Hey You,

We lead this bizarre existence where entire personalities, hearts and souls get written in this public space, and yet vast stretches of our lives simply don’t exist for each other. Like living someone else’s life through TIVO. only the drama, the joy, the excitement of what we choose to show you. Or maybe just the commercials and the highlights. Never a complete picture.

It’s cathartic to have strangers care, to comment and encourage, and sympathize. If I were to die tomorrow, nobody here would know, but so many of you are people who intellectually at least understand me in ways I don’t trust myself to open up to those I see every day.

Perhaps we commented back and forth for a while before one of us stopped writing. I still find it amazing after all this time how connected I can feel to someone with whom I have never exchanged more than a sentence or two a month. Some of you I have developed real world friendships with. Others were my literary equivalent of one night stands. Some of you appeared out of nowhere right when I needed to hear you the most, and then vanished back into the aether, perhaps to provide inspiration to others.

Just proves that words have more power than we give them credit for.

So, Thanks. Thanks for the free therapy. Thanks for providing a place where your lack of existence only makes you more real. Thanks for sharing your thoughts and feelings, hopes and dreams, tragedies and triumphs. And thanks for the comments. even when I dont respond, I read them all and remember connections that sparked, however briefly, two humans reaching out and connecting with no ulterior motives, just a desire to make oneself heard by their fellow man.

You guys and gals are awesome. Keep being whatever it is you are when you aren’t here, because it’s working.

Having explored the northernmost section of Ireland, Brian and I returned to Dublin, had a pint, and the following day set out to explore another direction of the Emerald Isle. This time, we crossed the Cork and Kerry Mountains, setting our sights on Limerick, Galway and the cliffs of Moher

 

There once were two brothers so charming

who traveled places quite alarming…

Their pictures and tales…

describe their travails…

You’ll find them to be quite disarming!

This castle was built for the sole purpose of impressing the ladies. No really! Google that shit!

If this looks vaguely familiar to you at all

Thats because these are the Cliffs of Insanity scaled by the man in black in The Princess Bride

 

I have been blessed to travel quite a bit this year. India, Nepal, Singapore, Malaysia, Ireland, Scotland…looking back I dont know how I got so lucky. Each trip was remarkably different, not only in location and culture, but in whom I traveled with…my close friends, my girlfriend, my brother. Each one brought something different to the table, totally changed my experience of the country, and made it impossible to imagine doing with anyone else. Just wanted to take a moment to count my blessings. Anyway, onward to the tomfoolery

Arising early the next morning, Brian and I set off for Northern Ireland! After a quick breakfast of course

Our first stop, the Carrick A Rede Rope Bridge in Antrim.

This sums up my feelings about the experience pretty well. We could all use a little more wobbly bridges and discovering scaryness

Doesnt seem that bad, does it?

It’s a long way down to be wandering on a plank between two pieces of rope that were only added for tourists. This bridge used to be utilized for fishermen, who crossed it to reach the nearby island, a popular salmon fishing spot

Ireland truly has 100 shades of green

Just me and my potato, looking incredibly pensive and lonely

This is the softest grass it has ever been my pleasure to roll around in like a puppy. Read all the entries from the trip and you will eventually see a video of me doing just that!

After the rope bridge, we took a short drive over to the Giants Causeway.

Seen from afar, the causeway doesnt appear all that impressive, a simple strip of land jutting out to the sea. As the legends go the Irish Giant Finn Mcool, and his Scottish counterpart would shout at each other over the distance of the sea separating them

RAWR!

At one point, Finn threatened to come over to scotland to fight the giant and began building a series of steps across the sea, only to stop halfway when he realized just how large the scottish giant was, and retreat back home

But the scottish giant was having none of that, so he began the crossing himself, while Finn ran, hid, and told his wife

She came up with a clever plan, to dress Finn in the clothes of a baby, and place him in the bed of their child

Then, when the scottish giant arrived spoiling for a fight, the wife instead offered him coffee and told him her husband was out at the moment, but he was welcome to stay for tea and postpone the murder until Finns return. Bemused, he agreed

However, when a cry was heard from the next room, he ran in to see the biggest baby he had laid eyes upon and figuring that if the baby was that large, Finn must be even bigger, and not worth fighting. So he left, destroying the bridge behind him, leaving only the steps from Finns front porch behind

Also, a piece of his ear is somewhere still laying about.

In fact these natural rock formations were instead caused by volcanic eruptions and lava flow splitting basalt stones into this roughly hexagonal shape as lava flows hit each other

An impressive place to be no matter what the story of its origin, thinks Mr P

Castle on the Sea

Our next and last stop of the day was Belfast, one of the six counties of ireland that is still part of the UK rather than independent

These murals commemorate various sides of the fight for Irish independence, the loyalists and the IRA doing battle to determine the fate of a free Ireland

A lot of tragedy is quite literally, as well as metaphorically buried in this town

The old courthouse and prison stand as silent testaments to the horrors man can wage on his neighbor

This was all explained to us by the famous black cab tours of belfast, taxi rides given by those who grew up during what is only referred to as “The Troubles”

Even today, a large wall separate the protestant and catholic parts of town to prevent scrimmaging in a place where tempers still run hot beneath the surface. But we left our mark on the peace wall, two brothers who though we often fight, still come together for whats important

One of many memorial gardens to honor the dead from both sides who lost their lives fighting for what they believed in

All in all Mr Joyce, I think it would make a great story. Mr Joyce? Mr Joyce?

Our next day began bright and early, with a stroll along the River Liffey until we reached Trinity College

Trinity College is home to the Book of Kells, one of the oldest surviving illuminated manuscripts dating to the 8th or 9th century

The above is not it, but no photos of the Book are allowed, so you will just have to see it for yourself.

The above sculpture is entitled “The World”, but the local students refer to it as “The Death Star”. Told you Dublin has lots of Balls

But judging by the clock tower, CMON MARTY, WE GOT TO GET BACK!

 

So we hurried over to the train station with our trip mascot, Mr Potato Head, and set off for Bunratty Castle

The Mess, where the officers and infantry would have stayed. Although all the furniture is historically accurate to the period, nothing remained in the castle when it was found but the walls. 

The Great Hall, where the king would pronounce judgement

yes, he is.

King Brian and Mr P receive heads of state

While Vizier Dr J and Mr P deliberate on matters most grave

There’s a shortage of WHAT???

Quick! Hide me before some starving irishmen throws me into a stew!

Irish countryside from the ramparts of the castle

The great hall from above

Once again, the wind blows the door of this wonderful little virtual space open…Hi all, I’m home and back from yet another gallivant around the world, this time to Ireland and Scotland with my brother. He recently took the bar exam, and we figured we would celebrate the occasion by going on a brotherly binge to the land of a thousand welcomes, and the home of the highlanders.

So Raise your glass, toast Slainte!, and lets follow the Brothers through a thousand shades of green, beginning with the City of Dublin

We quartered ourselves in this converted wine cellar, Isaacs, now hostel to travelers from such exotic locales as germany, and northern california! A great hostel, cheap for the price, very clean and with a number of activities organized that we never quite found the time to make it too, but well worth your time should you need a place to stay

The first thing we learned? Dublin Has a lot of balls. It’s a recurring theme, though we are not quite sure why

Our first day was pretty much spent wandering the streets, taking the sites, and acclimating ourselves to a new continent, culture, and time zone. 

Temple Bar, in the the Temple Bar district was constantly packed with tourists, street performers (buskers, in the vernacular), and more bars than you could shake a stick at

 After walking the streets, we stopped in to visit St Patricks Cathedral

Yes, of THAT guiness family. 

 

 

 

Exiting the Cathedral, we explored the local park next door

I found a group of people playing capoeira, my former martial art before I got super lazy. Surprised how much I actually remembered

Brian with Molly Malone, the statue referred to as the Tart with the Cart. Miss Malone, a well known fishmongerer of her day, was believed to have supplemented her income with harlotry in the evening. Prostitution and fish-selling apparently have a long and storied history, and the ladies of the night would wear their fishnets from the day over their legs at night to accentuate their wares, emphasizing the catch of the day, as it were.

I cant even begin to tell you how happy this makes me

That happy, I guess

All over Dublin, brightly colored doors like those above are seen jumping out from otherwise plain buildings. We heard many stories as to the reasons for this, and my favorite is as follows: After the death of Prince Albert, the husband of Queen Victoria, which put her into such a state of mourning, she ordered all doors in the entire British Empire to be painted black. The Irish, being opposed to caving to such orders, immediately painted their doors as colorfully as was possible at the time. True or not, it’s a fascinating story, and one only too many tour guides and locals were happy to confirm

 

Dublin is built straddling the river Liffey, and supposedly hundres of hidden tunnels and catacombs cross underneath its banks as well as the city streets, just waiting to be explored, excavated, and perhaps even liberated of hidden treasure

As A final activity to our first day, Brian and I climbed onto the pictured bus for one of many haunted tours of Dublin. The company responsible for all of them was Hidden Dublin Walks, and puts on an excellent tour. Their guides are knowledgable, clearly enjoy their jobs, and are all super accomodating to requests. On this tour we visited and learned the haunted history of kilmainham gaol, trinity college, the viking church, and had a pint at a local pub, Gravediggers, where the undertakers used to request their guiness by tossing shovelfuls of dirt up against the back wall of the pub

Told you the guides were enthusiastic!

We met a couple of Dubliners on the tour, lovely ladies who joined us for a drink at a nearby whisky bar, where we made plans to meet up again later in the week for drinks and Dublins best fried chicken. All in All, the trip was off to a good start

There’s always an element of mystery about a hospital.

Patients will enter with a vague sense of uncertainy and unease, a nagging certainty that something is wrong but they dont know what. Having moved beyond their problem solving abilities, they turn to an authority, the physician. For some, the answers come easily: You have disease/condition x, the treatment is drug y which you have seen on tv, take it for 2 weeks and then you will be cured.

For others the suspense drags on: muttering in the hallways outside the patients room, increasing numbers of specialty consultants, treatment changes day after day. Oftentimes a mere 10 minutes to speak with the physician, hoping to obtain the medical equivalent of a facebook status update-Bob’s weakness is improving, Jack’s liver needs to be replaced, want to share your lab results with friends and family?

And through it all, the doctor is seen as the man behind the curtain, the conductor of a veritable symphony of nurses, techs, equipment and labs. After all, solving mysteries is what we do, isn’t it. CSI: You. Feeling weak? check the blood. Vomiting? scan the belly. Fevers? get a lumbar puncture and start some vancomycin. In internal medicine, the deepest satisfaction often comes from solving the mystery of you. Many treatment are simple enough once we have an idea of what’s going on. 

Coming in to the hospital every day, wondering what you will see, when you will figure it out, can it be beaten; it can be exciting for quite a while. But eventually all heart attacks, all strokes, all tumors look the same. The answer to diabetes is always better sugar control, the eventual outcome of cirrhosis is always poor. So how do you keep the magic/mystery alive?

By focusing in on the details. Yes, every heart attack gets treated with aspirin, but Cindy’s ischemia was caused by cocaine, Ethel’s by clogged arteries from an all bacon diet, and Ricky’s by being shot. Identifying and treating the condition makes you a good doctor. Remembering the person makes you a great one.

Which one am I? Which will I become? 

I guess there are a few mysteries left to unravel after all.

Tomorrow is a big day. A big day that I’ve already had. Tomorrow I reinterview for the gi fellowship position. A position that I worked my behind off to reach, then had snatched from me at the last second. In an email from my recent ex-gf, she wished me the best of luck, and reminded me that not everyone gets a second chance in life. It’s hard to say whether she was referring to the interview or perhaps hinting at something else.

There are few things as exciting as a comeback – seeing someone with dreams, watching them fail, and then getting a second chance. In some ways, it’s more meaningful to the recipient than if they had gotten what they wanted the first time around. Not to brush off the hard work that the first timers have put in, but who do you think appreciates the gold medal more…the person who won’t on their first try, or the one who placed silver the year before

It has recently come to my attention that throughout my life, I have never really had to fight for anything. Never have I been refused, rejected, or turned away in any meaningful way. This is not to say I have not worked for or earned what I have. Quite the opposite. Instead, I have seen something I wanted, and with the decision that I wanted it, it has become mine. Failing was never even a remote possibility. This has applied to everything from academics, to games, even relationships. I have been fortunate to lead a truly blessed life.

The downside to this of course is that I never until recently had the chance to learn what I am made of, the opportunity to see what kind of man I am. Never having to fight for what I believed in, I ended up never really believing in anything.

Well, this past year has presented me with opportunity after opportunity to overcome adversity. Some battles I have won. Once again I am being offered a chance at fellowship, selected from the thousands who applied across the country. A second chance to work where had my life gone a different direction, I would have been right now.

As for the ex, I don’t know how that battle will turn out yet. The wound is still too fresh. It’s impossible to say if I made the right decision for the wrong reasons or not. All I know is that should a second chance arise one day, I will know exactly what I have decided to fight for in a way that I never could have if things had worked out now.

Until then, all I can do is keep preparing for my comeback and learning about myself

You Knew this was bound to happen between the late nights and high stress of night float, right?

I present the Night Float  version of Carley Rae Jepsen’s Call me Maybe

If you are really lucky, I will make a music video version

[verse 1]

you were admitted last night

gave your family quite a fright

with those low electrolytes

oh yeah and by the way

chest pain and shortness of breath

coughing up blood right and left

looks like you’re approaching death

it’s time to save the day

bp aint holdin’

get those pressors flowin’

add some vanc and zosyn

oh my god he’s coding baby

[chorus]

hey I just met you

and this is crazy

but i’m MOD

so page me maybe?

you’re feeling weak now

and you’re eighty

need blood transfusions

so page me maybe

hey, i got signout

that you are crazy

here’s some ativan

so page me maybe

there are no other docs

that dont phase me

I’m the MOD

so page me maybe

[Verse 2]

you took your time with the call

patient in 3 had a fall

now she’s not speaking at all

let’s get a head ct

that guy with the DKA

he hasnt eaten all day

he’s signing out AMA

oh well less work for me

your heart rate’s slowin’

get that o2 flowin’

it’s another code and

guess i wont be sleeping baby

[chorus]

hey I just met you

and this is crazy

but i’m MOD

so page me maybe?

low urine output

place a foley

surgical patient?

then call SOD

hey, when i met you

you looked plaguey

place a ppd

then page me maybe?

there are no other docs

that dont phase me

I’m the MOD

so page me maybe?

Before you exit from this life,

fill out this polst form

change your code status

sign here on this polst form

Before you exit from this life

change your code status

you’ll be the gladdest

dnr status

[chorus]

you just don’t look right

sepsis lady

you need central lines

so page me maybe

hey I just met you

and this is crazy

but i’m MOD

so page me maybe?

there are no other docs

that dont phase me

I’m the MOD

so page me maybe?

Next stop in Malaysia was Bukit Malawati, or monkey hill, so named for the numerous silverleaf monkeys that live there

as you can see, the babies are bright gold/orange, and only darken with age

We spent a lot of time feeding the monkeys string beans before heading down to a chinese restaurant on the river and then onward to watch the fireflies at kuala selangor. No pics of that as my camera is not fancy enough to have that fast a shutter speed, but definetly worth it, and romantic…if you dont mind your romance being on a boat with 10 other people

The following day it was off to the elephant orphanage at Kuala Ganda

Michelle had found the best tour guide for this trip ever, the elephant man, who will take you to the sanctuary on the condition that you help care for the elephants while there including

preparing their food,

and cleaning their mighty poops. I got to play zookeeper for a day, and help some of these adorably majestic creatures

Michelle also got in on the action preparing and serving formula to the baby elephants

https://picasaweb.google.com/108873713548763236015/KualaGandah#5754807324525694626

click for associated video, having problems uploading. 

From Kuala Gandah

And thus ended the malaysia portion of our trip. Next and final post will be the best zoo in the world, the singapore zoo!

Another Stop on the weeklong excursion of Malaysia with my (now ex :-/) gf was Batu Caves

Rising almost 100 m above the ground, the Batu Caves temple complex consists of three main caves and a few smaller ones. The biggest, referred to as Cathedral Cave or Temple Cave, has a very high ceiling and features ornate Hindu shrines. To reach it, visitors must climb a steep flight of 272 steps.

At the base of the hill are two more cave temples, Art Gallery Cave and Museum Cave, both of which are full of Hindu statues and paintings. This complex was renovated and opened as the Cave Villa in 2008. Many of the shrines relate the story of Lord Murugans victory over the demon Soorapadam

you will note how that statue appears ginourmous no matter what distance you are from it

during the entire 272 step trip up these macaque monkeys chased us asking for food!

The entrance to temple cave

Temple cave is so called due the large number of Hindu Shrines inside.

Then after a very long walk down…

We walked along this small lake to the remaining caves

Next post…an elephant sanctuary?