Writer's block...

As evidenced by my 2 blog posts over the past 4 years, I've been anything but a prolific blogger. I've always been reluctant to blog - mostly because of fear.. but let me explain. Anything one post on the internet will be tied to that individual for eternity.. I don't know about you, but that scares the bergeesus out of me. With the emergence of social media tools like Facebook and Twitter, the microscope by which others judge our words has become increasingly magnified and reactionary. If you don't know what I'm talking about, just look at what happened to Pittsburgh Steelers running back Rashard Mendenhall in reaction to his Twitter comments after killing of Osama Bin Laden. While Rashard's comments might cost him a few million dollars here and there in endorsements and the like, it's not necessarily going to jeopardize his career as an elite NFL running back - he's not paid for his thoughts, he's paid to move the rock. As for an emerging physician posting his (or her) thoughts in the public domain on the other hand, he must be very measured and careful about the details or even opinions he posts about as it could cost him (and in this case she) her job. While this case, as discussed by the prolific medical blogger @KevinMD, was an example of a ER physician indirectly violating HIPAA policy, who's not to say a physician could not be fired from a hospital group for sharing their opinions about the rights to abortion or the use of medical marijuana, for instance?

So it's because of this fear, that my two previous blog posts have been very laboriously thought out. I'm not saying that either of these posts were impeccable or even right - but I wrote them with the notion that, if I were to ever run for Congress, for instance, would these words jeopardize my credibility.. And you might ask, what credibility does Derek have?! It's not necessarily the credibility that I possess at this time insomuch as the credibility I will gain as I develop into a surgeon/entrepreneur/public-policy thinker/whatever.  However, in my mental efforts to 'let go' I began by looking up what it means to "blog."  According to Merriam-Webster, a blog is: "a Web site that contains an online personal journal with reflections, comments, and often hyperlinks provided by the writer." During these past 3 years that I've been doing research, I've fallen in love with the podcast - which is essentially an audio blog.  It's often just a reduplication of a radio or television show, but sometimes it's a de novo discussion, uncensored and often very raw, but when intelligent individuals are on the other side of my earbuds, the often witty and unfiltered thoughts delivered routinely bring a smile to my face and a little joy to my usually mundane tasks of loading an SDS-Page gel or orally-gavaging Wistar rats with poision (warfarin), for example.  I listen to a lot of sports & technology podcasts, but I also enjoy catching up on NPR All Things Considered or an occasional Real Time with Bill Maher via the audio format.  I must say, however, that my true blogging inspiration comes from the sports writer Bill Simmons (@sportsguy33). He blogs and podcasts about pretty much all sports, but always tries to tie in popular culture references in one way or another, and does it in such a clever way that he often has me ROFL (Rolling On the Floor Laughing - come on Mom and Dad.. I'll get you speaking internet in no time!).  If I've peaked your interest, head over to Grantland.com.  I guarantee you'll be entertained. But I digress.. 


From now on I plan (and hope to keep my plan) to blog. Medical students are notoriously bad about keeping in touch with friends and loved ones due to the demands of school. I was already bad about keeping in touch, so medical school didn't do anything good for me in regard to these habits.  As I move away to begin my surgical training in 2 weeks time, I will likely be more isolated than I've ever been - both mentally and physically. I hope to use the blog, not only to keep in touch with you, my friends and family, but also the general public since this is a public blog and I am beginning to develop my public persona (which is apparently important for physicians to do). To my family, I have tried to keep you guys up to date as I went through the match process because I felt it the easiest way to communicate. I still plan on using email as there are some things too private for a public blog, but I encourage you to check in here periodically to see what I'm ranting about..

And on that note, I would like to attempt to address a question that was asked of me by my lovely soon-to-be mother-in-law last December because it is a question and naivety shared by many. (no offense Deb!)

I paraphrase her question, but it was something to the effect of "How busy are you going to be during residency? My only experience is from what I see on TV, specifically the show Grey's Anatomy."  


I can honestly say that I watched Grey's for a season or two.  It was a pretty interesting show. Mostly because of intertwining relationships of the residents and the attendings. I think it's safe to say, however, that show's meteoric rise in popularity wasn't due to the once-every-two-episode surgical emergency where a man was impaled with a large metal rod, or 45-person trauma was coming through the ED. I have not seen Grey's Anatomy in many years, but let me debunk a couple of myths portrayed by the show.  


First, the surgical residents always seem to head to work after sunrise, and leave work before sun down - this is probably the grossest error of the show.  Prior to the soon-to-be imposed new Resident Work Hour Requirements, the legislated "80-hour work week" was least followed by the surgical field.  Even though surgical residents reported working 80 hours in their work logs, they were often working 100 to 120 hours a week, serving 'on-call' every 3rd or 4th night (a 30+ hour shift at the hospital). The new requirements will require that I, as an intern work no more than 16 consecutive hours - but I will still be bound by the 80-hour weekly cap.  And you may ask yourself, how are they going to limit us to 16 hour shifts when interns used to 30 hour shifts? Answer: Night float. While I don't have my schedule yet, I am certain that at least 2 out of the next 12 months, I'll be working the graveyard shift (probably 7P - 7A).. So there may be periods where you rarely hear from me at all.. consider yourself warned.  


Next myth: all the residents in the program social and fraternize with each other (including some shenanigans in the call room). The main characters in Grey's Anatomy were all in the same year when the show started - the intern year. And somehow, they got to work with each other every day, eating meals together, and hitting the local bar together after a 'long' day. As an intern in a relatively small residency program, I will likely be the only intern on a particular service (e.g. vascular, pediatrics, etc) at any given time. The only time I will see my fellow interns will be at the weekly conferences, didactics, grand rounds, etc.. with the occasional beer in that rare opportunity that I share a day off with a fellow intern who doesn't want to use that time to sleep or spend it with his or her spouse whom he hasn't seen for 10 days at a time.


Final myth, residency though difficult at time, is mostly roses. In Grey's, the residents are always standing up for themselves and asserting their opinions. Let me put it to you like this: Surgical residency can best described as a cross between this scene from A Few Good Men 

and this one from Black Hawk Down.   

Of course I jest, but let's just say it's going to be intense.


So in conclusion, I will make some promises:

1. I may or may not blog on regular basis, but I have every intention posting 2 or 3 times a month as I take my journey through this new phase of my life. I may post multiple times in a week, and then you may not hear from me for a month.  I make no guarantees - only intentions known.
2. I will 'blog.'  This means that in addition to opinion pieces that might circumvent public policy issues, technology or issues that I observe with the surgical profession, I will also try and use this medium as a journal.  Some posts may have absolutely nothing to do with medicine.  While I may blow off steam here from time to time, as I said before, my words will be forever etched in the internet stone - and I will always try to be mindful of this. 
3. Not all my post will be nearly this long!  Holy crap I need to stop writing and go read a text book.