Getting a week's worth of errands ran in 3 days

In case you couldn't tell from the title, it's been a fairly hectic couple of days, but nothing all that blog-worthy. After dropping Mom off at the airport on Wednesday, it's been pretty much nothing but trying to get everything that needs to be done in person in Ohio (which is quite a lot) done before I leave for DC.

On Thursday, I had my meeting with Dr. Para, one of the Infectious Diseases specialists I worked with on that rotation, about the letter of recommendation he's writing for me. The meeting went fairly well, and he suggested I ask Dr. Schlesinger, the chair of the Infectious Disease division, for another letter, since I did research with him the summer between my first and second year. Unfortunately, Dr. Schlesinger wasn't in the office for these few days, so I handled all that via email (I think that's how Dr. Schlesinger prefers to work, anyway). So now that's taken care of, and I have four letter writers (which is the minimum), so I'm good in that regard.

So then I spent some time cleaning the apartment before my optometry appointment that afternoon (yay for new contacts), and then a mandatory med 4 meeting, which was mostly about reducing infection by washing our hands, and increasing patient satisfaction and stuff like that. The patient satisfaction stuff was based on survey results, which are the least reliable source of data, so I spent most of that meeting trying to distract myself from jumping up and telling them that those numbers mean nothing. But they did give us all-important business cards to give to our patients (which I will not do, in case you're wondering). Here's what it looks like:

After that meeting was the first Military Medicine Interest Group meeting, which got a lot more people than we were expecting (but we had enough food for everyone, so it was all good). I think we answered a lot of people's questions, and that's always the goal. It's strange to be a fourth year now and be the authority on all these things, instead of being the one asking the questions, like I was a couple of years ago.

Yesterday was more of the same. I went to Target to print pictures of MMIG members in uniform doing all sorts of military medicine-type stuff for our display case (it has to be updated every year at the beginning of the year; we just put up new pictures each time), then I had my travel appointment at the Health Center for my Papua New Guinea trip. I only had to educate the nurse practitioner on one thing, mostly because I didn't give her a chance to get it wrong on anything else--I told her what medications I would like and which vaccinations I need. The one thing she didn't get was terminal prophylaxis for maleria, which is when you take a treatment dose of a medicine that kills the liver form of the disease after returning from a long trip (defined by LTC as >4 weeks), to prevent relapse. She had never heard of it, and had to talk to the doctor, who agreed with me. Unfortunately, they don't carry that drug in the pharmacy, and I only get insurance in that pharmacy, so that's going to be expensive.

After that was more running around getting stuff taken care of, such as turning in receipts for reimbursements and taking some old study books to the "book closet" to be used in a book sale (it's a bit like selling books to a used book store). Then Jeff, Adrienne's fiancee, came into town and took us out to dinner, and fun was had by all.

Back in Ohio

This was our fourth day of driving (which was yesterday). It was a shorter day than some of the others, getting us into my apartment at about 5:30 Eastern time.

Being back in Columbus is quite the experience so far. It doesn't really feel like I've been gone for two months, and it's an interesting re-adjustment for Adrienne as well, who's had the apartment to herself for those two months. At any rate, she left early for work this morning (most of my classmates are on a rotation right now; I only have a vacation because I started last month early), and Mom and I wasted some time around Columbus before I took her to the airport at about three. Just our luck, though, it was raining today, which somewhat impeded our plans (going to the park and going for a walk; there's not much to do around Columbus), but it did let up enough for us to do that later in the morning.

Anyway, Mom is somewhere between here and Portland now, and I'm getting all sorts of stuff ready for the next few days and for my rotation at Walter Reed next month (I'm flying on Monday, assuming the government's travel agency gets me my travel documents). Tomorrow I have a meeting about a letter of recommendation in the morning and a Med 4 lecture about reducing infection through hand-washing (as if we didn't know that already) in the evening, followed by the first Military Medicine Interest Group meeting of the year, which I'm in charge of getting food for (guess it'll be pizza yet again). In other words, there's a lot going on in the next few days. I'm almost looking forward to my next rotation starting because it'll give me some more time to relax.

Heading back to Ohio: Days 2 and 3

Last night there was no free internet at the hotel, and tonight I'm tired from A LOT of driving, so this is a short post.

Day 2: Salt Lake City to Colorado Springs. This was originally supposed to be Salt Lake City to Denver, but the Democratic National Convention was in Denver, so that ruined that plan. Instead, we made it an even longer day of driving and headed down to Colorado Springs. We did some hiking in the Rockies on the way, which was nice.

Day 3: Colorado Springs to Fulton, MO. LONG DAY! It was probably 12 hours of driving, plus a time zone change, which makes for a long, boring, and very tiring day. Between the ever-exciting landscape of Kansas (that was a bit of sarcasm) and just being really tired of being in the car, it was not that thrilling of a day. However, we didn't have any scares with the gas, so it's all good.

Tomorrow: back to Columbus!

Heading back to Ohio: Day 1

This morning at around 7:30, Mom and I headed out for Day 1 of our return trip to Ohio. In the course of about 12 hours, we drove from Camas, WA to Sandy, UT (just outside Salt Lake City). It was a lot of driving, complete with worry about running out of gas. Near the border between Idaho and Utah, we passed a sign saying "Next gas 26 miles". Well, we figured we would have no problems going 26 miles with what we had, so we continued. Twenty-six miles later, about five miles or so after the gas light came on, we pulled into the station, grimacing about the price ($4.35) and the fact that we had to pre-pay inside. So, figuring we would get about seven gallons of gas, which would get us to our hotel, we tried to get into the convenience store, to discover that they were closed. To make it even more fun, right before the exit to this gas station, we passed a sign saying "Next gas 38 miles". Without any other options, we hopped back into the car, turned off the AC, and drove at about 60 mph (speed limit is 75) across the Utah border and to the next gas station, where fortunately gas was much cheaper. It was incredibly close; the gas tank holds 14.5 gallons, and we put 14.2 in. All sorts of fun.

Goodbye, Madigan

After crashing at Rachel and Jason's last night, I got up this morning and headed over to Madigan for the last time, for my out-processing, which is really just wandering around the hospital and getting signatures for doing things like turning in my white coat and badge.

This is a picture of Madigan I pulled off of Wikipedia. It's actually a fairly old pictures; the short buildings between the hospital and Mt. Rainer is the Annex (otherwise known as Old Madigan), which is where I was working. I know it's an old pictures because there are about half as many buildings there now. My building is near the middle of this group, which is now the edge of the group of buildings (there's a large field there now).

After a month at Madigan, I will have to admit that I am going to miss the place, especially things like always being able to find a parking place, hanging out with the interns, listening to LTC Wiesen talk about making President's Hundred on the rifle (he's one of the top 100 riflists in the country), trying not to laugh at the guys getting lost on their way to STD clinic, running on base in the morning when it's still cool, and enjoying the view of Mt. Rainer. However, there are also things I'm not going to miss, like that windowless box of an office I shared with the interns (windowless and without air conditioning), the strange animosity amongst the residents, documenting everything in AHLTA, and the like. Overall, it was a good month, and if it weren't for the fact that the residency program is focused on the things I find most boring about preventive medicine (public health department-type stuff), I would really enjoy doing my residency here. We'll see how things go at Walter Reed Army Institute of Research next month.

Anyway, after out-processing, I drove back down to Camas and proceeded to spend the entire afternoon stuffing my junk into suitcases so Mom and I can begin our cross-country trip back to Ohio tomorrow. And when I say stuffing my junk into suitcases, I'm not joking. I have three suitcases, three book bags, four boxes of wine bottles for Adrienne, and still more stuff that will just go into whatever crevice we can find in the car. That's a lot of junk.

See? A lot of junk. Hopefully it will all fit into the car tomorrow.

Interrupting my day with work

My days at Madigan are quickly dwindling down, as is my workload. Pretty much, I've finished everything that's on my list of things to do, with the exception of giving my scoliosis presentation (I've already finished the powerpoint slides), so I spend most of my time twiddling my thumbs and waiting for something to happen. Well, I occasionally do things out of extreme boredom to break up the boredom, like on-line training modules that aren't due for about a year or taking extra time for lunch to walk to Madigan (prev med is in the annex, not the actual hospital), buy lunch, walk over to the park, and eat and read my novel.

I did have to interrupt that nothingness with TB clinic this afternoon, which was fine by me. It's my favorite clinic of the three I do (TB, STDs, and travel), but travel is a close second, and I got to do that yesterday. I like TB clinic because there's some detective work (you have to decide if it truly was a positive TB skin test, and then what their exposure might have been), and a chance for patient education, and I feel like the patients leave with a better grasp of what is going on than they had coming in, and often feeling better about the situation. I can imagine it would be pretty scary to come back from deployment to be told that you have TB, and they don't really understand what a positive skin test means, and so we get to explain that to them and let them know it doesn't mean that they're dying or infecting their loved ones.

Tomorrow is my last full day of preventive medicine at Madigan, and then I'm out-processing on Friday. It's been a good month overall.

A weekend in Moses Lake

After arriving back in the great state of WA from New Mexico, I climbed (literally) into Kit's big red rental pick-up, crashed at his place for the night, and headed over the mountains for the heat and sagebrush of Moses Lake on Saturday. Not much happened on Saturday; Mom and I visited Stephanie, Madison, and Boe, and then we headed out to the Hochstatter's for a pinochle party (something that one doesn't really see in Ohio).

Sunday was Thea's baptism, followed by a family/church/whoever felt like showing up barbecue at Lou and Debbie's. Danelle and Nicholas were a bit wary of me at first (as Ben said, Nicholas must be able to sense the doctor), but they eventually realized I wasn't going to be poking or prodding, and that I wasn't too scary, and Danelle even went so far as to demonstrate several animal sounds and motions by the middle of the afternoon.

Then it was back over the mountains, at which point I remembered that I had stuff (namely, my suitcase with my uniforms and boots) still in Kit's apartment, with no Kit. Since they were jet skiing in one of several large pockets of no cell phone reception, I wasn't able to get a hold of him to figure out a way in. Fortunately, after we called just about everyone we knew in Moses Lake, Jon showed up, so we were able to get in and get my stuff, and then it was back down to Tacoma for me, to start my last week at Madigan.

On my way back home

I'm sitting at the Phoenix airport now, enjoying my three and a half hour layover on the way back from Albuquerque at the Military and Veteran's Hospitality Suite, which is like the USO rooms, only not sponsored by USO. It's all the same--free internet, free snacks, and Marines playing cards and video games. Not much else to do.

Anyway, the conference ended on a strange note. Throughout the week, I noticed a definite lack of cohesiveness among the Madigan PM residents, which is unusual. Most residency classes are rather close-knit, but not this group. We had one van for the group of us, and at any given time, about half of us knew where it was and when it was leaving either the hotel or conference center. One of the majors was left behind in the morning almost every day, because nobody made any effort to make sure that they communicated the day's plans to anyone. This morning, for example, the two interns and I assumed that we were leaving at 7:30, because the first session started at 8. Well, we were sitting around at the continental breakfast, and finally saw one of the residents at about 7:50, who then informed us that the van was leaving at 9. In other words, we could have gotten an extra hour and a half of sleep. Not only that, but we missed the one good session today, which was at 8:30. And then, by the time we arrived at the conference at 9:40 (the hotel is about ten minutes away... we were just that delayed in leaving), we were too late to walk into a 9:30 session, and 10:00 was a break session. In other words, we had nothing to do until 10:30. So, to recap--the interns and I did NOTHING but sit around not knowing what was going on for three hours. By this time, CPT Wilson and I were so annoyed that we decided to go for a walk around downtown Albuquerque (which is not all that exciting, in case you're wondering) instead of going to any of the sessions, which we weren't interested in anyway.

Tonight, Kit's picking me up from the airport, and then Kit, Alex, and I are headed over to Moses Lake tomorrow to see family and for Thea's baptism on Sunday.

USMLE Step 2 CK score

Yay! I passed Step 2 CK! I got an email this morning as I was getting ready to head out for the conference saying that my score was in. However, when I tried to click on the link, the settings on Internet Explorer were off or something, and it wouldn't open, and I didn't have time to fix it before I had to leave. So, I figured that I passed, because if I failed, it would say something along the lines of "click here to reschedule", and it didn't. I finally got to check when we returned to the hotel in the evening, and I did indeed pass, and beat the national average by 2 points (which was a closer margin than my Step 1 score).

Other than that, the most exciting event of my day was my "interviews" for residency positions with the two Preventive Medicine residency directors (Madigan and Walter Reed). I use that word lightly, because it was really just a conversation about why I'm interested in PM and how the two programs are different. That, and this was nothing scheduled--I showed up where I knew they were sitting between sessions in the conference (granted, LTC Wiesen told me where they were going to be and told me they would be there between 9 and 12, but that was it).

There were a few good sessions, a few boring ones, and when the day was over, we headed back to the hotel, ordered dinner, and watched the Olympics. All in all, a good day.

Aaron's ordination and visiting the cemetery

I guess I'm a little slow with the posting. On Sunday, Mom, Dad, and myself went down to Hillsboro to attend Aaron Putnam's ordination. It was a nice ceremony, and it was good to see family I hadn't seen in awhile (or ever, for some of them).

After that, we swung by the Lewis Pioneer Cemetery, because I still hadn't seen Grandma's headstone. We discovered that the cemetery had a new sign.

I thought it was pretty cool.

Grandma's headstone. I think it turned out rather nice.

We also saw Ted's headstone while we were there. If you notice, both of these have pennies on them. Those were the two newest graves (at least in the Hesse plot), so we thought it had something to do with marking them for something, but we weren't sure. Dad emailed Troy and asked, and he said that the pennies are signs from above, placed by our loved ones in places we wouldn't expect to get our attention. Well, it worked, because we noticed them.

I'm in Albuquerque right now, at the Army's Force Health Protection conference. Not much exciting so far, just listened to a few talks on malaria in Afghanistan and diarrheal diseases while deployed.