More Good Things in November

Friends and Family!

I feel awful for neglecting to send October's Letter. My excuse: Well, I suppose priorities were a bit misplaced during the first few weeks on Internal Medicine (IM) rotation, which began late October. Long, long days at the hospital with 4 days off allowed during the entire month left me quite spent, and no energy = no letter. Things are better now :)

What is working in a big hospital like? Here is the breakdown of the 2 Fort Worth hospitals I have been in:

Spent my first 4 weeks at Plaza Medical Center in Fort Worth. This is a private hospital that saw mainly old patients with health insurance. I worked with IM residents (actual doctors who are still learning) to take care of the patients belonging to 3 primary care physicians' medical practices. Our philosophy: to provide the best care, cheaply and efficiently. Efficiency was often more of a wish than a reality, and this largely because of communication problems between doctors in various specialties working on the case! Out of many cool cases, the most interesting was a patient with Tylenol toxicity who nearly went into coma, but who completely recovered after treatment besides some physical weakness due to innactivity! After following her from the emergency room to the regular floor and then to the intensive care unit, thinking her nearly beyond hope, I was so amazed with her improvement!

The 2nd month of IM is at John Peter Smith, the county hospital of Tarrant County. Goodnight! This hospital is quite a bit larger, and much wilder! Our patient demographics are different too, people with out insurance, citizens and undocumented, and a more varied age range. I work with family practice residents here, admitting patients to an internist's medical service. We (3 students and 3 residents) start the week "on call" meaning we admit sick people from the ER from noon until the cap is met at 16 patients... which usually happens around 1-2am. Our team then wakes up early to round on the patients with our attending doctor... and finish around noon. Our job is to kick as many patients out of the hospital as possible (if their health improves) because every day in the hospital increases patients' risk of hospital acquired infection, being a patient is not fun or comfortable, the hospital doesn't loose money on prolonged services, and the patient care team can breath easier. As long as we have patients in house, they must be seen every day.

One of my favorite things about November, I'm in a city full of people I love! After 4 months in rural Texas, I'm realizing how much I need friends and church family. Don't get me wrong! I did leave friends in Crockett and Cuero, but 2 months of cultivating relationships is somewhat shallow compared to the roots that dig deep over 2 years. Definitely thanked God for people this Thanksgiving.

Yep, so I hope this helps you understand more about life here in Fort Worth.

On a fun note: during one of my days off in October, my dear friend and fellow medical student, Dan Leverenz, needed manly assistance in fence building. Of course, I needed to dig out the work boots from the closet. 4 hours, 6 post holes and several calluses later, we finished cementing the poles into ground. Not quite as far as we expected. Golly! Manual labor sure felt good after hospital work. Slept well that night. Dan finished it Sunday morning by himself.

So maybe this is TMI (to much info), but I have to talk about something, and I'm "proud" of it. :)

Thank you all for friendship and familyship. Love you,

~drew

Where-O is Cuero?

(Actually a shot of Presidio La Bahia 26mi away, where Colonel Fannin and 300 of his men you massacred by General Santa Anna. The fort was built in the 1749. "Remember the Alamo! Remember La Bahia!")

Hello Friends,

You might ask yourself this very question and be flabbergasted, quickly open a web-based map engine and find this small town of 7,000 people located in South Texas (between San Antonio and Victoria). Cuero is most famous for its annual Turkey Festival, during which tons of turkey-fun activities occur, such as a race between a Cuero turkey and a Worthington, MN turkey.

I am very blessed to be at this site. The hospital is friendly, busy, and has provided me free housing at their abandoned nursing dormitory. When I first visited this site back in July 2008, I arrived after dark and clumsily hauled my belongings through the buidling... only to be greeted by its inhabitants!

The next day I met a Physician Assistant student who related how creepy the place was when she first came to Cuero. She quickly moved to a hotel inside town. Of course, I agree, the place is spooky, but it has been a good opportunity to overcome my fear of the dark and of the unknown. But even now, I'll get "the shivers" and glance behind me in the dark stairwell leading up to my room... but only every now and then...

My attending, David Hill DO, is a great doctor. The patients love him and will wait hours for him because he spends time listening to them. He is also an excellent clinician.... and a fisherman.

I am learning a lot from him :)'

"Wooo -Hooo!!! I'm on a boat! I'm on a boat"

Love you guys,

~drew

Under General Anesthesia

The time passes so quickly; before I realize it, I'm waking up to the end of my first rotation. Part of me is happy to be "moving on" with life and education, but another part is saying, "Whoa! hold it buddy, You are going to really miss these people." Crockett is a small town, but left a big impression. My two attendings (physicians in charge) went above and beyond in their care and instructing.... the nurses and surgical staff so often lightened a moment with laughter..... the fish gulped my delicately presented fly so readily.... They will all be missed!

At this time, I can't say that I will never enter an operating room again. First, because surgeons aren't the only doctors who operate, and second, I cannot entirely rule out surgery. It's common knowledge that medical students think they know (for sure) which specialty they will enter as 1st years, but often change minds once they experience it real time in the hospital. We'll have to continue this game of musical chairs to make a decision, but primary care is still the main focus.

Surgery Positives - the procedures (working with my hands, being able to do definitive things for people, action)

Surgery Negatives - the sress (working inside of people is a very serious undertaking; althought the benefits are worth the risks... the risks are still present)

Litte Fionna, her daddy and I chowed down on burritos a few weeks ago. It seemed that a hat would be appropriate attire for this time of year... with the withering summer sun and all. I think reflective baby wear may catch on; perhaps auction it on Etsy?

POETRY CORNER:

My friend Cathy Kimbell lent me a book by a Japanese author, The Wind is Howling, which a bit of poetry in Eastern form called "Tanka". Tankas are short peoms that are meant to capture a moment's emotion and share it. The book moved me enough to begin writing some of my own....

7/06/2009 -

Patient and physician, chat in the sweltering room; He palpates her pulse, auscultates her heart and lungs, ignores her concerns.

(wrote this one after an interaction at a free clinic; I did not feel that all this patient's real concerns were addressed and she left unsatissfied. Practically, I know that each encounter can only last so long, yet I want to remember this.)

7/09/2009 -

In the face of death, medicine can lift our hopes, without Godly trust; But when medicine fails us, is there room for God?

(Surgery is often an extremely controlled environment. The surgeon knows the anatomy, what goes wrong with it and how to fix it/anesthesiologist suppresses normal breathing and breath for the patient manually/other staff follow orders to a T. I found it difficult to see God in this setting at first... The people were in control, so how did God enter the picture? Ah! But sometimes everything was not under control. The patient may breath in stomach contents, despite the anesthesiologist's best efforts, or may bleed to death, spiting the team's efforts in ligating arteries and transfusing platelets (infrequent persentage). As the rotation progressed, I found that asking God for mercy/grace in procedures became more natural and needed. In my own practice, I will need Him in every decision and every encounter; not to take anything for granted. I suppose that is how all life should be carried on.)

On my last full day the sky opened and gave birth to hail and sheets of rain! It trapped me inside the HEB across the street from the hospital. If you look carefully, you can see our country's flag spread out by the wind. For some reason, patriotism welled up inside of me. Distant cannons could be heard in place of the thunder; flashes of lightning appeared as muskett fire. But the star spangled banner still swayed intact! May God have mercy on us as the government continues to change.

\

(left)Visiting my cousins in Baytown, TX

(right)The site of my famed, larger than life, but actually true fish tale. {you'll have to ask me about that one indivually, PETA sensitive information}

I hope and pray that you all are living well.

~drewski

Crockett, TX; where Davy had his gallbladder taken out

(The parents visit; just before an entertaining show by the Gillett Brothers... folk artists extraoridnare from NYC)

Hello Family and Friends,

Being elbow deep in people's insides is a crazy experience! Mom, don't worry; my elbows get washed every night. :)

Quick overview of my time in Crockett, TX:

I am here for 2 months to learn from 2 surgeons who have practiced in this small town for years. Their rural practice is very diverse and I get to participate in many of the cases. Surgeons often have a notorious reputation for their gruffness/coldness/meanness towards students... but my attendings are very kind, fun and great educators. They have provided the rotating students, like myself, with a house next door to the hospital, and I get to eat for free in the cafeteria. The lunch ladies and I have a ball! Every day I throw on my scrubs, pull on some foot covers and don a surgeons cap for work, very different garb than I'm used to. (I don't really use this machine, the nurses do all the hard work; but I do like to pretend :)

My dad turned a wonderful 51 years last weekend and we spent it out on Houston County Lake.... searching for monster panfish. My flyrod needed some dusting off, but she got the job done alright... 4 fish later. By the way, my dad is cool; my aunts kept on telling me that when I was growing up, and lately I am agreeing with them more and more. Ken knows how to chill out on the lake [when he gets the chance to], set up a fishing rig for bottom fishing, sail a catamaran, take a big sigh of contentment after a long cold swig of some non-alcoholic beverage [probably a sonic slush], laugh when the laughing is contagious and buckle down to work before the trees say goodmorning to big Mr. Yellow. He loves Jesus and his actions don't contradict it[with-in mortal limits]. I could have just said, "I love my dad!", but us Aggies need a little extra explaining;)

(my cousin, Jeremy, and I in boats)

Dad and Jeremy did a little Humpty Dumpty off their canoe... twice!!! Fortunately for them, the lake was dehydrated. (Daddio and Jeremy in the muck)

OK, just a quick note before bedtime. Next time I'd like to share some peoms about my experiences in surgery... so If I forget, please remind me.

~drew

osteopathic medical student

Best Vacation Ever.... Since Christmas

Manhattan bridge

Hello Friends and Family,

Checking in with you guys after a month of fun! In the 4 weeks since my board exams, I have traveled a bit; I got to ride the Charlie (the mass transit) in Boston, MA, walk the street in New York City, see my cousin's dance recital in Fairfax, and search out family history in West Virginia... good times! I really wanted to get a "feel"/understanding of some other cultures in the USA because sometimes, when it seems like I've lived in Texas nearly all my life (which I have), thinking of places like New York seems foreign, kind of like a separate country. But perhaps that stems from the fact that Texas is almost its own country!

Mom kindly lent me her camera so I could have a little fun with photography. Hope you enjoy the pictures.

Brooklyn bridge and lower Manhattan

My understanding of the Northeast has progressed a litte further; finding that life happens up there a little differently than I've known before, but at the end of the day, the locals still tuck themselves into bed for a good night's sleep. Recently I watched a movie, "Moonstruck", with Cher and Nicholas Cage....the movie really came alive and touched me since I had just visted Brooklyn. While in New York, I journeyed from NYC proper way out to Yonkers, exploring the city of my mother's early childhood. With my Mimi's help, I even found their old house and took a picture for them... they haven't returned since my mom was 5 years old. Yonkers is definitely not a top 10 tourist destination or on any tourist's radar who visits NYC, and I enjoyed this side-step all the more because of that.

Yonkers

On nearly every airplane/long distance bus trip, and in many restaurantes I met people from all over the USA who didn't mind chatting a little and sharing some about their lives... The converstations turned many a dull hour into one tremendously more interesting. I hope and pray they are doing well now.

Stretching in a NYC park, 6AM... the city seemed almost deserted at that hour. But people popped out of the mortor work soon afterwards. The bustling, busy body streets definitely live up to their reputation.

North End Harbor

My friend Tao, was kind enough to let me crash at his place in Boston. Friends since Texas A&M, we found tons of things to do.

Uncle Darroll guided me through his homestate of West Virginia, showing me Valley Falls State Park, where I almost fell into the raging Monongahela river.... site of an early 1850s mill. Luckily I grip rock like an Appilachian Mountain goat.

Great Uncle Darroll and I explored my Great Great Great Grandfather Peter McDiffitt's house at Glover's Gap, West Virginia. The last residents abandoned the building in the 1950s and the house is in general disrepair. Really cool!

Playing with food at Ryan's in WV. This guy's name is Ryanoff the Sweet; made of jelly beans, pineapple rinds, lemons, waffle cone, whipped cream and a chocolate raisin.

After journaling/processing this trip more, I'm hoping to get some insight about where to practice medicine, wether urban or rural. ( right now my only stipulation is that the location must be a medically undersereved area). Each environment is unique in how its residents live in community... hang out, interact, do daily things....

I have had a blast doing normal people stuff too; like watching movies, reading for pleasure, hanging out with people I haven't seen since putting my head in a hole to study, thrift store shopping for clinic clothes, and witnessing many friends commit to eachother in marraige.

Surgery rotation begins this Monday, which I'm super excited about. I almost feel prepared, after practicing my suturing on pigs feet bought from Fiesta. Will keep sending monthly letters to keep in touch.

Love,

~Student Doctor Drew

Boards Are FINISHED!!!

my post test movaction

Hello Friends and Family!

I'm so excited to share with you guys that I am now ready to enter my third year of school. I finished my last exam today.... and 16 hours and 736 questions later.... I'm still alive and could probably pass a sanity test!

What a journey. Now that I am this far it has seemed to fly by, but as I reflect, the difficulties faced are still shocking. And this must be made clear: that God has carried me through the difficulties, that He has wiped the sweat from my brow after a day's hard thinking and lifted my chin up when it hung low with shame and discouragement, and that all of my joy and motivation stems from Him.

Thank you all for praying, calling, writing and hugging

love,

~drew

Madness is Around the Bend

My friends and I before a muscle skeletal exam.

My darling neice.  I want to be her awesome, crazy uncle.

Hello Frineds,

Life continues to be much more interesting and fun than I deserve.  Between studying medicine, playing music, and hanging out with local friends, old friends, homeless people and old people, I can not gargle up a complaint.  Lately I have noticed that people are supprised to found out that I love my work.  [It's really not often that you meet a medical student who is "fired-up" about something like prostate cancer (although my room mate is because his father's personal experience!)].  To that, I must admit lapses of frustration/feelings of being overwhelmed, but mostly true and good stuff.  So any good thought, smile, or praise should be diverted to the one who gives rest from this World's troubes, Jesus Christ.  

Well, our lovely month of April was a time to focus extra time on Board exams, since our Psychology class was the easiest of the year.  And speaking of exams.... the big two are coming up quite soon, about 25 days from now!  I have so much to study and will probably not write a letter for May, but stay tuned at June's end, I will finish my second Board exam by June 4th and will be off touring the East Coast afterwards.  

"Bubbles Instead of Bullets"

Mounds of fun creating this peice that I later entered into an art contest at school, although I didn't win.  At my good friend, Melanie Wilson's (Bristow) wedding, we were blowing bubbles as the couple left the reception and I had this thought: 

What would it be like if all people at war with eachother were suddenly suprised to see bubbles flying out of their fire-arm barrels and at their arch enemies?  I hypothesize that everyone would begin to laugh histerically, lay down their now worthless weapons and hug each other; all their trite disputes forgotten.  

Prayer: the topic is board exams, which I need to pass to become a doctor and excell to procure a decent residency.  

-wise time management

-focus

-retention of two years medical knowledge

I am so thankful for you who are care to read my letters and pray about this boy's requests (even a few moments)!  

love,

~drew

Wedding pics: Left - men's tie op ::: Right - Isn't Giant Jesus inviting?  "Come here little people so I can eat cough cough.... hug you!"

March Showers Bring Wedding Flowers

Hello Friends and Family,

I am happy you have hung in there for another month!  

Wedding Bliss:

I had the honor and luck to see two friends married this month!  In case you know them... Eric Barcack (classmate) and Ricky Board (church friend).  Consider yourself very fortunate to have glimpsed me in this state because I don't wear fancy pancy clothes like this all the time!  

Austin Revisited:

In early March I went back to Austin to try my hand at politicing some more.  This event was much more fun than the last because I went the the rural crew at my school... along with the rural hospital association of Texas.  The board of directors from Cuero Hospital (where I am completing my rural experience) showed up, so we got to hang out and get to know eachother.  Talk about some fun old men... they meant business with the congressmen but were full of jokes and laughs between office visits!  

The picture below: I'm getting a breath of fresh air on the capital steps before my next medical advocacy encounter.  I will admit... it was a planned pic.

Special Spring Break:

Over the holiday, "Spring Break", notorious for exciting adventures and dreamy road trips to distant lands, I didn't actually go anywhere new.  But I did get some good life experience in.  The guys in my home group spent this week intentionally living for Jesus.  Yes, we should always live in such a way, but it doesn't often happen because of time, work, other bothersome stuff... etc.  Well, we did have lots of time and little work... KAPOW!!! We spent a lot of time hanging out with the homeless down on E. Lancaster (near the shelters).  Also, we have wanted to make some music, share it, and praise God, so we asked God to give us more creativity than we can normally muster during normal school hours, and God blessed us with some sweet songs and a lot of fun!  I would love to share our recordings with you, but don't have them yet... wait for that post in the future.

Lovely times!  As I write, I'm thinking of you and hope you are doing well.

~drew

Praise: some of my medical student friends were introduced to Jesus over the spring break mission trip, we have been praying for that many months!

(if you have time to shoot up a quick one)

Prayer: Can I be a little selfish and ask for more blessing on Board Exam Study?  

A "Normal" Month

Normal?

Can any month really be normal?  This is a conversation I had with a coffee barista who insisted that his life was normal and dull.  He said this because he was not accomplishing what he wanted to do in life, and I could definitely agree with my friend if Jesus did not shake things up so often.  I'm not talking about a bag of "Shake-n-Bake" chicken either!  

Our lives have a purpose that is way beyond the normal routine of getting up, eating breakfast, and going to work again again and again.  New challenges are rising all the time, whether it is learning to play the banjo, learning neuropathology or genuinely and sacrificially loving my roomate, Ryan.  Yeah!  and we don't have to live in Zimbabwe or work as a CIA agent either.  

I suppose all this is to encourage us not to waste a day, instead to live fully.

Above pics: 

Upper - my lifegroup celebrates Vicki's birthday (I baked the delicious baked a chocolate ganauche cake)

Lower - astounding colors! Afternoon in Fort Worth

Austin and back in 24 hours: DomeDay 

On feb 26th, Osteopathic doctors and students gathered at our Texas capitol building to swarm representatives' and senators' offices, voicing our concerns and opinions about medicine inTexas.  I was a nervous jumble during my first office visit, but after a few more the formality and sterness seemed to dissapate and my genuine concern/passion over a few issues were more clearly expressed.  

In case you're interested, some of the issues were:

"increasing residency positions in Texas - because 40% of our medical students go out of state" "increasing insurance company responsibility for our patients and their clients"  --> right now these companies will often not reimburse appropriately, leaving physicians to bill their patients or absorb the cost.  They also limit how physicians treat their patients by limiting the medical care they will pay for.   

"the rural doctor shortage"

This coming week I'll be down in Austin again with the Rural group, lobbying-it-up!

 I have problems with normal poses!  Probably some medical/psychiatric condition.

Praises: Thanks for praying, because I felt like Jesus overflowed from this person a bit more.

Prayer: Diligence and focus in Board Exam studies this month.  It's coming along, but needs to be ratcheted up.

Gravdia 24 / Para 23 / Abortus 0

Medical Jargon:

I know!  The title is really weird... although perhaps 

not to mothers.  Gravida is the number of pregnancies a woman has had / Para indicates the number of viable births / Abortus stands for the number of failed pregnancies.... 

In my case, I am in my 24th year of life, with 23 good ones behind me and no failures.  Pretty good record, eh?  Bet it would be a record if my years were pregnancies!

Campout at Joe Pool Lake - Cedar Hill, TX:

Medical school friends, home church friends and I enjoyed a relaxing afternoon, chilli night, and beautiful morning in God's wonderful Creation.  Dina, the Philipino girl,  had never been camping.  Denise, the Congolese girl, suggested we show her what the "real" Texas looked like, so she doesn't finish school and think it's all urban.  I brought a guitar and another friend, Michael, brought his jimbe drum and some sweet jams ensued around the campfire.  

"!Escuelo Divertido!" Fun school, bad Spanish:

Please don't think I'm too strange, because I am loving medical school!  So far in 2009 we have finished an endocrine class and are half way through reproduction.  Acutally, my first Repro exam is in one hour.  Studying pregnancy and other aspects of reproduction has been so rewarding.  I can really envision myself as the primary care physician of an underserved area, providing prenatal services and delivering kiddos.  It is one aspect of medicine that affects half of the world's population directly and the other half indirectly...  not just sick people either, but healthy people that may not normally see a physician.  Below are a couple videos taken during class.

 

Love you,.... should be going to my exam now!

~drewfus

Praises: I am understanding more and more how much God loves His children... which includes me.

Prayer Request: Please pray that this understanding of God's love would fill me up and overflow onto people around me.  

The Year of our Lord 2009... rock on!

Praise: I have survived a crazy Christmas break and find myself again blessed to continue my medical studies.

Prayer: please call and ask me... we can even share! 281-793-9176

Happy New Year Friends and Family,

Hope you like my frame up, it went with my application for my first Board Exam to liscence me for doctorhood!  This exam and I will be bumping heads six months from now and until then there are still quite a few subjects left and bed pan full of studying.  The date is somewhere during late May/early June to be exact.

Friends, if you have not visited Big Bend NP, it is well worth the day long drive.  My family and I drove west on Interstate-10, turned south, passed by Fort Stockton, home of the Roadrunner mascot, and on into a desert wonderland.  Four nights and five days of sleeping under stars, hiking on mountaintops and spending time with family sure does leave a person refreshed!  The pic on the left was taken during our "hour on the 3rd highest peak in Texas", 7,825feet.  

On December 18th, just after my last exam and on my way to shadow my rural Doc in Cuero, TX, the old trusty car decided to capoot out on me in Waco.  The crank shaft had been damaged and wouldn't be fixed in time for me to make the preceptorship.  After resigning myself to these seemingly awful circumstances I was surprised and blessed to stay with an aquaintance (who even had my car towed back to Fort Worth) and I caught the last rental car in town! On Friday night, the 19th, the mustange muscle/rental car and I pulled into Cuero, only one day late.  Wow! What an adventure to have just a few hours into the Christmas break!  I wish there were some pictures to back this story up, but alas! Only receipts can give testamony to these events. 

To speak of my last order of business, you must imagine me dancing in line with the spritely old ladies in the picture above.  While following my rural Doc in Cuero, TX I met up again with my friends who line dance together.  They were happy to welcome this "Rover" into their Christmas party.  

Loves,

~drewsen