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Al's Internal Medicine Grade

Internal Medicine Grades came back! Finally!

Al copied and pasted the info from the school website:

Tanner, Allen 2009

Final Grade for this clerkship: Honors (H)
NBME Score: 77 NBME National Percentile: 69

Summary Comments on Student PerformanceComments for inclusion in the Medical Student Performance Evaluation (MSPE)

The final evaluation of Mr. Allen Tanner for the twelve week junior clerkship in Internal Medicine from July 9 to September 28, 2007 is based on 1) the subjective assessment by faculty and house staff of the student's performance on the medical wards of two hospitals and in the outpatient setting, 2) the NBME Internal Medicine Subject Examination, 3) the assessment by an observing faculty member of the student's ability to take a medical history and perform a physical examination, and 4) the written histories and physicals performed by the student.

A summary statement of the student's evaluations is as follows: Mr. Tanner showed excellent skills in gathering information through history and physical examination. His knowledge of medicine was described as excellent at this point in the student's education. His utilization of data for decision-making in diagnosis and patient management was excellent. Mr. Tanner developed excellent relationships with patients and co-workers. He demonstrated a high level of motivation.

Comments made by evaluators were: "Mr. Tanner played a very important role in our ambulatory care clinic. He was thorough in his histories and physical exams. He was able to propose a good differential diagnosis and treatment plan He would telephone patients to inform them of their test results. His performance is clearly above average for a beginning 3rd year medical student." "Allen was very motivated and offered to do more work than was ever expected. Very professional. Used Up-To-Date well and appropriately. Enjoyed having him on the team." "Allen did a very good job in evaluating his patients and in his written work. He displayed care that was empathetic and respectful. Very hard working student. He was motivated to learn as much as he could about his patients. Medical knowledge is very good for his level."

Rah! Rah!! Rah!!!

I guess we've found another one of Missouri's passions. Besides baseball, Nascar, and beer they are totally into Halloween. I had no idea.
We drove to the subdivision next to ours, one that is more kid friendly, to do our trick or treating with Avery. When we told Avery we were going trick or treating she couldn't get out to the car fast enough. She was so excited!!

We were pretty amazed at what we found when we parked the car. There were a few houses that had big bonfires going on out in front. A lot of garage doors were open and people had tables set up that were loaded down with hot chocolate, hot dogs, pop, etc. A lot of the neighbors would get together in one garage and have several bowls of candy lined up. They would have you take candy from each bowl and then would try to have you take a hot dog along for the road. Avery got lots of candy, goody bags that had several candies in each of them, bags of popcorn, a full-sized snickers, a hostess ho-ho and hostess cupcake, and a fairly big plush ghost that is holding a pumpkin. Somebody actually gave that to her as a "trick-or-treat."

Avery was so cute at each house. She would hold out her pumpkin and say, "Treat!!" (she conveniently left off the 'trick' part). They would toss in a few candy bars and then Avery would call out, "Thank you!!" So cute! Lots of the people would ask Avery to cheer and she would reply with "rah! rah! rah!"

Most of the houses were decked out with Halloween lights and big pumpkins. One of the houses had a life-sized Freddy Krueger doll waiting for you at the front door. Freddy's eyes would move and he would start talking to you as you approached. Avery just grinned ear to ear when she saw Freddy. The people in the house couldn't believe that she wasn't scared, and was in fact smiling. They got quite a kick out of it.

I don't want to brag, but Avery was pretty popular out there. Have you ever seen a cuter cheerleader??

The Whole Nine Yards...

Well, here we are decked out in our Halloween finery. We've had Avery's costume for months but weren't sure what Al and I were going to do for the big event.

One night I was talking with Sarah and she suggested making it a theme. I went with her advice and dressed as a football player with Al as the couch. Avery is really great at boosting our team spirit :)

Trunk or Treat

Last night was our ward Trunk or Treat. This was Avery's first experience with trick or treating so we were interested to see how she would handle it.

She loved it!

We only stayed for about an hour but Avery had a blast and loved seeing all the other kids dressed up.

Little Songbird

In the past week or so Avery has started to sing songs. It is really cute. At first it took me a while to catch on because most of the words aren't that clear, but when I figured out what she was doing I made her repeat it over and over again.
Avery sings, "Twinkle Twinkle Little Star," "Row Row Row Your Boat," and the "Clean Up" song from nursery. She doesn't sing "Yankee Doodle" yet, but makes requests for it by exclaiming, "Doodle!!"

Some other fun things Avery has learned:

She knows her letter "A" and likes to point it out on things.

She knows the colors pink and yellow.

Avery likes to chew gum. She found some in the car the other day and helped herself to it. She will chew it for a very long time and doesn't swallow it. I'm not sure where she learned this from.

Al has been working the nights and sleeps during the day. The first day Al came home and was sleeping I had to sneak into the bedroom to get dressed. I thought that Avery would stay in the other room playing, but she barged in a few seconds later. I whispered, "Daddy is night-night. He's sleeping." Avery looked at me with serious eyes and put her finger to her lips and said, "Shhh!" It was hard not to laugh.

We have a pop-up Halloween book that I was given several years ago. It is aimed at older kids and is a little on the spooky side. Avery loves to get this book out and have you move all of the things that move or pop out. She gets really excited and giggles or puts her hands on her cheeks and makes a big "O" with her mouth. But there is this one part that absolutely terrifies her and she will burst into tears and run away. I told her that we had to put the book away because it was too scary. A few minutes later she brought me the book again and was begging to read it. I gave in. Once again she loved it until we got to that one part. She ran off crying again. The funny thing is that she keeps bringing me the book, several times a day, even though it creeps her out.

The Pumpkin Patch

Twins!

Today Avery's best friend Em came over to play. We were tickled when we saw that the girls we dressed almost identically--we had to get a picture.

I wish I could get one where they were both smiling, but that seemed impossble. Anyway, they are still cute!

Halloween barette and shirt

I bought Avery this Halloween shirt and barette quite a while ago. Avery likes the pumpkin on the shirt, but really gets excited about the bat barette. Every day since I've bought it Avery has brought it to me at least once a day asking to have it put in her hair. I have even caught her on several occasions trying to put the bat barette in her hair herself. I've explained that we can't wear it until it cools off outside.

Today it was finally cool enough to wear long sleeves. I told Avery that she would get to wear her pumpkin shirt and wear the bat barette and boy was she excited. She was practically bouncing off the bed while I was trying to put the barette in. When I was finished I told her that she had the bat in her hair. At first she looked really pleased. Then she looked puzzled and reached up to touch the barette. I watched as she tried to pull it out of her hair. I think she had decided that it was more fun to play with the bat barette than to wear it. I explained to her that she would have to keep it in her hair. She thought about this for a second and then her bottom lip stuck out about as far as I've seen it go. I wondered how long the bat barette would last.

Avery actually left it in the whole day. Every once in a while she would reach up and touch it, I guess to make sure it was still there.

Early Celebration

Since Al had the entire weekend off after finishing his rotation we decided to celebrate our 4th anniversary a little early. We kind of did a big celebration this year since we have a little fun money from the babysitting job. Al planned for us to spend the night at a hotel and to take Avery swimming.

All of Friday Avery carried her swimsuit around the house and would say, "pool! pool!" I would have to explain over and over that we had to wait until daddy got home from taking his test.

When Al got home we packed and headed off to start our little mini-vacation. There were cookies in the lobby and Avery and I helped ourselves while Al checked us in. We were off to a great start! Then we went up to our room. Avery thought it was the greatest. She was obsessed with that telephone on the nightstand. She would pick up the receiver and say, "hello!" and then proceed to have a gibberish conversation. When she was done talking she would hang up. A few seconds later she would place another phone call. She had a lot of people to talk to I guess.

The pool was great! We were the only people in it and the water was actually not too cold. Avery had a blast swimming around with Al. She mostly wanted him to swim with her, so I was on camera duty. After quite a bit of swimming we sat in the hot tub for a while and then decided to head to dinner.

We ate dinner at Qdoba, which is a step up from Taco Bell and really tasty. After that we did a little shopping and then decided to head back to the room so Avery could go to bed. She had other plans though. I guess she was pretty wired being in a new room and maybe we shouldn't have let her drink sprite at dinner...she did not want to go to bed! At least she was being good. She just rolled around in the pillows on the bed.

Avery has been sick for the last few days and if we had another free weekend we maybe would have postponed the activity, but this was it. It was a terrible night's sleep. Avery was coughing all night, crying, etc. I think all three of us spent much of the night awake.

After breakfast we headed to a mall and did more window shopping. Then we went to kind of a ritzy area and went into some little shops. Lots of antiques and home decor shops. We did make a very important stop to the Lake Forest Confectionary. Al bought our traditional chocolate-covered strawberries. They were delightful!

We made it home pretty early and we all just crashed. Everybody got the medicine that they needed and naps were taken. It was a very fun weekend.

Halloween Cupcakes

I know it is a little early but I couldn't resist baking Halloween cupcakes. Avery gets all excited about the holidays, just like her mom, so I decided it would be fun to make the funfetti Halloween cupcakes.

Al took some time off from studying and helped Avery put on the sprinkles after I frosted the cupcakes. Avery did a couple of them but mostly liked to watch Al do the sprinkles. After every cupcake was finished Avery would look at it and exclaim "pretty!!"

Avery's favorite part of the activity was eating the sprinkles that fell onto the plate and then of course, eating the finished product.

Into Make-up

Avery usually hangs out with me in the bathroom every morning while I get ready and put on my make-up. She is fascinated by the different shaped containers and bottles and likes to line them up along the vanity or on top of the toilet tank. Today started off as usual. She came in and climbed up on the toilet (this is where she sits) and then she carefully stood up to gain access to the make-up. Normally I would agree that this doesn't sound like that safe of a situation, but I keep a very close eye on her.

Anyway, I was in the middle of brushing my teeth and putting my contacts in when Avery reached for my moisturizer. She didn't set it on the vanity like she usually does. Instead she pretended to put some in her hand and rub it on her face. I stopped what I was doing and watched in amazement. She followed with the foundation, like I always do, and pretended to rub that on. She went through my entire routine, except for the eye-liner. It was crazy how accurrate she got the whole thing! I mean when she reached for the blush she only pretended to apply it to her cheekbones! I'm not even kidding. One thing that made me laugh is that she pretended to put the eyeshadow and mascara below her eyes, not on the eyelids and lashes.

After her facial was complete (he he he) she proceeded to go through my hair products and apply them to her hair. Avery is just too funny! She is definitely a girly girl.

Other cute Avery things:

Today Avery gave her baby doll eskimo kisses. This is something that Al and I do with her. It was the cutest thing ever!

Today we went to the post office. They had decorations up for Halloween, one of which was a ghost figurine. I pointed it out to Avery, much to her delight, and she started squealing and had a huge grin on her face. She was doing knee bends and started saying, "boo...booo...boooo!" The post office worker was getting a big kick out of it. I wish I would have had my camera with me.

One of Avery's new favorite games is to have me or Al draw pictures on her magna-doodle and then she gets to guess what the picture is. She will bring us the magna-doodle, set it in front of us and say draw. It is pretty fun and she is really good at it!

Avery will take out Al's deoderant, while I'm getting ready, state, "dada's." and then put it away.

Avery can read!!

Okay. It's not quite reading, but Avery has memorized half of this book! I think it is so cute! The other day I was reading it to her and before I could say the words she started to say them.

I have made up some actions that I do along with this book. Avery not only says the words but she does the actions too. The first time she did it I yelled down to Al and had him come up so he could see it for himself. I was so tickled by the whole thing.

Truthfully there aren't too many words or pages in this book. Every page shows a Sesame Street monster with a different expression on their face and words that describe the emotion. Avery's favorite pages/words are the "sleepy face," "silly face," and "naughty face." She also likes the "worried face" but mostly because it has a picture of Telly monster trying to get away from the bee. Avery just gets excited and jabs at the bee exclaiming, "bee! bee!"

The Butterfly House

On Monday Al, Avery and I went to the Butterfly House at Faust Park. It is only about 15 minutes away from where we live.

We all thought it was really neat! There is a movie to watch about butterflies, exotic bugs in aquariums on display (I didn't like this part), a shadowbox with a map of the world showing what butterflies are particular to certain parts of the world, and a lot more.
The butterflies were in a huge green house that was extremely hot and humid. There are over a 1000 butterflies flying around. You are not allowed to touch them, but they fly around and land on you and are everywhere!! There are also tons of exotic plants and a waterfall in the greenhouse.

After we looked around at the butterflies for a while we explored the outside grounds and the classroom that had tons of puppets, puzzles and toys for kids to play with.
Faust Park is huge and has a large outdoor playground and carousel. We didn't have time to do everything, but I know we will go back.

Tower Grove Park

Last week Avery and I met some of the med-wives and their kids down at Tower Grove Park. It is right in the middle of downtown and is huge! We have been there before, for a class picnic, but haven't really explored it too much. There are tons of pavillions, trees, grassy fields, etc.

The activity was to go to the fountains and wading pool. It is free to the public and wasn't very crowded now that kids are in school. They had one bigger fountain and then a ton of smaller fountains that shot water up from the ground--like at Gateway in SLC.

Avery's favorite part was the wading pool. It was only a couple of feet deep at it's deepest point and so she could walk around in it. Most of the time she wanted me to bounce her up and down in the water, or to help her lay on her back or tummy and float through the water.

The girl in the pink Cardinal's baseball cap is Avery's best friend, Em. After swimming we went over to Heather's and Em's house for lunch. It was a very fun outing.

Face to face with a hippo

Al had the day off on Saturday so we took Avery to the zoo.
Avery had a front-row view of the hippos and as you can see one of them swam right up to where she was standing!
The hippos are Avery's second favorite part of the zoo. I tried to get pictures of Avery in the penguin exhibit, but it is too hard. She is always lunging and flapping her arms and calling out to the penguins. Every picture comes out as a blur.
I think these hippo pictures are cool though.

Return to Grant's Farm

On Friday Avery and I went to Grant's Farm with some of the med-wives and their kids. It wasn't nearly as hot and humid and not nearly as crowded, so it was quite a bit more enjoyable.
Avery's favorite part was feeding the baby goats with a bottle of milk. I couldn't get a picture of it because those little goats are strong and I had to help Avery hold the bottle. She was squealing and giggling. The other kids were feeding the goats, but they were more subdued. I think Avery is just much more spirited than a lot of kids. The other moms where saying, "Is that Avery laughing?" Then they would get a big grin on their face. Avery just seems to enjoy everything so much. It makes it a lot of fun.

Ahoy!

Here is Avery in her new dress! I think she looks so cute! I worried if the bow in the hair was too much with the bow on the dress, but I left it anyway. Al assured me that it was good.