Hey all
Merry Christmas! Hope everyone is having a nice holiday. I have been very fortunate in that I got Christmas week off so I came home over the weekend and get to spend a few days at home. Last week was pretty busy though. I had to give grand rounds lecture so I spent most of the week preparing that. I don't think anyone is a fan of public speaking so I just had this horrible feeling of nausea the whole week in anticipation of giving the stupid lecture. Anyway it went well overall and I was just happy to get the dang thing over with. Between staying up late to research and waking up early to round it was one of those crazy weeks that went by quickly.

I've had this blog for just over two years. It's always amazing to reflect on how fast the time flies. I don't know if I've grown so much as a person since I first started this, but I've made some progress. Hopefully as a doctor I've learned a little bit in the past two years. My co-residents and I are always like...did we know anything in med school? Although when I'm an attending I'll probably think the same thing about myself as a resident.

I've been thinking a lot lately about what I want to do with my career. You always get asked what you're really gonna do after residency and I've been purposely avoiding the answer. But now my residency is exactly half over and i can't keep putting my head in the sand. I've purposely not mentioned this but my specialty is internal medicine. (three years) I have ideas of what I don't like but that passion that's supposed to grab me just isn't quite there.

I've also been considering staying on to do a chief residency year but again I'm not sure about it. There would be a lot of advantages to doing it and as my friend says you can only be chief once but I'm not terribly excited to spend another year with my salary in the dumps. Surprisingly I've become interested in hem/onc (blood disorders and cancer) over the last few months but I have no aptitude for research so I know that probably wouldn't be the best field to go into although I like the clinical aspects of it.

The point of all that rambling is to say I gotta do some soul-searching. In the meantime, enjoy the holidays everyone and start working on those new years resolutions. Some of my role models below. :)

hi friends
i'm back from vacation. it was only a week, really too short (as all vacations are) but a great trip all the same. the two things i wanted to talk about in particular are 1. my naked yoga experience and 2. coming out to my best friend from medical school.

the nude yoga experience was wonderful. i'm really glad i got to do it. as a physician i'm constantly violating people's personal boundaries so i don't find anything particularly exciting about nudity. it is definitely powerful though to participate in a non-sexual activity naked. it is just so liberating to be free of your clothing. our instructor was just very straightforward and told us to get undressed and that was it. then there we were, a small group of naked individuals ready to do some yoga. while there was a little bit of self-consciousness upon first getting naked, once we started practicing i really just kind of forgot i was naked. i had not done yoga prior to this, but i liked doing the yoga itself and honestly doing it nude just seems like the most perfectly natural thing to do. maybe it seems silly to think that having everyone naked would build closeness but i definitely think it adds something positive for everyone to be themselves, naked and simple. if i lived in that city i'd definitely be a regular. i would highly recommend you check out whether something like it is offered near your home. try it once!

i stayed with one of my best friends and i had decided before i came that i would tell him i'm a big homo. the first night i got there we went to a bar for some drinks and i met his girlfriend. we had some drinks, she had to go home, then we moved on to another bar to meet some other friends from medical school who also work in the city. being nicely lubricated by all the drinks by the time we got back to my friend's place, i knew i had better do it then or lose that opportunity for the rest of the trip. so i told him that i knew that he knew i was a big homo and we had a nice deep conversation about it.

rewinding a little bit, i've known my friend has known i'm gay since about 4th year of medical school. basically a guy i hooked up with had also hooked up with an openly gay guy in our class who happened to be in one of our circle of friends. that classmate had told my friend about me, i had found out my friend knew from the guy i was hooking up with, but i was too indignant my friend would know all this but not mention any of this to me so i didn't feel the need to confront him on the issue. very dramatic i know.

anyway, i finally told him officially on this trip and it went as well as it could have. i actually wish i was a little less drunk -- i get this anterograde amnesia pretty easily when i drink not even too heavily now-- but we had at times an intense conversation that would have been nice to remember all the details. we talked about a lot of different aspects of my being gay, like why i've hidden it for so long and still hide it from the public at large, and what i really want as far as a relationship and all that. one thing that i remember telling him was that i am just afraid of being hated by the people i love.

i am afraid of being hated by the people i love.

i am afraid of being hated by the people i love.

i am afraid of being hated by the people i love.

that hit me the hardest saying it out loud and it brought me to tears to say that. i think it's the concept that has most paralyzed me from being open about myself. blah blah i know all that crap about the people who really care about me won't care about who i sleep with at night but it is just so hard to overcome that fear of being judged. although at this point in my life i don't really care about being judged so much as finding the man i want to be with for the rest of my life, it's still a reason i'm not shouting from the mountain tops that i'm a faggot. but i am so happy that i finally told my friend the biggest glass secret in our friendship and i'm encouraged to go further from this point being honest about who i am with the world.

Hey all
Hope everyone had a nice holiday. Thanksgiving is my favorite holiday so I was really looking for to it. Unfortunately I had to work Friday so I couldn't go home home for the holiday but I had a nice little dinner with some of the other residents. Now I'm home and I'm on vacation for the week so I'm excited to take a little break from work. I'm going to be visiting a big metro and staying with one of my best friends from med school so it should be a good trip.

My STD symptoms are gone..I decided to just prescribe myself antibiotics rather than get seen again. I'm pretty certain I got some atypical urethritis and there wouldn't be any good test to get a diagnosis so I just went for the doxy. Yea I know, not the most kosher way to do things but doctors do make the worst patients. Anyway it was an interesting ordeal to say the least. I doubt it will do much to change my sexual practices. I still play safe for anal but I just could not bring myself to get blown with a condom on.

Phone guy is out of the picture. Yes I realize the whole thing was really fiction without any true commitment to meet for real. It was a powerful thing though. As much as it sucks it didn't work out for all the insane reasons you guys warned me about, it was nice. At least I have hope that I could find something like that again. It's funny there's that saying about plenty of fish and now with all our stupid phone apps and online sites you'd think it'd be even easier to find a good man but I almost think this over-connected world makes it even harder to really connect meaningfully.

In unrelated news I saw this story on naked yoga the other week and I found the idea intriguing. Yoga would definitely be a good way to meet some positive-minded men and the chance to do it naked, why not? I looked up both naked yoga and gay men's yoga in my city and alas neither is offered. But where I'm going on vacation will potentially have a class so I'm gonna try to get away on my own and try it. I'm a sexual deviant at baseline but aside from that I just find something very liberating about nudity. Trust me I don't have a Sean Cody model body but it's just nice to be naked. And to be able to participate in a group naked in a non-sexual way sounds very refreshing and like a great experience. So I'll let you guys know if I get to attend and if you're in a big metro check it out and see if anything like it is offered and try it out and report back!

i received my test results today. negative for gonorrhea and chlamydia (GC and CT). WTH??? i don't know what to make of these results. i thought for sure i'd have something. to make matters worse i'm still having a little bit of symptoms so i don't think i've been treated completely.

i'm not sure whether to believe the GC/CT tests. the urine sample i gave was a midstream sample when it's supposed to be a first-void sample. i was pretty sure the urine for GC/CT had to be first-void (meaning the urine when you first start peeing) versus midstream (taken when you've peed out a little) but i asked the nurse and she was like, "oh give a midstream sample!" so i did. i don't know how much that affects the test results but when you get results you don't believe you look for any little thing. i did a literature search on first void versus midstream and it shouldn't make that much of a difference but i'm still doubtful. yes being this anal about how a urine sample is collected is why i'm a doctor.

ideally i wish i could have just done a urethral swab and gram stain on myself and just made a definitive diagnosis. i was even thinking last week, how hard would it be to get into the hospital lab and set up my own slide without raising any eyebrows. but then i remembered i would have no idea how to set up a gram stain anymore so that option was out. nerd science talk out of the way, i'm not sure what to do next. my options:

1. be re-seen by a healthcare provider and do whatever they want, then quietly dictate what care i actually want. (by the way we hate patients who do this)
2. treat myself with a cocktail of antibiotics.
3. be seen by the public STD clinic.
4. ignore things for a few days then decide what to do.

4 is very tempting (well they all are), but realistically i'll probably do 3...and maybe still politely suggest they do all the things i want them to do if they don't suggest it themselves. i'm just hoping there's not something more serious or weird going on. i'm actually wondering whether i got the urethritis from rimming/oral interchange but as you might imagine it's hard to find good data on that.

on a side note, i wonder how my care would have been if i didn't mention that i was a doctor. i was seen by a PA and she picked up fast that i knew a little healthcare lingo and we both knew why i was there. after she said she'd run the urine tests that was the last i saw of her though and some nurse came in to give me my butt shot and my discharge papers. i was a little disturbed because 1, the nurse forgot to mention that i had a prescription for the pills i needed to take and 2, the prescription technically wasn't written correctly and i got no instruction otherwise.

the treatment for gonorrhea is ceftriaxone 250mg IM (intramuscular..aka the butt) and azithromycin 1000mg by mouth in one dose. the azithromycin is for added activity against gonorrhea (but is not sufficient treatment alone for gonorrhea) and also for presumed co-treatment of chlamydia. (since they frequently run together) anyway the script for the azithromycin was just written out as a standard z-pak, so if i was a regular person i would have gotten the pills and taken it the wrong way and still potentially be infected. that's just bad healthcare. i'm giving the PA that saw me the benefit of the doubt that she did things that way 'cuz she knew i would know what to do and otherwise would have explained things out to me if i was just some regular slut off the street, but who knows.

the point is, make sure you know what your doc is trying to do to you and always ask questions if you don't know what the hell is going on. yes we hate when patients ask questions but you guys deserve at least a few answers.

anyway i'll keep yall updated...hope this is all not TMI, but better to live vicariously through me than experience it yourself.

well two embarrassing things to talk about today but i'll be an open canvas and share with yall.

1. re: phone guy, he ended up calling me the day after i posted so i felt stupid for writing a post freaking out about it. he had dropped his phone in the toilet and had trouble getting back his data including my number. so i was relieved to know he wasn't dead or critically ill. i should have made it more clear but i did try to contact him in that week so i presumed something was up from his lack of a response. thanks for your comments though..i did like the one comment from an anonymous poster who said, "Welcome to gay dating, where people will be all about you one moment and completely over you the next."

anyway that was a relief to hear from him to know that he was not completely over me and had tossed me aside. we got back to our routine but then had a discussion about where this was going and if we were ever going to meet each other for real. a little bit difficult to rehash exactly how the conversation went, but basically he is still adamant about not wanting to get truly involved while i'm in residency. in fact, he doesn't even want to meet. he says he doesn't want to be a distraction to me while i finish but obviously i think there is a lot more behind that. i know it's difficult to convey to you readers, but we have a definite connection, and i think he is scared to meet me for real and fall in love and be stuck in this long-distance relationship. i know he's a hypersexual guy and that would be hard for him and all the baggage that comes with a long-distance thing. but as i tried to tell him (and some of you have pointed out), how can we know any of this is real without seeing what the chemistry is like in person? but he doesn't even want to give it a shot.

so that left us with what are we doing with each other now? why are we even bothering wasting our time talking if it really won't go anywhere for the foreseeable future? as you can imagine, now we are trying to emotionally separate ourselves. yes i've been setting myself up for this over the past few months. but i was happy to. this (sadly?) was the deepest relationship i've had and if anything at least i know the possibility of the intense emotional connection i want from a man is out there. i don't believe in soul mates but at least i know there is probably another man out there who is right for me. it may still end up being phone guy. i don't believe the story is closed with him, but for the time being it's being laid aside.

2. i very likely contracted an STD. i started having symptoms at the end of last week (painful urination, penile discharge..gross i know) and against every bone in my body i went and got seen at an urgent care over the weekend. i swear if the treatment for gonorrhea was a pill and not a shot in the butt (which i got, and FYI it hurt like a mother for a few hours) i would have just prescribed the damn medication to myself. but i went the more ethical route and got treated officially even though any monkey could diagnose an STD.  the official test results will come back in a few days so i'm at least interested to see what it is. i think it was probably a non-gonococcal urethritis as the discharge wasn't as copious and purulent as is typical for gonorrhea but who knows. and while my symptoms weren't that bad, in general, having discharge from your cock is a horrifying thing.

so comes the point of how i got it. i've actually been dating a guy for the past month and i had last seen him about two days before i started having symptoms. i've talked to him about it, and i have been the only guy he's been with, for several months actually. and i believe him. he told me he actually had had a little dysuria a few weeks ago after one of our dates, got tested, was negative, and didn't tell me about it 'cuz it was negative, which i also believe. that just leaves me wondering how exactly this cycle worked. i certainly believe i'm the more promiscuous one and if anything i gave something to him, which he gave back to me, although ironically i wasn't sleeping around while dating him so i guess my infection predates me ever going out with him.

this was all based off oral btw. if you have ever thought that oral is safer than straight up raw bareback anal sex, you are very wrong. both gonorrhea and chlaymdia can infect the throat, and they may not necessarily cause symptoms, so one can end up being colonized by these bugs and pass it on unknowingly. so every time you suck a dick or have someone take yours, you take that risk of getting an STD. but obviously no one likes getting sucked oral with a condom on -- i can think of maybe one situation in the past where a guy has wanted to use a condom for oral to be safe - it just doesn't happen in the gay (or straight even) culture.

so if you thought oral sex was safe, i hope i've enlightened you. if you already knew that there was risk, but did it anyways, at least let me be a cautionary tale that infections are out there. i obviously have been aware of the risk of STDs even with oral sex, but i have always chosen to ignore that risk, and here i am today. it is also important to note that resistance to gonorrhea is increasing, especially in the 'men who have sex with men' population, meaning it is very plausible down the line that we will not have an effective treatment for gonorrhea. very scary thought. i'm actually a little concerned because i'm going into almost 48 hours post-treatment and i'm still having some symptoms..oh geez i hope i didn't hit the jackpot and get the resistant bug.

will this experience change the way i practice sex in the future? i don't know. i sure like getting and giving oral without a condom. but i also don't like crazy disgusting discharge coming from my dick and shots in my ass.

i do know that i will be celibate for awhile as i think about this infection and about phone guy. kind of a sucky one-two punch this week.

interestingly this all happened when i've tried to be a good boy and date and take things in the right steps. i've hooked up with dozens of guys and done some very, very questionable things in the past, and escaped for the most part without any problems. i certainly have more than deserved something to happen to me, and i guess here it is. i will do the right thing and try to contact any sexual partners in the last 60 days to tell them to get checked and i will be getting checked again for syphilis and HIV in a few months. (i was recently checked but gotta check again after a diagnosis of an STD)

i guess my point of all this is, no one is immune to STDs, not even the doctors who treat them. i'm not thrilled to be sharing this news with the internet and if you want to judge me for having an STD that's fine with me. i think it's funny that society is like "ewww STD!" but is like "sex? great!" you can't really have it both ways. the risk is always there and i think it's important that we all get a reality check that infections happen. but you make your decisions and live with the consequences. just don't be surprised if it happens to you. be educated, be as safe as you can be, and be honest with your partner(s). and don't believe what anyone else tells you about being "clean"!

hi all
well since my last post i thought things were going as well with phone guy as they could for that kind of situation. but for the past week i haven't heard from him at all. i missed his call the last time he called me which was last weekend and he was a little drunk at the time but his voicemail was normal and didn't hint at anything being wrong. and he sent me a message the day after so i know he at least wasn't involved in some accident that night.

now though it's been almost a week and i've had no contact from him. ya ya i know you guys were all skeptical about this situation to begin with, but i don't think he'd cut off all contact like that. i just can't believe he'd be so busy in the last week not to give me a call or send a message when we've been talking or at least in touch nearly every day for the past two months. the scenarios of what has been going on with him have been running through my head, from the more innocuous ones to the more morbid ones.

i don't know how worried i should be about this. unfortunately other than by phone i have no other way to contact him. we never exchanged emails or facebook or any online type thing. i do know where he works and what he does so with some sleuthing i could devise a means to contact him there. although the problem there is i don't know his last name---it never really occurred to me to need to know that about him. when do you ask somebody their last name? that's something i never actively try to find out about another guy but maybe i should start doing that...

i don't know how crazy stalker i should be about this. by phone i think i can only wait for him to contact me but i'm seriously wondering if i should try to find out his work contact info if i don't hear from him in another week or so. if he's lost interest in me that's fine but i at least want to know he's safe. there are certain things that have been going on in his personal life that just give me this nagging feeling something sinister has happened.

this whole thing is and has been insane i know. yall are probably shaking your head, but for me--and i think him also--this has been very real and i just don't think he'd leave me hanging like this.

i'm glad i'm not the only one who's noticed.

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