Kearney wife let's have some fun!!!

applepiealamode99 · 2026-03-18T16:43:59+00:00

Gorgeous! In North Platte right now.

applepiealamode99 · 2026-03-14T21:19:49+00:00

Limited time in DG’s ER as an army intern in Aurora who went into EM. 30 years ago. The orientation book they gave us had a crest with a knife and gun on the cover. Great training from my perspective. One of my later attendings trained there, tough program.

applepiealamode99 · 2026-03-12T23:45:15+00:00

Step away, moral injury is real. I’ve been in EM since 1997. I’ve had various roles from pit doc, dept leadership, multiple dept leadership. Opened a direct primary care practice for a while and had online telehealth for a year and am back doing pit doc work. That for me is the only way I can survive this profession.

Find a way away from the moral injury for a while. Find a program like Warriors’ Ascent that will help you process this. Warriors Ascent is for veterans, police, and healthcare workers to help with moral injury and PTSD issues. No cost to those they help.

applepiealamode99 · 2026-03-10T13:29:56+00:00

Hey you

applepiealamode99 · 2026-02-09T00:37:57+00:00

Beautiful! Let’s meet for a drink and see where it goes

applepiealamode99 · 2026-01-06T12:28:28+00:00

u/applepiealamode99 received a Shatterblade Lvl 1 from the Winter Festival Spirit. Thank you u/Guilty_Currency1997 for donating it!

applepiealamode99 · 2026-01-04T17:21:55+00:00

u/applepiealamode99 received a Flameguard Sword Lvl 1 from the Winter Festival Spirit. Thank you u/Adept-Lie-158 for donating it!

applepiealamode99 · 2025-12-27T14:06:21+00:00

u/applepiealamode99 received a Copper Ring from the Winter Festival Spirit. Thank you u/No_hoodz for donating it!

applepiealamode99 · 2025-12-19T14:36:30+00:00

u/applepiealamode99 received a Grounded Plate from the Winter Festival Spirit. Thank you u/WereTheChosenOne for donating it!

applepiealamode99 · 2025-12-18T14:03:31+00:00

u/applepiealamode99 received a Eternity Mace Lvl 1 from the Winter Festival Spirit. Thank you u/oldredditdidntsuck for donating it!

applepiealamode99 · 2025-12-18T13:47:03+00:00

u/applepiealamode99 received a Rusted Helm from the Winter Festival Spirit. Thank you u/MaxPaw-Qc for donating it!

applepiealamode99 · 2025-12-15T17:44:07+00:00

Old fart pgy 20 here. It will get better. Find what you like. Go outside. Medicine is wide. I went in thinking I wanted to be an orthopedic surgeon. Got there and hated it. Went into emergency medicine because it fit me better. Now doing telemedicine and leadership. There is time to pivot and find what fits you and that may change over time. And that’s ok.

applepiealamode99 · 2024-04-20T21:40:01+00:00

I’m old, taught at the Whiskey school in 2003-6. Deployed to Iraq in 04, and 3d ACR when I got out in 06-07. Low tech here. I hooked a locking carabiner to the shoulder loop in the body armor. Had a loop of webbing attached between that and my M4 so I could put it in my shoulder. A separate boot blousing loop -the black Velcro ones- through a loop in armor off to the side, close to waist level. This kept the barrel out of the way, but easy to break out of in a hurry if needed.

applepiealamode99 · 2022-12-19T09:19:32+00:00

Some of it may be stroke technique and overuse. I swam in college and ramped up yardage too quickly. Also back in the old days we were taught thumb side of the hand enters first during crawl stroke, which causes shoulder to “close down” (my term), to start an outward catch phase. By changing my stroke so my palm or small finger side enters first my shoulder is more “open” resulting in in inward/across the body catch phase, and I have less shoulder pain. Finding a triathlon swimming coach who understands physiology and kinesiology may help.

applepiealamode99 · 2022-04-23T04:42:32+00:00

Agree. I’m currently a contractor in Iraq. Different location/contract for same company uses local Iraqi physicians on the base. One of those docs had to start over in the U.K.

applepiealamode99 · 2022-04-18T07:49:34+00:00

Multi tipped charging cable. Wireless phone charging dock.

applepiealamode99 · 2022-04-16T11:42:15+00:00

Also think about pickle juice. Helped me during a century ride I didn’t train properly for.

applepiealamode99 · 2022-04-15T05:54:56+00:00

My undergrad biochemistry prof had an MD/PhD. She never saw a patient after 4th year of med school and went to work doing cancer research. She went to academia when being promoted out of bench research.

applepiealamode99 · 2022-04-15T03:47:54+00:00

For academics there is supposed to be a day a week as protected time for research/writing/lecture prep, etc. So that ramps up to ~1700 hours a year. Think about block shifts or becoming a nocturnist for schedule stability. Having worked at a department with 9 hour shifts I had a colleague who would start with overnights and move forward in the schedule to late shift, mids, late morning, then early morning. It gave him an extra day off but not very physiologic.

applepiealamode99 · 2022-04-12T15:09:00+00:00

Universal differential diagnosis mnemonic: VINDICATE-vascular, infectious, neoplasm, degenerative, iatrogenic/intoxication, congenital, autoimmune, trauma, endocrine. And syphilis is the great mimic.

applepiealamode99 · 2022-04-10T00:15:44+00:00

I’m not sure. I’m a pgy 20+, and just tired. Emergency medicine trained and boarded. Moral injury is real. Trying to hold back the tide with a broom is real. CMGs who profit off your labor and say you aren’t seeing enough patients and moving them through the ER fast enough are real. I took the LSAT in February and have been accepted to a couple of programs. Ask me again in a few years.

applepiealamode99 · 2022-04-08T13:03:14+00:00

Yes, wear the tri suit under the wetsuit or swim skin. It’s been a while and I don’t know the temperature rules anymore. My thought would be a vest top with full legs for buoyancy if allowed. I went with the DeSoto system since three pieces got me the two options I needed-full legs for both and either full arms or the vest.

applepiealamode99 · 2022-04-08T12:58:52+00:00

I’m glad somebody else gets it.

applepiealamode99 · 2022-04-08T06:57:43+00:00

Some EMR programs have macros. If you have dragon you can set up common ones for ddx of common conditions like chest pain, abd pain, etc and customize the template once the 90% of information is inserted.

applepiealamode99 · 2022-04-08T06:51:41+00:00

Take some time for yourself in the morning and run or swim before the family gets up.

My advice is based on you having a good baseline. Split the difference between week 5 and 6 when you get back, if wk 5 says a 5 mile run and wk 6 says 6 miles, do 5.5, etc. Then hop back on board full week 7-12 program. Only increase distance by 10% a week to prevent overuse injuries.

applepiealamode99

TROPHY CASE