Medical Arms Race

Astute. These guys get extra points for doing it in the style of Dr. Seuss. There is an extra dash of irony here, considering that Dartmouth Med School just took on Dr. Seuss' name. It's just what the Dartmouth Atlas has been telling us for years: empty beds and idle OR suites don't stay that way. The more you have, the more you use, and the more everyone pays.

Thankfully Hilary, as a family practitioner, is a bit removed from the front lines of this decades-long medical arms race. It is tough to argue that there are too many general practitioners, or that they are over-consumed (over-worked, maybe, but that's different).

Homecoming

One of the wonderful things about being back in New Hampshire is that we're only an hour from Dartmouth, so it was easy for us to drive up for Homecoming on Friday night. I really wanted to go, despite being on call all weekend, and it was absolutely worth it. We drove up after a quick dinner and didn't leave Hanover until 11 PM! It was awfully fun to wander through Baker with Brynna at 10:30 at night, looking for the new King Arthur cafe. (Which is very tasty, by the way.)

Here's the gathering on the Green. I must say the speeches lasted MUCH longer than I remember!

Brynna tried out a higher vantage point.

And here we go!

Brynna was in awe.

And wanted to join in:

And is down a layer, cause it was HOT!

Use the Force, Brynna!

Hanging out in front of Dartmouth row. With a lightsaber. Awesome!

Yeah, I chopped my hair off. But not with a lightsaber.

"I love it at Dartmouth," Brynna said to me as we were sitting there together. Us too, little B!

Trip to Dartmouth

On Sunday, Hilary helped out a hiker/resident friend by staging a car in Waitsfield, VT, then shuttling her down to meet her husband in Killington, VT, so that they could spend the next week hiking the northern half of the Long Trail. Brynna and I went along for the ride for only the first portion, then spend a good chunk of the day in Hanover. Clearly we are trying to indoctrinate our child by giving her such good memories of playing on the Green.

Dare to dream!

But that can't entertain a child for hours on end, so I rolled her across the river into neighboring Norwich, so that we could spend some time at the Montshire Children's Museum. Knowing that I might have such a walk ahead of us, I opted to bring the jogging stroller rather than some other pedestrian conveyance. All well and good, except that the Chariot has pneumatic wheels, just like a bicycle. And, just like a bicycle, such wheels are prone to damage.



Yup, a 3/4" nail went right through and had me walking flat before we got there. And yes, I just so happened to have a Gerber tool on me to pull the nail out. Ah well, I just pushed on ahead. And in fact, because Hilary got a bit delayed picking us up and Brynna blew through her usual naptime, I ended up wheeling the sleeping child back across to Hanover on that same flat tire.

It wasn't until Sunday night, when I sat down to repair the tube, that I found out that there were no less than six punctures clustered around the original entrance wound. Good grief!

Bonfire

My folks were in town this past weekend. It also happened to be Dartmouth's homecoming weekend. Being near and dear to our hearts, and my parents' hearts, and being just an hour up the way, we met up in Hanover Friday night to witness the homecoming bonfire. My parents met at the bonfire way back when, and Hilary and I nearly got engaged at the bonfire some years later.

For those that don't know, Dartmouth's Homecoming bonfire is a real piece of work. For the last few decades the design has been more or less standardized around the following (homegrown) design. Traditionally, railroad ties were used (the creosote really lit up), but they're harder to come by, so we instead now order tie-sized green lumber from a mill yard. Like popsicle sticks, the ties are stacked layer upon layer, first in a star shaped base, then a hexagon that closes off the star points, tapering to a square tower that gets topped with numerals for that year's freshman class, who goes most of the grunt work. The interior structure is filled with scrap wood, mostly old shipping pallets. The structure stands about 35 feet tall when complete; flames can easily top 100 feet when in full flare. During the lighting ceremony, things get started with a couple buckets of kerosine and six flares wielded by chosen members of the freshman class. Then they all run around the fire in various states of dress, no matter the weather, while the rest of the college and community urge them on.

Following the collapse of Texas A&M's bonfire while under construction in 1999, Dartmouth changed a few things. The ties above head height now get lifted up using a lull, rather than hoisted up on ropes. Large garden spikes are used to ties some of the upper courses together, to lessen the chance of the structure shearing off to one side (either during construction or when half-burnt). There is a visible police presence both outside and inside the assembled crowd. Highway construction spotlights bath the scenePlywood sheets are now affixed to the outside of the star base, ostensibly to provide a canvas for students to tag, but really to make it difficult for anyone to climb the bonfire after it is first lit (I kid you not, this did happen in the past).

We were joined by my Uncle Tom, who took some great shots:

This year's production.

The assembled crowd gazes in awe of our pagan rituals.

It was chilly, so we put Brynna into her Everest expedition wear.

The Conflagration!

Dartmouth Day 2

I must say, as pathetic as I felt getting the pregnant lady room (1st floor, right by the class tent, a single with its own bathroom), it's actually fantastic. No 3 AM trips down the hallway...no stairs to pant up...though the haze of marijuana smoke outside in the hallway earlier was perhaps not ideal for either my lungs or the crumpet's. It doesn't seem to have percolated through the door, though, so that's good. Ah, the joys of being back at college!

The girls and I all met up for breakfast this morning, splitting our allegiance between the Dirt Cowboy Cafe (iced chai! blueberry muffin!) and the Bagel Basement. Then we had a walk around Occom Pond.

My parents took us out for lunch at the Canoe Club, very elegant! Here's a nice shot of our group (me, Katie, Lauren, Sara, Kristin, Dad, Mom, Rachel):



I totally did not see this coming, but it actually turned into a mini-shower for the crumpet! I got photos and descriptions of several goodies that are on their way to Rochester (how did they know that my duffle bag can't take much more?). Sara is knitting us a baby blanket, and was very disappointed that baby-soft wool does not seem to come in Dartmouth green. It's a lovely blue-green instead, though, which I'm sure the crumpet will love. Here she is working on it:



Lauren also made us the most wonderful baby scrapbook by having a copy of Goodnight Moon re-bound with extra blank pages inside to write on and attach photos to. So creative!

I also picked up a little pair of baby socks at the Co-op today. I couldn't resist, as they say "Dartmouth" and have a little moose pattern all over them.

Later in the afternoon, after Dirt Cowboy chai #2 of the day, I headed out to visit Panache, who is really having a lovely retirement in Norwich. I groomed him for a little while and got a chance to catch up with Lisa and Don as well. Less fuzz fell off than last time since his summer coat is basically in by now, but he was very itchy from bug bites and so appreciated the attention with the curry comb very much.



This evening there was a dinner down near the river, and the after-party is now going on full blast outside my window. I'm hoping that I'll still be able to get to sleep pretty soon...it's going to be a long week of traveling and taking exams, and I don't want to go into it too tired!

Lest The Old Traditions Fail

How many other nights at Dartmouth have ended like this, with EBA's at 1 AM?



Reunion Day 1 has been lovely. I've been able to spend time with several of my best girlfriends, and the weather is just spectacular. Hanover is looking particularly green compared to the arid Southwest! I've had a chance to catch up with many familiar faces. However, I am sticking close to my friends, as venturing afield alone results in me noticing people looking at me like I am a complete alien...at our next reunion, many many people will be pregnant or toting babies, but for now it's quite an oddity.

The only thing that would be better is if Alex were here, too. But the crumpet and I will be headed back to Minnesota in just a few days. For now, we're enjoying an interlude in the other place that I consider home!

Sara read her favorite book to the crumpet this evening: Elephant Elements, which she discovered during her term abroad at Oxford.

Blogging the Road Trip

Sorry to all you techies, but I'm going to interrupt the AA to USB posts to report on where I've been over the last week while Alex has been at home, holding down the fort and getting his geek on!

Last Wednesday, I flew back to New England to interview for the joint family medicine-preventive medicine program at Dartmouth. This would be an "outside-the-match" residency position, letting me know months and months in advance where we will be spending the next few years. If I get in, I will spend January to March of next year in New Hampshire, starting Masters of Public Health courses in Lebanon (just down the road from Dartmouth) and also doing some clinical work at the family med residency in Concord. Then I'll start the family med residency in June. That lasts three years, and then I would finish the MPH coursework and do a "practicum" year during which I would implement a quality improvement project. Total time about four and a half years. Whew!

Anyway, the combined program sounds like a perfect fit for what I want to do, giving me great family med training and also teaching me a lot about how to carry out practice improvements. After submitting my paperwork in February, they set up a two-day visit for me last week. I was at the Concord program on Thursday for eight—yes, eight—interviews with faculty and current residents. It was a little stressful, but everyone was very pleasant, and many of the interviews were more like nice chats. Then, that evening, I went out to dinner with the program director, his wife, and a couple of residents. I'd really like to do my training there—they have a great curriculum, the residents are quite happy, and the program seems to be very responsive to proposed changes that residents and faculty suggest.

Friday was spent in Lebanon, where the preventive med part of the residency is based. I had four interviews in the morning, which all seemed to go very well, and then spent the afternoon at a couple of class sessions. First was a leadership session, with a discussion on different leadership styles. Then, several of the residents presented their progress on practicum projects. I loved this part of the visit as well, and was very inspired by the great relationship between the faculty and residents.

Here I am in my maternity business suit:


I had a minor panic last week that my planned shirts were not fancy enough for my interviews, and went running off to Motherhood Maternity, where I found several quite sophisticated ones. I think I looked about as zippy as a 25-week pregnant lady can look. I got away with the same black suit jacket that I've had since med school applications (no buttoning anymore), and a pair of black maternity pants from Target.

As you can see, dad was enjoying some time with his granddaughter:


After the stressful part was over, we had a wonderful weekend in the Upper Valley, and then back at home in Connecticut. We went to Spring Sing to hear some a capella, shopped at the Co-op (ciabatta, cheese, Grade B maple syrup), hit King Arthur for some scone mixes, had breakfast at Lou's with Chris and John, and checked for baby goodies at the Dartmouth Co-op.

I also got to spend a couple of hours at the barn with Panache. Here he is with buddies Luna and Aly:


He is in full spring shedding swing, so most of that time was spent scrubbing lots and lots of fuzz off of him. Here's the pile—I think he beats Jasper for its size, and all of this was manually removed, too—no clippers!


It was wonderful to see him, even though I couldn't ride this time. He's weathered the winter OK, but will probably fatten up a bit now that it's spring. He's almost 30 now, and is certainly enjoying his Vermont retirement.


We also hit the Norwich Bookstore had a great dinner at the Norwich Inn pub with John and Peggy.

Back in Connecticut, it was great to catch up with folks around town. I also continued the crumpet's tour of important New England landmarks (most of which, interestingly, involve food) with donuts at Phillip's and ice cream at Charlie's. Spaghetti dinner with the regular crew on Sunday night rounded out the weekend beautifully.

Now I'm back home, very happily reunited with Alex and Jasper. The residency program has promised a decision by the first week of May, so keep your fingers crossed!

Jones Seminars and Energy

One of my favorite things back when I was at Dartmouth (particularly in my later, heavy-engineering years) was the Jones Seminars at the Thayer School. Friday afternoons, at the end of a long week (usually with a long weekend ahead, too), we'd gather in room 100 for coffee and cookies and a lecture. Yes, this is a geeky way of kicking back.

These were general interest lectures in science and technology given by distinguished guests or Dartmouth professors. Some of my more memorable ones were about the Columbia Accident investigation, bio-engineering a yeast to produce complex human hormones and proteins (now the focus of a successful Dartmouth spinoff), some interesting futures in robotics, the two-mile time machine, high-efficiency solar cells, and so on.

This fall, the subject of all the Jones Seminars are on energy, climate change and, most importantly, what can we do about it. Being a mostly-engineering audience, the focus of the interventions are things like cellulosic ethanol (another dartmouth spinoff) and carbon capture and sequestration. But, consistent with the Thayer School's mission, there were have also been speakers from non-profits and, just yesterday, from BP. There was a tie-in to an energy symposium put on the by the Thayer School as well.

Absolutely the best part about all this is that these lectures, which were always videotaped, are now available as video podcasts, too. I can remember a few years ago wanting to watch one of these lectures again, and having to wait four weeks for the videotape to be post-produced and available through the library (not on the shelves, even). Now, the post production is done in a day or two, and the video can be downloaded and watched by anyone, anywhere. They are available in large video format (640x480, approx 100 MB / lecture), small video format (QVGA, about 60 MB), or just straight audio. Unfortunately, they need to be transcoded (i.e., reformatted) to fit properly on my iPhone. The transcoding is kind of slow, so mostly I just watch on my computer.

Although these series are given to a mostly engineer audience, they are accessible to most folks. The focus this term on energy and what we can do about it is, I believe, particularly important. These are very informative and entertaining lectures given by very intelligent people, and I encourage all our readers to check them out.