Things I overheard (but not while talking to myself)

Which is a reference to Alan Alda's new book, the title of which just cracks me the heck up.

I discovered this while cruising the Barnes and Noble this morning looking for knitting books (I'm still trying to come up with the perfect scarf pattern). I had a little time to kill before the hamburger place opened up (Five Guys Famous Burgers and Fries...it's an east coast chain, and the world's perfect post-call, I've-been-up-all-night sort of food, which I developed a craving for sometime around 4am. Maggie? Also enjoyed her cheeseburger) so I decided to go to the B&N next door.

I love books. And bookstores. Bookstores always make me a little euphoric, especially when combined with exhaustion. I think it's the fumes from the pages or the bookbinding glue or something. Definitely book fumes. No, really, it's a problem. I have literally a thousand books or more that have accumulated over the years, and I just keep reading. I'm thinking of developing a crack habit, it might be cheaper.

So anyway. I was on call again last night. It wasn't bad. And I managed to collect three very amusing quotes:

1. "Don't try your devilish ways on me, woman!" One of the men up on long-term said this to me when I was trying to convince him to take his sedative after he started swinging at staff members. I thanked him, told him it had been an awfully long time since a man called me "devilish".

2. "Oh, and I'm a vegetarian." From a very pleasant, very manic woman I admitted overnight. This wouldn't actually be funny, except that she said it through a mouth full of chicken sandwich.

3. "Patient's father has a heroine addiction." On a chart that was faxed to me to try and get me to accept the patient. I think they meant "heroin." Those are different things. But then, these are also the people to whom "Well, when you send all the documents we require, I'll have to look at her chart and call you back before I can accept her for transfer" somehow meant "send the patient right now."

q3

Egh, so I'm on call again tonight.

Last night, for some reason I was thinking about this call I had in I think January or February of my OB internship. We used to do these horrible q2 weekends - so, I'd get there on Friday morning at, like, 4:45 or 5, be up most of the night, leave at noon or one on Saturday, then be back at 6am on Sunday, be up most of the night again, and leave at noon or 1 on Monday. I'd typically have two of those weekends in a month, then have one weekend where I'd be on Saturday, then one weekend off. It was awful. But anyway, during one of those q2 weekends, I had a really rough night on Friday. Didn't sleep at all, had a couple of hectic deliveries, and then was expected to do a C-Section the Saturday morning when I could barely still talk. So I left I think around 11 or noon, and it was snowing. A lot. But I couldn't care less about anything but hugging my dog and going to bed. And what was awfully nice, I got home, and one of my neighbors had already shoveled my driveway.

Aww.

So Mags and I napped, hard, and I woke up at like 4 or so all deliriously fresh-woke, and realized that, a, it had snowed another two feet, and b, on top of that, they'd plowed my street and plowed me in, so I had a pile of snow at the foot of my driveway that was almost as tall as me. Great. I went out, and shoveled off the top two or three feet, and then decided I was too damn tired and didn't really care. So I put the Jeep into four wheel drive and just backed over the pile of snow at the end of the driveway again and again until it was flat enough that I could get over it again in the morning. And then I went back to bed.

Yeah, I don't know why I felt it necessary to share that story with you just now, either, really...

So can I just say, women? Are crazy.

The women's unit has been an adventure, for sure. I have to go to court today to testify that my one patient needs to stay despite the fact that she wants to leave. And one of my other patients is threatening to sue me. And then, I'm walking down the hall, right, and this very loud, vulgar woman who's apparently pulled all of her hair out is talking to the tech. And the patient makes some innocuous comment about me, and so the tech says, "Isn't that the woman who you were saying earlier was really pretty?" Which, aw, that was nice of her to bring that up...if, it turns out, somewhat misguided. Because the patient says, "Yeah, she's real pretty. She also has the biggest ass I've ever seen in my life."

::sigh::

Texas Memeing

My cousin, Danielle, mom of Annalise, tagged me with this. I didn't even know she had a blog! Wow.

It is a pretty fun one, though. You answer the questions, and then do a Google Images search for the answer, and post your favorite picture that comes up. Cute.

1. What is your age at your next birthday?- Thirty.

(Oops)

2. Place I would like to travel- Chicago (I'm still a little homesick)

3. Favorite place- Hilton Head Island, SC.



4. Favorite objects - Books.



5. Favorite food- Italian


6. Favorite animal- Dogs



7. Favorite Color- Red

8. Nickname- Doc Johnson

(This was the only clean picture that came up, interestingly enough)

9. Birthplace- LaGrange, IL

I'm tagging Barb and Sarah. Have fun!

Soliloquy, with stick figures.

So yesterday was my very first day on the women's unit at State Hospital. And then I was on call. It was a rough night. I know this not because I was a fair and accurate judge of how well I handled things last night, but because this morning, when I went in and retrieved the stethoscope I'd left in Screening and Admissions, the admissions guy said, "It was crazy last night!"

And, indeed, it was.

It was supposed to be a quiet night. When I came on, there was, like, one patient coming in. The big explosion of patients? Happened after midnight. Why, why, why does it seem like a good idea to anyone to send crazy people out in the middle of the night? It's just disruptive to everyone, especially the patients, but also, me.

Fortunately, I only had to leave the building once, to go to the Adolescent unit and sign a seclusion order for this kid that got mad because another kid called him dumb because he didn't know what 12 times 12 was (Barb, are you feeling better about your math skills?) and so he threw a fit and hit himself in the face and got blood everywhere and then proceeded to start jumping up to the ten foot ceiling and breaking the light fixtures. I was about to either sign him to the Bulls or put him in restraints (it was a toss up) when the injection of Benadryl we'd given him finally kicked in and he calmed the heck down. But it was one of those things where just when one of us outside the door would get nervy enough to say "Well, I think he's finally slowing down" he would start screeching like a banshee and trying to break stuff again.



See? All you could do was throw your hands up and roll your eyes. No, I have no idea why the stick figures seemed like a good idea. It was something I came up with while I was trying to stay awake in morning report this morning. It should tell you something, though, about my mental state at the moment...

I also spent an awful lot of time doing this last night:



Which, as you can clearly see from the expertly rendered drawing, is almost getting to bed. Here's how that would've been captioned if I could've gotten the text box feature to work on Paint:

Me: Ahhh! Finally! I get to go to bed! Maybe my head will actually touch the pillow this time before the pager -

My pager: BEEP! BEEP! BEEP! BEEP!

Me: Oh, *^*$##@$$ it!

Which also led to several episodes of me, trying to fill out paperwork at four AM, and dozing off.



See the pen in my hand? Seriously, if anyone can read anything I wrote between three and six am, I'll be amazed.

I finally got to bed, for real, and got actual sleep, between 6 and 7 this morning. And at 7:10, I rolled over and looked at the clock and thought, ahhhhhh. The attending comes in at 7. Which means I don't have to admit anyone else who comes in now, because he -

My pager: BEEP! BEEP! BEEP!!!

Me: Oh, sonofa--

Back to reality

Today I start yet another brand-new service. I'm on the women's unit at State Hospital. Which, I'm told, is very different from the men's unit at SH. And I actually wouldn't mind going back to work today except for the fact that I'm ON CALL tonight, and I truly dread my psych call at SH because we don't sleep. I can only hope that the holiday weekend filled us up and that we'll be on delay for, like, everything. But that's so not going to happen. Why? Because I'm there tonight. Oh, and then I'm on call again on Thursday. So if we're full tonight we'll have room again by Thursday. This is going to be a rough week.....

On the plus side, I usually can post from SH, so maybe I'll toss another entry in tonight if I have time. Meanwhile, wish me sleep.

And apparently I'm whiny, too

So, I'm home. And very tired. And on call tomorrow. And I have no food in the house. And I'm so not ready to be back to the real world. Alas...

Insisting that the world keep turning our way

(If you missed the reference, click here. And be ashamed of yourself! That's, like, the ultimate road trip classic.)

So I'm in Charleston. The one in West Virginia. There's two out here, you know. Allegedly that confuses a lot of northerners, or so I'm told. I was hoping to get all the way to Beckley, WV, but, I got kind of a late start, and you know, that extra hour seemed like it was going to be a lot longer tonight than it will be tomorrow...and it's still a mere 5 hours to home, now, so hey.

I'm in the Hampton Inn. I've only stayed at this chain once before, when I went down to NC to look for apartments. On my way home, I was going to stop for the evening, and then decided, nah, I'll just keep going, but as long as I'm off the highway, I should get gas. And I started filling up my tank, and the nozzle promptly fell out of the gas tank and danced around a little until it shut off, soaking me with gasoline from about mid-thigh down in the process. Fortunately, I was travelling, so I had a spare pair of pants right on hand. I threw the old ones out in the gas station restroom, but figured I still ought to get to the nearest possible shower and decontaminate (did you ever see that episode of M*A*S*H where Klinger threatens to immolate himself, and then Colonel Potter realizes he just has water in the gas can, and so while he's inside "negotiating" with Max, Radar switches it out for a real gas can, and Max walks back out, all dramatic, and pours this gasoline over his head, and realizes the switch, and says, "Hey! Wait a minute! Somebody put gasoline in my gasoline!", and then runs flailing into the nurses' shower screaming "Stand back! Stay away from me with that cigarette! Nobody light a match!!"? I felt a little like that...). And, the Hampton Inn just happened to be behind the gas station. And it was one of the nicest places I've stayed, I have to say. The desk agent even upgraded me to a suite after I told her about the gasoline incident (I figured I ought to explain the smell as well as my immediate inquiry about laundry facilities). And the bed was insanely comfy. This room is equally nice.



Fancy. And under $100. If only there was room service, I might just move in.

The rooms across the hall, however, are still being renovated with the carpet all ripped up and the doors off their hinges and mattresses still in bags strewn all over. So it's a little bit of a war zone outside my door, and the place sort of smells like paint. But the rooms over here are, like, all new and shiny.

I'm really tired, in case you missed that. I'm not sure I actually have anything very profound to say tonight, actually. So maybe I'll go investigate the insane comfyness of that bed...

Potpourri

Today, I bring you a collection of randomness...

This morning, the gals and I had a wonderful time over at Peggy's Strands of Heaven (check Meg's blog, I think there will be pictures up soon), the new preferred LYS of my old Sunday knitting group. Bridget, the owner, has been super nice and very accommodating to our little clatch after we got the "Oop, sorry, did we forget to tell you we're not going to be open on Sundays anymore, too bad for your little charity knitting group" from the other shop, and then the coffee shop we'd been meeting in randomly and abruptly went out of business. She had a FABULOUS SALE. Fabulous. Here's what I got.

This is a mohair-lambswool blend called Yarn By Bessie in the color Black Cherry, from Farmhouse Yarns. It's going to become a felted bag for work.

This is two balls of Cascade Superwash in Chocolate and four balls of (sigh) Rowan Tapestry (wool and soy. Squee!) in, uh, that color, that's destined to become a scarf, hat, and fingerless gloves set, just as soon as I come up with a stitch pattern for the scarf. I'm thinking I might do something along the lines of the Fetching mitts, so maybe something with mini-cables? Or maybe bigger cables? All suggestions are certainly welcome...

And then I got a sock pattern, and one of those GoKnit pouches that enable you to wander around with your knitting attached to you. It's even camouflage, so, um, you know, if I ever want to knit in a hunting...lodge...or...whatever you would be in when you went hunting...

The whole store was 40% off. Forty percent!! If you got there early enough, which of course I did. And my mom even came with me, despite the fact that she doesn't herself knit. And it was really good to see everyone one more time. And I got yarn! And there was coffee! Could this get any better?

As long as we're on the topic of yarning, I've got two whole repeats of my Fawkes socks done. Wanna see?

Here's a close-up.

Cool, huh? Sarah was right, it's a great, very easy pattern.

And as long as we're discussing things I made, here's the end result of my mom and my bread adventure yesterday:

The white stuff on top is sesame seeds, FYI. We made four big loaves and eight little tiny ones. My mom's been doing this for years; this was the first time I'd attempted to make this bread (I have been known to bake other bread, in the past, so I wasn't a total novice). It's my great-grandmother's recipe (a word I use loosely in this instance) and starts with a five-pound bag of flour and you add "enough" of stuff until you get it the way you want it. My mom remembers watching her grandmother make it, using a saucer to measure out her flour. That's how we roll, the cooks in my family. You add enough of things and you cook it at hot enough until it's done. And our new twist on the recipe, which we tried for the first time yesterday, was to use roughly half white flour, half wheat flour (which my aunt's dad - i.e., my grandfather via my uncle's marriage - does, when he makes the same kind of bread). It turned out really well.

It was a good time.

And the final bit of randomness I'll leave you with today is this, a quote I stole off of the BABble blog:

My shape has taught me that some people will love me for how I look, some people will hate me for it, and others will find it to be entirely irrelevant.

It strikes me how true that is, regardless of what "shape" you substitute in there.

Anyhow.

I'm off to pick up my best friend for lunch, then we're going to kill some time, and then go over to my soon-to-make-me-an-aunt-again friends' house for dinner with the crew. It's been a good week.

Well, frankly? No shit.

How is this "counterintuitive"? We fat folks have known it for years. No kidding, being fat isn't a be-all, end-all, horrible health-stealing death sentence. And maybe it's even possible to be fat and healthy. Shocking!

I especially liked the Harvard epidemiologist who called the study "rubbish," more or less invoking the "because I said so" defense (but it just can't be! It can't! Fat people are scary! They all must die, if only from their sheer repulsiveness!). Which, really, doesn't stand up in the peer-reviewed literature very well. Moron.

More meme-ing

So, a while ago, really, Barb tagged me with this meme. And I didn't forget, I just haven't really had time to sit and do it. But, it seemed like an appropriate Thanksgiving kind of thing - plus, my mom and I are making bread, which involves spurts of activity interspersed with several hour+ periods of waiting for things to rise - and so, here goes...

1. What were you afraid of as a child?

For a while, nothing. When I was really little, man, I was fearless. But then I got a glimpse of what evil really was, and since I really had no control in that arena, my anxiety and fear manifested itself in a whole host of ways. I was afraid of heights, I was afraid of crowds, I was afraid of elevators, I was afraid of a vast list of things. Not that it ever really impacted my ability to do stuff, necessarily, it just caused me a whole lot of internal drama and panic when I did. I'm still sort of like that. There are a lot of things of which I'm afraid, or which cause me significant anxiety, but that doesn't actually stop me from going ahead and doing them. And now it's less specific phobias - like heights - and more about, how fantastically am I going to fail at this, or, how viciously will people judge me?

2. When have you been most courageous?

When I left my last residency. I'd been letting them abuse me for ten months. I'd let them convince me I was inept and worthless. I'd come to believe I didn't even deserve as much as they gave me. And then, finally, I realized just how much they were about to damage not only me, but my career, my ability to provide the kind of care I wanted to, my livelihood. It was the single most difficult thing I've ever done to say, "no more," to, having reached the end of my rope, stop clutching at the fraying ends, to let go and fall into the unknown and trust that it was going to be better than what I was leaving.

3. What sound most disturbs you?

My best friend makes this weird slurping sound she calls "the thirsty noise." I cannot explain it, because it's not actually that noxious a sound, but it just drives me crazy. And, I recognize, that's not a very far trip...

4. What is the greatest amount of physical pain you’ve been in?

I have the pain tolerance of a brick building, so this was sort of a difficult question to answer. I had chronic appendicitis for nine years (before someone finally thought, oh, hey, maybe it's your appendix), that hurt a lot.

5. What’s your biggest fear for your children? (or children in general if you don’t have some of your own.)

That someone will hurt them in the most intimate and insidious ways possible and I will be powerless to protect them. And less so, that I will be unwittingly as destructive to them as I can be to myself.

6. What is the hardest physical challenge you’ve achieved?

Honestly? I think it's this year. This high stress/high anxiety/severe sleep deprivation combo is more physically draining than you really understand until you're doing it, and then when you couple that with the fact that most of our "good" habits fall casualty to convenience...

7. Which do you prefer: Mountains or oceans/big water?

Oceans. By far. Not that I don't like mountains, too, but I have some connection to water I don't quite fully understand. So much so that, like, I definitely need to live on the coast (as in, step out your back porch and into the saline, have a full understanding of hurricane-proof windows) at some point in my life.

8. What is the one thing you do for yourself that helps you keep everything together?

Therapy. And music. And driving. And my dog. And my friends and family. And the escapism of books. And writing. So that's more than one thing. Hey, there are a lot of forces tying to pull me apart that need to be countered, here.

9. Ever had a close relative or friend with cancer?

Many. It sucks pretty much every time.

10. What are the things your friends count on you for?

I don't know, ask them. Their answers would be better than mine ("Not returning phone calls, forgetting their birthdays because I don't know what day it is....")

11. What is the best part of being in a committed relationship?

How the hell would I know? We've discussed my winning taste in men, haven't we?

12. What is the hardest part of being in a committed relationship?

See answer 11.

13. Summer or Winter? Why?

Can I pick spring? I like all the renewal of spring, and the tempest of the spring storms, and the blooming, and the lability of the weather, and the smell of thawing earth. Not to mention the lengthening days. And then I'd also say I really like fall, and those crisp, chilly days, and the vibrancy of the foliage, and the smell of burning firewood and approaching cold fronts, and ripe apple orchards on a chilly grey day. Then probably winter, then summer.

14. Have you ever been in a school-yard fight? Why and what happened?

No, I tend to be more the verbal parry-and-thrust sort.

15. Why blog?

It makes me feel like I'm connected to something beyond myself. Although it perpetually amazes me that any of you continue to read this drivel.

16. Did you learn about sex, and/or sex safety from your parents?

Um, no.

17. How do you plan to talk to your kids about sex and/or sex safety?

My kids? Are going to have a mother who's a traumatologist who used to be a gynecologist, and live in a house full of books on sex and sexual health and the psychology of sex and recovery from sexual violence and female anatomy, and I'll be lucky if I don't get a letter from their preschool asking me what the hell I'm doing to my children and what the heck is a tenaculum, anyway?

18. What are you most thankful for this year?

Being here at all. A fresh start. People that love me. My dog. My tenacity. Effexor. Warm blankets. Granola bars. Family, in all respects. Connection. Complexity. A steady paycheck (that isn't made of wool).

All right. Lorna, Sarah, I tag you. And anyone else who reads and has a blog and thinks this would be a useful thing to do.

Happy Thanksgiving, y'all!

Driving nostalgic

::sigh:: It's Wednesday. And I can already tell that I need at least another week at home.

Which, let me just say, it's not the weather that's making me all nostalgic. This I could easily have missed without missing it at all. And then it's supposed to SNOW tomorrow. Which, it's possible I could get a little excited about that...

So I went to Tuesday Night Knitting last night, back at the shop I worked at last year. It was such a good time. But more about that in a minute. Because, can I just say, I am totally in love with the 355 Extension.

Who knew I could hold so much affection for a tollway?

Last year, it routinely took me an hour and a half to get to work from my parents' house. Maybe we could make it in an hour and ten, hour and fifteen if we were going when there was no traffic, and once my uncle shared his secret McCarthy Road shortcut. Maggie and I listened to a lot of loud CDs and got through a lot of audiobooks with that three hours of commuting time. We'd wind through the back roads, finally get to Lemont road, hop on 55, then take 355 over to 75th street or to 88 and then to route 59, and finally get to the mall. Then, the tollway folks decided to extend 355 almost directly to my parents' back patio.

It's wide. It's clean and shiny. And it took FORTY-FIVE MINUTES to get from the yarn store to my folks' last night. (Gasp!) Just, delightful.

Knitting was a big ball of fun last night, too, which, it always is. And I think this was the thing that made me the most homesick, by far, yet this week. Because it used to be such a rejuvenating ritual. My parents, I miss seeing them all the time, and I definitely wish they were nearby, but we talk on the phone every night I'm not on call. My cousins up north, my goddaughter, there have been times when I didn't see them for four months before. It was unpleasant, but, it happened. These people I used to see twice a week. And it was so restorative, and so much fun. And gosh, it was so nice to see everybody. It had certainly occurred to me earlier in the week, but last night it really hit me how much I miss everyone up here. I think Friday's going to be like this, too.

But, anyway, a good time was had by all. I acquired yet another ball of sock yarn, got talked into making the Fawkes socks, because Sarah was wearing them and they were super cool, had a good dinner, drank some good wine. I even got the scoop on what's happening with the sale of the old place (turns out one of the potential buyers is an old friend of mine), and managed not to growl anything sarcastic when my old boss lamented that I'd just missed the UPS guy (he knows I'm in town. He knows my number. And he's quickly losing any ground he may have had for future admonitions that I'm a bad friend). And I probably got talked into getting up far too early to hit a yarn sale on Friday. Ahhh, good times.

Okay. I need to go find my shoes and put some makeup on, because tonight I'm going to see my niece Lily. And her parents, of course, and my other friends from medical school. But they were all walking and talking the last time I saw them.

Seeing the light (and everything else)

I CAN SEE AGAIN!

Oy. So it took until nearly 1pm Chicago time today to get me one tiny little replacement contact lens. Just the left one! Which was lucky, because Pearle Vision didn't have the right one. But I did! So everyone finally got all their fax machines coordinated and the optometrist in NC finally signed the prescription (it helps) and my mom drove me over because if I had tried to drive, I wouldn't have been able to see the speedometer (not that I look at it much anyway) much less the road, and finally, finally, I can read what's on the screen of my laptop without leaving nose prints.

Ahhhh. So much better. I forget how freakin' blind I really am.

So, commencing with today's rant, there's an interesting little kerfluffle going on over on Jen Lancaster's blog, which is so very like so many other similar kerfluffles, except that Jen closed the comments on hers, which was probably wise. Some reader wrote in, and basically told Jen that she was doing a bad job with her blog, and was all incensed because Jen is, you know, a professional writer and so clearly it was her duty to post something to the blog every single day.

Riiiight. 'Cause that's the point of personal blogs.

And then, she wrote back, and apologized, and told Jen to make sure she posted that she had apologized, because everyone was saying mean things about her. Jen, who's very, um, direct even when she's not being personally attacked, was like, yeah? Tough shit, cookie. And wrote one of the best lines I've read in a while:

"Here's where you learn a valuable lesson about consequences."

So, first of all, I kept thinking back about the Harlot's post on, um, you people realize that when you make statements on a blog you're in public, right? And second, I'm a little bit envious of Jen's ability to be so forthright like that. Because, do you know the large chunk of my day that is typically spent explaining to people in very tactful and delicate ways that, um, actions? Always, always, always have a consequence. You know, like, if you threaten to kill your momma? You end up in the state psych hospital. If you don't take your meds? You start hearing voices again. If you sell your body for rock? That actually does make you a crack whore. If you swallow a whole bottle of Tylenol? Your boyfriend probably won't come back to you, and, you might have killed your liver.

And, I know you weren't thinking about that when you threatened your mom/threw out your meds/sold yourself/chased the Tylenol with a fifth of vodka. That's sort of the point. You know that whole "Pause" campaign on Fox, where they're like, before you do something, think? That's actually pretty solid advice.

And I can't just fix it. And you can't fix it until you decide that there's something wrong with the current picture. But, by the way? THERE'S SOMETHING WRONG WITH THE PICTURE.

On the whole, though, people tend to get really touchy when you tell them they're being shortsighted and acting like idiots. I don't know why that is, exactly, but...

Flit, Flit, Flit

As I think I've mentioned, I have quite the social calendar laid out this week. Last night I had dinner with my cousins from up north (as in, the north side, not, like Wisconsin or anything). Tomorrow, I'm going to knitting. Wednesday, I'm having dinner with friends from medical school, Thursday is the family turkey thang, and Friday I'm meeting up with my friends from high school. And of course, Saturday, it's back in the car (and I get back to NC on Sunday, I'm on call Monday, and so then Tuesday night I FINALLY get to pick my dog up from the boarder. Not that I miss her or anything). And in the mornings I get to hang out with my parents. So it's going to be a full and eventful week of social butterflyness.

Tonight, my goddaughter came over. She's five, and has way more energy than I will ever have again, cumulatively, in the whole rest of my life even if I live to be, like, 120. Holy cow. But she's awfully cute. She's in all day kindergarten, and then plays soccer. And sometimes she goes to the art teacher's room after school. And her soccer team is called the Hawks. And yesterday her dog stole a whole chicken right off the kitchen counter. And she really likes popcorn. And she doesn't like her hair being short (well, I don't like mine short either). But the funniest line was this one, recounting her trip to Mexico with her mom to visit some relatives:

"And I kept saying to my mom, 'are we in Mexico yet? Are we in Mexico yet? Are we in Mexico yet?' And then she got a headache."

I can't imagine...

I, however, have a whole other sort of headache. Someone, possibly me, made the very brilliant decision to come all the way to Illinois and not bring my glasses or a spare set of contact lenses. And then, of course, I ripped one. And have I mentioned that I'm blind as a damn bat without my contacts? Like, seriously, I'm legally blind without corrective lenses. In fact, I'm not entirely certain what I'm typing, here (you think I'm joking....). Fortunately, Pearle Vision opens up at 9:30...

I'm Greek. We're dramatic. Get over it.

I'm in Chicago. Made good time, didn't fall asleep, managed not to hit anything, even remembered my toothbrush (although did forget my hairbrush).

But then this evening, guess what it does? It starts sleeting. Sleeting! It's 42 degrees out and there's tiny little bits of ice falling from the sky. I'd been back up north for less than five hours. I mean, really.

Nothing like coming home at the cusp of winter to make me want to run back to NC and hide under my blankets. People there think 50 is really cold.

But on the plus side, I did feel much better this morning when I got my bill at the Embassy Suites. Turns out the price they charged me for the room was roughly half the price listed on the door. Which is more the price range to which I remember the ES belonging. Whew! Why would they do that, jack the price up so much on the door thingie? Did they want me to almost collapse right there? Did they? I mean, if I keel over, I can't eat their crappy room service burgers (it was overcooked to my standards, and if you've ever eaten beef with me, you know how hard that is to accomplish. I said "well", not "charcoal briquette") or use their free-at-every-other-hotel-in-America-but-not-here wireless internet. If I'm passed out in a puddle at the doorway, they lose any hope of me drinking the FOUR AND A HALF DOLLARS A LITER "gee, aren't we nice to supply this right here in your room" bottled water, or of me ordering outdated movies on Pay Per View for the price of a month of Netflix (not that I did either of those, but, someone else might have).

Hmm. I had no idea I was still this bitter about the whole ordeal, now that I don't have to mortgage my house to pay for it...

Today's Anecdote

So, in defense of the wretchedly expensive hotel, that was an absurdly comfortable bed.

Anyhow, before I get back on the road, I'll leave you with this funny story (or at least I was amused) from Friday night's call:

One of the women I discharged had come in to have something called a SPECT scan, which is essentially a CT of your brain that helps us understand where the blood is flowing. To do this, they inject you with this little bit of radioactive tracer during some sort of event and then stick you in the CT scanner within a half hour. In her case, the goal was to inject the tracer while she was having a seizure, which would give us a snapshot of where the focus of abnormal blood flow - and thus, abnormal electrical activity - was while she was seizing. This is called an Ictal SPECT, because "ictal" means seizure. Okay. So we finally caught one (because, of course, to get the scan she had to have a seizure between the hours of 8am and 3:30pm), we scanned her, we sent her home. And her epileptologist recommended that she have another SPECT scan as an outpatient, when she wasn't having a seizure, or more precisely, between seizures, which is appropriately called an inter-ictal scan.

Okay.

So I put in her discharge orders, and ask the staff to make this appointment for her. And the unit secretary comes up to me about an hour later, and says, look, I've been on the phone with nuclear medicine trying to make this appointment for like 20 minutes now, and they can't find it in the computer to order it. So I spell it, we discuss the point of the scan, okay. And he comes back about ten minutes later and sits down next to me and shakes his head, and says, "I figured out the problem. They were looking for an inter-rectal SPECT scan."

Ouch.

$7000 per night and there isn't even free wireless

So, someone, possibly me, although I may never admit to it, had the utterly brilliant idea of driving back to Chicago when she was post-call. Now, admittedly, I did get some sleep last night. And I managed to leave about 1 pm, and I had a lot of loud music to accompany me, and I just kept driving and driving, possibly out of sheer inertia. So I'd more or less decided to stay in Morehead, KY. But then I inadvertently passed up Morehead, KY. And by this point, I was finally actually tired (I'd been doing reasonably well up until then) and decided, okay, that's it, I'm staying in Lexington. I was bound and determined to not pass up Lexington, which I've done twice now while driving from NC to Chicago. So I found Lexington and I pulled into the first hotel I saw, gleaming like a bright beacon of respite in the dark night.

Now, I should've known this was a bad idea when I pulled up and there was a Porche parked out front. And a bellhop (he wasn't parked out front, I'm referring more to his mere existence). And a coat check. But, I proceeded to the desk and asked for a room. And I found it a little peculiar that she didn't mention how much I'd be spending on this evening of gleaming respite. But I figured, well, okay, because I never remembered the Embassy Suites being a "luxury" hotel, per se. I figured it was probably more expensive than the Red Roof Inn, maybe a bit more than the Courtyard, but not astronomical. So in what can only be described as a profound and ridiculous lapse of judgement that clearly must be the result of my addled, post-call exhaustion, I handed over my credit card.

And she still didn't tell me the price. It wasn't until I walked into the room and looked at the rate on the back of the door that I nearly passed out.

Did I mention I'm in fucking Lexington, Kentucky? Who in the hell wants to pay nearly that much to stay in Lexington, Kentucky, period?

And then I can't log in to the wireless network, right? So I call the front desk. And they're like, oh, there's a $10/24h charge for that.

Of course there is.

But at this point, hell, it's a drop in the bucket. I'm already broke and can't afford this anyway, so who cares?

Where is my sugar daddy? Why am I not a golddigger? Isn't there some rich widow out there who'd like to adopt me?

And have I mentioned that I now definitively hate the entire state of Kentucky. For far more reasons than its overpriced hotels.

Oy.

I'm really, really tired, though. And I still smell like the hospital.

My last night on Neuro went pretty well, though. I got some sleep, I got three easy admissions, and prior to those I had discharged my whole patient load, including finally getting the patient who is trying to die out of the hospital and into hospice (not that it didn't happen without a lot of fuss and fury). My patient who had the stroke? Loved the hat. She got so excited when I gave it to her, and swiped it up and stuck it on her head and was still wearing it when she left. Turns out she's a knitter, too, but is stuck at the scarf stage and was duly impressed that I could even make a hat. She then proceeded to tell anyone who came within listening distance that I'd made it for her. Too cute.

And the drive went well. I made really good time, even if I ended up grossly overpaying for my stupid hotel. Seriously. I think my night in this hotel is costing more than Maggie's whole week at the boarder. And, remember when I decided not to bring her along, because then I wouldn't have to worry about stopping at a pet-friendly hotel? ::sigh:: I miss my dog even more, now.

Alright. I need to go to bed. I'd better sleep like a damn NyQuill commercial tonight, is alls I'm saying.

Oh, and to answer the comments from the last post - 1) I'm planning on coming to knitting on Tuesday - I won't make it to IL in time for this Sunday's group, and I'm leaving next Saturday, so Tuesday it is. Which is a shame, because I'd love to hang out in the new locale. 2) I managed to get Thanksgiving off because a, we have 14 interns, and b, everyone wanted Christmas. 3) No, driving, yes, and of course I'll miss you!

Wagons West

So, I'm all packed up, even if it was hasty and I probably forgot, like, everything, while simultaneously overpacking...but tomorrow after I get out of the hospital (I'm on call tonight), I aim west and head back to the Windy City for a week. Which should be awesome, if a little frantic (I'm already completely booked up for the whole time I'm going to be there).

Keep your fingers crossed that I actually get sleep tonight, because having to nap before I leave will just be annoying...

And hey, there's still knitting group on Tuesday night, right??

Proof of quick knitting...

So, Monday night I admitted this 45 year old woman who had a stroke. It was not in and of itself a "catastrophic" event, but in the context of her life, it was devastating. So they offered her this experimental therapy involving lasers and voodoo, and she accepted, and has done well. The caveat to the laser treatment? She had to shave her lovely hair. Bald. Cue ball-esque.


So, what could I do? I knit her a hat.

It look less purple in real life, and the variegation is subtler here. The band is a standard, boring, spiral lace pattern. The rest of the hat, I sort of pretended I had a pattern, and then reworked it when it wasn't working. So, basically, I made the thing up. It's in a dye lot second of Dream in Color Yarn from when I used to work there. And it took me a few hours, I wasn't really keeping track.

I like it. I hope she does, too.

CSI:North Carolina

So I get home tonight, right, and one of the townhouses in the building adjacent to mine was all blocked off with yellow "CAUTION: DO NOT CROSS" tape.

I'm not sure how I feel about this.

Now, it doesn't actually say "Crime Scene: Do Not Cross." And there's no big mobile crime investigation truck out front (you know, like when I lived in Aurora and that guy got shot at the hotel across from my apartment). And I don't see, like, Grissom out there anywhere. But it still makes me a little nervous.

Remember how the town I live in is supposed to be one of the five safest towns in America?

I do not like this....

Diffuse brainwave slowing

I...am so....so tired.

So, tonight's post? Just this:



No, I have no idea who this dog is. I don't actually even know where I got this picture - it's in a folder in My Pictures called Randomness. But it's awfully cute, isn't it?

Well, okay. As long as we're at it, here's another cute picture of my dog...

In the time-honored tradition of Garfield...

Happy freakin' Monday.

It's way too early for me to be late for work already....

The more boys I meet, the more I love my dog

Which, incidentally, is a line from this song on the new Carrie Underwood CD. Which on the whole is just okay, but there are a couple of songs I really, really love. Including this one.

Why can't they be warm and loyal, open and friendly? Huh?

Anyway.

The latest in this week's very long line of men who have really just pissed me off are at least somewhat less personal. Namely, Aaron, the Firedog online chat tech who told me that the 100 or so pitures I just deleted off my photo card when I was trying to delete three (which didn't even get deleted) are just gone, too bad for me. And also Craig, the previous Firedog tech, who told me to look in the trash. No shit, Craig-o. Thanks.

Maggie's response to my exasperated screaming about magically erasing the photos I just spent over an hour shooting? Was to lick my ear. It was wetter, but a much more appropriate response than, "did you check the trash?"

OF COURSE I looked in the recycle bin. Even though, they don't go there off a memory card. I know that, but I looked anyway. GDR.

And they were just environmentals, but, really, I spent an hour and a half shooting them. And they were good pictures! And I had all sorts of camera adversity (a way-too-small memory card, dying batteries) that I overcame to shoot them. And then? Poof. Gone. Even Barb's husband couldn't revive them. ::sigh:: Oh, well.

So why did I run around shooting pictures for an hour and a half today? Well, you see, it's fall in North Carolina.

(That's my nephew, Basil. Like the herb, don't go getting all British. And he actually isn't in NC, he's in Chicago, but is that not the most perfect picture of fall, like, ever? Look, here's another picture of him in the bushel basket.


Just the cutest thing, I swear).

So it's fall in NC. And it's really pretty down here. Like, seriously? Fall in NC kicks fall in NH's ass. I always thought the New England "fall colors" were a little overrated, at least where I lived. It's quite lovely down here. I wish I had pictures to show you that, but, I will eventually.

Maybe my crazy is showing

I'm sitting here importing a bunch of my old CDs into iTunes (this is no small feat, because I own well over 300 CDs). The title? Is a line from a very old Bryan White song (Between Now and Forever, if you were wondering), which I'd totally forgotten about and still think that line is just funny as hell. Now, perhaps more so than I did back when I was a freshman in college. Which was a disturbingly long time ago.

There are an awful lot of bad CDs I didn't even remember I owned. Still importing them, because every now and again you still get a craving for some really corny old song, knaamean?

So, today, this woman...well, let me start this story with a little neurology lesson. There are two types of things that sometimes get called seizures. The epileptic sort, where a group of neurons in the brain misfires, and then more and more neurons around them get electrically rerouted, and sometimes the whole brain gets involved. There are lots of different ways that epileptic, or electrical, seizures manifest, from "zoning out" or tapping your foot to the thing that most people think of classically as a seizure, the big, arms and legs jerking, thrashing around, foaming at the mouth, biting your tongue sort of event.

And then, there are non-electrical seizures, which are sometimes called psuedoseizures, or psychogenic seizures. Which are different from epileptic seizures because the brain actually still works fine, it's the mind that gets in the way. Now, unresolved emotional baggage can cause a lot of medical problems. And it has that stigma of being factitious - something you're intentionally doing for attention. Which, yes, there are people that do that. My patient that I FINALLY discharged last week after TWENTY FIVE FREAKIN' DAYS IN THE HOSPITAL? She did that. You could tell, because sometimes the phone ringing, or, like, threatening not to feed her dinner would miraculously bring her out of a four hour "seizure". Conversion disorder, pseudoseizures, that sort of stuff? Not voluntary. But it still carries that stigma of being "all in your head," which is really difficult for people to handle when you tell them their seizures aren't "real", because they are really, generally, they're just not an electrical storm in the brain.

Okay.

I have this patient, right, who came in while I was on call in "status epilepticus." Which, for those of you who've made the silly choice to pursue a career in something other than medicine, is a state where you have either one really long intractable seizure, or many in a row so fast that you don't have time to return back to normal. And we give drugs like valium to break this. But, she, clearly, clearly has non-electrical events. Even you non-medical types can figure this one out: she has seizures every month when she menstruates, which started after she had a miscarriage.

Um...as we sometimes like to say in psychiatry....duh.

And so when she has these things, her vital signs are normal, she's physically safe, whatever. Yet, they still gave her EIGHT MILLIGRAMS OF VERSED in the ER. Which, if you know what that means, dude! I know! And if you don't, well, if you walked over and injected that into me? I'd probably stop breathing. Dumb, dumb shit, for, clearly not status epilepticus, because, not epileptic! But, whatever. So this woman, right? Has clear axis II stuff going on, obviously having pseudoseizures, etc, comes in for EEG monitoring. And her epileptologist goes in yesterday and tells her, these aren't electrical. And then the psych consultants go in, and completely piss her off (and, off the record, left me one of the worst consult notes I've gotten from any service all month). So today, I tried to calm her down, and promised to come back and do a little therapy on this topic (which isn't quite how I pitched it to her, but, you know). And I do, and she keeps interrupting me, right, and asking me stuff about myself. Like, am I married, do I have kids, etc. And I basically answered her briefly and then redirected her back to her stuff, because it wasn't anything too personal, and she was saying a lot of other things to indicate that she was clearly identifying with me, which is a useful therapeutic tool. And then she says, "How old are you?" And I told her, and she was all, "Really? Really?? You're actually 29?" And then she says:

"I thought you were like, 40."

.........?

Forty?

I mean...what?

Now, if I were forty, then it would be okay (it's kind of like, if I were a nurse, it'd been cool when people ask me if I'm their nurse. Because it would be okay for me to be a nurse, but I'm not, so it irritates the crap out of me that people assume that because I'm female I'm the nurse, not the doctor, despite the fact that I'm wearing a long white coat and...well...doctoring them. Because if I were their nurse I'd have a lot less debt and wouldn't have had to work my ass off in medical school and right now would be making a lot more than $8/h and working a lot less than I do. But, I digress). But I have eleven years to go before I'm 40! And, she explained it away by saying that she thought I looked young, but, assumed that to be a doctor I had to be much older.

Not helping.

On a related note, I'm wondering if I made a big political faux pas this morning. My attending, who's kind of a cocky bastard, and is also a behavioral neurologist, went in this morning and gave her a very good talk about pseudoseizures and why that doesn't mean we think she's crazy (we think that for other, unrelated reasons), that these are very real events, etc. Now, I'd warned him that she was pissed at psych and offended that "we all thought she was making it up", and I'd talked to her a little already, but, he just did a very good job with it. And a lot of people don't, as my psych colleague clearly demonstrated. And so when we walked out, I said to him, I think very genuinely, "That was a good explanation." And he says, "Yeah? Well, I've given it a few times." And I couldn't quite tell if he was being, um, coy (for serious lack of a better term), or really sarcastic. And it occurred to me later that my comment could've come off as being sort of condescending and a little insubordinate. Because, well, I'm an intern. He was interviewed by the New York Times yesterday as an expert on dementia.

And back at the Emerald Palace I used to get criticized a lot for "not knowing my place." Which, I concede, I usually don't.

I dunno. I figure I'm probably okay, because I've also noticed that recently he assumes every patient is mine and has started wearing cologne to rounds.

Damn, this post got awfully long. Nice of you to still be reading it!

Oh, it's so naptime...

Yesterday's post? Was supposed to automatically post at 8:30am. It just showed up now. What the heck? Clearly, Blogger and I need to have a talk about being responsible...or maybe I just need to learn how to use the dumb thing...anyhow.

So, who watched Bones on Tuesday night? There was this great moment, where she's interrogating this Jeffersonian Institute professor guy who's all smug and better than everyone, whom they suspect of murdering his mistress. It goes like this:

Aldrich: Dr. Brennan, surely I merit someone higher up the food chain than an FBI consultant.
Brennan: Kyle. I know you get everything you want by flaunting your superior intellect. But that won't work with me.
Aldrich: Why is that?
Brennan: Because I'm smarter than you are.

I? Love that.

I think I had more to say, but I'm also really, really tired. I had an interesting, but exhausting call. And I have to be at the hospital really freaking early again tomorrow. So, maybe I'll just go to bed...

Gratuitous Cuteness

This? This is my niece, Lily. She's a giraffe.

I'm starting to love Halloween.

But even better? She just turned one. And of course, there was cake.

She's the daughter of one of my dear friends from medical school. I was in her parents' wedding. So, again, I take full credit for her brilliance and adorableness.

Enjoy. I'm on call again today. Here's hoping for a quiet night, and a couple of good stories.

Misty watercolored memories

For those of you who missed it, Otter made a very accurate comparison in the comments about my last post: Internship must be like childbirth, you forget how bad the pain really was.

Totally.

And the two years of limbo and sleeping in on weekdays and working in a yarn store didn't help. Plus, I think there's just some outright traumatic repression factored in - it was sort of hard to tell what badness was general intern crap and what was actually the result of the Reign of Terror that was my OB program. And I'll be the first one to admit, freely, that this time around is so much better. It's nice not being the whipping child. I don't miss being constantly berated and demoralized. SO MUCH BETTER.

Which, does not, however, make it good.

You do forget the peculiarities. The dull ache in your upper back from the thirty pounds of stuff you have crammed in the pockets of your white coat. The mania induced by not sleeping every fourth night (which has struck me a lot this month, when we routinely sleep deprive patients to make them have seizures. Um, does anyone else see a problem, here?). The constant, vague sense that you're doing something wrong. The sheer mass and speed with which shit rolls downhill (and you're the valley, baby). And the bone-deep, leaden fatigue that never quite goes away, even when you technically are getting "sleep".

There came a point in medical school, early in my third year or so, where I had to become a doctor because my loans were so huge that I couldn't afford not to. Which was fine, because I actually wanted to be a doctor, but it still was sort of intimidating, in that holy-crap-I-guess-I-can't-change-my-mind-now sort of way. That's sort of where I'm at again. I've had a couple of moments this year where I'm like, really? Do I really want to be a psychiatrist? Am I sure? And then some part of my brain comes in and squelches that and says, fuck that, kid. You picked it, you're stuck with it, because I am so not doing this intern year thing ever again.

And again, it helps that I really do think I want to be a psychiatrist. But after this year? Never doing q4 in-house call, ever, ever again. Never going to be a scut monkey for a service I don't even belong to (ahem, family practice) again.

So ready for this to be done, and I'm not even crowning yet. Can I at least get an epidural?

So, okay, maybe it's not quite as bad as all that. I mean, it does have its moments. Like, I got to do a nerve block on a headache patient today, which was pretty cool. And the psych stuff can be very frustrating, but it's certainly never boring. Plus, I do like my cohorts. And I'm meeting interesting people, especially now that I'm off-service and in a big hospital where we can call in consultants. And it's only one year.

At least I've stopped swearing every single time my pager goes off.

Only 237 days to go...

So, two years ago, when I left my OB program, I remember having this conversation with this guy I was soon to fall madly in love with (which turned out to be a terrible mistake - when isn't it? - but nevertheless) about what the hell to do with the rest of my life. And we went back and forth about finding a new residency and staying in gynecology and blahdy blah blah blah. And so I made the memorable comment, "I don't mind having to repeat my intern year. I mean, the intern shit, I can handle. Being an intern? That I can do."

You know what? I do sort of mind. I'm tired.

Today was long. We had a family meeting with the sons of a patient of mine who had something close to a catastrophic stroke, who's doing really poorly, and who, incidentally, I've taken a lot of flack on for doing things that were very reasonable (like calling the hospice people to see if she was eligible after my attending said, "Let's get hospice involved." And then this morning everyone was all, what?! You called HOSPICE?! I...um...yeah. Remember when you told me to?). It was heartbreaking. She was, by all reports, a vibrant and wonderful woman. She, now, can't eat, can't move half her body, can't stay awake, can't really communicate. And her son -when we were discussing whether or not to put in a feeding tube - says, "You know, as long as she can swallow" (which she currently can't) "that's fine. I mean, I don't care if someone has to feed her, or, you know, if she doesn't know what day or month it is, whatever."

I wanted to cry. I have a feeling that would matter to her.

Talk to your families, folks. Be explicit in your advance directives. Tell the people you love how you would want to be treated if you can't make those decisions. Talk to your family about what they want. It sucks to think about these things, and you don't ever want to think they'll happen to you or to anyone you love, but, it does. And you'll be glad you had those conversations in a calm, rational moment when things aren't so calm and no one is feeling very rational.

Well, it was a nice idea...

So I agree to do this daily posting thing, right? Only to discover last night that I can't sign in to Blogger from the hospital. Don't know why, just can't. Seriously, I tried like six different computers.

Argh.

So I could, technically, cheat and backdate my post so it looked like I wrote it yesterday, but I, I am not a cheaty-head, and so I'm going to just go forward and try to plan better for the days when I'm on call.

Call was actually quite nice last night. I spent most of my evening fretting about my patient in the stroke unit and chasing her blood pressures and freaking out at her heart rhythm on the monitor (only to call the Cardiology fellow and have him say, "Pah, PVCs. That wouldn't worry me at all." Which he said in a rather friendly sort of way, or I'd have muttered something nasty under my breath about Cardiologists. But this one is fairly nice, and has endeared himself to me in the past, and I'm pretty sure he was just trying to reassure me that she wasn't going to flip into v-tach and DIE in the next five minutes). But then I got to bed around 10 or 10:30, woke up a couple of times to roll over, call the stroke unit and pester the nurse about how my patient was, and then go back to sleep until 6:30, when I finally got up and was like, wow, what a great call that was.

And then we got a new attending today.

Now, I've mentioned that I'm not overly crazy about my new team. But our attendings over the past two weeks have been really pretty cool, which I've greatly appreciated. This one? This one is a strange, strange little man.

He came on all blustery and puffed up like a surgeon this morning. And then he calmed down a little, and got a little bit more comfortable with us, and then he started doing things like taking extensive psychiatric histories on our patients for no good reason (sometimes it's warranted. Sometimes it's just annoying). I was like, you do remember that you're a neurologist, right?

Bleh.

So we'll see how it goes. If nothing else, it's twelve days, and three calls, to go. And, the strange little man could turn out to be amusing when I'm better rested and less likely to feel threatened by his insinuations that I'm a moron because I can't read an EEG or I lump MRIs into the categories of either "that's probably fine" and "this one looks funny."

I'm a psychiatrist, dude. And the real point of this month? Learning when to call a neurologist.

But in the meantime, to make up for my lack of posting yesterday, here is a gratuitous cute picture of my niece, Annalise:

She's a banana. Ha! And five months old this week. And one of the cutest children in existence, all of whom seem to be somehow related to me. And by "related" I mean she's my cousin's kid, who isn't actually my cousin but we grew up together and I always called her parents Aunt and Uncle, and you know how Greek relatives don't actually have share genes with you. In the coming month I also have other gratuitous cuteness planned featuring probably more of her as well as my other friends' children, all of whom have been claimed as my nieces and nephews and can expect to be spoiled accordingly. That's just how it works.

NaBloPoMo.

No, it isn't screwed up pig Latin. It stands for National Blog Posting Month and is apparently this online community thing where bloggers agree to post every day for the month of November. I was reading about it on Jen's blog and thought, what the hell is that? And then I clicked on the little link and was like yeah, yeah, whatever, until the point where they said:

"The Groups tab will help you find other likeminded individuals. I'm looking at you, knitting bloggers."

Now, it's not that I actually consider myself a knitting blogger (because we all know how much knitting is going on around here these days), so for no real good reason, that cracked me up. And I said, okay. I'll toss in my two cents. I've been bad about posting lately, and it's been bugging me, so maybe this will be good motivation (not sure how well this will work with my call schedule, either, but hey). And there's a cool button. I don't think I'm eligible for fun prizes or whatnot, because I didn't actually figure this out until November third, but, you know, whatever. We'll see how it goes...

Confessions of a Cranky Call Girl

So, week two of Neurology, down. For a while there, I was actually really enjoying it. But then the month changed and so the team changed, and now? Now I'm just crabby.

On the whole it hasn't been a bad month. Initially, there were two of us off-service types - me, the psych intern, and a Physical Med and Rehab intern I'll call Liz - as well as three second year Neuro residents and one senior, about to graduate in July-type Neurology resident. The six of us got along well. Our chief was laid-back and practical. Our attending for the first week was very cool and also really liked me, which was a plus. Our attending this week (they change weekly) is a very nice guy, quiet, soft-spoken, very easy going, but with this very disarming razor-sharp dry wit. Prior to Wednesday, I'd had two very easy calls. Ahhh.

And the system, as it is, is very nicely set up. Whenever the second year takes call, they're on by themselves. So they do consults, admissions from the ER, stuff on the patients already admitted, whatever. And they wind up being on a little bit less than q4, although not much. When Liz or I - who are strict q4, on every 4th night - are on, there's an upper level resident with us. So we take care of the patients already on service, up on the floor, and we do any direct admissions (transfers, clinic patients, whatever). The upper level, who theoretically knows something about Neurology, handles consults and makes decisions about admitting people down in the ER. Plus, they're available for any point at which the off-service intern finds themselves in a situation where they need guidance. It's actually quite pragmatic and useful, plus, we both have an easier night than we would've alone.

Oh, and did I mention how much better it is that being the only medical doctor overnight in a state psych hospital that has over 500 patients? And isn't always staffed by the most competent medical providers during the day?

But then November first came along. And we lost four residents, and only gained three. Liz and I are still there, and I'm so glad, because holy cow do I like her. She's a good egg and a very good co-intern. But we now only have a chief and two second year neuro residents. Our chief is high strung and intense and micromanaging and, while very nice, is kind of a lot to handle. And, AND, she does things like decide we need to round at freakin' 8am (we'd been rounding at 9:30 prior to this), which means I have to leave my house by 6 to get there in time to preround on all my patients, which totally bloody sucks. And then yesterday she made the whole team stay until after she was done with clinic, so we didn't leave until way too late, despite the fact that the two of us who could leave (Liz was on call) had been done for some time. And while one of the new 2nd years is actually a really nice guy whom Liz and I both really like, the other one is a condescending jackass. Which, we all know how well I take to condescension. Arrrrrrrrgh.

But at least I have today off. Which is nice, because I need the chance to catch up on my sleep, because of course I'm on call again tomorrow. Such a good time. I'm on with one of the second years from our old team, who's a great guy, but always admitted a ton of people on call. We'll see how it goes.

Incidentally, the title of today's post comes from my habit of answering the question, "Are you on call tonight?" with something along the lines of, "Yep, I'm your Call Girl this evening." I said that on Wednesday, and the nurse and the RT I was talking to (both men), were all shocked and scandalized and giggly. I, on the other hand, was like, it's kind of a corny joke, y'all, calm down.

There are many ways in which I whore myself out for this job. That? Is not one of them.

In other news, in what spare time I do have I've been reading a lot, which has gotten in the way of me knitting a lot, which I hope to remedy soon. And all the people who told me my wool stash was useless down here? Oh, you lied. Lied like a hand-crocheted rug (you know, like the one in my bathroom). I may not need quite the same level of woollen insulation that I did in the Chi, but, it's gotten sort of chilly down here. You can tell because Maggie, who usually looks like this when she naps:

has started sleeping like this:

And the leaves are starting to change for real, which is very pretty. I'm told the Carolina springs are even more gorgeous. I have to say, I have yet to meet a season which isn't lovely in this part of the country (even if the summer was sort of steamy). We'll see how I feel about winter.