Saturday, April 30, 2016

Pre-Residency Trip to Taiwan!

After finishing up my last rotation ever as a medical student, I flew back to Taiwan for a quick trip. Lucky for me, my parents are always up for upgrading our plane tickets if at all possible, especially for a long 13 to 14 hour plane ride as is the case from SF to Taipei.

On the menu....

Can't forget the ice cream on board!
It's pretty crazy how my energy level is these days especially when I look back and remember that I used to be able to not sleep the entire overnight plane ride to Taiwan, land at 5 to 6 am local time, and then have enough energy to last the entire day in Taiwan before going to bed at 9 pm. That's me not sleeping for 36 to 48 hours!! Oh, those were the good middle school and high school days. Now, that's certainly not the case anymore. As soon as I finished eating the late night dinner, I completely zonked out for nearly 7 hours.

A cool little travel pack

Sleep time...

After I woke up I decided to watch Spectre 007 on my tv screen (another big and positive change to flying) followed up by another 1 hour nap. Spectre was good although I wouldn't say it's one of the better James Bond movies. After waking up, I watched Big Hero 6 while eating the morning breakfast meal. Practically everyone had told me that Big Hero 6 was a really good movie and so many little kids have seen it that I felt that it was about time to catch up with the times and watch it for myself. I must say...I teared up quite a few times during the movie, basically because of Tadashi!! Anyway, solid cartoon movie and one of the better recent ones!

Finally, after eating and another 40 minute nap, we arrived! Even though I slept close to 9 hours on a 13 hour flight, I still felt exhausted!! Seriously getting old, sigh.

Spotted the giant Taiwanese flag as the plane was pulling in

Welcome to Taiwan!
We left Taoyuan International Airport and took a quick bus ride to the Taoyuan High Speed Rail Station where I grabbed some 7-eleven food. Taiwan is known for its amazing convenience store food and atmosphere. Whether its 7-eleven, Family Mart, OK, or Hi-Life, all the convenience stores here never let me down. An interesting fact is that Taiwan has the world's highest density of convenience stores per person, with a rough estimate of 1 store per 2,500 people. It's pretty common to see multiple convenience stores on one corner of the street here.

A korean BBQ + kimchi onigiri (NT28) and garlic spicy cold noodles (NT39) from 7-eleven translates to just about $2 in American money and a very, very full Evie. Solid food.

Once the high speed rail train arrived, we took it all the way to the last stop, 左營 Zuoying, which is in 高雄Kaohsiung. My cousin picked us up and we drove back home to 屏東Pingdong! All this and it wasn't even noon yet!

Saturday, April 23, 2016

Rotation #7 Diamond Headache Clinic

During the past two weeks I finished the last of M4 year with a short rotation at the Diamond Headache Clinic. The clinic treats many patients whose headaches are refractory. Many of them have already been seen by several doctors including going through their primary doctors then various neurologists before arriving at the clinic here in Chicago. A good number of patients that I saw travel from all over the United States, some even from other countries to be treated here. Many patients make multiple trips to Chicago every year to be seen. Not only is there a clinic but the Attendings here can directly admit their patients to the Headache Unit which takes up the entire 9th floor at St. Joseph's Hospital.

There are several different types of primary headache diagnosis. The four that I saw the most included 1) Migraines 2) Clusters 3) Tension and 4) New daily persistent headaches. Although the age range of patients that come to the clinic is incredibly wide, I was mostly interested in those in the younger age group. Most of those in this group, between the ages of 11-24, were newly diagnosed with new daily persistent headaches which is commonly caused by EBV, the Epstein Barr virus.

What I found so amazing was that patients had suffered from headaches for so long prior to presenting here and with their debilitating headaches, there were often a multitude of psychiatric diagnosis that were associated. The most common were depression and anxiety, but a couple of patients also had bipolar, chronic fatigue syndrome, fibromyalgia, and various other pain syndromes. It's no wonder that most patients, especially those that were over 40, were on over ten different medications including antidepressants, antianxiolytics, antipsychotics, antiseizure meds, antiinflammatories, and about 3-4 different pain meds. This does not even include medications most older patients were taking for relatively common diseases such as hypertension, hyperlipidemia, and diabetes. The amount of medication management required for these patients is a complete art alone and it was crazy to watch my Attendings run through the list for each patient on every visit.

Those with chronic headaches tended to also have depression as a diagnosis as well and it reminded me how interrelated neurology, pain management, and psychiatry truly is. It's so connected that it's difficult to treat one without dipping into the realm of the other two.

On a side note, recently, I also had an interesting conversation with my sister regarding euthanasia and physician assisted suicide. Then I happened to run across a video posted by the Economist on YouTube. It's a short documentary called 24 & Ready To Die and it explores euthanasia in Belgium which has one of the world's most liberal physician assisted suicide programs. Very very touching and an extremely well done video.

Thursday, April 14, 2016

I love...

Great Attendings!

One of my favorite Attendings from M3 year emailed me last night and wrote:

4 minutes later he emailed again:

The joys in my life :) :) :) Kobe will be dearly missed on the courts!

Friday, April 8, 2016

Boston: Day 5

Oh Boston, bringing in the snow on my last full day here! Day 5 started out with brunch at Cafe Luna in Central Square. Since George and I went on a Monday morning, we avoided all the weekend lines and reservations and were seated right on arrival. Their weekday brunch menu was pretty eclectic so it was hard trying to decide what to get.

My grilled pear, bacon, and gorgonzola omelet. SO delish!

George got the Jalepeno mac n' cheese with bacon and eggs!

After brunch, we went next door to get Toscanini's which apparently the New York Times called "The World's Best Ice-Cream." I will say that it was pretty darn good and left me way too full.

Then came the pretty sad part. I dragged George all the way to Belmont (suburbia land) to try this supposedly really good macaron shop (according to Annie), called Praline. It was snowing like crazy and also really cold but we managed to get there only to find out that it was CLOSED on Mondays!!! Anyway, I was dying because I never got the best macarons and then we were stranded in the middle of nowhere in the cold and waiting for the bus. Well, I guess it was only a 6 minute wait or so (got lucky) but it was still so very sad.

Instead of macaron pictures, this is us freezing, but still with smiles :) !

So instead of hibernating inside like what normal human beings would do, George was kind enough to take me to Fenway Park and give me a quick tour of the surrounding areas. He also took a bajillion more pictures for me accompanied by the snow and tormenting wind. He's such a good friend!! Bff, seriously, really.

By this time, he was probably sick of trekking around the snow with me (just kidding, kind of), so I made my way over to Boston Children's Hospital, the #1 Children's Hospital in the United States, just to see what it was all about. It was hard to adequately judge how pretty the hospital was because it was just an overall gross day and the hospital was also doing some serious construction at the front to make it look prettier. Nonetheless, I got to roam around the inside of hospital and with the exception of some bright lights, I can't say it was very pretty. It definitely did not match up to the kingdom that is Children's Hospital Colorado or Seattle Children's which are 2 of the best children's hospitals in the west coast. I really liked Boston Children's logo though - Until every child is well, but Children's Hospital Los Angeles' logo is pretty darn good too - We treat kids better!

After realizing that it was somewhat strange to be roaming inside a children's hospital with no obvious purpose, I decided that it was about time for me to retreat indoors and catch up on my internet life. So I did just that for a few hours before meeting up with Annie one last time before I left the city. Annie and I went to a Thai restaurant in Brookline called Brown Sugar Cafe which had a really cute interior that was perfect for eating out and hiding from the snow.

Brown sugar mango fried rice

Mango with sticky rice (and a raspberry smiley face)

I headed back to Boston Logan Airport early the next morning and flew back to Chicago. Thank you Annie for coming to Brookline to eat dinner with me, for taking me to so many places, and for recommending so many delicious places to eat! I will definitely have to make it to Praline in the future (perhaps very far in the future though). Also, I'm so happy I got to see you this year because honestly, who knows when I'll see you next! Finally, thank you George for being a wonderful tour guide and photographer and for never complaining even when we were stranded in suburbia with no macarons. I hope you weren't sick of me after 5 days, especially after I forced you into watching so much ice skating!! :) :) :) You are seriously, seriously the best.

Thursday, April 7, 2016

Boston: Day 4

Day 4 was really the beginning of the cold, cold weather hitting the East again (in April, ugh). George and I headed out to Beacon Hill in the morning for brunch at the Tip-Tap Room. I got the Chorizo, brussels, and corned beef hash which had a nice spicy kick to it to start off the day. Then we walked around Beacon Hill for a bit and I was on a mission to find the signs to Massachusetts General Hospital (typical tourist) but it's currently ranked as the best hospital in the world (not in Pediatrics though!) and is the 3rd oldest general hospital in the United States behind Pennsylvania Hospital and New York Presbyterian which I had visited last December on an interview!

Mission accomplished, found the sign!

Beacon Hill is a super quaint area in Boston with lots of brick houses, cobblestone roads, hills, and fancy restaurants. After walking through the area, we made our way to the Boston Public Garden which I loved! It's the perfect place to stroll through on a warm summer day. I kind of went crazy with the pictures in the gardens so I have to extend my many thanks to George for being the photographer!

Chasing squirrels :) :)

I got George to take a picture with a pretty tree!

After the gardens, we walked down Newbury Street in Back Bay Boston (which houses fancy upscale stores and boutique shops) where Annie and Penn found us. Annie recommended going into L.A. Burdick Handmade Chocolates and since I'm pretty much a chocolate obsessed person, I immediately said yes! Best decision because I'm an avid dark chocolate bar collector and found a Brazilian chocolate bar with hints of lychee and mint. I also got a dark chocolate mouse which the store is famous for handmaking!

We headed towards the Boston Public Library afterwards and made our way around and up the three floors where I found some cool collections of books, including a book on Taiwanese art with the name of an artist who happens to live right around my house in San Jose! (What a crazy coincidence).

Entrance to the Boston Public Library

It took a bit more walking and another detour through two other chocolate shops - Lindt and Godiva (yes, between Annie and I, we could probably go into every chocolate shop ever) but we made it to Cafe Madeleine, another Annie recommended cafe, where George and I had the pleasure to try a fantastic, beautifully made, strawberry macaron! Craving satisfied.

Mm mm yum! So pretty too

As if all those sweets weren't enough, my next stop was to walk to Blackbird Doughnuts followed by Flour Bakery & Cafe in Boston's South End. Practically freezing by this point, and still bundled in coat, gloves, and earmuffs, we hightailed it to George's lab at Boston University to feast on all the collected desserts in warmth. That was perhaps the best feeling of the day!

Salted caramel, strawberry basil, and chocolate!

The yummy Flour sticky bun! So good

I love this. Pretty much wanted to steal it and put it on my own wall!

Feeling adequately full and warm, I ventured back outside in the 35 degree weather to explore South End more and to catch the sunset from afar. I also decided on eating Otto's Pizza for dinner at 9pm because they had some pretty interesting flavors! We got the spicy pork and mango (omg, so good, I wish I ate more but was too full) and I also got an extra slice of the margherita. I'm not one to eat pizza often but Otto's was delicious! With all this roaming around on Sunday, Pacer logged in 22,200 steps!

I am so pro at finding the signs!!

Spicy pork and mango pizza. EXTRA YUMMY!

Wednesday, April 6, 2016

Boston: Day 3

Day 3 kicked off with brunch/lunch at a fairly new Chinese restaurant in Cambridge. None of us had tried it before so it was nice to eat at a new place all together! They also served some Taiwanese breakfast items too so that was a nice touch.

甜豆漿 Sweet soybean milk 

小籠包 Soup dumplings!

Shanghai soup with marinated pork, tofu, and bamboo shoots

Shanghai fried rice with pork and veggies in a clay pot

This was my favorite! Pork and chicken with black beans and pine nuts wrapped in lettuce!

Afterwards, we stopped by Annie's apartment, then headed out to the Museum of Science! The Museum was pretty large but we were able to see a lot of the exhibits. My favorite was the Hall of Human Life exhibit because hey, that's my life! We got to do some pretty cool activities and I learned that apparently I burn the amount of 6 or 7 grapes when I walk a little! I don't get it. They also had a really cool mini 3D theatre where we watched a short film on our immune systems. Another cool exhibit was the the Light House one where it was all about mirrors and light reflection and refraction. Annie and I stared at each other through mirrors until I saw her face sitting on my body.

The Museum of Science sits right along the Charles River

Body heat!


Being a kid

Lying on a bed of nails!

My jump
My frozen shadow!
After almost 3 hours at the museum, we headed back to the Boston Public Market where I finally bought a couple of items to bring back home for my family. I also tried these delicious mini cider donuts that were freshly made and SUPER hot!! So yummy. After a cup of kale juice from Mother Juicery in the market, I was just too full to eat dinner that night. Instead, we headed back to North End where I finally bought some authentic Italian cannolis from Maria's!

With the sun going down and the rain clouds rolling in at this point, Annie, Penn, and I made a final stop at Piers Park in Charlestown. It was super windy but the view of Boston from the park was amazing! We caught it at the perfect time, just as the sun was setting and the lights of the city were turning on. So worth the trip there! Thank you for taking me around today Annie & Penn!

Panoramic view of Boston across the Charles River

Chocolate cannoli
Vanilla cannoli with pistachio topping on the sides

The night ended with me bumming around in George's house, making him stream the ladies free skate event with me online and eating the still super fresh and crisp cannolis I had bought earlier that day. Saturday logged in 12,000 steps!