Friday, June 27, 2008

No more residency

This afternoon, I did my usual late rounds in the hospital, tucking in my patients. Talked to a couple of the nurses about some small things, going from unit to unit. I tried not to think about the fact that I would probably never set foot inside those buildings or see those nurses ever again.

Being done is such a strange feeling. In two days, we will be checking in to our hotel in San Francisco with two weeks of honeymoon ahead of us. It's the first time in three years, I have had more than 5 workdays off in a row. I am wired in a strange way that only allows me to enjoy something if I feel like I have worked for it. Lots of people are probably like that but years and years of school and, now, residency, have made me a particular glutton for punishment. I need to smell the roses these next two weeks because after that it's probably going to be a fall full of busy work.

Running-wise, the legs are smooth in a way I have not felt since my track days. I went out running the other night and did some 800m intervals that felt great. I made the decision to run the 25K race next weekend. I realize it's probably more of a fun run distance for that particular event and there probably won't be a lot of competition. But I just feel so fast now and I don't want to blow it with a 50K now. I may be unrealistic but I am eyeing up a couple of PRs this summer (5 miles, 10K). Also, the Girl is running the 50 and I will have fun watching her running. She will kick ass that day.

Oh well, the Olympic trials are on.

Sunday, June 22, 2008

So I "graduated" Friday, although I still have to pay back my paternity leave for one more week. And then what? I don't have a job lined up; I thought I did but I learned last week that I would not get approved for it. So instead of the joy of being done with residency, I get unemployed.

It's scary as hell. I have a few leads but nothing really great. Our hospital is the overwhelming forci in this area and I it has been made clear to me that I will be damaged goods for at least a few years. There is a smaller hospital in town; they have a job that wouldn't be too bad but it's a job that I already turned down once when I was first applying some months ago. I don't know how much that counts against me. The only other job within driving distance is actually a job in an Indian Health clinic; that one would be boring but would look good on a CV.

I guess for now, I'll be hired on as a research associate at my hospital for a month or so while I find something else. At least that's something.

Running has been strong. Last four days have seen 14, 8, 15 and 11 miles, a lot of them fast. Today, I ran over to the YMCA to run a tempo on the treadmill. It's so hot out I felt like running inside. The 5K tempo was run in 16:54, which is 10 seconds faster than my previous fastest 5K tempo this year. I am very excited about it; it probably means I am in low-16s 5K race shape.

The 50K is two weeks away now. I'm still worried about the distance after what happened at Chippewa. There is a 25K there also; I thought about swithcing to that. I woundn't have to worry about bonking and I could watch the Girl run the last part of the 50K. I think she will win, looking at last year's times.

The Girl is slowly but surely starting to train with a purpose. She is taking easy days now and runs some days harder than in the past. The way she set a 5K at the end of a triathlon tells me she is ready for a strong summer. With all races, winning depends on who else shows up, but I think she will win either the 50K or the fall marathon we are signing up for. My guess is she will dip below 20 in a 5K we are doing in July. I am slipping into kind of a coaching role; it's a lot of fun. If she trained exactly like I wanted her to (and didn't get injured), she would become wicked fast in no time.

Tuesday, June 17, 2008

ER weekend

Had my first 48-hour shift in the ER this last weekend. The weekend began with an easy day on urology. I basically just pick the patients I want to see with the different attendings. If I sneak off to write some email or work on some reearch, no one cares.

48 hours is a long time of being locked away in a job but, overall, it was a sweet weekend. Friday night, I slept almost all night. Saturday night, it was slow and I could get out for a run around the hospital. I like the feeling of not being looked at like a resident. In residency, we seem to play this game where nurses etc. aren't allowed to tell us what to do. Only if we are about to kill a patient will a nurse say something like "sometimes, we give this drug and they do really well". In the real-life ER, the nurse tells you what she thinks it is and it's up to me to agree or disagree.

One little girl came in with some pretty non-specific symptoms but she smelled a little like appendicitis. I think she would have got a CT scan at a bigger ER in a second. But in a tiny ER, where you have to wake up someone to come in from home to fire up the scanner, you think twice before scanning everyone. I talked it over with the nurse. Could she come back in the morning (this was 2 am)? Should we scan now? Well, we scanned her and it was appendicitis and the nurse and I high-fived, happy about having made the right choice.

Monday, June 9, 2008

My first triathlon

As usual, we got out of the house too late. A huge storm was blowing through the area and we had laid all night listening to the thunder. I didn't think the would run the event.

Well, my event was held but the Girl's Olympic distance event was cancelled or, rather, reduced to a sprint. However, it was still held as two separate events, which felt a little odd. I think they felt they had bought all the awards so they may as well use they, plus they were probably worried that some people would get mad.

The evening before, the organizers had talked about doing a run-bike-run if there was any lightning. I was semi-hoping that would be the case, as I imagined I would probably be in a good position to win the race. On the other hand, it wouldn't have been a triathlon; it would have been a duathlon, which is a whole other ball of wax.

Getting ready for a tri is not easy. I get flustered before road races, not knowing where to stash my warm-up clothes etc. Yesterday, we suddenly had to worry about what went into the transition area, while quickly getting dressed for the swim. For me, that was essentially putting on my running shorts, swim cap, goggles and ear plugs). The Girl had to get into her wet suit in less than five minutes. She howled and screamed while doing jumping jacks to get into the suit and finally made it:

But what's wrong with this picture? The wet suit was inside out. Now, the Girl had to scramble to get ready and both myself and mother-in-law (who was there watching the Lorax) had to help her get into the suit. The Girl was in the second wave and had to make her way through all the later waves down to the beach. It was a little comedic but also quite stressful.

The Girl was off and there I was, in the next wave. My wave consisted of the "young male" age groups, probably all the way up tp 35 years. The water had been cold the other day when we practiced but it felt warm yesterday. I suspect I was simply so pumped I didn't feel how cold it was.

Most of the other guys were wearing wet suits. I was the only person in running shorts, which was a little embarrasing. Everyone warmed up a little; I did a few stroked and felt good, like I probably could manage a crawl the whole way. I found a spot near the back before the gun went. I probably managed less than 50 yards before I found myself gasping for breath in a panic. I switched to breast stroke, which felt ok. At this point, I was in last place. The guy right on front of me was morbidly obese and seemed to know the people from the local tri club. I got the distinct feeling that he was a guy who was in the process of changing his life around, probably wrestling with his first endurance event of many to come. But my nearest competition he was and he also quickly converted to breast stroke. We looked each other in the eye as I was passing him, like "what the heck are we doing out here?". I later saw him finist last during the award ceremony under a hearty applause.

I would crawl a little, then get overwhelmed and go back to breast stroke. A guy in a kayak was sitting there quietly, looking at me struggle to move forward in the water. I could tell that he felt that I may be someone in need of help, based on my quick shifting between strokes and my running shorts. I moved by him, inch by inch. Just after I passed the halfway point, the fast swimmers from the following wave started passing me. They must have felt pretty good in their skin, effortlessly gliding past us strugglers. And I say "us", because at this point I was actually gaining on a few people from my wave. One guy was breast stroking and one was side stroking; both looked more than a little overwhelmed. I would gain on them every time I did a crawl effort and eventually passed both of them.

But there, ahead of me, was the boat landing where I would go from being a drowning cat to a competitive athlete. Closer and closer it came and, finally, I was out of the water. I got the 107th fastest swim time out of 180. I am amazed that so many people were slower than me but this includes, of course, men and woman all age groups.

Oh, how it felt great to be out of the water. One guy who had just passed me from the other wave was walking up to the transition zone as were several people from my wave. I started sprinting up the hill into the transition zone. Got into my cycling shoes as fast as I could. I couldn't get my shirt on because I was wet so I just pulled it over my head and slipped it on as I was on the bike. My transition time was the fourth fastest of the entire field! Of course, a lot of people had wetsuits on, which slowed them down.

The first part of the bike course had some good tight turns. I decided to go all out and took the turns with my hands in the drops, leaning in. I think I passed 20 people in the tight turns alone. Biking felt really cool. It was raining hard; I would lean deep into the tribar, head between my arms. I had started to pass some of the women in the Girl's wave, so I figured she wouldn't be far ahead. And there she was, looking strong. We talked a little before I took off. Overall, the bike section was the most fun. I passed people continuously for 17 miles straight, feeling great. Two guys passed me. They must have been from waves behind me and, I suspect, battling for the win. One guy had a plate wheel on the back; he looked very cool.

I got 8th on the bike. I had thought it would be a little higher but 8th it was. Some of those tri people can bike, I guess.

Then it was off to running. Ahh, my specialty! But no, the legs felt like think logs. I waddled out of the transition area and quickly noticed that I was not the only one with a waddle. The run went by so quickly I don't remember much from it. At about half way, the legs woke up and felt really good. I passed people throughout the run. There was an out-and-back section, where I saw a couple of guys who ended up placing in the top three. I knew that the course was too short for me to catch them. Oh well. The last half mile, I sprinted like a maniac and got some good wows from the spectators. Thankfully, I got the fastest run out of the field at 17:50. Weirdly, it felt much slower, especially in the beginning.

I jogged back to see the Girl come in. She was running like a dervish, passing people left and right. Her run and bike had gone okay but the run was her territory. She, unbelievably, PRd in the 5K with a 21:35. A lot of the top men would have been happy with that time. My lady is fast as hell these days. She is probably ready to get way below 20 minutes for the 5K.

Overall, I took 6th and won my age group. But, ok, 3 of the 5 guys in front of me were in older age groups. 5th place was three minutes ahead of me.

The Girl took 11th and 2nd in her age group.

If we want to do better, we have to learn how to swim better. Well, actually, the Girl swam okay. She beat my time by over 30 seconds but it still wasn't fast enough to be competitive. But the swim isn't enough. We both need to bike faster, too. I would only have taken third, even without the swim part. The winner beat my bike time by 6 minutes and I only beat his running time by one minute. So even in a run-bike-run I would only have gotten second.

Triathlons are a lot of fun. We have both gotten the bug pretty badly and are talking about joining a tri club. Yesterday, I thought about the half marathon I won a month ago. I didn't have any fun that day. It hurt like hell to beat that college kid in a sprint and I couldn't walk the next day. Today, I feel great. This triathlon will definitely not be my last.

Thursday, June 5, 2008

Sicko type day

Once in a while the medical insurance system gets so inhumane it drives me nuts.

I saw a guy in the hospital in October. He was, essentially, dying of lung cancer. I remember him well, which isn't true for very many patient from 6 months ago. But I was the one who had to tell the poor man what was going on in his lungs. I have only had to do that a few times, at least in this type of situation where I had to take a deep breath outside his room before going in.

So he went home on hospice a few days after his diagnosis. His one lung had collapsed so he went home with an oxygen tank. He died not long thereafter (which I didn't know till today, when I looked him up).

So yesterday, I receive a fax from his insurance company stating that their documentation stated that he had had 89% oxygen in his blood when he was discharged and that, according to their policies, they would only pay for patients sick enough to have less than 88%. I'm not kidding here.

I spent half an hour looking up what was in the electronic records and, to my joy, the latest recorded oxygen saturation was, actually, 88%. So I dictated a long letter and filled out the paperwork. My nurse faxed it in and, seriously, the company wrote back complaining that on this document we had not evaluated the "estimated time of treatment". The man died 6 months ago, shortly after discharge, and he used less than one tank of oxygen and they are trying to charge the widow for his oxygen.

In other news, we went to practice on the triathlon course. It turns out that I'm definitely not going to be able to crawl the whole quarter mile. I got panicky swimming in the freezing brown water and swallowed too much water. I will be the only one without a wetsuit, I bet. Here is the Girl, emerging from the waters like some whale-skinned nymph.

One other thing. For the odd male who likes to see semi-nude gorgeous women writhe and contort while getting out of their wetsuits, triathlon transition zones may not be so bad. But then again, most men are probably above stuff like that.

Here is some guy, who happens to be balding, pale and hairy; but please look beyond those characteristics. Slyly, he is wearing running shorts for a tri swim practice, his goggles cost 2 dollars in play-it-again sports and he has no clue how to use wax ear plugs.

Oh, it will feel awesome to get on my bike.

Today, I went for an awesome run. It felt just shy of 20 miles and throughout I felt strong and race-ready. That 50K is in a month and I feel good.

June running log

June 1 - 16 miles on the trails with the Girl. The Lorax was wathced my MIL. Great day.
June 3 - 5 miles - transitions over and over again for the tri
June 4 - A little feeble swimming on the tri course
June 5 - 18 miles (?) in the woods. Felt really good. Great legs towards the end.
June 7 - Some transitions and not much else
June 8 - 3 miles running - as part of a sprint triathlon
June 9 - 24 miles in Frontenac State Park (I think 24; we ran for 3.5 hours). Mostly ran apart, as one of use pushed the baby jogger while the other ran the trails. Great day
June 11 - 6 miles at night
June 13 - Biked one hour
June 14 - 5 miles - while working!
June 15 - 7 miles - twisted ankle after feeling really good.
June 16 - Biked 1 hour
June 17 - 8 miles
June 19 - 14 miles fast on the trails
June 20 - Ran 8 miles with the Girl. Did some mild fartleks.
June 21 - 15 miles with my dad and the Girl (dad ran 4 miles). Hot day; felt bad.
June 22 - 11 miles. One 5K on the treadmill in 16:54!! New PR. Felt really good.
June 25 - 8 miles
June 28 - 16 miles with the Girl
June 30 - 11 miles in San Francisco by Golden Gate Bridge

Total: 177 miles in 16 efforts

Tuesday, June 3, 2008


Wow, this last week has been stressful. There was a situation at work where one of my superiors (ie an attending physician) had said some negative things about me. I don't know who or what was said. My name was brought up at a couple of competency meetings and, thankfully, a lot of people came to my defense.

I think I know who the person is but I will never know for sure. She once commented on how much I had changed since I met the Girl. It was obvious from the way she said it that I had changed for the worse. One thing is certain: my job used to be the main ingredient in my life; now, it's secondary.

There has been the stress of getting our various applications ready for Europe. We have to get originals and certified copies of everything and send them to various offices over there. Each little certification is pretty easy on its own but we are juggling six or seven types of visas, passports, medical certifications, credit for residency etc.

My running has been really good lately. I ran or biked hard every day last week for a total of 58 miles in 5 efforts, which is probably the highest for me this year. Sunday was a little over two hours on the trails at a very fast pace. It felt really good.

This Sunday, we are doing a triathlon. It's a first for both of us. The Girl is doing the Olympic distance; I'm doing the sprint. I don't know what to expect but hopefully it will be fun. I do have some goals:

Swim: Goal is not to drown or get kicked in the face; to take it easy and remember that I can't swim. Honestly, I don't think I can crawl the whole way. Hey, there is no shame in a little breast stroke.

Bike: I am not sure about this one. I mean, I have been in competitive group rides, with friends or complete strangers and I know that I go faster than most. Goal is pass as many fast swimmers as possible. This will be my first cycling competition so I'm excited.

Run: Goal is to post the fastest time of the field. Hey, compared to these guys, I'm a specialist.

Transitions: This one is interesting. I actually went out today and, instead of just running, I biked one interval, changed into running shoes, ran, changed back to bike shoes etc. Did that 5 times.

Bought a slick looking aero bar. It felt really good on the bike. I can't wait to try it for real on Sunday. Luckily, my swim is so poor that I will be at the back of the field. I will feel like a rock star, making my way up the pack.

I should mention that the reason we can do this as new parents is that mother-in-law is coming to watch the Lorax during the race. That's really cool of her.