Total Awesomeness.....

“Don't wait until everything is just right. It will never be perfect. There will always be challenges, obstacles and less than perfect conditions. So what. Get started now. With each step you take, you will grow stronger and stronger, more and more skilled, more and more self-confident and more and more successful.”

~ Mark Victor Hansen

Life is beautiful. There are a number of times in our lives that we achieve something and feel like we are on top of the world. Whether it is a graduation or the birth of a child, the feelings of accomplishment are overwhelming. These are probably the most appropriate time to use the word awesomeness.

I have done all of my graduating and I think I am done with the kid thing, so the only thing I have that gives me the feeling of awesomeness is completing marathons. I recently finished the Vancouver marathon. I chose Vancouver because, well, I thought it would be a nice run in a beautiful town. Since it was a beautiful course and an awesome town, I thought I would document the race with pictures so that maybe you all could share in my total awesomeness.

The morning is May 4, 2008. It is a clear Sunday. A good day for running. I reach the start, my head phones in my ears. You may ask what is playing, but those of you who are familiar with my blog have already guessed it .... TOOL



I look down, and visualize the course in my mind's eye.
The horn blows. I look up as I make our way to the start line. My hand is on my watch .... the timer is started.

The weather is beautiful. A slight chill in the air. Everyone is in good spirits. The first part of the course is in the city. I pass a wheelchair racer along the way. He waves.

I come up to about mile 3. This is where I see the front runners for the only time during the race. They were moving.


We make our way through Vancouver. As with most marathons, for some reason you have to go through China town. I am not really sure why.




As we crossed one of the bridges, you can see the city amongst the mountains. Breath taking....

At mile 10, I see my family and friends cheering me on. It was nice. I got a high five from my son. Total awesomeness....

Ahhh ... water stop ... I caught this dude by surprise. The water was much appreciated though.


Ah, there is nothing like running though a park. Out of the concrete jungle and into paradise.



(ROCK HANDS IN THE AIR) The band is rocking out doing some cover songs of 80's music.


Now at this water station I did not suprise her. Look at the smile.

Ahh, looking at Vancouver from the park, what a city.

How would you like to have this gig. Hanging out in the park playing for the runners. What a view.


Ok, this woman was at about the 16 mile point. I have never seen someone having so much fun by herself. She was just high on life, I guess. The only thing that would have made this better would have been a disco ball.


And back into the city we go. We are welcomed with a 1/2 mile up hill at mile 24. Nice .....


Ok, right about now the blisters on my feet were killing me. I came to a corner and this little guy was just cheering for us. Awesomeness ....


At this point, I can smell the finish. Foot pain, quad burn ..... irrelevant. It is the finish line.


So there you have it. It was a nice time. I hope you enjoyed it. It was total awesomeness.



Ok, four cellos rocking out with the singer from slipknot is also qualifies as total awesomeness.

“Success means having the courage, the determination, and the will to become the person you believe you were meant to be”

~ George Sheehan

There'll be no shelter here ...

"They who have put out the people's eyes, reproach them of their blindness."
~ John Milton

...
I need to watch things die
From a good safe distance
Vicariously, I
Live while the whole world dies
You all feel the same so
Why can't we just admit it?
...

Vicarious
TOOL

I remember when it began. At the time, it was a novel thought. I don't know if MTV knew it at the time, but The Real World was ground breaking. It opened a whole new genre, entertaining through others' fortunes or misfortunes. For Generation Y, this has always been a part of their lives. Caricatured lives placed in the open for all to see. Computers and the Internet have perpetuated our desire to create worlds for make believe lives. Avatars are created; caricatures of our inner selves. Social networking sites explode. We don't call any more, just text. In this make believe world, we can live our fantasy lives and project our opinions in a forum with little anxiety, fear, or regulation. For those who felt they had something worth being heard, they took to blogging.

When I began blogging, I wasn't sure what to expect. What I found was that it was a wonderful community of people with different opinions on any number of topics. For many of the anonymous posters, it is a world where their voices could be heard. Like the wild west, it is an unstructured platform where opinions can be made, discussed, and debated without fear of repercussion. This community has its own set of rules. For many of the medical students and residents, it is their venue. They grew up here. From Myspace to Facebook to Twitter, their lives and ideas have been free form on the Internet. In this brave new world, I am a learner.

...
Hospitals not profit full
The market bull's got pockets full
To advertise some hip disguise
View the world from American eyes
Tha poor adore keep feeding for more
Tha thin line between entertainment and war
fix the need, develop the taste
Buy their products or get laid to waste
Coca-Cola was back in our veins in Saigon
And Rambo too, we got a dope pair of Nikes on
Godzilla pure m@#*&fu%@n' filler
Get your eyes off the real killer

Cinema, simulated life, ill drama
Fourth reich culture, Americana
Chained to the dream they got you searchin for
Tha thin line between entertainment and war
...

There'll Be No Shelter Here
~Rage Against The Machine

In terms of technology and popular information, the medical community is generally behind the times. Caught up in our world of IV's and Ambu bags, we lose perspective on the real world. We teach the youth of America, yet we have no perspective on what is important in their world. Our eyes open only when topics are discussed in the media or cause a direct effect on us (the medical community). We are naive on many issues and undereducated outside of our world.

Change and the unknown create fear. Blogging and social networking is an uncontrolled medium. A venue where opinions can be voiced anonymously open forum. The paranoid mind says this medium will be used to slander the institution or organization and must be regulated. Although universities claim to welcome differences, there are policies that prevent true open discussion of all opposing views. In the Ivory Towers of academic medicine, popular ideas flourish. We feign tolerance. Unpopular thoughts are discounted and discarded. Hierarchy and politics rule. In this atmosphere, subordinates believe they lack the power to question. In an open forum, would I voice my opinions to a superior? As a subordinate, where is my platform?

Born with insight and a raised fist
A witness to the slit wrist, thats with
As we move into 92
Still in a room without a view
Ya got to know
Ya got to know
That when I say go, go, go
Amp up and amplify
Defy
I'm a brother with a furious mind
Action must be taken
We don't need the key
Well break in

Something must be done
About vengeance, a badge and a gun
cause I'll rip the mike, rip the stage, rip the system
I was born to rage against 'em

Fist in ya face, in the place
And I'll drop the style clearly
Know your enemy...know your enemy!

Yeah!

Hey yo, and d!$k with this...uggh!
Word is born
Fight the war, f@!k the norm
Now I got no patience
So sick of complacence
With the d the e the f the I the a the n the c the e
Mind of a revolutionary
So clear the lane
The finger to the land of the chains
What? the land of the free?
Whoever told you that is your enemy?
...

Know You Enemy
~Rage Against The Machine

Inspirational ...

My mother sent me this and I thought I would share with my blog friends.

In the final analysis, love is not this sentimental something that we talk about. It's not merely an emotional something. Love is creative, understanding goodwill for all men. It is the refusal to defeat any individual. When you rise to the level of love, of its great beauty and power, you seek only to defeat evil systems. Individuals who happen to be caught up in that system, you love, but you seek to defeat the system.

~Reverend Dr. Martin Luther King

Ok .. this was just kind of awesome ....

Ok .. this was just kind of awesome ....

Valentine's Day just seems irrelevant

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

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

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

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

To my Kirkwood family, I grieve with you.

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

To my family and friends, I love you.

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

~Lao Tzu

Congrats AM.......

“Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think." Christopher Robin speaking to Pooh

~A. A. Milne

There are some days I ask myself the question, "why do I do this?" The OR is a struggle. In clinic, patients are unappreciative. Insurances deny a study or questions your rationale for treatment. Referring physicians get upset because they did not receive a patient's consult note. At the end of the day, there is a stack of paperwork to be completed, school excuses, gym excuse, PT referrals, etc. It can be exhausting. So, why do it?

The other day I walked into my office. As I passed my secretary's desk, I asked, 'is the anything for me?" She said, "yes. AM called. She wanted you to know that she received her schools award for courage." I smiled.

That is why I keep coming back.

Congratulations AM. You ROCK.

“Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow.'”

~Mary Anne Radmacher

Feeling Human again ...

"To laugh often and much; to win the respect of intelligent people and the affection of children...to leave the world a better place...to know even one life has breathed easier because you have lived. This is to have succeeded.”

~Ralph Waldo Emerson

As physicians, we treat any number of illnesses, speak to patients about treatment options, and comfort families when bad news is given. Although we are sometimes held to a higher standard, held in high regard, or think very highly of ourselves, we are still only human. Every once and a while one of are own, family, friend or colleges, is struck ill or dies and it reminds us how human we are. We are not gods or immortals, but human.

One of our colleagues was affected this past Christmas eve. I will say a prayer for him and wish his family well. I will hug my children a little longer tonight.

"Carpe diem! Rejoice while you are alive; enjoy the day; live life to the fullest; make the most of what you have. It is later than you think.”

~Horace

Happy Thanksgiving

I hope everyone has a wonderful Thanksgiving Day. God Bless.

~Someonect

I wonder if this makes me famous?

I am currently completing a mission trip in China. I made the Chinese news paper. I wonder if that makes me famous. I will be back in the US this coming week.

I support Dr. Firlit

Please visit this site. Thank you all.



Someonetc

This was nice ... I thought I would share it.

I received this in an email today. I thought I would pass it along to all of my friends in the blogsphere. Enjoy.

TWO FRIENDS WERE WALKING
THROUGH THE DESERT.
DURING SOME POINT OF THE
JOURNEY, THEY HAD AN
ARGUMENT; AND ONE FRIEND
SLAPPED THE OTHER ONE
IN THE FACE.
THE ONE WHO GOT SLAPPED
WAS HURT, BUT WITHOUT
SAYING ANYTHING,
WROTE IN THE SAND:

TODAY MY BEST FRIEND
SLAPPED ME IN THE FACE.

THEY KEPT ON WALKING,
UNTIL THEY FOUND AN OASIS,
WHERE THEY DECIDED
TO TAKE A BATH

THE ONE WHO HAD BEEN
SLAPPED GOT STUCK IN THE
MIRE ! AND STARTED DROWNING,
BUT THE FRIEND SAVED HIM.

AFTER HE RECOVERED FROM
THE NEAR DROWNING,
H E WROTE ON A STONE:

"TODAY MY BEST FRIEND
SAVED MY LIFE ".

THE FRIEND WHO HAD SLAPPED
AND SAVED HIS BEST FRIEND
ASKED HIM, "AFTER I HURT YOU,
YOU WROTE IN THE SAND AND NOW,
YOU WRITE ON A STONE, WHY?"

THE FRIEND REPLIED
"WHEN SOMEONE HURTS US
WE SHOULD WRITE IT DOWN
IN SAND, WHERE WINDS OF
FORGIVENESS CAN ERASE IT AWAY.
BUT, WHEN SOMEONE DOES
SOMETHING GOOD FOR US,
WE MUST ENGRAVE IT IN STONE
WHERE NO WIND
CAN EVER ERASE IT."

LEARN TO WRITE
YOUR HURTS IN
THE SAND AND TO
CARVE YOUR
BENEFITS IN STONE.

THEY SAY IT TAKES A
MINUTE TO FIND A SPECIAL
PERSON,
AN HOUR TO
APPRECIATE THEM, A DAY
TO LOVE THEM, BUT THEN
AN ENTIRE LIFE
TO FORGET THEM.

TAKE THE TIME TO LIVE!

DO NOT VALUE THE THINGS
YOU HAVE IN YOUR LIFE, BUT VALUE
WHO YOU HAVE IN YOUR LIFE!
AND IF I HAPPEN TO GET IT BACK,
THEN I KNOW MY PLACE IN YOUR LIFE

"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
...AMEN TO THAT

Okay ... I am a big kid

Alright, I know I am a big kid, but I use to love the Transformers. I use to watch them everyday after school. One of my residents showed me this, so I had to share. First, you need to see when Optimus Prime died.



What would happen if they brought him back? This is hilarious.

Medical Blogging grand rounds .... 4.02

I have to say this was rather cleverly done. I wish I was this smart. Please take a look at Musings of a Distractible Mind. Dr. Rob is the host of grand rounds 4.02. It is cleaver and fun to read.

I love movies ....

I love movies. I love quoting movies. Do you ever have a movie that every time it is on you end up watching it? I have several. Mr. and Mrs. Smith, may be it is because it is always on cable and those two have some chemistry. Another is Silence of the Lambs, because Hannibal is such an evil character. But, one of my favorites is Aliens. Yeah, Aliens. Why? It is not for all the action, or Sigourney Weaver or the special effects. The reason why I love this film is Bill Paxton. He has the best set of comedic lines for a supporting character in a non-comedic that I can remember. I think his character is hilarious. I have even found a blog post about W.W.B.D (What Would Bill Do?). So, I thought I would share the awesome youtube tribute. ENJOY!

Still I Rise ....

Yeah, this has really nothing to do with orthopaedics, but is a wonderful poem by one of my favorite poets. Although written from a black woman's point of view, it can be a very inspirational piece for anyone regardless of gender and race. For those times when you think that times have gotten you down and there seems no end in sight, you may still rise.

Still I Rise
by Maya Angelou

You may write me down in history
With your bitter, twisted lies,
You may trod me in the very dirt
But still, like dust, I'll rise.

Does my sassiness upset you?
Why are you beset with gloom?
'Cause I walk like I've got oil wells
Pumping in my living room.

Just like moons and like suns,
With the certainty of tides,
Just like hopes springing high,
Still I'll rise.

Did you want to see me broken?
Bowed head and lowered eyes?
Shoulders falling down like teardrops,
Weakened by my soulful cries?

Does my haughtiness offend you?
Don't you take it awful hard
'Cause I laugh like I've got gold mines
Diggin' in my own backyard.

You may shoot me with your words,
You may cut me with your eyes,
You may kill me with your hatefulness,
But still, like air, I'll rise.

Does my sexiness upset you?
Does it come as a surprise
That I dance like I've got diamonds
At the meeting of my thighs?

Out of the huts of history's shame
I rise
Up from a past that's rooted in pain
I rise
I'm a black ocean, leaping and wide,
Welling and swelling I bear in the tide.

Leaving behind nights of terror and fear
I rise
Into a daybreak that's wondrously clear
I rise
Bringing the gifts that my ancestors gave,
I am the dream and the hope of the slave.
I rise
I rise
I rise.

Please, there has to be a better argument than peanut butter

I saw this on over!my!med!body!. I had to post it. If he was on a debating team, I think he may lose with this argument.

I have a new toy ...

“Don't worry about the horse being blind, just load the wagon.”
~John Madden

This past week our little hospital opened a new NICU and OR. It is nice. It is bigger. Everything is shinny and new. We have lots of bells and whistles. Of all the fancy devices, the new tile, nice lockers, and larger rooms, there is only one thing that has really excited me. We have a telestrator. I am so excited. I think I have a new teaching tool.

“Self-praise is for losers. Be a winner. Stand for something. Always have class, and be humble.”
~John Madden

I'm tired .....

“Three Rules of Work: Out of clutter find simplicity; From discord find harmony; In the middle of difficulty lies opportunity.”

~Albert Einstein

To all that have continued to check my blog, thank you for continuing to visit. Things should be slowing down (I hope), so I should be able to more consistently post. As a resident, I remember thinking that my attendings had it easy. We would do the grunt work and they would just come down to the OR or Clinic after they were done drinking coffee in their office. Sometimes, I wish that was the case. The past 3 weeks have been particularly brutal. It is the main reason for the dearth of posts. Over the past few weeks, we have been unseasonably busy. We are still getting a lot of trauma and the elective load has been steady. What wears you down is not one day, it is the accumulation over time. I am recharging and getting be back on my game.

“Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma - which is living with the results of other people's thinking. Don't let the noise of other's opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”
~Steve Jobs

Yeah .... I knew the IRB was put in place for a reason ...

“There is nothing like looking, if you want to find something. You certainly usually find something, if you look, but it is not always quite the something you were after.”
~J.R.R. Tolkien

For those of you who have done or are doing research, you have probably dealt with the institutional review board (IRB). The IRB was set up to protect patients from abuses.

In the United States, IRBs are governed by Title 45 CFR (Code of Federal Regulations) Part 46.[1] This Research Act of 1974, which defines IRBs and requires them for all research that receives funding, directly or indirectly, from what was the Department of Health, Education, and Welfare at the time, and is now the Department of Health and Human Services (HHS). IRBs are themselves regulated by the Office for Human Research Protections (OHRP) within HHS. IRBs were developed in direct response to research abuses earlier in the twentieth century. Two of the most notorious of these abuses were the experiments of Nazi physicians that became a focus of the post-World War II Nuremberg Trials, and the Tuskegee Syphilis Study, an unethical and scientifically unjustifiable project conducted between 1932 and 1972 by the U.S. Public Health Service on poor, illiterate black men in rural Alabama.

So, I like most who have done research have and will complaint about the IRB, but it does serve a purpose. It is in place to protect patients rights.

What made my write a little about the IRB? Well, I was reading through a number of blogs this morning as I do on a Sunday before a long run and I ran arcross a post on a site called The Museum of Hoaxes, written by Alex Boese. In his research for his book called Elephants on Acid: And Other Bizarre Experiments he ran across a number of bizarre experiments. This list of The Top Twenty Most Bizarre Experiments od All Time should reaffirm in your mind the purpose of the IRB and that they are not there just to make more busy work for you.

To research my new book, Elephants on Acid, I scoured scientific archives searching for the most bizarre experiments of all time — the kind that are mind-twistingly, jaw-droppingly strange... the kind that make you wonder, "How did anyone ever conceive of doing such a thing?"

Listed below are twenty of these experiments. You'll find all of them (and about 80 more) discussed in greater detail in my book, which will be published this November, 2007 by Harcourt. Kirkus Reviews calls it, "One of the finest science/history bathroom books of all time."

One question you may be wondering: Why are these experiments listed here, on the Museum of Hoaxes? They're not hoaxes, are they? No, they're not. All of these experiments really did occur. I put the list here simply because I already had this site up and running, and I didn't feel like designing a new site just for one list.

There is clearly a reason for the IRB, but sometimes I wonder about parents making decisions for the underage. Do they make the decisions for the best of the child or because they don't understand why they aren't "normal". With the increase of the diagnosis of ADD and ADHD as well as Bipolar disorder, this may be true. All of those teenage angst songs about parents may also be true.

A great song from the early 80's by Suicidal Tendencies titled Institutionalized about teenage angst and the frustration of parents not listening to them. This ends with the teen being institutionalized for being a teenager. My favorite part of this song is:

I was in my room and I was just like staring at the wall thinking about everything
But then again I was thinking about nothing
And then my mom came in and I didn't even know she was there she called my name
And I didn't even hear it, and then she started screaming: MIKE! MIKE!
And I go:
What, what's the matter
And she goes:
What's the matter with you?
I go:
There's nothing-wrong mom.
And she goes:
Don't tell me that, you're on drugs!
And I go:
No mom I'm not on drugs I'm okay, I was just thinking you know, why don't you get me a Pepsi.
And she goes:
NO you're on drugs!
I go:
Mom I'm okay, I'm just thinking.
She goes:
No you're not thinking, you're on drugs! Normal people don't act that way!
I go:
Mom just give me a Pepsi please
All I want is a Pepsi, and she wouldn't give it to me
All I wanted was a Pepsi, just one Pepsi, and she wouldn't give it to me.
Just a Pepsi.

“There is nothing like looking, if you want to find something. You certainly usually find something, if you look, but it is not always quite the something you were after.”
~J.R.R. Tolkien

Miss Teen South Carolina as an orthopaedic resident ...

Question: What are the treatment options for treating this elbow fracture?


"I personally believe that the distal humerus elbow is difficult to treat because, uhmmm, some elbows people have are different and uh, I believe that elbows, operations like such as uh, the knee, and uh, the spine, everywhere like such as, and I believe that elbows should, uhhh, our operations of the elbow should help the distal humerus, uh, should be like the knee, it should help the spine and the shoulder so we will be able to place screws and rods, for the fixation."