8.27.2006

8.25.2006

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!"

8.21.2006

boards.

so totally over. for a couple years anyway.

8.20.2006

boards.

tomorrow. eek.

8.18.2006

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.

8.14.2006

who'd've.

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

8.13.2006

i can stop studying now.

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

8.10.2006

8.09.2006

can't sleep.

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

8.04.2006

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!"

8.03.2006

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!!!

7.27.2006

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.)

7.18.2006

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.

7.02.2006

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.

6.22.2006

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.

5.21.2006

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!

5.02.2006

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.

4.30.2006

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

4.26.2006

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.

4.20.2006

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.