Jan 26, 2010

Justifications for violence

I have a nice long blog out there waiting for you people, but it's put on hold because of the above, and the recurrence of a virus I've been fighting off solidly for three days and off and on for a week has made a sick and cowardly surge that severed my connection briefly, so I will, be brief...

I prefer to live in a civilized society where people settle things with discourse, and barring that, insults against the opponent's mother. That being said, the unique creators of Internet Security 2010 virus need to be hauled out of their mothers' basements by an angry mob of syphilitic wolverines, otherwise known as the closest thing to women these f*tards are ever going to get, have a team of angry medical students rip their naughty bits asunder with lemon-tipped dull scalpels, and then get beaten to death with the same buggy Dell computers they've rendered useless in their relentless pursuit of my credit card information before having their corpses spit on with smug satisfaction by all the mac users saying "Oh, our computers don't get viruses".

I'm reasonably sure that if I can televise the demise of the Internet Security 2010 virus assembly crew, I will make enough off the proceeds to buy an insanity plea AND a sparkling new Macbook.

So, off to sleep so I can head off to another day of working with children. Let that one roll around in your heads for a while.

Jan 12, 2010

Children and zebras...

Okay, for those of you who watch House (hopefully all of you), you've heard the medical cliché "If you hear hoofbeats, think horses, not zebras" which pretty much summarizes the syndrome medical students have where we want to diagnose people who have diabetes as being infected with a silver-bellied Peruvian brainworm. And the only reason we have this syndrome is because we've been infected with a silver-bellied Peruvian brainworm.

Thing about kids is they have zebras. Obviously I can't go into strategic detail because HIPAA doesn't have a clause to make exceptions in privacy settings for crap I think is cool... though they totally should, but since starting peds a week ago, I've probably seen 4 kids that have syndromes that were filed in medical school under "Why do I have to learn about stuff that only affects 1 in 40,000 people?" Oh, because those 40,000 people are more likely to go to the hospital than others, and when they're kids, they're still ironing out the details of how to manage the condition, so bam, hospital.

And then there's the kid who has, at present, stumped everyone on the floor, required consult by a specialist whose contribution included not having seen a case like this in umpteen years of practice and that if we had any thoughts, we should feel free to input them because f- if they know. So they're running more tests.

What I'm liking about peds is that in peds so far, they seem way more interested in puzzling out what they're dealing with. I don't know if it's because they like kids, like medicine, or just watch as much House as I do, but it's refreshing. And the stuff they're dealing with is frequently really interesting, which helps.

Then there's the seventeen thousand babies with bronchiolitis. But then those kids don't tend to present with the spectrum of baggage adults have so their cases are fairly straightforward. They're also far less inclined to yell at me for taking too long during an examination before demanding drugs.

And so far exams on kids hasn't been too bad. The sort of expectation of crying helps, but then they don't really hold grudges, and they're easy to placate afterward. And what's wrong usually shows up as what's wrong rather than oh, these skin lesions are from an untreated fungal infection, and there's existing diabetic peripheral neuropathy and blah blah blah.

Of course, the fact that kids are being less difficult than I expected means it sucks when they get really sick, so that can be a stone cold bummer.

And I'll talk briefly about the staff... while I can't count myself as being someone described by anyone as "someone that loves kids", the people that choose to go into pediatrics seem to, which seems to instill a refreshing position in them of being patient advocates, so I think we all get slightly less cynical as a result of it.

Though no worries; surgery will beat it straight back into us.

And lest anyone think I've gone soft on path for peds, recall that one of the reasons I'm liking the crap out of peds (minus the hours) is because I get to see weird stuff, which is not really the motivation most parents want their pediatrician to have.

Jan 5, 2010

New Year; New Rotation

Greetings people-recently-incarcerated-on and people-recently-freed-from Grenada! And all you other lovelies as well.

I just started my pediatrics rotation which is screwing me up by being way more difficult than I thought, while having attentive and interested attendings and residents, which makes me actually want to try hard at it, despite my love of things that are dead and jammed under a microscope, while this rotation has an abundance of loud squirmy pink things. That all have bronchiolitis. I'm giving myself about 3 days before I'll inevitably catch the upper respiratory tract grown-up version of it from the little tykes.

But now, it's my fabulous roomie's birthday, so yet again, I'm off.

Hope you're all having a wonderful new year!

Dec 20, 2009

The review you've been waiting for...

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

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

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

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

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

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

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

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

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

Dec 10, 2009

Another video break

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



Enjoy!

Nov 30, 2009

Nerdy hooray

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

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

Nov 28, 2009

So... wow...

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

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

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

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

(sleep hiatus)

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

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

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

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

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

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

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

Nov 15, 2009

Nov 3, 2009

Progress?

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

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

I'll explain...

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

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

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

Which, I suppose, is the point.

Oct 29, 2009

Brief advertisement...

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

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

Oct 28, 2009

Pause for Fall...

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

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

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

Still freaking awesome though. Thanks Patrick!

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

Oct 24, 2009

IM starts to near to a close

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

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

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

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

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

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

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

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

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

Oct 16, 2009

ICU next week

And woo hoo for I dunno, sicker patients?

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

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

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

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

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

Oh, happy early Diwali to my Hindu associates.

Oct 13, 2009

Zombie hiatus...

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

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

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

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

Now, to undo the debauchery of the weekend!

Oct 1, 2009

It would take less time to treat TB than present it

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

Rinse, repeat.

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

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

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

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

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

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

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

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