Caffeine Free in Med 3

New Star Trek top ten

2010-12-05T13:43:00.000-08:00

I checked online today, and I saw that the next re-booted Star Trek is due, supposedly, in June 2012. I wish we didn't have to wait that long, especially since we seem to get a Twilight movie every 6 months or so. So I decided to take a moment to discuss my enjoyment of the rebooted Star Trek. Don't call me a fair-weather fan either. I watched TOS in elementary school and have seen all TOS movies and TNG movies. My husband and I working our way through all seven TNG seasons. If you don't know what any other those abbreviations mean, then you aren't as geeky as I am.

Ten reasons that Star Trek is newly awesome

1. Did you see Spock kiss Uhura?

2. Brand new cool transporter special affects.

3. CGI done right - take note Star Wars!

4. The first ten minutes . . . a birth, death . . . WOW!

5. Eric Bana's over-acting

6. Solving all pesky continuity issues with the alternate universe solution.

7. Young Spock's cool judo throw.

8. No Shatner.

9. Tricked-out Enterprise.

10. Did you see Spock kiss Uhura? Wait, I mean, hot new cast all signed on for two sequels.

Glorious new blog feature

2010-09-13T19:25:00.000-07:00

I know it has been a long time since I updated my blog. Nothing happened to me except residency. As I am less than a year from graduating, I just haven't had time. Besides, rather than tell rambling stories about my life, I'm trying a new feature on my blog: Random Thoughts Top Ten. I'll give a little paragraph about why I am doing said topic. Some of this will be medical. Some of this will be pop culture like TV and movies. Some of it will be from my own life i.e. pregnancy. Hopefully this will motivate me to update more regularly.

Today's topic was inspired by a day off from my ER rotation. I have started rewatching my season 1 and 2 Grey's Anatomy DVDs, now from the resident and future attending perspective.

Ten Things from Grey's Anatomy that never happened during my internship

1. Never made-out (let alone slept with) any other doctor/nurse/tech/patient/desk clerk at the hospital.

2. Never allowed a surgical resident to perform Pediatric Advanced Life Support on any infant - surgeons never attend deliveries.

3. Never performed an unauthorized procedure/autopsy/surgery. Period.

4. Never had the time to meet every day with my friends for private lunch.

5. Never performed a intubation/procedure without any protective equipment.

6. Never deliberately sabotaged a patients recovery to make them sicker, let alone cutting LVAD wires.

7. Never used a call room for a conjugal visit, though I showed my husband the call room once with the door open.

8. Never got in a fist fight with a patient or other staff member at work or outside of work.

9. Never felt any of the patients issues were a direct mirror of the problems I was having in my own life.

10. Never restarted a patient's heart with a paddles or an overly dramatic chest thump after CPR failed.

New job, new life

2008-12-07T10:37:00.000-08:00

Well it's not excatly a new life - but I'm now a pediatric intern at a medium to large children's hospital. Life is weird like that because two years ago I thought I was going to be a single Emergency medicine intern in Ohio.

Internship is kind of rough, it's about finding the balance of work, sleep, and spouse right now. Call takes on a completely different meaning when you are an intern than it did as a medical student. You really are the doctor; you are supposed to have an answer for the problem. (But not THE answer, ask your senior for that)

I'm on my sixth month of internship, and let's see what I accomplished.

July: lots of well baby checks!! Saw my brother get married.

August: step down NICU and first call month. Attended multiple deliveries, saw 2 that didn't make it, and got my first infant intubations and line placements.

September: trial by fire in Peds ED. (Decided not to pursue Peds EM as a fellowship.) Lots of stitching and 2 lumbar puncture attempts.

October: learned alot about peds cancer and learned that to stop SVT you really need to smash that bag of ice on the baby's face.

November: Newborn Nursery - 20 baby checks per day with a gaggle of med students. Also, I'm not going into infectious disease.

December: back in step down NICU, remarkably easier this time as I am not completely lost.

I've still got multiple months on wards, NICU, and wards again before I am a second year. And also step 3.

Wish me luck, and I am still caffeine free (no caffeine since before my senior year in college)

I love to be busy and dumb

2008-05-21T05:47:00.000-07:00

So I have less than two weeks left in medical school. I should be tying up loose ends and making sure I'm ready to graduate. Except that I'm not.

I just volunteered myself to go to the NICU for my last week of med school. I have a free month and the end of my (unnecessary) EM elective to complete. The elective is almost complete, but I've been procrastinating about certain things. When I didn't end up in EM, rather than publicly humiliate myself by presenting at EM grand rounds, I was switched to writing a paper, which actually is much more time consuming than a powerpoint. My EM shifts were moved to Children's hospital. And then I procrastinated about doing those things on account of getting married and going on a honeymoon. So its my own fault.

And yet I wanted to get some NICU experience. The truth is, my peds rotations are going to have lots of NICU and baby experience. The last time I touched a hospitalized baby was . . . last June. I did ICU and ED in adults this past year. I saw a few kids in the Sports Med clinic and the Child protective service rotation was more about socioeconomic issues than acute illness. In fact, I have spent all of 7 hours in the NICU total in my med school career and now I'm going to be a resident in it. I've decided now would be a good time to get some non graded non essential experience so I'm not absolutely clueless.

Maybe not a smart move since I'm trying to move out of my old house, move out of our condo, get promoted a belt level in judo, and finish up all the paperwork/requirements before I leave for residency.

Except I love being busy.

Hey, it's been even longer

2008-05-20T15:34:00.000-07:00

So now in the final month of my medical school career, I get back to posting. Here is a quick summary of what has been going on.

Residency - I matched into Pediatrics. I did apply to both EM and peds since I really liked them both. I also had my significant other's dreams of law school to take into account so my Match list was a mix of EM and pediatrics. I I won't deny that it has caused some awkwardness among some of my EM peeps but what can you do? did get my first choice peds program, which is awesome, and I can't wait to start. (after I enjoy this last month of fewer responsibilities)

Married - I got married in April. We were engaged exactly 5 months to the day. It was wonderful, scary, amazing, and everything in the same time. I can't even being to talk about what it was like. We did the whole Jewish wedding with the Ketubah, Hora, chuppah (aka marriage contract, chair dance, and wedding canopy). We honeymooned on a nice Caribbean cruise, and I can't even start about how lucky I am to be married to such a great man. It is still a little tough to get used to saying my new name and that I am a 'Mrs.'

Sickness - I had my tonsils removed in February for my second peritonsillar abscess. I only burst the scab once and didn't have to be hospitalized overnight for it. Other bad bad news, my dad has colon cancer. We thought we lucked out that we caught it early and it was only stage 2. Our luck didn't last because genetic testing revealed a higher possibility of reoccurrence and he is in a study that gives him some very aggressive chemo. This has been extremely hard on my family. He was able to walk me down the aisle with my mother which was very important to me.

Moving - I am relocating for my residency and my new husband's law school. I am finally moving out of the Midwest to somewhere warm! At least for the three years it will take for me to finish residency. The husband got into a law program he loves - almost like we planned it. ;) It is hard to try to pack everything we own to move to a new state. My brother, who is getting married in July, only has to move across town to his new house.

Med school is ending. Wow, it is really ending and I am going to be a doctor. Wow again.

Ring on the finger

2007-12-13T15:08:00.000-08:00

I know that I haven't posted for a long time - but I have an excellent excuse. I got engaged last month. He did the whole one knee, holding up the box, confessing his love. If you ask me, I'll tell you the whole mushy story. (There are no perfect moments in life, just moments you want to remember perfectly)

So while things were heating up relationship-wise in my life, I was ending my 4th year block of semi-serious rotations. When I say 'semi-serious,' I mean that because MICU and ER were my only two really rough time consuming rotations this year. ICU was July, August was off to do stuff for EM and Step 2, September was hard work in the ED, and October/November were both outpatient stuff. I probably should have been blogging more in that time, but I was getting ready to do interviews and pretend to do wedding planning.

My interviewing actually started with one interview each during my October and November months. I'd have done more in November, but I spent an AMA weekend in Hawaii which used up all my time off. This month I am practicing procedures on cadavers for an anatomy elective that lets me do LOTS of interviews. January will certainly be worse because I think I have 2-3 interviews per week that month. I do have 17-18 interviews and I am going to go on EVERY ONE. (Any med student will tell you that going on that many interviews is kind of crazy.)

It costs a lot to interview, since I have to repeatedly fly to different cities in a pretty large area. I applied Minnesota to North Carolina and was able to drive to about half of my interviews. About half the places provide a hotel and half don't - occasionally I get to stay with family or friends, but it generally costs 150-200 dollars per interview. I originally budgeted about 3,000 for all of interviewing, but it looks like I need to up that amount.

My new plan goes like this. I'll keep interviewing through January, and then I have a February away outpatient rotation near his family/my future in-laws. I'll do an inpatient March month of anesthesia - match that month - and get married in April! Obviously move and graduate med school.

So will I have to change the name of my blog?

9/11/007

2007-09-11T10:43:00.000-07:00

Remembering the day:

Part of my memory of September 11th will be always remembering what I was doing on that day in 2001 and this day in the future. Even if the internet becomes outdated and I stop blogging, I'll think about that day.

What did I do today? I worked the 11pm-7am shift in the ER. It was a relatively long night but somewhat slow. I only saw four patients, which is normal for a med student rotator who isn't planning on doing it for life. I on the other hand usually see about 6-7 patients per 8 hour shift. I was on the road driving home by 7:30am. I talked after my shower to my boyfriend for about 20 some minutes till 8:30 but kept falling asleep. I crawled under the covers and pretty much slept until noon.

When I woke up I started watching TV and the History Channels 9/11 coverage. I was disappointed that more channels weren't covering anything. They didn't even have the American flags up in the corners of the screen. I expected more.

Step 2 CK

2007-09-07T20:11:00.000-07:00

While it seems that test taking is all I do lately, I am just returning from a month off from taking step 2 CK. CK is a nine hour computerized test that is graded on a similar scale to the step 1 test - 360 questions, 60 of which are experimental and the other 300 determine your score. Unlike step 1 instead of pathophysiology, you are graded on diagnosis skills and treatment. In my case, that is a very good thing because EM pretty much that.

Now about step 2 CK, it felt very different than step 1. I purchased the Kaplan Qbank with a friend, and Kaplan questions felt MUCH harder than the real test. I am not willing to hazard a guess on my score, but I feel better about this test. I also took that same month off to take PALS (pediatric advanced life support) and audit ATLS (Advanced Trauma Life Support). Even though they cut into my study time, I feel like I got alot out of them. Trauma and peds are relatively 'high yield' on Step 2 it seemed. They are also pretty high yield on my EM rotation that is just starting.

Passed CS

2007-08-17T12:25:00.000-07:00

Thank goodness I passed CS. I got the results 2 days ago. Good luck to everyone else that is being forced to take it. It's stupid, ridiculous, and (at least for me) over.

Give me my money back CS

2007-07-07T21:24:00.000-07:00

Give me my 1000 dollars back!!! I just took Step 2 CS (clinical skills) in Houston. An entire day dedicated to me 'performing' 'exams' on 'patients.' What's with all the ''? These were standardized patients pretending to be ill, with me pretending to examine them because they didn't have physical findings. I paid about 1500 dollars - the test plus my flight - to do something that I do regularly at my home med school for free. I even have to take another OSCE at my school, but at least they won't charge me.

I cannot say enough bad stuff about CS. Their end of test survey didn't even have a write in comment option to ask how they could improve it. How about not having stupid security measures in which you confiscate my feminine products? Was I planning on writing an entire History and Physical on a tampon? Really? Did we need an hour of boring video orientation in which you repeated the instructions already gave us? Was it necessary to give me a 'warning' for deleting my half finished word when the time ran out?

I will be really pissed if I didn't pass. I'm not really sure how I couldn't have, since I even put some time into preparing and because I've passed every previous CS type practice test with flying colors. I'd say more, but I was forced to promise to not reveal extensive details of this absolutely worthless test in the event that it would help someone 'cheat' on their future test.

This morning . . .

2007-06-12T16:05:00.000-07:00

This morning I was on my ambulatory pediatrics rotation looking at new babies and setting them up for their first shots. While I was doing that, Sarah at died. I recommend reading her blog from start to finish. The last few entries are by her husband when she became to ill to write while receiving treatment for mets to the brain.

Happy 1 year anniversary

2007-05-30T15:22:00.000-07:00

When I started this blog last year, I was writing with a broken heart and belief that I may not be worth anything. I was facing Step 1 and the wide unknown of Med 3 waiting over the horizon. There was lots of anger, lots of freaking out, and general questioning of if I should or shouldn't even keep going. My future seemed to stretch in front of me as a wide expanse of loneliness and unhappiness.

In the past year, I've gone 32 hours without sleep. I lost an election, got written up, and made a few enemies in the medical community. On the other hand, I've delivered a baby by myself. I was referred to as 'doctor' by patients who wanted my advice. I danced with the dance majors at the university and earned a brown belt in judo. I wrote the first third year emergency medicine elective at my school and won the state judo championship. I discovered some amazing people on my rotations and helped some of my friends through what could be the worst times of their lives.

One year later, I am no longer questioning what I am doing. I disagree with many things in medicine, but I do not doubt that I am doing the right thing by being here. I feel that I am stronger and more in control that I was during med 2. Recently, I started reading the blog of a melanoma patient Sarah who is dying, and when she was well enough, she had written about the things she'd delayed or missed because she thought she'd have time for it later. She talked about how fear and the ease of putting things off makes all of us miss things we should be embracing.

That being said, I'm going to open up about something. For the past 5 months, I have been seeing someone, stating that it's nothing serious and that I don't want commitment. I've had this box around myself, insisting that I don't feel anything beyond the enjoyment of hanging out.

To steal portions of the Izzy' Steven's speech:
"I am an optimist. I am hopeful. I am not sure . . . [] I can't promise the future. I can't promise perfection because we're us and I'm me and who knows what will happen . . . "

What did that mean? It means that I am acknowledging my willingness to figure out if I have a future with this person. I'm not ready for 'forever' right now, and nowhere near saying the 'l word,' but I am saying that I'm not going to pretend anymore that I don't care. I see it as a very distinct possibility that things will come crashing down and I will be broken, but unless I open up to the pain, the possibility of falling for him and making things permanent does not exist.

You miss 100 percent of the swings you don't take.

Hiding from my patient

2007-05-28T08:06:00.000-07:00

On my last day of my inpatient peds rotation, we got some imaging from one of my patients. This patient had been in my care for a long time. He was, technically, was an adult but was being treated in peds anyway. Which meant I had a pissed off adolescent teenager who was pretty unreasonable.

Yeah, I said it. Unreasonable. Being sick sucks. I got it. Grow up, life isn't fair. He had a diagnosis that had a long recovery ahead after surgery - scheduled a week away - that my service fought very hard to get approved. He lived in total denial of what was happening to him and had a freak out my last day over the size of scar he will have with screaming and crying that he wouldn't have the surgery. I so much wanted to reach out and shake him, 'if you don't have the surgery you will die and no one will care how nice of a corpse you look!' His ever-present parents were very aware of how bad his prognosis was without surgery.

Before you judge me too harshly, this is not his first freak out. This is like his 20th. I spent alot of time keeping his nurses spirits up, whom he treated pretty badly. His diagnosis wasn't cancer (since I was on a non-cancer service) so it's not like I'm talking about a kid that had been sick for years. This 'kid' can fight for his country, he can vote, he can drive, and he is allowed to make healthcare decisions for himself.

So moving past that part of the situation. We sent him down for some additional imaging. We saw something we didn't expect to see, and it was BAD news. My last rotation in surgery tells me that what we saw changed everything. It was very likely that we weren't talking about a surgery next week with a hopeful discharge for his graduation. We were probably talking about a surgery as soon as they could get the team assembled.

However, without the official word, we could tell the patient nothing. In fact, my house staff specifically told me not to re-enter the room for any reason. We did not have an official read of the results and we did not have a plan of action. The plan was up to the surgeons, and all we would do is upset the family and screw up the care of the patient by not having solid answers.

Thus I hid. It was my last day, but under no circumstances was I coming back to say good-bye to the family. I know myself. They would ask me about the test results, and I would have trouble saying 'no official read yet' without betraying our suspected BAD BAD news. It sucks to say this, but in medicine, until you have an official attending backing you up, you aren't allowed to say what you think.

I was sent home before the surgery team even found out the news. Yes, it is an unsatisfying climax to a story, but that is how medicine can be.

D@mn, it's good to be a doctor

2007-05-26T05:52:00.000-07:00

First class delivery

So you are on a plane and a woman goes into labor. Normally that wouldn't be your problem, except that you are a doctor, which does make it your problem. Even if you are out of your specialty, you probably know more about OB than anyone else unless an OB nurse happens to be there.

Which is why a pediatric cardiologist (Dr. Robert Vincent) and an adult cardiologist (Dr. Dieter K. Gunkel) delivered a baby on a plane. The peds guy almost certainly had more experience with L and D than the adult guy did. Still, judging by their titles and photos of pediatrics guy, it had probably been a good 5-10 years since either of them had delivered a baby in a hospital - let alone a mile above the ground in the first class row.

Having done an OB rotation more recently than either of them, it must have been rough. Especially with the baby going all bradycardic (thank goodness they were cardiologists and were able to HEAR the baby's heartbeat slowing in whatever crappy stethoscope kept in the air emergency kit) Maybe they'd have had their own stethoscopes . . . wait, they were probably attendings and wouldn't carry that.

That being said, I bet Delta will be instituting a new pregnancy policy because its not that often you have docs on international flights. Good thing that there was that cardiology conference last week in Europe, I'd bet.

Maybe they'll start offering reduced prices for flights now if you flash that MD. I can only hope.

Surgery - I just don't get it

2007-05-24T15:08:00.000-07:00

We all know I love the TV show Grey's Anatomy. I watch it religiously and will endlessly talk about it if given the opportunity. However, there is no way that I would EVER become a surgeon after my past rotation and now being on peds. The surgery rotation is made to crush your spirit and is practically a waste of time on account of its overwhelming ineffieciency. Worse, the cracks in the foundation are extremely obvious and it's maddening that everyone has to pretend how wonderful it is. While I now respect the surgeons more, I think that anyone who tolerates this is insane.

So I wanted to make a comment on some of my pet peeves about the surgery rotation. (I am writing this 2 months after I finished it, and I still feel just as strongly)

1)Why am I here at 4:30am? Honestly, I don't really know because the nurses haven't even draw the labs. It doesn't make sense for me to get here this early because WITHOUT labs no notes are complete and pre rounding can't even be done. Most days the labs aren't up until 7am, and you can't finish notes or round without labs. And without rounding, no resident can scrub into the cases.

2)Why can't the attendings round by themselves? My service had six attendings last month. Yes, six. No one could go home until we had rounded as a team with all six attendings. It was even worse when one attending would be very late and decide he wanted to teach. Most fo these attendings rounded on their patients in the am and the pm. They get impatient and pissed off if the team isn't waiting for them to round - perhaps it is because we are rounding w/another attending. Heaven forbid you round by yourself in the am and then communicate to the chief what 3 new orders you put it. Did all of us need to be there to see you replaced Ms. K's potassium?

3)Why can't you use your manpower effectively - aka - why am I even here? The first two weeks on my service were horrible b/c the chief resident insisted on doing things in a 'his way' format that was inefficient and worthless. He was gone for a week and didn't realize we went to a moderately more efficient set up which involved the med students seeing a section of the hospital w/o the residents. When he came back he accused us of skipping out on work and refused to talk to us for a few hours before he asked us what we had done all morning. Heaven forbid we put some organization into our day.

4)What 80-hour work week? As with many other specialties, it is still a joke. The residents are lying about their hours. I don't need another talk about how the 80 hour work week is the worst thing that happened to medicine from someone who has been brainwashed into believing this is good. I can't believe how some absolutely brilliant people can buy into a rhetoric that denies them basic sleep deliberately. I think surgery was certainly the worst of the group with OB and medicine coming in close second and third.

You know, I could go on for a long time about what is wrong with surgery and how we train for it, but it is like yelling at the rain. You can't change the wet, but you can get an umbrella.

That shoulder - she's separated

2007-05-22T19:06:00.000-07:00

So I was having a good time in Peds. Babies are cute and, even when their mommas abandon them at the hospital, Auntie Allie is there to hold them - of course while auscultating with my stethoscope. I had enough time to see the sun sometimes, and even fight in a judo tournament. I did lose a match in overtime on account of being out of shape.

In an effort to push my training into higher gear, I went to judo more. There is a third degree black belt with a hurt shoulder. We were sparring in stand up, and one of the throws went bad. I heard this tearing sound from my shoulder, and that told me there was something very wrong.

Finally got it confirmed by an ER attending - that left shoulder - she's separated. And it will hurt like hell for a month. So it will be the spring of my left arm's discontent.

In other sad news, Veronica Mars was officially canceled. What will MDave and I watch during Med 4?

Hardly partying

2007-05-06T19:04:00.000-07:00

So here from the land of pediatrics, I'm having a less stressful time than on surgery. Well, the patients are cuter and they aren't as annoying since many of them aren't able to talk yet. It is also less hours than surgery, which means I could go out! And when I say 'go out,' I mean 'drink very lightly.'

Friday night: Birthday Blackout
Drink count: 3
In the ongoing celebration of Stacey's and Aaron's birthday, I attended yet again this year. I left judo early b/c I wasn't feeling so hot, but I perked up a little bit after eating dinner. At the party, I missed Sanjida, ran into Donny, MDave, and Ene, and was easily recognized at the 'video well-wisher' from last year. I've yet to see this year's pictures. However, based on past years, it will be quite exciting. This year I even climbed out the window onto the roof, which I have avoided doing in past years. My window exit had nothing to do with my drinking because I stayed long enough to metabolize my cup of vodka-sprite and Mikes Lemonade.

Saturday night: Cinco de Mayo
Drink count: 1
I was on my way to bed when the text message came through inviting me out with some of his friends. After determining the where/when, I coerced Anna into accompanying me to said event. She performed beautifully, successfully meeting him for the first time and charming his friends. I like to think I performed appropriately well too. There was dancing, dart throwing, and pool playing - except me who readily admits to sucking at pool. We didn't stick around to close down the bar, but that 6am wakeup for the hospital the next morning seemed pretty darn early.

Excessive talking helps

2007-04-25T20:18:00.000-07:00

You never know how much making random friends will help you out. Here's an excellent example yesterday. Or maybe it just showed how weird med student life is.

So I woke up Tuesday morning not feeling so hot. I ate breakfast, headed to the hospital, and then found out the first 2 surgeries were canceled so we had a few hours to kill. My stomach had felt sort of upset, but I ate my animal crackers and diet sprite anyway. Then I started puking. I reached the point where it was pretty much just dry heaves. After 4 hours of this, I was the color of paper, woozy, passing out in the restroom, and propping myself up on various walls.

Fortunately I had struck up conversations with one of the anesthesia residents at earlier visits. After establishing that I was so dehydrated it was tough to even find a vein (opps, too much studying and not enough drinking), I got my very own liter of Lactated Ringer's running into my arm. We ran that baby in so fast that we almost blew my vein and I ended up with quite the bruise afterward. The resident also made sure that I informed my attending who sent me home since there were no actual surgeries that day.

Good thing too. I had a 100+ temperature and wasn't at all appropriate to be around patients, even if I didn't look like death warmed over.

Moral of the story: be nice to everyone, even those not on your rotation. You never know when you'll be so dehydrated that someone needs to put an IV in you. Just make sure you have the anesthesia resident, not the PMR resident.

Glass half sideways

2007-04-18T19:47:00.001-07:00

On the day of a spinal surgery scheduled to last forever, I was sent this from 'black belt blue gi' for some inspiration.

His message:
"The pessimist looks at how many people are in front of him in line. The optimist looks at all the people behind him - they would count themselves lucky to have his spot."

My response:
"The realist stands in her 15 pound lead apron for 8 hours during spine surgery and realizes the resident is beside her, the attending across from her, and those lucky nurses behind her don't have to worry about contaminating the sterile operating field."

The lead apron you wear to protect you from the x-ray is heavier than you think it is. All of the weight just crushes you - though the other option looks like this though it is possible that they were joking.

Good luck on that one, Lord

2007-04-14T05:45:00.000-07:00

I've been on ortho surgery for the past two weeks (more on that later), but I was given the chance to remove the sutures off of the amputated fingertips of a schizophrenic homeless man who had many many other health problems. His fingertips were amputated because he'd gotten frostbite a few months ago. He was somehow consented to take two of them off - but 8 black necrotic dead fingertips remain.
-------------------------------
Attending: Sir, your fingers are healing well, but you have some other fingers that need to come off. Can we do another surgery to get the other ones?

Pt: No, just take the stitches out of my fingers. They are hurting me. I have so much pain.

Attending: In your fingers?

Pt: From that nurse who tried to poison me this morning. The pain in my legs and my head.

Attending: So you don't want us to do surgery. Those fingers aren't going to heal.

Pt: No, I saw these people, selling the God cream. You know the holy-rollers. Go door to door. I'll get that cream, and it will fix this. (waves those fingers again where you can see the dead bone sticking out of them)

Attending: You don't want surgery. You want to go with cream?

Pt: Yep. Cream will fix this.
--------------------------------

After I removed the stitches the attending came back in and tried again. The patient was very clear that he only wanted cream for his fingers and only the cream sold by those God people. He insisted God would be fixing his fingers with the magical cream. (He also went on at length about his voices and all the people out to get him)

I'm pretty sure his chart says something along the lines of 'Pt opts for non-operative treatment.'

One year already . . .

2007-04-08T20:35:00.000-07:00

Last weekend Brian Shaffer has been missing for one year. Please help us find him.

Surgery Week IV

2007-04-01T19:53:00.000-07:00

The last week on that horrible rotation.

Sunday 0 hours first day off in 2 weeks
Monday 8am-7:30pm 11.5 hours
Tuesday 5:30am-6:30pm 13 hours
Wednesday 5:30am-5pm 11.5 hours
Thursday 6am-7pm 13 hours
Friday 6am-3pm 9 hours
Saturday - off

A mere 58 hours in five days and that included that I got off a few hours early on Friday for an organized medicine meeting. My a$$hole chief resident came back on Monday, but all the surgery residents had a conference on Tuesday so they weren't around. I was really happy on Wednesday when our pissed of intern sent us to a conference that didn't exist and the chief threw a total fit b/c he thought the med students were skipping out on work. He treated us like crap for 2 hours before finally asking and realizing we had been there since 5:30 and had covered 12 patients he hadn't even seen.

So lets look at the bill. In the eyes of the hospital, I was a staff member for 26 days and worked a total of 285.25 hours. That averaged out to about 11 hours a day. I had two days off the ENTIRE month. I know I got off pretty lightly with the meeting and the doctors appointment. The residents, I'd estimate, worked at least an hour more than me per day.

Thank goodness my next service is super laid back and lots of outpatient clinic - ortho surgery.

Surgery Week III

2007-03-24T19:44:00.000-07:00

Here we are with hours for my third week.
Sunday - continuation of Saturday 0 hours
Monday - 8am - 8:45 am 24.75 hours
Tuesday - continuation of Monday 0 hours
Wednesday - 7:30 am - 6:15 pm 12.75 hours
Thursday - 5:30 am - 7:45 pm 12.25 hours
Friday - 5:30 am - 7:00 pm 13.5 hours
Saturday - 5:30am - 12:45 pm 7.25 hours

This week 70.5 hours. 'Q 2' call was absolutely brutal. I wasn't event supposed to get out that early on Monday, but my 9:15 am doctor's appointment got me out of there 5 hours early. We also got out a little early on Wednesday to go to 'journal club,' but I had a prior commitment. I still managed to attend two hours of journal club though. Our service was getting overwhelmed by the sheer number of patients and having our chief resident off. I also got a little extra sleep because I had an outpatient clinic on Wednesday morning too. One more week to go on this service.

Surgery Week II

2007-03-17T01:58:00.000-07:00

I have now completed my second week of surgery. Let's check my hourly breakdown.

Sunday - 6am - 11am 5 hours
Monday- 8 am - 6:45 pm 10.75 hours
Tuesday - 6am - 8:45pm 14.75 hours
Wednesday 5:30am - 6:45 pm 13.25 hours
Thursday 6am - 6:30 pm 12.5 hours
Friday 5:30 am - 6 pm 12.5 hours
Saturday unable to remember - 29.5 hours

98.25 hours in 7 days. Don't tell me that Saturday can't be over 24 hours. It's called 'call,' and I was so out of it by the end that I had trouble finding my way around my own hospital. I went up the wrong flights of stairs a few times and got confused in the hallways. Incidentally, none of that would happen if I hadn't been so sleep deprived.

And now I am about to commit as 'so called' absolute medical no-no. I'm going to be back on call tomorrow. Yep, I'm on Q2. I have a doctor's appointment on Tuesday morning, and since being ill is not encouraged I took call again rather than get punished in some way by my rotation or team. But since I'm not a real doctor yet, technically, the ACGME rules don't apply to me. Not that they are followed anyway since my residents last week stayed at least an hour past when I did every day.

Surgery Week I

2007-03-10T12:17:00.000-08:00

So I just completed my almost first week of surgery. Let's do some surgery math.
Monday 7am-5pm. 10 hours.
Tuesday 8:30am-6:00pm 9.5 hours
Wednesday 6am-6:30m 12.5 hours
Thursday 6am-7pm 13 hours
Friday 6am-7:30pm 13.5 hours
Saturday day-0ff 0 hours

That would be 58.5 hours in 5 days. The first two days were orientation days so I got to start late and get back early. I tried to do the math for next week - I'll be on Sunday for about 8 hours, on for 12 hours for the next 5, and on for 28 when I'm on call. That would be about 96 hours. Big yay there.

Impulsive - so sue me

2007-03-04T17:49:00.000-08:00

Now that I am moving onto to my surgery rotation - which scares me alot - I'm taking a moment to slap down my true personality and assume the proper respectful Med 3 position: meek. I'm going to be at a big outside hospital that sees alot of trauma and charity cases. That puts me in line to see alot of 'poor outcomes' (aka, people are going to die on the table.) It sounds bad, but I haven't seen someone die for the past few months.

I just spent a month on neuro and psych, neither of which were my cup of tea. They are two different breeds of people. The truth is, they were WAY too laid back for me. I'm intense. It doesn't make me an intense studier necessarily, but I'm just intense. If I'm doing something, it doesn't matter what it is, I'm doing it all out.

Sometimes this leads me to doing said thing RIGHT NOW. Yeah, I'm impulsive, but I don't regret that. It makes me the intense person I am. I'm dedicated and it makes sense to do it this very second. (Greetings from a future ER physician.)

Which leads me to a pet peeve: people who say they are going to do something and then don't. If I say I'm going to do something, I do it. If I don't do it, I'm sure as heck trying to do it or contacting the appropriate place and telling them why I'm not doing it. It doesn't matter what is going on elsewhere in my life; I'll probably still do it. Heck, I returned phone calls on Thanksgiving with my family in the car.

However, I have a strong suspicion that I'm going to have to clamp that off during surgery. It's going to be hard for me to because I am who I am - and you should probably not leave me alone with the patient and the scalpels when you aren't scrubbed in yet. I probably can't do the entire operation myself, but I have a pretty good idea how to start - yep, another budding ER doc. :)

I can't stand tests

2007-02-22T16:16:00.000-08:00

The thing about test week is that I stop shopping, doing laundry, and cooking. I run out of vegetables, milk, and cereal. Even though I don't actually have food, I have this tendency to clean or reorganize my house/apartment. It doesn't mean my house is any neater or cleaner though, it's just different.

I also am seized (and I mean real seizure, not pseudo) to do random things. For example, I built legos today for a little bit. I don't know why, but the mood came over me. I also went hunting for my digital camera, which is now MIA for like month 6. Since this is my second . . . or third digital camera, I must not be using them very much.

Spring break starts tomorrow. I have no idea what I'm really going to do with my free time beyond sleep. I haven't decided when I'm leaving Columbus or coming back. I've been planning to fight in the Arnold Expo. Hopefully there will be other ladies to fight - or at least make cry.

On the other hand, I start my surgery rotation in about a week. It might be a good idea to spend some time with my significant other since he's about to find out how hard it is to be with one of the interns on Grey's Anatomy. (That show has a poor track record of outside the hospital relationships surviving - Izzy's hockey player boyfriend from season 1 and Meredith's McVet aka Chris O'donnell)

Somebody save me!!!

2007-02-16T19:54:00.000-08:00

Thank you, Five for Fighting for writing that song worthy ofSmallville. It also is due to the random topic of good deeds and saving others. I mean, I'm a med student, so I'm sort of required daily to do work that helps other people. However, recently, I have noticed a random number of good deeds.

1.Push random person's car out of the snow - I was walking home from the hospital and saw these two people who had no idea how to get their car out of the parking lot. (obviously not snow-belters) I set down all my stuff and helped trample down snow and push them out.

2.Lunch time blood donation - I was on my way to clinic and the red cross was having an emergency blood drive, also due to the snow problems. They sped me through, with some nice people letting me go ahead of them so I could get to clinic. I finished donating my pint in 6 minutes, got taped up, and headed to clinic - which ended up being canceled after all.

3.McDreamy rescues Meredith - I had nothing to do with that but I just watched Grey's Anatomy. And it was so heroic when he comes out of the water with her. And also I attended a pretty good talk on hypothermia during my emergency medicine rotation. Body temp 80 degrees F? No problem!

Okay, and I'm done for now.

neuro is psych w/IVs

2007-02-13T18:26:00.000-08:00

I thought when I got out of psych I would go back to seeing patients with so-called 'real' illnesses. The history and physical would be important again, not just the patients perceptions of what was going on. I would be doing physical exams again, carrying my stethoscope and the all important reflex hammer.

On the contrary, here on inpatient psych . . . er neuro, I deal with everyone's favorite patients - the pseudoseizure patient. These patients are having non-epileptic psychogenic seizures. In other words, mental illness is causing them to have these spells. It's not a medical illness per se, it's a conversion disorder, and most of my day is spent weeding out the fake neuro from the real. I've seen a few strokes and LOTS of pseudo seizures.

How do I know that it is a pseudo seizure? Well, for example, if it lasts over 5 minutes (or 3 hours as one patient told me) and the patient did not have brain damage afterward, that would be a pseudo seizure. If there is head shaking, similar to saying 'no,' it's a pseudo seizure. If the patient checks out for a little bit and becomes unresponsive while over the age of 18, it's a pseudoseizure. If the patient has 4 different types of spells, also a pseudoseizure.

And all of that is just from description of the events themselves, let alone before I get the person's family and social history to know all the other psych and emotional problems the patient has. I had one borderline pseudoseizure patient try to manipulate me so blatantly that I had to write it up as an addendum for additional documentation purposes.

Don't call me heartless or angry. I'm just telling it like it is. I'm learning to be a doctor, and as much as patients don't want to hear it sometimes the answer is 'there is nothing we can do for you here because your problem is caused by stress.' I'm sorry if you don't agree, but there is no reason to waste more time and money on a problem that needs to be dealt with outside of my inpatient neurology unit.

For the record, two weeks and two days into my rotation, I have yet to see a real seizure.

I am not a nice person

2007-02-09T15:05:00.000-08:00

I guess I should amend that. I am not a nice person at judo. How mean I am varies from day to day, but on a competition day, I'm a killer. My first match lasted all of 10 seconds, which my team missed seeing, it was that fast. My second match was a little longer, maybe 20 seconds. I didn't get to fight the black belt I did last year because she gained 20 lbs and I lost 5 which put us two weight classes apart.

My third match was against this younger girl who gave me this sob story about being inexperienced and scared. I thought to myself, "let's go easy on her; I'll use this match to work on my extra throws." Jorn, my sandan, warned me to do otherwise, but I was pretty confident. So we went out there and I held back to see what she was going to put out there, trying my other techniques. She got a penalty for stalling and did a really crappy throw. I dodged the throw and went to choke her. She started to cry, and I didn't have the choke as well as I should have so the ref stood us up to continue the match.

So I backed off a bit and then she tried to go after me. Like seriously go after me. She wasn't being smart, she wasn't using good technique; she was just trying to take me down. My brain said the equivalent of 'are you f*cking kidding me?' Kid gloves off, I saw her go in for a throw, saw that it wasn't going to be a full point, and went down with it. I spun around her and cranked out my most merciless choke.

And she cried more. Too bad.

Lesson learned. Never ever lower your guard for anyone at a competition. Be fierce, be mean, be focused. Take names and crush them. It doesn't hurt to have a powerful okuri eri jime (sliding collar choke) to enforce your will. As I said, I am not a nice person, and I am willing to take you down directly.

(Of course, I was also at this website for people who are less direct.)

I'm crazy, not stupid

2007-01-24T18:54:00.000-08:00

One of the things that I had to get used to in psych was not carrying my stethoscope. I don't even bother to do a physical exam most days - actually one of my friends on psych consults told me they are told specifically not to touch the patient.

So not shockingly, when one of my schizophrenic patients was complaining of belly pain, I never did a physical exam. I asked all the proper questions but did not touch the patient. My resident ordered some tests, and not too shockingly, she may have had mild pancreatitis.

Which leads me to the point of my post. I got to go prepare her and talk to her about the Xrays and CT she was going to get which involved a trip to radiology. We discussed the machines and how she would have to hold still. Then I said it.

"Are the voices okay with you having these tests?"

She looked at me like I was crazy. And honestly, was I just appealing to auditory hallucinations that I know don't exist?

Worse, she laughed and patted me on the head, telling me that it would be fine.

---------------------------------------------------------------

In mostly unrelated news, I got the stuffing beat out of me in judo today, which proves I am both crazy and stupid.

Silently mad

2007-01-15T07:49:00.000-08:00

One of my co-workers on psychiatry and I had a nice talk today. Even more hilarious was my joke about my possibly having ADHD. My co-worker responded with 'I had you pegged in the first five minutes. Even when you couldn't talk, you were still interrupting.'

It was said because I had laryngitis for the first week of my psych rotation and had to 'write' to talk. Do you have any idea how rough it is to not speak for a week, especially when your main job is talking to your patients? While I am now a killer charades player, there isn't an easy why to pantomime 'are you having auditory hallucinations?'

Kudos to my partner Brandon for patiently trying to translate my impatient scribblings on my trusty silence notepad. Who knew doctors and doctors-to-be had terrible handwriting?

Psych is one of those things that is both exciting and disappointing at the same time. It's cool in some ways because your job is to communicate with your patients and try to understand how and what they are thinking. However, during inpatient psych, you also don't feel like you are being a doctor - I'm not even carrying my stethoscope. Physical exam equipment in nonexistent. Heck, I even snuck down to the ER to get a measuring tape. (It's not stealing; it's a redistribution of the hospital resources)

That doesn't even start on the patients. In theory, about 1 in 3 patients have a mental illness, which means that psychiatric disorders are massively under diagnosed. By the time you end up on the psych floor of the hospital, you have be be practically uncontrollably mentally ill. We're talking psychotic, my TV is monitoring my movements, psychotic. There isn't alot counseling and therapy can do for people who are sure the government is putting thoughts in their heads. Your best bet is to medicate them out of their psychotic break and hope that the types of therapy you teach them prevents them from doing this again.

However, the social problems of this all still prevails. For example, what can you expect from a schizophrenic that has never held down a job because the illness disrupts basic functioning? Or that poor manic patient who spent her lifesavings and then some during her last manic episode where she also got fired from her job? A lucky few of the seriously mentally ill will get rehabilitated and rejoin society. The rest of them will be back here on my floor again in a week, a month, a year.

Non resolution

2007-01-01T14:08:00.000-08:00

Everyone asks you what your New Year's resolutions are. I've decided that to combat the boring 'lose weight' and so forth ones people make all the time. Instead I am going to list 5 things from the past year that I REFUSE to change.

Allie's 2007 non-resolutions
1. Watching as much medical TV as possible: It's an excellent way to fake study. Really. Seriously. Also allows you to pick out all the medical inaccuracies - especially on nip/tuck.

2. Keeping my friends in the loop: 2006 was the year my friends came up big and I'm blessed to have them in my life. I've seen Sarah and Rori more often in the past 12 months than I did in the previous 2 years, and my set of Columbus friends have come up big for me.

3. Working out all the time: exercise is one of the best ways to keep life balanced and survive med 3. It's also more awesome when you are strong enough to pin someone at judo. Maybe I'll win that intramural weight lifting contest yet.

4. Decorating my apartment is totally worth it: Some of the best things I did was make my apartment my own. This is the first year I decorated for Christmas, and I'm making decision based on what kind of life I want next year. The value of black out curtains cannot be under-estimated.

5. Making up for unhealthy weeks on the weekend: I was pretty surprise to find out that I could make up most of my nutrients if I ate salads and meals on the weekends and lived on garnola bars during the week. Pretty soon I'll market it my new diet and make enough money to pay off my debt.

Ta-da. That's the way the year ends. Keep on rolling.

The clock always runs forward

2006-12-21T19:58:00.000-08:00

I'm taking my shelf board tomorrow and getting a break. That also means I'm rotating out of the ER. Without a doubt I will miss it, but I know I need a little time to process what I'm going through against what I've seen.

Last week I was two miscarriages in one day, which is the same number of miscarriages I was part of during OB in six weeks. While I have my suspicions about how the MOBs (mother of baby) felt about the 'demise,' the most distrubing thing I saw came from some random OB resident. One of the miscarriages happened at 18 weeks and the completition of the miscarriage needed to be helped. The resident was extremely unsympathetic and said 'oh, I stopped by and pulled 'it' out.' I thought back to my previous experiences, when the nurses wouldn't let the students into those rooms on L&D. How does the woman who experienced that loss feel about the 5 white coats standing in her room right now pretending we don't see the POC (products of conception) on the floor?

No mourning. No acknowledgement. Just go grab the ultrasound and move on with your day.

In my last two shifts, two patients died. I didn't have anything to do with their deaths, but it's sobering all the same. One was a GSW that nicked a critical blood vessel, and the other was a hemorrhage. I was the person standing in CT scanner when the head CT came back white. I was the first person to see the death sentence. At least my attending on that one cared because the wasn't any holding back on the 'god d@mn it.'

While I'm sure this is what I want to do, I need a little distance to accept all of this. I don't want to be that resident who didn't exhibit a shred of humanity. Only I still don't know how I think that I can walk home after everything and return the phone message from that cute boy, like none of this happened.

All I need is a little time. Especially since it is always running forward on everyone.

ER Office Christmas Party

2006-12-16T07:42:00.002-08:00

It was a long week in the ER, at least for me. It's been a bit of an endurance trial some days. However, I am absolutely in love with the rotation so at least that works.

I did end up going to the first office party of my life with the ER staff. I forced myself into last year's formal dress (in which I can neither bend or breathe), let down my hair, and took someone else's fiancee to the event. In the past, I used to curl my hair and people wouldn't know who I was. In the ER, I put my hair down and no one knew who I was. The 4-5 inch heels I wore might also have made me a little more disorienting too, but there were lots of double taking from people on this rotation.

The evening was dedicated to looking at other people's clothing and schmoozing. (big points to man in red leather pants) It is what everyone does at an office party. I didn't become significantly intoxicated, which meant nothing embaressing was said, and I feel I circulated well. Some things were said to me that made me feel better about myself. For example, an intern told me I was a good student and asked where I was interviewing. She was pretty surprised to find out I was still a Med 3. One of my attendings introduced me to one of the unit clerks as a natural ER resident-to-be.

The party itself was a bit tame, but since we left at 10 that might have been the issue. I think it would have been out of control if it had been open bar instead of cash bar. A different attending I have to say was certainly the life of the party . . . It was interesting to see who brought whom to the party, pretty much a glimpse into the personal lives of people you see professionally. Which can be scary and brings up it's own set of unaskable and unanswerable questions.

But I guess that is the true purpose of the Office Christmas Party.

Graveyard in the ER

2006-12-10T08:08:00.000-08:00

Quality night in the ER, hour by hour.

11pm: Arrival and picking up my first patient. My mentor is there signing off, but I check in with the chief resident like I am should. I pick what I thought was straightforward ToothExtraction. TE turns out to be more complicated due to uncontrolled diabetes and blood sugars in the 600s. And TE had a bleeding tooth, one of multiple tooth extractions if my tooth numbering is anything to go by. There isn't any signs of fever, which is good with TE is allergic to penicillin.

Midnight: With TE getting DKA ruled out and a consult to dentistry, time for a new patient. Lucky for me around 1 am, ItchyHives roles in. IH woke up this morning with hives that have spread to the face and starting down the legs and arms. IH also has 'strep' which was treated with amoxicillin. Mono and strep have similar presentations so I get permission to call the lab and find out how long it takes for an EBV test for mono to get back.

1am: Dentistry says we should just pack TE's tooth and recommend follow up with the dentist that pulled the tooth. Oh yeah, and deal with TE's blood sugar medically because they don't know what to do. IH wants the hives to stop itching and will consent to the mono test. That patient will get some anti-histamines, steroids, and the door as soon as we can get the paperwork through.

2am: TE has stopped bleeding and the CBC/chem 7 show blood sugar in the 300s, but no DKA. Hopefully soon as some fluids get in TE and the paperwork finished, TE will be out the door. I use my mentors 'paperwork makes the world go round' line to tell TE it could be a while. I pick up BackPain who has been transfered from an outside hospital. After spending some time with BP, it appears the 'pain' is supratentorial in nature due to a very inconsistent physical exam. BP claims 'numbness' over a non-existent dermatone and a paralyzed leg which is 'unparalyzed' when BP turns over to let me do my lung exam.

3am: The bars are closed on this Friday night so everyone comes in with their drunk related traumas - namely DrunkGuys 1-5, mostly cuts. A few traumas come in but they are claimed by surgery (hi other medstudents doing trauma call!) IH has been sent home. BP is getting scanned, and TE is still waiting on paperwork. I head off with one of the interns to stitch up DG1 who is accompanied by his uninjured friend DG1a. The intern leaves to go get something, and I get stuck with DG1 and DG1a hitting on me because they must have seen too many episodes of Grey's Anatomy. I try to ignore them as I wait for my intern to come back and rescue me. It takes a long time.

4am: Still sewing up DG1, while my resident takes care of DG2 and DG3. There is a really nasty FaceCut that plastic surgery is coming down to sew up. There is no hurry and DG4 who is pretty altered (aka stuporous drunk) needs his skull lac stapled. With the 3am rush of patients finished, triage is empty and the board is emptying. BP's scans are clean and it is time for the discharge to be repaired. BP is very needy and wants attention, but none of it is the ERs problem. We just can't fix BP's martial problems and depression here.

5am: Nothing new on the board. DG1 and DG1a with their HotFriend leave. DG4 is so out of it, he doesn't really do much when I put 3 staples in the back of his head. TE's paperwork is finally finished and out the door at last. I hang out with the residents and try to do some of my family practice reading.

6am:BP is being discharged but still wants attention . . . and more pain meds. I can't solve BP's problems. I go to check out FC and happen to be in there while 2 docs from plastics are checking out the injury. Note to self: never get in a bar fight with glass involved. Plastics leaves to go fill out some paperwork and will come back later. I only have a few minutes left in my shift and am not picking up the new patient RotatorCuff. Trauma arrives and in come the surgeons and their trauma med students. Note to self: sharp objects are pointy and dangerous. HotSurgeon that I knew from internal med is in charge, but since someone is bleeding, he doesn't see me. I'm fine with that.

7am: BP has finally left and I'm getting ready to leave too. Then plastics comes back and recruits me to watch them suture FC. I know this is a learning experience, but I want to go home. I'm smart enough to not say that because unless you are an ER doc, no one understands 'my shift is over and I want to go home.' The two surgeons try to sell surgery to me. I'm smart enough to plead undecided because I don't want to be pimped or piss them off. We discuss safer topics like Grey's Anatomy and Nip/Tuck as FC sleeps through the entire procedure.

8am: FC is all sewn up with 30-40 stitches. I'm free to go. I check in with my program director for further plans this week. He thought I went home an hour earlier. We rearrange my schedule a little bit for the week. I'm going to spend a long time putting in IV's on Wednesday. I bundle back up and walk out of work into a bright bright sunshiny day. I'm totally going to bed. I'm asleep by 8:30 am.

Hours Part I

2006-12-08T15:58:00.000-08:00

I've been a med 3 for almost 6 months now, but I still don't understand how to 'fix' my sleep cycle when on call or late shifts. They both have different issues, but today I will address the much friendlier topic of trying to work the 11pm-7am shift.

Let me start with a short story about my previous life as a nurses aide at an assisted living home. During my last month in college, all of the 11-7 workers were fired and I was asked, as a part time aid, to fill in. So I found myself with a schedule that looked something like
11-7am - work 8am-12noon - class 12noon-4 - sleep 4-7 - track practice/dinner 7-10 - sleep

Up until med 3, that was probably the longest month of my life because I had no schedule to regulate my sleep cycle. I was constantly falling asleep all over the place because I was still trying to maintain a daytime existence. It was less dangerous than the time I did 11-7am without sleep and fell asleep while driving multiple times, but it still wasn't fun.

So three years later, I'm still trying find a way to convince my body that it needs to be awake for that night shift. While not the supreme test of endurance of call, it is still pretty difficult to achieve. The anticipation of the night is much harder on you then the actual event - i.e. - trying to sleep for the second time during the day so your body thinks it is the middle of the day at night. I find I'm most functional if I make an effort to sleep about noon-five.

Yeah, that post was not all hospital related. The next one will be.

Talking about the dead

2006-12-05T15:51:00.000-08:00

Now that I know what I want, I've been thinking alot more about what it means to be a doctor. I don't mean the play doctor that everyone was in Med 1 and 2, but the real thing. Even now as a med 3, I'm still in the safe bubble of not making the decisions. Right now I stand on the sideline and encourage the intern who is making a decision. Sometimes I feel superior because I'm sure on my course of action and can see that it doesn't really matter which beta-blocker we pick from the hospital formulary. To the intern, it is much more 'what if the beta blocker I pick has side effect X and I just killed another human being?'

I would say in the past month and a half, I have been more profoundly affected by the ER and woundcare patients than I would have been before on my other rotations. I think it is because I have a little more time to think, whereas IM and OB kept you so busy you never processed the people ill/dying around you. I've had alot more time to see abuse and neglect now, and it makes me wonder what the rest of my life is going to be like.

With all the HIPPA regulations, I feel like I can't even talk about some of the things I have seen to anyone who is not a peer or an official med representative. Even when you do, it feels like some type of evaluation of your character. There is still this feeling that outsiders aren't supposed to see the dark side of the physician's soul. Or insiders for that matter. That may sound dark and twisty, but it's true. My patient is dying of X and no one on my service will use the word 'die' in a conversation about his/her care? We can say the treatment fails or the patient expires, but the mere word die cannot be spoken.

Honestly, how does anyone go home and talk about this stuff? Is there a normal well-adjusted way to say 'today we shocked a guy back to life . . . but he's sort of brain dead so he won't enjoy it . . . he's in the ICU and I might check up to see if I did anything wrong . . . he was a really cool case.' Did I refer to the death of a human as a cool case?

Or what do you say on that crappy day when you didn't shock him to life? Can you tell your mom about getting the couple to sign the death certificate for their 18 week gestation baby that did not 'live' in the eyes of the state? It scares me that I can be affected by all of this, and that there is a question of who I am when it stops affecting me.

And then I worry about what that will eventually mean to whomever I eventually end up with, and partially makes me wonder why I even bother. No one understands what it is like to be a physician like another physician/nurse and so forth. It also helps that you spend most of your time around other health professionals, so it makes sense to date them. Except that part where its a bad idea to date people you work with, especially if you eventually can be their superior (Grey's Anatomy isn't completely untrue). Which leads back to dating outside of that realm. Not that I have time to meet anyone outside, or, even if I did, explain to them how my life is going to work; let alone welcome them into my world of 'so-and-so died today.'

If, at that point, I can even use the word 'die.'

It's been an interesting month

2006-12-02T21:27:00.000-08:00

I have officially been twenty five for a month. It has been a very interesting month. When it rains it pours, but you just can't tell if the downpour is going to last. There were some good choices, there were some bad choices, and there were choices that I didn't make that were made for me. It happens, but even more, I'm not upset about any of it.

I think it might have something to do with my rotation. I am the first Med 3 in a few years to get an ER rotation, and they are still in the process of figuring out what to do with me. This puts me in this strange nowhere between the shadowing of Med 1 and 2 and the responsibility of Med 4.

But I wouldn't change it for the world. It's been pretty amazing so far and has basically solidified what appears to be more and more of the reality of me wanting to be an ER doctor. Honestly, this is the most I want to study, well, in ever.

Fitness videos

2006-11-21T21:00:00.000-08:00

You may be wondering, why is she talking about fitness videos? It is because I went to the local public library and got out a video by 'Self' that promised to help me get my 'best butt fast.' Seriously.

I popped that sucker in my DVD player to work out in the comfort of my own home and discovered something pretty quickly - I am in too good of shape. The music was slow; the moves uninspired/lacking energy, and it was way way way too short. The end was all yoga/pilates, which I still find a little silly.

Back in July, I certainly wouldn't have predicted that I would be in pretty good shape now. It might be the judo 3x, lifting 2x, constant random cardio in my apartment, and my 500 situps every morning. (I maintain they improve my performance in clinic b/c I've stopped studying) It might also be all of the practices I mentioned in the last blog I attended up through now.

Or maybe it's Melissa's fault for pushing me through my workouts until I want to throw up, or the judo club for my expectation that I will leave practice with bruises, a broken bone, or at least a sprain - my m-p jt on my left 5th finger is currently sprained.

Last, speaking of injuries - I get to be a fight physician again!! I have the best job in the world.

102,960,000

2006-11-07T20:57:00.000-08:00

Now that my computer is back in top form, I've been meaning to comment on this - I finally headed to the podiatrist to get my arch supports replaced. I got my first set when I was about twelve. This inspired me to do some random math about estimating how far I've been in my old arch supports.

I got them when I was 12 and I played 10 seasons of softball, 7 seasons of track, 8 seasons of basketball, 8 semesters of cheerleading, 6 seasons of volleyball, 1 season of cross country, and ran 3 marathons and 2 half marathons in one set of arch supports. As a simple estimate of how much punishment they took, 13 years X 30 miles a week X 50 weeks in the year = 19,500 miles. Or 41,184,000 strides. Or 102,960,000 feet.

The math could go on from here, but I'll spare you it. FYI, orthopedic arch supports are supposed to be replaced every 2-4 years, not every 12.

Not a cardiologist

2006-10-25T08:11:00.000-07:00

The med school has corrected my badge. Due to a clerical mistake in Summer of 2004, my badge read 'Cardiology Medicine' instead of 'College of Medicine' for over 2 years (and 2 clinical rotations). This error has been corrected, and in an act of revenge by the system, I am now the only Med 3 whose name is all lowercase letters.

Death of a harddrive

2006-10-22T12:20:00.000-07:00

On Monday night, my harddrive stopped working. A diagnostic trouble-shoot revealed that it was DEAD DEAD DEAD. It is still under limited warranty, but it will take me some time to get everything reinstalled onto my new harddrive. (And to relearn all my passwords to everything)

I was offered the chance to spend about 2000 dollars to get send the harddrive out and get all the information removed. Was my Seasons 4-5 of scrubs, Season 2 of Veronica Mars and Grey's Anatomy worth that much? Or possibly my very random selection of 800 songs?

The only fortunate thing was that I had backed up my research project and all of my photos through May 2006. The unfortunate thing is that I am was behind on my EValue diagnosis and stuff for school - and now I won't have internet access from my house for a while.

OSU judo attracts tornadoes

2006-10-11T19:05:00.000-07:00

For the second Wednesday in a row, OSU judo practice has been cancelled mid-throw because of the weather. Stupid tornado warnings getting in the way of my fun. Two Wednesday in a row is a weather conspiracy!

(And now it's back to studying)

Non-productive behavior

2006-10-08T13:41:00.000-07:00

With my library trip over, I absolutely recommend The Olympians by Rick Riordan.

Here is the premise: Percy Jackson is a dyslexic 6th grade troublemaker with ADHD who has been getting trouble since birth. Trouble, in the form of weird events that no one else seems to understand, seems to follow him and keeps finding a way to get him expelled from multiple schools. A few serious monster attacks later, Percy finds himself holding the Minotaur’s horn and at Camp Half-blood, a summer camp charged with training and protecting half-god children like himself. All of the children in attendance happen to be the illegitimate children of the Greek gods with mortals and have had similar life courses. Of course, Percy, who happens to be the son of Poseidon, may or may not be the demi-god of prophecy that will prevent the world from descending into chaos before he turns 16.

And you guessed correctly, you sense a quest being born here. Will Percy, accompanied by a trusty satyr and a daughter of Athena, fulfill his destiny and be a tool of the gods? Or will he suffer the fate of many demi-gods before him
(Heracles, Castor/Pollux, Theseus) getting killed in some in some spectacular fashion - poisoning, murder, eaten by monsters . . .

While I did enjoy the Harry Potter books, I like this series better. The similarities of all magical school training stories cannot be avoided - wise conflicted mentor, clumsy best friend/smart best friend, giant prophecy, the appealing part of this series is that it interprets the Greek myths against American culture with rather hilarious results. Most of the action occurs with our heroes roaming Western Civilization in ways that anyone born in the US can relate. For example, what would Medusa do if she moved to America – open a garden gnome store. The sea Odysseus sailed through in the Odyssey has been moved to the Bermuda Triangle and Circe changes men into guinea pigs for kindergarten classes. The gate to the underworld is in Hollywood at a record producers house eternally playing Barry Manilow.

Our heroes’ personal situation is closer to home because every half-blood is the equivalent of a child of divorce, since their literal ‘god’ parent is absent. Some of the kids resent that parent, some of them eternally try to gain their favor, and some of them don’t even know which god is their parent. Percy, when he didn’t know his father was the sea god, had to ask himself why exactly he was gifted at canoeing rather than archery, swordplay, or smithy. Even two books into the series, he still thinks its great and all that his father is an all powerful god, but couldn’t he stop by his mom’s house to say ‘hi,’ take his son out to the mall, and maybe pay some child support?

Other good points, what J.K. Rowling takes 30 pages to say - often with far too much effort - what Riordan says in one very subtle paragraph that you will often catch on the 2nd reading, yet does not detract from the storyline for younger readers. Since Riordan only uses Greek myths, you aren't wondering if you missed that Muggle related joke because you weren't up to snuff on your Norse, Celtic, and Hindu mythology. I'm not trying to knock the Harry Potter series - I am looking forward to the final book, but I find this series more enjoyable.

Incidentally, the books weigh in at 200 pages paperback and are fine for a kid to read for the adventure or for the adult who enjoyed Greek Myths, but doesn't want a brain aneurysm trying to decipher all the jokes.

Beware of public libraries

2006-10-06T19:10:00.000-07:00

Oh med students, beware of public libraries. Especially if you happen to be visiting one in the middle of the day.

Let me explain. I have recently had some trouble concentrating on learning medicine at my own home. So there is a huge public library right across from my hospital and I decided to study there. I wandered in, and honestly, this was the most books I have ever seen in my entire life. Yes, I have never been to a true city library (the Smithsonian doesn't count), but, again, that is the most books I have ever seen. It just is.

I set out my books and tried to study. Unfortunately, all the books outside my cubby were very clearly looking at me, just asking to be browsed and read. (As you can see, this did not bode well for my studying) I at least showed some restraint and went home with merely 9 books - limited to Foxtrot and 3 other books I had previously read.

Avoid libraries with real books in them, is the lesson of the day.

The saddest thing

2006-10-01T19:11:00.000-07:00

This is the saddest thing I have read for a long time. Brian has been missing for six months.

This week on Grey's

2006-10-01T08:23:00.000-07:00

It has been two episodes, and I realize that I didn't have a post about Grey's Anatomy. While Ene has been on the ball, I have not. My apologies.

So my favorite interns are still interns, and in the past two episodes, potentially 3 days have passed since Season 2's season finale. However, this has been long enough for Derek and Addison to split(hello McSteamy), Meredith still not pick between McDreamy and McVet, Christina to meet Burkes mom (apparently 3 days after he was shot), Chief's wife to leave him, and George to continue to be George with Callie. And also Izzy go from living on the bathroom floor to muffin making to Bailey forgiving her to get her back in the program.

The second episode worked better for me than the first because the first episode had too many flashbacks and not enough hospital centric drama. While I have nothing against flashbacks, most of them didn't serve much of a purpose. They physically showed us events we had already heard described - like Meredith meeting McDreamy in the bar for the first time. The only flashback I truly appreciated was the fight between Derek and Addison after he caught her cheating. Fortunately, in episode II, we were back at Seattle Grace for the frontal lobe tumor guy and non-compliant lung cancer lady. (And stripping, panty claiming, and one drunk Addison)

As for Meredith's non-choice, I love McVet. He's hot, he's nice, and he appears to be a great kisser. Unfortunately, he is also a guest star, so this does not bode well for the chances of him staying on. Oh the sadness.

Also very key, and not Grey's Anatomy related - Veronica Mars returns for Season 3 this week. It will be right after Gilmore Girls on the new CW Tuesday at 9pm.

Addicted to Yahoo.

2006-09-26T16:27:00.000-07:00

The Matrix and

the Muppets! I guess it isn't just Yahoo. I recently watched She-Ra princess of power on youtube.com as well.

Not post call

2006-09-24T16:50:00.000-07:00

So my friend Amy had an apartment-warming party which I went to after getting out of the hospital after 7:30 pm. I tried to take a cat nap but ended up staring at the ceiling in my room for about 20 minutes. Eventually I headed to the party and stayed till about 2 am. It wasn't that I was drinking (I had one and a half drink); I was happy to have some hospital related freedom.

That might have been a bad plan since I had to be back at the hospital at 6am. I rolled out of bed, twisted my hair back, put on my glasses, and headed over. My resident looked at me and asked me if I was post-call. I told her I was building up a sleep debt from all my hard work.

I went home and got 2 hours of sleep before the OSU game. Then the fun continued.

Robots and surgery

2006-09-20T18:42:00.000-07:00

So on my first day of gyn-onc I was offered the chance to be bored or do surgery. I decided to go with surgery. I didn't get any random surgery; I got the robot surgery. While some people would find this an amazing opportunity; I wasn't sure how I felt.

But seriously, it wasn't that exciting, and they really didn't use robots. The 'robot' isn't so much a robot so much as an extension of the surgeon's hands to perform surgery. (I was hoping for something along the lines of Threepioor at least HAL)I spent the first two hours watching the monitors during a lymph node dissection. Maybe it was three hours, but either way, I think the anesthesia doctors had a good time watching me stretch and exercise in place.

I eventually was given stuff to do - I even got to put in and take out my first foley. Not in that order. I don't see doctors in any danger of getting replaced by robots. No chance.

In brief and unrelated news, my Diab group met for dinner. We are extremely nerdy and spent a great deal of our meal discussing Star Trek and the meaning of Science Fiction, especially Raj. It was hilarious. And very very very geeky. Yay for geek love.

The new season of Grey's Anatomy starts tomorrow. I wonder if those crazy kids will ever graduated past intern to first year resident?

Quality weekend w/my soulmates

2006-09-17T16:08:00.000-07:00

Any girl who has watched Sex and the City will remember the episode about soulmates which are actually your closest girlfriends.

My two soulmates, Sarah Rori, came to Columbus on Friday night for Rori's 24th birthday party. Since Rori and I graduated in 2004, the three of us have been together exactly 4 times. We met for Rori's graduation party in 2004, last October w/our ex's, Christmas 2005, and this Friday.

It was so great to see my two best friends at the same time. We were three single gals having our own celebration and hitting the town. We went to 4 bars, ran into two other birthday parties, discovered B Hamptons doesn't make great drinks, and danced a while at Spice. While my low respect for drunk males has been unchanged, I didn't have to use any of my judo skills to send the not so subtle 'back the h3ll off' messages. The only bloodshed that night was on Sarah who cut her head on a step - don't ask.

Looking back to how much my life has changed since I graduated from college, I find it remarkable that I still have these two amazing people in my life. We figured out that between the three of us, we probably talk every other day. I might only get to see them both every other month, but I know they are there for me. It often takes me a few seconds to wrap my head around the idea that I have known Rori for 6 years and Sarah for 4.

While guys in our live have come and gone, and we've made other friends, some of whom have stayed, some of who have not, it's feels good to be sure the other two are always going to be there. Happy weekend to all three of us!

5 years ago

2006-09-11T13:54:00.000-07:00

5 years ago:
I was a sophomore in college and attending my Tuesday morning molecular and cellular biology lab. At 7:30 am, Lorriane and I were dripping reactant onto denaturing proteins every three minutes, and right before nine, our lecture professor came by and told us that something had happened. He wanted us to know so we weren’t confused when we saw people upset outside. Planes had crashed into the World Trade Center. We didn’t have a TV in the lab so they dug up the dinky little Bio Department radio to listen to news broadcasts as it happened. I’m pretty sure by the time we got the radio, the second tower had fallen. It’s all a blur of just standing there listening to the voices on the radio, hearing what was the end of the world as we knew it, punctuated every once in a while by Lorriane tapping me on the shoulder, ‘It’s been three minutes. Allie, it’s been three minutes.’

It’s hard to count three minutes when you are wondering if there will be another one minute at all.

This year:
At 8:30 I scrubbed into a hysterectomy on my OB rotation. It was partway through when I got there, and I was immediately put to work holding retractors. I was focusing on trying to see what I was not at any angle to see and following a procedure that I could not follow because I came late. My attending was cutting things and suturing away when he checked the clock and said, ‘it’s not quite time for the moment of silence.’ I looked at him blankly, asking myself if there was normally a moment of silence during this operation or if this was a pre-pimping ritual. Then I remembered and saw we still had about five more minutes till it was time. The operation continued and was lengthened by aforementioned surgeon dropping several instruments on the floor and needing replacements. The next time I looked at the clock it was 9:15.

Amazing how time moves when you are clueless as to what is coming next.

Break time

2006-09-06T17:02:00.000-07:00

I had a lovely break from med school. After pouring my brain onto a piece of paper for my shelf exam, I went to my apartment and cleaned. When it was clean (almost uncomfortably so) my best friend Rori came buy and we played some quality med school soccer, which was everything Kalki said it would be. After randomly meeting more med students at Giant Eagle, Rori and I had bonding night over movies and picking out my new hair color.

The next morning I drove home and hopped a flight to Vegas. It was 110 degrees there. Not humid so much as just extremely hot and sunny. Over the next 2.5 days, which is all the vacation time my family could get together, I got to tourist my way across Vegas - the Luxor, the Dancing fountains of the Bellagio, the Pirate Show at Treasure Island, the amusement park at CircusCircus, shopping at Caesars Palace, gambling at Casino Royale, and the light show at Fremont Street. We had a bumpy flight home where I got my hair cut and attended the final Gary and Carol's Labor Day party.

As a final note. On my trip, I purchased my very own tribble, which I have been told "It's trilling seems to have a tranquilizing effect on the human nervous system." Now the question is - do you, reader of this blog, know what a tribble is?

Tribbles!

Goodbye IM

2006-08-23T16:49:00.000-07:00

I'm rotating my way out of internal medicine this week. On my week off I will be visiting the Vegas w/the family for a bit, and then probably going to the county fair before I attend a blow-out Labor Day Party on Sunday. Even though I should be studying for the hellish IM shelf exam, I needed a few moments to reflect on my entire experience in these past two months. Consider them 'learning issues' as one of our IM attendings likes to point out, some of it don't have much to do with medicine.

1. Cancer=never funny. Delirium/psychosis(compared to cancer)=absolutely hilarious. It's alot easier and mentally less taxing to find a patients behavior funny rather than being depressed with terminal/chronic illness, because nothing you do seems to be making much of a difference.

2. When you get your newest attending, something will happen that will profoundly embaress you - be it falling asleep on rounds, having someone bring up your dating history, or failing to put in that NPO order for a surgery/biopsy. (It's a really bad day if all 3 things happen in one day.)

3. The hospital is inherently inefficient. Being mad at it won't make your 14 hour, 80 work week violating day any easier. Accept it for now, and hope no one enters you apartment and thinks you were kidnapped 3 weeks ago due to the lack of washing your dishes.

4. You cannot study the weird condition afflicting your patient and the required shelf board material. Pick one or the other and get some sleep. Or do neither and learn to rely on BS to make through.

5. Teams of any type need to be an even amount of estrogen and testosterone. Seriously. It doesn't mean that women or men are inherently bad, but there is a saturation point in which homicide seems feasible. (OB here I come!!)

6. If it is important, you will find a way to get it done - be it talking to a cute boy, making that batch of cookies, or helping a friend through a tough time. It doesn't matter if you haven't slept for days, you'll make time.

Call - AOx2

2006-08-20T14:59:00.000-07:00

So I survived another night of call. It actually wasn't that bad of a night. I ran into various members of the anesthesia team, who don't seem to have a ton to do on the weekend w/o surgeries going on. They apear at Codes, intubate, and scamper away.

My intern - whom I love - told me a little after midnight to try to catch some sleep in the med student call rooms, and she'd page me if anything interesting happened. The med students call rooms are a total of 2 rooms with 4 beds in each room. So you are sharing 1 of 2 bunks with other people in the class, and when you drag yourself there late, you find an open bed, don't turn on the lights, and just collapse on that uncomfortable mattress w/o a pillow. You could be sharing your call room with your best friend, worst enemy, or love of your life and you wouldn't know because under NO circumstances are you supposed to wake up the other students.

After popping my contacts out and fighting to find a comfortable position while wearing my pager, I fell asleep around 1. Right before four I woke up with a page that said 'We're admitting a homeless bum. Help if you want.' So I shoved my contacts back in my bright red eyes, tried to not wake my roommates, and hoofed it to the ER. My intern wasn't there. I paged her, waited a while, and then walked back to our normal floor. She wasn't there. Then I remembered that she carries the team phone, so I could just call her. In fact, I could have called her the moment I got the page.

She told me she didn't page me, and nothing was happening. I looked at my pager and didn't see the page. However, in my half-awake state, I could have very easily just deleted the page, the same way I turn off my alarm clock. I mean, I forgot we had a team phone, and that the cancer service doesn't admit bums normally because most of them don't walk of the street with a cancer dx. Of course, I might not have been able to pass the mini-Mental Status exam in my just waking state. (Hmm, she appears to be AOx2)

Normally I would never think this, but maybe there just wasn't a page. Maybe I was that disoriented. Maybe I was sundowning . . .or since all our med school pagers have very similar numbers, it is very easy to mistype and send the wrong service the page. I know for a fact that a med student on psych - whose service regularly admits bums - is one digit from mine. I tend to doubt that I dream of hallucinogenic pages.

The key is not thinking

2006-08-16T19:35:00.000-07:00

Things are better when you don't think about them. It's very tough to perform or assist in procedures if you actively think about the fact you are performing them on a live human being. I'll confess; I was a pretty grossed out when I helped put in a central line. Performing a bone marrow biopsy was pretty rough too.

But today, I did an ABG w/o flinching. I've attempted it during my first rotation w/o success, but my resident handed me the needle, told me to do it, and it just happened. I was too busy and too focused at that time to think about the times I hadn't done it well. The ABG needed to be done right then and that was the end of my mental discussion. I didn't have time to worry or be nervous.

So I guess the key is, grit your teeth, be confident, and go all NIKE (just do it).

-------------------------------------------------
For all the surgical junkies "It's like candy, but with blood, which is SO MUCH BETTER!" - Christina Yang on Grey's Anatomy

Cheating at IM softball is possible

2006-08-16T16:19:00.000-07:00

Yes, I know that Intramural softball is only a game, and I know that I really don't like to play softball. (Why don't I like to play softball? I was on the college softball team, and I just didn't enjoy softball enough to want to play it 2-5 hours a day October-June and train for it on the off months.)

IM is different though. It's slow pitch, and everything I was good at is illegal. For example, any form of base stealing and bunting is illegal. I was taught multiple forms of bunting because I was small, lefthanded, and quick. All of those things are off-limits during an IM game. So basically, you hit the very slow moving ball as far as you can. Except I was trained to not do that in college, which makes for difficult batting.

Because of my somewhat apathetic attitude, in a generally amusing fashion, some people think I don't understand softball. Since I've been playing since I was 6, that isn't the case. I happen to not care about whether I get a free IM Champions Tshirt. It's slow pitch IM softball, not the Rockford-Racine World Series game.

So it was the last inning or our playoff game, and I was up with one out. Someone tried to give me advice (again) 'Allie, all we want you to do is get on base.' That annoyed me. Since slap bunting and drag bunting were blatantly illegal; I dropped a swinging bunt on the third baseline. While not as obviously illegal, it was still illegal. However, I got on base, took second by correctly tagging up immediately when I saw the 2nd out hit on the air, and ended up scoring.

My team thought this was all great and they were impressed. It's not that impressive. It's what I was taught, and is technically - illegal.

It's been a nice day.

2006-08-12T21:02:00.000-07:00

The past 24 hours have been uncommonly nice for me. First of all, I got off at about 8pm, and I had about 3 phone messages waiting for me. I called my brother, who is in the process of moving. Then I called my parents since it was their anniversary. Even better, my grandparents were at my house so I got to talk to them too. I'll get to see them in about 3 more weeks.

Then, I got to go out to dinner, that I didn't pay for. With cute boy in tow, I headed over to the med school social event at Skye Bar. For the hourish that I was able to stay awake, I saw a ton of people that I hadn't seen for a few months. Actually, more people wanted to talk to me than I could hold conversations with, which is a little odd to me. Unfortunately, I couldn't quite keep my eyes open and ended up heading home.

Since I wasn't on call, I got to sleep into a glorious - I tell you GLORIOUS - 10 am. Yes, I did wake up before then, but I was able to just keep sleeping anyway. When I did decide to get up, I did my laundry for the first time in 3 weeks. (I have discovered I have enough clothes to last 3 weeks) During laundry I stopped by Giant Eagle to pick up groceries, for the first time in 2 weeks, and got hit on by the bag boy.

I spent the rest of the day catching up on my phone calls, cooking, and studying. I ate my first fresh fruit in about 2 weeks. I had rootbeer floats and some delicious choclate milk, all things I've been missing out on lately. My studying involved me sitting outside and seeing the sun, which once again rocked. It wasn't too hot and not too cold. It was the perfect 'date.' (Have you not seen Miss Congeniality)

And today I will book my tickets to the AMA conference in Las Vegas with one quality abstract behind me.

My day was definitely better than the one other people had in the airpot today. Can't ask for everything I guess.

heal thyself or not

2006-08-08T17:40:00.000-07:00

I'm actually ill. Normally that wouldn't bother me, but right now all of my patients are immunocompromised. I might be a little feverish and a little coughing/sneezing. However, you aren't allowed to really be ill during Med 3 because we have a limited number of days of illness - well, if any. Theoretically, I could have three days off.

Except I'm not going to take them. No med student actually takes them. You just can't. You don't know that much to begin with and every day is an uphill battle. There just isn't time to be sick.

Despite all of that, I am dragging my worsening self to the resident's clinic tomorrow. It's not really about me. It's really the idea of making my patients sick and possibly kiling them. That would be bad.

Still missing

2006-08-05T18:15:00.000-07:00

Brian Shaffer is still missing. I can only imagine what an eternity it has been for his girlfriend, Alexis. If you know anything about this or just want to know more - this site is where you want to go.

(I went to his church last weekend. His father got up and played this song: The Impossible Dream from 'Man of LaMancha)
To dream the impossible dream
To fight the unbeatable foe
To bear with unbearable sorrow
To run where the brave dare not go

To right the unrightable wrong
To love pure and chaste from afar
To try when your arms are too weary
To reach the unreachable star

This is my quest
To follow that star
No matter how hopeless
No matter how far

To fight for the right
Without question or pause
To be willing to march into Hell
For a heavenly cause

And I know if I'll only be true
To this glorious quest
That my heart will lie peaceful and calm
When I'm laid to my rest

And the world will be better for this
That one man, scorned and covered with scars
Still strove with his last ounce of courage
To reach the unreachable star

Help find Brian

Patient issues

2006-08-05T17:18:00.000-07:00

As I rotate through Internal Medicine, there is a vast change of patient population between services. You don't really think about it, but it completely changes your mind set about your patients. I always worry about my patients, but I have totally different worries about each set.

Diabetes service: Many overweight patients who don't eat regular meals or take their blood sugars. Most people are chronic and will be in again when they don't do their follow up appointments. I know there are many accucheck using, insulin compliant patients out there, but those aren't the ones in the hospital. The more 'non compliant' you are, the more likely you are to end up here. You check every patient to see if they are going blind, losing their kidneys, or getting horribly deformed feet because diabetes destroyed their nerves. I worry that someday I will be saying that magic word - amputation.

Nephrology: Very few people are truly innocent here. A large number of my patients didn't take care of their diabetes, used drugs and destroyed their kidneys, or did not monitor their hypertension. The government covers the terribly expensive ESRD (end stage renal disease) so no patient worries about how to pay for this. Several of my patients had no desire to make life changes and seemed ready to sign out AMA because I could not fix their multiple health problems. I was more worried they would skip out, come back with sepsis from an infected dialysis line, get into the ICU (again for some of them), and end up back on my service to do it again.

Heme: Most of my patient historys sound a little like this - you've never drank, smoked, used drugs, and have been faithfully married for 40 years with 3 kids, 14 grandkids, and have lymphoma/leukemia. You are completely compliant with all medications and yet, medically, we have not been able to cure you. I worry that I'm going to give you some horribly immuno toxic drugs that will either destroy your immune system to the point that a cold kills you, or after feeding you these toxic substances, we will fail to cure your cancer and we tortured you for nothing.

It's night and day. One month I'm begging my patients and trying to convince them that being non compliant kills. Another month I'm facing the fact that being compliant may kill.

I have a name. Use it.

2006-08-04T20:51:00.000-07:00

I doubt any actual doctors read this, but if you become a doctor and you decide to introduce someone to a patient, call them by their name. Not a name you made up, but their actual name. Particularly the one that is probably listed on their uniform or their ID badge if they happen to be an employee.

So I was taking a patient history and actually came upon some pertinent facts that had been missed in the original H&P. I had spent a good 15-20 minutes with the patient and had built a pretty good rapport. I'm just a med student so I introduce myself to everyone by my first name. Well, a doctor saw me and pulled me out of the patient's room because it was late. I shared my knowledge that actually got a diagnosis for the patient and led to an eventual discharge.

Now, most people would be happy about that - unless, of course, said doctor puts you back in the room that where you were just taking a history, introduces you by the wrong name, and then leaves you with the patient to explain his illness. This wouldn't have been an issue if
A)my name weren't written on both my white coat and my ID
B)I hadn't just spent a bunch of time w/the patient
C)the doctor hadn't been on my team for 1 week

I felt pretty disrespected and belittled. On one hand the doctor was expressing his confidence in my skills, while undermining it by failing to treat me like a colleague. It made both the doctor and myself look bad, since the patient was not only aware of my name, since I had told him it earlier, he couldread it!

When I'm feeling a bit sad about med school, or bordering a TINY bit on bitter, I like to read SDN and Panda. I'm not alone.

And knowing that is half the battle. Well, maybe 10 percent. Or 4/32nds. Something like that.

Words to the wise

2006-07-30T07:38:00.000-07:00

It is necessary to share some important quotes from my first rotation. None of them are in order, and ask me for the backstory on each if necessary.

Andrea: Was she back in the magic insulin shower?

Neeral: Once it hits your lips, it's so good! (Old school kids)

Neeral: Ah-ha, you have caught onto my thinly veiled sexism.

Me: Blame the game, not the player.

Psych service

2006-07-27T19:05:00.000-07:00

So I am currently on my Internal Medicine service. And I love my resident. And I love my intern. And I love my SubI and my fellow, Raj.

However, despite this being the med service, my patients are all in need of psych. It's like I've seen psychosis, OCD, bipolar, suicidal, schizoid, and the list goes on. Ain't nothing like knowing your patients need way more help that you can even begin to supply.

Boys will be boys

2006-07-21T21:12:00.000-07:00

Someone glared at me today for doing using my feminine 'wiles' to get information from a patient. I had a teenage boy in my care, and he had a big crush on me. It's not because I'm beautiful or awesome. I'm mysterioiusly older, neat, clean, well dressed, confident, and open w/o being vulnerable. That is way better than what the average high school girl has going for them. Of course its not shocking that boys get crushes on their female med students.

So no one has any right to be remotely pissed off that I used that knowledge to get my point across. Nothing hits harder than a girl you are crushing on telling you that you can get erectile dysfunction and go blind before you die if you don't take your insulin. In fact, don't be pissed that my characteristics that you find attractive, my patients found attractive too. If you have something you need to say, open your mouth and say it, don't glare at me like you think I clubbed your favorite kitten to death.

(No kittens were injured in the posting of this blog)

The bad med student

2006-07-21T21:02:00.000-07:00

I confess; I am not a good med student. For starters, I have this fearless concept so I miss giving the proper respect to people. And I have a tendency to greet people and talk to them normally, even if they are the head of 'such and such' department. Today for example - I was heading home at 7pm and happened to say 'have a good evening' to a surgeon that walked by.

Him: It's starting to look like it will be. (Begins walking me down the hall.)
Me: Well, I guess, seeing as you are a surgeon and will be here forever.
Him: 'Forever,' that's a little . . . what's the word?
Me: I don't know. Naive? Mean? Sterotypical? Outstandingly presumptous?
Him: *laughs* I like the last one. (Looks around) Do you know where room X is?
Me: (points b/c we are standing right next to it) Right next to X-2
Him: Okay, thanks. You have a good night, honey.

Yeah, I know, 'honey.' Are you kidding me? I'm an M3 who not very subtly made fun of your hours. I have no room to talk, and you still call me honey.

And now for something completely different . . .

2006-07-21T16:50:00.000-07:00

A few people have commented to me that all I seem to talk about on this blog is movies and judo. Yes, that is true. I mean, come on, you don't want to hear more boring boring med speak. And I spend so much time being good and nice at work, it's a little refreshing to try to strangle someone at judo.

However, in the interests of my readers, yesterday Ene took her Boards. After an exhaustive search for a random esoteric fact for my attending (see here for pimping comments), I managed to get to Brazenhead for a drink. When I say drink, I mean 'sit there and not drink, but talk to people who are not in the hospital' .' I tell you it was highly refreshing. I met some of Ene's Erins, got invited to a party, and heard yet another reason why I will not become a surgeon from a fellow Med 3.

But once again, most important thing was Ene taking her boards. As stated in many a post before, boards really does suck. They force you to memorize all of this stuff and then try to make you regurgitate it back up for 360 convulted questions. Well, about 40 of the questions are so hilariously easy it wasn't worth studying, but the other 320 are still rough. And only 300 technically count, so you have no way to know how well you did.

Trinity has nothing on me

2006-07-17T18:50:00.000-07:00

I got to go to judo today. Dr. H called me 'Matrix' because I have keep landing on my feet when he tries to throw me. For all intents and purposes, I should be on my butt, but I'm flexible and sort of dodge and jump. Today Virgil went to throw me, and I hopped over it. Since he had clearly missed, it took him two tries to just shove me down. The rest of the team teased him about his second and third efforts.

In other news, white guy black belt in the blue gi told me I was cute and patted me on the head. I grabbed him by the gi and pulled him like I would throw him. Since he was surprised, he almost got tossed by a lowly green belt like me. Brian was, "yeah, we don't need to protect her honor here, she does it on her own. I can't wait till some crusty surgeon calls her 'Honey' and she scapels him."

It was a pretty good day. My attending gave me pretty positive feedback for my first 2 weeks. Our new attending is very different, but our entire team gets along great. I really like my intern and my resident. In fact, I would consider seeing them socially after we are no longer in an 'evaluative relationship.'

Career counseling w/the dean

2006-07-12T20:04:00.000-07:00

I passed Boards!

Hilariously enough, I was seeing Dr. Clinchot for something else when he mentioned that I should check my email. There was a email that my score was at the med school, and I needed to talk to him. Before he gave me my score, he asked me what I wanted to be. Me:Dunno, maybe ER. (He gave me my score; I sort of stared)

And then he started career counseling me right there. And this was the gist of his comments - you are doing a great job. Keep working like you did for Step 1 and you have nothing to worry about.

Who would have known, I did something well. :)

Congrats to everyone else in the med school who survived or are surviving boards!

It happened.

2006-07-07T19:29:00.000-07:00

My first patient died today. I don't know what to say.

The Devil Wears Prada

2006-07-04T16:25:00.000-07:00

I successfully saw two movies this past weekend - one with Tobi and one with Anuradha. So let's hit the reviews - on a scale of 1-5. (1 being "my mother's poodle could have made a better movie" and 5 being "I'll convert to this director's religion.")

The Devil Wears Prada - 4
This movie is a comedy, but not a romantic comedy in the 'boy meets girl' sense. It is really more about falling under the spell of fashion and glitter and trading your values for a terrible job that 'a million girls would kill for.' I give this a four because I have been and will be in positions where you will do whatever it takes to meet and please whatever random and illogical whim another person has. I have been told med 3 is alot like this sometimes, and I guess I really felt for that.

On the less positive. The guy who was the romantic competition was not hot enough or a good enough actor. I'm sort of sad that they changed the ending from the book. I would recommend reading the book and watching the movie. I also wish that had outright said something specifically about how stupid it is to starve yourself for fashion. It was implied, but I really wish we had a voice over about our hero regaining the weight or some PSA.

Superman 2.5

2006-07-04T15:27:00.000-07:00

Superman - 2.5
I was disappointed. I expected more from a Bryan Singerproduction. The action scenes, particularly the plane one in the beginning were good, but there were some significant problems. For example, Superman came off more of as 'super creepy super stalker' to me, abusing his Xray vision and super hearing more than I was comfortable. Next, unlike in X-men, the boundaries of Superman's powers are never defined. He really has no limits - or if there are apparent limits - the rules keep getting bent. (Compare his relative strength in the airplane scene versus his outer space scene near the end)

The biggest problem I have is actually with Clark Kent, or lack thereof. The linchpin of all the previous Superman movies and Smallville is Clark Kent. As portrayed by Chrisopher Reeve, the fun part was the interactions between Clark and Lois. He's all steady and supportive while she has the biggest crush on Superman. All of that was missing in this movie. That aspect was completely taken over by Cyclops (James Marsden). Worse, should we be rooting for our hero, Superman, to break up a solid relationship that has a child?

Accepted at last

2006-07-02T21:02:00.000-07:00

Today, I went to judo practice, and Virgil actually did ground work against me. It does seem odd that I would celebrate the fact that a 350lb 6th degree black belt allowed me to be crushed by him, but that's not the point. Virgil doesn't let you fight him until he decides you are ready enough or at least, I guess, worthy. The last girl who was here NEVER fought him.

So I guess I've been accepted. Wow, bruises, split lip, and irritation of the common peroneal nerve aside, it was great!

Space Banjos of the world unite!

2006-06-26T12:07:00.000-07:00

Serenity - the movie - is full of Space Banjos. Yes, I did say 'Space Banjos.' This is different from the 'Space Violins' of Star Trek or the 'Lonely Saxaphone' of Taxi Driver. At every scene change in Serenity, the Space Banjos play.

I never watched the cancelled TV show, Firefly, but I picked up the movie from the public library and watched it yesterday at my new apartment. I was vaguely aware that Firefly was considered a 'Space Western,' but I guess I was unprepared for the actual Space Banjos.

About the actual movie itself, I don't know what I feel. The computer generated ships were actually more enjoyable than in the more recent Star Wars prequels, but I never got much of a feeling on the characters. For example, Inara. I had no clue who she was or why she left the ship, though I later looked up that she was a 'Companion' (aka Space Hooker). In other words, the action was excellent, but the characterization was so-so.

I definitely recommend watching the 'out-takes' after you see the movie. They are really funny, especially when the fearless captain destroys a serious scene with adlibbed instructions about what to do with the dead to his crew. The deleted scenes are helpful as well to give you a glimpse of aforementioned characters that I didn't really know. I recommend skipping the Joss Whedon interview unless you are a huge fan because they go on and on and on and on about how awesome the fans are.

Other random news - the move into my apartment went pretty well. I'm spending this week getting exercise, forcing my body clock onto Med 3 time, buying Med 3 stuff like books, reading lots of books, and watching random TV I downloaded.

7 days till they let me see patients. I'll be on Gen Med 3 service.

One of my favorite wastes of time

2006-06-22T15:01:00.000-07:00

For people who haven't noticed, I love watching TV. I have my favorite shows - Grey's Anatomy (beware it plays music), Veronica Mars, and Scrubs, and then there are shows I watch in passing or just keep up with what is going on, like the O.C. and Smallville.

So for all the other TV junkies out there that never really have time to catch everything, I highly recommend - Zap2it.com's TVGal. She has a new column every Monday with commentary about shows you care about - and shows you don't.

My personal other fav is Television Without Pity. Originally a site to mock Dawson's Creek, it has expanded to recap many, many, many TV shows. A recap of a new episode typically occurs about 6 days after its first showing. Beware, recap reading is addictive, and I am not responsible for lost wages/sleep/sex/energy/time due to reading them.

It's things like this that help me survive in Med school. And just for you,Anuradha, here is a recap of a DOOL back during the Salem Stalker.

Looking good, it appears

2006-06-22T14:58:00.000-07:00

In the midst of moving, I had a meeting at the Med school today. I picked out some random professional outfit that was OSU colors and headed over to the med school. In the underground hallway, I ran into this guy I taught Kaplan with. He was very much 'wow, I almost didn't recognize you.'

Me:"The clothes?"

Him:"Looking pretty good."

Aww, its nice to sometimes look so polished that you're mistaken for someone else. I didn't even think of whether he used proper English. And actually, now that I have thought about it, I don't care.

Nice weather, right? Wrong!

2006-06-17T19:49:00.000-07:00

So I was on a date talking about how nice the weather was, and then the worst thought occurred to me. I was returning home for the weekend, and nice weather = hay bales. As a matter a fact, by returning home, I would be forced to participate in that valuable family passtime.

With Dad being so injured since his accident in April, we've been hiring different members of our high school football team to help out. My brother is both sick and in Columbus, so that leaves the daughters to bale hay. Except the married one.

And sure enough, I am home and baling hay. I'm dodging cows, coughing and sneezing like crazy, pulling wagons (I kid you not), and throwing 45 lb bales of hay in 90 degree weather dressed in sweat pants and long-sleeved flannel shirts.

There indeed is nothing quite like this. If you are lucky, I'll have photos to post of this thoroughly character building (demoralizing) experience.

The 'how many question'

2006-06-15T12:13:00.000-07:00

Ene has tagged me in the 'how many question.' She asked 'how many times do I talk on the phone a day?' In my case, it is probably about 4-6 times a day. Between boys, family, friends, and the ever increasing AMA-related phone calls, I'd put the bar about there. For example, I have already spoken to four people today, and it's about 3pm. Maybe I will be less popular when Med 3 kicks up.

To pass this on to other people . . . please answer this question on your blog and pass it on by asking a question to two more people.

Stacey - how many times have you visited Ohio?

Anuradha - how many pairs of shoes are in your closet?

I'll be posting sometime hopefully on my last weekend at the AMA conference. I promise that it was a blast.

Chicago Chicago

2006-06-13T09:40:00.000-07:00

Let's hit the highlights of the AMA National Conference so I can then talk about my part in the action. For the most obvious, Aaron became the new Speaker of the AMA-MSS. Justin, from Wright State, got elected Alternate Delegate. As State Chair of the Ohio, I can proudly say they are from my state, and I spent most of my weekend trying to use my OSMA funding on all my fellow Ohioans - temporary or otherwise. I believe the only thing I spent money specifically for myself was buying eye-liner - all 4 dollars.

Now for the rapid fire event summary, followed by Allie's own personal learning issues.

Thursday: Didn't quite finish the H&P for ICM before I had to run to meet Sanjida. We then had to wait a bit to meet up with Abbey at O'hare before heading to the Hilton. We unpacked and, while Sanjida was in a meeting, Abbey and I ran to the much loved Jewelesco or whatever it's called to purchase some groceries. I ended up putting on my favorite power suit/dress and going to regional meetings, state chair meetings, and the alcohol-less regional mixer.

Then Abbey, Sanjida, and I put on our formal dresses to hit the party at the AMA HQ. Abbey wore this halter thing, and I wore a dress that was given to me by my much smaller roomie, Nicole, who has recently left for Iraq. The dress was at least AMA purple, and I got to wear the black gloves. That was possibly a bad idea because after consuming a few glasses of boxed wine (Franzia) I was tipsy enough to not be annoyed with guys molesting my gloves. Yes, they kept touching my gloves and telling me how hot/sexy/raunchy/dirty I had to be since I had gloves on. I don't get it. Honestly, the gloves make me MORE covered than I previously was.

Friday: After four glasses of wine the night before, I could not drag myself out of bed until about 8:30. When I did get up, I checked in with the group and stole some bags so I could smuggle a lot of alcohol into the hotel for the Ohio Party. At the alochol-less mixer, I had promised the complainers that we would have beer and pizza at the party. Yeah, good plan, how do you smuggle 18 bottles of beer into a carry-on bag?

The Ohio candidate campaigns were in full swing, and when I ended up leading the Region V meeting, I had some resistance. Most of the chapter leaders were gone, so I had a bunch of people who didn't know how to ask questions to candidates trying to decide the questions. I eventually got our 'fun' question to be 'show us your best air guitar, singing and dancing not required but highly encouraged.' We changed it over to 'air instrument' after Justin laid down on the floor. Aaron played Roxanne on the piano, and one crazy girl didn't play an instrument at all but seemed to want to be Lindsay Lohen or something. Trust me, there was blue eye shadow.

Skipping ahead to the Ohio party on floor 20, it was a college party at its very best. There were random people I didn't know there, but I guess turned out to be from my state. We ended up getting kicked out of our first room, so we carried the party (and my computer) to my suite, before heading to the club. Sanjida and I take turns sitting in the lobby chairs - see learning issues.

The club was the same place we went last year, a combo of dance club and karaoke. Erin D. was meeting one particular guy, Aaron K was selling his persona quite well, Sanjida was playing pool, and I was supposed to be dancing with Tina. This is the first time in over a year that I really let loose with my dancing, which appears to have a different effect with the straight crowd than it did with the gay bois. (learning issues again)

Saturday: After a taxi home, with a brief in the rain delay on my part, Tina, Sanjida, and I were in bed by about 3 to get up bright and early before 7 to cheer on Aaron and Justin. I missed the big moment because they were still tallying the votes when I went to a networking workshop. I ended up taking Ohio with me for real Chicago style pizza and then visited Magnificent Mile - where Roxanne let us take a chocolate shot from Godiva.

Then I probably dragged Tina and Sanjida to extra specialty meetings. The OB people were a little scary, but maybe because I'm not used to seeing old white men as OBs. It was probably worse for Tina and Sanjida who stuck out more than I did. Post that, we rounded up Ohio and headed to where we thought we were eating dinner, but they wouldn't seat us, so we ended up eating at the hotel resturant instead. I had a TERRIBLE Long Island Ice Tea and mistakenly ate some meat, which made me sick. Fortunately, Sanjida had just discovered Bloody Mary's which helped relieve some of my discomfort.

The older representatives of the OSU group and a significant portion of the AKFS campaign headed over to the med school party, where it appears thatAaron had to take a celebratory drink with everyone he saw. It wasn't as fun as Friday, but my energy might have been flagging at this point. I saw Erin D. for the last time before she was an official MD. Our night concluded a little earlier than expected, but I needed the sleep.

Sunday: I woke up b/c people had forgotten some of their stuff in my room. I ended up packing extra clothes into my suitcase. Anna ended up picking me up, and I was back in time to haunt the hospital and keep packing up.

Learning issues (identified at the end of any med student event)
1. Ohioans sure can drink, but that doesn't mean we can hold our liquor.
2. 'Thrones' is an excellent game to play in the lobby with 2 girls suffering from post-relationship stress and 2 guys from Wright State.
3. After drinking, pick targets you don't have to see again.
4. Always exchange phone numbers, if you don't, you'll miss dinner.
5. Erin/Aaron is a very popular late 1970s/early 1980s name.
6. "I don't punch; I strangle" does not deter guys.
7. Look at the taxi floor before you get in it.

He is everywhere

2006-06-06T21:32:00.000-07:00

It has been two months since Brian Shaffer disappeared. Even though I am about to enter the unreal reality of Med 3, the sad reality of the truth cannot be escaped. Today they were teaching us how to use MedStar, and they had the websites on the massive overhead in Meiling. His missing persons poster with the reward was listed on the website - about 5 feet tall. Our class got really quiet then, so I hope they were all thinking about Brian, like I was.

It was apparent all of capstone. He was supposed to be in my capstone group, and a computer glitch forced us to 'evaluate' him in order to pass capstone. Even checking our grades, any med student can see the census go from 163 to 162 for the last test. His girlfriend updated her facebook today; he hasn't updated since March.

Two months. Has it just been two months? Sometimes it seems like an eternity. I know what I did the night he disappeared. I was on a date with a different Brian. We saw this huge chemical truck turned over on a 270 bridge. I remember thinking how neat it would be that the truck thing would be on the news. Then my friend Erin and I had some wine and fell asleep watching 'Charlie's Angel's:Full Throttle.' The next night I drove to the gallery hop and went to a birthday party at the nuthouse - or whatever it's current name is - all by myself, not having any idea what we were gong to learn about Brian.

I wasn't one of his super close friends, but I knew him. He and I had PCM together, and we had to do some herb/alt med presentation together in the beginning of the year because we had last names starting with the same letter. At the start of Med 2, I went dancing with him and his group and was all 'aww, look how sweet he and his girlfriend are together.' They seemed so happy and lucky.

I knew his mom had passed away, and I kept an eye on him from class. From far away, he seemed to be doing fine. I watched his girlfriend because sometimes the girl reflects the guy. She was doing fine. Everything was fine.

And then two months ago, it wasn't.

Fleeting weekend of fun

2006-06-04T14:21:00.000-07:00

Now that boards are over, I have this one beautiful free weekend. (Other than next weekend in Chicago.) Okay, it was this one beautiful free weekend in Columbus, specifically.

Friday - post boards I got to go to a soccer party at Bash's house. I hung out with Amy and Sanjida, who were dressed as cheerleaders/ball girls/or something. It was a fun time. I brought salad because that was the only thing I was actually able to make because I hadn't actually bought food for a few weeks. I had a bag of spinach I hadn't opened, so I was able to throw whatever random vegetables I had into the salad.

Saturday - hung out with Amy. First we suntanned to get a start on that skin cancer. Then we went running for 2.4 miles around a park with a pond by Bethel - I think. I don't know. It was a pond. After that I rented my storage space for the next month, and then went out with Amy to see X-men 3 for the second time. I still enjoyed it.

The evening really got going when I headed over to Mel L's boyfriend's house for a mini party. A bunch of my fellow med school ladies were there and Mel's brother were there. We made our way to Spice where we met up with tons of other random med students. I tried to be very careful about not touching the other med student guys. I worry about that. I actually probably said that a few times.

Sunday - my exciting moving day. Most of my furniture is going to be gone in a few days. And soon I will be homeless. At least I will be in beautiful exotic Chicago.

Step 1 is actually an IQ test

2006-06-03T18:08:00.000-07:00

So I took Step 1. It was rough. I mean, I knew things, but I didn't feel like that was being tested on what I studied. The test was more of this intuative/apply the concept test rather than 'did you learn anything' test. Somehow it seems like it wasn't a question of how much studying I did; it was whether or not I looked at the tet's random diagram and just knew what to do. I'll know how I did in about six weeks.

Fingers crossed that I did pass. I'm performing a boards exorcism on my house. It's very exciting and cleansing. I'm considering setting them on fire.

Not all learning is from books

2006-05-31T23:04:00.000-07:00

On the eve of my boards, I have made a realization (or more of an acceptance) at last about people in general. Some people simply do not want to risk anything to be happy. For many people, in fact, it is safer to stay in that safety zone and never take the chance because they could fail and get hurt.

I don't understand that at all. I'm nothing amazing, no one particularly special, but I can't imagine deliberately choosing to not be happy. I guess I can't 'settle.' Someone I used to know informed me that they were going to settle with their level of not-unhappy because actually being happy would take more than they were willing to put into it. They would rather feel 'not much' than feel 'alot', and nothing will change their mind.

In the past I would have pleaded and begged them to change, but not anymore. I can't control their choice or anyone's choices except my own. I'm finally becoming able to accept that just because there is a positive solution, some people will simply choose not to take it. They know they are broken, and that there is a cure, but they would prefer to remain broken. The fear of change is greater than their pain at where they are, and all the support or love or help in the world won't make a difference. This a probably a good lesson to have learned before I start med 3, but it's a horrible one to have to experience.

At least I know who I am. I don't settle. 'Not miserable' is not a substitute for 'happy.' I'm either all in or all out. There isn't any half way with me.

MP3 players aren't for extending use

2006-05-31T17:46:00.000-07:00

So I'm learning that MP3 player earbuds were not designed with board studying med students in mind. I probably shouldn't be wearing them for 11 hours because my ears really started to hurt.

Fortunately, my ear pain in no way impairs my eyes, unlike some undergrads who were studying in the library today. A few didn't read that 'cell phones should be used in the stairwell' sign - rather than the main studying area. Or the giggling girls who felt it was necessary to be loud and annoying by the elevators.

I do have the best brother in the world. He came by yesterday to help me review in a subject he knows nothing about. You can't ask for more that that. While he did eat a significant amount of my food, he really put himself out there for me. I have no idea what I did to deserve a great brother like that.

Random number in my life - I own 8 white tank tops. I started buying them because they were good staples of any wardrobe, but I think this is getting a little bit out of control.

AerOhio and I

2006-05-28T22:30:00.000-07:00

It is a tough week to be AerOhio since someone died today during a tandem jump. The diver apparently 'slipped' out of her harness - and died by hitting the ground at an excess of 120 mph.

It's funny/scary because about a month about 10 OSU med students/affiliates went sky-diving with AerOhio. And last weekend, I think, the OSU sky diving class took about 50-70 students there. A girl in my tap class is in the class, and she is still around. Thinking about my recent experience, I wonder how the person slipped out. They kept checking how tightly I was strapped in, and you are connected to the experienced jumper by 4 hooks. Then that led me to wondering if that nice 22 year-old college student I jumped with was the guy who was hooked to her.

I do know I signed alot of forms before going up, which absolved AerOhio of my possible death - though I could have purchased some type of insurance for 50,000 dollars. I opted to not purchase that, though maybe a fellow Kaplan teacher - D.H. - who recently completed at least jump #39, might want to start thinking about it.

Big shout out to Sanjida who posted on this first and was actually one of the reasons I ever considered jumping out of a plane.

Anyone want to miss OSU med school graduation to come watch my tap performance? Lol, didn't think so. It starts at 7pm in the dance building, but I have no idea who long it will last or when we'll be up. We're dancing to M.I.A.'s 'Pull Up the People.' I can appeal to all males because there will be either lots of girls shaking it on stage - or it is dance with excellent choreography set to a political rant. Girls, same goes for you.

And mostly, I get to do toe stands. Seriously, it is that fun.

Chivalry isn't dead, but lots of the Xmen are

2006-05-27T20:50:00.000-07:00

So the guy held doors for me, and opened my car door, and waited till I sat to sit down at dinner. Chivalry might not be dead after all.

The following is a review for X-men: The Last Stand.

This was one of those movies where it would make zero sense if you hadn't seen the first two. If you had, then things would make sense, and you wouldn't mind they don't explain who is who. I'll try to keep this snarky but semi-spoiler free.

The Random: Part of being a super villian/villianess would be the obligatory eVil outfit of red and black. When I head over to the dark side, I'll hire Jean Grey's stylist. Interesting that being dead and coming back to life turns your hair 4 shades more red and let's you kiss as many hot X-men as possible. And just because you have an Oscar and got a bigger part this year, Ms. Berry, you really need to get those highlights retouched.

The Good: Hugh Jackman, I would watch him read a phone book. I'm fine with watching him kill people, fight for the woman he loves, and periodically get his flesh peeled off. Oh, did I mention claws? I will forgive that you are actually over six-feet tall, though Wolverine is supposed to be very short. Also, the constant Captain Picard versus Gandalf dynamic gets better each time. Sure, they have the same arguement each time, but that is what seperates superheroes from supervillians - and the aforementioned eVil outfit.

Also important, McSteamy, aka Dr. Mark Sloan, from Grey's Anatomy made an appearance as Multiple Man. Let's just say there is more than enough to go around.

The Okay: There was a high body count, and I don't mean 'soldier #4,5, 24, and 34.' They kill people who actually have lines and are in the movie for more than one scene. This series isn't afraid to kill off people we care about (or did if we saw the previous movies). It's great, assuming your favorite character didn't die. And also, Angel/Warren Worthington III, it's cool you were in the movie and all, but when people have ice and reality destroying powers, your wings just seem boring.

The Bad: What is a 'level 5' mutant? I have no idea, and I speak geek. This is the best I could come up with. Anna Paquin, it's time to get a new agent or use your will like Halle Berry did to get more to do during the next movie. My favorite character, Rogue, did zilch during this movie. Apparently this is what happens when you are assigned to be a 'conflicted' character with no action-worthy superpower - see my Angel comment.

All in all, the movie was pretty good. I'm not sure how it ranks up against the other two. I think the original might be my favorite because it was more character focused. This one was so full of events, I never felt like we had time for real character developement, unless your name is Wolverine.

I am Christina Yang

2006-05-25T19:32:00.000-07:00

Okay, yes, I know I am supposed to be board studying, right now, but I needed to comment - I am currently living the life of Christina Yang. My room is her apartment. I have a bunch of magazines I'm not reading, I'm not washing clothes - I'm buying new ones so I don't have to do laundry. The only thing I have in my fridge is yogurt and mozzeralla cheese. The maids that John hired to come here didn't run away screaming, I actually pilled everything up on my bed so they could at least vaccuum.

(That clean floor is presently covered in papers again.)

People may be wondering what is with the tap dancing. I mean, seriously, aren't I busy enough? That is the thing about tap class. For 1.5 hours, I am not a med student. I'm just a middle of the pack dancer who doesn't care about the brachial plexus or toxoplasmosis infections. I'm not being smart, I'm not trying to find the cure for cancer. I'm not worried about professionalism or anything. I am being me, for better or worse.

Back to the books!

Evil evil clocks

2006-05-23T18:17:00.000-07:00

So I was studying today, and I knew I had tap class at 2:30. I checking the clock by the water fountain over and over. Unfortunately, someone hasn't adjusted the clock or its battery is dying. Either way, I left at what I thought was 2pm, and it was actually 3pm. I got thrown into the staging of the tap dance. I"m in the middle front/middle.

It seriously is like riverdance. I mean, some of the OSU real dancers have the real shoes. And even funnier, one of them looks like half a girl in my class and the other half of a girl in my class. Fortunately, both halves seem to like me.

However, the crappy part of the class is that I have to write a paper - 3 pages - vaguely related to tap. I was considering writing about my undying love for Michael Flatley, but it seems that someone has already done that.

Maybe I'll just give up and go on a rampage. Too bad they won't have places to work when they get over it.

Hitting the ground running

2006-05-21T20:07:00.000-07:00

I did some counting today and really realized how soon my test was. It also reminded me how busy I was this weekend - not studying - though I did read the same pre-Bcell page about 6-10 times. This is what happens when people you rarely see hang out with you and need you to answer questions. It also is what happens when your opinion suddenly starts counting at the state OSMA level.

And my poor little Cleveland heart is breaking for my city's teams. The Cavs lost, twice, the Indians lost too. I had a chance to go to the game, but instead thought I would study. I didn't. I ended up rubbing elbows and hanging out in the 3000 dollars a night Presidential Suite in the Cleveland Intercontinental Hotel. I eventually found my way back to our 'wonderful' hotel. Fortunately, my disappointement was alleviated by a quality game of UNO. Actually, I lost every single hand of UNO.

If you see me in the library for next 2 weeks, I may seem very frazzled. Don't take it personally. I have boards in less than 2 weeks. If it doesn't involve studying, I will probably be skipping it. Due to Boards stress, I've had to vote some guys off the island. Only the strong survives this immunity challenge.

In honor of my life set now to the soundtrack of Grey's Anatomy, Scrubs, and Veronica Mars, below you will find some of the lyrics to Maria Taylor's 'Song Beneath a Song.'

Cryptic words meander
Now there is a song beneath the song.
One day you'll learn
You'll soon discern its true meaning.

The lives and times of Marissa Cooper

2006-05-18T19:19:00.000-07:00

Alas, today on the OC, it would appear that Marissa Cooper has gone to the great mall in the sky. While I used to very seriously watch the OC with my TV buddies, none of whom I see anymore, I sort of stopped as its campy quality feel. Putting all of that aside, let us take this moment to mourn the loss of Marissa's dysfunctional personality and look back on the happier times in her life. Oh, wait, when were those?

Okay, so I guess we'll look at really stupid storylines revolving around Marissa each season. (Thank you Television Without Pity for your recapping help.

Season 1: Marissa goes to Tijuana and takes a bunch of painkillers - the start of her randomly appearing and disappearing problem with substance abuse. Her parents were getting divoraced, and her boyfriend cheated on her. Sweetheart, just wait until that soon to be ex-boyfriend starts sleeping with her mom. Good thing Ryan was there to rescue her. Don't worry, she makes friends with Stalker-azi Oliver, whom she meets at the counselor's office. He eventually goes all nuts and gun-waving crazy - but Ryan rescues her then too.

Season 2: After Ryan leaves for a whole summer to wait for the impending birth of his possible love child, Marissa makes an attempt to date first DJ the lawn boy, and then Alex, during that ill fated experiment with lesbianism. She and Alex probably actually break up because Marissa proved how useless she was by being unemployed and unable to do laundry. Post camp-out with Ryan in a mall, she later almost gets raped by his brother, but ends up shooting him while he is beating the crap out of Ryan on the day of Marissa's step-fathers funeral.

Season 3: Though Ryan originally takes the blame for the shooting, Marissa ends up being sentenced to public school - who cares? Most of the audience is in public school too. Either way, she and Ryan finally have sex, but she screws it up by getting weird feelings for the pseudo-Ryan (Johnny). Don't worry, Johnny drunkenly kills himself for Marissa - which reminds us that she is an alcoholic long enough to have a six episode downward spiral. She comes out of it to help keep her sister from being expelled with the use of a very short prep school skirt. And then of course be killed at the end of tonight's episode by another guy obsessed with her. Ryan does rescue her from the burning car.

Okay in summary, let's look at the count. Healthy relationships - 0. Dysfunctional relationships - Luke, Ryan, Oliver, DJ, Alex, Ryan, Trey, Ryan, Johnny, Volchek. Umm, that is like 10, but let's go with 8. And how many of those people became obsessed with Marissa in a DSM-VII way - Oliver, Trey, Johnny, and Volchek. All of them either resorted to assualt or suicide attempted or otherwise. Volchek is the clear winner for actually killing her.

Hopefully the correct person will be prosecuted for the crime - aka - not Ryan again. He should totally hire Mars Investigations to help him because that's right Veronica Mars has been renewed!

Resistance is futile

2006-05-17T21:07:00.000-07:00

So I started listening to the music listed by Ene from Grey's Anatomy. Bad plan. Bad plan. I stayed up for a long while longer downloading Grey's Anatomy, Veronica Mars, and Scrubs music. I was then late for my Stang session to get it onto my mp3 player, but to hear Kate Havnevik's music this morning was worth it.

Grey's Anatomy is an addiction. I need some disulfram STAT. Maybe some naloxone. Or some clonidine. Three guesses what subject I studied today . . .

I'm glad to say that Dave came back from his trip to exotic Utah. I can't wait till we can have our Veronica Mars season finale discussion. I'm praying that CW picks it up for another season this Friday. I don't care if I have to stand in the rain with the rabbit ears next year to get reception, it's worth watching.

The Cavs vs. Pistons series is 3-2. I was offered the chance to join a 'Come Home to Cleveland' facebook group today. I didn't join because I don't need to 'come home to Cleveland.' True Clevelanders can pronounce Geauga and Cuyahoga, loved the Indians when they were 40 and 110, wore orange and blue for the Cavs, had a candle light vigil when the Devil (Art Modell) stole the Browns, and know that no matter how far away you are from the Lake, it's always home.

A highly educational weekend

2006-05-14T07:20:00.000-07:00

Things that I learned this weekend.

1. When a guy orders you beer, the proper answer is 'beer's okay, but I'd prefer something else.' Not 'I'll have what your having' or 'I hate beer.'

2. A liter is alot of wine. Light-weights like me, no matter the situation, should not feel the need to help finish it.

3. Black belts do not like it when they can't throw the little green belt. It doesn't mean the black belt doesn't win, it means her coach yells at her for not throwing me.

4. 'My insoles make my shoes squeak' is not an excuse to stop wearing them for your flat feet. I had my first of what will be the many painful morning runs because I stopped wearing them and put them back in to run.

5. My HTML programming is still there - after six years. Why on earth can't my calculus be there too . . .

6. It's a good thing your sister put your name on your mother's day card. A very good thing.

Now I'm going to head to the library and do med school learning. Micro day 3!

Bruises

2006-05-10T20:37:00.000-07:00

One of the bad things about judo is the bruises. Everyone seems to like to throw from their right - I know, big shocker there. I'm good at dodging those throws, but my right shin and my left knee really take a beating. I'm a little bit worried about explaining to the guy who is buying me dinner this week why there are very obvious finger marks on my arms.

I got my PPD test today. I had to once again explain that I did have a TB free chest Xray back in July. "Someone broke my ribs, but it wasn't on purpose."

I find I look forward to my advanced tap class WAY too much during the day. I know I have to walk an extra two miles to attend, but who can say dancing with metal nailed to your shoes isn't worth it. Not to mention that it is taught by one very nice gay man who loves Xmen. I really do enjoy the class. Absolutely zero med student brain cells are firing during it. I get to learn how to do all sorts of neat tricks, and all the dance stuff sort of translates back to judo. Coach Brian had to tell me my Harai Goshi looked too much like an arabesque today.

This weekend I have my second judo tournament in my life. My dad is coming to watch. Wrestling was his thing in college, so this is the closest I'll ever get to that.

Long day

2006-05-07T05:58:00.000-07:00

I was going to post this late at night, immediately after the fact because I was too 'up' to go to bed, but to smart to stay out later. In the words of my friend, Sarah I, "I feel giddy." However, our power went out as did our wireless, so I got ready for bed by candle light.

While a ton of random events happened today, I must really mention Aaron's and Stacey's birthday party. (And also Rob). They both were turning 25, and it was the first Aaron party I have been at in about a year. I did go to a Dave party last June or something. Otherwise, I have been off the boi scope for about a year.

I didn't really drink much (and it took a long time for what I did drink to work its way out of my system-yay giving blood), but I had fun. I had forgotten how much fun it was to randomly dance for absolutely no reason. It's been a rough this past year, and somehow fun didn't really have a place in it. Before I went to dance, one boi (black shirt, red lettering) looked at me and was like, "You should look happier. You're pretty, thin, nice dark blonde hair, healthy looking, and I can tell you almost any girl you know would trade places with you." That was very sweet of him.

And I danced. I am nothing amazing, but I do have enthusiasm going for me. 'The Electric Slide' did not get played, but the Cha-Cha song and Marcarena did, lol. I'm depending on Stacey and Sanjida for some quality pictures. Or maybe I'm hoping that they didn't get any quality pictures of me. I ended up donating 2 dollars for other people's dollar dances. I was shocked, I tell you, shocked at how tan the abs of the dancer was. To protect the innocent, or not so innocent, I'll stop there because if you locate the aforementioned pictures, I'm sure they will tell the story better than I can.

(Though I know now Dave is never EVER allowed to hold one of my collectable shot glasses.)

And let's hear it for the Cavs. They have made it into the second round of NBA playoffs by beating the Wizards OT in game 6. I am not thinking about our odds when it comes to Detroit, but seriously, for a Cleveland fan - hope springs eternal. Every day I wake up and believe this is 'The Year' for the Browns, the Indians, and the Cavs. It must be somethng they put in the Northeast Ohio water.

Welcome to studying limbo

2006-05-05T16:38:00.000-07:00

Today was my last Med 2 test. I will now be trapped in this very exciting world that we can refer to as 'studying limbo' or just plain old 'ISP.' I have a long month ahead of trying to convince myself to study. So I'm not longer a Med 2, and I should be celebrating, but instead I feel 'blah.' It might be because I gave blood today, which has tired me out more than I thought possible. I guess I will save my drinking till tomorrow at Aaron's.

In other med 3 preparing news, I've tried to cover all my bases for getting prepped now. We got our palm pilots three weeks ago - I'm already a solitaire addict. My friend Erin gave me some scrubs, which I shared (for trying on purposes) with half the med school. I actually sent out an email to all the women in the med school advising them on how to pick their scrub sizes. I even :gulp: included my measurements on there for reference. I turned in my pager form today and will be meeting w/Dean C. about electives.

Now for sports news important to me. One of my friends is throwing discus at a track meet tomorrow. She's really awesome and has already qualified for Nationals. I have a family event and will miss her meet, but I wish I could be there.

Now for sports news less important to me - Chad Carroll just sold his loyalty to the Royal's on Ebay for $278.74. I love how they make it sound like its such a novel idea. Have they ever been on a date? When faced with two 'okay' guys, you give your loyalty to the one that bought you a better meal. After my last break up, I would place how much a guy is willing to spend on you as a factor in whether or not he sees you have potential.

Wait - I'm not a med 3 yet?

2006-05-02T19:45:00.000-07:00

Okay, yes, I know I'm not a med 3 for another month, but I got my schedule today. This is the first time I have really actually realized how close I am to taking care of patients. And how much studying I have to do before boards.

Yes, so I decided to start a blog. It happens. I have 31 days till boards. I have 6 rotations taking up July - July of my next year. I'm seeing about few different guys right now, being AMA chair of the state of Ohio, trying to be a serious participant in judo, and attempting to tap dance my way to the front row against the half of the OSU dance team. (I also juggle chainsaws)

And I will be attempting to do all of this on a caffeine free lifestyle. We'll see if it kills me first.