Friday, December 30, 2005

THIS JUST IN!!!!!!!!!

WOW!!!!!!!

Beth just received a phone call from her brother, Will. He and his wife, Alana, and her brother, Jordan, and his wife Katie, along with a drummer are in a band called Hollow.

On January 14th, they will be opening for BON JOVI!!!!

We are so excited for them and this opportunity. Remember their name, Hollow. You heard about them here first!

Reflections

It's Dec. 30th, there are less than 32 hours left of 2005, um, wow. So let's reflect.

A year ago I was 15 pounds heavier than I am right now, however, I'm 15 pounds heavier than I was 7 months ago...still -15lbs total.

Match Day came and changed my life. It was settled that Beth and I would spend 4 more years in Houston while I completed a residency in Internal Medicine/Pediatrics.

I graduated medical school and went gambling with my friend Billy. I bet $5 on black 11, minimum bet was $15, he gave me $10 and yup, it hit. $540 and ONE HUGE MISUNDERSTANDING later and Billy and I are forever friends.


Beth and I moved the burbs and have part of the white picket fence scenario (no 2.5 children...yet...unless you count Dante and Picasso). The house is GREAT and when they get done building the one next door (and STOP hammering at 6:30 in the morning) it will be even better.


I was not an MD a year ago and I didn't have the power to write prescriptions. Since then, I have I written orders in the hospital for everything from tylenol to OxyContin, morphine, and Levophed (a medicine to raise blood pressure when it's dangerously low).

I was reminded how fragile life is and how it changes in an instant. Kyle Lake was a guy I knew from Tyler, I wouldn't call us friends because we didn't really hang out and he was about 4 years older than I, but his parents were my Sunday School teachers and we had several conversations over a couple of years and Kyle never met a stranger and was always kind. Kyle was electrocuted and died in Waco seconds before he was to baptize a women into Christ. He left a wife, a daughter (5) and twins sons (3). The world has a little less light in it with him gone.

On a much happier note, I was honored to take part in the marriage of my good friends Vanessa and Jeremy Dalton. Dalton (to keep the Jeremy confusion to a minimum) was my resident when I was an RA in Wall/Gates and Texas Tech. After my taking 2 years to get into medical school, we ended up in the same med school class. His wife is in the year behind us. He's a Peds resident at UT-Houston and Vanessa is going through the match to be a pediatrician as well. Beth and I love us some Drs. Dalton. They are true friends and fellow dachshund lovers.

Christmas was spent at our house and most of our families got to come. We missed Scott, Kristina, Tori and Eric, and Beth's aunts and their families, but we got to spend time with Grandma Shirley, Grandpa Henry, Laura, Will and Alana, my Mom (Frances) and brother L.D., and my Dad even came for a few days. I wish my Granny and Grandmother had been able to make the trip, but much love to them both.

To 2006:

I'm sure you will be filled with love. Sadly, there most certainly will be loss as well. Lessons to be learned and patients to see. Memories to make and pictures to take. The road will be rough, smooth, steep, and have too many forks with too many decisions. Laughter and tears, making new friends and saying good-bye to old ones. There are songs to be sung, and blogs to type. Resolutions to make. And what would those resolutions be if there weren't a few to break. Is this the year the Lord grants us a child? Or are there roads yet to travel and lessons yet to be learned?

May the year be full of health. May the Lord have mercy on us and guide us with His love. May we stand firm in His grace when trials come and rest in His Strength knowing that His will is perfect and there is peace to be found in it. May we have the courage to make the right decisions even when they hurt and aren't easy or safe. May we hold our head high and be proud of what is good. May our dreams come true.

To you and yours,

Happy New Year!

Wednesday, December 21, 2005

Beth's new blog

Beth has created a new blog at:

http://www.myspace.com/narnianwardrobe

I may move mine there, eventually...but I haven't had the time to stop and work with it and feel comfortable with everything.

Here's the link to my Myspace.com anyway:

http://www.myspace.com/utmedpeds

Saturday, December 17, 2005

2nd post in 2 days

Strangely, it's a nice night in the county hospital ER. It's 12:30 Friday night (Saturday morning) and there are no patients waiting to be seen. Hmmm. There's always a bit of superstition in the ER that we don't say the "Q" word, or things go down the tube. But we have an adequate number of physicians and no patients. So I type.

For some reason, I suck at sending cards. I did send Thank you notes for graduation, but I can't seem to get motivated about mailing Christmas Cards. And I certainly can't find the motivation to take a picture, put it on a nice card and THEN mail it. COME ON! Beth and I have received several nice cards from friends. Pictures of kids and Christmas trees...and each year I tell her that we're going to send cards to family and a few friends (not everyone we've ever know), but each year, Christmas comes and goes, and the Brown's have managed to once again NOT send a Christmas card. I think that Beth is working on some, and after the Mother's Day fiasco (it's too horrific to even speak about), my mom will most definately get a card BEFORE Christmas.

I do think that we'll manage to get some cards out this year. Beth has already started. So maybe.

Random shift in thought:

I am ready to switch to the Pediatric side of my training. I have mostly enjoyed these past 6 months in Internal Medicine, but it's time for a change. I am also nervous at the same time, given that Day 1 on Peds is in the NICU. Tiny babies that came too early. I will then spend a month at MD Anderson Cancer Center followed my a month in the Pedi ER. I spent a month in the Pedi ER as a 3rd yr. med student and had a good rotation. Again, the switch from adults will be nice. I'm a little leary of kids with cancer...I have no idea how I will handle the saddness. Hopefully there will be more days of hope and joy than loss and despair.

I have found myself constantly humming Christmas carols. Two radio stations here in Houston are playing nothing but Christmas music until Christmas. Not holiday music, not season's greetings music, Christmas music. AND I LOVE IT! Even though I will spend Christmas Eve night and Christmas Day night (7 p.m.-7 a.m.) here in the ER, I still plan on having a wonderful Christmas with my wife and our families.

May this Christmas bring you happiness and joy. May your heart be filled with the love of family, food, and the celebration of Jesus' birth.

God Bless,

Jeremy

Thursday, December 15, 2005

For Becky

My friend Becky (Jell-O Universe) threatened me the other day if I didn't blog...so here it is. Hard to believe my last post was in OCTOBER ( I should be threatened!) but life as a resident is busy. November was a clinic month where I worked only 2 full days and 3 half days a week, sometimes..., so I really have no excuse. But there are others who have dropped the blogging ball, so I don't feel alone. I did get the chance to celebrate the marriage of Dr. & Mrs. Dalton in Lubbock and spend Thanksgiving with Mom, L.D., Grandmother, Kristina, Eric, and (the cutest little girl in the whole wide world) Tori. The rest was more than welcomed.

This month I am in the ER at the county hospital. Why would someone wait 8-9 (NINE!!!) hours to tell me they have a headache?!? Some people are really sick, like the HIV+ patient with a lung mass. Or they lady who came with a migraine, spiked a 103 fever, and left with a diagnosis of pneumonia. I'm happy to take of these patients, but really...you've had chest pain for 2 weeks (maybe because of the cough you have) and you come to me worried about your heart??? If you were having a heart attack...it would have killed you 12-13 days ago. And oh yeah...maybe you should quit smoking. It can't be good for your obstructive sleep apnea, high blood pressure, diabetes, or reflux disease.

I may seem a bit cynical, but it's 12:30 a.m. and I am up for the night. I start working the 7 p.m. - 7 a.m. shift tomorrow night (Thurs.-Fri) so I thought the best way to prepare was to stay up all night tonight (Wed-Thurs). So I have the next 7 hours to try and find SOMETHING that is going to keep me awake. I'll probably play some more games online (Spades, Bridge) and maybe watch some TV, although I don't want to bother Beth. I also desperately need to clean the top of my desk (which I haven't seen in weeks). I would like to think that I could pass the time by reading something medical related that I need to know (anything Pediatrics at this point) but lets face it...medical texts are not the most captive reads; great sedatives, though!

Beth and I are getting ready for Christmas at the Browns'. Her step-mother, Laura, and Grandpa Henry arrive the 22nd. Her brother and sister-in-law are coming...sometime. My mom and brother are coming the 26th. Her Mom's mom and Cousin Kristin are also coming although I have no idea when. Unfortuantely, I am working nights the 22nd, 24th, 25th, and 26th. But then I have the 27th-Jan. 2nd off, which will allow me to go to Dallas to watch Tech play and WIN in the Cotton Bowl.

One (more) random thought...wasn't I alive when Southwestern Bell and AT&T were the same company? And didn't the goverment bust them up after accusing them of being a monoploy? And didn't SBC and AT&T just merge? Hmm...

Wednesday, October 19, 2005

Sports Central!

It's official. I'm forever an Astros fan. They are currently 3 outs away from their first World Series. I went to bed sad Monday night after one of the greatest home runs ever hit. My hat's off to Albert Pujols. I may have been even more sad that my WIFE got to go to the game while I watched it on TV. That's for another blog. Even if something goes terribly wrong in the bottom of THIS 9th inning (Game 6), I will still forever be an Astros fan.

The last few years have been tough. I married a Cardinals fan. Her aunt, Becky, whom you could find on the Cardinals' website in a red wig recently, has weekend season tickets. She's been a Cardinals fan longer than I've been alive. Needless to say, my Christmas present last year was a little tough to swallow. It was an Cardinals National League Champions t-shirt.

If the shoe ends up on the other foot this year...I hope she's as good a sport, because that's what she's getting for Christmas. Love you, Aunt Becky.

I am going to sign off now and watch the last 3 outs of Game 6. I have more to say about the Texas Tech, u.t. game this weekend, but I will save it for later.

GO ASTOS!!!!!

Thursday, October 13, 2005

No time to post

I know it's been awhile since I've posted. Sorry. But I am in the Medical Intensive Care Unit (MICU) this month and I am on-call 11 nights. That translates into 308-330 HOURS that I am physically in the hospital when on call. 28-30 hrs per call * 11 calls = 308-330 hours. And that doesn't take into account the 6-8 hours a day that I am in the hospital the day before I go on call. For a bit of perspective, if you have a "normal" 8-5 job and work 40 hours a week, then in one month's time, you work 160 hours. Needless to say, Beth said to me 2 weeks ago, see you in November (which has TEN GLORIOUS DAYS OF VACATION!!!). I have not gone more than 2 days (and only twice have I gotten 2 days in a row) in a row without having to go to work.

I'm not complaining, I'm just telling you why I haven't blogged in awhile. This month is MUCH different from last month at LBJ. The MICU has patients who are REALLY REALLY sick. Sick enough, that at any moment they can take a drastic turn, either good or bad. It's too early to say if it's going to be a good month. There are several factors that will need to be blogged about when I am not here and the potential for people who need to be blogged about are not around. (I'm fairly certain the previous sentence is a run on, and those of you who have degrees in English will anguish at reading it).

I was on-call the first day, Oct. 1, and I was MISERABLE! I had NO IDEA what I was doing. Luckily for me, the nurses here in MICU are OUTSTANDING! I have learned quickly these past 13 days and my confidence level is leaps and bounds higher than it was when I left here on day 2 after a 30 hour stent on-call. As an intern, most of the medicine I've learned in medical school is theoretical. They teach us about insulin, where it's produced, what it does, and how the body can mess that up. What they DON'T teach us is the Mr. X is a brittle diabetic and even the smallest amount of insulin makes him hypoglycemic and unresponsive. Other patients, who give them MASSIVE amounts of insulin and their sugars are still SKY HIGH. That's what I mean by theoretical. We talk about mechanical ventilation and breathing for patients, but we don't talk about the machines and the 45 different ways you can accomplish the same task, inhilation and expiration. It's just not as simple as "in and out" when the vent is involved.

And so I learn. I try to read. And I learn some more. I ask TONS of questions. And I learn. I have had to tell a family that it's time to say good-bye to their loved one and then write the order to turn off the vent. I've seen lab values that are incompatible with life and have the patient tell me where they are. People are amazing. Medicine is amazing. I wouldn't have it any other way.

On a much different note. Beth and I had the pleasure of Rachel's (a link to her blog, "The Wonder Years" can be found to the right) company at our house last night. She was in town for work and came over for coffee and brownies. We had a GREAT time. I've know her since...6th? 7th? grade. Her husband, too. I have yet to meet Buddy, but hopefully that can happen in the near future. Rachel spent about 2 hours with us and we laughed and talked about work and high school (she's a college recruiter) and had a nice time. I'm glad she came and hopefully she will come again should work bring her back to our neck of the woods. Rachel and I decided that we need to have Becky come to D/FW and we can have a mini-reunion with Eric and Christina since neither Becky nor I got to attend Eric's wedding. There was this hurricane that kept me from getting to Eric's wedding. I'm still a little sad about that. I've known Eric since 1986. 19 YEARS and counting. I've been friends with him longer than anyone outside of family. I hated not being there. Sorry, Eric. Life happens.

Well, I better get back to work. There are labs to check and orders to write.

One more comment. Texas Tech beats u.t. and ends their hopes for a national title.

Sorry, Becky, you are still required to love me and call me your friend. But you heard it here first.

Friday, September 23, 2005

Rita is Here

Time for an update.

So it's 2:00 p.m., Friday, September 23, 2005. My sister's birthday. Happy Birthday Sis! Remember in my last blog that I said it would probably take Beth 8 hours to get to Austin. It took her 28, yes, TWENTY-EIGHT hours to go less than 250 miles. For her it was a nightmare. I was too scared to sleep. Never in my life do I ever want to go through what I experienced in the past 36 hours. There are many, many thoughts and emotions associated with it and Beth and I will spend many hours trying to sort them all out.

For now, the important thing is that Beth is safe. Dante and Picasso (our 2 mini-dachshunds) are safe. I LOVE VOLKSWAGEN!!! and they will get a BIG letter of THANKS from me in the near future. Beth drives a Passat, and when she left our home her gas tank was full. When she got to Bastrop (30 miles outside of Austin) 26-27 hours later, she still had 1/4 of a tank of gas. The batttery in her car is dead due to the extreme heat, duration of the trip, and not being able to go faster than 10 miles an our for 28 hours, but she didn't get stuck on the side of the road without gas. I am eternally grateful.

I am going to be at LBJ County Hospital until the storm passes. We have some critically ill patients that will be our help should we lose power and backup generators.

Regardless of what you may hear on the TV and radio. IT WAS ABSOLUTELY IMPERATIVE THAT PEOPLE LEAVE WHEN THEY DID! If they had started the evacuation 24 hours later, many, many people would have needlessly lost their lives. They system worked. Maybe not 100%, but it worked. We wil lnever know how many people were
spared because they made the decision to leave, even if they did sit on I-10 for 16+ hours.

Time to get down to business. Take care, and I'll again when I can.

Because of His grace,

Jeremy

Wednesday, September 21, 2005

Rita is coming...and she's not bringing Tequila

Gulf Hurricane, Take 2

It's Wednesday night and I felt the need to blog before Rita makes her presence known. Rest assured that the citizens of Galveston and Houston and the surrounding areas are taking Rita and her fury extremely seriously. It is taking 5 hours (normally a 1 hour trip) to drive from Galveston to downtown Houston.

Beth plans to leave for Austin tonight in the middle of the night. It will probably take her 8 hours to make a normal 3.5 hour trip. She is taking the dogs and a few keepsakes and heading for higher ground. This storm is so big that I'm sure Austin will get plenty of rain.

Me, you ask? Well, as an intern in the medical field, I am reporting for duty. My team is on-call (admitting patients for the night) starting Friday morning at 7:00 a.m., a few hours before we start to see effects of the hurricane. We have been told that we will stay in the hospital perhaps untilSunday or Monday depending on the storm, since the other residents won't be able to make it to the hospital. Even if I have the opportunity to leave Saturday morning, I won't. Beth and the dogs will be taken care of and I'm sure that they will need help in the hospital.

Say a prayer of us. That the casualties will be few and the damage minimal. Pray for patience as people spend many hours in the car trying to get out of harms way.

Time to batton down the hatches. See you on the other side.

Jeremy

Thursday, August 25, 2005

Thank you notes

This may well be the area of my life that I STINK at the MOST!!! I've NEVER been good at writing them. It's not that I'm not thankful. It's not that my mother didn't teach me better. I am. She did. I'm eternally grateful for the kindness and thoughtfulness that has been shown to me in the past. I just can't (or won't, or DON'T) sit still long enough to write a simple thank you, put a stamp on an envelop, address it, and put it in the mail.

When I sent out graduation announcements I PROMISED myself that I wasn't going to revert to my old habits. That if people were going to take the time to congratulate me, that it was only RIGHT AND PROPER, that I take time to THANK them.

The first 10 gifts I received...thank you notes went out within a week! Then we moved, then I graduated, then I started residency.

You know where this story is headed.

LAST NIGHT...I finished the thank you notes for gifts received for graduation! Mind you, some of these notes have been DONE in their envelops since JUNE!!!!! I just never stuck them in the mail. Do you know how hard it is to find stamps these days??

I'm quite sure that I've forgotten SOMEONE and more than likely I've sent someone a thank you note TWICE for the SAME gift. But at least they're done and not sitting there staring at me. I am going to hand deliver the thank you notes from our friends at church who not only came to graduation, but came over our house that night and helped us celebrate. Billye brought GREAT ice cream, Lorinna made an AWESOME cake, Jenny brought cherries, Gerry and Mary brought pigs-in-a-blanket, Jo brought daisies to plant in the flower bed, and I know there are a few others that I'm forgetting.

I was so blessed to receive cards from friends and family. Some of whom I've known my whole life. Friends of my parents, parents of my friends, and friends I've made along life's journey. I am truly thankful they took the time to write. Thank you. Your continued friendship, love, and support mean the world to me.

Anyway, that task is done and next week I am going to start addressing our Christmas cards. Maybe you'll get your's by Valentine's Day!

Ha!

Sunday, August 21, 2005

STOP SPAMMING MY BLOG

Is there NO shame?!? I have had to alter how comments are left on my blog b/c the wonderful world of spammers have decided to invide my blog. So STOP! This is a place for me to catalog my life as an intern and NOT a place for you to litter my website with your dribble. Does anyone know how to STOP this MADNESS. THOSE comments will be welcomed.

Saturday, August 20, 2005

"Primum Non Nocere"---"First, Do No Harm"

"First, Do No Harm" These words are not actually in the Hippocratic Oath, but that is a discussion for another time. I want to tell you about their application in my life.

EDIT: in the first edition of this post, I had a long story about a pt and surgery. Here's the 2 sentence version.

Chance finding on CT, pt to surgery, pt experienced a complication, different surgery. Now with colostomy (he had a bowel resection after a perforation) intubated and in serious condition with a good chance for a MAJOR infeciton that could lead to septic shock and his death.

I tell you this story because it reminded me that nothing we (I) do in the practice of medicine is without consequence. Pt. X's AAA was an INCIDENTAL finding. If we hadn't done a CT Abdomen, he might have lived the rest of his life (?30-40 years?) and never known he had this. And now, he's fighting for his life in th ICU because we "helped" him. I belive we did the right things for Pt. X and no malpractice has occured. But life is fragile and sometimes even feeding a patient after surgery can be dangerous and not without risks.

The morning of this second surgery, there was ALOT of confusion when he came back from surgery. He was dehydrated and evetually required 17 liters of fluid. His family was there asking questions that didn't have an answer. I had come to know X's wife, because he's been in the hosptial for several weeks. I noticed that no one had gone out to talk with her.

So I went.

I couldn't give her a prognosis, I could merely explain what had happened, what the surgeons had done, and that all we could do at this point was wait. We had hit a bump in the road and things were going to be rocky for several...?days? I felt completely inadequate, like ANYONE other than me should be the one talking to this family. But I was the one who had rapport with them and felt I should go.

So I went.

His wife started crying, which meant that I started crying. She hugged me and we cried a little more. It was good. I don't mind admitting to you that I cried. I was scared, she was scared, neither one of us knew what was going to happen in the coming days. I'm glad that I went. I believe that I made a small difference in this family coping with bad news. The day I can't cry at something tragic and sad, is the day I need to find a new line of work.

Saturday, August 06, 2005

Call

I have managed to survive my second night of call as an intern. Let me explain. I am on a rotation in the CCU--the Cardiac Care Unit. The patients we admit either have a previous diagnosis of heart disease, or they are being admitted to our service because they have experienced "chest pain" and need to be "ruled out" for having a heart attack or MI (myocardial infarction--fancy way of saying heart muscle injury). Monday, Aug. 1st, was my first day in the CCU, we change rotations on the first day of each month. I was on call. My first night of call as an intern. Call means that we show up to the hospital at 6 a.m. one day, see our current patients, and admit any new patients to to the cardiology service to our team. We do that all day and all night until 7 a.m. the next morning. Then we round with our attending (see previous post for hierarchy of doctors) and go home (hopefully) by noon, 18 hours after we entered the hospital. We go home, sleep and show up at 6 a.m. and start all over. Call is q4, meaning that every 4th night this month I will spend the night (not that I get to sleep there, mind you) in hospital admitting new cardiology patients and taking care of small issues with our current patients.
Call #1: Aug 1st. Starting a new rotation was ALWAYS unnerving as a medical student. Your grade depended on how well you performed and how well the attending and residents liked you. As an intern...It's worse. You show up at 6 a.m. and have 4-8 patients that assume in 5 minutes you will know their entire medical history, what brought them to the hospital, and how best to take care of them and send them home...All before the first (of many) bottles of diet coke has had time to settle in your stomach. And to top it all off, Day #1, I'm on call and carrying the CODE PAGER!! That's right, if someone in the hospital codes (their heart stops beating or they stop breathing on their own, or both) and a code blue is called, the code pager (I'm carrying one of many such pagers) goes off and alerts me (and a whole bunch of other epople) to the patients room number, where it is expected that I will show up in a matter of seconds and begin resuscitation efforts on that patient.

In case there's any doubt in your mind, this is one of the scariest things about being an intern. We all have to take ACLS (Advanced Cardiac Life Support) and learn how to "run a code," but until you show up and see one in progress and have someone asking you (me) what drugs to give to get this person's heart beating again...You have no idea what to expect.

So, of course, at 2 a.m. my first night in the CCU, my first night of call, the code pager goes off. Thankfully, I was not the first doctor there and therefore did not have to make any decisions. I would like to tell you that I put on my Superman cape, ran into the room, and in a moment of brilliance saved a person's life. It didn't happen that way. This patient was being well attended to by the time I got to the room, but I might as well have been 3 years old...I had no idea what to say or do. I don't know if I've ever been more intimidated in my whole life. I never went to a code as a student and like anything you do for the first time, you don't know what's expected or what to do or how to handle the situation until you've been there. [This is the main reason people without children (myself included) are so STUPID (again, me included) when they start talking about how they could raise someone else's child better, or how they would NEVER let their child do this or that] (This attitude has probably ensured AT LEAST 2 or 3 temper tantrums in Wal-Mart or a museum from children that I hope to have someday...Sorry Mom and Laura, that's not today, or even this month, really, not even this year. The next code I go to, I will be a bit more prepared for and hopefully will handle the pressure better.

Call #2: As I type this, I am post-call. I went to the hospital yesterday at 6 a.m. and got home around 12:30 this afternoon. I would like to say that in a city of 4 million people, no one got sick, no one had chest pains, and that no one came to the hospital. ALAS! None of that happened! Was it a full moon last night? I went to the ER about 3:00 a.m. and it looked liked a rock concert gone bad. There were people EVERYWHERE! Thanks to the same ER last night, and the nurses of 3 Cullen (the main floor where the cardiac patients go) I got a grand total of 30 minutes of sleep last night, and fortunately, not all 30 minutes were at one time (insert sarcastic voice here).

There's so much more I could tell you about last night, but let's face it, I've had little sleep and rambled on enough, even for me. Regardless about what (or how) you read the above...I'm loving it! I am doing what I've been waiting my whole life to do. I have MUCH to learn, but man, this is good stuff.

p.s--As I went back and read the above verbage, I realized how vulnerable saying these things can make me. It's hard to admit your failures or weaknesses and there are some who would say that they would have handled the code much better than me. And they would be correct. But they've been there and done that before. My friend, Keith, from medical school, who is currently in Iraq serving his country, was a paramedic before medical school. He ran TONS of codes on the back of an ambulance. As a 3rd year student, Keith happened to be outside a patient's room as they coded. Keith stepped in (as a 3rd year STUDENT, mind you) and began to run the code in spite of his attending and others there who were "??more qualified??" than he was to run the code. I was not there, but the story goes that someone asked Keith's attending (as Keith was performing CPR and yelling at nurses to push drugs) if he was capable of "running a code". The attending very matter-of-factly said, "Yes. And probably better than you or me." I will be in a code situation again, and by the time I finish my intern year I may not be a good as Keith (this guy is amazing) but I will be better at handling codes.

Sunday, July 24, 2005

Lost

No, not the TV show (which I've never seen). My wedding ring. It disappeared Wednesday night or Thursday morning. I have no idea. Beth and I went to dinner with my Aunt and Unlce and my mother's 2nd cousin (apparently he and I are not related at all, no 3rd cousins, no 2nd cousins twice removed). He is related to my mother and my mother is related to him and his father, but he and I are not legally related. That was an interesting conversation. I had no idea. But I digress. I remember having my ring at dinner. When we came home that night I put everything (at least I think I did), my keys, wallet, watch, my Alpha/Omega ring from Beth for graduation and my wedding on the "bar" ledge from the living room into the kitchen. I leave for the hospital early in the morning and often get dressed in the dark. So, I left everything in the living room. I got up Thursday morning and went to work. I don't remember NOT putting my ring on. As I was speaking to a patient's family member, I went to play with my wedding ring. It wasn't there. I have gotten into the habit was playing with it more lately. It's loose and comes off easily. At that point I thought I had simply forgotten to put it on that morning when I was getting ready. I knew it would be there waiting for me.

It wasn't.

It's been 3 days and no sign of my ring. Fortunately, Beth has NOT flipped out. I have. It makes me very sad. I know it's only material...but still, I wasn't planning on throwing it away or trading it in any time soon. One thing is for sure though, I will have to get a new ring soon. I can't stand the feel of there being nothing on my left ring finger. I hope that as soon as I do get a new ring, the old one will show up.

If you happen to find it, let me know.

Sunday, July 17, 2005

I crashed a High School Reunion

It was my high school reunion...sort of. For those of you who don't know, a brief explanation. I lived in Abilene, TX from Feb. 1986 (3rd grade) until July 1993 (end of soph. yr). This weekend was Abilene Cooper's 10 year reunion. I went. I only spent 2 years in Tyler and I can only think a 5-6 people who will be at that reunion that I would want to see.

On the other hand, this weekend in Abilene, I had the extreme pleasure of seeing some of my oldest and dearest friends. Friends who taught me how to laugh, how to love, how to cry, how to be me. I AM SO BLESSED!!! Many of these friends I had lost contact with after leaving Abilene. For some, it had been 12 years since I had seen them. This weekend, I felt like we were 16 again and that nothing had changed. NOT that I would want to BE 16 again! We had an absolute BLAST this weekend. Even Beth, my wife, who basically knew no one (and LOATHES these sorts of things) had a good time. As she will tell you, "Two makes a family." Looking as most of my former classmates, Beth and I are WAY behind in the baby department. Some had 3, THREE, kids. We have 2 dogs.

I had such a great time this weekend and I want to thank the "true" Abilene Cooper Class of 1995 for letting me continue to be a part of them. And thanks for helping Beth feel like a part of the gang.

Becky--your name is mud for not showing up. I hope you're ok.
Rachel and Jason--I'm sorry I didn't get to meet Buddy (name changed to protect the innocent) but I love you guys--see you soon.
Eric and Christina--Christina I'm glad I got to meet you, see you at the wedding. Eric, I hope that we always stay in touch--
Lara--your husband is a riot, I think he and Beth bonded (should we be scared?). I'm so glad you're happy. You look GREAT!
Em--you sure know how to throw a party!!!! It was SO GOOD to see you! Next time, I'll help!
Leya--I never knew your mom liked me so much, HA! I could have used that...your little girl is beautiful. Best of luck to you and Brian
Ann--I vote you, "THE ONE WHO STAYED MOST THE SAME" and I LOVE IT!!! You look happy, confident, and at peace. You're an amazingly talented woman and I expect great things. Perhaps the Mrs. and I can make it to AZ to see you!
Alison--you're too cool for words. Not many have the gumption to show up to a reunion unemployed! Best of luck...we need to have a mini reunion in D/FW (since almost EVERYONE from our class lives there!)
Shea--you're one of the funniest people I know. Don't worry, it's a good thing. I'm glad that you came and that you're doing well. Good luck with grad school. Hopefully you can join the mini reunion.
Rachel H-M--you're a dear friend--good luck with the one of the way. Your boys are too cute and I know that they'll love having a new brother/sister. Call us ANYTIME you're in Houston. Until next time, there's always email.
Ben-We have too many mutual friends NOT to keep up! Taiwan will be a challenge. Good luck with Mandarin
Andy--I'm sure we'll keep up through IM. I'm sorry it had been so long before this that we had talked.
Jackson and Erin--you guys look great, I know that you're already FABULOUS parents. Jackson, I know that you're patients are in GREAT hands. Good luck whereever life leads you.
To the rest of the Class of 1995, Emily L., Dave B., Tiffany H, Sherry S. Zac and Bru, Jurel, Emily C, Christy, Justin, and whomever else I've left off this list. Thanks. I can't wait to do it again 5 years from now.
To those from the class that are missing and that couldn't make it. You need to be found, and you need to show up in 2010. It really isn't the same without you.

I go to sleep tonight happy. Happy because this weekend I was able to relive some of the best years of my life with some of the best friends I've ever had. I'm a lucky man. Call me anytime.

Monday, July 04, 2005

End of the First Week

I guess it's safe to say I survived my first week of internship. And no one died. At least none of my patients. I did feel bad for one intern...they came in one morning and one of their patients had died overnight. No, the intern didn't kill this patient. They were very sick and died of natural causes. But imagine how the intern must have felt. No one called to let them (I'm being gender neutral so there is no HINT of a HIPPA violation...I'll explain later) know that the patient had died. The last few days have been interesting.

In hospitals, the team of doctors taking care of patients changes every month on the first of the month. For me, this year...I will spend 5 weeks on the Renal Ward Team because interns started 1 week earlier. That meant that on Friday, me and the other intern got a whole new upper level staff. The resident was post-call from his June month, so he was at the house asleep. The Renal Fellow, who just finished her Internal Medicine Residency, was day 1 as a Fellow. And the Attending was new as well. Not a new attending, but new to the service. Let me explain the higherarchy that is Medicine.

Medical Students--what I was 2 months ago. Basically, can't do anything legal and therefore help their intern AS MUCH AS POSSIBLE!!! They are usually the ones running to x-ray or finding out lab results. We call this kind of work SCUT. And medical students are affectionately called Scut-Monkeys.

Interns--that's me--Graduated medical school 1-2 months ago. New MDs.
Interns are in their first year of their residency (3-5 yrs. depending on the specialty). Interns report to the Resident.

Residents--2nd,3rd,4th...yr of residency. They have supervisory responsibilities of the interns and medical students. Residents report to the Fellow (if there is one) or to the Attending

Fellow--done with Residency. A Fellow has chosen a sub-specialty--cardiology, Nephrology, CV Surgery, Oncology, etc. A Fellowship is 2-4 yrs and most always involves research. Fellows report to Attendings.

Attending--Staff--done with training. Could operate in Private Practice. Board Certified in their filed of training. Eligible to make more money than me, which is less than $40,000 during residency for 80+ hours/week.

So, it's a new month with a new team. My fellow intern was given 4 days of vacation around the 4th of July and won't be back until Thursday the 7th. In Internal Medicine, we all get 4 days vacation around a holiday...he just happened to get the 4th. That stinks for him. Mine are around Thanksgiving in order to attend the wedding of my friend and fellow (not Fellow) Pediatric intern, Jeremy Dalton. So, for the next 4 days, it's me, the resident, and the Fellow on the team. That translates into more work for me!

Happy 4th of July! I will work until noon and then go home and get ready for a little grill time.

In His grace.

Friday, June 24, 2005

Day 1, OVER


Well, I guess you could say that I've survived my first day as a doctor. I actually had a nurse call me and ask what to do about a patient with chest pain. And let me just say...I've not often had quite so odd a feeling as I did today when I wrote a prescription for pain medicine for a patient to take to Walgreens or CVS, and signed MY NAME to it. Uh, that's weird.

Day one as a Med/Peds Intern began at 6:00 a.m., that's when I arrived at the hospital. I was up at 5:00! Thanks to the modern advances of technology, I was able to look up SOME information on my patients last night from home. Please understand that when speaking about patients or things I MIGHT have seen, I must be vague and general. HIPAA regulations guarantee patients the right to privacy and I personally could be fined THOUSANDS of dollars if it's found that I violate that privacy. So I won't. Anyway, I began to see my patients, introduce myself, and write notes in their charts that will forever, good or bad, be a part of their medical history.

It's all a little surreal. Today was not a bad day. Yes, it could have been better. Yes, I wish my resident had held my hand a little more..he didn't even check the prescriptions I wrote...we just sent the patient home...but at the same time, it's here. It's real. The chance to make a difference.

I covet your prayers that God will watch over me and guide me. That He'll make His presence felt, especially in those dark hours that are sure to come.

Please don't email me and ask for narcotics. The answer is no.

Jeremy L. Brown, M.D.
Internal Medicine/Pediatrics Intern
364 of 365 days as an intern to go

Thursday, June 09, 2005


Graduation cake made by Lorinna Hopping
Posted by Hello

Life moves on

It's been 6 weeks or so since I've lasted posted. MUCH has happened! I will briefly recap. Beth and I moved into our new home on May 21. My dad came to visit on 3 days later and I don't know that he's EVER going to come back. After giving Lowe's Home Improvement store more money that I should have, we spent the next 4 days hanging celing fans, mini blinds ( a WHOLE house full) and 2 garage door openers. We didn't even get to the surround sound. We bought a lawn mower and weed-eater...after all the yard isn't going to mow itself. And then I HAD TO HAVE a grill, which will be used for the first time this Monday. Mary Fritz and I planted flowers. The splinkler system was installed and grass laid in the backyard. THEN family came. We ate, ate some more, went to my graduation from MEDICAL SCHOOL (yes, you can call me doctor), ate some MORE, then came back to the house and threw a party for 50-100 of our closest friends and family. It was more than a little nuts around here. Did I mention that Beth's friend from Oregon flew in Saturday afternoon about an hour before those 50-100 people showed up at our door? Jo Sandifer brought more work, in the form of Shasta Daisies and some Mexican Hair Grass which is now planted in the flower bed, which I LOVE! One of Beth's favorite flowers is the daisy. I can't wait for them to bloom. Billye Sims brought some fine ice cream and Jenny Fagg brought cherries. Mom and Grandmother brought banana punch (until the glass ladel broke and it had to be dumped out), banana cake and banana bread (do you sense a theme here...who knew I liked bananas so much!) Lorinna Hopping made an AMAZING cake...which I will post a picture of here when I'm done rambling. Mary Fritz brought pigs-in-a-blanket which were gone in 5 minutes. Someone in my family (at my request) brought wings from Hooters. (Please hum "These are a few of my Favorite Things" quietly to yourself. I'm sure that there are others that brought something that I have forgotten. Please DON'T shoot. I am grateful for EVERYTHING EVERYONE did to help out. Kristina and Eric were kind enough to bring my precious niece, Tori, to see us on Thursday at which time Dad quit working. She played and we all fell in love with her all over again. Please see rosesareredheads.blogspot.com for my sister's blog about, yup, the red-headed Tori. Laura, Will and Grandpa Henry came to help us celebrate and we are SO thankful for them and their help. I don't think the entertainment center would have gotten finished without Grandpa Henry!
I just got back today from a 1700 mile road trip that took me to Southern Illinois to my mother-in-law's house. She gave me and Beth Beth's Dad's desk. It was hand-made by a family friend. It's GORGEOUS! It's HUGE! And the only way to get it to Houston was for me to go get it. It took 13.5 hours to get there, we spent the next day and then loaded up to come home. When I say we, Chris H. went with me. I'm not sure 1700 miles was his idea of a good time, but I know it beat the alternative. You know how 16 year-olds get in trouble, right? Well, he did, and rather than sit in his room staring at the ceiling...he rode with me for 1700 miles listening to me sing everything from Evanesence to Simon & Garfunkle to Rent. Someone should tell his parents that he's been tortured enough and I'm sure he'll never do what it was that got him into trouble in the first place. Yes, I know what that was, but it's not for me to rat him out on the internet. Thanks Chris, I couldn't have done it without you.
It's good to be home. We close on the condo in a few days, I think. The buyer keeps changing her mind. July 1-June 17-July 1.
Training for me starts Tuesday with PALS (Pediatric Advanced Life Support) and then 2 days of Neonatal Resucsitation Program. Then hospital orientations and banquets to honor those completing their residency, and then June 24th is the first day on the job. I'm not even 100% sure where I'm starting. I bet they tell me before I have to be there though.
My 10 year high school reunion is about 5 weeks away. I am going back to Abilene even though I didn't graduate from there. I lived there for 8 years until the summer after my sophomore year of high school and 90% of my pre-college friends are there. So I am crashing their reunion and going back to catch up. I can't wait!

For those I have seen or been in correspondence with lately, your thank you note in soon coming in the mail. Until then, please know how truly blessed I know that I am to have such wonderful friends and family. Blessed that you care enough to call, write, or come and help Beth and I celebrate an important milestone in our life. God is good, and faithful, and he has blessed me beyond measure. More than I could have hoped for. To Him be the glory and may He continue to guide me in this next phase of my life.

My love and thanks to you all!

Friday, April 22, 2005

No Day but Today

Well, after four years, 8 semesters, 16 Basic Science Courses, 6 3rd year clinical rotations, 9 4th year clinical rotations, COUNTLESS EXAMS (I KNOW I took 66 over the past four years...maybe a few I have forgotten about) Steps I & II, too many call nights to remember (thankfully some I have forgotten) and lastly, today, ACLS (advanced cardiac life support) I am FINISHED with medical school. The first Friday of medical school I ate at Chipotle with my friend Wes. Today, he and I finished the way we began, with lunch at Chipotle. It was poetic.

Medical School has shown me challenges that I never thought I would know at age 28. Struggling with school for the first time in my life. Dealing with the loss of my father-in-law, Beth's dad (he was 51). Trying to balance school, family, Beth (we found out I was accepted into school the day we got back from our honeymoon), hobbies, responsibilities all at once, at times, has left me confused and uncertain. Marriage is not for wimps. Beth and I have been tested and I'm sure that we will be tested in the future. But God knew the kind of woman that I needed and he brought me the most perfect wife. Not that she's perfect (Laura can vouch for me...Scott and Will too!) but she's perfect for me. And I love her. I am in love with her and that love grows deeper every day she puts up with me. She has put her dreams on hold to support me these last 4 years. I cherish her and am amazed that she sticks by this stubborn old mule. If you meet the Gallants and the Turners (Mom and Dad's mothers' family, respectively) you would know that I didn't stand a chance when it came to stubbornness. We are opinionated and we DON'T like to be wrong and we don't mind telling you. Ha! My mom's family reunions are a HOOT! 80+ year old women each telling their other 80+ year old sisters how they should do things. And each resenting the others for saying something. But back to Beth. One thing that will always stick with us...My Granddad Brown (Dad's dad) Thanksgiving 1999, just a few months before he passed away, when we were going around the table saying what we were thankful for, said this, "I'm thankful for my little bride, my little Nell." I may not tell her enough, or show her enough, my I am thankful every day that God brought Beth into my life. We have much left to accomplish...Together!

Many positives have also come out of the last 4 years. I have made friendships that will last a lifetime. I have renewed old acquaintances (who knew Rhonda (the girl next door in Abilene) would show up for an appointment with the doctor that I was working with fifteen YEARS after I had seen her last?!?). I have lived a dream. When I matched into Med/Peds, I realized a dream that I've had for a long time. The dream of being a doctor. Now, my dad will tell you that's been my dream since I was 5--he always wanted me to be here--and never let me settle for second--THANK YOU, DAD. Of course, there are many others who rightly deserve thanks as well. Mom--I remember those nights in Abilene when I waited until the ABSOLUTE LAST MINUTE to START a project. And we'd go up to your work and spend 4 or 5 hours copying, typing, cutting, pasting, and putting the finishing touches on whatever it was. I would read and you type. I would think and you would help me put it into words. For those of you who might not know...My mother is a saint on Earth. God has blessed me richly with 2 parents who've spent everything they had to make sure that their children had what they wanted...Even when we didn't need it. I love you both enormously!

Grandparents and best friends, childhood and college, in-laws and out-laws (you know who you are), ministers and mentors, music teachers and classmates...You have all shaped my life and helped me stand where I am today. I think of you all often and my door, phone, anything you need is open, 24/7 all you need to do is ask. I know that I've made some mistakes in my life. And for those, I am truly sorry. Hopefully none to justify losing a friend over. And hopefully ones that you have forgiven. I bring this up because my 10 year high school reunion is this summer, and I plan on attending...but I will have to blog about that another time. This one is already getting long, and I'm not finished!

The coming days are both terrifying and exciting all at once. There are still many questions to answer. We haven't sold our condo, yet, ergo, we haven't been able to move to our new house. Some of our "med school friends" are moving to different cities to begin their residencies and therefore leaving us without their company. We wish them all the best. There are new friends to be met and made once residency starts. All exciting and terrifying, all at once.

On May 28th, I will enter George R. Brown Convention Center a 28 year-old kid from Abilene, Texas. I will leave Jeremy L. Brown, MD. And June 24th, someone is going to page me and ask me to take care of their loved one. Me, Jeremy.

May the Lord Bless you and Keep you all.

Friday, April 08, 2005

A Whole New World

So I am taking some inspiration from my beautiful wife Beth and am going to try to blog. This should be interesting considering the world which I am soon entering. That of an Intern.

First let me say a few things about the world today. Michael Shiavo had the right to decide what happened to his wife. I know that his may draw some fire from those around me (aka Mom), but regardless of the money, the affair, or whether or not Terri Shiavo was in a persistent vegetative state, her husband legally had the right to make that decision. For the record, if any of you reading this ever find me in the same condition as Terri was, PLEASE pull my feeding tube! I PROMISE that I will forgive you and not hate you or curse you, even if I know that I'm being starved to death. Terri was in the same condition the day before she died as she was 15 years earlier when her heart stopped and her brain was deprived of oxygen for some amount of time (I don't know personally how long a time this was). Sure, give me 2 months to see what happens, see if there is some chance of improvement, but PLEASE do not feed me through a tube for 15 years. That is not the life that I want. I would rather sing with the angels, than be fed through a tube.

Secondly, I am marveled by the faith of the man known as John Paul II. I have been transfixed ever since the night they reported that he was gravely ill. I even stayed up until 2:00 a.m. watching the latest news. In reading his will on CNN, there is no question that he was a man of God and fought with all his might to stand up for the things that he believed in. In his will, he left nothing because he had nothing to leave. No car, no cell phone, no retirement fund. His instructions merely said burn my personal papers and bury me in the ground. The weight he carried leading 1 Billion Catholics is nearly impossible to fathom. The grace, passion, and faith in which he did it, is remakable.

Graduation is 7 weeks from tomorrow, then this blog truly will be the "Ramblings of a Med/Peds Intern".

Thanks for reading.