June 23, 1996

   I spent several hour Friday afternoon in the VA emergency room with the plastic hand fellow repairing a right index finger crush injury. A 35 year old gentleman caught his hand in a hydrolic cylinder of some sort. He presented with an open avulsion/laceration over the extensor surface of his PIP joint with an underlying lateral band laceration and a comminuted middle phalanx neck fracture not involving the articular surface of the joint. He had good movement and strength in flexion and extension with some weakness in extension compared to his left index finger; two point discrimination was intact distal to the lacertion . So, we repaired the tendon in the ER ...

   Most of the week has passed now and it is Sunday morning. My mother a sister will be leaving latter this afternoon. They arrived late Friday night for their first visit to Houston since I started residency 2 years ago. We swung by the Village Grind for some late night entertainment before bed. The solo keyboard player was loud and the couches, seats and tables were all taken. We faded fast and were home within the hour. I got called into Ben Taub ER at 1am to see a 50 yr old gentleman with elephantiasis. Both lower extremities were 3 times the normal size and his RLE had a fungating, chronically infected, non healing ulcer with flies buzzing around it. In fact when I came looking for the patient, the surgery chief didn't even give me his name, she just said follow your nose. Fortunately he did not have an acute problem and my upper level Plastics resident ok'd his admission to the Critical Wound Unit. By 2am my workday was over.

   The alarm rang at 600am and I was rounding at the VA by 630. We had staff rounds from 7-830 and I reviewed journal articles with 2 fellow residents until 1000. We brunched at the Buffalo Grill, a popular Houston breakfast/brunch/lunch spot which is conveniently within walking distance of my apartment We were drenched by a thunder shower on the way home. The rest of the afternoon we visited, watched the Olympic trials in diving and track & field. Dan O'Brien didn't no height in the pole vault and went on to win the trials in the Decathlon. I sort of know what he feels like because I did the same thing in the IC4AA championships my senior year. We were competing at Yale and I was winning with 3 events to go in the competition; furthermore, I was on target to qualify for the division I nationals. I missed the opening height 3 times in a row. I got 0 points for the event and fell to last place. I digress. Anyway, it was cathartic to see Dan prevail. Let's hope he breaks 9000 at the Games.

   After watching the trials all afternoon we went for a 6mile run. Later we went to La Griglia for dinner and then the Mucky Duck to enjoy Toni Price , a folk/blues singer from Austin. I began dozing off at the end of the show, even though the mix was loud and the performance energetic. After the show we turned in.

   So, Sunday has arrived too fast. I'm back from morning rounds the sun is out and, once again, its time to eat. I think we'll try the Empire Cafe in Montrose. We're going to tour the Tex Med Center today and watch the track & field finals. I'll run mom and sis to Hobby at 5 pm, swing by the VA to preop the cases for tommorrow.

From Houston,

Peter. .

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