We survived our first hurricane

Here is a link to some pictures plus the videos below: https://picasaweb.google.com/110826757084200001915/HurricanePictures

The other, other white meat

Well, I just finished my newborn nursery rotation. I've changed more diapers this month than I have the rest of my life combined. It was a nice rotation with good hours and I feel much more comfortable wrapping up those little baby burritos. I've been much more diligent in my working out since I started intern year. I go to the gym, sometimes by bike, 6 days a week alternating weightlifting and conditioning days. It's good stress relief, getting up at 5 in the morning to workout before work. I couldn't do it any other way, after work I'm too tired to get a good workout in. I joined Fitocracy.com to help track my workouts and use the Evernote app to keep track of what I'm doing on a daily basis. The problem is now I'll be starting nights on the pediatrics floor, so I'm not sure how this will affect my schedule.

End of my first month

I just finished my first rotation as an intern and survived. I was in the NICU all month taking care of sick babies, mostly premature babies that live in isolettes that look like little terrariums. I didn't have a good experience with NICU during my one week rotation in third year of medical school so I thought I would hate it. Turns out I actually liked it a lot. We had a great team that got along well together. The attendings were not like they make them out to be on Scrubs. They were very down to earth and taught us well. I enjoyed learning about all the different ventilators and how to adjust the settings on them based on the results we would get from blood gases and labs. My best memory is how one of my patients developed sepsis or an infection in the blood and how once we started antibiotics a few days later he started being weaned off his ventilator support and was soon extubated. He was my rockstar.

Today I had my first continuity clinic. My clinic is every Wednesday in the afternoon. Typically, we will start each day off with some sort of conference and quick teaching lesson. They tried to start me off easy with only two patients, only they had scheduled four for me. I got through it okay and even got a verbal pat on the back, so that felt good. Our clinic is probably the most efficient well organized clinics I've ever been a part of. The building is brand new and the staff and attendings are excellent. I'm looking forward to clinic next week.

This next rotation I'm going to be on Newborn nursery, which should all be healthy babies ready to go home soon. I kind of miss the NICU, but I have to move on.

Tomorrow an Intern

Today was probably the last day we won't have to answer our pagers for the rest of our lives. We start in the hospital tomorrow as interns with shiny, new and longer, white coats. I start off in NICU or neonatal intensive care unit. M is on peds wards or the general pediatrics team. So if you don't hear from us over the next year it's because intern year has started. Luckily our program give us 3 weeks off a year, as well as a few days around either Christmas or new year's. This is the most vacation by far of any program we interviewed at. I'm going to be pretty busy in the NICU. Working 12 hour shifts 6 days a week. I was always scared of those little baby terrariums as a third year med student. Now I have at least 7 kids to see in the morning.
We are all set up in our house. I'll add some pictures to picasa at some point. Pray for us as we start the hardest year of our lives.

Some Notes on Notes

I'm going through a box of undergraduate notes right now. For some reason I felt the need to save notes from every class I took. All of my biology, chemistry, physics, psych, calculus, and bible notes are in there. When I threw out most of my med school notes a few weeks ago I didn't have as much nostalgia. I've been reading through my undergrad notes and see evidence of the budding relationship between me and my wife, inside jokes between friends, birthday wishes written down, quotes from my favorite teachers, and grades both excellent and horrifying. My wife and I sat together in several classes we had and I'm amazed at how much we wrote in each other's notebooks back and forth. I've found doodles of whatever I was occupied with at the time: hacky sack, politics, etc. My friends would write in my notebook when it was my birthday and leave me notes calling me "fatty" and "peter pan", nicknames I had from different people at the time. It makes me appreciate how much time and effort my professors put into teaching us and cultivating a relationship with us when I see quotes from their classes written down. There are classes I should have gotten A's in that I somehow managed to get B's in. There are classes like Dr. G's Plant Biology where I needed to ace the final to get an A in the class, and I studied like a fiend to get the highest grade in the class and get the A. Dr. G knew how to make a hard test. I'm amazed at how much I've remembered and how much I've forgotten. I look at my calculus notebooks and it looks like they are in a foreign language. I look at organic and can't remember the names of the reactions but somehow it looks familiar like I could figure it out again. Well, that's enough reminiscing, back to throwing away some of my old stuff, or maybe not.

Graduation and Why I Still Don't Know Anything

So, after today I'm officially a doctor. It's kind of a surreal feeling. We were gowned, robed, tasseled and handed a diploma. I guess it's like a birthday. You get gifts, you take pictures, maybe feel a sense of pride but don't feel very different on the inside. I've worked toward this goal for at least 4 years of medical school, but also my whole life. In some ways, I guess, I've wanted to be a doctor since my mom got me my first play stethoscope and doctor bag that I used to give her a "check-up" after she gave birth to my sister. Earlier I said: After four years of high school I though I knew everything, after four years of college, I thought I knew something, after four years of medical school, I feel like I don't know anything. I suppose that's just part of this whole educational journey thing. "It's a journey not a destination." That applies to learning medicine as much as anything else. One of the pieces of advice every physician offers us is to "never stop learning". So as I embark on this next four year voyage (that seems to be the general cycle) I'm left with a profound sense of dread about how much I don't know and how much I have left to learn. They say learning the amount of material in medical school is like trying to take a sip from a fire hydrant. Sorry this post has been mainly stream-of-consciousness; I'm too tired to finish this post so maybe I'll write more later. But I couldn't have gotten here without my parents, wife, family and church family, so as you congratulate me right back at you. I couldn't have done it without any of you. Thanks everyone!

Why Med-Peds?

I thought I would explain some of my reasons for going into med-peds. For those that I haven't explained it to, Med-peds is a 4 year residency which is a combination of 2 years of pediatrics and 2 years of adult internal medicine. Those programs alone would be 3 years each.

Originally I thought I would be going into surgery when I started med school. I was really intrigued by laparoscopic surgery and even during med school I thought it was fascinating. But then, one day I cut my finger while making jerky and my Uncle Kerry made fun of "the surgeon". Just kidding, that wasn't why I decided differently. Also, I figured I might hate life if I had to go through the 5 grueling years of surgery residency. I rediscovered something I always knew. I get along well with kids. I love taking care of kids, even sick ones, which can be scary and emotionally trying at times. Multiple times my friends and neighbors would tell me I should be a pediatrician, but I always just kind of put it in the back of my mind for later. I also discovered I loved internal medicine. Some of my most gracious and respectful patients were old men at the VA. They thank you profusely for everything you do for them; I hate waking them up in the morning to exam them. Some of the hardest patients that test your patience are at the MED, the county hospital in Memphis. These people need love and healing as much as the next person because they are made in the image of God. I figure the average patient lies somewhere in between. 

One of my favorite things to study is the digestive tract, and maybe it's because I have Crohn's and I spent time at the Peds Gastroenterologist when I was younger, but I could definitely see myself as a gastroenterologist. I fellowship, or additional training after residency in Peds Gastro would be another 3 years. I also considered the possibility of doing a combined fellowship which would add even more years to my training.

The other, more serious reason I wanted to do Med-peds is because I want to do medical mission work. I don't know if this means short term missions or extended years away from home. So, I'm left wondering should I stop after residency and see where God sends me or continue training in fellowship. Do I settle down as a country doctor doing primary care or give away all my possessions and go into the world? I also have to take into account what my wife wants to do permanently, although I know she wants to do medical mission work as much as I do. I have much prayer left to do and a few years to make a decision. Pray that I have patience as the great physician works in me. 

Apologetics and the O.C. Supertones

I recently fell in love with a new band called the O.C. Supertones. Unfortunately, like many things I discover they have long since been disbanded, e.g. Firefly, Arrested Development, almost any classic rock band. Using Last.fm is a good way to discover new music you might like, so randomly one day I'm listening and start hearing this funky ska-core rhythm, some horns come in, and the lead singer starts rapping about apologetics. Not just any apologetics, but presuppositional apologetics.

For those that don't know apologetics is the field of Christian thought that tries to present a rational basis for Christianity. After all Paul says we should always be "prepared to make a defense to anyone who asks you for a reason for the hope that is in you." Lately I've been interested in presuppositional apologetics, especially the books written by Cornelius Van Til. One of my heroes, Francis Schaeffer, was one of his students and developed his own outlook on apologetics as a compromise between Buswell's evidentialist apologetic and Van Til's. To be honest I'm partial to Schaeffer's own outlook. He saw himself primarily as an evangelist and not as an academic. Schaeffer's view is called "Taking the Roof Off" as illustrated here:

So back to the O.C. Supertones. I've read that the lead singer, Matt Morginsky, is "reformed" and has given lectures on presuppositional apologetics, and it's obvious from his lyrics.

And here we stand

naked, barehanded futily prepared

for the blows to be landed. 

Presuppositions is all you can stand on. 

Can you twist their wrist 

when they lay a hand on? 

Learn how to fight 

from words on a paper. 

learn from the shoguns, 

Bahnsen and Schaeffer. 

Plus he mentions Schaeffer! I think I just found one of my new favorite songs. 

I don't know anyone else that can rap so well about apologetics.

Kids in universities, 

drowning in an ocean 

of apostate philosophy. 

We need apologetic instruction... 

mental reconstruction. 

Ignorance reduction, 

to halt the mass abduction. 

Evangelical mind 

has been scandalized.

Wisdom and truth 

have been vandalized,

by the unevangelized. 

No truth in a world 

that is randomized.

These lyrics are from a song called Grounded. In the song, Chase the Sun, the lyrics say:

My thoughts are like a circle, 

with Jesus in the middle. 

One thing Van Til argues is that if one argues accurately from Christian presuppositions it eventually leads to circular logic. But, their is nothing wrong with this, because he shows how the non-christian argues in a circle as well.

The chorus goes like this: 

Throw your hands up, 

throw your hands up high! 

Tear the roof off and pull down the sky! 

Chase the sun back to California, 

tears in my eyes. 

Tell me where you're from, 

the mighty west side! 

What's that? Tear the roof off, sounds a lot like Schaeffer's method of apologetics.

They made songs that speak on the benefits of knowing and memorizing scripture (something I've been working on this year), attacking the health and wealth gospel, and the struggle with doubting at times.

I was going to write a lot more on apologetics, but I'm not sure my feeble writing could do it justice, so far now I'll just provide some links.

On presuppositional apologetics: http://www.frame-poythress.org/frame_articles/2005Presuppositional.htm

Schaeffer's article A Review of a Review: http://www.pcahistory.org/documents/schaefferreview.html

The Match, Depression, and following where God leads

Every third Thursday in March fourth year medical students find out where, after four years of hard work, they will be doing their residency. You see four years of medical school is only the beginning of training for a young doctor. Everyone must do a residency in a field, mostly of their choosing. My wife and I both applied to 15 med-peds programs and went on about half that many interviews. We are not the most competitive in terms of grades and board scores, but certainly in the middle of the pack. Our main goal was to stay in the southeast and be somewhat close to family.

We decided, after much thought and deliberation, we would like to stay in Memphis, with family only ~4 hours away. We  thought UT had a great program, we got along great with the residents here, we felt like we could learn a lot from our attending physicians here, and believe it or not after four years Memphis began to feel like home. We submitted our rank list and put UT Memphis at the top.

For those that don't know, applicants submit a rank list of programs they would like to go to and have presumably interviewed at. Residency programs submit a rank list of applicants they would like to have in their program. Later, after an obscene amount of waiting, a giant computer algorithm tells everybody where they will be going. 

Back to Match Day. Despite our interviews going well, despite many people from within and without the program telling us we were shoe-ins, despite feeling like maybe God had brought us to Memphis for a reason, we did not match at UT. All around us amidst many of our classmates either feeling joyous or disappointed, we were shocked. We would be moving half way across the country to Eastern (North) Carolina. Away from our church family of 4 years, further away from our family. We will now have to sell (or rent) our house, pack up our bags and move.

After Match Day my wife's family came in town to hang out for awhile. It was nice having them in town; we don't get to see them very often, but we were still depressed about what happened. Unfortunately when I'm stressed or depressed about something I tend to internalize it and it seems to go straight to my gut. Only after about a week did I realize over the course of my education I have never gotten my first "choice". I wanted to stay at CHS to play soccer, but a new high school opened up and I had to go there. God had other plans. I wanted to go to Vanderbilt, but because of my parents' divorce we couldn't afford it. God had other plans. I ended up going to Lipscomb and couldn't imagine it any other way. I wanted to stay in Nashville and go to Meharry or Vandy, again that didn't work out. God had other plans; and my education at UT memphis has been excellent. 

It seems God is trying to tell me something about making my own plans.

Sola fide,

Our Reason to Blog

Two weeks ago we got news we would be shipping across country in a few months to begin our medical residency. This was quite a shock to us as we had planned on staying here in Memphis for residency. But perhaps we'll talk about that in another post. Our good friend Rachael, we've been friends with since we went to Lipscomb, recommended we start a blog to keep her and our other friends and family informed about what we're up to. To be honest I've always wanted to start a blog but never had the courage to start one. I've always hated writing (or reading) anything for a class, but once I'm not forced to do something I seem to enjoy it a lot more. I also realized my hero, Francis Schaeffer, wrote numerous books and read constantly despite being dyslexic. So in spite of my lack of creativity I am here to blog about my family's life and thoughts.

Also, I roped my wife into blogging with me (as I did with all of her social media experience e.g. facebook, twitter, reddit, etc.) So look for her contributions as well. On the page I've linked to twitter and our picasa photo album. Look forward to many run-on sentences, incorrect grammar and general disregard for syntax.

Soli Deo Gloria,