For those who are curious, here's a picture of the tat at age two days. I ignore it, but quietly am proud of it. A great icon of Mt Hood and the water from it and that flows by it. Blame Eli for the pink shirt, it seems I don't dress cool enough for eldest son and need a fashion coach. He even showed me how to tuck in the shirt differently "because it is knit". Ignorance was truly bliss.After two days as an attending on the wards I am reassured that this was a great move professionally. The pathology here is thick and deep. It’s fair to say that we are still ironing out the kinks of emigrating as it were but we are well into it and are for the most part truly enjoying it.Yesterday we had a gentleman with HIV (virtually 90% of all the admissions are HIV+) who had severe pneumocystis pneumonia. This bug causes large cysts on the lung about the size of a grape or larger. In the states it’s rare to have this disease anymore as the new anti HIV meds help to prevent it and if one does get it, rarely does it advance to this stage. The cysts are capable of rupturing and causing a collapsed lung (pneumothorax). If the pneumothorax if from a leak in one of the cysts it might cause the collapsed lung to be under pressure (tension pneumothorax) and the chest cavity can become so pressurized that the heart is shoved over into the opposite side along with the wind pipe (trachea). This guy already had a pneumothorax on one side and now had a tension pneumothorax on the other. The lung under pressure was about the size of a lemon! And the cysts were hanging out there in the apex of it, unbelievable! The med resident on the team slipped in a chest tube as slick as you please and our patient started to act like he was enjoying breathing for the first time in a day.Love to all,Papa, Mike