Yabadabadoo

So it's the day before the big storm, right? Windows are boarded up, sandbags are in the doorway and I've got tons of tuna and canned soup and I'm hunkering down, waiting for Wilma. What could possibly happen?

Nothing except my toilet backs up and it spills into the shower and my room smells like sewage central. I see bits of corn and oatmeal swirling in a brown-colored brew. What's absolutely compelling about the situation is that I have to pee after the enormous amounts of tea I'd imbibed at breakfast.

Funny thing is that Wilma isn't even here yet and I am already ankle deep in shit.

So I passed my Step, what next?

Wow, all that struggle for this one piece of paper and when I tried to determine exactly what the numbers mean, I get this:

"Both scores reflect your overall performance on the examination. The number of test items you answered correctly is
converted to two equivalent scores, one on a 3-digit score scale and one on a 2-digit score scale. Both scales are
used for score reporting purposes."

OK.
So, what does a three-digit score mean?

"On the 3-digit scale, most scores fall between 140 and 260. The mean score for first-time examinees from accredited
medical schools in the United States is in the range of 200 to 220, and the standard deviation is approximately 20.
Your score report includes the mean and standard deviation for recent administrations of the Step."

Huh?
So what does the two-didgit score mean?

"The 2-digit score is derived from the 3-digit score. It is used in score reporting to meet requirements of some
medical licensing authorities that the passing score be reported as 75. The 2-digit score is derived in such a way that
a score of 75 always corresponds to the minimum passing score."

Now I'm confused. I like how they say "in such a way" but not tell you what way it is or how exactly it is they came up with your score. And noticed how they used up three lines by saying absolutely nothing at all? Statistics mumbo jumbo that somehow determines the course of my life.

All I can say is thank god it's over. What's next is anybody's guess.

DRE: Destination Black Hole

All simple beginnings start with a small step. When I was three, being able to tell my mom I needed to go use the potty versus crapping my pants was that kind of a step. Then at sixteen, or eighteen, or whatever the legal age is, being able to go to second base without having an orgasm is also a small step. At 25, small steps, for me at least, meant being able to pay the rent and the electricity bill and still have enough left over to eat.

Today, as I enter Turd year of med school, I have entered yet another phase of small steps, which I am hoping will eventually pile up to a gimongo step, in a series of precariously placed small step events.

So, a bunch of us MS III's got together to celebrate something or other like finishing a rotation or the first time getting your ass chewed in front of people by your attending. It's a nice, unclassifiable place which serve Cuban delicacies, has a Flemingo (or was it Flemenco? Whatever it is, she looked like a bird) dancer and decorated with sea shells and chinese paper lanterns. It's like a schizo who forgot his meds and has a personality disorder. Anyway, as we are munching away on Cuban delicacies and sipping sangria, chit chatting about the week's past events that may or may not have embarrassed us, I excitedly announce that I performed my first DRE (Digital Rectal Exam), except when I said it, there was a slight pause in the night's musical entertainment and I said the word "rectal" with decibel or two louder than normal speech, whereby several heads turned our way, fork stilled in mid air and food falling off and hitting the fine china with a loud "plunk".

I am sure there are many causes for excitement; a new promotion, scoring one with a hot chick or a stud dude, a delectable meal with great wine, your first born child, the death of your mother-in-law (generic MILs, mine being the grand exception)and now, rectal exams. It was my first on a real life person versus a dummy lower torso I affectionately call "P. Elvis", with his legs ripped off and his ass hole the size of a ping pong ball due to many years of abuse by many, many index fingers, which makes me think of how sick a person must be to offer his asshole for teaching purposes, especially in the light of some monetary reward. So, understandably, this was quite a small step for me.

It is always awkward to ask someone if you can stick any type of an appendage into holes in their bodies that we ourselves would protect like it was Fort Knox under normal circumstances. However, since rectal bleeding constitutes some type of an immediate thing and that not doing a rectal exam might mean problems for your asshole in the future as it is torn a second cousin by wolverine-like lawyers who revel in human suffering and the celebration of new assholes, it was indeed pertinent to perform one, for which I half volunteered (I know, sick) and was half appointed by my attending.

So I approach this little old lady and nice enough, she obliged to let my finger in. At this point, I am thinking of my fellow colleague who is a 6-foot, 245-pound hunk of a Georgian who is built like a brick wall. In fact, I ran into him one time and fell over. I have seen his fingers and it scares me to think of it in a hole with a definite circumference.

I tell the lady that she has to make pretend like she is going to poop as I slip my finger into her anus. I go in and I feel, except I have no frigging clue what I am supposed to be feeling for. Rectal hemorrhoids? Polyps? Fistulas? Old people are supposed to have a rectal shelf. I've always wondered why they call it a shelf. It makes me think of food when I am sure it is sick to think of food in that context. What? A shelf....does it hold peanut butter or mayonnaise or a can of relish?

And then the little old lady farts on my finger, which I am sure embarrassed her more than it did my finger. Finally, the ordeal is over. I ask the little old lady how I did and she smiled and said it went OK. The greatest comment she gave me was that I was very gentle. It was great, since I did not know what the hell I was doing. It was great also since I can put that under my belt and check off the list of things to do. Small steps, you know. Start from the very bottom and work up. Very soon, before you know it, I would be performing brain surgery.

Look at me, I'm so cute in my scrubs

We are always looking for symbols to represent our desires or our triumphs or puff up or little egos. For some reason, people think it's cool to wear scrubs because it tells the whole wide world where you've been. It doesn't matter if you've just gotten done looking up someone's colon with a probe and you were dumb enough to pump it up with too much air and forgot to decompress it.

Like when you go to the grocery store for a stick of gum and the cashier looks at you, wide eyes, beaming: "So, what kind of doctor are you?"
And it makes you feel good because someone noticed.

So my fellow MS III wears scrubs to work because he thinks it's cool and he rationalizes: "I just hate to wear a tie."
Right. So he makes his own rules.
And he is relating a story of how he wore his scrubs to go visit his friend recovering from surgery at a big hospital. With a big, idiotic smile on his face, he tells of how a nurse hands him a chart and says "he's all yours, doc".

Aw, I said, did that make you feel good?

Well, yes, he says in his Carolina drawl.
Gee, is it such a big surprise that he wants to be a surgeon?

It's so amazing too how it is that some folks like to fill up the void of what they don't know by throwing out medical terms that mean "go forward" or "feeding tube" or "right eye" and hope someone notices that they were a former paramedic or nurse. It is also amazing how these same folks like to refer to "us kids" that don't know the system. Well, duh, I thought that was why we were in medical school. Does a baby know that he is supposed to swallow instead of vomit or to ask to go to the bathroom instead of poo in his pants the minute he plops out of the uterus?

My point exactly.

We've all got to start somewhere and this condescending bit about: "Aw, you poor things don't know what an admission order is" or "TKO is to keep open" or "a banana bag means multivitamins" is just rubbing it in my face a little too raw. It's like wasabi up the nose when you're not prepared for it.

But today, there is a score for the "Us Kids" as we round and meet with a person in alcohol withdrawal and flailing in his restraints.
I said: "Oh no, that's no good because before we know it, his CPK is sky high and he goes into renal failure."
In normal speak, this translates to the guy is going to break down his muscles because he is flailing and having seizures that he is going to screw up his kidneys.
The former nurse turns her cute head and laughs a great big one my way shooting me this "but seriously" look.

"Look at that," says the attending as he flips through the chart. "Look at the CPK value. The next thing we know, he is going into renal failure."

Exactamundo. The nurse is refusing to look my way.