FOR IMMATURE AUDIENCES ONLY

OK, here’s my real title for today: Top Ten List of Things that I Could do with a Life-sized Cast of a Hospital Administrator’s Hardware

If the above offends you, I suggest you stop reading now. This story was related to me by a friend, and too funny to not pass on, so here goes:

A woman in her mid-sixties went in to see her gynecologist the other day. She had been having problems with urinary incontinence, and a Birch procedure was scheduled for repair of a cystocele found on exam. During a previous visit, the two had discussed the procedure and the doctor had explained that although the surgery focused on repairing the bladder, sometimes remodeling of the vagina is necessary. The patient had stressed that she and her husband were very sexually active, and she was concerned about being able to maintain their activities after surgery. He had told her that she could resume her sexual exploits a few weeks after surgery, and although things might feel a little different at first, he didn’t anticipate any problems.

Everything was going well enough, when abruptly she reached into her purse and pulled out a life-sized cast of her husband’s erect penis. She said that she wanted the doctor to have it available in the OR to make sure that it would still fit. At that point the doctor turned beet red and my friend had to turn away to keep from laughing aloud. He politely declined the use of her model and convinced her that it wasn’t necessary.

Apparently, the woman’s husband is also on the administrative board at that particular hospital and she convinced him to make a cast of himself by saying that they wouldn’t be able to have sex for a year afterward if she wasn’t properly fitted. I would think that anyone in his position would know better, but perhaps he was more interested in participating in the sculpting activities! Unfortunately, woman and penis left the office together, so no administrators will be hurt by the re-telling of this tale. If I had been the gynecologist, I would have been tempted to keep the cast, if nothing else, so that people would believe me!

Top Ten List of Things that I Could do with a Life-sized Cast of a Hospital Administrator’s Hardware:

10. Make a customized hood ornament for my rental truck.

9. Photo-op tour featuring various historic locations across the US.

8. Bring it to future board meetings as negotiating power… “Well, what does Mr. Happy think of that idea?”

7. Paperweight.

6. New anatomically-correct placards for men’s restrooms.

5. Replace garden gnome in unsuspecting neighbor’s yard.

4. Donate it to a local school’s sex-education program.

3. Avant-garde art in a fertility clinic.

2. Holiday gift for Viagra/Cialis/Levitra drug rep.

1. Mount it beneath his picture in the hospital lobby.

No More Hoops to Jump

As of now, I am a free woman! Today was my last day of clinical rotations. Ever. The surgeon I have been working with is out-of-town tomorrow and has the rest of the week off, so I finished mid-week! All that is left now is walking in a silly cap and gown and collecting my diploma. I still can't quite believe that they are letting me become a doctor! Graduation is not for several weeks yet, and this weekend I leave to find housing. After that, there is much packing and organizational stuff to be done for the move. I am also squeezing in a small vacation and hopefully more hiking adventures before graduation.

When I look back at the past four years, there have been many times when I have wondered if I would do it again, knowing what I do now. The answer is still yes. I am really excited about the future, despite some unwanted advice from a very bitter anesthesiologist yesterday. During multiple cases, he told me I should abandon emergency medicine as a career as it would most certainly lead to unhappiness and career burnout. I don't know why some people seem compelled to dump their negativity on others. While it is true that I may have gently steered a couple of people away from my particular medical school, when I encounter pre-med students or medical students in classes behind me, I generally try to be supportive. It is hard enough trying to choose a major or career, without some random stranger whining about how unhappy they are.

I think that when people ask for advice they have often already made up their own mind and are really just looking for reassurance. Plus, I figure that most medical students are pretty determined individuals, so unwanted advice or negativity generally gets ignored or immediately opposed...at least that is how I often react.

In the end, I really think that individuals are responsible for their own happiness. If you don't like something, change it. If you are not happy with your career or job, retrain. If you are not happy with your money situation, get another job or spend less. If you are not happy with being tired all of the time, work less. I know that's a really oversimplified version of life, but don't we all tend to make things more complicated than they really are? So many times I tend to confuse wants and needs and make things much more difficult for myself along the way.

Another Day Older and Deeper in Debt

Today I turned 28, and overall it was a good day. In honor of other Taurus people out there, this is the Stock Market Bull statue in NYC. And no, that is not me hiding behind the statue! I don’t put much stock in astrological signs, although I can be a pretty stubborn gal. One of my friends has likened me to a grizzly bear—quiet and self-sufficient, until you start poking me with a stick or backing me into a corner. Plus, I am a woman who appreciates her sleep, and have never been of a sunny disposition when rudely awakened.

At this time last year, I was doing a general surgery rotation in the Bronx and spent my birthday at the Metropolitan Museum of Modern Art. This year was just as much fun, having spent the day visiting with my family and friends.

Birthdays always seem to be a milestone to reflect on one’s accomplishments. For me, being 27 came with a lot of insecurity and questions about my future. Right now, 28 is looking pretty good—between starting a profession and re-establishing my independence, I am pretty positive about the year ahead.

I ♥ Midwest Airlines

I flew home from Philadelphia using Midwest Airlines with a layover in Milwaukee. The first flight was on their Signature Service, while the second was a Saver Service flight. In case you have never had the pleasure of flying Midwest let me tell you a little secret: THEY SERVE YOU FRESH-BAKED WARM CHOCOLATE CHIP COOKIES MID-FLIGHT! I was so excited by this. On the Signature flight, all of the seats were leather and there were only two to a row with a wide armrest. I wasn’t expecting the cookies on the Saver flight, but there they were—just as warm and fresh as on the first flight. Another bonus of the cookies: for at least part of the flight, the gross B.O. smell that comes with having over a hundred passengers crammed in a large germ tube gets covered up temporarily!

I was just discussing this with my friend, but do you know what I hate? When you bite into a cookie, fully expecting the semi-sweetness of chocolate chips and you end up tasting raisin. And, just when I thought that the oatmeal cookie fake out was the ultimate travesty, she one-ups me with this one—there’s nothing worse than biting into a chocolate muffin and ending up with bran: YUCK!

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On a happier note, this afternoon I took the last exam of my medical school career, assuming I passed anyway. Just a week and a half left of rotations and I'm DONE!!!

Photo Tag

Chris, of the-world's-longest-website-address-ever-.com photo tagged me a few days ago, and here's my results. I've never done this before, and while I have friends who blog, and friends who have digital cameras, I can't think of anyone who has both to tag next.

Something that I made:


This is a counted cross-stitch project I've been working on since late 2001, so technically I guess I'm still making it. It was supposed to be a gift for my father's birthday in August of 2002, so one year it'll be an ever big surprise that I got it done!

Something that was given to me:


This is a very soft and warm scarf that was made by my friend, Ru. Now that I'm moving away from the desert, it will get even more use!

Something strange:


I adapted this category to someone strange. I spotted this guy last spring during a rotation in New York. Tighty-whities in Times Square, now that takes some balls (Pun fully intended)!

Something with a pig:


Believe it or not, I couldn't find any photo-worthy pigs in Philadelphia! This is a sugar bowl in our house... the curly tail doubles as a serving spoon. This is the first sugar bowl pig I've ever seen, but maybe it's a common household item?

Something unique:


This is a bud vase that was hand-carved so that a small test tube fits inside. It was originally given to my great-aunt by someone in her assisted living complex. I think that it is darling, but at age 103, she has outlived him, too.

Philadelphia, part 2

Unfortunately, the majority of my day yesterday was taken up by my exam. I woke up at 5:30 am and tried not to think about how it was really 2:30 back home. The exam went well enough, orientation videos and registration took almost 2 hours in itself. Most of the cases were pretty clear cut—I think my greatest problem was probably with the first patient I saw. The case itself wasn’t bad, I just hadn’t gotten into the swing of things yet, and was nowhere near finished writing my note when time was called. I have heard that they only evaluate 10 out of the 12 cases, so hopefully that one will be dropped. Since it is pass/fail, I feel pretty good about the whole thing. My school just requires us to have taken the exam prior to graduation, but passing it is a requirement for licensure.

After the exam I drove downtown. When I woke up yesterday, it was raining, and it still hasn’t stopped. Traffic was extra slow, in an already busy part of town overcrowded with tourists. I had downloaded a walking tour for my iPod before arriving in Philadelphia, and despite it being rainy and 47^o, I went ahead and did it anyway since my only other option was to get up super early and attempt it in the morning. Luck was on my side, as I diverted from the tour route to duck in to the Liberty Bell Center, and was able to see the bell 15 minutes before they closed!

I have never downloaded a tour onto my iPod before, and I think it was a nice option because I was able to get around at my own pace, without having to return to turn in equipment. Cost was approximately $15.

However, by the end of the walk my jeans were completely soaked through, as were my poor socks and sneakers. Luckily I was carrying a leather messenger bag, and cows are waterproof, so the bulk of my stuff stayed dry. Note to self: the umbrella was smart, but next time extra socks and shoes if you’re going to walk around in the rain.

After the walk, it was off to The Franklin Institute where I had tickets to a Body Worlds exhibit and an IMAX movie on the human body. Body Worlds was excellent (unfortunately, no pictures allowed). The dissections were truly amazing and somewhat humbling compared to the work we did during first year. They did not give any information about the donors, but I was kind of curious about that, since most of the bodies had excellent musculature and seemed to have come from younger persons. There were a couple of animals on display as well, shown completely by the outline of their blood vessels. My only complaint was that the exhibit was clearly male-dominated, with probably about 80% of the bodies being male. It was funny though, that uh, genitalia was either dissected and arranged to flow with the motion of the exhibit, or simply whacked off. There were also many thin slices on display, but after looking at so many CT images and textbooks, it was hard to remind myself that they were real.

Although I finished my night at 10:30, it wasn’t until almost midnight that I returned to my hotel. It was only 10 miles away, but between the crazy weekend traffic, and the rain, I ended up all disoriented and turned around. It was impossible to make out any of the lane lines in the road. I never did quite adjust to the time change and ended up having dinner at Dunkin Donuts at about 11:00 pm. My next workout is going to suck.

This morning, I woke up completely exhausted, and though I would have liked to walk around downtown for a few more hours—there are several statues I would have liked to have seen, the rain dissuaded me. I also didn’t get to the Philadelphia Museum of Modern Art—apparently Rocky ran up those steps (I don’t know, I never saw any of those movies.)

So there you have it, my haphazard mini-vacation. I don’t know that I will seek out a trip to Philadelphia anytime soon, but there’s certainly much more to do!

Philadelphia, part 1

I made it in ok last evening. You know what's funnier than driving a Chevy Aveo around town? Driving a sea-foam green Chevy Aveo around town!!! I swear I have a bridesmaid's dress the exact same color in the closet of my old bedroom at my parent's home... and no, I will NEVER wear it again! At least I didn't have to worry about someone stealing my car!

This morning I drove an hour away to see an Ansel Adams exhibit at a museum. I've always liked his work, and I saw a few scenes that I had never seen before. One featured the arch of a rainbow across a waterfall that was strange to see in black and white, and in another he captured a black sun--I can't currently remember if that is a solar eclipse or a lunar eclipse. There was also a portrait of an old woman looking out from behind a screened door that I really liked because of the way that both she and the grid of the screen were perfectly focused.

After that, I went downtown to the Mütter Museum, which features an anatomical collection that is pretty extensive. I didn't see the signs that no cameras or videocameras were allowed until I was in the second room, so here's a bootleg shot for you:

Luckily for you, I have no shots of the colon from a patient with Hirschsprung's disease that contained over 40 lbs of feces when he expired! Also featured were shrunken heads, various fetuses with congenital anomalies, specimens taken from John Wilkes Booth and Grover Cleveland, etc.

For dinner, I had ate at Bookbinder's at the recommendation of a friend. It was pricey, so I stuck with New England clam chowder, a salad, and a glass of wine.

Not too much else to report. I hope to spend more time roaming around town tomorrow after my exam.

Let's Get Physical

I don’t believe I have whined about this one yet…

On Thursday, I leave for Philadelphia. The powers that be in this country have recently added a fourth component to the medical licensing exam. It is now required for all US medical students to spend a full day being video-taped conducting histories and physicals with mock patients. It’s kind of like that episode on Seinfeld where Kramer got hired to pretend like he had gonorrhea for a medical school, only bound to be less entertaining. I will have 12 patient encounters, and I’ve already been forewarned by others that one of them will be a jerk to test how I interact with difficult patients. I guess maybe the whole thing wouldn’t be so annoying if it wasn’t costing me $1500, including travel expenses.

While I do think that it is important that future physicians be evaluated on their bedside manner and ability to communicate, I think that could have easily been objectively evaluated by certified preceptors at some point during my last two years of clinical evaluations. The test is also bogus, as something like 97% pass on the first try, so it’s really not even a valid test. Even more agitating to me is that my classmates have told me that my evaluation will be just pass/fail. So the day won’t even be a learning experience for me, as I’ll have no idea what I could improve on.

Whatever. My exam day isn’t until Saturday, so I plan on making a mini-vacation of it and exploring Philly on Friday as I have never been there before. The other bonus is that tomorrow will be my last day here. It really hasn’t been that bad, just boring.

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The other day we discharged “Old Blue Eyes”. He had brought in by his “caretaker” who insisted that he was demented, having increased falls at home, and needed to be placed in a nursing home. First off, it turned out that his increased falls were due to alcohol. Then it turned out that this woman was not even a family member or his medical power of attorney. She was just some stranger who had found him passed out in his car in the parking lot of their apartment complex on several occasions, and has made herself his personal nurse. Since OBE wasn’t drinking during his hospital stay, we found him to be completely lucid. Several thorough investigations by the physical and occupational therapists found that he had no trouble balancing, or getting around with his walker. She insisted that he couldn’t be left at home alone, and that she was exhausted from continually caring from him. Basically, the guy refused to go to a care home, but his “caretaker” made a big stink about it. I think she had several issues of her own, but that’s a whole different story.

I guess my whole point in bringing this patient up, is that one can’t force someone to get help. Sometimes, the best you can do is provide information and hope that people will follow your advice/recommendations. Unfortunately, it is not a crime for an adult to slowly drink themselves to death. People choose their drugs/drink over their family and their own personal health. I think that the depression that results from those losses just feeds their habit more. As long as a person is mentally competent and not putting anyone at risk with his/her habit, there is nothing that we can do about it. My psychiatry rotation last year was with an addiction specialist. We had several patients who just didn’t do very well with the program because they were simply interested in fulfilling a court-order or proving something to someone else, rather than being interested in seeking recovery.

Memory Lane

Going back to my hometown is always somewhat of a surreal experience. Things still change in a small town, but at a much s-l-o-w-e-r pace, almost as if the earth’s revolutions slow down in just that one spot. Hence, I still know exactly what buildings are where, but maybe the paint color has changed, or a new sign makes things just different enough to feel foreign.

I never thought much of it at the time, but when I was in high school, you could recognize people by their vehicles. A certain pickup meant a close friend, while another body style barreling down the road meant trouble. When I left for college, it took a while to stop waving at vehicles I thought I recognized. It gradually sunk in that there were people that owned a yellow slugbug other than my English teacher.

Another strange thing about that town was that when we first moved there, you only had to dial a 7, followed by the last four digits of a person’s phone number. Our phonebook was the size and thickness of a comic book, and it included at least two other towns!

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I ended up driving down immediately after work on Saturday night. I took the longer route, driving down from the north as it was already after dark, and I’m of the opinion that it is a wee bit safer. When I left, an almost-full orange moon was behind me. After turning south, it appeared on my left, seeming to race me towards Mexico. Despite my best tries, the moon ultimately won out—although I blame the angle of the highway for that one.

Twenty miles north of my hometown, I was greeted by multiple sets of flashing lights. This time, it wasn’t the Sheriff’s Department, but only the Border Patrol. I always forget about their little checkpoint. It’s been a recent addition in the last two years. To be honest, their presence there pisses me off. I’m not leaving the country, so why should I be forced to slow down so that they can peer into my vehicle or punch my license plate number into a computer? And what kind of profiling are they doing to base their searches on? I’ve never been stopped—perhaps because it would be difficult to smuggle more than one person in my car’s trunk—but I doubt that’s true for my darker-complexioned friends who live in the area.

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On a lighter note, Easter dinner was great. I ate too much, as is the norm at holiday dinners. I had brought down Gewurztraminer wine to go with the ham—this was at the recommendation of several websites, don’t think I am cultured enough to know anything about wine! It went over well, and I’m only mentioning it here so that next time I’ll be able to find the name of it again.

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After dinner, I left early enough so that I could take the route east back. This involves driving across reservation land along a bidirectional highway with many turns, and no shoulder. To this girl, no shoulder means one thing: no hidden cops! So, I did what anyone would do—I cranked up the music and criss-crossed back and forth across the double lines, straightening out the curves like my father taught me to. I was pleasantly surprised to find that the highway had recently been repaved, and my car sailed over the small dips like a boat at sea. I regret that I had but four cylinders to give!

It has probably been about ten years since I had been on that highway, and the drive brought back memories of many trips to away games during high school. The only thing bad about that road is that there are scraggly cows that wander free along one section of it, so I don’t like to drive it at night. Along the way, I was a bit startled by the numerous small, white crosses that flanked the road. A classmate and a teacher of mine have both been claimed by the local highways, and the small shrines I passed with votive candles lit for the holiday were a sobering reminder.

Picture Pages

I installed Moxilla Firefox today, so hopefully less problems with posting. So far, so good. No cameras were allowed in the caverns; these pictures were taken during our hike after.

Back on the Wagon

Sorry, I haven’t dropped off the face of the earth, I’ve just been feeling a little lugubrious lately. I don’t really know what my problem is. I have a lot of things to look forward to in the upcoming months. Every now and then, I seem to just slip into “blah” mode and it takes me a week or two to emerge.

On Monday, I attempted to run 3.5 miles, but ran out of steam after 2.25. It’s my own fault as I think I only went to the gym three days last week. Today, I pulled it off. It took me 38 minutes, but I did 3.56 miles! I guess I just need to push myself a little harder to get back on track.

My other issue has been with my laptop. Although I’ve been picking up a wireless signal here for the past 3 weeks, this week Explorer has been giving me headaches. I have pictures from last weekend that I’ve been trying to post, but despite multiple attempts, it just isn’t happening.

I’m back out of my slump now, and am looking forward to seeing the PU’s (parental units as my friend calls them) and the older brother, W and his wife, D on Sunday for Easter dinner. The little brother (I suppose I shouldn’t call him that as he’s 6’5”) is currently in Kenya with the Peace Corps. My family is not the touchy-feely type, but it’s been weird not seeing T at holidays and birthdays this year. I think he still has about 15 months to go. My immediate family has all been in the same state since we moved here in 1989. It’s kind of funny though, as us 3 kids are now all leaving at once. I will be leaving around mid-June and W & D are currently applying to do a year of teaching English in Japan. I moved out of my parent's home at 18 when I left for college, but I suppose I've always had a 250-mile safety net.

Sunday Spelunking

Unfortunately, my current rotation involves working six days a week, so getting home on weekends to see my friends has been a little daunting. To cheer me up, my best friend came out for a visit last night after I had finished work. We saw “Thank You for Smoking” and ate all sorts of things with no nutritional value.

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This morning, we got up at 5 am and drove down to this place, which was way cool. The park has been in existence for less than twenty years, and there is much more effort being put forth towards preservation of the caverns than others that I have visited. And, although I was already familiar with stalagmites and stalagtites, today I learned about helictites, soda straw formations, and troglobites just to name a few.

We currently have a disagreement going on about the word spelunking—she says it specifically means scuba diving in caves, but www.m-w.com just gives the brief definition of cave exploring, so I’m using it!

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After the cave tour, my friend and I went a hike, with this one being about 4 miles long. Once again, it was in the noonday sun, but for most of it we had a good, strong breeze.

A Time to be Born...

Sometimes everything just flows together with everyone on our whole, sloppy planet seeming to be entwined. The same subject spoken about with a friend appearing as the segment of a daily talk show. A lecturer discussing treatments for alcoholism the very morning that my alcoholic patient dies, surviving less than seven minutes off the ventilator.

What can I say? Some say it is coincidence, and some say it is God. And, some say it is simple statistics that out of the thousands of statements one hears or says in the course of one day, a subject is bound to be repeated. At the same time, once my attention is drawn to a subject or person, I no doubt notice it again and again, or even seek it out.

I don’t really know where I was going with that thought, but that was how my day started out.

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Yesterday, I decided to do something nice for myself and bought a cluster of stem daffodils while at the grocery store. I wasn’t sure quite what they would do, if they would open at all, or slowly and progressively, like one firework at a time.

This is what they looked like yesterday:

When I got home this evening, I came home to KA-BOOM!!!

I didn’t expect almost all 20 to go at once!

They’re practically duking it out for space!

I have always liked watching vibrant flowers emerge from seemingly dead, dried-up bulbs. One year for my mother’s birthday, I spent hours digging up the strip of dirt along the driveway and planting a mixed bag of about 80 daffodils. That spring, and every year thereafter, they come up and put on a show like clockwork.

That’s another thing I’m looking forward to about getting my own place in a few months… houseplants, and maybe a garden.

8 5 3

I am disappointed with myself. I am guilty of failure to act, and frankly, it is not the first time. Sometimes opportunities to help people present themselves so quickly that I am caught off guard. However, this time I definitely could have said something.

My friend and I were out for a late lunch the other week, and there was a woman in her thirties not ten feet away from us. She was dressed nicely, her hair and makeup were done—everything appeared to be in order. However, as she moved forward in the line, it was then that we noticed her arms. All along both arms from shoulder to elbow there were bruises in different stages of healing, with most of them being along the inner, medial aspect of her arms. This was not an accidental pattern of injury. There is no way that those bruises could have been the result of a one time fall. And if she had fallen, it’s unlikely that both arms would have been bruised so symmetrically.

My friend and I looked at each other. We both agreed that the markings had to be the result of violence. The woman walked off. She appeared to be alone but still, neither one of us said or did anything.

Here’s a few statistics I try to keep in my head:

-One in eight women will develop breast cancer.
-One in five women will be victims of domestic violence at some point in their lives.
-One in three women will develop ischemic heart disease.

At the time, I didn’t know what to do. I did not want to embarrass or anger her by a comment on her appearance. I also felt somewhat at a loss for words as I don’t even know the names of any of the local women’s shelters or support hotlines. It can be frustrating to deal with these types of situations, but I still should have at least said something to her. Ultimately, everyone makes their own choices in life, but at least if I had drawn her attention back to the issue, it might have been the start of a decision to change her situation.

For the rest of that day, I felt pretty bad about the situation. Although it’s becoming more of a distant memory now, my inaction still bothers me. At the same time, I know that it is pointless and ineffective to keep dwelling on the incident. But really, what kind of doctor sees someone in need, and then does nothing? I was again reminded of that afternoon when I ran across this little gem the other day: “But if anyone has enough money to live well and sees a brother or sister in need and refuses to help—how can God’s love be in that person?” 1 John 4: 17

The best I can do now is to determine how I could have better handled the situation. For starters, I think a simple, “Are you okay?” would have done nicely. That way if she didn’t want to talk about it, it gives her an easy exit. At the same time, hopefully it doesn’t come across as judgmental. And a little research on local shelters is definitely in order.

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On a much lighter note, today I ran 3.27 miles—which is a new record for me. I wasn’t sure I’d be able to add another .25 miles as I had kind of backed off a little on my workouts this past week, but I did it!

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I don't know if you can appreciate this from the picture or not, but see those shower curtain rings? Those are actually binder rings, like from an office supply store. This apartment is wacky!

Spare Change

Dear US Mint:

Enough is enough. First you messed with the quarter, creating a frenzy of state quarter collection display kits. Then, let’s not forget the “golden dollar” fiasco. I mean really, how did you expect to replace a $1 bill with a coin? Did you not take into consideration how this new piece of metal would be incompatible with vending machines? (Thank you Ohio Turnpike for giving me no less than eight golden dollars in change last October—they are still sitting on my dresser at home.) Now you have started messing around with nickels.

But today was the last straw: I finally got one of those new-fangled $10 bills from Starbucks as part of my change, and I have one word for you—fugly! It’s not even green anymore! The entire thing is cat-piss peach! Do you really think any one is going to take our country seriously when our currency is PEACH? It also has crazy gold and copper metallic ink splashed on it, and different-sized ovals devoid of any ink on either side.

I have news for you: if embedding plastic strips in currency doesn’t evade counterfeiters, what makes you think a crazy LSD-inspired color scheme will?

-Kate

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Also at Starbucks: I dropped my change as I was paying the guy at the drive-in window, so I opened my door to pick up the dime I had dropped (Yes, I am that CHEAP!) and there was a whole pile of coins there! Is it wrong that I scrounged up another $ 0.40?

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And finally:

On the cardboard insulating strip around my coffee, it reads:

Succedaneum—winning word from the 2001 national spelling bee.

I was the spelling bee champ at my school in both the 6th and 7th grades. Do you know what my winning word was that first year?

P-I-Z-Z-A

--I guess we weren’t exactly known for our academics!

Bottom Dwelling

This afternoon I packed up my tiny Saturn and drove off to a distant city to start a four-week rotation in internal medicine. I briefly inquired about my potential roommates while stopping by my school to pick up a key to the student housing last week and was told that I would be sharing the apartment with FIVE GUYS! Not to mention that they are five guys from the class of 2007, so they might as well be perfect strangers. You might think a single, independent-minded woman such as myself would appreciate these statistics, but you would be wrong, dead wrong. Student housing tends to be moldy, musty, and over-crowded.

However, when I arrived this afternoon, the four-bedroom, two bathroom apartment was deserted. I may or may not have claimed the room with the best desk and lighting, and moved the second mattress out, making my room the only single room in the apartment. I was not at all disappointed in terms of the moldy or musty aspects of the apartment. My cell phone reception is horrendous as we are in the basement of the building, but I am picking up a free wireless internet signal right now! Huzzah!

One roommate showed up this evening, and despite my lumping him in with the other married, clean-cut, male types that my school seems to attract, he does seem like a pretty cool guy. No one else has shown up yet, but the one odd thing is that the fridge is fully stocked--despite there being no claims to any of the bedrooms in terms of clothing/bedding. There are even fresh herbs and unexpired milk in the fridge--which leads to daydreaming of an almost extinct species--the bachelor who can cook, but this girl's not getting her hopes up too high.

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On the drive down, I called and spoke to my great-aunt. She's 103, and likes to use her age to maneuver you into doing as she pleases. For me, this means stopping by for a visit as I relocate myself across the country. I have one friend who is crazy enough to want to accompany me on this drive. She may change her mind when she hears about the addition of a stop for dinner at an assisted-care home. And R- if you haven't already decided to bail out on me, realize that dinner for seniors is served promptly at 4:30 pm in the cafeteria. If we are five minutes late, they'll be out of the good fish!

And as for the family reunion in July? I didn't give her a firm, "No way in hell!" but conceded to, "Well, we'll see if I have that weekend off."

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As for the rest of my weekend, there were no residual aches/pains from Friday's hike and my run yesterday was 3.06 miles!

Half Baked

I took advantage of having today off by going for another hike. I purchased a hydration back pack yesterday in anticipation of more difficult hikes to come, and it seemed like it worked pretty well. Next time I will definitely freeze half the water beforehand, so I won't be sipping hose-temperature water after only a few hours' time.

Unfortunately, my friend and I are not morning people, so by the time we hit the trail (Post lattes and a blueberry scone, of course!) it was already 10:30. However, after 3 hours of hiking, I think I've come away with only a slight sunburn at my hairline, so not too bad. I definitely feel drained after spending that much time in the sun, and have a mild headache despite drinking TONS of water and powerade. During summers in high school, I used to lifeguard at the local swimming pool, and it always took a few weeks to adjust to that much sun exposure.

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As part of an evil genius landscaping scheme, the buildings at my school are all named after various cacti. And by the sign of each building is its representative cactus--how clever! We always say that the one in front of the Sahuaro building looks like it's giving you the finger, and I guess I can see the resemblence.

Here's a nicer view, sans finger:

Rorschach Test

I had problems with uploading over the weekend, so here are some more pictures from Saturday's hike.

Does anyone else see a skull in this cloud, or have I just lost it?

Fine Print

My contract arrived today! It was much shorter and more vague than I expected, but it did give me a start date of July 1st, and what my salary will be. I guess reading it also made the whole process seem that much more final. I also have to decide how to have my new white coat embroidered and request vacation dates.

I will be happy to retire my student coat that I've worn constantly over the past two years. The sleeves have permanent rings of grime around the wrists, and there are stains from chemicals, food, and um, patients, that just won't come out. FYI- Student coats are shorter in length. If your healthcare provider is wearing a coat that is the length of a regular blazer, than you're probably being seen by either a nurse or a student. If the coat extends to the knees or below, then you're being seen by a resident doctor/attending, or in some places, a nurse practitioner.

Personally, I don't enjoy wearing a white coat. For one thing, I'm pretty klutzy. Also, none of my own doctors have ever worn them. The only people I associate with a long, white coat are butchers. I don't think that is exactly what my profession was going for, but I can't help but smirk when I see the white coats coming down the hall.

Weekend Update

I went for my long run on Friday, and managed to stick it out for 2.82 miles! It was tough though, as my butt muscles were already making their presence known after having incorporated some lunges into my routine two days before. I could almost picture my piriformis muscle—hot, swollen, and tapping on my right sciatic nerve like a bad knock-knock joke, sending shooting pains down my right leg.

The teen on the treadmill next to me didn’t help the situation either as he apparently went for a swim in cheap cologne. He showed up around mile one, and the cologne was so strong that I could almost taste it! Fortunately, he went on his smelly way ten minutes later. It was almost worse than having a runner next to you fart. I mean, that’s the last thing you want to be smelling when you’re already breathing hard, but at least that smell drifts away! Fortunately, I have only been the victims of one-time bombings—I don’t know what I would do if the offender had multiple emissions!

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On Saturday, I went hiking with a friend. The trail was new to us, and steeper than we had expected. It was somewhat humbling that we were only keeping up with the elderly gentleman in front of us, who was using a golf club upside-down as a walking stick. (It was an iron, too. I would have thought a driver would have made for a more comfortable handle!)

After our hike, we ate at a nearby Greek restaurant which was a treat because I usually only go there with another of my friends who is lactose-intolerant. If you have never had Saganaki (AKA Greek Flaming Cheese), I highly recommend it.

After lunch, we went to the movies where my friend and I actually ended up walking out of a movie. I have never done that before, but it was so horrible that we left after about 15 minutes, and I would say that the two of us are generally pretty hard to offend. I don’t watch television at all. (Not because I have better things to do, but because there’s no cable in my room, and the main TV in our house is constantly occupied by children’s programming.) However, this was the last time that I go to a movie because a friend likes the lead actor and, “Well, he kind of looks like a pirate again.”

Instead, we ended up seeing a silly romantic-comedy. It put me in a better mood, but between the hiking in the sun and the enduring of previews/commercials for over an hour, I was pretty exhausted!

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This morning, I was awakened by loud screams from the baby—the one who rarely ever cries. Apparently, he had fallen off my friends’ bed onto the carpet. By the time that they brought him to me, he was already giggling. After a quick trauma survey for deformities and reproducible pain, everything appeared to be in order.

I am in this awkward transition right now from being just a medical student to becoming a physician. Sometimes I know what to do, and sometimes I default to, “I really think you need to see a doctor.” People are starting to take me more seriously, and while in some respects that’s cool, it is also terrifying!

It was not quite the way I like to start my Sundays, but good morning to you, too!

Whirlwind

Late this morning, I found out where I will be going for residency training. It turns out that I have matched with the program that is the furthest distance away! I am having some mixed emotions about it, although the idea of an entirely fresh start is definitely appealing. I have been in this state for almost 17 years now, so perhaps a change of scenery is more than overdue. Also, packing up and moving will allow me a gracious exit from a couple of situations that I have avoided confronting.

The program that I am going to has an excellent reputation, and they have already called to welcome me to the fold. I am sure that many adventures are in store for me, but I am a little reluctant to be putting so much distance between myself and the friends that I have here. I have always been a person that is horrible at goodbyes. I tend to form friendships easily, but so many people have wandered in and out of my life, sometimes never to return. I just hate the thought of that happening with some of my current friends. Chris was writing the other day about actively choosing whom one associates with, and I suppose that this new start will allow me to do just that.

However, in the meantime I plan on enjoying my surroundings, including attending a match party tonight to find out how my classmates fared!

People Watching

There was not a whole lot going on today, either. I saw a smattering of cancer patients with my preceptor this am, and then went to the gym this afternoon. On my drive this morning, there was a small, red car in front of me with custom plates that read “RAPSALOT”. On the back of his limo-tinted rearview window were the words, “GETO FOREVER” in big white letters. I’m pretty sure he meant ghetto. If he was my homie, he’d be out of the gang for such a mistake, but maybe there aren’t a lot of spelling bee aficionados in the hood.

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Since I don’t have much to discuss, I’ll attempt to entertain you with more characters that frequent my gym. Some people watch birds, but I watch people! And I figure it’s not too evil to give them nicknames as I’ve come up with one for myself, too.

Whirling Dervish- This woman can always be found in a step aerobics class. She has attended so many times that she has all of the sequences memorized. However, she must have bad knees as instead of using a step in the step class, she chooses the twirl and spin around like a leaf caught in a breeze, all while keeping pace with the instructor. It’s kind of mesmerizing to watch those white curls flipping and turning.

Hunky Treadmill Guy- This guy is probably in his late-30’s to early 40’s and I’ve seen him around since I started going to this location almost two years ago. He’s made a lot of progress since I first saw him, and now has shoulders and back muscles that are fabulous to look at! Unlike the other muscle-types, he actually does quite a bit of cardio, too. Of course, I’ve never had the nerve to actually talk to him, but had been entertaining the idea of a simple “hello” until last month when he brought the worst accessory ever to the gym… a teenage daughter!

Mennonite Woman- This one’s particularly intriguing as I know absolutely nothing about this religion other than picking them out by their um, garb. However, she can often be spotted during early afternoons in the weight section. I’ve never seen her doing cardio stuff, but then again, if I was wearing an almost floor-length dress with a white headdress, there’s no way in hell I’d be running around in that heavy cloth, either.

The Good Twin- This guy looks exactly like my ex-boyfriend, and if he’s the good twin, then that makes my ex… well, you get the picture. Anyway, he has the same hair color—but longer ponytail, a habit throwing “Rock On” hand signals across the room, and only wears long-sleeved shirts, even in the summer. The long-sleeves, if he’s truly like my ex, are used to cover tattoos in public.

And as for me, I am Tall, Sweaty iPod Girl who is there almost every day and nods hello occasionally, but talks to no one!

Lazy Daze

I had the day off today, so I slept in until all of 7:15 am. Why is it that garbage trucks are so freakin' loud? And I live on a cul-de-sac, so I'm really not sure why they kept driving in reverse, necessitating the use of their back-up alarms!

Most of the morning was spent sipping coffee and returning emails/phone calls. For lunch, I drove across town to meet up with a friend for sushi... well, crab rangoon and salmon sashimi to be exact. Yumm... I have given up sweets for Lent, but am definitely making up for it with salty and fried food.

I love having days off in the middle of the week because stores aren't crowded and you can get a ton of errands done. Unfortunately, everyone else is at work so hanging out options are limited.

And Then There Were Six...

After checking my email frantically at my new preceptor's office this morning, I found out that I MATCHED!

I had been trying not to think about it all weekend, but I was so nervous this morning as I made the hour-long commute to work. Although scrambling can be an exciting option as you can slip into an unfilled spot in any specialty, I am so glad that I don't have to!

It's a good feeling to finally know what I'm going to be when I "grow up", and that is an emergency medicine physician! I don't even mind waiting three more days to find out where I matched. I'm certain that I will be happy at any one of the six programs that I ranked.

Out of Focus

Today was my day for a long run, but I was having a hard time getting into any kind of stride. Right now I am exclusively doing treadmill running, but I like to be able to look out a window and focus on trees or clouds in the distance. I guess it makes me feel like I am actually going somewhere. Unfortunately, there are only a few treadmills at my gym that face the windows. Rather than waiting, I ended up on one that faced a six-foot mirror across the aerobics area. There was a useless 2’x2’ window to look out, but all I could see was a bit of grey sky and part of a telephone pole that kept bouncing up and down with every step. So between the telephone pole and the expanding ring of sweat from my collar, there wasn’t much of a view. I had my U2 albums on shuffle, but I still couldn’t find my moment of Zen. My arms were awkward and useless; flopping around like those of a Tyrannosaurus Rex. Finally, I called it quits after dragging my carcass 2.59 miles.

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After threatening with clouds most of the week, it finally rained today. It was freezing, so I figured it was perfect weather for coffee and studying blood disorders. Apparently, everyone else thought so too, as the coffee shop was packed! Outside, there was a truck with a dissolving snowman in the back. They must have been on their way back from somewhere up north. It looked kind of morbid—like one of Calvin’s snowmen from the Calvin & Hobbes comic strip, pock-marked from being hit by the rain.

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There was no line at my local Great Clips, so I decided to drop in. Not only did I get more attention than the usual 90-second hair trim, but I managed to learn my something new for the day. My stylist was commenting on my ear because I recently got an old piercing through the upper cartilage of my left ear (the helix) redone and she noticed that it is still healing. Somehow that progressed to informing me of where all of her piercings were (you really don’t want to know), and a lovely tale about her boyfriend. Apparently, he was sitting on the couch letting the cat chew on one his piercings when it pulled his nipple ring right off! I briefly entertained giving her a quick lecture on Pasturella multocida infections from cat bites, but refrained. So there you have it: if you have nipple piercings, you had better keep ‘em covered around the cat.

Random

My friend keeps whining that she should have studied marine biology instead of medicine, so I bought the above guide for her birthday. I had to giggle when I saw it lying next to a Victoria's Secret catalog on my desk. Yes, I am silly.

(Note: The above items were photographed away from my desk to protect the disorganized nature of the author!)

Blame It On the Rain

On my drive to work this morning there were dark clouds looming behind the mountains to the north and the ones to the east. Off in the distance, I could make out the blurred lines of rainfall. I have heard it said that during a storm, the normally positive electrostatic field of the earth becomes more negative as electrons migrate during rain formation. Having never studied meteorology, I don’t know if this is true or not, but I was wondering if those tiny changes in electrical charges could have contributed to my bizarre day.

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Today I saw a 75 year old diabetic whose husband was completely incapacitated, having never recovered from a cervical fracture last year. On top of that, he has now managed to develop Pick’s disease (aggressive form of dementia with dramatic behavioral changes). Sounds like my patient from Friday, right?

I asked her how she was doing and she said, “How do you think I’m doing? My husband hates me, social services is worthless, and I have a very big house to clean!”

I asked her if she had someone to talk to and she told me that years ago she spent five years with a therapist from UCLA. (Apparently, I was supposed to be impressed by the name she dropped, but I’d never heard of him.)

I asked her if she wanted a referral to someone in town and she said, “Who’s going to know more about living than ME?”

So, we moved on to her diabetes. When asked about exercise, she said that she wasn’t doing anything now and wished that she had never stopped doing yoga. “And if you aren’t doing yoga now, you had better start!”

And that, my friends, is when the 75 year old diabetic with retinopathy, who came in with a walker stood up, bent forward, and planted the palms of her hands on the floor.

“Not bad, huh?” she said.

I was feeling a little flabbergasted when the drawn-out discussion I had expected turned into senior citizen calisthenics, but whatever.

However, I should have thanked the patient this time. Her visit again reminded me of the different ways in which we all deal with stressors. Her reaction to her situation was entirely opposite from the woman on Friday. Rather than dealing with her emotions, she just shoves them aside and moves on, with a dash of piss and vinegar thrown in for good measure. I don’t know if she is being all that healthy by repressing her emotions, but she is definitely dealing with life on her own terms, rather than letting it happen to her.

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Later, I was at the grocery store, picking up some uh, personal items. I have one quick comment and then I’ll leave this topic:

It was more than a little offensive to find that the tampons and maxi pads in this particular store were stocked in the baby aisle—right next to the diapers. They are quite a different product, and I am positive that diapers are the last thing any woman wants to look at who has failed to get pregnant. Seniors needing Depends are probably also offended to find them in the diaper and baby food aisle.

Just my "two cents" if any store managers out there are reading.

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On my way home, a mini-van pulled up even with my car and stopped. I turned to look, and the driver was just sitting there staring at me dead on. Maybe I should have smiled back, but I turned my head and looked forward. I could see out of the corner of my eye that he was still sitting there for about 30 seconds more before finally pulling up to the intersection. Why would you do that? I hadn’t cut him off, I had pulled into the slow lane. And if he was trying to pick me up, he should have waved or something, right? Staring is just c-r-e-e-p-y, especially with a baby in the backseat.

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It still hasn’t actually rained in my part of town, and I am hoping that it also missed wherever my preceptor was out golfing. We only work a half day on Wednesdays. If his golf game got cancelled, I’m sure there will be a foul mood to deal with tomorrow, not to mention lots of questions about tonight’s reading assignments!

I did spend about an hour at Starbucks reading today, but couldn’t concentrate when the guy sitting next to me decided it was necessary to flip through today’s newspaper reading just the ads—aloud and at full volume. On the plus side, now I know who guarantees the best price on washer/dryer sets.

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I'm just hoping it will rain overnight and wash all of the wackos away!

Open Apology

I would just like to take a brief moment to apologize to anyone I may have offended in the past by squealing "Gross!", squishing up my face, making retching noises, or clasping my hands to my throat and feigning death at the mention of the word lox.

A good friend of mine invited me over for brunch on Sunday, and I am not sure if it was technically lox, but the seasoned salmon cream cheese spread we had on 12-grain toasted bagels was awesome! Ignoramus that I am, I alway pictured lox as being whole fish like anchovies, complete with eyeballs glaring back at you, on top of cream cheese and a bagel.

I love visiting with J-- her apartment has a such an international flavor. She's Jewish and grew up in New York City and married a French guy. I have never been to France, but if it involves lox, fresh pears, strong coffee, and a giggling baby-- then I am totally up for it!

One Slipped Through the Cracks

I have not allowed patients to get to me emotionally for some time. My force field is intact… you can cry, you can scream, you can insult me and my mother, but you won’t break me. Until Friday that is…

It started off innocently enough; she was just there for a follow-up visit. She is in her 80s and we were supposed to be talking about her diabetes. We have the same first name. She was born and raised in Ireland. Being a redhead, I often get mistaken for being Irish. I asked her how she was doing, and she started to tear up. She said she had been having a rough couple of weeks. It turned out that her husband, who has been struggling with dementia, tried to commit suicide two weeks ago, and had to be moved from an assisted living center to an Alzheimer’s unit with constant observation.

I told her that I was sorry to hear that, and started asking her more about how she was dealing with it. She quickly admitted to depression, but said that the last thing that she wanted right now was more medication. I told her about my grandmother, who no longer recognizes me. To my surprise, I found myself tearing up a little bit, too. We talked about how dementia is almost worse than death because the disease ravages so much of a person’s character. It is like they are gone, but yet you can’t grieve their loss because you continue to see them. As a family member, you get stuck with this horrible conflict of emotions. Visits become more and more difficult as the disease progresses. At the same time it doesn’t feel right to not visit your family member, even though they don’t know who you are, or can even become fearful of your presence. She said that she was feeling guilty about not seeing him every day, but it had gotten too difficult for her emotionally to visit him more than once a week.

I really didn’t know what to say and was trying to block myself from becoming too emotionally involved, so I stalled by talking about her diabetes for a bit. After answering a few questions, I wrapped it up by saying that I thought she was making excellent progress controlling her blood sugar, but that I was concerned about the emotional stress that she was dealing with. She said that her daughter was her only source of support, but that she was stressed out about the situation and had her own family to raise. I asked her if she would like to speak with a counselor or maybe someone at her church.

She then said that she had given up on her church after they had not bothered to come to see her in the hospital last summer. Apparently, she had undergone heart valve replacement and had asked a priest to visit her after having dreamed of her own death after the surgery. The priest blew her off on a bishop, who never showed up or even called to check on her later. Just like that, a woman who had attended church every week for over 80 years quit going. I could tell from her tone that she was still very angry and hurt by the incident. She mentioned that she had thought about going back, but didn’t want to go during Lent.

She waited for me to say something, and I started wondering how I ever got from a simple follow-up appointment to someone wanting spiritual encouragement. So often I feel that there are certain boundaries that shouldn’t be crossed when it comes to discussing religion, particularly in a professional setting. Clearly, she wanted me to say something though, so I just said that I thought that she needed someone to talk to. She said that a social worker involved with her husband’s case had mentioned a support group. I said that I thought that would be a good idea and that if she didn’t want to talk to strangers, she could always just go and listen. She said that she did think that she would return to her church. I told her that I would have been very hurt if I had been in her situation as well, and suggested that maybe she attend a smaller parish, where she might feel like part of a community.

Finally, I went and got my preceptor after I’d spent over a half hour talking to her individually. I briefly told him about her situation. Although he told her that he was sorry when he walked in the room, he didn’t say one other word to her about it. Five minutes later, we were done with the appointment. As she left, she thanked me for caring so much and told my preceptor and the front office receptionists that I was very nice. I could tell that I had lifted her spirit just by listening, and was glad that I had addressed an issue that otherwise would not have been covered. I know that everyone has their area of expertise, and that a lot of physicians aren’t comfortable dealing with depression and other issues, but at the same time you can’t just ignore them! I have a friend who is a psychiatrist, and I really admire him for being able to help people the way that he does. I could never do it; I would rather deal with fallout from the local knife and gun clubs. I guess I internalize things too much, ending up exhausted and drained.

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I talked with a couple of my friends about the situation over the weekend because clearly this patient tugged at my thoughts. So far, two out of two agree that I should send an anonymous note to her priest. I certainly don’t want to draw any attention to her in any way that would cause her to feel ostracized, but I just feel like maybe they could use a reminder of how important their interactions are with sick patients. A woman was calling out to them for help, on what she believed to be her deathbed—what a horrible time to be forgotten!

One More Day

Argh! I just was emailing a classmate the schedule for the Match only to realize that it is March 16th, not the 15th! I guess one more day of waiting won't kill me.

Marching On

Exactly two weeks from now I will know where I’m going and what I will be doing for the next three years. As the date is approaching, I am finding myself becoming more excited about the changes to come. I guess that’s a good thing, since this whole process has been filled with so much anticipation and even some dread. I am feeling good about my list and think that I will be happy to wind up at any of the programs that I ranked.

There is always the possibility of not matching and having to scramble into an open spot, but at this point everything is out of my hands. Technically, the decision has already been made and a match has either been established or not (Allegedly, the computer program only takes a few hours to run.), so there’s really no point in worrying as I’m just now waiting to view the results. I feel really blessed to have had such support from my friends and family over the past few months.

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Yesterday I was talking to BDG (Blind Date Guy) who also has a lot going on as far as getting his career started—but in music, not medicine. He was saying something about being given the advice to be more proactive and set goals for himself for three months in the future. He said that you should then reevaluate those goals every three weeks and if your goals aren’t changing or being updated, then there’s something stagnating your progress and you need to reevaluate your situation.

Three months from now I want:

1. To graduate.
2. To be able to run 5 miles without stopping.
3. To be out on my own again, be it renting/purchasing a place.
4. To be updating this blog at least 10 times a month.

So there it is, now I guess it is my responsibility to make it all happen. Famous last words, but it seems like a good idea. Lately I just feel so passive, like I’m just waiting for everything to happen to me. Of course I’ll probably regret posting this, as now I have an audience for potential failures, but perhaps this is also an exercise about not basing my self esteem on the approval of others.