fat salad

Today for lunch I went to this place in Richardson that I had been advised had good salads. I got a three-salad sampler for something like $7.00... and it came with like THREE POUNDS of salad. For serious. I think there was like a whole chicken's worth of chicken salad. I had to bend and lift with my knees (not with my back) to pick up the tray. Needless to say I did not finish that mammoth salad because I'm not in the habit of eating three pounds of food at one sitting (not since college, at least) and becoming obese is not a current goal of mine. But all around me were bigger people chowing down and finishing the whole darn thing. And it made me think about how much restaurants try to trick you with the salad, into thinking that it's usually a health option. Like at Taco Bell, where you basically get a little bit of shredded lettuce and then like a cup of ground beef and a half a cup of sour cream and a little bit of tomato and a heap of cheese in a big fried shell. You would probably do less damage eating about six bean burritos. And of course there's the worst (and also best) of all the salad places Souper Salad, Because you get unlimited refills of salad, and the salad bar has basically the equivalent of a cold tuna noodle casserole, and all the big people who go there serve themselves an equal ratio of lettuce to bleu cheese with some diced ham on top. Plus you can get pizza and that awesome gingerbread on the side. The only one I knew of in Dallas recently closed down because they're putting in a high rise or something, but it's probably better that they did because that place was dangerous. For me. It put me back in the state of mind I had in college, where you just keep eating because there's a ton of low quality food and you have to keep eating it because it's not that great tasting and so you never get satisfied, you just all of a sudden realize that you're really uncomfortably full and need a post-gorging nap. And then you decide that you should have dessert because they have a soft serve machine with sundae toppings. And then you forget how miserable the SS made you and go back the next month.

PS: anyplace I used the word "you" in the above ramblings, I really meant "I".

my mom doesn't need any help grilling me about my dating life, thanks. I'll let you know if she ever does.

So, today was my first day of outpatient pediatrics. I went to a private practice office in Richardson Texas. It was boring. Every kid either had Strep throat, a virus that mimicked the symptoms of strep throat, or they were perfectly healthy, or they had been swimming in Garland, Richardson, or some other suburb north of Dallas in a public pool and now had diarrhea caused by cryptosporidium (a parasite). The most exciting thing I saw was a diaper rash with a superimposed fungal infection.

Between patients, the physician I was following asked me if I had a boyfriend, then why didn't I have a boyfriend, then advised me that I should try and get a serious boyfriend or better yet a fiancee before I graduate, because once in residency I will be even busier and men will be more intimidated by me once I'm a practicing surgeon. She went on to tell me that if I waited until my 30s to have kids then I will only have time for two and I'll have to have them really close together. And that I should try and marry a Doctor so that they will understand how hard my job is, or at least a male nurse (for the record, I'd kind of prefer to have a stay at home dad. As Aretha and Annie so aptly put it, "sisters are doin' it for themselves".)

How am I supposed to respond to such a barrage? here are the thoughts I was having as this advice vomit flew through the air at my head:
1) I came to medical school to get an MD, not an MRS.
2) If a man is intimidated by my education, it's probably because he's insecure about his own
3) What the hell decade are we in, anyways?
4) If all else fails, I'll buy a trophy husband from Eastern Europe and keep him here by having power over his greencard.
5) if plan outlined in #4 doesn't work, I can always become a dried out old workaholic spinster, which sounds pretty bad but remains a solid option. Plus I can buy foreign babies like Angelina Jolie.

I'm not like an uber feminist man hater or anything. I just think that some people in Texas can be a bit behind the times when confronted with single women over the age of 23.

smoky hair?

Ever find yourself in the situation where you get back at 1 AM from a karaoke dive bar that specializes in attracting both surprisingly amazing singers and chain-smokers? And you know you have to be at work taking care of children at 6:30 the next morning? what a coincidence, me too. To get smoke out of your hair, spray liberally with Febreze and blow-dry. It works better than actually washing your hair. And volumizes! Seriously, whoever invented Febreze deserves a Nobel prize. I don't even care if it's a science category, they should get the peace prize. Way more deserving than that fruit loop Al Gore. And for those keeping track, yes I am a semi-closeted karaoke junkie. It brightens my day... and hopefully yours.

Oh, and the makers of the tide stain removal pen should also get a prize.

Mama Mia and other Mamas.

I went yesterday with Karla to see Mama Mia. It was one of the funnest movies ever and fully satisfied my hunger for 70's Swedish pop kitsch as well as my need to occasionally see a group of men in bathing suits and flippers doing coordinated song and dance routines (a need I didn't know I had until I saw the movie). While discussing the brilliance of the movie this morning at work, one of my colleagues claimed that he had never HEARD of ABBA! HERESY! I even sang a line of "Dancing Queen" and he still didn't get it. For those of you who are unfortunately not in the know about the wonders of this group, here's a pic:



Another great thing about the movie: you get to see Meryl Streep in a role where she doesn't have a sad life or a terminal disease. Maybe not Oscar-worthy, but still super fun. And you get to see Colin Firth in sequins and spandex and platform shoes.


Other Mamas: ruining my life at work. Either they're overbearing (page the resident because the baby's poo is green...fourth time mom.) or they're getting hauled off by CPS.

things I have learned

Unofficial medical knowledge:

T/T ratio: the Tattoo to tooth ratio. the higher the ratio, the harder my job is going to be.
Hat rule: If someone comes in wearing a crazy hat, they're crazy.
Beware of people from the 903 area code (last patient I had from here had parents who missed CPR training because they were smoking meth.)

I'll share more knowledge as it finds me.

I'm not dumb

Today for the first time I had a patient's parent lie to me to try and save their own skin. I knew they were lying. I called several clinics where the baby was supposed to have been seen and confirmed that they were making up stories. The baby came in after almost dying, and yet the parent was more concerned with covering their own tail than with giving us correct information to allow us to provide care for the child. This is the reason why I could never go into pediatrics. It's one thing for patients to destroy themselves (the CHF patient on a low-salt diet going to McDonalds when the nurses aren't looking); I don't deal well with seeing parents practice destructive behavior around their kids. gross.

update: got my USMLE score today and am happy to see that the sacrifice of my right hand was not in vain. I did about as well as I had hoped.

more good quotes from dorksville

the engineering school at Duke once had T-shirts made that said "too school for cool". I think I need to get that permanently tattooed on some part of my body... except I don't really like tattoos very often. I think If you're going to get one, it should be something giant and awesome. Example: one of my friends has a giant dragon tattooed on his torso. Someone else I know has a giant lightning bolt across his chest. My main point is that if you're going to permanently ink your body, it should be something that says "Hell yeah I have a tattoo!" and not some little wimpy crap thing that you got in Padre when you were young drunk and stupid. I can't think of anything that I like enough for me to want it on my body in a hell-yes way, so I just leave the ink to the truly dedicated.
that was a tangent. My main reason to post today was to share some delightful quotes from my ongoing education.

From morning rounds:
Med student-"The patient (a 14 year old girl) would not permit me to feel her chest at all... like for examining."

From a lecture this afternoon on bowel disease:
Senior Resident-"The first thing you do when you see a patient with this condition is sit down and thank your lucky stars that it's not you."
I'll keep that in mind. Thanks.

I get a weekend this weekend and I'm super excited about it. hooray!

kind of terrible but kind of funny

if you live in the medical world, you will inevitably laugh at things that are kind of completely awful. The following is an example of something I laughed at today and then felt like an inhuman bitch. Then I thought about it again later and it was still funny. It took place during morning rounds.

Medical student, concerned: "My patient's ejection fraction is 13%... is that compatible with life?"
Attending : "is she alive?"
Medical student: "yeah"
Attending: "well... there you go!"

above are some random pictures from when I was at home a few weeks ago.

this is my life.

An update on what I'm doing these days:
4:30 or 5:00 wake up and get ready
5:30ish At work; once there, I start collecting information on how my patients have done overnight, look up their new labs, see if any of the values are abnormal, think of a way to correct whatever is abnormal, and calculate how much the patient ate, drank, and peed. Then I go look at the patient and hope that I can understand whatever I'm seeing (I asked for backup the other morning because I didn't know if a baby had an abnormal heart beat or was just hiccuping. Thank God it was hiccups). Then I write all the things I discovered on a sheet of paper that will go in the chart.
7:00 my Senior Resident comes in and I tell him what I found and what I think, and he tells me whether I'm being reasonable or being an idiot (luckily I'm on pediatrics and the people are too nice to ever actually tell me I'm an idiot even when I am one).
8:30 lecture one some educational topic. Bagels are provided (yay!)
9:30 rounds are scheduled to begin
10:15 rounds actually begin. Try and sound competent while presenting my patient. Pretend not to be thinking "WTF?" when asked if I think that my patient is on an adequate dose of a drug that I memorized for a test I took last October (I have no idea, but I can tell you that its side effects include loss of taste, cough and a rash!)
12:15 meeting re: Medical Ethics. Ethics training in one hour. Lunch and cookies are provided.
1:15 lecture about some pediatric problem. The last one was about UTIs and the resident brought us candy.
2:30 see interesting patients and try to absorb some drops of knowledge from the attending physician.
3:45 hope that I don't have enough experience/authority/power to do anything else useful for the day, so that I can go home. (I'm willing to stay and do stuff if I can actually DO stuff, but more often the medical students are forgotten because everyone is busy with patients and we wait around for a while until someone notices that we're there and then dismisses us)
Afternoon/evening: attempt to get my life together, study for the shelf exam, write a 10 page report about a patient, etc.
8:30 go to bed pooped.

Highlights: I figured out why I don't have any financial aid, and it should be coming in later this week. I also diagnosed a patient with milk-alkali syndrome this week (you get it from eating lots and lots of Tums while drinking lots and lots of milk) proving that the hours I spent looking up random useless info on Wikipedia last year weren't completely wasted!
Lowlights: my hand hurts really bad and I'm about to start writing aforementioned 10 page report. booo.

ugh.

financial aid doesn't want to give me my money, every handout and powerpoint presentation that comes out of the dept of Pediatrics is written in comic sans, and I had three unnecessary, boring meetings today that recapped things I learned in much greater detail two months ago. The upside is, someone thought I was a genius for being able to describe the potter sequence. but really I just want financial aid to come to my aid and I would like to feel for once that I had any idea what was going on at any time, ever. not awesome.