Saturday, August 25, 2012

Milwaukee Spring + Summer 2012

Bike Project!

For those that do not know I am currently residing in Milwaukee as part of a program that focuses on urban under-served medicine and public health.  Thus, in addition to time in the clinic and hospital, we receive dedicated hours to work on a public health project.  I have been partnered with the Sixteenth Street Community Health Center (a group of clinics in South Milwaukee that primarily work with Latino patients).  My first project revolved around access to healthy and affordable food in the local communities and is detailed in a prior blog entry.  Since that time I have been working on something new...


When I first arrived in Milwaukee I was told, hey, there is a pediatrician who is into bikes, you should talk to him.  I did, his name is David Waters (strange coincidence on the name huh?), and we immediately hit it off.  Based off our own experiences with the benefits and joy bicycle use can bring and newer research demonstrating huge gains in health and staggering cost savings if short inner-city trips less than 8km are replaced by bike we set out to see what we could do on the south side of Milwaukee to increase bicycle use. (if you are interested in the article please see:

After months of connecting with local community members as well as bike shops and organizations involved with bicycle use and advocacy we decided to take a dual-pronged approach of 1) holding an event to create excitement around bicycle use as well as 2) conduct a survey to delineate a more evidence based approach to increasing bicycle use on the south side.  The survey is in it's final revisions but just last Saturday we held the first annual Southside Bicycle Day and it was a huge success!  See pics below:

Our Bike day logo!

 We estimate between 100 and 130 community members showed up!  We had representatives from the Wisconsin Bike Fed teaching about safe city riding, free helmets we fit on kids (ran out and will need more next year), the Urban Ecology Center, The Hank Aaron State Trail (a great riding/walking path along a river close to the community that almost no one at the event had heard of!), Milwaukee Police Bike unit, bike mechanics from two local shops offering free safety checks and minor repairs to all comers, and lastly free t-shirts and food to top it off.

 Officer Lemke from the MPD bike unit and me with a girl who really wanted a pic with us!

Officer Lemke leading a group on one of two groups rides he conducted on the park's trails during the event.  It was awesome to see 30-40 kids and adults stretched out behind the officer in their orange event t-shirts like little ducklings!

Signing kids up for the next ride.

Anton from Ben's Cycle Shop gettin' things done!  Our volunteer mechanics (also Russell from Dream Bikes) were a huge asset to have at the event - thanks guys!

Melissa from the Hank Aaron State Trail about to explain to another participant the wonders of the trail and how to best access it.  Nice!

 Our planning team minus Dr. David Waters who could not attend unfortunately (but has been instrumental in making things happen).  L-R Ed, Tatiana (my "boss" so to speak), and me.  Couldn't have asked for better people to work with!


Other Awesome stuff I want to share...


No, not mine, my brother Matthew got married!  His wife, and my new sister in law, is Alicia, and we couldn't be more excited to "officially" have her as part of the family!  The big day was July 28th and we held the wedding and reception at my parent's place on Bainbridge Island.  I was worried hosting the wedding would get us all stressed out but in the end we all banded together to get the work done, enjoyed each other's company and that of many family members and friends we had not seen in some time, and had a great day!  The sun even came out right in the middle of the outdoor ceremony - beautiful - we couldn't have asked for more:)  Congrats Matthew and Alicia!

Patrick and me tag-team toasting our brother Matthew and his wife Alicia - great fun!

Couch Surfing!

The title pretty much says it all.  In response to living alone in a two-bedroom apartment and being rather lonely at times I signed up for a website called couchsurfing.  The basic premise is to connect people who are willing to let someone stay with them for a night or two with travelers coming through. I was skeptical at first but the site has each person create a profile you can review and after meeting/hosting the two respective parties provide feedback i.e. "_____ was great to talk with, helped with dishes, and was very neat."  While I am not in a position to travel right now I have hosted some pretty cool people from all over the US as well as India, Germany, China, French and Italy!  And the bonus, the people I have hosted have all invited me to visit them in their countries - essentially I am creating a world-wide network of friends!

Karo from Germany and Spring (adopted name) from China.  We were just sitting down to an amazing chinese feast prepared by Spring!  Spring also helped me clean my kitchen and bathroom without me asking for it (don't worry mom, they weren't too bad to start with:)

Visiting a kite festival on Milwaukee's lakefront with two gals from France who visited me.  They had some huge kites!  The one's in the pic were at least a 100ft long!

Visit from my brother!

The evening after I finished 9 hours of testing for my Step 2 United States Medical Licensing Exam I had the awesome reward of being able to pick up my brother Patrick from the Milwaukee airport.  We had 5 days together and we packed it full of fun and adventure - two 60+ mile bike rides, several smaller rides, time at the lake front, a 10-12 mile trail run, cooking up huge feasts (including making pizza from scratch!), having friends over for dinner, visiting our grandfather and more.  It was a blast to show off my new home to someone who shares so many life passions with me!

The pizza team!  It was my first time making pizza from scratch and it turned out delicious!  L-R my brother Patrick, me, and my former med school roommate Anst who came for a day of adventuring with us.

Using basil from our med student garden we made home-made pesto, then added feta, brocolli, and mushrooms to top it off - yum!

Surgery Sub-Internship

From the above stories/pics you might think I am no longer in med school but this is not at all the case!  The fact that I only have time to write every few months is testament to my normal state of affairs:)

Third year ended well, I took my step 2 exam and I am now nearing the end of my first clinical 4th year rotation.  In the 4th year we are able to set our own schedule as long as we meet certain requirements.  I have started out with a month of general surgery and had the good fortune of being with a surgeon who is amazing and breaks all the stereotypes.  Dr. A loves to teach, is an incredible communicator and beloved by his patients, and has provided me with a great deal of responsibility and learning opportunities.

For example, one of the days we were on call Dr. A was in the operating room (OR) when he was paged by the emergency room (ER) that they had a patient with CT evidence of a perforated appendix and free air in the abdomen.  In medicine, free air is almost synonymous with a speedy trip to the OR for emergency surgery.  It usually indicates there is a hole somewhere along the person's intestinal tract and the patient is in acute danger.  Being scrubbed-in on a case Dr. A asked me to go to the ER in his stead, evaluate the patient, and report back to him with what I thought we should do.  Yikes!  This was the real deal!

Trying to remember the key history and physical elements of appendicitis and the criteria for sepsis I hurried down to the ER.  The patient I encountered was a 69-year-old man from a nursing home, wheel-chair bound after two strokes, with bad COPD (a bad lung disorder) and numerous other medical conditions.  While he was uncomfortable and had a distended abdomen he was not in acute pain and I could find no signs of peritoneal inflammation (certain signs that tell us extreme badness is happening inside the abdomen).  From what I could gather his intestinal perforation likely took place a week or so ago and what had brought him in acutely was nausea/vomiting and food intolerance secondary to his intestines becoming blocked or ceasing to function due to the inflammation/irritation within.

With his many co-morbidities and stable clinical picture I did not think taking him to the OR emergently was a good plan and might in fact do more harm than good.  However, I did not know if this was correct and bounded upstairs to share my assessment and plan with Dr. A.  After hearing my presentation he agreed with me (!) and upon seeing the patient himself he reaffirmed the plan.  Our patient is still in the hospital but has made moderate improvements and so far it has not been necessary to take him to the OR.

Needless to say, experiences such as this have provided me with a great deal of learning.  As I continue to gain more knowledge and confidence it has been most exciting!

Well that's all for now - please write back if you can!