I started to get into rock climbing about 5 months ago and recently it has been the only physical activity I’ve been engaged on a consistent basis recently. I been taking it pretty slow, trying to nail down easier climbs, improve my strength and endurance, and develop my climbing IQ before jumping into higher level climbs. What I’ve enjoyed about climbing is that each one is a puzzle, and as you move to more difficult climbs it doesn’t just get more physically demanding, but it also requires you to think more critically and creatively, and just like with mental puzzles, even when you get it wrong the first time something about it has you coming back to try it again to figure it out. There is not just one way to do any particular climb, but there usually is a “best” or “lowest effort” way. The freedom to fail and to try things out and work slowly is something I’ve missed since being back in school, so it’s been nice to have this as an outlet.


When talking about seizures, we often talk about a postictal state – a period of altered consciousness or fatigue after seizure stops. I only recently made the connection between that term ictal and something I learned about back in high school marching band. Ictus refers to an inciting event and is often synonymous with the onset of a seizure. In music, the ictus is like a recurrent beat and in the case of conducting, I was taught that the ictus was the bottom of my arm strokes, which indicates the exact moment of the beat (can also think of it as the apex of the stroke). I’ve known both these terms, at least since I was in high school but didn’t realize the connection/ similarity until my attending said the word ictus in clinic the other day (usually when talking about seizures we always hear -ictal).

I don’t have a deep life-lesson or reflection to glean from this realization, I just thought it was interesting.

Existential Crisis

I recently found out my entire existence up to this point has potentially been a lie. As long as I could remember, I lived believing I was a Sagittarius. All the basic astrology sites and calendars I’ve used told me November 22, 1995, the Sun was in Sag. Turns out at 7:00 AM that day, it was still in Scorpio. Every horoscope I’ve read, every personality reading rendered based on my birth chart, became a complete and utter farce. The thought had crossed my mind before since my birthday is right on the cusp and some astrological calendars consider Nov 22 to be in Scorpio depending on the year. But this was the first time I actually went through the trouble of confirming (as far as I could recall).

As I was planning out all the changes I would need to make to my personality, wardrobe, lifestyle choices, etc. I thought I’d better double check the time of my birth with Mother. I immediately called her with an urgency befitting the situation. She didn’t pick up, so naturally I called 3 more times before I decided to give it a rest for the time being.

Eventually, she called me back and confirmed that I was in fact born at 7:00… PM. So crises everted and the world will be ok. I moved all my bedroom decorations back to the way they were earlier that morning and canceled my appointment with the tattoo artist.

Neurology – Day 4

It can be hard being constantly confronted with the massive gap between where I am at and where I feel like I should be. That sad I do feel like I am making progress each day, even if small. Over the few days I’ve been able to go into clinic I definitely have had many opportunities to practice my Spanish and slowly I am feeling more comfortable with basic conversation.

I need to work on just being more comfortable with some material so I thinking about localization and stuff is just second nature. This is going to involve just making a lot of mental connection between things.

Dried Out

The snake plant in my room as looking pretty dried out. It’s a hearty plants and it’s still green, but it just looks a little more wrinkly than it did before. I tried to give it some water yesterday, but it still looks a but dry. It prob needs more than the little trickle of leftover water I gave it. I haven’t been taking the best care of it, but thank goodness for it’s resilience.


Different people have different standards for what they are are willing to accept for themselves. And those standards can change over time and depending on specific circumstances. Sometimes things that seem like the end of the world at one point seem pretty insignificant in another. If at any point something seems insignificant, does that mean it ever was actually that important? We should be constantly asking ourselves what we are willing to accept for ourselves, and what things are trivialities(?) in the bigger picture.

(1) People watching
(2) Christmas markets with local vendors
(3) Shared retail/vendor spaces


When I see the lines at the In-N-Out drive through (literally every one), I can help but wonder if all those people actually think this is the best thing they’ve tasted in their life, or if In-N-Out is a master of marketing and culture and have elevated their food and brand beyond a source of sustenance and into a symbol (a symbol of what I can’t say). It always blows my mind that people wait as long as they do for a meal at In-N-Out. Don’t get me wrong it is a decent burger and a great price (though looks like even they aren’t immune to inflation) and they do an excellent job keeping things moving despite the crowds, but to willingly subjecting yourself to 30 mins a car queue that is 17 cars deep seems a bit much.

(1) Snake plants
(2) Self Checkout at Target
(3) People who use their blinkers


Coffee, beer, veggies, wine, dark chocolate. What makes us crave things that objectively leave a bad taste in our mouths? Is it the abstract knowledge (not sure if I’m using this term correctly) that their consumption has some type of desirable property outside of its flavor (i.e. stimulation, intoxication, health benefits, etc.) or is there something about the bitterness itself that we actually crave or is there something about these things that we seek out despite the bitterness and despite the their effects. I supposed it could be, and likely is, multifactorial as almost everything in this life is. Even when we subject ourselves to some form of physical or mental hardship (e.g. exercise, studying) there is both some form of direct and future reward that is motivating us in the form of endorphins and health/ vanity or the elusive flow state (neural mechanisms not well understood) and job prospects. Wouldn’t it be more advantageous to experience all these things as pleasant through and through? C’mon evolution! I guess that would make for a very boring life.

(1) Small, hidden, out of the way watering holes.
(2) Very large doors.
(3) My dad’s parallel parking formula.

The Option

Sometimes I wish my eyesight was just slightly not good so I could have the option to wear glasses. I always thought they looked cool, but I also realize that this is probably a terrible thing to wish for. So I guess I’ll just have to settle for wearing my blue light glasses in the privacy of my home and appreciate a more refined, intelligent looking Niko all by myself.

(1) Vision
(2) DIY YouTube channels
(3) Quilted blankets that aren’t too thick

Surgery – Day 18/19

This is the longest day I’ve had in medicine. I wanted to be on non-trauma today so I could be on the trauma service on Friday when I would expect to see more actual trauma. Today we were nonstop with non-trauma consults pretty much from pass-on (ends around 8:30 AM) through about now (2:00 AM the next day). It’s kind of gone by fast, but now that I have a second to rest the fatigue is catching up with me. I can’t wait to go home and sleep in 7 hours.

(1) Fanny packs.
(2) Surgeons who don’t take themselves too seriously.
(3) Nurses who keep doctors in check.