Police and Bikes

The title of this post is a juxtaposition (I think that's the word) because anyone who knows me knows that I love bicycles and I abhore the police. One provides me with freedom and the other disgusts me with its attempt at controlling me. This morning I was walking to school when I realized I forgot something at home. I turned around and went back home and then when I was home I decided to ride my bike to school. I went to OB-GYN and then left to come home. On my way back home I left the "campus" of school via a pedestrian tunnel that leads to the center of town. When I emerged from the tunnel I walked up a flight of stairs with my bike and at the top of the tunnel I was at a kind of cul de sac of a street that was one way and I couldn't pedal down the street, so I mounted my bicycle and rode on the sidewalk on the very edge of it so much so that I could have easily fallen into the street. The funny thing about this is that this street in particular has very wide sidewalks which is very uncharacteristic of this city. I almost never ride on the sidewalk because they are narrow and there are too many people on them, specifically tourists who don't know where they're going. Anyway, I don't even get a hundred feet and a cop stands in front of me. I almost don't even need to stop because I was going so slow that all I needed to do was put my foot down to stand up. Anyway, he asks me for my passport and asks if I know why he stopped me....I say I don't because I feel like if I do say I know why he stopped me I can't plead ignorance. Anyway, he tells me that it's a 2000 crown fine for riding on the sidewalk and that the sidewalk is only for pedestrians and the street is for cars and bikes. Now anyone who knows prague knows that this is bullshit. I'll get to that in a second. Now even though I hate the police and I abhore control and I especially am disgusted by the fact that of all the things going on this city a medical student on a bike on a sidewalk warrants a good going up and down I will say that the cop wasn't that much of an asshole and he gave me my passport, called me Mr. Kameny and told me that next time I shouldn't do that. He gave me the little shame on you finger sign it was kind of funny. I walked my bike to the intersection, got on and peddled away on the street. Now I almost never ride on the sidewalk and the only time I really do that is when it's absolutely unsafe otherwise. Riding a bike in this city is the fastest way anywhere because the sidewalks are the slowest. So that's it, never again, now I know bikes only belong in the street so now I will always be on the street on my bike taking as much space as I deem necessary. However just yesterday a car clipped me while riding in the street and often when crossing streets in the crosswalk cars blow through the crosswalk narrowly missing me. I'm not a violent guy but the closest I get to violence is daily when I'm on my bike in this city. The calousness that drivers have towards anyone not in an automobile is staggering. I have a twenty pound krytponite chain lock which has almost been employed in self defense on a few occasions.
Bicycling is my preferred method of transport for many reasons. I don't try to be elitist about it or scoff at others for not following suit but I do get annoyed when people who drive cars list my alternatives as though because I'm not good enough to own a car I have now limited my options to bus, train, or tram because god forbid I infringe on their roadways at all.
One of the big reasons I don't want to return to America is the return to the car culture. I like not owning a car. I sold my car back in '01 and it's been one of the best things I've ever done. The amount of money I spend on a bike is miniscule in comparison. The bike I have now was bought for me by my sister (Thanks Janice) about 1.5 years ago and it was $300. It's going to be done for soon and I'm thinking about buying a real deal bike in the range of 700-800$. i think that that's a lot of money but when I think about how a quality frame and fixed or single speed bike of that price will last me forever in the city I think it would be money well spent. With the price of gas being what it is back in America I think bikes are the smartest thing going in terms of transport, the only problem is that back in America the infrastructure is not set up for it and if you live in a city and bike there the problem is that you don't have the possibility of getting out of the city quick. For me to live in a small rural town is impractical. I have this idea that on my return to America I will have to live in a big city because that's probably my best shot at getting a job I only hope I can find a liveable, green city.

Gulag

So the other day I went to visit my friend at the anatomy building. As I rolled up on the scene with my bike I saw this old guy and what appeared to be his two sons flanking him. They were all speaking American English and the old guy sounded like he had an accent. He took a picture on the steps of the anatomy building and I heard him say about five times to everyone that was around that he was a medical student here 60 years ago. He went upstairs to the lecture halls and my friend and another professor let him in and gave him a mini tour. He pointed to what was his seat in the second row 60 years ago and told some stories. I was outside so I didn't hear all that went on but when my friend came out he told me this was what the guy said: 60 years ago he was a student at our school. He was then a pilot in the German Luftwaffe, possibly against his will he was forced in. He was shot down over Russia and spent a year in the Gulag. After the war he immigrated to the U.S. and spent his life in the U.S. as an internal medicine doctor of which he retired 8 years ago at the age of 80. The whole time I was hearing this story I could not help but think that anatomy lectures at my school definitely prepared him for the boredom of the Gulag...both are forms of torture which should be outlawed by Geneva convention.

Strata Času: (cz: "Waste of Time")

Well as always I start out with such high expectations and by midweek I am thinking about which way to cut my wrists. I started out thinking that OB-GYN for two weeks would be a great way to get a jump on OB-GYN knowledge for next year. I read through a book: "Blueprints in OB_GYN" and I was hoping to put it all into practice. I hate surgery and this keeps being presented to me as like the only option everyday. I don't like observing surgery and I especially don't like assisting in surgery. I don't want to be a surgeon so I don't learn so much from being there. The only part of the OR I like is the anesthesia part. Today when I was asked what I would be interested in seeing I said I'd be interested in doing some out patient stuff. I went to the office of one of our doctors and I saw three patients with him. They all came for cervical cancer screenings and I actually saw some squamous metaplasia and rectoceles. It was informative and it was only for about 40 minutes. One of the patients asked the doctor why everytime she comes to the office he speaks English and he told her that it's because he's in charge of the english students and they had a short conversation about how most of the english speaking students are from the UK and of Indian or Pakistani origin and they're not too interested in learning Czech. They had a brief chuckle about how their language is so hard and so necessary, etc. I don't know why but for some reason I was really upset by this. I've been here for 5 years and I've heard this discourse many times. Many people don't learn Czech at all and then there are many people, myself included, who have learned Czech very well. But I'm not a native speaker and I'll never be perfect. But I do get mad when sometimes I'm not even allowed out of the gate. Many times before the doctors even meet us they just have already decided that we can't speak Czech and that we should be put someplace with no patient interaction at all. It gets quite tiring. I spent the first three years learning Czech on my own and attending horrible classes in Czech. We had medical Czech classes in the 3rd year and I really tried hard to get proficient so that I could be allowed to do things in the later years. For the most part this hasn't happened. Occasionally I show up somewhere and it's a different story. Last year I spent 2 weeks in the ICU in the surgery department and all the doctors were in surgery so I was left alone with the nurses who only spoke Czech, it was OK. I continuously feel duped. You pay alot of money to study here. They tell you that you have to learn Czech to speak with patients, but they never really have any intention of letting you. It all gets to be a little too much sometimes. You spend a lot of time fighting the good fight and trying to do things the right way but you continuously find that the road to enlightenment in medical school isn't paved with good intentions but with frustration, blood and tears and in fact it's the road kill on the med school superhighway that had the best of intentions.

Good and Bad

Today was my second day in OB-GYN. I spent the day in ultrasound. It was a pretty good day. I saw quite a bit of stuff. The doctor who ran the show there was quite a well travelled guy it seems. We spoke for a little while about spending time in different places doing medicine and how important it is. He said that he had spent time in America and in U.K. He was stressing the importance of time abroad to some of the other students that were there. Something he said really rang true for me. He said that the reason to go abroad is to see how things are done other places but also to see how things are done worse in other places so that you can know what you do well back home in your own country. It made me think about medicine as an apprenticeship in addition to it being a science. I like the idea that maybe you can become good at being a doctor by travelling around and picking up tricks of the trade from other places.

There is a "yellow book" that they issue you at my school that tells you all the rules for studying here and it gives some historical information about medical studies. It says in the book that only in the past century or so has there been an actual curriculum at medical school. It says that in years past you learned to become a doctor more as a type of apprenticeship. You "read" medicine and you learned the art of medicine by working along side doctors. I like that idea. It's just that here we don't always get that. Too many lectures about things that we can only learn by reading.

Today was a pretty good day but it was also a reminder that OB-GYN isn't as happy as it might appear on the surface. In addition to seeing ultrasounds of healthy pregnancies I also saw ultrasounds of pregnancies gone bad and pregnancies having not "gone". Time to get back to the books.

On another note I have drastically cut down my coffee consumption. As I thought it isn't an addiction it's all linked to boredom. As I sit here writing this I am drinking my first cup of the day and it's 4:00 P.M.

It's definitely summer

Well it's definitely summer. The streets are flooded with loud, jet black haired tourists who all wear wraparound sunglasses more reminiscent of a car windshield than anything you would wear on the bridge of your nose. My roomate, the noisy one, left for home this morning leaving only the quiet roommate who will be leaving in a few weeks time. On monday I start my summer clerkship in OB-GYN and then after that I do my clerkship in internal medicine. The internal medicine clerkship was a pain in the ass to line up because we are not expected to do it here in Prague. They give us these summer clerkships and expect that we are going to go to small community hospitals in the country where the only departments that they have are "surgery" and "medicine". Here at school when you go to the various departments looking for a clerkship they all tell you that they are "too specialized" and that we need to do a general internal medicine clerkship. Well I'm not going to run all over the country looking for a department which will ignore me for two weeks.

I'm glad that the year is over. I had this week off and I've just been sleeping alot and doing some reading for my OB-GYN and internal medicine clerkships. I'm catching up on my social obligations. It's my friend Conrad's birthday and we're going to meet at our old neighboorhood bar "Jeep Bar". It's the basement of some guy's house filled with WWII memorabilia and there's a full sized howitzer on the front lawn.......

School as a digestive system of sorts

It's 6:00 a.m. here. I have been up since about 4:30. I have a test today and as always right before tests I can't sleep because my mind races all night long running possible "worst case scenarios" like there's that "WOPR" computer from the movie "Wargames" inside my head. Anyway, after sitting in bed for about an hour and a half dissolving myself in sweat (it's hot here) I decided to get up if for no other reason to not have to wash my sheets tonight. I checked my email and a facebook friend of mine asked me how things were going here at school. I took a moment of silent reflection and for some reason the idea of school being a sort of digestive system sprung into mind. As of lately school really does seem like a digestive tract. You enter on one side looking fresh and tasty and you come out the other end as foul smelling shit whose useful materials have been extracted and now is ready to just be composted or put into a landfill. I feel like I am the shit byproduct of too many years of formalized education. What "landfill" will I end up in? What is the equivalent of a landfill in the life of a medical terd? Does this mean that I will end up working in a nursing home or a Veteran's hospital (which are notorious for being poor and of low standards)?

Here at school we have these little books called "indexes". These indexes are like little passports. We get our teachers to sign in them when we have been good little boys and girls and passed exams or gotten credit for classes. The "indexes" on the first page have a picture of us when we first came to school five years ago back in '03. Now the purpose of these photos is to make sure that when we show up to take exams we are who we say we are, however I think that there's a deeper meaning to this...when we graduate I think we can take a moment of reflection and stand there with our diplomas looking at how we looked in the picture way back when and then cry for our loss of youth and innocence. BOO HOO!! :( One thing is for certain, I'm glad I took a few years off after college before coming here because I did lots of cool things and it's knowing that I did all those things like high diving that allows me to deal with the frustration of this place.

Cleaning out my SD card

So

here you can see what remained on my phone's SD card.  I was at a restaraunt down the street from me with unbelievably good food and a Homer Simpson theme.  Next to that I am pointing out yet another bust of Jan Evangelista Purkynje (He's a famous Czech) and then you can see a picture of the view at the top of my new bike riding route which takes me to the east side of the city overlooking Palmovka.  

Hum Drum

Nothing new is going on here at school. We are in our last rotation of the year and it's looking like it might suck. We are in endocrinology and metabolism. We have had two days of class and we've seen two acromegalies, a hypertriglyceridemia, and a partridge in a pear tree. I think they just select doctors according to "Boredom Survivor." If you can survive boredom for six years than you will be crowned as a doctor by the tribal council. I mean honestly they can't liven it up for us anymore. Six years of reading books and interviewing patients. I understand that 80% of cases are solved with history and physical and that fancy lab tests are quite often misused or overused but I want to be a doctor, not Dick Tracy (hollywood detective). My Czech friends think that this education is very good because they say that you have alot of time now to read books and that I won't have time to do that when I'm a doctor. To an extent I agree with them but I also disagree with them. School everyday takes place from about 8 a.m. to 12 p.m. and then we go home and read books for a few hours. I agree that it's good to have time to read all this stuff but I still stick to my hypothesis that you can have all the time in the world to read books and still suck as a doctor because what you need is to be pointed in the right direction and told what's most important to read and remember. When left up to our own devices we assume everything is important and get bogged down in the molecular biology of everything and although that might be the actual pathogenesis of something I think that it does nothing but lead us down the primrose path of being horribly unprepared to actually apply. I don't know we'll see what happens. Time will tell. Ten years from now we can do statistics of how many kills we've had in our doctor career and we can crown each other "007" (license to kill)