The Flash Mob: Let It Die Already and Put It Out of Its Misery

the typical obnoxious flash mob

Before I proceed to the main topic of this post, I should announce that Jared (not the former subway spokesperson Jared  but the guy who had my name tattooed to his bicep in order to avoid serving an LDS mission) and I are officially once and for all kaput. We've both dated other people for the past year, so it's not as though this new development is any great blow to me. What clenched the deal, so to speak, is that he is now engaged to one of my closest friends, Megan (the girl whose family owned the lesbian hen). I think they're far more suited for each other than Jared and I ever were for each other. I couldn't be any happier for them than I am. They've tentatively set their wedding date for August of 2017. I've been asked to be a bridesmaid, and I very happily accepted the invitation.

Now I shall address a topic that is the diametric opposite of being near and dear to my heart. The subject of discussion here is the semi-passe-but-still-happening-just-often-enough-to-annoy-me phenomena known as flash mobs. I concede that flash mobs are essentially harmless. Moreover, they seem to make a lot of people happy.  If people genuinely derive pleasure from participating in them,and if others enjoy watching viewing them, by all means they should continue, though preferably in venues where the audience is not captive and can walk away if they are perturbed by them as I am.

The subject of flash mobs came up recently because it has become almost expected that someone in the graduating class will organize a flash mob to perform during their medical school's Match Day ceremony. Match Day, which happens on the third Friday each March, is when 4th-year medical school students learn if and/or where they will serve internships or residencies. Fourth-year med school students travel to be interviewed by various programs. Skype interviewing isn't really recommended because students tend to be happier if they rank their preferences for internship or residency programs based on having actually traveled to the places. The residency programs simultaneously rank their preferences in candidates, and a computer program sorts the data and spits out matches. (I hate to think of what some amoral mastermind like Karl Rove might do to manipulate the system, but so far he's been more fixated upon presidential election outcomes than Match Day results. Furthermore, at least as far as I know, no one has received a "match" with an institution not even ranked on their list.)

Cutting to the chase, the Match Day ceremony at each med school has its own long-standing traditions, but one tradition that seems to be creeping its way past many of the more established customs is the dreaded flash mob. the expectation that a group is to produce a flash mob is, in my humble opinion, all the more reason not to do one. a flash mob is only successful -- and only in the rarest of instances, in my view, are they EVER successful  -- if there is an element of surprise in the performance. If all the attendees at  a Match Day ceremony are sitting around waiting for the inevitable flash mob to start, where is the element of surprise. Not there; I guarantee it.

Flash mobs have pervaded our societal functions to the point that a newly-wedded couple sometimes questions both the sanctity and the legality of their union if a flash mob did not take place at some point int their proceedings. The wedding reception flash mob has grown into a cliche of sorts.  I haven't seen a single wedding reception flash mob, either in real life or on YouTube, that I considered even remotely clever or well-done. A few actual wedding ceremony flash mobs -- while I wouldn't necessarily have wanted either to participate in them or to have them performed at my own wedding -- were both undeniably well-executed and sufficiently unexpected as to contain an element of surprise. I'm not big on people performing circus-style acrobatics right in the middle of a church service, but still, the level of skill and preparation was admirable.

I must admit that a large measure of my disinclination for flash mobs stems from my critical nature. While I don't consider myself a singer (for good reason), as a musician I nevertheless have a strong sense of both absolute and relative pitch. People who sing in flash mobs are, as often as not, at least a bit pitchy. Listening to them disregard each others' tones hurts my ears. 

Dance flash mobs are probably more common than singing flash mobs. I have less problem with them, though I usually find the cheerleader-style dance moves often seen in flash mobs to be rather tiresome. (I no longer hate either cheerleaders or cheerleading per se; I'm just not terribly fond of the style of dance employed by most cheerleading squads and wish it would have both its beginning and its end in actual cheerleading performances and competitions and would cease with its attempts at infusion into other dance genres. [I was a cheerleader very briefly, and dancing in that choppy and forced manner very nearly did me in.])

All of that being said, there are a few places I would kill to see flash mob performances.

        1. A flash mob in an LDS temple ceremony would be classic.  The
            geriatric temple workers might very well succumb to the shock 
            of the unexpected, but even (or especially) if it were my own grand-
            father, I'd say the flash mob was easily worth the price.

        2. A flash mob at a funeral might be nice. this should never happen 
            at the funeral of an infant who died of SIDS or of a high school 
            student who was killed by a drunk driver or at the funeral of a 
            serviceman who gave his life in service of his country. Performing
            a flash mob under such circumstances would be disrespectful and 
            basically wrong in every way. Under other circumstances,  however,                   a flash mob might serve to give an otherwise grim ceremony a bit 
            of ambience. I nominate my own grandfather, for that time when he                   ultimately meets up with The Grim Reaper, to be the recipient of
            a colossal flash mob sendoff. I'll even organize it. We'll use an appro-
            priate ditty: "If You Don't Know Me by Now" by Harold  Melvin and
            the Blue Notes. click on the link and scan the lyrics if you're unfamiliar               with the song. I'm sure you'll agree that the song is fitting funeral fare.
http://www.lyricsmode.com/lyrics/h/harold_melvin/if_you_dont_know_me_by_now.html
 
         3. A flash mob in Judge Alex's courtroom would be a hoot. I would never
             participate in it, but I would get a charge out of seeing how many 
             people he threw in jail for contempt of court.

Even with this post being essentially a vilification of the flash mob phenomenon, two flash mobs stand out as having been especially nicely executed. One is the performance of Ode to Joy by the symphony in Catalonia. The other is too good to pass up.  I will include a video of the flash mob that is the absolute quintessence of all flash mobs. I'm thoroughly jealous and may never get over the fact that I was not an engineering student at the University of Toronto in 2013 and didn't get to participate in this flash mob. The singing isn't perfect, but considering that these people are engineering students and not music or theater majors, and that they're singing while walking on narrow and slippery tables between rows in an auditorium-style lecture hall, it's both respectable and commendable. This is one reason I think no more flash mobs really need to happen (except for the one at my grandfather's funeral): no one else will ever do it better. 

NOTE: I don't own this video. I'm including it as a sign of my sheer admiration and respect, and I sincerely hope no one who has any rights to it is offended by its inclusion here.
      

Happy Mother's Day, Or At Least Un-Miserable Mother's Day, to All for Whom the Greeting Applies

This isn't a picture of my mother. My mother does not want me to post pictures of her on my blog. Instead, I randomly chose a picture to represent my mom. I believe the person actually pictured here is Natalie Portman. Natalie Portman is something like fifteen years younger than my mom, though my mom looks
young for her age, and my mom's hair is a bit lighter, and her eyes are blue.
As to just how closely my mother otherwise actually resembles Natalie Portman, I offer no opinion. I will leave that to the readers who know my mom to decide.

Holidays are supposed to be joyous occasions. Sometimes they're not. Any family gathering is a potential source of ugly conflict in some families. I have firsthand experience with this, as my father has more than a few rather loathesome siblings and siblings-in-law, not to mention a loathesome parent. The holiday will not suck in that regard for me, however, as I do not have to spend Mother's Day with the greater part of my father's extended family. My dad visited his mother last weekend because he knew this weekend would be a logistically difficult time for him to travel to Utah. When he visited my grandma, my dad extended the usual invitation for her to return with him or at any time later and to stay however long she would like, including permanently. She's never taken us up on the offer before, though we hope that if she's still in good health, she will come to Matthew's and my graduation in two years.

Holidays can also be times of emotional difficulty following divorce or death of a close family member. If a relative's death, especially  a particularly untimely death, happens near any given holiday, that holiday is often marked with sadness with each passing year. The first time through any holiday following the loss of a relative who was important to a family's observance of the holiday also stirs bittersweet emotions. For anyone experiencing this, I hope the holiday is, in spite of a recent loss, filled with more happiness than sadness.

The holiday, of course, exists primarily so that the greeting card, florist, and restaurant industries can make a huge windfall off all of our collective guilt for not showing greater appreciation to our mothers throughout the year. Mothers are taken for granted. If I'm ever a mother, I assume I'll be taken for granted as well.  C'est la vie. This, however, does not make it acceptable to take our mothers for granted.

My own mother's path to motherhood and through it has not been entirely smooth. She had a nearly-successful-but-failed attempt at acquiring twins before having Matthew and me. Once she finally had us, as much as she actually had wanted us, there surely must have been times when we caused her to question the costs versus benefits of actually having children. We weren't always the world's sweetest  or most cooperative children, yet she never let on that she was having second thoughts in terms of motherhood.  

Early in our lives my mom developed health issues including Graves' Disease, thyroid eye disease, and leukemia, along with  less serious but still incapacitating urinary calculi, otherwise known as kidney stones.  Through all her health issues, at least as far as Matthew and I  could tell, my mom seemed to prioritize our needs above her own. There were two  intervals n which she was hospitalized for a few months at a time. Otherwise, she sought treatment and returned home as soon as was practical after each procedure, often leaving hospitals against the advice of her doctors because she had two young children at home.

My mom stayed home with my brother and me until our final year before kindergarten, and only worked part-time even that year so that she would be home with us when we were not in preschool. From that time on, except for the times she was being treated intensively for illnesses, she worked on a full-time basis. She probably didn't have to work, as I suspect my dad earned enough to have kept us in the homes we lived and clothing we wore, and his earnings probably kept food on our table as well. What my mother's earnings did accomplish, though, was to cover our medical school tuition costs so that Matthew and I will start off our careers debt-free. Few of our med school peers will have this luxury. Both Matthew's and my undergraduate educations were financed with scholarships, and I've had enough scholarship money left to cover my med school expenses so far, but if it runs out, I won't need loans. 

My mom probably could have spent every day either at a spa or practicing music, but she chose instead to make a financial investment for my brother and me. She probably would have grown tired of having massages and facials anyway, but she could have switched from one hobby to another whenever she became bored. Instead, she dealt with students and with pesky special education issues for something like twenty-three years. Entire forests have been cleared to provide the paper that is necessary to document -- usually in multiple formats -- the most minute details about every student enrolled in any special education program. If anyone out there thinks that working in special education is just about helping especially vulnerable children, think again. It is about helping kids, but a whole lot of additional time is spent providing the documentation that will hopefully keep oneself and one's employer out of litigation. It's the sort of paperwork that causes literal headaches. A lesser person that my mother would be addicted to Vicodin if not benzodiazepenes. She still works, though not in special education any longer. She teaches music at the university level. Some university professors profess that their students are every bit as "special" as the most involved special ed. students, though I don't think the verdict is yet in on that where my mother is concerned.

In any event, my mom has earned far more than any lame gift I can ever give her. To her I give my love and admiration, and to all mothers everywhere who have done the very best they could with their circumstances, I  give my utmost honor and respect.

Sarah Hepola, BYU, Alcoholism, and Honor Code Enforcement

BYU students protest the role of honor code investigations follow the reporting of sexual assaults among the university's students.

I'm doing very little of anything other than intense studying these days. My reading material is limited essentially to content I need to review in preparation for Step 1 of the USMLE. (There. I said it again out loud, or at least wrote the name of the exam. Doing so continues to make me nervous, though I would expect that if lightning were going to strike me dead for referring so explicitly to the gatekeeper exam, I would already be six feet under.)

In any event, though  I have little time for pleasure reading, I took the time to re-read Sarah Helpola's Blackout: Remembering the Things I Drank to Forget. Reading the book was a most welcome diversion from reviewing the symptoms of (and i'm not exaggerating in the least) every medical condition under the sun and some that aren't.

My extended family has a bit of shared history with Ms. Hepola, a journalist who wrote and edited for, among other publications, Salon magazine. my cousin and her first-cousin-once-removed were fans of Sarah Hepola and frequently responded to her blog posts. Ms. Hepola had a fascination with all things Mormon at the time, which eventually led to a two-part interview with my cousin and her cousin. The interview may still be accessible in some long-forgotten archives somewhere on the Internet, though I wouldn't have a clue as to how to go about finding it. 

Sarah Hepola's book is probably the most excruciatingly  honest memoir I've ever read. She doesn't spare a single self-incriminating detail of her drinking exploits as far as I I can tell. She writes of taking her clothing off when drinking and of waking up in the beds of strangers following alcohol-induced blackouts.  She shares details of her very early introduction to sex at the hands [or, more literally, at the phallus] of a man far older than she.  Her life, even up to the point when she reached the age I presently am,  is one I could scarcely imagine.

I've been cautioned by a few presumably well-intentioned individuals about the evils of alcohol consumption, though I don't buy into most of what I would consider scare tactics along these lines.  I'm aware that being under the influence of alcohol can leave any person -- particularly one of my gender and size -- more vulnerable than she would otherwise be. 

Still, it will be my choice to continue to imbibe [albeit relatively moderately] on occasion. After careful consideration, I have decided that a couple of drinks in one sitting when I'm surrounded by people I have good reasons to trust will not place me in any particular peril. I haven't consumed any alcohol other than my twice-weekly half bottle of Guinness, which I detest but drink for health reasons, since my birthday nearly five months ago. I have no idea when I will again feel compelled to drink myself into  the nirvana-like state between  buzzed and wasted, though I know it will happen.

In relation to the negative press BYU is getting over enforcing its controversial honor code in relation to the reporting of sexual assault, I've certainly thought about alcohol consumption and its role in creating vulnerability.  I don't have a great deal to say about the particular issue because I don't feel that there is much more to be said about it. A person needs to have a solid handle on how much he or she can drink and still maintain control of his or her circumstances. On the other hand, it was with good reason that I chose not to attend Brigham Young University, where I would be subjected to the draconian policies of the LDS-operated institution.  Besides, BYU doesn't even have a medical school. I'd be finished with them by now even had I done my undergraduate work there.

I don't think there are many rational minds out there who would place the blame on a woman who was sexually assaulted for having consumed alcohol prior to the assault. For me, though, I don't want merely not to be blamed. If I drink, it will be to have a good time that is not spoiled by the prospect of assault of any kind.  I will always be careful where and with whom I drink, but  I could not ever take another drink for the rest of my life and still be sexually assaulted again. The last time I was assaulted, alcohol played no role.. Life offers few guarantees.

Order at Your Own Risk

I didn't cut the model's head off; STYLEWE did. Either that or the model insisted upon remaining anonymous, which wasn't a bad choice if such was her intent. 

Tonight I clicked on a link for a clothing company that calls itself "STYLEWE."  Here's the link if anyone is interested:  https://www.stylewe.com/product/embroidered-pierced-mini-dress-21184.html?gclid=CMTeppH8lswCFYiVfgodrmELXA . I don't believe the link or site is embedded with any malware content.

I would describe most of the clothing featured at this site as tawdry in an attempt to be charitable. The dress pictured here is OK -- one of the more tasteful garments I viewed at the site -- although it's not something I'd choose for myself. It's more my friend Megan's style, and her birthday is approaching. I assumed I'd probably want a small for her, as she usually wears a size 4. I clicked on the size guide to confirm that my expectations were in line with their sizing protocol. Much to my amazement, I discovered that Megan would only be able to squeeze into a size XXL. 

Seriously, on whose planet does size 4 equate with extra-extra-large?  I would not buy that dress for Megan even if I thought it would be her most prized dress of all the dresses she would own for the rest of her life. For one thing, I'd have to cut the size-indicating tag out of it to avoid hurting her feelings, and who gives someone a dress with the tag cut out? More importantly, though, I refuse to do business with a company whose size protocol is, in essence, a method of fat-shaming. 

For that matter, the company is fat-shaming even skinny people. My mom wears clothing in sizes  2 to 4 depending upon the garment and the manufacturer. She would need an extra-large (XL) size of this dress at the very least, and possibly even an XXL.  My mom is 5'3", is small-boned,  and is arguably thinner than a person should be. Granted, the company is not marketing its products to forty-nine-year-old women such as my mother, but if she were her same size and 21 years old, she'd be thin by any standard other than perhaps in comparison to starving Ethiopian refugees.

I wear size zero. Two years ago I was probably a double zero, but clothing I wanted didn't usually come in size 00, so I had to make do with over-sized clothing or with children's clothing.  It's unfortunate that I did not know about STYLEWE back in the day.  By patronizing this company, I could have worn slutty and tacky clothing every day of the week with very little effort. My Aunt Cristelle probably wishes the company had been in business when she was scouring the planet for clothing to dress me up in the Halloween that I was Trailer Trash Barbie. If she'd bought a size-00 outfit and tossed it in the dryer on "high" for twenty minutes, it might have been snug on me even then.

Incidentally. STYLEWE's sizing guide for the dress in question indicates that sizes "small" and "medium" are identical. My guess is that virtually no one orders medium when a small garment fits identically. I would probably feel better about wearing a medium for once in my life, but I acknowledge that I'm in the minority.

On top of everything else, I wouldn't think their marketing strategy would be an advantageous business model, but then, what do I know? Perhaps STYLEWE is targeting their merchandise to those on the down side of anorexia and to those suffering from the acute hyperthyroid phase of Graves' Disease or with inflammatory bowel disease.

another charming STYLEWE offering

Here's another sweet STYLEWE garment. In this one, the model (if you could see her face) looks as though she is stoned,which a person would almost  have to be in order to voluntarily wear this dress. Edited to add that I have slightly amended my position in regard to this dress. I now think the top looks like a top especially made for breastfeeding. A five-year-old could probably breastfeed discreetly under that top, not that I would ever be caught dead breastfeeding a five-year-old.

Bleeding Tonsillectomy Wounds, Third Marriages, and a Kibosh on Adult Baby Stories

Meredith tried to interest her parents in a Hello Kitty wedding but they weren't interested.

I don't have anything profound in the least to share this evening -- not that I do under normal circumstances -- but my pseudouncle told me that the Adult Babies post has begun to grate on him. He said every time he clicks on my blog to see if I've posted anything new, he sees one of the pictures of the adult babies (I think I may have taken one of the pictures down, as it was starting to creep me out as well, although I may have just had a Vicodin-enhanced dream that I took the picture down) he becomes just a little more weirded out by the pictures. He said he'll wash my car for me on his next day off if I'll either take the Adult Babies post down or post something else after it so that he doesn't see the adult babies unless he scrolls down. As my car most gravely needs to be washed, and as I'm likely to be either too weak to wash it myself or too wasted to drive legally or safely to an automated car wash, I find myself blogging at this rather odd hour.

I had to go back to the hospital yesterday to have one of my wounds cauterized. Despite my valiant efforts at keeping myself hydrated, the scabs over two areas dried up and came off, which caused bleeding that wouldn't stop. I wasn't hemorrhaging, but the bleeding was likely to continue until something was done to stop it. My surgeon cauterized all the surgical sites since I was knocked out anyway and he thought the other wounds didn't look all that terrific, either.The cauterization procedure itself didn't cause me any pain, as I was knocked out for it, but it's about as sore now as it was the first day after the surgery. This, too, shall pass, but I'm growing weary of being stoned.  I'd forgotten about this after other surgeries, but a point may be reached where one can have too much of a good thing  --  even where something so delightful as hydrocodone is concerned. I look forward to having a clear mind.

My doctor asked me to give up studying for five days. I've humored him by putting my materials away since then, and I'll stay away from them for the most part for the next three days, but  friends and relatives quizzed me using some of my pre-prepped study materials. My total study time each day  was somewhere around three hours each day, however, as opposed to my usual twelve-to-fourteen hours of studying per day. I'll need to get back to the more intense studying next week, but I can afford to take things slow for a couple more days.

The week after next,  I'll need to adjust my study schedule so that my day off is on Saturday because I must provide music for a wedding. The wedding will be an interesting one. My friend Meredith's parents are getting married for the third time. It's not just one of those sentimental renew-the-vows sorts of ceremonies, either. It will be an entirely legal wedding. Meredith's parents were first married about two years before she was born. They first divorced when she was somewhere around three. Then they each remarried others, but divorced their respective spouses and decided to give marriage to each other another whirl when Meredith was eight. This time the marriage lasted seven years before they decided to pull the curtain on it.  Meredith's dad remarried twice in the time following their more recent divorce. The first of his subsequent marriages was annulled, while the second one lasted scarcely longer than the little tulle-wrapped packets of rice handed out at the wedding reception. (Meredith's dad is so incredibly frugal that he gathered up rice packets that were not used, unwrapped and poured them into a canister, and cooked and ate the stuff until it was no more. He was eating the leftover Jordan almonds as well until he broke a tooth on one of them once the candied almonds had started to get a bit stale and even harder than usual, if it is even possible for Jordan almonds to be any harder than they usually are. Meredith said she believed  her father endured physical pain in throwing out the Jordan almonds but that, with the cost of dental implants being what it is, he could not justify risking any more teeth on them.)  Meredith's mom had a live-in boyfriend to whom she was engaged at one point, but she never actually remarried.

Meredith's parents are eccentric people.  Her mom is an accountant. While one can never  expect that every single person of any given profession will fit neatly into some sort of compartment, most accountants with whom I happen to be acquainted are sensible, practical, matter-of-fact sort of people. Megan's mother fits the prototype of an account in terms of her skill set. She has multiplication facts committed to memory all the way  to ninety-nine times ninety-nine.  Why in hell would any  person -- even an accountant --need to clog his or her brain with such dispensable data? Autistic savants and others [my dad] can calculate them so rapidly that it's almost as though they've memorized them (even I can calculate them in my head, though I need a few seconds to do so), but not Blondina. As an undergrad accounting major, she went to the trouble of painstakingly memorizing all the way through to one hundred. And she can quote tax codes in her sleep. In other ways, however, she is the very antithesis of what one would expect an accountant to be. When Meredith and I were in high school, Blondina unexpectedly inherited a decent chunk of money. I don't think even Meredith knew the total sum, but I'd guess it was somewhere around a couple hundred thousand dollars. Late one night when I was sleeping over at their home, I came downstairs from Meredith's room to get a drink of water (I don't drink bathroom water; it's one of my quirks)  to find Blondina seated at the kitchen table with an almost anguished expression on her face. I asked her if anything was wrong. She explained that she had come into a wad of money. She had narrowed how she was going to use the money down to two options: #1, she was contemplating purchasing a racehorse; #2, she was  considering putting the money away in a college account for any future grandchildren. The two options she gave would seem to be so diametrically opposing that it would be hard to accept that the same person came up with both of them. Perhaps therein lies the answer. Maybe there is more than one Blondina inside her head.

Meredith's father is named Chad. (His twin brother is named Jeremy. If you know much about the early-to-mid sixties music scene in the U.S. and Britain, you'll probably make the connection. His parents were perhaps a bit frivolous.) Chad is a psychology professor in the University of California system. (Thank God I never had the misfortune of enduring him as a professor.) He has been arrested numerous times during the annual Black Friday protests against furs (and realistic fake furs) at Union square in San Francisco. (I totally understand a person's distaste for the use of real fur in clothing, at least here in the lower forty-eight,  as down and suitable synthetic fibers can keep us about as warm as fur would.  Realistic-looking fake furs, though? That's a stretch.) Chad is a vegetarian about 97% of the time, but roughly one day out of each month, he goes on a binge and  eats practically his weight in bacon. He looks almost like a semi-starving polar bear going after his kill when he eats his bacon. Chad doesn't waste anything. He rinses, saves, and reuses saran wrap, which is  more challenging than it sounds. He doesn't use facial tissues, relying instead upon the use of cotton hankies to clean up the by-products of his chronic allergies. Meredith's mom insists on using a separate washing machine to launder her clothing and linens. I can't say that I blame her.

i do not yet know what musical selections I will play for the wedding. I don't even know what instrument I'll be asked to play. For all I know, it could be a kazoo The traditional Wagner and Mendelssohn are not out of the question, as they're going for the traditional wedding routine with the blushing bride wearing a formal white gown, the groom in a tux, and with ushers and bridesmaids and the full treatment. It would seem to be a bit excessive for a third wedding (TO EACH OTHER!!!) for a fifty-something couple, but who am I to judge? 

Will the third time be the charm for this couple, or will their rather obvious differences force them apart once again? Time alone will tell.

Her parents didn't take the bait on the zombie apocalypse wedding she proposed, either.

Adult Babies!?!?!?!?!?!?!?!

Why is it that I'm ALWAYS the very last person to learn about everything? I completed [and passed with flying colors] a physician training course  on mental illness. Why did I not learn about this in that course? 

What I'm concerned about not discovering or being told until an hour or so ago is the adult baby phenomenon. In case you didn't know, there are adults, possibly even living and breathing among us, who, in their spare time, dress up as and pretend to be babies. 

Isn't that the most bizarre fucking thing you've ever heard in you entire fucking life? Seriously, I may go wake up my parents as soon as I finish typing to ask them if they've ever heard of such a thing, and if they have, why they never bothered to tell me about it. 

I sent a message to Judge Alex asking him if he'd ever heard of it. I mentioned it to Knotty. She said that there are B&B facilities that cater to adult babies. They supposedly offer cribs. Are the cribs specially made, or do companies like Graco and Kolcraft make cribs for adults just like they make them for babies? Nuk pacifiers, I just learned, are made in adult sizes. 

Why stop at cribs and pacifiers? what about high chairs and strollers? I suppose a wheelchair would work as a stroller, but it wouldn't be quite the same.

I wonder what the adult babies do for diapers.  Do Pampers and Huggies make their products in adult sizes as well, or do adult babies  just buy Depends or those godawful Tena products, or do they purchase fabric by he bolt to make cloth diapers? I'm afraid that just thinking about this might give me a rash, an NOT a diaper rash, in case anyone had gotten the idea that I plan to practice this lifestyle.

Did you all know about this already?

If a certain person shows up here and announces that he or she is an adult baby, I will need electroshock therapy. I say this in all seriousness.

Just when I thought the world couldn't possibly get any weirder, it did.

Children of the Candy Corn

I may have studied for longer than I should have yesterday and last night, and am probably paying for it today. I'm not up to studying at all today, but it's OK because all of the study guides and study methods recommend studying just six days per week for Step 1 of the USMLE. For the most part I plan to take Mondays off rather than Sundays, as it's nice to have one's day off be a business day, plus I like the idea of sleeping late on Mondays. I'm not exactly sure why, as sleeping late is sleeping late no matter what day of the week it is, but somehow it just seems more decadent to do so on a Monday than on a Sunday.

Matthew and I are having company later this afternoon and this evening. A few people from school are stopping by to visit. It will be Matthew's job to entertain them. I'll come out of hibernation only to the extent that I feel up to it.

I didn't say a whole lot about this at the time, but during the last two quarters, all of us in my cohort were required to fulfill several stints of physician-shadowing. I did two here -- with my PseudoUncle Scott and with a neuro-ophthalmologist who is a close friend of the family. I did four more at school, including a 24-hour stint in the emergency room.

One of our professors was trying to warn us that what we would see to a small extent in the shadowing assignments and to a larger extent in our clerkships and internships would challenge anything  and everything we have ever come to believe about how society as a whole functions. She expressed an opinion that most of us have led relatively sheltered existences as children and adolescents and that most of us had relatively high-functioning parents, surmising that most of us would not have made it to medical school had we not had functional parents. Raptor Jesus II offered a slightly dissenting opinion when he said to the professor that I [Alexis] would have made it to medical school even if my mom had been a crack ho and my dad had been any one of 100 of her johns in months near my presumed date of conception. God, how I love that guy.

Anyway, the professor said that we would see -- particularly in the E.R. -- some examples of parenting that would make us question how our species  had survived up to this point and would give us a very dismal outlook for the future of the human race. I don't know if such has been or will be the case for everyone in the cohort, but it has certainly rung true for me.

One of the standard complaints almost everyone who works in an E.R. expresses is that a segment of our population treats the emergency room as their family physician's office. The Affordable Care Act was designed at least in part to put a stop to or at least to make a significant reduction in this practice, but I can't see that it's made much of a dent.

I shared a story in an earlier blog about a fifteen-year-old girl whose parents had her transported by ambulance to the E.R. because of what ended up being menstrual cramps, and probably not even a very serious case of cramps. She carried on as though it was a gall bladder attack or kidney stone (her mother was sure the girl was plagued with one of those two conditions) as long as any medical personnel were looking, but was sending relatives to the vending machines for snacks when she thought the nurses weren't looking. I was never quite sure what she hoped to accomplish with her E.R. visit, as she seemed a bit young to be an opium addict. Then again, one never knows.

I can't remember if I shared this incident from one of my shadowing assignments, but a grandmother brought her thirteen-year-old grandson to the E.R. because he had a small asymptomatic discoloration about the size of a Rice Krispy on one of his testicles. He'd had the discoloration for maybe three weeks according to the grandmother.  I don't know what force motivated the grandmother to all of a sudden bring the kid to the E.R. at 1:00 a.m.  on a Saturday for a 21-day-old testicular discoloration of 1.5 by 2 centimeters presenting neither pain nor even itching. I'm all for checking out testicular abnormalities, but this particular case probably could have waited until clinic hours the following Monday.

The E.R. case I witnessed personally that showed me just how directly society is going to the dogs is one you will not believe. i wish I had been allowed to videotape it, but anyone who has been to an emergency room or even to a physician's office in the past ten years or so knows all about HIPAA regulations and how medical school students cannot violate patients' privacy to film even the most unbelievable of cases even if it would serve the public to know how their tax dollars are being squandered by submoronic parents with public insurance. I'm confident  that sooner or later this particular case will end up being shown on one of those cable network real-life E.R. reenactments. Please let me know if you see it. 

Anyway,  two boys came to the E.R. via ambulance -- a four-year-old and a five-year-old -- accompanied by their mother. She had been shopping with them earlier in the day. This was in November, and  Halloween candy had been priced for clearance sale. The mother bought each of her four children his or her own bag of candy corn. The five-year-old ate his own bag of candy corn, his one-year-old sister's bag, and had started in on his two-year-old brother's bag of when he began to suffer from acute gastric distress. Meanwhile, his four-year-old brother presumably ate at least a few candy corns, but also managed to lodge one up each nostril and into each ear canal. the mother used the tweezers from an Operation board game (she did a bit of damage because she thought that as long as the Operation tweezers weren't making a buzzing noise, she wasn't actually hurting the child) to attempt to remove the candy corns from the child's ears and nostrils, but had only succeeded in lodging the candy corns even more firmly into their respective cavities. 

Instruments were used to removed the candy corns from the four-year-old's nasal cavities and ear canals. The kid predictably screamed the entire time. The mother wanted to know why something couldn't be prescribed to make the little boy feel better or at least to calm him. The doctor said, "Because he needs to know that if he sticks things up his nose and into his ears, having them removed won't be a pleasant experience." Removing the candy from the kid's nose should not  have been particularly painful (except for his nasal cavities being a bit tender from his mother rooting around inside them with the Operation tweezers), though it's not pleasant to have objects stuck up one's nose, which would have been a great reason for the kid not to have put the candy corns there in the first place. The doctor did put anesthetic drops into the kid's ears.

The physician checked out the five-year-old to ensure that his vital signs were OK, that appendicitis wasn't being overlooked, that there was no evidence of a blockage or rupture of any kind, or that such was not impending. There wasn't and it wasn't. The diagnosis was "ingestion of too much candy," for which there is an actual ICD code (WX46.887, if you're interested). She told the kid and his mother that if he eats two entire bags of candy in a single sitting, he should expect to feel lousy. The mother was insistent that her child be given something to make him feel better. The doctor said she couldn't recommend even Pepto-Bismol because it might constipate the kid, which is the last thing in the world anyone should want at that point. She said that if the condition turned into diarrhea, Pepto-Bismol would be fine, but it shouldn't be given to the child until or unless he actually experienced diarrhea. The mother wanted the E.R. physician to provide her with the Pepto-Bismol that the child might eventually need. The physician gave her a list of pharmacies with addresses. The physician told me afterward that she would have provided the pink bismuth medication to the parent except that she really didn't want it to be given to the kid if he didn't have diarrhea, and that the mother probably wouldn't go to the trouble of acquiring the medication and giving it to the little guy needlessly if she had to go to the pharmacy and pay for it herself.

If you had any doubt that your tax dollars are being wasted in our nation's emergency rooms by irresponsible parents, doubt no more. Don't blame the E.R. personnel, however. They're doing the best that they can to minimize the damage.

Surgeries, Pain Management, and Gross Surgeries Not for the Faint-of-Heart

This is what i'm looking forward to for the next couple of days once the IV comes out, which makes the idea of deriving any pleasure whatsoever from painkillers to seem like a figment of some truly twisted person's imagination.

I'm not yet ready either to run a marathon or to spend a night partying, but I'm closer to being a part of the world of the living than I have been since Tuesday morning. Opiates are still in my system and probably will continue be for a few more days, but I'm no longer bona fide stoned. I managed, under the influence or not, to get in a solid eight hours of USMLE preparation today.

Tonsillectomies used to be almost the rule rather than the exception. Among those who came of age in the early 70's or before, close to half of those who received regular medical care lost their tonsils somewhere along the way. Since then, medical attitudes have shifted. It was concluded that tonsillectomies didn't necessarily solve quite as many problems as was previously thought, and the assessment of risk versus  benefits of the procedure was looked at more carefully, especially considering current knowledge of inherent risks associated with any use of general anesthesia. Still, sometimes tonsillectomies are medically necessary.

For practical purposes, the distinction between a minor surgical procedure and a major one lies in who in undergoing the procedure. If someone else is having a tonsillectomy, I would probably consider it to be a minor procedure. If, on the other hand,  a tonsillectomy is happening to me, it's clearly a major procedure. I don't claim to be even as stoic as the average person. I do not like pain and do not go out of my way to bring it on myself.

I've undergone more surgical procedures than I'm willing to bore my readers with in this blog. My experience has led me to the conclusion that, with a few exceptions, surgeries are approximately equally painful. Obvious exceptions to this are procedures such as open-heart surgeries during which a person's sternum has to be split in order to access the heart, or even maxillary or mandibular osteotomies, in which an upper- or lower-jaw bone must be cut or fractured by a surgeon. Procedures such as these are in leagues of their own in terms of the resulting discomfort. I've also been told that a few ocular procedures -- particularly the orbital decompression, wherein a surgeon makes an incision through the inside of a person's upper lip, takes instruments through the incision to the cheek bones, drills holes in the cheek bones, takes instruments though those holes to the eye sockets, pushes the eyes out of the sockets, shaves bone from two to four walls of the eye orbit, suctions the shaved-off bone and extraneous fatty tissue through the nose, puts the eyes back, and stitches the incision in the inside of the upper lip -- are more than a bit grim. While this sounds like something that could have been dreamed up by an author of combination science-fiction-and-horror-film genres,  the procedure is for real. My mom underwent it about seventeen years ago. 

For most procedures, however, the difference in the level of discomfort is in the post-surgical pain medication that is given. Adults usually get better pain meds than kids do, which now works in my favor. In-patients are given more potent meds than out-patients are, which hasn't worked out to my advantage with this most recent procedure, as tonsillectomies are now in-and-out procedures. 

A tonsillectomy -- with or without an adenoidectomy -- is, in the grand scheme of things, objectively speaking, a minor surgical intervention.  The procedure itself is more complicated for an adult than it is for a child, though, primarily because each time a person's tonsils or adenoids are infected, more scar tissue builds up, making it more difficult for a surgeon to get to the organs to remove them. (Anesthesia, however,  is a trickier proposition for a child.) Adults suffer more than twice as many post-surgical complications from tonsillectomies as do children, primarily because of the greater difficulty in accessing the organs and because the tonsils of adults are larger (not necessarily larger in proportion to the size of a person's body, but larger nonetheless), leaving larger surface wounds upon removal. 

I'm legally and technically an adult, but my tonsils were more like those of an adolescent than of an adult. My surgeon reported that my throat was an even bigger mess of scar tissue than he had expected, but that removing it all wasn't terribly difficult. As much as it pains me to admit this, my pain hasn't been any greater than is the pain of the average person who has undergone a tonsillectomy and adenoidectomy.  I did have a whole lot of nausea, but I have enough doctor relatives that I'm able to have an IV at home to prevent dehydration -- which is essential in recovery from a tonsillectomy.  

The proverbial diet for tonsillectomy recovery is ice cream. I didn't get to have any until this evening because of my nausea, but I'm now able to tolerate ice cream. If I continue to keep things down, I will have my IV removed tomorrow. I'll be very glad to lose the IV, but I will have to  deal with liquid pain medication once the IV is gone. I'm not sure how to explain my disgust for liquid pain medication other than to say that if given a choice, I would opt to eat a teaspoon of dirt from the yard outside rather than to consume the same quantity of liquid medication of any kind. Dirt from the garden, however, will do nothing to alleviate the pain from the rather large holes in my throat, so I'm stuck with the liquid medication for now.

That's all I really need to share about my tonsillectomy. People who recount their hospital stories ad nauseum are tiresome. I'll try not to be one of such people.

It's Alexis Speaking Through a Fog of Liquid Hydrocodone

I'm reasonably sure I'm still alive because if I were dead I couldn't possibly be in this much pain. The liquid hydrocodone can only do so much.

My Tonsils and Adenoids Are Living on Borrowed Time

I'm having surgery in six hours or so, or I'm reporting to the hospital in less than six hours, anyway. God alone knows how long I'll have to wait around after arriving. I'm supposed to be first after the children, diabetics, and emergencies, and the most dire of emergencies will be serviced elsewhere, although my anesthesiologist could be taken away by a crisis of some sort.  I will wait around for my anesthesiologist if he's called away. It's not actually your surgeon who will usually kill you but rather, sloppy work on the part of your anesthesiologist. It pays to know who the best anesthesiologists are and to use any connections you may have to obtain their services.  

My dad was in Utah with my grandmother, who is being treated for sepsis. He flew home unexpectedly earlier this evening because of my tonsillectomy / possible adenoidectomy. I was a bit insulted. He was needed in Utah, and if I cannot at the age of 21 handle a simple tonsillectomy without my dad lurking outside the O.R., it would appear that there will never be much hope for me to function as an adult. My dad, my brother,  and two of my uncles have already donated blood for the unlikely event that I need it. I'm not sure exactly what my dad thinks his presence will accomplish. He said that he left my Uncle Michael, who is also a physician, in Utah to keep an eye on things there, and that he'll fly back to Utah in three days or so once I'm past the highest-risk period for complications. I'm less than thrilled, but what can I do?

On an entirely unrelated note, I looked at the traffic sources on my blog's information page. One of the search terms that allegedly led a reader to my blog was "my grandfather's existence angers me." I'm the first to admit that I'm far from being my grandfather's biggest fan, but never have I said or written anything to the effect that his very existence angers me. Hell, if he had not existed, I would not exist, or at least not exactly in my present form. (It's conceivable that I would exist in a better form were it not for the existence of my grandfather, but that is entirely beside the point.) I don't know how in the world Google and Blogspot conspired to link that search term to me. Perhaps Google is now reading my mind.

I'm not sure when I will return, but I will return.

A Change in the Blog

It has come to my attention that some of my readers are uncomfortable with some  comments made in response to my blog. Most blog authors, I would assume, wish for the reading of their blogs to be light-minded experiences, or, at the very least, certainly not something that would increase anyone's level of concern or anxiety.  If comments by any given person have caused others to avoid visiting my blog site, the time has come to make a change of some sort.

I considered making my blog private, but that would in some ways defeat the purpose of my even having a blog. One reasons for which this blog exists is so that I might have a wider audience. If readers had to request my permission, most would not bother doing so. Furthermore, some people I want to read my blog are not registered at google or blogspot or anywhere else that would gain them access to this blog. 

I have decided instead to moderate comments and have changed my settings to include moderation of comments. 

I didn't make this choice in order to hurt anyone's feelings, and I'm very sorry if I do hurt anyone's feelings in the process. if former readers avoid me blog because of a single reader's comments, however, there's little point for me to have a blog.

Thank you in advance for you understanding. 

Mormon Christmas on April 6 and Other Aberrations

This is probably further even than Mahonri's family takes their Mormon Christmas holiday/

I don't know how I made it so far in life with my parents still withholding this little gem from me, but it finally occurred to them to spill it, so now I of course have to share it with all of you . . .

Some of you may remember my Uncle Mahonri. He's my uncle by virtue of his being married to my father's sister Marthalene. The most noteworthy thing about Uncle Mahonri is his proclivity toward theft. My mother holds a doctorate in clinical psychology, and even she cannot determine whether Mahonri is a common thief, a kleptomaniac, or even something much worse. It probably doesn't matter. The bottom line is that he habitually helps himself to things that do not belong to him. This little idiosyncrasy very nearly cost Mahonri his job with the church educational system when he was caught stealing a crate or large carton of disposable douches from the loading zone of a big box store somewhere in Utah County.

Now i have learned that Mahonri may not be alone in his predilection for accessing the property of others. Mahonri's family of birth has a rather strange holiday tradition, about which I feel obligated to enrich the lives of my readers.

A bit of backstory is needed here in order that most of you may put what has been to me a veritable bonanza of information into its proper context. Mormons believe that Jesus was born on April 6. I asked my dad a couple of years ago when the LDS church will back away from of this particular teaching, as they have done with so many things they once taught. ("I don't know that we teach that" was how Gordon W. Hinckley disavowed a particular teaching when confronted with it in a televised interview.) My dad said they'll probably never drop the myth of April 6, as scientific or historical information will never pop up to debunk it as the birthday of Jesus. For that matter, there's approximately 1 chance in 365.25 that Jesus was born on April 6 -- and an even greater chance if you rule out any time in the bleakest part of winter for logistical reasons, as some historians have done, as the likely date of Jesus' birth.

Mormons celebrate Christmas on December 25 along with most of the rest of Christendom. No one else who actually thinks about it really believes December 25 to be the actual date of Jesus' birth, either; it's just that no one else has settled on an actual date, arbitrarily or otherwise. Leave it to the Mormons to be different.

Some Mormons actually commemorate April 6 with a celebration of sorts. One family to whom I'm related draws names and gets together to exchange homemade gifts and to sing carols about Jesus being born in the dead of winter every April 6. Some of them send out homemade cards, though only to other Mormons. On some level they have to know it's just too bizarre an idea to try to foist upon the rest of the world.

My Uncle Mahonri's family has its own peculiar take on the quasi-holiday, to which they refer as "Mormon Christmas"  (italics added by me). Each nuclear family buys Dollar Tree-calibre gifts for each individual member of each family unit. Before you reach the conclusion that Mahonri and his siblings and their spouses must be incredible cheapskates (which is true), I should explain that Mahonri is one of twelve children. He and Marthalene have thirteen children, and most of his siblings have families as large as his if not larger. (They really should have their own reality show. The premise would fall somewhere between the Honey Boo Boo fiasco, the disaster otherwise known as the Duggars,  and the debacle featuring Todd Chrisley's family.) The nuclear families have to come up with an average of 156 gifts each. (The number of gifts would be higher now, as Mahonri and some of his siblings are grandparents.) They would all be in serious debt for the remainder of the calendar year if the gifts were anything more extravagant than Dollar Tree purchases.

As if what I have already explained is not bizarre enough, I'll now get into Mahonri's family's even more peculiar take on the already peculiar enough holiday of Real Christmas. Each April 6 after Mormon Christmas gifts have been distributed and opened, after carols have been sung, after the Christmas story as told in the gospel of St. Luke has been read, and after massive quantities of ham and turkey have been consumed, Mahonri and his siblings all draw small folded squares of paper from a rather hideous bowl made to look like the detached head of Baby Jesus. Eleven of these squares are blank. The twelfth square displays  an X.  The lucky sibling who draws the slip of paper bearing the X is not required to buy gifts for his or her parents, siblings, siblings-in-law, and nieces and nephews. Instead, he or she must, with the help of his or her spouse and offspring, steal something that belongs to every single member of the family throughout the next year. Even the babies are stolen from in this most warped version of a holiday tradition. Then, on the next April 6, the stolen items are presented, gift-wrapped, to the people from whom they were stolen, along with all the rest of the gifts.

The person who draws the X and is obligated to pilfer goods from the rest of the family is known as The Jester. Some joke, huh? My dad said that Mahonri tried to get the tradition started in our family as well, but my grandmother said it was the most batshit-crazy idea she had ever heard of in her entire life (though probably not in those exact words) and that her family would have no part in such an aberrant practice.

Could anything positively scream the pure love of Christ and the peace surrounding his birth as much as petty or grand theft among close family members?

Heidi Cruz, Melania Trump, Their Husbands, PACs and SuperPACs, and Other Players in the Most Recent Drama

The contest is a bit more balanced

when Donald Trump doesn't choose the pictures.

I won't recount too many of the details of the Facebook ads released by Liz Mair, who heads the super PAC Make America Awesome, and of the ensuing Twitter debate. Anyone who cares has already read the material. For anyone who doesn't care, it's bad enough that I'm devoting space and time even to the fallout.

I don't have any strong feelings about Heidi Cruz other than the feeling that the man to whom she is married is perhaps a raving lunatic. As far as her appearance is concerned, she looks like an ordinary person to me. She's probably at least as attractive as are the mothers of most of my friends. 

I will go on record as saying that releasing the ad featuring a nude Melania Trump was not a strategically well-planned tactic. The Mormons already didn't like Donald Trump. Cruz already had the Mormon republican vote. There was little to gain and a lot to lose by releasing the pro-Cruz anti-Trump endorsement, since it isn't 1896, and word of what is released to the Facebook feeds of people living in Utah usually makes it to the rest of the population, some of whom may be put off by sexist implications of the endorsement.

The add was not distributed by Cruz's campaign but, instead, as was noted earlier, by a super PAC opposing Trump.  While  the super PAC's  role in releasing this ad diminishes the culpability Cruz and those operating his campaign perhaps slightly, neither can Cruz accept the benefit of the super PAC's involvement while simultaneously denying all responsibility for what the group does when the group's actions appear to have crossed lines that shouldn't have been crossed. If he's unwilling to categorically distance himself from  all tactics and maneuverings of a super PAC, he'll be linked with anything said or done with the presumed intent of disposing of Donald Trump as the republican candidate for president.

Cruz claims that spouses are off-limits. Will he cling to that mantra if he eventually wins the republican nomination and finds himself running against Hillary Clinton? I'd be very surprised. Perhaps spouses should be off-limits, but if there's anything about a spouse that is interesting enough to be used against a candidate in a political campaign, in all probability it can and will be used.

Trump's tweet juxtaposing the photo of Heidi Cruz's face caught in an awkward pose next to a glamour shot of his wife was asinine beyond belief. Melania Cruz would have to be considered to be more physically attractive than Heidi Cruz would be. At the same time, it's far from a level playing field to select a flattering photo of one person, then to place it, for purposes of comparison, next to a picture snapped while another person is speaking. Depending upon the particular dialect of a given U.S. region, there are between forty-eight and fifty phonemes used to produce the American dialect of English. A list of these phonemes is probably available on Wikipedia or at some similar site. A curious person might download the list, them take a selfie while producing each of these sounds. When the person viewed the selfies, the person would probably discover that he or she looked quite silly when articulating certain phonemes. If you think I'm exaggerating, look at yourself in a mirror while you are making a /v/, /f/, /r/, /p/, /b/, /m/, or /w/ sound.

Any major disparity between the perceived levels of attractiveness possessed by Melania Trump and Heidi Cruz can probably be explained with the rationale that
Melania Trump is a former supermodel while Heidi Cruz is not. When I think about it, the very idea of Ted Cruz being married to a supermodel is ludicrous. He's most fortunate to have found a wife as attractive as Heidi Cruz is. The idea of Donald Trump being married to a former supermodel would be even more outrageous were it not for the fact that Trump is in possession of an almost insane amount of money. That sort of money can be a motivating factor in marriage. Sometimes a person who is leaps and bounds above another in physical attractiveness  may be persuaded by money to tie the knot with a person as aesthetically challenged even as is Donald Trump. 

That Donald Trump is posting his wife-comparison tweets is inane. That Ted Cruz is responding is equally farcical. That the national media is covering this not-even-schoolyard-worthy dispute is even more preposterous.

It would be funny if it weren't very closely connected to a U.S. presidential election. One of these two men will very likely have the republican nomination in a few short months. God help us all.

USMLE -- I said it aloud and haven't been struck by lightning yet.

The face pictured here is not mine.

I've finished coursework. In just a couple of moths I'll take Step 1 of the USMLE. My initial plan was to pursue hedonistic pleasures this week, to have my tonsils (and possibly my adenoids as well) removed next week, and to recover for a period of ten days to two weeks following the surgery, studying only intermittently. Following my recovery, I would begin a six-to-seven-week period of rather intense study for the first installment of the USMLE, which is said to be the mother****er of all tests.

Old habits die hard, however. I didn't get to my current station in life (which is not all that much about which to boast, though what I have achieved would be even more pathetic by comparison  had I gone through life up to this point as a slacker) by waiting until the last possible moment to prepare for any exam.

I began the arduous process of studying for Step 1 of the USMLE this morning. I didn't study for the full the twelve-to-fourteen hours that I plan to devote to test prep once I begin studying truly in earnest, but I gave "the Boards" a solid eight hours and forty minutes of my time. I'll probably do the same for most of the days this week. I'll still manage to knock at least three of the four items off my short-term "bucket list" for this week, but I could not give up studying even were I to try. Studying is such a habit for me that it's not much of a stretch to call it an addiction. 

Step 1 of the USMLE contains 280 multiple-choice questions (dropping, as of May 2016, from 322 questions)  which are to be completed over an eight-hour span, with forty-five minutes of the eight hours allotted for break time. A person can increase his or her break time by skipping the optional fifteen-minute tutorial at the beginning and/or by finishing each of the seven sections in less than one hour. Unless a person taking the test has highly extenuating circumstances, i.e. lactating or something similarly compelling, it would seem rather foolish either to skip the tutorial or to give any section less that its fully allotted time merely to increase one's break time. Then again, I don't smoke. Perhaps I'd feel differently about breaks if I were a nicotine addict.

Results for Step 1 of the USMLE are reported as scaled scores -- a three-digit score as high as 300, along with a two-digit score that we're told is not a percentile ranking but looks, sounds, and smells eerily like one.  The minimum passing score is 190, but anyone whose score skulks anywhere near 190 will be forced to settle for the very dregs of placements in terms of internship or residency.  Medical schools vary with regard to the number of attempts allowed. A person may take the test up to six times; my med school allows only three attempts before the candidate's enrollment is terminated. I will not jinx myself by suggesting that there's no way I will fail the test on my first attempt, but I seriously have no intention of taking the Boards three times.

I have a detailed study plan mapped out in writing, borrowing heavily from someone else's plan I found online. I've already deviated from it, though, by having  begun my study yesterday. I'd love to take a laid-back approach to this thing, but I can't. Neither can I pretend that my level of obsession is a good thing. On the other hand, were I not stressing out over the USMLE, I'd undoubtedly be stressing out over something else. The USMLE is as worthy as any other cause for stress.

I''m not depicted in any of these drawings.

Good-Bye Tonsils (sung to the tune of "Good-Bye, Little Sebastian")

This is not MY throat, and these are not MY tonsils, by the way.

I made it though finals with minimal stress. All test scores have been reported except for the last one, and I maxed out exam scores. The last one shouldn't be much different than the others. (Thanks for asking, la perla.) Our course grades are pass/fail.

 Now it's on to bigger and better things. Our cohort is now de facto disbanded as we individually prep for the mother of all exams. We had a final social event which was attended by a large percentage of us. Some of us will choose to study together for a portion of our USMLE preparation, and we'll continue to see each other from time to time in the hospital and elsewhere as we begin clerkships. Still it will not be the same. The cohort was like being in a self-contained fourth-grade class, and then having the class move en masse the next year to fifth grade. We'll have the rare meeting as well, but it won't be the same. Alas, even good things must come to an end.

After partying with my classmates ( I limited myself to two mixed drinks, light on the alcohol in both), I slept for about twenty-six hours uninterrupted. Then I packed and drove to my parents' place on the central coast. I have nine days to relax, after which my tonsils are being removed. The tonsil removal is not without controversy. My pediatrician does not think the surgery is necessary. Two doctors at my school, however, consider me a walking strep factory as long as my tonsils are in place, and both of them knew that I wouldn't have the surgery done in their location, so they had no financial incentive to push the surgery on me. The ENT I saw for my secondary consultation said that my adenoids may need to come out as well, but it probably won't be known for certain until the surgeon gets a better look.The bottom line is that it's not my uncle's area of specialty, but he's still asserting his opinion. My dad said if I'm really contracting strep on a regular basis, it would be irresponsible to move on to clinical rotations with my tonsils still in place, but it was my decision. 

As much as I don't want to go through this procedure, if it must be done, now is the time to do it. I have an extremely accomplished surgeon.  I can recuperate in the comfort of my plush room at my parents' home, and I can study when I feel up to it. My dad and uncles can even help me study if I want their help. A couple of weeks following the surgery, I'll head back up north to the condo and will study there.

Meanwhile, I have a short-term list of goals to be accomplished. I need to para-sail at least once, preferably off the coast of Catalina. I want to see at least one musical before my surgery, and I don't yet have any tickets.  I would really like to find a viola to buy for a reasonable price. My cousin named a prize heifer after me, and I need to meet this creature. I can knock off my goals one at a time if I skimp on sleep. There will be ample time for sleep after my tonsils (and possibly adenoids) have been unceremoniously ripped from my throat.