Sede

I've had a lot of thirst lately. Mostly in the morning. When I arrive to the hospital, I put my stuff away and head straight for the nurse's lounge, where there is a water cooler. I find a 4 oz cup. And I drink. I drink as though I'm not going to have the opportunity to drink later in the day. I fill up that little fucking cup about 10 times. 40 oz of ice cold water. Sometimes the water is so cold I have to take a break because I don't want an ice cream headache. But once the feeling of impending brainfreeze passes, I continue to drink.

I cannot explain this morning thirst. It is a symptom with which I am not familiar. Maybe my room is hot and I'm losing water through insensible losses. Maybe I'm not hydrating well enough during the previous night. Regardless of the cause, my thirst rages during the morning and I correct it in full display of the nursing staff. I'm pretty sure they think I'm an alcoholic. If I were them, that would be the most logical explanation for my morning thirst...

Granos

Ever since I've arrived to Buenos Aires, I've been breaking out in pimples like a nerdy adolescent. I have no idea why this has been happening. My skin hygeine is still excellent. I'm advancing in age, which I think should decrease my risk for pimples. But no. This has not been the case. My T zone has been the breeding ground for a number of angry pimples. When I first started in the intensive care unit two months ago, I had a ferocious pimple on my nose. It hung around for so long I thought it was infected with a superbacteria that I had caught in the ICU. Now I have one on my lip, unfortunately a common landing zone for these pimples.

I've hypothesized two reasons for this outbreak. Uno, the change in the climate. Not sure what the scientific basis for this theory would be, but correlacion=causation??? Also, along the same lines, it could be the food. But the food here is generally less greasy than the food in the US. I have been eating a lot of chocolate — that could be it. Que se yo...

Agotado

Speaking and listening to Spanish is exhausting for me. Obviously I have to pay much closer attention to Spanish than I pay to English because if I miss a word — bam — the entire story someone was telling no longer has any chance of making sense. The only days which I don't come home exhausted are the days when I don't do a good job paying attention and am therefore not tired from the normally-exhausting processing I'm doing while listening.

I imagine myself to be like a video game character when I'm attempting to endure hours upon hours of Spanish. I start out with a certain amount of life in the beginning. When people speak Spanish to me, I gradually lose life. At the end of the day, I don't have any life left. Little things can restore some life — lunch, naps — but son pocos.

I'm convinced that the bilingual center of my brain, located somewhere between Wernicke's and Broca's areas, is underdeveloped. The constant insult of Spanish has been sending massive amounts of blood to this area, which is clearly accustomed to minimal blood flow. Yes, that is what's happening.

Pimped: Parte 2

I suppose for this story, I wasn't actually being pimped as the question was directed at the general population. The question was what condition does Eikenella Kingella normally cause in the context of a fantastic lecture given by an ID specialist about common manifestations of rare bugs and rare manifestations of common bugs. Anyway, after a few seconds of silence followed said question, I blurted out the answer in my shitty Spanish: endocarditis. It's a HACEK organism.

The lecturer signaled that I had gotten it right: bueno. And even asked me for my name because I'd been so quiet in the last few lectures that I hadn't really existed until now. Then he told me felicitaciones. Pretty funny stuff — especially beacause it was me and 4 residents in the room, one of whom said, "huh?" when the lecturer mentioned the name of the bacteria. Anyway, on the flip side, these residents know more than me so it was nice to take advantage of some special secret trivia knowledge.

I'm still feeling stupider by the day, but the rate at which I'm feeling stupider has slowed down. You follow me — you gotta know derivatives and shit to understand that. I'm a dumb nerd.

Intoxicacion por Alimentos

I abruptly awoke at 3 AM this morning with painful cramps in the tummy and a powerful urge to go to the bathroom. As well as farts. I got out of bed, put my sandals on quickly, and rushed across the patio into the kitchen and reached the bathroom. Upon making it to the toilet, I had diarrhea. The same story repeated 2 hours later. And then 2 hours later, when my alarm went off. I texted one of the residents to tell him I would be late to work. He responded with the following text, "Estamos igual. Todos con el mismo problema. Fue el pollo seguro." In other words, the lunch we ate yesterday was the source of our food poisoning.

Upon arriving to work, after the runs had settled down enough for me to be sure I wouldn't crap my pants on the bus ride to the hospital, I learned that the staff of the entire hospital had suffered from this same diarrhea. Secretaries, nurses, doctors. There was a debate about whether it was the rice or the chicken in the lunch. There was another debate (of course, we're in a hospital) about the identity of the causal organism. Top candidates were S. Aureus, B. Cereus, and E. Coli. Anyway, it was probably an toxin-producing bacteria since everyone improved after 10-12 hours. And btw, everyone ate the lunch today. Ravioli, salad with carne (yikes!) and fruit salad. Probably the unluckiest person was my friend who was on call. Upon just falling asleep at 4AM, he was awoken by a torrent of diarrhea. Pobre.

Mullet

Without realizing what was happening, I grew a mullet. That is half true at least. Here's the story... I got a haircut a few weeks ago. It was a pretty good haircut. Hair was even — there were only a few hairs I had to cut myself to even things out when I returned home and looked in the mirror. I'll admit it — I realized that the back was a little longer than it normally is. Anyway, when it was first cut, it was not a mullet. Over the past few weeks, it has grown into a mullet. How do I know?!?!?! Because my hair curls when it reaches a threshold length. The hair on the back of my head is curling. Front — straight hair. If I were to listen to what the hair on the back of my head were saying, I would get a haircut tomorrow. The hair on the front of my head tells me that I can wait at least of month before a return trip to the barber.

On another note, there are obviously many words that don't translate precisely in terms of meanings in English and Spanish. One subtle example is bueno. In many cases, bueno means "ok" and not "good", it's primary definition. A subtle, yet important difference. For example, today a nephrologist was discussing with a cardiologist how a patient was pretty much fucked. When the conversation ended in the mutual agreement that the patient was in a futile situation, the nephrologist said, "bueno." He did not mean "good".

Confidence

Okay — now for the first serious post of the blog...

I learned a lot about myself during third year of medical school. It was a year full of emotional swings for me. I can remember certain points where I rode highs of confidence and plenty of times where I considered myself subhuman. From all of this, I realized that my self-confidence is largely decided by how I perform academically — I guess now it would be considered professionally. I can distinctly remember days where I felt as though I had performed well in the hospital — when I returned home and did whatever or if I went out that night, it didn't matter what happened — I felt good about myself.

Upon discovering that my self-confidence was inextricably linked to my professional performances, I searched to see if others derived their self-confidence from school/work as well. I learned that I am probably in the minority. When I feel smart, I feel good. For others, this relationship does not hold true.

I knew before I came to Bs As that my confidence would take hit for reasons I've already explained above. When you don't understand the language and when ppl don't understand you, it's tough to get a sense of feeling smart. Also when you're bad at learning languages in general, that's another problem. However, I've tried to do some things so I can retain at least a minimum level of confidence.

Step 1 is to have already done third year and succeeded, which I did: i.e. build up a reserve of self-confidence for cold winters when there is sure to be a shortage of opportunities to feel smart. The second step is to break the connection between self-confidence and performing well professionally because for at least the first 3-4 months that I am here, there is little chance of performing in a way that I would consider successful. Anway...so far, it's not going so well — there are days where I get really worked up and just want to speak english and explain that I actually understand what's going on (although these occasions do not occur often). But I don't — and I don't know if I should consider the inner-explosion of frustration as a lapse into bad habits or the successful bottling of the frustration as a victory, working towards a steadier sense of self-confidence.

The funny thing about my connection between intelligence and self-confidence is that it doesn't matter if I am smart, e.g. have a high iq y cosas asi. What is important is that time in and time out, I prove that I am smart. It seems strange to write and even if this idea is more common that I think, I definitely have a little embarassment admitting to it. Why couldn't my self-confidence be derived more from being nice to ppl? That's a good things to do and relatively easy as well. Pero no es asi.

The reality is that I'm not here to improve my self-confidence. That's a pretty ridiculous reason to do anything. Also, you don't move to a foriegn country where you don't know the language — away from an environment you feel extremely comfortable in, — to feel smart and in control. Por lo menos, life is not all about self-confidence and I'm hoping that I can find other personal characteristics(??), characteristics which have in the past been pushed aside for the sake of self-confidence, to cultivate while I am down here.

Man, that post was really self-absorbed. I promise, no more of those. Sheesh...