Sunday, September 19, 2010

Why It's Been Awhile

It's been over 2 months since I last posted, and I know exactly why.

There are a lot of reasons, actually. The first reason is the obvious one: I've been busy, working 14 hour weekdays followed by a 30 hour weekend shift, then less than 24 hours off til it all starts again. I get a weekend off (2 whole days!) every 4 weeks, and when I do I usually have so much on my to-do list I don't have time to sit and collect my blogger's thoughts.

Then there's the fear of writing about things that are so far removed from everyone else's experience that I'm writing more for myself than for an audience. If I were to try to explain (complain about) the logistical horror of scheduling an MRI for a patient, it really wouldn't mean anything to anyone but myself, really. I'd probably just get myself all riled up about it again unnecessarily and earn myself a reputation of being a big ol' whiner (hmm that may already be true).

Then there's the fact that I don't want to have a blog full of sad stories. The experiences I have the biggest desire to write about are the sad ones - they're the ones that leave the most lasting impression on me. The truth of the matter is that the majority of the people I take care of are happy stories, or at least neutral stories. Kids get sick, we treat them, they get better, they go home with their supportive or at least moderately competent families. They've just had a serious life experience - illness requiring hospitalization - but to me they're a dime a dozen.

But then there's the baby girl whose dad was trying to play X-Box and got frustrated that she was prying the controller from his hands, and so he shook her so hard she bled not only into her brain but into her retinas, too, and had non-stop seizures for 5 days and will never be the same again.

There's the boy who has a mysterious illness that can be curtailed with a strict no-fat diet, whose parents, due to extremely frustrating cultural differences and lack of education cannot comprehend the nature of his disease, keep feeding him bacon and eggs and asking angrily why we can't fix him with surgery or medication.

And then there's the baby girl who fell between the bed and wall and asphyxiated as her parents lovingly painted her new bedroom next door, who was rushed in without detectable cardiac electrical activity, whose chest I compressed, whose eyelids I later pressed closed for the last time, and whose sobbing parents I listened to I sat on a gurney in the hallway, stunned at my own lack of tears.



And see? That was super depressing. That's what I'm afraid of doing. Because the truth is, I love my job, and I feel lucky to be paid for what I essentially paid to do as a medical student. I laugh on a regular basis, and I have amazing colleagues and friends to share these experiences with. I am happy. I'm afraid of sounding sad, because I'm actually very happy. I'm afraid of telling sad stories and making all of you sad, because then I'm causing sadness while I'm not too sad, myself.

And then I'm afraid of saying so, because what cold hearted demon is happy when her arm is sore from doing chest compressions for 20 minutes on a girl who is now dead?

So you see,

it's been awhile, and that's why.

Thursday, July 29, 2010

Six Weeks Later

Six weeks later, and I still like my job.

These past 2 weeks I've been working in the Childrens Health Clinic (CHC), which means seeing scheduled appointments and walk-ins from 8 to 5 each day. I have thoroughly enjoyed the 7+ hours of sleep and time to go to the gym (not that I went to the gym, but surely the option was there!).

But I don't really like the Health Clinic. It serves the children in DC who don't have the resources, parental motivation, insurance, etc. to see a private practice pediatrician; it turns no child away. So our kids come in for well-child visits (annual check-ups) on a walk-in basis. Now think about this: when have you ever gone for an annual check-up without making an appointment?

Normally, walk-ins have a 15-minute appointment slot. They're supposed to be for quick acute problems of known established patients - fever, sore throat, ear infection, rash - that kind of thing. Well-child visits are supposed to be, at minimum, 30-minute appointments - at a well-child visit, you have to go through growth and development, nutrition, school performance, behavior, exercise/activity, etc on top of the usual health stuff. And give shots, and do hearing and vision screens. Etc. That's 30 minutes, when the visit is straightforward.

Alas, the patient population at the CHC is not straightforward. Many of them come from complex families with difficult social situations; many are in and out of homeless shelters, a frighteningly large number have been abused, many have behavioral problems, most are not eating or exercising the way they should. Everyone has asthma. Nobody has their shots up to date.

It is, in short, a clusterfart. The visits take way too long because of the complexity of each child's situation. Often, multiple siblings are brought in for one visit in one walk-in time slot. So the patients pile up in the waiting room as your 30-min appointment turns into 2 hours of sheer frustration, their parents growing angrier by the second. And as much as you want to tell them they should make appointments if they don't want to wait for a next available doctor, you can't. You have to empathize with the lot they've been handed in life and apologize for the wait, and look somber and apologetic as you thank them for their patience.

And pray that their kids somehow break through the cycle, and that their kids' kids will someday be seen every year by the same doctor, by appointment, in some private peds office somewhere better than here.


In other news - we're in a bocce league, and we're pretty awful but who cares!?
And babies are cute,
and pediatricians really are the nicest of them all,
and tomorrow is my last day of CHC,
and then I have 2 weeks of nights,
and all is good.

XO!

Monday, July 05, 2010

Education

There are things they never teach you in medical school.

They never teach you how not to look and sound like an idiot in the middle of the night when, foggy with sleepiness, your mouth is saying something other than what your brain is saying, and your glasses are slipping off your face but you can't use your hands to push them back up because your hands are sterile.


And they certainly never teach you how to write a death summary -

something that you don't really realize you need to know how to do until... well, suddenly, you do.

These things, you learn by doing. And, after everything is quiet and you're alone in your call room with the door closed, by reliving, and reflecting.

Friday, June 25, 2010

Bloggin' from a call room

Today, a nurse asked me to come talk to a mom about a baby's rash because the mom wanted to talk to "a real doctor".  My first instinct was to say: I'm not a real doctor!  But instead, I examined the baby and reassured the mom.  I introduced myself as "Dr. [Newlastname] and didn't let slip the fact that the nurse knows way more than I do about baby rashes.
 
Toto, we're not in medical school anymore!!
 
I'm on my second night on call, and it's blissfully slow right now (KNOCK ON WOOD).  In medicine, there are people who are known to be "white clouds" - when they are on service, the patients are all well, there is minimal difficult work to be done, and there are few new admissions.  For white clouds, call nights are full of sleep and fun. 
 
And then there are "black clouds" or "dark clouds" - people who inevitably have a million admissions while being paged non-stop with emergencies and annoying tasks.  Dark clouds don't sleep on clouds.  I, my friends, am a dark cloud.  I am the girl whose patient HAD A SEIZURE at the very moment she walked into his room on her first ever call night in medical school.  I am the girl who admitted the record number of patients to my team overnight.  When my co-intern and I went to a twin delivery, my twin was the one who decided not to breathe and got admitted to the NICU, while my co-interns was pink and screaming and went straight to the newborn nursery.  Le sigh.
 
And so I shouldn't have been surprised, on Monday, when my first call night was full of very little sleep and very many babies.  I'm crossing my fingers that tonight is a rare white-fluffy-cloud-filled day!

Babies are cute, but I hate when they're born blue and not breathing, and I'm the person who has to fix it!  Repeatedly, all night!  And fill out all the paperwork involved in such situations!
 
And so, a list of things I've decided over the past week as a "real doctor":
- I never, ever, ever want to have twins  (knock on wood)
- I think the worst part of having a baby will be the inability to drink water during labor - it could be 24 hours!!
- Almond butter & jelly sandwiches only sustain me for 4 hours, max
- there are more, but I should probably stop emailing a blog post!
 
Happy scorching weekend!!

Tuesday, June 15, 2010

Who? Me?

I'm having an identity crisis! My ID badge says "Jessica [New last name], MD", and the combination of "Dr." and the new last name are just not familiar to me. I'm like. Oh!! Me!! You're talking to me!! I wonder when I get used to all of it. And which will I get used to first, the Dr. part or the new last name part??

I am currently exhausted from being oriented to computers, rules, schedules, policies, security, saftey, etc. etc. for 12 hours a day. Ah, orientation. I shall blog more when I'm less tired (hee, yeah right) and have more time (haw). Or... when the major sporting events are over and I'm post-call or something. It turns out my month in the NICU was not in vain; I start in the NICU! And I'm overnight every 4 nights, which sucks but I'm kind of looking forward to it. But it means 80+ hour weeks, so we shall see how this goes.

Happy summer, yinz! Lakers in 7!! Gooo Gasol!

Thursday, June 03, 2010

Aloha from Paradise!

The subtitle to this blog post is:

HOLY MOLY!!!

We're married! We're in Kauai! We've been newlyweds for 4 days and in Hawai'i for 2.5 days!

Moreover, we're moved into our apartment in DC, Eric's done with finals and now an MS-2, Scope & Scalpel (the school play) is done x2, and I graduated and am an MD (this still hasn't set in yet)! (This all deserves like, a hundred exclamation points but I will spare you, you're welcome). The seemingly insurmountable mountain created by all the little (and big) tasks/events are behind us, and I really CANNOT believe it. There were times when I couldn't wait to be on the other side of it all, and there are definitely lots of aspects of the last few weeks that I am SO GLAD are behind us.

But the wedding itself flew by in flash, and Eric & I find ourselves poring over pictures people have posted to remind ourselves of all the moments that slipped us by. It was like the best dream I ever had. I've never felt surrounded by so much happiness, support, and love. And there's nothing better than hearing what a great time our guests had! I know I've said a million times that people should just elope, but I'm definitely in the have-a-wedding! camp now. Get married! Have a wedding! Please! You may not have the most generous and amazing family to fund the most amazing wedding ever, like we did, but really it's not about the venue or the flowers or the ridiculously nice rehearsal dinner(s) - it's about looking up and seeing all the best friends you ever had wipe tears away as you exchange your vows, and watching your parents dance with your friends as you ruin your wedding dress with all the fun you're having.

Thanks to everyone who came out. You added that much more to our happiness that day.


Ahhh happy!!!!!!!

Monday, May 10, 2010

No Cavities

... and a goodie bag filled with a new toothbrush, travel-sized toothpaste, floss and mouthwash.

Last visit to the Pittsburgh dentist!

Now gotta get back to packing AHHHHHHHHH I've never said it but never has a moment been more deserving of an FML!

Monday, May 03, 2010

We Did It!

Half marathon - check!

Eric & I ran the Pittsburgh half marathon yesterday. We like to think that together, we ran a full marathon. Hee. We woke up at 5am and made our sleepy way downtown, where we ate breakfast in the car and putzed away the time until about 7:05, when we got in line to use the port-a-potties and nearly missed the start at 7:30. But no matter, we were way at the back of the start, so we didn't cross the start line until 7:45 anyway.

We ran and ran and ran. It was rainy, which I loved. We crossed over 5 bridges and all 3 rivers during a pleasant 13.1 mile run. I felt great - never really got tired or out of breath, and my upper body didn't get achy the way it sometimes does during long runs. At 13 miles I felt like I could easily run 5 more (but no full marathons for me, no thanks).

Our time? 129:07

Philly half marathon in November, anyone? I'd like to do it in less than 2 hours. Let's train!

Thursday, April 29, 2010

Just Gotta Say It

Dates totally look like cockroaches to me, and are therefore NOT TO BE EATEN.

Also, if one is in a hot stuffy crowded room sitting amongst 40 of his/her classmates, you would think he/she would excuse him/herself to go and pass gas rather than REPETITIVELY FART DEATHLY FARTS THROUGHOUT REHEARSAL.

This ends today's rant.



Guess what? I'm 27 and I'm getting married in a month! Aaaaaaahhhhhh!!!

Tuesday, April 20, 2010

Making Music

...out of raindrops!

Back in Pittsburgh after a short impromptu trip to DC. It's fun coming back to RSVP cards!

Friday, April 16, 2010

Fed up!

OMG can I just say right now:

I am SO sick of doing something in the apartment (e.g. cooking) and reaching for a requisite item (e.g. honey) and finding that the roommate has used all of it such that it is either a) not there, or b) completely empty (not thrown away, not replaced).

Other examples: salt, pepper, cumin, chili pepper, butter, frozen rice balls, ziploc bags, aluminum foil, the beer I specifically put in the fridge with happy anticipation of imbibing on a later date, fresh fruit from the grocery store, and toilet paper.

*end rant*

In other news, it's raining harder than I've ever seen it rain before.

Eeeeek!!!

There are only 44 days left 'til the wedding!
That's like, not very many!

The RSVP postcards have been steadily coming in... I've gotten 2-4 every day. I LOVE getting these in the mail. Seriously! Every day, I wait for that tell-tale sound of the mail carrier dropping the mail through the door slot (sliiide...BANG!), and after I know he's gone (can't scare him can I now), I run downstairs and gather the mail. I go through the other mail before I let myself see who's responded. I haven't been this mail-responsive since April 2001, when college admissions started coming back!

I LOVE reading what people have written in the comment box. Some people have written a perfunctory note; I imagine these are the people who always follow instructions and therefore feel obligated to write something, anything, and so write "see you soon", or something to that effect. Then there are the people who draw pictures (e.g. An and Sarah), and people who write nice loving notes about marriage and love.

There are people who write funny things:

Eric, great job on the invitations, beautiful color scheme
- bridesmaid's boyfriend. I seriously laughed out loud when I read his note.

There are the international folk who have clearly painstakingly looked up words in the dictionary and write the most awesome things:

I want your fine wedding and happyness -uncle in Japan

And then there are the people who leave it blank (what's up with that, yo?).

I also find strange enjoyment in seeing what people are going to eat. For some people it's like, oh of course, they're totally health conscious so would choose fish/vegetarian. For others it's like, what? that meat-lover is eating eggplant crepe? (ahem, Sarah!). There are couples in which both individuals decided to eat the same thing. Wouldn't you rather choose 2 things and share? Spice up your life with a little variety?

But anyhow, I digress. These are the little golden moments of my days. :)

The tally so far, with 44 days left til the wedding, and 13 left until the "kindly reply by" date:
NO: 14 parties (28 people)
YES: 45 parties (76 people)
No response: 40 parties (83 people)

I'm so excited to see everyone!

Thursday, April 15, 2010

YES!

It IS iced coffee weather!
Hooray for 80 degrees in the burgh!

Sunday, April 11, 2010

Things I Dig on the Blogosphere

Yes, I b*tch and moan a lot about how much sh*t I have to do in the next 2 months. Yes, with all of that sh*t to do and senior musical rehearsals, I am pretty busy (and jaded, and I've turned into quite a potty mouth, yes, so whatofit whoyoulookin'at?).

But that doesn't keep me from exploring the blogosphere! And falling in love with the wit and funny everywhere!

For example: someone had the GENIUS idea of combining my TWO FAVORITE foods, sushi and rice krispie treats!
(But gotta admit, I'm notthe biggest fan of Peeps. Speaking of Peeps, having you ever tried roasting one over a campfire? I swear they're coated in polyurethane)

And HEE! with the hilarity that this was named the saddest book ever written (courtesy SF Weekly):

And HA! Gotta love when people use math to prove that religion can be hypocritical as all hell (source):

And a great source of fun (the one about the loud animals in the morning is just way too true).

I hope I've successfully distracted you with this post. Happy exploring the blogosphere!

Friday, April 09, 2010

Adventures in Pepper-slicing

A couple months ago, I sliced my thumb open on my Henckel knife. It's nearly 4 years old and had never been sharpened. The dulled edge slid off of the slippery edge of a rascally red bell pepper, into the soft pad of my first little piggy.

It bled and bled, and took over a week to heal.

Since then, instead of sharpening my knife like a normal person, I just cut everything with extreme caution. Peppers especially. And I eat a lot of peppers; my favorite food right now is a sandwich of hummus, peppers and mixed greens (yummmm). I think my prep time for most foods increased by 10% or so, due to the cautious chopping and slicing.

Today, I finally busted out my knife sharpener (a birthday gift from last year). Forty slices through the sharpener and about 3 minutes later, my knife was good as nearly-new! I made paper-thin slices of my peppers, and I know it can't be true, but I swear they tasted better having been cut by my newly-sharpened knife!

Which leads me to ask:

Why do I put off doing those small easy tasks that take minimal time and effort and dramatically improve my quality of life?

Do you do it too?




Also, totally unrelated: I like these pieces. The first piece hits the nail on the head; I could have written that exact piece, if I could put the proper words together in an eloquent way. Not that it is an indication of how I feel in my current relationship, but it rings true for life in general.

Thursday, April 08, 2010

I love this!

Is it iced coffee weather?

Apparently no, for me. How bout for you?

Wednesday, April 07, 2010

Transformation

I was gone for 10 days. The day I left, it was 43 degrees and rainy. At the rest stop on the way to DC, my friends and I ran from the car to the shelter to avoid the damp wind. My fleece jacket went everywhere with me; socks were requisite. The trees were hunched and bare, and the grass was deadish brown. It was a long, cold winter with entirely too much snow.

So imagine my delight to find, when I finally ventured outside this afternoon, spring had painted COLOR everywhere in Pittsburgh! I had forgotten that the trees lining the side of the house bloomed tiny sprays of yellow flowers, and that the lawn was full of lush green grass. There are tiny daffodils along the front porch with their orange mouths wide open, singing to the sun. There are purple hyacinths lining the sidewalk, and pink and white magnolias in the trees above.

Soon there will be lilacs and peonies, and dahlias. Oh, dahlias! I love dahlias.

It's really actually honestly truly SPRING, and I love it! May happy colorful flowers be all around you, too.

Thursday, April 01, 2010

Firsts!

It's APRIL FIRST!

Yesterday, we got our FIRST wedding gift!

Yesterday, I wore a SKIRT for the FIRST time in 2010!

We also went apartment hunting for our FIRST home!




...now I have to go the stationery store, so I can write our FIRST thank you cards. ;)

Happy glorious weather to everyone, everywhere. Whoever doesn't like spring is a bah, humbug.

Wednesday, March 31, 2010

Come A Long Way

I've never really loved treadmill running, and I've always had to push myself to go 3o minutes at a 6.0-6.5mph pace. When the weather gets nice each year, I take the running outside. I generally don't have a good sense of my speed and endurance on a treadmill vs. outdoors, although I'm sure they're about equivalent.

I was running on the treadmill today and found that I felt most comfortable at a 6.7mph pace (just under 9min/mile) - not too fast, not too slow. I upped it to 7.0 for 10 minutes then slowed back down again, for a total of 50 minutes of running, and 5.3 miles. This was faster, for longer, than I've ever felt comfortable on a treadmill. And I realized: all this running has really been doing something for me. I've come a long way, and a half marathon seems like just another long weekend run.



In the next couple of days, Eric and I will look at about 10 apartments - the hunt has officially begun! In 2005, I moved into my very first real adult apartment in Center City, Philadelphia. My roommate and I went into it knowing it was just for the year; temporary housing for a temporary year. The apartment was a "bigbox" type place, big and bright and somewhat impersonal. ALL of my furniture was donated, and the majority of it was covered in cat and ferret fur. My bed smelled like animal pee (don't worry, I replaced it). A day or so after I moved in, I saw a GIANT cockroach scuttle across the living room floor and had an instant of cataplexy; I fell to the ground, out of breath and paralyzed by fear/disgust/hatred of roaches. I wanted to call my dad to have him kill it. That year, I got biweekly paychecks and roamed the city in my just-out-of-college naivete, unaware of just how young I was.

And here I am, five years later, apartment hunting again. This upcoming year, I'll roam a new city (or, more likely, the hospital), unaware of just how young I am. But this time I'll be married (in 60 days!), with less donated furniture, and when I see a giant cockroach I'll just scream for the husband to off it. But there'd better not be any cockroaches! I'll get biweekly paychecks again, but this time, work won't be a job but the start of a career, and this new place won't be an apartment but our first home.

It's been a long five years, and it's satisfying to see that they've been full of growth, and progress. Thanks for coming along on the ride.

Friday, March 26, 2010

Tah-Tah for now, Responsibility!

Yesterday marked the last day I will ever have to wear my short white coat. Yippee!! I have no more clinical responsibilities until June 21, 2010, when I will don a long white coat with cloth buttons and my name embroidered on it, followed by the letters MD. Oi!

Until then my responsibilities include:

- sleeping an average of 8 hours per night
- finding an apartment in The District
- moving into said apartment
- getting married, and wedding-ed
- going on honeymoon
- preventing the stress-induced duodenal ulcer that will inevitably form as the first day of intern year approaches
- avoiding medical emergencies, as I will actually be expected to do something other than say "call 911!" as I run away,

and

- a whole boatload of other stressful crap that I don't really want to think about at the moment, thankyouverymuch.

Today I had the shortest "half day" ever (8:15-9:30 does not equal 4 hours), and now I'm off to get some of that other stressful crap done before I head off to DC.

Happy weekend, all! I hope everyone's receiving their invitations. Isn't my sister's calligraphy simply stunning? I can't believe I'm related to her! I'm looking forward to getting those RSVP's back from all y'all. Hooray!

Happy Spring!