kiddo in Kill Bill Vol. 1, tracing out three sides of a square in the air).

You are a Square. What a weirdo.

What kind of Sixties Person are you?
brought to you by Quizilla

Another blow to my girlfriend's ego, thanks to online quizzes

Here's what website she would be:

You are You are many things to many people. You try to find what people are looking for, but you're not very good at it. You suck.
Which Website are You?

Monday, February 14, 2005

Languishing somewhere among Google's top 1,820,000

I tried a simple Google search of my blog's name this morning, and much to my disappointment learned that my blog does not appear in the top 100 results for "Not rocket science." What does appear (as #100) is a site containing the words, "Penis enlargement is not rocket science." I have taken this finding to mean either that 1) my blog has not been referenced enough to compare favorably with the almost two million other sites that include the words, "not rocket science," or 2) I don't talk enough about penises. In either case, my goal is to one day enter into Google's top 100.

P.S. The actual plural of the word penis is penes, but because that fact is not generally known, the term penises can perhaps be more easily employed in text to humorous effect.

Sunday, February 13, 2005

What happens to a Valentine's Day deferred?

My girlfriend and I, in observance of our rapidly approaching board exams, have decided to postpone Valentine's Day until early March. Which makes me wonder...

What happens to a Valentine's Day deferred?

Does it dry up
like month-old roses in a vase?
Or disseminate like a spore--
And then pepper your face?
Does it stink like too much perfume?
Or crust and sugar over--
like another damn box of chocolates to consume?

Maybe it just sags
like an American ass.

Or does it pass gas?

Wow, that was really lame. I'll have to figure out a reasonable argument as to why I shouldn't have my blogging privileges revoked after that one. My profuse apologies to Langston Hughes.

Oh, and I just learned from the Extreme Unction blog (which is a great read, by the way) that Pagoda Egg Rolls are the key to attracting traffic to one's blog. Apparently, scattering the term Pagoda Egg Rolls into your posts can substantially improve the number of searches that yield your blog's address. There's something magical in those Pagoda Egg Rolls. Mmmm...Pagoda Egg Rolls.

Friday, February 11, 2005

For a good laugh...

If you've ever found yourself entertained by Snoop Dogg, you should certainly check out Gizoogle. I started cracking up as soon as I saw the o's sporting spinning rims. Then, I translated my own blog and laughed so hard my girlfriend had to leave the room. Good times, good times.

I should be studying for my board exam.

Tuesday, February 08, 2005

The zero-sum game of knowledge

Ahh, medical school. The general public hears this term and pictures eager students dissecting cadavers in sterile rooms, pompous professors bloviating before packed auditoriums, and inexperienced, nervous students testing their new skills on a few willing (or unwitting) patients. What the uninitiated do not know, though, is that medical school is, in reality, a highly efficient mechanism for purging intelligence from one's brain. The reason for this fact lies in the simple truth that the brain contains only a finite number of neurons, and each neuron can participate in the recollection of a finite number of memories; thus, memory formation, at its core, remains a zero-sum game. Further, because medical school requires roughly 120 hours of work per week -- leaving 48 for sleeping, eating, defecating, and performing various other vegetative functions -- the world of training to become a physician is an insular one indeed. Once you throw in the monotony of day and night studying followed by unending toil in the hospital, the basics of higher cognitive function begin to deteriorate. In any case, I used to know a decent amount about a lot, and be able to do something with it. Now I know an obscene amount about very little, and I'm highly qualified to do (as yet) essentially nothing.

For the sake of illustration, here is a brief list of pieces of knowledge I used to possess, and the new specialized facts that have supplanted them.

Old: All the presidents of the U.S. --> New: All the diseases one can contract by mowing over a rabbit in the yard
Old: The plots and themes of Shakespeare's plays --> New: The DSM IV diagnoses of Hamlet, Ophelia, Caliban, Othello, Macbeth, Richard III, etc.
Old: Every word of The Wasteland by T.S. Eliot --> New: Every word of First Aid for the USMLE Step I by Vikas Bhushan, Tao Le, and Chirag Amin.
Old: How to program HTML and VbScript --> New: how to digitally disimpact a constipated rectum and use a fiberoptic scope to pick a nose
Old: All the synonyms for the word rigid --> New: All the scientific and colloquial euphemisms for impotence ("I'm making love with a stuffer, not a poker.")

But, you know, I'll be a better doctor for it. Now I just need to train for seven more years so that I can actually reap that reward. Meanwhile, I would recommend that you take your Metamucil -- lest you end up being the means for another med student to forget the basics of web development.

Sunday, February 06, 2005

...And more still

At least the act of taking the quizzes is entertaining.

You are .swf	 You are flashy, but lack substance.  You like playing, but often you are annoying. Grow up.
Which File Extension are You?

It seems that both of these quizzes highlight my flashiness as a common denominator. I'll have to see what my friends think about that.

More minutes I'll never get back

What the heck is this all about?

You are You are funny and animated.  You have a large following, but many people still don't get you. You are flashy. You talk funny.

Which Website are You?

Saturday, February 05, 2005

Blogger's guilt

Being new to this whole blogging thing, I did not anticipate the existence of such a phenomenon as blogger's guilt. However, after not posting for a week and learning from my site meter that -- wow! -- a couple of people actually visited my site, I felt like an odious little waster of Internet space and browsing time. To think that I allowed a week to pass without providing content for someone gracious enough to care what I have to say! What a selfish bastard I've been! I'll have to schedule some zealous self-flagellation for sometime in the next couple of days. I'll pencil it in, anyhow -- hopefully I can get around to it.

Due to the fact that I recently committed to seven more years in Nelly's hometown (interestingly, also the hometown of Chingy, Murphy Lee, and J-Kwon, for those who care), a search for real estate has elevated itself to priority number one in my life. I have spent about 98% of my free hours in the past week poring over MLS listings, driving through neighborhoods, and viewing properties. Of course, there is one primary reason for my rapt enthusiasm for the new home search: my Step II board exam! As is always the case with fourth year medical students, the exigency of the need to study comes in inverse proportion to the will to complete said studying, and in direct proportion to the passionate desire to occupy oneself with any diversion, however mundane. So despite my looming exam date -- Feb. 22nd -- I will spend all day tomorrow looking at lofts and condos, fretting over whether I want to splurge on a unit with upgraded granite counter tops or stainless steel appliances. Hopefully, though, I'll make time for a little blogging. At least blogging seems a more likely endeavor than studying, which bodes well for my blogger's guilt. (Not so well for my overachiever's guilt).