Attached is a link to my final project: highlights from the course.
http://picasaweb.google.com/lh/photo/7lUBNkBa9d6e81pKpp4bvg?authkey=Gv1sRgCKfok7HM8Mvw8QE&feat=directlink
It was a pleasure to work with and learn from such excellent physicians and physicians-to-be.
See you on the trails,
Jordan
Friday, April 10, 2009
Sunday, March 29, 2009
Hyper-Bueno Rotation
Hey team, as reality hit today about moving across the country and starting a real job soon, I just wanted to say that I had a blast surviving the wild with all of you. The "epicity" was off the hook and a great way to end four long years of medical school. I'm excited to see where the future takes each of you in your careers, life, etc. (guess that means I better join facebook and have my wife teach me how to use it). As I reflect on the month it's apparent that we are a fortunate group of folks:
1. Learned some awesome medicine in nature's amphitheater
2. Made 20 great new friends (doubled Pat and Dave's census...ha ha)
3. Got credit towards becoming a DOCTOR for hiking, biking, backpacking, climbing, snowshoeing, navigating, jumping in rivers, etc.
4. Had a lot of great laughs and made some amazing memories
5. Didn't die falling off a snowy cliff during the final exam OR meeting a backcountry rattler OR picking up a fire salamander (which I was really tempted to do, leave-no-trace!)
Good times....I'm gonna go catch some dinner with a squirrel pole. I'll try and attach my slideshow to the blog. If anyone finds my pant legs or wants to hang out in Portland, ME gimme a holler (505) 270-5314. Peace out, Mike
1. Learned some awesome medicine in nature's amphitheater
2. Made 20 great new friends (doubled Pat and Dave's census...ha ha)
3. Got credit towards becoming a DOCTOR for hiking, biking, backpacking, climbing, snowshoeing, navigating, jumping in rivers, etc.
4. Had a lot of great laughs and made some amazing memories
5. Didn't die falling off a snowy cliff during the final exam OR meeting a backcountry rattler OR picking up a fire salamander (which I was really tempted to do, leave-no-trace!)
Good times....I'm gonna go catch some dinner with a squirrel pole. I'll try and attach my slideshow to the blog. If anyone finds my pant legs or wants to hang out in Portland, ME gimme a holler (505) 270-5314. Peace out, Mike
Black & White Cookie Recipe
Hi all,
It was a great month and I hope to see many of you in the future. Since the black and whit cookies were my final project, I decided to share the recipe, just in case anyone wanted to make a few for themselves.
Lars
Black & White Cookies
Cookies
3C Flour
Scant ¾ Tsp salt
¼ tsp baking soda
1 1/3 C Sugar
2/3 C butter (slightly softened)
½ C white shortening
2 large eggs
2 ½ tsp vanilla
2 tsp white corn syrup
Scant ¾ tsp lemon extract
1/3 C sour cream
Fondant
¼ C light corn syrup
5 C powdered sugar
¾ tsp vanilla
2 oz unsweetened chocolate
Combine flour and baking soda in a separate bowl
Beat sugar, butter, shortening in another bowl
Add eggs, vanilla, corn syrup – mix well
Beat in ½ flour mixture
Add sour cream – mix until just blended
Add remainder of flour mixture
Let stand 5 minutes
Using a 1/4 C of dough at a time, make dough into balls and then pat them down with your hands on a cookies sheet
Bake at 350 degrees for 11-14 minutes (done when edge is light brown)
Let cool completely.
Fondant
Bring ½ C water and corn syrup to boil
Remove from heat and add powdered sugar, stir until blended and mixture is thick but can be spread
Chop chocolate and keep in separate bowl
To chocolate add 2/3 C fondant until chocolate melts, then another ½ C fondant
Ice cookies with fondant
It was a great month and I hope to see many of you in the future. Since the black and whit cookies were my final project, I decided to share the recipe, just in case anyone wanted to make a few for themselves.
Lars
Black & White Cookies
Cookies
3C Flour
Scant ¾ Tsp salt
¼ tsp baking soda
1 1/3 C Sugar
2/3 C butter (slightly softened)
½ C white shortening
2 large eggs
2 ½ tsp vanilla
2 tsp white corn syrup
Scant ¾ tsp lemon extract
1/3 C sour cream
Fondant
¼ C light corn syrup
5 C powdered sugar
¾ tsp vanilla
2 oz unsweetened chocolate
Combine flour and baking soda in a separate bowl
Beat sugar, butter, shortening in another bowl
Add eggs, vanilla, corn syrup – mix well
Beat in ½ flour mixture
Add sour cream – mix until just blended
Add remainder of flour mixture
Let stand 5 minutes
Using a 1/4 C of dough at a time, make dough into balls and then pat them down with your hands on a cookies sheet
Bake at 350 degrees for 11-14 minutes (done when edge is light brown)
Let cool completely.
Fondant
Bring ½ C water and corn syrup to boil
Remove from heat and add powdered sugar, stir until blended and mixture is thick but can be spread
Chop chocolate and keep in separate bowl
To chocolate add 2/3 C fondant until chocolate melts, then another ½ C fondant
Ice cookies with fondant
Reflection
Hey all,
I hope everyone had a day or two to rest up before your journey continues. A few days of reflection on the course has given me the opportunity to focus on what exactly I feel the main learning experiences of this course are. First off let me say that this class was one of, if not the best, class that I have seen thus far.
After 4 years of medical school you all know medicine relatively well. With a little refining of the patient assessment and gaining some emergency medicine and rescue experience you all were set to go. The essential element was not medicine…
The traits and skills that everyone brought to the course and built upon, or gained throughout the course, was impressive and hopefully life changing. The temporary transformation that this course brings on will carry over into other aspects of your life. The situations that everyone encountered, scenarios or genuine life, gave you all the opportunity to truly test your body and mind. To find out if you’ve really, “got it.” Whether you were happy with the results or not the journey is not over. You all will continue with your medical journey and be incredibly successful. I encourage you to seek out your next voyage in the hills and find that strength, clarity and confidence can be found there.
Thank you for making the month incredible and stay in touch.
-Jason
A good article for those interested…
http://www.gymjones.com/knowledge.php?id=5
Friday, March 27, 2009
So I was looking through some of the pictures from grand gulch tonight when I saw the one of the salamander that the long hike group found. I could have sworn that I remembered the black and yellow spots from somewhere.
This is a fire salamander. They are fairly common and can live up to 40 years. They can excrete a very toxic poison when threatened. From glands located behind the head and along the flanks the poison can cause Hyperventilation, HTN, and muscle spasms. Having said this, the poison rarely if ever (that i could find) effects humans.
Its been a fun month with you dudes.
Final Party and Creative Project Presentations...
Hey guys,
Map to my house posted below. Please feel free to bring friends/family or some random guy off the street... Kicks off at 6:30pm. There is limited parking around my house but plenty at the park across the street.
From Tramway and Paseo Del Note head North. Turn Right, east, onto Cedar Hill. Take the second left onto Cedar Hill Ct. 727-12. See you all there, call 505-249-0170 if you get lost.
Jason
View Larger Map
Map to my house posted below. Please feel free to bring friends/family or some random guy off the street... Kicks off at 6:30pm. There is limited parking around my house but plenty at the park across the street.
From Tramway and Paseo Del Note head North. Turn Right, east, onto Cedar Hill. Take the second left onto Cedar Hill Ct. 727-12. See you all there, call 505-249-0170 if you get lost.
Jason
View Larger Map
Thursday, March 26, 2009
Into the Gulch of Death, the 20 hours, and the 3 Incomparables
It is terribly unfair to characterize the Grand Gulch of Utah’s Cedar Mesa as the Gulch of Death. It was, after all, a source of life to uncounted generations of Anasazi people in presumably wetter times. It was also a treasure of other-worldliness for us who backpacked there during the wilderness medicine course, not only in its geological presentation but also in the art and architecture left for us by those who once called it home.
I call it the Gulch of Death because death, after all, is the final helplessness, and it was in the Grand Gulch that I came to a point at which I truly felt helpless. The hike began as hikes usually do, with buoyant walking, bearing a quite manageable load. It rapidly became obvious to me, however, that I was not up to the task of keeping the same pace as the others in my group. I was a slow hiker years ago even when younger and fitter, and now am fatter and indisputably middle-aged. I was told that a brisk pace was necessary to reach a particular distance goal that day.
Now it does no good to kick a lame horse, and it did no good to urge me to speed on. I certainly tried to increase speed, but this was at a cost of safety, as I then tended to stumble and once almost twisted my ankle. I had chosen what had been presented to me as the “short hike group” of our three divisions because I knew myself. I reasonably believed I could complete a long hike based upon my experience, but at my accustomed pace. I did not sit out the Grand Gulch trip because, earlier in our course, I had little difficulty in completing the orienteering hike during the survival weekend and the snowshoe hike up the mountain during the Taos weekend, where I had been advised that “it’s the journey, not the destination” and to hike at my own pace.
I pressed on as fast as I could. We made our first camp by nightfall. We arose Sunday morning and set off. All of us enjoyed the Green Mask painted in amazingly still-vibrant hue by a long-departed Anasazi artist high on a cliff face, as well as other paintings and ruins along the way.
After stopping for lunch I realized how tired I felt. When we resumed the hike, I found that I could barely place one foot in front of the other, plodding at a speed that could hardly be called walking. The group divided up my pack and its contents. Even without a burden to carry, I found it hard to walk. I was short of breath and could feel my pulse racing. I sometimes felt mild, diffuse pain in my left chest and left upper back as I walked. I did not feel overheated, but my companions wet my shirt down out of concern for me. We walked to a cool spot where I could lie on a tarp on a rock.
Like most people, I prefer to be self-reliant and contributory, and I did not like it that others had to carry my pack. No one complained, and everyone was gracious, but I still did not like it. Nevertheless, reality was obvious to me. I simply could not do what I wanted to do. I could not will my way through it. I could not will strength to my body nor will my racing pulse to slow like some legendary Yogi from the Indian subcontinent. I realized that, had I been alone, I would possibly not have made it out.
After a time, I walked to where others had made our camp and pitched a tent for me. I rested supine in the tent with a headache and nausea. Shortly after consuming some electrolyte solution kindly prepared for me, I projectile vomited. I subsequently received intramuscular Phenergan and oral Benadryl. I slept a few hours, which was less then expected, and the nausea was gone for good.
The next day, I slowly walked and climbed out of the Grand Gulch with a near-empty pack. Upon our return to the ranger station, I received a bolus of intravenous saline. We returned to Albuquerque.
Shortly after I returned to where I was staying, the incomparable Dr. Joe Alcock called me to discuss his concern that I had experienced a cardiac event. He picked me up and accompanied me to the UNM Emergency Department. I was there 20 hours. After I made it past the waiting room, EKGs, and initial labs, the incomparable Dr. Diane Rimple had arrived and was my attending through the night. The cardiologists saw me in the morning, I had a stress test and echocardiograms, and by Tuesday evening the incomparable Dr. Daryl Macias had come on as my attending and discharged me.
The upshot was that the cardiologists detected no obvious or severe heart disease. I attribute my misadventure to over-exertion and dehydration, although my own perception would have been that I was hydrating adequately.
I still feel tired but not at all like I did in the gulch.
A few things to think about:
1. Foreknowledge is hard to come by. When we hike with friends or family of known ability, both they and we know to some degree what we’re all getting into. In a situation like our Wilderness Medicine class, we don’t possess that knowledge and must acknowledge ahead of time that we will all have to adjust. In reality, because beating a lame horse more won’t make her win the Kentucky Derby, the group will usually have to adjust to the less-able members.
2. It might be helpful if, prior to departure, everyone in a group communicates about the plan. I never saw a map or participated in any detailed discussion about what we were going to do. I usually had no idea where I was. I was just tagging along.
3. There is a strong argument for a group staying together. At one point, I heard a whistle and called out in that direction. It turns out that four of us, all at the end of the caravan, were walking on three divergent paths. Also, I am perhaps the worst person on this side of the galaxy to choose the correct path at any given fork. I am probably the Tracker Tom Brown in the Bizarro World, if any of you have read old Superman comic books and get my drift.
4. It’s a great comfort when your colleagues show that they are really decent human beings when you are relatively helpless. It shows the true character that we all hope to find in a physician or EMS rescuer. The actions of the members of our little “short hike” group bode well for our collective future.
5. Pack lighter and drink more (water, that is, not Patron Tequila).
That’s it. I’m glad I’m alive to write this, and I am glad to have met you all. God grant you a happy future.
I call it the Gulch of Death because death, after all, is the final helplessness, and it was in the Grand Gulch that I came to a point at which I truly felt helpless. The hike began as hikes usually do, with buoyant walking, bearing a quite manageable load. It rapidly became obvious to me, however, that I was not up to the task of keeping the same pace as the others in my group. I was a slow hiker years ago even when younger and fitter, and now am fatter and indisputably middle-aged. I was told that a brisk pace was necessary to reach a particular distance goal that day.
Now it does no good to kick a lame horse, and it did no good to urge me to speed on. I certainly tried to increase speed, but this was at a cost of safety, as I then tended to stumble and once almost twisted my ankle. I had chosen what had been presented to me as the “short hike group” of our three divisions because I knew myself. I reasonably believed I could complete a long hike based upon my experience, but at my accustomed pace. I did not sit out the Grand Gulch trip because, earlier in our course, I had little difficulty in completing the orienteering hike during the survival weekend and the snowshoe hike up the mountain during the Taos weekend, where I had been advised that “it’s the journey, not the destination” and to hike at my own pace.
I pressed on as fast as I could. We made our first camp by nightfall. We arose Sunday morning and set off. All of us enjoyed the Green Mask painted in amazingly still-vibrant hue by a long-departed Anasazi artist high on a cliff face, as well as other paintings and ruins along the way.
After stopping for lunch I realized how tired I felt. When we resumed the hike, I found that I could barely place one foot in front of the other, plodding at a speed that could hardly be called walking. The group divided up my pack and its contents. Even without a burden to carry, I found it hard to walk. I was short of breath and could feel my pulse racing. I sometimes felt mild, diffuse pain in my left chest and left upper back as I walked. I did not feel overheated, but my companions wet my shirt down out of concern for me. We walked to a cool spot where I could lie on a tarp on a rock.
Like most people, I prefer to be self-reliant and contributory, and I did not like it that others had to carry my pack. No one complained, and everyone was gracious, but I still did not like it. Nevertheless, reality was obvious to me. I simply could not do what I wanted to do. I could not will my way through it. I could not will strength to my body nor will my racing pulse to slow like some legendary Yogi from the Indian subcontinent. I realized that, had I been alone, I would possibly not have made it out.
After a time, I walked to where others had made our camp and pitched a tent for me. I rested supine in the tent with a headache and nausea. Shortly after consuming some electrolyte solution kindly prepared for me, I projectile vomited. I subsequently received intramuscular Phenergan and oral Benadryl. I slept a few hours, which was less then expected, and the nausea was gone for good.
The next day, I slowly walked and climbed out of the Grand Gulch with a near-empty pack. Upon our return to the ranger station, I received a bolus of intravenous saline. We returned to Albuquerque.
Shortly after I returned to where I was staying, the incomparable Dr. Joe Alcock called me to discuss his concern that I had experienced a cardiac event. He picked me up and accompanied me to the UNM Emergency Department. I was there 20 hours. After I made it past the waiting room, EKGs, and initial labs, the incomparable Dr. Diane Rimple had arrived and was my attending through the night. The cardiologists saw me in the morning, I had a stress test and echocardiograms, and by Tuesday evening the incomparable Dr. Daryl Macias had come on as my attending and discharged me.
The upshot was that the cardiologists detected no obvious or severe heart disease. I attribute my misadventure to over-exertion and dehydration, although my own perception would have been that I was hydrating adequately.
I still feel tired but not at all like I did in the gulch.
A few things to think about:
1. Foreknowledge is hard to come by. When we hike with friends or family of known ability, both they and we know to some degree what we’re all getting into. In a situation like our Wilderness Medicine class, we don’t possess that knowledge and must acknowledge ahead of time that we will all have to adjust. In reality, because beating a lame horse more won’t make her win the Kentucky Derby, the group will usually have to adjust to the less-able members.
2. It might be helpful if, prior to departure, everyone in a group communicates about the plan. I never saw a map or participated in any detailed discussion about what we were going to do. I usually had no idea where I was. I was just tagging along.
3. There is a strong argument for a group staying together. At one point, I heard a whistle and called out in that direction. It turns out that four of us, all at the end of the caravan, were walking on three divergent paths. Also, I am perhaps the worst person on this side of the galaxy to choose the correct path at any given fork. I am probably the Tracker Tom Brown in the Bizarro World, if any of you have read old Superman comic books and get my drift.
4. It’s a great comfort when your colleagues show that they are really decent human beings when you are relatively helpless. It shows the true character that we all hope to find in a physician or EMS rescuer. The actions of the members of our little “short hike” group bode well for our collective future.
5. Pack lighter and drink more (water, that is, not Patron Tequila).
That’s it. I’m glad I’m alive to write this, and I am glad to have met you all. God grant you a happy future.
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