Rural Rounds

The year began wonderfully and quietly, and I believed it would turn to be an excellent year. Then on January 10th, or 11th, Pam Miller committed suicide. I received a phone call from John Drage informing me of what had happened. We hadn't been very close for quite some time, but Pam Miller is possibly the person most responsible for who I am now today. I believe there are God-ordained moments in time that influence our entire lives, and for me one of those moments came in the winter of 2002, the second semester of my freshman year at MU. I had grown apart from the friends on my floor I had initially made when their desire to go party and drink and my desire to stay sober led to our no longer hanging out quite so often. On a Saturday night I sat in the 4th floor lounge of Hatch Hall playing old school Nintendo alone, and most of the floor was gone doing other things. Pam Miller suddenly appeared passing through, and having met before she saw me and came and said hello. She invited ...

Last weekend I was able to attend the Global Missions Health Conference in Louisville, Kentucky. The conference is on Christian missions-field medical and health care work, both nationally and internationally (although international medical missions is overwhelmingly represented). I attended the conference with one other person, Halley, a nursing student I am friends with who heard of the conference through the Nursing Christian Fellowship group. We left town together on Thursday night last week to be able to attend the whole day's sessions on Friday. Being a six-and-a-half hour drive from Columbia (seven and a half when factoring in the time I drove in the wrong direction), we arrived in Louisville at 3 a.m. central time. Louisville unfortunately is on eastern time. After a two hour nap on Friday morning I awoke shortly after six to get over to the conference. The church that it is held at is so big you could fit my entire hometown's population inside the building (West Plains...

I apologize in advance for the length of this post, but it will likely be a week before writing again due to a busy schedule at the moment. So sit back and digest this in pieces if you like (although, if you want to know when you can see Dr. Peppers in action, scroll down to the last heading). I've provided some headings for breaking it up a little bit. Today was the second time my APD (read: advanced physical diagnosis) group met over at the VA hospital. This time however we were actually able to see patients, thanks to Dr. K, who is the resident paired with the attending in charge of our APD group. Dr. K had a talk with us about how she understood we needed to see patients in order for this to be a learning experience at all, and we proceeded to the second floor wards. Today we saw three cases. This week's cases: VA Hospital Mr. H was an elderly man who had developed pneumonia and a pleural effusion in his left lung. He was cooperative with allowing student doctors to exami...

Today was the Rock Equippers retreat. Basically, the equippers retreat is a day long getaway out of town somewhere where the small group leaders can gather together, be encouraged, share stories, and have John Drage remind us of what we have committed to as leaders and renew our commitments to ministry. One of the verses John shared in his introduction of our time together was 1 Peter 2:9. It says: But you are a chosen people, a royal priesthood, a holy nation, a people belonging to God, that you may declare the praises of him who called you out of darkness into his wonderful light. - 1 Peter 2:9 The verse is exceptionally powerful. I was reminded of the following quote: "It is a serious thing to live in a society of possible gods and goddesses, to remember that the dullest and most uninteresting person you talk to may one day be a creature which, if you saw it now, you would be strongly tempted to worship....There are no ordinary people. You have never talked to a mere mortal....

***Note, some of this material may not be suitable for those sensitive to squeemish topics. Those sections will be starred for your own warning*** Last night was my first day of ACE (Ambulatory Care Experience, basically a glorified shadowing patient-seeing experience before your clinical years) and this block I am doing my ACE in the Emergency Department. I was apprehensive at first, not because of what I might see, but because having volunteered there as an undergrad I was not given much to do in terms of volunteer service. In fact, they acted like they didn't know what to do with me. I called the ER to get the passcode for entry shortly before 4 p.m., and then, donning my white coat, proceeded down the hallway leading towards the west elevators and turned the corner towards the ER door. I let myself in, walked confidently up to the first person manning a desk station, and asked for the attending. There were two that night, and I was recommended to go to Dr. D. Introducing myself...

In psychiatry, there's a set of three patterns of thought that are observed in depression known as the cognitive triad. The cognitive triad consists of the following: A negative view of oneself A negative interpretation of experience A negative view of the future Outside of clinical depression syndromes, I feel it adequately describes the pattern of thinking in any episode of depressed mood. Having tried to think through my own periods of moodiness and depression, I've found that the mood often exists and persists only when all three patterns of thought are present. More on this later, but first a breakdown of how the triad has occured in my own thought process. To start, I've had a decent amount of difficulty with self-esteem, and with large groups of people social anxiety as well. When I begin to start feeling depressed, it will often start with "a negative interpretation of experience". Usually with people this manifests as an anxiety that the person or people ...

Last week was the end of block test week, and at the very end of the week, on Friday, I left for Mexico, Missouri for my church's annual 22-hour retreat. For the last two years it has been perfectly scheduled to coincide with the very end of test week and the beginning of break week, and both times so far has been an incredibly refreshing way to escape the world of academic medicine and the bustle of the city. "Cell phones don't work out here," I mused on the drive out to the camp. The camp where we hold our retreat is several small buildings owned by a Baptist church group out that way that allows us to use it each year. The property is the size of several football fields, with a creative array of fields, wooded hollows, remnants of a creek and some runoff lanes between rises in the ground. There's a lake with a dock that is the perennial wilderness baptismal. There's also a barn-like building that now serves as a chapel. A firepit next to an outdoor ampithea...

The summer research jump from last year to this year has been quite a step. I did a small research project, not too terribly important, last summer, that was published in a free online-only journal (in other words, not a real big deal, but worth being proud of). This past summer, I worked on infectious disease research in the pediatric department at the University's Children's hospital. My mentor, Dr. Mato, gave me and my classmate Amanda assurance that we would most definately see our work published. Yesterday, when I dropped by Dr. Mato's office while up on the pediatrics floor, she spoke of submitting my research for the Pediatric Academic Societys' annual meeting in Toronto for presentation. If my work is accepted, it would mean the chance to present my poster and research in front of doctors and researchers from across the country. Being only a medical student at best, I was humbled to find out she sees us presenting research amists other researchers who have done ...

Today I attended my fifth (yes 5th) wedding of this year. No one else that I know of is getting married before the end of the year, and that's good, because one season of giving wedding gifts is enough to break the bank. I easily spent an undisclosed large sum of money altogether on wedding gifts. Sheesh! Weddings can be incredibly wonderful, and sometimes difficult. Incredibly wonderful predominates however, as I am usually very excited to be able to participate in a lovely couple's special day and celebrate with them. Difficult sometimes in that if I'm not careful I can either 1.) start to feel the wedding-fever creep up and make me feel like I need to start looking for my own wife-to-be, or 2.) remind me that I haven't gotten to that point of finding someone to marry yet. I'm glad that for today's wedding, I was able to avoid falling into both traps. Now, about the wedding. Aaron Ferguson and Stevi Davis had known each other since I can remember. I had always...

Four weeks of school have gone by faster than should be allowed, and I'm already looking downhill towards my first test week of the second year. I'm thankful that Labor Day weekend falls right at this point; the three day long weekend will give me some chance to catch up. I have unfortunately been spending too much time in the evenings to socialize with those who come to visit (which, in the last two nights, has been a lot of people over). But I also think, maybe that's fortunate, because I know how easy it can be for me to fall into a sense of loneliness if I don't get enough contact with people, especially the kind that leaves me feeling as though I've been able to connect with others. I was asked today by my friend Davey if school has started to be stressful yet. I find it unfortunate that I usually feel stressed in general about school. Having a perfectionist attitude combined with school not being exactly the easiest thing in the world causes me to stress. What...

Lately, I've been thinking about Tyler. His desk chair and his electric razor are two things of his that I kept (many people who knew him took items that belonged to him, to put them to use instead of going to trash and to remember him by). Sitting in what was once his chair, I can "visit" with him, in a sense. I know others who knew him are doing the same when they look at pictures, or what they kept of his. "You are the salt of the earth. Buf if the salt loses its saltiness, how can it be made salty again? It is no longer good for anything, except to be thrown out and trampled by men. You are the light of the world. A city on a hill cannot be hidden. Neither do people light a lamp and put it under a bowl. Instead they put it on its stand, and it gives light to everyone in the house. In the same way, let your light shine before men, that they may see your good deeds and praise your Father in heaven." --- Jesus, Matthew 5:13-16 This was the foundation for my fri...

It's been all about the S the last few days. On Saturday (ironic, it starts with an 'S' day), my battery in my Jeep completely died a sudden death. There was a plastic sleeve attached to the battery that contained the purchase receipt. Purchased in 2002, well that explains it. It took about 10 - 15 phone calls to actually find someone available to take me to O'Reily's (I was trying to work out in concentric circles from my house), but I finally got a new battery. The guy testing the old one simply said, "Yup, it's dead," with a total resignation telling me that there was no hope in rejuvenating it. New battery, check. Now I'm mobile again... Fast forward to where I'm headed west on Stadium. A loud thunk followed by an instantaneous loss of power steering control, coupled with a drop in battery voltage from 14 V to barely 10 V, and a slowly rising engine thermometer told me something was wrong with the Jeep. I drove to HyVee's parking lot, p...

Originally Aug, 3rd In the last week and a half, I think that I have been asked "How are you doing/feeling?" more times than I can ever recall in such a short period. I had talked with someone about how reflexive it is for me to simply say 'pretty good' and push off the question. The truth is, I have not been good, and I don't know how to answer that question. The truth is, I want to talk about how I am doing, but often don't see so simple and common a greeting as a gateway to really opening up about how I feel. The truth is, I have probably still withheld a lot of feelings and problems I have dealt with in the last twelve days than most people are even aware of, and not because I don't want to share them. I haven't shared everything that has been going on because I don't know how to share it. I don't know if I should share it. I don't know how honest I can be about how I feel. I love my church community. I can't stand my church communi...

Sometime Friday, July 21, 2006 "Hey James, it's your mother" "Hey mom." "Your dad was told by work he has to go to Conneticutt on Sunday for two weeks on business...come down this evening so you can go golfing and boating all tomorrow instead." 6:00 p.m. Friday, July 21, 2006 "Alright Tyler, I think I'm headed out. I'll be home Monday sometime." "Alright, see ya bro, have a good weekend." 12:32 p.m., Saturday, July 22, 2006 "Hey James, this is John Drage....call me back." I had been out golfing that morning with my dad and younger brother. On the way home my phone rang at least once, but I decided not to pull it from my pocket since I was driving and I thought it was likely someone from Columbia , where I wasn't currently at. Once home I listened to the message. I still didn't suspect anything beyond that John wanted to talk about something (I thought possibly fall canvas group stuff). I called him back aro...

I'm in a halt with research lately, since there are no more subjects I can currently gather data on. Why is that bad? Because I start class in the second week of August, and because I'm not even halfway to finished with this research project. Why can't my research move forward? It's because the billing department's wonderful worker who's been helping us has not been able to find subjects using the search method she is employing. Also, she's a tad slow in getting work done and to us in a timely manner. In other news, my grandparents came to visit on Friday of last week. I love my grandparents with a passion. Age has definately awarded them wisdom. It has also awarded them humor. The highlights: Grandma: "Want to go in that Lakota place and get some coffee?" Grandpa: "We can't go in there, we're not carrying laptops!" "Those fancy coffeeshops don't have senior coffee. I can get one for $.50 at McDonald's" - Grandpa...

Here we are. The very first works of James: artist, future doctor, gardener, superman (maybe that last part is an exaggeration).

I've had a $25 gift card to Wal-Mart just lying around for over a year now, so I decided to use it today. I had earlier had the idea to possibly buy a canvas and some paint, and paint my own abstract or contemporary-ish art to hang in my room or somewhere around the house, to add some color. I figured it would be cheaper than buying something, and nicer than a poster. Well, I went to Michael's first, and their painting supply is high-dollar. Disappointing. I later found some 16"x20" canvases at Wal-Mart, as well as some cheap acryllic paint. I bought primary colors and black and white in big $1.67 tubes, more than enough for the canvases (maybe I can make more art later). I also bought a candle, and a wooden box in the craft area that I thought looked nice for a dresser organizer (I put my keys, watch, cufflinks, etc., in it to take away clutter). It feels good to be able to beautify a living space, even a temporary one. Having a creative flow at times, be it art, fur...

I've been reading the book The Provocative Church lately, and must say I give it two hands up and an amen. Reading this book will jump in the face of everything you thought evangelism was. Once not long ago (as in, beginning with my entrance into college and up until just recently) I felt very guilty regarding evangelism. The book hit this to a T when it sums up that most Christians feel that evangelism is something that ought to be done, but they don't readily do because they don't know how, they don't feel good at doing it, or they don't want to subject friends to a church that they themselves are bored and unfulfilled with. I have always wished to evangelize, but have always had the principle hindrance in feeling that it does no good to talk about God to someone who isn't really curious. And, to that end, I've simply strove for Christian progress (see Justification, Sanctification, Reconciliation, in a previous entry). This book holds that just such an ap...

I went to see The Da Vinci Code last night with Thane. He wanted to see it after reading the book, to see how the movie compares. I wanted to see what the hubbub was all about without reading the book. Boy, was a silly little story. I believe it's been out a couple weeks now, and it is probably going to be pulled from theaters real soon; the Forum showing we went to had five people watching it, including Thane and me. Thane says that the movie isn't completely like the book, and that it fails to embellish certain very important parts that in the book were elaborated to no end. Afterwards, we both drove back to my place and Thane came in for a while. We had been discussing the movie, and religion, and other things. Eventually we started talking about faith and apologetics and evidence of the truth of Christianity. Thane was telling me about what the book Case for Faith is like, and his intentions to read Case for Christ later on. He made an exceptional point in an exceptionally ...

"There are two great lies I've heard: The day you eat of the fruit of that tree, you will not surely die And that Jesus Christ was a white middle-class Republican And if you wanna be saved you have to learn to be like Him" - Derek Webb, A King and a Kingdom Lately Tyler and I have had lots of discussions on the subjects mentioned in the title of this post. To use a second quote from Derek Webb (I know, two in one post!), "A lot of the songs on Christian radio are just outright misrepresentations of the character of God." I want to move that beyond radio and music, however. I think that it is far too easy to fall into the trap of putting God in a box, as they say; for someone to write a book that gives a suddenly new "insight" into who God is and what He's about. It's also a problem to assume to have correctly interpreted the Bible, which has for centuries been hotly debated as to what it means or instructs in many instances. What strikes me as ...

This past weekend I had the honor and privilege of being an usher in my friends' Joe Wallington and Liz Thorne's wedding. I was the usher on behalf of the bride, my longtime friend Liz, and was given the opportunity to take part in the wedding not merely as an attendee, but as a participant. I arrived in St. Joseph on this past Friday (May 26th), a day before the wedding. I didn't leave early enough to attend the rehearsal, assuming that as an usher, my duties were relatively straightforward. I had received an invitation to the rehearsal dinner, what I imagine was once termed the betrothal feast in a period not so long gone from the present. It was a spectacular event; the dinner was at an Italian restaurant in an older building in the slowly reforming downtown of St. Joseph. The rustic appearance of the restaurant, combined with the fantastic cousine, made me experience the event as something of a bygone age when weddings as multi-day events were the norm. Washing down the...

I stole this from Scott's blog, who got it from someone else. I found it entertaining so I decided to repost it here. Instructions : Use the picture you like best from the first (no clicking around for 44 pages) page of the search results on Google Image, and then answer the following questions. 1. The city and state of the town you grew up, no quotation marks. Ah West Plains Missouri. Small town at it's finest. 2. The town where you currently reside. Columbia, MO lies between St. Louis and Kansas City on I-70. It is the home of the University of Missouri Tigers, the famous Broadway Diner, open 11 p.m. to 11 a.m., and the recently released Quinn Snyder. 3. Your name, first and last, no quotation marks You may think that I'm a Beatles fan for posting this. I like the Beatles, but really I post this because my dad was a sargeant in the army. That's right, Sargeant Peppers. 4. Your grandmother's name Willa Ottersbach didn't turn anything up, so I went with Wil...

SERUM MARKERS OF INFLAMMATION AND ENDOTHELIAL FUNCTION ARE ELEVATED BY HORMONAL CONTRACEPTIVE USE BUT NOT BY EXERCISE-ASSOCIATED MENSTRUAL DISORDERS IN PHYSICALLY ACTIVE YOUNG WOMEN Hinton PS, Rector RS, Peppers JE, Imhoff RD, Hillman LS Department of Nutritional Sciences, University of Missouri-Columbia, USA You can index me in PubMed after June 2006.

So I've been away for a while now. Last week was our spring break (yeah, we had a week off a couple of weeks ago too. Yeah, I went to Guatemala that week with a group of Christian medical students. Yeah, it was great), and I went home to see family for the first part of the week. Once back in Columbia however, I was living it up and not studying at all. I had brought back my hunting rifle from home, so me and my friend Ben went out to Finger Lakes park to shoot. He had a stake target with spinning ping targets. It was made of ~ 1/2" steel plates. He pinged it several times with his Sig Sauer 9 mm. Unfortunately for Ben, my .308 can shoot right through 1/2" steel. Unfortunately I didn't know that before I shot a hole in his brand new target. The rest of the week was spent going running, playing basketball, making amazing homemade pizza, and building a headboard. I built this with my friend Aaron's help. Now, I've got a sweet headboard where before was plain whi...