Now, this wasn’t my first rodeo, as I’ve had to spend the night at the hospital before. But in all of those instances I was paired up with a resident so I didn’t really have any responsibility. I did have to remain awake throughout the night, but it was more of learning experience than anything else. At Philmont, on the other hand, we were thrown into the fire.

Around 10 p.m., after a full day of clinic, the other medics leave and the on-call medic is left in charge. The clinic is closed but the infirmary is still open for walk-in emergencies. Besides handling these emergencies, the two other main duties of the on-call medic is to monitor the handful of inpatients and answer any radio calls that come in off the trail. Officially, there is also an on-call physician, who is available for questions over the phone and to come in if required. Of course, there’s kind of an unspoken badge of honor over making it through the night without having to wake the doctor (without seriously harming any of your patients). It’s amazing though, no matter how small the decision, it gets magnified when you’re the one responsible.

On my first night, I saw my last Scout in the clinic, checked on all the inpatients, and wrapped up all of my paperwork around midnight. At that point I decided I should try and stock up on sleep while I could, preparing for the inevitable life-threatening emergency that was going to come in. I decided to keep my uniform on because I reasoned that the 30 seconds it would take me to put it back on could be the difference between life and death. I placed my phone, which doubles as my alarm clock, under the pillow where my ear would rest so there was no way I could sleep through a page. And there I laid, in bed with racing thoughts. I obsessively went through all of my duties in my head, double and triple checking everything I was supposed to do. When I was satisfied, I tried resting my eyes but they would snap back open with any noise. Every sound, my mind would transform into something more sinister. A car passing by turned into an ambulance speeding into the ambulance bay. The cleaning lady working outside my room became a walk-in stumbling through the infirmary to find me. The grinding of the ice machine morphed into the post-concussive patient in the room next to me having a seizure.

Then the morning came. I had been ready for anything but nothing happened. After the dust settled, I had made it through my first call unscathed. Sure, I had gotten up to answer a few radio calls and I had compulsively checked on all the inpatients a couple of times, but everyone survived and so did I. I didn’t get Scouts walking in with life-threatening injuries. I didn’t get any asthmatics that needed a surgical airway. I didn’t get any advisors having a heart attack. And of course, I didn’t get any sleep.

In grade school, one of my teachers taught me to start any speech or paper with an onomatopoeia, so as to catch the audiences attention. Of course, at that point my audience was a room full of 2nd graders, but it’s something I’ve carried with me throughout my educational career. The sentence italicized above is pretty much all I have written for my personal statement for residency so far.

It’s not really a secret but personal statements are the bane of my existence. They have always been difficult for me to write because I don’t have a whole lot of hardships to draw from. I’m really not complaining and I wouldn’t change my childhood for anything, but as it turns out, being a white middle class male with a very supportive family doesn’t provide me with many obstacles to overcome. I’m considering making my own children live on the streets for a year just so they can experience some adversity… and have something to write about in personal statements.

I don’t know how writers do it. It’s taking me forever to write one page because I’m scrutinizing every word of every sentence. I can’t imagine how someone can write an entire book. Also, I was kidding about starting my personal statement off with an onomatopoeia… or was I?

I’m about halfway done with my Philmont rotation and things have slowed down to the point where I thought I should post an update. I’ve learned and experienced quite a bit so far. I’ve gotten to suture, start I.V.s, remove ingrown toenails, drain abscesses and a lot of other hands on skills that I might not have experienced otherwise in medical school. I also get to carry a load of responsibility, from taking emergency phone calls to being on 24 hours of call overnight at the hospital.

75% of the patients that come in fall within the stomach flu, blister, rolled ankle, or altitude sickness domain. The picture above was actually taken by one of my colleagues and I don’t really know the whole story beyond, a guy fell into a cactus patch. But that’s just a sampling of what the other 25% of our patients are.

There are six of us medics in the health lodge and we’re all 4th year medical students from KU (two are missing from the picture above). We make up a minuscule percentage of the employees here at Philmont and I pretty much fall right in the middle on the spectrum of staff personalities. I’m not hip enough to have brought my own musical instrument to play (bagpipe, mandolin, flute, etc) but I’m not twin brother enough to play Dungeon and Dragons in the staff lounge while watching Dr. Who.

The sleeping arrangements are tight, but at least I’m not shacked up in a tent like a lot of the other staff. We’re living in the remnants of the old health lodge. It’s pretty much a throwback to my dorm days at KSU… just with less temperature control. The new health lodge on the other hand is pretty 21st century.

Each year, the health lodge staff makes a poster commemorating their summer at Philmont. Past posters are mostly tastefully done artistic pieces with everyone’s name on it. Ours is pictured above and it’s more of a mural depicting a true story for the summer. The picture is fairly self explanatory but it goes a little something like this: A bear was attacking a goat (named Esmerelda) and an old guy ran out and punched the bear in the face… with a double rainbow overhead. Unfortunately, two weeks later Esmerelda succumbed to infection from the attack and a halo had to be added, but she was a fighter. Our names are listed below our motto for the summer, “We can fix everything but a broken heart.”

That is what I had been living for the past month. I had done so many practice questions I couldn’t think straight. I couldn’t even watch (excellent) movies without them taking on the form of a word problem. Fortunately, I took my boards last Saturday and at last, the nightmare is finally over. Unfortunately, I didn’t have much time to catch my breath because I had to take the overnight train down to New Mexico for my next rotation. I felt like Professor Lupin heading back to Hogwarts, only with a lot more boy scouts… and a lot less Dementors.

As I mentioned before, I’m working at the Philmont high adventure camp for the month. The hours have been pretty grueling so far but my schedule should lighten up later in the month. I promise I’ll update more then. Hopefully, all of my preparation for my boards will pay off during this rotation as this is probably the sharpest I’ll ever be in regards to my basic science knowledge base. Of course, my patients will have to present themselves to my clinic with five multiple choice options for me to pick from when diagnosing them.

After July, I will be doing a rotation in New Mexico where I’ll be playing the role of medic at Philmont Scout Ranch. I went there as a boyscout and coincidentally, KU provides the staffing for the health lodge. It sounded like a great experience and I had heard only good things from students that went in the past, so I signed up.

Finally, for the two months after Philmont I’ll still be traveling. In September I’ll be doing a rural rotation in Somewhere-West-of-Here, Kansas. And in October I’m doing an away rotation at Oregon Health and Sciences in Portland. Sure, being away from home for three months would be difficult for anyone. But since home is where the heart is, I’ll be bringing my home with me because Nina is joining me for my rural rotation and rotation in Oregon!

Of course, traveling won’t be all fun and games. During this time, I’ll have to start/finish my residency application and not to mention work on wedding plans… well, nod my head and try not to say the wrong thing.

General Surgery
Cardiovascular Surgery
Maxillofacial Surgery
Neurosurgery
Orthopedic Surgery
Otolaryngology
Pediatric Surgery
Colorectal Surgery
Surgical Oncology
Thoracic Surgery
Transplant Surgery
Trauma Surgery
Urology
Vascular Surgery

Time to do some spring cleaning. Recently during my final rotation of the year a group of us were together being nostalgic about the first three years. The conversation drifted from topic to topic but eventually settled on each of us sharing which month(s) of school was our least favorite. One student said adjusting to the very first module made those months the most difficult. Some disliked other modules for their own legitimate reasons. And a few others disliked certain rotations due to an individual staff or resident. Mine was my two months of surgery.

My first month was general surgery out at the VA in Leavenworth. My second month was Urology. They were both… ok. It’s not that I had a bad experience in either one, but it’s not like I had a good one either. For instance, the most memorable part of the Leavenworth rotation was being able to drive through the hometown of Melissa Etheridge (they had multiple signs up).

It’s hard to put my finger on why I dislike these months as much as I do. Heading in, surgery was low on my list of prospective specialties but I hadn’t ruled it out. By no means was it my most time intensive rotation. And it’s not like there was any more distracting homework or presentations than other clerkships. The actual procedures weren’t bad, but I don’t think I have the patience to do them day in and day out. There’s a lot of red tape (for all the right reasons) that has to be navigated through for each surgery. And if I really want to do procedures, there are a lot of other disciplines that have them, they just don’t focus solely on them.

I have a theme of titling these posts after the field I’m ruling out, but if that weren’t the case I probably would have called this one, “Praise is the Absence of Criticism.” I was told by a surgeon that this was his teaching philosophy. As you might imagine, this wasn’t an easy adjustment for someone who thrives off of positive reinforcement. This, accompanied with the general negativity of some of the people I worked with, created an unhappy atmosphere. It was emotionally draining, and while only a small sample size, I quickly realized this wasn’t the field for me.

Finally, just an observation I made, surgeons seem to be the most prevalent Bluetooth wearers of any other physician. Read into that what you’d like.

*Nurse hands me chart*

Nurse: “This is an older woman complaining of back pain, most likely musculoskeletal in origin.”

*Knock on door*

Me: “Hello, my name is Adam. What brings you into the clinic today?”

Patient: “I’ve had some low back pain for a couple months now.”

Me: “Tell me more about this pain.”

*Ten minutes later*

Patient: “Oh, also, I have that Patrick Swayze disease.”

Me: “Ok… wait, what?”

Thank you everyone for putting up with my semi-cryptic post the other day. As most of you surmised, the post was one stop along the way to my proposal to Nina. We had been pretty open about our desire to get married for a while so it wasn’t easy for me to surprise her. Therefore, I decided to make her work for it and make a day out of the whole thing. I sent her for a massage, a manicure with her friends, and several other of our own spots around town. Music, parents, and poems about as good as the one you read on my last post were involved. Eventually, I was waiting for her at my apartment (yes, I cleaned it) where I proposed and then we proceeded to meet up with family and friends at the Cheesecake Factory to unwind and debrief. This was one of the only weekends that I knew we would both be free so not only had I been planning this for a long time but I got the ring a while ago so it was burning quite the hole in my pocket. A special thanks goes out to my parents who were incredibly supportive and patient with me throughout this whole process. Now on to wedding planning!

Fingernails can be painted red,
Toenails can be polished blue.
Fingers that will soon have a new ring deserve something special,
So that’s where I’m sending you!

Click Here!

Playlist Trip 5