A bit of heaviness for you to marinate on...

I came upon the scene above while tramping through the woods up on Signal Mountain this afternoon... Depending on what caught your attention first, you were likely either enthralled initially by the natural beauty of the scene, or repulsed by the background of decay. I felt both of these emotions, in that order, followed by a serene moment of Zen.

I thought this photograph was such a great juxtapositional representation of the tragically beautiful (beautifully tragic?) conundrum that we face each morning upon awakening; this insane roller-coaster ride that we're all on; this collection of moments of happiness and remorse; of love and rage; of ecstasy and despair...

This thing called "Life"

The New Place

So... after battling the record-breaking summer heat, a slowly worsening hull leak, and the foul smelling yet much-deserved results of having to leave Monte aboard the boat alone during a 14 hour workday, I've decided to find an apartment. The sailboat has started taking on more and more water, and the last thing I'm going to want to do after a 36 hour trauma call is shop-vac my bedroom and pass out on soggy sheets. I thought maybe I could trailer her and do a quick fiberglass fix, but can't locate any obvious damage. I think the bumpy ride north may be to blame, but don't have the time or cash to search out and repair it right now. While I am frustrated with the boat leak causing me to opt out only two months into my pirate adventure, it sure is nice having a cool, dry spot to call home.

My place is located in an old 19th century bread factory, about two miles from the hospital. From here, I can walk or bike to all the downtown attractions (aquarium, bars, dog park, farmers market). I've also been able to retrieve my knives from storage and get back into cooking a little bit. One has only so much creative culinary freedom whilst preparing meals on a camp-stove. Monte is definitely enjoying the space and cool cement on his belly, and I've attached a video of his favorite pastime in the new place...

Anesthesiology is going well thus far... I'm brushing up on my intubation skills and line placements... plus I'm usually done by early afternoon and can entertain the pooch.

I want to say thanks to the fam for helping out with everything, I'm glad I'll have a roof for you guys now when you come visit. If anyone reading this has extra furniture, kitchen stuff, or similar items you'd like to get rid of, shoot me an email and let's talk turkey... Right now I've got an air mattress and a pool table and may need a few other things to round out the ol' Ay Pee Tee...

Cheers from Chat-town

On the Avoidance of Drowning

Looks simple enough, right?

The first month of my intern year is halfway done, and it's been awesome. We've had conferences and skills labs; worked a couple shifts in the ED and figured out the computer system. Even so, I've had a good bit of time for poker, climbing, and most recently, cutting my teeth on some whitewater...

Now, you guys know that whitewater in MS is nearly non-existent... If I remember correctly, the Okatoma has that one hard right turn where you might go ass-over-ears in a canoe if you've had a few too many cold ones, but otherwise it's pretty chill. And the Mississippi River Scouting Incident, (although hella scary and likely the closest to death I've been thus far) likewise did not have rapids or falls to maneuver through. Here in Chattanooga, it seems everyone I meet has some boating experience... Bryan Vance, one of my fellow interns, is a 15 year veteran, having paddled some of the sickest water in the U.S. and New Zealand. We were sharing stories over cold PBRs the other day when he mentioned plans for a trip to the Ocoee, and I jumped on board full steam. Although I'd never set foot in a whitewater boat, had never been in real whitewater, and knew nothing about the C-to-C roll technique (of paramount importance to avoid drowning), I figured he'd be the guy to learn from. Now Vance is a playboater, meaning he stays on one feature or hole for awhile, surfing and doing tricks. This is in contrast to river runners or creekers because you can spend the whole day in one location and not worry about getting from point A to point B. After a quick crash-course in rolling technique, he paddled off towards the rapids, leaving me to practice in the slower moving eddy.

Now the thing about these tiny whitewater kayaks is, you're crammed in so tight that you almost feel you're trapped. So flipping upside down underwater and attempting (unsuccessfully) to right yourself can be a bit...unsettling. I quickly realized just how easily I could dislodge my lanky ass from that boat after a couple unsuccessful rolls. Once I was confident in my ability to escape, my worries disappeared and I started hitting the whitewater right alongside Vance. After paddling a bit I would infallibly get flipped over, flounder around attempting to roll, and bail out of the boat, swimming like hell in the hopes of making it to the bank before being washed down the next set of rapids... (which happened to be named Broken Nose). We played for several hours on some of the rapids and whirlpools, and I eventually succeeded in righting myself a couple times. I bummed one of Vance's boats, and plan to practice rolling in the calm water here at the pier until I'm confident in my ability to avoid both drowning and bailing out. This could be the beginning of some really good times... and no, that's not me... yet.

Game on...

So... the next chapter has officially started: The degrees have been conferred, the Champagne has been popped, and the moving trucks have been loaded... This blog update is coming to you directly from my new home on the Tennessee river. After a whirlwind of fourth year electives, months of travel, obligatory graduation ceremonies, celebratory shindigs, and family reunion-cum-fishing tournaments, I find myself here on the sailboat, newly (and officially, so as not to piss off Poseidon) dubbed Miss Lizzie. Tomorrow begins my year as an Emergency Medicine intern here at Erlanger, and I'm looking forward to getting to work. I'll be pretty steady until November, when I've scheduled a week off in order to support a certain young lady in her ambitions of pounding Manhattan's asphalt jungle...

Lizzo, MD - NYC marathon - 11/7/10... you want to be there.

Thanks to my folks for being awesome and helping move my ass up here... I know the boat trailer was a pain but I can't describe how happy I am to have this rig back in the water... and looking good by the way. After a long winter on cinder blocks, one helluva wash, a new coat of paint, and a new name, my home on the water has some of the local salty dogs envious... I plan to live aboard for awhile, as an exercise in both frugality and minimalism... After the past few months living and camping out west, then traveling through India, I actually feel a bit spoiled floating here on the river with my mini fridge full of Coors and my AC blasting... I have a backyard full of bass, a driveway that leads out to the river, and some really cool fellow pirates as neighbors...

As the dust settles from the craziness of the past year, and I begin the next phase of training here in Chattanooga, I have a feeling that things will work out just fine... The department here is young and dynamic, a new wilderness medicine guy is starting up a fellowship here this year, and the town seems to have a ton of outdoor opportunities... I'm disappointed that Elizabeth and I couldn't stay in the same zip code, but ecstatic that we are in the same time zone... My lady and my mutt are only a short (and beautiful) motorcycle ride away...

Thanks to everyone who helped out over the past several months... I especially want to thank EJH for enriching this whole experience with your love, my awesome family for the support and for all the help with the move, Matt Fitzsimmons and family for the delicious grub, and Stephanie Jane for your organizational acumen and tireless work in putting the graduation party together... You guys are incredible and I truly appreciate each and every one of you.

Namaste... now pass the Guinness

What a ride!

After our monthlong journey through northern India, 17 nights in a tent, and a serious deficit in my normally carnivorous diet, it feels pretty awesome to be sitting here in Columbus digesting a Christy's cheeseburger and sippin' a Fat Tire. I'm glad to be home and excited about the graduation festivities. I look forward to hanging out with the fam, getting ready for the move, and planning the next step. I'll be moving up to Chattanooga, TN and helping Elizabeth as she heads to Lexington, KY. Gonna be a hella-busy few weeks...

India was incredible: Loud, vibrant, dirty, beautiful... I already miss the crazy traffic and the constant in-your-face-ness of Delhi. We began our month in the capital city, touring the bazaars and sampling the food... checking out the Bha'i Lotus temple and the Taj Mahal, before meeting the crew and heading north to Himachal Pradesh. The next several weeks were filled with amazingly beautiful mountain views, incredibly friendly people, and a ton of GERD patients. We then spent another 3 days back in Delhi, exploring, eating, and enjoying the posh amenities of our hotel.

From Delhi we took a train north to Chandighar, then SUVs up to Dharamsala, home to the Dalai Lama and the exiled Tibetan government... From D'sala we journeyed northwest to Saho, backtracked to Holi, then headed southeast to Bir, Bharot, and Manali... These rural areas were filled with smiling, hard-working farmers whose beautifully terraced land was a verdant explosion of wheat, cauliflower, and apple orchards. We saw and treated 300-500 patients a day and saw pathology ranging from cholelithiasis and GERD to CREST syndrome and Bitot spots... Besides local villagers, we also visited and treated patients in several Buddhist monasteries. We were able to tour the monasteries, speak at length to the monks about there lives and experiences, and listen in on the pujas, or prayer ceremonies.

The Himalayan Health Exchange crew was great, our schedule was impeccably organized, the food was delicious, and our campsites were never wanting for firewood. Each afternoon we explored the surrounding hills before returning for case discussions and libations around the fire. We usually camped for a week or so at a time, broken up by 1-2 night stints in guest houses and hostels.

I thoroughly enjoyed the month, and am already brainstorming how to work another HHE trip into residency... Despite India's struggles with corruption and poverty, it is an incredibly diverse, culturally rich country, and the people are among the happiest and friendliest I've met... After another few beers and several ribeyes, I'll be ready to return.

El fin... Almost

As my time here in New Mexico draws to a close, I find myself experiencing the familiar mixture of sadness and excitement... I've had a blast, shared some amazing experiences, and developed friendships that I am sure will last for the rest of my life. Sharing the experiences of rock climbing in Socorro, slaying the gnar in Taos, and riding the rollercoaster of match day has solidified us as a team in many ways... I'm a bit saddened to be leaving this exceptional group of people. However, as the time draws near for the final exam and my journey back East, I am also excited about the next adventure...

The final exam for the wilderness medicine course will be conducted this Friday on Sandia peak... We will work as mountain rescue teams: locating, stabilizing, packaging, treating, and extricating injured patients from the hill... Beats the hell out of a Scantron. Afterwards, we will part ways, off to wrap up the last few months of medical school and prepare for our fast approaching internships...

I will be hitting the road at the ass crack of dawn Saturday in order to spend a bit of time with the fam before jumping on a plane for India. Elizabeth and I will be in Himachal Pradesh for the next month, treating the exiled Tibetan Buddhist monks in Dharamsala before heading out into the Himalayan foothills to set up clinics in the rural villages. After being on the road since around Christmas, I am excited to see my lady, my dog, and my family... You guys are incredible and I love you all... that reminds me:

Happy Birthday Roo!

New Mexico, way better than Old Mexico...

Que onda?

So... after ending my stint in Telluride with a string of powder days, having to reroute after Lizard Head pass was closed by an avalanche, and a quick jaunt out to L.A. for the damn Step 2 CS, I've finally settled into my home for the month of March. Albuquerque and the University of New Mexico, will be base camp for a month-long wilderness medicine course. We will learn search and rescue techniques, camp in some of the most beautiful areas on the planet, and work as the medical teams for the Bataan Memorial Death March Marathon. We will hone our improvisational medicine skills, learn to survive in the bush, and walk the razor's edge of our physical limits... Kinda like summer camp if Silky was in charge... Hoo-ah!

It's gonna be a blast... In only four days we've already learned a ton of improv and evac techniques, experienced hypothermia firsthand, and gotten to ski/bike/rockclimb/hike like crazy... This weekend we will spend learning survival techniques and land nav at Cabezon, a volcanic rock formation some 70 miles into the desert. Then, we'll head north to Taos to study avalanche science and high altitude illness while living in self-dug snowcaves. I've heard the snow is great right now, so I'm definitely planning to put the new sticks to work.

After a day off, its back to work in Socorro with the Abq mountain rescue team teaching us some high-angle rope rescue techniques for use on more gnarly terrain. We'll get to hoist up from Blackhawks courtesy of the NM National Guard, then head south to set up for the Bataan Marathon. Take all these ridiculously fun lessons, roll them around with some awesome desert hiking/mtn biking/rock climbing, then sprinkle it with some of that steep and deep Taos powder and you have one helluva good time... Man I love 4th year electives!

Now 'scuse me, I gotta study...