Suspending reality

So I've taken to watching movies on Netflix during my workouts. 30 minutes at a time, on my tiny iPhone screen, on the treadmill. But you'd be surprised how big that screen seems when you get into the movie. Anyhow, I only had 20 minutes left of the movie Up, so I just finished watching it.

I'm going to need to watch it again, not broken into 30 minute chunks.

So far I'm going with, cute. I really liked Kevin, the bird, and Doug, the dog. Really liked the dog. Kinda makes me wish Maggie had one of those collars. She's so quiet. I'd love to know what goes on in that furry little head.

Might have to Redbox it and take it to my parents'.

Next up in my queue is Outsourced, or maybe Kickass. Prior to Up I watched Easy A, which is a modern-day, high school take on The Scarlet Letter and which I also highly recommend (I was laughing, in public, on the treadmill, at my tiny iPhone screen).

As beyond believable as I found Up, this still sometimes seems preferable to the real world, where today in clinic I saw a high school student who already had three kids.

Sometimes reality is just as beyond belief.

Wordful Wednesday

So today was my first day at the State Hospital outpatient clinic.

It was unceremonious and overwhelming.

But none of my patients showed up, which is a little weird for that setting.

We spend all day there on Wednesdays and the afternoons there on Thursdays. So I have a meeting tomorrow, then a lecture, then supervision, then two therapy patients. BUT! The morning County clinic is canceled, so I have to morning to myself. I'm going to go to coffee, then maybe the gym, then I'm going to get to SH a little early and continue setting up my office.

I have a private office all to myself. Where I will do therapy. And I LOVE it. 

There's a little short table with little short chairs. There's a chalkboard and a bookshelf with toys. I have a dollhouse and a deck of cards and a plastic dinosaur. And I hit up the "toy room" today for crayons, markers, and colored pencils (since most of my patients are teenagers). I'd like a little different furniture, but I fully intend to make that place all mine for the next two years. Today after clinic I went to Staples and bought some...well, you know.

No clinic. Fresh office supplies. Tomorrow morning is going to be just like Christmas. Only warmer, and will feature me trying to clean the mildew out of the air conditioner vents...

Oh, Don Piano!

So, Sarah walks into my office today. We're having a seemingly normal conversation, until she replies with: "Oh, Don Piaaaaaaano."

I....what now?

She then tells me, oh! It's my new favorite expletive.

I looked dubiously at her, and she showed me this:

Working pretty well, actually.

I was thinking this morning on my way in to work (aka the only hospital in the area that provides indigent care, fyi) about Sarah Palin's comment in a recent speech: "Hey America - how's that whole hope-y change-y thing working out for you?"

(And then, of course, Will Ferrell's George W. Bush on SNL saying, "Gosh, Sarah, you're just so darn folksy. I tried to be folksy, but it just came off douchey.")

I'm so glad the HCR bill passed. It isn't sufficient, in its current inception, to really fix the system, but it's a step in the right direction. And we need to take some serious steps. The system, as it stands, cannot sustain much longer. It is going to fall apart, soon, and dramatically. Medicare and Medicaid are imploding (Medicare reimbursement was supposed to be cut this month by more than a quarter, independent of any such reform measures, because old and disabled people are just so gosh darn expensive! Yeah, that's the solution. Cut their access to care even more...). And folks, don't think you aren't already paying for the uninsured and the illegal immigrants - we got ourselves in this mess because everyone who IS insured is paying more because the uninsured are sucking down resources. And they're using expensive ER visits instead of primary care offices, long medical and psychiatric hospital stays that could have been avoided with early intervention. People are sucking the system dry - not because they refuse to work and want to be taken care of. The irony is, THOSE people have coverage. Instead, the vast majority are doing so because they have no other choice. They need care, they are sick. As a kind and ethical people, we cannot just throw our hands up and say, oh, sorry, you're just not important enough to society. Which - news flash - in a pure, orthodox, strictly Capitalist model? That's exactly what would happen.

Remember this?

"Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!"

I'm so proud to be an American today. And so ashamed of those in my country who would rail against what ultimately amount to basic human rights, who stoop to violence and slinging harsh and hateful epithets, who would deny and exploit the vulnerable in our society. I invite them to spend a day in my ward, or better yet, the state psych hospital. I invite them to sit with any one of our social workers, struggling to find placement, housing, affordable medication, or even just follow up for some of the people that are in the most dire need of good care. I invite them to spend an hour at the homeless shelter on Rosemary Street, or at the Spanish-speaking mental health clinic down the road. I urge them to spend a morning in our Geropsychiatry clinic for a full-on view of how the current Medicare system works. And if they possess a soul, if they retain even a glimmer of compassion and humanity, I challenge them not to want to change the system.

And if that makes me a Socialist...well, so be it.

Please turn the crazy down.

So I'm at work today, and I'm at the nurses station, amidst the cacophony of the unit, simultaneously on the phone with an outside therapist, text paging my attending, trying to keep one of my freakinawesomeintern's more irritating patients at bay, and trying to keep my black-belted freakinawesomeintern from slugging said patient...when one of freakinawesomeintern's other more annoying patients jumps up so he is leaning onto the counter, pushed up on his forearms, feet off the ground, and leaning so far forward he's about six inches from freakinawesomeintern's face. He said something to her, and I didn't hear what, but I quickly interrupted Outside Therapist with a, "hang on." And I covered the mouthpiece of the phone and I gave him what my friend Robin would describe as a "teacher look." You know - the very pointed, you know you're not supposed to be doing that, you'd better stop it now or there's going to be hell to pay, every schoolchild fears this look, that teacher look.

And I said - again, very directly - "You need to get down off that counter. Right. Now."

He backs about halfway off (this is when I knew I was going to win), and says, "Why?" I said, "Do you want to go into seclusion?" And then he was like, yeah, seclusion would be fun, blah, blah, blah.

That was a gaffe. What I should've said was something more along the lines of, "If you don't get down, we will put you in seclusion." Or, even better, said nothing. But I recovered with my best alpha dog staredown (in which you look fixedly and directly into one eye - normally we look back and forth between someone's eyes. Only looking into one produces a much more unwavering stare and thus confers much more dominance). He mouthed off to me a bit, but backed off, and walked away.

Later, I walked on to the unit, and he gives me this shadowboxing bob-and-weave kind of maneuver. I gave him the teacher look again, and pulled out my best Dog Whisperer calm assertive energy. He backed down immediately.

It never fails to amaze me how much people are like dogs.

And how unlike dogs they are. Because dogs let go of things, run back and play, tails wagging.

And that was just one of our patients.

People are crazy.

My head hurts.

Oh, my, my, my....

Today crashed in with a vengeance.

So I'm on the Crisis unit, which is the shortened form of Adult Crisis and Stabilization, its full name. It's known for being a land of borderlines and substance abusers, at least at Baby Blue (because remember, we have seven subspecialized units. So things get sort of boiled down to their essence). It's also known for it's high drama and high turnover.

We had both today.

Now, as the third year resident, because I still have clinic responsibilities (we're supposed to be 75/25% inpatient/clinic, but it really ends up being more like 50/50), I only carry 6 patients, whereas the intern, who has no clinic, carries 9. So I was like, oh, okay, I can handle this. I had 6 on my Gero service. No big deal.

Except there's a LOT more drama, of course. And a lot more gaminess. And, oh, did I mention, I discharged 4 of those people today. Which ends up being a freakin' lot of paperwork, if nothing else.

Whew.

Well, one day down.

At least (okay, it's rather a lot), my intern is the bomb-diggety. She's hard working and efficient, and also funny and smart and good to work with. That is always a huge, huge factor.

But at the very least, I don't have the pox this go round...

Oof-ta.

Oyyyy, what a Monday.

I'm on the gero unit - AGAIN - covering ECT for Fang today, tomorrow, and Wednesday. I can't seem to leave the gero unit. And painfully (for them; this was much easier for me) I had the same three patients I had the last time I was on ECT. Sent one of 'em home. Oy.

Had to call social services today. Spent an hour on the phone with them. Meanwhile, my schizophrenic patient showed up on the wrong day for his shot. And I had to reschedule my entire afternoon clinic because they scheduled me for my physical therapy intake tomorrow, and I had a clinic full of patients, but the soonest I could reschedule was the FOURTEENTH. So, okay, fine, I'll move people around... And then I had to run to the off-site gero clinic this afternoon. It was a full and emotionally taxing day.

I...I have this whole post in my head about the real meaning of independence, as I spent the whole day working with people whose independence we're trying to take...for their own safety, obviously, but it still feels horrible. But, it's already 10:15, so that's going to have to stew until another day.

Fortunately, I had dinner with my aunt and uncle tonight (my Southern family, after a week with my Northern family, as it were). And that was a lot of fun. And some seriousness. But definitely pleasant, and very tasty. It was a nice way to wrap up the day.

Mars

I made a skinny girl cry today.

So I'm on the eating disorders unit now. I'm covering for Mike this week and Sparrow next week. And then I'm back for a full month in June. It's an interesting thing, to be up there. It's a whole different planet, really. With very underweight, constipated little Martians.

When I decided to go into psychiatry, I'd originally planned on being an eating disorders doc. I haven't abandoned the idea, but I think that it might be more in the context of trauma. Which is an interesting thing at the moment, because our inpatient unit is really a weight stabilization unit. Which means we tend to get the severe anorexics, who tend to be more on the OCD spectrum. What we tend not to get up there are the bulimics, who tend to be more normal weight, and also have a higher correlation with a history of trauma. They're generally more borderline-y, less inflexible, and I tend to understand them a bit better (duh). The anxious, perfectionistic, rigid anorexics make no sense to me. And because they make no sense, I have a harder time figuring out how to work with them in any sort of useful way. Because the program is so structured, too, I have a hard time figuring out exactly where the therapeutic part of my job is and where I fit into the picture.

The staff is pleasant. My attending is awesome. There's an NP on the service now, too, whom I've known for a while and like very much. I actually really like about half my patients, and the others are tolerable.

But we had this family meeting this morning. And for whatever reason, I identify with this girl. Yes, she can be a pain in the ass, but I really do think she's working hard. And I listened to her parents sit there and give her all sorts of mixed messages about what she's worth to them. She regressed a lot. It stressed me out.

But the crying and yelling and throwing of non-injurious items didn't actually bother me. I have a high tolerance for that stuff. She called one of the staff members a bitch. I laughed. The staff member got huffy and walked out. I was like, really? This isn't about you. She's just being a brat because she doesn't have the ability to say what she's actually trying to express. And if that's the worst thing I'd get called by a patient, cool. But no, she wanted a response, she wanted to push the staff member away, she accomplished what she was trying to do. So the staff member walks out, I kept talking about how we believe she can do this, we know it's hard to tolerate, etc. I made a couple of extra interpretations. By the time I walked out of the room, the patient was able to give me a little humor.

So, you see the difference, there? I tolerated the affective storm without reinforcing it, and we connected in some small way. The other technique? Puts up walls. I agree with the idea that you need to set limits about the way people treat you, but come on.

So I'm back up on the unit later, and the staff member comes to me and is just like, oh my God, that girl, blah blah blah. And I was like, oh, dude, she's terrified, etc, etc, but the staffer couldn't see past the obnoxiousness. The staffer was also incensed that the mother (of this adult woman) didn't say anything about the name calling. I couldn't control the eye roll on that one.

And then I made some comment about the eating disorder being a life-long illness, that you can be in recovery but you're never recovered. And the staffer starts arguing with me about that. And finally ends with, "well, it's controversial."

Uh....no, it isn't.

This annoyed me more than anything up to this point. She says later, "I just think people need to have some hope. By this time, the unit nurse and my friend John had joined the conversation, and were both like, nah, we see people up here over and over. We've seen people relapse after 20 years. Which, I have, too. You can be in recovery, you can be really strong in recovery, but you can't ever take it for granted. Because the moment you aren't looking? It will kick your ass, just because it can.

Seriously, lady. Why are you working with this population if you have no desire to figure out what's really going on, here?

Argh.

Fortunately, John rescued me and made me leave the unit and then bought me a cup of coffee. I'm not sure he consciously recognized the intervention, but let me tell ya, it was so exactly what needed to happen right then.

Silence, part two (take two)

So, here's the thing.

There's this "silent protest" going on at work. Because...um........okay, I'm not entirely sure what we're supposed to be protesting. The idea, I guess, is that there are things about our residency that aren't perfect. And if we continue to recruit people to the program, then nothing will ever get fixed. So, instead, a couple of my cohorts are promoting that we should abstain from all contact with the prospectives that are filing through in small, black-suited droves three times a week.

I......I can't even enumerate all the things wrong with this plan.

Let's start with, they're tweaking things at our program all the time. Two, our program? Pretty much rocks. We work hard, harder than most psych programs, but we get solid training as a result. They listen to us, they support us, we work with good people and we get a very broad range of experiences. Three, if none of us were to do recruiting, then we would end up with poor quality residents in the next class. 3.5, if you don't like the kind of people in the residency, you're shooting yourself in the foot by not having a say in who comes in next year. Four, this leaves a significant burden on those of us who now have to pick up the slack from those who aren't participating. Which means, for example, I'm interviewing every week and attending between two and four recruitment events per week. Five, the people who are "protesting?" Are the ones who don't want to get involved to effect change, and in fact are resisting the proposed changes the hardest. Six? Don't think the administration isn't well aware of who's in the pit up to their elbows and who is standing on the sidelines whining.

To name a few.

But beyond that, the principle of this whole thing irritates me. I mean...the thing about a silent protest is, no one can hear you. And don't misunderstand - I'm all for civil disobedience. This country wouldn't be where it is right now if it weren't for a tired black woman on a bus. But to do nothing and expect that to cause things to change? Um, go back to elementary physics, my friends, and talk to a man named Newton....

I'm the first one to point out that you cannot apply logic to an irrational situation, which this clearly is, but come on, people!!! There is absolutely no logic in this!

And, we do this. We, as humans, we want people to "just know." We don't want to have to tell our husband what we want for Christmas; instead, we buy into this notion that if we were important enough to him, he would know us well enough to get the perfect gift. But here's the kicker - no matter how important someone is to you, no matter how well you know them, you still can't induce telepathy. And let me tell ya...the sooner we let go of this notion, the better.

No one can read your mind, so you have to tell people what's in it.

The thing that is really pissing me off, here, is the reluctance of those complaining to do anything active to fix the problem. And I get it, I do. It's easy to whine, to be unhappy, but it's scary to try the unknown, even if it might be better. But it's irritating as shit to the people around you, especially when they're trying to help and you just keep pushing back.

Here's the thing, folks - there's a lot of truth to the adage about how if you aren't part of the solution, you're part of the problem. And in refusing to become part of the solution, in my humble little opinion, you forfeit your right to whine about what's not working. You can either complain, or do nothing, but you can't do both.

So I'm irritated about this situation, obviously. But I've decided that being pissed off about it is also not part of the solution. I'm not entirely sure what *is,* yet, but I'm working on it.

Blah blah blah

Today turned into a really long day. One of my coworkers is having some pretty rotten family stuff going on, so we all have sort of scrambled to take on what of his we each could. Which translated only into a couple of things for me, but one of them was going to the pre-interview dinner tonight. Which turned out to be quite lovely, actually. I met one candidate in particular with whom I definitely vibed well. She's also a knitter, and we spent a good deal of time swapping stories about leaving jobs we couldn't tolerate. It was very nice. They were fun. We laughed a lot.

But it also, as I said, extended my day by about three hours. And I'm on walk-ins again tomorrow, so I need to go to bed. But here are five random things, just to make your stopping by worthwhile. Ready? Go:

1. Apparently, high heels began as a men's fashion, related to their shoes not falling out of the stirrups when they rode. I learned this at dinner tonight. I find it hilarious, because I can't imagine most of my male cohorts doing well at all in heels (cowboy boots notwithstanding).

2. I spent a while in L&D with Eva yesterday watching her babies on the monitor (she's fine, just a little puffy). I really miss obstetrics.

3. I had a patient today who claimed to have had "just one glass" of wine yesterday, who turned out to have a BAL of 0.45 (remember, legally intoxicated is 0.08). When sober, I reminded the patient that that blood alcohol would kill me. And I'm thinkin' that was a very big glass.

4. I had another patient, a cute little old lady who's been hearing this buzzing noise, which presented like an auditory hallucination (which it may well be). And I'm asking her about it, and she's like, nope, I never hear it outside the apartment, but it's almost constant there. And I was like, has anyone else listened for it? And her boyfriend says, "NO. I'VE NEVER HEARD IT." And I giggled a little bit - inwardly, of course - and thought, turn your hearing aids up, grampa.

5. I really like this picture, which I stole off of Twitter. I was listed as, "Not a hot dog, but a warm dog."

Long ass week

So, I sit down at my computer tonight to write something bloggy, and I find yesterday's post...still waiting....hadn't published. Guess it decided not to. Bleh.

So, there it is.

Meanwhile, read this story.

This case has been in my periphery for a while, although I didn't know it. I'm glad they found her and the families involved can have closure. And I hope her husband gets a really big, really sadistic cellmate.

And did you hear Oprah's retiring her talk show in 2011? That might actually be a sign of the apocalypse. Maybe we should be worried about 2012....

I've gotten a fair amount of bad news in the past couple of days. And did I mention, Monday I was sick with this URI thing. Tuesday, my left knee gets all swollen and sore. I don't think the two are related, but I'm really annoyed by both. I don't actually remember doing anything to said knee...

So....here's something a little happier...



Also happy? Tomorrow's Friday!!

Fr d ay fra ent s

Because I wasn't fragmented enough by the end of the week....
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Apparently there's a nationwide shortage of propofol. The company is blaming a manufacturing error, but personally? I had no idea Michael Jackson's habit was that bad...
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The end result of the above is that this morning in the ECT suite we had to use sevoflurane, an inhaled anesthetic. I...I can't stand that stuff. I've had it a couple of times when I was under the knife, and I had a hell of a time coming out of it, I was nauseated; it's good stuff for most people, but I'm just not a big fan. And I remember when I was in GYN, when we'd have a long day of cases, I'd occasionally be quite woozy and wacky from inhaling that stuff all day. So when I smelled that this morning, I was not super pleased to be standing at the head of the bed.

One of my inpatients, however, came back up to the floor after his morning ECT treatment all like, "wow, they used this different anesthesia today, and man, that stuff was great! I feel so much better!!" I relayed this to the team downstairs between cases, and they all cracked up. Apparently he was one of the few people that had a pretty profound activation reaction to the anesthetic, and got rather giggly and was flirting with the nurses.
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My dog is sleeping with her back feet up by her head. She is the cutest thing ever.
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Here's a funny story I'm stealing from my cousin Danielle - her daughter, who's 2, came up and told her that the dog had nipped her. Danielle asked, why did he do that? Her too-smart-for-her-own-good kid says, "Because I pissed him off."
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I'm watching this week's SVU while I write this. All the major players are bickering at each other. That kind of makes me queasy, like watching your friends' parents fight.
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I do appreciate that Alex Cabot is back - again - though. And when the hell did Dickie Stabler grow up and get adorable?
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So things get a little loose in the psychiatry department on Friday afternoons. This evening, Eva comes into my office and convinces me and Betty to accompany her down the ER for a brief little thing she had to do down there. So we're on our way down, and we were contemplating what you would call a group of psychiatrists? A herd? A gaggle? Eva says, nah, I'm pretty sure it would be a murder, like crows. A murder of psychiatrists. I said, hmm....do you think we're really a murder? Or just, like, a homicidal ideation? So we start giggling about this. And relate the story to Sparrow, who looks at us, deadpan, shakes her head and says, "Word salad." Which lead to a lot of cackling (shrink humor. Not to mention that at this point, Eva, Betty, Peng and I were sitting in an office that belonged to none of us) and Betty howling, "We're a homicidal word ideation salad!" I, of course, couldn't leave that alone, and finally caught enough breath to yelp, "We're a homicidal salad!!!"

Heh. And our patients think we're sane....

Never a dull day...

So, this morning, I'm in the resident workroom, and Scott (who's night float this week) points out this chief complaint of a patient in the ER that neither of us can quite decipher. It says, "AMS: MSC OD." Okay...altered mental status. An overdose on something. We throw out a couple of guesses, and we finally give in and look at the chart. The triage note reads something like this:

"19 year old female found by EMS on [major street near the hospital]. Initially reported to be unconscious, but was alert by the time EMS arrived. Patient was found outside Marble Slab Creamery. She states that she works there, and broke in to the store around 2am. Patient was found covered in chocolate ice cream..." Later in the notes, it says, "in ER, patient noted to have chocolate all over face and bilateral hands."

I love my job.

Calling Dr. Kate...

Yeah, so I covered the first half of the intern psych call today, because it's Intern Retreat weekend. I was supposed to be done at 8. It's 11 and I'm still here. But hopefully leaving shortly...

Lots o' crazy out today....

Girly

Today was...wait for it....long.

I got to work around 6:30am. Of course, my 7am patient cancelled while I was on my way in. So I putzed. I wrote a discharge summary. I wandered around and talked to people. I burned pictures onto a CD for Mikaela. I fussed with the patient distribution on the unit ("No, if you give him to me and her to him and then the right resident will have an open spot for the patient who's coming in and needs to be on that service..."). I did some actual doctoring.

One of my patients fell last night, which turned into a 4-hour fiasco for me trying to get him down for a procedure he was supposed to have today (nobody read the xrays. And then they wouldn't take him. And then they decided ortho needed to see him. And he needed an MRI. Except ortho was like, "That's crap." And on and on...). I had a new patient to see. I got interviewed for some graduate students' research thing. I had supervision with my new psychotherapy supervisor, whom I like very, very much. He's like a million years old and this totally old-school analyst, and just knows, like, everything. And is much more constructive than critical when I screw something up (which I always do, because, that's the nature of being human). I appreciate that.

Scott called me an "invited nuisance" today. I had stuff to leave on his officemates' desks, so I knocked, and no one answered, so I opened the door and went in. Because I do that in their office. And of course, he was like, uh, you're in my office. I said, yeah, sorry, I'm intruding (notice that I did not actually stop intruding...). He countered that I was welcome to do so, which sort of made it hard to intrude, what with my being invited and all. So, really, I was more of an invited nuisance. I observed that this might say something about those who invited me.

The whole thing cracked me up, because, this is what Scott and I do. He tries to push my buttons, and generally fails (outwardly, at least, because I can actually tolerate a lot of button-pushing), which makes it more of a challenge to find my buttons. Which amuses me, and this continues. And, notably, on the couple of rare occasions he's actually found a button, if it's a significant button, he backs the hell off. We're both a bit contrary, so this whole thing is not especially bothersome to me. Mikaela, however (one of said officemates), does not tolerate these tendencies of his very well at all. So I'm relaying the above story to her later, and she just sort of rolls her eyes and says, "I think that's actually a term of endearment. Seriously."

Most people would go more with something like "friend" or "hon" or "pookie." I'm just sayin'.

One of the patients coded today on our unit. Don't ever try to die on a psych floor. It doesn't go well. Fortunately, there happened to be a bunch of consultants on the unit at the time. And a giant pile of people show up for an actual Code Blue. And ultimately, she was fine (and on her way to the medical side of the hospital). But it was way more excitement than we're used to having up there.

Did I mention the day was really, really long?

But, it was capped off with a Girls' Night Out - Peng and some of our wine friends went out for dinner at a local fondue place. The food was overpriced and not spectacular, but the company was awesome. We had so much fun we scared our waiter a little.

He was pretty hot, actually. And has a degree in mechanical engineering. And currently stirs cheese for a living. So, really? Between the two of us...I kinda think he had the worse day.

"Why do you think people would treat you worse if they knew the truth?"

I'm watching last night's episode of House.

(Don't worry, no spoilers.)

He's in the psych ward. Several of my patients today were really upset about this episode, and I'm trying to figure out why. My conclusion thusfar (I'm maybe halfway through) is that it's just the State Psych Hospital feel of the set. Which...I have a lot of trouble believing someone like House would be in a place like this. But, okay.

I really like the lead psychiatrist (or at least, I did until the boundary crossing). I identify with him, I'm not sure why. I wonder what it says about me (I'm kind of wondering why it's not House I identify with). Maybe it's the stubborn. Or the interpretations. I've had a lot of patient visits and family meetings over the past few days in which I've spent a lot of time being way more directive and interpretive than I normally tend to be. So far, it's worked out, although there's one case I'm a wee bit worried about.

Okay, that's not true. I'm worried about most of them. It's what I do.

I dunno, y'all. I'm tired. And my stomach hurts. And I don't feel so good in general. I'm unsettled, and I'm pensive, and...I...yeah, I dunno....

So, episode over, and my opinion of it is overall positive. Although I think the catatonia girl storyline was pushing dramatic license a bit.

And, there was one line in there (not the title line, which I also like) that I think very eloquently sums up my own ideas about therapy:

"You've got to make things better, you can't just keep talking and hope for the best."

Funny how many people don't get that.

Friday!

We made it.

I'm not yet sure what the weekend looks like, because I'm just too tired to even try to plan for tomorrow. I have things I need to do, things I want to do...and mostly, I just need sleep.

It's been a long week.

Today, though, I spent two hours trying to teach my peripartum patients to knit. Either I've lost my touch or the crappy plastic circular needles the OT gave me to teach them with sucked. But we had fun. And then my one patient (who's just doing so much better)'s kids came and we had fun with them. I really like having kids and babies on the unit.

I have one more week as the peripartum resident. I'm going to miss it.

Foow.

And now for a little Friday randomness....my cousin sent me this on Facebook. Watch. Consider.



I'm a little embarassed to admit this, but it made me cry a little.

There was a lot (LOT) of crying in my day today. Fortunately, this was the first time it was me tearing up.

It's one of those nights...

...when I have so many things to say that I just really don't know what to say.

Lots of other specialties think we have the easiest job in the hospital.

Most days I think we have the hardest.

Even if we don't round until 8:30am.

I'm just sayin'.

Giddy

I love spinning. I so heart it. And I totally need a wheel (thanks, by the way, to all who sent recs both on and off the record).

I had such a good time at class tonight, it almost made up for my day. Which started early, with my trainer kicking my ass. And then I came home, and showered, and then I flopped back on the bed to read some email, and Maggie comes up and snuggles right up to me....

So hard to find the motivation to leave after that.

I get into the hospital, and I poke my head into the workroom to say hello to the call team (also because I could smell Rene's maple oatmeal all the way out in the hall, and it smelled really, really good). And I walk in and Scott points at me, and then dropped the first bomb of the day in my lap. I got that fire down to a slow burn (sort of...) and then went up to the unit, where another one hit as I walked through the door. That one, fortunately, was fairly quickly (although not especially easily) extinguished.

::sigh:: It was a long day, y'all.

Yarn pics tomorrow. Meanwhile, I'm going to bed...