Rotation #1- Family Medicine

My third year has officially begun, and it's flying by already. My first two years were spent sitting on my toosh in school listening to lectures and studying the rest of the day and night until 10:30 pm or I couldn't handle it anymore. The third and fourth years are quite different. Here's how it works: I am assigned to a doctor(who is my "preceptor") for four weeks in a certain specialty and those four weeks are termed a rotation. The doctor is my teacher and also my evaluator. My responsibilites are different on each rotation depending on what the doctor feels comfortable letting me do, but in theory I'm supposed to go into the patients room after the nurse measures height, weight and vitals and get the history of the chief complaint and perform whatever physical exams I think are necessary. Then I let the patient know what I think needs to happen, go talk to the doctor to tell him about the case, and tell him my best educated guess of the diagnosis and proper treatment. He'll then see the patient and either agree with me, tell me i'm way off, or say i'm close but recommend a different course of treatment. That is what's supposed to happen but it doesn't always go that smoothly.

My first rotation was with Dr. Hoy in family medicine. He has his own private practice with a small staff of only one medical assistant, two receptionists and a billing specialist. It's rare to see a Dr. working for himself in todays world because of the fear of malpractice lawsuits and the insurance being so expensive. I'm glad I got to experience it first hand and see how an office is run. Dr. Hoy was a 60 year old vietnam vet with a slightly filthy mouth but was a great teacher who had great insights after 30+ years of practicing medicine. He had one problem though: he was addicted to smoking. Yeah I thought it was weird too to see a dr. who smoked. It was especially strange and disheartening when a patient responed after I inquired how managing her diabetes was going with "Dr. Hoy told me to start smoking again after I quit because I gained so much weight!" At first I couldn't believe Dr. Hoy would recommend such a thing, but then quickly concluded that she probably misunderstood him and was using that as an excuse to start smoking again. She was a typical patient at this practice. It was located about 15 min north of downtown Columbus in a fairly low income area. I was a little overwhelmed at first when it felt like every patient had 20 diseases and were taking hundreds of medications. That is an exagerration but certainly the majority of the patients were obese, had high blood pressure, diabetes, a heart problem, degenerative disk disease and some other crazy thing going on. Their was lots of diversity with an almost equal amount of african americans and caucasians. Sadly, not very many took care of themselves and it was a good thing I had the Vicks vaporub I could shove up my nostrils when the smell of a person who hadn't bathed in weeks became unbearable! I got to see a lot of patients and feel like I understand medicine much better than four weeks ago. I felt the most important thing I did on this rotation was seeing 100's of normal eardrums, eyes, mouths, noses, throats, hearing the normal heart and lungs and then comparing those with the abnormal eyes, ears, noses etc. I've got a long way to go but i'm amazed at how much easier it is for me to notice what is wrong after only one month of seeing patients. I think I'll feel pretty comfortable seeing patients after two more years of this and three more years of residency. Here are some of my conclusions of family medicine:

1. We need good docs in family medicine. They really are the quarterback of the healthcare team and the better the family doc, the better the overall care of the patient will be.

2. Family medicine can be a great lifestyle. My hours on this rotation were 9 am to 4:30 pm. and on fridays it was 9 am - 12 pm. Those are hours I can live with! The doctor's hours were more like 8 am to 5:30 or 6 pm and sometimes 7, but that really isn't too bad. Especially compared to the surgeons. He didn't take much call at home or on weekends either.

3. I don't like pap smears. I know ladies don't like them either, but I can assure you I hate performing them more than you hate getting them. I could elaborate...but this is a PG blog so enough said.

4. I really like suturing. I only got to put in two stitches the entire rotation, but I really enjoyed it. All the practice I did in surgical skills class definately paid off! :)

5. Vick's Vaporub is from heaven. I never knew there were so many foul smelling people in this world, and nasty smelling abscesses either. I don't think i would've kept my lunch on several occasions without it.

6. I enjoyed getting to know people, but still have a long way to go in learning the skill of asking the right question or phrasing a question the right way. I'll always remember the 40 year old lady who came in with a possible urinary tract infection, and I was trying to figure out what might be causing it. I asked her point blank if she were sexually active(I guess my blog is PG-13 now), and she gave me the most dangerous looking dagger eyes and said "Is that important!?" I said it was because "you may have an STD." Oops. Big mistake. She denied that it could ever happen and then went on a tirade of how she hated men. She told me she was "into women now" and all I could say to keep her from getting more upset was that it was ok. I don't think what I asked her was innapropriate because knowing her sexual history could've potentially affected how we treated her, but I think I can be more tactful in finding out that information and giving a better explanation to why I need the info rather than "you may have an STD". :) Live and learn, right?

7. There are some people who share with you wayyyyy more than you ever wanted to know about them. Enough said.

I really enjoyed working with Dr. Hoy and his staff and we sure enjoyed alot of fun times and tasty free meals together. I don't know if i'll end up as a family practicioner but I will definately consider it. I have another four weeks of family practice starting tomorrow with a different doc and we'll see how that goes.

I'm loving Columbus, and also visited Cincinnati and Cleveland the last few weekends. They are fun cities. I love how close I am to so many major cities and attractions. The next two years are going to be great!

ENGAGED!!!

As most of you already know from facebook or word of mouth, the rumors are true and I am engaged! My sweetheart has been mentioned many times on this blog, it's the lovely and beautifully amazing Makenna Barton. I want to share a little bit of our dating experience and how I proposed. Warning guys, it may get mushy, stop reading now if you can't handle it. :) We met on July 13th, 2008 at the annual pioneer day fireside/fireworks at Weber State, which the singles ward we were attending went to for an activity. After the fireside I started chatting with her about her iphone and we pretty much talked for the rest of the night, hardly noticing the fireworks. Her mom had made a delicious corn puff dessert previously to eat while we waited for the fireworks to begin and I used that as the way to get Mak's phone number. I asked her to text and/or email me the recipe so I could make it when I went back to Iowa. Makenna, being the kind, sweethearted girl that she is, readily agreed. Little did she know that it really was my way of asking for her number(I'm pretty smooth, I know.) ;) I found out later that she wanted to get my info also that night...so it turns out I wasn't quite as beguiling as I thought. I headed back to Iowa the following sunday and we kept in touch by all sorts of ways that we are so blessed to have these days: we texted, emailed, talked on the phone and used a web cam. It became clear really fast how things kept falling into place for us to start dating. For example, I originally was scheduled to drive home with Tyler Sudweeks the morning of the day I met Mak, but earlier that week I felt like I needed to stay an extra week at home so I bought a plane ticket to leave instead a week later...not really knowing why at the time. The way the web cam and phone dates worked out was another example. How we communicated so easily with each and became best friends was another.

We decided we officially started "dating" in September of 2008, after we had been on several phone and web cam dates and were talking regulary. Our dating situation was unique and so our relationship has been unique. We built our relationship on friendship and communication because that's all we had to begin with. I enjoyed sending and receiving packages to and from her, and it was nice being able to focus on the intense studies of med school but always looking forward to our conversations at night. One of the most memorable phone dates for me was when we got Naked togeter for the first time...the fruit juice of course. ;) We talked on the phone and went to the same store and got the same drink and just chatted as we sipped the juices in our cars. We'd do this to make it sorta feel like we were in the same place. Another time we both ordered Applebee's to go and then chatted on the phone as we went to pick it up and then brought the food back to our houses and used the web cam to chat as we ate. We then played games together the best we could in our little virtual world. It was so fun and I enjoyed every minute of it. We also would watch movies together by renting the same movie and starting it at exactly the same time, while we had the web cam on to see each others reactions and talk about the movie. It was different not being in the same room, but we had so much fun and made it work though we were 1000 miles apart.

I knew I was falling in love with her a short time after Christmas but didn't want to tell her for the first time over the phone. The months dragged on and sometime toward the end of April, I couldn't hold it in any longer and I clumsily but purposely said over the phone that I loved her. Expecting her to reply immediately with an I love you back, all I got was silence. Silence. My mind started racing and I thought I had blown it. After what seemed like eons, she finally and almost hesitantly(although she'll probably deny this) said I love you back. Phew, I thought to myself...at least she didn't hang up. I should let you know that I was extra nervous because this was the first time(besides my Mother and sisters of course) that I had told a girl I loved them. I always wanted to be absolutely sure it was true and not just hollow words. Well, our friendship and love continued to grow and seemed to accelerate when I came home for the summer. I mentioned in the previous post of how that played out. She ended up making the 26 hour drive with me back to Columbus(we stopped in Des Moines of course to spend the night) and it was en route to Columbus that I proposed.

We were staying in Sandusky, OH on Wednesday July 29th. We were dropping my buddy Nick and his family off to where he would be doing his rotations, because we had shared a moving truck with him to ease the expenses of moving. Sandusky lies on the southern shore of Lake Erie, one of the great lakes, about two hours north of Columbus. The Marblehead Lighthouse towers over the Sandusky bay and I had the idea for quite a while to propose to her at the lighthouse. Her and my parents thought I'd be proposing to her that night, but we were having so much fun at the Cedar Point amusement park I decided to push it to the following morning, also so things wouldn't be rushed. I told her about the lighthouse and we made a plan to go the next morning. She thought it was just to see the lighthouse. I had other plans of course. So Thursday morning, I went shopping to get what I needed, while she got ready for the day. She thought I was getting supplies for lunch. We made it to the lighthouse park and there were tons of people already there lined up to see the lighthouse. She doesn't like to draw attention to herself, so I wondered how i'd propose without everyone and their dog enjoying the moment with us. I packed everything into my backpack but left a dozen roses into the car. We took lots of pictures at the base of the lighthouse and finally got to go into the lighthouse for our tour. It was a beautiful day and I nearly got on my knee when we made it to the top of the lighthouse, but I wanted to follow through with my plan so I waited. I nearly proposed again on our way down the winding steps, but again decided to wait. After the lighthouse tour, we found a secluded picnic table next to lighthouse on the rocks of the shore of the lake for "lunch". I couldn't have asked for a better spot. The waves were lightly crashing against the rocks, the birds were chirping, the trees were brilliantly green, the sky a beautiful shade of blue and the view amazing. As I set down my backpack, I turned to Mak and said that I'd forgotten something in the car, handed her the keys and asked her to go get it. She asked me what it was, and I evaded the question by telling her it was in a brown sack. She again asked again what it was and I told her she would find out. She gave me that funny face, you know the one, the half frustrated, half confused look because I was being so evasive, and took off for the car. After she left, I hurried and set up all the things I had gotten earlier in the day, which were things that reminded me of several of our dates together. I tried to light three colored candles but the breeze kept blowing them out. She finally came back with the dozen roses in her hand and knew something was up. She sat down on the other side of the table and I proceeded to tell her what everything meant. Then I got to the candles and explained that the blue one on the left represented our friendship(both our favorite colors are blue), and the red one on the right represented our love. I then said when you bring those two together, it can symbolically create the white candle in the middle, which represented purity and eternity. I then went over to her side of the table, got on one knee and asked her to marry me. She said yes, without any pause or hesitation this time, and I liked that response much better than the silence I got when I first told her I loved her! :) She then got really excited and wanted to take pictures of everything. It was such a great day and one that we'll always remember! I bought her a christmas ordament of the lighthouse, so we'll always remember the day, which is pretty cool since our anniversary will be on Dec 22nd if all goes according to plan. I love Makenna and can't wait to have her with me forever!

There is a quote from Paulo Coelho's book, The Alchemist, that comes to mind when I think about our courtship: "And, when you want something, all the universe conspires in helping you to achieve it." I've really felt this is what happened to bring us together, the universe conspiring for us, with God having his hand in it every step of the way because of our righteous desires. Neither one of us were desperate, anxious just to get married just for the sake of getting married or for selfish reasons, but were looking for someone we could love, trust and become best friends with to get each other back to the Celestial Kingdom. I don't believe in "soul-mates" but there is no doubt in my mind the Lord helped us out and brought us together. In long distance dating, there are plenty of reasons to give up, but I'm a firm believer that if its right, and our desires are right, then it will happen the way it's supposed to. Hopefully I haven't divulged to many details. Mak, let me know if I have. Thanks to all who have helped and enjoyed this journey with us, especially her parents and my parents!

1/2 Doctor

It is official! I finished my second year of medical school in May, and passed the Osteopathic Board licensing exam in June, which allows me to start my clinical rotations tomorrow! I'm excited to move on from sitting in classrooms all day and spending all night studying for test after test after test. I'm a little nervous to start seeing patients though. I'm nervous about getting "pimped" by doctors, asking me ridiculous questions that only they or the "gunners" know the answer to. But I'm ready for the challenge and want to learn all that I can so I can be the best dang doctor I can be. :) I spent last week moving from Iowa to Columbus, Ohio. The amazing woman in my life, Makenna, took the road trip with me and we had a most fantastically awesome time! She was so helpful and a great mover. She flew home yesterday and I already miss her.

I spent the last two months in Utah, but the first month wasn't really a vacation at all. Don't be offended if I didn't get to spend time with you...it was a busy summer to say the least. The first month was all about studying for the "boards." A typical day started at 6:30 am with exercise and breakfast. After getting ready, I would try to start studying by 8:00 am and continued until 8:00 pm for the first few weeks, but went until 10 pm in the final week before the exam. I always had something great to look forward to at the end of the day though: Makenna! I would usually spend an hour or two with her before going to bed between 10 and 11pm. It was an intense month of study and discipline, but after it was over I sort of missed the discipline and efficiency I developed. The second month was full of fun, family and dating. I only dated one girl...you guessed it, Makenna. We did all sorts of fun and exciting things. Some of the highlights were: The ifly indoor sky diving in Ogden(which my fearless Dad also did with us), horseback riding up by Adam's Canyon, hiking the Crimson Trail in Logan and then visiting my Grandma, a jungle themed date Makenna planned(I can still taste the coconut shake's and the chicken pinapple kabob's she made...mmmm good), went to a rodeo on the 24th, the Anderson family reunion and waterskiing, double dates with both her and my friends and much more. We also enjoyed the low-key events like playing games with family, hanging with my nieces and nephew and watching the latest red box release.

It was a great last official summer and I wish I had time to blog about everything that I did with every person I spent time with...but even though I dont, I want ya'll to know I enjoyed every minute at home. My parents are still the best ever. Lichelle and Trent and their family are always a hoot and fun to be with and I wish I had more time to play with those cute kids! Brad is great and a pleasure to be around and still helps me think through things I may not have considered...and he humbled me in tennis and dunk ball! He was super great for letting me drive his car to Omaha and helping Mak and I avoid a horrible experience riding in the back of a 5 person vehicle with a baby! It was fun to have Jami and Sam come home from portland for a week to play and spend time with them, and they are great to be with and great people! Emily is still her gregarious self and so full of life and fun! She is driven and will accomplish anything! Good luck at Utah State! Taylee is really coming into her own and I enjoyed chatting with her and seeing her smile and laugh! She was a great performer in her music camp performance! She will do amazing things. I wonder sometimes how me, an average guy, got so blessed to be apart of such an amazing and talented family? Perhaps to teach them patience? ;) Anyway, it's a great time to be alive, and I hope I survive my third year rotations. Wish me luck!