May 30, 2011

Never fear, the crippled doctor is here

So I'm crashing with my mom for a while until the big move... She's a nurse, for context, which keeps my doctor god complex in check while allowing for all the other complexes to seep in.

As you know, I injured myself and have been transitioning from full crutches to one crutch to "f- it; I hate crutches" so I was hobbling around on a camwalker, which was hurting a bit, but not enough to put me back on a crutch. Since I was too cheap to justify buying a cane for myself, mom got me one.

OMG you guys, I'm House. It took four long years, and I didn't get a cane when I sprained my ankle because it's Grenada, but now I have one, and I already feel more curmudgeonly and like I can hit people on the subway in the shins with it. Not because they've done anything... just cuz.

Helps too.

Anyway, I was on my way to dinner in the city when my train refused to leave the station because while the people on public transportation have been awesome to me, the public transportation itself has been almost purposely screwing with me lately.

I thought this unscheduled delay was due to a fairly aggressive panhandler on the train being hunted by the conductor who was on his radio and going up and down the stairs leading off the platform, so I moved to the window to get a better gawking view and saw... horizontal legs. Sigh.

So I said to my mom "Someone's down" and we wandered off to see what we could do. Different homeless guy was seizing so my mom moved him onto his side and I knelt behind him to stabilize. Mom was like "I'm a nurse; she's a doctor" to the conductor and I considered making that wishy washy "sort of" hand motion. An off duty police officer kept people from stepping on us, because they were certainly trying to, while I tried to get a history from the dude who was coming around because during clinicals, I was told (re: yelled at) many times that a good history is the most important part of being a doctor. I overheard the conductor say into the radio "Yeah, we have a doctor as a good samaritan".

Two things. One, I outranked my mother sufficiently to bump her from the billing, despite that she's been a nurse of over 35 years, despite being a greenhorn that's entering a specialty that has less patient contact than a hospital janitor. Two, the whole 'good samaritan' thing that kept me feeling warm and fuzzy back when I could do CPR with impunity is now mildly terrifying since it can have different implications for doctors.

Another thing I learned is that medical conditions are far less terrifying when you've studied them and seen them before. Quick! What do you do when a man near you has a seizure??? Panic! Hold them down! Put something in their mouths! Call an exorcist!

Or roll them on their side and if they're really thrashing, try to keep their head from hitting anything solid. Wait. Hope they breathe shortly. They almost always do. Talk to them as they come out of it. Collect data. Ask about conditions, medications, and previous events. Make sure they're oriented to time place and location. Ask if they hit their head when they fell or if anything hurts. Standard stuff. Mostly it's just waiting around and trying to get bystanders not to step on your patient.

About that last thing... I've been concerned that New York has turned me into more of an asshole than I previously was, which is no small feat. I have, at times, seen someone down but that was surrounded by paramedics that looked like things were under control, and kept right on jogging. I have used my ipod as a defensive weapon since I got it.

However, I have yet to argue with a police officer (he put his badge around his neck) about train schedules while attempting to step over a large half conscious sick guy and two kneeling women. Oh, for and the next person that hassles me for not being more understanding about moms dragging strollers up the stairs, a couple lifted their stroller over this guy to avoid using the other stairwell, while the cop was yelling at them. Family bonding? "This, Jimmy, is how you ignore the homeless. They're not real people, and you must never let them divert you in your quest for killer Thai food. Try not to hit the lady that has the cane on your way over, because she may smack you in the shin with it like that mean man on television."

May 22, 2011


Blah blah blah Rapture.

Yes, I laughed a lot. Yes, I'm going to a Left Behind BBQ tomorrow (it's a place that serves *amazing* Cajun food, so there's no way I'm missing that), and yes, I drank a beer at 6 PM (my last drink ever was going to be Singha; is that sad?). I'm easily amused, and jump on any meme but lolcats with impunity. I should probably insert a picture of Sad Keanu here with Kanye West's "Imma gonna let you finish" over it to make my point.

Graduation is coming up, and I got my dad's ticket forwarded from Christmas to apply to this one because back in December, one of Orbitz's employees in India spent 45 minutes on the phone with me, Delta, and his manager to apply a refund to my ticket even though it was nonrefundable, because he's frigging awesome and he felt bad for me.

Speaking of human compassion, I tend to be fairly skeptical, and I tend towards social awkwardness as a default, plus I deliberately isolate myself in public places by the enthusiastic use of electronic devices. I'm currently living in the supposedly scariest borough (Brooklyn is gradually being gentrified beyond recognition, so it doesn't really earn me any street cred) of one of the cities in the world that's most known for being populated by rude, miserable people. All that being said, I'm learning if that you ever want a "faith in humanity" refill, crutches.

I know I mentioned this before, but I've been rocking these murder stilts for over a week now, and I'm still astounded every day by how out-of-the-way compassionate EVERYONE is. A guy in Long Island flipped his car around across a double yellow line to give me a ride to work in the rain. A woman drove me from the train station on another day. My coworkers fairly regularly get my coffee from the breakroom, which requires not only making it, but throwing in an extra shot of espresso. I have gotten a seat on trains, subways, and buses EVERY single time. Today, I was rocking the one crutch so I could carry a bag from Target, and had people opening doors left and right, even turning around to go back to help me, and coming up the subway steps, had a guy grab my bag and go all the way up with it without ever taking his ipod off (my kinda guy). People smile at me, chat with me, etc. I'm honestly not sure if that last part is because I'm gimpy or because this is the first time I've made eye contact with strangers deliberately since I moved here, but it makes me feel warm and cuddly.

In other news, being a foreign grad gives me extreme paperwork paranoia, though possibly to my favor. One of the worst things about being an IMG is not 'the stigma', and it's not having the same "Where is Grenada?" conversation with *everyone*, it's the degree of red tape you have to cut through to get anything done. Taking the licensing exams? Costs more money AND you have to be approved through the ECFMG with subsequent paperwork. Graduating from school? Still need that ECFMG certificate. Everything needs backup confirmations, our transcripts still have to be mailed directly and verified for everything. Through the years, you have to manage travel documents, student visas, airfares, apartment leases in other states, weird tax forms, residency applications, loan paperwork, etc. None of the stuff that needs to get done is really in the same place, too. And getting all your health stuff? Good luck. Drug screens? Some hospitals have it, some don't, how it's set up can be difficult. You have all your initial stuff at a hospital; you may have different requirements when you go to different hospitals... argh!

So then you get a residency, and you get sent a package that contains a brick of paperwork, and you're thinking that this process is going to be exactly like school. Half of it won't make sense, most of it will have to be self arranged, and a third of the stuff you send out will not make it to its intended destination. Threats will be held over you. I recall madly faxing paperwork from Canterbury because my loans hadn't been processed because of the hyphen in my name, only to arrive back in Grenada to discover they still weren't through and I was borderlining a leave of absence if I couldn't get this stuff straightened out by way of panicked phone calls to New York from the Chancellery.

But... they tell you the timeline. You send in your application for licensure. You send in the benefits package... I keep waiting for the other shoe to drop. I have a set appointment for my physical, titers, and drug screen. I thought I was going to need to scramble to find a BLS class, but they handle that. I keep thinking I've forgotten something and I'm going to show up and they're going to say "Oh, we canceled your residency because we emailed you form L14-A0987 and you never responded, so we assumed you weren't interested anymore." But nope, so far, the coordinator's just emailed me in response to my "DO I NEED _______? OMG" forms with pleasant missives that she's looking forward to meeting me.

It might be time to relax :) How often do you hear that pre-residency?

May 13, 2011

Ends like it began

Naturally, since having a diploma, an ECFMG certificate, my transcripts, my paperwork in (minus my benefits package, which I have to overnight) is not enough to really *end* the process of being a student at SGU, I figured I'd do what I did when I entered medical school... which is... be on crutches.

Shit. For reference:

One of my earlier posts from the island

I would have said, prior to ripping my plantar fascia, that being on crutches in Grenada is one of the biggest pains in the ass on the planet. Now, I will correct that notion and say that being on crutches in NYC is one of the biggest pains in the ass on the planet. Do you have any idea how many stairs there are in this city? It's obscene.

It's giving me a few perspectives though.

1. While crutches do a great deal to alleviate the pain in your actual foot/leg, they make your upper body feel like you've been rock climbing while an obese child rides you piggy back and periodically kicks you in the stomach.

2. Spring in New York feels like summer in the Sudan to your foot when you have a brace on it.

3. In the NY metro systems, crutches trump visibly pregnant ladies trump old people. Seriously, in a place known for the general malignant nature of its populace, I had crackheads leaping out of the way to surrender a seat to me. It doesn't make me any more of a fan of the Bhutan death march that is getting from the R train to the LIRR at Atlantic terminal, but it still gives me the warm fuzzies.

4. If you're wearing anything with a lower cut than "overalls" or "mom jeans", you have to stop, move your crutches to one hand, and haul the pants up and your shirt down every 10 feet.

5. Dude, you can't carry *anything* with these stupid things. Coffee? Gotta hoof it like Tiny Tim with a caffeine addiction. Purse? Gets caught. Groceries? Yeah frigging right.

6. Handicap bathrooms... so THAT'S what those bars are for.

7. I'm a good little newly minted doctor, thus I don't ride the crutches with in my armpits because I don't want to lose the use of my hands. The result? Extreme rib chafing.

So that's my whine.

Meanwhile... I saw a Broadway show (not Spiderman), which was on my NY bucket list, by taking my mom to see Phantom of the Opera. There was quite a bit of drama on obtaining the tickets, because the ticket broker is operated by imbeciles and the theater doesn't really care since they're not really going for the repeat business. But I managed to get them, and so it was actually really cool. I may have the bug for it, though next time I get tickets, I'm going to see if these bad boy crutches earn me a front spot at TKTS so I can forgo the whole online ticket thing. We also ate at Sardi's, because we had a Groupon and that place is expensive. I discovered my ability to recognize celebrities based on their caricatures is even less impressive than my ability to recognize them when I walk by them (I have poor facial recognition).

What else? Yadda yadda rooftop bar. Yadda yadda endless paperwork for starting residency.