Ohio State vs. Florida, National Championship Game, Part 2

Here we go again ...

Monday night, April 2, Ohio State and Florida will battle for the 2nd time in 12 weeks for a major collegiate national championship. I won't speak again of what happened in January, but I hope for the sake of all that is good in this world that OSU can exact some measure of sporting revenge against its newest rival.

Prediction

Ohio State: 76
Florida: 65

Jealousy

I get a little bit jealous every time I go into my local comics store. Admittedly, I have a rather extensive collection of comics dating back into the 1980s, but over the last year I've branched out to sample some other odds and ends, and all this has made me want more. I have a subscription to 10 monthly comic books and a few bi-monthlies through the store (10% discount with 10 monthlies = swell!), so each week I have 3-4 issues waiting for me when I walk in the shop.

Other guys, however, have stacks of 10, 20, and sometimes even 30 books, and they spend their time browsing the racks for more. Before you go getting all worried, I cannot fathom spending $35, $65, or $100 PER WEEK on comics -- all hobbies have their limit, and mine stops way before that. But it does make me exceedingly greedy when I see these guys walking around with a stack of comics that could keep a small army in supply for a few days; oh, the fun I could have spending an entire day reading nothing but cartoon captions!

I can see my set-up now -- a sun chair out in my freshly mowed backyard, a radio broadcasting the afternoon major league baseball game, and a cooler full of Cokes, waters, and Gatorade. I could construct a comics stand out of cardboard and our leftover TV box, and Sula would bring me a cheeseburger and some fries from Wendy's at my beckon call. Then, after I get sunburned (usually about 15 minutes in the early summer), I could come inside to a new episode of Gilmore Girls or Grey's Anatomy and fall asleep on the couch, my lymphatics bursting with chylous (digestive) fluid reflecting my extraordinarily fatty meal and my brain buzzing with the post-Coke caffeine rush. Then I would make a token attempt to study, decide its not worth the effort, and then drive to Whetstone Park and throw the Aerobie with Sula until dusk.

What a day ...

Three More Bite the Dust

Endocrine, reproductive, and gastrointestinal path tests all found their way into Thomas' "Passing Score" examination collection today. Hip, hip ... oh, wait ... there's still more to be done? Good grief.

Final Four!

OHIO STATE ADVANCES TO THE FINAL FOUR!!!!

Ohio State -- 92
Memphis -- 76

Joey "The Mouth" Dorsey, he of recent fame by calling OSU freshman phenom Greg Oden "a lot overrated," had a huge contribution in the Tigers' blowout loss by chipping in with 0 points, 4 rebounds, and 4 personal fouls. Oden, playing David to Dorsey's self-proclaimed Goliath, scored 17 points, grabbed 9 rebounds, and participated in cutting down the nets in San Antonio after winning the South Regional final.

Ohio State punched the first ticket to the Final Four and will play the winner of tomorrow's North Carolina vs. Georgetown matchup in the East Regional final.

[p.s. -- my other national title game pick, UCLA, beat West #1 seed Kansas tonight to earn its place in the Final Four ... shoulda put some money on this bracket!]

TN Trip

This last trip down to TN to visit the family was an interesting one. Grandparents feeling better, 80-degree weather in March, and spending almost an entire Buckeyes basketball game without really knowing what was going on is a bit strange for me. We finally saw Buzz's TTU dormroom and met her beautiful black-and-white shorthaired feline, Blossom. Thursday afternoon at Rock Island was a blast. Friday night's fire was too. Too bad it all had to end so soon.

Updating the Tourney Picks

Poor Sula. In a previous post I wrote a few comments about some pretty outlandish tourney picks she made (Wisconsin in the title game, Holy Cross in the Elite Eight), and both came back to bite her in the butt. Not that it really matters ... one of my Final Four picks, Texas, got ousted last night by Southern California, and my national champion -- Ohio State (who else?!?) -- needed a last-second desperation 3-pointer to squeak by giant-killer Xavier. Play like that against a better opponent and OSU will be watching the Final Four from the couch.

After the first weekend, when everyone's brackets are already busted, "getting it right" doesn't really concern me anymore. Sula and I have watched most of the games on sportsline.com's MMOD viewer, including Holy Cross' valiant effort that fell short, and we've had a pretty darn good time doing it. I think I want to keep it that way.

Next up: Ohio State vs. Tennessee in the Sweet Sixteen, 9 pm on Thursday. Divided loyalties? Not a chance -- scarlet and gray all the way!

Steak Night

Tonight's menu:

1. Two ridiculously monstrous T-bone steaks

2. Two buttered, salted baked potatoes

3. A heaping plateful of vegetables

4. Italian dinner rolls

5. Peaches

6. Coke

7. After-dinner chocolate (and lots, at that!)

Bad Moon a Risin'

Being in the 11th hour of my Med-2 year is a frightening thing. A lineup of what has to occur over the next 43 days:

1. 8 ISP exams -- endocrinology, gastrointestinal path, reproductive path, ophthalmology, neuro path, psychiatry, hematology, and rheumatic & musculoskeletal pathology

2. Advanced Cardiac Life Support (ACLS) training -- two full 8-hour days in April and an exam for certification

3. PCM exam -- April 13

4. CAPSTONE x 4 sessions

5. PD/PCM OSCE (a kind of "hands-on" test where we interview standardized patients and conduct physical exams as well)

6. CAPSTONE exam -- April 25

All of these things have to happen BEFORE I can really start digging into my Step 1 board preparation. I've started using the First Aid series (a nationally recognized prep tool) in my tradition studies in order to familiarize myself with the layout of the texts, and sometime next week I hope to begin the process of working through 2,250 USMLE-style Q-Bank practice questions.

Should I somehow mess up and survive the imminent three-month-long nightmare, I have one of the hardest rotations in all of medicine -- Surgery -- waiting for me on the other end. Yippee.

Predators Blow It

After spending much of the season firmly entrenched in first place in the Western Conference, the Nashville Predators were humiliated in back-to-back games against archrival Detroit on Tuesday and Wednesday nights. The losses (5-2 and 4-2) drop Nashville into second place in the Central Division and into the 4th seed position in the upcoming NHL playoffs.

Superman #660

Taking a break from the Arion/End-of-the-World/Armageddon arch that has encompassed the last five or six issues of Superman, this month's addition finds the Man of Steel in a more "comic" predicament. An absurd gangster known as Nitro G, who has the ability -- imagine this -- to magically create explosive nitroglycerin (NTG) out of thin air, seeks help from long-time Superman nemesis Prankster in order to knock over a couple of Metropolis-based banks. The Prankster's role in this comic is quite generic: create a laughable diversion so Superman comes running in to save the innocents below, all while Nitro G and his band of thugs can go and steal millions in diamonds and cash.

Fool Superman once -- shame on you. Fool him twice -- nah.

Who didn't see this ending coming? After Nitro G threatens to kill Prankster with a flaming ball of NTG, Prankster succumbs to his demands, only to (literally) expose Nitro G and thoroughly embarrass him -- with Superman's help, of course.

Ah, the hilarity of it all. Sometimes I wonder why I pay $2.99 for a couple of new comics every week, but the sheer ridiculousness of the stories and the joy I get out of reading them more than makes up for the price.

End o' Quarter Doldrums

After waiting 10 weeks for the end of the quarter to arrive, the next-to-last chapter in my 6-part preclinical sequence is finally finished. The undergrads have finals this week, with Spring Break commencing just as soon as one walks out of his/her last exam. ISP students, on the other hand, have no such thing as a spring break to tide us over until the next round begins -- the knocks keep on 'a coming whether we like it or not. Next week's trip to TN with Sula will help stem the malice of ISP's rigorous springtime demands, but even there I'll have to work mornings in the TTU library simply to "keep current" on what is going to turn out to be the most furious two-month period of my life.

All that being said, I find the end of this quarter especially bittersweet in terms of my hobbies. The very first week saw football come to a crashing halt, and now basketball season's winding down, leaving me with no school sporting activities to keep up with on a near-daily basis. Unlike most other fans, baseball season takes a while to wind up for me -- by about mid-May I'm usually really into it, but April is still cold in Columbus, so I'm unable to join the Boys of Summer until my skin turns a bit darker.

March Madness is nice, and April's showers suit me just fine, but give me Sula, a Barq's Root Beer, two lawnchairs, and a wide-open stretch of beach to help these winter blues roll away. Catch you on the flipside.

Time for OB/GYN

Today I'll dedicate the entirety of my study time to obstetrics and gynecology.

Let the joking commence.

Fill Out Your Brackets

Two nights ago Sula and I filled out our NCAA Tournament brackets:

TC3MD's Final Four:

Oregon (3 seed, Midwest)
UCLA (2, West)
Texas (4, East)
Ohio State (1, South)

Sula's Final Four:

Wisconsin (2, Midwest)
Pittsburgh (3, West)
Boston College (7, East)
Ohio State (1, South)

Championship game picks:

TC3MD -- OSU 66, UCLA 63
Sula -- OSU 89, Wisconsin 88

Of note: Sula also picked 13th-seeded Holy Cross to fall in a tight game against Pitt in the Elite Eight. I love you, babe, but it ain't happening!

Both brackets include a Sweet Sixteen matchup of 5th-seeded Tennessee against Ohio State. If this happens, I see OSU dominating the paint and Oden pouring in at least 27 points.

Surprise, surprise that at least half the sports writers on CNNsi.com, ESPN.com, and cbs.sportsline.com are picking the Florida Gators to bring home the hardware on April 2. My bold prediction is that Florida doesn't make it past the Elite Eight.

Two years ago I correctly picked the national championship game (North Carolina over Illinois), but last year's tourney busted my bracket after the first weekend. Never, ever, ever will I pick Florida to win any sort of championship, not even if my mortgage or school loans were on the line. My upbringing as a die-hard Vols fan surely prevents it, and I'm pretty sure my dad would hemorrhage out if I ever tried such a thing.

I think we'll try to keep the old man around a few more years before attempting anything risky ...

OSU Wins Big Ten Tournament!

The rubber match between #1 Ohio State and #3 Wisconsin left no doubt as to the identity of the better team this time -- after splitting two games with the Badgers by a total of four points, Ohio State steamrolled to a 66-49 victory in the championship game of the Big Ten Tournament.

Curiously, #5 Florida -- a 21-point winner over Arkansas in the SEC tourney -- secured the top overall seed in the NCAA tournament, which begins this Thursday. When did the NCAA basketball selection committee start rewarding teams of one sport based on the championship game successes (or, in the Buckeyes' case, failures) of their football teams?

Hat Trick

Conference freshman of the year and defensive player of the year Greg Oden scored 22 points, grabbed 8 rebounds, and blocked 4 shots in leading #1 Ohio State to a 72-62 victory over Michigan in the quarterfinals of the Big 10 basketball tournament earlier this afternoon. The win caps a 3-0 season against UM in men's basketball and means Ohio State will finish the 2006-2007 academic year without a loss in the three major sports against its arch rival.

The Difference a Week Can Make

Another Friday, another Capstone class, another day of feeling bad about ... no, wait! I actually knew what was going on in all the cases today! How did that happen? I think knowing what to expect from the course now helped me calm down enough to let my instincts take over. I'm beginning to be able to sort through all the different tests, signs, symptoms, etc., etc., and arrive at a decent differential of diagnoses. They're not always 100% accurate, but progress -- substantial progress -- is being made as I type this. Neurons forming new pathways and connections, glial cells cleaning up all the garbage that doesn't belong, Vince trying to climb walls ...

[Abrupt ending. We've got a rotten cat on our hands here, folks.]

Torture on TV

Sula sent me an article this afternoon that makes mention of certain groups of people who think Jack Bauer is too violent for primetime television.

These people likely will not wake up in the morning.

Wit

This gem of a movie from Emma Thompson (2001, HBO Home Video) tackles head-on the issue of physician insensitivity in a medical field increasingly dominated by poor bedside manner. Thompson plays the role of a hard-nosed English professor whose otherwise brilliant career in academia parallels the obstructive roles professional hubris and lack of compassion can have in medicine as well. Playing a difficult role as a patient slowly dying of stage 4 metastatic ovarian cancer, Thompson initially delivers each line with the poise expected of an unforgiving professor but becomes more and more human as her life painfully comes to an end. She is the embodiment of what we loathe in college ("that" professor whose mother you would love to slap) and a reminder of the humanity behind the falsely fabricated mask of intellectual self-importance. No matter their past, present, or future, patients certainly deserve more from us than this.

Gears of War Obsession

The only video game I've played for the last four months is Gears of War on the Xbox 360. Normally I don't obsess over one game for such a long period of time -- even Halo 2 and Knights of the Old Republic didn't garner this much attention. In terms of dialogue and offering wide-open gameplay, Gears is below average. Missions must be completed in sequence, and the ever-annoying "sudden appearance" phenomenon (e.g., when the player crosses a certain imaginary threshold or changes rooms, new enemies suddenly appear out of nowhere) is used way too often for my tastes. Weaknesses aside, however, this is one of the more perfect system-based shooters available, simply for its over-the-top grotesque presentation, super-tight controls, and addictive adrenaline-pumping action. Blowing an enemy to shreds with the Torque Bow or chainsawing monsters in half with the Lancer rifle's supersweet bayonet never gets old.

Printing Party

Tonight Sula and I participated in our last printing party -- 228 pages of pure musicological goodness is now finalized and ready for binding, courtesy of Prior Health Sciences Library!

BooksBooksBooks

One thing I haven't held back on purchasing in medical school is books. Many of my peers prefer to obtain required learning resources online (either free through the library or in purchased e-book format), but there's something about the smell and feel of brand new books that I find highly appealing. Perhaps I'm a bit old-school, but flipping through page after page of unforgivably dense text and finally finding the answer to your question(s) is more rewarding to me than using an auto-find feature on a web browser.

In other news, I just celebrated my 75th birthday and am currently telling tales about how "there was no such thing as toys when I was a kid" ...

Tax Season Tactics

I'm a fan of getting my taxes done early. Way early. It helps that OSU's due date for FAFSA (Free Application for Federal Student Aid) submission is March 1 and that the FAFSA requires one's tax information from the previous year, but it's also much less a headache and source of stress than waiting around until April 15.

Apparently, most of my fellow countrymen do not share the same sentiment. The IRS is now reporting that an estimated $300 billion in due taxes goes unpaid every single year -- an average of $2680 per household. In other words, this amount is more than enough to cover the national deficit, pay for Pres. Bush's overseas mistakes, and help rebuild New Orleans. About 70% of that amount comes from underreporting on the part of individual Americans while the remainder can be tagged to businesses, both big and small.

I fail to understand the sense in this. Perhaps it's the fact that I've never made enough money in a year to require a hefty pay-in during the spring, or the fact that my parents raised me better than that (when all else fails, blame it on a good upbringing!), but it seems one of the most moronic things you can do is expose yourself to an audit that potentially could destroy your finances for the rest of your life. Don't get me wrong: I loathe the fact that we as a people allow our government to fleece us for nearly 40% of our collective income by requiring as much in payment for its below-average services, but hasn't the old adage, "Give to Caesar what is Caesar's," been proven most wise already?

Ohio State Beats Michigan ... Again

Since I've been at Ohio State, the three major varsity sports -- football and men's & women's basketball -- have beaten the University of Michigan like there's no tomorrow. This afternoon was no different. The #1 Ohio State men's basketball team came from behind to win its 14th consecutive game, this time over Michigan 65-61 in front of a loud and supportive crowd in Ann Arbor to finish 15-1 in conference play (the lone loss coming Jan. 9 at Wisconsin) and with a final regular season record of 27-3. The other two losses were at North Carolina (without then-injured superstar center Greg Oden) and at Florida (in one of Oden's first games back).

The question of Ohio State's recent sporting dominance over UM is starting to pop up in local indie newspapers -- "Has this gotten old yet? CAN this ever get old?" Both can be summed up quite succinctly: No. During the '90s Michigan owned OSU in football, and until the latter part of the decade the same could be said for men's basketball as well. Now the pendulum is in full swing back toward Columbus, and most sports fans in town couldn't be happier.

It would be ludicrous to expect such good fortune to last forever (next year's football game, in addition to be played in Ann Arbor, will be OSU's first without Wolverine-killer QB Troy Smith since 2003 [perhaps not so ironically, the year of Ohio State's last loss to Michigan]), but rest assured the entire state is enjoying what has been a long time in the making.

CAPSTONE

The "final course" of the first two years of medical school at Ohio State is called CAPSTONE, a class designed to put the finishing touches on pre-clinical medical learning and prepare the student for life in the trenches next year. Last Friday (2/23) was my class' first CAPSTONE meeting, and I left feeling absolutely stupid. The entirety of the first two years of medical school is spent learning physiology and disease states in a 'unidirectional' manner -- i.e., name of disease, etiology (aka "causative agent"), epidemiology ("who gets it?"), pathophysiology ("how does it work to cause disease?"), signs and symptoms, and treatment. I've trained my mind to work fairly well in this manner, as reading through a course packet or a fairly dense pathophysiology textbook is no longer the chore it once was.

But here's the thing about CAPSTONE -- now I have to "unlearn" everything I've learned about medicine and start applying it in reverse. Last Friday we were given six packets of patient cases; in each of these packets are summaries of four fictional patients with a wide variety of current medication lists, presenting symptoms, physical examination findings, and relevant histories. Our job now is to apply what we've learned since August 2005 and find out exactly what is causing the problem. Easy, you say? Think again.

The only analogy I can think of is this: imagine learning to play the piano without your hearing. Your ears have been plugged, and the only things you can rely on to play this instrument are (1) your manual dexterity, and (2) your sense of sight. You certainly would be able to read the music and process your visual sensations into specific finger movements after a good deal of training. That part is like being a Med-1/2 student.

Now imagine your ears have been unplugged for the first time since your piano training began -- except now your vision is taken away in return. Part of the skill set you used to learn the material in the first place is gone, and now you need to teach your ears what your eyes already knew using only the memory of movement and placement ingrained in your fingers. The only problem is that you need to do this quickly. And flawlessly. Why? Because your grade and subsequently your chance at a prestigious placement in postgraduate training depend on it. This is akin to being a beginning third-year medical student.

Ready for a breather yet?

Despite the overwhelming nature of the course, I think CAPSTONE will be of great benefit to those of us willing to take it seriously. The learning curve is steep, but in the wake of "solving" the first case (see below), I believe our group of six students has taken the first step in the process of transforming our thinking. And that is a very good thing.

Case 2a -- 3/2/2007

Middle-aged white paraplegic female with a history of breast cancer with spinal metastases presents with a 2-day history of progressive dyspnea (shortness of breath) and tachypnea (increased number of breaths per minute). Patient has difficulty completing a sentence without stopping to catch her breath and has difficulty eating and drinking. Patient denies chest pain but does have a dry cough.

Medications:

Naproxen 375 mg po BID
Percocet 5/325 mg po q6h
Duragesic patch 75 mcg q72h
Xeloda (dose unknown), per protocol

Physical Exam:

Temp. -- 100.4F (normal 98.6F)
Respirations -- 40 per minute (normal 12-20)
Heart Rate -- 149 per minute (normal 60-100)
BP -- 90/40 (normal 120/80)
Pulse oximetry on room air -- 89% (normal 99%)
Pulse oximetry on 100% oxygen -- 93%

Due to her immobility, history of malignant cancer, heart rate > 100 bpm, and increased respiratory rate, our group diagnosed this patient with a pulmonary embolism resulting from deep vein thrombosis (i.e., a clot resulting from stagnant blood in the deep veins of the patient's legs broke off from its site of formation and traveled through the venous system into the right side of her heart; since blood from the right side of the heart is pumped into the lungs for re-oxygenation, this clot became lodged in pulmonary vessels leading to the lungs and is causing her shortness of breath, increased rate of breathing, and decreased arterial oxygen content).

It seems easy in hindsight, but when first confronted with this illness script after learning about pulmonary emboli in the way described above, it was a bit daunting, to say the least. Several different diagnoses have to be considered and discarded before finally settling on the most correct one (the process of developing such a list of possible problems is called "formulating a differential diagnosis"), and eventually it will have to be done within a matter of seconds. All the possible disease states this patient could have -- pneumonia, pleural effusion, acute pulmonary edema, sudden inflammatory response syndrome, congestive heart failure, etc. -- have to be thought of, considered, and ruled out before the doctor can begin discussing treatment options with his/her patient.

I was lucky to be able to come to a conclusion after an hour of re-reading through textbooks and study guides. Your doctor is able to do this in less than 15 seconds.

I've got a long way to go ...

Hey Coach Amaker ... Shutup!

Michigan coach Tommy Amaker was called for a 2nd-half technical foul in this afternoon's Ohio State v. Michigan basketball game; apparently Amaker was incensed that OSU center Greg Oden was not called for a foul on the other end.

First of all, if there was a foul committed, it would've been ticky-tacky at best. Second, Amaker's goons were all over Oden the entire game: he ended up with four fouls simply for playing in the same way Michigan's hackers were doing.

Next time, Tommy Amaker, do yourself a favor and keep your mouth shut. Until your verbal diarrhea, you benefited from some major home cooking and were on your way to an upset of #1 OSU. Now you find yourself not only the loser of a game you should have won, but you quite possibly cost your team a spot in the NCAA tournament. Way to go!

Yarn Store Outing

Today's adventure will be to the yarn store (with Sula -- I've only made one solo trip and am frightened of doing so again) and to Kroger. I find knitting adventures to be somewhat cathartic, but I'm always able to fill right back up again with a little junk food from the snack section at Kroger.

Only three hours left in the 4th season of 24 -- terrorists have just released the warhead-containing rocket into the sky, Jack Bauer's caught the ire of the Chinese government for his attack on their U.S.-based consulate, Audrey's ticked as can be at Jack, and the Tony/Michelle tension is starting to ease up a bit. How can Jack possibly take down the rocket, win back Audrey, and save his own skin all at the same time?

After several consecutive days of near-springlike weather, a small snowstorm again blanketed the area this morning. Ahhhh, winter in Ohio!

The Strangest Film

I love the Gilmore Girls. There, I said it. Laugh, point, smirk, and whisper your good-for-nothings behind my back -- I'll just be sitting here enjoying sass and wit and pure weirdness, the likes of which you can't begin to imagine. In one of the past seasons, Kirk, perhaps the most eccentric of all residents of Stars Hollow, CT, produced and displayed a film he created co-starring the equally odd Mary Lynn Rajskub (she of 24 fame as CTU agent Chloe O'Brian). This 2-minute masterpiece is so bizarre it makes me uncomfortable and slightly hiccupish. Especially noteworthy: the out-of-place "I love you" delivered to Kirk before entering the house.

Last PCM Ever!

Today I attended my last PCM small group ever -- patience and perseverance are not two of my strongest qualities, but somehow I managed to pool two years' worth of both into accomplishing this single task.

PCM (Patient Centered Medicine) is a class Ohio State offers in addition to the core curriculum that focuses on the doctor-patient relationship and its importance to the student. The two components of the course, lecture and small group, offer different takes on a given topic within the current subject (i.e., Ethics, Substance Abuse, etc.). The lecture component generally introduces the topic to the class, then the small group session serves to further elaborate on it in a more "intimate" environment.

I don't know what it is about PCM that bothers me so much. The facilitators have all been excellent, the material is clinically relevant, and I enjoy hearing my classmates' opinions on different -- often controversial -- medical matters, so what could be the problem? Maybe it's my own impatience shining through, or the fact that the core curriculum seems so much more important right now, or that my ISP status effectively is negated by the small group attendance policy (only one "allowed" absence per year). Whatever it is, there's a kind of je ne sais quoi about the whole affair that leaves a bitter taste in my mouth.