25 October 2013

Journey to Ithica

Medicine:

It's difficult to stay motivated. I'm disenchanted with my job. That is not to say I don't like my work, as I love learning and neurology, just the work I'm doing in the hospital has drained my soul over the last three and a half years. Stupid, blind bureaucracy, dotting my "I"s, crossing my "T"s, having to kiss ass and bow to certain hierarchy loving bosses; these things are wearing at me heavily. I have received a couple of poor "evaluations" secondary to my absolute hatred of the hierarchical system that some of my (foreign) bosses were raised in, and have grown accustomed to.

http://blogs.riverfronttimes.com/dailyrft/Lick%20my%20boot.jpg

I often question reasoning behind (unnecessary) imaging and (futile) plans of care for patients in a rather blunt manner, which is likely perceived as confrontational as my disdain is thinly veiled. Defensive medicine bothers me, especially when it is not in the patient's best interest.

In a meeting with my mentor we decided that, for my own sake, I should just keep my head down, work hard, and get through it (please reference image above). I also need to work on not showing my disgust and hatred so openly on my face, as it has been noticed...

Time to fucking lick boot... 2.5 years to go).

Combine all of that fun, with some financial strains (~$400k student debt for me, close to another $100k for my wife, etc), and it's easy to see why my soul is fading fast. My wife has noticed this more than me though, and is, with increasing frequency, mentioning how I am too negative, too jaded, for someone who has been in practice for such a short time.

I am excited (though cautiously optimistic) about my future possibilities in spite of diminishing reimbursement potentials with this "affordable" care act now in full bloom. I'm working on starting a concussion clinic, as well as forming a new 'sports neurology' fellowship for myself at Michigan State. Sports neurology is a specialty just in its infancy, but with all the press regarding concussions, there stands to be a large demand for neurologists with expertise in concussion (not to mention myself with considerable collegate, amateur, and professional sports experience).

I find it hard to keep myself grounded in the process of learning. "The journey" is something I need to learn to enjoy, not just worrying myself with the end-goal of finishing my training and being a 'real' neurologist. 

An excerpt from "Ithica" I believe is appropriate here.

"Always keep Ithaca fixed in your mind.
To arrive there is your ultimate goal.
But do not hurry the voyage at all.
It is better to let it last for long years;
and even to anchor at the isle when you are old,
rich with all that you have gained on the way,
not expecting that Ithaca will offer you riches.
Ithaca has given you the beautiful voyage.
Without her you would never have taken the road.
But she has nothing more to give you.
And if you find her poor, Ithaca has not defrauded you.
With the great wisdom you have gained, with so much experience,
you must surely have understood by then what Ithacas mean."

I guess this can be extrapolated, as the message is salient for many things in my life. (Medicine and residency, as well as weightlifting/training.)

Weights

Still rehabbing my shoulder, with some improvement. I was able to rack/front squat 225 for a single this week. I'm continuing to do DeFranco's shoulder rehab, which includes hundreds of band pull-aparts, YTWL's, face pulls, etc. Additionally, I've been working on my shoulder external rotation. I still cannot do overhead work... Soon.

I keep having a slight desire to do some crossfit workouts. Since starting crossfit a decade ago, I have occasonally done a WOD or 2. I, at one time, had a 3minute Grace and Fran (at 110kg bodyweight), and could rock a 100kg Grace in under 8 minutes. Last week I did the "Bring Sally Up" challenge at 135lbs. (~30reps of a squat with some 4 and 10 second pauses in the hole).  It lit my quads up, and my legs were shaking for the rest of the workout.

My ego got the best of me, and I decided to try it again with 225. I threw my belt on, and tried... and failed...  I got halfway through the torture (15 reps). I found myself progressively melting under the bar in the hole. It got ugly, and was probably dangerous. For the life of me, I dont think it hurt my hip though.

My current lifting plan is based off of Jay Ashman's program. "The A.S.S. Book"- Basically it has alterations of lightweight and heavy weight rotations. It makes a solid month of training. It allows for personal selection of exercises as needed, which is good for us with program ADD. I can't stick to a program for the life of me. I'm giving this a solid go, and constantly going for rep records or max weights depending.

I had not done more than singles in the deadlift over 500lbs for the last few years. Since my failed 600 deadlift last month, I've been doing rack pulls with good effect. Last week I actually trippled 500... twice from the floor. Bench on the other hand is a bitch to me like always... Since dropping from the 270's to the 250's my bench has slid. 295 for a triple was hard last week.  I think I need some technique work; finding the proper amount of 'elbow tuck', when and how much to flair (if any?). Things like this I need work on.

Current setup is 4 days of lifting (bench, squat, deadlift, overhead), 2-3 days of conditioning per week.  Though, I can't really hit heavy squats  or overhead (I'm substituting incline press for overhead, and likely high-rep and pause squats and heavy deadlift partials for squats)

Diet:

Current Wt: 256
Just coming off of night shift, I'll be blunt: My diet has been shit. I've been eating whatever my wife makes or gets (Chinese, pizza, whatever.) I do curb my carb intake most of the time, but I'd say 3-5meals/wk have been absolute shit.Through all the shit, I still tried to push 250-300g protein...

I'm considering adding in some fasts again, as its a bit hectic to get all my meals in during 'normal' work weeks... We'll see... I want to get to the 240's solidly by December.

I'll accomplish this by continuing to do my conditioning work, Limiting my carb intake to Periworkout only. (~100g), On off days I'll either be threading in Protein (shake) Sparing Modified Fasts, or just staying very low carb (<30g).

I just need to be diligent with my food-tracking...

With that said?-   I dont know what to feed my daughter most of the time. I eat meat, some veggies occasionally. She... doesn't love my food. Shopping for her at the grocery store is difficult, as I put my prejudiced against most foods that kids eat. "No, dont buy her mac n cheese, that's all carbs."... Fuck. She's a kid. Not a performance driven machine. Maybe I just need to find some healthy kid-meals that are easy to make?...