domo arigato, mr. vibrato

I've taken to wearing my pager to bed with me. Not because I'm on call, but because I've been using it as my alarm clock. Since I usually wake up anywhere between 5:00am and 5:30am to go to work (a time perhaps more precisely called "dark o'clock in the morning") I don't really want to wake up everyone else in the house with my alarm clock. So I set the alarm on my pager, turn it to vibrate, and wake up when my left hip starts buzzing. Silent but deadly.

application season

I know I haven't talked much on here since last Spring about our plans for next year, but the reason I haven't said anything is because I don't really know what to tell you. After Joe didn't match last year, we took a few weeks to regroup, and then started the application process anew, following up stray leads for a few less formalized training programs and getting together the paperwork for the 2009 fellowship application cycle. He wants to match into a plastics program, of course, but we aren't willing to just say yes to any program anywhere, regardless of circumstances.

Joe just had an interview for a fellowship down South last week, but after some deliberation, decided afterwards to withdraw his application. It was a nice enough place, but for a variety of reasons, it wouldn't be right for him, or for us as a family. There is still one more lead for a 2008 fellowship that he's pursuing, but right now, our changes of staying in New York for at least one more year are significantly higher.

So I've started applying for a fellowship myself. I'd been holding off, since there wasn't really a good way to apply for anything when I had no idea where we were even going to be living, but the situation being as it is, I've decided to apply for the fellowship in Regional Anesthesia at [University Hospital]. Basically, the fellowship involves further training in nerve blocks, perineural catheter placement, and a variety of acute pain interventions prior to being unleashed upon the world. There probably is the option to do some research, and spend some time over on OB or Peds or Pain doing interventions. Additionally, I could always moonlight to earn some extra money and keep my general OR skills sharp.

I'm a little late to the party, just starting the application process now (most of my classmates have already matched already into their various fellowships--usually acceptances are rolling), but I'm starting to get things together, with the education office helping me make copies of my Dean's Letter, med school transcript, USMLE scores and whatnot. Then I have to whomp together a personal statement, and hit up a few attendings that don't hate me to write me a letter of recommendation.




The sad thing is that, even though this is an application for a medical fellowship at a major hospital, Cal's preschool application process is probably going to be significantly more complicated.

what not to wear

Cal is very particular about his pants. The one kind of pants that he'll predictably let us put on without a fight are these schlumpy cotton jersey shorts that we got at Old Navy.




He probably has 10 pairs of these (which he calls his "Better Shorts") in every possible color, which is just enough to get him through the week. (I know that sounds like a lot of pairs of shorts, but Cal changes his clothes two or three times a day, not counting pajamas for his curtain call. It's like he's hosting the Academy Awards or something. That is, if all Academy Awards hosts changed their gowns because they kept befouling them with a combination of food, dirt, and bodily waste. I'm looking at you, Steve Martin.)

Here is the conversation that usually ensues when I try to put him in any other kinds of pants.


MICHELLE
(Trying to sneak on a pair of cargo pants)
OK, here we go...

CAL
No. No like. Put away.

MICHELLE
No Cal, these are nice pants! Look how soft!

CAL
No! No like! Too tight! Put away! Better! Better Shorts!

MICHELLE
These aren't too tight, these are new pants, so they're bigger. And we're not going to wear the Better Shorts today, because it's too cold.

CAL
No! Better one! No! Too tight! No like! (Etcetera.)


Usually after the disputed pants are actually on, he forgets about the whole thing and happily goes about his day, but it's just hard to get him to let me put them on most of the time. He did have a pair of khakis earlier in the Spring that were a little snug in the waist, and I think that from this he's imprinted that all pants are too tight around the midriff (or, as he puts it, "too tight inna button.")

Unfortunately, it is now almost October, and the season for the Better Shorts is coming to a close, at least outside of the house. So in shopping for his fall and winter pants, I took special pains to really examine every single pair of pants that I was buying, feeling the softness of the fabric, the stiffness of the seams, the elasticity of the waistbands, what have you. Whatever it takes to cajole him into pants without a fight. Anyway, I'm tired of him looking like a middle school gym teacher.

(Not that I'm one to talk. I wear the exact same clothes every day. It's like in those Charlie Brown cartoons, where he opens up his closet and just has 20 identical yellow shirts with black zig zags across the chest. Makes getting dressed in the dark easy, though.)

isn't it good, norwegian wood

I was doing anesthesia for a handful of plastics cases yesterday, and the attending surgeon had his iPod on. Near the end of the case, "Norwegian Wood" from the Beatles' Rubber Soul album up on the shuffle.


MICHELLE
You have a good iPod.

SURGICAL ATTENDING
(Musing)
You know, I always wondered what this song was about.

MICHELLE
What?

SURGICAL ATTENDING
All these years, I could never figure out what this song was about.

MICHELLE
Are you serious? You know.

SURGICAL ATTENDING
No I don't.

MICHELLE
It's about how he spends a night with another woman! A woman who was not Yoko!

SCRUB NURSE
Paul McCartney?

SURGICAL FELLOW
No, John Lennon was married to Yoko. Paul McCartney was married to that blonde vegetarian.

MICHELLE
It says so right in the lyrics. Have you listened to the lyrics?

ATTENDING SURGEON
But what's "Norwegian Wood" mean?

MICHELLE
I don't know. Some hippy crap.

ATTENDING SURGEON
But surely it means something. Does it mean drugs?

MICHELLE
Drugs?

ATTENDING SURGEON
You know, like "Lucy in the Sky with Diamonds." I mean, duh.

MICHELLE
I think it's just hippy talk.

MEDICAL STUDENT
We could easily find this out.
(Looks up "Norwegian Wood" on Wikipedia.)

MICHELLE
Man, what did we do before the internet?

CIRCULATING NURSE
Hey, have you all seen the You Tube video with the kid singing Britney Spears?
That is hilarious. Here, let me show you guys.
(Pulls up You Tube on the room computer and starts playing the video.)

MED STUDENT
Ha!

ATTENDING SURGEON
Ha!

SURGERY FELLOW
I'm sorry, I can't watch You Tube because I'm a little busy PERFORMING SURGERY right now.


Man, the patients don't know what they're missing. Or maybe they're just really embarrassed and feigning sleep so that they don't have to talk to us.

recycled content

Someone asked for a full-page printable version of "The 12 Type of Med Students," so here it is. Don't get excited, this comic is more than three years old.



The scary thing is that every single type in this comic is based on a real person I went to med school with. (Joe is "The Sensitive Soul," I waffled between "Painfully Enthusiastic" and "Sane." Guess I wasn't sane enough.)

the full monty


So here is the full comic. As always, click for bigness. Thanks to your eagle eyes, I have corrected the typo in the dermatology panel, and I have also changed the neurologist's neckwear from a necktie to a bowtie, which was basically the equivalent of a typo. Thanks for reading, this little exercise has certainly revitalized the "Scutmonkey" series, as well as my interest in it. I will try to introduce a couple of small new comics in the future, possibly more often if you don't mind them being a little more casual, just sketched out and scanned, no frames and penciling and inking and erasing. I mean, if I can stand it looking all sloppy like that. Otherwise I'll just have to buy some time somehow to do it up right.

once more, with feeling

Basically what I was trying to say about the stereotype of anesthesiologists, only in musical form. (Thanks to Steve for the link.)

Medical Specialty Stereotype #12: Anesthesiology



And thus endeth the 12 Medical Specialty Stereotypes. I know there are tons of specialties that I didn't get to, but honestly, I couldn't think of any good overarching stereotypes for, say, ophthalmology or internal medicine. If you guys have any good ones, please share, we all would love to hear them.

Tomorrow I will post the whole 12 panel strip en bloc, if I can figure out how to get the scale right so that you can actually print it out (if you like) and read the words. Or I might not, being one of the lazy bums pictured above. Seacrest out.

Medical Specialty Stereotype #11: Radiation Oncology



(See also: PM&R)

On a completely unrelated note: to all you women out there who do not sit on public toilet seats, don't you know that it is YOU who are making the seats unsittable? You think, "Oh, I cannot possibly let my delicate ass skin touch this horrible, contaminated toilet seat that other asses have touched!" And so you hover, and in doing so, spray the entire toilet seat with pee. And then you do not wipe up the pee, the pee that has issued forth from your own urethra, and then when I have to use the bathroom, in a rush during my too-short break from the OR, guess who has to do the dirty work? If you would just sit on the toilet seat like Thomas Crapper intended, then we would all be able to share in the goodness.

And for the last time, you will not contract "diseases" from sitting on a public toilet seat. Dr. Oz, famed Oprah proxy and noted cardiothoracic surgeon at [University Hospital] says so, therefore it must be true. So just sit down, for chrissake.

Medical Specialty Stereotype #10: Obstetrics and Gynecology

Medical Specialty Stereotype #9: Dermatology



I think the dermatologists are really smart, and I love reading their consult notes (so detailed! elaborate drug charts!) but I don't think I could handle a job that entails scraping off pieces of dandruff onto agar. I am not squeamish about too many things (blood and guts, code browns or what have you), but skin diseases are on my list of Things That Are Gross. In fact, one of the reasons that I went into Pediatrics originally is that I just couldn't handle it when, in the ER, old people would take off their socks, the motion of which was followed by a squall of white, flaky dead skin that would billow through the air before falling to the ground like so many snowflakes. Just disgusting. (With all apologies to the old people.) And don't get me started on toenails, because I won't go there.

My dad is a dermatologist (though not a Glamazon) and we used to get this skin journal in the mail called Cutis (rechristened by Joe as "Pus Weekly") that always had some god-awful photo on the cover of, I don't know, a man's desquamated testes or something. Why they didn't ship that thing in brown paper wrapping, I don't know.

not exactly my feeling, but...




I guess six years really must have gone by, that no one thought that this looked strange up on a theater marquee.

(I believe that this is actually a band, not a sentiment of, "Woo! September 11th!" Though I have been wrong before.)

Medical Specialty Stereotype #8: Neurosurgery



(See also: Cardiothoracic Surgery.)

Medical Specialty Stereotype #7: Emergency Medicine



Joe, Cal and I went to a barbecue last night Dave's house. Dave and Joe used to share an apartment in med school, before I supplanted him as Joe's roommate. And LIFE MATE. But anyway, time has flown, and Dave has since completed his ER residency and he and his lovely girlfriend are ER attendings in Brooklyn. "Oh, you're still a resident?" she asked me, in the incredulous tone of voice of someone finding out that I was actually a double amputee--shocked, yet inspired that I was somehow able to carry on while keeping up such a brave front. I guess it's true what they say, once you're an attending, it's impossible to look back.

Anyway, we brought Cal along, because there was nowhere else for him to go. This is the first time that we've brought Cal to such a flagrantly non-childproofed environment, so that was a little interesting. First of all, it was a grown-up party for grown-ups. Not to say that there were people snorting cocaine off strippers or anything, but there were candles everywhere, live wires, a smoky barbecue grill sitting in the middle of the backyard, gigantic citronella torches alight, sticking out of the ground. It was quite an effort to keep Cal from bursting into flame any number of ways. Luckily, with two ER docs, an anesthesiologist, and, uh, an ophthalmologist on premesis, we had almost everything covered. Including traumatic globe rupture.

The biggest emergency actually had nothing to do with the environment, rather with the fact that Joe neglected to restock the diaper bag before we left the house, and I neglected to check. Which led to this scene: diaperless Cal sitting in Joe's lap in Dave's bedroom, watching "The Wiggles" on You Tube, me sprinting down 7th Avenue to the nearest CVS, hoping to outrun Cal's bladder. Luckily, the good guys won. And the burgers were really good too.

Medical Specialty Stereotype #6: Pediatrics



Do you ever have a specific attending who you're just certain thinks you're a complete idiot? I do. Look, I'm a third year anesthesia resident now, and I think I do a good job with even complicated patients, and that I'm a reasonably responsible doctor. Other attendings have also told me as much, so I don't think I'm being delusional on this point. But there's this one attending that, whenever I'm with him, something always goes wrong. Either its a stupid oversight on my part, the likes of which I have not made since first year, or just some freak thing, like equipment failure, unexpected difficult airways, struggling with access, what have you. Every time that I see I'm working with his attending, I show up to work extra early and try to make sure that this time, THIS TIME, I will do everything PERFECTLY, and then he will see that I'm GOOD. And yet something always goes awry. Not while working with anyone else, mind you, but always with him. Therefore, he understandably thinks I am a moron. Probably.

It's starting to get to the point of self-fulfilling prophecy, because I just get so nervous whenever I'm with him that maybe I'm just screwing myself up. Though I wasn't aware that my mood could somehow cause the computerized anesthetic record keeper in the OR to catch on fire. Maybe I'm like Carrie.

Medical Specialty Stereotype #5: Radiology



Coming up tomorrow: the Pediatricians get theirs.


* * *


After that gigantic box came in the mail, I thought may we had gone overboard. I mean, we really do have a shitload of Duplos in this house. But now all regrets are gone. Because you need a shitload of Duplos to do stuff like this. (Architect: Michelle, Structural Engineer: Joe, Creative Consultant/Best Boy/Key Grip: Cal)




Welcome to Lego Haus. Might I invite you for a tour? Here is where the Lego women sit to have brunch and talk about their menses.




Below you can see the rear view of Lego Haus, including the sadistic mother and daughter team which stand on the balcony to watch hapless victims slide into a brick wall.




Here is the lounge where the Fire Chief and the Police Motorcycle sit and rest, before descending the stairs to the atrium where the indoor helipad is located.




The next time people ask me what plans I have for my Friday night, I think I should just keep my mouth shut. It's just too embarassing.


* * *


I have to work on inking panels 6 through 12 of the "Medical Specialty Stereotypes" strip this weekend. The heat is on. If I don't get it done by Sunday night, I won't be able to continue serializing them for next week. Nothing like a little bit of time pressure to help get the job done.




I don't technically run ads on this site, but: My med school friend Andy just published first novel. It's available on Amazon and everything. The book is fiction, but it's all medical and shit. Also, it looks sad, so you can read it and cry and then think about how non-sad your life is in comparison. I think people should order it because Andy's a really good writer, and it's just generally inspiring to see well-rounded doctors out there. I just bought my copy. (I also pre-ordered Chris Ware's "Acme Novelty Library #18" and the new Adiran Tomine book, "Shortcomings.")

Medical Specialty Stereotype #4: Psychiatry



Now that summer has passed, we're currently in the thick of the much discussed Manhattan Preschool Application Steeplechase. Historically, the first Tuesday after Labor Day is the day that all Manhattan parents of the toddler set get on the horn and frantically call up their choice nursery schools, demanding applications (if not already online) and validation for their peerless child-rearing. That was only three days ago, and already we've reached our first hurdle.

One of the schools for which we submitted an application has a mandatory "Admissions Information Meeting." Which is held on a Wednesday. At 12:45pm. Only after attending this meeting, we are told, can we be taken on an private individualized tour of the school (no group tours here, my word) and proceed with the application process.

Who exactly can attend a meeting in the middle of the day during a work week? And what kind of a message are they sending, exactly, to families with both parents that work, scheduling a meeting at that time with no alternatives given?

I'm sorry, but that just rubs me the wrong way. Over my righteous indignation bone.

Medical Specialty Stereotype #3: Family Medicine



Oh (awkward segue ahead!), speaking of family medicine, our cut rate eBay Duplos arrived. It is now funny because we have gone from being Duplo-less to obscenely well-stocked with Duplo over the course of just a few weeks, but man, you can't beat that deal. (The whole haul was $37, and I picked the cheapest possible shipping, which is why it took so long to come.) I am pleased. The box arrived the afternoon that I was on call, but I made Joe take pictures.




Here is a picture he took of the great bathing. Overall they were pretty clean, but some were a little dusty and scuzzy, with thin rinds of grime. Ew.



Drying off some of the animals and accessory pieces. (There are some more vehicles too, not pictured. There was also a battery operated light and siren for the firetruck, but Joe didn't see it buried in the rubble and threw it in the bathwater with all the other bricks. It may already have been defective when we received it, but either way, it sure doesn't light up now.)



Look at the farm what I built! Here's the part where you may question whether or not I really got this for Cal or for me and Joe. We have been having a little too much fun with these things overall. Joe especially, who recently built an elaborate fire station and spent five minutes explaining to me the structural innovations. ("See, the guy comes up the stairs here, and can slide down the slide through this door here to the command module, where he can jump down to this platform there..." etcetera.) Construction fun aside, I am charmed by the vintage nature of these Duplo, which, while in fairly good shape, are clearly holdovers from an earlier era. There's one lady wearing an an Icelandic sweater with a Dorothy Hamill haircut that I find especially amusing.

Medical Specialty Stereotype #2: Neurology

I had my first night on call last night as Team Captain. What is it like being Team Captain? Imagine, if you will, that you have ten children, all of whom want your attention simultaneously. Five of whom are newborn quintuplets. And you have no arms or legs. And you are getting sprayed by a fire hose.

Now you're getting close.

BORING SHOP TALK, DO NOT READ IF YOU WANT TO STAY AWAKE:

(No, seriously, I warned you.)

Some people have asked what drawing materials I use for my comics, and the answer would probably disappoint you, because they are not very arty or fancy. Basically, I have followed the same method for drawing comics for the past ten or so years (I used to do a comic strip in college), and it's pretty basic.

First, I do a rough sketch in my notebook, so I know how to lay everything out. Then I pencil in the strip with a Zebra mechanical pencil with 0.5mm HB lead. In college I used to use a more readily available Bic 0.5mm disposable mechanical pencil with 2B lead, but I've since found the harder HB lead gives the line a little more control and is less smudgy. The down side is that the harder lead takes a little more elbow grease to erase.

After I pencil in the whole strip, I go over all my lines with ink, and I have three pens that I use for this, depending on the thickness of the line that I need. For the thickest line, like for the borders or for large text, I use a regular old black Sharpie. For thinner lines, like for all dialogue and the speech bubbles and most of the writing, I use a black Pilot Xtra Fine Razor Point, which is just basically a fiber-tipped ink pen. Because of the fiber tip, it gets dull rather quickly, so I have to have kind of a big stash on hand, but also because of the fiber tip, there's a nice smooth friction-y control that comes with the line. And for the thinnest lines, I use a Pigma Micron 01, which I believe has a 0.25mm tip. It's also a fiber tipped pen, so you have to be careful not to push too hard or else the tip will splay out and you will be pissed. (I used to use a Pilot P-500 to this same end as I do tend to press hard when I draw or write and the Pilot pen has a sturdy metal tip, but that didn't really work out in the end because ballpoint gel ink pens tend to skip when you're tracing over pencil lead.)

As for the paper I use, I tend to use something like this, it hasn't always been this exact brand, but just any kind of 9" x 12" archival paper for pens that is relatively non-bleedy. Because I don't like bleeding, anywhere, ever. I also have recently been using a large sketch clipboard, not because I want to look pretentious and arty (that's accomplished with my beret and existential ennui) but because my desk is such a mess that I need it just to have an empty surface to draw on. I take the board and balance it between the edge of my desk and the armrests of my desk chair, and voila! I do not have to clean my desk. Which is good.

After I finish inking in all the pencil lines, I erase all the pencil with a big fat eraser (good to do this outside or in the fire escape, because those little bits get everywhere) and then I scan the comic into Photoshop. I don't do a lot of Photoshop with my comics because I don't know how--the extent of my manipulations is limited to cropping out individual panels for computer layout purposes, or erasing/filling in little spots that were missed manually. Rarely, I will use color, but mostly I don't, because it's just too much damn work. Overall, for a six panel strip, the whole process from start to finish can take anywhere from 4 to 6 hours.

OK, that's it, hope it was helpful or interesting to someone at least. If you have e-mailed me or commented asking me about my drawing materials in the past, I apologize for not giving a real answer until now, but as you all know, I am a horrible person with a shrivelled black heart and a categorical problem with returning e-mail in a timely fashion. Boring shop talk over, resume your lives.

mas y mas y mas scutmonkey

In an unexpected spurt of productivity, I have also started another "Scutmonkey" comic in the spirit of "The 12 Types of Medical Students," entitled, "The 12 Medical Specialty Stereotypes." It is a 12 (duh) panel comic, so I will try to post one panel a day if I can, and post the whole spread in its entirety at the end of next week. (I would just post the whole thing now, but while all the pencilwork is done, I'm not done inking and scanning the thing yet, hence: serialization.) Enjoy!

Medical Specialty Stereotype #1: Orthopedics

the medical hierarchy: a visual guide

Hi there! Hello! I know it has been a long time (years, in fact), but I finally drew a new Scutmonkey comic. There it is, down there. It's obviously too small to read as is, so click on the image for bigness. If you are blind like me, you can also click here for extra bigness.





As for what finally incited me to overcome the considerable inertia and arrange for the appropriate juxtaposition of free time and absolution from childcare duty--well, let's just call it a Labor Day miracle.