proof that i have no life.

it's saturday night. i'm home for the weekend. laying on my mom's couch. watching the food network. reading past postings and reminding myself of how funny i am.

******

i'm currently working in columbia at university hospital. doing peds heme/onc. it's not as sad as i thought it would be. mostly because our patient census is fairly low. i did do a nice presentation on neuroblastoma friday morning. go ahead. ask me anything.

it's also mostly fun being in columbia because of the close proximity to family and old friends. i live with a good friend from high school who is currently working at MU.

i got to go hang out with stacy and the kids on a week night. that was fun. like staying out late on a school night. and i'm going to try to make it for abby's gymnastic practice. she showed me some of her tricks, and let me tell you... it was impressive. ;-)

next weekend will be busy - hanging out with some college friends friday night. hopefully hanging out with jen and stacy and their kids saturday night. watching ruth clog it up sunday afternoon. fun fun fun.

******

philly was a good time. here's a hot photo of tanner and i after boards were done. yippee.


and the other side of the table... jamie and marc.


and the next day we went walking around downtown. we saw the famous sites... dawn, remember when we found the liberty bell and it was glassed in and you could barely see it and you definitely couldn't photograph it because of the glare of the flash and you had to use a flash because it was dark out? well, they've built a huge building/museum around it. it was kinda nice, and HIGHLY "secure" as we had to remove our coats and go through metal detectors to get into the building. the security guards were hardly paying attention to us as we went through though. they were discussing someone's "baby daddy"... one of the guys pointed out that he'd never heard anyone use that phrase so seriously before. it was a good time. then we started the independence hall tour, but became quickly bored, so we skipped out. then we found a cute coffee shop for a quick pick-me-up. all in all, not a bad trip. except that boys are obnoxious. and especially those boys. but we had fun.

he loves me.

here's what dr. mcdreamy had to say about me in my evaluation:

"Amanda did a great job in the PICU and showed significant growth during the elective. She presented with a strong pediatric and physiologic knowledge base and exhibited an intense interest in learning. Her fund of knowledge is likely greater in some areas than some current pediatric interns and at times she answered questions the senior residents didn't know. She demonstrated excellent airway management skills - first on a mannequin and then on an infant with respiratory failure. Her documentation is complete and well written. She was definitely a team player and it was a pleasure having her in the PICU. She will be a solid pediatric resident and we would love for her to do her residency here at Children's Mercy Hospital."

here's what i read:

"... love ... her ..."

10 weeks to go.

you read right, folks... i'm done with rotations in 10 weeks! this week is technically not over until friday, but i'm heading to philadelphia today with tanner and a couple of our other friends to take our physical exam boards. it's a little scary, mostly because it's $1000 test and there's not way to study for it. cross your fingers and hope for the best, i guess... eek! my friend sarah said she was more nervous about it after taking it than she was before taking it. gee, thanks for that, friend sarah.

i'm at jen's because she's taking me to the airport today. i'll fly back on saturday, and then it's off to the races... i have to pack up my car for the next 10 weeks and be in columbia by monday. if i hadn't be so exhausted (read: lazy) this week, it'd already be packed. oh well.

******

i had dinner with my best friend from high school on monday. i hadn't talked to her in years. (weird that i'm old enough to say something like that.) i had seen her grandma earlier in my rotation when the doctor and i were grabbing lunch before heading to the wound clinic (gag!) and she had asked me if she could give suzy my number. so i said, "sure" (just for you, jen), presuming she would never call... but then she saw my mom at work last week, who told her i'd be taking off soon... and she actually called. we had a good time... her husband (who was also in our class) and almost-4-year-old son went out with us too. somebody remind me to call her when i get back in town the end of april, k? thanks.

grey's.

why didn't anyone tell me not to bother with last week's grey's anatomy? for real, people. i thought we were friends.

******

looks like i'm going to be in columbia next month, doing peds cardiology. then 6 weeks in kirksville doing some random nothingness. then? then, done. and boy doesn't that sound good.

in the middle there, there's match day. you know, the day i find out where i match for residency. march 15th to be exact. and you know what they say. beware the ides of march. yikes.

happy double o' 7.

so it's the new year. yada yada yada.

******

to address the comment section... i have no idea how much a femur weighs... but i know it depends on whether or not it is alive or dead. dead femurs are very light. live femurs would be light too if you sucked out all the bone marrow. but if you sucked out all the bone marrow, the bone wouldn't be alive anymore... it's an unsolvable conundrum. i'm not sure if that word is spelled correctly. you'll get over it.

but if you have to answer the question, i'd go, oh i don't know... maybe half a pound or so.

******

as far as where i go when... i'll be in harrisonville until the end of january, at which point i fly to philedelphia to take another (MUCH less stressful, MUCH more expensive) set of boards. afterwards, i'll start a new rotation... i've requested one in independence (which means i'd live with my friends in raymore again... which would be loads of fun...) but it's not been approved yet. i'm starting to get a TEENSY bit nervous about that... but it'll work out in the end. so, let's see... 4 weeks in independence (hopefully) and then 6 weeks in kirksville, mo. that should be fun - one of my only cross-over friends (meaning, we were good friends in college and then went to the same medical school) is an intern (first year resident) there and i'll be staying with her for at least part of the time i'm there. exciting.

******

i'm currently in columbia. i have an interview tomorrow. then just one more next week in omaha, nebraska. i'm fairly certain i don't want to go there, but i'm going to the interview to see my friend sarah who lives there. we'll hang out friday night, then i'll come back through saturday in time for the big birthday bash! a good time will indeed be had by all. then it's time to nail down the official rank list... eeeeek. eek eek eek. the good news is, no matter what happens on match day (the day i find out which program i'll go to), i'm pretty sure i'll be happy. the people everywhere are so very nice.

oh, and this is fun - i met a guy tonight who worked with dr mcdreamy. you know, MY dr mcdreamy. i don't think he loves him as much as i do, but he liked him a lot too. and the guy was cute too. and he is staying in the hotel room next door. maybe it's destiny.

december's almost done.

i can't tell you the number of times this month i've been yelled at for not posting. sorry.

******

the doctor i'm working with works nextdoor to my highschool. it's awesome! after months of a 45 minute to hour long commute, the 4 minute drive is WONDERFUL! we start at 7 most days. if i leave by 7:04, i beat him there...

and he's awesome. he is fun and laid back and smart and so nice. and he grew up here too. and so did his wife. and he's related somehow to about every other patient or so. we've been working on drawing out the family tree... his wife has a HUGE extended family... he goes to one of the baptist churches in town, so even our circles of friends overlap some... it's fun fun fun. and he cracks me up... he's always telling funny stories about his kids... he has four of them between 3 and 10 yrs old... like the three year old squeezing his preschool teacher's "bunnie-wunnies"... or the ten year old asking if he had to have sex when he got married... it's a riot, i tell ya!

his nurse is fun too... and she thinks i'm funny and is constantly saying some variation of "you fit in so well here!" hopefully there's a job offer floating somewhere in there... we'll see... it's a family practice office, so i'm not sure they'd let me in... but one of the partners is internal medicine... so maybe. wouldn't that be something...

******

mom and i are going to see "the holiday" tonight... meridith said it was cute. but i have some laundry i need to get going on before then. so you'll have to take this as your update...

fast.

that's how time is going. i'm not all that busy, and i'm not all that entertained in my spare time, but it's somehow going by SO quick... like i think one day i may wake up and my entire life have just rushed by. i mean, i'm practically 30.

maybe this feeling is exaggerated right now because my weekends have been very busy. very very fun. and very busy. it's made my chicago month race. unlike my last chicago month... but let's not relive that again...

weekend #1 - skinner came in from pittsburgh: we ate, we played games, we dyed her hair, we shopped. it was so fun to see her! here's one of the few pictures of our weekend. it was bright and sunny!


weekend #2 - sarah came into town for an interview and stayed with me at meridith's house. we went to dinner friday night, then helped meridith and her boyfriend with a puzzle (that took us a WEEK to finish, by the way), saturday morning she had her interview, then the four of us went out for a sushi lunch. sarah and i then took the train downtown where we intended to shop a little, then meet a friend for dinner. we only went to old navy so she could get a scarf and gloves... it was cold! then as we were heading towards the pub where we were supposed to be meeting our pal matt, we accidentally ran into santa claus. turns out, that night was the parade and fireworks show prior to the lighting of the michigan avenue trees. it was fun and pretty, and made us a little late. which turned out to be ok because matt ended up working a little late. we beat him there by about 10 minutes. after dinner, which was amazing! we met matt's friends and ended up staying out until about 3 am... (there was a small decision making session around midnight, when we would've needed to leave to catch the last train out... we decided to stay over with matt at his friend ryan's and take the train in the morning...) sarah was exhausted! she had been up since 5 am, and had only slept a few hours the night before! we headed out for the train station after a brief nap... made it onto the 8:30 train, which subsequently broke down and got back an hour later than it was supposed to. no matter though. we grabbed some breakfast and went back to meridith's where sarah showered and headed out for detroit. this is one of the only photos that i took before my camera batteries died. i had extras with that were also dead. sarah took a few, but she hasn't sent them to me yet.

weekend #3 - thanksgiving... i had about 5 full days off work and really wanted to come home. i decided not to since it's an 8 hour drive and i am coming home on friday anyway... now i'm even more glad that i didn't make the trip since everyone was sick sick sick. i ended up having thanksgiving with meridith's family on thursday. we put together another puzzle (it's possible we've become obsessed...). thursday night we attempted to do some pre-black friday shopping at some nearby outlet malls that had "midnight madness"... it was madness alright. absolute madness. we sat stopped dead on the interstate for an hour and a half... all three lanes of traffic. dead. stop. we ended up making our way to the left lane and skipping past the outlets and turning around at the next exit and heading home. we made it back home about 2, i got up at 4 to go to best buy (where the line was insane and they had hired a dj to entertain the crowds) to get my new red razr phone which is so so pretty and then went back home to bed. about 7 we got up and went to old navy. then back home and to sleep until about 11. later that night, we made a successful attempt at the outlet malls. which was fun and the weather was so nice. saturday i went with meridith's family to her sister's house in milwaukee. her neices are real cute. it was fun. when we were getting ready to go, the 2 year old was giving everyone kisses... she looked at me and said "camden, kiss?" it was so cute!

so that's about all. and really sums up my month here. the actual rotation has been a waste of time. but it's been easy and guilt-free to take time off to interview... i'm 3 down and have another in des moines on friday. then next week in kansas city. then??? not sure where... but there are a few left after that. i'm still waiting for one to jump out and scream "pick me"... otherwise, they have all gone very well and i could be happy at pretty much any of them.

there you have it. a post. and check out the ticker... 6 months. eek.

in which i say nothing witty.

as if anything i say is witty. but i like to humor myself anyway.

******

i'm staying with my best friend from college this month. and this weekend our other really good friend flew in from pittsburgh for girl's weekend. we had fun. and did girly things. like hair dye-ing and foot spas and shopping (but we were all really good and nobody bought anything!!!). and we went to meridith's parent's house... they have a new kitten and it's super super cute! and it really makes me want one!!

******

next weekend, my friend sarah comes into town. she has an interview at one of the residency programs here, and she's going to stay with meridith and it. it will be good to see her. though i'm not sure we'll do anything actually exciting. at all.

******

we don't have clinic until tomorrow afternoon. but i have to go in at 9am anyway... to discuss spina bifida. i'm mostly annoyed because i can't stand listening to mcgreasy speak. and it's highly possible that he intends to talk about spina bifida from 9am until noonish. and that makes me want to poke my eyes out.

eewww.

dr mcdreamy (who truly does love me) has been replaced with dr disgusting. i'm not sure he's showered in the past couple months. he doesn't smell, but his hair is so greasy and out of control and probably hasn't been cut since the last time he washed it. ick. and he's weird. weird weird weird. and he thinks he's funny. but he's not. good thing for me he doesn't really work all that much, and i have to take a bunch of days off for residency interviewing and whatnot.

******

speaking of residency interviewing. i had my first one yesterday... and it went really really well. there were a lot of things about the program that make it very attractive. and several that make me want to run. the problem is, that's how it's going to be everywhere, and i have to be fair (to the programs and myself) and figure out a way to weight those things in order to determine where i would be the happiest. i know that i really really want to be in kansas city, but there are definite disadvantages to that program as well... so, i smell a big pros and cons excel spreadsheet coming my way! :-)

******

back to mcdreamy... i kinda miss him. and the rest of the PICU team. and him. it was by far the best rotation of my clinical experience thus far. (and not just because he's mcdreamy. though that didn't hurt...)

PICU.

so, everyone is crabby because i haven't posted in, umm, forever. it's because the picu (pediatric intensive care unit) is a crazy hole of madness and messes. just when you think things are settling down, you have three code blues within an hour. that's a lot. it's a high stress environment even when things are settled. it makes me nervous how much i like it though.

i perhaps like it so much because of my very own dr mcdreamy. h.o.t. and he loves me. and he's on the residency selection committee. it's good times. and did i mention h.o.t. and single. and h.o.t. :-)

the residents that i've been working with are really great and all the doctors make great teachers. i've learned more in the past few weeks than in the last several months combined.

but it makes me tired. so i'm going to sleep now.

ouch.

i've come to the sad sad realization that i am allergic to cinnamon gum. everytime i chew it, i get these sores in my mouth (this time worse than ever before...)... and i googled it... "cinnamon gum" and "allergic reaction"... totally exists. and if i don't stop chewing it, i'll get squamous cell carcinoma in my mouth. and besides that, it hurts real real bad.

do you have any pumpkin?

ps, it's highly possible that this is a you-had-to-be-there story...

friday night after the ray-pec high school homecoming football game, i went to get frozen custard with the family i'm living with because we had buy one, get one free coupons. we're all standing around, staring at the menu, deciding on our individual orders and it's mary's and my turn... we had made the decision and were ready to order...

but when we got up there, she saw a sign that said "pumpkin spice latte"... and decided she'd like to have pumpkin in her concrete (like a blizzard from DQ, but about 47 times better...). except pumpkin isn't listed on the list of things you can get in your concrete, so i explained to her that it's a seasonal thing, so obviously it wouldn't be on the menu that lives there all year...

so we go back up to the window, and i ask the girl, "do you have any pumpkin something that you can put into a concrete..." she kind of stares at me and then points at a LARGE sign hanging directly above her head that reads "pumpkin pie concrete"... yeah, so mary gets excited and orders it. and loves it, i might add.

as we're driving out, one of the kids says "pumpkin pie concrete"... at which point we all look over and on the HUGE sign for the custard place it says in gigantic wording (that we can probably read from our front door...) "PUMPKIN PIE CONCRETE!"

we almost died laughing. i can't remember the last time i laughed so hard. mostly because we're big dorks... but oh man... the ridiculousness with which i asked the question just keeps magnifying itself...

rad.

radiology is pretty boring. make that very boring. it would probably be ok if i were actually reading films with a doctor. but instead i hang out with the techs while they are shooting the films (or ultrasounds, or ct scans, etc)... and it's boring. very boring.

******

i officially have two. count them TWO invitations to interview for residency positions. i anticipate a few more (maybe 5 or 6; i applied to 10 programs)... but i just submitted my application on friday, so we're looking good so far! currently, i'll be interviewing in des moines and omaha. i applied only to midwest programs... so i'll stay semi-close no matter what. (at least that's the plan as it stands for now...)

******

in order to keep myself from puking from nerves about interview invitations, i bought these.

$1.99

guess what that bought me today!!

ears. noses. throats.

aka ENT. sometimes it's fun to see how many acronyms you can get into a sentence. it's like a language within a language.

what a great weekend! i saw a lot of my family on saturday, and had lunch with my best friend from high school today (haven't seen her in 3 years) (and ps, she has a cute cute baby girl who is 4 months old. and cute!).

i have to be in the OR at 730 tomorrow. yuck. one more week of ENT, then two weeks of radiology. good times, huh? we shall see.

i know this isn't the post you've been pining for... but i'm tired. good night.

to keep you busy.

eewww.

decovin totally peed on me after we came inside from our walk this evening. gross.

it's good to be home.

can i just say that decovin is the happiest baby i know. he's so sweet and good and playful.

******

friday, i went to see my friend sarah in omaha (her hometown) where she is doing a rotation. we babysat all night. well, until like 1:30am anyway. but apparently a baby was recently killed by it's sitter and so her aunt, who is notoriously hyper-vigilant anyway, was flipping out. and sarah, who cannot say no because she is catholic (which is a guilt far greater than camden-guilt), said we would come babysit. it was fine, i guess. i'm not sure what we would have done anyway. but when we got back to sarah's we were hyped up a little, and decided to go for a quick swim. it was pretty chilly out. chilly enough such that the temperature of the air made the temperature of the water feel warm. kind of. it was freezing. we stayed in maybe 3 or 4 minutes. but at least we had some excitement!

i left there saturday morning and drove the rest of the way home. i spent the rest of the evening unloading my car and filtering through things. somehow, i collect a lot of things. but hopefully, i've pared down to just a few suitcases to get me by the next few months (while i'm living with friends in the city).

sunday was pretty fun. church was great and it was wonderful to see so many old friends. one of my teen girls came up to me and said she was desperate to talk to me, so i took her to lunch and heard all about the woes of teen love and the drama that goes with it. she's a good kid though, and it was fun to spend a little time with her.

sunday night, mom and i went to see the devil wears prada, which was pretty cute.

monday, we came to jen's. where i am now. getting ready for sleeping. because it's late!! we had a nice pesto salmon dinner with vegetables, went for a walk, and played darts. and did i mention i snuggled that baby a LOT?

all in all, it was a very nice holiday weekend. and i don't have to work this week. so it's won.der.ful. i could get used to this!

i'm movin' on.

woowhee. i've lived in davenport for 6 months now. that's kind of a long time. long enough to get acclimated to your living space. long enough to learn the best route to the best mall. long enough to pick out a favorite coffee shop. the weird thing is, it's not long enough to make this place home. or perhaps it was my mindset from the beginning. when you know things are temporary, you never think of them as permanent. you start the countdown from the start, and when the countdown is up, you pack up your little ford focus and hit the road. and it doesn't even matter if your name is jack. today's the day. i loaded up the car last night (to the brim, mind you) and will take off in a few hours. i'm going home.

it was surprising, i didn't even cry when i said goodbye to the friends i'd made here. and i would consider them to be good friends... and i cry easily... and it's hard to know when we'll see eachother again... and all those things combined, i expected to cry. but maybe knowing from the start that all this was temporary somehow shielded me... that and the fact that i'm really ready to leave. because i'm going home!

so i have a couple of errands to run today, and tonight i'm going to visit a friend in omaha. but tomorrow? tomorrow, i'm going home.

ps. i'm excited!

9 months.

sweet!

just like grey's anatomy.

this week i started an anesthesia rotation. i'll finish it up next week. 2 week rotations are great.

this doctor thinks i actually am an anesthesiologist. he stays in the room long enough to start the case and then leaves me to play with the gases and keep the patient still. and breathing. yikes.

******

here's my new haircut. i love it. love.

******

my roommate and i went to see the world trade center movie tonight. depressing. good. but depressing.

******

so i've had a headache for the past 4 days and today the doctor noticed. so he took me into an exam room in the pain clinic (where we worked this afternoon - but i hadn't met any of the nurses there yet...) and cracked my neck, then gave me a shot of toradol (cousin of ibuprofen, but much, much better), then turned out the lights and told me to take a nap.

a few minutes later, i hear a nurse outside talking about how she thinks there's someone in room 5. she opens the door and asks if she can help me. i explain to her who i am and she leaves the room. i hear her a few minutes later explaining to another nurse that "there's a med student sleeping in there. it's just like grey's anatomy!"

boards.

so totally over. for a couple years anyway.

boards.

tomorrow. eek.

quite a cluster.

so, i've been up for 2 hours now. left my house at about 8... drove around for about an hour and ended up back at my house. see, first the road to the coffee shop that we study at was blocked. so i thought i'd try one of the other roads... and then another and then another. then i thought i'd stop and ask one of the cops that was blocking the way except he screamed at me to keep going (which made me even madder because he was young and cute)... then karen (my roommate who left 45 minutes after i did) asked a lady who was helping direct traffic and found out that there was a gas leak or something. so then we decide to go to panera. except panera was BUSY. and karen doesn't deal with lots of noise well when she's studying. so we made the decision to just get coffee and then come back home to study. so here i am. if i fail boards, i'm totally blaming the cop who screamed at me.

who'd've.

as in, "who would have"... can you have a word with 2 contractions in it?

i can stop studying now.

proverbs 17:22 "a cheerful heart is good medicine"

it's official.

i'm a 4th year!

can't sleep.

insomnia? too much coffee? too much excitement over the end of internal medicine? could be all three.

little old ladies say the darndest things.

little old lady #1 who had some double vision and stumbling yesterday at the fair:

little old lady: "we had a couple beers..."
a little later: "2 or 3 beers..."
later still: "3 or 4 beers... i probably had 4 beers."

******

little old lady #2 who had lost her license after an accident that was not her fault because the cop wrote the word "confused" in his report. we had to do a mental status exam to determine if she was, in fact, too confused to drive:

dr king: "starting with the number 100, count backwards by sevens."
little old lady: "oh, but i've never been very good at history!"

studying.

or should i say "studying"... because i've been here at my most favorite coffee shop in the quad city area for an hour and a half and have yet to crack a book or answer a single online practice question. but that's about to end. right after i finished this update. because i know how important the updating is to my friends and family. :-)

******

the awfully slow doctor complimented my progress note writing ability today. it made me slightly less disgusted with his slowness today. that and it's thursday and i have thursday afternoon off. and who doesn't love an afternoon off??

******

my favorite barista, lizz, asked me about why the honey jar says not to give honey to babies earlier. so i guess that's kind of like studying. because i totally knew... don't want no floppy babies! (for those who might not know, honey can have botulism spores in it which create the same toxin used for botox injections, which, if ingested by babies leads to floppy baby syndrome. and floppy babies are bad, just so you know.)

******

i just got off the phone with my good friend sarah. i miss her. she's almost done with her year of rotations in detroit. she's sick of school too. i'm going to see her the first weekend of september and that will be fun! this is another of the pictures she just sent me from my time in detroit. those were good times.

******

17 days until boards. 9 months 3 weeks 3 days until GRADUATION!!!

he ate the whole thing.

mark in detroit

******

i'm almost done with my 2nd week of internal medicine. which i LOATHE. it's terrbile. the first problem is that half our patients are old. we're talking how-on-earth-have-you-lived-this-long old. they can't hear and they don't bathe regularly. the other half have a list of medical problems longer than life itself. they're crabby and non-compliant. and some of them don't bathe regularly either.

the second problem is that the doctor i'm with is slow. i don't mean short-bus slow. just flat out slow. he speaks so slowly and deliberately that i think occasionally, i doze off between words. it's bad.

the third problem, which really doesn't bother me until i think about how much i'm paying for this month of my education, is that i don't see any of the office patients on my own. i only get to see patients on my own if they are in the hospital (of which we've had three the past two weeks...) and otherwise i just follow him around all day. horrible!

******

the other day we had a patient named earl. earl had the hairiest ears i'd ever seen. i couldn't stop staring.

******

i spent the majority of this afternoon contemplating whether or not it was acceptable to meet a guy in the laundromat. on one hand, he's at the laundromat, which means he probably doesn't live with his parents (because he's at the laundromat) and he probably doesn't have a serious girlfriend (who'd do his laundry for him... or at least with him). but on the other hand, it's the laundromat. and there are some pretty different sorts of people at the laundromat. what's your opinion? (just for the record, he was really cute, and clean as far as i could tell.)

hating.

i really hate when your toe nails are polished very nicely with your best friends polish that is a hundred miles away and then the big one on the right begins to peel.

******

i also really hate when dead-beat alcholics finally show up for a court date, only to find out their nearly-worthless lawyer chose to skip out and everything gets pushed back another month.

******

i also really hate when everyone has exciting things going on in life and you don't. like getting engaged and having babies kind of exciting. which is way more exciting than becoming a doctor. because let me tell you... this is not all that exciting. as a matter of fact, this month really stinks. it's all old people and slow old doctors that don't let me do anything on my own. and when i say slow. i mean SLOW.

******

i also really hate when you feel like you have a million things to do, but you aren't really sure what they all are, but it just feels like there are millions of things swarming above your head that you have to get done and if you don't get them done the world might implode.

******

and one more thing... i also really hate when you feel like you are STILL spending every waking minute studying but nothing, NOTHING! sticks. it all just slips out like your ear canals are coated with tanning oil and letting everything slide out as fast as you can shovel it in. may be a valid reason NOT to study by the pool...

i'll get back to you on that one.

processing.

29 year old white female brought to the ER by ambulance at 2:30am 7/2/06 after her husband heard her gasp for breath and then pass out while sleeping. He immediately calls 911.

when they rolled her through the doors from the ambulance bay doors, i had a sinking feeling. she was already intubated and the paramedics were still doing chest compressions. the monitors showing asystole - no electrical activity in her heart.

the rest of her clothes are removed and the fury of activity ensued. she was petite, and upon removing her pants, it was impossible not to notice the swelling of her abdomen. a catheter was immediately placed into her bladder and a urine pregnancy test was run. meds are being pushed; more IVs are started; her hands and feet are blue and her face is dusky; the respiratory therapist is manning her airway and breathing for her; a paramedic continues to beat for her heart.

the urine pregnancy test is negative. how can that be?

word arrives that her family is here and i'm sent out to get some history. what meds is she taking? does she have any medical problems?

a nurse beat me to it and comes back with the info. she's 3 months post-pardum. she takes some meds for depression, but they don't know the name of it. she also has a 6 year old daughter and her 3 month old daughter has a serious heart condition for which she has already undergone one open heart surgery.

the cycles of cpr continue as the doctor and i go out to speak with the family. he explains that the only explainations for her condition is a blood clot in her lungs or that she had overdosed on some medications trying to hurt herself. but she hadn't been trying to hurt herself. she had been sleeping. we were waiting for some medicine from the pharmacy that would help break up the clot.

her husband and parents came back to the room with us.

the doctor takes over chest compressions as the family adjusts to the picture before them. she regains a pulse, but it's slow and weak. more drugs are pushed. she's in v-tach and needs to be shocked. everyone backs up. her mom clutches me and i hold onto her. the jolt makes her body jump, and noone in the room breathes, as if our holding our breath would will hers to somehow return.

a medic takes over chest compressions for a few minutes. cpr continues. the doctor points at me and tells me to take over chest compressions. i do. but it's hard. i get tired after only a couple of minutes and am relieved by the medic. the activity continues.

her husband begins rubbing her feet, and i imagine that she's probably begged for him to rub her feet. i wonder if he did. her mom holds her hand and begs for God to help her baby. she knows it's out of our hands.

the clot busting medicine has been in for about 18 minutes. if nothing has changed by 20 minutes, the doctor says we have exhausted our options. but she miraculously regains a pulse just in time. more meds are pushed and she is rushed to CT for a scan. she maintains her pulse throughout the scan, but when she gets back, it begins to weaken again, and then it fades completely.

it's about 4:30am now. cpr is continuing. i've long since lost hope that there could be a good outcome. my heart is breaking for her husband; her mom and dad; her babies.

i'm sent to see other patients who have been waiting almost three hours at this point. it's hard to feel sympathy for them. their "emergencies" are so minor that i want to scream at them. at some point, while i am with a little old lady who fell out of bed, the doctor calls it. i can hear the crying of the mom in the hallway. my heart hurts. i'm sewing a laceration on a drunk guys hand from where he hit a mirror and i hear the little baby crying in the waiting room. a sob catches in my throat. i am selfishly glad that i didn't see the older daughter.

there are likely no good answers. and there are definitely no words to ease their pain. i just hope they recognize that we did the best we could. and i hope they know that our hearts are breaking for them.

and i silently wonder what i've gotten myself into.

oh, hey. how are you?

so many stories, so little time. the short of it (because, you know... no time for the long of it...) goes something like this...

finished 4 weeks of surgery - some of it was great... a couple of the surgeons i was with were awesome. SUPER nice and H.O.T. my very own mcdreamy... SO hot. and nice. and did i mention HOT? the one, in particular. hot. he liked to play music trivia in the O.R. and ask me questions about who sang the song blaring from his i-pod. i never knew the answers. ever. he liked telling people i was from missour-uh. and, you know. he's hot. i really miss him and was kind of jealous that my roommate got to hang out with him until 1:30 am yesterday. (she was taking call, people. seriously.) the only thing i didn't like about him is that he liked working with the female surgeon...

the one female surgeon in the group (who thankfully was in hawaii on her honeymoon the first two weeks of my rotation) was heinous. absolutely awful. mean to everyone. i didn't work with her very much, but i dreaded every minute that i did work with her. until my last day, when she was actually nice to me. and since she was nice to me, i actually left surgery with a sweet taste in my mouth and miss it dreadfully. but trust me... heinous.

this week i started ER. which is nowhere near as exciting as you might think. it's mostly ankle sprains and muscle strains and i have back pain and just ran out of vicodin and please, sir, may i have some more, with your occasional difficulty breathing and chest pain thrown in for good measure. then you have the other half of your patients... those with urinary tract infections or earaches who just need to see the family doc, but they don't have one because they don't have insurance... and so they land on our doorstep. fantastic. here's your bactrim, ma'am.

we did have one exciting case today... a code blue brought in by ambulance. complete with hot paramedic performing chest compressions. aside from that, it was pretty boring too. it's much less intense and takes a lot longer in real life than it does on tv. and i feel bad getting annoyed with the dying guy for taking so long.

and my car won't start. grr. i had it towed today to the dealership who will probably charge me 2-3 limbs and half of my last loan check, but i couldn't find anyone else.

the good news? i don't have to work tomorrow - the beauty of the ER. 4 twelves. 3 day weekend. and really, it's more than three days... because i have to work next weekend, so i'm pushing my actual work week back... and maybe i'll not work again until tuesday or wednesday. i'm thinking about heading home this weekend... which will be more easily decided after i have, you know, transportation.

sorry.

i'm not really apologizing. my life, it seems, is a little busier than i like to pretend. either that or i'm just lazy about updating. either way, you'll get over it.

******

so i just finished two weeks of dermatology. it was pretty interesting, and i really liked the doctor i was with. and. AND. he's going to remove my accident scars from my leg. with lasers! for *FREE*. well, virtually. he's just going to charge it as an office visit. it's probably not completely ethical. but the scars. they're so ugly. i tried to upload a picture of them for you, but they were so ugly that blogger rejected them. that's ugly.

******

i start surgery tomorrow. i'm nervous. turns out, surgeons don't have the reputation of being "nice"... eeek!

b.a.d. day.

the doc i'm with right now always says that no matter how bad his day is, it's never as bad as the patient's days. and today was a bad day.

and i ate a lot of bad food today.

and i couldn't go to the y after work because i didn't have a hair tie.

and cancer sucks.

the end.

goals.

so, i went to the gym 4 times this week... and i ate well until friday night. it's been downhill since. but hey, that wasn't part of the week's goals, now was it...

this week is going to be interesting... i'll only be able to make it to the gym twice, since i'm going HOME! on thursday after work... (and i don't have time on wednesdays...) i think i'm going to try for something active at least 5 times this week anyway... but i should obviously be working on my dietary modifications too...

week 3 goal: stick to modified eating habits everyday except friday
longer term goal: button white coat (which i can do as long as i'm standing... )
end-all be-all goal: 140 lbs

too much to say.

i hate sprint. officially. hate them. do you know anyone in monterrey mexico? yeah, me neither. but apparently my phone does. and it's been calling regularly... $224 worth of regularity. and apparently we can't dispute the calls until they are actually billed. the lady told me they were calls made throughout my billing cycle on to multiple phone numbers, but could not tell me any more details regarding specific dates or times of said calls until the end of my billing cycle. so i checked my phone's outgoing call list, expecting to find 150 minutes worth of calls made by ??? to ??? and instead found the last 20 phone numbers that were called were all to people located in the good ole' usofa. for the love. it never ends.

******

and while i was lamenting to myself about how awful all this was, i remembered a patient we saw today. i'm on heme/onc. hematology/oncology. blood/cancer. she's 54, nonsmoker, nondrinker and until 2 weeks ago, she was healthy. then she went to the doctor and found out she had lung cancer so she started radiation right away. today she came back and we told her that it was in her brain, her liver and her bones too. if we do nothing she'll die in 6 weeks. if we do horribly nasty therapy that starts with a dangerous surgery to place a catheter into her brain, she may get 14 weeks, but she'll be very sick the whole time. makes my $200 phone bill seem a little trivial, eh?

******

so, goals... well, sorry i'm late. i've been busy crossing things off lists. turns out i didn't exactly meet last week's goal. i had a little run-in with the norwalk virus that rendered me unable to leave my apartment for a couple days. but... it was a good way to jump start weight loss... i'm down 5.1 lbs.

this week's goal: gym 4 times (i've already been twice)
short term goal: button white coat
end-all be-all goal: 140 lbs.

confession.

ok, today is when we get real. guess what... i weigh too much. no, i didn't just realize it, i've known since i was about 10 or 12. i've just decided that today is the day that i tell you about it. the day that i draw the line in the sand, so to speak. i have gained about 20 pounds since my accident in december. i'm not ok with that. so, the thought is, if i tell you about my current weight loss efforts, i will be more inclined to keep at it. i can't bring myself to tell you at this point how much i weigh or how much i'd like to lose, but give me time. i'll tell you when i'm a little more comfortable with the actual numbers.

the new game i intend to play (and i invite you to play along) is to post a weekly goal. you are welcome at any time to ask me about said goal and i am required to answer you honestly. sounds like fun, huh? my week will go from monday to sunday, and i'll do my best to post my goal for the following week on sunday. if they're not up by monday, you can bug me about it.

i'll also carry through a longer term goal. not the end-all be-all magic number that i'd like to see, but a little something that i'm working towards that will take longer than a week... i'll carry that goal until i reach it, then make up a new one. see, you want to play too, don't you? (it doesn't have to be related to your weight... it could be anything - your level of physical activity, how much reading you do, organizational goals, etc...)

this week only has a few days left in it, and i am going to a party that will likely make goal meeting difficult... so i'll make this week's goal one that i'm half-way to meeting already.

WEEK 1 GOAL: go to the gym 4 days this week. (see, i've already been twice.)
LONGER TERM GOAL: to button my white coat
END-ALL BE-ALL GOAL: 140lbs.

goodbye roots.

got my hair done today!

04.05.06.

i love dates that are catchy... like this one.

******

my precepter is out of town this week at a conference, and i'm hanging out with a different doctor who happens to not work on wednesdays. beautiful. so here's the list of all the things i got done today.

1. moved an old computer desk from the corner of our living room into my bedroom to be used as a vanity.
2. cleaned my room.
3. put the living room back in order (minus the old computer desk from the corner).
4. cleaned my bathroom.
5. ate frozen lean cuisine pizza at 10:15 am.
6. watched food tv for a couple hours.
7. went to the laundromat where i had to fight off a 4 year old black kid (i'm really confused about the kid's heritage... he was calling an asian woman "mommy" and there was an grandma-aged white lady with them too.) who came over begging for a quarter and when i wouldn't give him one (because i'm that mean) he reaches into my pocket and grabs ahold of my phone at which point i grab ahold of his hand and tell him he needs to let go.
8. watch the 4 year old black kid (who, by the way, at first i couldn't tell if he was a boy or a girl as he had a ponytail) with the asian mommy and white grandma sneak out of the laundromat into the parking lot and try opening the car door. on MY CAR!
9. finished the laundry.
10. put all the laundry away.
11. listened to two sermons i downloaded from the church website.
12. wrote some thank you notes - 3 to doctors i've rotated with, 2 to people at the church here who had me over to their homes on saturday (one for lunch, one for dinner).
13. wrote a blog that is hopefully long enough to get rid of the gross wound picture for the majority of you with average sized computer monitors.
14. (from here on are things i intend to accomplish with the rest of the evening...) return a shirt that i bought at target without trying it on.
15. buy deodarant.
16. go to church.
17. have some whitey's ice cream. only. the. best. stuff. on. the. planet.

it's shake and bake, and i helped.

because i can't stand not letting you know about this... the doctor i'm with this month does wednesday morning wound clinic instead of thursday... and he MAKES ME HELP!!!! yes. me. with my own two hands i used a metal curette to scrape away layers of ickiness from wounds that look like this:ps, jen - the new picture is just for you... love ya, babe!

birds of a feather.

ok, now i promised a long and entertaining post today. i'm not sure i'll pull through, but i'll throw in a bunch of pictures so it looks long... :-)

i'm in between rotations now. 4 more weeks down. it's amazing how quickly the 4 week blocks fly. i spend the 1st week of every rotation hating it, thinking it's going to be the longest 4 weeks ever, the next two weeks thinking, "hey, this isn't THAT bad..." and the 4th week dreading the end of the week and the awkward here's-my-evaluation and will-you-write-me-a-letter-of-recommendation conversations and the fact that the following week is another week 1.

anyway, this morning, i thought i'd take myself out for a walk. thinking it would feel good to get outside, i went to a park instead of the Y. ok, it was cold, but entertaining enough. i'm not sure how long the trail was, but i was out for a couple hours.

i've never seen a sign like this before, but thought it was pretty interesting.

this bird was the first of many that i saw. it was SO bright red and beautiful.

this was the only mile marker sign i saw, and i'm pretty sure i went well over a couple miles, so i'm not sure what the sign was marking.

one of these things is not like the other... :-)

i'm wondering who this sign is warning. the birds? "hey guys - don't nose dive into the path, it'd hurt!"

these birds were very chatty.

i swear i saw these ducks three different times along the trail, but i'm not sure it was possible. i know that they were the same ducks at least two of the times, but the third time i truly believe it must have been the twin ducks of these ducks.

the tandem bikers. they were cute. i saw them a couple of times.

a couple of geese (i think you can only see one of them in this picture.)

a REALLY old bike. REALLY old.

me...

...and my shadow

ahh... a welcome site...

inside my car... :-) instant smile. hot T has a picture of a cute baby on his dash, and i thought it was a great idea. (my cute baby picture is cuter than his cute baby picture...)

let's make a deal.

ok, i promise, i'll give you a nice, long and interesting post tomorrow.

for today, all you get is this... my feet STINK today!

sick.

in three days, i've eaten 11 servings of guacamole.

staring at babies is officially my favorite pasttime.

decovin, 2 months

nathan, 3 months

me and jen

mom and stacy

******

what a great weekend home! the trip was made easier by a few books on cd that i practically had to steal from the davenport public library. don't worry, i did convince them to give me a library card, but it was NOT an easy feat. the books made time pass and the drive almost pleasant. if gas weren't so expensive and i could have every friday off, i'd go home EVERY weekend! wouldn't THAT be fun.

*sigh*

you know how, some days, you're just sad to see the day end? today is one of those days... because my hair is REALLY cute today.

devastation.

i realized this week that i've lost something very dear to me. since the accident and the pinning of my great toe, i no longer have the monkey grasp ability in my right foot that has gotten me through life thus far. this calls for some serious physical therapy.

thursday morning wound clinic.

alternatively titled, "pain in the..."

mindless humor.

What Napoleon Dynamite Phrase Are You?
Name
DOB
Date
Pick One	Pink Blue Green Purple Yellow Orange Black Red
Your Phrase	GOSH!!!
Napoleonness - 89%
Will You Ever Be As Cool As Napoleon??	(8) - Better not tell you. - (8)
This cool quiz by pimpinit772 - Taken 558121 Times.

New - COOL Dating Tips and Romance Advice!

r.e.s.p.e.c.t.

i really admire people who are able to walk into a public bathroom stall that has not been flushed by it's prior, eh... "occupant" and flush it for them. it completely disgusts me and i can't do it. so thank you to you if you can. i don't admire you enough to aspire to be like you, but i really appreciate you.

and they say boys aren't observant.

the other day, we were going out for a good-bye dinner as several of us were leaving detroit. tanner says to me, you put eyelash stuff on. that looks hot. nevermind that i wear it EVERYDAY. he said i looked hot. i heart him.

life size.

time.

i waste so much of it. i'm going to stop doing that. tomorrow.

******

i'm thinking about going blonde again.

self.

do you think it's bad that i really like the photo of myself to the right there. the profile picture. several reasons... for lack of anything better to talk about, i'll outline them for you...

1. look at that hair!
2. i like the way my chin sticks out past my hair.
3. have you seen my tan?
4. if you could see the full-size image, you'd know how H.O.T. i look in the reflection
5. i can remember that night... i was on spring break in daytona beach, and sarah and i were getting ready to go out. it was a good time.
6. i like the angle of my chest and the small amount of definition of my clavicle.
7. i like the artistic edge to the photo.
8. i like that you can see the flash in the mirror, but you can't see the person taking the photo.

that's all.

the entry that lacks a good title.

today's the official start day of the scheduling of 4th yr rotations. biggest problem is, i don't really want to do any 4th yr rotations. does anyone have any spare motivation?

*yawn* nights.

i'm working nights this week. OB nights. which sounds a lot worse than it actually is i think. for instance, last night - here's what i did...

8:25pm - nap at mark and tanner's apartment
9:20pm - tanner wakes me up by rubbing my back and singing a little diddy about it being time to go pull babies from vaginas.
9:22pm - run home, shower, reclothe for the "day"
9:42pm - hospital bound
9:52pm - run up the secret back entrance stairs to the OB floor
10:00pm - catch up with the night resident, who proceeds to tell me that there's nothing to do, and that i can go claim a call room and she'll call if something comes up
10:02pm - watch grey's anatomy while printing articles for a presentation i have to do wednesday morning
10:44pm - sob silently while watching grey's anatomy alone
11:00pm - go to bed
4:15am - wake up to ringing phone, it's the night resident who proceeds to tell me that there is a new patient, but that she forgot i was there, and thus had already done everything, but i should come up to look at this awesome example of ferning which is what happens when you wipe some amniotic fluid onto a glass slide and look at it under the microscope - a test to verify that your water has in fact broken
4:19am - arrive on OB floor, look at ferning, sit at nurse's station waiting for futher instructions while the night resident talks to the attending
4:22am - am told to go back to bed
4:22:07am - leave OB floor for call room
5:20am - phone alarm goes off
5:25am - phone alarm snooze goes off
5:30am - arrive back on OB floor to round on my post-partum patients
5:58am - finish rounding and writing progress notes; wait for morning team to arrive
6:30am - sit through morning check-out with day team
6:48am - grab breakfast; run in to sarah in the cafeteria; tell her about the night
7:00am - sit through a lecture... about... ???? oh yeah... epidural abscess. you don't care, i promise.
8:02am - leave the hospital feeling refreshed and ready to start the day.

don't forget breakfast.

the other day i almost passed out while holding a retractor in a woman's vagina. it was a long long case, and even though i had eaten breakfast, and i didn't feel particularly hungry, i all of a sudden started to feel like i was going to vomit. then i started sweating and the doctor looks up at me and asks if i'm ok. i mumble something about not feeling well, and he told me to step back and sit down. the circulator (the nurse in the room who is not sterile and gets things for those of us who are sterile) put a wet towel on my forehead and lectured me about the importance of eating breakfast. it wasn't a lecture really... she was super nice. i ended up leaving the room and eating some peanut butter crackers and orange juice. i felt much better afterwards. but what i learned from the scrub tech (the person in the room who is sterile and hands all the instruments to the surgeon) is that it's always better to step out as soon as you start to feel that way. the last thing you want to do is fall and contaminate everything. now THAT would be embarrassing.

and always eat breakfast.

three's a crowd.

this post is not for the faint of heart. i'm going to use the word vagina. you've been warned.

******

today i started my week of gyn surgery. as in gynecologic. i spent the morning watching the backs of people who were standing in a small semi-circle around the object of intense attention. then, in the afternoon, i became one-third of that semi-circle. my resident had clinic this afternoon, so i was the only one to scrub in for the afternoon cases. the first was kinda boring, but the second was pretty cool.

we have the patient in the lithotomy position - you know what i mean - stirrups. then the three of us stand in a semi-circle between the legs. the lady had a hysterectomy several years ago and now her vagina was collapsing in on itself, so we rebuilt it for her. with mesh. it was a very interesting procedure, and i think we got good results. good times, huh?

catch.

i helped deliver a baby today. meaning i put my hands where the resident told me to and held on. those things come out slippery!

rerouted.

so, i went in to the hospital this morning to start a new rotation. can i just say, i hate first days. hate 'em. it's like starting a new job every month. blech. anyway, i get there and the med ed lady has me scheduled to do OB, which is not what i was planning to do but is probably wiser in the end. so instead of having fun intubating people and starting spinals and stuff, i'm sitting around waiting. and waiting. and waiting. for babies to be born. and it takes so long.

******

i'd like to point out that the correct spelling of the former car's name is "anne marie" - you know... with an E. though, stacy, i do enjoy "anne ma-rio" as well.

and the new car - named after my roommate at the rehab facility. her name was sylvia. and she had a brain injury. just like me. except she really did have a brain injury and she really did need a bib with her dinner. minor differences, i know.

i also wanted you to know that my new car has a second name. kinda like my bologna. but not. her second name is joy. after the rehab facility itself (marianjoy). sylvia joy. kinda cute, huh? i'm not sure why the place gained the distinction of having my car named after it. it started as kind of a joke, but i think it's stuck. oh well. she's still cute. as a button.

meet sylvia.

she's a 2001 ford focus. and she's name after my roommate with the brain injury at the rehab facility (i'll tell you about it one day... WORST 3 days of my life, i think...). i'll show you more pictures of her later, k?

ten fingers!!

Nathan Patrick Teitelbaum
12.8.2005
8 lbs 3 oz, 19 in

Decovin Joseph Plummer
1.16.2006
7 lbs 9 oz, 20 1/2 in

******

guess who has regained (almost) full use of all ten fingers again!! ha! it's so nice! the pins are still in, but my ortho surgeon said that if i move my hand before taking the pins out, it'll hurt less. we'll see about that. anyway, typing is MUCH easier, and for that... you get an update. :-)

******


i should've given you this earlier - but check this out. weird, huh? i found his site on a google search looking for some school info last summer.

******

so, i spent the last two weeks in a pathology laboratory. now, before you get all excited and think i was helping out with something really interesting like autopsies or something, settle down. i sat in an office by myself all day looking at microscopic diseases. the exact antithesis of exciting.

******

so now, i'm on 2 more weeks of vacation, but will not get the pins out of my toe until at least three weeks from now. hopefully the removal of the pins will not cause too much set back in my ability to ambulate.

******

...back to the car search...

head on.

that's how i was hit. that's how i choose to deal with the aftermath.

******

here's the version of the story i mailed out to random peeps last week... it's hard to type with 7 fingers, so it's likely the only one there'll be... at least until the splint comes off. most of the people who got this email were medical folks, so if anything needs explaining, let me know.

******

i was spending the month of december in the chicago area doing my ob/gyn rotation, living with my best friend from college. it was supposed to be a great time.

it was dec 5th and i'd had an exciting day at the hospital. i was on my way home and couldn't wait to share the stories of the day. it was almost 7:30pm, i was 3 blocks from home. the night was dry, and so were the roads. it was freezing out. the car in front of me swerved and was immediately replaced with headlights. my skid marks were only 6 ft long. we hit almost directly head-on. if he'd been in anything larger than his cavelier, there's no doubt in my mind that i would not have lived through the accident. from what we heard he was drunk, and at this point, though he is still in the hospital, he was uninsured. my car spun and the passenger side rear of my car hit the car that was traveling behind me. that lady wasn't hurt. the crash was very fast. i ended in the ditch facing the opposite direction. my driver's side window had shattered and busted out, the windshield was in a million little pieces, but was still intact. my steering wheel was bent. my airbags had deployed. i could move all my fingers and toes, but my left thigh was jammed between the dash and the seat.

a stranger came up to the window to see if i was ok. they called the people i was staying with and my mom. the paramedics showed up, and one of the sat in the backseat with a blanket wrapped around us so we wouldn't get glass in our eyes as the others worked to free me from the wreckage. i was in so much pain. they eventually freed my leg, and pulled me out the driver's side door. i was taken to the nearest ER as a level 1 trauma for treatment.

my left hip was posteriorly dislocated, i had a broken right 5th metacarpal, a broken and dislocated right proximal phalynx of the great toe, a gash on my knee that required 8 staples, some other minor cuts and scrapes and a lot of bruises. i think i've found a new bruise everyday since the accident.

they reduced my hip under concious sedation, and two days later, i had pins placed in my hand and toe. i was discharged from the hospital on saturday dec 10, and was taken to a rehab facility for intense inpatient physical therapy. unfortunately, that place was not what i expected... they had gotten word that i had a traumatic brain injury, and were treating me as such. i was on a lot of morphine while i was in the hospital, and a lot of things are fuzzy... but i'm fairly certain that my brain was uninjured. i checked out of the rehab facility on monday dec 12, and got set up with in-home physical therapy.

i'm doing pretty well at this time. i have a walker, but haven't used it in almost a week. i'm getting better with my left hand and i can maneuver stairs. i'm in less pain everyday. i had to take three weeks of vacation, and i'll have to reschedule an OB rotation. i'll fly home (as previously planned) on christmas eve. i'll then do a 2 wk pathology rotation at st joe's in detroit (i was scheduled for an endocrine rotation, but the lack of the ability to drive or write, the DME said path would work better...). on jan 13 i'll fly back to the chicago area (previously planned) for a friend's wedding. afterwards, i'll stay in chicago on two more weeks of "vacation," during which time i'll have surgery to remove the pins, and have all of the follow-up appointments i'm supposed to have. i'll be cleared to drive after the pins are out, so i'll hopefully be able to get a car during those two weeks as well and afterwards i'll head back to detroit for another 4 weeks. i'm scheduled for anesthesia that month, but perhaps that will have to be changed. at that point, i should be pretty much back to normal and good to go.

things have been pretty stressful, but the friends i am living with are so helpful, and have really gone out of their way to get things done. they even rearranged their house, turning their formal dining room into a bedroom so that i could have a room downstairs. it'll be good to go home next week, and i'll be glad to get back on the other side of the stethoscope.

******

the car

walking at the hospital

i'm going to be OK!

panera.

i've been spending a lot of time at panera this week. you know, because of the free wireless internet. i'm there right now, actually. at panera. on LaGrange road. which is also 96th street. or 45 highway. why? why three names for one street? the world may never know.

******

sometimes i really like coffee, and sometimes i think it tastes like cigarette butts smell. you ponder that one for a couple minutes.

panera.

i've been spending a lot of time at panera this week. you know, because of the free wireless internet. i'm there right now, actually. at panera. on LaGrange road. which is also 96th street. or 45 highway. why? why three names for one street? the world may never know.

******

sometimes i really like coffee, and sometimes i think it tastes like cigarette butts smell. you ponder that one for a couple minutes.

ob/gyn.

wowsa. ever feel really, really dumb? i mean, really. dumb. i know next to nothing about obstetrics. and gynecology. too bad my preceptor starts every interrogation session with "what do you know about...." NOTHING i want to scream. NOTHING AT ALL. i know i'm disappointing you on at least an hourly basis by not knowing the most common cause of vaginal itching or the epithelial cell type in the endocervix or the incidence of neural tube defects in women who took folate supplements versus those who did not. i'm IGNORANT. and don't offer to let me in on a procedure by asking me the question "any good at phlebotomy?" in front of the patient. i'm going to have to shake my head no. even though the one time that i did it, i hit it on the first stick. but that in no way means i'm GOOD at it. i've done it ONCE. and dimples (my phlebotomy partner, who happened to be H-O-T) had really good veins.

argh. i'm just frustrated with feeling so out of my element. and not really knowing what i should be able to do. i mean, we did inpatient rounds this morning on the post-surgical patients. i coulda done that by myself. written the progress notes, discharge orders, consult orders, etc. all. by. myself. apparently i'm supposed to put myself out there and just start offering to do things.

on a lighter note. i've seen a LOT of vaginas in the past couple days. i'm getting better at measuring fundal heights. i did an ultrasound the other day. not very well, but i had minimal instruction, so i fumbled through on my own. it wasn't a necessary ultrasound - just a mom with her 6 year old daughter who wanted to see the baby. so he let us play together.

i stopped by the hospital to give the nurses my phone number so they could call me when there's a delivery coming. i mean, come on. that's really the only part that seems exciting to me. i'm reading about the stages of labor now so i'll be ready. not really. i'm reading it because just before i left this morning, dr. b asked me what i knew about labor. (see above for answer). so then i was assigned stages of labor and management of complications within each stage. which is an ok thing, because even though i don't have my text in yet (barnes and noble ordered it for me monday night), i DO have lecture notes from last year that enclose those topics in two very succinct power point presentations.

******

the only really good thing is the hours. i work very few hours. which is unusual as far as obgyn rotations go. i work mondays 1-6, tuesdays 1-5, every other wednesday 1-3, thursday 1-8 (but he says he never makes the students stay the whole time...), and friday 10-noon. it works out nicely, since there's so much READING for me to do.

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in other news, thanksgiving here was nice. different, but nice. we had to wear dress up clothes and we ate off of china and drank sparkling grape juice out of crystal wine glasses. fancy, no?

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one more thing. i love panera. and i LOVE that they have free wireless internet. i took this picture on my way here this afternoon to show you how much i loved it.
let's be honest. i really took it to show you how hot i look today.

what.

a. long. day. 7 am to 10 pm. and it's not like last month where i just slept over at the hospital and left at noon the next day. i have to be back in at 7 am. and i'll be there until 5. at least in the afternoon tomorrow we have lecture, so it will be less work. but more stress as it turns out, as i haven't looked at the lectures or discussion questions. can you say not good?

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in other news. two days left, and i'll have another month under my belt. insanity, i tell you. BUT... the good news is that i am starting to be able to see that you will be comfortable with things by the time you are in residency and confident in your skillz by the time you are an attending.

i'm amazed at how much fun it is when you actually have kids coming in. you know. sick ones. and there are things to think about. and stuff to read about. and it's kind of like a game. 308 is spiking fevers, give him some tylenol and keep a close eye on him overnight. 305 isn't eating well, start her IV fluids back up. 415 is eating like a champ, stop his IV fluids. 413 has an oozing sore behind her ear, culture the drainage and start IV antibiotics. it's fun, actually.

i'm dreading the end of this month just a little bit. this will end my 3 month stint of seeing only pediatric patients. i will now delve into the world of adult medicine. which will undoubtedly be much more like work and much less like a game. hopefully i can find ways to amuse myself amidst the dreaded mile long lists of medications. i'm going to miss all the cuteness though, that is for shizzle.

nothing really to say.

but i wanted to post anyway.

i'm sad about missing the big family thanksgiving gathering. it's my first major holiday away. i guess i stuck around longer than all ther other kids... who'd been missing holidays for years by the time they were 25. anyway, i'm still sad. especially because so many of the other kids will actually be there this year.

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i have to do a presentation tomorrow morning during rounds about crohn's disease. i'd link for you, but i'm lazy right now. it's an intestinal problem, and you should count your lucky stars if you don't have it. it wouldn't be fun. trust me. anyway... it's only supposed to be 5 minutes long. unfortunately, mine will be longer than that, and people will be annoyed. because there are things to do. sick kids to take care of. LIVES TO SAVE. and all that jazz.

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i move on wednesday. i'm really ready to not be in des moines anymore. it's pretty lonely here.

untitled.

one of my classmates' 5 month old daughter got sick last week. she's now on life support and the doctors say there's nothing they can do. they are probably going to pull support tomorrow. i can't imagine the agony. maybe one day doctors will learn to heal sick people.

"p" fruits make you poop.

something i learned today during didactics. (see: fancy word for lecture). the "p" fruits include prunes, pears, peaches, pineapple, etc. and are good things to give kids who are constipated. we doctor types are good for something, huh?

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my patient this morning did bad things overnight last night. he has a neuromuscular disease (see: bad nerves and bad muscles), and has pneumonia on top of it (and multiple other issues). well, the pneumonia is a problem for him because since he has bad muscles (this includes the muscles you use to breathe with), he has trouble breathing over the pneumonia. and so last night he dropped his oxygen saturation a few times and they had to bag him (see: not breathing good and needing extra help to breathe). at the last hospital i was at, if you were bagging someone on the floor (see: not the PICU), you had to call a code (see: bad). i guess this is not the policy here.

so this morning, he had been flying pretty well for about an hour or so by the time i saw him. and my intern (see: 1st year resident) left me to do an exam on the kid and write a progress note. the respiratory therapist was doing his morning treatments at the time, so i started my note before seeing the kid. i had written no more than the date and time when one of the RTs comes out of the room to summon help as the kid's SATs were dropping again. so i page the intern and walk into the patients room as if i know what i'm doing and will be of a great deal of help to these people.

the next two hours were a flurry of activity. there was me, the intern, a second year resident, a third year resident, both of our attendings, the nurse, the nursing student, the transport nurse, at least 4 respiratory therapists and perhaps 3 RT students. it was a LOT of people. we ended up transfering the kid to the PICU (see: pediatric intensive care unit) and intubating him (see: breathing for him).

it was sad.

because jen is a crabby pants.

no, that's not why. actually because i have a few minutes free right now. that's why i'll post for you. first of all, here are the before and after shots of the haircut. mind you, the after was taken about 30 seconds ago. and it's been a long day.

beforeaftermy newest hobbymy latest discovery. it's addicting.
and the time starts as soon as you get to the page. so HURRY!

and this is really how i spend my days these days. not with this pumpkin. though i'd love to. but with pumpkins just like him. except they have snotty noses and fevers. and they aren't nearly this cute. well, maybe a couple of them are.

they cry when you look at them and scream when you touch them. they may puke on you when you look in their throat and pee on you when you're checking their femoral pulses. but sometimes they pull your hot pink pen light out of your pocket all on their own and their eyes get big and they grin with glee. why would you want to do anything else?

jealous?

today i got my hair cut and taught myself to knit.

diagnosis unknown.

chief complaint: "constant fatigue."

history of present illness: amanda has just worked for about 32 hours straight. she is status-post call, and has been so for about the last hour and a half. she was able to drive, but reports being unable to form complete sentences. symptoms began just over a week ago and are exacerbated by soccer games, scrabble and algebra homework, but seem to be the worst around 4:45 am when she begins to hear ringing in her ears. symptoms improve when patient self medicates with oral caffeine intake, and she reports needing to use this treatment 3-4 times per day.

past medical/surgical history: negative for history of disease of the reticular activating system, which mediates arousal and daytime alertness.

medications: moderate-to-large doses of caffeine every 4-6 hours

allergies: crying 2 year olds with asthma exacerbations (patient breaks out in hives); grumpy 12 year olds with multiple infections and rashes on their butts (patient's airway closed completely off at last exposure); nervous interns, screaming residents and questioning attendings (patient reports varied vague reactions to different exposures)

family/social history: there is no family history of similar symptoms. there is also no history of heroine use or chlamydia infection. and even if there was, you would not be told about this.

Physical Exam:
general: patient is difficult to arouse and appears to have not changed her clothes or showered in at least 48 hours.
HEENT: normal appearing head. patient drools while sleeping.
Heart: beating
Respiratory: breathing. sometimes.
GI: alternating diarrhea and constipation.
Neuro: patient scores disturbingly low on mental status exam.
extremities: cold and clammy.

Assessment and Plan:
this patient is a 25 year old white female who reports to her bed with extreme fatigue following a 32 hour shift.

1. monitor drooling, heart beat and breathing for signs of distress and ongoing fatigue.
2. attempt to regulate dietary intake to normal eating hours of the day.
3. discourage operation of heavy machinery.
4. STOP WHINING ABOUT THE LACK OF POSTING!

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just kidding. about all of it but number 4. wait. that's backwards. history and physical is accurate up to #4. i'm going to sleep.