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Archive for May, 2009

Congratulations to TUSOM Class of 2009

May 20th, 2009 No comments

We are the only real Katrina class.  The medical school is the only school to stay open, to truly persevere, and overcome all the bullshit.

To everyone in the TUSOM, congratulations and go forth and kick ass.

P.S. I posted a few pictures from graduations in my private album. Contact me if you want the pass.

Katrina Pictures

May 13th, 2009 No comments

I finally got around to posting some of my Katrina Pictures.  They can be found in the public gallery.

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Tulane: The highs and the lows

May 13th, 2009 No comments

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Huriccane Katrina

Since graduation is only 3 days away, I feel a bit reminiscent about my medical education.

My class’s medical education began like none other.  Just as the class of 2009 was settling in and preparing for its first exam, Hurricane Katrina manifested itself in the Gulf of Mexico.  Many people in my class panicked (rightfully so) and others planned on weathering the storm.  I was one of the latter.  I bought hurricane supplies (hurricane mix, rum, vodka,.. the essentials).

However mere hours before the storm made landfall, I was convinced by track of the storm and a friend at the Sewerage and Water Board to evacuate.  So decided to leave with the clothes on my back and drive to my Uncle’s in Northern Florida.  Over the next few days, I was glued to the TV and watched the horror unfold as the city I called home slipped below the water.  I was left not knowing what would become of my medical education, what would happened to many of my friends that stayed int he city, and where I would go next.

Over the course of the next month, the class of ’09 was left to speculate and rant on an online with very little information and communication from the administration (mainly since all TU’s servers/website/listservs were destroyed).  I did my best to pass the time by catching a 12 lbs large mouth bass, catching butterflies and other insects for my entomology hobby, and spending time with my Uncle.  One afternoon when I logged onto the internet, I was shocked to find out the entire TUSOM was moving to Houston and would operate from Baylor’s campus.

At first, I was vehemently opposed to this plan.  I had other accommodations lined up, and I was not convinced that two medical schools would co-exist without sacrificing our education.  However, I soon learned that Tulane even in the purgatory of Houston is better than any medical school anywhere else.

I moved to Houston with only my car and my fishing clothes that I brought to my Uncle’s.  I used my government Katrina bailout (Katrina Card) to buy clothes, a bed, and eveything else that was left in NOLA.  I failed to obtain housing through TU’s housing match system and through pure serendipity found a house through my Dad’s colleague’s sister.  The house was in an amazing neighborhood, however was in a state is some disrepair.  A friend/roommate and myself spent the first couple days removing the carpet that the last renters let their relieve themselves upon for many years.  We did many other miscellaneous repairs, while attempting to study for an anatomy exam at the end of our first week in Houston.

Much of the remainder of our first year was similar ad havoc on a condensed time table.  However after a couple months, I realized that we were getting a fantastic education; we had our TUSOM professors driving/flying in for a lectures and we had the benefit recruiting the best of the Baylor staff to fill in the gaps.  We had lectures for Tulane giants like Dr. Leon Weisberg and then followed by Baylor’s Dr Debakey (who trained at Tulane in the 1930s with my Grandfather).  We were very fortunate to be among the last classes that both of these legends taught.  And perhaps even more important, the heart and soul of TUSOM followed us to Houston.  Tulane is medical school where people want to help one another, we go out and have fun as a community, and we do not need an excuse to have fun.  From day number one, we stood in stark contrast to Baylor,… we enjoyed medical school, I do not feel like Baylor students did.

Like most of my other classmate’s, first year was very hard on a personal level.  In October, I when I was able to return to New Orleans, I found out I had been extensively looted.  I lived on the 13th floor, there was no forced entry, and the management company rented generators to power the elevators so “cleaners” could “clean the refrigerators.”   I wanted to (and still do) settle this with the building’s or contractor’s insurance company, however, the management refused to answer my questions, and I had to hire lawyers to follow up on the looting.  Four years after the looting, the case is currently awaiting trial.  The biggest lose occurred at the beginning of 2006 when my Uncle, whom I stayed with during Katrina, passed away.  This was a very depressing event for me.  My close friends know the other problems my family was littered with over the course of first year.

Needless to say every member of the class of 2009 was overburdened between medical school, Katrina, and their personal lives.  These events deeply impacted/changed every person who went through them and I believe will make us better humans and doctors.  And I believe we were lucky to have had the opportunity to do it as a class.

At the beginning of second year, we mercifully returned to New Orleans.  NOLA was full of hope.  For the first time in many years, many people were investing in the city.  Many new buildings broke ground, plans were drawn up for some very ambitious projects , and many people were hoping the city would have a true re-birth.  Oddly enough at the same time, most people had not returned, most stores/schools were closed, and many intersections still had blinking lights.  Over the course of second year, people slowly returned, schools/restaurants re-opened, and the omnipresent reminders of Katrina were slowly painted over.  Our second year was more-or-less like the education we would have received pre-Katrina.  And of course at the end of second year came the angst that every medical student feels when preparing for the first step.  I took my Step I, May 28th.  I took it early because I used our 2nd year finals to prepare for the test and I figured why not get it out of the way and enjoy the summer!  I have no regrets about Step 1.

Third year is were our educations began to get interesting again.  At this point in time, people were flooding back to New Orleans.  About 85% of the city is gone, but 2/3 of the pre-Katrina population returned.   (Most of the destruction includes projects and low-income housing/neighborhoods. )  Needless to say this creates some very interesting legal and medical problems.   On my first clinical rotation, I was shocked/appalled to learn about the complete lack of mental health clinics in a city suffering from PTSD with continuing trauma and the revolving door or psychiatric hospitals.   Katrina syndromes were notable among classmates and ever-present in the community.   I then proceeded to surgery where on my first week I made my first three diagnoses of neurosyphilis.  After congratulating myself on having the balls to speak up and get an RPR done, I had reflected on how collected the attendings/residents were and that neurosyphilis as common/boring as a cold.  I soon learned that AIDs ,  PML, G/C, and Hep are assumed in all of our patients will proven otherwise.  I have cared for several patients with active TB!  Though all of 3rd/4th year, I was able to see pathology, perform maneuvers, and see operations that friends at other medical schools have never heard off.  One thing that every Tulane graduate will take with them is the knowledge of how to work up any patient and keep an open mind that it could be anything!

Since there is an abundance of ‘pathology’ in the community, there has been an amazing outreach from the students at Tulane.  The students have successfully started a student clinic, created healthy living programs, early health education for children, and help with countless other programs.  The students do this not for school credit, but in their free time because they want to.  I must point out the ‘pathology’ is not a post-Katrina issue, New Orleans has long been a very underserved community and Tulane has lead the efforts to eliminate everything from plaque to yellow fever to AIDs to mental illness.

I take alot of pride in my education at TUSOM and most of education was from the patients I was fortunate enough to care for during my clinical experiences.  The most amazing thing is that my class saw relatively little compared to what was common at Charity Hospital pre-Katrina.   As an undergraduate, I was able to visit charity on several occasions.  I remember walking into the Charity’s ED with a 12+ hr wait.  People pulling at your coat begging for help and thinking this is America?  I cannot imagine what it must have been to be a resident in such a place.  Hopefully, LSU (who manages Charity) will see the way through Louisiana Politics and see fit to rebuild a better Charity for the people who really need it (this is a whole other rant).

For anyone considering a medical education at Tulane, I do not think is a better place.  Tulane will make you a great clinician, it offers a patient population like none-other, and it offers a fantastic community.  There are times one wished the adminstrationw as more proactive, and there are good and bad rotations.  Our Medicine program is amazing; other schools contract Dr. Weise (the Program Director) to re-organize their programs to mirror Tulane!  And I can honestly say that even our weakest program (OB/Gyn) has made tremendous strides over the past year and has quite a bright future.  I hope my brother stays at Tulane for medical school and I challange other medical schools to match education and community TU offers.

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Moving, . . . always a wonderful experience.

May 12th, 2009 No comments

I just finished moving from NOLA to Florida.   It was a mostly smooth move, but with a few very large hiccups along the way.

After match, I began looking into U-Hauls and moving companies.  I was surprised to see a one-way U-Hail being very comparable to professional movers.  And I thought to myself (albeit very misguided), why move yourself when someone can take the hassle out of it?  So, I get a few quotes and decide to go with United Van Lines, since they seemed reputable and quoted a reasonable price.

Well that is when everything began to go wrong.  After not hearing anything from United for a couple weeks, I gave them a call to ask a few questions, such as confirming the reservation and when they typically come out.  When I spoke with the receptionist, they could not find my reservation or confirmation #.  They told me the person who normally looks into these things was out to lunch.  After living in New Orleans for 10 years, I expect these things.  So I wait 4-5 hours, and after no follow-up I call back and straighten things out.  I also found some of my paperwork was missing from my packet and had to have it emailed to me.

Six days before my move, I call again to confirm.  I find out that a truck has not yet been confirmed for my move, but they told me they would have one by Monday and they would call me then.  So, I wait till Monday.

By Monday afternoon (T minus 3 days till move), I had not received a call, so once again I call to the office.  And find out things appear to be finally on track.

Wednesday morning, I decided to sleep in before the move scheduled the next day, only to be rudely awakened by several people wearing United shirts.  I was quite confused, knowing the day was Wednesday and I was moving on Thursday.  When I informed the movers this, they asked me what day of the week it was, the date, if I was sure, and if they could just move then.  At this point, I was a bit more awake and was delighted to see track marks decorating both the arms of two of the so-called ‘movers.’  At this point, I turned them away and waited a couple minutes so the van crew could phone in and I called the United office.  They had no idea what transpired and could no explain what transpired.  At this point, I was left with very little recourse, I fired them.

At this point, I booked a U-Haul with a trailer for my car (several hundred dollars cheaper than the estimate a few weeks ago!).  I then scrambled and called/emailed everyone I knew in town and was very lucky to receive help moving by a few great friends.  With a fully packed 17′ U-Haul and the company of my best friend, I hit the road to Florida.

Everything was going swimmingly till mile marker 168 in Florida, when the rear wheel of my trailer blew out.  No damage was done, but I was even luckier to have a friend making the trip with me to preserve my sanity while waiting 90 minutes for the repairman to come to replace 2 wheels (another wheel was about 1 mile from blowing out)

So other than absolute incompetence, drugged out movers coming a day early, and losing a tire at 70 mph the move went fantastically!

Swine Flu: Much ado about nothing

May 1st, 2009 No comments

Every year “The Flu” rages across the world.  Leaving in it’s wake a trial of thousands dead.  Most of the casualties being the elderly, newborns, and immune impaired (AIDs, chemo, diabetes patients).  This happens every year, and it rarely makes a human interest piece on the news.

So why is swine flu different?  Why is is causing thousands of American public schools to close their doors even without infected students, causing riots in Mexico, and worldwide travel restrictions?  The simple truth is the media love fear.  Fear gets them ratings.  The so called swine flu is N1H1, these refer to surface proteins on the flu capsid, is mainly a zoonose (native to animals, not humans)  and when zoonoses leap into humans it can be a big concern.  Since the human immune system has never seen these viruses before they are often devastating.  The next pandemic killer will likely be a zoonose of pox virus.

So why shouldn’t we worry about swine flu?  Simple, the vast majority of people who contract the virus have very mild flu symptoms.  Most of the people who have died from the virus were elderly or very young.  Preliminary studies indicate that it has a very low virulence value (it is not well adapted to humans and does not easily spread).  So this means that the virus will only spread in heavily populated areas, causing mild illness, and can likely be curtailed with nothing more than hand-washing and other sanity rituals.

Fear is an easy emotion to capitalize upon and make ratings!   Yes the public needs to be informed about epidemics, but schools should not be shut down.  Yes 328 people have been diagnosed with swine flu and 18 have died.  That is 5% and that is a terrifying number.  But here’s what the media doesn’t want you to know.  There have only been 328 confirmed cases.  There have likely been >3000 total cases!  Suddenly 0.5% mortality doesn’t seem so news worthy.  This more realistic estimation makes swine flu about as harmful as the regular common flu.  And as swine flu gets better at infecting people, it will likely be less virulent…. as a good respiratory virus succeeds the most if the host feels good and coughs while at work/school.

The solution is simple.  Wash your hands.  If you feel sick, have the common courtesy to stay home a day or two (sick days are NOT for going to the beach!).  If you feel a little sick, stay home and chances are you will feel great in 48 hours; there is no point in going to a doctor’s office and being exposed to everyone else’s germs.  If you feel really sick, see a doctor.

Categories: Intern, Random, Rants Tags: , , ,