Happy 25th Christmas, Moron.

February 3, 2007

“Happy Birthday, Topher!” I’m half asleep at 7am as Mrs. Thatcher gives me a hug. I sit down to poke at my porridge (had to look up the spelling) and drink my orange juice. I turn to Kelly, “We’re working too much. If your mom hadn’t told me, I would have completely forgotten that today was my birthday.””You’ve turned into that guy.” I know it. Our plan was to return from the first two years in the islands and hole up in a library for two and a half months, studying furiously for the Boards. Coming from the Caribbean with the deck stacked against you, it’s not enough to pass this test; you have to destroy it. Regurgitating everything we’ve learned during two years (in an 8 hour test) sounds like fun.

We are studying at the University of Cinicinnati medical school library. It’s six stories tall with walls of glass, no furniture, and doors at both ends to let the heat out with everyone’s smoke break. We shiver underneath our long underwear, hats, fleeces, coats, scarfs and mittens. Since coming, I have spent $200 on layers. Not clothes; layers. If it weren’t for the desks, I’d study in the Thatcher’s front lawn and save the drive. We put in ten hours at the library, come home for dinner, and put in another three hours before bed. Saturday is not different from Wednesday. My week is seven Studydays in a row and I guess I wasn’t that surprised that I forgot about my own birth. C’est la vie.

We’re here more than any of the medical students, and people are getting curious. We’re learning names as they stop by to size us. Tim is my favorite. Tim’s skin is taught across his face, revealing the bug-eyed intensity that drives him to walk fitfully, arrange everything on his desk perpendicularly with one inch margins between objects, and has him sniffing around wondering why we’re sitting in the spot that he has clearly sprayed with his urine. Tim’s obituary will include the fragments “26,” “dedicated to helping people,” and “massive heart attack.” We really like Tim.

Then there’s Puss n Boots. If you’re reading this PnB, I love you.

The rumors have circled and everyone knows we’re from SGU. A few students stopped by for help with Pathology and Physiology, and we took some pride in being “the guys from Grenada who probably know the answer.” We’re wearing it on our sleeves. Our SGU sweatshirt sleeves. I guess I owe you that story too.

Kelly and I loved SGU and our time in Grenada. For my money, I’ve never lived so well and my life was never so rewarding and simple: wake up, learn things, sleep. Also tan. Like anyone proud of his school, we both wanted SGU tshirts and sweatshirts to wear back home and around campus. Problem was that the SGU bookstore didn’t carry things you’d want to wear and their prices made sure of it. Trying to change the world, Kelly and I contacted the main offices with ideas for shirts. Six months later, nothing had happened.

So we were in St. Vincent at this point with no bookstore and no chance to buy these shirts. “You know, we could just make them ourselves and sell them to people.” I looked at Kelly like he had two heads. “My brothers and I did it all the time. It’ll work.” So with that, Kelly and I searched the island for a tshirt printer, made a few designs on our computer, and did some market testing. Once we settled on a design and colors, we started paying people that were traveling to the US to fill oversized suitcases with cheap clothing. After a few rounds of this, we had the merchandise, the design, and the means. We invested $1000 of our loan money into the project and began selling them in class to students, faculty, staff, anyone.

We ran deals on buying three shirts at a time. We took custom orders for new shipments. We had all sizes, all colors, a cash drawer and a functioning inventory. We cleared an obscene amount of money and still managed to sell them for less than the bookstore in Grenada was charging. Illegal? Not in the Caribbean, mon. The profits paid for our rent and utilities for almost three months. Good times all around.

Back in the library, in what was turning into a pretty decent birthday, Deathmetal came by. Deathmetal is the skinny kid that plopped down for an early dinner in the library, put in his headphones, and proceeded to blast Metallica so loud that I could hear every lyric and sweet guitar lick from thirty feet away. Everyone stopped what they were doing to stare at him, waiting for him to figure it out. Each of them, so miserable being so polite. The pageantry was killing me. It was like a priest farted in church, was how hard it was to suppress my laughter right then. My schoolgirl giggling got Deathmetal’s attention and he looked at me with a question mark on his forehead. How he heard me, I don’t know. Guy’s got to be deaf from the volume.

I had his attention; what could I do?

I COULD ROCK. Slow at first, I began to lip sync every lyric as I heard it and began pantomiming Lars Ulrich’s thundering drum set. I didn’t half-ass this either; I could have been at a bachelor’s party three beers away from a canceled wedding for how committed I was to this performance. It was glorious. It took a few beats for him to realize that (a) I could hear his music and (b) this was inconsistent with the intention of earphones. He stopped the song, looked around, and sorry’d us. We laughed so hard after that, I thought I’d get sore.

I went to bed that night surprised to be 25 and totally oblivious to the fact that I had no missed calls on my phone as I set its alarm.

The next morning was the same as all the others. The day in the library the same as all the others. It was Studyday, just like last Studyday. It was not untill I came home and checked my email that I saw a few well wishes, and none of them belated. I went downstairs to see if the envelope from my parents had arrived a day late as my dad had promised (no luck). I then headed upstairs to see eight missed phone calls. I checked the date on my computer: Jan 30th, 2007. 8:40 pm.

Mrs. Thatcher had gotten the date wrong and I hadn’t realized it. This meant that twice in two days (in the same year) I had forgotten my birthday. I never thought I would be THAT guy. I told her and Kelly and we all had a nice laugh, but really I was feeling pretty disoriented. I guess I had it coming the next morning.

Half-asleep at 7am, I walk downstairs to eat my porridge. Mrs. Thatcher walks up to me, gives me a big hug and says, “Merry Christmas, Topher.”




October 8, 2006

It just took me 15 minutes to outsmart a mosquito in my room. The bastard has been getting fat, happy, and maybe a little buzzed off me the last few nights. I lit a citronella candle in the room and discovered that the mosquito has a higher tolerance for that smog than I do. Mosquitos don’t wear belts nearly as well as I do, so it all balanced out.

It hasn’t been a productive day or week, so I might as well be the writing-kind of nonproductive. Some of my favorite lessons from the term:

If you ever take an oral estrogen pill, there’s a chance it contains equilin, which is obtained from a pregnant mare’s urine. Nocebo means ‘I will do harm’ and someone needs to name their next dog “nocebo”. Amaurosis Fugax is my new favorite term though I’ve forgotten what it means. Crazy people have hypomarble-emia (joke courtesy of roommate Kelly). The pharmacology course has taught me that a shot of expresso before a pot of coffee in an afternoon is properly termed a loading and maintenance dose of caffeine. It’s nice to have fancy words. Read the rest of this entry »


September 13, 2006

Shout My landlady just popped and brought the baby over. While my roommates are cooing over how cute he is, I ask if I can hold him. Want to know a cool trick about babies?

If you let a healthy baby’s head drop suddenly, it’s arms will reflexively extend and grasp. I think this is a defense against falling from the mother’s arms. Instead, I like to use it in the following context where “*” means dropping the baby’s head.

“Now waiiiit a minute. You know you make me want to SHOUT*! Come on now, SHOUT*! Come on now, SHOUT*! Come on now, SHOUT*!”

By the way, this never gets old.

Greetings from St. Vincent. Read the rest of this entry »

Goodbye Grenada

July 17, 2006

Grenadian Sunset

I came home from my family reunion to books. For seven straight days I studied with breaks for food, completed hundreds of practice questions and made review sheets. And then review sheets of my review sheets. Monday was the Path final. Most people walked into this exam knowing exactly how many they could miss to save an A. I was no exception and after the exam finished and we were allowed to check our answer, you could hear people cursing under their breath as the first fifty questions sealed their fate before they could consult the other hundred.The toasts downstairs were split evenly between “Horray!” and “Path sucks!” My roommates still had some shopping to do. You see, Kelly is in charge of the Senior Slide Show and the refreshments. They have given him entirely too much money.

After getting alcohol and pizza, the roommates meet up to practice for the Advanced Clinical Skills final. Each of us takes two tests, learns them, and performs them on each other. I pulled Peripheral Nervous System and Abdomen. The exam is cumulative but we ignore the tests premidterm.

The next morning (9:00), we put on our Sunday best and grab our little kits. Here’s how it works: every imaginable test is laid out on a table face down. You stand at the top of the lecture hall until summoned to pick randomly. You then follow your tutor into a booth with a standard patient and begin. I picked up the Venous System. Lame. Because I haven’t studied this (premidterm material), I look at the checklist to jog my memory of the Trendelenburg test and Pratt’s test. The tutor yells at me, “You can’t look at that! Now follow me.” I play dumb, drop the test back into the pile face down and follow her. “Where’s the test?” “You told me that I shouldn’t look at it!” “Go back down and grab the test.” She shakes her head at my idiocy. I walk down and pull the Abdomen Exam. Perfect. 95 A.

So I’ve finished Path and the ACS lab. I’m feeling the euphoria of “finished.” We all sit around the apartment watching the World Cup and helping Kelly finish the slideshow. It’s going to be great. We set up at 6:00 the student bar which consists of several 5 gallon jugs of Hurricanes mixed by our own Louisiana natives. With the class appropriately loosened, the slideshow begins. It’s a riot with clapping and cheering along its entire length and Kelly is the true rockstar of the hour.

The next morning, instead of sleeping off a hangover with the rest of my class, I’m in the Anatomy lab with a bone saw, cutting some man’s hat off. I can sum up the entire experience with one word.


If you’d like to read the complete description, click here. The gist is that cutting into someone’s head, while gruesome, is also thrilling. To carry out the dissections that I want (on an intact jaw) I have to cut a circle around the top of this man’s head, cut out his brain, and then cut straight down the middle of his face. After all of this, you pull the two halves apart and you’re looking straight down at the target. My arm is sore and at least once I was shocked out of the moment by the absurdity of it: left hand clutching the lip of his skull, right hand punching the hacksaw down the center of his face and rattling of in my head the spaces in our skulls that I’m destroying. All of this and smiling, I could forgive someone for stumbling into the room and smartly assessing the situation before walking out slowly. And backwards.

What I’m doing know has nothing to do with collecting data and everything to do with a pretty picture. You see, whenever you carry out interesting anatomical research, you have to do a good job collecting data, but the pissing contest of “who is the best dissector” is far more important. That’s why I’ll spend two whole days on a jaw that would take two hours to dissect the ugly way. All that time in the lab, alone, was difficult, especially with everyone else out on the beach day after day.

Especially when all of the pacemakers go off at 9:15pm every night. They’re screaming at someone to change their batteries. I whisper back to them, “It doesn’t matter.”

So I end up spending a week dissecting a few jaws and sending off a case report to the Journal of something or other. I’d love to sit around and just be nostalgic about Grenada, but my time is tied up in boxes and small errands. I do make time for a few things. I ride to Grand Anse to eat at Nick’s for the last time. After that I see Mr. Green Jeans and ask for one last banana shake. I’m not even that hungry; I just want to hear him swing the mallet. I make it up the hill to Maurice Bishop highway. I wait my turn to pass a Red Reggae bus that opens up the rest of the straightaway. And with my shirt flapping up against my back and the Hero Panther Moped squealing for a fifth gear that isn’t there I’m reaching 80km/hr and flying. Tomorrow morning I’ll be calling a bus to take me to the airport, but that’s tomorrow. Right now I’m passing the wind, the sky is blue walls with a pink ceiling, and it’s beautiful.

Goodbye, Grenada.

Related Strangers

June 16, 2006

I have ants in my pants. I have them in my computer. And in the apartment. I’m trying to build up a head of steam in these last days in Grenada and it’s tough with all of these ants. I’ve discovered a lot about myself in the process. I am, if nothing else, an unflinching murderer of ants. I go to brush my teeth and they are swarming around the cap of my whitening toothpaste. They grin at me with teeth three shades whiter than before. I mash them.

By the time I’ve finished, I’m too worked up to sleep. The breast helps. I’ve learned that nothing is so boring as female pathology. If everything else fails, I read and write. I’ve read so much lately since discovering GoogleReader. I’ve discovered that an entire world of medical writers exists online. Students, residents, attendings and retired. They all have interesting things to say and many have published their work. I started reading one journal and lost a week of my life to depression. You see, his writing is much better than mine. Painfully so. I went back to his archives over the last three years and read it all. Exhausted, I decided I would could never write as well.

Or I could just copy him. So I started writing online as well, a second blog to the one that keeps the record of all of these emails. Sorry for cheating on all of you. The material is a little more stream-of-consciousness and a little less appropriate for mass emails. I write about wearing sheepskins and kicking wildly, you know: pagan things. I started writing a few medical essays and have submitted them to an online magazine of medical writing. I had two articles accepted and, feeling worth something again, have stopped writing so frequently.

I have a piece of software that tells me how people find my site. Search items include:

(1)the greatest pair of shoes
(2)inguinal hernia video exam
(3)coax feces from anus (Can’t. Stop. Laughing)
(4)yellow jealousy
(5)”why go to medical school?”
(6)reasons not to go to medical school
(7)shiny scalpel gonna cut you open
(8)where is the hanging statue of Lenin in Prague?

Back to the books. I have learned that in Rheumatoid arthritis a painful growth of the joint occurs and this is called a “pannus” which makes people want to walk less, become obese, and develop an apron of fat that hangs over their knees, called a “panus.” I have no idea how my dyslexic friend is cutting it here.

In Clinical Skills I keep getting the same tutor. Most students hate this guy because he’s unprofessional. He cracks jokes where every punch line is “that’s what SHE said!” He offers to meet all of us at Angie’s after class which, from what I’ve pieced together, is a whorehouse behind the Grand Anse Bank. He sits nervously, rocking back and forth always stealing peaks outside the curtain. Whether he’s checking out a student, watching the clock or high as a kite I don’t know. He describes a certain type of gait as “Clarke’s Ataxia,” after his favorite rum. In a previous life he inspired A Confederacy of Dunces.

Henry VIII

Why don’t we complain? Why do we continue to let him be our tutor? Well, this is Clinical Skills after all and each of us thinks that he’s making us better at handling unprofessional people. We’re also trying to diagnose him. My money is on “Henry the VIII’s Affliction” otherwise known as alcoholism with a splash of tertiary syphilis.

Still in school, my family threw a reunion in the Poconos. I took the weekend off to meet related strangers. Off the plane and into the rented van, we quickly fall into our old roles: passive-aggressor, attention-seeker, policeman, frayed nerves, joker, instigator, smartass, complainer. I should give my family more slack since I’d forgotten how funny they all can be, when drunk. Two drinks in at dinner and we’re laughing about our own idiocy and the tiny miracles of iPod Jesus.

arcade game

All’s well. I have my Path final in three days, so I’m wrapping this up. I’m embarrassed that my arm is sore from playing a video game where I had to hold a plastic gun at eye level for twenty minutes. I am not embarrassed that I spent twenty dollars to beat it (not an exaggeration). Of course, money was spent on dumber things.

The Larkin Clan was 6 tables strong in the banquet hall, and my brother and cousins were sitting at a table with a pitcher of beer to a man. Wasn’t too long before every other chair was in concentric circles around the booze and people were trying to eat seven saltines in a minute. I’ve never been to a race track, but this is what I imagine happens: Everyone sits around with money, someone emerges as an “expert” on how to pick a winner, and then people make twenty dollar bets while the horses choke on saltines. One horse can only finish two saltines and is put down while everyone mutters that, “it would have happened sooner or later.”

saltine cracker

This was the same evening where I accused a relative of being too shy. Turns out her jaw was wired shut. In good company, My uncle wondered on a crowded elevator if this was some kind of “wheelchair convention.” Close, it was a retreat for people with Multiple Sclerosis. Yeesh.

By far the biggest event of the weekend was Karaoke. I cringe whenever I see that word but my family did a fine job. One of my related strangers is an actress getting her masters. She went up and brought the house down with “Material Girl” and “Genie in a Bottle.” My cousin Ryan took a different approach: gusto. 6’4″ monster that he is, it’s hard not to cheer.


Karaoke singer’s are fascinating and I’ve tried to classify them.

The singer: this person has some pipes. They can pick a song, do everything correctly, and walk off to applause.

The shower: this person is delusional about their pipes. With a singer’s swagger, they pick a song, match it note for note until you don’t, at which point it’s jarring and painful for everyone. They didn’t know this would happen since they usually have the backup singers inside the radio to carry them. You feel awful and pity clap.

Guy singer: rumored.

Average guy: plays his strengths and avoids the weakness. For most, this means picking a song were the singer “talks.” REM’s End of the World or Billy Joel’s We Didn’t Start the Fire fit the bill. You talk, louldly with gestures, and fool everyone. Don’t be fooled by Johnny Cash’s Ring of Fire. That’s a hard song.


The Calvin: you’re particularly awful at carrying a tune but by the grace of God you know this already. You pick a “talkie” and then butcher it, all in good humor. It’s better if everyone knows this song so that they become involved and share in the joke. You then sing Billy Joel’s Piano Man and manage to sing “La, did de da, did de da-ahhh!” off key. People laugh. People cry. You’re the hero of the night. Nice job, Cal.

That was the reunion. Cheers, topher.

(1) the journal that is hauntingly well-written: http://tomwaitsatemybaby.blogspot.com/
(2) the online medical magazine is Grand Rounds. The archives are here.
(3) My youngest sister just graduated from High School and received an iPod Nano. Supposed to hold 1000 songs, she was boasting that hers held 1050. I asked her how many of the songs were about Jesus (she’s very religious). “Around 400.” It’s a miracle.

Commencement of Distraction

May 20, 2006

My sister, Honora, is graduating this Sunday. She’s the last in a long line of grey hairs for my folks and I’m so proud that she’s leaving the state for Regis University. Get free, Honora. Get free.

Speaking of freedom, the hog squeals again. I dumped $300 into my moped to get it running again and it feels great to be cheating death on a daily basis. Just yesterday I was trying to pass someone that decided to swerve violently in front of me and slam on the brakes in hopes of causing an accident. Thank you slackline; the balance you taught me saved my life. It was over before I knew what happened, but the students in the car behind me let me know:

“He tried to kill you. You tried to swerve out of the way and your bike went sideways and skid forward a yard without flipping on top of you, and then you got control and went to the side of the road. He looked back at you and screamed something. It was definitely on purpose. Is your foot ok?”

I look down to see that two of my proud climbing callouses have been ripped from my foot and the holes are bleeding. Sandals are not protective. I thanked them for checking on me and continued driving towards the nearest bandaid. I think that when my life really is in danger I’m going to be robbed of the whole “life flashing before the eyes” bit since near as I can tell I just draw blanks. The bike is now for sale.

For the first time since coming to Grenada a year and a half ago, I’m homesick. It doesn’t help matters that I am alone now since Sherin and I divorced. Sorry to dash so many hopes about torturing her in Michigan but it isn’t to be. No, I don’t want to talk about it. And instead of dealing with it in a mature way, I’ve elected for distraction.

This includes looking online for a tutorial on how to whistle with two fingers. I have technique but not power. I’ll keep you posted on how it goes. I still say the alphabet backwards once a day.

I edited the paper for the Annals and sent it back. Two days ago I received notice that it was accepted. I feel sorry for everyone with a birthday that’s 4-6 months away, because you’re getting a copy of the Annals of Thoracic Surgery that you DO NOT WANT and WILL NOT READ but are GETTING ANYWAY. I found out that I have one of the oral presentation slots for Congress this summer. I’m up against 14 other students, one of which won the prize last year. I have it on good authority that the boy whose voice cracks the most often will win this year. Fingers crossed.

The exams I studied so much for went well and while Path still remains, Microbiology is over. I learned some amazing things in that course and am sad to see it go. A few of the gems:

Military officers do not contract gonorrhea, that’s for enlisted men. Officers are afflicted with “bacterial urethritis.”
I rarely spell “gonorrhea” correctly. In fact, all medical words that contain an “h” have to be preceded by “rr.” Diarrhea, amenorrhea, rrhiccup, and so on.
Doctors are paid by the syllable and charged by the word. That’s why you’ll hear “Pyelonephritis by hematogenous spread” instead of “The bacteria got to your kidneys by your blood.” If each word costs a dollar and each syllable pays a dollar, the first sentence pays $9, the second sentence pays $4. So as a physician, I can either be plain-spoken and poor or rich and confusing. I think I’ve found my calling.


Bloody Mess

May 5, 2006

I’ve had a lot of practice since my last email, and am happy to report that I can now say the alphabet, backwards, faster than I can forwards. I’m clocking in at under three seconds. Go ahead, time yourself.

Kudos to my Mother and Petra, the only two people to read “retsfa si tebahpla” and realize that it was supposed to be “retsaF si tebahpla,” or “alphabet is faster” written backwards, which is in fact retsaf.

For all of those coming to Michigan this summer, Sherin is in tow and terrified. She has learned the names of the five brothers and five sisters, the spouses and children. Her three comments thus far:

“I cannot believe how Irish you are. Alex, Colby, Honora, Maura, Connor, Colin, Riley, Kimberly, William, Edward, etc.. My name is “Sherin”. I need to dye my hair red and my eyes green.

“I say “like” too much. I can’t meet your father. He’ll, like, never want to talk to me again.”

“Tell your family that I’m not going.”


I’ve been keeping busy aside from the general grind of school by wrestling with SGU over their admissions material since February of 2004. I wrote a “Welcome to Grenada” guide after first term and had that sent out to the next class of students. People seemed to like it. I reminded the folks in New York to send it out again with last terms class and they forgot. It’s complicated, so I understand. Let’s see if they can box their way out of a wet paper bag and send it off this term. To make sure, I emailed the person responsible with the letter, again, and have not heard a response.(I’m going to jump around a bit)

So the 2006 Match Day was a month ago. Match is a process where every gradating medical student ranks the residency programs that they want and every residency program ranks the graduates that they want. Somewhere, in the middle, they meet. Coming from a Foreign Medical School, about 50% of graduates match. At SGU, the number is closer to 80%. For a US med student it’s closer to 100%. Like all the students at SGU nervous about the hurdles ahead of us, I wanted the data from the match. I wanted to know how SGU faired. It wasn’t a surprise to me that it wasn’t available.

As a student here, little of the information that we want is available. For example: next term I’m going to be living on another island working in a hospital. While there, I have to choose where in NY or NJ I want to have my second two years of medical training. I’ll probably want to know something about those hospitals before I make that choice. I’ll want to know what other students thought. Actually, I want to know now.

Unfortunately, that information isn’t available to us. The reasons are 1) the school hasn’t hired someone to make that happen and 2) no student has just been pissed off enough to do it themselves. The Kantian that I am, I know that if I’m going to be mad at some student for not having already done it, then I have to be mad at myself for not doing it now. So our story begins.

I wrote the folks at studentdoctor.net saying that I was an SGU student and that I wanted to let people know about the school. They gave me a nice little cubicle on their website where I now write about SGU. I started my own website and began posting “guides” to each term and class, to Prague, to the BSCE test, and so on. I advertised this in a few forums at school, the assistant dean of students got a hold of it and included it in a campus mailing, and so at least a few students here are checking it. I made an appointment with the assistant dean of admissions and showed him everything that I had. Luckily, another admissions dean was on the island and came to meet me a few days later.

I gave him my pitch about information that’s easy and accessible, that students are unhappy about being in the dark about so much for no good reason, and that the school was losing applicants every day that think they’ll be studying by candle light. I wasn’t asking for much, I had done most of the work already, and I just needed someone with the power to say “yes” to say “yes.” And he did. He liked all of it. I gave him all of the files, the website, and he got on a plane to New York to speak with the not-assistant dean of admissions. So I may have a new job with the school, and maybe in three years students will be complaining that the Student’s Guide to Grenada is out of date. But at least it will be there.

So that’s all for now. I have a testathon over the next few weeks. And I’m disappearing for a bit.

Everyone join me as I look forward to the summer, topher.

retsaf si tebahpla

April 17, 2006

Sherin thinks that I have a gambling problem. It started with the SuperBowl bet of $500 that turned into $1100. Then at the IEA talent show there was a raffle. I bought 200EC in tickets and got 100EC back. Then for Sandblast I gave Sherin another 200EC to buy as many raffle tickets as possible (which involved filling out my name and phone number 200 times, poor girl). I ended up with over 700EC in merchandise and gift certificates. My gambling problem is convincing Sherin that my winnings are not her winnings. My logic is bulletproof: “If I had lost a whole lot of money, would you have shared the loss?” Too bad Sherin is logicproof.

I’ve always wondered why police officers ask people in a sobriety test to say the alphabet, backwards. No one can do it, right? I think the trick is that only a person with impaired judgement would try to pull it off, so even if you go from Z to A flawlessly you’re going to jail. While I never plan on putting myself in that situation, I cannot deny that it is an attractive stupid human trick, which is why I was thrilled when Sherin asked me if I could do it the other day. She had no idea how seriously I was going to take it. She would say “Z”, then I would say “Y” and so on with a reset if either one of us missed our cue. Within two minutes Sherin didn’t want to play anymore as I started screaming, “F comes after L? Come on, you know this!” This is why I can’t play with others. The interesting thing is that you should be able to say the alphabet backwards faster than forwards. It has everything to do with the phonetic groupings. Everyone knows that LMNO rolls off the tongue like “elemeno”. But try this beaut on for size: VUTSRQPONMLKJIHGFEDCBA


See what I mean? You really have to slow down at the end if you’re going from A to Z. Don’t worry, when I get home we’ll race each other. If I knew how to record it and attach it to this email, well, you’d be listening to it.

So Sherin’s Mom and sister are in town, which means Sherin finally gets a new computer, which is a miracle considering her history. When she first came to GND she dropped her computer on the floor, cracking the screen. She made the call back home to beg for a new one and somehow “I dropped it and broke” turned into “It doesn’t work right because it has a virus I think.” Her father was nonplussed. A year and a half later and that fixed computer is failing with a 30 minute battery life and a broken touch-pad. So the last computer her father will ever buy her is in her mother’s luggage waiting in New York to board the plane when Sherin puts the laptop on a chair with the mouse inside. The details aren’t important as they implicate me, but suffice it say that Sherin sat on her laptop and cracked the screen. As with most things, I recognized the humor of the situation and started laughing immediately. Sherin had a panic attack thinking about the loss of her Father’s love. It balanced out.

The meeting of the mother and the sister (Tasha) went well enough. Tasha teaches the first grade and has great stories about children being children. My favorite was the book report about “Elaphits Gerald”. Her mother and sister being here is also a great opportunity to whip out my Sherin-impression. Judging by her scowl, I say it’s dead on. But more than anything, the best reason to ever meet the parents is for the treasure trove of “You sound just like your Mom,” “God, you sound just like your Mom!” and my personal favorite, “Whatever you say, Mrs. T.”

Working on being non-confrontational, topher.

Golf is LIfe

April 17, 2006

We’ve just added another course to the pile. Walking into the lab, the professor announced that this was “Clinical skills, Advanced clinical skills.” This was funny only to me. When we broke into groups I introduced my self as “Lastname, Firstname Lastname.” Again, only funny to me.

I am with half of my path group as we learn how to take vital signs, inspect the cervical lymph nodes, etc. I hopped onto a bench and volunteered to be the dummy patient for the instructor. She inspected my scalp (newly shorn), my throat (I shaved off my neck-beard for just this reason) and my mouth. Now it’s the group’s turn to mimic her. With anything like this, there’s about 10 minutes of awkwardness before everyone relaxes and I enjoyed every moment of it.

First, when asked to describe the findings of examination, my friend Peter was very uncomfortable mentioning my Male Pattern Baldness. He was also unsure if my skull was of normal shape and size. The tutor said that it was within normal limits, which is tact-speak for “you’re absolutely right.” A few minutes later, Scott is trying to see the back of my throat and is accusing me of having a tongue that is “too big for my mouth. No one can see past that thing.” When inspecting the ducts underneath my tongue, I am politely asked not to gleek on anyone. I do my best.

Eventually more members of the group volunteer to be patients. We use tongue depressors to move the cheeks and tongue around. Each patient is responsible for holding his/her own depressor so that cross-contamination doesn’t happen. It takes three minutes before Scott and Sam are making-out by proxy.

All in all, fantastic experience and my new favorite class.

I wrote a few days ago that the dodgeball tournament was coming. After some soul-searching, my roommates and I decided not to play. We’re growing up, and that means becoming very boring. Instead, I sat in the library on a Friday night while the entire campus was cheering drunk. In my defense, the time was put to good use. Because SGU is not a wealthy institution and has no history of research, resources are scarce. To get around this, Marios emails a friend of his at Harvard with a list of journal articles that we need. His friend takes a camera into the library and sends us pictures, page by page. I then have to remove the camera glare, rotate the pictures into frame, and remove every thumb with Photoshop before I can send it to our black and white printers. Even in academia, there are hand-me-downs.

So dodgeball didn’t happen, but golf did. The roomates had signed up as a team, and as any team we try to bring the ridiculous with us. If it’s Kelly and Winston wearing togas to announce the beginning of the winter Olympics to our class or dumpster-cardboard Halloween outfits, we try to come up with something. We were too busy this time, but figured the least any of us could do was stop shaving and play with mustaches. Yes, I know exactly how stupid that sounds. The mustache didn’t look that great, so I decided to take it a little further. Into my head.

The golf tournament was a complete success and very profitable. The highlights:

Riding the 7am bus through the hills of GND with people still out from the night before, letting their 80s costumes double as totally normal golf attire. Getting a chip-in-birdie on the first hole from 60 yards out. Hitting a great drive on the 6th only to watch a Grenadian caddy walk into the fairway and pocket the ball. Arriving moments later huffing from a beer-fueled tee box sprint to find that my ball was fine. Finishing 9 holes of “captain’s choice” golf +8. Shaving the rest of your head to look professional for your tutoring session to be told that you have a sunburn-negative and are not fooling anyone.

1) “gleeking” is when you press your tongue in such a way that you shoot jets of saliva from underneath. I have a talent for this, both voluntary and involuntary.
2) “make-out by proxy” Like sharing gum, what was in my mouth is in your mouth. Sam and Scott were inspected with the same tongue depressor.
3) Captain’s Choice golf means four people hit a drive and all take their second shot from the best drive, and the best chip, and so on.

Not a doctor, not by a mile

April 6, 2006

Early this morning, at 1:02am, the time read:

01:02:03 on 04/05/06

Sherin says that this is special because it won’t happen again until 2106. I say it isn’t special because it will happen again at 02:03:04 on 05/06/07, and so on, until 09:10:11 on 12/13/2014 when we run out of conveniently numbered months.

Sherin says that, “No, it only counts if it starts with the number 01.”
To which I retort, “A straight is a straight! It’s the same thing!”
“No, you don’t start counting at 02, you start counting at 01.”
“You can start counting anywhere, so long as it’s a sequence with regular intervals!”
“TOPHER! A number line starts at 01! Not at 02, 01!”

Sherin wonders why I have to argue about everything. I argue that I don’t have to argue about everything, proving her point.

So I haven’t written in over a month and with good reason. I’ve been busy. For the first time I feel like a real grad student. Ana, when I see you again, I’m buying us beers and you must join me in a heavy sigh.

Pathology swallowed us hole and I haven’t handled it with any grace. In one week, the Board of the research society held elections, passed off any and all responsibility for training our replacements and the planning of the golf tournament. We must have thought we were saving time. Haste.

What happened, of course, was a President that was all show and no work, an alienated Board, a collapse of communication within the club, a huge drop in club morale, and a pending disaster on the golf course. Waste.

So to correct this we recruited our faculty advisor, Marios, to tear apart and emasculate Napoleon to the point where he can make no decision outside of Board approval. The previous President is now present for any and all meetings to report back to Marios and to keep Napoleon honest. Second, I started talking to the brave students that decided to make the golf tournament work. They were very excited to have made a brochure for golf. It was tri-fold, double-sided, and everything. It talked about how great the tournament was going to be and when it was going to be and a place for you to write your teammates. I found out about this the day they started handing them out so grabbed one. Here’s what it was missing:

What was included in the cost
Contact information
Registration information

But it was cool-looking. I’ll give them that.

So I wrote them an email detailing what changes had to be made to the brochure before they could distribute it. On second thought, I wondered how the actual tournament planning was going. So I wrote a second, more epic, email that took a player through the day of the tournament, pointing out everything that had to be handled before during and after the tournament for it to work. It was about 1000 words. To be tactful, I signed off:

“I’m sure you guys have thought of most of this already, I just wanted to make sure.”

The guy running the tournament saw me later that night. He was ashen.
“We hadn’t thought of any of that.”
“Well, you realize that all that stuff has to happen, right? The tournament doesn’t just throw itself, right?”
“Now I do.”

All of this is superimposed on Pathology and Microbiology, mind you. Once again, medical school has managed to be more work this term than the last, than the last, than the last. I bet next term is easier.

My Path group is made of 10 other people, all friends, and I hate it. I get three or four pictures of a disease. In the stomach, eyeball, head, leg, etc. I have to go look up that disease, know as much as I can, and then teach it to the rest of the group. I get to do all of this in front of an tutor (MD) who wants nothing more than to remind me that I am not an MD, but an idiot. Whenever I get anything wrong, or omit an important piece of information, the tutor calls me on it, and I promptly embarrass myself by stumbling through nonsense in a squeaky, pleading voice.


I just earned my group a ten minute exposition on the disease. Had I known my material and answered the tutors questions correctly we could move on and finish the 40 slides that are due this week. Instead, we have to come in on our days off. SO the extension of this is:

If a person in my lab doesn’t completely prepare, I don’t learn the disease and have to look it up on my own AND come in on my days off to finish the remaining slides. So naturally, I cringe every time someone is presenting and I can hear a quiver in their voice, because the tutors can hear that quiver and it’s like crack to them. And the entire time the tutor is speaking slowly to us (because we are idiots) I can feel my rage replacing my friendship with this person.

So 1-3pm, every day, is a stressful time in my life.

Luckily, my group has a sense of humor about it. We have two awards. The first is a statue of a woman in the throws of passion riding a crescent moon. The second is a sheet of xmas stickers. Brilliant comment of the day or best performance earns you the statue; and the biggest idiot gets a sticker on their books. I’m happy to report that I have dodged the stickers so far and have taken the trophy home twice.

It’s important that I keep my blood pressure under control, and I do give myself breaks now and again. A few weeks ago the 42nd Airborne division came to GND for disaster preparedness exercises. They were traveling between the islands setting up emergency clinics and treating everyone for free. They were nice enough to accept student volunteers and I jumped at the chance. For the first time, I was on a boat traveling through the Caribbean islands. We got off at Petite Martinique, marched the supplies down the road from the dock to an abandoned building where 200 people sat, blocking every entrance and exit, waiting for us. There were two minutes of confusion before someone started barking orders and everyone else started following. Bless the military for their chain of command.

I ended up in triage, asking little boys and girls why they felt sick. They would look puzzled, stare at their mothers, and then remember that their stomach was hurting them and their eyes were scratchy. No matter how many times I tried to tell the mother’s that it was ok to say “check-up,” they insisted that their children were very sick. We developed a code with the physicians:

“abd pain” means check up
“loss of appetite” means check up
“itchy eyes” means check up

The physicians had their own code:

“Here’s some medicine” means “I bet you have thin blood, here’s some iron.”

Everyone was treated for thin blood. It’s the carpal tunnel of free clinics.

Later I went to the General Practitioner and saw five patients before we had to pack it up and head back to GND. The highlight was an old woman who came in with “a stomach ache.” She had a strong heart murmur, hypertension, swollen legs and abdominal pain. I’m still teaching Neuro and Physio, so I knew this woman’s pathology pretty well and was able to talk to the physician about everything I found during her workup. She listened to all of this but didn’t catch any of it because of all the jargon involved. I became excited that I knew what was going on with this woman and she heard it in my voice. She smiled and asked what we were talking about. The doctor looked at her and said that we had medicine that might make her feel better and we would make sure she saw a heart doctor that week.

I’m not sure how to describe the feeling you get when you’re excited about someone’s congestive heart disease, but I hope no one reading this ever gets to go through it.

Another great distraction was my roommate’s parents coming into town. Sam’s father is a Cardiothoracic surgeon, and every year or so he and his surgeon friends travel to a different vacation spot for a week with their wives. They came to GND and decided to cook for us every other night, entertain us with stories from their careers, and explain to us why surgery was the worst profession to get into and why surgeons hated their jobs. So it’s official: I have yet to discover a single medical discipline where the people practicing it would recommend it before panning it. It’s a bright bright future.

They great thing to come of it was having Sam’s father look over the paper I had written, tear it apart, and make suggestions that helped turn it into the type of paper that could be submitted to a surgical journal. With those changes, I rewrote most of it over a weekend and submitted it with Marios to the Annals of Thoracic Surgery. Fingers crossed, everybody.

Back to school…

So two weeks before the Path exam the usual library bunker shenanigans started, complete with room-squatting and hurt feelings. While I was busy trying to learn the minutia of every disease and the names of every translocated proto-oncogene, the Path department was busy writing a painfully simple exam, with just the type of big-picture concepts and plainly-stated questions that you dream about. I can solve a problem in calculus but I can’t tell you what a number is. They wanted me to define a number. I did not do well.

I stayed to check my grade which was a mistake that cost me a day of studying to self-pity. That left three days till the Microbiology midterm. While Micro is 5 credits (making it of equal weight to Neuro or Physio from last term) it pales against Path’s 13 credits. So we ignore it much like we ignored Embryo in first term. Sure enough, I barely know the material, cram and cram and cram, and leave with an A. So add bacteria and viruses to the list of things that I don’t have to understand at all. They can keep the fetuses company.

So with Micro and Path behind me, I have this weekend to enjoy the dodgeball tournament on Friday and the golf tournament on Sunday. I’ll be wearing a mustache to both.

Cheers, and thanks for waiting. topher.