If It's Real...

I’ve been through a lot since my last post… short recap of my trip to Utah:

• Family dinner with the Riddle Family
• BBQ with the Soelberg’s
• Teaching Matt how to apply an arm bar (including offering my own arm for him to practice on... he will debate who's actually made the decision to allow him to use my arm... him or me, but I maintain that it was me)
• Trip to St. George with Greg, Nat & Garrett (in which Garrett did his best 3-hour impersonation of a stabbing victim… I don’t remember teething being that bad…)
• Dinner at my favorite restaurant with 2 of my funniest/coolest cousins
• Trip to Golden Corral with the Phillips Family, in which my dad was suspiciously absent
• A smattering of blind dates

Needless to say, a lot happened during that trip. It’s hard to describe how much fun I had seeing everyone, and it definitely got me ready to head back to North Carolina.

Which brings me to the present… I started orientation for residency on the 17th. We practiced suturing in the morning and then in the afternoon it was off to the ropes course. For those of you have done a ropes course, you know exactly what I’m talking about. For those of you that haven’t done one, let me see if I can paint you a picture.

The way I figure it, the ropes course was probably invented by two friends (not unlike me and my best friend… very similar in a lot of ways, but extremely different in many many ways). The first friend (we’ll call M. Ropes) was probably like a modern version of Robin Hood… you know... into climbing trees, ropes bridges, cargo nets, and what not. Basically your average Man’s Man. The second friend (we’ll call N. Course) was much more touchy-feely and preferred to talk more about his feelings than to climb through trees… definitely the more sensitive of the two. So these two get together, and turn a portion of the forest into an obstacle course where you talk about your feelings... like Boot Camp for your feelings...

It was a lot of fun to do the ropes course and to get to know the people that I’m going to be spending 80 hours/week with for the next 7 years of my life. Everything was great except for the leader of the ropes course Dan (picture a young, chubby Mr. Rogers with short shorts on). During one portion of the course Dan asked each one of us to describe “how residency would be like an island for each of us.” The following exchange occurred between Dan and a resident that I’m calling Steve:

• Steve: Residency will be literally be like an island for me because I am going to be alone for a large portion of it. My wife doesn’t finish PA school until December so she’s staying in Texas until she finishes. I know it sounds cheesy but we’ve been married for almost 3 years so it’s going to be hard to live away from her (PS great answer… completely appropriate).
• Dan: (Dramatic Pause… wrinkled brow… pursed lips)… Steve… (another dramatic pause… apparently nothing says ‘I want this exchange to be uncomfortable’ like a good dramatic pause) If it’s real… (dramatic pause... clearly Dan is the Michael Jordan of dramatic pauses) It’s not cheesy…
• Steve: Afraid to answer….
• Awkward silence…
• More Awkward silence…
• Dan: Alright (dramatic pause… really driving his creepiness home)… who’s next?

After this and a few other awkward exchanges, we went to a ropes course that involved walking on a cable that was 30 feet in the air. This particular cable had another cable 10 feet above it in the air (for heaven knows what purpose)… they asked us get into groups of two and help each other across the cable… My partner and I had the ingenious plan of using our belts to make a zip line out of the higher cable (we of course would spring this Tango & Cashesque plan on the group once we got into the tree). As we’re about to ascend to the tree tops, Dan notices our belts hooked together in my partners pockets. Dan realizing what a liability this would be immediately makes belt-zip-lines illegal in this particular activity. As we protested Dan reports to us that it would be too much of a liability.

I responded, “Ummm… (dramatic pause) Dan… it’s ok for us to climb 30 feet in the air? But not use a zip line?... what kind of s@#$ is this?...”
Puzzled by my inquiry Dan responds with, “Shut the heck up and climb....”

OK, he didn’t really say that… but I didn’t ask him that question either… So I guess it's a wash. The good news is that I’m loving residency so far, and the people I work with seem to be amazing and I couldn’t be more excited about them.

My Life... Matt's Entertainment

Wow! It’s been a crazy couple of weeks since graduation. Including:

• Site-seeing in Nauvoo
• Ditto in Chicago
• 14 hour drive from Milwaukee to Chapel Hill… with scenery provided by every hick town along the way
• Setting up shop in Chapel Hill
• A quick trip from Chapel Hill to DC
• A quick trip back from DC to Chapel Hill to fly home to Utah today

I’ll pull out the GPS at some point to give you all the nerdy stats but suffice it to say, a lot of time was spent in the car. Which normally would have caused me to go insane, but luckily I had Matt as a travel partner… There was never a dull moment, including:

1) On a rainy day in NC I send Matt from the car to the apartment to get some paper so that we can formalize our plan for the day. Matt speedily returns from the apartment holding 2 sheets of unfolded white paper out in front of him. As he carefully avoided the trees the torrential downpour was unleashed on these poor flailing pieces of paper. (Now some say that I'm a patient man… but the other 99% of the population would disagree with them). As he gets in the car, it takes all my self control to say (only slightly snarkily), “Matt! What are you doing?” Matt gets this grin on his face like it’s free burrito day at Beto’s and pulls two other pieces of paper out of his coat… apparently this is his idea of a joke… he walked the rest of the day…


2) I had to get my brakes changes the day we left for DC, so as I do so I'm scouring the internet for a deal on a hotel room. Now a deal on a hotel room in DC isn’t like a deal on a hotel room in a lot of other places. It’s more like a game of let’s see how close to $125/night we can get without ending up in a part of DC that looks like the backdrop for a post-apocalyptic movie.



Finally after a good 30 minutes of searching I stumble across the hotel on the right. It is called The Churchill, and was built as a luxury hotel at the turn of the century. The pictures are the exterior of the building and the lobby of the hotel. The best part is that I found the room for just under my target… We arrive at the hotel, and for two days I have trouble falling asleep at night because I feel like I stole something… as we’re packing up to go Matt says, “This place is nice and all, but I don’t think it’s that much better than a Hampton…” To which I lovingly responded, “Fine next time we’ll find something a little nicer for you.”


Most of the above stories are true… Matt was a fantastic help and the move would’ve been literally impossible without the big guy… But don’t tell him I said that, otherwise we’ll all be getting wet note paper for the next 40 years.

Dr. Who?...

So graduation came and went. I know this for several reasons, including:

• My sister-in-law
• Amazingly thoughtful gifts
• An awesome family that came out to Milwaukee
• Great friends who joined them
• I'm not going to school anymore
• I am expected to show in North Caroline in a few weeks with more than a smile and a witty personality
• And of course the photo evidence…

Other than that not much has changed. I don’t feel better about myself (which makes me wonder if that’s because there’s not level of self-esteem higher than the one I’ve achieved), I definitely don’t feel more important (see the last parenthetical statement), the only pronounced feeling is gratitude for the each item mentioned in the list above.

On a less sappy note, the morning of graduation we went fishing on Lake Michigan. It was a beautiful morning with Captain Jay and Silent Tony. My dad, our family friend Jack, Greg, Me, Brian, and Mighty Matt all set sail at 5:30AM. The sea and weather complied to make the atmosphere enjoyable, but joking around while remembering such manly things as Dumb and Dumber, Tommy Boy, and Napoleon Dynamite was definitely the highlight.

Apparently, we caught some fish too. It’s a sensitive topic for a lot of the more experienced fishermen among us, so I won’t go into too much detail. Let’s just say if I talk about who caught the biggest fish then Greg, Brian, and Matt will get upset (Jack and Dad couldn’t care less).

On the way home my dad decided that we should scout out the location for the ceremony. The following exchange literally occurred with absolutely no embellishments almost no embellishments

Dad: Mike (I was driving), I think we should go see where graduation is going to be.
Me: That’s a fantastic idea, and if I knew where that was it would be an even better idea
Dad: We can find it
Me: Ummm…. How?
Dad: Don’t you live here?...
Me: … (stunned silence)

So after a fruitless search I get frustrated and just start driving home. As everyone is wondering where I'm going, I pull up to an intersection in downtown (which happens to have a red light). I stop behind the red light, and then proceed through the intersection slowly to assess the oncoming traffic.

During this time an older gentleman with a winter coat and sunglasses (odd since it was 60 degrees and overcast) walks into the crosswalk and proceeds to the driver side of my car. For brevity’s sake we’ll call this guy drunk/confused/old/angry guy (DCOAG for short… and I'm not sure if he was all of these but I know he was at definitely 2 of them) throws his arms up to about shoulder height and stares at me (apparently he’s well enough to walk across the street but not spry enough to walk around a mini-van).

I'm the picture of poise at this point so I calmly scream at the top of my lungs “WHAT?? WHAT DO YOU WANT??” I can tell DCOAG cannot believe all the walking he has to do on this day that he set out walking… it’s really gotten him in a foul mood. DCOAG probably hates it every time he goes to concert (because of the loud music). I'm certain DCOAG hates church (because of all the fuss about this God character). DCOAG loathes school (because of all this learning mumbo jumbo). DCOAG is one of these people for whom things just never seem to go right…

At this point DCOAG realizes defeat (I'm not pulling into oncoming traffic or backing into the car behind me simply to make his life easier) and he reluctantly goes around me. I make my turn and drive about a half a block to the next intersection… Just in time to see DCOAG jay-walk… Man, now he can’t even get cross-walks to move to accommodate him… no wonder he’s DCOAG…

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P-H-I-L-L-P-S… and the P is for Prolific

Just finished writing a history and physical of a patient that took way too long, then worked on a presentation about pelvic pain that didn’t take nearly long enough. After all that you’d think, “What drivel does he have left?” (and you’re within your rights to ask). Let me just say, “You’re about to find out exactly what drivel I have left!”

I flew back from an awesome trip to North Carolina that included:

• Being sick (with what I can only figure was swine flu)
• 90 degree weather (or as I like to call it, The Weather Wisconsin Forgot)
• Great food (even the delightfully disturbing vinegar based NC barbeque)
• An awful housing market (where $180,000 will buy you three small rooms and more Formica countertops than you know what to do with)
• Good times with some friends (new and old)
• Found an apartment to protect me from the above weather during my first year of residency
• An unfathomable lapse in memory (which led to a lack of reading material on the plane to NC)

Needless to say, the trip was memorable for several reasons. However, my lack of reading material was one of the most fantastic. Fantastic? How could it be fantastic? Allow me to explain… When I left William Osler: A Life in Medicine in the trunk of my friend’s car, I had no idea that on the way home I’d stumble across an equally enlightening and erudite book. Yep… you guessed it… I picked up The Maxims of Manhood: 100 Rules Every Real Man Must Live By. I'm not sure if it was the faux leather or the faux duct tape that first caught my eye, but needless to say that after 400 pages of A Life in Medicine (a book equivalent to mental lasagna… meaty, cheesy, lots of layers, and especially delicious) I was pleased to drizzle a little mental maple syrup (you know… sugary, thicker than water… but only water, and goes down smoothly) on top of said lasagna.

I liked the book enough to read it in two days. I laughed out-loud at some points and audibly disagreed with others. After a cursory read, I decided to find out how many of the points I had (denoted by an H), don’t have (denoted by a D), and the ones I need (denoted by an N). The breakdown was H – 81% (stuff I solidly have either by effort or default), D – 13% (stuff I don’t have or need usually involving alcohol), and N - 6% (stuff I was surprised to find I lacked).

I was proud to “H” the truly manly stuff like #9 Celebrate Birthdays Like You Celebrate Tuesdays, #27 Always Hold the Door For Women, #75 A Buddy’s Fight is Your Fight, and #98 Never Wheel Around Your Briefcase (a huge pet peeve of mine). I felt justified by H’s I’ve had all along, like #10 Never Take Sides Against the Family, #40 Properly Order a Steak, or #49 No Fake and Bakes. Littered along this trail of self-affirmation I found gems like #4 Never Say Blossom:

In a single day you could run a marathon, slay a wild boar, and uproot a tree
with your bare hands. If, at the end of that day, you say to your wife,
“Sugarplums, out little boy is really starting to blossom,” you have just
knee-capped an entire day of virility.

Or #97 It’s Only A Flesh Wound

Obviously there’s a time and place for admitting pain. Simple enough. But even then sometimes the true heroes—the ones who really matter—will inspire. Every guy knows these role models. For me, it’s two grandfathers who first fought Hitler, then fought cancer. In one particularly rocky stretch of treatment, a nurse asked Grandpa to describe, on a scale from 1 to 10, the intensity of pain. The man was in agony. Eighty years old—recipient of multiple Purple Hearts—and now he couldn’t breathe, laugh, speak or twitch a muscle without lightning bolts of pain. He looked at the nurse and calmly said, “Four.”

Not only were they funny, but it made me think of my own life. I remembered similar “heroes” or experiences where I’d tried to be heroic. Like when Greg and I used to work construction, and we were hurrying to strip a foundation on the morning of the Forth of July. We couldn’t let the forms sit on the foundation until after the holiday, but every single one of us had plans that we were hurrying to get to. We kept going faster, and faster and faster, until we were all running from the hole to the trailer. We’d run to the hole and as a 2-person-team (one pulling from the top and pushing from the bottom), we’d yank the panels out of the hole, catch them in mid-air and carry them to the trailer. One particular time one of the panels I was pulling wasn’t standing straight up (in fact it was aimed right at me). With my partner’s push of the panel and my pull from the top, I basically helped push myself off an 8 foot wall. I fell onto the rocks below and the 100 pound form landed on me. Like a real man of 15, I sat up and yelled swear words that are still hanging over Draper somewhere. I fought back the tears and was surprised by a lack of salty discharge from my eyes. I bit my lip and stood up to go back to work…. Cooler heads told me to slow down and asked me if I was ok. They told me to take a breather… They laughed that I even wanted to work. One of my white-trashiest idols of all time said, “you’re the toughest little kid I know.” The only person whose opinion truly counted (my brother) walked coolly over to me, and in his best impersonation of my dad, coldly said, “You’re such a wuss…” And he meant it!... If only I’d found this book sooner…

NO! It’s Actually Unacceptable…

I love traveling, whether it be to far away destinations or back home. New destinations are so exciting because I get to see the way other people live, explore new cities, and learn about the history of another location. Home offers a completely opposite, but more enriching experience. I get to enjoy locations that are familiar to me. I get to relax and be comfortable in an environment that I know. Most importantly I get to see my family again, and no matter how much we’ve changed it feels like I never left.

This most recent trip home was fantastic because I got to meet my new, beautiful, and sleepy niece (who may be the most germ free baby I’ve ever met… at least I hope she is… for her mom’s sake…). It was great to see my younger brother (who I am jealous of in every way… except of course his math/physics skills, don’t need ‘em… don’t want ‘em). I got to hang out with my favorite nephew who, if he doesn’t grow up to be a janitor (see brooms, love of), is going to be an awesome cowboy (rivaled only by my youngest brother’s future in cattle roping). I got to hang out with my favorite sister and watched her choked down what I can only describe as vinegar ice cream, and chatting about life (she’s so smart, strong, and kind… I wish I was more like her). I got to devastate my dad on e-golf (despite his 3 eagles and 1 double eagle… I'm not sure how he did it, but he always mentions a C++ class he took way back and that’s the only thing I can come up with). Other highlights include:

• My aunt’s phone ringing in church…
• My aunt, embarrassed that her phone went off in church, loudly saying her daughter's name from 5ft away to chastise her for making noise during the meeting...
• My cousin sleeping/kissing/cuddling/making out in church…
• My family texting about all of the above…
• Seeing my best friends, and catching up…

At this point, I know exactly what you’re thinking… “All of those things sound ‘acceptable.’” And you know what? You’re absolutely right… that brings us to my trip home. After a day on the e-course and e-packing (no wait the packing was real… sorry I played so much Wii this weekend I'm having trouble separating ‘e’ and realit-e), I was taken to the airport by my dad (still reeling from the losses) and my brother (still thinking about the Chinese food at home in the kitchen). Their minds elsewhere, they slowed to a roll and I jumped from the car…

I checked in using the US Airways Kiosk, which printed 1 boarding pass and 1 receipt for a boarding pass that says, “Please proceed to your gate for the seat assignment.” Well I mustered all of the patience in my being and waited to ask the ticket agent until he was done talking to the traveler he was currently talking to. Once they’d finished blathering, I said something like, “I just got a receipt instead of a boarding pass (sighing… furrowing the eyebrow…), what does that mean?” He assures me that everything is going to be fine, I’ll be able to board that flight but they have to upgrade some of the coach people to first class before they can give me my seat assignment. To which I responded (with a tone as skeptical as I can muster), “Are you sure? Because if I'm going to get bumped, I’d rather be bumped here than Phoenix…” Again reassurance from my ticket agent (I wish I could remember his name, but for the purposes of this story, we’ll call him Moron (he’s actually not coming up again, but I think it’s important to label him as such))

After flying peacefully sleeping all the way to Phoenix I exited the plane and walk to the adjacent (yes… adjacent… I was definitely not lolly-gagging) terminal and ask for my boarding pass. The lady goes, “We oversold this flight and you’re on the standby list.” She then used the skill of “blankly-staring-at-the-client-without-giving-any-additional-information-at-a-crucial-point-of-the-conversation-where-more-information-would-be-appropriate” technique that she must have learned in her mandatory 1 hour “Working with Real People Seminar” (where she was ironically working with ‘fake’ people). I could feel my frustration boiling to the top, and we proceeded to have the following conversation (we’ll call her Idiot… not because it’s appropriate to call her an idiot… more because this is a family oriented blog, and it’s not appropriate to call her what she is):

• Me: So what does that mean?
• Idiot: It means you may not have a seat on this flight
• Me: (trying to prompt her to follow a logical path of the explanation of what I can only imagine is a common problem in her line of work) When will I find out if I have a seat or not?
• Idiot: It’s hard to say…
• Me: Well this flight is boarding in 20 minutes, and if I'm not getting on it I need to have an alternative plan. Do you know how likely I am to get on the flight?
• Idiot: (after looking me up on the list) If I were you I would try to get on another flight, because it’s highly unlikely that you’ll get on this fl…
• Me: Are you kidding me?
• Idiot: No sir, do I look like I have a sense of humor or a modicum of creativity (she didn’t say that last part… I'm reading between the lines…) We can get you there by Wednesday afternoon at the very latest sir, if you’ll just be patient…
• Me: Ma’am, I am a medical student I have patients that I have to see in the hospital tomorrow morning (I realize calling this a stretch is like calling the sun warm. I was flustered though and I panicked, so give me a break). So Wednesday is unacceptable!
• Idiot: Actually sir, it is acceptable! I understand what you’re saying but these are our opti…
• Me: No! Actually Wednesday is still UNACCEPTABLE and NO! You actually don’t understand! I need to be in Milwaukee tomorrow morning, are there any other options?
• Idiot: There are 2 other options available. Both are horrible convoluted options that meagerly compensate you for the hell we’re going to put you through because we made a bad choice (again, reading between the lines). The first gets into Milwaukee tomorrow at 4PM and the second takes you through Kansas City tonight, puts you in a hotel and then flies you on another airline into Milwaukee at 7AM.
• Me: (processing this horrendous ‘solution’ (if you can even call it that) to this problem) So are you paying for my hotel and food tonight?
• Idiot: Here is a brochure describing your rights.
• Me: (not breaking eye contact) I'm not reading a brochure. How about we just review the options again, and then you can explain the brochure to me.
• Idiot: I am an idiot (this particular message was nonverbal but it definitely was no longer hidden between the lines).

To make this story less voluminous… I went to Kansas City last night. Fell asleep for an hour. Flew to Milwaukee this morning and I'm home now… and happy again. Because no matter how horrible the last few paragraphs were… the first few paragraphs made it worth it…

How Much?

For the last four years of my life, I’ve lived on student loans (as do most people in my line of business). It’s not a complicated process… in fact, the steps go as follows: 1) every winter I fill out a FAFSA and Loan Application, 2) sometime in the Spring I walk into the Financial Aid office at my school and casually say, “Give me the max Hoss (not actually someone’s name… or even something I actually call anyone… moving on…)” 3) I pick up a check for my living expenses in the fall.

The fall checks amount to what people on welfare typically call “poverty,” or “poor as #$%@” in other circles. The big money goes to the amount being paid to the school. That amount has always simply been “numbers” (at least in my mind). The numbers are also very tricky because they’re split up over subsidized, unsubsidized, Perkins, institutional, and private loans (I know…. It’s as complicated as it is mind-numbing…). The point is that I’ve never seen the grand total on one line of a balance sheet… Until last Friday (we’ll call it black Friday… and definitely not because I'm “in the black”). I finally saw a grand total… it had an effect on me that was different than any other number I’ve ever encountered. I immediately started to agonize over how I would pay it all back, and how long it was going to take, and how complicated it is to have to defer the payments until I can actually afford to make said payments… After seeing the number, I sat through a meeting that lasted an hour and a half. All I learned during that meeting was that if I don’t pay back the number, at some point someone will sue me (unless of course I’ve carefully filled out all of the paperwork that was too overwhelming/complicated to understand).

I'm not sure why I'm writing about this, as it sounds like I'm complaining about something I chose to do. Like punching myself in the face then complaining that it hurts… well it’s not that way. In fact, I live my life by a certain set of rules and rule #7 is never complain to anyone about the consequences of something you chose to do. So I'm telling you this because well… it was either this or writing about my recent mandatory urine sample. Luckily for you rule #237 is don’t talk about mandatory urine sampling… unless you absolutely have to.