find some time, you just might find...

A return to normalcy, revised

2008-04-12T18:25:00.002-04:00

It's been almost a year since I wrote anything in this forum. I'd like to say it was due to my busy, "too cool for this" new California lifestyle. But that's just not true. I guess I was embarrassed by some of the content in the last posts I'd made. I really laid myself out there; the insecurities of facing huge new challenges, the risks I was taking with the best group of friends I could ask for. And part of me didn't want to have to revisit those thoughts now. I never wanted to go back and delete them either, because that's just not me. I like to think of myself as someone genuine and transparent, for better or worse. Accept me or don't.

I think I'm finally settled enough here to see some of the results of these insecurities, and they've worked out okay. And for that, maybe I'm back.

Clearly this has been a move that we're happy about. It's tough meeting new people and we miss our friends, but we have each other a small social group and a ton of fun things to do.

In the last year, Ryan and Patricia have been expecting, Justin and Liz got engaged, the Skins made the playoffs, the Caps became a national phenomenon, I started playing ice hockey, and a bunch of other things have started to happen.

We're healthier than ever.

We're having more fun than ever.

I've had the reassurance that I chose that right profession and feel very competent already.

Christine has hit her stride professionally.

And just a bunch more.

I'm really excited to go back East and catch up with friends and family. Two weeks is going to fly by so quickly but it's time to reconnect. I've been very impressed with the ability to stay in close communication with the guys in the last year, but we need some good old fashioned fun.

I'll post more, with better content, soon. I have boards to study for and if it's 87 degrees out in the sun, the shade right now should be just about perfect.

Hollow Bean Beach

2007-06-18T12:57:00.000-04:00

...along Pacific Coastal Highway.

peace

2007-06-13T18:36:00.000-04:00

I can't believe I live here.

It was warm today. 88 degrees, though not humid. Really, it was a heat that scorched the top of your head or your seat, but otherwise left you alone.

Our stuff is coming tomorrow so after taking the morning for business, I grabbed a bite with Paul at the Crepes restaurant a block away, then decided to finish my book while he went into the city.

I walked into Burgess Park, about 5 minutes away. I've mentioned it to my friends as a place perfect for soccer. Well, it's being renovated. Half of it is brand new sod. The other half, well, let's call that new-ish sod. I'd pay to play on either. Fortunately, soon I won't have to. There are full baseball fields and little league sized baseball fields, tennis courts, playgrounds, open space for reading/lounging/frisbee, benches everywhere, and--welcome to california--a skate park that unbelievably sits with mild use. I'd be tempted to take my rollerblades out there tomorrow, but I'm too old to handle a 1o ft drop right now. Wrists are fun to be able to use. There is also a huge pool complex with a kiddy pool, general use pool, and lap pool. They have waterpolo teams apparently as well. The pool is no longer the city's, however, so that costs some money.

Anyhow, I read my book in the sunshine and caught a few rays in the meantime. The train was drowned out by my iPod. Some of the chatter and laughter from the pool, fortunately, was not. An old stoner/hippie strummed his guitar in the shade just beyond earshot.

The walk home was peaceful. The air was warm and smelled like whatever flower I was passing by at the time, none of which I know except for the honeysuckles that are everywhere. The windows to my apartment are open, a crossbreeze is flowing by, and I think it's time for a sandwich.

I'll post some pics once I get my camera back. In the meantime, look for me on myspace. I think I'm finally succumbing.

easy hello

2007-06-12T21:24:00.000-04:00

It's 9:30pm now, or so my computer says. It is sunny and feels an odd degree of hot despite an objective 73 degrees with no trace of humidity. The flight was a turbulent one, and though I try to neglect a certain dramatic sense of foreshadowing, apparently I have failed.

The apartment is very clean, smaller than I recall, and hints somewhat of the house I have been reading about in Upton Sinclair's, "The Jungle". (For those who have not yet read the book, the house is one sold as "new" over and over again, all the while creating situations where new owners cannot afford it. The house becomes "new" again with simple repairs and a heavy dose of fresh paint). That book in itself may be shaping my mood somewhat, it being a novel of misfortune great enough to incite depression in its readers.

Paul (brother-in-law) and I arrived on time after about 9 hours of travel, did the apartment paperwork, then hit Target and Safeway for the basics. We stopped for some gourmet Jack In The Box. We learned a few valuable lessons: don't try the sweet and sour sauce, and don't try the sirloin burger. At Safeway, things really turned upwards. I looked down several aisles of wines, mostly local, and found many great bottles from a very wonderful last year of my life. I repurchased Honig Sauv Blanc (honeymoon), Chateau St. Michelle Merlot (graduation dinner at The Capital Grille), and the easy to find Copolla Merlot (dad brought it when he came to visit our apt for the first time).

And now I sit in a mostly empty apartment. All I hear is the hum of the refridgerator, a gentle breeze through the curtains, and the ruinous clacking of my keyboard. And I am beat.

But there is a bottle of wine chilling in the fridge, I have a mostly free day ahead of me tomorrow, I have the security of a great support network, and--slowly but surely--this ride has officially begun.

Perhaps now it's time to change my computer clock to 6:30pm...

tough goodbye

2007-06-11T23:25:00.000-04:00

Well it's 11:30pm. I leave in 8 hours. I just said goodbye to all my closest friends, minus Justin. For the first time I feel something less than positive about the move. I don't quite know how to classify it, but it's in the ballpark of fear. At its least, it can be called a moment of hesitation. I see clearly now that I am gambling personal preference of climate and adventure against great relationships. My very best friends--relationships earned over time through periods of turmoil, growth, and a youthful exuberance that just cannot be recreated--they are now in a place where we need to try and sustain our friendships through longterm communication and rare, expensive, and strenuous travel. And that's something I willfully did.

I gambled with my best friendships, and unless I return in a few years, they will be forever changed.

I am heartbroken. Excited also somewhere within, but deep down, I am very very sad right now.

I expect the next few months to be a kaleidoscope of these emotions, especially with these friends making such genuine efforts to come and visit. These visits, of course, will slow in frequency over time, and again I will feel like I do now.

Ryan, Neil, Marty, Justin, Jimmy...thanks. Maryland just wasn't for me. I don't know how else to explain it, but I just need to do this or I'll always regret it.

Ryan: carbombs + wooden blocks, sleeping under juanita, and "Shots On Goal".
Neil: minigolf in the halls, miss piggy mugs, and the albatross.
Marty: battery-powered calendars, koosh basketball, and "I've got a question for you".
Justin: head first in the trashcan, banana blitz, 26.2, and Maggie Moore's FC (champions).
Jimmy: basement pingpong, miller's hand = jimmy's hair, when you almost got stabbed at my bachelor party.

Alas, here I go......

For better or worse, here I go.

End of the road, top of the world

2007-05-23T11:59:00.000-04:00

I am on top of my world. I have achieved my life's grandest of pursuits over a ten year stretch, and along the road have collected wonderful relationships and experiences. I am very lucky.

This was not something I did on my own, but rather because of people like you.

I'd like to thank:

*Christine --

For being there from the beginning. When we met, I was a schmuck struggling to prep for the MCAT. I talked a big game, but made my insecurities just as visible. She didn't care if I became a doctor, a lab tech, a teacher, a psychologist, or whatever. She made me laugh and feel secure through med school rejection letters. She made me laugh and feel secure through biochemistry exams. She makes me laugh and feel secure today. And now, when I feel I can do anything this world has to offer, I possess a confidence that comes from her. Even if I were to fail, she'd be just as proud. I never have anything to lose. Marrying her was the best decision I've made in this whole process, and the memories we create everyday are far more satisfying than any achievement I could ever attain on my own.

*Neil, Ryan, Marty, Justin --

Talk about the beginning. Justin was there when I was terrorizing him at 12 months old. Marty, from eighth grade. Neil and Ryan, from freshman year of college. The greatest group of friends ever. These guys picked me up when everything was shades of gray and I couldn't fight anything but myself; the brief period when I became a man. Their kindness in those days--when I can't say I would have stuck around for the chaos myself--clearly made later achievements like this possible. Besides my wife, I will always choose to hang out with these guys above anyone else. Adulthood does funny things to friendships. People are getting married, moving away, having kids, building homes; and it really adds to the dynamics' degree of difficulty, but whenever we find the time, it always feels like college again, and it is easy to forget the time that has forged its way in between. Special additions for people like Jimmy--who has become a great friend the last few years; Harish-- a partner in crime who tells me my vices are okay, and with whom I have the greatest banter of random sports minutiae; Andre-- who, wonderfully, has found his way back into my life. Great friends are a blessing. Letting them slip away by time or circumstance is unconscienable.

*Family--

This group always believed in me, almost to a fault. The complexity of the road, of the struggle, of its intensity, was never really well understood. But they just always believed that I would get the job done. That I would figure it out. Having people who love and believe in you so blindly creates a challenge in itself. If you fail, you are not just failing yourself, but rather shattering an image of infallibility that others hold of you. Honestly, family has been one of the biggest struggles I've had in this pursuit, but ultimately I'd much rather deal with misinformation, misunderstanding, and general neglect of detail than ever have to feel there was reason not to believe in myself; to feel someone I loved thought I could not achieve. And that was never something I had to wrestle with.

*Mentors--

Namely, Dr. Jones, Dr. Perez; and also the help of Dr. Lehman, Dr. Foxwell, and Dr. Regenold. They led by example; provided leadership, support, and advice; and in some cases had direct contact with Dr. Louie, the training director at San Mateo, who I fully expect will be my next great mentor. Dr. Jones makes me want to work with children. Dr. Perez gives me hope that you can have a career dealing with misfortune without permanent personal difficulites. Dr. Lehman and Dr. Foxwell threw their weight around on my behalf and showed great kindness despite huge power differences in our relationship. Dr. Regenold helped me get into Med School, perhaps the biggest challenge of all.

*Luck--

Couldn't have done it without a little luck. Guessing the correct options on a few exams. Meeting the right people at the right time. Luck has an immeasurable impact on each of our lives and I understand that without a healthy dose of it, I could still be the guy with the BA in Psychology trying to get into med school.

So thanks, if you're apart of this list or if you're not. Everyone has had an impact. I couldn't be happier with how things have shaped up in my life, nor could I be happier about the prospects of my future. I hope to be a doctor that remains grounded and compassionate with the same friends who got me here. I hope to help others as I have been helped along the way. And I hope to really make a difference in the lives of children while living a life of personal fulfillment and inspiration. And I wish to you the same.

willow manor

2007-05-09T22:11:00.000-04:00

(1)Small, not super clean pool

(2)Our unit would be the bottom but on the other side

(3)View of living room and hall from front door.

(4)View from living room. Note sliding glass door and dining space adjacent to kitchen.

(5)View from dining space; clean appliances

(6)Awkward angle of walk-in closet

(7)Part of master bedroom from hall

(8)Parts of bathroom and 2nd bedroom from hall

(9)Fuzzy view of storage space in carport

The Information Paradox

2007-04-27T08:13:00.000-04:00

Has anyone else ever noticed that it is the people with the least information that are the most vigilant to expel it?

At the beginning of my medical training, it was always rewarding to proffer a nugget to someone, likely related to some recent lecture. I knew I didn't know much, but if I could help someone just a little, then super. Unfortunately, this practice is dangerous if taken too seriously by the recipient. Medical advice should take into account both the forest and the trees, not just a particular tree that looks vaguely familiar. Luckily for me and for anyone who was asking, I always knew my knowledge was incomplete, and provisioned any advice with this as well as the recommendation to go see a physician.

It is 8am, and I'm sitting in a Panera in Catonsville while my car gets its maintenance ($1700 for maintenance???). There are a few things that have gained my peripheral attention. The first is an overweight guy in his 50s with bad glasses, too much coffee, hair slicked back in the rear, no hair to slick any which way in the front, and a matching set of sweats. He's reading a book titled something along the lines of, "The 21 Irrefutable Laws of Leadership". He is also tabbing the good parts. My initial thoughts aren't very nice. But then again, most of what I blog about isn't very nice. So here goes...if you're in your 50s and haven't learned about leadership yet, you're probably not much of a success in either your business or personal life. This thought is reinforced when you're in a low rent suburb of a low caliber city on a weekday wearing sweats. But I hope he gets what he's looking for. At least he's not at home tweaking the rabbit ears to get a better reception of "Jerry Springer". And it's not like I've been a productive member of society lately either.

My second thought--and this is more relevant to the blog, I swear--is about a 350+ pound man who recently sat near me. He saw a young woman sitting alone studying and of course figured this was the perfect chance to hit on her. What a trainwreck. Anyhow, she starts telling him how she's studying to become a nurse. You can tell she's not one yet...too nice still. And she talks about her exam, "It's, like, multiple hours long!" (No fucking way. Hours??) But anyhow, as it usually goes, people looking for something to talk about with medical people go one of three different ways:
1. Do you watch Gray's Anatomy/ER/House/Scrubs?
2. I think medicine is all wrong. I believe in mystery herbs.
3. My thing hurts. What's wrong? (Implied: fix me with words).
4. *Bonus for psych #1*--Boy, do I have some business for you!!!
5. *Bonus for psych #2*--Do you analyze people you meet? Wait, are you analyzing me now?? *worried look*...........*awkward silence with poor eye contact*
6. *Bonus for psych #3*--See #2 above. (Implied: Tom Cruise was good in "Top Gun" so he must be right about religion and medicine too).

Again, I digress.
So this guy goes route #3. Shocker, his hip hurts....he's 350+ pounds. He's lucky that's all that hurts. Watching him eat makes my heart hurt! So his hip hurts and his knee is giving out on him. "What's going on?" he asks. Wait, wait, wait. What's going on?? You're a billion pounds! Don't eat breakfast, pleeeeeease. And then walk home. (Oh, and stop hitting on this girl. It's grossing me out.) The super nursing student's reply: "It's probably nothing". Wha? If you're going to try to help, at least say go see a doctor. If you're trying to blow him off, just say go see a doctor. But it's probably nothing?! There's missing the forest for the trees. And then there's this. She eventually asked some bad questions and then couldn't figure it out and lost interest. It was tragic.

My point is this...it is interesting that when I was armed with less information, I was more willing to help. My reality today is that I'm finding it difficult to take on the medical/psychosocial burdens of those I know, not to mention total strangers in my free time. If I see an accident. If I see an emergency. If I see an opportunity to really intervene to do some good for someone, okay, count me in. But now I know enough to see that most people need help in one way or another. Screening colonoscopy, mammogram, bloodwork for cholesterol, blood pressure control. Depression screenings, marital counseling, anger management. Some people want the advice while others do not. Ultimately, no one wants a stranger in Panera to tell you simply you're just too fat, regardless of your training. And whereas my inner compassion makes me want to help--compels me to share his burden--that attitude makes me a life raft with just too many on board. Ultimately we would all go down. And therein is my understanding of the phenomenon. People train to accrue special expertise in a sought commodity. If you make it freely available, ultimately there are too many takers, and it consumes you.

After all, physician heal thyself.

paypal

2007-04-13T11:13:00.000-04:00

Life Update

2007-02-23T00:14:00.000-05:00

I'll try to keep this short. For those who always check here looking to see what one-sided nonsense I may produce, or to see what is going on in my life, thanks for your patience. It has been a crazy several months.

1. Match
-Firstly, I updated my completed interview manifesto (below). If anyone was curious of my thought process at these places or of my experiences, take about 5 hours and read through it. It's only about 50 pages double-spaced. Seriously, why am I so long-winded?
-San Mateo remains my top choice. I am supremely confident now in my match after the training director called me on ranklist submission day to tell me I was in their top four. If he screws me here, oh man...Christine and I are looking into the details of the move and are super excited.
-We ended up bumping Cambridge-Harvard for UC-Irvine in the #2 spot. Lifestyle issues. Hopefully this is a moot point.
-Match is March 15th. If anyone not already planning on being there (read: med students) would like to join us, just let me know.

2. AHEC
-I finished up my "rural" medicine rotation today at Mercy Hospital in downtown Baltimore, where my preceptor only accepted insured patients. So much for an experience with the medically underserved. Alas, he was a great guy and though I did not have to go in often, it was always enjoyable when I was there.

3. Family Medicine Sub-I
-Starts on Monday with overnight call every fourth night. I already want it to be over.
*note: now this is medically underserved.

4. Step 2 Clinical Skills
-Scheduled for Philly on April 28th. This and the sub-I are all I have remaining in med school, or school in general. Ever!

5. Marathon
-Training is going well. No significant injuries to this point. Up to 15 mile runs. 17 miles this weekend. Fundraising is not going well. Need help with the website. Any volunteers?

6. Spring Break
-We looked into Europe, Hawaii, the South Pacific, the Caribbean, the Southeast US, and the South America. Since we know we're moving though, and could probably use the money, we think we might get a hotel in DC and do all the touristy stuff we've never done or would like to do again--Smithsonian, National Gallery of Art, go up the national monument, tour the White House, etc; then party in DC at night and go out to restaurants and stuff. Should be fun.

7. Book Chapter
-My part of the chapter on Diabetes in the Mentally Ill is focused on litigation issues currently and recently in this patient population. My manuscript is due in mid-March and I recently started researching it somewhat seriously. I need to pick up the pace.

8. Other
-It's great to be playing soccer again. It's great to be in decent shape again. I feel like I've regained my fire, my edge, my passion for life; and see that this is linked to my need for the pursuit of achieving some goal. Shame...I really wanted to be a beach bum too. :( In other news, poker game at my house this Saturday at 7pm. DVR'ed Caps game with our infamous college drinking game: "Shots On Goal" to begin around 4pm.

Everyone be well. Good luck with Match stuff. Good luck with job, house, and pregnancy stuff. Neil, try not to come back from India with eighteen brides. Mormons aren't outsourcing yet.

vibrance of youth

2007-02-22T23:54:00.000-05:00

This looks a lot better blown up with its fully vivid colors, but anyhow...

I took this pic in San Francisco as I wandered about Battery Park. I took it with the intention of giving it as a gift to a mentor of mine who inspired my interest in child psychiatry. My hope is that in times of frustration, he--and perhaps I--will be able to view this and be reminded that the vibrance of youth will remain with you always when helping a child in need.

Life itself

2007-02-22T23:42:00.000-05:00

The Pacific is life itself.

Known for its strength, it crashes, pounds into the earth, unabashedly, without apology. Yet it has charm, grace, and as such is forgiven. At times we struggle in its ebb and flow; no sooner feeling sweet control in our grip before finding ourselves once again loose, thrashing. The Pacific is like life itself in its reminders of our challenges, and of our achievements, our relative smallness, and of the times others gave selflessly to help us over the next swell. The Pacific is like life itself in its cycles. And though we may wander, its vitality, its innate presence of peace, draws our return. As its beauty closes into darkness, we think of the tides, of the cycles, of the strength, and we are once more reminded that though alone we struggled, with help we thrived. And we come to understand the Pacific, as we understand life: to be conquered by togetherness. And therein we find peace, and see the Pacific as life itself.

The Interview Diaries

2006-12-04T11:37:00.000-05:00

DISCLAIMER: I am writing this for 1.25 reasons. The major reason is for myself. I keep hearing that at the end of the interview season, things are all meshed together in your mind and you end up ranking on your gut feelings. Well I’m not paying all this money and spending all this time away from home just to forget the experiences. That said, I’ll be documenting tons of my experience, typically a few days after the interview so it’s had some time to settle and I can separate myself from any artificial feelings of goodwill. When it comes time to match, I’m sure gut feel will have its role. I just want more info than that. The other 0.25 of a reason is for you, dear anonymous reader. If you’re intellectually curious of my experiences, just plain bored, or have some affinity towards me that has led to a desire for some insight and shared experience, here you go. The real point of this disclaimer, though, is to warn you I’ll be documenting direct quotes, praise, off-color remarks, criticism, etc, that will best help me evaluate a program and its interest in me when the time comes to make a ranklist. If it seems at times self-serving, it is supposed to be. If it seems like a journal of braggadocio, then well, congrats to me, as I must be hearing good things. I hope things are similarly going well for each of you, both personally and professionally.

Note: I don’t want to hear comments about me bitching of program’s workloads. These are relative to my expectations of a psych residency, notorious for high quality of life. If you don’t like it, don’t do medicine, surgery, etc. Thanks.

Note #2: Please don't talk about this blog. I wrote this for the above stated reasons. The 0.25 reason is not worth this blog falling into the vision of the wrong people. If there are concerns about something written here, please take it up with me personally.
============================================================================
Charleston, South Carolina (The Holy City…crap)
Medical University of South Carolina (MUSC)
1.29.07

Am I really in the dirty dirty? Seriously? I’m sitting in a Starbucks on King St in the small but vibrant downtown scene of Charleston. I just completed my last interview and have 2 or 3 hours to kill before my dreadful overnight train ride back to Charm City. And, frankly, I’m a little confused. Confused about my future. Confused about my day. For the first time, there’s a little uneasiness about the uncertainty that accompanies the Match. Let’s start from the beginning…

In the summer when I first started thinking about programs, the idea of the internationally reknown Pitt program came up. Next, of course, then came the understanding Pitt involves living in the past-its-prime—yet somehow still acclaimed by many—Steel City. This was welcomed by no one in our house of two, and a rule quickly formed: we will live no further from the ocean than we do currently, roughly 150 miles. There were some easy choices to select along the west coast, and then some others in the northeast. I then turned to the southeast. There’s not a lot to choose from down there. I threw out the blasphemous—in Maryland, at least—option, “How about Duke?” This was pushing the 150 mile rule (as well as perhaps the stability of my impending marriage). So no Duke. Part of me was relieved. Emory? Also too far. Florida schools? No chance of staying there after residency with its horrendous situation regarding malpractice. UNC? Pushing the rule and just not that interesting. South Carolina…do they even have a program? They do. It’s called MUSC and the ratings at scutwork.com were phenomenal. Almost all 4s and 5s (out of 5). Weird. Student-Doctor Network also with some good reviews. US News and World Report (July 2003) listed the hospital to be 25th in the country in treating psychiatric disorders. June 2004 found the Department of Psychiatry to be ranked 17th nationally in NIH funding for research. But in South Carolina? So I pitched it to Christine. “I don’t want to live in the South”. But actually Charleston doesn’t much seem like the south. Supposed to be a liberal town hopping with great restaurants and bars, minutes from several beaches, steeped in history, with a reasonable cost of living. “We should give it a shot,” I say. We go back and forth. She hears there is a terrible public education system, and worries about how administrators in the bible belt will affect her ability to teach science the way she wants. But then she starts asking around, as do I. Public schools are crap down here. But there is a burgeoning biotech industry for bench research, and there are private schools that pay tremendously. There’s a surfing scene. Apparently it’s a top notch place for young couples who like the beach and want to do things outdoors year round. I dangle the carrot of a weekend together to check it out—“a vacation”. And that’s how I’m in Charleston.
We left about 3:30pm on Thursday to drive the 600 miles. Traffic sucked in the beginning, and we made it to the hotel about 2am. The hotel’s hot water something apparently broke at 10pm that night, so we had to make due until the morning, we were told. We woke up around 9 and I went for about a 12 mile run around the waterfront, through the city’s good and bad parts, and over the Cooper River bridge into neighboring Mount Pleasant (“mount p”). I learned the city very well, as it is mostly contained in a few square mile area on a peninsula. I made it back home and hoped I would just die instead of paying the knee and hip punishment from my run, but no such luck. Also out of luck was I with the hot water situation, still not fixed. I managed to clean up anyhow and we drove downtown to start walking around. We found a cool pizza place for dinner and went to a place Christine read about, Kaminsky’s for dessert and drinks. Fairly ingenious, this place. They offer alcohol, desserts, and a combination of the two. They were very busy. We had fun.

Saturday we did more of the same...walking, eating. We also drove to nearby Folly Beach, one of several in the area. We met up with a resident and her husband for drinks and dinner around 8. The program has a policy where they don’t pay for alcohol. I’ve commented on this before (See: UW Interview, 11/20). I think it’s crap to have people pay hundreds of dollars to evaluate a program for goodness of fit and then not pay for their drinks. However, at least they were up front about it, and it is the Holy City after all (note: but it’s okay to drink wine in church on Sunday mornings). This resident seemed a little unhappy with the program, having been a transfer from Hopkins when her husband had to relocate because of his job. But overall she seemed happy and loved the city. He was also very cool. We drank (too much) wine and ate a ton of great Thai food in a small, loud, overcrowded hotspot. Now there were five things I asked Christine to avoid talking about at this dinner: sex, drugs, alcohol, politics, and religion. These are my stay-aways in arenas requiring professional conduct. With their prodding and some wine and beer, my loving wife finished the night at 60%. Fortunately, this other couple completed the evening at a paltry 40%, thanks to some half-drunk awkward sexual advances/jokes by the husband (a college professor…no shock), including a transition from, “Why buy the cow when you can get the milk for free?” to “But the milk is better now that I’ve paid for it”. I watched his wife’s half-amazed, half-drunk, fully awkward, silent reaction. Awesome. Despite the objective criteria being fairly damning, I think the experience was more bonding, and showed an ability to hang out personally, which I hope and believe will translate into a sound evaluation from her if asked.

Sunday Christine drove home. I went to a nicer hotel (the program paid for half of it, but just for one night). Let me say this: king size bed, real blankets, walk-in closet, free wine and sherry, silver platter breakfast in bed, wireless internet. It was nice. I watched Tiger win his seventh in a row on tv, the Wiz roll in Boston on the internet, ordered in pizza, grabbed some wine, then went out for a night tour of Charleston’s “darker side”. The mercury fell and the wind kicked up as this tour of about 10 of us wandered through the eerie streets of Charleston. We learned about the city’s history of brothels, pirates, executions, worst crimes, and revolutionaries against the British and American governments. We walked through the oldest graveyards, saw round churches (“because the devil hides in corners”), and hid from the wind by the “four corners of law”, a unique intersection where you can find on each of three corners a judicial building from the city, state, or federal system. On the fourth stands a large church, the fourth law, “the law of God”. It was a pretty cool tour. And if you are ever in a port city and see a heart somewhere, typically carved in brick near the entrance of an old building, that building likely served as a house of prostitution.

I said served, Neil. Keep it in your pants.

Monday I made it to the Psychiatric Institute, a stand alone building which serves to house much of the residency program. There are a cluster of hospitals in a few block radius, so there are other services in other buildings, such as the ER or any of the VA services. Everyone all day was very friendly, though I can’t say overwhelmingly brilliant-seeming. Nor did anyone really exhibit any large desire for academics, with everyone selling the quality of life and “resident-driven” program. Great, but am I selling myself short? I spent much of the day with the residency coordinator, who was helpful and pleasant, and a source of good conversation. I first met with a recent grad, now an assistant professor. She spoke a lot about research and substance abuse, areas that totally miss the mark when trying to sell a program to me. However, she really came across as being sweet and genuine and happy. The interview went fairly well. I next met with the Training Director. If it did not say this on my interview schedule, I likely would still not know. He was so unassuming and friendly. At one point, I was talking about the variability one would find in the state of Maryland. He pulled up Google Earth and asked me to point out these characteristics (like the mountains, skiing, ocean, cities, suburbs, rural areas, access to other destinations) as well as where he could find UMBC. Really, we spent ten minutes talking about this. He was very interested in the CAPP program, as I found out many people were today. It’s strange, too, because this was my tenth interview and most people don’t much care about it, though it’s an invaluable experience and a leg up. I felt this interview went really well. I next met with an intern. It was the first time he had interviewed anyone. It wasn’t smooth. I finally stopped trying to directly answer his questions or to push my agenda and fully focused on making the interview just smoothly transition from one random topic to another. It wasn’t so helpful, but he’s probably a nice guy. I next met with the interim chair. Interim anything-high-up is normally scary. I was assured many times over that the last chair left “for the opportunity of a lifetime” at a brand new hospital in Texas, and that the next chairman will share in the current vision. I hope so. This interim chair was very cool though. An older gentleman, very polite, very easy to speak with. He made it easy to bring up the points I like to mention throughout an interview day. Time ran over too quickly. I think this interview also went very well. In fact, he mentioned, “I expect you to be a very competitive applicant in this program”. I went to lunch with an athletic PGY-3 going into child. He talked to me a lot about the flexibility of the program, especially after the second year, but even at times after the first year. He seemed very happy at this program but I couldn’t shake the feeling that he wouldn’t know any better even if the program was crap. He talked a lot about the NFL and intramural sports and we ate burgers and had a fine time. I met with the associate director next. I was fat and happy with my day, freshly out of questions and ready to keep rolling. This guy was just looking for me to ask questions though. Damn. It was pretty awkward at times as I reached for new questions and received mostly canned clichés for responses. I just wanted him to ask me a question. It didn’t happen though and I was released after 30 minutes. I met with a first year C&A fellow next, and she was excited to hear about my interest in the field. She hadn’t read my application but was at least open and apologetic about it. We only had about 20 minutes so I took half and told her my story. She seemed impressed at my commitment, and asked the follow-up questions I get most interview days. My answers were quick and polished and I left feeling my mojo was back. I would have liked more time to talk with her about the program though. I finished up my day with a cursory tour around campus by a PGY-2. He was a cool guy and we spent a good deal of the tour laughing, which is solid. I asked about paperwork, which can be heavy at times and is mostly manual. And I asked about perks. There is $1000 book stipend over the 4 years. There is a night float 2 months of the year. Your call is about 15 days over each month during that stretch, from 5pm to 8am. If you work past 2pm on any of those days, or any postcall day, you earn a comp day, transferable later for a free day off. Call is pretty light after that. You get about 3 weekends off, 1 on. Call on medicine and neuro are oddly q6 or so. That’s very light. Other perks include free parking, a monstrous gym that includes weights, cardio, racquetball, a rock climbing wall, and an indoor Olympic size pool. Moonlighting is abundant after intern year. Step 3 must be taken the intern year. Moonlighting is near and far. Some people drive as far as Greeneville, NC or Savannah, GA. This is up to 3 hours, but—it was said—“At 41 cents per mile and $100 per hour, I’m smiling all the way there and back”. Well, okay. The didactics are said to be weak by some. Time is not protected. The curriculum is pretty standard. I left feeling happy, but within a cloud of confusion.

I knew entering the day this program would not be top three. I have tried to ignore prestige when possible, but MUSC can’t hang with San Mateo or Harvard, and is questionably in the ranks of UCI or Brown. But the satisfaction level would be super high here. At least the satisfaction of easy days and surfing year round. But pride in the competitiveness of your institution is an inherent component of satisfaction of residency. Selling yourself short now, after all this work, for some beach time is a bit foolish. Especially when you can get beach time in SoCal. So MUSC can’t be top 3. But it will be 4 or 5, likely. So Brown or MUSC? I can’t yet say. I’ll have to do some more analysis and return to the topic later.

Strengths of the program:
-lifestyle (55 hours per week or so, live at the beach, great bars and restaurants), affordable cost of living, reasonably close to friends and family, very happy residents, good money to be made in moonlighting, fellowships if I wanted to stay

Weaknesses of the program:
-possibly selling myself short here; possibly not so great professionally for Christine; poor didactics; though close, airfare is more expensive than to Cali or the northeast

Whole grade:
Immediately — 8.4

I normally make some kind of definitive statement here. But as I’ve said, I’m a bit confused. About it all. I think it should be San Mateo, Harvard, UCI, Brown, MUSC, CalPac, Harbor-UCLA, Maryland. No rank of UCSF or UW. But really, now I’m questioning Harvard as high as #2. I question Brown as a 4 or a 5. I question any order of MUSC, CalPac, and Harbor-UCLA at 4 through 7. I’m fairly certain I should rank Maryland last, though it was a fine choice. I’ll have to get to writing a review of Harvard if I can remember enough, then start sending out more emails. One thing is for sure: by 2/21 at 9pm, this list will be certain, one way or another.

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San Mateo, California
San Mateo Medical Center
12.13.06

I wasn’t going to do much of a review of this program. However, since I’m now sitting in Chicago awaiting my connecting flight that has been twice delayed after the flight from San Jose included a security breach delay that went unsolved and then an entire flight without service because of turbulence for 1400 miles…after all this, I’ll jot down a few thoughts and stop bitching about airfare stuff.

San Mateo. It’s my top choice by far. Going back there was so great. I was stopped in the halls by security guards, MAs, nurses, attendings, and the chairman. These people spoke so nicely to me. Then I saw the interns I’d worked with and the residents and the other attendings and the program coordinator. Everyone was so warm. Many patients I had seen in my four weeks were back. It was a really nice day. People commented on my excellent choice of apparel—thank you Macy’s Union Square. It was just an awesome day.

I woke up feeling like total crap. I stepped out into the rain and dropped my suit jacket into a puddle. I uttered a solid string of muttered obscenities in my sick morning, gruff voice (that was later commented to be a “good phone sex voice”). After some cleaning/drying, I was en route.

I was fortunate not to interview with anyone I knew too well. I was worried about the formality of such an occurrence. I met with the associate director, who I had not yet met because he is usually running his clinic in a different part of the county. I was told he is “a tough nut to crack”. Perhaps. He was post-call and had not read my application very thoroughly but I tried my best to keep him awake. (Of note, when I looked in the mirror before I left, though super excited, my normally stoic face had morphed even further into one of contempt. Hmm, not what I’m going for, I say to myself. I try some things…thinking about happy things, exciting things…no dice. Uh oh. And I uttered a few words…terrible sounding. I would not hire me. Solution: I drove the whole way singing songs on the radio, trying to hit notes I knew I couldn’t, smiling profusely (at times using my hands to force my face into positions). Don’t forget I’m wearing a suit in a blue minivan. Most entertaining guy on the road, I bet. Best part? It worked!) So this interviewer, he kept talking about how they want residents who will participate in community action roles. Eventually I had to feed him the best I could with what I had to work with. I left not feeling super about it, but when I saw him later he gave me a huge smile, so who knows?

I then got to do a 90 minute lunch with my old colleagues. It was nice.

Then the big interview with the PD. And I believe I nailed it. I said everything I wanted to do. I smiled. I showed I was listening. I said what I wanted before he could say what they wanted, so he could piece that congruence together himself. And though he is known to be a very tough read in his own right—none of the interns this year felt strongly they would match at San Mateo despite voicing it as their top choice—he threw me more of a bone than I expected. “Jeremy, we would be very happy to have you here. It’s tough to say how things will turn out, but please call me in January if you intend on this being your top choice. I think you would do very well here, and we would be happy as well.” The man could have said he loved me and I would have been no less dumbfounded at that point. Awesome, awesome, awesome!

I walked into my last interview with the medical director, a woman who I had also not yet met. She was nice. She didn’t strike me as an administrator as much as someone who would frantically be running an underserved clinic somewhere all by herself. I asked her some questions about herself which opened her up to me right away and then we hit it off for the next hour. It all went just great.

Then I went home. I grabbed a quick nap and went out to Palo Alto where I had some Venezuelan hot chocolate with chile pepper, then grabbed penne and a syrah at a nearby wine bar and restaurant. I met a nice woman who frequents the restaurant almost every night after she finishes her business of financing loans. I went home and packed and now I’m almost home! …for good!

Strengths of the program:
-lifestyle (hours, caseload, call), sick patients, fully integrated network of psychiatric resources, warm friendly people, emphasis on balanced therapy, always finish in the top 3 of the national therapy exam, do well on the PRITE, get strong fellowships (including a new one in the works: joint community-child with Stanford), the office runs smoothly, palo alto is near enough to live an awesome life, half moon bay is as well if we choose the action surfing route over the young married adult route, etc etc etc!

Weaknesses of the program:
-people are great at work but they don’t work much, so they end up going home, resulting in a weak ready-made social support system for us to fall into. SF bay weather isn’t super.

Whole grade:
After externship – 9.3
Before interview – 9.1
Day after interview – 9.2

I don’t see how the #1 ranklist position could be usurped from San Mateo unless either Cambridge next month is really as amazing as I hear and then some, or unless the friendly folks at UCI can find a way to repackage their already great product into something even more appealing. What a great feeling.
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San Francisco, California
California Pacific Medical Center
12.12.06

I’m writing this review from the airport in San Jose two days after my interview. I’m sitting in the early morning darkness of the Bay Area’s winter weather: 50 degrees, fine mist interspersed with bouts of rain, and heavy purplish clouds that fill the sky three dimensionally. This is the first review I’m doing with another interview intervening in the processing of the program currently I’m reviewing. I went to San Mateo, widely known as my top choice, yesterday and I’m finding that my initially very high feelings of Cal Pac (aka CPMC) are lesser so today, likely a result of that San Mateo experience. Hopefully sifting through the details here will help me refocus on that initial impression.

Those close to the minutiae of my traveling experiences know I’m a huge proponent for the website Hotwire.com. I’ve always, and I mean always, ended up with a hotel much better than I should for the price I pay. People shy from this website because you are not choosing the hotel, but rather choosing areas in the location you are visiting as places to search hotels. From these—typically 4—areas you are given unnamed hotel selections that include the price per night, a star rating out of four, amenities, which area of the hotel is in, and some are listed as customer favorites. Additionally, you see what their star ratings are equal to on another part of the website. There are 8 tiers, ½ star up to 4 stars. This part of the website will tell you a 2 star hotel is equal to La Quinta, Comfort Inn, or Days Inn, for example. Now usually I don’t go below 2.5 stars, and typically I go with 3 stars. These end up being places like Marriotts and Sheratons and Holiday Inns. The rooms are huge, I often get free internet, showers are great, and the beds are super comfortable. There is usually a gym, and often a pool/hot tub. However, now feeling the financial stretch of my loan check at the end of a semester that included a wedding, honeymoon, and three months of almost constant travel, I looked into hotels at my last location—the San Francisco area—knowing I needed to stay cheap. I also knew this to be my most expensive location. However, I couldn’t see myself paying even $80/night plus rental car expenses for these three nights. There were many 2.5 star hotels available for well over $100, which I expected, so I decided I’d really gamble on this website I’ve come to trust and go bottom of the barrel. I booked the room for $36 a night next to the airport in South San Francisco (SFO). Yikes. Car rentals started at $44/day + tax in this area. Yikes again, since I’ve been paying around $14/day up to this point. I will not be denied, however, and long story made short, I left the lot with a minivan for $20/day and checked into my Travelodge in South San Francisco. It was what I expected, which is tons better than I feared. The room was a fine size, the bathroom met my needs, it was clean, it did not smell of smoke or sex, and was relatively quiet. Because I’ve been sick, I’ve had quite a bit of trouble sleeping lately, so the one deficit in the room was the comfort of the bedding, of which I’ve become quite spoiled lately. Some hotels have amazingly comfortable beds. This one had some flimsy padding beneath the sheets that easily crinkled and lumped as I tossed and turned. The thought struck me in the early morning hours that my bed was like the guy who wears a condom that’s too big: it also crinkles and lumps, ultimately resulting in a bedmate who is irritated and unsatisfied…I’d assume.

So I spent most of the night coughing and fighting a bleeding right nostril suffered from a lot of nose blowing coupled with the previous few days of SoCal aridness. I awoke at a reasonably early time to set off into the rain towards San Fran for my CPMC interview. I was surprised to find the traffic heavy but moving and couldn’t help but compare it to some of my recent LA experiences. If it rained like this down there, you might actually starve to death in your car.

I made it through the city without surprise and had some nice recollections of times spent riding the buses with Christine on our honeymoon. I found out how little respect a minivan gets in traffic as well. I parked in Cal Pac’s garage, as instructed, and easily found my way up to the 7th floor psych office. I was struck by the calmness of the city even in its weather-darkened urban setting complete with people moving in all directions. SF is an experience unto itself. Everyone should visit. The program coordinator was friendly and thanked me for coming, which was nice. As I was asked throughout the day how a student from Baltimore ended up interviewing at this small community program in SF, I’ll use this time to explain how I did end up at this place that no one reading this has probably ever heard of. Simply, Cal Pac was listed as a residency program in the bay area. I didn’t know a thing about it, couldn’t find out a thing about it other than their website (which I generally don’t trust from programs, by the way), and no one I asked knew anything about it. That seemed like enough reason for me to check it out. I’m not looking for a program that is full of intense research and world famous faculty as much as somewhere I’ll get the training I demand with the lifestyle Christine and I want. This could be a diamond in the rough, I thought, though probably it would not be. Alas, I went, and first met with the chairman.

He was very friendly, and you could feel his psychodynamic orientation easily just from the way his office was designed. He tried to sell me on the program, but though he was quite genuine, he was telling me things that many people would: we want residents who have good people skills, who understand the power of warmth and genuineness. That’s good. I appreciate those qualities in my colleagues as well, but is it enough basis to make a decision about residency? Not really. The hospital, being a community site, is doctor-driven and things tend to get done quickly. It reminded me of Mercy in Baltimore—at least from what I’ve been told—as I’ve never worked there myself. The program only takes 4 people a year from—and this was a surprise—over 300 applications. Part of me is skeptical of that since I know San Mateo to be well known on the West Coast and highly respected, but they get about 200 applications for their 4 spots. However, it is plausible as other things became known, such as their residents that left last year for fellowship all went to UCSD, UCSF, Stanford, and one went to the prestigious child program at Mass General. You can’t fake that kind of power. Oh, almost forgot. One of the first things the chair said to me was, “You sound like you come from a rural area. One thing interesting about San Francisco is that nobody, and I mean nobody, puts up with any kind of prejudice or intolerance* around here.” I decided right then and there to hold off on all my gay jokes until my next interview. Man, was I disappointed.

*Note: In fact, I’ve found that San Franciscans are incredibly inflexible and intolerant to those who do not share in their beliefs, which is typically some leftist yammering on about something or other. This is especially true in regards to those who show intolerance to race and sexual preference. I’m not saying they’re wrong by any means. I’m just saying don’t tout your great life views of live-and-let-live if you stoop to your opponent’s level whenever they spout their own gibberish.

I left the chairman’s office feeling—well, still sick as I hadn’t yet gotten past the morning congestion/headache/achiness period—but surprised and a little excited. I next met with a PGY-4 chief resident who took me out for coffee down the street. We had a great talk. He read my application thoroughly and made several strong arguments for how we were very similar and how those characteristics helped him thrive in the program. They seem to have very light schedules their first year, which gets heavier in 2nd year, which is interesting. Call is Q5. Caseloads are something like 6 patients as an intern. Very mild. Then 4 patients as 2nd year in half-time as you also have a few therapy patients in outpatient clinics. Since it is a busy urban center, the psych emergency room (not dedicated) is usually pretty busy, but it’s said residents normally get to bed by 1am. Oh, and this ain’t bad….call is from home!!! As long as you can reasonably get to the hospital within one hour, you can hang out at home unless you need to come in for something. This resident and I got along very well. There appears to be a great social support network amongst the residents. He dropped me off with a PGY-2 in Grand Rounds, where I would sit for 20 minutes to get the feel before we went to lunch.
Grand Rounds was a talk about psychiatric illness with HIV. Is it just me or is anyone in SF not there for something to do with HIV/AIDS? It was a good talk and I learned some things in my brief stint there. People seemed to be paying attention, and it truly was a doc’s hospital. Most of the audience was older. There were 5 or 6 wall-mounted HDTVs for the powerpoint presentation placed around the room for easy viewing from all seats. Very nice. Instead of making me scarf down cafeteria food, they took me to a nearby newly opened French restaurant where I ate very little, still feeling fairly sick. The conversation was good, though, and the resident was friendly and informative. She told me about moonlighting opportunities, which are available after achieving licensure, typically done late in 2nd year. Many people do not moonlight, however. This struck me oddly, as salary was $43k in one of the most expensive areas in the country to live. It turns out most moonlighting opportunities are about 30 mins drive away. That’s fair. I can see that as being prohibitive for people who don’t need the money, and reasonable for those who do.

By the way, since my San Mateo interview was the next day, and since I was feeling a little burned out towards interviews and finding my answers to questions were sounding a little more canned, less genuine, and less creative, I decided this was going to be a practice day for San Mateo. And though under the weather, I felt on fire all day after my meeting with the chairman. I was coming across as articulate, interested, and genuine. I was able to highlight my experience effectively. The residents were responding in line with my hopes for the things I was saying and it was smoothly setting up other points I wanted to make. I was really pleased.

I next met with another PGY-2. He was the epitome of what I just described. We had a nice conversation. I got the impression he decided really late in the game to do psych. I don’t know why exactly I feel that way, but it probably has to do with some weird dynamics that went on. He was easily won over, and then I felt a sense of deferment to my knowledge and experience, which was certainly odd and unexpected. When I explained to him my view of a current issue in psych that was recently elucidated in the CATIE study—Clinical Antipsychotic Trials of Intervention and Effectiveness—he actually called me sir. As Ricky Bobby would say, “THAT JUST HAPPENED!” It then happened again a few other times later in the interview. Maybe I just look old and weary? In any case, he got really excited and started to say that if I wanted to go there to email him later and he would corner the director and make sure it happened. He then said he couldn’t say that for ethical purposes and recanted. I think lawyers do that in court as well:

Lawyer 1: Miss Studebaker, this is case about Fraud….butisn’ttrueyouusedtobeaprostitute?????
Lawyer 2: Objection! Irrel—
Lawyer 1: Withdrawn!
Judge: The jury is instructed to disregard the previous statement.
Jurors 1-12: [writes on notepad: “Hooker!! Can’t be trusted!]

See what I’m saying? Good thing he can’t say that. Now I’ve totally forgotten about it. This reminds me of something else earlier I’d forgotten. The chief resident, when I’d returned from making my coffee less masculine, wrote down his personal cell phone number for me to call. “I don’t give this out. But you’re strong, this program is a great fit for you and vice versa, and I want you to come here.” The flattery portion of tonight’s competition now completed, we can move onto the bikini contest…

I next met with the program director, the absolute make-or-break meeting of any interview day. Another psychodynamic guy with whom right away I found myself talking in vague, guarded, entirely positive terms about my family dynamics within minutes. Otherwise, things all went well, though he gave off a weird therapy-is-the-past-present-and-future vibe. Now I’m more pro-therapy than just about everyone I’ve ever met, but if this viewpoint that came across is really his genuine belief that he touts, he’s gonna scare off a lot of people, me possibly included. But ultimately by this point I knew I was impressed by the program and wanted to rank it somewhere in the top five, so instead of presenting anything confrontational to his possibly firm belief system, I went into my float-like-a-butterfly-sting-like-a-bee routine. This is where I rely on a few basic principles that I know will show interest and make me come across well. The rest is improv. I see what the interviewer really wants with their questions and I feed it to them. Then I take subtleties from earlier in the conversation, repackage them, and re-present them later, showing at the very least I’m a good listener. It’s the gamesmanship of the interview process. And though I’m not interested in the dirty games that accompany the last minute ranking stuff, there’s nothing wrong with doing a little flirting with the girl next door while the supermodel you asked out yesterday is mulling things over.

Then my day was over. Supposed to be at least. The program director asked me if I was in a rush. I was not. He asked me to interview another faculty member. Tired, but intrigued at what that meant, I said yes. It was pretty boring and standard, the typical product of an interview of someone who hasn’t read your application and wasn’t necessarily prepared to spend their web-surfing time interviewing a kid in a suit with something to prove. I met with the chief resident thereafter to ask him to show me a few things I felt I needed to see before I left. He said the extra interview means they’re really interested and it’s an insurance interview of sorts to make sure their read on me is what they believe it to be. Excellent.

I left and immediately got lost, which is what I’d do in my closet if it were big enough. I suck. Then something awesome happened. Something I’d wished I could do my 5 weeks previously in the bay area but being sans car, I could not. I drove down Lombard Street, known as “The World’s Crookedest Road”. In a dodge caravan. In the rain. It was awesome. I continued to Union Square, which was all decked out in holiday cheer, parked, and decided to walk around. I was feeling like I still hadn’t found the right shirt/tie combo for the money pinstripe suit and I really wanted to look good—for the look good à feel good à be more impressive phenomenon—the next day at San Mateo. I also knew money is super tight. But with holiday cheer, er, sales, I managed an awesome combo for the price of a downtown dinner for one and opted to eat at IHOP that night to make up for it. I then got lost again, because, as mentioned, I suck tremendously. It was a great day back in Shaky Town.

Strengths of the program:
-excellent social scene, reasonable work hours, tremendous outflow to top notch fellowships, San Francisco is fun, they want me…and I think it’s like when you see a girl across the bar and you know she wants you but she looks coyly away until you show your hand first. (Wow, I’m full of analogies and whatnot today that are sure to rub people the wrong way…that’s what happens when you sleep on a Magnum condom for three straight nights, I guess)…also home call.

Weaknesses of the program:
-San Fran is super expensive relative to the $43k salary, I get the deep feeling there may be more work than they let on; though nice and friendly, these aren’t exactly the people I seek as friends; I worry about the emphasis on psychodynamic therapy without appropriate focus on other more useful styles; I don’t think I necessarily want to live/commute in/out of SF everyday.

Whole Grade:
Two days after: 8.6
1.29.07—8.4 (The location is really turning me off. I think back to the interview day and it has a gray filter all over it).

I think I could be happy here, but I think this is going to end up fitting between Brown and Harbor-UCLA. I know I keep saying this, but why gamble when there are sure things?

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Orange, California
UC-Irvine (Second Look)
12.7.06

Because I had canceled interviews and wanted to feel I was spending most of my time productively, and because on the adolescent unit while on externship at UCI I did not get much exposure to what an intern’s life is like on the adult unit, I spent a Thursday morning doing what ultimately counts as a second look. Unfortunately the PD, Dr. Maguire was out of town during this time. Ultimately, though, I really just wanted to observe what the interns did with their mornings and get another look at rounds with the impressive Dr. Nguyen.

I arrived a little after 8am and found them already present. They were cheerful and relaxed. They saw their patients quickly and were free to discuss the program, the intricacies of the new patients, and anything else that popped up. Fortunately for me there were no other med students on the unit, which due to scheduling occurs 2 of every 8 weeks. I was given a lot of attention and felt sharp enough to place a lot of input on the current dilemmas of the unit.

Rounds were quick; about 30 minutes. Things just happened to be really stable that day. After, I just watched the interns get their work done. It was slow, granted, but life seemed pretty good. I stuck around for lunch and Dr. Nguyen took me and an intern out for Japanese. It was excellent, as was the conversation. I was impressed that he paid for our meals, just as I was that an intern—Gina—would not let me pay for my coffee earlier in the morning. As we parted, I was invited to a dinner to be held later in the evening. My current plans were to watch football at a bar by myself, so I couldn’t really say I had anything better to do.

I fought the traffic—SoCal rush hour really makes you pay for making a wrong turn—and it took 70 minutes to travel the 10 miles. Fortunately I was prepared for this by now and I arrived exactly on time. I was really impressed by the restaurant’s regal structure, and by the people’s dress inside. Jeans, dress shoes, and a French-cuffed dress shirt put me in the bottom tier of acceptable attire, though I can’t really say I knew better ahead of time. No one there really cared anyhow. People were very nice and I was able to meet some people I had not yet met, and interestingly, I found out they have held meetings to discuss applicants—I guess—and so everyone there knew of me; and said positive things. It was very humbling. The wine was excellent. The steak was lean and huge. The chocolate cake with raspberries is hard to make badly. I spent a good deal of time talking with the chairman, and we had great discussions about old-time psych and where the field is headed. Then I wandered over to talk with more of the residents. A glass of wine brought out some—fortunately—well-timed comedy and I felt really comfortable in this room of somewhat evaluating not-so-strangers. The chief resident had 4 gifts to give out to the residents. They were Christmas cards created by psychiatric inpatients and then marketed. She presented one of these sets to me, “our special guest”. I tried once to turn it down, feeling humbled, but at her insistence I chose to take the route of sincere appreciation. Eli-Lilly, the makers of Zyprexa were paying for the event and they gave us all umbrellas, which is a weird gift for Southern California. No less odd, however, is that now they’re calling for rain on Sunday. I guess I’m prepared.
As the evening wrapped up with games and wine and laughter, an intern offered to take me out for a drink for further candid question and answer time. I took him up on it because he is very sincere and I don’t believe he has an agenda. He wouldn’t let me pay for my scotch and we talked about a number of things. The one unfortunate thing I learned was that though moonlighting is allowed as a PGY-2, there aren’t really any places to do it. That’s pretty disheartening since that’s important to me. There is a relationship being formed with a jail now, but otherwise most opportunities don’t arise until PGY-4. That really sucks. Oh well. It was a really great day at UCI. They made me feel recruited, wanted. They were first class all the way. We would be really happy being apart of this social group of residents with their light schedules, decent pay, and in this beautiful weather.

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Torrance (Los Angeles), California
Harbor-UCLA
12.5.06

I’m writing this on December 6, 2006, on a pier in Huntington Beach. It’s early afternoon and the sun is so bright, I have to turn askew just to view this screen. But that’s just fine. I intended to sit in a Starbucks a few blocks from the beach until this was completed, but what a waste that would be, I decided. It is in the 70s today throughout the area, but here the wind kicks off the ocean pretty strongly, and it feels much more like the low 60s. But, again, that’s just fine. The lampposts on the pier have large snowflakes hanging from them, which light up beautifully at night. Intellectually, I know Christmas is near, but I have difficulty reconciling the feelings it’s more a Christmas in July. I have tried to be productive with my days here, and though I canceled half my interviews from this trek, I am strengthening my relationship with programs of interest in those off days. But today is a rare day off entirely, to do with it my choosing. My choosing tends to lead me to the beach, I’ve found. I come here and I start to think right away of Christine. I always feel like calling, but it’s hard to talk of its beauty here to those back home without sounding like I’m just trying to rub it in. I then usually start to think of my other friends. My mind starts to spin, concocting schemes designed to bring them all to me to share in this together. To prevent the toughness of the decision to move from so many of those who I rely on for support. But what’s best for me certainly cannot always translate directly into what’s best for them, so I let my schemes fall unfinished in hopes that things will work out for everyone in the end. So I’m on this pier at my favorite spot, just shallow to where the waves break, with the view of the surfers clumped together, their eyes to the horizon in hopes the big one will soon step forward. It’s a calm day on the water so their rides are slow and short-lived, but to them, again, that seems just fine.

My first interview at Harbor-UCLA was rescheduled from 10am to 9am. The hospital is about 30 miles from where I’m staying in Orange. Having learned firsthand about traffic in the mornings here (see: Brown interview, traffic to LAX), and also at Steve’s (my generous roommate) advice, I left at 6:30 to get there by 9:00. Traffic turned out to be heavy but moving, and I arrived at the hospital at 7:15. I was pretty tired so I grabbed some coffee, checked in, and went to evaluate the cafeteria. In this brief period, I learned some things, which I’ll describe in a moment.

So I mentioned I’d canceled a bunch of interviews, including big names like UCLA and USC. Why did I do that? They were either too academic, or they were too reliant on the residents being killed with work. I know I’m not going into a career in academia. I know also that I’ll hate my life regardless of geography if I’m overworked. So adios to those; I’m happy enough with other choices. I opted to keep my interview with lesser known Harbor-UCLA because it is a community hospital. It’s a program much like San Mateo in that it throws the residents into the mix and they learn abundantly. I want the sink or swim environment. I’m ready for that. I’ve primed myself to get the most of my psychiatry residency. I don’t want my hand held. I just want good support for when I need it. This is what Harbor is about, I’d heard.

As I drove up, it was definitely an urban setting, as much as SoCal has an urban setting. Pretty busy area. As I walked in, I had to go through a metal detector. My fancy suit didn’t seem to matter. Off came the belt, emptied were the pockets, and then I was wanded. Plus, there were a lot of looks of disdain by the patients sitting around waiting for their clinic appointments in the front of the hospital. Yikes. Then I had the privilege of redressing myself in that same lobby. Awesome. The population was heavily latino. Note to self: I really need to pick up Spanish again. I walked through the hospital and I saw doctors hugging each other. Interesting environment. Then the strangest thing happened. I got the feeling I was watching “Scrubs”. I guess that’s a good thing? I met the office staff, who were very nice and informative. I was introduced to the program director (poor eye contact, no handshake at that time). This turned out to be a theme for the day with him. He was a young guy. I’m not sure if he was disinterested in the process or just overwhelmed with his duties, but I feel it is one of these things.

The interviews were of the hour long variety, which I’ve come to dislike. At least you can usually expect the opportunity to sell yourself, which some of the 30 minutes ones don’t afford at times. The problem is that if things aren’t clicking, it’s a terribly long awkward hour. I first interviewed with an outpatient attending. She was nice but hadn’t read my application, which really pisses me off. We talked a lot about what she seemed interested in: social roles in psychiatry, and politics. I also was able to ask a billion questions, which she answered pretty well. I left the interview thinking the hospital to be well-funded, which contradicts some with the low salary (~$37k). I’m all about funding being in place for a hospital and its patients, but when the UC schools are paying ~$43K, someone in charge of this hospital’s residency program needs to recognize that it puts it at a competitive disadvantage. When the hospital willingly eats imaging studies that cost a few grand all the time, they should recognize the return on their investment they’d receive by pumping a few grand more in salary to each of its residents. Anyhow, it seems a lot of good things are in place or being set up for the patients, and the hospital as a community facility has great investments in continuity of care, which I feel is super important. The patients seem very sick, and as such provide the best learning experiences. Call is reasonable at Q5 or Q6 the first two years. Moonlighting occurs in the second year once you get licensed, which most residents don’t seem to get around to until the second half of the year. Too busy? Not likely. Not prepared?? They say no. Hmmm.
My next interview was with the program director, Dr. Burgoyne. The chair was out of town so I didn’t get to meet with him. Dr. Burgoyne was pretty young for the role but seemed accomplished. He shook my hand finally and answered my questions handily. He had read my application, but didn’t ask me anything that really showed any interest. In the end of the interview, he said, “I’m not a guy to wink at applicants or tell them I’ll rank them. We have good residents here, and they want to be here. We tend to match halfway down our list anyhow, and any program that says they aren’t the same is lying to you. If you’re interested and want to take a second look later, I encourage it, but do it for you. It won’t impress me anymore. But ask the residents questions and take a good look and see if this is a program that fits for you. If it’s in your top two choices, rank us. If it’s fourth or fifth, don’t bother. We only want the people who really want to be here.” Thank you, Mr. Sunshine. Way to make me feel like a superstar. So I feel like he doesn’t care who matches other than that they’re not grumpy disgruntled bastards. Would this guy have my back if I needed him or would he cover his own ass? That’s an easy one. Points docked, sir.

At this point, I’ve met with two people who didn’t seem to care much about me, and I’m not exactly returning the favor. I like the program in structure, but the people were killing it for me. Then I met a PGY-2. And he was awesome. We got coffee and sat in the sunshine for an hour. We talked about the nuts and bolts of the program. He seemed really happy with his choice. He spoke of the autonomy he has in clinics. He keeps his own book and sees patients whenever as an early PGY-2. Great. The structure of PGY-2 is inpatient in the morning and outpatient in the afternoons. He said the hours were about 40 hours as an intern plus call. Even less hours as a second year. Nice. He introduced me to lots of people and when they weren’t giving me enough attention, he would drop things like, “Jeremy here is a very strong applicant. You should tell him about _________”. Or, “You would do really well at this program. It’s setup for people just like you and sounds like what you’re looking for”. He had read my application. We had a lot in common and he kept describing the program as exactly what I’m looking for. Many of the residents live at or near the beach. He goes on my list of people I wish I could work with in the future for sure.

I then met with an outgoing PGY-4 for lunch. He was from Argentina and we mainly talked about soccer, but the main thing I learned from him—his major gripe—was didactics. They aren’t super. Apparently you need to really be motivated to learn on your own. That’s cool. I’d like didactics, but I can totally learn on my own. I see it much like preparing yourself for the future, which is really what a community program is all about.

I finished up with an attending who had spent a year doing a child fellowship at UCI, knew of San Mateo, and did his residency at UCSD. He was into research, which is surprisingly strong at Harbor. He had also ready my application and did a good job or reiterating all the key points I’d heard from the residents. He also did a good job of making me feel competitive, which I’ve described previously as being really important in making me like a program. Just as programs want residents who want to be there, applicants want programs that want them to be there. He said a few things, such as, “If you rank us, you should have no problem matching here. Your application and attitude should put you among the top of our applicant pool.” This guy needs to be PD.

I went back to the PD’s office to tell him of the things I’d learned about the program and how it fits my expectations of a residency program, and how I hope they do rank me highly despite what he’d said. He was gone from the office for the day, unfortunately, so I exchanged some of that sentiment with the program coordinator and plan on passing this info along to the PD via email soon.

Strengths of the program:
-Really very much of what I’m looking for overall. It has autonomy and support, it prepares you for a career in psych. The hours are low, moonlighting is available, the people seem nice. There is a child fellowship present, though it’s not a good one. There a few in the area that are reputable though, so we wouldn’t necessarily have to relocate.

Weaknesses of the program:
-Didn’t much care for the security needs, didactics should be better, the PD didn’t overwhelm me, I don’t like the area so much, traffic is unbearable, pay is terrible. No child until PGY-3 year.

Whole Grade:
Immediately – 8.5
A few days later – 8.5
1.29.07 – 8.3 (The money issue is killing me).

This is a poor man’s (and County’s) San Mateo. There would be challenges, and this would likely feel more like a legitimate residency experience than most of the other places I’m considering. There would be challenging times and hardship, failures with patients, and great learning experiences. I would feel alone at times and part of community at others. Ultimately, I’d come out ready to take on the world, which is really the goal of residency. For that I’m ranking it above Maryland, and for the beachiness, likely above Brown, despite it being more difficult and with less happiness. Christine would surf here. I can’t say it competes with UCI, though it may be better training. And as a direct comparison with San Mateo, it can’t compete. I’m glad I went though, and it’s a decent backup plan. Now I’ll be dropping by UCI tomorrow for some schmoozing, then a 3 day weekend, a flight up to San Jose, then two interviews in that area next week.

Take care, everyone.

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La Jolla (San Diego), California
University of California San Diego
12.1.06

This was a bit of a reach interview from the outset. Most of you know Christine and I spent a summer living in San Diego in 2003. It was about 10 weeks. We lived in a beautiful area near Balboa Park in a historic apartment building on the outskirts of downtown. It was quiet and amazing. I think of it as the best summer of my life. And secretly, whenever things in med school got really stressed and I wanted to crack a bit, I went back in my mind to Mission Beach in the summer and bathed in the not-so-hot kind of heat San Diego is renowned for, letting the sounds of the beach wash over me. It was my happy place. About my second year of med school, I started to get an idea of what I wanted in a psych residency program. UCSD, though another top 5 program, just didn’t seem like the best fit type of training for what I want in a career, and personally as a resident. I heard it was research-focused. I heard it was too biologically-oriented. I heard residents weren’t social and worked too hard. However, it was San Diego. And I’ve also heard—and this has been recently validated—that programs’ reputations are often based on outdated program missions and false inferences. So away I went, leaving home again, this time after a lengthy 10 day stay.

I flew into SD on a nonstop flight with cloud cover for the first half of the flight. Near Denver things cleared up, showing the expected array of snow-laden Rocky Mountain awesomeness. Then the desert, parched, with large cracks, ravines, and gorges. More mountains, then SoCal in that typical ash-green and brown collage you see south of Orange County.

The airport is actually pretty much downtown with amazing views of the harbor, downtown, and the outskirts (I could see our old apartment building on the approach). It was overwhelmingly sunny and 65, a classic San Diego winter day. Things went smoothly with the travel nonsense and I was at the hotel and had knocked out a five mile run before 3pm. I scoped out the local sportsbar scene and found Junior Seau’s restaurant, aptly named “Seau’s”, to be a mile away and a highly rated place to catch the Thursday night Bengals-Ravens game. In short, I recommend the place to visitors. Tons of tvs with good sight angles, and a 25 or so foot long projection of pretty good quality. Cheapish food of good quality, friendly service. I was incredibly exhausted when I got home so I ironed my stuff and got some sleep.

I should note the hurdles in the day leading up to this lovely dining experience. So on Wednesday I was talking with Harish, who was a strong gust of wind from coming out to SD from Dallas instead of just going home to NY for the weekend. He asked me when I’d be done on my interview on Friday. I was gathering all that info together at the time, so I went to my Outlook where all my catalogued interview stuff is, but—uh oh—I don’t see my schedule for UCSD. I call them. They say they don’t have me on their schedule. Shit. I have a flight paid for, a car reservation no longer within the cancellation period, and a nonrefundable hotel paid for. I look at the reply I sent on October 9th, hours after their interview request. I don’t see a confirmation email. Shit. I acknowledge to them I made a careless mistake but forward the reply I sent them back on 10/9 to show that I did indeed reply and they lost that email. She went to “review the situation with Dr. Zisook (the program director),” which I took to mean “review this guy’s application again to see if he’s worth rearranging our schedule”. Fortunately I was. I mean, I would have been fine vacationing in SD for a weekend, and it would have been cheaper than staying home and changing my flight to Monday, but I had deep hopes for this program despite its unlikelihood of being the best fit for me. On Thursday, an applicant had to reschedule, so it all worked out anyhow. Not the best first impression though. Damn.

I wake up, fight through moderate traffic, and get to the program in the last third of people (but not the last!) before the 9am start time. 9am seems good, I’m thinking (see: correlation of start time and workload, Maryland interview), though this is considered early on the west coast. One guy tries to do introductions. People seem friendly but not really interested in all this right now. I’m one of them. Pleasant good mornings are what I do to people. We’ll all do introductions in a minute anyhow when all the important people show up. Dr. Zisook started off the day with a 90 minute powerpoint presentation. Yikes. However, being well-rested, feeling good vibes, and having an awesome breakfast of pineapple, melon, strawberries, coffee, and OJ; I had no problem listening to the man.

UCSD prides itself on its reputation and its composition of people. Faculty and residents are recipients of many prestigious awards and have the acclaim and recognition that comes with this. Residents average about 30 points above the mean on the PRITE at each year of training, 20% above the national mean for first time boards pass rate (>80%), >50% of graduates go onto fellowship (though not at UCSD! No fellowships!), 25% of grads go into private practice (>90% stay in SD…it’s so nice and there’s so much professional opportunity). It turns out their program is VA-based. Yikes. I hate the VA. I mean, I like the computer system so much it makes me want to work there for a month or so at a time, but I hate the nurses and the patients are a heterogeneous group of assholes. How varied would my psych education be? Would I be an expert on PTSD, depression, and dual diagnosis (psych illness plus substance abuse)??? Why not just stay in Baltimore? Okay, maybe getting carried away. But this is a huge drawback.

Zisook then did a slide called ‘myths, misconceptions, and partial truths’. Good idea. #1 was “too much time at the VA”. 2 months in first year, 6-8 months in 2nd year, none in third, selectives in 4th. Hmm, seems like a lot to me. Next of note was “too much basic research emphasis”. Turns out that this isn’t necessarily true. “Research is big in the psychiatry department here, but that is not what your residency training is supposed to be about. 80% of residents here have no interest whatsoever in research”. Good to know. Next, “no elective time”. Electives are replaced by selectives (see: Maryland interview for definition). Booo. Plus, these are in 4th year mostly. It seems this schedule is pretty rigid, though you can do some peds months as a PGY-1 if interested in child. Next, “too much work”. “This is a working residency…It has a harder 3rd year than most but you leave it knowing your psychotherapeutic skills are superior to others’”. Hmmm, not sure how I feel about that. Next, “not enough psychotherapy training…too biologically focused”. This they claim to be very false. The reputation is supposed to stem from being a west coast program with strong psychopharm. It was assumed that if it is very strong in psychopharm, then the natural deficit would be in therapy. Okay then. They specialize in CBT. They claim—like everywhere does—that the supervision is great.

There was a VA tour. Need I comment further on this one?

The first interview was with the cheerful chief resident. She loves the program and loves the people and just had a little girl and loves her and loves the world and isn’t everything just so great? She was nice, but—and big fuckup in my book—hadn’t read my application. First time I’d seen this. Are you just too busy? Too arrogant? Don’t care? Hmmm. It went fine except I challenged her some on the VA population, to which I think she got a little defensive. I just needed to see how the La Jolla VA differed from the downtown Baltimore one. I guarantee you they’re different, despite most people saying—and with good reason—“a VA is a VA is a VA is a VA”. La Jolla and Baltimore though are different enough to challenge this concept. She said they were all alike. She also said she’d never been to Baltimore. I noticed the nurses were friendly and smiling, and it was quiet. That’s all I’m saying.

I then went to the associate director, Dr. Lunn for a 20 minute interview. She was very personable and asked good questions. We had a fast-paced, we-want-to-talk-but-both-feel-the-time-constraints interview. She made me feel warm and fuzzy about coming to the program despite all I’d just heard. She could be a really solid mentor. The one question she did ask that I wasn’t prepared for—though sure as hell should have been—was about my strengths and weaknesses. Now this is tricky. You need to name a strength that is unique and not haughty. If it’s not really strong, you seem like you have nothing to offer. If it’s arrogant, that’s all that comes across. If it’s standard, you seem like you have nothing unique to offer the program. The weakness part is similar. If it’s really weak, you just ‘fessed up to your judge exactly what you’re concealing. Why? Because they asked you to. If it’s not weak enough or you don’t offer anything juicy, you seem like you have no ability to introspect, not so hot when you want to do psych. Fuck. I think I handled it all fine, but it wasn’t glorious. I need to think this one through before my next big interview (san mateo). And oh yeah, she hadn’t read my application yet either!

Next to Dr. Zisook, whose name is really difficult to type. He came across in the morning as being very in control and paternalistic, but a softie deep down. He mentioned walking on the beach with his wife on Sundays and commenting on their good fortune to be living with each other in paradise. Sentiment from my own heart! He started off the 20 minute interview by excusing himself to peruse my application, as “It’s been a several days since I read the applications”. Well, not several days since you read mine since I just got the interview less than 48 hours ago. So either he’d never read it, glanced at it in early October, or read it when the interview debacle occurred on Wednesday. Not pleased he wasn’t prepared. The interview went pretty vanilla. He tried to tell me more about the program and ask about my questions. Dammit, I have a lot to say. I’ve worked hard since undergrad to build up this application that sets me apart from my colleagues. Ask me about it! I spent the last minute trying to build a rapport that could extend into the future by citing something he’d said to me a few years ago. He says, “Oh, okay then. Good.” Doh.

Lunch at the faculty club. Watching the residents with us wander around unsure of things, I ascertained they don’t get to come here often. People were friendly though seeming a little stressed. And they all ended up having to leave “to go get all my work done”. Hmmm. I used the time to really get a feel for why these residents had chosen UCSD. “It’s just so nice here”. “It’s really well-ranked”. “The people were really friendly”. Well, okay then. That’s fine. Prestige is great. I want prestige. But only if it fits in with the rest of what I want. I want to live at the beach. I don’t want to sleep at the beach and work all day near it, despite people being friendly at work.

Some other details. Call is q6 through the first 2 years. It is about q5 weeks as a PGY-3. None as a PGY-4. Hours are 70ish, 60ish, 45ish the first 3 years. Medicine and Psych are not in 6 month blocks, like elsewhere. They are in 2 months blocks that intermix. I like that idea. Also, the first month is always inpatient psych, so interns may bond and this is called a “crash course”. Didactics are half a day. They are protected. No one goes while on medicine though. “Not enough time”. Hmmm. Moonlighting is typically started in 3rd year. It can be done in 2nd year, but no one is. They’re either too busy or the opportunities aren’t worthwhile. Oh. Salary is almost $43k.

I had one other interview that was fine. He was older, nice, and we had a nice chat. Only guy who read my application, by the way.

We went to La Jolla as part of the tour. Word is they used to do this in a limo. We went in a van, which is supposed to be more comfortable. Comfort be damned, I say. We got out near the children’s pool, which is now inhabited by seals. It was beautiful out, of course. The air smelled of salt and the sun made us squint. We walked out above the ocean atop the retaining wall. What an amazing selling point. San Diego is beautiful in a way that nowhere else I’ve been can compete. I love Orange County as well, but it’s just so different. Oh well.

I went to the happy hour. We were all very tired by this point. We socialized and a resident almost talked me into not canceling my USC interview. Of course he transferred to UCSD from USC as a PGY-2 so I missed his real argument. Though terribly fatigued, I realize the potential of a Friday night in San Diego. I tried to rally the troops for a night out in the gaslamp district….to…no…avail. “I’m so tired,” was the general consensus. Crikey. I considered going alone. Couldn’t do it. I didn’t want to be the creepy married guy on a business trip talking to people in bars on a Friday night. The girls would think, “Is this married guy flirting with me?” The guys would think, “I can’t have sex with this person”. It just wouldn’t work out. I went to Dr. Dunn’s dinner party instead. I went with a girl named Adry from Indianapolis. She was nice. It was her first interview and I gave her heavy doses of opinion, upon request. She asked for my breakdown of the day and I did so in a way that I hope helps her with her own analysis as she experiences more programs. We were very tired and did not stay long. I went back to the hotel and had the lamest Friday night in San Diego history. A shitty ending to a not-so-awesome day.

The strengths of the program:
-San Diego, home of the greatest summer of all-time. I still think I want to end up living there permanently one day. It’s a top notch program according to any rankings system. It’s easy to get into a fellowship and get a great job. The people were friendly, and appeared happy despite the workload. They are a talented group, from which I could really maximize my learning. They all do well on the PRITE and boards. Faculty is tremendous. I really like the intermixed medicine and psych blocks. I like the idea of a free year of psychotherapy. I think it would be a good introduction into learning of the experience. And after spending 70-75 hr/wk dealing with psych patients, I may need it.

The weaknesses of the program:
-I don’t really like the idea of working at the VA that much. I don’t like that much call and that kind of workload. I want to moonlight earlier. I’m pissed they didn’t care to read my application beforehand. I’m also not sold that they take psychotherapy that seriously. We’d have to relocate after 3 years if I wanted a child fellowship.

Whole Grade:
Immediately – 8.3
A few days later – 8.2

Ultimately, this program is not right for me. Would I be happy here? Probably not so much. Why am I ranking it, and ranking it higher than Maryland then? Because I cannot get beyond the idea of living in San Diego. It’s so money. The highlight of my day was Dr. Dunn. She was the only person who seemed to care if I came or not. I’m an attention whore. If you tell me you want me, it makes me feel good. I then have additional positive feelings in regards to your program. I then want to be a part of it more. This whole interview started off on the wrong foot with the miscommunication. I figured it was a dealbreaker but went forward with it anyhow. There were no surprises. Maybe the next big earthquake will move UC-Irvine into the San Diego area.
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Baltimore, Maryland
University of Maryland
11.28.06

Ahh, the courtesy home interview. I originally scheduled this program as my first interview…for practice. Things got turned around and I ended up having many of my favorites beforehand. Oops. I considered canceling, this program being #13 or so in my pre-interview rankings, but the match is a scary entity that makes you do strange things. With Christine working, all I’d end up doing is sleeping in and then watching tv in my boxers until she came home anyways. Might as well break out the new suit (pinstripes…money) and my blue crab tie (what did I have to lose?) and see some old contacts from UMB psychiatry.

I forced myself to wake up before 11am, which was a task and a half, sadly, as I’ve found a remarkable stubbornness in adjusting back to east coast time. I opted out of reading about the program, and watched poker on tv instead until it was time to go. The interview was at 7:45am, which I think is on the early side. I’m wondering about a correlation of early interview times to resident workload. I need to start paying more attention to this. Anyhow, I wandered over to 701 W Pratt, the fourth applicant of seven to arrive. I was impressed by the portfolios they put all our info in. I was not impressed that the “contract” inside had the following:

Salary: ____________________________

Um, guys? Fill that shit in. You’re naïve to think no one cares.

The terrible intros began as I surveyed the room. An anxious DO chick; a dude with a stern look on his face, poor eye contact, and the appearance of disdain for others when speaking; a cool volleyballer named Matt from UC-Irvine; and a few other boring people I’ve already forgotten. I started to wonder if it was too late to cancel. Then Solomon walked in. Saving grace. We started talking about plenty of things Marylan- and non-Maryland while others awkwardly eavesdropped, which was fine. What was not fine was anxious DO chick’s attempts to strike up conversation. I mean, I give her credit for effort alone, but how many poorly timed, poorly constructed, failed efforts does it take before you fold your hands and sit in silence like the rest of the people? You could say we weren’t meshing as a group.

On the bright side, only two interviews were scheduled. This is much better than the 6s and 4s from earlier on the interview trail. It also said to me, “we’ve already made our rankings. Express interest and you’ll move up, but mostly say or do something demonstrating some psychopathology yourself and you’re out.” So it wasn’t an interview. It was a screening out process. Maybe I shouldn’t have worn my blue crab tie. Or left every few minutes to go wash my hands while muttering barely audibly, “nothing is clean, nothing is clean”.

The program director, Dr. Luber, came in to do an informal presentation about the program and the city. It was fine save for a few points. Mainly, my bullshit detector was going off. I don’t even know why. He spoke eloquently and demonstrated a sense of humor and really came off as being quite personable. This was different than a meeting I had with him last spring. At the time, he was a little gruff. He had also been very little help in seeking information about other programs. I wondered if he didn’t know or if he was obstructing me in my search to increase the chances I’d stay home. If that’s the case, though, you’d imagine he would have been nicer. Hmmm. Anyhow, he claimed Baltimore to be a very safe city and cited some statistics and a New York Times article. Then he asked Solomon, who wants to go there (!), if he was telling the truth. Good thing he didn’t ask me. I don’t even try to lie, it comes off so badly. An interesting thing he did, which was entertaining though I think a bit inappropriate, was go around as each person introduced themselves, and take a minute to give further introduction of that person, showing off from memory what he had learned from their CV, personal statement, and dean’s letter. That’s cool he learned it, but show that to me in person, please. “This is Todd. His CV says he’s an astronaut. His weaknesses are injured puppies and the show ‘Top Chef’. Welcome, Todd”. See? Now Todd wants to die.

Another interesting thing. The tour didn’t come next. It came last. First time I’ve seen that. So now to knock out the two interviews.

The first interview actually didn’t go so well. The questions were all what-am-I-thinking questions. I don’t know, fucker. I understand the role of well-placed ambiguity in questioning in the field of psychiatry. I also understand if you want to know something, sometimes you need to just ask it. Anyhow, the conversation devolved into him asking my opinion on curricular changes in the first two years of med school that would lead to greater interest in psychiatry at University of Maryland. I was glad when it ended. Though these interviews were of the speed-dating duration—30 mins—I learned that even some speed dates must seem to last forever. I can’t say it went badly. I just didn’t leave with that fuzzy, excited feeling I normally do.

The second interview went incredibly well. It went with the well-established principle of kiss my ass and I’ll respond to you. Sad, but true. It was a faculty member who I already knew, and who speaks off the cuff, and for that I knew it would be a fun 30 minutes. He started off with, “Jeremy, this interview isn’t for you to sell yourself. You don’t need to do that. This time I feel like it’s my responsibility to sell the program to you. Do you want me to do it formally or informally?” Excellent. I was able to ask the hard questions. The things I didn’t agree with Dr. Luber about, such as reputation amongst other fields in the hospital. Dr. Luber said psychiatry was well-respected at Maryland. Bullshit. I’ve been on the wards. I wouldn’t, and for that matter, couldn’t defend psychiatry many times in their interdisciplinary battles. They simply did not demonstrate sound medicine, nor sound judgement at times. Fortunately, this interviewer agreed. I got a lot of the dirt I was seeking, and for that I hold this particular doctor in higher esteem than previously.

I get back and find out my first interview experience was soundly beaten out by Solomon’s.

“She asked me to present a patient”.
“What?”
“She said, ‘Pick a patient from your past and formally present them. It doesn’t have to be from psych. Just any interesting patient from your past’”.
“You should have left”.
“I want to go here though”.”Oh.”

I understand that when selecting a doctor that will be working in your program, he/she must be capable of basic tasks expected to have been mastered as a medical student. However, this should be addressed in his academic records. Solomon is no idiot. He goes to a solid medical school affiliated with this residency program. Don’t bust his balls in an interview. You should be massaging them gently so he’ll want to make the smooth transition into this program, strengthening the partnership between school and residency programs, and showing others that the students here want to stay!!! Poor form.

We went to Sheppard Pratt, where I’ve actually never been. It was pretty awesome. Dr. Sandson, who I really like, gave an overview. It was in an old boardroom with very old books and shiny dark furniture everywhere (and a chandelier). I almost fell asleep. It was terribly boring, despite Dr. Sandson’s very sharp wit. Then the tour, which reminded me of a collage of horror movies. Then back for lunch. Lunch was chicken, fettucine alfredo (I hoped no one was still nervous!), salad, cookies, soda/juice/water. A fine assortment. The residents seemed fairly happy, though a little overworked. I found out moonlighting starts in second year now, whereas I had been told previously it began as a PGY-3. Good news, indeed. Also, the call wasn’t quite as bad as I remembered hearing. And free parking. Caseload was as bad as I remember, though, up to 9 patients. Salary is not so hot at $41k. And worst, didactics, though said to be protected, apparently are not when on medicine—4 months long in the first year. If I need to pass my boards and take the PRITE (in-service exam), I’d better be allowed to go to lectures. The tour was fine. Actually, trying to look at it through a visitor’s eyes, it was very nice. The facilities at Maryland are actually pretty good. The computer system is above average. The architecture and sightlines are beautiful. The cafeteria is also…and I say this begrudgingly…quite…good. And of course, Donna’s and the cookie stand, of which I need not say a thing.

The day ended pretty early. This is also where it got most interesting. Things wrapped up with a 5ish minute meeting one-on-one with Dr. Luber. He asked where I was most interested in going. I didn’t want to kill my chances with Maryland as my safety school so I made up some line about Maryland being in the mix because it was home and I’d missed a lot of things while I had been away on externship. He bought it. Then—this is fun—he bashed San Mateo and UCI (how is that possible?). To pique my interest even more, he said, “But Brown, I can’t say anything about Brown. That’s just a quality program.” Wha??? They’re all quality programs!!!! Anyhow, he says very firmly, “I want you to come here. What can I do to make you come here?” I reply, “Well, like I said, there are some things about the program that make it a good fit for me and I’ll be considering that when making my ranklist in a few months…” He then goes on. “I really want you at University of Maryland. Maryland needs more people like you. Let me see if I can sweeten the deal.” So here’s where years and years of being a sports fan come into play. I start thinking of the Maurice Clarett and Reggie Bush scandals. Am I the next Chris Webber? (How many timeouts do we have?!). The movie “Blue Chips” pops into my head. And this is all in milliseconds. I get nervous and excited. Is he going to put me in a position of ethics? Because one, I won’t believe it if he offers me something illegal—though I guess technically it’s immoral and against the rules to say Maryland would even rank me prior to the match having occurred. And two, there’s not much he could offer to make me more interested in Maryland than my top 3 choices. And three, who am I kidding? I’m not a bribe kind of guy. Legally, sure, companies can bribe me with coupons and discounts. But bribes that could fuck me professionally? I’d never do it. Anyhow, I won’t get into the details of what he offered because I don’t know who’s reading this. But let me be very clear about this. His offer was not immoral or illegitimate beyond the fact of the implicit we’re-going-to-rank-you-highly that would go with such an offer. Of course it was explicitly stated as well, but he’s not the first to do so, so I’m not exactly offended by his candor. The offer was, however, very humbling. And if there’s a match day catastrophe and I slide to Maryland on my ranklist, at least I know there are perks.

The strengths of the program:
-it’s home! I get to stay near friends and family, which no other program I applied to can offer. It’s also a system with which I’m familiar, in an area where I know the layout and the real estate game and the traffic patterns and the best places to eat/shop/etc. It’s also a fairly strong program for the area. And there’s a very strong child fellowship attached. Sheppard Pratt used to be the top-ranked residency in the country before the merger with Maryland in the mid-90s (due to some funding issue). Therapy training is reasonably strong. I could get solid supervision, do research if so desired—even at MPRC, which has international acclaim. Plus, there’s the “deal sweetener”.

The weaknesses of the program:
-it’s Maryland!!! Plus, they work hard for not a lot of money without an abundance of moonlighting opportunities. They are friendly but don’t know each other that well. The loss of 100% protected time for didactics is a huge negative for me.

Whole Grade:
Immediately – 8.1
A few days later – 8.0 (It’s Maryland!)

All in all, this is a fine program, where I could really carve a solid niche for myself. The transition would be almost seamless. I know I would do well on medicine. I also know I could keep my medicine fresh, and feel I could make a positive impact on the program as well. However, I don’t care to work that hard for that amount of money. And we’re looking for more of a life-changing experience. Renting in federal hill and buying a new car isn’t exactly as life-changing as we’re expecting. That said, the match is tricky and we want a safety program rather than facing any chance of scrambling. I’m canceling programs I’d rather go to than here, based on the fact that I expect to match in my top two choices and I’d rather go to the beach or exploring than interview almost everyday for a two week stretch in Cali (I’m writing this at BWI en route to San Diego for 3 days, Orange County for 6, and the Bay area for 6). I will rank Maryland, and it will do if match day falls apart. Here’s to hoping March 15th goes much more according to plan. Cheers until next week.

================================================================
Seattle, Washington
University of Washington (“you-dub”)
11.20.06

I flew into Seattle mid-day on a Saturday. It was a city where I’d never visited but always heard good things. UW is a top 5 program pretty much any way you slice it rankings-wise. I was excited about the Monday interview, the weekend to go explore a new city, and the fact that my curricular work was complete until 2007. The forecast said rain. Lots of it. The first day could be partly cloudy, but then it’s rain for at least the next 9 days. Uh oh. It gets better. Seattle is in the midst of its…rainiest…month…in…history. Sweet. So flying in…it’s clear! And incredibly beautiful. Mt Rainier is impossibly large, and the view from Seattle is a three hour drive still to reach its base. So there’s this monstrosity covered in snow with two other smaller mountain ranges in sight, also snow-capped. There is water everywhere. The foliage is an abundant mixture of fir and brightly golden deciduous trees (cedar?). The hills softly roll until they hit the water’s edge, which is never too far away. The view from above shows a land being taken over by a creeping body of water, attacking from all angles.

There were the usual travel problems that I don’t feel like getting into but a couple hours later I’m meeting Ketaki at the car rental agency. She was in WA doing a month of her rural medicine (AHEC) rotation, and having it completed, was on her way to Vancouver, BC, with a weekend’s stopover in Seattle. We quickly headed downtown, fighting the fading daylight as we rushed to the space needle. We mostly lost our race, but the view was still incredible. 605 feet over a city that is beautifully designed with a concentrated downtown area and all the natural benefits I just described. We made it around and found some dinner, got a bottle of Columbia River merlot, then hit the University district for a night out. Let’s just say we weren’t impressed. At least smoking in bars is illegal.

Sunday brought the return of Seattle rain and cloud cover. The awesome hotel view of Mt Rainier was lost to the weather—which never returned during our stay. We made it downtown and did touristy things in a cold, windy, wet adventure. In short, Pike Place Market was very cool. The underground tour of the city that described its seedy origins and early history was worth the $11, though I can’t say I’m overwhelmed by it in retrospect. I looked into the Qwest Field (think Seahawks) tour, but was disappointed to find it only happens on Fridays and Saturdays. Doh. Found a pizza place for dinner, had a quiet night. Interview in the morning.

I awoke early and stumbled around the darkness getting ready, listening to the steady sound of rain outside. I managed to get across the street to the shuttle that would take me to UW Medical Center (UWMC) by 7:15am. The interview letter said continental breakfast at 8:15 and opening remarks at 8:30. My schedule said interview at 8. Confused, I called. Apparently I got a special appt with the program director for 8am. Why? Dunno. But so much for getting my head straight with bagels and coffee before the day truly began. Then something fun happened. The shuttle turned onto I-5 (“the five”) and headed towards downtown. Uh oh. UWMC is about a mile from the hotel and does not require freeway access. 20 mins later I’m at the sister hospital. I ask around and find out this shuttle swings downtown, waits (!), picks up more people, heads back to University district (“the U”) where I was just picked up, picks up those people, then goes to UWMC. I have to call and say I’m going to be late for my meeting with the program director. They’re very nice about it, and though I can’t say I’m terribly upset (UW being #8 on my list before the interview), I’m not trying to make this whole trip a waste of my time either. I make it to the hospital, navigate up to the 16th floor, apologize again, and we’re off!

Dr. Cowley’s office was amazing. Views of the space needle, great water (including “sleepless in seattle”’s houseboat, which apparently is a huge sightseeing destination) and foliage. Heading a top 5 program should have its perks, I guess. She was nice but not overwhelming. I told her the program’s reputation of extreme biological focus worries me about my psychotherapy training. I could have schmoozed some more, I suppose, but I didn’t go all the way up there to not ask the big questions. She actually did a surprisingly good job of alleviating my concerns. The interview ends and we make it over to the conference room where 6 other applicants were hanging out and mostly topped off on bagels and coffee….bastards*. And though it’s only about 10 feet from me, I don’t get a chance to eat for another hour.

*note: I knew and liked two of them from previously. Fumi interviewed at San Mateo on my last day of externship. Dan was one of my colleagues at the Brown interview who I first met (see: Brown University interview, resident dinner mishap).

Some things I learn in that hour: UW is the only medical school in the WWAMI region (WA, WY, AK, MT, ID…3rd grade geography….you know them). So since these areas are pretty rural, there needs to be a heavy primary care (PC) and consult-liaison (C-L) focus to their program. Research, of course, is also huge. And in the last few years, their psychotherapy is starting to gain acclaim. Okay! Unfortunately, I don’t much want further PC education and I don’t care much for C-L either. Off to a fantastic start.

Then I interview with a doc who is a PGY-2 who transferred after being faculty in Ob-Gyn. (Good for him). He wants to talk about my Ob-Gyn experience. Why??? At least he was nice. Then to lunch, which wasn’t super. I think I had a cold turkey and zucchini sandwich. Half of one. Less than half of one. And a coke. Guiltily*.

*note: the Ob-Gyn guy I’d just interviewed with had made a careless comment a minute earlier about something that would relate to no one but me, that I chose to sheepishly admit to. I forget the exact thing now. Then as I was sitting, he says, “We need more diet soda. No one drinks regular anymore!”—To which Dan and I smiled as I, again, sheepishly pulled out the regular (nay, Classic) Coke and placed it on the table. He apologized…again.

Then a great interview with the head of the geriatric fellowship, though I can’t say we really talked about me or UW as much as if we were just meeting on the shuttle and hanging out for a half hour. Then I got a mocha latte and watched the rainfall. Oh, by the way, this rain was new. I mentioned the rain in the morning, but then it inexplicably cleared and was beautiful all morning. This led to a lot of, “oh how lucky you guys are” comments. It was still cold and windy. Things still weren’t going super.

Another interview, a few more tours, time to go home!

Except there was a happy hour. Well, since I liked the other applicants and they were going, I agreed. We walked for 5 minutes in a really heavy rain in really expensive clothes. One person thought to bring an umbrella to seattle in their rainy season. I was not one of them. Oh, and she wasn’t with us yet. It was awesome. We got drinks before the residents got off work to meet us. Then they arrive and tell us they don’t pay for alcohol. “It looks bad as a business expense”. Know what looks worse, douchebag?

We get food and all start eyeing the door as more residents show up. Then an intern shows up and asks where a guy is from. Except he’s not an applicant. He’s a senior resident. Her senior resident!!!! Okay, so the residents don’t know even each other. The applicants agreed none of us were going here, we shared contact info, and we fled into the darkness…away from the clutches of the UW psychiatry residency program.

The strengths of the program:
-prestige, prestige, prestige. Programs this competitive don’t normally go out of there way to impress people, I guess. Also, great psychopharm, and—it appears—decent therapy. Seattle has fun things to do. And I could kayak to work. That is all.

The weaknesses of the program:
-call heavy. I don’t plan on being on overnight call during my 3rd and 4th years unless I’m getting a monster moonlighting check. Call it spoiled. Call it snobbish. But this is psych, and I’m not losing sight of that. If I can get the same experience but on a voluntary and additional pay basis, then that’s my angle. Also, seattle has a terrible cost of living and traffic. I know Cali does as well, but those should be trade-offs for quality of life. If I want cold and rainy in the winter, I could stay at home in Baltimore. I’ve said it a million times: if it’s cold, it had better be snowing. A few other reasons this place won’t work out: despite their efforts to say they were happy, they certainly didn’t smile much. Plus, they didn’t even know each other! And when asked if they hang out ever (obvious answer, right?....this is like a validity check question on an personality inventory…don’t try to lie to beat the system!), they said sure, but not during first year…”no one has the time”(!). I could probably go on and on. I know people feel cool saying U-dub all the time, but instead of doing that with presumed colleagues at 2am in a group let’s-say-u-dub session, I’d rather be home with my wife. Call me old-fashioned.

Whole Grade:
Immediately – 7.9
A few days later – 7.4

Hard to say this, but I think I may prefer even Baltimore to Seattle, especially with the laws to remove smoking in bars being pushed through. Talking with the locals reminded me a lot of their big dumb trees. Trees were prettier though. I can’t imagine I’m ranking this program. And that’s why we interview.

============================================================================
Irvine, California
University of California-Irvine
11.13.06

So I did a month at this location. I wanted to do child psychiatry but it turns out they consider their adolescent unit a child psychiatry unit—likely because they don’t have a child unit on site. I was a little unhappy about this. I walked in my first morning to find a bunch of sixteen year old girls wearing too much makeup and exhibiting various displays of perceived entitlement. The true problem with this externship was that it missed the point. I left my life behind. And I like to think I did this to evaluate a place for our future and to solidify a spot in that regard if we so desire it. The best way to evaluate a program is to be in the presence of those before you. Are they happy? Overworked? What are their challenges and how do those challenges relate to my desired experience in residency. Externships are valuable things. Unfortunately, and this is ultimately my own fault, I didn’t get to see much of that. Child and adolescent psychiatry in academia is the place for those completing fellowships. Call schedules are different than residents, and if a resident is present, it is usually a PGY-2 (second year resident) anyway. Now to get a PGY-2’s advice is great, but less immediately important to me at this time.

I was disgruntled for the first two weeks. I had been away from home for a long time and it was starting to burden me. I was stuck dealing with adolescents all day with psych and behavior problems, most of which were linked to a southern Californian culture of rich daddies, crystal meth, and an I-deserve-this-give-it-to-me-now attitude; most of which I was not that familiar with. The traffic going home sucked some days. Then I went back East for the Brown interview and my grandfather’s funeral. I was lucky and caught decent weather most of the trip, but the last day was really nasty. Raining and in the 40s. Pretty typical Baltimore November weather. I should be used to it by now. I landed at LAX around 10pm. It was 73 degrees. The next morning was sunny and warm and calm. It was just another SoCal day. I appreciated it a little more. The next day was my interview day at UCI. It reached into the 90s. Most of the interviews were outside. And finally finally finally, I got to see what a UCI psych residency is all about. And it was exciting.

The day consisted of overview, tour, brief observation of rounds, 2 interviews, lunch, 4 more interviews. There was one other applicant, a nice enough guy from UT-Galveston that I didn’t get to know too well. One thing I haven’t mentioned yet is the program director. His sincerity, charisma, drive, and dedication—to the program and to the residents—are really compelling. He’s hands on, funny, and puts you at ease. His pressuring me to come to UCI would probably make a difference, but that’s not his style. “We get good applicants each year,” he said. “We’ll have excellent fits come match. I want you to like it here. From what I hear, we would really be lucky to have you here. If you think this program is a good match for you and your wife, we would love to have you.” He later followed it up with, “If your wife has any questions or concerns…about life here, jobs for her, what your job would be like, what your lives would be like…tell her to call me. I’d love to talk with her.”

The associate program director, a young attending five years out of training, is named Dr. Nguyen. I’d heard good things but only spoken with him briefly after an excellent grand rounds he conducted. He runs the inpatient psychiatry unit where interns spend four months. What I sat in was awesome. His timing is great. So is his management style. To students, he said, “What’s your plan with this patient?” Word is, he may have his own opinion but if the plan given by a student or resident is solid, he’ll approve it. He makes sure you can’t mess up, and makes sure you don’t miss a chance to learn, either by looking at something from a different perspective or allowing you to test out your own treatment hypotheses. When I met with him individually for my interview, he said things like, “You’ve proven to be the self-starter that excels in this program. I hope you find this program a good fit for you. You need to be very careful how you rank programs. And I mean this broadly in the sense of your top three. But I really mean this specifically in the sense of your top choice. Expect to match there”. Well, okay, that’s good to know.

From the co-chair of psychiatry, “If you choose to want to go here. Make sure you are very clear about that to Dr. Maguire (program director). We’ve all been hearing a lot about the work you’ve done here.”

An aside: I am guilty about the work I did there. Well, not so much the work as much as the effort. Psych makes sense to me. You learn a few basics about management and the rest is all instincts. But since it’s been important, I’ve always really overdone it effort-wise. Well after being disgruntled and not pleased with traffic and having been away from home for so long, I didn’t feel like I was doing that well. Things were getting done and my patients were happy, and were generally getting better and going home. However, there were a lot of students on service (so less work for each), and I was limited by the system on the unit to where I wasn’t able to place orders for co-signing and my notes weren’t generally worth anything because the fellows just dictated their notes independently of the quality of my note written in the chart. Anyhow, I ended up with honors and perfect score on my—now meaningless—evaluation. Because it was an unhappy, half-hearted effort most of the way, I feel guilty.

Back to my evaluation of the program.

The interns I spoke with were all very happy. No one seemed like they’d rather be working anywhere else. The sub-I on the adult unit also seemed very happy. His interests in psych seemed new, but his instincts were sharp and he had excellent people skills. I would be really happy working with him. Many of the residents live near the beach. As in one block or so from the beach. I began to envision weekends of waking up at 11 and rolling out to the beach to go surfing with christine…75 degrees in December. That’s some kind of life as an intern.
Ultimately, that’s what this program choice would come down to. The money is okay. The training is good, but not the best I could get. But the lifestyle? Perhaps only San Diego would be a better fit for us, and that program likely isn’t as good a fit. As a whole package, UCI is an excellent choice for 3 years, 5 years, or more.

The strengths of the program:
-amazing lifestyle choices (live at the beach, warm weather year round, close to skiing/hiking), moderate amount of moonlighting available at start of second year (hours that peak about 40-45hrs 2nd year onward), could do a mixed child/adolescent and psychotherapy track including specific training and clinics geared towards that, excellent faculty and administration, psych is very respected in the hospital/med school (50% of 2006 awards from med school went to psych dept, last two years’ faculty of the year was Drs. Maguire and Nguyen), there is a great social network here (residents are like a family. Many are displaced easterners and Midwesterners so they understand the challenges of relocation. The program is a good size—8 people—so there is a group feeling but also the opportunity for each person to have their own niche), SoCal!!!!

The weaknesses of the program:
-intern year could suck more than at other programs I’m considering (60ish hrs/wk on psych, 80hrs for the 6 months of medicine and neuro), cost of living (though better than in the bay area), traffic (apparently bad here this time of year for some reason and partly a result of construction on a freeway that should be complete in a month or so), training may be a bit more academic than what I’d ideally like.

Whole Grade:
Immediately – 8.9
A few days later – 8.9
11.30.06 – 9.0 (creeping up after being away from the beach)

I slipped away for about 15 minutes at 11am on my last day. I bought a giant warm cookie and sat on a bench in front of the neuropsychiatric center. I wore sunglasses because it was bright. It was warming up…low 70s at that point. I felt the sun’s warmth, I stared at the row of orange trees lining the left side of the NPC’s entrance, and I slowly placed gooey chocolaty chunks of cookie into my mouth. I could have all this and more. And with Christine, maybe we will.

================================================================
Providence, Rhode Island
Brown University
11.9.06

I’m writing this a few days after my Thursday 11/9/06 interview at Brown University. Being the first of what is 20+ scheduled interviews around the country, I’m not exactly sure how I should start to wrap my brain around the experience. Let’s just start with locale. Or perhaps for your entertainment, how I got to the locale.

I woke up around 4:30am (thanks, beanz) pacific time, gathered my things, and was on the road by 6. It was 38 miles from Orange to LAX. I needed to drop off the rental car that was rear-ended a couple days earlier—also relieving me of paying for parking or having to burden Steve for dropoff/pickup responsibilities for my excursion. We can pinpoint this time as the moment when I truly learned of SoCal traffic. Christine and I had sat in some LA nastiness during a vacation previously, but it was vacation—where else did we really need to be on time? The closer I was to LA, the more congested the traffic. No accidents. Just stoppage. Well, except for the carpool lane, which became less and less occupied by multi-person vehicles as time elapsed. I thought and thought about it, but just couldn’t execute the movement one lane to my left. The threat of a nearly $400 fine did its job. I reached the rental agency at 8am. That’s right, 38 miles in 2 hours. You do the math. I dropped off the car, but not before they needed further description of the accident—like my hustled shorthanded account would trump the police report also in hand. I missed the shuttle. Another was waiting, but he wouldn’t leave until more people were onboard. His attempt to increase his tip from others thoroughly destroyed his chance to get one from me and a few other stressed out riders. We reached the airport about 8:20. There was a short line at sky cap so I just figured I’d check my bag there, holding onto with dear life the carry-on containing my suit. “Oh, you’re flight is canceled. You were going to phoenix first and we can get you on a flight there for your outbound connecting flight, early even!” It was in 20 minutes. I hustled through—thankfully—very light security traffic and made it on board as one of the last few passengers. The flight to phoenix was cramped but quick and relatively painless. I made my flight into providence from there, knowing things had to go like clockwork, as I’d RSVP’ed for a 7pm dinner with a 6:40pm flight arrival time. This being the case, and since RI is generally not in the same weather category as LA or phoenix, I wore jeans and a sweater to both airports, receiving quizzical looks by many, some of which were rich old ladies with little dogs in their purses, so I wasn’t exactly too self-conscious. Flight was on time into a cold sideways-raining providence. The baggage claim area didn’t mark which flights the bags were coming from so it was general chaos. After about 25 minutes of walking back and forth and back and forth, I found the sole attendant who says my flight’s bags are all done. Sweet. I go to the lost bags area, rushed and pissed. They take note, blah blah. I hustle over to the rental car counter where I have a reservation. No one. All the other companies, attendants present. Dollar? Nah. I use the phone and call them about the shuttle, which is coming. I sit as best I can outside, remaining mostly dry until the shuttle arrives. We make the short commute to the agency’s lot. And it’s all apologies. No cars left. They point to the backboard, site of a billion keyholders, all empty. Jerm is not happy. Reservation in hand gets more crinkled. I make them take me to another agency, Thrifty, who only has minivans. Sweet. A brown minivan and I’m super late. I take off into the windy wet darkness towards downtown providence. It takes about 15 minutes before I’m so lost I need to start calling people. The roads in providence are full of curves, hills, one-ways, and random name changes. One road actually changes from Ridge St to Pidge Ave, I kid you not. How is that not the naming commission trying to fuck with visitors? In a town historically known to be run by the mafia, how could I be surprised? Justin via mapquest gets me to the restaurant around 8:30. I walk in wet, apologetic, and hopeful they’re all still there. Turns out there are two applicants. Residents all no-showed. Not looking so good for Brown. Fortunately, they were friendly applicants and the food was fantastic. By 3am I had my luggage from the airport, courtesty of the attendant who was willing to drop it off after he was off work (since no paid drivers were willing); and I had found sleep. If 3 hours of sleep can be described as perfect, this is the case. Turns out the applicants had changed the restaurant and had a miscommunication with the program coordinator. These things happen, I understand, and was impressed by their embarrassment, sincerity, and attempts to make up for it the afternoon after the interview.

Now the locale. Providence is great for food. It’s a pretty standard small northeast city. I think of it like Worcester but not as hopeless. It pales next to Boston and New York obviously, but it seems there’s enough to do to keep you occupied. I feel its confusing nature would easily pass with a few weeks of navigation.
The Brown interview started at 7:30am at Butler hospital, a psych hospital built in 1844 and known for its humane treatment of psych patients even in the asylum era. Part of it looks rich with history and design. Part of it just looks really old. The exterior is largely renovated to keep the original structures prominent, but with expansion. The patient areas inside are as modern as anywhere else I’ve really seen. Sterile, well-lit. The Brown program is a multi-site facility with shared time at several area hospitals, but none more than 20 minutes apart from one another. There is private (Brown), public/poor (RIH), the VA, a dedicated children’s hospital (Bradley), and more. Varied experiences. This is definitely a positive. The downside here is probably the largest downside of the program though. Every few months, you go somewhere new and have to get new passwords and learn how new systems work. People really complain about this. Of course, people will really complain about something regardless, so maybe it’s a positive note for the program that this is what residents choose to harp on.

The interview’s first few hours were powerpoints about the program, the standard nuts and bolts lectures, the research opportunities (which is another awesome aspect…tons of clinical research. Do none. Do a little. Do a lot. All up to you. Want to dabble, as I do? This is the place). Then was the tour of the hospitals mentioned above. Then a reasonable closed door lunch with the residents. They seemed very nice, very sociable, very friendly. I know they’re supposed to be, but it wasn’t superficial. As a psychiatrist, I will have to trust on one my strengths—the quick read; my gut feel for people. These residents were happy. They liked their jobs. They liked their lives. They did not regret their choice, except for maybe one resident, who admitted it was his second choice with a few well placed questions to break down the salesman act.
Then came the interviews. SIX OF THEM. I was expecting three of four. Six? I guess I know what speed dating is like now. 30 minutes a pop. What I loved though was that each, quite incidentally I found out, picked a different part of my application to talk about. Some tried to play good cop. Some tried to play bad cop. In the end, everyone was satisfied on both sides of the table, I think. The program director in particular, I feel, liked me. We share some contacts and she really took interest in some of side projects. The associate PD was scheduled to play bad cop with me, but we got to talking about hockey, so that never really materialized. One resident stated, “You should have your pick of any program you want”. That’s a good boost for the ego. She later offered me a place to stay in her encouragement of me coming by for a second look. I think I’ll take her up on it.

After the interview, they rallied the troops and took us all out to an amazing downtown bar where we drank high end wine and scotch and ate expensive food. They were getting ready to go a resident’s house later that night, where they all meet on Thursdays to watch tv. Their workloads seemed pretty reasonable.

The strengths of the program:
-low work hours (probably 50-55 as intern, 40-45 thereafter), ability and opportunity to moonlight starting 2nd year, varied settings of experience, very friendly and social residents, good city setting, double the time doing child psychiatry (4 months as opposed to the almost universal 2 months; very exciting since I’m considering a child fellowship after residency), associated highly reputable child fellowship where they take all residents who are interested, ability to dabble in research with tons of interested faculty, very heavily focused therapy training, short commute from everywhere, relatively close to friends and family, close to lots of other fun cities, chance to play recreation ice hockey, reasonable cost of living with chance to own a home, christine would get to play in the snow during the winter and enjoy the beach during the summer, close to low quality ski resorts, close to the airport, I could wear a polo with popped collar and a faux hawk and no one would care. Okay, maybe not no one.

The weaknesses of the program:
-the struggles of learning all the systems in a multisite program, I really didn’t like the old rooms some of the residents had their teaching in, the weather (the summers are great but short. It’s so close to the water, snow is probably less likely than rain for much of the winter), something else intangible…likely related to the fact that it’s not California.

I would be very happy at Brown, at least for the 3 or 4 years I would be required to be there. It would be nice to go to a reputable program, make some money towards loans, buy a house, spend part of my life in the northeast, gain more experience with child psych and research, and be close enough to friends that visitation would be reasonable. Plus, everyone was just so nice and happy. Who wouldn’t want to be a part of that?

Whole Grade:
Immediately – 8.6
A few days later – 8.9
11.9.06 – 8.6 (The northeast can’t hang with SoCal for lifestyle!)
11.30.06 – 8.7 (Keep hearing good things about this program and the people were just so happy and friendly)

San Mateo

2006-10-19T00:32:00.001-04:00

I’m writing this from 30,000 feet. In the last several hours I have seen the Grand Canyon, snow covered Rockies, cracked desert earth, flat fertile plains, the Pacific Ocean, 2 major US cities from the ground, sunshine, clouds, and rain.

I’m en route to home…to my wife…to my friends…to an excerpt of my regular life. In 6 days, I’ll be doing this again, but moving the other way. To see christine again, and justin, and neil, and ryan, and hopefully ketaki and a few others…it is exciting and comforting and warm after a month of forging relationships and making temporary friends. I met good people, but they are not yet my people.

I wanted to write and reflect on my experience. For you, dear reader, if you care; but ultimately for me, come February when big decisions will be made about our future. I want to be able to see how I felt at the time of my experience. So I plan on doing this for my externships and for my interviews (no residency directors allowed!).

San Mateo Medical Center: San Mateo, California. A small hospital, 3 floors. 34 psych beds. 4 residents per year. 2 do psych, 2 do medicine/neuro; then the midyear switch. The hospital is nice. Up to date technology. Easy to navigate. No sense of bustling people. Old people sitting on benches in one of the two courtyards is how I think of it. Random docs say good morning and smile in the hallways. No one walks with haste. Cafeteria is small but better than expected. Lots of bbq, free food to interns. Tons of tax money, so bountiful resources. Elaborate network of stepdown/step-up programs in psychiatry. Staffed by friendly knowledgeable folks.

Residents are fantastic. Helpful, diverse by any definition, caring, smart, hardworking but not in the self-sacrificial sort of way so prevalent in academic medicine. Not social creatures outside. I mean, they are, but lots of married w/kids situations. Sense of community exists but not of the bond you see from people sharing in sacrifice. All in all for the best.

Program itself is a treasure. Small, competitive. The only residency program in the hospital. Not directly linked to any med school, but shared faculty with Stanford and UCSF. Didactics are a small group format. No powerpoints. Just see one, do one for everything. Residents take on a huge load of responsibility for teaching those beneath them. True sense of independent learning. Community hospital paradigm. Quintessence of such, in fact.

Program director smiles a lot. Won’t give you any sense of assurance. Wants people who want badly to be there, who share a sense of social responsibility; of medicine to the very ill simply because they are in need. Was a researcher until 5 years ago. Now half-time clinician, ¾ time medical education. Very badly wants all of the above in a resident but with research interests beneath the surface. He may have found his guy in me.

San Mateo area is just fine. Lacks the raw appeal of san diego or—to a lesser extent—orange county. Beautiful sights from atop monstrous peaks. Weather is good. Low 70s into the 60s in the fall, which brings clouds. Maybe low 60s or 50s with rain in the winter months. Many days bring the marine layer cresting over pine-laden peaks, which often burns off by lunch. Beautiful sunrises and sunsets. Traffic is full but moving. Great train access all throughout the bay area. Easy to get to San Jose, SF, or Oakland; or to many spots offbranching/in between. Cost of living is ridiculous. Easy to find million dollar condos. Cheapest are around $600k. Even there, often $500/month in condo fees. Single family homes easily in $700s, and often >50 years old. San Francisco is a beautiful city with a ton available to do. Zero emission buses that are clean and that everyone uses without class distinction. Great surfing is around if you can bear the frigid waters.

Externship Rating:
Undefined sense of desire: 9.5/10
Happiness with Christine there: 9/10 (tons to do; everything we want…except our friends)
Geography: 8/10
Program structure: 9/10 (independent learning; attentive to resident issues; great teaching; broad teachings in psychotherapeutic styles; “thrown right in there”; apprenticeship-like)
Residents: 8.5/10 (a little difficult to crack at first)
Caseload: 10/10 (6 patients max)
Call schedule: 10/10 (to 10pm once a week; no weekends ever unless moonlighting)
Salary: 10/10 (highest in country; abundant moonlighting after first year)
Prestige: 9/10 (well known on west coast as a producer of great psychiatrists)
Gateway to future I want vs probable in-residency happiness: 10/10 (great program that has very happy residents; all the regular faculty are recent residents. No one wants to leave!)
Total: 93/100

So this is my frontrunner for residency by a mile. Interview is on 12/13. I’ve been told by residents and faculty that I’m “an excellent match” and they have offered to support my application unsolicited. I am honored by their support, and by their heartfelt measures to so wholly want to remain in touch into the future. The residency director is notorious for never giving away his hand (so to speak) to applicants so I didn’t look for much from him. I am pleased with our meeting and how the things I said and have done are congruent with his vision. I am encouraged that he said he had been inquiring about my performance and had been hearing positive things.

I worked very hard this month. It was difficult to be away from christine like that, but ultimately it is an investment that could pay dividends in time together and financially; and from these, quality of life.

I am by no means probable to match at San Mateo, but I have done what I can thus far to help things out. I have a strategy on how to follow up this successful month in hopes of really locking in one of the four coveted spots that 200 applicants vie for each year.

But for now, nothing but 5 whole and 2 small pieces of days to spend reading, lounging, and enjoying with special appreciation all of the very wonderful people in my life.

Next stop, the city of Orange. UC-Irvine for child psych, with a quick interview trip up to seattle before bringing it all back home in time for thanksgiving.

slightly foggy day by the GG bridge

2006-09-25T02:17:00.000-04:00

endless fruit

2006-09-25T02:14:00.000-04:00

2006-09-25T02:12:00.000-04:00

hard to leave behind

2006-09-25T02:10:00.000-04:00

tree-hugging hippy. sure didn't take long

2006-09-25T02:08:00.000-04:00

2006-09-25T02:07:00.000-04:00

View from Alcatraz: "this is what you're missing"

2006-09-25T02:05:00.000-04:00

hallowed exterior of alcatraz

2006-09-25T02:04:00.000-04:00

lucky guy

2006-09-25T02:02:00.000-04:00

a city founded on finding fortune...seems american to me!

2006-09-25T02:01:00.000-04:00

way......downhill

2006-09-25T02:00:00.000-04:00

speaks volumes

2006-09-25T01:58:00.000-04:00

Nap Cab (as they say) grapes

2006-09-25T01:56:00.000-04:00

Afterword: Our New Beginning. So Close Yet So Far.

2006-09-25T00:29:00.000-04:00

Frequently in the last four months, I've looked to this space and considered writing. Documenting unique experiences, exploiting some small opinion or observation, placing cool pics, you name it. And each time, I've balked, too pressured by more urgent needs. It's been a busy time.

I just called my wife to tell her I love her. But not that I miss her for fear it would uncover in her a longing you take strides not to feel when one you love is far away living a life encompassed with the total strangeness of blank faces and new geography. I roused her from some point in deep sleep that left her incoherent and confused. My guilt flooded and I took the unselfish route of letting her drift back, uaware of the burden I feel from leaving her to live her life unsupported, and to handle the one I've left behind as well. She sweetly said, "Bye", and then deadness. Between you and me, anonymous reader, I sure do miss her.

So I figured I had done enough depressing reading from "House of God", the book all medical students are instructed ad nauseum to read for perspective. I find it antiquated and negative at best, misleading and just plain wrong at worst. Perhaps it's recommended by doctors to show inclusiveness to some club. Or whatever. This isn't a book review.

So I decided maybe I'd write in here for awhile.

San Mateo is nice. Palo Alto is northern Cal suburban paradise. I could live here. We could live here. The program is unbelievable. Small, elitist, competitive, thoroughly nonacademic. Located in a county with such abundant tax dollars that there is a fully integrated, multidimensional network of mental health resources available to a patient population that is largely friendly, and often previously known and remembered. If you are a sick resident, they will pay someone to cover you instead of forcing work on another resident. If you are hungry, meals are free. No weekends. No overnight calls. Abundant teaching. I would thrive here. And I am. The craziness of urban psych training in a disjointed system makes this cake. Really, it's all too easy so far. And that is my next three weeks, coupled with slipping into the city to take pics or to a bar to watch football.

At night, I close my eyes and go back to Napa. The heat on my forehead. Cabernet Sauvignon grape between my teeth, exploding tartness onto my tongue. Wine buzzed.

Or to the city. Wind whipping like people of New York; different directions, yet en masse and with purpose. The trolley bell clanging in the distance. Blue water downhill. Way downhill.

Things are slowing down. I am older. I feel older. Beaten on, nowhere near beaten down. It has been a long few months.

Above all, though, I feel thankful. I go to these places just behind my eyes and think of my good fortune, most of which is in Baltimore, or Virginia, or elsewhere near there and far far away from here. So these blessings in my life, though very real, are so distant and inaccessible that it is as if they may not exist. After all, if you leave a room, does that room still exist? This very question an odd recollection in itself of a time in Baltimore that no one knows but me and Neil. A time of "chickfillah" and "this is the point in the story where you draw a little screw". Good times. Again, I digress. So the very existence of these blessings, most assuredly await my return, and without them gives me the opportunity of exploring a new life. Everywhere I go, I know no one. I have become the guy eating at restaurants alone, but managing not to appear sad. I go to new places and am forced to bear with my thoughts alone or brave the obstacle of making new friends, temporary friends that will last an hour or two before pleasantly going back to being faceless strangers. It is weird and it is wonderful. It is my new, and perhaps appropriately, temporary life. The one true thing that follows me is this concept of wife. The one that perhaps has great meaning to a new temporary friend, with inspection of my finger finding a scratched, seemingly well-worn (already) symbol of this faithful, lifelong merger with some unknown being that likely fits into a preconceived mold in these new temporary friends' minds, much as they (still) do when I look at the very same symbols placed on their own fingers. Yet to me, this ring is foreign; an accesory, a fashion statement, seemingly a new purchase. And Christine is still my love without alteration. (Sidebar: "For love is not love that alters when it alteration finds or bends with the remover to the removed"). I ramble.

So for those who have inquired, this is me now. I am happy. I am excited. I continue to try and cover up that previously noted place which occurs with the unnecessary absence of a loved one; and to stave off my guilt for causing it, but otherwise, man, is life here sweet.

If I could only grab my wife and very closest of friends, then I perhaps would truly have it all.

Enjoy the pics.

Blog Functionale

2006-06-05T17:22:00.000-04:00

Evolution is a crazy thing.

The internet went from a place of information to a place to waste your life. Then blogs and myspace and whatnot came, and it was really all over.

Then my blog found a purpose one day....today....June 5, 2006.

A lot of you have inquired about seeking a roomie for our wedding on 9/9/06. I've lost track of many of you with ever-changing circumstances. Please use the comments section below as a craigslist of sorts. Hoping that this isn't a colossal failure, but if you'd rather not place your need for a roomie here, just let me know and I'll try to keep better track of things this time.

Jerm!

Fortune cookie

2006-05-24T15:05:00.000-04:00

Went to a drug company lunch today. Chinese, per usual. Boring and not so good, but free, right?

Anyhow, I open a fortune cookie to find the following:
"You will get what you desire if your expectations are not too great".

This in itself is bad enough. I thought China was in an economic upswing. Maybe this economic democracy/governmental communism model really is no good.

Neo-Confusciusism promotes low standards? Think of the implications.
-Shoot for stars, failure disgrace family.
-Even China need yes-men.
-Crush Tibet!
-Try marry doctor, be town whore.
-Big famiry eat smarrer portions. (sorry, had to do it just once...yes i'm a big racist...see earlier post for excuse)

At the end of a big fatty unsatisfying meal, you eagerly open this mystical cookie. Something seeded in childhood lets this ritual be a source of entertainment somehow. Probably one of the few times a kid will actually eagerly read anything at all in fact. (Tangent: I should make a fortune cookie video game. I'd need to incorporate guns, blood, ginormous-breasted females, and a few other stereotypes but these illiterate dummies will still buy it with their divorced parents' "love me best" money). So anyways, you're fat and lazy and looking for not just old school entertainment, but maybe even a little sage inspiration. Fortune cookies used to say--well for one, they used to always start out with "Confuscius say..."--something vague and nice, like, "Confuscius say Spring come first to those who smile". I mean, who the hell really even knows what that's supposed to do for you, but you leave a little bigger tip and smiling broadly like an idiot at every stranger you pass for the next 3 minutes. Great. Whatever. What's good enough for Confuscius is good enough for you.

Then some college kids decided that Confuscius' wisdom was deeper (pun intended) when applied to sex. Fantastic. All the more entertaining...and for Neil (whose culture wrote a little book called the Kama Sutra), perhaps even a bit inspirational. Then the Neo-Confuscius fortunes began and it all went to hell.

"You will get what you desire if your expectations are not too great...in bed".

Okay.

Partner A: "Honey, let's do missionary when we have sex on the 15th of this month like usual."
Partner B: "Let's not set ourselves up for failure. You know what Neo-Confuscius would say. Just go ahead without me. Less to go wrong that way."
Partner A: "Wow, you're always thinking...better cut back on that before people expect it!"

You get my point.

This fortune was a failure. I'd better grab another.

"You enjoy sports, horses, and gambling but not in excess"...in bed.

Read that again.

Wow.
-"$3 at 2:1 odds says I can get my legs behind my own head."
-Team Jerm calls for a 30 second timeout. What a great tactical decision. Coach really needs to draw up a play to get the momentum back.
-Jerm's still paying dearly for picking the wrong team to go all the way in last week's round robin tournament.
-Both of these teams have really been going at it all night. It's awfully tight. And here they come. I don't know. So close. A photo finish!
-And the horse thing.

How'd they know?

And like a fortune cookie, here's your reward. It's both theft from my brother as well as advertising for his blog (now in the links section). I just started reading it but it's hilarious.

Click for reward.

don't f with me

2006-04-30T13:05:00.000-04:00

jaaaarome 07: quality is nothing compared to quantity
Auto response from Skittlemehappy: Its always a fun day when you learn your qualitative worth.
jaaaarome 07: i mean, really, haven't you ever wondered how many jelly beans you're worth?
Skittlemehappy: yea...i strongly disagree
Skittlemehappy: no...i wonder about skittles...jellybeans aren't really my thing
jaaaarome 07: and wouldn't you be more interested in knowing that than having someone say you're very caring or whatnot?
jaaaarome 07: qualitative comments come and go
jaaaarome 07: quantitative ones make memories
jaaaarome 07: touch the rainbow
Skittlemehappy: lol
jaaaarome 07: phew
Skittlemehappy: but its the qualitative factors that are more important
jaaaarome 07: booooooorrrring
Skittlemehappy: not everything can be quanified
Skittlemehappy: quantified
Skittlemehappy: i can spellj
aaaarome 07: but it sure is fun to try
Skittlemehappy: lol, i'm sure Christine LOOOVES hearing that she's worth a million skittles
jaaaarome 07: tell neil you love him 4000 tadpoles worth, but that if he cooks dinner, he'd be worth 4200
jaaaarome 07: doesn't do much
jaaaarome 07: but you get dinner out of it at least
jaaaarome 07: she loves candy, btw
Skittlemehappy: but if its stated to be unconditional...how do you get incremental increases in taht?
Skittlemehappy: tehehhe
jaaaarome 07: i think i just found out how to get a free dinner
jaaaarome 07: well, by definition, that would be conditional
jaaaarome 07: who said it was unconditional
jaaaarome 07: they are liars
jaaaarome 07: if he went around and banged all your friends, would you still love him the same?
Skittlemehappy: so you think all love is conditional?
jaaaarome 07: noooooooooooooooooooooooooooooo
jaaaarome 07: so his love would be conditional on the fact that he doesn't bang all your friends
Skittlemehappy: i don't consider trust, respect, etc as conditions
jaaaarome 07: i think all blanket concepts are set up to fail
Skittlemehappy: that should be a given
jaaaarome 07: should be
jaaaarome 07: but if they're absent, then the love goes away
jaaaarome 07: sounds a whole lot like a condition to me
Skittlemehappy: you're frusterating, you know that?
jaaaarome 07: i guess we didn't watch the same fairy tale princess movies when we were kids
jaaaarome 07: :-)
Skittlemehappy: hell no, I liked Jem, she's no princess
jaaaarome 07: boooooooooorrrrrrrrrrring
Skittlemehappy: how is that boring??
jaaaarome 07: based on the fact that i have no knowledge nor no interest in whatever it is you just referred to
jaaaarome 07: but now that i've voluntarily intruded on another's concepts of love and living, let me flee
Skittlemehappy: lol, you are missin out on one quality show
jaaaarome 07: yeah, maybe we'll catch it together one day
Skittlemehappy: hahah
Skittlemehappy: sounds like a quality time
jaaaarome 07: 3 jellybeans worth of maybes
jaaaarome 07: see?!
Skittlemehappy: oh good lord
jaaaarome 07: ok, gotta go
jaaaarome 07: see ya
Skittlemehappy: lata!

Poker is a tough game sometimes

2006-04-22T17:52:00.000-04:00

I know that no one likes to read about tough beats. Well, that's not entirely true. I do. Here's the setup.

I buy into a $5.50 satellite with 42 people. I finish in 3rd (got outdrawn...argh) to win a seat to a $15 + 1.50 tournament with $10,000 in payouts. 635 people registered. I tried to play tight early and folded what became a set, then folded what flopped a full house. Then got into trouble with overcards that kept missing. With just 30 people eliminated, I was in trouble.

I'm a sticky player in general. Short-stacked I tend to make good decisions in tournament play. I kept folding, some of which turned out to be pretty good decisions with overcards since none of them went on to be the best hand. I doubled up whenever I could, and with about 500 players eliminated, I was still in trouble. Not all-in-with-the-blinds trouble, but needing a big hand to come around before a few more rounds of blinds.

With 140 or so people left, I get A-A with a small raise (2x bb) in front of me. Wanting to encourage another caller, I smooth call. The big blind goes all in for a little more than the pot. The initial raiser calls. I reraise all-in for another few hundred knowing I have the initial raiser pot committed. He calls.

We turn over:
BB: A-10 off suit
Initial raiser: 8-10 diamonds
Me: A-A

This is fantastic. The initial raiser was trying to steal, and is now just hoping to get lucky. He's such a large stack that it isn't going to cripple him to lose. The big blind hates life right now. His hand is dominated by my aces, giving him just one live card, and his opponent already has one of them showing, whereas he would need both of the remaining two to catch up to me. There are outside flush and straight draws, but I am feeling very good. I should triple up and be in great shape to outlast another 70 people to make the money, which starts at $30 payouts and extends to $2200. Not bad for my $5.50.

Below is a picture of what happened.

Poker is a tough game sometimes.

poker fun

2006-04-15T15:22:00.000-04:00

I may occasionally post some fun hands I encounter in here. Fun for some, not fun for others. This was a 10 player tournament. I was the big stack and got into a tangle with the 2nd biggest stack, something you generally try to avoid.

***** Hand History for Game 3987702967 *****
NL Texas Hold'em $6 Buy-in Trny:22164043 Level:4 Blinds(100/200) - Saturday, April 15, 14:55:04 ET 2006
Table Speed Mount Vesuvius (Real Money)
Seat 1 is the button
Total number of players : 6
Seat 1: edved ( $1998 )
Seat 5: the_Dman ( $2312 )
Seat 8: jbivs1021 ( $3270 )
Seat 4: jaaaarome ( $5050 )
Seat 3: mahusay ( $4360 )
Seat 7: halfbaked225 ( $3010 )
Trny:22164043 Level:4
Blinds(100/200)
** Dealing down cards **
Dealt to jaaaarome [ 4c 4d ]
the_Dman folds.
halfbaked225 folds.
jbivs1021 folds.
edved folds.
mahusay calls [100].
jaaaarome raises [800].
mahusay is all-In [4160]
jaaaarome calls [3360].

** Dealing Flop ** [ 4s, Ah, 9c ]
** Dealing Turn ** [ 6h ]
** Dealing River ** [ 4h ]

jaaaarome shows [ 4c, 4d ] four of a kind, fours.
mahusay shows [ Jh, Ac ] two pairs, aces and fours.
jaaaarome wins 8720 chips from the main pot with four of a kind, fours.
mahusay finished in sixth place.

Perhaps my call was a bit loose, but I just didn't buy what he was selling.

too much info!

2006-04-14T20:06:00.000-04:00

Hi guys.

Long time since a post, I know. Much longer since a good one, I definitely know.

Anyhow, the last couple of days I keep running into these crazy stories that need dissemination (no, neil that's not a volunteer position at the hospital). So here they are. I wish I had the time to expound a bit.

In brief, America is hurtling towards badness. But at least we're not the French. (And Bonds has zero HRs so far this year).

http://www.cnn.com/2006/US/04/14/microwave.killing.ap/index.html
http://www.cnn.com/2006/EDUCATION/04/14/omaha.schools.ap/index.html
http://www.time.com/time/magazine/article/0,9171,1181649,00.html
http://sports.espn.go.com/espn/page2/story?page=klosterman/060411
http://www.thesmokinggun.com/archive/0413061condi1.html

Enjoy.

Discussion welcomed.

be weary, men

2006-02-26T21:09:00.000-05:00

jaaaarome 07: if you're going to do it, do it right
jaaaarome 07: speaking of which, i saw an OJ jersey today
mtchbx79: really?
mtchbx79: someone wearing one around?
jaaaarome 07: yeah
jaaaarome 07: bills 32
mtchbx79: that's class
jaaaarome 07: it's baltimore!!!
mtchbx79: too bad not a 49ers "throwback"
jaaaarome 07: you know he just bought it too
jaaaarome 07: that wasn't available awhile back
mtchbx79: really a shame
mtchbx79: now if only i could get my ron mexico jersey
jaaaarome 07: do you want a "save the date" card?
jaaaarome 07: wait a sec
jaaaarome 07: kick me in the nuts
jaaaarome 07: hard
mtchbx79: save the date? you deserve a bitch slap
jaaaarome 07: did i just change an OJ/ron mexico conversation to wedding minutiae?
jaaaarome 07: ok, well what's done is done
jaaaarome 07: yes/no? circle one
mtchbx79: there is no saving you anymore
mtchbx79: 2nd weekend of sept?
jaaaarome 07: 9/9
mtchbx79: good enough.
jaaaarome 07: so no?
mtchbx79: i'll prob just lose the card
jaaaarome 07: woohoo, just cut 39 cents out of the budget!

It's about time I turned in my gun and my badge. You know...danger to self or others.

veteran affairs

2006-02-16T18:53:00.000-05:00

Well for those who don't know, or who care, I'm doing neurology consults this month at the VA hospital. I happen to be working with a guy named Brian who is Korean. This exchange occurred yesterday.

B: You have a brother? How old is he?
J: 18 months younger than me.
B: Does he try to to take over your birth right of inheriting the head of the family?

*pause*

J: Uh...let's just chalk this one up to cultural differences, okay, Brian?

I can't really be the only one that has these weird things happening to them all the time, right?
Similarly, I had a patient last week that decided to ask me to explain why his diabetes makes him impotent.

With his wife in the room.

All the while asking her for clarification of specifics.

I went through all the pathophysiology of it and how it relates to other more critical aspects of the disease, and emphasized how if its something important to him, we could start talking more about his pharmacologic options. He laughed, said he was already on two of them, and finished with, "but it sure was fun to make you go through all that".
J: Thanks for messing with me. It's friday. You're the last patient I have this week. And you're messing with me. You know I'm gonna go home and get a "How was your day?" and what will I say? I'll have to talk about you. Awesome.

Then I called him a babykiller and kicked him out of the office...just kidding :).

And today...
J: And have you experienced any chest pain recently?
Patient (P): Only when I'm having sex.
J: (weary look)
P: Just kidding with you, doc. But that reminds me of a joke.
J: (weary look)
P: A 75 year old man goes to church and enters the confessional.
-"Father, last night I met a 25 year old woman and had sex with her six times throughout the night".
-"And you're here repenting. Very good of you. Say 12 'Our Fathers' and 'Hail Marys'."
-"Uh, actually, I'm just trying to tell everyone I can!"
J: (fake laugh) You seem fine. I'll be right back. (jams pen directly into eyeball and twists)

It could be worse. If I was a chick, they'd be hitting on me. That's just creepy.

Of course it was the 90s when "Don't ask. Don't tell" went into place. 20 more years and med students are really going to be getting it from both sides.

(Double entendres make for good endings)

eyes in the back of your head

2006-01-23T21:43:00.000-05:00

When does looking both ways before crossing the street not help?
-The time you get rear-ended.

I'm not sure what I'm about to write, but it probably won't end well.

This won't be anything funny. In fact, it might not make any sense at all. But I write often enough to entertain, and rarely do so anymore to put all the pieces next to each other for a good looking over.

My life:

I have been blessed with abilities and plain luck for which no man should ever reasonably ask.

But I have no family.
Certainly not like you would think.

Whatever family seemed was a myth enrolled by misery, alcoholism, violence, terror, vertical jealousy, and hesitation. Either you know some of this or you don't. Doesn't matter.

My brother and I got through it together.

More ability/luck: I found Christine. If you know her well, she is one of your favorite friends. Smart, sweet, stronger than you'd ever first gather. I want to spend the rest of our lives learning from each other.

These are the two people that I'm supposed to grow old with.

I want them both. Family.

But I have no family. Certainly not like you would think.
I have love, unconditional.

But mainly, I have me. You can't stop me.

Victoria's Secret is a sense of awkwardness

2006-01-08T17:06:00.000-05:00

At VS downtown during their clearance event. Was there with the woman. Shoulder-to-shoulder contact with strange women. Underwear flying everywhere.

Jerm: I think I'm gonna go to the men's section
Miller (quizzically): Uh, I don't think they have a men's section
Jerm: Turn around

6 or 7 dudes sitting quietly on a ledge by the storefront window, bags in hands, heads held low.

Can't they put in a men's fun section like stores used to do for kids? Here's an XBox. Here's a magazine of all the 2007 car models. And while we're at it, here's a catalog of all the 2007 VS models....seems like good business to me.

Results of the bet

2006-01-08T17:04:00.000-05:00

Skins threw a halfback option.

That's okay, I can make even blue and khaki look good.

Men and Football

2006-01-07T01:04:00.000-05:00

It's awfully late and since a lot is going down tomorrow, I'll try to chronicle these events in brief. Men and football is something that at times I feel I could write 50 pages about, and at other times feel entirely speechless. Men and football just are, and it's beautiful if you get it. And part of the fun is gambling on the games, the players, the weather, whatever; a morally indefensible act....*yawn*.....and guys just love it. Also well documented in male culture are the acts of domination, typically done at pointless times over meaningless events. Dominance is usually in the form beatdowns, submission, or humiliation.

Harish and I know this last one well. We do football, we gamble, we banter. We hunt, gather, do whatever is necessary to be free on Sundays to watch the fates of our ill-conceived bets. And at times we disagree, leading to male clashing and that dominance thing. If you don't like football, or don't care, I'm not sure why you've read this gibberish this far. Thanks for coming by. You are dismissed. If you're like Ryan, Neil, Marty, Justin, Jimmy and all other football- and shame-loving guys, you'll appreciate this.

I made the off-handed comment that I'm calling a crazy Joe Gibbs play this week. Either a flea flicker or a double reverse (probably to james thrash). This in all likelihood isn't going down. But since it won't, I agreed to let Harish get equal odds that the skins won't run the HB option. This should be fun.

The rewards?

I have agreed to wear a New York Giants shirt if he wins, at my expense. He has agreed to wear a Washington Redskins shirt if I win.

The chances are slim, but this game is getting better and better as it draws near!

Jeremy if 'skins run HB option

Harish if 'skins run flea flicker or double reverse

The winner tells the loser when he will be wearing this apparel.

You can be damn sure the winner will be present for its grand showing.

And the best part is that to strangers we both look like the types that would wear this unknowingly!

Good times.

GO SKINS!!!!!!!!!!!!!!!!!
(go double reverse!)

New Year's Resolutions

2005-12-31T01:46:00.000-05:00

Another year is wrapping up, and with it comes the obligatory reflections of 12 months of memories. I hope yours has been one of progress and prosperity overall. Mine certainly has. Constitutionally, my height is the same, as is my weight. My chosen profession remains intact, though I'm now perhaps a bit more qualified. My love for life, for those in my life, and especially for the one I walk through life with...well, these are all in fine standing. I have new a place I call home, freshly furnished complete with (often) smiling bride-to-be. And of her, she accepted my proposal after inspiring a 2600 mile trek to do so. There has been family, with its conflict and its unity, with its things unsaid and successful cures of ravaging disease. And there has been international tragedy, bringing out the best of some and the worst of others. And there have been all of you, largely growing up and growing apart, for better and for worse.

I'm not a big fan of doing the expected, and this is normally true of New Year's resolutions. I don't normally need to quit smoking, drop 5 pounds, or exercise/learn more. That being said, I'm in the mood to hammer out a few.

1. Lose the single status
-I hear there are benefits that extend beyond those related to tax break, and I'm sure they will be wonderful. There are some truly liberating and exciting things about living a single life, but for the most part, I feel I've experienced them to my content, and the time came to grow up and have something more mature. Fortunately for me, it seems to have worked out. I know some of you reading this had a relationship you valued come to an end this year, and I'm sure you're getting enough advice from everyone else right now. I'm sorry for your loss, and for the pain its caused you, regardless of if its for the best or not in the long road.

2. Exercise more
-Egad, I never thought I'd need to remind myself to do the thing I most enjoy, but circumstances prevail, and I find myself in the worst shape of my life. All this other bullshit isn't going to change, so I'd better.

3. Spend more time with the boys
-Each year brings with it less time with the guys, and also a larger proportion of that time is used to go out drinking. Odds are, in 18 months I'll be somewhere else, and for that matter somewhere very far away. Sure, college is over forever. That time is done. I'm not the same and neither are they, but they're my best friends and I'm making a personal choice to leave it all behind in the pursuit of some climate fantasy that I've built up in my mind as being the road to a better life (when really, my life is pretty damn good as it is). If I don't take better advantage of the time we have left as young, relatively close, relatively free individuals, I'll surely regret it. And avoiding regrets is almost always a good thing.

4. Use the spoken word better
-For as easy as it is for me to write out whatever I'm thinking and have it come across well, my spoken word is far too often skeptical, sarcastic, or unadulterated. For the most part, people know me as a genuine person, but I still find myself spewing out the same old junk per reflex. This is gonna be a hard one to change, but the defensive self-conscious adolescent routine has gotten old, even for me. But if someone's an idiot, I'll still call them an idiot. Being truthful with reckless abandonment is something I kind of like. So give me a break with this one...it's going to be a work in progress.

5. Dance like I'll never get hurt...or is it like no one is watching? Shit.
-I guess I'll just keep this list to four.

Happy New Year to all. Be safe, have a DD, and do something nice for someone who deserves it.

jerm

My idiot friends

2005-11-10T22:10:00.000-05:00

I work 15 hours and come home to this:

i am BrownMan: without reading the link - it appears that hookers take 48 minutes to turn a trick. is that the phrase? turn a trick? do you think at hooker conventions they come up with the terminology? do you think male hookers and female hookers have the same conventions? b/c a convention is a hooker's dream, lots of lonely guys in from out of town, that's a cash cow. but do you think a hooker convention would still have prosititutes looking to earn a buck? i mean, think about it, a hooker working the hooker convention would be like, "what's going on here? i didn't get a memo about a hooker convention."

Auto response from jaaaarome 07: what a horrendous day. long call tomorrow.

i am BrownMan: then the head hooker would say something along the lines of "well we sent out emails about it. what's your address?" then the hooker would be like "MoJohns4Me@yahoo.com" and the convention leader would be "oh, we have 'johns' spelled without the 'h' - we'll correct that as soon as we get back to our hooker headquarters".

i am BrownMan: i had to get that out of my system before the weekend, thanks my man.

i am BrownMan signed off at 3:41:36 PM.

I'm such a good listener.

Women

2005-10-30T10:40:00.000-05:00

I'll be careful here. I could end up 3 days older with 50,000 words and an inkling of carpal tunnel. Or I could end up very very single. So I'll avoid the elephant in the room (DO NOT MISCONSTRUE THAT STATEMENT!!!), and just point out a discussion.

Christine. She needs a nickname for the blog...something like the The Miller Girl (TMG), but from time to time (in particularly times like this) she may morph into the jerminator.

Anyhow, she got new glasses. Very cute frames. Not overly impressed with the funky attachment thingies on the sides. Maybe I'll grow accustomed to them. Maybe she'll put them down and be unable to find them (hell, why do you think she wears glasses in the first place?). Bottom line: I like them, they're different, but so is she and that's what makes her special.

Like most things, if I'm not floored with the new accessory, then she deems either it sucks or I do.

Most of you know of my Tiburon experience (I was surfing off the coast of Cabo...I wish). Alas, the Tiburon is a Korean car. One drove past us yesterday and this is what I got:

"How come you like funky attachments on cars but not eyeglasses?"

I want you to take a moment here. It's easy to read through these things fast, but let this one sink in.

"How come you like funky attachments on cars but not eyeglasses?"

What?!

Think buildings imploding in perfect harmony.
This is the moment that joins nonsingle men together for sundays of football, beer softball, tinkering in the garage, and very very dark bars.

"The lights on backs of cars remind me of eyes. And the stuff all around them reminds me of eyeglasses. And the Tiburon has funky attachments...."

You visualize what would happen if you just disappeared instantly. You put your fingers in your ears to keep your brain from leaking out. You go to your happy place.

And at this point, I know I'm screwed. My genes are bankrupt of having any capacity to not make things go sour. If I speak, it's in incomprehensible utterances, of which she gets the main message, ultimately being, "Icepick me in the eyeball! Do it now! It's an eyeglass frame design. My opinion is valid for the 2 seconds it takes until I get distracted by thoughts of power tools or things with balls and violence. Then I forget about it until you make comparisons with flashy low end sports cars...which, by the way, arghhhhhhhh!" If I don't speak, then I may as well just be standoffish about how much I hate the glasses.

"Because the Tiburon is a Korean car, and it looks like the eyes are slanty"

I think I deemed it impossible to intentionally swallow my tongue in the next 5 seconds. The things you'd do for an on-demand seizure disorder sometimes...

But just like that, it was over. Your head's still a little light. You're not entirely sure if the coast is clear, so you play it cool for a couple mins, say something nice about [insert clothing item not related to article of current discussion here], and hope to God you don't see anymore slanty-lighted cars for the rest of the day. You then get several hour of normalcy. You rediscover everything wonderful about this person that you've chosen to spend your life with. You made it through your day with minimal casualties in this crazy crazy minefield many of us walk everyday.

Good Lord.

Women.

I might only have one week of life left

2005-10-30T10:10:00.000-05:00

Maya's turning "twelve x two" this week. Sister sent out an evite for the party next weekend. Black/white affair ("no ROY G BIV"). First of all, how can you not love a party invitation that stomps the virtues of man's ability to differentiate based on wavelength? But more of an issue is my kneejerk response:

"No ROY G BIV...Well I normally avoid gatherings that exlude the colored, but for Maya I just have to make an exception. HAPPY 24!"

Now if you don't know me, that could be pretty offensive. Since most of you aren't just bored strangers reading my blog randomly, I assume you do, and you know that I make fun of anything and everything. The trick is saying something that makes people's eyebrows start to raise before they realize that they're already laughing.

Did I go too far this time...probably not. I think it's more my own insecurities about being perceived as racist by black people, something that a lot of white people deal with and no one really discusses. Hell, it's a touchy world, and it was all the moreso when we were in our formative years, but being strictly PC-friendly when there's really no hate in your heart....well, that just makes you fearful and boring.

So in Carrie Bradshaw style, I ask (and use her voice here when you read this...it works)...when does being too comfortable with race relations put you at risk of being perceived as culturally insensitive?

Obviously there's no cut and dry answer to this type of question, but it was on my mind. Comment with thoughts.

Oh, and I think marrying someone of another race (even if only half so) should permanently exclude people from being accused of racism. Sure, there are people whose hate is more categorical than that, but really, do I have that kind of time?!

Friday night saltine challenge

2005-10-28T23:17:00.000-04:00

Those who know us well have seen a number of stupid challenges attempted over the years. Some are easy. Some are impossible. Some are safe. Others make Ryan puke for a solid night. Normally the payout is in the range of $5-10, and normally someone gets it done. In that spirit, via phone, I offered Ryan $10 if he could eat 4 saltine crackers in 60 seconds without drinking anything. He called me an idiot, picked up crackers on the way home, and thought of all the ways he could spend my ten dollars (this may or may not be my own conjecture). PLC (Dr. Craun) decided to stand by reason instead of her man, and agreed to film the event for me. They called when it was going down, she gave Christine and I the play by play via speakerphone, and let's just say my 10 GWs aren't going anywhere. If anyone wants the videos, hit me up with an IM or email (jwilk001@umaryland.edu).

2005-10-28T23:11:00.000-04:00

the face of salty defeat

Excellent

2005-10-10T16:29:00.000-04:00

Harish sent me this link:
http://www.overheardinnewyork.com/

This fits in nicely with the last post. Enjoy.

Heard on the street...

2005-09-29T12:27:00.000-04:00

So I'm walking home for lunch and I see this guy in a suit walking with two women. He says, "...homoerotic rubbing of my MUSCLES!" and I break out laughing. Silly grin still 2 mins later. Gets me to thinking, what kinds of things could I say with people walking by to really get their eavesdropped interest? Remember, with people walking towards you, the last part is the loudest.

- "...donkeypunched your SISTER!?"
- "...he's only doing this because i'm BLACK"
- "...it took the paramedics to get the GERBIL OUT"

Any suggestions???

Peds review

2005-09-29T01:57:00.000-04:00

Well it's pretty late and almost exam time but I can't sleep, so what's a guy to do....

I meant to do a review of my Ob/Gyn rotation 6 weeks ago, but I figured it would be a hateful tirade denouncing hypocrisy and the downsides of working long hours with negative people who themselves work too many hours. At what point in your life should you get tired of getting called into work at 3am whenever some bastard kid decides it is time to drop?

Anyhow, tomorrow is my last day of Pediatrics and I've had a bit more of a positive experience. It appears to be a field of moms...just friendly women who enjoy kids, and that tends to yield a less stressful learning environment. Sure, you get your share of screaming kids with ear infections, and moms who don't know what pediatricians are (seriously) because they themselves are only 14 or 15. And you get the people who bring their kids to clinic with "Move Bitch" written on their t-shirts, or who blind you with their gold fronts, or whose 4 year olds don't really talk because no one at home cares if they achieve anything, but welcome to Baltimore. These things you're prepared for going in.

It's the other things that will last more in memory. I spent my first 3 weeks on the inpatient pediatric hematology/oncology service. Kids with cancer. Kids beating cancer. Kids dying with cancer. Kids who don't know yet what's going to happen. And very quickly you accidentally grab onto their and their parents' coattails and wish and pray for it to all end well, looking for someone to tell you that things are going to be alright. Except while you're looking around, they're looking at you.

I made a friend there. She's 14. She went through all the treatment. It went away. They rejoiced. A year later, it's come back worse than ever and resistant to treatment. She will all but assuredly die soon from cancer. And I never could find a tactful way of imposing enough so to figure out if she even really understands. Where my role in that situation could have or should have been, I'll never really know. But I listened. Listened about happy times with her family, about her friends, about what she likes or does not. But never about what she wanted from her life. So I guess at the very least, she gets it deep down. Death is an ugly thing for a child to have to face all alone.

On my last night, a girl came into the ER. She was 18 and depressed to the point of total shutdown. Didn't want to talk. Didn't want to be there. Didn't want to leave. A year into a new onset disease process that caused her red blood cells to break down, she was the model of self-pity. 5 hours later, admitted onto the H/O floor, she was still the same, and I was going home. I walked past her room, stopped, didn't know. I could have been wrong. I feared I'd somehow make things worse. But moreso, I feared that not trying because it was easier not to care would lead me down a worse road. So I entered. Talked to her (or rather, at her) about the hardships of handling what you're dealt, about being sad, about bad relationships with those you love, about becoming an adult, about being happy. That everyone deserves it, even when you may have never been there, or when others may feel you shouldn't be. That being an adult gives you the freedom to find what makes you happy and cut out whatever tries to get in your way. And I told her I wasn't there as a doctor or a student or a friend. That she'd never see me again and could take my advice or brush me off, because as an adult, that's her prerogative. I wished her well and stood to go home, unsure if I'd helped or not. I walked away and she said, "Thank you". I turned. She smiled at me.
I walked home to Christine. The weather was perfect. The walk home was never sweeter. It was one year to the day before our wedding, and this Peds thing seemed alright.

just great

2005-08-17T20:15:00.000-04:00

Me: What did you say?
Christine: Nothing, just singing to myself.
Me: About how much you love me?
Christine: Actually, "Golddigger" by Kanye West.
Me: Oh. Crap.

our nation's capital and the DMV: ineptitude squared

2005-08-09T17:31:00.000-04:00

I was looking over the Washington Times today and saw an article of good fortune for those who have been driving through red lights in D.C. The MVA there is having air conditioning problems (think their public schools without the lead-laden water), so they're closed for the remainder of this week. And those who were fighting red light tickets this week? Don't bother. You're excused! Wow, you could have saved 30 seconds and not paid $75 for it this week!

Anyhow, this is the fun part. Notices will be sent via mail over the next couple of weeks informing these people of their excused tickets. Of course they'll probably already know by then when they've shown up this week to fight their tickets only to arrive at an overheated, closed D.C. courthouse.

And the article reporting these details didn't even mention this? How boring. I would have turned it into a scandal. Too bad the last creative thought in our nation's capital was when Marion Barry figured out how to do crack off a prostitute's a-hole. And in this accusation (the creativity one), I'm including the management of the Redskins and Caps (Nationals don't count yet, but they will once they get an owner...). John Buccigross in his NHL Eastern Conference update this week called the caps "by far the worst team in the league". Fantastic. Welcome back. D.C. was just a little too ambitious without you.

The Ob/Gyn story you will tell someone else someday

2005-07-22T00:21:00.000-04:00

So I knew I needed to get this blog going again now that life has resumed some sense of med student normalcy, but like most things in this life I just needed something to kick my ass in gear.

A little background: I am doing my Ob/Gyn rotation. I am doing the clinic part of it, which consists of going to the women's clinic for mostly women without insurance, especially those big preggo ones. Side note: it's actually not hell; I enjoy spending my days there making sure women can be confident their unborn babies are healthy...if I also have to find the cervix of a morbidly obese Gyn patient from time to time, then so be it.

Anyhow, I was done with all the patients I'm responsible for and was just wandering around the clinic seeing if anyone needed any help. I walked up to the check-in counter and found no employees. There was someone waiting though, unusual because he was a man, and a white man at that. We'll call him Poor Dumb Bastard, or PDB. His youth and sunglasses didn't exactly match what you would expect at the counter of a free women's clinic. He took off his glasses and made eye contact. Then this happened:

PDB: Hey, I have a question for you.
Jerm: I'll do my best. What's going on?
PDB: Can O negative blood and A negative blood result in a positive blood type?
Jerm: Not any way that I can think of (sensing impending danger, I chose to cover my ass), but I'm not entirely sure.
PDB: Well I'm O negative and my wife is A negative, but our new baby has a positive blood type.
Jerm (fighting off a smile): Well....(now smiling broadly)...let me go ask someone else.

As I walked away, the chief resident (CR), whom I had been working with that day, walked by. I hid out of PDB's sight until she could see me and I waved her over.

Jerm: Oh man, you're not going to believe the trouble I got myself into.
CR: What? What happened?
Jerm: (explains story)
CR (walks into the attending's office, which included the presence of another resident): (explains story)
CR, Attending, Resident #2 (more or less in unison, and a couple times each for emphasis): I'M NOT TELLING HIM!!!
CR, Attending, Resident #2: Jeremy you're gonna have to go take care of that.

I walked back up front.

Jerm: Well, I couldn't get a definitive answer from anyone. Sure, usually two negatives can only lead to a negative but I can't say that's for sure all the time. Do you have a physician you trust?
PDB: Yes.
Jerm: I would give him or her a call and explain the situation. Hopefully he or she will know more about it, since you respect them for a reason and since they are licensed, whereas I am not.
PDB: Yeah, I was always taught that two negatives can only make a negative.
Jerm: Sure, but I can't say there aren't exceptions, and the consequences of making accusations would be pretty severe if there are ways for a positive blood typed baby to occur from the two of you. Give your physician a call. Good luck.

I walked back to awaiting ears and decided I was going home for the day.

Could you imagine...your wife having someone else's kid and you figure it out yourself?
That poor dumb bastard.

Internet Scam, Part 11: a $2850 Bill

2005-05-09T17:36:00.000-04:00

Bill is back and better than ever.
Too busy right now for the chronicles but people are asking, so it's in progress and I'll update this weekend or early next week!

By the way, I think I've gotten 2 comments in this thing since it's inception. The counter shows 250 hits in the last 2 or 3 weeks so I know you guys are reading this. I'm not trying to get stroked here...just curious about different points of views, additional information, and interesting links. You can leave all the stroking in notes discretely placed in locker 275. ;)

2005-05-06T14:01:00.000-04:00

and then a legitimate pacific sunset

2005-05-06T13:58:00.000-04:00

Trying to take a 3pm picture and make it look like a pacific sunset.

2005-05-06T13:52:00.000-04:00

for christine

2005-05-06T13:51:00.000-04:00

La Jolla Cove

2005-05-06T13:48:00.000-04:00

What an amazing place to live....

2005-05-06T13:46:00.000-04:00

biggest...palm tree...ever. Check out that beetle next to it!

wizards-yankees

2005-05-05T16:27:00.000-04:00

mtchbx79: i was all set to rub in the monumental collapse of your wiz last nite

jaaaarome 07: yeah, that could have sucked

jaaaarome 07: i guess i'll just have to ask you what collapses like that feel like

mtchbx79: oh i should have seen that coming

jaaaarome 07: good thing a team with a .393 record can't really collapse this year

mtchbx79: it's a rebuilding year?

jaaaarome 07: building what? social security?

mtchbx79: i've got nothin

mtchbx79: i just shake my head

jaaaarome 07: i love it

2005-05-04T18:44:00.000-04:00

This used to be the land of opportunity :(. Now immigrants are dying just trying to get across and US citizens are volunteering their time to stand in the desert and keep them out. I'm not exactly a bleeding heart here or anything, but jeez, how about trying for some positive international PR once in awhile...

2005-05-04T18:41:00.001-04:00

And Joe and Jimmy said Mexico didn't have laws...

2005-05-04T18:41:00.000-04:00

Hard Rock Tijuana. Neil may or may not have enjoyed it just a little too much...

2005-05-04T18:39:00.000-04:00

Tijuana, Mexico.

2005-05-04T18:37:00.000-04:00

Balboa Park, San Diego, 5. This is one of the top two places where I wish we could marry, and it's also where we lived for summer 2003.

2005-05-04T18:35:00.000-04:00

Balboa Park, San Diego, 4

2005-05-04T18:34:00.000-04:00

Balboa Park, San Diego, 3

2005-05-04T18:33:00.000-04:00

Balboa Park, San Diego, 2

2005-05-04T18:32:00.000-04:00

Balboa Park, San Diego

a joke

2005-05-03T22:37:00.000-04:00

Joe tells his wife he is heading out to the pub for a drink. His wife starts complaining you never take me anywhere anymore. After hours of complaining the husband agrees to take his wife to the pub. They sit down at a table and the husband gets up and goes to get drinks for him and his wife.While he was gone a man walks up to Joe's wife and tells her he wants to turn her upside down fill her with beer and drink her dry. Joe's wife exclaims, "You sick pervert get out of my sight."Joe returned and his wife told him what happened and to go kick that guy's ass. Joe said, "No way you don't mess with a guy who can drink that much beer".

stress

2005-05-03T14:46:00.000-04:00

Everyone around me has lost their heads openly and outwardly, overcome with the burdens of their current rigors.

And though I experienced that a couple weeks ago, I have been feeling pretty good about it all lately, what, with planning being the solution to a busy schedule.

But then in class today I remembered a dream I had last night where an old friend and I were at some beach at night and we.....

Ready for this, because it's pretty odd?

Okay....

So we were on the beach. It was nighttime and the light was poor. I believe there was a fire nearby. Sounds nice except we were in a situation of having to fight to the death. Thinking of the absurdity of it, that how could we as friends possibly do such a thing, especially with unknown consequences, my old friend lunged forward with murderous intent. And in quick response, I avoided him and slid an 12 inch knife into his chest, then again, then as he fell to his knees, I repeated it until he was gone...

So maybe I'm a little more at wit's end than I'm giving myself credit for.

P.S.--I am not a ticking bomb.
P.S.S.--I will not say which friend, but if you're reading this, you probably wouldn't know him.

I'm not at peace with ending this post yet. I have no doubt that this will surely end up as one of the 10 random posts placed on blogger's main page, and I will be judged by strangers, but that's fine. I did a lot of reading about dream symbolism and the such in high school. I had some pretty crazy dreams then too (though not involving murder ;) ), and was curious what I could find out. Never finding anything too satisfactory, I haven't looked at those books since, and have concluded that dreams are a mix of your current internal environment and randomly spliced tidbits from your recent external environment. That's what disturbs me about this dream. It was totally random and I don't know what to make of it. Surely most people would dismiss it and that would be the end of it, and if this post fails to instigate conversation about it, then I probably won't give it another thought beyond tomorrow either. But still...the easy guess would be repressed aggression and the such, but I like to think I get my aggression out pretty quickly when it comes, and that I do it in fairly healthy ways. So now what? Well, probably nothing. I guess it's just paradoxically disturbing and rewarding to think of the things you are capable of when you really need to count on yourself to do the tough thing. And maybe really this friend's image was just my brain's feeble, mistaken attempt to bring consciousness to this last block of material, and the boards, and my mom's cancer treatment, and the wedding planning, and the moving, along with all the backgroud distractions and hurdles with which we are always embattled. And hopefully, instead of reacting instantly to it lunging at me by attacking back, I can be smarter and go get my homeboys (i.e., you guys) and we can get through this together. And just like that I'm feeling better about this dream.

Maybe next time I'll just tell a joke or something...

Internet Scam, part 10: impatience

2005-04-28T15:33:00.000-04:00

So now I'm getting strung-out junkie IMs from you folk demanding to know what's going on with Bill. Bill is fine, I'm sure. We tracked down his IP address to the Netherlands. What good does that do? Well, nothing yet, but it's good to know...and helps explain the horrendous spelling and grammar.

Anyhow, I got antsy and sent Bill an urgent email:

"Bill,

I have another offer on the desk. When will this check be here? I am going to be leaving in 2 weeks to teach a seminar on assault rifle technology. I need to know that it's on its way.

Thanks again,
Jeremy"

Too over the top? Yeah, maybe, but now I'm really antsy...

Internet Scam, Part 9: sweet vengeance

2005-04-27T20:07:00.000-04:00

So Bill is sending me my check.
I want to send Bill a copy of the money I'm "forwarding" to his "shipper". Really, I just want to give him a computer virus.

If anyone knows how, or has a better idea, please either respond here, or IM me at 'jaaaarome07'. The font looks weird but that's a zero, not the letter O.

My first thought is to get a virus--without infecting myself, of course--and embedding it into that scan. I don't know how to do this, of course. Hit me up with ideas.

Let's do it, people!

Internet Scam, part 8: jerm aka Pious J

2005-04-23T17:15:00.000-04:00

I would also like to point out that I tried to phone several government fraud agencies yesterday afternoon. The braintrusts behind our tax dollars has apparently decided that fraud must only occur M-F, 9am-5pm.

Thanks for having my back, Uncle Sam.

No, no, really, it's cool. Let's let him take my money and get away so he do it to others. You just have yourselves a nice weekend....

My response to Benevolent Bill:
"Sure, Bill.

I should be here all week, except for when I have to run errands or go to church. I'll let you know when it gets here. Please let me know if there's anything else I can do for you.

Sincerely,
Jeremy"

I mean, dude must have some inkling I'm fucking with him, right?
At least just a bit?
Come on.

I can't wait to see this check. $5 says the check is from Western Onion...

Internet Scam, part 7

2005-04-23T17:09:00.000-04:00

For those who don't understand this scam, I figured now would be a good time to explain it.
It's a variation of one of the most common sales transactions scams ever known: the fake check scam. Essentially, the thief sends excess money for shipping. The mark is placed in a "trusted" role to send that excess amount of money to the shipper on the same day. Of course the check/money order is fraudulent and it takes several days for the bank to find out. Meanwhile, the mark has sent money from his/her account to the "shipper". When the check bounces, the mark is out of the money, he/she sent to the shipper.

So, me being the mark, I would lose $2300 if I was as dumb as I look. Wait....nevermind.

Time for a response...

Internet Scam, part 6: "in God we trust"

2005-04-23T17:05:00.000-04:00

Bill isn't one for picking up subtle irony.
He just responded.

Loudly.

Good thing we've got trust.

"HELLO,
THANKS FOR THE UNDERSTANDING YOU HAVE RENDER IN THIS TRANSACTION, I SPOKE WITH WITH MY CLIENT REGARDING THE CHECK AND HE SAID HIS BANK HAS ISSUED THE CHECK OUT TO YOUR LOCATION,HE ALSO STATED TRUST BUT I TOLD HIM U ARE A TRUSTWORTHY PERSON AND A PERSON WE CAN RELY ON.HE ALSO STATED IN PHONE CONVERSATION THE EXCESS FUNDS YOU ARE MEANT TO WIRED WILL BE SEND TO OUR SHIPPER THAT HE WILL COME FOR PICKUP AT YOUR
LOCATION.AS SOON AS POSIBLE.HOPE THIS IS UNDERSTANDABLE WITH YOU?. JEREMY,I WILL LIKE YOU HOLD ON FOR THE CHECK,YOU WILL GET IT PROBABLYNEXT WEEK BY THE SPECIAL GRACE OF GOD AND IF YOU ARE NOT GOING TO BE AT HOME FOR THE DELIVERY OF THE CHECK I WILL LIKE YOU TO STATION SOMEONEFOR THE DELIVERY OF THE CHECK.AND ALSO I WILL LIKE YOU TO DEDUCTTHE NECCESSARY EXPENSES FROM IT,LIKE THE COST OF CASHING THE CHECKTHE COST OF WIRING THE EXCESS FUNDS TO MY SHIPPER,OK?. IF YOU KNOW YOU CANT DO IT LIKE THAT KINDLY LET ME KNOW ,SO THAT I CAN CALL MY CLIENT TO HOLD ON TO THE CHECK. BECAUSE MY SHIIPPING AGENT IN WILL BE EXPECTING PAYMENT ON THE SAME DAY YOU WILL RECIEVE THE CHECK,AND I DONT WANT ANY MISUNDERSTANDING. SO LET ME KNOW IF YOU CAN DO THE BUSINESS LIKE THAT. MAIL ME AS SOON AS POSSIBLE,TO KNOW YOUR OWN SIDE OF IT,OK?.THANK YOU AND HAVE A NICE DAY.

REGARDS
BILL"

Well at least the "regards" is back. I love a polite thief....

Internet Scam, part 5

2005-04-22T16:16:00.000-04:00

Our reply:

"Sounds good. I'll let you know when the money and shipping instructions get here.
I'm not sure how to expect them. So they're coming together? And is this in the mail or fedex or what?

By the way, I've never sold anything over the internet before. Thanks for being so accessible and helpful!

Talk to you soon.
Jeremy"

Oh sweet, Jesus.
This is going to be so much fun.
Now if I could only find someone to buy my desk...

Internet Scam, part 4

2005-04-22T16:06:00.000-04:00

I send Bill my info.
Everything.
Bank #s, credit cards, SSN, everything.

Because I'm as stupid as you are gullible.

I send Bill my shipping info. I then file an internet fraud report with the internet fraud commission. And good news...
Bill is on the ball, with punctuation improving every second that he thinks he's getting richer. Well, except of course for the longest run-on sentence ever in internet fraud history.

"Greetings,
Thanks for the reply and the information you sent.
Concerning payment I have just called my friend now and he has said he'd be sending a money order of $2850 to your contact address in which you will remove the asking price $450 after cashing it in a local check cashing point or in any western union outlet and an extra $100 for your running around and then wire the balance to the shipper via western union money transfer that he will use for all his flight charges and for the insurance of the shipment when being shipped. I hope I can trust you on this? So you will be getting the money order this week,The information of the shipper will probably be sent alongside the money order. I will notify you if he has sent it. Looking forward to completing this transaction w/ you.
Get back to me asap.
BILL"

What, Bill, no "regards" this time? Greedy fucker.
How dumb do you think I am?
I shouldn't have replied for a day and then wrote, "Sorry for the late response. I was busy playing 3 card monty. I can't believe how dumb I can be sometimes."

But I didn't.
I joined forces with Harish, which I contend is a friendship built for this sole experience (which means our time together is almost over, buddy).
We hashed out the details and responded simply, with just a small addition of irony.
Of course Bill would never see our transparently playful act with his greedy eyes on my loan money...

Internet Scam, part 3

2005-04-22T16:00:00.000-04:00

Good news! Our friend Bill is quite accessible, and quickly emails me back.

"Hey,
Everything sounds well and am okay with the prize $250.
l will offeryou $450 to keep all the buyers away. I have a friend who is ready to issue you a certified money order since I don't have the funds inyour currency. For convinient and easy shipping, I have a liable shipping agent who'd be responsible for the shipping as soon as you receive payment . I will therefore need the following information ofyours to forward to my client before he sends the money order......NAME IN FULL........ADDRESS IN FULLCOUNTRY..........ZIPCODE........CELL/OFFICE/HOME PHONE NUMBER.......
Waiting to hear from you
Regards
BILL"

Okay, so now this guy is doubling my asking price voluntarily before he ships it to the UK? Now I was putting it at a 70% scam. I do a little reading up on internet scams just to be sharp. But still, in fairness, even though about a thumbnail's worth of this adds up, I don't really have anything to lose. He can have my address. The whole world can. As long as you're not going to come and rob me. And....um....I'm hoping Bill doesn't. So I reply....

Internet Scam, part 2

2005-04-22T15:56:00.000-04:00

So I write the guy back:

"Hi,

Sorry to not send you all requested information in full. I have some questions first.
My asking price is still $250 USD, but I'm not sure how it would ship. It's quite large and heavy, and not easily disassembled.
The desk is 6 feet in each direction of the L-shape. It probably weighs over 100 pounds.
If your client is still interested, please let me know. I will take a picture and send it to you with my information.
Please let me know how you would like it shipped and if you would need it disassembled. Of course, I still have the manuals, including assembly instructions.

Thanks,
Jeremy"

Now keep in mind that I'm not feeling good about this, but I don't see the harm in seeing how this pans out. Curiosity kills the cat, it's said, but what happens to the noncurious ones? They die without mention....

Internet scam, part 1

2005-04-22T15:50:00.000-04:00

So the Spring Break thing will be completed later.
Some of you know that I've been trying to sell my desk. It's a 6'X6' L-desk with a hutch. It's pretty massive, and terribly heavy. We won't really have room for it when we move so I put it up on craigslist.

Almost immediately, I get the following email from Bill Clawson from a yahoo account:
"Hello.
i am interested in buying it. I riside in UK,I will beresponsible for the shippment down to my location, so please kindly write me back with your last offering price.I will also need some ofits recent pics, .I am Looking forward to your soonest reply I will therefore need the following information of yours to forward to myclient before he sends a check......NAME IN FULL........ADDRESS IN FULLCOUNTRY..........ZIPCODE........CELL/OFFICE/HOME PHONE NUMBER.......
Waiting to hear from you
Regards
BILL"

So I think, hmmm, this is weird. Why would a guy in the UK want my desk when he can buy it for a few hundred more than I'm selling it? This has to be a mistake. Or maybe he's just an idiot. So I write him back....

"i'll have the pancakes in the age of enlightenment"

2005-04-06T04:30:00.000-04:00

vegas...coming soon

2005-04-05T21:21:00.000-04:00

my design would have had a lady figure on each arm

2005-04-05T21:18:00.000-04:00

...i'd guess about 25 ft...

2005-04-05T21:13:00.000-04:00

sin city, you say? looks pretty peaceful to me

2005-04-05T21:12:00.000-04:00

fadslkfjavaldfhafkjahfd ave was next

2005-04-05T21:10:00.000-04:00

gotta love this state

The Day the Price Was Wrong

2005-04-04T21:33:00.000-04:00

This was a big part of our trip out west. People have been asking so here goes...

We arrived at the studios a few minutes after 8am. We weren't all that worried about being a couple minutes late because the tickets said priority seating starts at 8. We were all set. Our shirts read UMB Medicine, UMBC, and neil's buddha with something like "rub my belly for good luck". We had our fake TV personalities and were each prepared to go win a bajillion dollars. There were only about 10 people in line but taping didn't begin until 2:30pm. We sent Justin out to get in line anyways while we found parking. He calls us and says that these people are in line for TOMORROW! That today's people had all camped out and were already taken in. So we were kind of dumbstruck, and pretty pissed, dropping F-bombs that we woke up at such an early hour. But then it got interesting. People started showing up from around the country in their retarded, "i'm gay for bob" shirts. Too late was not good enough for some, as a few people had just flown in that morning to get on the special episode. Just imagine the senior citizen/red state fury that one usually only sees when it comes to supporting some eccentric Bush crusade, like trying to prevent baby female seals from weaning. "No to gay incestuous pedophile seals!" with a $100 billion backing...but I digress. So people were throwing their shirts at the poor bastard attendant. Pretty good stuff, even for tv.

But what about the tickets, everyone asks. Well let's just say we learned an LA lesson that only casting couch directors and the Governator can avoid: it may look and feel real, but that don't mean you're getting in.

So in a fitting end to a gray LA experience; unsatisfied, we rode off into the desert in search of neon strippers and midnight buffets.

Trent: They're gonna give daddy the Rain Man suite! You dig that? We're going to Vegas, Mike.
Trent, Mike: VEGAS!
Mike: You think we'll get there by midnight?
Trent: Honey, we're gonna be up five hundy by midnight!
Trent, Mike: VEGAS, BABY! VEGAS!

More of Santa Monica

2005-03-28T15:07:00.000-05:00

Home of the infamous Santa Monica Pier, this place actually turned out to be more interesting than the rest of LA combined. All you can play pier mini golf for $3 (made fun with drinking-style skins play) kicked it all off, well, after neil rode a cannon. Let me say, going on a vacation without women is a struggle. You have to strike that perfect balance of drinking just a little too much and being just a little bit insensitive in the presence of children and the elderly. Neil managed this scene perfectly. How often do you get the chance to use a cannon as a phallus, making children and their parents laugh together. The kids just thought he was riding it, the parents thought he was compensating. It was great.

And I mentioned the street performers. There was a korean guy who was doing amazing things with spinning a badminton racquet and a soccer ball together off a stick in his mouth. But he was a little pushy so no soup for him. Good free show for us. And then there was mr. genius. I don't know if he was homeless or just a pedophile, but this guy at the end of the pier stood next to his boombox with an "ernie" puppet from sesame street and had him lip syncing to music. Not children's music. Typical transient pop stuff. Now on stage, ernie and....g unit???

And do not let it escape you that ernie's lips are flat. That's some lip syncing.

So we eat (see pickle burger) and we're walking around 3rd Street Promenade, a nice family place (see police), and there it is. A cat. But no ordinary cat. This cat is old. And psychic. Yes, this is the famous Psychic Cat (It said so in the LA Times article attached to his post). And it just knew that Neil would pony up the $2 for his future to be told. I have a chunk of it on video if anyone's interested. His owner was a sleazeball but Psychic Cat was right on the money (all 2 dollars worth) handing Neil a fortune of great vagueness and ambiguity that slightly touched home everywhere it needed to. Ah, to be a psychic cat. Anyhow, it was time to get some more drinks and work on my lines. Big day tomorrow.

"The price is wrong....bitch"

LA 2

2005-03-28T14:45:00.000-05:00

We went out to lunch in Venice Beach with Neil's friend Pooja. With the wind, it ended up being the most uncomfortable meal we ate. Plus, there was the hippy factor. First, I ordered a coke. We've all had the experience of "Is pepsi okay?" or "We only serve __________ products here". Well not this time. My "coke" turned out to be Blue Sky Cola, a "natural soda" with no sodium, caffeine, preservatives, or artificial flavors. How did this $3 can of soda taste? Like freshly squeezed lemonade, which for the same price, was what I ordered when I made the hippies take back their hippie juice. I mean, protest to your hearts' content, but I happen to favor the destruction of caffeine trees and artificial flavoring bushes when it serves the greater good.

Then tofu came in my stir fry. Tofu! And it cost about 800 dollars. And then I could feel the glow of Blue Sky Cola manufacturers kumbaya-ing around a campfire, hemp necklaces bouncing in the moonlight.

2005-03-28T11:41:00.000-05:00

2005-03-28T11:37:00.000-05:00

2005-03-28T11:33:00.001-05:00

2005-03-28T11:33:00.000-05:00

2005-03-28T11:32:00.000-05:00

Thoughts on LA

2005-03-28T11:27:00.000-05:00

Pics below.
They got out of order so start with 1.

What an amazing country. Remember the elections when you saw blue on the coasts and red everywhere, then you looked at the popular vote and it didn't seem to make sense? I mean, sure, you can intellectually comprehend that the coasts are more populous, but then you go out west and you see a 50 mile stretch with no people. 50 miles...that's amazing. People will pay $1500/month in NYC for a broom closet with plumbing and there are unbelievable expanses of poorly accessible, undeveloped, dirt cheap tracts; and no one wants them. Don't know what I'm getting at really, but look at the pic. Snow capped mountain touching parched desert earth. Beautiful country we live in. You just have to look a little past suburban Maryland to see it sometimes.

So we landed in LA on Saturday. Nothing like the beginning of a week in sunny California. Except for el nino. Just as it rained in the deserts of Mexico and Arizone on me a couple weeks ago, the LA I know was transformed into a dirty gray, bringing out everything that makes it undesirable to others. It was chilly and dirty and traffic was all you've heard it to be. We picked up our Chevy Malibu (and used the horn 3 times in the first 10 mins...fun). If any of you ever buy one of these cars, prepare for etermal mock and shame from me (and yes, that's coming from someone who bought a Hyundai; the Malibu is really just that bad). We did touristy things. Nothing too exciting. We ate in Beverly Hills and managed to have some money left over for the rest of the trip. That was a cool thing to do. Despite popular beliefs, Paris Hilton WAS NOT having sex publicly on Rodeo Drive. Yes, I consider myself shafted. No, the pun was not intended. The best time in LA was Santa Monica, which coincidentally refused to join the other smaller cities when greater LA was formed. Santa Monica seems more beachy, less snooty, and it's a general good time. We met up with Tanner and his woman, and the 5 of us ate and enjoyed the Sunday night scene. I ate a pickle burger. It was pickles diced up in the ground beef and cooked together. I think I would have preferred just a pickle on the burger, but hey, I had to give it a shot. Experiences are there for the taking, and really, that's what a lot of this trip was all about. The night pretty much topped off when several cop cars rolled up at top speeds and arrested someone in a Barnes and Noble. Not sure what he did exactly, but he was black, and it was LA so let each man draw his own conclusions.

On the 2nd day we also went to Venice Beach. Once the sun came out, so did the freak show. Thankfully. For those who haven't been, Venice Beach is where you go if you want to be accosted by people in costumes, watch weird street performers, or if you feel like hippydom (which includes mass paintings of Bob Marley, more than a few references to "the pot", etc). My favorite memory is the man with a gray overcoat, yellow pants that only reached the top his knee high boots, a hat with a feather, and a pitching wedge. He requested a dollar for a pic with him, and he ran up to tourists trying to scare them by pretending to kick them or hit them with the golf club. Did I mention that he also had a 40? Or that it was 10am? Good times.

Gotta go. I'll pick this up later...

2005-03-14T16:45:00.000-05:00

first panoramic

politics and poker

2005-03-14T06:33:00.000-05:00

It's late and a test week so I should either be studying, napping, or freaking the hell out. Instead, I want to expound on a conversation I had with Christine in the shower earlier. I know, I know, my priorities are irreparably damaged. For the record, this is a continuation of pre-ring times, not a sad glimpse into my celibate future.

Anyhow, read this first.

Avid card players, of which quite a few will read this, know the United States. You're in a 10 person game and one guy through luck, good play, and a ton of aggression has half the chips at the table. Everyone looks on with some fear, some contempt. US will push you around and you will most likely fold...most of the time. You see that there seems to be a greater force to his good fortune and that with nothing to lose he will call you until you have nothing left. You do not mess with the US.

So there a couple of possible strategies. The US could sit back and let the others fight for the rest of the chips, and just avoid conflict safely, inciting a reverent jealousy. This never happens. I guess people think they should "stay with what got us here", even if that might involve an uncontrollable, slippery sense of luck. So instead, the US continues to push hyperaggressively, chopping down the small stacks; loud in actions, loud in speech, an elephant in the room. Everyone hates the US. And once that guy has done it long enough, made others desperate enough, the small stacks will fight back. And something to remember is that not everyone is weak. Someone else will soon rise from the masses with wealth and support--dangerously--and some of that may be from leaked wealth from the US in its hyperaggressive misjudgements.

And now the big stack all of a sudden has some trouble. Formidable adversaries. No allies. Everyone wants a piece now, purely out of distaste. China is no pushover. Don't fuck with them with your rhetoric and your threats. They will call. And you will look foolish, because everyone knows that every time you raise, you do not have the best hand. In fact, most times you have rags and everyone is suspicious even though they aren't in position to call you down yet.

China has a strong hand and the desire to go all-in with it. How strong is your hand, US? Is this a showdown you're willing to lose big on?

Anyhow, as mentioned, the weak don't always remain so. No one likes being the small stack. The US didn't when it chopped down a big stack (Britain) in the Revolutionary War. And the US used its new wealth to start a campaign of growth and prosperity. These other small stacks aren't all going to go away quietly. Of course, some are smarter than others. For example, North Korea is representing rockets (A-A). "They don't have aces," Christine astutely pointed out. True, but they may have A-7 or K-9 or J-10 suited or something that will win some of the time, and frankly, with our current streak of getting called out with Q-5 and the likes while representing the nuts, isn't it time to just give it some thought before reraising? True, North Korea probably has shit. It's probably a smart bet to call them. But we need to be careful, and that's all I'm really saying here. China is no joke. Syria, all those countries, go with peace while we rebuild our stack with smart moves, and if you then do something foolish, we will come after you and no one will fault us for it.

After all, the US can be smart by not bullying, and it's foolish for others to pick battles with the tough guy at the table, especially when he's thinking clearly and has a lot of ammunition. This is where we should be and what we should be moving towards.

The bully never wins at cards. Not in the end. He's not smart enough.

(shower...me...girl...and this is what I think of? stop judging)

2005-03-13T21:56:00.000-05:00

This pic kinda sucks but it's the best we have from that morning

2005-03-13T21:52:00.000-05:00

early morning at the beach