Indiana University
IUSM IU
IU School of Medicine IUSM Office of Admissions

Robert Oswalt

Fourth Year Medical Student



Robert
About Me IUSM Campus:
Evansville
Hometown:
Beech Grove, Indiana
PreMed Majors:
Biology, University of Southern Indiana
Little known fact about me:
I'm 6'7 and have a very ironic fear of heights.


Follow us on facebook



Robert’s tag cloud


Categories

Meta

Still Here, Still Ticking


Amother Speed Bump

Filed under: Uncategorized — Robert Oswalt on December 17, 2013 @ 12:10 pm

I know it’s been a while since I’ve posted on here…yet again, but my computer has been messing up which has made me avoid the internet for the most part. Unfortunately I didn’t start back to school in November like I had wanted to and after having to discuss with the school my use of pain medications and their impact on my ability to complete the curriculum it was too late for me to start in December either. Right now I’m currently slated to hopefully complete my last rotation of 3rd year in January at Community Hospital, but there may be another wrench in the cogs. I found out recently that I might need more surgery sooner rather than later. I’m hoping that I’ll be able to at least do this one month so I can finally say I’m a 4th year. It has a lot of implications in terms of loan repayment and disbursement of more loans, not to mention I just got approved for IU’s disability insurance. Just some more speed bumps on the road to being a doctor.

Best regards,
Robert Oswalt


Another chance to overcome adversity

Filed under: Uncategorized — Robert Oswalt on October 18, 2013 @ 2:30 pm

I apologize for the prolonged absence. For those of you that know me, you understand my absence. Back in April, as my wife and I were preparing to leave Boyne Falls, Michigan after a great vacation, I developed a tearing pain in my back that took my breath away. It was what I had feared ever since getting the diagnosis of Marfans. I had an aortic dissection in my descending aorta that went all the way down to where the iliac arteries split. I called an ambulance and my wife directed  them to us. Thankfully, McLaren hospital wasn’t that far from our condo we were staying at and they got me there in 15 minutes despite a terribile snowstorm that was developing. Because of the tear in my aorta, there was reduced blood flow to my internal organs and, between the surgeons in Michigan and those at IU where I was transported after a week when I was finally stable, they had to remove my pancreas, small intestine, spleen, a large section of my large intestine, part of my stomach and a section of my liver.  I was heavily sedated for the first month and remember nothing about that time period when I had all these surgeries, but everyone tells me it was probably for the best because I got very sick, septic and swollen. Imagine my surprise when I wake up and its a month after all this happened. I’m just so thankful for my wife and family who kept pushing the doctors to do everything they could to keep me alive, because here I am today trying to work my way back to school. I’m also thankful for all the doctors and surgeons who contributed to my care so that I could make it to this point. And I’d also like to give a shout out to Mike, Sarah, and Kathryn, who when they heard I wasn’t doing well in MI, drove all the way up after clinicals one night during a snowstorm to see me and were a huge support to my family throughout the remainder of my 5 month hospitallization.

It’s been a long battle to get to this point and despite all the new issues I’m having to deal with like diabetes and being on TPN, I feel blessed just to be alive. Anyways, my wife’s computer is running out of batteries so I’m going to get off here, I just wanted to post this quick update in case anyone was wondering where I’ve been since March.

Best Wishes,

Robert


Vacation Month

Filed under: Uncategorized — Robert Oswalt on March 26, 2013 @ 6:18 pm

So it’s been an interesting last three months and now that I’m on my vacation I’ve got a little bit more time. I’ll just start out with talking about my rotations. I believe the last post I did wrapped up psych and since then I’ve done neurology, inpatient and outpatient pediatrics. Here it goes.

Neurology wasn’t as terrifying as I thought it would be, though it would only happen to me that the day before we started our neuro rotation I would sleep on the couch wrong and develop a neuropathy in my left arm. I had numbness and pain down my arm that gave me a new appreciation for people with these types of issues chronically. Thankfully mine got a lot better with rehab therapy and a course of steroids. The steroids though weren’t without their own side effects and shot my INR up to 5.0. I only realized this after I missed a day of  peds neuro clinic with bad flank pain and bright red hematuria. Everything resolved after a few days and a CT scan showed there weren’t  any stones or kidney damage, but it was a real wake up call that I needed to be better about checking my INR when anything changed. Lesson learned, back to my neuro rotation.  Turns out for all the dermatomes, innervations and spinal cord levels they try to teach us, they’re not overly practical as anything more than a basis for understanding the field. I did two weeks at the VA and then two weeks in the peds neurology outpatient clinic and surprisingly enough never had to say which dermatome or spinal cord was involved, though when I gave a talk about one and a half syndrome I did have to highlight the pathways of horizontal eye movement.  The sad thing that I started to realize the further I got in neurology was that even when you can identify the lesion there’s little you can actually do. I had stroke patients at the VA and unfortunately at Riley in the outpatient pediatric stroke clinic as well. They always showed up too late for us to do any thrombolytic therapy to try and break up the clot, so we kept them until they were stable and we had imaging to show the extent of the lesion and then sent them to rehab. We also saw the frequently tested myasthenia gravis, cluster headaches, migraines, back pain, neurofibromatosis, mitochondrial disorders, Parkinson’s, benign essential tremor, seizures, and hearing loss. I wasn’t really a fan of working at the VA. I had some good patients, but I also had some bad ones that really frustrated me. I get the feeling it’s going to be a recurring theme in medicine constantly harping on people about losing weight and exercising, eating right, smoking, drinking, and drug use. Unfortunately there’s only so much pestering we can do and it oftentimes feels like a waste of time to tell these patients the lifestyle changes will make them feel better, because that’s not the answer they want. Frequently people have the misconception that we can just give them a pill and they will instantly feel better and there will be no side effects, no tolerance, and they’ll be able to keep the same habits that got them to this point. The reality isn’t even close and there’s a lot of issues we still don’t have real answers too. The most frustrated patients I saw during my outpatient days at the VA were the headache patients who had tried so many different medications and either got no relief or couldn’t tolerate the side effects.

I really enjoyed the pediatric neurology clinic though at Riley. I saw a lot of sad cases but it was inspiring how resilient some of these kids were. I’m not sure if it was just the naturally happy disposition of some children or because they didn’t really remember a time where they weren’t having some of these issues. It was great though because that was the first time I got to talk with children as patients. I was nervous but it was actually really easy for me to recognize the situation, try to get the child to open up and realize when I was better off getting the majority of the story from the parents. They’ve tried to teach us that certain age groups are better at this than others and that’s fine if that’s how you judge your approach to a situation but I found that it was really just a kid by kid basis and I could get a good enough assessment in the first few minutes of the interview to determine my approach. Some kids love to talk to you, especially if you joke around with them and don’t act like it’s all business and others are just incredibly shy and nervous (terrified that they are going to get a shot as I learned on outpatient peds) or just outright not feeling well.  I had grade school kids that initiated the conversation and were more aware of their health than some teenagers/young adults who would soon be in charge of their own healthcare. I really enjoyed these interactions with kids and on top of that I got to work with Dr. Walsh the pediatric neurogeneticist. This just rekindled my interest in genetics and was a nice transition to my complex care pediatric inpatient month.

I had so much fun on both of my pediatric months. I’ve got to give a huge thanks to Deb Brakel for really pushing me to do Complex care despite all the negative reviews it had gotten over the years. While I must confess there were some sad social cases while I was there, the kids were so much fun to work with. I held babies, I played with little kids, I tried to help teach the nursing students, I got a teddy bear named after me, and a very nice card made especially for me by one of my patients. I handed out muppet band-aids, I sang silly children’s TV show songs that I had listened to with my niece Madison, I got smiles every morning from some of the sweetest patients in the world. It was such a fantastic month it made it easy to forget that I was there from 7-5 Monday through Friday and 7-2 or 3 at least one weekend day a week. The kids were so much fun to play with and the parents were so nice to me as a student because I was able to put in the time to really explain and discuss things with them that the attendings didn’t always have time for. And sometimes the parents really just needed someone to sit and listen to them because they were there alone away from their normal support group. I did struggle at first finding my role on the team especially when I was only there a few days before the residents changed and the staff were only on for a week at a time, and I didn’t really like asking families to evaluate me because I didn’t want them to think for a moment that anything I had done in connecting with them or their children was about getting a nice evaluation though I had a number of them who would have probably written a very nice one. It was also interesting in that this was the first time Kilah and I worked in the same hospital together. I worked on the floor below her and occasionally had patients on her floor. It wasn’t as weird as we thought it would be but I think a majority of that came from the fact that she never had to take orders from me or had any of my patients. Her co-workers are apparently still talking about the time she kissed one of the “doctors” though. It really was a great month though and a nice reminder why I got into medicine.

I thought nothing could top my inpatient month, until I had my outpatient month at Epler Park.  A huge shoutout to the attendings and nursing staff who made it such an awesome month. They were even nice enough to get a cookie cake to celebrate my last day there on Thursday. It was really nice working in the outpatient office. I was kind of worried it would get boring, but it was actually a lot of fun talking to well patients from time to time and I actually got pretty confident in my ENT exams thanks to Dr. Porter and Dr. Wilson. The last few days I was there I didn’t miss a single ear infection, which may not sound like much but really is an accomplishment because they are surprisingly difficult to determine a normal ear from a fluid filled ear from an infected ear. It was really great getting to work at one office the whole month instead of bouncing around. One because it was nice and close to our house anyway, and two because Dr. Porter was really able to point out and help me with areas of diagnosis and physical exam that I needed to work on. It will come in real handy during residency even if it didn’t help that much on the exam because the questions and medicine they asked were so random and vague it was one of the hardest tests I’ve taken and didn’t really broach the topics I thought it would like milestones, COMMON pediatric illnesses, criteria for treatment, and any of the other things I saw regularly in clinic. It was very random and tested a lot more rare things that I hadn’t even seen working with the genetics and metabolism team. Hopefully I still did alright, the fact that I haven’t heard from Dr. Harris telling me I need to retake the test during my vacation is a good sign. It turns out I really just enjoyed my pediatrics rotation as a whole.

I’m glad pediatrics was everything I had hoped it would be. I was kind of on the fence about doing med-peds and guess I still am just a little, because I like the idea of doing transitional care for people with complex genetic problems, but after doing my peds rotation I really think I want to just work with kids. I’ve met a couple of med-peds docs who make a convincing argument about transitional care and the growing need in this country, but I’m afraid rather than having the patient census I want of primarily peds with some adults, I would see mostly adults with only a few pediatric patients. There’s still time for me to change my mind, but it doesn’t seem all that likely at this point. I think I’ve found my calling and the numerous parents that asked me “Do you want to do pediatrics? Because you’d be really good at it.” just helped affirm that point.

So now that I’ve caught you up on all that, I guess I should catch you up on family matters. My brother in law is continuing to have medical issues and had major surgery to place an LVAD to help alleviate the symptoms of his heart failure. He’s home and doing better but I don’t think it was the instantaneous feel-better procedure that he thought/had been told it would be. The recovery just from the procedure itself has been a little hard on him. All the prayers sent his way have been greatly appreciated. My niece went to see Dr. Escobar, the developmental/genetic pediatrician I worked with two summers ago, and he is going to make sure she gets the assistance she may need when she starts preschool. She’s come a long way and is racing all around, talking up a storm when she wants to, but he thinks she may have some issues with learning and is willing to help them get her the right assistance when her First Steps ends at 3 years old. Mom has healed well from her surgery and is enjoying chasing Madison all around, helping Michelle with her and Jon when she can. She and Michelle are both still looking for jobs, but with everything going on with Jon and Madison, it seems like a blessing in disguise that they are both off and free right now. Dad has been working for the last month or two now which is nice, here’s hoping the weather doesn’t get much worse and he’s able to keep up with his streak.

We actually just got back from visiting my wife’s family this past weekend in Rising Sun. Lucian is growing like a weed and was fussy as all get out while he’s trying to cut his first teeth at 7 months. He’s nearly caught Madison in weight and is wearing 12 month clothes. He stands with assistance, but is still working on the crawling motion.We enjoyed hanging out with her brother and sister-in-law at their house and then we met up with her dad and had a great dinner at a Japanese steakhouse to celebrate her sister-in-laws birthday. And we got to watch my younger brother-in-law play in a baseball tourney and catch up with her cousin/maid of honor who moved back to their home town to be closer to her family. It was a really nice weekend, but we had to cut it a little short because of the impending snowstorms and didn’t get everything done that we had hoped. It was so weird though that I got a little sunburnt at her brother’s baseball game on Saturday and then had to drive her to work in the snow yesterday morning because the roads were terrible. I guess that’s just Indiana weather and I should be used to it by this point.  I am taking my vacation this month despite my previous post to the contrary so we’ll hopefully have time to go back soon.

I decided to just take the vacation because the genetics elective I wanted to do this year was all full this month and before I found out from Dr. Lah, one of the geneticists I worked with on inpatient pediatrics, that I could probably petition my way in, my wife and I set up a vacation to Boyne Falls, Michigan up near Traverse City. I also figured it would be good to study and get Step 2 CK out of the way early so I’m studying now to take it in June or July depending on what my schedule looks like, whenever it’s finally released.

Anyways, I’ve got dinner to cook. Hopefully I’ll remember to update you guys more as this month goes along.

Best Regards,

Robert Oswalt


Christmas Break!

Filed under: Uncategorized — Robert Oswalt on December 28, 2012 @ 4:36 pm

Yeah it’s official, I’m the worst blogger ever.  I believe it’s been 4 months since I last posted which means 4 months worth of rotations you guys have missed out on.

I finished cardiothoracic strong and was ecstatic that I got to go to clinic the last week I was there with Dr. Brown. My only regret was that I didn’t get to go in sooner, meeting all these patients with congenital cardiac issues was amazing and just discussing with them how they’ve lived with and dealt with these issues was more inspiring than sad. I was sad to see my buddy Daniel head back to Texas though. He was a 4th year from Galveston who hopes to do CT surgery some day so he was doing an “audition” rotation here at Riley. I was excited to hear he got to interview up here and wish him the best as he finishes out his fourth year. So after the final day of CT, we were given a day off to study for surgery which was difficult to do given the vast amount of information it covered. To the people who said it was like the medicine exam, I’d have to concur except slightly more emphasis on surgical intervention and pre-, post-, and intraoperative management. My NMS surgery book combined with the Pestana Review I received from one of the residents I did night call with were enough to get me through. I sweated bullets heading into the surgery but in the end everything turned out alright.

I followed that up with inpatient internal medicine at Wishard hospital. I had a great time on the purple team with my fellow compatriots Tyler and Jeremy. It was a bit rough at first because I hadn’t been given a lot of opportunities to write notes at St. V’s or Riley, let alone writing full admission H&P’s or daily notes with in-depth treatment plans and differentials and there was also the task of presentations which I started to get better at just before the end of that part of the rotation, of course. While I liked internal medicine, I found myself becoming a bit jaded by the patients we saw. I can’t begin to recount the number of times we had to deny patient requests for pain medications because of their records on INSPECT. It was fairly disheartening how much time and energy went to dealing with patients who had minor complaints but didn’t want to go to a PCP, drug intoxication, or were drug seeking. Thankfully the residents were good at making sure we didn’t get too disenfranchised and we saw a lot of worthwhile cases as well. I also really liked our attending during the second half. She was pretty demanding in terms of effort, time and energy, but I learned so much from just having her as an attending and you could tell she really loved to teach.

After that I did internal medicine outpatient, which was interesting. I was involved in a number of random clinics in addition to a few typical ones and some procedural clinics. I did the Jr. Teaching clinics at the VA twice a week, but then I also was at the women’s clinic three times a week and the breast cancer clinic once a week. I even had my old allergist as a preceptor. I was surprised he even recognized me given how young I was when I went to see him, but it was nice seeing Dr. Goldberg again as a nonpatient. While I enjoyed being in the primary care setting and having to establish rapport with patients in a brief meeting, I had some issues with having so many different preceptors. It seemed like each one expected something different from me and a lot of them didn’t take the time to mention their expectations until nearly the end of the rotation or during our final feedback meeting. I recognize part of the fault lies in me in that I didn’t ask how they wanted things done, what they wanted me to write in charts, how in-depth to make my presentations, etc…, but often I was thrown into the fray the first day of these clinics so unless I was corrected, I just assumed I was doing things the way they wanted them.  Nonetheless I enjoyed being in the outpatient setting, talking to patient’s in clinic, even if it felt like I was back in OBGYN a little too frequently. In terms of future careers, I’ve got to put internal medicine up there as a definite maybe, especially given the multitude of career paths available after completion of a medicine residency.

Most recently I finished up psychiatry at Larue Carter in the chronically ill ward. While it was hard, because I knew there was little hope for a lot of our patients to ever get out of the hospital, it was a good experience that got me more comfortable with interviewing patients. I figure if I can talk to a patient who is actively delusional and believes I’m the head doctor interfering with his investigation of the hospital and if I continue to interfere he’s going to cut off my ears and mess up my hair, I should be able to talk to anyone.  It was also nice continuing to work with some patients as they actually got better during their time at LCH. I do believe in the notion that there is a window though to release some patients. It seemed like once they were better, waiting for the gatekeeper to set up a place on the outside made some of them regress behaviorally. It was a topic I discussed at length with Dr. Diaz who was my preceptor.  He was a very good preceptor who gave us little mini lectures that really helped on the exam. He also was from Evansville and big Indiana history buff so we had a lot to talk about. I may end up asking him for a letter of recommendation because he’s one of the few preceptors I got to work really closely with outside of the OR. I also got to work with Dr. Kellams in his MRDD clinic. He worked with a lot of patients whose IQ’s were less than 70 in an effort to stabilize their behavior or moods. That was a really good experience too and Dr. Kellams was extremely knowledgable about psych, congenital issues, and a lot of politics in the area. Both were very understanding of the time limitations students have as well and made an effort to get us out at a reasonable time so we could study at home. Overall, it was a good rotation and I’m considering doing an elective in child psych to hone my children interviewing skills, even though I’m not sure psych is the career for me.

So now I’m taking my break, and waiting patiently to start my neuro rotation. I have two weeks of inpatient/consult at the VA and then two weeks of inpatient/consult at Riley. I feel like that may be a nice transition to my pediatric rotation. I’m also trying to figure out what I want to do as an elective since I don’t plan on taking my vacation this year. With all my hard rotations out of the way, I feel like taking a vacation this year would be a waste when I’m so close to fourth year and could use the extra time next year to do interviews or away rotations.

In terms of the holidays, they’ve been good so far. We did Christmas at the Zoo with my family. Kilah and I had an opportunity to go back to Rising Sun and see her family. We got to see most of her family including our nephew Lucian and we made it back in time to spend Christmas day with my family and see our niece Madison. She is making leaps and bounds in terms of progress. She’s using words now, it’s only a matter of time before she’s able to string them together in a sentence. Lucian is getting to be a chunky monkey and he’s so active, making noises and flailing about. Both are doing well, as is my mother. Last I spoke of her she had her surgery and was recovering. I’m happy to report she’s doing great and getting her stamina back. Unfortunately with her lifting restriction she was unable to go back to her hospice job and is looking for a new one. She likes talking to patients, but also has a lot of experience, so she has a number of routes to take. She was also approved for longterm disability thankfully to help cover expenses while she’s looking for a new job. Unfortunately with all the new healthcare legislation taking effect and all this talk of fiscal cliffs, a lot of healthcare hirings are being put on hold for the time being. Hopefully the new year will bring new opportunities for my family.

I know for being 4 months behind in my posts, this was rather short, but I’m getting ready to leave for pizza at my folks’ house so I’ll hopefully fill in some details before I start neuro. If not, Merry Christmas and a Happy New Year to all!

Robert


3 day weekend!

Filed under: Uncategorized — Robert Oswalt on September 3, 2012 @ 9:29 am

So it’s been a long time since I got on here and felt it would only be right to take at least a portion of my 3 day weekend to update this blog, so here it goes.

OBGyn at Methodist is over. The experience was fantastic, but OBGyn is not for me. I enjoyed my time birthing babies and I can see why a lot of the residents picked that specialty because it combines surgery with clinic in a way that few other specialties can boast, but there was just a lot of things I saw while I was there that I knew I couldn’t handle on a regular basis. I’ve also got to give a huge thanks to the IU OBGyn residents that were at Methodist during my time there. They always made me feel like the work I was doing was worthwhile and they were great about giving positive and constructive feedback.  It was also rare and I could tell they felt horrible about doing it when they gave us what they considered scutwork. It was nice that they at least acknowledged it for what it was and I appreciated that they would do a lot of it on their own if things weren’t too busy. They were also great about helping us study in the downtime that we had, working us through algorithms for diagnosis and treatment options. It was a huge help combined with the review session that the OBGyn SIG put on. Overall it was a great rotation and I’m thankful for the experience, but I feel like everything to this point is just competing with pediatrics, no matter how many people tell me I look like an orthopedic surgeon (I’m pretty sure it’s because I’m a large person and has nothing to do with how I handle surgical tools).

Right now I’m at the halfway point of my surgical subspecialty rotation in pediatric cardiothoracic surgery at Riley. It was my first choice so I’m lucky in that regards and while the fellow was on vacation I got a lot of experience with being first assist and even got to make opening cuts and do a sternotomy with hand over hand assistance from the surgeon. I’m dealing with a lot of congenital heart conditions which is what I’ve wanted to do for a long time now, but I can still say surgery probably isn’t for me. I do like that I’m getting to deal with the entire gambit of cardiac specialists at Riley though. On Friday we have conference (unfortunately I show up late because we have lecture that morning) that involves pediatric cardiologists, the pediatric cardiothoracic surgeons, radiology, and pediatric critical care cardiac intensivists all discussing how to care for a patient with a congenital condition in pre-op, post-op and over the long term. It’s really neat and just further compounds that I need to be looking at subspecializing in pediatrics, whether it’s a combined pediatric medical genetics residency or pediatrics with a fellowship in cardiology. Right now that’s what it seems like everything is competing with and I’m honest with the residents about it. I let them know that I’m giving each rotation a fair shot and truly grateful for the experiences they are giving me, but at the end of the day or rotation for that matter I ask myself would I be happier doing this or pediatrics. I’m not going to lie and say I want to do something in the hopes that it reflects better on my evaluations, and while I’m taking some flack for my choice, it’s all good-natured ribbing and I think the surgeons recognize that some people are happier in clinic than the OR.

Now for the other things going on section of my blog. Kilah and I are aunt and uncle once again. Her sister-in-law gave birth to our nephew Lucian Anthony Banschbach on August 24th. At 21 inches, 9lbs 7 oz, he wasn’t quite the 10 pounder they were hoping for but he’s still a big dude and he’s got muscles.

Unfortunately my mother also had another aortic dissection that week. They were going to sit on it again and just watch it, but it started to get bigger her 2nd or 3rd day in the hospital so they decided to watch it stabilize and then place an endograft in to try and strengthen the area. Her surgery went great and aside from being sore and having a hard time sleeping completely flat again she’s doing fairly well (if you’ve ever been hospitallized for an extended period of time you’d understand it’s difficult to go back to completely laying flat without feeling like you can’t get enough air or you’re breathing too hard).  She had a local Marfans surgery specialist working on her case so we were very blessed in that regard. I have to thank all of my family and friends for being so supportive throughout the process. A special thanks to my aunt Marti who stayed up here with my mother while the rest of us worked. I know it wasn’t how she wanted to spend her vacation but we appreciate that she did.

And lastly we’ve gotten most stuff moved into our house. We still need some new kitchen chairs, to clean some stuff out of the garage, and some more furniture to fill up some of the empty space, but other than that it feels like home.

Anyways, I need to take the dog on a walk and get ready for this week’s cases so that’s all for now.

Robert


1 Down!

Filed under: Uncategorized — Robert Oswalt on July 19, 2012 @ 7:13 pm

So I completed my surgery rotation on Tuesday. It was actually a great rotation with a lot of good experiences that I’m glad I had, but I get the feeling that surgery may not be for me. St. Vincent’s was a great place to have my surgery rotation at, but I don’t think the lifestyle is for me. I got a lot of one on one opportunities with my doctor, which is unique for a surgery rotation. A lot of the other hospitals have so many fellows, residents, interns, 4th years, and other students looking for opportunities to scrub in that it can be a little difficult to get the experience. I actually had a couple of times where I was unable to scrub into the surgery because I was waiting to perform one of the other checkoff things we had to do like IV’s, Foleys, and NG tubes. The hours were really good too. I panicked a little bit when they discussed us working close to 80 hours a week. My heart doesn’t handle a lot of long hours with little sleep, but at St. V’s I kind of maxed out at like 53 hours or so and still got a lot more hands on surgical experience than several of my classmates. And when we did finally get surgical residents (St. V’s is just starting a surgical residency program), they gave me a lot of one on one assistance instead of taking away opportunities from me, giving me advice on how to get some of my checkoffs and do some other paperwork stuff that I wasn’t getting done previously because I wasn’t given access to St. V’s EMR. So my advice is to try and get the St. V’s surgery rotation whether you’re thinking of surgery or not, it’s just a great rotation all around and the facilities at St. V’s are fantastic.

Other news, I started OBGYN at Methodist today. it looks like it’s going to be a great rotation. Today alone I got to do a few pap smears and pelvic exams and even got to find some fetal heart sounds with the doppler. This was one of the things we weren’t really given a lot of opportunities to do previously, so I’ve had some hesitations going in, especially understanding how comfortable these procedures are for women. The resident that I was with at the resident’s was really good about encouraging me and letting me do what I was comfortable with and helping me out with things I wasn’t very comfortable with.

Also Kilah and I have finally found a house, now we just have to move our stuff over. It’s a nice two story home with a big yard for the dog. It has 3 bedrooms and 2.5 baths and a kitchen that I think is going to be better suited for Kilah’s cooking needs in terms of counter and cabinet space. We’re having issues with getting our stuff from down in Evansville. With me being on my OBGYN rotation I have a few weekend responsibilities this week and next week and Kilah is working 4 shifts in a row starting to do, so are time is a little strained. It’ll get done though. Our lease runs up on the 31st down in Evansville, so hopefully between the two of us and the assistance of our dads we’ll get our bed and the few remaining items that aren’t in her mother’s mule trailer out in Rising Sun.

Anyways, I need to read up on tubal ligations for tomorrow morning.

Robert


Finals! Complete! Step 1! Complete!

Filed under: Uncategorized — Robert Oswalt on June 4, 2012 @ 5:08 pm

This is just a short note to let everyone know I finally finished Step 1 and Finals and plan on making the most of my few days off while I’m still down here in Evansville. Finals were rough, but doable and more clinically applicable in the second year than the first year by far. Boards were similar though I found there to be a number of questions that are obviously not likely to impact clinical decisions in the future, but still a lot of clinical vignette’s that are fairly realistic. I’m glad I used DIT too. It was a great supplement to the First Aid book and I’m also glad that First Aid decided to include their pictures with their information instead of requiring you to go back and forth to look at clinical images. Overall though some great resources. Also I highly recommend getting your hands on the Goljan pathology lectures. He does an excellent job highlighting just the high yield stuff.
Other things going on. Having a hard time finding a house for rent still. We’re hoping to hear back on one soon. It’s a pretty nice little place in Greenwood. The yard is a little bigger than our house now, but there’s no loft for Darty to hide up in so that’ll be a big change for him. From the realtors that we’ve talked to though it seems like the biggest limitation is our animals. There’s no way we’re giving them up though so I guess we’ll just have to keep watching. We’re hoping for a fenced in yard too which has kind of reduced our options. I recommend when moving or looking for a house to use Craiglist cautiously. So far we’ve heard from two south African missionaries, a member of the Peace Corps in Poland, and one Nigerian prince all of whom were quite ready to send us the keys for the first month’s rent plus a down payment. That part is actually getting quite frustrating. Oh well. Hopefully we’ll get this one in Greenwood or find another one soon. We have plenty of friends, family and realtors looking for us so hopefully we won’t have to live with my parents for too long.
Well anyways I’m going to get out of here and go take Jagman for a walk. He was very excited to see me after my exam and since Kilah started her new job orientation at Riley today up in Indy, he’s been a little neglected.

Best Regards
Robert Oswalt


Finals!

Filed under: Uncategorized — Robert Oswalt on April 29, 2012 @ 5:26 pm

Ok, so I’ve pretty much resigned myself to the fact that I’m terrible at keeping this blog up to date. That being said, it’s finals week and I’m sitting in a much better place with all my classes than I was this time in first year. I have my concerns about getting through the path final and will be abusing my Goljan pathology review book in an effort to reignite some of those synapses I lost from disuse.

Genetics, I’m not overly concerned about. I did pretty well on the mid-term and have a good understanding of genetics, but I don’t really know how they are going to ask the questions on the state-wide. On top of that I probably need to brush up on all the genetic disorders, especially the metabolic ones.

We also have our physical diagnosis final and after using a lot of the techniques time and time again and realizing the significance of each one, I feel like it’s just a matter of trusting what I know on that one and not overthinking questions. That’s not to say I’m not gonna try and get through all those notes twice before Wednesday.

The only other two exams I have are the renal exam and ICM II statewide. I’m comfortable with ICM II and have done pretty well in the class as a whole, I just hope that translates well to the final.

Then there are the boards. I’d be lying if I didn’t admit I was a little behind in my review. I’ve been keeping up with my Doctors In Training review course and have done close to 750 Qbank questions, but I’m not where I wanted to be in my individual BRS books and First Aid. I’m still working on my first run through of the First Aid and I’ve only looked at a couple of chapters in my biochem and anatomy BRS books. I’m hoping I can get back on track and play catch up after finals. Hopefully.

To make matters worse though, Kilah and I haven’t found a place to live yet. If nothing else we have the fallback plan of staying with my folks for a little bit, but that would mean giving up the cat for a little while and finding a place to store all our stuff in the meantime. I’ve gotten in touch with one of my fraternity brothers though who is now a realtor and he’s helping us look around for a place on the southside. Now it’s just a matter of getting up to Indy to look at places. On top of that, Kilah hasn’t found a job yet. She’s had 3 interviews at Riley’s (the promised land for pediatric nurses in Indiana) and she is extremely excited about one on the transplant/med-surge unit, but we still haven’t heard back from them yet.

So you could say we’re a little stressed about the upcoming move. Anyways I need to get back to my renal notes.

Robert Oswalt


Spring Break Update!

Filed under: Uncategorized — Robert Oswalt on March 25, 2012 @ 11:49 pm

I know I promised my Doctor Dilemma blog was going to be my next, but it’s taking longer and a new physician has offered input that I’m having a hard time discerning where to put it. He makes a valid argument, but it really hasn’t swayed my opinion, mostly because he’s working with a completely different patient population than I plan on working with. We just finished our psych section in ICM II if that tells you anything.

First and foremost it’s spring break right now. Not that that means anything to me. So far I’ve just taken care of the animals, done some work around the house, read a book, went to see the “Hunger Games” movie, and of course studied for the boards. Kilah and I do plan on trying to take a little weekend trip to St Louis though. She’s never been there before and loves going to zoos, so it’ll be a nice little getaway.

As far as classes go we just finished up our psych block in ICM II and prior to that we had Hem/Onc in ICM and pathology. Before that we had Peds and GU, which I think was the last time I wrote anything on here. All of those blocks have gone pretty well, but I could really use a break from all the lectures. I’m starting to get into the individual study time and I get a little overly excited when I do well on my QBank questions. It’s nice though that the information is sticking. I also appreciate the fact that the clinical medicine seems to be coming to me better than last year’s material, but that’s old news I’ve probably mentioned before.

We also switched our preceptors just recently, so I’m no longer with Dr. Crawford. I really appreciated all the insight and help he offered over those couple of weeks and would also like to thank his staff for being so welcoming and helpful as well. They were quick to assist and never frustrated by my questions, no matter how dumb they may have seemed to an experienced health care professional. I also appreciate Dr. Crawford taking time out of his day to highlight some of his more recent unusual cases. Interesting things you just don’t normally associate with Family Practice. Fortunately though, I’m paired with another great preceptor, Dr. Carmack. She’s a local pediatrician who is letting me see cases in her office. All of Dr. Crawford’s were hospitalized so there really is a difference. The biggest one being I don’t have to bring all my tools to Dr. Carmack’s office since each patient room has its own tools available to me. I just carry my stethoscope. On top of that, Thursday is “jeans day” in her office and I’ve been given free license to wear something more comfortable than shirt and tie at the next visit. My first week with her, was great even if it was a long day. I have never done a complete pediatric H&P before so she let me observe and follow her, which was very helpful and makes me feel a little more confident doing one on my own next week.

This past week though, I got to do a physical on Mike in front of our professor Dr. Eubanks, just to make sure we were doing everything correctly. I was a little nervous and fearful that I had been doing something completely wrong the whole time or afraid she was going to assess something I hadn’t been able to do on a patient before. Turns out it was much more low key than that and Mike and I both did fine in assessing each other using the basic physical exam skills.

I also got pretty close to my first choice on clerkships.

  • Surgery
  • OB/GYN
  • Surg subspecialty
  • internal medicine
  • psychiatry
  • neurology
  • Peds
  • Vacation
  • Family Med

Wasn’t my top pick but pretty darn close! I’m pretty happy, especially considering all the people trying to trade now. I hope there is some way to make up for that so that people who didn’t get their first pick on order, get their first pick on sites or 4th year schedules. I just know a few people whose schedules weren’t really that close to what they had ranked and it would only be fair to let them have first choice next.

I’m also excited to announce my dad’s starting up work again and my sister’s contract for the telenursing group got extended to the summer. It actually works out well for my sister, since she just recently sprained the top of her foot, possibly broke her toe, and is on crutches. Since it’s over the phone she’s able to sit and put her leg up. Hopefully that’ll help the swelling go down. She’s really regretting the two-story house though since she has a really hard time on stairs. Her, Jon and Madison actually stayed in mom and dad’s spare room at least once since her fall, so she could sleep on a bed instead of the downstairs couch. I guess Madison still had a hard time falling asleep in a strange place so she stayed up all night “talking” to her grandma. From what I hear it really made grandma’s night even if it meant no sleep. Madison seems to be making strides now. The therapies are working and she is getting better with food and moving. I guess she doesn’t like her leg braces, but it’ll be worth it when her achilles isn’t so tight and she’s standing/walking normal. It reminds me of the vague memories I have of sleeping with tennis shoes on and a metal bar between my feet to keep them from turning in. It’s still amazing how effective some of the low tech therapies can be. Anyways, since I mentioned her I’ll end this with a couple of photos I recently got of her. One she’s standing next to her dog, Doodle, and the other she has a stethoscope around her neck. Obviously going into the family business!

 

Anyways, I’m up way too late. Kilah and the animals went to bed almost 3 hours ago!

Best Wishes!

Robert


Update

Filed under: Uncategorized — Robert Oswalt on February 24, 2012 @ 10:43 pm

Just writing a little note to let people know I’m still here. I’ve actually been working on a big blog lately, one I’ve wanted to do for a while, I’m just having a hard time compiling my thoughts. It’s about the role of the doctor’s title in the doctor-patient relationship. This is a debate I’ve had with a lot of people from friends and family to physicians and professors. Basically anyone with an opinion. Hopefully that’ll be up here soon, it’s just hard to find time between studying for class, studying for boards and keeping myself sane.
Since I last blogged though we started doing our full history and physicals. It’s been a great experience. I was so nervous in the days prior, it was a little ridiculous. You can sit there and discuss all these tests and aspects of the exam, but until you actually put your hands on someone and do them its hard to appreciate the difference between normal and abnormal. Like I said before, even though I’ve only done 3 and my last 2 were cut short for unforeseeable reasons, it’s been a great experience.
I love being out in the hospitals, actually talking to patients. I will admit I did get very frustrated with my second patient though. She had agreed to let me do a full physical and history on her, but she got tired or bored of the process about 20 or 30 minutes into it. That wasn’t what really bothered me though. What left me flustered was the fact that she didn’t tell me she was done, she just started “checking out”on me. She even went so far as to turn up the volume on her tv to ridiculous levels to drown out my questions, but never once did she just tell me she was done. So I wasted another 5 or 10 minutes trying to complete a physical on a patient who wasn’t non-compliant, but about as close as you can get. It was really the wasted time that frustrated me because I still had to drive out to Dr. Crawford’s office when I was finished to present the patient to him. I didn’t appreciate her VERY passive-aggressive way of telling me to scram.
On the plus side my first patient was great, a former nurse actually, who helped me out with areas of my physical exam that I was uncertain about. The most recent patient I had just last week was very drowsy and had a bit of dementia and memory loss, but she made up for it by having a number of oddities like a mitral murmur, obviously pulsing right jugular vein, and a DVT with serious swelling. Things we’ve heard about a million times, but haven’t really gotten to see. I feel bad to be excited about hearing or seeing those things, but it’s part of the learning process. Lucky for me her daughter was there to help fill in the blanks too because she could barely keep her eyes open.
Also, we got to go to BG last weekend. My family is doing well. Dad’s still out of work, mom’s job as a hospice nurse has picked up recently with her increased census, Jon is staying home to watch Madi and my sister got a contract job doing telenursing. Madi is still growing. Her growth has kind of dropped off and she’s having a hard time with foods that have a thicker or textured consistency (like applesauce) for some reason. They tried to do a swallow study on her, but surprise surprise, she wouldn’t drink the Barium ( I can’t say that I blame her). She has a lot of therapists that come to work with her now so hopefully she’ll make some progress with that. She’s so cute though. She tried to stand without support for Auntie Kilah and I. She would push herself up using Kilah’s knee and then let go, hold herself up for a second or two then fall down. It was funny because she did that a few times and then realized she didn’t have the balance so she pushed her self up and then stood leaning against Kilah’s leg (Kilah was sitting down on the floor playing with her) and started clapping for herself when she didn’t fall over. She kind of cheated, but I gave her points for creativity and effort.
Not much else is going on otherwise. We have the first ever IUSM-E Health Fair tomorrow which is exciting, but its mostly just studying for exams and boards right now.
Anyways, I need to get to bed so I can be ready for the Health Fair tomorrow.
Robert


Older Posts »
Follow

Get every new post delivered to your Inbox

Join other followers: