What a day

Every now and then, you have one of those perfect storms of things that keep you in the office until 7:30pm. Today was one of them. I discharged my whole service and admitted my whole clinic.

That? Is a whole lot of paperwork. And in my discipline, storytelling.

Which may be why I'm so short of words for telling my own story today...

It's only Tuesday?

I could do this Neurology thing for at least another couple of weeks. I'm doing nothing relevant.

I left today at like four, came home, and should've gotten some work done, because there's a truck full of stuff arriving Thursday, some of which is coming here. Except, then Bill called and convinced me to come to dinner with the crew.

Much more enjoyable.

Meanwhile, though, I didn't do a whole lot today, but I'm freakin' exhausted...I'm hoping for more sleep tonight....

Hallucinosis

So I'm watching last night's episode of House on the DVR (because, of course, last night was not a House call....if you will....sorry, I'm tired). And House has, over the last episode or two, developed this tag-along hallucination of his best friend's dead girlfriend. Whom, incidentally, I hated when she was on the show the first time, but I like her a lot more as a hallucination. So, she's this representation of his subconscious, but one he can talk to and interact with.

This is a totally fascinating construct to me.

I'm giving this talk tomorrow on dissociative identity disorder, right, to the first year residents, so I've been going over all this stuff and doing these slides and have a part in there where I talk about how the alters are (in object relations terms) split-off parts of the principle and typically have "jobs", or rather, parceled-out bits of emotion and affect which they're responsible for processing, containing, or decontaminating. It's interesting to look at the way the writers have set this up, in that context.

I know, that was mostly a lot of psychobabble.

Y'all, I'm really tired.

I do have to say, though, I'm SO COMPLETELY irritated with their medical advisers. ECT is safe. It's not for psychosis. And why couldn't he work if he was taking antipsychotics? Seriously. Call a psychiatrist. And pay attention to your social responsibility - do you know how many of my patients come in and talk about stupid things they saw on House?

Alright, fine. I give up. I'm going to bed.

No penguins in Argentina

So my mom's boss and one of her coworkers went to Antarctica for a three week fabulous bottom of the world cruise (the coworker happens to be married to the boss, so it's not all scandalous like that, calm down). They're back, they had a fabulous time, her boss didn't fall through the ice on a snowmobile like when they went to Alaska, and they brought my mom back a set of salt and pepper shakers (for those who don't know, my mother collects salt and pepper shakers, and her collection is EPIC. Like, four bookcases worth of epic. With some really neat ones, from all over the world, antiques, etc) shaped like penguins. Which they bought in Argentina, where the boat docked.

For some reason, when my mother told me this the other day, I found it just hysterically funny. I finally stopped giggling long enough to speak, and the conversation went something like this....

Me: That's so funny! There aren't penguins in Argentina!!
Mom: No, I think there are....
Me: Nonsense. I think there's only penguins beneath the Antarctic Circle.

(Now, how I could've forgotten the plight of the poor Australian Fairy Penguins nine years ago in their wee little knitted jumpers, I don't know, but, I digress)

Mom: Well, parts of Argentina are pretty far South.
Me (still giggling): Noooooooo. He he...there are no penguins in Argentina!
Mom: Well, not anymore, because they're in my house!
Me (another fit of giggles): That's just hysterical. Penguins in Argentina....(sobering)...right? There really aren't penguins in Argentina, are there?
Mom: I...I really think there are.
Me: Wait, no, there can't be...let me Google.

And, of course, Argentina is the native land to at least four species of penguins. So, given my busy day and my late night (I had dinner with my aunt and uncle tonight, which was WONDERFUL, and went quite late) and early freakin' appointment with Gomer tomorrow, I leave you with a picture of my new favorite species, a native of Argentina, and the best-named bird ever...

...the Macaroni Penguin.

Things that seem hysterically funny when you've been awake all night.

Seriously. I had to turn the sound down to almost nothing, because otherwise I was laughing myself into hyperventilating fits.



Ahhh, those were the days, back before Doogie was gay. When Vinnie was annoying but kind of adorable, when gaggles of big-haired girls all secretly hoped Doogie would realize what a bitch Wanda was and dump her ass, and when Mrs. Howser was the original MILF to legions of boys in Hammer Pants.

Then again, I do still love me some NPH...

Tonight was the first night of Night Float, and it wasn't bad. I got all my dictations finished, all (er, well, most) of my filing done, and even saw a few patients. Some little old lady up on the floor broke her hip, and is off to the OR this morning, and she and the nurses are now in love with me and my liberal use of IV dilaudid for sweet little old ladies who fall and end up with impacted femoral neck fractures.

I'm a little more delirious than usual, though. I was supposed to see my shrink this morning, but then I called her to reschedule when I realized the last two sentences I'd written in the H&P I'd started at 6:30 on the patient I saw at 4:45 (it was now 7:30 at this point, if that tells you anything) made absolutely no sense. But I've since had caffeine (I couldn't help myself) and am a little more lucid, and, well, we'll see....

Tomorrow night (er, tonight, I guess, technically), I'm hoping for an equally calm night. Tyler's birthday is tomorrow (no, like, actual tomorrow, so, Tuesday, really), and Sparrow is on with me overnight, so she's bringing a cake to pull out at midnight. Plus, I really need to get some knitting done. And now that I've said that and angered the NF gods, well, I have this bad feeling we're going to admit the whole county...

Ooh. Wait. I live in this county. If I get admitted, maybe I could get some sleep....

Dear little white cells of mine -

Listen, if you could step it up in there, that'd be great. Because frankly, I've had enough of this.

I'm so done with being sick.

I think I have bronchitis. I made Peng listen to my lungs today at work. And then emailed my doctor, "Peng says my lungs are clear. She's a real doctor and everything."

And then Peng declared that I need to quit dying, dammit. And, as she noted, since she said "dammit" I have to obey.

Then again, as Matt was quick to point out (helpful man that he is), physical exam alone will miss a pneumonia 50% 0f the time.

Matt also looked through my clinic files today and declared that he does think I'm more anal than he is. And let me tell you, my friends, that is a high-set bar. He then mocked my lung-hocking cough. So I punched him in the arm. So then he pulled my pigtails.

No, wait, that was second grade...that was something else entirely...

Meanwhile, Ruthie was running around the office today in a tizzy. She was behind in clinic, she was on call tonight, it was a day of chaos for her. I felt bad. Apparently not bad enough, though, to not point out her inefficient habits when she complained about clinic running late (I wasn't as blunt as all that, and in fact, was pointing out that she needs to hold her boundaries and respect her own needs over those of the clinic, the patients who show up forty minutes late and are super demanding, our supervisors who are also making demands, her office mates who label her compulsive need for completeness as "inefficiency"....). But then, I always was a bitch.

Heh. I love how our patients think we're all "normal" and shit...

So I rescheduled my day tomorrow and am staying in bed and mainlining orange juice and trying for the life of me to stop being sick (dammit). So maybe I'll have something less stream of consciousness and more insightful to say then. Meanwhile, I'm going to bed.

Oh, but, my dad's knee culture didn't grow anything, so they're probably throwing him out tomorrow after PT. No surgery, no antibiotics, but with closer ortho follow up. So that's a good thing.