Long-ass Tuesday...

Ai dios mio.

So I get to work today....and oop, it's like I never even left.

A, the damn pediatricians discharged my kid last night. Fortunately, his parents are responsible enough to have brought him back in today as a direct admission. Stupid, freakin'...oy.

But even better than that....right after I walked in the door, I get called into morning checkout and told that one of my patients that I admitted from clinic? Never showed up on the floor.

Um....??

And, uh, why is this just being addressed now?

I found her. She was fine, thank God. I convinced her she needed to come back. Apparently she'd told one of the clinic staff she was going home to get some clothes and they said, oh, okay! And then she got home and thought, you know, maybe I'm okay...

Who didn't see THAT one coming?

Oy.

So, everyone's in the hospital now. But I missed my entire morning clinic because of all the fussing. And was really stressed out.

And then I had afternoon clinic and class tonight and I? Am so just giving up on this day. Good night, y'all. If you need me, I'll be hiding under my covers....

Lockjaw would make it worse, come to think of it

So, my day.

It started badly.

And then it just kept getting worse.

Here's the most photogenic manifestation. This was about the third bad event of the morning.


I did this in the shower (toe vs faucet). While bleeding all down the other leg from a giant razor nick. Note the flap of skin on the medial surface of my big toe that's just been tacked down with a little purple band-aid all day. It probably could've handled a little stitch or two. And I probably could use an update on my tetanus shot, frankly (I'm right at the cusp). But no, I slapped on said little purple band-aid and just went the hell to work. Screw my lucrative career as a foot model!

Needless to say, between this and all of the falling off of my new bike that I did yesterday (21 gears and I can't find the one that will get me up a fucking hill), I did not walk to work today.

I had two clinics today (morning and afternoon). They were both full. Everyone showed up. The first patient in each clinic needed to be admitted. My very first patient of the day, whom, again, I had to admit, had to be escorted down to the ER by the police because he was scaring the attending. And then his mother yelled at me for lacking "human kindness" (he's in his 50s). After I bent over backwards being all soothing and empathetic and nice.

You want to see bitch? Because I can pull out bitch at any moment, old lady, just keep pushing.

Yes, yes, I totally understand she was stressed and upset. Which is why I just smiled and ignored the comment and kept up the soothing-empathetic-nice routine.

See? This is why I sometimes forget I'm allowed to feel stuff.

Because I already wasn't doing so hot when I got to work.

So, he gets escorted off by a man with a gun. I apologized profusely to my 9am patient. Thank GOD my 10am called and cancelled because he was stuck at the beach with his roommate. My 11? Came late and then took until 12:45.

Which meant I got to my 12pm committee meeting at 12:50. By when, thankfully, it was over, because I still had to eat.

I inhaled my lunch between 12:59 and 1:02.

No really, I looked at the clock.

My 1:00 comes in, looks like crap, is all depressed, I say, "do you think you need to be in the hospital?" She comes all unglued and is like, "yes, but I didn't think I could tell you." So, in comes #2. And while I'm admitting her (which is not a short process, but, on a full clinic day, it gets broken up a lot), my pager goes off.

One of my therapy patients is in the ER, having unintentionally overdosed on meds he stole from his mother. I went down to talk to him, and he didn't even respond to a sternal rub (for those of you who don't know what that means, drag your knuckles up and down your breastbone a couple of times. Now imagine me doing that like I mean it. Yeah, ouch). This later involved two...no, wait, four conversations with the ER resident and one with the on-call intern tonight about why this kid needed to be admitted. Now. And we'll put him in a bed when we have one. No, I don't care if he's all calm and awake now, he's coming in. COMING IN. BECAUSE I SAID SO, STOP ARGUING.

Damn passive-aggressive pediatricians. Say they'll admit him and then try to discharge him behind my back....

I'm just sayin'.

And, in case you were wondering, I JUST finished writing his H&P. At, like 10:15 pm.

I also had just a difficult couple of patients this afternoon. None of whom compared to the rest of the company, but, nonetheless.

And I don't like my socks that I just knitted. Or the other ones.

And I'm not even going to go into the biggest cranky-pants-inducing stuff that was making my day so bad. Because that lives in my head and needs to not be unleashed on the outside world.

Oh, my word, I'm so cranky....

At least? Tomorrow will be better. Because there aren't a lot of other directions in which it can go....

Ow.

Holy freakin' bad day, Batman.

Oop! And it's it's not even over yet! Still more work to do! Not to mention small issues like, you know, dinner.

Fuck...

Dude. Dude.

Oh, my gosh, I have so much to tell y'all. Good stories from call, good stories from today, fabulous pictures. And I'm so tired. And sore. And so need to go to bed.

So you're just gonna have to wait.

And, as it turns out....

I'm finally catching up on everyone's blogs, and of course, I managed to miss Marie's birthday. Hers was the 21st. She was, um, not 30. Go and check out the lovely pictures of her son and daughter-in-law's wedding, and her three other gorgeous children (her girls look positively stunning in the bridesmaids' dresses, with the flowers and the jewelry and the wraps that all coordinated...way to go, Claire).

Happy belated birthday, Marie. Hope the year gets progressively better and that the ceiling stops falling in on you!

Whew! What a day for birthdays!

Also of note in the blogosphere - go check out the handspun Charlie yarn over on The Daily Coyote. It's completely gorgeous. Makes me want to make a Maggie sweater....

Picture it:

Chicago, 1978. My best friend of more years than I care to count is born. Many years later, she chooses to comment on my blog under the name Claudia Ellen Ryan.

But! Picture this - Long Island, 1978. My other really good friend of about four years now, Annie, is born.

And, about two years later, in a place I just don't know, my friend Liz was born. I don't know if she reads the blog. But she was my co-intern and perpetual lifesaver on Neurology.

Whew! Apparently, today is a good day to be born.

Happy, happy, happy birthday to all of you.

Particularly to Claud and Annie for making it to the big 3-0. And for being as much as you both have been to me for so long. And for putting up with me for 16/4 really crazy years, through good times and bad, awesome and worse, momentous and of importance only to us. Through loss and change and progress and lots of fried cheese sticks and hot cocoa (respectively). For introducing me to white chocolate peppermint mochas and for adding "I know! Right?" to my daily vocabulary. For being awesome women and for telling me you think I'm awesome when you somehow know I really need to hear it.

I love you both. More than my luggage.

(PS - 20 bonus points to anyone who isn't Claudia who can name the movie that reference came from...)

Pictures. Aww.

Little Maxine came to hang out today. Mags babysat her while Sparrow and I were at work, because something was going on at Sparrow's house (something involving electricians at whom she didn't want Maxine to spend the day barking, I don't know). So I took the opportunity to break out the new camera again.

She's such the ham.

After I got home, she snuggled up on the bed with me until Sparrow got there. And did some high quality lookin' out the window.

Not to mention a little lookin' out the front door.

Apparently there was a lot to look at.

You know I couldn't help but slip at least one picture of my OWN dog in there....

From the little present Maxine left me, I'm guessing I'm not the only one that had a stressful day (at least it was easy to clean up. Meanwhile, what is it with the pooping dogs in my house?). It was my last day of inpatient coverage. I had my child therapy patient come in at the end of the day.

Seriously. His parents make me want to toke up.

But, you'll notice, I don't. And this is part of what we're working on for him, in therapy.

Then again, I don't actually have to live with them, either.

Ahhhh, childhood.

And I'm on call tomorrow. With Ruthie - it's her last intern call ever. And my 23rd-from-last-ever call (but who's counting?). Which means I really need to go to bed. Except, I just realized my scrubs are still dirty, because of course, I haven't done laundry all week. Or dishes, for that matter.

This is why I need my weekends off, damn it.

Guess I'll go read until the clothes are ready to go into the dryer...

Love (my photogenic pooch, and my photogenerative parents) Thursday

I had a long day, as per usual, really. We had Treatment Team this morning, which is something new and different on the Psychotic Unit. Treatment team is essentially this - one scared patient pulled into a room full of everyone involved in their care: doctors (4 people, including the med students), nursing (1), social work (2), pharmacy (1), occupational therapy (1), and rec therapy (1). So, 10:1. We put them in the hot seat and say, "how do you think things are going?" and assess where we are relative to our goals for treatment and their goals for treatment.

On the whole, this isn't as awful as it sounds, and actually tends to be very empowering to the patients (well, after the first one). Most of my patients did fine. One of them called me fat after I told him I was changing his medications and felt that he was not ready for discharge ("If we're going to get personal, you could stand to lose some weight." Hmm, yeah, thanks for the advice. Thank God you were here, I never would've known) and then railed on both me and my attending for eating meat. And...then said he'd have to just wait for his UFO to take him away.

Um...yeah.

Yesterday, he almost had me convinced that he was ready for discharge, had made a genuinely logical and somewhat reasonable argument....until he said..."Don't make me get the weather involved."

Uh-huh.

He continues.

"Fine, okay, two thousand years ago I was Jesus Christ, but..."

::sigh: You give a crazy guy enough rope, eventually...ah well.

So, long day. But then we had cake for Faye's birthday (we went out last night, but today was her actual birthday, and she was on call - ew - so Cleo brought her a cake and we sang and it was nice), and then Ruthie offered to drive me home. And then we decided while sitting in traffic that neither of us wanted to cook, so we went to this little diner for dinner. It was nice.

And when I got home, I discovered that my new camera came today! Thanks, Mom and Dad!

Fortunately, I had a willing and photogenic model.

Here's the shot from the old camera:


And the new:


So...um...bluer...better definition...well, I'm still learning how to use it...

BUT. This morning, I got some classic Maggie pics.

I found this new Whipped Cottage Cheese made by this company called Friendship Dairies. It's really good. Really good. This morning I finished the container, and Mags just looked so pathetic and forlorn and wanted something to eat...so I gave her the empty container to clean it up.


It was yummy.

So then she really went in for it.


Which didn't work out so well for Maggie, but I thought it was funny as hell.


Fortunately, she figured it out.




Mmmmmmm, tasty.

Well stated.

A friend of mine, in response to yesterday's post, said the following to me:

But having lived a large part of my life feeling numb - I think I prefer feelings. Even the bad ones.

I can't agree more.

Sadness

Sometimes, I forget I'm allowed to feel stuff.

It's one of those therapist-y things, to some degree, You know, we're supposed to be all neutral and not have personal lives and know how to handle shit. Which, of course, "handling" things doesn't actually mean not having emotions, but rather, having them, knowing what to do with them, working through them, blah, blah, blah. But you get used to being all dispassionate and impartial and "what do you think about that?", that sometimes you forget the tempered side of things doesn't actually mean being detached from everything. That's just boring.

In some part it's one of those trauma survivor things. You get into this mindset of, you know, like, "victims" are controlled by their emotions and their trauma, but, "survivors" control theirs. Which, is, of course, crap. There are many things that differentiate the two; that is not one of them.

I've been running around for the past two days, very, "oh, no, I'm fine, thanks." And I *am* fine. But I often forget it's just fine (even for me) to be a little not fine. So, yeah, I'm fine. I'm also sad. And exhausted. And I think I'm coming down with something.

Thanks, everyone, by the way, for all the kind words and support.

::sigh::

But in better news, my cellmates officemates and I went to dinner after work tonight, at this new chain spot called Evos. It's all organic, healthy, eco-conscious fast food, blah, blah, blah. They "air bake" their fries. I was skeptical, but it was really good. The fries, well, taste like fries. The burger was free-range, hormone-free, antibiotic-free, and really tasty. And I had one of the best chocolate shakes I think I've ever had. Plus, the company couldn't be beat.

I only had one class tonight, which was nice, because I hadn't even done the reading for that one. And then Sparrow and Maxine came over (to retrieve Sparrow's laundry). And now I'm watching the premier of SVU, which, the only thing I can say about it thusfar is, dude, I think that kid's been on our unit....

Huh. That was quick.

My grandfather died this morning.

So, technically, they didn't have time to "stop" the dialysis, the chemo, the radiation, or do anything else. Except give him some morphine to make his pain better. Which, hopefully, he should have already been getting.

I'm guessing he just let go.

I'm really sad.

Still haven't decided if I'm going to go home for the services. It turns out it's going to be a huge hassle, and you know what? As much as I want to have time to grieve, and as much as I want to support my family...I find no solace in funerals. They do not give me closure. They're a cultural rite based on an illogical belief that amounts to reanimation. I'm telling you, cremate me, scatter me to the wind, or dump me in a nice, biodegradable pine box, or, whatever is easiest. Then sit down and have good food and good wine and tell stories about me and laugh hard and cry for reasons both mirthful and sorrowful, and talk and laugh (and dance if the spirit moves you) deep into the night. Honor me, don't mourn me. Leave feeling better. I'll be dancing down my own path, the good energy from those interactions fueling me forward.

Anyway...

So, the thing about it is, he wasn't technically my grandfather; actually, I guess he was my grandfather-in-law. This was my mom's brother's wife's dad (so, my aunt's father). But, as I've said about a million and a half times on here, we're Greek. So, there really is no, Christmas at one family's house, Thanksgiving at the other, none of that stuff, our families just all mush together. So I grew up with them as my grandparents. Well, you know, more or less. It's complicated.

(Can you tell? If the look of my face doesn't say "complicated" loudly enough for you, count the bunnies, and then count the kids. But damn, we were cute, though, weren't we?)

But the point was, it never was with Costa. He was a good man. Always loved me like I was flesh and blood. Couldn't tell a joke to save his life, which made them somehow hysterical..one Thanksgiving, he was trying to tell us this joke from his Greek Joke a Day calendar, right? And he keeps talking - all old and cute, in his thick accent and broken English - about a ship, which made NO sense. And we're all sitting around the table getting more and more confused, and my aunt finally says to him, "ena ploiyo?" (at least, that's the Greek word I know for "ship"). And he gets all upset with us, and says, "No! No! A ship! The ship! You know....baa, baa, baa. The ship!"

I might actually have fallen out of my chair. It took a good five minutes for any semblance of order to return to the dinner table, and even then...

He taught me how to know how many days there were in the month. Apparently, if you make a fist, and you start counting at the outer knuckle, and you count the months off as you go across your hand - knuckles and valleys, and double up on the knuckle at the end when you reverse - the months you name when pointing to the valleys don't have 31 days. Try it - Jan (knuckle), Feb (valley), March (knuckle), April (valley), May (knuckle), June (valley), July, August (both on the far knuckle), September (valley, coming back towards you), October (knuckle), November (valley), December (knuckle). Cool, huh? Now, frankly, "30 days has November, April, June, and September" had worked just fine for me up until then. And, of course, I had a doctoral degree when he taught me this.

It was sweet.

I also remember, in a time when I was feeling a little like, well, the redheaded grandchild, him slipping me money at a church picnic. All very hush-hush, don't let your grandmother know. I never even told my other grandmother. I think it might have taken me a couple of years to tell my mom. It was a really nice feeling, knowing that I was important enough to warrant sneakiness.

My papou was 94, still walked to church every now and then when the weather was nice, still baked bread every weekend. He taught me how to carve a turkey. He taught me a lot about baking. Last year, he told me a story about how, back when he was a cook in the army, he made these pies, and instead of taking a bag of sugar off the shelf, he took an identical bag that was right next to the sugar, except he didn't notice it was labeled "salt." And the soldiers had been so excited about the pies, because let me tell you, the man could cook, and he didn't realize the mistake until the pies had been served. But some seventy-odd years later, he still got all welled up when he told me how bad he felt about letting his men down.

The men ate the pies anyway. Because they thought that much of him.

Me, too.

Goodbye, Papouli. I'm sorry I couldn't be the kind of granddaughter I wanted to be, but, you know how I tried, you know why I couldn't. Hope you're enjoying Heaven. Hope it's everything you expected it to be. Say hi to Toula. Tell my other Yiayia how much I miss her (but first tell her I said, hey, y'all! It's a Southern thing, she'll be amused). Same to her sister, if you see her. Sorry you won't be seeing my other Papou...if the afterlife turns out to be anything like you all anticipated it to be, I have a feeling he, and my great-uncle, could be otherwise engaged. But I have no doubt they're somewhere equally special.

Hey, though, save me some bread, huh?

Wow, am I going to miss you...

Just a dream and the wind to carry me

I've had this song stuck in my head all day.



Can't really complain, it's a nice little song. It's part of a mix I downloaded from iTunes based on that Yacht Rock series. Soothing. Smoooooth. And probably, of the several mixes I listened to very loudly today, one that my neighbors would find least objectionable.

I got a lot done today. Got up at a reasonable hour, went to Target and Whole Foods, came home and cleaned a crapton of stuff out of my fridge. Filled my whole garbage can (not just from the fridge). I vacuumed. I dyed my hair (thank God, finally! My roots were like a mile and a half long).

I had a good soundtrack for all of this. A nice mix of country, R&B, techno, gangsta rap...and, you know, loud, which is key.

I unplugged my iPod-blaring alarm clock (which, I never use it as an alarm, so, I'm not sure why I take up valuable bedside table space with it) and moved it to a more central location. Which, um, unfortunately turned out to be the bathroom...


I did a mountain (mountain) of dishes today. Again with the "finally."


Maggie and I thought about planting a flag on the top. Dish Mountain.

I then made a pie. Okay, not so much "made" as, removed from the wrapper and baked. It's from the Vermont Mystic Pie Company, which I bought yesterday when I was postcall and woozy and it somehow made me nostalgic (the box is a Stephen Huneck design, who is this local artist in Woodstock, VT, which is one of my favorite little towns). Mmmm, it smelled yummy. And in fact, it was yummy. But it also set off the smoke alarms.

Dude.

There are two smoke detectors in the hallway between my bedroom and the kitchen. Remember, my whole house is, like, 700 square feet. It's barely three strides to the kitchen. One of them, fortunately, is soft, but persistent. The other one is PIERCING and starts saying "Fire. Fire. Fire."

I did not know my smoke detector talked.

Maggie got worried. She was literally standing in the doorway, ready to bolt for her dog door, seemingly paralyzed by ambivalence about whether she should evacuate or not, for, like, two whole minutes.


So there's all this blaring and beeping and the one detector is telling me (quite calmly) that there's a fire and then there's me, jumping up and down like one of my patients the big raving lunatic that I am and waving a cutting board frantically at the detectors and screaming "Nothing! Is! On! Fire! Stop it! Stop it! STOPIT!!"


I think she finally went outside in sheer embarrassment.

I gave up for a little while once I got the talkie under control and just let the other fucking thing beep. I wandered outside, I took some pictures of the cool pink flowers I found randomly growing in my yard today. Sparrow (who came over later to do laundry) said they're called Surprise Lilies.


I was, indeed, surprised.

Pretty, though, aren't they?

These are, by the way, the um, exaugural (I'm not sure that's a word...well, it is now) pictures of my trusty Fuji Finepix. Because I've been having a lot of issues with darkfield photography, the slow shutter, depth of field, etc, etc. So my parents bought me a kickass new camera for my birthday. I'm so excited!! It should be here in a few days, and I'll be sure to take lots of exciting high-ISO fancy-pants pictures when it does.

Probably mostly of Maggie.

In less good news, my grandfather went into hospice today. He was diagnosed last week, I think, with "bone cancer" (who knows what the hell that means. Nobody else in the family speaks medical, or wants to, so it gets frustrating for me when bad things happen. I'm thinking this is multiple myeloma). He'd been on dialysis, getting chemo and radiation, and for whatever reason today they decided to stop dialysis and go to comfort care. Which, may well be a fine idea, I'm not trying to malign it.

It's such a complicated situation, that side of the family...well, more on that some other time. Right now, I just need to go to bed and pout.

More disbelief

Dude. Cubs win. And are now the NL Central Division champs.

I know, right?

It's not the World Series, but, it's a start.

(For you out-of-towners who don't get the goat reference, click here. It's a good lesson in why you shouldn't mess with my people.)

No one believes you

We had a patient in the ER tonight report that he was "self-medicating" with - ready for it? - 40 lbs of chocolate. A day.

Dude, whatever.

Besides, I think it was the vicoden with which you were self-medicating, actually.

I keep thinking about the magnitude of that. 40 lbs. So, the average Hershey bar is 0.095 lbs (according to Hershey.com. It's not like I randomly know this). Let's round up to a tenth of a pound for the sake of middle-of-the-night math. So, at ten per pound, that's 400 Hershey's bars per day. And roughly 84,000 calories.

Not even a champion chocolate chomper such as myself could do that. Not a chance, buddy.

It's always sunny in Chapel Hill

Alright, that's a lie.

But it's a gorgeous sunny Thursday today, at least. Seventies, Carolina Blue skies, lovely.

Today's Tin Can Brigade adventure went well. I flew out and back with this pediatric cardiologist and his echo tech, whom I've flown with before. My doc at the ACT team had decided to take a few days off, so I went out with one of the nurses and had a couple of my very own patients to see at the rest home we went to. I made some minor med changes. I did some quick home visits. It was nice, actually, and we still got done by two so I could hitch a ride back with the Cards guys.

We went to this Mongolian Barbecue place for lunch which was just so-so, but, it was lunch. They had these really interesting things she kept referring to a "Greek rolls", which were sort of like soft sesame crackers. Now, there was absolutely NOTHING Greek about this place, and I'm sure they were probably Korean, but they were the best part of the whole meal and my people are happy to take credit for them.

So I came home and took a nap, because I was sleepy and cranky and I have this bad habit of becoming unconscious every time I get in a plane (seriously. I don't think we'd hit cruising altitude - which, remember, is about a mile - before I was out. And probably snoring, which is one of the problems with this little habit of mine. Although at least on the Anchovy Tin everyone has earplugs in). I was going to go to the screening of the documentary that was done a year or so ago about our gallery of artists with mental illness, but my child therapy supervisor wanted to "meet" by phone at 7 (we talked for 20 minutes and then her phone died. Oh well. More to come). So I decided to start my laundry instead. And, having just decided that whatever I was wearing needed to be washed and dropped it into the washer, no sooner did that happen than someone knocked at the door.

Um. Oh.

I skittered to my bedroom and grabbed my bathrobe, which is of course very thick flannel with snowflakes all over it. In which it makes perfect sense to be answering the door at 4pm on a Thursday in 80 degree weather.

It turned out to be two of my neighbors, who moved in a month or two ago. I met their landlord shortly before, who went on and on about how they were "good Christian kids, boys on one side of the house, girls on the other" (I cringe every time the very first way in which someone describes themselves is as a "good Christian"). Thusfar, I'll concede, they have seemed pretty tame. You know, like the rest of us on this block. They were very pleasant, in a distant, "hey that's a big dog and you're wearing a bathrobe" kind of way. Aryan, plain, wholesome, skinny girls, probably Midwestern. As opposed to, say, the loud, outspoken, brash, swears like a drunken sailor, Zaftig suicide redhead kind of Midwesterner.

But, whatever, they brought cake.

It was dry and needed cinnamon. And maybe a touch more vanilla. But it was pretty. And, chocolate cake.

In other news, I finished the first of my quick-and-dirty plain old socks yesterday.



They're the first in a series, I think, of what I'm calling "leftover socks." Simple, short (I like the anklet-y type better anyway), reasonably quick and easy that I can bang out in a few weeks of lectures and use up some of my leftovers in my stash. These are from a skein of Dream in Color yarn in a color called Spring Tickle that ended up being a second because the blue dye didn't quite dissolve well enough and so, if you were able to look closely, you'd see that the yarn was actually a bit speckled. So we couldn't sell it to real people. So I destocked it and made a hat. For a pumpkin.


Note the little center stem-hole. I liked that hat. I don't think I took it with me when I left, but I should have. In case I ever have a pumpkin down here that has a cold head.

Well, tomorrow is going to be a long day (and night). The interns are off on their retreat tomorrow, so we're all covering their call. Tomorrow night I'm playing intern again with Sparrow as my second year, so we're sure to have two things: a very busy night, and a rockin' good time.

I have much to say...

...but I am tired. And I have to get up early again tomorrow to get into the little flying anchovy tin and head for the coast.

So, everyone think lofty thoughts tomorrow. The next two nights may well be minimalist blogs, too, but...well....hopefully this weekend I'll have more time to write something poignant.

On conversations, fantastic

Today was a long, long, long freakin' day.

We had one little girl scheduled in child clinic this morning. If I played my cards right, we'd be totally wrapped up with her by 10:30 and then I could spend the morning finishing my reading for tonight and doing stuff I needed to do, then I could get through my afternoon clinic well paced and all dictated, and then leave with plenty of time to get dinner and coffee before my psychoanalytic courses started tonight. Ahh, what a nice idea.

Ha.

So, instead of seeing the clinic girl, Dr. B sent me out on a consult. Which was cool, because usually the child fellows do the consults. So I put on my best authoritative fellow-like attitude and found my way over to the children's hospital. Where I saw this girl, and talked to her dad, and putzed and futzed as appropriate and finally left the floor after 11:30.

I spent the next hour, of course, and every other moment of free time I had this afternoon finishing that stupid consult note. Because I want to be thorough. Except that really, I want to keep Dr. B thinking I'd someday make a wonderful actual child fellow, and, I derive a fiendish little thrill from comparing the generalists' two-line social history to mine, which is, of course, like four paragraphs in a case like this. Plus, why collect the information if you're not going to put it somewhere?

My afternoon clinic was, blessedly, full of relatively stable patients. Well, sort of. I got through it. Didn't dictate a single note. I'll deal with that on the flip side. I bolted out of the building at quarter to 6, sat in traffic, dashed through a drive through, and made it to class with about 15 seconds to spare.

My first class, on Borderline Personality Disorder, which is co-taught by Dr. Jabba, was nice, actually. It was a nice group, a good topic, and a comfortable, conversational dynamic. The second class...well...two of my fellow students are one of the 1st year child fellows and my very favorite attending ever, Dr. Rosie. And I'm sure it'll be interesting. Maybe later. As for tonight...I...the distinguished 2008-2009 Raft Fellow of the PECC...was nodding off. In a class of four people. Not very distinguished. We would've been fine if either we got to play along or if the teacher hadn't kept rambling for an extra HALF HOUR beyond our designated finish time.

Oy.

Tomorrow should be better. Thursday will be long. Friday I'm on call. Ugh, this week.

Anyway.

It rained today. Which was lovely when I woke up...it was rainy, and dark, and cold in my room, and oh, just perfect for sleeping. But, no, I had to get up, damn it. And I looked at my dog, and I looked at the rain, and I thought....oh....I bet she's so not even going to use the doggie door today...

...so I get home, and...well, the following scene ensues:

Me (on the phone with my dad): blah, blah, bl-...oh, hell. It smells like dog shit in here. I knew this would happen today.
Maggie (in Dog): Ohmigosh! It's Kate! It's you! You're home! Ohmigosh! I thought you'd left me! I thought you'd left me foreeeeeeeever! FOREVER!! But you're back! And now you're here! And back! And ohmigosh...did you bring any food?? No, oh. Well, that's okay! because you're home! Wowie! Wowie!!!!
Me (in English): Yes, yes, hi, baby. Dad, I've got to go clean up the poop.
Mags: Wowiewowiewowiewowie! You're home! I'm so amazed! You came baaa-aaaaa-aaaaaack!
Me: Oh, yes, yes, yes, I love you too. Still have to go pick up the poop on my FLOOR.
Mags: Oh! But! See! I have the wiggles! I'm so wiggly I can't sit still! Because you came home! Look! It's the helicopter tail!! Aren't I so cute? Aren't I just so cute? How can you be mad at me?! Helicopter tail! Helicopter taaaaail!
Me: Okay, that is awfully cute. But, um, poop....
Mags: What? Who? I didn't do anything. Me? What?
Me: (grumbling about poop picking up)
Mags: Doot do do....think I'll go over, um, this way...
Me: What, have you been holding it in for the last three days or something?? And what's with all the pee? (Continues poop-related grumbling on way to washer) At least you managed to hit the towels that were on the floor from the roof leaking...uh, mostly...
Mags: Wow! The fan is on! Look at it go!
Me: Awww, man, I think I stepped in pee!
Mags: So comfy right now up here....ahhhh....oh! There you are again! Look! I'm on the bed! Aren't I just so cute!!!?
Me: You're in my spot.
Mags: I know!! It's so exciting! Isn't it?? Come on, say it!
Me: No.
Mags: Come on! Look at the cuteness! Look! I winked at you! I'm so cute!!
Me: No.
Mags: Come on!!!!
Me: Fine....(sigh) Look! Someone put a puppy in my bed!!
Mags: Awww! That's the ticket! Look, it's my belly!!!!
Me: Dude, I just scooped like eighteen pounds of poop off the FLOOR.
Mags: Belly! Belly! Belly!
Me: Fine..........

I'm such a sucker.

D'Oh!

Little did I know, I missed yet another friend's birthday. Jenn (sometimes known as TinyTyant, although I have yet to find her tyrant-y) turned, well, not 30 yesterday! I had no idea!

A very happy belated birthday, Jenn!!!!!!!

Just another one of those...

I wish it was Sunday.

(Ten points to anyone who gets that reference. But only ten points, because frankly, it's not very obscure...)

Culmination

We are home.


We are tired.

But seriously, folks

No, really. There are few things funnier than a group of drunken psychiatrists. Unless those things would be, a, a group of drunken psychiatrists square dancing, or, b, barely legal very drunk white dudes trying to crash the drunken psychiatrist square dancing party.

But we'll get to that.

So I am, of course, still in Asheville. The conference is winding down and we're having a hell of a good time.

Yesterday I whored myself out to the drug reps for some funny accoutrements. Sadly, I think the tables have all gone down and they will not let me pilfer in the morning. So I'll have to be satisfied with my current mind-warping booty.

Yes, that's a big orange clothespin. It's for the office. I don't know what we're going to do with it, but I thought we needed one. I already threw out the Risperdal highlighter set, it was crappy (it's good for them I already like their drug, because, if I were to be easily swayed by drug company trinkets...). Incidentally, for those of you worried that I'm being unduly influenced, I actually don't remember what psych drugs Lilly makes, I find Invega useless, I'm so not a fan of Seroquel, and I don't actually know who Ridgeville and QTCM are.

Yesterday morning had a couple of really good lectures, and one very boring lawyer who was not very informative. I spent most of that hour texting Peng and Claudia. And then I came back to my hotel and took a nap. Last night there was a nice little reception, and then, THEN we went on the Ghost Trolley Tour. I went with Ed and his wife Georgia, whom I had not previously met but now totally adore.

I love ghost tours, btw. Have I mentioned that? It's such a great way to get a flavor for the real history of a city. Last night's did not disappoint for spooky moments and awesome stories. And it had beer.


Our tour guide, who is actually an engineering student at UNC-A. Yes, yes, that is a Ghostbusters costume he's wearing.

We saw a lot of cool sites and heard a lot of good stories, including several about the Biltmore (apparently George Vanderbilt thinks he's very funny) and the Grove Park Inn, about destitute bankers who plummeted to their deaths on Black Tuesday and now walk around and give investment advice, and how two of the local high schools were built on mass paupers' graves. We had a slightly spooky moment at this place called Helen's Bridge, where this woman apparently hung herself after her young daughter died in a fire. Apparently, if you park under the bridge after dark and say "Helen, come forth" three times, Biggie Smalls will appear and bust a cap in your ass. Oh, no, wait, that was South Park. Here, she will either appear to you, stall out your car, or leave handprints on your car. Last night she did none of the above (can you blame her? A busload of shrinks?). But even the most stoic skeptic among us had to admit it ended up feeling a little spooky.

My very favorite spot on the tour, though, was one relevant to us:


This is the Insane Asylum (I don't know what it is these days) where F. Scott Fitzgerald's wife, Zelda, spent the last ten years of her life, until she died in a fire. First of all, is this not just a beautiful building for an asylum? Anyhow, apparently back in those days they used to chain the patients to their beds at night. One night, a fire broke out, and she and eight other women were immolated because they couldn't leave. Awful, what they used to do to the crazies.

I also learned that Big Blue still has a parapsychology program. It's one of two left in the country. Matthew, Veronica, how could you have not shared this with me?? We often joke about our patients needing exorcisms instead of drugs, but, I wonder if they'd actually do that. Can you call them for a consult?

We definitely saw some awesome places. Asheville is a gorgeous town. Sadly, though, because I was shooting at night without the flash on a bumpy trolley, most of my pictures came out looking a lot like this...


On the way home, though, I did manage to get a picture of the neon monstrosity of a hotel down the street:


On the other side or the marquis it says "With a touch of modern." I don't know what that means. Maybe it's the wireless.

That sign is just large and gaudy and amused me. But I have to wonder, what is he supposed to be doing in this little rendition in electrified vapor?


Fishing. I'm going to tell myself it's fishing.

Today was also very nice. The morning talks were decent, although the one I'd been so looking forward to, the talk I actually came to the conference for in the first place (on complex PTSD, which, well, it's what I want to do with my life), was quite disappointing. Oh well. We also had a talk on so-called "cosmetic psychopharmacology", however, discussing things related to prescribing for people who don't actually have an illness, i.e., ritalin to make you better in school if you don't have ADHD. It degenerated a little into a discussion of drug marketing in the Q&A, which also incurred a lot of self-righteous pontificating, but, nonetheless, the talk was good.

This afternoon was our resident-specific stuff, which was mostly only attended by the Baby Blue contingent and a couple of ECU fellows. It was awesome, though (of course, because Ed arranged it). Probably the most helpful thing all weekend.

We also went out for lunch today with Eva's 91 year old grandfather, who is a retired Child and Adolescent psychiatrist. I liked him. We had a very nice lunch at this little bistro place downtown, and Eva bought me lunch (a wicked good burger, although I must confess that I was a little jealous of Papa's fried peanut butter and banana sammich. I loved that it was even on the menu, and I totally loved that he ordered it). He came to the resident programming with us, too. He joked that the panel discussion was so helpful for career advice, he wished he'd seen it 65 years earlier.

Tonight was the awards presentation and dinner. We were all going to ditch it, but somehow got guilted into staying and so we sat in the back and heckled (quietly). And then we skipped out to the lobby because they were about to start the bluegrass music. Where we sat and laughed loudly and were obnoxious and generally had a good time cracking jokes and telling stories (best line of the evening - Tina, who's black, and her husband, also black, were discussing Ed and my lineage: Ed's Armenian and things, I'm Greek (and things). It's a long story how we got to that, but then Tina told us that her grandfather was Greek. And her husband turns to her and says, "Wait...we're Greek??!"), until these three, very drunk, probably-of-age hicks come by from a wedding reception down the hall and start telling us how they crashed the party in the ballroom and tried to square dance with a bunch of crazy psychiatrists. Apparently the one was very sad that they wouldn't let him cut in. So he asked one of the guys, "If I lie down on the couch in the lobby, will you tell me what's wrong with me?" And whomever he was talking to told him that he couldn't afford their rates.

We laughed about that whole episode for a good ten minutes after they'd stumbled upstairs. And then we snuck back over to see our square-dancin' colleagues in action.

Wow, y'all. I....really.....shit, if I'd ever doubted that I was in the South....let's just say I don't see that happening at the Illinois Psychiatric Association meetings...

Good times.

So now I'm back at the hotel, and I have to pack and get to bed so I don't oversleep for the bright-and-early lecture on insomnia. The conference ends about 12:30, and then I'm going to try and go to the LYS that's about 6 minutes away (according to the TomTom). And then I have a four hour drive back, and then I'm meeting Crazy Friend Rachel for dinner, because she's moving on Monday, and because she had to have Mazel euthanized this week. Poor old boy had lymphoma, no one even suspected. Poor baby kept up a good front (yes, I know he's the dog that bit both me AND Maggie, but still, he was, at heart, a good boy). Shalom, sweet boy.

Love Friday

No, I don't know why I'm still up. Damn insomnia.

Anyhow....with the new era of change upon us....I must say four things:

1. Love The Onion.


Bush Tours America To Survey Damage Caused By His Disastrous Presidency

2. Love Mariska Hargitay (it's the 9/10/08 blog entry, if you're reading this later).

3. Love America? Make sure you're registered, and vote.

4. If you don't vote, the terrorists win.

Thank you. I am done being political for now.

Q: How many psychiatrists does it take to change a lightbulb?

A: Only one, but the light bulb has to WANT to change.

I know, not that funny, nor original. Whatever, I'm tired.

So, I'm in Asheville. City of Lights...no, wait...City of Vanderbilts. Or, as it were, The City That Vanderbilts, er, Built. I'm here for a conference on the state of psychiatry in the State. Well, only sort of. Okay, I'll stop with the terrible puns. I'm here for the NC Psychiatric Association's annual conference. Some of which is on the state of the practice in NC.

I was on call last night. It was a loooooong night (Looooooooooooooooooooooong). I got a little bit of a nap, dropped Maggie at the day care (she was soooo excited. Sooooooooooooooooooooooo excited), and then picked up Jack, one of the child fellows, whose wife isn't coming in until tomorrow, so he rode out with me. We chatted about work and life and made small talk for four hours (I wowed him with stories of my dog's wart. God help me, I hope it wasn't as painful as it sounds...). And then we got lost, thanks to my TomTom. But, we made it.

Of course, I signed up far too late to get into our block of rooms at the hotel where the conference is being held, so I'm two miles away at a different Marriott. Which was $30/night cheaper (hopefully the department is paying, so, not that it matters that much).

It has a nice king bed.


Fresh baked cookies in the lobby.


Snazzy little toiletries.


And, are you ready for it? A spa tub.


Love it.

Not to mention a nice balcony....with a view of the Applebee's. But, you know, whatever.


It should be a good time. Tomorrow has some interesting lectures, and then tomorrow night we're going on the Ghost Trolley Tour of Asheville. Sadly, we've got a mandatory resident seminar during the Brews Cruise, so, we're going to miss that. Because there is nothing more fun than a boatload of drunken psychiatrists.

Meanwhile, I'm still exhausted from last night, and I have to get up early tomorrow, so...I'm going to try out that nice big king bed...

My nose hurts.

Well, it does.

Goofy, nose-breaking dog.

And I'm call. Which makes me even crankier.

Then again, maybe I could get that cute ER resident to take a look at my nose...

Long day

I kept trying to come up with a lyrical reference for the title. I had to Google, because the only songs I could come up with referenced "bad day", and, my day wasn't especially bad. And lo and behold, I came up with this song:



Which I cannot believe I didn't think of, especially since I've been on a Matchbox 20/Rob Thomas kick since I linked to the 3am song the other day. And particularly because I have long time fond attachments to two particular lyrical phrases in this song. Well, three. Because there's also this one:

"I'm surprised that you'd believe in anything that comes from me I didn't hear from you or from someone else."

Because I actually find that reasonably profound.

The two in question, however, are the following:

"I'm sorry 'bout the attitude I need to give when I'm with you 'cause no one else will take this shit from me."

I mean, that sums up my last four relationships, right there. Not to mention a large portion of my friendships. And, what I do professionally, because the point of therapy is often to transfer and express feelings you otherwise can't safely or appropriately emote. Which means we take a lot of vicarious crap from people. Which isn't as bad as it sounds; actually, it's usually pretty interesting.

"Reach down your hand in your pocket, pull out some hope for me."

Which....really....I think is a lot of what I do. For a living. I think, in a lot of ways, people pay me to give them hope. To find hope for them, or help them find it themselves.

So my day started and ended with therapy patients. My freakin' SEVEN AM patient is one I've been seeing for a little over a month now. Unfortunately, we decided that Tuesdays at 7am are a good time for a standing appointment every other week. Which...okay...it's not really that early. In my OB/G days, man, I'd have my first case in the OR by then. But for psychiatry? We complain when we have 8am patients. The more unfortunate piece of it is that my Tuesday nights are going to extend until 9:30, because the second course I'm taking at the Psychoanalytic Institute did not, in fact, get cancelled.

And let me tell ya. 15 hours? Long day.

So I had him at 7. And then our child clinic ended up being overbooked (which was totally ridiculous, because for the past three weeks we've been severely underbooked in that clinic) and down two members of the team. But Elspeth, the social worker, and I knocked it out. And then my afternoon clinic was full, but, two of my favorite patients came back. One of them brought me a present - art, and in that, art which he'd created, which is the coolest thing you can ever give me, particularly if you're my patient. And he's good, y'all.

So, and this is a total sidebar (shocking, right? Me, digressing?), we have this art gallery at the hospital, called Brushes with Life. It's all art that's been produced by artists with mental illness. We have so many pieces the whole Neurosciences hospital is lousy with them, and even at that there's a rotation, and some pieces only make it up once. But there's a big gallery up on the third floor, and every now and again we stage a real showing at a real gallery. It's amazing, some of the things that come out of that exhibit. And, two of the best featured artists are my personal patients. Who are also just really cool people in general. Anyhow, a year or so ago, some documentary filmmaker decided to a, uh, documentary film on the gallery. And several of my patients are in it, not the least of which is the patient I saw today. They're screening the film again next week. I think I'm going to go.

He also has a band, but I'm on call when they're playing next. Which is just as well, because I can't decide if that would be a boundary violation to go see him play. I mean, it's at one of the major local indie clubs. Where I've gone to see other bands perform. And he's just so tremendously talented, and frankly, he's not a therapy patient, I mostly just do med management with him. I kind of think a public venue like that, if I just went and didn't try to be all social with him, would be a non-issue. Which is the consensus of the people I polled today.

Thoughts from the crowd?

Anyhow, my last patient, who's my child therapy case, was at 5 (so, after clinic hours), was this kid I've seen in clinic, but this was our first therapy appointment. Man, he's driving his parents batshit crazy. Which, frankly, I think is a short trip. And honestly...I think he's a really good kid. Now, I'll also be honest and say that I'm glad he doesn't live with me. Mostly because I'm glad most any child doesn't live with me right now. And I'm not sure how I'd handle these issues if he were my kid.

But I think it's safe to say, if he were my kid, he'd have entirely different issues.

I feel for his folks. I do. It has to be hard. But shit, an hour with them makes *me* want to smoke pot. I can sorta figure out why he does it.

I know this child therapy gig is sort of along the lines of what I want to do, or, as it were, it's very along the lines of what I want to do in the short run. But wow, it's exhausting. Because with kids...well, with everyone, you end up having the whole family as your patient. I mean, no one exists in a vacuum. But with kids, you end up doing this whole-family thing more actively. Like, you actually treat the whole system instead of trying to do it as a theoretical and a little more by proxy.

It's a rough charge. That's a lot of stuff to tangle with. We have this saying, in psychiatry, about how the identified patient, the one who's coming to see you and actually branded with the "crazy" label, is usually the healthiest one in the system from which they come. Often, it's their job to bear the dysfunction of the whole family ("we're crazy because you make us crazy, so everything that's wrong is all because of you"), and because they're actually the healthiest of the bunch, they can't tolerate the dysfunction as well as the more dysfunctional (does that make sense?).

And kids? Don't come with a set of fully-formed coping mechanisms, adaptive or otherwise. It's hard to deal with badness and try to figure yourself out and mature into an independent functioning human all at the same time. And when you're in the middle of all that, and some random stranger tries to come "fix" you...it's hard to trust anyone. Particularly any adult. I mean, shit, I saw three different therapists when I was being actively molested, and I didn't tell any of them. It's going to be slow going with this kid. And, I respect that. His parents, like most families of "identified patients", want him "fixed." Like, yesterday.

It's a little bit exhausting all by itself.

And the real secret is? Adults? Really, psychologically speaking? Often just big, unresolved kids.

And, somehow it got to be 11pm (well, Sparrow came over, we got to chatting....). I meant to be asleep an hour ago. So I'm gonna go do that....

Presents!!

I'm so tired. So tired. Like, whole new levels of tired. Didn't sleep at all last night. Damn night float.

But, I got home tonight, and there were boxes on my front porch. Lots of them. Two, from Amazon, which I assumed carried things I expected (although why they divided my books into two boxes, beats the heck out of me). But then...somebody sent me a faucet?


I read the return address and quickly recognized the package as containing something far more exciting. My sock blockers from Lorna.


Aren't they just fabulous? Lorna's dad, right, he goes out and chops down his own wood, then lathes and cuts and sands and stains it into really freakin' awesome sock blockers. By hand. Amazing.

The Tolerance Socks were in the wash, so I had to make do with the one I've got on the needles.


She also sent me a very cool pattern for felted flip-flops. A nifty Southern alternative to felted clogs.

The other boxes, of course, contained books I'd ordered.


Kinda boring.


There. That's better.

So cool. Thanks, Lorna!! (Just...remind me how much I owe you for them? I'll PayPal it off to you ASAP.)

It's 3am, I must be lonely

(Which, if you missed it, is a reference to this song. For a completely heartbreaking rendition of same, not to mention confirmation that Rob Thomas is, like, the sexiest man ever, click here.)

To be precise, it's 3:28. And despite the fact that I've drugged the hell out of myself on two seperate occasions tonight...I'm...still....awake. WIDE awake. Given that I slept, like, twelve or thirteen hours last night, and am finally caught up on at least part of my sleep debt, I'm now bright eyed and bushy tailed and ready for another day of reversed Circadian rhythms.

Or I'm getting manic.

If I'm still up at 5, I'm just going to give up and go to work. Then again, if I'm not, I'm going to get up at 6 and go to work, so...

Stupid night float.

Tropical Sunday

So the tropical storm du jour has passed, and it was a balmy, sunny Sunday in North Carolina.

I woke up at 11:30 when Faye called to see if I wanted to have lunch. Which I did, if only to drag my lazy (well, tired), unshowered ass out of bed and get moving, since yesterday I did nothing but lie around like a big lump and watch reruns of House, which, frankly, I don't even like that much - the technical inaccuracies are inexcusable, and I just can't get invested in the characters - but I somehow still find endearing. And turned down no less than three invitations yesterday I really wanted to go to but did not see myself staying awake for. So I needed to get the hell out of mi casa.

We had a nice, chatty lunch at Panera. And then I did a little grocery shopping - for both me and the pooch. Wow, I wish Nutro made a people formula. My culinary life might be boring, but it would be so damn much easier. Scoop in the morning, scoop at night, done. And if they could make it taste like cheesecake...

I also bought a ridiculous amount of groceries for myself, mostly because for the past week I've found it next to impossible to eat an actual meal, but ridiculous for the fact that I'm going to be at a conference for four days out of this week. At least, I think I am. I'm still not sure the department is paying, and damned if I'm going to pay for it. I mean, there are some interesting things going on, and it's in Asheville, where I've never been, but the only reason I signed up is because they were going to pay for it.

I am paying for the Ghost Trolley Tour, which I think is Friday night. I was initiated into ghost tours of old Southern cities by my friend when we were in St. Augustine, and have been a fan ever since.

Anywho...I actually managed to get some stuff done today. I did a bazillion loads of laundry (PS - my new favorite thing? Method dryer cloths in Aloe and....something. They're, like, damp. And good for two loads. And smell amazing) and a week and a half's worth of dishes. I did some writing on some random project I'm working on. I made chili, which will feed me for half the meals I need to make this week (gonna be sick of chili by Thursday). And had poundcake with the most amazingly perfect, ripe, aromatic red raspberries for dessert. I seriously could've sat there and huffed the raspberries all night.

So tomorrow it's back to the regular old grind. My clinics for tomorrow and Tuesday are packed to the rafters (Tuesday is 7am to 6pm. I open and close with therapy patients and have my regular clinics, which are chock-full, in between. Fun!). And then I'm on call Wednesday night. And off to Asheville - in theory - on Thursday, until Sunday.

Hey, at least my life isn't boring.

Things good, bad, and random

Happy birthday to Allison, who also turns 30 today. In honor of same, I tried to steal pictures of her incredibly adorable tiny one off her blog, but alas, there seems to have been a computer glitch in my attempts to plagiarize. So you'll have to go visit her blog yourself. The picture of Joseph in the laundry basket alone is worth the browsing.

In less good news, my dear friend Annie's mom has been in a coma for a week now. Something happened during a routine surgery last week and she has an anoxic brain injury. She's doing better, is extubated and breathing on her own, but still hasn't awakened. Anne has asked that tonight, at 7pm eastern, everyone pray for her mom.

Other than that...I'm exhausted. Still. Partly from having my sleep schedule all screwed up, partly from TS Hannah. Hannah swept through here around 3:00 this morning and stayed a while. The big dead tree limb finally fell, and - thankfully - missed the house, the car, the cable and power lines, even missed my bicycle. We lost power at about 3:30. Don't ask why I was awake. It came back on around 5:30, right after I'd decided to save the 1/3rd of a pint of Ben and Jerry's in the freezer from melty extinction (hey, we lost the whole fridge AND freezer full of stuff in the big storm in July). Shortly after that I discovered that the roof had leaked all over the floor in the den. I blamed the dog at first for the big puddle, until I got dripped on.

And then the dog broke my nose.

I know, right?

I was getting back into bed and she was in my spot. And I probably leaned over to smooch her on the head or something (I've been known to do that), when she decided decided she needed to move. So she jumped up...and smacked her hard little skull right into my nasal bones. Heeee-yaww.

I also found my bottle of Effexor in her crate this morning. Fortunately, it doesn't look like she did anything other with it than chew off the lid. Maybe she's depressed?

What a week...

Oy, night float is finally done.

I'm so tired. Today was so unbelievably long. I worked all night, of course, and then I had a patient come in at 9. I have more to say about that, but the point right now is, I spent two hours with my patient. It was almost noon by the time I got that all wrapped up (Sort of...I still haven't dictated her), and then it took me another 45 minutes to get out of the hospital, and then...oy. I had an appointment at 3, which I made figuring I'd have gotten in a nap, but I ended up canceling it at 2:30. I finally did get a nap. But wow, am I still so tired. But I'm ready to get back on Human Standard Time. So I think I'll go to bed...

Um...

I think Maggie ate one of my earplugs last night.

Ew.

Best chief complaint of the night

A trauma that rolled into the ER while I was down seeing the SEVEN MILLION CRAZY PEOPLE who came in tonight:

"20 y/o female. Resident of X Dorm. Heavily intoxicated, fell off bunk bed. Trauma Code Yellow. Arrived via EMS in stiff collar and secured to long hard spine board."

Welcome back to college, kids.

Grump, grump....

I'll tell you what I don't like. It's 2:30. I've been awake for forty-five minutes. I fell asleep around 11. My body's confused and thinks we're post-call and thus going to fall asleep again at 8pm. Wrong, body!! Get with the program!!

I've been cranky since about 7am, though. This may turn out to be a longer week than I was expecting....

And if the damn campus police don't stop friggin' ticketing me when I'm tired and cranky, there may well be a little scene at the Dept of Public Safety tomorrow morning...can I call you guys for bail money?

One thing I never get tired of hearing...

"OHH! Dr. J! I'm so glad you're on call tonight!"

Floating

It's actually 2:30 am on the 2nd when I'm writing this, but since it's my Monday post, I'm back-dating it....

So I'm on night float.

So far, the night has been a series of small and somewhat frivolous adventures. I did some paperwork and fussing and faxing and opened our doors and our fax machine to the LME because the all-night Kinkos was, in fact, not. I took a field trip to the far opposite corner of the hospital to try and get our pager fixed, and that? Is not a short distance. And all we succeeding in doing was killing the pager. I went over because it's been all quiet and (beep-beep-beep) and no one can hear it and the interns are sleeping through it and you'd think there would be a way to adjust the volume, but, you would be wrong. I bought some trail mix and discovered that our ice maker had started falling apart. I tried to explain the geography of NC to a man in a ten gallon hat who was hearing voices. Turns out I lied to him, by the way. Greensboro is not, in fact, a lot farther from here than Butner. I have one patient to see in the ER, but, she's wicked drunk and I'm waiting for her to sleep it off, at least a little, so it's not completely illegal for me to try and sign her in.

The hospital at night is an interesting place. It's quiet, and darker, because either the lights on the units are turned low, or, so much of our ambient lighting in the main atrium is from the skylights it's just naturally dimmer. I discovered some interesting things on my sojourn to the bowels of the hospital where the off-hours communications office is. Like, we have a flower vending machine. No kidding. There's this machine, with all sorts of floral arrangements in it rotating around, and you pick the one you want, pay for it, and the door opens and, poof, you have flowers. 24 hours a day, no gift shop needed. It was sort of sad tonight, though....there's just one little vase of ivory-colored roses left after this big holiday weekend, riding around, and around, and around.....

I did have a scary crisis call, and talked to the police, who were very little help. Honey, if you're out there tonight, I just pray you find the strength to get away from him and get help. You're not alone.

There are two big lessons I've learned doing this job...first, anyone is capable of anything. And second, you're never alone.