Under the wire

Whew! Just made the posting before midnight deadline...

Today, today was so long. But I did greatly piss off some woman in the ER and then leave the medical student alone with her to deal with it. Which he did, very well. And I didn't do it on purpose - I left him to get the rest of her history, but before I did, I told her that we were indeed committing her. She didn't actually get agitated and angry until after I left. Or, believe me, I never would've just left him to navigate that chaos. And she wasn't dangerous or anything, she was just, well, pissed.

Wow, does she hate me.

Ah well.

The other patient I admitted was very manic and ridiculously hypersexual. She'd, um, found some very creative uses for her neighbor's potato masher. She was quite amusing and pleasant, though. And my very favorite part is that she'd actually been brought in for having thoughts of killing several people, including her boyfriend, and her boyfriend's...cows.

Cows!

We got into a whole discussion later about how you couldn't really call that "homicidal." So, in my note, it now reads, "Patient states that she currently has no homicidal, bovicidal, or suicidal ideation." I'm wondering if anyone notices it...

Oh, wait, it's Tuesday

All day long I've been thinking it was Wednesday. I guess it's just wishful thinking.

Have I mentioned that my new attending hasn't done inpatient psychiatry since, like, I've been alive?

Oy...

Serious as a gas attack

You know, I had this whole post written about today being the third anniversary of my escape from the Emerald Palace. But you know...I'm just not feeling it. I'm feeling the moving on.

I can't really tell you why, exactly, because honestly, there was actually quite a bit that was unpleasant about it, but...I had a really good day.

And. Bones is back.

I'm postcall and got home late and am completely exhausted and it's totally freezing in my house because it's 40 in North Carolina and all the windows in my house are open because it very recently was a lot more than 40 and I'm seriously just so tired and hungry and whatever, and still had to stay up and watch it.

And got great quotes like the title, and these:

Booth: What are we, brook trout?

Cam: The body was braised like osso buco.

Hodgins: I do bugs and slime, I don't do arithmetic.

Booth: Special Agent Seely Booth. Special.

Brennan: Oh, we're not blue fish.

Booth: That's very damn poetic of you.

Brennan: You want to come? To go bowling with us at the bowling rink?

Sweets: Me? I'm a dog person. I think that has meaning.

And my personal favorite -

Booth: I thought the whole point of therapy was to give us peace of mind, not to drive us crazy.

Ohh, how I've missed Booth and Brennan.

And now Maggie's barking in her sleep, which is the most adorable thing ever.

I'm just so glad to be living my life right now.

Instant Karma

So....I had just written the following...

So I'm on call. It's nearly 8pm. Remember, there's night float here tonight, so I'm only on until 10 (hooray). I've got one coming in, but she's arriving by sheriff and so that will probably take a while, because the ER staff has to see her and whatnot.

And then, of course, my pager went off. And it's the hospital police, saying that the sheriff just showed up with this kid, and you know, kids that age can't usually come in voluntarily and there's no parent with her...in other words....so, can you come fix this?

Aaaaaagh....

I don't own emotion, I rent

Ah, if only that were true.

Feeling a little better, on all fronts. Actually a little bummed that I missed the conference at this point, but less guilty that I missed it because I couldn't move without thinking my head was about to explode than if I had just chickened out and not gone. Not that this migraine wasn't in large part caused by stress, anxiety and general battiness (plus, a little pollen, I think. The crazy doesn't get all the credit), but, seriously, the wandering around in the dark this morning saying "Nono, doggie, shhh, shhhhhhhhh!" whenever the pooch made a sound, it does sort of legitimize and validate things.

Monday. Monday's going to be the really bad day, I can already tell you.

I'm for some reason very sensitive to anniversaries (probably because I don't do anticipatory anxiety very well). But this year is by far the worst, for the obvious reasons. Next year, when I'm actually a second year, and I actually got through my intern year okay, it's going to be so much better.

After I slept through most of the day, I finally watched Rent, which had been on my DVR since September. I was a little disappointed. I mean, it doesn't help that I can recite the score of the musical pretty much from "December 24th, 9pm, Eastern Standard Time" straight through to the last "No day but today." And it also doesn't help that the first time I saw it on stage the cast was phenomenal. Oh, my gosh, they were so good. I think the movie did it justice, but, eh, they broke up a lot of songs that needed to be sort of all over the place, they left out one of my favorite songs (Happy New Year), and their Maureen was a little disappointing. Now, no one could be as good as the Angel I saw on stage, so it's probably not his fault that this one wasn't quite as charismatic and engaging. And they left out some really good lines. But I do think they cleaned up the second half well. It's always been a little...mmm...floppy and not quite as together as the first half. The movie did a much better job with the second half.

Anyhow.

I'm on call tomorrow, so I should get to bed. So much for vacation.

Careful what you wish for

Needless to say, I'm not at the conference. My alarm went off at 6:15 this morning, after a totally not restful night of vivid nightmares (which, honestly, is not that unusual around here) and having got up twice to down a handful of antacid, and I had the worst migraine. Which was fairly confined to my right frontal head, until I woke up again at 8:30, when my whole frakkin' brain hurt. Ow. I don't think it's an aneurysm. Or West Nile. Or meningitis. So I think that 800mg of Motrin and a lot of lying in the dark will fix me right up.

I knew something was really wrong when Maggie came over and snuggled up to me in bed. She only does that when there's either a thunderstorm going on or she thinks I'm really sick.

Ow.

Freaking Out Friday

So, in roughly twelve hours I'm supposed to be at this conference, right? Gosh, it seemed like such a good idea at the time. It's right down the street from the hospital, sponsored by our department, four or five nice little talks, a good lunch. And the department offered to pay for the first ten residents who wanted to go. End of my vacation. Nice idea.

Except, I didn't realize the weekend when I asked to go.

And now I'm having a relatively big panic attack at the prospect of going to this thing tomorrow.

Oh, it's totally irrational. Although it was totally escalated when I just looked at the flier and realized that it's not being held where I thought it was and I actually have no earthly idea where this place is on campus.

So, three years ago, I spent the second weekend in April at this conference. It's the one I mentioned as being the event that changed my life and ultimately led to me not taking any more shit from the man behind the curtain and leaving the Emerald Palace. I was in all sorts of trouble for going to the AAGL class, right? But I went anyway. I thought maybe I could learn something. I thought maybe I could prove myself, you know? But I just ended up in trouble. So, anyway, I went to this thing, and all morning, I'm listening to these talks, you know, and that's fine, but in the breaks I start talking to talk to the other residents who are there. And they're listening to my stories - which I'm telling because I think they're normal - and they're all like, wow, that's...that's not good. I was like....um....okay....

And then we had lunch. There were these roundtable discussions, and I had, like, my top six choices all ranked in the program, and so I was headed to, table number 3 or whatever, for, like, Pearls for Reducing Your Rate of Complications in Hysteroscopy or something like that, when, suddenly, I didn't. For reasons I still can't explain I veered to what I think was my fifth choice, named something along the lines of Teaching Yourself Laparoscopy in Residency. Where I ended up sitting at a table full of residents, with one other intern who was SOOOOOOOOOO excited about her program, and the speaker, we'll call him Tony, who used to be a program director. I spent most of the lunch with my head down trying not to cry. These people were in a whole other world than I was. Tony was all "my residents" this and "my residents" that, so protective of them, and he had been in private practice for a couple of years by then.

Later that afternoon, we had labs. I spent the first half mostly with equipment reps, using the virtual reality trainer, picking seeds out of a pepper with a hysteroscope, plucking potato and toothpick "tumors" out of a pig bladder, that sort of thing. And then I went to the other room, to work on the older trainers and the foam rubber uteri with the real doctors and the real instruments.

And I was really good.

So here I am, right, on the trainer, and Tony comes up to me, watches me for a while, corrects my posture. He's like, you're really good. What are you, third year? I said, no, remember, I'm the intern who's in trouble for being here. I was running circles around my training partner, who actually was a third year. He's like, you have great dexterity. You're a really quick learner. Wow, you've got great strategy. And then I rotated on, and the next thing I know I'm doing moderately complex maneuvers with three of the best endoscopic surgeons in the country when back home, I couldn't tie a open field square knot without getting yelled at. It was surreal.

At one point, this black woman, who was like a fourth year resident somewhere else, she and I were talking, and I said something about things getting better when I got to second year. And she says, "Well, or you'll realize that your program just sucks." Um. Well...or there's that...

And then that night, I met up with my friends from home. I was still a little stunned from the day's events. And they were all like, good God, you look like hell, what are they doing to you up there?

It was a good question.

I went back the next morning (because it was a two-day conference), and talked to this other woman, this Greek girl who was doing her residency in Boston somewhere. I talked to Tony a little more, because it turned out that he and this Greek girl had gone to the same medical school. I listened to his lecture, which was essentially the same thing he'd told us at the roundtable the day before, but, it was, again, there was that undertone of "this is what you're entitled to as a resident. Someone's required to teach you, you're entitled to learn."

It was like someone had flipped a switch that first day. It was like some of the color had come back into my grey life. I went back, and within four hours of getting home my world started collapsing. My life, my career, my sanity, it imploded four days later. I can't even begin to explain the magnitude of that decision. How far-reaching the fallout would be. I still don't even comprehend the full scope of what happened. That sounds overdramatic, but trust me, it's not even close.

And Tony, well, Tony's a whole other post. Hell, Tony's a whole other blog.

Everything changed that weekend. Because I went to some random conference.

I know it's a whole different situation now. I know that what happened needed to happen. I know I'm in a very different place living a very different life now than I was then. I know I was skidding towards that catastrophe long before I even signed up for the AAGL class, that it was just a catalyst for things that had to happen. That this is so different. Different time, different people, different situation.

But that's not how PTSD works.

I don't know if I can go tomorrow. I don't know if I can do this. I don't know that it's the worst thing ever that I don't, and if I had shelled out for the registration myself I wouldn't think twice about not going. But I didn't pay for it. Now, honestly, I don't really know that the department did, either - I mean it's their conference.

It's totally irrational and superstitious, but you know, things are going well right now. I don't know if I can run the risk of everything changing again. I'm just completely terrified of it.

Okay, you know what? I never said I wasn't crazy.

Cute Thursday

I had a very cute vacation day. It was nice.

I got up, and went to my shrink's office (we're trying to squeeze as many sessions in as we can this week while I have, you know, time. It's not that I'm that crazy). And got a visit from the very cute cat who hangs out outside her office, I suspect because my shrink feeds her and it was time for breakfast. But she's this adorable little black thing, and this morning I noticed that she was missing the top of her left ear. So I said, oh! She must be an Operation Catnip cat!


(Not my shrink's random stray cat, actually my friend's ex-random-stray-cat-turned-housecat, Max, who IS an Operation Catnip cat)

No, she says, that's a raccoon nip.

Hmm. Not the same. But apparently she is altered, and she's awfully darn cute. Sometimes she comes to the window during our sessions and "listens" intently. It feels sometimes like I'm getting two therapists for the price of one.


But I think she's actually trying to get me to feed her by the sheer power of her kitten telepathy.

I then came home and met up with my psuedo-aunt and we set out in search of decent pizza, which she assured me we could find at this place called Z Pizza. It was good, actually. New York style, but, it'll do.

We then went wandering around Bond Park, which is nearby their house and is very nice and has this cool amphitheater where they occasionally have concerts.


The trails left a little to be desired - they weren't very clearly marked and were in desperate need of mulching after the winter, although a few of them had been. But it was a nice walk.


I ended up taking a lot of pictures of trees and roots and funky stuff, because not a lot is in bloom there yet. Although the Dogwood are. Isn't this the Dogwood state? I think it is...



We did see a couple of cute little lizards. I wasn't fast enough with the camera to get pictures of them.

So then we went to Starbucks, and then to a very cute used book store, where I only spent $8 and only acquired two hardcovers. It was actually one of the best used bookstores I've been in - clean, very well organized, didn't have piles of random books lying all over the floor (like this place I used to go to in Chicago. Or, say, my house). And they had a lot of current stuff - I could easily have spent a day's pay or so there (remember, they don't pay me much per hour, but I work a lot of 'em in a day). It's called Mr. Mike's Used Books and if you live in the Triangle, you must check it out.

So then I dropped her off and went to get groceries and I happened to notice the little shop next door happened to be open and they're always advertising that they sell Danskos, and, well, even though I keep falling off of my Danskos, I'm really getting sick of wearing my tennis shoes to work. So I went in. And I found these very cute shoes:



They're called Aravons and they're made by New Balance (of course). And they're JUST WICKED COMFORTABLE. They have memory foam inserts and just enough heel and are adjustable width throughout the whole instep and foot and oh, I'm so excited to wear them to work on Monday. I'm going to have to paint my toenails tomorrow.

I did ultimately go to the grocery store, and was checked out by the cutest adolescent boy on the planet. And not in that, Kate-stop-thinking-that-you're-almost-thirty! way, but he was just adorable. He was nineteen and has lived here for about 6 years but before that he lived in Mass (-achusetts) and you know he still kind of had the accent but he really liked it here because the winters were awful and oh, I had lived in New Hampshire, so yeah, I knew all about the winters, man, the snow up in NH was terrible holy cow they'd get four feet and not even call it a flurry and you know he used to go through like a container of Parmesan cheese a week because that was like all he would eat that and this spray butter on pasta did I remember that spray butter because that stuff was wicked good and man whatever happened to that stuff it was this one particular kind with the blue top and it was like actual butter not that greasy nasty mess you can sometimes still find. The whole thing amused me so.

And then, of course, as is customary when I go to that grocery store, I pick up a hamburger combo from the little place next door and I get Maggie a cheeseburger, and I don't even have to tell you, that's always a cute event. But tonight, I was ripping it into bite sized piece and tossing them in her food dish and Maggie was bouncing up and down and for some reason, she really wanted the pieces I was holding over the ones already in her dish. So I gave her one, and she galloped back to her crate to eat it, and then came back, and begged for me to give her another one, and did the same thing. And by then all the hamburger was torn up and in her bowl, so she gave up and just ate it out of there. But the whole thing was, in fact, way too cute.

::sigh:: It was a nice day.

Zzzzzz....

I slept through today.

So not kidding.

Woke up at 9:30. Got up. Went to see my shrink. Came home. Slept. Until I woke up, and then took a nap. And then I fell asleep. I'd better get up so I can go to bed....

Ahh, vacation...

More nostalgia

Three years ago today, I was on a plane to Chicago. My aunt, my uncle, my cousin came over for dinner. I remember feeling so wiped out, and, like, not even there. I felt grey. Colorless. Numb. I pulled out the two variations on black that I'd brought for the conference and picked one. And then I lay in my bed and stared at the ceiling fan and wished I could feel something other than blackness.

Three years ago today, I still wasn't thinking of leaving my program.

Today, I woke up at half past dark and pulled on my work clothes (still, variations on black, I admit) and went to a meeting about crazy pregnant lady with the OB/G department. I discovered that I was "famous" over there as the psych resident who can check a cervix. They love me. They? Seem to think I know OB. I find this really ironic. And they gave me a cookie for coming in at quarter to early on my vacation.

I'm a sucker for a cookie and some validation.

So then I went and checked in on the unit. Talked to one of my patients, who was like "You've been gone one day and they already changed my medication for no good reason and they're screwing it up." Then I did some paperwork, and then I had my annual review with my program director.

They like me. They really like me.

It was nice. I mean, I kinda knew that, since my attending gave me a review last week and said things like "I really think you were born to do this." But it was really nice to hear. And she asked if this experience was different from the last one. She says, "I hope it's like night and day." I laughed.

It's like night and penguins.

So then I spent a while on a conference call with crazy pregnant lady's guardian and her boss. Then I went to the noon lecture/conference/support group/free lunch thingie. Then I'm finally walking out of the hospital, and the woman whose house I'm trying to rent in June calls me. So I pop on over, chat with her, meet the dog, discuss the specifics. Somewhere in there my crazy friend Rachel calls me, and she's sick, and could I pick up her antibiotics? Of course I can. And then I had to get her car out of the muddy ditch at the end of her driveway, because I'm from Chicago, and we know how to do those things.

Then I came home and decided to brush out the dog for like a half hour. Which took almost two hours, because the little girls across the way decided they wanted to help. Still got a lot of fur off, though, eventually. And then I came in, changed out of the clothes covered in dog hair, and took leftover chili over to my aunt's. We ate chili. we watched a really sweet movie (The Jane Austen Book Club. I could've sworn I'd read the book, but, maybe I never got around to it. I know I own it, because my friend Sue gave it to me). I was instantly in love with the adorable male lead. So adorable.

It was a nice day.

Reflections on a new beginning

You'll forgive me if the next week or so I spend a lot of time waxing philosophical.

Know what I'm doing right now? I'm sitting in a Barnes and Noble in Durham, in the Cafe, drinking a Cinnamon Dolce White Mocha and blogging. I was planning on coming in and working on my many delinquent discharge summaries, but, alas, I'm on vacation. Sort of (I mean, I'm going in to work at quarter past early tomorrow for a meeting with the OB/G dept about my crazy pregnant patient, and then I have my review later in the morning, and then I'm probably going to stay for intern support group so I can kibbutz. And Saturday I'm spending at a conference here in town - which is really, really ironic, for reasons that will become apparent soon - and I'm probably taking call on Sunday. But, you know, vacation).

Know what I was doing right now (well, it may have been about an hour from now) three years ago?

I was getting in SO MUCH TROUBLE. Why? Because I was going to a conference on the 9th and 10th.

Also, I had just delivered my very last baby. But we'll talk about that some other time.

So there was this conference I wanted to go to in '05. In February, I pulled the flier out of my mailbox and went to toss it in the recycle bin like all the other solicitations I got, but for some reason it caught my eye. It was a conference for residents to improve their laparoscopic skills. Of which mine we very limited, because I was the bad intern and no one would ever let me play with the toys except for Ben, who liked having me operate with him alone (i.e., no upper level resident) on his laparoscopic or hysteroscopic cases. And it was in Chicago, so, bonus, no lodging costs. Plus I would be on my Anesthesia rotation, who made it abundantly clear (as in, they said it outright) that they didn't care if we came in at all for the whole month, this was clearly for our learning. Lots of the upper levels told me they went in one or two days a week while on Anesthesia (since you still had OB/G call and clinic responsibilities). Cool. So I emailed our program coordinator and said, can I go to this conference two whole months from now? And she said, this is how much you have left in your educational account, tell me if you want to use it on registration fees. And then I got my department chair to write them a letter saying that yes, I was a resident in our department, thus making me eligible for the resident rate and membership in the organization. I was excited. It looked really interesting. And maybe it would help me to improve my skills enough that someone would actually let me operate once in a while. I was trying to be better, despite the fact that I knew I was never going to be good enough.

So, the Wednesday before this conference, I send my duty hours in, and say, oh, by the way, don't forget that I'm going to this thing this weekend. At which point my program director was like, "What? What conference? Interns aren't allowed to go to conferences." I said, remember how I emailed y'all about this in February? And then by today, which was Thursday, she had concluded that I was totally abusing the system by taking Friday and Monday off to travel. I said, but Anesthesia's okay with me being gone, and Dr. A - the anesthetist in charge of me - and I have already worked out a plan to make up the hours I'm going to miss.

She said, "I see no reason to involve the Anesthesia department in this."

Um...other than the fact that I was responsible to them that month?

And it wasn't like I was going to the coast for a four day weekend, or skiing, or to Martha's Vineyard, like so many of my cohorts had done on that rotation. I was going to a conference. To learn surgical techniques they wouldn't teach me. Oh, my gosh, though, I was in so much trouble.

I was "allowed" to go to the conference, because I'd already made plane reservations but we were going to have to "talk about this when I got back."

I should've said it right then. I should've said it months before. I should've pulled out the "oh, fuck you." I should've told them I wasn't coming back from Chicago. I should've told her that if she were doing her damn job, instead of abusing and scapegoating me for everything that went wrong, instead of throwing me to the wolves when she wanted to avoid confrontation, if she would've acknowledged my strengths and been constructive instead of abusive, I wouldn't have been so miserable, confused, and demoralized that I was clinging to the last jagged shards of my sanity. I should've told her precisely what was wrong with this picture. I should've told her exactly how much more and how much better I was than she was portraying me to be.

But I didn't. Because at that point, I was so broken down I didn't know any better.

I did, however, go to the conference.

And the conference changed my life. In fact, I think it's not at all an exaggeration to say that it saved my life. You'll hear about that in a couple of days, I'm sure.

I doubt Saturday's conference is going to as life altering. But let me just say that not only am I going with the department's blessing, they're paying my $200 registration fee. I mean, it probably helps that we're hosting the conference, but, still.

I'm so grateful for my life right now. I'm so grateful for where I am, so grateful for what it, and I, are becoming. So grateful for what the last four years have taught me. So grateful that I'm even alive, and have a career ahead of me to speak of. So I guess there's really only one thing left to say, today.

Fuck you, Karen George.

Amusing videos

Because I'm tired and slept most of the day and yet...still tired. Call was vewy, vewy quiet until about 4pm. And then...eiy.

So, here, watch these. They're funny.

This has been circulating around the hospital. It cracks us all up, because we're a university hospital that deals with a lot of little community dumbass hospitals and it's just so true.



Don't believe me? Click here. It's one of the little local hospital chains. Eerie, huh?

These are funny too. This? Was totally me in medical school:



The whole series of these Real Med Students of Genius spoofs can be found here. They're very funny. My favorites are Mr. Floor Team Avoider Guy (SO TRUE - my med students that were on for the first half of Neurology were totally like this) and Mr. Really Bad With Children Guy.

One advantage to being single

Apparently, I could survive 133 days trapped in my house without electricity. But I'm guessing with running water.



And apparently only if I ate my dog.

This is a silly quiz (so, you should go take it, too). Because it doesn't take into account that whole running water thing, or the fact that I'm so never gonna eat my dog (she may end up eating me in the end, really), or the fact that I'm fabulously famine-resistant given my, ahem, large energy stores. Or how I might actually share some of that non-perishable food with the dog. Or how you can't really eat leather. But I wonder if wool has any nutritive value? Or dog hair?

I don't dare say anything about the kind of day I'm having on call because I don't want to jinx it. Yes, I know I was supposed to grow out of the magical thinking stage years ago, but...... Anyway, there's some new links in the Blogs I Love section and in general the amount of crap in the sidebar at right is just getting out of hand.

19 hours until vacation.

Love/Hate Friday

First, the hate.....

Seriously. The pine pollen is out of control. Look at this nonsense! It's like that awful yellow chalk dust from grade school, times, like, a billion.


Blahhhh. And I'm out of Zyrtec.

We're not even going to discuss the pine pollen paw prints on my carpet.

But, something cool did happen today. Actually, today was in many ways awful. Crazy pregnant lady hates me so much she won't even talk to me. New schizophrenic girl just gets worse every damn day. I had to get between her and her mom last night because she was "prophesying" loudly and angrily and was terrifying her already somewhat fragile mother. My ECT patient is still wacky, but at least she's a pleasant and giggle-prone wacky at this point. And my one patient I thought had done so well and with whom I was positive was getting better and who had this peculiar habit of hugging me and whom I thought I had done really well by wigged out and went complete borderline whack-job on me after my attending agreed with me in rounds that we were discharging her and then decided she needed to stay (and of course sent me to go tell her). I've gone from being "the only doctor she ever trusted" to the worst doctor ever in like, 2.8 seconds. That? Hurt.

But. I have this one patient. We've been doing individual therapy while she's in, and she's been doing a great job. Today, she told me that she'd heard the other girl yelling that I lied to her (I didn't) and she told me she was scared that I would do the same to her. That just about broke my heart. But we talked through it and she processed it well and it ended up being a fairly positive thing.

She processed it well. I? Am still pissed at the other patient for even making her think that. I'll get over it.

Anyway.

I've been giving her art therapy assignments, and for today I told her to draw me a picture of the inside of her head. She gave me this one to keep.

The picture really doesn't do it justice. The design was preprinted, but the color, and the explanation she was able to give me, was all her. I'm going to frame it and put it in my office next year.

She's an incest survivor. She's stronger than she knows. She's way braver than she thinks she is. She's just awesome.

Love Thursday...

...will be postponed until Love Friday. Day was long. Patients SO crazy. I'm so tired.

But.

The fact that it's taken me three days to mention this should be a clue as to how bad the past week has been. It's April. Which is a month important for reasons far beyond May flowers.

April is National Sexual Assault Awareness Month. Today, in fact, is the SAAM Day of Action.

I haven't quite figured out how I want to "celebrate" this month, yet, but we will. Because it's important to acknowledge those who've been victimized, and those who've survived. Those who are still fighting. Those who still don't have a voice. Those who stand by in support. Those who work hard because saving even one victim is worth everything. And all of us whose lives will never be the same.

Short call

Patients still crazy. Call amusing. Doctor very tired. Going to bed now.

I must be a bad doctor...

All my patients got crazier overnight. Even crazier than they were.

I spent so much time doing therapy and meeting with people and soothing family members today that I barely had time to breathe. My med student and I had planned to leave at 4. We left at 5:30 and I had to blow off my new patient's bleeding toe (it's a TOE! It can WAIT until tomorrow, crazy nurse woman!!) to bolt out the door. Didn't get a single note written. Came home, wrote two, and then the electronic chart crashed.

Oy.

Watch that woman's toe have fallen off tomorrow.

The perfect ending....

....to a less than perfect day.

OH MY FREAKING GOD work was so hellish today it simultaneously sucked and blew. The Psychotic Disorders unit is a frakkin' war zone. I spent at least half the day dealing with crazy mothers of my crazy patients. I spent a good portion of the day getting told I was an ugly, fat, stupid, horrible bitch by my crazy pregnant patient. I spent, let's face it, the WHOLE day putting out various fires. And then I still had notes to write. The nurses were stressed out and understaffed and horrible today. My really crazy patient is now batshit crazy. My other really crazy patient has become crazy as a fucking bedbug. And my other other really crazy patient had electroshock this morning and though she calmed down for a moment, by late afternoon she was, to quote my medical student, "crazy as a shithouse rat." There's leftover Easter candy everywhere and I ate way too much sugar, which in some ways is sort of fortunate because I had to toss about half my uneaten lunch because it was getting to the point that if I kept trying to eat it between interruptions I was going to ruin my dinner. And I should have ran and hid except then one of my patients had a meltdown, so I pulled her into the rec room and we had a little therapy session.

But then, PenguinShrink and Chef (her boyfriend. Guess what he does for a living. Go on, guess) had me over for dinner. Chef cooked Indian food reportedly for the first time since culinary school. He made this fabulous curried chicken and saag and homemade paneer cheese, which is my favorite thing ever. I, quite seriously, could live on saag paneer and a little naan. We cooked and we laughed and we watched a cool movie. And I felt much better. Because by the time I left the unit, I was close to killing someone.

This poor patient with the meltdown today, right? Everyone thinks she's schizophrenic and apparently when she got admitted they told her that they were going to start her on clozaril, which is the big gun of antipsychotics, and it very, very carefully used, because while it's strong as hell, it has very serious and potentially life-threatening side effects. I almost fell off my chair when she told me this. Because neither my attending nor I thinks she's really schizophrenic. And so we had this long session in which, among other things, she recounted a past that was too much like mine. She told me that the first time she was molested was on this beautiful spring day, and that she kept thinking, this can't be right, because nothing so horrible could happen on such a really beautiful day. It may not have been the first time, but I remember a clear, cloudless night and a big, bright, early summer full moon. I remember that it was so surreal. Oh, I felt so bad for her today. Because I've been there. She's another one, you know...I always look at my patients, or my friends, and I wonder, what's different, you know? Why do some of us respond in some ways, some of us in such vastly different manners? Why can I manage to be higher functioning than those that I treat? I don't understand it. I don't know what makes us different when I know what makes us so similar.

Yeah...so that's a clear sign I need to go to bed.......

Rainy Sunday Call

So, most of the time, when I talk about patients on this blog, I'm really obsessive about confidentiality. Identifying details are changed, or omitted, or outright confabulated. Because my patients deserve their rights and dignity, even the ones who commit phenomenal feats of jackassery.

But tonight I give you a verbatim quote directly from the patient record. Nope, nope, not a HIPPA violation. Why, you ask? Because there are no details in this thing that identify anything.

Part of being an efficient resident on call is cruising the ER census, a whiteboard-esque program called T-system. It gives the patient name, location, chief complaint (which all too often is "psych eval." Psych eval is not a chief complaint, people!! Who walks into the ER and says, "I'm here for a psych eval"? I mean really though), and a few other key pieces of data all at a glance, and then if you click on them, you can essentially read the patient's whole ER chart. From wherever else you may happen to be in the hospital. It's nice, actually. And so as a bonus you can surf T-system and keep on top of what patients they will probably be calling you about. Often, especially on kids, we'll just turn up before they even really call us if we can already tell they're going to. So, like, tonight, I see this patient listed as something psychiatric, so I click, and this is what the intake nurse has written, word for word:

Can not focus tried to get admitted several weeks ago but no bed admitted upstairs in November changes are quit aggression, if phone rings started Klonopin yesterday not SI yesterday said he did not want to liver.

Which is when I walked over to that part of the ER and said....um....what???

I've had notes from floridly psychotic patients that made more sense than this. Fortunately, the nurse who had written it thought it was almost as funny as I did.

Oy. It's time for bed, y'all. It was a long damn call day. But I still really like the going home at 10(ish) part.

Things that make you go...ARGH!

So, you might notice that the amount of days on my timer at right has gone up...

Oh, I can't tell you how pissed I am.

So you might remember that little debacle with my licensure after the evil jackasses at the Emerald Palace tried to screw me up. For those of you who don't, well, the evil jackasses at the Emerald Palace continued their two year run of harassment in turn for my treachery of leaving by sending a libelous and distorted "verification" of my training there. Which resulted in my license being delayed by three weeks until I ultimately had to go meet with a board member who was like, why the hell not? It's just a training license.

Well.

Until this week everyone seemed to be conveniently forgetting that three week delay. Which seems fair, because I didn't get any credit at all for the time served up north. Until the new chiefs took over, and so I get this email. Telling me that not only is the start of my second year being delayed for a month because of this, I have to do another month of crisis, and take another month of intern call, AND my "intern" year is being extended ELEVEN DAYS LONGER THAN ANYONE ELSE'S.

Eleven days.

Eleven days longer. Than any of the other interns. This will come out of my last year experience, he says.

So now I've done 10 months of internship in OB/G. I'll have done a full internship in psychiatry. And then I get to take almost two weeks out of my fourth year, so I could do even MORE internship. And they won't make any sort of allowance. They won't let me do clinic part time in July. They won't let me be in the second year call pool instead of the intern call pool (oh, but there'll be 5 interns on that month, so we'll be on every fifth night instead of every fourth. Big conciliation).

And the man behind the curtain wins again.

That's really the issue. Not the extra month. I can do another month on crisis, whatever. I can do the extra call. But I reserve the right to feel jilted about it.

In other news, the pine pollen has arrived in North Carolina.

It runs in sulfuric rivulets with the rain and it coats everything, inside and out. It's like the worst dust you can imagine.

Pine pollen is my nemesis.


My nose is running. My eyes itch. My throat hurts. I'm wheezing and squeaking by the time I walk into the hospital from the parking lot in the morning. I'm not sleeping well. I'm tired, I'm sore, from these puddled masses yearning to be trees.

And apparently, I make terrible puns in response to the pollenosis.



Maggie's dealing with it okay, though.

Meme-meme-meme-meme-meeeeeme.....

Oh, such a long, long day. I have eight patients. I managed to write one note. Oy. So I still have seven to do, and I've got a migraine, and all I really want to do is nap, and whine.

So instead, I'll do this little meme from my cousin Danielle instead.

What I was doing 10 years ago:

Hmm. I'm not sure I remember 10 minutes ago just now. Um, what was that, 1998? I was a sophomore in college. So I was taking O-chem and thinking about joining a sorority I would shut down two years later and being told I shouldn't even apply to medical school by my advisor (Had I ever thought about podiatry?) and falling in love with the asshole I'd become involved with over the coming year, and generally, hating life.

Five things on my to-do list today:
1. Actually make it to work (done)
2. Go to C/L conference (done)
3. Go to department lunch (done)
4. Go to Grand Rounds (didn't make it)
5. Write all my notes (Yeah, so I went back and finished those)

Snacks I enjoy:
1. Clementines
2. Frosted mini wheats.
3. Most things chocolate
4. Nachos
5. Cookies

Things I would do if I were a billionaire:
1. Start a foundation for survivors of sexual abuse and assault
2. Open my own multi-disciplinary treatment center somewhere down the road (you know, like after I'm board certified)
3. Buy a house on a big lot with a fence and a fireplace and hardwood floors and a nice big kitchen
4. Adopt like eight other dogs
5. Pay off all my damn debt

Five of my bad habits:
1. Not taking the best care of myself.
2. My housekeeping skill (okay, not really the lack of skills, but the lack of priority)
3. Internalizing way too many things
4. Not checking my mail very often
5. Picking at my nails, which are already flaking and bad enough
6. Not actually tagging people for memes (Consider yourself tagged)

Five places I have lived:
1. LaGrange IL
2. Aurora IL
3. Valparaiso IN
4. Lebanon NH
5. Cary NC

Love This

First of all, I appreciate no one commenting on how I misspelled the title of yesterday's post.

Second of all, read this.

He. He he he.

What's particularly amusing to me is that from this account of his behavior, I could petition and commit him in the state of North Carolina. I won't, because that would muck up the campaign. But the thought amuses me.

It was yet another looooooong day at work. We had a very anxiety-inducing lecture on anxiety. And then I had an even more anxiety-provoking, two hour long family meeting (which of course, started at 4) with the family of my really, really sick patient, which included the mother who yesterday told me I was killing her baby. And obviously the patient's dad. And the mother's sister (whom I would swear was related to the father, because she was so rational and level-headed). And the mother's brother, who's a psychologist, whom I was actually quite glad he was there, except that he kept posturing by pimping us about the medications. One of the differences between us (psychiatrists) and psychologists is that we deal in meds. PhDs can't prescribe. So he's all like "blah blah blah, what's the efficacy, can you speak about the side effect profile, blah blah blah". Which, wow, my attending was a rock star. He whipped out all this data and information and studies with big acronyms and I was like, wow, thank God you're here. After all was said and done, the meeting went amazingly well. The mom held it together and really tried to hear what we were saying. I stepped off my platform of "No. Seriously. This is quite possibly schizophrenia. You just need to accept it already."

It's Love Thursday. Today, I love my attending. And also, I love my medical student, who took such an active role in the family meeting and really in this patient's care altogether and she's just really good. And honestly, truly....even though I'm exhausted and drained and pissed off about a couple of things I'll elaborate at another time altogether....I love my job.

Weird Wenesday

Ohhh....here's seven reasons my day has been really stinkin' weird...

1. My patient who's still really crazy, whom I really, really want to transfer, we decided today that she's going to go for electroshock therapy. I posed this to her, and she acted like a kid at Christmas. She's SO excited about us running an electrical current through her brain and making her have a seizure. SO EXCITED. Now, I concede that she's manic, but, um, really now.

2. My other patient who's really sick told me this morning that God compelled her to put on an uncomfortable bra.

Later, her mother accused me of "killing her baby" and experimenting on her (with one of the OLDEST ANTIPSYCHOTIC MEDICATIONS we have. Uh, yeah, we're experimenting, for what, now?). ::sigh:: What can I say? I'm a bad doctor for letting my patient have a say in her medical care.

You know what? I'm ridiculously possessive and protective of my patients. As I've mentioned, I'm particularly attached to and invested in this one. So don't tell me I'm not taking care of your kid. I know she's your "baby" and I may not have "babies" of my own, but I wouldn't take care of my own kids any differently than I'm taking care of yours.

3. We got two new medical students this week, of course. One of them is fabulous, and I got her. The other one really annoys me. And today, I was commenting on a discussion that's been going on over at Shrink Rap and the comments I'd left, and he was like, "You're commenting with total strangers on a message board about prescription medications? Does legal know about this?"

Dude. I'm not advising any particular person on whether or not to take a med. It's all theoretical. And yeah, it's possible legal could have a problem with my comments, my blog, my general loudmouth assertions around the unit. But, I'm, I'm guessing not.

4. I still got stuck in traffic despite getting out of work an hour and a half later than I'd planned. So I diverted to the Whole Foods to buy cornbread to go with the chili I made for dinner. While I was there, I got super excited because I found these organic oranges in a bag that I've bought before and they were just so good. So I bought a bag (whee!) and when I got home, I cut into one while dinner was cooking....and it was a grapefruit. I just bought a whole big bag of grapefruit. Which is okay, but...

5. I got home from work (and buying grapefruit) and discovered three, probably 8-10-ish year old boys sitting on my back porch, in the chairs, drinking Capri Sun. So I opened the door, and was like, um, hi. Can you tell me why you're on my porch? And they were like, oh...well, we're sitting. Do you want us to go? Uh......yeah.

So then they stayed out in the backyard and played soccer. Maggie kept huffing and looking at me like, "boy, they're loud." Yes, sweetie, little boys are loud. One of them appeared to be named "OMAROMAROMAR!" and another one was "Clar-ence."

6. I had to stick my hand in another woman's vagina today. Which didn't used to be an unusual occurrence, but you know, not a lot of psychiatrists do that very often. I acquired that crazy pregnant patient today, and the OB wasn't going to be able to come see her and do the pelvic until tomorrow. So I said, do you mind if I check her cervix? And she was so nice, which really is kind of unusual from this OB department. She was like, great, actually, that'd be so helpful. And so I did. And she's probably remote from delivery. And we all feel better now. Because when I ordered that they send a delivery tray up to the unit to be sure that if something happened, we were prepared (if, IF, not when. I'm not planning on delivering her on the Psychotic unit, but you know, she had her last kid in a hotel room, and didn't call 911 for a good half hour afterwards), the whole staff freaked out.

7. When I got of the phone with the sick patient's crazy mother and had the other sick patient's crazy mother holding for me on the other line, I commented to my attending about how it was days like this that make me wish I drank more. He told me it was never too early to start.

I'm so tired.

Tomorrow we have a family meeting with the hysterical histrionic mother who accused me of killing her baby. Her baby who can legally drink and was wearing the uncomfortable bra that God smote upon her. ::sigh:: Send positive thoughts.

Crazy Tuesday

But then again, what day isn't crazy day in my world.

Such a long day at work. Ohhhh, dear.

My patients continue to be really, really, really sick. One of them is getting a little bit better, the college girl who had her first episode of schizophrenic psychosis...can you imagine how horrible that must be? For her, for her family...and, really, a little for her psychiatrist, who's like, wow, I didn't see this coming, but in retrospect, I so should have...which, no, he couldn't have until she actually had her psychotic break. Which, by the way, seems to be a very fitting word. She's done broke. And now she's broken. And hopefully we can fix her, at least a little. But, you know, two years ago she was a straight-A student. Now she's completely psychotic and trapped in the false reality of her own head. Her very sweet and loving and supportive parents are devastated, and I can't imagine how they could possibly be anything else. And in truth, I think the part of the girl that was that's still in there somewhere is struggling and fighting and really conflicted by what seems real. The meds are helping a little. It's heartbreaking.

My other really, really sick patient has gotten worse. She'd been doing better, and we were going to send her home at the end of last week. I said it, Thursday, that if we didn't discharge her, she was going to decompensate over the weekend. Sure enough, she's a whirling dervish now. Who's being rude and acting out and was caught with her hand in some other patient's lap this afternoon. Which is when she nearly found herself on a bus to the state hospital, but my attending told me not to be so impulsive. I hate to tell him this, but she's been walking that line for over a week, and I would've sent her a long time ago if he would have let me.

Tomorrow, I have a really crazy pregnant lady coming down to my service from the crisis unit. Seems appropriate, huh? She should be interesting...

But then again, it's always interesting on the psych ward.

Will someone please turn the crazy down?

Wow. It was bad on the psychotic unit today. Wow. Fortunately, the patients aren't quite as violent as they were two weeks ago when I started, but, they're just really, really sick.

Really, really sick.

It's so exhausting. I keep underestimating how exhausting this is.

Fortunately, at least, I'm not on call this week until Sunday. So at least there's that.

Random Endorsement Sunday

You know, 'cause I missed Love Thursday this week.

Happy Easter to all of you for whom it is, in fact, Easter.

Orthodox Easter follows Passover, so our Lent just barely started. I remember when I was little, my mom used to refer to Roman Easter as "Pagan Easter", which I didn't realize was a dig. So I wandered around referring to it as such for years. Heaven only knows how many of my grade school teachers I offended with that one.

And for those of you who are actually Pagan, well, happy equinox and happy Spring.

I tried to run errands today, but it turned out the only place I needed to go that was open was PetSmart. Where I needed to go because my dog walker left me a big note yesterday saying "NEED TREATS!!!"

So I went for treats. And here's what I got:

The treats are Maggie's very favorite. I suspect they're probably tasty, but I think the bigger point is that they're round, and they roll across the floor (you know, when I roll them across the floor), and then you can chase them, and pounce on them, and they're lots of fun. So I'm walking to the checkout counter, and I pass this display for something called the Furminator.

Wow. I so incredibly love this thing.

Mags was a little apprehensive at first, but afterwards was sort of like, ooooh. Yeah. Oh, brush a little more. And then after we spent about a half hour sitting outside brushing and brushing and brushing, she was like, okay, thanks, that's enough.

Holy Oh My Gosh, there was so much hair.

Sadly, I didn't get a picture of Maggie with all the undercoat hair all over her, but I can show you pictures of the fallout.
There were little Maggie hair tumbleweeds everywhere.

SO MUCH HAIR.
And a lucky cricket who just happened to be passing by.

Seriously. If you own a dog, who has fur that sheds, you need to go get one of these rightnow. (a Furminator, not a lucky cricket. Although...). PetSmart is open right now. Go, go.

Maggie says, get some treats while you're at it.

Meanwhile, we've gotten some random chores done and now we're watching Eight Below, which I taped off of Starz a long time ago. Maggie likes all the barking, I think. I always cry so hard at this movie. So hard. Maggie keeps trying to remind me that they're actor dogs and that me sobbing uncontrollably when Old Jack and Dewey die, or when Max gets lost, she says it's just silly.



She's probably right.

Shit

Oh, in so many ways.

So....last night, was bad. I admitted four people. I did full evaluations and admissions on three more. I totally worked one kid up and sent him to Other State Hospital, which is an involved process to begin with, but he was mentally retarded, which then adds this whole long process of requesting an exemption from some Senate Bill or House Bill or dollar bill or something like that. I did four consults we didn't admit.

The last admission was this very sad woman who had been tossed out of another local hospital after a bizarre altercation with the staff psychiatrist, who was just highly inappropriate. But she'd originally been headed to the medicine service overnight, but you know, then she sort of woke up, and so it's 2am, and I finally get a minute to breathe, and I'm literally closing down my computer to go to bed, and my senior (who, in her defense, had also gotten slammed all day with inpatient consults) says, can you just go evaluate this woman in the ER? You don't need to admit her yet, but, you know, just go see her.

That was 2am. I finally called my attending at 6.

Now, admittedly, I had everything except the orders pretty much wrapped up by the time I called him. I mean, why wake him up in the middle of the night if I don't need to? And I had some calls to field in there, too. So shortly after 7am I wandered up to bed. I got a couple more pages, and then finally dozed off for about twenty minutes until the pager woke me up again. It was an outside call, and at least half of those are other institutions trying to transfer a patient. Which, on a weekend like this when we're full to the gills, is an easy denial.

Instead, I got the call we all dread.

There was a woman on the other line, obviously having consumed some substance, who told me that she had overdosed on her sleeping meds. She kept telling me that she didn't want to wake up, how nobody liked her, how she wanted to die. I tried to talk her into coming in, into letting me call some help for her. She was a little gamey with me, but I finally managed to get her to give me an address. She kept going on and on, and I'm stuck in this call room, by myself, trying to figure out what the hell to do with her. So I finally went through the little bathroom that connects my call room to the second year's, woke up my senior, and tried to ask her to call the local police. Which is hard to do in the dark when you wake somebody up, so asked the girl to hang on, and wasn't off the phone for more than fifteen seconds. When I got back, she'd hung up. I tried to call her back, but the number she'd given me was disconnected. So we called the hospital police, who sent us to the town police, who told us to call 911. So I finally end up talking to the county police, who called me back and said that they went to the address, which was a vacant house.

Shit. All I could say to the officer was, shit.

We get about three or four calls from the ledge per year, from what I understand. Sometimes we can help. Sometimes we can't. I don't know. I don't know if she was fucking with me, if she was high/drunk/stoned and decided this would be fun, if she was setting up the person who was listed at that vacant address and had a similar name and happened to be listed in our medical records system so they got a visit from the county PD. I don't know if she actually had overdosed and really wanted to die. Maybe she slept it off and felt better. Maybe she's just personality disordered and wasn't in trouble to begin with. Maybe she needs help and will come in, to us or some other institution, to get it.

Maybe she's dead.

All I know is, that sucked. And I ten minutes to signout after I got off the phone (again) with the police. The last thing I needed was caffeine, but I went down to the coffee shop anyway for my morning cup of English Breakfast tea with cream. And a scone, because they don't have bagels on the weekend. I wasn't especially hungry, and I was already shaky (you know that feeling where you feel like you're trembling uncontrollably but you aren't actually shaking? Is is just me?), but I needed the routine of it. And I was $.50 short. And they were so nice to me, and just let it go, and she got me started on a club card, because "well, you get a free drink for every 15 you buy, and you're here every morning (and about half the time I buy my med students coffee, too), so it's silly that you don't have one." I felt a little better. And then I felt a little better when the intern who relieved me was all like, "oh my God!" But the senior coming on, who, by the way, is my completely useless "big sibling," was like, "yeah. Oh well, what are you going to do? So what do I need to do today? How come there's all these consults left?"

I'm new at this, alright? And I'm not sure this kind of thing is ever going to get easy. It really shouldn't.

The clincher? The senior I was on call with comes in to report and says, "So...someone, during the course of last night, went into the bathroom by our offices and left a large pile of feces on the back of the toilet. Who does that?"

Know what sucks?

Call.

Man, the crazies are out in force tonight. Damn full moon.

Match Day

Today, I'm going to break a hard and fast rule of my blog. For so many reasons, I never post pictures of myself on my blog. Not that it's really that hard to figure out it's me, here, if you know me, but nonetheless. While on the blog, as in life, most of my "rules" tend to be closer to "guidelines", this one's pretty much written in stone. Except today. Because, it just fits.

What's so special about today, you ask? Today is Match Day.

For those of you who don't know, the short explanation is that Match Day is this torture ritual cooked up by the Axis of Evil to add even more stress and drama to the life of a blossoming young doctor. See, what happens is, way back in August of your fourth year, you start submitting applications for places you want to train to do the specialty that you want to be in when you grow up. And the programs get all these hundreds of applications, and decide who they want to interview. So then, you interview at whatever programs, and they interview however many prospectives (i.e., we interviewed 90 for our 12 slots). Then after all that, which so far is not unlike getting a real job, in February you rank all the programs at which you interviewed in the order in which you would like to attend them. Meanwhile, the programs rank all the applicants they interviewed in the order in which they would like to have them. And then somewhere in Idaho or Texas or something some big computer puts all this together with a couple of complex mathematical algorithms and a hearty serving of voodoo and then spits out who goes where for what.

And that's the simplified version. We're not even going to talk about early match, the San Francisco Match, couples matching, or any of that shit.

Then comes Match Week. Match Day is always the third Thursday in March. But before that comes Black Monday, which is when you find out IF you matched, although not WHERE you match. The programs find out on Tuesday if they've filled all their slots, and then, the students who didn't match try to find open positions at programs that didn't fill, which may or may not be in their desired specialty and usually involves a lot of phone calls and faxing. This, appropriately enough, is called Scrambling. So then on Thursday, all the medical students in the whole country find out at 1pm Eastern where they're spending their next 1-8 years.

It's nerve-wracking. And a particularly sociopathic way to make people find jobs.

So last year the Match wasn't AS big a deal for me, because I was at home waiting for the results on my laptop in my parents' kitchen. Actually, last year Black Monday was the big day, because I only ended up ranking two programs (shhh) and the much bigger piece for me was if I had to scramble into a position. Once I knew I was in somewhere, I really had two options. I was a little surprised that I was going to Carolina, but, I'd waited so long for some stability and sense in my life and the ability to move forward by that point.

This year, it's a big deal because as of today the light at the end of the tunnel is finally confirmed to not be a train. There are people, with names and identities and pictures, who are coming to take my place in July. Fresh, new, impressionable minds that we can watch be progressively beat down and jaded next year and think fondly, well, at least it's not my turn anymore. Hmm, think I'll give myself the afternoon off from clinic next Tuesday.

Nah, actually, the interns are well supported around here. Intern year is just hard, even without the chaos and pathology and malevolence that made up my OB/G experience.

Four years ago (holy shit, it really was that long ago, wasn't it?) was a HUGE deal. My whole class, and all our families and friends, got together in this bar in Forest Park. And back then, you know, it was NOON Eastern, so 11 central that we found out. And Black Monday was so, like, whatever, because I knew then I wasn't going to NOT match, because my home program was going to rank me, but oddly, when I logged on that Monday to find out, and I looked at the little message that said, "Congratulations! You have matched." I got this weird sinking feeling in my stomach. So by the time Thursday rolled around, I was a nervous wreck. The Emerald Palace had once been at the top of my rank list, but after I went back for a second look, and after I did the same elsewhere, it dwindled down to #3. And my #1 rank had been heavily recruiting me. And please, my #2 should be so lucky to have me (although, I'm not sure why I thought I would match there, because I didn't like them, and they didn't really seem to like me, but, whatever). So I'd come up with two scenarios in my head: either I got my top rank, went home, put the house on the market, and moved to Baltimore, or I got my #2, went home, messed up the house again, and stayed in Chicago.

For some very bizarre reason, I had no contingency plan for #3.

And that year they'd made a rule that the bar wouldn't open until 11, when we all had our letters, because there'd been some embarrassing behavior in the past. And wow, I was a mess. I don't actually drink much, but let me tell you, I've never in my life been SO INCREDIBLY PISSED that no one would give me a drink as I was at 10:55 that morning.

So 11am finally comes. I go up to get my sealed letter telling me that (not that I knew this yet) I was being sent to hell. And I dawdled a little on the way back. And finally the friend who's standing on my right in the picture was like, "Well???" And then he dragged me to the back of the bar where my parents and my close circle of friends were waiting. And we all opened our letters. And I read mine. And fortunately, my friend Martha captured the moment on film:


Yeah, I wasn't so pleased.

Not that I could actually tell you why. I was more stunned than anything else. I kind of wandered around in a fog for a little while while the afore-mentioned friend and my other friend's husband kept feeding me drinks. And then a little while later we wandered over to the neighborhood Borders, where I again wandered aimlessly until I found myself in the Travel section. And then I thought, huh. I probably ought to get some books on New Hampshire.

So I loaded myself down with just about every book I could find, and then went back to the Cafe, where I encountered my friend Phil's wife, who had expected that they would match in Detroit but ended up matching in Cleveland, poring over an equally tall stack of books about the state of Ohio.

Last I heard, his mismatch turned out better than mine.

Whatever, I'm here now, and better days are in sight. Sometime I'll tell you about the night before Match Day 2004, which is a whole other story in and of itself (and involves a tattoo parlor). But pardon me while I escape to go drinking with my co-interns. We have a lot to celebrate...some of us even more than others.

Is it too much to demand...

...I want a full house and a rock 'n' roll band.

You know that Mary Chapin Carpenter song?

Here's what I want, at least tonight.

I want a rice cooker that doesn't burn my damn dinner.

I want my dog to understand that, just because it's raining doesn't mean you can't pee.

I want actual red hair, as in, roots that don't show when I get too busy to keep it up.

I want a couple more hours in the day to get stuff done.

I want someone else to pack up my house before I move in a couple of months.

I want to calm down and enjoy the rest of my intern year.

I want my patients to actually get better, and not just better enough.

I want cool quiet, and time to think.

I want more hours to sleep tonight.

I want you all to go download FHOD's new album, My Great Escape. My cousin wrote four of the songs on their new album. I don't actually know which ones yet. But I'll find out. I'm excited because I have new music to listen to on the way to work tomorrow.

Oh, and of course, I want world peace.

A tail of two puppies

Today, Maggie is six. You know, probably.

So in honor of same, she got a Jumbone, and her very own blog post. Here's the story of how I got Mags (with a lot of gratuitous pictures).

Once upon a time, I moved into a big house all by myself. Well, okay, that's not true. I moved in and my sorority sister from college moved in for the first semester. But then, she finished her internship at the engineering firm she was working at and went back to college. And I was a first year medical student, single, alone, in a big empty house that backed up to a trailer park.

So I got onto the Internet and started looking for a dog. And I found Wolfie.

Wolf was a Husky/Akita mix who was supposed to be 4. Well, they said later, maybe 6. The vet thinks he was somewhere closer to twice that old. He was a good, good boy, though. Oh, gosh, such a good dog. 90 lbs of snuggly, devoted, good, good dog. But what he wasn't was a well dog. The vet and I theorized later that he probably had metastatic cancer when I got him. I drove almost to Iowa and picked him up two days after Christmas, and he started having seizures about two days after that. He lasted almost a year, and it was a rough year. Once, when having a seizure, he bit me and I ended up in the hospital for three days. We had to clean his ears out twice a day because he had this horrible chronic infection. He had to take pills every day. Ultimately his liver failed and he got so sick he couldn't stand up and I had to euthanize him probably hours to days before he died a worse death. Aw, but he was just the best dog.

By then I was a second year medical student and was like, wow, this would be stupid for me to get another dog.

But then, my third year, my third roommate moved in, and he brought his dog, Kedzie.



Kedz? Also a good boy. Now such an old man. And I'd been longing for another pooch, so I thought, okay, this is good. I can get a vicarious puppy fix. And Kedz spent a lot of time down in my part of the house. But, although he liked me a lot, he was clearly Jeremy's dog.

I held out all the way to September of my fourth year. I started looking around and toying with the idea and even "interviewed" at this shelter in Naperville, who decided I was an unfit parent because I worked too much and denied me. And then one day, this woman my dad worked with said, hey, you know anyone who's looking for a dog? We've got a good one down at the shelter.

Well, that did it. I went down to see her. And I actually walked past her cage, because she was so timid and quiet, and all the other dogs were barking and making themselves known. But I stopped, and I said, oh. She's smaller than I was expecting. I want a big dog. And I was kind of thinking I wanted a male. But....she's awfully cute. And her tail started to wag.



And I said, well, is there a place I can take her for a walk or something? And the volunteer said, sure, and she picked up a leash. And wow, all the dogs went nuts. Barking, jumping...there was this big St. Bernard in the next cage who was banging on the cage door and just slobbering everywhere.

Maggie wagged her tail harder.



So we went outside. And she was so shy, and so timid, and so beaten down. And I scratched her head and played with her big velvety ears and she wouldn't look me in the eye. And Mags is part Greyhound, right, so she's a skinny gal as it is, but she was so thin you could see her ribs through her full fluffy Husky winter coat. She was clearly a damaged little soul. I rubbed her back, crouched down to pet her. And she leaned. You know how they do that. Knocked me over, actually. I laughed really hard. She hid behind my dad. And I was in love. This little girl? Was my dog.



So she couldn't come home with me that day because she wasn't done healing from her TAH/BSO (sometimes known in the non-former-OB/GYN community as being spayed). And it turned out that they adopted on a first come, first served basis. Which was a PROBLEM. Because she needed to be my dog, and I? Was taking step 2 of my medical boards on the day she was available for adoption. Crap.



So I gave my dad a letter, saying how much I wanted this dog, and that I had a nice house, with a big yard, and a dog run (that both my Husky Houdinis have had no problems getting out of, so it wasn't very useful, but I didn't mention that), and wow, I really wanted this dog. But you know, first come, first served. And when they opened the doors, three people were waiting for MY dog.

They ended up disqualifying one lady because she didn't have a fenced in yard or something. She had a little girl with her. So they put the other two names in a bowl and let the little girl pick. And because God, Allah, Vishnu, the Fates, and all the other ethereal powers knew that this was MY DOG, my name was on the paper she pulled out. I left the test, and there was a puppy waiting for me at home.



Oh, and ew, did I mention her name was Sweet Pea? Now, my girl, even before she recovered from her past life, even before she was the smart, funny, happy dog she is today, was so very not a Sweet Pea. So for the first three days of her new life she was named "Dog." And then one day, we were out in the back yard with Kedzie (whom she initially wounded but grew to love with reckless abandon), and I looked at her and I said, "Your name is Margaret, isn't it?" And she licked my face. And so it was. From then on she was Margaret Mae (like Maggie May, the Rod Stewart song).



They figured she was about eighteen months old when I got her. So I designated her birthday as six months for the day she came to live with me. Which is today. I've had Maggie for four and half years, and she really is the best puppy ever. We still don't really know what she is (except for the best puppy ever). She definitely has some Husky. She probably has some Greyhound. She may have some Shepherd. And the more I find out about them, she really seems to have a lot of Coyote (and they're rampant in the suburbs of Chicago). So my working theory right now is that her mom was probably something of a Husky/Greyhound mutt, and I'm guessing Dad was a Coyote who was passing by. I base this parental designation on, she had some training when I got her, so she was probably born to a domestic dog. Who was less likely to be a Coyote, because people generally don't have those at home bellying up to the water dish. Although I did try to pick one up on the side of the road once and take it to a vet. Because it looked like my dog, so it took me a second to realize, um, no, not somebody's errant pet.

But regardless of her roots, or whomever treated her poorly in the past, Maggie's been the best pal a girl could want. She went to New Hampshire with me. She came back to Chicago. She went on vacation to Florida. She went on interview trips with me. She even went to work at the yarn store with me and became our shop dog.



And now we're here. People criticize me often for being a "single mom" who works so much, and I'm not going to pretend that Mags wouldn't prefer I gave up my job and stayed home all day (actually, I think her Nirvana would be us both moving in to Daycare). But she's a very happy little pup, and she knows she's loved, and I like to think she wouldn't ask for a different life (with the exception of the afore mentioned Daycare clause). And I couldn't ask for a better companion through these last crazy years. To anyone who says money can't buy love, I would say, go down to your local shelter with $75. You'll get devotion, adoration, dedication, plus a leash and probably a bag of food. Spring the extra $3.50 on a Jumbone, add a little walk and a belly rub and you're guaranteed a friend for life. Shelter dogs are the BEST EVER. I have yet to meet a purebred who was as good a dog as my Wolfie and my Mags.


Love you baby. Happy 6th birthday.

So. Very. Tired.

What a long damn day. Holy cow.



It was a long day. It was a long call. I just finished all my notes at home. Which means it's time to go to bed, and maybe when I wake up, it'll be a good day. Because today, really, really not so much a good day. Stupid frakkin' really dumbass day.

I hate people.

GDR.

Lazy Sunday

Mags and I had a very useless weekend. I got pretty much nothing done.


This is how she spent most of her time.

I, on the other hand....well, I spent a lot a time doing kind of the same thing. But last night I went over to my pseudo-aunt and uncle's to watch Gone With the Wind. Which I had never seen, and they were appalled that I could consider living in the South and not have seen the most quintessentially Southern movie ever made. Fair enough. Definitely epic. Although I have to say, Scarlett...oy. I really have so many things to say about Miss Katie Scarlett. But I'll stick to a rough tally of the times I rolled my eyes and moaned, "Oh, my God." Which I'm estimating at about fifteen. Hey, it was a four hour movie.

Today I had lunch with a med student I worked with on Neuro. It was nice. We spent like three hours chatting. Mostly talking psych. At which she's very adept. I was more than a little disappointed when she told me she was thinking of doing OB/Gyn. I kind of wanted to shake her a little and give her some speech to the effect of "don't make the same mistake I did!" Except that she's precisely the kind of person who needs to be in OB/G. ::sigh:: Kind of like I was. Good with patients, empathetic, has a good appreciation of the psychological things that influence women's health. You know, that whole biopsychosociocultural model of health care that's the new buzzword of psychiatric care. But I did tell her a little more about what went down at the Emerald Palace so she can properly warn her colleagues to stay far, far, far away.

And I got some laundry done. And some dishes. But nowhere near the amount of work I wanted to get done. Ah, well.

I did take some gratuitous cute pictures of my dog, though. This one's my favorite.

I'm on call tomorrow night again. Ahhhh, good times.