Grand Rounds

     Every Thursday morning all the surgical residents go to Grand Rounds. For grand rounds we all meet in a large lecture hall and have an hour lecture on different medical and surgical topics, and because this is Hopkins we have had some phenomenal speakers. I am just so impressed each and every week by the amazing things these physicians are doing or have accomplished in their careers. Today the lecture was titled "Marshaling the Immune System to Cure Cancer." A lot of the lecture was a bit too scientific more me to understand at this point in my training. The speaker was Drew Pardoll, M.D. Ph.D who has dedicated the past 30 years of his life to cancer research and has been able to develop vaccines that are showing incredibly promising result in helping to cure various types of cancer, he has published over 250 articles on the subject and is in phase three of several clinical trials. To me, this is like meeting a rock star. I can't wait to see where this research goes.
     A few weeks ago we had a grand rounds lecture by Stanley J Dudrick M.D. who first conceived of the idea of total peripheral nutrition during his surgical residency. Everyone said that he was crazy but his rationale was that if we can be fed by a vein in utero then why can't we be fed by a vein in vivo? His experiments we designed using beagle puppies and he was successful in growing them using entirely parenteral nutrition. Then one day after giving a lecture on his beagle puppies a doctor came up to him and told him about a neonate he was taking care of who had a failure to thrive and asked if he would do his "puppy trick" on her. And that little neonate baby girl was the first human to be saved simply by being given nutrition through a vein. He told us in grand rounds that since that day total parenteral nutrition has saved the lives of over 10 million neonates. Not to mention the other millions of lives that he has saved from morbidity and mortality with his research.      It just amazes me that these are the types of doctors that I get to walk the halls with and hear from on a weekly basis. I am truly lucky to be learning at this amazing institution.

Thanksgiving

     This year for Thanksgiving I was so grateful that I was able to take the entire day off and my sister Christine flew out from Salt Lake City to spend it with me. I'm also grateful for my brother-in-law Peter who understood that I needed my sister for Thanksgiving a little bit more that he needed his wife and was happy to let her come visit for a few days.  It was a very short trip for her. She flew in Tuesday night and Alison, Steve, and I picked her up at the DC Reagan airport. This was nice because we drove around and showed Christine the quick tour of DC monuments.

Lincoln Memorial

     The next day after I was done with work I took Christine out to explore my little neighborhood in Fell's. We went to one of my favorite little sea food places called The Point and she got to taste the local crab cakes.... AMAZING! I really liked showing her around my new home and city.

In front of The Point Restaurant

     Thanksgiving day I took her to see Johns Hopkins Hospital. I gave her the grand tour including my messy on call room where we PA residents try to sleep sometimes but mostly it's just where we store all of our stuff. I showed her the new Bloomberg Children's Hospital. I think the best is the view from the top of Sheikh Zayed Tower that overlooks downtown Baltimore and Inner Harbor.

My view at work

    Thanksgiving dinner we were invited over to the Cornell household by Peter who is the Nurse Practitioner who has been training me my first few weeks at Hopkins. He and his wife were so kind to let us come and his parents were there too and they were very friendly. They have two little girls that are super cute and I brought over a little craft for them to do, where you put gum drops in apples to make a turkey. They loved it! Before dinner his older daughter, Wallace, who is 6 years old asked if we could hold hands and go around the table and say what we are thankful for. She started and said that she was thankful for Mommy and Mary.  Haha, I laughed hard about that and had to tease Peter because she didn't mention Daddy. We had a great time, the food was very good and I even liked the haggis. Peter made me put on the turkey day hat so he could take a picture and send it to everyone on our team.

Mid-levels Eckhauser Team Nov. 13'

Happy Thanksgiving!

Yolanda Dyer

Yolanda Dyer is my absolute, most favorite person at Johns Hopkins. She has been a scrub nurse at Hopkins for many many years. My first day in the OR she asked me my name so she could write it up on the board and she didn't believe me when I first said Dyer. She was like "Whaaaaat!?! Let me see your name tag..... Oh, I gotta show people this. You my sista, yes you my sista frum anotha mutha!"   And since then every time I see her passing in the hall or in the OR we say "Hey Sista!!"  Even the other OR nurses have caught on and call us sisters. 

The other day I ran into Yolanda in the hall as she was talking to another nurse. When I got closer I noticed tears in her eyes and running down her cheeks. She was just having one of those days that we all have and venting to her friend. When she saw me she said "Hey Sista" and introduced me to her friend. She was like "oh I wish I had a cell phone so I could take a picture of us. I was tellin' another girl friend about this little white girl who has the same last name as me, and I wish I could show people a picture of us."  So I got out my phone and had the other nurse take a picture of us with our name tags, then I emailed it to her so she could print it out.  It made me feel good because by the end of our short meeting in the hall Yolanda was happy, smiling, and being her cheerful self again. 

I love this picture of us together!

My Sista 

Good and Great Surgeons

Hopkins has the world's top surgeons. The most brilliant minds come together at this academic center and have made incredible advancements in just about every aspect of medicine. Everyday I am in awe of the genius that surrounds me. I am star struck when I ride the elevator with Dr. John Cameron or his son Andy who literally are the men who "wrote the book" of Surgery.

My own personal signed copy

I am currently on Eckhauser GI service and Dr Eckhauser is an AMAZING surgeon. I heard that after Dr. Cameron he has done the most Whipple procedures at Hopkins. But my question is What makes a great surgeon from a good surgeon? I think that a good surgeon would know this text book by heart and would be able to preform surgeries flawlessly with zero infection rate. A great surgeon picks up the mop and starts wiping down the floor to get the OR room changed over for their next case because that is what the patient needs at that time. Their focus is all on the patient not the procedure. Today I saw that I am working with a great surgeon.

Charm City

I have absolutely loved getting to know Baltimore. I feel like I am getting more settled and know how to get around a bit and where things are. I live in the neighborhood called Historic Fells Point which is right on Chesapeake Bay which is part of Inner Harbor Baltimore. I've walked around my neighborhood quite a few times now and taken a few pictures of things I find interesting. Each one of these pictures is from one of my walks less than ten minutes from my home. First I will start with a few pictures from my roof top balcony which I absolutely love.

This is the Balcony view from my condo looking South over the Harbor.

This view is looking North  and you and see The Johns Hopkins Hospital right in the middle.

This the fountain and pond in the common area of my complex. There are two 

coy fish in the pond which Kim and I have named Harold and Joseph. 

This is my rommie Kim and Me down at the running path just a few blocks from our condo.

There is a really cool shop to get your vinyl right across the street.

I didn't even know comic book shops still existed but they do. Right next to my home.

There are tons of little cafes and restaurants around the corner and almost all of them have 

live music just about every night of the week. I have sampled some amazing sea food 

from a few of them. The crab cakes are probably my favorite dish I've had so far.

A few blocks away this is where I get to do my grocery shopping.

This is the Bargain Outlet Super Linen shop that I actually love and have been to so many times that I'm probably their biggest customer. They just call me "Utah" when I go in there now and when I leave they say "good-bye Utah, see you tomorrow." 

There is some cool city street art scattered around my neighborhood.

One day I was walking down my street and there was this guy selling fruit out of 

his horse-drawn cart. It was the coolest thing I'd seen all day. There are lots of 

farmers markets that go on in my neighborhood, especially on the weekends.

Next to my condo complex is a huge warehouse bakery called H&S bakery. 

Each morning as I leave my home it smells of freshly baked breads that smells so yummy. 

It's like every morning smells like Sunday rolls.

Next to Fells Point is Little Italy, which is just the cutest little neighborhood. I haven't tried 

the food there yet but I've been given suggestions of some great restaurants that I need to go to.

A few more blocks West from my home is more into the Inner Harbor area where there is a lot of newer buildings and nicer shopping. I heard they are trying to make this area feel more like NYC.

 

These store that are just a few minutes walking are not really conducive to my resident salary.

I have to really use my self control when I walk around Inner Harbor.

Under Armour athletic clothing was started here in Baltimore so looking across the 

Harbor you can see one of their big factories and head quarters. This could also be 

troublesome for my little resident salary because there is a really nice Under Armour 

store by me. I need to find out where their factory outlet it located.

I'm excited for the summer time because they do concerts at this Harbor outdoor theater.

I absolutely love the Harbor with all the ships that come and go. My favorite ship in 

the Harbor might be the pirate ship that does tours, but my goal is to make friends 

with some one who owns a sail boat that will take me out sailing.

But if you don't own a ship you can always take the water taxi to get you where you want to go.

And every night I can watch the sunset over Baltimore. 

Johns Hopkins - Don't forget the S

Johns Hopkins was an amazing, inspirational, and visionary man. I am embarrassed that did not know more about this man before coming to Baltimore. This man wasn't even a physician (nor did he have much formal education at all) but saw the need of the people in his city and wanted to create something better. He wanted the world's best medical school and hospital along with the stipulation that all people that enter through the hospital doors were treated with the best health care no matter their race or ability to pay. That may still seem like a novel idea today, but imagine what that would have been like in the days when slavery was still an accepted practice. It is an amazing legacy in the advancements of health care and it's all due to this one man. I included a short bio about him that I retrieved from the JHH website.

 

Johns Hopkins

His great-grandmother was Margaret Johns, the daughter of Richard johns, owner of a 4,000-acre estate in Calvert County, Maryland. Margaret Johns married Gerard Hopkins in 1700; one of their children was named Johns Hopkins. the second Johns Hopkins, grandson of the first, was born in 1795 on his family's tobacco plantation in southern Maryland. His formal education ended in 1807, when his parents, devout Quakers, decided on the basis of religious conviction to free their saves and put Johns and his brother to work in the fields. Johns left home at 17 for Baltimore and a job in business with an uncle, then established his own mercantile house at the age of 24. He was an important investor in the nation's first major railroad, the Baltimore and Ohio, and became a director in 1847 and chairman of its finance committee in 1855. Hopkins never married.

He may have been influenced in planning for his estate by a friend, philanthropist George Peabody, who had founded the Peabody Institute in Baltimore in 1857. In 1867, Hopkins arranged for the incorporation of The Johns Hopkins University and The Johns Hopkins Hospital, and for the appointment of a 12-member board of trustees for each. He died on Christmas Eve 1873, leaving $7 million to be divided equally between the two institutions. It was, at the time, the largest philanthropic bequest in U.S. history. (http://www.hopkinsmedicine.org)

 



Orientation to JHH - Week 1

I have officially made it through my first week at Johns Hopkins. Most of what I have been doing is orientation stuff and getting acquainted with all the HR and HIPPA policies and all that good stuff. We have also had lectures and homework assignments to help familiarize us with common mistakes that occur on our services and how to avoid them. Then Friday was testing day. I have never felt so stupid in my entire life as I did on Friday. My in-patient and trauma management skills are definitely lacking in just about every aspect. Luckily the testing day ended with suturing skills which is something that I at least have some confidence in. It is also very intimidating to know that the surgeons and doctors that I will be working along side with are the best in the world and people from all over the world come to this hospital to have their procedures done. My main preceptor physician Dr. Chi is an amazing trauma surgeon who is building robotic arms that are controlled by the patient's own brain and nerve conductions. It's just one incredible thing after another at this hospital.

"A ship in harbour is safe, but that is not what ships are built for"

I was told that today, this the twenty-first of October two-thousand thirteen, marks my Johns Hopkins Birthday as I am now an official employee of this historic and ground breaking institution. I will discuss later and expound on the legacy of Johns Hopkins as I continue to learn more about why it has been declared the best hospital in America (U.S. News & World Report); but first a little about me.

First I must say that the quote entitling this post is a perfectly fitting analogy for my life at this point and it is courtesy of William Shedd; a theological philosopher of the late 1800's.

I was born and raised in Orem, UT and my parents named me Mary Deane Dyer for both my Grandmothers, Mrs. Gwendolyn Mary Franck and Mrs. Bonnie Deane Dyer. I am the middle child of a family of 7 children (one boy and 6 girls) and as such I believe I learned to be a sort of peace maker between the siblings, although others may have a different opinion.  My parents raised us all in the traditions of the LDS faith with strong emphasis in self-discipline with high expectations in our educational and vocational endeavors. As my father is a business professor at Brigham Young University I could not miss the opportunity of receiving a great education for an excellent price. After graduating BYU in 2010 I defected to the rivalry school, The University of Utah for my Masters of Physician Assistant studies, for which my father relented his distain only to the portion of the Medical School for which their MPAS program is ranked second in the nation. I received excellent training during my 27 month program and graduated early August of this year. Through this time of my didactic and clinical training I had many of my own personal challenges (including a divorce from a man I had been with for 8 years of my young life) but still I have always lived in Utah County with lots of family and friends around me for support through it all. So why then, after working so hard to get through school and finally achieving a comfortable state of being, did I feel the need to pick up all my things, leave the only home I've ever known and move to Downtown Baltimore to take a large pay cut with double the work load to spend a year as Surgical Resident at Johns Hopkins Hospital? The answer as to why I have ventured on this adventure is because I really do believe in these words by William Shedd.

This quote is also significant to me in that I have moved to an area of Downtown Baltimore called Inner Harbor. This is a beautiful area of the city and if you ever have a reason to visit Baltimore you must walk the paths around the harbor area. Each day as a resident I will be arising before the sun and leave the beauty of the Inner Harbor area and make my way through some of the more ghetto areas of the city to get to the Hospital (which I learned today, there was a shooting incident inside the Hopkins hospital in 2010 where one doctor was shot, a patient was murdered, and the shooter committed suicide). Each and everyday of my residency I will think of these words as I leave the comfort of my home on the harbor and go the intimidating sea of knowledge that awaits me at Johns Hopkins Hospital. I do know that this is the absolute best place for me to learn how to better serve and care for the patients and their families that come to me looking for help. And when days get tough, the hours get long, and the work never stops: I will remember - "A ship in harbour is safe, but that is not what ships are built for."

Inner Harbor, Baltimore taken 10/21/13