Valentine's Day just seems irrelevant

“Dream as if you'll live forever, live as if you'll die today.”
~James Dean

Valentines is a hallmark holiday in my mind. It is definitely not one of the majors (Christmas, Thanksgiving, Easter), and not like birthdays and anniversaries. I have begrudging participated over the years and continue to do so. I get the cards and little gifts. I have done the flower thing and bought the pretty jewelery. I say that because I am not above participating in the forced "date night." This year is a little different.

In our little town of Kirkwood, we have had a recent event that has made all of this seem quite irrelevant. About a 1/2 mile from my house sits the City Hall where I voted the Missouri primaries. Two days later, a disgruntled man stepped into that same building and shot 2 policeman, 2 city council members, 1 public works person, and the mayor. They were all killed except for the mayor. He lies in a hospital ICU in critical condition. This small suburb of St. Louis, a quiet, family oriented town, is in shock.

Tonight, as I drive home with my hallmark cards and box of chocolates, I pass children placing luminaries in the front of their houses. The streets are filled with these candle lit bags. A tribute to the fallen. Families walk the streets to observe the community's tribute. My eyes well up, and I realize that the chocolates and cards probably mean less to my family than just having my presence at home. I am sure the members of our city government said something I have said to my family many times, "I'll be right back."

To my Kirkwood family, I grieve with you.

To the families our mayor, city officials, and policy officers, I pray for you.

To my family and friends, I love you.

“Being deeply loved by someone gives you strength, while loving someone deeply gives you courage.”

~Lao Tzu

We all have our quirks ...

“The great aim of education is not knowledge, but action”

~Herbert Spencer

Looking back, residency was one of the best times of my life. Some of the experiences were priceless. I remember sitting in the resident's room and speaking with the other residents about the day. We would complain about the day. We would talk about the interesting cases that we had seen or done, what we had been accused of doing wrong (because we were always in the right), and what our upcoming plans were. Inevitably we would begin to speak about our "attending staff" and what they had said that day. We would commiserate about how we all had similar things said or done to us. I guess you could say after a while, some of the attendings became caricatures of their sayings and behaviors. If a resident would say a particular attendings "saying", we would all smile in acknowledgment. It was like an inside joke. Now, I am on the other end. I am one of the people that they mimic or mock. I guess we can't help it, we all have our quirks. It is fun to poke fun at people's eccentricities.

As an educator, it is important that you are self aware. We must understand out strengths and limits. To be effective at educating, we must understand what teaching style fits our quirks the best. I believe your teaching style should fit your personality, because the possibility of changing your general nature is slim to none. For instance, if you are not an outgoing and humorous person, you are not going to be that kind of educator. It is just a fact.

In evaluating myself, I realized I am a fire starter. Ok, that doesn't mean that I go out setting fires, but I like to look at things from the other point of view. I quite enjoy being the instigator. I do this during dinner conversations. My wife says she can see when it is coming because I get a little devilish grin. It is in my nature. I can't help it.

Usually when a resident comes to me with a plan, I like to take the opposing view point and argue that position. Even if I agree with the resident or medical students plan of care, I want to see if they have a reason. You may say that's mean. I don't know if it is, but it sure is fun. In truth, I want to see if they really understand why this is a good plan and aren't just parroting back what someone told them or what they read. I want to know that the understand enough to debate the subject. For example, a common debate I like to have with the residents is what type of graft to use for an ACL reconstruction, PROS and CONS. The resident usually fumble through this question because they usually haven't thought about it. Why do I ask it, because patients ask the same question. They need to have a good answer for why they recommend one over the other. Coming up with a plan is one thing, but being able to defend that plan is another.

I know we all have our quirks. I don't like a lot of futzing in the OR, I like foam in my casts ('cause it's cozy), and I like my coffee with cream and 1 Splenda ® (dam it). I say, "s/he's gonna love it," when I love it; and I say, "that makes me sad" or "that hurts my feelings," when I don't. If I am teaching, I want to see if the resident is actually thinking. The best way I have found to test someone's understanding of a subject is to debate of the topic. That's just how I roll. So, for now, I'll keep setting fires to see where it takes me.

“Tell me and I'll forget; show me and I may remember; involve me and I'll understand.”

~Chinese Proverb

University Hospital Cursades ... update

Hello all. I have been working on the story line for the University Hospital Crusades. I am looking for Ideas for characteristics to give the different specialties and supporting casts. Please send me some comments on what may be interesting quirks of your or others specialties. This includes my nurse, PA, and other friends, not just physicians. It is a light hearted look at medical training. Feel free to give some suggestions.

Thank you.

Someonect

Update: Back to Basics

Please take a look at my updates on Orthopaedic Surgery: Back to Basics.

Interviews are over ....

“The greater the difficulty, the more the glory in surmounting it.”

~Epicurus

Today was our last day of interviews. The rank list is done. The more I am involved in this process; the more I realize that it is not that scientific process. It gets difficult when you get to the last few applicants. What I have learned this year?

As I previously posted, I asked all of the applicants the same group of questions. In most of my interviews, these questions an provided the opportunity for further conversation. A couple of interviewees fell flat. I don't mean that the answered wrong or poorly, just that were flat. It is like a girl who likes a guy. She gives him every opportunity to "impress her," and he misses the cues. You know what I mean? All in all, the questions went pretty well.

For my first question, I asked, "in one sentence, tell me who you are outside of medicine?" To this question, the common themes were:

• hard working
• loves outdoors
• loves being with friends and family
• easy going
• loves sports

Very few actually gave me a sentence. Most just gave a bunch of adjectives that described attributes that they think would be good attributes in an orthopaedic resident. For the few that gave me sentences, here are a couple I liked:

• I am a geeky girl from the midwest.
• I am a father, husband and friend, that loves music and the outdoors.

To the second questions, favorite book and author, I surprisingly got some interesting answers. Mostly popular authors and books. Several people enjoyed Dumas. A few like historical and biographical books. For most of them, this was not a difficult question to answer.

To the third group of questions, favorite song/album and artist/group, the answer was not as obvious. Most had multiple choices from Country to Indy rock. U2 and the Beetles where probably the overall winners. Groups like Shane and Shane were new to me. GNR and metallica were also popular choices. Lupe Fiasco and Tupac came out of no where from one application. I liked that.

Overall, I think the questions did what I wanted. They initiated conversation made most feel comfortable. I learned a non-medical side of the applicant. I got a glimpse into their psyche. It surprised me that no applicants in their review of our program prior to coming found my blog with the questions. Oh well, I tried to give a heads up.

I do think I will use these again next year. I may change them a little. May be I will ask what ringtone they would give to my phone number. Maybe they would use the Imperial March from Star Wars, like I use for all of my partners (other attendings).



One of my residents just told me he tagged my number with Pantera's Walk. That was FFT.

Pantera's - Walk


Avenged Sevenfold's - Walk cover


May be I will ask what CD's are in their car or songs on their IPOD's recent played list? Or may be I will ask what their ring tone is? I will continue to search for ways to assess an applicants past the USMLE and grades. I look forward to this next year.

“What is not started today is never finished tomorrow.”

~Johann Wolfgang von Goethe