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"It was on my 10th Bike Ride Across Nebraska
(BRAN) that I realized ......" I don't know why I thought I
would have an epiphany on the 10th ride anymore than
I would on the 9th ride of what has become an annual
event for my family. It would be like me expecting some
sort of revelation this year because it is my 25th
year of practicing medicine since medical school. Although
we all have our 'ah-ha' moments, they usually are not connected
with anniversaries.
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BRAN http://www.bran-inc.org
is an annual bike ride in early June, which covers
about 500 miles over seven days. The route is different
each year, but generally starts in western Nebraska, and ends
near Omaha. Although Omaha is a great destination, (ranked
third among the "Top 10 best cities in 2008" (Kiplinger's
Personal Finance-2008), eighth for "Best places to Live for
Affordable Housing" (CNNMoney.com-2008), first on the list of
mid-size "Best Cities for Relocating Families" (Primary
Relocation & Worldwide ERC-2008), second among the "Best Concert
Markets" |
(Radio Advertising Bureau-2008), and one of the top 4 locations
for appreciation of the arts and hospitality to artists
(Artist's Magazine -2008)), for this ride, it is getting there
that is the most fun.
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It's hard to describe the appeal of the ride.
Perhaps it is the remoteness of western Nebraska.
http://www.westnebraska.com/index.php As author
Ian Frazier describes: "Remote, by definition, is a place
that's hard to get to. It's a place that, partly because
so few people go there, is lacking in the irritations and
troubles of home. Which is why such places seem so attractive
and appealing." It might not be a good ride for a mountain
biker, but for a road biker, it is paradise. |
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For a medical student that wants to practice emergency
medicine, the destination is to become board certified in
emergency medicine. To get there, you must complete a 3 or
4 year residency program. You want to be sure you choose a
program that has some things that are appealing to you. In
general ways, all programs are very similar, but in specific
ways, they can be very different. It is important to know
what you are looking for.
Preparation for the ride has become part of the spring
rhythm. It's time to start training when the cranes start
arriving, the grapes need pruning, Easter is approaching, the
lawns need mowing, the daffodils are blooming, the redbuds are
budding, and the morel mushrooms need hunting. If you wait
until the arrival of the 35,000 pilgrims to Omaha each spring to
attend Warren Buffet's (the Oracle of Omaha) Berkshire
Hathaway's annual meeting (the Woodstock of Capitalism) in early
May,
http://www.fatpitchfinancials.com/1468/ultimate-2009-berkshire-hathaway-annual-meeting-guide/
, you've probably waited too long. At least 20-30 hours riding
on the over 100 miles of urban bike trails in Omaha,
http://www.omahatrails.com/ gets your biking muscles
in shape, and helps you get through the toughest days of the
ride.
Emergency Medicine is still a pretty competitive specialty
to get into. If a medical student expresses interest in
going into the specialty, I advise them to do as well as they
can in medical school. This sounds kind of basic, but I'm
surprised how many students appear to just get by. The
preparation they do in medical school will not only help them
get into an emergency medicine residency, it will help them
perform better during it.
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Adversity is one thing you can count on during the ride.
My daughter once described the experience as sitting on a fence
post for 10 hours with fire ants biting your thighs. Yet
she wants to go back every year. Whether it is too cold
(rarely in the 30s), too hot (sometimes in the 100s), too windy
(oh my gosh), too hilly (yes, there are hills in Nebraska), too
rainy (once you get wet, it doesn't matter), too stormy (we have
seen a tornado, but lightning is more scary), or too many
mechanical problems, there is always some challenge. You
learn a lot about people when they are faced with adversity. |
At the end of the ride there is a real sense of
accomplishment. A sense that by doing this; you can face
about any challenge, physical or otherwise. Despite the
difficult days, it takes only one day riding on an isolated
country road in the middle of nowhere with the wind at your back
allowing you to coast up hills as well as down, or one evening
eating the church ladies apple pie, or one night looking at the
un-light polluted stars, which may not answer why you were
created, but makes you grateful you were.
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No matter how you look at it, residency is
tough. There is a lot of recent discussion regarding the
issue of resident work hours and patient safety. I am glad
these issues are being taken seriously as we train our next
generation of emergency physicians. But regardless of the
improvements that will be made, there will always be difficult
patients, difficult attendings, difficult rotations and
difficult shifts. Preparation helps, but many times,
endurance is the most important quality. |
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Fortunately, you will also have grateful patients,
mentoring attendings, great shifts, and understanding colleagues
sharing in the experience, which will make you thankful you have
chosen Emergency Medicine. |
Soon, six of our residents will be finishing their ride with
us. This will be our 3rd
graduating class, and they have been a joy to train and work
with. For some, the journey will end in Omaha.
Others will end up in Sioux Falls, Council Bluffs, Des Moines,
and Newark. We look forward to following their progress as
their careers unfold. My wish is that the wind will always
be at their back.
We had another successful match. Seven medical students
will come from Nebraska, Missouri, North Dakota, Minnesota and
California. They have assured us they will take their training
wheels off before they get here.
The department has been busy in other areas. Dr. Tran
and Li have made continued progress with the basic science
program. Two post docs have been added, an R-01 has been
submitted, and an AHA grant is in preparation. Dr.
Adhikari continues to make progress in the clinical scientist
program. He too will be submitting an AHA grant. The
rest of the faculty has had numerous abstracts, presentations
and publications this year.
Our visitors this year have included Drs. Dave Sklar and
Steve Seifert from the University of New Mexico. It was
good to see old friends again.
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We said goodbye to two faculty members. Dr. Oakes
followed her husband back to Canada. She contributed
greatly to the department, and will be missed. Dr. Jackson
decided to go to a clinical practice in another city. His
contributions to our group will also be missed. We
have welcomed two new faculty members.
Dr. Kirshner came from Texas to be our new poison center medical director, |
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and Dr. Hernandez will stay after residency to join our
faculty next year. We look forward to
their enthusiasm and growth as faculty members.
Hillary Rockwell, one of our graduating residents, got
married and should consider getting a tandem bike.
It was another fruitful year for our faculty and
residents as Drs. Bott, Mahapatra, Adhikari, Lindgren,
and Dean all welcomed a new member to their family and
need to add child seats to their bicycles. |
If you are looking for a good ride, consider training with us.
I can't promise there won't be some hills and headwinds, but we
will help you fix your flat tires.
As for the epiphany, it was "...that we should look into the Bike
Ride Across Rhode Island next year." Maybe an epiphany
will lead you to look into our program next year.
Robert L. Muelleman, MD, FACEP
Professor and Chairman
Department of Emergency Medicine
Please click on the dates below to read the previous letter
from the Chairman.
2003
Pioneer Spirit
2004 Crack Train
2005 Foolish Kinship
2006 Heaven or Omaha
2007 Crane Watch
2008 Grape Vines
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