Aquarium Update

Here are some of the latest additions to my obsession/hobby:



The tank is a 37 gallon tank with 110 watts of light at 6700K from a homemade fixture. It's CO2 injected with a paintball cylinder, regulator and pH monitor. The plants are Anubias nana and barteri, some green crypts, java moss, baby tears, purple cacomba, dwarf hairgrass, amazon swords and red leaf ludwigia. I'm still working on cultivating the plants and adding more to the tank. I regularly dose fertilizers (nitrate, potassium, phosphate, CSM+B) and maintain the tank at pH of 6.8 with 6 degrees of KH.





Bosemani Rainbow. The male is more brightly colored than the female. I have a juvenile male that is kind of intermediate between these two color wise but he is kind of shy with this dominant male around



Kribensis dwarf cichlid (complete with a nice string of poop)/ I tried to get rid of this fish because it seems a bit territorial but I was never able to catch it so its just chillin for now. I can't believe how fast it is when it wants to be. It seems to just putt around the tank very slowly most of the time. It took out most of my juvenile shrimp and also seems to snack on young Ramshorn snails.




TRUE siamese algae eater. This fish earns its keep. It eats hair algae like there's no tomorrow. I highly recommend this fish for a planted tank but make sure it is not a false siamensis or a flying fox. Do your homework so you know what to get. It seems to be a bit territorial around chow time with my Cory's which is atypical for this species but it hasn't done any harm so I think its just trying to be social. I purchased it when it was about 2 inches long and it has at least doubled in size. The girls call this one 'the Mommy fish' because its the biggest one in the tank right now.



Corydoras sterbai. I really like this fish and it's a great scavenger of leftover food. They get harassed by my SAE and the Kribensis but so far no major problems. It kind of reminds me of a mouse and occasionally rolls its eyes which makes it look like it's winking. This female occasionally lays eggs but none have ever been fertilized. I have a pair of these and it is pretty much the only fish I have left from my original setup. (See below) I lost some of my fish to infection and traded in a lot of the originals. Since I added a sterilizer, I have not had any problems with fish loss unless they were in poor shape on arrival.



Cardinal Tetra. I have about four of these left over from my attempt to acclimate a small school to my tank. Its hard to find a well handled group from the local fish stores but they make a great addition once they survive. They get a little bigger than Neon tetras and are much more colorful.



Olive Nerite snail. I had a horrible time with brown and green algae on my driftwood and plants and finally discovered these guys on eBay. I bought 5 and they cleared my whole tank of algae in about a month. They also clean my filter intakes and heaters. The only drawback is that they lay little white eggs everywhere. (white dots on the snail itself and see the driftwood pic above) They can't hatch in freshwater but they are a nuisance and attach tightly to everything, including other snails. I'm hoping the egg laying will slow down in a few months but for now I can put up with these better than algae.

Pediatric Surgery

I finished up Psychiatry and Neurology last month and moved on to 'The Big One' : my surgery rotation. I am currently on the pediatric surgery rotation at Nationwide Children's hospital and am loving every minute of it. I have seen a lot of really cool things this week. Yesterday I spent about 12 hours in the OR and then took call overnight and got to scrub into an emergent perforated duodenal ulcer repair. I have seen repairs for kids whose insides were on their outsides because their abdominal walls didn't form correctly (Gastoschisis), bowel resections, splenectomies, skin grafting, appendectomies, incision and drainage of abcsesses, feeding tube placements and takedowns and a variety of other procedures. Surgery at the student level consists of a lot of retracting, cutting and tying off sutures which may seem pretty menial to most of the other students but I love every minute of it.

Last night we were performing an exploratory laparotomy, which is just a large open midline incision and exploration of the abdominal cavity and organs, on a poor little kid who was pretty sick. The kid's CT showed free air in the abdomen which is a sign that there is a hole in the GI tract somewhere. This can be a life threatening condition so we operated in the middle of the night. The surgeon's found and patched a perforated ulcer in the patient's duodenum. At one point the surgeon asked me to stick my left hand inside the abdomen and check for adhesions around the liver and asked me if I felt anything. It was nice and smooth. "You're a surgeon now." he joked.

The surgeons at Children's are great. They are all very friendly, remember my name and try to teach me new things even at 4:00am when I'm sure they would rather just hurry as fast as they can and go back to bed. The patients are great, too. We have operated on kids from 6 months to 20 years old so far.

I think the most incredible thing about pediatric surgery is the hope that these people can provide to these patients and their families. I can imagine nothing more nerve racking or devastating than finding out that your child has a major birth defect or has been severely injured and needs a major operation. Wonderful advancements in surgical technology have turned potentially catastrophic problems into manageable conditions, many of which have very good outcomes.

Pediatric surgery is a 2 year fellowship which is completed after a 5-6 year general surgery fellowship. It is extremely competitive to get into and most fellows have taken time off for research. Essentially, most fellows have around 10 years of training after medical school by the time they are done with pediatric surgery training.

Update: At this point I am planning my 4th year courses to prepare to apply to General Surgery residency. I will blog more about my decision in a little while.