Monday, September 25, 2006

The Night Shift

When you ask people in the Northeast about fall, they wax poetically about the leaves changing colors, and enjoying the last days of good weather. What they fail to mention is that fall means it gets cold--ice freakin' cold. One day this week I was minding my own business, working on my deck when out of nowhere a chilled, almost refrigerated, breeze blew across my neck and caused me to shiver. Inside my house, the thermostat has been falling. On Friday, just before I left town, it was 62 degrees inside! I'm going to have to finally turn on the heat when I get back.


I left town early Saturday morning and met up with "The Phoenix". We watched "Jackass 2", which was very appropriate considering we had quite a Jackass in our department on Friday night. And yes, the movie was horribly disgusting and those guys set a terrible example, but there's something about watching people strap themselves to rockets that cracks me up.


On Friday, everything was well under control until about 11 pm when we reopened to trauma transports. Suddenly, we were hit with a 5-patient accident. At the same time, this guy decided to cause quite a commotion in the lobby. Apparently, rather than smoking his crack at home first like most of our patients, he decided to bring it with him to the hospital. After freebasing in our lobby restroom, this one-legged dude came charging out of the bathroom and started beating up on random people. I was in with another patient when suddenly a stretcher surrounded by about 8 people came barreling down the hallway, bouncing off walls and equipment like a pinball game.

My patient and his wife started remarking about how exciting life is here in the big city, that they never get to see this kind of action at their sleepy, local hospital. I suppose it was quite entertaining for people sitting back and observing all of our spectacles, but it made for quite a long night.


I did a tiny bit of hiking around with "The Phoenix" this weekend and we attempted rock jumping on Sunday afternoon, but the water was so cold we only did one jump. I'll post some pictures when I return.


Tonight I'm at the PU's house and we're going to head up north for the rest of my time here. In the meantime, I'm enjoying sleeping in and reading some stuff that has NOTHING to do with medicine!

Friday, September 22, 2006


I don't know where this week has gone. I'm leaving for vacation early on Saturday and I haven't done anything as far as all of my outdoor projects go. This morning I ran out to get some oil for the lawnmower, so I could do a quick job and proceeded to flood the lawnmower with oil. There was white smoke everywhere, cursing, and more smoke. I ended up having to make a separate trip to replace the oil-soaked air filter and managed to burn my forearm on the hot engine pretty well.

Work was a blur tonight. It wasn't that busy, but I just couldn't seem to get anything done. I really didn't see any complicated patients either, but somehow I ended up with an entire shift's worth of dictations to do at the end. I stayed an hour late, and still have 3 left to go.

I haven't really had much in terms of entries around here, but lately I get home and end the day with a soak in the bathtub rather than writing.

Monday, September 18, 2006

Chaos, Sweet Chaos

So, I'm back in the Emergency Department this week. Today's theme was "Stroke Workup Day". My 8-hour shift went by so fast after the 12 and 24-hour shifts I have been working. And yes, the staff and the patients are more disgruntled, but there's no place like home!

This evening I went out and saw "The Black Dahlia" with my friend, G. It was pretty suspenseful, and has more than enough nudity and gore to keep money rolling in at the box office. Perhaps it wasn't the brightest idea to watch it and then return home to an empty house, but I think it was freakishly bizarre enough that I won't have nightmares. And whomever Hilary Swank's personal trainer is, they need to be paid more... she looks amazing!

Sunday, September 17, 2006

Running Out

My month of surgery is over! This morning, after another 24-hour shift, I practically sprinted out of the hospital. I'm sure that I must have learned something during the last four weeks, but at this moment, I can't exactly tell you what.

One of my patients does get the award for creative use of tattoos. He had different letters marking the first knuckle of several of his fingers. While he was sedated and on the ventilater, I kept trying to lay them side by side. One of the nurses finally cracked the code when she placed one hand on top of the other. They read: LETS F--K (Censored for your sensitive eyes!) Pretty classy, huh? He's in his mid-seventies, so I couldn't help but wonder how well that would work for him in the rehab center with all the female residents.

I worked some more around the house today, but still have a lot to do outside. I'm leaving on Saturday for a short vacation, I hope I can get most of it done before then.

Friday, September 15, 2006


Will someone please call a surgeon
who can crack my ribs and repair this broken heart
that you're deserting for better company?

"Nothing Better" -The Postal Service

It's not that I like being melancholic, but sometimes I find myself just sitting around brooding about my failures, relationships that I shoved to the side over the years. I think that I am ultimately responsible for my own happiness, but it's hard when I look at the past and don't feel that I can make good decisions for the future.

100th Post!

Conversation at 4 am from the other morning:

1st Nurse: "Kat, do you have any kids?"

Me: "No!"

2nd Nurse: "See, that's why."

Me: "Why what?"

1st Nurse: "Why you're so good-natured."

Me: "You lost me somewhere."

2nd Nurse: "When we page the other people in the middle of the night, they yell at us. You're just so nice all the time. It must be because you don't have kids."

Me: "Hmm."


A poor medical student was stuck on our service this week. It's really no place for her to be since there's very little supervision, and it's not really a good learning environment. I was trying to help her out Wednesday morning since she was just kind of left floundering all by herself.

Being a medical student sucks. During clinical rotations you only have a few weeks to find your way around, and may times physicians and nurses don't think it's worth their time to slow down and teach you anything since you're just going to leave. One of my more pompous preceptors told me once that he was offended that I wasn't logging his "pearls of wisdom" in a book to refer to throughout my training. Sometimes it's all you can do not to laugh.

So here you go, if there's any students or interns out there who have found their way to this website this is what I've learned painstakingly over the past few years:
  • Invest in a good coffee maker, preferably one that you can set to automatic drip at 4:30 am.
  • Live in a quiet neighborhood.
  • Invest in drapes/blinds that block out light well so you can sleep during the day.
  • Always arrive 15 minutes early and ready to work.
  • If someone offers to let you go home early, leave and enjoy the extra free time.
  • Keep in touch with your friends, and do fun things when you can.
  • When you don't know something, look it up.
  • Develop a good poker face. Nobody likes a doctor who exclaims "Holy Crap!" or gags when they take off a dressing and see someone's skin slide off.
  • Never forget to say "Please" and "Thank you" when dealing with nurses, secretaries, or pretty much everyone. You may not be the smartest one they've ever encountered, but if you're a jerk, they won't forget it.
  • Develop a thick skin-- the best revenge is to not let them get to you. There should only be a few people on the planet who's opinions matter to you and most likely the person currently cursing or screaming is not one of them.
  • Don't point out that someone is practicing medical standards from 1950. Instead find ways to passively suggest other options. For example, "I read about _______, what do you think about trying that?"
  • Take time to smile and talk to your patients, sometimes no one else is.

Thursday, September 14, 2006

Beating Letterman to the Punchline

A while back, I took care of a patient with the last name of Motell. Her fiance's last name was Cooter. That's right-- if things work out, there will be a Motell-Cooter wedding. Heh.


My schedule has been a little better this week. I worked 24 hours on Sunday and had Monday and Tuesday off. Those days were both actually sunny, so I spent most of the daylight hours pulling weeds, finishing up with primer on the deck and starting the actual paint color.

My other big outside project is excavating my garage. One wall has bowed in after having dirt and rocks piled up 3-feet high along the side of it. The shingles in that area are somewhat rotted from having all of that moist soil trapped against it. I've been digging up that area and frugally using the dirt to fill in the flower beds out front and in the backyard.

My goal is to be parking in the garage this winter, but I don't want to go through the trouble of installing an automatic garage door opener until I know that wall can be fixed. I'll have to hire someone to actually re-align the wall, but I figured the job would be a lot less costly if I at least did the work of clearing out the area myself. I'm no engineer, but digging out the area and building a retaining wall should help prevent further damage and create enough space to fix it.


Yesterday I worked another 24-hour shift and have today and Friday off. My favorite traveling nurse told me last night that he lost his spot and will be leaving in October. The other day I sat down to lunch with one of the other interns in my program who happened to be sitting next to two of the hospital hunks I've been distracted by. I quickly learned that they're both married, so it looks like this girl's run out of options for the meantime.

It's raining already this morning, so I'm banished to the indoors.

Friday, September 08, 2006

Why I Don't Eat Fettucini Alfredo

Work has been crazy lately… I typically wake up at 4:30 am to get to work around 5:30 and get home sometime around 7 pm. Over the past few days I have put in chest tubes, explained pathology results of metastatic lung cancer to family members, and cut myself with glass shards while snapping open a lidocaine ampule. It has been nothing short of crazy. The bonus is that my least favorite attending has been on vacation for the past week, and the sharp-tongued one and I have come to an understanding: she tries to intimidate me, and I just dish back the sarcasm. The intern last month got ripped to shreds on her evaluation… I will either have an awesome evaluation, or will be repeating the month in the near future—let’s just hope for the first.

Disclaimer: stop reading now if you are eating.


Last Sunday, a patient in the unit expired while I was on shift. She had been on our service earlier in the week, but was transferred over to the medicine team when her biopsy results revealed cancer.

After she died, I was called to remove her chest tube. It was an odd feeling, pulling a tube full of warm blood from her still chest. I was all alone with her, and though the nurse had already cleaned her up, the television was turned on. The noise of a ball game in the background was offensive, so I turned it off. I realize that the nurse had probably turned it on so that she didn’t have to deal with the quietness of her death, but it just seemed so inappropriate.

The experience took me back to a night about five years ago. My partner and I were hanging out in the station and we got called for a code. When we arrived at the address, the fire engine was already there. Laid out on a white carpeted dining room floor was an elderly gentleman. He had been having dinner with his wife that evening when he suddenly began choking and collapsed.

We started CPR immediately, but the paramedic on scene was not able to intubate successfully. We spent 40 minutes on scene trying to resuscitate him. Time after time, gastric contents kept resurfacing. And in case you never have the experience, there’s nothing quite like the smell of partially-digested alfredo sauce. The smell was so bad that two of the firefighters on scene started vomiting. To put a gross anecdote to an end, the call ended with me wiping off the patient’s face and closing his eyes so that his wife wouldn’t have to deal with the mess.

I guess that what I’m trying to express is that for me there’s something very sobering and solemn about death. It doesn’t matter how familiar the person is to me or not, I think that every death deserves a certain amount of respect. The patient last week didn’t have any family contacts that we could find. She went off to the morgue alone. I guess maybe that’s why I was so upset by the irreverence towards her death. After assessing her and having to page the covering team repeatedly to come and see her as she was expiring, I just felt like nobody cared. And maybe that’s a little revealing about me—I don’t want to die and be shoved in a refrigerator unceremoniously. I don’t so much care what happens to my physical body, but just the thought of dying without mattering to anyone else is chilling.


I know that I should be doing something healthy to get rid of my stress, but when I go home I just want to sleep or sit in front of the tv. I had to back out of the 5k because if I don't leave on that day I won't get any hang out time with "The Phoenix" during my vacation week. I was worried that taking a week off in September would be too soon, but I think I'm more than ready for it.

Sunday, September 03, 2006

Avoidance Behavior

Today was hideous, and too much of a bummer to talk about right now. Yesterday I went to the state fair with one of the other interns. My goal was to find the unhealthiest item possible, and I think I may have found it in a deep-fat fried twinkie. It really just tasted like a funny doughnut, not all that impressive. My friend and I spent about 4 hours sipping wine slushies, eating garbage and stumbling around looking at livestock. It was dark and raining, so we really couldn't even get in that much people-watching.

I cut and pasted this from an email I filled out today:

Four Things you may not have known about me.....

Four jobs I have had in my life:

1. Emergency Medicine Technician-- That's right, I drove an ambulance like a maniac for 2 years!

2. Typesetter/proofreader for hometown newspaper

3. Lifeguard/Water Aerobics Instructor

4. Road Construction

Four Movies I would watch over and over:

1. Big Fish

2. Gattaca

3. Cast Away

4. Planet of the Apes (the original)

Four Places I have lived:

1. Here

2. Flagstaff, Arizona

3. Phoenix, Arizona

4. Rural South Texas

Four TV shows I love to watch: (I don't really watch tv, but have some series on DVD)

1. Grey’s Anatomy


3. Smallville ("The Phoenix" will kill me if I don't list this one)

4. still watching reruns of Seinfeld

Interesting places you've traveled to:

1. Antigua, Guatemala

2. Hong Kong

3. Seattle, WA

4. NYC

Web sites I visit almost daily:

1. Email (Hospital account, GMail, Yahoo)

2. Various Blogs

3. Money stuff (ING Direct, Bank of America, Sharebuilder)

4. Google

Four of my favorite foods:

1. Fudge

2. Tom Ka Gai soup (Thai soup with coconut, chicken and lime?)

3. Cherry Coke

4. Homemade tortillas with butter

Four Places I'd rather be right now:

1. On a massage table

2. Beach-- hot sand, roaring ocean, salty smell, cold drink

3. Asleep

4. Hiking