what's up.

I spent last weekend in Austin with my family. My sister Shannon had a surprise 30th birthday party for her husband and it was awesome. Family, friends, and unlimited barbecue. I ate a beef rib that made me feel like a Flintstone.

 

Here's the wonderful decorations:

 

Shannon, Ben and Anna:

 

 

then I helped Anna climb a tree outside. Her mommy didn't see this... I'm not sure she would have approved (I was holding on really tight Shannon!)

Finally, Anna helped Shannon to clean out her purse.


I love going to Austin but I'm always tired afterward. This time was worse because I came right back to a call day (32 hour shift). I still like the VA though. All my patients sound like movie cowboys... probably because they're all from podunk TX towns and have been smoking three packs a day for forty years.

Here's a list of what I meant to do today when I finished with work (at 2 pm):
1. call grandma, wish her happy birthday
2. take nap
3. do laundry
4. call Brittany
5. get mail
6. work out
7. study
8. groceries
9. pay rent
10. catch up in bible study reading of Heresies and How to Avoid Them (about orthodoxy and heresy in the church. Brings up a lot of things that I never thought to think about before)

Here's what I actually got done:
1. take a nap
2. eat four macaroons bought on sale at Simon David last week because there aren't many Jews in the Park Cities and they had a whole bunch of kosher food on sale. (I also got some matzo bread. It makes a nice alternative to water crackers)
3. re-read Agatha Christie crime novel (I think I've read everything she wrote at least once. don't believe me? I started reading her books when I was in the seventh grade. I am now in the 19th grade, and I can read two a day if I don't have anything else going on. My favorites are The Big Four and What Happened in Baghdad?. I haven't been able to find any new ones that I haven't read in the past year or year and a half, so I think I've come pretty close to reading them all.)

Yeah so my day was less productive than planned. And I have a pimple on my earlobe, which I have no idea why and how you even get one there, but I'm pretty weirded out by it.

good night.

everything's coming up chrysanthemums...

Today was my last day of enforced dysfunctionality. It's been a heck of a ride. In case you're wondering, yes, my grade did stink (I wasn't getting my hopes up), but so did the other student's and we have addressed the powers that be to appeal and try to fight the woooaahhh...man.
The good news is, I got to sleep for SEVEN hours last night even though I was on call, I got finished today at around 10 AM, and then I got to go home. Then I went to Lowe's and bought some terra cotta pots and a bunch of plants to make myself a container garden in front of my front door. I of course called my sister to ask her what I should plant (and by that what I really meant was what can't I kill?) and she told me to get something tall, something short, and something viney that droops/spreads. I took her advice, and this was the result:


Charming, no? of course after I finished I read the back of my bag of dirt and it said "NOT FOR POTTED PLANTS!!! KEEP OUT OF REACH OF CHILDREN. ALWAYS WEAR GARDEN GLOVES WHEN HANDLING THIS SOIL"... after I had happily been digging my hands into it for like twenty minutes. Oh well, my hands aren't burning just yet so I think I'm probably safe.
My sister told me I should be careful about what I'm bitching about on this blog... looking back, I haven't used any names, and I haven't said anything that I didn't also tell to my course director, resident, and other classmates.
This weekend is for fun only. Next Monday I start at the VA... on a team by myself. I'm already dreading the undivided scut!

woo hoooo

Tomorrow is my last day of work... really I'm going to be working overnight for 30 hours straight, so Friday is the technical last day, but tomorrow is the last time I will have to actually drive to the hospital in anticipation of having a bad day. Today the other med student on my team said, "every day, I feel like it's the worst day of my life". I told him to try Zoloft, because it really helps. Seriously.
It took me a while to write after recovering from my last call... during which I had a homeless crackhead with possibly active tuberculosis, AIDS, and syphilis in his brain trying to flick his scabies at me at 3 AM. Then when I got to leave the next day (at around 1:00 PM) My car wouldn't start because the battery was dead. I called AAA and they told me it would be 90 minutes. In that 90 minutes I passed out in my car and my cell phone died. I woke up like two hours later, realized what had happened, and had to call them again, wait another 45 minutes, then find out that my battery was not only dead, it was defective so I had to buy a new one for the low low price of $130.00. Then I went home, took a nap for four hours (and no, I didn't shower first, cause I got it like that) and then went to Central Market. My grocery list:
1. Meatloaf and mashed potato dinner for one
2. Pint of Bluebell Chocolate Chip Cookie Dough ice cream
3. 1/4 lb of chocolate covered gummi bears
4. Six pack of Shiner 99th anniversary brew (pretty darn good!)
5. Bottle of Argentinean Malbec
When I got to the checkout, the guy looked at me and asked, "long day at work?"
dude, you have no idea. My day was like a swiss watch of awesomeness.
Monday I started to get woozy at work, got paranoid that I had been given TB by my crackhead dude, left work early and got into bed. Then I slept for like 24 hours. When I got back to work today, all of my four patients had magically been discharged, so I had no responsibilities (the ultimate woo hooooo).
here's a picture from my cousin's wedding of my slick dance moves, which I will probably be breaking out this weekend in celebration of leaving my old attending in the dust.

Have you ever wondered how Donna Mills, the star of the hit 1980s TV show Knott's Landing, got her signature wonderful look? well you're in luck, because in 1986 she put out a video series called "The Eyes Have It". I'm sharing with you.

Basic skin care with yogurt and cucumbers


Don't forget, you want to look natural... not BE natural.


Don't forget to feather your eyeliner!


Fabulous work makeup. lavish on the mascara.


For those special evenings when you really want to shine, turn heads... be that special woman! give yourself over to romance and glamor.


This may look like it will hurt, but it won't.


you're welcome.

you can't teach an old dog to teach.

I know there's been a really strong theme of complaining about my attending in the last week or so. That's because she totally deserves to be complained about. But I'll try and talk about other, more interesting things besides how dissatisfied I am once I've vented.
She doesn't teach any science to us. She doesn't teach us anything at all about medical decision making, physiology, or patient care. The only "words of wisdom" we ever get are about how we should doubt everything that our patients say because they're probably either lying to us, evading the police, or evading someone else on the outside (granted, this is sometimes true). When she does try and show off her science, she is not infrequently wrong--and about very basic things. She only teaches us the grammar of medicine (formatting our notes, dotting our t's and crossing our i's) rather than the practice of medicine (how to make decisions and cure people). It's so frustrating because I feel like I'm not even thinking at this point. She doesn't want us to try and come up with a plan for a patient--we are only to repeat what the team decided, without trying to make any decisions ourselves. ugh.

So on with the rest of my life... I did visit my psychiatrist, who told me that he'd heard a lot of complaints from students about my attending(!) and also agreed that it wouldn't be a bad idea for me to re-start anti-depressants. I'm starting to feel a little better about the world and my place in it. It probably helps that I discharged all but one patient, who is probably going home tomorrow or Saturday. Tomorrow I have to give a short talk on a medical topic of my choice. I'm thinking hyponatremia. It should be thrilling.

sit down you're rockin' the boat!

I'm getting the feeling at work that I can't win with my attending. The interns tell me I'm improving. The resident tells me I'm getting better. But the attending tells me that I need to work really hard, because I'm ALMOST at a high pass. A high pass is equivalent to an 84. It is a shitty grade. And I'm not sure how much harder I can work (I'm already pretty darn thorough).

So I called my mom and she gave me this wonderful piece of advice; "Smile and let the B*tch wonder what you're up to." It's a good piece of advice for when I'm stuck in a bad situation. The other advice that was really good came from my friend Karla; "I think we both need margaritas". And so we did go get margs this evening and vented about how awful and smelly our lives are.

so for now my plan is this:
1. call my shrink and ask for some welbutrin stat.
2. think of my boss as dissatisfied with her life and taking it out on me because I'm young and full of potential
3. continue to work hard
4. drink margaritas when not at work. other drinks may be substituted as I see fit.
5. pray to God that I don't go crazy during the next two weeks on this service.
suggestions are always welcome.

I'm so excited... I'm so... scared!

We had our half-point review on Friday from our Residents in Internal Medicine. My comments?
"You just don't seem that excited. We can't tell that you're interested... and you need to Honor this course if you want to get into Orthopaedics."
I'm sorry, I thought I was in medical school, not a cheerleading competition. I don't have an "excited" personality. But I do know all of the information about my patients since the beginning of their stay, and relevant info from before. I check for drug interactions when no one else has (including my intern, who then told me it was overkill and that I shouldn't bother... AFTER I figured out that a lady with chronically low potassium, even to critical levels, was on three different drugs that make you pee it out in large amounts). I don't tend to speak in exclamation points at work, but I'm doing my job and I'm doing it well. For about 80 hours a week. Then I go home and study.
Not to mention that I have good evidence that my attending isn't giving me her full attention during rounds (She told a patient that she should make her husband take care of HER for a change... when I'd told her an hour before that the patient's husband has Alzheimer's dementia).
Also, in internal medicine you spend 5% of your time talking to patients, 15% talking to your superiors and trying to figure out what the hell is going on because documentation can be a problem, and 80% of the time filling out TPS reports. Then you get chastised for not putting one of the new cover sheets on the TPS report. Plus you have to work on Sundays (get excited! Parkland is your new Jesus!). And every fifth day you get to stay at work overnight filling out lots and lots of TPS reports. And your workplace smells like poop and dirty sick people and pus and burnt popcorn. And when you do get excited and try to go the extra mile, someone tells you not to.

I want a job where I'm excited to get more patients, not dreading them. I also want a job that doesn't steal God's day or crush my soul. And I want a job that doesn't make me feel like I need to re-start my anti-depressants.

But I did try and start to seem more excited. I wrote an email to my attending physician and used several exclamation points.

Then I called my sister and she felt sorry for me and told me to go get a pedicure as a treat from her (Nail Boutik on Lovers has LA-Z-Boy chairs instead of those silly salon chairs. Plus they give you like a ten minute foot and lower leg massage. it's awesome!)

Then I went to Sprouts (a grocery store with really cheap produce and bulk stuff) and bought 4 lbs of strawberries for $5. Strawberries are my favorite fruit except maybe for cherries, so that was the high point of my weekend. And I didn't study a lick today and I hardly even feel guilty about it. Medicine will NOT wreck my soul. Just my dreams.

PS the picture at the top is what came up when I googled "excited scared". It makes me feel that way too.

I know I'm not fully certified yet but...

Here's some good medical knowledge and advice, straight from me to you:
1. Don't get fat. if you do get fat, don't let yourself get obese. if you do become obese, please stop growing before you become morbidly obese. 300 lbs is the limit past which Parkland Hospital can not do any type of imaging procedure (X-ray, CT scan, MRI, etc). For this reason, 300 lbs is colloquially termed the "Parkland Unit".
2. Don't smoke cigarettes. They are bad for you.
3. Don't do cocaine. Especially if you weren't able to follow the advice listed as #1. Or if you're on Beta-blockers. if you ignore this advice, it can be very hard to make sure you don't die.
4. Don't swallow razors or other pieces of metal in order to get a vacation from jail.
5. If you have a disease, don't deny it. Take care of yourself. If you have diabetes and can't feel your feet, you should probably look at them from time to time to see how they're doing. If you don't look at your feet, you may one day lose them.
6. If you come to the ER for non-emergent care because you don't have a regular physician and you want to be seen for free, please don't complain when people who are acutely ill are seen before you. Also, please don't complain that students are involved in your treatment. We're paying for the privilege to go to work every day.
7. It's our job to know a lot about science, but if you're really sick, it will take a long time for you to get better. This doesn't mean we're stupid or bad at our jobs.

One week down, seven to go. The upside is that I got labor day off because my resident is really nice and lovely and amazing. The downside is that whenever I am at work I feel like I've fallen through a time-warp rabbit hole where minutes stretch into hours and days run into one another. And it's incredibly frustrating to see people who are very sick with things that could easily have been prevented if they had taken care of themselves.

Totally looking forward to Surgery.