Dr. Malo's Adventures

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This is coming to you from the future so it stays on top!

Thanks for stopping!

This is the real Grey's Anatomy.

Pictured above from right to left are the following residents:

1. Joanna: She is one of our ER residents. She loves ER and does a mighty fine job taking care of the crazy stuff we see in the ER in Chicago. You aren't going to find a better trained group of ER residents than what they have here in Chicago. She is fun loving, outgoing, and is a team player. Very easy to work with and very reliable. You need to be reliable and dependable, and Joanna is.

2. Mike: Our wonderful Chief Resident. Mike is Internal Medicine and is a great guy. Great personality, fun loving, easy going, and easy to get along with. He gets along with everyone and everyone loves him. His management stle is very chill and easy going. He leads by example and rarely gets riled up. It's very rare that he gets upset with you. You gotta be a really bad resident to get his attention. And even then, he deals with most situations with composure and professionalism. Mike already got one of our cardiology spots, he is a graduating 3rd year IM resident.

3. Jim: This is one of our surgery residents. Jim is an Ohio State grad and loves Ohio State more than anyone else I've met. He's been to a million games. Jim enjoys life and is a hilarious person to hang out with. Jim is always excited when major traumas come in and handles his bsiness with poise. A guy may come in missing body parts, or has very few still attached, and Jim just handles it. You aren't going to get better trianing than what we have here in Chicago.

4. Mohammed: That's me! I am a second year internal medicine resident working towards cardiology and interventional cardiology. I am a pretty cool, calm, and relaxed resident. I don't get too excited about anything. I'm pretty even keeled. I love what I am doing. I love playing sports. Football, basketball, soccer, whatever it is. I find medicine fascinating. I really enjoy trying to figure out what it going on with people and what is making them sick. It's like trying to solve a mystery. The sicker the patient, the more fascinating. I love reading about medicine and trying to learn more and more. I love teaching the medical students. When I am on general medicine, I give tons of student lectures. It's enjoyable, and I have a knack for speaking and explaining things in simple terminology and helping students figure it out. The students really enjoy my talks (based on feedback they have given me). I am a huge Denver Broncos fan and Ohio State fan. I just try to make the most of every situation. Some people whine and complain, I just try to have a good time! Just enjoy life! Make the most of every situation!

Is Grey's Anatomy real? No!
I will address this in a future blog. But no, Grey's Anatomy is not real. No one on earth has sex at the hospital. This will be a future post.

For us, week 9 wasn't about the undefeated Patroits and the undefeated Colts (Superbowl 41.5) facing off. It wasn't about Adrian Peterson setting a rushing record. For us, it was about row 2 seats at Detroit. Row 2!!!!!!!!

We made it to the Denver at Detroit game without incident. We love Ford Field, we've been to many Toledo and MAC championships at Ford Field. It's a great facility, great venue. Awesome football facility. However, I must say, the RCA Dome is much louder. Like I mentioned in a prior post, in the RCA Dome I was sitting next to Arwa screaming at the top of my lungs into her ear, and she had no idea what I was saying. No kidding. At Ford Field you can always hear the people around you.... it's not loud at all.

I wish we would have been about 20-30 minutes earlier, so we could get more autographs and chat with players, but that didn't happen. We arrived around 11:30Am for the 1PM kickoff.



We're talking Row 2. I mean Row 2! On Denver's sideline. We could hear and see everything. Above is our good friend Cutler and the Denver offense huddling before a play.

Of course, being this close, means you get to see everything, even the ugly. Below is Cutler being sacked by Rodgers, on the very play where he injured his lower leg.



We were right there when he got injured. He got up, started walking towards us, then the coaching staff motioned to him to go down. Apparently, if he goes down on the field, that allows a few extra moments for the backup to warm up as they go to commercial break. (Smart move!)




Ouch!

Afterwards, he did not return.


We were right behind the Denver bench and had a great view of some of our favorite stars. So close that you could take pictures like the above.


This is one of the guys that was heckling us! He was very funny and jovial! He and his friend made the day go by much faster and we had a lot of fun with him. He actually started cheering for us on the few rare occasions when we actual got first downs. He felt bad for us. When Arwa told him that we watched away games all the time at Indy, Detroit and other locations, he started laughing and said, "So you're like a glutton for pain. Ok, I know what I am working with now. I am going really lay into you guys!"


That's the guy and his friend sitting next to Arwa.

The fans in Detroit were great. They kept their heckling to friendly and jovial. We had a great time with them.

The stadium was "sold out", but there were tons of empty seats. Not sure why. About 5-10% of the stadium was Denver fans from what we could tell. Most were wearing orange, but some were wearing blue. I was hoping they'd all wear orange to stand out.

Above are some Denver fans who were at the end of our section.

The Denver fans that were sitting behind us were really whiny and annoying. Every single play they were whining about the play calling, whining about players not catching the ball, whining about every little thing. It wasn't normal cheering or the occasional "Come on, catch the ball." It was a slow drone of whining, and complaining, and moaning. It was very painful to be around them. Thankfully, they were fair weather fans and left after the third quarter started (they came late too!)

Look, we all love the Denver Broncos, but when your team is getting pounded, try to make the most of it. Enjoy the atmosphere, enjoy the stadium, enjoy the fans around you, talk to people. Be happy. Whining is not going to change anything.

Another weird experience, a lot of fan not only did not show up, but came late and left early. I mean some fans came in the second quarter, and left after half time. Weird. I would love to be able to go to every Denver game and watch every second. If you have the privilege of being able to watch all your team's games at home, why would you leave early?

Below is the final kneel down after the 44-7 loss. (Proof we stayed till the bitter end)



In the back field is Calvin Johnson, one of the more amazing physical specimens. He is 6 foot 4 inches tall, weighs 240 and runs a 4.3 forty. Wow! I can't say I have ever watched a more athletic human being.

Some highlights, Shuan Rodgers running downfield and Selvin Young trying to tackle him. Like I always tell my team mates, tackle their legs. There is no way that a guy like Selvin is going to get the massive Rodgers down trying to tackle him that high.

Another highlight was watching Cutler warm up before the game. I saw what this guy can do. He has the strongest arm in the NFL by a huge margin. He is in an offense that still hasn't put his arm to use yet. During warmups, he was on the 25 yard line and launching he ball over 75 yards into the endzone, with minimal effort. It was pretty crazy!

Travis Henry and Dre Bly are really short dudes, Henry seemed really short. But he is built like a tank. It was hard to tell, but I think I am taller than both of them. Of course, I don't have Henry's legs or thickness, but I could probably give Dre a run for his money in the forty yard dash. He isn't very big, and didn't look too fast.

Ryan Harris and Hamza Abdullah are both Muslim, and I didn't see them take a prayer break. Hahaha. Just kiddig.

Sam Adams is an enormous human being. I don't know that I have ever seen anyone that big before. Watching him move around was painful.

My wife and I lucked out and got front row tickets to the Denver Broncos game in Detroit against the Lions on November 4th. Should be a lot of fun.

We will be in row 2 in section 124 right behind the Broncos bench. We plan on going early, making this a whole day event, getting autographs and hanging out with the Broncos players and staff.

Pretty exciting! I am not sure why Lions fans sell their tickets for cheap and don't go to the games.

Saturday night at 10PM I played football with a bunch of my good buddies. It was really special, we played on the shore of lake Michigan on Northwestern University's practice field. The field was a nice turf field with some very bright lights. It was a phenomenol atmosphere.

It's too hot in the summer to play football in the day time. It's also Ramadan, and when it's 90+ degrees out and you haven't eaten or drank all day, it's even tougher to play.

At night, the temperature drops a nice 10 degrees and it was a cool 76 degrees out. We were playing a rivalry game against a group of guys who challenged us. The past 2 weeks they have demolished us. It's not that our team was playing badly, it's just that they were getting lucky on broken plays. Our defense didn't allow much, but they got lucky off broken plays and would win 1-0. I did not play in the first two games due to scheduling conflits.

I made it this week and we won 7 TDs to nothing. Yup, 7-0! Our defense played lights out and did not allow them into the redzone all day. The one time they did make it, we intercepted them. The rest of their day was futile.

Our offense was on fire! Ali was John Elway sitting back and picking them apart. Our offense started out running up the middle. I was pounding away through the tackles and forcing them to respect the run. As soon as they stiffen up inside, we start passing all over. They tried to cover the pass, and we hit them with options and sweeps.

We demolished them on offense and put up touchdown after touchdown. It was a lot of fun.

Our defense hurried the QB on every play. Our front line was very high pressure. Over top we had Kaiser, Nick and Shazi shutting down everything overtop.

I gotta give those guys credit, they did hang in there and did not give up. They kept playing.

Although, we are down 2-1 in the series, our team has scored more than them, and hence we will just have to keep playing and see what happens.

Ahhhhhhhhh! Tackle football!!!!!!!! The greatest thing to ever happen to mankind!

Of course, I had the option of staying home and watching my beloved Ohio State play, but my rule is simple: If you are ever presented the option of playing versus watching football, always choose to play! Simple.

Did I say I love this game?

Football!!!!!!!!!!!!!!!!!

My largest fantasy footbll draft of the season is coming up on Friday August 31st. This is the meanest, scariest, smartest, wisest band of brothers ever assembled. Everyone in the group has an IQ score of 120 and higher. All of them are either doctors, lawyers, business owners, or PhDs. Very scary stuff.

For the past five years, this group of 12 has been meeting on labor day weekend at a conference room at O'Hare airport to conduct our draft. It's been pretty crazy!

The highest I have finished was 8th. I am always in the bottom quartile in this ferocious league. I usually am in the top half in my other leagues, but with these guys, it's really tough.

Wish me luck!

I love tackle football. I will play with any one at any time. I have lucked out that in Chicago, I have always found people to play.

My good friend Jalal after a nice game.

Football is one of the most intellectually challenging sports humanity has seen. Yes, most kids when they pick up a ball and play don't view it as mental exercise, but it truly is.

Yes, anyone can just play and have a good time. But truly playing football means scheming. You see what the other team is doing and adjust. You don't need superiour athletes, you need a superior plan. That's the beauty of the game.

You need leadership on your team that can analyze, scheme, and execute gameplans as the game is being played. It's harder at our level, because we don't use a coaching staff, we are the coaches and the players, while playing.

Last sunday, we went to a field near the city to play at night. The lights were on and it brought back memories of high school ball under the lights. It's cooler at night, so we prefer it. We picked teams. I ended up with my buddies Kaiser and Jalal. But the big monster of a human being ended up on the other team.

This guy was huge. 6 feet 3 inches tall, 245 pounds of rock solid muscle. He had a 32 inch waist that flared out to huge shoulders. This guy could be on the Under Armor commercials, ripped and cut. His team started laughing at us and saying they were gonna kill us. And that it was over.

Jalal and Kaiser told me that they are just gonna hand off to this dude and he is gonna run over us. I huddled up the defense, told them what our gameplan was, then we started hyping each other up and getting ready. We basically, put everyone in the box to cover the run and left to cornerbacks on each side to cover the entire field behind us.

We dared them to throw. We gobbled up the running back. He lost yards, got flipped, tore up his shirt.... had no where to go. We had our corners on an island covering the entire field.

They could not move the ball.

On offense, we gave them the same look on every down, but mixed in run and pass. We ran 90% of the time, because they could not stop us.

It was awesome! That's just one simple example of scheming and gameplanning.

Football is the greatest sport humanity has ever invented. I will continue to play every weekend.

Someday I will be a high school headcoach. I can't wait! My teams will always win! Superior gameplan, not superior athletes, but having both is great! Smart players!

So the Journal of the American Medical Association published a comparison of 4 diets, and Atkins diet won again.....

"A twelve month study of 311 women published in the Journal of the American Medical Association (JAMA. 2007;297:969-977) concluded that the Atkins diet was the best one studied. Those on the Atkins diet had the best blood pressure levels, the best cholesterol levels, and lost the most weight.

Those women on the Atkins Diet (very low carbohydrate) lost 4.7 Kg (10.4 pounds).

Those on the LEARN diet (high carbohydrate with low fat) lost 2.6 Kg (5.7 pounds).

Those on the Ornish diet (super high carbohydrate with super low fat) lost 2.17 Kg (4.8 pounds).

Those on the Zone diet (40% carbohydrate, 30% protein, 30% fat) lost 1.59 Kg (3.5 pounds).

The study showed that though certain basic vitamins and minerals were not at ideal levels for some people on the Atkins diet, but none of the severe health problems condemned by critics of the Atkins diet occurred. The study showed long and medium term benefits and did not compare the four diets with exercise. "

Download the PDF Now! Great read!

Alright, in medical school and on clinical rotations, everyone supposedly learned how to do a "History and Physical." This is the basic way medical people assess a patient, figure out what is going on, and come up with a plan of action. Most of this is pretty standardized, and you are supposed to write it up in a certain way.

However, some medical students, residents, and even practicing doctors seem to come up with their own way of doing it. I guess if you have been practicing for years and have your own system, and work alone, no one cares.

But if you are a student, a resident, or teaching physician.... why can't you just follow the directions? It's pretty sad.

I see all kinds of weird stuff on history and physicals. I have seen everything from stuff being out of order, to stuff missing. Sometimes you even get people putting things in the wrong place. For example, I have had a student leave out a patient's past medical history. Are you kidding me? No, it wasn't that they forgot. It was they they were told by someone that it shouldn't matter, and you can put it in the HPI (history of present illness). And this student was vehemently against PMH (past medical history) having its own section. Now that is just wrong. Since the beginning of time, PMH has had its own section, and should.

I have seen others put the history in the assessment area. In the final assessment, you are supposed to answer the question, "What does this patient have now that required them to be hospitalized today?" It should not be a list of past ailments or surgeries, there is already a place for that. Assessment should tell us, what do you think is the problem NOW! Not 50 years ago.

I realize everyone learned this properly somewhere along the line, but they developed bad habits, take shortcuts, and just started being taught wrong while on rotations and messed up their teachings.

I think tomorrow, I will take the time to write up, how on earth you are supposed to do a correct H & P.

Just as I was talking about my dislike for sliding scales, it seems that our hospital is doing something about it.

Today at one of our resident meetings, a speaker came in to discuss a new insulin infusion protocol that they will be starting in the ICU. Basically, any patient in the ICU that has an insulin greater than 140, will be put on this insulin drip protocol.

They are going to test this on 50 patients at 3 different hospitals around the country and publish the results, and eventually make this protocol standard at our hospital.

This seems to be a follow up study to the New England Journal 2006 study I spoke about yesterday.

Progress!