Sunday, August 31, 2008

Plan to be surprised

So, as I think I mentioned earlier, tomorrow night I start night float. It should technically be tonight (usually night float is Sunday to Thursday), but, gosh darn it, it's a holiday weekend. Shucks. So in the interest of being functional for my overnights, I've been trying to stay up and work on flipping my circadian rhythms around.

Last night I went out with my co-intern from Neurology, whom I haven't seen in a few months. We went to this brick oven pizza place for dinner. I came home, I puttered around, I started a new, really basic (and thus quick) sock. I called my friend in California sometime in the middle of the night (heck, it wasn't the middle of the night there). He kept me busy for a while and introduced me to Yacht Rock, which was apparently this phenomenon out on the other coast for a while a couple years ago, produced by this Stone-and-Parker-esque group down in LA. I watched the rest of the episodes today, and highly recommend it. My particular favorites are episodes 7 and 10 (the latter of which demonstrates that the days of lyrical feuding way predate Biggie and Tupac). I promise this is less ridiculous and more actually funny than my previous recommendation, like, say, Trapped in the Closet (although, if you're looking for ridiculous, there on the same site you can find House of Cosbys....).

Ahh, the things you learn when rattling about in the middle of the night....

I ultimately fell asleep sometime around 6:30, woke up briefly when Little Maxine vaulted herself off my bed three hours later (when Sparrow stuck her head through the dog door and said, "Maxiiiiiiiine!!"), and woke up at 5 this evening. I was a little confused. Maggie was a little confused. My parents (who'd been calling me since noon, not that my phone rang, and not that I would've heard it anyway with my trusty earplugs in) thought I was dead in a ditch somewhere.

So, tonight's been a similar bit of random puttering. Maggie and I took a ride and got some dinner...er, breakfast....um, something. I unpacked a few boxes in the office and determined I need about three more bookcases. And, I watched one of the sweetest, funniest movies I've seen in a while, Dan in Real Life. It's one of those romantic comedies about how life sort of does what it wants, regardless of what you think it should do, how it brings people into your life when it wants to (and precisely when they need to be there) rather than when you'd like them to show up.

The last line of the movie is, of course, the title of today's post.

I pondered that for a good long while whilst I was unpacking. When I was in grade school, I planned to get married after high school (or maybe in college) and then start having babies around 21 or 22, because that was just so old. For much of high school I planned to go to a small liberal arts college in Ohio near my family there and major in music education, and then head into a life as a high school band director. When I graduated from medical school, I firmly intended to do my four years of generalist OB/GYN training, then do a 3 year fellowship in high risk obstetrics, and begin a nice long career and write some very smart scientific papers and maybe a book or two that may or may not have anything to do with obstetrics.

At no point in my life prior to, say, a couple of years ago, would I have believed you for a moment if you'd told me that, now, six weeks before I turned thirty, I'd be living in a little house I didn't own in a Southern college town, with a dog; that I'd be a single, second-year psychiatry resident in North Carolina; that I'd be writing in a very public forum about my life, being reasonably frank and up-front about being single, being a psychiatrist, being a trauma survivor and recovering bulimic and the million other things that I am; that I'd be planning on a child and adolescent psych fellowship; that I'd have dear, dear friends all across the country that I'd never met and that I'd be so far away from the people who were most familiar to me; that I'd have the people in my life that I do, and the ways they came into my life....not to mention the people who are gone in one respect or another whom I assumed would always be in my life... It really amazes me, sometimes, my life and what it is and how much I generally like it. And how it is always, invariably, so incredibly not what I had planned.

Hmm.

Saturday, August 30, 2008

Sock-cess!

I finished the Tolerance socks today.


The second sock went amazingly faster than the first. I mean, like, months. I started the first one in, what, January? December? This one took less than a week.

Then again, I had help.


Maxine was over to visit today, she gave me a hand.


Interestingly, you can see a big difference in the two. The second one (right foot) fits a lot better, despite my fiddling and shaping over the back of the ankle on the first. Oh well. The second one does have a tiny hole at the junction of the gusset and the heel flap.

The biggest problem I have is that where the heel flap starts (at the bottom, of course, because they're toe-up), it's weirdly squared. Which kind of pops out a little. Any thoughts on how to fix that??

I'm also thinking I should've done some plain ribbing at the top, and I'm not finding the sewn bind-off to be tremendously flexible.

They also pick up dog hair better than a Swiffer.

But I love the yarn (TinyTyrant may think she won the yarn swap, but I think I definitely came out on top), and I generally really like the pattern. I've started on another pair out of a leftover from the shop, which is probably too thick for the 3s (it's closer to a true worsted weight yarn than a dk weight, which the Royale Hare is, although it doesn't look too much thicker). Although if I can dig my yarn stash out of the pile of boxes in the office, I might do something different. We'll see....

Friday, August 29, 2008

Random thoughts

Ohh, I'm so in that post-call, really tired, disorganized wackiness. My head hurts. My tummy hurts (Ruthie and I went out to dinner. The conversation was lovely, the food was good, but something has clearly not agreed with me). So I'm going to spare you any of my random ramblings tonight...

Thursday, August 28, 2008

Lovely Thursday

So I'm on call.

I know! It's been a while.

The thing about Thursday (or Wednesday) call is that I don't go to the coast if I'm on call (or post-call). Because apparently they can't risk me being stranded at the beach when I'm supposed to be here and being all call-like. So I basically have the day off until 4:30 (when call starts).

Now, I start night float next week (wherein I work from 9pm to 9am and don't have clinic), so I have this great idea yesterday that I'm going to stay up late and sleep in today and start reversing my sleep schedule so I'm actually awake to do things next week.

Except I fell dead asleep a bit after midnight and work up at 8:30.

Oh well.

I did some stuff at home, read some things, futzed around, watched some very old reruns of ER on TNT, and finally dragged myself out into the sunshine around noon or oneish. Because despite the torrential downpours of yesterday, it was a glorious, gorgeous late summer day today, that was way too nice to spend completely indoors. I went over to visit Little Maxine, who is having to stay home at her new home these days (Sparrow, who of course moved ever so far away, a whole two blocks or so, had been leaving her at the old place during the day until our old landlord and my new landlord actually closed on the sale of the property this week). She was very happy to see me. We had a good snuggle and she peed outside and soaked in a little sunshine and then I gave her a little treat.

I then ran off to the Borders, because I got my Borders Weekly this morning and discovered that Kathy Reichs has a new book out (Devil Bones). I read the first chapter online and a couple of reviews (apparently the ending is hard to swallow) and then I sighed and decided to face the inevitable - that I would buy the book, devour it like a hungry wolf with a t-bone, and then grumble about the formulaic plot (Temperance catches a case. Something edgy happens regarding the case. Temperance has a conflict in her personal life. Temperance gets "in too deep" regarding the edginess of the case. Someone may try to send her a message. Temperance does something stupid, almost gets her ass killed, and gets saved at the last moment by the man of the hour, whom she still doesn't end up with) but somehow still love it - and just suck it up while the inevitable was 40% off. Plus, this book seems to be set in North Carolina. That always makes me happy. I like when she writes NC. I also got Crazy Aunt Purl's book and this other one I'd heard about, On Chesil Beach, on the buy one/get one half off rack. So now I have something to read next week in case night float is slow going. It sounds like it's been sort of hit or miss lately.

Okay, and how concurrently psyched and bummed am I that the new season of Bones starts next week? With a two-hour season premier that I will have to go to work in the middle of. But, well, I guess that's what the DVR is for....

I also hit the Starbucks and then came home and was like, hmm, it smells like dog urine in here...

Maggie, apparently, has decided it's okay to go in the house.

I'm crushed. Not because cleaning up dog messes from hardwood floors is just so difficult (hardly), but because she was doing so well with the doggie door thing. Everything was dry (how did I not smell this yesterday?), so I suspect the thunderstorm was probably the inciting factor. Yesterday was also when I noticed that she started hiding in her crate every time home (you know all those dog experts that are like, oh, they don't remember that they've done anything wrong for more than, like, 45 seconds? Whatever). We'll see how she does tonight.

Me, too. I had big plans for things like grocery lists and editing dictations and trying to stay awake at least a few more hours. But I promise not to pee on the floor.

Wednesday, August 27, 2008

STOP THE PRESSES!!!

So...I'm posting my previous post...and I think, hmm, it's almost September, what is today, anyway? It's the twenty-sev.....wait....ohhhhhhhh, bad Kate.....

My dear and darling friend Bianca has been thirty for a WEEK now. A week!!!!! And I...well, I'll be honest, I didn't forget your birthday, but I kind of forgot what day it was.

HAPPY BIRTHDAY BEI!!!!!!

Hope it was awesome. I'm sorry I missed it. Among other things I miss?? You!!!

(Bianca likes orange and green. It's the least I could do.)

Maggie may have to change her name to Toto...

::sigh:: I guess the drought is over....

So the remnants of TS Fay are here (you know, a week after I didn't fly to the coast because the Tropical Storm might ground us. Oh well). It's been raining like a damn monsoon (or, say, a tropical storm) off and on all day. Apparently, there were all sorts of tornadoes around the state today. Or, well, maybe. There are reports. We can't confirm anything. It's possible there were tomatoes spotted across the state today, we may not have the whole story straight.

Sometimes I really miss the Chicago Tribune.

It was sort of funny, though - I went to my psychotherapy supervision this morning, had a nice discussion of my last therapy session with my supervisor (so, I do therapy, and then I go and discuss it with a real therapist, who gives me feedback and makes suggestions and that sort of thing), stopped at the Starbucks and tried to read for this afternoon lectures, made it through part of the readings, couldn't bring myself to finish the CBT stuff, and gave up and came home for a while, because, well, Maggie isn't a big fan of storms. So we hung out, and, I'd left the TV on for her while I was gone today, right, because of all the raining and whatnot. And I'm lying on my bed reading my email and listening to the News 14 Carolina weatherman blather on and on about tornadoes and how deadly they were and that conditions were right and that the NWS was not going to hesitate to continue issuing tornado warnings pretty much on a whim and he felt the need to tell us, you know, the topography here isn't like the Midwest, tornadoes can just pop up all of a sudden... Okay, first of all, I don't know how he knew when he made that last comment that I had just moments prior looked out the window and said, "Nah, it doesn't look like it's going to tornado." But second, here's a tip, Mr. Weather Guy - they sort of just pop up in the Midwest, too. Not out of the clear blue or nothin', but, I'm just sayin'. Anyway, I had to change the channel for her before I left again to go to the hospital for lecture, because he was just way too anxious.

I used to be terrified of tornadoes when I was like, late grade school to high school. Terrified. Like, if there was a single cloud anywhere (and, let's review, I lived in Chicago) I'd get all worried that the day was going to end in disaster. But then, I had a lot of phobias that sprung out of sublimated neuroses back in those days...now, they only really bother me because of the dog. Although Maggie's outgrowing her hatred of thunderstorms, it seems, or at least she doesn't automatically pee all over everything the moment there's a distant rumble of thunder. But still, she's more tolerant of them if I'm here. And while I certainly worry about, you know, her well-being if our house were flattened by a tornado, but I just worry a lot more about her being scared.

Anyhow...one definite positive of the local newspaper's website, even if they can't tell me if there were actual twisters today, is this video. It's a political cartoon spoof of Adam Sandler's Hanukkah song, and it is not to be missed.

Although..........who else is disappointed in Obama for being a Sox fan?

Tuesday, August 26, 2008

Long-ass Tuesday

Not that my Tuesdays are going to get any shorter. I signed up for the two Tuesday night courses offered this term by the NC Psychoanalytic Society. They start in two weeks. A full day of clinic and then four hours of class is going to make for some long freakin' Tuesdays.

Today was particularly long, though, although, not wholly unpleasant. I walked to work today...it was one of those days where it's not quite raining enough to really warrant the umbrella, but still enough to get me pretty wet. Naturally our child patient was a half an hour late, and took for-ev-er. Then I had a loooong afternoon clinic. Then I had a therapy patient.

Sparrow says to me, "Huh. You had a kid, psychotics, and a neurotic. It's like the whole spectrum of psychiatry all in one day!" The bird makes a good point.

Then I had to dictate, and fuss, and my very cool pink lamp finally came, so I had to set that up, and I had to futz around for a while, and then I had to be social and stall a little more...and then, of course, I had to walk home again. It rained a little harder this time, but I still went back and forth with the umbrella.

So then I got home, and snuggled with the dog just long enough to get a text message from Faye, who is doing her VERY LAST call at State Hospital tomorrow. Which is just such a milestone, so, hurray for her. And naturally we had to go out and celebrate. So we went to dinner, which was really very nice, even if it did take us until 10:15.

It was very funny....I called her when I got to the restaurant, and I said, "are you here?" She says, yeah, I just walked in. So I go in....and I look around....and I can't find her. And so I call her back, and say, "Are you at the same Chili's I'm at?"

There's a pause...and then she says...."I thought we were going to Red Robin."

We finally managed to get into the same place, though, and we had a very lovely dinner. With dessert. I like friends who eat dessert. It's sort of diagnostic in today's society, you know what I mean?

Anyway. I'm really wiped out.....time for more dog snugglage. It's really fortunate that I don't have to be anywhere until 9 tomorrow....

Monday, August 25, 2008

Love Monday

Okay, so I'm a little early this week....

I was having a reasonably rough day. I had to admit one of my clinic patients to the hospital. For a while there, it was - to quote the Bangles - just another manic Monday (did you know Prince wrote that song? I did not). I finished my clinic late. I had to finish the H&P and put in orders for the patient I admitted. I had to just dictate that one....last...note. I ran to the car. I was late to my shrink's. I wandered - starving - around the Whole Foods for a while. And then I got home, and two really cool things were waiting for me. Well, three, if you count the Ben and Jerry's Banana Split ice cream in my shopping bag (seriously! Hadn't tried it, but it's soooooo good!).

One, my dog, right? She's been wandering around unencumbered during the day. She's been SO GOOD. But the best thing is when she realizes I'm home, and comes outside and stands at the gate...until I say, "Come on, meet me inside!" And she takes off like a rocket for the doggie door. Vwoosh! And then practically noses her way through the front door when I open it because it's justsoexciting!!!! that I'm home.

I mean, how can that not make your day?

And two, I had a box on my front door! Squeee! I knew Tiny Tyrant had sent me a present, so, I forced myself to put the groceries away and start dinner (feta and broccoli pizza - yum) before I opened it, or I knew I'd end up eating that pint of ice cream for dinner. So, okay, I got the boring stuff done. And then I peeked inside...


Pretty. There was a nice little card. And then I pulled off the top layer of paper....


....I found a toy for Maggie!! She gets super excited about presents, too.


Then there was a nifty coffee mug. With my old doggie's name on it! I'm sure that's exactly what the Sonoma-based Wolf Coffee folks were thinking when they named their shop back in 1990. Which, okay, Wolfie may actually have been born around the same time. Still. So cool.

And then I pulled off the pink paper...and holy cow!! Look at all this neat stuff!!


I was a little overwhelmed, frankly. I recovered quick.


There was a whole bunch of cool stationary stuff...a date book, these really neat colored pencils, a square journal, a card holder (how'd you know I needed a thing for carrying my new business cards??), nifty sticky notes, a cool pen....and a tiny mini Burt's Bees facial kit.

And of course....there was yarn. Wicked. Cool. Yarn.


This is more of the Royale Hare sock yarn from Santa Rosa, the same company that made the yarn I'm currently using for the Tolerance Socks. It's a sport weight silk/merino blend in Sonoma Spring. So soft. Almost as soft as Maggie. Oh, it's amazing.


And then, then, there were two balls of Koigu KPPPM in, um, color P 714. Koigu has to work on their naming. But the yarn is so awesome. I can't wait to see how it knits up! Except...I can't decide which one to use first!! Oh, the dilemma!! I'll be sure to savor that decision while I'm finishing up my current sock...see? Again with the tolerance.

As I mentioned, Maggie was excited about presents, too...she liked the package from the moment I brought it through the door. Probably because it smelled like Jenn's doggies...and she really liked her bone.


It was good for a game of "fetch", which in our world, translates to, "Kate throws it, and Maggie tackles it, and then trots back all proud of herself, sans toy." And a little nom-ing.


And of course, Miss Mags never disappoints in the goofy picture department...


So darn photogenic, my girl.

THANKS, JENN!!! You totally rock!!!! And your timing was impeccable. Thank you, thank you, thank you!!!

::sigh:: I have the coolest friends, ever.

Sunday, August 24, 2008

It's like magic!

So I finished my first Tolerence Sock on Thursday.


It's sort of based on Sarah's December Nights sock pattern, except, it's a beaded rib instead of using her star pattern.

But the idea is the same. It's my first, actual, completed, toe-up sock. I'm pleased. It's the Royal Hare sock yarn (which seems to have lost or moved its website...) that Tiny Tyrant sent me in our yarn swap way the heck back in January.

I did a little fiddling with the pattern...as I think I mentioned, I did some decreases over the Achillies tendon to try and fix the bagging...I'm not sure it helped, but, whatever. And my heel turn is boxy and square, but actually pretty comfortable.

I'm reasonably certain the second sock isn't going to match the first one, because I want to perfect the alterations in the pattern before I start my next pair, which is probably going to be a gift for Ruthie, who requested a pair of wool socks and has been completely fascinated the whole time I've been knitting this one. I keep offering to teach her to knit, but I think she's still in the precontemplation stage. I also have, like, thirty-seven other pair I want to knit for people, not to mention the fact that I have this idea about knitting myself a whole drawer full of socks (if nothing else, the people at the New Balance store will stop yelling at me every time I go in wearing cotton socks). But I really like the pattern.

I also, as many of you know, used to be a die-hard devotee of the DPNs for sock knitting. It's traditional, it's small and portable, it's the way my ancestors made socks, right, there has to be importance in that. I tried the two-circulars method, because most of my knitting buddies were fans of that, and found it waaaay too fiddly to have those extra needls flopping all over the place. And of course we all scoffed at the Magic Loop people. That was just silly.

Until one day, when I convinced my bosses at the yarn shop to order the Magic Loop book as a means of using up some of the store credit I had. I said, make sure you order an extra for me, because I want to try this. They, of course, didn't (let's face it - my bosses are better at the yarn wholesaler business than they were as yarn retailers). But I got one anyway, and tried it. And got frustrated. And then decided to take a different approach. So I sat down and read it, and then went to my yarn and tried to base what I was doing on the idea rather than the step-by-step.

I've been a convert ever since.

So Magic Loop isn't nearly as strange or magical as it may seem. You'll need a long circular needle - 36" seems to work well for socks; 24" is doable but tight and 40" is a little too much cord but it also works (the Tolerence Socks are being knitted on a 40").


Here's what you do:

1. Cast on your stitches.


2. Pull both needles away from the cast-on stitches, so that they are now sitting in the middle of the cord.


3. Divide them in half (or, roughly so. If you're doing a multiple-of-four pattern or something, you can have two more on one side than on the other, but, you get the idea). Fold the cord at that halfway point.

4. Push on the needle end (either one) and feed the cord through so it makes a loop between the stitches that are folded at the halfway point.


5. Set your work up in front of you so that the yarn tail is on the back row of stitches.


6. Pull on the approriate side that loop of cord until the stitches in front are back on the front needle. Your back needle should be free of the back row of stitches with significant mobility so that you can bend it around and use that needle on the front row.


7. Knit into the first stitch of the front row. Work to the end of the row.


8. Flip your work over and repeat.


Eventually this will become a tube. I've made hats, bags, mittens...you can make anything circular with this method. It takes a little pratice and fuss to figure out how to position the needle around the working yarn so that you don't get it all tangled up in the cable, but you get this pretty quickly. And anything you can do on straight needles, or DPNs, or two circs, you can do with this - increases, decreases, cables, bobbles...okay, please don't do bobbles. The world has enough bobbles already.

For those of you who are more visual or auditory learners, here's a nice video off YouTube.



And you can use any sock pattern, but for the more advanced, here's the next one I want to try. It's the Magic Loop sock pattern from Knitpicks. Free download! Hooray!

Thoughts? Questions? Tips from the gallery? And hey, Allison - did that help??

Saturday, August 23, 2008

Sleepy Saturday

So I spent most of today napping and trying to recover from call. Which was nice. About 5:30 or so, I heard this weird buzzing...and I woke up a little, and I looked over at my phone...and I thought, hmm. What is it doing? And then I went back to sleep.

Fortunately, I woke up a little while later and realized the phone had been ringing. I know, weird, right?

So Faye and Sparrow and Peng and I went out and had some dinner. It was nice. We had a good time.

Anyhow.

I'm still really tired. I promise to post my previously-intended sock post tomorrow. Honest. No, really.

Friday, August 22, 2008

Accidentally on call

(Which, if you didn't know, is a reference to this song. Good song. Weird video.)

So I got home today around noon. I didn't have any patients scheduled, so I went in for lecture, did some stuff, called some people, faxed some things, and then left, because, why just stick around? I got home, played with Maggie, checked my email, and, well, I was just going to lie down while I watched TV...well, maybe I'd take a little nap...

I woke up when Fang called me at 3:30. Poor guy's been sick as a damn dog all week, and was supposed to take call tonight. And he'd been feeling better, but...you know, as those things often go...so could I take his call tonight?

Of course. Except, because he woke me up, "of course" turned into "Yeah, yeah...sure....okay, wait, what time is it? Oh. Um, yeah, of course I can, yeah. Wait, um, let me think about what I, I, um, have to get some stuff together. Yeah. Okay. Let me do that. I'll be there by 4:30. I think I will. Yeah, okay..."

Articulate.

Anyhow.

I figured, what the hell, right? It's not like I had anything else pressing to do with my Friday night (sad, I know). I'd had a nap. Plus, I'm on with Renee tonight, so, that can't be bad.

It started out as one of those nights that was weirdly busy - like, there's still only one person on our call sheet (but there's two more in the ER we're going to get called on), but, that totally undeerrepresents the amount of work we've had tonight. Between the crisis pager, floor calls, other random shit...lots of fires to put out, stuff up in the air, etc.

And then, as my friend Barb would say, then the bulldog showed up.

So, I'm sitting in my office, finally eating my dinner that I had to order twice (because they somehow didn't get the order the first time), and I hear this tiny little voice in the distance...and it seemed to be saying, "Adult Rapid Response, 3 Neuroscience". Over and over again. A rapid response is like a step below a code blue. And the Neurosciences hospital is the one in which I live, er, in which all my patients are contained (psychiatry has floors 1 and 3-5; Neuro has 6 and some clinics on G. So Neurosciences. Plus, the ER's in the basement). So, I thought, wow. Shit. I probably should go. And so I open my door and Renee is standing in the hallway about to knock.

Turns out this is her very first rapid response.

So we hurried upstairs (you run to a code. You move quickly to a rapid response while hoping the medicine team will beat you there) and this patient of Ruthie's had a seizure. So he's lying on the ground drooling, having fallen out and conked his head on the chair on the way down (and yes, I did use the words "fallen out" and "conked" when conveying this to the medicine team that showed up. It's how we roll in the Dirty South). We got an IV started, we ordered some tests, we got him off the floor, etc. We fussed around like we knew what we were doing (and, okay, on this one, I actually did). I argued with neurology over whose service he should be on (theirs. But, knowing the resident on call as I do, he wasn't going to take him. And he's probably in better hands on our floor).

And then, right in the middle of all of this pandemonium, Renee grabs my sleeve and says, "Hey, can you help me with this?" Dr. Morgan, who supervises my psychotic disorders clinic, had paged her to find out some information on a patient from our clinic.

She killed herself tonight.

Apparently, her husband called Dr. Morgan at home (how he got that number, I don't know) to tell him. Dr. M was calling to get some information from the records from our ER. We couldn't find her in the ER census. We called the ER; they didn't know about her. So I called Dr. Morgan back, and it turns out she never made it to the ER - she was dead at the scene. I don't know the details, but it was like a bucket of cold water.

Wow, I hate it when they do that.

It reminded me of the first patient I disconnected from life support at the Emerald Palace (have I told y'all this story already? I can't find it, but I didn't look very long, either). I was on my ICU rotation, and this woman came in having run her car off the road. Her abdomen was still open because her liver was hamburger and she was too unstable to do anything but pack off her liver and run her up to the ICU. There's actually a much longer story attached to this event, but the short version is, her family finally faxed us her living will (which was handwritten and signed with a peace sign and a heart before her name - peace and love), and they decided that they didn't want to come in, because "that wasn't her anymore." Well, maybe, but she'd only been in the ICU a few hours and this was sudden and unexpected. And I wrote the order to turn off support, and then I walked into her room. And the nurses were like, it's okay, this could take a while, we'll call you when she's dead. And I said, no....someone needs to be with her when she dies. And the social worker overheard this, and he came in with me. And I held her hand as they turned off the vent and the meds keeping her pressure up and she didn't even try to draw a breath. It was over in less than two minutes. Quiet, peaceful, just like that. I pronounced her. I turned, and I walked out of the room, and I filled out my paperwork (there's always just so much paperwork), and I called the medical examiner (with whom I would be on a first name basis by the end of that month. I was the friggin' Angel of Death that month, I swear to God...).

And then I went into my call room, curled into the fetal position, and bawled like a frightened child for three hours. Or until I had to be a grown up again.

I can't imagine dying like that. Alone, in some big sterile place, with some strange woman holding my hand because she didn't want me to die alone. Not that I would begrudge my family for not coming - they were right, that probably wasn't really her anymore. But it still felt so...discarded. Oh well. What's for dinner?

I remember looking at her chart later and finding a whole bunch of psych notes, talking about her depression and including one admission for suicidality. And I felt this chill run down my spine.

I tried to convince myself that, because she'd had her dog (who, by the way, came through this whole crash unscathed, at least physically) in the car with her, it couldn't possibly have been a suicide attempt. But I still don't believe that. And I guess we'll never know the truth of whether or not it was, but...man, I just don't understand.

I had that same feeling tonight, trying to deal with this issue in the vacuum of the expanding chaos that surrounded me on the unit right then. That same cold emptiness and confusion at the pit of my soul that I felt that winter night in the call room. Except it was more solid and contained, because I was still the person in charge, I was still dealing with the seizure guy, I wasn't in the quiet solitude of my ICU call room. Or severely clinically depressed, like I was that cold November day.

It's 1:15 am now, and I'm still dealing with the seizure guy, in case you were wondering. All sorts of fussing. It's ridiculous. I think I finally have it straightened out, but I think I'm giving up and going to bed soon....

All I can hope is that Ms. J found her peace today. That she's liberated from her pain, and her voices, and the demons that haunted her. I can only hope she's in as beautiful a place as we all hope to find beyond this life. And I hope that where she is, her husband, her children can finally understand, have moved beyond their grief and resentment and confusion. That she's finally free in the arms of her God.

Rest in sweet, sweet peace tonight, Ms. J.

Thursday, August 21, 2008

Day (not) at the beach

So this morning they told me, sure, we can get you to the clinic, but, well, the storm was in South Carolina, and it may well be moving up the coast. So, gosh, you know, they might not actually be able to get me back home later.

Uh, yeah. No thanks.

So, I stayed home. Tough decision!

It was a nice day. There was even some sun in the mid-afternoon. I got some stuff done, ran some errands.

Mags was happy to hang out.


I went to Target in the morning. Got nothing very exciting. Well, except Jumbones. Including teeny-tiny ones for Little Maxine. And giganamous ones for Miss Mags. I gave Maggie one when I got home, the really huge Pedigree one (an Enormabone? Gargantubone? Something like that). She ate half and then spent the next hour trying to find exactly the right place to hide it.

I managed to go see my therapist early and then decided I wanted a latte (and an excuse to finish turning the heel on my Tolerance Sock), so I went to the Starbucks, and pulled up my usual spot at the bar. I like to watch the goings on from my perch up there. And I opened up my latest copy of Annals of Contemporary Psychiatry (so I could pretend I was working) and set about my task. I got through the heel. It looks better. I actually decreased more than the pattern called for and then increased back up again, which I'm hoping will help with the perpetual problem I always have of the sock bagging at the ankle. And it looks way better than the last time I tried the heel.

And then I got picked up by the cops.

So there I am, knitting at the bar, minding my own business, when some dude walks in (and as any psychiatrist knows, minding your own business is always the single most dangerous thing to do, especially when some dude is around. Worse is when there are two dudes. Whoa. Always leads to trouble!). And the next thing you know, there he is, sitting next to me, with a big ol' white mocha, trying to make conversation. With his little radio on his shoulder and his shiny badge and a shinier Glock. And he was smooth. Asked me what I was making, if I had any other hobbies, commented that he hadn't seen me there before (so lame)...didn't ask what I did, or why I was sitting at Starbucks at 3:30 in the afternoon on a Thursday (although we'd already established that I had a job, because I commented on how glad I was not to be there), but after bringing up the bizarre behavior of one of the other customers, asked me if I was a "professional people watcher." Which, by this time I'd stopped being quite as, "hmm, yeah, denied," and started laughing. And I said, "yeah, actually, that's pretty close to what I do."

We had a fairly nice conversation. He's a hostage negotiator, apparently. Given the way he worked me up, I can totally see that. We don't exactly live in NYC, so he says he uses his skills mostly talking down suicides. We swapped a couple of war stories. And then one of his squad walks in, who comes on over, and also starts chatting me up. The first officer asks for one of his blank cards so he can give me his number, um, because he might need a shrink (he gave me his cell). The other guy is all, well, what if she wants to call me instead?

Somehow I ended up with both of their numbers. I think that's sort of funny.

Then I got home, and my crappy $10 bike, which my parents had sent, was waiting on my front porch. So I spent an hour or so trying to reassemble it, with only moderate success. The mosquitoes were swarming so badly, I finally gave up.

Sparrow called me shortly thereafter and asked if I could go rescue Little Maxine (she's on call). Max hung out with us for a while, and then promptly went outside and started trying to dig under the gate.

Did I mention on Monday how she successfully escaped from our yard?

So, given that she was an elopement risk, I attempted to lure her with tiny little Jumbones. The first one, she just stole out of my hand as I stuck it out the dog door. But then I got smarter, and I lured her inside before taking the bone even out of the bag. And then I shut the dog door behind her.

She was sad.

She got over it.

Maxinie, enjoying her teenie-weenie Jumbone (can that tiny thing still be called a Jumbone?). I think she was trying to share it with Giant Loofah Dog.


"Wow, Giant Loofah Dog! These are great!!"

Wednesday, August 20, 2008

I'm a loser, baby...

This is today's song that's been lodged in my head.

This annoys me. For two reasons. A, I'm not a huge fan of Beck (although, I'll confess, that song has always sort of amused me...although, you can't listen to the lyrics too closely...). But B, because it's a symptom of just how effed up I am. Because you know when this started? Walking out of the auditorium.

I got a teaching award today.

No, no, yay for me. I got a similar award at The Emerald Palace, but it wasn't nearly as big a deal. Well, who knows, maybe it was, I'd already left. But it's really quite an nice thing - each year, one intern and one resident in each of the six core specialties receives this award, which is bestowed by the third year medical students. There was a ceremony and a check and a certificate suitable for framing involved. I really can't tell you how honored and humbled I am that they picked me. But initially, I was like, aww, thanks, that's nice. And then there was a lunch I was supposed to attend. And then, wait, it was a lecture. And then it turned into today, which turned out to be this giant auditorium (it has balcony seats!) about 60%-ish full of people, including all sorts of deans and faculty and students and then having to go up on stage (with about 8 or so other residents, thankfully) and me in the front row hyperventilating a little and wearing tennis shoes because it was kind of a hike from the hospital and I'm still having a lot of ankle issues. There were a lot of other awards handed out today, too, so it wasn't like it was all about me. Except in my head, where I was somehow ignoring the external validation and just focused on the fact that I looked like a Chicago commuter and was being completely neurotic about a whole host of other things.

Fortunately, no one else could hear the neurosing, no matter how loud it was in my head. It was a nice little shin-dig; this pathology prof gave a lecture about the history of medical education through the last three or so thousand years, the central point of which was, of course, everything comes from the Greeks. She started talking about how they evolved up from "this is punishment from the Gods" to the Hippocratic-era development of the four humours, and how disease resulted from their imbalance, and how redistribution of fluid was the answer back in 500 BCE, and I really, really wanted to yell, "just put some Windex on it!" It was actually quite a good lecture, though. I can see why she was their teacher of the year. And then there was lots of acknowledging of people who've done a good job with the med students this past year - best clinical rotation (Pedes), various faculty awards, a bunch of awards to this year's (as in, '09) graduating class. I cut out early because I had to get back for our afternoon of didactics, but I think there may have been a little buffet afterward, too.

I am so completely amazed that they thought enough of me to pick me. I seriously, truly, fully cannot tell you how much that means, especially after all of the intern-year PTSD and whatnot. Not to mention how much fun I had with the students this year. I mean, I really had some rock stars.

Okay, okay, I'm done.

Tonight I also had my first meeting as one of the Psych reps to the Housestaff Council (like Student Council, but, post-graduate. Residents and fellows, for those who aren't aware, are considered "housestaff". This is our governing body. You know, ish). It was quite nice. It was held in one of the conference rooms of this reasonably posh hotel in town. There was a good buffet, good conversation, and we got a little work done, too. I sat at a table with the other psych rep and our child fellow counterpart, a clutch of Family residents, an ER doc and this new Dermatology guy (Cute. Single. A little young). Basically we meet four times during the year at fairly upscale places, eat, and discuss a relevant issue or two. Not a bad gig.

Meanwhile, the outer bands of TS Fay have reached Carolina del Norte, although the bulk of the storm is still in Florida, at least according to all the NOAA emails I've been getting (I'm on their Storm Advisory Listserv - Atlantic). So it's raining nicely out there. I'm really, really hoping it grounds my plane in the morning, for no good reason at all except I, a, could really use the day off, and 2, so don't want to fly through a tropical storm - even the very edge of one, which, according to Forecaster Knabb, is currently back over water and gaining intensity - in a Coke can with wings that only flies a mile up off the ground. Yes, yes, I know that these are the same planes that they send directly into the eye of the storm, but, not with a flight-nervous psychiatrist on board!

Tuesday, August 19, 2008

Thinking outside the blog

I, just, had a weird day today. Not really a bad day, and I don't know that it was all that "stressful", but it was a really weird, anxious sort of day. Actually, everyone at work seemed to be having much the same kind of day. It started off poorly when I woke up at 8, having checked my calendar at 11pm last night and not had any patients scheduled for the morning, but upon waking up this morning I had one of those moments of, wellllllll, maybe I should just double (quadruple) check. And lo and behold, I had a 9am patient (crap!!). Whom, though, I really liked. And the rest of my patients today were all nice and stable. But it ended up just being a weird, stressful day.

So I bring you, tonight, some nice things from various other people's blogs. It's not an all-inclusive list of all the nice things I've seen on everyone's blogs today (like all of the growing-baby pictures! Aww!), but, it's a few.

First, check out what's been going on over at Crystal's blog. It's amazing. She has one heck of a kid, there (okay, so, she has three really remarkable kids). And then go eat at Red Robin. Maybe every night this week. The whole thing is just awesome.

Next, check out the pictures of Angie's wedding. Unbelievable. She looks amazing, Olivia looks beautiful, Rocky looks so very happy. Major props to Angie's mom for doing such a great job giving away the bride. And the scenery - oh, breathtaking! I'm totally loving the whole barefoot-on-the-beach thing.

It totally reminds me of Bianca's wedding, where I was, instead, barefoot in the forest (Ireland!!). I've been to a lot of weddings, and hers, by far, is still my favorite. Nothin' against the rest of y'all, many of whom have also had really fun and touching weddings, but, it was just so amazingly them...

(No, her wedding wasn't actually in Ireland...it's an inside joke....)

And, a really good YouTube video on Danielle's blog (oh, and the lyrics for it. Doesn't it sound like it should be an Ani DiFranco song?).

Tomorrow's going to be another long day, but, maybe I'll have something more to say about it....

Monday, August 18, 2008

Plutocrat

You ever get a word just stuck in your head? This is the one wedged in mine today. No, I don't know why. A plutocrat is a member of a ruling class that's determined by wealth. A plutocracy, as it were. So, I have no idea why that's rattling around in my cranium.

Seriously. I'm not the only one that has this problem, right?

I remember having a conversation with Kate when we were in college, about how she always had a song playing in her brain, and every now and then it would just revert back to a "default" song, which at the time, was that tinny little circus melody that you would know if you heard it but I can't sing it to you on a blog (and "de de de-de-de-de deet de deee de" isn't very helpful).

I was so relieved to hear that someone else did that, too.

There's always a song in my head. Always. I have this weird sort of multi-channel brain...and apparently one is a music channel. Sometimes a particular song is there for obvious reasons. Sometimes I have no earthly idea why it's there. Sometimes I don't even know what the hell song it is - I occasionally just have a phrase or a vague melodic idea. Mostly, though, it's a verse or a stanza.

I know. It's weird up in my head. You don't have to tell me that, I live here.

At the moment I have this line playing in my head:

My day's filled with mistakes, some that I didn't make, I carry them around.

It's from a song called 10,000 Stones by a woman named Adrianne, apparently. This one at least makes sense - it was playing in the background of the episode of One Tree Hill I was just watching. The first line - that line - caught my attention. You know how I'm a sucker for really good lyrics. I also like the chorus:

10,000 stones hanging deep in my heart
No, I don't know how they don't tear me apart
How could I ever believe
10,000 stones would build the best of me?

I identify with that. I think it's kind of profound.

(Claudia's out there rolling her eyes at me. She may not be the only one. Hey, profound is an individual thing, you know?)

Anyway.

I also feel the need to point out that I don't actually watch One Tree Hill very often. Or, okay, this is the first time I've watched it. Because I was reminded last week that it's filmed in the coastal town where I spend my Thursdays. Which, dude, it really is! That's kind of cool.

Is it wrong of me, by the way, that I'm kind of hoping TS Fay will spin up this way before Thursday morning and ground my plane? I like going coastal, and I think I'm not going for something like the next three weeks because of the call schedule, but I also could just really use a real day off.

I'm so very post-call, by the way. In case you missed that. Not that I didn't sleep last night (Peng rocks). But, well, I did sleep on the floor of our office. While trying not to sleep through any pages this time. And then there was Ed the Drunk Guy who's been calling the crisis pager all weekend, who somehow also got through to me, who wept and told me how much he trusted all of us and told me at least six times that his dad had cancer and his sister had a double mastectomy or that his sister had cancer and his dad had a double mastectomy or something, I wasn't really listening. Not that I didn't feel bad for the guy, but you know what? You can only listen to some old drunk guy for so long before he just totally stops making sense.

Today was a day with so much potential...see above re: full night of sleep. I left the hospital, ignored the parking ticket I got for leaving my car in a lot that's open on the weekends but apparently wasn't this morning, got gas, went to Starbucks, went to the Whole Foods, spent a ridiculous amount of money, had a little moment of "What the hell did I buy, diamond crusted strawberries???", came home, and was thinking about getting a move on my day when Mike called wanting to park in my driveway (he, also, gave up his parking privileges this year. He has scooter plans; I have walk/bike plans. Sparrow never has paid to park at the hospital). So I had to chat with him, and then I had to rescue Maxine (who, later, dug her way under the gate and escaped from our yard, a-HEM), and then...well...then I just kind of ran out of oomph. I spent most of the rest of the day lying on my bed reading. Or watching TV. Or out retrieving Maxine. I did manage to get the groceries put away, at least, and get the fruit washed. And I made pasta for dinner, which I promptly dumped into the sink when I was trying to strain it. So then I went out and got some dinner....

Anyway.

I should really go to bed....

Sunday, August 17, 2008

Look, Ma, no crisis pager!

Oh, wow. I had no idea what a difference that made.

See, the intern, which I am no longer, carries this screaming little black box of death thing called the "crisis pager." Which gets all the outside calls from patients, the referrals from other hospitals, and on the weekends, all the floor calls. The second year only gets the consults from other services and like consult-related issues (well, when I'm on night float, as Peng is right now - hi Peng! No, really, I'm going to bed - I'll have the crisis pager again). And I only had four consults to see today. Well, it started out as five...but then I got to the ICU and was like, okay, where's Ms. H? And this nurse sitting there says, "She's dead." Well, that's kind of what he said.

Allow me to illustrate this exchange:

Me (to med student): Okay, so, we have two people to see. Now, I think Ms. H is over here...
Nurse: Ms. H?
Me: Yes.
Nurse: She's dead.
Me: Dead??
Nurse: Yep. Dead.
Me: Wow.
Nurse: Expired.
Me: Huh.
Nurse: She's deceased.
Me: Mmm.
Nurse: See the big black box? (Gestures to monitor)
Me: Yeah.
Nurse: Dead.
Me: Right.
Nurse: She is no more.
Me: Okay.
Nurse: She's in rigor.
Me: (unintelligible sound)
Nurse: Dead.
Me: If I take her and whack her on the counter, will she still be dead, or just resting?
Nurse (who may or may not have known what I was referring to): Ha! That's great.

Hmmmm.

Reminded me an awful lot of this:


Fortunately, I do love that.

I saw another guy with an amazing story. He went out behind his shed, put his gun in his mouth, pulled the trigger...and the hammer caught on his sleeve. He says to me, "I guess I have a guardian angel out there."

I was floored. And this was, like, a week ago. He came in for something completely different. And he's feeling more hopeful now. But he also describes this feeling of pulling the trigger and the gun not going off, and being like....wait....am I dead? And he kind of opened his eyes and looked around, and could still hear the birds singing...and was like....no...I think I'm still here...and then went to move the gun down and realized what had happened.

I know that feeling. I remember it from when I rolled my car off the highway in NH. That feeling of...am I dead? Is this dead? Could I be dead? Wait...wait...no....okay....not dead. Except for the part where I didn't put the car in my mouth and pull the trigger. Er, you know what I mean. I can't imagine what it must be like to want to be dead, to think you're going to be dead....and then realize you've been given a second chance.

Crazy.

Saturday, August 16, 2008

Slowly, slowly

I'm getting things done around here, in bits and pieces.

It's amazing to me, how much intern year sucked the life out of me. Especially since now my days end up being way longer than they were on the inpatient units.

It was a productive day. I bought new shoes (walking-type, nothing too exciting). I went to Target. I looked for a bike. I decided I so totally did NOT want to spend $400 on a bike that I was going to leave outside at work and so my parents are paying $60 to ship me the hot-pink-and-purple ten-speed Huffy that I bought for $10 at a garage sale back in Chicago. Ya know.

So tomorrow is my very first second-year call. We'll see how it goes. I have different responsibilities as a second year, which is new and different. But I'm on with Renee, and then Peng is my night float counterpart that comes on at 10pm (oh, sorry, 9:30. This week, the Powers That Be decreed that we would be moving night float up a half an hour. Yeah, 'cuz that'll help). Should be a good time.

I did something else today, for the first time in 4 years. I walked into a Wal-Mart. Now, I think we can all agree that Wal-Mart is not the most ethical of places. And four years ago, Claudia and I instituted a boycott against them based on a number of heinous grievances. They refused to carry Plan B, they banned a number of "questionable" books, their hiring practices were discriminatory. And I had several patients who worked at the local Wal-Mart who, when the higher-ups learned they were pregnant, reduced their hours to the point that they lost their benefits. Etc, etc. Now, they're still a NOW Merchant of Shame, but, in recent years, they've come along a little, at least. They're selling Plan B. They've been forced into some more ethical employment practices. I haven't heard about any book bannings. And they did start the $4 prescription program, which, that has been a HUGE boon to so many people. Especially now that Target, Kroger, Walgreens (FINALLY), K-Mart, and so many others are also on the bandwagon. It's been a show of good faith, and so I thought I'd return the favor.

Wow. I forgot that I kind of hated Wal-Marts to begin with.

It was dirty. And I couldn't find anything I was looking for. And it was crazy. The prices weren't as cheap as I remember (i.e., they used to be just dirt cheap on electronics). And it was actually pretty stripped, which I couldn't figure out (there were a million an twelve people at the Target this morning, too)...until I walked past a display of UNC stuff. And realized, oh. All the college kids are back in town. And that Wal-Mart is halfway between UNC and Duke. The Target's right by NC State.

It took me back to my own college days, because back then, the only thing to do in town was drunken frat house debauchery (we were a dry campus, mind you) and the Super Wal-Mart. I cannot tell you how many times I could be found wandering around the Valparaiso Super Wal-Mart at 3am causing whatever trouble we could without getting thrown out.

The area's been built up a lot since I left. Which was a shockingly long time ago, at least in my world.

Dude, my five year med school reunion is coming up soon. And I'm barely not an intern anymore. That's going to be interesting...

Friday, August 15, 2008

Things people say

Life is like algebra: it goes on whether you understand it or not.

A quote from Allison's blog. Which apparently comes from her mom. Who is a wise woman.

My own life philosophies I've developed over the years? Sometimes life gets in the way. Sometimes the only way out is through. People occasionally suck. Sometimes when you get to the end of your rope, you just have to let go and trust that what you fall into is going to be better. People will disappoint you when you need them most, and amaze you when you least expect it. Life is like a box of chocolates.

Oh, wait, no, that last one's not mine.

Apparently, I'm very fond of "sometimes".

And if you were wondering, the title is actually a reference to this song.

I've been thinking a lot about words today, for a variety of reasons, not the least of which is a conversation I had with a colleague today about a lot of psychiatry-related esoterica.

But, for instance, I woke up this morning with a verse from this song in my head, which has in it this line: It's hard to make conversation when he's taking my breath away.

I really like that.

Actually, the first thing that was in my head this morning was something closer to this: Why are the neighbor's dogs barking? Wait...why is it so bright in here? Crap, what time is it? Awww, does that say six fif-....ugh, shit.

Hmm. Not as articulate. But as it turns out, I had left my phone, which is, of course, also my alarm clock, in the car. Helpful.

Anyhow. I digress.

So we've all started dictating lately. Because apparently this is faster than direct entry (it might be, actually). Now, some members of our class have been doing this for a while. Mike, for example, is a master dictator. Me? Not so much. I spend a lot of time saying things like, "Um....ummm....the, ah....." But what's been particularly amusing is how this all gets translated into text.

Seriously. You know that thing about how, if you set an infinite number of monkeys at an infinite number of typewriters for an infinite length of time, they would eventually produce the collected works of Shakespeare? Yeah, I'm wondering if maybe we could hire those monkeys.

We're all wondering what the heck is going on down in Transcription. They make up words, they input stuff that makes no sense, they take liberties with what we say...and it's so inconsistent. Yesterday, I was reviewing my reports, and like, they somehow understood the words "cacophony" and "cultural moree", but in that same group of reports was this sentence:

"Patient states that since that time, things have been ruff."

Wait. My patient was a dog? I totally missed that!

The mammalian theme continued today when PenguinShrink apparently had a patient who was "white as a sheep." She also had a patient who went from having Lou Gehrig's Disease to having "an LS".

I had another note regarding a patient who had some very strong things to say, and, as we often do, I included several direct quotes from the patient (in quotes. It's okay to swear in a note if it's in quotes). When I got the transcript, all of the expletives mysteriously became (INAUDIBLE).

Honest. You're not going to burst into flames if you type the word bullshit. I solemnly swear it. See? I'm not on fire.

Other amusing quotes of late, yesterday, Sparrow tells me (and I think she's right) that we may well be on the verge of World War III. Apparently, Russia thinks that Georgia brought this all on themselves. Sparrow says, "In general, it's a bad idea to invade people."

The other quote of the week? Ruthie. So, to fully understand this one, you have to understand two things. The first is that we're all supposed to be learning something called CBT, or cognitive behavioral therapy, this year. None of us are super thrilled about this. Because, among other things, it's this very formulaic kind of therapy with homework and worksheets and all that sort of stuff, but you know, it's not like we're going to know anything about the real meat of this stuff until after we've already started doing it.

The second piece of this story is our office. So Ruthie, Peng, and I are crammed into a two-person office. It's cozy, but, it's ours. Peng and I managed to find a few things for it...a nice little fridge, I had a little desk lamp, Ruthie had bought a microwave...and then, like, three weeks ago, Peng and I are on call together and hanging out in our office, and Ruthie shows up all of a sudden with a dolly full of...well...stuff. She brought a coffee pot and a grinder, another desk lamp, a bunch of random little things, a weird little black desk (that we promptly set the med student to work assembling), and this...well...there's this hot pink, cushioned, suede folding butterfly chair, and then there's this five-headed pink medusa lamp. So, basically, we have a dorm room (no really. There's even a bed...well, a camping mat...under my desk). Other words that have been applied are "bordello" and "trippy." John pointed out that he was walking down the hall and just "drawn in by the pink glow emanating from the doorway." So earlier this week, Ruthie and I were rearranging the office (all of our stuff fit just fine until we had to put, you know, Ruthie in there), and we solicited a second opinion on the layout from Tyler, and Edwina, who's one of the social workers. Tyler suggested we needed a stripper pole. Edwina suggested that we could use that as a means of teaching our patients a marketable skill. Like vocational rehab, I suggested.

So Ruthie and I passed this idea on to Peng. Who pointed out that she didn't really know how to use a stripper pole.

"Oh, no problem," Ruthie says. "Stripping is like CBT. You'll just pick it up as you go along."

I laughed my ass off. But, yeah, that was probably only funny to us, wasn't it....?

Thursday, August 14, 2008

What the bloody fuck, people?

(*This post contains strong language and may not be suitable for all viewers. As if you couldn't tell that from the title.*)


Okay, so, I was having a pretty good day, and I get home, and I have a comment on a post from March 3rd in my inbox. Which was, what, five months ago? And I thought, huh, that's weird. Because I remember someone making a stupid anonymous comment on that post around the time I posted it. It was a post about how I'd been having a particularly bad day, and among the things that had happened, Maggie had taken off running that day (Maggie, who thinks it's a game when I chase her, and who thinks it's fun, and who comes home the moment she thinks I'm going to just let her run). So I open it up, and this is what some, again, "anonymous" cowardly pig-fucker had to say:

"It is bad news. It's bad news that your dog came back. And now has to suffer living with miserable old you."

I....I didn't know what to think about that.

It occurred to me that it could've been a particular friend of mine who'd just been reading back that far (you know who you are, and if it is, email me and identify yourself RIGHTNOW so I can stop being all pissed off). Because it's kind of congruent with his very sarcastic sense of humor, in which case, knowing the source, it would actually be quite funny. But then I thought, why the anonymity?

And that's when I got mad.

First of all, why a five month old post? I've said many inflammatory things and made several dumbass remarks since then. Second, put your name on it. I don't care who you are, but saying something like that anonymously just makes you a punk-ass, chicken shit little bitch.

Third of all, if you don't like my blog? Go somewhere else. And while you're at it? Fuck off.

But most importantly, and so listen up, do not fuck with my dog.

That dog would take a bullet for me. And honestly? I'd take one for her. We may not have the "perfect" life, but it's a damn good one for us. She was in bad shape when she came to live with me. And now she's a happy, healthy, pretty darn well-adjusted pooch. I love that dog more than anything.

Get bit, you dumbass motherfucker.

And, by the way? Here's what Maggie thinks of you:

Wednesday, August 13, 2008

RIP

Sparrow calls me when she gets home tonight and says, "Is it still stinky over there? You want me to come sniff?"

That, right there, is a true friend.

It reminds me a little of how my best friend and I have this habit of reading books that it turns out we hate, and then giving the other one the book, saying "Oh, my God, this was such an awful book!! Here, read it." The funniest part of which is that, of course, the recipient does, and then we've both read a terrible book.

We have, for the record, been known to do that with enjoyable books as well.

Anyhow, so Sparrow comes over. She walks in, and she's like, "Wow. It stinks in here. I smelled it outside. Yeah, it's probably like a dead mouse or something."

I said, what? No. No mouses, thankyouverymuch. Plus, the whole house smells. And, I pointed out, there are no signs of mice. So we poked around, looking for mouse poop or actual dead mice. She says, "Is there one in your washer?"

I....what?? NO!! But we looked in there anyway.

She says, is it the garbage? We smelled the garbage. Not the garbage. She says, is it the poop outside? Did you clean up the poop? I said, no, it doesn't smell like poop. It smells like something dead. She said, well, yeah...

Kathy Reichs, in one of her books, wrote this scene where Brennan is out with her ex-(ish-)husband's dog, and the pooch just goes nuts. Brennan notices that she smells it, too. "It" turns out to be a dead squirrel. But has some line in there that all animals have a sensitivity to the scent of putrefaction, and humans aren't any particular exception to that. I've been thinking about that passage all afternoon.

Anyway, we poke around some more, finally go outside, and I make the big old mistake of opening the little access panel to the crawlspace under the house.

Ohhhhhhhhhhh, shit.

There is definitely something dead under the house. I'm guessing it's a raccoon, or a cat. Or maybe a homeless person. Or a bear. It frickin' reeks around here.

So I called my landlord, finally. Who said, oh. Sorry. And promised to dispatch the gardener. Our doesn't speak English, earns just over minimum wage, really nice guy, now has to crawl under my house in search of the smelly smelly dead thing, poor, poor gardener.

Ew.

Tuesday, August 12, 2008

Or not.

Something stinks.

I really don't know what.

Maggie's been loose in the house the last couple of days. We're working on making use of that doggie door, right? So I figured, she's made a mess somewhere. Except I can't find one. So then I thought, well, maybe she's dragged something in and hidden it somewhere? Except, I can't find any evidence of that, either. So I'm washing her doggie bed. Except...I don't think it's that, either....

I'm thinking maybe something crawled up under the house and died.

Either way...ew.

Anyhow.

So I get a forward today, one of those mass emails with the cute pictures and catchy phrases and the guilt clause of, you know, "if you don't send this back to me I'll know you don't love me." And it led off with this phrase:

"There comes a point in your life when you realize who matters, who never did, who won't anymore, and who always will. So don't worry about people from your past, there's a reason why they didn't make it to your future."

And I got to thinking about that.

I disagree.

I think that I've lost a lot of good people along the way, you know? I've certainly kept a bunch, too, like I mentioned at the end of my last post. But I think occasionally about the people who aren't in my life any longer, for whatever reason, mine or theirs. And sometimes it makes me a little sad.

Sometimes, though, I will concede, I spend more time thinking, "Wow. Glad I dodged that bullet."

An ex of mine told me once, people come into your life, when they come into your life, for a reason. But sometimes, once they've fulfilled that, they no longer have a place there.

He gave me a lot of sound bites, that one. And to some degree, I agree with him. I'm not sure I agreed that it was a good reason to break up with me, but, nonetheless. Sometimes I agree with the logic of the above statement. Sometimes, I don't. I guess it's a case by case thing.

Ruthie and I, while rearranging our office on her whim this afternoon, decided that the gestalt of pretty much all of psychiatry comes down to the title phrase - "Or not." You could treat the patient with meds....or not. You could hospitalize them....or not. This patient has reasonably good defensive mechanisms so she must have been traumatized at the post-Oedipal stage...or, perhaps, not. One of the great things about psychiatry, which is also one of the most frustrating, is the propensity for which things are always the way they are...except when they're not.

Yeah, I don't know where I'm going with this, really. Just sort of waxing philosophic. Then again, maybe there's a point...

...or, not.

Monday, August 11, 2008

Looseness of association

The windows of my soul
Are made of one-way glass
Don't bother looking into my eyes
If there's something you want to know, just ask

I have this verse stuck in my head. Which is better than what I had in my head previously, which was the theme song from the Stanley Steamer commercial. Anyway, it's from an Ani DiFranco song called Willing to Fight, which, I think has some of the best lyrics ever penned. In fact, here they are:

The windows of my soul
Are made of one-way glass
Don't bother looking into my eyes
If there's something you want to know, just ask


I got a dead bold stroll
Where I'm going is clear
I'm not gonna wait for you to wonder
I'll just tell you why I'm here
'Cause I know the biggest crime
Is just to throw up your hands
Say, "This has nothing to do with me
I just want to live as comfortably as I can."
You gotta look outside your eyes
You gotta think outside your brain
You gotta walk outside your life
To where the neighborhood changes

Tell me, who is your boogeyman
That's who I will be
You don't have to like me for who I am
But we'll see what you're made of by what you make of me

I think it's absurd
That you think I am the derelict daughter
I fight fire with words
Words are hotter than flames
Words are wetter than water

I got friends all over this country
I got friends in other countries, too
I got friends I haven't met yet
I got friends I never knew
I got lovers whose eyes I've only seen at a glance
I got strangers for great grandchildren
I got strangers for ancestors

I was a long time coming
I'll be a long time gone
You've got your whole life to do something
And that's not very long
Why don't you give me a call
When you are willing to fight
For what you think is real
For what you think is right

I don't know why this is so firmly lodged in my psyche right now, but it seems significant (certainly more so than the carpet cleaning jingle). It started because I was thinking about Facebook, and that little "status" line at the top. I was doing the dishes and thinking of things I could change my status to.

Kate...

....inexplicably has the Stanley Steamer jingle stuck in her head.

....thinks that's particularly weird because she has no carpet in her house.

....wishes the damn oven would preheat.

....is hungry.

....wonders if it's bad that she was so grateful that three of her patients didn't show up today.

....thinks it's funny that no one else in her residency is named Kate, but about half of her female patients are.

....wonders why she always seems to be doing dishes.

....is hyperventilating a little at the thought of, if she's forever doing dishes (and laundry!) now, and she's just one person, what the hell is going to happen if she finds some man crazy enough to marry her and/or knock her up?

....is making pizza.

....wonders if she remembers how to give a shot in the deltoid.

....thinks her dog is really funny.

....hasn't been on a bike in a really long time, but figures it's like riding a bike...

Et cetera.

And this got me to thinking about this Marmaduke comic my dad emailed me today, that centered around text messaging. Now, I think of Marmaduke as a seriously old-school comic. You know, back in the Leave it to Beaver days of big doghouses and Norman Rockwell families. Which got me to thinking about how pervasive pop culture and all these new innovations are in our lives. Like, who doesn't know what OMG or LOL means? Every grandparent has email. One of our more senior attendings sent me a message from his iPhone the other day. Little kids and homeless people have cell phones.

Not bad things. But, I keep thinking, like, if my great-grandmother suddenly woke up in the middle of all of this, what would she think about it?

So this gets me to thinking about the internet, and this blog, and Facebook and email and how I have really wonderful connections going right now with people I haven't seen in ten or fifteen years, or people I've never seen at all. Which I think is what got me to the line about "I got friends I haven't met yet/I got friends I never knew." And then I got stuck on the opening verse, because I think that one (and the one about the boogeyman, and the two lines about words are hotter than flame/words are wetter than water) has just so much interpretation and philosophy attached to it...

...yeah, there's no explaining how things work in my head.

Sunday, August 10, 2008

Not a lot of excitement...

I still really adore a day off. I also really like a productive day. Fortunately, today I had both.

I slept in until - are you ready for it? - eleven today. I never sleep that late! And I went to bed not all that late last night...again, around eleven.

Sparrow said that she spent much of her first month of second year kind of walking around in a fog, and spent a good portion of the first couple of weeks asleep. I've been gradually catching up on some of the things that have fallen to the side.

Today I started out back at the Starbucks (did I mention I finally, FINALLY finished all of my discharge summaries from intern year?). They closed the Starbucks in downtown Chapel Hill, so a few of the Baristas have come over to the Starbucks I like in Durham. One of them is this British guy who sounds exactly like Jack Sparrow (Pirates of the Caribbean, for those of you who live in a hole, who was actually Johnny Depp, who is actually not at all British). Rather looks a bit like him, too, come to think of it, if Jack Sparrow were an early 20-something, heavily tattooed coffee slinger, rather than, you know, a fictitious pirate. But I do so enjoy his accent.

And then I went to the Whole Foods, and for once, I actually made a list. I think I'm going to go back to my six small meals a day plan for a while. I've worked with a collection of dietitians in my day. One of them was awesome. One was okay. The others, I have to say, totally didn't get it. I'll let you in on a secret - most anyone with an eating disorder could be a dietitian. We all know the calories and amounts and ratios and portion sizes and blah, blah, blah. So, that's really not what we need help with. Marilyn, the world's best dietitian ever (who is sadly in Florida), spent all of our time working on normalized eating, mindfulness, triggers, and balance. Know the difference? She's recovering from an eating disorder. Anyway, Marilyn the Fabulous and I had this whole checklist thing figured out. And I've noticed (when I'm paying attention) that my blood sugar's tanking in the afternoons, especially with this walking to work and all that. So we'll see.

So, anyway, groceries. Came home, did laundry, did a bajillion and a half dishes. Played with the pups (Maxine is over). Made dinner eventually. Watched a lot of SVU (I love USA). Met the new neighbors. All in all, a nice little Sunday off.

Tomorrow, of course I have a jam-packed clinic schedule. As is the case on Tuesday. I'm hoping I've got the routine down a little better this time around. We'll see how it goes....

Saturday, August 09, 2008

Locopup

Whew! I do love me a weekend off. I have...well...I guess I still just have two of them this month, which is the same number I used to get when I was taking intern call, except that I'm only on call three times this whole month. Cannot tell you how exciting that is.

I'm finally starting to deal with fixing some of the collateral damage of intern year exhaustion. For example, this morning I dragged my laptop and my tired ass over to the Durham Starbucks and sat there for four hours or so doing paperwork that was way, way, way overdue. Dude, I had a lot of work piled up from last month.


I did something like fifteen discharge summaries this morning. And learned a few things. I.e., did you know that Trampoline is an official Olympic sport? As is BMX biking, which is apparently new this year (that was the free drink question of the day - what three sports are new in the '08 Olympics? BMX and Steeplechase are the two that I heard, although people had some other amusing ideas. Lawn Darts was my favorite wrong answer). I still have two more to do (the really difficult ones), so I'll probably spend a bit more time there tomorrow morning. Who knows what I'll learn then.

I am happy to report, however, that my second year paperwork is completely up to date. Every clinic note has been dictated and edited. But don't worry. I'm sure to get behind again in short order...

And Ruthie officially moves in to our office on Monday! I'm very excited. Peng and I have managed to have some semblance of productivity this past month, but, I'm sure that's going straight out the window. Add Ruthie to the mix, and no one in that office will ever get any work done in there again.

So tomorrow is PenguinShrink's birthday (Happy birthday, Peng!). Ruthie bought her a bonsai tree, because, she says, Peng is a Bonsai Psychiatrist - wee, but hardy. I laughed really hard. I may just start calling her Bonsai.

We had a very nice night out in honor of her reaching double digits turning not actually that much younger than me (although I like to give her considerable shit about her youth. Mostly because when we're fifty, I'm going to look 55 and she's going to look 30). Strangely, a lot of our cohorts were out of town this weekend, but we rallied the remaining troops. It ended up being more or less the usual cast of characters - Ruthie, me, Peng, Sparrow, and Tyler, who had quite a harem going tonight, really - as well as another of our classmates (whom I know I've referenced on here before but can't remember the pseudonym I gave her! Martha, maybe?), one of the social workers from State Hospital, and our psych pharmacist from Big Hospital. We went to this very good Persian place in town. I had some sort of pomegranate chicken that was outstanding, as was the assortment of appetizers we ordered, not to mention the Iranian beer.

We then wandered across the street to this place called Locopops. Which, as you might imagine, has a selection of unusual popsicles made in a Mexican tradition called paletas. They have such flavors as Cherry Hibiscus, Mojito, Olive Oil and Lemon (dude, I don't know about that one), etc. Our group sampled the Cookies and Cream, Blueberry Peach, Green Tea and Jasmine, and Mexican Chocolate (that was mine. Very cinnamon-y. So good). And, know what else they had? Are you ready for it? Beef.

Okay, they had beef and chicken, which were on rawhide popsicle sticks. Now does it make more sense? So, naturally, I had to bring one home for Maggie. Because she was a very good girl today, and deserved a treat. Maggie stayed home by herself while I was at Starbucks, out of her crate, the whole time I was gone (we're working up to making good use of that doggie door). And she did well - didn't destroy anything, didn't get into trouble, and her human even remembered to put all the garbage cans out of reach this time.

So I brought her home a beef pop.


She was super excited.


Started licking the bag, jumping up and down...in an effort to minimize the mess, I thought I'd give it to her in her food dish, but in her crate (since I figured it was going to end up in her crate anyway).


We played that game for a little while....I put it in the dish, she took it out. I put it back in the dish, she took it out again. Et cetera, until I just gave up and conceded that it was probably time to wash that stupid crate pillow anyway. (PS -see that maroon thing in the corner? You remember the shawl Peng gave me for Christmas? Maggie kept stealing it, so Peng made her one of her very own to curl up with. I know, awwwww...)


Maggie really liked the rawhide. She was pretty psyched about the beef part, too, but the rawhide seemed to be her favorite.


Okay, now we're just into gratuitous pictures. I'm sorry, I can't help it that I have the cutest dog in existence!


But then.....it was all gone....


She got over her momentary disappointment, though, and I got a lot of very cold, beef-scented puppy kisses. And she's currently sprawled out on my bed sleeping the sleep of the very contented.

A good time was had by all, this evening.