Day one Highwater Fest

Charleston really impressed 4/23/22 with a food drink and music display that went off without a hitch. Day one photos from local natives and modest mouse, west coast rock held the torch on Saturday. Isaac Brock yelling lyrics into his guitar pickups were a highlight.

Sunny days ahead (check the rest of day one photos after the break)

Fell in Love at the Air Show

There’s a lot to love about an air show. I really like how efficiently and safely the military runs a program. I also like that it’s free and appreciate seeing who comes to free events. Seeing the lines at the water refill station for example where an alternative to the three dollar bottled water is available. Rigel looked great in the cockpit of his all original 1954 prop plane.

Blue Angels

7 Tips to Ace Your Virtual Interviews

1) Lighting – buy a usb ring light and skip the glasses on interview day as the reflection can be distracting. Real plain neutral tone backgrounds are best, otherwise use the blur feature. Remember you want to stand out, not stick out.

2) Prepare – look up the interviewers the day before the interview. Download and run teams, zoom, and webex and familiarize yourself with basic features. Set a professional headshot as the background for when your video is off.

My Fellowship Headshot.

3) Keep yourself muted during presentations or when there’s more than one applicant in the room, keep your mic on during the one on ones.

4) You have to really pay attention to the interviewer. Give them plenty of time to finish their thoughts because you won’t get the same type of cues as you would in person.

5) I went back-and-forth wearing a tie or just button down with jeans depending on if I had patients to see that day. It’s probably better just to go tie. It doesn’t look good when the interviewer is dressed more professionally than the interviewee.

6) You want a location where you will not be interrupted. If you’re using a call room or an office at work put a note on the door that says that you’re interviewing and not to disturb. Forward your pager etc.

7) Make sure that if you want to talk about something that you put it in the hobbies section of your application because that’s one segment that every single interviewer will ask you about. Conversely if there’s something you don’t really like talking about that doesn’t inspire you leave it out of this section. If there are any time gaps in your CV this will also come up.

Fellowship Headshot Photoshoot Bloopers

(Affiliate link above for ring light)

Beware the Masqueraders


1. When a man has urinary issues it is often constipation, not the prostate

2. If they’re young and newly psychotic with any concern for seizure, fever, altered mental status, or autonomic instability think about autoimmune encephalitis before admitting to psychiatry

3. Think about ALS when a patient goes for c spine surgery and doesn’t benefit or the exam is worse than the imaging. Get a jaw jerk.

4. Recall that contrast is bright on non contrasted head ct and sometimes is confused for blood. Before diagnosing your patient with a devastating hemorrhage learn the kv trick.

5. Diabetic neuropathy causes weakness overtime. So does idiopathic neuropathy. Distal lower extremity weakness which is symmetric and accompanied by painful neuropathy is probably one of these and not CIDP

6. If someone else thought it was essential tremor it could still be Parkinson’s. Start checking for increased tone and bradykinesia in your 5m neuro exam

7. In a female patient remember to consider menstrual bleeding in addition to GI bleed. Either way h and h changes very late for acute bleed and is too slow to help much. Know the baseline hgb and check orthostatics

Salute the Solstice 2018

Moving to Charleston has been an exciting adventure.

This week I celebrated the longest day of the year with 200 some like-minded yogis in James Island County Park which was a magical experience.  I have to say I was a little disappointed nobody was doing acro, but generally was impressed by the good vibes and comfy southern weather.

The yoga highlight of the day was Kate Counts from Yoloha.

We may have been supposed to do 108 sun salutations, but the teachers before her seemed intent on repeating sun A for every bead of the Mala. Kate grabbed the mic and brought the funk! She got us into warrior one and an audible sigh of relief from the boredom swept the park. The most obvious and impressive element of her teaching was how comfortable she seemed with the group. It is not easy to perform in front of big crowds and she is certainly one for the stage. The mic cut out on her a few times and she started just yelling the poses. She even riffed that her kids would be glad that she didn’t have a voice when she got home. I can’t wait to take her class and get some more of her awesome energy!

Continue reading “Salute the Solstice 2018”

Into the Belly of the Machine

My brain. Neurologically intact for the record.

If you know that I applied for the match in neurology it might bewilder you to learn that I chose radiology for my last elective of medical school.  Alternatively you may think it appropriate but only because you know how integral imaging has become to the practice of modern medicine, or how beneficial it is for a neurology trainee to practice “reading their own films.” I learned a lesson today that did not come from an attending, patient, or book. I hope it will give me the ability to communicate honestly with my patients in the future about the process of getting in an MRI, how scary it can be, and how they can get through it by being adequately prepared.

Today I had a completely unique experience in my medical training. It was enabled by the courage of several people including my attending, the director of my elective, and a fantastic MRI technician.  The director of the rotation had the idea but it couldn’t have happened if my attending didn’t send me to MRI to meet the technicians and see some scans. During our introduction I mentioned it to the MRI tech and she totally ran with it. It was completely obvious how important she felt it was for me to have this experience. She immediately had me take off all of my metal and wanded me down after giving me a quick rundown (no implants? surgeries? ever been shot?) At this point it was sort of like a TSA experience. No major malfunctions and fear alarm only subtly sounding.

As soon as I put my head back in the cradle which immobilizes it completely I recognize my unpreparedness. I feel my heart pounding and she has not even put the top piece of the cage over my face or pushed me back into the tiny tube where I would reside for the next 20 minutes. Thankfully there were headphones, and there was music. Most importantly there was her voice and her presence coaching me through. I trusted her but still had a tiny panic sounding off: “did you forget to take off your name badge? It’s made of metal!?” Anxiety is real but now I have Al Green. As I push back into my tiny crawlspace of a cave of white plastic I go immediately to my breath. My yoga and budding meditation practice served me well this afternoon as I release my grip on the “panic ball” just a bit. The sequences are all unique. DWI is like a horrible alarm clock which you live inside which also shakes your bed at the head and then the leg over and over again. I exist. “I’m still in love with you.” Caught up alone with my thoughts but unable to think. My head starts hurting five minutes in and mysteriously stops after I escape the magnet.

There is no neurologically intact individual who would not feel some fear entering this machine for the first time. I wonder how many MRIs I will order in my career. I hope I can always remember what it felt like for me. I hope I never callously tell anyone “it’s no big deal” or “just take an Ativan.” I hope I never send a claustrophobic patient into that experience.  There is nothing harder than being a patient. I repeat my mantra, and hope.

On People vs. Things

I watched the Bryan Cranston film “Wakefield” tonight and was interested in the way it portrayed the role objects play in our lives.

The protagonist “Howard” leaves his family and work life to live in the attic above his garage for six months. He spends his time dumpstering food and communing with raccoons. His only social outlet is a voyeuristic relationship with his old family and a couple of kids with intellectual or emotional disabilities who bring him food when he is about to freeze to death. He basically has traded his life of making memories for a situation where he is surrounded by the remnants of an existence he once knew. A wedding dress hangs symbolizing the loss of love. A pair of binoculars highlight his new role – on the outside looking in. All of the objects that he was able to cloister in this forgotten chamber he is now forced to live with and experience every day.

I visited a friend’s storage unit in Queens once and thought it was a very sad place. All of these families aspire to unpack and move in – to finally have space for the objects they believe to be worthy of retention. A guitar, a bike, books looking for a shelf; they are all insignia of the tribe of lackaspace.  We grab what we’re looking for and get the hell out – it’s dark.

My own relationship to objects is complex. I can be a bit of a hoarder admittedly I hold onto things too long and my closets are cluttered. My mom has a lot of stuff of mine in Pittsburgh also but I am committed to simplifying these things I don’t use and mostly don’t even know exist. There are a lot of people in our society with very different approaches to belongings. People who have less value the things they have. Similarly the outlook on wealth and possessions simplifies as people age. They recognize the most important objects in their lives are ones with emotional salience.

#HMIChat Live Twitter Chat with Harvard Macy Institute

I am looking forward to participating in a live twitter dialogue on professional identity formation hosted by the Harvard Macy Institute on Wednesday June 7th at 9PM along with two of my medical school peers at Florida Atlantic University.  If you’re on twitter you can use the hashtag #HMIchat to follow along or ask questions of us in real time.


It will be hosted by Dr’s Hedy Wald and Elizabeth Gundersen of Brown and FAU with support from faculty at the Mayo clinic as well as the Karolinska Institutet in Stockholm. Needless to say it’s a huge honor to be included.

If you don’t know about my non-traditional journey to the medical profession I will disclose a shortened version here.  I got the phone call offering me a spot at Florida Atlantic University while driving to Michigan to work as official press for the Detroit Electronic Music Festival. I would spend three days photographing and interviewing artists, attending after-parties and publishing my adventures.  This was just another weekend for me. I was working as a DJ and PR professional in NYC for the years leading up to medical school and there was not really a transition period for me. The record kind of just got ripped off the turntable while it was still spinning.

There were a lot of reasons I wanted out. Mostly I had taken on a new lifestyle; meditation, yoga, vegetarianism, and this didn’t sync well with the nightlife circuit.  People I was djing for wanted to get drunk. They wanted to party and they wanted to take advantage of one another. I felt like I was encouraging people to harm themselves and even though the nightclubs in NYC are generally non-smoking the environment wasn’t conducive to health. I got into medicine because I thought I would find a community of individuals dedicated to wellness – who would be an example to their patients and not just lecture them about primary prevention and health practices.

I wanted a profession where I could feel like I was healing and I found that. I found incredible mentors who council patients and go out of their way to do the right thing. There is a pharmacist I worked with who legally adopts his patients when they don’t have an alternative to living on the streets. There’s a doctor specializing in memory loss who I spent many afternoons with who cares as much for the family members of her patients as she does for the people she’s officially tasked with providing for.  I found mentors worthy of emulating and I found out I didn’t totally have to give up my music. I still DJ our medical school yearly awards party for fun, I just haven’t been doing as many weddings or corporate gigs down here. And I still love to listen to music and collect records – maybe I even enjoy the music more now that I don’t have to think about whether or not it can work on a dance floor.

The process of professional development for me became an integration rather than an abandonment. I recognize that I learned from my experiences and I hope I will have something to offer because of them.


Coming soon- the 10 ways being a (moderately) successful club DJ in New York prepared me for medical school…