Which may explain a thing or two... the skinny, before having to get to bed late (the horror)...
6 AM to 5-6PM.
Run in the park.
Watch Inuyasha (I know it's marketed to 8 year old Japanese girls; I can't help it).
Bed.
Oh, and there was the sake bombing Saturday night, but ya know...
This week I have two straight weeks of teams with a Saturday call in the middle. I would be more pissed off about it (though I've been griping about it for a while now), but we're only on call every 9 days versus the every 3-4 days at some hospitals, so it's hard to be *too* upset, and I got this last beautiful weekend off AND was post call on Friday, so kind of a three day weekend.
Weirdly, the difference between a good surgery and a bad surgery lies in the people you're with. First two lap choles, awesome, I am a camera-holding goddess; circulating nurse being nice; good procedures. Exact same procedure; different doc; I am worthless at everything, the OR nurse hates students, and any med student holding a camera is trying to make some hideous Cloverfield/Blair Witch crossover. I also almost got kicked in the head by the patient. Fun for all.
Also, while I'm on the hardest team now, I like the chief and have scrubbed in with him before and he (gasp) likes to teach. Let's see what tomorrow brings.
Mar 22, 2010
Mar 5, 2010
Anti Powerpoint Rebellion
Though apparently I'm late on the bandwagon and there's already a group of anti-establishment Luddites that have taken this position, but I'm over PowerPoint. This hit me last night.
I'm not saying PowerPoint doesn't have its uses, like all three of them. As someone that's infatuated with pathology, you need PowerPoint (or some kind of visual projection device) to teach it. Diagrams are also useful, particularly in surgery, where they tend to do procedures that connect stuff to other stuff you wouldn't necessarily expect, and you kind of need a diagram representation of what GI anatomy looks like after you've put in Tivo and a hot tub. Or something. So yeah, if you need something that isn't "words", hooray for PowerPoint.
I was kind of indifferent to PowerPoint for a long time. I laughed when people put in the "funny" slide or the unnecessary slide effect, as you're supposed to, and the really bad PowerPoint presentations stand out as really bad PowerPoint presentations, so I hadn't really chalked them up to the program, but to people's inability to understand the concept of margins, grammar, or choosing colors that don't provoke seizures, and that's valid.
But two things happened yesterday. One, it was conference day, which pretty much means around 7 hours of PowerPoint. Some lecturers are good; some are not. But I realized that the second they dimmed the lights to put up the projections, I had a Pavlovian reaction. I pulled out my Surgical Recall to study.
So essentially, I don't mind PowerPoint because it offers me the opportunity for self-directed study unmolested without the distraction of an engaging or novel lecture. And books tend to be more significantly higher yield, probably because they're not in PowerPoint format. And they're in normal English because the authors presumably have not been doing language gymnastics to avoid direct plagiarism. And I realized the only way to actually pull me OUT of reading my book is to have a lecturer that is either distractingly good or distractingly bad. But most fall under the "okay" line of droning information that is already on their slides with topics they know well, but are no longer capable of presenting in an interesting fashion.
Then I watched one of the really good, extremely knowledgeable residents get the crap pimped out of her on topics that were already later addressed in her presentation, which in fairness, wasn't bad. But you have no flexibility in the direction you're going with PowerPoint because it's already on the slides. And then if the attendings toss you in another direction by ripping you apart with questions, you're still left having to come back to your presentation and plod through slides they may have just explained to make a point, at which point you just kind of stare blankly at the screen, glance at the audience, say "uhhh" and then flip quickly past an hour's work, most of which probably consisted of spacing out the bullets and changing the fonts. Your audience is bored, you've lost your mojo, and more importantly, an hour of your life you will never ever get back.
Everyone thinks about the bad PowerPoint lectures because they're hilarious. But then I thought long and hard about the last GOOD lectures I've had. I've had plenty of perfectly functional decent lectures, including by other students, even when I was forced to pay attention, because text on screen is still text with information, even if it's a wildly inefficient way to get it.
But even this rotation, the GOOD lectures? Half of them were rounding with attendings. The SICU chief who kept vividly maiming our patients when we strayed in the wrong direction: "After spending four hours convincing Anesthesia to actually let you do this procedure, the patient codes on the table. They're resuscitated AGAIN. Systolic pressure is 50". "Uhhh... well, I'd order..." "40." "I'd explore the..." "30." "AHHHHHHH!!!" "Patient begins pouring feces out of the incision site." "AHHHHH!!! Is that a real thing???? Yes?? AHHHHHHHHH!!!"
The lectures with our attending that tells dirty jokes and pimps us... the impromptu question reviews, even when I think they aren't going to be relevant because they're surgical resident question reviews and I haven't studied adrenal anatomy in 8 months. Almost none have used PowerPoint. The ones that do have either been almost exclusively image-oriented or the speaker has barely referenced them and flips through them in the middle of an interesting lecture because a PowerPoint presentation was required or he doesn't have a pen that writes well on the back of his hand. (I'd make one of many easy cracks at Sarah Palin here, but since I totally do that too, I can't.)
And why do the funny effects or that humorous cartoon, or the serene picture of the beach entertain us? Because PowerPoint lectures are so mindnumbing that we need the emotional break from wanting to kill ourselves.
Which finally brings me to my second point. I had to present an excruciating article for surgery today and was up late doing it (because I was late in a lecture and spent a good part of the day listening to an attending bitch and moan about medical students not 'being around' because we're unreasonably 'post 24 hour weekend call' or 'in mandatory conference'). The article was almost exclusively statistical analysis on other statistical values about a topic that wasn't really easy when you stripped it to the original condition, and because I'm not a statistician (nor am I good at arithmetic), I had to Wiki half the terms in the freaking thing.
So I *finally* was able to understand the article, its point, and the original topic it addressed, and interpret the numbers.
But THEN I *still* had the task of taking all the information I had in my head AND the organization and logical follow through, and then turn it into a deadpan samey boring ass PowerPoint presentation despite having no idea which way the attendings would direct it. Plus doing PowerPoints gives me complete mental constipation while I struggle to elaborate on bullet points without reading text off the slide like the listeners are illiterate children rather than board certified freaking surgeons. In addition, the article was virtually incapable of being made interesting by anyone nor to anyone, and the only way you can make it less interesting is by taking all those statistics and copying them onto a PowerPoint slide.
So I kind of rebelled. I put together like 5 slides with the main points on them (particularly since the entire point of the article is summarized neatly in the title and the entire paper is merely justifying why they aren't full of crap) and just talked about it, summarizing the key findings without blasting numbers on a screen at 7 in the morning, and pretty much ignored my own slides. I think I was stuttering a bit because I'd gotten four hours of sleep and was presenting to a group of attendings without the mental crutch, but no one seemed pissed, so who knows.
I'm not saying PowerPoint doesn't have its uses, like all three of them. As someone that's infatuated with pathology, you need PowerPoint (or some kind of visual projection device) to teach it. Diagrams are also useful, particularly in surgery, where they tend to do procedures that connect stuff to other stuff you wouldn't necessarily expect, and you kind of need a diagram representation of what GI anatomy looks like after you've put in Tivo and a hot tub. Or something. So yeah, if you need something that isn't "words", hooray for PowerPoint.
I was kind of indifferent to PowerPoint for a long time. I laughed when people put in the "funny" slide or the unnecessary slide effect, as you're supposed to, and the really bad PowerPoint presentations stand out as really bad PowerPoint presentations, so I hadn't really chalked them up to the program, but to people's inability to understand the concept of margins, grammar, or choosing colors that don't provoke seizures, and that's valid.
But two things happened yesterday. One, it was conference day, which pretty much means around 7 hours of PowerPoint. Some lecturers are good; some are not. But I realized that the second they dimmed the lights to put up the projections, I had a Pavlovian reaction. I pulled out my Surgical Recall to study.
So essentially, I don't mind PowerPoint because it offers me the opportunity for self-directed study unmolested without the distraction of an engaging or novel lecture. And books tend to be more significantly higher yield, probably because they're not in PowerPoint format. And they're in normal English because the authors presumably have not been doing language gymnastics to avoid direct plagiarism. And I realized the only way to actually pull me OUT of reading my book is to have a lecturer that is either distractingly good or distractingly bad. But most fall under the "okay" line of droning information that is already on their slides with topics they know well, but are no longer capable of presenting in an interesting fashion.
Then I watched one of the really good, extremely knowledgeable residents get the crap pimped out of her on topics that were already later addressed in her presentation, which in fairness, wasn't bad. But you have no flexibility in the direction you're going with PowerPoint because it's already on the slides. And then if the attendings toss you in another direction by ripping you apart with questions, you're still left having to come back to your presentation and plod through slides they may have just explained to make a point, at which point you just kind of stare blankly at the screen, glance at the audience, say "uhhh" and then flip quickly past an hour's work, most of which probably consisted of spacing out the bullets and changing the fonts. Your audience is bored, you've lost your mojo, and more importantly, an hour of your life you will never ever get back.
Everyone thinks about the bad PowerPoint lectures because they're hilarious. But then I thought long and hard about the last GOOD lectures I've had. I've had plenty of perfectly functional decent lectures, including by other students, even when I was forced to pay attention, because text on screen is still text with information, even if it's a wildly inefficient way to get it.
But even this rotation, the GOOD lectures? Half of them were rounding with attendings. The SICU chief who kept vividly maiming our patients when we strayed in the wrong direction: "After spending four hours convincing Anesthesia to actually let you do this procedure, the patient codes on the table. They're resuscitated AGAIN. Systolic pressure is 50". "Uhhh... well, I'd order..." "40." "I'd explore the..." "30." "AHHHHHHH!!!" "Patient begins pouring feces out of the incision site." "AHHHHH!!! Is that a real thing???? Yes?? AHHHHHHHHH!!!"
The lectures with our attending that tells dirty jokes and pimps us... the impromptu question reviews, even when I think they aren't going to be relevant because they're surgical resident question reviews and I haven't studied adrenal anatomy in 8 months. Almost none have used PowerPoint. The ones that do have either been almost exclusively image-oriented or the speaker has barely referenced them and flips through them in the middle of an interesting lecture because a PowerPoint presentation was required or he doesn't have a pen that writes well on the back of his hand. (I'd make one of many easy cracks at Sarah Palin here, but since I totally do that too, I can't.)
And why do the funny effects or that humorous cartoon, or the serene picture of the beach entertain us? Because PowerPoint lectures are so mindnumbing that we need the emotional break from wanting to kill ourselves.
Which finally brings me to my second point. I had to present an excruciating article for surgery today and was up late doing it (because I was late in a lecture and spent a good part of the day listening to an attending bitch and moan about medical students not 'being around' because we're unreasonably 'post 24 hour weekend call' or 'in mandatory conference'). The article was almost exclusively statistical analysis on other statistical values about a topic that wasn't really easy when you stripped it to the original condition, and because I'm not a statistician (nor am I good at arithmetic), I had to Wiki half the terms in the freaking thing.
So I *finally* was able to understand the article, its point, and the original topic it addressed, and interpret the numbers.
But THEN I *still* had the task of taking all the information I had in my head AND the organization and logical follow through, and then turn it into a deadpan samey boring ass PowerPoint presentation despite having no idea which way the attendings would direct it. Plus doing PowerPoints gives me complete mental constipation while I struggle to elaborate on bullet points without reading text off the slide like the listeners are illiterate children rather than board certified freaking surgeons. In addition, the article was virtually incapable of being made interesting by anyone nor to anyone, and the only way you can make it less interesting is by taking all those statistics and copying them onto a PowerPoint slide.
So I kind of rebelled. I put together like 5 slides with the main points on them (particularly since the entire point of the article is summarized neatly in the title and the entire paper is merely justifying why they aren't full of crap) and just talked about it, summarizing the key findings without blasting numbers on a screen at 7 in the morning, and pretty much ignored my own slides. I think I was stuttering a bit because I'd gotten four hours of sleep and was presenting to a group of attendings without the mental crutch, but no one seemed pissed, so who knows.
Feb 21, 2010
Surgical call...
sucked.
How can I be on surgical call for over 24 hours, two of which we were allowed to sleep, be busy for most of the night, and not see any... surgeries? Honestly, I barely know what was wrong with half the patients, though I certainly know what their labs were. OB-Gyn call could suck in that it was long and hard and you got scutted a lot and you were the definitive vitals/labs bitch, but all that stuff was punctuated with somewhere between 1 and 7 deliveries/c-sections a night which they insisted students be in on, so calling it "OB Call" was as advertised.
But guys, seriously. It's called "COMPUTERIZED CHARTING". For the love of all that is good and beautiful in this world, institute a program with more patient-organizing power than Office 97. That goes for about three quarters of the hospitals in this city. Why progress notes are still being scrawled illegibly on easily lost or damaged charts that have to be fought over by all the attendings, residents, medical students, and nurses who need them at the exact same critical times escapes me. And med lists... freaking... list every single medication a patient is *currently on*, changes to medication with date/time, and electronically attach that data to the patient's name. And to add an extra stage of programming that could be done by a precocious 12 year old with a Warcraft habit and his own 4chan meme, throw up a caution if any drug is prescribed to which a patient has an allergy or if there's a hazardous drug interaction. No, have some on the paper copy of the medlists, some on the computer, some in a different part of the chart (which you often can't check because the nurses, who have to dispense the medications, understandably need that chart as much if not more than you do), confirm by occasionally having medical students check to see what's in the IVs. WTF?
I know this *can* be done, because it *has* been done. Not only is the lack of electronic charting really irritating to medical students (and everyone else) that then has to dedicate hours and hours to rewriting information that is in one place into other places (if they can read it) or hilariously, *typing* information from one excel list to another, but it's unnecessarily hazardous.
Anyway. On the plus side, all the people in surgery I've met so far since I've been on surgery have been really nice, which has been an unexpected surprise. Surgical staff is not commonly associated with uh... social grace, or a particular love of our grimy, wound-contaminating, instrument-dropping ilk so not getting yelled at has been a bonus and I really like the main attending we've been introduced to, so not all bad.
And early in the night, the resident was showing us some bedside procedures which I didn't get in internal medicine, which I think is where I was supposed to. I got to drop an NG tube in ED (which was awesome), but last night I did get to listen for the gurgle to ensure proper placement, which was loud enough to be startling, so I'm finally getting some use out of my stethoscope beyond putting it on a patient's chest, listening intently, frowning, and then lying when the attending asks me if I can hear the murmur. At least I always remember to have the earpieces in.
How can I be on surgical call for over 24 hours, two of which we were allowed to sleep, be busy for most of the night, and not see any... surgeries? Honestly, I barely know what was wrong with half the patients, though I certainly know what their labs were. OB-Gyn call could suck in that it was long and hard and you got scutted a lot and you were the definitive vitals/labs bitch, but all that stuff was punctuated with somewhere between 1 and 7 deliveries/c-sections a night which they insisted students be in on, so calling it "OB Call" was as advertised.
But guys, seriously. It's called "COMPUTERIZED CHARTING". For the love of all that is good and beautiful in this world, institute a program with more patient-organizing power than Office 97. That goes for about three quarters of the hospitals in this city. Why progress notes are still being scrawled illegibly on easily lost or damaged charts that have to be fought over by all the attendings, residents, medical students, and nurses who need them at the exact same critical times escapes me. And med lists... freaking... list every single medication a patient is *currently on*, changes to medication with date/time, and electronically attach that data to the patient's name. And to add an extra stage of programming that could be done by a precocious 12 year old with a Warcraft habit and his own 4chan meme, throw up a caution if any drug is prescribed to which a patient has an allergy or if there's a hazardous drug interaction. No, have some on the paper copy of the medlists, some on the computer, some in a different part of the chart (which you often can't check because the nurses, who have to dispense the medications, understandably need that chart as much if not more than you do), confirm by occasionally having medical students check to see what's in the IVs. WTF?
I know this *can* be done, because it *has* been done. Not only is the lack of electronic charting really irritating to medical students (and everyone else) that then has to dedicate hours and hours to rewriting information that is in one place into other places (if they can read it) or hilariously, *typing* information from one excel list to another, but it's unnecessarily hazardous.
Anyway. On the plus side, all the people in surgery I've met so far since I've been on surgery have been really nice, which has been an unexpected surprise. Surgical staff is not commonly associated with uh... social grace, or a particular love of our grimy, wound-contaminating, instrument-dropping ilk so not getting yelled at has been a bonus and I really like the main attending we've been introduced to, so not all bad.
And early in the night, the resident was showing us some bedside procedures which I didn't get in internal medicine, which I think is where I was supposed to. I got to drop an NG tube in ED (which was awesome), but last night I did get to listen for the gurgle to ensure proper placement, which was loud enough to be startling, so I'm finally getting some use out of my stethoscope beyond putting it on a patient's chest, listening intently, frowning, and then lying when the attending asks me if I can hear the murmur. At least I always remember to have the earpieces in.
Feb 10, 2010
Another rotation rolls toward a close
And it's a snow day! It's hard to believe that in two years, I went from this:
to this:
Pretty sweet, eh? Makes me feel bad every time I'm a whiny-butt, which is often.
So the blizzard of the century or whatnot finally hit us after bathing the rest of the east coast in it, and so far, it hasn't been too bad. The salters and plows were out almost instantly, my subway was still running, and it was way less of a pain in the ass than the one that hit right before Christmas. It was also nice that it hit *today* rather than destroying the weekend, as they were expecting, which meant instead of getting stranded in Manhattan, I was peacefully in the pediatric ED discovering that while getting a nail jammed into a foot only causes minimal tears in a child, that tetanus shot that follows it is an act of hideousness Mother Nature herself couldn't concoct. To be fair, those things do burn.
The NYC population seems to have responded to the storm by whipping out garbage can lids, cardboard boxes, and anything else remotely flat and sledding down hills on them, so I suppose the winter horror isn't affecting the public morale too badly. I was way more responsible after work and responded by tossing snowballs at my colleague and then pushing her into the snow after she refrained from doing so to me because she thought I might have a laptop in my backpack (I didn't). It's this level of maturity that's going to make me such a good doctor.
But alas, not all can be snow play since I have my oral exam for peds tomorrow and my written exam on Friday. Then I get three glorious days of reckless winter merriment before surgery begins and my life effectively ends in a blaze of retractor-holding, 4 AM-rising joy.
to this:
Pretty sweet, eh? Makes me feel bad every time I'm a whiny-butt, which is often.
So the blizzard of the century or whatnot finally hit us after bathing the rest of the east coast in it, and so far, it hasn't been too bad. The salters and plows were out almost instantly, my subway was still running, and it was way less of a pain in the ass than the one that hit right before Christmas. It was also nice that it hit *today* rather than destroying the weekend, as they were expecting, which meant instead of getting stranded in Manhattan, I was peacefully in the pediatric ED discovering that while getting a nail jammed into a foot only causes minimal tears in a child, that tetanus shot that follows it is an act of hideousness Mother Nature herself couldn't concoct. To be fair, those things do burn.
The NYC population seems to have responded to the storm by whipping out garbage can lids, cardboard boxes, and anything else remotely flat and sledding down hills on them, so I suppose the winter horror isn't affecting the public morale too badly. I was way more responsible after work and responded by tossing snowballs at my colleague and then pushing her into the snow after she refrained from doing so to me because she thought I might have a laptop in my backpack (I didn't). It's this level of maturity that's going to make me such a good doctor.
But alas, not all can be snow play since I have my oral exam for peds tomorrow and my written exam on Friday. Then I get three glorious days of reckless winter merriment before surgery begins and my life effectively ends in a blaze of retractor-holding, 4 AM-rising joy.
Jan 27, 2010
Asthma
You thought "asthma" was going to have to do with pediatrics, eh? Well no. I'll get to that in a minute...
But first, for why you come to my blog... Ishie's 30 second movie review of things everyone else has already seen.... Casino Royale!
First impression: Not bad
Second impression: I'm calling sissy. Not for your average movie hero, obviously, but for James Frigging Bond. Sean Connery would have killed everyone Venice had ever loved before the archvillain got one of his socks off. Being tied naked to a chair helplessly before you and your disposable ladyfriend are rescued just isn't in the cards. Even if the aces are.
Third impression, and hence my title: Asthma is one of the least badass illnesses an archvillain could have, possibly topped only by fecal incontinence and a lisp. Even tied naked to a chair, if my tormentor had to take a drag off his inhaler every five seconds before punctuating his threats with inspiratory wheezing, I'd probably start laughing too.
Anyway, there hasn't been much to report in the hospital scene lately because I've spent very little of this last week at the hospital and even less of it seeing children. We have a 'study week' in pediatrics, which is one of the best ideas ever, and finally poses a solution to that endless dilemma medical students have where they're expected to be constantly as the hospital seeing patients, but also expected to study sufficiently to know all the enzymes in a kid that can break (hint: all of them). Essentially, last week, I studied. Which isn't exciting to report on, though I loved it and got a ton of crap done.
Oh, except Monday we actually got off thanks to our heroic clinical coordinator pushing for our holiday time, so Monday, I spent less time "studying" and more time "in a cabin in the snow playing bumper pool and visiting microbreweries." But the rest of the week, I studied.
And this is the point I was at in my post before where the puppetmasters in partial control of my computer decided it was shutdown time.
A little aside on this whole virus thing... I've finally gotten to a point where I'm not tech-unsavvy, which is probably why my computer isn't a smoking pile of plastic (yet), though honestly, this one's been living on borrowed time since I spilled half a bowl of cereal on it in Grenada (d'oh!) a couple years ago. Essentially, this virus keeps reviving itself for the last week, but I've been gradually winning battles if not wars. It managed to disable my ability to restart Windows in safe mode and defaulted to the blue screen of death (*(&(*&!!!) when I attempted it, disabled my internet connection at one point, deleted the essential files for my spyware and malware programs so they wouldn't work, and when I'd restored my internet, defaulted all my google search links to its evil little fake webpages. It also bugged up system restore, infiltrated my registry and a bunch of other stuff that quite frankly, could usually be only be accomplished by Sean Connery's James Bond. If I weren't so earth-shatterly pissed off about the whole thing, I'd be impressed. Fortunately, some experience with the interweb plus an internet phone when my computer *really* went off the rails has proved useful, providing such clues as re-downloading and renaming all the executable files of my antivirus/antimalware so the devil program can't find and snuff them. It's like a witness protection program for bits of code.
To get an idea of this thing's general effect on my life, despite the fact that my downtime tends to consist of either drinking or vegetating, I instead got to spend 7 hours of my Saturday testing how many times my computer could survive a cold boot without the processor grinding to a halt.
But babies. Cute little pink babies. My week's actually been going well. Last week I got a lot done on the study horizon, but could get absolutely nothing accomplished in any other venue. My loan status was unknown/pending, which is something that's had me on edge and driving everyone I know crazy for the last FIVE WEEKS. This one's not actually on the school, but on a medical bill of which I was unaware that got stuck on my credit report like ten minutes before I had to submit my loan application, so I did a lot of runaround, talked to the original billers and found that my insurance hadn't gone through, so resubmitted paid the extra, and was assured they'd take it off. Which they did. So when I called them to go "Uh homies? This shiz is still on my credit report as an open collection", and the lady very nicely told me that it was taken off and I could get a letter from them stating it, but that it could take as long as 30 days for the credit reporting bureaus to take it off.
So my opening statement to people asking how I was doing for that thirty days (which was past tuition due date for my session) was "Oh ya know... probably going to get kicked out of school."
I was also getting blocked at a prescription refill for yet another insurance related reason, and could not figure out for the life of me whose problem it was.
I was also trying to reclaim a locker from someone that put a lock on my locker, removed my nametag from it, and then removed all the notes the clinical coordinator put on it telling him/her to get the crap off and the lock off.
So that was Friday.
Tuesday.... my loan has been approved and dispersed and I'm waiting on the check, my prescription was worked out, and the lock got cut off my locker! And I beat my record time for jogging the 3.35 mile Prospect Park loop by a minute. It's a good time.
Oh, now that I'm back in baby land, I can tell you medical stuff again. I spent the first two days in the newborn nursery. This is a mixed bag...
Pros: the kids are healthy and happy and usually people are glad to see them. You don't see any sick ones because the second a kid even starts to breathe funny, they're shipped upstairs.
-nice doctors
-nice nurses
-scrubs and no white coat. It's a twofer.
Cons: Newborns are squicky. I'm sorry. I know they get cute when they're two, but they're not now.
-Babies scream. A lot. One baby screaming sets off the others. This has been proved by science to be one of the most annoying noises possible. Long exposure to high decibels of baby-scream has caused people's brains to explode out of their heads with some regularity. It's science, people.
-You have to check a lot of things on babies, because they're new to the world, and like a car built by blind people with ADD, you need to do checks most people don't expect. Two of these checks are disturbing. In one, you get to determine whether a boy baby's dropped both his sinkers down, and in the other, you have to make sure the baby's butt is properly connected to the outside world.
If you think there's expensive exhaustive medical instruments for doing those checks, guess again. It involves medical students having to cradle baby testicles and then, worse, peek inside the rear end to make sure there's a hole there, because *sometimes there isn't*. Yes, imperforate anus, possibly a candidate for one of the disorders the next James Bond villain can have!
After nursery this week, we have different specialty clinics each day. Yesterday was child advocacy clinic (re: child abuse) which was really interesting and the only two cases we saw had a minimum of soul crushery, so that was nice. The stories the director told though, geeze. People are freaks.
Today was pediatric heme/onc, which like child advocacy clinic, was way less depressing than I expected. The attending was really cool and let us interview the two kids that came in for check ups. Since peds heme/onc is an area with a lot of path, they had a monster microscope in the back with a ton of slides so at downtime, I asked if I could play with it and was promptly tied up with playing with iron deficiency slides for the next hour while trying not to break them. Damn 100X lens!
As I was back in the lab, I was overhearing a patient interview, significant in that it concluded with a ton of people making a ruckus in the hall. I poked my head out in time to see a pretty blond woman accompanied by a guy in a giant fox suit lean over to the last patient and say "Do YOU like basketball???" to which the child responded "Um... no?"
See, moments like *that* are when I love children. Not when I'm having to examine their nether regions. So the woman, undeterred, said "Well, you will!!!!"
Apparently we had a visit from the Nets. As an Ovarian American, I had no idea who the heck they were, but they were passing out signed baseball hats and we got a picture with the mascot, so cool. Unfortunately I don't think they realized that despite the potential for changing some frowns to smiles in a place called "Pediatric Heme/Onc", all the sick kids were downstairs and we had two kids, both of whom were perfectly fine and only in there for ten minutes for a follow up visit. And one of them doesn't like basketball.
Well, good night!
But first, for why you come to my blog... Ishie's 30 second movie review of things everyone else has already seen.... Casino Royale!
First impression: Not bad
Second impression: I'm calling sissy. Not for your average movie hero, obviously, but for James Frigging Bond. Sean Connery would have killed everyone Venice had ever loved before the archvillain got one of his socks off. Being tied naked to a chair helplessly before you and your disposable ladyfriend are rescued just isn't in the cards. Even if the aces are.
Third impression, and hence my title: Asthma is one of the least badass illnesses an archvillain could have, possibly topped only by fecal incontinence and a lisp. Even tied naked to a chair, if my tormentor had to take a drag off his inhaler every five seconds before punctuating his threats with inspiratory wheezing, I'd probably start laughing too.
Anyway, there hasn't been much to report in the hospital scene lately because I've spent very little of this last week at the hospital and even less of it seeing children. We have a 'study week' in pediatrics, which is one of the best ideas ever, and finally poses a solution to that endless dilemma medical students have where they're expected to be constantly as the hospital seeing patients, but also expected to study sufficiently to know all the enzymes in a kid that can break (hint: all of them). Essentially, last week, I studied. Which isn't exciting to report on, though I loved it and got a ton of crap done.
Oh, except Monday we actually got off thanks to our heroic clinical coordinator pushing for our holiday time, so Monday, I spent less time "studying" and more time "in a cabin in the snow playing bumper pool and visiting microbreweries." But the rest of the week, I studied.
And this is the point I was at in my post before where the puppetmasters in partial control of my computer decided it was shutdown time.
A little aside on this whole virus thing... I've finally gotten to a point where I'm not tech-unsavvy, which is probably why my computer isn't a smoking pile of plastic (yet), though honestly, this one's been living on borrowed time since I spilled half a bowl of cereal on it in Grenada (d'oh!) a couple years ago. Essentially, this virus keeps reviving itself for the last week, but I've been gradually winning battles if not wars. It managed to disable my ability to restart Windows in safe mode and defaulted to the blue screen of death (*(&(*&!!!) when I attempted it, disabled my internet connection at one point, deleted the essential files for my spyware and malware programs so they wouldn't work, and when I'd restored my internet, defaulted all my google search links to its evil little fake webpages. It also bugged up system restore, infiltrated my registry and a bunch of other stuff that quite frankly, could usually be only be accomplished by Sean Connery's James Bond. If I weren't so earth-shatterly pissed off about the whole thing, I'd be impressed. Fortunately, some experience with the interweb plus an internet phone when my computer *really* went off the rails has proved useful, providing such clues as re-downloading and renaming all the executable files of my antivirus/antimalware so the devil program can't find and snuff them. It's like a witness protection program for bits of code.
To get an idea of this thing's general effect on my life, despite the fact that my downtime tends to consist of either drinking or vegetating, I instead got to spend 7 hours of my Saturday testing how many times my computer could survive a cold boot without the processor grinding to a halt.
But babies. Cute little pink babies. My week's actually been going well. Last week I got a lot done on the study horizon, but could get absolutely nothing accomplished in any other venue. My loan status was unknown/pending, which is something that's had me on edge and driving everyone I know crazy for the last FIVE WEEKS. This one's not actually on the school, but on a medical bill of which I was unaware that got stuck on my credit report like ten minutes before I had to submit my loan application, so I did a lot of runaround, talked to the original billers and found that my insurance hadn't gone through, so resubmitted paid the extra, and was assured they'd take it off. Which they did. So when I called them to go "Uh homies? This shiz is still on my credit report as an open collection", and the lady very nicely told me that it was taken off and I could get a letter from them stating it, but that it could take as long as 30 days for the credit reporting bureaus to take it off.
So my opening statement to people asking how I was doing for that thirty days (which was past tuition due date for my session) was "Oh ya know... probably going to get kicked out of school."
I was also getting blocked at a prescription refill for yet another insurance related reason, and could not figure out for the life of me whose problem it was.
I was also trying to reclaim a locker from someone that put a lock on my locker, removed my nametag from it, and then removed all the notes the clinical coordinator put on it telling him/her to get the crap off and the lock off.
So that was Friday.
Tuesday.... my loan has been approved and dispersed and I'm waiting on the check, my prescription was worked out, and the lock got cut off my locker! And I beat my record time for jogging the 3.35 mile Prospect Park loop by a minute. It's a good time.
Oh, now that I'm back in baby land, I can tell you medical stuff again. I spent the first two days in the newborn nursery. This is a mixed bag...
Pros: the kids are healthy and happy and usually people are glad to see them. You don't see any sick ones because the second a kid even starts to breathe funny, they're shipped upstairs.
-nice doctors
-nice nurses
-scrubs and no white coat. It's a twofer.
Cons: Newborns are squicky. I'm sorry. I know they get cute when they're two, but they're not now.
-Babies scream. A lot. One baby screaming sets off the others. This has been proved by science to be one of the most annoying noises possible. Long exposure to high decibels of baby-scream has caused people's brains to explode out of their heads with some regularity. It's science, people.
-You have to check a lot of things on babies, because they're new to the world, and like a car built by blind people with ADD, you need to do checks most people don't expect. Two of these checks are disturbing. In one, you get to determine whether a boy baby's dropped both his sinkers down, and in the other, you have to make sure the baby's butt is properly connected to the outside world.
If you think there's expensive exhaustive medical instruments for doing those checks, guess again. It involves medical students having to cradle baby testicles and then, worse, peek inside the rear end to make sure there's a hole there, because *sometimes there isn't*. Yes, imperforate anus, possibly a candidate for one of the disorders the next James Bond villain can have!
After nursery this week, we have different specialty clinics each day. Yesterday was child advocacy clinic (re: child abuse) which was really interesting and the only two cases we saw had a minimum of soul crushery, so that was nice. The stories the director told though, geeze. People are freaks.
Today was pediatric heme/onc, which like child advocacy clinic, was way less depressing than I expected. The attending was really cool and let us interview the two kids that came in for check ups. Since peds heme/onc is an area with a lot of path, they had a monster microscope in the back with a ton of slides so at downtime, I asked if I could play with it and was promptly tied up with playing with iron deficiency slides for the next hour while trying not to break them. Damn 100X lens!
As I was back in the lab, I was overhearing a patient interview, significant in that it concluded with a ton of people making a ruckus in the hall. I poked my head out in time to see a pretty blond woman accompanied by a guy in a giant fox suit lean over to the last patient and say "Do YOU like basketball???" to which the child responded "Um... no?"
See, moments like *that* are when I love children. Not when I'm having to examine their nether regions. So the woman, undeterred, said "Well, you will!!!!"
Apparently we had a visit from the Nets. As an Ovarian American, I had no idea who the heck they were, but they were passing out signed baseball hats and we got a picture with the mascot, so cool. Unfortunately I don't think they realized that despite the potential for changing some frowns to smiles in a place called "Pediatric Heme/Onc", all the sick kids were downstairs and we had two kids, both of whom were perfectly fine and only in there for ten minutes for a follow up visit. And one of them doesn't like basketball.
Well, good night!
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.
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.
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!
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!
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!
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.
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.
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.
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!
Sadly, I don't have pictures because they don't allow them, and I'm not affiliated with them in anyway, but dayam. Awesome!
Subscribe to:
Posts (Atom)
