Wow its been a while...

Sorry, its been a while since I've written. A lot has happened, a number of milestones and new events, and it sure has been busy. But alas, I can sit and write, and realize that I've already had this blog for 1 year!

First of all, Nicole graduated from PA school, and moved up with me in North Carolina permanently about 2 weeks ago. It sure is nice to have my wife living with me finally! She graduated with her second Masters's degree (her first was her public health degree from Johns Hopkins) with a perfect 4.0 from Emory's physician assistant program, and was offered a great job at UNC Hospital (where I work!). She'll be working with the GI docs that specialize in esophageal disorders, working in clinic and doing procedures. No overnight call, no weekends!! She will surely be my sugar mama! It will be exciting to have her in the same hospital, so that we could occasionally meet for lunch, etc!

Second, as soon as Nicole got up here, we got a new puppy! Her name is Sofie, and she is a catahoula leopard dog (with a little bit of lab mixed), which is the American version of an Australian shephard. She looks a little like our dog at home in Tampa, Fozzy, which is partly why I loved her so much.

The face of an angel!

Sofie in the mountains. It's cold, let me in!

Third, work has gotten better and better for me. Yep, as you can tell from me not writing for a while, I have been really busy. Since the ICU, which was a really good month for learning, I did a month on the pulmonary service which was extremely busy. Lots of people with lung disease, and this included teens and adults with cystic fibrosis, people with bad COPD and pneumonias, lung cancer, and people who were on ventilators who are extubated (taken off the ventilator) and transferred out of the ICU to us. I always carried between 7-12 patients, and at one time had 15 patients!! But this was the month that really gain some confidence, because if I got through that month with that many patients, I could handle anything. And sure enough, it was about this time I started getting more comfortable at being an intern. I'd start doing procedures myself, start needing less help while cross-covering overnight, and felt more comfortable seeing patients on my own. You start knowing that a patient with chest pain "needs an EKG, cardiac enzymes x 3, fasting lipid panels, hemoglobin A1C, thyroid tests, telemetry, started on an aspirin, statin, nitroglycerin, meds for high blood pressure, a beta-blocker if is pressure is ok, and consider a heparin drip." It all rolls off your tongue, and you don't realize that, damn, over the past 6 months this has become second nature.

After my pulmonary month, I did a month of geriatrics, which was a really good month. These old people are so cute, and many of them pretty fascinating. They have been all over the world, or have had interesting jobs or positions, and many of them are still living the good life in their assisted living homes. But also, we had many of the more somber cases of nursing home residents, who often get the nursing home sicknesses (pneumonia, urinary tract infections, diarrhea, etc), come to the hospital, get better, and then are sent back to the nursing home to get their next infection. I remember specifically, we had one nursing home resident who comes to us with failure to thrive, decreased appetite, nonspecific abdominal pain. Turns out he was a prominent faculty member of the UNC medical school. He has no wife, no kids, no family around. He had a fall a few months ago, and had to be put in a nursing home as he had no one to take care of him. But since his placement, he seemed to be profoundly depressed, and his memory got worse and he just didn't want to eat, or do anything. Other things can cause this presentation, this wasting away and anorexia and weight loss and abdominal pain, mainly cancer. But we did a big workup, and eventually found that really this was all from depression. Even his memory loss was from big time depression, which is called "pseudo-dementia." All his former friends and colleagues are associated at UNC, and there was no where else he wanted to be than among them at UNC. But he had no other reason to be hospitalized. We let him stay about a week longer than he should have, but eventually had to force him back to his nursing home, where he would spend Christmas and New Year's alone. That's the other side of these elderly patients. I hope that none of my family and friends have to be alone when they're old.

Lastly, Nicole, Sofie, and I spent our first Christmas in our own home, which was really great. Nicole's mom Barbara came down and joined us for the holidays, and we set up lights, got a tree, they put up stockings, and we had a great time. I got 5 days off for the holidays which was badly needed. We spend 2 of those days after Christmas over in the mountains, visiting Margot, George, and Stefan, friends of ours who were at the wedding. Stefan and Nicole were born the exact same day in the same hospital in Dallas, and lived on the same street! They have been friends since Day 0, and its pretty cool to see them still keeping in touch.

I'm now starting on cardiology at UNC, and it will be another busy but good month! And after that, another week of vacation, followed by 2 "easier" months, one of which I'll have no call or weekends!! Half way done with intern year!!!!!!!!!!!!!!

There's a lot more to catch up on, and more pictures to post, so as one of my new year's resolutions I'll try to keep up on this blog again. I wonder if anyone is still reading this after my lastest lull though...oh well! Happy holidays and happy new year!