Week 17/18: you are not here to work, you're here to learn!

Sorry for the delay everyone! I took off this past week to stay out of the hospital and study for the usmle step 2 coming up really soon (March 30th). The week before this one was my first week in the new hospital.

My mornings are quite different now. I still get up around 5:30am but then take the bus at 6:24 to the train station, take the train at 7:03 and arrive in Hildesheim around 7:33, walk about 15 minutes to the hospital and start work around 8. On Mondays, Wednesdays, and Thursdays we have lectures until 5pm which doesn't get me back to my apartment until about 6:30. Due to the over hours we accumulate with the lectures, we get off Tuesday or Friday every other week. 

I'm currently in my surgical rotation. On the first day, we spent most of the time running around the hospital getting our lab coats, having lockers assigned to us, picking up our I.d. and chip cards. One of the surgeons sat down with us to divide us up in the departments. The first week I was in thoracic surgery. Then it'll be as follows for varying amounts of time: pediatric surgery, vascular surgery, general surgery and lastly trauma surgery.

I have a few vacations planned in between as well. 

My first week in a new hospital and new department went well. I spent everyday in the OR. I'd never really been in contact with thoracic surgery before and in the few days there I assisted in removing a lung, taking lung samples, cleaning out an infected pleural space, thoracoscopy and tracheotomy placement. It was cool to feel a breathing lung and touch a beating heart. 

The department is way smaller compared to what I'm used to. Thoracic surgery in this hospital consists of three people: chief, attendant and resident. Huge contrast to what I'm used to. But the whole hospital is a smaller scale than the university setting I've been working in. It's seems much more small town-y. People will open the doors for you, ask if you'd like some coffee, have a conversation with you. The chief himself sat down with me and discussed x-ray pictures with me. He made sure that I saw a lot and helped where I could. He also said that I'd be much better off being a thoracic surgeon than God forbid an urologist! It's so funny, the last few months I've lived in my urology world and thought it was the most normal thing in the world to want to be a urologist, work in that setting and treat those patients. Ever since I've come to the new hospital, everyone is amazed at my decision, shocked almost and tries to convince me to do something else and teases me about wanting to be a urologist. The urologists in the hospital are all supposedly really nice though and seem to have a lot to do. The other doctors like the urologists, they just can't wrap their mind around the idea of me becoming one.

One of the first things that the doctor that greeted us told us was that we are not there to work but rather to learn. We are supposed to get insight into the different departments and be as hands on as possible. That is great news for us! I really do look forward to learning a lot. I'll even be more excited once this board exam is over so I can actually relax and enjoy the time in the hospital. If the other departments are anything like the thoracic surgeons, I will be learning a lot!

Monday I start in pediatric urology, super excited! There is one surgeon who does pediatric urology. I'll try to work with him as much as possible. This upcoming week will be quite stressful since it's the week before my exam and I'll try to focus on that as much as possible. I apologize in advance if there is another week delay on the next post. I'll try to fit it in in one of my study breaks but no promises. Who knows what state I'll be in two days before the exam. 

Quick update on my meeting with the pediatric surgeons. In a nutshell, I was introduced to a little boy with a urological condition who comes from Azerbaijan. His family is in Germany on a scholarship and came in the hopes of receiving better care for their son. Unfortunately the insurance doesn't cover preexisting conditions. I've presented his case to the pediatric surgeons and urologist and have asked administration to let me know what the diagnostic test and most likely surgery will cost since the money will have to be fundraised. My fundraising goal is now set at about $13,000. I've been meeting with some people and getting the ball rolling on things and as of right now, if everyone pulls through, it seems promising. Up first is the diagnostic test to see how extensive the condidition is and what the best treatment option would be. In the upcoming posts I'll share a little more about this little boys story and also share information on how you can help me help him and his family if you want! 

Stay healthy everyone!

V

Week 16: My last week in Urology for a while

The past 16 weeks seem to have flown by so quickly! I assume this is mostly do to the old saying "time flies when you're having fun" but also due to the fact that almost all my free time before and after work was spent studying.

I spent most of my last week trying to complete my internship log book and get all the signatures I needed from multiple doctors. I was called into the OR to hold hooks in a cystectomy (bladder removal). Typically one of the longest operations urologist preform and I spent 4.5 hours holding hooks in my last week in the department. Only seemed fitting to end this way (because if I remember correctly, a cystectomy was the first urological operation I saw a year and a half ago when I did an elective in the department).

I baked 60 banana bread muffins and a "Kalter Hund" (German dessert consisting mainly of coconut fat, cocoa and graham crackers) Thursday night to take to work with me on Friday. I am genuinely sad that I won't be going to work in that department on Monday. The department consists of some pretty great people. The work atmosphere is the best I've been in and it really is more of a family than a group of doctors. I am thankful to the whole staff (doctors, nurses, secretaries, etc.) who helped me out during the last few months and didn't make me feel like an idiot if I asked a question. 

I also genuinely think that they are a bit sad that I won't be around anymore either.

My highlight while in the department was probably the whole situation with patient X. But I also have to thank all the patients who were kind to me. They were all a crucial part in my training and I thank them for having faith in me. 

Tomorrow it's off to Hildesheim every weekday until mid October. I'm not the biggest fan of the transistion periods. I've never been to this hospital, let alone have I ever traveled there. I don't know a single soul that works there. I've heard good things but it's always so overwhelming the first few days trying to figure out your orientation in a new hospital, observe and understand the dynamic of the people working there and getting to know the basic procederes (do you have to call for a consultation, or send a fax, or is it on the computer?). It'll be an overwehlming few days. Luckily, I have a little break from work starting Friday and all of next week to concentrate on the USMLE primarily since that is right around the corner as well (March 30th).

Since I'll be in a smaller hospital, I hope to be way more hands on than I have been. We will be rotating through different departments so little transistion periods will always be taking place. I'll be doing my surgical rotation so I assume I'll see the likes of trauma surgery, general surgery, maybe anesthesia. I'll know more tomorrow. 

Still can't say much about my appointment with the pediatric surgeons but I hope to be able to by next week. 

I hope you all had a great week and stay healthy in this crazy world!

V

Week 15: Falling out of love with medicine.

I've always joked that I am in a long term relationship with med school. With everything going on in my life...any potential real boyfriend would leave me due to lack of attention. So my guy med-school and I are having a bit of a rough patch. We've had rough patches before but this one seems to be going on a while.

View from the ward

I haven't fallen out of love with medicine itself, just the process I'm stuck in right now. I spend my early mornings before work studying, spend my evening studying, spend my Saturday and Sunday mornings studying....all for this dang USMLE. At work, I feel rather useless. We are so many "extras" and new residents that I don't actually get to do anything beyond questioning patients and doing an ultrasound. I fell my time is being wasted. I could be using the time to study (instead of getting up at 5) or use it painting, traveling, being crafty, baking, etc. But I'm stuck in the hospital trying to find something to do! Luckily, some of the consultants have gotten a hint that I am rather underwhelmed and will find new things for me to do. Even if it is setting up appointments or entering research data. At least then I'm not sitting around trying to look like I'm doing something when I'd rather be studying.

Since I had so much to do...didn't waste any nutella.

Its so frustrating because I hate sitting around! So the whole thing just seems tedious and annoying. I question why anyone willingly dedicates so much time and effort into this job when all you hear from most colleges is that if they could do it over....they wouldn't. How encouraging. Why sign up for a life of night shifts, on calls, weekend work, high stress level and 6 years of basic education before entering years on end of further training where you are used like an animal? You can't tell me its because of the money. There are easier, funner and quicker ways to make the same amount of money in this world. So in the core, it must be a love for the field. And that is the case for me. Just hard to see that sometimes with so many distraction around.

24 hours....Ready to get you!

Luckily, I decided to be on call on Wednesday after the doctor on call asked if I would join him. He is also one of those colleagues that suggest not doing medicine but at the same time, he is one of the best in the department (IMO). His patients love him, he works in favor of the patient, he keeps it real and is a pretty cool dude. Since this was my first on call during the week, it didn't seem as long as the ones where you come Saturday at 7AM and leave Sunday at 7AM and were you are the only two urologist in the house. On Wednesday, it was a normal work day until about 4:30PM and then it was the two of us. I had told him about how I feel about my current situation and all the fabulous things I see myself doing and he took that and told me I'd be doing most of the work for this on call.

This meant, I interviewed the patients primarily and did the diagnostic tests. There was even a pregnant woman with urinary problems and I had to do an ultrasound and obviously looked at the bladder so that I could also see the little foreign object sucking on its thumb! So cute! The doctor just rolled his eyes and said, "Women." I couldn't help myself.

Around midnight, we were able to go to bed. Not for long though. I was paged at 3:15AM and told a patient was coming in who thought he might have testicular torsion! I hopped out of bed and met the doctor and the patient in the out patient department. The patient's history and presentation were very classic for testicular torsion. We called the consultant to come in for the operation. I scrubbed in and assisted in alleviating the torsion on the one side. As a standard practice, the other side needs to be fixated as well. I got to do that and the consultant assisted! That meant I did the cut, the fixations and the sutures!! It was very exciting for me! Finally, hands on!

After finishing up a few things and letting the colleagues know what happened through the night, I went home around 7:30AM. I didn't sleep though, I had a meeting with my doctor thesis professor, had to take care of paperwork and had a meeting with the pediatric surgeons. Hopefully I'll be able to share some information from this meeting with you soon.

That on-call was what I needed to fall a bit in love with medicine again.

I know that once these exams are done and I can use the little free time I do have for other things, I will be more enthusiastic. Residency will be no walk in the park either but at least I'll be working.

I also participated in a pretty fun thing this past week. A guy I went to High School with, Zac Ziebarth, started an organization called SmartRoots Global. Their mission:

To create a generation of innovative problems and critical thinkers who are equipped to solve the biggest challenges in their community and world

 

Well Howdy Texas!

He has been working with students in Texas on the human systems and the health care system. He asked me if I'd be interested in skyping with some of the classes and talk about my medical journey and medical school in general. This came directly in the time that I was most demotivated on that subjected. But since I know its not my true feeling of the situation as a whole, I had a great time with the kids! They asked questions like, "What was your hardest operation?" "Have you seen a heart operation?" "What materials do you use in the hospital?". It was great to hear that about 10 students in each class are thinking about going into the medical field. Sure, they might just be 7th graders, but I knew what I wanted to be when I was in 7th grade and I'm in the midst of completing the first major part of that.


And as a last note, another yummy shake recipe:
-1 avocado
-1 banana
-2 fresh squeezed oranges
-1 cup coconut milk
-half a squeezed lemon or lime
-pinch of salt
Mix it up and enjoy the tropical breakfast smoothie!

Stay healthy!

V

Screen grab from the interview, click the link below to see the whole thing!

P.S. Found this (German) interview from the Urology Congress I went to in Heidelberg :)

Week 13/14: Cape Town, South Africa! I'm in love with this place!

Cape Town was AMAZING!! Guys, it was so much fun and its such a beautiful city and country!

So, I fly to Cape Town to visit a long time friend of mine. She was there with some more Germans and they knew more Germans so I primarily spoke German. I had 8 complete days there and they were packed with activities. Even though we hardly had down time, I still feel like I haven't even seen the beginning of all the things you can do there!

The weather was sunny almost all the time and hot! I highly suggest a visit there around this time of the year. Since this isn't a travel blog, I won't go into great detail about all the places we went and all the yummy restaurants we visited but rather, I show some pictures in the hopes that you can get a sense of how great the place is!

Stellenbosch: Tokara Wineyard, one of very many in the area

Table Mountain and Lions Head

Ocean View

Chapman's Peak

African Penguins in Boulders near Simon's Town

World of Birds: My monkey friends and I

Got a bit of inspiration for drawings

Big Bay: Red Bull's "King of the Air" Kite boarding competition

Boulders

We hiked up Lion's Head and the view was lovely

Probably my favorite of all. Table Mountain seen from Lion's Head

Lion's Head

Clifton Beach 1

The sunsets were the most beautiful I've ever seen

Cape Town, I'm in love with you :)

Reluctantly, I returned to Germany. I woke up the first morning at 5:30 again to get a round of studying in before work. Might as well get back to my normal routine as quickly as possible. I shadowed the consultations again on Thursday. Friday I hung around the outpatient department and tried to see new things here and there. The consultant working the department that day was really helpful. He had me watch different diagnostic procedures and then made me explain them to him.

I learned how a cystomanometry works. It used different pressure detectors and measures while the patient has their bladder filled with fluid and is then asked to either hold it or void. In doing so, we can interpret if the bladder is overactive, if the patient is using their abs instead of their bladder muscle and so on.

I watched a prostate punch biopsies being taken. It sounds and looks more painful than the patients make it appear to be. The biopsies are then looked at for prostate cancer.

There were a few cystoscopies performed which I watched.

My free time back home was then mostly spent with studying and editing. Now my music selection has a few songs that remind me of Cape Town and my tan that compliments my lab coat well. Already looking forward to the next travel oppurtunity!

Week 12: Bitter tears and 24 hour shifts.....but now it'S VK time!

Hey y'all!

Just got out of my 24 hour on call shift and thought I'd update everyone quick before I head off!

I started working in the outpatient clinic this week. Depending on the doctor working the clinic on any given day, there is more or less for me to do with patients. Luckily, the consultants had their consultation hours running parallel.

Urology can now also be found on Level 02

We also had two new girls doing electives this week. I played mom a bit for one of them making sure she saw as much as possible while she was in our department for one week. My days were spent between jumping in on some consultations, showing the girl around and doing some translation work.

Wednesday was a bit of a tough day. I'm still getting up before work every morning to study. And while this isn't effecting my mood substantially and I am surprised at how happy I am in general, I am still constantly under a certain level of stress making me a bit more prone to decompensating. I went in with the doctor to see a patient. He talked to the man and his daughter, gave the man the shot he came for and then left to let me do the ultrasound (rather standard procedure). Well, then the daughter started asking me about what dimensions a kidney should have. When I tried to explain to her that we don't generally concern ourselves with the exact dimensions of the kidney but rather look at the kidney's structure, she interrupted telling me she was from the medical field and that she would know that already.....well then why the heck did you ask?! So she became increasing difficult and then sprung the question on me if her dad was getting his prostate checked. Now, I have no issue with checking prostates but I usually ask when it was last done because there are more or less intervals in which it should be done. Her basically deaf father and she talked concurrently about how the prostate should be checked and this doctor said this and that doctor said that. When I told her I didn't know her fathers complete history and that the intervals are a bit dependent of the patients history, she yelled at me that I should know her dad's complete history since its all in the files (You are absolutely right, for your fathers outpatient appointment for a shot, I certainly intensely reviewed his 20 year urological appointment history in our department. Would you like to know his blood pressure from March 10th 1986?). She continued to yell at me that every doctor said something else and that we should know what we are talking about...blah blah blah! At some point I interrupted her and told her that it was not feasible to fulfill her vision of knowledge and even less considering I've been in INTERN in the department for merely a few WEEKS and the she could use a substantially nicer tone! And then I walked out. I told the doctor about the situation and then went to the bathroom. I just made it in time to the last stall to bawl my eyes out. I couldn't believe how mean she was to me. I was just there to help and would have discussed everything in a calm manner had she approached me in such a way but to just let out all her frustration with life on me was too much. I stayed in the stall for about 15 minutes until I couldn't cry anymore and tried to freshen up and hide the evidence. I was paged and asked where I was since there was a patient for me to see. I washed my face with cold water, put on some lip gloss and headed back to the outpatient department. The rest of the day was fine but this lady's inhumane treatment really irked me for a few more hours.

Urologist also have our own exit (and apparently use too much Viagra)

My friend wasn't feeling well and came to the hospital. After getting her all worked up and checked, I left the hospital after 12 hours.

Nothing all to exciting happened Thursday and Friday.

Yesterday (Saturday), I started my 24 hour shift. We had quite a bit to do. There were patients on the ward that needed us, the emergency room called almost every hour with a different case for us (mostly renal colic or infections). We also had to place renal fistulas as an emergency again (luckily this time it wasn't in the middle of the night). I did get 5 hours of sleep in all though. It was busy but interesting.

Today I leave to Frankfurt so that I can fly away tomorrow morning! Where to? Cape Town, South Africa!!!!!!!! I haven't really had it sink in yet since I've been so extremely busy with other stuff but since a few hours, I've been getting more and more excited! Of course I'll report a bit about my time there next week!

And as a last little thing for you all to try out (because its yummy!). I've been making this ginger-lemon-honey drink daily the past week. I wasn't going to risk getting sick! And like I said, its delicious!

-cut slices of ginger and pour over with hot water and let it stand over night
-1 fresh pressed lemon
-1 tablespoon honey
-some mint or lemon balm leaves for color
-mix it all together and enjoy while your colleagues think you brought a mojito to work ;)

Enjoy and stay healthy!

V

Week 11: Urology congress in Heidelberg= the only place the mens restroom has a line and the womens doesn't!

Well, I'm officially a quarter of a century old! 1/4 of my minimum goal reached!

The week started off with two rather unspectacular work days.

Wednesday I had to present some of my research data to the lab. I thought it would take about 10 minutest to click through my pictures and then they would tell me how little I've found and that I am a complete failure as a doctorate student. Okay, I didn't actually think it was going to be that bad but I had no idea what to expect. I had nothing definitive to show them. I composed some of the electron microscopy pictures I had taken and wanted to discuss these with the group of histology and anatomy professors and researchers. And in reality, that is what happened. The whole thing took 1.5 hours because each slide was discussed to great lengths with everyone there. I got some great input and some more direction as to what it is I am looking for. The conclusion is also that my endless hours in front of the electron microscope are long from over.

Wednesday night, I drove out to my aunt and uncles place to celebrate into my birthday. I facetimed my parents and opened my package of presents they had sent me. So happy! Amongst other things, I got a lot of material on Stephen Hawking. I'm excited to read his "A Brief History of Time" book on vacation. My friend got me travel guides for two of my destinations this year!

The next morning, my aunt and I took the train to Heidelberg. Most people know Heidelberg. Its a rather famous city also in respect to its medical history. I'd never been and have always wanted to go. Having won the tickets to the Urology Semi-Live Congress there, I finally had a reason to. My aunt and I ran around the city (sadly with not so great weather) but it truly is a gorgeous city.

The funniest thing happened in the candy store. There is a candy store that isn't very big but packed from top to bottom with candy from Germany and around the world. Even crazier than the collection of candy was the guy working there! Crazy beard and hair-do and thick leopard print nerd glasses. He spent about 10 minutes with each costumer at the register. So, don't go if you are in a rush. If you complain, he'll kick you out. What a cool way of working. Once we were up, my aunt told him it was my birthday. Before I knew it, he brought a stool in front of the register, told me to stand on it, made my "mom" hold my hand, gathered all the customers in the store around me, turned the light and radio off and announced to everyone that it was my birthday and that deserved a celebration, lit up a sparkler and made everyone sing Happy Birthday to me! It was fabulous and I couldn't stop smiling! He makes everyone at the register roll dice and play a little game and then you'll get more candy as a present. Super fun experience! I recommend it to anyone who visits. The store is called "Heidelberger Zuckerladen", has been around since 1986 and is located at Plöck 52 in Heidelberg.

At night, my uncle came and joined us. We had dinner at Moghul Tandoori, an Indian restaurant (Brückenkopfstraße 1, 69120 Heidelberg, Germany). I can also recommend this place.

Earlier in the day we had coffee at Coffee Nerd (Rohrbacher Straße 9, 69115 Heidelberg, Germany) (recommendation from the candy store guy and TOTALLY worth it). The coffee is ridiculously good.

I spent Friday and Saturday at the Semi-Live Urology Congress. The concept was that every half an hour, a different surgeon who is exceptional at the procedure, presents important information and techniques. Each was followed by a question and discussion road. In between there would be lunch and coffee breaks.

A little DaVinci practice never hurts

Right off the bat I met a student from Heidelberg and we ended up spending most of the time at the congress together. The presentations were more or less all really good. With about 300 participants present....there were only about 8 women. This meant this was the only place were the men's bathroom has a line and the women's doesn't!

I saw some operations I had never seen before let alone knew were a possibility. Friday night, there was a big dinner at a really old restaurant in Heidelberg. There was no lack of food.....it was so much food.....

Early morning walk to the congress

I made a connection with an Egyptian urologist and was invited to check out the facilities. The chief of urology in Heidelberg told me to apply for his department next year. The only people I didn't get a chance to talk to and wanted to were the two speakers from the States. I'll get in contact with them though. Over all it was a lot of information but really cool.

Heidelberg at night

Today I had a birthday brunch with some of my girlfriends.

Over my birthday weekend I didn't allow myself to study.....not that that made my guilty feelings go away any.....Its back to it tomorrow morning!

Hope you all had a great week!

Stay healthy!

V

Week 10: "Well, you don't place tracheotomy tubes, now do you?"......how rude! Get over YOUR fear of the penis Sir.

This week seemed incredibly long. This was mostly due to my numerous little naps in between. I am really able to fall asleep almost anywhere and sometimes I'm refreshed after just sleeping a few minutes.

Monday through Friday I got up at 4:30am, studied for the USLME until 6:10am, slept until 6:30am and went to work. Consequently, I went to bed around 9:30pm to at least get 7 hours of continuous sleep. Studying and answering questions in the morning significantly increased the amount I was getting right. It's still not where I want it in the end but I still have until the end of March to get there. I looked through the questions and worked on flash cards after work.

I attended a lecture Monday night held by Prof. Dr. Harald Lesch. He is a German physicist, astronomer, natural philosopher, author, television presenter, professor of physics at the Ludwig Maximilian University of Munich and professor of natural philosophy at the Munich University of Philosophy. He held a lecture about the smallest and the largest components of the universe and how they fit together. It was really interesting and refreshing to learn something different and new!

Wednesday, I was called into the OR to assist with a hydrocele operation. The patients ascites (excess water in the abdomen) was so extensive that it had reopened the processus vaginalis (connection between abdomen and scrotal sac) that usually closes in early development. Basically, he had excessive amounts of fluid in his scrotal sack....and since there was a lot of pressure from the fluid in his abdomen, it was like turning on the water faucet once we opened the membrane in the scrotal sack.

Cucumber, Apple, Basil, Lime Juice for the OR

Wednesday was a long day. The day involved ward work, operation, pathological conference lecture, evening meeting which was then still followed by a short educational lecture by one of the attendings. Luckily I had my back turned towards everyone to face the screen.....because I totally fell asleep for a minute or so....good thing I didn't snore. I was just so tired!

Friday looked like a busy day from the get go. One of the three interns wasn't there and the other didn't show up. We had two huge operations and two wards that needed to be tended to by interns.....and there I stood! My ward doctor was afraid I wouldn't be around to draw all the blood and his fear came true. Directly after the morning meeting I was sent into the OR immediately. I grabbed a coca cola and a biscuit and hurried off to the OR. I usually don't drink Coke, I did while in Ghana because coffee or tea wasn't very accessible and I needed caffeine. Now I do sometimes when a big operation gets sprung on me unexpectedly and I wasn't able to have breakfast yet. Caffeine and sugar to keep me from passing out while standing for 5 hours. Luckily the other intern had just overslept and was able to assist in the other huge operation.

Sometimes I just have to...

I was operating with the chief and he is tall. Although it was a 5 hour operation, my back didn't hurt nearly as much as it does when I operate with shorter surgeons. It was really nice operating with chief because he kept asking me questions. Sometimes anatomical, sometimes surgical or just logical to get me to think like a surgeon. He is an examiner for the board exams so it felt like a mini board exam.

Saturday I decided to tag along for an 24 hour on call. We started Saturday morning at 8am and I went home this morning at 8:30am. I slept for 2 hours and then again for 3. During the day we had quite a bit to do. The wards had to be tended to, the emergency room would call every now and again and we'd go there to check out the patients. We had some postoperative patients that weren't very stable and had to be transferred to intensive care. I hardly sat throughout the day.

We were called by the ENT-ward because they had a patient that hadn't peed in a day and a half. We asked them if they had placed a trans-urethral catheter. The doctor retorted that we (urologists) didn't place tracheotomy tubes so why should they place a trans-urethral catheter......Um....because every nurse should know how to!!! The genital area seems to be a big Tabu for many of the other departments and some doctors don't even take the time to look at the patient when it comes to urogenital tract problems and proceed to just call the urologist on call. Get over it people! Look under the blanket! Its only a penis!
 

Middle of the night, glazy eyes.

Late evening we were informed that a patient was being brought to the hospital with horrific labs. The patient was placed on acute dialysis when they arrived and desperately needed the kidneys drained. We couldn't do that until the acute dialysis was over though....which was around 1:30am. The doctor and I slept for two hours before being called to the CT to check out the patient's pictures and get the attending and nursing staff on call to come to the hospital and coordinate the anesthesiologists for the procedure. We were back in bed by 4am and slept uninterrupted until 7am. It was a long on call but also really interesting and the doctor and I get along great so that was nice too.

Outta there and walking home in the snow!

I get three days off in the week for being on call over the weekend. I am taking Wednesday-Friday off. Thursday I turn a quarter century old...  (0_0) ...... I'm heading to Heidelberg for the Semi-Live Urology Conference during my free days.

Hope everyone had a lovely week! Stay healthy!

Baci

V