But August is the cruelest month.
July was a training month for us, which means we literally were never without a handler, which is comforting, and in those sorts of situations, you always *feel* like you're learning everything. This is especially true when people are letting you do things, so you feel like you're in charge, but you always have them over your shoulders, often helpfully making suggestions.
I did have one fourth year that made me run a couple frozens by myself, which in itself was a little panic inducing, but still, the fact was I knew that he was there, and the very nature of the whole thing made it so that I knew if things went really wrong or if it were too complicate a specimen, he would rescue me.
July is also when I heard a lot of "I'm gonna be here for a while, so why don't you run on home?" which makes you hear the "go home" and not the "I'm gonna be here for a while".
August, we're let loose on our own. Today was my first grossing day, which is seriously intimidating.
I think I explained this elsewhere but pathology schedule is gross (cut stuff), preview (guess stuff) and sign out (be pwned on stuff).
Grossing seems like simply the grossEST as it's the opportunity to smell like unspeakable evil, splash formalin on yourself and such, but doesn't seem like the hardest. The real difficulty comes in interpreting what you see. The problem being, grossing badly brings down the whole house. If you cut poorly, the slides come out poorly, and the most skilled diagnostician on the planet cannot figure out margins that you haven't inked, false margins you have inked, or specimens that are mangled and only consist of blood clot. This failure not only potentially gets you in trouble with your seniors, but more critically, can directly screw up a patient's care. I can potentially apologize to my higher ups all day long, and they can think "Hey, she's a noob", but some patient could potentially wind up minus a diagnosis or with an additional surgery or whatever because I can't cut and paste.
So no pressure. Being faced with an increasing load of specimens and staring at something relatively simple like a skin lesion, I felt a pretty piercing hint of anxiety. For complex specimens, you page an attending or fellow (which I'm trying to get used to, since medical school taught me to NEVER DO THIS, and pathology residency teaches you to ALWAYS DO THIS. It is always easier to have a pro orient a specimen than have a pro un-fuck one). This leads to someone hand holding you, but under mounting pressure, you do things like "dictate while someone is telling you what to dictate and still forget what they said 30 seconds ago because there's a microphone in front of you".
Gods. In the end, I still feel incredibly lucky. This was probably my worst day of residency so far and the most "not fun" one, and it was still punctuated by not once getting yelled at, having three of my colleagues stop by at different after-hours times to offer help, and having two attendings come by after hours, one to do a complex specimen *for me* and the the other to take the load off, which included him staying three hours after leaving time and dictating half my remaining case loads so that I could leave at a semi-reasonable hour.
I have a less intensive residency than most and definitely a less malignant residency than most. I'm not sure how I would manage if either of those features were not present. But it does make me feel good that at the end of the day, my "bad" day consists of learning opportunities and people helping me. Tomorrow, I find out if my grosses were okay, and I'm really hoping that they were.
Night everyone
Aug 3, 2011
Jul 21, 2011
Social Reality Check
So I was wandering around the interweb before bed and discovered this thread, granted an old one: Dating a Medical Student. I focus on what medical school is like and the whole doctor scene, because hey, I'm self centered, but this is the whole "Other" view.
I'm not a student anymore woot, but it wasn't so much just the original post that paused me, but all the comments. It seems like dating us requires the same level of support group as one needs to, say, cope with being in love with a meth addict... who gambles... with babies.
Now, if I'm on youtube or something, I feel confident in the fact that the average commenter makes less sense than a monkey smearing feces on the keyboard, but this whole thing consists largely of well thought ideas and whole trends I see rampantly in myself, and previously defined more as "Weird independent female" and less "medical student stereotype". Are we that insufferable? Are we really that inevitably well defined?
I'm not a student anymore woot, but it wasn't so much just the original post that paused me, but all the comments. It seems like dating us requires the same level of support group as one needs to, say, cope with being in love with a meth addict... who gambles... with babies.
Now, if I'm on youtube or something, I feel confident in the fact that the average commenter makes less sense than a monkey smearing feces on the keyboard, but this whole thing consists largely of well thought ideas and whole trends I see rampantly in myself, and previously defined more as "Weird independent female" and less "medical student stereotype". Are we that insufferable? Are we really that inevitably well defined?
Jul 19, 2011
Medical mysteries in action...
You creep around the corner of the kidney, and there you see it, a throbbing gelatinous evil blob of tissue. You've fought this beast before. You bring your scalpel down and it screams. You grab it with the forceps so it can't wriggle out of reach and stab it again, cramming its protesting pieces into separate cassettes, so it can't reform vampire style.
Sighing, you resheath your blade in the curiously inefficient "safety" device used for them and take a deep breath. "Looks like I just blocked *your* flow", you say smirking, as hot lab ladies flock to your sides.
The next morning... the hearing... you're hungover... those ladies wouldn't entertain themselves after all, and with gams up to where their gams go, well, you don't tell em no. Still, no reason to ruin a good day. You stroll up to the corralled kidney tumor and throw its body under a microscope, give its family a good funeral, give a little lesson to is brothers... but wait... your blurry vision clears... you clean the scope.
That's not your tumor. It's a stranger. You look through the books on em, maybe bluff him a bit. Yeah, tumor. We know about you. We know about your brother. You're rare huh? Must be sitting here thinking you're pretty badass. So rare that the dregs down at county won't know what to do with you eh? I tell ya what, punk? I put condor eggs in my gin fizzes. That give you an idea what I think of rare? I spat in his face. You make me sick. And you're going down. I stormed out of the lab, before he could see he was getting to me.
As I brushed through the doors, the secretaries hastily fought for my arms. "Don't go!", they were flapping. The dames could wait. I had a book to read.
Sighing, you resheath your blade in the curiously inefficient "safety" device used for them and take a deep breath. "Looks like I just blocked *your* flow", you say smirking, as hot lab ladies flock to your sides.
The next morning... the hearing... you're hungover... those ladies wouldn't entertain themselves after all, and with gams up to where their gams go, well, you don't tell em no. Still, no reason to ruin a good day. You stroll up to the corralled kidney tumor and throw its body under a microscope, give its family a good funeral, give a little lesson to is brothers... but wait... your blurry vision clears... you clean the scope.
That's not your tumor. It's a stranger. You look through the books on em, maybe bluff him a bit. Yeah, tumor. We know about you. We know about your brother. You're rare huh? Must be sitting here thinking you're pretty badass. So rare that the dregs down at county won't know what to do with you eh? I tell ya what, punk? I put condor eggs in my gin fizzes. That give you an idea what I think of rare? I spat in his face. You make me sick. And you're going down. I stormed out of the lab, before he could see he was getting to me.
As I brushed through the doors, the secretaries hastily fought for my arms. "Don't go!", they were flapping. The dames could wait. I had a book to read.
Jul 18, 2011
Skills to learn...
For the past four years, I have not regular access to what people would conventionally call a "kitchen". Not that I was an exceptional cook before that. In Grenada, after a semester on campus with a stove top, I got my wonderful little apartment that featured a propane stove that my former Peace Corps working friend had to show me how to use, the oven was too small for almost anything, and two of the burners worked. The settings on those burners was "large open flame" and "No large open flame". Could make the hell out of some old fashioned popcorn though.
Moving onto Brooklyn, I graduated to a surprisingly similar gas/two burner functional half kitchen, which my roommate used enviably, but I mainly lived off of takeout, both as a function of kitchen size and laziness.
Now I live in a large three bedroom house that has a ginormous kitchen with an electric (gasp) stove. Roommate 1 cooks like a mofo. Like "Oh, these peaches are about to go bad and bazam restaurant quality pastry." I also have a yard now so the first thing I did upon having access to a vehicle was buy a grill because if there's one type of cooking I can do it's "Char things over fire" (thanks, Grenada!).
So I'm finally trying to cook quality food. I am pretty pleased with my blackberry cobbler and tonight, upon being too lazy to stop at the Piggly Wiggly (yes, really) on my way home from work, concocted a stir fry out of rice noodles and pale ale (no sherry) and it (drumroll) didn't suck!
I consider this further evidence of my whole "medical school delays maturity" hypothesis. By next year, I'll be buying car insurance and all matter of other things that most people master around age 25.
Moving onto Brooklyn, I graduated to a surprisingly similar gas/two burner functional half kitchen, which my roommate used enviably, but I mainly lived off of takeout, both as a function of kitchen size and laziness.
Now I live in a large three bedroom house that has a ginormous kitchen with an electric (gasp) stove. Roommate 1 cooks like a mofo. Like "Oh, these peaches are about to go bad and bazam restaurant quality pastry." I also have a yard now so the first thing I did upon having access to a vehicle was buy a grill because if there's one type of cooking I can do it's "Char things over fire" (thanks, Grenada!).
So I'm finally trying to cook quality food. I am pretty pleased with my blackberry cobbler and tonight, upon being too lazy to stop at the Piggly Wiggly (yes, really) on my way home from work, concocted a stir fry out of rice noodles and pale ale (no sherry) and it (drumroll) didn't suck!
I consider this further evidence of my whole "medical school delays maturity" hypothesis. By next year, I'll be buying car insurance and all matter of other things that most people master around age 25.
Jul 16, 2011
Free pizza remains awesome
Yeah, I pretty much talk about food and booze. If you're looking for decent medical advice, this may be the time to StumbleUpon elsewhere.
The patient-information-free update... soooo difficult.
If this entire process has made me anything, it's paranoid. Not mature, by any stretch of the imagination, but I start to think "You know where I went to school; you know where I'm doing residency; if I tell you the cases I'm grossing, you'll know who my patient is, and you'll HIPAA until I cry uncle."
So, pathology seems to be a two way street. If you guys are complete science dorks with a love for a full night's sleep, this is seriously the way to go. I spent time today trying to think of a residency that generally has better hours, and I couldn't think of one. On the minus side, it's very hard to tell anyone what you do. You will either bore them or horrify them. Possibly a little bit of both. In completely unrelated news, the roommate that now knows how I spent the day thinks I'm hardcore metal, but I believe may be a little wary of me. I went to a bar for my Friday night fuel, and generally introduced myself to the young and innocent by saying "I work at the hospital". One, because they're all youngsters and I seem to get carded enough to pass for one of them, and two, because "I'm a doctor" both carries with it snob weight *and* requires a little explanation of what I do... which may involve either "I sat at a microscope for ten hours" (boring to the public) or "I (censored) a baby and now you're horrified, and I have to be all "Oh, but... it wasn't cool. Except it was. Sigh. Who wants a free round?"
For those of you that can't connect the dots (hopefully most of you), I'm in a University program now, and it rules. Every day, we get "zebra cases". It's not that we have a bunch of the same rare stuff, but whether I'm grossing (cutting up surgical specimens), previewing (pretending I know what these things are) or signing out (having the attending demonstrate that I don't know what these things are), it's always some bizarre things, because pathologists just don't do that much normal.
Today I got to really have control of dictation for the first time. It is the most intimidating thing. English is genuinely my first language. I always got A's in the subject matter; I worked as a frigging technical writer, and public speaking does not give me hives. When you stick a specimen in front of me and a microphone in my face, it's magical. I literally forget how to name colors. I will be looking at a pink strip of skin and thinking it's a pink strip of skin, and my dictation will read "Uhhh... (rustling) Uhhh... Specimen A is... uh... submitted in formalin... and... uh... is... a... color... I think it's pink... that is.... 5... by 2 by zero point 3.... centimeters... wait.... zero point four.... centimeters... in... uhhh.... aggregate... and consists of... a... uhhh... puce fragment of... sorry... addendum... my name's Ishie... I work for ya'all."
It's like pulling teeth.
So that's a life lesson. All the times where you thought acting or reading or any other performance based field was a stupid overpaid profession, just to let you know, you probably suck at it. A lot. Like, you should feel bad, you probably suck so much.
Along with dictating, I'm grossing. I'm learning how to cut specimens so that they show me what I'm interested in. Tumor margins, type of tissue, how the normal tissue looks, whether it's near the blood vessels, that's all based on my decisions. The negative side is that it's stressful. I don't want to sample a curiously benign scrap of tissue only to have the rest of it be malignant horror cancer. The positive side is that I feel like by the end of the year, I'll be a kickass sushi chef, and won't have to pay 2 bucks a slice for scallops.
Reading/signing out... it is difficult to describe how tired this makes you. My friends are working from 6 AM to 10 PM six days a week, and I am decidedly not. But after about hour 6 on the scope, you start to go cross eyed. You feel dumber than usual. You require the department's free pizza for brain carbs. Yeah.
I can't complain too much though. I was talking about this on the phone with my mom today. I am doing exactly what I wanted to do since I was a tween. It's fucking cool; I can't lie. I cut up a case today that I was uncertain about because it was a complete mess, and on section, it was absolute textbook of a condition that fascinates me. I hope I never stop realizing how lucky I am to be where I am, in a program that's awesome and not malignant, and just be at this whole stage of my life. I can see how people would start in this field and completely hate it; I do. If you want to "help people", as we all wrote in our personal statements, and then are counting the mitoses in a high power field, you may not feel very doctory, particularly when you're trying to pick up a history major that's 9 years younger than you, but whatever you do in medical school, if you love it? Freaking do it. Your residency will be so much better by virtue of it.
The patient-information-free update... soooo difficult.
If this entire process has made me anything, it's paranoid. Not mature, by any stretch of the imagination, but I start to think "You know where I went to school; you know where I'm doing residency; if I tell you the cases I'm grossing, you'll know who my patient is, and you'll HIPAA until I cry uncle."
So, pathology seems to be a two way street. If you guys are complete science dorks with a love for a full night's sleep, this is seriously the way to go. I spent time today trying to think of a residency that generally has better hours, and I couldn't think of one. On the minus side, it's very hard to tell anyone what you do. You will either bore them or horrify them. Possibly a little bit of both. In completely unrelated news, the roommate that now knows how I spent the day thinks I'm hardcore metal, but I believe may be a little wary of me. I went to a bar for my Friday night fuel, and generally introduced myself to the young and innocent by saying "I work at the hospital". One, because they're all youngsters and I seem to get carded enough to pass for one of them, and two, because "I'm a doctor" both carries with it snob weight *and* requires a little explanation of what I do... which may involve either "I sat at a microscope for ten hours" (boring to the public) or "I (censored) a baby and now you're horrified, and I have to be all "Oh, but... it wasn't cool. Except it was. Sigh. Who wants a free round?"
For those of you that can't connect the dots (hopefully most of you), I'm in a University program now, and it rules. Every day, we get "zebra cases". It's not that we have a bunch of the same rare stuff, but whether I'm grossing (cutting up surgical specimens), previewing (pretending I know what these things are) or signing out (having the attending demonstrate that I don't know what these things are), it's always some bizarre things, because pathologists just don't do that much normal.
Today I got to really have control of dictation for the first time. It is the most intimidating thing. English is genuinely my first language. I always got A's in the subject matter; I worked as a frigging technical writer, and public speaking does not give me hives. When you stick a specimen in front of me and a microphone in my face, it's magical. I literally forget how to name colors. I will be looking at a pink strip of skin and thinking it's a pink strip of skin, and my dictation will read "Uhhh... (rustling) Uhhh... Specimen A is... uh... submitted in formalin... and... uh... is... a... color... I think it's pink... that is.... 5... by 2 by zero point 3.... centimeters... wait.... zero point four.... centimeters... in... uhhh.... aggregate... and consists of... a... uhhh... puce fragment of... sorry... addendum... my name's Ishie... I work for ya'all."
It's like pulling teeth.
So that's a life lesson. All the times where you thought acting or reading or any other performance based field was a stupid overpaid profession, just to let you know, you probably suck at it. A lot. Like, you should feel bad, you probably suck so much.
Along with dictating, I'm grossing. I'm learning how to cut specimens so that they show me what I'm interested in. Tumor margins, type of tissue, how the normal tissue looks, whether it's near the blood vessels, that's all based on my decisions. The negative side is that it's stressful. I don't want to sample a curiously benign scrap of tissue only to have the rest of it be malignant horror cancer. The positive side is that I feel like by the end of the year, I'll be a kickass sushi chef, and won't have to pay 2 bucks a slice for scallops.
Reading/signing out... it is difficult to describe how tired this makes you. My friends are working from 6 AM to 10 PM six days a week, and I am decidedly not. But after about hour 6 on the scope, you start to go cross eyed. You feel dumber than usual. You require the department's free pizza for brain carbs. Yeah.
I can't complain too much though. I was talking about this on the phone with my mom today. I am doing exactly what I wanted to do since I was a tween. It's fucking cool; I can't lie. I cut up a case today that I was uncertain about because it was a complete mess, and on section, it was absolute textbook of a condition that fascinates me. I hope I never stop realizing how lucky I am to be where I am, in a program that's awesome and not malignant, and just be at this whole stage of my life. I can see how people would start in this field and completely hate it; I do. If you want to "help people", as we all wrote in our personal statements, and then are counting the mitoses in a high power field, you may not feel very doctory, particularly when you're trying to pick up a history major that's 9 years younger than you, but whatever you do in medical school, if you love it? Freaking do it. Your residency will be so much better by virtue of it.
Jul 3, 2011
White coats obtained, time for a three day weekend
So I dunno how much of this blog is like "Shut up with your whining already" and how much is like "Shut up with you're 'my life rules' crap", so I'm just going to go with the latter because on the odd periods that I give in to complete egocentricity and reread previous entries, the whiny ones are where I want to slap myself the most. Plus, I don't feel whiny right now, because dude... I'm not sure when the other "this residency can't be this good" shoe is going drop, but it hasn't yet, and they're long past the point of needing to lie to us.
It's various stuff coming together too. I've had some nastiness in my life where it seemed like the forces of nature converged to make everything suck. Oh, you're out of money? Well, this seems like a good time for your car to break down. While you're walking to a phone booth (they had those back in my day, you damn kids)? Good time for someone to yell stuff out a window at you and then it starts raining.
This is like the reverse of that. My colleagues are awesome; I like all of them. Unless you count the discriminating finesse of the match (aka, the blind dartboard of chance), the hospital has nothing to do with that. The hospital is gorgeous. The other residents are nice. The attendings are friendly. They have parties, like, a lot. The hours aren't horrible. My insta roommates on Craigslist turned out to be great in a house I like, a situation which I really threw myself into without much of a safety net, and easily could have ended in a spectrum of awful from "meth lab" to "human skin suit". Stephen Colbert randomly shows up the day I start residency.
It's not *completely* random, granted. Homeboy is from here, and the school has a Colbert library for a reason, but I tried for two years in New York to cross him off my NYC bucket list along with the Daily Show to no avail, and boom, he shows in Charleston on July 1st.
Scored tickets to that, because, really? and then as I was sitting in the best altitude sickness seats that thirty dollars could buy, the interviewer came on stage and said "Stephen would like to welcome everyone to the lower seats" or something like that, so I ended up 5-10 rows from the stage. And he talked for two hours. And did a song and dance from Strangers with Candy. The whole time I had a complete doofus grin on my face.
Today was the full GME party (as opposed to the outgoing residents' party, the welcome to our department party, and the late fourth of July party next week) and it was held at a marina. After discovering the open bar and caterers walking around, I walked to the end of the pier to a pod of dolphins that was just chilling.
I keep expecting to wake up in some dystopian nightmare strapped to a wall explaining to a man in a metal clown mask that I was in a beautiful world where I could tie Stephen Colbert and dolphins together logically without performing questionable genetics experiments.
Awesome ones though. Note to self: satirist/dolphin hybrids. Good idea or great idea?
Farmers Market and beach, also quite nice.
But enough of that. Residency.
Like in your fourth year of medical school, once you've decided on a specialty (or have matched into a specialty), you become intolerant of anyone distracting you with stuff that's unrelated to it. This is a problem during orientation because if you're not in primary care, you are going to spend a lot of time trying to surreptitiously check facebook while being taught the software for assigning prescriptions to the outpatient clinic, a skill I will need precisely never. Similarly, orientations involve a lot of stuff that is probably important in some broader scale, but the people at whom they are directed are not going to take them seriously either, so everyone just ends up pretending to pay attention. Examples? Drug abuse and sexual harassment. Is it important not to steal drugs from the anesthesia cart while asking your patient what she's got under her gown? Certainly. Is a talk going to deter someone? Probably not.
Our sexual harassment guy was pretty cool though. Not only did he focus on the bizarre problem of hair touching (WT-holy-F), but he referenced Sexual Harassment Panda. On the first thing, despite the answer of "When is it appropriate to touch a colleague's hair?" being "NEVER", I feel like my answer "When it's dangling into a patient" should have gotten at least half credit.
But let this all be a lesson to you people out there. Do not pet the hair of people you work with. Addendum, you're freaks.
July 1st was the official start date, so we got oriented to our actual departments so that was extremely exciting. We got our laptops (my Grenada laptop made it to the end! Against all frigging odds!!! Infected by viruses with *no* battery left and unable to close, it lived long enough to see me to a departmental laptop. Rest, sweet, computer. You have earned it.). We got books and a microscope. We have an interns' pen to ourselves that has about eight cubicles that are large and have a ton of desk space, and the common area has a fridge, microwave, two coffee pots, and a water cooler just for us. It is fantastic. I did sign out with an attending and resident in the morning, which reinforced how much I need to study (Mystery tissue. Fallopian tube. Mystery tissue. Mystery tissue. Thyroid. Mystery tissue. Fallopian tube. That can't be normal. And no, dorks, not struma ovarii). Different cases.).
Afternoon, I had frozen sections but the day before a holiday weekend is not generally a heavily hit surgery day so spent part of my time learning how to click around Windows 7 at my desk, and the rest of the time haunting the gross lab to see how things are done.
Here's a thing I realized about myself that I'm trying to fix. I feel like book-smart wise, I can handle it. If I don't know how tissues look, I can study them effectively. If I don't know how to gross a spleen, I'll ask someone and learn and do it well. I can learn diseases and be good at all that.
I am absolutely *useless* at the general functional stuff. I was that medical student that wandered wide-eyed around the hospital clutching a piece of paper that had been passed off to be by someone because I had no idea where to put it, who to give it to, or who to ask. I get lost in hallways. I have no idea what the chain of command is. These are things that take me from seeming smart to seeming completely infantile, and usually, it leads to someone yanking whatever I'm holding away after I've had it for two hours, going "Oh for goodness sake!" and then putting it in a file basket that was five feet from where I started and has a sign on it with red font that says "ISHIE, PUT PAPER HERE" and a clip art image of me slamming my head against a wall.
So my New Year's resolution, since for residents, the New Year is July 1st, is to observe the day-to-day function stuff carefully and deliberately early on, so that I may be less of an idiot later. We'll see how it goes.
In other news, I continue to hate confrontation passionately, because I like fulfilling the stereotypes of my specialty. I live in a for-real house now that features a side yard that has a gate to it from the sidewalk. Today, Roommate B and I heard a lot of rummaging we mistook for the mailman that turned out to be a guy that had helpfully let himself through the gate into our side yard and was scavenging the trash because someone in our place just moved out, so he was collecting cds and perfume and such.
After several minutes of careful deliberation on how to handle someone trespassing and scattering garbage, and discounting such barbarous behavior as simply yelling "Hey jackass; get off our property" out the window, we decided that the most polite and ladylike way to handle the entire unpleasantness was to let Roommate C's Rottweiler out the back door.
In our defense, there was still another fence between the guy and the dog.
So let that be a lesson to you. Ms. Manners says, "Release the hounds."
It's various stuff coming together too. I've had some nastiness in my life where it seemed like the forces of nature converged to make everything suck. Oh, you're out of money? Well, this seems like a good time for your car to break down. While you're walking to a phone booth (they had those back in my day, you damn kids)? Good time for someone to yell stuff out a window at you and then it starts raining.
This is like the reverse of that. My colleagues are awesome; I like all of them. Unless you count the discriminating finesse of the match (aka, the blind dartboard of chance), the hospital has nothing to do with that. The hospital is gorgeous. The other residents are nice. The attendings are friendly. They have parties, like, a lot. The hours aren't horrible. My insta roommates on Craigslist turned out to be great in a house I like, a situation which I really threw myself into without much of a safety net, and easily could have ended in a spectrum of awful from "meth lab" to "human skin suit". Stephen Colbert randomly shows up the day I start residency.
It's not *completely* random, granted. Homeboy is from here, and the school has a Colbert library for a reason, but I tried for two years in New York to cross him off my NYC bucket list along with the Daily Show to no avail, and boom, he shows in Charleston on July 1st.
Scored tickets to that, because, really? and then as I was sitting in the best altitude sickness seats that thirty dollars could buy, the interviewer came on stage and said "Stephen would like to welcome everyone to the lower seats" or something like that, so I ended up 5-10 rows from the stage. And he talked for two hours. And did a song and dance from Strangers with Candy. The whole time I had a complete doofus grin on my face.
Today was the full GME party (as opposed to the outgoing residents' party, the welcome to our department party, and the late fourth of July party next week) and it was held at a marina. After discovering the open bar and caterers walking around, I walked to the end of the pier to a pod of dolphins that was just chilling.
I keep expecting to wake up in some dystopian nightmare strapped to a wall explaining to a man in a metal clown mask that I was in a beautiful world where I could tie Stephen Colbert and dolphins together logically without performing questionable genetics experiments.
Awesome ones though. Note to self: satirist/dolphin hybrids. Good idea or great idea?
Farmers Market and beach, also quite nice.
But enough of that. Residency.
Like in your fourth year of medical school, once you've decided on a specialty (or have matched into a specialty), you become intolerant of anyone distracting you with stuff that's unrelated to it. This is a problem during orientation because if you're not in primary care, you are going to spend a lot of time trying to surreptitiously check facebook while being taught the software for assigning prescriptions to the outpatient clinic, a skill I will need precisely never. Similarly, orientations involve a lot of stuff that is probably important in some broader scale, but the people at whom they are directed are not going to take them seriously either, so everyone just ends up pretending to pay attention. Examples? Drug abuse and sexual harassment. Is it important not to steal drugs from the anesthesia cart while asking your patient what she's got under her gown? Certainly. Is a talk going to deter someone? Probably not.
Our sexual harassment guy was pretty cool though. Not only did he focus on the bizarre problem of hair touching (WT-holy-F), but he referenced Sexual Harassment Panda. On the first thing, despite the answer of "When is it appropriate to touch a colleague's hair?" being "NEVER", I feel like my answer "When it's dangling into a patient" should have gotten at least half credit.
But let this all be a lesson to you people out there. Do not pet the hair of people you work with. Addendum, you're freaks.
July 1st was the official start date, so we got oriented to our actual departments so that was extremely exciting. We got our laptops (my Grenada laptop made it to the end! Against all frigging odds!!! Infected by viruses with *no* battery left and unable to close, it lived long enough to see me to a departmental laptop. Rest, sweet, computer. You have earned it.). We got books and a microscope. We have an interns' pen to ourselves that has about eight cubicles that are large and have a ton of desk space, and the common area has a fridge, microwave, two coffee pots, and a water cooler just for us. It is fantastic. I did sign out with an attending and resident in the morning, which reinforced how much I need to study (Mystery tissue. Fallopian tube. Mystery tissue. Mystery tissue. Thyroid. Mystery tissue. Fallopian tube. That can't be normal. And no, dorks, not struma ovarii). Different cases.).
Afternoon, I had frozen sections but the day before a holiday weekend is not generally a heavily hit surgery day so spent part of my time learning how to click around Windows 7 at my desk, and the rest of the time haunting the gross lab to see how things are done.
Here's a thing I realized about myself that I'm trying to fix. I feel like book-smart wise, I can handle it. If I don't know how tissues look, I can study them effectively. If I don't know how to gross a spleen, I'll ask someone and learn and do it well. I can learn diseases and be good at all that.
I am absolutely *useless* at the general functional stuff. I was that medical student that wandered wide-eyed around the hospital clutching a piece of paper that had been passed off to be by someone because I had no idea where to put it, who to give it to, or who to ask. I get lost in hallways. I have no idea what the chain of command is. These are things that take me from seeming smart to seeming completely infantile, and usually, it leads to someone yanking whatever I'm holding away after I've had it for two hours, going "Oh for goodness sake!" and then putting it in a file basket that was five feet from where I started and has a sign on it with red font that says "ISHIE, PUT PAPER HERE" and a clip art image of me slamming my head against a wall.
So my New Year's resolution, since for residents, the New Year is July 1st, is to observe the day-to-day function stuff carefully and deliberately early on, so that I may be less of an idiot later. We'll see how it goes.
In other news, I continue to hate confrontation passionately, because I like fulfilling the stereotypes of my specialty. I live in a for-real house now that features a side yard that has a gate to it from the sidewalk. Today, Roommate B and I heard a lot of rummaging we mistook for the mailman that turned out to be a guy that had helpfully let himself through the gate into our side yard and was scavenging the trash because someone in our place just moved out, so he was collecting cds and perfume and such.
After several minutes of careful deliberation on how to handle someone trespassing and scattering garbage, and discounting such barbarous behavior as simply yelling "Hey jackass; get off our property" out the window, we decided that the most polite and ladylike way to handle the entire unpleasantness was to let Roommate C's Rottweiler out the back door.
In our defense, there was still another fence between the guy and the dog.
So let that be a lesson to you. Ms. Manners says, "Release the hounds."
Jun 27, 2011
First day of doing stuff
Albeit, not a lot of stuff.
Computer training today, which was about 4 hours of learning how to use a lot of charting techniques I'm probably not really going to need, but it wasn't bad. Entering scrips and having to sign them "MD" in the system adds a level of importance that probably isn't warranted. Had a fabulicious dinner out on Johns Island with some of my co-interns. My colleagues are taking turns on the "provide transportation for Ishie" charity, of which I am the sole beneficiary. I swear, I will eventually get a car.
Next up, pager training on Wednesday. The for real stuff starts on Friday, but then we get the fourth off, so I'm kind of feeling like a bum, but in a good way.
In other news, Charleston has a crapton of mosquitoes. Like more than Grenada. It's amazing. I've counted thirty bites on my legs *tonight*. Time to put that bottle of DEET back by the door.
Computer training today, which was about 4 hours of learning how to use a lot of charting techniques I'm probably not really going to need, but it wasn't bad. Entering scrips and having to sign them "MD" in the system adds a level of importance that probably isn't warranted. Had a fabulicious dinner out on Johns Island with some of my co-interns. My colleagues are taking turns on the "provide transportation for Ishie" charity, of which I am the sole beneficiary. I swear, I will eventually get a car.
Next up, pager training on Wednesday. The for real stuff starts on Friday, but then we get the fourth off, so I'm kind of feeling like a bum, but in a good way.
In other news, Charleston has a crapton of mosquitoes. Like more than Grenada. It's amazing. I've counted thirty bites on my legs *tonight*. Time to put that bottle of DEET back by the door.
Jun 25, 2011
Requisite Grad Shots
How could I forget?
Today I found an amazing farmers market at Marion Square, thus continuing my increasing love of Charleston. Said market included a roti stand (!!!!?????), banh mi, and beignets. So much for losing weight here. Though the bike helps.
Today I found an amazing farmers market at Marion Square, thus continuing my increasing love of Charleston. Said market included a roti stand (!!!!?????), banh mi, and beignets. So much for losing weight here. Though the bike helps.
So everyone's just nice here?
Is that the way it works?
I lived in Charlotte, NC when I was in high school and aside from making some amazing friends, mark it down as one of the absolute worst periods of my life. The concept of "nice" when I lived there seemed less to do with nice and more to do with "being completely and often hostilely in my business for no particular reason". I recall specifically an incident where I was wearing the standard issue Nine Inch Nails shirt that EVERYONE in my age bracket owned and a woman walked up to me with "You know that band worships the devil".
So when people say a region is "nice", I generally snort derisively. Which probably isn't nice.
People here are NICE. Like not kidding around nice. And it leads to my getting way more things done in a day than I thought possible. If I don't have this paper or that paper, it's "Oh, well, let me see what I can do... well, we can do everything else today and you can just bring that in on Monday", "Oh, that's fine, your driver's license will be just fine. California? How exciting!" Bam, conversation, bam out. Waitresses, Rite Aid techs, employee health.
So today I managed to get my third, count em, THIRD TB test in as many months, pop onto my bike, take out money from one of my accounts (without a bank card), put money into the other account, get my rent check out of it, pick up a back rack for my brand new bike, and fill a prescription. In about two hours. I don't even know what to do with the extra time. And the feeling of well being. I did spend some of it attempting to put the rack on my bike, which was way harder than it looked, so that drained my goodwill, but then my roommate refilled it, only instead of goodwill, she used moussaka, which I think is an acceptable substitution.
I have another resident mixer party tomorrow. I feel more like I'm courting than working, but I'm certainly not complaining.
I'm hoping for a beach trip this weekend.
I lived in Charlotte, NC when I was in high school and aside from making some amazing friends, mark it down as one of the absolute worst periods of my life. The concept of "nice" when I lived there seemed less to do with nice and more to do with "being completely and often hostilely in my business for no particular reason". I recall specifically an incident where I was wearing the standard issue Nine Inch Nails shirt that EVERYONE in my age bracket owned and a woman walked up to me with "You know that band worships the devil".
So when people say a region is "nice", I generally snort derisively. Which probably isn't nice.
People here are NICE. Like not kidding around nice. And it leads to my getting way more things done in a day than I thought possible. If I don't have this paper or that paper, it's "Oh, well, let me see what I can do... well, we can do everything else today and you can just bring that in on Monday", "Oh, that's fine, your driver's license will be just fine. California? How exciting!" Bam, conversation, bam out. Waitresses, Rite Aid techs, employee health.
So today I managed to get my third, count em, THIRD TB test in as many months, pop onto my bike, take out money from one of my accounts (without a bank card), put money into the other account, get my rent check out of it, pick up a back rack for my brand new bike, and fill a prescription. In about two hours. I don't even know what to do with the extra time. And the feeling of well being. I did spend some of it attempting to put the rack on my bike, which was way harder than it looked, so that drained my goodwill, but then my roommate refilled it, only instead of goodwill, she used moussaka, which I think is an acceptable substitution.
I have another resident mixer party tomorrow. I feel more like I'm courting than working, but I'm certainly not complaining.
I'm hoping for a beach trip this weekend.
Jun 20, 2011
Home sweet home in the lowcountry
Sorry for the lack of updates; I've been busier than I've perhaps ever been and having to make a number of spot decisions that have all ended up working out better than anyone could reasonably expect.
Graduation. Awesome. Really had a good time, and saw so many people, some of whom I hadn't seen since Grenada, and it was fantastic. My dad flew up from North Carolina, I took him to see Mary Poppins (on Broooooooaaaaaaaadway), and I got to parade around in my cap and gown (which we actually got to keep this year) plus a hood. They kept the speeches fairly brief and to the point. I'm sure this is horrible sounding to Ivy Leaguers, but after enduring hours of drone in UCD's gymnasium, a succinct presentation that felt like it was *to* us rather than *at* us at Lincoln Center was greatly appreciated. I did get hooded upside down, but I don't think most people would be able to tell. Most importantly, I WALKED WITHOUT A CANE OR A LIMP. WOOOOOOOOOOOOOOO. Weirdly, despite nearly everyone at graduation having both a job and a diploma in hand already, no one took the opportunity to do anything weird.
Incidentally, they played Grenada's national anthem. To the surprise of most, it was not Temperature by Sean Paul.
So the pomp! The circumstance! The OMG I need to move to SC this week and either find a place to live near my hospital and buy a bike or find any place and buy a car!
That bit was a little nerve wracking. My initial living plans fell through so then I thought "I don't have anything to do until a physical/drug test on the 22nd, and then some social stuff, and then orientation the 27th, so I'll find a place when I get there since I have plenty of time." Which is true, but when you're in a moving van driving to a Motel 6 and honestly don't have a real address to give them, it's freaky.
I'd been surfing Craigslist, and found a few leads; contacted one agency that specializes in matching people with roommates, was wandering around roommates.com, and so forth, but then found a place on Craigslist that's biking distance from the hospital, costs half of what my rent was in Brooklyn, and comes complete with one of my new roommates' huge friendly Star Wars-named dog. And available this weekend, which is a plus when you're returning the van on Monday. And y'all... (I can say y'all now that I have an address in the South), this place, which is a for-real house, which I have not lived in since I was 12, has a washer/dryer (the holy grail), a backyard with a fire pit, a balcony, a walk in closet (!!!!), a giant pantry, and a giant kitchen. No words. If these two can be half as cool as my last roommate, I'll be happy, since I got all emotional and weepy when he left.
Dropped by to meet people, confirmed no one was a serial killer, signed the lease, made out the check, rented a storeroom for some of my mom's stuff, hauled that around (Charleston was about 96 degrees today; there were a couple moments where I honestly thought I was going to die), bought a bike, tossed it in the back of the much emptier moving van, went back to the house, dragged everything upstairs while nearly getting killed by my futon (no more bunk bed!) and drove back to the motel.
Whew. It's... done. I have an address in Charleston, a job starting up, I'm a doctor and it all happened. And this particular move even happened without a whole lot of drama or stress, which is completely unheard of in a move. I was much more frazzled and emotional moving from Park Slope to Sunset Park for six weeks because our lease was up.
I have a bicycle! I haven't had a bicycle in four years. I feel so environmentally conscious. Or more realistically, broke, and I don't want to deal with car payments and insurance for a while, though for graduation, my mom gave me enough money for a sizeable down payment. Thanks mom!
So now, the only thing that stands between me and employment is my ability to pee in a cup on demand. Better start drinking!!!!
Graduation. Awesome. Really had a good time, and saw so many people, some of whom I hadn't seen since Grenada, and it was fantastic. My dad flew up from North Carolina, I took him to see Mary Poppins (on Broooooooaaaaaaaadway), and I got to parade around in my cap and gown (which we actually got to keep this year) plus a hood. They kept the speeches fairly brief and to the point. I'm sure this is horrible sounding to Ivy Leaguers, but after enduring hours of drone in UCD's gymnasium, a succinct presentation that felt like it was *to* us rather than *at* us at Lincoln Center was greatly appreciated. I did get hooded upside down, but I don't think most people would be able to tell. Most importantly, I WALKED WITHOUT A CANE OR A LIMP. WOOOOOOOOOOOOOOO. Weirdly, despite nearly everyone at graduation having both a job and a diploma in hand already, no one took the opportunity to do anything weird.
Incidentally, they played Grenada's national anthem. To the surprise of most, it was not Temperature by Sean Paul.
So the pomp! The circumstance! The OMG I need to move to SC this week and either find a place to live near my hospital and buy a bike or find any place and buy a car!
That bit was a little nerve wracking. My initial living plans fell through so then I thought "I don't have anything to do until a physical/drug test on the 22nd, and then some social stuff, and then orientation the 27th, so I'll find a place when I get there since I have plenty of time." Which is true, but when you're in a moving van driving to a Motel 6 and honestly don't have a real address to give them, it's freaky.
I'd been surfing Craigslist, and found a few leads; contacted one agency that specializes in matching people with roommates, was wandering around roommates.com, and so forth, but then found a place on Craigslist that's biking distance from the hospital, costs half of what my rent was in Brooklyn, and comes complete with one of my new roommates' huge friendly Star Wars-named dog. And available this weekend, which is a plus when you're returning the van on Monday. And y'all... (I can say y'all now that I have an address in the South), this place, which is a for-real house, which I have not lived in since I was 12, has a washer/dryer (the holy grail), a backyard with a fire pit, a balcony, a walk in closet (!!!!), a giant pantry, and a giant kitchen. No words. If these two can be half as cool as my last roommate, I'll be happy, since I got all emotional and weepy when he left.
Dropped by to meet people, confirmed no one was a serial killer, signed the lease, made out the check, rented a storeroom for some of my mom's stuff, hauled that around (Charleston was about 96 degrees today; there were a couple moments where I honestly thought I was going to die), bought a bike, tossed it in the back of the much emptier moving van, went back to the house, dragged everything upstairs while nearly getting killed by my futon (no more bunk bed!) and drove back to the motel.
Whew. It's... done. I have an address in Charleston, a job starting up, I'm a doctor and it all happened. And this particular move even happened without a whole lot of drama or stress, which is completely unheard of in a move. I was much more frazzled and emotional moving from Park Slope to Sunset Park for six weeks because our lease was up.
I have a bicycle! I haven't had a bicycle in four years. I feel so environmentally conscious. Or more realistically, broke, and I don't want to deal with car payments and insurance for a while, though for graduation, my mom gave me enough money for a sizeable down payment. Thanks mom!
So now, the only thing that stands between me and employment is my ability to pee in a cup on demand. Better start drinking!!!!
Jun 11, 2011
Lincoln Center's met its match
Grad ceremony today! I get loads of ridiculous looking bling and the hunter green cape/trim thing plus a funny hat and everyone's all "She's a doctor" and I'm all "that's right".
Something like that. Gotta be better than Davis graduation in the rec center with minimal air conditioning and a tortilla fight. I think I get to keep my robes too, so I'm thinking of just wearing them for the foreseeable future, except for a South Carolina summer, it'll probably be hot.
In other "is she a real doctor yet?" news, I got my South Carolina limited license approved today! Wheeeeeeeeeee!!!!!!!!!
Something like that. Gotta be better than Davis graduation in the rec center with minimal air conditioning and a tortilla fight. I think I get to keep my robes too, so I'm thinking of just wearing them for the foreseeable future, except for a South Carolina summer, it'll probably be hot.
In other "is she a real doctor yet?" news, I got my South Carolina limited license approved today! Wheeeeeeeeeee!!!!!!!!!
Jun 8, 2011
Another milestone? So soon?
I think of these events as unique moments that resonate with me specifically and have a simple and precise meaning that I have never experienced before and that others couldn't possibly understand. Perhaps, because I believe that I'm still in high school. Fortunately, there are previous blog entries to remind me (yes, I'm one of those people that occasionally reads her own blog) that I am not unique, this is not unique, and I am going through the exact same cycle of emotions that I do with the onset of any new type of change, and the gradual sinking gut-sick is the exact same level of intestinal ambivalence that it was when I experienced it for my biochem retake. Or when my parents first caught me in a lie.
New York, how I've loved you. I love your people; I love your constant circus, I love the everloving hell out of your food and nightlife; I love my time here. During my stay, I got to live in a place I loved, do largely what I liked, and have the best frigging roommate anyone could want. Having been here for two years now, I even love being all exasperated and snooty about slow-walking tourists.
Grenada, you and I had our fights and our differences. I did threaten to ram inanimate objects in animate humans on multiple occasions and for multiple reasons during my stay in your lush arms, but how much hate can there be when finding a bottle of Ting or Carib in the states sparks a holy grail. And when Grenada Chocolate came to Whole Foods, I thought we were going to launch the Grenada reunion tour right there in the middle of Union Square. I have to love your turtles and your beaches, your hashes and visibly drunk bus drivers.
So now I'm off soon to heart Charleston. Soon. With, predictably, a spurious game plan that requires a lot of begging and luck. And then my four year venture of medical school will be over, and we can only hope that the title of this blog will be "A Caribbean MD WAS good enough for me." Then it's all resident stuff. Orders and charts and such. Deep manly doctor coughs.
And, like any other time that any change affects my life, I get embroiled in nostalgia and other useless things. Tomorrow is my last day at Other-Job. I have an awesome boss. I do a lot of stuff I like. I have decent autonomy. I like my coworkers. But it has to end. Graduation is on Saturday and a new crop will come in to replace the ones that defected. Do I want to stay? I want to start residency. With all the new challenges that faces.
But I'll do it. I feel, if meekly, ready to take on the world.
New York, how I've loved you. I love your people; I love your constant circus, I love the everloving hell out of your food and nightlife; I love my time here. During my stay, I got to live in a place I loved, do largely what I liked, and have the best frigging roommate anyone could want. Having been here for two years now, I even love being all exasperated and snooty about slow-walking tourists.
Grenada, you and I had our fights and our differences. I did threaten to ram inanimate objects in animate humans on multiple occasions and for multiple reasons during my stay in your lush arms, but how much hate can there be when finding a bottle of Ting or Carib in the states sparks a holy grail. And when Grenada Chocolate came to Whole Foods, I thought we were going to launch the Grenada reunion tour right there in the middle of Union Square. I have to love your turtles and your beaches, your hashes and visibly drunk bus drivers.
So now I'm off soon to heart Charleston. Soon. With, predictably, a spurious game plan that requires a lot of begging and luck. And then my four year venture of medical school will be over, and we can only hope that the title of this blog will be "A Caribbean MD WAS good enough for me." Then it's all resident stuff. Orders and charts and such. Deep manly doctor coughs.
And, like any other time that any change affects my life, I get embroiled in nostalgia and other useless things. Tomorrow is my last day at Other-Job. I have an awesome boss. I do a lot of stuff I like. I have decent autonomy. I like my coworkers. But it has to end. Graduation is on Saturday and a new crop will come in to replace the ones that defected. Do I want to stay? I want to start residency. With all the new challenges that faces.
But I'll do it. I feel, if meekly, ready to take on the world.
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."
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
Bandwagon
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?
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.
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.
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