Dr. Doctor, M.D.

The 35W Bridge is open again.

They remade it. Built it up again, re-connecting the two sides of Minneapolis that have been for the past year so inconvenienced by detours and extra commute time.

In a sort of morbid gluttony, I drove across the new bridge four times yesterday. The first time was just because it was close and I was there and all it would require for me to ride the wings of this shiny steel phoenix was simply to go one stop past my normal exit. And suddenly I was on the bridge, hastily but very carefully re-constructed after the tragedy of one year ago that had so briefly thrust Minneapolis in to the eye of the international media frenzy - remember when it was the top story on both CNN and BBC? And for like 45 seconds everyone in the entire industrialized world was afraid to drive across bridges? And there I was, driving across this particular bridge, with the skyline of the great City of Lakes rising dramatically from its reflection in the Mississippi, and all I could think was, "Is this all?" I don't know what I was expecting - perhaps something a little more... momentous. But it was just kind of a regular bridge, made of grey concrete, with railings and arching streetlights and a distinctive lack of fanfare. Well, to be fair, there seemed to be a vague sort of squiggly blue sculpture at either end that was designed to maybe represent the river? A tribute to the 13 fallen? The inevitable passage of time? The slow march of all things towards death? The perils of rush-hour traffic?

At some point on one of my trips across the river last night I thought it might be an appropriately symbolic event to mark my return to the world of the weblog, my own attempts at narrative having collapsed abruptly into their own whirling river over a year ago. The rescue efforts were valient, but at the time unfruitful. And yet here I am, in a testament to midwestern stoicism, still a resident, still working at the hospital, still trying occasionally to go out into the world and have some fun.

Now I am officially a second year emergency medicine resident, a title that holds more responsibility, more work, worse hours, and, yes, slightly more respect. And my passage into the brave new world of the G2 was, like the bridge to which this thin veil of symbolism clings, quite unmomentous and without much fanfare at all. In fact, on the night of our end-of the-year graduation party (which is perpetually Hawaiin-themed because of its title, The Aloha Party), I was on call in the hospital on Cardiology.

But despite the well-lit concrete harshness of it all, every day reveals more about the strange tragicomedy that is human existence. Last week I saw two patients in as many days who had parasite-based delusions. Each sat on their little hospital gurney and told me that the cause of their pain, without a doubt, was the large parasite that lived inside of their organs. And then last night, before embarking on my symbolic journey across the bridges of Hennepin County, I was stitching up the head of a 17 year old kid who had been shot a bunch of times. One of the bullets had gone into the top of his scalp, grazed his skull, and exited a few inches away from another part of the scalp, without damaging his brain at all. He was incredibly lucky, and I told him so. Standing behind the head of his bead, clipping his hair away in little clumps, fiddling with the familiar process of numbing, cleaning, prepping, setting up for suture placement, I witnessed the reunion between this boy and his parents. He half cried to his mom, "I don't want to be in Minnesota anymore." This was his second time being shot since he moved here a year ago. She said, "You don't have to, baby." And then she screamed as the water that I was using to irrigate his wounds shot through the tunnel that the bullet had formed in this kid's scalp and squirted out like a little fountain from the top of his head.

ps I'm back!!! Catchy new title, eh?

The churchbells were ringing in Minneapolis as I made my way home. Riding my bike home in the warm sunlight, trees swaying in the breeze, a cacaphony of sombre bells echoing across the lake as a solemn reminder.

The city is recovering from this enormous disaster, the aftermath of a major thoroughfare being practically swallowed by the Mississippi in one sudden gulp. I am recovering too, in a way.

Man, am I tired.

I just got home after a long night at the hospital. 17 hours? Something like that. I was called in to provide emergency assistance a few hours before my overnight shift, and then stayed this morning for conference and lecture and the obligatory departmental debriefing.

I wish I could say that I was saving lives all night long, but after my first two patients who literally had the bridge collapse from under their feet, I spent most of the remainder of the night treating drunk people who had gotten into fights. A bit anticlimactic.

All I can say is that i feel very proud to be affiliated with Hennepin County Medical Center, the hospital that took the brunt of the disaster casualties. My hospital. And I feel even more proud to be part of a field whose mission is to prepare for and treat the victims of such awful situations. It felt good to be able to help out during something so momentous.

My heart goes out to the victims and their families.

And now, sleep.

The 35W bridge over the Mississippi river in downtown Minneapolis just collapsed. It just broke and fell into the river, bringing all of the rush hour traffic down with it.

When my brother called me to let me know - a "heads up" on my shift tonight - I thought he was kidding. But then I saw the images on tv - mammoth slabs of highway asphault lying across the river, slanted up onto the land with shapes resembling cars, semis, a school bus scattered over their surfaces. The semi was on fire. There were cars in the river. From a helicopter-scale distance it was an eerily calm image, without much movement except for the clamor of the newscasters.

and then I got the following pages:

"get to HCMC NOW"
and
" Level 3 Incident - report to ED"

I threw on some scrubs, jumped on my bike and came in, running into the ED in a sweat.

My first patient was on the top of the bridge, running from his car, and rode the bridge down as it collapsed.

We will see how the evening unfolds.

I have the day off! I have the day off!

After a particularly brutal string of 12 hour shifts, I have not only 1 day off, but the entire weekend. And I got to sleep in and it is a beautiful day and I got to play guitar hero for the first time last night. Turns out, guitar hero is very very fun.

My first 2 weeks of internship have already come and gone, a fact which is utterly incomprehensible to me. This fast-forward time vortex that I seem to have stepped into - triggered I think by merely setting foot in the emergency department - is fueled by a combination of long hours and constant activity and a near total lack of free time. This is an exageration, but for the first week I did work noon to midnight every day except thursday, my day off, when I had to be there from 6:30 am til noon for conference. I felt like I when I wasn't literally in the hospital I was either sleeping, studying, or getting ready to go back to the hospital.

But once I am there, it is totally fun. And stressful, and weird, and hard to keep everything together. Because now that I am the "primary medical provider" for all of my patients, I am responsible for writing all the orders and all the prescriptions and fully documenting everything and admiting patients and calling for consults... etc. And when you combine this with my inherent slowness and newbie inefficiency, things take a while.

But, boy do I have some stories. For example...

Two words sum up my first shift as an intern: penile laceration. Welcome to your new life as a doctor, now stitch up that man's penis.

And then on my second shift (or maybe my third - who can keep track): there was the very pleasant gentleman who was spewing blood from his tracheostomy site - the hole in the neck that people who have had their larynxes removed breathe through. Everytime he coughed blood would spurt out of his neck and land on the underside of his chin, and then drip down onto his shirt. At one point he got lost on the way back from the bathroom and was wandering around the department with blood coming out of the gaping hole in his neck, using his robotic voice-amplifier device to ask people if they could help him. Just the nicest man.

And then I was working on the night of July 4th from 6 until 2am. There was a noticeable lull, a palpable calm before the storm, followed by an influx of drunk people who had injured themselves in a variety of very un-humerous ways. I got to reduce a guy's dislocated ankle, put a bunch of plaster splints on, and try to track down the man with the bloody face who had removed his c-collar and left the department, presumably to attempt his own brand of vigilante justice.

Then, at 3:30 in the morning, I got a security escort to the resident library, where I took advantage of the new plush leather sofa. I slept for a couple hours, and then made my way to the conference room where I was scheduled to lead the intern reading group in a discussion of lacerations to the scalp, face, lip, nose, hands, and feet.

As you can see, my life is exactly like Grey's Anatomy! I have already slept with 3 of my attendings and have been yelled at repeatedly by the stern and sassy senior resident, who, beneath it all, really has my best interest at heart. Also I am living in a house with all of the other interns and we accidentally see eachother naked all of the time and then learn valuable life lessons while competing with eachother for who can deliver the conjoined twins from the 14 year old amish transexual with three uteruses and a fatal brain tumor who just got impaled by a streetlight. Also, everyone is in love with me. Being a doctor is awesome!

Tonight is my last night of freedom. One could argue that I haven't technically been "free" for years, but one could also argue that being a 4th year medical student is much much easier than being a 1st year resident. In fact, I will argue this right now by stating that being an intern (a 1st year resident) will be approximately one million times harder than being a medical student. Now perhaps I am being unfair and pessimistic, because by "harder" I simply mean more responsibility, more pressure, more stress, vastly more time at the hospital, less sleep, less free time, and more ability to be sued for messing up... so its not really all that bad when you stop to think about it. To be honest, I will also be getting paid for the first time since I can remember.

But this might be the last night when I will be able to calmly eat lime basil sorbet at Sebastian Joes (my current activity) and then plan on calmly making dinner and watching a movie, without being oppressively exhausted. So I am going to enjoy this lime basil sorbet, gol darn it.

Tomorrow I have my first shift in the emergency room, which equates to my first official day as a resident and the first time I will introduce myself to a patient as "doctor." Hopefully, I will not start squeeling with uncomfortable laughter when that happens. My first month finds me on the emergency orthopedic service, which means that I will be focusing on musculoskeletal complaints such as fractures and dislocations and chronic low back pain that must be immediately resolved by narcotic pain killers. It also means that I will be working 12 hour shifts for many days a week. For example, every day next week except thursday I work the noon to midnight shift. And then thursday I have to come back in at 6:30am for conference. Lets just say there will be lots of learning taking place in this upcoming week, starting tomorrow. Lots and lots of learning.

Last week we finished our orientation, which consisted of 2 days of computer training, 2 days of Advanced Cardiac Life Support (ACLS) training, 1 day of watching videos about patient safety and airways, and 1 day of signing documents, peeing in a cup for drug testing, and getting fit tested for respirators, which involved a bunch of new residents wandering around a room with enormous masks over their heads trying to see if they could taste a saccharine solution while bending over, moving their heads around, and reciting prose. It was like a roomful of hazmat astronauts alternately doing calesthenics and reading educational literature. Very early in the morning. But now hopefully I won't get tuberculosis if I wear my little correctly-sized mask.

In the ACLS course I got to learn how to defibrillate (CLEAR!) and manage various flavors of cardiorespitory arrest. There is a very good chance, however, that I will retain precisely none of that knowledge in an actual arrest situation. "Doctor, the patient is in V-fib, what should we do?" "Boy, I don't know. Probably call a doctor or something." A real doctor.

In spite of all my recent training, and my years of medical education, I'm not sure that anything would be able to prepare me adequately for what will happen tomorrow. People use sayings like "diving in" and "trial by fire" and "the shit hitting the fan" as approximations of what will happen when I walk in tomorrow in my scrubs and long white coat, my pager newly affixed to my waist, from which it will be symbolically inseparable for the next three years. We were told to always carry it everywhere, even while off. We were also told to never get sick. Or more precisely, to never call in sick.

So.

Tomorrow.

I haven't written about this experience yet, mostly because I haven't had the time, but partly because I wasn't sure if I could do justice to what was probably one of the most intense things to happen to me in recent memory.

"Intense" has become such a meaningless word, but that's what it was. Intense.

Last Monday night I went to bed pleasantly exhausted after a lovely bike around the lakes, a get together with my new intern peeps (who, by the way, are very awesome) and a downtown minneapolis roof-top viewing of Litte Miss Sunshine. Nice way to end the day. Then I was awoken at 2:10 in the morning by the horrific sound of breaks screaching followed by a heavy metal crunch. The kind of gut-wrenching, univerally identifiable sound that you recognize, even in your sleep, as an awful awful car crash. Which is what it was. Kind of.

My first thought was that, based on the sound of the impact, there was a good chance that somebody was really hurt. And that if so, there was an even better chance that I would be the most qualified person to help. I threw on some clothes, took a seemingly endless amount of time to find my sandals, and ran outside of my building. A very large crowd of people were gathered around a car, and wedged under the front of the car was a young man, unconscious, bleeding from his head. All I could do was verify that 911 had been called, and ensure that he was breathing and had a pulse, which he was.

Apparently this guy had been attempting to stop someone from stealing his car, which he had left running while he walked his sister to her apartment. He ended up halfway inside of the drivers side window being drug down the street, smashed against cars, and eventually flung under a parked car. He did not look good. At all.

Within a couple minutes the ambulence was there, and they were able to pry the car up, strap him to a board, and take him away to HCMC, where my colleagues attended to him. But as I walked back to my apartment, literally shaking, I could not stop analyzing my role in the whole thing. I went over the scenario again and again in my head. Was there anything else I should have done? Why didn't I take charge of the situation? Why didn't I remember that I was a doctor?

I announced to people that I was a medical student. I literally forgot that I was a doctor.

There was one moment when I didn't find a pulse in his left arm, and had the instantaneous thought that I was going to have to do something- NOW. Fortunately, he had a very strong pulse in his right arm, so I deferred on my plan to command the help of the crowd to extract him from his position under the car in order to begin CPR. But I think I would have done it without hesitation if I needed to. I think I would have.

The whole experience left me shaken and, for some reason, kind of disappointed in myself. I sat on my balcony with a beer for a long while, until all the police vehicles had departed, trying to come to terms with what had just happened. What an amazing welcome to Minneapolis, I thought. Seriously, I move here one week ago and already someone almost dies in a car jacking outside of my apartment? What an incredible introduction to Emergency Medicine. Regardless of whether or not my response to the situation was ideal, it confirmed for me that I am going into the right field. Inspite of the chaos of the situation, of my own insecurity about my abilities, it felt right for me to be there, kneeling on the road, feeling the pulse of someone who, on an incredibly basic human level, just needed a doctor. Someday I hope that doctor will be me.

After numerous requests, and against my better judgement, I am posting the text of my graduation speech.

Please note the opening Lost analogy. Also note that the last word of my speech was a swear word. I think this was a fitting and appropriate way to officially make my mark on OHSU history.

For the reader's benefit I have provided this text in complimentary italic font to emphasize both its literally significance and as a reference to its deliverance in the past.

Graduation Speech (the actual title of my speech)

"Thank you, Mary. Thank you Dr. Keenan and Dean Richardson and Dr. Loriaux. Thank you to all the deans and faculty hooders and ushers. And on behalf of the class of 2007, I'd like to sincerely thank all of our family and friends for joining us on this momentous day - quite possibly the most momentous day of our careers to date.

And to the class of 2007, my colleagues and friends - Congratulations! ... Congratulations.

Thank you."

I know, I know. You're thinking: wait just a minute - this blog is called Adventures in Medical School, and yet its author just recently graduated from medical school, which by definition excludes her from the category of medical student... something is just not adding up. Seriously, what gives?

Or in the words of my favorite new phrase, DOES NOT COMPUTE (which clearly must be said in a robot voice).

Well, if you are confused by this change, you have a right to be. This small inconsistency is representative of an enormous transition in my life; actually, several enormous transitions all happening simultaneously. The transition from medical student to doctor. (DOCTOR!!) The transition from living in Portland to living in Minneapolis. From being on mental vacation to starting residency. The tragic transition from spending time with people I love in portland to ... not spending time with them. But spending time with new people, some of whom I love. From rain to oppressive heat and humidity and mosquitoes. From rivers to lakes, mountains to prarie, big evergreens to smaller trees that drop things on you (I guess these would be called "leaves").

I originally had an elaborate plan to do an entire blog redesign that would correspond with graduation. Running titles during my jam session with mike and steve included "Adventures in Medicine," "Adventures in Residency," and some other likely much better ones that would be authored by "Doctor Fiona, Medical Doctor." However, given my incredible list of things to do around the time of graduation - a list that included but was not limited to graduating, writing the graduation speech, taking boards, preparing program for and attending awards ceremony, welcoming and spending time with family, packing up apartment, saying goodbye - well, it just didn't happen. Ok? It just didn't. In the mean time, suggestions for new blog title are welcome.

It strikes me that I haven't really allowed myself an appropriate blog-time emotional response to the fact that I actually graduated from medical school and was awarded the title of MD. Which, when I stop to think about it, has realy been the primary goal of my life to date. So, regardless of how funny it sounds to me and how weird it makes me feel... I AM A DOCTOR! Barely, but still. Oh my god.

Graduation was really nice. And very momentous. It was actually technically a hooding ceremony, in which our doctoral hoods were bestowed upon us individually on stage. They called us up one by one, we kneeled down on an ornate padded stool with a rickety hand-rail (which we were told repeatedly not to use because it would break) and then two faculty members draped the fancy velvet-like hood, that badge of academia, over our shoulders. I was prohibited from fully savoring the full significance of this moment by the knowledge that I still had to give a speech - a speech that, by the way, I had showed to no-one. And also the knowledge that I had to sit on stage, right in front, in full view of the hundreds and hundreds of people in attendence, for the duration of the entire ceremony. And let me tell you, the combination of thick black polyester gown and bright stage lights is not necessarily wholly enjoyable.

Its weird what you think about when you are up on stage. For example, the whole time that I was up there I couldn't stop thinking about the amalgamation of bandaids and corn pads that I affixed to the back of my heels to prevent my vintage size 12 patent leather pumps from eating through my skin and severing my achiles tendons. And I was worried that this sticky "flesh-colored" contraption was hanging out from the back of my shoes, visible to everyone but me. But checking would entail lifting up my gown and leaning over at an odd and very conspicuous angle... this is what I thought about. In between bouts of paralyzing nervousness about walking to the podium. That and the fact that I had to go to the bathroom really bad.

But I gave my speech, and people laughed when I wanted them to (sometimes more than I expected them to - I think everyone was hopped up on a weird mixture of nostalgia and adrenaline). And the things that I was worried about - namely tripping and hitting my head on the podium and losing consciousness - did not happen. So I think that can be counted as a success. And then, inexplicably, I was given a very fancy gold-headed cane (a prestigious award and an enormous honor that I hope to some day be able to live up to). But it was nevertheless a cane, which one can't help but incorporate into various vaudeville-esque tap dance numbers. Couldn't be helped.

It was probably the proudest day of my entire life, and I was so glad that so many wonderful people were there to share it with me. My lovely family (including my awesome aunt from Australia), my beautiful friends, my incredible boyfriend. It was amazing.

And now I have to worry about what comes next. ie, Residency. ie, actually being a doctor.

I AM SO GLAD THAT ITS OVER.

The Clinical Skills exam was quite possibly one of the oddest experiences of my life. It was an all-day stress fest that was not only fraught with anxiety, but also suprisingly full of humor. It was actually incredibly hilarious, but no-one else seemed to get the joke.

For one, my day was spent surrounded by senior medical students and foreign medical grads (often who had practiced for years in other countries and were now pursuing licensure in the US), all dressed in white coats, and all completely serious at all times. I arrived half an hour early and expected to feel this sense of in-the-trenches comradery with my fellow examinees. But I walked in to the lobby of this corporate skyrise in El Segundo, California and ecountered a group of solemn folks who not only barely made eye contact, but seemed wholly uninterested in engaging in any kind of shared human interaction. My questions of "so, are you guys here for the exam...?" met with long pauses, and then one solitary, "yes."

Didn't anyone tell them this exam was about communication skills?

There was this one amazing moment when we were all herded into the freight elevator in the back of the building because the regular elevators weren't working. (There was a lot of white-coat herding that happened that day). I was one of the last in line to arrive, and when I turned the corner I was faced with about 20 doctor types packed shoulder-to-shoulder into the frieght elevator, all wearing white coats, all facing forward, all standing there in silence. "Ha!" I exclaimed aloud at the sight, which was quite reminiscant of a cattle car, or an elaborate joke punchline. That was also met with silence.

The day was extremely regimented, with designated holding rooms and lots of lining up according to assigned number. Everyone was wearing a white coat with a number pinned to the left lapel and left upper arm, and that became our identity for the day.

The main event took place in a very long, wide hallway with 12 exam rooms on each side. In each exam room was a standardized patient, a highly trained actor playing the role of a patient with a specific illness. We were all guided to stand in front of an exam room, and wait for the announcement that the examinees could begin the "patient encounter," which meant rapidly opening the info sheet that contained a brief summary of the patient, scribbling a few notes, and then knocking and entering the room.

24 people in white coats, lined up along both sides of a long hallway, all standing in front of a numbered door, just staring at the door in silence until the announcement came. Like a starting gait. Very humorous image.

And when the bell rang, we all jumped into action. 15 minutes to interview and examine the patient, 10 minutes back in the hallway to write the note. Top 5 diagnoses, in order of most to least likely, top 5 next tests/ exams to order. And then on to the next one.. then the next one... and the next. It made for an exhausting day, but one that went faster than I had expected. And the time spent with each patient seemed to go buy faster than I had expected as well. I tended to get rushed at the end, and probably missed some key examination points. There were things that I didn't think of until the second that I left the room, likely diagnoses that I then couldn't confirm with history. Lots of stupid omissions. A very weird interaction with a patient who was intentionally being very difficult.

Anyway... DONE. Assuming that I don't have to re-take it. Afterward I was so drained that, even though Andrew generously offered to take me out to ice cream and a movie, all I could say was, "I think I have to lie down." Fortunately, once I woke up from an incredibly restorative nap, I spent my last evening in LA with my good friends Ritchey, Andrew, and Starr laughing so hard for hours and hours about the deconstruction of modern slang. "Literally."

Last night I was sitting on the creaky wood floor in the bedroom of my new apartment in Minneapolis, slowly screwing my new IKEA bed together, piece by "medium brown"-finished piece. I had dug my stereo - the one I got for my 16th birthday - out of the cat carrier box I had packed it in to make the epic two-day drive across the country from Portland. I sat there on the floor, screwdriver in hand, beer at my side, listening to my new local radio station as a thunderstorm raged outside. For the first time in years I basked in that electric ethereal glow of an early evening thunderstorm and thought, "this is where I am going to live." And I felt pretty good about it.

Until I realized that I was missing the central "midbeam" for my new medium brown Malm bed frame, which was apparently not included in the 3 different boxes that contained the other parts of the bedframe, nor was it indicated on these boxes that another crucial - nay, indispensible - part of the bedframe was also required. This necesitated a very long and annoying trip to IKEA in the midst of an early evening thunderstorm, which, needless to say, killed my moment.

But the whole experience allowed me to utter the phrase, "I am really sore from the hours of screwing I did last night." I figure that makes it all worthwhile.

That was yesterday. Yesterday I was in Minnesota moving boxes up three flights of back stairs, purchasing an awesome red formica and chrome table and chair set, wrestling with the construction of my first actual new bed ever(!), and then, steeped in dried sweat, drinking microbrews with some old and new friends.

And then there's today. Today I am in Los Angeles. I am sitting in a coffee shop where I am supposed to be studying for my boards. Which brings me to tomorrow.

Tomorrow I am scheduled to take the Clinical Skills portion of the United States Medical Licensing Exam, Step 2. I am in LA instead of sitting in front of a computer screen at a prometric testing in portland because this exam is only given in a few testing centers in the country, and this was the closest (and the one in a city that I had friends to visit). The Clinical Skills exam is a "hands-on exam that tests the examinee's clinical communication skills through his or her ability to gather information from standardized patients, perform a physical examination, communicate the findings to the patient, and write a student note." In other words I will spend 8 hours tomorrow interviewing and performing physical exams on patient actors who are highly trained not only to portray specific medical conditions, but then to judge me on my every move. My every move will also be videotaped for review by a professional physician judge at a later date.

And since I graduate from medical school in literally 5 days, I sure hope I pass.

Being tested on your interactions with "standardized patients" brings up all sorts of interesting issues. Simple things like greeting a person become part of a complicated assessment of your professionalism, emapthy, and cultural sensitivity.

For example, according to the study guide book that I have been occasionally looking at:
- "Remain consistently aware of words you are using during this and all phases of the interview; it is often disquieting to patients if physicians use too informal or personal statements, e.g., "How are you?" or "I am pleased to meet you."
- "If a patient offers to shake your hand, returning the gesture is often appropriate. For cultural reaasons, it is better to not offer the handshake because not all patients are comfortable with this form of greeting."

Or how about this:
- " If the patient becomes teary... gently gaze at the patient with a compassionate expression in your eyes. It is permissible to convey supportiveness by resting your hand for one second gently on the patient's shoulder or upper arm (not the leg or hand, and do not pat)."

One mississippi... and release. Empathy officially given and recieved. Check.

This whole testing process is so interesting. Obviously there are certain qualities that everyone looks for in their doctor - but these qualities are very hard to test for in a standardized manner. But the USMLE is giving it a go.

It is safe to say that this is a very unique time in my life. And by unique I do mean stressful and crazy and emotionally, mentally, and physically demanding in a total-life-upheaval kind of way. But its also a pretty amazing and important and exciting transition in my life, when I stop to think about it.

Things accomplished in past two months:
- finished last class in medical school
- went to australia
- managed to return from australia without crashing onto a deserted jungle island
- purchased car for first time ever- enormous white 1993 toyota camry wagon, aka "Gigantor."
- packed new car full of belongings and drove it to minnesota (aided by little bro and the admiral)
- reunited with family and friends
- looked for and found apartment in new home town of minneapolis
- looked for and found local co-op, dive bar, coffee shop/art house, ice cream shop, thrift store, and hippy organic juice bar and herbal tea emporium
- purchased new couch at aforementioned thrift store and lugged it up three flights of stairs (aided so graciously by mom and bud)
- purchased incredible table and chair set and assembled bed
- studied on the flight from minneapolis to LA

Things to accomplish in next week:
- take and pass USMLE Step 2 CK exam
- finish program for AOA induction ceremony
- write graduation speech (I really really need to get on this one)
- plan graduation party
- graduate from medical school
- pack up remaineder of random stuff strewn about half-empty apartment
- say goodbye to everyone that I know and love in portland
- try not to sob too hard on the plane back to minneapolis

Sounds do-able, right?