Ugh...kvetching...

Emotionally I'm not in a good place. I'm beyond tired of waiting on things to happen. I'm tired of everything being dependent on somebody else's time schedule. I'm not sure what to do about somebody that's been a very close and serious part of my life for almost a year now. It's become obvious to me that the situation is static and is not working for me. But how do I change that without being a complete jerk? You want me as a friend...but you want to keep me on line romantically because you've admitted you have feelings for me. That's just not cool. You don't want to rock your own boat because it's "safe." That's a copout. Nothing worth having is "safe" or easy. You want to talk about living with me...thankfully I don't take you seriously...but later tell me that you just wanted to say it because you wanted to see what it would feel like to hear yourself say it...excuse me??? Perhaps it would've been a good idea to say that to somebody else...

In local news it's New Year's Eve. Not one of my favorite nights. I had originally planned to do something, but last night I went to sleep feeling like a bug under a brick, and I woke up not feeling emotionally or physically much better. Last year I went to Athens with Redd and Amigo...but Redd and I felt like grandparents at a preschool, so we gracefully bowed out not long after the countdown. In general I never have a great view on New Year's Eve because there are just so many people...most of them pretending to have the time of their lives. Ugh. There's just very little pleasurable about standing shoulder to shoulder with 400 of your drunk friends trying to do the Macarena, during which elbows and armpits continually find your face. No creo asi. On top of that I'm incredibly wary of having more than one drink because the police are justifiably everywhere. The problem is I need more than one drink to ignore the 400 drunk somebodies.

I'm just ugh...so I'm gonna sit here at home probably, have a glass of wine...and watch All About Eve. Go me?

Baby on Board

These signs need to go away in 2012. Through extensive therapy I have overcome the almost unyielding urge to barrel full steam ahead into the back of a car. This urge could ONLY be overcome with the knowledge that you had a baby on board...Fool. As if the giant car seat doesn't give it away.

Too Funny

Sad News

I found out today that an online pen pal died early on Saturday after a three year battle with stomach cancer. I'm not sure how to feel because I had never met him. We had talked about hanging out, but one of us was always off somewhere, so it never worked out. But we talked a lot. He was always positive and had a good sense of humor. He had a particular knack for rewriting the lyrics to some of my favorite Stevie Nicks songs. His new lyrics were somewhat, er, colorful, but I always had a laugh. I'll miss talking to you my friend. Rest in peace. It's just so sad. It's such a waste. Twenty-four years old. In what is perhaps going to become an all-too-common occurrence, it is bizarre looking at the Facebook pictures of someone who just died, and have them be your age.

Today's humor

Lifted from here:
Edited because swear words make me blush...but otherwise I find it hysterical, and entirely true.
Note: The grammatical errors ain't mine.

OK, I am not going to lecture you about the dangers of narcotic pain medicines. We both know how addictive they are: you because you know how it feels when you don't have your vicodin, me because I've seen many many many people just like you. However, there are a few things I can tell you that would make us both much happier. By following a few simple rules our little clinical transaction can go more smoothly and we'll both be happier because you get out of the ER quicker.

The first rule is be nice to the nurses. They are underpaid, overworked, and have a lot more influence over your stay in the ER than you think. When you are tempted to treat them like [horsesqueeze] because they are not the ones who write the rx, remember: I might write for you to get a shot of 2mg of dilaudid, but your behavior toward the nurses determines what percent of that dilaudid is squirted onto the floor before you get your shot.

The second rule is pick a simple, non-dangerous, (non-verifiable) painful condition which doesn't require me to do a four thousand dollar work-up in order to get you out of the ER. If you tell me that you headache started suddenly and is the 'worst headache of your life' you will either end up with a spinal tap or signing out against medical advice without an rx for pain medicine. The parts of the story that you think make you sound pitiful and worthy of extra narcotics make me worry that you have a bleeding aneurysm. And while I am 99% sure its not, I'm not willing to lay my license and my families future on the line for your [bum]. I also don't want to miss the poor bastard who really has a bleed, so everyone with that history gets a needle in the back. Just stick to a history of your 'typical pain that is totally the same as I usually get' and we will both be much happier.

The third rule (related to #2) is never rate your pain a 10/10. 10/10 means the worst pain you could possibly imagine. I've seen people in a 10/10 pain and you sitting there playing tetris on your cell phone are not in 10/10 pain. 10/10 pain is an open fracture dangling in the wind, a 50% body surface deep partial thickness burn, or the pain of a real cerebral aneurysm. Even when I passed a kidney stone, the worst pain I had was probably a 7. And that was when I was projectile vomiting and crying for my mother. So stick with a nice 7 or even an 8. That means to me you are hurting by you might not be lying. (See below.)

The fourth rule is never ever ever lie to me about who you are or your history. If you come to the ER and give us a fake name so we can't get your old records I will assume you are a worse douchetard than you really are. More importantly though it will really really piss me the [bleep] off. Pissing off the guy who writes the rx you want does not work to your advantage.

The fifth rule is don't assume I am an idiot. I went to medical school. That is certainly no guarantee that I am a rocket scientist I know (hell, I went to school with a few people who were a couple of french fries short of a happy meal.) However, I also got an ER residency spot which means I was in the top quarter or so of my class. This means it is a fair guess I am a reasonably smart guy. So if I read your triage note and 1) you list allergies to every non-narcotic pain medicine ever made, 2) you have a history of migraines, fibromyalgia, and lumbar disk disease, and 3) your doctor is on vacation, only has clinic on alternate Tuesdays, or is dead, I am smart enough to read that as: you are scamming for some vicodin. That in and of itself won't necessarily mean you don't get any pain medicine. Hell, the [nimcompoops] who list and allergy to tylenol but who can take vicodin (which contains tylenol) are at least good for a few laughs at the nurses station. However, if you give that history everyone in the ER from me to the guy who mops the floor will know you are a lying douchetard who is scamming for vicodin. (See rule # 4 about lying.)

The sixth and final rule is wait your [bloody] turn. If the nurse triages you to the waiting room but brings patients who arrived after you back to be treated first, that is because this is an EMERGENCY room and they are sicker than you are. You getting a fix of vicodin is not more important than the 6 year old with a severe asthma attack. Telling the nurse at triage that now your migraine is giving you chest pain since you have been sitting a half hour in the waiting area to try to force her into taking you back sooner is a recipe for making all of us hate you. Even if you end up coming back immediately, I will make it my mission that night to torment you. You will not get the pain medicine you want under any circumstances. And I firmly believe that if you manipulate your way to the back and make a 19 year old young woman with an ectopic pregnancy that might kill her in a few hours wait even a moment longer to be seen, I should be able to piss in a glass and make you drink it before you leave the ER.

So if you keep these few simple rules in mind, our interaction will go much more smoothly. I don't really give a [flip] if I give 20 vicodins to a drug-seeker. Before I was burnt out in the ER I was a hippy and I would honestly rather give that to ten of you guys than make one person in real pain (unrelated to withdrawal) suffer. However, if you insist on waving a flourescent orange flag that says 'I am a drug seeker' and pissing me and the nurses off with your behavior, I am less likely to give you that rx. You don't want that. I don't want that. So lets keep this simple, easy, and we'll all be much happier.

Sincerely,
Your friendly neighborhood ER doctor 

Just can't help but laugh...

I was sitting in the doctor's office today with my grandmama. The guy sitting relatively near us had his cellphone, but obviously forgot to silence it. While the room was dead silent, it goes off and I hear this: "You have another f*cking email." He heard it start to talk and out of the corner of my eye I saw him frantically try to silence it, to no avail. I just could not help but laugh. Grandmama asked me what I was laughing about (because of course she didn't hear it...) and I'm not sure I could have used the F-bomb in my Grandmama's presence...so I just said I read a funny joke on the internet. That satisfied her.

Movie Time

I saw "My Week with Marilyn" last night with Redd. Because none of the theaters near us were playing it (why?!?!) we had to haul tuchus across town. While searching for the theater, because a) the name had changed despite Fandango's insistence and b) Fandango's geographic awareness remains wonting, we stumbled across a Tapas bar that looked much more promising than the standard fare Chili's and Taco Bell-esque restaurants surrounding it. We were not disappointed. It was so good!

Then...for the movie. I thought it was really good. The performance of Marilyn was what I would call "delicate" or "fragile."  It wasn't over the top, it wasn't wishy washy, it wasn't "girly." I enjoyed the movie.

So so tired. I just want to do nothing, and I feel like doing nothing. Why does it take days to decompress?

Done...for now at least

All right. So I'm done, I guess for now. And I have no clue how things went with the USMLE Step 1. It was a just a really long Multiple Choice Question Blur. I don't even remember that many questions. One or two that I had a question about I've looked up, and I was right about the answer I chose. Perhaps that's a good sign. Having not slept much the night before, and having woken up at 4:15 the day of the test...I slept like a baby last night. The only problem was I woke up, with nothing to do. It's an odd feeling, and I'm afraid I'm going to get sucked into riveting tasks such as vacuuming, or ummm...doing anything but reading the stack of happy nonsense books I've neglected since the start of the decade.

At the moment I'm content to watch Will & Grace. Why? No clue. That pile of goo on the floor? Yeah that's my brain. It oozed out of my ear.

QOTD

A: Miriam Makeba, who's that??

B: You know, that black lady on the Cosby Show...

C: Oh yeah...her...

Dumb question of the day:

If laboratory tests determine that the patient has a general medical condition that underlies the symptoms, which of the following is most likely?

A: Addison's Disease
B: Cancer of the Pancreas
C: Hyperparathyroidism
D: Hyperthyroidism
E: Hypothyroidism

...Could I get some symptoms please....(Insert biggest eye roll ever). Finally I get to use those mind-reading and X-ray vision skills!!!

Taken from Lange Q&A: USMLE Step 1.

Um, duh?

This is an excerpt from an article I was reading. I'm so glad it took research to figure out what anybody with an ear and a brain connected to each other could deduce. Insert eye roll.

"The researchers at the University at Albany in New York found that R&B contained the most references to sex per song (an average of 16 sex-related phrases per song). The top three sexual themes in R&B songs were the singer's sex appeal, the singer's wealth as it relates to finding a partner, and descriptions of sex acts. A total of 19 song themes were examined."

And could this article be ANY longer???

29 November 2011

While studying I’ve learned that propofol is high in TGs, and potentially damaging to the pancreas. I wonder what Michael Jackson’s pancreas looked like when they did an autopsy…

Kvetching...

Beyond tired of over zealous Psychofacebookmoms, and my friend list has over two dozen new or young moms. Your child was cute until picture number 6,734—and that’s just this month’s crop. Also, I really do not care what cutesy thing your child had to say. I hope I remember this when and if I have children, but listen up; your children are only interesting to you. Sadly, because I know of the parent-child relationship in many of these cases, I look at the postings by the overzealous Psychofacebookmoms and I see a spoiled brat in the works. Remember, brats are the product of lousy parenting. After that thought runs through my brain for the millionth time, another occurs to me—this child’s sure-to-be-histrionic teenage years will be penance enough for subjecting hundreds of innocent Facebookers to never ending pictures, anecdotes, and not-so-cutesy quotes. Your child is a child, and needs to be appreciated as such. They did not hang the moon. Since I’ve noticed the vast majority of psychofacebookmoms only have one child, the recommended treatment should be the crank out another kid—STAT. Note: I have PLENTY of friends with children who aren't guilty of being a Psychofacebookmom.

28 November 2011

Due to inclement weather (I’d heard there’s a chance of snow) I went out into the deluge to get firewood. I wanted the wood inside so it would be completely dry in the event that we experienced a power outage. Like a schmuck I went without shoes. So naturally in the process of removing a piece from the wood pile, another piece decided it didn’t want to be left out, and landed squarely on my (bare) foot. Ouch. Not ten minutes later it is already hurting, and I have the hematoma from hell. It is sore but not broken, because I can stand solely on the ball of my left foot.

Today's lesson

I really need to learn to stop logging onto facebook on Saturday morning. There are too many idiotic postings glorifying various football teams, and almost all of them betray what are seemingly intelligent people. It's a game folks. Say Go Team X all you want, that doesn't bother me. What bugs me is "proud to be a (Insert Mascot)," or "I hate team X," Etc, etc, etc. None of them has ever stepped foot on an athletic field. Get a life!

I will admit I'm a bit sensitive to this issue right now after the Penn State sexual abuse scandal. All of that done in the name of football just makes my blood boil. If Jerry Sandusky had been my neighbor down the street, he would have been in jail years ago, and it would not have been allowed to go on for two decades. Ok, rant over!

I'm off to the lake to hide for a bit longer. I have no internet there, which makes me more productive!

I'm kvetching...

I sometimes get incredibly weary about the Catch 22 to which doctors and medical students are treated. An INCREDIBLY tense and stressful load is placed upon us, requiring us to shut ourselves off in the interests of completing the tasks and self-preservation. We then get ridiculed for being withdrawn and inhumane and are instructed to be more personable and expected to function socially in the same manner as someone with half the work load. In many cases people are forced to be superfluous to our existence, but our existence IS people--our patients! My fellow students are only so much help because I am embarrassed to be associated with many of them, and we see so much of each other anyway. Just get away from me. I want somebody who doesn't remind me of school.

It can be incredibly isolating, and it seems like no matter what you do you're pissing off somebody. It's draining and sometimes more than I want to take. It sounds like whining, I know. Sometimes it just gets to be so much that even something as benign and useless as a dumbass posting on an internet forum  hurts your feelings or makes you angry. It's the stupidest thing in the world to get upset about, but it's easier to get mad at something trivial because there's little consequence--I believe the term is displacement. Case in point, I simply do not appreciate being told I'm wrong about something I wasn't even discussing. Ordinarily I would just laugh and move on, because I'm a nameless and faceless individual on the forum, as is the boob who apparently didn't get my point. But right now I just want somebody to understand me, dammit. I thought I was using only factual information--because God forbid your opinion actually mean something--and attempted to rephrase my position, but that only made it worse. Although, on the flipside, if some of what I've posted on a stupid thread about the Las Vegas airport and gambling towns is the most questionable thing someone has ever read, I am tempted to question how widely a user reads...

And right now I feel like a lot of people know WHAT I'm doing, but they understand very little about it. I'm tired of doing nothing but reading. I'm tired of giving up everything for nothing. I am just plain tired of being tired. I am tired of being asked the same stupid questions, and my parents are the worst offenders:
"What'd you study today?" -- Waterhouse-Friderichsen Syndrome and thiazolidinediones Mom, ever heard of 'em? Yeah me neither...
"Are you getting enough done?" -- well I wasn't aware of it until you pointed it out for the second time today. I'm stressed to the max and now I have to be reminded I'm running behind, thankyousomuch.
"Is there anything I can do for you?"-- Yes! SHUT.UP! STOP IT! Stop walking around me like I'm on eggshells or a piece of fragile glass that is going to break. Stop reminding me that I'm studying and have a test coming up soon. Like I could forget? I set the date. I paid almost one thousand dollars to register for it. I'm well aware! Stop asking me what happens after this! The answer hasn't changed, because THIS hasn't happened yet! I have been asked the same five bloody questions for the past four months...and the never NEVER changes. How hard is it to grasp "When I know something, I'LL EFFING TELL YOU!" Even more frustrating is I am obliged to dumb down my answers (remember, they are always the same) because very few people even understand enough to know what I'm studying, much less what it means. The fact that it's not really something they should know doesn't make it any less annoying. Rattle off the generic of something as ubiquitous as Tylenol or the clinical term for high blood pressure and many people either look at you either like you've lapsed into Swedish or they think you're trying to make them look stupid by using big words. Sorry, I didn't make up the word! I'm just responsible for knowing what it means...

And most of all...I'm so annoyed that I cannot even see straight over the fact that Hallmark Channel has taken The Golden Girls off the air completely until January. I have watched The Golden Girls as I fall asleep for over a decade...This is totally screwing with my mojo.

Was that whiney enough for every body? Right now I'm three years old.

And we spent how much money in Afghanistan...

Stories like this just make me shake my head and go WTF! We spent how much money in "liberating" Afghanis from the terrible Taliban regime, only to replace it with a government that imposes many of the same laws. I want a refund! I have no problem with the Afghanis implementing the style of government of their choosing, but I DO have a problem subsidizing a zero-sum transition.

Last Dance with Mary Jane...

I have been hearing this song on an almost daily basis the last few months, on different radio stations in different cities in different states. Perhaps we have a generation of stoners reminiscing??
Also, was it impossible for Tom Petty and the Heartbreakers to make a video in the early 1990's that wasn't batsh*t crazy??

Mary Jane's Last Dance

Oh the Humana-ty!

In between my study time I've turned the TV on a few times, and without fail during at least one commercial break is a commercial for the Humana health insurance company. I tend to be wary and skeptical any time I hear someone bang on about their beneficial program, especially in the last few years with the Health Care Insurance...erm...stuff. These Humana commercials look like something my middle school AV squad came up with...yes please take responsibility for my health care even though you're too cheap to make a proper commercial...that gives me confidence! Either that or they're preying on the uneducated and/or stupid. Perhaps it's a play for the "good ole boys" to say, "well lookathere, what a no nonsense commercial. These people must be honest. They're not some giant, slick corporation."


The best part of it all is in one of the commercials they use blocks of Swiss Cheese to demonstrate the difference between different plans and supplements. Paraphrase: "Policy X leaves this HUGE hole right here, and many others. Policy Y has a smaller hole, but it's still there. With Humana that big hole is gone!" As he says this he holds up a piece of Swiss cheese that is still riddled with holes and says, "With Humana there are far fewer holes in your plan!" So let me get this straight, you fill what you claim is one really big hole, but I'm still buying a hunk of hole-riddled Swiss Cheese?? So there are still holes in my coverage?? This is right after you tell me how broad in scope and effective your plan is. Have you got two mouths or are you just talking out of both sides of only one?

Who wants to move like Jagger...

I do not like this song. It is stupid. It makes no sense. I just.do.not.get.it. Neither Adam Levine nor Christina Aguilera move like Mick Jagger. And quite frankly who finds that sexy?? I just picture Jack Skellington when I see Mick Jagger moving, pouting like Tina Turner and singing (or trying to, anyway). The idiotic idea and the reality juxtapose. Also...why is that a good idea?? SOMEBODY EXPLAIN THIS TO ME!!!

Just a thought...

Make note...whoever you are...Rush hour is not the time to put your Kentucky Derby Hat on, the top of your 3-series down...and take a leisurely stroll at 50 mph in the left-most lane of I-85

Slip of the tongue

"...lots of things can cause inflammation of the cervix...excuse me...cervical lymph nodes"

Thank you Captain Obvious…

 “…abdominal aortic aneurysms can cause death, which can be problematic…” Really? I must have my priorities out of line…

17 November 2011

Looking at all these EKGs today reminds me of a bozo PA that I was rotated through in South Florida. Contrary to everything else I had been told about PAs operating in the State of Florida this guy was effectively operating a one-man show. Disturbing, eh? He claimed his father-in-law was the physician he practiced with, but his FIL was retired…so in other words he just signed everything willy nilly. Doesn’t that make you feel warm and fuzzy? Notsomuch. According to what I’ve been told, Physicians Assistants by law aren’t permitted to sign orders or write scripts. The Physician must sign all scripts and co-sign anything the PA signs. Annnnyway, for two days I just sat there astonished at the sheer amount of incorrect information this guy was trying to tell us. This is just a sample:

1.     Attempting to tell us that when reading an EKG you go 300, 150, 100, 90, 75, 60, 50…Um, where’d you get NINETY pendejo? The best way to count an EKG heart rate (and that’s how it’s usually taught…) is to start with 300 at the big line and divide 300/1, 300/2, 300/3…etc etc etc. No integer will yield 90. I verified it with four texts when I got home that night. Yes I have that many useless medical texts lying around my house.


2.     THEN we got into heart blocks. I don’t even know where to begin, or how any of it makes sense. He began with stating that because this woman’s EKG showed a dropped QRS complex (the prominent pointy thing on an EKG) he had diagnosed her with a first degree AV block. Ummm, the entire definition of a first-degree block is predicated by the (albeit prolonged) PRESENCE of a QRS complex. He proceeded to discuss Wenkebach diagnoses and identified them as a Type II Mobitz, incorrectly describing them as a constant length QRS, with random QRS drop. Ugh, where do I start? First of all, he got the Mobitz Type II part right, but it’s not a Wenkebach. Wenkebach is a TYPE ONE Mobitz. There's even a song about it. Watch it and try to get the “AV Type I Mobitz” out of your head before tomorrow. Secondly, how can a First and Second degree both have dropped QRS complexes?  None of this would bother me as much if the guy hadn’t claimed to be a cardiac specialist.


3.     Acetazolamide. A classic carbonic anhydrase inhibitor. It prevents bicarb, HCO₃ from being reabsorbed by the kidneys. For those not in the know this is a diuretic, and it results in the basic compound of bicarbonate being eliminated via the urine. Bicarbonate is one of the most rudimentary (I would say “basic” but basic has two definitions in this case) buffers in the body. A loss of a basic substance means that the blood is going to become more acidic, and as such the pH will DECREASE. PA Bozo made the assertions that metabolic alkalosis (ie basic blood) will ensue and the pH will INCREASE. Ugh. Strike three pal, you’re out. I realize my degree in chemistry gives me a slight advantage when it comes to dealing with subjects such as acids and bases, but c’mon, anybody who has a master’s degree (which is what PAs have) much less BE a PA should be able to grasp that concept. Even if that’s too much, they should at least know what the hell the drug they’re giving a patient does!!!!!!!! ***

4.     As if all that wasn’t enough, we get to metformin. I’ll make it short and sweet. He stated that metformin works by getting the pancreas to secrete insulin. Head. Wall. Now! One of the advantages of metformin is that it works independently of a functioning pancreas (quite common in diabetes obviously). There are indeed drugs that function by stimulating the pancreas to release insulin, and they do so by closing K+ channels. Metformin mostly works by inhibiting gluconeogenesis, which is a liver function. To make sure I hadn’t confused a drug (let’s face it that can happen), I asked him “what about gluconeogenesis?” He said he didn’t know anything about that and had never seen a drug that worked that way. Ok, I’m out. Either this guy’s a complete moron and DANGEROUS for patients, or everything I thought I learned in medical school is incorrect. I’ll form a committee to decide... I tuned out for the rest of the day and alternated my concentration between stifling laughter to quelling fits of rage.

My main problem with this guy who doesn't know squat is he is effectively seeing patients with NO accountability. And on top of that most of his patients were poor immigrants who spoke little to no English. A Spanish-speaking PCP is not hard to find in South Florida, but people in this group tend to believe the first Spanish-speaking voice they hear. My main goal out of all of this is to not develop a prejudice toward Physicians Assistants. I’m working on it.

**Foot note: I’ve noticed that we chemists tend to be more persnickety about balanced statements and making one and one add up to two than our biology colleagues. That isn’t a slam, it’s just an observation. We are taught that if it goes into the system, then it’s gotta come out, and must be accounted for. In biology, a process, reaction, or an equation if you will, is rarely taught to be balanced or quantified. ATP comes flying in from I-don’t-know where. True, we are taught that each molecule of glucose ultimately yields ~32 ATP, but frankly that’s just oh gee wiz fare for the student when one considers that there are 3.012 x 10^23 molecules of glucose in a mole of sucrose (table sugar). A mole of table sugar off the top of my head is about 340g, or roughly a six pack of soda. Yeah, you do the math. I’ll pass unless I can fish out my TI-83 Plus, but I haven’t seen that thing in over three years. Some amino acid just randomly appears. That enzyme just happens to already be there chilling. All of this stuff has been quantified (usually by chemists or physicists with a biological focus by the way), but it doesn’t seem to be stressed. I totally get it, and do not begrudge the field at all. Were all that to be quantified and taught to students as such, four years wouldn’t be enough to finish what is taught in the first year of biology. It is so much more complex and intertwined. It’s so much more integrated than chemistry or physics. Chemists, on the other hand, have the benefit of observing a great deal of our processes as an isolated system, controlled and mostly free from exogenous influence. Balance is taught to be paramount, and the end product is frequently known, and often irrelevant to the study.

I have often thought that chemists would make excellent accountants, and vice versa, simply because we are taught from Day One to take into account things such as molar equivalents, quantifiable energy, etc etc from start to finish. Were we asked to take into account all that other STUFF and then quantify it, we’d never get done either. So, to me, the two fields have done a beautiful job of simplifying their subject, but in different ways. Biology has done away with accounting and in many cases mechanism on a large scale in favor of studying process and integration. For instance, biology on the “molecular” level usually stops with DNA, which drives me nuts because as a chemist I know that a septiquadrilion little molecules make up that big molecule of DNA. Little mention is neither made about what actually makes Enzyme A convert Product A to Product B and why Inhibitor Q prevents said miracle, BUT, you can see the whole process at once. Chemistry has done away with integration of the process as a whole in favor of accounting and individual mechanisms, and in many cases the outcome is already known and incidental. It’s the how much and how that matters most. For instance, in the spoon-bending-minds-required abstract field of Physical Chemistry we spent hours modeling the structures of molecules we had known for years, such as ethanol. The biologist would in many cases be happy with the outcome simply being ethanol. The chemist in many cases already knew it was going to be ethanol, and wants to know why it’s shaped that way and precisely why it was allowed to be made in the first place. Biochemistry manages to integrate the two, but on a limited scale, and to study biochemistry you have to already know your fundamentals of chemistry and many of the fundamentals of biology. And we all wonder why these two ideologically juxtaposed fields get into interdepartmental fights??

Now back to your regularly scheduled programming…

Today's Microbes

F. Ingbullox

I. Amsickofthismalarky

U.Rencyclopaedic

N.Omoremicrobesplease

H.Ellnawiwillnotrememberthis

S.Hootmeplease

16 November 2011

It really aggravates me when I am trying to study and actually read the review answers and I get something like this horse squeeze:

“Laboratory tests are ordered for two hospitalized patients. During the phlebotomy procedure, the Vacutainer tubes drawn from these patients are mislabeled. One of the patients receives a blood transfusion later that day. Within 1 hour after the transfusion of RBCs begins, the patient becomes tachycardic and hypotensive and passes pink-colored urine. Which of the following statements best describes how this reaction is mediated?”

I had it narrowed down between:

B) Antibody-dependent cellular cytotoxicity by natural killer cells

D) Complement-mediated lysis of RBCs

Needless to say I got it wrong, and chose B, but that’s not what aggravates me, because I usually LEARN from answering questions incorrectly. I proceed to the explanations and this is what I get RE: answer B:

“…Natural killer cell lysis is seen with antibody-mediated diseases.” You don’t say, Sherlock! Obviously I should have known that the process was complement-mediated, but I thought differently. C’est la vie, I can get over that. I’m kvetching because that is a completely USELESS statement. Yeah I’m making something out of nothing, but it’s these “DUH!” circular statements that make me wonder how much the schmucks who wrote this got paid…

A real gem...right??

The SRY gene encodes for testes determining factor. As in “SoRrY” ladies, I gotta make testes. Without this a fetus will automatically undergo development as a female. So all the men who think they’re something special just because they’re a man…well, just think, your body is perfectly capable of being a female, and was certainly plumbed for it when you were conceived. Look no further than your nipples.

15 November 2011

Hiding at the lake for a few days, posts will be retrospective.

Just made a run into Laketown for some caffeine. Also decided to supplement the nutritious benefits of Coca Cola Classic with a pint of Ben & Jerry’s Half Baked. Oh, and that all-important generic CVS Ibuprofen. For some reason, and it might be the incoming weather front, the top of my head and behind my forehead has been hurting since late last night. The medical student in me freaks out that I’m having a subdural hematoma by way of aneurysm…but two days the later the medical student in me says that I would be dead by now if that were the case, or at least have some sort of motor impairment. Right?

Coming back from town I was reminded why I don’t live here anymore: the drivers would give me the aneurysm I was concerned about if I had to drive here full time again. HIYA Lady stops at a green light because I don’t know why, and then she doesn’t pull to the right when an ambulance is coming…DUMBASS! = YOU. Then I get behind an astutely clever gal whose probably-perpetually confused expression I could see in her side view mirror. She proceeds to put her turn indicator on and slow down to 30 mph almost a mile before her turn (and there were no other turns on the road)…and as if that wasn’t enough, comes to a complete stop in order to make a ninety-degree turn (with no other car for miles…other than me that is). Ugh, I swear people need to take an idiot test before being allowed to drive or reproduce.

A typical day of studying right now is looking like this.

I do my best to get up before 8am, some days I’m more successful than others. No later than 10 I want to be plugging away. I learned a long time ago that I’m not good for much more than one solid hour of studying at a time, and then I need at least a half hour to let all that information process and sort (through the Papez circuit thank you very much) itself out. Then I go again. And it continues like this until either I’m so frustrated with a concept I cannot see straight, or I get through the daily allotment. 

QOTD

 "Meningitis will kill you a lot quicker than ghonnorhea." Thanks...but I'll pass on both...


In reference to distinguishing N. meningitidis from N. gonnorhoeae. They cause completely different diseases (meningitis and ghonnorhea, I'll let you figure out which one does what...). And N. meningitidis ferments maltose. Think "Maltose" = "m"...profound, I know.

Total Scooby Doo "eerrghhh???" moment

"Selection bias: A questionnaire of risk factors for MI is sent out to survivors of MI --> what about those that did not survive the MI?"....Let me know how many responses from non-MI-survivors are received...

Today's rambling rant

I know I'm supposed to be learning how to care for people and all that...but sometimes I wonder if people like Jerry Sandusky should just be shot on sight...how do you rehabilitate somebody like that??? And what's even worse are the people who tried to sweep this cesspool under the rug in exchange for monetary benefit. All because of damned football. And my father wonders why sports fanatics piss me off into an unknown oblivion...

Absolutely hysterical...but I can't remember where I stole it from

How to improve your gaydar: You walk down a busy street and look for a really hot guy walking the same direction as you .... you follow him ...( the next bit is the tricky part) instead of focussing on him , pay attention to the guys coming the other way, watch out for the ones whose eyes do a quick flick as he walks past (if they turn around for a second look as he passes all the better) try this for a few weeks and your gaydar will improve ( although you may walk into a few lampposts/rubbish bins/ sandwich boards along the way) .

Unforgettable patient

I was doing a 12 hour shift in a South Florida ER, lucky me right? Being South Florida, and the neighborhood this hospital was located in, 99.999999999999999% of the patients were Latino, and consequently the ER functioned using Spanish, except written records. I often wonder how many times some of the nurses who spoke less-than-perfect English flubbed written instructions, but whatever.

At some point during the evening a woman arrived in the ER. I heard her before I saw her and I my head snapped around because after hours of speaking Spanish, hearing English grabbed my attention. But it wasn't just any English, nay nay. This woman talked like Larry the Cable Guy and Loretta Lynn had a red-headed bastard. The attending was  perfectly bilingual, but couldn't understand a word this woman said. I, however, must claim that I understand Hick, Hillbilly, and Redneck beautifully and can transition between the three with little effort. No, I'm not overly proud of that, but hey, roots is roots y'all. My grandmother left Small Mountain Town in the late 40's, but never dropped her Hillbilly speak. For instance, "7" is pronounced "sevum," 11 becomes "elevum." Nancy becomes NAIN-cee. Jennifer becomes "GINNNNiferrrr." Michael becomes "Mahkahl." And so on and so forth. I'm not making fun of her, just stating facts. So, to make a long story short, I had little difficulty deciphering this lady's obviously mountain accent. The doctor did, however, and there are no words to describe the look of relief when I translated and then took over the interview. He also decided that the stench from her cigarettes was also more than he could bear. The remainder of the conversation went something like this:

Me: Well, ma'am, let's see what we can do for you. -- transliteration "whale maham, let's seeah whut we can do fer you." (Damn! Was that me talking just now???? STOP IT!). Apparently I speak like that around my grandmother. Oh.god.

I proceeded with my interview and examination. She quivered and giggled when I examined the LLQ and LRQ. Would anybody mind if I wretched??
PMH: A whole bunch of stuff I wish I could elaborate on...but won't because of HIPPA, and a procedure she described as..."They took out all mah toys!"...And this affects me how?....
Social: from Western part of State X where there are many mountains. Ahah!!! Paydirt!. Came to South Florida (Flerdy as she pronounced it...) to have a procedure. Had a gay roommate, not sexually active. Are the two statements mutually exclusive? Nevermind. I don't want to know.  She also felt the need to tell me what her children did for a living. So, because you're dying to know: her daughter is an, ahem, exotic dancer, and bears a striking resemblance to Ann Margaret. Thanks for telling me? Doesn't drink, but smokes what she says aren't cigarettes but aren't cigars but are kinda like both of them. Thanks, that helps. She smokes them because they only cost $1/pack. Ahhh, that would explain why my eyes are watery and I'm getting a migraine. (I'm very sensitive to tobacco smoke). She also admitted to smoking a rock of crack the day before her symptoms started. Ugggh! Greeaattttttt! Lady, you've just insured you'll be here at least two extra hours. Can't wait. At the end of everything she said "I like you! You're nice and got a grayt smahl." Oh goody! Thankfully that concluded our interview....

BUT...nobody else in the ER could understand her. So guess who got tracked down if she needed something...yubba, yours truly. It would go something like this:

FOB-y Cuban nurse: Esa mujer en 9, no puedo entenderle! Habla con la puta! -- I can't understand that woman in 9. Go talk to the bitch.


Me: Uhhh, ok, algo mas? -- Um, sure, anything else?


FOB-y: No! La puta solamente!!! No! Just go talk to the bitch!

The type of humor only a medical student would get

We indentured servants, er, Medical Students, over time develop our own, ahem, unique sense of humor. Some of it is derived out of necessity, because more often than not if we didn't laugh we'd be giving ourselves lobotomies. Some of it develops naturally, because who else is going to find something like the following funny:

(Playing Words with Friends, and as such using the little chat feature, when I probably should have been studying um, something).

Me: oh you needed vowels...I had four os.....(intending to type O's, but it just didn't work out that way)
Me again: and if I get even one cervix or uterus joke I will kill you...

Opponent (also a medical student): lol, hahaHa (verbatim what he said). Sidenote...why do we type lol....and then HAHAHA??? I do it myself, and ask myself why even as I type it. I still send it, though.

Click here if you need to know what an "os" is... No it's not some pretentious pronunciation of the word "ass," as my brother asked...

Studying Gems...

‎"Picture 7.3 shows a woman with a white forelock and bilateral hearing loss"...um...thanks? now I know what a deaf woman looks like...


Really bugging me that the TV series Homeland is showing it's protagonist as taking clozapine without a script...I'm pretty sure I remember a little British lady banging on about clozapine and consequential agranulocytosis for about an hour...Bad psychiatrist! Bad psychiatrist!


‎"people who are appropriate for using psychoanalysis and related therapies " should be among other things "intelligent and not psychotic"...are those mutually inclusive???? If so that's a very short list!


Although women attempt suicide three times as frequently as men...men are three times better at it...gotta love behavioral...


‎"Markers in many chromosomes including 1,2,5,6,7,8,11,13,15,17,18,19,22, and the X chromosome have been associated with schizophrenia." -- gee, that narrows it down for me!


A: Why am I so tired? And It's only 10!!
B: our telomeres are getting shorter...


I had a dream that half of my tooth fell out, and I woke up to find it burning like it was in the dream. My own personal somatiform disorder??


Don't ever ask me "what's new"...I'm just going to tell you c/lambda


Whoever came up with words like "disinhibition" needs to be strung up by their toes...


"A 4-month old boy presents with frequent episodes of weakness, accompanied by sweating and feelings of dizziness".........I just want to know how a 4-month old feels dizzy in the first place, and then is capable of relaying that bit of information...


this conversation happened:
"Hey what are you doing?"
"I'm reading about um, lemme see what I'm reading about..."

Studying the GI tract is really crappy

Buenos Aires...finalmente

So it is about time that I should post my trip to Argentina: Three months later.

The trip was one of relative short notice. I was to be joining a friend for a little over a week in Buenos Aires. Said friend would be in Buenos Aires for a month studying Spanish. For me it was just an excuse to go have fun (and of course hang out with my friend in Buenos Aires...but that should go without saying)!  My Spanish was already pretty decent, and I had been living (and working/studying) in Miami for six months so I was comfortable using it. I was looking forward to it! I decided to book Delta because (yet again) I was traveling out of Atlanta and they had the best fare AND a nonstop. Why bother with a stop when the nonstop is cheaper?? I was actually able to save enough versus connecting that I got a chance to try out Economy Comfort. All in all I was excited.

10 June 2011

DL 101 ATL-EZE

STD: 2050

ATD: 2145

Due to the eruption of a volcano in Chile, I was on pins and needles the entire week before worrying about my trip. How considerate...So I ended up checking every day's flight, and a few days were cancelled, while some days the flight went out as scheduled. The irregularity did not ease my anxiety! The day of the trip finally arrived and I was checking the status every half hour it seemed: On Time. So I made the trek to the airport. I checked in and dropped my bag. I remember it weighed 37 lbs. No heavy bag fee for me! I've gotten pretty good at packing! I remember being incredibly annoyed as the two people in front of me were both traveling to Brazil (ok ok Brasil) and they each had about five bags. The Delta agents were moving, but definitely at their own beginning-of-shift pace. Because I'm that inconsiderate of the rules, and unappreciative of novice travelers, I usually use the South Security Check Point. They have it advertised as for SkyPriority passengers mainly, but in fine print, there is an allowance for "expert travelers." I consider myself well-traveled and always have all of my possessions off my person in about fifteen seconds. This line is usually much faster as its users typically know what they're doing--usually.

I got through security and proceeded to look for something to eat. My departure gate, A21, meant that I would not be able to enjoy the better food offerings of the T-Gates or Concourse E. I needed a little bit to eat as invariably on international flights they board very early, and ATL during the late-evening hour is a ramp zoo, so I figured it would be at least two hours from the time we boarded until we were given food (it turned out to be almost three). I grabbed some nuggets at Chik-fil-A. We boarded almost an hour prior to departure. I found my seat in the Economy Comfort Section. The seats are distinguished by their red seat numbers and grey upholstery. The seats themselves are standard-fare Delta economy seats, but they recline more (a plus!) and offer more legroom (another plus!). I was happier about the legroom, as I'm 6'1, and 4 feet of me is leg. Being able to cross my legs and get out of the window seat without disturbing my neighbor is huge on a ten hour flight. I also had two windows all to myself, so you folks in BusinessElite can get bent!!

Yes I was wearing jeans in June because it was going to be in the 40's F when I landed in Buenos Aires. I was really looking forward to cold weather. I missed W09-10 other than two weeks at Christmas because I was in Dominica, and I missed W10-11 other than Christmas because I was in Dominica before, and Miami after New Years. And it was even hotter when I moved back to Atlanta at the beginning of June. I desperately needed some cold weather! Snow would've been a bonus...but alas, no.

As predicted, it took at least an hour to board the aircraft, and then we sat at various places on ramp/tarmac/taxiway for almost another hour. Ordinarily watching the ground traffic would not have bothered me, but I was on the opposite side of the aircraft from the runway, and it was otherwise dark. Le sigh.

We finally took off and we all got comfortable. The flight was booked in all cabins. Being in Economy Comfort, naturally we were served first, and offered complimentary beverages. I had a Bloody Mary and a gin and tonic, at separate times. I was attempting to make as much of the flight pass unconsciously as possible, but more on that in a moment. The food was standard-fare economy food, so in other words warm matter that tasted something like pasta. I find it's really hard to screw up pasta, it's carbs and cheese, with some canned tomato sauce, so I typically get the pasta dish on airplanes, regardless of the airline I'm flying. One look at the chicken option confirmed my choice. Accompanying the meal was a roll that could have been bowled at the next Ashes, a decent salad and a very good brownie. After dinner I brushed my teeth, took out my contacts, and downed two melatonin. I don't remember much after getting back to my seat. I woke up with about three hours left in the flight, and decided to do a little reading. I pulled out my Kindle and read The Fall of Apartheid. I thought it was really detailed and fairly objective. Obviously I can't ascertain that as I have never been to South Africa, much less during Apartheid! About the time I finished that book the flight attendants began serving breakfast. It was the standard fare breakfast of a banana and a granola bar, with some water and orange juice. In the words of Linda Richman, no big whoop. I had to wait a few minutes to get into the lav, and noticed that there was a large group of Japanese tourists on this flight. The tour director was going from seat to seat making sure that everyone had their immigration cards filled out properly. I remember thinking that some of the translations were almost too literal, and as such a bit funny. But unfortunately I cannot recall any specific examples.

We flew over what I presume is Northern Argentina and Uruguay in the morning hours as the sun was rising. We landed about thirty minutes early at Ezeiza, along with 777s from Alitalia and American, and 767s from Continental, United, and American, and several A320s from LAN. In short it was a LONG trip through immigration and baggage claim. I had to stand in line for an entrance visa, $140, then stand in line to get it stamped...because having that done all at once just makes too much sense. I then waited forty-five minutes for my bag to finally make the twenty feet from the aircraft to the belt. From the baggage claim I was standing at, I could literally look up through a window and see the aircraft as it was being unloaded. I was starting to get tired and a bit cranky, so I just wanted my bloody bag. It finally came. THEN came a twenty minute wait for customs. Pure delight! It would have been longer if I didn't do as the locals and assume that a giant gap in the line was an invitation to join it in the same locale. Finally I got through customs and my bag is scanned, and I made my way to the taxi counter. I elected against taking a bus because I hadn't the foggiest clue where my apartment was located. The ride was interesting. Ezeiza Airport is about an hour outside of Buenos Aires. During the ride I chatted  a little with my taxi driver, but he spoke no English, and having not slept my Spanish was turning into Spanish-German-French. Every word I had ever learned in a language besides English was coming to my head, despite the fact that I knew I knew the correct Spanish response. I'm going to chalk it up to a lack of sleep and being a bit overwhelmed. I was content to look out the window. The outlying areas of the city are not nearly as well off as the central areas of the city. Every few miles there was either a bus or several cars (some of them quite old) parked or sitting on the side of the road. The area the driver exited the expressway was not an area I would call overly desirable--in fact it was downright sketchy--and I was nervous for a few moments. Remember I had no clue where I was going! My concerns were allayed when we pulled up to my building.

I rented an apartment for the duration of my stay in Buenos Aires as for less money I could get a studio apartment in a good neighborhood, and I could eat a little cheaper. A quick trip to the grocery store and I had yoghurt, granola, and orange juice for the week for less than ten dollars :). Everything I read about Buenos Aires told me that many of the best restaurants and shopping were in or near the Palermo Soho neighborhood, so I started my search there. I also wanted an apartment that was less than five blocks from public transportation. I scored! The apartment was in a newly renovated building that was nicely modern. Since it took longer than anticipated to get through the airport, I phoned the representative of the leasing agent and she waited for me. She gave me a very good map and a good set of directions.

 It was a studio, but I was only going to sleep there, and it had a wireless internet connection! I was very pleased. In the picture to the left my apartment is in the middle building, the floor below the balcony, to the right. It was small, but perfectly adequate. The heater/AC worked to keep it perfect. My friend and her roommates were a bit jealous of my surroundings--namely that I had it to myself. The company was great and I would definitely recommend them to anybody considering a trip to Buenos Aires:   http://www.bairesapartments.com/

After getting everything situated the very first thing I did was to take a nice hot shower to wake up and feel clean. I figured that going straight to sleep, even though I was a bit tired, was a very bad idea. I showered and changed and started exploring! According to the original plan Redd was to already be in Buenos Aires, and we would meet up and explore. She would have had a night's sleep, but I'm used to dealing with jet lag, so I would've enjoyed it regardless. Alas, that was not to be. I figured, since it was a Saturday, that I would do the typically tourist things. I started by finding the nearest "Subte" station. Mine was Scalabrini Ortiz on the D-Line. I also busied myself finding an ATM, as I needed a little cash! I started at the Plaza de Mayo, the location of the Casa Rosada. I wandered around there and Calle Florida for a bit. I quickly found that Calle Florida would be one of the LAST places I wanted to spend much time. Tourist much? With very little orientation to the city, other than that provided by a very good guide book and a map, I decided to hop on one of the double decker buses. It was a GREAT tour. I got a very good sense of what was to be seen where, and a feel for the various neighborhoods. I took note of the main sites, and other things to see or do that Redd and I would return to do or see. Everywhere we went Portenos were very friendly toward us, frequently waving at us. I even got a thumbs up and a huge smile from a kid on his bicycle. I also came across this:

I can't say my brother and I didn't come up with our own variation of skateboard-behind-a-bike with a golf cart and a pair of roller blades, however, we did not do it on a seven-lane highway!!

The tour lasted over three hours, and ended just before dark. I was tired, but figured I would stay up a little longer and find myself a steak. After all, Argentina has an entire ministry devoted to cattle! Or at least that's what I was told on the tour... I wandered up a few blocks from my apartment to the Plaza Armenia and took note of my surroudnings. There are a lot of shops on Calle Armenia, and it is a very pleasant area to walk.

The next day I had several hours to kill before I knew I could see Redd (her flight was due to arrive that morning). I had been monitoring Redd's flight. As it turns out she was rebooked on the Delta nonstop...grrrr for group tickets! We were both due to attend a Boca Juniors game that night, but as her plans were delayed and she was understandably exhausted from all the happenings and stress, she decided she'd be better off sleeping. Hard to argue with that!  We met up and had a cup of coffee and then I headed back. But I still went and had a fantastic time!

I purchased my tickets through an internet vendor and they picked me up at my apartment. We then met in La Boca, the neighborhood where La Bombanera (or Boca Juniors stadium) is located. I had been through the neighborhood on the bus tour the day before. I associated a little with my group mates, most of whom were Spanish speakers, trying hard not to make a complete fool out of myself, with varying degrees of success. I later made my way toward a group of Aussies and  Brits, who also happened to be my seat mates. We got to know each other pretty well. It turns out that all of them were on extended MONTHS-long tours of South America. It sounded great, but I cringed a little inwardly when one of them told me she quit her job (in this economy!) to do a four month tour of South America. Priorities, eh?

We were at the front row of the very top section.The picture to the right shows the section of seats that is blocked off between the Home (Boca Juniors) and Visiting (Banfield) teams. Apparently much of the reputation many South Americans futbol fans is grounded in reality. Both sides of the section were patrolled by a line of security and lined with barbed wire, and there were indeed fights. You could see a fight manifest in the waves of people that would just randomly start moving across the stadium. All this for a soccer match! I felt it wise to keep that thought to myself! Indeed, the fans were passionate! Incredibly entertaining. I must say that although I

did enjoy watching the game, my understanding of the tactics and plays of the game leaves a lot to be desired, and I was primarily enjoying the experience. I spent just as much time watching the Home (Boca Juniors) fans in the tier below me. The team apparently has songs, that all the fans knew. Suffice it to say I joined in the perpetual, rhythmic screams of "Dale!" but little else. Some fans, somewhere unseen to me, had GIANT drums that could be heard all over the place. The crowd would also start jumping, all at once, and the stands would start to shake. Keep in mind this stadium seats upwards of 50,000 people--all of them jumping at once!!! I'm trying to remember the physical phenomenon and wave theory etc etc, but yeah, that was so 2007. I saw what I'm sure were happens hundreds of times every game--a dad bringing his son to the match, standing just a few seats from me. The boy couldn't have been more than eight years old, and there he was, bundled up (La Boca is right on the water and it was quite cold and windy) and on his dad's shoulders cheering for Boca, shouting Burro! (literally "donkey" but more appropriately "ass!") at the Banfield team, and I couldn't help but smile. The match was an incredible experience, and ended close to 11pm. Getting out of the stadium and back to transportation was in a word: chaotic. Remember all those tens of thousands of people? Yeah, we all left at once. Fifty thousand people, in the dirty, narrow streets of La Boca. If it hadn't been for our guide I would 

probably have been there until the next morning, trying to figure out, where in the sea of people I 

was supposed to be, hoping not to get my pockets snatched from me. This area of town has a less-than-stellar reputation to begin with (and yes I just ended a sentence in a preposition). We eventually made it back to our van, and were driven to our various locales. I was one of the few staying so far out of the center. I must say I'm glad I did, as after the dinner hour the center of the city is mostly deserted, and that can be a bit unsettling. Forget walking back to your hostel at four in the morning. NOT.happening.

My initial perceptions of the language were a bit mixed. I was thrilled that I was able to be understood with very little difficulty. The other way around was a horse of a different color. There are some characteristics of Argentine Spanish that I had never been exposed to before. For instance, the pronunciation of "ll." I was taught Spanish by a Costa Rican, and there, and many other places as well, that sound is pronounced with a "j" or a "dg." Obviously most people associate that with a "y." I learned both and sometimes intertwined them. In Argentina, it is pronounced "sh." After a day or two I actually found this tripped off my tongue much easier than the other two. What I did not ever get my head wrapped around was "vos." I would like to be able to explain the conjugation and appropriate usage, but I cannot! I can say that if they say "vos" they are talking to you as a singular person, and that's about as far out on to the branch I am willing to step! I guess that means I must go back :P

My routine consisted mostly of sleeping until I wanted to, eating breakfast, and then making a loose plan of what, where and when. After I had a rough list of places, I would head downtown to wait for Redd to get out of class. I would peruse some shops while I waited. Sometimes she would get out early, more often than not a bit later. We literally went all over the city.  The various neighborhoods are called barrios. And in many cases it is quite obvious where one starts and another ends just by crossing the street. Like every city there were some good parts and some not so good parts. But I absolutely love to see the entirety of a city, and I literally start walking that way. One morning while I was waiting for Redd to get out of class I walked through the residential barrio, Almagro. It was very different from the upscale Recoleta, which is great. I love seeing all sides of life. I stopped at a small cafe, and got the usual less-than-stellar service, but absolutely fantastic empanadas. I would never be able to find this place again. All I know is that it is on Avenida Corrientes, at least I think that's where I remember it being. I am 90% positive it ran on that road because the Subte Red Line runs along the same street. After lunch I continued down Corrientes until I was pushing time a little close. But it was nice to see how people lived, without the eyes or influences of tourists. The buildings were less glamorous, but more authentic. 

What I must point out, and what I am kicking myself for not getting a picture of, were the hoards of posters and fliers scattered about in this part of town that had Eva Peron's picture on it. Even more, and in my humble opinion a bit creepy, were the comparison's between Eva (better known as Evita) and Argentina's current president Christina Kirchner. I'm going to have to chalk my reservations, curiosity, and amusement to a cultural difference that I am not likely to fully understand, even if it were explained well to me. Most of my "knowledge" of Eva Peron has not been acquired via discourse with Argentinians. Rather, it has been through more critical sources. So I guess I need to read up a little more on her and the situation before making my own call. I had a very hard time explaining what little I knew about Eva Peron and her importance to my friends. I've read enough to know that she was/is a prominent figure in Argentine history and politics. The facts get muddled a bit after that, I think, and the interpretation of the facts depends entirely upon whose account one is reading. I did, however, go to the Eva Peron museum. Her speaking voice...totally not sexy. And she was downright short. But I thought it did a good job of explaining what she meant to Argentines, both positive and negative, without commenting on her work, or deifying her more than she already has been.

Another thing I realized when Peron's sister was describing her embalmed body is that Spanish speakers and English speakers are programmed to think very differently of equivalent words and phrases. It's completely cultural, and as a result sounds downright corny even when translated properly. Certain words like "intimate" and "passion" and "romance" have completely different meanings to a speaker of English versus a Spanish speaker. Balancing the two can be a bit of a head trip.

At this point I should also admit that despite my attempts to explore Buenos Aires' many aspects, in pure touristic fashion I was usually singing one of the songs from the musical Evita to myself as I walked. How much cheesier could I get??

And now is the part where I start talking about THE FOOD. After my frist experience with the ojo de bife, or ribeye steak, I was hooked, and will probably never be able to enjoy steak anywhere else again in the world. The steak was just outstanding. Tender, juicy, delicious, good lord. I must marry an Argentine just so I can eat beef like that (insert really bad joke *here* go ahead, I know you want to). The picture below doesn't really do the thing justice. It was literally bigger than my hand, and almost an inch thick...for twelve bucks. Smith & Wollenski quality for Sizzler prices. How hard is that to beat!! I'll answer it for you...you cannot! The meal

was always accompanied by some really good bread, and some pickled something or another that I never could figure out what it was. Part of me did not want to know what it was, because it looked like it could have been eggplant or something that resembled fatback. Pickled fatback, now doesn't that sound scrumptious? Ignorance is bliss in this case. It tasted good, however. The steak was also accompanied by what I can only call a churasco, though whether that's correct and what was in it besides tomato I have no clue. It was simply delicious though, and I didn't ask many questions beyond that! I just enjoyed my meals knowing that when I returned 

to the states such indulgence would come with a much heftier price. A steak, salad, side dish, and WINE for $25. And speaking of the wine...it was simply amazing. Malbecs everywhere as far as the eye can see. And they were delicious. Light, fruity, and tasty! And cheap! I had at least one glass of wine with every meal :P We would usually not eat until at least 8:30. The first night we went for dinner we waited until 7:00 to leave, and go to the restaurant we were looking to try, Don Julio's in Palermo, on Calle Nicaragua. We arrived about ten minutes later, to notice that the waiters were just beginning to take the chairs off the tables and set up for the dinner rush. We decided we would walk around and explore the neighborhood a little. Everybody in the area was just starting to come out and do their evening routine. The shops were still open, but many of them had staff-activated doors for security purposes. Comforting, no? We figured out why once we entered them...thousand peso purses and boots and other leather works!

We returned to the restaurant around 8:15 and it was starting to get busy. Even when we left around 10:00 there were still families with their children eating, and the kids were wide awake. We noticed someone close to our age eating alone, and we invited him to join us if he so chose. He was an Australian in his early thirties waiting for a flight. The Volcano had caused him problems as well. It turns out he was heading to London to visit friends after having spent almost four months in South America, on his own. He would then return to Australia where he had a job waiting. I wasn't sure if he was going to want to join us, but I have eaten alone, and when traveling it's always fun to meet new people. I figured what's the worst that could happen, he would say no? Ok, no big deal. But he did join us, and even though I don't remember his name the three of us had a nice dinner and a good conversation. It should go without saying a bottle of Malbec was involved.

She will not like that I've posted it here...but it shows the meal pretty well! This was the night we had dinner with her roommates. We had an amazing dinner consisting of four steaks, a big Caesar salad, mashed potatoes, and a bottle of Malbec, which was outstanding. The cost for the four of us? Less than $100, and this was at a very good restaurant. Not five star mind you, but the quality was amazing.

 This was my lunch many days. Muy delicioso.

This putrid little concoction however, was not. I'm sorry, mayonnaise and green olives have no business being slathered on crostini. There was a cafe off Avenida Santa Fe not far from Redd's apartment in Recoleta that served small treats with every cup of coffee. We got in the habit of having a cup of coffee and a small snack between 4:30 and 5:00 to hold us until we could eat a bigger meal, but not usually after 8:00. I got in the habit of waiting at the coffee shop next to her apartment after the lady who owned her apartment wouldn't let me wait in the lobby, nine floors below, even with Redd...and with approval of the security guard. Oh no, not this yente. "Esperamos aca por sus amigas, Senora." We are waiting here for Redd's friends ma'am (who also happened to be this lady's tenants as well). "No se puede! No puede entrar." No, you cannot enter. Very well. I just thought it was odd that it was made plainly obvious I was her friend, made plainly obvious I had no intentions of going anywhere further than the lobby, made plainly obvious that the security guard could see me. Apparently obvious doesn't work for this woman.

The second Saturday of my visit we took the commuter rail to a small town outside of the city, the name of which unfortunately escapes me at the moment. This town is on the Rio de la Plata, and is more or less a retreat for many city dwellers. The town has an amusement park, rowing clubs, and small country houses for miles. We took a sunset cruise up the river, and had a little too much fun with my camera settings! You can see those below. In the first one I wasn't quite sure what was happening, hence the blank look. On the train ride, there and back, people were selling the most random things. They would walk up and down the car showing you whatever product they had come across. It could be some form of potato chip, or chocolate sweet, toilet paper, tissues, or in one case they had razors! I had to laugh to myself at that one! Then they would move on to the next car. 

The same thing would happen on the Subte. For one or two stops men, women, and in many cases children, would put something on your lap like a map of the underground system (identical to the ones freely posted all over the place), a package of Kleenex, or in many cases just a piece of card stock with a message about how hard it is for them to raise their children, or buy groceries, etc, etc, etc and could you please help. The cynic in me wanted to know where they acquired the items they were then selling, but of course your heartstrings are also tugged. I must say I do admire the folks who were at least trying to give you something for the money you gave them. There was one case that I don't think I will forget as long as I live. There was a little girl, she couldn't have been more than nine, and she had a younger sister with her that could not have been two years old. These children just looked poor and they were definitely dealt a BAD hand. They were filthy dirty, though they didn't look malnourished. The older sibling parked the younger near the door of the train, and then proceeded to do her routine. I think I saw one person give her 20 pesos (like $US5), and she didn't even say thank you. She just tucked the money into her back pocket and kept walking. While she was doing her job, the younger child, probably oblivious to what was really going on, poured her charms on a lady sitting near her, and began to play with her and her son, who looked to be of a similar age. When the older sibling came back and saw this she jerked her little sister away from the lady, and then they left the car. I felt so sorry for those kids 1) because they had to spend their childhood in what must have been such an unpleasant existence, and 2) they were either orphaned or more likely being pimped out by their parents to beg for money. That little girl had absolutely zero life in her eyes, and just looked so miserable and unhappy. We saw a lot of very poor people while we were traveling around. When we bought our tickets at the train station there were several people literally parked on the ticket counter just holding out their hands. Most people pretended they were not there, and nobody said anything to them. A few people gave them pocket change. 

The day I was to leave I went with Redd and her crew to the San Telmo market. On Sundays the entire barrio of San Telmo transforms into a street market. I was packed and ready to go before I left the apartment. Getting there took a hitch because the Subte let me off at a different section of the same station, which totally threw me when I made it up to the street. I was turned around for a few minutes. Eventually I met up and we explored the streets. I bought a mate gourd and a CD of tango music. The market literally has EVERYTHING one could want, at least of the boutique variety. There's a junk section, an antique section, a clothing section, and a market that has pretty good produce. It was a nice way to close out my trip. Dr. SS and I seemed to be on the same page the entire day. We were literally finishing each other's sentences in English and Spanish. We had talked a little bit over the course of the trip, and we got along rather well. I enjoyed getting to meet her. So after a nice afternoon and lunch talking with Redd and her friends, who were all sad to see me go, I had to go. I gave everybody a hug and a farewell, and sadly turned around and started my trek back to Palermo. I was sad to be leaving. I walked to the train, and didn't realize that the area of San Telmo I would be walking through would be so deserted! It was kind of shocking that in the middle of the day I would literally be the only one in the street. I eventually found my train station and went back to Scalabrini Ortiz, and walked up Calle Armenia. I made to my apartment, with the intention of waiting for its owner to give me my deposit back. While I was waiting I thought I would clean up and take out the trash. I had everything in a bag and I made my way outside. It was nearing the time he was due to come and I wanted to be ready to leave. After dumping the trash I came back to the apartment. I opened the door and noticed an envelope on the floor. I must have missed it the first time I got back because I had my eye on the door to the building the entire time. In it was my cash deposit and a nice note in broken English from the landlord telling me he hopes I enjoyed my stay. Suffice it to say I did! I made sure all my things were in order and the apartment was as neat as I found it, and locked the door. The note instructed me to leave the keys at the building next door. Great, but I had no way of getting into said building. One must either have a key or do the whole door buzzer thing. Gee that's neat. Thankfully this building had a doorman. In broken Spanish I was trying to relay the situation to him. It was a bit of a challenge, given I didn't know the Spanish phrase for "drop off" and my instructions were in English...BONK! Eventually I was able to tell him that I was a tourist staying in the next building, and here are the keys to the apartment. That did the trick, at least I think it did because the light bulb came on. After thanking the doorman I headed to the corner and hailed a cab. I had been watching the traffic for several days, and knew that barely five minutes went by that a cab did not cross this intersection. I also knew that if I got desperate I could just walk five blocks and be on a main road. Literally the second I reached the corner there was a cab. I hailed it and said "aeropuerto Ezeiza por favor." "Ezeiza Airport please." Off we went! It was a decidedly less slummy drive OUT to the airport, which I thought was very strange.

19 June 2011
Delta DL110 EZE-ATL
STD: 2030
STA: 0555
I arrived at the airport almost three hours early, but I left so early on the advice of many people, as they said that the traffic is very unpredictable. I was one of the first to check in, and then I had 2.5 hours with which to do very little. Grand. I found a pen, and filled out my immigration card. Then I strolled about the airport shops, looking and ooing and ahhing at all the cool-sounding destinations like Lima and Cordoba and Asuncion. Then I went through security. The airport has a very interesting layout, in that it isn't linear or logical in anyway. It's just kinda there, and you keep walking this way and that way  turning left and right and going through some random liquor store until your gate is reached. Naturally mine is one of the last ones. I bought a chocolate snack to keep my stomach happy until we got into the air, while I was buying it I noticed two Delta flight attendants looking for their gate, so I said to them "Ladies you're at 8 tonight." They said "thanks, glad somebody's looking out for us!" I said well hopefully shortly you'll be taking care of me. I'm such a flirt...maybe?

The aircraft was not towed to the gate until about twenty minutes prior to boarding. I noticed that seated in the boarding area was my flight attendant from my flight a week or so prior. I spoke to her once we were boarded. She said that they get a 36 hour break between the two flights, and that she does the flight to Buenos Aires every Friday evening, and returns on Sunday. She does that three times a month and she's done. Sounds rough...

My seatmate was a rather large, but not fat, Israeli man who could not seem to keep his person in just his seat. Thankfully we were seated at a bulkhead, and I had the window seat. So as long as I leaned against the wall, I was fine. I had plenty of room to get out of the seat and was able to get around him without disturbing him. He was a very nice man, headed to San Jose I believe, and he offered to share his computer with me and let me watch movies with him. I told him I appreciated the offer but I had a book that I wanted to read. What the book was about I know people are dying to know: Evita.

Again the drinks came around after our on-time take off. I had a gin and tonic and another Bloody Mary before consuming my melatonin before dinner. Again I chose the pasta. Again it was ok, more warm matter. After that I slipped into la la land for at least four or five hours. But I was wide awake with about four hours to go. I decided to actually watch the in flight entertainment that was contributing to my inability to sleep. As I had the bulkhead seat, there was a screen mounted on the wall in front of me, and the bright light was distracting. I watched some movie with Matt Damon and Emily Blount. It's one of those movies that's good one time. I also watched a pretty interesting documentary about the demolition of Yankee Stadium. After that, the show Parks and Recreation came on, and I have to say, that is without a doubt the dumbest thing I have ever tried to watch. How this show got past test audiences I think reflects on the poor quality of that test audience. Anyway, I couldn't watch another episode of that drivel, so I pulled out my book and turned on my iPod, and read until breakfast. We landed shortly after breakfast, with little muss or fuss, and it was almost a straight shot into the airport, because, after all, it was about 530 in the morning. What insanity. Immigration was the same ole same ole, not too slow, but not hurried. There really isn't much of a point in rushing through immigration as you still have to collect your bags to go through customs. And sure enough it took at least ten minutes for my bags to get to me. Several other flights from South America were mingling in the customs area. After getting my bag and clearing customs, I rechecked, recleared security, and was through to the terminal in less than ten minutes, where my mom was waiting to pick me up. I got home and went back to bed! A great ending for a great trip!