Cleaning Out the Inbox

I put myself into a bit of a predicament this week by getting incredibly behind on my dictations. I think I am just about caught up now, with the exception of three left over from today. There's always a push to get people seen, and keep the flow moving. However, at the same time, when I look back I wonder about what I'm missing. My stuff all gets reviewed by an attending, and sometimes a senior resident, but afterall we are all just a little distracted.

Learning on the job is fun. Today I helped put a dislocated shoulder back in place. I also spent a good amount of time getting a thorough history from a patient, but she still ended up surprising me. Despite having a recent period and using two forms of birth control, when I happened to place an ultrasound probe on her belly I found that she didn't have urinary retention, she had a 19-week fetus in her uterus!

All in a Day's Work

Somewhere, in a land far away, "The Phoenix" is doing a student rotation in emergency medicine. The other day she said to me, "I hate your job. I don't know how you can do this."

I returned to my department on Monday after being out on off-service rotations since about September. I love my job. I like going into work, not knowing what my day is going to be like. There's no appointment book to let you know that you're impossibly behind; no listing of names of people you dread seeing. Best of all, when the day is done, I leave. There's no sleeping in a call room or being paged at home.

I spent a good part of my shift last night repairing the finger laceration of a guy that accidently stuck his hand into the rotating blades of a snow thrower. His fingertip was shredded with multiple breaks, and his entire fingernail had been pulled off. After a lot of work to realign his skin, my attending taught me how to fashion a new fingernail out of a piece of plastic, shove it up under his cuticle, and sew (doctors say "suture" because it sounds more manly) it in place. It was nasty, but pretty cool.

Then there was a patient that was seeing clowns and hearing voices that were telling her to set herself on fire.

Then there was the guy with a needle phobia that needed a spinal tap. I just about had it when he started jerking around and demanded to have the needle taken out of his back. He left AMA (against medical advice).

Then there was the young woman who flew through a windshield that needed a FAST scan (ultrasound done in the trauma bay looking for intra-abdominal bleeding).

Then there were about 5 others I saw that were drunk, had colds, or just needed to be referred to a specialty clinic. Not too bad for a Tuesday night! How can you not love this stuff? Unfortunately, I just get a few more days of it and then I'm being banished to the pediatric floor for 4 weeks.

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My great-aunt turns 104 in two weeks, so the PU's will be stopping by next week. There's nothing like having visitors to inspire some serious house cleaning!

Facing Fears

Ok, so it's kind of a bizarre fear, but I have this thing about not wanting to saw into anyone's arm.

Let me take you back to 1982...

I was age four, and just as difficult then as I am today. My younger brother was in the middle of his swimming lessons. My mother sat on the front row of the bleachers with the mother of one of my older brother's friends. I didn't have any friends of my own around that day, so I was kind of playing tag-along with the older bro. He and his buddies were jumping off the end of the bleachers onto the ground, and took off running around somewhere. I decided I wanted to be cool and jump off the bleachers, too.

I approached the end of the metal bleachers cautiously, and looked down. Although they couldn't have been more than 5 feet above the ground, it still looked pretty high up to me. I looked off in the distance and bit my lip. My brother and his friends were still chasing each other. There was no one egging me on, no one taunting me, but I still didn't want to chicken out.

The next thing I remember was the crack of my arm beneath me as I landed on the cement on the side of my body. I had gotten too scared to jump off the end. Instead, I decided that if I rolled off the end I could turn myself around mid-air like the falling black cat I had seen on television and land on my feet.

It didn't work.

My mom carried me over to a lifeguard who said that I was fine, but my mom could see the gross deformity in the shape of my arm. My mom left my brothers in the care of her friend and took me to the hospital. I still remember thinking that if I stopped crying that I wouldn't have to go if I could convince her that I was fine, but that didn't work either.

Hours later I had a heavy plaster cast on. I had midshaft fractures in both my left radius and ulna. After many weeks of taking baths with a bread bag over my cast, I finally went to the doctor's office for a follow-up. I still remember sitting in the waiting room. My mother had dressed me in one of my better outfits, a navy blue dress. We went back behind the waiting room door, where they proceeded to cut off my cast with a rotating saw blade that looked like a pizza cutter. By the end of it all, my dress was coated in white powder. And, during the process, they underestimated the padding of the cast and cut into my forearm. It wasn't very deep and I don't recall it really hurting, but I still have the scar.

Today, I helped cut off three casts, and felt a little panicky when we got out the saw. It worked out well enough, but was I was more than a little nervous. I guess now I can cross that fear off my list.

Next week: spiders? Maybe not.

Like Sands Through the Hourglass...

Work - Eat - Sleep
Work - Eat - Sleep
Work - Eat - Sleep

This is what I have become.

Rinse, Lather, and Repeat.

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There's something sick and wrong about awakening at 4:30 am. It's not like there are cows that need milking! The past 10 days or so have been a blur of ankles and elbows. There are casts to set, dressings to change, and endless labs to check. No matter how helpful I try to be it isn't quick enough. I seem to spend much of my day climbing up and down nondescript stairwells, seemingly making no progress. It's almost like being stuck in an M.C. Escher painting. Blah. Much of my day is spent gathering supplies and hauling them from here to there.

This is coming to an end soon. Just a few days left and I can stop being a dysfunctional cog in a machine I want no part of. I have to wonder what the point is in scurrying around like mad, when there's never any progress being made. Blame rolls downhill and I am at the bottom. I have a good support system, but I find myself being short with friends and family on the phone. The other interns and I just console each other with ridiculous stories of what we have been chewed out for, and somehow the inappropriate laughter helps.

This morning we came in to find casualties of our first snowmobile trauma of the season. Other than that, the day was unremarkable. I don't want to sleep because that will just bring tomorrow more quickly.

Another Memory

Christine walked lazily ahead of me. Her calves, like mine, were streaked with mud. She bent down to pick up the green glass bottle and tossed it into the plastic bag I was struggling to keep a hold of. The plastic was hot and slippery in the heat, coated with sweat from my grubby little hands.

"I think that should do it," she said with a crooked grin.

We walked into the gas station with our treasure and I struggled to lift the plastic bag onto the counter. It settled with a few satisfying clinks. The cool air conditioning was a shock against our sweaty skin.

Dale smiled down at us from the register, showing a few aged teeth, his blue eyes dancing. "Do you girls want the usual?"

"Yes, sir." I said, reaching for one of those sugary packaged treats--two oatmeal cookies with a thick layer of cream connecting them. Christine grabbed our ginger ale and we were on our way.

It was a good morning's work collecting enough bottles from the kitchen and alongside the highway, but the treats were always well worth it. My mother would have flipped out if she had known her nine year-old was out walking up and down a country highway, but then again, that was half the fun.

Snow Play

Yesterday it snowed like crazy! When I got home, about six inches had accumulated, so I didn't think I could pull my wee car into the driveway. So I did what any other crazy woman would do: I fired up the snow thrower/gas-powered thingy I bought months ago. It was a lot of fun. I have been getting clobbered on this current rotation and have been in a bad mood by the end of the day. There was something therapeutic about blasting music via my iPod and watching this crazy machine arc sprays of snow against the side of my house and into the neighbor's yard.

Unfortunately, this evening there wasn't any more snow when I got home, but they're calling for it all next week.

Wild, Wild, Northeast

The wind has been angry my friends. Over the past few nights as I lie in my bed, it whips around the corners of my bedroom, whistling and screaming. It blows hard enough to rattle the outer storm windows of the house. It still has been much warmer than normal this time of year, however at night the beast comes out, huffing and puffing out frigid air. Winter is coming soon, there's no mistake about it.

Tonight, as I pulled onto my street, I saw a familiar site at the edge of my headlights' reach. It was the rolling bounce of a plant tumbling across my lane. I was reminded of the occasional tumbleweeds one could see on long drives across the desert back home. Then I noticed the glints of silver. This was no weed, it was someone's old Christmas tree!

2006 Movie List

Because lists make for nice, easy entries and I don't want ya'll to think I'm too much of a bookworm, here's my rental list from Netflix This probably also contributed to a shorter reading list this past year! Some of these are old favorites, but many I have just been hearing about forever.

July - December 2006

Wedding Crashers
Ladder 49
Raising Arizona
The Princess Bride
Finding Forrester
Gattaca
A Beautiful Mind
Rat Race
Old School
Good Will Hunting
The Day After Tomorrow
Mr. Deeds
Lord of War
Bringing Out the Dead
Eternal Sunshine of the Spotless Mind
Mystic Pizza
Seven
Mother, Jugs, and Speed
Lucky Number Slevin
House, M.D.: Season 1, Disc 1
Lost in Translation
House, M.D.: Season 1, Disc 2
Far and Away

Currently, I'm watching perhaps the ultimate girl-power flicks... Kill Bill, Volume 1 & 2 on TBS (I think 2 is much better!)

Invisible

I'm being a copycat. Chris posted this on his website, and I thought I'd share it. I thought my name was a little more unique, but I guess not. I typed in a few names, and "The Phoenix" doesn't even register! Maybe she's never paid taxes? Hmm...

HowManyOfMe.com

There are: 28 people with my name in the U.S.A. How many have your name?

2006 Reading List

This year's reading list is much shorter than last year's. I guess I have been distracted just a little bit.

The Old Testament: 2 Chronicles - Jeremiah
Ok, so this project still isn't finished. I have been slowly working my way through the Bible chapter by chapter and haven't covered it all, even over a 3-year span (I read the New Testament first).

Devil in the Details - Jennifer Traig
What's there not to love about poking fun at people with obsessive compulsive personality disorder? This book seemed clever at first, and then just kind of got annoyingly not funny.

The Home Buyer's Question and Answer Book - Bridget McCrea
I picked this one up at Barnes and Noble. I think I probably read the whole thing twice. It's in question and answer format and very helpful for anyone who may be clueless about real estate. Although to be honest, I'm still a little confused about my escrow account.

Guns, Germs, and Steel: The Fates of Human Societies - Jared Diamond
I have this thing about forcing myself to start what I finish, and this book damn near killed me. It is perhaps why this reading list is so short this year. Pulitzer or not, this guy writes horribly long and uninteresting sentences. Ask Ru, she tried to read it aloud during our drive across the country and was equally bored.

The Book of Tells - Dan Collett
This was a quick, easy read about body language. Most of it was pretty basic, and a lot of it seemed to be without merit. Read it if you're interested in that sort of thing, but I doubt you'll come away with anything new.

Flesh and Blood - Jonathon Kellerman
A quick read while on vacation. The first book I've ever read by this author. I wasn't very impressed, but my mother said it wasn't one of his better reads.

The Rescue - Nicholas Sparks
Predictable, a half-day's read.

The Intern Blues - Bob Marion, MD
This is a collection of recorded journal entries from three interns during their first year of a pediatric residency program, with commentary and organization by their program director. It took place in the 1980's before a lot of the work-hour restrictions that we currently have. I am very thankful to not be working the schedules that they did. In some ways, I found it reassuring to read about failures and successes of others in a similar predicament.

Galloway's Book on Running - Jeff Galloway
After reading this, I plan on incorporating more walking breaks into my running schedule and am hopeful towards improving my progress.

Visions of Sugar Plums - Janet Evanovich
Short, fun, and entertaining. I am not big on series fiction, but I do like to read about the exploits of a bumbling bounty hunter every now and then.

Duh!

Sometimes I think I should take an IQ test, because seriously? Bad decision central, here.

Typhoid Gary asked me if I had already had lunch today. Instead of ending it with a simple "yes", I told the truth and said "no." He then promptly asked me to meet him downstairs at 1 pm. I hemmed and hawed, and said I had to find my resident and promptly went into hiding. Suddenly, this afternoon he's patting me on the small of my back, handing me a piece of gum, and telling me that my senior resident had better let me off tomorrow as we have a "standing lunch date."

At the same time, I found some new eye candy. I was hurriedly scribbling the crappiest progress note ever (although not dated 1993), when this broad-shouldered, scruffy-chinned guy walks by in a white coat. Before I knew it, I developed pathologic blushing syndrome, especially as some darned nurse took my space at the counter and I was forced to stand right above him, trying not to look down at him. He kept returning to the desk after leaving a few times, and I kept making eye contact, but shyly looking away.

I don't know what my problem is. The cute ones I can't seem to encourage enough, and the creepy ones I don't send away strongly enough. Argh!