Juju

My life is exceedingly strange.

I'm generally okay with that - it's never boring. But it does sort of beg a question or two.

Last night, Jen and Bill were kind enough to help me move my bed from the old apartment to the new one. The movers are coming in a week, but since I can't sleep in the old place without having some sort of allergic catastrophe, I really appreciate being able to stay in the new one without having to sleep on the floor (although, as I told my mother this morning, I almost think the little nest I've been sleeping on at their place is more comfortable than my bed...). So we get everything into the trailer, and are about ready to leave, and we're all sort of standing around the trailer when a woman I've never seen before comes out of my neighbor's doorway. She backs out, and is trying to shut the door when she falls back and bonks her head on the concrete. It was one of those moments where you see the inevitability of what's about to happen and are completely powerless to stem the flow of events. So, okay, down she goes, smacks her head, and starts SCREAMING, "I need 911! I need 911!!" I, of course, being as snark-tastic as I am, was like (in my head), relax, lady, you didn't hit your head that hard. But then she starts yelling, "my finger is off!!!"

Your...I...what?

She sits up, and is clasping her right hand in her left, and there's blood running down her hand because she's severed the tip of her finger. I ran in and got her some paper towels. She didn't want those. Bill sends me back in for a cold, wet rag, which I got, as well as a bag of ice and a couple of plastic bags (tip - never, ever put an amputated part in a bag of ice. Put it in a bag, insulate the bag with a towel or something, waterproof that - i.e., put that in a bag - and then put that whole mess in a bag of ice. Otherwise the digit in question will get frostbitten or macerated or something equally unacceptable). Jen called 911. Bill sat with her, held pressure, and tried to keep her calm. Jen and I had the enviable task, then, of looking for the finger amidst the bushes and pine straw mulch. We saw a piece of jagged glass on the ground, figured that was what had severed her finger, and so we looked and looked and searched and fussed in that general vicinity. No luck.

Finally, a little exasperated as to how the finger had come off anyway, I asked, "How in the world did you do that?" And it turns out she'd shut the door on her finger, which had sliced off the tip of it, down to the base of the nail.

First? Ouch. Second? I worked out the physics of that in my head. Severed while shutting the door. The tip of her finger wasn't in the bushes, it was in the house.

I looked at the door, and thought, aw, shit. My neighbor has these two horribly-behaved little dust mop dogs, who were at that very minute undoubtedly sitting on the other side of the doorway licking their little rat-dog chops.

Crap.

Her mother says, let's look in the house. The bleeding woman on the ground is insistent that her finger isn't in the house. Don't go in the house! she says. I say, "Okay, well, can *I* go in the house?" But the dogs are going to get out! they say.

Lady, that's the least of your problems.

And of course, no one is considering that the neighbor routinely lets the dogs out, off leash, to poop all over the neighborhood and they always come back. Unless they come in my house, but that only happened a handful of times, I mean really.

Bill assured them that he and Jen have a dog who LOVES to get out and run around and terrorize the neighbors, that they can handle it. I, meanwhile, have headed into the house with the woman's mother. There is, of course, no finger in sight. Nor is there even a spattering of blood on the floor. Which, of course, you would expect if the finger was severed in the door.

I looked at the dogs. They...well, were just being dogs....

So then the paramedics show up. They go to bandage her finger, and the medic looks at me and says, "Ma'am? You might want to turn your head before I take this towel off."

I managed not to laugh at him.

So they get her all put together, send her to the ER in her own car, and the other paramedic and Jen and I are cleaning up, and the paramedic sighs and says, "Well, if you see a little dog running around with a finger in its mouth..."

Jen and I had already had the opportunity to look at each other and mutter under our breath, "Dog? Yeah, dog." So were both like, "well, yeah, they have two dogs, so..."

The poor paramedic looked at us and went, "Oh. Ohhhh...."

But, on the plus side, here are five things I learned from this adventure:

1. The bad mojo in the apartment that I've been feeling for the past year and am feeling even more acutely now is definitely not just mine. Which makes me feel better about leaving, that I'm not the source of the bad juju (and thus the wheel of fortune may be turning for me. Here's hoping).

2. My friends are awesome. (Okay, I knew this.)

3. My life is weird. (Yeah, I knew this, too.) As is Ms. Stumpy's, or at least it is now that she collided with my weird life and the Evil Apartment Building.

4. I consistently keep getting reminded that the universe is conspiring around us. Five minutes earlier, Jen, Bill, and I were all inside the house. Five minutes later we would've been gone. There were reasons we got there later than we wanted to. But we were definitely supposed to be there right then. Call it fate, karma, synchronicity, whatever you'd like, there are most certainly forces at work here greater than ourselves.

5. It turns out that when you freakishly slice off your finger in a door frame, there's no one better to have around than a doctor, a social worker, and a convicted felon.

Thank heaven it's almost Saturday....

...because holy crap, today sucked.

It was just long and awful for a number of reasons. And instead of whining, I give you this, which is fun and amusing.

Enjoy.

Scary out there

So, I've always said, you can't shelter your kids from the world. To protect them, you have to stay with them, know where they're going, teach them how to protect themselves when they're not there. No child-safe internet blocker is ever going to work, because kids will find ways around everything.

They're kids. They're adaptive, and creative, and sneaky. It's what they do.

Things like this prove my point.

So, a friend commented on Facebook that she had to look up this thing she'd heard about called Chat Roulette. I, of course, tend to be curious about everything, and also, I have two adolescents therapy kids with whom I work closely (and, as I've discovered lately, I have to keep up with my 66 year old patient as well. But, I don't worry as much about her being preyed on. She's pretty sharp). Plus, I'm on the child unit, and headed into a child fellowship. I like to keep an eye on the landscape, know what's out there for them to get into.

The concept of this is kinda cool, right? You log on...well, not even that, because it's completely anonymous. You click a button, and you get matched up with a random stranger anywhere in the world. In one respect, this is awesome. I spent about 20 minutes wandering around, chatted briefly with some very nice people in France, and Australia, and elsewhere in the US. I talked for a bit with a nice man in China who's trying to improve his English. I got to use a little of my terrible French. The worst thing any of them said to me was that the one of the people in France told me I was old. I guess when you're 18... But in that aspect, it makes the world a little smaller, allows you to interact with people in other cultures, etc.

That, I recognize, is a tremendously idealistic view.

So, many of the people on this thing have webcams. I saw a lot of high school and college kids, who, yeah, kind of a vulnerable group. Especially considering some of the other things I managed to see on there. Wow. Not enough eye bleach in the world.


::sigh:: It's amazing. I'm guessing that wouldn't even be blocked at the hospital (whereas, you know, everything else is). The anonymity is superficially protective, but also disinhibiting. It perpetuates this idea that you can say or do or be anything you want, and not worry about it, when in fact you should worry about it quite a bit. Especially if your judgment isn't very good because, say, your frontal lobes aren't fully formed yet. There's no guarantee that the people on the site are over 16 (by clicking the button you agree that you're over 16. There isn't even a checky-box. Oh, yeah, that's gonna work...). Or aren't, say, serial killers and pedophiles. In fact, I'm guessing this would be a deviant Mecca in a way that Facebook or MySpace or any of the other sites we worry so much about never could.


Yeesh.


Now, admittedly, I'm a hypervigilant, socially suspicious psychiatrist with a trauma history. But, seriously, folks. The shit that's out there is scary. 

It's 6:40pm...

...and I'm thinking of going to bed.

I had candy corn for dinner. I mean, like, a handful, not a bag, but it's still not so good. And my stomach hurts now.

I'm so completely wiped out.

Got my flu shot today. Took both days' worth of our inservice exam. Got home and had a very fucking obnoxious voicemail from one of my cohorts. So I'm passive-aggressively ignoring what they asked me to do because a) it's ridiculous and 2) it's all I can do to stay awake.

I had such plans. Winding yarn, starting to pack, reading, dying my hair, working on a discharge summary or two. Y'all, I seriously can't keep my eyes open...

The point of all this: Wordless Wednesday has been postponed to Wordless Thursday.

Yeah, so clearly not wordless today....

Hello, Monday

One day down, four more until vacation.

Have I mentioned this? I'm headed to Hawaii for the next two weeks with my folks. It was originally supposed to be a somewhat bigger family trip, including my aunt and uncle that live nearby and maybe their kids, but in the end it's just us. Which is cool.

I'm actually more than a little anxious about this. First, there's all the damn flying. Sunday I fly back to Chicago. I have a day and a half there, and then Tuesday I spend like nine hours in the air with a brief layover in California. We're in Honolulu for five days, then there's a turbo prop plane involved in our transfer to Maui. Where we stay for another five days, and then I leave Hawaii on that Friday. Because I figured I should be home a couple of days to deal with the jet lag.

But get this - here's my trip home. So, Friday morning at like nine-ish, I get back on the flying tin can and go back to Oahu. Then around 1 I get on a plane back to the mainland. I spend four or so hours crossing the ocean, and then have a seven hour layover on the left coast. Fortunately, I also have friends there, so they're planning to whisk me away for a bit. But then I go back to the airport, and somehow spend nearly seven hours (according to the airlines. I mean, but....really?) flying the red eye back to the Chi. And then, I bum around that airport for about four hours and catch yet another damn plane back to NC.

I'm never going to see my luggage again...

But, meanwhile, I have a crapton of stuff to do between now and then. I haven't even located my suitcase, much less pack it. I realized today that it's probably going to be a lot warmer in Hawaii, and I'm not sure I really know where my lighter clothes are right now. I have books to buy and have to locate some sunscreen and I really wish I'd thought to buy a swimsuit this summer when stores were actually selling them. And I'm actually quite anxious about not being at work for a whole two weeks, despite the fact that I'm leaving them in good hands. And I'm still working on finding a place for Ms. Mags.

Meanwhile...I was driving out of the parking deck tonight, and was like, oh, well, at least today wasn't a very long day.

And then I looked at the clock, and did the math, and realized that I'd pulled in to the same parking deck almost exactly 11 hours earlier.

::sigh....::

"No. Really. Come back soon."

First of all, a very happy birthday to my cousin Danielle. She's a Baskin-Robbins this year (31). Many happy returns. Maybe I'll actually make it down to Texas to visit before we're 32. Or at least before Annalise is!!

Re, the title: I went up to the unit today to see one of my therapy patients who wound up on the inside, and ran into my friend John, whom I haven't seen in a while. The end of our conversation entailed a discussion of how I was going to be back working the inpatient units (also clinic. Eek) in two weeks. He was like, "good. It'll be good to have you back." I said, I'm sure you'd do just fine without me.

I tell you what. I had six patients scheduled today. My last one was at 2 and was the one that was admitted. I got in wretchedly early so I could leave by 4 at the very latest (nooooo problem, right? Ha) and make my rescheduled appointment with my trainer at 5.

I left the hospital at around 5:30 (which, incidentally, was a good hour or more before Peng got to leave. Catatonia slows everything down).

And oy, it was a long day. One of my patients didn't show. Another one cancelled (when I texted her ten minutes after her appointment time and said, are you coming?). I had THE LOUDEST HUMAN BEING ON EARTH's mother and case worker calling me to complain about each other (I'm not telling you whose side I'm on). I had a crapton of prescription refills, paperwork, and lab reports waiting for me. And of course I spent like two hours total up on the adolescent unit.

So my kid, who's getting closer to legal adulthood every day, got "in trouble" for talking to one of the younger patients about sex. I asked her about this, and she says, "well, the other patient had questions. I was honest with her. We talked about what it means to have that in your life. It wasn't like I was giving her advice on positions or anything."

I asked the staff, "what kind of 'talking about sex' was this?" They said, "well...it was about sex."

::sigh::

I'm sure the answer is somewhere between Little Miss Innocent and Little Miss Devil, but, come on, people.

Not to mention...here's the beginning of my conversation with John.

(John is standing in front of the nurses' station and, illustrating a point - although I can't imagine what point - has his hands up over his head and is reaching down his back. I happen to be walking behind him and poke at his fingers. You know, because we're 12.)

John: Hi, Kate.
Me: Hey, John.
John: I'd know those fingers anywhere!
Me: Shh! John! Don't tell them our business!
John: I meant anywhere geographically, not anywhere on my body! That's a whole other conversation we shouldn't have in front of the kids.

The nurses found this humorous (God only knows why). Now, I concede, John and I are both adults. My hands have never actually been lower than John's scapula (I think I've punched him in the shoulder a couple of times), and we're obviously friends, and obviously kidding. And the staff jokes at this level all the time (because? We're all secretly 12 when we walk on that unit). Which is fine, as long as everyone involved is okay with it (John and I know our limits, but part of the reason we get along so well is that he's as dirty as I am, and we both know this). But it does suggest an atmosphere of...casualness and permissiveness about these sorts of things.

There's a lot of ways to "talk about sex." Some of them are really inappropriate. Some of them are really beneficial. And the younger patient in question was a teenager. Hopefully, she's had some formal sex ed at this point. And you KNOW she's had some form of informal sex ed by that age. Plus, sex is kind of a basic human thing (anyone remember Maslow? Or Freud? Or Salt-n-Pepa?). You can make it something that can be discussed openly in a respectful and appropriate manner, or you can make it something that needs to be whispered about at night between bed checks.

I'm just saying.

(In a related story, my Aunt Aphrodite, earlier this week, was telling a story at our big family gathering about seeing this movie which referenced "BJs", and these two older women in the theater in front of her that were like, "What the heck's a BJ?" So she's telling this story, and several of my relatives were like...um...what IS a BJ? She says, think about what it stands for. And one of my uncles starts spelling. Seriously. "Is it b-l-o...?" I finally stuck my head out of the kitchen, and was like, "Oral sex. It's oral sex. Finish the story." Christ on a cracker, I'm THIRTY, people. And a doctor. As funny as it was, spelling things just ain't going to cut it...but back to my point.)

There are a lot of problems with assuming that kids don't talk/think/know about sex and making it a shameful or off-limits thing to discuss. You create a mysterious or rebellious drive to find out. You send them looking to other sources for information that can be unreliable or dangerous. You deprive them of learning what's appropriate to discuss when and how. Like I said, I don't know what the story really is, here, in this scenario, but I don't think it should automatically be a demerit just on principle.

And the thing that's most important to me in a group of kids like this who are at very high risk of abuse or exploitation, you make it impossible for them to talk to you about it. So, you've made it something bad and shameful, which you don't talk to adults about...how do you deal with it if someone's hurting you or making you do things or even just making you uncomfortable?

It's just sex, folks. Funny how it's important, but trying to make it seem unimportant makes it become just that much more important.

Defective

That's kind of how I'm feeling, the last few days.

Here's the latest installment. I went to see the podiatrist this morning. First of all, he was AN HOUR LATE. Allegedly because half the nursing staff called out, but, dude. I see patients every damn week before our office staff even gets there. So, fine, I walk the half mile to the other side of the hospital where the podiatry clinic is, I go to the, like, eight different places I have to go before I can get to the actual clinic (registration. Oh, no, that's the wrong registration. So to the other one. Then to the check in. Then to the clinic desk...) and then I sit for an hour. The podiatrist looks at my feet and pokes at my feet and makes me stand on my feet and my toes and my heels. So then he announces my feet suck. Apparently I have what's known as a "flexible flat foot" - my arches are really high when I'm not weightbearing, but the moment I actually stand up on them, my whole foot collapses. I also have Achilles tendons that are way too tight. And anterior shin splints. And general hypermobility of my bones. Somehow my feet are not especially suitable for walking.

So he made casts of my feet for orthotics (after which he set them on the counter and said, "See? See why it hurts to walk?") and prescribed me these big silly splints that I'm supposed to wear when I sleep. They're supposed to passively stretch my heel cords.

Hot, huh? Not exactly the kind of knee-high boots I prefer.

::sigh::

Sexy as they are...y'all, I can't even keep socks on my feet at night. I'm not feelin' this...

Did I mention...::sigh::...?

Migration...

So my day started nicely. I slept in, I was snuggled with my puppy, and then I noticed this little...thing on the dog. So I picked at it a little, and then its little feet started moving, and ew, ew, ew, it was a tick!

Dude, I'm a city girl. Born and bred. I don't know what the hell to do with a tick. This is why I put tick medicine on her, so I don't have to deal with this shit.

So I called the Banfield, and they told me to put a little alcohol on it and then pull it out with a tweezer. I ended up using a pliers (close enough - couldn't find the tweezers), and then looked at this thing...

I think it's Ichabod Tick.

Apparently I didn't get as close to the head as I thought...

Maggie was NOT pleased. And in fact wouldn't come back into the bedroom for the rest of the time I was home.

The handyman came as I was getting ready for work. I had one patient show up for clinic again today (hooray!), and then had a bunch of work to do this afternoon, which I decided I would do at Starbucks. So I came home to get my laptop, and found that the sink had migrated out to the front porch.

But, by the time I came home from class (last night of classes! I get my Tuesday nights back next week!), it had moved back into the bathroom...

Seriously. Are they kidding?? It's mounted to the wall with a friggin' piece of molding. That's hideous. What happened to the pedestal sink? What happened to the not putting the stupid sink back on the wall??

Uh, and I think there's something seriously missing, still....

I'm so not pleased. We're on day three, here.

Not to mention, he moved everything (for no apparent reason) and blocked off the door to the room with the dog door.

Oy.

Here's what Maggie thinks.

(You'll notice she got over her fear of the bedroom, though)

This little PIGgy

Tonight marks the beginning of the 2009 recruitment season. Tomorrow is our first set of interviews for next year's intern class, and so tonight is the traditional pre-interview gathering, affectionately known in our department as a PIG. It's pretty standard - the night before interviews at pretty much every program in every discipline, there's a meet-and-greet with the current residents at a local bar or restaurant, or when I was interviewing here, at one of the residents' houses. It's a nice, supposedly informal way to kind of get to know the people in the program, it gives you a feel for what people are like outside the hospital, and if you're particularly astute, it gives you a excellent way to gauge the dynamics of the people involved - are they snooty and distant? Generally relaxed and happy? Do they talk about work with each other or just when they're giving you their sales pitch (for those playing along at home, remember that we spend roughly twice as much of our awake time at work than not, so, if they're not talking about work at all, something's awry)? Are they snippy about it? Jovial? Excited? Dry? That can tell you an awful lot about peoples' attitudes toward their work and their patients. Do they generally avoid each other, or do they have inside jokes, ask about kids, family, hobbies? Do they volunteer positive information about each other ("Oh! Martha's really interested in community psychiatry, you should talk to her about our AHEC stuff," or, "Kate knit her own socks!" or, "Mike just ran a half marathon two weeks ago, you should talk to him about the running clubs around here")? Now, of course we're all on our best behavior, but, there's still a lot to be learned. And the residents - who often have a say in the rankings - can gather useful information as well. Generally, I like these things, and am hoping to go to as many of them (and the lunches during the interview day) as possible.

You'll notice, however, that tonight, this little piggy is blogging and making pizza.

Let me tell you how my day went...

I got a late start this morning. Way, way later than I wanted to. And I finally get out the door, and I get a table at the Starbucks, and read through some stuff....and then I get this text message from Sparrow:

"Dogs out."

I looked at that a moment...thought, huh? Is she just making a pop culture reference? Does she want to go take the pups somewhere? Is she...and then, it clicked.

Dog's out.

My dog.

Is out.

Shit!

I immediately started packing my stuff up and making a beeline for the door as I called her. Juan, our lawn guy/man Viernes had called her and said that Maggie had made a break for it. They were off to go corral her. I said something along the lines of "i'llberightthere!" Fortunately, Mags was standing right in front of the house (although Juan said she had started off towards Sparrow's house), and was easily redirected into my house, where the dog door was subsequently slammed shut. Sparrow called, and I stopped driving like a felon with a two-second headstart. By the time I got back home, Maggie was like, "Guess what happened! Guess what happened! Guess what...ohhhhhh, wait, I'm in trouble, aren't I? Ohhhhhhhhhh......"

It was cute. I hugged her. Sparrow'd already told her she was crazy.

Near as we can tell she did indeed go over the fence from on top of the air conditioner. Which is a dilemma I hopefully have solved, at least for the moment, as I took one of my old plastic shelving units and set the shelves upside down on top of the air conditioner. And there's a ladder in front of it. Maggie seems disappointed. For the record, I did NOT think she would go over that fence, certainly not more than once. It's a five foot drop, for Pete's sake! But then, Maggie is nothing if not spry and resilient...

I also discovered that there's been a large grey housecat living under my house. The entrance to which is right on the other side of the fence from the air conditioner (and which has again been sealed off). Dollars to donuts Maggie saw her and was all, "KITTY!!!" And, boop, over the fence she went.

(It was particularly amusing watching me try to explain this theory to Juan, I'm sure, given my pathetic command of Spanish and his limited English. It was a lot of me going, "Perro...con gatto..." and making leaping and scampering motions with my hands. The best part of that whole exchange, though, was when he picked up the recycle bin that's sitting next to the fence covering the hole that Maxine dug during their last jailbreak. He looked down and saw the hole, and all I said was, "Perrita Maxine." And he said "Ohhhhhhhh" in that knowing way, and laughed, and put it back down...)

::sigh::

So then I met up with Sparrow and Martha at this little deli in town, and we chatted and hung out and I had really good falafel. I then went to the Lowes Foods, where I suddenly discovered I was not feeling so well. Which perplexed me. Until two things happened: a, I finally got to the point where I felt so awful I was like, crap, I just need to go home, and 2, it finally occurred to me where we were in the month. So I attempted to finish shopping, checked out, and drove home, not yet realizing that I'd forgotten about half of what I'd gone for, including most of the components of tonight's dinner. Like, you know, cheese, and, say, pizza crust.

I curled up into a ball for a while, thinking some nasty things about Eve and bemoaning the five weeks I have left until Larry (my doc) puts in a shiny new progestin-eluting IUD and hopefully remedies a lot of this (have I mentioned that my insurance company is giving me a Mirena for Christmas? I'm so excited. Soexcited. In fact, never have I been so excited about a sharp poke in the cervix. I am hoping, however, this goes better than the last Mirena that Larry and I tried to put in together). But eventually I got up and realized that it was 4:30 and I'd forgotten about half the things on my list. And that this little piggy was going to have to go back to market.

So I got up. Went to Target. Went to Whole Foods. Came home, went to start dinner...and realized I still hadn't remembered to buy mozzarella cheese.

There was a long string of expletives, but fortunately the six cheese Italian blend I'd bought a month ago had a little mozzarella in it, so we converted from Greek pizza (because it turns out I didn't have any non-moldy feta, either) to fancy six cheese pizza (which I forgot to put seasonings on. I just remembered that. The leftovers have been in the fridge for over a half hour). I then started a load of laundry, and started doing the dishes. And promptly ended up looking at the clock, covered in dog hair and dishwater and swearing at anything in sight, and deciding that this? Was NOT the image I wanted to project to prospective interns.

I'm all for realism, and being up front, but, there is a limit to how much crazy I let people see. Even y'all.

I'm giving up and writing this whole weekend off. Tomorrow will be better. Even if I am on call twice this week. And then again next week.

Never mind. I'm going to go hide under my covers and snuggle with my jailbird dog...

Night moves

So, here I am again. Floating.

It's 4:30am and I'm waiting for the ER to call me about some dimwit who cut herself because she got into a fight with her boyfriend. She's saying (according to the ER notes) that it was impulsive and silly and she's not suicidal, so I don't really need to see her but $20 says they call me anyway. Technically, they're supposed to consult us on potential admissions; stuff like this they're supposed to be able to handle. And who knows, maybe they will. But they stole all her clothes and dressed her out in those silly blue paper scrubs we give to potentially suicidal people, and that's a very strong indicator that there's going to be a psychiatrist sometime in her near future.

Meanwhile, I blog.

It amazes me sometimes how much people don't want me around. I think I went from the one profession people really don't want to go see to the only one they want to see less. When I was a gyn, I had a woman tell me she'd rather get a root canal than have to see a gynecologist. As the shrink, I think most people would rather have a gynecologic exam. Some, I think, would rather have a gynecologic exam in Times Square than have to talk to me. People get so resentful that their "real" doctor called a psychiatrist to see them. Because my presence clearly indicates the other doctor thinks either, a, they're crazy, or 2, they're making it up. Not so, folks, not so. You wouldn't believe the reasons we get consulted (earlier tonight, Fang fielded a consult on a burn patient because she was crying. What?! Someone who's burned badly enough to end up in the ICU is - gasp! - crying?! Holy cow! Fire up the ECT machine, STAT! Seriously, though, I think "crying patient" is probably #4 or so on the list of reasons we get called by other inpatient services). What always makes me a little nuts, though, is the people who do things like, you know, try to kill themselves, and then get all pissy when someone calls a psychiatrist. Because, you know, they're not crazy.

Please. Like crazy is such a bad thing.

Is it bedtime yet?

So I've actually spent the evening seeing patients (and writing up long-ass interviews with same) and haven't gotten any knitting done. Which is a shame, because all I have left on my one project is the duplicate stitching and then I can felt it, but, I would've SWORN I had yarn needles in my desk, and alas, I do not. So sad. That's about all I can tell you about the projects I'm working on right now, though, because they're super top secret. Because I'm knitting for the CIA. No, okay, because they're gifts. But I promise pictures just as soon as I can post them.

I'm trying to decide what to put on the needles next. More simple socks? A throw for the new intern work area? An afghan? A new scarf? I'd really like to knit a nice thick sweater coat thing, but that seems like a fairly big undertaking, and I might not finish it until it's warm out...

Aaaand there goes my pager. Because they want a full consult on the dimwit. I got news for you, kids, it's not a committable offense to be stupid....

Boom.

I fell down today. A lot. And gloriously.

On my way to work. In front of my neighbor's house. It was wet, there was something slick on the ground, next thing I know I'm sprawled out on the pavement bleeding.

I should've just turned around and gone back in my house, really. But no, I kept going.

Metaphoric, really.

I further damaged my iPod, which was of course already agonal. I scraped up my knee and my elbow. I threw my hip and my back and my shoulder out of whack. I'm a little worried that I may have cracked my fibula, but Ruthie and I are reasonably certain it's just a muscle bruise, and besides, that's not a weight-bearing bone, so what are you going to do about it anyway?

Apparently the treatment for my injured toe was to bang the rest of me up so badly I wouldn't notice anymore.

This is so totally not my week.

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....

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.

One for the money, two for the show...

I know, "three to go" isn't the next item in that set. But, that's where we're at.

Happy birthday, by the way, to my cousin Danielle. Welcome to mid-life. I'm right behind ya...

So, call #4 down. I saw one patient, admitted same, and still left 40 minutes late. But he was a kid (they always take longer), whose mom didn't speak English (our Spanish interpreter down there rocks), and then I wrote the longest HPI (history of present illness) in the history of HPIs (you think I'm kidding). He was adorable. And possibly psychotic. Although I think there's something wrong with his brain. Neurology's going to love this consult tomorrow.

And then I came home, called my folks, and had a distracting little IM conversation. And now there's an ant crawling across the screen of my laptop.

Lost little bug, there's nothing to eat there!

I think that's about all of this day that I can handle.....

Operant conditioning

So today, we started our Academic half day. Which means that we have lecture all Wednesday afternoon. My classmates don't have clinic scheduled in the afternoon. The time is supposed to be "protected" for all residents. Which means they sat in lecture and I got paged all frakking afternoon.

Blah.

Okay, I ignored most of the pages, mostly in the hope of beginning the process of conditioning the floor to not freakin' page me during the hours of 12 and 5:30 on Wednesday. It didn't go so well. Particularly when the medicine resident misordered the blood gas she didn't bother to tell me she was ordering in the first place. Argh.

My dog, though, has the concept of operant conditioning down cold. So, now, Maggie, is useful for keeping things clean around here. We have a good system. I drop something edible on the floor, I say, "Uh-oh, doggie!" (shortened from, "uh-oh doggie, you'd better come here!"), she immediately drops whatever important doggie task she's doing, and she gets a tasty tidbit for her troubles. When this becomes particularly amusing is, like, tonight, I'm making dinner, and I added way too much of something, and I say, "Oh, shit!"

Dog wakes up out of a dead sleep, leaps off the bed, scrambles into the kitchen, and gets all confused when she can't find anything on the floor. It was very cute.

Today was long. And I'm so tired. And I still have six notes to write, but, I came home to write them, and now the electronic medical record won't let me in.

::sigh::

I did get a lot of knitting done during our lectures, at least. And, since I was knitting, I was paying attention, and they were actually enjoyable.

Have I mentioned how excited I am about psychotherapy clinic this year?

Also with the being done with intern year. I'm definitely excited about that as well. 25 more days.

In my continuing efforts to live life on life's terms (to borrow an AA aphorism), I am taking this as a sign from above that I am supposed to snuggle with the dogs and go to bed early.

Oh, but I'll leave you with today's SVU quote of the day, courtesy of everyone's (okay, my) favorite TV psychiatrist, Dr. George Huang:

"Boys are socialized to express their anger. Girls are socialized to be nuts."

Oyyy, I'm still an intern....

Fuck. Somewhere over the holiday weekend I forgot how much work this was.

The new med students are cute, though. They're all super-eager and green. One of them, today, was like, "Can I watch you put in that order?" Aww.

Today was loooooooooong. Which wasn't helped by the fact that I was running on 5 1/2 hours of sleep. Oh, holy shit, was I cranky when I left.

Looooooooooong.

Yesterday, when everyone else was running around being all jittery and anxious and whatnot about their first day, I'll confess, I was sort of glad to be up to my old routine. Today? Today I was a little jealous. *I* wanna be in clinic, too...

I will be soon enough. I cherry picked my first patient today. She's this woman I inherited on the unit who has all of this totally amazing art in our gallery (the coolest thing ever). It was like meeting a celebrity. I saw her name on my patient roster and was like, oh! Oh my God! I can't afford her stuff! And wouldn't you know she needs a new outpatient psychiatrist. So, I flipped open my appointment book and called our scheduler and ta-da! She's my patient now. I'm so excited.

Oy. But I was there a solid 12 hours today, and only left when I did because I had an appointment with my shrink. Tomorrow, we start this "academic half day" thing, where we're in lecture all afternoon. So I have to get all my orders done and patients seen and notes written (HA!) by noon. Yeah, it's going to be another late night. But I'll probably come home and work, at least. My goal is to be OTD at 5 on the nose.

And now, of course, I'm still totally wiped and it's 11:15 because, you know, I came home, and had to talk to my folks (Happy Birthday, Dad!!), and then to my friend who called from California, and then I had to go next door and have a glass of high-quality Riesling with Sparrow and bitch about work (I'm mostly through this post, and she calls and is like "Oh, I see out the window that you're still up. Want wine?" Of course I do). So I foresee that tomorrow's also going to be a highly caffeinated day...

"Alright, and what else is new?"

I had a very long day at State Hospital. Although I was actually busy today, which was a nice change, although I concede a lot of it was busy work and fussing and logistical crap. Whatever. Hopefully tomorrow will be a reasonably early day, because Wednesday is my last full 30 hour call at SH. Possibly (I think it is) the last one ever in my life, actually. Hooray! I'm on call again on Sunday night, but that doesn't start until 8pm.

Anyway, I'm at the end of this long, long day and waaaay down at the other end of the hall (the women's unit is very loooooooong), one of Ruthie's patients is arguing with her. And she screams, "Fuck you!" and storms down the hallway to her room, loudly slamming the door behind her. I continue walking down the hall and grab Ruthie by the arm (she's one of my good friends and one of my cellmates office mates next year) and start harassing her about, dude, Ruthie, what kind of doctor are you, patients all slamming doors up in here? And she rolls her eyes and says, "Right. And I'm going to hell."

I said, "Haven't we already established this?" Ruthie and I have had multiple conversations about how, not only is she a heathen and a sinner, she has failed to accept Jesus Christ into her heart as her personal savior (as I think I've mentioned previously, Ruthie's Jewish).

She says, "Well that's what I told her! I said, 'alright, and what else is new'? Ugh!"

I assured her we'd have a good time.

Maybe she can be a third for Claudia and my standing Canasta game on Tuesdays in Hell. Or perhaps PenguinShrink and Chef will have us over, for pork, I assume, on a Friday during Lent. Peng has often commented on how they're already looking at a nice condo with a view of the River Styx.

Seriously, if we went to hell every time our patients told us we were going there, we'd already be in hell right now (or maybe that's the point of intern year. Nah, I think that's more like purgatory).

Oh, speaking of the afterlife, did everyone know that George Carlin died? I'm a little sad. And I wonder if Jesus will, in fact, serve him pork chops tonight.

Anyhow.

It was just a long damn day today. Mondays usually are, but today, man. My patients were extra cranky, two of the men got in a big, table flinging, chair throwing, drag-out of a fight up in the mall (we have this thing called the psychosocial rehab mall, which is just a wing where patients go to groups and classes and such. It isn't an actual like a shopping mall or anything. But it confuses a lot of new folks. The first time I heard this I was like, you're taking them where??). I stood there and looked puffed up and large and immobile. On the unit we call this "show of force." It's basically an intimidation tactic where we display our presence to the patient in hopes of getting them to back down and comply with what we want them to do, and usually involves several large black men and me standing there looking severe. Occasionally, it's just a numbers thing - i.e., we pack as many staff members as we can find into as large a posse as possible to overwhelm them with our sheer numbers. Most of the time it works, actually, and we avoid having to lay hands on the patients and physically restrain them or whatnot. But truth be told? If that guy had so much as blinked twice in my direction you would've been amazed at how fast my fat ass was across the room and diving behind the upended table for cover.

I had one patient who was trying to tell me that her mother had schizoaffective disorder, which is something we diagnose when someone has both schizophrenia and a mood (affective) disorder, like depression or bipolar. But she told me that her mother was schizodefective.

Um...I know she may have seemed that way to you, but...

But, when I came home, I had gas! And in a good way, not because we went for Indian food yesterday. It actually smells a little more strongly that I'd like by the fireplace, which is a gas log and has a pilot light, so I'm trying to air the place out a little and keep telling myself it's just because the gas hasn't been on in so long. We'll see. I'm going to go see my shrink in a few minutes. so we'll close up and see how bad the smell is when I get back.

Oh, and Maxine came over when I got home, because Sparrow's flown off to the mountains. She and Maggie are still being all jealous and competitive. But they occasionally unite forces to protect the house from errant squirrels or falling leaves and cars and such.


Aww.

PS, I'm back now, and it smells less like gas in here. I guess we'll see what it's like in the morning. Oh, and my shrink made what had to be one of the shrinky comments of all time. We were talking about how I get in my own way - everyone does. It's therapy, resistance is expected - and I was saying that part of the reason I think this is true for me is because of my intellect, and thus my ability to intellectualize the crap out of anything and everything. I framed this as, "On occasion I'm just too smart for my own well-being." And what I assume (hope) she was trying to say was, your intelligence is just fine the way it is.

What she said was, "Kate, you're not too smart."

I laughed really, really hard. Fortunately, so did she.

Timing is everything

Maybe Karma isn't as mad at me as I thought (or, maybe my Karma is finally catching up with me?). So I'm sitting here in the Starbucks in the town where I now live (yay!) and it occurs to me how well the timing of the things around this move have been pretty fortuitous, on the whole. Like, Maggie breaks her foot two days before we move to a house with no stairs. Starbucks introduces free wireless internet as a perk of registering your Starbucks card three days before the big long break in my internet access.

The move went...well, in the end, I'm in my new place, and I love it. Well, I think I do. Because I'm pretty sure it's there somewhere under all the boxes.

Things started out...inauspiciously. I was the second move of the day, which the guy who did the estimate assured me meant that they six man crew and large truck would show up between 12 and 1. Which was veryimportant, because I was supposed to present the Distinguished Teacher Award from the PGY-1 Class (or something like that) at Graduation last night, which started at 7. I told him I had to be there by 6. He said it might be a close shave for 6, but, it'd be fine.

They came at 5.

But, after a semi-frantic phone call and an afternoon of "Shit, they're still not here!" text messages, Mike (who's so my hero right now) stepped up and fixed it (he either took my place or found another intern to do it). Which is really lucky, because the movers didn't leave the new place until after 9.

But they were a good bunch of guys and man, they were hard workers. And because they came so late, they actually brought a crew of nine people, and three more came to the old place and picked up the three things that went to storage. The were a little disorganized...i.e., I KNOW I have way too much stuff for my new place, but, um, here's what the doorway to the office (which is actually the larger bedroom) looked like when they left:

Yeah, not getting in there. The whole front room was also a wall of boxes. With one little gimpy puppy trapped on the couch. Can you find her?


Here's a close up.


Don't worry, that big stain is from the water glass she knocked over.

But on the whole, I'd definitely recommend them, although I'd suggest being the first move of the day if you can. But they were very nice, very good, quite professional (also rather fun guys)and generally good to work with. Oh, not to mention cheap. So if you live in the Triangle, TROSA's the way to go. I would definitely use them again, except, I'M NEVER, EVER MOVING AGAIN. They also do lawn care, contracting, framing, eBay sales, have a furniture thrift shop, and sell Christmas trees seasonally. If I find the front room before December, we'll have a TROSA Christmas tree this year.

Unfortunately, after they left we had sort of a rough time. I couldn't find my bedsheets. Or my pillows. Or my sanity Maggie's food dishes. Or a bath towel with which to take a shower. Plus, there were no screens in my bedroom, the landlord didn't actually manage to get the place cleaned before we moved in, the washer/dryer hookup is wrong, Kyle (the old tenant) took all the light bulbs when he left (such a prick) and I couldn't find more than two bulbs of my own, the shower drain was full of hair, etc, etc, etc.

So Mags and I got in the car, went for a drive, purchased some bottled water from McDonald's (I drank 2 liters of water in about 30 minutes. I did a lot of sweating yesterday, y'all), and called my parents and had a little meltdown.

My poor mother. I hung up on her. I was hysterical and sobbing and tired and she kept saying exactly the wrong thing because there was no right thing to say, which I finally told her, I just needed to have my little temper tantrum and then I'd be fine.

Which I was. It was okay. I came home. I found some sheets, if not the ones I was looking for. I found a pillow, if not the ones I was looking for. I threw it at my dog, who was lying on the bed looking forlorn. Here's what she did with it:

She's so cute.

And ultimately I cleared a path into the office, and found soap and a towel to take the best shower of my whole life, and put a light bulb up in the kitchen, and finally went to bed. And then I decided (since I'd turned the air on, because I have no screens in the bedroom) that I wanted my comforter, which I knew was in the cedar chest. And I had trouble opening it...couldn't figure out why, until I finally got the latch to pop, and poof! There were my pillows, crammed in on top and smelling sweetly of cedar.

Things definitely looked better in the light of day. So I cleared a spot big enough in the front room for Maggie's crate,

(Such a good girl, my girl.)

and headed off here. And now I'm going to the Home Depot and Whole Foods and Target. And my aunt's coming back over and we're going to try to make a dent before I take my pork-themed desserts over to Mike's for his Porkfest blowout tonight (Kate - sure you can't make it??). And I have a little time to work tomorrow before I'm on call tomorrow night. So we'll see how it goes. But regardless, we're home!

A Wednesday of randomness

First and foremost, Happy First Birthday to my niece, Annalise.


I love that picture. He.

Mags and I are all worn out today. She? Had a busy two days at daycare. Came home soaking wet again, but she keeps licking her paw and I think maybe her paw pad is burned a little. It has been awfully hot around here. I? Had a long call. It wasn't super breakneck busy, so I had too much time between patients to just stay in admissions, but busy enough that I didn't have enough time between admissions or floor calls or whatever to actually fall asleep. So I spent a lot of time lying in that awful State Hospital bed (which I think may have bedbugs, because I get bit by something every. single. time. I'm on call there. But it's uncomfortable and the stuffing's literally coming out the side and the sheets don't fit. They're the same beds the patients have. I'm hoping that's not the case at New State Hospital because those are more or less molded into the floor) staring at the darkness and waiting for the pager to go off.

Call had some interesting moments. I admitted a really scary guy from County Crisis and Assessment, the kind of patient we euphemistically refer to as "well known to our service", after the police found him ranting about various psychotic things, and then searched his scary psycho guy van and found a dagger, two machetes, rope, a video camera, and...of all things...a beanbag chair. We had a brisk interview, to say the least.

I also had a very amusing encounter with one of my former Big Hospital patients. He's a very sick gentleman with some weird and rare neurodegenerative thing, whom we very affectionately refer to as "Lips" because, during a prior admission to Big Hospital, when he was very psychotic, he...warning, this is gross....bit off his own lips. So, needless to say, Lips is a messy eater. I went up to the men's long term unit last night to see a different patient in seclusion, when suddenly there was this big crash in the nurses' station. We all went running, of course, and there, sitting in the middle of the floor, is Lips, covered in pureed food off his dinner tray (which had been taken into the nurses' station when the others were served, because he usually eats elsewhere) from head to toe, shoveling food into his mouth with both hands (half of which, of course, was dribbling out down his shirt), and looking just as giddy as a pig in shit. I couldn't do anything but laugh and help him up off the floor. There was baby food everywhere - all over him, all over the floor, and as I would unfortunately not discover until this morning, all over me. It was one of the cutest things I've seen in a long time.

PenguinShrink and I were talking this weekend...when I went to pick up the boxes from our clinic manager, she says to me, "I really don't know how you guys do what you do." The other day, I said to her, you know, honestly? Some days I don't know either. We get so desensitized, we normalize things that are so far beyond the rest of the world's reality.

We had this grand rounds speaker a couple of weeks ago, who heads up the Trauma program at a prominent psychiatric hospital up north. He's the Trauma guy, really. And our chairman asks him, can you tell us the kind of things your patients are dealing with? And he starts spilling the highlights of these absolutely horrifying stories. And I keep thinking, right, yeah, this friend of mine had a childhood event much like that. My other friend had a similar occurrence. My patient told me something very much like that. Oh, I've been through that. Hmm. Yeah. Okay. Fortunately, I think the majority of my cohorts were more appropriately appauled.

There's a fine line between being desensitized and being numb. Numb is...well, not the goal. Unfortunately, removed (okay, dissociated) is something I do well.

Then again, I've for a very long time said that the key to being a good psychiatrist is having a good psychiatrist....

A dangerous post...

Wow, I'm bored. It's not even 11am, I've been out of work to do for about an hour, and most of what I spent the 9:00 hour doing was busywork. I've been trying to call charities that will come pick up my crap, because it turns out the one that told me they'd have no problem squeezing me in this week can't come until the 26th. She says, are you sure you don't want to get put on the waiting list for that day? I said, um, no, I'll be long gone by then. Thanks, though. Meanwhile, no one else will answer.

Dude, someone's taking all that crap. I don't want to throw it out.

The reason it's very dangerous right now to be talking about all of this is that I'm on call tonight. And by verbalizing my boredom, particularly in such a public forum, I'm quite certain the Fates are now laughing at me. I will not sleep at all tonight for the stream of very psychotic patients flowing through our doors, even if we suddenly went on bypass for the whole hospital. Mark my words. I know this is a very un-PC, anti-"The Secret" way of thinking, and some might say I'm fostering bad karma by verbalizing and inviting it in. Call me superstitious, but I think my fate is sealed.

It's possible I could be wrong.

::EDIT::

Ah, but, I'm not....

I did find someone to take all my crap, though, at least.