End of Medicine month

It's a wierd feeling to ponder the trepidation with which I approached call before Medicine month. Now I feel like I could handle any problem on the floors. In the beginning I called my seniors to check everything; now my seniors call me to see if I'm still alive because they haven't heard from me in hours. It's been intense. I've cried many times. Sometimes from frustration, but more often tears were shed with patients, knowing that I had helped them or that I could, even if it was only making their death comfortable and with dignity. Medicine isn't just a lot of hours, it's a lot of heart, for to be a good doctor you must emotionally invest in your patients at least enough to care about their lives, for they are in your hands. I'm glad though for the repreve of going home and forgetting about work. I try, and am mostly successful I think, to leave work behind when I leave. I've never cried about work at home. I mostly just try not to think about it too much. Fortunately there are plenty of distractions, with Anna and her hyper-active dog, Montana, always ready for a run or a hug or a dog pile.

One Twelf

Almost one 12th of the way done with my intern year!  Yay!  My next month is internal medicine which will carry more responsibility and time pressure.  This month ended up realively easy since it was all outpatient clinics unless I was on-call in the hospital.  So far it's been pretty much like Gray's Anatomy.  j/k, more like scrubs.  I would characterize my residents as "giggly" and also quite intelligent.  I have learned a lot and look forward to sponging more.  Wish me sleep!

Fewer Americans are smoking, poll reveals

Finally,  something to celebrate about in our current public health climate.

WebMD (7/28, Hitti) reported that a new "Gallup poll on smoking shows that 21 percent of U.S. adults currently smoke cigarettes." Gallup first started "asking people in the U.S. about their smoking habits in 1944. Back then, 41 percent of poll participants reported smoking." This year's Gallup smoking statistic "is very low, but it's not quite an all-time low. 'From a statistical perspective, a 22-percent reading in 2004 and a pair of 23-percent measurements in 1999 and 2006 would be considered equivalent to the current reading,' states Gallup." The new Gallup poll also reveals that "most current smokers -- 55 percent -- report smoking less than a pack of cigarettes daily." And, "81 percent of current smokers say they would like to give up smoking and 79 percent say they're addicted to smoking." Additionally, the Gallup report indicates that "one in four current smokers report starting to smoke before age 16. That percentage hasn't been lower since 1991, according to Gallup."

First Week as Dr. Nuwer

Being a doctor is scary! Mostly because I feel like I don't know anything and I don't want to kill anyone because I'm an idiot. Hopefully this feeling will go away soon because it turns me into a bumbling idiot. For example, the code pager went off indicating someone was dying somewhere, so I run to the room get there and the lady is stiff and shaking - not a seizure, but a drug reaction to this chemo drug she's on. I'm panting, the nurses ask if I'm a doctor and I meekly say "Yes", because I have NO idea what to do. Fortunately, my senior resident came strolling in and took care of it. What did I learn in the last 4 years? Not much practical stuff!

Any way, I'm getting my feet under me and learning to introduce myself as Dr. Nuwer. It's really weird. I have my first patients already: a mom and baby that I delivered, or rather, assisted with her C-section. Exciting!

Happiness is BLU

This weekend I had the opportunity to watch my favorite sports team win a prestigious tournament, the Stanford Invite. My UCLA Ultimate team, BLU, beat the Pie Queens of UC Berkeley in finals. I got to see them whip University of Washington in Semis too. I couldn't help but feel proud every time a player made a sweet play. My favorite part, however, was seeing the change that has happened since our first year together. The players have developed so much since our first season. It still surprises me sometimes to see someone make an unexpected play. A formerly tentative player gets a diving blocks or a player that used to have weak throws steps around to throw a difficult pass. A player that struggled with long throws for years, finally consistently throwing beautiful long throws. A zone offense that I toiled to get them to use and understand, shredding the zone defense of another team. This work has not been done by me, it's been done by them and their coaches since then. I love seeing something that I helped create flourish without me even needing to be there. I helped set the pieces in motion. I helped set original strategies. I helped shaped their game by providing a strong example and through coaching. And now I can sit back and enjoy the beautiful artwork that they create for all of us to watch and admire with happiness.


I'm working on a research project right now about the effects of long-distance running on children. I mostly enter data, but there are some things I can't help but feel. One of the questions is rate your daily mood on a scale of 1-10 with 1 being always sad and 10 being always happy. The kids involved are middle school age. Everyone knows middle school is a rough time. Still it makes me fundamentally sad when the children answer any number less than 6. Kids are supposed to be happy and having fun!

The other thing that I've been noticing is how many children have checked the box indicating that their family income is less than $20,000/year. I have a hard time imagining living on that as one person. I think about the sacrifices that these family must make to make ends meet. I wonder how these kids pay for good running shoes...maybe they can't afford them. I can't help but feel privileged and at the same time called to help these poor families in whatever way I can.

The good news is that neither of these 2 data points seem correlated. The kids from poorer families seem to have the same distribution of happiness as the privileged kids. Maybe money can't buy happiness after all.


If you didn't think I could take Ultimate to the extreme - I just did (and you should know me better!). I just played in the World Flying Disc Federation's World Club Ultimate Championships. It happens every 4 years in different locations around the world. This year's was in Perth, Australia. Yeah, I had to look it up too.

Perth is a large modern city on the West coast of Australia. It's big draw are loads of beautiful beaches - crocodile and shark free. We stayed in some beach condos just north of the city, but spent most of our time at the incredible field complex. There was Ultimate as far as the eye could see.

I played on a team from San Francisco. We were in the co-ed or mixed division which had 41 teams from around the world. Our team Red Fish Blue Fish was seeded 15th,and we finished an astonishing 4th in the WORLD. How cool is that? We lost in Semi-Finals to a long-time rival from San Fransisco Brass Monkey. Then we just ran out of energy in the 3/4 game.

Japan swept the Men's, Women's, and Master's brackets. They are so fast and flexible and make up for their short stature with incredible jumping ability. In the Mixed division, Team Fisher Price from Vancouver beat Brass Monkey.

I had a great time meeting people and hanging out with my team. Although I only knew one other player before the tournament, we quickly bonded and had a lot of fun together. In total we played 267 points of Ultimate in 11 games. I played 160 points, the second most to Gretchen who played 164. We were short on women so all 6 of us played a lot. If you care, here were our games:

Pool Play:
Red Fish Blue Fish 17 7 Pula (Philippines) *
Red Fish Blue Fish 17 10 Bootius Maximus (Australia #1)
Red Fish Blue Fish 17 13 Drunk Dogs (Japan #3)

Power Pool:
Red Fish Blue Fish 17 7 Dis'Chords (Canada #5)
Red Fish Blue Fish 17 12 Woodies (Germany #1)
Red Fish Blue Fish 17 12 Camelot (Canada #2)
Red Fish Blue Fish 8 17 Slow White (USA #2)

Prequarters: 16 10 Bootius Maximus (Australia #1)
Quarters: 17 14 Bad Larry (USA #6)
Semis: 8 14 Brass Monkey (USA #4)
Bronze Medal Match: 15 17 Slow White (USA #2) **

cardiovascular health strikes again...and again

This is a direct quote from the book that I'm studying for my liscensing exam:

"A 50-year-old marathon runner who eats well and has a high HDL without other risk factors for coronary heart disease (diabetes, high blood pressure, smoking, family members with early heart attacks) is unlikely to have had a heart attack. A long-term smoker with a positive family history and chronic high blood pressure, diabetes, and high cholesterol has had a heart attack until proven otherwise!"

Here's another one for the young people:

"Smoking is the single most significant source of preventable morbidity [illnesses that don't kill you] and premature death in the United States."

Oh the places you'll go

I have my first residency interview on Oct 30th. Should I go in costume? Maybe as a doctor... I think I want to stay in California. I applied to 5 programs in Northern California and 3 in Southern Cali. I'm also going to see a program in Albuquerque that looked interesting to get some variety. I want to choose a program with an associated Sports Medicine fellowship because you get better training in that area. However, only 3 of the programs I applied to meet that criteria (San Jose, UC Davis in Sacramento, and Santa Monica). So we'll have to wait and see which ones I like the best.

The way the residency applications work is weird. We submit our top choices in order (Rank List) and all the residencies submit their top applicants in the order they would like them. Then a computer matches us. It's called the Match. I'll get the results on March 15, 2007.

And then on to Graduation on June 1, 2007, but who's counting ;)