Thursday, April 22, 2010

Bicycling New Haven

The Spring weather in New Haven is turning into a nice perk of being at Yale. It makes it incredibly easy to hop on my bicycle to commute and for errands. So in honor of Earth Day, I thought I'd post some critical elements of my bicycle commute that have helped me bike through all four seasons.

1. Get a bike that fits. If it hurts to bicycle, you won't do it! I'm 6'4" and weigh a sturdy 240 lbs BEFORE you account for the messenger bag that could carry one of my smaller co-residents! I shopped around for big boy commuter bikes and settled on a 25" Trek 7.3. I don't have to jack the seat up super high and I like how hybrid handlebars can let me ride home leisurely after overnight call and the frame lets me lean into rides for exercise. It's also very nice not to have to stop pedaling between standing and seated positions! So far it has helped me ascend both San Francisco's hills (when I spent a month working at the county hospital there) and the winter streets of New Haven without any problems. I got the factory model, which I'd probably do again, although I've had to tune the gears a few times and let my chain get too rusty through use on the heavily salted streets.

2. Find a safe route and stick to it. If you know your route like the back of your hand, you'll be familiar enough with traffic patterns, potholes and the more dangerous intersections to predict trouble spots. That way, you can also focus on ice spots, playing kids and other potential threats to your balance. I use the Orange St. bike lane until it ends and then the regular lanes until turning right on the sleepy Crown St. on my way in to the hospital. Several other bicyclists take this route so drivers are almost used to seeing us...

3. Secure your bicycle in a safe place. I got a key to the enclosed bike locker across the street from the hospital. I keep my lock there (NOT OCCUPYING A PRECIOUS STALL!) so that I don't have to lug it around. I park my bike in the same safe place every day and then walk to wherever I need on campus.

4. Find a shower at work. I've located 4-5 that I can use in a pinch. Not only is this useful if you sweat, but also if there is a downpour and you need to refresh. It also helps that my work uniform is always available in the form of a scrubs locker. Otherwise, you will need to bring in clothes. When I needed to wear a tie, I kept two pair of dress pants in my locker and carried my shirts in with me every day.

5. Waterproof packs, whether they be over the shoulder (hurts my back), saddle bags (not for me) or a full-on messenger backpack are vital. Otherwise you will worry about your clothes, papers or computer getting wet and you will break down and drive in.

6. Clothes are important, but you don't need to overdo it. I wear sweats with cheap rain gear or windbreakers as needed most of the year. Warm gloves are vital when it rains or when it's cold. In the summer, I'll don the biker shorts & suspenders, but then you run the risk of co-workers pointing out that you forgot to put on your pants as you walk in... But then again, I also wear a fluorescent reflective construction vest to draw drivers' attention to me.

7. Biking at night? You cannot have enough flashers or reflective tape and clothing. I'm up to 7 lights and am looking for more to clip on to my backpack clothing and helmet.

8. Be nice. I admit, I am an aggressive biker. But I observe traffic or pedestrian laws (whichever is more convenient), and only pedal between two lanes if it's clear I can cross with the walkers. Otherwise, if you ride in the road, observe the rules of the road. If drivers don't like that you are riding at the speed limit or with the flow of traffic, I'm always aware of an out should they try to run you off the road. And never assume that a driver sees you.

9. Learn about your bike. I can't true wheels, but I've tinkered with my rig enough (and watched people who know what they are doing) to do minor repairs. When in doubt, take it in to have a professional work on it. But if you need to do a quick fix, it helps you stay out of the car to know how to change a chain or adjust the shifter.

10. Have fun. I ride only to commute. But I live near East Rock Park, which has a challenging ascent. If I'm up for it, I'll divert to there on my way home. Or if you see a friend walking home, take the opportunity to stop and say hi. Having portable transportation makes interacting with your community easier!

Happy Earth Day from New Haven!

Thanks to my cousin-in-law for inspiring this post by asking me about my Robey-sized bicycle.

Monday, April 19, 2010


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Wednesday, April 7, 2010

Journal Club

This morning, I will be leading a journal club discussion for the Yale-New Haven Hospital emergency medicine residency. The topic is "Fight or Flight in the Face of Epidemics: Making a Case for Codes of Ethics." We will be looking at some of the ways codes of ethics succeed in shaping physician behavior and where they might break down.

As an icebreaker, I am asking my colleagues to put themselves in the context of various disasters to think about how they might respond. Since all three questions are New Haven-themed, I thought I would pose them here, as well!

1. A SARS-like illnes broke out in NYC two weeks ago. There are 76 fatalities, including five physicians and 7 nurses. Boston just reported its first death, and there are 5 patients in YNHH with the disease. Will you:

A. Volunteer for MICU coverage
B. Come to work as usual
C. Call in for backup
D. Head for the hills

2. The Indian Point (north of NYC) nuclear reactor's cooling system was sabotaged by an environmental terrorist group, resulting in a meltdown that was not properly contained. New Haven is in the predicted fallout area, but the extent is still unknown. Will you:

A. Sign up for surge (ED surge that is) duty
B. Work for the first few days, then leave town
C. Avoid the chaos entirely

3. Hurricane Zelda slams Long Island Sound in a late season perfect storm situation. Manhattan experienced a storm surge of 15 feet, incapacitating the health care system in NYC. New Haven has flooding, but the hospitals still function. FEMA and the military are looking for docs to staff tent hospitals. Would you:

A. Stick around to treat the victims of this disaster
B. Get out of harm's way but stay close enough to help radiation-contaminated victims
C. Take an extended holiday yo the West Coast

... and now, your answers please!