I was looking at the back of my shoes today, and thought that the logos were printed at an angle … until I realized that my SHOES were at an angle! Looks like internship has taken quite a toll on my soles. My first rotation on a ward service has taught me the importance of having a pair of comfortable shoes that will allow me to run between 8 different floors of the hospital building and still go reasonably well with a pair of slacks. The other thing I’ve learned on general medicine is how much I can hate my pager. As a med student, we wore our pagers like a sheriff’s badge, a symbol of responsibility. Of course, back then, we were just paging each other about what to order for take-out on call nights. But now, with pages ranging from ICU call-outs with acute shortness-of-breath to cross-covers threatening to leave AMA because we won’t feed their narc addiction, the buzz of the pager has come to evoke both a sense of fear and aggravation. I can hardly wait until my upcoming vacation, when I’ll be pager-free for two full weeks.

My elective in medical management has been quite a change of pace from intensive care medicine. Last week, I left the confines of the medical ICU and stepped onto the 11th floor of Prudential Tower, the headquarers of Partners Healthcare Systems. Formed in 1994 by the Brigham and MGH, Partners has become the dominant operator of hospitals and other healthcare facilities in this region with a revenue of $6.5 billion. The reason for its success stems from the ability of organized providers not only to negotiate with payers, but also to provide better and more efficient medical care. Of course, this requires a think tank of businessmen and lawyers whom I got to interact with. From boardroom meetings on public relations strategies to contract negotiations with insurance companies, the experience opened my eyes to the world of corporate medicine. But more importantly, the rotation also gave me my weekends back – allowing me to revisit MGS4 and also check out the new game Spore. From the creator of the Sims, the game encompasses all of evolution. Playing a clearly non-Christian god, you control the fate of an organism from a single-cell stage swimming around in primordial soup to their future as a civilization exploring other worlds in space. So far the game shows some potential, but I’ll have to see if it has good enough replay value for my vacation later this month.