The Business of Being Born

Also a very interesting documentary by the same name. Thought provoking. If you want your thoughts provoked, go check it out streaming on NetFlicks.

I'm starting my Obstetrics (baby delivering) part of Ob-Gyn this week. On Labor and Delivery next week. Been studying my ACOG (American College of Obstetrics and Gynecology) Clerkship book:

"Cesarean delivery is the most frequent major operation performed in the United states. Until 1965 the rate of cesarian delivery was stable at less than 5%, when it began to increase; it was more than 30% in 2005....However, no major improvements in newborn outcomes have occurred as a result...Decisions regarding cesarean delivery have important ramifications, because the maternal mortality rate associated with cesarean delivery is two to four times that of a vaginal birth."

Also very interesting in light of listening to This American Life this week, which was part 1 of a 2 part series on...what else, but the hot topic of American Healthcare. Estimates are that 30% of the medical care in this country is unnecessary. And isn't making us any healthier. In fact, it may be harmful. And, this blew my mind to think about it this way, medicine doesn't seem to follow the normal supply and demand curves. When the number of doctors goes up, the number of visits, and interventions goes up, and they don't become any cheaper. They just become more frequent. You can listen to this podcast til next Monday for free on This American Life: More is Less.

It's an interesting career I've signed myself up for. Excited to learn more.

Rotations

Greetings to my long lost blog. Where have I been? One word: rotations.

So far, I've complete two weeks on dermatology (awesome hours, nice residents, small surgery bonus), two weeks on radiology (booooring, and my grades probably reflect that I was bored the entire time), four weeks on neurology (a completely mixed bag that I both loved and wanted to tear my hair out over), and one week on psychiatry.

I've learned a lot so far, but rather than dwelling on medical trivia, I thought I'd pontificate on those things that have a larger life meaning.

-I'd rather be frustrated with the medical system in place than become apathetic that we're not providing good care (see article below).

-I love "crazy" people. (meaning, I love my psychiatry rotation, in lay terms) They are fascinating, and rarely all that crazy. They're often just normal, magnified.

-When you work more than 14 hours in a day, a iced chai is in order, with no guilt.

-Leave work at work, as much as you possibly can.

-You'll always remember a face and a person better than a chapter in a book.

Here's an interesting article I came across in The Atlantic Monthly. I haven't even finished it yet, but I think his general premise about American's (through little fault of their own, since the system has evolved this way because of various legislation and tax benefits) propensity to expect their health insurance to pay for ALL health care, even routine, as erroneous, and a big part of the reason we end up paying more for health care is a good one. After all, if you were paying out of pocket, wouldn't YOU be more likely to find out how much it cost and why?

Health Care Killed My Father

Can someone explain?

Why do signs outside of elevators say: "In case of fire, use stairs"?

For the first six or seven years of my life, I literally thought that I could never use the elevator, in case there was a fire while I was in there.

I think its missing a word. "In THE case of fire..." or "In the case THERE IS A fire, use stairs." That would be MUCH more clear.

This is right up in level of mystery with why book indexes say, for example: Reflux esophagitis; see esophagitis, reflux. Doesn't that take MORE ink than just telling me what damn page its on?

Also, why are valuable and invaluable the same thing?

Please, can some one explain?

Doga

As one person noted in a comment to this article: The recession can't be THAT bad if people have the money to do this: Doga.

Happy earth day!

In celebration of Earth Day today, I'm going to tell you about the happiest place on earth: Rancho Margot, a "sustainable, off-the-grid ranch" near Volcano Arenal in Costa Rica, which I recently stayed at for two nights while on vacation.

The ranch is the living incarnation of the dream of a Chilean man named Juan, who wanted to be able to live without the necessity of the outside world and in a fashion that would not be harmful to the environment. He's spent the last 5 years building on that dream, and now that the ranch is a reality, Juan rarely leaves. And why would he need to?

The ranch is run on its own power, which is created by harnessing the flow of a small river. The two hydroelectric damns Juan and his team have built are enough to power the large central buildings, the dozen or so bungalows, the field house where the workers live, and the bunkhouse.

Nearly all the food at the ranch's scrumptious daily meals are produced at the ranch, organically (while the coffee was not yet produced there--surprising for Costa Rica, which is known for it's smooth brews--they are working on growing coffee plants, which take several years to produce their first fruits. Also, they need a master brewer on location. Hint, hint).

Gardens...



I think I ate this chicken for dinner...

The food...This was an (overexposed) breakfast.
The ranch builds everything on site: from the windows to the floors. They still bring in the wood right now, but they're reforesting areas that will then be used partially for building as well...

They have yoga twice a day, the way yoga should be done...outside, with the breeze (or the fresh morning mist) blowing at you. This is the yoga studio...

Not only can visitors do yoga at the ranch, but can milk cows, ride horses, go kayaking in the nearby Lake Arenal, hike, go waterfall rappelling, hang out at their natural pools and learn about the huge array of tropical flowers at their extensive gardens.

But...the hot water for the entire ranch is my favorite part. It is heated by the collection of thermal energy from the decomposition of compost. That's right. My hot showers were the product of plants biodegrading and cow/horse/pig poo. Here's the apparatus (they're building a new, bigger one).

The idea is that water is run through the coils (which are deep within the compost, where it gets pretty hot, we felt it) and eventually collects at the end. It's then piped out all over the ranch, including heating the pool.

Cool beans, eh? Have I convinced you that you want to go? Too bad. Juan's ultimate dream is to turn the ranch into an educational center, where people can learn how to live sustainably and provide for themselves in ecologically sound ways. He was just using tourism dollars to get the project up and running. And it's worked. Apparently, they're done booking tourists, they're revamping the bunkhouse into dorms with desks, etc for the students to move in next season.

So, if you tell me to go to my happy place, this is where I'll be...but unfortunately, only in my memory.

Things you could do with $22,344 (other than go to medical school)

In the 2007-2008 school year, I paid 22,344 dollars in tuition (apparently). This is JUST the cost of actual tuition, not living expenses. This year, I've been fortunate enough to be MAKING money, but next year, it's back to rotations, back to no income, and back to paying tuition. This is making me think: What else could I do with that much money?

-Buy a 2009 Prius, starting at $22,000. Good for the enviornment, good for la image.
-Get 319 60 minute massages at Zender's Aveda Salon ($70 a pop). That's almost a massage a day, folks. I guess I can take vacations off, since I'll already be so relaxed.
-Pay in full 38 one year memberships to The Core for all my closest friends.
-Feed 186 children in Africa for a year.
-Happy hour on me: Purchase 8,937 Vine Steins (in Iowa City) or 7,448 (in Coralville). That 50 cent difference sure does add up.
-Fly from Cedar Rapids to London 45 out of the next 52 weekends. *based on a price search for a May, 2009 weekend on NWA*
-Pay off 61% of my share of the national debt, as of today. National Debt Clock.
-Purchase a daily cup of joe from Java House for the next 30 years and 7 months of my life (based on a regular cup of drip coffee at current prices). PS: in terms of time, for the average wait for 3 minutes to get the damn individual drip coffee, this will translate to 23 days of my life waiting for that coffee to drip. Coffee NOW, people!!
-Paid for 2.5 year's tutition at Texas A&M if I were a Texas Resident.

Sigh.

Cedar Rapids, who knew?

To my surprise, I've found myself in my hometown of Cedar Rapids, Iowa several times in the last couple of weeks. Cedar Rapids a pretty white-bread place. Chain restaurants do very well. Trends arrive two years after they become blase on the coasts. The city is used as a testing ground for products (such as the infamously "explosive" Olestra Potato Chips) because it's so ordinary. It's known for flooding, Rockwell, and a mysterious extra season more than it is for its character, class, or art.

So imagine the pleasant shock I received when this weekend I spent a very enjoyable evening at an art gallery (okay, so it's actually in Marion, not Cedar Rapids, but anyone from the area will understand that it is close enough). Campbell Steele Gallery has been in Marion for years, and I know I've been there a time or two in the past, but on Saturday nights the gallery is in the evening, not only to sell art, but to host musical guests. Since a friend of a friend as bartending at the event, we all headed downtown Marion to check it out. Here's a taste:


The gallery space.



Upstairs studio.

The gallery is an open space with high, old-style decorative ceilings and with multicolored glass artworks hanging cheerfully in the front window. Scattered tables housed couples and a few small groups mostly of the 30s to 60s crowd (and a few of us party crashing young-uns like myself). Some were short with chairs, some tall with stools or just for standing, each with a wine bottle with a simple flowered arrangement. Past the art, the audience, and the band, a a small cash bar featuring a few wines, a few (choice) beers, and some tasty looking platters of fruit and cheeses at moderate prices ($5/glass, $4/beer, $12 for tasty snacks).

The band on this particular Saturday was World Port, a duo of guys from the Des Moines area that play an eclectic mix of jazz and all kinds of "world music" (at one moment I felt like I was at a bar mitzvah, the next I felt like doing an Irish jig) with only a guitar and an electric horn. What's an electric horn, you ask? It's like the synthesizer of horns: it can produce all kinds of different kinds of sounds, but you still blow into it and it has fingering "like a trumpet."

The people who own the gallery are also artists, and use the upstairs studio. The upstairs, which is, I gather, not always open, is absolutely beautiful. Brick walls, the gears for an old elevator, lots of plants, hardwood floor, open space, warm light, a docile dog named Buddy...I'd never want to leave. And the thing is, they don't. The front of the upstairs studio space is where they live, and the sitting area we were lounging on, he informed us, was in fact their after-hours livingroom.

The whole evening made me want to be an artist. Though it probably helped that they were the lucky, well-established, and successfully-wine-drinking, world-music-listening types, instead of the starving types.

I'll be going back when they have a pianist, as I'm itching to hear that shiny grand they have in action. I recommend you come with me.