Dec 20, 2009

The review you've been waiting for...

I know I know; not enough blog updates and all that, but I figured after such a long hiatus, I should at least get in the *important* information.

Avatar didn't suck. I know! I saw the whole Smurf Trail of Tears thing and was extremely skeptical, expecting to be, at best, "World of Warcraft: the Movie" (not necessarily a bad thing, mind you), but was pleasantly surprised, and ended up getting drawn in, predictable plot and all. And heads up for the Xena war cry for all you 90s babies out there. But blah blah; google it. I can't think of any more positive reviews that haven't been said and I can't think of anymore jokes about the alien cat creatures that weren't made a month ago, so hey.

Annnnnd I finally got to see my boyfriend after months and meet his parents, which is one of those weird things you don't think about until you realize you've been on the Rock or in different states for the better part of three years and relationshipp-al milestones get delayed or shifted around. Oh the hazards of medical school.

Speaking of medical school, a couple of you readers out there who haven't given up on me and didn't get here by googling "Avatar" and "World of Warcraft" (greetings, fellow geeks!) might be curious as to that whole OB-Gyn thing I was doing for the last six weeks.

Well, for starters, there's a reason I haven't been out for weeks and it's because I haven't been out for weeks. Well, except when I've been sleeping, which is when I've been out. And the stories to tell are quite like when I worked in a morgue in that by the time I've tamed down the disgusting for a regular audience, there's nothing left to tell. I can compare OB-Gyn to being in an anatomy lab by saying that preserved bodies are WAY less goopy than giving birth. I can think of only two occasions in the lab despite four years of being there where I felt like I could get hit with a literal wave of something disgusting, but in OB, that was a daily concern.

On the other hand, people in OB-Gyn tend to be far happier. Even in the gyn department because there's stuff that goes from being a daily quality-of-life-destroying ordeal to pretty much fixed with a surgery and a few office visits. Not all, mind you, but certainly more than get fixed in a morgue.

I also ended up with three calls rammed very close together through a combination of factors, which had me working resident-hours. On those calls, weird crap seemed to go down so rather than having a few hours to sleep, there'd be a crash section or an ectopic pregnancy or something like that because women simply cannot have issues at any normal time of day. Still though, it was awesome. What's nice about OB-Gyn too, at least at my hospital, is you frequently feel useful. MORE useless if you aren't good at something because you were attempting to perform a necessary function, but if they say hold retraction on a surgery, they actually need someone to do it. Granted, it's always a medical student, but if you aren't there, someone will get stuck doing it. They sometimes need us to help interview people in triage if they get backed up. They need scut stuff, which can be annoying, but also gives you something to do and makes you feel like part of the team.

So I was a fan. Not enough of a fan to give up my love of microscopes, definitive diagnoses, and avoiding talking to annoying patients face to face (ie, pathology), but enough to keep me entertained. The oral exam was a little frightening, but I felt like I held my ground. But the hours were also heinous enough that the coming two weeks of holiday time not only makes me leap with joy, but at times, I barely know what to do with myself because I have free time again. Probably study for peds. The bastards broke me.

But winter... it's SNOWING! Like a LOT. Like feet and feet of it. Like having to get home from boyfriend's parents' hotel required a driver with a car that looked like it was used to transport heads of state. Like I need to buy boots that aren't suede *tomorrow*. And I know I'll incur the wrath of all native New Yorkers here, but it's cool! It probably won't be cool mid February when I'm trudging through the snow at 5 in the morning for my surgery rotation, but for Christmas? Woot!

Dec 10, 2009

Another video break

We're still running content light here. To give you an idea, I'm midway through a 90+ hour week.


Nov 30, 2009

Nerdy hooray

After a long hiatus of becoming utterly and inexplicably incapable of blood draws/IVs, I nailed two in a row. Solid hits. No hunting, dithering around in the skin, or trying to pawn off the job on nurses because I got cold feet from a string of misses. Just blammo-in and blammo-in.

I also managed to be scrubbed into a surgery for 3 hours without touching my face, knocking something over, contaminating someone else, or sawing off my finger with the Bovie. It was a good day.

Nov 28, 2009

So... wow...

OB-Gyn has been a killer, and NYC is a killer but in a good way (mostly). So much to talk about, so little time; so much procrastination, and hey, I'm on call for somewhere between 14 and 24 hours tomorrow, so that'll be a breeze. On the plus side, I've had a three day glorious vacation, helped by getting to go home early on Wednesday, so kind of a three and a half day vacation.

To briefly summarize what's been happening, to expand upon later when you guys finally descend on me for being a poor blogger-updater:

Started OB/Gyn residency:
-Wow, there's a LOT more hours than in IM. Holy hell. And they expect you to do stuff, possibly because the nurses there let you do stuff rather than snarling at you.
-Helped catch a baby. Whoa. It's like Alien, only everyone's really happy about it... and it seems more painful. But it's actually cool, and cooler than I thought.
-Scrubbed in on two c-sections. Got to do stuff like cut sutures and retract, which for now, is freaking awesome. I've heard that by midway through the surgery rotation, it is much less awesome, hence the term "Retractor Bitch". Saw some others.
-On vaginal childbirth vs c-section, I have to grudgingly admit that thus far, the 'natural' way seems to produce more kids that are pink and screaming, which is ideal. C-section, on the other hand, has the bonus of not being a vaginal birth.
-24 hour call is way better when you have things to do. I hit the wall around 4 am, got license to "go sleep" (yeah right), and ended up moonwalking around the halls near the library and giggling because I felt so fried.
-Somehow I wound up with quite a bit of time off call and now heading into three weeks of call every three days or so, which is so going to suck... Goodbye, friends and family.

Had my whole "birthday/Roman festival" thing, which pretty much consisted of a 50 hour binge. Wow. I blame this on spending the first 8 hours of my birthday on call and then crashing and waking up at 4 PM.
-Lorrie came for 8 days; woot! Discovered I can't actually navigate NYC particularly well when I'm completely exhausted. Walked around Union Square twice before finding the same chocolate shop I've walked by seventeen thousand times.
-Grace came out from NJ to join me on my birthday night starter at McSorley's, the oldest continually operated bar in NYC. We ran into two guys that helped us navigate the only food item there: crackers, Irish cheddar, horseradish, and onions. Clearly this was make out night for no one. There are also only two kinds of beer at McSorley's; light and dark. They serve them two at a time and they're insanely cheap. Matt and Chelsea were leading the expedition through the underbelly of the East Village.
-Follow the nuns. We had some sisters not only bless McSorley's, but wind up getting into Burp Castle to bless the place as well. They had a jet black nun van. It was like Batman if Batman were a group of nuns.
-Pomme Frites. They are delicious... And they soak up McSorley's beer, crackers, horseradish, onions, and cheese.
-"Cheap Shots". A place recommended us by our partners in crime at McSorley's. They have this thing where if it's your birthday, all your drinks are free the entire night. They also have this thing called a "Mystery Beer" on tap, which is a dollar. The latter makes you regret ever bitching about Bud Light. The former makes you wish you'd never been born.
-Crif Dogs: Have you ever been eating a hot dog and thought "This would be way more awesome if it were wrapped in bacon and then had eggs and cheese wrapped around it?" No? Well, go to Crif Dogs anyway.
-Karaoke. The only karaoke bar I've been to was in Grenada and no one was really doing it; it was just sadly playing the words to "La Bamba" on the screen while we ate rice and beans. So we found one, and heard Journey's "Don't Stop Believin'" about seventy gajillion times. Which still beat listening to anything by Oasis.
-Pool hall until last call shut us down as I was actually about to win a game of pool. To people who know me, this happens about as often as a full solar eclipse, so I was greatly disappointed when everyone got thrown out.
-We ended up following a random guy to the upper east side (via taxi, GRRR) on the promise of a place with a pool hall that was open late. Lies!
-Due to this long jaunt to a burb that is over an hour away from my neck of the woods, this landed us at Grand Central Station around 6:30 or 7 in the morning. Since Lorrie hadn't seen many of the joys of midtown, I decided this was the perfect opportunity to show her around.
-This started as just a tour of the upper hall of Grand Central, since it's all famous and such. Then the outside of Grand Central because it looks cool. Then Radio City Music Hall, then Rockefeller Center to see if the skating rink had been laid down yet (yes).
-Rockefeller had three camels being led around it. At 8 in the morning. With nothing to indicate that this was for tourists or anything else to explain why three big ass old school camels were wandering around. Lorrie finally ventured the question to the dead eyed handlers. To which they replied "For the Christmas show".
-I'm a secular type. It actually took me around 12 hours to make the connection between "Christmas show" and "nativity scene", so until the dawning of that, I had just pictured Santa Claus and the Rockettes jamming away with random camels roaming around the set. Then I felt stupid.
-St. Patrick's cathedral. Love it. It can compete with the European ones. There are also only a few feelings of "shame" that rival "touring a church in the morning when you've pulled an all nighter."
-MTV studios... I haven't seen MTV since Kennedy was on it. The annoying VJ, not the president or senator. Long story short, MTV studios are in Times Square, thus, like most of Times Square, they are not "all that".
-Broadway. Phantom of the Opera marquee and a greatly needed trip back down to the subway station to crash at 10 am.

(sleep hiatus)

To the famous Beergarden in Queens, for my *official* birthday celebration. I spent the first 45 minutes of it with a big Czech pint of beer in front of me going flat while I drank ginger ale. Heh. It's a Bohemian place, so they have Czech beer and Czech food, which is fantastic, so we got to all have Prague flashbacks. It was also raining and hellishly cold so we spent the vast portion of the evening inside, but lots of friends, all lined up at the table old school, drinking pitchers of Staropramen and eating dumplings. Hooray! Then the weather finally relented enough to go to the outside Beergarden and resume festivities, albeit tucked into a blanket.

I figured that would be the end of things, because... come on... but then got invited to Dumbo (home of that scene of the Brooklyn bridge that is in EVERY movie about NYC) at 11 am the next morning (or the same morning, since it was 2 AM) to eat Grimaldi's pizza in the park, followed by Jacques Torres hot chocolate, so I had to hit that up, because...

That Sunday night, I think I crashed at about 7 PM. Wow.

What else? Hmm... I saw part of Wolfmother but had to bail about halfway through the set because they came on late, I had to work the next day, and I am that much of a dork. There's only so much tired a girl can take.

I saw the Macy's Thanksgiving Day Parade, after making an extremely half-assed last minute decision to go, since I'd planned on avoiding it. This embarrasses me, but it was actually really cool, and I don't regret going at all. Plus now I can avoid Times Square on New Year's with a clear conscience since I've done two definitive NYC holiday things, and that's enough. I would add the tree lighting at Rockefeller, but I'm on call. :(

After the parade, booked it to NJ to spend Thanksgiving dinner with Ashley, who cooked a massive feast for us, and I got some dog therapy, since my dog died a few months ago and sometimes you just need to flop some ears around and go "WHO'S A GOOD BOY". Then she actually *drove* me back to Brooklyn from NJ. Dang, hostess with the mostest there.

Yesterday I vegetated and studied, which was inexcusable for more than a day, so today I went to the Met after discovering that the 20 bucks to get in is "suggested". I got awesomely excited over mummies, because apparently, I'm 5 years old. But... mummies are cool.

Nov 15, 2009

Nov 3, 2009


Though hopefully enough progress to net me a decent grade on my Internal Medicine oral exam tomorrow.

IM is strange in that I'm learning medicine without really feeling like I'm learning medicine, and then the knowledge manifests itself in strange ways. It's also giving me odd moments of confidence when I get lists of lab values on UWorld before smacking me down by the fact that I'm still getting the wrong answers, just in a more efficient way. So far my most reliable sources of "WRONG" relate to picking antibiotics (there's a frigging billion of them!) and prioritizing diagnostic studies (Ohhhhh, abdominal CT before cholelithocystopancreatoduodenogenography, sucker! Your 'Gold Standard' is not welcome here!)."

I'll explain...

A great deal of time on pathology, pathophys, and USMLE questions was spent on getting a list of lab values, looking up the list of lab values (which are generally provided), figuring out which ones are buggy, separating those out, THEN coming up with a list of differential diagnoses for buggy lab values, THEN coming up with a definitive treatment or test. This understandably takes a lot of time.

Now, due to just random patient follow up in IM, when I see charts of lab values, I'm like "blah blah chloride giant who cares blah blah, hoo-damn that's some high calcium!!"

I'm also learning which abnormal lab values are associated with which chronic conditions and which abnormalities are not *that* abnormal, thus no longer look like such an idiot quite as often when I'm presenting to an attending with "OMG THE PLATELETS ARE 125K!!! GET THE CODE TEAM READY!!"

Which, I suppose, is the point.

Oct 29, 2009

Brief advertisement...

If you live in NYC, the Steampunk Haunted House is definitely worth checking out, and it's only ten bucks for students, apparently including medical students.

Sadly, I don't have pictures because they don't allow them, and I'm not affiliated with them in anyway, but dayam. Awesome!

Oct 28, 2009

Pause for Fall...

Or in my case, spend 7 hours in Brooklyn Hospital's library OCDing all over your presentation, come home, and hastily tap out a case report on yet another Patient Who Has Everything and Complains About Even More Things.

Oh, and realize that when you spend as much time attached to your computer as I do, even 20 gigs of music isn't enough and your old standbys are starting to wane. Right now, I'm trying to re-stimulate my urge to care by combining Pandora's "Turntabilism and Beat Science" with "Bluegrass Instrumental". Ohhhh yeah. I can be a dorkitron AND sell out at the same time! Take that!

Speaking of music, I finally got out to the Bowery Ballroom on Sunday to see Thursday with Midnight Masses and Some Other Band. Now *that* was an old school show. A mosh pit even I was afraid to venture into, stage diving, crowd surfing, and lead singer sweat spray that got further back into the audience than a show at Sea World. Lest anyone think I'm being irresponsible, doctoring is fully destroying my love of things that are bad for me as I was thinking "I would join in the closer-to-the-stage festivities, but I don't want a fatal brain injury." Plus, I'm pretty certain that at this stage, if I got hit hard enough in the head, USMLE World questions would leak out, and then I'd get busted for violating copyright.

Still freaking awesome though. Thanks Patrick!

ANYway, as I was hitting Stumble around the internet today to give my tired eyes a rest from uh... the computer screen, I found a webcomic near to my dorkly widdle heart, so I figured I'd share its Autumn sentiments with you.

Oct 24, 2009

IM starts to near to a close

Oh yeah, I did the whole start ICU thing... er... let's just say I long for the unbridled excitement of the floor.
My day:
Ishie: "So, what brought you into the hospital?"
Intubated patient: "..."
Ishie: "No problem! I'll read your chart!"
Chart: (Unintelligible scribbling)
Ishie: "No wonder everyone whines about my handwriting."

ICU is also revitalizing my desire to fill out a "DNR/DNI/DNfreaking touch me under the following conditions: ___________, ___________ etc etc" notification with detailed, fact-checked data points that have been looked over by a team of doctors and lawyers, notorized, and then forwarded to every hospital in the country plus a bonus copy in my wallet, and heck, possibly tattooed across my back. This is not to discourage or dehumanize anyone, but the amount of unending human tragedy that has come about with the misinterpretation of phrases like "Do everything" is staggering. And trying to interpret pre-condition patient wishes from a host of subjective third party accounts and opinions is about as useful as consulting a magic 8 ball. Just saying.

It's also annoying when the lack of communication leads to very well intentioned family members trying to do everything to respect the wishes of hospitalized party, but the original intentions get lost in the medical mumbo jumbo so you end up with incomplete documentation that allows you to do sort of half a revival.

Bah, but anyway. I've been learning a lot, and with oral and written exams pending as well as my first Halloween in NYC, I'm trying to cram in a whole lot of study and 11th hour case write ups in a very short period of time. Because once a procrastinator, always a.. well, I'll get back to you tomorrow. Except that I won't.

In the meantime, I'm trying to get some semblance of a direction to go career wise. My current struggle is with my unending love affair with pathology and pathology-like subject matter, but then I find myself caught up in the general arguments against pathology (and radiology, but I suck at reading X-rays, and that's apparently important) which is its general stigma of individuals within the profession as maladjusted sociopaths that aren't real doctors. Not that I believe these arguments, but the potential future of having to qualify my job to everyone I come across is annoying. Of course, if I went into Emergency Medicine, Internal Medicine, or Surgery, I would just have to continue my same explanation which is "I am not a nurse. I am not training to become a nurse. No, I'm not planning on going into OB/Gyn. No, not pediatrics either. Because I'm not overtly fond of children. Why not? Because I'm a maladjusted sociopath that's not a real... aw man!"

Also there is the patient contact issue. I like some patients, and I like to help people (at least that's what my personal statement said), but as I've also said, I don't like mean people, and I don't like hurting nice people. My job description as a "seeing patients" doctor would generally involve either sticking needles, catheters, or scalpels in nice people and getting yelled at by mean people (while also sticking needles, catheters, or scalpels in them).

I also like to either see something and diagnose it or have something diagnosed that I can then remove manually. This pretty much limits me to pathology or surgery.

But we'll see. You never know, and I'm still keeping my options open.

In the meantime, since I'm busy writing up three case reports and bleaching the nastiness out of my white coat (I wish I could be hardcore and claim it's blood, sweat and tears, but I think the majority of it is curry sauce and balsamic vinegar), here's a video that's not related to anything, but I thought it was hilarious. Enjoy!

Oct 16, 2009

ICU next week

And woo hoo for I dunno, sicker patients?

MICU/CSCU will mark my last three week stint of Internal Medicine, meaning I'm going to need to make sure that I spend some copious downtime learning everything there is to know about... uhhh... medicine. Pathology, here I come. On the long term patient management contact, there seem to be the "Mean/Stupid; sometimes both" patients and the "Nice so I feel bad sticking needles into them or giving them bad news" patients.

Also the whole teaching hospital thing still feels ridiculously strange every time there's a patient with an interesting disease or pathogonomic symptom and then we all wait in line to interview/prod that person. On the one hand, doctors need to learn and having the first case of MS we see either lucked into by drawing the patient or actually being responsible for an MS patient AS a doctor would be bad. On the other hand, it's kind of like a carnival side show for the unfortunate. "Hey, those intermittent neurological symptoms that your husband thinks you're making up sure must suck. Mind if I smack you with a reflex hammer for the sixth time?"

Some of them are pretty cool though. We saw a case of Stevens-Johnson Syndrome, aka "holy crap, those antibiotics made my skin fall off" and the patient who was pretty much letting us do whatever we wanted in the interest of learning. That one fell under the "Nice so I feel bad sticking needles into them or giving them bad news" category. Wasn't my patient though, so I didn't have to do either.

I'm looking forward to ICU. OB/Gyn will be my next rotation, which I've actually heard is very cool despite my general dislike of humans under the age of 2. Not considering it as a specialty or anything, but hey... I get to wear scrubs.

In other news, NYC had about a 2-3 week period of "Wow, what beautiful weather and such a nice change from the unrelenting heat" right into "HOLY HELL, it's cold outside!". I expected a little longer of "long sleeved shirts" rather than hopping right into gloves, two pairs of socks, a sweater, a jacket, and a hat. But that should mean the ice skating rinks open earlier.

Oh, happy early Diwali to my Hindu associates.

Oct 13, 2009

Zombie hiatus...

Yes, in the eternity of excitement that *IS* Internal Medicine, I took a minute to find out how kickass Zombieland is after the good part of a day was spent with the roommate scarfing Indian food, costume-shopping, tea-drinking, and Times-Square-smack-talking.

Friday was kind of a crappy day at work, made better by having Daniel come home about 30 minutes after I did and suggest Maria's Happy Hour. Hells yes.

Saturday was shopping day; I have new clothes, shoes, and smiles. Then Saturday night with the Maenad and her fair god of wine at the Slipper Room (hosted by a Sealboy) followed by a wine bar. Good times.

Sunday, hit a travel expo with my mom after taking her to an awesome lunch in Nolita. The distinguishing part of the day after that was trying to zipline while keeping my dress "family friendly". That took some doing, and I'm sure there's some youtube videos showing where I failed.

Now, to undo the debauchery of the weekend!

Oct 1, 2009

It would take less time to treat TB than present it

Hi again, I'd have updated before, but uh... well, IM is IM. About 20 minutes of patient contact to 5 hours of lecture, so it doesn't make for interesting reading. "Saw a guy I can't tell you too much about because of confidentiality. Fell asleep during morning report. Rounded and learned about biased studies. Fell asleep during noon conference. Learned about DKA. Went home. Did USMLE World questions. Engaged in either the activities of A: "Going out" or B: "Staying home, drinking a glass of wine, and watching the Big Bang Theory/True Blood."

Rinse, repeat.

But now, I've spent the better part of two days doing exactly what I did in college when I needed to write a paper, which is consult entirely too many references, read them, know the first halves so well that I could reproduce them from memory into machine language, and extensively work up the first part of the presentation/paper before getting bored with the topic, stay up too late, and ram all the conclusions together, which is where the punchline of the study usually is. Thank goodness for abstracts and Mountain Dew.

Pretty much, I want this presentation to go well so I can both avoid boring the living crap out of my colleagues (a tall order after an entire day of lecture) and more to the point, avoid continuing to present the impression that I am completely useless to our chief attending. Thing is, since he makes me nervous, I don't tend to screw up in front of anyone else, but the second I get within shot of this guy, my (on vibrate!) cell phone starts pumping out the MP3 player at full volume with no discernible motivation, I lock myself in or out of conference rooms, and drop things. Oh, do I drop things... papers, pens, stuff out of my pockets while picking up papers and pens, books; I'm just glad I haven't been around him while trying to transport a patient or there'd be someone with a fresh orthopedic consult thanks to me.

Not like I can say I'm having too rough a go of it. I'm still enjoying my life; I'm still enjoying this big wonderful city, and I am absolutely giddy over the notion that it's *actually getting cold*. Maybe I'll regret this come February, but four months of unrelenting un-airconditioned-above kitchen mugginess was enough and I am basking in the fact that last night I got to sleep under that Ikea comforter I bought back in May, rather than relying on ice packs and fans.

What else... the loan checks came in just in time for everyone, though I made the mistake of hauling ass to a nice Wachovia branch (couldn't find one in Brooklyn) while looking scruffy. So naturally this prompted a full jeans-t-shirt take and an evaluation of my check. For reference, this check looks like it was issued by the federal government. It's got freaking heat and fingerprint sensors on it.

"Have you deposited these checks before?"
"No, they were being sent to my father and he deposited them."
"There's no Wachovia branch in Grenada."
"Is there a problem?"
"Well, does this check look different to you than before?"
"Ummm... I didn't see the previous ones, so no."
"Because they look completely different."
"It should be from St. George's University."
"No, it's from University Services LLC." (Oh, my frigging bad)
"When was the last check deposited?"
"One in May; one in December or November or something."
(Pause... she prints something out)
"You see? This is the one from May. It looks completely different."
"I don't know what to tell you. You can call them."

So she takes my driver's license, has a fairly hushed conversation on the phone to which I got hints of "No, she only wants to deposit it". At this point, I'm vaguely wondering if I'm going to have to explain myself to the police for daring to try to deposit a check of greater value than someone of my general appearance would get from a "Check into Cash" place.

All that and she got authorization, but then kindly but firmly tells me she's placing a hold on it until October 6th, which is one day after my rent's due, but whatever. I figure it's just the standard, but apparently the holds are determined by the branch, which meant after determining that I was not the world's most brilliantly stupid villain (I can create perfect heat sensor checks, but then choose to defraud banks by depositing them with no cash back to my verifiable bank account), she still thought I was so suspicious that we needed over a week to make sure I wasn't pretending to be an airline pilot from Pan-Am or something. So I'm gonna throw away those jeans, I think.

Uh oh; what's this? It's lecture time!

Sep 17, 2009

Bummer, dude

So a patient we saw a couple weeks ago died. He wasn't my patient or anything, but I did manage to botch his blood draw twice even though he had really awesome veins, and instead of being a whiny jerk about it like some people are on even the first stick when they're in the hospital primarily because they like dilaudid and would like more of it, instead he said it was no problem and asked if I wanted him to kick his family out if they were making me nervous.

Basically, the thing with him is he didn't seem very sick, and he was a nice guy. I mean, he had a lot of troubling symptoms, but he was a healthy guy, not a particularly old guy, and didn't have any risk factors. He didn't smoke, drink heavily, or have unprotected sex with IV drug abusing unimmunized bestiality-specializing prostitutes. He stayed in shape. He just got sick, got short of breath, and died extremely rapidly without much of anything medicine could do for him short of botch his blood draws while he was insisting he didn't have AIDS (he didn't). Weirdly, AIDS would have been a far better diagnosis. Weirdly as well, it was the one all the students were hoping he wouldn't have just before they discovered how much deadlier "idiopathic" is. If this were an episode of House, there'd just be some banter about how "idiopathic" means "f- if we know" and there'd be some miracle diagnosis at the 49 minute mark and this guy would go home to his wife. But, as mentioned, medicine is way more like Scrubs, so everything just carries along normally, and everyone's making jokes, and then they just cap someone in the last five minutes because it's sweeps week.

Weirdly, in this sort of thing, it's just a sort of depressing blip in your day before you go back to being told how unmotivated and incompetent you are before proving your maturity by framing one of your colleague's for stealing the other's reflex hammer. It's the way it goes. But it sucks sometimes.

Sep 15, 2009

So I did the whole 5K thing...

And woohoo, definitely a fan. Hooray for breast cancer research and running in Central Park. In celebration, our Heme/Onc lecture today was on breast cancer. I figured running in the 5K should make me exempt, but life isn't fair.

Speaking of life not being fair, this whole sickle cell/HIV combo everyone seems to have is a bitch. I feel genuinely bad for most of my patients, which should inspire me towards going into IM and helping them more, but more, it kind of inspires me to lean toward surgery since IM seems like a lot of playing with medications while watching people die. Not all of them, obviously. Oh, and lectures. Tons and tons and tons of lectures. I'm not knocking lectures, and more of them are clinically relevant than say, memorizing the essential amino acids, but it's SO much lecture. I attend way more lecture in clinicals than I ever did in basic sciences, not that that's saying much. I'm also doing more reading. I've already read enough of Blueprints that I'm searching for other books to buy because I need a more comprehensive coverage.

Oh yeah, the 5K (like I'm going to cover things in order?), over 25,000 people in Central Park. Very difficult to jog through unless you want to risk invoking the karma of pushing down breast cancer survivors, but still awesome, and still snagged a better time than usual for my 5K, helped by the fact that Central Park doesn't have the terminal hill of death that Prospect Park does.

My mom's moved to the city (upper east though; no Brooklyn for her!) so she came out to cheer, and I spent a good portion of the last weekend playing New York to New Jersey and back again Pong. Strangely, the forces of a GPS navigation system seemed hellbent on dumping me in Times Square as many times as possible, in one instance getting me there just in time to be caught in an angry 9/11 conspiracy theory mob. Oh joy. The other time, I just got the unprecedented joy of driving through it on a Friday night, which is surprisingly easier than walking through it.

Uhhh... this weekend, headed for the Jersey Shore with a bunch of H&Ps (History and Physicals) to write and relevant articles to read in the interim. IM is destroying a bit of my weekday hedonistic drives, but it shall not break the weekend!

Sep 1, 2009

Sometimes a favor isn't a favor...

Hi again... still here trying not to violate HIPAA or torch my evals.

There's a couple other third year students from another school rotating with us. We had the last two just rotate off and now we just got two more yesterday. I had two patients and didn't really get a chance to get much of a history/physical on one yesterday because rounds started early, so today, since one of the students had no patients and wanted to do something, I asked if she wanted the one I hadn't done much on, since the patient had been really nice yesterday.

The other student enthusiastically agreed, so I talked to my remaining patient, checked the new labs and vitals and got ready to write up my progress note. I wandered by the other patient's room only to hear LOUD profanity carrying from the room as the student tried to get a history from a woman that was cussing the hospital and everything in it up and down.

Whoopsie. It's a testament to other student that she doesn't hate me now. I swear I didn't know!

In related news, I'm still not great at dealing with hostile patients when I actually have to talk to them. In the ED it's easy because you just walk by hastily while looking at a chart because you aren't charged with getting a 40 minute history and several follow ups while the patient screams at you.

On an unrelated note, I've discovered that it's only taken a few short months for me to be completely desensitized to genitals in all forms. I was pretty blasé about them before, but now it's just ridiculous. Fortunately this has taken place at the hospital and not in the subway. As I saw a man wandering naked through the halls dragging his bedclothes, my first thought was "Oh crap; I hope he doesn't trip over his blanket" the second "Oh crap; that means a decline in his mental status" and third "Oh crap; I hope Dr. X doesn't make us list all the differentials for mental status change. Where the frig is my textbook? Rounds start in 15 minutes."

Other things I'm learning as a medical student:
-With a few exceptions, you are In The Way. You will be reminded of this frequently.

-The thrill of the white coat wears off really really fast. At first it's a "I'm gonna be a real doctor!" The next day it's "Oh god, people are calling me doc and expect me to do something". The day after it's, "Hey, I can store all my crap in these pockets!" After about a week, it's "My shoulders are killing me! Why do I have all this crap in my pockets?" Yes, that's right... you can actually shove enough seemingly necessary stuff into your coat to cause permanent orthopedic damage. And Batman does it all with a belt. Git.

-The stethoscope does not grant status. What grants status is being so high on the totem pole that you just miscellaneously grab other people's stethoscopes and use them.

-No matter how much you read, any answer you give is going to be met with rolled eyes and "Oh my god". Lest you think that means not reading, think again.

-During conference room lectures on any floor, there are two temperatures: Balls-Hot and Tomb-Cold. Dress in layers and don't be too proud to grab a blanket out of the storeroom.

-Ramadan affords the opportunity to score free lunch tickets from fellow students; however, caution should be taken when teasing these individuals. Fasting + Getting Pimped = Cranky. Love ya, J ;)

-Noon conference = Resident/student naptime. Do not disturb. Those unable to sleep during noon conference due to a Mountain Dew bolus during lunch can entertain yourselves by taking pictures of your sleeping colleagues and superiors. Just remember to turn the flash off.

-If you forget to bring a 4X4 gauze pad into a patient's room when you do a blood draw or give a shot, the patient WILL bleed from the site of a tiny little needle hole as if you've opened up their aorta with a chainsaw. Sleeves, the bedsheets, or the packaging to the needle are considered poor substitutions for gauze. Crying, praying, swearing, and fleeing the room are also considered unacceptable.

-Protonix, Lactulose, Motrin, and Heparin.

-Kerley B lines are a myth perpetuated by radiologists to see how many medical professionals they can get to claim they see them.

-No, no one actually believes you're allergic to tylenol, toradol, motrin, aspirin, and codeine.

-Know all the system passwords. Know them early.

-Yes, it's exactly like Scrubs. No, it's nothing like House.

Aug 25, 2009

Shamelessly stolen...

from someone's facebook comments list, but let's just say it rings pretty true after over a week of morning reports and noon conferences. Also after two years of basic sciences and four years of undergrad.


Aug 20, 2009

Adios ER

Though thanks to being in the same hospital, I still get to see the residents around occasionally; even got a big hug from one I ran into in the stairwell.

The rotation itself was good, though as I mentioned before, I'm looking forward to seeing some of the end diagnoses for the more complicated cases, though half the patients still seem to walk out AMA, which I thought stopped down in the ED. The nice thing with the ED is you're pretty much allowed to do what you're willing and comfortable doing. The staff is pretty chill and I like the overall "ER personality". If you're at a hospital that has it as an additional third year requirement option, I'd definitely recommend it.

Now I'm onto Internal Medicine. It's much more lecture based now, which is both good and bad. Good because it keeps adding in new information, and it's important information, plus it breaks up the day. Bad because I'm still adjusting my schedule around, am chronically underslept, and having a conference right after lunch that involves the lights dimming is making for... difficult concentration, shall we say. But we're already seeing more diagnoses. Also difficult on IM is that due to the morning rounds involving a lot of people, the patients seem to grow frustrated quickly, with one walking out as he was sick of the "crew" and another ordering all "trainees" out of the room immediately.

But we're adjusting.

In other NYC news, it's been muggy and humid and nasty as all get out, which has some promise of relief next week. We had a really sudden storm blow through last night with high gusting winds that apparently took down a bunch of the trees in Central Park. It came through so fast that it went instantly from being nasty hot, then suddenly the wind blew through the windows, knocked everything off the refrigerator, and then started tossing the sign to the falafel stand under us around. Yikes!

But another day in IM tomorrow with bonus lectures, so we'll see how it goes.

Aug 16, 2009

Blair Witch Weekend

Another short post because I'm starting Internal Medicine in the precariously near future.

Speaking of precarious, never start hiking at 3 PM in a place called "Roaring Kill" that features a number of side trips the begin with the word "Devil's" lest you end up scrambling up boulders at 6:30 PM, realizing you're about to be in big trouble at 6:35 PM, hastily retracing your steps down the mountain so you can at least be on semi flat trail for when you are stumbling along in the dark using a broken digital camera as your sole source of light, and contemplating whether you're going to have to spend a hungry night sitting in mud while raccoons eat your face.

But we saw a porcupine!

Saturday night... well, I have rarely felt a relief and joy as pure and unadulterated as that which I found when we saw the car in the trailhead parking lot around 10 PM after finding the guest book we'd signed at the beginning of our adventure attached to a tree nearby. By that point, Stephanie's broken digital camera (whose cracked LCD had been shining a bright, trail marker finding light) was dead and my digital camera was out.

Sunday, we atoned for all of that by breezing through Woodstock for some tea and jam (the actual concert site is in Bethel, which was about 90 minutes away) and then went to a Bluegrass festival at the Saugerties lighthouse, which was awesome. Perfect way to celebrate the end of our respective rotations, complete with a bonus swim in the Hudson.

Now, though sad to see ED go, looking forward to the nitty gritty IM. Hopefully the enthusiasm lasts.

Aug 12, 2009

I love short notice...

We have our Emergency Medicine test on Friday, and got 4 of the 11 powerpoint lectures for it today, so that'll be some fun fast studying. Didn't get *any* of them until about two weeks ago, and it's like urgggh. One, would have liked to have more run time up to the test, but two, a lot of the stuff would have been useful for ER, specifically on splinting and wound management.

But no more EM as of Friday after the test, which is sad in a way, but I'm also looking forward to starting Internal Medicine, since that's the sort of bread and butter of things. It also might give me a shot at getting my schedule semi normal!

More info later; busy week.

Aug 4, 2009

Another trip to Jersey

And for a good cause...

That angry young man behind someone's miscellaneous devil horns is Maynard from Tool, aka "that band I've been wanting to see live since I was 15 and somehow never got to do so".

Oh yeah baby. I went to All Points West, which was a three day music festival in Jersey City that had a ferry leaving from Battery Park straight to the festival. I had to work Friday night to Saturday morning, meaning I couldn't go Friday (which is fine since they replaced the Beastie Boys with Jay-Z) and on Sunday (missing Coldplay, so sad) I was recooperating, but Saturday was mine. I got home from work, slept for three hours, and met a couple of friends in lower Manhattan at a bar that oddly has the original Magna Carta upstairs (??) and headed off to see Arctic Monkeys, Neko Case, Tokyo Police Squad, My Bloody Valentine, and oh yeah, TOOL.

Show was incredible. I love music festivals, even if they are a little tightly run now-adays. Woodstock, this is not. They have pretty intense security (largely to check for alcohol) and fenced off "beergardens" (drunk zoos, no real beergarden looks like that) where they charge 7 bucks for a Bud Lite and don't let you leave the fence for it.

Loved the whole scene though, despite that stuff. It had been raining quite a bit all week, though the day of the festival was sunny, but the place was mudded out. I deliberately wore flip flops and a dress I got at a craft fair so I could thrash both in the mosh pit, but they turned out to also be a good precaution against getting anything nice destroyed by mud.

I mainly pushed forward to see Tool, and got shoved, pressed, overheated, but it was all worth it. Oh, though weirdly some random guy came up behind me in a massive breathing throng of people and started telling me how I pretty I look, how I shouldn't be up here with all these men, and how he wants to kiss me. Ew. Has that ever worked for anyone? "Hey random girl who hasn't seen my face. I know you're busy worshipping at the altar of greatness and readily distracted by the mohawked, shorts-clad singer on stage, but wanna hook up?" He and the "Hey beautiful, why don't you get in my car?" guys from Grenada should troll for tail together. At least they'd have each other to go home to after they get summarily rejected by anything with two X chromosomes.

Annnnnyway. It was fun. And Tool is great, and so was everyone else. It was also at a state park that featured less flattering views of the Statue of Liberty.

All hail the freedom and glory that is... Statue ass. There's a NJ joke in that somewhere, but I won't make it. I haven't been in New York long enough yet.

It was a pretty view getting out there though.

Look, it's Grenada.

I did get soaked in mud, which was great because when we hit the train station back at Battery Park, you could tell everyone who'd been to the concert because they had mud caked knee deep. That was all well and good until I got on the express D train rather than the local D train because they were working on the R train and screwed up my mojo, so I ended up in south Brooklyn at 2 in the morning with the leaving-the-bar-for-home scene, who were all probably wondering where on earth I had been that I ended up knee deep in mud and smelling vaguely of sweat and cow crap.

Oh yeah, but that whole doctor thing.

I really like ER, and I definitely like the trauma cases, but on the medical cases, there's a sense of really wanting to know the end diagnosis that is infrequent for us because we send all the serious cases upstairs, so I'm like "Wait, was that actually CHF presenting atypically? Was it something else? What tests would be run to confirm something weird??" It's not necessarily that I want to get to know the patient over weeks or months and all that, but maybe just an email dropped from the medicine people going "Oh, turned out it was ulcerative colitis. Have a good weekend".

Having just gotten off the night shift, there's also the mystery patients that come in with something chronic that probably should have been seen in a general clinic two months ago, and there's been no worsening of symptoms, but suddenly they're like "I've been having this vaginal bleeding" (it's ALWAYS vaginal bleeding) and for some reason, it gets to around two in the morning, and they're like "And I want it taken care of now."

Which is fun since there's not as many staff on, and a lot of times it's male, which means the patient has to wait around while someone tracks me down as sometimes the only person that can serve a "chaperone" role since I'm female. It's not that I mind or anything and it gives me something to do, but it feels weird to be a necessary member of the medical team when the person doing an exam is an attending that's been a doctor for 20 years. "Sorry ma'am, I'd like to do this exam which I've done seventeen thousand times, but I just need to track down that third year medical student to make sure everything's kosher."

I'm also not getting too much of the sexism that I was expecting, which is fantastic, except for one patient that I kind of wanted to slap in the head, but that was for a number of reasons. I think it's the white coat. I'm getting called "doc" a lot, particularly when the police are around, and periodically get introduced as "the young doctor" by the residents and attendings because patients balk when you say "medical student", even if you're only getting a history and checking their heart and lungs.

I'm also learning the "I have a patient" doc-walk. When I first got in there, I had that sort of tendency to glance around at everyone smiling nervously, which made me target zero for patients that were getting pissed off about one thing or the other (and they all are) and saw me as a receptacle for complaints (see "white coat"), which would be fine, but I don't actually know much, and especially if I haven't seen the patient, I don't know what their problem is, who their doctor is, or how I can help them.

So I took a tip from a large part of the wait staff in Grenada (and the doctors and nurses) which is sort of a variation of the "subway stare" in which you're looking straight ahead but never actually make eye contact with anyone, nor let them observe that you know they're there. Walking quickly also helps, preferably holding a clipboard. WAY less stressful.

I'm also learning that for patients I actually have, reassurance that I haven't forgotten about them goes a long way. Stuff takes forever; labs being run, short staffed at night, etc, but most patients are okay so long as I stop by every half an hour and say "we're still waiting on your lab results, and I'm sorry for the wait, but just sit tight and we'll see what's going on. Do you want a blanket? I know it can be kind of cold in here."

So that's good. I've gotten some really good patients; I've gotten some really bad ones. I wish people would just be honest on their social history and pain level. The social history really annoys me. I drink alcohol. I don't care if you drink alcohol. Either 90% of Brooklyn is Mormon or they're all liars. If you drink a pint of vodka a day, I'm not judging you, but for the love of whatever, would you just TELL me that when you present with your legs swelling up so I can start following the "liver" pathway rather than the heart one? Por favor? And then they get pissed off that their issues aren't being resolved, and it's like "That's because I'm having to work you up for seventeen different conditions because you won't tell me anything."

But the pain, oh the pain. Everyone is a 10 out of 10 on the pain scale. I equate a 10 on the pain scale with being pretty much unable to speak and either screaming like a horror movie victim or being about to drop into unconsciousness. People are holding normal conversations with me and they're like "Oh yeah, my pain is a 10."

It's giving me a true love for the other type of patients though. The "I drink a glass of wine a day, smoke a joint or two on the weekends, and my pain level is a 6. You see, I had a little too much to drink tonight, fell off a balcony, and now the x-ray of my arm looks like a jigsaw puzzle. But take your time; I'm not going anywhere, and it was stupid of me to do it, so I appreciate you fixing me up. So you're becoming a doctor? That's really awesome."

*Love* those patients. They're honest, in the ER for a good reason, admit that some of the incidents that befall them might actually be a result of their own actions and not somehow related to me, and present interesting cases that allow me to suture or splint stuff, which is fun for me.

I'm also finding that the mildly inebriated (not fully inebriated; they are their own form of obnoxious) tend to be the easiest to do procedures on. Usually fairly cooperative, kind of sheepish about being a little drunk, and don't respond too badly to pain. Not that I'm advising people run out, get drunk, and injure themselves, nor self medicate injuries with alcohol; it's just been a limited experience run, and I like people that don't squall at me when I start IVs or inject lidocaine.

Well conference day tomorrow, so bed time to me.

Jul 29, 2009

Spanish lessons from the Emergency Room

"Tengo que poner un dedo en el ano para sangre."

So, how was your night?

Jul 28, 2009

Requisite blog post

Hi ya'all and welcome to another installment of Ishie's blog. It came to my attention that it had been quite a while since I'd had one, giving that whole third year absentee impression that actually seems to be more due to living in NYC than it does to the actual work load of third year, though I'm sure, once I get to my surgery rotation, that impression will change.

Speaking of change, it's pretty remarkable the ones that I've embarked on since I decided to embark on this little venture called "medical school". I feel like I've grown up, grown down, been dressed down, and probably caused two decade's worth of liver damage in a short period of time. Medical school, as an entire experience, including the whole "in the Caribbean" thing, is probably the best and worst thing I could have ever done.

But I'm liking it, facilitated by starting off my third year existence with psych and then transitioning to ER, which keeps things fun, but is also a P/F class that doesn't require *that* much studying. The med surg people seem far less enamored of their lot in life.

Problem with ER is it lends itself to a TON of stories, most of which cannot be relayed on the internet, at least until several months have passed so I don't risk encroaching on the sacred HIPAA rules (man sprayed with mace by drag queen posse) that would risk casting me to the streets loans unpaid.

So that leaves me pretty much regaling my stories of living in NYC for the first time which consists of "spend too much money. Indulge in excess. Spend too much money. Go off on some alcohol fueled Nick and Nora fantasy with a waxing and waning group of friends. Convince one virginal satellite friend to try absinthe. Find exciting new venue you'd never heard of. Spend more money. Repeat. Go to work at 11 and regale the missing medical students and residents of the times you had in your down hours. Repeat."

Oh, and jog. I'm training for a breast cancer fundraiser 5K in September, which goes a small way towards physically and karmically repairing the damage I've been doing otherwise. Monica's helping keep me honest.

On the ER side of things, as mentioned, I finally got my IV sticks. I got on this kick where I could do ANYTHING so long as it didn't involve a vein. Arterial blood draws? Sure! NG tube? Sutures? Staples? No problemo. Simple butterful stick off a vein? Put an IV in an unconscious person? Problem. Complete failure to perform.

But finally kicked that in the ass so now I'm at 3 successful IV pushes to 1 unsuccessful in the last two days. The unsuccessful was on a woman with notoriously difficult veins, whose daughter decided to help me by saying "This experiment is OVER". Can we have a barb wire enclosure where we keep family members? That'd be super awesome. Better yet, if you're going to backseat doctor, how about taking your loved ones to something that isn't a teaching hospital? Mmkay, bye.

Oh, I also won a suture-tying contest, which meant someone else had to do the Guaiac on my patient. Gotta love the small victories.

Jul 26, 2009

Short one

Work schedule's a little buggy this week. I've been working the 11 PM to 7 AM shift for a week, had Friday off, and work Saturday Sunday, so I'm leaving for work in approximately (checks watch) 15 minutes.

Uhhh... ER is cool. NYC is cool, though nasty muggy hot lately. Training for a 5K in September with my co-conspirator, Monica. Dog died three days ago, so much crying, staggered by working, staggered by going out drinking with friends. Got two successful IV sticks (FINALLY), and doctor that seemed to hate me now being nice, so hooray.


Jul 16, 2009

Conference? Nah, let's go to the beach

So because I'm incredibly lucky, yesterday, instead of having to show up for case conferences starting early (which sucks after a 3-11 shift), the residents had a beach BBQ at Jones Beach for the interns, and the medical students were invited. There was a great deal of humming and hawing on our parts since we weren't sure if it was a true invite or a "Oh... um, yeah, if you want to come, that'd be fine or something", but the Resident In Charge Tuesday night was like "You should go. You should totally go", etc, so we went.

I had gone to Jones Beach on the previous Saturday, but really wanted to even out my sunburn since my last trip left me white in the front and red on the back, so I looked like a playing card. Mission accomplished. Now I have a pretty even burn down the front, so no places on my body will have a melanoma advantage over others. I like to be fair.

So that was fun. Doctors aren't as scary when they're in their bathing suits playing volleyball.

But the rest... hmm... still have managed to avoid sticking my fingers up anyone's butt, but have had to do a pelvic and watch two of them. The joys of being female. I've given a couple of shots now, screwed up a couple of IVs and blood draws (I used to be able to do them; what happened??), patched up some superficial wounds on a fall victim, and helped splint a leg. I've also helped dissect a pizza that was brought into one of the patient cubicles and screened off, so when I was told to come up, I thought I was being called on to help with a procedure, but turns out I just got first crack at the dinner special. Niiiiiice.

So I'm having fun, feeling more comfortable, and so on.

Jul 8, 2009

You know you're out of shape

when you're huffing and puffing while jogging along in the park and you glance over at your (much fitter) roommate and realize he's walking along side you. Time to step up the yoga classes!

Case conferences today topped off by a rousing game of resident jeopardy (med students had the job of sitting there going "Holy crap; am I supposed to KNOW that in two years??), so not a lot to report.

In other news, a lot of people can attest to the fact that I'm not a giant stickler for being clean; I'm not that worried what's in my food and will pretty much try anything no matter what rat-infested street cart it came off and I've been caught sniffing shirts to see if they have another day's wear in them, but that being said, doing real medicine is giving me a serious case of OCD. Yesterday, we had a patient that was... uhh... oozing out of several orifices, one of which she wasn't born with, and stuff was going everywhere. At the time, I was thinking "Wow, this is intense" and also that doing stuff like running to get bedpans and helping do damage control on cleaning up a mess of substances that is too revolting to detail on this blog would help endear me to the nurses, so no big deal; had gloves on, didn't get stuff on my clothes, and did the normal hand wash/hand sanitizer afterward. Got home and started to make dinner... ten minutes later, I'm still scrubbing my hands in the bathroom "Unclean!! Unclean!!!" Go back to the kitchen... nah, probably not clean enough to touch my food. Granted, on a dare, I once ate an ant off a floor, but still don't want to touch my food.

Also, I'm already extremely appreciative of chill patients. When I was giving the tetanus shot and being instructed on technique by the other third year medical student, the patient is saying "Now don't you worry honey. I have had medical students practicing me all the time when I had the surgery, so don't you worry none about hurting me. Yup, you're doing great... heh heh, listen to me telling the medical student what to do." Thank you, incredibly chill patient. One of my friends when she was working prior to medical school had her first blood draw patient tell her something to the effect of "if you screw up, I'm going to sue you", so I know how lucky I am.

Jul 7, 2009


Started ER yesterday and it's an experience quite removed from psych as anyone can tell you. I also keep introducing myself that way as "this is my first MEDICAL rotation" lest anyone thinks that 6 weeks of dealing with schizophrenia entitles me to put in an IV.

There are two sides to this particular ER: Acute and Urgent. Acute is for people that have complicated diseases, may require being admitted, and may be in danger of dying if not treated fairly immediately. Urgent care is your broken bones, lacerations, stomach pains, throat aches, and that sort of thing. I spent yesterday in Acute care being terrified and trying to elicit a history from a 105 year old without full uhh... mental acuity. I also got seriously pimped for my first time ("This may be your first medical rotation, but I assume you know BASIC physiology?") and learned how to do and somewhat read EKGs.

Today I was on urgent care; saw viral pharyngitis and a corneal abrasion, the latter of which I got to not only examine but say "Uhhh yeah, there's something in his eye" because I could *see* it. They saw it and confirmed with dye and a Wood's lamp, but I suppose I'm not as useless at eye exams as I thought. Either that, or it was a really big piece of something. Then I screwed up by taking the patient's charts up to ophthalmology but not the patient, because I didn't know I was supposed to, so he was like "you forgot me", and it's like "no! I'm just an idiot!"

Then bounced to acute care for a while and had a patient that was kind of a mess, with ulcers, a serious UTI causing sepsis, and a whole host of other problems, so I hung out there for a while, helped the nurse and CPA clean up the mess (don't ask; let's just say, I'm still washing my hands) and in return, got to see a Foley cath and a wound cleaning, which was cool. Came back to urgent care and got to do a tetanus shot (woot!) before interviewing an ob/gyn patient and getting a crash course on pelvic exams (I get to do the next one) and starting IVs (I get to do the next one).

So it was an interesting day. I feel like I know absolutely nothing and somehow manage to forget to ask the most basic questions that the residents then immediately ask about like "does the pain radiate to her back?" "Uhhh... no? Okay, I didn't ask. Even though I know to ask."

Oh, now that I'm back at Brooklyn instead of MPC, I get to use meal vouchers, so that should shave a significant portion off my costs. Unfortunately today, I was spectating through lunch and by the time I got to the cafe for my free meal, they were closed. So sad!

Jul 3, 2009

Favorite interchange of the week

Situation: Fire-breathing, leather-clad Scottish man, making his way around the audience putting his fire torches on people's tongues, shows hesitation to fully dip a flaming torch into a conservative looking woman's mouth...

Conservative looking woman: "Oh, don't worry; I've done this before."

Jun 28, 2009

Outpatient clinic

Just finished three days of that... well, not today, more like Friday.

In psych, we do 6 weeks total, and the vast majority of that is at Manhattan Psych, which is an inpatient facility. Three days of the rotation; however, is at the outpatient clinic in Harlem, aka, right down the street from the Apollo, which is cool. Should have gone over there, but ended up wandering into H&M instead, and spent the evening at Arlene's Grocery over in the Lower East Side, the LES being "where I spend most of my time when I'm not at the hospital". My roommate's love of LES got me hooked and the music kept me going. So far it's delivered two fantastic live music venues, a 'burlesque' show that... uhhh... well, has a serious case of Glen or Glenda, a hookah bar, good food that isn't hideously overpriced, and so on.

Today, I caught a ride to and from Jersey to a wedding party, which was fantastic. I got to see the "Garden State" part of Jersey with winding green pastures going up through increasingly dense forests to arrive at a sprawling beautiful property with a salt water pool... and an open bar... and bbq. The bride is one of my sister Tori Amos fans and presented me with both the cd I'd lent her, and a jacket from Scarlet's Walk, which means if we're the same blood type, she's owed a kidney. I think I already owe someone else my other kidney, so if both collect at the same time, I'm going to be in some serious trouble.

But, going back to psych, because what continuity? Uhhh... outpatient clinic was interesting, but not interesting in the same sense as the acute psych ward is, which was not unexpected, which is why I spent part of Tuesday sulking that I had to spend the rest of the week doing outpatient. Then I remembered that since the outpatient clinic is in Harlem, that means not having to take the Ward Island bus, which means I got to avoid things like people that stare fixedly at you for forty minutes saying "Your skirt's chocolate brown. You like chocolate brown? Melts in your mouth, not in your hand... chocolate brown... yeah.." Fantastic.

Why are there weirder people on the buses than on the subways? Well, usually.

Being at the outpatient clinic also means we spent quite a bit of time between patients no-showing and such reading charts... which sounds uninteresting until the backstory on some of the patients is revealed, which is kind of like watching true crime shows. Even saw two charts for a serious case of folie a deux, which sadly, I know about because of the X-Files. This dorkitron knowledge bank did not start with House, nor will it likely end there.

Jun 18, 2009

Staying in tonight

At long last...

Sooo the stuff they say about the psych rotation is pretty true. I'm actually learning a lot, but it is still pretty much like being on vacation, particularly since it's my first rotation and I just got my loan check.

But where was I. Ummm... whew, awesome parties; awesome clubs; awesome bars; awesome restaurants; awesome sites; awesome free Fridays at MoMA; awesome friends; awesome experiences.

That sounds about right. But you people may actually want to know something about what I've been doing school wise.

I'm getting more comfortable in the psych hospital environment. I'm getting to know the patients on my floor and which ones are pretty benign and which ones it's a good idea to make sure I'm standing behind a nurse if I talk to them. Today, due to the rain and a bit too late of a hookah night, I walked in a few minutes late. My patient says "OOOOOOOOH, you gonna get fired! You late!" She then tells me I should have my hair in a ponytail and tries to sculpt it into one. Then, as I was being let into the morning meeting, she yelled "SHE LATE AGAIN!!!" over my head, to the staff's amusement.

There's a new patient who's apparently King Allah and a kung fu master. He's got crazy eyes. I'm looking forward to that transition.

The nearly catatonic man is actually making demands, claiming he wants to see the doctor because the man talking to him is "just a nurse", and upping his activities. The staff refers to this as "You woke him up; you fix him".

It's cool stuff. Nearly every day, our doctor gives us an assignment to read from the Blueprints Psych book, so we present, and then he gives us about an hour lecture on whatever the topic is. He's not a big fan of personality disorders, so the psychologist borrowed us yesterday as none of us had anything to do, so we got a close on personal contact on all the Cluster A, B, and C disorders, complete with him doing imitations of the patients. I really like the people at this hospital.

Oh, though there's one medical doctor that's after anyone with small obnoxious habits, so naturally I'm patient zero. He's grabbed my wrist once (I was playing with my watch band), my pen once (no bad habits in front of the patients!), and the psychologist's pen twice. Noooo idea.

We have some lectures; some of them are really good and helpful; some less so. They also have grand rounds and case conferences that a ton of people in the hospital attend, so I've been to a bunch of those. I've been up to the treatment mall to watch some of the patients' classes. We learned about some famous people that had gone through the program as well as the profiles of a few of the more... uhh... criminally memorable people in Kirby.

So no complaints! In my non hospital time, I've pretty much been finding a new venue every night, but tonight I needed a night off to catch up on sleep.

Jun 13, 2009

Favorite conversation of the week

Staff member, referencing a patient that keeps acting out and getting sent back to our floor: "What's wrong with this guy?"

Doctor: "He's an asshole."

Staff member: "Is that an Axis II diagnosis?"

Doctor: "It's Axis 6. He's an asshole."

Jun 7, 2009

No more stupid flu

And on a related note, I'm so in love with sudafed and Mexican sweet chili tea that it elates me. Pretty much, I spent Friday aching, sleeping, lying in front of the tv, and feeling sorry for myself. Saturday, since our porch is inexplicably leaking onto the falafel place, I got to watch them send people up through our apartment for like three hours, but then felt okay health-wise. Sniffly, but nothing my friends sudafed and tea couldn't handle!

I found a B&N in Park Slope and was able to reserve two of the Blueprints books at it, and when I went over, found the other ones, so now I have the complete series for the cores, plus the Pharmacopoeia. Okay, the latter is 15 dollars, and the thing is the size of a fast food calorie guide. I know it's absolutely wonderful and essential and all that good stuff, but come freaking on. I thought these things were a drug company handout. Are they destroying *all* the perks?

So that venture was hideously expensive, but wound up with me finally getting the B&N membership because it made things cheaper. When I got back, I signed up for the full year USMLEWorld for the step 2 CK, because I figured it would help focus my direction of study for the cores and make sure I know the questions in and out, especially with drugs, where I'm weak.

This all resulted in me spending on study supplies nearly what I spend for a month's rent. So I bought myself a pair of Italian sandals because... I mean, come on. And they were on sale. The books were not.

Ended up heading over to the East Village with Lori for good and pricey Mexican food complete with homemade cheese, followed by live jazz at a place a few doors down.

New Yorkers don't seem to really care how other people dress, which is awesome for me since I have no fashion sense and no money (though I'm waking up latent shopping instincts I've never seen except when I shop for scuba gear), but I discovered the benefit to dressing in those cute little cocktail dresses every woman in the city has rather than the jeans I was kicking it in... people think you work at the restaurants. I got asked when I was walking back to the bathroom and was just "Uhh... no, just passing through."

Which, since NYC is expensive, might be helpful in picking up tips. Also, since a lot of these places charge 7 bucks for a Brooklyn lager, which I can get in 6 pack form at TJs for 8 bucks, I stand to make 34 dollars worth of profit sans tip. Hmmm...

Eh, prolly illegal.

Park Slope has some great brunch deals (like 4 dollar all you can drink sangria, which is a *great* idea), so did that with a big group this morning, followed by climbing up someone's fire escape to a HUGE roof space connecting all the apartments. Cue Dick van Dyke impressions.

Tomorrow, back to the hospital to present my SOAP notes and hope clinical skills has prepared me well. Problem is, the SOAP notes we did for physiology were pretty different, plus relied on a medical history (not psych) that was written up, not gained from an interview. The write ups we did for clinical skills were ridiculously long and involved questions that annoyed the doctors and made a patient interview take 45 minutes on a simple and focused procedure.

We'll see how it goes.

Jun 5, 2009


So I have the stupid flu. I don't know whether I have the stupid *swine* flu, but death doesn't seem too imminent, so I'm not all that worried, though it did mean missing a day of my psych rotation because I woke up feeling like I'd been beaten and the perpetrator had stuffed all my head holes with dead jellyfish.

Weirdly, due to the surprisingly interesting nature of this rotation, I'm less worried about my grade and more irritated that the new admit to our ward had promised some really interesting fireworks today, and I had to miss them because I was lying in bed or in front of our new (LCD!) tv playing the "drastically varying temperature" game with my fever.

Psych is... hmm... I can't say I want to go into it as a specialty because there's too many hopeless cases, and for criminal psych, I don't like people with antisocial personality disorder (who does?), but I can say the rotation is proving way more elucidating and fun that I ever expected. Nearly every day that I'm there gives me some new "holy crap, this patient..." story, and our attending is really good. He's a really good instructor and likes to give us sort of mini assignments rather than just pimping us, and then focuses a specific lecture around it the next day, largely geared toward the boards, but illustrating examples with memorable patients we've seen during rounds.

So never forgetting what schizoaffective, bipolar type looks like. It's uh... memorable.

The deal is that there are eight of us assigned to the hospital (up off Harlem, so kind of a gnarly commute from Brooklyn), and then we're split off into twos and assigned to different wards. My cohort and I had the good luck of being assigned to the acute psych ward, which gives up the weirdest cases and the best excuses for being late to lecture "sorry we're late, there was a woman blocking the door that was trying to grab us while calling one of the doctors many varieties of MF, and it took a minute to get her out of the way because everyone else on the ward was getting an extremely noncompliant patient down the hall so she wouldn't kick the social worker halfway across the room again."

It's a good program though, but the patient population frequently is from a criminal background and extremely difficult cases, so the rehab can be hard, but they have a whole series of classrooms in the upper part of the building called the "Mall" where patients are expected to report for classes that can teach them anything from art to activities of daily living, the latter of which has a kitchen to learn how to cook, a room they have to clean, lessons on how to apply for an apartment lease and how to open a bank account, so the ones that can eventually be discharged are able to function in society through a variety of community outreach programs, which is cool.

It also helps stimulate their minds, even for the patients that do need extensive inpatient care, and most of them really seem to look forward to it, so you don't get that "screaming in a tiny room at the walls all day every day" thing we saw in Grenada.

It's weird; because the hospital is such a "last resort" place, people keep asking us if we're surprised by it. I say considering what we saw at Mount Gay, it was surprising in a good way.

I think we are getting the chill rotation though, and our attending is particularly chill, so the hours are good, thus last Wednesday, after getting off at 3, we all met for the pre-Happy Hour in Manhattan, which was quite cool.

Oh, I'm going to have to turn in my first patient write up, which makes for interesting reading, since the patient goes extreme flight-of-ideas mode, so my write up included looking up what on earth ma'afa meant, as well as the word "bullshit", just like that, in quotes.

So, so far (except for the flu), I'm really enjoying NY and I'm really enjoying the rotation.

May 31, 2009

First week, check

So one week of rotations under my belt, and uhh... not so bad so far. Of course, I'm in psych, which is classically not one of the miserable rotations. I have friends that are already taking overnight call, inserting foley catheters, starting IVs, and getting seriously pimped, so I think I just drew the lucky first rotation.

I've been accounting for this discrepancy in hours by going out damn near every night. Can't tell you how much I'm loving NYC and its perpetual live music, fantastic food, copious well drinks, and festivals.

For psych, I have quite a long commute, since the psych portion for Brooklyn hospital, for us, at least, is at Manhattan Psychiatric Center, which is two subway transfers and a bus ride from where I live in Brooklyn to where it is up off Harlem.

On the other hand, most of what we're doing is "watching". There aren't that many procedures to learn in psych, except on the hypothetical. It all gears around the patient interview and knowing the meds patients are on, but otherwise, what is there for us to do? And the floor I'm on is the most acute psychiatric patient care one, so I can't really help with their work schedule by taking cases since no one's about to let a small inexperienced female medical student into a room by herself with a patient that hasn't been able to get along on the other floors.

It's interesting though. I've seen one patient that is showing remarkable improvement due to some pretty creative prescribing and House-ian thinking on the part of our attending. We have one patient that required five people to hold her down and still managed to tag a nurse pretty badly. Another patient, everyone's favorite, that they had me interview, which involved her ranting at me for about 10 minutes. I'm assured she'll probably cuss me out three or four times in our six week hiatus.

Today, I'm heading out to walk around Prospect Park for a while. Should be a blast.

May 27, 2009

I'm back, baby!

I love internet so much it consumes me. And though I love my little Blackberry storm because it enables me to not only look up all the stuff I don't know, but also to use my phone like a little GPS finder to locate the right subway, it just doesn't match the pure unadulterated joy of full screen, full access surf-mania. Ahhhhhh...

BROOKLYN! Like all the major changes in my life, of which there have been many, I was approaching the move to New York as if it were going to be some huge horrible thing where the second I got here, I was going to be apartment-less, followed by being tortured and robbed.

So, yeah... freaking loving New York City. The food is so good and the band schedule line ups so copious that I may never leave. I have a sweet pad and roommate (SGU!) in Park Slope, I'm surrounded by ethnic food, Italian ice, and organic grocery stores, and I live staggering-home-drunk distance from the subway, which weirdly, manages *not* to pass under my apartment and vibrate my walls.

In the slightly-more-than-a-week time, I've managed to do SO much stuff. Daniel and his Zipcar(tm) got me to and from Ikea so I could put my bedroom together without trying to cram 400 lbs worth of furniture onto a subway. The food here is SOOO good. Tonight it was cheap/trendy Thai food. Yesterday, it was home cooked turkey burritos courtesy of a collection from Trader Joe's. Thanks to Lori, it was Vietnamese food and french chocolates. It was organic veggies saturated with some sort of heaven-sent vinegarette. It's Mexican chili tea and iced coffee and microwavable naan, and and and. And wine. Lots of it. Good and varied.

Coupled with walks through Grand Central Station, Central Park, St. Patrick's Cathedral, and the East Village, and thanks to Lori, base of the Brooklyn Bridge, across the Brooklyn Bridge, city hall, courthouse, Ground Zero, Chinatown, Little Italy, Soho, Noho, Nolita, Union Square and mojitos and more. With guided history. And with Daniel, Times Square, Union Square again with bonus capoiera, the food carts that won the "Vendy" awards, Gramercy Park, the closing Virgin Megastore where I got the Tori Amos album and a cloth messenger bag for 35 bucks, Greenwich Village.

Not including the grand tour of Park Slope I gave myself simply by strolling around aimlessly while I did my freaking laundry. Used bookstores, parks, churches, old houses.

And the guy threatening to slit a cabbie's throat, and a woman smacking a car for cutting off a pregnant woman trying to cross the street. A thousand "give me money" subway announcements. An improv doo wop band on the M train that actually did manage to get some money because they made me smile. Cellists and guitar players and dobroists wherever they feel like setting up. Secret service-like men in black guarding the Armani store from the poor people. BBQs and border collies and old friends in Jersey. Sin City and Zinfindel.

And that whole med student thing. I started my psych rotation, and randomly got assigned to the most acute of the psych wards that they'd actually let medical students into, but the staff are incredibly chill, and the patients fascinating. I get a triple transfer hour long commute to get there, but that gives me plenty of time to catch up on my HP Lovecraft when I'm not perfecting my thousand yard subway stare.

Freaking... Love... It.

May 21, 2009

Not doing third year abandonment

Just woefully out of internet (most of the time) until next Wednesday when we can get it installed.

Quick summary: Brooklyn. Awesome. Roommate. Awesome. Food. Awesome. Trader Joe's in easy subway distance (if you don't take four subways in the wrong direction because you're me). Awesome.

I'm a fan. And already did a dry run to the hospital where I'm orienting, but going to head to Manhattan for my psych hospital dry run tomorrow, since it's considerably farther away, and where I'm starting out.

May 14, 2009

Girly crap

Thanks to realizing clinical rotations were starting and I pretty much owned *no* nice clothes save for a kind of weird patterned go go dress I got at Goodwill for three dollars, I had to engage in a two day estrogen-fest at the local mall for a day of clothes shopping, including *finally* buying a couple nice dresses so I don't have to beg clothes off people for social events, and a day of shoe shopping, while looking longingly at Spencer's Gifts.

Shoe shopping and I... ergh. My shoe shopping expeditions used to consist of going to Payless and picking out keds, wearing them out, and repeating. I tried for hipper shoes, but I was a pennyless teenager, so I occasionally was able to score cooler stuff from thrift stores. Then I got converted to running shoes, which I'd long associated with being part of the consumerist establishment, but like portable electronic devices, that was before I discovered how freaking awesome they are.

So my pattern until today: Go to New Balance store. Tell them exactly what I want. Have them bring out three pairs of shoes, from which I generally choose one, not particularly mindful of what it looks like, leave store within twenty minutes. Wear shoes for 1-2 years until I have destroyed them. Repeat. Expanded slightly for Grenada because I needed two pairs of shoes prior to going.

The last two days; however, I feel I've finally lived the "girl" experience of having to hunt down sales because nice clothes are frigging expensive, and then having to spend another day hopping from shoe store to shoe store in an attempt to find a nice, hospital appropriate shoe that remotely matches the crap I had to buy the previous day, isn't 80 dollars, and doesn't leave leather-strap induced ulcers all over my feet.

This is no easy task.

Being a former ice skater (I know), I was also confident in my strength of ankles, thus my ability to walk in heels without snapping off part of my fibula, until I fell off a half inch path at Aquarium for no particular reason and turned one of my ankles into a bloated Christmas tree first term, and now I'm all paranoid.

Shoe shopping seems to spark a very teenage sense of rebellion in me as I'm looking at my 17th pair of 'why the hell do we have to be going into summer and there are NO close-toed shoes' and as I'm passing the hipster shoe stores, I get a nearly overwhelming urge to just throw caution to the wind and buy a pair of stiletto heels that appear to be made of pink care bear fur, largely because they were probably the most hideous things I've ever seen, which made me want them. And, by the letter of the law, conformed to most hospital dress code policies, but would have likely netted me a nasty write-up about professionalism.

This is why I buy running shoes. And then run in them. But after a ridiculously long mall trip, and a ridiculous number of stores and sales, I have shoes for work and shoes for play. Oh, and shoes for *real* play, which are my beloved trail runners that I've had to shower cow/horse/goat crap off of on no less than three occasions. If my new nice shoes and clothes can survive a hash as well, I may change my tune.

Addendum, for those wondering why I'm shopping for clothes and shoes in Modesto when I'm going to be living in NYC, it's because in one of the three episodes of Sex and the City that I have ever seen, one of the sociopaths/main characters is having some sort of Sophie's Choice moment over a pair of 400 dollar shoes, so I became instantly convinced that to buy work shoes in New York, I'd need to supplement my student loans. And yes, I believe everything I see on television.

May 8, 2009

Hooray for Housing

And for friends helping friends find friends... and friends. I think I lost a word.

I have a roommate and an apartment in Park Slope, and best of all, said roommate is someone I know from SGU rather than a psycho on craigslist who stuffs my stethoscope down my throat as soon as s/he finds out I have to get up mega early once my surgery rotation starts. AND no huge multi-thousand dollar up front fee, so now I just get to be excited rather than miserably stressed/excited.

Orientation's on the 22nd for Brooklyn, and I'll be starting in psych, which means I'll be reporting to northern Manhattan since that rotation is off site and the commute is longer, but it also gives me the street cred of working in Manhattan. Heh.

Since I'm still in California (which had been complicating my search), I'm flying out on the night of the 17th to attempt to stuff as much Ikea furniture into my bedroom before my rotation starts. My new roomie also introduced me to the concept of the ZipCar, which should make the process of transferring furniture a *lot* easier.

May 6, 2009


Or so they say!

Yesterday, got an email saying I was good for Brooklyn, which makes me really happy.

Today, went Monterey diving for the first time in nearly 3 years, though camera-less so I wouldn't be task loaded, but I still felt really comfortable in the cold water, though towards the end of the dives, on the chilly end of comfortable, but the big thing is...

Sea lions! And harbor seals!

Grenada: eels, wrecks, sharks that are big enough to be awesome but lack the interest or size potential to eat you, significantly lower hypothermia potential.

Monterey: Rocks encrusted with life, giant anenomes; furry marine mammals that periodically dive bomb you, kelp forests, opportunity to wear giant dive knife strapped to leg which looks really badass even though it's just used for kelp.

So hard to choose; why not do both? Grenada had a ton of things I absolutely loved, but there is nothing quite like having a sea lion loop you. Granted, they have the same bite potential as a bear, but they are extremely freaking cute.

Happy Cinco de Mayo! Well, technically now, Seis de Mayo.

May 3, 2009

Still in the in between...

Not for blog abandonment; just for lack of things to say, really. Though I'm sure I'll remedy that with some rambling!

I got an email today saying I had US health clearance and that was being sent to the clinicals, which means, crossing my fingers, I may get my final placement soon! Woot!

It also means that someone at SGU was working on a Saturday at 9 PM. I'll let that sink in for a minute.


My preliminary placement was for Brooklyn, which I really really want. Now, I'm in sort of a scared holding pattern for it, because I've been looking at housing, and it's freaking me out. Grenada offered the safety of the dorms to kind of satellite out the housing options in the area until you inevitably lost the housing lottery or went insane from the construction noise, so you could scurry out to an apartment and scurry back which offset the high cost of living and allowed you to get familiar with the area.

Of course, I say this with the comfort of someone that lucked into an apartment I really really loved that somehow wound up relatively cockroach free and proud despite being in the tropics. Others were not so lucky.

So now reality's back, and it needs a place to live in Brooklyn.

I realized that NYC housing would be a challenge, but figured I'd grown accustomed to astronomical housing rates due to Grenada and I don't have a problem with small spaces or lack of light. On that note, apparently, an apartment that doesn't have an actively running meth lab requires an application fee, a credit check fee, an income, a guarantor, your first month's rent, your last month's rent, a security deposit, and possibly a broker's fee, which is also equivalent to first month's rent. Possibly also your firstborn.

The problem? I don't get my loans until the start of clinicals and I've been off in neverland studying for the step 1, which doesn't give me 5000 dollars worth of free spending money to drop on my first month's rent when I was planning on a much more reasonable month's rent plus security deposit. It would, on an unrelated note, give me enough money to have a luxurious month-long diving holiday in Borneo though. Just saying.

It may get easier once I get the final word on the placement. For the time being, I think part of the stress is in the hypothetical. I can't start ferreting out roommates or arrange appointments until I have an active placement lest risk backing out on someone at the last minute, but I feel the burden of time ticking away, plus I'm in California, so I can't just alleviate my fears by going and *looking* at places, even casually, to get a feel for it in the interim. Google maps street view is helping somewhat. I'm also surfing craigslist, which is kind of inundating me with a billion apartments and roommate options, any one of which could prove either my dream apartment (meaning no roaches, reasonable distance to the hospital, and internet), or could provide me with the opportunity to have to utter the phrase: "Officer, I swear it's not mine!!" or worse, "Why am I in a bathtub full of ice?"

So I've got a little case of the cold feet.

On a not "holy crap I need a place to live" note, I headed up to the little town of Columbia, CA yesterday, which is a pleasant little gold mining town from the wayback that reminds me of a more mountainous version of Old Sacramento. Then, since it was pouring and I was carrying more than one portable electronic device, I headed to the Moaning Cavern, which probably has the distinction of being the only cave in gold country without gold. Since I dislike yellow gold and like limestone, I consider this a plus. It also has the distinction of having a number of people fall through it's cleverly disguised top opening over the last few thousand years, so when it was formally discovered, there was a pile of bones at the bottom of a 160 foot drop. Kind of a "we are the world" moment when you realize the number of people over the centuries that shared the exact same "walking through a fiel ahhhh" moment regardless of class, culture or creed.

For something that's been a tourist attraction since the gold miners went "hey, there's no gold here", it's actually not hokey, the cave itself is gorgeous, and the winding spiral staircase that goes down is old (but tested) and made out of a recycled ship, so I got a more authentic feeling out of it, which I appreciated.

I also got to meet an awesome fellow-guitar player that lives and works up there, so that was a highlight.

Diving on Tuesday, aka Cinco de Mayo, so we'll see what my return to cold water diving after nearly 3 years looks like. I'm guessing it'll involve a lot of shivering.

Apr 22, 2009

Not dead yet

But whirlwindy. Would my life be anything else?

Quick update: New Orleans: Freaking WOO HOO... so so so awesome. So so so much liver damage. Oh, and street cred for taking a vampire tour on Easter. I finally beat my curry Christmas. Bonus tip: don't do a mule cart ride immediately after drinking something that has the word "octane" in it. More details later (hopefully) and Dave took good care of me, which is fortunate, since a couple of times, caring for myself was spotty.

After: packed up to move out of New Bern almost immediately. Figured since there's no furniture and I only have to fit stuff in my car or take it to a storeroom, that "this time, moving won't be so bad."

It's always that bad. It just always is. I need to stop pretending that it isn't. So far my easiest move out was from Grenada, which still sucked, but also allowed me to leave tons and tons of stuff for my housekeeper and whoever else wanted it, rather than having to get every item out of an apartment, including the fifty pens everyone accumulates but then doesn't want to throw away, but who wants to pack fifty pens, half of which are dead?

I planned a stop at Slappy's along my way, and she had written to me if I wanted to see a play the night of my final moveout. Forgetting the above paragraph and firmly in denial, I said "Sure, I'll be out of my apartment my around noon, maybe 2 at the latest, which will give me plenty of time." Fortunately, she didn't buy the tickets since I called her at around 2 or 3 to tell her I still wasn't out so I'd miss the play, and around 6 PM to tell her I'd be in at midnight.

Freaking. Hate. Moving.

But stayed with her for a couple of days and fantastic time. Went in my first Ikea store.

And now, driving to Modesto, CA to stay for a couple weeks before clinicals start and hoping like hell they don't pass off my Brooklyn spot while I'm waiting on varicella. So I'm currently at a motel in the middle of New Mexico. Huzzah.

Addendum: People who think the South is creepy should drive through Oklahoma.

Apr 10, 2009


It's off to New Orleans I go for the weekend, with the wonderful Dave, who made this is birthday present to me in November, so he gets to take leave of his Island Prison briefly to lovingly show me around his old haunts. Naturally, I'll be drinking grenades out of novelty cups.


Apr 7, 2009

We're talking mega-ecstasy-bliss

So I was going to write an encouraging blog post about the major depressive episode that is the last few weeks leading up to taking the Step 1, but then some housing stuff went foul for a couple of days and I found myself envying the dead again, so it seemed like a poor time.

But that's resolved, and now... holy crap, there's nothing left to study. I have very very few responsibilities for the next few weeks other than those shared by the general population. It is indescribable.

It's not like right now my life has undergone such a drastic change. I don't know people very close by, I'm lazily packing up my apartment to spend a few weeks back in Cali before the march to Brooklyn, trying to struggle through the school's deathweb of red tape, and spending a lot of time vegetating in front of my laptop.

But prior to the exam, I was experiencing a depression that was creeping up insidiously. Started with just an "oh, I'm sick of studying", but it wasn't even so much that, since I actually liked most of the material I was reviewing and stuff was beginning to mesh together and make sense in ways it hadn't before.

No, it's more that there is this constant and unending pressure. ANY time I wasn't studying, I felt guilty. Days off, I felt guilty. Taking too long to go to sleep. Felt guilty. Watching tv. Guilty. Talking to my family. Guilty. Walking the dog. Guilty. And gradually, while not feeling actively miserable, I was experience what I would call a "happiness black hole" in which normal situations that would induce pleasure no longer did. So I would go out, take my dog for a walk in a beautiful night, look up at the stars, look out at the river near my house, and then walk him up to the town hall, which is still lit up and old style Dickenesque, and think "huh".

And not even "I need to finish off the glycolytic pathway by noon tomorrow so I can get started on the..." or being *distracted* from what I was seeing, since I was far too braindead for contemplation, but more "Hmmmm. That used to make me happy. Ah well." And walk home.

It's sort of like I bypassed acute panic because you just can't suffer from it for 10 weeks or your heart will explode, and went beyond it. Even the morning of the exam or the night before wasn't panic so much as just a more elevated tachycardic depression.

I would recommend after the exam, NOT suddenly having your personal life go to shambles, because it makes the transition more confusing, and that tingling peripheral neuropathy in your limbs and tightness in your chest sticks around.

But then... ahhh... It's beautiful. I enjoy the taste of food again. I enjoy the church bells I can hear from my bedroom (yes, I am currently living in a town *that* quaint).

In the meantime, I'm preparing for yet another fantastic birthday adventure provided by Dave, so I get to meet him this weekend in New Orleans, also notable as being one of my favorite cities outside San Francisco and Prague. Upon my arrival back, I'll be piling into a car and driving cross country (again!). It'll be on I-40 this time, so I'm guessing I'll amass a lot of pictures of bleak nothingness. On the good side, I think the scenery is generally so uninteresting that you're legally allowed to bury the needle on whatever car you're driving to make the time go faster.

My "task" at the moment other than packing, consists largely of sorting out my health forms for SGU. They changed the TB requirements from two in a year (which I had) to two in six months (which I didn't), necessitating two TB tests in two months.

Ohhh, and my varicella titers aren't sufficient (A-FREAKING-GAIN, I can't get chickenpox! Just accept it and stop charging me astronomical amounts of money to stab me in the interest of preventing a disease no one gives a crap about!). Oh, and my still-not-two-years-old mumps part of my MMR underachieved too. I hate my stupid antibodies. Except the Hep B ones; those RULE.

This is also relevant because (and fortunately by harassing the nurse I got this info), had I gotten the MMR and V vaccines *1st* as I initially intended, this would have negated the TB test for the next 4-6 weeks, which is definitely relevant since I NEED TO START CLINICALS THEN. Sigh.

Also fun is that one overpriced chickenpox vaccine isn't good enough; I need two, and they need to be 30 days apart, which starts to cut it close... which adds to the fun because no one wants to give a varicella vaccine to an adult, so even finding a place to overcharge you for it is a rare thing.

I got my TB test read today after spending 48 hours willing there to not be a mark. The one I got a month ago reacted so little, I finally just circled it because you couldn't see where the hole had been. This one got the proper wheal when it was inserted and then... freaking stayed red for a while, so I'm just going "if you false positive me and I have to then arrange a stupid chest x-ray on top of everything else, I am going to cut that section out of my arm."

It was impressed, and retreated. 0 mm! Suck it!

I've also been faxing the physical and first TB test, the receipt from the testing facility for the USMLE, completing my MPNs and all that other fun stuff that reminds me why I wanted to be a doctor and not jobs that involve mass quantities of paperwork. Oops, except doctors do. I also got to do the NY health requirement CE course, a newly introduced (after last term was up) cultural sensitivity class the school made up. This is particularly important because if you are SO thick that you can't become culturally sensitive after attending a medical school that has representatives from like 150 countries, that is actually located in another country, I'm sure a last minute online class administered in your USMLE study period will cement in the love-of-fellow-man. Oh, spoiler alert... if your patient has not-Western-medicine beliefs and you like, point at the patient and openly mock his culture, religion, and ways, that may harm patient communications, and could, potentially, get you sucker punched by a holy man. I hope that doesn't constitute giving away answers.