OK, this is probably funny to no one but us residents, but in our hospital's relentless push to perfection, they have focused attention (ahem...wonder why) on the rate of falls in the hospital. If you're familiar with "The House of God" story, you know all about hospital falls, and even how they can occasionally serve a purpose. However, in general, they're bad. In our hospital, they're a pretty good benchmark of the care you get on each floor, and each floor is different.

For example, there is one floor ruled by an ancient doyenne of a charge nurse, who, I imagine, counts General Patton among her idols. Things run with the precision of a Swiss timepiece on that floor, and as we speak, they are currently on day 19 of no falls. I'd be willing to bet that the fall 19 days ago was likely with a nurse floating from another floor.

By comparison, there is another, not-to-be-named floor, in our hospital, where our team proposed that it would be safer if the patients were all simply placed on the floor on arrival. I have noticed in the last week that this floor has not even bothered to put up the "X days since fall" sign.

The picture of the floor posted above, was a floor where our team had a large number of patients over the last month, so we spent a lot of time there. Our med students religously kept watch over the board, and one day were swearing that the nurses had skipped a day, and had gone from 1 day to 3, and were in fact cheating.

Vacation Day

So last Saturday, Karen, Dan, Payal and I decided to take a "Vacation Day." Granted, it was a weekend, and we were all off anyway, but whenever one of us said something like, "I need to get back to do "X," Dan would say, "We don't have to go back yet, it's Vacation Day," so that's where that term came from. We drove out to Geneva-on-the-Lake (the lake in question being Lake Eerie), which is this cute little touristy town on the edge of the lake, about 45 minutes from where we all live. It's a nice quiet drive on small roads out there, and you curve around for a while, and then you're suddenly on this strip with all sorts of cheesy t-shirt shops, arcades and ice cream shops. There are a couple wineries there, and they were sort of our destination.

Me, Dan & Payal at the lake shore

Dan & Payal on a bench by the lake. It totally looks like they're dating, from the pictures I took, but they're really not. They just happened to be in all the good photo ops.

Me, Karen and Payal at the lake

This is the Firehouse Winery. It's really more of just a bar, but that's OK. They do make some OK wine there.

Karen & Dan, wine-tasting

Payal and I, with our wine-tasting trays



We were happily enjoying our wine and our Vacation Day when this huge storm blew in. The picture doesn't do it justice. The sky was dark gray and the lake suddenly became this weird green/gray color, and there were some water spouts.

We retreated inside with everybody else, and then made out way down the street to hang out at a townie bar for a while, which was fun for everyone but Dan, because we told some guys (when they asked how he got to hang out with 3 such pretty girls) that we were all nurses and he was gay. He wasn't amused.

After we hung out at that bar for a while, we wandered over to the only really nice hotel in town, which has this huge lawn facing the lake. We stayed inside until the sun came out, and then we went out on the lawn with (seemingly) everyone in the hotel to watch the sunset. It was so beautiful, that when it was done everyone clapped.

All of us about to go watch the sunset

After the sunset, we all went inside the hotel and warmed up at this neat fireplace. It was the perfect way to wind up the perfect Vacation Day.

So last week I got to join two great friends from Texas, Mitra & Brooke in NYC. We were all supposed to get in on Thursday afternoon, and then head to the hotel. Of course, NYC decides to have thunderstorms all afternoon, so everyone's flights got cancelled/delayed, and we were all late getting in. Eventually we all got there & were able to meet up in time for a late dinner at this cute Italian restaurant that was right down the street from our hotel. Our hotel was in a great area - it was only a few blocks away from Central Park in one direction, and then just far enough away from the 5th Avenue shopping area to help you work off that bagel you ate for breakfast on the way down there.

I'm sure it's been said before, but NYC is seriously about the prettiest city I've ever seen. Maybe pretty isn't exactly the word, but that's about all I can come up with. It's just unique and awesome in a difficult-to-describe way.


The skyline is absolutely beautiful, and thankfully I was sitting next to this really nice guy on the flight in who pointed out all the major sites, like the Brooklyn Bridge and the Statue of Liberty, from the air. It was a great intro to Manhattan. The Chrysler building is still my favorite building....here it is below:

Me, Mitra & Brooke out at the Italian place where everyone spoke Spanish:

On Friday morning, Brooke had to get up early to go a conference, and Mitra and I slept in and then walked down to the shopping area around 34th St. & 5th Ave. Apparently our hotel was on the border of Hell's Kitchen, which sounds scary but wasn't. It was a very varied area - all different kinds of ethnic restaurants, flower stands, and the occasional soup kitchen/homeless shelter. We started out at Macy's, partly just to say we'd been there, and partly to check out their entire floor of women's shoes!

Below is just a random view of 34th St.:

We struck out shopping-wise, but had fun looking. We went through their Christmas department which had all these 1950's toys like Jacks and Pick-up-Stix. It felt very A-Christmas-Story-ish. Then we spent the rest of the morning wandering around the shops down that way, and waiting to meet up with Brooke when she was done at the conference. We eventually all met up, shopped a bit more, and then went home to get dressed to go out with my friend (and fellow AZCOM alum) Luke, who is an intern at St. Luke's Roosevelt in Manhattan.

View of Macy's from the outside:

They had these neat wooden escalators you could ride that were seriously made of wood and looked like they were original to the store:

Us out on the town our first day:

I got thirsty and so we stopped for Starbucks. Here we got to see God's way of saying you should always stop and talk to cute boys: Mitra left her purse in Starbucks, and if we hadn't stopped to talk to this guy (he's the doorman at the Russian Tea Room but that's just to pay the bills - he's really an actor...seriously!) it wouldn't have given the nice lady from Starbucks time to catch up to us and give Mitra back her purse! Take home lesson: always stop to make time for the cute guys.

The next morning Mitra and I got some coffee and bagels at a stand in Central Park and then walked around for a while. This bridge has been in a bunch of movies, none of which I can remember right now, but everyone stopped for pictures there because it was so pretty. There was this neat saxophone player you can see in the background, playing Christmas carols. I don't know how he did it - seriously it must've been in the 20s and it was windy! I gave him $2 for his fortitude.

Central Park was beautiful - the trees still had pretty yellow/orange leaves on them, and there were lots of people just milling about. Very relaxing.


Here's what it would've looked like if we'd been able to go back on our last day in NYC (it only snowed on the way out, of course!):



Here is a picture of the Trump ice skating rink in the park. You can't see the Trump Zamboni grooming the ice in this one, but it's there. Trump seriously has his name plastered on everything around there - even the Zamboni.

Heeding the lesson from the night before, we stopped to take a picture with these guys. Too bad you can't see the one taking the picture - he was by far the cutest but we couldn't figure out how to gracefully tell the older guy to get out of the picture and grab the camera from Cute Guy.

My camera wasn't good for much, but the one good thing about having a ridiculously slow shutter speed (yes, even on a digital camera!) is that my camera is so slow it can now take time-lapse pictures!!

Here's a better one of a random side of Times Square, which isn't actually a square:

Mitra & Brooke, getting ready to go out I think:

Luke, Me & Mitra just goofing around:

Me & Mitra attending a communist rally. Seriously - there was a pro-Chavez/anti-Bush rally going on outside - of all places - a VERY upscale mall and a Whole Foods. That cop was totally laughing at us:

Saturday night Mitra & I went to see the NYC Ballet perform "The Nutcracker" at Lincoln Center. It was so neat to be there - I've seen it on all kinds of PBS music specials, but it was really something else to be there in person. It really didn't feel as big as it looks in this picture, and even our view from the cheap seats was GREAT.



The ballet was beautiful, and it was so neat to see it again - I remember going quite a bit when I was little and I loved it. We had champagne and gummy bears at intermission. Very sophisticated. It was funny though - I remember people dressing up very formally for the ballet before, and here they were in everything from furs to un-tucked flannels and grubby jeans. Things have apparently changed quite a bit since I was little....

However, the Snowflake dance was beautiful, and made me forget the tacky people:



The Sugar Plum Fairy and her Prince were pretty great too:



Mitra & I found this great, very "New-York-ish" cafe on the way that we liked so much we went back for dessert after the ballet. It was a fun night, and once again, I really didn't want to go back home. I can't wait to go back to NYC (and Boston too!) at the first opportunity!

Boston, Day 2

On Thursday, we went to the conference for a bit and then took the T (their name for the subway) out to the Sam Adams Brewery. The tour was….wait for it…..awesome. Our tour guide was hilarious, and we got to taste all different kinds of barley and smell the hops (you don't taste those). The barley is great - it tastes like a cross between Nutri-Grain cereal and actual beer. You chew it and then it feels like you have solid beer stuck in your teeth, were it possible. Then we got our free tasting mugs (only 7 oz., unfortunately) and went to taste beer. The state of Massachusetts only lets them serve 21 oz. of beer to 1 person on a tour (so we only got to taste 3 kinds), but they did make sure to point out that you are welcome to take as many tours in a day as you want.



These people really really really do love their beer. The commercials really don't even do them justice. And apparently the cute older bald guy with the long beard in the commercials not only works there, but was working there that day, but we didn't manage to catch a glimpse of him. We really wanted a picture with him, but I guess we'll have to save that for next trip. So apparently all the employees there taste beer every day at 10:30 am and 2pm. The tour guide was like, "Yep, we start drinking every day at 10:30am, for YOU guys." And even the lowliest employee has to go through this course where they learn all about beer and beer making and beer tasting, and have to be able to tell not just good from bad, but what's wrong with it if it does go bad. Pretty darn impressive.



If they find any beer on store shelves that is past its sell-by date, they buy it back at retail price because their owner, Jim Koch (the founder and the guy in the commercials) would rather do that than have people drink stale beer. And every year the employees save samples of bad batches of beer and put it into a dunk tank, into which Mr. Koch gets dunked, as he says he'd rather put people into stale beer, than stale beer into people.


Our guide about to hand out the barley and hops for us to try:



Our tour guide teaching us more about how beer is made:

Beer being "finished"

Finally, getting to taste the finished product:

Below, our guide is explaining about "Utopias." It's this non-carbonated, almost liqueur-type beer that's something like 26% alcohol that they only make every few years. They only produce 9,000 bottles (or something like that), and it's illegal in most states because of the alcohol content. So you have to pre-order it in another state and then go pick it up. You drink it in a tumbler, not a regular beer glass. It comes in this golden mini-beer-finisher-model bottle, which you can't really see in this picture. Most of us had never heard of it, until some beer aficionado raised his hand and asked when the next batch was coming out. Luckily for him, it's this November.

Below is a picture of "The Perfect Pint" glass.

So what is The Perfect Pint? one might ask...It's the final result of Jim Koch's obsessive (I told you he loves his beer!) quest to create the perfect glass in which to drink Sam Adams Boston Lager. It's perfectly designed for just that beer, and when in Boston, you're supposed to send SABL back if it's not served in the Perfect Pint glass now. Funny. I suppose all other types of beer turn to dust in it, right? It's really almost ridiculous how much thinking/work went into this glass: the bottom is laser etched to send a continuous stream of bubbles to the top; the lip is created to deliver the beer to the back part of your tongue, which is where the bitter sensors are; it's made so that your hand won't warm to beer past it's optimal temperature (yes, they actually have an optimal temperature at which SABL should be drunk), etc., etc., etc.

Here is a link to an article about how Jim Koch designed "The Perfect Pint" glass: http://money.cnn.com/magazines/fortune/fortune_archive/2007/03/05/8401280/index.htm. It's actually really interesting, everything that goes into it. Who knew beer drinking could have advanced so far, technologically-speaking???

On Thursday night, we decided to go to this place called Dicks Last Resort. The waiters there are known for their rudeness, and the ruder you are back to them, the better your service. At first our waiter didn't seem all that mean, but then when Natalie tried to helpfully point out where her birthdate was on her driver's license when he was carding us, he was like, "I know how to do my job!" And they make silly hats for the diners out of white butcher paper, with various and sundry insults on them. Brian got one that said "I vacation on Brokeback Mountain." The girls get either hats or helium balloons that they attach to some of your hair so they float above your head.

Us at Dicks:

They give everyone bibs, for no particular reason....

Brian's lovely hat:

Natalie and i with our balloons..Very funny....

After that, we went back to - you guessed it - Pub Row.

Boston, Day 1

So I just got back from a trip to Boston. Our program makes us go to the ACOI ("something-something-Osteopathic-Internists") conference each year, and this year it was in Boston. I went with Natalie and Brian, my fellow "IM" interns (the quotes are because only one of the three of us is planning on having anything whatsoever to do with internal medicine, but I digress….). So basically for agreeing to be labeled "IM" interns, we all got a free trip to Boston and a week off of work without having to use any precious vacation time. Not too shabby.

We left on Tuesday (the 9th) afternoon, and despite being delayed at LaGuardia (which is an every-day occurrence, our pilot kindly informed us), we got in in time to go out for dinner. Our concierge sent us to this awesome neighborhood restaurant called The Fireplace, and I think it's my favorite restaurant of all time. It was a bistro-type restaurant, but had (surprisingly enough) a cozy fireplace, a great menu, and the only other people there were clearly locals who knew all the staff, so we kind of felt like we were at a sort of bistro-version of "Cheers."

So the next day was the first day of the conference, and after snoozing my way through a couple lectures (seriously, some were almost comically bad - how can they hand out educational credits for some of this garbage???), I was so excited to see some of the residents from Botsford there (this was the hospital where I spent 5 months in Michigan as a 3rd year). I really loved working with those residents, and I didn't learn how good they were until I left and had to work with less-stellar residents, so it was great to see them again. I'm glad I got to see them then, because like all good, soon-to-graduate residents, they promptly split and we didn't see them for the rest of the conference.

Here we are in our hotel lobby, all happy and optimistic, before we discovered how lousy the lectures were going to be:

We left as soon as we figured out there was no merit becoming martyrs to that dribble (OK, so pretty much I decided, and thankfully Natalie & Brian were in agreement), and headed for the North End (Boston's Little Italy) to eat lunch. At this risk of overusing the a-word, this place was awesome. It was this cute street that is one of the oldest parts of Boston, and it's lined with family-owned Italian restaurants. We picked one and had the best Italian meal I've ever had. While we were eating, a guy outside wearing a track suit and comically-large sunglasses did business with a giant wad of cash with another guy who seemed to be in the window business. Natalie and I decided they were negotiating what exactly was going to fall off of a truck that night. The North End is really something else - the only people speaking English are the tourists - everyone else is speaking Italian. The street is like nothing else I've seen, and I'd say it's the first place you need to go to after getting into Boston (if you're hungry, that is). The place we went was Antico Forno, if anyone's taking notes.

That was the first night we went out looking for a good Irish pub. This being Boston, we found an abundance of them. Where we ended up that night was a string of pubs right next to the Union Oyster House (the oldest restaurant in continuous operation in the U.S., open since something like 1826). They sit on the oldest block in Boston, which must be pretty old. Between some of the pubs a very crooked and uneven cobblestone street runs, which adds to the aged feeling. Our favorite pub was this really old-looking one called The Bell in Hand. That's the fun thing about Boston - there are some pubs with boring names like The Tap, but then there's Rosin Dubh (the Black Rose), The Purple Shamrock, The Bell in Hand, and things like that. So we drank some Guinness and then went home.

The barely-visible sign over The Bell in Hand, my favorite pub:

The three of us at The Purple Shamrock (I think...it may actually have been The Tap...hard to tell as I think this was the night we went to 5 different pubs....)

Picture disclaimer: If you haven't heard, I accidentally laundered my nice digital camera a few months ago, and most unwisely bought a cheapo substitute at Target before leaving on this trip. I have since learned that digital cameras are not something one should scrimp on, as this one took terrible pictures. That is why they're all dark and fuzzy. I am still figuring out some horrible way to kill this camera in retaliation for making my Boston pictures come out so lousy, but in the meantime, please accept my apologies for their terrible quality. When Brian emails me his better pics, maybe I'll replace these.

Neat shot of this cool building, Fauneuil Hall

(most unfortunately pronounced by all Bostonians as "fan-well")