Tuesday, December 11, 2012

Homestretch with a Limp

I hate anatomy and I hate how my instructors are teaching it.  Their personalities are fun and their talks can be really entertaining but they're incredibly sexist: 64 slides on the male lower abdomen and sexual organs, ONE slide on the female anatomy, not a single female specific anatomy part on our 'to find' list but 18 male specific anatomy parts and yes we do have female cadavers.  I could go on and on with other examples***. I worry that it's not preparing us enough for the boards and clinical but more so I worry that this sort of sexism is pervasive throughout medicine and the course teaches for that.

This block has been tortuous. I've struggled to keep my motivation and bombed my first two exams. I need an 85% on our final to pass the course. I've been gunning the last couple of weeks because the idea of having to repeat this is about the worst nightmare I can think of right now. Besides, if I fail, I lose my scholarship thus costing me 60K. How's that for a perspective?

Last Friday, we had our 1st year radiology final. It was an independent study course that paralleled topics that we covered in our other classes.  The game of identifying different structures on different films was awesome.  I did well on it and it gave me some much needed confidence and motivation. Anatomy isn't medicine... Anatomy isn't medicine...

I have 4 more exams, including anatomy, in the next two weeks. Then, absolute, no guilt for not studying freedom.


*** Ok, one more example: 'fun' slides demonstrating aging included before/after photographs. For the male examples, we were given various faculty members and politicians. As women, we're expected to age like Sophia Loren and Madonna. ARGGHHHH! Seriously?????

Tuesday, November 6, 2012

Invisible

I've noticed a number of constants over the last few weeks of this course.  It took me a little while because our lecturers are fun. They joke with each other, poke fun at their favorite students and make a hard (boring) subject entertaining.

They also don't see the 40% of the class that carry two Xs.

None of the students pimped are women. Not ONCE have I heard a female name called out.  There's no negativity towards us; we're just ignored.

No examples in any of the pathological examples in lecture are female bodies.

And today during an embryology lecture on the face, the composite photo of variability examples consisted of:

Men                                                       Women
1. Harry Truman                                        1. Jennifer Lopez
2. Michael Jordan                                       2. little Pakistani girl
3.  A 40 something Asian Violinist               3. a perfectly symmetrical Asian teen model
4. Dwight Eisenhower                                4. A very young Sharon Stone
5.  A Caucasian Marine                              5. Tyra Banks
6.  Morgan Freeman
7. Geraldo Rivera

Seriously, am I reading too much into this? That the examples of 'variability' for us women are 4 western-world-idealized women and a child?



Wednesday, October 17, 2012

Celebration

So... to celebrate that I scored precisely 5 out of 58 on the practice anatomy practical tonight.. (EEK!)
I've compiled two top 5 lists.

Things that I misplace daily (which is really annoying)

1.  The lens cloth for my glasses.  My glasses are chronically smudged and I've an unhealthy dependence on wiping them, an act I perform several times an hour.  You can call my microfiber lens cloth my security blanket. I refuse to use anything else (besides kimwipes swiped from the lab in desperation) because a) glasses scratch really easily and b) they're insanely expensive.  Last night, I emerged from my apartment after 11:00 for the 24 drug store because I direly needed a new cloth. They're like those single socks in the dryer; they up and disappear. This morning, the cloth was gone. Seriously. I set it on my counter and it walked away while I was sleeping.

2. My Ipod nano. It disappears from the gym bag pocket that's its home on a weekly basis only to return (after tearing apartment apart in search) to that same pocket. It's like the traveling garden gnome; at times I half expect postcards of 1.98x10^14 fathoms per fortnight (my nano's moniker because I really am that dorky) posed on the Great Wall.

3. Any important mail. I have the horrible horrible habit of sticking it in the book that I'm currently reading. When I go to retrieve it, I have to try to remember which volume du jour it had been. Books spore you know. You think that you have only a few hundred but then.. you blink... a week passes.. and suddenly you're tearing through thousands looking for the stupid electric bill.

4. My Ipad stylus. Despite the fact that it has an established home, like fathoms- it has pathological wanderlust. I put it in the same pocket of my bag after every class but when I return to put it to work, it's gone! I swear the Bermuda Triangle is legitimate, effective and exists in my bag.

5. My cell phone.  I actually don't have a problem with its disappearance days on end. I don't use my phone very often and my family has learned that email is a much more reliable way to get a hold of me. It usually will turn up randomly like when I'm putting groceries away or running a load of laundry.

List II : things my cat eats that she shouldn't

1. My houseplants. EVERY. SINGLE. ONE. HAS. BEEN. DESTROYED.

2. My remaining windowsill herb.  Apparently, cats love basil.

3. My Ipad charger.  ARGGHH!

4.  Used Qtips. She unlatched the bathroom door, opened the cupboard and dug out the Qtips. She was on a mission!

5.  My favorite pre-school splurge:
Sigh.... I really liked those shoes.





Thursday, October 11, 2012

Dangling Threads

So far the greatest challenge of medical school for me has been keeping track of all the random ridiculous things that I'm responsible for.

Coming in, I had feared most that I wouldn't be able to manage the actual academics. The coursework though, has been really manageable. In contrast to undergrad, all the professors want us to succeed and work to make things clear and graspable. It's been pretty effortless to do well on the exams.

The overall BCMS organization is really confusing though. There's a daily class calender on our homepage but there are three other websites with pertinent info that we need to be constantly up on.

For example, a couple of months ago, we had a meeting listed on our daily calendar about a mandatory project.  The group of us went and during the meeting discovered that we had been required to watch a video beforehand. I had looked around the lecture hall and saw the same WTF faces on everyone else.  Afterwards, I spent 45 MINUTES hunting for any clue about the prereq or the video itself. Finally, after discovering, thru a link on a link, I found the assignment. Crap.

During that same hunt, I had stumbled on a service requirement that's due this coming week. Fortunately I made a note then and there and have been assiduously keeping at it. The assignment suggested going to two school departments for assistance but when I went, the folks there had no clue what was required. It seems the project is brand new to our particular class. But there has been no other mention anywhere else. Yesterday, I posted on our class facebook page reminding people about it and immediately received dozens of responses. It seemed that no one else had even known it existed.

It's been a reoccurring nightmare that I overlook something and fall into serious trouble with the school.

Well, this morning, I received THE EMAIL. For every completed course, every individual student is required to complete evaluations. The powers-that-be even send out email reminders.  There's even a tab on our homepage leading to the evaluation forms. Believe me, remembering all 20 lecturers for a particular course in order to evaluate them individually is a chore but I pushed through it. Well, it turns out that we're also responsible for evaluating the course in its entirety, link found on a different previously unknown website. Oops.

It burns me that I first hear about this requirement through an email telling me that I didn't complete them and my permanent record has been tagged with a 'concern for professionalism'. I can't help but wonder how many BCMS graduates have been 'tagged for unprofessionalism' because of the insane, confusing way the school HIDES the requirements we are supposed to fulfill. I hope if most of us get a tag here or there, it doesn't make a difference overall. It almost makes me regret letting my classmates know about the service assignment. I could have had lots of company in my unprofessional behavior.

I guess it's an augury for what my future as a physician will be: lot's of weaving unnecessary dangling threads (insurance, paperwork, bureaucracy etc) into a blanket while trying to improve patients' health.

ARGHH!  I want to SCREAM!!


Wednesday, September 26, 2012

Deflated Like a Flan in a Cupboad*

*partial Eddie Izzard quote..



So my romance with the musician fizzled. All I wanted to do was talk about anything but school and all he wanted was to hear stories about medical school.  Besides, he wouldn't listen to any music but his own. Not cool.

The first block of classes has successfully ended. Starting off with material that was familiar and came easily had spoiled me. Now, I'm nervous to all git about this new block: DUM DA DUM... anatomy!...

I like concepts, pick them up pretty quickly and love figuring new ways to apply them. Going into exams for cellular bio, chemistry or the MCAT (I can't believe that I'm admitting this...), I would secretly get excited like I was starting a new trivia pursuit game. Woohoo! A challenge! It was easy to see the trees and not the forest. I would approach each question like I was playing Whac-A-Mole.  Long confusing question? BAM! Knock that varmint back in the hole. I would leave the test giddy for all the rodents I had smushed and unconcerned about the few that I knew I missed. We all miss some of the little buggers when they pop up. The significance of the test in the grand scheme never really occurred to me until long after the effect.  My nerves have always twisted in those spare seconds before opening the results.

Well.. I just can't seem to get excited about anatomy. No game, nothing to figure out, either I memorized the material or I didn't. I'm really a pretty lazy person and an easily distractible one. This is something of a nightmare: sitting down for four months of nothing but brute memorization on an epic scale.

It's going to be an amazing struggle to keep up with the material. Bah.

Oh.. and herb plant numera tres esta muerta. Descanse en paz, Aloysia Citrodora...

Friday, September 14, 2012

What a Wonderful Life

It's been so long since I've written and nothing very significant has happened.

I'm doing very well in my classes. They're not as challenging as I had feared and so I have unexpected free time. I've been reading quite a bit. In anticipation of gross anatomy starting next week, I've been reading Stiff by Mary Roach.  It's humorous and irreverent, yet somehow respectful.

I just finished a two hour conversation with my closest friend, an adventurer living on the other side of the world. I investigated and she's now exactly 173 degrees longitude away from me.  We hadn't spoken since I started school and it was wonderful to catch up.  She's so very different from me; she's amazingly spiritual, artistic and sensitive. She can float through a social event and engage anyone. People remember her laugh decades after meeting her. Somehow our opposites fit perfectly like Emil Fischer's Lock and Key enzymes.

One of our few similarities is our chronic singlehood. We'd rather be alone than in an unsatisfying relationship. Yet over the last few weeks, we've both met someone. Ironically, our new lovers are the ideal for the other!

She's dating a serious, bibliophilic pragmatist and I'm dating the sensitive musician, a bass player.

As I mentioned, school is going really well. I honored my first two courses and have been tapped into tutoring some of my classmates for our upcoming biochem final, a daunting endeavor.  Knowing the material enough to do well on a test is one thing; knowing it enough to explain to pedantic, obsessive medical students is something else entirely!

We met our cadavers last week. There was a ceremony. All of the students, the ministry and many of the faculty came. Several students spoke about how this lab defined the true transition into 'doctor training' unlike the distilled science that we were currently studying. During the service, I had stood next to one of our primary science lecturers and I saw hurt in his eyes. Though I felt similarly about the significance of this transition, I felt awful.

Later that week, during a lecture, the professor commented on the ceremony. It wasn't directed specifically toward the student who made the speech but we all understood who the professor meant. The student turned red and slunk into the seat. Facebook encouragement flooded his/her inbox.

Though I was only peripherally affected, the situation made me so uncomfortable. I can easily understand both perspectives and the vulnerabilities of both student and teacher. The professor put in so much work to organize meaningful and useful lectures for us. Facing the boards next year, I know I'll be thankful for the precise and detailed handouts my teacher created. Yet, the anatomy lab is the first diversion from what has essentially been an extension of our undergraduate education. It is symbolic of our transition into medical training.

I face my first standardized patient next week in the hopes of successfully completing a history. If you had asked me last year, I would have never predicted the anxiety I feel now!


Tuesday, August 21, 2012

Exams, Here and Gone

There are a couple of folks in my small group section who 'know everything and are always right'. Ahem. Cough. Cough.

It drives me crazy when they come to a conclusion and then stop without considering another idea.  Several times now, an alternative answer has been dismissed or an inconsistency has been pointed out and then ignored. It's not that big of a deal; we're all pretty respectful of each other and, most of the time, we listen to the others' contributions. It's just that, maybe because we're being overwhelmed with new information, there lies a thread of intellectual laziness, an 'I don't understand why- I just memorize the correct answer' attitude.

It's just that I tend to want to look really deeply and make things more complicated. It's a study habit I've had since high school. Wondering "what if?" helps me to really incorporate the material, see it from all angles and prepare for scenarios that may be presented on exams.  I know that it's probably annoying when I seem to make mountains out of anthills but there have been several occasions when I've been completely on the mark of what the profs are looking for. (sometimes I'm totally off-base- but we'll disregard that as it doesn't support my point :) )

Anyway, it happened again on 3 of the problems today. Huzzah! I feel so smugly validated at being right.  (I'm sure my classmates never noticed, in hindsight, that I gave the correct answer, but I sure did!)

I also honored my first exam!


Friday, August 17, 2012

Friday Night, Weekend pre-Exam

Our first two exams menacingly loom over Monday morning.  I was managing just fine until this past Wednesday, when the lecturer piled 65 densely packed slides of intricate reaction mechanisms over 150 assigned pages of reading. Some of it was familiar; much was new minutiae. Ugh.

She repeated this distribution level both Thursday and today so I now have a mountain of new information to conquer before the weekend is out.

I'm in pretty good shape. I knew last week's material cold and have some familiarity with that of this week. I really feel for my classmates who don't have my chemistry background. They have a Herculean task. I think I'd rather steal the golden fleece, myself.

Anyway, I set up a study schedule and because I'm sacrificing my weekend to the (greater good?) of acing my first exams, I decided to treat myself to a pre-celebratory sushi dinner.

I walked down to the neighborhood sushi bar with my (amazing) Ipad full of notes and readings and snuggled into the banquette at a corner table overlooking the bustling bar.  Glass of wine in hand and saba sashimi on the way, I began to review ubiquitin modification in DNA repair. (awesome right? yawn.)

Losing myself in the notes, I didn't notice the couple next to me until the lady asked me what I was studying. I glanced down at my pad and then back to her smiling face and said. "Biology".

"Oh! Are you in nursing school?"

I smiled at her (I get that question a lot). I'm sometimes embarrassed to reveal that I'm in medical school; I don't want to EVER seem to be boasting and it's the type of confession that provokes preconceptions. Nonetheless...

"Medical. I'm at BCMS." (inner grin-thrilled at the self-reminder)

Gasp. Pause. Blurt.

"I've never seen a chubby med student before!" I could tell by her face, she was mortified at what slipped out.  I couldn't help my sharp shocked bark of laughter. Sometimes people just say the most awesome things.

"Oh. They make rare exceptions for really brilliant applicants." This was one of those rare times when my witty comeback didn't wait to 'come back' several hours after the fact.  Hee. She and her friend quickly settled their bill and I ordered a second glass of wine and some edamame.

I'm so glad I did! The next resident of the table turned out to be an adorable late seventies gentleman in a straw boater with a pale blue ribbon. He was unfamiliar with sushi but looking to be adventurous. We chatted; I gave him my recommendations and he told me about trying new things since his wife died.  I 'wasted' an hour of study time (totally worth it) meeting the character I hope I become when I grow up.

We left at the same time, hugged outside the restaurant and I turned to watch him stroll away, dapper with cane in hand.







 








Wednesday, August 15, 2012

Classmates

Today was a day of firsts. I finally met a classmate that I just cannot like.  Normally, I try to look beyond the irritating (god knows- I'm sure I can be really annoying too) but just sitting near this person, hearing the vitriol (s)he spewed about other classmates and the inane, superficial chatter that interspersed the venom, was absolutely torturous. I so profoundly hope that I never have to work directly with this person. Ever.

Another first; I met a classmate who just doesn't like me, one of my small-group members. We meet once a week and, under the guidance of a physican-proctor, discuss suggested readings, ethical issues and learn the practical side of medicine. Every gathering, one person, assigned alphabetically, is responsible for writing up a summary of the readings to guide the discussion.

Well, the largest (by orders of magnitude) reading chunk was the week that my turn fell on.  We found out today though, that the group doesn't meet the week prior to that.

I sent out an email suggesting that this other classmate and I exchange assignments as I had already started the reading and the summary for the massive task. I thought that I was being nice, volunteering to keep the big assignment. Oops. I was wrong.

My classmate immediately shot back a response. It was polite but angry, telling me that the original order should be kept and it didn't matter if I had started the reading because "everyone should read everything" anyway. Then after lecture, my classmate brushed right by me without a word but with a very articulate glare.

I'm pretty bothered by the exchange. I like everyone in my small group and really felt that the environment was encouraging. I guess I'll just wait and see what next week brings.

We had the sexuality lecture in Human Development. It was awesome. The professor taught the men all about proper foreplay (laugh) and peppered the entire 2 hours with anecdotes from his tenure working in the Emergency department. The things people insert into their bodies! Ew.





Monday, August 13, 2012

Second Week, Day One

Well, I'm firmly entrenched in the grit of medical school. We've covered 1/6 of our biochem/cellular bio course and our midterm is next Monday. My. Birthday. Huzzah!

I'm actually feeling pretty comfortable (so far) with the pace we've set. I'm sure, though, that I'll have a different sentiment this coming Sunday. 

We've had a few lectures in our development course on men's vs women's health, full of statistics and how social constructs affect medical outcomes.  It struck me though that the men's lecture was full of clinical techniques to counter these issues but there was not. a. single. one. introduced in the talk on women's health despite so many more inequities being quantifiably demonstrated (representation in clinical trials, the masculine body being the normal presentation in academics etc. I won't even go into the social/cultural contexts women deal with). 

Our class is, strangely, predominately male. A 60-40 ratio, I think.  Even with this disproportion, the female contribution, whether in the form of questions or thoughts, has been minimal. Besides my own, I've only heard two other feminine voices raised in lecture. Is this normal at other schools? I would have thought that anyone who reaches this stage in their education would be more assertive, more confident in contributing.

The school's fitness center is right next door to the building our lectures are in. It's amazing! Before, I'd always had the best intentions regarding working out but I rarely followed through beyond the first or second week. Now, it's pretty effortless. I go to class in the morning, study on campus for a few hours afterward, then walk down the hall toward the parking garage. But, wait, there, a beautiful pool, steam room and hot tub! So I wander in. I tell myself "you can relax as long as you want in the jacuzzi, just first: run 2 miles and swim 2 laps." So I do! It takes about 45 minutes and then, I soak. LOVELY.  I can already feel the difference in my body, I'm falling asleep more easily, waking up more readily and can really focus on the class material.  I know that I wouldn't make the same effort if the gym wasn't so bloody convenient. I actually felt guilty last Friday for skipping out early. I'm determined to get my resting heart rate down to the 60s (I'm high 70s-low 80's now) by the end of the term.

That's all for now. I'll update more later this week. 











Wednesday, August 8, 2012

First Week Halfway Point

I'm halfway through the first week.  It's been a rockin' start.  Classes start at 8:00 am and run until 4-5pm (except Tuesday, when we leave at 6:00).  BCMS is easing us in.  The only uber-demanding course is the biochem, which, thus far, has been all review for me.  Hee.   The small-groups meet first for 3 hours and work on the assigned problem sets covering the previous day's material. Then we all gather for the new 2 hour lecture.

I've always been an independent learner. Usually when I 'study' with other students, it's more distracting than constructive.  I've always performed well on exams after solitary study- not so much when I've had study-partners.  That said, the small-group format here has really impressed me. We've had 2 sessions thus far and I really feel like I understood the material so much better afterwards.

I'm officially a medical student! Sometimes that thought just trips across my mind and I can't help but grin. I'm really happy.

Some of my classmates are awesome and some haven't made such a good impression. I'm trying to not be judgmental.

All of the opportunities are overwhelming. We've already been introduced to so many, I can't keep them straight. I'm giving myself until the end of the month to acclimate to the academics and then I need to start planning the next four years. Research? International Study? Honors program? Interest groups?

Over the last few months, I had explored different study/organization options and settled, hesitantly, on an ipad. It's totally worth the insane amount of money!  I'm not the most tech savvy individual (I'd always been a paper and pen note-taker) but my transition has essentially been seamless.  Every day, Dr. __p____, my BC professor alone posts over 60 pages of slides/notes/objectives. Multiply that by all the classes of an MS1 and you'll get aching shoulders. With, i-annotate (an application) I can organize, write notes with a stylus, type etc over any file format (that I'm aware of). Sliding a tiny 1.5lb sliver of brilliance into my bag totally beats lugging around 50+lbs of books/binders. I wish I had had one as an undergrad; my back would be healthier.

Oh and the cat killed another herb, the chives. Only a few seeds had sprouted but I babied the group for weeks, hoping that they'd proliferate. She pulled them all out by their roots and left them scattered across the hardwood floor. That's 2/6 of my herb window garden gone. Bah.







Sunday, August 5, 2012

Orientation Week and the Night before D-Day

Wow.

Last Monday, the line for registration wrapped around the atrium and stretched down the stairs.  130 students waiting anxiously to check in; last name first, first name last. I listened as my new classmates shuffled forward. Smith, Dana. Check. Jones, James. Check. Here's your packet, fill this out, drop that off at security. Make sure you complete everything on this list today. There won't be other opportunities.

Finally, it was my turn at the broad folding table in front of the library. I opened my mouth to state my name, last name first, first name last, but the folks from admissions said it for me.  They recognized me from brief interactions 7 months ago! I guess the little brown wren stands out when surrounded by swans.

This past week has thoroughly erased any hesitations and doubt I've struggled with. I'm so excited for all the opportunities laid out like an academic smorgasbord. I'm really going to have to work on my gluttony and make some hard decisions. Next summer, do I organize a research project or take advantage of the extensive global health immersion programs my school offers? I want to do both!

During one of the 'get-to-know-us' lectures, the dean put up a grid of our ages, MCAT scores and GPAs. I'm the oldest, in the bottom third grade-wise and tied at the top for MCAT score. The class, with an average age of 22, is so young. There are only three other students in their thirties.

The week consisted of a series of social meet-and-greets.  The most common conversation pieces consisted of "Where are you from? Undergrad? What have you been doing since college?"

Everyone seems pleasant enough. They're all so tall! I only spotted one other vertically challenged student, a competitive gymnast.  I am grateful (sort-of) for my excess adipose tissue. The fat hides any wrinkles and I look younger than I am. No one guessed that I was at the apex of the age pyramid and the looks of disbelief when I confessed were gratifying in a superficial way.

I glanced through the pdfs for tomorrow's eight hours of lecture (!) and am already overwhelmed by what we're going to cover. It's going to be a doozy of a year.



Sunday, July 29, 2012

Orientation Tomorrow

My anxiety has evolved into anticipation. I spent the evening checking and rechecking all my to do lists confirming that everything is, in fact, done.  I'm really excited.

Tomorrow is going to be mostly routine legalities: computer class, bursar's office, fin aid, security for parking and ID badge, student health etc.

Tuesday and Wednesday will consist of 'meet everyone even remotely affiliated with BCMS' talks. Deans, class leaders, volunteer services, student support services, advisors, student advisors, med spanish group, security systems, the janitors, patients who haunt the ED and the guy who rides his bike past the hospital every day all have an hour slot to tell us what they're about.

Thursday and Friday are the CPR classes. Luckily I'm slotted for Thursday so my first med school weekend is a 3day! Booyah!

Well, except for the "voluntary" day of service on Saturday.  Actually, I looking forward to it, it being the first time I'll really engage in my new neighborhood.

I leave you with a few photos:
Teton Range: Middle Teton is the far left peak
Me on Middle's summit with the Grand at my back

Even the homestretch had stumbling blocks
I know, I know, climbing a mountain is so cliché but the pimple on my chin looks exactly like the Grand Teton and I couldn't help myself. These photographs have the double contradictory effect of lifting my spirits and keeping me humble.  After my photo is taken twice tomorrow, once for the ID and the other for the composite class photograph, I'll carry (literally) the memories of my climbing adventures all through school.
 








Saturday, July 28, 2012

Homestretch/Green Mile

I've had a busy week.

I've reorganized my closets. Twice.  And replaced the inner tube on my bike's front wheel and bought a new saddlebag basket and new reflectors. It's been a few years since I've biked regularly in the city and I can barely wait to get back in the habit.  I love love love not having to find, or pay for, parking!

I killed one of my herbs, the lavender. I don't know what happened. It had good drainage and I watered daily. I think the heat conquered. I fear that this is an ominous sign of the coming year. I'll report back next June on the number of plants that survive MS1.

I  had my respirator fitting and TB screen. Why do hospitals not trust other hospitals' ppd results? Tuesday marked the 4th time in the last 7 months that I was poked (once for the yearly at work and twice before volunteering at a hospice). But BCMS required that I have one done by them too. Argh. Of course, it was negative. Again.

The obligatory pre-first day pimple woke up on my chin this morning. Yay.

I've been trying, the last few weeks, to adjust to waking up earlier. With over a decade of working second/third shift, my body understands that anything earlier than 9:00 is obnoxious. But, this morning I woke up before my alarm at 6:45! I'm thinking optimistically that it's the retraining of my circadian rhythm and not stress, despite the pimple. And the nightmare.

Ask any professional restaurant server (the career that paid for all my adult life) and they'll tell you all about the typical server nightmares: the section or table that swells with new people every time you go back, the unreasonable boss, the evil chef etc.

Years ago, when I started working for a truly nasty boss, my server nightmares stopped. I suppose with actually living the nightmare, My superego had to deal with coping with the stress thus leaving nothing for my subconscious.

On rare occasions, the night before terminally extubating my mother or, as the case may be, the nights before medical school, the server nightmare manifests.  Last night, I was back working for the nightmare boss.  I guess that shows how stressed I am. MCAT pshaw, moving cross-country pshaw, tackling two full time jobs simultaneously hah!  The day before school being on par with deciding to let my mother die?!! 

I know that the next few years are going to bring incredible stresses.  I'll be really lucky if my nightmares continue to be about waiting tables and not about things that could happen in the hospital. I can deal with the angry diner who didn't get her Coke refill.

Today, I do laundry, clean, and pay all the bills for the coming months.

Oh. I received a call from my service provider. The other phone I pay for has shown a spike in activity; would I like to add texting to the plan? Apparently, my grandmother has discovered a great new way to communicate to her friends and family. She's sent out 637 texts this month alone.

It makes sense for a woman who is very hard of hearing- there are fewer misunderstandings. I laughed despite the added cost. My almost 90yo Gram is so tech savvy. She has more facebook friends than I do!

Tomorrow, I go grocery shopping- with my new bike basket! and hit the zoo. I wanted to do something fun and relaxing the day before D-day.







Sunday, July 22, 2012

One Week.

The moment came today. I was walking to the market, a truck drove by and cast a cloud of dust and grime into my face. I coughed and pulled out a cloth to wipe my glasses. Then it happened. My perspective shifted. Medical school ceased being a vague, holy-cow-not-really-happening-to-me, intangible ambition and suddenly became real.

The financial aid is in my bank account. Orientation comes next week and I pick up my books tomorrow. Tuesday is the ppd screen and respirator fitting.

I am so completely terrified.

I walked past the market, continuing on aimlessly. Thinking. I ended up in a little rundown park by the river in an iffy neighborhood and sat, staring at the garbage bobbing in the murky water.

Am I making the right choice?

I remember telling the doctor-uncle of an old flame that I was thinking about becoming a doctor. I was 21 at the time, fresh out of working in the national parks and hadn't even started college. I had no idea then how challenging just getting accepted would be. He wasn't encouraging, a sentiment echoed by the soon-to-be ex.  Life became dramatic and I left that dream on a musty closet shelf of an old apartment.

The years passed and I continued to ramble aimlessly across the country.  I found myself 26, living in Seattle with lots of disposable income. What to do? What to do? Hey! I'll take a couple of community college classes!

And so it began. That first day, my chemistry professor told us that half the class would drop before the term's over. Humph. I'd show him. And I did. I ended up with the highest grade in the class and friends with a premed aspirant. She reminded me of the idea I had had once and, soon, I found myself on the road to medicine.

It quickly became apparent how competitive the premed curriculum and the med school application process were.  My ambitions were not very well received on the family front and my college mentor adamantly wanted me to go into a graduate chemistry program rather than medicine. Having striations of a strong Irish-Scot stubbornness, my "I'll show them" attitude came on gusting. Somehow, the determination to succeed, to beat the challenge by getting an acceptance got tangled up with my purer reasons for wanting medicine. Those reasons I had had before I knew that the challenge, the doubt, existed.

Today, in my terror, I tried to unwind them. Am I starting this insane, exigent path for the right reasons? Now, having shewed them, is this what I really want?

Or is my fear that I'm not good enough, that I won't, can't succeed, murking up the waters, like the garbage floating in front of me, causing me to question my own motivation?

I don't know. 

I'm reading my journal from work, remembering my favorite patients and how the medicine and the dynamics of medical care intrigued me. It's helping a little.

School needs to start. I'm hoping that once I'm on the rat wheel, I won't have time for these self-defeating doubts. Oh, I hope.









Tuesday, July 17, 2012

I Cried Today

A few months ago, I met up with a childhood friend. We had drifted a little apart over the years. I had moved out west, he went to seminary school in Massachusetts.  But we communicated every couple of months and I still counted him as one of my most trusted friends.

When he came into town for the Easter holiday, we made an effort to get together. It was the first time in almost ten years that we met face to face.

It started off great. We caught up on our daily lives (he's building a massive orthodox church in Vermont- I recounted my school application adventures) and then we talked philosophy. It had been a shared passion in high school-one that we'd both explored deeply since.

I minored in moral philosophy in college and absolutely love the intellectual sport of debate. We found ourselves discussing the continental rationalists and I argued Spinoza's work over Leibniz's. I joked that it was ridiculous that Leibniz couldn't comprehend infinite regression in his monadic theory but that he had no problem with it mathematically. After all, calculus is, in part, the study of infinite series.

Everything was going great, we had coffee, we laughed, we reminisced. I treasured that, despite our differences on the religion front- rather because of those differences, he offered an intelligent insightful world viewpoint. One that, as a scientist and atheist, I'm not often privy of. Most of my other friends hold similar views to my own.

Well. As our brunch wound up, he tried to save me, spiritually- that is.

I'm not a militant atheist. I hate that I'm labeled by what I don't believe in. I don't believe in many things- Santa, the toothfairy. I wouldn't like to be called adentemfatist. It seems another useless qualification.

I tend to be very shy about my lack of belief. I've seen how much comfort the sick, the dying and those left behind obtain through their beliefs. I saw how much it helps my grandmother to believe that she'll be with my mother again in the Catholic heaven.  It seems to me, that broadcasting my own thoughts to others would only result in being hurtful for them. In fact, I sometimes wish that I could acquire that same comfort. I miss my mom.  But I can't convince my rational mind that it exists. It's just not there.

And I can live my life, fulfilled, happy and with purpose without believing in god. I truly think that it is impossible to convince, with a rational argument, the rightness in a religious belief to someone who doesn't hold that belief.

Anyway. Suffice to say, our brunch did not end happily. I tried to explain that I wasn't going to change my mind and "let's celebrate the diversity our differences bring to the lives of each other".

He wouldn't have it. He told me that he couldn't truly trust someone who didn't believe in god.  And he dropped our friendship in the rubbish can on his way out.

Well, that hurt. All of my care in choosing: eating ethically, minimizing my carbon footprint, volunteering in underdeveloped countries, helping people, spending days helping to clean out his father's church after a flood, all negated in his mind because morality can't exist without a deity to police our behaviors.

Today, I received a call from the financial aid office of BCMS. They chose me as the recipient in my class of their *Service to Humankind* Scholarship. It's a huge huge honor and I'm floored and humbled and thrilled and sad. 

I cried because a big institution, one that doesn't yet know my heart, the responsibility I feel to people and the world, looked at my CV and talked to my interviewers and decided that of all the brilliant amazing and worthy 200 people in my class, that I -stupid, underachieving, insignificant me- most represented to them, a moral spirit. (which is totally weird btw- seriously? me? I'm going to school with Rhodes Scholars, people who organized major endeavors to help others, people who have accomplished so much more than I in much less time. Weird.)  But my 'friend', someone who had known me, my heart, my choices and actions for over two decades... Bah.

Sigh. I guess everybody has to deal with getting over toxic relationships at some point in their lives.  I'm just having a really hard time doing that today.





Monday, July 16, 2012

Settling In

So I've unpacked and organized all of my stuff.  The apartment is small and technically a studio (though there's an alcove between the entryway and the kitchen- meant to be a dining area- I made it into a little bedroom.) It's clean with high ceilings, beautiful floors and tons of light.  I'm thrilled knowing that I'll have at least four years here. I finally have a home.

The last three years have been tumultuous for me.  I spent most of 2009 in a strange city, surfing the couches of friends of friends. My mom had had a bilat lung transplant and it hadn't gone well. Long story short: she spent 4 months post op in the ccu, graduated to the step-down vent rehab unit, crashed, back in ccu for 5 months, stabilized, transferred to another strange city to a LTACH for 3 months. SIRS -> MODS then she died.  The summer before her transplant, I arranged to finish my final undergrad requirements online and moved from Seattle to the east coast to take over as her caregiver, POA and medical proxy. After her death, we put the house on the market. I stayed there to keep it up and make necessary improvements but I continued to live out of my suitcase, not knowing when I'd have to up and move.

When we finally sold the house, I moved into a tiny studio knowing that I'd be moving for school in 8 months. So it never really became home.

Now... I can plan things like my window sill herb garden and the tomato plants I'll grow over the winter.  I grew these from seed- the far lower pot was the coriander that hadn't survived the 900 mile journey.

I also have a separate desk from my dining table! I'm so excited that in just a few weeks, I won't have to pack up all of my study materials to have a meal!

I'm living in a vibrant beautiful stimulating city. I have a home. I'm going back to school!  I'm on my toes with anticipation and happiness. Ironically, these are the times that I most acutely feel the absence of my parents. I so wish I could share the excitement of my future with them.

On another positive note: My cousin Becks, the crack addict, went through rehab a few months ago and has completely turned his life around. He's doing fabulously. He's out of a toxic relationship, has a new job and is really stepping up as a dad. I'm so proud of him!


Wednesday, July 11, 2012

Beginnings

So. I am sitting in a cute little coffee shop in my new hometown. School starts in 19 days.  My family 'helped' me move. I'm never never letting them again! This is my 5th move of >1000miles but it was more stressful than all the others combined. It's so much easier to a) hire strangers to help load/unload b) organize it without the input of those who think they know best. 

In hindsight, I can't help but laugh but in the midst of it all I had wanted to cry. 

I'm loving my new little apartment and all the things to do around here. I can't wait though to get my teeth back into academics.  I've been footloose for too long and want some structure again.

The school emailed me the MS1 booklist and I'm trying very hard not to jump the gun. I've been averaging a 'fun book' a day in an effort to cram in a year's worth of pleasure reading before school starts. I think that I've overdosed though.  I've reached the bottom of my 'to read' pile and can't drum up the interest to find anything else for the next couple of weeks. Any suggestions out there in cyberworld?

I'm off to the zoo now.

Tuesday, June 5, 2012

Not The Destination But The Journey There...


I am currently 13 hours into a train ride to Big City. I am starting my apartment hunt. I decided take the train because it was so much cheaper than flying or driving and I have the time.  I’ve only ever been on Amtrak a handful of times and they all were over a decade ago and on the opposite coast. Though I’ve traveled rather extensively by rail in Europe and Asia, the mode had never been part of my own cultural vernacular and so domestic intercity train travel never really crosses my mind as an option when I decide to go somewhere.

I think that is going to be changing. I’ve really enjoyed myself.  The entire process, from check in, the trip itself and leaving has been hassle free. I went through no crazy security check points, I could pack snacks AND DRINKS for the trip and I’m going to just step off the train and walk into the city.

There’s an old proverb that states “If time matters, and of course it does, take a plane: If time is even more important, go by ship.”

This train is my ship today. I love that distance traveled to Big City is part of my journey and not just an interruption.  I can stand, walk, meander to the dining car and have a glass of wine. I’ve interacted with a group of nuns, a family of Mennonites and the two potheads talking about volunteering at Lollapalooza next August.

The cars have wifi (Awesome!) and people just seem friendlier and more helpful. Maybe it’s the overall relaxed atmosphere. Anyhow, I think that I’ll take it.

Wednesday, May 9, 2012

Hometown Blues

The greater metropolitan population of my hometown is about 200,000.

There are over 90 bars, all of which serve the same house wine, domestic tap beer and have the same smoky dingy interior. There is one bookstore: Barnes and Noble- also the only free wifi location in town.

The male-female ratio is about 76:100.  Median income is 18,000 and 25% of the population lives in poverty.

The political tone is strongly republican and no one that I've talked to cares that the best gym at the local Y is men only.  After all, I'm such a feminist.

The average driver's age is 59.

There is a local racetrack and 2 movie theaters.  There are no art galleries.

A nurse on U8, one of the few who was interested in more than getting married and having babies, was after me for weeks to get together. Finally, we had a common day off and made plans.

I was thrilled to finally share conversation. She didn't show up. She sent me a text message the next morning telling me how sorry she was but a friend showed up in town unexpectedly.

Now, a week later, she acts as though we are best buddies, girl-flirting with me at work and constantly playing with my hair. I ignore it.  My resentment towards her is minor. Rather I resent that this stifling, backwaters town has so lowered my standards for friendship.  I miss my wonderful, interesting, reliable Seattlite friends.

She asked me if I was going to be sad on my last day next week and I laughed at her.

I hate this town and, now that my family is mostly gone, can hardly wait til I'm gone.

Monday, May 7, 2012

Matriculation


I passed my background check.  Though I didn’t have much rational doubt, I confess that I was terrified that somehow that check that I bounced when I was 16 had somehow snowballed into a felony that, unknowingly, had chased me for 15 years. It’s a relief that the federal government doesn’t care about my teenage irresponsibility. Whew.

I’ve withdrawn from most of my acceptances. I’m holding out on one though.  I know that I want to go to BCS but I hesitate to withdraw from town Podunk because ‘what if there’s a mistake?’ What if I withdraw from one and my financial aid doesn’t come through or I mistook the other’s offer and they didn’t really accept me? It’s safer having two places to go.

What if I mess up somehow on the stupid convoluted crazy-ass paperwork that they require?

I’m thinking about that student that’s on the waiting list and hoping desperately that she gets accepted. I want to give her that chance because waiting sucks. I was fortunate enough to know before Christmas but it wasn’t soon enough. I just can’t send that withdraw notice because what if it’s a mistake?

Friday, May 4, 2012

Countdown

It's the homestretch of my life at U8; tonight marked shift 10 in my countdown. I'm thrilled to be moving on and immersing myself in school but terrified at the idea of being unemployed for four years and intimidated by how hard medical school is going to be. What if I'm not disciplined enough?

In wonderful circular serendipity, one of my all time favorite patients, a friendly inspirational and endearing character is back for my last weeks.  I worked with him at the start of my time here and now I get to say goodbye. It's the perfect end to my clinical interactions and a great memory to tide me over until I get back to the floors in two years.

I decided to go to the big city medical school (BCMS).  I was vacillating between the two for months and had decided on small-town nearby because I convinced myself that my quality of life would be better there. (family pressure may have been a factor)

Then BCMS offered me an amazing scholarship thus giving me the freedom to acknowledge that I would be happier in the program and in the city. It was enough to topple even the strongest objections to the choice. Hooray!!

I'm going to the city next month to look for an apartment.  I'm so excited for this summer!




Monday, April 9, 2012

Patient Remembrance

A recent patient (P) of mine was a peripheral co-worker of my mother's. They both worked in different departments of a large institution.

I recognized her immediately but, fortunately, she didn't remember me. I'm always ill at ease when acquaintances of my parents meet up with me and express their own grief.

As the day went on, people from this workplace came and went visiting P. Well, someone inexorably knew me. Sigh. The news spread like wildfire through the waves of visitors and I was stopped a number of times in the hall to answer questions about my life, how my family is without my mom and to listen to how sad they were, how much they miss her etc.

Don't get me wrong, it's comforting to know that so many people were affected by mom. She was an amazing special woman. She was, without a doubt, my closest friend.

It just makes for an uncomfortable workday.

I'm training someone in the end stages of orientation. This person was practically running the group and so I was able to avoid more of the prolonged interaction.

It wasn't until the end of the night that I had to re-enter the room solo.

P. saw me and thrust out her hand.

"Kate! There's another Kate on the floor whose mom worked with me. It was so tragic her dad died and then her mom... Oh.. What was her name? Oh.. Not Kate.. that's the daughter's name.. What was her name?..."

I sighed.

"Her name was M___. I'm Kate ___. The only Kate on the floor."

P. stared at me for a moment then burst out in sobs.

"Oh.. your mom was the sweetest lady ever. We all miss her so much and think about her every day... blah blah blah blah."

I found myself comforting a hysterical patient for over forty five minutes about the death of my own mother; a woman whose name she couldn't even remember!

To cap it off, P. sent candy and a card to the unit after her discharge thanking everyone personally for their care. "Sue was so kind and helpful. Janet was so smart... etc" But she didn't remember my name! I laughed and laughed. It was so poetically ironic!

I sure ate some candy though.

Thursday, April 5, 2012

Neighbors

My neighbors are fighting again. They scream, swear and throw violent words at each other. It’s actually rather filmy. I’m listening to tranquil Leonard Cohen and eavesdropping on a explicit fight. The walls are thin; eavesdropping is inevitable.

Neighbors usually like me. I’m very quiet. I think about my relationships. They’ve all been boringly civilized. My last boyfriend and I broke up in a Vietnamese restaurant. Silent tears over a steaming bowl of pho and a hug at the end. He remains a friend.

I once dated someone who had abusive tendencies. It didn’t last long. Though it was, by far, my very worst breakup, I helped carry his boxes to the car. He drove away. I waved. We never spoke again. (best day of my life btw)

I’m not a screamer but it fascinates me when people react so strongly that they shout and scream and break things. They’re so very alive. I sometimes wonder what it would be like to lose that control. I just can't picture myself letting go like that.

Monday, March 19, 2012

Oh Brother



Sometimes, my oldest brother has a way of making me feel as small as a flea. I love him desperately; he was even more excited about my first acceptance to school than I was. I can remember the look of thrilled shock on his face when I told him. Everyone should have someone to be so genuinely, unselfishly happy for them. I’m fortunate.

That said, he’s a freakin’ type A, control freak, micromanager with so-not-his-business. Argh. I called him today to chat. We take turns calling and so usually talk several times a week. I mentioned meeting an aunt for coffee and visiting our maternal grandmother in the afternoon.

Gram took great pleasure in reliving some of my “stubborn little pip” anecdotes. She and my aunt laughed at memories of me, a naked 4 year old interrupted from a fight with her brother, claiming that “Just because little girls are staying with their grandma, doesn’t mean that the grandma OWNS them.” Apparently, I was aware of my civil rights even at age four. I blame my mother.

I gave him quick updates on several of our cousins then mentioned finding sprigs of pussy willows on a walk. I have bouquets of willow shoots, winterberry and dried hydrangeas, pretty, easy to maintain and much much cheaper than fresh flowers. He’d always admired my displays when visiting.

Anyhoo, I also mentioned that when I went to the market I noticed that sashimi grade tuna was on sale for 7.99/lb and splurged on a filet ($5.28). I was excited to indulge myself on this weekend off.

His temper exploded and he ranted. How I can’t expect to pay for school, our shared mortgage etc, if I can’t budget my income… blah blah blah.

Now. I. Am. A. Freakin’. Penny. Pincher. I can satisfyingly squeeze a week’s worth of meals on a $30 budget with some creative use of spices and inexpensive staples (quinoa, eggplant, cauliflower etc.). I am also a master of the free/cheap entertainment: volunteering with the zoomobile for a free season pass to the zoo, free city wifi and no cable TV, forgoing downhill skiing for cross-country in open parks. I haven’t seen a movie in the theatre in years. Other than a few pairs of (clearance-no grey’s anatomy for me) scrubs and my interviewing suit, the only clothing I’ve purchased in the last 2 years has been socks and underwear.
I don’t mind. I’ve always been pretty low maintenance, but hell if, at 31, I’m going to be explaining every little purchase to anyone. I told him so. It escalated. Dammit. He’s just like our father; careful, loving and thoughtful but rigid, old-fashioned and by-the-book.

I remember being a teenager and chafing against my father’s restrictions. It was the primary motivation for my moving thousands of miles at eighteen to work for national parks. Every time that I jumped out of a plane, hitchhiked to the rodeo, climbed a difficult mountain or pushed myself past things that scared me, I thought “so there!” to my father.

Right now, I’m garnishing my tuna in a lemon wasabi remoulade (less than $1.50 to make- even with locally raised free range and hormone free eggs) sipping a glass of prosecco ($2.25) and thinking “so there!” at my brother.

Addendum: My brother, bless his soul, sent me an apologetic message a few minutes ago. He and my (favorite) sister-in-law have been under unrelated stresses and he didn’t mean to take it out on me. * sigh * How can I maintain my rebellious angst (damn you! Camus and Morrissey) when my family is so bleeping awesome?

Wednesday, March 14, 2012

Quality of Life

We have a patient on the floor, a social admit. Adorable. She’s completely independent, mobility-wise, and wanders the floor constantly, asking that her ever-present Styrofoam cup of prune juice to be reheated. She flirts with all the men, telling them they’re the spitting image of Clark Gable, sugar lips and all.

From the desk, I see her make her revolution around the unit. She pauses next to the room with the moaning confused man with a hip fracture. I see her raise her hand to the doorframe. She makes no move to go in or even peek. But her hand trembles and she’s obviously affected.

She continues on to the end of the hall, looks out the window at the pitiful view, then returns to the desk and asks me to heat up her prune juice. As far as I can tell, she doesn’t actually drink the stuff but promise her a new fresh cup and she beams.

She makes several rounds, pausing outside noisy rooms and staring out the windows at the end of the corridor. This time of year, the trees are naked and the sky is grumpy. She’s riveted though. She always comes back to the desk and chats with me. It’s the same short conversation throughout the night. She doesn’t feel like doing the dishes. Can they wait until the morning? She’s tired and wants to go to bed.

Despite her fatigue, she makes another rotation. Whenever one of our staff passes in her in the hall, they call out her name with a bright hello. She beams and tells them that they’re the spitting image of someone famous. I look like Ann Margaret. Preeti looks like Pocohantas and Aimee’s Linda Blair.

We talk about patients and quality of their life. This lovely special little old lady has been able to affect the quality of life of everyone on this unit. Talk about giving back. We’re blessed to be a way station on her journey.

Tuesday, March 13, 2012

Hovering

So my nurse manager has been present on the unit later than usual these last few days. He’s interviewing graduate nurses for our summer influx. Between his interviews, he hovers around the desk. I think it makes the nurses nervous, but I used to work for an honest-to-god narcissistic personality disorder with an impulse control problem. Mauro used to chase us down the restaurant screaming and spitting in front of the guests, just to make sure we dropped a check in a timely manner. He was CRAZY. Hovering Nurse Manager (HNM) is easy-peasy in comparison.

It’s actually been great. I think he’s finally seeing how busy our shift can get. Yesterday, the phone was ringing nonstop, the call bells dinging and two of our surgeons were piling their charts haphazardly across half-wall of the nurses’ station. BAM! Two of the charts fell and exploded like ticker tape flutter across the floor.

The nicer of the surgeons picked up the mess and brought it to me to reorganize. The other surgeon complained to his PA about the cheap folders the hospital uses for charts. HNM whispers to me that maybe he should call another nurse in. I snorted and said that it was calm compared to the previous day and he turned new eyes toward the scene.

The resident, interrupted by her pager and a call from the covering attending, swore during her dictation. As she rushed to the PACU (something about p-waves), she called out a verbal orthopedic consult request to Mean Surgeon. He turned to Lackey PA and snidely commented that she was going to save a life. HNM turned to me and asked if I had heard her swear. I mentioned my childhood with brothers and an acutely developed selective hearing. People swear. There are bigger things to worry about.

As I shuffled through the disordered progress notes, we chatted. I mentioned my love of Nick Drake and the new discovery of Damien Rice’s music and HNM said he totally digs him! How awesome is that? I am a little resentful though that so many people have known about this great musician for so long and didn’t share the riches (Yes, I’m talking to you, Solitary Diner ☺).

I notice that the admission orders for one of the charts being reassembled demands that the patient (admitted last week) be under cardiac monitoring. OOPS. I point it out to Nurse Manager then page Cursing Resident. She calls from, ironically, the telemetry unit. I hear in the background: “GI Bleed-rapid response”. I hand the phone to HNM who takes a telephone order to discontinue cardiac monitoring.

I update the Kardex, manage a new flurry of phone calls and flag down HNM to record a critical labs result. I admit it is nice having an RN at the desk. Normally our charge takes a group and so I’m left responsible for all the mechanics of unit flow. Though I like having my finger on the pulse of the action, it sucks that there’s such limitation to my scope: I can’t take telephone orders, record critical lab results, verify medication orders or ‘waste’ narcotics (verify the use of only a partial dose) for the nurses. I sit helplessly waiting for someone certified to have time to step in.

I often stay late to finish up everything I’m allowed to (checking diets and labs, stuffing charts etc) but it sucks when there are dozens of charts to be checked (hours of work) and I’m on the elevator waving goodbye at the bleak faces of nurses with a longer night ahead of them.

This week, I hope that HNM realizes how much work gets delayed because he doesn’t schedule a nurse to run the desk after 1500. I really think that if the powers that be break it down, it would be much cheaper to eliminate my job and add a nurse to the roll call. Having a nurse at the desk would likely eliminate at least 6 hours overtime every night. That combined with my income minus said nurse’s wage would amount to more than $45,000 saved for the institution every year.

Saturday, March 10, 2012

Laundry Pieces and Admission Oppositions

Laundry had piled up. It had overflowed from my hamper in the bathroom sprawling into the hall. Plus, I was completely out of clean underwear, even the old granny panties formerly buried deep in the bureau. So I spent the morning, and two rolls of quarters, at the Laundromat, armed with two months of un-listened to news and politics blurbs on my Ipod. I am now caught up, sort-of, in a dilettantish way, on world mechanics.

I was listening to the NPR weekend edition podcast “In Today's Economy, How Far Can A GED Take You?” from 2/19 and the closing music was the instrumental of Dar Williams’ “February”. It’s my least favorite song on that album; I prefer “Southern California Wants To Be Western New York”- mostly because I was once (still am? ) a mousy SUNY student composting in long underwear and the idea of being lusted after… a lovely novelty. Still… I love NPR ☺

Also fruit flies that drink alcohol are protected from parasitic wasps who can’t hold their liquor. It’s self-medication of an awesome sort. Courtesy of “Cheers! Fruit Flies Drink To Their Health, Literally” from weekend update 2/22.

I went head to head with admissions last night. Our unit was one patient away from its limit. Our nurses are not supposed to have more than 7 patients (which, in my opinion, are still way too many, particularly with the acuity we often have on our med-surg floor. It’s dangerous). Anyway, we had been slammed with 6 admissions/add-on post-ops, all within an hour when we got the call for the final one: 50yo man 400lbs AMS and oozing cellulitis, combative, infected with everything that you can think of, bacterial and viral. Bah.

I studied the census board and then called down. We’ll need to move these ladies together, transfer that dude to that room and then we’ll put Conan into this bed.

Admissions response? “Just put Conan into bed 36A.” I could hear her eyes rolling through the receiver.

“We can’t put Conan there. The roommate just had a major surgery. You don’t put infected patients in with surgical. Besides he needs to be closer to the nurse’s station. We don’t have enough staff for a sitter.”

She argued.

Jeez. Did she think I was just looking to occupy my time? We were crazy busy on the floor and who would be doing the actual physical transfer of the patients and all of their belongings and update all the computer records, charts, assignment sheets, ADT book and kardexes? ME. All she had to do was enter in a few keystrokes.

More arguing.

I called the nursing supervisor. She came up, glanced at the census and then called down to the admissions office.

She !!still!! argued but, eventually, the lady in admissions acquiesced and plotted the patients.

Seriously.

Tuesday, March 6, 2012

Choices

I've narrowed my school choices down to two. One is in a small city just a couple of hours from my family and the other is in one of my favorite metropolitan areas a long flight from home.

Both schools are wonderful, state of the art and awash with opportunities for their students.

This is the first time that I've ever been so excited to make such a hard decision.

I'm tempted to choose metropolis because the program starts a month before small city and I can't wait to get started!!

I'm loving life right now!

I've also fallen in love :)

http://www.youtube.com/watch?v=dRPwFAoQwxc&feature=relmfu


I know.. I know.. but his voice is haunting.

Thursday, February 2, 2012

'Tis the Season

We are awash with new fractures, new nursing students and bad weather in this neck of the woods. My work days are long and busy.

There was a call in tonight so busy became frenetic. There were the usual culprits of laziness but I was amazed with one of the nurses.

Airyeal* is one of the younger staff members and has always given the impression of someone who doesn't really care about anything outside the scope of her own comfort/pleasure. Tonight though, she was incredible with one of the students. She spent her entire break showing the student the ins and outs of charting, how to find information in the computer and in the chart, and what particulars are important to know as a nurse.

It was awesome and set a really good example for the rest of the preceptors. Watching their interactions totally made my night.

Tuesday, January 24, 2012

Drink of Choice

It was a very busy day at work tonight. The hospitals in the area are at red alert; maximum census. We traded and juggled patients within our unit and with other floors to maximize bed usage. I'm the one responsible for making sure that, in these situations, the patient's television and meal services follow him/her.

We have different bed models and I have to make sure that the model bed in the room is suitable for the particular patient. Some beds can support the trapezes used by the orthopedic patients, others can't. Some beds can be lowered closer to the floor for the lols and loms who have trouble getting up. With a dozen discharges and admits/transfers, it can get fairly hectic.

All in all, there were dozens of little tasks that needed to be balanced throughout the night. Charge and I, deflected some of the stress fantasizing about paradise. It didn't include 72 virgins but rather several handsome men (we decided that we didn't need as many as 72), tropical beaches and endless backrubs and beverages.

Anyhoo, I mentioned that I don't care for most liquor but that an occasional scotch is divine.

One of the nurse's came back to the desk as I was describing my drink of choice: a rich, peaty scotch with hints of wood, straight up.

It wasn't until she laughed that I realized that it sounded like I was mixing my fantasies up. And so a new euphemism 'sipping the scotch' was born into our unit vernacular, joining, among others: "nasonexing the gift" -another sexual reference whose etymology is convoluted and traces back to the behavior of one of our frequent flyer patients.

Oh the things we come up with....

Wednesday, January 18, 2012

Tantrums at Work

One of our exclusively elective surgeons is on vacation and so our unit census is low. When this occurs, our scheduled staff rotates either floating to another unit or gets called off.

This nurse
arrived, saw that a coworker was floated and proceeded, behind the closed door of the breakroom but perfectly audible down the hall, to shout, slam things around and basically throw a ten minute tantrum worthy of an ambitious two year old.

Why?

Apparently, it was her turn to be called off and she's so sick of other units 'taking advantage of our low census' and 'stealing' our staff.

Wow.

Monday, January 16, 2012

Sheepishness


After my last 'oh woe is me..' post, I've actually had a good time at work and made plans to share some vino and conversation with one of the new nurses.

We've discovered a mutual appreciation for Bollywood movies and the absolute awesomeness of SRK.



She's new to the area and I think that she's lonely too.

I've got an interview in Chicago next month for school. I'm excited. I love Chicago!

Friday, January 13, 2012

Laziness and Loneliness

I'm lonely.

When I moved back from the west coast to my itty-bitty industrial town, my life changed completely. During the subsequent two years when my time was consumed with caring for my mother, my smart, stimulating and worldly friends across the continent dropped away. I just hadn't the time to nurture our relationships.

I'm trying to create new stimulating relationships but apparently I'm weird.

My nursing coworkers, the pinnacle of education in this working class town, are consumed entirely with creating and raising families, getting married or engaged. We're friendly enough at work but I so miss talking with people about things beyond our immediate sphere of family and work.

Those who read, read Twilight and the Hunger Games. They tease (not maliciously) me about the books that I bring in and I can't find any interest in the antics of Belle or Edward.

Growing up here, I was the lonely little girl in the tree with a book fantasizing about evading the trolls below. When I left at eighteen, I discovered a wonderful world full of fascinating curious people who read, traveled, explored cultures, food and art, fought for environmental preservation and human rights. They celebrated their own uniqueness and seemed to appreciate mine. I swore that I'd never return to this area.

Then dad got sick and mom got sick and I again was tethered.

I know that the end is in sight; I'll be leaving in a few months and re-entering a world of more curious people.

This last year has been brutal though. Those who have applied to medical school probably remember how demoralizing the process is. You basically rip your life and history apart, present the pieces to anonymous adcoms and wait for them to decide that you're lacking. With the deaths of my parents and my relocation thousands of miles and several time zones away from my friends, I lost all of my social and emotional support.

Every time that someone I work with asked why my applications were failing, I withered away a little more. Trying to explain the immense competition involved came across as just defensive and it showed in their expressions.

Emotionally, I'm hibernating now. The acceptance that I received validated me in a way that I could have never predicted. My intellectual loneliness isn't so severe now that I know that it's finite.

I don't feel defensive anymore when people insinuate that I'm lazy because I don't plan on working through medical school. I can just wait a few short, yet impossibly long, months and I'll be with folks who'll understand that I'm not lazy.

I'm grinning now in anticipation. I know that I'm leaving an intellectual desert to conquer an ocean of knowledge. It'll be hard, I know, but it'll never be as hard as the last few years of dehydration. It can't be.

Tuesday, January 10, 2012

Directions

One of the new attendings came up to me today and asked for directions. She was new to the area and not sure on how to get home. She lives next to a major landmark and the drive is pretty straight forward from the hospital, a two-turn trip.

Because she seemed so dubious about my verbal directions, I drew a little map.

Still hesitant, she gratefully watched as I pulled up the google maps version.

Aha!

As she was walking away, I called out: "do you want the map?"

"Oh no, I'll just GPS it. Thanks."

We all laughed about it the rest of the night. So ridiculous!


BTW: Interview invitation Numero Dos esta noche!! ole!

Sunday, January 8, 2012

Outrage

It was a busy crazy day at work. I’m usually the only one on the desk on evening shifts; the charge nurse takes a group of patients. This week, the patient who will not be named was here again so I worked with Charge in that room and managed the desk.

We’re implementing a new rounding system next month and so I was also responsible for logging all patient call bell requests in preparation for the new protocol.

There was a water line rupture in the unit next to ours and the shut-off affected some of our patient rooms, public bathrooms and other facilities. I needed to contact Engineering, itemize the affected plumbing, and make other arrangements for patients and staff.

We also had a stroke response on one of our post-ops. I had to monitor the call, STAT orders, arrange for CT, and, afterwards, restock the crash cart. The house staff was going to send the patient to telemetry and I arranged the transfer between the units.

In the meantime, we received 2 contact precaution admissions from the ED and, with no available isolation rooms, I had to rearrange the already admitted patients, inform the nursing staff, direct the aides, contact housekeeping to clean the rooms and then admissions to confirm the computer transfers.

While the stroke response was occurring, the nursing supervisor arranged for a transfer of someone already downgraded to medical from telemetry to make room for our unfortunate patient.

It soon became apparent that our patient belonged in intensive care and not tele. I began those arrangements.

Despite the alleviation of urgency, the other unit decided to send up the transfer, walking! before we were ready. I scrambled to find somewhere for her while her room was prepared. Argh! Her meds hadn’t been hung and she was due for pain medicine so she complained the entire time while I tried to juggle everything. Her new nurse was still dealing with the stroke situation.

Finally things settled a bit and, ten minutes before shift change, the supervisor called about a non-urgent transfer from intensive care. “ICU only has two patients, can this wait until morning?” “No, this patient needs to start PT first thing in the am.” “Sigh, alright.” I HATE moving patients around at 11 pm. I think it’s hard enough for them to get sleep without the jostling and noise from rolling squeaking beds and housekeeping carts. But I took down the details, another iso-room needed! and began rearranging our patients.
The aides grumbled but they moved the patients. The call bell system erupted from all the newly awake patients. “I have to use the bathroom.” “Am I due for pain medicine?” “Will you call my family to let them know about the change?” etc..

11:10 One of the nurses from ICU called to give report. I told her that we weren’t ready yet. Our nurses were just starting report themselves.
“NO! I need to give report NOW.”
“Um. No you don’t. It’s a non-urgent transfer and I know that your shift isn’t over until 0700”
“We’re just starting an in-service. I want to give report before it starts. I won’t send the patient up for a while.” Sigh.
“Jackie would you mind taking report now? She’s insisting.” I rolled my eyes and handed the phone to an incredibly patient nurse. Jackie gets report and says that the patient’ll be up between 12 and 12:30.

11:15pm. I track down the housekeeper just before he finishes his shift and beg him to clean the room for our transfer.

11:17 ICU nurse calls with update on the transfer patient. I tell her that the nurses are in report and that Jackie will call back when she’s ready.

11:19 Housekeeping is still in the room cleaning. The elevator door opens and our patient steps off, white knuckles grasping his walker and the aide carrying his belongings. !!!!

“The room’s not ready! Why are you here!”
“Oh. I just came on. They told me to bring him up.”
“You have to go back down. We’re not ready.”
“I can’t go back down; They already stripped his bed, we don’t have anywhere to put him”

Seriously? I lead them down to the room and pull a chair out into the hall for the patient.

Following the aide back, I laid into her.
“We told you folks several times that we weren’t ready! This is inexcusable. You didn’t even bring him up in a wheelchair!”
“I’m sorry, I just came on. I’m just doing what they told me to.”
Sigh.
“I know that it’s not your fault but this is ridiculous!” Grumble Grumble.

The aide leaves and I go back to the room to get the patient settled in. When I come out, the nurse from ICU is yelling at Jackie.

“How dare you yell at my aide! Blah blah blah, miscommunication that’s all your fault.. blah blah blah..”
I could feel the hackles grow across my shoulders like the hump of a grizzly bear. I’m outraged and start to jump in but a nurse grabs my arm and I pause. Jackie diffuses the confrontation by apologizing and the ICU nurse righteously storms off.

I’m told that the ICU nurse is something of a barracuda, is always right and never lets things go. After she leaves, the nurses gather and complain about her unjustified behavior and how awful she is.

It’s now five days later and I’m still stewing over the situation. It makes me so mad when people like that ICU nurse get away with laziness, superiority, inconsideration and recklessness because people are afraid to call them on their crap.

In hindsight, I know that if I had gotten involved, the confrontation would have escalated. It wouldn’t have been fair to the night crew to spark it and then leave when my shift was over.

But I HATE that someone else gave an apology for my behavior. If my behavior calls for an apology, I want, I NEED, to be the one to offer it.

In this situation, though I cognitively recognize Jackie’s motivation to diffuse the situation, her apology stabs me viscerally. I know that I should just let it go but I’m so outraged.

Wednesday, January 4, 2012

New Year's Resolution.

It was a rough end of the year for me. I try hard not to resent the families abandon their older relatives at the emergency department... "Grandma (who is 96 and unable to walk without assistance) attacked us"... My own family, parents, grandparents, siblings has decreased to two (my brother and grandmother) over the last few years. I don't know if I'll ever share the joy of the winter seasons again like I did in years before. I hate that people can just throw the gift of family away.

My heart breaks when the holiday passes and the poor 'social admissions' wonder what they did, cry for their families or stare blankly at the wall. The families rarely seemed to visit.

I did have a lovely time reflecting on the year to come though. I'm hopeful that it will be a monumental series of experiences.

I don't normally make resolutions but I'm determined to squeeze out every bit of adventure, enjoyment, stimulation and happiness that I can. I have a tendency to be complacent; spending my time reading in my apartment and being alone. The last few years of my life have revolved around taking care of my mother, my grandmother, my brother's family and work. I hadn't made any plans because other things were more important. I fell into a deep gloomy rut.

I want to get up and go every morning, make plans and rediscover an anticipation of life that I've somehow lost. I won't wait anymore for things to just happen; I will do.

I've got months of time off saved up and I'm going to use every drop before I leave my job.

That's my New Year's Resolution.

Cheers all.